16 1 retary") shall, in accordance with section 101 (7) of the 2 Act (defining the term "developmental disability"), deter3 mine the neurological conditions of individuals which should 4 be included as developmental disabilities for purposes of the 5 programs authorized by parts B and C of the Act. Within 6 six months of the date of enactment of this Act the Secretary 7 shall make such determination and shall make a report 8 thereon to the Congress specifying the neurological condi9 tions which he determined should be so included, the neuro10 logical conditions which he determined should not be so in11 cluded, and the reasons for each such determination. After 12 making such report, the Secretary shall periodically, but not 13 less often than annually, review the neurological conditions not so included as developmental disabilities to determine if 15 they should be so included. The Secretary shall report to the 16 Congress the results of each such review. 14 17 18 20 (b) (1) The Secretary shall contract for the conduct of an independent objective study to determine (A) if the basis 19 of the definition of the developmental disabilities with respect to which assistance is authorized under such parts B and C is 21 appropriate and, to the extent that it is not, to determine an 22 appropriate basis for determining which disabilities should 23 be included and which disabilities should be excluded from 24 the definition, and (B) the nature and adequacy of services 17 1 provided under other Federal programs for persons with dis2 abilities not included in such definition. 3 (2) A final report giving the results of the study re4 quired by paragraph (1) and providing specifications for 5 the definition of developmental disabilities for purposes of 6 such parts B and C shall be submitted by the organization 7 conducting the study to the Committee on Interstate and 8 Foreign Commerce of the House of Representatives and the 9 Committee on Labor and Public Welfare of the Senate not 10 later than eighteen months after the date of enactment of the first Act making an appropriation for such study. 11 IDENTICAL AND SIMILAR BILLS TO BE CONSIDERED BY THE SUBCOMMITTEE H.R. 667, introduced by Mr. Murphy of New York on January 14, 1975; H.R. 946, introduced by Mr. Roe on January 14, 1975; H.R. 1023, introduced by Mr. Shriver on January 14, 1975; H.R. 1208, introduced by Mr. Young of Florida on January 14, 1975; H.R. 2303, introduced by Mrs. Burke of California on January 29, 1975; H.R. 2472, introduced by Mr. Roe (for himself, Mr. Anderson of California, Mr. H.R. 2691, introduced by Mr. Lehman on February 4, 1975; and H.R. 3485 introduced by Mr. Roe (for himself, Ms. Abzug, Mr. Boland, Mr. Brown of Michigan, Mr. Cleveland, Mr. Edgar, Mr. Ford of Tennessee, Mr. Gaydos, Mr. Giaimo, Ms. Holtzman, Mr. Madigan, Mr. Mazzoli, Mr. Minish, Mr. Mitchell of Maryland, Mr. Mollohan, Mr. Patten, Mr. Rodino, Mr. Roybal, Mr. Sarbanes, Mr. Stark, Mr. Stokes, Mr. Tsongas, Mr. Waxman, Mr. Whitehurst, and Mr. Winn) on February 20, 1975. Mr. ROGERS. As our witness here today we are very pleased to have the Honorable Caspar Weinberger, the Secretary of Health, Education, and Welfare who has brought with him a number of his colleagues from the Department. Mr. Secretary, it is a pleasure to have you with us today and you may want to introduce your colleagues or anyone else that you have with you. I think you have met most of the members of the subcommittee here. Others will be coming along, so we are delighted to welcome you to the subcommittee. We are pleased to have you with us and would be pleased to receive your statement. STATEMENT OF HON. CASPAR W. WEINBERGER, SECRETARY, DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE, ACCOMPANIED BY THEODORE COOPER, M.D., ACTING ASSISTANT SECRETARY FOR HEALTH; STANLEY THOMAS, JR., ASSISTANT SECRETARY FOR HUMAN DEVELOPMENT; STEPHEN KURZMAN, ASSISTANT SECRETARY FOR LEGISLATION; AND LOUIS M. HELLMAN, M.D., DEPUTY ASSISTANT SECRETARY FOR POPULATION AFFAIRS, OFFICE OF ASSISTANT SECRETARY FOR HEALTH Secretary WEINBERGER. Thank you very much, Mr. Chairman. Mr. Chairman, members of the committee, this is a great honor and pleasure for us and we are delighted to be here. This is the first time we have had an opportunity to present testimony this year but we have, as you know, had an opportunity to have a short briefing session a few days ago and we are delighted to be back. I am accompanied by Dr. Theodore Cooper, Acting Assistant Secretary for Health; Stephen Kurzman, Assistant Secretary for Legislation, and Stanley Thomas, Assistant Secretary for Human Development. Mr. ROGERS. We welcome you gentlemen to the committee. Secretary WEINBERGER. We thought these people would be able to answer your questions. I have a comparatively lengthy statement, Mr. Chairman, and it will cover in detail the reasons why the administration opposes the bill as passed last year and which is presently before the committee. I will also discuss some of the possibilities that we hope to develop with regard to the developmental disabilities bill which I will take up at the conclusion of this statement. Mr. ROGERS. Certainly. Secretary WEINBERGER. With your permission I will proceed and if at any time you have any questions, please feel free to interrupt me. Mr. ROGERS. Thank you. Secretary WEINBERGER. The "Health Revenue Sharing and Health Services Act of 1975," as H.R. 2954 is called, would continue and expand the state formula grant program under section 314 (d) of the Public Health Service Act. It also provides for the revision and expansion of the community mental health program, the community health centers program, the migrant health program, and the family planning program. It would also establish a National Commission for the Prevention and Control of Rape in the National Institute of Mental Health and create six new categorical activities, a commission for the control of epilepsy, another commission for the control of Huntington's Disease, a program for research and control of hemophilia, a program to develop and expand blood separation centers, a program of demonstration projects for home health services, and a commission to study mental health and illness of the elderly. H.R. 2954, as you said, Mr. Chairman, is identical to H.R. 14214, which was passed by the 93d Congress, but disapproved by the President on December 21, 1974. GENERAL COMMENTS Current economic and fiscal crises have necessitated that the President submit a revised 1975 budget request and a restrictive budget request for categorical and controllable health programs for fiscal year 1976, especially since even with the cost savings proposed, Federal expenditures for medicaid and medicare will be an estimated $22 billion in fiscal year 1976 as compared to $20.4 billion in fiscal year 1975, an increase of $1.6 billion. Some may have asked why it is we always appear to be reducing certain programs. The answer, Mr. Chairman, is that among other things, our budget is 95 percent uncontrollable so when fiscal restraint is necessary, as it is this year, we have to look to the controllable programs. We note that the President's memorandum disapproving Ĥ.R. 14214 stated "H.R. 14214 conflicts with my strong commitment to the American taxpayers to hold Federal spending to essential purposes. The bill authorizes appropriations of more than $1 billion over my recommendations and I cannot, in good conscience, approve it. These appropriation authorizations are almost double the funding levels I have recommended for fiscal year 1975 and almost triple the levels I believe would be appropriated for 1976." The President summed up his reasons for disapproval by stating that: "Although the purposes of many of the programs authorized in this bill are certainly worthy, I just cannot approve this legislation because of its effect upon the economy through increased unwarranted Federal spending." I might add, Mr. Chairman, that increased Federal spending contributes to inflation which hurts the people our Department serves more than any other group. Therefore, we feel a great responsibility for trying to control inflation as does the rest of the administration. The authorizations in H.R. 2954 exceed the President's requested budget authority for 1975 by approximately $500 million and for 1976 by approximately $700 million. Mr. ROGERS. May I just ask you to give us the figure at this time. as to how these authorizations compare with the actual appropriations? Secretary WEINBERGER. The actual appropriation-well, there wasn't any appropriation, Mr. Chairman. There was never an agreement on the authorization bill, so we are operating under a continuing resolution. The continuing resolution for 1974 is $621 million. The President's proposed budget for 1976 is $419 million, a difference of $184 million, and that is represented almost completely by the recommended 20-percent increase in non-Federal funding which the President has recommended as part of his budget proposal. Mr. ROGERS. You say that these authorizations have exceeded the President's requested budget authority by approximately $500 million in 1975, $700 million in 1976. I was asking if you could give comparable figures as to how it compares with the actual moneys 49-210 O 75 10 |