AIDS Prevention projects were awarded on April 30, 1987, for a total of approximately $24.4 million, of which $14.3 million went to high incidence areas. The breakdown for high incidence areas by project area is as follows: Area of High AIDS Incidence California (Includes separate award to Los Angeles and San Francisco) Colorado Connecticut Florida Georgia Louisiana Massachusetts Michigan New Jersey New York State 744,375 1,425,213 489,915 569,484 648,206 575,321 969,931 2,654,664 607,284 716,342 978,291 492,978 371,221 TOTAL FY 1987 Funds 14,330,671 High Incidence Areas Dr. DOWDLE. I might also say that the new funding for all locations in the States will actually not come out until May. The States are still operating on the previous allocations. Mr. WEISS. The U.S. Conference of Mayors, to aid communitybased groups, was funded at $250,000 in 1986. How much has been budgeted and spent on this in fiscal year 1987? Dr. WINDOM. I can't give that to you at the moment, sir. I will have to try to supply that for the record. [The information follows:] Approximately $250,000 is budgeted for FY 1987, and is expected to be awarded on June 1, 1987. Mr. WEISS. Our information is that, in fact, there has been zero spent in fiscal 1987 for the U.S. Conference of Mayors' eight community-based groups program. Dr. WINDOM. That we would have to check, sir. Mr. WEISS. All right. Dr. DOWDLE. It is budgeted, sir, for 1987 and 1988. Mr. WEISS. How much was budgeted for 1987? Dr. DOWDLE. $300,000. Mr. WEISS. Can you tell us how much of that has been spent in fiscal 1987? Dr. DOWDLE. No; I really can't speak to that; no. Mr. WEISS. You will supply that for the record. [The information follows:] Approximately $250,000 is budgeted for FY 1987, and is expected to be awarded on June 1, 1987. Mr. WEISS. And now I would like to ask about the communitybased capacity project in 37 low incidence States. How much of the budgeted $5 million was actually spent in fiscal year 1986? Does Budget have that? Do you have that breakdown? Dr. WINDOM. We don't have that breakdown, sir. Mr. WEISS. Will you give that information as well as how much has been spent so far in the first 5 months of the current fiscal year? Dr. WINDOM. Yes, sir. [The information follows:] In FY 1986, $4,580,744 was spent on Community-based capacity building projects. In FY 1987, the funds for these projects were consolidated with the funds for the Augmentation projects and the Counseling and Testing projects, and were awarded on April 30, for a total of approximately $24.4 million. Mr. WEISS. The AIDS prevention augmentation projects were funded at $5 million for fiscal year 1986. Can you tell us how much was actually spent in fiscal year 1986 and so far in 1987? Again, if you don't have that, please submit it for the record. Dr. WINDOM. We will submit that, sir. [The information follows:] In FY 1986, $6,611,095 was spent on the AIDS Augmentation projects. In FY 1987, the funds for these projects were consolidated with the funds for the Capacity building projects and the Counseling and Testing projects, and were awarded on April 30, for a total of approximately $24.4 million. Mr. WEISS. Finally, the community-based demonstration projects were funded at $4 million in fiscal year 1986. How much was actually spent in 1986 and how much was spent in 1987? Dr. WINDOM. That again will have to be submitted for the record, sir. Mr. WEISS. I am distressed that we don't have that information available since these are your major information education programs that are currently ongoing. I would think that somebody would have that information. Dr. WINDOM. We do have it. We want to give it to you exactly, sir, and we just don't have it right at our fingertips. [The information follows:] In FY 1986, $3,732,152 was spent on the AIDS Community based Demonstration projects. In FY 1987, no funds have been obligated to date. The projects are expected to be renewed no later than September 29, 1987, for an estimated $4,006,098. Mr. WEISS. All right. I am going to ask you a summary question. Excluding funds for testing for other risk reduction projects, how much was appropriated and how much was actually spent by the Federal Government in all of fiscal year 1986 for AIDS information dissemination and education? Dr. DOWDLE. For 1986? Mr. LITTLE. Excluding testing, but including the health education, risk reduction activities? Mr. WEISS. Right. Would you come closer to the microphone so that we can hear you? Mr. LITTLE. $26.9 million, excluding- Mr. WEISS. Say that again. Mr. LITTLE. Excluding the alternate test site activity that occurred in 1986, the total in 1986 was $26.9 million, including the health education and risk reduction activities in the State health departments. Mr. WEISS. For this year, Dr. Windom, you stated in your testimony that the Public Health Service will spend more than $79.5 million solely for education. Is that correct? Dr. WINDOM. Yes, sir. Mr. WEISS. Again, that is solely for education, not for the risk reduction programs or the testing programs; is that right? Dr. WINDOM. That includes risk reduction which is part of the education packet, the program is education and risk reduction and dissemination of information. That would be $79.5 million. Mr. WEISS. How much is it just for education and information? Mr. LITTLE. Approximately $15 million, sir. Mr. WEISS. Approximately? Mr. LITTLE. $15 million. Mr. WEISS. Do you have any idea how much has actually been spent so far within the first 6 months of fiscal year 1987? Mr. LITTLE. Sir, since the appropriation was only enacted in November and many of these programs are new, the $80 million total for 1987 compares to approximately $30 million in 1986. The RFP's we discussed earlier have not all been finalized, and much of the money has not been awarded. I would estimate that the awards to date would be very small, but that is due in large part to the fact that we had such a large increase in 1987 compared to 1986. I can give you the exact numbers for the record. Mr. WEISS. I would appreciate that. [The information follows:] Acquired Immune Deficiency Syndrome Information Dissemination/Public Affairs [Total 1987 obligations as of Mar. 31, 1987] Mr. WEISS. For fiscal year 1988, which as you all know, begins October 1 of this year, and again, exclusive of moneys for testing and other prevention activities, how much has been requested by the Department just on information education? Dr. WINDOM. $15,900,000. Mr. WEISS. That will include the total major media campaign that you just issued the request for proposal on; is that correct? Dr. WINDOM. Yes, sir. Mr. WEISS. Dr. Dowdle, last summer you said, and I quote, and I hope accurately, "It's very clear we haven't done everything in the education field that we would like to do and should be doing" and "The money is not here for a large educational program right now." As the Federal leader on AIDS, can you tell us what is needed by way of dollars? What should we be looking for, for an education program that in fact would do the job? Dr. DOWDLE. I don't know that I could give an exact figure, sir. Quite frankly, there are a number of different opinions and a number of different ideas. I'm sure a number of different experts have different ideas on how the information education program ought to be run at a national level. One of the reasons for getting the ad agency involved is to get experts together with other consultants to determine the most effective way that we can run this campaign, what is the most effective way not only to get information out-which, by the way, is considerable at the moment-but to have it out in such a way that we can effectively change behavior. Mr. WEISS. Late last year, you contracted to have a management consultant firm, Coopers & Lybrand, review CDC's organization and management of AIDS activities. Why was that undertaken at that time? Dr. DOWDLE. Why, sir? Mr. WEISS. Yes. Dr. DOWDLE. Because the feeling was that CDC's earlier role had been in epidemiology and in laboratory research, leading to prevention, but that now, we were going to be involved in a much different and much more extensive way in information and education programs. In short, this was a different mode than what CDC had been involved in up to now. That was the reason for the review. Mr. WEISS. I have the memorandum concerning their findings and recommendations. I will ask you to tell us what the findings were rather than my quoting them. Dr. DOWDLE. Well, basically, they recommended that there be a central office for AIDS within CDC, under a Deputy Director of CDC, and that that office should have line responsibility. I was appointed to that particular job. Second, they pointed out that there should be consolidation of CDC contracts with the States. That con solidation is well underway. They were talking about consolidating three grants, and consolidation of at least two of the three grants is in process. They also referred to different ways in which the organization within CDC should lead to enhanced communication. That too is now in effect through the organizational arrangement that we now have. One of the other points was to emphasize the need for CDC to go out into further types of information education responsibilities. Mr. WEISS. The findings that we have indicate the following: First, that AIDS has placed a severe strain on CDC, and second, that major changes should be given serious consideration. Dr. DOWDLE. Yes. Mr. WEISS. Major State and local discontent with CDC regarding grant programs and management exists. Dr. DOWDLE. That's correct. Mr. WEISS. Third, that the traditional CDC response to crisis has apparently not worked well and places great strains on the agency personnel. They say that the single greatest scarcity is personnel. The number of people allocated to CDC to perform the new duties expected of it clearly does not allow the agency to fulfill its new responsibilities. Dr. DOWDLE. That's correct. Mr. WEISS. Finally, AIDS has consumed considerably more time, not only of people assigned to AIDS, but of others; right? Then they made a number of recommendations based on that. One was to request needed personnel; two, to contract out some activities; three, to simplify grant and cooperative agreement processes and miscellaneous others. Dr. Dowdle, last December 1, you expressed again the need to mobilize the non-Federal sector into the AIDS information effort. Before I get into that, what has been done to follow up on the findings and recommendations besides, I guess, your work and your coordinating role which is an important step? Beyond that what has been done to get additional personnel and so on? Dr. DOWDLE. Well, as I've indicated, all of the recommendations with one exception-that we look at other ways of contracting out in-house activities have been implemented. The one reason why we have not gone further in contracting out is because we think we have explored this quite thoroughly. All of the recommendations of the Coopers & Lybrand group essentially are in place. Mr. WEISS. Have you requested additional personnel? Mr. WEISS. Yes. Dr. DOWDLE. Yes. We are getting additional personnel for the Office of the Deputy Director; yes. Mr. WEISS. Is that the only area where the consultants thought you needed personnel? Dr. DOWDLE. No. There are other areas, too, in which additional FTE's were thought to be needed. Mr. WEISS. Have you made the request for those? Dr. DOWDLE. Yes, sir; we have. |