Copyright 2002 eMediaMillWorks, Inc.
(f/k/a Federal
Document Clearing House, Inc.)
Federal Document Clearing House
Congressional Testimony
February 28, 2002 Thursday
SECTION: CAPITOL HILL HEARING TESTIMONY
LENGTH: 6596 words
COMMITTEE:
HOUSE BUDGET
HEADLINE: FISCAL 2003
BUDGET
TESTIMONY-BY: TOMMY G. THOMPSON, SECRETARY
AFFILIATION: DEPARTMENT OF HEALTH AND HUMAN SERVICES
BODY: STATEMENT BY TOMMY G. THOMPSON SECRETARY
DEPARTMENT OF HEALTH AND HUMAN SERVICES
BEFORE THE HOUSE BUDGET
COMMITTEE
FEBRUARY 28, 2002
Good Morning Chairman Nussle,
Congressman Spratt and members of the Committee. I am honored to appear before
you today to discuss the President's FY 2003 budget for the Department of Health
and Human Services. I am confident that a review of the full details of our
budget will demonstrate that we are proposing a balanced and responsible
approach to ensuring a safe and healthy America.
The budget I present to
you today fulfills the promises the President has made and proposes creative and
innovative solutions for meeting the challenges that now face our nation. Since
the September 11th attacks we have dedicated much of our efforts to ensuring
that the nation is safe. HHS was one of the first agencies to respond to the
September 11th attacks on New York City, and began deploying medical assistance
and support within hours of the attacks. Our swift response and the overwhelming
task of providing needed health related assistance made us even more aware that
there is always room for improvement. The FY 2003 budget for the Department of
Health and Human Services builds on President Bush's commitment to ensure the
health and safety of our nation. The FY 2003 budget places increased emphasis on
protecting our nation's citizens and ensuring safe, reliable health care for all
Americans. The HHS budget also promotes scientific research, builds on our
success in welfare reform, and provides support for childhood development while
delivering a responsible approach for managing HHS resources. Our budget plan
confronts both the challenges of today and tomorrow while protecting and
supporting the well being of all Americans.
Mr. Chairman, the total HHS
request for FY 2003 is $488.8 billion in outlays. This is an increase of $29.2
billion, or 6.3 percent over the comparable FY 2002 budget. The discretionary
component of the HHS budget totals $64.0 billion in budget authority, an
increase of $2.4 billion, or 3.9 percent. Let me now discuss some of the
highlights of the HHS budget and how we hope to achieve our goals.
PROTECTING THE NATION AGAINST BIOTERRORISM
Mr. Chairman, as you
know, the Department of Health and Human Services is the lead federal agency in
countering bioterrorism. In cooperation with the States, we are responsible for
preparing for, and responding to, the medical and public health needs of this
nation. The FY 2003 budget for HHS bioterrorism efforts is $4.3 billion, an
increase of $1.3 billion, or 45 percent, above FY 2002. This budget supports a
variety of activities to prevent, identify, and respond to incidents of
bioterrorism. These activities are administered through the Centers for Disease
Control and Prevention (CDC), the National Institutes of Health (NIH), the
Office of Emergency Preparedness (OEP), the Substance Abuse and Mental Health
Services Administration (SAMHSA), the Health Resources and Services
Administration (HRSA) and the Food and Drug Administration (FDA). The efforts of
this agency will be directed by the newly established Office of Public Health
Preparedness (OPHP).
In order to create a blanket of preparedness
against bioterrorism, the FY 2003 budget provides funding to State and local
organizations to improve laboratory capacity, enhance epidemiological expertise
in the identification and control of diseases caused by bioterrorism, provide
for better electronic communication and distance learning, and support a newly
expanded focus on cooperative training between public health agencies and local
hospitals.
Funding for the Laboratory Response Network enhances a system
of over 80 public health labs specifically developed for identifying pathogens
that could be used for bioterrorism. Funding will also support the Health Alert
Network, CDC's electronic communications system that will link local public
health departments in covering at least ninety percent of our nations'
population. Funding will be used to support epidemiological response and
outbreak control, which includes funding for the training of public health and
hospital staff. This increased focus on local and state preparedness serves to
provide funding where it best serves the interests of the nation.
An
important part on the war against terrorism is the need to develop vaccines and
maintain a National Pharmaceutical Stockpile. The National Pharmaceutical
Stockpile is purchasing enough antibiotics to be able to treat up to 20 million
individuals in a year for exposure to anthrax and other agents. The Department
is purchasing sufficient smallpox vaccines for all Americans. The FY 2003 budget
proposes $650 million for the National Pharmaceutical Stockpile and costs
related to stockpiling of smallpox vaccines, and next-generation anthrax
vaccines currently under development.
Another important aspect of
preparedness is the response capacity of our nations hospitals. Our FY 2003
budget provides $518 million for hospital preparedness and infrastructure to
enhance biological and chemical preparedness plans focused on hospitals. The FY
2003 budget will provide funding to upgrade the capacity of hospitals,
outpatient facilities, emergency medical services systems and poison control
centers to care for victims of bioterrorism. In addition, CDC will provide
support for a series of exercises to train public health and hospital workers to
work together to treat and control bioterrorist outbreaks.
Today, the
United States has one of the world's safest food supplies. However, since the
September 11 attacks, the American people have a heightened awareness about
protecting the nation's food imports and food supply at home. The FY 2003 budget
supports a substantial increase in the number of safety inspections for
FDA-regulated products that are imported into the country. Physical examinations
of food imports will double in FY 2002 over the previous year, and double again
in FY 2003. We anticipate further progress as new staff become fully productive.
The FY 2003 budget also includes $184 million to construct, repair and
secure facilities at the CDC. Priorities include the construction of an
infectious disease/bioterrorism laboratory in Fort Collins, Colorado, and the
completion of a second infectious disease laboratory, an environmental
laboratory, and a communication and training facility in Atlanta. This funding
will enable the CDC to handle the most highly infectious and lethal pathogens,
including potential agents of bioterrorism. Within the funds requested, $12
million will be used to equip the Environmental Toxicology Lab, which provides
core lab space for testing environmental samples for chemical terrorism. Funding
will also be allocated to the ongoing maintenance of existing laboratories and
support structures.
INVESTING IN BIOMEDICAL RESEARCH
Advances in
scientific knowledge have provided the foundation for improvements in public
health and have led to enhanced health and quality of life for all Americans.
Much of this can be attributed to the groundbreaking work carried on by, and
funded by, the National Institutes of Health (NIH). Our FY 2003 budget enhances
support for a wide array of scientific research, while emphasizing and
supporting research needed for the war against bioterrorism.
NIH is the
largest and most distinguished biomedical research organization in the world.
The research that is conducted and supported by the NIH offers the promise of
breakthroughs in preventing and treating a number of diseases and contributes to
fighting the war against bioterrorism. The FY 2003 budget includes the final
installment of $3.7 billion needed to achieve the doubling of the NIH budget.
The budget includes $1.7 billion for bioterrorism research, including genomic
sequencing of dangerous pathogens, development of zebra chip technology,
development and procurement of an improved anthrax vaccine, and laboratory and
research facilities construction and upgrades related to bioterrorism. With the
commitment to bioterrorism research comes our expectation of substantial
positive spin-offs for other diseases. Advancing knowledge in the arena of
diagnostics, therapeutics and vaccines in general should have enormous impact on
the ability to diagnose, treat, and prevent major killers-diseases such as
malaria, TB, HIV/AIDS, West Nile fever, and influenza.
The FY 2003
budget also provides $5.5 billion for research on cancer throughout all of NIH.
Currently, one of every two men and one of every three women in the United
States will develop some type of cancer over the course of their lives. New
research indicates that cancer is actually more than 200 diseases, all of which
require different treatment protocols. Promising cancer research is leading to
major breakthroughs in treating and curing various forms of cancer. Our budget
continues to expand support for these research endeavors.
BUILDING UPON
THE SUCCESSES OF WELFARE REFORM
President Bush has said that American
families are the bedrock of American society and the primary source of strength
and health for both individuals and communities. Our budget includes a number of
new initiatives that support this principle by targeting resources to strengthen
our nation's families. We look forward to working with Congress in considering
the next phase of welfare reform and other elements of the President's proposals
to help America's low-income families succeed.
Temporary Assistance for
Needy Families
As a former governor, I can tell you that the Temporary
Assistance for Needy Families program - or TANF - has been a truly remarkable
example of a successful Federal-State partnership. States were given tremendous
flexibility to reform their welfare programs and as a result, millions of
families have been able to end their dependency on welfare and achieve self-
sufficiency.
Since 1996, welfare dependency has plummeted. As of
September of 2001, the number of families receiving assistance, which represents
the welfare caseload, was 2,103,000 and the number of individuals receiving
assistance was 5,343,000. This means the welfare caseload and the number of
individuals receiving cash assistance declined 52 percent and 56 percent,
respectively, since the enactment of TANF. Between January and September of last
year national caseloads actually declined about 2 percent, and while the July to
September statistics indicate a slight increase, the figures are still well
below the previous year's caseload levels. The general trend suggests the
national caseloads are not rising but, instead, have stabilized.
In New
York City, where we are understandably most concerned about job opportunities,
the City has achieved more than 53,000 job placements for welfare recipients
from September through December 2001. While the number of TANF recipients
increased briefly directly because of the tragedy on September 11, by December
there were about 15,000 fewer TANF recipients on the rolls than there were in
August. Indeed, in December the City had its lowest number of persons on welfare
since 1965.
Some other positive outcomes we have seen since the law's
passage include:
-Employment among single mothers has grown to
unprecedented levels.
-Child poverty rates are at their lowest level
since 1978. Overall child poverty rates declined from 20.5 percent in 1996 to
16.2 percent in 2000. The poverty rate among African American children declined
from 39.9 percent to 30.9 percent - the lowest level on record. The poverty rate
among Hispanic children declined from 40.3 percent to 28.0 percent - the largest
four- year drop on record.
-The rate of births to unwed mothers has not
increased.
But even with this notable progress, much remains to be done,
and States still face many challenges. Last year, I held eight listening
sessions throughout the country to discuss the state of their TANF systems and
understand the new challenges they are facing. The States overwhelmingly support
this program. While keeping the basic structure and purpose of the program,
States, administrators, recipients, employers, and advocates have provided
valuable insight into where we could make the program even more responsive to
the needs of families.
Our reauthorization proposal embraces the needs
of families by maintaining the program's overall funding and basic structure,
while focusing increased efforts on building stronger families through work and
job advancement and adding child well-being as an overarching goal of TANF.
Our budget proposes $16.5 billion each year for block grants to States
and Tribes; $319 million a year to restore supplemental grants; $2 billion over
five years for a more accessible Contingency Fund; and a $100 million a year
initiative for research, demonstration and technical assistance primarily to
promote child well-being through strengthening family formation and healthy
marriages. In addition, our proposal will call for modification of the bonus for
high performance to reward significant achievement in promoting employment of
program participants.
We maintain State flexibility, but include
important changes to improve the effectiveness of the program. We will also
expect States to engage all families they serve and help them make progress
toward their highest degree of self-sufficiency - even those cases that may
appear hard to employ. We will eliminate the separate two-parent work
participation rates and give States more flexibility in designing productive
self-sufficiency activities while ensuring that the participation rate
requirements are meaningful. We will also ask States to set performance goals
for their TANF programs and report on their progress toward meeting these goals.
I look forward to working with Congress on reauthorization of this
hallmark program. I am confident that together we will witness even greater
achievements under the TANF program.
Other Programs Supporting TANF
Goals
The President's Budget also includes funding for several other
programs at the State and community level that work to support the goals of
TANF. The Job Opportunities for Low-Income Individuals program (JOLI) provides
grants to non-profit organizations to create new employment and business
opportunities for TANF recipients and other low-income individuals. Our budget
provides $5.5 million to continue this valuable program. The Individual
Development Account (IDA) demonstration program similarly seeks to increase the
economic self-sufficiency of low- income families by testing policies that
promote savings for post- secondary education, home ownership, and
micro-enterprise development. The President's Budget calls for $25 million to
support IDAs. More broadly, the Social Services Block Grant (SSBG) provides a
flexible source of funding for States to help families achieve or maintain
self-sufficiency and provide an array of social services to vulnerable families.
The President's Budget request for SSBG is $1.7 billion.
The President's
Budget extends the Transitional Medical Assistance (TMA) program which provides
valuable health protection for former welfare recipients after they enter the
workforce. This important program allows families to remain eligible for
Medicaid for up to 12 months after they are no longer eligible for welfare
because of earnings from their new job. TMA is an important stepping stone in
helping workers and their families successfully transfer from welfare to work
without fear of losing vital health coverage.
Child Care
Child
Care has played an important role in the success of welfare reform by providing
parents the support they need to work. The President's Budget recognizes this
critical link and maintains a high level of commitment to childcare. Continuing
the substantial increase in funding that Congress has provided over the last
several years, the President's Budget includes a total of $4.8 billion in
childcare funding in conjunction with our request to reauthorize the mandatory
and discretionary funding provided under the Child Care and Development Block
Grant and the Child Care Entitlement. States will also continue to have
significant flexibility under the TANF program and under the Social Services
Block Grant program to address the needs of their low-income working families.
These additional funding opportunities have substantially increased the amount
of resources dedicated to child care needs. For example, in FY 2000 States
transferred $2.3 billion in TANF funds to the Child Care and Development Block
Grant.
Child Support Enforcement
The Child Support Enforcement
program offers another vital connection to families' ability to achieve
self-sufficiency and financial stability. The President's Budget proposes to
increase child support collections and direct more of the support collected to
families transitioning from welfare. Under our proposal, the Federal government
would share in the cost of expanded State efforts to pass through child support
collections to families receiving TANF. Pass through payments enhance a family's
potential for achieving self-sufficiency while also creating incentives for
non-custodial parents to pay support and custodial parents to cooperate in
securing support. Similarly, States would be given the option to adopt
simplified distribution rules that ease State administration but, more
importantly, benefit families that have transitioned from welfare by directing
support otherwise retained by the State and Federal governments to these
families.
Overall collections would be increased by expanding our
successful program for denying passports to parents owing $2,500 in past-due
support, requiring States to update support awards in TANF cases every three
years, and authorizing States to offset certain Social Security Administration
payments when they determine such action would be appropriate to collect unpaid
support. Our child support legislative package would also impose a minimal
annual processing fee in any case where the State has been successful in
collecting support on behalf of a family that has never received assistance.
Strengthening Families
The FY 2003 budget contains funds for
four competitive grant programs, targeted at community and faith based
organizations, to assist in delivering innovative services, to strengthen
families and help change lives. The Compassion Capital Fund, at $100 million,
will expand the capacity of groups and organizations willing to step up and help
provide these critical social services. $20 million is included to promote
responsible fatherhood by providing competitive grants to organizations that
work to strengthen the role that fathers play in their children's and family's
lives. The budget also supports $25 million in new authority for the mentoring
children of prisoners initiative first proposed last year. Finally, young
pregnant mothers and their children will be provided safe environments through
the $10 million included for Maternity Group Homes.
Promoting Safe and
Stable Families
The President's Budget would increase the funding level
for this program to $505 million, fully supporting the increased authorization
included in the new law. These funds will be used to help promote and support
adoption so that children can become part of a safe and stable family, as well
as for increased preventive efforts to help families in crisis.
This
landmark legislation also authorized a new program to provide vouchers to youth
who are aging out of foster care so that they can obtain the education and
training they need to lead productive lives. The President's Budget includes $60
million for these vouchers, bringing the total request for the Foster Care
Independence Program to $200 million.
Child Welfare/Foster Care/Adoption
Our budget framework includes resources for a number of additional
programs targeted to protecting our most vulnerable and at-risk children. Foster
Care, Adoption Assistance, Adoption Incentives and Child Welfare Services are
designed to enhance the capacity of families to raise children in a nurturing,
safe environment. The President's Budget provides resources to help States
provide safe and appropriate care for children who need placement outside their
homes, and to provide funds to States to assist in providing financial and
medical assistance for adopted children with special needs who cannot be
reunited with their families, and to reward States for increasing their number
of adoptions. At the same time, the budget also supports Child Welfare Services
programs with the goal of keeping families together when possible and in the
best interest of the child.
The budget provides nearly $4.9 billion for
Foster Care, $1.6 billion for Adoption Assistance, and $43 million in Adoption
Incentive funds. In addition, the President's Budget seeks almost $300 million
in funding for child welfare services and training. Together, these funds will
support improvement in the healthy development, safety, and well being of the
children and youth in our nation.
Abstinence Education
The
President's Budget proposes to reauthorize $50 million in mandatory funding for
abstinence education grants to States. These resources complement the proposed
$73 million in abstinence education grants to community-based organizations and
Adolescent Family Life's CARE grants ($12 million). Both grant programs will
continue to support the message, through mentoring, counseling and adult
supervision, that abstinence from sexual activity is the only sure way for teens
to avoid out-of-wedlock pregnancies and sexually transmitted diseases.
Repatriation
Finally, our commitment to supporting America's
families does not stop at our borders. The President's Budget seeks $1 million
in funding for the Repatriation program to assist U.S. citizens and their
dependents returning from foreign countries under extreme circumstances.
INCREASING ACCESS TO HEALTHCARE
The issues that have confronted
the nation in the past six months will have far reaching effects. Of all the
issues confronting this Department, none has a more direct effect on the
well-being of our citizens than the quality and accessibility of health care.
Our budget proposes to improve the health of the American people by taking
important steps to increase and expand the number of Community Health Centers,
strengthen Medicaid, and ensure patient safety.
Community Health Centers
provide family oriented preventive and primary health care to over 11 million
patients through a network of over 3,400 health sites. The FY 2003 budget will
increase and expand the number of health center sites by 170, the second year of
the President's initiative is to increase and expand sites by 1,200 and serve an
additional 6.1 million patients by 2006. We propose to increase funding for
these Community Health Centers by $114 million in FY 2003. Our long-term goal is
to increase the number of people who receive high quality primary healthcare
regardless of their ability to pay. With these new health centers we hope to
achieve this goal.
The Medicaid program and the State Children's Health
Insurance Program (SCHIP) provide health care benefits to low-income Americans,
primarily children, pregnant women, the elderly, and those with disabilities.
The FY 2003 budget we propose strengthens the Medicaid and SCHIP programs by
implementing essential reforms, such as the extension of expiring SCHIP funds.
As a first step, we propose to develop legislative proposals that build
on the Health Insurance Flexibility and Accountability (HIFA) demonstration
initiative, which would give states the flexibility they need to design
innovative ways of increasing access to health insurance coverage for the
uninsured. In addition to HIFA, the Administration's plan would allow those who
receive the President's health care tax credit to increase their purchasing
power by purchasing insurance from plans that already participate in their
State's Medicaid, Children's Health Insurance, or State employees' programs.
This could help keep costs down and provide a more comprehensive benefit than
plans in the individual market.
We also need to make an effort to narrow
the drug treatment gap. As reflected in the National Drug Control Strategy,
Substance Abuse and Mental Health Services Administration estimates that 4.7
million people are in need of drug abuse treatment services. However, fewer than
half of those who need treatment actually receive services, leaving a treatment
gap of 3.9 million individuals. Our budget supports the President's Drug
Treatment initiative, and to narrow the treatment gap. We propose to increase
funding for the initiative by $127 million. These additional funds will allow
States and local communities to provide treatment services to approximately
546,000 individuals, an increase of 52,000 over FY 2002.
STRENGTHENING
MEDICARE
The FY 2003 budget dedicates $190 billion over ten years for
immediate targeted improvements and comprehensive Medicare modernization,
including a subsidized prescription drug benefit, better insurance protection,
and better private options for all beneficiaries. Last year, President Bush
proposed a framework for modernizing and improving the Medicare program that
built on many of the ideas that had been developed in this Committee and by
other Members of Congress. That framework includes the principles that:
All seniors should have the option of a subsidized prescription drug
benefit as part of modernized Medicare.
Modernized Medicare should
provide better coverage for preventive care and serious illness.
Today's
beneficiaries and those approaching retirement should have the option of keeping
the traditional plan with no changes.
Medicare should make available
better health insurance options, like those available to all Federal employees.
Medicare legislation should strengthen the program's long-term financial
security.
The management of the government Medicare plan should be
strengthened to improve care for seniors.
Medicare's regulations and
administrative procedures should be updated and streamlined, while instances of
fraud and abuse should be reduced.
Medicare should encourage
high-quality health care for all seniors.
The improvements the President
and I have proposed include not only a subsidized drug benefit as part of
modernized Medicare, but also better coverage for preventive care and serious
illness. Thus, we propose that preventive benefits have zero co-insurance and be
excluded from the Part B deductible. We must make these improvements to more
effectively address the health needs of seniors today and for the future.
Let me assure you, the President remains committed to the framework he
introduced last summer, and to bringing the Medicare program up to date by
providing prescription drug coverage and other improvements. We cannot wait: it
is time to act. Recognizing that there is no time to waste, the President's
Budget also includes a series of targeted immediate improvements to Medicare.
As you know, last year the President proposed the creation of a new
Medicare-endorsed prescription drug card program to reduce the cost of
prescription drugs for seniors. This year, HHS will continue its work on a drug
card program, which will give beneficiaries immediate savings on the cost of
their medicines and access to other valuable pharmacy services. The President is
absolutely committed to providing immediate assistance to seniors who currently
have to pay full price for prescription drugs.
Assistance, however, will
not come only through the prescription drug card program. The budget proposes
several new initiatives to improve Medicare's benefits and address cost. This
budget proposes additional federal assistance for comprehensive drug coverage to
low-income Medicare beneficiaries up to 150% of poverty - about $17,000 for a
family of two. This policy would eventually expand drug coverage for up to 3
million beneficiaries who currently do not have prescription drug assistance,
and it will be integrated with the Medicare drug benefit that is offered to all
seniors once that benefit is in place. This policy helps to establish the
framework necessary for a
Medicare prescription drug benefit
and is essentially a provision that is in all of the major drug benefit
proposals to be debated before Congress. That is, the policy provides new
Federal support for comprehensive prescription drug coverage for low-income
seniors up to 150 percent of poverty. And in all the proposals, the Federal
government would work with the States to provide this coverage, just as we are
proposing with this policy.
Recently, I announced a model drug waiver
program-Pharmacy Plus- to allow States to reduce drug expenditures and expand
drug only coverage to seniors and certain individuals with disabilities with
family incomes up to 200 percent of the federal poverty level. This program is
being done administratively. The recently approved Illinois initiative
illustrates how states can expand coverage to Medicare beneficiaries in
partnership with the federal government. The Illinois program will give an
estimated 368,000 low-income seniors drug coverage. The model application I have
announced is easy to understand and use, and the Centers for Medicare and
Medicaid Services is working with numerous States-at least 12-that have already
expressed interest in this program. Making it easier for States to take similar
steps to help their citizens who need help the most is the goal I believe we all
share.
The President's Budget also includes an increase in funding to
stabilize and increase choice in the Medicare+Choice program by aligning payment
rates more closely with overall Medicare spending and paying incentives for new
types of plans to participate. Over 500,000 seniors lost coverage last year
because Medicare+Choice plans left the program. Today over 5 million seniors
choose to receive quality health care through the Medicare+Choice program.
Because it provides access to drug coverage and other innovative benefits, it is
an option many seniors like, and an option we must preserve. The President's
Budget also proposes the addition of two new Medigap plans to the existing 10
plans. These new plans will include prescription drug assistance and protect
seniors from high out-of-pocket costs.
Some of these initiatives give
immediate and tangible help to seniors. But, let me make clear: these are not
substitutes for comprehensive reform and a universal drug benefit in Medicare.
They are immediate steps we want to take to improve the program in conjunction
with comprehensive reform, so that beneficiaries will not have to wait to begin
to see benefit improvements. I want to pledge today to work with each and every
member of this Committee to fulfill our promise of health care security for
America's seniors- now and in the future.
This budget proposes a $1.50
charge for submitting paper or duplicate claims as an incentive for providers to
submit electronic claims one time only. These proposals will help reduce claims
processing costs and ultimately speed up payment of claims. I recognize that a
few health care providers in disadvantaged circumstances may have to submit a
paper claim. This proposal will allow me to waive this requirement for providers
in rural areas or those providers whose special circumstances make it difficult
to comply with submission requirements. Together, these fees generate $130
million in FY 2003. The Paper claims fee is expected to produce $70 million in
FY 2003. In future years, we expect the amount of the fee collected to decrease
as more providers submit electronic claims. The Duplicate and unprocessable
claims fee is expected to produce $60 million in FY 2003. The effective date for
each proposal is March 1, 2003 to allow time for CMS to modify systems to
incorporate this change. Each proposal amount represents 7 months of fee
collections.
SUPPORTING HEALTHY COMMUNITIES
The FY 2003 budget
includes $20 million for a Healthy Communities Innovation Initiative - a new
interdisciplinary services effort that will concentrate Department-wide
expertise on the prevention of diabetes and asthma, as well as obesity. The
purpose of the initiative is to reduce the incidence of these diseases and
improve services in 5 communities through a tightly coordinated public/private
partnership between medical, social, educational, business, civic and religious
organizations. These chronic diseases were chosen because of their rapidly
increasing prevalence within the United States. In addition there is $5 million
for related activities in CDC.
More than 16 million Americans currently
suffer from a preventable form of diabetes. Type II diabetes is increasingly
prevalent in our children due to the lack of activity. In a recent study
conducted by NIH, participants that were randomly assigned to intensive
lifestyle intervention experienced a reduced risk of getting Type II diabetes by
58 percent. HHS plans to reach out to women and minorities to help make this
initiative a success.
IMPROVING MANAGEMENT AND PERFORMANCE OF HHS
PROGRAMS
I am committed to being proactive in preparing the nation for
potential threats of bioterrorism and supporting research that will enable
Americans to live healthier and safer lives. And, I am excited about beginning
the next phase of Welfare reform and strengthening our Medicare and Medicaid
programs. Ensuring that HHS resources are managed properly and effectively is
also a challenge I take very seriously.
For any organization to succeed,
it must never stop asking how it can do things better, and I am committed to
supporting the President's vision for a government that is citizen-centered,
results oriented, and actively promotes innovation through competition. HHS is
committed to improving management within the Department and has established its
own vision of a unified HHS -- One Department free of unnecessary layers,
collectively strong to serve the American people. The FY 2003 budget supports
the President's Management Agenda.
The Department will improve program
performance and service delivery to our citizens by more strategically managing
its human capital and ensuring that resources are directed to national
priorities. HHS will reduce duplication of effort by consolidating
administrative management functions and eliminating management layers to speed
decision-making. The Department plans to reduce the number of personnel offices
from 40 to 4; centralize the public affairs and legislative affairs functions;
and consolidate construction funding, leasing, and other facilities management
activities. These management efficiencies will result in an estimated savings of
700 full time equivalent positions, allowing the Department to redeploy staff
and other resources to line programs.
HHS continues to be at the
forefront of the Government-wide effort to integrate budget and performance. We
were one of the first Departments to add tables to its GPRA Annual Performance
Reports that provide summary tables that associate resource dollars and
performance measures HHS-wide. Although we work in a challenging environment
where health outcomes may not be apparent for several years, and the Federal
dollar may be just one input to complex programs, HHS is committed to
demonstrating to citizens the value they receive for the tax dollars they pay.
By expanding our information technology and by establishing a single
corporate Information Technology Enterprise system, HHS can build a strong
foundation to re-engineer the way we do business and can provide better
government services at reduced costs. By consolidating and modernizing existing
financial management systems our Unified Financial Management System (UFMS) will
provide a consistent, standardized system for departmental accounting and
financial management. This "One Department" approach to financial management and
information technology emphasizes the use of resources on an enterprise basis
with a common infrastructure, thereby reducing errors and enhancing
accountability. The use of cost accounting will aid in the evaluation of HHS
program effectiveness, and the impacts of funding level changes on our programs.
HHS is also committed to providing the highest possible standard of
services and will use competitive sourcing as a management tool to study the
efficiency and performance of our programs, while minimizing costs overall. The
program will be linked to performance reviews to identify those programs and
program components where outsourcing can have the greatest impact. Further, the
incorporation of performance-based contracting will improve efficiency and
performance at a savings to the taxpayer.
GOVERNMENT PERFORMANCE AND
RESULTS ACT
HHS is committed to continual improvement in the performance
and management of its programs and the Administration's efforts to provide
results-oriented, citizen-centered government. The budget request for FY 2003 is
accompanied by annual performance plans and reports required by the Government
Performance and Results Act (GPRA). The performance measures cover the wide
range of program activities essential to carrying out the HHS mission. Some
notable FY 2001 achievements include:
Reducing Erroneous Medicare
Payments: CMS has continued to reduce the payment error rate from 14 percent in
FY 1996 to 8 percent in FY 1999, 6.8 percent in FY 2000, and 6.3% in FY 2001.
CMS, with the assistance of the Office of the Inspector General, is committed to
further reducing the error rate to 5 percent by FY 2002.
Moving Families
Toward Self-sufficiency: ACF reported that 42.9 percent of adult recipients of
TANF were employed by FY 1999. This is a primary indicator of success in moving
families toward self-sufficiency. It improves on the FY 1998 baseline of 38.7
percent and exceeds the target of 42 percent.
Families Benefiting from
Child Support Enforcement: The Child Support Enforcement program broke new
records nationwide in FY 2001 by collecting $18.9 billion, one billion over FY
2000 levels. In one such initiative in FY 2000, the government collected a
record $1.4 billion in overdue child support from Federal income tax refunds,
and more than 1.42 million families benefited from these collections.
These are just a few of the dozens of impressive success stories found
in the 13 performance plans and reports. GPRA has been and will continue to be
an important part of our effort to improve the management and performance of our
programs.
WORKING TOGETHER TO ENSURE A SAFE AND HEALTHY AMERICA
Mr. Chairman, the budget I bring before you today contains many
different elements of a single proposal; what binds these fundamental elements
together is the desire to improve the lives of the American people. All of our
proposals, from building upon the successes of welfare reform, to protecting the
nation against bioterrorism; from increasing access to healthcare, to
strengthening Medicare, are put forward with the simple goal of ensuring a safe
and healthy America. I know this is a goal we all share, and with your support,
we are committed to achieving it.
LOAD-DATE:
March 5, 2002