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116th Congress      }                                         {    Report
                                  SENATE
 1st Session        }                                         {    116-26

======================================================================



 
     REPORT ON LEGISLATIVE ACTIVITIES OF THE DCOMMITTEE ON HEALTH, 
                     EDUCATION, LABOR, AND PENSIONS

                                _______
                                

                 April 1, 2019.--Ordered to be printed

                                _______
                                

  Mr. Alexander, from the Committee on Health, Education, Labor, and 
                   Pensions, submitted the following

                              R E P O R T

[Pursuant to section 136 of the Legislative Reorganization Act of 1946, 
 as amended by the Legislative Reorganization Act of 1970, as amended]



                         COMMITTEE JURISDICTION

    The jurisdiction of the Health, Education, Labor, and 
Pensions Committee in the 115th Congress was set forth in 
paragraph 1.(1) of Rule XXV of the Standing Rules of the Senate 
as follows:

      (m)(1) Committee on Labor and Human Resources, to which 
        committee shall be referred all proposed legislation, 
        messages, petitions, memorials, and other matters 
        relating to the following subjects:

         1. Measures relating to education, labor, health, and 
            public welfare.
         2. Aging.
         3. Agricultural colleges.
         4. Arts and humanities.
         5. Biomedical research and development.
         6. Child labor.
         7. Convict labor and the entry of goods made by 
            convicts into interstate commerce.
         8. Domestic activities of the American National Red 
            Cross.
         9. Equal employment opportunity.
        10. Gallaudet College, Howard University, and Saint 
            Elizabeths Hospital.
        11. Handicapped individuals.
        12. Labor standards and labor statistics.

                                  (1)

        13. Mediation and arbitration of labor disputes.
        14. Occupational safety and health, including the 
            welfare of miners.
        15. Private pension plans.
        16. Public health.
        17. Railway labor and retirement.
        18. Regulation of foreign laborers.
        19. Student loans.
        20. Wages and hours of labor.

      (2) Such committee shall also study and review, on a 
        comprehensive basis, matters relating to health, 
        education and training, and public welfare, and report 
        thereon from time to time.

                        COMMITTEE ORGANIZATION*

    During the 115th Congress, the committee was organized into 
the following subcommittees:

                         Children and Families

                           Mr. Paul, Chairman

Ms. Murkowski                       Mr. Casey
Mr. Burr                            Mr. Sanders (I)
Dr. Cassidy                         Mr. Bennet
Mr. Young                           Mr. Kaine
Mr. Hatch                           Ms. Hassan
Mr. Roberts                         Ms. Smith

                    Employment and Workplace Safety

                         Mr. Isakson, Chairman

Mr. Roberts                         Ms. Baldwin
Mr. Scott                           Mr. Casey
Mr. Burr                            Mr. Murphy
Mr. Paul                            Ms. Warren
Dr. Cassidy                         Ms. Smith
Mr. Young                           Mr. Jones

                 Primary Health and Retirement Security

                           Mr. Enzi, Chairman

Mr. Burr                            Mr. Sanders (I)
Ms. Collins                         Mr. Bennet
Dr. Cassidy                         Ms. Baldwin
Mr. Young                           Mr. Murphy
Mr. Hatch                           Ms. Warren
Mr. Roberts                         Mr. Kaine
Mr. Scott                           Ms. Hassan
Ms. Murkowski                       Mr. Jones

    (*Note.--The Chairman and the Ranking Minority Member are 
ex officio if the subcommittee they do not serve on.)

                     REVIEW OF LEGISLATIVE ACTIVITY

    The Committee on Health, Education, Labor, and Pensions has 
jurisdiction over approximately 1,000 Federal programs relating 
to health, education, disability policy, children and families, 
older Americans, pensions, labor, and public welfare. These 
programs are administered by the Departments of Education, 
Health and Human Services, Labor and over a hundred independent 
agencies, councils, and bureaus.
    During the 115th Congress, which convened on January 3, 
2017 and adjourned on January 3, 2019, 583 bills and 
resolutions were referred to the committee for its 
consideration, reflecting the substantial interest in issues 
within the committee's jurisdiction. The committee and its 
subcommittees held 66 hearings, and produced 21 public laws, 
most of which came within the area of health care.

                       FULL COMMITTEE ACTIVITIES

    In addition to the legislation referred to the committee, 
63 nominations were received by the committee during the 115th 
Congress, 50 were reported and 35 were confirmed by the Senate.
    The committee reported 28 bills and 1 resolution to the 
Senate, and 21 measures within its jurisdiction were enacted 
into law.
    The committee and its subcommittees held 66 days of public 
hearings and held 16 executive sessions for the purpose of 
considering legislation and nominations. There were no 
conferences held with the House of Representatives.

        I. BILLS APPROVED BY THE HELP COMMITTEE ENACTED INTO LAW

                             A. Health Care

                  Opioid Crisis Response Act of 2018 
                     (Short Title as Passed Senate)

    The Opioid Crisis Response Act of 2018 (Short Title as 
Passed Senate) -- (SUPPORT for Patients and Communities Act 
(Short Title as Enacted, H.R. 6): Provides for opioid use 
disorder prevention, recovery, and treatment, and for other 
purposes.
    This bipartisan package of ``landmark'' legislation to 
fight the opioid crisis included more than 40 HELP Committee 
proposals. It deals with the nation's worst public health 
challenge by helping to stop deadly fentanyl from coming from 
China to the United States by mail, finding new non-addictive 
pain killers, allowing opioids to be dispensed in blister 
packs, for example a 3- or 7- day supply, and providing more 
opportunities for treatment.

          [Public Law 115-271, enacted Oct. 24, 2018. H.R. 6.]

             Sports Medicine Licensure Clarity Act of 2017 
                     (Short Title as Passed Senate)

    The Sports Medicine Licensure Clarity Act of 2017 (Short 
Title as Passed Senate, S. 808) -- (The FAA Reauthorization Act 
of 2018 (Short Title as Enacted), H.R. 302): Provides 
protections for certain sports medicine professionals, to 
reauthorize Federal aviation programs, to improve aircraft 
safety certification processes, and for other purposes.
    This law ensures when a sports medicine professional 
travels with a team outside the state in which they are 
licensed, they will continue to be covered by their medical 
malpractice insurance provider.

        [Public Law 115-254, enacted October 5, 2018. H.R. 302.]

     Protecting Patient Access To Emergency Medications Act of 2017

    The Protecting Patient Access to Emergency Medications Act 
of 2017 (H.R. 304): Amends the Controlled Substances Act with 
regard to the provision of emergency medical services.
    This bill amends the Controlled Substances Act to direct 
the Drug Enforcement Administration (DEA) to register an 
emergency medical services (EMS) agency to administer 
controlled substances if the agency submits an application 
demonstrating that it is authorized to conduct such activity in 
the state in which the agency practices. The DEA may deny an 
application if it determines that the registration is 
inconsistent with the public interest.
    If someone is the victim of a life-threatening emergency, 
like a burn victim or a child experiencing a seizure, this law 
ensures that he or she will continue to have access to time-
sensitive and life-saving treatments under the supervision of a 
physician.

       [Public Law 115-83, enacted November 17, 2017. H.R. 304.]

                 Improving Access To Maternity Care Act

    The Improving Access to Maternity Care Act (H.R. 315): 
Amends the Public Health Service Act to distribute maternity 
care health professionals to health professional shortage areas 
identified as in need of maternity care health services.
    This bill amends the Public Health Service Act to require 
the Health Resources and Services Administration (HRSA) to 
identify maternity care health professional target areas, which 
are areas within health professional shortage areas that have a 
shortage of maternity care health professionals, for purposes 
of assigning maternity care health professionals to those 
areas.
    This bill will help bring more doctors and nurses to 
provide care for pregnant women living in rural areas and other 
areas where there is a shortage of these health care providers.

       [Public Law 115-320, enacted December 17, 2018. H.R. 315.]

                SOAR To Health And Wellness Act of 2018

    The SOAR to Health and Wellness Act of 2018 (H.R. 767): 
Establishes the Stop, Observe, Ask, and Respond to Health and 
Wellness Training pilot program to address human trafficking in 
the health care system.
    This bill directs the Department of Health and Human 
Services (HHS) to establish a program, to be known as the Stop, 
Observe, Ask, and Respond to Health and Wellness Training 
Program or the SOAR to Health and Wellness Training Program, to 
train health care providers and other related providers to:
         identify potential human trafficking victims,
         work with law enforcement to report and 
        facilitate communication with such victims,
         refer victims to social or victims service 
        agencies or organizations,
         provide such victims with coordinated care 
        tailored to their circumstances, and
         consider integrating this training with 
        existing training programs. [H.Rept. 115-327]

      [Public Law 115-398, enacted December 31, 2018. [H.R. 767.]

                Firefighter Cancer Registry Act of 2018

    The Firefighter Cancer Registry Act of 2018 (H.R. 931): 
Requires require the Secretary of Health and Human Services to 
develop a voluntary registry to collect data on cancer 
incidence among firefighters.
    This bill requires the Centers for Disease Control and 
Prevention (CDC) to develop and maintain a voluntary registry 
of firefighters in order to collect history and occupational 
information that can be used to determine the incidence of 
cancer among firefighters. The registry must be used to improve 
monitoring of cancer among firefighters and to collect and 
publish epidemiological information. The CDC should seek to 
include specified information in the registry, including the 
number and type of fire incidents attended by an individual. 
[H.Rept. 115-301]
    Firefighters are exposed to a range of harmful toxins, and 
research has shown a strong connection between firefighting and 
an increased risk for several major cancers. This legislation 
creates a national registry for firefighters diagnosed with 
cancer.

         [Public Law 115-194, enacted July 7, 2018. H.R. 931.]

          Congenital Heart Futures Reauthorization Act of 2017

    The Congenital Heart Futures Reauthorization Act of 2017
(H.R. 1222): Amends the Public Health Service Act to coordinate 
Federal congenital heart disease research efforts and to 
improve public education and awareness of congenital heart 
disease, and for other purposes.
    This bill amends the Public Health Service Act to replace 
the authorization for a National Congenital Heart Disease 
Surveillance System with a requirement for the Department of 
Health and Human Services (HHS), regarding congenital heart 
disease, to enhance and expand research and surveillance 
infrastructure. (Congenital heart disease is a condition caused 
by a heart defect that is present at birth.) [H.Rept. 115-329]
    If you're the parent of a child who suffers from a 
congenital heart disease, this reauthorization is important 
because it will continue to support the research and data 
collection that is needed to better understand congenital heart 
disease.

      [Public Law 115-342, enacted December 21, 2018. H.R. 1222.]

                  Action For Dental Health Act of 2018

    The Action For Dental Health Act of 2018 (H.R. 2422): 
Amends the Public Health Service Act to improve essential oral 
health care for low-income and other underserved individuals by 
breaking down barriers to care, and for other purposes.
    This bill amends the Public Health Service Act to 
reauthorize oral health promotion and disease prevention 
programs through FY2022. [H.Rept. 115-328]

      [Public Law 115-302, enacted December 11, 2018. H.R. 2422.]

                    FDA Reauthorization Act of 2017

    The FDA Reauthorization Act of 2017 (H.R. 2430): Amends the 
Federal Food, Drug, and Cosmetic Act to revise and extend the 
user-fee programs for prescription drugs, medical devices, 
generic drugs, and biosimilar biological products, and for 
other purposes.
    This reauthorization of the four Food and Drug 
Administration (FDA) user fee agreements ensures the FDA has 
the funding it needs to quickly and safely bring new drugs and 
treatments to patients and make sure the promising research 
supported by the 21st Century Cures Act actually reaches 
patients. [H.Rept. 115-201]
    Related bill: S. 934.

        [Public Law 115-52, enacted August 18, 2017. H.R. 2430.]

                      RAISE Family Caregivers Act

    The RAISE Family Caregivers Act (Recognize, Assist, 
Include, Support, and Engage Family Caregivers Act of 2017) 
(H.R. 3759): Provides for the establishment and maintenance of 
a Family Caregiving Strategy, and for other purposes.
    This bill directs the Department of Health and Human 
Services (HHS) to develop and make publicly available a 
National Family Caregiving Strategy that identifies recommended 
actions for recognizing and supporting family caregivers in a 
manner that reflects their diverse needs.
    HHS shall convene a Family Caregiving Advisory Council to 
advise the department on recognizing and supporting family 
caregivers.
    The council shall terminate after three years.
    This law helps develop a strategy to coordinate federal 
programs to better support the millions of Americans who are 
caregivers for a family member.
    Related bill: S. 1028 [S. Rept. 115-364 -- Special 
Committee on Aging]

       [Public Law 115-119, enacted January 22, 2018. H.R. 3759.]

  Children's Hospital GME Support Reauthorization Act of 2018 (Short 
                          Title as Introduced)

    The Children's Hospital GME Support Reauthorization Act of 
2018 (Short Title as Introduced) (H.R. 5385): Amends the Public 
Health Service Act to reauthorize the program of payments to 
children's hospitals that operate graduate medical education 
programs, and for other purposes.
    This bill reauthorizes the children's hospital graduate 
medical education (CHGME) program that provides funding to more 
than 50 freestanding children's hospitals around the country, 
supporting the training of pediatricians and improving 
children's access to care.

      [Public Law 115-241, enacted September 18, 2018. H.R. 5385.]

    Animal Drug and Animal Generic Drug User Fee Amendments of 2018

    The Animal Drug and Animal Generic Drug User Fee Amendments 
of 2018 (H.R. 5554): Amends the Federal Food, Drug, and 
Cosmetic Act to reauthorize user fee programs relating to new 
animal drugs and generic new animal drugs.
    This reauthorization of the FDA animal drug and animal 
generic drug user fee agreements helps bring new animal drugs 
to farmers and ranchers, families, and veterinarians to keep 
their animals healthy and our food supply safe.

       [Public Law 115-234, enacted August 14, 2018. H.R. 5554.]

 Trickett Wendler, Frank Mongiello, Jordan Mclinn, and Matthew Bellina 
                        Right To Try Act of 2017

    The Trickett Wendler, Frank Mongiello, Jordan Mclinn, and 
Matthew Bellina Right To Try Act of 2017 (S. 204): Authorizes 
the use of unapproved medical products by patients diagnosed 
with a terminal illness in accordance with State law, and for 
other purposes.
    This bill amends the Federal Food, Drug, and Cosmetic Act 
to exempt, from specified requirements and restrictions under 
that Act and other laws, the provision of certain unapproved, 
investigational drugs to a terminally ill patient who has 
exhausted approved treatment options and is unable to 
participate in a clinical trial involving the drugs. The 
manufacturer or sponsor of an eligible investigational drug 
must report annually to the Food and Drug Administration (FDA) 
on any use of the drug in accordance with these provisions. The 
FDA shall post an annual summary report of such use on its Web 
site.

          [Public Law 115-176, enacted May 30, 2018. S. 204.]

                   Childhood Cancer STAR Act of 2018

    The Childhood Cancer STAR Act of 2018 (Childhood Cancer 
Survivorship, Treatment, Access, and Research Act of 2018) (S. 
292): Maximizes discovery, and accelerate development and 
availability, of promising childhood cancer treatments, and for 
other purposes.
    This bill amends the Public Health Service Act to authorize 
the National Institutes of Health (NIH) to provide support to 
collect the medical specimens and information of children, 
adolescents, and young adults with selected cancers that have 
the least effective treatments in order to achieve a better 
understanding of these cancers and the effects of treatment.
    If you're the parent of a child with cancer, this law 
encourages pediatric cancer research by building on last year's 
RACE for the Children Act and reauthorization of the Food and 
Drug Administration (FDA) user fee agreements.

          [Public Law 115-180, enacted June 5, 2018. S. 292.]

          Early Hearing Detection And Intervention Act of 2017

    The Early Hearing Detection and Intervention Act of 2017
(S. 652): Amends the Public Health Service Act to reauthorize a 
program for early detection, diagnosis, and treatment regarding 
deaf and hard-of-hearing newborns, infants, and young children.
    This bill amends the Public Health Service Act to revise 
programs for deaf and hard-of-hearing newborns and infants, 
including to expand the programs to include young children. The 
programs are reauthorized through FY2022. Health Resources and 
Services Administration support for the education and training 
of personnel and health care providers for such programs is 
expanded to include education and training of family members.
    If you're a parent with a newborn, infant, or young child, 
this law supports state-based efforts to screen them for 
hearing loss and ensure proper follow-up care, including 
diagnosis and early intervention.

         [Public Law 115-71, enacted October 18, 2017. S. 652.]

                 National Clinical Care Commission Act

    The National Clinical Care Commission Act (S. 920): 
Establishes a National Clinical Care Commission.
    This bill establishes within the Department of Health and 
Human Services (HHS) a National Clinical Care Commission to 
evaluate and make recommendations regarding improvements to the 
coordination and leveraging of federal programs related to 
complex metabolic or autoimmune diseases that result from 
issues related to insulin and represent a significant disease 
burden (e.g., diabetes). The commission must report on: (1) HHS 
programs that focus on prevention, (2) current activities and 
gaps in federal efforts to support clinicians in providing 
integrated care, (3) improvement in federal education and 
awareness activities related to prevention and treatment, (4) 
methods for outreach and dissemination of education and 
awareness materials, and (5) opportunities for consolidation of 
overlapping federal programs.
    This law creates a commission of leading experts to study 
complex metabolic or autoimmune diseases, like diabetes. The 
commission will recommend improvements to federal programs that 
work to help prevent diseases like diabetes or educate patients 
on their condition.

         [Public Law 115-80, enacted November 2, 2017. S. 920.]

           Supporting Grandparents Raising Grandchildren Act

    The Supporting Grandparents Raising Grandchildren Act
(S. 1091): Establishes a Federal Advisory Council to Support 
Grandparents Raising Grandchildren.
    This bill establishes an Advisory Council to Support 
Grandparents Raising Grandchildren.
    The council must identify, promote, coordinate, and 
publicly disseminate information and resources to help older 
relatives meet the needs of the children in their care and 
maintain their own health and emotional well-being.
    If you are a grandparent raising your grandchild, this law 
helps you navigate that process by creating a task force, made 
up of federal agencies and grandparents, to coordinate federal 
resources and information available to you.

          [Public Law 115-196, enacted July 7, 2018. S. 1091.]

                Bold Infrastructure For Alzheimer's Act

    The Bold Infrastructure For Alzheimer's Act (S. 2076): 
Amends the Public Health Service Act to authorize the expansion 
of activities related to Alzheimer's disease, cognitive 
decline, and brain health under the Alzheimer's Disease and 
Healthy Aging Program, and for other purposes.
    This bill amends the Public Health Service Act to award 
cooperative agreements: (1) for the establishment or support of 
national or regional centers of excellence in public health 
practice in Alzheimer's disease; (2) to state public health 
departments, Native American tribes, and other entities to 
promote cognitive functioning, address cognitive impairment and 
unique aspects of Alzheimer's disease, and help meet the needs 
of caregivers; (3) for analysis and public reporting of data on 
the state and national levels regarding cognitive decline, 
caregiving, and health disparities, and monitoring of 
objectives on dementia and caregiving in the Department of 
Health and Human Services' Healthy People 2020 report.
    This legislation will create Centers of Excellence to 
advance public health knowledge and ensure public health 
professionals, doctors and nurses, and patients and their 
families have the support and updated information on 
Alzheimer's and related dementia diseases they need.

       [Public Law 115-406, enacted December 31, 2018. S. 2076.]

       State Offices of Rural Health Reauthorization Act of 2018

    The State Offices of Rural Health Reauthorization Act of 
2018
(S. 2278): Amends the Public Health Service Act to provide 
grants to improve health care in rural areas.
    This bill amends the Public Health Service Act to 
reauthorize through FY2022 and revise the grant program for 
state offices of rural health, including to require the 
Department of Health and Human Services (HHS) to make the 
grants, thus removing HHS's discretion to make them.
    This law reauthorizes grant programs that strengthen rural 
health care systems and develop long-term solutions to rural 
health challenges.

       [Public Law 115-408, enacted December 31, 2018. S. 2278.]

   Sickle Cell Disease and Other Heritable Blood Disorders Research, 
          Surveillance, Prevention, and Treatment Act of 2018

    The Sickle Cell Disease and Other Heritable Blood Disorders 
Research, Surveillance, Prevention, and Treatment Act of 2018
(S. 2465): Amends the Public Health Service Act to reauthorize 
a sickle cell disease prevention and treatment demonstration 
program and to provide for sickle cell disease research, 
surveillance, prevention, and treatment.
    This bill amends the Public Health Service Act to authorize 
the Department of Health and Human Services to award grants to 
government, educational, and nonprofit entities for the purpose 
of supporting data collection and public health activities 
regarding sickle cell disease.
    At least 100,000 Americans have sickle cell disease, but 
the exact number is unknown because we do not have sufficient 
data. This bill will allow the Department of Health and Human 
Services to study sickle cell disease and other heritable blood 
disorders so we know how many people are affected by these 
conditions and implement strategies to help treat these 
diseases.

       [Public Law 115-327, enacted December 18, 2018. S. 2465.]

                 Patient Right To Know Drug Prices Act

    The Patient Right to Know Drug Prices Act (S. 2554): 
Ensures that health insurance issuers and group health plans do 
not prohibit pharmacy providers from providing certain 
information to enrollees.
    This law bans the ``gag'' clauses that prevented a 
pharmacist from telling a patient their prescription would be 
cheaper if they paid with cash instead of using their 
insurance.

        [Public Law 115-263, enacted October 10, 2018. S. 2554.]

                  Preemie Reauthorization Act of 2018

    The PREEMIE Reauthorization Act of 2018 (S. 3029) -- 
(Prematurity Research Expansion and Education for Mothers who 
deliver Infants Early Reauthorization Act of 2018): Revises and 
extends the Prematurity Research Expansion and Education for 
Mothers who deliver Infants Early Act (PREEMIE Act).
    This bill reauthorizes through FY 2023 and revises the 
Prematurity Research Expansion and Education for Mothers who 
deliver Infants Early Act. Among other changes, the Centers for 
Disease Control and Prevention must publish its research report 
on its website.
    In Tennessee, about 11 percent of babies are born preterm. 
This bill reauthorizes legislation first introduced by 
Alexander in 2003 to help researchers, doctors, and parents 
prevent premature births and give more babies the chance for 
long and healthy lives.

       [Public Law 115-328, enacted December 18, 2018. S. 3029.]

                              B. Education

 Strengthening Career and Technical Education For The 21st Century Act

    The Strengthening Career and Technical Education for the 
21st Century Act (H.R. 2353): Reauthorizes the Carl D. Perkins 
Career and Technical Education Act of 2006.
    The effective date for this bill is July 1, 2018.
    This bill amends the Carl D. Perkins Career and Technical 
Education Act of 2006 to revise and introduce definitions, 
including common definitions for terms already defined in the 
Workforce Innovation and Opportunity Act. The bill divides 
career and technical education (CTE) students into CTE 
concentrators and CTE participants. [H.Rept. 115-164]
    More than 200,000 students in Tennessee participate in 
career and technical education programs. This new law updates a 
nearly $1.2 billion federal program of grants to states that 
help fund the programs that train the workers we need, for 
example, a high school student looking to become a computer 
coder, or an adult going back to school to learn about 
commercial construction.
    Related bill: S. 3217. [S. Rept. 115-434]

        [Public Law 115-224, enacted July 31, 2018. H.R. 2353.]

                Museum and Library Services Act of 2018

    The Museum and Library Services Act of 2018 (S. 3530): 
Reauthorizes the Museum and Library Services Act.
    This bill amends and reauthorizes through FY2025 the Museum 
and Library Services Act and provides funding for library 
services and technology through FY2025.
    This bill reauthorizes programs for museums and libraries, 
including the only federal program exclusively for libraries--
the Library Services and Technology Act.

       [Public Law 115-410, enacted December 31, 2018. S. 3530.]

                         II. VETOED LEGISLATION

    In the 115th Congress, no legislation was vetoed by the 
President.

III. BILLS REPORTED FROM THE COMMITTEE ON HEALTH, EDUCATION, LABOR, AND 
          PENSIONS, NOT ENACTED INTO LAW IN THE 115TH CONGRESS

                               A. Health

                Firefighter Cancer Registry Act of 2018

    The Firefighter Cancer Registry Act of 2018 (S. 382): 
Requires the Secretary of Health and Human Services to develop 
a voluntary registry to collect data on cancer incidence among 
firefighters.
    On April 24, 2018, the bill was considered in executive 
session by full committee and ordered favorably reported 
without an amendment and on April 25, 2018 the bill was 
reported with an amendment in the nature of a substitute to the 
Senate on April 18, 2016, without written report.

             Sports Medicine Licensure Clarity Act of 2017

    The Sports Medicine Licensure Clarity Act of 2017 (S. 808): 
Provides protections for certain sports medicine professionals 
who provide certain medical services in a secondary State.
    On June 26, 2018, the bill was considered in executive 
session by full committee and ordered favorably reported with 
an amendment in the nature of a substitute and was reported to 
the Senate on July 9, 2018, without written report.

       Strengthening Mosquito Abatement For Safety and Health Act

    The Strengthening Mosquito Abatement for Safety and Health 
Act (S. 849): Supports programs for mosquito-borne and other 
vector-borne disease surveillance and control.
    On April 26, 2017, the bill was considered in executive 
session by full committee and ordered favorably reported with 
an amendment in the nature of a substitute and reported to the 
Senate on May 1, 2017, without written report.
    This bill will improve public health preparedness 
capabilities to help combat the Zika virus and other mosquito-
borne diseases that threaten public health by strengthening key 
programs that support state and local mosquito surveillance and 
control efforts.

    Patient Access To Substance Use Disorder Treatments Act of 2018

    The Ensuring Patient Access to Substance Use Disorder 
Treatments Act of 2018 (S. 916): Amends the Controlled 
Substances Act with regard to the provision of emergency 
medical services.
    On April 26, 2017 the bill was considered in executive 
session by full committee and ordered favorably reported with 
an amendment in the nature of a substitute and reported to the 
Senate on May 1, 2017, without written report.

                    FDA Reauthorization Act of 2017

    FDA Reauthorization Act of 2017 (S. 934): Amends the 
Federal Food, Drug, and Cosmetic Act to revise and extend the 
user-fee programs for prescription drugs, medical devices, 
generic drugs, and biosimilar biological products, and for 
other purposes.
    On May 11, 2017, the bill was considered in executive 
session by full committee and ordered favorably reported with 
an amendment in the nature of a substitute and reported to the 
Senate on May 11, 2017, without written report.

                      Raise Family Caregivers Act

    The RAISE Family Caregivers Act (Recognize, Assist, 
Include, Support, and Engage Family Caregivers Act of 2017 (S. 
1028): Provides for the establishment and maintenance of a 
National Family Caregiving Strategy, and for other purposes.
    On May 11, 2017, the bill was considered in executive 
session by full committee and ordered favorably reported 
without amendment and reported to the Senate on May 11, 2017, 
without written report.
    This law helps develop a strategy to coordinate federal 
programs to better support the millions of Americans who are 
caregivers for a family member.
    [S. Rept. 115-364 -- Special Committee on Aging]

               Maternal Health Accountability Act of 2017

    The Maternal Health Accountability Act of 2017 (S. 1112): 
Supports States in their work to save and sustain the health of 
mothers during pregnancy, childbirth, and in the postpartum 
period, to eliminate disparities in maternal health outcomes 
for pregnancy-related and pregnancy-associated deaths, to 
identify solutions to improve health care quality and health 
outcomes for mothers, and for other purposes.
    On June 26, 2018, the bill was considered in executive 
session by full committee and ordered favorably reported with 
an amendment in the nature of a substitute and reported to the 
Senate on July 9, 2018, without written report.
    This legislation aims to support states in reviewing 
pregnancy-related deaths to identify ways to improve maternal 
care and reduce maternal mortality in the United States. (H.R. 
1318 became law per LIS P.L. 115-344, December 21, 2018 -- 
Senate language subbed in.)

        Over-The-Counter Drug Safety, Innovation, and Reform Act

    The Over-the-Counter Drug Safety, Innovation, and Reform 
Act (S. 2315): Amends the Federal Food, Drug, and Cosmetic Act 
to clarify the regulatory framework with respect to certain 
nonprescription drugs that are marketed without an approved new 
drug application, and for other purposes.
    On April 24, 2018, it was considered in executive session 
by full committee and ordered favorably reported with an 
amendment in the nature of a substitute and reported to the 
Senate on May 14, 2018, without written report.
    This legislation would modernize the way over-the-counter 
medications are regulated and brought to market, to encourage 
the development of new drugs for patients.

    Animal Drug and Animal Generic Drug User Fee Amendments of 2018

    The Animal Drug and Animal Generic Drug User Fee Amendments 
of 2018 (S. 2434): Amends the Federal Food, Drug, and Cosmetic 
Act to reauthorize user fee programs relating to new animal 
drugs and generic new animal drugs.
    On February 28, 2018, it was considered in executive 
session by full committee and ordered favorably reported with 
an amendment in the nature of a substitute and reported to the 
Senate on March 7, 2018, without written report.
    This reauthorization of the FDA animal drug and animal 
generic drug user fee agreements helps bring new animal drugs 
to farmers and ranchers, families, and veterinarians to keep 
their animals healthy and our food supply safe.

      Children's Hospital GME Support Reauthorization Act of 2018

    The Children's Hospital GME Support Reauthorization Act of 
2018 (S. 2597): Amends the Public Health Service Act to 
reauthorize the program of payments to children's hospitals 
that operate graduate medical education programs, and for other 
purposes.
    On April 24, 2018, the bill was considered in executive 
session by full committee and ordered favorably reported with 
an amendment in the nature of a substitute and reported to the 
Senate on April 25, 2018, without written report.
    This bill reauthorizes the children's hospital graduate 
medical education (CHGME) program that provides funding to more 
than 50 freestanding children's hospitals around the country, 
supporting the training of pediatricians and improving 
children's access to care.

                   Opioid Crisis Response Act of 2018

    Opioid Crisis Response Act of 2018 (S. 2680): Addresses the 
opioid crisis.
    On March 9, 2016, the bill was considered in executive 
session by full committee and ordered favorably reported with 
an amendment in the nature of a substitute and reported to the 
Senate on April 5, 2016, without written report.
    This bipartisan package of "landmark" legislation to fight 
the opioid crisis included more than 40 HELP Committee 
proposals. It deals with the nation's worst public health 
challenge by helping to stop deadly fentanyl from coming from 
China to the United States by mail, finding new non-addictive 
pain killers, allowing opioids to be dispensed in blister 
packs, for example a 3- or 7- day supply, and providing more 
opportunities for treatment.

 Pandemic and All-Hazards Preparedness and Advancing Innovation Act of 
                                  2018

    The Pandemic and All-Hazards Preparedness and Advancing 
Innovation Act of 2018 (S. 2852): Reauthorizes certain programs 
under the Pandemic and All-Hazards Preparedness Reauthorization 
Act.
    On May 23, 2018 the bill was considered in executive 
session by full committee and ordered favorably reported with 
an amendment in the nature of a substitute and was reported to 
the Senate on June 18, 2018, without written report.
    It is crucial we are prepared to face a range of public 
health threats--including outbreaks of infectious diseases like 
Ebola, Zika, or the flu; natural disasters, such as hurricanes 
and the wildfires that swept across East Tennessee in 2016; or 
deliberate attacks with dangerous agents, like anthrax or 
nuclear weapons. This legislation strengthens our preparedness 
and response capabilities so we can better protect Tennesseans 
and all Americans from 21st century threats.

                  Action For Dental Health Act of 2018

    The Action for Dental Health Act of 2018 (S. 3016): Amends 
the Public Health Service Act to improve essential oral health 
care for low-income and other underserved individuals by 
breaking down barriers to care, and for other purposes.
    On July 25, 2018 the bill was considered in executive 
session by full committee and ordered favorably reported with 
an amendment in the nature of a substitute, and was reported to 
the Senate on August 15, 2018, without written report.
    This legislation supports states, dental associations, and 
community-based oral health programs to help prevent dental 
disease, and expands efforts to provide care to underserved 
patients.

Emergency Medical Services For Children Program Reauthorization Act of 
                                  2018

    The Emergency Medical Services for Children Program 
Reauthorization Act of 2018 (S. 3482): Amends the Public Health 
Service Act to reauthorize the Emergency Medical Services for 
Children program.
    On November 29, 2018 the bill was considered in executive 
session by full committee and ordered favorably reported 
without amendment and was reported to the Senate on November 
29, 2018, without written report.
    This bill will ensure that, from the ambulance to the 
emergency department, emergency health care providers are 
prepared to treat children, who typically require smaller 
equipment and different doses of medicine.

       Traumatic Brain Injury Program Reauthorization Act of 2018

    The Traumatic Brain Injury Program Reauthorization Act of 
2018 (S. 3657): Reauthorizes the Traumatic Brain Injury 
program.
    On November 26, 2018 the bill was considered in executive 
session by full committee and ordered favorably reported with 
an amendment in the nature of a substitute and was reported to 
the Senate on November 29, 2018, without written report.
    This bill reauthorizes state grants and programs related to 
surveillance, prevention, care, and research of traumatic brain 
injuries, and encourages data collection and analysis so we can 
better understand trends and causes of concussions. (H.R. 6615 
House version became law per LIS P.L. 115-377, December 21, 
2018) -- Senate language subbed in.)

                              B. Education

 Strengthening Career and Technical Education For The 21st Century Act

    The Strengthening Career and Technical Education for the 
21st Century Act (S. 3217) an original bill, reauthorizes the 
Carl D. Perkins Career and Technical Education Act of 2006.
    On July 16, 2018 was considered in executive session by 
full committee and ordered favorably reported and was reported 
to the Senate on December 19, 2018, with written report no. 
115-434.
    More than 200,000 students in Tennessee participate in 
career and technical education programs. This new law updates a 
nearly $1.2 billion federal program of grants to states that 
help fund the programs that train the workers we need, for 
example, a high school student looking to become a computer 
coder, or an adult going back to school to learn about 
commercial construction.

  IV. OTHER BILLS UNDER THE JURISDICTION OF THE COMMITTEE ON HEALTH, 
 EDUCATION, LABOR, AND PENSIONS, CONSIDERED BY THE SENATE IN THE 115TH 
                                CONGRESS

                               A. Health

                              Jessie's Law

    Jessie's Law (S. 581) is a bill to include information 
concerning a patient's opioid addiction in certain medical 
records.
    This bill requires the Department of Health and Human 
Services (HHS) to develop and disseminate best practices for 
health care providers and state agencies regarding the display 
of a patient's history of opioid addiction in the patient's 
medical records. On Aug. 3, 2017, the Senate passed the measure 
with an amendment by Unanimous Consent. It was subsequently 
referred to the Subcommittee on Health, of the Committee on 
Energy and Commerce.

                          BENEFIT Act of 2017

    The BENEFIT Act of 2017 (Better Empowerment Now to Enhance 
Framework and Improve Treatments Act of 2017) (S. 1052) 
strengthens the use of patient-experience data within the 
benefit-risk framework for approval of new drugs.
    This bill amends the Federal Food, Drug, and Cosmetic Act 
to require the Food and Drug Administration (FDA) to consider 
patient-focused drug development data, such as patient 
preferences, patient-reported outcomes, and patient 
experiences, as part of the risk-benefit assessment of new 
drugs. Following approval of a drug, the FDA must include a 
description of how this information was considered in its 
statement of patient experience. On Aug. 3, 2017, the Senate 
passed the measure without amendment by Unanimous Consent. It 
was subsequently referred to the Subcommittee on Health, of the 
Committee on Energy and Commerce.

                                CURD Act

    The CURD Act (Codifying Useful Regulatory Definitions Act)
(S. 2322) was introduced to amend the Federal Food, Drug, and 
Cosmetic Act to define the term natural cheese. Congress found 
that there is a need to define the term ``natural cheese'' in 
order to maintain transparency and consistency for consumers so 
that they may differentiate ``natural cheese'' from ``process 
cheese''. On Dec. 13, 2018 the Senate passed/agreed with an 
amendment by Voice Vote. It subsequently failed passage in the 
House on Dec. 20, 2018.

                              B. Education

               Children of Fallen Heroes Scholarship Act

    The Children of Fallen Heroes Scholarship Act, S. 597, 
increasing Federal Pell Grants for the children of fallen 
public safety officers, and for other purposes.
    This bill amends title IV (Student Assistance) of the 
Higher Education Act of 1965 to eliminate the expected family 
contribution (EFC) used to determine financial need in the case 
of a Pell Grant-eligible student whose parent or guardian died 
in the line of duty as a police officer, firefighter, or other 
public safety officer. Such student is eligible to receive an 
automatic zero EFC and qualify for the maximum Pell Grant award 
if the student was less than 24 years old or enrolled at an 
institution of higher education at the time of the parent or 
guardian's death.
    On Sept. 7, 2017, the Senate passed the measure without 
amendment by Voice Vote. It was subsequently referred to the 
Committee on Education and the Workforce, and in addition to 
the Committees on the Judiciary, the Budget, and Subcommittee 
on Crime, Terrorism, Homeland Security, and Investigations.

V. LIST OF PUBLIC LAWS OF THE 115TH CONGRESS FROM THE COMMITTEE 
ON HEALTH, EDUCATION, LABOR, AND PENSIONS

    1. P.L. 115-31 [enacted May. 5, 2017], making appropriations for 
the fiscal year ending September 30, 2017, and for other purposes. 
(H.R. 244)
    2. P.L. 115-71 [enacted Oct. 18, 2017], to amend the Public Health 
Service Act to reauthorize a program for early detection, diagnosis, 
and treatment regarding deaf and hard-of-hearing newborns, infants, and 
young children. (S. 652)
    3. P.L. 115-80 [enacted Nov. 2, 2017], to establish a National 
Clinical Care Commission. (S. 920)
    4. P.L. 115-83 [enacted Nov. 17, 2017], to amend the Controlled 
Substances Act with regard to the provision of emergency medical 
services. (H.R. 304)
    5. P.L. 115-119 [enacted Jan. 22, 2017], to provide for the 
establishment and maintenance of a Family Caregiving Strategy, and for 
other purposes. (H.R. 3759)
    6. P.L. 115-176 [enacted May 30, 2018], to authorize the use of 
unapproved medical products by patients diagnosed with a terminal 
illness in accordance with State law, and for other purposes. (S. 204)
    7. P.L. 115-180 [enacted June 5, 2018], to maximize discovery, and 
accelerate development and availability, of promising childhood cancer 
treatments, and for other purposes. (S. 292)
    8. P.L. 115-194 [enacted July 7, 2018], to require the Secretary of 
Health and Human Services to develop a voluntary registry to collect 
data on cancer incidence among firefighters. (H.R. 931)
    9. P.L. 115-196 [enacted July 7, 2018], to establish a Federal 
Advisory Council to Support Grandparents Raising Grandchildren. (S. 
1091)
    10. P.L. 115-224 [enacted July 31, 2018], to reauthorize the Carl 
D. Perkins Career and Technical Education Act of 2006. (H.R. 2353)
    11. P.L. 115-254 [enacted Oct. 5, 2018], to provide protections for 
certain sports medicine professionals, to reauthorize Federal aviation 
programs, to improve aircraft safety certification processes, and for 
other purposes. (H.R. 302)
    12. P.L. 115-263 [enacted Oct. 10, 2018], to ensure that health 
insurance issuers and group health plans do not prohibit pharmacy 
providers from providing certain information to enrollees. (S. 2554)
    13. P.L. 115-302 [enacted Dec. 11, 2018], to amend the Public 
Health Service Act to improve essential oral health care for low-income 
and other underserved individuals by breaking down barriers to care, 
and for other purposes. (H.R. 2422)
    14. P.L. 115-320 [enacted Dec. 17, 2018], to amend the Public 
Health Service Act to distribute maternity care health professionals to 
health professional shortage areas identified as in need of maternity 
care health services. (H.R. 315)
    15. P.L. 115-327 [enacted Dec. 18, 2018], to amend the Public 
Health Service Act to reauthorize a sickle cell disease prevention and 
treatment demonstration program and to provide for sickle cell disease 
research, surveillance, prevention, and treatment. (S. 2465)
    16. P.L. 115-328 [enacted Dec. 18, 2018], to revise and extend the 
Prematurity Research Expansion and Education for Mothers who deliver 
Infants Early Act (PREEMIE Act). (S. 3029)
    17. P.L. 115-342 [enacted Dec. 21, 2018], to amend the Public 
Health Service Act to coordinate Federal congenital heart disease 
research efforts and to improve public education and awareness of 
congenital heart disease, and for other purposes. (H.R. 1222)
    18. P.L. 115-398 [enacted Dec. 31, 2018], to establish the Stop, 
Observe, Ask, and Respond to Health and Wellness Training pilot program 
to address human trafficking in the health care system. (H.R. 767)
    19. P.L. 115-406 [enacted Dec. 31, 2018], to amend the Public 
Health Service Act to authorize the expansion of activities related to 
Alzheimer's disease, cognitive decline, and brain health under the 
Alzheimer's Disease and Healthy Aging Program, and for other purposes. 
(S. 2076)
    20. P.L. 115-408 [enacted Dec. 31, 2018], to amend the Public 
Health Service Act to amend the Public Health Service Act to provide 
grants to improve health care in rural areas. (S. 2278)
    21. P.L. 115-410 [enacted Dec. 31, 2018], to reauthorize the Museum 
and Library Services Act. (S. 3530)
    VI. LIST OF FULL COMMITTEE AND SUBCOMMITTEE HEARINGS OF THE 
COMMITTEE ON HEALTH, EDUCATION, LABOR, AND PENSIONS

    1. Nomination of Betsy DeVos to Serve As Secretary of Education. 
(January 21, 2017)

    2. Nomination of Tom Price to Serve As Secretary of Health and 
Human Services. (January 18, 2017)

    3. Obamacare Emergency: Stabilizing the Individual Health Insurance 
Market. (February 1, 2017)

    4. FDA User Fee Agreements: Improving Medical Product Regulation 
and Innovation for Patients, Part I. (March 21, 2017)

    5. Nomination of Alex Acosta to Serve As Secretary of Labor. (March 
22, 2017)

    6. FDA User Fee Agreements: Improving Medical Product Regulation 
and Innovation for Patients, Part II. (April 4, 2017)

    7. Nomination of Scott Gottlieb, M.D., to Serve As Commissioner of 
Food and Drugs. (April 5, 2017)

    8. The Cost of Prescription Drugs: How the Drug Delivery System 
Affects What Patients Pay. (June 13, 2017)

    9. Nomination Hearing for Deputy Secretary of Labor and Members of 
the National Labor Relations Board. (Patrick Pizella, Marvin Kaplan, 
William Emmanuel) (July 13, 2017)

    10. Nomination Hearing. (Lance Robertson, Brett Giroir, Robert 
Kadlec, Elinore McCance-Katz, and Jerome Adams) (August 1, 2017)

    11. Stabilizing Premiums and Helping Individuals in the Individual 
Insurance Market for 2018: State Insurance Commissioners. (Sept. 6, 
2017)

    12. Stabilizing Premiums and Helping Individuals in the Individual 
Insurance Market for 2018: Governors. (Sept. 7, 2017)

    13. Stabilizing Premiums and Helping Individuals in the Individual 
Insurance Market for 2018: State Flexibility. (Sept. 12, 2017)

    14. Stabilizing Premiums and Helping Individuals in the Individual 
Insurance Market for 2018: Health Care Stakeholders. (Sept. 14, 2017)

    15. Nominations. (Janet Dhillon and Daniel H. Gade, Equal 
Employment Opportunity Commission; and Carlos G. Muniz, General 
Counsel, Department of Education) (Sept. 19, 2017)

    16. The Every Student Succeeds Act: Unleashing State Innovation. 
(Oct. 3, 2017)

    17. Department of Labor and National Labor Relations Board 
Nominations. (Oct. 4, 2017)

    18. The Federal Response to the Opioid Crisis. (Oct. 5, 2017)

    19. The Cost of Prescription Drugs: How the Drug Delivery System 
Affects What Patients Pay, Part II. (Oct. 17, 2017)

    20. Examining How Healthy Choices Can Improve Health Outcomes and 
Reduce Costs. (Oct. 19, 2017)

    21. Exploring Free Speech on College Campuses (Oct. 26, 2017)

    22. Implementation of the 21st Century Cures Act: Achieving the 
Promise of Health Information Technology. (Oct. 31, 2017)

    23. Gene Editing Technology: Innovation and Impact. (Nov. 14, 2017)

    24. Encouraging Healthy Communities: Perspective From the Surgeon 
General. (Nov. 15, 2017)

    25. Nominations. (Brigadier General Mitchell Zais, USA (Ret.), 
James Blew, Timothy Kelly, Kate O'Scannlain) (Nov. 15, 2017)

    26. Reauthorizing the Higher Education Act: Examining Proposals to 
Simplify the Free Application for Federal Student Aid (FAFSA). (Nov. 
28, 2017)

    27. Nomination of Alex Azar to Serve As Secretary of Health and 
Human Services. (Nov. 29, 2017)

    28. The Front Lines of the Opioid Crisis: Perspectives From States, 
Communities, and Providers. (Nov. 30, 2017)

    29. Department of Education and Department of Labor Nominations. 
(Dec. 5, 2017)

    30. Implementation of the 21st Century Cures Act: Progress and the 
Path Forward for Medical Innovation. (Dec. 7, 2017)

    31. The Cost of Prescription Drugs: An Examination of the National 
Academies of Sciences, Engineering, and Medicine Report ``Making 
Medicines Affordable: A National Imperative. (Dec. 12, 2017)

    32. Implementation of the 21st Century Cures Act: Responding to 
Mental Health. (Dec. 13, 2017)

    33. The Opioid Crisis: An Examination of How We Got Here and How We 
Move Forward. (Jan. 9, 2018)

    34. Facing 21st Century Public Health Threats: Our Nation's 
Preparedness and Response Capabilities, Part I. (Jan. 17, 2018)

    35. Reauthorizing the Higher Education Act: Financial Aid 
Simplification and Transparency. (Jan. 18, 2018)

    36. Facing 21st Century Public Health Threats: Our Nation's 
Preparedness and Response Capabilities, Part II. (Jan. 23, 2018)

    37. Nomination of Frank T. Brogan to be Assistant Secretary for 
Elementary and Secondary Education. (Jan. 25, 2018)

    38. Reauthorizing the Higher Education Act: Access and Innovation. 
(Jan. 25, 2018)

    39. Reauthorizing the Higher Education Act: Accountability and Risk 
for Taxpayers. (Jan. 30, 2018)

    40. Roundtable On Small Business Health Plans. (Jan. 30, 2018)

    41. Reauthorizing the Higher Education Act: Improving College 
Affordability. (Feb. 6, 2018)

    42. Exploring the ``GIG Economy'' and the Future of Retirement 
Savings. (Feb. 6, 2018)

    43. The Opioid Crisis: Impact on Children and Families. (Feb. 8, 
2018)

    44. Improving Animal Health: Reauthorization of FDA Animal Drug 
User Fees. (Feb. 13, 2018)

    45. The Opioid Crisis: The Role of Technology and Data in 
Preventing and Treating Addiction. (Feb. 27, 2018)

    46. Nomination of John F. Ring to be a Member of the National Labor 
Relations Board. (March 1, 2018)

    47. The Opioid Crisis: Leadership and Innovation in the States. 
(March 8, 2018)

    48. Perspectives on the 340B Drug Pricing Program. (March 15, 2018)

    49. Nomination of Sharon Gustafson to be General Counsel of the 
Equal Employment Opportunity Commission. (April 10, 2018)

    50. The Opioid Crisis Response Act of 2018. (April 11, 2018)

    51. Examining Oversight Reports on the 340B Drug Pricing Program. 
(May 15, 2018)

    52. The Healthcare Workforce: Addressing Shortages and Improving 
Care. (May 22, 2018)

    53. The Cost of Prescription Drugs: Examining the President's 
Blueprint ``American Patients First'' to Lower Drug Prices. (June 12, 
2018)

    54. Effective Administration of the 340B Drug Pricing Program. 
(June 19, 2018)

    55. How to Reduce Health Care Costs: Understanding the Cost of 
Health Care in America. (June 27, 2018)

    56. Reducing Health Care Costs: Eliminating Excess Health Care 
Spending and Improving Quality and Value for Patients. (July 17, 2018)

    57. Modernizing Apprenticeships to Expand Opportunities. (July 26, 
2018)

    58. Reducing Health Care Costs: Decreasing Administrative Spending. 
(July 31, 2018)

    59. Financial Literacy: The Starting Point for a Secure Retirement 
Security. (Aug. 21, 2018)

    60. Prioritizing Cures: Science and Stewardship at the National 
Institutes of Health. (Aug. 23, 2018)

    61. The Impact of Zero Tariffs on U.S. Autoworkers. (Sept. 5, 2018)

    62. Reducing Health Care Costs: Examining How Transparency Can 
Lower Spending and Empower Patients. (Sept. 18, 2018)
    63. The Every Student Succeeds Act: States Leading the Way. (Sept. 
25, 2018)

    64. Health Care in Rural America: Examining Experiences and Costs. 
(Sept. 25, 2018)

    65. Rare Diseases: Expediting Treatments for Patients. (Oct. 3, 
2018)

    66. Reducing Health Care Costs: Improving Affordability Through 
Innovation. (Nov. 28, 2018)

VII. ANTICIPATED ACTIVITIES FOR 116TH CONGRESS

                             A. Health Care

    Reauthorization of the Older Americans Act, Community 
Health Centers, and numerous public health bills. In addition, 
we will work on an extensive project to examine ways to lower 
health care costs in the United States.

                              B. Education

    Reauthorization of the Higher Education Act that expired in 
2015.

                                C. Labor

    Conduct oversight of labor laws and prepare to reauthorize 
workforce programs as the Workforce Innovation Opportunity Act 
nears expiration.

                              D. Pensions

    Work to address the growing crisis among multi-employer 
pension plans.

                                APPENDIX

 I. REPORTS OF THE COMMITTEE ON HEALTH, EDUCATION, LABOR, AND PENSIONS


115-434

S. 3217

Strengthening Career and Technical Education for the 21st Century Act

Reported: Dec. 19, 2018.
Related reports:
Remarks: Pubic Law 115-434.

           II. PUBLIC LAWS ENACTED DURING THE 115TH CONGRESS

H.R. 244

S. 652

Early Hearing Detection and Intervention Act of 2017 .

Oct. 18, 2017. PUBLIC LAW 115-71.

S. 920

National Clinical Care Commission Act.

Nov. 2, 2017. PUBLIC LAW 115-80.

H.R. 304

Protecting Patient Access to Emergency Medications Act of 2017.

Nov. 17, 2017. PUBLIC LAW 115-83.

H.R. 3759

RAISE Family Caregivers Act.

Jan. 22, 2018. PUBLIC LAW 115-119.

S. 204

Trickett Wendler, Frank Mongiello, Jordan Mclinn, and Matthew Bellina 
Right To Try Act of 2017.

May 30, 2018. PUBLIC LAW 115-176.

S. 292

Childhood Cancer Survivorship, Treatment, Access, and Research Act of 
2018.

June 5, 2018. PUBLIC LAW 115-180.

H.R. 931

Firefighter Cancer Registry Act of 2018.

July 7, 2018. PUBLIC LAW 115-194.

S. 1091

Supporting Grandparents Raising Grandchildren Act.

July 7, 2018. PUBLIC LAW 115-196.

S. 2353

Strengthening Career and Technical Education for the 21st Century Act.

July 31, 2018. PUBLIC LAW 115-224.

H.R. 302

FAA Reauthorization Act of 2018.

Oct. 5, 2018. PUBLIC LAW 115-254.

S. 2554

Patient Right to Know Drug Prices Act.

Oct. 10, 2018. PUBLIC LAW 115-263.

H.R. 2422

Action For Dental Health Act of 2018.

Dec. 11, 2018. PUBLIC LAW 115-302.

H.R. 315

Improving Access to Maternity Care Act.

Dec. 17, 2018. PUBLIC LAW 115-320.

S. 2465

Sickle Cell Disease and Other Heritable Blood Disorders Research, 
Surveillance, Prevention, and Treatment Act of 2018.

Dec. 31, 2018. PUBLIC LAW 115-327.

S. 3029

Patient Right to Know Drug Prices Act.

Dec. 18, 2018. PUBLIC LAW 115-328.

S. 1222

Congenital Heart Futures Reauthorization Act of 2017 .

Dec. 18, 2018. PUBLIC LAW 115-342.

H.R. 767

SOAR to Health and Wellness Act of 2018.

Dec. 31, 2018. PUBLIC LAW 115-398.

S. 2076

Bold Infrastructure For Alzheimer's Act.

Dec. 31, 2018. PUBLIC LAW 115-406.

S. 2278

State Offices of Rural Health Reauthorization Act of 2018.

Dec. 31, 2018. PUBLIC LAW 115-408.

S. 3530

Museum and Library Services Act of 2018

Dec. 31, 2018. PUBLIC LAW 115-410.

           III. HEARINGS BY FULL COMMITTEE AND SUBCOMMITTEES

                     HEARINGS BY THE FULL COMMITTEE

OBAMACARE EMERGENCY: STABILIZING THE INDIVIDUAL HEALTH INSURANCE MARKET

Examining the Affordable Care Act, focusing on stabilizing the 
    individual health insurance market.

Date: Feb. 1, 2017.

Number of volumes: One (S. Hrg. 115-238).
  

   FDA USER FEE AGREEMENTS: IMPROVING MEDICAL PRODUCT REGULATION AND 
                    INNOVATION FOR PATIENTS, PART I

Examining Food and Drug Administration user fee agreements, focusing on 
    improving medical product innovation for patients.

Date: Mar. 21, 2017.

Number of volumes: One (S. Hrg. 115-255).
  

   FDA USER FEE AGREEMENTS: IMPROVING MEDICAL PRODUCT REGULATION AND 
                    INNOVATION FOR PATIENTS, PART II

Examining FDA user fee agreements, focusing on improving medical 
    product regulations and innovation for patients.

Date: Apr. 4, 2017.

Number of volumes: One (S. Hrg. 115-333).
  

 THE COST OF PRESCRIPTION DRUGS: HOW THE DRUG DELIVERY SYSTEM AFFECTS 
                           WHAT PATIENTS PAY

Examining the cost of prescription drugs, focusing on how the drug 
    delivery system affects what patients pay.

Date: June 13, 2017.

Number of volumes: One (S. Hrg. 115-355).
  

    STABILIZING PREMIUMS AND HELPING INDIVIDUALS IN THE INDIVIDUAL 
        INSURANCE MARKET FOR 2018: STATE INSURANCE COMMISSIONERS

Examining stabilizing premiums and helping individuals in the 
    individual insurance market for 2018.

Date: Sept. 6, 2017.

Number of volumes: One (S. Hrg. 115-).
  

    STABILIZING PREMIUMS AND HELPING INDIVIDUALS IN THE INDIVIDUAL 
                  INSURANCE MARKET FOR 2018: GOVERNORS

Examining stabilizing premiums and helping individuals in the 
    individual insurance market for 2018, focusing ongovernors.

Date: Sept. 7, 2017.

Number of volumes: One (S. Hrg. 115-).
  

    STABILIZING PREMIUMS AND HELPING INDIVIDUALS IN THE INDIVIDUAL 
              INSURANCE MARKET FOR 2018: STATE FLEXIBILITY

Examining stabilizing premiums and helping individuals in the 
    individual insurance market for 2018, focusing onstate flexibility.

Date: Sept. 12, 2017.

Number of volumes: One (S. Hrg. 115-).
  

    STABILIZING PREMIUMS AND HELPING INDIVIDUALS IN THE INDIVIDUAL 
          INSURANCE MARKET FOR 2018: HEALTH CARE STAKEHOLDERS

Examining stabilizing premiums and helping individuals in the 
    individual insurance market for 2018, focusing onhealth care 
    stakeholders.

Date: Sept. 14, 2017.

Number of volumes: One (S. Hrg. 115-).
  

      THE EVERY STUDENT SUCCEEDS ACT: UNLEASHING STATE INNOVATION

Examining the Every Student Succeeds Act, focusing on unleashing State 
    innovation.

Date: Oct. 3, 2017.

Number of volumes: One (S. Hrg. 115-).
  

               THE FEDERAL RESPONSE TO THE OPIOID CRISIS

Examining the Federal response to the opioid crisis.

Date: Oct. 5, 2017.

Number of volumes: One (S. Hrg. 115-).
  

 THE COST OF PRESCRIPTION DRUGS: HOW THE DRUG DELIVERY SYSTEM AFFECTS 
                       WHAT PATIENTS PAY, PART II

Examining the cost of prescription drugs, focusing on how the drug 
    delivery system affects what patients pay.

Date: Oct. 17, 2017.

Number of volumes: One (S. Hrg. 115-).
  

 EXAMINING HOW HEALTHY CHOICES CAN IMPROVE HEALTH OUTCOMES AND REDUCE 
                                 COSTS

Examining how healthy choices can improve health outcomes and reduce 
    costs.

Date: Oct. 19, 2017.

Number of volumes: One (S. Hrg. 115-).
  

               EXPLORING FREE SPEECH ON COLLEGE CAMPUSES

Examining free speech on college campuses.

Date: Oct. 26, 2017.

Number of volumes: One (S. Hrg. 115-).
  

IMPLEMENTATION OF THE 21ST CENTURY CURES ACT: ACHIEVING THE PROMISE OF 
                     HEALTH INFORMATION TECHNOLOGY


Examining implementation of the 21st Century Cures Act, focusing on 
            achieving the promise of health information technology.

Date: Oct. 31, 2017.

Number of volumes: One (S. Hrg. 115-).
  

             GENE EDITING TECHNOLOGY: INNOVATION AND IMPACT

Examining gene editing technology, focusing on innovation and impact.

Date: Nov. 14, 2017.

Number of volumes: One (S. Hrg. 115-).
  

 ENCOURAGING HEALTHY COMMUNITIES: PERSPECTIVE FROM THE SURGEON GENERAL

Examining encouraging healthy communities, focusing on perspective from 
    the Surgeon General.

Date: Nov. 15, 2017.

Number of volumes: One (S. Hrg. 115-).
  

REAUTHORIZING THE HIGHER EDUCATION ACT: EXAMINING PROPOSALS TO SIMPLIFY 
              THE FREE APPLICATION FOR FEDERAL STUDENT AID

Examining reauthorizing the Higher Education Act, focusing on examining 
    proposals to simplify the Free Application for Federal Student Aid 
    (FAFSA).

Date: Nov. 28, 2017.

Number of volumes: One (S. Hrg. 115-).
  

    THE FRONT LINES OF THE OPIOID CRISIS: PERSPECTIVES FROM STATES, 
                       COMMUNITIES, AND PROVIDERS

Examining the front lines of the opioid crisis, focusing on 
    perspectives from states, communities, and providers.

Date: Nov. 30, 2017.

Number of volumes: One (S. Hrg. 115-).
  

  IMPLEMENTATION OF THE 21ST CENTURY CURES ACT: PROGRESS AND THE PATH 
                     FORWARD FOR MEDICAL INNOVATION

Examining implementation of the 21st Century Cures Act, focusing on 
    progress and the path forward for medical innovation.

Date: Dec. 7, 2017.

Number of volumes: One (S. Hrg. 115-).
  

    THE COST OF PRESCRIPTION DRUGS: AN EXAMINATION OF THE NATIONAL 
   ACADEMIES OF SCIENCES, ENGINEERING, AND MEDICINE REPORT ``MAKING 
             MEDICINES AFFORDABLE: A NATIONAL IMPERATIVE''

Examining the cost of prescription drugs, focusing on an examination of 
    the National Academies of Sciences, Engineering and Medicine report 
    ``Making Medicines Affordable: A National Imperative''.

Date: Dec. 12, 2017.

Number of volumes: One (S. Hrg. 115-).
  

  IMPLEMENTATION OF THE 21ST CENTURY CURES ACT: RESPONDING TO MENTAL 
                                 HEALTH

Examining implementation of the 21st Century Cures Act, focusing on 
    responding to mental health needs.

Date: Dec. 13, 2017.

Number of volumes: One (S. Hrg. 115-).
  

 THE OPIOID CRISIS: AN EXAMINATION OF HOW WE GOT HERE AND HOW WE MOVE 
                                FORWARD

Examining the opioid crisis, focusing on how to move forward.

Date: Jan. 9, 2018.

Number of volumes: One (S. Hrg. 115-).
  

 FACING 21ST CENTURY PUBLIC HEALTH THREATS: OUR NATION'S PREPAREDNESS 
                   AND RESPONSE CAPABILITIES, PART I

Examining facing 21st century public health threats, focusing on our 
    nation's preparedness and response capabilities.

Date: Jan. 17, 2018.

Number of volumes: One (S. Hrg. 115-).
  

 REAUTHORIZING THE HIGHER EDUCATION ACT: FINANCIAL AID SIMPLIFICATION 
                            AND TRANSPARENCY

Examining reauthorizing the Higher Education Act, focusing on financial 
    aid simplification and transparency.

Date: Jan. 18, 2018.

Number of volumes: One (S. Hrg. 115-).
  

 FACING 21ST CENTURY PUBLIC HEALTH THREATS: OUR NATION'S PREPAREDNESS 
                   AND RESPONSE CAPABILITIES, PART II

Examining facing 21st century public health threats, focusing on our 
    Nation's preparedness and response capabilities.

Date: Jan. 23, 2018.

Number of volumes: One (S. Hrg. 115-).
  

     REAUTHORIZING THE HIGHER EDUCATION ACT: ACCESS AND INNOVATION

Examining reauthorizing the Higher Education Act, focusing on access 
    and innovation.

Date: Jan. 25, 2018.

Number of volumes: One (S. Hrg. 115-).
  

  REAUTHORIZING THE HIGHER EDUCATION ACT: ACCOUNTABILITY AND RISK FOR 
                               TAXPAYERS

Examining reauthorizing the Higher Education Act, focusing on 
    accountability and risk to taxpayers.

Date: Jan. 30, 2018.

Number of volumes: One (S. Hrg. 115-).
  

REAUTHORIZING THE HIGHER EDUCATION ACT: IMPROVING COLLEGE AFFORDABILITY

Examining reauthorizing the Higher Education Act, focusing on improving 
    college affordability.

Date: Feb. 6, 2018.

Number of volumes: One (S. Hrg. 115-).
  

           THE OPIOID CRISIS: IMPACT ON CHILDREN AND FAMILIES

Examining the opioid crisis, focusing on the impact on children and 
    families.

Date: Feb. 8, 2018.

Number of volumes: One (S. Hrg. 115-).
  

 IMPROVING ANIMAL HEALTH: REAUTHORIZATION OF FDA ANIMAL DRUG USER FEES

Examining improving animal health, focusing on reauthorization of Food 
    and Drug Administration Animal Drug User Fees.

Date: Feb. 13, 2018.

Number of volumes: One (S. Hrg. 115-).
  

 THE OPIOID CRISIS: THE ROLE OF TECHNOLOGY AND DATA IN PREVENTING AND 
                           TREATING ADDICTION

Examining the opioid crisis, focusing on the role of technology and 
    data in preventing and treating addiction.

Date: Feb. 27, 2017.

Number of volumes: One (S. Hrg. 115-).
  

       THE OPIOID CRISIS: LEADERSHIP AND INNOVATION IN THE STATES

Examining the opioid crisis, focusing on leadership and innovation in 
    the states.

Date: Mar. 8, 2018.

Number of volumes: One (S. Hrg. 115-).
  

             PERSPECTIVES ON THE 340B DRUG PRICING PROGRAM

Examining perspectives on the 340B Drug Discount Program.

Date: Mar. 15, 2018.

Number of volumes: One (S. Hrg. 115-).
  

                 THE OPIOID CRISIS RESPONSE ACT OF 2018

Examining an original bill entitled, ``The Opioid Crisis Response Act 
    of 2018''.

Date: Apr. 11, 2018.

Number of volumes: One (S. Hrg. 115-).
  

      EXAMINING OVERSIGHT REPORTS ON THE 340B DRUG PRICING PROGRAM

Examining oversight reports on the 340B Drug Pricing Program.

Date: May 15, 2018.

Number of volumes: One (S. Hrg. 115-).
  

   THE HEALTHCARE WORKFORCE: ADDRESSING SHORTAGES AND IMPROVING CARE

Examining the healthcare workforce, focusing on addressing shortages 
    and improving care.

Date: May 22, 2018.

Number of volumes: One (S. Hrg. 115-).
  

  THE COST OF PRESCRIPTION DRUGS: EXAMINING THE PRESIDENT'S BLUEPRINT 
            ``AMERICAN PATIENTS FIRST'' TO LOWER DRUG PRICES

Examining the cost of prescription drugs, focusing on examining the 
    President's blueprint `American Patients First' to lower drug 
    prices.

Date: June 12, 2018.

Number of volumes: One (S. Hrg. 115-).
  

       EFFECTIVE ADMINISTRATION OF THE 340B DRUG PRICING PROGRAM

Examining effective administration of the 340B Drug Pricing Program.

Date: June 19, 2018.

Number of volumes: One (S. Hrg. 115-).
  

HOW TO REDUCE HEALTH CARE COSTS: UNDERSTANDING THE COST OF HEALTH CARE 
                               IN AMERICA

Examining how to reduce health care costs, focusing on understanding 
    the cost of health care in America.

Date: June 27, 2018.

Number of volumes: One (S. Hrg. 115-).
  

REDUCING HEALTH CARE COSTS: ELIMINATING EXCESS HEALTH CARE SPENDING AND 
                IMPROVING QUALITY AND VALUE FOR PATIENTS

Examining reducing health care costs, focusing on eliminating excess 
    health care spending and improving quality and value for patients.

Date: July 17, 2018.

Number of volumes: One (S. Hrg. 115-).
  

          MODERNIZING APPRENTICESHIPS TO EXPAND OPPORTUNITIES

Examining modernizing apprenticeships to expand opportunities.

Date: July 26, 2018.

Number of volumes: One (S. Hrg. 115-).
  

     REDUCING HEALTH CARE COSTS: DECREASING ADMINISTRATIVE SPENDING

Examine reducing health care costs, focusing on decreasing 
    administrative spending.

Date: July 31, 2018.

Number of volumes: One (S. Hrg. 115-).
  

PRIORITIZING CURES: SCIENCE AND STEWARDSHIP AT THE NATIONAL INSTITUTES 
                               OF HEALTH

Examining prioritizing cures, focusing on science and stewardship at 
    the National Institutes of Health.

Date: Aug. 23, 2018.

Number of volumes: One (S. Hrg. 115-).
  

             THE IMPACT OF ZERO TARIFFS ON U.S. AUTOWORKERS

Examining the impact of zero tariffs on United States autoworkers.

Date: Sept. 5, 2018.

Number of volumes: One (S. Hrg. 115-).
  

   REDUCING HEALTH CARE COSTS: EXAMINING HOW TRANSPARENCY CAN LOWER 
                     SPENDING AND EMPOWER PATIENTS

Examining reducing health care costs, focusing on how transparency can 
    lower spending and empower patients.

Date: Sept. 18, 2018.

Number of volumes: One (S. Hrg. 115-).
  

         THE EVERY STUDENT SUCCEEDS ACT: STATES LEADING THE WAY

Examining the Every Student Succeeds Act, focusingon states leading the 
    way.

Date: Sept. 25, 2018.

Number of volumes: One (S. Hrg. 115-).
  

 REDUCING HEALTH CARE COSTS: IMPROVING AFFORDABILITY THROUGH INNOVATION

Examining reducing health care costs, focusing on improving 
    affordability through innovation.

Date: Nov. 28, 2018.

Number of volumes: One (S. Hrg. 115-).
  

                        HEARINGS ON NOMINATIONS

                        DEPARTMENT OF EDUCATION

Elisabeth Prince DeVos, of Michigan, to be Secretary, Department of 
        Education.

Date: Jan. 17, 2017.

Number of volumes: One (S. Hrg. 115-206).

  
Carlos G. Muniz, of Florida, to be General Counsel, Department of 
        Education.

Date: Sept. 19, 2017.

Number of volumes: One (S. Hrg. 115-).

  
James Blew, of California, to be Assistant Secretary for Planning, 
        Evaluation, and Policy Development, Department of Education.

Date: Nov. 15, 2017.

Number of volumes: One (S. Hrg. 115-).

  
Mitchell Zais, of South Carolina, to be Deputy Secretary of Education.

Date: Nov. 15, 2017.

Number of volumes: One (S. Hrg. 115-).

  
Kenneth L. Marcus, of Virginia, to be Assistant Secretary for Civil 
        Rights, Department of Education.

Date: Dec. 5, 2017.

Number of volumes: One (S. Hrg. 115-).

  
Johnny Collett, of Kentucky, to be Assistant Secretary for Special 
        Education and Rehabilitative Services, Department of Education.

Date: Dec. 5, 2017.

Number of volumes: One (S. Hrg. 115-).

  
Frank T. Brogan, of Pennsylvania, to be Assistant Secretary for 
        Elementary and Secondary Education, Department of Education.

Date: Jan. 25, 2018.

Number of volumes: One (S. Hrg. 115-).

  

                DEPARTMENT OF HEALTH AND HUMAN SERVICES

Thomas Price, of Michigan, to be Secretary, Department of Health and 
        Human Services.

Date: Jan. 18, 2017.

Number of volumes: One (S. Hrg. 115-228).

  

Scott Gottlieb, M.D., of Connecticut, to be Commissioner of Food and 
        Drugs, Department of Health and Human Services.

Date: Apr. 5, 2017.

Number of volumes: One (S. Hrg. 115-341).
  

Elinore F. McCance-Katz, of Rhode Island, to be Assistant Secretary for 
        Mental Health and Substance Use, Department of Health and Human 
        Services.

Date: Aug. 1, 2017.

Number of volumes: One (S. Hrg. 115-390).

  

Lance Allen Robertson, of Oklahoma, to be Assistant Secretary for 
        Aging, Department of Health and Human Services.

Date: Aug. 1, 2017.

Number of volumes: One (S. Hrg. 115-390).

  

Robert P. Kadlec, of New York, to be Medical Director in the Regular 
        Corps of the Public Health Service.

Date: Aug. 1, 2017.

Number of volumes: One (S. Hrg. 115-390).

  

Alex Azar, Indianapolis, IN, to serve as Secretary of Health and Human 
        Services.

Date: Nov. 29, 2017.

Number of volumes: One (S. Hrg. 115-).

  
                         PUBLIC HEALTH SERVICE
Brett Giroir, of Texas, to be Medical Director in the Regular Corps of 
        the Public Health Service, to be an Assistant Secretary of 
        Health and Human Services.

Date: Aug. 1, 2017.

Number of volumes: One (S. Hrg. 115-390).

  
Jerome M. Adams, of Indiana, to be Medical Director in the Regular 
        Corps of the Public Health Service, to be Surgeon General of 
        the Public Health Service.

Date: Aug. 1, 2017.

Number of volumes: One (S. Hrg. 115-390).

  

                          DEPARTMENT OF LABOR

R. Alexander Acosta, of Florida, to be Secretary of Labor.

Date: Mar. 22, 2017.

Number of volumes: One (S. Hrg. 115-268).

  

Patrick Pizzella, of Alexandria, VA, to be Deputy Secretary of Labor.

Date: July 13, 2017.

Number of volumes: One (S. Hrg. 115-374).

  

Cheryl Marie Stanton, of South Carolina, to be Administrator of the 
        Wage and Hour Division, Department of Labor.

Date: Oct. 4, 2017.

Number of volumes: One (S. Hrg. 115-).

  

David G. Zatezalo, of West Virginia, to be Assistant Secretary of Labor 
        for Mine Safety and Health.

Date: Oct. 4, 2017.

Number of volumes: One (S. Hrg. 115-).

  

Kate S. O'Scannlain, of Maryland, to be Solicitor for the Department of 
Labor.

Date: Nov. 15, 2017.

Number of volumes: One (S. Hrg. 115-).

  

Preston Rutledge, of the District of Columbia, to be an Assistant 
Secretary of Labor.

        Date: Nov. 15, 2017.

Number of volumes: One (S. Hrg. 115-).

  

William Beach, of Kansas, to be Commissioner of Labor Statistics, 
Department of Labor.

Date: Dec. 5, 2017.

Number of volumes: One (S. Hrg. 115-).

  

Scott A. Mugno, of Pennsylvania, to be an Assistant Secretary of Labor.

Date: Dec. 5, 2017.

Number of volumes: One (S. Hrg. 115-).

  

                EQUAL EMPLOYMENT OPPORTUNITY COMMISSION

Janet Dhillon, of Pennsylvania, to be a Member of the Equal Employment 
Opportunity Commission.

Date: Sept. 19, 2017.

Number of volumes: One (S. Hrg. 115-).

  

Daniel M. Gade, of North Dakota, to be a Member of the Equal Employment 
Opportunity Commission.

Date: Sept. 19, 2017.

Number of volumes: One (S. Hrg. 115-).

  

Sharon Fast Gustafson, of Virginia, to be General Counsel of the Equal 
Employment Opportunity Commission.

Date: Apr. 10, 2018.

Number of volumes: One (S. Hrg. 115-).

  

                     NATIONAL LABOR RELATIONS BOARD

Marvin Kaplan, of Kansas, to be a member of the National Labor 
Relations Board.

Date: July 13, 2017.

Number of volumes: One (S. Hrg. 115-374).

  

William J. Emanuel, of California, to be a member of the National Labor 
Relations Board.

Date: July 13, 2017.

Number of volumes: One (S. Hrg. 115-374).

  

Peter B. Robb, of Vermont, to be General Counsel of the National Labor 
Relations Board.

Date: Oct. 4, 2017.

Number of volumes: One (S. Hrg. 115-).

  

John F. Ring, of the District of Columbia, to be a Member of the 
National Labor Relations Board.

Date: Mar. 1, 2018.

Number of volumes: One (S. Hrg. 115-).

  

          HEARING BY THE SUBCOMMITTEE ON CHILDREN AND FAMILIES

           RARE DISEASES: EXPEDITING TREATMENTS FOR PATIENTS

Examining rare diseases, focusing on expediting treatments for 
patients.

Date: Oct. 3, 2018.

Number of volumes: One (S. Hrg. 115-).
                                 ______
                                 

    HEARINGS BY THE SUBCOMMITTEE ON EMPLOYMENT AND WORKPLACE SAFETY

    No hearings held by the subcommittee in the 115th Congress.
                                 ______
                                 

 HEARINGS BY THE SUBCOMMITTEE ON PRIMARY HEALTH AND RETIREMENT SECURITY

               ROUNDTABLE ON SMALL BUSINESS HEALTH PLANS

Examining small business health plans.

Date: Jan. 30, 2018.

Number of volumes: One (S. Hrg. 115-).
  

   EXPLORING THE ``GIG ECONOMY'' AND THE FUTURE OF RETIREMENT SAVINGS

Examining the ``Gig Economy'' and the future of retirement savings.

Date: Feb. 6, 2018.

Number of volumes: One (S. Hrg. 115-).
  

     FINANCIAL LITERACY: THE STARTING POINT FOR A SECURE RETIREMENT

Examining financial literacy, focusing on the starting point for a 
secure retirement.

Date: Aug. 21, 2018.

Number of volumes: One (S. Hrg. 115-).
  

      HEALTHCARE IN RURAL AMERICA: EXAMINING EXPERIENCES AND COSTS

Examining health care in rural America, focusing on experiences and 
costs.

Date: Sept. 25, 2018.

Number of volumes: One (S. Hrg. 115-).
  


                         V. RULES OF PROCEDURE


           rules of procedure (as agreed to january 16, 2019)

    Rule 1.--Subject to the provisions of rule XXVI, paragraph 
5, of the Standing Rules of the Senate, regular meetings of the 
committee shall be held on the second and fourth Wednesday of 
each month, at 10:00 a.m., in room SD-430, Dirksen Senate 
Office Building. The chairman may, upon proper notice, call 
such additional meetings as he may deem necessary.
    Rule 2.--The chairman of the committee or of a 
subcommittee, or if the chairman is not present, the ranking 
majority member present, shall preside at all meetings. The 
chairman may designate the ranking minority member to preside 
at hearings of the committee or subcommittee.
    Rule 3.--Meetings of the committee or a subcommittee, 
including meetings to conduct hearings, shall be open to the 
public except as otherwise specifically provided in subsections 
(b) and (d) of rule 26.5 of the Standing Rules of the Senate.
    Rule 4.--(a) Subject to paragraph (b), one-third of the 
membership of the committee, actually present, shall constitute 
a quorum for the purpose of transacting business. Any quorum of 
the committee which is composed of less than a majority of the 
members of the committee shall include at least one member of 
the majority and one member of the minority.
    (b) A majority of the members of a subcommittee, actually 
present, shall constitute a quorum for the purpose of 
transacting business: provided, no measure or matter shall be 
ordered reported unless such majority shall include at least 
one member of the minority who is a member of the subcommittee. 
If, at any subcommittee meeting, a measure or matter cannot be 
ordered reported because of the absence of such a minority 
member, the measure or matter shall lay over for a day. If the 
presence of a member of the minority is not then obtained, a 
majority of the members of the subcommittee, actually present, 
may order such measure or matter reported.
    (c) No measure or matter shall be ordered reported from the 
committee or a subcommittee unless a majority of the committee 
or subcommittee is physically present.
    Rule 5.--With the approval of the chairman of the committee 
or subcommittee, one member thereof may conduct public hearings 
other than taking sworn testimony.
    Rule 6.--Proxy voting shall be allowed on all measures and 
matters before the committee or a subcommittee if the absent 
member has been informed of the matter on which he is being 
recorded and has affirmatively requested that he be so 
recorded. While proxies may be voted on a motion to report a 
measure or matter from the committee, such a motion shall also 
require the concurrence of a majority of the members who are 
actually present at the time such action is taken.
    The committee may poll any matters of committee business as 
a matter of unanimous consent; provided that every member is 
polled and every poll consists of the following two questions:
          (1) Do you agree or disagree to poll the proposal; 
        and
          (2) Do you favor or oppose the proposal.
    Rule 7.--There shall be prepared and kept a complete 
transcript or electronic recording adequate to fully record the 
proceedings of each committee or subcommittee meeting or 
conference whether or not such meetings or any part thereof is 
closed pursuant to the specific provisions of subsections (b) 
and (d) of rule 26.5 of the Standing Rules of the Senate, 
unless a majority of said members vote to forgo such a record. 
Such records shall contain the vote cast by each member of the 
committee or subcommittee on any question on which a ``yea and 
nay'' vote is demanded, and shall be available for inspection 
by any committee member. The clerk of the committee, or the 
clerk's designee, shall have the responsibility to make 
appropriate arrangements to implement this rule.
    Rule 8.--The committee and each subcommittee shall 
undertake, consistent with the provisions of rule XXVI, 
paragraph 4, of the Standing Rules of the Senate, to issue 
public announcement of any hearing or executive session it 
intends to hold at least one week prior to the commencement of 
such hearing or executive session. In the case of an executive 
session, the text of any bill or joint resolution to be 
considered must be provided to the chairman for prompt 
electronic distribution to the members of the committee.
    Rule 9.--The committee or a subcommittee shall require all 
witnesses heard before it to file written statements of their 
proposed testimony at least 24 hours before a hearing, unless 
the chairman and the ranking minority member determine that 
there is good cause for failure to so file, and to limit their 
oral presentation to brief summaries of their arguments. 
Testimony may be filed electronically. The presiding officer at 
any hearing is authorized to limit the time of each witness 
appearing before the committee or a subcommittee. The committee 
or a subcommittee shall, as far as practicable, utilize 
testimony previously taken on bills and measures similar to 
those before it for consideration.
    Rule 10.--Should a subcommittee fail to report back to the 
full committee on any measure within a reasonable time, the 
chairman may withdraw the measure from such subcommittee and 
report that fact to the full committee for further disposition.
    Rule 11.--No subcommittee may schedule a meeting or hearing 
at a time designated for a hearing or meeting of the full 
committee. No more than one subcommittee executive meeting may 
be held at the same time.
    Rule 12.--It shall be the duty of the chairman in 
accordance with section 133(c) of the Legislative 
Reorganization Act of 1946, as amended, to report or cause to 
be reported to the Senate, any measure or recommendation 
approved by the committee and to take or cause to be taken, 
necessary steps to bring the matter to a vote in the Senate.
    Rule 13.--Whenever a meeting of the committee or 
subcommittee is closed pursuant to the provisions of subsection 
(b) or (d) of rule 26.5 of the Standing Rules of the Senate, no 
person other than members of the committee, members of the 
staff of the committee, and designated assistants to members of 
the committee shall be permitted to attend such closed session, 
except by special dispensation of the committee or subcommittee 
or the chairman thereof.
    Rule 14.--The chairman of the committee or a subcommittee 
shall be empowered to adjourn any meeting of the committee or a 
subcommittee if a quorum is not present within fifteen minutes 
of the time schedule for such meeting.
    Rule 15.--Whenever a bill or joint resolution shall be 
before the committee or a subcommittee for final consideration, 
the clerk shall distribute to each member of the committee or 
subcommittee a document, prepared by the sponsor of the bill or 
joint resolution. If the bill or joint resolution has no 
underlying statutory language, the document shall consist of a 
detailed summary of the purpose and impact of each section. If 
the bill or joint resolution repeals or amends any statute or 
part thereof, the document shall consist of a detailed summary 
of the underlying statute and the proposed changes in each 
section of the underlying law and either a print of the statute 
or the part or section thereof to be amended or replaced 
showing by stricken-through type, the part or parts to be 
omitted and, in italics, the matter proposed to be added, along 
with a summary of the proposed changes; or a side-by-side 
document showing a comparison of current law, the proposed 
legislative changes, and a detailed description of the proposed 
changes.
    Rule 16.--An appropriate opportunity shall be given the 
minority to examine the proposed text of committee reports 
prior to their filing or publication. In the event there are 
supplemental, minority, or additional views, an appropriate 
opportunity shall be given the majority to examine the proposed 
text prior to filing or publication. Unless the chairman and 
ranking minority member agree on a shorter period of time, the 
minority shall have no fewer than three business days to 
prepare supplemental, minority or additional views for 
inclusion in a committee report from the time the majority 
makes the proposed text of the committee report available to 
the minority.
    Rule 17.--(a) The committee, or any subcommittee, may issue 
subpoenas, or hold hearings to take sworn testimony or hear 
subpoenaed witnesses, only if such investigative activity has 
been authorized by majority vote of the committee.
    (b) For the purpose of holding a hearing to take sworn 
testimony or hear subpoenaed witnesses, three members of the 
committee or subcommittee shall constitute a quorum: provided, 
with the concurrence of the chairman and ranking minority 
member of the committee or subcommittee, a single member may 
hear subpoenaed witnesses or take sworn testimony.
    (c) The committee may, by a majority vote, delegate the 
authority to issue subpoenas to the chairman of the committee 
or a subcommittee, or to any member designated by such 
chairman. Prior to the issuance of each subpoena, the ranking 
minority member of the committee or subcommittee, and any other 
member so requesting, shall be notified regarding the identity 
of the person to whom it will be issued and the nature of the 
information sought and its relationship to the authorized 
investigative activity, except where the chairman of the 
committee or subcommittee, in consultation with the ranking 
minority member, determines that such notice would unduly 
impede the investigation. All information obtained pursuant to 
such investigative activity shall be made available as promptly 
as possible to each member of the committee requesting same, or 
to any assistant to a member of the committee designated by 
such member in writing, but the use of any such information is 
subject to restrictions imposed by the rules of the Senate. 
Such information, to the extent that it is relevant to the 
investigation shall, if requested by a member, be summarized in 
writing as soon as practicable. Upon the request of any member, 
the chairman of the committee or subcommittee shall call an 
executive session to discuss such investigative activity or the 
issuance of any subpoena in connection therewith.
    (d) Any witness summoned to testify at a hearing, or any 
witness giving sworn testimony, may be accompanied by counsel 
of his own choosing who shall be permitted, while the witness 
is testifying, to advise him of his legal rights.
    (e) No confidential testimony taken or confidential 
material presented in an executive hearing, or any report of 
the proceedings of such an executive hearing, shall be made 
public, either in whole or in part or by way of summary, unless 
authorized by a majority of the members of the committee or 
subcommittee.
    Rule 18.--Presidential nominees shall submit a statement of 
their background and financial interests, including the 
financial interests of their spouse and children living in 
their household, on a form approved by the committee which 
shall be sworn to as to its completeness and accuracy. The 
committee form shall be in two parts--
          (I) information relating to employment, education and 
        background of the nominee relating to the position to 
        which the individual is nominated, and which is to be 
        made public; and,
          (II) information relating to financial and other 
        background of the nominee, to be made public when the 
        committee determines that such information bears 
        directly on the nominee's qualifications to hold the 
        position to which the individual is nominated.
    Information relating to background and financial interests 
(parts I and II) shall not be required of nominees for less 
than full-time appointments to councils, commissions or boards 
when the committee determines that some or all of the 
information is not relevant to the nature of the position. 
Information relating to other background and financial 
interests (part II) shall not be required of any nominee when 
the committee determines that it is not relevant to the nature 
of the position.
    Committee action on a nomination, including hearings or 
meetings to consider a motion to recommend confirmation, shall 
not be initiated until at least five days after the nominee 
submits the form required by this rule unless the chairman, 
with the concurrence of the ranking minority member, waives 
this waiting period.
    Rule 19.--Subject to statutory requirements imposed on the 
committee with respect to procedure, the rules of the committee 
may be changed, modified, amended or suspended at any time; 
provided, not less than a majority of the entire membership so 
determine at a regular meeting with due notice, or at a meeting 
specifically called for that purpose.
    Rule 20.--When the ratio of members on the committee is 
even, the term ``majority'' as used in the committee's rules 
and guidelines shall refer to the party of the chairman for 
purposes of party identification. Numerical requirements for 
quorums, votes and the like shall be unaffected.
    Rule 21.--First degree amendments must be filed with the 
chairman at least 24 hours before an executive session. The 
chairman shall promptly distribute all filed amendments 
electronically to the members of the committee. The chairman 
may modify the filing requirements to meet special 
circumstances with the concurrence of the ranking minority 
member.
    Rule 22.--In addition to the foregoing, the proceedings of 
the committee shall be governed by the Standing Rules of the 
Senate and the provisions of the Legislative Reorganization Act 
of 1946, as amended.

           *       *       *       *       *       *       *


  Guidelines of the Senate Committee on Health, Education, Labor, and 
Pensions With Respect to Hearings, Markup Sessions, and Related Matters


                                hearings

    Section 133A(a) of the Legislative Reorganization Act 
requires each committee of the Senate to publicly announce the 
date, place, and subject matter of any hearing at least one 
week prior to the commencement of such hearing.
    The spirit of this requirement is to assure adequate notice 
to the public and other Members of the Senate as to the time 
and subject matter of proposed hearings. In the spirit of 
section 133A(a) and in order to assure that members of the 
committee are themselves fully informed and involved in the 
development of hearings:
          1. Public notice of the date, place, and subject 
        matter of each committee or subcommittee hearing should 
        be inserted in the Congressional Record seven days 
        prior to the commencement of such hearing.
          2. At least seven days prior to public notice of each 
        committee or subcommittee hearing, the majority should 
        provide notice to the minority of the time, place and 
        specific subject matter of such hearing.
          3. At least three days prior to the date of such 
        hearing, the committee or subcommittee should provide 
        to each member a list of witnesses who have been or are 
        proposed to be invited to appear.
          4. The committee and its subcommittee should, to the 
        maximum feasible extent, enforce the provisions of rule 
        9 of the committee rules as it relates to the 
        submission of written statements of witnesses twenty-
        four hours in advance of a hearing. Witnesses will be 
        urged to submit testimony even earlier whenever 
        possible. When statements are received in advance of a 
        hearing, the committee or subcommittee (as appropriate) 
        should distribute copies of such statements to each of 
        its members. Witness testimony may be submitted and 
        distributed electronically.

         executive sessions for the purpose of marking up bills

    In order to expedite the process of marking up bills and to 
assist each member of the committee so that there may be full 
and fair consideration of each bill which the committee or a 
subcommittee is marking up the following procedures should be 
followed:
    1. Seven days prior to the proposed date for an executive 
session for the purpose of marking up bills the committee or 
subcommittee (as appropriate) should provide written notice to 
each of its members as to the time, place, and specific subject 
matter of such session, including an agenda listing each bill 
or other matters to be considered and including:
          (a) a copy of each bill, joint resolution, or other 
        legislative matter (or committee print thereof) to be 
        considered at such executive session; and
          (b) a copy of a summary of the provisions of each 
        bill, joint resolution, or other legislative matter to 
        be considered at such executive session including, 
        whenever possible, an explanation of changes to 
        existing law proposed to be made.
    2. Insofar as practical, prior to the scheduled date for an 
executive session for the purpose of marking up bills, the 
committee or a subcommittee (as appropriate) should provide 
each member with a copy of the printed record or a summary of 
any hearings conducted by the committee or a subcommittee with 
respect to each bill, joint resolution, or other legislative 
matter to be considered at such executive session.