DEPARTMENTS OF LABOR, HEALTH AND HUMAN HEARINGS BEFORE A SUBCOMMITTEE OF THE COMMITTEE ON APPROPRIATIONS HOUSE OF REPRESENTATIVES ONE HUNDRED FIRST CONGRESS SECOND SESSION SUBCOMMITTEE ON THE DEPARTMENTS OF LABOR, HEALTH AND MICHAEL A. STEPHENS, ROBERT L. KNISELY, SUSAN E. QUANTIUS, Alcohol, Drug Abuse, and Mental Health Administration 811 1 29-530 Printed for the use of the Committee on Appropriations U.S. GOVERNMENT PRINTING OFFICE For sale by the Superintendent of Documents, Congressional Sales Office COMMITTEE ON APPROPRIATIONS JAMIE L. WHITTEN, Mississippi, Chairman WILLIAM H. NATCHER, Kentucky SIDNEY R. YATES, Illinois EDWARD R. ROYBAL, California TOM BEVILL, Alabama BILL ALEXANDER, Arkansas JOHN P. MURTHA, Pennsylvania JOSEPH D. EARLY, Massachusetts LINDY (MRS. HALE) BOGGS, Louisiana W. G. (BILL) HEFNER, North Carolina LES AUCOIN, Oregon DANIEL K. AKAKA, Hawaii WILLIAM H. GRAY III, Pennsylvania STENY H. HOYER, Maryland BOB CARR, Michigan ROBERT J. MRAZEK, New York RICHARD J. DURBIN, Illinois RONALD D. COLEMAN, Texas ALAN B. MOLLOHAN, West Virginia LINDSAY THOMAS, Georgia CHESTER G. ATKINS, Massachusetts JIM CHAPMAN, Texas SILVIO O. CONTE, Massachusetts JIM KOLBE, Arizona DEAN A. GALLO, New Jersey FREDERICK G. MOHRMAN, Clerk and Staff Director DEPARTMENTS OF LABOR, HEALTH AND HUMAN SERVICES, EDUCATION, AND RELATED AGENCIES APPROPRIATIONS FOR 1991 THURSDAY, MARCH 8, 1990. OFFICE OF THE ASSISTANT SECRETARY FOR HEALTH WITNESSES JAMES O. MASON, M.D., DR. P.H., ASSISTANT SECRETARY FOR HEALTH J. MICHAEL MCGINNIS, M.D., DEPUTY ASSISTANT SECRETARY FOR NABERS CABANISS, DEPUTY ASSISTANT SECRETARY FOR POPULATION AFFAIRS WILLIAM A. ROBINSON, M.D., M.P.H., DIRECTOR, OFFICE OF MINORITY HEALTH KENNETH J. BART, M.D., M.P.H., DEPUTY DIRECTOR, NATIONAL VACCINE PROGRAM WILMER D. MIZELL, EXECUTIVE DIRECTOR, PRESIDENT'S COUNCIL ON PHYSICAL FITNESS AND SPORTS WILFORD J. FORBUSH, DEPUTY ASSISTANT SECRETARY OF HEALTH OP- W. HARELL LITTLE, DIRECTOR, DIVISION OF PHS BUDGET Mr. NATCHER. We take up now the Office of the Assistant Secretary for Health. We have before the Committee Dr. James O. Mason. Dr. Mason, before you give us your statement, tell us who you have with you there at the table. INTRODUCTION OF WITNESSES Dr. MASON. Mr. Chairman, I would be delighted to do that. Thank you for your welcome. Starting on my far left is Nabers Cabaniss the Deputy Assistant Secretary for Population Affairs. Next to her is Dr. Jarrett Clinton, Acting Administrator for the Agency for Health Care Policy and Research. Next to him is Mr. W. Harell Little, Director of the Division of PHS Budget. On my right side is Wilford Forbush, Deputy Assistant Secretary for Health Operations and Director, Office of Management. Next to him is Dr. William A. Robinson, Director of the Office of Minority Health. On my far right is Dennis P. Williams, Deputy Assistant Secretary for Budget. I would also like to introduce some of the big-leaguers who are here since we have been talking about baseball. Sitting behind me is Wilmer D. Mizell, Executive Director, President's Council on Physical Fitness and Sports, a former Assistant Secretary in the Department of Agriculture, and as you know, a real pitcher. Also behind me is Art Lawrence, who is with the National AIDS Program Office and Dr. J. Michael McGinnis, Deputy Assistant Secretary for Health who is responsible for disease prevention and health promotion activities. Mr. NATCHER. Thank you very much, Dr. Mason. It is a pleasure to have you before the committee again. You have appeared on many occasions. Dr. Mason, I had the pleasure to say to your successor the other day that if he was just half as good as you were he would be all right. Dr. MASON. That was kind of you. I want you to know that he is excellent. Mr. NATCHER. I hope he is down at the Center for Disease Control. We will be following events down there to see if he is half as good as you were. We will be pleased to hear from you at this time. OPENING STATEMENT Dr. MASON. Thank you. I would like to read my opening statement and insert for the record the separate statements of the Office of Assistant Secretary for Health and the Agency for Health Care Policy and Research. Mr. Chairman and members of the committee, we are pleased to be here today to present the 1991 budget request for the Office of Assistant Secretary for Health and the Agency for Health Care Policy and Research. The Office for the Assistant Secretary for Health is requesting an appropriation of $206 million, which is a net increase of $13.6 million over the fiscal year 1990 level. The increase includes $11.6 million for the Office of Minority Health and is reflective of our efforts to improve the health status of minorities. Since the establishment of the Office in 1985, some improvements in minority health status have been achieved. However, despite numerous efforts, there continue to be large disparities. In almost every category of mortality, death rates for minorities continue to be uniformly higher than for whites. Life expectancy for Black American males is actually declining, and is now six years shorter than life expectancy for white males. The budget request presented to you today includes $9.4 million to support the Adolescent Family Life Program's demonstration and research program. This is the only federal program solely focused on the complex issues and problems of early adolescent sexuality, pregnancy and parenting. In fiscal year 1991, $139.1 million is requested to support the administration's proposal for a State-administered family planning program authorized under Title X of the Public Health Service Act. This is the same level of support as that provided in fiscal year 1990 for the family planning discretionary grant program. Under the inistration's proposal, all Title X funds would be awarded States and territories. तः |