House Appropriations Committee Issues Report on Departments of Labor, HHS, Education, Related Agencies Appropriations Bill, 2018 (Part 5 of 10)
Multi-institute Research Issues
Addressing Hispanic Research Issues.--The Committee is encouraged by
Adolescents and Medication-Assisted Treatment.--The Committee applauds the ongoing coordinated efforts at
Adolescents and Young Adults.--The Committee encourages an
Amyloidosis.--The Committee recommends that
Angelman Syndrome.--The Committee recognizes the promising scientific gains made in the pursuit of treatments for Angelman Syndrome. The Committee applauds the significant contributions of the Angelman Syndrome Natural History Study, funded by
Bilateral Renal Agenesis.--The Committee requests
Children in
Chimpanzee Sanctuary Support.--The Committee commends
Chronic Fatigue Syndrome.--The Committee is pleased that
Coordination with the
Dietary Reference Intake for Carbohydrates.--The Committee notes keen public interest in various dietary guidance proposals and food labeling initiatives regarding consumption of carbohydrates. Yet, the last Dietary Reference Intake (DRI) review conducted regarding carbohydrates was completed in 2002. The Committee encourages
Fragile X.--The Committee commends
Gut Microbiome.--The Committee commends the
National Children's Study (NSC) Follow-On.--The Committee continues to recognize the importance of investigating the effects of environmental exposures on child health and development. The National Children's Study (NCS)/Environmental Influences on
Neurofibromatosis.--The Committee supports efforts to increase funding and resources for Neurofibromatosis (NF) research and treatment at multiple
Neurogenic Bladder and Kidney Disease.--The Committee encourages NIA, NIDDK,
Pediatric Precision Medicine.--The Committee is encouraged by the enormous potential of precision medicine for all populations, including children, since much of adult health is rooted in the earliest years. The Committee is aware that, at an All of Us Research Program stakeholder briefing,
Teacher Stress.--The Committee is aware that high levels of stress are adversely affecting the health of teachers. Elementary school teachers who have greater stress and show more symptoms of depression create classroom environments that are less conducive to learning. Stress is contributing to the high turnover rate among teachers. The Committee encourages
Trisomy 21.--The Committee continues to recognize that the presence of a third copy of human chromosome 21, which causes Down syndrome, predisposes individuals to significant immune system dysregulation. This dysregulation is associated with the occurrence of Alzheimer's disease as individuals with Down syndrome age and the high incidence of autoimmune disease as well as protections against most solid tumor cancers and cardiovascular disease. These findings present a rich research opportunity and, based on the
Undiagnosed Illnesses.--The Committee urges the Undiagnosed Disease Network (UDN) to continue efforts to enhance access to patients, caregivers, and other stakeholders as well as make information obtained through the UDN available to Federal agencies and health-related agencies.
Usher Syndrome.--The Committee continues to urge the
Valley Fever.--The Committee commends
Young Investigators.--The Committee expects
BUILDINGS AND FACILITIES
Mission.--The Buildings and Facilities appropriation provides for the design, construction, improvement, and major repair of clinical, laboratory, and office buildings and supporting facilities essential to the mission of the
The Committee notes
The Committee recommends
The Committee includes bill language directing the Secretary to exempt the Mental Health
The Committee does not include the requested bill language allowing the Assistant Secretary for Mental Health and Substance Use to transfer three percent or less of funds between any of the SAMHSA accounts.
The Committee directs SAMHSA, where statute allows, when issuing new funding opportunity announcements, to include as eligible applicants, States, political subdivisions of States such as local government or communities, Indian Tribes or tribal organizations, health facilities, or programs operated by or in accordance with a contract or grant with the
MENTAL HEALTH
The Committee provides
The Committee requests an update in the fiscal year 2019 Congressional Justification information on the costs to law enforcement, first responders, judicial systems, and health systems that accrue due to recidivist clients, including potential options for more cost-effective solutions to providing care for such clients.
Within the total provided for Mental Health Programs of Regional and National Significance, the Committee provides the following amounts:
Budget Activity.......................... FY 2018 Committee
Capacity:
Seclusion and Restraint..........................
Mental Health First Aid.......................... 14,963,000
National Child Traumatic Stress Network.......... 48,887,000
Children and Family Programs..................... 7,229,000
Consumer and Family Network Grants............... 4,954,000
Mental Health System Transformation and Health 3,779,000
Reform..........................................
Project LAUNCH................................... 23,605,000
Primary and Behavioral Health Care Integration... 49,877,000
Suicide Prevention:
National Strategy for Suicide Prevention......... 11,000,000
Zero Suicide................................. 9,000,000
American Indian and Alaska Native Set- 2,000,000
Aside...............................
Suicide Lifeline................................. 7,198,000
Garrett Lee Smith-Youth Suicide Prevention:
State Grants..................................... 35,427,000
Campus Grants.................................... 6,488,000
American Indian and Alaska Native Suicide 2,931,000
Prevention......................................
Tribal Behavioral Health Grants.................. 15,000,000
Homeless Prevention Programs..................... 30,696,000
Minority AIDS.................................... 4,206,000
Criminal and Juvenile Justice Programs........... 4,269,000
Assisted Outpatient Treatment.................... 15,000,000
Science and Service:
Garrett Lee Smith-Suicide Prevention Resource 5,988,000
Center..........................................
Consumer and Consumer Support Technical 1,918,000
Assistance Centers..............................
Primary and Behavioral Health Care Integration 1,991,000
Technical Assistance............................
Minority Fellowship Program...................... 8,059,000
Disaster Response................................ 1,953,000
Homelessness..................................... 2,296,000
Mental Health First Aid.--The Committee is pleased with the progress of the Mental Health First Aid program including training more than 740,000 Americans to recognize the signs and symptoms of common mental disorders. In continuing competitive funding opportunities, SAMHSA is directed to include as eligible grantees local law enforcement agencies, fire departments, and emergency medical units with a special emphasis on training for crisis de-escalation techniques. SAMHSA is also encouraged to allow training for veterans, armed services personnel and their family members. Any qualified community mental health education program should be considered as eligible for funding under the Mental Health First Aid program.
Mental Health
The Committee recommends a total of
The Committee continues the ten percent set-aside within the Mental Health
The Committee recommends
Pediatric Psychiatric Beds.--The Committee understands there is a shortage of psychiatric beds, particularly pediatric psychiatric beds, which help treat children with mental health and substance abuse issues. The Committee recommends SAMHSA review the best practices of pediatric psychiatric programs and provide an update in the fiscal year 2019 Congressional Justification on this topic.
Projects for Assistance in Transition from Homelessness
The Committee recommends
Protection and Advocacy for Individuals with Mental Illness
The Committee recommends
SUBSTANCE ABUSE TREATMENT
The Committee recommends
State Targeted Response to the Opioid Crisis.--The Committee includes
The Committee is aware of the significant challenge presented by opioid abuse, and believes that addressing the opioid crisis requires that states coordinate efforts among myriad agencies and organizations. Regional collaborations involving hospital systems, institutions of higher education, local government, and the judiciary can drive best practices and have shown success in identifying solutions for opioid abuse. Therefore, the Committee encourages SAMHSA to utilize such regional collaborative stakeholder teams.
Within the total provided for Programs of Regional and National Significance, the Committee recommends the following amounts:
Budget Activity......................... FY 2018 Committee
Capacity:
Opioid Treatment Programs and Regulatory
Activities......................................
Screening, Brief Intervention and Referral to 30,000,000
Treatment.......................................
PHS Evaluation Funds......................... 2,000,000
Targeted Capacity Expansion-General.............. 67,192,000
Medication-Assisted Treatment for 56,000,000
Prescription Drug and Opioid Addiction......
Pregnant and Postpartum Women.................... 19,931,000
Recovery Community Services Program.............. 2,434,000
Children and Families............................ 29,605,000
Treatment Systems for Homeless................... 36,386,000
Minority AIDS.................................... 65,570,000
Criminal Justice Activities...................... 78,000,000
Building Communities of Recovery................. 3,000,000
Science and Service:
Addiction Technology Transfer Centers............ 9,046,000
Minority Fellowship Program...................... 3,539,000
Screening, Brief Intervention and Referral to Treatment
The Committee provides
Targeted Capacity Expansion
The Committee recommends
Pregnant and Postpartum Women
The Committee provides
Criminal Justice Activities
The Committee provides
Drug Courts.--The Committee continues to direct SAMHSA to ensure that all funding appropriated for Drug Treatment Courts is allocated to serve people diagnosed with a substance use disorder as their primary condition. The Committee directs SAMHSA to ensure that all drug treatment court grant recipients work directly with the corresponding State substance abuse agency in the planning, implementation, and evaluation of the grant. The Committee further directs SAMHSA to expand training and technical assistance to drug treatment court grant recipients to ensure evidence-based practices are fully implemented.
Minority AIDS
Viral Hepatitis Screening.--The Committee commends SAMHSA for encouraging grantees to screen for viral hepatitis including the use of innovative strategies like rapid testing. The Committee notes the disproportionate impact of viral hepatitis among minority populations and the co-infection rate among individuals with HIV/AIDS. The Committee encourages SAMHSA to continue its work with grantees to incorporate hepatitis screening into programmatic activities and requests a report on the implementation of hepatitis screening activities in the fiscal year 2019 Congressional Justification.
Substance Abuse Prevention and Treatment
The Committee recommends a program level of
Handheld Analyzers.--The Committee understands the role played by handheld drug analyzers, particularly for police officers and other first responders. These instruments can identify various drugs and assist first responders in treatment referral. They also keep officers safe by minimizing the exposure to toxic drugs, while reducing the overall cost and backlog of cases at crime labs. The Committee encourages SAMHSA to work with the relevant stakeholders to clarify the policy of block grant funds and handheld analyzers.
Pregnant Women.--The Committee remains concerned about the lack of treatment options for pregnant women and women with dependent children. States are required to allocate a portion of their block grant funds to support treatment for this population. The Committee requests information in the fiscal year 2019 Congressional Justification on the amount of funds from the Substance Abuse Prevention and Treatment
SUBSTANCE ABUSE PREVENTION
The Committee recommends
Within the total provided for Programs of Regional and National Significance, the Committee provides the following amounts:
Budget Activity....................... FY 2018 Committee
Capacity:
Strategic Prevention Framework.......................
Strategic Prevention Framework Rx................ 10,000,000
Grants to Prevent Prescription Drug and Opioid 12,000,000
Overdose Related Deaths.............................
First Responder Training............................. 12,000,000
Rural Focus...................................... 6,000,000
Minority AIDS........................................ 28,843,000
Federal Drug-Free Workplace.......................... 4,894,000
Sober Truth on Preventing Underage Drinking
National Adult-Oriented Media Public Service 1,000,000
Campaign........................................
Community Based Coalition Enhancement Grants..... 5,000,000
Interagency Coordinating
Underage Drinking...............................
Tribal Behavioral Health Grants...................... 15,000,000
Science and Service:
Technologies....................................
Science and Service Program Coordination......... 4,072,000
Minority Fellowship Program...................... 71,000
Federal Drug Free Workplace.--The Committee is concerned that the Secretary of
Overdose Fatality Prevention.--The agreement reflects strong concerns about the increasing number of unintentional overdose deaths attributable to prescription and nonprescription opioids. SAMHSA is urged to take steps to encourage and support the use of Substance Abuse and Prevention
Strategic Prevention Framework.--The Committee directs SAMHSA to provide continuation grants for Strategic Prevention Framework activities in fiscal year 2018.
HEALTH SURVEILLANCE AND PROGRAM SUPPORT
The Committee provides
The Committee provides the following amounts for Health Surveillance and Program Support:
Budget Activity...................... FY 2018 Committee
Health Surveillance..................................
PHS Evaluation Funds............................. 22,428,000
Program Support...................................... 73,043,000
Public Awareness and Support......................... 11,572,000
Performance and Quality Information Systems.......... 12,893,000
Agency-Wide Initiatives..............................
PHS Evaluation Funds............................. 998,000
HEALTHCARE RESEARCH AND QUALITY
The Committee recommends
Budget Activity..................... FY 2018 Committee
Prevention/Care Management........................... 11,649,000
Health Information Technology (IT)............... 16,500,000
Health IT to Improve Quality..................... 14,500,000
Healthcare-Associated Infections (HAI) Prevention 36,000,000
Combating Antibiotic-Resistant Bacteria (non-add 10,000,000
within HAI).....................................
Section 933 Grants............................... 10,000,000
Patient Safety and Medical Errors................ 19,000,000
Patient Safety Organizations..................... 5,276,000
Crosscutting Activities Related to Quality, 68,731,000
Investigator-Initiated Research Grants........... 25,731,000
Program Management................................... 66,844,000
The Committee notes that the findings from research conducted and supported by AHRQ provide evidence to improve the quality, safety, accessibility, and affordability of health care. It is in the Nation's interest to ensure this work is being supported and managed effectively and efficiently, and in a way that avoids unnecessary duplication with other Federal agencies and/or the private sector. The Committee directs AHRQ to enter into an agreement with the
DRI for Sodium.--The Committee notes that the systematic review for updating the DRI for sodium for healthy populations is already underway. The Committee is concerned that the key questions being asked in the AHRQ systematic review ignore the impact of sodium intake on healthy populations within the normal (as defined by medical literature) versus low sodium ranges. This question must be answered in order for the DRI committee to be able to determine optimal sodium intakes for healthy populations, including whether the impact to health at normal vs. low intakes is linear or non-linear. The Committee requests that AHRQ answer this question and report back to the Committee before finalizing the systematic review and sending it to the DRI committee.
Patient-Reported Outcomes in Children.--Patient-reported outcomes play a major role in assessing the type and quality of care being received by patients. While patient-reported outcome measures are being advanced as an important component of clinical decision-making, there is little evidence to guide pediatric providers with respect to implementation and application of these measures, particularly as children move from early childhood through adolescence and to adulthood. The Committee requests that AHRQ report back on the state of patient reported outcomes in children with kidney disease and how the agency intends to advance the scientific application of these measures toward improving health outcomes in kidney patients as they mature from newborns to young adults in the fiscal year 2019 Congressional Justification.
Bibliography of Peer-Reviewed Tick-Borne Diseases Literature.--The Committee encourages AHRQ to assemble a bibliography of peer-reviewed tick-borne diseases literature, appropriately organized for use by the scientific community, treating physicians, and the public. The bibliography should include literature relating to possible mechanisms of persistent infection with Borrelia burgdorferi or other types of Borrelia.
GRANTS TO STATES FOR MEDICAID
The Committee recommends
The Committee continues bill language providing indefinite budget authority for unanticipated costs in fiscal year 2018. Federal Medicaid grants reimburse States for a portion of their expenditures in providing health care for individuals whose income and resources fall below specified levels. Subject to certain minimum requirements, States are provided certain limited authority within the law to set eligibility, coverage, and payment levels.
PAYMENTS TO THE HEALTH CARE TRUST FUNDS
The Committee recommends
This account includes the general fund subsidy to the
PROGRAM MANAGEMENT
The Committee makes available
Continues with Part 6 of 10
Chubb Launches Dedicated Multi-line Practice Focused on Large Transportation Clients in North America
House Appropriations Committee Issues Report on Departments of Labor, HHS, Education, Related Agencies Appropriations Bill, 2018 (Part 7 of 10)
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