House Report 117-96 — Departments of Labor, Health and Human Services, and Education Appropriations Bill, 2022
Summary
House Report 117–96, the report of the Committee on Appropriations on the Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Bill, 2022, dated July 19, 2021, in the 117th Congress, 1st Session, together with minority views. It explains the bill making appropriations for the fiscal year ending September 30, 2022. The general summary states that the Committee recommends $237,466,000,000 in current year discretionary funding. The report discusses public education, public health infrastructure, the Centers for Disease Control and Prevention, and $46,434,000,000 for the National Institutes of Health.
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“House Report 117-96 — Departments of Labor, Health and Human Services, and Education Appropriations Bill, 2022.”
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117TH CONGRESS REPORT
" HOUSE OF REPRESENTATIVES !
1st Session 117–96
DEPARTMENTS OF LABOR, HEALTH AND HUMAN SERV-
ICES, AND EDUCATION, AND RELATED AGENCIES AP-
PROPRIATIONS BILL, 2022
JULY 19, 2021.—Committed to the Committee of the Whole House on the State of
the Union and ordered to be printed
Ms. DELAURO, from the Committee on Appropriations,
submitted the following
R E P O R T
together with
MINORITY VIEWS
[To accompany H.R. 4502]
The Committee on Appropriations submits the following report in
explanation of the accompanying bill making appropriations for the
Departments of Labor, Health and Human Services (except the
Food and Drug Administration, the Agency for Toxic Substances
and Disease Registry and the Indian Health Service), and Edu-
cation, and the Committee for Purchase from People Who Are
Blind or Severely Disabled, Corporation for National and Commu-
nity Service, Corporation for Public Broadcasting, Federal Medi-
ation and Conciliation Service, Federal Mine Safety and Health Re-
view Commission, Institute of Museum and Library Services, Med-
icaid and CHIP Payment and Access Commission, Medicare Pay-
ment Advisory Commission, National Council on Disability, Na-
tional Labor Relations Board, National Mediation Board, Occupa-
tional Safety and Health Review Commission, Railroad Retirement
Board, and Social Security Administration for the fiscal year end-
ing September 30, 2022, and for other purposes.
INDEX TO BILL AND REPORT
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Page number
Bill Report
Summary of Estimates and Appropriation .............................................. ........ 3
45–129
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Page number
Bill Report
General Summary of the Bill .................................................................... ........ 3
Title I—Department of Labor: 2 13
Employment and Training Administration ....................................... 2 13
Employee Benefits Security Administration ..................................... 20 27
Pension Benefit Guaranty Corporation ............................................. 21 28
Wage and Hour Division .................................................................... 22 28
Office of Labor-Management Standards ........................................... 22 30
Office of Federal Contract Compliance Programs ............................ 23 30
Office of Workers’ Compensation Programs ..................................... 23 30
Occupational Safety and Health Administration ............................. 27 33
Mine Safety and Health Administration ........................................... 28 35
Bureau of Labor Statistics ................................................................. 30 36
Office of Disability Employment Policy ............................................. 30 37
Departmental Management ............................................................... 31 37
General Provisions .............................................................................. 36 45
Title II—Department of Health and Human Services: 46 46
Health Resources and Services Administration ............................... 46 46
Centers for Disease Control and Prevention .................................... 56 79
National Institutes of Health ............................................................. 63 108
Substance Abuse and Mental Health Services Administration ...... 73 166
Agency for Healthcare Research and Quality ................................... 79 187
Centers for Medicare & Medicaid Services ....................................... 80 191
Administration for Children and Families ........................................ 84 205
Administration for Community Living .............................................. 97 225
Office of the Secretary ........................................................................ 100 232
Public Health and Social Services Emergency Fund ....................... 104 250
General Provisions .............................................................................. 106 257
Title III—Department of Education: 134 261
Education for the Disadvantaged ...................................................... 134 261
Impact Aid ........................................................................................... 135 265
School Improvement Programs .......................................................... 136 266
Indian Education ................................................................................. 138 270
Innovation and Improvement ............................................................. 138 271
Safe Schools and Citizenship Education ........................................... 139 280
English Language Acquisition ........................................................... 140 283
Special Education ................................................................................ 140 284
Rehabilitation Services ....................................................................... 145 288
Special Institutions for Persons with Disabilities ............................ 146 290
Career, Technical and Adult Education ............................................ 147 291
Student Financial Assistance ............................................................. 148 292
Federal Direct Student Loan Program Account ............................... ........ 294
Student Aid Administration ............................................................... 148 295
Higher Education ................................................................................ 151 296
Howard University .............................................................................. 152 308
College Housing and Academic Facilities Loans .............................. 153 308
Historically Black College and University Capital Financing Pro-
gram Account ................................................................................... 153 308
Institute of Education Sciences .......................................................... 154 309
Departmental Management ............................................................... 154 311
General Provisions .............................................................................. 156 317
Title IV—Related Agencies: 163 319
Committee for the Purchase from People Who Are Blind or Se-
verely Disabled ................................................................................ 163 319
Corporation for National and Community Service ........................... 164 319
Corporation for Public Broadcasting ................................................. 169 323
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Federal Mediation and Conciliation Service ..................................... 170 324
Federal Mine Safety and Health Review Commission ..................... 170 324
Institute of Museum and Library Services ....................................... 171 324
Medicaid and CHIP Payment and Access Commission ................... 172 326
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Page number
Bill Report
Medicare Payment Advisory Commission ......................................... 172 325
National Council on Disability ........................................................... 172 326
National Labor Relations Board ........................................................ 172 326
National Mediation Board .................................................................. 173 327
Occupational Safety and Health Review Commission ..................... 173 328
Railroad Retirement Board ................................................................ 173 328
Social Security Administration .......................................................... 175 329
Title V—General Provisions: 180 334
House of Representatives Report Requirements ........ 335
SUMMARY OF ESTIMATES AND APPROPRIATIONS
The following table compares on a summary basis the appropria-
tions, including trust funds for fiscal year 2022, the budget request
for fiscal year 2022, and the Committee recommendation for fiscal
year 2022 in the accompanying bill.
2022 LABOR, HHS, EDUCATION BILL
[Discretionary funding in thousands of dollars]
Fiscal Year— 2022 Committee compared to—
Budget Activity 2021 2022 2022 2021 2022
Enacted Budget Committee Enacted Budget
Department of Labor ......................... $12,536,098 $14,320,422 $14,720,051 +2,183,953 +399,629
Department of Health and Human
Services ......................................... $96,962,754 $119,972,989 $119,845,125 +22,882,371 ¥127,864
Department of Education .................. $73,536,533 $102,823,263 $102,823,263 +29,286,730 –––
Related Agencies ............................... $15,428,615 $16,845,305 $16,867,354 +1,438,739 +22,049
GENERAL SUMMARY OF THE BILL
For fiscal year 2022, the Committee recommends a total of
$237,466,000,000 in current year discretionary funding—the 302(b)
allocation—and $253,805,000,000 in overall programmatic funding,
including offsets and adjustments. The fiscal year 2022 rec-
ommendation is an increase of $55,236,000,000 above the fiscal
year 2021 enacted level.
The Labor-HHS-Education bill supports some of the nation’s
most critical programs that touch individuals and families through-
out their lifespan, from Early Head Start to Social Security. Many
of the bill’s programs have been severely strained over the past 18
months during the simultaneous public health and economic emer-
gencies related to COVID–19. Fortunately, the President’s fiscal
year 2022 budget proposes to invest significant resources in these
critical programs that provide opportunities for millions of families.
Through this bill, the Committee is moving ambitiously to help the
country recover from the worst pandemic in a century and move
forward to strengthen opportunities for every individual to have a
better chance at a better life—with a good education, a good job,
and access to affordable health care.
The Committee recommends historic investments in education
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programs, including meeting the Biden-Harris Administration’s
commitment to more than double federal funding for Title I Grants
to Local Educational Agencies in fiscal year 2022 to a new level of
$36,037,000,000. These investments will strengthen Federal sup-
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port for high-poverty schools and support the delivery of a high-
quality education for all students.
The Committee also recommends a historic investment in re-
building our public health system. As the country recovers from the
worst pandemic in a century, the Committee includes more than
$10,500,000,000 for the Centers for Disease Control and Prevention
(CDC), an increase of nearly $2,700,000,000, which is the largest
increase in budget authority ever provided to the CDC. This in-
cludes a new flexible funding stream of $1,000,000,000 for public
health infrastructure and capacity, as well as an increase of
$250,000,000 for CDC’s global health activities.
The Committee continues to build on investments made over the
past six years in biomedical research by increasing funding for the
National Institutes of Health (NIH) by $6,500,000,000, including
an increase of $3,500,000,000 for basic biomedical research at exist-
ing NIH institutes and centers. As part of the Committee’s invest-
ment in health research, the Committee also includes
$3,000,000,000 to support the President’s request to establish the
Advanced Research Projects Agency for Health, or ARPA–H, to ac-
celerate the pace of scientific breakthroughs that have the potential
to transform health care and address our most complex health
challenges.
And the Committee invests in workforce training and worker
protection agencies, including significant new investments to re-
build capacity to enforce federal labor laws to protect workers’ pay-
checks, benefits, and ensure the health and safety of our work-
places. The Committee also makes a major commitment to retired
workers by including an increase of $1,000,000,000 for the Social
Security Administration’s operating expenses, which will restore
federal capacity to provide earned benefits and services through So-
cial Security, one of the cornerstones of the federal safety net.
Some of the most notable initiatives in fiscal year 2022 include:
Investing in Public Education
The Committee is committed to increasing investments in core
Federal programs that support high-quality public education oppor-
tunities for all students. Our nation’s public schools serve more
than 50 million children, more than 50 percent of whom come from
low-income families. Research shows that low-income students are
more likely to struggle academically and often attend high-need
schools with fewer resources, less experienced teachers, and more
limited access to advanced coursework. At the same time, there is
overwhelming empirical evidence on education spending and stu-
dent outcomes that finds more funding in schools yields statis-
tically significant positive results for students.
Overall, the Committee recommendation provides
$65,551,722,000 for Federal K–12 education programs, including
Individuals with Disabilities Education Act (IDEA), an increase of
$24,998,971,000 over the fiscal year 2021 enacted level and the
same as the Biden-Harris Administration’s fiscal year 2022 budget
request. The recommendation is a 62 percent increase over last
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year.
In particular, the Committee recommends an additional
$19,500,000,000 over the fiscal year 2021 enacted level for Title I
Grants to Local Educational Agencies for a total of
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$36,036,802,000. Title I serves an estimated 25 million students in
nearly 90 percent of school districts and nearly 60 percent of all
public schools.
The Committee recommends $1,000,000,000 for the English Lan-
guage Acquisition program, which provides formula grants to
States to serve English Leaners (EL), an increase of $202,600,000
over the fiscal year 2021 enacted level and $82,600,000 above the
fiscal year 2022 budget request. Federal data shows that signifi-
cant achievement gaps exist between ELs and their peers. At the
same time, many States and school districts have experienced rapid
growth in their EL populations. Providing increased resources to
improve educational quality for EL students is a top priority for the
Committee.
The Committee recommends $15,537,429,000 for IDEA Part B
Grants to States, which is $2,599,972,000 above the fiscal year
2021 enacted level and the same as the fiscal year 2022 budget re-
quest. The Committee is concerned that the Federal share of the
excess cost of educating students with disabilities has declined and
notes the critical role this increase will play in helping to reverse
this trend and serve as a significant first step toward fully funding
IDEA.
Public Health Infrastructure
The COVID–19 pandemic exposed the inadequacies of the cur-
rent public health ecosystem. After the COVID–19 pandemic is
over, public health agencies cannot go back to what they were and
can no longer only get attention during a crisis. The Committee
recognizes that State, local, territorial, and Federal public health
partners need a long-term strategy and long-term investments, be-
ginning at CDC. The bill includes more than $10,500,000,000 for
the CDC, an increase of nearly $2,700,000,000.
The Committee provides a new, annual funding line to turn the
tide on the nation’s public health infrastructure by providing a sta-
ble source of disease-agnostic funding so that nation’s State, local,
territorial, and Federal public health agencies are better equipped
to coordinate together to save lives. This bill includes
$1,000,000,000 for Public Health Infrastructure and Capacity to
begin to address mission-critical gaps nationwide.
In addition, this bill includes increases of: $50,000,000 for Public
Health Workforce and Career Development to invest in essential
public health workers who protect our communities and are em-
powered by science; $100,000,000 for Public Health Data Mod-
ernization to advance the transformation of the collection and utili-
zation of public health data from retrospective reporting to driving
action in real time; $15,000,000 for the National Center for Health
Statistics to initiate investments in the next generation of surveys;
and $250,000,000 for Global Health to modernize and expand dis-
ease surveillance and response capabilities to strengthen global
health security.
NIH Research
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The unprecedented speed with which scientists were able to de-
velop effective COVID–19 vaccines would not have been possible
without years of sustained investments made by Congress in bio-
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medical research supported by the National Institutes of Health
(NIH). The Committee continues and accelerates this investment
by providing $46,434,000,000, an increase of $6,500,000,000 above
the fiscal year 2021 enacted level. The bill includes an increase of
$3,500,000,000 for traditional NIH research and activities, the larg-
est annual appropriations increase for NIH since fiscal year 2003.
The Committee continues its ongoing support for key NIH initia-
tives, such as the Cancer Moonshot, BRAIN Initiative, and the All
of Us Precision Medicine Initiative. The bill also includes sufficient
funding to provide an across-the-board increase of no less than five
percent for each Institute and Center. The Committee remains con-
cerned that targeted funding for specific research initiatives in re-
cent years has slowed the growth in other areas of basic research
that may lead to unforeseeable scientific breakthroughs.
The Committee also includes $3,000,000,000 to establish the Ad-
vanced Projects Research Agency for Health (ARPA–H), as pro-
posed in the President’s budget request. Modeled after the Defense
Advanced Research Project Agency (DARPA), ARPA–H will invest
in large high-risk, high-reward research projects that have the po-
tential to achieve breakthroughs in the treatment of diseases such
as cancer, Alzheimer’s disease, diabetes, and amyotrophic lateral
sclerosis (ALS).
Employment and Training
The economic recession resulting from the COVID–19 pandemic
impacted American families and further exposed existing inequities
in our society. For example, while the unemployment rate peaked
at 14.8 percent in April 2020 and is now at 5.9 percent, the unem-
ployment rate for Black workers peaked in May 2020 at 16.7 per-
cent and is now at 9.2 percent and the unemployment rate for His-
panic workers peaked at 18.9 percent in April 2020 and is now at
7.4 percent. The unemployment rate for White workers peaked at
14.1 percent in April 2020 and is now at 5.2 percent. In addition,
COVID–19 had devastating impacts on women’s participation in
the labor force, especially for women of color. As our nation
emerges from the COVID–19 pandemic, unemployment assistance
and workforce development opportunities will continue to play a
critical role in our recovery.
As such, the Committee recommendation includes needed invest-
ments in workforce and training systems. Specifically, the rec-
ommendation includes $6,237,181,000 for Workforce Innovation
and Opportunity Act Programs, an increase of $825,326,000 above
the fiscal year 2021 enacted level and $271,750,000 above the fiscal
year 2022 budget request. The recommendation includes
$285,000,000 for registered apprenticeships, an increase of
$100,000,000 above the fiscal year 2021 enacted level and the same
as the fiscal year 2022 budget request. The recommendation also
includes $100,000,000 for the Strengthening Community Colleges
Training Grant program, an increase of $55,000,000 above the fis-
cal year 2021 enacted level and the fiscal year 2022 budget request.
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This program helps community colleges build capacity for training
workers. The recommendation includes $100,000,000 for a new
grant program to support communities suffering dislocations re-
lated to changes in fossil fuel and other energy industries.
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The recommendation also includes $2,866,214,000 for Unemploy-
ment Compensation State Operations, an increase of $509,398,000
over the fiscal year 2021 enacted level and the same as the fiscal
year 2022 budget request. This funding will help support States in
overcoming challenges associated with administering unemploy-
ment insurance programs. Altogether, these investments will con-
tinue to support families struggling with the economic con-
sequences of COVID–19 and prepare workers for new employment
opportunities.
Protecting America’s Workers
The Committee recommends $2,095,685,000 for Department of
Labor agencies responsible for worker protection and worker rights.
This is an increase of $305,015,000 over the fiscal year 2021 en-
acted level and $1,161,000 over the fiscal year 2022 budget request.
The Wage and Hour Division employs fewer investigators today
than it did in 1948, despite the workforce having grown signifi-
cantly in that time. To help make up for this lost ground, hold bad-
acting employers accountable and defend working people so they
receive the pay they earned and are legally entitled to, the Com-
mittee recommendation includes $300,000,000, an increase of
$54,000,000 over the fiscal year 2021 enacted level and an increase
of $23,500,000 over the fiscal year 2022 budget request.
The Occupational Safety and Health Administration (OSHA) cur-
rently has the lowest number of health and safety inspectors in the
agency’s 48-year history. OSHA enforcement is critical to pre-
venting workplace tragedies from occurring, which is why it is con-
cerning that, under current staffing levels, the agency would need
165 years to inspect each workplace under its jurisdiction just once.
To reverse the erosion of enforcement capacity at OSHA, the Com-
mittee includes $691,787,000, an increase of $100,000,000 over the
fiscal year 2021 enacted level and $27,163,000 over the fiscal year
2022 budget request for this critical worker protection agency.
The Committee also recommends $316,925,000 for the National
Labor Relations Board, an increase of $42,701,000 over the fiscal
year 2021 enacted level and $15,000,000 over the fiscal year 2022
budget request. This increase will address decline in field staff the
Board has seen over the past four years.
Early Childhood Education
The Committee includes over $20,000,000,000 for early childhood
education programs through the Child Care and Development
Block Grant (CCDBG), Head Start, and Preschool Development
Grants—an increase of $3,075,000,000 over the fiscal year 2021 en-
acted level.
Child care is one of the most critical needs of families with young
children—it is essential—and yet CCDBG currently reaches only
15 percent of children who are eligible to receive child care serv-
ices. The increase included in this bill will provide CCDBG-funded
child care for approximately 200,000 additional children, which will
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also enable more parents in low-income families to remain in the
workforce. Women, particularly women of color, are disproportion-
ately impacted by the child care crisis in this country, and the in-
vestment in this bill builds on the $52,500,000,000 in supplemental
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funding that Congress provided for child care during the
coronavirus pandemic: $3,500,000,000 in the Coronavirus Aid, Re-
lief, and Economic Security (CARES) Act (P.L. 116–136),
$10,000,000,000 through the Coronavirus Response and Relief Sup-
plemental Appropriations (CRRSA) Act, 2021 (P.L. 116–260), and
$39,000,000,000 through the American Rescue Plan (P.L. 117–2).
The bill includes an increase of $1,434,000,000 for Head Start,
including increases of $250,000,000 for Quality Improvement Fund-
ing for Trauma-Informed Care and $750,000,000 to expand Head
Start, Early Head Start, and Early Head Start-Child Care Partner-
ships to over 40,000 additional infants and toddlers from low-in-
come families. The bill also includes $200,000,000 for Head Start
programs to extend to full day services, to better support working
parents and bring additional programs into compliance with the
2016 Head Start Program Performance Standards.
The Committee further recommends $450,000,000, an increase of
$175,000,000, for Preschool Development Grants to build State and
local capacity to provide early childhood care and education for
children birth through five from low- and moderate-income fami-
lies.
Higher Education
In the aftermath of the COVID–19 pandemic, college afford-
ability and access are vital to our nation’s recovery efforts. There-
fore, the Committee recommendation makes necessary investments
in programs supporting student financial aid, student support serv-
ices, and other programs supporting institutions of higher edu-
cation and their students.
The recommendation includes sufficient funding to support an in-
crease in the maximum Pell Grant by $400 over the fiscal year
2021 enacted level, from $6,495 to $6,895, which is the same as the
fiscal year 2022 discretionary budget request.
In addition, the Committee recommendation provides
$1,434,000,000 for Federal Work Study, an increase of
$244,000,000 over the fiscal year 2021 enacted level and the fiscal
year 2022 budget request. The Committee recommendation also in-
cludes $1,028,000,000 for the Federal Supplemental Educational
Opportunity Grants, an increase of $148,000,000 over the fiscal
year 2021 enacted level and the fiscal year 2022 budget request.
The Committee recommendation includes $1,297,761,000 for the
TRIO programs, an increase of $200,761,000 over the fiscal year
2021 enacted level and the same as the fiscal year 2022 budget re-
quest. The recommendation also includes $408,000,000 for the
Gaining Early Awareness and Readiness for Undergraduate Pro-
grams, which is $40,000,000 more than the fiscal year 2021 en-
acted level and the same as the fiscal year 2022 budget request.
In an effort to assist postsecondary institutions in addressing
barriers in completion and attainment, the Committee rec-
ommendation includes a total of $1,134,054,000 for programs that
serve high proportions of students of color (Historically Black Col-
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leges and Universities, Hispanic-Serving Institutions, Tribal Col-
leges and Universities, and other Minority Serving Institutions), an
increase of $345,000,000 over the fiscal year 2021 enacted level and
the same as the fiscal year 2022 budget request.
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The Committee also includes robust funding to support teacher
preparation. The recommendation includes $20,000,000 in new
funding for the Augustus F. Hawkins Centers of Excellence pro-
gram, and the recommendation includes $132,092,000 for the
Teacher Quality Partnerships program, an increase of $80,000,000
over the fiscal year 2021 enacted level and the same as the fiscal
year 2022 budget request.
Maternal Health
The U.S. has the highest maternal mortality rate among devel-
oped nations, with a particularly high mortality rate for Black and
American Indian/Alaska Native women. To help eliminate race-
based disparities in outcomes among birthing people and drive
down the rate of maternal mortality, the bill provides an increase
of $56,000,000 for CDC’s Safe Motherhood and Infant Health pro-
grams. This funding allows for the expansion of Maternal Mortality
Review Committees and Perinatal Quality Collaboratives to all 50
States and territories, and for increased support to current States
and territories, as well as increased support for other programs in-
cluding Sudden Unexplained Infant Death. The bill includes an in-
crease of over $178,000,000 at HRSA to support activities to im-
prove maternal health, including an increase of $30,000,000 for
State Maternal Health Innovation Grants, an increase of
$5,300,000 to expand the Alliance for Maternal Health Safety Bun-
dles to more States, an increase of $2,000,000 to support and ex-
pand availability of the Maternal Mental Health Hotline,
$25,000,000 to conduct a demonstration program on pregnancy
medical homes, an increase of $5,000,000 to double funding for
Screening and Treatment for Maternal Depression and Related
Disorders, an increase of $5,400,000 for Rural Maternity and Ob-
stetrics Management Strategies. The bill also includes increased in-
vestments in research related to maternal health and health dis-
parities at NIH and the Agency for Healthcare Research and Qual-
ity (AHRQ).
HIV Initiative
Advances in medications for the prevention and treatment of
HIV, improved diagnostic tests, and new outbreak detection tech-
nology provide a unique opportunity to alter the trajectory of HIV
infection rates in the U.S. with a goal of eliminating new HIV in-
fections. This bill provides a total of $688,000,000, which is an in-
crease of $245,000,000 for the third year of the Ending the HIV
Epidemic Initiative, which began a new era of moving the U.S.
from HIV prevention to HIV epidemic control.
Firearm Injury and Mortality Prevention Research
Firearm injury and mortality is among the leading causes of
death for people aged 1–64 in the U.S. In 2019, there were nearly
40,000 firearm-related deaths in the U.S. Addressing the gaps in
knowledge around this issue and identifying effective prevention
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strategies are needed steps toward keeping people, families,
schools, and communities safe from firearm injury. In fiscal year
2020, the Committee provided the first funding in more than two
decades to address the public health emergency of firearm violence
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with a total of $25,000,000 to CDC and NIH. This bill doubles the
total funding to $50,000,000 to support research to identify the
most effective ways to prevent firearm related injuries and deaths,
and to broaden firearm injury data collection. Building on these ef-
forts to address firearm injury and death, this bill also includes
$100,000,000 for a new evidence-based community violence inter-
vention initiative at CDC, which aims to prevent intentional vio-
lence, such as mass casualty violence or gang violence.
Mental and Behavioral Health
The existing mental health and substance use disorder crises
were worsened by the COVID–19 pandemic, with Americans re-
porting increased levels of anxiety, depression, suicidal ideation,
and substance use. Between September 2019 and August 2020,
more than 85,000 people nationwide died from drug overdoses, and
47,000 people died from suicide in 2019.
The Committee recommendation includes $9,160,277,000 for the
Substance Abuse and Mental Health Services Administration
(SAMHSA), making a range of investments across the behavioral
health continuum to support prevention, screening, treatment, and
other services. The Committee includes a total increase of
$1,366,020,000 for mental health activities. This includes an in-
crease of $825,000,000 for the Mental Health Block Grant and an
increase of $125,000,000 for Certified Community Behavioral
Health Clinics. The bill increases the mental health crisis set-aside
to ten percent, creates a new set-aside for prevention and early
intervention, and makes investments to prepare for the launch of
a new three digit National Suicide Prevention Lifeline.
The Committee includes $100,000,000 to establish the Mental
Health Crisis Response Partnership Pilot Program, to help commu-
nities create mobile crisis response teams that divert the response
for mental health crises from law enforcement to behavioral health
teams.
The bill supports children’s mental health with a $28,113,000 in-
crease to the National Child Traumatic Stress Initiative, a
$17,000,000 increase for Infant and Early Childhood Mental
Health, and an additional $25,000,000 for Children’s Mental
Health services.
The Committee includes a total increase of $1,657,187,000 for
substance use treatment activities. This includes an increase of
$1,000,000,000 for the Substance Abuse Prevention and Treatment
Block Grant and an increase of $500,000,000 for State Opioid Re-
sponse Grants. The bill creates a new set-aside within the block
grant to support recovery services. The Committee recommendation
also includes an increase of $35,284,000 for substance misuse pre-
vention activities.
OVERSIGHT OF THE EXECUTIVE BRANCH
The Committee has also fulfilled its responsibility to maintain
oversight of the Executive Branch by holding seven oversight hear-
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ings—in addition to annual hearings on the fiscal year 2022 budget
request. The Committee has focused on ongoing crises in health
care, education, and labor, which have highlighted unjust racial
disparities which were further exacerbated by the COVID–19 pan-
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11
demic. These oversight hearings have informed many of the deci-
sions in the fiscal year 2022 Labor-HHS Education bill.
COVID–19 and the Child Care Crisis
The Committee held a virtual hearing to discuss the devastating
impacts that the COVID–19 pandemic had on a child care industry
already in crisis. Affordable child care was already a significant
and severe issue, but rising operating costs and decreased enroll-
ment as a result of the pandemic were too much for the razor thin
margins of many child care providers, and other providers were left
grasping for financial assistance. The Committee heard from policy
experts, a State administrator, and a program director, about the
critical financial needs of child care providers struggling to stay
afloat, the necessity of child care for parents and especially for
women in the workforce, and the impact that the child care short-
age has on job reports and unemployment statistics. The hearing
highlighted how COVID–19 exacerbated the child care crisis, and
exposed the necessity for a financially stable child care industry, to
support women and communities of color, and for post-pandemic
economic recovery. Soon after the Committee’s hearing, House and
Senate Democrats passed the American Rescue Plan (P.L. 117–2)
which included $39,000,000,000 for the Child Care and Develop-
ment Block Grant program.
Ready or Not: U.S. Public Health Infrastructure
The Committee held a virtual hearing to examine the status and
challenges of our nation’s public health infrastructure, with a par-
ticular focus on public health data, laboratories, and workforce. The
COVID–19 pandemic exposed the inadequacies of the current pub-
lic health ecosystem, and the Committee heard from State and
local public health officials about the importance of flexible, long-
term investments in public health. As a result of this hearing, this
bill includes a new funding line of $1,000,000,000 for Public Health
Infrastructure and Capacity. The Committee’s action denotes that
the tide has turned for public health funding, as it establishes a
disease-agnostic source of funding to address mission-critical gaps
in public health infrastructure nationwide.
Health and Safety Protections for Meatpacking, Poultry, and Agri-
cultural Workers
The Committee held a virtual hearing to examine dangerous con-
ditions faced by meat, poultry, and farm workers, especially during
the COVID–19 pandemic, and to highlight the role strong federal
enforcement from the Occupational Health and Safety Administra-
tion (OSHA) can play in addressing the problem. The Committee
heard from a worker safety and health expert, a farmworker advo-
cate, and the child of a Smithfield meatpacking worker about the
concerning hazards workers faced during the pandemic and the
need for urgent action from OSHA to hold these industries account-
able to protect vulnerable workers. As a result of this hearing, this
bill includes an increase of $100,000,000 for OSHA above the fiscal
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year 2021 enacted level. The recommendation, a 17 percent in-
crease over last year, will support additional OSHA inspectors and
restore the agency’s capacity to conduct more complex, labor-inten-
sive inspections.
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12
COVID–19 and the Mental Health and Substance Use Crises
The Committee held a virtual hearing to examine the impact of
the COVID–19 pandemic on the mental health and substance use
crises and the responses to this emergency, and heard rec-
ommendations on how to build a stronger behavioral health system
capable of meeting the demand for services. The COVID–19 pan-
demic dramatically worsened these existing crises, creating new
barriers to treatment while increasing numbers of Americans are
reporting anxiety, depression, and substance use. People with exist-
ing vulnerabilities have been disproportionately affected—including
communities of color, underserved communities, essential workers,
people who were already struggling with a mental illness or sub-
stance use disorder or were otherwise in poor health, children, and
families struggling economically. As a result of this hearing, the
Committee is making substantial investments to strengthen the be-
havioral health continuum of care to increase access to prevention,
screening, treatment and other critical services.
Addressing the Maternal Health Crisis
The Committee held a virtual hearing to identify the reasons
why the U.S. lags behind other industrialized nations in maternal
health outcomes; examine the disparities in maternal health out-
comes by race, socioeconomic status, residence, and other factors;
and identify opportunities to address these issues through invest-
ments in HHS programs. As a result of this hearing, the bill in-
creases funding for programs across HRSA, CDC, NIH, and AHRQ
to improve access to quality maternal and postpartum health care
and reduce disparities in maternal health outcomes.
Building Capacity, Building Community: Increasing Investments in
Community Colleges
The Committee held a virtual hearing that explored the impor-
tance of community colleges, as well as their strengths and chal-
lenges. Today, there are more than 1,000 community colleges. Com-
munity colleges touch upon the lives of individuals in every State
and even the outlying areas. Community colleges are typically open
access institutions, serving a diverse student body with unique
challenges. While, typically, the associate’s degree is the highest
degree awarded at community colleges, these institutions also offer
a wide variety of postsecondary credentials. In this way, commu-
nity colleges are uniquely positioned to meet the workforce develop-
ment and educational needs of our country simultaneously. As a re-
sult of this hearing, the recommendation includes robust increases
for programs that help support community colleges and their stu-
dents: the WIOA programs, the Strengthening Community Colleges
Training Grant program, the Apprenticeship Grants program, the
Strengthening Institutions program, and the Child Care Access
Means Parents in School program.
Mental Health Emergencies: Building a Robust Crisis Response
System
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The Committee held a virtual hearing on how to create a robust
mental health crisis care system with services available to anyone,
anywhere, anytime, with a goal of diverting people experiencing a
mental health crisis from the criminal justice system into mental
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13
health treatment. The lack of sufficient mental health care re-
sources in communities means mental illness often goes untreated,
which can lead to law enforcement responding to mental health
emergencies because there are no alternatives to respond to the cri-
sis. As a result of this hearing, the bill increases funding for men-
tal health crisis services and creates a Mental Health Crisis Re-
sponse Partnership Pilot Program for communities to create, or en-
hance existing, mobile crisis response teams that divert the re-
sponse for mental health crises from law enforcement to behavioral
health teams.
TITLE I—DEPARTMENT OF LABOR
EMPLOYMENT AND TRAINING ADMINISTRATION
Appropriation, fiscal year 2021 ......................................................... $10,025,760,000
Budget request, fiscal year 2022 ....................................................... 11,254,695,000
Committee Recommendation ............................................................. 11,625,914,000
Change from enacted level ......................................................... +1,600,154,000
Change from budget request ...................................................... +371,219,000
The Employment and Training Administration (ETA) admin-
isters Federal job training grant programs and Trade Adjustment
Assistance and provides funding for the administration and over-
sight of the State Unemployment Insurance and Employment Serv-
ice system.
TRAINING AND EMPLOYMENT SERVICES
Appropriation, fiscal year 2021 ......................................................... $3,663,200,000
Budget request, fiscal year 2022 ....................................................... 4,210,672,000
Committee Recommendation ............................................................. 4,407,108,000
Change from enacted level ......................................................... +743,908,000
Change from budget request ...................................................... +196,436,000
Training and Employment Services provides funding for Federal
job training programs authorized primarily by the Workforce Inno-
vation and Opportunity Act of 2014 (WIOA).
Adult Employment and Training Activities.—For Adult Employ-
ment and Training Activities, the Committee recommends
$923,174,000, which is $60,525,000 more than the fiscal year 2021
enacted level and $23,187,000 more than the fiscal year 2022 budg-
et request.
Youth Employment and Training Activities.—For Youth Employ-
ment and Training Activities, the Committee recommends
$988,604,000, which is $67,474,000 more than the fiscal year 2021
enacted level and $24,767,000 more than the fiscal year 2022 budg-
et request.
Dislocated Worker Employment and Training Activities.—For
Dislocated Worker Employment and Training Activities, the Com-
mittee recommends $1,183,554,000, which is $122,001,000 more
than the fiscal year 2021 enacted level and $28,276,000 more than
the fiscal year 2022 budget request.
Dislocated Worker Assistance National Reserve.—The Committee
recommends $435,859,000 for the Dislocated Workers National Re-
serve, an increase of $155,000,000 more than the fiscal year 2021
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enacted level and $55,000,000 over the fiscal year 2022 budget re-
quest.
The Committee recommendation includes $100,000,000, an in-
crease of $55,000,000 over the fiscal year 2021 enacted level and
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the fiscal year 2022 budget request, for Strengthening Community
College Training Grants to support a new grant competition. This
funding will continue to help better align workforce development
efforts with postsecondary education and build off lessons learned
from the Trade Adjustment Assistance Community College and Ca-
reer Training Grant program. The Committee recommendation con-
tinues to direct the Department to follow the program require-
ments as laid out in House Report 116–62, except that the 120 day
requirement for the solicitation shall not apply.
The Committee recommendation also includes $100,000,000 for a
new program designed to assist communities experiencing disloca-
tions occurring in fossil fuel and other energy related industries. A
part of the Interagency Working Group on Coal and Power Plant
Communities and Economic Revitalization, this program builds
upon the Obama Administration’s POWER initiative and is in-
tended to support the economic well-being of workers and commu-
nities impacted by changes in the coal, oil, gas, and other indus-
tries.
The Committee includes $10,000,000, the same as the fiscal year
2021 enacted level, for grants to support national out-of-school time
organizations that serve youth and teens and place an emphasis on
age-appropriate workforce readiness programming to expand job
training and workforce pathways for youth and disconnected youth,
including soft skill development, career exploration, job readiness
and certification, summer jobs, year-round job opportunities, and
registered apprenticeships. Funding will also support partnerships
between workforce investment boards and youth serving organiza-
tions.
The Committee includes $5,000,000 for the Department of Labor
to establish an Automation Impacted Industries Pilot Program to
award competitive grants to industry or sector partnerships to sup-
port demonstration and pilot projects relating to the training needs
of workers who are, or are likely to become, dislocated workers as
a result of automation. Under this program, grantees may use the
funds for one or more of the following: 1) Providing training serv-
ices, which may include training services that prepare workers for
in-demand industry sectors or occupations.; 2) providing assistance
for employers in developing a staff position for an individual who
will be responsible for supporting training services provided under
the grant; 3) purchasing equipment or technology necessary for
training services; 4) providing job search and other transitional as-
sistance to workers in industries with high rates of job loss; 5) pro-
viding a training stipend to workers for training services; 6) pro-
viding integrated education and training.
The Committee includes $5,000,000 in fiscal year 2022 for a dem-
onstration program to provide fulltime, work-based learning coordi-
nators in underserved communities with an already proven track
record for secondary career and technical education. Work-based
learning coordinators will conduct outreach, engagement, recruit-
ment and coordination of work-based learning activities, including,
but not limited to, paid internships or pre-apprenticeships for high
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school students, with local community employers, especially with
in-demand industries of information technology, health sciences,
and engineering. The work-based learning coordinators may be em-
ployed by the local education agency, local workforce development
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board or local workforce development agency, a group of employers,
or a consortium of eligible entities. In making grant awards, the
Committee directs the Secretary to ensure to require a plan for
evaluations in each individual grant proposal, including types of
work-based learning opportunities completed, demographics of par-
ticipating students, and students’ post-secondary career plan, as
well as to conduct a national assessment of all grantee proposals
once complete.
Native Americans.—For the Indian and Native American pro-
grams, the Committee recommends $58,000,000, which is
$2,500,000 more than the fiscal year 2021 enacted level and the
same as the fiscal year 2022 budget request.
Migrant and Seasonal Farmworkers.—For the National Farm-
worker Jobs program, the Committee recommends $96,711,000,
which is $2,815,000 more than the fiscal year 2021 enacted level
and the same as the fiscal year 2022 budget request.
YouthBuild.—For the YouthBuild program, the Committee rec-
ommends $145,000,000, which is $48,466,000 more than the fiscal
year 2021 enacted level and the same as the fiscal year 2022 budg-
et request.
Reintegration of Ex-Offenders.—The Committee recommends
$150,000,000 for training and reintegration activities for individ-
uals with criminal legal histories or who have been justice system-
involved, which is $49,921,000 more than the fiscal year 2021 en-
acted level and the same as the fiscal year 2022 budget request.
The Committee directs the Department to ensure grantees estab-
lish formal partnerships with employers and that program partici-
pants receive industry recognized credentials and training in fields
that prepare them for successful reintegration, including ensuring
participants receive training and credentials in fields where their
criminal record is not a barrier to entry or continued employment.
The Committee also directs the Department to consider the needs
of communities that have recently experienced significant unrest or
have been disproportionately impacted by the COVID–19 pan-
demic.
The Committee also continues the set-aside of $25,000,000 for
competitive grants to national and regional intermediaries for ac-
tivities that prepare young adults with criminal legal histories or
who have been justice system-involved or who have dropped out of
school or other educational programs, with a priority for projects
serving high-crime, high-poverty areas. The Committee directs the
Department to consult data from the Department of Education and
prioritize grants in communities where students of color have dis-
proportionate rates of expulsions and suspensions.
The Committee is aware that recent re-entry programs are an
excellent way to help address workforce challenges, including those
in the advanced manufacturing sector. The Committee directs the
Department to provide an update in the fiscal year 2023 Congres-
sional Budget Justification on information from the last three fiscal
years on pathways and relationships built with employers, includ-
ing data on formerly incarcerated individuals who have utilized the
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program, rates of increased credentials, and placement in higher
paying positions.
Workforce Data Quality Initiative.—The Committee recommends
$7,250,000 for the Workforce Data Quality Initiative, which is
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16
$1,250,000 more than the fiscal year 2021 enacted level and the fis-
cal year 2022 budget request. The Committee supports the work of
States in using these funds to create and utilize data to align pre-
school through workforce systems.
Apprenticeship Grants.—The Committee recommends
$285,000,000 for the apprenticeship grants program, which is
$100,000,000 more than the fiscal year 2021 enacted level and the
same as the fiscal year 2022 budget request. The Committee estab-
lished this program in 2016 to expand work-based learning pro-
grams in in-demand industries through registered apprenticeships.
Registered apprenticeships are a proven strategy for meeting the
needs of our nation’s workforce and industry simultaneously.
The Committee continues to invest in expanding opportunities
relating to Registered Apprenticeship programs registered only
under the National Apprenticeship Act, to be available to the Sec-
retary to carry out activities through grants, cooperative agree-
ments, contracts and other arrangements with States and other ap-
propriate entities. As part of these opportunities, the Committee di-
rects the Secretary to continue funding for national and local ap-
prenticeship intermediaries, business and labor industry partner
intermediaries, and equity intermediaries. The Committee also di-
rects the Department to ensure that these intermediaries are given
opportunities to apply for competitive grants, cooperative agree-
ments, contracts, and other funding opportunities. The Committee
urges the Secretary to ensure that States engage both business and
labor as part of any State funding opportunities associated with
this program. In addition, the Committee continues to support the
funding and development of industry or sector partnerships as a
means to expand work-based learning programs and registered ap-
prenticeships in in-demand industries.
The Committee directs the Secretary to submit a report to the
Committees on Appropriations providing details on entities award-
ed funding, selection criteria used, and the funding amount for
each grant or contract awarded at the time such awards are made.
Not later than 90 days after enactment of this Act, the Department
shall provide the Committees on Appropriations a detailed spend
plan of anticipated uses of funds made available, including admin-
istrative costs. The Committee also directs the Department to pro-
vide quarterly briefings on all spending activities under this pro-
gram to the Committee.
The Committee is encouraged by the Administration’s actions to
restore the Federal Government’s role in ensuring high-quality
training opportunities by taking steps to rescind the industry reg-
istered apprenticeship program. The national apprenticeship pro-
gram is in dramatic need of modernization through expansion of
registered apprenticeship, youth apprenticeships, and pre-appren-
ticeship programs to create more job training opportunities, espe-
cially in the face of shifting workforce needs and in-demand career
skills. In light of this need, the Committee encourages the Sec-
retary to identify key sectors, beginning with cybersecurity work-
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force and advanced manufacturing, with growing workforce de-
mands that adapt well within apprenticeship models and develop
streamlined plans with key stakeholders to execute apprenticeship
programs.
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The Committee strongly supports efforts to expand Registered
Apprenticeships to traditionally underrepresented communities and
encourages the Department to explore the feasibility and expansion
of Registered Apprenticeship programs within the arts, theater,
film, and television industries. Specifically, the Committee requests
that the Department explore expanding the Registered Apprentice-
ship model to create career training strategies for all roles in the
entertainment industry such as creative, production, technical,
marketing and public relations roles.
In addition, the Committee notes that apprenticeships are an im-
portant path to the middle-class. However, women are largely
underrepresented in apprenticeship programs, and women who do
participate make far less than men. Therefore, the Committee di-
rects the Department to accelerate efforts to recruit and retain
women as part of these programs and to ensure equal compensa-
tion.
The Committee is also concerned about shortages nationwide of
qualified drinking water and wastewater operation professionals,
especially in rural areas, and encourages the Secretary to make
funding available to address these challenges. Further, the Com-
mittee directs the Department to work with eligible community or-
ganizations to support the creation of new training programs fo-
cused on filling identified gaps in the maritime workforce.
The Committee also supports the use of apprenticeship grants
that provide worker education based on public-private partnerships
in in-demand fields, including first responders, as well as in goods
movement sectors such as global logistics, rail and other freight-re-
lated employment.
The Committee encourages the Department to support appren-
ticeship programs that increase the number of trained workers in
cybersecurity.
The Committee notes that apprenticeship programs contribute to
higher wages and fewer injuries for workers in the energy industry.
The Committee also notes that as the United States combats cli-
mate change, we need to expand the clean energy workforce. How-
ever, we currently lack sufficient apprenticeship programs in the
clean energy sector. Therefore, the Committee encourages
prioritization of apprenticeships in clean energy and encourages
the Department of Labor to accelerate efforts to support appren-
ticeship programs that increase the number of trained workers in
the clean energy sector, with an emphasis in regions anticipating
a loss in fossil fuel industry jobs.
National Youth Employment Program.—For the National Youth
Employment Program, the Committee recommends $50,000,000,
which is the same as the fiscal year 2022 budget request. This new
competitive grant program will provide funding for youth employ-
ment programs, including summer and year-round opportunities.
Veterans’ Clean Energy Training Program.—For the Veterans’
Clean Energy Training Program, the Committee recommends
$20,000,000, which is the same as the fiscal year 2022 budget re-
quest. This new competitive grant program will prepare veterans
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and their spouses for careers in clean energy.
Community Project Funding.—Within the funds included in this
account, $63,956,000 shall be used for the following projects in the
following amounts:
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Project Amount
AIDS Service Center of Lower Manhattan, Inc. dba Alliance for Positive Change, New York, NY for a
workforce development initiative ............................................................................................................... $1,000,000
Anne Arundel County Government, Annapolis, MD for Youthworks! ............................................................. $500,000
Arizona Opportunities Industrialization Center, Phoenix, AZ for the provision of comprehensive training
courses and job placement in the hospitality industry ............................................................................ $1,200,000
Avivo, Minneapolis, MN for workforce training related to clean energy and green building, including
equipment .................................................................................................................................................. $1,000,000
Benedict College, Columbia, SC for workforce development activities, including technology, equipment,
and supportive services ............................................................................................................................. $2,000,000
Beyond the Sanctuary, Inc., Rochester, NY for job readiness program, including equipment and sup-
portive services .......................................................................................................................................... $525,000
Bristol County Chamber Foundation, Fall River, MA for workforce development activities ......................... $500,000
Broward College, Ft. Lauderdale, FL for workforce development initiative, including mobile training units $2,000,000
Buffalo Sewer Authority, Buffalo, NY for a workforce development initiative related to green infrastruc-
ture, including equipment, stipends, and supportive services ................................................................ $575,000
California Mobility Center, Sacremento, CA for a workforce development initiative, including equipment $2,000,000
City of Boston, MA for short-term training programs, including stipends ................................................... $1,000,000
City of East Providence, RI for a training program ...................................................................................... $350,000
City of Greensboro, NC for a workforce development initiative, including technology and supportive
services ...................................................................................................................................................... $1,600,000
City of Houston, TX for a workforce development initiative related to a solar initiative, including job-
placement, stipends, and supportive services .......................................................................................... $750,000
City of Perris, CA for a workforce development initiative ............................................................................. $1,000,000
City of South San Francisco, CA, for workforce development services, including career services and job
placement .................................................................................................................................................. $500,000
Coalition for Responsible Community Development, Los Angeles, CA for transitional employment and
training for formerly incarcerated adults, including supportive services ................................................ $250,000
College of Eastern Idaho, Idaho Falls, ID for workforce training program and equipment ......................... $100,000
College of Lake County, Grayslake, IL for a workforce development initiative related to manufacturing,
including equipment .................................................................................................................................. $900,000
Colonial Farmhouse Restoration Society of Bellerose, Inc., Floral Park, NY for a workforce training initia-
tive, including equipment .......................................................................................................................... $200,000
Community Assistance Programs, Chicago, IL for job training, job placement and supportive services ... $100,000
Comunidades Organizando el Poder y la Accion Latina Education Fund, Minneapolis, MN for workforce
development activities, including equipment ........................................................................................... $1,000,000
Cornerstone Revitalization Foundation, Inc., Birmingham, AL for workforce development activities, in-
cluding opprtunities to obtain a GED, postsecondary credentials, and stipends .................................... $1,500,000
Council for Native Hawaiian Advancement, Kapolei, HI for workforce training programs ........................... $1,200,000
Covenant House Florida, Ft. Lauderdale, FL for work-based learning and supportive services for home-
less youth ................................................................................................................................................... $300,000
DC Central Kitchen, Washington, DC for culinary job training, including stipends and equipment ........... $500,000
Dream It Do It Western New York Inc., Jamestown, NY for job training and placement ............................. $250,000
Eclectic Soul VOICES Corporation, Indianapolis, IN for a job training program, including supportive
services and stipends ................................................................................................................................ $100,000
Emerald Isle Immigration Center, Woodside, NY for workforce development activities, including career
and supportive services ............................................................................................................................. $60,000
Fairfax County Government, Fairfax, VA for a job training program for pregnant and parenting teens
and non-parenting young adults, including equipment ........................................................................... $1,000,000
Fairfax County Government, Fairfax, VA for an apprenticeship training program, including stipends ....... $400,000
Florida Endowment Foundation for Florida’s Graduates, Flagler Beach, FL for an at-risk youth jobs pro-
gram ........................................................................................................................................................... $1,500,000
Frederick County Government, Frederick, MD for a mobile career center ..................................................... $250,000
Hire Heroes USA, Alpharetta, GA for job placement and career services for veterans ................................ $625,000
iFoster, Inc., Las Vegas, NV for a workforce development and readiness program ..................................... $150,000
Jewish Family Service of Colorado, Denver, CO for workforce development activities, including tech-
nology and equipment ............................................................................................................................... $500,000
Kent State University at Tuscarawas, New Philadelphia, OH for advanced manufacturing equipment and
training ...................................................................................................................................................... $250,000
Kentucky Capital Development Corporation, Frankfort, KY for cybersecurity/IT workforce development ...... $440,000
La Colaborativa/Chelsea Collaborative, Chelsea, MA for workforce development initiative ......................... $300,000
Lansing Community College, Lansing, MI for mobile skills laboratories, including equipment .................. $400,000
Living Classrooms Foundation, Baltimore, MD for workforce development activities, including technology $750,000
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Macomb County, Clinton Township, MI for workforce development and certification courses, including
technology and supportive services .......................................................................................................... $525,000
Make the Road New York, Jackson Heights, NY for workforce development, including adult education
and equipment ........................................................................................................................................... $400,000
Mary’s Mercy Center, Inc., San Bernadino, CA for a training program and supportive services ................ $300,000
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Project Amount
Mecklenburg County, Charlotte, NC for a training program and supportive services ................................. $1,000,000
Meristem, Inc., Fair Oaks, CA for a training program for individuals with autism, including stipends .... $450,000
Mi Casa Resource Center, Denver, CO for a workforce development program ............................................ $20,000
Milwaukee Metropolitan Sewerage District, Milwaukee, WI for a workforce development initiative, includ-
ing equipment and stipends ..................................................................................................................... $1,000,000
Montgomery County Office of Broadband Programs, Rockville, MD for a technology job training pilot
program, including equipment and supportive services .......................................................................... $1,000,000
Multi-Craft Apprenticeship Preparation Program, Inc., Rochester, NY for workforce development initia-
tive, including stipends and equipment ................................................................................................... $200,000
National Institute for Medical Assistant Advancement, Denver, CO for a training program, including
technology and equipment ........................................................................................................................ $450,000
Neighborhood House Incorporated, Seattle, WA for job placement and career services .............................. $275,000
Neighbors and Neighbors Association, Inc., Miami, FL for work readiness and vocational training .......... $500,000
New Century Careers, Pittsburgh, PA for pre-apprenticeship and apprenticeship programs in advanced
manufacturing, including job placement services. ................................................................................... $500,000
New Jersey Chamber of Commerce Foundation, Trenton, NJ for student training and equipment, includ-
ing information technology ........................................................................................................................ $270,000
Newark Emergency Services for Families (NESF), Newark, NJ for a workforce readiness program for
hard-to-serve target populations .............................................................................................................. $325,000
Northern Maine Community College, Presque Isle, ME for a mechanized logging operations training pro-
gram, including equipment ....................................................................................................................... $1,000,000
Opportunities Industrialization Center (d/b/a Philadelphia OIC), Philadelphia, PA for a healthcare-re-
lated job training program, including equipment .................................................................................... $575,000
Opportunity Village, Las Vegas, NV for workforce development initiative for individuals with intellectual
and related disabilities ............................................................................................................................. $525,000
Para Los Niños, Los Angeles, CA for a youth workforce development initiative, including career and
supportive services .................................................................................................................................... $350,000
Passaic County Community College, Patterson, NJ for workforce training and career coaching, including
equipment .................................................................................................................................................. $1,950,000
Path of Life Ministries, Riverside, CA for workforce development activities, including supportive services
and stipends .............................................................................................................................................. $250,000
Philadelphia Works, Inc., Philadelphia, PA for workforce development activities, including transitional
employment ................................................................................................................................................ $1,000,000
PIDC Community Capital, Philadelphia, PA for workforce development activities, including technology
and stipends .............................................................................................................................................. $525,000
Presbyterian Villages of Michigan, Flint, MI for a workforce development iniatitive, including a certifi-
cation program .......................................................................................................................................... $600,000
Prince George’s County Office of Human Resources Management, Largo, MD for a job training program $2,000,000
Project QUEST, Inc., San Antonio, TX for an education and training program, including supportive serv-
ices ............................................................................................................................................................. $1,000,000
Proyecto Del Barrio Inc., Arleta, CA for a job training program ................................................................... $300,000
Quad County Urban League, Inc., Aurora, IL for education and skills training to enter apprenticeships
or positions in construction or TDL industries, including equipment ...................................................... $425,000
San Jose Conservation Corps & Charter School for workforce development iniatitive for youth, including
stipends and technology ............................................................................................................................ $275,000
Second Harvest Food Bank of Central Florida, Orlando, FL for a culinary workforce training program, in-
cluding internships, equipment, and supportive services ........................................................................ $775,000
South Bay Workforce Investment Board, Hawthorne, CA for workforce development activities, including
supportive services .................................................................................................................................... $500,000
Southeast Michigan Community Alliance Inc., Taylor, MI for a work-based learning program for at-risk
in-school youth age 14 or older, including stipends and supportive services ........................................ $850,000
Southern California Regional Occupational Center, Torrance, CA for a workforce development initiative .. $1,000,000
Southern Maine Community College, South Portland, ME for welding workforce training, including
equipment .................................................................................................................................................. $1,000,000
State of Hawaii Workforce Development Council, State of Hawaii Department of Labor and Industrial
Relations, Honolulu, HI for digital skills literacy training ........................................................................ $975,000
Sunnyside Community Services, Sunnyside, NY for a workforce development initiative .............................. $175,000
SUNY Maritime College, Bronx, NY for offshore wind energy training program, including equipment ....... $800,000
The Corporate Source, Garden City, NY for IT training and certification training program for people with
disabilities, including equipment and supportive services ...................................................................... $125,000
The HOPE Program, Bronx, NY for a job training program for green jobs to support justice-impacted
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invididuals, including technology and equipment .................................................................................... $800,000
Tri-Council Development Fund, Aurora, IL for a pre-apprenticeship program, including equipment and
supportive services .................................................................................................................................... $975,000
TXRX LABS, Houston, TX for employment and training activities, an apprenticeship program, and a
youth STEM initiative. ................................................................................................................................ $550,000
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Project Amount
Uintah Basin Technical College, Roosevelt, UT for electrical apprentice training program and the pur-
chase of equipment ................................................................................................................................... $515,000
United Community Services for Working Families, Reading, PA for job training for youth, including sti-
pends, technology, and supportive services ............................................................................................. $450,000
United Northeast Community Development Corporation, Indianapolis, IN for a job training iniativie, in-
cluding supportive services ....................................................................................................................... $600,000
United Way of Central Jersey, Milltown, NJ for workforce development activities, including career and
supportive services .................................................................................................................................... $425,000
United Way of Chester County, Exton, PA for job training services ............................................................. $100,000
United Way of Long Island, Deer Park, NY for a YouthBuild program, including stipends ......................... $700,000
United Way of Miami-Dade Inc., Miami, FL for job training activities and supportive services for vet-
erans and their families, including stipends, technology, and supportive services ............................... $250,000
University of Rochester, Rochester, NY for youth workforce development initiative for youth, including
technology and equipment ........................................................................................................................ $300,000
UPROSE, Brooklyn, NY for workforce development initiative ......................................................................... $175,000
Urban League of Hillsborough County, Inc., Tampa, FL for preapprenticeships and paid internship pro-
grams, including supportive services ....................................................................................................... $300,000
Vehicles for Change, Halethorpe, MD for a workforce training initiative, including stipends and equip-
ment ........................................................................................................................................................... $750,000
Warren County Employment & Training Administration, Glens Falls, NY for job recruitment and training
program, including the purchase of information technology ................................................................... $205,000
Workforce Connections, Las Vegas, NV for a workforce development initiative ........................................... $800,000
WorkSystems, Inc., Portland, OR for registered apprenticeship opportunities in construction, including
supportive services .................................................................................................................................... $1,000,000
WV Council for Community and Technical College Education, Charleston, WV for aerospace training,
equipment, and curriculum ....................................................................................................................... $300,000
JOB CORPS
Appropriation, fiscal year 2021 ......................................................... $1,748,655,000
Budget request, fiscal year 2022 ....................................................... 1,754,759,000
Committee Recommendation ............................................................. 1,830,073,000
Change from enacted level ......................................................... +81,418,000
Change from budget request ...................................................... +75,314,000
Job Corps is the nation’s largest residential employment and
workforce development program for youth, helping prepare thou-
sands of young people ages 16 through 24 for jobs in in-demand oc-
cupations with good wages each year.
Operations.—For Job Corps Operations, the Committee rec-
ommends $1,653,325,000, which is $50,000,000 more than the fis-
cal year 2021 enacted level and $50,314,000 more than the fiscal
year 2022 budget request.
Construction, Rehabilitation, and Acquisition.—The Committee
recommends $138,000,000 for construction, rehabilitation, and ac-
quisition activities, which is $25,000,000 more than the fiscal year
2021 enacted level and the fiscal year 2022 budget request.
Administration.—The Committee recommends $38,748,000 for
the administrative expenses of the Job Corps program, which is the
same as the fiscal year 2021 enacted level and the same as the fis-
cal year 2022 budget request.
For over 50 years, Job Corps has successfully educated and
trained millions of young adults for jobs in high demand industries
and trades. Job Corps has campuses across all 50 States and Puer-
to Rico and provides a safe living, learning and disciplined residen-
tial setting that allows disconnected and opportunity youth to gain
the employment and skills that U.S. employers seek. The Com-
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mittee recommendation includes funding for Job Corps to meet ca-
pacity and ensure a safe learning environment for all students and
staff, including to train youth for employment in industry sectors
facing critical shortages of skilled workers, such as construction,
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21
healthcare, manufacturing, transportation, and cyber technologies.
Job Corps centers are capable of serving approximately 50,000 out-
of-work and out-of-school youth each year, and the Committee en-
courages the Department to use such funding accordingly.
In addition, the Committee is concerned with the administration
of the Job Corps program, including the underutilization of centers
relative to on-board strength, industry-standard training, and per-
formance incentives.
To better utilize Job Corps centers, the Committee directs the
Department to include an update in the fiscal year 2023 Congres-
sional Budget Justification on Job Corps application and enroll-
ment data to evaluate the relative efficacy of different investments
in producing Job Corps-eligible applicants, arrivals, and their fami-
lies, including social media, national television or radio buys, and
local outreach efforts targeted at eligible youth, guardians, and
influencers.
As millions of disconnected youth struggle with housing, food in-
security, and unemployment, the Committee supports the efforts to
resume operations at Job Corps centers as safely and rapidly as
possible. Like other schools across the country, once Job Corps staff
are vaccinated, the Committee encourages full resumption of Job
Corps operations. The Committee directs the Department to in-
clude an update in the fiscal year 2023 Congressional Budget Jus-
tification on the requirements and measures the Department will
utilize to approve Job Corps centers resuming operations at full ca-
pacity.
The Committee has previously expressed its concern that the
transition to fixed price Job Corps contracts may negatively impact
students and staff by prioritizing reducing costs over improving
student outcomes. The Committee encourages the Department to
ensure that Job Corps contracts offer competitive wages and bene-
fits. The Committee directs the Department to include an update
in the fiscal year 2023 Congressional Budget Justification on the
process by which the Department evaluates cost-realism in bid
evaluations, particularly with respect to budgeting to pay pre-
vailing wages, and data on the rate of contract turnover over each
of the last ten years.
COMMUNITY SERVICE EMPLOYMENT FOR OLDER AMERICANS
Appropriation, fiscal year 2021 ......................................................... $405,000,000
Budget request, fiscal year 2022 ....................................................... 405,000,000
Committee Recommendation ............................................................. 450,000,000
Change from enacted level ......................................................... +45,000,000
Change from budget request ...................................................... +45,000,000
The Community Service Employment for Older Americans pro-
gram provides grants to public and private non-profit organizations
that subsidize part-time work in community service activities for
unemployed persons aged 55 and older whose family income is
below 125 percent of the poverty level.
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The Committee recommends $450,000,000 for the Community
Service Employment for Older Americans program, which is
$45,000,000 more than the fiscal year 2021 enacted level and the
fiscal year 2022 budget request.
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FEDERAL UNEMPLOYMENT BENEFITS AND ALLOWANCES
Appropriation, fiscal year 2021 ......................................................... $633,600,000
Budget request, fiscal year 2022 ....................................................... 551,000,000
Committee Recommendation ............................................................. 551,000,000
Change from enacted level ......................................................... ¥82,600,000
Change from budget request ...................................................... –––
The Trade Adjustment Assistance program (TAA) provides as-
sistance to workers adversely affected by international trade. TAA
provides training, income support, wage subsidies for older work-
ers, job search and relocation allowances to groups of workers who
file a petition and are certified as eligible to apply for such benefits
due to job losses resulting from increases in imports or foreign
trade.
The authorization for this program is set to expire on July 1,
2022, and a sunsetting provision took effect on July 1, 2021, caus-
ing the program to revert to limited eligibility for the program. The
amount for fiscal year 2022 reflects this reversion.
STATE UNEMPLOYMENT INSURANCE AND EMPLOYMENT SERVICE
OPERATIONS
Appropriation, fiscal year 2021 ......................................................... $3,416,649,000
Budget request, fiscal year 2022 ....................................................... 4,121,761,000
Committee Recommendation ............................................................. 4,176,230,000
Change from enacted level ......................................................... +759,581,000
Change from budget request ...................................................... +54,469,000
The total includes $4,087,164,000 from the Employment Security
Administration Account from the Unemployment Trust Fund and
$89,066,000 from the General Fund of the Treasury. These funds
are used to support the administration of Federal and State unem-
ployment compensation laws.
Unemployment Insurance Compensation.—For Unemployment In-
surance (UI) Compensation, the Committee recommends
$3,125,214,000, which is $559,398,000 more than the fiscal year
2021 enacted level and the same as the fiscal year 2022 budget re-
quest. The recommendation provides additional resources for States
to increase staffing capacity and to accommodate sustained in-
creases in workload.
In addition, the recommendation provides contingency funding
for increased workloads that States may face in the administration
of UI. The Committee recommendation includes bill language so
that, during fiscal year 2022, for every 100,000 increase in the total
average weekly insured unemployment (AWIU) above 2,008,000, an
additional $28,600,000 shall be made available to States from the
Unemployment Trust Fund.
In the event that additional funds are provided to States under
the AWIU contingency authority, the Department is directed to
provide notification to the Committees on Appropriations of the
current projected AWIU level for the fiscal year, when funds were
provided to States, and how much additional funding was provided
in total and to each State within 15 days of funding being provided.
In the event that additional funds are provided on a quarterly
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basis, the Department shall provide this information on a quarterly
basis.
The Committee includes $117,000,000 for the Reemployment
Services and Eligibility Assessments program, and an additional
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23
$133,000,000 is made available pursuant to the Bipartisan Budget
Act of 2018 (P.L. 115–123), which is $50,000,000 more than the fis-
cal year 2021 enacted level and equal to the fiscal year 2022 budget
request.
UI Integrity Center of Excellence (UIICE).—The recommendation
provides $9,000,000 for the continued support of UIICE, including
$6,000,000 for the benefit of States to the entity operating the
UIICE.
GAO Study on Unemployment Insurance Compensation.—The
Committee notes that the significant increase in Unemployment In-
surance (UI) Compensation claims during the COVID–19 pan-
demic, which Congress provided to address the corresponding eco-
nomic crisis, has strained the ability of state agencies responsible
for administering UI Compensation in a timely and reliable man-
ner. In a few short months, the unemployment rate increased from
3.5 percent in February 2020 to 14.8 percent in April 2020, requir-
ing States to respond to unexpected workloads. Moreover, fraudu-
lent filing for, and receipt of, UI Compensation, increased signifi-
cantly as well. The Committee directs GAO to study existing defi-
ciencies in the administration of UI Compensation, including but
not limited to the need for investment in technological improve-
ments at the state-level, and provide the Committees on Appropria-
tions with its findings and recommendations.
Pandemic Unemployment Assistance.—The Coronavirus Aid, Re-
lief, and Economic Security Act (CARES Act, P.L. 116–136) estab-
lished the Pandemic Unemployment Assistance (PUA) program,
which delivered billions of dollars in emergency assistance to indi-
viduals who became unemployed due to the economic effects of the
COVID–19 public health emergency. Further, this program sus-
tained American families and provided needed economic relief. The
Committee notes that critical emergency assistance during simulta-
neous public health and financial crises should be targeted to indi-
viduals who are eligible for benefits. The Department and States
should ensure that proper safeguards—including program integrity
and fraud prevention tools and procedures—are in place to identify
any schemes to defraud this emergency program. The Committee
urges the Department to work with the Office of the Inspector Gen-
eral on this matter and to utilize the UIICE to assist States in ef-
forts to ensure benefits are delivered to individuals and families
who qualify for them.
Unemployment Compensation National Activities.—The Com-
mittee recommends $118,108,000 for National Activities, which is
$100,108,000 more than the fiscal year 2021 enacted level and the
same as the fiscal year 2022 budget request. This increase in fund-
ing is intended to help modernize information technology systems
and support States in administering the UI program.
The Committee supports ongoing efforts by the Department’s
Employment and Training Administration to collaborate with state
workforce agencies to modernize unemployment insurance manage-
ment systems. The Committee urges the department to develop a
comprehensive long-term strategy for delivery of assistance to state
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workforce agencies that would: develop an open-systems approach
and modular program of unemployment management systems that
can be adapted for state-by-state usage plans; standardize employ-
ment and wage records reporting requirements; incorporate 21st
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24
century accessibility standards; develop enforcement and oversight
methods so that states meet established US DOL technology guid-
ance such as Unemployment Insurance Program Letter 2–1; avoid
use of high-risk automated decision-making and identity-proofing
systems to deny claims; standardize dashboard and claimant portal
information; require public dissemination of by-county demographic
data on benefits denials, delays, overpayments, and fraud deter-
minations; correct past inequities in benefits distribution by taking
into account user-experiences of historically disadvantaged groups;
conduct user testing and a full consultation with state-level stake-
holders, users, and worker organizations.
Employment Service.—The Committee recommends $748,862,000
for the Employment Service allotment to States, which is
$78,810,000 more than the fiscal year 2021 enacted level and
$50,000,000 more than the fiscal year 2022 budget request.
The Committee also recommends $22,318,000 for Employment
Service National Activities, which is the same as the fiscal year
2021 enacted level and the fiscal year 2022 budget request. Within
the total, the Committee provides $2,500,000 to reduce the proc-
essing backlog for the work opportunity tax credit program and for
assisting States in adopting or modernizing information technology
for processing of certification requests, which may include training
and technical assistance to States.
The Employment Service offers vital services such as referrals
for job openings, career counseling, and job searches for individuals
seeking employment, including veterans and people with disabil-
ities. Since 1933, this Federal-State partnership has facilitated the
connection between employers in need of workers and individuals
seeking employment. Given the nature of this exchange, the De-
partment has historically required that the Employment Service
system rely on State merit-staff employees to ensure that these
services are rendered in the public interest and not solely to meet
private interests. However, under the previous Administration, the
Department issued a final rule that marked a dangerous departure
from this operation. As such, the recommendation includes new bill
language preventing the implementation of the final rule, entitled
‘‘Wagner-Peyser Act Staffing Flexibility’’ (85 Fed. Reg. 592).
Foreign Labor Certification.—The Committee recommends
$94,075,000 for the Foreign Labor Certification (FLC) program,
which is $16,265,000 more than the fiscal year 2021 enacted level
and the same as the fiscal year 2022 budget request. The rec-
ommendation includes $67,793,000 for Federal administration, an
increase of $10,265,000 over the fiscal year 2021 enacted level and
the same as the fiscal year 2022 budget request, that is intended
to be used to ensure effective oversight and enforcement of em-
ployer regulations, and $26,282,000 for grants to States, an in-
crease of $6,000,000 over the fiscal year 2021 enacted level and the
same as the fiscal year 2022 budget request.
H–2A Program.—Given the rapid growth of the H–2A program,
the role of farm labor contractors, and the troubling rate of viola-
tions within the program, the Committee directs the Secretary to
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submit a report to the Committee on Appropriations on the Depart-
ment’s enforcement of farm labor contractors (FLCs) within 180
days of enactment of this Act. The report shall contain, at a min-
imum, the following information for each of the last 5 years: an
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25
analysis of H–2A certifications for fixed-site employers and FLCs;
an analysis of the inspections, audits, investigations, administra-
tive complaints, and judicial litigation regarding findings of viola-
tions by farm labor contractors in the H–2A program, including
remedies; and recommendations to deter violations and improve
compliance by farm labor contractors in the H–2A program and
how to ensure that farmworkers obtain adequate relief for any vio-
lations. The content of the final report shall be made publicly avail-
able on the agency’s website.
H–2B visa disbursements.—The Committee directs the Depart-
ment to include an update in its fiscal year 2023 Congressional
Budget Justification on the number of labor certifications granted
through the H–2B non-immigrant visa program. At a minimum,
the report shall contain, but is not limited to, the number of job
openings published on seasonaljobs.dol.gov each fiscal year, cat-
egorized by industry and occupation.
Schedule A Occupational Classification.—The Committee is
aware that the Schedule A occupational classification list currently
includes only two broad occupational classifications and a narrow
subset of other applicants. The Committee continues to encourage
the Secretary to consider rulemaking to improve the experience of
employers and to effectively allocate Department resources with
the goal of protecting U.S. workers from undue foreign competition
through the labor certification process.
One-Stop Career Centers/Labor Market Information.—The Com-
mittee recommends $67,653,000 for One-Stop Career Centers and
Labor Market Information, which is $5,000,000 more than the fis-
cal year 2021 enacted level and the same as the fiscal year 2022
budget request. The recommendation also includes language au-
thorizing the Secretary to transfer certain funding to the Office of
Disability Employment Policy for research and demonstration
projects.
ADVANCES TO THE UNEMPLOYMENT TRUST FUND AND OTHER FUNDS
The Committee recommends such sums as necessary for Ad-
vances to the Unemployment Trust Fund and Other Funds. The
funds are made available to accounts authorized under Federal and
State unemployment insurance laws and the Black Lung Disability
Trust Fund when the balances in such accounts are insufficient.
PROGRAM ADMINISTRATION
Appropriation, fiscal year 2021 ......................................................... $158,656,000
Budget request, fiscal year 2022 ....................................................... 211,503,000
Committee Recommendation ............................................................. 211,503,000
Change from enacted level ......................................................... 52,847,000
Change from budget request ...................................................... –––
The recommendation includes $144,497,000 from the General
Fund of the Treasury and $67,006,000 from the Employment Secu-
rity Administration Account in the Unemployment Trust Fund.
The Committee includes new bill language ensuring Office of Ap-
prenticeship resources support Registered Apprenticeships and ade-
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quate staffing in the Office of Apprenticeship and State offices.
Prize Competition.—The Committee encourages the Department,
in coordination with the Office of Science and Technology Policy, to
establish a prize competition consistent with the requirements of
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26
section 24 of the Stevenson-Wydler Technology Innovation Act of
1980, to support eligible programs designed to prepare high school
students to enter and succeed in an in-demand industry sector or
occupation.
Long-term Unemployed.—The Committee notes the economic
challenges millions of individuals now face due to the coronavirus
pandemic and high-unemployment. Within a matter of months, a
nine-year period of sustained economic recovery and growth was
swept away by a wave of pathogen, shuttering businesses and cre-
ating economic uncertainty. The Committee also notes that the eco-
nomic prospects for many individuals unemployed prior to the start
of the national emergency were worsened as a result of COVID–19.
Prior to the pandemic, these individuals faced significant barriers
to employment, having been unemployed for 27 weeks or more.
While it is essential that the Department supports policies and
practices that put Americans back to work in a safe and sustain-
able way, the Department must also ensure that the long-term un-
employed do not fall through the cracks of our economic recovery.
To advance this effort, the Committee encourages the Department
to support reemployment programs targeting long-term unem-
ployed workers.
Open Data Formats.—The Committee notes that Congress has
made a significant investment in our workforce development, post-
secondary, and career and technical education systems. As a result
of this investment, the number of credentials in the U.S. continues
to rise. However, the Committee is aware that many workers and
students may face challenges in navigating an intricate network of
diplomas, licenses, certifications, and badges. Therefore, the De-
partment is encouraged to require any information publicly dis-
closed related to occupational and professional licenses and certifi-
cations, as well as credentials and competencies earned through ap-
prenticeships, whether directly or through contracts, be published
using an open source description language that is designed to allow
for public search and comparison of such data, including any such
data on credentials and competencies. Such information may be
published through open data formats such as the credential trans-
parency description language specifications or a substantially simi-
lar approach. The Department is further encouraged to provide a
briefing to the Committees within 120 days of enactment of this
Act, outlining a plan for providing such data, including any chal-
lenges, barriers to implementation, as well as anticipated costs.
National Guard Job ChalleNGe.—The Committee appreciates the
value and success of the National Guard’s Youth ChalleNGe Pro-
gram, and the benefits the Department of Labor’s collaboration
through Job ChalleNGe provides to the youth served through the
experience. The occupational skills training, individualized career
and academic counseling, work-based learning opportunities, and
leadership development activities provided through the Job Chal-
leNGe are even more vital in the aftermath of the economic fallout
associated with the pandemic. The Committee encourages the De-
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partment to build upon its collaboration with Youth ChalleNGe
programs and offer youth occupational skills training, individual-
ized career and academic counseling, work-based learning opportu-
nities, and leadership development activities.
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Gun Violence.—The Committee encourages the Department to
prioritize Workforce Innovation and Opportunity Act funding op-
portunities, like the Young Adult Reentry Partnership and
YouthBuild, to support reintegration, transitional employment,
long-term impactful positions, union positions, and living wages for
systems-involved youth and older adults in cities disproportionately
impacted by daily gun violence.
Collaborations between manufacturers and educational institu-
tions.—The Committee encourages the Department to develop dem-
onstration and pilot programs that facilitate education and training
programs in the field of advanced manufacturing. Eligible entities
include local educational entities (e.g., technical college, community
college, a manufacturing extension center, or an entity that assists
educationally underserved communities) partnering with manufac-
turers that employ individuals who have advanced manufacturing
skills. These programs should (1) develop skills and competencies
of workers in communities with expected growth in advanced man-
ufacturing; (2) provide education and training for available and an-
ticipated jobs in advanced manufacturing; (3) educate individuals
about career advancement opportunities within advanced manufac-
turing; (4) strengthen community college partnerships with manu-
facturing extension centers and advanced manufacturing busi-
nesses in an effort to meet the needs of businesses for adaptability
in training of workers; and (5) give priority to incumbent workers,
dislocated workers, and unemployed individuals.
Justice Involved Workers.—The Committee supports the Depart-
ment’s intention to expand education, skills training, and work ex-
perience programs to connect justice-involved individuals with em-
ployment opportunities to obtain and retain jobs. The Committee
urges the Department to develop and improve the availability of
employment and transitional job programs that support work-based
learning activities designed to increase reentry employment as an
equitable workforce approach. To increase alignment of work expe-
rience opportunities across Federal programs, the committee also
encourages the Department to work with national nonprofit organi-
zations that have proven track records in this area, including orga-
nizations with partnerships with the SNAP Employment and
Training program.
EMPLOYEE BENEFITS SECURITY ADMINISTRATION
SALARIES AND EXPENSES
Appropriation, fiscal year 2021 ......................................................... $181,000,000
Budget request, fiscal year 2022 ....................................................... 218,475,000
Committee Recommendation ............................................................. 218,475,000
Change from enacted level ......................................................... +37,475,000
Change from budget request ...................................................... –––
The Employee Benefits Security Administration (EBSA) assures
the security of retirement, health and other workplace-related ben-
efits of working Americans.
The Committee recommends $218,475,000 for EBSA, which is
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$37,475,000 above the fiscal year 2021 enacted level and the same
as the fiscal year 2022 budget request.
Mental Health Parity and Addiction Equity Act (MHPAEA) Com-
pliance.—The Committee has included resources for EBSA to fully
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28
implement Section 203 of Division BB of the Consolidated Appro-
priations Act, 2021. Section 203 requires that all group health
plans perform comparative analyses of the design and application
of nonquantitative treatment limitations (NQTLs) to ensure those
imposed on mental health and substance use disorder benefits are
not more restrictive than limitations for medical and surgical bene-
fits.
These funds will enable EBSA to hire additional health inves-
tigators who will focus exclusively on MHPAEA NQTL compliance
and contract with external consultants with expertise in NQTL
comparative analyses to assist and train investigators. To the ex-
tent resources allow, the Committee also encourages EBSA to cre-
ate templates and tools for collecting and scoring the comparative
analyses and rendering decisions on compliance; enhance coordina-
tion, standardization and MHPAEA-related decision-making uni-
formity among regional offices; and conduct follow-up investiga-
tions into group health plans whose comparative analyses indicate
likely noncompliance or areas in which further examination is
needed to determine compliance.
PENSION BENEFIT GUARANTY CORPORATION
Appropriation, fiscal year 2021 ......................................................... $465,289,000
Budget request, fiscal year 2022 ....................................................... 472,955,000
Committee Recommendation ............................................................. 472,955,000
Change from enacted level ......................................................... +7,666,000
Change from budget request ...................................................... –––
Congress established the Pension Benefit Guaranty Corporation
to insure the defined-benefit pension plans of working Americans.
WAGE AND HOUR DIVISION
SALARIES AND EXPENSES
Appropriation, fiscal year 2021 ......................................................... $246,000,000
Budget request, fiscal year 2022 ....................................................... 276,500,000
Committee Recommendation ............................................................. 300,000,000
Change from enacted level ......................................................... +54,000,000
Change from budget request ...................................................... +23,500,000
The Wage and Hour Division (WHD) enforces Federal minimum
wage, overtime pay, recordkeeping, and child labor requirements of
the Fair Labor Standards Act (FLSA). WHD also has enforcement
and other administrative responsibilities related to the Migrant
and Seasonal Agricultural Worker Protection Act, the Employee
Polygraph Protection Act, the Family and Medical Leave Act, the
Davis Bacon Act, and the Service Contract Act.
The Committee recommends $300,000,000 for WHD, which is
$54,000,000 above the fiscal year 2021 enacted level and
$23,500,000 above the fiscal year 2022 budget request. The in-
crease will support additional investigators to combat wage theft
and protect workers. The Committee urges WHD to explore and ex-
pand strategic enforcement approaches to the agency’s work to
make the most of this increase.
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Language Access.—In hiring investigators, the Committee en-
courages WHD to focus on employing and retaining a greater num-
ber of multilingual investigators. In the fiscal year 2023 Congres-
sional Budget Justification, WHD is directed to include information
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outlining the WHD’s goals for meeting critical language access
needs through its investigator workforce.
Retaliation.—Because retaliation and the threat of retaliation re-
main critical challenges to workers’ ability to exercise their work-
place rights, the Committee requests for WHD to provide informa-
tion regarding its volume of retaliation complaints, the status of
those complaints, and how WHD is working effectively protect
workers from retaliation in the fiscal year 2023 Congressional
Budget Justification.
Accessibility.—The Committee notes the importance of making
sure all workers can access WHD’s resources, including workers of
color, immigrant workers, workers in rural communities or with
limited access to transportation, and workers with disabilities. The
Committee encourages WHD to undertake efforts to improve acces-
sibility of WHD offices, translate WHD documentation and signage
into languages spoken by 5 percent or more of the population in a
given WHD region, and translate WHD’s online webpages, com-
plaint forms, and resources to match regional needs identified. In
addition, the Committee encourages WHD to establish protocols
that permit workers to participate in investigations and hearings
remotely where appropriate.
Community-based Organizations and Partnerships.—The Com-
mittee believes that community-based organizations are critical in
establishing necessary trust, connecting workers with agencies, fa-
cilitating communication between agencies and workers, and de-
ploying enforcement resources strategically. Working with commu-
nity-based organizations helps agencies cooperate with workers
who might be otherwise difficult to reach, including workers em-
ployed by small businesses, workers with literacy challenges, work-
ers with limited access to broadband, and workers in high-hazard
industries most vulnerable to wage violations. Therefore, the Com-
mittee urges WHD to increase its capacity to conduct outreach and
collaborate with community-based organizations.
U and T Visa Certification.—The Committee notes the critical
role WHD plays in completing U and T visa certifications on behalf
of victims of crime and victims of trafficking in the workplace. En-
suring that all workers regardless of immigration status can par-
ticipate in WHD investigations and exercise their workplace rights
is critical to the full and effective enforcement of Federal labor
laws. The Committee urges WHD to use resources provided in fis-
cal year 2022 to ensure the efficient and timely processing and cer-
tification of all certification requests.
Domestic Workers.—The Committee is concerned that domestic
workers are particularly vulnerable to workplace exploitation, in-
cluding wage theft, verbal abuse, trafficking, and sexual assault.
Domestic work commonly takes place in private homes where
workers are often isolated and alone. This workforce is predomi-
nantly female and represents populations that are already vulner-
able, including immigrant women and women of color. The Com-
mittee is concerned by the limited enforcement of workplace rights
for this population and the severe power imbalance between domes-
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tic workers and their employers. In response to these concerns, the
Committee includes new bill language directing the Secretary to
use funds made available under WHD to establish a national hot-
line to support domestic workers. In addition, the Committee urges
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WHD to prioritize investigations in sectors where workers are more
vulnerable to wage theft, including domestic work, long term care,
and home health care.
OFFICE OF LABOR-MANAGEMENT STANDARDS
SALARIES AND EXPENSES
Appropriation, fiscal year 2021 ......................................................... $44,437,000
Budget request, fiscal year 2022 ....................................................... 51,554,000
Committee Recommendation ............................................................. 44,437,000
Change from enacted level ......................................................... –––
Change from budget request ...................................................... ¥7,117,000
The Office of Labor Management Standards (OLMS) administers
the Labor-Management Reporting and Disclosure Act (LMRDA),
which establishes safeguards for union democracy and union finan-
cial integrity, and requires public disclosure reporting by unions,
union officers, employees of unions, labor relations consultants, em-
ployers, and surety companies.
The Committee recommends $44,437,000 for OLMS, which is the
same as the fiscal year 2021 enacted level and $7,117,000 below
the fiscal year 2022 budget request.
OFFICE OF FEDERAL CONTRACT COMPLIANCE PROGRAMS
SALARIES AND EXPENSES
Appropriation, fiscal year 2021 ......................................................... $105,976,000
Budget request, fiscal year 2022 ....................................................... 140,732,000
Committee Recommendation ............................................................. 140,732,000
Change from enacted level ......................................................... +34,756,000
Change from budget request ...................................................... –––
The Office of Federal Contract Compliance Programs (OFCCP)
ensures equal employment opportunity in the Federal contracting
community through enforcement, regulatory work, outreach and
education to workers and their advocates.
OFCCP is responsible, per Executive Order 11246 (EO 11246),
for ensuring Federal contractors and subcontractors take affirma-
tive action to ensure that all individuals have an equal opportunity
for employment, without regard to race, color, religion, sex, or na-
tional origin.
The Committee recommends $140,732,000 for OFCCP, which is
$34,756,000 above the fiscal year 2021 enacted level and the same
as the fiscal year 2022 budget request. The Committee supports
OFCCP’s efforts to make sure contractors and subcontractors are
adhering fully to EO 11246.
OFFICE OF WORKERS’ COMPENSATION PROGRAMS
SALARIES AND EXPENSES
Appropriation, fiscal year 2021 ......................................................... $117,601,000
Budget request, fiscal year 2022 ....................................................... 140,809,000
Committee Recommendation ............................................................. 140,809,000
Change from enacted level ......................................................... +23,208,000
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Change from budget request ...................................................... –––
The Office of Workers’ Compensation Programs (OWCP) admin-
isters the Federal Employees’ Compensation Act, the Longshore
and Harbor Workers’ Compensation Act, the Energy Employees Oc-
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31
cupational Illness Compensation Program Act, and the Black Lung
Benefits Act. These programs provide eligible injured and disabled
workers and their survivors with compensation, medical benefits,
and services including rehabilitation, supervision of medical care,
and technical and advisory counseling.
The Committee recommendation includes $138,604,000 in Gen-
eral Funds from the Treasury, which is $23,180,000 above the fis-
cal year 2021 enacted level and the same as the fiscal year 2022
request, and $2,205,000 from the Special Fund established by the
Longshore and Harbor Workers’ Compensation Act.
National Commission.—The Committee is concerned by an ongo-
ing and systematic decline in the adequacy of benefits provided to
injured workers under the State-based workers’ compensation sys-
tem. Costs for disabling workplace injuries are being shifted to
Federal programs, such as Social Security Disability Insurance, be-
cause of reduced coverage under State laws. With the growth of the
gig economy and misclassification of workers as independent con-
tractors, millions of workers are falling through the cracks in State
workers’ compensation systems. Given the impact to the Federal
government, the Committee believes that State workers’ compensa-
tion programs should be monitored on an ongoing basis. Following
the issuance of the report of the National Commission on State
Workmen’s Compensation Laws in 1972, the Department prepared
an annual report on the operations of State workers’ compensation
programs, but ceased doing so in 2004. Since then, there has been
no reporting or analysis as State legislatures have passed, and gov-
ernors have signed, significant legislation affecting the availability
and adequacy of workers’ compensation. The Committee requests
that the Department, through the Office of Workers’ Compensation
Programs, include in the fiscal year 2023 Congressional Budget
Justification an assessment of the resources necessary to reinstate
OWCP’s monitoring of State workers’ compensation programs and
preparation of an annual report.
SPECIAL BENEFITS
Appropriation, fiscal year 2021 ......................................................... $239,000,000
Budget request, fiscal year 2022 ....................................................... 244,000,000
Committee Recommendation ............................................................. 244,000,000
Change from enacted level ......................................................... +5,000,000
Change from budget request ...................................................... –––
These funds provide mandatory benefits under the Federal Em-
ployees’ Compensation Act.
SPECIAL BENEFITS FOR DISABLED COAL MINERS
Appropriation, fiscal year 2021 ......................................................... $40,970,000
Budget request, fiscal year 2022 ....................................................... 32,970,000
Committee Recommendation ............................................................. 32,970,000
Change from enacted level ......................................................... ¥8,000,000
Change from budget request ...................................................... –––
These funds provide mandatory benefits to coal miners disabled
by black lung disease, to their survivors and eligible dependents,
and for necessary administrative costs.
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The Committee recommends $32,970,000 for Special Benefits for
Disabled Coal Miners. This amount is in addition to the
$14,000,000 appropriated in fiscal year 2021 as an advance for the
first quarter of fiscal year 2022. The total program level rec-
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32
ommendation is $8,000,000 less than the fiscal year 2021 enacted
level and the same as the fiscal year 2022 budget request.
The Committee recommendation also provides $11,000,000 as an
advance appropriation for the first quarter of fiscal year 2023.
These funds ensure uninterrupted payments to beneficiaries.
ADMINISTRATIVE EXPENSES, ENERGY EMPLOYEES OCCUPATIONAL
ILLNESS COMPENSATION FUND
Appropriation, fiscal year 2021 ......................................................... $62,507,000
Budget request, fiscal year 2022 ....................................................... 63,428,000
Committee Recommendation ............................................................. 63,428,000
Change from enacted level ......................................................... +921,000
Change from budget request ...................................................... –––
These funds provide mandatory benefits to eligible employees or
survivors of employees of the Department of Energy (DOE); its con-
tractors and subcontractors; companies that provided beryllium to
DOE; atomic weapons employees who suffer from a radiation-re-
lated cancer, beryllium-related disease, or chronic silicosis as a re-
sult of their work in producing or testing nuclear weapons; and
uranium workers covered under the Radiation Exposure Com-
pensation Act.
BLACK LUNG DISABILITY TRUST FUND
Appropriation, fiscal year 2021 ......................................................... $382,991,000
Budget request, fiscal year 2022 ....................................................... 331,505,000
Committee Recommendation ............................................................. 331,505,000
Change from enacted level ......................................................... ¥51,486,000
Change from budget request ...................................................... –––
The Black Lung Disability Trust Fund, supported with manda-
tory funding, pays black lung compensation, medical and survivor
benefits, and administrative expenses when no mine operator can
be assigned liability for such benefits, or when mine employment
ceased prior to 1970. The Black Lung Disability Trust Fund is fi-
nanced by an excise tax on coal, reimbursements from responsible
mine operators, and short-term advances from the Treasury. The
Emergency Economic Stabilization Act of 2008 authorized a re-
structuring of the Black Lung Disability Trust Fund debt and re-
quired that annual operating surpluses be used to pay down the
debt until all remaining obligations are retired.
Black Lung Benefits Claims Processing.—The Committee is con-
cerned with lengthy delays in the processing of Black Lung Bene-
fits Act claims, particularly where the mine operator’s ability to
pay the claim is in question. Delays impede access to necessary
medical care while claims are pending. The Committee supports ef-
forts by the Secretary to resolve these claims expediently to ensure
miners can receive the benefits and medical care they need. The
Committee requests that the Secretary provide an update on the
Department’s efforts to improve the speed and quality of its black
lung claims processing in the fiscal year 2023 Congressional Budg-
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et Justification.
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OCCUPATIONAL SAFETY AND HEALTH ADMINISTRATION
SALARIES AND EXPENSES
Appropriation, fiscal year 2021 ......................................................... $591,787,000
Budget request, fiscal year 2022 ....................................................... 664,624,000
Committee Recommendation ............................................................. 691,787,000
Change from enacted level ......................................................... +100,000,000
Change from budget request ...................................................... +27,163,000
The Occupational Safety and Health Act of 1970 established the
Occupational Safety and Health Administration (OSHA) to assure
safe and healthy working conditions by setting and enforcing
standards and by providing training, outreach, education and as-
sistance.
Within the total for OSHA, the Committee provides the following
amounts:
FY 2022
Budget Activity Committee
Safety and Health Standards ....................................................................................................................... $28,450,000
Federal Enforcement ....................................................................................................................................... 274,634,000
Whistleblower Programs ................................................................................................................................. 30,000,000
State Programs ............................................................................................................................................... 118,737,000
Technical Support ........................................................................................................................................... 26,394,000
Federal Compliance Assistance ..................................................................................................................... 86,175,000
State Consultation Grants .............................................................................................................................. 63,500,000
Training Grants .............................................................................................................................................. 14,787,000
Safety and Health Statistics .......................................................................................................................... 39,479,000
Executive Direction and Administration ......................................................................................................... 9,631,000
Compliance Safety and Health Officers (CSHOs).—The Com-
mittee is concerned about the significant reduction in OSHA Com-
pliance Safety and Health Officers (CSHOs) in recent decades rel-
ative to the number of workers they oversee. These CSHOs enforce
Federal workplace standards across the country, inspecting work-
sites and ensuring that employers comply with worker safety and
health regulations. That is why the Committee is strongly sup-
portive of OSHA’s plans to use additional resources to support and
rebuild OSHA’s enforcement program by hiring additional CSHOs.
The Committee encourages the agency to focus on employing and
retaining multilingual officers crucial to thorough inspections of
workplaces across the country.
Penalties.—The Committee notes that OSHA penalties are
among the lowest of any Federal agency and believes they are woe-
fully inadequate in deterring workplace health and safety viola-
tions by employers. For instance, despite widespread reports that
meatpacking facilities were becoming deadly COVID–19 hotspots
as early as March 2020, OSHA waited six months before issuing
two small financial penalties totaling $29,000 to a Smithfield and
a JBS plant. For context, in 2019, JBS’ annual revenue was $51.7
billion and Smithfield’s was $14 billion. To address these concerns,
Committee urges OSHA to adopt policies that encourage the use of
full penalties or a penalty multiplier for serious violations in large
businesses.
Whistleblower Protection Program.—The Committee is concerned
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with the increasing caseloads and unprecedented length of time
taken by OSHA to complete whistleblower investigations. OSHA’s
whistleblower investigative staff enforces protections for employees
who suffer retaliation for protected activity under more than 20
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34
statutes, and the number of statutes continues to increase with
three more added in the past two years. OSHA’s already-overbur-
dened Whistleblower Protection Program staff faced an unprece-
dented surge in complaints during the COVID–19 pandemic. Dur-
ing the first four months of the pandemic, the average number of
whistleblower complaints received per investigator increased by 30
percent—39 percent of these were COVID–19 related. At the same
time, the Whistleblower Protection Program’s FTEs decreased be-
tween 2019 to 2020 to only 120 investigators, causing an increase
in the number of cases handled by each investigator. The Office of
Inspector General concluded in August 2020 that when OSHA fails
to respond in a timely manner, it ‘‘could leave workers to suffer
emotionally and financially’’ and may lead to the erosion of evi-
dence needed for the case. To bolster the Whistleblower Protection
Program’s capacity to conduct critical investigations in a timely
manner in industries across the country and bring the agency clos-
er to compliance with statutory requirements of more than 20 stat-
utes, the Committee increases resources for the Whistleblower Pro-
tection program by $10,936,000 above the fiscal year 2021 enacted
level. This increase will support OSHA’s efforts to update its dec-
ades-old Whistleblower database to the current OSHA Information
System for OSHA’s main enforcement program or to develop a new
system.
Susan Harwood Training Grants.—The Susan Harwood Training
Grants to non-profit organizations reach workers in dangerous in-
dustries with critical education and training on workplace hazards
and statutory protections. The latest statistics from the Bureau of
Labor Statistics show that workplace fatalities are increasing for
Black workers and that fatality rates are higher among Latino and
Black workers. The Committee supports OSHA’s efforts to provide
funding to non-profit, community-based groups, and other non-prof-
it organizations with the capability to reach workers in low-wage
industries and workers in dangerous industries. In addition, the
Committee urges OSHA to allow grantees to train on multiple haz-
ards. In addition, the Committee encourages OSHA to support
grants for workers employed in disaster recovery and rebuilding
sectors.
U and T Visas.—The Committee strongly supports efforts by
OSHA to ensure all workers, regardless of immigration status, can
participate in OSHA investigations and exercise their workplace
rights. However, the Committee notes that OSHA does not, like
WHD, outline a process for U and T visa certification. The Com-
mittee encourages OSHA to evaluate the merits of establishing a
policy on U and T visa certification requests and consider assisting
workers with U and T visa certification.
COVID–19 Testing for Meatpacking Workers.—The Committee is
supportive of workplace health and safety procedures that include
adequate COVID–19 testing for meatpacking workers. Even before
the pandemic, meatpacking, poultry, and agriculture have been
dangerous industries for workers. The pandemic exacerbated these
hazards, which are disproportionately felt by workers of color.
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OSHA Noise Standard.—The Committee is aware that the Na-
tional Institute for Occupational Safety and Health (NIOSH) esti-
mates that 22 million US workers are exposed to potentially dan-
gerous levels of noise in the workplace every year and that hearing
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loss is the most commonly recorded occupational illness in manu-
facturing, accounting for 1 in 9 recordable illnesses. The Committee
is also aware that the OSHA Noise Standard for employers was es-
tablished in 1983, but has not been updated since that time even
as the Department of Defense (DoD), NIOSH, and many other
countries have recommended or adopted more protective noise ex-
posure limits. Accordingly, to better protect the American work-
force and reduce the risk of noise-induced hearing loss, the Com-
mittee encourages OSHA to lower the current permissible exposure
level to 85 dBA TWA using a 3 dB exchange rate. Such a change
would substantially reduce the excess risk of developing occupa-
tional noise-induced hearing loss over a working lifetime and be
consistent with current exposure limits specified by the DoD and
voluntarily adopted by many private employers.
Needlestick Safety.—The Committee recognizes the risks posed
by the COVID–19 pandemic to our nation’s essential healthcare
workforce as they continue to ensure the administration of FDA-ap-
proved COVID–19 vaccines. With the increase in demand for sy-
ringe-administered vaccines comes the increased risk of exposure
not only to COVID–19, but also to bloodborne pathogens including,
but not limited to, hepatitis B, hepatitis C and human immuno-
deficiency virus. OSHA should continue to work with the Depart-
ment of Health and Human Services (HHS) to monitor the supply
of safety-engineered devices for COVID–19 vaccinations. If OSHA
and HHS determine that there is a shortage of these devices, the
Committee requests that OSHA include cost estimates that will en-
sure the standards prescribed in the Needlestick Safety and Pre-
vention Act are enforced to the extent feasible in the fiscal year
2023 Congressional Budget Justification. The authorization in-
cludes a standard which states that employers are required to
evaluate, select, and use engineering controls to eliminate or mini-
mize exposure to contaminated sharps.
Occupational Heat Stress Protection Standard.—The Committee
recognizes the urgency of developing a workplace safety standard
to protect workers from excessive heat, and is aware that a stand-
ard has already proven to be feasible to implement, and in light of
rising temperatures urges OSHA to take all necessary steps to
issue a proposed occupational heat stress protection standard by
the end of fiscal year 2022. The Secretary is directed to submit a
schedule to the Committee within 90 days of enactment of this Act
on the action steps it will be taking to promulgate an occupational
heat stress protection standard.
MINE SAFETY AND HEALTH ADMINISTRATION
SALARIES AND EXPENSES
Appropriation, fiscal year 2021 ......................................................... $379,816,000
Budget request, fiscal year 2022 ....................................................... 447,201,000
Committee Recommendation ............................................................. 404,816,000
Change from enacted level ......................................................... +25,000,000
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Change from budget request ...................................................... ¥42,385,000
The Mine Safety and Health Administration (MSHA) enforces
the Federal Mine Safety and Health Act in underground and sur-
face coalmines and metal/non-metal mines.
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Coal, Metal, and Non-metal Mines.—MSHA is directed to include
in the fiscal year 2023 Congressional Budget Justification and all
future Congressional Budget Justifications historical and budget
year information on enforcement activities and outcomes, distin-
guishing between coal and metal/non-metal mines. To promote
transparency in agency spending on its enforcement activities,
MSHA shall continue to separately present annual spending on
coal and metal/non-metal mines as it has in past Congressional
Budget Justifications.
Resources and Activities.—The Committee notes significant work-
er dislocations and mine closures because of economic conditions
throughout the mining industry, and in coal mining in particular.
The Committee reiterates its support for the ongoing effort to bring
MSHA enforcement into proportion by redistributing resources and
activities to the areas where mine production is currently occurring
and where MSHA identifies the most significant safety hazards.
BUREAU OF LABOR STATISTICS
SALARIES AND EXPENSES
Appropriation, fiscal year 2021 ......................................................... $655,000,000
Budget request, fiscal year 2022 ....................................................... 700,653,000
Committee Recommendation ............................................................. 700,653,000
Change from enacted level ......................................................... + 45,653,000
Change from budget request ...................................................... –––
The Bureau of Labor Statistics (BLS) is an independent national
statistical agency that collects, processes, analyzes, and dissemi-
nates essential economic data to the Congress, Federal agencies,
State and local governments, businesses, and the public. Its prin-
cipal surveys include the Consumer Price Index and the monthly
unemployment series.
The Committee recommendation includes $632,653,000 from the
General Fund of the Treasury and $68,000,000 from the Employ-
ment Security Administration Account in the Unemployment Trust
Fund. Within the total amount for BLS, the Committee includes
$28,470,000 to continue the relocation of the BLS headquarters,
which was initiated in fiscal year 2020.
Within the total for BLS, the Committee provides the following
amounts:
FY 2022
Budget Activity Committee
Employment and Unemployment Statistics ................................................................................................... $221,000,000
Labor Market Information ............................................................................................................................... 68,000,000
Prices and Cost of Living .............................................................................................................................. 233,033,000
Compensation and Working Conditions ......................................................................................................... 89,875,000
Productivity and Technology ........................................................................................................................... 12,375,000
Executive Direction and Staff Services .......................................................................................................... 66,329,000
National Longitudinal Survey of Youth (NLSY).—The Committee
is supportive of BLS’ plan for the planning, development, and im-
plementation of a new NLSY cohort and provides sufficient re-
sources to implement this plan without delay. Specifically, the
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Committee supports the Department’s plan to increase spending on
the new NLSY cohort in fiscal year 2023 to $14,500,000 and re-
quests an update on future spending plans in the fiscal year 2023
Congressional Budget Justification.
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37
Preserving Existing Statistical Work and Staff.—When imple-
menting the NLSY and other new investments, the Committee di-
rects BLS not to reduce or eliminate existing statistical work. Fur-
ther, the Committee directs BLS not to reduce the number of full-
time equivalent positions beyond the apportioned fiscal year 2021
full-time equivalent ceiling.
Artificial Intelligence.—The Committee is aware of the develop-
ment of artificial intelligence and encourages BLS to examine this
trend’s impact on the economy.
Job Openings and Labor Turnover Survey (JOLTS).—The Com-
mittee recognizes the need for enhancements to JOLTS to better
understand national labor market dynamics. Therefore, the Com-
mittee requests for the Department to provide cost estimates in the
fiscal year 2023 Congressional Budget Justification for expanding
the JOLTS sample level and for releasing JOLTS data monthly to
improve timeliness.
OFFICE OF DISABILITY EMPLOYMENT POLICY
SALARIES AND EXPENSES
Appropriation, fiscal year 2021 ......................................................... $38,500,000
Budget request, fiscal year 2022 ....................................................... 42,711,000
Committee Recommendation ............................................................. 42,711,000
Change from enacted level ......................................................... +4,211,000
Change from budget request ...................................................... –––
The Office of Disability Employment Policy (ODEP) provides pol-
icy guidance and leadership to eliminate employment barriers to
people with disabilities.
The Committee recommendation for ODEP is $42,711,000, which
is $4,211,000 above the fiscal year 2021 enacted level and the same
as the fiscal year 2022 budget request. The Committee is sup-
portive of the budget proposal for ODEP to invest in research and
demonstration projects related to testing effective ways to promote
greater labor force participation of people with disabilities.
DEPARTMENTAL MANAGEMENT
SALARIES AND EXPENSES
Appropriation, fiscal year 2021 ......................................................... $349,364,000
Budget request, fiscal year 2022 ....................................................... 439,970,000
Committee Recommendation ............................................................. 457,219,000
Change from enacted level ......................................................... +107,855,000
Change from budget request ...................................................... +17,249,000
The Departmental Management appropriation provides funds for
the staff responsible for Departmental operations, management,
and policy development.
The Committee recommendation includes $456,911,000 from the
General Fund of the Treasury, $107,855,000 above the fiscal year
2021 enacted level and $17,249,000 above the fiscal year 2022
budget request, and $308,000 from the Employment Security Ad-
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ministration Account in the Unemployment Trust Fund.
Within the total for Departmental Management, the Committee
provides the following amounts:
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FY 2022
Budget Activity Committee
Program Direction and Support ..................................................................................................................... $35,023,000
Departmental Evaluation ................................................................................................................................ 10,040,000
Legal Services ................................................................................................................................................ 154,629,000
International Labor Affairs ............................................................................................................................. 136,000,000
Administration and Management ................................................................................................................... 39,308,000
Adjudication .................................................................................................................................................... 41,013,000
Women’s Bureau ............................................................................................................................................. 25,000,000
Civil Rights Activities ..................................................................................................................................... 10,344,000
Chief Financial Officer ................................................................................................................................... 5,862,000
International Labor Affairs Bureau (ILAB).—Of the $136,000,000
recommended for the International Labor Affairs Bureau (ILAB),
the Committee directs the Secretary to allocate not less than
$40,175,000 in grants to build the capacity of countries to enforce
labor rights to promote a more level playing field for workers in the
U.S. The Committee directs ILAB to use its fiscal year 2022 fund-
ing increase to place additional labor attaches in strategic countries
focused on fundamental worker rights such as freedom of associa-
tion, collective bargaining, protection from sex discrimination, and
acceptable conditions of work. The Committee urges ILAB to
prioritize these additional attaches in areas of strategic importance
such as Honduras, Guatemala, Vietnam, and Bangladesh.
Flagship Reports on Child Labor and Forced Labor.—ILAB is di-
rected to continue its work on three key reports, including: DOL’s
Findings on the Worst Forms of Child Labor; the List of Goods Pro-
duced by Child Labor or Forced Labor; and, the List of Products
Produced by Forced or Indentured Child Labor. The Committee in-
cludes the resources requested in the fiscal year 2022 budget re-
quest for staff and contract costs to fulfill a new statutory mandate
requiring the List of Goods Produced by Child Labor or Forced
Labor to include goods that are produced with inputs that are pro-
duced with forced labor or child labor.
USMCA Implementation Act.—The Committee urges ILAB to use
USMCA Implementation Act funding to directly support workers’
rights and capacity to organize independent unions in Mexico.
These activities must be central to ILAB’s monitoring, enforcement,
and capacity-building roles in USMCA implementation. ILAB can
also advance this critical work through technical assistance that
strengthens the capacity of independent unions in USMCA priority
sectors. Further, ILAB can fund research and legal teams, includ-
ing through academic institutions, to develop sustainable programs
that train and support labor lawyers and researchers in priority
sectors. Finally, ILAB can support key USMCA objectives by fund-
ing innovative supply chain monitoring and accountability mecha-
nisms, focused on ensuring the effective recognition of workers’
rights to organize and collective bargaining in USMCA priority sec-
tors. Such efforts to develop necessary research, legal assistance
and monitoring mechanisms will collectively supplement and
strengthen core ILAB program to directly educate and train work-
ers to build independent unions.
In the fiscal year 2023 Congressional Budget Justification, ILAB
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is directed to include spending plans for resources provided in the
USMCA Implementation Act for fiscal years 2020 through 2023.
Spending plans should include descriptions and amounts for
projects and staffing.
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Sex Discrimination in Employment and the Workplace.—The
Committee recognizes the vital role ILAB plays in building the ca-
pacity of other countries to enforce and improve labor protections
for workers and in enforcing the labor provisions of U.S. trade
agreements and preference programs; however, the Committee is
concerned that the issue of sex discrimination has not received
enough attention in the Bureau’s capacity-building, monitoring,
and enforcement activities. It is essential that workers around the
world are protected from pregnancy- and maternity-based discrimi-
nation, discriminatory recruitment and hiring, and the manifesta-
tion of unconscious bias in the workplace. Further, many female
workers receive unequal access to training opportunities and work
schedules that prevent them from acting as primary care givers
and accepting positions that would help them advance. In addition,
the Committee is concerned by the complete absence of gender
mainstreaming in labor inspections; lack of labor inspector training
on best practices for identifying and addressing sex discrimination;
and inadequate complaint mechanisms for women to anonymously
report sex discrimination in employment and the workplace. Fi-
nally, the Committee believes workers should receive equal pay for
work of equal value. In response, the Committee urges ILAB to
prioritize these areas of concern through its capacity-building, mon-
itoring, and enforcement efforts.
Child Labor in Cocoa.—The Committee is concerned about the
continued prevalence of child labor in the harvesting and produc-
tion of cocoa beans. Further, the Committee notes that while the
Child Labor Cocoa Coordinating Group (GLCCG) has facilitated
progress in the reduction of child labor in cocoa production, sub-
stantial levels of children remain engaged in child labor in the in-
dustry. The Committee is concerned about the progress of the
GLCCG in accordance with goals established in the Harkin-Engel
Protocol. The Committee encourages the Department to report on
indicators of progress being made by high-risk countries to elimi-
nate child labor and forced labor in the cocoa sector, including
progress being made to map all cocoa farms. In addition, the Com-
mittee encourages the Department to report on government and in-
dustry use of available best practices for management, reporting,
and verification, and on the active and meaningful participation of
worker organizations in order to provide consumers with assurance
that cocoa products are produced without the use of child labor and
forced labor.
Women’s Bureau.—Of the $25,000,000 appropriated to the Wom-
en’s Bureau, the Committee provides no less than $6,794,000 for
the Women in Apprenticeship and Nontraditional Occupations
(WANTO) program, which is $5,000,000 above the fiscal year 2021
enacted level and the fiscal year 2022 budget request. This pro-
gram helps employers and labor unions recruit, train, and retain
women for nontraditional employment opportunities. These re-
sources are essential in helping women overcome traditional bar-
riers to entry and supporting women’s full participation in the
labor force.
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Women’s Unemployment.—The Committee is concerned by the
dramatic increase in the unemployment rate for women as a result
of the COVID–19 pandemic. The Committee encourages the Wom-
en’s Bureau to make it an agency-wide priority to mitigate and re-
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40
verse this trend in fiscal year 2022. Additionally, the Committee is
supportive of the recommendations from GAO’s report on the gen-
der pay gap in the federal workforce (GAO–21–67) and is sup-
portive of GAO’s ongoing work to identify improvements regarding
measures taken by the Department of Labor to mitigate women’s
unemployment, including the immediate and long-term effects of
COVID–19 on women’s employment. The Committee is interested
in the impacts of COVID–19 on unemployment rates for low-income
women and women of color, groups that have been disproportion-
ately impacted by the pandemic
Operating Plan.—The Committee directs the Department to sub-
mit its annual Operating Plan to the Committees on Appropria-
tions within the 45-day statutory deadline.
Advertising Spending.—The Committee understands that, as the
largest advertiser in the U.S., the Federal Government should
work to ensure fair access to its advertising contracts for small dis-
advantaged businesses and businesses owned by minorities and
women. The Committee directs the Department to include the fol-
lowing information in its fiscal year 2023 Congressional Budget
Justification: Expenditures for fiscal year 2021 and expected ex-
penditures for fiscal years 2022 and 2023, respectively, for (1) all
contracts for advertising services; and, (2) contracts for the adver-
tising services of (I) socially and economically disadvantaged small
business concerns (as defined in section 8(a)(4) of the Small Busi-
ness Act (15 U.S.C. 637(a)(4)); and (II) women- and minority-owned
businesses.
Employees.—The Committee directs the Department to provide a
report not later than 30 days after the conclusion of each quarter
detailing the number of full-time equivalent employees and attri-
tion by principal office and appropriations account.
Investments in Impoverished Areas.—The Committee supports
targeted investments in impoverished areas, particularly in per-
sistent poverty counties and in other high poverty census tracts. To
understand how programs funded through the Department are
serving these particular areas, the Committee directs the Depart-
ment to submit a report to the Committees on Appropriations on
the percentage of funds allocated by all competitive grant programs
in fiscal years 2019, 2020 and 2021 to serve individuals living in
persistent poverty counties, as defined as a county that has had 20
percent or more of its population living in poverty over the past 30
years, as measured by the 1990 and 2000 decennial censuses and
the most recent Small Area Income and Poverty estimates, or any
territory or possession of the United States, and high-poverty
areas, as defined as any census tract with a poverty rate of at least
20 percent as measured by the 2014–2018 5-year data series avail-
able from the American Community Survey of the Census Bureau.
The Department shall report this information to the Committees
within 90 days of such data being available and provide a briefing
to the Committees not later than 180 days of enactment of this Act
on how the Department is carrying out this directive. In the case
of any competitive program for which at least 10 percent of the
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funds allocated were not allocated to persistent poverty counties or
for which the percentage allocated to high-poverty areas in fiscal
year 2020 or 2021 was less than the average percentage of Federal
assistance allocated to high-poverty areas awarded under the pro-
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41
gram in fiscal years 2017, 2018, and 2019, such report and briefing
shall explain why such a benchmark is unable to be met.
Evidence-based Policymaking Act.—The Committee is supportive
of efforts by the Department to consider evidence of effectiveness
in grant competitions and requests an update in the fiscal year
2023 Congressional Budget Justification on implementation of the
Foundations for Evidence-based Policymaking Act (P.L. 115–435)
and implementation plans for the coming year. The Committee en-
courages the Secretary to develop guidance to ensure relevant par-
ticipants and grantees are involved in the Department-wide process
of prioritizing evidence needs, including participating in Depart-
ment led evaluations. Consistent with program statutes, the Com-
mittee encourages the Secretary to ensure that evidence of effec-
tiveness is a consideration in grant opportunities.
Organizational Priority Goals.—The Committee directs the De-
partment to comply with title 31 of the United States Code, includ-
ing the development of organizational priority goals and outcomes
such as performance outcome measures, output measures, effi-
ciency measures, and customer service measures. The Committee
further directs the Department to include an update on the
progress of these efforts in the fiscal year 2023 Congressional
Budget Justification.
Streamlining Service Delivery and Improving Customer Service.—
The Committee continues to support efforts to improve customer
service in accordance with Executive Order 13571—Streamlining
Service Delivery and Improving Customer Service. The Committee
directs the Secretary to develop standards to improve customer
service and incorporate the standards into the performance plans
required under 31 U.S.C. 1115. The Committee further directs the
Department to include an update on the progress of these efforts
in the fiscal year 2023 Congressional Budget Justification.
Use of Force.—The Committee supports vigorous action to im-
prove training for all Federal, State, and local law enforcement offi-
cers on racial profiling, implicit bias, procedural justice, the use of
force, and the duty for officers to intervene when witnessing the
use of excessive force against civilians. The Committee therefore di-
rects the Secretary to work with the Attorney General and the Fed-
eral Law Enforcement Training Centers to implement improved,
mandatory training on these topics for all federal law enforcement
officers, along with the development of related standards that can
be applied in hiring and performance assessments. These training
requirements and standards should be based on the related provi-
sions in H.R. 1280, as passed by the House of Representatives in
March 2021.
The Committee directs the Department’s Division of Protective
Operations, to the extent it has not already done so, to submit its
use of force data to the Federal Bureau of Investigation’s National
Use of Force Data Collection database. The Committee requests a
briefing within 90 days of enactment of this Act on current efforts
to tabulate and submit use of force data to the FBI.
Inter-agency Collaboration.—The Committee identifies a need for
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more inter-agency collaboration between the Department (including
WHD and OSHA), Equal Employment Opportunity Commission,
and the National Labor Relations Board to enforce labor and civil
rights laws fully and effectively. The Committee encourages the
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agencies to review and evaluate current enforcement efforts, re-
scind harmful regulations and sub-regulatory guidance, and ensure
each agency is using all the tools and policies at their disposal to
protect workers. This includes robust coordinated outreach and
education to rebuild trust in government enforcement, especially in
communities of color.
Critical Minerals.—The Committee recognizes the importance of
critical minerals for use in the United States. In response to this
growing need, as part of the Consolidated Appropriations, Act of
2021, Congress authorized in section 7002 a workforce assessment
and workforce development program in the Department of Labor to
address mineral security. The Committee requests an update on
these efforts in the fiscal year 2023 Congressional Budget Justifica-
tion.
Family-Friendly Workplaces Certification.—The Committee rec-
ognizes the importance of promoting family-friendly workplaces.
The pandemic has placed an unexpected burden on working par-
ents, particularly working mothers who have left the labor force in
disproportionate numbers since March 2020. Therefore, the Com-
mittee directs the Secretary to evaluate the feasibility of estab-
lishing a certification program that recognizes exemplary family-
friendly businesses and incentivizes businesses to adapt best prac-
tices that reflect the challenges faced by working parents. Modeled
off the Environmental Protection Agency’s Energy Star Program,
this Family-Friendly Workplaces Certification would evaluate busi-
nesses based on a number of policies including; paid sick days, paid
family leave of at least 12 weeks per year, childcare subsidies, lac-
tation support, assistance paying for or referring employees to fer-
tility or adoption services, and accommodations for pregnant work-
ers. The Committee directs the Secretary to submit this feasibility
report within 270 days of enactment of this Act.
VETERANS EMPLOYMENT AND TRAINING
Appropriation, fiscal year 2021 ......................................................... $316,341,000
Budget request, fiscal year 2022 ....................................................... 324,831,000
Committee Recommendation ............................................................. 334,841,000
Change from enacted level ......................................................... +18,490,000
Change from budget request ...................................................... +10,000,000
The recommendation includes $67,500,000 from the General
Fund of the Treasury and $267,331,000 from the Employment Se-
curity Administration Account in the Unemployment Trust Fund.
The Veterans Employment and Training (VETS) program serves
America’s veterans and separating service members by preparing
them for meaningful careers, providing employment resources and
expertise, and protecting their employment rights.
Within the total for VETS, the Committee provides the following
amounts:
FY 2022
Budget Activity Committee
State Administration Grants .......................................................................................................................... $180,000,000
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Transition Assistance Program ...................................................................................................................... 31,379,000
Federal Administration ................................................................................................................................... 52,538,000
Veterans Employment and Training Institute ................................................................................................ 3,414,000
Homeless Veterans Reintegration Program .................................................................................................... 67,500,000
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The Committee recommendation includes $31,379,000 for the
Transition Assistance Program, which is the same as the fiscal
year 2021 enacted level and the fiscal year 2022 budget request.
This funding will enhance the quality of employment support serv-
ices for transitioning service members and allow VETS to develop
and implement a course curriculum to help military spouses over-
come the challenges they face related to employment and career de-
velopment.
The Committee includes $67,500,000 for the Homeless Veterans
Reintegration Program, which is $10,000,000 more than the fiscal
year 2021 enacted level and the fiscal year 2022 budget request.
Funds will be used to further support the needs of veterans experi-
encing homelessness.
The Committee includes $500,000, which is the same as the fis-
cal year 2021 enacted level and the fiscal year 2022 budget request,
to support the HIRE Vets Medallion Program authorized by the
Honoring Investments in Recruiting and Employing American Mili-
tary Veterans Act of 2017.
The Committee recommendation includes $300,000 within Fed-
eral Administration, which is the same as the fiscal year 2021 en-
acted level to continue the operation of the Disabled Veteran Pro-
gram (DVP), which was initiated by the Committee in fiscal year
2020. The DVP addresses the high unemployment and low labor
force participation rate of veterans with service-connected and non-
service-connected disabilities. The DVP helps increase employment
and advancement opportunities for veterans with disabilities by
working with Federal, State, and private partners to promote the
hiring of veterans with disabilities, improve coordination of avail-
able employment services and supports, and to identify and share
employment best practices for hiring, retaining, and advancing vet-
erans with disabilities in the workforce.
Equity and Access for Homeless Veterans.—The Committee di-
rects the Department to include an update on racial equity and ac-
cess to programs at the Department providing services to homeless
veterans in its fiscal year 2023 Congressional Budget Justification.
The update shall also track departmental expenditures within the
Homeless Veteran Programs, specifically with regard to minority,
female, and LGBTQ populations. Where available, the Department
shall disaggregate data by ethnicity, age, gender identity, and dis-
charge status.
Military Spouse Occupational License and Certification Port-
ability.—The Committee encourages the Department of Labor to
work with states to encourage them to implement occupational li-
cense and certification portability measures for military spouses
through full license recognition. The current framework for license
and certification portability often poses a barrier to employment,
and this is particularly problematic for military spouses as they
frequently are required to relocate due to the nature of their
spouse’s military employment. The number of jobs that require a
license has steeply risen from 5 percent in the 1950s to 30 percent
today. The increase in licensing requirements and frequent moves
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contribute to the high unemployment rate of military spouses, cur-
rently at 24 percent. Addressing this issue demonstrates the Com-
mittee’s appreciation for the service of military members and the
sacrifices their families make on a daily basis.
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Veterans’ Pilot Program.—The Committee encourages the De-
partment to pilot an accelerated veteran transition program in re-
gions surrounding military installations in the United States, in-
clusive of exiting soldiers and retired veterans. The pilot program
would utilize funding under this account for direct services to sup-
port veterans and transitioning military members into in-demand
civilian occupations aligned with their military training and experi-
ence. This project is needed as available veteran resources do not
fully pay for school, transitional benefits (in terms of training), or
target regional career/trade demands. While transitioning soldiers
have access to available resources, those sources do not offer the
job-placement-centric approach that this program would prioritize.
Additionally, existing allocation from the Workforce Innovation and
Opportunity Act (WIOA) resources does not fund certificate edu-
cation in prospective targeted occupations.
INFORMATION TECHNOLOGY MODERNIZATION
Appropriation, fiscal year 2021 ......................................................... $ 27,269,000
Budget request, fiscal year 2022 ....................................................... 37,269,000
Committee Recommendation ............................................................. 37,269,000
Change from enacted level ......................................................... +10,000,000
Change from budget request ...................................................... –––
Information Technology (IT) Modernization provides a dedicated
source of funding for Department-wide IT modernization projects
together with funding through the Department’s Working Capital
Fund.
OFFICE OF INSPECTOR GENERAL
Appropriation, fiscal year 2021 ......................................................... $90,847,000
Budget request, fiscal year 2022 ....................................................... 95,398,000
Committee Recommendation ............................................................. 95,398,000
Change from enacted level ......................................................... +4,551,000
Change from budget request ...................................................... –––
The Office of Inspector General (OIG) conducts audits of Depart-
ment programs and operations in order to determine that they
comply with the applicable laws and regulations, that they use re-
sources effectively, and that they are achieving their intended re-
sults.
The recommendation includes $89,738,000 from the General
Fund of the Treasury, which is $4,551,000 more than the fiscal
year 2021 enacted level and the same as the fiscal year 2022 budg-
et request, and $5,660,000 from the Employment Security Adminis-
tration Account in the Unemployment Trust Fund.
Pandemic Unemployment Assistance.—The PUA program was de-
signed to ensure that critical emergency assistance was delivered
immediately, so it would be available to unemployed workers when
it was most needed. It is important to ensure that resources for
such critical emergency assistance during simultaneous public
health crisis and financial crisis should be targeted to individuals
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and families who are eligible for benefits. The Committee supports
the Inspector General’s oversight activities and efforts to inves-
tigate any illegal schemes to defraud the PUA program.
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GENERAL PROVISIONS
Sec. 101. The Committee continues a provision to prohibit the
use of Job Corps funds for the salary of an individual at a rate in
excess of Executive Level II.
(TRANSFER OF FUNDS)
Sec. 102. The Committee continues a provision regarding trans-
fer authority.
Sec. 103. The Committee continues a prohibition on use of funds
to purchase goods that are in any part produced by indentured chil-
dren.
Sec. 104. The Committee continues a provision related to grants
made from funds available to the Department under the American
Competitiveness and Workforce Improvement Act.
Sec. 105. The Committee continues a provision to prohibit recipi-
ents of funds provided to the Employment and Training Adminis-
tration from using such funds for the compensation of any indi-
vidual at a rate in excess of Executive Level II.
(TRANSFER OF FUNDS)
Sec. 106. The Committee continues a provision providing the Sec-
retary with the authority to transfer funds made available to the
Employment and Training Administration to Program Administra-
tion for technical assistance and program integrity activities.
(TRANSFER OF FUNDS)
Sec. 107. The Committee continues a provision allowing up to
0.75 percent of discretionary appropriations provided in this Act for
specific Department of Labor agencies to be used by the Office of
the Chief Evaluation Officer for evaluation purposes consistent
with the terms and conditions in this Act applicable to such office.
Sec. 108. The Committee continues a provision relating to sur-
plus property and apprenticeship programs.
Sec. 109. The Committee modifies a provision relating to the Sec-
retary’s security detail.
Sec. 110. The Committee continues a provision relating to the
Treasure Island Job Corps Center.
Sec. 111. The Committee continues a provision relating to Job
Corps.
Sec. 112. The Committee includes a new provision relating to the
Working Capital Fund.
Sec. 113. The Committee includes a new provision relating to the
Consolidated Appropriations Act, 2021 to clarify the availability of
funds provided under Section 118(a) of division BB.
Sec. 114. The Committee includes a new provision relating to the
Wagner-Peyser Act Staffing Flexibility regulation.
Sec. 115. The Committee includes a new provision relating to
regulations pertaining to industry recognized apprenticeship pro-
grams.
Sec. 116. The Committee includes a new provision relating to
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processing of Applications for Temporary Employment Certification
for certain industries.
Sec. 117. The Committee includes a new provision relating to the
determination of prevailing wages.
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Sec. 118. The Committee includes a new provision relating to
processing of Applications for Temporary Employment Certification
for employers with violations of labor laws.
TITLE II—DEPARTMENT OF HEALTH AND HUMAN
SERVICES
HEALTH RESOURCES AND SERVICES ADMINISTRATION
Appropriation, fiscal year 2021 ......................................................... $7,207,234,000
Budget request, fiscal year 2022 ....................................................... 7,813,294,000
Committee Recommendation ............................................................. 8,723,922,000
Change from enacted level ......................................................... +1,516,688,000
Change from budget request ...................................................... +910,628,000
The Health Resources and Services Administration (HRSA) sup-
ports programs that provide health services to disadvantaged,
medically underserved, and special populations; decrease infant
mortality rates; assist in the education of health professionals; and
provide technical assistance regarding the utilization of health re-
sources and facilities.
The Committee recommendation for HRSA includes
$8,723,922,000 in discretionary budget authority, $316,778,000 in
mandatory funding and $16,200,000 in trust fund appropriations
for the Vaccine Injury Compensation Program Trust Fund, and
$5,000,000 for the Countermeasures Injury Compensation Pro-
gram.
PRIMARY HEALTH CARE
Appropriation, fiscal year 2021 ......................................................... $1,683,772,000
Budget request, fiscal year 2022 ....................................................... 1,733,772,000
Committee Recommendation ............................................................. 1,831,772,000
Change from enacted level ......................................................... +148,000,000
Change from budget request ...................................................... +98,000,000
Health Centers
The Committee recommends $1,830,772,000 for the Health Cen-
ters program, $148,000,000 above the fiscal year 2021 enacted level
and $98,000,000 above the fiscal year 2022 budget request. Health
Centers deliver affordable, accessible, quality, and cost-effective
primary health care to millions of people across the country regard-
less of their ability to pay. Programs supported by this funding in-
clude community health centers, migrant health centers, health
care for the homeless, school-based, and public housing health serv-
ice grants.
In addition, the American Rescue Plan (P.L. 117–2) included
$7,600,000,000 in discretionary appropriations to support Health
Centers’ response to the COVID–19 pandemic.
The Committee includes bill language providing up to
$120,000,000 for the Federal Tort Claims Act program, the same
as the fiscal year 2021 enacted level and the fiscal year 2022 budg-
et request.
Alcee L. Hastings Program for Advanced Cancer Screening in Un-
derserved Communities.—The Committee is extremely concerned
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about the disparity in cancer screening—and corresponding higher
levels of cancer incidence and adverse outcomes—in medically un-
derserved communities. Several studies have demonstrated that
this problem has only been made worse by the pandemic. The Com-
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47
mittee includes $25,000,000 to fund Health Centers to increase ac-
cess and address barriers to cancer screening, including patient
education, case management, outreach, and other enabling serv-
ices. Grantees must partner and coordinate closely with NCI-des-
ignated cancer centers to deploy cancer-center trained and super-
vised outreach specialists and navigators to improve cancer screen-
ing and referrals among vulnerable populations in their catchment
areas.
Ending the HIV Epidemic (EHE) Initiative.—The Committee pro-
vides $152,250,000 within the Health Centers program for the
EHE Initiative, $50,000,000 above the fiscal year 2021 enacted
level and the same as the fiscal year 2022 budget request. This ini-
tiative provides funding to Health Centers in high-need jurisdic-
tions to increase the use of pre-exposure prophylaxis (PrEP) among
people at high risk for HIV transmission.
Health Center Dental Services.—The Committee recognizes the
importance of Health Centers in providing comprehensive primary
and preventive health services to the nation’s underserved commu-
nities. Health Centers provide dental services for many who would
otherwise face barriers to dental care. The Committee is aware
that some Health Centers have partnered with Community Dental
Health Coordinators (CDHCs) to provide patients with greater ac-
cess to dental care. CDHCs provide community-based prevention,
care coordination, and patient navigation to underserved popu-
lations in rural, urban, and Native American communities. The
Committee encourages HRSA to work with Health Centers to ex-
pand their work in this area.
Health Center Mental Health Services for Children.—The Com-
mittee is concerned about the many challenges faced by children in
need of mental health services because of the COVID–19 pandemic.
The pandemic has had serious impacts on children’s mental, psy-
chological, and emotional well-being, especially in low-income and
minority communities. This impact will likely last for an extended
period. The Committee strongly encourages HRSA to provide fund-
ing to Health Centers to support vital mental health services for
children.
School-Based Health Centers (SBHCs) and Health Center Serv-
ices at School-Based Sites.—Recognizing the critical role of Health
Centers as part of our nation’s health care safety net, and that
Health Centers providing services at sites located at schools within
the communities they serve are currently one of the most effective
sources of mental health care for children and adolescents, the
Committee includes a total increase of $50,000,000 within the total
for Health Centers to support the delivery of health care services
at school-based sites. The Committee includes $25,000,000 to make
grants to establish new school-based health centers and expand
services at SBHCs pursuant to 42 USC 280h-5. SBHCs provide a
convenient access point to high-quality, comprehensive primary
health care, mental health services, preventive care, social services,
and youth development to primarily children and adolescents from
low-income families. The Committee also includes $25,000,000, an
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increase of $20,000,000 above the fiscal year 2021 enacted level, for
awards to Health Centers operating at school-based sites to in-
crease their capacity to meet the increasing demand for health
services, including mental health services. The Committee encour-
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ages HRSA to award grants to applicants that previously sub-
mitted fundable applications under HRSA–21–093 but that did not
receive such funding.
Health Center Controlled Networks.—Health Center Controlled
Networks (HCCNs) are the foundation of health information tech-
nology (HIT) services for the nation’s community health centers.
Health Centers function as the largest primary care network in the
country, caring for 30 million patients. HCCNs are voluntary asso-
ciations of community health centers that band together to invest
in HIT tools, optimize the use of these technologies, digitally con-
nect to health care and community partners, and more. The HIT
infrastructure requires robust federal investment to support the de-
mand caused by the COVID–19 pandemic’s resulting shift in how
health care is provided. The Committee strongly supports the work
of HCCNs.
HRSA Strategy to Address Intimate Partner Violence and Project
Catalyst.—The Committee includes no less than $2,000,000 for the
HRSA Strategy to Address Intimate Partner Violence, an increase
of $500,000 over the fiscal year 2021 enacted level and the fiscal
year 2022 budget request. The Committee encourages HRSA to
support training, technical assistance, and resource development to
assist public health and health care professionals to better serve
individuals and communities impacted by intimate partner vio-
lence.
Native Hawaiian Health Care Program.—The Committee pro-
vides $22,000,000 within the total for Health Centers for the Na-
tive Hawaiian Health Care Program, $1,500,000 above the fiscal
year 2021 enacted level and the fiscal year 2022 budget request.
The Native Hawaiian Healthcare Systems help improve the health
status of Native Hawaiians by making health education, health
promotion, disease prevention, and Native Hawaiian traditional
healing services available.
The Committee understands the importance of ensuring that in-
digenous people, including Native Hawaiians, have access to health
care. The Committee requests a report from the Government Ac-
countability Office (GAO) on the status of health care accessibility
and affordability for Native Hawaiians living in Hawaii, to include
the rural and medically underserved islands.
Free Clinics Medical Malpractice
The Committee includes $1,000,000 for carrying out responsibil-
ities under the Federal Tort Claims Act, the same as the fiscal year
2021 enacted level and the fiscal year 2022 budget request. The
program provides medical malpractice coverage to individuals in-
volved in the operation of free clinics to expand access to health
care services to low-income individuals in medically underserved
areas.
HEALTH WORKFORCE
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Appropriation, fiscal year 2021 ......................................................... $1,224,006,000
Budget request, fiscal year 2022 ....................................................... 1,380,384,000
Committee Recommendation ............................................................. 1,564,876,000
Change from enacted level ......................................................... +340,870,000
Change from budget request ...................................................... +184,492,000
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The Bureau of Health Workforce strengthens the health care
workforce by providing grants, scholarships, and loan repayment
programs to help communities recruit and retain health care pro-
viders where they are most needed.
In addition to the amounts above, the American Rescue Plan
(P.L. 117–2) included $1,000,000,000 in discretionary appropria-
tions to support health workforce programs in response to the
COVID–19 pandemic.
The Committee bill strikes language prohibiting HRSA funds
from being used to support alternative dental providers. Dental
therapists are licensed providers who play a similar role in den-
tistry to that of physician assistants in medicine, and work under
the supervision of a dentist to provide routine dental care like
exams and fillings. Ending this prohibition on funding will give
States flexibility to expand the oral health workforce and improve
access to dental care, particularly in rural and underserved com-
munities.
National Health Service Corps (NHSC)
The Committee includes $185,000,000, an increase of $65,000,000
above the fiscal year 2021 enacted level and the same as the fiscal
year 2022 budget request, for NHSC to support competitive awards
to health care providers dedicated to working in underserved com-
munities in urban, rural, and tribal areas.
In addition to the amounts above, the American Rescue Plan
(P.L. 117–2) included $900,000,000 in discretionary appropriations
to support NHSC in response to the COVID–19 pandemic.
Loan Repayment for Opioid and Substance Use Disorder (SUD)
Treatment.—The Committee includes $155,000,000, $25,000,000
below the fiscal year 2022 budget request, for loan repayment for
clinicians that provide opioid and substance use disorder treat-
ment. Within this total, the Committee includes $15,000,000, the
same as the fiscal year 2021 enacted level and the fiscal year 2022
budget request, to support NHSC awards to participating individ-
uals that provide health services in IHS facilities, Tribally-Oper-
ated Health Programs, and Urban Indian Health Programs.
Maternity Care Target Areas (MCTAs).—The Committee includes
$5,000,000, an increase of $5,000,000 above the fiscal year 2021 en-
acted level and the same as the fiscal year 2022 budget request,
within NHSC to implement requirements contained in the Improv-
ing Access to Maternity Care Act, including establishing criteria for
and identifying MCTAs and collecting and publishing data on the
availability and need for maternity care health services in health
professional shortage areas.
National Health Service Corps Rural Demonstration Program.—
The Committee strongly supports the NHSC program for improving
access to quality care in rural and underserved areas. The Com-
mittee notes that rural communities continue to face acute work-
force challenges, with approximately five percent of incoming med-
ical students coming from rural areas and only one-third of NHSC
placements in rural communities. The Committee includes
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$25,000,000 within NHSC for a pilot program to evaluate the ben-
efit to patient access and practitioner recruitment and retention of
extending loan repayment for five years and $200,000 for providers
serving in rural areas that are part of a Health Professional Short-
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age Area. The Committee also directs HRSA to include an assess-
ment of program utilization and impact in the annual NHSC report
to Congress and to submit a final report after completion of the
pilot.
Health Professions Education and Training
The Committee includes $565,404,000 for Health Professions
Education and Training Programs authorized under title VII of the
PHS Act, $125,870,000 above the fiscal year 2021 enacted level and
$37,992,000 above the fiscal year 2022 budget request.
Addressing the Shortage of Behavioral Health Professionals.—
The Committee is concerned that increased gun violence and the
pandemic’s exacerbation of health disparities has unveiled an im-
mediate and desperate need for behavioral health professionals, in-
cluding social workers, psychologists, counselors, occupational
therapists, and psychiatrists. Neuropsychiatrists and advanced
practice behavioral nurses are specially trained to diagnose mood
disorders or biochemical imbalances. A HRSA report found that
there will be a shortage of 250,000 mental health professionals by
2025. The Committee directs HRSA to submit a report addressing
the scope of the shortage of behavioral health professionals, bar-
riers to careers in behavioral health, Federal support available, and
recommendations to Congress to address the shortage within 180
days of enactment of this Act.
Social Work Reinvestment Commission.—The Committee is
aware that millions of Americans are not receiving the mental, be-
havioral and social care services they need. The COVID–19 pan-
demic has increased the need for services. The nation’s 700,000 so-
cial workers are the largest provider of these services, so it is im-
perative that we ensure a robust social work workforce. As such,
the Committee directs HRSA in collaboration with SAMHSA, ACF,
OMH, and CMS, to conduct a study and to report to Congress and
the Secretary on policy issues related to social work recruitment,
retention, research and reinvestment. Not later than 18 months
after enactment of this Act, HRSA shall submit its findings and
recommendations regarding recommendations and strategies to en-
sure a sufficient and strong social work workforce.
Health Professions Training for Diversity
The Committee supports programs that improve the diversity of
the health care workforce. HRSA’s diversity pipeline programs, in-
cluding the Health Careers Opportunity Program, Centers for Ex-
cellence, Faculty Loan Repayment, Nursing Workforce Diversity,
and Scholarships for Disadvantaged Students, help advance patient
care and ensure opportunity for all health care providers.
Centers of Excellence (COEs).—The Committee includes
$31,711,000 for COEs, $8,000,000 above the fiscal year 2021 en-
acted level and $5,000,000 above the fiscal year 2022 budget re-
quest. This program provides grants to health professions schools
and other institutions to serve as resource and education centers
for the recruitment, training, and retention of underrepresented
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minority students and faculty. The Committee notes that COEs
educate a disproportionate share of health professionals from mi-
nority and underserved backgrounds and address the need for a di-
verse and culturally competent American health care workforce.
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Health Careers Opportunity Program (HCOP).—The Committee
includes $20,500,000 for HCOP, $5,500,000 above the fiscal year
2021 enacted level and $2,000,000 above the fiscal year 2022 budg-
et request. The Committee notes that HCOPs assist students from
minority and economically disadvantaged backgrounds navigate ca-
reers into the health professions. The Committee encourages HRSA
to continue its improvement of the diversity and distribution of
needed health care professionals through the National HCOP Acad-
emies.
Faculty Loan Repayment.—The Committee includes $2,310,000
for Faculty Loan Repayment, $1,120,000 above the fiscal year 2021
enacted level and the same as the fiscal year 2022 budget request.
This program provides loan repayment to health profession grad-
uates from disadvantaged backgrounds who serve as faculty at eli-
gible health professions academic institutions.
Scholarships for Disadvantaged Students (SDS).—The Com-
mittee includes $61,970,000 for SDS, $10,500,000 above the fiscal
year 2021 enacted level and $10,000,000 above the fiscal year 2022
budget request. This program provides grants to health professions
and nursing schools to provide scholarships to students from dis-
advantaged background who have financial need.
Within this total, the Committee includes $5,000,000, a
$2,500,000 increase over the fiscal year 2021 enacted level, for
grants to educate midwives to address the national shortage of ma-
ternity care providers, and specifically the lack of adequate diver-
sity in the maternity care workforce. This amount will double the
number of five-year grants first made available beginning in fiscal
year 2020.
Primary Care Training and Enhancement
The Committee includes $49,924,000, an increase of $1,000,000
above the fiscal year 2021 level and the fiscal year 2022 budget re-
quest, for Primary Care Training and Enhancement programs,
which support training and direct financial assistance for future
primary care clinicians, teachers, and researchers.
Eating Disorders Screening, Brief Intervention, Referral, and
Treatment (SBIRT).—The COVID–19 pandemic worsened eating
disorders across the nation, with one study reporting up to 76 per-
cent of respondents engaging in eating disorder behaviors. Despite
the medical and psychiatric acuity associated with eating disorders,
many patients remain undetected and untreated, as only 20 per-
cent of surveyed medical residency programs offer elective training
in eating disorders and only six percent require such training.
Within the total for Primary Care Training and Enhancement, the
Committee provides up to $1,000,000, in coordination with
SAMHSA’s National Center of Excellence for Eating Disorders, to
provide trainings for primary care health professionals to screen,
briefly intervene, and refer patients to treatment for the severe
mental illness of eating disorders, as authorized under section
13006 of the 21st Century Cures Act (P.L. 114–255).
Oral Health Training
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The Committee includes $42,673,000 for Oral Health Training,
$2,000,000 above the fiscal year 2021 enacted level and the fiscal
year 2022 budget request. Within the total, the Committee includes
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not less than $14,000,000 for Pediatric Dentistry Programs, an in-
crease of $2,000,000 above the fiscal year 2021 enacted level. The
Committee directs HRSA to provide continuation funding for sec-
tion 748 post-doctoral training grants initially awarded in fiscal
year 2020 and dental faculty loan repayment program (DFLRP)
grants initially awarded in fiscal years 2018 and 2021. The Com-
mittee directs HRSA to initiate a new pre-doctoral grant cycle, and
to initiate a new DFLRP grant cycle with a preference for pediatric
dentistry faculty supervising dental students or residents and pro-
viding clinical services in dental clinics located in dental schools,
hospitals, and community-based affiliated sites.
Interdisciplinary Community-Based Linkages
Area Health Education Centers (AHEC).—The Committee in-
cludes $50,000,000 for the AHEC program, an increase of
$6,750,000 above the fiscal year 2021 level and the fiscal year 2022
budget request. This program links university health science cen-
ters with community health service delivery systems to provide
education and training networks.
The Committee encourages HRSA to support AHEC oral health
projects that establish primary points of service and address the
need to help patients find treatment outside of hospital emergency
rooms. The Committee encourages HRSA to work with programs
that have already been initiated by some State dental associations
to refer emergency room patients to dental networks.
Geriatrics Workforce Enhancement Program (GWEP).—The Com-
mittee includes $52,737,000 for the GWEP program, an increase of
$10,000,000 above the fiscal year 2021 level and $6,200,000 above
the fiscal year 2022 budget request. This program supports train-
ing to integrate geriatrics into primary care delivery and develops
academic-primary care-community based partnerships to address
gaps in health care for older adults.
Mental and Behavioral Health Programs.—The Committee in-
cludes $43,916,000 for Mental and Behavioral Health Programs, an
increase of $6,000,000 above the fiscal year 2021 level.
Graduate Psychology Education (GPE).—Within the total for
Mental and Behavioral Health Programs, the Committee includes
$25,000,000, $6,000,000 above the fiscal year 2021 enacted level
and the same as the fiscal year 2022 budget request, for the inter-
professional GPE Program to increase the number of health service
psychologists trained to provide integrated services to high-need,
underserved populations in rural and urban communities. The
Committee recognizes the severe impact of COVID–19 on Ameri-
cans’ mental and behavioral health and urges HRSA to strengthen
investments in the training of health service psychologists to help
meet these demands.
Behavioral Health Workforce Education and Training
(BHWET).—The Committee includes $181,000,000 for the BHWET
Program, $69,000,000 above the fiscal year 2021 enacted level
$43,874,000 below the fiscal year 2022 budget request. This pro-
gram establishes and expands internships or field placement pro-
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grams in behavioral health serving populations in rural and medi-
cally underserved areas.
Adolescent Addiction Medicine and Addiction Psychiatry Work-
force.—The Committee applauds HRSA for issuing a funding solici-
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tation for the Addiction Medicine Fellowship (AMF) program and
the Mental and Substance Use Disorder Workforce Training Dem-
onstration, as both programs will build the capacity of our nation’s
addiction medicine physician workforce. However, the Committee
remains concerned by the lack of pediatric and adolescent addiction
medicine and addiction psychiatry expertise. Currently, there are
insufficient opportunities to effectively train a robust mental health
and substance use disorder (SUD) workforce. Only 75 of the na-
tion’s 179 accredited medical schools offer addiction medicine fel-
lowships, and only one program focuses on fellowship opportunities
for pediatric and adolescent addiction medicine and addiction psy-
chiatry. The Committee encourages HRSA to support fellowship
programs focused on increasing the number of board certified pedi-
atric and adolescent addiction medicine and addiction psychiatry
subspecialists.
Peer Support Specialists in the Opioid Use Disorder Workforce.—
Within the total for BHWET, the Committee includes $15,000,000,
an increase of $2,000,000 above the fiscal year 2021 enacted level
and the fiscal year 2022 budget request, to fund training, intern-
ships, and national certification for mental health and substance
abuse peer support specialists to create an advanced peer work-
force prepared to work in clinical settings.
Substance Use Disorder Treatment and Recovery (STAR) Loan
Repayment Program.—The Committee includes $28,000,000 for this
program, $12,000,000 above the fiscal year 2021 enacted level and
the same as fiscal year 2022 budget request. This program address-
es shortages in the SUD workforce by providing for the repayment
of education loans for individuals working in a full-time SUD treat-
ment job that involves direct patient care in either a Mental Health
Professional Shortage Area or a county where the overdose death
rate exceeds the national average.
An estimated 21 million Americans needed treatment for SUD in
2017, but only four million received any form of treatment. The Bu-
reau of Labor Statistics data has cited tremendous shortfalls in the
SUD treatment profession. Without strategic investments in the
SUD workforce, this gap will not close and more lives will be lost.
Funding is now needed to increase the ranks of a well-trained SUD
workforce in communities across America. Congress can save lives
by equipping the frontline professionals who prevent and treat ad-
diction, provide recovery support, and help reduce the negative con-
sequences associated with substance use. The Committee directs
HRSA to provide a report to the Committee on the progress and
implementation of this program within 180 days of enactment of
this Act.
Mental and Substance Use Disorder Workforce Training Dem-
onstration.—The Committee includes $34,000,000 for the Mental
and Substance Use Disorder Workforce Training Demonstration
program, $4,300,000 above the fiscal year 2021 enacted level and
the same as the fiscal year 2022 budget request. This program
makes grants to institutions, including but not limited to medical
schools and Federally-Qualified Health Centers (FQHCs), to sup-
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port training for medical residents and fellows in psychiatry and
addiction medicine, as well as nurse practitioners, physician assist-
ants, and others, to provide SUD treatment in underserved commu-
nities.
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National Center for Health Workforce Analysis (NCHWA)
The Committee includes $5,663,000, the same as the fiscal year
2021 enacted level and the fiscal year 2022 budget request, for the
NCHWA. This program collects and analyzes health workforce data
to provide information on health workforce supply and demand.
Public Health and Preventive Medicine Training Programs
The Committee includes $23,000,000 for Public Health and Pre-
ventive Medicine Training Grant Programs, $6,000,000 above the
fiscal year 2021 enacted level and $5,000,000 above the fiscal year
2022 budget request. Within this total, the Committee provides an
increase of $3,000,000 for the Preventive Medicine Residency
Training Program and an increase of $3,000,000 for Public Health
Training Centers.
Nursing Workforce Development
The Committee recommends $314,472,000 for Nursing Workforce
Development programs authorized under title VIII of the PHS Act,
$50,000,000 above the fiscal year 2021 enacted level and
$46,500,000 above the fiscal year 2022 budget request.
In addition to the amounts above, the American Rescue Plan
(P.L. 117–2) included $200,000,000 in discretionary appropriations
to support nursing workforce development in response to the
COVID–19 pandemic.
Impact of COVID–19 on the Rural Nursing Workforce.—The
Committee directs HRSA to submit a report within 180 days of en-
actment of this Act on the impact of the current public health
emergency on the nursing workforce, especially in rural areas, and
summarize strategies to mitigate and address these impacts.
Registered Nurse Shortages.—The Committee is concerned about
current and projected shortages of registered nurses (RNs) in the
U.S. As discussed in the HRSA publication ‘‘Supply and Demand
Projections of the Nursing Workforce 2014–2030’’, California, New
Jersey, South Carolina, and Texas are projected to have a deficit
of 10,000 or more full time equivalent RNs by 2030. The Com-
mittee directs HRSA to give priority in new funding announce-
ments to public entities for training of additional RNs, specifically
for acute care settings. In addition, the Committee directs HRSA
to give priority to applicants in States listed by HRSA as having
the greatest shortages.
Advanced Nursing Education.—The Committee includes
$82,081,000 for Advanced Nursing Education, $6,500,000 above the
fiscal year 2021 enacted level and $1,500,000 above the fiscal year
2022 budget request. This program supports traineeships and fac-
ulty and curriculum development to increase the number of quali-
fied nurses in the primary care workforce.
Nursing Education, Practice, Quality, and Retention (NEPQR).—
The Committee includes $51,913,000 for NEPQR, $5,000,000 above
the fiscal year 2021 enacted level and the fiscal year 2022 budget
request. This program supports academic, service, and continuing
education projects to enhance nursing education, improve the qual-
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ity of care, increase nurse retention, and strengthen the nursing
workforce.
Nurse Practitioner Optional Fellowship Program.—The Com-
mittee provides $15,000,000, an increase of $10,000,000 above the
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fiscal year 2021 enacted level and the fiscal year 2022 budget re-
quest, for grants to establish or expand community-based nurse
practitioner residency and fellowship training programs that are
accredited, or in the accreditation process, for practicing post-
graduate nurse practitioners (NPs) in primary care or behavioral
health, where supported education and training specialties will in-
clude family, adult family, adult-gerontology, pediatric, women’s
health care, nurse midwife, and psychiatric-mental health. The
Committee directs HRSA to give preference to FQHCs, as defined
by section 1861(aa)(4) of the Social Security Act. The Committee is
concerned the Nation is unprepared for health care provider short-
ages and recognizes that postgraduate programs with this focus, in-
tegrating primary care and behavioral health, will help to address
this problem. Patients need expert primary care and behavioral
health providers prepared to manage the social and clinical com-
plexities experienced in FQHCs. The program provides residency
training and fellowships to enable postgraduate NPs to transition
to an integrated model of care consistent with current high stand-
ards of NP education and practice meeting the needs of our na-
tion’s most vulnerable populations. The events of 2020, from the
global COVID–19 pandemic to national recognition of the severity
of health disparities and health inequities in our country, has made
this even more urgent.
Nursing Workforce Diversity.—The Committee includes
$26,343,000 for Nursing Workforce Diversity, $6,500,000 above the
fiscal year 2021 enacted level and $3,000,000 above the fiscal year
2022 budget request. This program increases nursing education op-
portunities for individuals from disadvantaged backgrounds by pro-
viding student stipends, scholarships, and preparation and reten-
tion activities.
Nurse Corps Scholarship and Loan Repayment.—The Committee
includes $108,635,000 for Nurse Corps, $20,000,000 above the fis-
cal year 2021 enacted level and the fiscal year 2022 budget request.
This program supports scholarships and loan repayment assistance
for nurses and nursing students committed to working in commu-
nities with inadequate access to care.
In addition, the American Rescue Plan (P.L. 117–2) included
$200,000,000 in discretionary appropriations to support to Nurse
Corps in response to the COVID–19 pandemic.
Nursing Faculty Loan Program.—The Committee includes
$30,500,000 for the Nursing Faculty Loan Program, $2,000,000
above the fiscal year 2021 enacted level and the fiscal year 2022
budget request. This program supports schools of nursing to pro-
vide loans to students enrolled in advanced nursing education pro-
grams who are committed to becoming nurse faculty.
Children’s Hospitals Graduate Medical Education (CHGME)
The Committee includes $400,000,000 for the CHGME payment
program, $50,000,000 above the fiscal year 2021 enacted level and
the fiscal year 2022 budget request. This program helps eligible
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hospitals maintain graduate medical education programs, which
support the training of residents to care for the pediatric popu-
lation and enhance the supply of primary care and pediatric med-
ical and surgical subspecialties.
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Medical Student Education
The Committee includes $75,000,000, $25,000,000 above the fis-
cal year 2021 enacted level and the fiscal year 2022 budget request,
to support colleges of medicine at public universities located in the
top quintile of States projected to have a primary care provider
shortage. The Committee directs HRSA to give priority to applica-
tions from academic institutions located in States with the greatest
number of Federally-recognized Tribes. The Committee also directs
HRSA to give priority to applications from public universities with
a demonstrated public-private partnership.
Pediatric Subspecialty Loan Repayment Program
The Committee recognizes that there are significant shortages of
pediatric subspecialists, child psychiatrists, and other child mental
health providers in underserved areas and includes $25,000,000 for
the Pediatric Subspecialty Loan Repayment Program under section
775 of the PHS Act. The Committee understands that high grad-
uate debt load is a significant barrier to providers choosing to com-
plete additional training to enable them to provide specialized care
for children with special medical and mental health care needs.
National Practitioner Data Bank (NPDB)
The Committee includes $18,814,000 for the NPDB, the same as
the fiscal year 2021 enacted level and the fiscal year 2022 budget
request. The NPDB is a workforce tool that collects and discloses
information to authorized entities on past adverse actions of health
care practitioners, providers, and suppliers to reduce fraud and
abuse and improve health care quality.
MATERNAL AND CHILD HEALTH
Appropriation, fiscal year 2021 ......................................................... $975,284,000
Budget request, fiscal year 2022 ....................................................... 1,100,084,000
Committee Recommendation ............................................................. 1,188,784,000
Change from enacted level ......................................................... +213,500,000
Change from budget request ...................................................... +88,700,000
The mission of the Maternal and Child Health Bureau (MCHB)
is to improve the physical and mental health, safety, and well-
being of the Nation’s women, infants, children, adolescents, and
their families.
Congenital Syphilis.—The Committee is concerned with the rise
in congenital syphilis as well as the need to expand efforts to pre-
vent this disease and reduce infant mortality. To improve the qual-
ity of health care to mothers and their children, the Committee en-
courages MCHB to support efforts to increase prenatal screening
for congenital syphilis and postnatal follow-up for both mothers
and babies to ensure that congenital syphilis is detected at the ear-
liest possible stage.
Maternal and Child Health (MCH) Block Grant
The Committee recommends $868,700,000 for the MCH Block
Grant, $156,000,000 above the fiscal year 2021 enacted level and
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$46,000,000 above the fiscal year 2022 budget request. States use
the MCH Block Grant to improve access to care for mothers, chil-
dren, and their families; reduce infant mortality; provide pre- and
post-natal care; support screening and health assessments for chil-
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dren; and provide systems of care for children with special health
care needs.
The Committee recommends that HRSA continue to support
MCH Block Grant partnerships with Federal and State partners to
address gaps in services to mothers, children, and their families in
all 50 States, the District of Columbia, and the territories; includ-
ing densely populated Medically Underserved Areas and Medically
Underserved Population designated Health Professional Shortage
Areas.
Special Projects of Regional and National Significance
The Committee continues bill language identifying specific
amounts for Special Projects of Regional and National Significance
(SPRANS). The Committee provides the following within SPRANS:
FY 2022
Budget Activity Committee
Set-aside for Oral Health ............................................................................................................................... $5,250,000
Set-aside for Epilepsy .................................................................................................................................... 3,642,000
Set-aside for Sickle Cell Disease ................................................................................................................... 10,000,000
Set-aside for Fetal Alcohol Syndrome ............................................................................................................ 1,000,000
State Oral Health Programs.—The Committee includes $250,000
to continue demonstration projects to increase the implementation
of integrating oral health and primary care practice. The projects
should model the core clinical oral health competencies for non-den-
tal providers that HRSA published and initially tested in its 2014
report ‘‘Integration of Oral Health and Primary Care Practice’’. The
Committee encourages the Chief Dental Officer to continue to play
a key role in the design, monitoring, oversight, and implementation
of these projects.
Alliance for Maternal Health Safety Bundles.—The Committee
includes $14,300,000, an increase of $5,300,000 above the fiscal
year 2021 enacted level and the same as the fiscal year 2022 budg-
et request, to support continued implementation of the Alliance for
Innovation on Maternal Health Program’s maternal safety bundles
to all U.S. States, the District of Columbia, and U.S. territories, as
well as tribal entities. Maternal safety bundles are a set of targeted
and evidence-based best practices that, when implemented, im-
prove patient outcomes and reduce maternal mortality and severe
maternal morbidity.
Children’s Health and Development.—There is increasing evi-
dence that experiences in early childhood have long-term health
consequences over the course of one’s life. These experiences are
critical in all areas of children’s educational, social, and physical
development and economic well-being. Children living in persist-
ently high poverty experience more negative health outcomes. The
Committee includes $3,500,000 to build upon the work done to ad-
dress these challenges, and directs HRSA to fund projects bringing
systemic change, such as Statewide systems of early childhood de-
velopmental screenings and interventions, in States with high lev-
els of or disparities in childhood poverty. The goal of the program
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is to yield comprehensive and integrated models for other States to
utilize in improving child health and development outcomes.
Early Childhood Development Expert Grants.—The Committee
includes $25,000,000, an increase of $25,000,000 above the fiscal
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58
year 2021 level and $15,000,000 above the fiscal year 2022 budget
request, to place early childhood development experts in pediatri-
cian offices that serve a population with a high percentage of Med-
icaid and CHIP patients.
Group Prenatal and Postpartum Care Programs.—The Com-
mittee recognizes the important role of group prenatal and
postpartum care (GPC/PC) programs, such as Centering Pregnancy,
can have on improving prenatal care and providing support for ex-
pecting mothers. GPC/PC programs provide the opportunity for ex-
pectant mothers to learn more about pregnancy, a network of social
support, educational tools, and ultimately work towards lowering
rates of infant and maternal mortality. The Committee includes
$2,000,000 within SPRANS for grants to establish new or support
existing GPC/PC programs.
Hereditary Hemorrhagic Telangiectasia (HHT) Centers of Excel-
lence.—The Committee includes $2,000,000 to establish a new com-
petitive grant program for HHT Centers of Excellence. This fund-
ing will support coordination and expansion of care for HHT pa-
tients and participation in a prospective, longitudinal registry of
HHT patients to better understand this rare disease and accelerate
the development of new diagnostic and treatment options.
Implicit Bias and Racism Training for Health Care Profes-
sionals.—The Committee includes $5,000,000, an increase of
$5,000,000 above the fiscal year 2021 enacted level and the same
as the fiscal year 2022 budget request, to make grants to train
health care providers on identifying and avoiding implicit bias.
Infant-Toddler Court Teams.—The Committee includes
$25,000,000 to continue and expand research-based Infant-Toddler
Court Teams to change child welfare practices to improve well-
being for infants, toddlers, and their families. The Committee ex-
pects this increase of $15,000,000 above the fiscal year 2021 en-
acted level to: (1) build upon the work of sites currently supported
through the Infant-Toddler Court Program provision of training
technical assistance, and additional support for Infant-Toddler
Court teams’ efforts across the country, and (2) provide grants to
plan and support additional Infant-Toddler Court Teams.
Maternal Mental Health Hotline.—The Committee includes
$5,000,000, an increase of $2,000,000 above the fiscal year 2021
level and $1,000,000 above the fiscal year 2022 budget request, to
support a maternal mental health hotline. The COVID–19 pan-
demic has exacerbated maternal mental health conditions, with
pregnant and new mothers experiencing anxiety and depression at
a three to four times higher rate than prior to the pandemic. The
hotline shall provide 24 hours a day voice and text support that is
culturally and linguistically appropriate. Funds provided shall also
be used to raise public awareness about maternal mental health
issues and the hotline.
NASEM Study on Bias Recognition in Clinical Skills Testing.—
The Committee includes $1,000,000, $1,000,000 above the fiscal
year 2021 enacted level and the same as the fiscal year 2022 budg-
et request, to support a NASEM study that will make recommenda-
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tions for incorporating bias recognition in clinical skills testing for
accredited schools of allopathic medicine and osteopathic medicine.
Pregnancy Medical Home Demonstration.—The Committee in-
cludes $25,000,000, an increase of $25,000,000 above the fiscal year
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2021 level and the same as the fiscal year 2022 budget request, to
support a demonstration providing incentives to maternal health
care providers to provide integral health care services to pregnant
women and new mothers, with the goal of reducing adverse mater-
nal health outcomes and maternal deaths.
Regional Pediatric Pandemic Network.—The Committee provides
$13,000,000, an increase of $3,000,000 above the fiscal year 2021
enacted level and the fiscal year 2022 budget request, within
SPRANS to continue the work of the Regional Pediatric Pandemic
Network to prepare the pediatric community for and coordinate
timely research-informed responses to future pandemics.
State Maternal Health Innovation Grants.—The Committee in-
cludes $53,000,000, $30,000,000 above the fiscal year 2021 enacted
level and the same as the fiscal year 2022 budget request, for State
Maternal Health Innovation Grants to establish demonstrations to
implement evidence-based interventions to address critical gaps in
maternity care service delivery and reduce maternal mortality. The
demonstrations should be representative of the demographic and
geographic composition of communities most affected by maternal
mortality.
Sudden Infant Death Syndrome.—The Committee includes
$5,100,000, an increase of $4,000,000 above the fiscal year 2021 en-
acted level and the fiscal year 2022 budget request, for the Na-
tional Fetal, Infant, and Child Death Review (FIDCR) program to
expand support and technical assistance to States and tribal com-
munities and improve the availability of data on sudden unex-
pected infant deaths (SUID). The Committee urges HRSA to con-
sider making grants to support families who have experiences
SUID by providing information, referrals, or peer or follow-up sup-
port services.
Maternal and Child Health Programs
Sickle Cell Anemia Demonstration Program
The Committee includes $9,205,000 for this program, an increase
of $2,000,000 above the fiscal year 2021 enacted level and the fiscal
year 2022 budget request. With the start of new five-year grant
awards in fiscal year 2022, the Committee is interested in learning
how the program is supporting the growth of comprehensive Sickle
Cell Disease (SCD) centers that provide the latest treatment op-
tions following evidence-based guidelines and have mechanisms to
identify and serve patients with SCD, who are not currently being
cared for by SCD specialists. The Committee directs HRSA to pro-
vide an update in the fiscal year 2023 Congressional Budget Jus-
tification on its plans to meet these goals.
Autism and Other Developmental Disorders
The Committee recommends $57,344,000 for Autism and Other
Developmental Disorders, $4,000,000 above the fiscal year 2021 en-
acted level and the same as the fiscal year 2022 budget request.
These programs seek to improve the health and well-being of chil-
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dren and adolescents with autism spectrum disorder and other de-
velopmental disabilities and to advance best practices for the early
identification and treatment of autism and related developmental
disabilities.
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Leadership Education in Neurodevelopmental and Related Dis-
abilities (LEND).—The Committee provides $38,245,000,
$2,000,000 above the fiscal year 2021 enacted level and $856,000
above the fiscal year 2022 budget request, for the LEND program
to allow the existing 52 LEND sites to maintain their capacity to
train interdisciplinary professionals to screen, diagnose, and pro-
vide evidence-based interventions to individuals with autism spec-
trum disorder and other developmental disabilities.
Heritable Disorders
The Committee provides $25,883,000 for the Heritable Disorders
program, $7,000,000 above the fiscal year 2021 enacted level and
the fiscal year 2022 budget request. This program supports activi-
ties that strengthen the newborn screening system to ensure in-
fants born in every State receive rapid identification, early inter-
vention, and potentially life-saving treatment.
Severe Combined Immune Deficiency (SCID).—Within the total
amount for Heritable Disorders, the Committee provides
$4,000,000, an increase of $1,000,000 above the fiscal year 2021 en-
acted level and the fiscal year 2022 budget request, to support
wider implementation, education, and awareness of newborn
screening and follow-up for SCID and other newborn screening dis-
orders. The Committee recognizes the progress that has been made
in screening for SCID at birth to enable early interventions, includ-
ing bone marrow transplantations and emerging investigational
gene therapies. This work has been extremely beneficial to families
who will soon have access to additional support with the launch of
a virtual, facilitated caregiver support group this year. The Com-
mittee directs HRSA to continue supporting this and related work
that focuses on helping families understand and navigate the proc-
ess from diagnosis to treatment and follow-up and to expand access
to these resources for providers and families of infants with SCID
and other newborn screening disorders with a focus on reaching
underserved populations.
Healthy Start
The Committee recommends $145,000,000 for the Healthy Start
program, $17,000,000 above the fiscal year 2021 enacted level and
the fiscal year 2022 budget request. The program provides grants
to communities with high rates of infant mortality to support pri-
mary and preventive health care services for mothers and their in-
fants.
The primary purpose of Healthy Start is to reduce maternal and
infant mortality and to generally improve maternal and infant
health. Grants are awarded to nonprofits, State and local health
departments and community health centers in eligible communities
with high rates of infant mortality and other adverse birth out-
comes, to develop a package of innovative health and social services
for pregnant women and infants, and evaluate those services.
Funding is provided to both increase funding to existing grantees
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so they can increase the number of individuals served and to sup-
port new, additional awards to community-based organizations for
targeted initiatives to reduce disparities in maternal and infant
health outcomes.
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Remote Blood Pressure Monitoring Initiative.—Preeclampsia/ec-
lampsia is the most dangerous form of hypertension that can de-
velop during pregnancy or the postpartum period, affecting as
many as one in twelve pregnancies and resulting in 15 percent of
premature infant deaths. While new preeclampsia diagnostics are
being evaluated by the Food and Drug Administration (FDA), the
Committee understands that medical providers continue to rely on
regular blood pressure monitoring to identify pregnant and
postpartum people at highest risk of developing preeclampsia. The
Committee also understands that preeclampsia disproportionately
affects racial and ethnic minorities and those living in rural com-
munities, and supports efforts to improve blood pressure moni-
toring for people lacking access to consistent prenatal care, particu-
larly efforts to support remote blood pressure monitoring of preg-
nant people through use of blood pressure cuffs and easy-to-under-
stand patient information to identify the signs and symptoms of
preeclampsia and allow patients to proactively engage their health
providers. The Committee urges the Healthy Start Program to
work with States, health care providers, and nonprofit patient or-
ganizations to design and support an initiative that will strengthen
remote blood pressure monitoring programs among high-risk vul-
nerable populations and communities.
Maternal Mortality.—The Committee recognizes the rising ma-
ternal mortality rate in the U.S. as a pressing public health issue.
Analysis of maternal mortality review committee data indicates
that over 60 percent of pregnancy-related deaths are preventable.
The Committee continues to provide no less than $15,000,000, the
same as the fiscal year 2021 enacted level and the fiscal year 2022
budget request, for Healthy Start grantees to support nurse practi-
tioners, certified nurse midwives, physician assistants, and other
maternal-child advance practice health professionals within all pro-
gram sites nationwide. Clinical staff will provide direct access to
well-woman care and maternity care services to reduce barriers in
access to maternity care and help address maternal health dispari-
ties among high-risk and underserved women, including those in
rural areas and maternal and infant care deserts. Clinical staff will
also support health educators by conducting training on maternal
early warning signs.
Universal Newborn Hearing Screening
The Committee includes $19,518,000 for the Universal Newborn
Hearing Screening program, an increase of $1,700,000 above the
fiscal year 2021 enacted level and the fiscal year 2022 budget re-
quest. This program awards grants to 53 States and territories to
support Statewide systems of newborn hearing screening and early
intervention programs.
Emergency Medical Services for Children
The Committee includes $28,134,000 for Emergency Medical
Services for Children, an increase of $5,800,000 above the fiscal
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year 2021 enacted level and the same as the fiscal year 2022 budg-
et request. Funding is available to every State emergency medical
services office to improve the quality of emergency care for children
and to support research on and dissemination of best practices.
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Screening and Treatment for Maternal Depression and Related Dis-
orders State Grants
The Committee provides $10,000,000 for the Screening and
Treatment of Maternal Depression and Related Behavioral Dis-
orders Program (MDRBD), an increase of $5,000,000 above the fis-
cal year 2021 enacted level and the same as the fiscal year 2022
budget request. Maternal mental health (MMH) conditions are the
most common pregnancy and postpartum complication; however, 75
percent of mothers go untreated. The COVID–19 pandemic has ex-
acerbated maternal mental health conditions, with pregnant and
new mothers experiencing anxiety and depression at a three to four
times higher rate than prior to the pandemic. MDRBD trains
health care providers to screen, assess, and treat for MMH condi-
tions and provide specialized psychiatric consultation to assist the
providers. The Committee directs HRSA to make grants to estab-
lish new State programs, and improve or maintain existing State
programs. Grants shall include culturally competent approaches to
assist in the reduction of maternal health inequities. The Com-
mittee recognizes the high need amongst States and directs
MDRBD to provide technical assistance to non-grantee States.
Pediatric Mental Health Access
The Committee includes $25,000,000 for Pediatric Mental Health
Access, an increase of $15,000,000 above the fiscal year 2021 en-
acted level and the fiscal year 2022 budget request. This program
supports expanded access to behavioral health services in pediatric
primary care by supporting the development of pediatric mental
health care telehealth access programs.
Maternal, Infant, and Early Childhood Home Visiting Program
The Committee recognizes that good oral health is an important
component for improving the health and well-being of children and
families. The Committee encourages HRSA to explore opportunities
to facilitate linkages between the agency’s Home Visiting Program
and Community Dental Health Coordinators, where available. The
Committee also encourages HRSA to work with oral health initia-
tives such as Community Dental Health Coordinators that have al-
ready been initiated by dental organizations to provide dental edu-
cation, community-based prevention, care coordination, and patient
navigation to children and vulnerable families.
RYAN WHITE HIV/AIDS PROGRAM
Appropriation, fiscal year 2021 ......................................................... $2,423,781,000
Budget request, fiscal year 2022 ....................................................... 2,554,781,000
Committee Recommendation ............................................................. 2,654,781,000
Change from enacted level ......................................................... +231,000,000
Change from budget request ...................................................... +100,000,000
The Ryan White Human Immunodeficiency Virus/Acquired Im-
munodeficiency Syndrome (HIV/AIDS) program funds activities to
address the care and treatment of persons living with HIV/AIDS
who are either uninsured or underinsured and need assistance to
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obtain treatment. The program provides grants to States and eligi-
ble metropolitan areas to improve the quality, availability, and co-
ordination of health care and support services to include access to
HIV-related medications; grants to service providers for early inter-
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vention outpatient services; grants to organizations to provide care
to HIV infected women, infants, children, and youth; and grants to
organizations to support the education and training of health care
providers.
Within the total for the Ryan White HIV/AIDS program, the
Committee provides the following amounts:
FY 2022
Budget Activity Committee
Emergency Assistance .................................................................................................................................... $700,876,000
Comprehensive Care Programs ...................................................................................................................... 1,387,005,000
AIDS Drug Assistance Program ............................................................................................................. 900,313,000
Early Intervention Program ............................................................................................................................. 207,079,000
Children, Youth, Women, and Families .......................................................................................................... 80,088,000
AIDS Dental Services ...................................................................................................................................... 15,122,000
Education and Training Centers .................................................................................................................... 44,611,000
Special Projects of National Significance ...................................................................................................... 30,000,000
Ending the HIV Epidemic Initiative ................................................................................................................ 190,000,000
Ending the HIV Epidemic (EHE) Initiative.—The Committee in-
cludes $190,000,000 within the Ryan White HIV/AIDS Program for
the EHE Initiative, an increase of $85,000,000 above the fiscal year
2021 enacted level and the same as the fiscal year 2022 budget re-
quest. Funds are distributed to high-need jurisdictions to increase
linkage, engagement, and retention in care with the goal of increas-
ing viral suppression among people living with HIV.
Ryan White Part A Formula Disparities.—The Committee directs
HRSA to take action to revise and improve the funding formula
disparities under Part A of the Ryan White HIV/AIDS Program.
Funding allocations utilized under the Ryan White HIV/AIDS
Treatment Extension Act of 2009 are largely based on a formula
which considers the place of residence of persons at the time of ini-
tial diagnosis when making formula-based grants. Under current
law, if a person diagnosed with HIV in one area of the country
moves to another part of the country, the funding for the case is
not transferred to the new location. Therefore, the Committee di-
rects HRSA to develop methods for calculating RWHAP formula
funds to reflect the number of persons living with HIV in eligible
jurisdictions, as well as other factors that reflect variability in
funds and other resources. Additionally, HRSA should review their
methods for awarding supplemental funds to effectively and accu-
rately address the need for RWHAP Part A funds among eligible
jurisdictions and report their findings back to the Committee with-
in 180 days of enactment of this Act.
HEALTH CARE SYSTEMS
Appropriation, fiscal year 2021 ......................................................... $129,093,000
Budget request, fiscal year 2022 ....................................................... 136,093,000
Committee Recommendation ............................................................. 147,093,000
Change from enacted level ......................................................... +18,000,000
Change from budget request ...................................................... +11,000,000
The Health Care Systems Bureau supports national activities
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that enhance health care delivery in the U.S., including maintain-
ing a national system to allocate and distribute donor organs to in-
dividuals awaiting transplant; building an inventory of cord blood
units; maintaining a national system for the recruitment of bone
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marrow donors; operating the 340B drug discount program; and op-
erating a national toll-free poison control hotline.
Organ Transplantation
The Committee includes $34,049,000 for the Organ Transplan-
tation program, $5,000,000 above the fiscal year 2021 enacted level
and the fiscal year 2022 budget request.
Maximizing Deceased Donor Organ Recovery, Acceptance, and
Utilization.—The Committee supports swift implementation of the
CMS final rule for Organ Procurement Organizations (OPOs) Con-
ditions for Coverage (CMS–3380–F), including efforts to decertify
underperforming OPOs. OPO failures are disproportionately borne
by patients of color, which means OPO reform is an urgent health
equity issue. The Committee believes swift and effective implemen-
tation of the Final Rule is a first step toward ensuring OPOs per-
form their public duties to secure more organs in an inclusive and
equitable manner. The Committee supports regulatory and enforce-
ment efforts to minimize excessive and frivolous expenses reim-
bursed by Medicare, including the CMS proposed rule on Medicare
reimbursement for organ acquisition costs (CMS–1752–P). The
Committee also encourages HHS to make all efforts to promote
competition for the Organ Procurement and Transplantation Net-
work (OPTN) contract, and to use the announced movement of the
Division of Transplantation to the Office of the Assistant Secretary
for Health to facilitate coordinated organ donation reforms.
Reimbursement of Travel and Subsistence Expenses Toward Liv-
ing Organ Donation Program.—The Committee includes
$18,800,000, an increase of $12,800,000 above the fiscal year 2021
enacted level and $5,000,000 above the fiscal year 2022 budget re-
quest, for the Living Organ Donation Program. The Committee
supports the expansion of this program to reimburse a comprehen-
sive range of living donor expenses for the greatest possible num-
ber of donors, including lost wages, childcare, eldercare, similar ex-
penses for donor caretakers, and removing other disincentives to
donation. The Committee supports significant expansion of income
eligibility for the program to allow as many donors as possible to
qualify and to ensure that financial reimbursement and monetary
exchange take place outside of the organ donor-organ recipient re-
lationship to the greatest extent possible.
National Cord Blood Inventory (NCBI)
The Committee includes $20,266,000 for the NCBI, an increase
of $2,000,000 above the fiscal year 2021 level and the fiscal year
2022 budget request. The NCBI program supports cord blood banks
to build an inventory of the highest quality cord blood units for
transplantation. The National Cord Blood Inventory program
builds a genetically and ethnically diverse inventory of high-quality
umbilical cord blood for transplantation. The Committee applauds
HRSA for the growth of the number of units collected and main-
tained under the NCBI.
C.W. Bill Young Cell Transplantation
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The Committee includes $33,009,000 for the C.W. Bill Young Cell
Transplantation program, an increase of $2,000,000 above the fis-
cal year 2021 level and the fiscal year 2022 budget request. This
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program supports coordinating the procurement of bone marrow
and and umbilical cord blood units for transplantation.
The Committee continues to support cell transplantation using
bone marrow, peripheral blood stem cells, and cord blood. The
Committee appreciates HRSA’s efforts to increase the diversity of
the volunteer registry and has provided funding above the budget
request to significantly reduce barriers to transplant for patients.
This includes increasing targeted donor recruitment efforts, inter-
vening with community referring physicians upon patient diagnosis
to accelerate the path to transplant, and propelling innovation to
improve outcomes and establish new treatment options to ensure
a matched donor for all searching patients, regardless of their ra-
cial/ethnic background, socioeconomic status, age, ancestry, or any
other individually defining characteristic. The highest priority
should be given to providing immediate and free testing of patients’
cellular markers to quickly determine if a there is an available
matched donor. Eliminating these barriers would allow therapies
for patients to be delivered on time and to provide equal and suc-
cessful outcomes for all.
Office of Pharmacy Affairs (OPA)
The Committee includes $17,238,000 for OPA, $7,000,000 above
the fiscal year 2021 enacted level and the same as the fiscal year
2022 budget request. OPA administers the 340B drug pricing pro-
gram, which was designed to help safety net providers maintain,
improve, and expand patient access to health care services. The
340B program has lowered the cost of outpatient drugs to health
clinics and nonprofit and public hospitals that serve a dispropor-
tionate share of low-income and rural patients. These entities pro-
vide additional services and benefits to their communities with the
savings realized. Funding will support implementation of 340B
Program statutory obligations, oversight of participating manufac-
turers and covered entities, operational improvements, and in-
creased efficiencies using information technology.
340B Drug Discount Program.—The Committee recognizes that
the 340B program is a critical lifeline to safety net providers, in-
cluding Community Health Centers. Health Centers are model
stewards of the program and reinvest 340B savings to ‘‘stretch
scarce Federal resources as far as possible, reaching more eligible
patients and providing more comprehensive services’’, as Congress
intended. The Committee is pleased that HRSA sent letters to six
pharmaceutical companies on May 17, 2021, determining that on-
going actions by the companies have resulted in overcharges to
340B covered entities. Furthermore, the Committee notes that
HRSA articulated that continued failure to provide the 340B price
to covered entities utilizing contract pharmacies may result in Civil
Monetary Penalties, as described in the final Civil Monetary Pen-
alty rule. The Committee encourages HRSA to continue to use its
authority and any available measures, including the imposition of
civil penalties, where appropriate, to hold those drug manufactur-
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ers in violation of the law directly accountable. The Committee di-
rects HRSA to provide a report no later than 120 days after enact-
ment of this Act on actions taken to safeguard covered entities’
lawful access to discounted drugs.
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The Committee is aware that in 2011, GAO issued a report out-
lining five recommendations for HRSA to improve performance and
accountability within the 340B program. The Committee commends
HRSA for implementing three of those recommendations and di-
rects HRSA to report to the Committee within 120 days of enact-
ment of this Act on plans to implement the remaining two rec-
ommendations, which focus on clarifying eligibility criteria for
340B patients and providers. The Committee also directs GAO to
update the 2011 report on the performance of the 340B program.
Poison Control Centers
The Committee includes $26,846,000 for Poison Control Centers,
an increase of $2,000,000 above the fiscal year 2021 enacted level
and the fiscal year 2022 budget request. The Poison Control Cen-
ters program supports a national network of centers that prevent
and treat poison exposures by providing cost effective, quality
health care advice to the public and health care providers.
Hansen’s Disease Program
The Committee includes $13,706,000 for the Hansen’s Disease
Program, $122,000 for Hansen’s Disease Buildings and Facilities,
and $1,857,000 for Payments to Hawaii for Treatment of Hansen’s
Disease. These funding levels are the same as the fiscal year 2021
enacted levels and the amounts requested in the fiscal year 2022
budget request. The programs support inpatient, outpatient, long-
term care, as well as training and research in Baton Rouge, Lou-
isiana; a residential facility at Carville, Louisiana; 11 outpatient
clinic sites in the continental U.S. and Puerto Rico; repair and
maintenance of buildings at the Gillis W. Long Hansen’s Disease
Center; and medical care and treatment of persons with Hansen’s
disease in hospital and clinic facilities at Kalaupapa, Molokai, and
Honolulu, Hawaii.
RURAL HEALTH
Appropriation, fiscal year 2021 ......................................................... $329,519,000
Budget request, fiscal year 2022 ....................................................... 400,209,000
Committee Recommendation ............................................................. 400,209,000
Change from enacted level ......................................................... +70,690,000
Change from budget request ...................................................... –––
The Federal Office of Rural Health Policy’s programs provide
funding to improve access, quality, and coordination of care in
rural communities; for research on rural health issues; for technical
assistance and recruitment of health care providers; for screening
activities for individuals affected by the mining, transport, and
processing of uranium; for the outreach and treatment of coal min-
ers and others with occupation-related respiratory and pulmonary
impairments; and for the expansion of telehealth services.
Rural Health Outreach Programs
The Committee includes $90,000,000 for Rural Health Outreach
Programs, an increase of $7,500,000 above the fiscal year 2021 en-
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acted level and the same as the fiscal year 2022 budget request.
This program supports projects that demonstrate new and innova-
tive modes of outreach in rural areas, such as integration and co-
ordination of health services.
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Rural Maternity and Obstetrics Management Strategies
(RMOMS).—The Committee recommendation includes $10,400,000
for RMOMS, an increase of $5,400,000 above the fiscal year 2021
enacted level and the same as the fiscal year 2022 budget request.
RMOMS supports grants to improve access to and continuity of
maternal and obstetrics care in rural communities by increasing
the delivery of and access to preconception, pregnancy, labor and
delivery, and postpartum services, as well as developing sustain-
able financing models for the provision of maternal and obstetrics
care.
Rural Health Research and Policy Development
The Committee includes $11,576,000 for Rural Health Research
and Policy Development, an increase of $500,000 above the fiscal
year 2021 enacted level and the fiscal year 2022 budget request.
Funding supports the Federal Office of Rural Health Policy’s activi-
ties to analyze, advise the Secretary, and provide information to
the public regarding issues that affect the availability, access to,
and quality of health care in rural areas.
Rural Hospital Flexibility Grants
The Committee includes $79,009,000 for Rural Hospital Flexi-
bility Grants, $23,400,000 above the fiscal year 2021 enacted level
and $21,500,000 above the fiscal year 2022 budget request. These
programs support States to assist small and critical access rural
hospitals to remain economically viable and to provide high-quality
care.
Small Rural Hospital Improvement Program (SHIP).—The Com-
mittee recommendation includes $23,242,000 for SHIP, an increase
of $2,300,000 over the fiscal year 2021 enacted level and the fiscal
year 2022 budget request.
Rural Emergency Hospital Technical Assistance Program.—The
Committee includes $10,000,000 within the total for Rural Hospital
Flexibility Grants to establish the Rural Emergency Hospital Tech-
nical Assistance Program. This program will provide technical as-
sistance from existing State Flexibility Programs and other stake-
holders to assist facilities in the implementation of the new Rural
Emergency Hospital model.
Rural Provider Modernization Technical Assistance Program.—
The Committee includes $5,000,000 within the total for Rural Hos-
pital Flexibility Grants to establish the Rural Provider Moderniza-
tion Technical Assistance Program. This program will provide tech-
nical assistance to hospitals and other health care providers to im-
plement sustainable models of care that address social deter-
minants of health and health equity.
Rural Provider Modernization Grants.—The Committee includes
$4,000,000 within the total for Rural Hospital Flexibility Grants to
establish the Rural Provider Modernization Grants program. This
program will make grants to support hospitals, public health de-
partments, clinics, and community-based organizations to plan and
implement emerging, sustainable models of care.
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State Offices of Rural Health
The Committee includes $13,000,000 for State Offices of Rural
Health, $500,000 above the fiscal year 2021 enacted level and the
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68
fiscal year 2022 budget request. HRSA supports the establishment
and operation of State offices of rural health to strengthen rural
health care delivery system.
Black Lung Clinics
The Committee includes $12,190,000 for Black Lung Clinics, an
increase of $690,000 above the fiscal year 2021 enacted level and
the same as the fiscal year 2022 budget request. This program
funds clinics that treat respiratory and pulmonary diseases of ac-
tive and retired coal miners, steel mill workers, agricultural work-
ers, and others with occupationally-related respiratory and pul-
monary impairments.
Radiation Exposure Screening and Education Program (RESEP)
The Committee includes $2,734,000 for the RESEP program, an
increase of $900,000 above the fiscal year 2021 enacted level and
the same as the fiscal year 2022 budget request. This program pro-
vides grants for the education, prevention, and early detection of
radiogenic cancers and diseases resulting from exposure to ura-
nium during mining and milling at nuclear test sites.
Telehealth
The Committee includes $39,000,000 for Telehealth, an increase
of $5,000,000 above the fiscal year 2021 enacted level and
$2,500,000 above the fiscal year 2022 budget request. Funds sup-
port the Office for the Advancement of Telehealth, which promotes
the effective use of technologies to improve access to health services
for people who are isolated from health care and to provide dis-
tance education for health professionals.
Telehealth Centers of Excellence.—The Committee includes
$7,500,000 for Telehealth Centers of Excellence, an increase of
$1,000,000 above the fiscal year 2021 enacted level. Grantees ex-
amine the efficacy of telehealth services in rural and urban areas
and serve as a national clearinghouse for telehealth research and
resources. The Centers of Excellence serve to promote the adoption
of telehealth programs across the country by validating technology,
establishing training protocols, and by providing a comprehensive
template for States to integrate telehealth into their State health
provider network. Additional funding for the Centers of Excellence
will support the development of models of care and best practices
for the expansion of telemental health.
Urban Focused Telehealth Network Grant Program.—The Com-
mittee believes that a fundamental element to ensuring our health
care system is prepared for pandemic events is the development of
robust telehealth services and integrated systems that can provide
a continuum of care across State and regional lines. This is espe-
cially true in the nation’s urban areas, where a pandemic event has
the potential to disproportionately impact and overwhelm the
health care and delivery system. The Committee believes increased
investments in urban telehealth services could have a tremendous
tkelley on DSK125TN23PROD with HOUSE_REPORTS
impact on the health and well-being of the nation’s most vulnerable
citizens and medically underserved populations, especially during
times of national public health emergencies. The Committee en-
courages HRSA to establish a pilot program to expand academic
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69
health system telehealth programs aimed at addressing the health
inequities of urban populations.
Rural Health Residency Program
The Committee includes $12,700,000 for the Rural Health Resi-
dency Program, an increase of $2,200,000 above the fiscal year
2021 enacted level and the same as the fiscal year 2022 budget re-
quest. This program funds physician residency training programs
that support physician workforce expansion in rural areas.
The COVID–19 pandemic has exacerbated the challenges in ac-
cess to care faced by Americans in rural areas, particularly when
they require specialty care. The Committee commends the Federal
Office of Rural Health Policy for its efforts to expand the physician
workforce in rural areas and supports continuation and expansion
of the program to develop new rural residency programs, or Rural
Training Tracks (RTTs). This Committee encourages HRSA to ex-
pand the current program to include RTTs in obstetrics and gyne-
cology, as women in rural communities are more likely to begin
prenatal care late and are more likely to experience maternal mor-
tality and severe maternal morbidity. The Committee requests a
report in the fiscal year 2023 Congressional Budget Justification on
the progress made to date and efforts to expand RTTs in obstetrics
and gynecology.
Rural Communities Opioids Response
The Committee includes $140,000,000 to continue the Rural
Communities Opioids Response program, an increase of
$30,000,000 above the fiscal year 2021 enacted level and
$25,000,000 below the fiscal year 2022 budget request. The Com-
mittee recognizes the devastating impact the opioid epidemic has
had on rural communities and how the COVID–19 pandemic has
worsened the opioid crisis. The Committee expands funding to sup-
port treatment for and prevention of substance use disorders, in-
cluding opioid abuse, focusing on rural communities with the high-
est risk for substance use disorders. Within the funding provided,
the Committee includes $10,000,000 to continue the three Rural
Centers of Excellence, as established by Public Law 115–245 and
continued in Public Law 116–94.
FAMILY PLANNING
Appropriation, fiscal year 2021 ......................................................... $286,479,000
Budget request, fiscal year 2022 ....................................................... 340,000,000
Committee Recommendation ............................................................. 400,000,000
Change from enacted level ......................................................... +113,521,000
Change from budget request ...................................................... +60,000,000
The Committee includes $400,000,000 for the Family Planning
program, $113,521,000 above the fiscal year 2021 enacted level and
$60,000,000 above the fiscal year 2022 budget request. In addition,
the American Rescue Plan (P.L. 117–2) included $50,000,000 in
funding to support emergency needs of the Family Planning pro-
gram due to the COVID–19 public health emergency.
tkelley on DSK125TN23PROD with HOUSE_REPORTS
The Family Planning program administers Title X of the Public
Health Service Act. This program plays a vital role not only in en-
suring access to affordable contraceptive education, services, and
supplies, but also in STD prevention, screening, and treatment;
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70
cervical and breast cancer screenings; first-line infertility services;
and other community and health care services.
The Committee directs the Secretary to ensure that grantees cer-
tify that they: (1) provide medically accurate and complete coun-
seling, including referral as requested, on all matters; (2) shall not
condition the receipt of Title X-supported services on patients re-
maining sexually abstinent until marriage; and (3) will not make
any appointments or referrals for patients that are contrary to the
patient’s wishes. The bill requires that all recipients of funds under
this heading offer services consistent with the best available evi-
dence-based standards, including the Quality Family Planning
guidelines from the CDC and the Office of Population Affairs
(OPA).
Telehealth Guidance.—The Committee recognizes that the
COVID–19 pandemic has increased the importance of access to
telehealth services across the health care system, including for
Title X providers and patients. The Committee urges the OPA to
release telehealth guidance and best practices for Title X projects
that reiterate the importance of telehealth in providing quality
family planning services.
Ensuring Health Equity.—The Committee recognizes that the
Title X program remains an important component of the health
care safety net and is essential to addressing health inequities.
Building a more inclusive Title X program requires focusing on
grantmaking that will continue this work.
Recommendations for Quality Family Planning Services.—The
Committee directs the Secretary to begin the process of revising
‘‘Providing Quality Family Planning Services,’’ evidence-based rec-
ommendations from the CDC and OPA that were last updated in
2017. Revisions should incorporate new evidence and support holis-
tic reproductive and sexual health needs. The Committee requests
a briefing on the status of this process no later than 180 days of
enactment of this Act.
Estimated Need for Services.—The Committee requests the Sec-
retary conduct a study, within 270 days of enactment of this Act,
reflecting the current estimated need for Title X services and cost
required to provide such updating the 2016 study published in the
American Journal of Public Health.
PROGRAM MANAGEMENT
Appropriation, fiscal year 2021 ......................................................... $155,300,000
Budget request, fiscal year 2022 ....................................................... 167,971,000
Committee Recommendation ............................................................. 536,407,000
Change from enacted level ......................................................... +381,107,000
Change from budget request ...................................................... +368,436,000
Program management supports the cost of Federal staff and re-
lated activities to coordinate, direct, and manage the programs of
HRSA.
HRSA Chief Dental Officer.—The Committee is disturbed to
learn that despite its directive in House Report (116–450) to have
HRSA ensure that the Chief Dental Officer (CDO) is functioning at
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an executive level authority with resources and staff to oversee and
lead all oral health programs and initiatives across HRSA, no such
authority has been delegated. The Committee directs HRSA to re-
store the authority of HRSA CDO with executive level authority
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71
and resources to oversee and lead HRSA dental programs and ini-
tiatives as well as have a role within oral health across the agency.
The CDO is also expected to serve as the agency representative on
oral health issues to international, national, State, and/or local gov-
ernment agencies, universities, and oral health stakeholder organi-
zations. The Committee requests an update as part of the fiscal
year 2023 Congressional Budget Justification on how the CDO is
serving as the agency representative on oral health issues to inter-
national, national, State and/or local government agencies, univer-
sities, and oral health stakeholder organizations.
Action for Dental Health.—With the enactment of the Action for
Dental Health Act of 2018, the Committee encourages HRSA to ex-
pand oral health grants for innovative programs under PHS Act
Section 340G (42 USC Section 256g) to include Action for Dental
Health activities. The Action for Dental Health program helps re-
duce barriers to dental care through oral health education, preven-
tion, and the establishment of dental homes for underserved popu-
lations.
Oral Health Literacy.—The Committee includes $500,000 to con-
tinue the development of an oral health awareness and education
campaign across relevant HRSA divisions, including the Health
Centers Program, Oral Health Workforce, Maternal and Child
Health, Ryan White HIV/AIDS Program, and Rural Health. The
Committee directs HRSA to identify oral health literacy strategies
that are evidence-based and focused on oral health care prevention
and education, including prevention of oral disease such as early
childhood and other caries, periodontal disease, and oral cancer.
The Committee urges HRSA to ensure that the Chief Dental Offi-
cer plays a key role in the design, monitoring, oversight, and imple-
mentation of this project.
Targeted Investments in Impoverished Areas.—The Committee
supports targeted investments in impoverished areas, particularly
in persistent poverty counties and in other high-poverty census
tracts. The Committee directs HRSA to develop and implement
measures to increase the share of investments its programs in per-
sistent poverty counties, high-poverty areas, and any other impov-
erished communities that HRSA determines to be appropriate
areas to target. The Committee appreciates the report HRSA pro-
vided in response to the Committee’s request in House Report 116–
450 and directs the Department to provide an update to the Com-
mittee within 180 days of enactment of this Act on how HRSA is
carrying out this directive.
Community Project Funding
The Committee includes $367,415,000 for projects financing the
construction and renovation (including equipment) of health care
and other facilities and for one-time grants supporting other
health-related activities. The budget request does not include fund-
ing for this purpose. The Committee includes $4,000,000 within
this total for agency administrative expenses. The bill includes
tkelley on DSK125TN23PROD with HOUSE_REPORTS
funding for the following projects in the following amounts:
Project Amount
26Health, Orlando, FL for purchase of equipment ........................................................................................ $250,000
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72
Project Amount
Advocate Health and Hospitals Corporation dba Advocate Christ Medical Center, Oak Lawn, IL for facili-
ties and equipment ................................................................................................................................... 150,000
Advocate Illinois Masonic Medical Center, Chicago, IL for facilities and equipment .................................. 300,000
Affinia Healthcare, Saint Louis, MO for facilities and equipment ................................................................ 2,000,000
Aging in PACE Washington, Seattle, WA for facilities and equipment ......................................................... 700,000
AIDS Care Group, Chester, PA for facilities and equipment ......................................................................... 1,000,000
Aleutians East Borough, Sand Point, AK for facilities .................................................................................. 2,000,000
Alzheimer’s Foundation of America, Amityville, NY for education and training services ............................. 100,000
Andy’s Angels, Jackson, MI for facilities ....................................................................................................... 300,000
Arc of the Ozarks, Springfield, MO for equipment and autism diagnostic and treatment services ........... 800,000
Asian American Drug Abuse Prevention, Los Angeles, CA for a health initiative ........................................ 250,000
Asian American Health Coalition of Greater Houston, d/b/a HOPE Clinic, Houston, TX for a health initia-
tive, including facilities and equipment ................................................................................................... 1,000,000
Asian American Health Coalition of Greater Houston, d/b/a HOPE Clinic, Houston, TX for facilities and
equipment .................................................................................................................................................. 2,000,000
Atlantic Health System, Morristown, NJ for facilities and equipment at Atlantic Health System—Newton
Medical Center ........................................................................................................................................... 750,000
Aurora Community Mental Health Center, Aurora, CO for facilities and equipment .................................... 1,000,000
Autism New Jersey, Robbinsville, NJ for facilities and equipment and purchase of information tech-
nology ......................................................................................................................................................... 200,000
Avenidas, Palo Alto, CA for facilities and equipment for the Avenidas Rose Kleiner Center ...................... 150,000
Ballad Health, Johnson City, TN for facilities ............................................................................................... 450,000
BANJ Health Center Inc., Compton, CA for a health initiative ..................................................................... 50,000
Baptist Health Hardin, Elizabethtown, KY for facilities and equipment ...................................................... 300,000
Battle Ground Healthcare, Battle Ground, WA for facilities and equipment ................................................ 320,000
Bay Area Community Health, Fremont, CA for an electronic health records initiative ................................ 1,000,000
Baylor College of Medicine, Houston, TX for facilities and equipment ........................................................ 1,100,000
Beach Cities Health District, Redondo Beach, CA for facilities and equipment for the Youth Wellness
Center ......................................................................................................................................................... 1,000,000
Benton County, Kennewick, WA for facilities ................................................................................................. 2,000,000
Bethel School District #403, Spanaway, WA for facilities and equipment for the School-Based Health
Clinic at Graham-Kapowsin High School .................................................................................................. 2,000,000
Bexar County Hospital District d/b/a University Health, San Antonio, TX for a health initiative ................ 300,000
Blood Bank of Hawaii, Honolulu, HI for facilities and equipment ................................................................ 2,000,000
Bluefield State College, Bluefield, WV for facilities ...................................................................................... 300,000
Board of Trustees of the University of Illinois, Urbana, IL for facilities ...................................................... 2,000,000
Bon Secours Mercy Health Inc., Cincinnati, OH for facilities and equipment .............................................. 1,000,000
Bowling Green-Warren County Community Hospital Corporation dba The Medical Center at Caverna,
Horse Cave, KY for facilities and equipment ............................................................................................ 250,000
Brooklyn Communities Collaborative, Inc., Brooklyn, NY for a telehealth and electronic medical records
initiative ..................................................................................................................................................... 875,000
Brooklyn Hospital Center, Brooklyn, NY for facilities and equipment ........................................................... 2,000,000
Broward Community and Family Health Centers, Inc., Hollywood, FL for facilities and equipment ............ 225,000
Brownsville Community Development Corporation dba BMS Family Health and Wellness Centers, Brook-
lyn, NY for facilities and equipment ......................................................................................................... 1,000,000
Bucks County Department of Mental Health: Developmental Programs, Doylestown, PA for facilities ....... 500,000
Burre Dental Center, Arcata, CA for facilities and equipment ..................................................................... 1,000,000
C.W. Williams Community Health Center, Charlotte, NC for facilities and equipment ................................ 1,150,000
California State University, Dominguez Hills, Carson, CA for facilities and equipment and an electronic
medical records initiative .......................................................................................................................... 700,000
Camino Community Development Corp., Charlotte, NC for facilities and equipment and an electronic
health records initiative ............................................................................................................................ 200,000
Cape Cod Healthcare, Hyannis, MA for an electronic health records initiative ........................................... 1,500,000
Capital Health System, Inc., Trenton, NJ for purchase of equipment .......................................................... 550,000
Capstone Rural Health Center, Parrish, AL for facilities .............................................................................. 725,000
Care Plus Bergen Inc. DBA Bergen New Bridge Medical Center, Paramus, NJ for facilities and equip-
ment ........................................................................................................................................................... 2,000,000
CareSTL Health, Saint Louis, MO for facilities and equipment .................................................................... 1,000,000
Caridad Center, Inc., Boynton Beach, FL for facilities and equipment ........................................................ 1,150,000
Cedars-Sinai, Los Angeles, CA for facilities and equipment ........................................................................ 1,000,000
Center for African American Health, Denver, CO for facilities and equipment ............................................ 1,000,000
Central Michigan University College of Medicine, Mount Pleasant, MI for telepsychiatry services, equip-
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ment, and associated information technology .......................................................................................... 370,000
Centre Volunteers in Medicine, State College, PA for facilities and equipment .......................................... 1,065,000
Centro De Salud Familiar La Fe, Inc., El Paso, TX for facilities and equipment ......................................... 925,000
Centro Las Americas, Inc., Worcester, MA for a telehealth and electronic health records initiative, in-
cluding the purchase of equipment .......................................................................................................... 975,000
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73
Project Amount
Chestnut Health Systems, Bloomington, IL for facilities and equipment ..................................................... 430,000
Child Focus, Inc., Cincinnati, OH for facilities and equipment .................................................................... 1,000,000
Children’s Health System of Texas, Dallas, TX for facilities and equipment ............................................... 850,000
Children’s Hospital Colorado, Anschutz Medical Campus, Aurora, CO for a health training initiative ....... 500,000
Children’s Hospital Los Angeles, Los Angeles, CA for equipment ................................................................ 550,000
Children’s Hospital Los Angeles, Los Angeles, CA for purchase of equipment ............................................ 1,600,000
Children’s Hospital of Wisconsin, Inc., Wauwatosa, WI for equipment ........................................................ 400,000
Children’s National Hospital, Washington, DC for facilities and equipment ............................................... 2,000,000
Chiricahua Community Health Centers, Inc., Douglas, AZ for facilities and equipment ............................. 625,000
Christian Community Health Center, Chicago, IL for purchase of equipment ............................................. 20,000
Church Health Center of Memphis, Memphis, TN for facilities and equipment .......................................... 350,000
City of Auburn, WA for facilities and equipment for the Auburn Consolidated Resource Center ................ 500,000
City of Baltimore, MD for facilities and equipment and a telehealth initiative .......................................... 2,325,000
City of Brooklyn Center, MN for a health initiative ....................................................................................... 100,000
City of Hope Duarte Medical Center, Duarte, CA for purchase of equipment .............................................. 450,000
City of Hope National Medical Center, Duarte, CA for equipment ................................................................ 700,000
City of Hope National Medical Center, Duarte, CA for equipment ................................................................ 1,200,000
City of Houston Fire Department, Houston, TX for facilities and equipment ............................................... 450,000
City of Houston Health Department, Houston, TX for facilities and equipment ........................................... 900,000
City of Long Branch, NJ for facilities and equipment for the City of Long Branch Health Department ..... 2,000,000
City of Morgantown, WV for facilities and equipment .................................................................................. 100,000
City of Mount Sterling, KY for facilities and equipment ............................................................................... 1,000,000
City of Rochester Department of Recreation and Human Services, Rochester, NY for facilities and
equipment .................................................................................................................................................. 225,000
City of West Wendover, NV for facilities and equipment .............................................................................. 320,000
Clinica Amistad, Tucson, AZ for a telehealth initiative and purchase of equipment .................................. 185,000
Clinicas de Salud del Pueblo, El Centro, CA for facilities and equipment .................................................. 1,000,000
Colorado Coalition for the Homeless, Denver, CO for facilities and equipment .......................................... 2,000,000
Columbus Neighborhood Health Center, Inc., dba PrimaryOne Health (P1H), Columbus, OH for facilities
and equipment ........................................................................................................................................... 500,000
Commonwealth Healthcare Corporation, Sapian, MP for facilities and equipment ..................................... 1,200,000
CommuniCare Health Centers, Davis, CA for facilities and equipment ....................................................... 400,000
Community College District 502, Glen Elyn, IL for purchase of equipment ................................................. 500,000
Community Health Access Network, Newmarket, NH for an electronic medical records initiative .............. 700,000
Community Health Centers of Pinellas, Inc., Clearwater, FL for facilities and equipment ......................... 2,000,000
Compass Health, Everett, WA for facilities and equipment .......................................................................... 2,000,000
ComWell, Red Bud, IL for rural mental health and psychiatric care ........................................................... 250,000
Contra Costa Regional Medical Center, Martinez, CA for a health training and electronic health records
initiative ..................................................................................................................................................... 900,000
Cooper University Health Care, Camden, NJ for facilities and equipment ................................................... 500,000
Cornerstone Care, Inc., Greensboro, PA for facilities and equipment for a facility in Clairton, PA ............ 1,500,000
Cornerstone Services, Inc., Joliet, IL for facilites and equipment ................................................................ 1,050,000
County of Alameda, Oakland, CA for facilities and equipment for the West Oakland Health Council ....... 1,250,000
County of Benton, Corvalis, OR for facilities and equipment for the Benton County Crisis Respite Center 1,000,000
County of Clear Creek, Georgetown, CO for facilities and equipment for the Clear Creek County Collabo-
rative Care Center ..................................................................................................................................... 1,000,000
County of Contra Costa Health Services Department, Behavioral Health Division, Martinez, CA for facili-
ties and equipment ................................................................................................................................... 1,000,000
County of Fairfax, Fairfax, VA for facilities and equipment for the Merrifield Crisis Response Center ...... 2,000,000
County of Fairfax, VA for a health information technology initiative, including purchase of equipment ... 375,000
County of Fairfax, VA for a health IT initiative ............................................................................................. 800,000
County of Franklin, Columbus, OH for facilities and equipment for the Franklin County Mental Health
and Addiction Crisis Center ...................................................................................................................... 500,000
County of Henrico, Henrico, VA for facilities and equipment ....................................................................... 1,000,000
County of Lane, Eugene, OR for facilities and equipment for a rural community health clinic in Cottage
Grove, OR ................................................................................................................................................... 1,500,000
County of Orange, Orlando, FL for a health workforce initiative .................................................................. 300,000
County of Orange, Santa Ana, CA for facilities ............................................................................................ 2,000,000
County of Prince George’s Department of Health, Largo, MD, for a telehealth initiative, including pur-
chase of equipment ................................................................................................................................... 4,000,000
County of Prince William, Prince William, VA for a health initiative ........................................................... 800,000
County of Santa Barbara, Santa Barbara, CA for facilities and equipment for the Lompoc Health Clinic 900,000
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County of Santa Clara, San Jose, CA for a health workforce initiative ....................................................... 1,000,000
County of Wayne, Honesdale, PA for facilities and equipment ..................................................................... 2,000,000
Dallas County Hospital District d/b/a Parkland Health & Hospital System, Dallas, TX for facilities and
equipment .................................................................................................................................................. 275,000
Day Kimball Hospital, Putnam, CT for facilities and equipment .................................................................. 550,000
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Project Amount
Delaware Division of Libraries, Dover, DE for a telehealth initiative, including the purchase of equip-
ment ........................................................................................................................................................... 275,000
Delaware-Morrow Mental Health & Recovery Services Board, Delaware, OH for facilities ........................... 750,000
Denver Health and Hospital Authority, Denver, CO for facilities and equipment ........................................ 1,200,000
Dientes Community Dental Care, Santa Cruz, CA for facilities and equipment .......................................... 1,050,000
Dimock Center, Inc. d/b/a The Dimock Center, Roxbury, MA for facilities and equipment ......................... 1,000,000
Doylestown Health Foundation, Doylestown, PA for equipment and associated information technology ..... 100,000
East Los Angeles College, Monterey Park, CA for a health workforce initiative, including facilities and
equipment .................................................................................................................................................. 925,000
Easterseals Midwest, St. Louis, MO for equipment, information technology, and support services ........... 200,000
Easterseals of Southwest Florida, Sarasota, FL for facilities ....................................................................... 2,000,000
Edward M. Kennedy Community Health Center, Inc., Worcester, MA for an interpreter services program .. 1,000,000
El Centro de Corazon, Houston, TX for facilities and equipment ................................................................. 225,000
El Paso County Hospital District/University Medical Center of El Paso, El Paso, TX for purchase of
equipment .................................................................................................................................................. 1,200,000
El Proyecto del Barrio, Inc., Winnetka, CA for facilities and equipment ...................................................... 1,000,000
El Rio Santa Cruz Neighborhood Health Care, Inc., Tucson, AZ for facilities and equipment .................... 1,450,000
Equitas Health, Columbus, OH for purchase of equipment .......................................................................... 150,000
Erie County Health Department, Sandusky, OH for facilities and equipment .............................................. 2,000,000
Erie Neighborhood House, Chicago, IL for facilities and equipment ............................................................ 2,000,000
Erlanger Health System, Chattanooga, TN for facilities and equipment ...................................................... 2,000,000
EveryMind, Rockville, MD for telehealth ........................................................................................................ 325,000
Excela Health, Greensburg, PA for equipment ............................................................................................... 125,000
Excela Health, Greensburg, PA for equipment ............................................................................................... 650,000
Families Flourish Northeast, Lebanon, NH for facilities and equipment ...................................................... 500,000
Family Services, Inc., Poughkeepsie, NY for facilities and equipment ......................................................... 1,200,000
Jewish Family and Children’s Service of Palm Beach County, West Palm Beach, FL for an electronic
health records initiative ............................................................................................................................ 325,000
Flanner House of Indianapolis, Inc., Indianapolis, IN for facilities and equipment .................................... 250,000
Floating Hospital, Inc., Long Island City, NY for facilities and equipment .................................................. 925,000
Florida International University, Miami, FL for facilities and equipment ..................................................... 2,000,000
Flushing Hospital and Medical Center, Flushing, NY for facilities and equipment ..................................... 750,000
Free Clinic of Meridian Inc., Meridian, MS for facilities and equipment ..................................................... 315,000
Fresno City College, Fresno, CA for a health workforce initiative ................................................................ 475,000
Friend Family Health Center, Chicago, IL for facilities and equipment ....................................................... 250,000
Gardner Family Health Network, Inc., San Jose, CA for facilities and equipment ....................................... 900,000
Gateway Community Health Center, Inc., Laredo, TX for facilities and equipment ..................................... 2,000,000
Gavin Foundation, Inc., South Boston, MA for facilities and equipment ..................................................... 1,000,000
George Mason University, Fairfax, VA for a health workforce initiative ....................................................... 1,150,000
Glenbrook High School District 225, Glenview, IL for facilities and equipment .......................................... 250,000
God’s Love We Deliver, Inc., New York, NY for a health initiative ............................................................... 775,000
GoochlandCares Inc., Goochland, VA for facilities and equipment .............................................................. 15,000
Grandview Foundation, Dayton, OH for facilities ........................................................................................... 1,250,000
Great Lakes Recovery Centers, Ishpeming, MI for facilities and equipment ................................................ 680,000
Greater Bergen Community Action, Inc., Garfield, NJ for facilities and equipment ..................................... 1,500,000
Greater Lawrence Family Health Center, Methuen, MA for facilities and equipment .................................. 2,000,000
Greater New Bedford Community Health Center, New Bedford, MA for facilities and equipment ............... 2,000,000
Green County Human Services, Aging & Disability Resource Center, Monroe, WI for a rural health initia-
tive, including the purchase of equipment ............................................................................................... 200,000
H. Lee Moffitt Cancer Center and Research Institute, Inc., Tampa, FL for purchase of equipment ........... 2,000,000
Habilitative Systems, Inc., Chicago, IL for facilities and equipment and for an electronic health records
initiative ..................................................................................................................................................... 500,000
Hackensack Meridian Health, Edison, NJ for purchase of equipment .......................................................... 775,000
Hackensack Meridian School of Medicine, Nutley, NJ for facilities and equipment ..................................... 775,000
Hana Health, Hana, HI for facilities and equipment .................................................................................... 1,000,000
Harbor Community Health Centers, San Pedro, CA for facilities and equipment ........................................ 1,000,000
Harbor Hospital, Inc., Baltimore, MD for a telehealth initiative, including the purchase of equipment .... 875,000
Harry E. Davis Partnership for Children’s Oral Health, Yarmouth, ME for a telehealth initiative ............... 650,000
Health Care Coalition of Rural Missouri, Lexington, MO for facilities and equipment ................................ 2,000,000
HealthPoint, Renton, WA for facilities and equipment, including telehealth equipment ............................. 350,000
Hennepin Healthcare System, Inc., Minneapolis, MN for facilities and equipment ..................................... 2,000,000
Henry Ford Wyandotte Hospital, Detroit, MI for facilities and equipment, including telehealth equipment 900,000
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Henry Ford West Bloomfield Hospital, West Bloomfield, MI for purchase of equipment .............................. 1,150,000
Henry Mayo Newhall Hospital, Valencia, CA for equipment .......................................................................... 610,000
Hepatitis B Foundation, Doylestown, PA for public health programming ..................................................... 475,000
Hill Country Mental Health and Developmental Disabilities Centers, Kerrville, TX for facilities and equip-
ment ........................................................................................................................................................... 2,000,000
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Project Amount
Hill Hospital, York, AL for facilities and equipment ..................................................................................... 575,000
Hurley Medical Center, Flint, MI for purchase of equipment ........................................................................ 1,450,000
Illinois College of Optometry, Chicago, IL for facilities and equipment ....................................................... 300,000
Independence Health & Therapy, Woodstock, IL for an electronic medical records initiative ..................... 60,000
Ironbound Community Health Center, Newark, NJ for purchase of equipment ............................................ 550,000
It Takes Philly, Inc. d/b/a/ Black Doctors COVID–19 Consortium, Jenkintown, PA for facilities and equip-
ment ........................................................................................................................................................... 2,000,000
Jackson County School District, Marianna, FL for facilities .......................................................................... 85,000
Jamaica Hospital Medical Center, Richmond Hill, NY for facilities and equipment .................................... 1,500,000
Jessie Trice Community Health Systems Inc., Miami, FL for facilities and equipment ............................... 400,000
Joseph P. Addabbo Family Health Center, Inc., Arverne, NY for facilities and equipment .......................... 1,500,000
JWCH Institute, Inc., Bell Gardens, CA for purchase of equipment .............................................................. 300,000
Kids First Health Care, Commerce City, CO for facilities and equipment ................................................... 800,000
Kōkua Kalihi Valley Comprehensive Family Services, Honolulu, HI for facilities and equipment ................ 1,050,000
La Clinica Tepeyac, Inc., Denver, CO for facilities and equipment .............................................................. 2,000,000
Lake County Health Department & Community Health Center, Waukegan, IL for facilities and equipment 1,000,000
Lakewood Community Services Corporation, Lakewood, NJ for facilities ...................................................... 400,000
Lebanon Valley College, Annville, PA for facilities ........................................................................................ 1,000,000
Legacy Community Health, Houston, TX for a health initiative .................................................................... 20,000
LGBT Life Center, Norfolk, VA for facilities and equipment .......................................................................... 1,800,000
Linda Crnic Institute for Down Syndrome, Aurora, CO for purchase of equipment ..................................... 950,000
Lions Eye Institute for Transplant and Research Foundation Inc., Tampa, FL for facilities and equip-
ment ........................................................................................................................................................... 2,000,000
Loma Linda University Health, Loma Linda, CA for facilities and equipment ............................................. 1,000,000
Loma Linda University Medical Center—Murrieta, Murrieta, CA for equipment .......................................... 600,000
Long Island FQHC, Inc., Westbury, NY for facilities and equipment ............................................................ 2,000,000
Long Island FQHC, Inc., Westbury, NY for facilities and equipment ............................................................ 1,000,000
Loretto Health and Rehabilitation Center, Syracuse, NY for the purchase of equipment and software for
a medical records system ......................................................................................................................... 260,000
Los Angeles LGBT Center, Los Angeles, CA for facilities and equipment .................................................... 775,000
Louisiana State University Health New Orleans, New Orleans, LA for the purchase of equipment ............ 2,000,000
Main St. Missions, Doylestown, PA for facilities ........................................................................................... 200,000
Manet Community Health Center, Quincy, MA for facilities and equipment ................................................ 500,000
Martin Luther King, Jr. Family Clinic, Dallas, TX for a health workforce training initiative, including
equipment and technology ........................................................................................................................ 100,000
Mary Bird Perkins Cancer Center, Baton Rouge, LA for equipment ............................................................. 775,000
Maverick County Hospital District, Eagle Pass, TX for information technology and telehealth services .... 500,000
McLaren Northern Michigan, Petoskey, MI for facilities and equipment ...................................................... 500,000
McLaren Oakland Hospital, Pontiac, MI for purchase of equipment ............................................................ 400,000
Medstar Southern Maryland Hospital Center, Clinton, MD for facilities and equipment ............................. 925,000
MedStar Washington Hospital Center, Washington, DC for facilities and equipment and an electronic
medical records initiative .......................................................................................................................... 800,000
Meharry Medical College, Nashville, TN for facilities and equipment .......................................................... 1,000,000
Memorial Hospital at Gulfport Foundation, Inc., Gulfport, MS for facilities and equipment ....................... 2,000,000
MemorialCare Health System, Long Beach, CA for facilities and equipment and an electronic health
records initiative ........................................................................................................................................ 575,000
Mental Health Care, Inc., Tampa, FL for facilities and equipment for the Mariposa Women’s
Neuropsychiatric Hospital .......................................................................................................................... 2,000,000
Methodist Health Services Corporation, Peoria, IL for facilities ................................................................... 2,000,000
Metropolitan Family Health Network, Inc., Jersey City, NJ for facilities and equipment .............................. 800,000
Miami SCI Wellness Inc., Miami, FL for equipment ...................................................................................... 440,000
Millikin University, Decatur, IL for facilities and equipment ........................................................................ 2,000,000
Minnesota State College Southeast, Red Wing, MN for facilities and equipment ....................................... 825,000
Mississippi State University, Mississippi State, MS for facilities and equipment ....................................... 1,000,000
Missouri Valley College, Marshall, MO for facilities and equipment ............................................................ 2,000,000
Monongahela Valley Hospital Foundation, Monongahela, PA for facilities ................................................... 455,000
Montefiore Medical Center, Bronx, NY for facilities and equipment, including telehealth equipment ........ 3,350,000
Montefiore St. Luke’s Cornwall, Cornwall, NY for facilities and equipment ................................................. 2,000,000
Mount St. Mary’s Hospital of Niagara Falls, Lewiston, NY for facilities and equipment ............................ 2,000,000
Muslim Community Center, Inc., Silver Spring, MD for facilities and equipment ....................................... 250,000
National Alliance on Mental Illness, Ohio Chapter, Toledo, OH, for facilities and equipment .................... 2,000,000
Nemours Foundation, Jacksonville, FL for equipment and information technology ...................................... 105,000
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Nevada State College, Henderson, NV for facilities and equipment ............................................................ 35,000
New Alternatives for Children, Inc., New York, NY for purchase of equipment, including telehealth
equipment .................................................................................................................................................. 500,000
New York City Health + Hospitals/Elmhurst, Queens, NY for facilities and equipment .............................. 800,000
New York City Health + Hospitals/Elmhurst, Queens, NY for facilities and equipment .............................. 3,000,000
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Project Amount
New York City Health + Hospitals/Queens Hospital, Jamaica, NY for facilities and equipment ................. 1,000,000
New York Community Hospital of Brooklyn, Inc., Brooklyn, NY for facilities and equipment ...................... 975,000
Newark Community Health Centers, Inc., Newark, NJ for facilities and equipment .................................... 760,000
Newark-Wayne Community Hospital, Newark, NY for equipment .................................................................. 180,000
Night Ministry, Chicago, IL for facilities and equipment .............................................................................. 275,000
Norman Regional Hospital Authority, Norman, OK for facilities and equipment .......................................... 650,000
North Country Community College, Saranac Lake, NY for facilities and equipment ................................... 1,000,000
North Oakland County Fire Authority, Holly, MI for purchase of equipment ................................................. 500,000
North Shore Community College, Danvers, MA for facilities and equipment ............................................... 900,000
North Shore Community Health, Salem, MA for facilities and equipment ................................................... 1,000,000
Northern Dutchess Hospital/Nuvance Health, Rhinebeck, NY for facilities and equipment ......................... 300,000
Northern Nye County Hospital District, Tonopah, NV for facilities and equipment ...................................... 2,000,000
Northwell Health, New Hyde Park, NY for facilities and equipment ............................................................. 2,000,000
Nursing Care Quality Assurance Commission, Tumwater, WA for a health workforce training program .... 1,000,000
NYC Health + Hospitals/Coney Island, Brooklyn, NY for equipment ............................................................ 2,000,000
Oakland LGBTQ Community Center, Oakland, CA for facilities and equipment ........................................... 350,000
Oklahoma Medical Research Foundation, Oklahoma City, OK for facilities and equipment ........................ 835,000
Oklahoma State University Center for Health Sciences, Tulsa, OK for facilities .......................................... 2,000,000
Olivet Nazarene University, Borubonnais, IL for facilities and equipment ................................................... 90,000
One Brooklyn Health System, Inc., Brooklyn, NY for an electronic health records initiative ....................... 425,000
One Brooklyn Health System, Inc., Brooklyn, NY for purchase of equipment ............................................... 1,000,000
Oregon Health & Science University Northwest Native American Center of Excellence, Portland, OR for a
health workforce initiative ......................................................................................................................... 800,000
OSF St. Joseph Medical Center, Bloomington, IL for facilities and equipment ............................................ 700,000
Outer Cape Health Services, Harwich Port, MA for facilities and equipment .............................................. 250,000
Pace Center For Girls Inc., Jacksonville, FL for a telehealth initiative, including the purchase of equip-
ment ........................................................................................................................................................... 500,000
Pace Center for Girls, Inc., Jacksonville, FL for facilities ............................................................................. 2,000,000
Palm Beach State College, Lake Worth, FL for facilities and equipment .................................................... 700,000
Palo Verde Hospital District, Blythe, CA, for purchase of equipment .......................................................... 350,000
Pascua Yaqui Tribe, Tucson, AZ for facilities and equipment ..................................................................... 900,000
Patrick County Economic Development Authority, Stuart, VA for equipment ................................................ 600,000
Penn State Health St. Joseph Medical Center, Reading, PA, for a rural health initiative, including the
purchase of equipment .............................................................................................................................. 500,000
Pennsylvania Organization for Women in Recovery, Pittsburgh, PA for facilities and equipment ............... 1,500,000
People Coordinated Services of Southern California, Inc., Los Angeles, CA for facilities and equipment .. 600,000
Petaluma Health Center, Inc., Petaluma, CA for facilities and equipment .................................................. 1,000,000
Petaluma Health Center, Petaluma, CA for facilities and equipment .......................................................... 1,600,000
Phoebe Putney Health System, Inc., Albany, GA for facilities and equipment ............................................. 1,000,000
Piatt County Nursing Home, Monticello, IL for facilities and equipment ..................................................... 215,000
Pierce Center for Arts & Technology, Tacoma, WA for facilities and equipment ......................................... 450,000
Pikeville Medical Center, Inc., Pikeville, KY for facilities and equipment .................................................... 675,000
Planned Parenthood Mar Monte, San Jose, CA for facilities and equipment ............................................... 1,000,000
Planned Parenthood Mar Monte, San Jose, CA for facilities and equipment ............................................... 1,000,000
Pomona Community Health Center dba ParkTree Community Health Center, Pomona, CA for facilities
and equipment ........................................................................................................................................... 775,000
Potomac Valley Hospital, Keyser, WV for facilities and equipment .............................................................. 750,000
Preston Memorial Hospital, Kingwood, WV for facilities and equipment ...................................................... 580,000
Primary Health Care, Inc., Des Moines, IA for facilities and equipment ...................................................... 100,000
Primary Health Care, Inc., Des Moines, IA for facilities and equipment ...................................................... 200,000
Providence Milwaukie Hospital , Milwaukie, OR for facilities and equipment ............................................. 800,000
Puerto Rican Organization to Motivate, Enlighten, and Serve Addicts, Inc., Bronx, NY for facilities and
equipment .................................................................................................................................................. 825,000
Queens College, The City of New York, Flushing, NY for facilities and equipment ..................................... 1,850,000
Refuah Health Center, Inc., Spring Valley, NY for facilities and equipment ............................................... 2,000,000
Regents of the University of California, Los Angeles, CA for the purchase of equipment, including tele-
health equipment ....................................................................................................................................... 600,000
Regents of the University of Washington, Seattle, WA for purchase of equipment ..................................... 550,000
Regional One Health, Memphis, TN for purchase of equipment ................................................................... 1,000,000
Research Institute at Nationwide Children’s Hospital, Columbus, OH for purchase of equipment ............. 500,000
Richmond Medical Center of Staten Island, Staten Island, NY for facilities and equipment ..................... 1,815,000
RIDOH Division of State Laboratories and Medical Examiners, Providence, RI for purchase of equipment 900,000
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Rochester General Hospital, Rochester, NY for a health workforce initiative .............................................. 1,000,000
Rockland County Pride Center, Nyack, NY, for facilities and equipment ..................................................... 1,500,000
Roosevelt Special Hospital, Portales, NM for facilities and equipment ....................................................... 600,000
Rosalynn Carter Institute for Caregivers, Americus, GA for purchase of equipment ................................... 1,100,000
Roswell Park Comprehensive Cancer Center, Buffalo, NY for purchase of equipment ................................ 1,500,000
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Project Amount
Rowan University/Rutgers-Camden Board of Governors, Camden, NJ for facilities and equipment ........... 500,000
SAC Health System, San Bernadino, CA for purchase of equipment ........................................................... 375,000
Saint Francis University School of Health Sciences and Education, Loretto, PA for facilities .................... 500,000
Saint Joseph’s Health, Paterson, NJ for facilities and equipment ................................................................ 1,000,000
Saint Louis University, Saint Louis, MO for facilities and equipment .......................................................... 500,000
San Antonio College, San Antonio, TX for facilities and equipment ............................................................ 1,050,000
San Francisco Community Clinic Consortium, San Francisco, CA for facilities and equipment, including
an electronic medical records initiative .................................................................................................... 1,000,000
San Juan College, Farmington, NM for facilities and equipment ................................................................. 1,100,000
San Juan County, Monticello, UT for cancer screening ................................................................................. 520,000
Savio House, Denver, CO for facilities and equipment ................................................................................. 300,000
Schenectady Family Health Services, Inc., D/B/A Hometown Health Centers, Schenectady, NY for facili-
ties and equipment ................................................................................................................................... 750,000
Sharon Hospital, Sharon, CT for facilities and equipment, including telehealth equipment ...................... 400,000
Shasta Community Health Center, Redding, CA for facilities, equipment, and information technology ..... 750,000
Sixteenth Street Community Health Center, Milwaukee, WI for facilities and equipment ........................... 1,250,000
Snohomish Health District, Everett, WA for a telehealth and electronic health records initiative, includ-
ing purchase of equipment ....................................................................................................................... 250,000
Spectrum Health Lakeland, St. Joseph, MI for facilities and equipment, including information technology 505,000
Spokane County, Spokane, WA for equipment ............................................................................................... 1,125,000
St. Barnabas Hospital, Bronx, NY for facilities and equipment ................................................................... 1,350,000
St. John’s Episcopal Hospital, Far Rockaway, NY for facilities and equipment for the Behavioral Health
Equity Renovation Project .......................................................................................................................... 2,000,000
St. John’s Episcopal Hospital, Far Rockaway, NY for facilities and equipment for the Women and
Newborns Health Equity Renovation Project ............................................................................................. 2,000,000
St. John’s University, Jamaica, NY for facilities and equipment .................................................................. 1,250,000
St. Louis Center for Exceptional Children and Adults, Chelsea, MI for facilities and equipment ............... 500,000
St. Luke’s Hospital, New Bedford, MA for facilities and equipment ............................................................ 975,000
St. Luke’s Quakertown Hospital, Quakertown, PA for facilities ..................................................................... 400,000
St. Mary’s University of San Antonio, San Antonio, TX for facilities and equipment .................................. 875,000
St. Tammany Parish Hospital Service District No. 1, d/b/a St. Tammany Health System, Covington, LA
for equipment ............................................................................................................................................ 1,000,000
Stanislaus County Behavioral Health and Recovery Services, Modesto, CA for facilities and equipment .. 2,000,000
Staten Island University Hospital, Staten Island, NY for facilities and equipment ..................................... 2,000,000
Stepping Stones Inc., Joliet, IL for facilities and equipment ........................................................................ 2,000,000
Stillman College, Tuscaloosa, AL for facilities and equipment .................................................................... 800,000
STOP Inc., Virginia Beach, VA for a telehealth initiative, including purchase of equipment ...................... 250,000
Summa Health, Akron, OH for facilities and equipment ............................................................................... 1,000,000
SUNY Downstate Health Sciences University, Brooklyn, NY for facilities and equipment ............................ 1,925,000
Terros, Inc.—DBA Terros Health, Phoenix, AZ for facilities and equipment for Terros Health—Stapley
Health Center ............................................................................................................................................. 600,000
Terros, Inc. DBA Terros Health, Phoenix, AZ for facilities and equipment ................................................... 900,000
Texas Southern University, Houston, TX for facilities and equipment .......................................................... 2,000,000
Thresholds, Chicago, IL for facilities and equipment ................................................................................... 1,000,000
Tidalhealth Nanticoke, Seaford, DE for facilities and equipment ................................................................. 350,000
Tillamook Bay Community College Foundation, Tillamook, OR for a health workforce training initiative,
including purchase of equipment ............................................................................................................. 425,000
Touro University California, Vallejo, CA for facilities and equipment .......................................................... 1,000,000
Town of East Millinocket, ME for purchase of equipment for the East Millinocket Rural Ambulance Serv-
ice .............................................................................................................................................................. 300,000
Town of Randolph, MA for facilities and equipment at Randolph High School ........................................... 1,000,000
Truman Medical Center Inc., Kansas City, MO for facilities and equipment ............................................... 2,000,000
Tulane University, New Orleans, LA for facilities and equipment ................................................................ 1,000,000
United Way of Tarrant County, TX for a health initiative ............................................................................. 25,000
United Way of the Crossroads, Victoria, TX for a rural health initiative ..................................................... 40,000
Unity Care Northwest, Bellingham, WA for facilities and equipment ........................................................... 2,000,000
Universal Community Health Center, Los Angeles, CA for facilities and equipment ................................... 300,000
University at Albany, Albany, NY for purchase of equipment ....................................................................... 1,000,000
University Health System, Inc., Knoxville, TN for facilities ........................................................................... 2,000,000
University Health System, Inc., Knoxville, TN for facilities and equipment .................................................. 2,000,000
University Hospitals Cleveland Medical Center, Shaker Heights, OH for facilities and equipment for the
University Hospitals Portage Medical Center ............................................................................................ 1,000,000
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University of Alaska, Fairbanks, AK for facilities .......................................................................................... 2,000,000
University of California San Diego, La Jolla, CA for a telehealth initiative, including purchase of equip-
ment ........................................................................................................................................................... 950,000
University of California (San Francisco) Fresno Regional Campus, Fresno, CA for facilities and equip-
ment ........................................................................................................................................................... 475,000
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Project Amount
University of California, Davis Health, Sacramento, CA for an electronic health record and telehealth
initiative ..................................................................................................................................................... 1,700,000
University of California-Davis, Davis, CA for a health workforce initiative ................................................. 1,000,000
University of Cincinnati Medical Center, Cincinnati, OH for facilities ......................................................... 4,000,000
University of Colorado Anschutz Medical Campus, Aurora, CO for a health workforce initiative ................ 1,000,000
University of Florida Health Jacksonville, Jacksonville, FL for facilities and equipment ............................. 705,000
University of Hawaii System, Honolulu, HI for a rural health initiative ....................................................... 1,000,000
University of Illinois—Chicago, College of Dentistry and Oral Health, Chicago, IL for facilities and
equipment .................................................................................................................................................. 500,000
University of Kansas Medical Center, Kansas City, KS for purchase of equipment for the Kansas Univer-
sity Cancer Center ..................................................................................................................................... 1,000,000
University of Massachusetts Boston, Boston, MA for facilities and equipment ........................................... 1,350,000
University of New Mexico, Albuquerque, NM for facilities and equipment ................................................... 1,500,000
University of Pittsburgh Medical Center Northwest, Seneca, PA for facilities and equipment .................... 100,000
University of Saint Francis—Crown Point Campus, Fort Wayne, IN for facilities and equipment .............. 225,000
University of Texas at Dallas, TX for facilities and equipment and a telehealth initiative ........................ 850,000
University of Texas Southwestern Medical Center, Dallas, TX for facilities and equipment ....................... 1,000,000
University of Texas Southwestern Medical Center, Dallas, TX for facilities and equipment ....................... 800,000
University of Toledo Medical Center, Toledo, OH for facilities and equipment ............................................ 500,000
Urban Health Plan, Bronx, NY for facilities and equipment ......................................................................... 500,000
Urban Health Plan, Inc., Corona, NY for facilities and equipment, including telehealth equipment .......... 100,000
Veterans Transition House, New Bedford, MA for a telehealth and electronic medical records initiative,
including the purchase of equipment ....................................................................................................... 375,000
Via Care Community Health Center, Los Angeles, CA for facilities and equipment .................................... 150,000
Village of Dwight, Dwight, IL for equipment ................................................................................................. 250,000
Vinland National Center, Loretto, MN for facilities ....................................................................................... 500,000
Virginia Garcia Memorial Health Center, Hillsboro, OR for facilities and equipment .................................. 2,000,000
Visiting Nurse Association of Central Jersey Freehold Family Health Center, Freehold, NJ for facilities
and equipment ........................................................................................................................................... 700,000
Visiting Nurse Association of Central Jersey Red Bank Primary Care Center, Red Bank, NJ for facilities
and equipment ........................................................................................................................................... 400,000
Washington Hospital Foundation, Washington, PA for facilities and equipment ......................................... 1,210,000
WEAVE INC., Sacramento, CA for facilities .................................................................................................... 275,000
Wenatchee Valley College, Omak, WA for facilities ....................................................................................... 2,000,000
West Central Alabama Area Health Education Center, Demopolis, AL for a community health worker ini-
tiative and purchase of equipment ........................................................................................................... 300,000
Westchester Public/Private Membership Fund for Aging Services, Mount Vernon, NY for telehealth, in-
cluding telehealth equipment .................................................................................................................... 375,000
Wheeling Health Right, Wheeling, WV for facilities and equipment ............................................................. 350,000
White Memorial Medical Center, Los Angeles, CA for facilities and equipment .......................................... 1,200,000
Will-Grundy Medical Clinic Inc., Joliet, IL for facilities and equipment ....................................................... 300,000
William F. Ryan Community Health Center, Inc., New York, NY for facilities and equipment .................... 2,000,000
WINGS Program Inc., Rolling Meadows, IL for facilities and equipment ...................................................... 250,000
Winters Health Foundation, Winters, CA for facilities and equipment ......................................................... 500,000
Wood River Health Services, Hope Valley, RI for facilities and equipment .................................................. 1,000,000
Young Men’s Christian Association of Greater Charlotte, Charlotte, NC for facilities and equipment ....... 2,000,000
Youthbuild Louisville , Louisville, KY for facilities and equipment .............................................................. 600,000
VACCINE INJURY COMPENSATION PROGRAM
Appropriation, fiscal year 2021 ......................................................... $11,200,000
Budget request, fiscal year 2022 ....................................................... 16,200,000
Committee Recommendation ............................................................. 16,200,000
Change from enacted level ......................................................... +5,000
Change from budget request ...................................................... –––
The Committee includes $16,200,000 for administrative costs as-
sociated with the Vaccine Injury Compensation Program, an in-
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crease of $5,000,000 above the fiscal year 2021 enacted level and
the same as the fiscal year 2022 budget request. This program pro-
vides compensation for individuals with vaccine-associated injuries
or deaths.
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COVERED COUNTERMEASURES PROCESS FUND
Appropriation, fiscal year 2021 ......................................................... $0
Budget request, fiscal year 2022 ....................................................... 5,000,000
Committee Recommendation ............................................................. 5,000,000
Change from enacted level ......................................................... +5,000,000
Change from budget request ...................................................... –––
The Committee includes $5,000,000 for administrative costs asso-
ciated with the Countermeasures Injury Compensation Program
(CICP), an increase of $5,000,000 above the fiscal year 2021 en-
acted level and the same as the fiscal year 2022 budget request.
The CICP provides benefits to individuals who are seriously injured
as a result of a vaccination, medication, device, or other item rec-
ommended to diagnose, prevent or treat a declared pandemic, epi-
demic or security threat.
CENTERS FOR DISEASE CONTROL AND PREVENTION
Appropriation, fiscal year 2021 ......................................................... $7,874,804,000
Budget request, fiscal year 2022 ....................................................... 9,552,519,000
Committee Recommendation ............................................................. 10,571,419,000
Change from enacted level ......................................................... +2,696,615,000
Change from budget request ...................................................... +1,018,900,000
The Committee recommendation for the Centers for Disease Con-
trol and Prevention (CDC) program level includes $9,612,761,000
in discretionary budget authority, $55,358,000 in mandatory funds
under the terms of the Energy Employees Occupational Illness
Compensation Program Act, and $903,300,000 in transfers from the
Prevention and Public Health (PPH) Fund.
CDC’s mission is to protect Americans from health, safety, and
security threats, which it accomplishes by supporting core public
health functions at State, local, and tribal health departments, de-
tecting and responding to new and emerging health threats, pro-
moting health and safety, and providing leadership in the public
health workforce.
IMMUNIZATION AND RESPIRATORY DISEASES
Appropriation, fiscal year 2021 ......................................................... $821,005,000
Budget request, fiscal year 2022 ....................................................... 945,930,000
Committee Recommendation ............................................................. 950,930,000
Change from enacted level ......................................................... +129,925,000
Change from budget request ...................................................... +5,000,000
The Committee recommendation includes $531,580,000 in discre-
tionary budget authority and $419,350,000 in transfers from the
PPH Fund.
Immunization cooperative agreements are awarded to State and
local public health departments for planning, developing, and con-
ducting childhood, adolescent, and adult immunization programs,
including enhancement of the vaccine delivery infrastructure. CDC
directly maintains a stockpile of vaccines, supports consolidated
purchase of vaccines for State and local health agencies, and con-
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ducts surveillance, investigations, and research into the safety and
efficacy of new and presently used vaccines.
Within the total for Immunization and Respiratory Diseases, the
Committee recommends the following amounts:
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Budget Activity FY 2022 Committee
Section 317 Immunization Program ............................................................................................................... $718,572,000
Acute Flaccid Myelitis .................................................................................................................................... 6,000,000
Influenza Planning and Response ................................................................................................................. 226,358,000
Adult Hepatitis B Vaccination.—The Committee is concerned
about the rate of adult hepatitis B vaccination, as low rates of vac-
cine coverage among adults represent a missed opportunity. The
Committee urges CDC to develop a plan to achieve adult hepatitis
B vaccination goals.
Cost Estimates.—The Committee looks forward to reviewing the
fiscal year 2023 report on estimated funding needs of the Section
317 Immunization Program and urges that the report be updated
and submitted not later than February 1, 2022. The updated report
should include an estimate of optimum State and local operations
funding, as well as a discussion of the role of the 317 Program, as
coverage for vaccination under public and private resources con-
tinues to evolve. The fiscal year 2023 report should include specific
information on the estimated cost to fully address evidence-based
public health strategies that could be funded through CDC to im-
prove coverage for human papillomavirus and influenza.
COVID–19 Antibody Testing.—The Committee is aware that
there is some concern that antibody or serologic testing has been
underutilized in the response to the COVID–19 pandemic and that
CDC guidance on the use of these tests may warrant further re-
view. The Food and Drug Administration has authorized numerous
antibody tests. These tests can be deployed to inform
seroprevalence surveys and to improve patient care. The Com-
mittee encourages the use of antibody tests, where appropriate,
and requests an update on this topic in the fiscal year 2023 Con-
gressional Budget Justification.
Enhancing 317 Immunization Program.—The Committee in-
cludes an increase of $99,925,000 to enhance adult immunization.
The COVID–19 pandemic illuminated a variety of gaps in our pub-
lic health capacity, including the need for a comprehensive adult
immunization program. This expansion holds the potential to meet
longstanding issues of inequity in protection from vaccine-prevent-
able diseases and to address vaccine hesitancy.
Immunization Rates.—The Committee is concerned about the
marked decline in routine childhood and adolescent vaccines as a
result of the pandemic. The Committee urges CDC to engage pro-
viders, health care stakeholders, educators, community organiza-
tions, and parents/guardians about the importance of ensuring that
children and adolescents visit their primary care provider and re-
ceive their routinely recommended vaccinations, including HPV
vaccination. In addition, the Committee urges that immunization
reminder recall is prioritized. The Committee requests a report
within 90 days of enactment of this Act regarding the strategy and
plan for the public awareness campaign to increase childhood and
adult routine vaccination rates and reduce barriers to routine vac-
cinations including, but not limited to vaccine hesitancy. This re-
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port should include information on immunization rates of all age
groups and provide disaggregated data on vaccines rates to deter-
mine disparities across race, ethnicity, sex, age, and zip code, as
available, for both routine and COVID–19 vaccinations. In addition,
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the report shall address actions taken and plans to strengthen
awareness, understanding, and trust in vaccines.
Improving Immunization Information System Infrastructure and
Data.—The Committee is concerned about the state of interoper-
ability across Immunization Information Systems (IIS), especially
as vaccine administration information becomes more critical with
respect to stopping the COVID–19 pandemic. It is important that
IIS across the country interoperate with each other, are capable of
transmitting information to public health authorities, including
CDC, and that each IIS has the capacity to intake data and satisfy
bidirectional queries. The Committee includes $5,000,000 for CDC
to consult with stakeholders to outline the steps toward a more ro-
bust common core data set for collection of vaccine administration
information and to initiate a national framework that includes the
minimum functional standards for IIS to interoperate.
Influenza Planning and Response.—The Committee includes an
increase of $25,000,000 to enhance CDC’s influenza activities, in-
cluding expanding vaccine effectiveness monitoring and evaluation,
and increasing influenza vaccine acceptance by removing barriers
to vaccination and promoting vaccination coverage.
Influenza Vaccine.—The Committee encourages CDC to consider
including vaccines produced through recombinant DNA technology
in addition to traditionally-produced vaccines in future solicitations
to facilitate the competitive process for all vaccine manufacturers.
Respiratory Syncytial Virus.—The Committee applauds the ongo-
ing development of novel immunizations to provide protection for
all infants against Respiratory Syncytial Virus (RSV) disease. Cur-
rently, there is no licensed immunization that can protect all in-
fants from RSV. The Committee encourages CDC and the Advisory
Committee on Immunization Practices (ACIP) to review any novel
immunization, including monoclonal antibodies, that holds the
promise of broad protection for all infants and public health benefit
to children, for inclusion on the Child and Adolescent Immuniza-
tion Schedule and in the Vaccines for Children program.
Shared Clinical Decision Making.—The Committee encourages
CDC to work with health professional organizations to utilize deci-
sion making support tools to promote recent changes made to the
Evaluation and Management office visit Current Procedural Termi-
nology codes which allow for the use of ‘‘Total Time’’ or the use of
‘‘Medical Decision Making’’ as key contributing factors, for the
basis of payment for vaccination counseling and administration.
This will ensure that medical professionals and patients are in-
formed and have a clear understanding of and continued access to
the immunizations they should receive across the life course.
Vulnerable Populations.—The Committee commends the CDC
ACIP recommendations and the Office of Civil Rights for its contin-
ued vigilance regarding potential discrimination in vulnerable pop-
ulations during the COVID–19 pandemic and for working collabo-
ratively with States to ensure State guidelines reflect best practices
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for serving individuals with disabilities and the elderly.
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HIV/AIDS, VIRAL HEPATITIS, SEXUALLY TRANSMITTED DISEASES, AND
TUBERCULOSIS PREVENTION
Appropriation, fiscal year 2021 ......................................................... $1,314,056,000
Budget request, fiscal year 2022 ....................................................... 1,420,556,000
Committee Recommendation ............................................................. 1,501,556,000
Change from enacted level ......................................................... +187,500,000
Change from budget request ...................................................... +81,000,000
CDC provides national leadership and support for prevention re-
search and the development, implementation, and evaluation of
evidence-based HIV, viral hepatitis, sexually transmitted diseases
(STD), and tuberculosis (TB) prevention programs serving persons
affected by, or at risk for, these infections. Activities include sur-
veillance, epidemiologic and laboratory studies, and prevention ac-
tivities. CDC provides funds to State, local, and tribal health de-
partments and community-based organizations to develop and im-
plement integrated community prevention plans.
Within the total for HIV/AIDS, Viral Hepatitis, STD, and TB
Prevention, the Committee recommends the following amounts:
Budget Activity FY 2022 Committee
Domestic HIV/AIDS Prevention and Research ................................................................................................ $1,080,712,000
HIV Initiative .......................................................................................................................................... 275,000,000
School Health-HIV .................................................................................................................................. 50,081,000
Viral Hepatitis ................................................................................................................................................ 44,500,000
Sexually Transmitted Infections ..................................................................................................................... 166,810,000
Tuberculosis .................................................................................................................................................... 140,034,000
Infectious Diseases and the Opioid Epidemic ............................................................................................... 69,500,000
Congenital Syphilis.—The Committee is concerned about the
massive interruptions in sexually transmitted infection care and
preventative services due to the pandemic. The Committee urges
priority be given to jurisdictions experiencing the highest preva-
lence of congenital syphilis (CS) cases. The Committee urges CDC
to prioritize CS programming and multi-point testing of pregnant
women in community organizations, and STD and drug addiction
clinics.
Hepatitis B.—The Committee urges CDC to maintain its invest-
ment in hepatitis B grants to support community-based organiza-
tions that are vital to serving disproportionately impacted commu-
nities to help ensure these groups receive the necessary testing and
linkage to care. CDC is also urged to expand the viral hepatitis dis-
ease tracking and surveillance capabilities of the States to permit
an effective targeting of resources and evaluation of program effec-
tiveness.
HIV Initiative.—The Committee includes an increase of
$100,000,000 for the third year of the Ending the HIV Epidemic
initiative to advance the four key strategies: diagnose, treat, pre-
vent, and respond. The Committee recognizes that sexually trans-
mitted diseases are associated with increased risk of HIV acquisi-
tion. The Committee commends CDC for including dedicated fund-
ing within this initiative for sexually transmitted infection clinics.
Infectious Diseases and the Opioid Epidemic.—The Committee in-
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cludes an increase of $56,500,000 to expand activities to target the
infectious disease consequences of the public health crisis involving
injection drug use, including expanding the implementation of and
access to high quality syringe services programs nationwide.
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School Health.—The Committee includes an increase of
$16,000,000 to bolster school capacity for evidence-based sexual
health education, and access to sexual health services and safe and
supportive environments.
Sexually Transmitted Infections.—The Committee includes an in-
crease of $5,000,000 to address the high rates of sexually trans-
mitted infections (STIs). The Committee recognizes that direct
funding to State and local health departments is critical to address
STIs and other infectious diseases. In addition, the Committee
notes the investment of more than $1,000,000,000 from the Amer-
ican Rescue Plan (P.L. 117–2) to bolster support and enhance the
disease intervention specialist workforce nationwide to respond to
COVID–19 and other infectious diseases.
Tuberculosis.—The Committee includes an increase of $5,000,000
to enable CDC, along with State and local entities, to provide TB
screening, identification, treatment and prevention services, and to
restore funding to the TB Trials Consortium. The Committee is
concerned that the COVID–19 pandemic caused significant impacts
on individuals with TB and on State and local TB programs, in-
cluding delays in care for people with TB and postponement of
identification and treatment of individuals with latent TB infection,
stalling efforts to eliminate TB in the U.S.
Viral Hepatitis.—The Committee includes an increase of
$5,000,000 to enhance efforts to eliminate the public health threat
of viral hepatitis.
EMERGING AND ZOONOTIC INFECTIOUS DISEASES
Appropriation, fiscal year 2021 ......................................................... $648,272,000
Budget request, fiscal year 2022 ....................................................... 678,272,000
Committee Recommendation ............................................................. 726,272,000
Change from enacted level ......................................................... +78,000,000
Change from budget request ...................................................... +48,000,000
The Committee recommendation includes $674,272,000 in discre-
tionary appropriations and $52,000,000 in transfers from the PPH
Fund.
Programs funded under Emerging and Zoonotic Infectious Dis-
eases (EZID) support the prevention and control of infectious dis-
eases through surveillance, outbreak investigation and response,
research, and prevention.
Within the total for EZID, the Committee recommends the fol-
lowing amounts:
Budget Activity FY 2022 Committee
Antibiotic Resistance Initiative ...................................................................................................................... $177,000,000
Vector-borne Diseases .................................................................................................................................... 57,603,000
Lyme Disease .................................................................................................................................................. 21,000,000
Prion Disease .................................................................................................................................................. 7,500,000
Chronic Fatigue Syndrome ............................................................................................................................. 5,400,000
Food Safety ..................................................................................................................................................... 75,000,000
Emerging Infectious Diseases ........................................................................................................................ 194,997,000
National Health Care Safety Network ............................................................................................................ 26,000,000
Quarantine ...................................................................................................................................................... 72,772,000
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Advanced Molecular Detection ....................................................................................................................... 35,000,000
Epidemiology and Laboratory Capacity .......................................................................................................... 40,000,000
Healthcare-Associated Infections ................................................................................................................... 12,000,000
Harmful Algal Blooms .................................................................................................................................... 2,000,000
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Advanced Molecular Detection.—The Committee includes an in-
crease of $5,000,000 and recognizes the value of the Advanced Mo-
lecular Detection program through its crosscutting and collabo-
rative work that introduces and helps establish biotechnology-fo-
cused innovation to public health programs across CDC and in
State and local health departments. The Committee is aware that
at the start of the COVID–19 pandemic, there were only a few pub-
lic health laboratories capable of performing the necessary ad-
vanced molecular detection tests. The Committee requests a status
update on the capabilities at public health laboratories in the fiscal
year 2023 Congressional Budget Justification.
Antibiotic Resistance.—The Committee includes an increase of
$5,000,000. The Committee recognizes the importance of effectively
combatting antibiotic resistant bacteria as part of CDC’s broader
efforts to mitigate the clinical and public health impacts of the
COVID–19 outbreak. Furthermore, the Committee recognizes the
importance of addressing the problem of antibiotic-resistant bac-
teria through a ‘‘One Health’’ approach and by tracking resistance
through local, regional, national, and global surveillance. The Com-
mittee encourages CDC to competitively award research activities
that address aspects of antibiotic resistance related to ‘‘One
Health,’’ including global surveillance and research and develop-
ment for new tools to counter antibiotic resistance among entities,
including public academic medical centers, veterinary schools with
agriculture extension services, and public health departments
whose proposals are in line with CDC’s strategy for addressing an-
tibiotic resistant bacteria.
Epidemiology and Laboratory Capacity Awards.—The Committee
urges CDC to work with States to prioritize funding to local health
departments based on factors such as population size, disease bur-
den, and other public health metrics to promote equitable funding
distribution.
Harmful Algal Blooms.—The Committee includes funding to sup-
port monitoring and health reporting concerns related to harmful
algal blooms (HABs). The Committee urges CDC to continue work
to understand and prevent illnesses associated with affected
waters, with a focus on freshwater and the related dangers to
drinking water supplies. CDC has a unique role in better under-
standing the intersection of public health and environmental im-
pacts of HABs using a One Health approach to: (1) increase out-
reach efforts to States and local public health officials to use these
monitoring and reporting systems; and (2) work with a variety of
agencies that currently collaborate on HABs such as the Harmful
Algal Bloom and Hypoxia Research and Control Act Interagency
Working Group and the Great Lakes Restoration Initiative. The
scope of future research may expand to include improving labora-
tory methods for HAB-related toxins in biological specimens and
clinical diagnostic methods to identify HAB-related symptoms and
illnesses, optimizing emergency response capacities, and identifying
and addressing the impacts of harmful algal toxins to humans.
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There is an important nexus between freshwater and health
through drinking water and recreation, and CDC is encouraged to
expand their work regionally to understand HABs impact on our
nation’s largest fresh bodies of water.
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Food Safety.—The Committee includes an increase of
$10,000,000 to help address the critical unmet needs in the nation’s
food safety system, in part through programs that enhance State
and local public health capacity to support vital national surveil-
lance, improve foodborne outbreak detection and investigations, en-
hance food safety prevention efforts, and maintain vigilance for
emerging threats to our nation’s food supply.
Live Animal Imports.—The Committee is aware that importation
of live animals, particularly dogs, has increased substantially dur-
ing the COVID–19 pandemic and is concerned by instances in
which live animals have been held at ports of entry for hours or
days. The Committee emphasizes the importance of prioritizing in-
spection of live cargo by CDC personnel to ensure that all due
standards of animal welfare are maintained and urges CDC to
adopt policies limiting the maximum amount of time between the
arrival of cargo containing live animals and inspection to the short-
est practicable period.
Lyme Disease.—The Committee includes an increase of
$5,000,000 to support efforts to develop improved diagnostics with
appropriate sensitivity and specificity for the detection of subclin-
ical or low-level infection for use in disease eradication, and sur-
veillance networks so that disease burden can be more accurately
determined; and to bolster critical prevention and provider and
public awareness efforts. Furthermore, the Committee encourages
CDC to reevaluate the practice of utilizing the classification of
States as high or low incidence as surveillance criteria.
Mosquito-Borne Diseases.—The COVID–19 pandemic response re-
quired many State and local health departments to redirect staff
from other vital tasks such as mosquito control-related activities,
resulting in less capacity to surveil and mitigate potential mos-
quito-borne public health threats. The Committee is concerned
about the spread of mosquito-borne diseases, such as Zika, and en-
courages the use of the Mosquito Abatement for Safety and Health
Program to provide grants and technical assistance to States and
political subdivisions to prevent and control mosquito-borne dis-
eases.
Myalgic Encephalomyelitis/Chronic Fatigue Syndrome.—The
Committee commends CDC for its recent progress in myalgic
encephalomyelitis/chronic fatigue syndrome (ME/CFS) medical edu-
cation and in its participation in the Interagency Working Group
for ME/CFS.
Mycotic Diseases.—The Committee provides an increase of
$2,000,000 in Emerging Infectious Diseases for mycotic diseases,
including, but not limited to, surveillance and prevention, building
capacity in the State and local health departments, cooperative
agreements, education of the public and healthcare providers, and
laboratory support. The Committee requests an update in the fiscal
year 2023 Congressional Budget Justification on how this funding
is being utilized.
National Healthcare Safety Network.—The Committee includes
an increase of $5,000,000 and recognizes the value of this system
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for healthcare quality measurement and improvement. The Com-
mittee supports the modernization of the system’s infrastructure
resulting in increased timeliness and accuracy, reduced burden on
healthcare facilities, and the ability to collect urgent data.
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Natural History Museums.—The Committee notes that the na-
tion’s natural history museums provide an unparalleled resource
for studying zoonotic diseases such as COVID–19. These museums
hold millions of animal samples collected over decades from across
the globe, offer deep and broad scientific expertise, and are unique-
ly positioned to assist in preparing for and predicting the next pan-
demic-causing viruses. The Committee encourages increased utili-
zation and support of this largely untapped resource.
One Health.—The Committee understands that despite unprece-
dented efforts to address the COVID–19 pandemic, many questions
remain about the prevention of future pandemics, especially those
caused by zoonotic disease transmission. The Committee supports
a One Health approach that recognizes that human, animal, and
environmental health are fundamentally interconnected.
Prion.—The Committee includes an increase of $1,000,000 and
recognizes the critical work of the National Prion Disease Pathol-
ogy Surveillance Center. The workload related to chronic wasting
disease in deer and elk populations in the U.S. is in addition to the
Center’s ongoing efforts related to human prion diseases that in-
cludes research, surveillance, tissue banking, and technical and
supportive assistance to providers to families.
Quarantine.—The Committee includes an increase of $30,000,000
to enhance programs to protect the U.S. from infectious diseases,
including expanded coverage at the most heavily trafficked airports
and land border crossings and increased capacity for health
screenings.
Vector-Borne Diseases.—The Committee includes an increase of
$15,000,000 to address the steady increase in the incidence of vec-
tor-borne disease and to sustain the Regional Centers of Excellence
program, including State-level surveillance and research being con-
ducted by partners. The Committee encourages CDC to examine
options to provide greater coverage of the Northwest region for vec-
tor-borne disease resources.
Wastewater Surveillance.—The Committee commends CDC’s
work implementing the National Wastewater Surveillance System
with partners at State health labs and academic institutions to bet-
ter track COVID–19 and understands the important role waste-
water testing plays for our nation’s biosecurity.
CHRONIC DISEASE PREVENTION AND HEALTH PROMOTION
Appropriation, fiscal year 2021 ......................................................... $1,276,664,000
Budget request, fiscal year 2022 ....................................................... 1,452,664,000
Committee Recommendation ............................................................. 1,557,064,000
Change from enacted level ......................................................... +280,400,000
Change from budget request ...................................................... +104,400,000
The Committee recommendation includes $1,302,114,000 in dis-
cretionary appropriations and $254,950,000 in transfers from the
PPH Fund.
Programs supported within Chronic Disease Prevention and
Health Promotion provide national leadership and support for
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State, tribal, and community efforts to promote health and well-
being through the prevention and control of chronic diseases.
Within the total provided, the Committee recommends the fol-
lowing amounts:
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FY 2022
Budget Activity Committee
Tobacco ........................................................................................................................................................... $250,000,000
Nutrition, Physical Activity, and Obesity ........................................................................................................ 56,920,000
High Obesity Rate Counties .................................................................................................................. 15,000,000
School Health ................................................................................................................................................. 17,400,000
Health Promotion ............................................................................................................................................ 47,500,000
Glaucoma ............................................................................................................................................... 4,000,000
Vision and Eye Health ........................................................................................................................... 1,000,000
Alzheimer’s Disease ............................................................................................................................... 25,000,000
Inflammatory Bowel Diseases ............................................................................................................... 1,500,000
Interstitial Cystitis ................................................................................................................................. 1,500,000
Excessive Alcohol Use ........................................................................................................................... 5,000,000
Chronic Kidney Disease ......................................................................................................................... 4,500,000
Chronic Disease Education and Awareness .......................................................................................... 5,000,000
Prevention Research Centers ......................................................................................................................... 31,961,000
Heart Disease and Stroke .............................................................................................................................. 148,105,000
Diabetes .......................................................................................................................................................... 153,129,000
National Diabetes Prevention Program .......................................................................................................... 34,300,000
Cancer Prevention and Control ...................................................................................................................... 385,799,000
Breast and Cervical Cancer .................................................................................................................. 230,000,000
WISEWOMAN .................................................................................................................................. 33,120,000
Breast Cancer Awareness for Young Women ........................................................................................ 5,960,000
Cancer Registries .................................................................................................................................. 51,440,000
Colorectal Cancer .................................................................................................................................. 45,294,000
Comprehensive Cancer .......................................................................................................................... 20,425,000
Johanna’s Law ....................................................................................................................................... 12,000,000
Ovarian Cancer ...................................................................................................................................... 14,000,000
Prostate Cancer ..................................................................................................................................... 14,205,000
Skin Cancer ........................................................................................................................................... 4,000,000
Cancer Survivorship Resource Center ................................................................................................... 475,000
Oral Health ..................................................................................................................................................... 21,500,000
Safe Motherhood/Infant Health ...................................................................................................................... 119,000,000
Arthritis ........................................................................................................................................................... 12,500,000
Epilepsy .......................................................................................................................................................... 13,000,000
National Lupus Registry ................................................................................................................................. 10,500,000
Racial and Ethnic Approaches to Community Health ................................................................................... 73,950,000
Good Health and Wellness in Indian Country ....................................................................................... 27,000,000
Social Determinants of Health ....................................................................................................................... 153,000,000
Million Hearts ................................................................................................................................................. 14,000,000
National Early Child Care Collaboratives ...................................................................................................... 5,000,000
Hospitals Promoting Breastfeeding ................................................................................................................ 9,500,000
Alzheimer’s Disease.—The Committee includes an increase of
$4,500,000 to support provisions enacted in the Building Our Larg-
est Dementia (BOLD) Infrastructure for Alzheimer’s Act (P.L. 115–
406), including the implementation of the Road Map Series, ex-
panding the number of Centers of Excellence, and building a robust
Alzheimer’s and other dementias public health infrastructure
across the country.
Arthritis.—The Committee includes an increase of $1,500,000 to
expand the number of State-based arthritis programs, provide ac-
cess to proven arthritis self-management and physical activity pro-
grams, and improve data collection and surveillance.
Breast and Cervical Cancer.—The National Breast and Cervical
Cancer Early Detection Program provides critical, lifesaving breast
cancer screening and diagnostic services to uninsured and under-
insured women. Patient navigation programs have been proven to
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ensure people who are diagnosed with cancer are able to access
proper care. The Committee encourages recipients to implement
navigator programs to ensure patients are followed from diagnosis
to cure.
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Breast Cancer Awareness for Young Women.—The Committee in-
cludes an increase of $1,000,000 to expand awareness and preven-
tion efforts for young women.
Chronic Disease Education and Awareness.—The Committee in-
cludes an increase of $3,500,000 to expand public health education
and awareness activities that help to improve surveillance, diag-
nosis, and proper treatment for chronic diseases. This competitive
grant program expands and advances CDC’s work with stake-
holders on education, outreach, and public awareness activities for
a variety of chronic diseases for which there is a clear disparity in
public and professional awareness that are not already specified
under CDC in this report.
Chronic Kidney Disease.—The Committee includes an increase of
$2,000,000 for a public health approach to kidney disease screening
for early detection and treatment and prevalence surveillance, so
that the progression of kidney disease can be slowed and complica-
tions can be reduced, which will dramatically improve the quality
of life of patients.
Colorectal Cancer.—The Committee includes an increase of
$2,000,000 to expand efforts to address disparities in colorectal
cancer screening rates and to improve access to underserved popu-
lations.
Diabetes.—The Committee includes an increase of $5,000,000 to
prevent diabetes and its complications, and to reduce inequities
through prevention strategies, translational research, and edu-
cation. In addition, the Committee includes an increase of
$5,000,000 for the Diabetes Prevention Program to expand efforts
of this public-private partnership that provides diabetes prevention
for people with prediabetes.
Early Child Care Collaboratives.—The Committee includes an in-
crease of $1,000,000 for the expansion of the core program to at
least one new State and to enhance efforts to address food insecu-
rity. The Committee is aware that COVID–19 escalated food inse-
curity for children and families and recognizes the early care and
education setting is important for promoting healthy habits in
young children and ensuring that they have access to nutritious
food. The Committee includes funding for the National Early Child
Care Collaboratives Program to support technical assistance to
States for integrating best practices into existing State and local
systems for early care and education, as well as direct provider-
level training in implementation of comprehensive programming to
support healthy eating and physical activity best practices. The
Committee encourages the program to serve a mix of rural, subur-
ban and urban areas, including areas with high childhood obesity
rates.
Early Detection of Brain Aneurysms.—The Committee recognizes
that there are typically no warning signs or symptoms unless brain
aneurysms rupture. Even when an aneurysm has ruptured, the
symptoms are not widely known. The Committee encourages CDC
to capture and disseminate information about best practices.
Eating Disorders.—The Committee encourages CDC to assist
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States in collecting data by including standard questions on
unhealthy weight control practices for eating disorders, including
binge eating, through the Youth Risk Behavior Surveillance Sys-
tem and the Behavioral Risk Factor Surveillance System.
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Epilepsy.—The Committee includes an increase of $2,500,000 for
epilepsy. The Committee recognizes the opportunity to advance
public and provider awareness and improve care for the epilepsy
community through meaningful timely investment in successful
public health activities.
Excessive Alcohol Use Prevention.—The Committee includes an
increase of $1,000,000 to expand alcohol epidemiology capacity
through improved data collection on excessive drinking and related
harms in more States, and monitoring identifying strategies to re-
duce youth exposure to alcohol and alcohol marketing.
Farm-to-School.—The Committee includes $2,000,000 within Nu-
trition, Physical Activity, and Obesity to continue research and
education activities related to farm-to-school programs that result
in promoting healthy eating habits for students.
Food Allergies.—The Committee includes $2,000,000 for a school-
based effort to address food allergies and reduce potentially fatal
anaphylactic reactions.
Heart Disease and Stroke.—The Committee includes a total in-
crease of $20,000,000 to address cardiovascular diseases. The Com-
mittee includes an increase of $5,000,000 to support, strengthen,
and expand evidence-based initiatives at the State, local, tribal,
and territorial level. The Committee recognizes the vital impor-
tance of addressing cardiovascular disease among women and un-
derserved communities, communities of color, those communities
with limited access to information about cardiovascular health dis-
ease, and communities at risk for delaying regular monitoring of
cardiovascular health as a result of the COVID–19 pandemic. The
Committee supports CDC’s efforts to improve our understanding of
the outcomes and health effects of COVID–19 infection, including
cardiovascular disease. The Committee includes an increase of
$5,000,000 for the WISEWOMAN program to be expanded to addi-
tional States, growing the number of low-income, uninsured and
underinsured women who are assessed and connected to resources.
The Committee also includes an increase of $10,000,000 for the
Million Hearts initiative to increase education and outreach about
the importance of healthy behaviors, regular heart screenings, and
prevention measures.
Inflammatory Bowel Diseases.—The Committee includes an in-
crease of $500,000 to support an initial pilot education and out-
reach program targeted toward healthcare providers, inflammatory
bowel disease (IBD) patients, and people with IBD-type symptoms,
including those from minority populations, and focused on improv-
ing remission rates by reducing the time to diagnosis and the start
of effective treatments. Additionally, the Committee encourages
CDC to collaborate with organizations that serve the IBD patient
community in planning and executing this pilot.
Interstitial Cystitis.—The Committee includes an increase of
$400,000 for interstitial cystitis activities.
Johanna’s Law.—The Committee includes an increase of
$2,000,000 for CDC’s Inside Knowledge Campaign that raises
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awareness of the five main types of gynecological cancer: cervical,
ovarian, uterine, vaginal, and vulvar. This campaign educates
women of all ages, races, and ethnic groups, and healthcare pro-
viders.
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Lung Cancer.—The Committee remains concerned about the high
morbidity and mortality of lung cancer. Early detection and treat-
ment of lung cancer translates into higher survival rates. The Com-
mittee encourages CDC to incorporate lung cancer screening
awareness and referral into its tobacco prevention and control ac-
tivities.
Lupus.—The Committee includes an increase of $1,000,000 for
activities to advance public health knowledge about lupus, which
will lead to improved care for those living with the disease.
Multiple Myeloma.—The Committee is concerned about the bur-
den of multiple myeloma on patients and their caregivers. The
Committee encourages CDC to increase outreach and education of
myeloma among high-risk individuals especially among African
Americans, Hispanics, and other communities of color.
Nutrition, Physical Activity and Obesity.—The Committee sup-
ports CDC’s efforts to protect the health of Americans at every
stage of life by encouraging regular physical activity, good nutri-
tion, and preventing adult and childhood obesity. The Committee
is concerned that the eligibility for the High Obesity Program is
limited to communities with high obesity rates solely among adults,
without taking into account childhood obesity rates. This exclusion
represents a missed opportunity to address the important public
health problem of childhood obesity, which can lead to high blood
pressure, sleep apnea, high cholesterol, fatty liver disease, psycho-
logical problems and more. The Committee encourages CDC to con-
sider including high childhood obesity rates in its eligibility criteria
for the High Obesity Program.
Oral Health.—The Committee includes an increase of $2,000,000
to expand support to State and territorial health departments in
their efforts to reduce oral disease and improve oral health through
effective interventions.
Ovarian Cancer.—The Committee includes an increase of
$2,000,000 to advance ovarian cancer prevention, early detection,
risk assessment, and access to the standard of care.
Prevention Research Centers.—The Committee includes an in-
crease of $5,000,000 to expand the national network conducting
prevention research and translating research results into policy
and public health practice that address local health needs.
Prostate Cancer.—The Committee supports CDC’s efforts to in-
crease the public’s awareness of prostate cancer risks, screening,
and treatment, and improve surveillance of this disease. The Com-
mittee encourages CDC to increase outreach and education among
high-risk men, especially African-American men.
Psoriatic Disease.—The Committee recognizes the value of the
Public Health Agenda for Psoriasis and Psoriatic Arthritis and its
impact in interventions to address psoriatic disease over the past
decade. Despite significant advancements in research, treatment
options, and care approaches for this community, the Committee is
concerned that many individuals, especially people of color, remain
undertreated and are not achieving optimal health outcomes. The
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Committee encourages CDC to develop an updated public health
agenda and action plan to be focused on addressing the systemic
nature of the disease, unmet needs, heterogeneity of disease and
treatment response, and diversity of diagnosis, care and outcomes.
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Racial and Ethnic Approaches to Community Health.—The Com-
mittee includes a total increase of $10,000,000 to continue scaling
this program to all States and territories, and support grantees in
building capacity for collaboration and disseminating evidence-
based strategies in communities. Racial and Ethnic Approaches to
Community Health (REACH) is a vital initiative to help eliminate
healthcare disparities in minority communities. The Committee’s
recommended level includes an increase of $5,000,000 for Good
Health and Wellness in Indian Country.
Safe Motherhood and Infant Health.—The Committee includes a
total increase of $56,000,000 for this portfolio of programs to im-
prove the health of pregnant and postpartum individuals and their
babies, including to reduce disparities in maternal and infant
health outcomes. Building on the commitment made in FY 2021,
the total funding allows for the expansion of Maternal Mortality
Review Committees (MMRCs) and Perinatal Quality Collaboratives
(PQCs) to all States and territories and for increased support to
current States and territories, as well as increased support for
other programs including Sudden Unexplained Infant Death
(SUID). The Committee encourages CDC to help MMRCs build
stronger data systems and improve data collection at the State
level to create consistency in data collection, analysis, and report-
ing across State MMRCs. This investment is necessary to provide
accurate national statistics on U.S. maternal mortality rates and
will inform data-driven actions to prevent these deaths. The Com-
mittee requests a report within 90 days of enactment of this Act
on barriers to effective and consistent data collection and opportu-
nities to improve coordination among State MMRCs. PQCs improve
maternal and neonatal outcomes using known prevention strate-
gies such as reducing severe pregnancy complications associated
with high blood pressure and hemorrhage. PQCs help to address
the high incidence of maternal mortality, particularly among
women of color, maternal opioid use disorder and neonatal absti-
nence syndrome as a result of the opioid crisis, which has been ex-
acerbated by the COVID–19 pandemic. The Committee requests an
update on the PQC program and challenges faced, including those
created by the COVID–19 pandemic, within 90 days of enactment
of this Act. Furthermore, little is known about the tragic, sudden,
and unexpected deaths of young children because of variations in
investigations and the way deaths are certified. The Committee
urges CDC to facilitate data and analysis, including the expansion
of the SUID and Sudden Death in the Young Case Registry, to im-
prove SUID prevention strategies.
Social Determinants of Health.—The Committee includes an in-
crease of $150,000,000 for investments in social determinants of
health (SDOH) to improve health equity. The Committee includes
funding to expand activities to address SDOH in States, local, trib-
al and territorial jurisdictions to improve outcomes among persons
experiencing health disparities and inequalities, including, but not
limited to, expanding and implementing Accelerator Plans, initi-
ating a SDOH implementation program, providing technical assist-
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ance to communities and continuing to build the evidence base and
advance data collection to better understand health disparities. So-
cial Determinants Accelerator Plans should include a description of
the health and social outcome objectives; identify populations that
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would benefit from implementation of the plan, including Medicaid-
eligible individuals; and identify non-governmental, private, or pub-
lic health organizations and community organizations that would
participate in the development of the plan. Grantees may use a
portion of grant funding to convene government entities, public and
private stakeholders, and to engage qualified research experts in
developing Social Determinants Accelerator Plans.
Tobacco.—The Committee includes an increase of $12,500,000 so
that CDC and States can more robustly respond to the public
health threat caused by youth use of e-cigarettes, enhance efforts
to reduce tobacco use among disparate populations and in areas
with high tobacco use rates and tobacco-related mortality, and ex-
pand education efforts to reach youth influencers.
Vision and Eye Health.—The Committee is aware that vision im-
pairments and eye disease contribute to or complicate many other
serious and costly chronic health conditions, including diabetes,
cardiovascular disease, injuries and death related to falling, depres-
sion, and cognitive decline. State and community partnerships are
essential in promoting messages of early detection and coordinating
access to treatment to prevent eye disease from progressing to per-
manent vision loss.
BIRTH DEFECTS, DEVELOPMENTAL DISABILITIES, DISABILITIES AND
HEALTH
Appropriation, fiscal year 2021 ......................................................... $167,810,000
Budget request, fiscal year 2022 ....................................................... 172,810,000
Committee Recommendation ............................................................. 186,810,000
Change from enacted level ......................................................... +19,000,000
Change from budget request ...................................................... +14,000,000
This account supports efforts to conduct research on and address
the causes of birth defects and developmental disabilities, as well
as reduce the complications of blood disorders and improve the
health of people with disabilities.
Within the total, the Committee recommends the following
amounts:
FY 2022
Budget Activity Committee
Child Health and Development ...................................................................................................................... $66,800,000
Birth Defects ......................................................................................................................................... 19,000,000
Fetal Death ............................................................................................................................................ 900,000
Fetal Alcohol Syndrome ......................................................................................................................... 12,000,000
Folic Acid ............................................................................................................................................... 3,150,000
Infant Health ......................................................................................................................................... 8,650,000
Autism ................................................................................................................................................... 23,100,000
Health and Development for People with Disabilities ................................................................................... 80,660,000
Disability & Health ................................................................................................................................ 41,000,000
Tourette Syndrome ................................................................................................................................. 2,000,000
Early Hearing Detection and Intervention ............................................................................................. 10,760,000
Muscular Dystrophy ............................................................................................................................... 8,000,000
Attention Deficit Hyperactivity Disorder ................................................................................................ 1,900,000
Fragile X ................................................................................................................................................ 2,000,000
Spina Bifida .......................................................................................................................................... 7,000,000
Congenital Heart ................................................................................................................................... 8,000,000
Public Health Approach to Blood Disorders ................................................................................................... 11,400,000
Hemophilia Activities ...................................................................................................................................... 3,500,000
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Hemophilia Treatment Centers ....................................................................................................................... 5,100,000
Thalassemia ................................................................................................................................................... 2,100,000
Neonatal Abstinence Syndrome ...................................................................................................................... 2,250,000
Surveillance for Emerging Threats to Mothers and Babies .......................................................................... 15,000,000
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Blood Disorders.—The Committee includes an increase of
$5,000,000 to expand sickle cell data collection efforts in multiple
States. The Committee urges an expansive sickle cell surveillance
program to better identify affected individuals, understand their
health outcomes and comorbidities, and evaluate their utilization of
the most effective and appropriate treatments to prevent complica-
tions and risk factors that affect individuals living with the dis-
ease.
Cerebral Palsy.—The Committee encourages CDC to explore
cross-divisional funding opportunities, networks, data sets and sys-
tems to accelerate data-driven public health research to improve
Cerebral Palsy (CP) surveillance and develop increased under-
standing of the mechanisms leading to earlier diagnosis and im-
proved outcomes to reduce the public health burden of CP. The
Committee also encourages CDC to conduct an updated study from
the 2003 report on the healthcare and societal costs of CP in the
U.S.
Congenital Heart Defects.—The Committee includes an increase
of $1,000,000 for grants or cooperative agreements to provide tech-
nical assistance to State and local agencies to complement intra-
mural programs and to conduct applied research related to screen-
ing, evaluation, diagnosis, results reporting, data collection, sur-
veillance, intervention programs, systems, and follow-up of children
identified through Critical Congenital Heart Defects screening to
better understand the long-term outcomes and needs of this popu-
lation.
Early Hearing Detection and Intervention.—The Committee is
aware of the significant racial and ethnic disparities in care facing
children with hearing loss, and the effect unaddressed congenital
hearing loss has on communication skills, psychosocial develop-
ment, educational progress, and language development. The Com-
mittee encourages CDC to expand their work to improve surveil-
lance of early hearing detection and intervention systems to ensure
access to timely identification of congenital and acquired hearing
loss and develop materials to enhance connection to follow up serv-
ices among racial and ethnic minorities, and other medically under-
served populations.
Fetal Alcohol Spectrum Disorders.—The Committee includes an
increase of $1,000,000. The Committee is concerned about the ris-
ing trend of prenatal alcohol consumption and increased rates of
fetal alcohol spectrum disorders (FASD). The Committee urges
CDC to increase support to: expand prevention efforts to heighten
awareness of FASD and the risks associated with prenatal alcohol
exposure; and strengthen existing national community-based and
professional FASD networks to expand access to diagnostic, treat-
ment, intervention, and other essential services.
Fragile X and Fragile X-Associated Disorders.—The Committee
commends CDC’s efforts to identify and define the population im-
pacted by fragile X (FX) and all conditions associated with the gene
mutation with the goal of understanding the public health impact
of these conditions. To help this effort, the Committee urges CDC
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to support additional strategies to promote earlier identification of
children with FX. The Committee also urges CDC to work to en-
sure underserved populations at risk of FX conditions are being
properly diagnosed and are aware of medical services available.
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Improving the Health of People with Intellectual Disabilities.—
The Committee includes an increase of $5,000,000 for the expanded
provision of year-round, grassroots activities in communities to cre-
ate opportunities for health screenings and access to quality
healthcare, and health and wellness programming for people with
intellectual disabilities. These efforts enhance the lives of individ-
uals while eliminating stigmas and stereotypes.
Muscular Dystrophy.—The Committee includes an increase of
$2,000,000 to enhance Muscular Dystrophy research and disease
surveillance initiatives, including the Duchenne Muscular Dys-
trophy Care Considerations. The Committee directs CDC to provide
a report within 120 days of enactment of this Act describing the al-
location for specific activities in fiscal years 2020 and 2021. The re-
port should, to the extent practicable, identify program priorities,
including an evaluation of the impact of the Duchenne Muscular
Dystrophy Care Considerations across the country on patient out-
comes and any remaining gaps, particularly in rural and under-
served areas. CDC should also address the following three areas of
unmet need: evaluating the differences in care and outcomes be-
tween Certified Duchenne Care Centers (CDCC) and non-CDCC
MD-STARnet data and other data sources; the availability of con-
sistent and coordinated care for adults with Duchenne as they
transition from pediatric care settings to adult care settings; and
the impact of progressive disability on the mental health of pa-
tients and their caregivers. The Committee encourages CDC to
partner with stakeholder organizations to leverage additional
knowledge and resources to advance this work.
Prenatally and Postnatally Diagnosed Conditions Awareness Act
(P.L. 110–374).—As a response to the growth in prenatal screening
and testing, Congress passed this Act to ensure women receive ac-
curate information on genetic testing, community support, and out-
comes of care for their children when they receive a prenatal or
postnatal diagnosis for Down syndrome or similar conditions. The
Committee requests an update on the efforts to implement the Act
in the fiscal year 2023 Congressional Budget Justification.
Spina Bifida.—The Committee is aware of a growing incidence
of sudden death in the adult spina bifida population, and under-
stands that there is a significant need to study this issue and to
address the transitional and adult care needs of the growing, aging
spina bifida community. Therefore, the Committee encourages CDC
to use funding for the National Spina Bifida Program to support
the continuation of the Spina Bifida Clinical Care Monitoring and
Tracking Program, which works with the National Spina Bifida
Registry, to guide the health care community in best treatment op-
tions for people living with spina bifida; and to expand and mod-
ernize data collection, including the National Spina Bifida Patient
Registry and surveillance activities to allow for data collection from
more clinics and individuals with spina bifida.
PUBLIC HEALTH SCIENTIFIC SERVICES
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Appropriation, fiscal year 2021 ......................................................... $591,997,000
Budget request, fiscal year 2022 ....................................................... 741,997,000
Committee Recommendation ............................................................. 756,997,000
Change from enacted level ......................................................... +165,000,000
Change from budget request ...................................................... +15,000,000
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This account supports programs that provide leadership and
training for the public health workforce, support infrastructure to
modernize public health surveillance, promote and facilitate science
standards and policies, and improve access to information on dis-
ease outbreaks and other threats.
Within the total, the Committee recommends the following
amounts:
FY 2022
Budget Activity Committee
Health Statistics ............................................................................................................................................. $190,397,000
Surveillance, Epidemiology, and Informatics ................................................................................................. 460,600,000
Public Health Workforce ................................................................................................................................. 106,000,000
Artificial Intelligence Recruitment.—The Committee recognizes
that there are many challenges in recruiting the public health
workforce and encourages the consideration of human resource
technology augmented by cloud-agnostic, commercial off-the-shelf
automated machine learning decision assistance software, while
preserving fairness throughout the human resource processes.
Community Health Workers.—The Committee commends CDC
for integrating community health workers into care teams, commu-
nity-based organizations, and coordinated public health-led actions
to manage COVID–19 among priority populations within commu-
nities. The Committee urges CDC to continue this critical invest-
ment by supporting, promoting and expanding State investments in
the community health worker workforce in the COVID–19 response
and long-term efforts to address the social determinants of health
and achieve health equity in partnership with community health
worker professional organizations.
Disability Data.—The Committee encourages CDC to ensure dis-
ability data is included as a core demographic component across
surveys and surveillance systems administered by the National
Center for Health Statistics. The Committee encourages CDC to
support and fund research focused on the community of people with
disabilities as a whole.
Familial Hypercholesterolemia.—The Committee includes
$100,000 to support public health efforts focused on this inherited
genetic disorder to improve diagnosis and care delivery and prevent
heart disease.
National Center for Health Statistics.—The Committee includes
an increase of $15,000,000 for the National Center for Health Sta-
tistics, a component of our nation’s public health infrastructure, to
monitor the health of the American people and to make much-need-
ed investments in the next generation of surveys and products.
National Neurological Conditions Surveillance System.—The
Committee includes $5,000,000 within Surveillance, Epidemiology,
and Informatics to continue efforts on the two initial conditions.
Overdose and Suicide Data Collection.—The Committee recog-
nizes the importance of timely and accurate data to understand the
incidence and prevalence of health outcomes to effectively respond
to emerging trends, especially drug overdoses and suicides. Data on
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fatal overdoses and suicide become publicly available six months to
over a year after they occur. These delays hinder the ability of com-
munities to respond quickly to preventable deaths. The Committee
directs CDC to evaluate its current process for fatal overdose, non-
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fatal overdose, suicide, and suicide attempts/self-harm data collec-
tion. The Committee further directs the CDC to develop rec-
ommendations to reduce reporting lags while maintaining data ac-
curacy, and to submit these recommendations to the Committee
within 180 days of enactment of this Act.
Primary Immunodeficiencies.—The Committee includes funding
to continue the existing program of education and awareness re-
lated to primary immunodeficiencies and to expand allowable use
of funding to include genetic sequencing surveillance. This program
has proven effective in identifying undiagnosed patients and link-
ing them to centers of care.
Public Health Data Modernization Initiative.—The Committee
initiated the funding for the Data Modernization Initiative (DMI)
to create modern, integrated, and real-time public health surveil-
lance with CDC, State, territorial, local and tribal partners in fiscal
year 2020 and provided significant resources through annual and
supplemental appropriations, including $500,000,000 in the Amer-
ican Rescue Plan (P.L. 117–2). The Committee directs CDC to cre-
ate a standards-based, interoperable public health infrastructure
where systems can communicate and share data seamlessly; ad-
vance standards so that information can be stored and shared
across systems and facilitate complete and timely reporting so that
our public health system has essential data on race, ethnicity,
pregnancy status, treatments, and co-morbidities that are critical
for achieving equity in public health responses. The Committee
urges CDC to consider innovative mechanisms to ensure States and
local jurisdictions, where appropriate, have access to this funding
to modernize their vital records data systems in accordance with
the goals of the initiative. The Committee reiterates that the Na-
tional Center for Health Statistics is to be fully integrated in the
DMI. The Committee acknowledges the need for sustained funding
for this public health infrastructure and thus, includes
$150,000,000, an increase of $100,000,000, to continue to move
from siloed and brittle public health data systems to connected, re-
silient, adaptable, and sustainable systems to achieve real change.
Essential to this significant effort are core data standards and sup-
port to recruit and retain the data science workforce. This is a mas-
sive undertaking by CDC, and it will only be successful with the
commitment to improvement by the entire agency and active en-
gagement with partners.
Public Health Workforce.—The Committee includes an increase of
$50,000,000 to aid in the rebuilding of the public health workforce.
At this funding level, CDC will double the number of Epidemic In-
telligence Service and Laboratory Leadership Service Fellows, en-
suring the opportunity for placement of a fellow in every State. The
Committee recognizes that a robust and well-trained public health
workforce is critical to maintaining a highly effective public health
infrastructure.
Vital Statistics Reporting.—The Committee encourages CDC to
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engage with the National Academies of Science, Engineering, and
Medicine to improve vital statistics and death reporting.
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ENVIRONMENTAL HEALTH
Appropriation, fiscal year 2021 ......................................................... $222,850,000
Budget request, fiscal year 2022 ....................................................... 332,850,000
Committee Recommendation ............................................................. 343,350,000
Change from enacted level ......................................................... +120,500,000
Change from budget request ...................................................... +10,500,000
The Committee recommendation includes $326,350,000 in discre-
tionary appropriations and $17,000,000 in transfers from the PPH
Fund.
Programs supported within Environmental Health conduct sur-
veillance and data collection to detect and address emerging patho-
gens and environmental toxins that pose significant challenges to
public health, as well as determine whether and at what level of
exposure these substances are harmful to humans.
Within the total, the Committee recommends the following
amounts:
FY 2022
Budget Activity Committee
Environmental Health Laboratory ..................................................................................................................... $72,750,000
Newborn Screening Quality Assurance Program ..................................................................................... 23,000,000
Newborn Screening /Severe Combined Immunodeficiency Diseases ...................................................... 1,250,000
Environmental Health Activities ....................................................................................................................... 17,000,000
Safe Water ........................................................................................................................................................ 8,600,000
Amyotrophic Lateral Sclerosis (ALS) Registry .................................................................................................. 10,000,000
Climate and Health .......................................................................................................................................... 110,000,000
Trevor’s Law ..................................................................................................................................................... 2,000,000
Environmental and Health Outcome Tracking Network ................................................................................... 34,000,000
Asthma ............................................................................................................................................................. 34,000,000
Childhood Lead Poisoning ................................................................................................................................ 50,000,000
Lead Exposure Registry .................................................................................................................................... 5,000,000
Amyotrophic Lateral Sclerosis Registry.—The Committee directs
CDC to present a plan to the Committee within 90 days of enact-
ment of this Act to enhance the oversight and advisory process for
the National ALS Registry to increase transparency and better re-
flect the needs of the ALS community. This plan should consider
ways to translate Registry findings to human application that can
lower the risks and disease burden of ALS, make disease reporting
more representative, more accurate, and more inclusive, and in-
clude a range of estimates rather than point estimates of ALS prev-
alence. Equally important are updates to the survey process to en-
sure the data they collect are impactful and respectful of partici-
pant burden. Finally, the plan should ensure that the ALS commu-
nity can view as much Registry information as possible without
compromising the privacy of participants.
Asthma.—The Committee includes an increase of $4,000,000 for
the National Asthma Control Program to increase the number of
States carrying out programmatic activities. The Committee recog-
nizes that millions of people in the U.S. suffer from asthma, and
that it disproportionately affects African American children.
Childhood Lead Poisoning.—The Committee includes an increase
of $11,000,000 to support the expansion of direct CDC assistance
and funding to additional State and local public health depart-
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ments. The Committee believes that CDC’s expertise and technical
assistance can be a valuable asset. The Committee directs CDC to
provide a report within 90 days of enactment of this Act on plans
to make direct assistance and funding available to additional State
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and local programs. Furthermore, the Committee encourages CDC
to require that States receiving funding for lead prevention report
all blood tests in a standardized format through the Nationally
Notifiable Noninfectious Diseases and Conditions reporting system.
Climate and Health.—The Committee includes an increase of
$100,000,000 to expand the Climate and Health program to all
States and territories to identify potential health effects associated
with climate change and implement health adaptation plans. Cli-
mate-related events affect everyone, but not everyone is affected
equally.
Improving Pediatric Reference Intervals.—The Committee encour-
ages CDC to initiate efforts to improve the accuracy of pediatric
reference intervals.
Lead Exposure Registry.—The Committee includes an increase of
$500,000 for the Flint, Michigan Lead Exposure Registry.
Newborn Screening.—The Committee includes an increase of
$5,000,000 to further support newborn screening efforts so that af-
fected newborns can receive early and often life-saving treatment
through the timely implementation for all Recommended Uniform
Screening Panel conditions. The Committee is aware that State
laboratories need specialized support to begin screening for addi-
tional newborn conditions and recognizes CDC’s expertise in work-
ing with laboratories to implement accurate newborn screening
tests. The Committee urges the Newborn Screening Quality Assur-
ance Program to support State laboratories as they implement
screening for new disorders. The increase in funding will enable
States to establish testing for new conditions and improve testing
of current conditions; build technical capacity in States by pro-
viding education, training and technical assistance to address test-
ing challenges and determine appropriate testing methods for rapid
screening; and ensure test results for new conditions are accurate
by improving test result interpretation and expanding data ana-
lytic capacity.
Tuberous Sclerosis Complex.—The Committee encourages CDC to
take into consideration Tuberous Sclerosis Complex (TSC) as a pos-
sible cause of autism, epilepsy, and cardiac rhabdomyomas in sur-
veillance. The Committee encourages CDC to counsel researchers
and other stakeholders to facilitate development of a viable new-
born screening assay for TSC.
INJURY PREVENTION AND CONTROL
Appropriation, fiscal year 2021 ......................................................... $682,879,000
Budget request, fiscal year 2022 ....................................................... 1,103,169,000
Committee Recommendation ............................................................. 1,064,169,000
Change from enacted level ......................................................... +381,290,000
Change from budget request ...................................................... ¥39,000,000
Programs supported within Injury Prevention and Control pro-
vide national leadership on violence and injury prevention, conduct
research and surveillance, and promote evidence-based strategies
to inform real-world solutions to prevent premature death and dis-
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ability and to reduce human suffering and medical costs caused by
injury and violence.
Within the total, the Committee recommends the following
amounts:
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FY 2022
Budget Activity Committee
Domestic Violence and Sexual Violence ......................................................................................................... $40,200,000
Child Maltreatment ............................................................................................................................... 7,250,000
Child Sexual Abuse Prevention ............................................................................................................. 2,500,000
Community and Youth Violence Prevention ................................................................................................... 115,100,000
Domestic Violence Community Projects ......................................................................................................... 10,500,000
Rape Prevention ............................................................................................................................................. 101,750,000
Suicide Prevention .......................................................................................................................................... 14,000,000
Adverse Childhood Experiences ...................................................................................................................... 7,000,000
National Violent Death Reporting System ...................................................................................................... 34,500,000
Traumatic Brain Injury ................................................................................................................................... 8,750,000
Elderly Falls .................................................................................................................................................... 2,050,000
Drowning ......................................................................................................................................................... 2,000,000
Injury Prevention Activities ............................................................................................................................. 28,950,000
Opioid Overdose Prevention and Surveillance ............................................................................................... 663,369,000
Injury Control Research Centers .................................................................................................................... 11,000,000
Firearm Injury and Mortality Prevention Research ........................................................................................ 25,000,000
Adverse Childhood Experiences.—The Committee includes an in-
crease of $2,000,000 to expand efforts including technical assist-
ance to States to analyze data and burden. The Committee re-
quests a report within 120 days of enactment of this Act on the via-
bility and utility of a Positive Childhood Experience Surveillance
System that measures resilience factors in a State or community.
Child Sexual Abuse Prevention.—The Committee includes an in-
crease of $1,000,000 and recognizes the severe and often life-long
physical, cognitive and emotional impact of child sexual abuse.
CDC’s child sexual abuse prevention research includes opportuni-
ties to improve surveillance systems and data collection, increase
the understanding of risk and protective factors, and develop and
disseminate effective prevention efforts.
Community and Youth Violence Prevention.—The Committee in-
cludes an increase of $100,000,000 for a new evidence-based com-
munity violence intervention, which aims to prevent intentional vi-
olence, such as mass casualty violence or gang violence. The Com-
mittee encourages CDC to fund a broad range of interventions, in-
cluding programs to provide de-escalation and conflict mitigation
skills.
Domestic Violence and Sexual Violence.—The Committee includes
an increase of $5,000,000 for domestic violence and sexual violence.
The Committee notes the importance of the collection, reporting,
and sharing of data on domestic violence and sexual violence. In
addition, the Committee recognizes that the fiscal year 2022 appro-
priation invests in efforts to end gender-based violence across mul-
tiple Federal agencies. The Committee notes that the United Na-
tions urged countries to adopt national action plans to combat gen-
der-based violence and violence against women, including domestic
violence. The Committee directs CDC to work in coordination with
the Administration for Children and Families, the Office of the
Surgeon General, and the Department of Justice to create a Na-
tional Domestic Violence Prevention Action Plan to expand, inten-
sify, and coordinate domestic violence prevention efforts among
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Federal, State, local, and tribal government agencies and with
other relevant stakeholders to ensure a whole-of-government, goal-
oriented, community-informed, forward looking approach in ad-
dressing domestic violence prevention in the U.S. and report the
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plan to the Committee no later than one year after enactment of
this Act.
Domestic Violence Community Projects.—The Committee includes
an increase of $5,000,000 to expand the reach of the Domestic Vio-
lence Prevention Enhancement and Leadership Through Alliances
(DELTA) program.
Drowning.—The Committee includes new dedicated funding to
scale proven drowning prevention programs, including programs
working with underserved youth, and to support State drowning
surveillance efforts and a national plan on water safety. The Com-
mittee is concerned that protocols for proper lifeguard positioning
at pools are not based on scientific testing, and therefore, life-
guards are often positioned so that they cannot identify a patron
in distress before drowning leads to serious injury or death. The
Committee urges CDC to identify gaps in scientific evidence for
lifeguard positioning to support the Model Aquatic Health Code
provisions, specifically as it relates to Zone of Patron Surveillance
requirements. Furthermore, the Committee is concerned about
drowning rate of children with autism. The Committee urges CDC
to work with State and local organizations to identify subgroups of
the populations at greater risk for drowning, including autistic chil-
dren and specific racial/ethnic groups, and to develop initiatives
aimed at preventing drowning among these populations.
Drug Use Surveillance.—The Committee notes that trends in
drug use change quickly and vary significantly geographically. The
Committee encourages CDC to develop a strategy to expand the
use of the National Wastewater Surveillance System for drug use
surveillance to quickly detect emerging drug-use trends to more ef-
fectively implement public health interventions.
Firearm Injury and Mortality Data.—The Committee urges CDC
to collaborate with the National Institute of Justice to compile,
share, and improve gun violence data. Such data should include the
Uniform Crime Report and include data from hospitals treating vic-
tims of nonfatal gunshot wounds.
Firearm Injury and Mortality Prevention Research.—The Com-
mittee includes an increase of $12,500,000 for research on firearm
injury and mortality through a public health approach that focuses
on data to understand its causes and to inform prevention strate-
gies. The Committee directs CDC to focus on activities that will
have the greatest potential public health impact. Furthermore, the
Committee recognizes that community gun violence, such as gang
violence, constitutes a significant portion of gun homicides in the
U.S. There is a disproportionate impact of community gun violence
on low-income communities of color, which is not often reflected in
the national narrative surrounding gun violence. The Committee
encourages CDC to support research on community gun violence,
reflecting the diversity of the victims of gun violence. Furthermore,
the Committee urges CDC to investigate the impact of access to
teen and youth services in a community on rates of community vio-
lence.
Injury Control Research Centers.—The Committee includes an in-
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crease of $2,000,000 to award additional grants.
National Violent Death Reporting System.—The Committee in-
cludes an increase of $10,000,000 to collect data on gender identity
and sexual orientation. This data will increase our understanding
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of violent deaths among disproportionately affected groups and in-
form efforts towards decreasing the number of deaths across
groups.
Opioid Abuse and Overdose Prevention.—The Committee includes
an increase of $187,790,000 and appreciates efforts by CDC to en-
sure that funding for opioid and stimulant abuse and overdose pre-
vention reaches local communities to advance local understanding
of the opioid overdose epidemic and to scale-up prevention and re-
sponse activities, as intended by Congress. The Committee encour-
ages CDC to consider community member naloxone education as a
criterion when distributing overdose prevention funds. In addition,
the Committee directs that CDC report on the results of the invest-
ments in local cities, counties, and communities and ensure that
traditionally underrepresented communities, including rural and
tribal communities, receive equitable access to funds in the fiscal
year 2023 Congressional Budget Justification. In addition, the
Committee notes that chronic pain is a disabling and costly health
condition; who is affected, the extent of resulting disability, the na-
ture and accessibility of effective pain management, and related
costs all remain largely unknown. The Committee directs CDC to
conduct the collection, analysis, and publication of population re-
search data using questions from the National Health Interview
Survey and other nationally representative population-based sam-
ples to describe those with chronic pain by patient age,
comorbidities, part of body affected, socio-economic status, geo-
graphic location by State, county and city, payor source, race, and
gender. The Committee further directs CDC to analyze and report
data from the Medical Expenditure Panel Survey regarding the use
of and associated direct healthcare costs related to pain manage-
ment treatments and services as well as indirect costs related to
pain. Finally, the Committee directs CDC to report on the status
of these activities in the fiscal year 2023 Congressional Budget Jus-
tification.
Public Health Approach to Violence.—The Committee notes
House Report 116–450 directed CDC to provide a report under this
heading. The Committee is still awaiting this report and looks for-
ward to its submission.
Rape Prevention.—The Committee includes an increase of
$50,000,000 to support rape prevention and education programs.
Suicide.—The Committee includes an increase of $2,000,000 to
expand surveillance and comprehensive prevention efforts, as sui-
cide is devastating communities across the U.S.
Traumatic Brain Injury.—The Committee provides an increase of
$2,000,000 to begin to address concussion surveillance, particularly
among children and youth.
NATIONAL INSTITUTE FOR OCCUPATIONAL SAFETY AND HEALTH
Appropriation, fiscal year 2021 ......................................................... $345,300,000
Budget request, fiscal year 2022 ....................................................... 345,300,000
Committee Recommendation ............................................................. 360,300,000
Change from enacted level ......................................................... +15,000,000
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Change from budget request ...................................................... +15,000,000
The National Institute for Occupational Safety and Health
(NIOSH) conducts applied research, develops criteria for occupa-
tional safety and health standards, and provides technical services
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to government, labor, and industry, including training for the pre-
vention of work-related diseases and injuries. This appropriation
supports surveillance, health hazard evaluations, intramural and
extramural research, instrument and methods development, dis-
semination, and training grants.
Within the total for NIOSH, the Committee recommends the fol-
lowing amounts:
FY 2022
Budget Activity Committee
National Occupational Research Agenda ....................................................................................................... $123,000,000
Agricultural, Forestry, and Fishing ........................................................................................................ 28,500,000
Education and Research Centers ................................................................................................................... 32,000,000
Personal Protective Technology ...................................................................................................................... 23,000,000
Mining Research ............................................................................................................................................. 61,500,000
National Mesothelioma Registry and Tissue Bank ........................................................................................ 1,200,000
Firefighter Cancer Registry ............................................................................................................................ 2,500,000
Other Occupational Safety and Health Research .......................................................................................... 117,100,000
Agricultural, Forestry, and Fishing.—The Committee includes an
increase of $2,000,000 to expand efforts to protect workers in this
sector by providing leadership in applied research, disease and in-
jury surveillance, education and prevention.
Assessment of the Extent of COVID–19 Infections and Deaths
Among Workers.—The Committee is aware that many groups of es-
sential workers faced higher rates of COVID–19 infections and
death during the pandemic, such as those employed in health care,
first responders, meat and poultry, corrections, grocery, corrections,
and transit industries. Many of these are low wage workers of
color, whose jobs required them to report to work in person
throughout the pandemic. In order to fully assess the extent and
impact of the COVID–19 pandemic on workers and to protect them
from unnecessary future exposure and infection, the Committee di-
rects CDC to prepare: (1.) A study quantifying COVID–19 deaths
by occupation and industry based upon an analysis of death certifi-
cates. Such report shall compare the higher risk occupations and
the rate of COVID–19 deaths in the general population. Such re-
port shall be provided to the Committee on Appropriations and the
public 180 days from the date of enactment of this Act; and (2.) A
report on the extent of COVID–19 infections among working popu-
lations by occupation, the factors that contribute to this increased
risk, and a description of disparate impacts by race and ethnicity.
The report should include an assessment of the adequacy of report-
ing and data collection of COVID–19 infections, outbreaks and
deaths among workers, and recommendations and a professional
budget justification for improvements in data collection and report-
ing by employers, localities, States and the Federal government for
COVID–19 and future epidemics. Such report shall be provided to
the Committee on Appropriations and the public within 180 days
of enactment of this Act.
Education and Research Centers.—The Committee includes an
increase of $2,000,000 to support efforts to reduce work-related in-
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juries and illnesses through prevention research, education, and
implementation of programs to improve occupational health and
safety and minimize the dangers faced by workers across the coun-
try.
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Mining Program.—The Committee commends CDC for the
progress outlined in the 2019–2023 mining program strategic plan
to reduce overexposure to hazardous airborne contaminants in the
mining environment by conducting studies to: (1) improve measure-
ment of exposures to hazardous dusts, and to better understand
the risks for respiratory diseases among mine workers; (2) develop
and assess the effectiveness of interventions and technologies to
prevent overexposure to hazardous dusts; and (3) to improve the
adoption of control interventions and technologies.
Personal Protective Technologies.—The Committee recognizes the
important role that CDC continues to provide regarding personal
protective technologies in response to the COVID–19 pandemic and
to protect workers every day and includes an increase of $3,000,000
to support these efforts. The Committee directs CDC to review and
report back to the Committee within 180 days of enactment of this
Act, a consideration of how technology, including voice-activated
technology, could save PPE and clinicians’ lives. This review should
include specific analysis of the impact on nurses employed in acute
care hospitals.
Total Worker Health.—The Committee includes an increase of
$4,000,000 to expand the Total Worker Health program, which sup-
ports and conducts ground-breaking research to advance the over-
all safety, health, and well-being of U.S. workers.
ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION
PROGRAM
Appropriation, fiscal year 2021 ......................................................... $55,358,000
Budget request, fiscal year 2022 ....................................................... 55,358,000
Committee Recommendation ............................................................. 55,358,000
Change from enacted level ......................................................... –––
Change from budget request ...................................................... –––
The Energy Employees Occupational Illness Compensation Pro-
gram provides compensation to employees and survivors of employ-
ees of Department of Energy facilities and private contractors who
have been diagnosed with a radiation-related cancer, beryllium-re-
lated disease, or chronic silicosis as a result of their work. NIOSH
estimates occupational radiation exposure for cancer cases, con-
siders and issues determinations for adding classes of workers to
the Special Exposure Cohort, and provides administrative support
to the Advisory Board on Radiation and Worker Health.
GLOBAL HEALTH
Appropriation, fiscal year 2021 ......................................................... $592,843,000
Budget request, fiscal year 2022 ....................................................... 697,843,000
Committee Recommendation ............................................................. 842,843,000
Change from enacted level ......................................................... +250,000,000
Change from budget request ...................................................... +145,000,000
Through its Global Health activities, CDC coordinates, cooper-
ates, participates with, and provides consultation to other nations,
Federal agencies, and international organizations to prevent and
contain diseases and environmental health problems and to develop
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and apply health promotion activities. In cooperation with min-
istries of health and other appropriate organizations, CDC tracks
and assesses evolving global health issues and identifies and devel-
ops activities to apply CDC’s technical expertise.
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In addition, the American Rescue Plan (P.L. 117–2) included
$750,000,000 for global disease detection and emergency response.
Within the total, the Committee recommends the following
amounts:
FY 2022
Budget Activity Committee
Global AIDS Program ...................................................................................................................................... $128,421,000
Global Tuberculosis ........................................................................................................................................ 9,222,000
Global Immunization Program ........................................................................................................................ 226,000,000
Polio Eradication ................................................................................................................................... 176,000,000
Other Global/Measles ............................................................................................................................ 50,000,000
Parasitic Diseases and Malaria ..................................................................................................................... 31,000,000
Global Public Health Protection ..................................................................................................................... 448,200,000
Global Health Security.—The Committee supports CDC’s work to
protect global health security through programs that detect, pre-
vent, and respond to infectious diseases and other health threats.
Emerging infectious diseases such as COVID–19 and Zika and the
global threat of spread of known diseases such as Ebola, represent
profound challenges to our health system. The Committee supports
CDC’s continued work on the development of new tools, especially
diagnostics, the application of advanced molecular detection for the
identification and tracking of diseases and disease variants at
home and abroad, and core technical contributions to developing
and validating tools for use by U.S. bilateral and multilateral glob-
al health programs and laboratory efforts to monitor and combat
drug and insecticide resistance, functions essential to ensuring that
global health programs are responsive, efficient, and tailored for
maximum impact. The Committee urges CDC to ensure that the
importance of research and development to global health security
is appropriately reflected in their international engagements. The
Committee requests an update in the fiscal year 2023 Congres-
sional Budget Justification on how CDC is working with FDA,
BARDA, and NIH to jointly coordinate global health research ac-
tivities with specific measurable metrics used to track progress and
collaboration toward agreed upon health goals.
Global Public Health Protection.—The Committee includes an in-
crease of $245,000,000 to support and enhance CDC’s mission to
protect the health of our nation including by working across the
globe. The Committee supports CDC’s global efforts to detect epi-
demic threats earlier, respond more effectively, and prevent avoid-
able crises, including by providing support of program implementa-
tion and scientific and technical experts in Atlanta and in the field
with concentrated efforts on countries, populations, and programs
where resources will have the greatest public health impact. In ad-
dition, the Committee requests an update in the fiscal year 2023
Congressional Budget Justification on wastewater-based epidemi-
ology and surveillance global detection efforts in the global re-
sponse to COVID–19, including a professional judgement on the
necessary budget and infrastructure requirements to fully
operationalize these programs.
Global Water Strategy.—The Committee recognizes CDC’s work
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to provide sustainable Water, Sanitation, & Hygiene (WASH) in
healthcare facilities, aligned with the 2017 U.S. Global Water
Strategy, and to support WASH efforts to contribute to the elimi-
nation of cholera as a public health threat as outlined by Ending
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Cholera—A Global Roadmap to 2030. The Committee urges CDC to
increase its WASH efforts in areas where Neglected Tropical Dis-
eases are endemic.
Parasitic Disease and Malaria.—The Committee provides an in-
crease of $5,000,000 recognizing the important role CDC plays in
the fight against malaria and parasitic disease. CDC provides cru-
cial monitoring and surveillance of transmission, evaluation of
interventions for effectiveness and impact, development of key
diagnostics, and testing of tools in a real world setting that are
critical to ensuring that our global health investments are smarter,
better, and not wasteful. Therefore, the Committee encourages
CDC to continue to research, monitor, and evaluate efforts for ma-
laria and parasitic disease in collaboration across the agency and
with other agencies.
Population-based Surveillance Platforms.—The Committee di-
rects at least $5,000,000 to be used to support existing longitudinal
population-based infectious disease surveillance platforms that en-
able comparative analysis between urban and rural populations in
the developing world.
Soil Transmitted Helminth and Related Diseases of Poverty.—The
Committee includes $1,500,000 to extend the currently funded CDC
projects aimed at surveillance, source remediation and clinical care
to reduce soil transmitted helminth infection.
PUBLIC HEALTH PREPAREDNESS AND RESPONSE
Appropriation, fiscal year 2021 ......................................................... $842,200,000
Budget request, fiscal year 2022 ....................................................... 842,200,000
Committee Recommendation ............................................................. 862,200,000
Change from enacted level ......................................................... +20,000,000
Change from budget request ...................................................... +20,000,000
The Public Health Preparedness and Response (PHPR) account
supports programs that build and strengthen national prepared-
ness for public health emergencies, both naturally-occurring and in-
tentional. PHPR supports needs assessments, response planning,
training, epidemiology and surveillance, and upgrades for labora-
tory capacity and communications systems.
Within the total, the Committee recommends the following
amounts:
FY 2022
Budget Activity Committee
Public Health Emergency Preparedness Cooperative Agreement .................................................................. $715,000,000
Academic Centers for Public Health Preparedness ....................................................................................... 8,200,000
CDC Preparedness and Response .................................................................................................................. 139,000,000
Public Health Preparedness Cooperative Agreements.—The Com-
mittee includes an increase of $20,000,000 to enhance investments
in State, local, and territorial health departments to quickly detect,
monitor, and respond to health threats. Public health system in-
vestments serve as the backbone for disaster and outbreak re-
sponse in every State and the pandemic has shown that increased
funding for preparedness is necessary for a baseline of consistent
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protection. The Committee directs that grant recipients incorporate
Limited English Proficient (LEP) Individuals into their emergency
response. Grant recipients must ensure they are conducting tai-
lored and robust outreach efforts to LEP communities. In addition,
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the Committee requests a State distribution table in the fiscal year
2023 Congressional Budget Justification, which should also include
how funding is being allocated to local health departments and how
States are determining these allocations.
BUILDINGS AND FACILITIES
Appropriation, fiscal year 2021 ......................................................... $30,000,000
Budget request, fiscal year 2022 ....................................................... 55,000,000
Committee Recommendation ............................................................. 55,000,000
Change from enacted level ......................................................... +25,000,000
Change from budget request ...................................................... –––
This account supports capital projects as well as repairs and im-
provements to restore, maintain, and improve CDC’s assets at fa-
cilities in seven States and San Juan, Puerto Rico.
The Committee continues language to allow CDC to retain unob-
ligated funds in the Individual Learning Accounts from departed
employees to support the replacement of the underground and sur-
face coal mine safety and health research facility.
Maintenance Backlog.—The Committee includes an increase of
$25,000,000 to make significant progress on reducing CDC’s back-
log of maintenance and repairs.
CDC-WIDE ACTIVITIES AND PROGRAM SUPPORT
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