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S. HRG. 102–226, PT. 2

DEPARTMENTS OF LABOR, HEALTH AND HUMAN

SERVICES, AND EDUCATION, AND RELATED
AGENCIES APPROPRIATIONS FOR FISCAL YEAR
1992

J

HEARINGS

AG
BEFORE A

102nd
SUBCOMMITTEE OF THE no. 12

pt. 2
COMMITTEE ON APPROPRIATIONS' Docs

UNITED STATES SENATE
ONE HUNDRED SECOND CONGRESS

FIRST SESSION

ON

H.R. 2707/H.R. 3839
AN ACT MAKING APPROPRIATIONS FOR THE DEPARTMENT OF LABOR,
HEALTH AND HUMAN SERVICES, AND EDUCATION, AND RELATED
AGENCIES, FOR THE FISCAL YEAR ENDING SEPTEMBER 30, 1992, AND
FOR OTHER PURPOSES

Part 2 (Pages 1-1184)
Department of Health and Human Services

National Council on Disability

Printed for the use of the Committee on Appropriations

U.S. GOVERNMENT PRINTING OFFICE

WASHINGTON : 1991

38_711#

For sale by the U.S. Government Printing Office
Superintendent of Documents, Congressional Sales Office, Washington, DC 20402

ISBN 0-16-037043-4

COMMITTEE ON APPROPRIATIONS

ROBERT C. BYRD, West Virginia, Chairmon
DANIEL K. INOUYE, Hawaii

MARK O. HATFIELD, Oregon
ERNEST F. HOLLINGS, South Carolina TED STEVENS, Alaska
J. BENNETT JOHNSTON, Louisiana

JAKE GARN, Utah
QUENTIN N. BURDICK, North Dakota THAD COCHRAN, Mississippi
PATRICK J. LEAHY, Vermont

ROBERT W. KASTEN, JR., Wisconsin
JIM SASSER, Tennessee

ALFONSE M. D'AMATO, New York DENNIS DECONCINI, Arizona

WARREN RUDMAN, New Hampshire DALE BUMPERS, Arkansas

ARLEN SPECTER, Pennsylvania FRANK R. LAUTENBERG, New Jersey PETE V. DOMENICI, New Mexico TOM HARKIN, Iowa

DON NICKLES, Oklahoma BARBARA A. MIKULSKI, Maryland

PHIL GRAMM, Texas HARRY REID, Nevada .

CHRISTOPHER S. BOND, Missouri
BROCK ADAMS, Washington

SLADE GORTON, Washington
WYCHE FOWLER, JR., Georgia
J. ROBERT KERREY, Nebraska

JAMES H. ENGLISH, Staff Director

MARY S. DEWALD, Chief Clerk
J. KEITH KENNEDY, Minority Staff Director

SUBCOMMITTEE ON DEPARTMENTS OF LABOR, HEALTH AND HUMAN SERVICES, AND

EDUCATION, AND RELATED AGENCIES

TOM HARKIN, Iowa, Chairman
ROBERT C. BYRD, West Virginia

ARLEN SPECTER, Pennsylvania
ERNEST F. HOLLINGS, South Carolina MARK O. HATFIELD, Oregon
QUENTIN N. BURDICK, North Dakota TED STEVENS, Alaska
DANIEL K. INOUYE, Hawaii

WARREN RUDMAN, New Hampshire
DALE BUMPERS, Arkansas

THAD COCHRAN, Mississippi HARRY REID, Nevada

PHIL GRAMM, Texas BROCK ADAMS, Washington

SLADE GORTON, Washington

Majority Professional Staff
J. MICHAEL HALL, JAMES J. SOURWINE, CAROL C. MITCHELL, AMY SCHULTZ, and MARGARET

STEWART
Minority Professional Staff
BETTILOU TAYLOR and CRAIG A. HIGGINS

Administrative Support
GLADYS CLEARWATERS and SUSAN A. MCGOVERN

(II)

CONTENTS

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Department of Health and Human Services: Office of the Secretary ..........

THURSDAY, MARCH 7, 1991

Department of Health and Human Services:

Family Support Administration ...........

Office of Human Development Services

Office of Inspecter General ............

Health Care Financing Administration ................

Social Security Administration

TUESDAY, MARCH 12, 1991

Department of Health and Human Services:

Office of the Assistant Secretary for Health

Agency for Health Care Policy and Research ..........

Centers for Disease Control ..........

Alcohol, Drug Abuse, and Mental Health Administration

Health Resources and Services Administration

..............

National Council on Disability

THURSDAY, MARCH 14, 1991

Department of Health and Human Services:

National Institutes of Health .......

National Cancer Institute ......

National Heart, Lung, and Blood Institute ...........

National Institute of Dental Research .

National Institute of Allergy and Infectious Diseases

National Institute of Diabetes and Digestive and Kidney Diseases

National Institute of Child Health and Human Development

National Institute of Environmental Health Sciences ..

John E. Fogarty International Center for Advanced Study in the

Health Sciences ......

National Institute of Neurological and Communicative Disorders and

Stroke ............

National Institute on Deafness and Other Communication Dis-

orders ...........

National Institute of General Medical Sciences

National Eye Institute

National Institute on Aging ...

National Institute of Arthritis and Musculoskeletal and Skin Dis-

eases ....

National Center for Research Resources ..........

National Center for Nursing Research .......

National Center for Human Genome Research

National Library of Medicine .........

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(III)

DEPARTMENTS OF LABOR, HEALTH AND HUMAN SERVICES, AND EDUCATION AND RELATED AGENCIES APPROPRIATIONS FOR FISCAL YEAR 1992

TUESDAY, MARCH 5, 1991

U.S. SENATE,
SUBCOMMITTEE OF THE COMMITTEE ON APPROPRIATIONS,

Washington, DC. The subcommittee met at 2:08 p.m., in room SD-126, Dirksen Senate Office Building, Hon. Harkin (chairman) presiding.

Present: Senators Harkin, Burdick, Bumpers, Specter, Hatfield, and Gorton. DEPARTMENT OF HEALTH AND HUMAN SERVICES

OFFICE OF THE SECRETARY STATEMENT OF HON. LOUIS W. SULLIVAN, SECRETARY

BUDGET REQUEST Senator HARKIN. Good afternoon. The Subcommittee on Labor, Health and Human Services, Education, and Related Agencies will come to order.

I want to welcome Secretary Sullivan this afternoon to review with us the fiscal year 1992 budget for his Department. The 1992 total request for Department programs under the jurisdiction of this subcommittee, is $160.6 billion, of which $22.8 billion is for discretionary programs and $137.8 billion is for mandatory programs.

Again, as in the past years, we see mandatory spending increasing by 10.6 percent, well over the rate of inflation, while discretionary programs are increasing by only 0.9 of 1 percent, well below the rate of inflation. The request would permit mandatory programs to grow by $13.2 billion and discretionary programs have a net growth of only $200 million.

In addition to these requests, the Department will have an estimated $448 billion available from the permanent trust funds. This will result in total 1992 spending authority available to the Department to be an estimated $609 billion, or 41 percent of the entire Federal Government.

This afternoon's hearing will be followed by five additional hearings to examine in greater detail the requests of the various agencies in the Department of Health and Human Services. This hear

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