accommodate the needs of elderly and handicapped personnel. Additionally, due to poor quality workmanship and inferior construction materials used during original construction, numerous structural, mechanical and electrical deficiencies continue to plague the home and require corrective action. A specific "four year" renovation plan does not exist but we have aggressively endeavored to systematically overcome the most critical deficiencies that have the greatest impact on resident safety and quality of life. Major work accomplished in recent years is summarized as follows:. FY87: FY88: FY89: . FY90: $800K Repair bathrooms in resident rooms and showers in $425K Install fire alarm system and overhaul air $13.7M Replace exterior walls/roof; replace primary electric feeder cable; upgrade/repair all elevators; install emergency lighting; replace transfer switch for emergency power system. $660K Install emergency exit lights; install ground fault interrupters at all wet areas; upgrade post office to allow 24 hour access; install overhead lights, expand oxygen system in hospital patient rooms, upgrade nurse stations; install handicap facilities in 1st floor bathrooms; construct additional fire walls/install fire doors in dormitory area; replace air conditioning system condenser pumps; design repairs to exhaust system ventilation; install hand rails 2nd and 3rd floors. Due to lack of funding, we have not been able to accomplish any major repair work in FY91. Our plans included the following: FY91: $338K Install therapeutic pool at hospital; design for installation of an additional emergency generator; design for upgrade of the nurse call system in the hospital and the main facility public address system; design and enclosure of a storm drain that divides the north section of the property and is a safety hazard to residents. Plans for FY92 are as follows: FY92: FY92: $1.253M (funded by OMB) Repairs and alterations to $1.3M (unfunded by OMB) $613K for following capital SUBCOMMITTEE RECESS Senator HARKIN. This subcommittee will stand in recess to reconvene at 2 p.m., to receive testimony from the remaining agencies. [Whereupon, at 12:32 p.m., Thursday, March 21, the subcommittee was recessed, to reconvene at 2 p.m., the same day.] (AFTERNOON SESSION, 2:16 P.M., THURSDAY, MARCH 21, 1991) The subcommittee met at 2:16 p.m., in room SD-192, Dirksen Senate Office Building, Hon. Tom Harkin (chairman) presiding. Present: Senators Harkin, Specter, Stevens, and Gorton. NATIONAL COMMISSION TO PREVENT INFANT MORTALITY STATEMENT OF LYNDA JOHNSON ROBB OPENING STATEMENT OF SENATOR HARKIN Senator HARKIN. Good afternoon. The Appropriations Subcommittee on Labor, Health and Human Services, and Education will come to order. This afternoon we will hear testimony from the final panel of independent agencies funded under title IV of our appropriations bill. We will begin this afternoon with testimony from Mrs. Lynda Johnson Robb on behalf of the National Commission to Prevent Infant Mortality. The Commission's fiscal year 1992 request is $450,000, an increase of $50,000 over last year's level. We are certainly delighted and honored to have Mrs. Robb with us today. Since her days as First Lady of Virginia, Mrs. Robb has been a vocal and dedicated proponent of both national literacy and children's issues. I want to personally welcome you here today in your first appearance before this subcommittee. The Commission was created during the chairmanship of my distinguished predecessor, former Senator Lawton Chiles, now Governor of the State of Florida. When it was established in 1987, the Commission's mission was a critical one, and it remains so today. The Commission is responsible for creating a national strategic plan to reduce infant mortality and morbidity in the United States. Recent statistics underscore the need for this kind of dedicated effort. So, I look forward to hearing more about the Commission's current efforts to implement its recommendations and the activities planned for 1992. At this point, I would ask unanimous consent to keep the record open for any opening statements by Senator Specter. Again, my apologies to you, Mrs. Robb and to all of you, for being late, but as you know, we just had a vote on the Senate floor and you know what that means. Ms. ROBB. I'm all too familiar with having things delayed by Senate votes. [Laughter.] Senator HARKIN. Well, thank you for being here and please proceed with your statement. Ms. ROBB. Senator Harkin, I want to thank you for this opportunity to appear before you today regarding the ongoing work of the National Commission to Prevent Infant Mortality. On behalf of Governor Chiles and the other members of the Commission, I want to convey our appreciation for your continuing support of our work. In our testimony I will discuss the Commission's many efforts to promote the health and wellbeing of pregnant women and children. I will also briefly discuss the work we are doing with our private sector support. As you know, in fiscal year 1989 and through 1991, our appropriation requests have been decreasing. Both this year and last, our funding level has been maintained at $400,000. Each year we have requested either fewer funds or no funding increases because we are committed to obtaining private support to augment our public support. We feel that such public/private partnerships are critical for galvanizing the Nation's creativity and commitment for mothers and children. We will continue to work closely with the private sector and foundations, but for 1992 we are requesting an increase to $450,000 to accommodate for inflation and necessary salary adjustments that we have been absorbing over the last 3 years. We appreciate your consideration of our request. The current work of the Commission is focusing on promoting the recommendations made in our 1988 report to Congress and the President, "Death Before Life: The Tragedy of Infant Mortality." For your reference and for the record, Mr. Chairman, I have included with my testimony a recently completed status report on the Commission's past and current activities and our future plans. As an overall statement, we believe that there is notable progress being made on many of the recommendations of the Commission. For example, financial coverage for health care primarily through increased Medicaid eligibility has been improved for pregnant women and children. Many communities are conducting public awareness activities about prenatal care. States are working with physicians to encourage them to take in low-income patients. More and more business leaders are recognizing that improving maternal and child health makes good business sense. There also is growing activity in one of the most effective strategies I know of and one that is strongly promoted by the Commission: Resource Mothers. These home visiting programs provide services directly in the home and also link mothers up with the community services that they need. The Resource Mothers programs that I am most familiar with are in Virginia. We have had great success. We serve teenage mothers, and we have been able to reduce the infant mortality rate to 8.4 compared to 14.7 for babies born to teenage mothers not enrolled in Resource Mothers. The low birthweight rate for our babies averages 5 percent compared to 11 percent for those who are not in our program. And our young mothers are much more likely to turn to high school than others. Certainly helping these young women finish high school is one of the best insurance policies that we can ever give her and her child. We have enjoyed working particularly with you to promote Resource Mothers, and we appreciate your joining us in releasing our GAO report on home visiting last year. Despite this good progress, however, the Nation still has a long way to go. Our country's infant mortality rate is still higher than |