Labor, Health and Human Services, and Education: FY2019 Appropriations

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Labor, Health and Human Services, and

Education: FY2019 Appropriations

Karen E. Lynch, Coordinator

Specialist in Social Policy

Jessica Tollestrup, Coordinator

Specialist in Social Policy

David H. Bradley

Specialist in Labor Economics

Ada S. Cornell

Senior Research Librarian

William R. Morton

Analyst in Income Security

Angela Napili

Senior Research Librarian

Kyle D. Shohfi

Analyst in Education Policy

August 5, 2019

Congressional Research Service

7-....

www.crs.gov

R45869

SUMMARY

Labor, Health and Human Services, and

Education: FY2019 Appropriations

This report offers an overview of actions taken by Congress and the President to provide

FY2019 appropriations for accounts funded by the Departments of Labor, Health and

Human Services, and Education, and Related Agencies (LHHS) appropriations bill. This

bill includes all accounts funded through the annual appropriations process at the

Department of Labor (DOL) and Department of Education (ED). It also provides annual

appropriations for most agencies within the Department of Health and Human Services

(HHS), with certain exceptions (e.g., the Food and Drug Administration is funded via

the Agriculture bill). Finally, the LHHS bill provides funds for more than a dozen related

agencies, including the Social Security Administration (SSA).

FY2019 Supplemental Appropriations for the Southern Border: During the 116th

Congress, on July 1, 2019, the President signed into law P.L. 116-26, a supplemental

appropriations act for FY2019 focusing primarily on the provision of humanitarian

assistance and security at the southern border. The bill was passed by the House on June

27 and by the Senate on June 26. (An earlier version of the bill had passed the House on

June 25. A related bill, S. 1900, had passed the Senate on June 19; this bill was

substantially similar to the final version of P.L. 116-26.) As enacted, the bill contained

nearly $2.9 billion in emergency-designated LHHS appropriations for the Refugee and

Entrant Assistance account at HHS. The FY2019 enacted levels presented throughout

this report are based on amounts provided by the FY2019 LHHS omnibus (P.L. 115-245,

see below) and do not include these supplemental funds, which were provided in

addition to the annual appropriations.

R45869

August 5, 2019

Karen E. Lynch,

Coordinator

Specialist in Social Policy

-redacted-@crs.loc.gov

Jessica Tollestrup,

Coordinator

Specialist in Social Policy

-redacted-@crs.loc.gov

David H. Bradley

Specialist in Labor

Economics

-redacted-@crs.loc.gov

Ada S. Cornell

Senior Research Librarian

-redacted-@crs.loc.gov

William R. Morton

Analyst in Income Security

-redacted-@crs.loc.gov

Angela Napili

Senior Research Librarian

-redacted-@crs.loc.gov

Kyle D. Shohfi

Analyst in Education Policy

-redacted-@crs.loc.gov

FY2019 Supplemental Appropriations for Disaster Relief: During the 116th Congress,

on June 6, 2019, the President signed into law P.L. 116-20, a supplemental

For a copy of the full report,

appropriations act for FY2019 focusing primarily on certain expenses arising from

please call 7-.... or visit

hurricanes, typhoons, wildfires, earthquakes, tornadoes, floods, and other natural

www.crs.gov.

disasters or emergencies. The bill was passed by the House on June 3 and by the Senate

on May 23. (An earlier version of the bill had passed the House on May 10.) As enacted, the bill included roughly

$611 million in emergency-designated LHHS appropriations for accounts at DOL, HHS, and ED. The FY2019

enacted levels presented throughout this report are based on amounts provided by the FY2019 LHHS omnibus

(P.L. 115-245) and do not include these supplemental funds, which were provided in addition to the annual

appropriations.

FY2019 LHHS Omnibus: During the 115th Congress, on September 28, 2018, the President signed into law the

Department of Defense and Labor, Health and Human Services, and Education Appropriations Act, 2019 and

Continuing Appropriations Act, 2019 (H.R. 6157, P.L. 115-245). This law contained full-year LHHS

appropriations in Division B. This is the first occasion since the FY1997 appropriations cycle that full-year LHHS

appropriations were enacted on or before the start of the fiscal year (October 1). The FY2019 LHHS omnibus

contained discretionary appropriations totaling $189.4 billion. This amount is 1.5% more than FY2018 enacted

levels and 8.9% more than the FY2019 President’s budget request. The omnibus also provided $869.8 billion in

mandatory funding, for a combined LHHS total of $1.059 trillion. The distribution of discretionary funding was

as follows:



DOL: $12.1 billion, 0.8% less than FY2018.

HHS: $90.5 billion, 2.6% more than FY2018.

ED: $71.4 billion, 0.8% more than FY2018.

Related Agencies: $15.3 billion, 0.1% more than FY2018.

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Labor, Health and Human Services, and Education: FY2019 Appropriations

FY2019 LHHS Senate Action: The Senate Appropriations Committee reported its version of the FY2018 LHHS

appropriations bill on June 28, 2018, by a vote of 30-1 (S. 3158). Instead of taking up the committee-reported

vehicle, the Senate chose to take up a different appropriations vehicle (H.R. 6157) and amend it to contain

FY2019 LHHS appropriations as well. (Those LHHS appropriations, which were added as Division B of H.R.

6157, were substantially the same as S. 3158.) During floor consideration of H.R. 6157, the Senate also adopted

31 amendments to the new LHHS division of the bill (see Appendix B for a summary of these amendments). The

Senate passed an amended H.R. 6157 by a vote of 85-7 on August 23, 2018.

The Senate-passed bill would have provided $189.4 billion in discretionary LHHS funds. This would have been

1.5% more than FY2018, and 8.9% more than the FY2019 President’s request. In addition, the Senate-passed bill

would have provided an estimated $869.8 billion in mandatory funding, for a combined total of $1.059 trillion for

LHHS as a whole. The distribution of discretionary funding would have been as follows:



DOL: $12.1 billion, 0.8% less than FY2018.

HHS: $90.5 billion, 2.7% more than FY2018.

ED: $71.4 billion, 0.8% more than FY2018.

Related Agencies: $15.4 billion, 0.5% more than FY2018.

FY2019 LHHS House Action: The House Appropriations Committee’s version of the FY2019 LHHS

appropriations bill was ordered reported by the full committee on July 11, 2018, by a vote of 30-22, and reported

to the House on July 23 (H.R. 6470). This bill would have provided $187.2 billion in discretionary LHHS funds, a

0.3% increase from FY2018 enacted levels. This amount would have been 7.6% more than the FY2019

President’s request. In addition, the House committee bill would have provided an estimated $869.8 billion in

mandatory funding, for a combined total of $1.057 trillion for LHHS as a whole. The distribution of discretionary

funding would have been as follows:



DOL: $11.9 billion, 2.4% less than FY2018.

HHS: $89.3 billion, 1.3% more than FY2018.

ED: $71.0 billion, 0.2% more than FY2018.

Related Agencies: $15.0 billion, 2.2% less than FY2018.

The House committee-reported version of the LHHS bill did not receive floor consideration.

FY2019 President’s Budget Request: On February 12, 2018, the Trump Administration released the FY2019

President’s budget. The President requested $173.9 billion in discretionary funding for accounts funded by the

LHHS bill, which would have been a decrease of 6.8% from FY2018 levels. In addition, the President requested

$869.8 billion in annually appropriated mandatory funding, for a total of $1.044 trillion for LHHS as a whole. The

distribution of discretionary funding was as follows:



DOL: $10.9 billion, 11.1% less than FY2018.

HHS: $86.7 billion, 1.6% less than FY2018.

ED: $63.2 billion, 10.8% less than FY2018.

Related Agencies: $13.2 billion, 14.0% less than FY2018.

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Labor, Health and Human Services, and Education: FY2019 Appropriations

Contents

Introduction ..................................................................................................................................... 1

Report Roadmap and Useful Terminology ...................................................................................... 1

Scope of the Report ................................................................................................................... 2

Important Budget Concepts....................................................................................................... 2

Mandatory vs. Discretionary Budget Authority .................................................................. 2

Total Budget Authority Provided in the Bill vs. Total Budget Authority Available

in the Fiscal Year.............................................................................................................. 3

Status of FY2019 LHHS Appropriations ........................................................................................ 4

FY2019 Supplemental Appropriations for the Southern Border ............................................... 4

FY2019 Supplemental Appropriations for Disaster Relief ....................................................... 6

FY2019 LHHS Omnibus........................................................................................................... 7

Earlier Congressional Action on an LHHS Bill ........................................................................ 8

FY2019 LHHS Action in the House ................................................................................... 8

FY2019 LHHS Action in the Senate ................................................................................... 8

FY2019 President’s Budget Request......................................................................................... 9

Conclusion of the FY2018 Appropriations Process .................................................................. 9

Summary of FY2019 LHHS Appropriations ................................................................................. 10

Department of Labor (DOL) ......................................................................................................... 13

About DOL ............................................................................................................................. 13

FY2019 DOL Appropriations Overview ................................................................................. 13

Selected DOL Highlights ........................................................................................................ 14

Employment and Training Administration (ETA)............................................................. 14

Bureau of International Labor Affairs (ILAB) .................................................................. 15

Labor-Related General Provisions .................................................................................... 15

Department of Health and Human Services (HHS)....................................................................... 18

About HHS .............................................................................................................................. 19

FY2019 HHS Appropriations Overview ................................................................................. 20

Special Public Health Funding Mechanisms ........................................................................... 21

Public Health Service Evaluation Tap............................................................................... 21

Prevention and Public Health Fund .................................................................................. 23

Selected HHS Highlights by Agency ...................................................................................... 23

HRSA ................................................................................................................................ 24

CDC .................................................................................................................................. 24

NIH ................................................................................................................................... 25

SAMHSA .......................................................................................................................... 26

CMS .................................................................................................................................. 26

ACF ................................................................................................................................... 27

AHRQ ............................................................................................................................... 28

ACL .................................................................................................................................. 28

Restrictions Related to Certain Controversial Issues .............................................................. 29

Department of Education (ED) ...................................................................................................... 36

About ED ................................................................................................................................ 36

FY2019 ED Appropriations Overview .................................................................................... 37

Selected ED Highlights ........................................................................................................... 37

Career and Technical Education........................................................................................ 38

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Student Financial Assistance............................................................................................. 38

Free Application for Federal Student Aid (FAFSA) ......................................................... 39

Related Agencies ........................................................................................................................... 41

FY2019 Related Agencies Appropriations Overview ............................................................. 41

Selected Related Agencies Highlights..................................................................................... 42

SSA Limitation on Administrative Expenses (LAE) ........................................................ 42

Corporation for National and Community Service ........................................................... 43

National Labor Relations Board (NLRB) ......................................................................... 43

Figures

Figure 1. FY2019 Enacted LHHS Appropriations .......................................................................... 8

Figure 2. FY2019 Enacted LHHS Appropriations by Title ........................................................... 12

Figure 3. FY2019 Enacted HHS Appropriations by Agency......................................................... 21

Tables

Table 1. Status of Full-Year LHHS Appropriations Legislation, FY2019 ....................................... 4

Table 2. LHHS Appropriations Overview by Bill Title, FY2018-FY2019 .................................... 11

Table 3. DOL Appropriations Overview ....................................................................................... 14

Table 4. Detailed DOL Appropriations .......................................................................................... 16

Table 5. HHS Appropriations Overview........................................................................................ 20

Table 6. HHS Appropriations Totals by Agency ........................................................................... 30

Table 7. HHS Discretionary Appropriations for Selected Programs or Activities,

by Agency .................................................................................................................................. 33

Table 8. ED Appropriations Overview .......................................................................................... 37

Table 9. Detailed ED Appropriations ............................................................................................ 39

Table 10. Related Agencies Appropriations Overview .................................................................. 42

Table 11. Detailed Related Agencies Appropriations .................................................................... 44

Table A-1. FY2019 LHHS Discretionary House and Senate Initial 302(b) Suballocations,

FY2019 Enacted Levels, and FY2018 Enacted Levels .............................................................. 49

Table A-2. LHHS Appropriations Overview, by Bill Title: FY2018-FY2019............................... 50

Table B-1. Senate Floor Amendments Offered to H.R. 6157 ........................................................ 52

Appendixes

Appendix A. Budget Enforcement Activities ................................................................................ 46

Appendix B. Senate Floor Amendments Offered to H.R. 6157 .................................................... 52

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Labor, Health and Human Services, and Education: FY2019 Appropriations

Contacts

Author Contact Information .......................................................................................................... 55

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Labor, Health and Human Services, and Education: FY2019 Appropriations

Introduction

This report provides an overview of FY2019 appropriations actions for accounts traditionally

funded in the appropriations bill for the Departments of Labor, Health and Human Services, and

Education, and Related Agencies (LHHS). This bill provides discretionary and mandatory

appropriations to three federal departments: the Department of Labor (DOL), the Department of

Health and Human Services (HHS), and the Department of Education (ED). In addition, the bill

provides annual appropriations for more than a dozen related agencies, including the Social

Security Administration (SSA).

Discretionary funds represent less than one-fifth of the total funds appropriated in the LHHS bill.

Nevertheless, the LHHS bill is typically the largest single source of discretionary funds for

domestic nondefense federal programs among the various appropriations bills. (The Department

of Defense bill is the largest source of discretionary funds among all federal programs.) The bulk

of this report is focused on discretionary appropriations because these funds receive the most

attention during the appropriations process.

The LHHS bill typically is one of the more controversial of the regular appropriations bills

because of the size of its funding total and the scope of its programs, as well as various related

social policy issues addressed in the bill, such as restrictions on the use of federal funds for

abortion and for research on human embryos and stem cells.

Congressional clients may consult the LHHS experts list in CRS Report R42638, Appropriations:

CRS Experts, for information on which analysts to contact at the Congressional Research Service

(CRS) with questions on specific agencies and programs funded in the LHHS bill.

Report Roadmap and Useful Terminology

This report is divided into several sections. The opening section provides an explanation of the

scope of the LHHS bill (and hence, the scope of this report) and an introduction to important

terminology and concepts that carry throughout the report. Next is a series of sections describing

major congressional actions on FY2019 appropriations and (for context) a review of the

conclusion of the FY2018 appropriations process. This is followed by a high-level summary and

analysis of enacted and proposed appropriations for FY2019, compared to FY2018 funding

levels. The body of the report concludes with overview sections for each of the major titles of the

bill: DOL, HHS, ED, and Related Agencies. These sections provide selected highlights from

FY2019 enacted and proposed funding levels compared to FY2018. (Note that the distribution of

funds is sometimes illustrated by figures, which in all cases are based on the FY2019 enacted

version of the LHHS bill.1)

Finally, Appendix A provides a summary of budget enforcement activities for FY2019. This

includes information on the Budget Control Act of 2011 (BCA; P.L. 112-25) and sequestration,

budget enforcement in the absence of an FY2019 budget resolution, provisional subcommittee

spending allocations, and current-year spending levels. This is followed by Appendix B, which

provides an overview of the LHHS-related floor amendments that were offered in the Senate

during its consideration of H.R. 6157, an appropriations measure that was amended to contain

LHHS appropriations for FY2019.

1 The dollars and percentages in each figure also are generally illustrative, except as noted, of the parallel distribution

of funds enacted in FY2018 and proposed by the FY2019 President’s budget, and the House committee-reported and

the Senate-passed bills.

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Labor, Health and Human Services, and Education: FY2019 Appropriations

Scope of the Report

In general, this report is focused strictly on appropriations to agencies and accounts that are

subject to the jurisdiction of the Labor, Health and Human Services, Education, and Related

Agencies subcommittees of the House and Senate appropriations committees (i.e., accounts

traditionally funded via the LHHS bill). Department “totals” provided in this report do not

include funding for accounts or agencies that are traditionally funded by appropriations bills

under the jurisdiction of other subcommittees.

The LHHS bill provides appropriations for the following federal departments and agencies:



the Department of Labor;

most agencies at the Department of Health and Human Services, except for the

Food and Drug Administration (funded through the Agriculture appropriations

bill), the Indian Health Service (funded through the Interior-Environment

appropriations bill), and the Agency for Toxic Substances and Disease Registry

(also funded through the Interior-Environment appropriations bill);

the Department of Education; and

more than a dozen related agencies, including the Social Security Administration,

the Corporation for National and Community Service, the Corporation for Public

Broadcasting, the Institute of Museum and Library Services, the National Labor

Relations Board, and the Railroad Retirement Board.

Note also that funding totals displayed in this report do not reflect amounts provided outside of

the annual appropriations process. Certain direct spending programs, such as Social Security and

parts of Medicare, receive funding directly from their authorizing statutes; such funds are not

reflected in the totals provided in this report because they are not provided through the annual

appropriations process (see related discussion in the “Important Budget Concepts” section).

Important Budget Concepts

Mandatory vs. Discretionary Budget Authority2

The LHHS bill includes both discretionary and mandatory budget authority. While all

discretionary spending is subject to the annual appropriations process, only a portion of

mandatory spending is provided in appropriations measures.

Mandatory programs funded through the annual appropriations process are commonly referred to

as appropriated entitlements. In general, appropriators have little control over the amounts

provided for appropriated entitlements; rather, the authorizing statute controls the program

parameters (e.g., eligibility rules, benefit levels) that entitle certain recipients to payments. If

Congress does not appropriate the money necessary to meet these commitments, entitled

recipients (e.g., individuals, states, or other entities) may have legal recourse.3

2 For definitions of these and other budget terms, see U.S. Government Accountability Office (GAO), A Glossary of

Terms Used in the Federal Budget Process, GAO-05-734SP, September 1, 2005, http://www.gao.gov/products/GAO05-734SP. (Terms of interest may include appropriated entitlement, direct spending, discretionary, entitlement

authority, and mandatory.)

3 Sometimes appropriations measures include amendments to laws authorizing mandatory spending programs and

thereby change the amount of mandatory appropriations needed. Because such amendments are legislative in nature,

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Labor, Health and Human Services, and Education: FY2019 Appropriations

Most mandatory spending is not provided through the annual appropriations process, but rather

through budget authority provided by the program’s authorizing statute (e.g., Social Security

benefits payments). The funding amounts in this report do not include budget authority provided

outside of the appropriations process. Instead, the amounts reflect only those funds, discretionary

and mandatory, that are provided through appropriations acts.

Note that, as displayed in this report, mandatory amounts for the Trump Administration’s budget

submission reflect current-law (or current services) estimates; they generally do not include the

President’s proposed changes to a mandatory spending program’s authorizing statute that might

affect total spending. (In general, such proposals are excluded from this report, as they typically

would be enacted in authorizing legislation.)

Note also that the report focuses most closely on discretionary funding. This is because

discretionary funding receives the bulk of attention during the appropriations process. (As noted

earlier, although the LHHS bill includes more mandatory funding than discretionary funding, the

appropriators generally have less flexibility in adjusting mandatory funding levels than

discretionary funding levels.)

Mandatory and discretionary spending is subject to budget enforcement processes that include

sequestration. In general, sequestration involves largely across-the-board reductions that are made

to certain categories of discretionary or mandatory spending. However, the conditions that trigger

sequestration, and how it is carried out, differ for each type of spending. This is discussed further

in Appendix A.

Total Budget Authority Provided in the Bill vs. Total Budget Authority

Available in the Fiscal Year

Budget authority is the amount of money a federal agency is legally authorized to commit or

spend. Appropriations bills may include budget authority that becomes available in the current

fiscal year, in future fiscal years, or some combination. Amounts that become available in future

fiscal years are typically referred to as advance appropriations.

Unless otherwise specified, appropriations levels displayed in this report refer to the total amount

of budget authority provided in an appropriations bill (i.e., “total in the bill”), regardless of the

year in which the funding becomes available.4 In some cases, the report breaks out “current-year”

appropriations (i.e., the amount of budget authority available for obligation in a given fiscal year,

regardless of the year in which it was first appropriated).5

As the annual appropriations process unfolds, the amount of current-year budget authority is

measured against 302(b) allocation ceilings (budget enforcement caps for appropriations

subcommittees that traditionally emerge following the budget resolution process). The process of

measuring appropriations against these spending ceilings takes into account scorekeeping

adjustments, which are made by the Congressional Budget Office (CBO) to reflect conventions

they may violate parliamentary rules separating authorizations and appropriations. For more information, see CRS

Report R42388, The Congressional Appropriations Process: An Introduction.

4 Such figures include advance appropriations provided in the bill for future fiscal years, but do not include advance

appropriations provided in prior years’ appropriations bills that become available in the current year.

5 Such figures exclude advance appropriations for future years, but include advance appropriations from prior years that

become available in the given fiscal year.

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Labor, Health and Human Services, and Education: FY2019 Appropriations

and special instructions of Congress.6 Unless otherwise specified, appropriations levels displayed

in this report do not reflect additional scorekeeping adjustments.

Status of FY2019 LHHS Appropriations

Table 1 provides a timeline of major legislative actions for full-year LHHS proposals, which are

discussed in greater detail below.

Table 1. Status of Full-Year LHHS Appropriations Legislation, FY2019

Subcommittee

Approval

Resolution of House and

Senate Differences

Full Committee

Approval

House

Senate

House

Senate

6/15/18

voice

vote

6/26/18

voice

vote

H.R. 6470

H.Rept.

115-862

7/11/18

30-22

S. 3158

S.Rept.

115-289

6/28/18

30-1

House

Initial

Passage

Senate

Initial

Passage

Conf.

Report

House

Final

Passage

Senate

Final

Passage

H.R. 6157, H.Rept.

Division B 115-952

8/23/18

85-7

H.R. 6157,

Division B

9/26/18

361-61

H.R. 6157,

Division B

9/18/18

93-7

Public

Law

P.L. 115245

9/28/18

Source: CRS Appropriations Status Table.

FY2019 Supplemental Appropriations for the Southern Border

On July 1, the President signed into law P.L. 116-26, an FY2019 supplemental appropriations act

focused primarily on humanitarian assistance and security needs at the southern border. The bill

was passed by the House on June 27 and by the Senate on June 26. (An earlier version of the bill

had passed the House on June 25. A related bill, S. 1900, had been reported by the Senate

Appropriations Committee on June 19; this bill was substantially similar to the final version of

P.L. 116-26.)

As enacted, the FY2019 border supplemental contained nearly $2.9 billion in emergencydesignated LHHS appropriations for the Refugee and Entrant Assistance account at HHS. These

funds were primarily intended to support the Unaccompanied Alien Children (UAC) program,

which provides for the shelter, care, and placement of unaccompanied alien children who have

been apprehended in the United States. According to a letter to Congress from the Office of

Management and Budget (OMB), as of May 1 the number of apprehensions referred to HHS had

increased by almost 50% from the prior year.7 In this same letter, OMB requested about $2.9

billion in supplemental funds for the UAC program, noting that these funds would provide

6 For more information on scorekeeping, see CRS Report 98-560, Baselines and Scorekeeping in the Federal Budget

Process. See also a discussion of key scorekeeping guidelines included in the joint explanatory statement

accompanying the conference report to the Balanced Budget Act of 1997 (H.Rept. 105-217, pp. 1007-1014).

7 Letter from Russell T. Vought, Acting Director, Office of Management and Budget, to Michael R. Pence, Nancy

Pelosi, Mitch McConnell, Charles E. Schumer, Kevin McCarthy, Richard C. Shelby, Nita Lowey, Patrick J. Leahy,

Kay Granger, May 1, 2019, https://www.whitehouse.gov/wp-content/uploads/2019/05/Pence.pdf. (This letter requested

$2.8 billion in supplemental funds for the UAC program, but a subsequent letter clarified that the actual request level

was $2.88 billion. See letter from Russell T. Vought, Acting Director, Office of Management and Budget, to Nancy

Pelosi et al., May 17, 2019, https://www.whitehouse.gov/wp-content/uploads/2019/05/Report-and-Notice-ofAnticipated-Deficiency.pdf.)

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Labor, Health and Human Services, and Education: FY2019 Appropriations

“critical child welfare services and high-quality shelter care.” The letter estimated that these funds

would allow HHS to increase shelter capacity to approximately 23,600 beds.

Of the $2.9 billion appropriated to the UAC account, some funds were set aside for designated

activities or purposes, such as state-licensed shelters (not less than $866 million); postrelease

services, child advocates, and legal services (not less than $100 million); additional federal field

specialists and increased case management and coordination services intended to place children

with sponsors more expeditiously and reduce the length of stay in HHS custody (not less than $8

million); project officers/program staff and the development of a discharge rate improvement plan

(not less than $1 million); and oversight activities conducted by the HHS Office of the Inspector

General ($5 million).

In addition to these reservations, the bill also placed a number of conditions on the use of the

supplemental funds. For instance, the bill



directed HHS to prioritize community-based residential care, state-licensed

facilities, hard-sided dormitories, and shelter care other than large-scale

institutional facilities (§401);

prohibited funds from being used for unlicensed facilities, except in limited

circumstances (e.g., on a temporary basis due to a large influx of children) when

specified conditions are met (e.g., comprehensive monitoring for an unlicensed

facility operating for more than three consecutive months) (§404);

required HHS to ensure, when feasible, that certain types of children (e.g.,

children under age 13, children with special needs, pregnant or parenting teens)

are not placed in unlicensed facilities (§406);

required HHS to reverse any reprogramming within the account that had been

carried out pursuant to a notification submitted to the appropriations committees

on May 16 (proviso within UAC appropriation);

prohibited funds from being used to prevent a Member of Congress from visiting

a UAC facility for oversight purposes (§407);

prohibited funds from being used by the Department of Homeland Security

(DHS) to detain or remove sponsors (or potential sponsors) of unaccompanied

children based on information provided by HHS as part of the sponsor’s

application, except when specified criteria are met (§409); and

prohibited funds from being used to reverse or change certain operational

directives previously issued by HHS, except in limited circumstances (§403).

The bill also included a number of notification and reporting requirements associated with these

funds. For instance, the bill required HHS to



notify the appropriations committees within 72 hours of conducting a formal

assessment of a facility for possible lease/acquisition and within seven days of

any acquisition/lease of real property (proviso within UAC appropriation);

submit to the appropriations committees a discharge rate improvement plan

within 120 days of enactment (proviso within UAC appropriation);

provide specific information to the appropriations committees at least 15 days

before opening an unlicensed facility and provide the committees with monthly

reports on the children placed at such facilities (§405);

submit to the appropriations committees (and make public) a monthly report on

the number and ages of unaccompanied alien children transferred into HHS care

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Labor, Health and Human Services, and Education: FY2019 Appropriations



after being separated from parents or legal guardians by DHS, along with the

reasons for the separations (§408); and

submit to the appropriations committees a detailed spending plan of anticipated

uses of funds within 30 days of enactment (§410).

FY2019 Supplemental Appropriations for Disaster Relief

Over the course of FY2019, the 115th and 116th Congresses considered supplemental

appropriations to several federal departments and agencies for expenses related to various recent

wildfires, hurricanes, volcanic eruptions, earthquakes, typhoons, and other natural disasters or

emergencies (e.g., H.R. 695 in the 115th Congress; H.R. 268, S.Amdt. 201 to H.R. 268, and H.R.

2157 in the 116th Congress). Each of these bills included appropriations for several accounts

typically funded in the LHHS bill.

Ultimately, on June 6, the President signed into law P.L. 116-20, a supplemental appropriations

act for FY2019. The bill was passed by the House on June 3 and by the Senate on May 23. (An

earlier version of the bill had passed the House on May 10.)

As enacted, the bill included roughly $611 million in emergency-designated LHHS appropriations

for accounts at DOL, HHS, and ED. With limited exceptions, the bill explicitly directed the

LHHS funds toward necessary expenses directly related to Hurricane Florence, Hurricane

Michael, Typhoon Mangkhut, Super Typhoon Yutu, wildfires and earthquakes occurring in

calendar year 2018, and tornadoes and floods occurring in calendar year 2019.

The FY2019 supplemental provided the following definite LHHS appropriations:



$50 million for the dislocated worker assistance national reserve at DOL, of

which up to $1 million may be transferred to other DOL accounts for

reconstruction and recovery needs and up to $500,000 is to be transferred to the

DOL Office of the Inspector General for oversight activities.

$30 million to the Child Care and Development Block Grant at HHS to support

the costs of renovating, repairing, or rebuilding child care facilities.

$90 million to the Children and Families Services Programs account at HHS for

necessary expenses related to the disasters and emergencies referenced by the

law. Of the total, $55 million is directed to Head Start programs, $25 million is

directed to the Community Services Block Grant, $5 million is directed to the

Stephanie Tubbs Jones Child Welfare Services program, and up to $5 million

may be used for federal administrative expenses.

$201 million for the Public Health and Social Services Emergency Fund at HHS

for necessary expenses directly related to the disasters and emergencies

referenced by the law. Of this amount, HHS is directed to transfer

 not less than $100 million to the Substance Abuse and Mental Health

Services Administration (SAMHSA) Health Surveillance and Program

Support account for grants, contracts, and cooperative agreements for

behavioral health treatment, treatment of substance use disorders, crisis

counseling and related helplines, and other similar programs to support

impacted individuals;

 $80 million to the Health Resources and Services Administration

(HRSA) federal health centers program for alteration, renovation,

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

construction, equipment, and other capital improvements to meet the

needs of affected areas;

 not less than $20 million to the Centers for Disease Control and

Prevention (CDC) for CDC-Wide Activities and Program Support for

response, recovery, mitigation, and other expenses; and

 up to $1 million to the Office of the Inspector General for oversight

activities.

$165 million for Hurricane Education Recovery at ED to assist in meeting the

educational needs of affected individuals. Of the total, $2 million is to be

transferred to the Office of the Inspector General for oversight activities and up

to $1 million may be used for program administration.

In addition, the supplemental provided a combination of definite and indefinite appropriations to

the Medicaid program at HHS to support program costs in the Northern Mariana Islands, Guam,

and American Samoa.8

FY2019 LHHS Omnibus

During the 115th Congress, on September 28, 2018, the President signed into law the Department

of Defense and Labor, Health and Human Services, and Education Appropriations Act, 2019 and

Continuing Appropriations Act, 2019 (H.R. 6157, P.L. 115-245). This was the first occasion since

the FY1997 appropriations cycle that full-year LHHS appropriations were enacted on or before

the start of the fiscal year (October 1). The House and Senate had previously agreed to resolve

differences on the measure via a conference committee. (Conferees on the bill were named in the

House on September 4 and in the Senate on September 6.) The conference report (H.Rept. 115952) was adopted by the Senate on September 18, and the House on September 26.

LHHS discretionary appropriations in the FY2019 omnibus totaled $189.4 billion. This amount is

1.5% more than FY2018 enacted and 8.9% more than the FY2019 President’s budget request.

The omnibus also provided $869.8 billion in mandatory funding, for a combined LHHS total of

$1.059 trillion. (Note that these totals are based only on amounts provided by the FY2019 LHHS

omnibus and do not include the supplemental funds, which were provided in addition to the

annual appropriations.)

See Figure 1 for a breakdown of FY2019 discretionary and mandatory LHHS appropriations.9

8 The Congressional Budget Office estimated total LHHS budget authority in the FY2019 supplemental to be $611

million. Of that amount, $536 million is outlined in the bulleted list above, and the remaining amount, a portion of

which is unspecified in the law, is presumably for the Medicaid funding in Section 802.

9 While the percentages in this figure were calculated based on amounts in the FY2019 LHHS omnibus, they are

generally also illustrative—within a few percentage points—of the share of mandatory and discretionary funds in

FY2018 and under the various FY2019 proposals (e.g., President’s budget and the House-committee and Senate-passed

bills).

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Labor, Health and Human Services, and Education: FY2019 Appropriations

Figure 1. FY2019 Enacted LHHS Appropriations

Source: Amounts in this figure are generally drawn from or calculated based on data contained in the

conference report (H.Rept. 115-952) on the FY2019 LHHS omnibus (P.L. 115-245). For consistency with source

materials, amounts in this figure generally do not reflect mandatory spending sequestration.

Notes: Details may not add to totals due to rounding. Amounts in this figure (1) reflect all budget authority

appropriated in the bill, regardless of the year in which funds become available (i.e., totals do not include

advances from prior-year appropriations, but do include advances for subsequent years provided in this bill); (2)

have generally not been adjusted to reflect scorekeeping; (3) comprise only those funds provided for agencies

and accounts subject to the jurisdiction of the LHHS subcommittees of the House and Senate appropriations

committees; and (4) do not include appropriations that occur outside of appropriations bills.

Earlier Congressional Action on an LHHS Bill

FY2019 LHHS Action in the House

The House Appropriations Committee’s LHHS subcommittee approved its draft bill on June 15,

2018. The full committee markup was held on July 11, 2018, and the bill was ordered to be

reported that same day (30-22). The bill was subsequently reported to the House on July 23 (H.R.

6470, H.Rept. 115-862). It did not receive floor consideration in the House.

As reported by the full committee, the bill would have provided $187.2 billion in discretionary

LHHS funds, a 0.3% increase from FY2018 enacted levels. This amount would have been 7.6%

more than the FY2019 President’s request. In addition, the House committee bill would have

provided an estimated $869.8 billion in mandatory funding, for a combined total of $1.057 trillion

for LHHS as a whole.

FY2019 LHHS Action in the Senate

The Senate Appropriations Committee’s LHHS subcommittee approved its draft bill on June 26,

2018. The full committee markup was held on June 28, 2018. The committee approved the bill

(30-1) and reported it that same day (S. 3158, S.Rept. 115-289).

Instead of taking up S. 3158, the Senate chose to consider and pass H.R. 6157 on August 23,

2018, by a vote of 85-7. The bill was amended on the Senate floor to contain FY2019 LHHS

appropriations in Division B. (Division A contained the appropriations act for the Department of

Defense.) The text of Division B that was considered for amendment was the same as S. 3158

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(with minor alterations). During floor consideration, the Senate also adopted 31 amendments to

the new LHHS division of the bill (see Appendix B for a summary of these amendments).

The Senate-passed bill would have provided $189.4 billion in discretionary LHHS funds. This

would have been 1.5% more than FY2018, and 8.9% more than the FY2019 President’s request.

In addition, the Senate bill would have provided an estimated $869.8 billion in mandatory

funding, for a combined total of $1.059 trillion for LHHS as a whole.

FY2019 President’s Budget Request

On February 12, 2018, the Trump Administration released the FY2019 President’s budget. The

President requested $173.9 billion in discretionary funding for accounts funded by the LHHS bill,

which would have been a decrease of 6.8% from FY2018 levels. In addition, the President

requested $869.8 billion in annually appropriated mandatory funding, for a total of $1.044 trillion

for LHHS as a whole.

Conclusion of the FY2018 Appropriations Process

On March 23, 2018, President Trump signed into law the Consolidated Appropriations Act, 2018

(H.R. 1625, P.L. 115-141). The bill was agreed to in the House on March 22 and in the Senate on

March 23. The bill provided regular, full-year appropriations for all 12 annual appropriations acts,

including LHHS (Division H).

LHHS discretionary appropriations in the FY2018 omnibus totaled $186.5 billion (this total does

not include emergency funding provided by an earlier supplemental appropriations act for

FY2018, P.L. 115-123). This amount was 7.6% more than FY2017 levels and 25.3% more than

the FY2018 budget request from the Trump Administration. The omnibus also provided $817.5

billion in mandatory funding, for a combined FY2018 LHHS total of $1.004 trillion.

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Summary of FY2019 LHHS Appropriations

Dollars and Percentages in this Report

Amounts displayed in this report are typically rounded to the nearest million or billion (as labeled). Dollar and

percentage changes discussed in the text are based on unrounded amounts.

Unless otherwise specified, appropriations levels displayed in this report refer to the total amount of budget

authority provided in an appropriations bill (i.e., “total in the bill”), regardless of the year in which the funding

becomes available.

Funding levels are generally drawn from (or estimated based on) data contained in the conference report (H.Rept.

115-952) on the FY2019 LHHS omnibus (P.L. 115-245).

Throughout this report, the FY2019 House Appropriations Committee-reported LHHS bill and Senate

Appropriations Committee-reported LHHS bill are commonly referred to as the House and Senate “committee

bills.” The version of H.R. 6157 that passed the Senate is referred to as “Senate-passed” or “Senate Floor.”

Amounts for the FY2019 Senate Floor version integrate the budgetary effects of the LHHS-related floor

amendments that were adopted in the Senate during its consideration of H.R. 6157.

Enacted totals for FY2018 do not include emergency-designated appropriations provided by the supplemental

appropriations act in P.L. 115-123. (For informational purposes, and per the convention of source materials,

FY2018 supplemental amounts are displayed separately in tables throughout the report.) Also per the convention

of source materials, enacted totals for FY2019 do not include the emergency-designated supplemental

appropriations provided in P.L. 116-20 or P.L. 116-26, nor are these amounts shown separately in the tables. (One

exception to this rule is made in Table A-1, which includes FY2018 and FY2019 supplemental funds in the

“Adjusted Appropriations” totals, as scored by the Congressional Budget Office.)

For consistency with source materials, the FY2018 and FY2019 numbers in this report generally do not reflect

actual or anticipated postenactment budgetary adjustments, except as noted.10

Table 2 displays FY2019 discretionary and mandatory LHHS budget authority provided or

proposed, by bill title, along with FY2018 enacted levels. The amounts shown in this table reflect

total budget authority provided in the bill (i.e., all funds appropriated in the bill, regardless of the

fiscal year in which the funds become available), not total budget authority available for the

current fiscal year. (For a comparable table showing current-year budget authority, see Table A-2

in Appendix A.)

10 The general practice for CRS reports on the LHHS bill has been to reflect conventions used in source materials.

These conventions have varied over the years. For instance, CRS reports on LHHS appropriations for FY2012-FY2015

generally relied on source materials that adjusted appropriations amounts in the prior-year column to reflect

sequestration, reestimates of mandatory spending, transfers, reprogramming, and other adjustments for comparability.

However, the FY2016 version of this report broke from that practice due to differing display conventions in source

documents, and did not reflect any such adjustments (except sequestration for the Prevention and Public Health Fund

(PPHF)). The FY2017 version of this report differed from both of these prior practices, in that it reflected a smaller

subset of transfers (generally concentrated at the National Institutes of Health) and other adjustments for comparability

(e.g., program moves from one account to another), but not reprogramming of funds or mandatory sequestration

(except sequestration of the PPHF). Due to the display conventions in the FY2018 and FY2019 source materials, the

current version of this report generally does not reflect any transfers or other budgetary adjustments except PPHF

sequestration.

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Table 2. LHHS Appropriations Overview by Bill Title, FY2018-FY2019

(Total budget authority provided in the bill, in billions of dollars)

Bill Title

Title I: Labor

FY2018

Enacted

FY2019

Request

FY2019

Senate

Floor

(H.R.

6157)

FY2019

House

Cmte.

(H.R.

6470)

FY2019

Enacted

(P.L.

115-245)

13.8

12.3

13.6

13.4

13.6

Discretionary

12.2

10.9

12.1

11.9

12.1

Mandatory

1.6

1.4

Title II: HHS

847.6

895.4

899.2

898.0

899.2

Discretionary

88.2

86.7

90.5

89.3

90.5

Mandatory

759.5

808.7

Title III: Education

74.3

66.7

74.9

74.5

75.0

Discretionary

70.9

63.2

71.4

71.0

71.4

Mandatory

3.5

Title IV: Related Agencies

68.3

69.3

71.5

71.1

71.5

Discretionary

15.3

13.2

15.4

15.0

15.3

Mandatory

53.0

56.2

Total BA in the Bill

1,004.0

1,043.7

1,059.2

1,057.0

1,059.2

Discretionary

186.5

173.9

189.4

187.2

189.4

Mandatory

817.5

869.8

4.0

—

Advances for Future Years

(provided in current bill)a

183.3

186.1

186.7

Advances from Prior Years

(for use in current year)a

168.9

183.3

-7.5

-5.2

-8.2

-9.4

P.L. 115-123 (emergency)

Memoranda:

Additional Scorekeeping Adjustmentsb

Source: Amounts in this table are generally drawn from or calculated based on data contained in the conference

report (H.Rept. 115-952) on the FY2019 LHHS omnibus (P.L. 115-245). Enacted totals for FY2018 do not

include emergency-designated appropriations provided by P.L. 115-123. For consistency with source materials,

amounts in this table generally do not reflect mandatory spending sequestration, where applicable, nor do they

reflect any transfers or reprogramming of funds pursuant to executive authorities.

Notes: BA = Budget Authority. Details may not add to totals due to rounding. Amounts in this table (1) reflect

all BA appropriated in the bill, regardless of the year in which funds become available (i.e., totals do not include

advances from prior-year appropriations, but do include advances for subsequent years provided in this bill); (2)

have generally not been adjusted to reflect scorekeeping; (3) comprise only those funds provided (or requested)

for agencies and accounts subject to the jurisdiction of the LHHS subcommittees of the House and Senate

appropriations committees; and (4) do not include appropriations that occur outside of appropriations bills. No

amounts are shown for Title V, because this title consists solely of general provisions.

a. Totals in this table are based on budget authority provided in the bill (i.e., they exclude advance

appropriations from prior bills and include advance appropriations from this bill made available in future

years). The calculation for total budget authority available in the current year is as follows: Total BA in the

Bill, minus Advances for Future Years, plus Advances from Prior Years.

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Totals in this table have generally not been adjusted for further scorekeeping. (To adjust for scorekeeping,

add this line to the total budget authority.)

Figure 2 displays the FY2019 enacted discretionary and mandatory LHHS funding levels, by bill

title. (While the dollars and percentages discussed in this section were calculated based on the

FY2019 enacted amounts, they are generally also illustrative—within several percentage points—

of the share of funds directed to each bill title in FY2018 and under the other FY2019 proposals.)

As this figure demonstrates, HHS accounts for the largest share of total FY2019 LHHS

appropriations: $899 billion, or 84.9%. This is due to the large amount of mandatory funding

included in the HHS appropriation, the majority of which is for Medicaid grants to states and

payments to health care trust funds. After HHS, ED and the Related Agencies represent the nextlargest shares of total LHHS funding, accounting for 7.1% and 6.7%, respectively. (The majority

of the ED appropriations each year are discretionary, while the bulk of funding for the Related

Agencies goes toward mandatory payments and administrative costs of the Supplemental Security

Income program at the Social Security Administration.) Finally, DOL accounts for the smallest

share of total LHHS funds, 1.3%.

However, the overall composition of LHHS funding is noticeably different when comparing only

discretionary appropriations. HHS accounts for a comparatively smaller share of total

discretionary appropriations (47.8%), while ED accounts for a relatively larger share (37.7%).

Together, these two departments represent the majority (85.5%) of discretionary LHHS

appropriations. DOL and the Related Agencies account for a roughly even split of the remaining

14.5% of discretionary LHHS funds.

Figure 2. FY2019 Enacted LHHS Appropriations by Title

Source: Amounts in this figure are generally drawn from or calculated based on data contained in the

conference report (H.Rept. 115-952) on the FY2019 LHHS omnibus (P.L. 115-245). For consistency with source

materials, amounts in this figure generally do not reflect mandatory spending sequestration, where applicable,

nor do they reflect any transfers or reprogramming of funds pursuant to executive authorities.

Notes: Details may not add to totals due to rounding. Amounts in this figure (1) reflect all BA appropriated in

the bill, regardless of the year in which funds become available (i.e., totals do not include advances from prioryear appropriations, but do include advances for subsequent years provided in this bill); (2) have generally not

been adjusted to reflect scorekeeping; (3) comprise only those funds provided for agencies and accounts subject

to the jurisdiction of the LHHS subcommittees of the House and Senate appropriations committees; and (4) do

not include appropriations that occur outside of appropriations bills.

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Department of Labor (DOL)

Note that all amounts in this section are based on regular LHHS appropriations only. Amounts in

this section do not include mandatory funds provided outside of the annual appropriations process

(e.g., direct appropriations for Unemployment Insurance benefits payments). All amounts in this

section are rounded to the nearest million or billion (as labeled). The dollar changes and

percentage changes discussed in the text are based on unrounded amounts. For consistency with

source materials, amounts do not reflect sequestration or reestimates of mandatory spending

programs, where applicable.

About DOL

DOL is a federal department comprised of multiple entities that provide services related to

employment and training, worker protection, income security, and contract enforcement. Annual

LHHS appropriations laws direct funding to all DOL entities (see the text box).12 The DOL

entities fall primarily into two main functional areas—workforce development and worker

protection. First, there are several DOL

entities that administer workforce employment

DOL Entities Funded via the

and training programs—such as the Workforce

LHHS Appropriations Process

Innovation and Opportunity Act (WIOA) state

Employment and Training Administration (ETA)

formula grant programs, Job Corps, and the

Employee Benefits Security Administration (EBSA)

Employment Service—that provide direct

Wage and Hour Division (WHD)

funding for employment activities or

Office of Federal Contract Compliance Programs

administration of income security programs

(OFCCP)

(e.g., for the Unemployment Insurance

Office of Labor-Management Standards (OLMS)

benefits program). Also included in this area is Office of Workers’ Compensation Programs (OWCP)

the Veterans’ Employment and Training

Occupational Safety and Health Administration (OSHA)

Service (VETS), which provides employment

Mine Safety and Health Administration (MSHA)

services specifically for the veteran

Bureau of Labor Statistics (BLS)

population. Second, there are several agencies

Office of Disability Employment Policy (ODEP)

that provide various worker protection

Departmental Management (DM)11

services. For example, the Occupational

Safety and Health Administration (OSHA),

the Mine Safety and Health Administration (MSHA), and the Wage and Hour Division (WHD)

provide different types of regulation and oversight of working conditions. DOL entities focused

on worker protection provide services to ensure worker safety, adherence to wage and overtime

laws, and contract compliance, among other duties. In addition to these two main functional

areas, DOL’s Bureau of Labor Statistics (BLS) collects data and provides analysis on the labor

market and related labor issues.

FY2019 DOL Appropriations Overview

Table 3 generally displays FY2019 discretionary and mandatory DOL budget authority provided

or proposed, along with FY2018 enacted levels. The FY2019 LHHS omnibus decreased

discretionary appropriations for DOL by 0.8% compared to the FY2018 enacted levels. Similarly,

11 Departmental Management includes the DOL salaries and expenses, Veterans Employment and Training Service

(VETS), IT Modernization, and the Office of the Inspector General.

12 The Pension Benefit Guaranty Corporation (PBGC) is funded primarily through insurance premiums and related fees

from companies covered by the PBGC.

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discretionary DOL appropriations would have decreased, compared to FY2018, under the

FY2019 President’s budget request (-11.1%), as well as the FY2019 House committee bill (2.4%) and Senate-passed bill (-0.8%). Of the total funding provided in the bill for DOL, roughly

89% is discretionary.

Table 3. DOL Appropriations Overview

(Dollars in billions)

Funding

FY2018

Enacted

FY2019

Request

FY2019

Senate

Floor

(H.R. 6157)

FY2019

House

Cmte.

(H.R. 6470)

FY2019

Enacted

(P.L.

115-245)

Discretionary

12.2

10.9

12.1

11.9

12.1

Mandatory

1.6

1.4

13.8

12.3

13.6

13.4

13.6

0.1

—

Total BA in the

Bill

P.L. 115-123

(emergency)