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I ask you the question, how does it square?

Dr. HARMON. Well, the 1992 budget proposal seeks to target resources in the highest incidence areas of infant mortality, and use some of those, many of those interventions you are mentioning, but to target them.

Regarding the health professions budget, it is targeted toward minority health professions, $88 million for professionals who are more likely to serve in the highest need areas. Also, the National Health Service Corps increase will help to locate health professionals in some of these areas of greatest need, as will the health professions student loan approach, which is proposed.

On the health professions, there are considerable funds that go into that kind of support from HCFA, through the Medicare direct and indirect funding of graduate medical education, nursing, and allied health education. And also, there is a role for State and local government and the private sector in the health professions, and also in targeting infant mortality, which are all parts of our healthy start proposal.

Senator HARKIN. Does the budget proposal before us reflect your original budget request?

Dr. HARMON. I am sorry. I did not catch that.

Senator HARKIN. Does the budget proposal before us reflect your original budget request?

Dr. HARMON. No; I would be happy to submit for the record what our request was, Senator.

Senator HARKIN. I would appreciate that. Thank you.

[CLERK'S NOTE.-Answer to the question can be found in questions submitted by the subcommittee.]

RYAN WHITE AIDS CARE ACT

Senator HARKIN. Dr. Harmon, would you please give the committee an update on the Ryan White AIDS Care Act. Which additional cities are eligible for title I emergency assistance today? Which cities are predicted to be eligible by October 1? Are additional cities likely to become eligible during 1992? And last, what is the status of the title II funds? Have States gotten those funds yet? How much money was put in there, $87 million?

Dr. HARMON. Senator, I am pleased to say that the project is on schedule. We have been working very hard with very tight deadlines. Dr. Stephen Bowen, who is the new Bureau Director, has come to us from the CDC, and is working very closely with that agency. I would like him to list some of the progress to date. Steve. Dr. BOWEN. Senator, to date the formula grant money under title I has been awarded to all of the 16 eligible metropolitan areas; 14 of the awards were made on January 29, which was 6 days ahead of the statutory mandate, and the two remaining grants were made on March 1; their award dates were delayed at the request of the cities, because parts of their application were not completed.

During the last 2 days we have been meeting with an outside panel to review the requests for the additional resources under the competitive part of title I, and we anticipate making those awards on or before April 4. In regard to title II, $17 million has already been awarded to the States to continue their drug reimbursement programs, if they requested to continue that activity. That is an op

tional activity this year, but we felt it was important to make those funds available, to be sure patients were not cut off their treatment programs, if the States needed those funds.

The rest of the funds that will be awarded by State formula grant, which is a total of $60 million more to be awarded above the $17 million that has already been awarded, for a total of $77 million, will be made on or before April 1. States will be getting those resources under title II at that time.

If you repeat the other questions, I will attempt to address those. I believe they had to do with additional cities becoming eligible. Senator HARKIN. Right. Which cities are projected to be eligible by October 1?

Dr. BOWER. Right now, two cities have passed the 2,000 case mark_ according to statistics compiled and summarized by the Centers for Disease Control. Oakland, CA, and Baltimore, MD, have both passed the 2,000 case mark. They will be eligible?

We can submit for the record what cities are anticipated to possibly become eligible by that subsequent date that you mentioned. Right now, the next closest area is Nassau Suffolk, NY, at about 1,730 cases, approximately.

[The information follows:]

HIV/AIDS EMERGENCY RELIEF GRANTS-TITLE XXVI, PART A
[Ryan White Care Act, Title I]

Area

Formula grant

Cases as of Feb. 28, 1991

Fiscal year 1991-Statutory eligibility for formula grants under section 2601 as

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Fiscal year 1992-Statutory eligibility for formula grants under section 2601 as of March 31, 1991 (currently eligible):

Oakland, CA

Baltimore, MD

based on current data (the statutory deadline is March 31, 1992):

Nassau-Suffolk, NY

Seattle, WA

Tampa-St. Petersburg, FL

New Orleans, LA

2,078

2,013

Fiscal year 1993-Potential eligibility for formula grants under section 2601

West Palm Beach, FL

1,723

1,697

1,650

1,496

1,488

1,465

Detroit, MI

'Bigibility for formula grants under section 2601 is interpreted to mean that, "as of June 30, 1990, in the case of grants for fiscal year 1991, and as of March 31 of the most recent fiscal year *** for any subsequent fiscal year" there is "a cumulative total of more than 2,000 cases" or "the per capita incidence of cumulative cases is not less than 0.0025."

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Senator HARKIN. Was Philadelphia in the first 16?

Dr. BOWEN. Yes; Philadelphia has already received its formula funds under title I and will be eligible for supplemental funds. They were among the first 16.

Senator SPECTER. I had just commented to the chairman, just hearing you mention two cities, I said to Senator Harkin, neither was in Iowa or Pennsylvania.

Dr. BOWEN. Of the two new cities.

Senator SPECTER. But I understand now that that has other aspects, so I thank you.

Senator HARKIN. I rather doubt that any cities in Iowa will ever get in that group. I just do not think so, fortunately. Oh, additional cities likely to become eligible during 1992. You mentioned one

more.

Dr. BOWEN. Baltimore and Oakland are already past the 2,000 case mark.

Senator HARKIN. Yes; but next year. I am looking ahead.

Dr. BOWEN. There could be more in the future, as I mentioned; the next highest area, Nassau-Suffolk, NY, has more than 1,700 cases. Depending on the rate at which cases are reported, there could be four or five additional metropolitan areas which becomes eligible during the next year.

Senator HARKIN. Four or five additional.

Dr. BOWEN. Four or five additional. Whether they will have that number of cases reported by any particular date depends on a number of different factors, among which are how actively and aggressively the cities look once they get close to the 2,000 mark.

Senator SPECTER. We had such a difficult time last year on the Senate floor in trying to find adequate funding. One of the very toughest issues and most compelling, given all the background circumstances, and I am sure we are going to face even tougher problems this year.

Senator HARKIN. That is why I wanted to get some idea of how many we are looking at coming down the pike.

Dr. Harmon, that is really all I have today. I will be continuing these discussions with you on the status of the

NATIONAL HEALTH SERVICE CORPS

Senator BUMPERS. You do not mind if I ask a couple of questions, do you?

Senator HARKIN. Senator Bumpers.

Senator BUMPERS. Dr. Harmon, let me ask you a couple of questions about the National Health Service Corps. First of all, I have been just elated about President Bush's attitude about that program. Ronald Reagan practically killed the Corps.

I have a number of concerns about administration of the Corps. Can you tell me right now, how many scholarships you awarded in the fall of 1990?

Dr. HARMON. Dr. Gaston, the Director of that bureau, can respond, Senator.

Senator BUMPERS. Dr. Gaston.

Dr. GASTON. Senator, in 1990 we were only able to award 71 scholarships nationwide.

Senator BUMPERS. Only 71?

Dr. GASTON. Yes; 71.

Senator BUMPERS. Was that with your 1991 money that you awarded those?

Dr. GASTON. Fiscal year 1990.

Senator BUMPERS. That was with 1990 funds?

Dr. GASTON. That was right, 1990 funds.

Senator BUMPERS. OK, so you will use your 1991 funds this fall? Dr. GASTON. That is right. And we will be able to award over 400 scholarships this year, because of the increase in funding. It is important to note, though, that even though that is great, and in 1992 we will be able to add 500 more, they will not be available for service for 6 or 7 years. But this will really increase the pipeline.

Senator BUMPERS. Yes; I understand that. One of my concerns is this. Can you tell me, are there any schools that predominate among those 71 scholars? Are they pretty well scattered across the country? I know none of them are from Arkansas. I know no Corps scholars went to the University of Arkansas Medical School last fall, but can you tell me where they did go?

Dr. HARMON. Senator, they tend to be the more expensive, private schools, although some have a large percentage of minority students.

Senator BUMPERS. What do you mean, some?

Dr. HARMON. Meharry, for example, and Howard University. Senator BUMPERS. How many went to Meharry, and how many went to Howard?

Dr. HARMON. Well, if we look at the total history of the National Health Service Corps, Meharry had the most scholarships at 426, and Howard was fourth at 287.

Senator BUMPERS. Since the program began?

Dr. HARMON. That is correct, and I think the denominator is about 13,000. Now there were recipients from most medical schools. Dr. Gaston has some additional information.

Dr. GASTON. I do not have those in terms of all the schools, at this point.

Dr. HARMON. We can submit that for the record, Senator. We would be glad to do it.

[The information follows:]

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