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Ronald Reagan Presidential Library
Digital Library Collections
This is a PDF of a folder from our textual collections.
Collection: President, Office of the: Presidential
Briefing Papers: Records, 1981-1989
Folder Title: 01/03/1984 (case file 273336)
Box: 38
To see more digitized collections
visit: https://reaganlibrary.gov/archives/digital-library
To see all Ronald Reagan Presidential Library inventories visit:
https://reaganlibrary.gov/document-collection
Contact a reference archivist at: [email protected]
Citation Guidelines: https://reaganlibrary.gov/citing
National Archives Catalogue: https://catalog.archives.gov/
Jy
Page 101
ID # 273336
WHITE HOUSE
OFFICE OF RECORDS MANAGEMENT
WORKSHEET
X-MEDIA
H-INTERNAL
Name of Document: BRIEFING PAPERS
FOR PRESIDENTS
Subject Codes:
SCHEDULED
APPOINTMENTS FOR
JAN0384
PR 007 - 01
Ds Subject: Meeting regarding the first draft
SP 230 - 84
of the State of The Union address
FI 001 - 01
FG
010 - 02
2) Meeting regarding an analysis of
HE 001 -
revenue projections performance and
ED
-
JL 005 -
FI
004 -
3) mgeting of the Cabinet Council onHuman
FG 035 -
Resources to discuss:
I
A) liver transplantation
I
B) school violence / discipline report
-
by the CCHR Working Group
-
-
4) Fiscal Senators: year 1985 Badget meeting with
-
-
A) Howard Baker
-
B) Robert Dole
-
C) Pete Domenici
-
ROUTE TO:
ACTION
DISPOSITION
Office/Agency
(Staff Name)
Action
Tracking Date
Type of
Completion Date
Code
YY/MM/DD
Response
Code
YY/MM/DD
RMHENL
RSZ
C
Referral Note:
The President has seen
THE SCHEDULE OF
PRESIDENT RONALD REAGAN
Tuesday, January 3, 1984
9:00 am
Staff Time
Oval Office
(30 min)
(Baker/Meese/Deaver)
9:30 am
National Security Briefing
Oval Office
(15 min)
(McFarlane)
9:45 am
Senior Staff Time
Oval Office
(15 min)
10:00 am
Personal Staff Time
Oval Office
(50 min)
10:50 am
Meeting with Ambassador
Oval Office
(10 min)
Donald Rumsfeld
(McFarlane)
11:00 am
NSPG Meeting
Situation Room
(60 min)
(McFarlane)
12:00 m
Lunch
Oval Office
(60 min)
1:00 pm
Budget Meeting
Roosevelt Room
(60 min)
(Darman/Fuller)
2:00 pm
Meetings with Cabinet Council
Cabinet Room
(60 min)
on Human Resources and Cabinet
Council on Natural Resources
and Environment
(Fuller)
3:00 pm
Meeting with Senators
Oval Office
(45 min)
Dole, Baker and Domenici
(Oglesby)
3:45 pm
Personal Staff Time
Oval Office
(45 min)
4:30 pm
Meeting on State of the
Oval Office
(30 min)
Union Address
(Darman)
REVISED
UNP 01/03/84
9:30 am
THE SCHEDULE OF
PRESIDENT RONALD REAGAN
Tuesday, January 3, 1984
9:00 am
Staff Time
Oval Office
(30 min)
(Baker/Meese/Deaver)
9:30 am
National Security Briefing
Oval Office
(15 min)
(McFarlane)
9:45 am
Senior Staff Time
Oval Office
(15 min)
10:00 am
Personal Staff Time
Oval Office
(60 min)
11:00 am
NSPG Meeting
Situation Room
(60 min)
(McFarlane)
12:00 m
Lunch
Oval Office
(60 min)
1:00 pm
Budget Meeting
Roosevelt Room
(60 min)
(Darman/Fuller)
(TAB A)
2:00 pm
Meetings with Cabinet Council
Cabinet Room
(60 min)
on Human Resources and Cabinet
Council on National Resources
and Environment
(Fuller)
(TAB B)
3:00 pm
Meeting with Senators
Oval Office
(45 min)
Dole, Baker and Domenici
(Oglesby)
(TAB C)
3:45 pm
Personal Staff Time
Oval Office/
Remainder of the Afternoon
Residence
UNP 12/30/83
4:00 pm
MEMORANDUM
THE WHITE HOUSE
WASHINGTON
January 12, 1984
TO:
DAVE FISCHER
FROM:
PAM TURNER
A
SUBJECT:
Attendance at Meeting with the President
The following individuals attended a meeting with the President on
January 3, 1984 at 3:00 p.m. ( 45 minutes) in the Oval Office
to discuss the FY '85 budget:
The Vice President
Senator Howard Baker (R-Tennessee)
Senator Robert Dole (R-Kansas)
Senator Pete Domenici (R-New Mexico)
OMB Director David Stockman
Staff
James A. Baker III
Edwin Meese III
Richard Darman
M.B. Oglesby
THE SCHEDULE OF
PRESIDENT RONALD REAGAN
Tuesday, January 3, 1984
9:00 am
Staff Time
Oval Office
(30 min)
(Baker/Meese/Deaver)
9:30 am
National Security Briefing
Oval Office
(15 min)
(McFarlane)
9:45 am
Senior Staff Time
Oval Office
(15 min)
10:00 am
Personal Staff Time
Oval Office
(50 min)
10:50 am
Meeting with Ambassador
Oval Office
(10 min)
Donald Rumsfeld
(McFarlane)
11:00 am
NSPG Meeting
Situation Room
(60 min)
(McFarlane)
12:00 m
Lunch
Oval Office
(60 min)
1:00 pm
Budget Meeting
Roosevelt Room
(60 min)
(Darman/Fuller)
2:00 pm
Meetings with Cabinet Council
Cabinet Room
(60 min)
on Human Resources and Cabinet
Council on Natural Resources
and Environment
(Fuller)
3:00 pm
Meeting with Senators
Oval Office
(45 min)
Dole, Baker and Domenici
(Oglesby)
3:45 pm
Personal Staff Time
Oval Office
(45 min)
4 -
4:30 pm
Meeting on State of the
Oval Office
(30 min)
Union Address
(Darman)
REVISED
UNP 01/03/84
9:30 am
THE SCHEDULE OF
PRESIDENT RONALD REAGAN
Tuesday, January 3, 1984
9:00 am
Staff Time
Oval Office
(30 min)
(Baker/Meese/Deaver)
9:30 am 10:06
National Security Briefing
Oval Office
(15 min)
(McFarlane)
9:45 am
Senior Staff Time
Oval Office
(15 min)
10:00 am
Personal Staff Time
Oval Office
(60 min)
SHULTZ-BUD
10:50 Am
DON ROMSFELD PHOTO
OUNL
11:00 am
NSPG Meeting
Situation Room
(60 min)
(McFarlane)
12:00 m
Lunch
Oval Office
(60 min)
1:00 pm
Budget Meeting
Roosevelt Room
(60 min)
(Darman/Fuller)
(TAB A)
2:00 pm
Meetings with Cabinet Council
Cabinet Room
(60 min)
on Human Resources and Cabinet
Council on National Resources
and Environment
(Fuller)
(TAB B)
3:00 pm
Meeting with Senators
Oval Office
(45 min)
Dole, Baker and Domenici
(Oglesby)
(TAB C)
3:45 pm
Personal Staff Time
Oval Office/
Remainder of the Afternoon
Residence
UNP 12/30/83
4:00 pm
THE SCHEDULE OF
PRESIDENT RONALD REAGAN
Tuesday, January 3, 1984
WHTV
9:00 am
Staff Time
0905-0930
Oval Office
(30 min)
(Baker/Meese/Deaver)
9:30 am
National Security Briefing 0930-
Oval Office
(15 min)
0940
(McFarlane) (McForlane, Poindexter, Baker, Deaver)
Czu from RevJ. Jackson in Suria (9:41-9:51)
9:45 am
Senior Staff Time
Oval Office
(15 min)
10:00 am
Personal Staff Time
Oval Office
(60 min)
Full PHOTOOP
10:50 am
Rumsfeld Photo Op
( Photographer only )
Oval ofc
11:00 am
NSPG Meeting (Shultz, Mcfarlane
Situation Room
(60 min)
(McFarlane)
1100-1245
12:00 m
Lunch 1245-1305
Oval Office
(60 min)
1:00 pm
Budget Meeting
1305-1400
Roosevelt Room
(60 min)
(Darman/Fuller)
(TAB A)
2:00 pm
Meetings with Cabinet Council
1400 -
Cabinet Room
(60 min)
on Human Resources and Cabinet
Council on National Resources
1505
and Environment
(Fuller)
(TAB B)
3:00 pm
Meeting with Senators
1506-1600 1600
Oval Office
(45 min)
Dole, Baker and Domenici
1
(Oglesby)
(TAB C)
3:45 pm
Baker, Mc Failune 1606-1632
Personal Staff Time
Oval Office/
Remainder of the Afternoon
Residence
4:30 pm
Mty on State of the union Address
Oval Ofc
30mm
1632-1648
UNP 12/30/83
4:00 pm
THE WHITE HOUSE
WASHINGTON
MEETING WITH THE PRESIDENT
SUBJECT: STATE OF THE UNION ADDRESS
Tuesday, January 3, 1984
4:30 (30 minutes)
The Oval Office
FROM: RICHARD G. DARMAN
us
I. PURPOSE
This meeting is for you to provide your general reactions to
Ben Elliott's first draft of the State of the Union. In
light of your reactions, and senior staff comments, a
refined draft will be prepared for your review and editing.
II. PARTICIPANTS
The President
/
James A. Baker III
Michael K. Deaver
Richard G. Darman
/
Craig L. Fuller
/
David R. Gergen
/
James E. Jenkins
Michael A. McManus
Bentley Elliott
/
EPS FORM 25
(03/75)
EXECUTIVE PROTECTIVE SERVICE
To: Officer-in-charge
Appointments Center
Room 060, OEOB
Please admit the following appointments on
January 3
, 19 84
for The President
of
White House
:
(Name of person to be visited)
(Agency)
The Vice President's Office:
Mr. Donald P. Gregg
State:
Secretary George P. Shultz
Amb Donald H. Rumsfeld
Dep Sec Kenneth W. Dam
Defense:
Secretary Caspar W. Weinberger
Dr. Fred C. Ikle
CIA:
Mr. William J. Casey
JCS:
General John W. Vessey, Jr.
Admiral Arthur S. Moreau
USUN:
Amb Jeane J. Kirkpatrick
OMB:
Mr. Alton Keel
White House:
NSC:
Mr. Edwin Meese, III
Mr. Donald Fortier
Mr. James A. Baker, III
Mr. Geoffrey Kemp
Mr. Michael K. Deaver
Mr. Robert C. McFarlane
MEETING LOCATION
Building West Wing White House
Requested by Cathy Torgerson
Room No. Situation Room
Room No. 372 Telephone
3044
Time of Meeting 11:00 a.m.
Date of request January 3, 1984
Additions and/or changes made by telephone should be limited to three (3) names or less.
DO NOT DUPLICATE THIS FORM
APPOINTMENTS CENTER: SIG/OEOB - 395-6046 or WHITE HOUSE - 456-6742
THE WHITE HOUSE
WASHINGTON
MEETING WITH THE PRESIDENT
SUBJECT: REVENUE
Tuesday, January 3, 1984
1:00 p.m. (60 minutes)
The Roosevelt Room
FROM:
RICHARD G. DARMAN
1
CRAIG L. FULLER
I. PURPOSE
This is the first of at least two meetings on the subject of
revenue. (Previous budget meetings have concentrated on
outlays.) This meeting will present an analysis of revenue
performance and projections. (The next meeting will
concentrate on options for the '85 budget and beyond.)
II. PARTICIPANTS
The President
Secretary Regan
David A. Stockman
Edwin Meese III
James A. Baker III
Richard G. Darman
Craig L. Fuller
David R. Gergen
M.B. Oglesby
Larry M. Speakes
John A. Svahn
Martin Feldstein
III. AGENDA
Don Regan will lead off. Discussion will follow.
CABINET COUNCIL ON HUMAN RESOURCES
January 3, 1984
PARTICIPANTS
The President
Secretary Heckler, Chairman Pro Tempore
Secretary Regan
The Attorney General
Secretary Clark
Secretary Baldrige
Chairman Feldstein
James Baker, Chief of Staff and Assistant to the President
Jack Svahn
Deputy Secretary Lyng
(Representing Secretary Block)
Under Secretary Abrams
(Representing Secretary Pierce)
Deputy Secretary Burnley
(Representing Secretary Dole)
Under Secretary Collins
(Representing Secretary Hodel)
Under Secretary Jones
(Representing Secretary Bell)
Deputy Director Wright
(Representing Director Stockman)
Deputy Administrator Alvarez
(Representing Administrator Walters)
Richard Darman, Assistant to the President and Deputy to the
Chief of Staff
Craig Fuller, Assistant to the President for Cabinet Affairs
James Jenkins, Deputy Counsellor to the President
Larry Speakes, Assistant to the President and Principal Deputy
Press Secretary
Lee Verstandig, Assistant to the President for Intergovernmental
Affairs
Paul Simmons, Executive Secretary
Don Clarey, Associate Director, Office of Cabinet Affairs
For Presentation:
Edward Brandt, Assistant Secretary for Health, HHS
John Cogan, Associate Director, Human Resources, Veterans, and
Labor, OMB
Michael Horowitz, Counsel to the Director and General Counsel
OMB
Gary Bauer, Deputy Under Secretary for Policy, Budget and
Evaluation, Department of Education
Alfred Regnery, Administrator, Juvenile Justice and Delinquency
Prevention, Department of Justice
Additional Attendees:
Michael Baroody, Deputy Assistant to the President and Director
of Public Affairs
Jack Courtemanche, Deputy Assistant to the President for Public
Liaison
Kenneth Cribb, Assistant Counsellor to the President
Becky Norton Dunlop, Deputy Assistant to the President for
Presidential Personnel
Nancy Risque, Special Assistant to the President for Legislative
Affairs
William Roper, Special Assistant to the President for Health
Policy, OPD
Steve Rhodes, Assistant to the Vice President for Domestic Policy
Tom Komarek, Assistant Secretary of Labor for Administration and
Management
THE WHITE HOUSE
WASHINGTON
MEETING WITH THE PRESIDENT
SUBJECT: REVENUE
Tuesday, January 3, 1984
1:00 p.m. (60 minutes)
The Roosevelt Room
FROM:
RICHARD G. DARMAN
run.
CRAIG L. FULLER
I. PURPOSE
This is the first of at least two meetings on the subject of
revenue. (Previous budget meetings have concentrated on
outlays.) This meeting will present an analysis of revenue
performance and projections. (The next meeting will
concentrate on options for the '85 budget and beyond.)
II. PARTICIPANTS
The President
Secretary Regan
David A. Stockman
Edwin Meese III
James A. Baker III
Richard G. Darman
Craig L. Fuller
David R. Gergen
M.B. Oglesby
Larry M. Speakes
John A. Svahn
Martin Feldstein
III. AGENDA
Don Regan will lead off. Discussion will follow.
THE WHITE HOUSE
WASHINGTON
December 28, 1983
MEETING OF THE CABINET COUNCIL ON HUMAN RESOURCES
DATE:
January 3, 1984
LOCATION:
The Cabinet Room
TIME:
2:00 pm (60 minutes)
FROM:
Craig L. Fuller
as
I.
PURPOSE
To discuss Administration policy regarding liver
transplantation and to receive the report of the CCHR
Working Group on School Violence/Discipline.
II. BACKGROUND
There are three major questions to be resolved on liver
transplantation. First, while it has become the consensus
of medical experts that this procedure is no longer
experimental, especially for children with congenital
conditions, broad policy questions with large long-range
cost implications must be addressed to make these procedures
eligible for medicare, medicaid, and private insurance
reimbursement. Second, is the question of whether the
government or voluntary agencies will be responsible as the
clearinghouse for organ transplantation. Third, is the
question of the buying and selling of organs. This entire
issue is highly emotional as well as politically sensitive.
The report of the CCHR Working Group on School Violence/
Discipline is timely. This report sets forth a proposed
agenda of Presidential leadership that follows-up your
initiative taken in response to the Commission on Excellence
Report. Principal recommendations are: address this
problem in the State of the Union, convene a meeting with
individuals identified with reform in this area, and visit a
school where discipline has been restored.
III. PARTICIPANTS
A list of attendees will be attached to the agenda
IV. PRESS PLAN
None
V.
SEQUENCE OF EVENTS
You will enter the Cabinet Room, take your seat and open the
meeting. Liver transplantation will be discussed first,
followed by the school violence working group report.
HEALTH
HUMAN
THE SECRETARY OF HEALTH AND HUMAN SERVICES
WASHINGTON, D.C. 20201
USA
DEC 16 1983
MEMORANDUM FOR THE CABINET COUNCIL ON HUMAN RESOURCES
FROM:
MARGARET M. HECKLER
Think
SUBJECT: Liver Transplantation and Related Issues
(CM429)
ISSUE
What should be the Administration policy on liver transplants and related
subjects?
BACKGROUND
In 1980, the PHS assessed liver transplantation as "experimental" which pre-
cluded HCFA from including the procedure as a reimbursable technique (cite).
In April 1982, the Health Care Financing Administration asked the Public Health
Service to reassess the safety and efficacy of liver transplantation in light of
new technology, drug therapy, clinical trials, etc.
Because of the complex scientific issues, the National Institutes of Health
convened a Consensus Development Conference in June 1983, in which the skills,
resources and institutional support needed for liver transplantation were
discussed. The consensus of the participants was that "liver transplanta-
tion offers an alternative therapeutic approach which may prolong life in some
patients suffering from severe liver disease that has progressed beyond the
reach of currently available treatment and consequently carries a prognosis of
death". However, it was also the consensus that in many forms of liver disease,
the precise indications and timing of liver transplantation remain uncertain or
controversial. With materials from these and other sources, the Office of
Health Technology Assessment developed its report as to the safety and efficacy
of liver transplantation. The report indicates that significant advances have
been made in human liver transplantation so that it can be performed safely and
effectively: a) in carefully selected patients with certain forms of end-stage
liver disease, b) by transplant surgeons specifically trained to perform the
procedures, and c) in hospitals having special arrangements to support the
process.
There are four related issues to be resolved on this question. First, the
legality of buying and selling solid organs. Second, whether the government
or voluntary agencies will be responsible for donor identification, recipient
coordination and transportation of organs. Third, whether Medicare will cover
liver transplantation. Fourth, the composition and structure of an advisory
committee to address the bio-ethical, legal, economic and social questions
concerning organ transplantation.
Not discussed in this paper are the fiscal implications of coverage decisions
according to varying populations. It is the presumption of this Department that
the medical-scientific questions should be the driving force behind the decisions
leading to a federal policy on organ transplantation.
Page 2
STATEMENT OF THE ISSUES AND OPTIONS
ISSUE I: The Buying and Selling of Organs
1. Ban the buying and selling of solid organs whether from a living donor or
from a cadaver.
2. Oppose federal action on the buying and selling of organs.
ISSUE II: Organ Procurement Clearinghouse
1. Federal organ procurement agency.
2. Private sector clearinghouse with Federal participation.
ISSUE III: Medicare Coverage for Liver Transplantation
1. Accept the findings of the NIH consensus conference as a basis for coverage
guidelines and limit procedures to institutions with special capacities.
2. Cover persons with Biliary Atresia and conduct clinical trials for others.
3. Establish broad clinical trials involving 224 cases (adults and children).
ISSUE IV: Transplantation Advisory Committee
1. This committee should be appointed by the President.
2. This committee should be appointed by the Secretary.
ISSUE I: The Buying and Selling of Organs
During this session of Congress, Senator Orrin G. Hatch (R-Utah) and Congressman
Albert T. Gore, Jr., (D-Tennessee) introduced separate pieces of legislation to
impose a federal ban on the buying and selling of solid human organs, such as
livers, kidneys, corneas, hearts, lungs, pancreas and bone.
On December 6, 1983 the American Medical Association (AMA) joined the American
Society of Transplant Surgeons, the National Kidney Foundation, the National
Association of Patients on Hemodialysis and Transplantation in "opposing the
sale of non-renewable, transplantable organs for the purpose of profit..." In
addition the AMA Judicial Council stated "The voluntary donation of organs in
appropriate circumstances is commendable and is to be encouraged. However, it
is not ethical to participate in a procedure to enable a donor to receive pay-
ment, other than for the reimbursement of expenses necessarily incurred in
connection with removal, for any of the donors non-renewable organs."
OPTIONS
1. Ban the buying and selling of solid organs whether from a living donor or
from a cadaver. (Such a ban would not preclude payment for the cost of
locating, harvesting, transporting, storing, matching or transplanting.)
ARGUMENTS FOR:
-- The buying and selling of organs regardless of the source appears
morally and ethically repugnant to most of society; sanctioning the
profitable trafficking in body parts would be unseemly for this Admini-
stration. Moreover, in the case of living donors selling organs,
Page 3
medical ethics would appear to be violated: physicians performing
the subsequent transplants would be de facto sanctioning potentially
dangerous medical procedures for the healthy donors who have no
familial ties to the recipient.
- This would protect individuals unable to make informed decisions
(retarded, etc.) from being exploited for profit.
- Commercialization might give donors an incentive to conceal medical
history leading to inappropriate organs being transplanted.
-- Public insurance, Medicare and Medicaid would pay for such transactions,
requiring the need for a federal regulatory effort.
ARGUMENTS AGAINST:
- Potential donors would be unable to sell organs with the intent of
giving them to survivors or to charitable causes (non-sale transfer
would of course remain an option).
- The number of organs available might diminish, assuming the cash
incentive would increase the number of donors.
--
A ban at the federal level could be regarded as intervention in the
regulation of medical practice, traditionally performed by the states.
- A ban has the potential for creation of a black market for transplant-
able organs.
2. Oppose Federal Action on the Buying and Selling of Organs
ARGUMENTS FOR:
- Avoids the need for Federal enforcement efforts.
- Permits the maximum personal liberty in choosing organ disposal whether
for profitable, charitable or medical purposes.
- Allows States to regulate this activity (to date, no States have laws
applicable to this).
ARGUMENTS AGAINST:
- Places young, poor, bereaved and mentally incompetent persons at risk
of exploitation.
--- Not consistent with efforts to achieve orderly and safe utilization of
organs using clinical criteria.
- Due to the inter-state use of organs, Federal action is necessary to
avoid conflicting State standards.
Page 4
ISSUE II: Organ Procurement Clearinghouse
TO provide the most efficient use of scarce human organs, it is necessary to
have a mechanism for matching donors and potential recipients. Since solid
human organs have a short period of viability, it is essential that such a
clearinghouse be operated continuously, as is currently available for kidneys.
TO assist the establishment of such a system for the other organs and to develop
a mechanism for encouraging organ donation, the Surgeon General convened two
workshops involving organ procurement agencies, transplant surgeons and other
private sector organizations concerned with organ transplantation. From these
conferences, the American Council on Transplantation was formed.
1. Federal Organ Procurement Agency.
ARGUMENTS FOR:
- Reflects clear Federal commitment to a leadership role.
- Provides somewhat better potential for uniform data collection.
-- More likely to approach uniform, universal coverage and access.
ARGUMENTS AGAINST:
- Creates the potential for political intrusion into the process of organ
procurement.
- Creates Federal intrusion into an area where voluntary groups have
already demonstrated effective, coordinated action.
--- Reduces incentive for local or regional participation in the process.
2. Private Sector Clearinghouse With Federal Participation.
ARGUMENTS FOR:
- American Council on Transplantation provedes an effective mechanism
reflecting broad-based participation by all major parties of interest.
-
Established regional organizations are already providing an effective
harvesting and referral service and can be readily integrated for added
effectiveness for multiple organ harvests from appropriate available
donors.
- Avoid another layer of decision-makers in this process.
Page 5
ARGUMENTS AGAINST:
- Will be perceived by some as an unwillingness for the Federal government
to assume responsibility.
- May stimulate jurisdictional disputes between existing organ harvest
and referral organizations.
ISSUE III: Medicare Coverage for Liver Transplantation
There are a significant number of medical conditions leading to end-stage liver
disease for which liver transplantation offers the only alternative to death.
Even then, the palliative potential of transplantation is likely to be effective
only for certain causes of end-stage liver disease in selected patients, when
performed by experienced surgical teams with appropriate supportive ancillary
services.
Even under optimal circumstances, serious questions remain to be addressed to
assure that diffusion of this technology occurs in an orderly fashion which
avoids subjecting patients to unnecessary risks and puts scarce institutional
resources to use for those individuals who have the optimal chance to be helped.
1. Accept the Findings of the NIH Consensus Conference as a Basis for Coverage
Guidelines and Limit Procedures to Institutions With Special Capacities
According to the conference, patients with the following diseases are most
likely to benefit. Other causes do exist and would be assessed on a case-
by-case basis:
Biliary Atresia
Chronic Active Hepatitis
Primary Biliary Cirrhosis
Type 1 Antitrypsin Globulin Deficiency (Pi ZZ)
Wilsons Disease
Crigler-Najjar Syndrome
Miscellaneous Metabolic Liver Diseases
Primary Sclerosing Cholangitis
Patients whose medical conditions would be least likely to be improved
by transplantation include:
malignancy metastatic to liver or where the malignancy extends
beyond the liver
viral induced liver disease if persisting virus is present
alcoholics not in remission
active substance abusers
diseases likely to recur in the transplanted organ
Note that this population is limited to those conditions outined above;
for instance, those with liver malignancies or for "reformed" alcoholics
transplantation is likely to be beneficial.
Page 6
ARGUMENTS FOR:
- Guidelines were decided by panel of experts.
- Broad level of acceptance in significant parts of the medical
community.
- Identifies broad outlines of groups likely to benefit (i.e.,
children with biliary atresia).
- Excludes on clinical grounds specific groups unlikely to
benefit.
-- Has potential for restricting the number of centers likely to
perform the procedure to those with special preparation and
facilities.
ARGUMENTS AGAINST:
- Medical knowledge continues to expand; it is not known which
individuals may best benefit from this procedure.
-- The long term survivability of transplant recipients is unclear.
- Scientific questions may remain unanswered since no guarantee
exists that data collection would occur.
- Legal issues may arise by excluding alcoholics and substance
abusers (Section 504) despite basis for exclusion being medical.
2. Cover Persons with Biliary Atresia and Conduct Clinical Trials for
Others.
ARGUMENTS FOR:
- Largest single category of diseases with both natural history
data and transplant data, thus, adequate information is avail-
able to proceed.
- Coverage for Biliary Atresia supportable by consensus con-
ference.
- Any further information needed on Biliary Atresia can be
derived from nearly 100 cases with this diagnosis already
transplanted.
-- No group of adults large enough to reach meaningfully
scientific conclusion exists, except malignancy which has
negative experience. More data necessary for other diseases.
- This procedure currently covered under Medicaid at State option.
Page 7
ARGUMENTS AGAINST:
-
Would not answer many questions about Biliary Atresia, such as:
who might benefit from Kasai procedure (an alternative to trans-
plantation) and
when Kasai procedure is followed, successful or not, should trans-
plant be done.
-
No greater overall experience with children than adults:
55% cases, children
45% cases, adults.
3. Establish Broad Clinical Trials Involving 224 Cases (Adults and Children).
Certain critical questions remain which, when answered, would enable the
Secretary to make a decision based on better information than is currently
available while continuing to allow transplantation for those patients who
we now believe would benefit. The critical questions presented below re-
present a framework for a collaborative study of liver transplant criterion
in both the long and the short term.
A. Patient selection:
On the basis of information now available, we do not have definitive
answers to these important questions:
1.) Which patients are likely to benefit from transplant?
which patients may benefit from alternative medical and
surgical procedures which can substitute permanently or for
some period of time for a liver transplant, (i.e., Kasai
procedure).
2.) In which individuals may liver transplants be the only treatment?
B. Long term risks and benefits:
Recent advances in surgical technique and in immunosuppressive drugs
and the treatment of rejection phenomenon are suggested to have im-
proved short-term survival. The following, however, are not understood:
1.) The cause of both the mortality and morbidity that is seen in
transplant patients.
2.) The impact transplantation will have on the physical and mental
development of children.
ARGUMENTS FOR:
- Could answer the above questions.
- Provides scientific basis for a decision.
- Has had precedent in heart transplant trials.
- Study could be interrupted at any point should adequate data exist
to answer questions.
Page 8
ARGUMENTS AGAINST:
- Some desirable candidates may not receive transplant during trial
period.
- May be perceived as needless further study to save federal dollars.
- Findings may not advance knowledge beyond that developed at con-
sensus conference.
-- Private sector insurance coverage determination would be deferred,
limiting availability for some patients.
ISSUE IV: Transplantation Advisory Committee
There remains a number of bio-ethical, legal, economic and social questions
concerning organ transplantation. An advisory committee on transplantation
should be established to address these issues.
This committee would be complsed of physicians, patients or their guardians,
lawyers, clergymen, economists and others who would bring a diverse set of
skills and concerns to bear on these difficult issues. The committee would
monitor the existing transplant experience as well as new information (i.e.,
clinical trials) to provide advice as how best to deal with the complex
issues involving organ transplantation.
1. This committee should be appointed by the President.
ARGUMENTS FOR PRESIDENTIAL COMMITTEE:
- This would underscore the commitment of the Administration toward
this therapy.
- Reports by this committee would receive a wider degree of public
awareness.
- Some may perceive Secretarial committee as lower level decision-
making body.
2. This committee should be appointed by the Secretary.
ARGUMENTS FOR SECRETARIAL COMMITTEE:
- It is more appropriate for this committee to answer to the
Secretary.
- The highly technical information addressed by this committee
would be more appropriate for analysis by the Department of
Health and Human Services.
- It would report to the Secretary, allowing the President the
option of reviewing the decisions.
APPENDIX 1
COSTS FOR BROAD CLINICAL TRIALS (Option 3)
Year 1 4
Year 2 4
Year 3 4
Year 4 4
Year 5 4
TOTAL
PROCEDURE
1,200,000
1,200,000
DATA 1
1,120,000
790,000
680,000
620,000
620,000
3,830,000
ANALYSIS 2
150,000
150,000
300,000
400,000
500,000
1,500,000
CASES 3
(224)
(158)
(136)
(124)
(124)
(224)
TOTAL
2,470,000
940,000
980,000
1,020,000
1,120,000
6,530,000
If Option 2 is chosen costs would be half of those shown.
1 Subject costs estimated based on $5,000 per patient per year. Data collection includes
appropriate clinical and charge information to be developed in linkable, machine readable
form.
2 Analytic staff cost include required analytic staff, support staff, and computer costs.
3 Based on one time intake of 224 cases in the first year with subsequent attrition due to
mortality. To reach 224 cases, actual intake. May exceed one year.
4 Five year followup may be required to access long term effects. However, design could allow
for 1, 3, or 5 year followup end points.
APPENDIX 2
TRANSPLANT CANDIDATES FOR BROAD CLINICAL TRIALS (Option 3)
PRIVATE
MEDICARE
MEDICAID
TOTAL
Adults Under 65
0
0
112
112
Children Under 18
92
0
20
112
Total Patients
92
0
132
224
Total Costs
18,400,000
0
26,400,000
44,800,000
(Average cost per
patient $200,000)
Federal Costs
0
0
13,200,000
13,200,000
If Option 2 is chosen no children would be necessary
DEPARTMENT OF EDUCATION
UNITED STATES DEPARTMENT OF EDUCATION
OFFICE OF THE DEPUTY UNDER SECRETARY FOR PLANNING, BUDGET AND EVALUATION
ENTED STATES UNITED STATES OF AMERICA
MEMORANDUM TO THE PRESIDENT
FROM:
CABINET COUNCIL ON HUMAN RESOURCES WORKING GROUP ON
SCHOOL VIOLENCE/DISCIPLINE
SUBJECT: EXCERPTED SUMMARY: "DISORDER IN OUR PUBLIC SCHOOLS"
INTRODUCTION
The Commission on Educational Excellence has focused long overdue
concern on the quality of American education. [But, als James
Coleman concludes in his recent book, High School Achievement:
"When study of the effects of school characteristics on
achievement began on a broad scale in the 1960's, those
characteristics that were most studied were the
traditional ones[:] per pupil expenditures as an
overall measure of resources, laboratory facilities,
libraries, recency of textbooks, and breadth of course
offerings. These characteristics showed little or no
consistent relation to achievement characteristics
of schools that are currently found to be related to
achievement, in this study and others
can
be
broadly divided into two areas: academic demands and
discipline.
There is general agreement with Coleman's view of the importance
of an orderly environment to learning:
The Excellence Commission found that improved discipline
is a prerequisite for improving our nation's schools.
A bi-partisan merit pay task force in the U.S. House of
Representatives cited improved discipline as essential
to upgrading the quality of teachers and teaching.
A forum of leaders of diverse educational organizations
united in defining safe schools and discipline codes as
"prerequisities" for maintaining teacher effectiveness.
A number of other major critiques of American education
have followed the Excellence Commission report in
emphasizing that orderly and safe schools are
requirements for effective education.
400 MARYLAND AVE., S.W. WASHINGTON, D.C. 20202
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For each of the last 10 years, the Gallup Education Poll has
indicated that the public's major concern over public schools has
been the lack of discipline. Our citizens want order restored to
the classroom and the quality of education improved. Schools
must be encouraged to respond to our citizens concern.
Mobilizing such individual concern into community action is a
task clearly within the President's responsibility not only to
head the government but to lead the nation.
DISORDER IN THE SCHOOLS: HOW BIG IS THE PROBLEM?
Students
The most comprehensive study of crime and violence in the
America's public schools was completed in 1978 by the National
Institute for Education in response to a Congressional mandate.
The NIE reported that:
Each month 282,000 students were physically attacked in
America's secondary schools.
Each month 112,000 students were robbed through force,
weapons, or threat in America's secondary schools.
Each month 2,400,000 students had their personal
property stolen in America's secondary schools.
According to the NIE three million secondary school children were
victims of in-school crime each month, and almost 8 percent of
urban junior and senior high school students missed at least one
day of school a month because they were afraid to go to school.
A major 1983 study of school violence by [the] Director of
Rutgers University's Institute for Criminological Research
concluded that the NIE data had probably understated the actual
incidence of school violence at the time the survey was
conducted.
And, a November 29, 1983 report [on Boston public schools]
prepared by a blue ribbon panel chaired by a retired
Massachusetts Supreme Court justice, Making Our Schools Safe for
Learning, also indicates that the problems described in NIE
report have likely worsened over time. According to the study,
four out of every ten high school students surveyed by the panel
reported they had been the victims of robbery, assault, or
larceny during the course of the past year alone. Moreover, an
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astonishing 37% of male students and 17% of female students
surveyed in Boston high schools reported they had carried a
weapon in school at some time during the school year -- a problem
about which the panel had "no doubt" is "on the rise." In
discussing the report, the Boston superintendent characterized
his city's schools as safer than those in other cities.
Teachers
The National Institute for Education 1978 report to Congress
stated that in 1978:
Each month, 6,000 teachers were robbed in America's
secondary schools.
Each month, 1,000 teachers were assaulted seriously
enough to require medical attention in America's
secondary schools.
Each month, 125,000 teachers were threatened with
physical harm in America's secondary schools.
Each month, 125,000 teachers encountered at least one
situation where they were afraid to confront misbehaving
students in America's secondary schools.
[A]ll indications are that the problem has increased in the last
five years. The percentage of teachers polled by the NEA who
reported being physically attacked during the preceding year, for
example, increased by 53 percent between 1977 and 1983, and the
percentage reporting malicious damage to their personal property
increased by 63 percent over the same period. And, according to
the November 29, 1983 report on violence in the Boston school
system, 50 percent of a large sample of Boston teachers who had
responded to the panel's mail survey reported that they had been
victims of robbery, assault, or larceny during the course of the
past school year.
[T]he crime statistics describe merely the "tip of the iceberg".
The American Federation of Teachers found, in a survey
of a cross-section of California schools in both urban
and rural areas, that "teachers spend between 30 percent
and 80 percent of their time on discipline."
In a 1983 National Education Association poll about one
in two teachers reported that student misbehavior
interfered with teaching to a "moderate or great
extent."
-4-
The International Labor Organization concluded in 1981,
after studying schools in the United States and two
other countries, that "up to 25% of teachers suffered
from severe stress that is 'significantly' affecting
their health. This stress is mainly due to pupil
violence." (Wall Street Journal, July 9, 1981)
One psychiatrist who has treated many victims of teacher
burnout describes it as producing symptoms identical to
those found in World War I shell shock victims. This
psychiatrist calls teacher burnout "a combat neurosis."
Out of 7,000 teachers responding to a recent survey,
over 85 percent answered yes to the question: "Were
there chronic health problems stemming from teaching?"
Twenty-seven percent of those in the sample indicated
that they were victims of stress-related illness, and 40
percent said that they took prescription drugs to treat
health problems resulting from teaching."
A study of teacher burnout among Chicago teachers
"painted a picture of teachers who were physically
alive but professionally dead' ... Some teachers, who
had all but depleted their stockpile of teaching
vitality, were simply going through the motions of
teaching, marking time until either retirement or a
better job offer came along."
It thus should come as no surprise that studies repeatedly show
that poor student discipline is a factor even more important than
income in causing teachers to leave their profession:
The Oklahoma City Federation of Teachers discovered that
66 percent of the city's middle-school teachers and 52
percent of all teachers have considered quitting because
of the verbal and physical abuse they receive from
students.
A 1980 NEA nationwide poll indicates that teachers who
experience significant problems resulting from student
misbehavior are more than twice as likely to say that,
had they the choice to make again, they would not become
teachers.
-5-
Taxpayers
The NIE study statistics are again striking. It reported on a
monthly basis in American schools:
2,400 acts of arson;
13,000 thefts of school property;
24,000 incidents of vandalism; and
42,000 cases of damage to school property.
The National PTA has observed that the annual cost of vandalism
-- probably in excess of $600 million a year -- exceeds this
nation's total spending for textbooks. And this figure does not
include the escalating costs of school security. Vandalism and
policing/security practices, however, are only one component of
the bill for school violence and discipline problems -- a bill
that also includes the cost of lost teacher time and the
demoralization of schools and school systems.
MINORITIES HAVE A PARTICULAR STAKE IN RESOLVING THE PROBLEM
Minorities are even more worried than whites about the lack of
discipline in the public schools. This concern reflects the fact
that minority students are doubly affected by violent and
disruptive schools. First, they are more likely to be the
victims of attack. Second, they are more likely to have their
learning disrupted.
Minority students are especially likely to be attacked while at
school. [S]erious attacks on black, Hispanic, Asian, and
American Indian students occur at a rate at least twice that
experienced by white students.
Moreover, minority students are more likely to attend a school in
which discipline has broken down and learning is disrupted.
[s]tudents in predominantly minority secondary schools are
twice as likely to be the victims of serious crimes as
students in predominantly white schools;
[t] eachers in these schools are five times more likely to
be victims of attacks requiring medical treatment and
three times more likely to be robbed; and
-6-
[w]hite teachers who teach in predominantly minority
secondary schools are seven times more likely to be
attacked and need medical attention.
Polls show that over 80 percent of minorities believe disorder in
the public schools to be a serious problem -- and about half
consider it a very serious problem. This is a higher proportion
than the white population (although about 60 percent of the white
population also consider discipline a serious problem).
The prior Commission on Civil Rights' position on the problem
vindicates the Administration's concerns about the "civil rights"
it advocated. Against all evidence that minorities want more
discipline for their children, not separate and unequal
standards, the Commission opined that:
"Minority students are more often suspended for
'institutionally inappropriate behavior Thus, basic
differences in culture, lifestyle, and experiences in a
white-dominated society and the reluctance of the system
to accomodate these differences account, in part, for
the high rate of suspension for minority students."
Therefore:
"the cultural standards on which [disciplinary codes]
are based, and whether they are fair standards for all
children must be examined.
The former Commission, as well as others who have argued that
school discipline is a synonym for anti-minority school policies,
had the matter precisely backward: The hard-won right of
minority children to an equal educational opportunity is being
eroded by unsafe and disorderly schools. Permitting the current
deterioration of order in the public schools to continue would be
"anti-minority" in the most fundamental sense.
WHAT SOME SCHOOLS HAVE DONE
[S]chools where severe discipline problems have been "turned
around" [have taken] such simple steps as staff agreement on the
rules students are to follow and the consequences for disobeying
them, and involvement and support of principals and teachers in
the disciplinary process.
The El Camino High School experience described by the President
in his National Forum speech is, of course, not the only instance
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in which a school has adopted a rigorous student disciplinary
code and has witnessed a parallel, dramatic improvement in
academic achievement. The American Teacher describes the change
at Southwestern High School in inner city Detroit:
"Once one of the city's most violent, racially polarized
high schools with the highest truancy rate, Southwestern
is now a place where teachers can teach without fear of
verbal or physical abuse, where students no longer roam
the halls during classes, and where attendance has
soared from around 53 percent to close to 87 percent."
And Walter Williams describes the transformation of Eastside High
School in Paterson, N.J.:
"At Eastside, where the enrollment is two-thirds black,
one-third Hispanic, in the space of one year 82 percent
of ninth graders passed a basic math test, compared with
55 percent the previous year. Fifty-six percent passed
an English skills test, compared to 39 percent the
previous year."
George Washington High School in the Watts area of Los Angeles is
a similar success story. Four years ago, it was a school rampant
with gangs and drugs, with a 25 percent absentee rate and one of
the lowest academic ratings in all of Los Angeles County. Then a
new principal was hired who demanded strict discipline, including
a strict "discipline compact". Now, absenteeism has been cut to
6 percent and George Washington boasts the Los Angeles School
District's biggest increase in the number of students taking
SAT's. Five years ago, only 43 percent of Washington High's
seniors even wanted to go to college. Last year, 80 percent
actually went.
[Many similar examples exist and can serve as national models.]
WHY MANY SCHOOLS HAVE DONE LESS AND OFTEN LITTLE
School officials may be motivated to down-play the problem for
several reasons: One reason is the fear of appearing
incompetent. Public school officials in many communities may be
rewarded more for functioning smoothly without public attention
than for exceptional performance. Calling attention to acts of
violence or disruption or dealing with angered parents or the
courts are actions which at times and in many communities do not
benefit school officials.
-8-
Another reason is that [existing disciplinary] procedures prevent
effective [action]. Until very recently, students who entered
the Boston public schools received a twenty-five page document,
called "The Book", which, according to [a recent study by Gerald
Grant in the Fall 1982 issue of Public Interest Magazine]:
"contains thousands of words on student rights but only
eleven lines of type referring to their
responsibilities. From this pamphlet, a student learns
that there are five different types of suspensions and
that the least serious is the short-term suspension for
three days or less. Before even the latter can be meted
out, a student has the right to request an informal
hearing with the principal and his parents, and, if he
is dissatisfied, to appeal to the community
superintendent
The pressures on districts to adopt such "books" come from
several sources. [T]he American Civil Liberties Union, in a
widely circulated and influential document, has called for "a
recognition that deviation from the opinions and standards deemed
desirable by the faculty is not ipso facto a danger to the
educational process." The National Education Association struck
a similar note in early testimony before a Senate Committee
hearing on school violence. School violence, the then NEA
president opined, was attributable to student alienation
resulting from Vietnam, Watergate, and America's alleged
"reliance on military force." As regards robberies of students:
"Any system that perpetuates children carrying money and places
those in an awkward position who do not have it to carry,
requires a hard close look."
And these "students" rights" advocates have enjoyed considerable
success -- often without effective opposition -- in the courts.
Thus, the courts have construed existing statutes so as to permit
legal actions against teachers, school administrators and school
board members for personal liability in instances where
disciplinary actions are taken -- as Justice Powell emphasized in
the case of Wood V. Strickland (420 U. S. 308 (1975)), school
officials must "now at the peril of some judge or jury
subsequently finding that a good-faith belief as to applicable
law was mistaken and hence actionable." The Working Group
believes that review of existing statutes may be in order toward
the end of further limiting potential liability of school
officials exercising disciplinary authority in non-malicious
fashion.
-9-
ACTION IS UNLIKELY, HOWEVER, UNLESS THE AMERICAN PEOPLE ARE
MOBILIZED TO DEMAND IT
[T] he evidence that the problem is being ignored is overwhelming:
Only 1 of every 6 robberies or attacks recognized by
school principals is reported to the police (NIE, Safe
Schools Study, 1978).
Over 60% of teachers who were victims of attacks felt
that school principals failed to take appropriate action
(NEA Teacher Poll, 1981).
43% of the students who attacked teachers received only
the proverbial "slap on the wrist" -- or no punishment
at all (NEA Teacher Poll, 1983).
Over 75% of all principals reported that crime was
little or no problem in their schools -- during the same
period in which 3 million students and teachers every
month were victimized by crime in America's secondary
schools. According to the principals, only 157,000
illegal acts occurred each month -- two thirds of which
were never reported to the police (NIE, Safe Schools
Study, 1978).
According to the NIE study over 3,000,000 crimes occurred each
month in America's secondary schools -- and school officials
reported only 51,000 of them to police: a ratio of 58 unreported
crimes for each one reported. And, again, the current situation
may at best be unchanged. According to the 1983 Boston survey,
the lack of confidence that wrongdoers will be punished is so
pervasive that only 65% of students, and an astonishing 28% of
teachers victimized by school violence, reported the incidents to
officials.
THE NEED FOR LEADERSHIP
"I'm going to do everything in my power to call
attention to the successes achieved by our educational
system, but I won't hesitate to raise issues like
parental choice, discipline, course requirements, and
merit pay that go to the heart of our current crisis."
-- President Reagan, Letter to the National School
Board Association
School environments can be dramatically improved -- if the
American people act. National concern over disorder in the
-10-
schools can be translated into action. The issue of school
disorder represents an opportunity for the exercise of leadership
on a national problem ignored by prior administrations.
The Departments of Education and Justice
The Working Group fully supports the actions that the Departments
of Education and Justice are prepared to undertake and believes
that they will be effective, yet involve no Federal intrusion
into the management and policy discretion of local schools or
state systems. Rather, they are designed to support and defend
the efforts of principals, teachers, parents and students to
restore an orderly learning environment and thereby to establish
a basic condition necessary for the achievement of educational
excellence.
The Department of Education is prepared to exercise efforts, at
its highest levels, to focus research and public attention on
problems of school disorder. One of the National Institute for
Education centers would conduct extensive research into the
prevention of school discipline/violence problems. Other
components of the Department are prepared to evaluate anti-crime
activities currently underway in local education agencies and
will collect and disseminate examples of effective school
discipline. In addition, the Department will give greater
visibility to its joint project with the National Institute of
Justice to identify how local jurisdictions might better use
their own resources to reduce school crime. In addition, the
Department will make the records of schools in the area of
discipline and crime a major factor in selecting winners in the
Secretary's Exemplary Elementary and Secondary School
Competition. Finally, the Department is prepared to sponsor
regional hearings on school discipline to seek possible solutions
and to highlight successful local efforts; this process would be
along the lines of the Department's earlier, successful hearings
on the findings of the National Commission on School Excellence.
The Department of Justice is prepared to file "friend of the
court" briefs in appropriate cases on the side of increasing the
authority of teachers, principals and school administrators to
deal with school discipline problems. In addition, the
Department's Office of Juvenile Justice and Delinquency
Prevention will be establishing a National School Safety Center,
which will collect and disseminate data on school safety problems
and their solution. Key elements of this program will include a
computerized national clearinghouse for school safety resources;
and publication of handbooks and other publications apprising
principals, teachers, and parents of their legal rights in
dealing with disruptive students and information on successful
approaches to specific discipline problems.
-11-
The President
The Working Group believes that it is ultimately the President
alone who can play the critical role in restoring to our nation's
schools the ability to reverse what past misguided attention, and
tragic inattention, have wrought in the area of school discipline
and violence.
[I]nitial reaction to the President's remarks in Indianapolis
demonstrates that Presidential leadership can play the vital role
in fostering long overdue action to insist on order and
discipline in our nation's schools. Towards that end, we suggest
that the President:
Deliver a major address on the problem of school
disorder, pointing to examples of how various
jurisdictions have overcome it. Such an address could
emphasize the particular importance of educational
excellence to minorities and the disadvantaged, and
identify the lack of discipline as a critical enemy of
excellence in our public schools today.
Convene a meeting in Washington with individuals
identified with reform in the area, whom the President
could directly encourage and from whom he could further
learn. Governor Deukmejian [who has done much in the
area] could play a central role at such a meeting to
which school administrators, principals, union officials
and students could be invited.
Visit one or more schools in which discipline has been
successfully restored. We believe that few things would
be as dramatic as a series of visits by the President to
schools such as those described in this memorandum.
Attend one or more of the regional hearings on school
disorder to be held by the Department of Education.
Address the problem of school violence in his State of
the Union message.
[The] Working Group believes that Presidential leadership in
restoring the authority -- and, thereby, the professional status
-- of teachers, principals and school officials is a necessary
condition for the achievement of educational excellence.
-12-
well: A recent issue of Contemporary Education Magazine put the issue
"The issue in the 1980's no longer centers on whether or
not violence in American schools is serious; the issue
no longer centers on whether violence is increasing or
decreasing; the issue no longer centers on technical
anomalies concerning under-or-over reporting of
incidents. In the decade of the 1980's, the primary
issue before large proportions of our urban schools (and
sizeable numbers of our suburban and even rural schools)
revolves around the continued viability of American
education as it existed a generation ago."
Based on our efforts, the Working Group urges the Administration
and, more particularly, the President to speak out and to
exercise national leadership on the need to restore order and
discipline to the nation's schools. We believe that there are
few actions likely to offer greater promise and payoff for
America's children.
THE WHITE HOUSE
WASHINGTON
December 30, 1983
MEETING WITH SENATOR HOWARD BAKER (R-TENNESSEE)
SENATOR ROBERT DOLE (R-KANSAS), AND
SENATOR PETE DOMENICI (R-NEW MEXICO)
DATE: Tuesday, January 3, 1984
LOCATION: The Oval Office
TIME: 3:00 p.m. (45 minutes)
FROM: M.B. Oglesby
I. PURPOSE
To discuss the FY '85 budget.
II. BACKGROUND
On December 14, you met with Senate Majority Leader Howard Baker
to discuss your plans for the FY '85 budget. At that time, Baker
suggested that the two of you meet again and include Senators
Robert Dole and Pete Domenici.
Dole and Domenici, as well as Senator Laxalt, have had meetings with
White House staff over the past few weeks to discuss plans for
the budget.
The purpose of today's meeting is to give these Senate Republican
leaders an opportunity to express their concerns and recommendations
with respect to the budget prior to your making a final decision
on your own recommendations. Generally speaking, these Republicans
are anxious to work out an agreeable plan to avoid Republican
infighting over the budget during an election year. One of their
main concerns will be the level of defense spending. Since the
budget will be one of the main legislative items considered in
the upcoming year, it would be helpful to achieve some basic agree-
ment on the major parts of the package before you submit it to the
Congress.
III. PARTICIPANTS
The President
The Vice President
Senator Howard Baker (R-Tennessee)
Senator Robert Dole (R-Kansas)
Senator Pete Domenici (R-New Mexico)
OMB Director David Stockman
-2-
Participants (Continued)
Staff
James A. Baker III
Edwin Meese III
Richard Darman
M.B. Oglesby
IV.
PRESS PLAN
White House photographer only
V. SEQUENCE OF EVENTS
Senators to arrive Northwest Gate, enter the West Lobby and
be escorted to the Oval Office for a 45-minute meeting with
the President.
Attachment: Talking Points
SUGGESTED TALKING POINTS FOR MEETING
WITH SENATORS BAKER, DOLE, AND DOMENICI
-- Well, Happy New Year to all of you. I hope you have enjoyed
the holidays with your families.
-- From the looks of the Congressional schedule for 1984, it
appears that you will have a relatively short session, but I
know that session will be full of some very important items.
I expect that our FY '85 budget will be at the top of the list,
and that is the subject that I would like to discuss with
you today.
--- I know that my staff here at the White House has been meeting
with you during the past few weeks to give you some idea of where
we're headed in putting together our budget recommendations. I
discussed this subject with Howard Baker earlier in December, and
he suggested that we all sit down together before the final
decisions are made on the package which I will submit to the
Congress.
--- I think it is vital that we Republicans maintain the highest
degree of unity we can in the upcoming year, and I know that
these budget issues can become pretty controversial in some areas.
I want to work closely with all of you to avoid this kind of
controversy, and I would like to get your impressions about
where we are headed before I finalize my own decisions.
-2-
-- Howard, I will ask you to lead off here and get our discussion
started.
(Howard Baker will lead off; general discussion to
follow.)
-- Well, this discussion has been very helpful to me, and I will
weigh your recommendations carefully in finalizing my own
decisions. As long as we can work together on this, I think
we will have taken a giant step toward a productive and harmonious
Second Session of the 98th Congress.
THE WHITE HOUSE
WASHINGTON
MEETING WITH THE PRESIDENT
SUBJECT: STATE OF THE UNION ADDRESS
Tuesday, January 3, 1984
4:30 (30 minutes)
The Oval Office
FROM: RICHARD G. DARMAN
us
I. PURPOSE
This meeting is for you to provide your general reactions to
Ben Elliott's first draft of the State of the Union. In
light of your reactions, and senior staff comments, a
refined draft will be prepared for your review and editing.
II. PARTICIPANTS
The President
James A. Baker III
Michael K. Deaver
Richard G. Darman
Craig L. Fuller
David R. Gergen
James E. Jenkins
Michael A. McManus
Bentley Elliott