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
