S. HRG. 102–226, PT. 2 DEPARTMENTS OF LABOR, HEALTH AND HUMAN SERVICES, AND EDUCATION, AND RELATED J HEARINGS AG 102nd pt. 2 UNITED STATES SENATE FIRST SESSION ON H.R. 2707/H.R. 3839 Part 2 (Pages 1-1184) 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 ISBN 0-16-037043-4 COMMITTEE ON APPROPRIATIONS ROBERT C. BYRD, West Virginia, Chairmon MARK O. HATFIELD, Oregon JAKE GARN, Utah ROBERT W. KASTEN, JR., Wisconsin 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 SLADE GORTON, Washington JAMES H. ENGLISH, Staff Director MARY S. DEWALD, Chief Clerk SUBCOMMITTEE ON DEPARTMENTS OF LABOR, HEALTH AND HUMAN SERVICES, AND EDUCATION, AND RELATED AGENCIES TOM HARKIN, Iowa, Chairman ARLEN SPECTER, Pennsylvania WARREN RUDMAN, New Hampshire THAD COCHRAN, Mississippi HARRY REID, Nevada PHIL GRAMM, Texas BROCK ADAMS, Washington SLADE GORTON, Washington Majority Professional Staff STEWART Administrative Support (II) CONTENTS Department of Health and Human Services: Office of the Secretary .......... 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 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 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 National Institute of Neurological and Communicative Disorders and National Institute on Deafness and Other Communication Dis- National Institute of General Medical Sciences National Institute on Aging ... National Institute of Arthritis and Musculoskeletal and Skin Dis- National Center for Research Resources .......... National Center for Nursing Research ....... ............ (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, 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 |