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Senate Hearings Before the Committee on Appropriations S. HRG. 111–604 Senate Hearings Before the Committee on Appropriations Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Fiscal Year 2011 111th CONGRESS, SECOND SESSION S. 3686 DEPARTMENT OF EDUCATION DEPARTMENT OF HEALTH AND HUMAN SERVICES DEPARTMENT OF LABOR NONDEPARTMENTAL WITNESSES Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations, 2011 (S. 3686) S. HRG. 111–604 DEPARTMENTS OF LABOR, HEALTH AND HUMAN SERVICES, AND EDUCATION, AND RELATED AGENCIES APPROPRIA- TIONS FOR FISCAL YEAR 2011 HEARINGS BEFORE A SUBCOMMITTEE OF THE COMMITTEE ON APPROPRIATIONS UNITED STATES SENATE ONE HUNDRED ELEVENTH CONGRESS SECOND SESSION ON S. 3686 AN ACT MAKING APPROPRIATIONS FOR THE DEPARTMENTS OF LABOR, HEALTH AND HUMAN SERVICES, AND EDUCATION, AND RELATED AGENCIES FOR THE FISCAL YEAR ENDING SEPTEMBER 30, 2011, AND FOR OTHER PURPOSES Department of Education Department of Health and Human Services Department of Labor Nondepartmental Witnesses Printed for the use of the Committee on Appropriations ( Available via the World Wide Web: http://www.gpo.gov/fdsys U.S. GOVERNMENT PRINTING OFFICE 54–977 PDF WASHINGTON : 2011 For sale by the Superintendent of Documents, U.S. Government Printing Office Internet: bookstore.gpo.gov Phone: toll free (866) 512–1800; DC area (202) 512–1800 Fax: (202) 512–2104 Mail: Stop IDCC, Washington, DC 20402–0001 COMMITTEE ON APPROPRIATIONS DANIEL K. INOUYE, Hawaii, Chairman PATRICK J. LEAHY, Vermont THAD COCHRAN, Mississippi, TOM HARKIN, Iowa CHRISTOPHER S. BOND, Missouri BARBARA A. MIKULSKI, Maryland MITCH MCCONNELL, Kentucky HERB KOHL, Wisconsin RICHARD C. SHELBY, Alabama PATTY MURRAY, Washington JUDD GREGG, New Hampshire BYRON L. DORGAN, North Dakota ROBERT F. BENNETT, Utah DIANNE FEINSTEIN, California KAY BAILEY HUTCHISON, Texas RICHARD J. DURBIN, Illinois SAM BROWNBACK, Kansas TIM JOHNSON, South Dakota LAMAR ALEXANDER, Tennessee MARY L. LANDRIEU, Louisiana SUSAN COLLINS, Maine JACK REED, Rhode Island GEORGE V. VOINOVICH, Ohio FRANK R. LAUTENBERG, New Jersey LISA MURKOWSKI, Alaska BEN NELSON, Nebraska MARK PRYOR, Arkansas JON TESTER, Montana ARLEN SPECTER, Pennsylvania CHARLES J. HOUY, Staff Director BRUCE EVANS, Minority Staff Director SUBCOMMITTEE ON DEPARTMENTS OF LABOR, HEALTH AND HUMAN SERVICES, AND EDUCATION, AND RELATED AGENCIES TOM HARKIN, Iowa, Chairman DANIEL K. INOUYE, Hawaii THAD COCHRAN, Mississippi HERB KOHL, Wisconsin JUDD GREGG, New Hampshire PATTY MURRAY, Washington KAY BAILEY HUTCHISON, Texas MARY L. LANDRIEU, Louisiana RICHARD C. SHELBY, Alabama RICHARD J. DURBIN, Illinois LAMAR ALEXANDER, Tennessee JACK REED, Rhode Island MARK PRYOR, Arkansas ARLEN SPECTER, Pennsylvania Professional Staff ERIK FATEMI MARK LAISCH ADRIENNE HALLETT LISA BERNHARDT BETTILOU TAYLOR (Minority) SARA LOVE SWANEY (Minority) Administrative Support TERI CURTIN JENNIFER CASTAGNA (Minority) (II) CONTENTS WEDNESDAY, MARCH 10, 2010 Page Department of Health and Human Services: Office of the Secretary ................. 1 THURSDAY, MARCH 23, 2010 Department of Labor: Office of the Secretary ....................................................... 51 WEDNESDAY, APRIL 14, 2010 Department of Education: Office of the Secretary ................................................ 109 WEDNESDAY, MAY 5, 2010 Department of Health and Human Services: National Institutes of Health ...... 171 Nondepartmental Witnesses ................................................................................... 231 (III) DEPARTMENTS OF LABOR, HEALTH, AND HUMAN SERVICES, AND EDUCATION, AND RELATED AGENCIES FOR FISCAL YEAR 2011 WEDNESDAY, MARCH 10, 2010 U.S. SENATE, SUBCOMMITTEE OF THE COMMITTEE ON APPROPRIATIONS, Washington, DC. The subcommittee met at 3:05 p.m., in room SD–124, Dirksen Senate Office Building, Hon. Tom Harkin (chairman) presiding. Present: Senators Harkin, Reed, Pryor, and Cochran. DEPARTMENT OF HEALTH AND HUMAN SERVICES OFFICE OF THE SECRETARY STATEMENT OF HON. KATHLEEN SEBELIUS, SECRETARY OPENING STATEMENT OF SENATOR TOM HARKIN Senator HARKIN. The Subcommittee on Labor, Health, Human Services, Education and Related Agencies will come to order. Well, Madam Secretary, welcome back to the subcommittee. I first want to start by commending you for the outstanding work you’re doing to help enact healthcare reform. We can see the finish line at last. And your leadership is one of the reasons that we can see that finish line. I know it will be tempting for Senators on both sides of the dais to want to debate the pros and cons of health reform with you today. But I would urge the subcommittee members to keep their focus on the subject of our hearing. And that is the President’s pro- posed fiscal year 2011 budget for the Department of Health and Human Services (HHS). On the whole, there’s much to like in the HHS budget. As we all know the President’s budget holds the line on nonsecurity-related spending overall in fiscal year 2011. But the President promised to use a scalpel, not an ax, to achieve that freeze. And HHS is one of the Federal agencies that would get an increase, 2.5 percent more than in fiscal year 2010. I was particularly pleased that the President included a major boost for efforts to root out fraud in Medicare and Medicaid. Reduc- ing healthcare fraud and abuse has been a priority of mine for many years. And it will play a key role in bringing our long-term deficits under control. Significant increases were also proposed for the National Institutes of Health (NIH), for Head Start, childcare (1) 2 and a new caregiver’s initiative that will help families take care of their elderly relatives. Other provisions in the budget raise cause for concern, however. For example, the President’s budget would cut funding for the Cen- ters for Disease Control and Prevention (CDC). The budget also in- cludes a $1.8 billion cut to discretionary funding under the LIHEAP program. But overall, I think the President’s budget is a good start. I look forward to discussing it in more detail with you during this hearing. I also want to add, Madam Secretary, how lucky you are to have an Assistant Secretary like Ellen Murray to advise you on all these issues. At last year’s budget hearing she was sitting next to me on the dais. Today she is advising you. I can tell you from experience you’re in very good hands. And I read it just as she wrote that for me right there. Senator HARKIN. Now I turn to Senator Cochran. STATEMENT OF SENATOR THAD COCHRAN Senator COCHRAN. Mr. Chairman, thank you very much for con- vening the hearing. Madam Secretary, we appreciate your being here to talk about the budget request. And we look forward to hearing your testi- mony. PREPARED STATEMENT I ask unanimous consent that the balance of my remarks be placed in the record. I will also include a statement from the Chair- man, Senator Inouye. He regrets that he could not be present. Senator HARKIN. Thank you very much, Senator Cochran. [The statement follows:] PREPARED STATEMENT OF SENATOR THAD COCHRAN Mr. Chairman, thank you for chairing this hearing to review the budget for fiscal year 2011 for the Department of Health and Human Services. We are pleased to welcome the Secretary of Health and Human Services, Kathleen Sebelius to her sec- ond appearance before our subcommittee, and we look forward to working with her to support our Nation’s investment in healthcare, social services programs, medical research, and disease prevention. I am pleased that your budget includes a $1 billion increase for the National In- stitutes of Health. These additional dollars are essential if we are to continue to make scientific discoveries in cancer, autism, heart disease, and the many other maladies that plague so many Americans. I was also pleased to see your announcement last week regarding the $10 million in funds from the America Recovery and Reinvestment Act to help communities find ways to curb smoking and combat obesity, improve access to healthy foods, and in- crease physical activity. This subcommittee will be challenged to balance the competing needs of the pro- grams contained in your $74 billion budget. We look forward to working with you to maintain our commitment to fiscal restraint while providing much needed in- creases for high-priority programs. PREPARED STATEMENT OF SENATOR DANIEL K. INOUYE Secretary Sebelius, last October Dr. Mary Wakefield, the Administrator of the Health Resources and Services Administration, visited Hawaii and I would like to thank you for your support of her trip. She visited a number of Community Health Centers and toured several hospitals and educational facilities on the neighboring islands. The people of Hawaii were very grateful to host her visit and thankful for 3 the opportunity to discuss critical healthcare concerns of the State. In addition she met with representatives from the National Kidney Foundation of Hawaii to talk about the increasing incidence of kidney disease among the Filipino population. Thank you again, and I will provide questions for the record to the subcommittee later. Senator HARKIN. Again, Madam Secretary, welcome back to the subcommittee. And again, thank you for your leadership. And just by way of introduction, Kathleen Sebelius became the 21st Sec- retary of the Department of Health and Human Services on April 29, 2009. In 2003, she was elected Governor of Kansas and served in that capacity until her appointment as Secretary. Prior to her election as governor she served as a Kansas State Insurance Commissioner. She is a graduate of Trinity Washington University and the Uni- versity of Kansas. Madam Secretary, welcome. Your statement will be made a part of the record in its entirety. And please proceed as you so desire. SUMMARY STATEMENT OF HON. KATHLEEN SEBELIUS Secretary SEBELIUS. Well, thank you very much, Chairman Har- kin and Senator Cochran and members of the subcommittee. I am glad to be back to discuss the 2011 budget for HHS. I think the budget builds on many of the themes that President Obama laid out in his State of the Union Address this year, strengthening our healthcare system, laying the foundation for future growth, and rooting out waste and fraud to make programs even more effective.
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