Copyright 1999 Federal Document Clearing House, Inc.
Federal Document Clearing House Congressional Testimony
February 23, 1999, Tuesday
SECTION: CAPITOL HILL HEARING TESTIMONY
LENGTH: 5761 words
HEADLINE:
TESTIMONY February 23, 1999 DONNA SHALALA SENATE APPROPRIATIONS
LABOR, HEALTH AND HUMAN SERVICES, EDUCATION F2000 LABOR, HHS
BODY:
Testimony of The Honorable Donna Shalala U.S.
Secretary of Health and Human Services before the Subcommittee on Labor, Health
and Human Services, Education and Related Agencies Committee on Appropriations
United States Senate February 23, 1999 Good morning, Chairman Specter, Senator
Harkin, 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 What makes my
appearance this year before your subcommittee distinct from all the others is
that 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 $1 0 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 long-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 same time 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 Io 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 nite) 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 drug 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 of $1 00 million. Included in this amount is an increase targeted to
communities to provide state of the art clinical care to an additional 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 African Americans 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 "O'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 case 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 in
developing 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 epiderniologic 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 finish 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 $ 1 0 million increase,
to expand the PulseNet network of health labs which preform DNA "fingerprinting"
of disease causing 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
$1 01 million, an increase of $2 7 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 vaccine- preventable 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, an increase 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 urge 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 # l" - 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. GPR4 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 happiness the 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 Specter, Senator Harkin, 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 budget. We have
much to accomplish, and no time to waste. I would be happy to address any
questions you may have.
LOAD-DATE: March 9, 1999