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grantees will still have that base amount in addition to the $100 million.

Senator HARKIN. Well, let me read from the committee report. It says here, and this is both House and Senate, “The committee intends that the funds made available under section 640(a)(3) shall be used to supplement and not supplant grants made with funds under section 640(a)(5). The committee expects the Department to continue to provide cost-of-living increases and that the funds under this section”, which is the quality reserve section, “will not replace such increases." In other words, quality funds may not be used for cost of living.

Are you saying that you want to ignore the report? Ms. GALL. Senator, we have taken a look at the language of the act, and we feel that we are meeting in both 1991 and 1992 the language of the act. We will negotiate with each grantee to ensure the maintenance of a quality program.

In addition to that, as I have said, we are asking the inspector general to work with us to determine what needs the grantees might have to address quality improvements and management. As we take a look at that information plus the monitoring reviews, that will give us a better picture of where we need to go.

Senator HARKIN. I cannot speak for the other body, but I believe that this subcommittee is not going to look too kindly upon using the quality reserve moneys for cost of living when we specifically wrote that in the report and intended that they not be used that way.

We believe that that program decisions should coincide with the intent of the law as the law was written. So we will have some further discussions on that. I just wanted to let you know that we are not going to look very kindly on that.

Again, it all comes down to just where we are going on Head Start. Is this just all rhetoric, or are we really going to put something into it? Are we going to talk about it and then start shuffling these moneys around, or are we going to try to meet the goal in 1994, your own stated goal?

I have a different goal, and that is to fully fund Head Start, not just for 4 year olds but for all eligible kids from 3 to 5.

Ms. GALL. Senator, we believe that we are doing a very good job in reaching as many children as possible, and we believe that sound management requires us to take a look at the program this year and to see where we are going and how best to get there. We think that a $100 million increase will do just that for us. It will continue our expansion. It will also help us to take a sound look at where things stand with our grantees and then where to go from there.

Senator HARKIN. Let me make it clear. I am not saying that you are not doing a good job out there. I am not saying that.

Ms. GALL. That is good.
Senator HARKIN. I am not saying that.
Ms. Gall. I understand.

Senator HARKIN. What I am saying is, here we are, here is where we want to go, and I am not certain—no, I will go beyond thatI know that this budget request from the administration is not going to get us there. It is just not. I do not want you to be playing funny games here and not trying to comply with the law as clearly written or the intent of Congress as made clear in the report.

Ms. GALL. Senator, we do not want fun and games, either. That does not serve our children or our families.

Senator HARKIN. That is right. Again, $100 million? Is that really so? How much of that is going to serve new kids? You say about $90 million. I am not certain that $90 million is going to be eligible if you meet the clear intent of the law. I do not think $90 million will be available. It looks to me somewhere around maybe $60, $70 million, if that much, will be available. That pushes that 1994 back even further even for 4 year olds.

Ms. GALL. You know, our concern is quality and the ability to manage the program and to do right by those children and those families and the taxpayers who are paying for the program.

Senator HARKIN. Well, then, request more than $100 million.

Ms. GALL. We want to make sure we can use it and use it well and manage the program well. That is our concern for this year.

As you know, the administration has a strong record of asking for significant increases in the Head Start Program. Again, the reason we did this this year is so that we could take a good look at where we are and where we need to go in terms of training and the other issues we have to address to maintain the level of services.

We would be happy to share with you additional materials as we get the inspector general report and other materials that we have when we take a look at where we are with our grantees. We would be happy to share that information with you.

If I might add, Senator, we do not always hear about some of the difficulties that our Head Start grantees are dealing with. When I was in New York the other day, I found out that a significant number of children are coming into our program with tuberculosis. There are some other special health concerns in the New York City area that we are addressing. There are some innovative approaches that we are taking in New York. In particular, we are setting up a Head Start Program and a residential drug treatment program for women and their young children.

So we are making progress in terms of developing creative approaches to the Head Start Program, but at the same time we are trying to identify those particular issues that we need to address. Some of our Head Start programs in New York City have as many as 21 nationalities of new immigrants coming into the United States that present some particular challenges to those Head Start grantees.

We just want to make sure that we do not lose the tremendous momentum that we have at the State and Federal level for the Head Start Program by running into lots of management or other snags. So we want to take this breathing period to address those kinds of issues and get them under control.

Senator HARKIN. One of the stated health objective goals for 1980 was to eradicate tuberculosis. It is actually on the increase. We covered that the other day with Dr. Sullivan.

Let me talk just a little bit about block grant proposals, and then we will move on. I was looking at the authorization for the block grants. The 1992 budget identifies $21 billion in grants from five

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major policy areas for possible turnover to State and local governments as part of a single block grant. The social services block grant is one of the programs identified for consolidation.

OK, let us go back in time. Beginning in 1982 the social services block grant was formed by replacing grants for certain things. Social services, child care, and training were all put into the social services block grant. I remember that debate very well. The argument was used that consolidating would give the States more flexibility in administering these programs. What actually happened was that we gave the States fewer dollars.

If we had kept up just with the rate of inflation for all those programs in 1982 that were consolidated, the program would need $4.587 billion next year just for the rate of inflation. It is authorized at $2.8 billion. That is the administration's number.

So really, what we have done is take all those programs together and actually fund them at one-half the rate of what we did in 1981, in real dollars, constant dollars using the GNP deflator.

So I am wondering if we are going down that same path again, putting the social services block grants into a new block grant with housing, community development, education, environment, everything, throw it all together, and it is just like 1982 all over again. We will put it out there and then cut the funds to the States. You know what the States are facing out there with budget shortfalls.

So that is why we are concerned about this and about the impact. I just wondered if you have any thoughts on that.

Ms. GALL. A couple of thoughts. First of all, we are funding SSBG, the social services block grant, at the full authorization level.

Second, I admit that my views are somewhat parochial because I deal primarily with the issues in HDS, although we do coordinate with other departments and agencies. I will tell you, one of my greatest frustrations in particular in dealing with the child welfare issues and the high numbers of children we see coming into foster care as a result of alcohol, crack, cocaine, and a number of other related challenges is the difficulty that local jurisdictions have in coordination of services, integration of services, blended funding streams, and so on.

In many communities, Senator, it is disastrous. The children in the families are not being served well. One of my greatest frustrations is getting the courts and the judges and the case workers and the doctors and the child protective service workers and the housing people, the welfare people, the FDC, so on and so forth, to work together to serve our children and families. It is not happening the way it should be.

If we can address some of those issues by blending funding streams, by making it easier for local jurisdictions to blend their pots of money to address those issues, in my parochial view, would help us serve children and families much better. If this system is going to work, then I am all for it.

Senator HARKIN. That is all right as long as the funding continues, but if you just put it out there and say work together and then we are going to cut all the funding, I do not think that does much good, either.

Mr. WILLIAMS. Mr. Chairman, you will remember that when this proposal was presented to the Governors early in February, they reacted extremely favorably to this idea. I think our interest is very much in exploring further this whole idea.

Ms. GALL. One of the greatest frustrations folks in the child welfare services community have is that we have lots of pots of money. We have abandoned infants here, we have our youth gang/drug treatment pots of money over here. We have all kinds of pots of money, and they spend one-half their time filling out forms.

Senator HARKIN. The things you just mentioned are not really part of the proposal to be consolidated.

Ms. GALL. We are talking about SSBG and a number of other types of funding, and anything we can pool to help address those concerns we would support.

If I may put a plug in, I think those are the kinds of things we need to be thinking about with other programs as well.

Senator HARKIN. There is one last one that I want to cover, shifting from kids to the elderly. There is a bill pending that I hope will get through all right. It is the Older Americans Health Promotion and Disease Prevention Act, one of a package of bills I introduced focusing on prevention.

It expands part F of the Older Americans Act to establish a State grants program that would provide disease prevention and health promotion services and information at senior citizen centers, congregate meal sites and things like that, home meals, Meals on Wheels. Again, it is prevention and health promotion.

The administration has never requested funding for part F of the Older Americans Act, which is health prevention for older Americans. Do you feel that these services are important? Do you feel that you might be requesting some money for expansion of part F? That is, prevention and health promotion.

Ms. GALL. As you know, Mr. Chairman, health promotion and disease prevention is one of Dr. Sullivan's prime goals in addressing all our age groups. We very much support dealing with our aging population.

Those kinds of activities can be carried out under our existing authorities and, in fact, many of our area agencies do, in fact, do those kinds of activities under existing authority. This, coupled with some of the elder care components that our Commissioner of the Administration on Aging has undertaken we feel will address those issues along with nutrition.

Senator HARKIN. I have been at I do not know how many congregate meal sites. I have worked days on home delivered meals and Meals on Wheels. I have been to senior citizen centers all over Iowa. With one exception, which was not a senior citizen center but a day-care center for the elderly, I never saw any kind of prevention or health promotion activities at all. None.

Ms. GALL. I will be sure to pass that along to the Commissioner. First of all, she will be delighted that you visited all those

Senator HARKIN. I did not visit them all. I visited most of them.

Ms. GALL. I will pass that information along to her so she can take a look at that.

Senator HARKIN. There needs to be an active outreach program of prevention. Now there may be instances and isolated cases in

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some cities where I have not been where they do take blood pressure tests, where they do cholesterol checks and things like that, but there is no coordinated, concerted effort throughout the whole program to do that. There may be, as I say, individuals in certain communities that understand the benefit of that and do that on their own.

Ms. GALL. That is a very popular activity with most of our areas offices on aging, I should tell you. That is something that we see routinely in our programs, but I will be happy to pass that along specifically to the Commissioner.

Senator HARKIN. I want to pass on to you that we need some funding for expansion of part F to expand those services.

I have some questions from Senator Adams, but we will just put those in the record.

That is all I have. Thank you very much.
Ms. GALL. Thank you, sir.

Senator HARKIN. As you can see, we have an intense interest in the Head Start Program. We will be pursuing that with you as the months go by, and you will get those figures to us?

Ms. GALL. Yes; we would be happy to work with you on that, and we appreciate your interest very much. Thank you.

QUESTIONS SUBMITTED BY THE SUBCOMMITTEE Senator HARKIN. Thank you very much.

There will be some additional questions which will be submitted for your response in the record.

[The following questions were not asked at the hearing, but were submitted to the Department for response subsequent to the hearing:]

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