Copyright 1999 Federal News Service, Inc.
Federal News Service
FEBRUARY 10, 1999, WEDNESDAY
SECTION: IN THE NEWS
LENGTH:
5735 words
HEADLINE: PREPARED TESTIMONY OF
THE
HONORABLE DONNA SHALALA
U.S. SECRETARY OF HEALTH AND HUMAN SERVICES
BEFORE THE HOUSE COMMITTEE ON APPROPRIATIONS
SUBCOMMITTEE ON LABOR, HEALTH AND HUMAN SERVICES, EDUCATION AND
RELATED
AGENCIES
BODY:
Good morning, Chairman Porter,
Congressmen Obey, and members of the Subcommittee. I am pleased to appear before
you today to discuss the President's FY 2000 budget for the Department of
Health and Human Services.
STANDING AT THE CROSSROADS OF
THE NEW MILLENNIUM
This is the seventh time I have come before you to
present the President's annual budget. What makes this appearance distinct from
all the others is that, as I come here today, we are not only submitting a
balanced budget for the second straight year, but we are also celebrating a
landmark bipartisan achievement -- last year's budget surplus, the first on the
books in three decades. In the past, we have spoken at great length about the
need to balance the budget, and thanks to the hard work and cooperation of the
Congress and the Administration, we have been able to achieve that goal. Mr.
Chairman, while we can all take pride in helping to achieve this success, we
must now look ahead together to the challenges that still confront us. These
challenges are many: helping Americans live not only longer but also healthier
lives, extending protections to those without health insurance
or who are at-risk, safeguarding our public health, and working
to better the lives of our nation's children. As we stand at the crossroads of
the new millennium, the combination of our fiscal discipline, the expanding
economy, and a new age of scientific breakthroughs provide us with a unique
opportunity to meet these challenges. The budget I present to you today begins
to meet these challenges through critical investments in the
health and well being of our citizens. It is a budget that
keeps faith with the President's vision of a 21st Century America where every
family can get ahead and no one is left behind.
Mr. Chairman, the total HHS
budget request for FY 2000 is $400.3 billion (Outlays). The amount before this
committee totals $230.7 billion (BA), of which $38.527 billion is discretionary.
This discretionary component represents an increase of $1.352 billion over last
year. Let me now highlight the main components of our FY 2000 budget request.
THE PROMISE OF A RETIREMENT WITH DIGNITY FOR ALL AMERICANS
Thanks to
advances in medical science and health care, Americans are now
living longer than ever before. By 2030, the number of Americans over 65 will
double, from 34 million to
69 million. This change creates a new set of
demands on our health care system, from an increasing need for
long-term care services to preparing Medicare to meet the needs of an expanding
pool of beneficiaries. Meeting these demands will help older Americans live not
just longer lives, but healthier ones.
Long-Term Care
America's aging
population, which continues to increase, needs better long-term care. Our budget
addresses this need with a multi-faceted initiative to help the five million
Americans who require long-term care and to those who care for them.Studies show
that those who need long-term care prefer to remain in their own homes and
communities rather than receive care in nursing homes or other institutional
settings. The majority of caregivers are women, and one-third have full time
jobs. Sadly, research shows that rates of depression among caregivers are
significantly higher than those of non-caregivers of the same age. We must
assist these caregivers in their difficult task.
Our budget invests $125
million in FY 2000 for a new National Family Caregiver Support program in the
Administration on Aging to assist approximately 250,000 families nationwide who
are caring for elderly relatives with chronic diseases and disabilities. This
investment will enable states to create comprehensive support systems that
provide a range of community-based services to caregivers, including quality
respite care, information about local services, counseling, and training for
complex care needs.
Our budget also provides seniors, as well as younger
Medicare beneficiaries, with critical information to help them better understand
their long-term care options. We have requested $10 million for a national
Medicare information campaign to provide Medicare beneficiaries of all ages with
information on the long-term care coverage available under Medicare and
Medicaid, private insurance options, and community-care services. The budget
also expands access to home and community-based care services to people of all
ages with significant disabilities by allowing states to provide Medicaid
coverage to people with incomes up to
300 percent of the federal SSI level
who need nursing home care but choose to live in the community. This new
Medicaid option will help make eligibility for nursing homes and community based
services more comparable and eliminate one of the sources of
Medicaid's"institutional bias." This 1ong-term care initiative also includes
policies from other Departments, including a tax credit to compensate for the
cost of long-term care services; providing the Federal government with the
authority to offer private long-term care insurance to its employees at group
rates; and an innovative housing initiative to create and integrate assisted
living facilities and Medicaid home and community based care.
Nursing Home
Quality Initiative
While we develop the means to support those who receive
long term-care in home and community- based settings, we must also continue to
ensure that those in nursing homes and institutional settings are getting the
quality care they deserve. Last summer, the President announced an initiative to
strengthen enforcement and oversight of nursing home quality and to crack down
on those who repeatedly violate program standards. While key provisions of this
initiative are already being implemented, this year's budget will provide the
$60.1 million needed to complete implementation of these provisions. Funds will
support increased state surveys of nursing homes, Federal oversight and
development of a national criminal abuse registry to screen potential employees,
as well as the costs of the additional litigation and appeals that result from
stepped-up enforcement efforts.
Reforming HCFA Management and Combating
Medicare Fraud, Waste, and Abuse
As steward for some of the most important
programs for our elders, the Health Care Financing
Administration faces the daunting challenge of reorganizing and modernizing
while at the sametime meeting pressing statutory deadlines for program changes
mandated in the Balanced Budget Act (BBA) and the Health
Insurance Portability and Accountability Act (HIPAA). HCFA must be highly
sensitive to the needs of its customers as it undertakes these reforms. While
HCFA's recent reorganization has made some progress in achieving the necessary
changes, more needs to be done. The President's budget outlines a five-part
reform plan that will increase HCFA's administrative flexibility while also
enhancing accountability, thereby enabling HCFA to be responsive to its
customers and serve as a more prudent purchaser of health care.
As HCFA begins to accomplish the basic objectives of these reforms, we will also
begin reviewing legislative proposals to increase the stability of HCFA's
funding in the future.
While we pursue our efforts to strengthen HCFA
management, we also will continue our fight against fraud, waste, and abuse in
the Medicare program. Since 1993, the government has increased prosecutions for
health care fraud by over 60 percent and increased convictions
by 40 percent, and I would like to thank the Subcommittee for supporting these
efforts so strongly. This budget continues the fight by providing $864 million
for the Medicare Integrity Program and the Health Care Fraud
and Abuse Control Account, which support the efforts of both HHS and the
Department of Justice in fighting fraud and abuse. It also includes proposals to
spend Medicare dollars more wisely by eliminating the overpayment for Epogen and
excessive markups for outpatient drugs, requiring private insurance companies to
provide secondary payer information, reducing the misuse of partial
hospitalization services, and making "Centers of Excellence" a permanent part of
the Medicare program. In total, these programs will save an estimated $240
million in FY 2000 and $2.9 billion over the next five years.
QUALITY,
AFFORDABLE HEALTH CARE FOR AMERICA'S WORKING FAMILIES
Today, too many people are denied the benefits of health
breakthroughs because they lack insurance or access to care. We must take steps
to ensure that in the new millennium our health care delivery
system keeps pace with advances in medical science and provides high quality and
affordable health care to every American family. To do so, our
budget expands access to health care and
health insurance, particularly for our most vulnerable
populations.
Increasing Access to Health Care for
Uninsured Individuals
Nearly 43 million Americans lack
health insurance. Many of these individuals receive care only
sporadically in hospital emergency rooms. To help these people get the primary
care and other services they need, the President is proposing a five year, $1
billion initiative to help communities and health care
providers to develop integrated systems that can deliver a more coordinated
array of health care services more efficiently to
uninsured workers. This program would provide $25 million in
grants this year, and $250 million a year from 2001 to 2004, to assist over 100
communities in establishing the infrastructure necessary to develop and
participate in coordinated care arrangements and finance additional core
health services for uninsured workers within
integrated systems of care.
Improving Mental Health
Services
Every year approximately 44 million American adults experience some
form of mental disorder, including 10 million who suffer serious mental illness.
In addition, up to 4 million children ages 9 to 17 experience a serious
emotional disturbance. Yet estimates show that less than one quarter of these
people are treated for their disorders. Our budget includes $359 million for the
Mental Health Block Grant, an increase of $70 million, to
provide additional funds for states to create comprehensive, community based
systems of care for both adults and children. It also provides $31 million for
the Projects for Assistance in Transition from Homelessness (PATH) grant
program, an increase of $5 million, which will increase by approximately 13,000
the number of individuals served and increase the number of services provided to
those already enrolled.
Ensuring Access to AIDS Therapies (Ryan White)
We have made significant progress in the fight against HIV and AIDS. Due to
the widespread use of combination anti-retro viral therapy, the AIDS death rate
in 1997 was its lowest in nearly a decade. But the news is not all good. While
the overall AIDS death rate is declining, the disease is exacting an
excruciating toll in minority communities. In 1997, 47 percent of those newly
diagnosed with HIV were African American and 20 percent were Hispanic. We must
continue our efforts to expand access to drag therapies and improve the quality
of care, particularly in minority communities. The President's budget continues
the fight against HIV and AIDS by providing $1.5 billion for the Ryan White
Program, an increase orS100 million. Included in this amount is an increase
targeted to communities to provide state of the art clinical care to
anadditional 10,000 people living with AIDS. In addition, the AIDS Drug
Assistance Program (ADAP) will receive a $35 million increase to help
individuals gain access to combination drug therapy. The budget also continues
to build on the effort initiated by the President and this Committee to address
the AIDS crisis in minority communities. The budget for FY 2000 includes $171
million for special initiatives that will be specifically targeted to HIV/AIDS
prevention, treatment, and capacity development needs within the
African-American and other racial and ethnic minority communities.
Reducing
Racial Health Disparities
Unfortunately, members of
minority groups are often less healthy than Americans as a whole. Despite
improvements in overall health outcomes, minorities continue to
bear a disproportionate burden of the nation's disease and illness. For example,
the infant mortality rate for AfricanAmericans is more than twice that of
Caucasians, and American Indian and Alaska Natives are about three times as
likely to die from diabetes compared to other Americans. The President is
committed to ending these racial disparities in health status,
and the budget provides $145 million to target many other Department resources
in the effort to provide health education, prevention, and
treatment services targeted to minority populations.
Medicare, Medicaid, and
the Children's Health Insurance Program
Our budget also
includes a variety of legislative proposals to expand access to Medicare and
Medicaid for groups that would otherwise be denied health
insurance for any number of reasons.It allows Americans ages 62 to 65 to buy
into Medicare by paying a premium, provides a buy-in option for displaced
workers ages 55 to 62 who have lost employer-provided health
coverage, and allows retirees between the ages of 55 and 65 whose companies have
reneged on their health benefits to buy into their company's
health plan. Another proposal would give states the option of
providing Medicaid coverage to legal immigrant children, pregnant women, and
certain groups of immigrants with disabilities who have entered the United
States after the enactment of the welfare reform legislation in 1996.
The
Children's Health Insurance and Medicaid programs represent a
valuable means of providing health insurance to poor children
who might otherwise go without care. But many families are unaware that their
children are eligible to receive care under these programs. Our budget will
allow states to increase spending by $1.2 billion over the next five years on
benefits and outreach and give them additional flexibility to expand outreach
efforts through development of new and innovative approaches.
Making Work
Pay for People with Disabilities
Our Budget also promotes opportunities for
Americans with disabilities. All too often, disabled Americans are prevented
from working by their legitimate fears of losing access to Medicaid and Medicare
coverage once they go to work. To enable these Americans to work and earn a
living wage, our FY 2000 budget extends Medicare coverage, and at the option of
states, Medicaid coverage, to working people with disabilities. This proposal
also includes new incentives for states to help them start their programs and to
link workers to necessary support services.Since President Clinton and Vice
President Gore took office, the American economy has added 17.7 million new
jobs. However, the unemployment rate among working age adults with disabilities
is still nearly 75 percent. People with disabilities can bring tremendous energy
and talent to the American workforce, yet institutional barriers often limit
their ability to work. The President's budget proposes a historic new $2 billion
initiative that removes significant barriers to work for people with
disabilities. It includes the Work Incentives Improvement Act, which invests
$1.2 billion in providing options for workers with disabilities to buy into
Medicaid and Medicare; a new $700 million investment in a $1,000 tax credit for
workers with disabilities; and more than double the government's current
investment, an increase of $35 million, in assistive technologies that make it
possible for individuals with disabilities to work. MAKING AMERICA A HEALTHIER -
AND A SAFER - PLACE TO LIVE
As we enter the 21st century, new threats to our
public health are continually emerging. From the challenge of
confronting infectious diseases, to the possibility of a bioterrorist attack and
the ongoing problems of foodborne illness, we must constantly be vigilant. The
only way to successfully combat the public health problems of
tomorrow is by investing today in the necessary medical research and public
health and disaster response infrastructure.
The
International Challenge of Infectious Diseases
If you will permit me, Mr.
Chairman, I would also like to speak briefly to the importance of fulfilling our
commitment to support the World Health Organization and the
work it does to improve the health of people throughout the
world, including our own citizens.
I recognize that funds for the WHO are
appropriated to the Department of State through another subcommittee. But those
of us responsible for the health of the American people need to
understand that the WHO's ability to fulfill its mission and responsibilities
can make a real difference in fulfilling our own public health
goals. Key areas include the WHO's work in the surveillance and outbreak control
of infectious diseases, headed by a distinguished American (David Heymann), the
Tobacco Free Initiative, Roll-back Malaria, the elimination of polio, and the
Stop TB initiative.
International trade, commerce, and tourism have truly
created a global village. Because infectious diseases do not recognize borders,
it is increasingly necessary to protect the health and safety
of American citizens by investing in a global public health
strategy.
Tuberculosis provides a striking example. In this decade, we have
had to aggressively combat a resurgence of TB in the United States. We have made
extraordinary progress, with the number of cases declining dramatically.New York
City was among the hardest hit. Now, the only new cases are found among the
City's immigrant population - among people who were exposed elsewhere.
Working in partnership with the WHO, and providing the necessary resources,
we can develop the global strategy that is critical to protecting our citizens
and people around the world.
Responding to the New Threat of Bioterrorism
Terrorism represents a serious threat to the peace and prosperity of our
nation. While terrorist attacks can take numerous forms, the threat posed by
bioterrorism is particularly deadly, because it can affect a large population,
remain undetected for some time, and cause secondary illness or death if the
agent is communicable. As the lead federal agency responsible for preparing for
and responding to the medical and public health consequences of
a bioterrorist event, we are mounting a comprehensive public
health effort to combat this deadly threat.
The President's
Budget includes $230 million for the Department to undertake a coordinated,
four-pronged initiative to prepare for the medical needs and
health consequences resulting from a potential terrorist use of
biological weapons. First, our budget invests in the infectious disease
surveillance infrastructure needed to detect the occurrence of a bioterrorist
attack and to determine its cause, including improvements in ease reporting,
epidemiological and laboratory capacity, and the development of information
technology to allow coordination among Federal, State and local public
health officials. Second, it funds the purchase of a stockpile
of the vaccines needed to treat the most likely biological agents. Third, the
budget invests indeveloping the medical response capability at the local level
to respond to an outbreak by training local health providers
and supporting the creation of 25 Metropolitan Medical Response Systems.
Finally, it provides funds for research and development activities to develop
and expedite review of new vaccines and therapeutics and new rapid screens for
diagnosing chemical agents.
Creating Superior Public Health
Surveillance and Food Safety
Our nation needs a high quality surveillance
system to collect and analyze epidemiologic information if we are to be able to
respond effectively to a future outbreak of disease. The President's budget
proposes to strengthen our surveillance system by providing a total of $65
million to support the implementation of a National Electronic Disease
Surveillance Network Initiative (NEDSNI) at the Centers for Disease Control.
This Initiative would integrate electronic communications related to
surveillance for the Emerging Infectious Diseases ($15 million), Bioterrorism
($40 million), and Food Safety ($10 million) programs and will establish
communication links with the public health and medical
communities to enable them to furnish timely information on outbreaks of
communicable diseases to State and local public health
departments and assure better communications among public
health entities.
Surveillance is just one of the keys to
fighting outbreaks of foodborne illness. Food-related hazards are responsible
for as many as 33 million illnesses and up to 9,000 deaths each year. To combat
these outbreaks, the budget seeks $29.5 million for the CDC, a $10 million
increase, to expand the PulseNet network of health labs which
preform DNA "fingerprinting" of diseasecausing bacteria. In addition, FDA is
seeking $79 million to support its food safety efforts.
Expanding Medical
and Health Care Quality Research
Biomedical research has
been the foundation of the unprecedented gains we have made in improving the
health of both Americans and the world. Last year, the
President made a commitment to increase the budget for the National Institutes
of Health, the world's largest and most distinguished
organization for biomedical research, by nearly 50 percent over five years, and
this Committee responded by passing an increase of almost $2 billion. This
year's budget continues the President's commitment and keeps us on the path set
last year with an investment of $15.9 billion, an increase of $320 million. The
FY 2000 request, combined with last year's 14.6 percent increase, represents a
17 percent increase over two years. This year's request will enable NIH to fund
nearly 30,000 research projects grants, the highest total in history.
Along
with his commitment to increase funding for biomedical research, the President
last year also made a commitment to ensuring that scientific advances are
translated into better health care for the American people. The
President's budget honors this commitment as well, providing an increase of $35
million for the Agency for Health Care Policy and Research.
These funds will be spent on health care research that will
enhance knowledge about how to improve outcomes and quality of medical treatment
and how to best translate research results into daily practice to improve
health care for all Americans.
THE RIGHT TO A SAFE AND
HEALTHY CHILDHOOD
Mr. Chairman, the health investments that
I have outlined are critical to meeting the challenges that will confront us in
the next century. But we must also invest now in what will undoubtedly be our
greatest natural resource in the new century, our children.
Curtailing Youth
Smoking
Last year's settlement of the State tobacco lawsuits affirmed the
responsibility of the tobacco industry to pay for health care
costs associated with smoking. While this agreement was a step in the right
direction, there is more that needs to be done to preserve the public
health -- and to protect our children from the dangers of
smoking. It is horrifying to think that over 400,000 deaths each year are due to
cancer, respiratory illness, heart disease and other smoking-related illness. It
is even more horrifying that three thousand young people will begin smoking each
day, and one thousand of them will die earlier than they should as a result of
smoking.
Our budget reaffirms our commitment to combat smoking among the
nation's youth. First, the President has proposed raising the price of a pack of
cigarettes by 55 cents to reduce teen smoking. The budget also includes $101
million, an increase of $27 million, to expand the Center for Disease Control's
support for State tobacco control programs. The budget also provides $68 million
for the Food and Drug Administration to support outreach and enforcement
activities to curtail youth smoking, an increase of $34 million.Last year, after
extensive negotiations, the states' Attorneys General reached a settlement with
the tobacco companies that was based in part on recovering the medical costs of
those with tobacco-related diseases. Since U.S. taxpayers paid a substantial
portion of the Medicaid costs that were the basis for much of the state
settlement with the tobacco companies, federal law requires that the federal
government recoup its share. However, the Administration will Work with the
states and the Congress to enact legislation that, among other things, resolves
these Federal claims in exchange for a commitment by the states to use tobacco
money to support shared national and state priorities which reduce youth
smoking, promote public health and children's programs, and
assist affected rural communities.
Promoting Childhood Immunizations
The most cost-effective way to prevent infectious disease among young people
is to immunize every child. As a result of the Administration's Childhood
Immunization Initiative, the nation exceeded its childhood vaccination coverage
goals, with over 90 percent of America's toddlers receiving each basic childhood
vaccine. Thanks to these efforts, the incidence of vaccinepreventable diseases
such as diphtheria, tetanus, measles, and polio are at all-time lows.
The
President's budget provides a total of $1.1 billion for childhood immunization,
including $526 million in discretionary funding, an increase of $77 million over
last year. These funds will allow the program to provide all the vaccines
recommended by the Advisory Committee on Immunization Practices, including
vaccines for rotavirus and catch-up vaccinations for hepatitis B. The budget
also includes $99 million for global polio and measles eradication, anincrease
of $17 million, to support the efforts of the World Health
Organization to eliminate polio throughout the world by the year 2000.
Advancing Innovative Treatments for Asthma
Over the past 15 years, the
number of Americans afflicted with asthma has doubled to approximately 15
million, with the sharpest increase in rates among children under age 5. Asthma
is one of the leading causes of school absenteeism, and often results in
limitations in activity and disruption of family routines. To begin to arrest
this growing epidemic, our budget proposes $50 million in demonstration grants
to states to test innovative asthma disease management techniques, derived in
large part from NIH-funded research, for children enrolled in Medicaid and CHIP.
Participating States will measure success in reducing asthma related incidents
such as emergency room visits and length of hospital stays.
Ensuring
Continued Educational Excellence in the Nation's Children's Hospitals
Expertly trained pediatricians are a critical ingredient to keeping children
healthy. Children's hospitals play an essential role in the education of the
nation's physicians, training 25 percent of all pediatricians and more than half
of many pediatric sub-specialties. To support the vital efforts that children's
hospitals play in training physicians, our budget includes $40 million to
provide financial assistance to support graduate medical education at free
standing children's hospitals.
Making Child Care Safe, Reliable, and
Affordable
In millions of American families, both parents must work to
support their children. In millions of others, single parents must work doubly
hard to maintain family income. This Administration, working together with the
Congress, has taken numerous steps to support families of all types, ranging
from the Earned Income and Child Tax Credits to the Family and Medical Leave Act
and the Children's Health Insurance Program. The next step we
must take is to help all parents find child care that is safe, reliable, and
affordable. This is not only important as a way to support the needs of working
families. Safe, quality child care is essential to the healthy development of
our children. Study after study provides evidence that investments in quality
care can have major benefits for children, their families, and our society.
Let me thank you for having made a down-payment towards the President's
child care initiative with $173 million in quality funds and $10 million for
child care related research. The President's FY 2000 budget again includes a
requested increase of $10.5 billion in mandatory funding over five years for
child care programs in HHS, as well as critical increases in the Departments of
Treasury and Education. These additional funds will dramatically expand the
availability of safe and affordable child care for working families, as well as
improve early learning and the quality and safety of child care. The Child Care
and Development Block Grant was used to serve 1.25 million children in 1997.
With these additional funds, we are committed to increasing the number of
children served by more than one million by 2004.Enhancing Head Start
Head
Start has been and will continue to be one of the Administration's top
priorities. This program has been successful in ensuring that low-income
children start school ready to learn. Since 1993, enrollment in Head Start has
grown by 17 percent. The President's budget invests $5.3 billion, an increase of
$607 million, to allow Head Start to serve an additional 42,000 children,
bringing the total number of children served to 877,000 and moving forward on
our commitment to enroll one million children by 2002. Consistent with last
year's Head Start reauthorization, our budget provides funds to improve program
quality, enhance staff development, and reduce staff turnover. This request
includes over $420 million for the Early Head Start program, which will provide
almost 45,000 infants and toddlers and their families with early, continuous,
intensive, and comprehensive child development and family support services.
Curtailing Violence Against Women
Each year an estimated 2.1 million
women are raped or physically assaulted in this country. The President's budget
provides $218 million, an increase of $28 million, to combat this serious
problem that affects families across our nation. This includes $102 million for
the Grants for Battered Women Shelters program, which will provide approximately
40,000 survivors of domestic violence and sexual assault with counseling,
shelter, and other services. Funds will also be targeted to activities designed
to change the social norms that condone violence against women.
MANAGEMENT
IMPROVEMENTS AND INNOVATIONS
Managing the complex problems that will
confront us in the 21st century requires the development of innovative
management strategies that enhance productivity while promoting accountability.
We have and will continue to work closely with the Congress and this
Subcommittee to develop management reforms that allow us to put every dollar to
efficient and effective use.
Y2K
As this Committee is well aware, I have
taken the Year 2000 millennium problem (Y2K) very seriously. In fact, in
September 1998, I informed all of the HHS Operating Division heads that Y2K was
this Department's "Job #1 ". With your agreement, I redirected $42 million from
other HHS activities to ensure that HCFA had the funds it needed for Medicare
contractor renovations. As a Department we have engaged in a series of strong
administrative actions, undertaken a comprehensive review of our funding needs
to ensure millennium compliance, and encouraged staff throughout the Department
to work diligently to see that our equipment, facilities and systems are all Y2K
OK. Although I cannot declare total victory today, I can assure you that 85
percent of our mission critical systems are now Year 2000 compliant and I expect
the remainder to be fully compliant within the next couple of months. While this
part of the work will be completed prior to FY 2000, we must not relax our
efforts, and we must continue our work on other Y2K activities including
outreach to communities, infrastructure and biomedical equipment remediation,
and business continuity and contingency planning. It will take continued,
intense efforts, working together with our colleagues in State and local
governments and our public and private partners, to overcome this daunting
challenge. We cannot allow the millennium bug to impair our mission or disrupt
our services to the American people. Therefore, as part of the FY 2000 budget, I
am requesting $165 million to ensure that all of our systems are Y2K ready.
GPRA
Our budget submission also includes HHS' FY 2000 GPRA performance
plans. We have been working hard to improve our performance plans and our GPRA
process within the Department. Our plans are much better than the first set of
GPRA plans we submitted last year. They reflect increased involvement of senior
staff, increased consultation with our partners, clearer linkages with the
Strategic Plan, and the refinement of measures, baselines and targets. Still,
there are several significant challenges facing HHS in GPRA performance
measurement. We continue to work toward the increased use of outcome measures,
to confront complex data issues, and to work closely with our partners and
stakeholders in the development of performance goals and measures. We are
confident that our GPRA performance plans for FY 2000 are sound ones and we look
forward to continued discussions with the Congress on our plans.
THE MOMENT
IS NOW
Mr. Chairman, I have put before you today a blueprint for preparing
our health and social service systems to meet the challenges of
the new millennium. The goals of making health and happinessthe
defining characteristic of our senior's retirement, of providing a better future
for our children, and of enabling all Americans to live a longer and healthier
lives are ones that we all share. And like you, I am committed to achieving
these goals while maintaining the balanced budget discipline we have all worked
so hard to create.
Chairman Porter, Congressmen Obey, and members of the
subcommittee: I appreciate the support you have provided us in the past and I
look forward to working with all of you to meet the challenges before us in this
bud.get. We have much to accomplish, and no time to waste. I would be happy to
address any questions you may have.
END
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