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Withdrawal/Redaction Sheet Clinton Library DOCUMENT NO. SUBJECT/TITLE DATE RESTRICTION AND TYPE 001a. letter From Bill Clinton to Mr Frederick H MacVicar; RE: address [partial] 09/04/1996 P6/b(6) (1 page) 001b. letter From Frederick H MacVicar To President Bill Clinton; RE: 08/05/1996 P6/b(6) address/phone/fax number [partial] (1 page) COLLECTION: Clinton Presidential Records Policy Development Lyn Hogan OA/Box Number: 10043 FOLDER TITLE: Child Wel [Welfare]---Long-Term [1] 2011-1010-S ms196 RESTRICTION CODES Presidential Records Act - [44 U.S.C. 2204(a)] Freedom of Information Act - [5 U.S.C. 552(b)] P1 National Security Classified Information [(a)(1) of the PRAJ b(1) National security classified information |(b)(1) of the FOIA] P2 Relating to the appointment to Federal office [(a)(2) of the PRAJ h(2) Release would disclose internal personnel rules and practices of P3 Release would violate a Federal statute [(a)(3) of the PRA] an agency |(b)(2) of the FOIA] P4 Release would disclose trade secrets or confidential commercial or h(3) Release would violate a Federal statute [(b)(3) of the FOIA] financial information |(a)(4) of the PRAJ b(4) Release would disclose trade secrets or confidential or financial P5 Release would disclose confidential advice between the President information [(b)(4) of the FOIA] and his advisors, or between such advisors [a)(5) of the PRA| b(6) Release would constitute a clearly unwarranted invasion of P6 Release would constitute a clearly unwarranted invasion of personal privacy [(b)(6) of the FOIA] personal privacy [(a)(6) of the PRAJ b(7) Release would disclose information compiled for law enforcement purposes |(b)(7) of the FOIA] C. Closed in accordance with restrictions contained in donor's deed b(8) Release would disclose information concerning the regulation of of gift. financial institutions [(b)(8) of the FOIA] PRM. Personal record misfile defined in accordance with 44 U.S.C. b(9) Release would disclose geological or geophysical information 2201(3). concerning wells [(b)(9) of the FOIA] RR. Document will be reviewed upon request. Withdrawal/Redaction Marker Clinton Library DOCUMENT NO. SUBJECT/TITLE DATE RESTRICTION AND TYPE 001a. letter From Bill Clinton to Mr Frederick H MacVicar; RE: address [partial] 09/04/1996 P6/b(6) (1 page) COLLECTION: Clinton Presidential Records Policy Development Lyn Hogan OA/Box Number: 10043 FOLDER TITLE: Child Wel [Welfare]---Long-Term [1] 2011-1010-S ms196 RESTRICTION CODES Presidential Records Act - [44 U.S.C. 2204(a)] Freedom of Information Act - [5 U.S.C. 552(b)] PI National Security Classified Information [(a)(1) of the PRAJ b(1) National security classified information [(b)(1) of the FOIA] P2 Relating to the appointment to Federal office [(a)(2) of the PRAJ h(2) Release would disclose internal personnel rules and practices of P3 Release would violate a Federal statute [(a)(3) of the PRA] an agency [(b)(2) of the FOIA] P4 Release would disclose trade secrets or confidential commercial or b(3) Release would violate a Federal statute |(b)(3) of the FOIA] financial information [(a)(4) of the PRA] b(4) Release would disclose trade secrets or confidential or financial P5 Release would disclose confidential advice between the President information [(b)(4) of the FOIA] and his advisors, or between such advisors [a)(5) of the PRAJ b(6) Release would constitute a clearly unwarranted invasion of P6 Release would constitute a clearly unwarranted invasion of personal privacy |(b)(6) of the FOIA] personal privacy |(a)(6) of the PRA] b(7) Release would disclose information compiled for law enforcement purposes [(b)(7) of the FOIA] C. Closed in accordance with restrictions contained in donor's deed b(8) Release would disclose information concerning the regulation of of gift. financial institutions [(b)(8) of the FOIA] PRM. Personal record misfile defined in accordance with 44 U.S.C. b(9) Release would disclose geological or geophysical information 2201(3). concerning wells [(b)(9) of the FOIA] RR. Document will be reviewed upon request. [∞/la] September 4, 1996 Mr. Frederick H. MacVicar P6/(b)(6) Dear Fred: Thank you very much for your letter and for sharing your concept for a positive national program for American youth. I have passed along your proposal to my staff. As I have said many times, children are our most precious resource and our most profound responsibility, and America must not retreat from the investments we have made to ensure their well-being. As I work with Congress to achieve meaningful reforms, I will continue to fight for and strengthen our initiatives in education, crime prevention, nutrition, and health - - initiatives that benefit all Americans. I look forward to your continued and active involvement in this vital endeavor and stand with you in your efforts to put the needs of our children first. Sincerely, BILL CLINTON BC/RSM/DWB/ech-lynn (Corres. #3106124) (8.macvicar.f) CC: Lyn Hagan, 217R OEOB, DPC, w/attachments and incoming Withdrawal/Redaction Marker Clinton Library DOCUMENT NO. SUBJECT/TITLE DATE RESTRICTION AND TYPE 001b. letter From Frederick H Mac Vicar To President Bill Clinton; RE: 08/05/1996 P6/b(6) address/phone/fax number [partial] (1 page) COLLECTION: Clinton Presidential Records Policy Development Lyn Hogan OA/Box Number: 10043 FOLDER TITLE: Child Wel [Welfare]---Long-Term [1] 2011-1010-S ms196 RESTRICTION CODES Presidential Records Act - [44 U.S.C. 2204(a)] Freedom of Information Act - 15 U.S.C. 552(b)] P1 National Security Classified Information [(a)(1) of the PRAJ b(1) National security classified information |(b)(1) of the FOIA] P2 Relating to the appointment to Federal office [(a)(2) of the PRAJ b(2) Release would disclose internal personnel rules and practices of P3 Release would violate a Federal statute |(a)(3) of the PRAJ an agency [(b)(2) of the FOIA] P4 Release would disclose trade secrets or confidential commercial or b(3) Release would violate a Federal statute [(b)(3) of the FOIA] financial information |(a)(4) of the PRA] b(4) Release would disclose trade secrets or confidential or financial P5 Release would disclose confidential advice between the President information |(b)(4) of the FOIA] and his advisors, or between such advisors [a)(5) of the PRAJ b(6) Release would constitute a clearly unwarranted invasion of P6 Release would constitute a clearly unwarranted invasion of personal privacy [(b)(6) of the FOIA] personal privacy [(a)(6) of the PRA] b(7) Release would disclose information compiled for law enforcement purposes [(b)(7) of the FOIA] C. Closed in accordance with restrictions contained in donor's deed b(8) Release would disclose information concerning the regulation of of gift. financial institutions |(b)(8) of the FOIAJ PRM. Personal record misfile defined in accordance with 44 U.S.C. b(9) Release would disclose geological or geophysical information 2201(3). concerning wells |(b)(9) of the FOIA] RR. Document will be reviewed upon request. " a bold new initiative for American Youth.' August 5, 1996 President Bill Clinton [001b] Executive Office of The President 1600 Pennsylvania Avenue, NW Washington, DC 20500 Dear Mr. President: On the following pages, I have outlined my concept for a positive national program for American youth. In my opinion, this concept provides the framework for a need-based program that will contribute to the well-being of American youth, as well as to every other major segment of American society. This is an innovative concept for a far-reaching, positive social program that should immediately garner universal and enthusiastic public support. Obviously, this concept will need expert input in several of its major elements, such as educational materials, organizational structure, judging, etc. However, the concept is simple, direct and positive. The need for this program is obvious and the timing for you and your administration is perfect. I think you'll see its vast potential and hopefully, place it high on your list of priorities for positive action. While recuperating from surgery, I've devoted the past three months to this concept. Obviously, I'm convinced that it can become one of the strongest, most positive social programs in American history. Mr. President, you have the charismatic leadership and the dedication this program will need to be successful. I am looking forward to hearing your opinion. As I see it, this can be your "bold new initiative for American Youth" and for all of American Society. Fred MacVicar Sincerely yours, Frederick H. MacVicar cc: Vice President Gore; Mr. Philip Lader; Mr. Peter Knight; Mr. Charles Corbett; The MacVicar Children and Grandchildren. P6/(b)(6) Fred & Mary Jane MacVicar. P6/(b)(6) CONCEPT THE NATIONAL ENDOWMENT FOR AMERICAN YOUTH "...a bold new initiative for American Youth." Frederick H. MacVicar August 5, 1996 " a bold new initiative for American Youth. TABLE OF CONTENTS Summary of the Concept 1 Eligibility Requirements 2 Savings and Investment Earnings Schedule 3 Bonus Point Flexibility 4 Major Benefits to American Youth 5 Major Benefits to American Society 6 Anticipated Widespread Enthusiastic Support 7 Judging, Scoring, Rules and Penalties 8 Hypothetical Cost/Benefit Analysis 9 Management and Organizational Structure 10 A Telltale Quiz 11 Biographical Data 12 " a bold new initiative for American Youth. SUMMARY OF THE CONCEPT The Concept of The National Endowment for American Youth is multi-faceted, objective and innovative, as briefly described below: 1. Every American youth between the ages of 12 and 21 is eligible to participate as long as he or she meets the eligibility requirements. Page 2. 2. Each participant can earn up to 1000 Savings and/or Investment Points annually, each point equal to $1.00 in cash. 3. To earn points, the participant must perform a service without compensation which in some way will contribute to Quality of Life in America. 4. The calendar year will be divided into two six-month service periods -- January through June and July through December. The participant can earn up to 500 points in each service period by performing at least one and up to three Quality of Life services. 5. Service recipients and the parent or guardian will attest to the validity of the participant service report. The school will attest to the educational requirements, police to deportment. 6. Participant's point earnings must be allocated to Savings and/or Investments in fixed ratios, as in the tentative Earnings Schedule. Page 3. 7. Participants must deposit in savings or invest all points earned within 90 days of completion of each 6-month service period. 8. Upon high school graduation, participant can elect to use any or all of his or her savings or investment assets to pay for further education, payable directly to the educational institution or training facility. 9. To continue participation after high school, the participant must be enrolled in a full- time or part-time educational program or in vocational training at an accredited institution. 10. At age 21, all savings and investment assets become the sole property of the participant and the Endowment has no further ownership or lien. Page I " a bold new initiative for American Youth. ELIGIBILITY REQUIREMENTS 1. American Citizen between the ages of 12 and 21. 2. Student in school, college or vocational training. 3. Maintaining satisfactory grades and attendance. 4. No known involvement in crime, drugs or violence. 5. Registered to vote at Age 18. 6. Performing Quality of Life service without pay. DEFINITION OF QUALITY OF LIFE SERVICE This term is used in lieu of "Community Service" in the belief that Community Service is viewed by many youngsters as being demeaning and/or a form of mild punishment, such as that given to Dallas Cowboy Irwin in lieu of imprisonment he "richly" deserved. Also, Quality of Life Service is all-encompassing and more accurately describes the intent and nature of the selfless type of work we want participants to perform. Quality of Life Service would include any service, large or small, which would contribute in any way to a high standard of Quality of Life in America, such as 1) environmental protection; 2) aid to the needy; 3) child safety; 4) aid to the elderly; 5) wildlife preservation; 6) recycling; 7) interracial relations; 8) mental or physical health; 9) anti- littering; 10) shelter for the homeless; 11) volunteer work for any charitable organization; 12) any other such service. Every government agency, every community organization and every charitable organization combined could be asked to compile a list of such services, existing or needed, to guide participants to hundreds of service opportunities available to any participant of any age. I predict that many of these youngsters will discover Quality of Life needs and opportunities that we don't even know exist. Young minds are perceptive, fresh and imaginative. They're not yet cluttered with the negatives which invade us with age and experience. Page 2 a bold new initiative for American Youth. SAVINGS AND INVESTMENT EARNINGS SCHEDULE Every participant can earn up to 1000 Investment Points per year -- up to 500 Points per semi-annual Service Period -- which must be allocated to Education, Savings and/or Investments in the fixed ratios set forth in the following schedule: 1. Ages 12 and 13: 100% of earnings must be deposited in a Savings Account. 2. Ages 14 and 15: 50% of earnings in Savings and 50% in Investments. 3. Ages 16, 17 and 18: 25% of earnings in Savings and 75% in Investments. 4. Ages 19 and 20: Any percentage in Savings, Investments or both. 5. High School Graduates: Upon high school graduation, participant may convert any or all of his or her savings and/or investments into cash payable directly to any college or accredited training institution for post-high school education. 6. Age 21: This program ends on the participant's 21st birthday, whereupon all Savings and/or Investment Assets become the sole property of the participant with no further obligation to the Endowment. SAVINGS VERSUS INVESTMENTS Savings must be deposited in an FDIC insured Savings Account. Investments are limited to publicly traded American stocks, bonds and/or mutual funds listed on the major American Exchanges, such as AMEX, NYSE and NASDAQ, etc. Page 3 " a bold new initiative for American Youth. BONUS POINT FLEXIBILITY 1. Federal Government: Any Federal Government Department or Agency could offer Bonus Points for any six- month Service Period for any Quality of Life Service where concentrated effort might be desirable. For Example: The Department of Transportation could offer participants 100 bonus points for any Service which would contribute to highway safety. For Example: The Forest Service could offer participants 100 bonus points for any Service which would help prevent forest fires. 2. State, County and Municipal Governments: State, County and Municipal Governments could offer Bonus Points for resident participants during any given Service Period for Quality of Life Service in priority categories: For Example: The State of South Carolina could offer a Bonus of 100 Points for Service by resident participants contributing to the reduction of the school dropout rate. For Example: Beaufort County could offer 100 Bonus Points for any Quality of Life Service which would promote the conservation of fresh water during a period of drought. For Example: The Town of Hilton Head Island could offer 100 Bonus Points to resident participants who perform services contributing to the preservation of Island dunes. Such Bonus Points could be extremely beneficial to focus resident participant efforts on areas of particular need or concern in particular years or at particular times of the year. State, County and Municipal Governments could even suggest specific services which would be of value. Every Bonus Point plan would be subject to the approval of the National Endowment to ensure adherence to national standards, fairness of judging, Quality of Life value, etc. Page 4 " a bold new initiative for American Youth. MAJOR BENEFITS TO AMERICAN YOUTH The National Endowment For American Youth will provide numerous important benefits to participating youngsters, including (but not limited to) the following: 1. The Responsibilities of American Citizenship: Participants will necessarily be law abiding citizens, rejecting drugs and violence in order to participate. They will have a constant tangible reminder that their good deportment is both necessary and advantageous. 2. The Importance of Education: To become and remain eligible, participants must attend school and maintain satisfactory grades, attendance and deportment. Furthermore, in order to maximize their earnings through the Endowment, they must continue their educations and/or training beyond high school graduation. 3. Training and Experience in Money Management: While pursuing a formal education and/or training each participant will necessarily learn the value of Saving, Investing and sound Money Management. They will discover and experience for themselves the basics and principles of wise financial risk-taking in a realistic environment. 4. Structure and Value of the Free Enterprise System: Participants will necessarily become personally involved in our unique American System of Free Enterprise through ownership of shares of stock in American corporations. They will gain new respect for business, the economy and the necessity of education and training beyond high school. 5. Exposure to Complexities of American Quality of Life: Through uncompensated service to their communities and to American society as a whole, participants will gain a new respect for the vast scope and importance of the variety of social needs and services which contribute to overall Quality of Life Values in America. Predictably, many of these youngsters will adopt favorite causes, acquire the habit of community service and continue to serve for the rest of their lives. Furthermore, the values they will inevitably acquire will provide the foundation for the family values they will instill in their children for future generations. Page 5 a bold new initiative for American Youth. MAJOR BENEFITS TO AMERICAN SOCIETY If American Society enthusiastically endorses, supports and participates in this self- perpetuating youth program, and we will, the benefits are enormous. These are a few: 1. Fewer Drop-outs, Less Juvenile Crime, Drugs, Violence: The current trends underline the need for the strengthening of our values among Youth, not only family values but basic American values which provide the foundation for our entire Society and Quality of Life. All of America will benefit from this major national youth initiative for decades to come. We can't change family values in time to help today's youngsters, but we can instill values that will overcome some of their present circumstances and supplant existing values with better alternatives and better opportunities. 2. Every Segment of American Society will Gain Perspective: Involvement in this program, even if peripheral, will almost inevitably re-focus all Americans on the real needs, values, delicate balances and responsibilities inherent in our real Quality of Life. Adults will become volunteers. Parents will become involved in their children's projects. Seniors will mentor, judge and score and gain a new understanding of modern American Youth. Siblings and peers will join in project discussions and investment decisions. Communities will re-focus on Youth as a vast and powerful asset to be nourished, encouraged and protected. Business and industry get a new perspective on the importance of youth. Millions of hitherto untapped man hours will become available to non-profits, struggling charities and dozens of worthy causes. 3. The American Economy will Prosper and Grow: Billions of new investment dollars will become available to American Business and industry for capitalization, growth and progress. Millions of new jobs will emerge. Millions of better educated, better informed and better trained men and women will become available as managers and workers. More reliable, more responsible, more productive and more cognizant employees with broader perspectives and stronger commitments to the Free Enterprise System and our Quality of Life, both personal and vocational. And new strata of better educated, more informed and more affluent consumers will emerge year after year, demanding new and improved Quality of Life commitment, awareness, products and services. Page 6 " a bold new initiative for American Youth. ANTICIPATED WIDESPREAD ENTHUSIASTIC SUPPORT With the exception of organized crime, drug dealers, gang leaders, fanatics and terrorists, it would be difficult to identify any major segment of American Society opposed to the concept of The National Endowment for American Youth. I believe you can expect support from all of the following: 1. Parents, grandparents, foster parents and guardians. 2. School Boards, educators and PTA's 3. Colleges, Universities and Vocational Schools. 4. Democrats, Republicans and Independents. 5. The Far Right, The Far Left and the Ambidextrous. 6. Law Enforcement, EMS and Fire Fighters. 7. Religious leaders and the religious community. 8. All age groups, all ethnic groups and all races. 9. Wall Street, the Chamber of Commerce and Economists. 10. State, County and Municipal Governments. 11. Non-profit Organizations and Youth Organizations. 12. The entire Medical community. 13. National Business and Industry Associations. 14. Business and Industry, Management and Labor. 15. Politicians, Child Psychologists and Social Workers. 16. Environmentalists, the NRA and Community Leaders. 17. The Pundits, the Congress, the Senate and the Press. 18. The wealthy, the poor and everyone in between. 19. Our Allies and international Workers for Democracy. 20. Above all, The Youth of America. OUR CHILDREN WILL ALWAYS BE OUR HIGHEST AMERICAN PRIORITY Page 7 " a bold new initiative for American Youth." JUDGING, SCORING, RULES AND PENALTIES This is one of the most important elements of the Program and one which deserves further study and input from your experts. However, this is how I envisage the procedures: 1. Judging: Through Social Security, AARP and other reliable sources, recruit 75,000 Senior Citizens between the ages of 50 and 75 with a minimum education of high school graduation. Each would judge and score up to 1000 Service Reports semi-annually, requiring approximately 5 minutes per report or a total of about 40 man hours -- 80 hours per year. These are our modern-day "village elders" and I believe they'd welcome and thoroughly enjoy their participation in this program. 2. Scoring: Participant Service Reports would be scored on a curve, not only measuring the participant's performance in comparison with other participants, but factoring in both age and type of residential community (city, suburb, town, village, rural) or foreign residency. Scoring would begin with 250 points, awarded for any meaningful participation, and range upward to a maximum of 500 points per Service Period in increments of 25. The average score nationwide should be about 375 per six-month Service Period or 750 Investment Points annually. Three judges would independently score each Report and the participant would be awarded the highest score of the three. Our goal is to attain maximum participation, motivation and satisfaction, encouraging more service and higher earnings. 3. Rules: The basic rules are spelled out on the preceding pages and should not be inundated with legalese nor bureaucratic red tape. Parents, guardians, teachers and the recipients of the participant's service should sign off on the validity of the report and the eligibility of the participant. Reports can be "spot-checked" and Judges can "flag" suspicious reports. 4. Penalties: The only penalties I envisage would be (1) the loss of all Investment Points for any six- month Service Period during which the participant failed to maintain eligibility because of unsatisfactory grades or attendance, etc., or (2) the loss of all prior earnings if the participant drops out of school, commits a crime or "cheats" on the Service Report, whereupon all accrued assets would become the property of the Endowment. Page 8 " a bold new initiative for American Youth. HYPOTHETICAL COST/BENEFIT ANALYSIS While the numbers and percentages are based on my guestimates, they should serve to illustrate and analysis of cost versus measurable benefits. Again, your experts should have these numbers and percentages at their beck and call. 1. Cost of Savings and Investment Points Awarded Annually: Assuming a total universe of 30 Million eligible youngsters between the ages of 12 and 21 and a participation factor of 75%, approximately 22.5 Million youngsters would be awarded Investment Points. Assuming the average Investment Point score will be 750 Points, the annual gross would be 16.9 Billion dollars. Adding a few dollars for administration, etc., under this scenario the cost of The National Endowment for American Youth would be about: $17 Billion Annually 2. Projected Reduction in the Annual Cost of Other Programs: A 50% reduction in the cost of juvenile crime: A 50% reduction in the cost of drug treatment: A 50% reduction in the cost of social services: A 50% reduction in the cost of juvenile violence: A 50% reduction in the cost of unemployment insurance: A 50% reduction in the cost of emergency medical services: A 50% reduction in the cost of welfare payments A 50% reduction in the cost of juvenile incarceration: A 50% reduction in the cost of personal bankruptcies: Whether the percentages of various cost reductions are 50%, 25% or 10%, they will be significant and offset much of the annual cost of the Endowment. The balance of the cost is more than justified by millions of new man hours in Quality of Live service to American Society. The benefits far out-weigh the cost of The National Endowment for American Youth. Page 9 a bold new initiative for American Youth.' MANAGEMENT AND ORGANIZATIONAL STRUCTURE 1. Management: To give the Endowment stature and impetus, I would like to see it launched under the leadership of Vice President Gore. Although I have never met your SBA Administrator, Mr. Lader, his name and fine reputation are well known on Hilton Head Island. He would seem to me to be the ideal person to serve as CEO of the Endowment, especially in its formative stages. He is a proven Administrator, a man of vision who conceived The Renaissance Weekend, and he's experienced in business, academic and government administration. Let's hire him. There are many capable people in government who would welcome the opportunity to be part of this new initiative, especially in an era of elimination and/or reduction of old, outmoded government programs. If necessary, they can be supported by specialists recruited from the private sector. 2. Organizational Structure: Much of the needed organizational structure already exists in various departments, agencies and services, such as in the SEC, Education, Commerce, Social Security, Agriculture and Justice. These elements could be transferred to the Endowment or given specific tasks to perform for the Endowment. Obviously, the large numbers of participants and judges who would be involved, as well as the volume of detail generated by the various elements of the program, would require a large-scale state-of-the-art computer system which would acquire, organize, analyze and disseminate the various data. A large volume of printed and audio visual material would be necessary to educate and train participants, volunteer judges, the many participating entities such as educators, community leaders, parents, the financial community and numerous others. Recruiting, informing and enthusing the many publics involved would be an essential major segment of the Foundation effort. The right people can get the Endowment up and running by July 1, 1997, in time for the second six-month Service Period of the year. By the year 2000, the program should be proven, fully refined and be a bright new chapter in American history. Page 10 A TELLTALE QUIZ 1. Can this positive social program lead to better values, better opportunities and better lifestyles for American kids? Yes No Undecided 2. Will this program motivate American youth to attend school and pursue post- high school education and training? Yes No Undecided 3. Will this program focus public attention on the "good" boys and girls and shift focus away from the "bad"? Yes No Undecided 4. Could this be the most meaningful, far-reaching and effective self-help program ever created for American youth? Yes No Undecided 5. Will parents and grandparents, rich and poor, young and old, enthusiastically support this program? Yes No Undecided 6. Might Bob Dole or Ross Perot oppose this program and by so doing, be viewed as mean-spirited old codgers? Yes No Undecided 7. Could this program become one of the most popular and long-lived government programs in modern American history? Yes No Undecided 8. Will this program garner votes for sponsors and put a positive spin on their political campaigns? Yes No Undecided 9. Is the timing right in terms of public opinion, the strength of the economy, the problems of youth and political realities? Yes No Undecided 10. Does this program stand alone as the only positive program for American Youth on the political horizon today? Yes No Undecided Page 11 BIOGRAPHICAL DATA Frederick H. MacVicar Age 67. Married. Four Children. Five Grandchildren. Born in Canada of American parentage, enlisted in the United States Army in 1948 at Age 19. Commissioned in 1950. Served five years on active duty with primary assignments as Infantry Rifle Company Commander and Infantry Battalion Intelligence Officer. Dual citizenship, the United States and Canada. Worked in responsible marketing positions for twenty years in New York City, Georgia and Washington, DC. Employers and clients included Bloomingdales, Sears Roebuck, W.R. Grace, The Georgia Department of Industry & Trade, Southern Airways, United States Peace Corps, Newhouse Newspapers, Callaway Mills, Columbia Nitrogen, The American Advertising Federation and The Smithsonian Institution. Management responsibilities included every segment of marketing and public relations, including Sales Manager, Advertising and Public Relations Director, Director of Marketing Research, Creative Director, Marketing Director and Business Manager. Advanced Seminar, Marketing Management, Harvard Business School. Past Governor, 7th " Deep South" District, American Advertising Federation; Honorary Lifetime Member, Atlanta and Augusta GA Advertising Clubs; Gold Medal Award, American Advertising Academy; Co-founder, Student Advertising Campaign Competition; Author "Careers in Advertising", University of Georgia Press; Co-author, "Crossed Pens", Acropolis Books South. Qualified as Expert Witness, Marketing and Public Opinion Research, Supreme Court of South Carolina. Recipient, AAF Silver Medal Award. Presently Senior Partner in the firm of MacVicar & Earley, Marketing and Public Opinion Research, Hilton Head Island, SC. Opinion Researcher, Marketing Strategist, Free-lance Writer. Page 12 Another Sound Concept: 1966 to 1996 This too was my concept almost exactly thirty years ago, also designed to satisfy the need for direction, more practical education and more hands-on experience for college students. The "captains of industry" were not very supportive, but we persevered and saw it into existence. I'm very proud to see that it has become one of the most valuable tools in advertising education in colleges and universities throughout America. It will undoubtedly grow and flourish for many decades to come. Our youth bought the Concept and it will be there forever more. The NEFAY concept will inevitably enjoy the same success. Clinton Presidential Records Digital Records Marker This is not a presidential record. This is used as an administrative marker by the William J. Clinton Presidential Library Staff. This marker identifies the place of a publication. Publications have not been scanned in their entirety for the purpose of digitization. To see the full publication please search online or visit the Clinton Presidential Library's Research Room. Booklet: " 7th District American Advertising Federation, A History, 1967 Through 1995, 29 pgs. NSAC STUDENT ADVERTISING CAMPAIGN COMPETITION Districtriet AMERICAN ADVERTISING FEDERATION A History 1967 THROUGH 1995 casa® LEGISLATIVE UPDATE FEDERAL ACTION RELEVANT TO CASA AND THE CHILDREN WE SERVE Child Protection Block Grant Included CASA Funding for 1996 Included in to reconsider the bill until after Congress in Welfare Reform Legislation. The Vetoed Bill - Further Action Stalled By and the White House reach accord on a Congressional Welfare Reform package Budget Impasse. The President vetoed balanced budget. The Budget Agreement sent to the President in December would the appropriations bill for Commerce, may also impact the level of funding that also impact federal child abuse preven- Justice, State and Judiciary in Decem- the Appropriations Committee recom- tion and protection programs. While ber. Included in the appropriations mends in its revised bill. The Justice vetoed by the President, welfare reform measure was $6 million for CASA for FY Department is unable to award 1996 is also included in the current Budget 96, to continue the grants program to funding for National CASA and for new Agreement discussions between Congress expand CASA/GAL representation, and CASA program grants until the funding and the White House. The Welfare for the provision of training and techni- is finalized by Congress and approved by Reform legislation approved by cal assistance by National CASA. The the President. Congress would contain three Appropriations Committee does not plan important components with respect to child abuse and prevention: 1. Elimination of the Child Abuse Preven- tion and Treatment Act (CAPTA), Adoption Opportunities Act, and other federal child and family support programs. Funding previously available through these programs would be rolled into a new "Child and Family Services" block grant to states. 2. A block grant to states of Title IVB family preservation funds and Title IVE funds for administrative costs. 3. Continuation of Title IV foster care and adoption assistance funding. In order for a state to receive block grant funds, Congress eliminated the require- © Lorraine A. DarConte ment that a Guardian ad Litem be appointed in every case alleging child abuse or neglect; nor would states have to certify that a system is in place to ensure cooperation among state agencies in protecting children. Each state would design its own system and priorities for addressing child abuse prevention, protection, family and child support needs using the federal block grant funds. A child's voice in court "Tom's File by Moira Walsh As with many children referred to often put out of the classroom for Meanwhile, 1 talked with Tom's the San Francisco CASA program, disruptive behavior. school principal, counselors, and Tom's' social service case file had As his CASA volunteer, I read teachers about his school needs. Tom grown thick with paper. Each page told through Tom's thick case file, pieced was transferred to more appropriate a story of repeated rejection and together his sad history, and began inves- classes and we began working on his disappointment. tigating resources. As it turned out, Tom homework together. Tom had first become a dependent had a number of relatives living in the Tom started weekend visits with his of the Court when he was only four Bay Area; uncles, aunts, a grandmother, aunt and uncle. These went well. After months old. His mother, then only 16, eleven months in the group home. the was using drugs and was incapable court allowed him to move in with his of taking care of herself or her baby. aunt, uncle, and their three sons. Tom was taken to a shelter and to tem- Although the move has entailed porary placements before his father was many new adjustments another home, given custody. new friends, a new school - I believe the Only nine months later, Tom consistent presence of one CASA became a court dependent again when it volunteer for the past eighteen months was discovered that his father, also a has helped Tom cope. I have worked substance abuser, had been leaving the hard to try and earn his trust and show toddler unattended for days at a time. him I care. If nothing else, Tom needs For the next two years, Tom lived in to know that a CASA volunteer will be a series of shelters, placement with one adult - perhaps the first in his life - relatives, and foster homes. Meanwhile, who will not reject him. the courts terminated the parental rights Things seem to be going well for of both his mother and father. Tom recently. He has begun to call his At the age of five, Tom was moved to cousins - but Tom was most interested in aunt and uncle mom" and "dad" and the home of Mr. and Mrs. Jones* who, hearing about his father. To Tom, it refers to his cousins as his "brothers." our years later, became his legal guard- made no difference that, legally, his The best news is that the family recently ans. With this, the courts consider a father no longer had any parental initiated proceedings to adopt Tom. child to be permanently placed, and rights. He wanted to get in touch with I am hopeful that Tom has finally Tom's file was once again removed from his father; he wanted to live with his found the permanent home denied him dependency court jurisdiction. father again. for so long. Perhaps an adoption decree But when he was twelve, Tom ran I made contact with Tom's father will become the last paper to go into away from the Jones' home. Picked up and coordinated supervised visits with Tom's case file. S *Names of all persons in this article have been changed to protect their privacy. Moira Walsh is an attorney with the firm of Carr, McClellan, Ingersoll. Thompson, and Horn. She has been a San Francisco CLINTON LIBRARY PHOTOCOPY CASA volunteer since March. 1993. This article first appeared in the newsletter of San Francisco CASA. Reprinted with permission. U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES Washington, D.C. HUMAN SERVICES. USA & HEALTH OF DEPARTMENT THE FISCAL YEAR 1997 BUDGET The attached document is based on the President's Budget scheduled for delivery to the Congress on March 19, 1996, and is strictly embargoed until 11:00 a.m. that day. DEPARTMENT OF HEALTH AND HUMAN SERVICES FY 1997 BUDGET TABLE OF CONTENTS Page 1. SUMMARY 1 2. FOOD AND DRUG ADMINISTRATION 14 3. HEALTH RESOURCES AND SERVICES ADMINISTRATION 18 4. INDIAN HEALTH SERVICE 23 5. CENTERS FOR DISEASE CONTROL AND PREVENTION 27 6. NATIONAL INSTITUTES OF HEALTH 35 7. SUBSTANCE ABUSE AND MENTAL HEALTH SERVICES ADMINISTRATION 42 8. AGENCY FOR HEALTH CARE POLICY AND RESEARCH 46 9. HEALTH CARE FINANCING ADMINISTRATION 52 -- Medicare 53 -- Medicaid 57 -- Program Management 61 10. ADMINISTRATION FOR CHILDREN AND FAMILIES -- Discretionary Program Summary 67 -- Entitlement Program Summary 72 11. ADMINISTRATION ON AGING 80 12. DEPARTMENTAL MANAGEMENT -- General Departmental Management 84 -- Office for Civil Rights 86 -- Policy Research 87 -- U.S. Office of Consumer Affairs 87 13. OFFICE OF INSPECTOR GENERAL 89 14. PROGRAM SUPPORT CENTER 92 SUMMARY DEPARTMENT OF HEALTH AND HUMAN SERVICES (Dollars in millions) 1995 1996 1997 Request Actual Policy* Request +/-Policy Budget Authority/Income $302,150 $317,258 $354,695 $37,437 Outlays $303,107 $327,463 $354,126 $26,663 * Based on levels of the ninth CR, including an incremental policy adjustment. FY 1997 DISTRIBUTION OF OUTLAYS Discretionary 9% Other Entitlement 2% Medicaid Family Support Pymts 30% 5% Medicare 54% 1 SUMMARY CREATING OPPORTUNITIES WHILE ENCOURAGING RESPONSIBILITY The FY 1997 Budget proposes a balanced budget by FY 2002 through a combination of savings, responsible reforms, and good management. In so doing, the budget preserves our core values of protecting our most vulnerable Americans, especially senior citizens, people with disabilities, working families and children. The FY 1997 Budget for the Department of Health and Human Services (HHS), totals $354 billion in outlays, an increase of $27 billion, or 8 percent, over the comparable FY 1996 amount. The discretionary portion of the HHS budget totals $34 billion in budget authority, an increase of 5 percent over the FY 1996 policy level. The FY 1996 policy level is based on levels of the ninth continuing resolution, including an incremental policy adjustment. HHS is a major part of the President's effort to realize a seven-year balanced budget through the combination of welfare reform and revision of the Medicare and Medicaid programs. Reform of these entitlement programs is a substantial part of the savings in the President's plan. The President's Medicare plan strengthens and improves the program, reducing spending by a net $124 billion over seven years and guaranteeing the solvency of the hospital insurance trust fund for more than a decade. Specific reforms give seniors more choices among private health plans, make Medicare more efficient and responsive to beneficiary needs, attack fraud and abuse through programs praised by law enforcement officials, cut the growth rate of provider payments, and hold the Part B premium at 25 percent of program costs. Comprehensive welfare reform is a key component of our effort to promote self-reliant and stable families. The President has been working to make welfare a second chance rather than a way of life and is committed to signing a welfare bill that succeeds in moving people from welfare to work. Real welfare reform must emphasize work, responsibility, and family--imposing time limits, tough work requirements, and high standards upon parents to take responsibility for themselves and their children. Children should be protected and families must get the child care they need to go to work. The President's FY 1997 Budget includes a major proposal to replace the Aid to Families with Dependent Children program with a time-limited conditional entitlement. This proposal would also increase funding for child care programs and improve child support enforcement measures. The Administration supports rewarding States while holding them accountable for their efforts to put people to work, not for simply cutting families off of welfare assistance. States would have the flexibility to design welfare programs which would meet the needs of their communities. This plan would save a projected $40 billion over seven years. With the 2 support of Congress, we will enact changes to encourage parental responsibility, promote economic security, and protect families. In addition to these reforms, HHS remains committed to a path of tough management and strategic investment in priority areas. The FY 1997 HHS Budget continues to promote health and science by increasing funding in key areas such as the National Institutes of Health, Ryan White AIDS Treatment grants, substance abuse and mental health treatment, and heightening our vigilance against emerging infectious diseases. The FY 1997 Budget also invests in Head Start, the Child Care and Development Block Grant, and a new Teen Pregnancy Prevention initiative. STRENGTHENING MEDICARE AND MEDICAID Medicare Improvements that Expand Choices and Add Preventive Benefits The President's plan for improving choice in Medicare refines and enhances standards, increases the options available to Medicare beneficiaries, and expands the types of organizations offering Medicare products. It will improve Medicare's health plan payment coverage, foster continuous improvements in health plan quality, help beneficiaries become more informed about their choices, and level the playing field for Medicare managed care and Medicare supplemental coverage. Other changes begin the transformation of the traditional fee-for-service program from a bill-paying insurance program into a responsive health plan by giving Medicare authority to adopt many of the purchasing and quality techniques pioneered by private sector payors. The budget also expands and improves Medicare managed care by: ensuring beneficiary protections while increasing the types of plans--including Preferred Provider Organizations (PPOs) and Provider Sponsored Networks (PSNs)--available to seniors; and instituting a coordinated open enrollment process--similar to that used by the Federal Employees Health Benefits Plan (FEHBP)--during which beneficiaries use comparative information to choose among managed care and supplemental insurance options. In addition, the budget expands coverage of preventive benefits to include annual mammograms and the elimination of mammography coinsurance, colorectal cancer screening, and increased payments for flu shots. Finally, the budget introduces a respite care benefit to provide some relief for families caring for relatives with Alzheimer's disease. Survey and Certification Ensuring the safety and quality of care provided by health facilities is one of HHS' most critical responsibilities. HHS contracts with State agencies to inspect health facilities providing services to Medicare and Medicaid beneficiaries to ensure compliance with Federal 3 health, safety, and program standards. Quality oversight efforts include initial inspections of providers who request participation in the Medicare program, annual recertification inspections of nursing homes and home health agencies (HHAs) as required by law, investigation into all long-term care facility complaints, and periodic recertification of other health care providers and suppliers. In FY 1997, we are requesting a total of $173.8 million for direct survey and certification activities and workloads. We expect to survey more than 31,000 facilities in FY 1997. This $28 million increase over the FY 1996 policy level is necessary both to conduct initial inspections of more than 3,200 facilities expected to request Medicare participation (including the elimination of any prior year backlog), and to increase the frequency of annual surveys performed on non-long-term care facilities (e.g., End Stage Renal Disease facilities, hospices, rural health clinics). Congress did not fund the full FY 1996 President's request of $162.1 million for this activity, appropriating $145.8 million instead. Medicaid Reform that Guarantees Coverage and Promotes State Flexibility The Administration is committed to Medicaid reform guided by the following principles: preserve the guarantee of coverage with meaningful benefits for the most vulnerable Americans; maintain a strong Federal/State partnership; enhance State flexibility while ensuring protection for beneficiaries and accountability to taxpayers. The President's plan for Medicaid reforms the program and preserves the guarantee of health and long-term care coverage for the most vulnerable Americans. It saves $59 billion over seven years responsibly, by limiting spending on a per-person basis (a "per capita cap") and reducing Disproportionate Share Hospital payments and retargeting them to hospitals that serve large numbers of Medicaid and uninsured patients. The plan provides special payments for States to transition into the new system, and to meet the most pressing needs. It also gives States unprecedented new flexibility to administer their programs more efficiently. Finally, this plan retains current nursing home quality standards and continues to protect the spouses and other family members of nursing home residents from impoverishment. Maintaining and Expanding Coverage for Working Americans The Administration's FY 1997 Budget contains several provisions to make health coverage more accessible and affordable for working Americans. 4 The President's insurance market reforms will enable more Americans to maintain health insurance coverage when they change jobs and will stop insurance companies from denying coverage for pre-existing conditions. To put the self-employed on a more equal footing with other businesses, the reforms gradually raise the self-employed tax deduction from 30 percent to 50 percent. To give small businesses the purchasing clout that larger businesses have, the budget proposes $25 million a year in grants that States can use for technical assistance and for setting up voluntary purchasing cooperatives. The President also proposes a four-year demonstration program to provide annual grants to States to provide health insurance for temporarily unemployed workers and their families. Under the program, States could provide up to six months of coverage for eligible workers and their families. RESTORING TRUST AND UTILIZING INNOVATIVE APPROACHES TO MANAGEMENT Program Integrity As responsible managers of the public's money, the Secretary has made the integrity of Medicare and Medicaid a primary objective for the department. In FY 1997, the Federal Government will spend nearly $316 billion to purchase health care services for 72 million low-income, elderly, and disabled persons through these programs. Unfortunately, the large sums of money in Medicare and Medicaid have made them prime targets for those who would steal, take advantage of loopholes, and otherwise mismanage program funds. Increasingly sophisticated schemes are siphoning taxpayer dollars and robbing beneficiaries of their health care security. Responding to this epidemic, the HHS Inspector General (IG), together with the Health Care Financing Administration (HCFA), and the Administration on Aging (AoA) launched a major effort in FY 1995 to attack fraud and abuse in Medicare and Medicaid. Entering into a partnership with State Medicaid Fraud Control Units (MFCU), the Department of Justice, the Federal Bureau of Investigation and other State and local law enforcement officials, HHS initiated a five-state anti-fraud and abuse demonstration as part of the Vice President's Reinventing Government, Phase II. This two-year demonstration, "Operation Restore Trust," is currently operating in New York, Illinois, Florida, Texas, and California and focuses on curbing fraud, waste and abuse in providing three of the fastest growing Medicare services: nursing facilities, home health, and durable medical equipment. In FY 1997, we are seeking permanent legislation to expand Operation Restore Trust to all States and Medicare services. We will continue to work with MFCUs and law enforcement agencies to ensure that claims are properly paid in both Medicare and Medicaid. To achieve our objectives, two new HHS programs, along with new initiatives in the Department of Justice, designed specifically to fight health care fraud and abuse are proposed: the Medicare Anti-fraud and Abuse Program (MAAP) in the Office of the HHS Inspector General and the Medicare Benefit Integrity System (MBIS) in the Health Care Financing 5 Administration. These new mandatory programs will provide secure and dependable funding for anti-fraud and abuse efforts. We are proposing $97 million for MAAP in FY 1997, an increase of $54 million over FY 1996 estimated Medicare-related IG spending. MAAP will expand current efforts in the HHS Office of Inspector General (IG) to identify and investigate cases of fraud and abuse in Medicare. Working closely with the FBI and the Department of Justice, the IG will help to ensure that program defrauders are brought to trial. As a result of the intensified efforts, the IG will identify problems and recommend corrective actions that may be taken by HCFA, State Medicaid agencies and Medicare contractors. MBIS is proposed to be funded at $500 million in FY 1997, an increase of $104 million over current spending levels. This program will replace current Medicare payment safeguards activity. MBIS will emphasize front-end review of Medicare claims to ensure appropriateness of care, to determine if other parties are liable for payment, and that claims are paid right the first time. With MBIS, we will redesign and upgrade program operations and data systems to close the door on defrauders and abusers before they can take advantage of the program and its beneficiaries. Right-Sizing the HHS Workforce Through its Reinventing Government initiative, this Administration is creating a government that works better and costs less. As part of this effort, we are rethinking our business at HHS, making sure that our programs work well and achieve their intended results. We have committed ourselves to a seven-year right-sizing effort which will reduce the department's personnel by 7,000 FTE by the year 2000, bringing HHS in line with the President's plan to shrink the size of government. Using a combination of early-outs, selective hiring freezes and buy-outs, we reduced HHS staffing by nearly 3,300 FTE, or 5 percent, between FY 1994 and FY 1995, making a substantial down payment on our plan to right-size HHS. Staffing levels will remain at FY 1995 levels through both FY 1996 and FY 1997, and then decline by 2,500 FTE in the following three years. Innovative Approaches to Management In March 1995, the Social Security Administration (SSA) became an independent agency with approximately 50 percent of HHS staff transferring to this new independent agency. This transition was handled smoothly and in a timely manner with minimal personnel disruption. The end-product was two viable organizations. This was accomplished through the use of careful planning and is a significant accomplishment by HHS and SSA. Pursuant to the Vice President's Reinventing Government program, we closely examined and made changes to the remaining organizations within HHS. An entire management layer was eliminated by consolidating the Office of the Assistant Secretary for Health (OASH) into Departmental Management (DM). This consolidation creates a unified corporate 6 headquarters for the Department that brings expertise in public health and science closer to the Secretary. This merger and reconfiguration creates a new role for the Assistant Secretary for Health (ASH) who becomes the head of the Office of Public Health and Science (OPHS). The ASH will act as senior advisor for public health and science to the Secretary and provide senior professional leadership in the Department on population-based public health and clinical preventive services. The ASH also directs program offices within the OPHS; provides professional leadership on cross-cutting Departmental public health and science initiatives; and at the direction of the Secretary provides assistance in managing the implementation of Secretarial decisions for the PHS operating divisions. All Public Health Service Operating Divisions (OPDIVs) now report directly to the Secretary. The OPDIVs, along with the new OPHS and the Regional Health Administrators, continue to constitute the U.S. Public Health Service, with the Secretary at its head. We have also merged the operations of the Assistant Secretary for Management and Budget with the Assistant Secretary for Personnel Management. The final result of these reorganizations is a smaller, more focused Office of the Secretary. Finally, in the wake of SSA's departure and the DM/OASH merger, the Program Support Center (PSC) was created in FY 1996 as a new self-supporting operating division whose sole purpose is the provision of a broad range of administrative services. As the first true business enterprise at HHS, the PSC will provide services on a competitive, fee-for-service basis to customers throughout HHS and to other Federal agencies. This market based approach provides incentives for customers to reduce their costs by decreasing demands for service, and for providers to reduce their costs to remain competitive. The goal of the PSC is to further streamline and minimize duplication of functions in the provision of cost- effective services. The financing for the PSC has also been streamlined. All activities of the OS Working Capital Fund will be merged into the Service and Supply Fund (SSF) in FY 1997. A new SSF charter has been approved, establishing a new Board of Directors chaired by the Deputy Secretary, with the Assistant Secretary for Management and Budget as the vice-chair. This governing body, designed to provide customer involvement on cost and service levels, includes representatives from each HHS Operating Division, the chief management officers of the PSC, and the Inspector General's Office. BUILDING STRONG FOUNDATIONS AND SAFE PASSAGES Today's young people are tomorrow's leaders. They will guide our democracy in the 21st century and, therefore, must be prepared to accept the challenges they will face. In order to ensure a positive future for our Nation's children, we need to work together to promote their healthy growth and development and to create safe, stable families in economically secure communities. The Department is committed to this goal and has developed a multifaceted strategy to promote strong futures for all children and youth. This strategy includes investing in Strong Foundations--the building blocks of success for children 7 and families, and Safe Passages--the tools for navigating the often turbulent journey from childhood to adulthood. Head Start A child's physical and mental well-being is dependent upon a strong foundation. Head Start programs help to establish that foundation for many disadvantaged children and families by providing comprehensive education, nutrition, health services and social services. In FY 1997, we are committed to expanding enrollment and making that opportunity available to more children. A budget increase of $350 million over the FY 1996 policy level will allow us to serve an additional 40,000 children. As part of this increase, an additional 1,200 infants and toddlers will be able to participate in the Department's Early Head Start program. This request will also allow us to continue making important quality improvements to local Head Start programs to ensure that children and families receive the highest quality services possible. Head Start is just one of the many programs funded by HHS which builds strong foundations, laying the groundwork for the critical journey through adolescence. Child Care and Development Block Grant/Child Welfare The availability of quality child care for low-income families is critical to maintain economic self-sufficiency and to promote healthy child development. The FY 1997 Budget request for the Child Care and Development Block Grant (CCDBG) is $1.049 billion. Over 750,000 children currently receive services. CCDBG also supports activities to improve the quality and availability of child care across the nation. In addition, in FY 1997, the budget includes $419 million in discretionary funding for a range of programs that help States and local communities to protect children by strengthening families and preventing abuse; intervening when families are in crisis; and when necessary, making placement decisions to ensure children's safety. In 1993, States received reports on nearly three million children who were alleged victims of child abuse and neglect, reflecting a 25 percent increase in the rate of children reported since 1988. Teen Pregnancy Prevention Teen pregnancy is a serious social problem for our Nation. Not only do we spend scarce health and welfare dollars to assist families begun by teenagers, but our Nation also suffers as we fail to realize the full potential of many of these teens and their children. In an effort to address this problem, the Department will launch a $30 million Teen Pregnancy Prevention Initiative in FY 1997. These funds will be used to implement and evaluate promising prevention strategies in communities which have demonstrated a commitment to community problem solving. This initiative is an important step forward to ensure safe passages for our Nation's adolescents. 8 PROMOTING HEALTH AND SCIENCE National Institutes of Health - Biomedical/Behavioral Research The FY 1997 Budget continues the Administration's high-priority investment in biomedical and behavioral research to secure the long-term health of Americans. The proposed $12.4 billion for NIH is a $467 million, or 4 percent, increase over FY 1996. NIH is devoted to expanding fundamental knowledge about living systems and the causes of disease, and to applying that knowledge to improve the health of human beings. Chief among NIH's mechanisms to accomplish this are investigator-initiated research project grants which receive an increase of $166 million and fund 6,827 new and competing research grants and a record 25,400 total grants in FY 1997. The other prominent part of the FY 1997 Budget request for NIH is the revitalization of the operations and facilities of the Warren G. Magnuson Clinical Center. The request includes a total of $310 million to build a new state-of-the-art Clinical Center with replacement hospital and laboratories for the more than 40-year-old Clinical Center on the NIH campus. Furthermore, the FY 1997 Budget requests all of NIH's AIDS-related funds--$1.4 billion--in a single consolidated account for the Office of AIDS Research to ensure a coordinated and flexible response to the AIDS epidemic. Ryan White The FY 1997 request of $807 million for the Health Resources and Services Administration's Ryan White AIDS treatment activities, a $32 million increase over the FY 1996 policy level, continues our commitment to improve the quality and availability of care for individuals and families with HIV and AIDS. Funds will be used to expand activities in all four program areas including Emergency Relief for Cities, improve services for underserved and hard to reach populations, and support primary care services for an additional five to ten thousand individuals who are infected with, or at-risk of, HIV infection. The Administration is also proposing a $52 million budget amendment in FY 1996 to help states improve access to new promising HIV therapies, including protease inhibitors, a new class of AIDS drugs which are beginning to be approved by the Food and Drug Administration. Providing Health Care to Native Americans The FY 1997 President's Budget demonstrates our ongoing commitment to improving the health of American Indians and Alaska Natives and also in assisting those tribes who wish to take over the operation of their local health programs from the Indian Health Service. An increase of $43 million is requested to provide water and waste disposal service to existing Indian homes. The provision of such services, the top priority of the National Indian Health Board, is critical in reducing incidents of waterborne and other communicable diseases, gastroenteric disease, and neonatal death rates. Increased funding (+$16 million) is also requested for new health initiatives for women, children, elders, and urban Indians. The 9 President's Budget contains an additional $46 million to cover the contract support costs incurred by tribes in their operation of local programs. Substance Abuse and Mental Health In light of recent trends in drug use and mental illness in the country, the President's Budget also proposes an increase of $244 million to treat and prevent mental illness and substance abuse. An expanded knowledge development and application program will provide critically needed information about managed care; early childhood problems; individuals with, or at risk for, both mental health and substance abuse problems; services in the criminal justice system; and application of knowledge to improve service delivery systems at the local and State levels. The budget also proposes $1.5 billion for both the Substance Abuse and Mental Health Performance Partnership State grants. New and Emerging Infectious Diseases Emerging infectious disease outbreaks pose a threat to everyone in the country. Our vulnerability to waterborne, foodborne, and airborne infections has been dramatically demonstrated and widely publicized with recent disease outbreaks caused by Cryptosporidium parasites in the water supply in Milwaukee; E. coli 0157:H7 bacteria in undercooked hamburgers in the Pacific Northwest; and hantavirus from rodents in the Southwest. The request includes an increase of $26 million, or a total of $45 million, to double our investment in the Centers for Disease Control and Prevention national prevention strategy-- "Addressing Emerging Infectious Disease Threats." This investment will facilitate rapid identification and investigation of infectious disease outbreaks, reduce the burden of illness due to infections, and reduce associated health care costs. 10 HHS BUDGET BY OPERATING DIVISION (Dollars in millions) 1995 1996 1997 Request Actual Policy* Request +/-Policy Food and Drug Administration BA $882 $878 $878 $0 Outlays 860 877 881 4 Health Resources and Services Administration BA 3,237 3,263 3,309 46 Outlays 2,613 2,955 3,130 175 Indian Health Service BA 1,960 2,000 2,174 174 Outlays 2,008 1,928 2,042 114 Centers for Disease Control and Prevention BA 2,125 2,155 2,230 75 Outlays 1,786 1,971 2,066 95 National Institutes of Health BA 11,284 11,939 12,406 467 Outlays 10,875 10,916 11,949 1,033 Substance Abuse and Mental Health Services Administration BA 2,195 1,854 2,098 244 Outlays 2,444 2,105 2,024 -81 Agency for Health Care Policy and Research BA 141 80 90 10 Outlays 139 129 97 -32 Health Care Financing Administration BA 245,796 261,231 295,950 34,719 Outlays 248,924 272,475 297,219 24,744 Administration for Children and Families BA 33,178 32,610 34,296 1,686 Outlays 31,993 32,875 33,488 613 11 HHS BUDGET BY OPERATING DIVISION, Continued (Dollars in millions) 1995 1996 1997 Request Actual Policy* Request +/-Policy Administration on Aging BA $876 $828 $828 $0 Outlays 951 776 819 43 Departmental Management BA 230 172 178 6 Outlays (Federal Funds) 262 204 157 -47 Office of Inspector General BA 79 74 75 1 Outlays (Federal Funds) 89 74 75 1 Program Support Center BA 212 220 229 9 Outlays (Federal Funds) 208 224 225 1 Receipts BA -45 -46 -46 o Outlays -45 -46 -46 0 TOTAL, HHS BA $302,150 $317,258 $354,695 $37,437 Outlays $303,107 $327,463 $354,126 $26,663 Full-time Equivalents 58,924 58,924 58,924 o * Based on levels of the ninth CR, including an incremental policy adjustment. 12 COMPOSITION OF THE HHS BUDGET (Dollars in millions) 1995 1996 1997 Request Actual Policy* Request +/-Policy Entitlement Programs (outlays): Medicare $180,097 $197,427 $210,106 +$12,679 Medicaid 89,070 94,892 105,571 +10,679 Family Support Payments to States 17,133 17,366 17,955 +589 Foster Care and Adoption Assist 3,244 3,740 4,144 +404 Social Services Block Grant 2,797 3,183 5,001 +1,818 JOB Opportunities and Basic Skills 1,012 1,000 1,000 0 State Legalization Impact Assist. Grts 4,000 0 0 0 Family Support and Preservation 150 225 201 -24 Other/Financing Offsets (26,203) (21,918) (22,699) (781) Subtotal, Entitlement Programs: Outlays $271,300 $295,915 $321,279 +$25,364 Discretionary Programs (Budget Authority): National Institutes of Health $11,284 $11,939 $12,406 $467 Other Public Health Programs 10,335 10,050 10,587 537 HCFA Program Management 2,178 2,132 2,202 70 Children & Family Services Programs 4,876 4,825 5,280 455 Low Income Home Energy Assistance 1,419 1,000 1,000 0 Grants to States for Child Care 948 935 1,049 114 Administration on Aging 876 828 828 0 Refugee & Entrant Resettlement 406 405 382 -23 Departmental Management 171 151 154 3 Office for Civil Rights 22 19 22 3 Office of Inspector General 79 74 75 1 Subtotal, Discretionary Programs: Budget Authority $32,594 $32,358 $33,985 $1,627 Outlays 31,807 31,548 32,847 1,299 TOTAL, HHS OUTLAYS $303,107 $327,463 $354,126 +$26,663 * Based on levels of the ninth CR, including an incremental policy adjustment. ** Does not add due to rounding. 13 FOOD AND DRUG ADMINISTRATION (Dollars in millions) 1995 1996 1997 Request Actual Enacted Request +/-Enacted Current Law: Program Level $973 $981 $985 + $4 Budget Authority 882 878 878 0 Outlays 860 877 881 +4 Proposed Legislation: Program Level 0 $39 + -$39 Budget Authority 0 0 0 Outlays 0 0 0 Total, Net Proposed Law: Program Level $973 $981 $1,024 + $43 Budget Authority 882 878 878 0 Outlays 860 877 881 +4 FTE 9,264 9,264 9,264 0 FOOD AND DRUG ADMINISTRATION Summary Current Law Millions The FY 1997 budget request for the Food 1200 and Drug Administration (FDA) under $978 $981 $985 1000 $934 current law is $985 million in program level $826 $800 8766 spending, of which $107 million is to be derived from authorized, targeted, $600 industry-specific user fees. In addition, 8400 FDA is proposing two new additive user fees bringing the total proposed program $200 level spending to $1,024 million, a $0 $43 million increase over FY 1996. Under 1992 1993 1994 1995 1996 1997 the FY 1997 request, total budget authority will be maintained at the FY 1996 level. 14 Food Safety Although the United States has the safest food supply in the world, the Centers for Disease Control and Prevention estimate that there are as many as 9,000 food-related deaths and 80 million food-related illnesses each year in this country. The annual costs for hospital stays alone related to food-borne disease are estimated to be $3.1 billion, with seafood-related illnesses costing about $144 million annually. FDA is proposing a series of Food Safety initiatives to address current concerns and to meet the safety issues the Nation is likely to face in the 21st century. A modest $4 million increase would allow FDA to expedite implementation of the new Seafood Hazard Analysis Critical Control Point (HACCP) program, expand and develop new partnerships with academia and industry to increase our food science capabilities, and use third party reviewers to improve the timeliness and efficiency of the food additive petition review process. Prescription Drug User Fees The Prescription Drug User Fee Act (PDUFA), first implemented in 1993, has been highly successful in enabling FDA to significantly accelerate approval of safe and effective human drugs. FDA has met or exceeded all of the Act's performance goals to date. Already, FDA has achieved one of the major 1997 performance goals in FY 1994--a full three years ahead of schedule. For the drugs submitted to FDA in FY 1994, FDA reviewed and acted upon 96 percent of them on time. In most cases, that meant action within 12 months. The backlog of overdue applications has been eliminated. To sustain momentum toward reaching the final performance goals in FY 1997, the FY 1997 budget includes $87.5 million in user fees, a 7 percent increase. This will provide for additional review staff, bringing FDA to a total PDUFA staffing increase of 700 FTE. Mammography Quality Standards Act FDA will continue to implement the Mammography Quality Standards Act to assure that women receive quality mammography from facilities that maintain a high standard of safety and accuracy. In FY 1997, FDA will focus its energies on ensuring that all facilities are meeting the quality standards for mammography and that identified deficiencies are corrected. By the end of FY 1996, for the first time, certified personnel will have inspected over 10,000 facilities in all. During FY 1997, FDA will fund 10,000 annual inspections and will conduct 3,000 facility recertifications. To achieve these goals, the FDA request includes $26 million for implementing the Mammography Quality Standards Act, of which $13 million is to be collected in fees from inspected facilities, as authorized by the Act. Proposed New User Fees In FY 1997, FDA is requesting authority to implement two new user fee activities totalling $39 million. Of these fees, $24 million is to accelerate the medical device approval process and $15 million is to improve the effectiveness and efficiency of its imported products regulatory compliance program. FDA is proposing to incorporate the concepts embodied in 15 the highly effective Prescription Drug User Fee Act into the medical devices field to eliminate the current backlog and to reduce the time it takes to approve medical device applications. The user fee goal is to increase the percentage of pre-market notification (510-(k)) applications completed within 90 days from 50 percent in FY 1995 to 90 percent in FY 1997, and pre-market approval applications completed within 180 days from 44 percent in FY 1995 to 75 percent in FY 1997. The new import user fee will provide FDA the resources necessary to substantially reduce the risk posed by potentially harmful foods and other products that reach the American marketplace through import channels. 16 FDA OVERVIEW (Dollars in millions) 1995 1996 1997 Request Actual Enacted Request +/-Enacted Current Law: Salaries & Expenses: Foods $215 $222 $226 + $4 Drugs 445 446 449 +3 Medical Devices 166 170 170 0 National Center for Toxicological Research 35 38 38 0 Program Management 43 42 42 0 Subtotal, Salaries & Expenses $904 $918 $925 + $7 GSA Rental Payments 46 46 46 0 Buildings & Facilities 18 12 8 -4 Revolving Fund 5 5 6 +1 Subtotal, Program Level $973 $981 $985 + $4 Less User Fees: Prescription Drugs $79 $85 $88 + $3 Mammography Inspection 7 13 13 0 Revolving Fund 5 5 6 +1 Subtotal, User Fees $91 $103 $107 +$4 Total, BA $882 $878 $878 0 Proposed Law: User Fees: Medical Devices $0 $24 + $24 Import Inspection 0 15 + 15 Subtotal, User Fees $0 $39 + $39 Total, Program Level $973 $981 $1,024 + $43 FTE 9,264 9,264 9,264 o 17 HEALTH RESOURCES AND SERVICES ADMINISTRATION (Dollars in millions) 1995 1996 1997 Request Actual Policy* Request +/-Policy Program Level $3,042 $3,091 $3,122 +$31 Budget Authority 3,031 3,083 3,116 +33 Outlays 2,455 2,803 2,979 +176 FTE 2,010 2,010 2,010 0 * Based on levels of the ninth CR, including an incremental policy adjustment. Summary The FY 1997 budget request for the Health Resources and Services Administration (HRSA) is $3.1 billion. HRSA is responsible for developing primary health care services and resources, providing access to health care for the medically underserved, protecting and improving the health of all mothers and children, and maintaining a high quality of health care nationally. As managed care is becoming an increasingly important component of health care delivery at the State and local level across the United States and medically underserved populations served by HRSA programs are being directed into managed care, HRSA is addressing these changes. HRSA has established a Center for Managed Care to coordinate activities across HRSA and has initiated new efforts to ensure that HRSA funded programs are active and knowledgeable participants in managed care systems, that managed care providers are aware of and actively attempting to meet the needs of underserved populations, and that an appropriately trained primary care workforce exists to provide services in managed care settings. HRSA has supported the creation of networks for managed care to assure that its health centers and other HRSA grantees can negotiate arrangements with State Medicaid agencies and HMOs. HRSA has offered over 100 managed care training sessions in medical management, information systems, contract negotiations, and financial risk assessment. In addition, special training programs have been offered to providers of care for special populations--HIV infected individuals, mothers and children, and the homeless--tailored to their specific needs. 18 Ryan White The Ryan White AIDS CARE Act has enabled over 300,000 individuals with HIV and AIDS to receive health and supportive services, allowing many, who would have died, to live and lead productive lives. The FY 1997 request of $807 million for the Ryan White activities, a $32 million, or 4 percent increase over the FY 1996 level, continues our commitment to improve the quality and availability of care for individuals and families with HIV and AIDS. This request includes an additional $17 million for Emergency Relief for Cities (Title I) to ensure that each of the 42 metropolitan communities funded in FY 1995 and the up to ten additional cities eligible in FY 1996 will receive the same formula grant as well as provide funds to any newly eligible communities in FY 1997. Included in the request is $285 million, or a 4 percent increase, for formula grants to States to improve services in areas with critical gaps for underserved and hard to reach populations, as well as to augment States' flexibility in selecting pharmaceuticals. A total of $64 million, or a 3 percent increase, is requested in discretionary grants to allow an additional five to ten thousand individuals who are infected with, or at-risk of, HIV infection to receive primary care services. For Title IV pediatric projects, a total of $34 million is requested, a 6 percent increase, which will provide enhanced services for preventing maternal HIV transmission. On March 5, 1996, the President proposed a $52 million budget amendment for the AIDS Drug Assistance Program (ADAP). The ADAP program provides AIDS drugs that prolong and enhance the quality of life for the over 55,000 individuals currently enrolled. This increase is needed to assist States in making available to patients the long-anticipated new class of AIDS drugs, protease inhibitors, as soon as they are approved by the FDA. Protease inhibitors, used in combination with already approved AIDS drugs, are expected to improve the length and quality of life for individuals suffering from AIDS. Consolidated Health Centers The FY 1997 request for the Consolidated Health Centers cluster provides $757 million for grants to local health centers which serve vulnerable underserved populations, including migrant workers, homeless individuals, and residents of public housing. This funding level maintains our commitment to ensure that the most vulnerable of our populations receive quality health care. These community-based centers provide accessible, quality, primary health care to more than 8.1 million medically underserved individuals--44 percent of whom are children--through over 720 grantees at 2,204 sites nationwide. Today, over 150 health centers are involved in managed care contracting throughout the Nation, primarily serving Medicaid managed care patients. Health Professions The FY 1997 budget request for health professions programs is $366 million. HRSA is continuing to propose consolidation of numerous separate health professions training programs into five clusters over a period of three years. The cluster strategy allows greater flexibility in effectively responding to emerging health workforce challenges. The clusters will enhance our ability to assist students financially, encourage expansion of 19 multi-disciplinary, outcome-oriented primary care training, as well as bring simplicity to the administrative processes of application submission and grant issuance. The Health Professions Workforce cluster ($117 million) will merge six student assistance programs into one program, providing student assistance through obligated financial assistance, non-service subsidized loans, and non-service market rate loans, as well as focus on national workforce research and data efforts. This cluster will include the entire National Health Service Corps. The Enhanced Area Health Education Training cluster ($35 million) incorporates eight categorical programs into one program which will require the formation of consortia to link educational systems with States, communities and employers to expand the operation of interdisciplinary, outcome-oriented training. This critical effort ties medical education to the service needs of the underserved. It provides benefits to those being trained so that they receive solid grounding in practical health care. It also provides benefits to States and communities by providing knowledgeable individuals prepared to deal with the health issues they face. The Minority and Disadvantaged Health cluster ($64 million) consolidates seven programs into one program which will support targeted, outcome-oriented activities that increase the number of minority and disadvantaged health professionals. This program will help advance the development of human potential and strengthen the capacity of Historically Black Colleges and Universities and Hispanic Serving Institutions. This cluster will eliminate restrictive eligibility and project requirements while increasing flexibility in responding to minority health needs. The Primary Care Medicine and Public Health Training cluster ($80 million) consolidates six programs. This program will fund comprehensive, flexible, and effective activities that will increase the number and enhance the quality of primary medical care providers and public health workers in order to meet National, State, and local health care needs. The Nursing Education Practice Initiatives cluster ($70 million) combines six programs into three activities focusing on basic nurse training, advanced practice nurse training, and workforce diversity. It provides solid reinforcements to our continued efforts to help provide well-trained individuals in this key component of the health care workforce. Services to Mothers and Children In keeping with the Department's strong commitment to investing in programs which support Strong Foundations and Safe Passages for our Nation's children, the HRSA budget supports funding for several programs with the sole mission of improving the health of women of childbearing age and their children. These programs include the Maternal and Child Health Block Grant, a total program level of $681 million; Healthy Start, a total program level of $75 million; and the Title X Family Planning program, a total program level of $198 million, an increase of $5 million, or 3 percent, over FY 1996. The family planning 20 program provides services to approximately four million persons, primarily women and adolescents, in over 4,000 clinics nationwide. The funds will increase outreach to underserved individuals, place an emphasis on comprehensive reproductive health services, and focus on adolescent pregnancy and sexually transmitted disease prevention. Other HRSA For the remaining HRSA programs, total spending of $238 million is proposed. This level will ensure sufficient funds are available to adequately fund rural health initiatives such as telemedicine, critical to assisting rural physicians in their daily practice, and internal HRSA initiatives such as technology improvements and workforce development to allow HRSA to continue to streamline its workforce and organization while maintaining a high level of service to the vulnerable populations it serves. In addition, this level will allow HRSA to keep its organ transplantation and Bone Marrow Donor programs viable. 21 HRSA OVERVIEW (Dollars in millions) 1995 1996 1997 Request Actual Policy* Request + /-Policy Ryan White $633 $775 $807 + $32 Other AIDS Services 23 12 23 +11 Community Health Centers 757 756 757 +1 Health Professions Clusters: Workforce Development 124 115 117 +2 Enhanced Areas Health Education 48 42 35 -7 Minority/Disadvantaged 91 81 64 -17 Primary Care Medicine & Public Health 79 74 80 +6 Nurse Education 59 56 70 +14 Subtotal, Health Professions $401 $368 $366 -$2 Maternal and Child Health Block Grant $684 $681 $681 $0 Healthy Start 104 75 75 0 Family Planning 193 193 198 +5 Special Populations Cluster 17 12 8 -4 Rural Health Research 9 8 8 o Rural Outreach 26 43 30 -13 Malpractice Databank 11 8 6 -2 Program Management 124 114 116 +2 Other Services 60 46 47 +1 Subtotal, Disc. Program Level $3,042 $3,091 $3,122 + $31 Offsets -11 -8 -6 +2 Total, BA $3,031 $3,083 $3,116 + $33 FTE 2,010 2,010 2,010 o * Based on levels of the ninth CR, including an incremental policy adjustment. 22 INDIAN HEALTH SERVICE (Dollars in millions) 1995 1996 1997 Request Actual Policy* Request +/-Policy Program Level $2,156 $2,214 $2,400 +$186 Budget Authority 1,960 2,000 2,174 +174 Outlays 2,008 1,928 2,041 +113 FTE 14,856 14,856 14,856 0 * Based on levels of the ninth CR, including an incremental policy adjustment. Summary The FY 1997 budget request for the Indian NEW INITIATIVES IN FY 1997 Health Service (IHS) is $2.4 billion. (dollars in millions) Additional funds will be used primarily for 250 sanitation construction, to make it easier for tribes to take over the operation of their 200 local health programs, to provide additional 150 staff in six new/expanded health facilities, and to increase services for populations with 100 special needs (e.g., women, children, urban 50 Indians, the elderly). The request assumes collection of $222 million in insurance 0 1994 1995 1996 1997 payments (e.g., Medicaid, Medicare, Sanitation Const. Contract Support employer provided) for Indian patients, consistent with FY 1996 levels (total FY 1997 reimbursements of $226 million include $4.5 million from rental of quarters). Agency Description IHS provides medical care to about 1.4 million American Indians and Alaska Natives (AI/AN) who are members of Federally recognized tribes. Care is provided directly through a network of 49 hospitals and 484 health centers and stations located primarily in Oklahoma, the Northern Plains, California, Alaska, and the Southwest. Local tribes operate 11 of the hospitals and 372 of the centers and stations under contract with IHS. Medical care is also purchased ($369 million in FY 1997) for Indian patients from local hospitals and medical providers. While care is primarily provided in areas which are on or near reservations, funds are also provided to urban health grantees ($23 million in FY 1997) in 41 cities with 23 large AI/AN populations. In addition to providing medical care, IHS provides preventive and environmental health services, mental health care, and alcohol/substance abuse prevention and treatment. IHS also provides funds to increase the supply of AI/AN health care providers and as incentives for health care professionals to practice in Indian country. The health statistics for Indian people have DECLINING MORTALITY RATES improved dramatically, both in absolute (Deaths per 100,000 Pop.) terms and in comparison with all Deaths per 10,000 for Accidents Americans, since IHS began keeping 12 records in the early 1970s. Two areas 10 which have seen significant improvement in 5 recent years are infant mortality and deaths 6 from accidents. Infant mortality has 4 declined by 15.3 percent while the death 2 rate for accidents has declined by o 1987 1988 1989 1990 1991 12.8 percent. Infant Mortality Accidents Trends in Indian Health, 1995 IHS Restructuring The final report of the Indian Health Design Team (IHDT) was published in November of 1995, the product of more than a year's worth of development, including extensive feedback from IHS' customers (i.e., tribes, tribal organizations, and individuals throughout Indian country) and employees. The IHDT recommends shifting control to the local level where IHS staff or tribal self-determination contractors provide health care. Headquarters and regional operations will be consolidated to provide additional dollars and staff for health care operations. Implementation has begun with the restructuring of IHS' headquarters, reducing ten existing offices to three (Office of the Director, Office of Health Support, Office of Administrative Support). The second phase of implementation will consolidate operations at IHS' twelve regional or area offices, each one of which now oversees all IHS operations in a geographic area. Administrative support functions (e.g., finance, procurement, personnel) will be consolidated in Regional Support Centers. Health Professions support (e.g., maternal and child health, injury prevention, consultations with local health care providers) will also be consolidated into a smaller number of specialty sites. The IHDT recommendations will also reduce headquarters and area office budgets and free up FTE for local health care provision. Changes From FY 1996 The FY 1997 budget requests an increase in budget authority of $174 million (+8.7 percent) primarily for Clinical Services (+$80 million), Self-Determination Contracting (+$46 million), and Sanitation Construction (+$43 million). The request also assumes an increase of $12 million in insurance collections (+5.3 percent). Insurance collections are used to make improvements to hospitals and health clinics identified by accreditors from the Health Care Financing Administration and the Joint Commission on Accreditation of Health Care Organizations. 24 The additional $174 million will fund a number of new initiatives in FY 1997: Self-Determination Funds ($212 million; +$46 million): The request provides an increase of 28 percent to cover contract support costs, which are the management expenses tribes incur when they take over the operation of local health programs from IHS. The Indian Self-Determination Act gives tribes the right to take over these operations but their ability to do this is hindered unless sufficient funding is available for contract support costs. Tribally operated programs have increased steadily since the Act's passage and accounted for about 37 percent of IHS' budget in FY 1995. Sanitation Construction ($128 million; +$43 million): IHS has been providing water and waste disposal services to Indian homes since 1960, helping to increase the number of homes with such service from about 20 percent to over nearly 90 percent. Of the $128 million, $86 million will be used to provide services to 17,400 existing homes (up from 8,800 in FY 1996), and $42 million will be used to provide services for new homes as they are built (the same as in FY 1996). Health Initiative for Special Populations (+$16 million): IHS will begin four special initiatives focused primarily on the needs of women, children, elders, and urban Indians. Funds will be used for outreach services aimed at preventing domestic violence (women and children), other preventive services for women (diabetes, cancer, alcohol and substance abuse), to provide training and access to off-reservation services to better serve the growing elderly population, to provide additional services to urban Indians, and to expand community efforts to reduce injuries (e.g., DWI, seat belts/child restraints, sports injuries, violence, pedestrian/motor vehicle collisions). Operation of New Facilities (+$27 million): The request includes funds necessary to provide an additional 382 staff for six facilities opening in FY 1996 and FY 1997. These facilities are Harlem (MT), White Earth (MN), Kotzebue (AK), Shiprock (NM), Anchorage (AK), and Hayes (MT). IHS is not proposing to increase its total staff level between FY 1995 and FY 1997. To the extent these new staff are Federal employees, they will be offset by staff reductions primarily in headquarters and area offices. Other Initiatives (+$7 million): The request also includes $3.5 million to purchase medical services for five newly recognized tribes (Mohegan Indian Tribe of Connecticut; Jena Band of Choctaw of Louisiana; and three tribes from Michigan: Little Traverse Band of Odawa, Little River Band of Ottawa, Pokagon Band of Potawatomi), $2 million for health professions scholarships, and $1.5 million for system upgrades and improved electronic communication. IHS is also requesting $44 million for pay costs and inflation, and for the costs associated with turning area and headquarters operations over to contracting tribes (e.g., change of duty station, severance pay). Dollars requested for new health facility construction will be reduced (-$9 million) with the full funding of all ongoing facilities construction occurring in FY 1996 (Hayes, MT and White Earth, MN). IHS will complete design of three facilities in FY 1997--Pinon, Ft. Defiance, and Hopi (Second Mesa)--all located in Arizona. 25 IHS OVERVIEW (Dollars in millions) 1995 1996 1997 Request Actual Policy* Request +/-Policy Services: Clinical Services $1,370 $1,418 $1,498 +$80 Preventive Health 77 78 82 +4 Direct Operations 50 49 51 +2 Self-Determination Contracting 159 166 212 +46 Other 51 50 56 +6 Subtotal, Services $1,707 $1,761 $1,899 +$138 Facilities: Sanitation Construction $85 $85 $128 +$43 Facility Construction 28 12 3 -9 Fac/Envir Health Support 88 90 92 +2 Other 52 52 52 0 Subtotal, Facilities $253 $239 $275 +$36 Total, BA $1,960 $2,000 $2,174 +$174 Reimbursements 196 214 226 +12 Total, Program Level $2,156 $2,214 $2,400 +$186 FTE 14,856 14,856 14,856 0 * Based on levels of the ninth CR, including an incremental policy adjustment. 26 CENTERS FOR DISEASE CONTROL AND PREVENTION (Dollars in millions) 1995 1996 1997 Request Actual Policy* Request +/-Policy Program Level $2,223 $2,256 $2,343 +$87 Budget Authority 2,125 2,155 2,230 +75 Outlays 1,786 1,971 2,066 +95 FTE 6,645 6,592 6,592 0 * Based on FY 1996 appropriation, including an incremental policy adjustment. Comparable Table--includes Bureau of Mines Safety and Health Research comparable figures for FY 1995 and FY 1996. Summary The FY 1997 President's Budget request for the Centers for Disease Control and Prevention (CDC) provides a $2.3 billion level of spending. CDC is the leading public health agency responsible for disease prevention and health promotion efforts. Consistent with the strategies articulated in the Healthy People 2000 report, emphasis is placed on expanding proven prevention services which target improving the health status of all Americans. Special attention is placed on healthy lifestyles at an early age and on preventing costly health problems, particularly those affecting the economically disadvantaged. As this nation moves closer to the millennium, CDC is focusing on developing measures of prevention effectiveness and health outcomes. Childhood Immunization It is the Administration's goal that, no later than the year 2000, at least 90 percent of the nation's two-year-olds will be fully immunized. Over the past three years, investments in childhood vaccines and State vaccine delivery infrastructures have moved the Nation further toward accomplishing this goal. For 1995, the National Immunization Survey (NIS) indicates that 75 percent of our two-year-olds are now fully immunized compared to just 55 percent in 1992. In FY 1997, the Administration will spend a total of $1.0 billion on childhood immunization--$488 million on CDC discretionary programs and $524 million on the Vaccines for Children (VFC) entitlement program. 27 As part of its broad Childhood Immunization Initiative, the CDC has HEALTHY CHILDREN been working toward global polio Meeting Our Immunization Goals eradication--and this goal is within Millions reach--achievable by the year 2000. 8.2 Million Children Under 2 Years of Age The FY 1997 request includes an increase of $20 million, or a total of 10 7.4 Million $47 million, for global polio 8 6.2 Million eradication. Data now indicate that 6 polio cases are down by 80 percent 4 globally since 1988. According to 2 1994 data, 145 countries in the world 0 1996 1997 1998 1999 2000 are already polio-free. Yet, the World Health Organization (WHO) Children Immunized Children Under 2 estimates that over 100,000 children are needlessly crippled by polio paralysis each year. Pediatric Vaccine Series Over the past year, tremendous 1996 Dollars 350 strides have been made in 1992 $312.75 implementing the new VFC 800 $245.84 entitlement program. Over 39,000 250 providers in the U.S. have been 200 $164.29 recruited to provide VFC vaccines to 150 $122.19 Medicaid, uninsured, underinsured, 100 American Indian, and Alaska Native 50 children at their first medical point of o contact. Enrolling providers in VFC Private Public Private Public reduces the missed opportunities for DTP DTP/HIb HIb DTaP immunization formerly caused by MMR OPV Hepalitis Varidella provider referrals to public health clinics which required parents to make a second trip away from a child's medical home for vaccinations. In FY 1996, the VFC program will become fully operational and Medicaid payments for vaccines will be completely phased out. For the first time in FY 1996, CDC also will be able to help States target resources to pockets of need because of the new National Immunization Survey. HIV/AIDS A total of $617 million, an increase of $34 million (6 percent) over FY 1996, is requested for CDC HIV/AIDS prevention programs. The request includes $20 million for applied HIV/AIDS research which will enable CDC and its prevention partners to identify effective interventions for specific populations, for instance--women; injecting drug and other substance abusers; and high-risk youth, both in and out of school. In addition, $12 million will be used to build on the community planning model established by the HIV/AIDS program last year. This model gives grantees broad discretion in setting program priorities and determining how funds will be spent--resulting in customized programs necessary to meet 28 the needs of diverse communities across this nation. This flexibility permits communities to target resources to where they are most needed and will have the most impact--for instance meeting the needs of adolescents. Also requested is an increase of $2 million to meet the growing demand for tuberculosis testing of HIV-infected individuals. Of the total request, $298 million will be awarded through an HIV/AIDS Performance Partnership Grant and $319 million will remain with CDC for national outreach and education, technical assistance, and research. New and Emerging Infectious Diseases Emerging Infectious Diseases National Plan In recent years, infectious disease Dollars In Millions 50 $45 M outbreaks have taught us that we are - susceptible to infectious diseases-- 40 - HIV, plague, and influenza are good 30 - examples of that risk. Potential $18 M 20 threats to U.S. health are steadily - $8 M 10 escalating because of increasing - $1 M 0 global interdependence, modern - transportation, trade, and changing FY 1994 FY 1995 FY 1996 FY 1997 social and cultural patterns. CDC is Surveillance Applied Research seeking a total of $88 million for infectious disease activities. Of this Prevention Intrastructure amount, $45 million is included to implement the CDC national prevention strategy for addressing emerging infectious disease threats--an increase of $26 million over FY 1996. Since FY 1993, CDC's total budget for preventing and controlling infectious diseases has more than doubled. The FY 1997 request will provide financial and technical support to 30 State health departments for surveillance, epidemiologic and laboratory investigations, and educational programs on infectious diseases, including rapid identification and investigation of outbreaks and drug resistant diseases. Three additional population-based Emerging Infections Programs would be established, for a total of eight nationwide. This investment has the potential to reduce the burden of illness due to infections and reduce health care costs substantially. For example, Salmonella infections now kill at least 1,000 Americans a year and add $1 billion in medical costs to the country's health care burden; Campylobacter infections add another $1 billion to our nation's health care bill; and influenza produces direct medical costs approaching $5 billion and lost productivity costs of almost $12 million each year. 29 HHS Survey Integration -- National Health and Nutrition Examination Survey (NHANES) HHS has closely reviewed its health data surveys and produced a long-range plan for health survey integration. This plan calls for linkages--field work, study samples, data collection questionnaires, etc.--and will result in more comprehensive data collection and analysis--as well as saving resources from economies of scale. In addition, surveys that were once periodic (done once a decade) are being converted to continuous surveys with the same periodicity--to be more responsive to the fast pace of the nation's health care enterprise. For the National Center for Health Statistics, the request totals $90 million for health statistics in FY 1997. The FY 1997 request includes an increase of $10 million, or a total of $14 million, for the National Health and Nutrition Examination Survey (NHANES). As part of the HHS survey integration plan, NHANES will be linked to the Medical Expenditure Panel Survey (MEPS) and the National Health Interview Survey (NHIS). The analytic linkage of these three surveys is crucial for providing ongoing monitoring of our nation's health status, insurance, expenditures, and health risk and behaviors. NHANES is a consolidation of data efforts of multiple agencies and departments, not just CDC or HHS. Food fortification policy at FDA relies on NHANES measures, as does monitoring of toxicants for the EPA. NHANES provides unique information through direct physical examinations, biochemical measures, and nutritional analysis from a large, representative sample of persons. By direct standardized measurements, NHANES is able to objectively measure health conditions and risks, even if they are not known to the survey respondent. NHANES also is the only national source of objectively measured health status data, and is essential to interpreting information from other integrated survey components. NHANES obtains direct measures of health necessary to measure the outcomes--not just the costs of--investments in health. These data also allow us to relate health care needs to health care use and expenditures. NHANES is an important part of national surveillance capability for infectious diseases, behavioral and environmental risk factors to health, undiagnosed preventable illnesses, food safety, nutritional status, and other critical issues. No other effort in the public or private sector provides the type of information available through NHANES. Examples of NHANES data uses include monitoring of: lead exposure, toxic exposure and environmental effects, genetics, food safety (for instance, olestra), folate (food fortification impact), hypertension and cholesterol (program success), and HIV and Hepatitis C Seroprevalence (necessary to protect the national blood supply). National Institute for Occupational Safety and Health (NIOSH) CDC is requesting a total of $136 million in FY 1997. A major component of this request is an investment of $36 million to fully fund the NIOSH new advanced research facility. This state-of-the-art laboratory will increase the nation's occupational safety and health research capacity by more than one-third. When fully staffed, more than 300 researchers will have the opportunity to make advances in biochemistry, immunotoxicology, and molecular and 30 cellular biology that will be translated into information that directly assists work site health and safety programs. The facility will open in the Spring of 1996. NIOSH programs establish and disseminate scientific and public health information necessary to ensure safe and healthful working conditions for 127 million American working men and women. Americans are working more hours than ever before, in environments that may profoundly affect their health. Even with the passage of the Occupational Health and Safety Act in 1970, and the mine safety laws that were enacted in 1969 and 1977 to protect miners, workplace hazards continue to inflict a tremendous toll in both human and economic costs. Even now, work-related injuries and illnesses still cost an estimated 63 thousand lives each year. Work injuries alone cost our economy over $100 billion a year, and occupational illnesses cost additional billions of dollars. Research plans for the coming year will focus on occupational lung disease, musculoskeletal injuries, cancers, traumatic injuries, reproductive disorders, neurotoxic disorders, cardiovascular disease, noise-induced hearing loss, dermatologic conditions, and protective equipment. These efforts will help to address solutions to occupational disease and workplace safety concerns in those fields where the dangers are the greatest--mining, construction, transportation/communications/public utilities and agriculture/forestry/fishing. Mine Health and Safety Research-Bureau of Mines Transfer In FY 1997, CDC will take over the management of the health and safety research functions formerly performed by the Bureau of Mines. While the Mine Health and Safety Research program was initially transferred to the Department of Energy in FY 1996, the program will become part of the National Institute for Occupational Safety and Health (NIOSH) in FY 1997. A total of $32 million and 413 FTE is requested for continuing this program in FY 1997. Infectious Disease Laboratories: Repair and Improvement The FY 1997 request of $8 million for buildings and facilities includes an increase of $4 million for design and construction of 15,000 square feet of BLS-3 (Biosafety Level 3) containment laboratory space necessary to allow CDC to renovate its current laboratories which are 35 years old and deteriorating. The current building and facilities budget is not adequate to both build a new building and address CDC's backlog of building repair and improvement projects, so CDC has found offsets within programs that will directly benefit from the new laboratories. Conditions of existing laboratory space, including antiquated airhandling systems, place several hundred scientific employees at risk from highly infectious and dangerous organisms. This lab project is a top priority for the agency. 31 Rape Prevention/Education and Domestic Violence Demonstrations The FY 1997 request includes $32 million from the Violent Crime Reduction Trust Fund to continue three programs authorized by the Violent Crime Control and Enforcement Act of 1994. CDC will distribute $29 million to States as part of the Prevention Block Grant for rape prevention and education, and award $3 million for domestic violence demonstration projects. These programs were first funded in FY 1996. Chronic Diseases and Disabilities The FY 1997 request includes $268 million to address the significant premature death and avoidable illness and disability that are caused by personal behaviors and exposure to toxic substances and natural disasters. Chronic diseases, including those present at birth, represent over 70 percent of the causes of death in the United States. Prevention of disease and its progression is based on reducing or eliminating behavioral risk factors-such as tobacco use, physical inactivity, and poor nutrition; increasing the prevalence of health promotion practices; detecting disease early to avoid complications; assessing human risks from environmental exposures; and reducing or eliminating exposures to environmental hazards. The CDC addresses a wide range of chronic and environmental diseases, including cardiovascular disease--the leading cause of death in the United States; diabetes; cancers; birth defects; reproductive disorders; and chronic fatigue syndrome. Sexually Transmitted Diseases and Tuberculosis The request includes $223 million to continue CDC programs to prevent and control infectious sexually transmitted diseases (STDs) and tuberculosis (TB). It is important that the Nation remain vigilant in maintaining adequate resources to hold STDs and TB in check. As recent as 1989, the U.S. had a resurgence of TB--a disease that had steadily declined since the 1940s. As a result, the CDC budget for TB has more than doubled since FY 1992--from $67 million to $145 million--and Medicaid coverage now provides approximately $130 million for State TB services in non-traditional settings (for instance in crack houses, rather than in health clinics). Data from 1994 indicate that there has been a 9 percent decline in TB cases since 1992 when the peak number of cases was reported (26,673). Maintaining resources necessary to prevent and control STDs is a high priority. More than 750,000 cases of pelvic inflammatory disease (PID) are diagnosed and treated each year, resulting in more than 165,000 hospitalizations for women aged 15-44. Annually, PID, secondary to either gonococcal or chlamydia infection, accounts for more than 125,000 cases of tubal infertility and nearly 50,000 cases of potentially fatal ectopic pregnancy. Delay in treatment and repeated episodes of symptomatic and asymptomatic PID result in higher rates of infertility, and result in complications for children born to untreated mothers. To further complicate matters, these diseases are now presenting new challenges to the medical establishment as more and more multi-drug resistant (MDR) strains are diagnosed. 32 Although once easily and cost-effectively treated with antibiotics, medical care for MDR-TB and STDs is much more costly and more often fatal than for non-MDR strains. Prevention remains our best defense. Performance Partnership Grants Similar to last year, the FY 1997 budget proposes to consolidate 32 CDC categorical grant programs into four Performance Partnership Grants--an HIV Grant, an STD/TB Grant, a Chronic Disease and Disability Prevention Grant, and an Immunization Grant. As proposed, these consolidations are designed to increase State flexibility, streamline Federal management, improve program performance, and ensure accountability. With the creation of these new, simplified grants, CDC will be able to extend Federal resources to States with fewer strings attached, with less grant submissions, reviews, and negotiations, and with broader discretion at the State level to pursue their own priorities. States will be asked to submit a single annual grant application for each grant program and their performance on specific goals they choose will be monitored to see that their performance improves public health. CDC will retain responsibility for research, demonstration, training, and technical assistance programs as well as targeted national programs including: purchasing childhood vaccines, addressing new emerging infectious diseases and environmental health issues, and eliminating child lead poisoning. CDC also will retain the existing Prevention Block Grant. 33 CDC OVERVIEW (Dollars in millions) 1995 1996 1997 Request Actual Policy* Request +/-Policy Immunizations: Partnership Grant $177 $177 $177 $0 Vaccine Purchase 152 141 141 0 Other Immunization 135 150 170 +20 Subtotal $464 $468 $488 + $20 HIV/AIDS: Partnership Grant $286 $285 $298 + $13 Other HIV/AIDS 304 298 319 +21 Subtotal $590 $583 $617 + -$34 Infectious Diseases 54 62 88 +26 Health Statistics 81 80 90 +10 Occupational Safety and Health 132 137 136 -1 Mine Health & Safety Research 42 32 32 0 Building & Facilities 3 4 8 +4 Preventive Health Svcs Block Grant 158 145 145 0 Rape Prevention/Education 0 29 29 0 Domestic Violence Demos 0 3 3 0 Injury/Violence Control 44 43 43 0 Chronic Diseases & Disabilities: Partnership Grant $118 $118 $117 -$1 Chronic & Environmental Diseases 103 107 106 -1 Breast/Cervical Cancer 20 45 45 o Subtotal $241 $270 $268 -$2 Sexually Transmitted Diseases/TB: Partnership Grant $186 $183 $182 -$1 Sexually Transmitted Diseases 22 25 25 0 TB Elimination 17 16 16 0 Subtotal $225 $224 $223 -$1 Epidemic Services 73 70 69 -1 Prevention Centers 8 8 7 -1 Lead Poisoning 36 36 36 0 Toxic Substances/Disease Registry 69 59 58 -1 Director's Office 3 3 3 0 Subtotal, Program Level $2,223 $2,256 $2,343 + $87 Less: PHS Intra-Agency Transfers Receipts -98 -101 -113 -12 Total, BA $2,125 $2,155 $2,230 + $75 FTE 6,645 6,592 6,592 0 * Based on levels of the ninth CR, including an incremental policy adjustment. Comparable Table--includes Bureau of Mines Safety and Health Research comparable figures for FY 1995 and FY 1996. 34 NATIONAL INSTITUTES OF HEALTH (Dollars in millions) 1995 1996 1997 Request Actual Policy Request +/- Policy Program Level $11,295 $11,950 $12,435 +$485 Budget Authority 11,284 11,939 12,406 +467 Outlays 10,875 10,916 11,949 +1,033 FTE 15,474 15,474 15,474 0 Summary The FY 1997 request for the National Institutes of Health (NIH) totals $12.4 billion, an increase of $467 million, or 4 percent, over the FY 1996 level. This includes an additional $274 million related to the construction of the Clinical Research Center and an additional $193 million for research activities. NIH has constructed its budget request to minimize the impact on research project grants of this one-time extraordinary facilities cost. Our Nation's historic commitment to biomedical research has spawned a steady march of progress--from the creation of new drugs targeted to specific diseases to the mapping of the human genome. NIH is the preeminent biomedical and behavioral research organization in the United States and provides world leadership in these fields through the conduct, support, and promotion of outstanding research both in its own intramural laboratories and in partnership with over 2,000 of our country's colleges, universities, and other scientific institutions. The Institutes and Centers funded by NIH's 24 appropriations are committed to supporting initiatives having the greatest potential for improving health, reducing the risk of disease, and ultimately, improving the quality of human life. Investments in research are the engines of long-term economic progress. This is why, in a time of limited growth across the Federal Government, this Administration continues to fight for steady increases in research, as evidenced with this FY 1997 budget request for NIH. In the past three years, these efforts have paid off, time and time again. They have helped lead to the discovery of three genes linked to hereditary breast cancer; to the first drug treatment for severe sickle cell anemia; to the first treatment for the most common form of stroke; to five new licensed anti-viral drugs for people living with HIV/AIDS; and to three recently approved protease inhibitors, a whole new class of drugs to combat AIDS. Yet, these advances were also the culmination of many smaller, less dramatic discoveries over many years, which demonstrate the need to take the long view of basic research. A panel of experts sent a tough wake-up call last December when it concluded that the promise of gene therapy, while awe inspiring, is still miles away from being realized. It reminded us that we 35 must invest more in the foundation of our NIH FUNDING HISTORY scientific universe, in the incremental gifts BA In Billions of basic science that help us unleash $14 blockbuster discoveries over time. Stable $12.4 $11.9 $12 $11.3 and secure funding is needed to nourish the $10.9 $10 $10.3 seeds of research, to create an atmosphere $10 in which young investigators are pulled into $8 science, inspired to stay there, and $6 ultimately train the next generation of scientists. $4 $2 For FY 1997, NIH has identified five $0 biomedical research areas for emphasis in 1992 1993 1994 1995 1996 1997 which it sees an opportunity to explore a set of emerging technologies, approaches, and treatments that will help expand the frontiers of biomedical knowledge and that offer great promise for curing disease and furthering the Nation's health. NIH plans to spend an additional $99 million in FY 1997 to emphasize research on the biology of brain disorders; on new approaches to pathogenesis, the study of disease origins and development; on new preventive strategies against disease; on genetics of medicine; and on advanced instrumentation and computers in medicine and research. Research Project Grants The highest priority of NIH is the support NEW/COMPETING RESEARCH PROJECT GRANTS of basic biomedical research through (1987-1997 Request) investigator-initiated research project grants (RPGs). These grants support new and 1987 7,197 1988 6,867 promising ideas cutting across all areas of 1989 6,157 biomedical research. In FY 1997, the NIH 1990 6,620 budget provides $6.6 billion to support a 1991 6,462 1992 6,768 record total of 25,400 RPGs, including 1993 6,149 6,827 new and competing RPGs. This 1994 6,474 represents an increase of 207 new and 1995 6,858 1996 6,620 competing RPGs, and an increase of 733 in 1997 6,827 the number of total RPGs compared to 0 2,000 4,000 6,000 8,000 FY 1996. In recognition of its importance to the NIH mission and the current state of knowledge for future breakthroughs in many disease areas, NIH is devoting 86 percent (+$166 million) of its non-facilities increases in FY 1997 to the RPG mechanism. Funds for small business research and technology transfer grants are also slated to rise by $43 million in FY 1997, in accordance with statutory earmarks. In addition, NIH is continuing its pilot studies to fine-tune and streamline the peer-review system to ensure that every dollar counts and that research funds are spent wisely and effectively. 36 FY 1997 NIH BUDGET Percent Change by Selected Mechanism Mechanisms RPGs 2.6% Training 2.4% Centers 0.6% RM&8 0.3% Other Res. -0.1% Intramural -0.2% Contracte -0.9% -1.5% -1% -0.5% 0% 0.5% 1% 1.5% 2% 2.5% 3% Percents Clinical Center Revitalization A major feature of the FY 1997 President's budget for NIH is the commitment to revitalize both the operations and the facilities of the Warren G. Magnuson Clinical Center. The Center is the core clinical research facility at NIH and is the largest of its kind in the world. It provides protocol-specific patient care in support of the intramural research programs sponsored by most NIH Institutes, and serves as a resource for training clinical investigators. Each year, an average of 20,000 children and adults from across the country, and in some instances, the world, are referred to the Clinical Center for experimental treatment and study. These patients account for approximately 65,000 inpatient days and 70,000 outpatient visits a year. Nearly 1,000 clinical research protocols are ongoing at the Clinical Center at any one time. This represents approximately 25 percent of all Federally funded outpatient visits associated with clinical research and nearly half of all the Federally funded clinical research beds in the Nation. Funding for the Clinical Center is derived from assessments on the participating Institutes and Centers. An "Options Team," created by the Secretary last summer, recently completed a thorough review of Clinical Center operations. The Options Team has identified numerous processes and structures that will be reengineered to improve the effectiveness and efficiency of the Clinical Center. The Team's report recommended fundamental alterations in the way the Clinical Center is governed, funded, and managed. As a result, a new Board of Governors is being created to oversee the operations and budgeting of the Clinical Center and to assist it in developing strategic, long-term planning with measurable objectives. NIH has committed to ensure that funding for the Clinical Center is made more stable through its Management Fund assessments and through a budget proposal to make such funds available for two years, instead of the usual one. Authority is also being sought to allow the Clinical Center to collect and keep third-party reimbursements for some patient services. Furthermore, as a result of its intensive self-review, the Clinical Center has initiated steps to reduce regulations, enhance autonomy, and improve personnel and procurement practices. In addition, the FY 1997 President's budget for NIH requests a total of $310 million for the construction of a new, state-of-the-art Clinical Research Center on the NIH campus in Bethesda, Maryland, to replace the 500-bed hospital component and build some additional associated laboratories. The current facility was built in the early 1950s and is now 37 physically deteriorated and is becoming functionally obsolete. This budget request is the product of over seven years of study of NIH's facilities, including critical independent assessments by the U.S. Army Corps of Engineers in 1991, and the NIH Director's External Advisory Committee on the NIH Intramural Research Program in 1994 which recommended the Clinical Center's hospital component be downsized from the current 500-bed capacity to a 250-bed facility. This new facility will be more efficient to run, more affordable to maintain, more flexible to staff, and more rapidly adaptable to the clinical challenges of the future. Together, these operational and facilities improvements will ensure that the Clinical Center flourishes well into the next century as the national core of clinical research. Office of AIDS Research The FY 1997 President's budget again includes all of NIH's AIDS-related funds--$1.4 billion--in a single account for the Office of AIDS Research (OAR), as these funds were appropriated in FY 1995. The Director of OAR will transfer AIDS funds to the Institutes in accordance with the comprehensive plan for AIDS research developed by the OAR along with the Institutes. The Administration strongly supports a consolidated AIDS appropriation as a vital part of ensuring a coordinated and flexible response to the AIDS epidemic. The AIDS research effort is unlike any NIH HIV/AIDS-RELATED RESEARCH FUNDING other program at the NIH in that it spans BA In Millions the agendas of every Institute at NIH. 1,600 $1,408 $1,432 Managing this complex and vast research $1,400 $1,334 $1,296 portfolio requires a unique and 1,200 $1,047 $1,071 unprecedented level of scientific leadership 1,000 to determine research priorities and to $800 ensure collaboration and minimize $600 duplication in a united front against this devastating epidemic. The creation of the $400 OAR has meant that there is now a single $200 entity solely devoted to directing and $0 1992 1993 1994 1995 1996 1997 coordinating the entire NIH AIDS research program. The consolidated appropriation also gives the OAR the opportunity to reassess resource allocations across the Institutes based on scientific developments that may occur after the budget is developed. The FY 1997 budget includes $1.4 billion for AIDS-related research. This is an increase of 1.7 percent over FY 1996. The requested net $24 million increase for AIDS represents an additional $53 million for the support of investigator-initiated research projects and small business grants, with a $29 million decrease in the research contracts, intramural research, other research, and administrative support mechanisms. This emphasis on investigator- initiated basic research will allow for a broader search and assessment of the HIV/AIDS disease itself, which is needed at this time before major new advances in AIDS treatments and vaccines are likely to occur. Fundamental research on AIDS is also expected to have a significant impact on research in non-AIDS areas as well, as NIH focuses on better integrating behavioral and biomedical research programs related to AIDS. Similarly, the 38 construction of the new Clinical Research Center is also expected to greatly benefit AIDS research; approximately ten percent of research conducted in the current outdated Clinical Center is related to AIDS. Other Research Mechanisms In FY 1997, NIH plans to increase spending for research training by $10 million over FY 1996, a 2.4 percent increase. This will allow NIH to support 14,749 individual and institutional full-time research training positions. Within this increase, NIH will provide a 2.2 percent across-the-board stipend increase, the first stipend increase since FY 1994. All other research mechanisms, excluding research project grants and training, are being held nearly constant in FY 1997, compared to FY 1996. Research centers are increasing only 0.5 percent, intramural research is decreasing 0.1 percent, and research contracts are decreasing 0.9 percent, all reflecting NIH's emphasis on investigator-initiated research project grants in the FY 1997 budget. Research management and support costs are generally being maintained at the reduced FY 1996 levels. 39 NIH OVERVIEW (by Institute/Center) (Dollars in millions) 1995 1996 1997 Request Actual Policy Request +/- Policy Institute: NCI $1,913 $2,025 $2,060 +$35 NHLBI 1,243 1,298 1,321 +23 NIDR 163 171 175 +4 NIDDK 725 760 773 +13 NINDS 628 658 671 +13 NIAID 537 573 584 +11 NIGMS 880 921 937 +16 NICHD 509 534 543 +9 NEI 292 305 310 +5 NIEHS 266 283 289 +6 NIA 432 452 462 +10 NIAMS 228 239 243 +4 NIDCD 167 175 179 +4 NIMH 541 568 578 +10 NIDA 290 305 312 +7 NIAAA 180 188 192 +4 NINR 48 51 52 +1 NCRR 287 322 309 -13 NCHGR 153 169 178 +9 FIC 15 16 16 0 NLM 136 149 154 +5 OD 214 234 227 -7 OAR 1,334 1,408 1,432 +24 Third Party Reimbursements 0 0 18 +18 Subtotal $11,181 $11,804 $12,015 +$211 B&F 114 146 420 +274 Subtotal, Program Level $11,295 $11,950 $12,435 +$485 Offsets: NLM User Fees -$11 -$11 -$11 $0 Third Party Reimbursements 0 0 -18 -18 Total, BA $11,284 $11,939 $12,406 +$467 FTE 15,474 15,474 15,474 0 40 NIH OVERVIEW (by Mechanism) (Dollars in millions) 1995 1996 1997 Request Actual Policy Request +/- Policy Mechanism: Research Project Grants $6,046 $6,420 $6,586 +$166 [No. of Non-competing] [17,069] [18,047] [18,573] [+526] [No. of New/Competing] [6,858] [6,620] [6,827] [+207] [Total No. of Grants] [23,927] [24,667] [25,400] [+733] SBIR/STTR Grants $173 $186 $229 + $43 Centers 1,006 1,038 1,044 +6 Research Training 381 395 405 +10 R&D Contracts 723 771 764 -7 Intramural Research 1,241 1,300 1,297 -3 Research Management/Support 519 481 482 +1 Nat'l Library of Medicine (NLM) 139 152 157 +5 Office of the Director 239 261 252 -9 Women's Health Study [non-add] [57] [57] [57] [0] Minority Health Study [non-add] [58] [63] [63] [0] Other Research 714 800 781 -19 Buildings and Facilities 114 146 420 +274 Third Party Reimbursements 0 0 18 +18 Subtotal, Program Level $11,295 $11,950 $12,435 + $485 Offsets: NLM User Fees -$11 -$11 -$11 $0 Third Party Reimbursements 0 0 -18 -18 Total, BA $11,284 $11,939 $12,406 +$467 FTE 15,474 15,474 15,474 0 41 SUBSTANCE ABUSE AND MENTAL HEALTH SERVICES ADMINISTRATION (SAMHSA) (Dollars in millions) 1995 1996 1997 Request Actual Policy* Request +/-Policy Program Level/BA $2,195 $1,854 $2,098 +$244 Outlays 2,444 2,105 2,024 -81 FTE 649 649 649 0 * Based on levels of the ninth CR, including an incremental policy adjustment. Summary The FY 1997 budget request for the Substance Abuse and Mental Health Services Administration (SAMHSA) totals $2.1 billion. This request will provide important substance abuse and mental health services to thousands of pregnant women and their children, high risk youth, and other underserved Americans. SAMHSA is the Department's lead agency for mental health and substance abuse treatment and prevention. Given the heightened attention to the drug abuse prevention and treatment needs in the country, SAMHSA has devoted considerable effort to identify the most effective and efficient treatment and prevention programs and disseminate that knowledge to the States through the Substance Abuse Performance Partnership Block Grant. The FY 1997 budget continues to pursue State Performance Partnerships in the mental health and substance abuse areas. While similar in concept to the current block grant program, the Performance Partnerships will require fewer earmarks, increase State flexibility, and increase emphasis on outcomes. In addition, SAMHSA will provide support to a wide array of demonstration efforts through the Knowledge Development and Application (KDA) program. New focuses in FY 1996 and FY 1997 will include: managed care, early childhood, emerging issues, co-occurring disorders, criminal justice, changing systems, and practice standards and guidelines. Making Substance Abuse Prevention and Treatment Work The annual cost of substance abuse in the United States--in terms of unnecessary health care, extra law enforcement activity, auto crashes, crime, and lost productivity--is more than $166 billion. The chronic drug user accounts for the bulk of illicit drugs consumed, and is a significant contributor to crime and violence. These statistics are indicative of a compelling need to identify effective and efficient approaches to address the nation's most costly public health problems. To respond to this crisis, SAMHSA's FY 1997 budget focuses on the 42 treatment of substance abusers--with a special focus on groups which use a Compare the Costs: Yearly Average significant share of treatment resources, Treatment Cost To Society for One Adult contribute disproportionately to the societal $20,000 $10,880 costs of drug abuse, and for whom little improvement has been made. $16,000 614,800 The FY 1997 request for substance abuse $10,000 prevention and treatment totals $1.6 billion. This includes $1.3 billion for the Substance 85,000 Abuse Performance Partnership Block 88,000 $2,300 Grant. This program will give States 80 Correctional Residential Outpatient Methadone maximum flexibility to develop treatment Institution Treatment Treatment Treatment Sourse. Amer lean Correctional Assec systems that ensure access, quality, and improved outcomes for substance abusers, particularly in areas of high incidence and prevalence. The FY 1997 request also provides a total of $352 million for substance abuse prevention and treatment demonstration activities. New funding for treatment demonstrations will address issues that enhance access to drug treatment through managed care, client and family-oriented substance abuse services, and effective drug treatment. SAMHSA funded programs have had great Criminal Activity Drops Significantly success at minimizing the costs to society as Year After Substance Abuse Treatment a result of effective and efficient treatment Sourse DAL DATA. 1994 35% and prevention services for substance abusers. For example, SAMHSA's Center 30% for Substance Abuse Treatment (CSAT) has 20% used discretionary grants to support a range of programs that have shown results. In 20% W before treatment California, a study of treatment Yr after treatment 16% 68.3% effectiveness showed significant decreases Drop 10% in criminal activity after treatment for 63.3% Drop 615% alcohol and other drug abuse disorders: 5% Drop 74.5% Drop $7.14 in savings for every dollar invested in 0% dele/holped Box for law Used weepen Boal drugs or drugs bouse/ or forms treatment. In Colorado, a follow-up study vahicle found that of the clients who had been arrested in the two years prior to treatment admission, 94 percent had not been rearrested for driving under the influence and about 80 percent had no arrests for other offenses during the follow-up period. Finally, the Miami Coalition for a Drug Free Community used SAMHSA funds to support collaboration between law enforcement and family/neighborhood task forces that were instrumental at reducing crime by 24 percent, making over 8,000 arrests, and identifying and destroying crack houses. 43 Mental Health Services SAMHSA's FY 1997 budget request of $419 million supports the Federal Government's role in the generation of knowledge and dissemination of research results on improving access to quality mental health services. The FY 1997 request maintains most Center for Mental Health Services (CMHS) programs at the FY 1995 enacted level. Included in the request is $275 million for the Mental Health Performance Partnership Block Grant. Most of the funding will be used to support existing grants. An additional $10 million over the FY 1995 enacted level is requested to fund FY 1997 Knowledge Development and Application (KDA) activities relating to mental health. Future Plans--Managed Care Initiative In 1995, nearly 60 percent of Americans (107 million) with private health insurance were enrolled in some type of specialty managed behavioral health program. States are moving aggressively to place large numbers of persons who have no private health insurance into mandatory managed care plans. For persons with mental illness and substance abuse disorders, the rapid growth of managed care is profoundly altering the public and private substance abuse and prevention system. The extent and impact of these changes has not been measured. In 1997, SAMHSA will continue to expand a managed care initiative to address the needs and concerns of the mentally ill and those with substance abuse problems. SAMHSA will target at least $20 million of FY 1997 Knowledge Development and Application (KDA) funding resources to managed care issues. These initiatives include: improving quality, monitoring and reporting; establishing quality and performance measures; strengthening public-private partnerships; improving consumer information; streamlining administrative processes; and enhancing programs geared toward the special needs of this vulnerable population. Studies within the publicly funded managed care network have shown signs of some success. For example, the Massachusetts Medicaid program has reduced costs by 22 percent below projections, based on past experience. The managed care vendor achieved savings by diverting hospital admissions to outpatient care, and by negotiating substantial price reductions with hospitals. For persons with substance abuse disorders, inpatient hospital treatment was cut by 61 percent, while treatment in freestanding detoxification centers, methadone counseling, and dosing increased substantially. The challenge here is to ensure that the goals of quality and access are not sacrificed and savings are achieved through a managed care system. 44 SAMHSA OVERVIEW (Dollars in millions) 1995 1996 1997 Request Actual Policy* Request + /-Policy Substance Abuse: Prevention KDA $238 $106 $176 +$70 Treatment KDA 216 106 176 +70 Performance Partnership Grant 1,234 1,205 1,272 +67 Treatment Capacity Expansion 7 0 0 0 Subtotal, Substance Abuse $1,695 $1,417 $1,624 + $207 Mental Health: Mental Health KDA $52 $37 $62 + $25 Training and AIDS Training 1 1 0 -1 Children's Mental Health 60 59 60 +1 Performance Partnership Grant 275 264 275 + 11 Homeless PATH Grants 29 0 0 0 Protection and Advocacy 22 20 22 +2 Subtotal, Mental Health $439 $381 $419 + $38 Program Management $61 $56 $55 -$1 Forfeiture Fund (non-add) (14) 0 0 0 Total, BA $2,195 $1,854 $2,098 + $244 FTE 649 649 649 0 * Based on levels of the ninth CR, including an incremental policy adjustment. The Policy Level also reflects the $200 million transfer proposed by the Senate from the Safe and Drug Free Schools Act program of the Department of Education for youth substance abuse prevention programs in schools and communities. 45 AGENCY FOR HEALTH CARE POLICY AND RESEARCH (Dollars in millions) 1995 1996 1997 Request Actual Policy* Request +/-Policy Program Level $159 $126 $144 +$18 Budget Authority 141 80 90 +10 Outlays 139 129 97 -32 FTE 267 267 267 0 * Based on levels of the ninth CR, including an incremental policy adjustment. Summary The FY 1997 request for the Agency for Health Care Policy and Research (AHCPR) provides a program level of $144 million. Consistent with a Department-wide HHS Survey Integration Plan, AHCPR will fully fund the Medical Expenditure Panel Survey (MEPS)-- replacing the National Medical Expenditure Survey (NMES)--at $45 million, as well as continue to fund its highest priority ongoing research commitments. AHCPR directly contributes to improving the management of this nation's health care enterprise. Results of its health services research and clinical practice guidelines are used every day by health care providers working to improve quality of care while managing the financial bottom line. Its data collection and analysis are important to health policy analysis and help guide the decisions made by those steering the future of this nation's health care industry. AHCPR works in partnership with the private sector in determining which medical interventions work best and provide the most value for our health care dollar in the day-to- day practice of medicine. In addition, AHCPR research addresses the effectiveness and cost- effectiveness of the organization, financing, and delivery of health services. Research on Health Care Outcomes and Quality The FY 1997 request for the Research on Health Care Outcomes and Quality program (HCOQ), formerly the Medical Treatment Effectiveness program (MEDTEP), is $48 million. At this level, AHCPR will continue to fund high priority continuation projects in outcomes research, particularly for conditions prevalent in the Medicare and Medicaid populations. HCOQ research helps consumers and providers make more informed choices about health 46 care. Part of that effort is to first determine what works in clinical practice through outcomes and effectiveness research and then educate consumers and providers on research results, particularly through the clinical practice guidelines program. To cite a recent example of outcomes research, a grant to Duke University showed appropriate anticoagulant therapy could prevent strokes and save $600 million annually, cutting the number of strokes each year from 80,000 to 40,000. Implementation of AHCPR findings in just 20 percent of patients for the following conditions could save health care costs as follows (1996-2002): acute low back pain ($1.2 billion); stroke prevention ($832 million); prostate disease ($770 million); and acute pain management ($599 million). Other HCOQ research includes: Emergency Department Triage for Suspected Acute Cardiac Ischemia (ACI): Some 3.5 million of the 7 million people with ACI's who present to emergency departments annually are hospitalized, yet 50 percent of those are found not to have ACI and another 7 percent are sent home erroneously. This multi-center prospective controlled clinical trial will evaluate the potential of scanning aids to improve the accuracy of diagnosis of ACI. Pediatric Asthma Care: This two-stage randomized controlled clinical trial is assessing the cost-effectiveness of comprehensive intervention for pediatric and adolescent asthma patients. The major outcomes to be measured include cost, functional status, results of pulmonary function tests, and changes in medication use. Pelvic Inflammatory Disease (PID): This project is testing the most effective treatment approach for PID. This condition affects more than one million women a year and can result in infertility, ectopic pregnancies, and chronic pelvic pain. The cost of treating PID and its complications is estimated at $4 billion annually. Strategies for Care of the Very Low Birthweight Infant: Neonatal intensive care has been the main reason for reduced infant mortality, but with success has come escalating medical treatment costs and increasing burdens of long-term functional impairments and disabilities. This study, which is scheduled for completion in 1997, addresses the outcomes, costs, and utilities of neonatal intensive care. Improved methodologies have been developed for the second round of Patient Outcomes Research Teams (PORT II). Areas of research in FY 1997 include the care, cost and outcomes of local breast cancer and improving the cost-effectiveness of care for depression. Pharmaceutical outcomes research projects will be continued in FY 1997, and will study the efficacy and cost-effectiveness of prescription drugs and related pharmaceutical interventions for treating clinical conditions. One recent example of this research is a grant to Vanderbilt School of Medicine that showed requiring prior authorization from the Tennessee Medicaid program in order to prescribe more costly arthritis medication saved $12.8 million over two years, without causing the substitution of other, more toxic drugs or increased use of medical services. 47 During FY 1997, AHCPR will support seven Research Centers on Minority Populations, focusing on which clinical strategies are best for clinical conditions with the greatest prevalence among African-Americans, Latinos, Asian and Pacific Islanders, American Indians, and/or Alaska Natives. Conditions being studied include high blood pressure, kidney disease, tuberculosis, low birthweight, substance abuse, and certain cancers. AHCPR's clinical practice guidelines program enhances the quality, appropriateness, and effectiveness of health care. AHCPR has arranged for the development of 22 science-based clinical practice guidelines that address some of the most significant health care problems facing Americans. Seventeen of these guidelines have been released ranging in subject from treatment of acute postoperative pain to cardiac rehabilitation. This month AHCPR released an update of the Urinary Incontinence in Adults guideline, which reaffirms the work of the 1992 panel and shows that urinary incontinence is treatable and those afflicted need not suffer in silence. AHCPR's guidelines not only reduce medical treatment uncertainty, they can directly benefit consumers and medical practitioners by improving patient outcomes and quality of life. The guidelines can also benefit the nation by eliminating or reducing the use of medical tests and therapies that do not work or are unnecessary. Research on Health Care Systems Costs and Access The FY 1997 request includes $49 million for the Health Care Systems Cost and Access program (HCSCA), formerly the Research on Health Care Costs, Quality and Access program. HCSCA research develops the analyses and tools needed to improve the functioning of the health care system. At this level, AHCPR will fund high priority continuation projects in a variety of areas, including consumer decision making; the health care marketplace; primary care; managed care; rural health services; and AIDS health services. AHCPR will continue to support a major initiative to assist consumers in selecting high quality health plans and services, the Consumer Assessments of Health Plans Study (CAHPS). Surveys by objective, non-government polling firms have shown that most Americans would like to have more information to help them choose hospitals, doctors, and health care plans. CAHPS brings together the nation's top experts in patient satisfaction and survey research to develop and test the best methods for measuring consumers' satisfaction with their health plans and methods for getting the results to consumers. Also, research on market forces in a changing health care system will be sustained. These projects are examining how changes in the structure of defined markets have affected the way health care providers produce and deliver care and the price, distribution, and quality of services available. The request will maintain support for research on primary care, the most frequent site of health care delivery, and the source of most referrals to secondary and tertiary care. Examples of primary care research include a study testing the effect of an interactive CD designed to decrease cervical cancer by improving the frequency and quality of screening for patients in community health centers. 48 Managed care research supported by AHCPR provides a greater understanding of the rapid financial and organizational changes occurring in the U.S. health care system. An example of managed care research underway is a study showing that managed care patients spent two fewer days in an intensive care unit than patients with fee-for-service health insurance, with the average stay for managed care patients costing $8,000 less, with no difference in mortality or ICU readmission between the two groups. AHCPR will continue to fund five specialized centers for rural health services demonstrations in Iowa/Nebraska, Maine, West Virginia, Arizona, and Oklahoma. AHCPR also will continue to support the HIV Cost and Services Utilization Study (HCSUS), a large-scale study that provides vital information on costs and services resulting from health care delivery to the HIV-infected persons. Health Insurance and Expenditure Survey The FY 1997 request includes $45 million, an increase of $30 million over FY 1996, to support the second year of the Medical Expenditure Panel Surveys (MEPS). This investment will fund costs associated with the move from the development phase and early data collection phase of the surveys to the full data collection phase. The field work for the household and nursing home surveys started in FY 1996. In FY 1997, these surveys both continue with the household survey intensifying, plus the health insurance plans survey, the medical provider plan survey, and the national health insurance survey will all start data collection. During the full data collection phase, all five surveys will be in the field where extensive interviews are conducted by employing such innovations as computer assisted personal surveys that will greatly improve the timeliness of MEPS results. Early access to data for analysis will allow health care policy makers to base decisions on more current information than has been available in the past. No surveys other than MEPS provide the Federal Government or the private sector with detailed information regarding the health care services used by American families and individuals; the cost, scope, and breadth of private health insurance coverage held by and available to the U.S. population; and the specific services that are purchased through out-of-pocket and/or third-party payments. This information is essential for developing national and regional estimates of the impact of changes in financing, coverage, and reimbursement policy, and estimates of who benefits and who bears the cost of a change in policy. Under the Department's Survey Integration Plan, important linkages with other HHS surveys have been established that will help keep survey costs lower than originally projected--and improve data collection and analysis of health care expenditures and health insurance in the U.S. MEPS builds upon the strengths of the 1977 and 1987 National Medical Expenditure Survey (NMES) and streamlines the Department's data collection efforts. Unlike NMES, which developed its own large sampling frame of families to interview, MEPS relies upon an existing nationally representative sampling frame developed by the National Center for Health Statistics (NCHS) and eliminates duplication that existed with the Health Care Financing Administration (HCFA) in surveying the over-65 population. MEPS also incorporates and links the National Health Interview Survey (NHIS) with the survey 49 components of MEPS. MEPS, which began in FY 1994, will now include a national employer health insurance survey component. The purpose of the employer health insurance survey is to obtain national and state-specific estimates of the availability of health insurance at the workplace, type of coverage provided by employers, and the associated costs of coverage. Analytical work on the data collected will begin in FY 1997 and is expected to be complete by FY 2001. As part of the Department's Survey Integration Plan, MEPS will no longer be a periodic annual survey. Instead it will be converted to an ongoing continuous survey--resulting in a continuous resource for those dependent on these data to manage this nation's health care industry. Over time, MEPS will provide more comprehensive data for public and private sector decision makers. 50 AHCPR OVERVIEW (Dollars in millions) 1995 1996 1997 Request Actual Policy* Request +/-Policy Research on Health Care Outcomes and Quality . $80 $55 $48 -$7 Research on Health Care Systems Cost and Access 62 54 49 -5 Health Insurance & Expenditure Survey 15 15 45 +30 Program Support 2 2 2 0 Subtotal, Program Level $159 $126 $144 +$18 Less Transfers: PHS Intra-agency -18 -46 -54 -8 Total, BA $141 $80 $90 +$10 Medicare Trust Funds [Non add] [6] [3] [6] [+3] FTE 267 267 267 o * Based on levels of the ninth CR, including an incremental policy adjustment. 51 HEALTH CARE FINANCING ADMINISTRATION (Dollars in millions) 1995 1996 1997 Request Actual Policy* Request +/-Policy Budget Authority $262,272 $285,566 $320,107 +$34,541 Outlays** 248,920 272,475 295,675 +23,200 FTE 4,100 4,100 4,100 0 * Based on levels of the ninth CR, including an incremental policy adjustment. ** Includes non-HCFA administrative costs, and is net of offsetting receipts. Summary The FY 1997 budget request for HEALTH CARE FINANCING ADMINISTRATION the Health Care Financing FY 1997 Net Outlays $296 Billion /1 Administration (HCFA) is $296 billion (net of offsetting Hospital Insurance receipts) for Medicare and Benefits: Medicaid benefits and operating $121 Billion (41%) costs, an increase of $24 billion over FY 1996 (see Figure 1 for Supplementary Medical the distribution of spending). Insurance Benefits: $65 Billion Spending for the Medicare and (22%) Medicaid programs represents Federal 84 percent of the total HHS Administration: Medicaid: 12 budget for FY 1997. $4 Billion $108 Billion (1%) (36%) The Medicare and Medicaid /1 Numbers may not add due to rounding /2 Includes Benefits and State and Local Administration budget includes legislative proposals that reduce spending by $3 billion in FY 1997. Figure 1 Medicare and Medicaid combined will pay for the health care costs of approximately 72 million elderly, disabled and economically disadvantaged Americans in FY 1997 (individuals eligible for both Medicare and Medicaid are not double counted in this figure). In FY 1997, the number of people served by these programs will increase by about 2 million, or 2.3 percent, over FY 1996. Slightly more than a quarter of all Americans will receive Medicare or Medicaid services in FY 1997. 52 MEDICARE Summary Medicare is a Federal health insurance program for people age 65 or older and people under age 65 who are disabled or suffer from end-stage renal disease (ESRD). In FY 1997, the program will serve approximately 38.1 million eligible individuals. Medicare consists of two parts: Part A--Hospital Insurance (HI) Pays for inpatient hospital care, certain inpatient care furnished in skilled nursing facilities, home health care and hospice care. The HI program is funded through the HI Trust Fund. The Fund receives most of its income from the HI payroll tax (2.9 percent of payroll, split between employers and employees). Part B--Supplementary Medical Insurance (SMI) Pays for medically necessary physicians' services, outpatient hospital services, treatment for ESRD, laboratory services, durable medical equipment and certain other medical services and supplies. The SMI program is funded through the SMI Trust Fund. The Fund receives income primarily from two sources: a general revenue transfer and premiums paid by enrollees. Total Medicare benefit outlays in FY 1997, including the effect of legislative proposals, are estimated at $206 billion, 6.6 percent higher than FY 1996 estimated benefit outlays. This increase in outlays reflects projected growth in beneficiary enrollment, service utilization and inflation. Strengthening Medicare The President's Medicare plan strengthens and improves the program, reducing spending by a net $124 billion over seven years and guaranteeing the solvency of the trust fund for more than a decade. Specific reforms give seniors more choices among private health plans, make Medicare more efficient and responsive to beneficiary needs, attack fraud and abuse through programs praised by law enforcement officials, cut the growth rate of provider payments, and hold the Part B premium at 25 percent of program costs. Provider Payment Reforms and Program Savings Hospitals: The budget reduces the annual inflation increase or "update" for payment for inpatient care and adjusts payments for capital. It also reforms the payment method for outpatient departments while protecting beneficiaries from increasing charges for those services. Managed Care: The budget reforms payments by using reasonable rate-of-growth limits 53 on updates for managed care payments and reducing the current geographic variation in payments. Physicians: The budget reforms physician payments by paying a single update for all physicians and replaces current "volume performance standards" with a sustainable growth rate. Home Health Care/Skilled Nursing Facilities: The budget implements a series of interim payment reforms before the establishment of fully prospective payment systems for home health care and skilled nursing facilities. Fraud and Abuse: The budget introduces aggressive and comprehensive policies to help stamp out Medicare waste, fraud, and abuse, and extends and enhances Medicare secondary payor policy to ensure that Medicare pays only when it should. Other Providers: The budget freezes updates for durable medical equipment and ambulatory surgical centers and reduces payments for oxygen. Beneficiaries: The budget continues, but does not increase, the requirement that beneficiaries pay 25 percent of Part B costs. Provisions to Improve Rural Health Care The President's plan enhances access to, and the quality of, health care in rural areas. To do so, it extends the Rural Referral Center program, directs Medicare reimbursement for nurse practitioners and physician assistants, improves the Sole Community Hospital program, and expands the Rural Primary Care Hospital program and provides grants to promote telemedicine and rural health outreach. Program Improvements that Expand Choices and Add Preventive Benefits The President's plan transforms the traditional fee-for-service program from a bill-paying insurance program into a responsive health plan by giving Medicare authority to adopt many of the purchasing and quality techniques pioneered by private sector payors. The budget also expands and improves Medicare managed care by: ensuring beneficiary protections while increasing the types of plans--including Preferred Provider Organizations (PPOs) and Provider Sponsored Networks (PSNs)--available to seniors; and instituting a coordinated open enrollment process--similar to that used by the Federal Employees Health Benefits Plan (FEHBP)--during which beneficiaries use comparative information to choose among managed care and supplemental insurance options. In addition, the budget expands coverage of preventive benefits to include annual 54 mammograms and the elimination of mammography coinsurance, colorectal cancer screening, and increased payments for flu shots. Finally, the budget introduces a respite care benefit to provide some relief for families caring for relatives with Alzheimer's disease. Medicare Baseline The President's budget estimates that Medicare benefits will be $1.6 trillion from 1997-2002. This represents a decrease in the estimate of $5.3 billion over the six years compared to Mid-Session Review (MSR), a drop of 0.3 percent. However, this reflects an increase of $37 billion in Hospital Insurance (HI or Part) balanced by a decrease of $42.3 billion in Supplementary Medical Insurance (SMI or Part B). While economic changes brought the estimate for Medicare spending down from the MSR, technical changes worked in the opposite direction to increase the estimate of outlays. The $7 billion upward technical re-estimate for the period 1997-2002 was comprised of the following baseline adjustments: - The estimated Part A increase of $41.4 billion hinged on higher projected outlays for inpatient services, skilled nursing facility services, and home health services. The largest estimated increase, both in percentage and actual dollars, occurred in home health services, with a technical increase of over $27 billion. The increases were partially offset by a lower estimate for hospice services, which dropped about $8 billion. - The estimated Part B technical decrease of $34.3 billion largely offset the Part A increase. The Part B decrease was comprised of lower spending projections for physician, outpatient, and group practice outlays. Estimates for both independent labs and Part B home health outlays increased by a small amount. The economic decrease of $12.3 billion for the period 1997-2002 incorporated the following baseline adjustments: - In Part A, new economic assumptions decreased the baseline by $4.4 billion due to decreases in growth assumptions for wages and prices. - In Part B, new economic assumptions decreased the baseline by $7.9 billion, due almost solely to anticipated decreases in the Medicare economic index. This index is also sensitive to changes in wages and prices. 55 MEDICARE OVERVIEW (Beneficiaries in millions) 1995 1996 1997 +/- Persons Enrolled: Hospital Insurance (HI Part A) 36.9 37.5 38.1 +0.6 Supplementary Medical Insurance (SMI Part B) 35.5 36.0 36.5 +0.5 (Outlays in millions)¹ 1995 1996 1997 Request Actual Policy Request + /-Policy Current Law: HI Benefits $113,403 $124,841 $136,799 +$11,958 SMI Benefits (including ESRD) 63,482 69,055 76,287 +7,232 Peer Review Organizations 190 268 270 +2 Subtotal, Med. Ben. w/PROs $177,075 $194,164 $213,356 +$19,192 HCFA Admin/Research $2,109 $2,137 $2,191 +$54 Intergovernmental Transfer -- $319 -- -319 SSA/Non-HCFA Admin 913 968 1,009 +41 Subtotal, Admin $3,022 $3,424 $3,200 -$224 Total, Current Law Outlays $180,097 $197,588 $216,556 +$18,968 Proposed Legislation: Part A Savings - -$151 -$14,184 -$14,033 Part B Savings -- -10 7,734 7,744 Total, Outlays, Net Proposed Law $180,097 $197,427 $210,106 +$12,679 Offsetting Receipts -$20,242 -$19,842 -$20,287 -$445 Effect of P.L. on Offsetting Receipts² -- -- 288 +288 Total, Net Outlays3 $159,855 $177,585 $190,107 +$12,522 1 Numbers may not add due to rounding. 2 Offsetting receipts include premiums collected from beneficiaries under Medicare Parts A and B. 3 Total Net Medicare Outlays equal current law outlays minus the impact of proposed legislation and offsetting receipts. Total does not include the Clinical Laboratory Improvement Amendment (CLIA) or the HMO Loan Fund. 56 MEDICAID Summary In FY 1997, Medicaid will provide grants to States for the medical care of about 39 million low- income individuals. The Federal share of Medicaid payments is expected to reach $102 billion. This is a $7.4 billion (7.8 percent) increase over projected FY 1996 spending. The President has recently submitted a comprehensive Medicaid reform package, which streamlines the program while preserving the guarantee of health and long-term care coverage for the most vulnerable Americans. Enhancing State Flexibility States have considerable flexibility in structuring the Medicaid programs, including determining provider payment rates, certification standards, and developing alternative health care delivery programs. In addition, waivers from various portions of the broad Federal guidelines are also available to States. Freedom-of-choice waivers allow States to implement cost-effective systems of care, such as case management and competitive bidding arrangements. Home and community-based service waivers allow States to cover community-based care as an alternative to institutionalization. States have also begun to restructure eligibility and coverage under Medicaid through the use of Section 1115 demonstration waivers. Under these demonstrations, States acquire savings by incorporating managed care concepts, redirecting uncompensated care payments, and consolidating State health programs. States use these savings to expand coverage to previously uninsured populations. States are using Section 1115 waivers to reform health care by expanding coverage without increasing the amount the Federal Government would have otherwise spent. Since 1993, this Administration has approved twelve Section 1115 demonstrations, and is committed to working cooperatively with additional States to support innovative ideas. Delaware, Vermont, Hawaii, Oregon, Tennessee, Minnesota, Oklahoma¹, and Rhode Island are currently operating approved demonstrations, extending health care coverage to about 672,000 Americans who were otherwise not covered by health insurance. Florida, Kentucky, Massachusetts, and Ohio have approved waivers but have not begun operation of their demonstrations. Once fully implemented, these twelve demonstrations could extend coverage to 2.2 million individuals, at no increased cost to the Federal Government. Legislative Proposal The President's plan for Medicaid reforms the program but preserves the guarantee of health and long-term coverage for the most vulnerable Americans. It saves $59 billion over seven years responsibly, by limiting spending on a per-person basis (a "per capita cap") and reducing 1 Oklahoma has no expansion population in its 1115 waiver. 57 Disproportionate Share Hospital payments and retargeting them to hospitals that serve large numbers of Medicaid and uninsured patients. The plan provides special payments for States to transition into the new system, and to meet the most pressing needs. It also gives States unprecedented flexibility to administer their programs more efficiently. Finally, this plan retains current nursing home quality standards and continues to protect the spouses of nursing home residents from impoverishment. The President's Medicaid reform proposal would also give States more flexibility in managing their Medicaid programs. Changes include: Boren Amendment: The plan repeals the so-called "Boren amendment," eliminating Federal provider payment requirements for hospitals and nursing homes. Managed care: The plan allows States to enroll beneficiaries in managed care without Federal waivers. Home- and community-based care: The plan allows States to provide services in home- and community-based settings to people who need long-term care without having to seek Federal waivers. Coverage expansions without waivers: The plan enables States, without waivers, to expand coverage to any person in a family with income less than 150 percent of the Federal poverty line. Background Medicaid is a voluntary program, initiated and administered by the States. State expenditures for medical assistance are matched by the Federal Government using a formula that measures per capita income in each State relative to the national average. Current matching rates for FY 1996 are projected to range from 50 to 77 percent for medical assistance payments and from 50 to 100 percent for administrative costs. The Federal matching rate on average is approximately 57 percent. Most individuals' eligibility for Medicaid is based on qualifying under the cash assistance programs of Aid to Families with Dependent Children (AFDC) or Supplemental Security Income (SSI). All AFDC and most SSI recipients, commonly referred to as the "categorically eligible," are covered under State Medicaid programs. States cover some individuals not eligible for AFDC or SSI (e.g., higher income persons in institutions, low-income pregnant women and children, and aged, blind and disabled persons below the poverty line). States may also cover "medically needy" individuals. Such persons would meet the categorical eligibility criteria, but have too much income or resources. By incurring medical expenses, these persons may spend down to the medically needy standard. States are required to provide a core of 13 services to all eligible recipients. Those mandatory Medicaid services include inpatient and outpatient hospital care, health screening, diagnosis and treatment to children, family planning, physician services and nursing facility services to 58 individuals over 21. States may also elect to cover any of over 30 specified optional services, which include prescription drugs, clinic services, and services provided in intermediate care facilities for the mentally retarded. Medicaid covers children under the age of six and pregnant women whose family income does not exceed 133 percent of the Federal poverty level. Medicaid coverage of children aged 6 through 18, born after September 30, 1983, whose family income does not exceed 100 percent of the Federal poverty level, is being phased in. By 2002, all children under the age of 19 living below the poverty level will be covered by Medicaid. In addition, Medicaid pays Medicare premiums and cost sharing for Medicare coverage of certain poor seniors and disabled individuals eligible for Medicare, also referred to as Qualified Medicare Beneficiaries (QMBs). The President's Medicaid reform proposal would preserve these important protections and expansions. Federal Medicaid outlays rose dramatically from FY 1989 through FY 1992, at a 25 percent average annual rate. However, outlay growth slowed to less than 12 percent in FY 1993, followed by 8 percent growth in FY 1994. The decline in the rate of Medicaid increases is due to many factors, including legislative changes (such as Limits on Provider Specific Taxes and Donations), decreases in the projected growth of SSI caseloads, and States' efforts to control costs. The President's plan maintains these appropriate limitations. 59 MEDICAID OVERVIEW (Recipients in thousands) 1995 1996 1997 +/- Beneficiaries: * Aged 65 and Over 4,234 4,389 4,553 +164 Blind and Disabled 6,009 6,341 6,626 +285 Needy Adults 7,774 8,041 8,260 +219 Needy Children 17,574 18,169 18,659 +490 Other 576 576 576 +-- Unduplicated Total 36,168 37,516 38,674 +1,158 (Outlays in millions) 1995 1996 1997 Request Actual Policy Request +/-Policy Current Law: Benefits $85,194 $90,480 $97,653 +$7,173 State and Local Administration 3,491 3,965 3,927 -38 Vaccines for Children 185 213 469 +256 Survey and Certification 137 154 163 +9 State Medicaid Fraud Control Units 63 79 82 +3 Total, Current Law* $89,070 $94,892 $102,294 +$7,403 * Numbers may not add due to rounding. 60 PROGRAM MANAGEMENT Summary HCFA's FY 1997 Program Management budget request is $2,202 million, a 3.3 percent increase over estimated FY 1996. The Program Management account provides resources for administering the Medicare and Medicaid programs. Program Management supports the following activities: Medicare Contractors; Federal Administration; Medicare Survey and Certification; and Research, Demonstrations and Evaluation. While workloads have continued to increase every year, the Program Management budget has remained relatively flat or decreased, requiring HCFA to find more efficient methods to accomplish its mission and its goals as established in its strategic plan. HCFA is attempting to fulfill a significant part of this mission with the development and implementation of the Medicare Transaction System (MTS), HCFA's state-of-the-art information management initiative. MTS will consolidate the current system of 77 claims-payment contractors utilizing nine shared computer systems into one system operated by three contractors using standardized data elements. This initiative will achieve substantial administrative savings through the use of new technology, consolidation of processing systems and standardized data. MTS will affect all aspects of Medicare, positioning HCFA to reengineer itself more productively for the challenging times ahead. Medicare Contractors The Medicare program is administered through private organizations, usually private insurance companies, which are referred to as contractors. Contractors' responsibilities include processing claims and making benefit payments, performing certain functions to ensure the appropriateness of Medicare payments and to protect the Medicare Trust Funds, developing management improvements called productivity investments, and responding to the needs of its many customers and stakeholders, the Medicare beneficiaries and the provider community. Despite a growing investment in MTS and an increasing claims workload, the Medicare Contractor budget will increase by only 0.6 percent, from $1,604.2 million in FY 1996 to $1,614.2 million in FY 1997. The four key contractor activities are claims processing, beneficiary and provider services, payment safeguards and productivity investments. Approximately 53 percent of the FY 1997 contractor budget request, or $849 million, has been designated for claims processing, a 2 percent decrease from FY 1996. HCFA's success in controlling processing costs has resulted in reduced unit costs of processing claims, allowing the agency to process an expected 861 million claims in FY 1997 within statutorily limited processing times. This workload level represents a 3.4 percent increase over revised FY 1996 estimates. HCFA anticipates that increased managed care enrollment will limit growth in claims and billings. Beneficiary and provider services comprise 16 percent of the Medicare Contractors' FY 1997 request, or $254 million. This amount will maintain funding for the Medicare beneficiary 61 toll-free telephone lines, timely hearings and reconsiderations, prompt responses to provider and beneficiary inquiries, provider education and training efforts, and the Medicare participating physicians program. HCFA will continue its innovative use of audio response units (ARUs) for telephone inquiries, as well as continuing its use of the telephone to conduct hearing reviews and reconsiderations. These activities demonstrate HCFA's combined efforts toward more cost-effective management and a greater commitment to providing better customer service. This request provides $396 million for payment safeguard activities to prevent and recover inappropriate Medicare payments, an amount virtually equal to that appropriated for the last three years. These activities include financial audits, medical and utilization reviews, and the identification of Medicare beneficiaries who have other insurance plans with primary responsibility for paying claims. Funds are also earmarked to support carrier efforts in detecting, developing and investigating program fraud and abuse. HCFA expects to generate $5.6 billion in savings to the Trust Funds with its $396 million investment in payment safeguard activities in FY 1997, a 14 to 1 return on investment. Building upon the Department's current efforts in Operation Restore Trust to combat health care fraud and abuse, HCFA currently has legislation before Congress to provide a stable and reliable funding source for these activities under the direct spending budget. HCFA's long-term strategy to fund current Medicare payment safeguard activities is the Medicare Benefit Integrity System (MBIS). MBIS removes these activities from the discretionary account and moves them to the entitlement account, using Trust Fund dollars. Should this legislation be enacted, an additional $104 million would be added to the above amount to supplement HCFA's current effort. The budget request allocates $115 million for productivity investments. Productivity investments enhance the cost-effectiveness and quality of contractor operations and are part of the long-term reform of Medicare administration. In FY 1997, HCFA will begin implementation of the Medicare Transaction System (MTS). MTS implementation will be completed in FY 1999. After that time, HCFA estimates that MTS will achieve $200 million in annual administrative savings. Other productivity investments costs include transition costs for contractors who may leave the program. Federal Administrative Costs For FY 1997, the President's budget requests $359 million for HCFA's Federal administrative costs. This request also includes a staffing level of 4,100 FTE. HCFA remains on target to meet the Department's FTE targets, thereby supporting the President's mandate on reducing the size of the Federal work force. This funding level also includes funding to support the extensive data processing requirements for the Medicare and Medicaid programs, as well as necessary maintenance and enhancement of 80 automated data systems. This funding level also allows HCFA $2 million for HCFA On-Line to continue activities to make the agency more responsive to providers and beneficiaries. HCFA will also spend $20 million to update and distribute the Medicare Handbook to all Medicare beneficiaries in FY 1997. HCFA will also fund its new Long-Term Care initiative in FY 1997. Activities to 62 begin creating and developing alternative long-term care models will be funded at $1 million in FY 1997. Research, Demonstrations and Evaluation The FY 1997 budget requests $55.3 million for the Research, Demonstrations and Evaluation program. HCFA's research program supports research and demonstration projects to develop and implement new health care financing policies and to evaluate the impact of HCFA's programs on its beneficiaries, providers, States, and our other customers and partners. Information from HCFA's research program is used by Congress, the Executive Branch, and States to improve the efficiency, quality, and effectiveness of the Medicare and Medicaid programs. In addition to basic research, this budget fully funds the Medicare Current Beneficiary Survey and the Information, Counseling and Assistance Grants program. Basic research funds will support research and demonstration in the areas of monitoring and evaluating health system performance, improving health care financing and delivery mechanisms, meeting the needs of vulnerable populations, and improving consumer choice and health status. HCFA will continue its commitment to rural health needs in FY 1997 by supporting efforts for telemedicine demonstrations in rural areas. Survey and Certification Ensuring the safety and quality of care provided by health facilities is one of HCFA's most critical responsibilities. HCFA contracts with State agencies to inspect health facilities providing services to Medicare and Medicaid beneficiaries to ensure compliance with Federal health, safety, and program standards. HCFA's quality oversight includes initial inspections of providers who request participation in the Medicare program, annual recertification inspections of nursing homes and home health agencies (HHAs) as required by law, investigation of beneficiary complaints, and periodic recertification surveys of other health care providers and suppliers. For FY 1997, the President's budget requests a total of $173.8 million for direct survey and certification activities and workloads. This $28 million increase over FY 1996 is necessary both to conduct initial inspections of more than 3,200 facilities expected to request Medicare participation (including the elimination of any prior year backlog), and to increase the frequency of annual surveys performed on non-long-term care facilities (e.g., ESRD facilities, hospices, rural health clinics, ambulatory surgical centers). As mandated by OBRA 87, HCFA conducts recertification surveys (over 24,000) on nursing facilities and home health agencies annually--a coverage level of 100 percent. HCFA plans to reach a recertification coverage level on non-accredited hospitals and psychiatric hospitals, hospices and other providers of 25 percent. As part of the Health Care Quality Improvement Program, HCFA is currently placing greater emphasis on effective internal quality management systems within Medicare facilities, as well as the provider's responsibility to monitor outcomes. In FY 1997, HCFA will be retraining 63 surveyors across the country to reinforce our focus on patient outcomes, which will result in improved quality throughout the program. Legislative Proposals The President's health care legislation package provides added protections for individuals and small businesses and makes health coverage more accessible, portable, and affordable. The Health Insurance for the Unemployed proposal provides funds to States to finance up to six months of coverage for unemployed workers and their families. Other proposed insurance reforms restrict pre-existing conditions exclusions and prohibits lifetime benefit maximums or caps on benefits for specific conditions. A small State grant program will be established to accelerate the development of health insurance purchasing cooperatives, which have successfully reduced costs and increased choice for small businesses by allowing them to pool their employees for purposes of purchasing health insurance. Clinical Laboratory Improvement Amendments of 1988 The Clinical Laboratory Improvement Amendments of 1988 (CLIA '88) expanded survey and certification of clinical laboratories from Medicare-participating and interstate commerce laboratories to all facilities testing human specimens for health purposes. CLIA '88 also introduced user fees for clinical laboratories to finance survey and certification activities. User fees are credited to the Program Management account but are available until expended for CLIA activities. The CLIA program is fully operational, with about 152,000 laboratories registered with HCFA; about 26 percent of the labs are subject to routine inspection under the program. 64 PROGRAM MANAGEMENT OVERVIEW (Obligations in millions)¹ 1995 1996 1997 Request Actual Policy Request + /-Policy Medicare Contractors: Claims Processing $873 $869 $849 -$19 Bene./Prov. Services 269 268 254 -14 Payment Safeguards² 415 396 396 - Productivity Investments 47 72 115 +43 Subtotal, Medicare Contractors $1,604 $1,604 $1,614 +$10 Survey and Certification 146 146 174 +28 Federal Administration 354 328 359 +31 Research 75 55 55 - Subtotal, BA (current law) $2,178 $2,132 $2,202 +$70 CLIA 34 37 43 +6 Total, Program Level³ $2,353 $2,169 $2,245 +$76 FTE 4,100 4,100 4,100 0 1 Numbers may not add due to rounding. 2 The FY 1995 Appropriation for payment safeguard was $396 million. 3 Not included in these totals are the legislative proposals for the Medicare Benefit Integrity System (-$396 million from Payment Safeguards in FY 1997), for the Health Insurance for the Temporarily Unemployed (+$1,519 million in FY 1997), and for the state grants for health care purchasing cooperatives (+$25 million in FY 1997). 65 HCFA SUMMARY (Outlays in millions) 1995 1996 1997 Request Actual Policy² Request +/-Revised Current Law: Medicare Benefits $177,074 $194,164 $213,356 +$19,192 (includes PROs and ESRD) Medicaid Benefits 89,070 94,892 102,294 +7,402 HCFA Administration 2,109 2,137 2,191 +54 Other-HHS Administration 913 968 1,009 +41 Intergovernmental Transfer -- 319 -- -319 HMO Loan Fund 3 1 1 -- Total, Outlays Current Law $269,169 $292,481 $318,851 +$26,369 Proposed Law: Medicare -- -161 -6,450 -6,289 Medicaid -- -- 3,277 3,277 Program Management -- -- -- -- - - Total, Outlays Net Proposed Law $269,169 $292,320 $315,678 +$23,357 CLIA [Non-Add] [30] [36] [42] [+6] Offsetting Receipts³ -20,242 -19,842 -20,287 -445 HMO Loan Fund -7 3 -3 : Effect of P.L. On Offsetting Receipts -- -- 288 +288 Total, Net Outlays4 $248,920 $272,475 $295,675 +$23,200 FTE 4,100 4,100 4,100 0 1 Numbers may not add due to rounding. 2 Based on the levels of the ninth CR, including an incremental policy adjustment. 3 Offsetting receipts include premiums collected from beneficiaries under Medicare Parts A and B. 4 Total net outlays equal current law outlays minus the impact of proposed legislation and offsetting receipts. 66 ADMINISTRATION FOR CHILDREN AND FAMILIES (Dollars in millions) 1995 1996 1997 Request Actual Policy* Request +/- Policy Program Level/BA: Discretionary $7,649 $7,169 $7,710 +$541 Entitlement 25,050 25,441 26,586 +1,145 Total $32,699 $32,610 $34,296 +$1,686 Outlays: Discretionary $7,829 $7,495 $7,361 -$134 Entitlement 24,164 25,635 26,660 +1,025 Total $31,993 $33,130 $34,021 +$891 FTE 1,803 1,803 1,803 0 * Based on levels of the ninth CR, including an incremental policy adjustment. Discretionary Program Summary ADMINISTRATION FOR CHILDREN AND FAMILIES FY 1997 Discretionary Funding The Administration for Children and Families (ACF) is the Department's lead Head Start 52% agency for programs serving America's children, youth, and families. In FY 1997, ACF is seeking $7.7 billion for Devel Disabil 2% discretionary programs within ACF that VAWA/Teen Preg 1% promote healthy children, supportive Other 4% Child Welfare 6% Comm Serv Block 5% families, and vibrant communities. LIHEAP 13% Child Care Block 14% The Department has a strong commitment Refugee Programs 5% to ensuring that our nation's children and $7.7 Billion youth are healthy, safe, and developing to their full potential in stable families and secure communities. To better fulfill government's responsibility toward children and families, the Department has developed a multifaceted strategy that promotes strong futures. Secretary Shalala commissioned a Governing Council on Children and Youth and charged this group with increasing coordination and collaboration throughout the Department on program and policy issues affecting children. That collaborative strategy is also evident through investments in programs which support Strong Foundations--the building blocks of success for children and families--and Safe Passages--the tools for navigating the transition from childhood to adulthood. Head Start, child care, and child welfare services emphasize early childhood health and development and promote Strong 67 Foundations for our children. Equally important are the supports needed to ensure Safe Passages for the critical journey through adolescence. The Department is moving forward to launch and coordinate a wide array of activities to promote Safe Passages for our nation's youth including a teen pregnancy prevention initiative and the community schools program. Head Start Investing in Head Start and expanding enrollment are key Presidential priorities. The FY 1997 budget request of $3.98 billion for Head Start will serve an additional 46,000 children. This request, an increase of $447 million over FY 1995, will establish strong foundations for a total of 796,500 children and their families. As a result of this Presidential investment, Head Start will grow to serve over one million children by the year 2002. Head Start continues to be one of the nation's most successful programs for low-income children and families, providing comprehensive education, nutrition, health services and social services. Evaluations of Head Start children continue to show that the Head Start experience has a positive impact on school readiness, increases children's cognitive skills, self-esteem, and achievement motivation, and improves school social behavior. Head Start also helps to improve the parenting skills and employment related skills of Head Start parents. Important funding increases sought by the HEAD START Clinton Administration during the last three Increases in children served 1993 - 1997 by type of program years have allowed local programs to make significant increases in program quality. 800,000 These increases are directed at much-needed improvements in facilities, hiring of family workers, and more competitive salaries and 760,000 infant / toddler benefits in order to attract and retain quality full-day programs part-day programs staff. Through more effective monitoring 700,000 and technical assistance, we are assuring that all Head Start programs provide good quality services and we are replacing 650,000 1993 1994 1995 1996 1997 programs that cannot. One important aspect of the quality improvement process has been the revision and updating of the Head Start Performance Standards and Measures, important yardsticks for evaluating the effectiveness of local programs. The Head Start Program Performance Standards were developed in the 1970's as a guide for day-to-day program operations. These standards cover the areas of health, social services, parent involvement and education for children ages three to five. As directed by the 1994 Head Start reauthorization act, HHS is engaged in revising the standards to better support quality. We anticipate publishing a proposed regulation for comment this spring. The revised standards include two new sections: Family and Community Partnerships, and Program Design and Management. The updated standards also incorporate services for pregnant women, infants and toddlers to support the Early Head Start program. HHS has 68 engaged in extensive consultation to revise these standards, convening over 70 focus groups and receiving the input of over 2,000 people and national organizations. Head Start is also in the process of developing Program Performance Measures to assess the quality and effectiveness of the program through outcomes and indicators. These measures are intended to provide a process for continuous improvement over time. Another recent advance involves services to young children. In FY 1995, the Early Head Start program was established in recognition of the mounting evidence that the earliest years are extremely important to children's growth and development. Serving low-income children under the age of three and pregnant women, Early Head Start funds in FY 1997 will be equal to 4 percent of the total Head Start budget or $159.3 million. In FY 1997, these funds will support an estimated enrollment level of 25,600 children and their families, a 41 percent increase in enrollment since FY 1995. Children and families enrolled in Early Head Start will receive early, continuous, intensive and comprehensive child development and family support services. Child Care and Development Block Grant The FY 1997 budget request for the Child Care and Development Block Grant (CCDBG) is $1.049 billion. This request is a component of the Administration's continued commitment to promoting family self-sufficiency by helping States fund child care services for over 70,000 additional children from low-income working families. The availability of quality child care for low-income families is critical to maintain economic self-sufficiency and to promote healthy child development. Over one million children could require child care assistance by the year 2000 in order to meet the work requirements put forth in most major welfare proposals. Many low-income working families spend up to 25 percent of their income on child care. The Child Care and Development Block Grant provides child care funds to States for low-income families with a parent who is working or attending a training or educational program or children in need of protective services. Over 750,000 children currently receive program services, but waiting lists for assistance still exist nationwide. CCDBG also supports activities to improve the quality and availability of child care across the nation. Funds are used by States to support consumer education, provider training, licensing and monitoring, and outreach to build the supply of infant care, school age care, care for families working non-traditional hours, and care for children with special needs. In an effort to further improve service, ACF has streamlined operations and recently launched a national campaign, "Healthy Child Care America," to promote sound health and early childhood development practices in child care settings. CCDBG funds provide the foundation for safe and healthy care so critical to optimal child development. 69 Low Income Home Energy Assistance Program (LIHEAP) The FY 1997 budget request for LIHEAP includes $1 billion in regular appropriations and $300 million in emergency funding. In addition, ACF is requesting a $1 billion advance appropriation for FY 1998. The LIHEAP program provides grants to States, territories, tribes and tribal organizations to assist low-income households in meeting home energy costs. Flexible program requirements allow States to target assistance to the areas with the greatest needs, support weatherization efforts, and leverage additional energy dollars from non-Federal sources. To date in FY 1996, $900 million has been made available, primarily for heating and crisis assistance. Child Welfare/Child Abuse In FY 1997, ACF is requesting $419 million in discretionary funding for a range of programs that help States and local communities to protect children by strengthening families and preventing abuse; intervening when families are in crisis; and when necessary, making placement decisions to ensure children's safety. A total of $50.6 million will be used to fund Community-Based Resource Centers which support statewide networks of local child abuse and neglect prevention and family resource programs. In FY 1997, ACF will also consolidate research and training programs into the Child Welfare Innovative Programs account, totaling $39.1 million, to allow greater flexibility in funding promising initiatives and to disseminate knowledge on what works best across the spectrum of child welfare services. In 1993, States received reports on nearly three million children who were alleged victims of child abuse and neglect, reflecting a 25 percent increase in the rate of children reported since 1988. The U.S. Advisory Board on Child Abuse and Neglect estimated that 2,000 of these children die each year as a result of abuse or neglect. As demands on the child welfare system to protect abused and neglected children increase and State and local agencies are overburdened, ACF has dedicated funding to promote children's healthy development by preventing and treating the effects of child abuse and neglect. Teen Pregnancy Prevention Teen pregnancy rates remain alarmingly high in the U.S. President Clinton, recognizing the impact of this tragedy, has referred to teen pregnancy as one of our most serious social problems. In an effort to help local communities further develop effective prevention strategies, HHS will launch a $30 million collaborative Teen Pregnancy Prevention Initiative in FY 1997. Demonstration grants to combat teen pregnancy will be made available to selected cities with relatively high teen pregnancy rates. Funds will be targeted to communities that have demonstrated a commitment to community problem solving and developed an appropriate infrastructure for implementing proposed strategies. Grant funds will be available to initiate, expand, or enhance comprehensive prevention strategies which utilize social, economic, and educational approaches to reaching at-risk teens. Drawing upon 70 strong community and family support for this initiative together we can help to ensure safe passages for our Nation's adolescents. Refugee Resettlement The FY 1997 budget request for the Refugee and Entrant Assistance program is $381.5 million, based on a projected refugee ceiling of 75,000 and an additional 15,000 Cuban entrant arrivals. In order to be designated as refugees, people must have a well-founded fear of persecution in their country of origin because of race, religion, nationality, membership in a particular social group, or political opinion. Entrant arrivals are a result of the U.S./Cuban Migration Agreements which sought to end mass illegal immigration from Cuba. Over 22,000 Cuban entrants arrived in the United States in FY 1995 while nearly 100,000 refugees and Amerasians arrived. In January 1996, the last of the 30,500 Cubans and 500 Haitians previously detained at Guantanamo Bay were admitted to the U.S. This funding level will provide States the capacity to provide eight months of refugee cash and medical assistance, as well as reimbursement for the care of refugee unaccompanied minors. This request will also support Preventive Health, Targeted Assistance and Social Services programs administered by public and private non-profit agencies. These programs help refugees become self-supporting and socially adjusted upon arrival in the U.S. Community Services Block Grant The Community Services Block Grant Program provides States, territories, and Indian Tribes with a flexible source of funding to ameliorate the causes of poverty. In FY 1997, ACF is requesting $389.6 million for this program. Grant funds will be used by a network of local agencies including community action agencies, tribes, and tribal organizations to provide a range of services and activities to assist low-income individuals. ACF is not seeking funding for other discretionary Community Services programs. This decision reflects the concerns of Congress to reduce the number of discretionary grant programs and the Administration's intention to develop more comprehensive programs. Developmental Disabilities In FY 1997, ACF is requesting $121.9 million to support programs that protect the rights and promote the self-sufficiency of Americans with developmental disabilities and their families. The Administration for Developmental Disabilities programs serve nearly four million Americans with severe, chronic disabilities attributable to mental and/or physical impairment, which are manifested before age 22, are likely to continue indefinitely, and result in substantial limitations in major life activity. Funds for this program help State governments, local communities, and the private sector to integrate disabled individuals socially and economically into mainstream society through the development of Statewide coordinated systems, the establishment of protection and advocacy systems to assist individuals in exercising their human and legal rights, university affiliated programs to 71 disseminate information, and special projects which focus on the most pressing national issues affecting people with developmental disabilities and their families. Violence Against Women Programs In his State of the Union address, President Clinton challenged the citizens of this nation, stating, "I call on American men and women in families to give greater respect to one another. We must end the deadly scourge of domestic violence in our country." In FY 1997, ACF is requesting $15 million in grants for battered women's shelters for a total Family Violence program level of $47.6 million. This funding helps States, territories, and tribes provide shelter services to victims of family violence and their children and for related services, such as alcohol and substance abuse prevention and family violence prevention counseling. The budget also includes $400,000 for the Domestic Violence Hotline (1-800-799-SAFE). This national, 24-hour, toll-free hotline was first funded in FY 1995 and began providing crisis assistance, counseling, and local shelter referrals across the country on February 21, 1996. Hotline counselors are also available for non-English speakers and the hearing impaired. ACF Entitlement Programs For three years, the Administration and the Department have worked aggressively to overhaul the nation's welfare system both incrementally through State waivers, and comprehensively, through fundamental legislative reforms. We have granted waivers to nearly 40 States, to provide them with the freedom to move people out of welfare and into jobs. As a result, nearly ten million welfare recipients are in households where the adults are being required to work, and to take more responsibility for their families and their future. These incremental successes are encouraging, but they are only a beginning. Building upon the principles of work and responsibility, we are committed to working with the Congress to enact a bipartisan welfare reform bill. The President's FY 1997 budget includes a revised proposal to reform the welfare system. The new plan saves $40 billion over seven years while promoting sweeping work-based reforms and protecting children. The key elements of the President's welfare reform proposal are: A time-limited conditional entitlement in return for work: AFDC would be eliminated and replaced with the Temporary Employment Assistance (TEA). The TEA program would provide cash benefits to eligible families with needy children. As soon as they join the rolls, beneficiaries would have to develop and sign a personal responsibility contract with their welfare office. Within two years, able- bodied parents would have to work or lose their benefits. Cash assistance would be limited to five years. In order to protect vulnerable families, exemptions from the time limit would be allowed for hardship cases and vouchers would be provided for children whose parents reach the time limit. 72 Child care to reward work over welfare: Child care is vital to moving people off welfare and helping them stay off. The President's budget contains $3.8 billion for child care programs to help low-income parents gain the skills to hold a job, or look for one. Child care funds also would help parents avoid welfare in the first place. Work programs to help recipients move into the labor market: The President's welfare reform proposal establishes tough work requirements by replacing the JOBS program with the Work First program. The plan would provide a block grant to States to cover the cost of providing job placement, job training and other employment services, administering the cash benefit program, and delivering emergency assistance. It provides States with increased flexibility to design and operate work programs that best meet the needs of their communities. States would receive financial incentives for moving families from welfare to work. Protection during economic downturns: The President's plan maintains a flexible funding structure that adjusts to changing economic circumstances. In a recession, State revenues fall even as welfare caseloads rise because more jobless families seek public assistance. Without a funding structure that can adjust to caseload changes, a recession could render many States unable to keep paying welfare benefits and still meet the tough work requirements of any real reform. While providing this protection for States, the President's plan also requires States to maintain their stake in moving people from welfare to work and holds States accountable for making welfare reform a success. Tougher child support enforcement: The President's plan includes new child support enforcement measures that emphasize parental responsibility including: revoking driver and professional licenses for parents who refuse to pay child support, improving interstate laws to find such parents, and strengthening the tools to establish paternity so that both parents take full responsibility for their children. Now, we must encourage the Congress to do its part to enact changes that will encourage work, protect families, and reduce spending. Until then, we will continue the process of welfare reform through waivers, one State at a time. The following pages summarize projected spending for AFDC and related programs under current law in the event that comprehensive welfare reform is not enacted prior to FY 1997. Job Opportunities and Basic Skills Training A total of $1 billion would be required under current law in FY 1997 to support the Job Opportunities and Basic Skills Training (JOBS) program, a key element of current efforts to help welfare recipients achieve self-sufficiency. The program gives States flexibility to provide training and work opportunities geared to their particular AFDC recipients' needs. Currently, over 600,000 people are active in JOBS programs each month. States have wide flexibility in structuring the mix of programs they offer to recipients. Programs must include: educational activities (e.g., high school or equivalent level, basic and remedial 73 education); job skills training; job readiness training activities; and job development and placement assistance. States must also include at least two of the following components in their programs: job search programs; on-the-job training; work supplementation programs; and community work experience programs. Aid to Families with Dependent Children The Aid to Families with Dependent Children (AFDC) program provides funding to States for cash assistance to low-income families with dependent children who have been deprived of parental financial support due to the death, disability, unemployment or continued absence of a parent. Reductions in caseload over the last year of approximately 6.6 percent have resulted in decreased spending in FY 1996 for this program. Recent estimates suggest that budget authority for benefit payments in FY 1996 will be 8 percent below comparable spending in FY 1995. In addition to AFDC benefits, States also have the option of operating the AFDC Emergency Assistance program. This program provides financial assistance, medical, and/or social services to needy families with children to meet temporary, emergency needs. Budget authority of $1.9 billion is requested for FY 1997, including amounts to pay for claims from prior years. State claims under the Emergency Assistance program have increased by over 1,000 percent since 1991 as more States have begun to participate, and as States have attempted to claim Federal reimbursement for a wider range of activities, including various types of child protective services and medical emergencies for children not receiving Medicaid, and to cover a broader range of recipients. In FY 1996, the Administration for Children and Families issued policy clarification to States that prohibited the costs of juvenile justice programs from being funded as Emergency Assistance. AFDC Child Care (Title IV-A) In FY 1997, $1.45 billion would be required under current law for three child care programs: child care for JOBS participants, former AFDC recipients who work, and those at risk of becoming AFDC recipients. More than half of these funds, $880 million, will support current AFDC recipients' efforts to become self-sufficient by paying for child care that these recipients need to participate in education, training, and work activities. As recipients become self-sufficient and leave the AFDC rolls due to increased employment income, States will provide recipients with up to 12 months of child care to ease the transition from welfare to work. A total of $268 million is requested for this Transitional Child Care program in FY 1997. Finally, the At-Risk (non-AFDC) Child Care program provides child care assistance to families at risk of becoming AFDC recipients. The FY 1997 request for this program totals $300 million. Child Support Enforcement The Child Support Enforcement (CSE) program is a joint Federal, State and local partnership that seeks to locate noncustodial parents, establish paternity, and set and enforce support 74 orders. Costs of these activities are jointly financed by the Federal Government (66 percent) and the States (34 percent). In FY 1997 it is estimated that a total of $2.1 billion will be expended in order to collect over $12.5 billion in payments. The first $50 of currently-due support collected on behalf of an AFDC family in a month is given to that family, while the balance can be used by Federal, State and local governments to offset their costs of assisting these families. From the Federal share, States also receive an incentive payment based on program efficiency and the amount of their collections. The remaining Federal share is available to offset Federal AFDC benefit costs. Collections made on behalf of non-AFDC families are paid directly to these families. For non-AFDC families with low incomes, receipt of child support assists them in remaining off the welfare rolls. Since the creation of the child support enforcement program, total child support collections have increased annually. In recent years, States have increased collections by using approaches such as income withholding, offset of income tax refunds, support guidelines and closer links to credit bureaus. In FY 1997, $12.5 billion in child support collections are projected to be distributed to families and shared by governments, an 8 percent gain in collections over FY 1996. In FY 1996, this represents a total return of almost $4 for every dollar invested in the administration of the program. Since the inception of the program in FY 1975, a total of $83 billion has been collected. The Office of Child Support Enforcement (OCSE) has a new initiative to promote dramatically improved performance, service quality and public satisfaction with the child support enforcement program. As a pilot project under the Government Performance and Results Act (GPRA), HHS has begun strengthening partnerships with State child support agencies. OCSE has approved 33 applications from State and local governments to implement innovative approaches in their programs. Examples include new efforts to improve access to medical insurance, encourage welfare mothers' cooperation in identifying and locating alleged fathers, and provide employment counseling to noncustodial parents. 75 CHILD SUPPORT ENFORCEMENT COLLECTIONS AND COSTS (Dollars in millions) (outlays) 1995 1996 1997 Estimate Actual Policy Request +/- Policy Total Collections Distributed to: AFDC/FC Families $476 $509 $544 +$35 Non-AFDC Families 8,018 8,730 9,446 +716 AFDC program 2,143 2,278 2,437 +159 FC program 22 23 24 +1 Total $10,659 $11,540 $12,451 +$911 Distributed to AFDC Program: Net Federal Share $822 $853 $907 +$54 State Share 1,321 1,425 1,530 +105 Total $2,143 $2,278 $2,437 +$159 Administrative Costs: Federal Share $1,993 $2,026 $2,109 +$83 State Share 918 976 1,055 +79 Costs $2,911 $3,002 $3,164 +$162 Program Savings and Costs: (Collections minus Costs) Federal Costs $1,171 $1,173 $1,202 +$29 State Savings (403) (449) (475) +(26) Net Costs $768 $724 $727 +$3 Foster Care, Adoption Assistance and Independent Living A total of $4.4 billion in budget authority is requested in FY 1997 for the Foster Care, Adoption Assistance and Independent Living programs. Of this request, $3.8 billion is requested for the Foster Care program, which will provide payments on behalf of almost 285,000 children each month. This request will also fund State administration, including child welfare case management systems, training, and State data systems. In FY 1997, under the Adoption Assistance program, ACF is requesting $568 million to provide subsidy payments to families who have adopted special needs children. Payments are made on behalf of adopted children up to their 18th birthday and this level of funding will support approximately 131,000 children each month. The Independent Living Program will receive $70 million to continue services to help teenagers under State supervision make the transition to living on their own. 76 Family Preservation and Support For FY 1997, $240 million will be made available to States and eligible tribes as part of a continuing five-year funding plan started in FY 1994 to strengthen family preservation and support services. These services help State protection welfare agencies and eligible Indian tribes establish and operate integrated, preventive family preservation services and community-based family support services for families at risk or in crisis. Family preservation services are activities that help families alleviate crises that might lead to out-of-home placements of children because of abuse or neglect. Family support services, often provided by community-based organizations, are voluntary, preventive activities to help families nurture their children. These activities help to prevent the unnecessary separation of children from their families and improve the quality of care and services. 77 ACF OVERVIEW DISCRETIONARY SPENDING (Dollars in millions) 1995 1996 1997 Request Actual Policy* Request + /-Policy Head Start $3,534 $3,631 $3,981 +$350 Child Care Development Block Grant 935 935 1,049 + 114 Low Income Home Energy 1,419 1,000 1,000 0 Emergency Funding (non-add) (500) (300) (300) 0 Child Welfare: Child Welfare Services 292 292 292 0 Child Welfare/Child Abuse 127 72 127 +55 Subtotal, Child Welfare $419 $364 $419 +$55 Refugee & Entrant Assistance $400 $400 $381 -$19 Targeted Assistance 6 5 0 -5 Community Services Block Grant 458 429 390 -39 Runaway and Homeless Youth 69 57 69 + 12 Developmental Disabilities 122 116 122 +6 Violence Against Women Programs 33 38 48 +10 Native Americans 38 35 38 +3 Teen Pregnancy Initiative 0 0 30 +30 Social Services Research 15 0 10 +10 Other ACF 39 8 13 +5 Federal Administration 162 151 160 +9 Total, Program Level/BA $7,649 $7,169 $7,710 + $541 * Based on levels of the ninth CR, including an incremental policy adjustment. 78 ACF OVERVIEW ENTITLEMENT SPENDING (Dollars in millions) 1995 1996 1997 Increase/ Actual Estimate* Estimate* Decrease Social Service Block Grant $2,800 $2,800 $2,800 $0 Foster Care/Adoption Assistance 3,597 4,322 4,445 + 123 Family Support & Preservation 150 225 240 +15 JOBS 1,012 1,000 1,000 0 Family Support Payments (FSP): AFDC/Related Assistance** 11,451 10,408 10,780 +372 Emergency Assistance 984 1,687 1,867 +180 Child Care 1,152 1,404 1,447 + 43 AFDC State Administration 1,780 1,679 1,875 +196 Child Support Enforcement Admin 2,124 1,916 2,132 +216 Subtotal, FSP $17,491 $17,094 $18,101 +$1,007 Subtotal, Entitlements $25,050 $25,441 $26,586 $1,145 Total, ACF BA $32,699 $32,610 $34,296 + $1,686 FTE 1,803 1,803 1,803 0 * Funding levels are based on the Administration's most recent estimates of entitlement spending under current law. ** AFDC and related assistance is shown net of child support collections. 79 ADMINISTRATION ON AGING (AoA) (Dollars in millions) 1995 1996 1997 Request Actual Policy* Request +/-Policy Program Level/BA $876 $828 $828 $0 Outlays 951 776 819 +$43 FTE 177 177 177 0 * Based on levels of the ninth CR, including an incremental policy adjustment. Summary ADMINISTRATION ON AGING The FY 1997 budget for the Administration FY 1997 Budget on Aging (AoA) provides $828 million for $828 Million programs aimed at improving older Supportive Services & Centers Americans' quality of life. In addition, the 35% budget reflects the Administration's desire to consolidate, in AoA, the management and oversight of programs that serve the Other AoA 11% elderly. The Department of Agriculture will transfer administration of their Nutrition Programs for the Elderly to AoA, and the Department of Labor will transfer administration of their Older Workers Meals Programs 54% program to AoA. The programs funded by AoA help senior citizens remain independent and productive. AoA serves older persons and their families through the administration of the Older Americans Act and aging-related research and educational projects. As the focal point in the Federal Government for serving older persons, AoA works to advance the dignity and independence of the nations' elderly. By the year 2030, the number of people aged 60 and older will increase to 89 million, while those 85 and older will increase to almost nine million. AoA recognizes the need to address these demographic changes, and is striving to prepare both older and younger Americans for their aging. Nutrition Programs For FY 1997, AoA requests $451.2 million for Nutrition Programs. Over 240 million meals 80 were served last year through the Aging Network--about half of meal recipients are low-income elders and about 16 percent of recipients are members of minority groups. Recipients of home-delivered meals are among the most vulnerable elderly in the community, with 73 percent considered to be frail and disabled and 53 percent being low-income. Between 1980-1993, the number of home-delivered meals increased by 180 percent, reflecting not only a growing elderly population but also an elderly population composed of increasingly older and more frail individuals. Moreover, the volunteers who deliver the meals often serve as informal gatekeepers, assessing if recipients have other needs and linking them to additional services. Congregate nutrition services provide a cooked, ready, nutritious meal to seniors in a group setting. Participation in a group setting reduces isolation and encourages continued physical and mental functioning. The Older Americans Act directs that priority be given to those who are in greatest economic and social need, with particular attention to low-income, minority older persons. Supportive Services The FY 1997 budget request reflects AoA's commitment to ensure that older Americans have an independent, productive, healthy and secure life. Supportive services represent the cornerstone of the comprehensive and coordinated system of home and community-based services that address the needs of the elderly. The FY 1997 budget provides funding for a network of 57 State units, 228 Indian tribal organizations, 670 Area Agencies on Aging, approximately 6,000 senior centers and more than 27,000 service providers throughout the country. Supportive services and centers have provided over 40 million rides, over 12 million responses for information and referrals, nearly 10 million personal care services to elderly in need, and approximately one million legal counseling sessions. Long-Term Care One of the great challenges confronting America's families is care for relatives who are elderly or disabled. This challenge is often accompanied by fear as older and disabled persons face their own aging or increased disabilities. The FY 1997 request reflects a commitment to addressing these family needs as it shapes a long-term care system for the future. The FY 1997 budget request provides $9.2 million for in-home services for the frail elderly. The rapid growth of the age 85 and over population brings new demands for care because of limited mobility, increasing disability, more elderly living alone and the higher risk of poverty. By supporting the provision of services to frail older individuals, the program increases the access of vulnerable older individuals to needed assistance and helps them avoid institutionalization. The Long-Term Ombudsman Program will be funded at $4.5 million in FY 1997. This request underscores the crucial role ombudsmen play in the long-term care system and the useful assistance they provide to residents and their families related to their care. 81 Ombudsman programs in all States, Puerto Rico and the District of Columbia serve the Nation's 1.5 million nursing home residents, who are the most frail and vulnerable group in the long-term care system. Additional activities funded through AoA include basic and applied research on the chronic illnesses that contribute to disability and efforts to improve the efficiency and effectiveness of community-based long-term care systems. The challenge here is to enable States and local governments to design and build on innovative models of integrated care and service delivery and to make their long-term care systems more customer-oriented in FY 1997. Proposed Transfers AoA's reauthorization legislation pending before Congress proposes to transfer $150 million from the USDA's Nutrition Program for the Elderly, and replace it with the Nutrition Services Incentive Program under Title III-C of the Older Americans Act. The Nutrition Services Incentive Program would be administered by AoA; however, the funds would continue to be appropriated to the Department of Agriculture. The reauthorization also proposes to transfer the Department of Labor's Community Service Employment for Older Americans program (Title V) to AoA. This proposal would ensure national responsiveness to local community needs. It would allow greater flexibility to consolidate, coordinate, link and expand limited resources to enhance community service and employment and training for low-income seniors. The proposed transfer would amount to $350 million. 82 AoA OVERVIEW (Dollars in millions) 1995 1996 1997 Request Actual Policy/1 Request + /-Policy Current Law; Supportive Services $306 $295 $295 $0 Meals: Congregate Meals 376 357 357 0 Home-Delivered 94 94 94 0 Subtotal, Meals $470 $451 $451 $0 In-home Services-Frail Elderly. $9 $9 $9 $0 Indian/Tribal Grants 17 16 16 0 Preventive Health 17 17 17 0 Research, Training and Demos. 26 12 12 0 Ombudsman Services 5 5 5 0 Prevention of Elder Abuse 5 5 5 0 Pension Counseling 2 2 2 0 White House Conference 3 0 0 0 Federal Administration 16 16 16 0 Federal Council on Aging 0.1 0.2 0.2 0 Subtotal, BA $876 $828 $828 $0 Proposed Transfers:/2 Department of ./NPE ($150) ($150) ($150) $0 Department of Labor (396) (350) (350) 0 Subtotal, Proposed Transfers ($546) ($500) ($500) $0 Total, BA $876 $828 $828 $0 FTE 177 177 177 0 1/ Based on levels of the ninth CR, including an incremental policy adjustment. 2/ Proposed Bill language transfers $150 million from the Department of Ag. Nutrition Programs for the Elderly (NPE) and $350 million from the Department of Labor Community Work Program for the Elderly to be administered by AoA. 1995 Actual and 1996 Policy levels for these programs are provided for comparison only. 83 DEPARTMENTAL MANAGEMENT (Dollars in millions) 1995 1996 1997 Request Actual Policy* Request +/- Policy Program Level $214 $192 $198 +$6 Budget Authority 188 172 178 +6 Outlays 256 219 167 -52 FTE 1,544 1,544 1,544 0 * Based on levels of the ninth CR. Summary The Departmental Management (DM) budget includes requests for five separate appropriations--General Departmental Management, Office for Civil Rights, Policy Research, Office of Consumer Affairs, and the Public Health and Social Service Emergency Funds--that fund activities which provide leadership, policy, legal, and administrative guidance to HHS components; carry out the Department's civil rights and nondiscrimination enforcement programs; present consumer needs and viewpoints in the Federal Government; and support research to develop policy initiatives and improve existing HHS programs. DM also incorporates the activities of the former Office of the Assistant Secretary for Health (OASH), including adolescent family life, disease prevention and health promotion, physical fitness and sports, minority health, research integrity, women's health, HIV/AIDS policy, and emergency preparedness. The operation and maintenance of central and common administrative, fiscal, and personnel support services have been centralized in the Program Support Center, a newly created HHS Operating Division (OPDIV). General Departmental Management The FY 1997 budget request provides a program level of $165 million for General Departmental Management (GDM), including an appropriation of $145 million and intra-agency transfers of $20 million in one-percent evaluation funds. GDM supports those activities associated with the Secretary's roles as chief policy officer and general manager of the Department through nine Staff Divisions (STAFFDIVs): the Immediate Office of the Secretary, the Offices of Public Affairs, Legislation, Planning and Evaluation, Management and Budget, Intergovernmental Affairs, General Counsel, and Public Health and Science, and the Departmental Appeals Board. The operations of the Assistant Secretary for Personnel 84 Management and the Assistant Secretary for Management and Budget were merged in FY 1996. As part of the Department's reinvention and streamlining processes, the Office of the Assistant Secretary for Health was merged with the Office of the Secretary, eliminating an entire management layer. The new Office of Public Health and Science (OPHS), headed by the Assistant Secretary for Health (ASH), and the Public Health Service OPDIVs report directly to the Secretary. The ASH functions as senior advisor for public health and science to the Secretary and provides senior professional leadership in the Department on population-based public health and clinical preventive services. The ASH also provides direction to the following OPHS program offices: Adolescent Family Life Program - supports grants which encourage adolescents to delay sexual behavior, OFFICE OF PUBLIC HEALTH AND SCIENCE provides service to pregnant and FY 1997 Request (Dollars in millions) parenting teens, and researches adolescent pregnancy issues. The request will support the same PCPFS $1 AFL $6 ODPHP $4 number of grants (18) as in FY 1996. ORI $4 OMH $20 OWH $3 OHAP $1 Office of Disease Prevention and OEP $7 Health Promotion - coordinates Immediate Office $4 health promotion and disease prevention activities among the Includes $5 million for anti-terrorism activities in OEP. Excludes OIRH reimbursable and OPHS one-percent evaluation funds. Department's Operating Divisions, other Federal Departments, and the private and voluntary sectors. President's Council for Physical Fitness and Sports - promotes and encourages physical activity/fitness and sports participation for Americans of all ages and abilities. Office of Minority Health - coordinates disease prevention, health promotion, and health service delivery for disadvantaged and minority individuals and supports research on minority health topics, the goal of which is to improve the health status of racial and ethnic minority populations in the United States which continues to lag behind the health status of the American population as a whole. Office of Research Integrity - oversees and directs the research integrity efforts of the Public Health Service, with the exception of the regulatory research activities of the Food and Drug Administration. Office on Women's Health - serves as the Department's focal point for the improvement and protection of women's health by redressing inequities in the conduct of research, health services, prevention, and public and health professional education and training on women's health issues. 85 Office of Emergency Preparedness - manages and coordinates the health and medical and health-related social services that are provided by the Federal Government to victims of catastrophic disasters through the Federal Response Plan Emergency Support Function (ESF) #8. Under ESF #8, HHS coordinates the support of 12 Federal agencies in the preparedness for, response to, and recovery from natural and man-made disasters. The Department is the lead Federal agency for the management of the response to the health and medical consequences of a major terrorist event. The Office of Emergency Preparedness has been tasked by the National Security Council to assess and remedy any shortfalls in the health and medical consequence response capabilities necessary in the event of a terrorist use of a weapon of mass destruction, be it chemical, biological or nuclear. The FY 1997 budget request includes anti-terrorism funding of $5 million to begin to ensure an effective and coordinated local, State, and Federal Government response to a terrorist incident. Office of HIV/AIDS Policy - provides professional expertise to the Secretary and the Assistant Secretary for Health in the areas of HIV/AIDS prevention, treatment and rehabilitation and leadership in policy development and program coordination related to the Department's response to the HIV epidemic in the United States. Office of International and Refugee Health - serves as the HHS focal point for policy guidance, planning, evaluation, and program coordination related to international and refugee health affairs, funded through reimbursable agreements with the Department of State, United States Agency for International Development, and international health organizations (WHO and UNICEF). Office for Civil Rights The FY 1997 budget request for the Office for Civil Rights (OCR) is $22 million, the same as the FY 1995 level and an increase of $3 million over the FY 1996 operating level. OCR is responsible for enforcing nine major civil rights statutes that prohibit discrimination in Federally-assisted health care and social services programs. These statutes cover nondiscrimination on the basis of race, national origin, disability, age, and in limited instances, sex and religion. In addition, OCR is responsible for coordinating the implementation of the Section 504 regulation that prohibits discrimination against persons with disabilities in programs and activities conducted by HHS. OCR enforces nondiscrimination requirements by processing and resolving discrimination complaints, conducting reviews and investigations, monitoring corrective action plans, and carrying out voluntary compliance, outreach and technical assistance activities. OCR has made significant progress in addressing issues such as race discrimination in access to health care and discrimination against persons with disabilities. In FY 1995, OCR completed 5,655 discrimination complaint and review cases, with 40 to 50 percent of the cases resulting in changes in policies and practices. This budget request reflects the continuation of the implementation of OCR's strategic plan. The plan has resulted in significant reengineering of OCR's investigative and compliance 86 processes through redesign and streamlining. The plan calls for expanded use of innovative partnerships both within HHS and at the State and local levels to ensure civil rights compliance. As a result of strategic plan initiatives, review and complaint investigation production is projected to increase by more than 45 percent. In addition, the FY 1997 budget request includes funds to support outreach and other compliance initiatives that seek new ways of preventing civil rights problems and addressing potential discrimination in HHS programs. Policy Research The FY 1997 budget request includes $9 million for Policy Research (PR) to support research on policy issues of national significance. Priority issues that PR will examine are those related to welfare reform, health care, family support and independence, poverty, at-risk children and youth, aging and disability, science policy, and improved access to health care and support services. U.S. Office of Consumer Affairs The FY 1997 budget request for the U.S. Office of Consumer Affairs is $2 million. These funds will support presentation of consumer viewpoints within the Executive Branch especially related to fraud, telecommunications and privacy issues; publication and distribution of the Consumer's Resource Handbook and other consumer information materials; and operation of the National Consumer Helpline, a Federal clearinghouse for consumer complaint handling, information and referral. 87 DEPARTMENTAL MANAGEMENT SUMMARY (Dollars in millions) 1995 1996 1997 Request Actual Policy* Request +/- Policy General Departmental Management $181 $162 $165 + $3 Office for Civil Rights 22 19 22 +3 Policy Research 9 9 9 0 U.S. Office of Consumer Affairs 2 2 2 0 Subtotal, Program Level $214 $192 $198 + $6 Less: Intra-agency Transfers -26 -20 -20 0 Total, BA $188 $172 $178 + $6 FTE 1,544 1,544 1,544 0 * Based on levels of the ninth CR. 88 OFFICE OF INSPECTOR GENERAL (Dollars in millions) 1995 1996 1997 Request Actual Policy* Request +/- Policy Program Level $79 $74 $75 $1 Budget Authority 79 74 75 +1 Outlays 89 67 75 +7 FTE 927 927 927 0 * Based on levels of the ninth CR. Summary For FY 1997, the Office of Inspector General (OIG) requests $75 million, an increase of $1 million above the FY 1996 level. OIG is charged with conducting and supervising audits and investigations relating to programs and operations of HHS; providing leadership and coordination for, and recommending policies and corrective actions concerning, activities designed to promote economy and efficiency in the administration of the Department's programs; and preventing and detecting fraud and abuse in HHS' programs and operations. In FY 1997, OIG will focus its resources in the following areas: reviewing departmental efforts to improve children's welfare and child support enforcement collection initiatives; evaluating providers and services in the Medicare and Medicaid programs; ensuring the effectiveness of the public health delivery programs; and auditing management control systems and financial operations. All of these reviews will assist HHS program managers to improve the health and welfare of program beneficiaries. OIG resources will also be devoted to the final phase of Operation Restore Trust. Under this project, OIG, HCFA and AoA will continue their interdisciplinary teams of Federal, State, and private sector representatives targeting health care fraud and abuse in California, Florida, New York, Texas and Illinois--these five States account for more than a third of all Medicare beneficiaries and nearly 40 percent of Medicaid recipients. The project team is focusing on the three fastest growing areas of Medicare expenditures: nursing facilities, home health, and durable medical equipment. The Medicare Anti-fraud and Abuse Program (MAAP) is a proposed new initiative to restore trust and accountability to Medicare. This program would build on the proven effective aspects of Operation Restore Trust, enhance general Medicare fraud protection activities, allow OIG to pursue innovative anti-fraud initiatives, enhance data systems to assess trends and identify possible fraud and abuse, and expand OIG resources by retraining and adding 89 staff to those parts of the country where fraud schemes are unfolding. Should this legislation be enacted, an additional $54 million will be added to supplement OIG's current effort. In FY 1995, OIG asserts that its activities resulted in over $10.2 Savings to Federal Government billion in settlements, fines, FY 1981 and 1991 - 1995 restitutions, receivables and $12 savings to the Federal Government. The OIG asserts $10 $10.2 that the return on investment $8 $8.1 increased from $160,000 per OIG FTE in 1981 to $9.7 million $ In billions $6.8 $6 $5.9 $6.1 in 1995, and from $4 in savings $4 for every OIG budget dollar spent in 1981 to $115 in savings $2 for every OIG budget dollar $0 $0.2 spent in 1995. These amounts 1981 1991 1992 1993 1994 1995 are based on independently scored estimates from the Congressional Budget Office, HCFA actuaries, and HHS Program administrators. During the same time period, successful judicial prosecutions rose from 165 in FY 1981 to 620 in FY 1995. Administrative sanctions against individuals or entities that defrauded or abused HHS programs and/or beneficiaries also rose from 39 in FY 1981 to 1,563 in FY 1995. OIG is continuing to streamline its operations and management structure to minimize costs and OIG Return on Investment ensure that the greatest portion of its resources are concentrated on Savings per dollar Invested investigations, audits, and inspections. OIG is also reinventing its $4 processes and exploring creative $115 1981 ways to effectively deploy its resources to aggressively combat 1995 fraud, abuse, and waste in the Department's programs, including: 90 Administrative Operations Service The Administrative Operations Service (AOS) supports the administrative management functions within the Department in the areas of property and material management, and support services ranging from telecommunications services and commercial graphics to mail distribution. Included is the operation of a medical supply depot located in Perry Point, Maryland, that provides support to over 1,700 customers on a worldwide basis and is an economical source of supply for all Federal customers. The FY 1997 estimated expenses of $142 million for AOS includes a $5 million increase for the expansion of product lines within the Supply Service Center and increased communication capabilities through the Telecommunication Improvement Project. This project consolidates telephone services under one contract; this collective bargaining results in savings of up to one-third in the rates charged by the telephone company for services to agencies in the Parklawn Complex and the National Institutes of Health campus. Information Technology Service The FY 1997 estimated expenses for the Information Technology Service (ITS) is $11 million. The ITS provides automated data processing (ADP) services for HHS and other Federal entities. It provides its customers with various ADP services, resources, technical support and ADP planning assistance. In addition, the ITS develops and operates the Departmental Information Management Exchange System, a nationwide telecommunications network, and serves as the HHS Executive Agent for Department-wide connectivity. 93 PROGRAM SUPPORT CENTER ENTITLEMENT SPENDING Retirement Pay and Medical Benefits for Commissioned Officers (Dollars in millions) 1995 1996 1997 Increase/ Actual Estimate* Estimate* Decrease Retirement Payments $112 $130 $136 + $6 Survivors' Benefits 8 9 11 +2 Medical Care 22 25 26 +1 Military Service Credits 2 3 3 0 Total, BA $144 $167 $176 $9 Outlays $152 $167 $176 $9 * Funding levels are based on the Administration's most recent estimates of entitlement spending under current law. Summary This appropriation provides for retirement payments to Public Health Service (PHS) Commissioned Officers and payments to survivors of deceased retired officers. This account also funds the provision of medical care to active duty and retired members and to dependents of active duty, retired and deceased members of the PHS Commissioned Corps. In addition, this account includes amounts to be paid to the Social Security Administration for military service credits which are earned by active duty Commissioned Officers for non-wage income. 94 Establishing partnerships with State auditors under which OIG provides States with audit methodologies for their use in conducting audits of HHS health care programs. In addition to recovering taxpayer dollars, these partnerships will also result in program improvements and a reduction in the cost of providing needed services to Medicaid and other recipients. Conducting joint investigations with other Federal law enforcement agencies, including the Secret Service, the Federal Bureau of Investigation (FBI), the Internal Revenue Service, the Postal Inspection Service, State governments, other Inspector General offices, and the HHS OPDIVs. As part of Operation Restore Trust, a "voluntary disclosure" program is being piloted that encourages corporate health care providers to disclose potential instances of fraud and abuse that the providers themselves have discovered within their corporations. OFFICE OF INSPECTOR GENERAL SUMMARY (Dollars in millions) 1995 1996 1997 Request Actual Policy* Request +/- Policy Total, BA $79 $74 $75 +1 FTE 927 927 927 0 * Based on levels of the ninth CR. 91 PROGRAM SUPPORT CENTER HHS Service and Supply Fund (Dollars in millions) 1995 1996 1997 Increase/ Actual Estimate Estimate Decrease Expenses $225 $232 $237 +$5 FTE 1,261 1,261 1,261 0 Summary The Program Support Center (PSC) is a new Operating Division formed by combining the administrative activities formerly located in the Office of the Secretary (OS), and funded by the OS Working Capital Fund, with activities from the Office of the Assistant Secretary for Health, and funded by the Public Health Service (PHS) Service and Supply Fund. The formation of the PSC resulted from the Department's REGO II analysis with a goal of further streamlining and minimizing duplication of functions in the provision of cost-effective administrative services to components of the Department and other Federal agencies. Services will be provided in four broad business areas: human resources, financial management, administrative operations, and information technology. Human Resources Service The FY 1997 estimated expenses for the Human Resources Service (HRS) are $43 million. HRS provides a full range of personnel management services including payroll management and operations; personnel operations services for civilian and commissioned personnel; common needs training; employee relations and labor relations; and administration of the Board for Corrections of PHS Commissioned Corps Personnel Records. Financial Management Service The Financial Management Service (FMS) estimates its expenses at $41 million for FY 1997. FMS supports the financial operations of HHS and other Federal Departments through the provision of payment management services for departmental and other Federal grant and program activities; accounting and fiscal services; debt management services; and the review, negotiation and approval of rates, including indirect cost rates, research patient care rates, and fringe benefit rates. 92