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of Denver, Aurora and Cherry Creek; the Denver and Aurora Police Departments; the Denver Juvenile Court system; and non-profit youth and family serving agencies from all three communities. Another model being tested by many consortia is similar to that of the city of Los Angeles, where a broad range of Federal (ACYF, Housing and Urban Development, Labor and Justice) resources are being coordinated and concentrated to undertake youth gang prevention activities in five public housing sites.
Question. Is the Youth Gang Drug Abuse Prevention Program limited to urban communities only, or are there gange or groups in suburban or rural areas that are being targeted under this program?
Answer. ACYF has funded grants ranging from $1,000,000 service projecte in large urban centers, such as Los Angeles and Denver, to $50,000 planning projects in small communities with emerging gang problems, such as Caldwell, Idaho, and Jefferson County, Alabama. One very successful community-based consortium project is headed by cities in Schools in Pinal County, Arizona. This county is rural and is rated the poorest in the State. Several grantees cover urban, suburban and rural areas through extended partnerships.
Question. Researchers estimate that 375,000 babies per year had been exposed to illicit drugs. In FY 1989, 4,875 infants were reported to the Child Welfare Agency in New York City with a positive drug test--a 26% increase from 1986. The Center for Disease Control projects that by 1991 there will be 10,000 to 20,000 children with HIV. Given these increased needs, why are you requesting level funding for this program?
Answer. First, we have already funded or are in the process of funding 32 major metropolitan areas, and we feel that we have reasonably good geographic coverage at this time. Secondly, we have requested a substantial increase in the funding for title IV-B child welfare services, which dollars can be used for some of these same purposes.
Question. The Abandoned Infants Assistance Act requires that the Secretary of Health and Human Services conduct a study to determine how many infants and young children are abondoned each year. When will this study be completed?
Answer. We will complete this study by December 1991 and will be ready to submit it to the Congress in February 1992.
QUESTIONS SUBMITTTED BY SENATOR MARK O. HATFIELD
RUNAWAY AND HOMELESS YOUTH ACTIVITIES
Question. There are approximately 1 million youth who run away annually, and by all indications, this number is increasing. In addition to the runaway population, there are approximately 300,000 youth who are homeless. Your budget request would support 360 centers and will serve approximately 65,000 youth, the same number
as in FY 91. Why are you proposing to level fund this program when there are many homeless youth still in need of services?
Answer. We recognize that the problems of runaway and homeless youth are great, but we do not feel that the Federal government alone carries full responsibility for resolving these problems. In our view, responsibility for these at-risk youth lies (1) with the parents, (2) with local, county, and State welfare agencies, such as child protective services and foster care, and (3) with the Federal government. The shelters supported by the Federal government are essentially crisis and referral centers. We provide short-term lodging, food, and counseling while we arrange for either the parents or local agencies or both to assume their responsibilities for long-term care.
The typical youth center we fund has from 10 to 12 funding sources in addition to the Federal dollars. These sources include the United Way, local churches, local governments, and others. This demonstrates that many groups across the country are addressing these youth problems.
Question. One of the requirements of the Runaway and Homeless Youth Program is that a grantee have a plan for keeping statistical profiles of the clients (both youth and families). What have you learned from these data profiles?
Answer. We have learned that, in general, troubled youth come from troubled families. Youth do not run away from home casually. In almost all cases, youth are running away from severe conflicts, usually with their parents or guardians, often with social institutions such as schools or the juvenile justice system. Two-thirds of the youth cite arguments or fights with parents as their principal reason for leaving home.
Often these conflicts are accompanied by violence. Parental physical abuse, parental domestic violence, parental sexual abuse, physical or sexual abuse by other family members, and physical or sexual abuse by non-family members are cited respectively by 19.9, 9.6, 5.9, 4.6, and 3.5 percent of the youth.
The personal problems the youth carry with them when they enter runaway shelters are equally disturbing, and equally difficult to resolve. Approximately half have very low self esteem and are depressed. Fourteen percent are possibly suicidal.
One-third of the youth are having trouble with the school system, as shown by poor attendance, truancy, bad grades, and inability to get along with teachers. One quarter of the boys are in trouble with the juvenile justice system.
Shelter directors note that, increasingly, the youth they serve are multi-problem youth. For example, they are in conflict not only with their parents but also with the schools and the juvenile justice system. In addition, many have problems with alcohol and other drugs, as well as with teenage pregnancy and sexually transmitted diseases.
Question: Since the 65 and over population is the fastest growing age group in this country today, I would think that the need for services to that population would also increase. Your budget, however, shows level funding for programs in FY "92. What is the rationale for level funding these programs?
Answer: The Department of Health and Human Services has assigned a high priority to assuring that adequate resources are available to support the program efforts required to address the pressing needs of the Nation's older citizens. We note that Administration on Aging programs have received significant budgetary increases during the past decade. During that period we have also encouraged programs to solicit increased contributions from older recipients able to pay and have emphasized efforts to improve the management of service efforts. We believe that the results have been very positive. For example, over the seven year period 1982-1989, meals provided under the title III-C program have increased by more than one third, from 190,000,00 to 250,000,000. Voluntary contributions have more than doubled from $69,000,000 in 1982 to $150,000,000 in 1989. Where opportunities present themselves, the aging services network will make additional efforts to expand services through increasing voluntary contributions and further improving service program administration.
In addition, the Administration on Aging has recently launched its national Eldercare Campaign designed to mobilize additional resources from both the public and private sectors on behalf of older persons at risk of losing their independence. The Campaign is nation-wide in scope and will assist the aging services network to draw upon significant resources which have not been available in the past.
Question. Congregate and home-delivered meals are provided 5 days a week. Some of the elderly receiving these meals may be unable to prepare food for themselves. Ha the Administration given any thought to providing these meal services 7 days a week. What would be the cost of providing meals on a daily basis?
Answer. Generally, congregate and home delivered meals operate 5 days a week. However, the older Americans Act and applicable regulations currently allow State and Area Agencies on Aging to serve for more than 5 days a week. There are cases where this has been tried on a demonstration basis. It is not widely the practice. Some home delivered meals projects have provided needy elderly participants with an extra meal that is easily reheated and can be consumed at a later time. Based on discussions with State and Area Agency staff and others involved in the program, there is not a very large part of the elderly population that need or would want meals every day or more than one publicly provided meal each day. If more is needed, perhape other services, such as homemaker service, shopping assistance or a group living arrangement should be considered.
We do not doubt that there are circumstances where the need for 7 day service exists and could be appropriately met by expanded service. We have no estimate of the costs of providing 7 day service. However, we would expect it to be more expensive per meal
than regular service because of overtime rates for labor, additional staff costs, and a loss of efficiencies of scale due to a smaller number of clients served on weekends.
Question. When the Department's request for application was published, over 272 proposals were received, however only 45 were able to be funded. How many children is this program currently serving?
Answer. The first Transitional Living Program projects were funded in September, 1990. It is anticipated that between 900 and 1200 youth will be served, on a residential basis, within the first year.
Question. These Transitional Living Programs have been in operation for almost a year. What types of evaluations have been done to date?
Answer. Although funding was available in fiscal year 1990, the first group of projects were not awarded funds until September 1990. These projects have actually been operating for less than six months. An evaluation strategy has been designed which, when implemented, will determine the cross comparative results of the funded projects, their overall impact and effect, and will make recommendations for the further enhancement of the national program.
In addition, a systematic reporting system is being developed in order to obtain consistent, systematic data from all TLP projects.
OFFICE OF INSPECTOR GENERAL
STATEMENT OF RICHARD P. KUSSEROW, INSPECTOR GENERAL ACCOMPANIED BY DENNIS P. WILLIAMS, DEPUTY ASSISTANT SEC
RETARY FOR MANAGEMENT AND BUDGET
Senator HARKIN. The next witness is Mr. Richard Kusserow, the inspector general of the Department of Health and Human Services. Mr. Kusserow has served in this post for 10 years now. In that time, his office has compiled an impressive record of investigation into areas where Government spending could be reduced without compromising program effectiveness or impact on beneficiaries.
Welcome back to the subcommittee, Mr. Kusserow. We are looking forward to an update on the work your office is doing. We are also interested in knowing how your office will implement the new Chief Financial Officers Act, which mandates detailed financial statements of most agency spending.
As always, your complete statement will be made a part of the hearing record. Again, Mr. Kusserow, of the different departments under the jurisdiction of this subcommittee, it is this Senator's feeling that the Inspector General's Office that you head and you, in particular, are doing an outstanding job. We urge you to keep up the good work you are doing. With limited budgets, tight constraints, we have to go after any waste, abuse, fraud, inappropriate indirect costs or whatever we can to make sure that our dollars are being spent wisely. Again, welcome back, and please proceed as you so desire.
SUMMARY STATEMENT Mr. KUSSEROW. Thank you, Mr. Chairman. This is my 10th appearance before this committee. I am pleased to be here, and I am very appreciative of your kind remarks. We are prepared to discuss the issue of indirect costs at universities. We are also prepared to discuss any detail you would care to go into with regard to the chief financial officers legislation.
I would like to take advantage of your offer and just submit my formal statement for the record. I will just highlight some of our request to allow a maximum amount of time for explanation and questioning.
As you pointed out in your introduction of me here this morning, we are a kind of a rare commodity for this committee in the fact that we are not policymakers. You have plenty of policymakers come before you. Our job really is to look at the way things are operating and determine whether they could operate better. As to whether you cap programs or eliminate programs, raise taxes or