NIDA's Appropriations Hearing for the House Labor/HHS Subcommittee
On March 22, Dr. Leshner testified before the House Labor/HHS appropriations subcommittee (John Porter, R-IL, Chairman). During his presentation, Dr. Leshner declared NIDA's Year 2000 goal to have science replace ideology as the foundation for drug abuse prevention, treatment and policy strategies. (The President's FY 1996 Budget Request for NIDA totals $452,069,000, a 3.3% increase over the FY 1995 appropriation.)
FY 95 Rescissions -- Senate
The Senate passed its version of H.R. 1158, the rescissions/emergency supplemental appropriations bill, on Thursday, April 6, by a vote of 99-0. After a week of negotiation and compromises, the bill emerged with $16.1 billion in cuts. Senate action has resulted in $9 million in additional cuts for NIH, with the cuts totalling $79 million. All of the cuts are to be taken from NIH's intramural construction account. The House bill included rescissions to NIH intramural and extramural construction projects. The House cut was divided into two parts: $20 million from the National Center for Research Resources for FY 95 extramural facilities grants program and $50 million from an NIH account designated for intramural construction projects -- according to NIH sources these funds had been allocated for the new primate center in Frederick, Maryland and the second phase for the Natcher building.
Differences between the two versions of the bill have to be worked out. Senate Minority Leader Tom Daschle (D-SD), includes the $100 million for drug-free schools as an essential element of the package. President Clinton has said that he would sign H.R. 1158 as passed by the Senate as it removed some of the cost-cutting elements of the $17.4 billion House rescissions bill.
A major tax-cut bill [H.R. 1215] passed the House on April 5 in which tax cuts are paid for by cutting discretionary spending by $100 billion over five years, increasing the contribution by Federal employees to their pension fund, and cutting Medicare. The Senate has said it will not take up this bill, but the Senate Budget Committee may include some tax cuts in its budget resolution later this Spring. Senate Republicans are preparing to unveil a plan to balance the budget by 2002. As drafted, the $1 trillion, seven-year proposal gets most of its savings from reductions in Medicaid [about $160 billion), Medicare (about $250 billion), other entitlement programs (about $250 billion including savings from changes to the Federal retirement system); discretionary appropriations for domestic programs (about $200 billion); and debt interest (about $160 billion). The plan was prepared by Senate Budget Committee Chairman Pete Domenici (R-NM).
Health Care Reform
H.R. 1455 was introduced by Representative Peter Stark (D-CA) and James Hansen (R-UT). The bill would earmark 9% of the revenues from a proposed $2 per-pack tax on cigarettes--estimated at about $1.5 billion annually--to fund research supported by NIH. About 88% of the money generated by the bill would be earmarked for the Medicare Part A Hospital Trust Fund. A newlycreated National Fund for Medical Research would receive 9% of the funds generated by the bill or approximately $1.5 billion a year.
Dr. Harold Varmus, Director, NIH, announced on April 11 that cost containment will no longer be an issue in the cooperative research and development agreements (CRADAs) that govern NIH partnerships with industry. This action, which was taken by Dr. Varmus along with top officials at DHHS, stemmed from concerns that the reasonable pricing clause had driven industry away from potentially beneficial collaborations with NIH. It is not clear whether there will be opposition to the removal of the pricing clause from Congress.
Surgeon General Nomination
A confirmation hearing was held on May 2nd and 3rd before the Senate Labor and Human Resources Committee for Dr. Henry Foster, the nominee for U.S. Surgeon General. Committee Chairman Nancy Kassebaum (R-KS) had stated that only Dr. Foster and members of Congress would testify. Senate Majority Leader Bob Dole (R-KS) said that he might use his power over the schedule to prevent the full Senate from ever considering Foster's nomination. Senator Barbara Boxer (D-CA) stated that she would retaliate by objecting to unanimous consent requests on other Senate business.
Congressional Departures To-Date
The following congressional members have announced their retirement -- Senators Hank Brown (R-CO); Jim Exon (D-NE); Howell Heflin (D- AL); J. Bennett Johnston (D-LA); Paul Simon (D-IL); and Representative Mel Hancock (R-MO) -- each will finish out his term. Senator David Pryor (D-Ark) is expected to announce his retirement soon, bringing to 5 the number of Senate Democrats not seeking another term.
Ed Long, formerly Minority staff on the Senate Labor/HHS appropriations subcommittee, is now vice president of congressional relations with Capitol Associates. No replacement has yet been named.
Bills of Interest
The amended version of H.R. 4 passed the House on March 24 by a vote of 234-199 with the three elements of welfare reform [H.R. 1157, H.R. 999, and H.R. 1135] reincorporated into H.R. 4. Title VI, Supplemental Security Income, Section 601(d) states, in part, "for carrying out the medication development project to improve drug abuse and drug treatment research (administered through the National Institute on Drug Abuse), $5,000,000 for each of the fiscal years 1997 through 2000". It would also provide $95 million for the drug abuse treatment capacity expansion program as provided under section 1971 of the Public Health Service Act.
This legislation [H.R. 4] gives broad authority over a wide range of social services, including welfare checks and school meals. It would replace 44 programs with five block grants, giving States unprecedented authority over cash welfare, child welfare programs such as foster care; child care; school meals; and special nutrition programs for pregnant women and young children. The Senate Finance Committee, chaired by Senator Bob Packwood (R-OR), has talked about replacing the entitlement for welfare checks, and possibly other social services, with block grants to the States. Democrats, led by Senator Daniel P. Moynihan (D-NY), generally oppose the concept. One of the first questions Senate leaders must resolve is whether to include welfare in the reconciliation bill, an omnibus budget package designed to reconcile taxes and spending with deficit-reduction goals [reconciliation bills cannot be filibustered]. Meanwhile, Democrats are trying to develop a strategy -- whether to draft their own bill or simply oppose anything the Senate GOP proposes. President Clinton reportedly urged Senators Moynihan and Tom Daschle (D-SD) to start working on a welfare reform bill during the recess.
The House passed H.R. 1271, Family Privacy Protection, on April 4. It would require any Federal department or agency to obtain "written consent" before a minor could submit to a survey or evaluation that reveals certain information (including illegal, anti-social or self incriminating behavior). During markup by the House Government Reform and Oversight Committee, the term "written consent" was deleted and "prior consent" was substituted. However, prior to House floor consideration, Representative Mark Souder (R-IN) asked the leadership and committee staff to include an amendment to require "written consent." His request came as the result of a survey given to his child at school. He objected to the questions in the survey and his consent was not requested. Representative Cardiss Collins (D-IL) had expressed strong support for the committee approved language requiring "prior consent" rather than "written consent."
Crime legislation was passed in the form of six separate bills by the House in February. H.R. 728 concerns anti-crime-block grants which would combine last year's grants for police hiring and crime prevention into a block grant program that would give localities more choice in how they spend the money. The Senate Judiciary Committee, chaired by Senator Orrin Hatch (R-UT), is expected to conduct at least one more hearing on crime legislation in late April or May, then begin marking up one or more bills. The key proposal is S. 3, sponsored by Majority Leader Bob Dole (R-KS) and Senator Hatch which would shift last year's funds as authorized under the anti-crime law [P.L. 103-322] from crime prevention programs to prison construction and law enforcement. Sec. 105 of S.3 includes a provision which would amend the Violent Crime Control and Law Enforcement Act of 1994 to require the Bureau of Prisons to include in an annual report to congress "a full examination and evaluation of the effectiveness of the [substance abuse] treatment [provided in accordance with the Act] in reducing drug use among prisoners." Debate is expected in both chambers over repealing the 1994 ban on certain semiautomatic assault style weapons. President Clinton has threatened to veto any measure that undermines last year's police hiring grants, such as the House block grant legislation [H.R. 728].
On March 22, H.R. 1289, the Newborn Infant Notification Act, was introduced by Representative Gary Ackerman (D-NY). It would require, in certain circumstances, States to disclose HIV status of newborn infants to legal guardians of the infants. While there is no mention of research in the bill, the CDC believes that it could effectively halt their survey involving use of about-to-bediscarded blood from samples collected for routine newborn health screening. The CDC met with Representative Ackerman on March 30 to discuss the impact the proposed legislation would have on the agency.
The conference report to S. 244, the Paperwork Reduction Act, no longer includes provisions to change the date of the health services research report or to terminate all statutorily mandated reports to Congress within five years.
S. 555 was introduced on March 14 by Senator Nancy Kassebaum (R-KS) to amend the PHSA to consolidate and reauthorize health professions and minority and disadvantaged health education programs. The bill would, in part, require a Deputy Assistant Secretary for Minority Health to coordinate PHS activities. Also, PHS agencies would be required to submit reports summarizing the agency's minority health activities, and serve as ex officio members of the PHSA advisory committee.
National Drug Control Strategy Hearing
On April 6, ONDCP Director, Dr. Lee Brown testified before the House Government Reform and Oversight Subcommittee on National Security, International Affairs and Criminal Justice. The hearing was a continuation of the one held on March 9 at which Nancy Reagan and former Drug Czar Bill Bennett were among the witnesses.
Members continued the theme of criticizing the Administration's lack of leadership on the issue of drug abuse and the need to shift resources from demand to supply reduction. Dr. Brown responded to vigorous assaults on everything from failure to provide leadership to questions about his honesty in using travel funds. Dr. Brown continued to defend the Administration's focus on hard core drug users. He mentioned CALDATA and RAND findings emphasizing that money spent on treatment is a good investment. He challenged the chart the committee used which plotted reductions in drug interdiction funds against rises in marijuana use. He defended the effectiveness of the drug free schools program and stressed
the importance of drug courts. He also supported random drug testing of all federal employees, Members of Congress and their staff. The Chairman agreed.
At the end of the hearing the Chairman, William Zelliff (R-NH), said the Subcommittee plans to continue efforts to focus attention on this important issue. He also said that they are planning to meet with major CEO's around the country and will be looking at the issue of random drug tests for all Federal employees.
Senate Hearing on Supplemental Security Income (SSI)
On March 27, Dr. Herb Kleber, Executive Vice President and Medical Director of CASA at Columbia University, testified before the Senate Finance Committee on the SSI program. Dr. Kleber told the committee that benefits should be for the use of treatment, and that cash benefits for alcoholics and drug addicts are not an incentive for them to receive treatment. Prior treatment should be used as a condition of eligibility for SSI. He also stated that more funds should be used for drug abuse research, specifically for medications development.
Senator Larry Pressler (R-SD) was the only member present to ask about alcoholics and drug addicts eligibility under SSI. He was concerned as to whether an alcoholic or drug addict could simply quit working, declare themselves a drug addict or alcoholic and collect SSI. He was also concerned about the length of time an alcoholic or drug addict continues to receive SSI. In response, Dr. Carolyn Weaver, American Enterprise Institute, indicated that there would have to be documentation that the disability was severe enough to collect SSI. Also, Dr. Kleber explained that there are effective treatment programs and that effective methods currently exist to identify the right treatment program depending on the individual. Senator Pressler asked if we have evidence that the SSI program is successful (that when someone is given treatment they no longer receive SSI) Dr. Kleber responded that the SSI program is not the place to look for effectiveness. However, the majority of outcomes from alcohol and drug abuse treatment are in general very successful.