[House Hearing, 115 Congress]
[From the U.S. Government Publishing Office]
DEPARTMENTS OF LABOR, HEALTH AND HUMAN
SERVICES, EDUCATION, AND RELATED AGENCIES
APPROPRIATIONS FOR 2018
_______________________________________________________________________
HEARINGS
BEFORE A
SUBCOMMITTEE OF THE
COMMITTEE ON APPROPRIATIONS
HOUSE OF REPRESENTATIVES
ONE HUNDRED FIFTEENTH CONGRESS
FIRST SESSION
_________
SUBCOMMITTEE ON LABOR, HEALTH AND HUMAN SERVICES, EDUCATION, AND
RELATED AGENCIES
TOM COLE, Oklahoma, Chairman
MICHAEL K. SIMPSON, Idaho ROSA L. DeLAURO, Connecticut
STEVE WOMACK, Arkansas LUCILLE ROYBAL-ALLARD, California
CHARLES J. FLEISCHMANN, Tennessee BARBARA LEE, California
ANDY HARRIS, Maryland MARK POCAN, Wisconsin
MARTHA ROBY, Alabama KATHERINE CLARK, Massachusetts
JAIME HERRERA BEUTLER, Washington
JOHN R. MOOLENAAR, Michigan
NOTE: Under committee rules, Mr. Frelinghuysen, as chairman of the full committee,
and Mrs. Lowey, as ranking minority member of the full committee, are authorized
to sit as members of all subcommittees.
Susan Ross, Jennifer Cama,
Justin Gibbons, Kathryn Salmon, and Lori Bias
Subcommittee Staff
________
PART 6
Page
Oversight Hearing--Federal Response to the Opioid Crises ........ 1
Oversight Hearing--Advance in Biomedical Research ............... 75
Department of Education.......................................... 281
Department of Labor.............................................. 395
[GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT]
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Printed for the use of the Committee on Appropriations
______
U.S. GOVERNMENT PUBLSHING OFFICE
27-226 WASHINGTON: 2017
COMMITTEE ON APPROPRIATIONS
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RODNEY P. FRELINGHUYSEN, New Jersey, Chairman
HAROLD ROGERS, Kentucky \1\ NITA M. LOWEY, New York
ROBERT B. ADERHOLT, Alabama MARCY KAPTUR, Ohio
KAY GRANGER, Texas PETER J. VISCLOSKY, Indiana
MICHAEL K. SIMPSON, Idaho JOSE E. SERRANO, New York
JOHN ABNEY CULBERSON, Texas ROSA L. DeLAURO, Connecticut
JOHN R. CARTER, Texas DAVID E. PRICE, North Carolina
KEN CALVERT, California LUCILLE ROYBAL-ALLARD, California
TOM COLE, Oklahoma SANFORD D. BISHOP, Jr., Georgia
MARIO DIAZ-BALART, Florida BARBARA LEE, California
CHARLES W. DENT, Pennsylvania BETTY McCOLLUM, Minnesota
TOM GRAVES, Georgia TIM RYAN, Ohio
KEVIN YODER, Kansas C. A. DUTCH RUPPERSBERGER, Maryland
STEVE WOMACK, Arkansas DEBBIE WASSERMAN SCHULTZ, Florida
JEFF FORTENBERRY, Nebraska HENRY CUELLAR, Texas
THOMAS J. ROONEY, Florida CHELLIE PINGREE, Maine
CHARLES J. FLEISCHMANN, Tennessee MIKE QUIGLEY, Illinois
JAIME HERRERA BEUTLER, Washington DEREK KILMER, Washington
DAVID P. JOYCE, Ohio MATT CARTWRIGHT, Pennsylvania
DAVID G. VALADAO, California GRACE MENG, New York
ANDY HARRIS, Maryland MARK POCAN, Wisconsin
MARTHA ROBY, Alabama KATHERINE M. CLARK, Massachusetts
MARK E. AMODEI, Nevada PETE AGUILAR, California
CHRIS STEWART, Utah
DAVID YOUNG, Iowa
EVAN H. JENKINS, West Virginia
STEVEN M. PALAZZO, Mississippi
DAN NEWHOUSE, Washington
JOHN R. MOOLENAAR, Michigan
SCOTT TAYLOR, Virginia
----------
\1\}Chairman Emeritus
Nancy Fox, Clerk and Staff Director
(ii)
DEPARTMENTS OF LABOR, HEALTH AND HUMAN SERVICES, EDUCATION, AND RELATED
AGENCIES APPROPRIATIONS FOR 2018
----------
Wednesday, April 5, 2017.
OVERSIGHT HEARING--FEDERAL RESPONSE TO THE OPIOID ABUSE CRISIS
WITNESSES
BARBARA CIMAGLIO, DEPUTY COMMISSIONER, VERMONT DEPARTMENT OF HEALTH
BILL GUY, ADVOCATE, PARENTS HELPING PARENTS
NANCY HALE, PRESIDENT AND CEO, OPERATION UNITE
ROSALIE LICCARDO PACULA, SENIOR ECONOMIST AND CO-DIRECTOR, DRUG POLICY
RESEARCH CENTER, RAND CORPORATION
Mr. Cole. Good morning. It is my pleasure to welcome our
witnesses today to the Appropriations Subcommittee on Labor,
Health and Human Services, Education, and Related Agencies to
discuss the Federal response to the opioid abuse crisis. I want
to thank all of our witnesses for coming and I look forward to
hearing your testimony.
Today, we are here to learn about the Federal response to
address opioid abuse. As we have all heard reported in the
media, the growth of this epidemic is staggering. Data released
by the Centers for Disease Control and Prevention for 2015 show
a continued increase in the number of overdose deaths involving
an opioid. On average, 91 Americans are lost each day due to an
opioid-related overdose. That is one person every 16 minutes.
And that literally means in the course of this hearing we will
lose probably eight people.
In response to this growing epidemic, Congress has
dramatically increased investments in this area. In the 114th
Congress, as part of the 21st Century Cures Act, we established
a grant program to supplement the State response to the opioid
abuse crisis. We appropriated $500,000,000 in the State
response grants as part of the current year's continuing
resolution in order to expedite the aid to the hardest hit
States and communities. The proposed budget from the
administration continues these activities for fiscal year 2008.
In addition, with leadership from our colleagues in the
Senate, we passed the Comprehensive Addiction and Recovery Act,
which included numerous initiatives aimed at reducing overdose
deaths, expanding access to treatment, and supporting people
through their recovery. Congress, understanding the urgency for
resources, supported these programs by including them in the
continuing resolution.
As we finalize this year's appropriations and begin to work
on the next fiscal year, we continue to look at programs that
provide education to young adults, parents, and medical
providers on prevention strategies, access to medication-
assisted treatment, and training for first responders to
prevent overdose-related deaths.
Today we look forward from hearing from our witnesses about
the strategies we can most effectively help those who are
addicted, their families, and their communities. The issue of
opioid addiction is multifaceted and Federal efforts must be
strategically coordinated with the States, cities, and
community organizations for a comprehensive, holistic response.
We hope to learn more about how we can best target our Federal
investments in this area to ensure we are making a maximum
impact.
Today I am pleased to welcome the following witnesses.
Rosalie Pacula? I hope I got it right. We Okies don't always
get these names very good. So Bill will help me through it, I
am sure. As the senior economist at the RAND Corporation, she
serves as co-director of RAND's Drug Policy Research Center.
She has been actively engaged in evaluating the impact of
recent policies to expand treatment for opioid use in the
United States. Her work on prescription drugs has specifically
covered misuse in a variety of populations, including the
elderly, the disabled, and the poor.
Bill Guy, who is in full disclosure one of my constituents,
comes to us from Norman, Oklahoma. Bill works with Parents
Helping Parents, an addiction prevention advocacy group. Bill
and his wife Rita are the parents of three grown children and
have eight grown grandchildren. Bill works for the Oklahoma
Education Association. He will be sharing his story of how
addiction has impacted his family.
Barbara Cimaglio is a nationally recognized leader in the
field of alcohol and drug abuse prevention, treatment, and
recovery. Her career spans almost over 40 years of service at
the State and local level. She is currently the deputy
commission for the Vermont Department of Health, overseeing
substance abuse, prevention, treatment, and recovery services,
along with various public health programs. She is also on the
board of the National Association of State Alcohol and Drug
Abuse Directors.
Nancy Hale worked for 34 years as a teacher, career
counselor, and administrative coordinator. She retired from
public education in 2012 and joined Operation UNITE, where she
currently serves as president and CEO. Congressman Hal Rogers,
our good friend and colleague, started Operation UNITE in 2003.
And just parenthetically, as everybody on this committee knows,
the reason why we have been as bipartisan and focused on this
issue as we have been is because of Chairman Rogers' leadership
here for many, many years. He has really made an extraordinary
difference for all Americans in this effort.
Operation UNITE, again, works to rid communities of illegal
drug use through undercover narcotics investigations,
coordinating treatment for substances abusers, providing
support to families and friends of substance abusers and
educating the public about the dangers of using drugs.
I want to add, I was looking at your biography and I don't
know anybody who has ever won volunteer of the year for 4 years
at the State level. So thank you for your personal commitment.
And before I close out, I want to point out my good friend
Phil English is here somewhere, our former colleague. Right
over here. I know he is involved in some efforts in this area
as well. So we are delighted to have him here as well.
As a reminder to the subcommittee members and our
witnesses, we will abide by the 5-minute rule so that everyone
will have a chance to present their testimony and ask
questions. I look forward to hearing from our witnesses.
I would like to now yield to my good friend, the ranking
member, the gentlelady from Connecticut, for any opening
remarks she would care to make.
Ms. DeLauro. Thank you very much, Mr. Chairman. Thank you
for holding this hearing. I would like to welcome our witnesses
this morning.
I think if it is Italian it could even be Cimaglio, so
there you go.
So in any case, I know so many of you have traveled so far
to be with us today and we are so grateful to have you with us
for what is a very, very important hearing, and especially
thankful, thankful, not only that you are here, but thankful
for the work that you do every day in our communities to help
families who are living with addiction.
Over the past year and a half I have heard a lot from
community members from my community, experts across the State
of Connecticut about the local impacts of the nationwide opioid
epidemic. I have done a lot of events like forums at community
health centers, townhalls, a productive meeting with the former
Office of National Drug Policy Director Michael Botticelli. All
of these folks came in and out of the city of New Haven and
Hartford to talk us through this issue.
It was clear then and it is clear now that we have an
epidemic, an opioid epidemic that requires a response from all
levels of government. It has been sounding alarms for far too
long. According to CDC, Centers for Disease Control and
Prevention, about 90 Americans die every day from an opioid
overdose, more than twice the rate in 2013. In 2015 more than
33,000 Americans died from an opioid or heroin overdose, more
than the number of people who died in car accidents.
And sadly, opioid deaths are likely undercounted. In
Connecticut, our State's medical examiner's office reported
that 917 people died from overdoses in 2016. That was a 25
percent increase over 2015. The largest increase involved the
synthetic opioid Fentanyl.
The Federal Government has a critical role to play in
supporting State and local communities as they work to combat
the tragic consequences of addiction. In 2016, this
subcommittee included several important funding increases to
address the opioid crisis on a bipartisan basis. I was proud of
our work to increase funding for the Substance Abuse Prevention
and Treatment Block Grant by $38,000,000, increased targeted
prevention and treatment program funding by $35,000,000, and
increase of the CDC's prescription drug overdose program by
$50,000,000.
We need to build on these investments in the 2017 budget,
which we soon hope that we will have completed and moved
forward on, and we need to do the same in 2018, because in fact
what this is all about, what these issues are about today are
life and death. And lives are on the line. This is not parks,
roads, bridges, or other areas which we take up at the Federal
level.
And the administration has proposed to maintain the 21st
Century Cures Act funding for opioid abuse. Quite honestly, it
is not specifically clear what they will propose for the
remaining programs across Health and Human Services. There is a
skinny budget that is out and for me the writing is on the wall
in that regard. And I look at it and I see some reckless cuts.
I hope that is not going to be the case in this area.
The administration's budget proposes really slashing the
nondefense spending by $54,000,000,000, and that would include
$15,000,000,000 from Health and Human Services, the
subcommittee that you are appearing before today.
So we are in the middle of this crisis, which you can all
identify, people are dying, and we have to make a determination
of where our priorities are. And instead of starving those
priorities, we need to deal with funding public health
emergencies robustly. We have an obligation to react to this
crisis with the urgency that it deserves.
Which is why, and the chairman knows this, I introduced
something called Public Health Emergency Preparedness Act. It
would provide $5,000,000,000 to the Public Health Emergency
Fund, which the Department of Health and Human Services could
use to combat opioid epidemics.
We have a natural disaster emergency fund, which is between
$8,000,000,000 and $10,000,000,000. I think health emergencies
are equally important as natural disasters are. We should be
able to react to public health emergencies like they are
disasters, because for the millions of affected families they
are.
I have also urged the Food and Drug Administration to
reclassify naloxone from a prescription to an over-the-counter
medication so that more have access to this lifesaving drug.
And above all, the issue that I hear the most about--and,
Mr. Guy, you were very poignant on this issue--we need to
increase access to immediate treatment. Delays to treatment put
lives at risk. And the biggest issue is ensuring that people
can quickly get the treatment that they need, not wait a week,
3 weeks, a month, because we know that that often leads to a
very, very bad outcome.
We need to reduce the stigma surrounding substance abuse.
We need to acknowledge substance abuse for what it is, a
disease, a brain disease.
When individuals get out of treatment and they want their
lives back on track, they run into countless obstacles. They
have a hard time accessing jobs, they have a hard time
accessing housing. And with the work requirements that are
being thought about to be imposed on Medicaid or elsewhere, we
create oftentimes an impossible situation for recovered members
of our communities.
Let me also highlight the importance of the Affordable Care
Act's Medicaid expansion. In many places, Medicaid is the most
significant source of coverage and funding for substance use
prevention and treatment. Many States with the highest opioid
overdose death rates have used Medicaid to expand access to
medication-assisted treatment.
And I will just make a point of noting that that is
something that the American Association for Opioid Dependency
has said, that NIDA, N-I-D-A, has firmly established that
Medicaid-assisted treatment increases patient retention,
decreases drug use, infectious disease transmission, and
criminal activity.
So we have good scientific data which tells us what we need
to do, and the fact is that Medicaid has been used to expand
that kind of access. In West Virginia, Kentucky, Pennsylvania,
Ohio, Medicaid pays for 35 to 50 percent of all medication-
assisted treatment. In some of those States, the uninsured rate
would triple if the ACA were repealed.
If the Republican healthcare bill had passed, 14 million
low-income Americans would have lost Medicaid coverage and
their access to treatment along with it. That is
unconscionable, in my view, and the repeal of the essential
benefits package would have stripped millions of their access
to substance abuse treatment as well.
Lastly, I would highlight the importance of passing a full-
year Labor-HHS bill later this month. There is bipartisan
support for addressing the opioid crisis. That is real. And we
need to pass a full-year bill to show our strong support for
these lifesaving programs by not just level funding these
priorities, but by enhancing their funding. We cannot afford to
wait to act when addiction affects the lives of so many of our
neighbors and our families, our brothers, our sisters, and our
community members.
I want to thank you all for being here today, not, as I
said, for just testifying before us, but for what you have
committed your professional lives to, to help to deal with this
crisis every single day. I look forward, and I know we look
forward to your testimony today.
Thank you, Mr. Chairman.
Mr. Cole. I thank the gentlelady.
I want to next go to the gentlelady, the ranking member of
the full committee. As the ranking member of the full
committee, she is a member of all 12 subcommittees. But she
comes so frequently to our committee, I know we are her
favorite subcommittee.
So with that, my friend is recognized.
Mrs. Lowey. Should I say I love all of my family equally?
Well, first of all, I want to thank Chairman Cole and
Ranking Member DeLauro for holding this very important hearing,
and to our distinguished panel for joining us and for your
important work that you have done on this absolutely critical
issue.
In 2015, opioids, including prescription drugs and illegal
drugs such as heroin, killed more than 33,000 Americans, just
surpassing death by firearms. In my home State of New York more
than 800 people lost their lives, the highest death toll due to
opioids in our history. Sadly, as we await the 2016 data, the
record could once again be broken.
The opioid epidemic knows no gender, racial, or
socioeconomic lines. It is wide ranging. It is everywhere. This
epidemic is destroying lives, breaking apart families, and
wreaking havoc on communities big and small throughout our
country.
Last year, Congress came together to pass the Comprehensive
Addiction and Recovery Act, as well as the 21st Century Cures
Act, providing $1,000,000,000 over the next 2 years to support
State efforts to address opioid abuse.
I do want to share Chairman Cole's praise for my colleague
Chairman Rogers, who couldn't be here today, because he has
really taken the lead on this issue.
As the Federal Government continues to combat this epidemic
a few things are certain. We do not have a single day to waste
with 91 Americans dying each day from an opioid overdose. Our
response must rely on the best evidence of what will work,
knowing that there may not be a silver bullet, and any person
seeking help for substance abuse or mental health should never
be told that help is not available. There are wait lists that
delays treatment or--and I emphasize this point--that substance
abuse or mental health treatment would not be covered by
insurance.
I want to repeat that again. No one in this country should
be told that mental health treatment or substance abuse, and
they are very often interrelated, never should anyone be told
that insurance will not cover their treatment, putting
treatment out of the reach of millions of Americans.
Today, I look forward to hearing from our experts, those
who chose to work in this field and those like Bill Guy who are
called to this work after losing a loved one to the horrors of
addiction. Thank you so very much for testifying and for
sharing your stories with us.
Thank you, Mr. Chairman.
Mr. Cole. Thank you.
We will now go, Ms. Hale, to you for any opening statement
that you would care to make.
Ms. Hale. Good morning. Thank you for giving me this
opportunity to speak with you today. I am Nancy Hale, president
and CEO of Operation UNITE. UNITE stands for Unlawful Narcotics
Investigations, Treatment and Education. UNITE was launched in
2003 by Congressman Hal Rogers shortly after a special report,
``Prescription for Pain,'' exposed the addiction and corruption
in southern and eastern Kentucky.
Many of us were shocked to learn that per capita we were
the top painkiller users in the entire world. Congressman
Rogers and other local leaders feared that if we did not take
swift and decisive action an entire generation would be wiped
out. We held community meetings to find out the scope of the
problem and what should be done. Teachers, preachers, parents,
judges, police officers, everyone we spoke to had stories,
personal stories, and they were ready for action.
Operation UNITE then pioneered a holistic approach that has
become a model for other States and the Nation. Let me start
with the first pillar, investigations and enforcement.
Over the last 14 years UNITE detectives have removed more
than $12.3 million worth of drugs from the streets, arrested
more than 4,400 bad actors, achieved a conviction rate of more
than 97 percent, and processed nearly 22,000 calls to our drug
tip line. But we have long recognized that we cannot arrest our
way out of this unique epidemic. That is why treatment is our
second pillar.
Long-term recovery transforms substance users into healthy
and productive members of their families and communities. We
staff a treatment help line to connect people to resources and
we have supplied vouchers to help more than 4,000 low-income
people enter long-term rehabilitation. In addition, UNITE's
assistance has helped increase the number of drug court
programs in the region from five to one in all 32 counties we
serve.
The final pillar is education and prevention. To make
progress we must not only cut off the supply, but decrease the
demand as well. Our education programs introduce youth and
adults to a life without drugs. We have reached more than
100,000 students thus far.
Federal funding has been critical, from ARC grants helping
us to educate prescribers to SAMHSA's assistance in providing
treatment vouchers. Through AmeriCorps we provide math
tutoring, teach antidrug and wellness curricula, and sponsor
antidrug UNITE clubs. And the results are dramatic. Students
have shown an average 30 percent growth in math knowledge and a
35 percent growth in drug awareness and healthy decisionmaking.
I am pleased that the Federal CARA legislation enacted by
this Congress last year will enable regional organizations like
UNITE to take advantage of these new Federal funds focused on
addressing the opioid epidemic, and I am grateful to each of
you who supported that bill.
Congress' collaboration on CARA must be replicated
elsewhere. In the antidrug world we have to collaborate with
stakeholders across a variety of professions, institutions,
schools, and faith-based organizations.
When it became unfortunately clear that the challenges we
had been experiencing in rural Kentucky had exploded across the
country, we worked to share UNITE's holistic approach through
the establishment of the National Prescription Drug Abuse and
Heroin Summit, now the largest gathering of medical
professionals, advocates, law enforcement, and policymakers in
the United States. Our next summit, by the way, is April 17th
through 20th in Atlanta. Many of your colleagues have attended
in the past and I hope to see you there.
Now I would like to touch on a few of the lessons we have
learned over the last 14 years that may benefit similar
organizations in your home district.
The first is that you must bring all stakeholders to the
table at the beginning. For example, we did not engage the
medical community early enough. It was not until a local
physician was tragically murdered for refusing to give a
patient pain medication that we all rallied together at the
same table.
Second, UNITE could have done a better job working with
families in the beginning, helping them understand that
addiction is a chronic disease and teaching them how to support
their loved ones.
Third, you must have a champion to lead, to motivate, to
encourage, and to fight alongside you, and for us that champion
is Congressman Rogers.
Another lesson is that you cannot expect short-term
treatment to yield long-term results. Models of recovery should
be based on long-term goals.
The final and most important takeaway is that education and
prevention are the tools to achieve those long-term results.
The longer I am involved in fighting this epidemic, the more I
am convinced that education, particularly K through 12
prevention education, is the key to saving our next generation.
And it is only through collaboration and a holistic approach
that we will succeed.
Thank you for your time.
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Mr. Cole. Thank you very much.
Ms. Cimaglio, you are recognized for whatever opening
statement you would care to make.
Ms. Cimaglio. Chairman Cole, Ranking Member DeLauro,
members of the subcommittee, my name is Barbara Cimaglio, and I
oversee Vermont's substance use disorder treatment, prevention,
and recovery system. It is a privilege----
Mr. Cole. Would you turn your mike on?
Ms. Cimaglio. Oh.
Mr. Cole. Thank you very much.
Ms. Cimaglio. I will move it closer. Okay. Is that better?
It is a privilege to be here and it is a privilege to serve
Vermont under the leadership of Governor Phil Scott and Dr.
Mark Levine, the health commissioner. I have held similar
positions in the States of Illinois and Oregon and have been a
longtime member of the National Association of State Alcohol
and Drug Abuse Directors, NASADAD.
First, I would like to thank the subcommittee for the
Federal funding that flows through agencies like the Substance
Abuse and Mental Health Services Administration, CDC, HRSA, and
others. And second, we are very appreciative of the decision to
allocate a billion dollars over the next 2 years to help
support States' work on the opioid issue.
In a time of very tight budgets, we fully appreciate the
significance of this action and the importance of managing
public dollars in an effective and efficient manner.
Vermont, a small State of only 625,000 people, has been
greatly impacted by the opioid problem. This impact is felt in
every community, particularly in most rural areas.
In 2014, heroin overtook prescription opioids as the most
commonly used opioid among those in treatment for substance use
disorders. From 2010 to 2016, overdose death rates more than
doubled.
Although we face many challenges, I am proud to report
actions that are truly making a difference in Vermont. Because
of the opioid problem, we developed our Vermont ``Hub and
Spoke'' model of treatment. This model began when we set up
regional opioid treatment centers around the State to treat
those with the most complex needs with medication-assisted
treatment and counseling. This part of the system represents
the hubs. Primary care physicians who lead a team of nurses and
clinicians in office-based treatment are the part of the system
that represent the spokes.
All patients' care is supervised by a physician and
supported by nurses and counselors who work to connect the
patient with community-based support services. This model
ensures that more complex patients are supported at the
appropriate level of care. In addition, the system ensures
opioid use disorder treatment is part of the overall healthcare
system.
Between 2012 and 2016, medication-assisted treatment
capacity increased by 139 percent. While we still experience
small waiting lists, we are moving toward achieving our goal of
treatment on demand. An initial evaluation of the Hub and Spoke
system suggests that our approach saves money by reducing the
utilization of more expensive interventions. This includes
cutting down the number of hospital admissions and outpatient
emergency department visits, for example.
We also saw longer treatment stays for patients in our Hub
and Spoke system. In 2016, from January to June, 74 percent of
new clients in the Hub and Spoke system were in treatment for
90 or more days, which is the evidence-based recommendation.
Treatment is an important part of our work, but we are also
doing work on prevention, intervention, and recovery. Vermont
supports 12 recovery centers located throughout the State. The
Vermont Recovery Network, through our Pathway Guides program,
initially funded through a SAMHSA grant and now carried forward
through our Medicaid waiver, supports clients in accessing peer
recovery. Of the 216 people connected to a Pathway Guide in
2015, 73 percent sustained abstinence from opioid misuse by a
6-month follow up.
We recognize that investments in prevention services are
critical. Our efforts include funding through the Substance
Abuse Prevention and Treatment Block Grant or regional
prevention consultants who support staff in schools and in
community prevention coalitions.
There are additional initiatives described in my written
testimony, but I will now turn to my recommendations.
First, Federal initiatives must specifically include
involvement of State substance abuse agencies like mine, given
our expertise and authority over the addiction prevention,
treatment, and recovery system. Collaboration with public
health, criminal justice, and other partners should be
expected.
Second, I recommend strong support for the Substance Abuse
Prevention and Treatment Block Grant, a vital part of our
network that averages 70 percent of State substance abuse
agencies' funding for primary prevention, which supports our
community work. These funds form the foundation of a
comprehensive system.
And finally, I encourage Congress and the administration to
continue to work with State-based groups heavily involved in
this issue, including the National Association of State Alcohol
and Drug Abuse Directors and the Association of State and
Territorial Health Officers, and also our parent group the
National Governors Association, which has provided critical
leadership in this area.
Thank you for the opportunity to testify. I look forward to
answering any questions.
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Mr. Cole. Thank you very much.
We will next go to Mr. Guy for your opening statement.
Mr. Guy. Chairman Cole, Ranking Member DeLauro, and members
of the committee, thank you so much for this opportunity to
speak to you today.
It was an unexpected phone call on September the 26th,
2016, that brought the news that our 34-year-old son Chris had
died 2 days before from an injected dose of heroin.
Incomprehensible. Just one brief phone call could evoke such
utter grief and pain. But it is a call that is replicated
thousands and thousands of times every year following the
deaths of those who die from drug overdose in America.
Multiplied missives of misery, thousands and thousands of
times.
Yet, years earlier, on December the 21st, 1981, it was also
an unexpected phone call from the adoption agency that brought
us incredible, exhilarating news. Just 4 days before Christmas,
we were given the best present we could have imagined, William
Christopher Guy.
Chris became a daddy's boy. You would most often find him
either on my lap or in my arms. He loved all creatures, great
and small, puppies, kittens, rabbits, and much to the chagrin
of his mom, frogs, lizards, and snakes.
Chris was a gifted artist. He studied graphic arts. But for
most of his adult life he worked as a cook in good restaurants
in Portland, Boston, Nashville, Oklahoma City. Chris was a
bright and beautiful soul. He was kind, caring, compassionate.
He was raised in church. He was adored by an extended family.
He had such potential, such hope for a bright future.
But unbeknownst to us, Chris was also a drug addict. For
more than 20 years he was trapped in a terrifying house of
mirrors, hoping that this twist or that turn might bring relief
from crippling anxiety and depression, but more often finding
sorrow and pain, guilt and shame.
And for far too long, feeling guilt and shame ourselves for
not being aware of his plight and then not knowing how to help
him, we unwittingly provided financial support that only
perpetuated the misery. We were at a loss, not knowing how to
find help for him or for ourselves.
Finally, with grace, and the help of programs like Al-Anon
and Parents Helping Parents, his mother and I came to realize
that Chris' addiction was an illness, part of an eviscerating
epidemic sweeping this Nation.
On any day in Oklahoma some 700 addicts who need
rehabilitative treatment cannot get it. Waiting lists are long
for State-assisted treatment and there are not even enough
placements for those who can pay for them. For those who work
in jobs with little or no health insurance or who cannot work
because of their illness, the despair can be debilitating.
Chris' addiction was something that he could no more
overcome without professional help then he could self-cure a
cancerous tumor. He tried desperately to get well. He sought
treatment many times, only to be told that it could be days or
even weeks before a placement might become available. On the
streets, with no viable support, he couldn't get the help he
needed, and we couldn't get it for him. It was an abject
nightmare. I cannot begin to describe to you the depths of
despair.
Often compounded by mental health issues, the disease of
addiction is a life-and-death struggle, made even more
debilitating by guilt and shame. Relying on short-term
emergency room care and the incarceration of the addicted and
the mentally ill, without hope of long-term professional
treatment, can doom them to lifelong cycles of disease and
their families to unmitigated agony.
Meanwhile, all of society is paying for it, either
monetarily or emotionally or both. Surely it makes sense, even
if only economic sense, to increase the availability of
preventive education and treatment programs, and isn't it also
the compassionate thing to do?
I join the many families afflicted by this insidious
disease of addiction who are heartened by the bipartisan
passage of the Comprehensive Addiction and Recovery Act and the
CURES Act, but there is much work left to do. In the words of
Saint Francis of Assisi, start by doing what is necessary, then
do what is possible, and soon you may find you are doing the
impossible. Thank you.
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Mr. Cole. Thank you very much.
Ms. Pacula, we will next go to you for your opening
statement.
Ms. Pacula. Chairman Cole, Ranking Member DeLauro, and the
other distinguished members of the subcommittee, thank you very
much for allowing me the opportunity to testify to you today.
As was said earlier, I am a senior economist at the RAND
Corporation and I co-direct RAND's Drug Policy Research Center.
RAND's mission as a nonprofit, nonpartisan research
organization is to produce and disseminate objective
information that can be used to help solve our Nation's most
pressing challenges. Along with my colleagues at RAND, we have
evaluated the effectiveness of various drug control strategies,
and I will share with you today some of the lessons we have
learned that might help inform the Federal response to this
opioid crisis.
First, it is important to say that the strategies involved
take a mix of strategy. No one single strategy will be a silver
bullet for any epidemic. The most effective and cost-effective
mix of strategies, however, depend on where you are at a
particular point of time in an epidemic.
Unfortunately, it is hard to determine exactly where we are
today in the opioid epidemic because it is fueled by two very
different classes of opioids, prescription opioids and then the
illicit heroin and Fentanyl opioids, and these trends are
moving in different direction.
However, it does seem absolutely clear in light of the
level of overdose fatalities experienced today that we are in
the territory where treatment must be part of the policy mix.
And, thankfully, this is where we have the strongest evidence
base regarding the effectiveness and cost effectiveness.
Opioid addiction is, as stated clearly already, a chronic
medical condition that is receptive to treatment, and the use
of medication-assisted therapies, or MAT, including methadone,
buprenorphine and naltrexone, have been demonstrated to be
among the most effective forms of opioid treatment. Research
shows a number of policies have been effective at expanding
access to this MAT, including insurance parity, expanding the
patient limits buprenorphine-waivered physicians are allowed to
treat from 30 to 100, and State Medicaid policies that provide
coverage for buprenorphine and place it on preferred drug
formularies.
Just expanding access to MAT, though, is not enough.
Strategies must encourage delivery of high quality treatment.
Policies and programs that improve training of providers in the
delivery of this therapy, such as those currently being
considered by the Centers for Medicare and Medicaid as well as
ARC, appear promising and could improve the quality of care
received.
When it comes to the other drug control strategies
undertaken by the agencies under the purview of the
subcommittee, the evidence base demonstrating effectiveness is
still developing. In the case of naloxone distribution, there
is solid evidence that naloxone can be safely administered by
first responders and laypersons who are properly trained and
educated in its administration, resulting in a saved life in
that episode.
Questions remain, however, about whether the general
distribution of naloxone leads to a rise in overall overdoses
and there the evidence is thin. I can speak to it more later.
Prescription drug monitoring programs have been evaluated
quite a bit, but the results are mixed. It appears the
effectiveness of these programs can be influenced by certain
elements that are either present or not present, including
mandatory participation of all prescribers and pharmacies,
inclusion of all scheduled drugs, and real-time access and
updating of the system. Recent studies that evaluate the
effectiveness of these more enhanced PDMPs suggest that they
can be powerful at reducing the supply of opioids as well as
the demand and harm associated with them.
Policies emphasizing the adoption of clinical guidelines
for safe opioid prescribing are also frequently advocated,
although usually implemented in combination with other
initiatives, making it hard to understand their effectiveness
alone. In the VA's Opioid Safety Initiative, which was
undertaken in 2013, there they implemented it with aggressive
education of the providers, risk management tools, pain
management strategies for patients in chronic pain, and
improved access to MAT therapy, and substantial reductions in
inappropriate prescribing, total prescribing of opioids, as
well as cutting in half overdose mortality of veterans occurred
from this comprehensive approach.
Given the availability of both legal and illicit opioid
products in many communities, we have to be cautious about
policies focused on solving just one part of the opioid
problem, for example just focusing on prescription opioids, or
just within one particular health system, like the VA, because
people can move to other health systems and do.
The complexity of the opioid epidemic requires a
thoughtful, comprehensive approach to access of all opioids and
careful evaluation and monitoring to avoid the unintended
consequences of any singular policy approach.
Thank you for inviting me to testify, and I am happy to
answer any questions.
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Mr. Cole. I want to begin by thanking all of our witnesses,
because I have got to tell you, you do a much better time of
staying within your 5 minutes than any of my colleagues up here
do on either side of the aisle. So thanks for setting such a
high standard.
In the interim, we have been joined by the former chairman
of the full Appropriations Committee and the current chairman
of the State and Foreign Operations. And if I may say, the guy,
as both sides of the aisle recognize, has done more to focus
Federal attention on this problem and done more to bring
resources to bear to try and help Americans not just in his
district or his State but all across the country than anybody
else.
So it is my privilege to recognize my good friend and
colleague and mentor for any opening remarks he cares to make.
Mr. Rogers. Well, thank you, Mr. Chairman, for those
wonderful words. You went on a bit too much. But like Mae West
once said, too much of a good thing is simply wonderful.
And, Ranking Member DeLauro, thank you for letting me sit
in on your subcommittee. I will be brief, hopefully, and keep
myself out of your way.
I am delighted to see my great friend Nancy Hale here
today. You have heard from her already. But you have heard me
ad nauseam, I think, praise the work of Operation UNITE back in
Kentucky and now across the country, helping us take back our
communities from the grip of drug traffickers and addiction.
And Nancy is a big reason why they have been so successful
in Kentucky. She was a part-time volunteer for UNITE and worked
her way up to be president and CEO, and she keeps the momentum
going in this seemingly never-ending fight.
You have heard me tell the story of UNITE. It stands for
Unlawful Narcotics Investigations, Treatment and Education, a
holistic approach. We can't arrest our way out of this, we
can't educate our way out of it singly, and we can't treat our
way out of it singly. We have to do all of that at the same
time, endlessly and permanently, and that is what UNITE was
organized to do.
Thirteen years ago, we had a horrendous problem in my
eastern Kentucky district, one of the first ground zeros for
OxyContin, people dying and kids in the emergency rooms and so
on. It was new at that time, new to really the world.
So I called together people from all walks of life and we
brainstormed and brainstormed and finally came up with a
concept of this holistic approach. And since that time, for
example at the outset they had 35 undercover agents to cover
about a one-third of the State, 30 counties. They had 35
undercover agents, very professional. And so far they have put
in jail 4,400 pushers just in that part of Kentucky.
We have treatment centers, we have UNITE clubs in schools,
most of the schools that do after-school things make it fun,
drug courts in every county, and so on. It is a holistic and
successful approach. But we are a long way, as Nancy has said,
from being perfect. We have got a long ways to go.
But I am especially grateful that Nancy has taken the time,
especially now, to share her experience. It is a busy time for
UNITE because 6 years ago UNITE decided to take their operation
national and they called a prescription pain drug summit in
Orlando.
Started out with around 1,000 people there. It has now
grown. We will be holding the sixth annual summit week after
next in Atlanta. We will have upwards of 3,000 people there
from every walk of life, every nook and cranny of the country
and the world. We will have congressmen and senators and
governors and attorneys general and treatment experts and
medical experts and NIH and CDC and DEA and ABC at this
conference.
Last year, the President came. He has been invited again, a
different President. So we are hoping that he and/or the Vice
President will join us there.
But it is the only place where all of the disciplines that
make up this fight that we are in come together in a single
place under one roof, because the treatment people need to
understand what the prosecutors are doing and the judges need
to know what the attorneys general think about it and so on.
And it is a great place for sharing of ideas and learning from
each other and taking best practices and spread them across the
country. That is what these summits are doing.
And I hope that each one of you will be there. I am looking
our panelists in the eye and I am looking Members of the House
in the eye, hoping that all of you can be there for the annual
prescription drug summit in Atlanta.
What is the date, Nancy?
Ms. Hale. April 17th through the 20th.
Mr. Rogers. Are you taking reservations?
Ms. Hale. Yes, I have forms in my packet here.
Mr. Rogers. Thank you, Mr. Chairman, for letting me be here
with you.
The fight goes on. It is getting worse, it seems. And we
have got new drugs coming at us like crazy. We have got a
government that must be resilient and adept to switch with the
times and the attack and where it is coming from. That is no
small chore.
But this subcommittee, Mr. Chairman, Ranking Member, you
are on the front line, and we are looking to you as we have in
the past for great leadership. I thank you for letting me
speak.
Mr. Cole. I thank the chairman. And thanks, when you put us
on the front line, you were never shy about giving us bullets.
So thank you very much. The country owes you a lot in many
regards, but particularly in this regard.
Ms. Hale, let me start with you, and then I am just going
to work across quickly.
You know, late President Lyndon Johnson used to say doing
the right thing isn't hard, knowing the right thing to do is.
And you each have had vast experience in this area, but from
very different points of view, and have had a chance to look at
some of the things that we fund from a Federal level.
And, again, as I told you in the back, I am not going to
ask you to name losers, unless you want to, but I am going to
ask you to try and give us--because we will have tough
decisions to make, even with the resources that we have
available, and I share my friend the gentlelady from
Connecticut's concern about that.
But whatever, there is never enough, and this is an area
where we really need to make sure that whatever resources we
have we direct where people that are actually working the
problem think this can make a difference. So I would really
like your opinions for the record on two or three initiatives,
whatever number you care to pick out, that you think Federal
dollars really matter in.
Ms. Hale. I think definitely you have to have that holistic
approach. And we have been very reactionary in this epidemic.
We had to start out really strong in southern and eastern
Kentucky with an emphasis on law enforcement, those undercover
investigations that Congressman Rogers mentioned.
Over the years, we have seen what he was telling us to be
true, that we cannot arrest our way out of the problem. And I
think what we are seeing now is that we have got to move
prevention to the forefront. We have got to be proactive where
we have been reactionary in the past.
And I firmly believe that we are seeing a generation of
young people that need a K through 12 prevention curriculum in
their schools that builds consistently, that is developmentally
appropriate, culturally appropriate.
Two years ago I was in one of our counties doing a program,
On The Move! It is a mobile prevention unit. I was in our
trailer with eighteen 16-year-old boys, going through the
PowerPoint, sharing all the information about gateway drugs,
and we had a great discussion.
And as the boys were leaving to go out of the trailer, one
young man stopped and his body language was very angry. And he
said, ``I have two things to say, two things to ask you.''
And I said, ``Okay.''
And he said, ``One, I want you to know that I have smoked
pot before, but I am not going to anymore, because my goal in
life is to get smarter, not dumber.'' And he said, ``But what I
want to ask you is why no one has told me this before.''
And so I began--we all began to see these young people want
to make good choices. They want to be given the facts, the
information. And that is how we are going to build on people
who make those choices.
So I think our prevention programs are ones that we need to
replicate, that we need to fund definitely, but then providing
vouchers for the treatment programs.
When Congressman Rogers helped establish Operation UNITE,
there were very few treatment facilities in Kentucky, and now
we have many who are opening their arms. We are working with
law enforcement to initiate programs such as the Angel
Initiative, where people can go into the State police post in
crisis and ask for help, and our treatment facilities are
accepting them, and then UNITE is helping to provide them
vouchers.
Those are two.
Mr. Cole. I am going to try to move quickly here or I will
come back to this question because I don't want to rush
anybody.
But, Ms. Cimaglio, the same question.
Ms. Cimaglio. I think you have heard from all of us in one
way or another that the important element is a comprehensive
approach. We aren't going to get ahead of this problem by just
doing a single strategy. And for Vermont it does include
prevention, intervention, treatment, recovery, support, and
others.
Some of the elements of our comprehensive strategy have
focused on public information and messaging. It is critically
important that we have messages that speak to people throughout
the community and throughout our States.
Pain management and prescribing practices. We have
guidelines similar to the CDC guidelines in our State and have
done education with our medical community, because we know that
we have to change the practices of the physicians on the ground
and also be there to support them with how to address addiction
when a person comes into their office and is struggling. What
do I say? Where do I send them? How do I give them help? So
having clear guidelines and education for physicians.
Prevention and community mobilization is critical and I
will leave that there. I think you have heard a lot about that.
Drug disposal. Safe disposal practices on the Statewide
level is something that we have been working on, gearing up for
Drug Take Back Day on the 29th. It has to be easy for people to
dispose of these substances.
Mr. Cole. I am going to have to ask you to stop there
because I can't be tough on the rest of these guys if I am not
tough on me. I will come back to our other two witnesses in my
next round of questioning. I want to go to my good friend, the
gentlelady from Connecticut.
Ms. DeLauro. Thank you very much, Mr. Chairman.
And thank you all very, very much for your testimony.
I just will say to you, Mr. Guy, there is no way that we
can replace the hole in your heart, but I am hopeful that this
subcommittee can help alleviate some of that pain.
Mr. Guy. Thank you, thank you.
Ms. DeLauro. Ms. Cimaglio, just a series of questions very
quickly because I want to try to get to a second question as
well. This has to do, Ms. Cimaglio, with Medicaid and it
serving as the most significant source of coverage and funding
for prevention and for treatment, which you have highlighted as
well as Ms. Hale has.
In some places Medicaid is paying up to 50 percent of the
cost of medication-assisted treatment. Healthcare experts
estimate that 1.6 million individuals with substance abuse
disorders gained health insurance through Medicaid expansion.
So is Medicaid responsible for expanding access to
medication-assisted treatment in Vermont?
Ms. Cimaglio. Yes, it is. We actually had Medicaid
expansion before the Federal Government acted, but it has been
significant. As many as 70 to 80 percent of folks are getting
treatment because of the support of our Medicaid program, and
that has allowed us to expand our Hub and Spoke model.
Ms. DeLauro. Which I want to get to later on, Hub and
Spoke, right.
If the Affordable Care Act is repealed, the States forced
to scale back Medicaid programs, impact on Vermont in terms of
treatment for substance use disorder?
Ms. Cimaglio. Well, as I said, since a high percentage of
people are supported through the Medicaid program, it would be
a challenge and a disaster, I think, if we had to pull back all
of the work that we have done to develop the system.
Ms. DeLauro. In your experience, if you have to interrupt
the treatment because of loss of health insurance, what is the
outcome, what does that mean? If you are on, then you have no
insurance coverage, and then you are off, and then you go you
go back, what is interrupted to your process here?
Ms. Cimaglio. Well, I think there are two outcomes. To the
individual, it disrupts treatment, which is not a good thing,
and we wouldn't want to see that happen. But then that means
that the State picks up the cost. So through our block grant we
would then support to the extent we could, and that is the
Substance Abuse Prevention Treatment Block Grant is the
foundation of statewide system.
Ms. DeLauro. So let me just see if this is accurate. If we
repeal this Medicaid expansion, it does not continue in some
way, if we cut back dollars to Medicaid, yes or no, would it
worsen the crisis in your State of Vermont? Would it affect it
first and would it worsen the crisis?
Ms. Cimaglio. If it cut back access to services it
definitely would affect it and worsen it. And I think each
State has their own approach, but our approach has been very
comprehensive. And we appreciate the talk of flexibility so
that each State can do what they need to do.
Ms. DeLauro. One of the things that has concerned me about
this is that something that you used, you would have to then
deal with how you would adjust to dealing with an affected
population. In my mind, in instances of when I have seen block
granting in this area, is that been a State is forced to choose
who. And that is a Sophie's choice. You begin to take a look at
rationing. Would that not be the case in this instance?
Ms. Cimaglio. It certainly could be, depending on the
extent of the reductions. But as I said, we worked very hard to
get to where we are today in a very comprehensive way and we
would not want to see having to go backwards.
Ms. DeLauro. And if I might add to Ms. Hale and Ms.
Cimaglio, I will ask the question quickly. The Institute of
Medicine has called for 10 percent of public funds to be spent
on young people to be directed toward effective prevention
interventions to promote healthy behaviors. You have talked
about prevention, you have talked about K through 12, or maybe
even preschool.
Does that sound right to you with the IOM, the Institute of
Medicine, say, 10 percent? Would you support that kind of an
effort, 10 percent of public funds spent, directed at young
people?
Ms. Hale. Well, when you have had nothing----
Ms. DeLauro. Ten percent is better than nothing. Okay. I
hear you. I hear you.
I guess I am out of time, but I want to come back in terms
of your prevention programs. You talked about what works and
doesn't. And the SAPT Block Grant, if that were cut by 18
percent. So think about that, what that would mean to you.
Thank you, Mr. Chairman.
Mr. Cole. I thank you.
We next, as tradition dictates, go to the gentlelady. The
ranking member of the full committee from New York is
recognized.
Mrs. Lowey. Thank you, Mr. Chairman. And I want to
apologize in advance because after I ask the questions I have
to go to another hearing.
Mr. Cole. That is why I am going to you next.
Mrs. Lowey. Thank you. But I want to thank you. And I want
to thank Chairman Rogers because we have been working together
and you have done such an extraordinary job.
And to the whole panel, and especially you, Mr. Guy. Thank
you so much for being here today. As a grandmother and a mother
we all feel for the difficult time you went through. Thank you
very much.
Mr. Guy. Thank you.
Mrs. Lowey. Since 1999 sales of opiates in the United
States have quadrupled. I am so concerned about this increase,
particularly as there is no data to support Americans are
facing more physical pain than they did two decades ago. And as
opioids are not intended to treat chronic pain, I cannot fathom
how nearly 300 million prescriptions are written each year.
There is clearly a vast over prescription of opioids. And a
staffer of mine was just telling me as we were preparing for
this hearing, she had a sprained ankle and the doctor gave her
a 1-week prescription for vicodin, for her sprained ankle.
The CDC has been taking steps to provide best practices for
physicians, but much more must be done. And if whoever would
like to respond, or in the time I have a few of you could
respond, what steps should the Federal Government take to work
with providers to prescribe opioids only when necessary for the
health of the patient or in more limited doses? Clearly they
are not doing it now.
Thank you.
Ms. Pacula. So it is absolutely necessary to educate
prescribers, all prescribers, and it is not just physicians.
Dentists can prescribe opioids as well. Vets can prescribe
opioids as well. And opioid-seeking patients know these things.
We need as active an education of our prescribers as we have in
the advertising of the effectiveness of the drugs at treating
pain.
One of the successful elements of the VA strategy was the
pharmacists who are part of this situation being the ones
educating the prescribers, the doctors, the ER people, on how
much needs to be distributed and why it might not be
appropriate to give two overlapping opioids to a patient
because they aren't sure which one they want. Give them one.
Make it restricted. If it doesn't work, have them turn it in
and give them the second one.
There is effective strategies to doing this. They just need
to be disseminated. When we talk about education, this is an
area where it is not just educating our kids--although that is
extremely important--educating the medical community, and by
that I mean it as broadly as dentists and vets as well, about
the risks, about the abuses, and how to identify potentially
patient-seeking behavior and participation in this prescription
drug monitoring programs.
While many physicians are aware of them, States do not
mandate that all prescribers participate. They don't know that
this patient has already received a prescription from another
provider because they don't have access to that information
because their State system is not set up to do that.
Enhancing prescription drug monitoring programs enables
physicians to have access to that information, providers. Vets
can participate, dentists can participate if it is part of the
policies. Let's make it part of the policy.
Mrs. Lowey. I would just--since I have just a minute,
little less than a minute left, I just don't get it. Because if
you are a physician or if you are a dentist, you don't know
what these drugs can do? What does your research show?
Ms. Pacula. I don't know that it is----
Mrs. Lowey. I had a tooth pulled recently, and I said, no,
thanks, and I didn't--well, I didn't take anything. But I don't
get it.
Ms. Pacula. There is a problem in our system in that
physicians and hospitals are ranked in the quality of care that
they are given, and part of that measure of quality is if the
patient believes their pain was effectively managed.
So there is actually in our system a financial incentive to
provide patients with too much medication because the patient
is more likely then to respond that their pain was effectively
managed. We need to educate patients as well as providers, but
there is, unfortunately, misaligned incentives in our
healthcare system today.
Mrs. Lowey. Thank you very much, Mr. Chairman. And I
apologize for having to go off to another hearing.
Mr. Cole. Just a point of information before we move the
next member for my friend. I actually had an interesting
conversation with Dr. Collins at the NIH recently. You may want
to bring this up. Because they are beginning to find--to look
for medicines that don't have opioids that can achieve the same
results.
So we are actually--and I think Mr. English is actually
working on something similar to that. So this is an area we may
want to explore when the NIH comes up here to testify because
it could be a real contribution.
Mrs. Lowey. Thank you very much. And thank you all.
Mr. Cole. Thank you.
We next go to the vice chairman of the subcommittee, the
distinguished gentleman from Arkansas.
Mr. Womack. Thank you, Mr. Chairman. And what a riveting
discussion that we are having here concerning what I consider
to be one of the--if not the most important issue facing our
country today, insofar as the impact it has on young people and
their future development and progress.
I don't know what would be more important. I will say this
upfront, that I believe in my heart that addiction is a disease
and not a moral failing of an individual. And our country needs
to recognize that it is a disease and not a moral failing.
Mr. Guy, when I heard and read your testimony, it became
apparent to me that you, as a parent, became overwhelmed with
the inability to fix a problem.
Mr. Guy. Absolutely. Absolutely.
Mr. Womack. I don't know--short of people having a similar
experience, I don't know what more we can do. There has got to
be some things we can do to help people understand that, as has
been mentioned, that a holistic approach is the only solution;
that you can't just fix certain elements of it; that there is a
progression of these diseases; and that, you just can't lock
them up and throw away the key and hope that the situation per
individual is going to be fixed. Can you?
Mr. Guy. No, you can't. And I would advocate for greater
opportunities for people who are experiencing these kinds of
things to be able to network with each other and to--and, you
know, you addressed a significant part of it, is that there is
still--there is still some degree of stigma and shame, you
know, related to this issue.
And I think that there are some people who are reticent to
reach out, and that is one of the reasons that I have gotten
involved with the program called Parents Helping Parents,
because it is a peer group. The purpose of it--the primary
purpose of it is to provide opportunities for people who are
experiencing this in their families, to be able to come
together to share information, to share resources.
In the Norman Chapter, we provide a lending library. We got
a grant from the United Way to provide a lending library. We
have a comprehensive lending library. We are working with the
police department in Norman because the police department has
told us that they are often on the frontline, if someone
overdoses or if someone is arrested; that they have parents
that were in the situation that we are in that they don't know
what to do. And the police department in Norman has been very
forthcoming in working with us because now they have a resource
to refer people to.
You know, I think preventive education--I think not just
education for children but education for parents as well. And I
think anything that we can do to help people feel like that
they are--I was talking to someone earlier, it is a huge club,
and it is a club nobody wants to join.
But I think the more that we can do to help people see that
even people who are not affected by this personally are open to
helping the people that they are. I think that would go a long
way.
Mr. Womack. There has been some discussion in this briefing
so far about naloxone and its use in the emergency rooms on an
overdose. It just makes sense to me that once an individual has
been treated in an ER setting, that to just--because a lot of
these folks are just going to be released--
Mr. Guy. Right.
Mr. Womack [continuing]. Back out on the street. And those
demons will call again, and those individuals are going to be
back in need.
Mr. Guy. Right.
Mr. Womack. It would seem to me that it would be very
appropriate and worthwhile to get these folks in some treatment
program upon an incident like this. I don't know who might want
to take that for just a moment. I have only got about 20
seconds left in my time.
Ms. Cimaglio. One of the things that Vermont has proposed
in our 21st Century Cures application is exactly that,
expanding partnerships with emergency departments to make those
linkages with peer support workers that can help link
individuals and families to help and support. That is one of
the most frequent comments we hear in the community, that
people need help from other people. And I agree 100 percent
that that is a missing link often.
Mr. Cole. Thank you.
We will next go to my good friend, the gentlelady from
California, Ms. Roybal-Allard.
Ms. Roybal-Allard. First of all, Mr. Guy, I want to join my
colleagues in thanking you for being here and helping to put a
human face on this crisis of opioid addiction.
Mr. Guy. Thank you.
Ms. Roybal-Allard. Ms. Pacula, in your written testimony,
you say the following: ``Improving the quality of medication-
assisted treatment may be particularly important for improving
outcomes for historically underserved or high-risk populations,
such as racial, ethnic minorities, individuals with HIV, and
individuals in rural counties who may not receive effective
treatments for opioid use disorders at the same rate as non-
minority individuals. Policies and programs have improved
delivery of this therapy, such as those currently being
considered by CMS, and AHRQ could be just as important as
expanding treatment.''
As you may be aware, the administration has proposed
eliminating AHRQ next year. Given your emphasis on the need to
improve delivery of medication-assisted treatment, do you think
that AHRQ provides valuable research to help improve the
delivery of services in healthcare settings, and in your view,
is it important to continue to support AHRQ research in this
area?
Ms. Pacula. I can tell you, they absolutely deliver
valuable research. As RAND does receive funding from AHRQ, I
think I have to be honest in disclosing that we do receive
funding from AHRQ to do--and we do find this funding to be
unique, filling holes that are not necessarily filled by the
other funding agencies and have enabled important research on
the effectiveness of not just MAT but other important
activities.
For example, one of the things I was referring to in my
testimony is the integration of primary care and medication-
assisted treatment. In order to administer buprenorphine, you
have to get a waiver from the Federal Government. And those
that do are not necessarily treating all the patients they
could treat under those waivers.
How do we educate more providers to get those waivers in
areas where we have need, and how do we help them understand
how to do this in a way that helps the patient? There is
resistance, because these are difficult patients. And now these
patients are--then become part of your patient mix that are
going to rate your quality. That is not attractive to some
practices. But there are successful strategies and AHRQ has
been at the forefront of trying to evaluate those and
disseminate them.
Ms. Roybal-Allard. Thank you.
Ms. Cimaglio, as was mentioned earlier, despite the fact
that the majority of doctors and other members of the medical
community are licensed to prescribe opioids and other narcotics
to treat patients with pain, most American physicians receive
little or no training during medical school regarding evidence-
based prescribing substance-use disorders and pain management.
And currently, only five States require all or nearly all
physicians to obtain continuing medical education on these
topics.
As my colleague, Ms. DeLauro, mentioned, CDC released
guidelines for prescribing opioids for chronic pain last year.
However, one of the concerns that I have is that not all
medical professionals know of or are even adhering to these
guidelines.
What should be done to--nationally to standardize CME
requirements for all medical professionals prescribing opioid
medications? And should States require that patients receive
multiple ongoing opioid prescriptions, that they should see a
specialty in pain management, such as a pain management
physician or CRNA?
Ms. Cimaglio. Thank you for the question. In Vermont, we
actually have passed State law with basically the CDC
guidelines and probably a little bit more than that in ours.
And all of our physicians have to meet those guidelines, and
that is what our medical practice board uses to evaluate how
the physicians are doing.
We have also increased the number of hours that they need
to receive. So clearly, we do believe that that is an important
aspect. We also require all physicians to enroll and use the
prescription monitoring program. So I think where the States
have the ability to increase their own guidelines and
regulations, I think that is a tool.
I don't know that across the board the Federal Government
can do that. I am just not versed enough to know whether that
is a possibility, but I think anything that can be done through
the associations, through training, through guidelines, is
critical.
We have to change the culture. That is what we are really
talking about here, is using a variety of tools to change the
culture. And make it clear that opioids are not the first
choice, that when you are prescribing opioids to a patient,
there need to be checks and balances to ensure that they are
being monitored carefully.
Ms. Roybal-Allard. What about requiring someone to see a
pain management specialist as part of the process for a cure?
Ms. Cimaglio. Yes. I think if a patient is experiencing
chronic pain, definitely going to see a specialist is an
important element. There aren't enough of them. We struggle
with having access to pain management and pain specialists, but
also alternative and complementary approaches are important.
And so making sure we have the choices and the support for
managing pain that isn't just based on taking a pill.
Ms. Roybal-Allard. Thank you.
Mr. Cole. Next, we will go to my good friend, the gentleman
from Tennessee, Mr. Fleischmann.
Mr. Fleischmann. Thank you, Mr. Chairman.
And to each and every one of the panelists, I want to echo
the sentiments of folks on both sides of the dais. This has
really been a very important testimony for us as policymakers,
and I thank each and every one of you for your participation in
this national epidemic.
Ms. Pacula, your testimony, you addressed that it is too
soon to have an evaluation of the impact of programs in the
Comprehensive Addiction and Recovery Act and the 21st Century
Cures Act. As we begin to provide a framework for these
programs, what factors should we keep in mind as to import the
assessing programs as to their effectiveness?
Ms. Pacula. I think that requiring data collection of
implementation as well as outcomes is vitally important, and
providing broad access to that is important. A lot of work was
stalled on the effectiveness of some of the medication-assisted
therapies because of the redaction of information of patients
who had mental health and addiction diseases from general
health care.
In CMS data, we were not able to get combined data sets
that had both their healthcare utilization and mental health
and addiction until just last year. It was redacted because of
concerns over privacy for people who had these conditions. That
is a legitimate concern. But the inability to do analyses to
see where--primary care prevention is where we need to be doing
addiction therapy. If they are not integrated, we can't
evaluate it.
So I emphasize the need for data on both implementation and
outcomes in order to assess. I think documenting as many--
SAMHSA has done effective programs in getting information out
immediately to the State agencies. And the medical agencies on
those effective programs are also extremely valuable and useful
at this point in time. But I also think that research,
continued research and dissemination of that research is very
important.
Mr. Fleischmann. Thank you.
Ms. Cimaglio, can you discuss some of the efforts you
undertook at the State and local level to develop a strategy
that met the needs for ground, and what factors should States
consider when developing a plan?
Ms. Cimaglio. Well, clearly, having a good plan is an
important part of our approach, and what we started with is the
need to have a comprehensive plan. We gathered information from
around the State. We used data. Our work is data driven. We
look at the National Household Survey, the Youth Risk Behavior
Survey. We look at where the local needs are. We listen to
people in the communities.
So it is a combination of things. But we also are driven by
our healthy people 2020 goals, and our legislature actually
requires that all of the State programs set their own goals and
have measures. And we actually have a dashboard. I can send you
a link to our website. But accountability is a big part of what
we are held to in our State, and we feel it actually has really
helped us improve the quality.
Back to the AHRQ question, we are also asking our
medication-assisted treatment specialty providers to meet the
AHRQ standards for specialty care. Because any tool we have
that shows us how we are doing and how people are measuring up
against standards help us deliver a more high-quality product.
Mr. Fleischmann. Thank you.
Ms. Hale, your work with AmeriCorps and education efforts
seem to be a key aspect of your approach to crisis based on
your testimony. Can you discuss in more detail how you use
volunteers to reach out to young people to keep them drug free?
The reason I ask that, I would go out and I would talk to
students in high schools all the time, and I said, ``Don't do
drugs. Don't smoke pot.'' You know what, sometimes I get booed.
I get booed.
Then I say, well, let me tell you some stories about some
lawyers I knew or I practiced with. They are no longer
practicing law because they have lost their law license due to
addiction or they are dead now and things like that, and then
it gets silent. So please, tell us how you work with your
volunteers?
Ms. Hale. Well, with those, we have 54 AmeriCorps
volunteers in our elementary schools, 54 elementary schools.
But one of the things that they have done is to bring in
volunteers into the school, particularly from the recovery
community. It is important for these young people to hear their
stories. It is important for them to hear--like Mr. Guy's
story, that is how they identify.
And so I think working with the--bringing the volunteers
into the communities. Our community coalitions, we have a
coalition in every one of our counties, and their input--we
were founded on community input and providing programs. Someone
mentioned, you know, not only educating our children but
educating the adults as well.
Our volunteers, we train them to teach programs such as
``Accidental Dealer,'' because many of our students, our young
people are getting their first prescription drug out of their
own medicine cabinets or grandmother's medicine cabinets. And
so using our AmeriCorps members who are trained to pull
volunteers from those communities, the communities know what is
their greatest need.
And they respond. They want to be trained. So in that
aspect--and we are bringing in a lot of volunteers into our
school system to work with our young people who had very bad
experiences when they were in school, in that very same
building, perhaps. And they are beginning to see what they can
do to change the culture for their children.
Mr. Fleischmann. Thank you.
And to each and every one of you all, please continue to do
your great work. I appreciate that so much.
Mr. Chairman, I yield back. Thank you, sir.
Mr. Cole. Thank you very much.
We will next go to my good friend, the gentleman from
Wisconsin, Mr. Pocan.
Mr. Pocan. Great. Thank you, Mr. Chairman and Ranking
Member.
Thank you to the panel for your testimony, and Mr. Guy, for
sharing your very personal story. I appreciate it. The one
thing, I guess, I would add is, we keep referring to the 33,000
people who died from overdoses.
But, you know, I had--one of my very first employees,
almost 3 decades ago, is a family friend, went for about 20
years, worked at a law firm, did very well in New York, kept
moving up, family member died, he wound up, you know, doing
opiates along with alcohol. Finally, after falling down a
flight of stairs and getting $100,000 titanium shoulder, got
some treatment, but it was like a 3 or 4-week treatment, not
the comprehensive treatment you are referring to.
He stayed with my husband and I immediately after that for
a week, because we live out in the country. So he was very
broken. And within a week, he was back to using, and within 2
months, he died from arrhythmia at his house alone in New York,
and they found his body like 10 days later.
There is no question that that death was also caused by an
addiction to opiates. And I think, you know, the more we can
share those numbers, I think that is important too. Because it
is not just the overdose; it is the other actions due to the
addictions.
So the question I have, and it kind of follows up with what
Mrs. Lowey was saying, specifically Dr. Pacula, you are talking
about the VA program. And the VA in Tomah, Wisconsin, is a
facility that was overprescribing opioids, to the point that it
got called Candy Land up there. And we had a lot of issues. We
had a couple deaths related to it. There is inspectors general
report that didn't do a good job, so we didn't quite get to
things in time.
But now they have this opiate safety initiative that you
brought up that is seeming to work really, really well. It
takes a non-prescription approach towards veterans' pain
through variety of things, and they have had a 48 percent
reduction in the amount of veterans receiving opiates and other
similar type drugs.
And nationally, I think it is about a 16 to 24 percent
reduction, depending on the intensity of the drug, we have seen
out of this program. Can you just talk about those kind of
programs, and specifically if--because they have a single,
unified medical system they can keep track of people better as
opposed to people who patient shop at various hospitals and
clinics and dentists and veterans.
Could that approach be used perhaps with Medicare and
Medicaid, and some other ways that we could try to find that. I
am just really curious on the success they have had?
Ms. Pacula. You highlight exactly the feature that made it
very successful by having a unified system as well as a very
comprehensive approach.
One of the things I failed to say earlier is that in
dealing with this, you have to deal with the patients who are
already addicted to the pain medication and figure out how best
to treat them while also preventing new patients from becoming
addicted and dealing with people who obtain them outside the
community. And those strategies differ in a given community.
Implementing what the VA did, aspects of it could be done
in any healthcare system. The extent to which a State
prescription drug monitoring program is made available State-
wide to all prescribers, elements of it can be implemented
regardless of the system because then the physician has
knowledge. You have to provide--of what the patient is getting.
You also have to instill in that physician and any provider
the other options that might be available. VA actively provided
alternative forms of chronic pain management. That was part of
what they were educating their doctors about and what they were
doing in the system.
Private insurance companies are starting to do this.
Medicare with the disabled population is definitely starting to
do this. I can say to you though that only having a certain
number of physical therapy or chiropractic visits covered
leaves you short in the sense that chronic pain is, by
definition, not going to last--is going to last past those 20
or 30 visits.
So thinking about those other options. I think NIH has done
a lot of work to look at alternative strategies that can be
effective in long term. We need much more work. And there are
more people who are more knowledgeable than me who can speak
to----
Mr. Pocan. And just a quick followup, because I have less
than a minute, for you or for anyone who can address. The other
thing is, you know, I look at this as it is a prescription
drug--or prescribed, overprescribed, and then it is
prescription drugs that can help you. And at some point, I know
there is a lot of other natural things including plants.
I know that one of the things we dealt with recently was
kratom, for example, where they are finding that it doesn't
have the same--it has some of the pain-relieving effects for
people, and they have used it around the world, but not the
receptors that give you the high. So it is a way to try to deal
with it naturally.
Is there other work on that, and should we be doing more to
figure out what else is out there naturally?
Ms. Pacula. There are lots of--there is lots of work that
is going on. The evidence of the science--the science base is
very, very difficult, particularly for plants, because dosages
vary in a plant. You don't know how much is being received. So
the gold standards for doing research on these alternative
medications, when they are plant based, is very, very
difficult.
Mr. Pocan. Thank you.
Mr. Cole. I thank the gentleman.
We next go to my good friend from Maryland, distinguished
gentleman, Mr. Harris.
Mr. Harris. Thank you very much, and obviously, a very
important topic. I am an anesthesiologist, and both my
subspecialty and just physicians in general have some role to
play. Unfortunately, they had a role to play, I think, in
getting people into this addiction problem, and hopefully they
have a role to play getting people out.
But let me just get up to a little higher view of what goes
on. I do think that the message that comes from the government
about drugs is important. And, you know, we chuckle, you know,
just say no to drugs, but, you know, we should tell our
children just say no to drugs, bottom line.
I don't know. I was disturbed that the last President was,
for all we know, the first President we ever had who used
cocaine and marijuana and wrote about it. Didn't say it was
wrong, wrote about it. Now, honestly, thank goodness we have a
president who says don't do drugs because of a personal tragedy
in his family of addiction. No question about it.
And we have other issues now because, you know, we have
another trend going on nationwide that I think does--and I know
it is controversial, but I think it does contribute to it, and
that is the spread of recreational use of marijuana, legally.
And, you know, Dr. Volkov, who just presented to the
Doctors Caucus a couple days ago, does believe it is a gateway
drug. Not for everybody, not one-to-one, not exclusive, you
know, every person who uses marijuana is going to go on to have
a more serious addiction.
But because of its interaction with the dopamine systems,
just like nicotine and alcohol, I mean, all these things that
do this, that have cross-sensitization, it actually makes sense
that someone who has used these substances actually might be
more liable to be an addict.
And, you know, we have discussions now going on about
whether or not to enforce Federal drug law. I mean, it is
stunning. I mean, our Federal laws are pretty good. We should--
in my opinion, we should enforce them. But I am going to ask
your opinion, all three of you, about something.
And, oh, by the way, on the subject of marijuana, the
strangest thing that has come up now is--I know because we
just--actually, we just defeated the act in Maryland--is to say
that medical marijuana somehow is good for treating opioid
addiction. You know, maybe in a couple of cases it is, but I
have got to tell you, this is dangerous, when we start talking
about using an addictive drug to somehow think we are going to
treat another addictive drug with no scientific evidence for
it.
Anyway, the surgeon general wrote a report on addiction.
You know, it is about an inch thick. I don't know if any of you
have read it. I doubt anybody has read through the whole thing.
But I was particularly interested, because when I was in the
Maryland legislature, I sat on the Health Committee, and this
was a problem, you know, 10 years ago, 12 years ago. Now it is
an acute crisis, but it was a problem for a long time.
And the debate that went on was whether or not the States
should fund faith-based treatment. And it was stunning to me as
a physician that there are actually people who say, no, we know
it works, we know it actually has a pretty good record; in
fact, relative to other methods, a lot of people believe it
actually has some of the best outcomes. But, nope, we can't
touch it because it has the word ``faith'' in it. It is faith
based in some way.
That bothers me, because if we are really serious about
doing this and doing everything we can, and we are going to
bring the government in to help solve this problem, I think we
have to get over this.
So I am going to ask all your opinions. Do you think that
we should include--and oh, by the way, to get back to the
surgeon general's report, it doesn't mention faith-based
programs in it. And I pointedly asked them, why doesn't it
mention faith-based programs? Well yeah, you know, we should--
you know, it is an all inclusive--everything should be
included. And I say, well, how come you didn't mention the one
that some people think worked the best?
So I am going to ask your opinion, this panel, what do you
think about faith-based programs? Do they have a role? And
should we seriously consider getting over the fact that it has
the word ``faith'' in it if we want to treat this problem
seriously?
Ms. Hale. I will begin with that, if you don't mind. Yes, I
think faith-based programs should be definitely included. I
have a son who is 9 years into recovery, a daughter-in-law who
is 10 years into recovery. And one of the things that both of
them have told me is that in their recovery process, and they
both went through an abstinence-based program, is that they
know that there has to be something between them and that next
pill, that next drink, whatever. And for them, they have
realized, after, you know, 19 combined years, that that faith
provides that element.
You know, when I go home this afternoon, there are a lot of
roads that I can take back to Mount Vernon, Kentucky. But if
you block one of--the road that I am taking, because it was my
choice, because I felt like it was the best route, then that is
going to make me detour or it is going to cause me to be very
frustrated.
And I think that is probably what we have done with the
faith-based treatment programs. We have tried to vilify them
and undeservingly. I think that those programs that worked, you
know, there are other roads to take to Mount Vernon, but if I
choose that one for faith based, I think that we should have
that support.
Mr. Cole. I am going to allow all of you to respond to Dr.
Harris' question, but I would just ask you to be short, given
the time.
Ms. Cimaglio. I can go next. Being a State official, we
support a variety of programs, especially community prevention
programs. And I know there are people involved in faith-based
approaches that are participants and part of managing those. So
we say there are many paths to recovery, and one size doesn't
fit all.
So I think whatever we do at a policy level we need to be
open to a variety of paths that people choose.
Mr. Guy. I would just quickly say that I think that we
should--anything should be considered as long as it works. If
there is research that says it works, it should at least be
considered.
Ms. Pacula. And there is research that suggests that it
does work.
Mr. Harris. Thank you.
Mr. Cole. Thank all of our witnesses.
Next, I want to go to my good friend, a new member on the
committee, distinguished lady from Massachusetts, Ms. Clark.
Ms. Clark. Thank you so much, Mr. Chairman.
And thank you to the panel and the work that you do and for
being here, and especially to Mr. Guy----
Mr. Guy. Thank you.
Ms. Clark [continuing]. For reliving the very worst day and
phone call to help other families. As a parent of three boys, I
thank you from the bottom of my heart----
Mr. Guy. Thank you.
Ms. Clark [continuing]. For sharing your story and your
work.
And in Massachusetts, this is a terrible crisis, much like
Vermont and Kentucky and other States. We have this terrible
bond together.
Two thousand opioid, fatal overdoses in 2016, in
Massachusetts, and it is trending very young. We are really
taking out a younger generation. If you are age 25 to 34, one-
third of all deaths in that age group are opioid fatal
overdoses. And if you are a young man, that is 40 percent of
all deaths in that age group. We have to do better. And we have
to listen to Mr. Guy when he quoted St. Francis by starting by
doing what is necessary.
And Dr. Pacula, as I looked through your testimony, you
talked about medical-assisted treatment expansion of narcan
prescription, drug monitoring, guidelines for safe prescribing,
and talking about prevention and education and hopefully
getting to these young people before they are in the throes of
substance abuse disorder.
Can we do this on less financial support from the Federal
Government? Can it be done with less dollars?
Ms. Pacula. Not right now. If we knew that there were a few
key strategies that were the special sauce, I would say, yes.
But the science isn't there to know what few strategies are the
most effective, and I think we have to take a comprehensive
approach to discover what is.
Ms. Clark. Thank you.
And I wanted to ask Ms. Cimaglio----
Ms. Cimaglio. Cimaglio.
Ms. Clark. Cimaglio. Sorry, I should know this. I too am
from New Haven, so I should know this. Come on. But I wanted
to--we had Secretary Price in last week, and he would not
directly answer my questions, but seemed to be doubtful about
mandating under essential benefits that treatment for substance
abuse disorder and mental health treatment, that we keep that
mandate, instead that we go to more of a cafeteria-style
approach.
So you can purchase for--a variety of different things,
including substance abuse treatment from, you know, your
insurer as need arises. So this is, I guess, in his opinion,
some sort of liberty that you would be able to not pay for this
if you did not opt to.
How do you see an insurance system like that, cafeteria
style, working from what you have seen in Vermont and the need
for comprehensive care?
Ms. Cimaglio. Well, in our State, we have been inclusive of
all of the elements of the plan as it is right now, and we
would not want to go backwards. Behavioral health, mental
health, addiction treatment, is health, and it belongs in
health care just as fixing a broken arm. And it has been too
long, you know; it has been too long that we have had to fight
to have coverage for these afflictions in the package.
And so we absolutely believe that we should continue to
support behavioral health, mental health, addiction treatment
as part of the essential benefit. It is part of what we cover
in our State, and we want to continue to cover it.
Ms. Clark. And I guess, my question--maybe Dr. Pacula, you
could--do you see families who are in the throes of this
crisis, you know, in dealing with this incredible, devastating
epidemic, would they be able to go out and purchase, do you
think--do you see that as a system that would work? Mr. Guy,
maybe you want to address that. I see you shaking your head.
Mr. Guy. No.
Ms. Clark. I have 29 seconds.
Mr. Guy. No, because, you know, although it would have been
difficult for us, we could have perhaps paid for some kind of
treatment. But when you are dealing with an adult son who has
mental health issues, you can't force them, you know, to do
something.
And as I said in my testimony, we are paying for this. We
are paying for it in the most expensive way, and it makes much
more sense to do it by education and prevention and treatment.
Ms. Pacula. If I could add one other point, we are pushing
really hard to get mental health and substance abuse treatment
and education done at the primary care level. And if primary
care physicians aren't reimbursed for that care, they don't
know when the patient walks in, necessarily, unless the nurse
tells them, what coverage the person has.
But if they have to worry about, oh, the patient is going
to have to pay for this or they can't pay for this, should I
deliver it, that shouldn't be part of that decision. It should
be the physician taking the needs of the patient and
considering the needs independent of ability to pay.
Ms. Clark. Thank you.
Thank you, Mr. Chairman.
Mr. Cole. I thank the gentlelady.
I am going to arbitrarily lower us to 3 minutes, just so
that if anybody hangs around, they have got a chance for a
second shot, because we don't have that much time left.
Let me begin with you, Mr. Guy. And obviously, all of us
felt the power of the story and all of us appreciate you being
willing to share it. And not to ask you to relive it in any
difficult way, but you must, like any of us in a situation, try
to think back, what would have made a difference at a critical
time.
I was so struck by your testimony about, you know,
struggling to, you know--what can we do. Just an average
person, average family that gets hit with something like this.
So as you think back, what do you wish you knew that you didn't
know at the time? What do you wish your government or community
could have done for you that we didn't do at the time?
Mr. Guy. Well, that is a really difficult question to
answer. I guess, I wish that there had been some more
comprehensive education programs in school. As you well know,
we have high schools in Oklahoma that have 1,400 to 2,000
students that may have two counselors, you know.
So I think education would have been vital. And I think--
you know, it is not that we were reticent to do anything that
we could do for our child. But if it had been--if it had just
been part of our health insurance coverage that there were no
questions asked, I think that that would have been an avenue
that was open to us that we would have maybe pursued more
vigorously, you know.
You know, we do ask ourselves that question many times. But
I think--again, taking away the stigma, taking away the shame,
providing opportunities for people to network around these
issues, I think that would be beneficial.
Mr. Cole. Well, you are doing your part and doing that just
by being here and making that testimony and being public, and
so we thank you for that.
Mr. Guy. Thank you for the opportunity.
Mr. Cole. You bet.
Let me go quickly--I don't have a lot of time left--Ms.
Hale, to you, because I think you have exactly the same
perspective, having been a classroom teacher and seeing some of
these things unfold and now your activity. What can we do,
again, ahead of time to try and help people before they get hit
this way?
Ms. Hale. I think what Mr. Guy said would be what I would
reiterate for us. We were seeing it in the school system. We
were averaging in our small county of 16,000 a death a week,
according to our coroner. And we did not know how to react in
the school system. Then it came to our own doorstep, and we
were never educated, we were not told. We went to our family
doctor. He was like, I don't know what to tell you. I will try
and call and find some information and things.
So I think, you know, the prevention, making people aware,
there has to be a comprehensive approach, and the support for
families. But I think having people share those stories and
having a greater awareness within our communities, preparing
our families, not only how to prevent but how to support when
that person moves into recovery.
Mr. Cole. Well, we all want to thank all of you today
because that is precisely when you are doing, is sharing
stories that really make a difference.
With that, I go to my good friend, the gentlelady from
Connecticut.
Ms. DeLauro. Thank you very much, Mr. Chairman.
Just a couple of pieces. I think, Ms. Pacula, you will be
interested to know that there is a piece of legislation, which
is Promoting Responsible Opioid Prescribing Act; in fact, it
was introduced in the last session of Congress by
Representatives Mooney and former Chairman Rogers. It is about
removing the link between patients' satisfaction surveys about
pain management and physician hospital reimbursement.
So if you think that is a worthy cause, it hasn't yet been
introduced. It is something that I have cosponsored. I am
hoping my colleagues do, but push people to cosponsor this,
because I think you are absolutely right.
I am just going to make this comment. Ms. Hale, you talked
about the value of your AmeriCorps volunteers. I am going to
plead with you to make your voice heard on that because we are
looking at the potential possibility of seeing the elimination
of AmeriCorps and the Senior Corps, which, as I hear from you--
and it is just a yes or no from you--that has made a real
difference for what you can do.
Ms. Hale. It has, because of their prevention curriculum
that they are teaching.
Ms. DeLauro. Fabulous. Please speak up.
Let me just ask a question with regard to naloxone, and
that is, Vermont has a standing order on naloxone. Some States
have similar processes. I am not going to go through all the
information here, but basically my question is, given that the
experience of a standing order, do you think that this kind of
access should be available in all States? Why are States not
doing this? And do you think naloxone should be reclassified as
over the counter? I am going to ask you, please.
Ms. Cimaglio. Yes. We do have a standing order. We have
tried to spread naloxone throughout the whole State through
emergency responders, police departments, recovery centers,
treatment centers, needle exchanges, et cetera. So I think it
should be available.
I think it is one of the reasons we have been--of all the
New England States, we are the only one that isn't seeing a
statistically significant rise in our overdoses. And I think it
is because of naloxone and our increased access to treatment.
Ms. DeLauro. Over the counter?
Ms. Cimaglio. Yes.
Ms. DeLauro. Over the counter, Ms. Hale, naloxone?
Ms. Hale. I think every life is worth, you know--we have
not really dealt with that that much.
Ms. DeLauro. Okay. Ms. Pacula.
Ms. Pacula. Yes.
Mr. Guy. Absolutely.
Ms. DeLauro. Okay. Thank you.
Do you think--I have just got 27 seconds here--should we
require physicians to follow the CDC guidelines for
prescribing? CDC, understanding, is not a regulatory agency,
but should we require physicians to follow these guidelines?
Yes or no from you guys.
Ms. Pacula. It depends on the patient.
Ms. DeLauro. Okay. Mr. Guy.
Mr. Guy. I don't really--I am not able to comment on that,
but I think it is good to think about.
Ms. DeLauro. Okay.
Ms. Cimaglio. Yes.
Ms. DeLauro. Yes.
Ms. Hale. I think it depends on the patient as well.
Ms. DeLauro. Okay. Thank you.
Mr. Cole. Just for the record, I am tough, but I am not
mean. I would give you the time.
Ms. DeLauro. Well, thank you. If we have any more time, I
will take it later, Mr. Chairman.
Mr. Cole. Okay. Well, we have been joined by one of our
distinguished members, Ms. Herrera Beutler, from Washington.
And in this case, she will get the full 5 minutes because she
did not have an opportunity to participate in the first round.
Ms. Herrera Beutler. Thank you, Mr. Chairman.
Thank you, all, for being here.
I am going to read my first question because I want to get
it out. And this is for Ms. Cimaglio--am I saying it right?
Great.
Our Nation's opioid epidemic has particularly been
devastating for infants, among others. Recent data suggests
that there has been a fivefold increase since 2000 in infants
experiencing drug withdrawal after birth. I have actually seen
this happen in certain instances and a NICU situation. And this
is known as neonatal abstinence syndrome.
We hear gaps about access in treatment across the board,
but I want to ask specifically about pregnant women and
parenting women. The GAO conducted a review of programs and
stated in their 2015 report that the program gap most
frequently cited was the lack of available treatment programs
for pregnant women. And we know this population is incredibly
vulnerable, but also oftentimes extra motivated to seek
treatment, for obvious reasons.
So can you speak to the treatment gaps for pregnant women
and parenting women in both residential and nonresidential
settings, and what would be needed to close that gap? And in
addition, how can we ensure that the States receiving Federal
funds are addressing and prioritizing treatment for pregnant
and parenting women with substance abuse disorders?
Ms. Cimaglio. Well, first of all, pregnant and parenting
women are a priority for our Federal block grant funds, so we
do have to prioritize them, just to be clear on that.
However, I think we, particularly in rural States, struggle
with the availability of specialized programs that serve women
and families. So I think we need more resources that can really
help us provide those specialty programs that cannot only focus
on the addiction but also on the comprehensive needs of those
families in treatment.
In terms of the neonatal abstinence and all that comes with
that, I think a close collaboration with the child welfare
system so that we are reaching the highest risk families and
making sure that we get them into treatment. And also specialty
neonatal units and physicians who have that expertise at our
largest medical center in Vermont, we do have a special
program, and it has been lifesaving.
We are seeing for those moms in treatment who deliver
babies with neonatal abstinence syndrome, those in the program
are experiencing fewer days in the NICU, better outcomes. And
so NAS is not negative if we are doing all the right things,
but we need the resources to make sure that we can deliver
evidence-based treatment.
Ms. Herrera Beutler. Great. Thank you.
And I have a couple--I have one more, one about drug take-
back that I wanted to ask, but I kind of wanted to throw this
one open to the group because it is something I have been
pondering on. I did a roundtable this summer with a--it was
DEA-type folks, it was law enforcement, it was former--or
addicts who have been overcoming their disease. It was a pretty
good, robust group. It was medical providers.
And it was really, for me, a learning experience, what
should I be considering in this epidemic that we are trying to
fight. And it was actually the gentleman to my--who sat next to
me who had been exposed at a very young age, had been
overcoming a pretty serious addiction, but had gone through the
whole--I mean, he went to the end and back.
And he--I am from Washington State. And he commented at one
point because some--I don't know who brought it up, but
Washington State has legalized marijuana for recreational
purposes, not for medical purposes. I draw that distinction.
And he jumped in to comment on it and said it was--he was--and
I am paraphrasing but it was a big mistake, as someone who had
been down a pretty tough road. And he elaborated on that.
And I was just wondering if anybody who has been impacted
by this, if anybody on the panel had any comments on that?
Mr. Cole. I would ask you all to be brief.
Ms. Herrera Beutler. Oh, yes. I have 48 seconds.
Ms. Pacula. We are currently doing research to evaluate the
impact of adoption of these--we have looked at medical
marijuana laws, the recreational laws on the opioid epidemic.
There appears to be a correlation, but the question is who is
changing use. And to the comment about whether it is useful for
opioid treatment, there is no science at all.
To the question of whether or not it could help as an
alternative form of chronic pain management for certain types
of pain, there is suggestive evidence, depends on the products.
Again, it should be done with physician oversight, but it is--
--
Ms. Herrera Beutler. I am interested in that report when it
comes out. And that is probably all I have got.
Thank you.
Mr. Cole. Thank you very much.
I want to next go to the gentlelady from California for 3
minutes.
Ms. Roybal-Allard. Ms. Hale, the drug-free communities
program has been an essential, bipartisan component of our
Nation's substance abuse prevention since its passage in 1998.
And over the years, the number of grantees has increased from
92 original grantees to more than 2,000. However, despite
growth of the program, there has only been enough money over
the years to fund 32.7 percent of the communities that applied
for funds.
I understand that Operation UNITE is part of Carter
County's DFC grant, and that you told us your community has
been--or has seen massive reductions in youth drug use and
improvements in college career readiness and even in graduation
rates.
What do you consider to be the reasons for the success of
the DFC program in your community? And based on your
experience, do you believe we should be putting more emphasis
on investing in effective prevention programs like the DFC
program and Operation UNITE?
Ms. Hale. Yes, I do. I do believe that we need more
funding. Carter County is one of several of our counties in the
Fifth Congressional District that has a DFC community grant.
I think the success to it has been with those coalitions,
that organization of people within that community, within that
county, having the funding to do those education programs, to
provide the awareness, the treatment. It has made a world of
difference in having people who can go into the school system,
who can go into the civic organizations, who can go out into
the community because of the funding that they are able to
provide to bring in programming, to bring in training.
And so the drug-free community grants have been invaluable
in rural Kentucky in helping those communities that are most
hard hit.
Ms. Roybal-Allard. Okay. Thank you.
I yield back.
Mr. Cole. I thank the gentlelady.
We next go to Ms. Clark for 3 minutes.
Ms. Clark. Thank you, Mr. Chairman.
Dr. Pacula, we know that frequently substance use disorder
starts in adolescence, and there are unique brain development
issues continuing on into a person's 20s that can be impacted.
Has RAND studied the particular challenges of looking at
understanding and treating substance use disorder in
adolescence and young adults?
Ms. Pacula. Actually, we have done a lot of work on that,
and we have found that therapies and strategies to some extent
differed than adults in some ways. But indeed, treatment can be
very effective with adolescents, as well as with some adults.
It may need to be a coerce treatment. Not everybody goes into
treatment willingly, with acknowledging a problem, and coerce
treatment can be effective.
Ms. Roybal-Allard. Have you looked at MAT particularly with
adolescence? Have you looked at medically assisted treatment?
Ms. Pacula. I don't know. I can get back to you on that.
Ms. Roybal-Allard. You mentioned it in your testimony, and
part of the figures we were looking at was that as of 2014, a
study was done, 89 percent of people struggling with substance
use disorder did not receive treatment. And you mentioned that
sometimes there is a cultural or perception of a practice that
may be driving part of that.
Can you give us a better sense of why doctors aren't taking
advantage of MAT as an population for their patients? Is there
a structural, a regulatory, a cultural problem?
Ms. Pacula. There is a concern about replacing one
addictive good with another addictive good. Because medication-
assisted therapy is not something that everybody can go off of.
It is for some. It is a life-long medication, just like some
people need to have blood control medication. And depending on
the nature of the product, it could have similar effects on the
body.
Our methadone in the U.S. is different than the methadone
delivered in, say, Australia, which actually still has
psychoactive properties. Our methadone does not. So the long-
term implications are not as severe. But there has to be,
obviously, a willingness to consider for certain patients. The
right form of therapy will depend on their own beliefs about
their willingness to initiate this therapy.
We use these things for detox all the time. The question is
whether or not we maintain it for long-term therapy. The
struggle with treatment, why treatment sometimes doesn't work,
is it is too short. They leave and they overdose. Medication-
assisted therapy can reduce those cravings, but there is the
concern about being tied to another substance.
Ms. Clark. And in my last 15 seconds, do you think it is
helpful to be working with doctors, in particular, to identify
and address substance abuse disorders and dealing with pain
prescriptions? It seems like it is an area in medical school
that isn't as covered as much as we might think.
Ms. Pacula. Absolutely.
Ms. Clark. Thank you.
Thank you, Mr. Chairman.
Mr. Cole. You bet. Thank you.
We next go for our last questions to the gentlelady from
Washington, Ms. Herrera Beutler.
Ms. Herrera Beutler. Thank you, Mr. Chairman.
Obviously, we are inundated with prescription medications.
And what I have seen in this whole conversation and have heard
so much about is people have leftovers, and they put them in
their medicine cabinet. And in a family, you have all members
of a family coming in and out of those rooms where those are
stored.
And I think there are--you know, I have seen some
stewardship models that are great. I think the biggest
challenges are at the county level in some areas, in some
States. And there is no State-wide take-back program. I mean,
there is a 1 day--or there is an event, but there is nothing
big picture that is ongoing, because you don't know when you
are going--you know, when you don't need it anymore and what
you are going to do with it. It may not coincide with that 1-
day event.
So beyond the DEA's take-back event, where can the Federal
Government invest resources efficiently to ensure that the
unused medications are safely disposed of? That is for anybody.
Ms. Cimaglio. Yeah. I can say, in our State, we have done a
lot of work on this. And the biggest question we get is why
can't pharmacies take back unused medication. They have the
permits to hold and dispense; why can't they be the ones who
also take it back?
Because for law enforcement, they are worried about
amassing large quantities and the security of their evidence
rooms and so forth. So that is the biggest question that I get
is, why can't the Federal Government do something about the
pharmacy's responsibility.
Ms. Herrera Beutler. Any other thoughts on that?
Ms. Hale. One of the things that we have with Operation
UNITE is going through our coalitions. We have a take-back box
in every county in the sheriff's office, but we did a great
deal of educating with the sheriffs, with the community on how
important it was to dispose of those medications properly. It
has been extremely successful.
Our detectives are the ones who go in and empty those and
work with the DEA in keeping track and everything of that. But
it has taken a great deal of education to help people realize
the importance of proper disposal and working in the
communities.
Ms. Herrera Beutler. And with my last 46 seconds, on my
last question about marijuana use, I didn't know if anybody
else had any thoughts?
Ms. Hale. You know, I think when it comes to marijuana, I
have to go back to what Yoda said in Star Wars: ``Mind what you
have learned. Save you it can.'' And I think we can look back
at the history of tobacco, we can look at the history of
alcohol. And, you know, knowing what we have learned from Dr.
Volkov, from NIH and things, you know, do we need a third legal
drug that can do the damage that we now are realizing, like
tobacco and alcohol did.
Ms. Cimaglio. And we come back to the importance of
prevention. Whatever we do, we have to keep our focus on the
prevention.
Mr. Guy. I will tell you that we know now that our son
started smoking marijuana when he was twelve. I don't know
whether that led to his subsequent death, you know, nobody
knows, but that is fact.
Ms. Pacula. And it can be tied with tobacco. I spoke to
high schoolers just last year, and they were completely unaware
that there was marijuana in vape pens. They thought they were
just doing flavored oils and possibly nicotine, not realizing
that some of them do, in fact, contain marijuana. So educating
adults and children on how this is getting to them is also very
important.
Ms. Herrera Beutler. Thank you.
Thank you, Mr. Chairman.
Mr. Cole. Anytime you have run a hearing where the figures
quoted range from St. Francis to Yoda, you know you have
covered a lot of ground. I want to congratulate you, but I want
to call on my friend, the ranking member, to offer any final
observations or comments that she cares to.
Ms. DeLauro. Thank you again, Mr. Chairman.
I was struck by this headline, and it is a story that
appeared in my local papers, but it is about Milwaukee. And it
is, ``Youngest Opioid Victims Are Curious Toddlers,'' which
is--this is a staggering article.
Sorry we did not get to talk about hub and spoke, but maybe
we can do that offline. And just to mention that I think what
you have said is that there is the importance of the substance
abuse prevention and treatment block grant. That is critically
important. Please make your voices heard. There may be an
attempt to cut that program by about 18 percent. That would be
devastating.
Mr. Chairman, there is this article St. Louis Post-
Dispatch: ``Social Change and Economic Disappointment Create an
Epidemic of Deaths by Despair.'' Sometimes we lose track of
what the effects of potentially economic despair have in
people's lives.
I just think, this is a study that has been done by two
Princeton University economists. They found that between 1999
and 2014 middle-age, 45 to 54 white Americans with a high
school education or less died at a rate never before seen in a
modern industrial society. Suicides, drug overdoses, liver
disease caused by alcohol poison, and that is what they have
classified as death by despair.
What they--in the report to Brookings, they suggest that
while income inequality and wage stagnation may play a
background role, it is a lifetime of cumulative disadvantage
catches up with the demographic.
A slice of the population hit the job market as low-skilled
jobs were being mechanized, computerized, globalized. They grew
into adulthood as cohesion-building social institutions like
marriage, family, and churches became weaker. They didn't have
spouses often, pastors, work buddies, or kids to back them up.
They did have opioid painkillers that added fuel to the flames
making the epidemic much worse than it would have otherwise
been. They found that among men in the labor force, nearly half
are taking pain medication most often by prescription.
Mr. Chairman, I just say that if we do not begin to
understand the economic issues that people face in their lives,
and oftentimes the disasters that are not of their making and
that relationship to what we are seeing today in drug
overdoses, suicides, and other ways in which people's lives
are--and health ways being affected, then we are not going to
be able to do the job that we were tasked to.
These problems are all related and interconnected. And you
have to address all of them. And you have got to walk and chew
gum at the same time if we are going to help to try to make a
difference in people's lives.
You are really, truly remarkable individuals that we have
heard from today. Thank you so much.
Mr. Cole. Would the gentlelady like to submit the article
for the record?
Ms. DeLauro. I would very much like to do that.
Mr. Cole. Without objection.
Ms. DeLauro. Thank you very much.
Mr. Cole. I just want to conclude again by thanking each
and every one of you. In many cases, you have come from a long
way away and you have got very important stories and very
important expertise to share with this committee and the
Congress as a whole and, frankly, through them, beyond that to
the American people.
I appreciate more than I can say the fact that you were
willing to do that. Believe me, your testimony--as you could
see, the committee was awfully engaged and awfully moved by
what you had to say.
I also want to tell the committee members how proud I am of
them, because I can tell you, they all did their homework. I
don't know how many times, I read your testimony, I did that.
And, again, that is a sign of the seriousness, and it is also a
sign of how respectful they are of your expertise your
contribution here today.
So, again, thank you, very, very much.
Mr. Guy, in particular, thank you. All this testimony was
helpful. Yours was probably the most personally difficult to
deliver but probably the most important for us all to hear,
because we all know, there for the grace of God go I.
And we all know somebody else or some other family that has
walked this same very difficult journey. And it is important
that the personal dimension here be put on this because I think
that is the most compelling thing to get people to act and to
change.
As Ms. Hale said, stories make a lot of difference. And
anecdotes and, you know, and humanizing something so it is not
just statistics and policy, you know, is a powerful motivation
for political change.
Again, I want to thank my good friend, the ranking member.
This was a great hearing. And with that, we are adjourned.
Wednesday, May 17, 2017.
OVERSIGHT HEARING--ADVANCES IN BIOMEDICAL RESEARCH
WITNESSES
DR. FRANCIS COLLINS, DIRECTOR, NATIONAL INSTITUTES OF HEALTH
DR. ANTHONY S. FAUCI, DIRECTOR, NIH, NATIONAL INSTITUTE OF ALLERGY AND
INFECTIOUS DISEASES
DR. GARY H. GIBBONS, DIRECTOR, NIH, NATIONAL HEART, LUNG, AND BLOOD
INSTITUTE
DR. JOSHUA A. GORDON, DIRECTOR, NIH, NATIONAL INSTITUTE OF MENTAL
HEALTH
DR. DOUGLAS R. LOWY, ACTING DIRECTOR, NIH, NATIONAL CANCER INSTITUTE
DR. NORA D. VOLKOW, DIRECTOR, NIH, NATIONAL INSTITUTE ON DRUG ABUSE
Introductions
Mr. Cole. Good morning. We will go ahead and bring the
committee to order because I want to try and stay on time.
There seem to be other activities this morning that seem to be
distracting people, but we are going to do our work.
Anyway, good morning. It is my pleasure to welcome you to
the Subcommittee on Labor, Health and Human Services, and
Education to discuss the National Institutes of Health and the
recent advances in biomedical research. We are looking forward
to hearing the testimony of Dr. Collins.
And I would like to publicly thank Dr. Collins and the
staff at the NIH for hosting our subcommittee members and
myself for our annual briefing and tour at the NIH campus in
February. As usual, all the members learned a lot about the
important work that you do every day to improve the health of
Americans and people around the world.
Investment in NIH has been the key driver in making the
United States the world leader in biomedical research and has
led to vast improvements in life expectancy and the quality of
life. The NIH is the primary source of funding for basic
medical research not only on the NIH campuses, but also at
2,500 universities and research institutions in every State.
I am very proud that Congress increased NIH funding by
$2,000,000,000 in the fiscal year 2017 omnibus spending bill.
Congress also passed the 21st Century Cures Act last December,
which will build upon and greatly enhance the efforts to find
cures for diseases such as cancer and Alzheimer's.
I was, therefore, especially disappointed to see a proposed
budget cut to the National Institutes of Health this year. I am
concerned that the reductions in the request would stall
progress that our recent investments were intended to achieve
and potentially discouraging promising scientists from entering
or remaining in biomedical research.
Personally, I believe that continued investment at the NIH
is extraordinarily important to bending the cost curve on
healthcare in general for the American people. It is also the
key to protecting the American people from pandemics like Ebola
and Zika, which will certainly happen again in the future.
And finally, I think keeping America at the forefront of
this is not only important for us in terms of our healthcare,
it is important for our economy and, frankly, it is important
for American global leadership. It is something this country
can be extraordinarily proud of as a contribution, not only to
the well-being of its own citizens, but to people all over the
world.
We have been a very blessed country and we have
responsibilities, honestly, in accord with those blessings, and
this is one of the areas in which I think our country can be
proud, wherever you are on the political or ideological
spectrum, of the contributions we have made as a people to the
well-being of all of humanity.
I look forward to hearing about the recent progress in
biomedical research as well as about how the NIH will focus
resources on its top priorities in the upcoming fiscal year. I
intend to work with you going forward to maintain momentum
towards developing new treatments and cures for diseases while
achieving efficiencies and being a responsible steward of
taxpayer dollars.
I welcome, of course, Dr. Francis Collins, the NIH
director, to the subcommittee. Dr. Collins is accompanied by
five of his institute directors, who can assist answering
specific member questions. They are Dr. Anthony Fauci, the
director of the National Institute of Allergy and Infectious
Diseases; Dr. Doug Lowy, the acting director of the National
Cancer Institute; Dr. Gary Gibbons, the director of the
National Heart, Lung, and Blood Institute; Dr. Joshua Gordon,
director of the National Institute of Mental Health; and Nora
Volkow, the director of the National Institute on Drug Abuse.
As a reminder to the subcommittee and our witnesses, we
will abide by the 5-minute rule.
Before we begin, I would like to yield the floor to my good
friend, the ranking member, the gentlelady from Connecticut,
for any opening remarks she cares to make.
Remarks Rep. DeLauro
Ms. DeLauro. Thank you very much, Mr. Chairman.
And I too want to welcome Dr. Collins, director of the
National Institutes of Health, as well as Dr. Lowy, Dr. Fauci,
Dr. Gordon, Dr. Gibbons, Dr. Volkow. Thank you. Thank you so
much for being here this morning to discuss the future of
funding for the National Institutes of Health.
The sheer talent on your side of the table cannot be
overstated. You and the work that you do with the NIH represent
the power to do more good for more people than anything else
within the purview of our government.
The NIH is the leading biomedical research entity in the
world, and my colleagues on the subcommittee have often heard
me say that medical research is special. A breakthrough at the
NIH saves not just one life, but potentially millions over
generations to come. That breakthrough can improve the life of
not just a sick individual, but the lives of their loved ones,
caretakers, and friends. That is what the NIH represents. As a
survivor of ovarian cancer, this is personal to me.
Everyone on this committee recognizes the importance of
restoring purchasing power for the NIH, and I want to say a
thank you to Chairman Cole and all of the members of the
subcommittee for their bipartisan work to support NIH research
in the past. Last year Congress showed once again that the NIH
is a bipartisan priority by providing an additional
$4,800,000,000 over 10 years through the 21st Century Cures
Act.
The Trump administration's budget proposal, however, would
eliminate that entire amount in just 1 year by cutting
$8,000,000,000 from the NIH. This would decimate the NIH,
reducing the agency's research purchasing power to a level not
seen since the 1990s.
We cannot turn back the clock on lifesaving biomedical
research. This is not just theoretical. When we face a public
health emergency, NIH research is often our best tool to combat
the tragic loss of life. You take Ebola. Just Friday, the World
Health Organization declared an outbreak in the Democratic
Republic of the Congo, which is why the work that you are doing
to develop a vaccine remains critically important, not just for
public health, but for global security. It is clear that the
Ebola crisis is not over.
Last week, one of my committee staff members visited Puerto
Rico to meet with the principal investigator of a phase II
clinical trial of the Zika vaccine candidate. The vaccine
candidate was developed by the NIH. Those are NIH dollars at
work.
The administration's budget proposal would also completely
eliminate the Fogarty International Center. This program
represents only a sliver of the NIH's budget, yet it has an
outsized impact on the prevention and the mitigation of
outbreaks abroad. Their work helps to ensure that diseases are
quickly contained and never reach our country.
The Fogarty Center has actively increased capacity in
countries facing health crises like Ebola, they have trained
some of the best practitioners on the ground, accelerating
discoveries and building essential infrastructure. As we have
seen with the diseases like Ebola, Zika, HIV/AIDS, public
health emergencies know no borders.
In fiscal year 2016, the NIH funded 35,840 grants. In 2017,
under the omnibus we passed just 2 weeks ago, the NIH should be
able to fund an additional 1,500 grants. This is the direction
that we need to be moving in. But a cut of $8,000,000,000, like
the administration has proposed, could eliminate approximately
5,000 to 8,000 grants. In Connecticut, a cut of the NIH
magnitude could result in our State losing our $100,000,000 or
over 250 grants.
Sixteen years ago, NIH funded about one in three
meritorious research proposals, but today that rate has fallen
to about one in five, a slight improvement over recent years,
but still low by historical standards. We are missing
opportunities to work toward cures for life-altering diseases
that affect far too many people. Those unfunded grants
translate to medical discoveries not being made, lives not
being saved.
We are choosing to hamper our progress as a Nation, we are
choosing to ravage our medical community, and it makes you just
wonder why we would move down that road. And even without this
proposed cut, NIH's budget has declined by nearly
$6,500,000,000 since 2003 when you adjust for inflation.
While the NIH is now funded at an all-time high of
$34,100,000,000 thanks to the $4,000,000,000 of increases over
the last 2 years, funding has not kept pace with the rising
cost of biomedical research. Think about the choice we would be
making if we cut already insufficient funding even further.
In the last Congress, I introduced the bipartisan
Accelerating Biomedical Research Act, which would reverse the
devastating funding cuts to the NIH and attempt to provide
stable, predictable growth for years to come. It would untie
the hands of the committee, it would allow us to go above the
caps. This is the same mechanism that we use for the healthcare
fraud and abuse account. This would set us on the path of
doubling the NIH budget, as we did in the late 1990s under
Chairman John Porter.
Investing in the NIH creates jobs, because biomedical
research is a driver of economic growth. And diminishing the
NIH's ability to conduct basic science research would result in
fewer discoveries, which would lead to fewer cures and
therapeutics being developed by the private sector because of
basic science research that the NIH does.
I am almost inclined to dismiss the administration's
budget, but I cannot ignore it. It would be a disservice to the
American people to pretend that it does not exist. It does
exist. In fact, senior officials like HHS Secretary Tom Price
and OMB Director Mick Mulvaney have tried to defend it.
There is no defending cutting thousands of research grants.
The budget would inflict immeasurable harm on one of the jewels
of our scientific research. This proposal should be dead on
arrival. We should be talking about increasing the NIH's budget
by $8,000,000,000, not cutting it by $8,000,000,000.
I thank all of you. I look forward to your testimony and I
look forward to your new discoveries today and your new
discoveries in the future. Thank you for the work that you do.
Thank you, Mr. Chairman.
Remarks by Rep. Lowey
Mr. Cole. I thank the gentlelady.
And we have been joined by the ranking member of the full
committee, and we will move to her. Just for purposes of
announcement, we may well be joined by the full committee
chairman, and if that is the case, I will certainly recognize
him when he arrives for whatever opening remarks he cares to
make.
So with that, it is my great pleasure to yield to the
gentlelady from New York for whatever remarks she cares to
make.
Mrs. Lowey. Well, a lot going on this morning.
Thank you very much to my friend Chairman Cole and Ranking
Member DeLauro for holding this hearing. I would also like to
thank our distinguished panelists, Dr. Fauci, Dr. Gibbons, Dr.
Gordon, Dr. Lowy, Dr. Volkow, and Dr. Collins for joining us
today.
I never thought I would be troubled by a hearing on Federal
funding for the NIH. Ordinarily, this is one of the best
hearings of the year with the leading scientists in the world
on groundbreaking medical breakthroughs, and partisan politics
usually falls by the wayside as we marvel at the advances your
work is making to improve the lives of Americans.
And I must say at the outset, I look forward to working
with our distinguished Chairman and Ranking Member and all the
members of the committee in a bipartisan doubling of the money
to the NIH, because I remember I served with John Porter. I
don't know what that wonderful smile is, but I thank you, Mr.
Chairman. I am not going to read your mind. I will leave that
for anybody else. But I look forward to working together,
because we have done it before and I hope we do it again.
So it is with this spirit that this committee negotiated an
increase of $2,000,000,000 for the fiscal year 2017 spending
bill, and yet a dark cloud hangs over us today. The Trump
administration has proposed an $8,000,000,000, or 24 percent,
cut to the NIH budget. I barely can say it. This would result
in 5,000 to 8,000 fewer annual research grants, a direct
assault on universities' research centers by targeting so-
called indirect costs, and the elimination of the Fogarty
International Center.
These cuts would decimate biomedical research and the
economy. According to a recent study, it would amount to losses
of nearly 90,000 jobs, more than $15,000,000,000 in economic
activity. In my home State of New York, nearly 6,500 jobs would
be lost and communities would take a $1,300,000,000 hit
economically.
As for medical research under the Trump budget, America
would cede our global stature, medical advances could be
stalled, suffering would increase, and for many, the cure that
is right around the corner would now be out of reach.
At a time when the NIH is taking the lead on the Cancer
Moonshot, precision medicine, the BRAIN Initiative, and so much
more, we must commit to increasing funding, not abiding by
arbitrary and misguided attacks on the NIH and science itself.
Earlier this year, members of this subcommittee met with
researchers at the NIH. We heard from scientists devising new,
more effective ways of targeting prostate cancer and
researchers doing groundbreaking work on understanding the
working of the human brain. We capped off our day meeting with
a group of young researchers. These men and women will lead
medical advances for a generation if we continue to invest in
their impressive work.
And I do want to say, because I visit schools and labs all
the time, and we don't want to see these young researchers
decide, ``Hmm, I am going to be out of work next year. I better
go to Yahoo and Google.'' I don't want to say there is anything
wrong with Yahoo and Google, but we want to make sure there are
continued incentives so they work on your absolutely essential
lifesaving investments.
The Trump budget signals that the United States will no
longer be the leader in biomedical research, that these young
researchers should look abroad to pursue their careers. If a
budget is a statement of our values, then this one is a slap in
the face to the scientific community and, frankly, to the men,
women, and children depending on research to save and improve
their lives.
I do hope my colleagues will join me in defeating the Trump
proposal. We have a responsibility on this committee to do so.
We cannot slash these vital healthcare and economic engines.
And thank you again for all you do to improve the lives of
Americans. And I look forward to your testimony.
Mr. Cole. I thank the gentlelady. And just so she knows, I
was smiling at your opening remarks because you reminded me so
much of my mother, who used to, any accomplishment, would say,
``Oh, that was wonderful,'' and then nudge me and say, ``But I
think you could do a little better.'' So it is always good to
have my friend with us.
Mrs. Lowey. I just have to say that I have confidence in my
friend, the chairman. And I know as we move forward, not as his
mother, but as a good friend--at least he didn't say
grandmother--I know, as a good friend, we will work together,
because this committee has always been on the lead. And thank
you for your kind words. I love my mother.
Statement of Dr. Collins
Mr. Cole. You would have loved mine. She would have loved
you as well, by the way. But, again, I thank the gentlelady for
her comments.
And, Dr. Collins, we want to go to you for any opening
statement you care to make to the committee.
Dr. Collins. Well, good morning, Chairman Cole, Ranking
Member DeLauro, distinguished member Mrs. Lowey, and all of you
distinguished members of this subcommittee. It is an honor for
my colleagues and me to be here before you today.
I especially want to thank you for the recent
appropriations increase for fiscal year 2017, which built on
your fiscal year 2016 investment. And I promise you, your
sustained commitment to NIH will ensure that the U.S. remains
the global leader in biomedical research, with all that means
for human health.
I am going to ask you to turn your attention to the screen.
Today I would like to highlight several areas of exceptional
opportunity, including a few patients whose lives depend on
advances, along with some young investigators who are working
hard to make these dreams come true.
INVESTING IN BASIC SCIENCE
Let's start with an opportunity that shows the
transformational power of investing in basic science at NIH.
Imagine you could determine the precise molecular structures of
proteins targeted by pharmaceuticals and see exactly how they
interact with each drug. This is starting to happen thanks to a
new technology called cryo-EM.
This image you see here shows in atomic-level detail the
structure of a protein channel of great interest. The channel
is indicated in gray mesh here. And this channel regulates salt
and water balance in the lungs so that it can travel through
that channel from inside to outside of the cell.
1. CYSTIC FIBROSIS
This protein is a famous one, but we just learned its
structure 2 months ago. It is the one that is miscoded in
people with cystic fibrosis, or CF, our Nation's most common
fatal genetic disease.
New structural information is key to designing better drugs
to help patients with CF, like little Evelyn Mahoney, who will
be celebrating her second birthday in just a few weeks.
Evelyn's life hasn't been easy. She required surgery for an
intestinal blockage shortly after birth. But she is doing
pretty well now. Just a few decades ago, she probably wouldn't
have been able to make it past her teens, but no longer. Today,
we have two FDA-approved targeted drugs for cystic fibrosis and
much more to come, all building on NIH-supported basic
research. And we are not done. Our goal is to turn CF into a
100 percent curable disease.
For that, we need the next generation of scientific talent.
Among those early stage investigators tackling this challenge
is Stephen Aller of the University of Alabama. Trained in both
computer science and biology, he plans to transform, using
cryo-EM, in fundamental ways how we design and deliver drugs
for all kinds of conditions.
2. SICKLE CELL
A second case. Treatments only exist for 500 of the 7,000
diseases for which a molecular cause is known. Among those in
desperate need of breakthroughs is sickle cell disease, a life-
threatening disorder in which red blood cells are deformed in a
way that clogs small blood vessels. Sickle cell disease is
caused by a genetic misspelling. It was understood 60 years
ago, but we still can only cure this by a bone marrow
transplant from an unaffected donor.
Now, that can work really well for some patients, like
Chris Sweet, who is shown here with his family. Chris received
a transplant at the NIH Clinical Center 6 years ago and is now
essentially cured. But unfortunately, most patients with sickle
cell disease don't have a well-matched bone marrow donor, and
it is too risky otherwise.
So what if we could actually correct that genetic sickle
misspelling in a patient's own blood cells. A few years ago, I
would have said that is just not likely, but no more. NIH's
Courtney Fitzhugh is seeking to use a new gene editing system
called CRISPR to modify the bone marrow stem cells in people
with sickle cell disease. The goal is to fix the underlying
genetic defect and make the patient's own cells healthy.
If Courtney and other young scientists can get this to work
for sickle cell disease, and I believe they can within a
decade, just imagine what they might do for thousands of others
still awaiting a cure.
3. CANCER
Another tough challenge is cancer. Imagine a world in which
we could consistently and reliably cure this long-time foe. In
your visits to NIH, you have met folks with advanced cancer who
are enrolled in clinical trials of immunotherapy. One of them
shown here is Judy Perkins Anderson, here meeting with
Secretary Price and researcher Steven Rosenberg. Judy came to
NIH with breast cancer that had already spread to her liver,
the dreaded stage 4. All efforts at chemotherapy had failed.
Her only hope was a trial that sought to activate her own
immune system to attack the cancer, yet this approach had never
worked before for breast cancer.
First, one of Judy's tumors was removed. The immune cells
in it were examined. It turned out those immune cells were
asleep and not going after the cancer as they should. So Dr.
Rosenberg's team grew these cells up in a lab dish and took
them to school, taught them what to look for, and those
educated cells were then infused back into Judy, and a battle
raged.
Now, a year and a half later, it is clear Judy's immune
system won. She has no signs of disease. She appears to be
cured from metastatic breast cancer. What an amazing story.
But sadly, immunotherapy doesn't always work this way. We
have miraculous outcomes and then we have disappointments. We
need to understand why, and for that, we need to better
understand the human immune system.
4. YOUNG INVESTIGATORS
So enter Matthew Spitzer of the University of California
San Francisco, who is creating a detailed atlas that will help
reveal the many ways in which human immune cells can be
activated. If young scientists like Matt succeed, they will
expand the promise of immunotherapy, not only for cancer, but
potentially for other conditions as well.
So all of us here are motivated by a sense of urgency to
help patients in need of breakthroughs. The next generation of
innovative and passionate young researchers will be the most
critical part of achieving that brighter future. Our Nation's
health and well-being depend on your strong support for them.
So thank you, Mr. Chairman, and we welcome your questions.
[The information follows:]
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CONTRIBUTIONS OF BIOMEDICAL RESEARCH IN BENDING COST ON MEDICARE AND
MEDICAID
Mr. Cole. Thank you. And let me begin by, number one,
congratulating you on your distinguished stewardship there, Dr.
Collins. And every member of this committee is supportive of
you and appreciative of the way in which you have interacted
with all of us.
I have got a question, because these cures individually are
startling and they are wonderful and they are inspiring, quite
frankly, but we also live in a time with very tight budgets and
have to make very tough choices on this committee.
And I think one of the compelling arguments, and I would
like you to expand on this if you care to, for this is actually
the ability to bend the cost curve on some of these awful
diseases. Everybody up here knows how much money we spend
through Medicaid, for instance, on Alzheimer's. It is literally
$250,000,000,000-plus a year. And it is the right and
appropriate thing to do, looking after Alzheimer's patients.
But if we could do something that either slowed or
positioned us in a way that we could ultimately reach a cure,
not only would human life be incomparably better, but,
honestly, it would be a huge boom to the Treasury and a pretty
strained budget as well.
So I would like you to talk about some of the ways in which
some of the things you do at NIH not only help us individually
and cure these awful diseases, but also contribute longer term
to bending the cost curves on Medicare and Medicaid.
Dr. Collins. Well, thank you for the question, because that
is one of our major goals and part of our mission, and we are
making headway in a substantial way. When we talk about cancer,
it may come up that the death rate from cancer is dropping by
about 1 percent per year, and that has been happening now for
almost 20 years. That is slow and we wish it was faster, but
the progress is happening, based upon molecular understanding
of this disease. Each 1 percent drop in cancer deaths is
estimated by economists to be worth $500,000,000,000 to our
economy. So just that small part of what we do has a big
impact.
Look at what has happened with heart attack and stroke.
Deaths from heart attack and stroke now are down by 70 percent
over where they were 40 years ago, much of that based upon NIH
research followed by good implementation of our discoveries
across the board.
And you mentioned Alzheimer's disease. I just want to show
you this diagram of just how serious it is that we have to
attack this problem.
So here we are in 2017, the cost to our Nation is estimated
at $259,000,000,000 right now in taking care of the roughly 5
percent of people who have that condition, with all that means
for their caregivers and lost economic benefits from those
folks being able to work. And in 2050, the estimates are that
it will be over $1,000,000,000,000. It will absolutely break
our budget if we don't come up with something.
Thank you to the Committee, because the fiscal year 2017
Omnibus added an additional $400,000,000 to our Alzheimer's
disease research budget, which is in the green bar, but you can
see it is still modest compared to what we are facing. We
promise you every dollar of that will go into identifying ways
to prevent and treat this disease to try to bend that cost
curve, which is one of the scariest ones around.
I could also mention diabetes. It is now costing us
$300,000,000,000 a year in our healthcare, and we need to come
up with better ways. And with things like the artificial
pancreas, just for the first time getting to the point of an
FDA-approved version of that, we are on the way. But it takes
that kind of focus. And it is a long-term investment. It is not
a sprint, it is a marathon.
INVESTMENT IN YOUNG INVESTIGATORS
Mr. Cole. Well, thank you for that. And as my good friend
the gentlelady from Connecticut suggested during her remarks,
we went a dozen years without significant increases at the NIH,
and in the last 2 years have reversed that trend.
Let us know, if you can--we often talk about--my friend
from New York always likes to set the goal of doubling. My goal
has always been just sustained regular increases. And what sort
of difference would it make in your long-term planning if you
could think forward and know, okay, every year we are going to
sort of make this modest investment and keep these research
dollars coming? And what would it do in terms, in your opinion,
of decisionmaking of younger people thinking about long-term
careers in biomedicine?
Dr. Collins. Well, I really appreciate your question,
because we think about that a lot. And you are right that young
people right now are particularly concerned, because they are
under stress. What was traditionally a one chance in three of
getting funded, now it is down to one out of five is putting a
lot of stress on those new careers. Are they going to be able
to get up and going?
For me, as the NIH director, what we would most like to
plan on would be a stable, predictable trajectory of research.
The roller-coaster model is really destructive both for our
trying to plan projects and for people staying in the field,
who wonder: Is there a career path for me?
What you have done the last two years, which is essentially
inflation plus about five percent, has been a wonderful
recovery from what was a long, difficult time since 2003. And
for NIH to be able to stay on that kind of trajectory would be
enormously beneficial for all of medical research.
Mr. Cole. Well, I thank you.
And with that, I want to go to my good friend the
gentlelady from Connecticut for whatever questions she cares to
ask.
FOGARTY CENTER'S ROLE IN BIOMEDICAL RESEARCH
Ms. DeLauro. Thank you very much, Mr. Chairman.
Just on that note, I would hope that we could have a
discussion about what is now the bipartisan Accelerating
Biomedical Research Act, which deals with predictability of
growth for years to come, and that is the opportunity to look
at going above the caps the way we do, as I said, for the
healthcare fraud and abuse account. We do this. This is not
something that would be new. And that way we would be set on
that path to make sure that we are dealing with inflation every
year as we move down the pike. So I hope we can have a
conversation about that.
Dr. Fauci, I wanted to ask you--first of all, let me say,
your point on cystic fibrosis was very touching, because I was
in school with, one of my college classmates, with a brother
and sister who both died with cystic fibrosis. Their dad was a
physician and could do nothing to prevent their deaths. So
thank you for that work.
Dr. Fauci, again, interested in understanding the impact of
eliminating the Fogarty International Center. It is my
understanding that to stop infections with a pandemic potential
in their tracks, whether we are looking at flu from Southeast
Asia, MERS from Saudi, hemorrhagic fevers from Africa, Zika
from the Americas, other kinds of potential pathogens in animal
reservoirs, that it requires global investment that includes
scientists and labs.
So can you talk about the Fogarty Center, the role that it
has played in your work when you are dealing with emerging
infectious diseases? Is it value added? And let me just follow
that up with what, the Fogarty trainees, what role have they
had in administering the Zika vaccine trial that NIAID is now
running and what would happen to that research?
Thank you, Doctor.
Dr. Fauci. Well, thank you for the question, Ms. DeLauro.
The last part of your question really is the fundamental
basis of the answer, which is the people that the Fogarty
International Center trains. If you look just historically at
what we have been experiencing over the last many years and
even as recently as the last few years, from A to Z, from HIV/
AIDS to Zika, all of the things that are threats to us here in
the United States, but that are global issues that need to be
addressed at the global level. And virtually all of the
collaborations that we have, starting from the HIV clinical
trial units that we have in South Africa, if you look at the
leadership of those individuals, almost all of them have been
trained in one way or another at the Fogarty International
Center.
If you look at the situation with Ebola, there were some
very difficult times that you might remember, because we
discussed this at a committee hearing, where individuals who
were infected in West Africa traveled to places like Mali, but
the outbreak was completely suppressed there because the people
who were in charge of managing the outbreak were Fogarty-
trained people. The same occured when the epidemic went to
Nigeria, the people in charge were Fogarty-trained people.
These are people that are our brothers and sisters in what we
do.
And your last part of the question regarding Zika, we now,
as I have mentioned to you before, have a network to implement
our Phase II clinical trial of Zika, which is going on right
now predominantly in the Americas, in South and Central
America. Several of the investigators who are leading that
Phase II in country on the ground, for example, in Peru, are
people who were trained by the Fogarty International Center.
So the Fogarty International Center is really part of our
army of defense against diseases that will ultimately have an
impact right here in our own country. Even though they are
foreigners, they are helping us to be protected from disease.
Ms. DeLauro. I would just say, at the same time the Fogarty
Center is working to build an infrastructure in those
countries, that without that infrastructure there would be a
greater burden on us to engage. But we are building the
capacity of these countries to be able to deal with infectious
diseases or any crisis.
Dr. Fauci. An example of that is Mali. If you look at the
Malaria Research and Training facility in Mali, it is developed
by, run by, and implemented by people who were Fogarty trained.
Ms. DeLauro. Thank you.
Let me just if I can--maybe we have to come around again--
this is about a vaccine update, Dr. Fauci, on your efforts to
develop an Ebola vaccine and treatment, the Zika vaccine
candidates. And you may have to come around at the next go-
round here. And I am interested in the longer-term efforts to
develop a universal flu vaccine, as well as a vaccine for HIV/
AIDS, and I would like to have you update us on those kinds of
efforts that you have been engaged in over the years.
So I think my time has run out, so I will get you on the
next go-around.
Dr. Fauci. I will get back to you on that.
Ms. DeLauro. Thank you.
Mr. Cole. I thank the gentlelady.
Before I go to my good friend, the ranking member of the
full committee, just a quick history lesson, which I just got
from late Representative Fogarty's daughter, who came to visit
us. I did not know this, but he was, I guess, elected when he
was 27, that the institute is named after, served until he died
of a heart attack at 53.
Well, there you go. Of course, there is never anything my
ranking member doesn't know.
Ms. DeLauro. Mr. Public Health.
Mr. Cole. Yeah. But served on this committee for 20 years,
16 as chairman, the longest-serving person ever to serve on
this committee. So we probably ought to have one picture up
here someplace. I am going to talk to my chief clerk.
Ms. DeLauro. That would be great.
Mr. Cole. It would be right up there.
With that, let me go to my good friend, the ranking member
of the full committee.
BENEFITS OF GOVERNMENT'S INVESTMENT IN BIOMEDICAL RESEARCH
Mrs. Lowey. I want to thank my good friend again for
conducting this hearing and an opportunity to meet with such a
distinguished panel.
As you can tell, I am very upset with the 24 percent cut
requested by the Trump administration, because it will result
in more human suffering and more lives lost that could have
been saved. And yet the administration is dismissive of the
impacts, arguing that the private sector can pick up the slack
and that advances in innovation would not suffer. I am worried
that not only would the U.S. Government and research
institutions be decimated as a result of these cuts, but the
private sector itself, which relies on NIH research, would also
be harmed.
Dr. Collins, is it even feasible for the private sector to
invest enough to bridge this funding cliff, and what would
these cuts do to private sector research and economic
development?
Dr. Collins. Well, it is very interesting. Just two weeks
ago the White House convened a meeting of leading CEOs in the
biotech and pharmaceutical company arena, as well as leading
academics from some of our Nation's most highly regarded
institutions, as well as NIH and FDA. That was attended by very
high-ranking people in the White House, including a brief visit
with the President. And for the two hours of that meeting, the
conversation was very much along the lines of what you are
talking about.
America's efforts to develop new medicines and prevent
disease is the envy of the world. Clearly, we have led in this
space for decades. And yet, the leaders from the private sector
were quick to say that is in large part because of the success
of this ecosystem where NIH, through support from your
committee and from the taxpayers, carries out the basic
science, makes those discoveries that allow light bulbs to go
off that something might then be brought to clinical benefit.
But if we were not doing the basic science, the companies were
quite clear, they would not be able to, their stockholders
would not necessarily appreciate them putting money into things
that are not going to be connected to a product.
So between the industry effort, the academic effort
supported by NIH, venture capital, philanthropy and advocacy
groups, the conclusion of that group was we have an amazing
engine for discovery, something that was called in an op-ed by
Eric Schmidt and Eric Lander a ``miracle machine,'' because it
produces miracles.
But you don't want to put some sand in the gears or find
that there is some part of the machine that has sort of run out
of its particular maintenance. And they were quite clear that
anything that would reduce the inputs from industry or from
academia or from NIH would put this country at risk. And they
were very clear about the potential of losing our lead to
China, given the massive investments that are happening in
China in this very space. China has read our playbook. They
want to become us, and I don't blame them, but we should be
sure that we are still us.
E-CIGARETTE RISKS
Mrs. Lowey. Okay. You noted the popularity of e-cigarettes
has led to more kids getting hooked on nicotine and that e-
cigarettes meet the criteria for an addictive substance.
Dr. Collins, Dr. Volkow, what are the health risks
associated with e-cigarettes? What makes e-cigarettes
particularly dangerous for children and adolescents? If you
could answer that quickly.
Dr. Volkow. There is limited research with regard to e-
cigarettes, but what we do know from that limited research is
that it appears that, first of all, if they are used to deliver
nicotine, they are addictive. Nicotine is an addictive
substance. And what we are observing is teenagers that
otherwise would have no transition into smoking combustible
tobacco are doing so after they get first exposed to electronic
cigarettes.
So we are concerned that all of the advances we have made
on prevention of smoking may be lost by the accessibility of
these electronic cigarette devices.
Mrs. Lowey. So since I have 45 seconds left, it is no
question in your mind that it is a gateway to cigarettes?
Dr. Volkow. For teenagers when they use it with nicotine,
yes.
Mrs. Lowey. Otherwise they wouldn't be calling it Yummy
Bummy and pretending with all these names that you attribute to
candies that they put on cigarettes.
Thank you very much.
And thank you, Mr. Chairman.
Mr. Cole. Absolutely.
We will next go just on the basis of arrival to my good
friend the gentleman from Tennessee, Mr. Fleischmann.
UPDATE ON NEW ``GRANT SUPPORT INDEX'' (GSI)
Mr. Fleischmann. Thank you, Mr. Chairman.
And, Dr. Collins, and to your entire panel today, I am the
eternal optimist, so I am going to say thank you for all of
your past successes and your current endeavors to really
address all of the medical maladies that affect human beings.
So thank each and every one of you all for your great efforts.
This committee and the Medical Research Committee have
continued to voice concerns over the pipeline for the next
generation of researchers. This is a question for Dr. Collins,
sir. I am interested to learn more about the new Grant Support
Index you are considering. While I know the process is early, I
do have some basic questions I would like to see addressed and
would appreciate you keeping my staff informed as you move
forward.
First and foremost, should the GSI be implemented, what
follow-up actions are you considering to ensure it has the
desired effect of funding and sustaining more early career
investigators? Second, are you considering steps to ensure we
do not inflict unintended harm on current scientific progress?
And, thirdly, in the interest of time, sir, finally, are you
considering mechanisms that might allow exceptions on the caps
for situations where they might hamper or roll back progress or
where they do not align properly with some of the unique
research structures that are out there?
Thank you, sir.
Dr. Collins. Thanks for those questions. This is a topic of
intense conversation right now amongst all the institute
directors and our biomedical research community.
The basis for this proposal that we might consider using
this Grant Support Index is the graph that you see here. This
tells you what happens in terms of productivity per dollar by
the best metric we have got, which depends on publications and
their impact, as a function of how many grants a particular
investigator is currently holding. And on the Y axis is that
measure of impact, and on the X axis there is the number of
grants.
So you can see the curve actually kind of flattens out. As
one goes above, about three grants per year, it gets pretty
flat. And that says that those dollars are not giving us as
much of an impact as if they were perhaps given to somebody who
had no grants or maybe one and was going for two. This is new
data. It is based upon a whole lot of metrics that we have
developed and analytics that we now have. That is our
motivator.
Now, we have to be very careful in making broad, sweeping
conclusions from that, but it does suggest that if we are going
to be good stewards of the taxpayers' money, which is our
charge, we ought to look at those individuals who are in that
flatter part of the curve. They are still producing great
science, but dollar for dollar, perhaps not quite at the same
level. It could be that we redistribute those funds to younger
investigators or mid-level investigators who are not as well
funded but still have a lot of potential.
So we want to be sure that if we do this, and it is still
under discussion, that we follow carefully to see what happens,
where do the dollars end up, that we don't cause harms, and we
will need to have an exceptions process to be sure that there
is no harm done to exceptional individuals. One of the things
we are figuring out, is we don't want to penalize people who
are doing public service, for instance, with a training grant
or running a center, which maybe isn't that much benefit to
them personally, but helps the whole community.
So we are deep into that kind of sophisticated
conversation. Every one of our advisory councils is discussing
this issue. This month, we had a stakeholders conference call.
It will be a topic for my Advisory Committee to the Director
coming up in just two weeks. And ultimately, then, we will
figure out what makes the most sense here. But we are
determined to take some action now that we have this data.
Mr. Fleischmann. Thank you, Doctor.
With that, Mr. Chairman, I will yield back.
Mr. Cole. Wow. That is unexpected. Thank you. But Ms. Lee
thanks you even more.
Ms. Lee. Thank you very much.
Mr. Cole. I recognize the gentlelady from California, my
good friend.
UPDATE ON HEALTH DISPARITIES AND HIV/AIDS
Ms. Lee. Thank you. Good morning. And thank you all for
being here and for your great work. Really, we are looking at
an institute and individuals who are really making a difference
in terms of saving lives and extending lifespans for so many
people. So thank you.
I have to agree with my ranking member in terms of doubling
the budget. That is what I want to see. And I will tell you
why. And I will try to ask all my questions very quickly.
The Office of Minority Health, for example, has been
critical in identifying racial and ethnic health disparities,
which have existed since the beginning of time really. And that
is why we need more money, to really begin to close that gap--
those gaps--and you have been critical in creating and
implementing programs that address health disparities. Without
the National Institute on Minority Health and Health
Disparities, I don't know where we would be.
And, so, I would like to just ask you what some of the
efforts are at this point as it relates to health disparities
research and applied research, and with a focus on social
determinants of health and how is that going to be carried out.
Secondly, with regard to HIV and AIDS, I know the office
had been flat funded for a while now, and you know that the
global fight against HIV and AIDS, it is really at a tipping
point in terms of the critical window that we have now to turn
the tide of the epidemic. And I am wondering where we are in
terms of the development of vaccine and what really the effects
of a stagnant program would mean in terms of future progress in
this area.
And also, of course, the National HIV/AIDS Strategy, where
are we on that? I haven't heard back from the administration on
how we are proceeding. I would like to know that.
Thank you again.
Dr. Collins. Thanks for the questions.
In terms of NIMHD, we are very fortunate to have recruited
a leader of that effort, Eliseo Perez-Stable, who has come in
with a lot of really good ideas to try to increase our focus on
health disparity research, including bringing more actual
research projects into the Institute, which we are pretty
excited about.
I am going to ask Dr. Gibbons to say a quick word about a
particular study that has very recently happened that looks at
this issue of health disparities in terms of cardiovascular
disease, and then I will ask Dr. Fauci to answer your question
about HIV/AIDS and vaccines.
HEALTH DISPARITIES AND STROKE
Dr. Gibbons. Well, thank you for that question.
Certainly we have made tremendous progress in reducing
cardiovascular disease, over 71 percent over the last 50 years.
But with that progress, we recognize that not all communities
have benefited from the fruits of those research investments
and we have to do more. Indeed, there are a lot of disparities
that relate to race and ethnicity, in which those communities
lagging behind, particularly African Americans, who have
hypertension, and are predisposed to stroke.
We are also noting geographic disparities. A recent report
came out this week that indicated there are certain parts of
our country where, in fact, maybe things are going the wrong
direction. In fact, life expectancy may be shortening. And it
is particularly disturbing, because it is affecting America's
heartland. There appears to be a swath in the middle of the
country from the hills of Appalachia, western Virginia,
Kentucky, Tennessee, Arkansas, over to Oklahoma, Mr. Chairman,
and down the Mississippi River Valley, Louisiana, Mississippi,
and Alabama.
And this is really a call to action, I believe, that if we
are going to reverse that trend, we have to address some of the
challenges those communities are facing, and a lot of those
relate to both social determinants, as well as adopting and
getting access to healthy lifestyles.
HIV AIDS RESEARCH
Dr. Fauci. The microphone is not working. We are all
flashing, but I can speak loud.
There are two aspects of HIV/AIDS research that you asked
about: one, the status of an HIV vaccine, and two, how what we
do in terms of research has an impact on the National AIDS
Strategy for the United States.
With regard to HIV vaccines, what we have right now is, I
think, a considerable amount of progress. There are a couple of
things that happened since we testified before this committee
last year. We have implemented the amplification of the
original Thailand trial.
You recall the famous RV144 trial, which showed a 31
percent vaccine efficacy in Thailand. We have now used that
same protocol to amplify the vaccine strategy used in RV144
with multiple boosts and an adjuvant to start a Phase II b III,
vaccine study in South Africa with a version of the virus that
is now circulating in South Africa. That is one component of
HIV vaccine development.
The other component is the use of broadly neutralizing
antibodies in a passive transfer study called AMP, Antibody
Mediated Prevention, which just a few months ago was started in
southern Africa. If that trial proves the concept that the
broadly neutralizing antibodies work, we would use the same
structural, biological, and cryo-EM techniques that Dr. Collins
just described to determine what the right conformation of a
vaccine immunogen would be, and I think we would see some
really important advances in HIV vaccine research in the next
year.
Finally, how does the NIH have an impact on the National
AIDS Strategy? As you well know, you were involved in that
strategy, the number one component of the National AIDS
Strategy is to prevent and decrease the incidence of HIV
infection in the United States, and there are a number of
things that we have done to amplify that.
One is pre-exposure prophylaxis, or PrEP, which is highly
successful in preventing HIV infection when used. And the other
one is the implementation of treatment as prevention. We know
now from studies from San Francisco, New York, and other places
that if you treat HIV-infected individuals and bring their
viral load to below detectable level, the chances of them
transmitting the infection to someone else is virtually zero.
We never like to say ``zero'' in biology, but it certainly is
close to that. If we implement these strategies based on NIH
studies, we are going to make the first component of the
National AIDS Strategy a success.
Mr. Cole. Okay. With that, we will move next, again on
order of arrival, to my good friend from Michigan, Mr.
Moolenaar.
EMERGING AND REMERGING INFECTION DISEASES
Mr. Moolenaar. Thank you, Mr. Chairman and members of the
panel.
And I also just want to thank you for the chance to tour
the NIH and your hospitality. I thought that was very
informative, and I appreciate that.
I am going to address these questions, I guess, to Dr.
Collins, and then if there are others who you feel are the best
to answer the question, feel free to send them over. But over
the last several months, many experts and news reports have
raised concerns about our Nation's level of preparedness to
deal with a possible new pandemic or emerging infectious
diseases.
And I am asking what additional steps that you believe need
to be taken for the United States to strengthen our level of
preparedness and allow us to develop effective countermeasures
and treatments posed by emerging infectious diseases.
And I also just wondered if you might comment on the role
outside research partners play in battling these threats and
any insights you have on what additional things Congress could
be doing.
Dr. Collins. Well, very appropriate question. I am going to
ask Dr. Fauci, as our lead in that area, to answer.
Dr. Fauci. Thank you very much for that question.
Now, obviously, when one addresses emerging and reemerging
infectious diseases it is not a one-agency issue. It has to be
a cooperation and a collaboration. So one of the mechanisms
that we have within the Department of Health and Human Services
is called PHEMCE, the Public Health Emergency Medical
Countermeasures Enterprise, and that involves the NIH, BARDA,
the Biomedical Advanced Research and Development Authority, the
FDA, the CDC, and other components, including interagency
partners, like the Department of Defense.
The role that NIH has is to provide the research to be able
to respond one by, one, understanding the disease, exactly what
we did with Ebola and what we are doing with Zika; and two, to
provide resources and reagents and capabilities of people in
the field to be able to address the disease. Again, we
successfully did that with Ebola, and with Zika. There are
other examples, but those are the two most recent ones. We also
have done it with Chikungunya and other diseases.
And then, finally, we work to develop the research
capability to respond with countermeasures, of which there are
three main types: diagnostics, therapeutics, and vaccines. And
right now what we see are some successes, and I hope we can
continue to make progress. For example, the Ebola vaccine,
which may be deployed against the outbreak in the Democratic
Republic of the Congo because of what we learned from NIH-
supported trials for Ebola in West Africa, in the three most
affected countries.
Another example is that we are in the process of a phase II
vaccine trial of a DNA-based Zika vaccine that was developed at
the NIH's Vaccine Research Center. There are about four or five
leading candidates for a Zika vaccine. One of them the DNA-
based candidate, is advanced enough that if we have outbreak
conditions as we get into the summer in Puerto Rico, we will be
able to have hopefully what we call a vaccine efficacy signal,
namely, knowing if we actually have a vaccine that works.
So we are the research component, but by no means the only
component of how this Nation responds to an outbreak.
UPDATE ON BRAIN INITIATIVE
Mr. Moolenaar. Okay. Thank you. Thank you for the update.
And just to switch gears a little bit, my understanding is
that pathophysiology--am I saying that word right,
pathophysiology--of central nervous system disorders is not as
well understood as in other diseases, such as infectious
diseases or cancer. The 21st Century Cures Act authorized
funding for the BRAIN Initiative. I just wondered if you could
update us on your plans.
The hope is, I know, to fill major gaps in our current
knowledge of how the brain enables the human body to process,
store, and retrieve information at the speed of thought. I am
just wondering your plans on how that funding will be used, and
is it your intention to devote the full amount of funding for
this research?
Dr. Collins. I will ask Dr. Gordon, who co-leads this
effort with Dr. Koroshetz at NIH, to answer your question about
the brain, which is something we are all very excited about.
Dr. Gordon. So as you noted, central nervous system
disorders are particularly challenging for physicians and
researchers alike because we know so little about how the brain
works. And the BRAIN Initiative is really meant to jump-start
our efforts to really get down to the nitty-gritty of how
neurocircuits produce behavior and how dysfunction within those
neurocircuits produce disorders in the central nervous system.
We are very grateful to the work of this committee and
other Members of Congress to continue support for the BRAIN
Initiative both through the Cures Act that was passed and
signed in December and also through the appropriations in
fiscal year 2017, which gave us an extra $100,000,000 for the
BRAIN effort.
All of those funds will be devoted to the BRAIN Initiative.
And the BRAIN Initiative's targets over the past several years
and for the next couple of years are really to develop novel
tools that we can use to explore the relationship between brain
activity and function and dysfunction.
And over the next couple of years, you will see us pivoting
in a few directions. One, dissemination of those tools
throughout the neuroscience community so everyone can take
advantage of them. Two, education and training of new
researchers. Three, data sharing, so that we make sure that all
the data that everyone generates through the BRAIN Initiative
is available to all researchers to maximally take advantage of.
And then, four, trying to figure out how to use these tools to
make an impact on illness.
Mr. Moolenaar. Okay. Thank you.
And now we will go to my good friend from Wisconsin, Mr.
Pocan.
INDIRECT COSTS, 21ST CENTURY CURES ACT, AND MARCH-IN RIGHTS
Mr. Pocan. Thank you, Mr. Chairman.
And thank you, Dr. Collins and everyone, for being here.
First, I just want to say I associate myself with the
remarks from our ranking member on the subcommittee and on the
committee about concern over the cuts to NIH that could be
coming under the Trump budget. You know, the University of
Wisconsin-Madison Morgridge Center gets a lot of assistance. It
is a world class research facility doing a lot of amazing work.
I was a journalism major, so I took physics for poets. I
don't pretend to be someone who fully is in the science realm.
But when I go visit companies and see some of the research and
learning about 2D and 3D cell technology, it is really amazing
stuff that is going on.
So I have three questions I am going to try to put out,
three different areas, so the best we can try to answer them.
The first is on--when Dr. Price was here--on indirect
costs. I have a real concern, because it was greatly implied
that the cut proposed is basically the indirect costs that are
often spent by facilities, that is just the cuts, you won't
hurt research with the cuts proposed by the Trump budget.
But reality, it is the indirect costs, and other nonprofits
have lower levels. We know that Ford Foundation recently went
from 10 to 20 percent, they actually went the other direction,
recognizing people have bigger costs. And as I understand it, a
lot of times the costs when they get these other grants, the
university is filling in the dollars.
Could you just talk a little bit about the indirect cost
issue?
Second, the 21st Century Cures Act, big issue that Tammy
Baldwin and I have worked on is this loss of young researchers,
or potential loss. The fact that grant has gone up to, what, 41
now on average, up about 5 or 6 years from just a couple
decades earlier.
Can you just talk a little bit about specifically what you
are doing in that area? And are you working with stakeholders
to get their input as you move along the process? I think that
is a really big concern to those folks.
And the last one, if we have time, I would love to talk a
little bit about march-in rights on prescription drugs. You
know, we have a lot of NIH research going into this. So
sometimes on the front end and then sometimes on the back end,
the drugs are being paid for with Medicare and Medicaid.
Government is really heavily involved. I don't think we have
ever used march-in rights. There have been some issues around
that.
If you could just talk about that briefly. But the first
two are the ones I really have the most interest in. I can
submit that for questions.
Dr. Collins. Well, thank you. Let me see if I can get
through at least two and maybe three.
Indirect costs are a topic of great interest right now in
terms of what are they, after all. Basically, over time, the
commitments that the government has made with its grantee
institutions is that we are trying to cover the fully loaded
cost of research, which means that institutions are motivated
to take part of it, as is true certainly in Wisconsin, where
great research goes on every day.
Frankly, we have not quite lived up to that. Indirect costs
generally don't fully cover, and institutions are, in fact,
themselves having to put their own money into supporting the
effort.
Indirect costs are not negotiated by NIH. They are
negotiated by a component of HHS, the Division of Cost
Assessment. And they decide, based upon an OMB guideline,
exactly what is appropriate for universities to ask for in
terms of covering the actual cost of research, and that
includes things like keeping the lights on, maintaining the
facilities, running institutional review boards to look at
human subjects applications, and so on. And those are
negotiated every 4 years based upon the guidance from OMB.
The idea that those could be paid at a lower rate by other
sources has certainly been raised by things like foundations.
But those foundations are a very small proportion of the
overall support of any institution, so perhaps they can afford
to absorb that, but they would feel much less happy about
having a chance to have to absorb more of that from their major
funder, which is, after all, in biomedical research, the NIH.
So it is a very important issue, and certainly presidents
of universities are very focused on this, as you can imagine,
and we are answering lots of questions from those folks as we
go through this conversation.
In terms of early stage investigators, several things. One
is, for several years we have insisted that somebody who comes
to NIH with their first grant application competes against
other people like themselves, who are not the experienced grant
writers but the first-timers, and that gives them a boost so
they are not being penalized for a limited track record, they
are just getting started, and they are not being penalized for
being really well-trained grant writers. That has provided
quite a benefit for those first-timers.
On top of that, we have designed a number of programs that
you can't apply to unless you are a first-time investigator.
And we particularly ask those to be very innovative and
creative in trying to inspire the creativity.
And then there is this issue that we talked about a moment
ago, which is with the Grant Support Index, where we are aiming
to see whether we could better utilize the funds that we are
given by redistributing some of the dollars from investigators
who are very well funded but who are on that flatter part of
the productivity curve, and provide those to early stage
investigators who are still trying to get started. All of this,
of course, depends upon having that stable trajectory we talked
about earlier.
Mr. Pocan. Are you seeking input with those folks as you
are doing this?
Dr. Collins. Yes. So we have multiple workshops and
opportunities. The AAU is convening another gathering to talk
about this in June. We are listening closely. My advisory
committee, the director, has had a major focus on the workforce
and what we can do about it for several years now.
And I guess your last question about march-in rights, I
will answer for the record.
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Mr. Cole. We will next go to my good friend from Arkansas,
Mr. Womack.
INSTITUTIONAL DEVELOPMENT AWARDS (IDEA)
Mr. Womack. Thank you, Mr. Chairman.
Dr. Collins, and to your team, thank you. Not lost on me is
the fact that this panel before us is as dedicated to what you
do as you are accomplished in your fields, and I am grateful,
eternally grateful. I always enjoy being with you when we come
to visit.
And, Dr. Collins, you know that coming from a small State
like Arkansas, I have probably got a question about the
Institutional Development Awards.
Dr. Collins. I am not surprised.
Mr. Womack. So here goes.
That program is a safeguard to ensure that NIH funding ends
up in places where we don't have a real high success rate in
applications. So what are you doing to ensure that the IDeA
States are remaining competitive when they are applying for
funding?
Dr. Collins. Well, we are very much a fan of that program.
We know there is talent all over the country, and that includes
in all 50 States, even though not all 50 States happen to have
research institutions that are in the top 10 in the country.
But talent exists all over. And so the IDeA program
provides an opportunity for the States in that group, 24 of
them, to have a capability of being supported through special
programs like the Centers of Biomedical Research Excellence,
so-called COBRE programs, and the Network of Biomedical
Research Excellence, the NBRE programs.
And when we look at the productivity of those, and we look
closely, we are very pleased with what we see. And many times
that has provided an opportunity for an investigator to get
funding and then come back in a fully competitive application
to NIH and receive funding for that as well. We have got a lot
of success stories we can tell in that regard. We are pleased
to see that in the fiscal year 2017 budget that you all
approved there is an additional increment for the IDeA program.
Another thing we are excited about is the creation of an
IDeA States Pediatric Clinical Research Network, which is part
of the ECHO program, the new program that is looking at
childhood illnesses, and particularly environmental influences.
And having the opportunity to put this in place has been really
quite exciting, because this greatly enlarges our opportunity.
When there is a chance to look at asthma or a childhood cancer,
we have got a broader array of network participants than we
would have had before. So we are very much in this space.
Mr. Womack. You mentioned the networks.
Dr. Collins. Yes.
Mr. Womack. So how have the networks assisted in that
broader biomedical research arena?
Dr. Collins. So the networks are State specific. And NBRE
is an opportunity to give an award which brings together the
research institutions in a particular State and convinces them
of the value of working as a collaborative venture as opposed
to isolated institutions. And if you talk to many of them--I
have not been to Arkansas, but I went to Louisiana and heard
the stories there--this has been real glue, and glue with money
attached to it, to encourage that kind of network building and
sharing of disciplinary expertise and projects.
DRUG ABUSE
Mr. Womack. You should come to Arkansas. I will get the
invitation to you.
My next question, I have got a couple of minutes remaining,
I want to pivot over to Dr. Volkow.
Our Nation is incredibly impacted by drugs. There is not a
person in this room that doesn't know somebody or related to
somebody, myself included, in terms, you know, that is
impacted. And this is a national problem, and even those that
think they may not be impacted are impacted because of the
indirect consequences of our inability to get in front of this
problem, 52,000 overdoses just last year, 20,000 of them from
opioid addiction. This is a top priority for our committee. It
is, I think, a shared top priority for the Congress.
So, Dr. Volkow, as Director of the National Institute on
Drug Abuse, what strides have you made and are making to enact
positive outcomes to alleviate our country from such an awful
epidemic? What can we do?
Dr. Volkow. Yeah. And thanks for the question.
And indeed this is a priority for HHS. It is a priority for
the institute. And the first thing that we are doing is, of
course, working collaboratively with our sister agencies. And
then within our mission, we have a multipronged approach to
address, number one, how do we prevent the prescription opioid
epidemic that we are observing from occurring, from people
becoming addicted to it, how do we prevent the overdoses, and
for those that are actually already addicted, how do we treat
it.
So in this respect, for example, the current treatments
available for addiction of opioid use disorders have been
developed out of research funded by the NIH. But we need much
more.
So we have actually identified three areas for development
of new therapies. One of them is we need additional medications
for the treatment of opioid use disorders, and we are
partnering with industry in that process. Number two, we need
additional interventions to prevent and revert overdoses from
opioids. And, number three, we want to actually contain this
epidemic and prevent it from happening in the future, we need
alternative, effective, and safe treatment for the management
of chronic pain.
Mr. Womack. I appreciate that.
Mr. Chairman, before I yield back, this is a classic pay me
now or pay me later proposition. I yield back.
Mr. Cole. I couldn't agree more. I thank the gentleman.
I now go to my good friend, the gentlelady from
Massachusetts.
BIOMEDICAL RESEARCH
Ms. Clark. Thank you, Mr. Chairman and Ranking Member
DeLauro and Ranking Member Lowey.
I thank you, Dr. Collins, and your entire team for the work
you do and for being here. I am so supportive of your efforts,
as I know everyone on this committee is, and it is one of the
few bipartisan bright spots that we can agree on this. And I
think the 2017 budget that we passed was such a positive step,
and I have been so concerned about the proposed cuts and the
devastation that would have.
But I have two questions for you, Dr. Collins. One is, as
you said, we are now doing inflation plus 5 percent. That is
positive. But this is one of our best examples of using public
resources to partner with private enterprise. And other
countries are making investments at rates that far exceed what
we are. I hear from private companies in my district that their
talent is being recruited and their research is being outpaced
in China, Singapore, Brazil, Israel.
If you can give us some context to what you are seeing in
competition. We know the human toll if we don't do research.
What is the economic toll for the future of the United States
and our innovation economy if we do not support the NIH at
higher levels?
And second is you mentioned the importance of consistency
in funding. I think a great example of that is in my own
district in the Framingham Heart Study that next year will mark
70 years, of third generation of Framingham citizens who are
participating in this study. And I wonder if you can talk about
particularly the value of that research and, sort of more
generally, the value of that long-term research that comes with
consistency of funding.
Dr. Collins. Great questions.
So with regard to what is the situation with America and
the rest of the world in terms of competition, first let me
say, the economic case for support of biomedical research has
been analyzed by many experts, and it is very compelling. NIH
currently supports 379,000 jobs in the United States directly,
and those are high-quality, high-paying jobs.
But if you consider the whole ecosystem that builds upon
NIH discoveries, that is about 7 million jobs, including the
biotech and the pharmaceutical industry. And the return on
investment is estimated that every dollar that you all allocate
to NIH over the course of 8 years returns $8.38 in terms of
return on investment and economic growth as a consequence of
that. That is a pretty good turnaround.
And there are a few stunning examples. I won't be able to
resist mentioning the Human Genome Project that was one of them
where the money that was put into that now estimates 178 to 1
return on investment in terms of the economic benefits that
have come forward to the United States because we led that
effort. And we still lead genomic research and all the
technologies that come out of that.
Other countries, though, as I said earlier, have read this
playbook, and they are very much seeking to do the same sort of
thing. And China in particular, on the course they are, will be
spending, not just as a percent of GDP, but in total dollars
more than the United States, depending upon which curve you
look at, around 2021, not that far off. And they are building
universities and they are building laboratories and putting a
great deal of funds into that. And many very talented
scientists that we were confident we could recruit and retain
in the United States now go back to China for wonderful offers.
So we have to think carefully about that. If this has been
such a strong engine for our country in terms of economics, in
terms of health, we don't want to see that engine struggle, and
that is very much what your committee has been, gratefully,
focused on.
Your question about consistency is also critical, because
many of the projects we are talking about, many of them are not
70 years like Framingham, most of them on the average are at
least 4 or 5 years, and to be able to plan for that.
FRAMINGHAM HEART STUDY
Ms. Clark. We are very exceptional.
Dr. Collins. Maybe I will ask Dr. Gibbons to say a word
quickly about Framingham in the last 35 seconds just to say
what an amazing example that is.
Dr. Gibbons. Yes. The Framingham Heart Study has been an
iconic program, as you pointed out, reaching its 70th birthday.
Yet it remains very vibrant. It clearly underpinns all of our
advances in reducing cardiovascular disease by identifying risk
factors.
And it has been reinvented in the last decade. It is now
the cornerstone of our Transomics for Precision Medicine (TOP
Med) program, where we are now layering on the new technologies
of genomics in that cohort. It is going to be telling us a lot
about the problems, for example, of Alzheimer's disease and
vascular dementia. We need to understand the other factors that
are critical mediators of those processes and at least identify
the new drug targets for tomorrow's breakthroughs. It is still
going to continue to pay great dividends.
Ms. Clark. Thank you.
Dr. Collins. And forgive me. Even though this seems like a
big investment, when you consider the consequences, that drop
in heart attack and stroke that we talked about, 70 percent
decrease, if you figure out what was NIH's role in that, it was
major, and it cost each American about the cost of two lattes
per year.
Ms. Clark. Wow. On that note, thank you, Mr. Chairman. I
yield back.
Mr. Cole. Thank you.
I next go to my good friend, the gentleman from Maryland,
Mr. Harris.
MEDICAL MARIJUANA--THERAPEUTIC USES
Mr. Harris. Thank you very much.
Good to see all of you again.
Dr. Volkow, I am just going to ask you a very brief
question about a topic that has come up in Maryland, and it has
to do with marijuana, medical marijuana and the uses of it. We
had a bill in the Maryland legislature that would have added
treatment of opioid addiction to one of the indications for
medical marijuana. Is there any basis for that in scientific
research?
Dr. Volkow. Thanks very much for the question. And,
unfortunately, there is no evidence that marijuana can be used
for the treatment of opioid use disorder. But the question does
highlight the need, that actually there is an urgent need for
more research to understand better the effects of marijuana,
because people across the country are taking it believing that
it is beneficial for their ailments, and yet the evidence is
not there.
Mr. Harris. And I know that we actually have a bipartisan
bill we are going to file very soon that will attempt to make
it easier to do medical research, not reschedule it, not make
it more widely available except to bona fide researchers. Is
that something that is a good idea for the country?
Dr. Volkow. I think that would be a very good idea. That
would help accelerate our knowledge about what is it that
cannabinoids can do and what is it that they don't do and how
can they be harmful or beneficial.
Mr. Harris. Okay. And could you just, off the top of your
head, just name all the diseases where there is solid
scientific evidence that it is the best drug to use, medical
marijuana is the best drug to use to treat something?
Dr. Volkow. I do not know that there is any one study that
has shown that marijuana is the best drug for a particular
disease. I would say from the perspective of what is the
strongest evidence for potential therapeutic benefits for
marijuana, we know that one of them is an analgesia, another
one is as an anti-nausea, and there is some low evidence that
it may be useful for glaucoma.
Mr. Harris. And maybe spastic diseases, I think, too----
Dr. Volkow. Correct.
INDIRECT COST TO UNIVERSITIES
Mr. Harris. But it is a very limited amount. That is what I
thought.
Could I have--I think I have a couple of slides lined up
here, since we are showing slides today. Who do I to ask to
get----
Dr. Collins. You ask me, and there it is.
Mr. Harris. Oh, there it is. Thank you very much. Thank
you. And I guess this is the only one I want, except the only
thing I want to point out is I have another slide, but I don't
need to show it. You know, indirect costs over at the NIH are
over $6,500,000 a year. And, again, I know, because I have seen
the budgets of grant requests, I mean, indirect costs are not
paying the researchers, they are not paying for whatever you
need directly to conduct your experiment. They are overhead
costs. I mean, we would call it overhead, I guess, the common
person. But what is the average indirect cost that the NIH pays
to universities?
Dr. Collins. Thirty percent of the total cost is the
average.
Mr. Harris. No, but the addition, because indirect costs
are the grant plus a certain amount. What is that certain
amount?
Dr. Collins. About 50 percent.
Mr. Harris. Fifty percent. Okay. So the American taxpayer
is paying 50 percent.
Now, if a university writes a grant to the American Lung
Association, they pay zero percent overhead costs; and if they
write a grant to the American Heart Association, it might be up
to 10 percent; Alzheimer's, 10; March of Dimes, 10; Juvenile
Diabetes, 10; Bill and Melinda Gates, $4,000,000,000 in grants,
10 percent to universities; and Robert Wood Foundation, they
are generous, they are at 12 percent.
It sounds like there is a different standard for the
American taxpayer, that the American taxpayer pays a whole lot
more for indirect costs. Now, some of these are to
universities. And remember, some universities declared
themselves sanctuaries. So that, you know, the Federal
Government is not good enough to describe immigration law, but,
boy, they are good enough to take $6,000,000--$6,000,000,000, I
am sorry, wrong letter in front, $6,000,000,000 a year to help
fund our overhead.
Why do you think it is not the American taxpayer paying far
more than private--these nonprofits? And we assume--we are a
nonprofit, we are just the largest nonprofit in the world, I
guess. Why is this not--why is this reasonable? Why should we
pay more than these other nonprofits, my taxpayers, people in
the First Congressional District? And we all want research, but
if we freed up this $6,000,000,000, we have heard the effect of
$6,000,000,000, if we freed up a significant amount of that, we
could fund thousands of more grants.
Dr. Collins. So this is a topic of great interest right
now, and you are contributing to it, I think, by raising this
question about why these differences exist. Presidents of
universities that do a lot of research would tell you that they
can afford to absorb the costs of taking on grants from
foundations of this sort because it is a small proportion of
their budget. But if they were asked to do that with the
majority, which tends to be, if it is biomedical research, the
NIH, many of them would not be able to continue the effort,
they would need to drop out, particularly public universities
that don't have large endowments.
But I do think there is an important issue here. People
don't realize how these indirect costs are set. They are set by
a guidance that is put forward by the Office of Management and
Budget and reconfigured every 4 years in a negotiation that
goes on between an office in HHS, the Division of Cost
Allocation, and universities. We don't play a role in that. We
are simply told what is the indirect cost rate for that
institution.
I would say universities will also argue that a lot of the
cost that they are asking for help with is because of
bureaucracy that we put down upon them. And this might be a
really good moment to revisit a lot of the regulations that we
have asked them to put forward, things like effort reporting,
which take a lot of time, that don't really accomplish very
much. I think it would be useful to perhaps open up that
conversation, think about our contract with our institutions.
But I do want to say that universities would argue, and I
will just echo their statements, that they are already paying
well over the cost of research that they would be doing if we
were fully loaded in our reimbursements. Talk to your friends
at Hopkins. Paul Rothman will tell you the hundreds of millions
of dollars that they have to put in of their own money in order
to keep their research operation going.
Mr. Harris. Sure. Thank you. And I agree, we should look
into those regulatory burdens.
I yield back.
Mr. Cole. I thank the gentleman.
We will next go to my good friend from California, Ms.
Roybal-Allard.
ENVIRONMENTAL INFLUENCES ON CHILD HEALTH OUTCOMES (ECHO)
Ms. Roybal-Allard. Thank you, Mr. Chairman.
And welcome, Dr. Collins and panelists, and thank you for
everything that you do.
Dr. Collins, as you know, I and other members of this
subcommittee have been strong long-time supporters of the
National Children's Study. We are anxious to hear a progress
report on the environmental influences on child health
outcomes, the initiative that was subsequently created to meet
the goals of the NCS, because we believe it is vitally
important to investigate the impact the environment has on the
health and development of children.
That is why I was pleased to see since our last meeting
that Dr. Matthew Gilman has joined the team to head up the
initiative. I am also pleased that 34 ECHO grants have been
awarded to a series of existing cohort studies.
Given the NCS original plan to recruit child-bearing-age
women and follow their children through adulthood, I am
particularly interested in how many of the cohorts you awarded
included mothers during pregnancy or preconception. Can you
provide us with a summary analysis of the characteristics of
the cohorts that were funded?
Also, what are the next steps for getting this program up
and running? For example, are you asking the existing cohorts
to expand what they are already doing in order to meet the
research goals of the original NCS?
Dr. Collins. We are very excited about the ECHO program,
and thank you for asking about it. Some 84 cohorts have now
been brought together as part of this study to try to learn
everything we can about environmental influences on child
health. Three-quarters of those 84 cohorts were involving women
who were enrolled preconception or during prenatal time.
So we have a lot of data there in the earliest stages of
development. We have now, because of those cohorts, have the
opportunity to start following more than 50,000 children, so
the size is substantial, and Dr. Gilman has turned out to be a
very skillful project manager for this effort.
All together, this means we are funding something like 44
States to take part in this, and we are looking at ways that
the whole can be a whole lot greater than the sum of the parts
by adding additional kinds of measurements as we follow these
children and their parents that were not contemplated as part
of the original cohort studies.
The group has coalesced quite nicely. The leaders of these
efforts are meeting monthly to design ways in which this
project could be even more bold than we might have imagined to
begin with. And we have an external scientific advisory group
that will meet for the first time on May 31, which I will be
there to give them a charge and to listen to their thoughts
about how we can manage this program in the most responsible
way possible.
On top of that, the ECHO program, as I mentioned earlier,
also funds this IDeA States Pediatric Research Network, which
is an additional resource that we think is going to be
extremely valuable for carrying out pediatric trials in States
where previously we didn't have the opportunity to do so.
CHIMP ACT
Ms. Roybal-Allard. Right. That is good news. Thank you.
Dr. Collins, with the passage of the CHIMP Act in 2000 and
with the CHIMP Act amendments in 2013, Congress has shown
strong bipartisan support for the retirement of federally owned
research chimpanzees to Chimp Haven, which is a national
primate sanctuary. I know that the humane treatment of these
primates in retirement is a priority for you also and that NIH
has made a commitment to moving all remaining chimps to Chimp
Haven as soon as possible. However, I am concerned that 4 years
have passed since the passage of the CHIMP Act, and a large
number are still languishing in laboratories, mostly because of
the lack of sanctuary space.
My question is, is it true that we pay 100 percent of the
cost to keep chimps in laboratories but only 75 percent of the
cost to care for them in sanctuary, which is much less
expensive? And is it also true that over the last few years,
the CHIMP Act, which requires the Federal Government to pay 90
percent of sanctuary construction costs, that Chimp Haven has
had to take on that full responsibility?
Dr. Collins. I appreciate your interest and concern about
this issue, and I share that. I have spent a lot of my own
personal time trying to be sure that we are moving away from a
time where chimpanzees were utilized for research to a time
where we are retiring them all to sanctuary. That is NIH's
commitment based upon a National Academy study and our own
internal deliberations.
It is challenging, though, to achieve the retirement. This
past year, 44 chimpanzees were moved from their existing
locations to Chimp Haven. Chimp Haven, because of the need to
incorporate those chimps, who often come with their own social
groups, needs time with each shipment to be able to accommodate
that. So they have asked us not to send more than one shipment
per month, and a shipment is no more than nine animals. That is
why it has only been 44 animals in the past year and it will be
hard to go above that.
So at the moment, actually the limiting factor is not space
in Chimp Haven sanctuary, it is the pace of being able to do
the transfers.
We now have a very good system where the veterinarians work
together to be sure that everything is being done in the
fashion that assures the best likelihood of a good outcome for
the transfer. I am personally informed weekly about how this is
transpiring.
You are right that the way the CHIMP Act was written, we
support 75 percent of the care in Chimp Haven, whereas we were
supporting 100 percent in the research laboratories, but that
is just basically what the law says. We are 100 percent in
favor of moving along with the retirement, but realistically,
considering we still have 350-some chimpanzees that have not
yet made it to sanctuary, it is going to take us several more
years.
Ms. Roybal-Allard. Okay. And I have some other questions
that I would like for you to respond to for the record.
Dr. Collins. Be happy to.
Mr. Cole. Okay. We will next go to my good friend from
Washington, Ms. Herrera Beutler.
NIMH SUICIDE PREVENTION EFFORTS
Ms. Herrera Beutler. Thank you, Mr. Chairman.
I have a couple questions, and I think I am going to start
with--I believe they will go for Dr. Gordon. And I am just
going to read them so I get it right.
In 2014, suicide was the leading cause of death in youth
ages 10 to 24 and young adults ages 25 to 34, and ultimately
suicide claimed the lives of over 12,000 people in these age
brackets in 2014 alone. And in the city of Battle Ground, which
is where I live in Washington State, these troubling statistics
have manifested in increasing trends of mental illness issues,
depression, and suicide ideation among students. And, I mean,
we have been going through it.
Both the city of Battle Ground and the Battle Ground school
district have taken steps, any steps that they can, quite
frankly, offering counseling, mentoring. And despite their best
efforts, I think Battle Ground still is constrained by the
resources and continues in honestly understanding how to
confront this public health crisis.
So I am aware of the efforts to prevent teen suicide
through your Pathways to Prevention workshop. And in that vein,
what new research will the Institute of Mental Health be
focusing on related to prevention and preventing teen suicide,
and is there anything NIH can recommend, quite frankly, to
assist this community and others across the country in their
ongoing effort? We can't wait years and years for research in
this situation.
Dr. Gordon. No, we can't. Suicide prevention is a priority
from a research perspective at NIH and from a care perspective
throughout HHS. And you are right, we can't wait years, and
this is a short-term research need.
The good news is we are putting a lot of resources into
this effort, we are putting a lot of resources into efforts
that we hope would pay off in the short term, so we hope to be
able to bend the curve. But it is a very challenging curve to
bend. As you know, the rates are not just high among youth,
they are rising, and they are rising nationwide, and they are
rising in almost every age group.
Ms. Herrera Beutler. And they are rising across class and
gender.
Dr. Gordon. That is correct.
Ms. Herrera Beutler. I mean, it is really phenomenal.
Dr. Gordon. That is correct.
Particularly with regard to youth suicide, there are
several things which we are confident in but really need a
little bit more research in terms of helping roll it out.
So, for example, the most important thing that you can do
is ask about suicide, right? And people are often afraid to ask
about suicide, but, in fact, it has been shown in study after
study that asking doesn't raise risk, it lowers risk.
And, in fact, a questionnaire that is essentially--it is a
very simple four-item questionnaire that was developed in the
Intramural Research Program at NIMH and tested across the
country at several different academic institutions both here in
D.C., in Massachusetts, in Ohio, has shown to dramatically
increase the number of at-risk youth who are identified. And
this questionnaire is being used in all sorts of settings, but
primarily in healthcare settings.
We have several studies that are aimed at this
questionnaire and other questionnaires like it to try to
demonstrate definitively that it works, but more importantly,
to show how it can be rolled out into communities.
So that is just one of actually more than five studies we
have specifically targeted at youth suicide trying to look at
identification. And then, of course, once you identify at risk
youth, you need to know how to treat them. And so we have
active programs in trying to figure out what are the best ways
to prevent suicide once the high-risk youth are identified.
Ms. Herrera Beutler. Thank you for that. And I would love
to receive that information if that is something you would be
willing to pass along.
Dr. Gordon. Sure. We can do that through the record.
[The information follows:]
[GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT]
STUDIES ON POSTPARTUM DEPRESSION
Ms. Herrera Beutler. And let me move over, I mean actually
stick with you, but issues. Perinatal depression is one of the
most common medical complications during pregnancy and the
postpartum period, impacting one in seven women. Perinatal
depression and other mood disorders, such as bipolar and
anxiety disorders, can have a horrific effect on women,
infants, and families. In fact, maternal suicide exceeds
hemorrhage and hypertensive disorders as a cause of maternal
mortality.
I had no idea, although I have a son who is about to turn 1
this week. And that fog of war that happens, especially when
you are adding to your family, you already have one, is quite
something.
And suicide and overdose are the leading cause of maternal
mortality in a growing number among States. And given these
trends, I wanted to talk about what your--in terms of
prioritizing research in pregnant and postpartum women. And I
have a bill on safe medications, and so we are interested in
this space.
Dr. Gordon. That is really wonderful to hear that you're
interested from a legislative perspective.
I come at it from a very personal perspective, I had a
patient I treated for years and years, stable on medications
with bipolar disorder. She wanted desperately to have a child
and we took every safeguard we could. She was fine through the
pregnancy and absolutely had a devastating year-long fight with
postpartum depression that led to several suicide attempts and
months in the hospital. And that is a patient I care deeply
about fortunately, I can say that she recovered. But we were at
a loss, because every medicine we had ever tried on her failed,
electroconvulsive therapy failed, and it was a very challenging
situation.
So we need to know more about what makes postpartum
depression different from other forms of depression and what
forms of treatment work in there in that setting.
Currently, we support research on psychosocial
interventions, and we have several grants that we are
supporting in that area for postpartum depression. We also have
several treatment studies on antidepressant use in pregnant
women to try to find out will that actually help forestall, and
is it, as you mentioned, is it safe. There are safety concerns
as well.
So this is an area of active investigation for us that we
are deeply committed to, and I am happy to provide the details
afterwards for the record.
[The information follows:]
NIMH Studies on Postpartum Depression
NIMH-funded efforts to understand postpartum depression range from
basic science to identify biomarkers of risk, to research on social
factors, to services and interventions research. NIMH also supports
research to advance treatment for women with postpartum depression,
including psychosocial interventions and antidepressant use in pregnant
women. Ultimately, we hope that this research will help us learn more
about how pregnancy interacts with risk for certain mental illnesses--
including depression--and effective treatment interventions.
Ms. Herrera Beutler. I would love to have that. Thank you.
I appreciate it.
Mr. Cole. I thank the gentlelady.
We will next go, finishing out the first round, to my good
friend, the distinguished Subcommittee Chairman for Energy and
Water, Mr. Simpson from Idaho.
INDIRECT COST
Mr. Simpson. Thank you, Mr. Chairman.
First let me say how glad I am and appreciative of the job
that you and the Ranking Member did on this appropriation bill
with NIH. It shows the bipartisan effort that we can do, and it
is vitally important.
I am not one who is easily impressed, but I am always
impressed when I come out to the NIH and talk to you all and
your researchers out there about the work that you do, and it
is one of the fascinating places to go.
And as I have said repeatedly, I say this in Idaho
speeches, that it is the best kept secret in Washington, D.C.
They do such great work out there, but a lot of people don't
know what NIH is and the impact that it has because of all the
extramural grants that you have to give out. So, Johns Hopkins
gets all the credit for this and all that kind of stuff, but it
is funding that comes from the taxpayer through you to do a lot
of that research, and it is one of those things we need to
continue to work on.
A follow-up on what Mr. Harris was talking about on the
indirect costs. You know, it is great if you can reduce the
indirect costs and make it make sense and you can put more
money into the research and we could, as he said, fund
thousands of more research products. The problem is, is you are
not funding thousands of more research products if at the same
time you are cutting the budget by $5,000,000,000 or
$6,000,000,000. If you are saving money there and can put it
into research, that is great. So we need to be clear about what
we are talking about here.
And the question I was going to ask was actually addressed
by Mr. Womack, and the need for some of these smaller States
and their research universities and those types of things and
some of the incredible work that they do. And I know it is not
your job to make sure that all the money is funded fairly
throughout the country and so forth, your job is to get the
research done at the best place to do it.
But as you are well aware, there are many smaller States
that have research capabilities and are developing more and
more research capabilities. Boise State University is doing
some great biomedical research. When I look at the dollars that
are being spent in Idaho versus Montana or the Dakotas or Utah
or something like that, you know, your first reaction is, well,
that is not quite fair.
I think they just don't know the opportunities that exist.
And what I would like to invite you to do is when you stop in
Arkansas to see Mr. Womack, get back on the plane and come to
God's country in----
Mr. Cole. You mean Oklahoma?
IMPACT OF 16-DAY SHUTDOWN
Mr. Simpson. Yeah. You passed right over Oklahoma.
And stop. And I would ask that you--you know, I know if you
can't make it out there, what I would like to do is ask you to
sit down with the researchers at Boise State University and the
other research institutions in Idaho and talk about the
collaboration and the efforts that they can have of the
opportunities that they might have to work in some of these
areas, but they are really developing some great capabilities
in some of these smaller States. And I know you know that.
So the question I am going to ask is one that--I have given
this answer many times, but when we were out visiting NIH a
year ago, year and a half ago, something like that, two years
ago maybe it was, one of the Members that was with us asked you
a question. And I have repeated this answer many times, but I
think you need to repeat it for the public record, especially
since I have seen individuals say that maybe what we need is a
good government shutdown in September. First of all, I have
never seen a good government shutdown.
What was the impact of the 16-day shutdown, the last
shutdown we had, on NIH, and how did it affect you and your
colleagues?
Dr. Collins. It was probably the darkest hour that I have
experienced since I have been the NIH director, and it is now 8
years. For those 16 days, all of our intramural scientists were
sent home, because they were not allowed to come to work. They
were even told they might be prosecuted if they did. That meant
that experiments that were in the middle of being conducted,
many of them which take many days, were wasted.
The most heartbreaking part was what this required me to do
as far as overseeing our Clinical Center, the largest research
hospital in the world, where we basically had to turn patients
away who had, many of them, been scheduled for weeks or months
to come, oftentimes because we are the court of last resort.
That is what the NIH Clinical Center does. People come
there when everything else has run out of possibilities and we
have an experimental protocol they are willing to try. And
except for a few patients each day who were literally in an
extreme circumstance of potential imminent death, we had to
turn away everybody else, and for 16 days hopes were dashed.
That was a deeply, deeply troubling circumstance that I
hope never would be repeated.
Meanwhile, all of our extramural efforts, we had to cancel
thousands of peer review sections that were scheduled to review
grants, and all of those had to somehow be quickly rescheduled
after the 16-day period started up again. Enormously
challenging and stressful for everybody. We were determined not
to have it result in a slowdown of grant reviews, but it was
painful, to put it mildly.
So my hope would certainly be that whatever we have to do
to figure out budget circumstances, that a shutdown would not
be on the list of options. For us, it was just purely
destructive.
Mr. Simpson. I thank you for that answer. It is good for
the public to know that, because oftentimes we hear, you know,
out in the hinterlands when we go home or something like that,
``Well, you know, the shutdown didn't affect me. What the
heck?'' It has a real impact, and people need to know that. As
I have said, I have repeated your answer many times in talks
that I have given and stuff.
So, I appreciate and thank you all for the work that you
do. It is incredible stuff.
Mr. Cole. I want to thank my friend for a great question.
And just a little piece of advice, Dr. Collins. When you go
to Idaho, as I am sure you will, try to pick football season.
My guys at the University of Oklahoma will tell you they play
pretty good football out there too.
Dr. Collins. Sounds like I am going to be traveling a lot
this year.
Mr. Cole. We can arrange your fall schedule.
Mr. Simpson. Yes, we can.
H7N9 BIRD FLU
Mr. Cole. But just in the interest of time, I want to
advise my colleagues we are going to try and cut to 2 minutes
so we can get as many additional questions as we can in. And
let me begin that round.
Dr. Fauci, I understand that while the H7N9 flu virus
circulating in China right now is not easily transmitted, or
not yet at least, easily transmitted between humans, it has
shown signs it really could be a lot deadlier than other flu
strains that we have seen circulated in the United States So
would you please tell us what both you are doing at the NIH and
NIAID is doing to better understand the virus and prepare?
I mean, sadly, we have all learned we are only one pandemic
away from a real challenge, and these things seem to be popping
up, if anything, more frequently than they did and moving much
faster than they did in previous eras.
Dr. Fauci. Thank you for the question, Mr. Chairman.
The H7N9 bird flu, which is an influenza that affects
chickens, predominantly in China, what we saw starting in 2013
was the ability of that virus to jump from the chicken to a
human. In humans, it causes very serious disease, and has
caused 30 or more percent mortality.
Fortunately, it jumped from chicken to human, but did not
develop the capability of going efficiently from human to
human. But every single season from 2013, 2014, 2015, and 2016,
we have had cases of a virus that keeps recurring. In 2017,
what we have seen is a virus that has reemerged as a slightly
different strain in a way that is not covered by the vaccine
that we made back in 2013 and put in our stockpile.
So the major effort underway right now, together with the
PHEMCE group that I just described a few minutes ago, is to
develop a vaccine that would be specific against this
particular strain of the H7N9 virus. And we are working
together with the CDC, the FDA, and BARDA, and pharmaceutical
companies to be able to get that into the stockpile in case
that virus does develop the capability of spreading from human
to human.
One last thing to mention for a few seconds. This is the
reason why we need a universal influenza vaccine and what we
are putting a lot of effort on, so that we don't have to be
constantly responding to potential pandemics and seasonal flu.
But maybe I could provide additional information that at
another question.
Mr. Cole. Absolutely. And it is also the reason why we need
to maintain a very robust capability, which was one of the
points I wanted to make. This is not something--we can't
recreate what you guys do overnight. And so if you don't have
it and maintain it, you don't have the ability to respond when
something like this pops up.
With that, I want to go to my good friend, the gentlelady
from Connecticut, the ranking member.
DEVELOPMENT OF UNIVERSAL INFLUENZA AND MOSQUITO VACCINES
Ms. DeLauro. Let me pick up on that, and I am going to try
to get in a couple questions here. But my question was to
follow up on the vaccine, which is, where are we on the long
term to developing a universal vaccine?
And then you have got the issue of a broad spectrum
response to mosquito-borne flaviviruses, if that is what they
are called, Zika, Dengue, West Nile, Yellow Fever, in terms of
one product, if you will, dealing with that.
And then, Dr. Collins, I want to ask you about the impact
of the hiring freeze on the NIH's ability to conduct and
support biomedical research.
Dr. Fauci.
Dr. Fauci. For the universal influenza vaccine, on May 23,
literally in a few days, several of our scientists will be
meeting with individuals in Palo Alto who are putting together
a program of consortia of a meeting that we will be holding
here in the Rockville area in the third week in June to get the
best scientists in the country together to have a consortium of
an effort to develop a universal influenza vaccine. I can't
tell you exactly when we will have a universal vaccine, but the
scientific advances are substantial, and we are doing it as a
consortium, the same way we did many years ago when we put
people together to create the Vaccine Research Center. It will
be a center without walls. And we are going to be aiming
towards that.
I will give a final answer to your question about maybe a
universal type of vaccine against mosquitoes. There is a very
ingenious approach that though I can't tell you it is going to
be ultimately successful, is essentially to develop a vaccine
against proteins in the saliva of a mosquito. When the mosquito
bites there will be an inflammatory response around the bite
area which would prevent whatever microbe, Zika or Chikungunya
or any of the other flaviviruses or other viruses or even
malaria, to block the microbe before it actually disseminates
through the body. That is being started right now at the NIH.
HIRING FREEZE
Ms. DeLauro. Yay.
Dr. Collins, hiring freeze.
Dr. Collins. Very quickly on the hiring freeze. Every time
there is a change in administrations, those of us that have
been around a while recognize that a hiring freeze is likely to
be imposed as the new group comes to town and figures out how
they want to manage.
We have, of course, a particular circumstance where we,
with a very large staff, 17,000 people, and patient care
responsibilities, have a particular need to be able to keep
things moving. We were pleased that patient care positions were
exempted from that, so we have been able to continue to staff
our Clinical Center for the most part, with some exceptions of
things that were still being studied.
And we have very recently, working with the Department,
with Secretary Price, been given an opportunity to proceed with
other critical hires, such as what we need now to staff up the
Precision Medicine Initiative, the All of Us Program that is
going to enroll a million Americans over the next two or three
years and aims to launch in the next few months and needed some
very senior staff to manage it, and they have given us a green
light for that.
So, we are hopeful that this difficult period, which
happens every time there is a change in administrations, is
beginning to settle out.
Ms. DeLauro. Thank you, Mr. Chairman.
Mr. Cole. Thank you very much.
We will go next to my good friend, the Ranking Member of
the Full Committee.
LACK OF DETECTION METHODS FOR CERTAIN CANCERS
Mrs. Lowey. Dr. Lowy, I am particularly concerned, as you
know, about a lack of early detection tools for certain
cancers, in particular kidney and pancreatic cancer, which can
often develop into an advanced stage before a patient may even
know he or she is sick. If you can tell me what research is NIH
supporting to lead to early detection of these cancers.
And the development of immunotherapy has been a great
public health achievement, leading to lifesaving outcomes for
some cancer patients. However, immunotherapy is not an option
for all cancer patients. Why is this the case? Are there ways
to bridge this gap so that more tailored cancer treatments are
available to more patients.
In about 1 minute.
Dr. Lowy. Thank you, Congresswoman Lowey.
So, first, in terms of early detection for pancreatic
cancer and kidney cancer, we certainly share your concern, and
the NCI is supporting research in both of these areas. With
pancreatic cancer, we have joint programs with the National
Institute of Diabetes and Digestive Kidney Diseases,
particularly focused on diabetes as a potential biomarker for
early steps in pancreatic cancer.
For kidney cancer, the two principal areas right now are
imaging, where sophisticated imaging processes are able to
detect cancer at an earlier stage than with older forms of
technique, and, in addition, there is some sense that urine
tests for kidney cancer and also for bladder cancer could be
hallmarks. These are areas of active investigation.
In terms of your second question, we certainly share your
interest in and concern about immunotherapy, which has in many
ways revolutionized the treatment of cancer, and not just one
form of cancer, but many forms of cancer. Thanks to the
generous support of your Committee and the Congress, the Cancer
Moonshot is supporting a major initiative to try to understand
why is it that some patients and some cancers make a strong
response to immunotherapy, whereas others don't.
Thank you very much.
Mrs. Lowey. Thank you.
Thank you, Mr. Chairman.
Mr. Cole. Absolutely.
The gentleman from Maryland, my friend Mr. Harris.
BIODEFENCE SPEND PLAN
Mr. Harris. Thank you very much.
And just to follow up with the gentleman from Idaho about
shutdowns, look, I was disappointed the Senate Minority Leader
basically was threatening to shutdown the Government over, you
know, not building a southern border defense. I can't
understand that.
I hope this administration will be different than the last
administration, though, in determining that the NIH is
essential to protecting human life and property, because the
President does have the ability to designate the NIH is
important to human life and property.
Just to the Director, I hope that we take a careful look at
the human-animal Chimera research and make sure that all
adequate ethical protections are in place, because it is kind
of an interesting type of research on the horizon, and that we
audit fetal tissue researchers. The Special Investigative Panel
on Infant Lives noted and found that there are investigators
who are probably acquiring tissue that is not in compliance
with statutes regarding acquisition, and I would hope that the
NIH is willing to audit that at some point.
Anyway, Dr. Fauci, my question to you is specifically about
biodefense measures. And my understanding is that some of--
about 15 percent of the funding administered by the NIAID
actually is spent on threats that are termed to be material
threats.
Is there a biodefense spending plan from NIAID looking into
the future? I mean, because I view your institute as kind of
critical to this. Is there a long-range plan----
Dr. Fauci. Yes.
Mr. Harris [continuing]. About what is needed?
Dr. Fauci. Thank you for that question, Dr. Harris.
There is a long-range plan. And what we have been doing is
transitioning over to the strategy of developing what we call
universal platforms to be able to respond to many organism, as
opposed to picking out this organism, that organism, and the
other, because if you guess wrong, you put a lot of investment
and you risk not having anything to be able to show for it.
So the vast majority of what we are doing right now, for
example, in the arena of vaccines, is to develop the 21st
century version of the vaccine rather than having to grow an
organism attenuated or kill it and then developed it into a
vaccine. And we are doing the same thing with universal
platforms for diagnostics, that you could just plug it in to a
single platform and know right away what organism you are
dealing with. That gets away from the guessing game, that
sometimes is not a good investment.
Mr. Harris. Thank you very much. And I yield back.
Mr. Cole. We will next go to the gentlelady from
California, Ms. Roybal-Allard, and then Ms. Lee on the second
round.
TRANS-DISCIPLINARY APPROACH TO PRECISION MEDICINE/CANCER MOONSHOT
Ms. Roybal-Allard. Dr. Collins, the National Institute of
Nursing Research supports scientific studies that build the
foundation for clinical practice that promote health and
prevent illness, manage and eliminate symptoms caused by
illness, and enhance end-of-life and palliative care.
Unfortunately, funding for the NINR has remained flat at less
than half of 1 percent of the total NIH research budget. And I
am going to just ask you to submit this, in the interests of
time.
Will you please submit highlights of the findings from NINR
research studies that have resulted in improved quality of care
and/or lowered health care costs? What percentage of studies in
other NIH institutes are conducted by nurse scientists? And how
is NIH working to promote a trans-disciplinary approach in its
initiatives like Precision Medicine and the Cancer Moonshot?
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NEW DIAGNOSTIC TREATMENT AND DIAGNOSTIC TOOLS
Ms. Roybal-Allard. And, Dr. Fauci, as you know,
tuberculosis is the leading global infectious disease killer,
taking the lives of 1.8 million people around the world
annually. And in the U.S., TB cases are found in every State,
and States are struggling to pay for the treatment of the
disease. Drug-resistant tuberculosis has also been identified
by the CDC as a serious antibiotic-resistant threat to the
U.S., but research and development on TB is underfunded
globally.
Can you update the subcommittee on how NIAID is
coordinating research to develop new diagnostic treatment and
prevention tools to address this global and domestic public
health threat?
Dr. Fauci. Thank you for that question.
Very briefly, the NIAID, as part of NIH is one of the major
components of a new tuberculosis working group that developed a
national plan that involves a variety of not only other
agencies, but also pharmaceutical companies. We had the mandate
to develop a report in December 2015, and we have just this
past March submitted that report, which is posted on the USAID
website, to be seen by everyone and anyone, and it is a plan
that is an accelerated way to partner with industry.
One of the specific examples of that is the new trial of
drugs against multiple-drug-resistant tuberculosis, including
delamanid and bedaquiline, along together with the existing
drug linezolid and they all look pretty good against multiple-
drug-resistant tuberculosis.
Ms. Roybal-Allard. Okay. Great. Thank you.
SICKLE CELL AND COPD
Mr. Cole. Okay. We will next go to my other good friend
from California, Ms. Lee.
Ms. Lee. Thank you very much.
Many of you know that I have had a very keen interest in
sickle cell research, sickle cell trait, COPD, and multiple
sclerosis. My mother passed away from complications from COPD.
And I have learned a lot about these diseases as a result of
personal experience, but also as a result of your understanding
and response on them.
So with regard to COPD, I have learned, of course, 15
million people have COPD, a lot--many of these don't even know
they have COPD. I want to thank you for developing and putting
forward a COPD action plan and want to know kind of what are
the key items from that and what resources do you need to
implement that.
Second, with regard to MS, where are we in terms of finding
a cure for multiple sclerosis and how the BRAIN Initiative will
engage patients living with MS.
And, finally, on sickle cell research, oh, boy, I tell you,
on the trait, we haven't done a lot of research. I want to know
if you are doing anything with regard to sickle cell, the
sickle cell trait, and where we are in terms of sickle cell
disease. I know, Dr. Collins, you mentioned to me that we are
close on disease, but I would like to know more.
Thank you.
COPD NATIONAL PLAN
Dr. Collins. Maybe to take it in order. Dr. Gibbons on
COPD.
Dr. Gibbons. Yes. Thank you for that. We received guidance
from Congress to put forward this COPD National Action Plan,
and we have collaborated with our sister agencies, CDC, CMS,
and key stakeholders. Certainly a key part of that engagement
involved patients and families, families like yours, that have
been touched by this devastating and debilitating disorder.
What we have learned from that engagement process has been
critical to formulating an action plan. In general, it has five
goals. A key thing was raising awareness. As you mentioned,
many individuals are affected, but unaware. So it is raising
awareness. Certainly, there was a great call to advance our
treatments, so much of what we do needs to be updated, and we
must advance new treatments, as well as preventive
interventions.
So we do have more work to do, and that is part of our
research agenda that has come forward with the action plan. And
we look forward to that being released soon perhaps within the
next week or two.
Mr. Cole. Okay. We will next go for our last set of
questions to my good friend from Massachusetts, Ms. Clark.
Ms. Lee. Can I just ask that the response to the other two
questions be in writing, if we don't have time?
Mr. Cole. Yeah. We are getting close, so if that is okay
with you, then that is what I would prefer.
Dr. Collins. Will do.
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Mr. Cole. Thank you.
Ms. Lee. Okay. Thank you.
Mr. Cole. Ms. Clark.
OPIOID OVERDOSE
Ms. Clark. Thank you, Mr. Chairman.
A couple of questions for Dr. Volkow.
Seven hundred and fifty people last year in Massachusetts
under the age of 35 died from opioid overdoses. We need to
study the long-term effects on young people, their brains,
social development, and how to best treat younger Americans who
are in the grips of this deadly crisis.
So my first question is, can you tell us what NIDA is doing
to better understand the needs of young people struggling with
substance use disorder, and do you have the support and
latitude to act in this area?
And a related question is, I have been very interested in
medically assisted treatment, specifically looking at that for
young people and increasing the alternatives that might be
available. Last week, Secretary Price referred to MAT,
medically assisted treatment, as, quote, just substituting one
opioid for another. I believe this kind of attitude is why it
is so difficult for people struggling to survive with opioid
use to gain effective treatment.
Do you agree that we need more access to MAT for people
struggling with addiction, including adolescents and young
adults? And can you tell us a little bit about why treating
Fentanyl addiction poses such a particular challenge? I know
you are doing some work and have an upcoming meeting on that.
Dr. Volkow. Yes. Thanks very much for the questions. And
indeed, within the tragedy of what we are living with the
opioid crisis, is of utmost priority, of course, are the young
people, because, first of all, they are much more vulnerable to
become addicted, and then if they do become addicted, they have
a whole life of consequences.
So one of our priorities in partnership with several of the
institutes at the NIH is the equivalent of the Framingham
study, but for adolescents. So we are recruiting 10,000
children, that as they transition from childhood into adulthood
we are going to be periodically characterizing them and
obtaining brain imaging to understand what are the normal
developmental trajectories of the human brain, so that we may
be able to understand better how drugs change it and how they
interact with the environment and how that affects also mental
illnesses.
As it relates to the treatment of opioid use disorders
among teenagers, we have actually--we have shown, we have
provided research to show that actually there is benefit of the
use of Buprenorphine treatment for the adolescent population,
that your outcomes are much better.
As you are mentioning, right now on top of everything that
we have seen with the opioid crisis we are faced with new
synthetic opioids which are much more potent than anything that
we have ever heard. As a result of that, we are challenged with
the fact that the medications that we use to use in order to
reverse the opioid overdoses are no longer working.
So one of the priorities that we have is to actually why
there is such an urgency to develop treatments that can reverse
these extremely lethal opioid drugs, and obviously, along all
of these, working with the other agencies in order to be able
to prevent access to these type of drugs, such as Fentanyl, or
even more potent ones like Carfentanil.
Ms. Clark. Thank you.
Mr. Cole. Thank you. And that concludes our hearing, but I
would be remiss--I certainly will--just not to thank all of our
witnesses.
Dr. Collins, thank you and your colleagues. It is always a
compelling display, quite frankly, of the talent, the
compassion, the commitment that we have working on our behalf
as American people at the National Institutes of Health. So we
very much appreciate you giving your time and your expertise to
this committee.
I now recognize my friend, the ranking member, for any
closing comments she cares to make.
Ms. DeLauro. Thank you very much, Mr. Chairman. And if I
can, I would love to get written responses. I wanted to ask Dr.
Lowy about where we are on the Moonshot. We have done 300
million, we are going to do another 300, where that takes us.
Ms. DeLauro. I associate myself with my colleague who
talked about the funding for the Institute of Nursing and what
the rationale is for where they come on the pecking order.
I will submit for the record a question on the sex-gender
balance in biomedical research and where we stand on that.
There were a couple of questions in that area. And also what in
terms of the funding for individual investigators, what kind of
allowances will be made or will there be special exceptions to
what you are looking at in that direction.
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Ms. DeLauro. But it is always enormously gratifying to
listen to what you all are engaged in. What you are engaged in
is what your life's mission is and what you have done to be
able to save lives. I count myself very blessed to have the
opportunity to be elected to this body and to have been here
now for 26 years. And what you do has never ceased to amaze all
of us, as we have said here today.
And what is critical in understanding for all of us on both
sides of the aisle is why we come here and what the potential,
because that is what this institution has, is great potential.
And that great potential, if we push the edge of the envelope
in the way that you push the edge of the envelope in your
discoveries, and to provide--we have the power here to provide
the resources to allow you to push the edge of that envelope
and to save lives.
That is pretty extraordinary with the mission of the United
States Congress, and you take it seriously, we take it
seriously. You don't have to comment on the budget, but we
certainly have to comment on what it is and where we believe it
needs to go.
Thank you very, very much, all of you, for what you do.
Thank you, Mr. Chairman.
Mr. Cole. I am certainly not going to try and top that. And
I can assure everyone in the listening audience, my friend does
push the envelope on behalf of things in which she believes
very, very extensively.
So with that, again, our gratitude to all of you coming and
testifying today. It is a very valuable committee. I think more
profoundly it is very important to the American people to have
an opportunity to hear both the possibilities and the
challenges that you face and why this is a very worthy endeavor
for them to invest their taxpayer dollars in, because, as you
have each demonstrated in different ways today, the return to
them and their families and, frankly, people all over the world
is astronomical.
So, again, we thank you for your work, and we appreciate
your time today.
The hearing is adjourned.
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Wednesday, May 24, 2017.
DEPARTMENT OF EDUCATION
WITNESS
HON. BETSY DEVOS, SECRETARY, SECRETARY OF EDUCATION
Introduction of Foster Youth Shadow Day Guest
Mr. Cole. Good to have you here, Madam Secretary.
Before we begin formally, I want to recognize Ms. Roybal-
Allard for the purposes of an introduction.
Ms. Roybal-Allard. Thank you, Mr. Chairman, for this
courtesy.
I would like to introduce Tommy Diaz, who is a former
foster care youth, who is shadowing me today for the Sixth
Annual Congressional Foster Youth Shadow Day. Tommy is a
resident of Downey, California, in my 40th Congressional
District. His educational aspirations are to earn a master's in
architecture and have a career in designing sustainable green
houses in the community.
I just want to thank him for coming to D.C. to help ensure
that the voices of current and former foster care youth are
involved in the child welfare reform discussion, particularly
efforts to support the well-being, talents, and educational
aspirations for every child involved in foster care.
And Tommy is the one with the blue around him.
Mr. Cole. Why don't you stand up real quick? Yes, stand up.
[Applause.]
There he is.
Chairman's Opening Remarks
Good morning, Madam Secretary. It is genuinely my pleasure
to welcome you here to the Subcommittee on Labor, Health and
Human Services, and Education. We are looking forward to
hearing your testimony.
Madam Secretary, you have one of the most important jobs in
Washington, and that is ensuring that all young people will
have access to the education they need to be successful in
coming decades. And frankly, I know it is a cause that you have
devoted your life to quite selflessly.
Many of our schools do fantastic jobs, some need some
support, and others are in need of significant improvement and
reform. But one fact remains, and that is we need to do the
right thing for all America's children, and your job is to
ensure that that happens.
The budget blueprint that came out in March was further
detailed yesterday and proposes some dramatic shifts in the way
your agency does business. It has a goal of opening doors for
more educational choices to families, whether those schools be
regular public schools, charter schools, or private schools.
I applaud your investment in high-quality charter schools
as a way to give options to many students who have had no
options in the past. I support high-quality education options
for all students, and I believe the neediest among us have the
most to gain from an excellent education. I have long supported
programs that help level the playing field for Indian children,
for disabled children, first-generation college students, and
poor children. I think that is a common objective on this
committee.
Today, I will have some questions about how your school
choice proposals would work and how they would mesh with the
reauthorization of the Elementary and Secondary Education Act
that was just completed over a year ago and was nearly a decade
in the making.
I also appreciate that your budget aims to protect the most
vulnerable populations--students with disabilities, English
language learners, and Minority Serving Institutions. It is
unfortunate that the timing of the final consolidated
appropriations bill and the production of the full budget
coincided such that the final fiscal year 2017 budget figures
were not known at the time your funding proposal decisions were
finalized. And I understand that makes apparent--or makes
sometimes cuts appear that, frankly, were not intended to be
cuts at all.
In many cases, it is obvious that the policy of your
administration was to maintain current funding for programs.
But Congress increased for particular programs, sometimes after
the fact, such that your proposal would appear to be a cut
when, in fact, that was not the intention at all. We simply
need to carefully explain ourselves when discussing proposed
increases and decreases today.
Your budget also shifts the way higher education student
financial assistance flows by proposing dramatic changes in the
Supplemental Educational Opportunity Grant (SEOG) and college
Work Study programs. I look forward to learning more about how
you believe these reforms will increase student access to and
completion of college programs.
Chairman's Opening Remarks Continued
Your budget consolidates and proposes over 20 programs for
elimination. Many of these are cited as being duplicate,
ineffective, or not a key Federal mission. I look forward to
discussing those, and your budget also proposes cuts in TRIO
and GEAR UP, which, frankly, I will advise you I have a
different point of view on. But I will be interested in
discussing this with you and learning your rationale.
I will also have questions about your proposed funding
levels for individuals with disabilities, particularly in light
of the recent Supreme Court decision, which found that schools
must provide a meaningful education opportunity to all children
with disabilities and not just a bare minimum level of
services. And again, I want to commend you for making a special
effort to protect these populations in your budget.
Finally, ultimately, this subcommittee needs to know the
specific details of how your cuts impact schools and students
and how new programs would be implemented. The budget provides
some of these details, and I know some are still being
developed, but we look forward to hearing what you are able to
share with us today.
As a reminder to the subcommittee and our witnesses, we
will abide by the 5-minute rule so that everyone will have a
chance to get their questions asked and answered. Obviously, we
have both the big Chairman and the Ranking Member here. So I am
going to move next to my Ranking Member, but we will certainly
be calling on them for whatever remarks they care to make as
well.
Ms. DeLauro. Thank you very much----
Mr. Cole. I recognize the gentlelady from Connecticut.
Ms. DeLauro. Thank you very much, Mr. Chairman.
And I want to welcome the Secretary. I will take one
second, if I will, because like my colleague Congresswoman
Roybal-Allard, I, too, have a young woman who is shadowing me
today. Justina Rosario, from the City of New Haven,
Connecticut, who, as with Tom, is part of the program that is
dealing with foster children and making it through the system,
which they both have.
So I want to welcome her. Thank you, Justina. [Applause.]
Ranking Member's Opening Remarks
Ms. DeLauro. Again, thank you, Secretary DeVos, for joining
us today and offer my congratulations to you. But let me launch
right in as we spoke about recently.
I believe the proposals contained in President Trump's
budget are alarming, and quite frankly, this puts us on a path
towards the privatization of public education. This budget
intends to shift public school funding and to advance an agenda
that transfers taxpayer dollars out of local community schools.
Education is the great equalizer in our country. At the
signing ceremony for the original Elementary and Secondary
Education Act, President Lyndon Johnson described education as
``the only valid passport out of poverty.''
Decades later, he is still right. The economic benefits
that are accrued for the individual and society are
indisputable. That is why our Government must be committed to
providing every child with access to a high-quality public
education. We need to focus our policies on strengthening
public schools, reducing class sizes, supporting the teaching
profession, providing more one-on-one attention, boosting
student enrichment opportunities, supporting parental
involvement, and making high-quality preschool available to
all.
ACHIEVEMENT GAP IN HIGH-POVERTY AREAS
We have an achievement gap in this country, and it is worse
in high-poverty areas, both urban and rural. Yet these are the
very areas we would starve with this budget. I note that a
concerted Federal investment has helped students of color and
low-income students make gains since the Department of
Education was created.
National Assessment of Educational Progress (NAEP) reading
and math scores have improved. I won't go into it now, but
later in the hearing will read you the success percentages of
our students with the NAEP scores.
At the same time economic inequities grew, high-poverty
districts received less funding. Their students are more likely
to be taught by novice teachers and less likely to take an
Advanced Placement (AP) course for which they have shown
potential.
FUNDING FOR PUBLIC SCHOOL CHOICE
Ninety percent of our kids are in public schools. We need
more resources to help them succeed. You can't do more with
less. You do less with less. And we certainly should not be
siphoning off taxpayer dollars to pay for vouchers. Vouchers,
in my view, will destabilize not only our schools, but our
communities, and I will fight at every step against any attempt
to take public money away from public schools.
Cutting funding for critical programs to increase Federal
investments in charter schools also raises public
accountability questions. I support charter schools, but I do
not believe that they should supplant the public education
system.
Transferring limited resources from public schools to
private schools is wrong. It creates a false choice for
families. When Congress completed the bipartisan
reauthorization of the Elementary and Secondary Education in
2015, it soundly rejected efforts to decimate neighborhood
schools, and we expect the administration to implement the new
law as written.
The Trump budget request includes $1.4 billion in new
funding to expand so-called choice. At the same time, the
budget puts $9.2 billion in cuts on the table, slashing or
eliminating funding for many programs that benefit kids in
public schools to pay for this ill-conceived proposal.
Despite budget documents and rhetoric claiming the request
maintains funding for core formula grant programs, it cuts $578
million from Title I and $114 million from the Individuals with
Disabilities Education Act (IDEA).
The budget also eliminates $1.2 billion for after school
enrichment programs that help keep nearly 2 million kids safe,
$2 billion for teacher professional development and class size
reduction, which would result in more than 7,000 teachers
losing their jobs.
Literacy is a mark of a civilized society. We spend money
to spread literacy internationally. Yet we are eliminating $190
million from the largest reading program for low-income
children and youth and $96 million from grants that help low-
skilled adults become literate.
Despite promises by the administration to champion the
American worker, the budget slashes funding by 15 percent for
Career and Technical Education programs that help prepare high
school and community college students for in-demand jobs. The
list goes on and on.
CUTS TO HIGHER EDUCATION
The budget also proposes deep cuts to or eliminations of
programs that help students access and succeed in higher
education that have enjoyed bipartisan support, and bipartisan
support on this subcommittee, for many years. Ten percent cut
to TRIO, which would end academic support services for more
than 130,000 college students.
Fifty percent cut to work study, which would punish
thousands of students who are working their way through
college. The complete elimination of both the SEOG,
Supplemental Education Opportunity Grants, that 1.5 million
students rely on, grants that allow schools to tailor programs
to students' needs, and the Strengthening Institutions program
that helps nearly 200 community colleges and other institutions
serve working-class students.
The budget calls for an end to Public Service Loan
Forgiveness (PSLF) for police officers, teachers, nurses, and
raids $4,000,000,000 from Pell without taking any steps to help
students access the economic freedom they deserve, such as
increasing the maximum Pell award.
Those in the administration claim to support Historically
Black Colleges and Universities (HBCUs) but refuse to admit or
simply ignore the fact that these disastrous budget proposals
would harm the very programs that HBCUs and their students rely
on.
I want to be clear. Fraught and painful history of
segregation in this country, HBCUs were not the product of
school choice. They were a product of our Nation's racist
segregation.
PROTECTING STUDENTS FROM POOR QUALITY FOR-PROFIT COLLEGES
Aside from your budget, I have questions about how you plan
to protect students from low-quality, high debt, for-profit
colleges. These companies prey on low-income students--students
of color and the honorable men and women who serve in our
military and sacrifice their lives for this country.
Students at for-profits represent only about 1 in 10 of the
total higher education population, yet they represent more than
a third of all Federal student loan defaults, calling into
question the quality and the value of education provided by
this sector. The borrower defense and gainful employment
regulations are critically important steps in reining in these
abuses. That is why I am alarmed that one of your first actions
as Secretary was to delay the gainful employment rule.
Failure to fully implement this regulation will not only
hurt students, it would be expensive. The Congressional Budget
Office estimated a $1.3 billion cost over 10 years to
taxpayers.
President George H.W. Bush once said, and I quote, ``Think
of every problem, every challenge we face. The solution to each
starts with education.''
We owe it to the future of our society to make a commitment
to all of our children that they get the best start in life
possible, and that cannot happen if we make misguided cuts to
education.
I look forward to a robust discussion today, and I thank
you for being here.
And I thank you, Mr. Chairman.
Mr. Cole. I thank the gentlelady.
And we are very privileged to have the distinguished
chairman of the full committee here today. So, Chairman, we
would love to hear whatever opening remarks you would care to
make.
Mr. Frelinghuysen. Well, thank you, Chairman Cole.
And I also want to welcome Madam Secretary DeVos here to
the Appropriations Committee. We look forward to your testimony
and hearing your frank and candid views on any number of
issues.
Chairman Frelinghuysen's Opening Remarks
Today's hearing is an important part of the oversight
duties of this committee. Now that we have formally received
the administration's budget request, the committee will
undertake a thorough analysis of each and every budget. We will
go through each and every budget line, question every witness,
and demand credible spending justifications, and only then will
we make our own determinations on the best use of those tax
dollars.
We intend to put forward a complete set of appropriations
bills that adequately fund important programs while working to
reduce and eliminate waste and duplication. I will work with
Mrs. Lowey, Chairman Cole, Ranking Member DeLauro to move
rapidly in the coming weeks and months to complete the fiscal
year 2018 appropriations bills.
Again, today's hearing is part of a process we follow to
determine the best use of taxpayers' dollars. After all, the
power of the purse lies in this building. It is the
constitutional duty of Congress to make spending decisions on
behalf of the people we represent at home.
ACCESS TO HIGH QUALITY EDUCATION
We owe it to our young people to ensure that they have
access to the best education possible, and your Department is
vital in keeping that promise. Many programs administered by
the Department of Education, like Pell Grants and those
established by the Individuals with Disabilities Education Act
(IDEA) ensure young people receive a quality education.
I visit many wonderful schools in my district in New
Jersey, some of the best in the Nation, throughout the school
year, and I hear from students, teachers, and parents on a
range of issues. In middle schools and high schools, I often
hear about the benefits of a well-rounded education that is
afforded by the Every Student Succeeds Act, which allow
students to pursue interests in the arts, music, and physical
education, as well as science, technology, engineering and math
(STEM) education and English.
In colleges and universities in my district, many students
remind me that they would not have the opportunity to attend
without programs like Pell and Federal Work Study. I am eager
to hear how your Department will ensure opportunity for these
students under proposed reductions, including the elimination
of the Supplemental Education Opportunity Grants.
Further, these goals can only be met by ensuring the next
generation of teachers have access to quality higher education
and the necessary tools in their careers. We need to work, as
we have in the past, in a bipartisan way to ensure that every
child in America is well educated.
In conclusion, Madam Secretary, I welcome you. I look
forward to working with you and this committee to make sure
that we have the best possible legislation possible.
Thank you, Mr. Chairman.
Mr. Cole. Thank you, Mr. Chairman.
And again, we are very fortunate to have the ranking member
of the full committee, my good friend from New York is
recognized for whatever remarks she cares to make.
Mrs. Lowey. And I want to thank Chairman Cole, and it is
good to have Chairman Frelinghuysen here, my partner. And
always good to have my friend Congresswoman DeLauro here. Thank
you both for holding this hearing. And I am very pleased to
welcome Secretary DeVos before this subcommittee for the first
time.
Madam Secretary, I will get right to it. I believe that
your budget proposal would do great harm to students in every
facet of education, from kindergarten through graduate school
and, for those with student loan debt, years beyond. It is just
another example of the broken promises in the Trump budget that
would harm hard-working Americans and set us back in preparing
a 21st century workforce.
PROPOSED CUTS TO DEPARTMENT'S 2002 LEVEL
To me, this budget reflects the views that do not represent
the majority of people in my district and people throughout the
country. Your budget would cut $9.2 billion from the Department
of Education, a cut of 13.6 percent, taking us back to 2002
levels.
It would siphon money from public schools to pay for
private school vouchers, eliminate more than 22 education
investments, including teacher training and after school
programs, leaving 1.6 million children without a safe
enrichment environment. And I want to say that has always been
one of my favorite programs because if you can't convince
people that they are enriching their children, at least they
are keeping them safe while their parents are both working.
It would make higher education more expensive by cutting
Federal Work Study in half, eliminating Perkins Loans for needy
students; preventing inflationary increase for Pell Grants,
robbing its surplus; ending Public Service Loan Forgiveness;
and more.
In my district, Rockland Community College is currently
taking part in a Department of Education initiative that
provides childcare for low-income parents taking college
courses, allowing students to earn a degree and enter the
workforce more quickly with less debt. Your budget would
eliminate this program, destroying the dreams of these hard-
working people who are trying to build a better life for
themselves and their children.
And I hope, by the way, before this budget is completed,
you would come to the district, meet these families, meet these
parents who are working jobs, going back to school so they can
have a positive, bright future.
This budget reflects the views of an administration filled
with people who, frankly, never had to worry about how they
were going to pay for their children going to college. And yet
I am most upset that this budget would undermine our public
education system and the working families who depend on them by
reallocating funding for disadvantaged students, including the
Pell surplus and Title I funding through private school
vouchers.
EVIDENCE BASE AND RATIONALE FOR VOUCHERS
Study after study shows these vouchers go to families who
would likely send their kids to private school anyway, yet this
budget would deplete public schools to fund them. It is clear
to me that you do not have the necessary understanding of our
education system, between this proposed budget and your
comments referring to public schools as a ``dead end'' and
public school teachers as being in ``receive mode.''
Please come. Come spend some time in schools in my school
district, where the teachers I know don't stop working when the
final bell rings. They work for hours every night getting
prepared for the next day. Many of these teachers and
administrators are on the front line, identifying the best way
to reach each student and at times being a parent, counselor,
teacher, and more.
And I am not saying that it is all perfect, but let us
improve the system rather than destroy the system. The teachers
I represent were angered and demoralized after hearing your
statements on public education. I hope that as you lead the
Department, you will see the hard work and good that most
public school teachers do every day and do better than this
budget proposal to empower them to succeed.
Thank you, Mr. Chairman.
Mr. Cole. I thank the gentlelady.
Introduction of the Witness
And Madam Secretary, again, it is a genuine pleasure to
have you here. You are recognized for whatever opening remarks
you care to make.
Opening Statement of Secretary of Education Betsy Devos
Secretary DeVos. Thank you, Mr. Chairman, Chairman
Frelinghuysen, Ranking Member Lowey.
Mr. Chairman, Ranking Member DeLauro, and members of the
subcommittee, thank you for this opportunity to testify on
behalf of the administration's budget proposal for fiscal year
2018.
I look forward to talking about how we can work together to
improve educational opportunities and outcomes for all students
while also refocusing the Federal role in education. While
today's hearing is meant to focus on the numbers and mechanics
of the budget, I hope we will all remember our goal and our
purpose, how to best serve America's students. Allow me to
share just one example.
I recently met a young man, Michael, whose story truly
spoke to me. Michael grew up in East Hartford, Connecticut, in
a low-income neighborhood. He was an average student throughout
elementary and middle school, but all that changed when he
reached the district high school.
Michael described a school where students were the real
ones in charge of the class, and they would make it impossible
for the teacher to teach. He was constantly bullied to the
point he was afraid to even go to the school's bathroom, and
this constant fear made him hate school. He described the
school he was assigned to as, and I quote, ``nothing more than
adult daycare, a dangerous daycare.''
But even though he was failing his classes, the school
simply passed him along from year to year, giving him Ds and
sending the not-so-subtle message that they didn't think
Michael would amount to much. Michael got a diploma, but not an
education.
Michael followed the path he thought he was destined for,
working in a low-skill, low-wage job. But with the
encouragement of his wife, Michael took a course at the local
community college to see what was possible for him. He found an
environment that was invested in his success, and much to his
surprise, Michael earned an A.
He thought it was a fluke. So he took more classes. Lo and
behold, he earned more As. He is now in the school's honors
program with the goal of working as an emergency room nurse.
His success is America's success.
Access to a quality education is the path to the American
dream. So I ask you to keep Michael and countless other
students like him in mind as we go about our shared work to
support America's students. No student should feel they attend
a dangerous daycare. No child's dream should be limited by the
quality, or lack thereof, of the education they receive.
EQUAL OPPORTUNITY AND DECENTRALIZING CONTROL
This budget lays out a series of proposals and priorities
working toward ensuring every student has an equal opportunity
to receive a great education. It focuses on returning decision-
making power and flexibility to the States, where it belongs,
and giving parents more control over their child's education.
Parents deserve that right, and frankly, that right has
been denied for too long. We cannot allow any parent to feel
their child is trapped in a school that isn't meeting his or
her unique needs.
The budget also reflects a series of tough choices. If
taxpayer money were limitless, we wouldn't need a budget at
all. But by its very definition, a budget reflects the
difficult decisions of how best to appropriate the limited
taxpayer dollars we have. This budget does so by putting an
emphasis on the programs that are proven to help students while
taking a hard look at programs that are well-intended, but
simply haven't yielded meaningful results.
This is why the President's fiscal year 2018 budget would
reduce overall funding for Department programs by $9 billion or
13 percent. I have seen the headlines and I understand those
figures may sound alarming for some. However, this budget
refocuses the Department on supporting States and school
districts in their efforts to provide high-quality education to
all our students. At the same time, the budget simplifies
funding for college while continuing to help make a higher
education more accessible to all.
PRINCIPLES GUIDING 2018 BUDGET
I would like to outline the principles that guided our
decision-making. First, our request would devote significant
resources toward giving every student an equal opportunity for
a great education. It emphasizes giving parents more power and
students more opportunities.
Second, the administration's request recognizes the
importance of maintaining strong support for public schools
through longstanding State formula grant programs focused on
meeting the educational needs of the Nation's most vulnerable
students, including poor and minority students and students
with disabilities.
Third, our request maintains funding for key competitive
grant programs that support innovation and build evidence of
what works in education. This also means strong support for the
research and data collection activities of the Department.
Fourth, our request reduces the complexity of funding for
college while prioritizing efforts to help make a college
education accessible for low-income students. As Congress
prepares to reauthorize the Higher Education Act, I look
forward to working with you to address student debt and higher
education costs while accelerating and improving student
completion rates through such efforts as year-round Pell and
reducing the complexity of student financial aid.
And fifth, consistent with our commitment to improve the
efficiency of the Federal Government, our request would
eliminate or phase out 22 programs that are duplicative,
ineffective, or are better supported through State, local, or
philanthropic efforts. Six additional programs were already
eliminated in the reauthorization of the Elementary and
Secondary Education Act. All told, taxpayers will save $5
billion.
In total, the President's budget fulfills his promise to
devolve power from the Federal Government and place it in the
hands of parents and families. It refocuses the Department on
supporting States in their efforts to provide a high-quality
education to all of our students.
Research shows that increasing education options can have
positive effects on students generally and an even greater
impact on poor and minority students. If we truly want to
provide better education to underserved communities, then we
must start with giving parents and students the power to select
high-quality schools that meet their needs.
We want to unleash a new era of creativity and ingenuity in
the education space. My hope is that working in concert with
each of you, we can make education in America the envy of the
rest of the world.
Thank you again for the opportunity to share the
administration's vision for improving education across the
country. I look forward to respond to your questions.
[The information follows:]
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Mr. Cole. Thank you, Madam Secretary, and I am delighted
again to have you here and appreciate your testimony.
Let me begin with the first of the many unfair questions
you are going to get. Unfair in this case because you will have
had so little time in your Department to react to it.
MEANINGFUL OPPORTUNITY MANDATE FOR STUDENTS WITH DISABILITIES
But as I am sure you are well aware, we recently had a
Supreme Court decision, Endrew F. versus Douglas County School
District, an 8-0 decision, which found that school districts
must provide a truly meaningful level of educational
opportunity for students with disabilities and not simply more
than a de minimis level of basic services.
I think it is early, obviously, to tell what the full
ramifications and implications of this are. But as you know,
this is a tremendous cost to local school districts. Obviously,
it is a major item in your budget as well, which, again, I
appreciate you defending.
Have you had a chance to think about what the impact of
this decision will be on local school districts and, obviously,
you know, how the Department might be able to assist the local
areas in addressing it?
Secretary DeVos. Well, thank you, Mr. Chairman, for that
question.
And this is an issue about which I have definitely become
aware and followed closely. Let me just begin by saying how
important I believe it is--the Federal Government's role is to
support the IDEA program supporting students with special
needs, with disabilities, and this budget does, in fact,
anticipate level funding IDEA.
What the implications are of this decision, obviously,
remain to be seen. We are looking closely at the decision and
the directive to help provide guidelines and are in the process
of working through that now.
But I would come back to, I think, the original reason for
the case, and that was that these parents felt their son was
not getting the kind of education that he needed. And they, as
any parent would do, fought hard to make sure that their child
was getting the support that he needed.
And I think that this is an area that is very ripe for
broader discussion around empowering parents more in these
decisions around their children.
Mr. Cole. This has been an area that this committee has
really focused on. As a matter of fact, with all due respect to
the last administration, they flat funded IDEA in their last
couple of budgets, and it was this committee, honestly, that
put more money for IDEA than either the Senate or the House. So
as you develop your strategies, it is a scenario that we are
going to want to visit with you about again. Because, again, we
know this is a challenge for a lot of districts, and obviously,
we want to make sure these young people are well taken care of.
PROPOSED TRIO AND GEAR UP REDUCTIONS
Let me also ask you and give you an opportunity, and in
full disclosure, I am a big TRIO fan. I have seen the impact in
my district. And it is a program, actually, I first found a lot
about when I was an academic back in the 1970s. It has been
around a long time. It is a Great Society-era program.
But it has produced over 5 million college graduates. So it
has served its purpose well. And again, that is an area that
had been flat funded, and this subcommittee has been the leader
on restoring funding there.
So I know you have proposed some reductions to that--and to
GEAR UP, if you care to address it in the time we have got. I
would love to have your thinking on this and your assessment of
the program.
Secretary DeVos. Thank you. Agreed there are portions of
the TRIO program that have been very effective and very
important for students who are aspiring to go to college who
may not have had that opportunity.
The focus of this budget and the portion of the TRIO
program that we are proposing to be eliminated are the McNair
Scholars and the Education Opportunity Center (EOC) portions.
McNair being focused on postbaccalaureate program students and
not--you know, sort of outside of the original intent of the
TRIO programs to begin with. And then the EOC program being
more of an ancillary activity to help support or market the
TRIO program.
So we felt that, again, with tough choices to be made, that
these were areas that probably were not really focused on the
original intent, as Congress intended the TRIO programs
originally. So we have proposed those be eliminated but
continue to fund the Upward Bound Program, Talent Search, and
the Student Support Services Program.
Mr. Cole. I appreciate that very much, and we will continue
to have a dialogue. I think you will find, if you look at
McNair in particular, it has helped a lot of students get
graduate school that otherwise couldn't because, again, they
are quite often coming from families of very limited means.
Secretary DeVos. Granted, it is just a high cost per
student in terms of its application.
Mr. Cole. And you are absolutely correct. It is much more
expensive per student, but that is partly because it is a
graduate degree as opposed to an undergrad. But you are correct
in your assessment in the cost.
With that, let me go to my good friend the ranking member.
Ms. DeLauro. Thank you very much, Mr. Chairman.
TITLE II--A TEACHER TRAINING FUNDS
Madam Secretary, you have previously stated that funding
designated for professional development in Title II, Part A of
the Every Student Succeeds Act (ESSA) is redundant and
duplicative. Eliminating Title II, Part A sends the message
that either teachers, school staff, and principals have hit all
the benchmarks and they do not need to improve, or teachers,
school staff, and principals are doing so poorly that there is
no need to invest in them. Which category do you believe
teachers, paraprofessionals, and principals fall into?
Secretary DeVos. Well, Madam Congresswoman, first of all,
the Title II-A program, we believe, has been spread--it has
been spread very thinly. It has been more prescriptive in
nature, and as the States go to implement their ESSA programs
and plans, they have great latitude with how to use other
funding sources and to devote them to the kinds of activities
that IIA has been intended for.
Twenty percent of the grants that have gone through that
program are of $10,000 or less, and so the efficacy of them has
been very much in question. We believe that with the
flexibility granted to the States that they are going to be
able to use the other funding streams in support of these
programs, if that is what is right for the plan and programs
and the students in their States.
Ms. DeLauro. I don't know these days that States have a lot
of leeway in other funding streams. I just point to the State
of Connecticut, which is in very serious financial difficulty.
Now when teachers feel prepared and supported, they stay in
the profession. Standards and curriculum change based on
research. Teachers need to improve and change as well. Do you
believe that that is true?
Secretary DeVos. Absolutely.
Ms. DeLauro. Okay.
Secretary DeVos. And that a good and effective teacher is
invaluable.
TITLEII--A CUTS AND POTENTIAL STAFF CUTS IN SCHOOLS
Ms. DeLauro. And they need the resources to do it. Okay. So
having the resources there is critically important in order to
deal with teacher development.
Many schools use their Title II, Part A funds to keep
classes from being overcrowded. So parents do not want their
first grader to be in a class of 30 with one teacher.
Eliminating this funding could mean firing approximately 8,000
teachers. How do you explain this decision to parents?
Secretary DeVos. Well, again, we believe with the
implementation of ESSA that States are going to be best
equipped and best able, along with their local education
agencies and authorities, to be able to make these decisions on
behalf of students closer to the decision----
Ms. DeLauro. Decisions, though, without resources.
Secretary DeVos. Well, there is resources through Title I
that are very flexible in that regard.
TITLE I--FUNDING FOR TEACHER QUALITY
Ms. DeLauro. Well, we have got a serious shift in funds
from Title I. We can get that in another round. Shifting of the
money out of Title I to school choice. That is part of where
you all want to go with Title I. So Title I isn't going to be
at the level that it necessarily needs to be in order to be
able to accommodate these efforts.
You talked about in your fiscal year 2018 budget that it
refocuses the Department's mission on supporting the efforts of
States to provide high-quality education. My view that
eliminating of Title II, Part A contradicts this mission. How
do you square this circle?
TITLE IIA--ELIMINATION AND DEPARTMENT MISSION
Secretary DeVos. Again, we believe that these decisions are
best made at the State and the local level, and their ability
to target the resources to where the needs are for their State,
for their students, and for their schools is the most
important. The flexibility afforded through ESSA is a very
important element in consideration of this whole budget
process.
Ms. DeLauro. Should every student--again, you can't do less
with less. That is my view. I don't know what everyone else's
view is. And we are cutting back significantly in the resources
to education and dealing with the notion that we do not have to
invest in teacher training or in reduced class size in order to
help better to have kids learn.
Should every student have access to a highly qualified
teacher? I am sure your answer is----
Secretary DeVos. Absolutely.
Ms. DeLauro [continuing]. Absolutely. How does the
eliminating Title II funding impact the belief? We know that
the Supporting Effective Educator Development (SEED) exists,
the Teacher Incentive Fund (TIF) exists. There are competitive
grants that don't reach every State and every school district.
So how do you--by eliminating Title II, how do you back up your
view that every student should have access to a highly
effective teacher?
Secretary DeVos. Again, reprioritizing the dollars that go
to the States for their flexibility to be used in the best
manner--that they deem the best manner possible for--on behalf
of the students they are serving.
And just with respect to your question and comment about
reducing class size, that portion of that program only was
effective or implemented for 8,000 teachers out of more than 3
million. So the number of teachers that are actually being
benefited or impacted through that is really very minimal.
Ms. DeLauro. Eight thousand. I guess if you are one of
those 8,000, you don't see yourself as minimal.
Secretary DeVos. Indeed.
TITLE I--EXPENDITURES AT DISTRICT LEVEL
Ms. DeLauro. Just one final comment. And you can--is there
evidence that States and districts aren't spending all of their
Title I money? Because you have claimed that they can use Title
I.
Mr. Cole. If the gentlelady would please----
Ms. DeLauro. There is no room to accommodate elimination of
these programs.
Thank you for your courtesy, Mr. Chairman.
Mr. Cole. And please, if you would care to respond?
Secretary DeVos. That is okay.
Mr. Cole. Okay. Thank you.
And again, we will try and be generous with the clock, but
please.
Ms. DeLauro. Thank you.
Mr. Cole. Okay. If we can, we next go to the full chairman.
Mr. Chairman.
Mr. Frelinghuysen. Madam Secretary, I visit some years as
many as 80 schools, juniors and seniors in high school, seventh
and eighth graders, some of whom may trek down here for their
Washington trip, and elementary schools promoting obviously
literacy, Read Across America, things that put a sort of a
human face on what we do as Members of Congress to support
public education.
IDEA AND FULL AUTHORITY SPECIAL EDUCATION FUNDS
I have had a particular focus, as has Chairman Cole on
IDEA, and I am hugely impressed and actually in awe of anyone
who teaches special ed. They are, should be ordained for
sainthood.
We have never met our full obligation. I think the law was
passed in 1975.
Secretary DeVos. Forty percent.
The Chairman. Forty percent partnership. Could you talk a
little bit about--where you are relative to greater
participation in terms of that partnership? I think it is
absolutely essential.
And may I just say for the record, and maybe it is true of
New York as well for Mrs. Lowey, that there are a number of
people who come to New Jersey because of court decisions which
require a thorough and efficient education for every child,
regardless of their circumstance. And many families with
disabilities, or who have children with severe disabilities,
the whole spectrum of disabilities, come to our State.
We have, obviously, a great public school system. We have a
supportive number of other schools maybe dealing with autism,
particular challenges. Where do you feel we are going, and how
supportive does this budget represent?
Secretary DeVos. Thank you, Mr. Chairman.
I share your concern and heart for both these students as
well as those who help teach them, and they have a tremendous
dedication to a wide range of needs and a wide range of
students. And your reference to the fact that when IDEA was
originally passed, the goal was to fund it at or to support 40
percent of the cost of it, if Congress were to actually fully
fund it, it would be $31.5 billion for IDEA.
We are--the budget and what you have traditionally funded
it the last number of years is at about the 15 percent range.
So you can see we are proposing to continue the budget funding
as has been done in the last number of years.
But I think, you know, it is a matter for robust
conversation. If Congress believes that the commitment to this
program should be at a much higher level financially, there is
certainly an opportunity there.
Mr. Frelinghusysen. I think at one point, Mr. Chairman, we
were up to 18 percent, and now we are down to, I think, 15
percent. I think we need to do better, and I just want to put
my oar in the water because I think it is very important.
Thank you, Mr. Chairman.
Mr. Cole. I thank the gentleman.
We will now go to the ranking member of the full committee.
Mrs. Lowey. Thank you, Mr. Chairman.
DIRECTING PUBLIC SCHOOL FUNDS TO PRIVATE SCHOOLS
As you have heard, I am extremely disappointed that your
budget proposes to take funding from public education and
transfer it to private schools. In my judgment, we need to
increase the resources. Remember, the Federal Government just
provides about 9 percent of resources for public schools. Most
of it comes from State and local taxes.
So what we have to do is increase resources for public
schools, not put an increased burden on the State and local
and, again, continue to work together to improve them, not
diminish them. So I think it is imperative that this committee
and the American people really understand just what this
proposal would do. So a couple of quick questions you can just
answer yes or no.
VOUCHER RECIPIENT RIGHTS TO IDEA DUE PROCESS
Under your proposal, would a student with disabilities
receiving a voucher for a private school have due process
rights under IDEA?
Secretary DeVos. Ranking Member Lowey, I thank you for the
question and thank you for being here today. Before responding
yes or no to your question, allow me to just address one of the
things that you said earlier about shifting funding.
We are not proposing any shifting of funding from public
schools to private schools. In fact, all of the proposals that
have been set forth in the budget continue to fully fund and
commit to funding public schools as we have. And so I want to
make sure that we are very clear on that, and if we are
misunderstanding numbers somehow, let us talk about that.
Mrs. Lowey. Aren't you talking about vouchers? Who is
paying for the vouchers?
Secretary DeVos. That is an additional program to the Title
I funds that have been carried forward in the budget.
Mrs. Lowey. Where----
Secretary DeVos. The Title I funds in the budget are
consistent from----
Mrs. Lowey. This is clearly a misunderstanding, so maybe at
another time, we could talk about that. If you are funding with
vouchers private school, the money is coming from someplace,
and there is an overall cut in the budget.
Secretary DeVos. There is a small--there is a proposal for
a $250 million investment in the innovation portion of the
budget that would help fund some pilot test programs around
school choice, and we talk about--everybody talks about
vouchers. What we also have to understand is that there are
many different mechanisms to provide parents choices, and
vouchers are but one mechanism.
The $250 million does not prescribe a method or a
mechanism. That remains to be discussed and decided upon if
that is funded as part of the appropriations process.
PERFORMANCE AND ACCOUTABILITY IN PRIVATE VOUCHER SCHOOLS
Mrs. Lowey. We will have to continue this discussion
because I would be interested in knowing whether private
schools funded with public taxpayer dollars will be held to the
same performance standards as public schools, and do you
believe that private schools that enroll voucher students
should be accredited and have to provide evidence of the
quality of their programs?
Secretary DeVos. Each State deals with this issue in their
own manner, and I can refer to the program in Florida where
there are 40,000 parents whose children are deemed students
with disabilities who have chosen to take what is called the
McKay Scholarship and take it to a private school of their
choice. Those parents are very happy with and satisfied with
that decision. They have made that choice to do that.
And I refer to that as a specific example of a State
addressing an issue in a way that is working for the students
and parents in their State. Each State has to deal with this, I
believe, in their own way.
CLARIFYING IDEA DUE PROCESS REGARDING VOUCHERS
Mrs. Lowey. Maybe I misunderstood, but can you clarify, a
student with disabilities receiving a voucher for a private
school have due process rights under IDEA. What is the law unto
that?
Secretary DeVos. Due process rights with regard to----
Mrs. Lowey. IDEA.
Secretary DeVos [continuing]. IDEA. They--if a parent
chooses to go to a school that is not a public school, then
that is a decision made and a contract made with that private
provider or that other provider.
Mrs. Lowey. But what is--will they have access to IDEA?
Will they have due process rights? Or is that--I mean, the
public should know that it is optional. Correct?
Secretary DeVos. The way that they handle it in Florida is
one approach. But again, each State has to--I believe if they
are going to offer choices to parents and to students, they are
going to deal with those issues in the way that works best for
their State.
Mrs. Lowey. Let me just say I see I have no time left, but
there are many questions I have--after school programs, Pell
Grants. We have worked very, very hard on this committee to
support public education all the way up, and I am very
concerned, when the Federal Government only pays 9 percent of
the budget, that you are supporting further cuts.
So I think we need increased dialogue here because
education for me is probably one of our most important
responsibilities if we are going to have a workforce that is
strong, healthy.
Secretary DeVos. I couldn't agree with you more.
Mrs. Lowey. Thank you. Thank you, Mr. Chairman.
Mr. Cole. Certainly. We are going to go a little bit out of
order, if we may, because our friend Ms. Herrera Beutler has
another engagement. So Mr. Harris has graciously agreed to
allow us to go to her, and then we will resume our normal
rotation.
YOUTH SUICIDE PREVENTION
Ms. Herrera Beutler. Very gracious. Thank you, Mr.
Chairman. And I thank the good doctor from Maryland.
So I will make it as succinct as I possibly can. In 2014,
suicide was the second-leading cause of death among young
people 13 to 19. And youth suicide is a problem in certain
areas of my district and across the country, quite frankly, and
I have made a commitment to helping our schools address this
problem.
I have a kind of a two-part question, Madam Secretary. The
first one is, how does the Department plan on partnering with
local school districts as well as other agencies to effectively
and swiftly address the mental health crisis that we are seeing
evolve in our Nation's youth?
And secondly, the second part, in many cases, school
resource officers, or SROs, play an important role in this
effort. They engage with students on a daily basis. They get to
know them and are critical in identifying depression and
suicidal behavior among these school-age kids or young people.
And for the last few years, the Community Oriented Policing
Service (COPS) hiring program has given additional resources--
or additional consideration to SRO grant applications, so the
school districts who make application for this. And I wanted to
hear what your thoughts are on the practice of school-based
policing through school resource officers, and is it something
you will be supporting?
Secretary DeVos. Well, thank you, Congresswoman.
First, let me say I share your concern about this crisis in
our youth, and I think, to start with, those issues, that
crisis is best addressed at the most local level possible. And
so to the extent that ESSA again allows States and local
communities great flexibility in how to invest the resources,
hopefully, that they will--in an area where that is a very
specific issue in crisis, they will certainly devote the
resources necessary.
From the Department level, we do have a program, the Office
of Safe and Healthy Students, that is involved with helping to
meet some of these needs. But again, it is a very distant
relationship there. And I think to the extent that local
communities have this issue as very high on their radar screen,
I hope and trust that States in implementing their plans will
account for that and address those needs very specifically
there.
Ms. Herrera Beutler. Do you think the Department of Justice
should continue to promote the hiring of school resource
officers within the COPS program?
Secretary DeVos. I am sorry. Could you say that again?
Ms. Herrera Beutler. Do you think the Department of Justice
should continue to promote the hiring of school resource
officers within the COPS hiring program?
Secretary DeVos. I think certainly school resource officers
are a very viable and important solution in some places. And I
think, again, that is best determined at the State and local
level.
CHRONIC STUDENT ABSENTEEISM
Ms. Herrera Beutler. Okay, with a little bit of time left,
in a 2014 Department of Education report, over 6 million
students were chronically absent or missed 10 or more percent
of school days. And in my State, we have the highest rate of
chronic absenteeism by school district in the Nation.
And unfortunately, that the research shows that the student
who is chronically absent is seven times more likely to drop
out of school than their peers who are not. There are reasons.
I had recently held a roundtable, and there are very important
reasons around why students--it is not just a random student
playing hooky, which is what we used to think of it. There are
home environments. There are community environments.
There are reasons, you know, I think in high school, when I
think about some of the young men who dropped out, they dropped
out because they go, get a better job, and they couldn't see
the relevance of being in class, right? So there are a lot of
issues here.
And I have recently introduced the Chronic Absenteeism
Reduction Act with Congressman Tim Ryan, which would give the
school districts the flexibility to implement strategies that
would combat the chronic absenteeism because it is different
per region and what the needs are.
And my question for you is how does the Department plan to
empower the local school districts to address this issue
effectively?
Secretary DeVos. Well, thank you for that question. I mean,
it is a very real issue in many areas. And so often it is a
matter of the student and the school not being a good fit for
one another, but yet the student doesn't have a choice or
another alternative.
And I think about a letter that the Department recently
received from an individual who is in the correctional facility
in Minnesota who really was lamenting the fact that he didn't
have the kind of fit that he needed in school. He went down a
bad path and ends up in jail and in prison. And now is getting
an education, but saying----
Ms. Herrera Beutler. With just a little bit of my time
left, I agree. Sometimes it is the fit. I totally agree with
you. But sometimes there are also extenuating circumstances.
Secretary DeVos. And again, I think it goes back to the
local districts and the State that really need to work together
to address the issues at the local level, closest to the
students that need the support and the help.
Ms. Herrera Beutler. Thank you, Mr. Chairman. I thank you
again, Dr. Harris.
Mr. Cole. You are certainly welcome.
We will now go to my good friend from California, Ms.
Roybal-Allard.
Ms. Roybal-Allard. Thank you, Mr. Chairman.
LEGALITY OF TITLE I PORTABILITY PROPOSAL
And welcome, Secretary DeVos. I want to go back to a topic
that was raised by the ranking member, which is how your
department treats Title I. Quite frankly, I was disappointed to
see your budget request includes focus grants, which is, in
essence, a $1 billion Title I portability proposal.
This request for an unauthorized, unproven carve-out from
Title I is alarming, especially in light of your request to cut
$578 million from other parts of Title I. As you know, Title I
portability was soundly rejected by Congress during
negotiations for Every Student Succeeds Act.
During the debate surrounding ESSA, numerous nonpartisan
experts and stakeholders ranging from the Brookings Institution
to the Association of School Superintendents concluded that
portability would result in more funding for wealthier school
districts at the expense of poorer districts.
My first question is, in your view, should high-poverty
schools receive more funding resources than schools that have
lower levels of poverty?
Secretary DeVos. Congresswoman, yes, I think the reality is
that they do receive higher levels of funding.
And if I could just actually refer back to one of
Chairwoman--Ranking Member Lowey's questions or the question
around Title I funding and the assumption that Title I funding
for vouchers was going to be a part of Title I. It is Title I-B
that is for a voluntary school choice program. It is not any
kind of a mandatory or imposed program. I just wanted to make
sure to clarify that.
And with respect to the funding for Title I, let us make
sure we are clear that the budget that we are working from was
prior to the omnibus changes in April. So we are working from
that, those funding levels, and the proposal is to carry
forward the Title I funding the same level and to fully fund
Title I around support to and through public schools.
Ms. Roybal-Allard. Just to be clear, so that you do agree
that high-poverty schools should receive more Federal resources
than lower-level poverty schools? Was that your testimony?
Secretary DeVos. I think--yes. I mean, I think that that is
the case.
Ms. Roybal-Allard. Well, as the ranking member said, they
don't. But my next question is, then, do you accept the basic
premise by experts that high-poverty schools face
disproportionate challenges when compared to moderate income
and wealthy schools?
Secretary DeVos. Yes, I do.
Ms. Roybal-Allard. Okay. Well, quite frankly, I am relieved
that you do acknowledge that. And then based on your answer
then, I find it curious that then you would endorse a proposal
that shifts more funding away from highest-need schools. So I
think there is a conflict there.
Secretary DeVos. We actually are proposing to protect all
of the Title I dollars to public schools, and the additional $1
billion is for a voluntary program that would allow students to
choose between public schools.
Ms. Roybal-Allard. But that money has to come from
somewhere, and we can--because of lack of time, we can maybe
explore this a little bit further. But any shifts in money,
given limited budget, have to come from somewhere, and it
appears that it is coming from areas that could truly help
these low-income kids and from programs that----
Secretary DeVos. Yes, and the reality is that it is
intended to help low-income kids, and it is intended to give
some more choices to them and their parents in finding schools
that fit for them.
Ms. Roybal-Allard. I think where the disagreement comes in
is that maybe the intentions are good, but the actual impact is
not meeting those intentions.
EFFECTS OF SCHOOL CHOICE ON SCHOOL DISTRICTS
This administration has made clear that restoring local
control is a major tenet of its approach to K-12 education. Yet
your budget violates that premise. Instead, your request would
incentivize districts to adopt portability in spite of warnings
that portability would undermine local control in limiting
districts from using the funds in ways they believe to be most
effective.
Has your Department considered the financial implications
that portability will have on districts, and has the Department
considered how it would mitigate the disruption a portability
structure would impose for public school districts, if enacted?
Secretary DeVos. Let me just say again, this is proposed to
be a voluntary program, an opt-in on the part of States and
local communities. And I would also kind of try to take us back
to the notion that we are talking about students and their
education, and I think we spend a lot of time talking instead
about schools and buildings and systems. I think we should be
focused on doing what is right for individual students.
And if a school is not working for a student, and a parent
doesn't have the economic means to do something different, I
think we should help find them ways to be able to make that
decision on behalf of their students and their children.
Ms. Roybal-Allard. Well, perhaps a better way would be,
though, is in these poor minority schools is maybe to invest
more and to bring all the schools up to a level, rather than
take away from schools that need these funds and putting them
into wealthier schools.
Secretary DeVos. Well, and you know, the Federal Department
of Education has invested a lot of funds in trying to do just
that. In fact, the last administration invested $7 billion in
school improvement grants specifically targeted at the lowest-
performing schools and areas with zero results and zero
improvement.
So we have tried that. I think it is time to try something
different.
Ms. Roybal-Allard. We may have a disagreement on that.
Mr. Cole. Well, the chair is going to gently admonish
Members. Please don't ask a question at the end of your 5
minutes. It puts the Secretary in a very difficult spot, and it
will inhibit our ability to reach a second round, which I would
like to do, a second shorter round.
So, with that, I go to my good friend from Maryland, Dr.
Harris, who was kind enough to delay his questions so that Ms.
Herrera Beutler could ask hers. Thank you.
Mr. Harris. Thank you very much, Mr. Chairman.
EFFECT OF SCHOOL CHOICE ON STUDENT ACHIEVEMENT
And welcome, Madam Secretary. It is a pleasure to have you
in front of the committee.
As you know, every Secretary I have questioned in the past
few years, I have always made known my preference for giving
parents the choice of where to send their students. Because in
the end, the parents are the taxpayers. The parents are the
ones who probably know best.
With that, I just want to read a sentence from your
testimony. I am sorry I wasn't here for your testimony, but you
said, ``In part, my support for educational choice is based on
my strong belief in the power of markets and competition as
drivers of educational quality and accountability.''
Well, let us start with educational quality. I am sure you
are aware that in international testing, the OECD nation tests
done, I guess, in 2015 or 2016, in math, reading, and science,
we didn't crack the top 10. In fact, we didn't crack the top
15. In fact, in math, we didn't crack the top 25.
So I think there is no question that we don't get a bang
for our buck in the American educational system. Because we see
education spending going up, we think that, I guess, the
measure on how effective education is how much money you spend
on it, and yet in all these objective tests, we are failing in
a global education economy.
And I welcome things like the Opportunity Scholarship
Program in D.C. It is interesting because, and I might ask for
a brief comment from you on it because they said, well, you
know, the latest report is that, well, the people--the children
in those schools don't do as well compared to the ones in
public schools in the latest one. Because, of course, the study
several years ago showed the graduation rate much higher,
things like that.
One possible explanation is, you know, competition actually
works. That actually when you do give people the choice, that
the public school system actually figures they better--they
better turn out a better product because now there is
competition. So, I mean, is that a reasonable reading of those
results?
Secretary DeVos. I think it is, indeed, Congressman. I
think that the NAEP scores for all of the District and the
students in the traditional schools in the District have shown
remarkable improvement in the last few years. And I think it is
directly relatable to the fact that there are robust choices
now within the District for all of the students.
Mr. Harris. There certainly are. I wish it were more robust
because the new scholarship awards for school year 2016 and
2017, as you are probably aware, was only 234 students. Now
interestingly enough, there were 2,349 applications for those
234 slots, a 10:1 ratio.
So these are parents deciding, you know, 10 times more than
slots are available, which actually correlates to what a really
good university gets in terms of its applicant to accept, you
know, an Ivy League kind of thing. So to somehow suggest that
these parents have no idea what they are talking about, and we
know better--you know, Federal Government knows better--is kind
of crazy. So I hope you are a strong advocate of the
Opportunity Scholars Program (OSP) and fully fund it.
FEDERAL IMMIGRATION ENFORCEMENT IN SCHOOLS
There are just two other things I wanted to bring up. One
is because Federal funds do flow directly to institutes of
higher education is this trend that I think is waning now of
these higher education institutions that come to the Federal
Government for billions of dollars, declaring themselves
sanctuary campuses. So we want the billions of dollars, but you
know, we are not going to comply with Federal immigration
authorities.
And I hope that you follow the lead of the DHS, Department
of Homeland Security, in their budget and write things or
request things written into law that suggest that, you know, if
you are coming to the Federal Government for dollars, you
better cooperate with our Federal immigration--with our Federal
law enforcement for immigration because in the end, that is the
only immigration enforcement we have at the Federal Government.
State and local governments are not given the authority to
write immigration law and have to cooperate with Federal
authorities, again, if they expect Federal largesse.
RELIGIOUS TITLE IX EXEMPTIONS
The very last thing I want to bring up and will submit some
letters to the question is that there are Title IX exemptions
from religious institutions I think before the Department, and
I don't think action has been taken on these. And I will submit
QFRs on this.
I would hope that the Department realizes that the freedom
of religion is an important freedom. It is a First Amendment
freedom, and that there are legitimate reasons to ask for
exemptions from Federal regulations, including Title IX, and
that the Department take action on those.
And with that, Mr. Chairman, I am actually going to yield
back the last 20 seconds.
Mr. Cole. You are an example to the committee. I thank the
gentleman. [Laughter.]
Next, on the basis of order of arrival, we will go to Mr.
Pocan from Wisconsin. The gentleman is recognized.
Mr. Pocan. Great. Thank you, Mr. Chairman. Appreciate it.
FOR-PROFIT CHARTER ELIGIBILITY FOR VOUCHERS
And I thank you, Secretary. I have really been looking
forward to today.
I come from Wisconsin, one of those States that,
unfortunately, has had a failed experiment in taxpayer-funded
voucher schemes and for-profit charters, and I know that
recently you saw there were some researchers showing that in
Indiana and Louisiana, Ohio, Washington, D.C., that students
receiving vouchers saw their test scores drop.
I think you were asked recently about this, and I know you
were on your way out and you didn't have a chance to answer. So
I am glad that today we have got a chance to ask some of these
questions.
But you know, my experience in the 14 years I was in the
legislature in Wisconsin was during almost the entire growth
period of this program. They turned down--kids with
disabilities don't get into these programs, left to be in the
public schools. They can turn down students who are gay or
lesbian within these schools. My rural areas often don't have
an alternative for people to go to. So they don't see that.
EFFECTIVENESS OF VOUCHERS IN WISCONSIN
But yet the one thing I would really disagree with you, in
Wisconsin anyway, those public dollars do go to the private
vouchers. So they are losing their money in rural schools to go
to this experiment, which hasn't worked.
But let me just read you a couple things on the Wisconsin
experience because, really, I know this inside and out.
National Public Radio did a story on the Milwaukee voucher
program. ``Over the years, much of the research found test
scores flat, lower in some cases, or slightly improved in
others.''
Milwaukee Journal Sentinel, ``On average, students in
Milwaukee's private school voucher program still performed
lower than students in the city's traditional public school
system.''
Again, Milwaukee Journal, another article, Right Step,
Inc.--I don't know if you are familiar with that school--a
taxpayer-funded voucher school in Milwaukee. They are being
sued by parents right now that the reports indicate that only 7
percent of their students tested at English language
proficiency and zero percent in math.
So this is our public dollars going to these schools. I
just would ask you, would you send your kids to a school where
they have 93 percent of the students who aren't English
proficient, and zero percent are math proficient?
Secretary DeVos. Would I? Congressman, thank you for the
question.
And I am really glad to hear you are from Wisconsin, and
you have had some of the experiences in Wisconsin. I was just
recalling the history of the program in Wisconsin----
Mr. Pocan. Since I only have 5 minutes, I appreciate that.
But----
Secretary DeVos. I know, but I want to remind you that
Polly Williams, a Democrat city councilwoman, was the one who
first introduced the Milwaukee program.
Mr. Pocan. And who now says it has not lived to its
promise.
Secretary DeVos. And who is no longer living.
Mr. Pocan. Right. Before she passed away said it does not
live up to its promise. You are familiar with that, right?
Secretary DeVos. But 321 students originally, and now
28,000 students in the City of Milwaukee.
Mr. Pocan. She said it didn't live up to the promise of
what the creation was. But the question is would you send your
children to a school with 93 percent not proficient in
English----
Secretary DeVos. Today, 28,000--28,000 students in the City
of Milwaukee are being sent there by their parents.
Mr. Pocan. Okay. Well, I guess you are not going to answer
that question either. So let me, if I can then, Madam
Secretary, if I can take my time back, if you are not going to
answer the question, let me ask a different question that you
might be willing to answer.
So the last expansion in Wisconsin of this program, 75
percent of the kids--the parents who got this money, their kids
already attended the school, and two-thirds of the money that
went in the tax vouchers to the folks who received this were
making more than $100,000.
So, largely, this is tax policy. This isn't education
policy. This is making sure people who are already attending
these schools. Do you think that your Federal program will
support this sort of thing? So it is not to encourage new
outlets in education. It is simply to give money to people who
already attend those schools.
Secretary DeVos. Well, I really applaud Milwaukee for
empowering parents to make the decisions that they think are
right for their students and their children. And I go back to
what I said earlier about the fact that I think we need to
shift our conversation----
Mr. Pocan. So will the Federal program--I guess, maybe I am
sorry if I wasn't clear. Under what you are doing, there are 20
programs zeroed out, from arts to foreign language, mental
health, Special Olympics. They are zeroed out under the budget
proposal. But you have got new dollars for this failed
experiment that I can tell you after 14 years in the
legislature, we have had these dismal results.
My question is, will the path of the new dollars you are
putting in for the Federal Government go down the failed path?
In Wisconsin, it is going to people who already attend the
schools. So there is nothing new about education. This is tax
policy. It should be before the Ways and Means Committee.
Is that the intention of the new program expansion that you
have?
Secretary DeVos. I know the 28,000 students that are
attending schools by the choice of their parents in Milwaukee,
that is a success for those students because their parents have
decided----
Mr. Pocan. So are you going to hold any accountability----
Secretary DeVos. Their parents have decided that is the
right place for their children.
Mr. Pocan. For example--Madam Secretary, seriously, you are
not answering the question. So let me try one more. I have got
40 seconds. Maybe my trifecta----
Mr. Cole. I would remind the gentleman, please give her an
opportunity to answer the question.
Mr. Pocan. But she is answering a different question than I
am asking, and I guess at some point, the 5 minutes----
Mr. Cole. Please allow her to finish her answer.
ACCOUNTABILITY STANDARDS FOR VOUCHER SCHOOLS
Mr. Pocan. Sure. So will you have any accountability
standards for these schools? So when we first started the
program in Wisconsin, money went to someone who started a
school who said he could read a book by putting his hand on it.
And people bought Cadillacs with the dollars they got in the
voucher program.
Are you going to have accountability standards in the
programs that you are offering new dollars to at the Federal
level?
Secretary DeVos. Wisconsin and all of the States in the
country are putting their ESSA plans together right now. And
they are going to decide what kind of flexibility they are
going to allow. They have more freedom than ever because of the
ESSA legislation to be creative and innovative, and our
conversation needs to shift from talking about schools and
buildings and institutions to what is right for individual
students.
Mr. Pocan. So I tried. I gave you 20 seconds. Will you have
accountability standards was the question.
Secretary DeVos. There are accountability standards. The
States are required to have accountability standards.
Mr. Pocan. Are you going to with the Federal dollars was
the question.
Secretary DeVos. That is part of the ESSA legislation.
Mr. Pocan. Thank you, Mr. Chairman. I have got a second
round. Thank you.
Mr. Cole. Absolutely. We now go to, I think, a Member that
is probably not a stranger to you, Madam Secretary, Mr.
Moolenaar from Michigan.
Mr. Moolenaar. Thank you, Mr. Chairman.
SEXUAL ASSAULT ON CAMPUS
And Secretary DeVos, thank you for being here with us
today, and I also want to thank you just for stepping up and
being a leader for our kids in education in our country at this
important time.
And from your message today, I think it is an important
message of trusting parents, trusting our local and State
educators, and really keeping the focus on kids and what is
best for them. So I very much appreciate that message.
I wanted to bring up a specific topic to you that I had a
recent listening session at Central Michigan University, and
students in my district came forward with concerns regarding
the rise of campus sexual assault across the Nation. And it has
been recently reported that 1 in 5 women and over 10 percent of
the student population will be a victim of sexual assault.
My understanding is you recently met with the First Lady of
Michigan, who has recently unveiled a program to combat this
growing issue by creating a campus sexual assault workgroup
called Let's End Campus Sexual Assault.
I guess what I am wondering is what--is there a role for
the Federal Government in this, meeting this challenge? And I
appreciate the fact that you are working with State officials
in addressing this concern. And I promised the student who
asked me this question that I would ask you directly in a
hearing. So thank you for being here.
Secretary DeVos. Thanks, Congressman. It is great to see
you.
And let me just say I share the concern that you and many
others have about the rise in this issue on campuses, as well
as many other issues on campuses. But the Office for Civil
Rights (OCR) at the Department of Education is very committed
to investigating complaints that reach the Office for Civil
Rights, and we are invested in fully funding OCR.
I think--I know that there are a number of viewpoints on
how the rules surrounding this have been implemented, and we
are looking at those very closely. I have been meeting with a
number of stakeholders, including First Lady Snyder from
Michigan, and we take this issue very seriously.
It is--it is certainly an issue for the Office for Civil
Rights to be engaged with and for the Department of Education
to grapple with. But we are not at a point where we can
communicate any change in direction or any new information at
this point.
Mr. Moolenaar. Okay. Well, thank you for that. And I would
like to keep in contact with you on that, and I know----
Secretary DeVos. I would welcome that.
Mr. Moolenaar [continuing]. That the students across the
country, that is a concern.
ENCOURAGING CAREER AND TECHNICAL EDUCATION
Another area that is a concern, in fact, I have heard as
recently as today from business leaders about the need for
skilled labor and career and technical education as a huge
priority and the opportunity for jobs in this area in the
future. I know there are different ideas. The Federal
Government has a role, and I appreciated your year-round Pell
Grant statement.
Are there partnerships or things that we can be doing at
the Federal level to encourage career and technical education,
and what thoughts do you have on that?
Secretary DeVos. Well, this clearly is an area that is of
great focus on behalf of the President and this administration.
And I have had the privilege and opportunity to visit three
different community colleges since I have been in this job and
all of them taking a really unique approach to partnering with
local businesses that have great needs for skilled workers in
skilled trades and really very high-skilled, high-paying jobs.
I think that the way we can best support it is to, in a
very targeted manner, focus the dollars to help support
community colleges in this pursuit--community colleges and
other institutions of higher learning. I think we have done our
young people a disservice over the last few decades by
suggesting that a four-year college or university is the only
way you can really be a success in life and that we have to
have a much broader conversation around multiple pathways and
multiple options for higher education, including, you know,
layered credentialing.
And some of these programs that are being implemented at
the community college level that are really meeting immediate
needs, students are getting the training and education that
they need and into a very well-paying job, can go back again a
year or two or three later and get additional credentialing.
We have many, many jobs going unfilled in this country
today that could be filled and addressed if there is that
partnership. Again, it comes down to really a local level
partnership with businesses and their needs.
I saw an amazing program in Salt Lake City, one in the
Orlando area, and another one in Miami, all meeting very
different needs for very different directions. But many of them
STEM focused, and that was a common theme. And so I think that
another area that we can play a role is to really highlight
some of the best practices and some of the successes that are
happening.
Mr. Moolenaar. Thank you.
Mr. Cole. We next go to the gentlelady from Massachusetts.
Ms. Clark. Thank you, Mr. Chairman.
LOAN FORGIVENESS FOR AMERICAN CAREER INSTITUTE STUDENTS
And thank you, Madam Secretary, for being with us today.
First, a quick question from home. We have 4,500
Massachusetts students who attended the now-defunct American
Career Institute. On January 18th, your Department told them
that their loans would be forgiven. It should be completed
between 90 and 120 days.
We are past the 120 days. Parents, our Massachusetts
attorney general, and students are not getting a response from
your Department. Can you reaffirm that you are moving forward
with this loan forgiveness?
Secretary DeVos. Thanks, thank you, Congresswoman.
Indeed, those to whom we have made a commitment, we are
going to make good on that commitment, and that is in process.
With regard to that regulation, that is something that we are
studying carefully and looking at, and we will have something
further to say on that within the next few weeks.
STUDIES, EVIDENCE AGAINST VOUCHERS
Ms. Clark. Great. And it would be very helpful if you would
get back to our attorney general and give some reassurance to
our students.
I want to go back to the discussion you were having with my
colleague from Wisconsin. You were recently in Indiana, where
you called opponents of school choice flat-earthers. And I
assume that you mean by that a flat-earther is someone who
doesn't look at evidence, doesn't look at data, isn't willing
to embrace innovation, creativity, just keeps believing what
they always believe.
But we have had some major studies in. As you are proposing
a $250 million increase in pilots that would include vouchers
for private schools, the studies from Louisiana, from Indiana,
from Ohio, all show that students who choose private schools in
voucher programs have experienced ``significant losses in
achievement.''
And the studies also show that if we want to achieve good
outcomes for students, those come through nonprofit schools
that are open to all and are accountable to State and/or
Federal authorities.
ENSURING CIVIL RIGHTS OF STUDENTS WITH PRIVATE VOUCHERS
You have talked a lot about the flexibility of States as
being preeminent. So I want to go back to Indiana, to
Bloomington in particular, and look at the Lighthouse Christian
Academy. The Lighthouse Christian Academy currently receives
over $665,000 in State vouchers for students to attend their
school.
They are also clear in their handbook and their guidance
that if you are from a family where there is homosexual or
bisexual activity--their word, not mine--or practicing
alternate gender identity, you may be denied admissions. If
this school, which obviously is approved to discriminate
against LGBT students in Indiana, if Indiana applies for this
Federal funding, will you stand up that this school be open to
all students?
Secretary DeVos. Thank you, Congresswoman, for your
question with regard broadly to school choice and----
Ms. Clark. It is actually kind of narrow because I have 1
minute left.
Secretary DeVos. And I would like to refer back to your
question about the comment about those who are resistant to
change----
Ms. Clark. I am sure you would. I want to ask particularly,
is there a line for you on State flexibility? You are the
backstop for students and their right to access a quality
education. Would you, in this case, say we are going to
overrule, and you cannot discriminate--whether it be on sexual
orientation, race, special needs--in our voucher programs? Will
that be a guarantee from you for our students?
Secretary DeVos. For States who have programs that allow
for parents to make choices, they set up the rules around that.
And that is----
Ms. Clark. So that is a no. Do see any circumstance where
the Federal Department of Education under your leadership would
say that a school was not qualified? What if they said we are
not accepting African-American students, but that was okay with
the State, does the State trump? Do you see any situation where
you would step in?
Secretary DeVos. Well, again, I think the Office for Civil
Rights and our Title IX protections are broadly applicable
across the board. But when it comes to parents making choices
on behalf of their students----
Ms. Clark. This isn't about parents making choices. This is
about use of Federal dollars. Is there any situation, would you
say to Indiana that school cannot discriminate against LGBT
students if you want to receive Federal dollars, or would say
the State has the flexibility in this situation, yes or no?
Secretary DeVos. I believe States continue to have
flexibility----
Ms. Clark. And so there is----
Secretary DeVos [continuing]. in putting together
programs----
Ms. Clark. So if I understand your testimony, I want to
make sure I get this right. There is no situation of
discrimination or exclusion that if a State approved it for its
voucher program, that you would step in and say that is not how
we are going to use our Federal dollars? There is no situation
if the State approved it that you would put the State
flexibility over our students. Is that your testimony?
Secretary DeVos. I think--I think a hypothetical in this
case----
Ms. Clark. It is not a hypothetical. This is a real school
applying for----
Mr. Cole. The gentlelady's time has expired, but I am going
to allow the Secretary to answer.
Secretary DeVos. I go back to the bottom line is we believe
that parents are the best equipped to make choices for their
children's schooling and education decisions. And too many
children today are trapped in schools that don't work for them.
We have to do something different.
We have to do something different than continuing a top-
down, one size fits all approach. And that is the focus, and
States and local communities are best equipped to make these
decisions and framework on behalf of their children.
Ms. Clark. I am shocked that you cannot come up with one
example of discrimination that you would stand up for students.
[Gavel sounding.]
Mr. Cole. You are not required to answer. We will go now to
the gentleman from Idaho, Mr. Simpson.
CONGRESSIONAL INTENT AND TRIO FUNDS
Mr. Simpson. Thank you, Mr. Chairman. I am sorry I had to
step out and finish a hearing over on the other side. But we
have got hearings going on all over the place here.
You mentioned--I am a big supporter of TRIO just like you
are in your comments, your answer I think to Senator Collins
during your confirmation. As the Chairman is and I think most
members of this program are.
And as you have said, you dropped the McNair and EOC
programs because you thought they were outside of the
Congressional intent of what we had planned for TRIO. If we
fund those programs, would they then be within Congressional
intent?
Secretary DeVos. If that is how you defined it, I guess
they would be. I am giving you the rationale for what we have
proposed in the budget, and we believe those programs fall
outside of the scope. And again, we have made some tough
choices and decisions with presenting our appeal for the
budget.
Mr. Simpson. And I understand that, and we will have those
discussions, and there are always differences between what any
administration proposes and what Congress wants to do. Those
are fairly, I think, well-supported programs within Congress,
and you will probably see funding in there.
2017 UPWARD BOUND APPLICATION PROBLEMS
In the fiscal year 2017 omnibus appropriations legislation,
the subcommittee included a directive that encouraged you to
use your discretion as the Secretary to review and score more
than 77 applications to the Upward Bound program that were
rejected for minor formatting issues like failure to double
space and typographical errors in the budget narrative.
Would you please update the subcommittee on your
Department's actions in response to that directive and also
please outline what steps the Department will take to provide
the opportunity for the rejected grant applications to be
considered for funding.
Secretary DeVos. Thanks for that question, Congressman.
As you know, this grant application process was under the
purview of the previous administration. The process was opened
and closed prior to my coming into the job.
And because it was when we found out about the issue with
regard to formatting errors, it was after the competition had
closed, and we looked at all viable legal remedies to try to
address it and did not find any. Since then you have seen fit
to appropriate $50 million. And going back and looking at it
again, we believe that that has materially changed our
available options, and so we are going to use those funds, the
$50 million, to reconsider those applications that were
considered not viable because of the formatting errors.
And so that is going to be our remedy, but let me just say
that this issue apparently has been going on through four
different Secretaries unaddressed. The moment I found out about
it, I issued a Department-wide policy indicating that we are
not going to reject applications for any competitive bid
process based on formatting, that this is a bureaucratic
requirement that we should be rid of now, and we are.
So anything going forward from here will not be held to
those same formatting requirements. But with regard to this
issue, which if you had any idea how much time it has chewed up
internally for us, you would be amazed.
But we are--we have, because of that material change with
the new appropriation, have found a way to be able to address
that particular issue.
PROPOSED CUT TO IMPACT AID
Mr. Simpson. Thank you. I appreciate that.
Your budget also puts $1.2 billion in for Federal Impact
Aid, which is a $67 million cut below Impact Aid payments
currently for Federal property and States in States like Idaho
and, in fact, States across the country that have Federal
facilities that impact school districts. What is your
justification for the cuts in the Impact Aid Program?
Secretary DeVos. So the portion of the Impact Aid Program
that we have proposed to eliminate is one that is not tied to
any students at all, and so there are no students being
supported in that particular Federal land area. And since those
locales have had about 40 years to consider this, we thought it
might be appropriate that they could have figured it out by
now.
Mr. Simpson. Okay. I appreciate that answer. That will be
interesting to look at.
Anyway, thanks for being here. I appreciate your testimony
and look forward to working with you.
Secretary DeVos. Thanks, Congressman.
Mr. Simpson. Thank you, Mr. Chairman.
Mr. Cole. I thank the gentleman.
We now move to my good friend from California, Ms. Lee.
Ms. Lee. Thank you, Mr. Chairman.
FEDERAL CIVIL RIGHTS ENFORCEMENT
Before I begin, I would like to introduce Latrenda Leslie,
who is our foster youth shadow from Oakland, California.
Latrenda, her oldest daughter will be
starting----
[Applause.]
Ms. Lee. She will be starting kindergarten this fall. And
so as we deliberate today, let us keep in mind the young
families who will be affected by our decisions. And I am
really--Madam Secretary, good to see you--kind of hurt, quite
frankly, that she heard your response to Congresswoman Clark's
question with regard to discrimination against students.
It has been the Federal Government that allowed me to go to
school, okay? And so when you say that it is up to the parents
and local communities, even if young people are being
discriminated against, that it is the parents and schools, and
to take the Federal Government's responsibility out of that is
just appalling and sad.
I see in your budget it reflects exactly what you said. You
are cutting $1.7 million from the Office for Civil Rights. To
me, it is outrageous.
And again, I have to go back to your statement when you
said that HBCUs, historically black colleges and universities
are real pioneers when it comes to school choice, which
completely ignores the fact that for many black students, HBCUs
were their only choice.
Secretary DeVos. I know that.
Ms. Lee. For too long, black students weren't allowed to
enroll in predominantly white institutions, even at public
schools in their own States. I could not go to public school,
Madam Secretary. And so for you to sit here and say, as our
Secretary, that it is okay if parents and local communities can
discriminate, it is very sad, shocking, and disappointing.
PROPOSED ZEROING OUT OF HBCU MASTER'S PROGRAM
Now I see in your budget you say that HBCUs, the President
said HBCUs are critical for black students. But I don't think
you really mean that because you don't increase the funding for
HBCUs, and you actually zero out the Strengthening Master's
Degree Programs at HBCUs that we funded in fiscal 2017, which
is extremely important for HBCUs.
And so I am wondering why are you doing that? What is that
about, and why would you do that? As well as--and I just have
to say cut so many programs, 24 programs that minority students
and low-income students rely on. Twenty-first Century Community
Learning Centers, that is after school programs for low-income
students.
You are cutting, you are zeroing out, American history and
civic academics. You are leveling out Preschool Development
Grants. I mean not leveling. You are cutting them. You are
eliminating them.
You are eliminating Special Olympics, $12.6 million. You
are just wiping out Special Olympics for disabled students. For
the life of me, I got to understand what your thinking is about
this budget and low-income students, vulnerable students,
minority students, students who really deserve a shot at a
good, quality public education.
Secretary DeVos. Thank you, Congresswoman. A lot of
questions or a lot of issues there.
Ms. Lee. Well, they are all wrapped around this budget and
a reflection of what you see being our values.
Secretary DeVos. Okay. Let me just start by saying I want
to be very clear. I am not in any way suggesting that students
should not be protected and not be in a safe and secure and
nurturing learning environment. They all should have that
opportunity, and I have continued to talk about that need for
all students to have a safe and secure and nurturing learning
environment.
Ms. Lee. That is not the issue. It is----
Secretary DeVos. And the Department--the Department is
going to continue and will continue to investigate any
complaints or any issues surrounding, you know, allegations of
discrimination. We have no proposal to change any of that.
So as we talk about States assuming more authority and
flexibility in their--in their, you know, how they implement
their programs for their students, nothing about that changes
our desire to ensure that students have a safe and secure and
nurturing learning environment.
With respect----
Ms. Lee. Madam Secretary? Referring to----
Secretary DeVos. With respect to your question around
HBCUs----
Ms. Lee [continuing]. Congresswoman Clark's, well, can you
answer her question real--very quickly?
COMMITMENT TO HISTORICALLY BLACK INSTITUTIONS
Secretary DeVos. Well, I would rather talk about the HBCUs
and how our commitment, our continued commitment to HBCUs by
continuing to fully fund at previous levels and----
Ms. Lee. I don't think that is what the HBCUs have
requested. In fact, they need to see a small increase in their
funding to make sure that black students have those educational
opportunities, and then the cut in the Strengthening Master's
Program at HBCUs is just wiping out. I mean, you are
eliminating that for the most part with HBCUs. So you are
really--it is eliminated.
Comment pertains to rows 1766-1822: Technically, the
Strengthening Master's Degree Programs at HBCUs is not a ``new
program'' as it was first funded in FY2009 for 6 years through
FY2014. Funding was not requested in FY2015 or FY2016. In
addition, the President's 2017 budget did not request funding
for this program; however, Congress appropriated $7.5 million
in the 2017 appropriations bill after decisions had already
been finalized for the President's 2018 budget request to
Congress. So, in essence, the Department didn't consider the
program in our 2018 budget because we didn't request funding
for it in our 2017 President's budget.
Secretary DeVos. It is--yes, okay. It is a new program that
hasn't been part of this budget. So it is not eliminated
because it hasn't been funded yet.
Ms. Lee. Wait just a minute. We did fund that at $7.5
million, the Strengthening Master's Degree Program, and you are
eliminating that.
Secretary DeVos. We are working from the budget numbers
that were available to us prior to your omnibus in April. That
was just a few weeks ago.
Ms. Lee. So you are not eliminating it, or you are
eliminating it?
Secretary DeVos. No.
Ms. Lee. You are not?
Secretary DeVos. The figures in the budget that we are
working from were all put together prior to the omnibus
legislature.
Ms. Lee. Okay. So you are going to restore the $7.5 million
in the strengthening master's degree program?
Secretary DeVos. Well, I think that is going to be up to
Congress to decide how to handle that anomaly.
Ms. Lee. So you are cutting it?
Mr. Cole. Well, to be fair, let the chair interject here.
And with all due respect, the gentlelady's time is up, but I
will certainly allow her to respond. I pointed this out at the
beginning. This is simply a case where Congress said we were
pretty late getting our omnibus done. That is on our fault.
And frankly, they had gone ahead and developed their
budget. So they didn't have the guidance there. So we will have
to revisit that ourselves, and I suspect the gentlelady
probably would be pretty pleased with the decision that gets
made, depending on the allocation.
But again, in fairness to the Secretary, they didn't have
that information, and they did not know Congress had authorized
that program at the time they were putting together their
budget. So it puts her in a difficult spot here, and nobody's
fault, but it is just we have sort of overlapping documents
here, and it creates some discrepancies on occasion.
Ms. Lee. I thank the chair, but I expect to see the $7.5
million. [Laughter.]
Mr. Cole. I have a great deal of respect for my good friend
from California, and I always listen to the point she makes.
And a lot of these decisions will depend on what our allocation
is, which we don't know. But I think the gentlelady knows we
have worked together on a variety of these issues before, and--
--
Ms. Lee. And I appreciate that.
Mr. Cole [continuing]. Look forward to continuing that.
Ms. Lee. And I hope we can restore some of these programs--
--
Mr. Cole. Absolutely. With that, we will go to Mr. Womack,
distinguished vice chairman of the committee.
Mr. Womack. Thank you, Mr. Chairman, and a great
discussion.
Madam Secretary, welcome. And it hasn't been said since I
have been here, but probably deserves to be said. We are
beginning to see the early stages of a much-needed robust
discussion about how we begin the process of getting our
Federal budget under control. And the inescapable fact that
many of the programs that we are talking about here are on the
discretionary side of the budget, and it is being squeezed by
runaway entitlement programs and the inability to address
those, which becomes a very difficult political problem for the
Congress, I understand that. But it is the truth.
And I am sad that we haven't taken up that particular
discussion, but we will save that for another day.
PRE-COLLEGIATE CAREER AND TECHNICAL EDUCATION
Pretty good discussion with my friend from Michigan on
career and technical education, and that is where I want to
focus my question with you. The response that you gave Mr.
Moolenaar was geared toward what we should be doing with our
community colleges. But you had just made a statement that I
completely agree with about--about what we have suggested to
previous generations about a pathway to success, that that
pathway has to be through a college degree.
I am of the strong opinion, based on my travels in my
district and in my conversations with my job creators, that a
lot of the really good opportunities out there exist today for
young people who could leave high school, maybe not even
without attending, darkening the doors of a college
environment, and go right to work with proper training and
proper skills and proper certifications, right to work with
really good-paying jobs, a fulfilling opportunity at a great
career in emerging technologies.
And so I believe in my heart that a lot of this training
should be happening long before the decision is made to go or
not to go to college. I have in my mind that that is probably
somewhere in that late junior high stage, based on aptitude.
But, so I am going to ask you, where is that time in a
young person's educational life, given the tremendous demand
for jobs today, skills today that a lot of our graduates do not
possess? Is this something that we should be doing in our high
school curriculums?
Secretary DeVos. Thank you, Congressman.
The whole area of career and career preparedness and
understanding the wide range of options that one has is, I
think, an area that definitely needs a lot more discussion and
a lot more energy around it. You know, today a lot of the
funding for things that support these efforts are kind of
bifurcated. Many of them, you know, in the Labor Committee or
the Labor Department, and some in the Department of Education.
But the notion that there are many, many different
opportunities for students beyond high school is not really
addressed at an early enough age. And I think I agree with you
that a couple of the places that I visited that have really
great dual enrollment programs have started to address this,
but I think there is an opportunity to have young people
exposed to some of these opportunities much earlier. And
apprenticeships and internships, we should be talking about how
to encourage and support the growth of these in a major way.
I had opportunity to visit a really unique high school
yesterday, one of the Cristo Rey schools. I don't know if you
have heard about this, but these are Catholic high schools
that, as a way to help support and fund the operations of the
school, the students actually go to work in a business one day
a week and, through doing so, gain a whole lot of personal
experience and confidence, but also help to support their
education. And they come out of high school, really, with a
much broader understanding of the professional world, the work
world, and options and opportunities they have.
Those kinds of unique and innovative approaches to exposing
young people to a wide range of possibilities early on are
things we should be encouraging. And I go back to this notion
that, again, States and local communities are best equipped to
try these things. They are the best laboratories of democracy,
and we should be highlighting those that are working well and
encouraging others to emulate them.
Mr. Womack. Yes, we may choose to agree or disagree on
certain matters regarding budgets. But on that particular
subject, we are in total agreement.
And I yield back my time.
Mr. Cole. I thank the gentleman, and just for informational
purposes for my friend and the Secretary, we would love to have
you visit Oklahoma, where we actually do have a great
interlocking career tech and high school system where young
people literally in late junior high, early high school go back
and forth and get exposed to technical kinds of career that may
be more appropriate for them.
But Ohio has a similar system, and I think we are two
unique systems in the country. And it is well worth coming to
see if you ever have an opportunity. We would invite you both.
Now with that, I want to go to my good friend from
Tennessee, who has had to shuffle back and forth and do a lot
of hearing. Mr. Fleischmann, you are up next.
Mr. Fleischmann. Thank you, Mr. Chairman.
And Madam Secretary, it is a privilege to have you here
before us today. I represent the people of the great Third
District of Tennessee. That is Chattanooga and Oak Ridge. And
as the chairman alluded to, I was over at the Energy and Water
Subcommittee this morning, so was a bit delayed.
First of all, I would like to mention how impressed I was
with the emphasis that you placed on school choice. I think it
is absolutely imperative that we give parents the options they
need to ensure their children are properly prepared for the
future. So I thank you for that position.
I was also especially impressed with the building evidence
around innovation section of the budget. I think we really need
investment in research activities that will allow school
districts to identify what works and what doesn't.
COMPUTER SCIENCE CUTS UNDER TITLE IV
On an area of concern, as you may know, I am an advocate
and I view myself as a champion for computer science education,
computer science literacy, and I think there is tremendous
bipartisan support for this endeavor. I was a little concerned
about the Department's proposed cuts to Title IV, Part A grants
authorized under ESSA.
In last year's appropriations bill, we worked hard to
ensure that States would be able to use some of this money for
computer science education. There are a half million computing
jobs currently unfulfilled in the United States. However, our
country only graduated and sent into the workforce 42,969
computer science specialists last year.
It is estimated that between 2016 and 2020, it is projected
that there will be 960,000 job openings in computer science. If
current graduation patterns continue, only 344,000 graduates
will fill them.
So my question is, do you agree with me and colleagues from
both sides of the aisle that we need partnerships with the
private sector, which is looking to hire Americans for computer
science jobs, and schools from kindergarten through high school
to help ensure students from all walks of life are prepared for
the computer science jobs that need to be filled now and in the
future? And if so, how can we work to ensure that we prepare
students for these jobs?
Thank you.
Secretary DeVos. Thank you, Congressman.
I definitely share your interest in ensuring that students
have exposure to STEM subjects and, in fact, have opportunity
to pursue really robust programs in that area. I would just as
an anecdote refer to the high school that my husband started, a
charter high school focused on aviation that has a very
distinct STEM focus and has been really doing an amazing job of
attracting kids that would have not been likely to be a part of
a high school like that.
But with regard to specifics in the budget, this budget,
again, was developed before the continuing resolution was
addressed. But we do have a $20 million experimental grant in
for STEM competition, and I think that is a good place and, you
know, good role for the Department. I think an important place
for the focus to be placed around STEM is really, again, at the
State level because they are putting the ESSA plans together.
They have the opportunity to really customize it for the
students in their States and their local communities.
And I had an interesting conversation I think it was last
week with a number of superintendents from one from a rural
district, one from a very large urban area, another from kind
of a medium-sized city, and then the other one was actually a
statewide superintendent, how they have implemented coding
programs in their districts. And I believe the organization
that they have partnered with on that has now entered 20
percent of the school districts in the country.
I think we need to continue to encourage that. I hesitate
to say we should mandate it from the Federal level, but we
should try to actually encourage and support those activities
as States are putting their plans together.
Mr. Fleischmann. Madam Secretary, I thank you, and I agree
with you. I have engaged in some of those coding opportunities
in the schools, particularly in some of our inner-city schools
in Chattanooga, which have been traditionally underserved, and
it was inspiring to go there and see high school students all
the way down to the second graders engaging in coding. And I
just look forward to working with you on this computer science
literacy and with my colleagues on both sides of the aisle as
we reach out to all American students in this regard.
Secretary DeVos. Likewise. Thanks.
Mr. Fleischmann. Thank you.
Mr. Cole. I thank the gentleman. We will now move to my
good friend from Alabama, Mrs. Roby.
Mrs. Roby. Thank you, Chairman.
And thank you, Madam Secretary, for being with us today. It
is good to see you again. I am really looking forward to
working with you and your Department through the oversight of
this committee.
And let me say thank you for your service to our country. I
want to convey my appreciation on behalf of all of the students
and parents and educators in the State of Alabama.
STATE AUTONONY AND FEDERAL OVERREACH
It was about a year ago when your predecessor was here and
sitting right where you are now, and we had a good exchange
about the role of the Federal Government in decisions
concerning standards and curriculum for the classroom. So let
me back up for a minute and just give you some background on my
involvement in this issue.
Back in 2013, I introduced a bill called the Defending
State Authority Over Education Act that prohibited the Federal
Government from making special funding grants and coveted
regulation waivers contingent upon whether a State is using
certain curriculum or assessment policies. For 3 years we
worked to get this language included in the comprehensive
rewrite of No Child Left Behind, which is now the law E-S-S-A,
ESSA.
Thankfully, we finally succeeded, and our strong State
authority language was included in the Every Student Succeeds
Act. So back to my exchange with your predecessor, which was
taking place during the very critical implementation process of
ESSA. What I was trying to get a straight answer on then was
whether the officials within the Department of Education would
simply ignore the law and continue their old habit of
exercising undue and inappropriate influence over State
education decisions.
You have to remember that that kind of thing was
commonplace under the previous administration, and I believe
that the former Secretary King and I got to a good place. But I
think we can get to an even better one today. So let me ask
you, Madam Secretary, number one, do you acknowledge that the
law now expressly forbids the coercion of States to adopt
certain education standards and curriculum, including Common
Core?
Secretary DeVos. Absolutely.
Mrs. Roby. And will the Department follow the letter and
spirit of the law?
Secretary DeVos. Absolutely, it will.
Mrs. Roby. I appreciate that answer, and so to be clear,
you can definitely count on me among those who believe that my
State of Alabama and all States should, indeed, set high
standards that challenge students and build critical thinking
skills. I am glad that our State has made an effort to raise
its standard in recent years when we lagged behind for so long.
And I certainly welcome collaboration with other States to
share best practices. However, the intrusion of the Federal
Government into that process directly or indirectly is
inappropriate, and it invariably comes with a political agenda
from Washington. This has bred a lot of confusion and distrust.
And in many States, it has contributed to a volatile policy
environment.
And so I appreciate your commitment and your forthrightness
on this issue, and any other comments that you want to make
about this I am welcome to hear.
Secretary DeVos. Well, thank you, Congresswoman.
We share that concern, and you have my commitment that the
Department is going to implement and follow the law that you
have set out through ESSA. I would, frankly, love to see a
competition on the part of all the States to outdo one another
on how high they set their standards and how high they shoot.
We should be shooting for excellence across the board, but in
no way should it be a top-down, one size fits all solution from
the Federal Government.
And my hope is that with the States' flexibility in
opportunities here that they do, indeed, shoot high and that
they are very ready to point out to others when they are not,
you know, living up to the task of preparing all of our
students for a great future.
Mrs. Roby. Thank you so much for your commitment.
Mr. Chairman, I yield back.
Mr. Cole. I thank the gentlelady, another model of turning
back time. I appreciate it.
I know the Secretary has a hard stop at 1:00 p.m. So we are
not going to be able to do a second round. I regret that. But
we had both the ranking member and the full chairman here, and
I think we all stretched our time a little bit beyond 5 minutes
anyway.
But I do want to allow my good friend the ranking member to
make any comment or closing statement or question she cares to,
and then I will do the same.
Ranking Member Closing Statement
Ms. DeLauro. Thank you very much, Mr. Chairman.
And again, thank you, Madam Secretary.
Let me just try to correct the record in some instances
here with my time. I think it is wonderful that we talk about
career and technical education. You may have seen the Pew
Research Center and Markle Foundation's ``The State of American
Jobs,'' which talked about 70 percent of American adults do not
have a 4-year degree.
And while we can talk about it and give a lot of lip
service to it, the fact of the matter is, and this was not a
continuing resolution issue, there was a decision made for this
budget to cut the career and technical education program by 15
percent, $168 million. This is not--and you can't talk out of
both sides of your mouth. You are either going to put the money
where we believe we are going to make the best possible bang
for the buck, or we should just be silent about it. Don't talk
about it and do something about it.
Let me talk about vouchers for a moment. Gold standard,
Institute of Education Sciences, gold standard evaluation of
Washington, D.C., the only federally funded voucher program,
found that vouchers negatively impacted student achievement.
D.C. students using vouchers performed significantly worse on
math in the first year they used the voucher. In the early
grades, they performed worse in both math and reading. Similar
results from Louisiana, Ohio, and Indiana, as my colleagues
have pointed out.
Madam Secretary, you continue to say that Title I has not
been cut. Title I has been cut by $578 million. The fact of the
matter is, is that with all due respect, on May 5th, we signed
an omnibus bill. I don't want any process piece here, and that
affects what my colleague Ms. Lee talked about, these are cuts
to programs.
So the fact is that the budget proposes cuts that, if
enacted, would impose real harm on our country's students. And
I have to make the point again with regard to vouchers and
children who are disabled or disabilities. You referenced the
McKay Scholarship Program, and I will tell you that in that
program, with information that I have, and we looked into it,
no due process rights under IDEA. They give up due process
rights granted by the individuals if you accept a Federal
voucher.
No accountability for the participating schools. They do
not have to be accredited. They do not have to provide any
evidence of the quality of their programs. No evidence of
student success. Because students do not take standardized
tests in private schools, it is impossible to hold private
schools accountable or compare their performance with public
schools. Key NAEP scores have declined or flat between 2009 and
2015.
Now I make those corrections because we can't--if we are
going to have a robust conversation about education, then let
us put the facts on the table and go from there. This is a
budget, and I characterized it, Mr. Chairman, in the Ag
Appropriations Committee this morning, it is cruel. It is
inhumane, and it is heartless. A $9.2 billion cut to education.
And fact of the matter is when my colleague talked about
there is 10 percent, there is less money going to high-poverty
areas. The teachers are more likely to be novices in these
places. Those underserved areas are going to be hurt.
None of us in here are going to be hurt. We are going to be
fine. Our kids and our grandkids are going to be okay. But
millions of kids around this country are going to suffer what
has been done with a $9.2 billion cut to our education
programs, which are supposed to serve our youngsters, make sure
they have a good future and a bright future.
And I am going to fight this budget, Mr. Chairman, with
every fiber of my body because it is wrong to do this to our
kids.
Mr. Cole. I have no doubt. [Laughter.]
Chairman Closing Statement
Mr. Cole. Madam Secretary, I just want to thank you very
much for being here today. I want to thank you for your
testimony, for your professionalism.
I particularly love the emphasis on choice and, frankly,
trying to give as many options to young people as we possibly
can, and you certainly laid that out robustly in your budget. I
know you have had to make some tough decisions. We actually
have three Cabinet-level jurisdictions here, and we are given
an allocation, and we end up having to make a lot of tough
decisions, too.
So we certainly have a great deal of sympathy for that, and
I want to assure you, you see this is a committee that is a
pretty spirited committee. And we appreciate you engaging with
us today. We look forward for other opportunities to do that,
and I know every member of this committee, on a bipartisan
basis, if they can assist you in any way, want to do that. We
want to see you succeed because we think your success
represents the success of America's students.
We know you care about that deeply. You have demonstrated
that over a lifetime. We know the President cares about that,
and we look forward to working with you in that common endeavor
as we go forward.
Secretary DeVos. Thank you, Mr. Chairman. Thanks for the
opportunity.
Mr. Cole. Thank you very much, Madam Secretary.
Secretary DeVos. Thank you to the ranking member.
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Wednesday, June 7, 2017.
DEPARTMENT OF LABOR
WITNESSES
HON. R. ALEXANDER ACOSTA, SECRETARY, DEPARTMENT OF LABOR
Opening Remarks by Chairman Cole
Mr. Cole. Good morning, Mr. Secretary, and welcome. It is
my pleasure to welcome you to the Subcommittee on Labor, Health
and Human Services, and Education. We are looking forward to
the hearing today.
I happened to notice when I was reading your biography that
you were sworn in on April 28. That happens to be my birthday.
I hate to tell you it is also Saddam Hussein's birthday, but I
still consider it an auspicious date in human history, so I
know we are going to have a good relationship.
This hearing is to review the Department of Labor's fiscal
year 2018 budget request. The committee understands that the
Department had a target level of funding in this budget and
that significant cuts needed to be proposed in many areas to
achieve that. The committee's task is to carefully consider the
budget request and to make recommendations for the funding
needs of critical programs at the Department, including job
training, worker safety, labor statistics, and others.
The committee also appreciates the Department's focus on
job training and employment needs of hard-to-serve populations,
including youth, Native Americans, formerly incarcerated
citizens, and the Nation's veterans, particularly the
Department's requested increase for the Homeless Veterans'
Reintegration Program. I hope the Department will continue to
work with the committee and the Congress to eliminate veterans'
homelessness and to better serve all of these populations.
COMBATING THE SKILLS GAP
An issue I view as critically important is the skills gap.
According to the Bureau of Labor Statistics, there are
currently over 5 million open positions for which employers are
unable to find qualified candidates. Many of these are high-
paying jobs, and I believe the skills gap is a very significant
opportunity cost for workers and for the economy overall. I
look forward to hearing your views on how job training programs
at the Department of Labor can better meet the needs of these
employers and reduce the skills gap.
DOL WORKER PROTECTION PROGRAMS
The committee also recognizes that enforcement is an
important part of the Department's worker safety programs, but
we continue to believe that worker safety should be the
principal goal. It has been difficult to ignore the previous
administration's adversarial and punitive pursuit of labor
enforcement. I believe most employers want to do the right
thing for their employees and have been understandably
frustrated by their partnership with these agencies at the
Department of Labor.
Beyond the shift of resources from enforcement to
compliance assistance, I would suggest that the culture at some
of these agencies needs to change. Inspectors and safety
experts must view their roles as cooperative partners of the
employers and employees to advance worker safety across the
Nation's industries. Hardworking Americans deserve to know that
the Federal Government has their back, both ensuring that good
jobs are created and that safety is ensured.
FISCAL YEAR 2018 BUDGET
It is unfortunate that the final consolidated
appropriations bill for fiscal year 2017 was not enacted prior
to the time that funding decisions for your fiscal year 2018
budget request had to be finalized. In many cases, if the
policy of the administration was to maintain current funding
for a program that Congress increased in fiscal year 2017, the
budget request would appear to be a reduction when, in fact,
that was not necessarily your intention. We will simply need to
carefully explain ourselves when discussing proposed increases
and decreases in those categories today.
Finally, the subcommittee needs to know the specific
details for how the proposed cuts in the Department's fiscal
year 2018 budget would impact job training programs and the
programs that target hard-to-serve populations. The budget
provides some of these details. I know that some are still
being developed. But we look forward to hearing what you are
able to share with us today.
I am sure the members of the subcommittee will have many
questions about the budget and policy issues, including the
fiduciary rule. So, without further delay, I would like to
remind members and our witnesses that we will abide by the 5-
minute rule so that everyone will have a chance to get their
questions asked and answered.
But before we begin, I would like to yield 5 minutes to the
full--well, to the gentlelady--okay, to the----
Mr. Frelinghuysen. To your ranking, please.
Mr. Cole. Well, we normally would do our ranking, so to the
ranking member of the full committee. Then obviously, we will
move to the full committee chairman for any remarks he cares to
make.
Ms. DeLauro. Thank you very much, Mr. Chairman of the
subcommittee and Mr. Chairman of the full committee. I
appreciate it.
Good morning, Secretary Acosta, and welcome to the
committee and to, I guess, your first appropriations hearing.
I would select the chairman's birthday as a date to focus
on versus Saddam Hussein anyway.
Mr. Secretary, as we did speak, I will be blunt. I do not
have anything complimentary to say about this budget request.
In fact, I think it is a disaster for American workers and for
their families. In your written testimony, you say that, quote,
``We are going to do more with less.'' Mr. Secretary, you
cannot do more with less. You can only do less with less. And,
in my view, that is exactly what this budget proposal will do,
less for American workers.
CUTS TO EMPLOYMENT AND TRAINING PROGRAMS
The budget request for the Department of Labor would
decimate the employment and training system by cutting more
than $2,000,000,000, roughly 40 percent of its funding,
eliminating services for seven to eight million Americans who
need help to find a job or move to a better-paying career.
The biggest economic challenge of our time is that too many
families do not make enough money to live on. They are in jobs
that don't pay them enough to live on. They are struggling
today. And we need to enact policy that ensures that everyone
can benefit from the economic recovery and that everyone has
the training they need to get good jobs with fair wages.
By 2020, two out of three jobs will require training beyond
the high school level. It is up to us to meet the need. This
budget would cut Job Corps by about $250,000,000, leading to a
shuttering of Job Corps centers around the country. Thousands
of at-risk youth would lose access to important skills
training.
Your testimony says the budget eliminates programs that are
less effective. In fact, it zeros out programs that are known
to be very effective. The Senior Community Service Employment
Program exceeds the Department's own performance targets in
entered employment, employment retention, average earning.
Migrant and Seasonal Farm Worker Training places participants
into employment 90 percent of the time, increases wages
threefold.
Through this committee, we have the opportunity to make
important investments in job training that we know work, like
providing the first-ever Federal appropriation to expand the
apprenticeship model throughout the country. And if we are
serious about job training, we would be making investments like
we did through the TAACCCT, the T-A-A-C-C-C-T program, which
provided $2,000,000,000 to more than half of all community
colleges nationwide.
IMPACT OF PROPOSED CUTS IN FY 2018 BUDGET
The President proposes to cut or eliminate programs that
help low-income and working-class families, and yet, we are
awaiting or at least we have an outline of a budget that
includes a massive tax cut for corporations and for
millionaires, a similar scenario that we saw with the
healthcare bill, the underlying purpose being to cut taxes for
the wealthy while cutting back on programs for middle class
families.
It was on the campaign trail that the President claimed
that he would be tough on trade. Yet, in his first budget he
proposes to eviscerate the office whose mission is to identify
cheating on trade deals. He wants to cut the Bureau of
International Labor Affairs, known as ILAB, by almost 80
percent. It is the lead agency for investigating labor
violations and trade agreements with our trading partners. It
compiles annual reports on products that are made with child
labor and with forced labor.
And the budget request should focus on modest increases to
compliance assistance programs. And while I agree that there
needs to be a balance between compliance assistance and
enforcement, I am concerned that you plan to scale back on
enforcement activities, which results in less oversight on
those who are out there. Yes, most employers want to do the
right thing, but, in fact, we do have bad actors, and you know
that, particularly when it has dealt with wage theft over the
years. This deprives workers of honest wages, exposes them to
dangerous health and safety hazards.
OSHA, only enough funding to inspect every workplace under
its jurisdiction every 159 years. Yet, the budget proposes to
eliminate funding Susan Harwood Training Grants that protect
and educate workers in the most dangerous jobs.
The budget also proposes to cut funding for the Women's
Bureau, $10,000,000, eliminates 70 percent of its staff. This
is a critical function to improving work environments and
opportunities for women. Pretty much unacceptable to slash its
budget when today women make 80 cents on the dollar.
Taken as a whole, the President is proposing to cut the
Department of Labor by $2,300,000,000. It is a reduction of 19
percent.
MAINTAINING LABOR PROTECTIONS FOR THE AMERICAN WORKER
Mr. Secretary, I think we need to know today whether or not
you agree that your Department should be cut by $2,300,000,000.
We also need to know if you are going to fight to defend the
protections for safe workplaces that your Department has made
in recent years, regulations to limit exposure to silica,
beryllium, coal dust that will save thousands of lives.
We need to know if you are going to protect the financial
safeguards to retirement savings that were put in place by the
fiduciary rule. And I hope that you do agree that financial
advisers should make recommendations in their clients' best
interests, not in the interests of advisers.
The New York Times had a front page story this week
alleging an upcoming rollback of worker protections. It says:
At the request of industry lobbyists, the Department is
planning to weaken regulations across the board, including
regulations on silica, beryllium, which are known carcinogens.
I hope that you will tell us, Mr. Secretary, that the report is
wrong and that you plan to enforce the Department's worker
protections.
Again, disappointed about the proposal to eliminate the
Office of Federal Contract Compliance, OFCCP, by absorbing it
into the EEOC, another area in which you have had experience.
The OFCCP actively ensures that Federal contractors are held to
a higher standard in their hiring practices, given that
contractors are entrusted with taxpayer dollars. So I strongly
oppose this proposal.
PAID PARENTAL LEAVE PROPOSAL
Final note, the administration has proposed what I view as
a paltry 6-week parental-only paid leave scheme in their
budget, despite the fact that more than 75 percent of people
who take family or medical leave do so for reasons other than
parental leave. Moreover, the intention is to fund its proposal
through the overburdened State Unemployment Insurance Programs,
which are insufficient to sustain the program and would erode
access to unemployment benefits should another recession hit.
The President's proposal does not reflect the reality that
workers face. We need a real family and medical leave policy
nationwide, funded responsibly and sustainably, without cuts to
essential programs.
To close, let me share a quote from one of my heroes and
the longest-serving Labor Secretary in our Nation's history,
Frances Perkins. She said, and I quote: ``The people are what
matter to government, and a government should aim to give all
the people under its jurisdiction the best possible life.''
That is how I view the mission of this Department. I hope
that that is the way that you view the mission of this
Department and that you will assure us that you intend to
improve the lives of working people.
Thank you very much, Mr. Chairman.
Mr. Cole. Thank you.
And now my pleasure to go to the chairman of the full
committee, and a great privilege to have the distinguished
gentleman from New Jersey, Chairman Frelinghuysen, for any
opening remarks he cares to make.
Remarks by Chairman Frelinghuysen
Mr. Frelinghuysen. Thank you, Mr. Chairman.
And welcome to the appropriations process, Mr. Secretary.
Today's hearing is an important part of the oversight
duties of this committee. Now that we formally have received
the administration's budget request, the committee will
undertake a thorough analysis of yours and every budget. We
intend to put forward a complete set of appropriations bills
that adequately fund important programs while working to reduce
or eliminate waste or duplication.
This hearing is part of a process we follow to determine
the best use of taxpayers' dollars. After all, the power of the
purse lies in this building. It is the constitutional duty of
Congress to make spending decisions on behalf of the people we
represent at home.
REGULATORY BURDEN ON SMALL BUSINESS
When I travel across my congressional district in New
Jersey, meeting with small-business owners and employees, I
often hear about how excessive government regulations are
hampering growth. According to The National Small Business
Association, the average small-business owner is spending
$12,000 annually dealing with regulations. That is why we must
work together to reduce these types of burdens, especially the
Department's fiduciary rule, and cut red tape, which often
requires resources that could be better utilized for other
purposes.
DECREASING VETERAN UNEMPLOYMENT
May I also say that, like many of my colleagues, I host an
annual veterans job fair in my congressional district with
local employers to directly advertise their employment openings
and retraining opportunities to those who have returned from
the war front. I am pleased to learn that the national
veterans' employment rate fell to 3.7 percent in April, which
remains below the national average. I know you will continue to
promote veterans' employment and training service programs and
many other programs, as these are critical investments directly
resulting in improved quality of life for veterans and their
families.
Welcome to the committee.
And I appreciate the time that the chairman has given me.
Thank you.
Mr. Cole. Thank you, Mr. Chairman.
And, with that, Mr. Secretary, we will go to you for any
opening comments you care to make.
Opening Statement by Secretary Acosta
Secretary Acosta. Well, Mr. Chairman, thank you. Mr.
Chairman and Ranking Member DeLauro, members of the
subcommittee, thank you for the invitation to appear today.
And perhaps let me begin on a note of bipartisanship. The
people are what matter, and I couldn't help but note that in
all the opening remarks the focus was on the people. And I
think if we keep that front and center, that is a great place
to start.
It is an honor to appear before this subcommittee to
outline the administration's vision for the Department of Labor
in fiscal year 2018 and beyond. Supporting the ability of all
Americans to find good jobs and safe jobs is a priority for
President Trump and for myself. And, to be clear, a good job
and a safe job are not and should not be mutually exclusive. It
should be both, and we can have both. I am proud and I am
humble to lead the Department in this critical work.
COMBATING UNEMPLOYMENT
Last week, the Department announced the U.S. unemployment
rate. It is at a 16-year low, 4.3 percent. It hasn't been that
low since 2001. This is amazing news. What is, I think, as
important but less talked about is that there are now 6 million
job openings. That is the highest number of job openings that
we have had since we started keeping this statistic in the year
2000.
We can get most Americans that are unemployed back to work
if we can simply match those job openings with who is looking
for a job. And to facilitate this match, we need to better
align job training, job education, and the skills the
marketplace demands. And the evidence tells us that effective
job education programs prepare workers for high-growth jobs
that actually exist. There has to be a focus between the job
that exists and the educational program that is preparing the
worker.
FOCUS ON APPRENTICESHIPS
And one approach to preparing workers for these high-growth
jobs are apprenticeships. It is a proven strategy that works.
High-quality apprenticeships--and the emphasis on high
quality--enable workers to be involved in the training of their
future workforce so they can be sure that new hires possess the
skills that are needed for the job. Apprentices receive wages
and, just as importantly, skills, and along the way they earn
while they learn. And that is just as important, because that
means they are not saddled with debt.
Apprentices earn nationally recognized certificates of
completion leading to long-term career opportunities. Many
registered apprenticeship programs also afford apprentices the
opportunity to earn college credit toward their degree.
Last week I met with three apprentices at the Ford Rouge
plant complex in Detroit, Michigan, and it was wonderful to
meet with them. They were excited. They thought that they were
learning, that their careers were expanding. They receive 600
hours of classroom instruction separate and apart from their
job.
Upon completion of the program, the apprentices will have
gained the skills to work in any department within the plant.
They will have transferrable skills from department to
department that will travel with them, irrespective of whether
they stay at Ford or they go elsewhere. And as importantly,
after the completion of the program, I was told that they only
needed three additional classes to get their degree.
High-quality apprenticeship programs are a huge win for the
apprentice and for the employer. The employer gains skilled
trained workers and the workers themselves have a wonderful
start to a prosperous career.
STREAMLINING DOL PROGRAMS
Getting Americans back to work also requires limiting
programs that are less effective at helping the American
worker. There are many programs intended to help Americans find
jobs or train for jobs, but some of them are duplicative or
less necessary or unproven or less effective. The Department is
committed to streamlining or eliminating programs based on
rigorous analysis of available data to access and to improve
program effectiveness.
When we match Americans who are looking for work with
available jobs, we want to ensure they are good and that they
are safe jobs, as I said previously.
The Department believes that a vast majority of employers
across the Nation are responsible actors, as was mentioned
earlier, but we also understand that that is not 100 percent,
and so we are fully committed to enforcing worker protection
laws, as we have been doing. The budget includes funding
increases of about $16,000,000 to the Department's worker
protection agencies to support this goal, with an emphasis on
compliance as well as enforcement.
We are going to do more with less, as was noted, and we
have to do more with less. We are going to focus the Department
on its core mission by making smart investments in programs
that work. The budget makes hard choices, and they are hard,
but they are responsible choices that have to be made.
Americans want good and safe jobs. The Department is here
to support Americans' desire to gain and hold these jobs, to
support Americans' desire to have skills that are transferrable
and that will set them on a career path that will ensure their
future. The budget restores the Department to this fundamental
vision, investing in programs that we know are successful. The
proposals are evidence-based and reflect the seriousness with
which this administration takes its responsibility.
I look forward to working with you, and I would welcome
your questions. Thank you.
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THE TRIBAL LABOR SOVEREIGNTY ACT
Mr. Cole. Thank you very much, Mr. Secretary. It is, again,
very good to have you here.
Let me begin with an issue that I mentioned to you a moment
ago when we had a chance to visit. And just to provide a little
context, when the National Labor Relations Act was passed in
the middle of the 1930s, the National Labor Relations Board was
not given any jurisdiction over governmental employees,
Federal, State, local.
The original legislation was silent about Indian tribes,
but for 60 years the Department exercised no jurisdiction over
tribes. In 2004, on its own, without a request from the
Congress or, as far as I can determine, without a request from
the administration at the time, they simply decided they would
draw a distinction--an artificial distinction, in my view--
between what they called governmental employees, law
enforcement, healthcare, and the like, and people that were
employed by tribes in commercial ventures, gaming obviously
being the most prominent, but lots of other areas as well.
That was universally and violently resisted by tribes all
across the country. There has been a lot of litigation about
it. There has been a lot of legislation about it. Actually,
last year the House of Representatives actually passed
legislation called the Tribal Labor Sovereignty Act that my
friend Mr. Rokita from Indiana carried, bipartisan majority, to
take that jurisdiction away from the National Labor Relations
Board.
The Senate failed to act, but this year the Senate actually
has already moved that legislation through the Indian Affairs
Committee, so there is at least a good prospect. And I think
certainly if that legislation comes to the floor here, it would
pass again.
So I wanted to give you an opportunity to at least, if you
have any thoughts about that, if you have a concern, because it
is something we have placed at least in the House-passed
version of your appropriations bill before. So this is apt to
be a legislatively live round, so to speak, in the coming
months.
Secretary Acosta. Mr. Chairman, thank you for the question.
As you know, I served on the National Labor Relations Board in
2003, so your question brings back memories that are more than
a dozen years old at this point.
You know, during my days as a U.S. Attorney something that
I was very sensitive to is understanding that there is a
sovereign-to-sovereign relationship between the United States
and tribes, and that is something that I tried to respect as
U.S. Attorney when engaging in law enforcement activities with
the tribes.
I haven't read the decision that the NLRB issued, it was
after my time on the NLRB, and I haven't seen the statute. But
at a general level, I would say this: That the United States
has made commitments that we would respect the sovereign-to-
sovereign nature of tribes, and that those commitments should
not be violated unless there is clear language to that effect.
And so I don't know where the NLRB found that language. But
ultimately, I think that Congress should carefully consider
this. And unless there is good reason, the sovereign-to-
sovereign relationship that we have with tribes is something
that goes beyond any one area and that has sort of been a
fundamental tenet of the relationship that we hold with those
entities.
Mr. Cole. Well, I appreciate that answer. And I would hope
that if you have time that you take a look at this issue,
because it is something that, again, we will be dealing with
probably on the floor of the House, certainly within the
confines of this committee.
JOB CORPS BUDGET CUTS
Let me ask you in the time that I have left, obviously--and
this was raised by a number of members--you have proposed
pretty serious cuts or substantial cuts in the Job Corps
program. Could you give the committee some idea about the
criteria you would use in making the decisions whether closures
were involved, how you see redistributing the funds that you
would have left, and, again, where you think there are areas
that could be reduced without costing us any effectiveness in
training young people to go into the labor market?
Secretary Acosta. Certainly, Mr. Chairman. As you are
aware, the Job Corps program encompasses many centers. Some of
them are quite effective, some of them much less so. And there
are formulas in place to measure Job Corps effectiveness.
At a personal level, I have looked at those formulas, and
one concern that I have with respect to those formulas are do
they focus on the end result. The Job Corps center is there to
teach skills so that individuals could get jobs. And my
question is, are they getting jobs?
And I think that is a very easy criteria in one sense, and
a very complicated criteria in another sense, because in some
hard-to-serve communities, if 50 or 75 percent of the
individuals find a job, that is a big win, because in some
hard-to-serve communities, given the population that Job Corps
serves, that is an outstanding result.
And so I think it is important that any decision on Job
Corps first be based on what the budget ultimately provides or
what the appropriations ultimately provide.
Second, it looks at the cost of running individual centers.
There are some centers that may need repair to maintain them.
That would be very expensive.
And thirdly, it looks on a rigorous data-based, evidence-
based, using evidence-based methodology, at ultimately are the
participants getting jobs, compensating for the fact that some
Job Corps programs serve hard-to-serve communities and what may
on its face be a less effective program may actually be quite
effective, given the community that it serves.
Mr. Cole. Thank you very much, Mr. Secretary.
I am going to go next, if the gentlelady has no objection,
to the full committee chairman, because I know he has many time
constraints.
So, Mr. Chairman.
Mr. Frelinghuysen. Thank you, Mr. Chairman.
Just one comment and then a question.
FOCUSING ON VETERAN EMPLOYMENT
As you look at our workforce, three of us on this
committee, on this panel, serve on the Defense Appropriations
Committee. I chaired that over the last couple of years. There
is an enormous need for welders out there. It is a tough job. I
think you know many of those in that type of occupation are
second or third generation. I do think as we look at sort of
opportunities, there could be more of a focus, which would be
beneficial to veterans and others.
And the other area, which is quite different but does
require particular skills, mostly found in the young, a cyber
workforce that is capable to meet sort of the challenges we
have today.
STATUS OF THE FIDUCIARY RULE
And so my question is unrelated. Where do we stand relative
to the fiduciary rule? I mean, I have to say I think Members of
Congress have been bombarded by a lot of their constituents
over the last 3 or 4 years. I have probably had 2,500 letters,
electronic and snail mail, on that issue. Could you just walk
us through briefly where we stand relative to the fiduciary
rule?
Thank you, Mr. Chairman.
JOB TRAINING AND APPRENTICESHIPS
Secretary Acosta. Mr. Chairman, I am happy to do so. And
first, let me acknowledge the earlier point that you raised.
Just this morning, I was talking with a major corporation that
has entered into a cybersecurity partnership with the
University of Maryland, where they are working with the
University of Maryland on the curriculum so that Maryland will
graduate individuals trained in cybersecurity, educated in
cybersecurity, ready for jobs.
And on the welder point, let me note that apprenticeships,
according to our data, on average, when they complete it, enter
professions where they earn an average of $60,000 a year, which
is an amazing salary for an entry level job, quite honestly,
higher than a lot of lawyers. And it is something that I think
individuals don't hear enough about.
UPDATE ON THE FIDUCIARY RULE
Going to your question on the fiduciary rule. As you are
aware, the fiduciary rule was adopted by the prior
administration. It was postponed for 60 days. The effectiveness
of part of it was postponed for 60 days to analyze it. This
administration looked at whether it should be postponed further
and concluded that there was no basis to postpone the effective
June 9 date any further.
The rule is being looked at. Just this morning at the OMB
website, at the OIRA website, a request for information went
public asking industry, asking consumers a number of questions
about the rule, about how the rule is being implemented, about
the impact that the rule has, and that is the first step in
this administration's review of that rule. But we need that
information and we need that data in order to decide how to
proceed.
Mr. Frelinghuysen. Thank you.
Mr. Cole. Thank you, Mr. Chairman.
With that, we will go to my good friend, the ranking
member, the gentlelady from Connecticut.
CLOSING THE SKILLS GAP UNDER PROPOSED BUDGET
Ms. DeLauro. Thank you very much, Mr. Chairman.
Mr. Secretary, in your testimony you note that with 6.9
million unemployed Americans, and there are 6 million job
openings, that we need to do a better job equipping workers
with in-demand skills and matching them with businesses that
are hiring.
So, as I pointed out earlier, I find it perplexing that as
you advocate to address the skills gap, your budget proposal
slashes $2,300,000,000 from job training. Forty percent,
$1,100,000,000 cut to the Workforce Innovation and Opportunity
Act, WIOA grants. Job Corps, my colleague asked about, 15
percent, $256,000,000. I was interested to hear your comment.
In terms of these cuts which are being proposed, you
reference an evaluation process that must go into
decisionmaking. I don't know, what was the decisionmaking
process that went into the evaluation of $256,000,000 to cut
Job Corps, $256,000,000 to cut the employment service,
$10,000,000 to cut Reintegration of Ex-Offenders, $5,000,000 to
the apprenticeship program.
Yes, apprenticeships, Germany, U.K., over the top on what
they are doing with apprenticeships. We added money in the
omnibus bill, which is a good thing. Why aren't we going back
to the program that we had and looking at the TAACCCT program,
$2,000,000,000, which went to community schools in order to be
able to close that skills gap and to be able to apply for
apprenticeships? You can't cut a program and say that you are
for the program.
Complete elimination, job training for migrant and seasonal
farm workers, $82,000,000; Senior Community Service Employment
Program, $400,000,000. These are all job training programs that
have been proven.
How do we provide workers with the skills we know they need
under your budget proposal?
Secretary Acosta. Well, I thank the ranking member for the
question, and it is an important one. As you noted, the skills
gap is real. Just this morning I was at a meeting of
businesses----
CRITERIA FOR BUDGET CUTS
Ms. DeLauro. How does your--I am sorry and I don't mean
to--I have very limited time, as it turns out, always on this
committee, because everybody comes. There is such good stuff we
deal with here.
How do you propose, with the cuts that have been proposed
in worker training, to go where you want to go, and what was
the process of evaluation of these programs with the initial
cuts that we see here? Who evaluated them? What were the
criteria that said we should cut Job Corps $256,000,000, we
should eliminate this program?
Secretary Acosta. So let me take your questions seriatim,
if I could.
With respect to what was the evaluation process, I think
what I was referencing is that there has to be an evaluation
process that is data-based and that is rigorous in order to
implement those reductions that are ultimately determined to
take place on programs like Job Corps, that it shouldn't simply
be we don't cut it because it's in this Member's district or
that Member's district, but it needs to be data-based. And I
was referencing the formula and thoughts on how to engage in
that evaluation process in order to implement the cuts that--I
am sorry?
Ms. DeLauro. All I just want to say is, I understand, we
understand evaluation here. We have program integrity dollars
where we look into what is fraud, waste, and abuse, all of the
above. I have no idea, and if somebody could tell me and get
back to me on what were the criteria that went into the cuts
that are here, $2,300,000,000, and the cuts to programs that
have been proven effective.
We all on this committee understand Job Corps to a fare-
thee-well. We have said close down those that don't work. I
don't know where you come up with $256,000,000 and what is
going there.
SHIFTING RESPONSIBILITY TO STATE AND LOCAL GOVERNMENT
The other piece of this which was interesting to me is, do
you really believe that States and localities are going to pick
up the slack on this effort? We are looking at, if I look at
overall of what the administration's proposals are, new costs,
you gut Medicaid, SNAP, TANF, LIHEAP, to name a few, and the
higher education spending per student is down by about 18
percent and we are going to get that to the States. How are we
going to do that?
Secretary Acosta. So, Congresswoman, I can't comment as to
the higher education spending, but what I can say with respect
to an important element of this budget is there are 37
different programs at DOL, many of those that flow down to the
States. And one element that I think will be helpful to the
States is increased flexibility in how to spend the money that
they have rather than line item each to a particular program.
Ms. DeLauro. They don't have the money, and we are cutting
further back in what they do. I just look to the State of
Connecticut. In no way could they take up the slack on these
programs.
Thank you very much, Mr. Chairman.
Thank you, Mr. Secretary.
Mr. Cole. I thank the gentlelady.
Next, based on the order of arrival, we move to the
distinguished vice chairman of the committee, the gentleman
from Arkansas.
Mr. Womack. Thank you, Mr. Chairman.
REVIEWING THE FIDUCIARY RULE
Thank you, Mr. Secretary, for your service and your
testimony here this morning.
The overall chairman asked about fiduciary. I want to go
back to that for just a minute because on Friday the rule takes
effect. But you said in your testimony two things: That OMB has
published a request for information and that you will continue
to look at it. What does ``look at it'' actually mean to the
average person?
Secretary Acosta. So, Congressman, let me be precise. I
think what I said was that OMB--it appeared on the OMB website,
and any request for information still needs to go through the
OIRA process.
Mr. Womack. I see.
Secretary Acosta. And so it has not yet been published.
So, as I tried to indicate--and I have to be very careful
because this is an ongoing litigation--as I tried to indicate,
this rule was enacted under the Administrative Procedure Act.
And through that act, Congress provided a methodology for
administrations to enact rules.
And I guess if I was talking to the average person, I would
say, when Congress enacts a law, you need a new law to change
the old law, and that new law needs to go through the same
process as the old law. When a rule is enacted, you need a new
rule to change the old rule, and that rule needs to go through
the same process as the old rule. And this is an
oversimplification to try to address your request, to sort of
oversimplify.
And so if there were to be a change, that change would have
to be based on information that is obtained through a record
process, the first step of which is a request for information
that establishes the beginning of additional information in the
record. And based on that information and if that information
supports it, then the administration could look to a new rule
that could change the previous rule, just like Congress, as it
gets new information, could say, we want to enact a law that is
somewhat different.
Now, that sounds cumbersome and that sounds--some have said
it is about process. But it is not about process, it is how the
democracy works. And no one in government should be able to
snap their fingers and undo laws or undo rules, because that is
not a respect for fundamental democracy.
Mr. Womack. There are concerns about inhibiting job growth,
job creation, cost-benefit questions, impacts on, say, younger
generation who are just now beginning to save for retirement.
Is it not obvious that this is going to limit their
options? Does it have some far-reaching effects that would be
counterproductive to particularly younger generation saving
opportunities?
Secretary Acosta. Congressman, there are concerns. Those
concerns were voiced in the original rulemaking process. And
the prior administration made a decision that those concerns
were outweighed by what the prior administration wanted to do.
At this point, the Administrative Procedure Act and
administrative law prohibit me from prejudging a rule. And so I
need to be careful. I will acknowledge those concerns, but we
need the data to substantiate those concerns, because the
decisions have to be based on the record or else it becomes
prejudgment. But those concerns certainly surfaced the first
time around and, unfortunately, they were not heard, and that
is what happens.
Mr. Womack. I hope they are heard in the next review.
CONSOLIDATING GOVERNMENT PROGRAMS
In the time that I have left, I do want to congratulate you
for attempting some consolidation to save money, because we do
operate under a finite resource environment. But specifically,
the OFCCP and the EEOC, are there other opportunities out there
to consolidate and create some economies of force, if you will,
among our departments?
Secretary Acosta. Well, Congressman, I do think an area of
consolidation, referencing the ranking member's question
earlier, we have, I believe, 37 different job education
programs just at the Department of Labor alone, and that
doesn't include the job development programs that we have at
Veterans Affairs, at the Department of Education and elsewhere.
And ultimately, we all want to provide job education. We
really, really do. Everyone wants to see the unemployment rate
remain low, everyone wants to see the job openings filled, and
that is something I think we can all share. The question is, is
that best done with the 50 or more programs throughout
government or is that best done with a handful of programs that
are highly successful?
Mr. Womack. Thank you.
I yield back.
Mr. Cole. Thank you.
We now go to my good friend, the distinguished lady from
California, Ms. Lee.
Ms. Lee. Thank you very much, Mr. Chairman.
Good morning, Mr. Secretary.
Secretary Acosta. Good morning.
Ms. Lee. Good to meet you.
IMPACT OF CUTS TO WORK FORCE TRAINING PROGRAMS
I want to follow up with regard to the cuts as it relates
to workforce training. But first let me just say there have
been several estimates about the overall Trump budget as it
relates to job losses, even though, unfortunately, we heard the
President talk about putting America First and creating jobs in
America. But I know one estimate has the overall budget
totaling a 1.4 million job loss by 2020, given this budget.
Your agency has a large part of this job loss responsibility,
quite frankly.
With regard to the workforce training, for example, the 40
percent cut under Title I for adults, youth, and dislocated
workers, it is really shameful, especially when you look at
what, for example, other departments are requiring in terms of
work requirements as eligibility for food stamps, for example.
Yet you are cutting the very work training programs that would
help people get jobs. And yet, on the other end, the Trump
administration is saying, but if you don't have a job, you are
not eligible for food stamps.
These cuts are outrageous as it relates to communities of
color. And I want to go and hear your understanding of why the
unemployment rate is still twice, for example, in the Black and
Latino community, 4.3 percent nationally, 7.5 percent in the
African American community, 5.2 percent in the Latino
community.
So investments in workforce training, in reintegration of
ex-offenders, you are cutting 12 percent out of that account.
You are cutting the 5 percent out of the apprenticeship
programs.
What is your analysis as it relates to communities of
color? And don't we need--and do you believe we need targeted
investments in communities of color where this unemployment
rate is still twice what the national average is?
Secretary Acosta. Congresswoman, thank you. Thank you for
the question.
Let me start off by saying I don't know where the data came
from regarding the job impact of the budget, but----
Ms. Lee. Economic Policy Institute is one organization that
has indicated about a 1.4 million job loss by 2020 by the Trump
budget.
FOCUSING ON JOB TRAINING WITH A LEANER BUDGET
Secretary Acosta. So I will have my staff pull that
information. But let me say, I am exceedingly focused on jobs,
jobs, and jobs. That is a very clear, a very, very clear
priority. And so I hear everything you are saying.
You know, just a few days ago I found out that--I was told,
and I don't know if it is factual or not, but I was told that
the Bureau of Prisons doesn't open--doesn't allow access once
individuals are moving into the community and starting to
reenter into apprenticeships, private sector apprenticeships.
And I directed my staff to call over and start finding out why,
because that does have a disproportionate impact on communities
of color.
And just this morning I was talking about the cybersecurity
apprenticeship program at the University of Maryland, and one
of the----
Ms. Lee. Mr. Secretary, I want to go to your budget, in
terms of the cuts and the impact on communities of color,
especially given the unemployment rates and given the cuts in
workforce training in Job Corps and employment services and
apprenticeship services as it relates also to the work
requirements of other programs.
Secretary Acosta. And that is where I was trying to go. The
point I was making about the apprenticeship program at the
University of Maryland is that they were telling me that it
disproportionately helps communities of color, because it is a
cohort program that provides a community and a support system.
And so I think your points are very, very important.
I think one of the issues raised by the budget and one of
the themes that I am hearing that I would push back against a
little bit is the notion that it is all about just how much you
spend. The budget overall makes very, very hard decisions. And
as part of that, we are going to have to reallocate the money
from some programs that are less effective to some programs
that are much more effective.
Ms. Lee. Mr. Secretary, how do you then allocate Department
of Labor cuts, in terms of workforce training, to create the
type of job training programs that everyone who is unemployed
who is trying to get a job needs with those cuts? And I
specifically ask because in communities of color you are
looking at 7.5 percent unemployment rate in the Black community
and 5.2 percent in the Latino community.
And so specifically, with regard to those cuts, how do you
create the skill sets and the eligibility requirements for
people to get these jobs that exist yet aren't filled?
Secretary Acosta. Congresswoman, and that is why I was
referencing programs like apprenticeships and others, where you
do not saddle individuals with debt, where you help them gain
job skills, and where particularly communities of color can
benefit and have been shown to benefit from gaining these jobs.
Ms. Lee. Mr. Secretary, there is a $5,000,000 cut in your
apprenticeship programs. And so what I am concerned about----
Mr. Cole. I would ask the gentlelady and the Secretary to
please--we are at time, and I want to give everybody a second
round if we can.
Ms. Lee. Okay. Thank you, Mr. Chairman.
But I still don't quite understand when you cut
apprenticeship programs and workforce training programs how you
help create a pathway to middle class jobs for people.
Mr. Cole. I appreciate that very much.
And now we will go to my good friend, the distinguished
doctor from Maryland, Dr. Harris.
Mr. Harris. Thank you very much.
Thank you, Mr. Secretary, for being here. Congratulations
on your appointment.
PRIORITIZING FEDERAL SPENDING
Look, I agree with the framework of the President's budget.
The bottom is, we do have to finally prioritize spending. We
have a $500,000,000,000-a-year deficit, a $20,000,000,000,000
debt, and the last President never presented a budget that
ever, ever balanced. Now, no family can do that. No business
can do that. It is about time the Federal Government doesn't do
that.
So we do need to prioritize spending to undo the defense
rollback of the last administration and to reduce our deficit
and eventually balance the budget. So I support the President's
framework, no question about it.
With regards to the Economic Policy Institute, I wouldn't
spend too much time looking into what they do. It is a union-
backed organization that--look at their website, look at the
front page--that is just a President-bashing site. I get it, I
understand there is division in the country, but their
alternative facts are just not correct.
H-2B VISA CAP RELIEF
Let me talk about two specific issues very important to
Maryland and my district. First is H-2B cap relief. We have
industries in my district, specifically the seafood processing
industry, that simply cannot find American workers to do those
jobs. Those jobs exist for only 4 or 5 months out of the year.
My idea of full American employment is not having every
American have a job that lasts 4 or 5 months if we can do that
with temporary foreign workers.
As you know, the omnibus bill did authorize up to an
additional 69,000 temporary worker visas, but after
consultation between DHS and DOL.
So I just want to ask you, what is the status of those
consultations and are we going to begin to see an increase in
the numbers of H-2B visas processed this year, especially for
the summer season, so important in my district?
Secretary Acosta. Congressman, thank you. Thank you for the
question.
And first, let me clarify, as the chairman mentioned
earlier, one of the confusions here is that, because there
wasn't a budget and there had to be a midyear change, the
increases and the decreases are difficult to measure.
But with respect to apprenticeships, the budget is being--
there is reduction in apprenticeship spending. It is the same
level as the 2017 continuing resolution.
Now, moving to your question on H1Bs. I am very sensitive
to your question and the concern. H1Bs generally I think fall
into----
Mr. Harris. H-2B.
Secretary Acosta. I am sorry. H-2Bs generally fall into two
categories, what I will call the truly seasonal worker, such as
you are referencing, and that is a very specific industry and a
specific geography and a more general worker. And something
that I think we need to look at are long-term fixes in a few
areas.
First, employers have to apply for jobs no more than 3
months in advance, but there is a 6-month window. And so if you
have to apply 3 months in advance for a 6-month window and the
caps are reached almost immediately in January, unless you are
starting employment in April, you are locked out of the system.
And that has an impact on a few geographical locations where
they are, in essence, locked out of the system. And my staff
has already started talking to staff about ways to address
that, possibly breaking down the number in a more logical way
that doesn't disadvantage certain geographies over others.
I think the second question that needs to be addressed is,
how do you address the needs of certain geographies that have
extreme peaks in demand that are seasonal for a short period of
time? And how do you address those without opening the program
broadly? Because for those geographies with extreme peaks, that
demand simply cannot be met by the local workforce or even a
workforce that is brought in.
And so those are two very complicated fixes that I very
much hope to work with Congress on a long-term solution.
As to the shorter-term solution, we are in discussions with
DHS that has the ultimate authority on this. And what I can say
is I am sensitive to your concerns, but there is also the
concern that raising the overall cap may not really address
what is a unique situation in your State and about half a dozen
other States throughout the country.
Mr. Harris. Thank you. Obviously, you understand the issue
and hopefully maybe this can be a bridge to solving it.
OVERTIME RULE
I just want to in the remaining few seconds just mention
that the overtime rule is very significant for educational
institutions, and in the University of Maryland system, it
would increase cost between $16,000,000 and $40,000,000 in a
year. So I would urge you to look at that cap and perhaps just
do an inflation adjustment instead of raising it as far as it
is, because it is so important to our educational institutions.
Thank you. I yield back.
Mr. Cole. Thank you.
We will now go to my good friend from Wisconsin, Mr. Pocan.
Mr. Pocan. Thank you very much, Mr. Chairman.
And nice to meet you, Mr. Secretary.
FOCUSING ON APPRENTICESHIP
I am very encouraged to hear what your personal goals are
around apprenticeship. I strongly believe that too. I wish we
had apprenticeship programs in technology and healthcare and a
whole bunch of other areas. I think that would be very useful.
And we do have a bill that was introduced, the LEARNS Act,
you might want to take a look at. We haven't reintroduced it
yet this Congress. It was bipartisan in the Senate. It talks
about some initiatives around that. But a strong supporter of
apprenticeships and glad to hear your commitment, and I know
you made comments when you came back from Germany.
MAINTAIING THE ADVISORY COMMITTEE ON APPRENTICESHIP
The questions I have, hopefully, are fairly brief, just
trying to get some idea. One is, are you going to maintain the
Department's Advisory Committee on Apprenticeship?
Secretary Acosta. Congressman, I have no current plans not
to. I think advisory committees are very, very helpful.
Mr. Pocan. All right, thank you.
CRANE OPERATION CERTIFICATION RULE
Second, I know there is a rule, a promulgated rule around
crane operation certification, crane operator certification,
and I know that there is some consensus around the industry. I
know they would like to talk to you about some changes. Are you
open to talking to them? I think there seems to be a consensus
among the industry, and if we could just make some changes, the
rule might turn out to be a little stronger for everyone.
Secretary Acosta. I love talking to both industry and
representatives of workers. I have already started outreaching
to many different organizations, and I would welcome the
opportunity for them to come in. And if your office or your
staff would provide the contacts, I would welcome that.
Mr. Pocan. Thank you. Appreciate that.
WAGE THEFT ENFORCEMENT STRATEGIES
On the Wage and Hour Division, you know, in the past they
have used a lot of the tools and penalties in order to have
some strategic enforcement around wage theft issues. Do you
intend to pursue similar enforcement strategies regarding wage
theft?
Secretary Acosta. And so I am not----
Mr. Pocan. Independent contractors especially.
Secretary Acosta. So I am not certain exactly what you are
referencing, but let me tell you at least my approach.
Something that when I was U.S. Attorney that I tried to find is
the high-impact cases. And there are different ways of
measuring effectiveness. One is, how many cases do you bring?
And another one is, do you bring what I will call impact cases?
And impact cases are larger cases that have broad-based impact,
and it is not just on the individual worker in this context,
but it is also the deterrent effect that it has.
And I do think there is a high value to bringing impact
cases, but that also has to be balanced with you can't give a
free pass to the small actor. And so while you are focusing on
the large impact cases, you also have to recognize that you
need to bring a reasonable amount of smaller cases so that the
small actor that is behaving wrongly doesn't feel that they
have a free pass.
Mr. Pocan. I would just encourage you to look. I think some
of the past actions were very helpful. When we met with the
Department of Labor last session when I was on Education and
Workforce, they are estimating up to 70 million people might be
independent contractors right now. Clearly, that is not the
realistic case that is out there. I have been an employer for
three decades. So if you can continue to look at that, we would
really appreciate that.
ELIMINATION OF SUSAN HARWOOD GRANT PROGRAM
Another question, a lot of concerns around the OSHA
outreach program that is being cut, the one that kind of does
work directly with workers, the Susan Harwood Training and
Education Grant Program. Could you just talk about that cut
briefly?
Secretary Acosta. Certainly. The Susan Harwood grants are
being cut. At the same time, though, there is a budget increase
of, I believe, $4,000,000 for compliance assistance. And so our
approach to that is we recognize that the money for the grants
around compliance will be reduced, but at the same time our
intent is to invest in providing that training and that
compliance assistance ourselves directly.
Mr. Pocan. Okay. We might just want to follow up with you a
little bit on that.
Secretary Acosta. Happy to do that.
Mr. Pocan. Appreciate you looking at that.
PRIORITIZING LOW-INCOME WORKERS
Also, how are you going to prioritize helping low-wage
workers? Specifically, I think one of the concerns we had last
session is people could be making $24,000 a year and then
working way beyond the 40 hours a week without any
compensation. Can you address how you are going to take a look
at that?
Secretary Acosta. Well, do you mean within the wage and
hour context or more generally?
Mr. Pocan. Wage and hour context.
Secretary Acosta. Well, let me answer both. How is that?
Within the wage and hour context, we are going to enforce, and
we are going to enforce vigorously. You know, just this week we
announced some really interesting enforcement actions that I
will provide----
Mr. Pocan. Excuse me, Mr. Secretary. I think broader, you
are right. I am sorry. How are you going to look at it? Because
the one thing the last administration, they were targeting that
$24,000 figure, just because it seemed so low, you shouldn't
have to work beyond the 40 hours for no extra compensation. If
you could just address that maybe more generally then, how you
are going to deal with it.
Secretary Acosta. Certainly.
So I think for lower income, there are two parts. One is,
where the law is being violated, we need to look at it and we
need to look at it carefully and vigorously.
And just this week, we announced two cases, one of which I
thought--I am a little over time--but I thought it was very
interesting because it involved what I will call severe
mistreatment of individuals that were here on visas. And we
will provide your staff with that.
[The information follows:]
[GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT]
But the kind of working conditions that no one should have
to work under. They were being asked to sleep in a bus that was
un-air-conditioned, you know, so that they could be by the work
site.
And so, as far as I am concerned, we are going to enforce
all that.
More broadly, going back to the skills gap, it is not just
about enforcement. You have to provide people a pathway out.
And I hate to sort of be one note on this, but particularly for
lower-income folks, providing those skills is, I think,
critical.
Mr. Pocan. Thank you.
Mr. Cole. We will next go to the distinguished member from
Michigan, my good friend, Mr. Moolenaar.
Mr. Moolenaar. Thank you, Mr. Chairman.
H-2B VISA PROGRAM
Mr. Secretary, thank you for being here with us today. And
I wanted to build on some of the discussion that you were
having with Dr. Harris about the H-2B visas. And I strongly
support the points that he made, and I appreciated your
understanding of this issue and also the idea that there are a
few things you are able to do in the short term to look at some
of the timing issues and also geographies with extreme peaks.
And also it may require more complicated legislative solutions,
and I would just offer to work with you on that in any way I
can be helpful.
Secretary Acosta. I appreciate it.
Mr. Moolenaar. You know, in Michigan the H-2B visa program
is extremely important to seasonal employers, and resorts and
other seasonal businesses throughout my district in northern
Michigan rely on the H-2B program to operate, especially during
the summer tourism season. And right now there are dozens of
businesses in northern Michigan, especially on Mackinac Island,
facing the prospect of limiting hours that they are opening--or
not opening at all--due to labor shortages and the early
exhaustion of H-2B visas.
And I don't know if you are familiar with that situation,
but it is something that I do want to bring to your attention.
And I was pleased that you have been consulting with Homeland
Security and would just want to raise that issue, because it is
a jewel of Michigan and I have heard repeated concerns about
the lack of workers that are projected.
Secretary Acosta. Congressman, if I could just--I am not
sure that was a question--but if I could just reemphasize my
comment. You know, I think it is very important that we look at
a way to address the truly seasonal demand and separate that
from the broader, because I understand and feel for those
businesses that are engaged in the truly seasonal demand, but
the current program does not separate those.
POSTPONING THE FIDUCIARY RULE
Mr. Moolenaar. Okay. And then just as a follow-up, you have
talked some about the fiduciary rule as well. And I understand
the point you are making about not wanting to prejudge. My
concern is that as we approach this June 9 timeline, I wonder
if you do have the ability to postpone it going into effect
until you are able to review it or if you have considered that.
I know that is something that would--if you were able to
postpone it until the review was done and any recommendations
you have, I think that would clarify and eliminate some of the
confusion on this issue.
Secretary Acosta. Congressman, thank you.
We looked very carefully at whether we could postpone it.
And to sort of fall back on the earlier analogy, when Congress
passes a law, the executive branch can't just postpone
implementation of that law. And when a rule is adopted, the
executive branch cannot--with very, very narrow exceptions--
just postpone implementation of that rule.
And if the executive branch was allowed to do that, then
that would be an immense power that the executive branch would
have. And so one of the difficulties is folks may say, well,
sometimes the executive branch takes upon itself power that it
shouldn't have, but that is not what the law says, and rules
can't just be postponed even if there are concerns.
So we have looked at it, we have looked at it very
carefully, attorneys at various levels have examined this, and
we have come to the conclusion that there simply is no basis to
postpone the June 9 date.
I should add that the full rule does not come into effect
on June 9. Several important provisions of the rule do not come
into effect until January 1. So the prohibition on arbitration
doesn't go into effect until January 1 and the State law causes
of action do not go into effect until January 1.
But as to the June 9 date, which is what is before us now,
we have looked at it very carefully, multiple attorneys have
looked at it, and the conclusion has been that there is no
basis to postpone the rule.
Mr. Moolenaar. Okay. Thank you.
PRIORITY APPRENTICESHIP PROGRAMS
And then just one last question, on the skilled trades and
some of the things you learned while you were in Michigan, the
apprentice programs. Are there certain apprenticeship programs
that you think should be at the top of the priority list?
Secretary Acosta. So I think particularly the skills trades
are looking at a shortage. And something that concerns me--I
mentioned earlier that apprentices make an average of $60,000
starting wage and joked that that is higher than a lot of
lawyers, and it is, as a factual matter. But if you look at
welders, if you look at carpenters, if you look at so many
others, these are professions that aren't attracting as many
youth, and these are professions that pay really good money at
the end of the day.
And we need to figure out a way to work through
apprenticeship programs and others. And these are also
professions, I should add, that have established apprenticeship
programs that are very effective. So the first thing is don't
break what is working, right? But let's find ways to increase
and scale what is already working, because we need folks,
particularly with the upcoming infrastructure, we knows folks
that know how to build.
Mr. Moolenaar. Thank you.
Mr. Cole. The chair is going to gently admonish the panel,
please don't ask the second question 7 seconds before the end
of your time. Not very fair to the Secretary. Not very fair to
the next people in line. And I do want to give people an
opportunity to ask as many questions as possible.
With that, my other good friend from California, Ms.
Roybal-Allard is next.
Ms. Roybal-Allard. Welcome, Mr. Secretary.
JOB TRAINING BUDGET REDUCTIONS
Before I ask my question, I just want to say that I am
equally confused about your emphasis on the dire state of the
skills gap and then what your budget proposal does to impose a
staggering 40 percent cut to WIOA State formula grants, which
would actually shatter the successful sector partnerships and
career pathways that currently benefits businesses at the local
level. And I just want to point out that it is estimated that
your budget would result in the loss of job training programs
for over 31,000 workers in California alone.
REVOKING FAIR PAY AND SAFE WORKPLACES ORDER
As you know, President Trump signed an executive order to
revoke the 2014 Fair Pay and Safe Workplaces order, which
required Federal contractors to give wage statements detailing
pay and hours to employees to guard against wage discrimination
and reduce the wage gap between men and women. The Fair Pay and
Safe Workplaces order also stopped companies with government
contracts from using forced arbitration clauses to keep sex
discrimination claims out of the courts and off the public
record. I am deeply concerned by the President's elimination of
these protections.
In the absence of the Fair Pay and Safe Workplaces order,
what are your plans to protect workers from Federal contractors
who violate labor and civil rights laws?
Secretary Acosta. Well, Congresswoman, let me answer your
question broadly and specifically.
First, let me say that the revocation of any particular
order is not intended to lessen enforcement. And more
specifically, let me go to the OFCCP and the responsibilities
that it has, as well as the Women's Bureau, where we are going
to--we have authority over Federal contractors, and we will use
that authority and we will use that authority fully and
vigorously.
The Women's Bureau, as well, is I think an important part
of DOL. And one of the areas that I think it is important for
the Women's Bureau to pursue is to look at these issues and to
make recommendations within DOL and within government as to
what can be done to address issues that are of importance to
women, issues that impact women disproportionately. I am glad
that the Women's Bureau is within this budget because it will
allow the Department of Labor to focus a particular entity on
exactly these issues.
MAINTAINING PROTECTIONS FROM FAIR PAY AND SAFE WORKPLACES EO
Ms. Roybal-Allard. Okay. If this executive order is not
intended to lower enforcement, you said, then what is the
purpose of this executive order in revoking the safety measures
that are in the pay equity of Fair Pay and Safe Workplaces?
Secretary Acosta. So, Congresswoman, I think there are
different ways things are measured, and sometimes effectiveness
is measured by dollars and sometimes effectiveness measured by
outcome. And sometimes protections are measured by process and
regulation, and sometimes effectiveness is measured by outcome.
And a reduction in process or a reduction in regulation
does not as a matter of necessity imply, nor should it be read
as, a reduction in protections. You can protect without having
the regulations that overburden or that require excess
disclosure.
Ms. Roybal-Allard. My colleague here just points out that
the Women's Bureau is cut by $9.6 million and 29 FTEs. So you
continue to cut the very programs that are meant to do exactly
what you said, and that is oversight and protection.
Let me just ask you this. What actions will you take to
prevent millions of dollars of Federal contracts from going to
companies that partake in labor and civil rights abuses,
particularly in pay equity?
Secretary Acosta. So, Congresswoman, let me answer your
question differently. The Fair Pay and Safe Workplaces EO that
you are referencing was the so-called--some in the media called
it a blacklisting provision. A CR was passed by this Congress
on that matter. We are still going to go after the bad actors
irrespective. We still have debarment authority. We have
enforcement authority. And we intend to use those fully.
Ms. Roybal-Allard. Can I just ask you, based on what
information? If this information isn't being provided, then
what are you going to use as a basis to go after these bad
actors?
Secretary Acosta. So my understanding of this is that the
information is available. The question is whether there is a
list that is kept that sort of automatically bars or prevents
without additional process or additional safeguards. And that
is different from enforcement. The United States engages in all
sorts of enforcement activity without keeping lists of
potential bad actors.
Ms. Roybal-Allard. Do you believe that companies----
Mr. Cole. The gentlelady----
Ms. Roybal-Allard. Just yes or no, do you believe that
companies with government contracts should be able to use
forced arbitration clauses?
Secretary Acosta. Congresswoman, I believe that when
engaging in contracting the government has the authority and
right to look at what is appropriate in any particular contract
situation. I believe it is the policy of Congress, as enacted
by legislation and, thus, the policy of the United States, to
favor arbitration as a general matter.
Ms. Roybal-Allard. Sorry, Mr. Chairman, I thought it was
going to be a yes-or-no answer.
Mr. Cole. Well, the gentlelady got extra time, but only
because the next gentleman asked for an untimed personal
announcement that he wanted to make.
Mr. Simpson. Yes. We have an announcement that we would
like to make. I spent the last 2 nights--this has absolutely
nothing to do with this hearing, but it is very important
anyway.
Mr. Cole. Yes, it is.
Mrs. DeLauro. Fire away.
MISCELLANEOUS COMMITTEE MEMBER COMMENTS
Mr. Simpson. I spent the last 2 nights watching two
incredible women's softball teams playing for the national
championship. Monday night's game went 17 innings. And I turned
on to watch the Nationals play the Dodgers, but it just kept
going and going and going. It was an incredible game to watch.
And last night the Oklahoma Sooners won the national
championship for the second time in a row, fourth time in their
history. And I am really getting tired of saying this, I want
to congratulate my chairman and his Oklahoma Sooners for the
women's national championship softball game.
Mr. Cole. Third time in 5 years.
Mr. Simpson. Yep. It was an incredible game to watch.
Ms. DeLauro. Do they get paid as much as the men get paid?
Mr. Simpson. In college they do.
Mr. Cole. Since you brought it up, just for the record, the
OU men's golf team won the national title 2 weeks ago, and for
the second year in a row, we are the only school to ever have
the men and women's gymnastic team claim the national title in
the same year. So for those of you who think we just play
football, we actually do other things very well.
Ms. DeLauro. Or those of us in Connecticut just play
basketball.
Mr. Simpson. The question is, did they do any educational
services, too?
Mr. Cole. These are brilliant young women. These are
brilliant young women. The men's golf team, maybe not so much.
But they are awfully a special bunch. But thank you very much.
Mr. Simpson. Thank you.
Mr. Cole. My friend is recognized for a normal round of
questioning.
Mr. Simpson. Thank you, Mr. Secretary. And thanks for being
here.
OVERTIME RULE'S IMPACT ON SEASONAL WORK
I want to talk for just a minute about this overtime rule
that was proposed by the Obama administration, and this has had
a disproportionate impact on seasonal recreation businesses
operating on public lands, like guides and outfitters. They are
required to obtain a permit to operate on public lands,
including in national parks and forests, and that permit makes
them a Federal contractor.
The regulations promulgated as a result of this executive
order is pushing these businesses off public lands. For an
experienced guide, he or she is really on the job 24/7 during
the season that they are working, and a week-long trip now
becomes prohibitively expensive. In fact, I have talked to many
college students who used to have great jobs working in the
summer as an outfitter or a guide or working with an outfitter
or a guide who now work in a Burger King, because the outfitter
or guide can't hire them anymore because of the overtime rule.
Does the Department have any plans to review and propose
changes to this regulation that has been promoted?
Secretary Acosta. So I am not certain what your question
is. Let me ask answer both possibilities that I think it may
be.
So we do have plans to look at the overtime as a general
manner, the overtime rule, as I mentioned at my confirmation
hearing. I think that any rule that has a dollar amount that
isn't updated for as long as this has been is a problem,
because life gets a lot more expensive. But I also think that
the way it was done created a shock to the system. And the
Department is in the process of drafting a request for
information that I think will be filed probably in the next 2
to 3 weeks asking for public information and public comment on
the overtime rule.
With respect to the more narrow question of how this
applies to public lands, that is something that I would have to
look into more carefully, and that certainly may be part of
that request for information.
Mr. Simpson. There are people who believe that the Forest
Service, as an example, shouldn't have to comply with this,
because they are just getting a permit to operate on public
lands, so they don't qualify as a contractor. But the Forest
Service feels that they have to comply with this. So that is a
question that needs to be resolved.
CONSOLIDATING DOL PROGRAMS
Secondly, when you are talking about jobs and consolidating
programs and finding those that work and stuff, we have talked
about this on this panel, I suspect there are, in different
areas in different States, different programs work differently.
And some are successful in one area, where they might not be in
another.
I will tell you one that works very well in Idaho. I had
the opportunity to visit a few weeks ago the Community Council
of Idaho's YouthBuild Program. It does incredible work with
young people that they are working with, giving them the skills
for the future. And so I hope you would work with this
committee as you look at trying to make these programs as cost
effective as possible.
IMPROVING THE EEOICPA PROGRAM
Lastly, I need to ask a question for Congressman
Fleischmann, who was ill today and couldn't be here, and he
asked me to ask this. It says: ``I strongly support a
Department of Labor program that partially compensates workers
who contracted serious illnesses from harmful substances and
radiation exposure as a direct result of their national
security work. The government, nor its workers who were
diagnosed with radiation-related cancers, chronic beryllium
disease, and other life-threatening diseases did not fully
understand the risk of their weapons-related work during World
War II and the Cold War. While major improvements were made
last year to implement the Energy Employees Occupational
Illness Compensation Program, more needs to be done.''
He has two requests. ``Will you personally review this
program to understand its importance along with examining the
two recent sets of recommendations by the Advisory Board?''
Secretary Acosta. Yes.
Mr. Simpson. And secondly, in addition, will you encourage
your staff to meet with his staff to work on these issues? We
work closely with workers in our districts--actually in my
district also--and need a good relationship with your
Department.
Secretary Acosta. I see no problem with that, absolutely.
Mr. Simpson. Okay. Thank you.
OFCCP COMPLIANCE ASSISTANCE AND ENFORCEMENT
Since I have got 51 seconds, and I won't go to 7 seconds,
the Department of Labor's Office of Federal Contract Compliance
Programs is tasked with the mission of protecting Federal
contractors and subcontractors by promoting diversity in
enforcement of the law. In some instances there be
opportunities for the OFCCP to partner with industries and
companies who are already working to create equitable and
inclusive workplaces.
How can the Federal Government be a better industry partner
to create these equitable workplaces, share best practices, and
work with contractor communities to further programs? In fact,
we put language in our last bill that was Senate language
relative to that issue.
Secretary Acosta. Congressman, so as a general matter, I
think compliance assistance alongside enforcement is very
important, and part of compliance assistance certainly is
highlighting best practices. I am happy to take that point
back, and I believe they are already doing that, but I am happy
to take that point back and reemphasize it.
Mr. Simpson. Thank you.
Mr. Cole. I am inclined to be gentle with my friend because
of his announcement, but for the record, you went to 9 seconds,
and that is just not a big help.
Mr. Simpson. I was trying to follow your instructions.
Mr. Cole. Yeah. Okay.
Now to my good friend, the distinguished gentlelady from
Massachusetts, Ms. Clark.
Ms. Clark. Thank you, Mr. Chairman.
And thank you, Secretary Acosta, for being with us today.
RESPONSES TO CONGRESSIONAL INQUIRIES
I want to go back briefly, there has been some mention of
the H-2B visa program, certainly a problem seasonally in New
England as we go forward. But, specifically, on February 17 I
sent you a letter regarding this program with 32 of my
colleagues, all of whom happen to be Democrats.
Last week it was reported that agencies have been
instructed by the administration not to respond to letters from
Democrats requesting oversight-related information. So my
question is, is that why I have not had a response?
Secretary Acosta. Congresswoman, I, you know, knowing that
I was going to come before you all, I checked last week to see
if we had responded to the letters that were submitted. And as
of yesterday I am told that we have responded to all letters
from all members of the subcommittee and the committee, the
larger committee.
And so I will--I see my staff writing furiously behind me.
So we will check to see where that letter is. I believe it--I
believe it has already gone out. But what we will do is we
will, if it has not, we will get back and we will get you a
copy of it as soon as possible.
Ms. Clark. Okay. So the good news is my response may be on
the way?
Secretary Acosta. That is the good news.
Ms. Clark. And is the better news that that report that you
have been instructed not to respond to Democrats is a false
report?
Secretary Acosta. So I am not going to comment on reports,
but I will say that we have responded to the members of this
committee, and both the subcommittee and the full committee,
and we are in the process of responding to the letters we have
received.
Ms. Clark. Were you ever told by the administration not to
respond to Democrats.
Secretary Acosta. I have not been told by the
administration.
H-2B VISAS AT MAR-A-LAGO
Ms. Clark. So I will look forward to my response. But in
the meantime, I did want to ask you about that letter while I
have you here. And one of our concerns was the H-2B visa
program as it specifically applies to the 64 visas that are
held at Mar-a-Lago.
We have an unprecedented situation where the President has
spent almost 40 percent--almost 30 percent of his time as
President visiting one of his private businesses and has stayed
almost 20 percent of his time as President at Mar-a-Lago where
there are these H-2B visas.
Given the security implications of having a President
present, are you relooking at the issuance of visas for what
the President deems his winter White House?
Secretary Acosta. Congresswoman, I am sorry, I don't mean
to be difficult. Are you saying are we treating any particular
business differently because of the ownership of that business?
Is that the question?
Ms. Clark. I guess that is the question, because we are
sort of in uncharted territories. I mean, would you consider--I
would assume normally your answer would be no--but since it is
now the President of the United States, with all the security
issues that are raised, would you consider relooking at--these
visas where issued before he took office.
Would that be a particular concern where we now have a
President of the United States sitting in a--staying at a
private business entity with these visas? Do you see any
national security concerns being raised?
Secretary Acosta. So what the Department of Labor does is
the Department of Labor does a wage certification with respect
to any particular visa and sends it over to the Department of
Homeland Security. Whatever security concerns may or may not
exist I think should be addressed by the Department of Homeland
Security.
As to the Department of Labor, I think we need to process
visas without picking and choosing which business we give
preferential treatment to. And our job, which is a labor
certification, is something that we should do and we do do
expeditiously.
Ms. Clark. And that certification says that there are no
Americans that could fill those jobs. Is that the certification
for H-2B, not enough workers who are able, willing, qualified,
and available to do the work? Is that the process?
Secretary Acosta. So the labor certification looks at the
wage levels and does look at whether or not there are,
depending on the program, in some cases, whether there are
available workers in other programs. There is no requirement as
to work availability, it depends on the type of visa. And so
what the Department of Labor does, the Department of Labor
processes it in its usual course irrespective of what business
that would be, and I think that is the right approach.
Ms. Clark. Thank you, Mr. Chairman.
Mr. Cole. Thank you.
And before we go to my good friend the gentlelady, the
ranking member of the full committee, I just want to--number
one, I want to tell you, I listened very carefully to the
response you gave Representative Clark and appreciate it. I was
very reassured about that in terms of your being forthcoming
and responsive to inquiries.
But just for the record, certainly the chairman, I think
every member of this committee would be very upset if we ever
saw some sort of systematic attempt to not respond to
congressional inquiries on the basis of partisanship. And I
thank you for making it clear that you do not. And I would
hope--and expect, quite frankly--that other members of the
administration would operate in the same forthright manner. So
thank you for clearing that up.
With that, let me go to my good friend, the ranking member
of the full committee. The demands that the chairman and the
ranking member have are extraordinary, so obviously she has
whatever time she needs to make whatever statement she cares to
and then to ask whatever questions she needs to.
Mrs. Lowey. You are very gracious. And I do apologize for
being late, but there are several hearings at the same time.
And I think I will get right to the questions because I
know that my colleagues have additional questions. So thank you
for appearing before us.
READY TO WORK PROGRAM (H-1B TRAINING GRANTS)
I would like to begin by talking about the Ready to Work
program. It is an impressive partnership that is a novel worker
training initiative. It was created by the Obama
administration. And it used funds from H-1B visa applications
to finance job training for the long-term unemployed.
Ready to Work does identify open jobs in a community and
trains Americans to fill those jobs. My district fortunately
received a $9,800,000 Ready to Work grant to fund a local
program, Jobs Waiting. It is designed to provide 425
individuals with intensive training for jobs in the healthcare
and IT sectors.
To date, 350 Hudson Valley employers are involved across a
seven-county region, 152 participants have been hired for new
jobs. Many more have gone on to additional trainings for
specific skills. Job Waiting is set to exceed its initial
enrollment goal by the end of June, more than 16 months early.
For many participants, this training has been life
changing, and it is an excellent example of the good that can
come from leveraging federal investments in the local economy.
Can you share with us the administration's plans for Ready
to Work? Will you commit to using funding to support this
initiative?
Secretary Acosta. Congresswoman, thank you for the
question.
H-1B training grants, as a general rule, I think, target
particular areas where, you know, we are bringing folks in
because we are seeing there aren't enough Americans that hold
those jobs. So alongside that we should work to find and
prepare Americans to hold those jobs. A should follow B.
And I can't talk with specificity as to that particular
program in your district, but from what you are saying it
sounds like a good program and a productive program, and one of
the things that as we are looking at H-1B issues we would want
to keep in the forefront, because ultimately if we are saying
there aren't enough folks to fill particular needs, let's also
try to find Americans that can be educated to fill those
positions. That to me seems very logical.
Mrs. Lowey. I am with you.
APPRENTICESHIP PROGRAMS
Let me get on to something that I think is relevant,
apprenticeships. It really does offer a ticket to the middle
class. And research shows that 91 percent of those who complete
apprenticeship programs find employment with average wages
above $60,000. However, women are significantly
underrepresented. And while women make up nearly half of the
labor force in 2015, they comprise less than 10 percent of
registered apprenticeships. And strangely enough, this
statistic has not budged for the past 20 years.
This committee helped create an apprenticeship grant
program in 2016, increased funding in the fiscal year 2017
omnibus. And the explanatory statement accompanying the omnibus
included language that directs the Department to prioritize
grant applications that recruit and serve women and
underrepresented populations. Your budget proposal cuts
apprenticeships, and the budget justification does not propose
targeted funding to reach underrepresented populations.
I would be interested to know how you arrived at a
$5,000,000 cut. Maybe people working with you didn't explain
how successful this program is. What research was done to
explain this cut? And why should the American people pay for an
unnecessary border wall while cutting funding for worker
training and apprenticeship programs?
Secretary Acosta. Congresswoman, thank you for those
questions.
First, as I referenced earlier, there is a confusion
because there are sort of multiple base lines because of the
budget process. But fiscal year 2018 has apprenticeships at
$90,000,000, which is the same level as the 2017 continuing
resolution. So from that perspective, I believe there is no
cut.
UNDERREPRESENTATION OF WOMEN IN APPRENTICESHIPS
Let me address the broader issue that you raised because I
think it is important. Women are underrepresented in
apprenticeships, and I think that is important to address. In
part, it is because currently many of the apprenticeship
programs are in the building trades and women as a whole are
underrepresented in the building trades.
From my perspective, I think it is important to broaden
apprenticeships far beyond the building trades to many other
areas and professions. Just this morning I was saying, if you
can see apprenticeships sort of from a big picture--you know, a
physician is an apprenticeship. They get education and they get
on-the-hands training and they are a resident. And so you could
rename a resident an apprentice, right?
And so I think it is important to reconceive
apprenticeships broadly, because I think that would be good for
industry, but that will also bring more women into the
apprenticeship program. I also think it is important that
existing apprenticeship programs focus on being accessible to
diverse populations, both women and underserved populations,
and we should be doing that within existing programs already.
Mrs. Lowey. Well, I just want to say that this is such an
important program, and it is very disappointing to me an as we
are beginning to approach our focus on the 2018--I think the
administration has called it the skinny budget--and there are
30 days left before the end of this cycle, before August. So I
do hope that you and your staff are really focusing on programs
such as the apprenticeship program, which has been so
invaluable, and not accept any proposed cuts in that program.
In fact, we should really expand it.
And I want to thank you, Mr. Chairman, for your
graciousness. I am sorry, I was at another hearing. Thank you.
Mr. Cole. Well, actually, we are sorry you were at another
hearing. We always like you at this hearing.
Well, since we are still in the first round, the gentlelady
from Alabama has just arrived, and so I want to recognize her
as next up.
Mrs. Roby. Thank you, Mr. Chairman.
And thank you, Mr. Secretary, for being here today.
OSHA VOLUNTARY PROTECTION PROGRAM
As you know, one of the most important functions of your
Department is to ensure compliance with laws and regulations
meant to keep the workplace safe. There are a lot of inherently
dangerous jobs out there, and we need sensible rules to keep
workers safe.
The Occupational Health and Safety Administration, or OSHA,
has broad authority when it comes to enforcing workplace rules.
But for the last several years, industries in States like
Alabama have felt targeted because of our Right to Work status.
I hope you will agree with me that advancing a political agenda
has no place in enforcing workplace compliance.
I strongly support OSHA's Voluntary Protection Program, or
VPP, which focuses on partnering with companies to bring them
into compliance rather than targeting them with aggressive
punitive penalties. I was happy to see in your budget request
that OSHA will, quote, ``continue to recognize VPP sites and
will continue to prioritize this activity in fiscal year 2017
and fiscal year 2018.''
Additionally, your budget request asked for an increase in
resources for compliance assistance to increase both the number
of outreach and compliance assistance activities and the number
of participants in its signature cooperative programs, such as
VPP.
I have actually worked on legislation for a number of years
to make the VPP program permanent. It just makes sense to help
companies become compliant with workplace safety rules on the
front end, to avoid costly fines and harmful penalties on the
back end, unless, of course, your whole goal is to penalize
businesses, which I suspect it is not.
So, Mr. Secretary, can you please speak to your views on
this issue? And will your Department prioritize its policy and
funding toward partnerships and not penalties?
Secretary Acosta. Congresswoman, thank you for the
question.
As a general matter, I think it is important that
enforcement have both an enforcement component and a compliance
assistance component.
The VPP program is particularly successful. I have talked
with Department staff about it, and they think it is quite
helpful because it really partners with industry and leverages
industry staff so that industry staff supports OSHA's work in
bringing places up to compliance and then certifying that they
are in compliance. And, in fact, the budget calls for an
increase in the VPP program. That is something that this
administration strongly supports, and that would be a positive
from, I think, just about everyone's perspective.
Mrs. Roby. I appreciate that, Mr. Secretary. And please
know that I want to be a partner to help you broaden your
Department's outreach compliance assistance activities in
support to small businesses and employees in all types of works
with compliance issues.
So thank you, Mr. Chairman.
And I appreciate, again, you being here today. Thank you so
much.
I yield back.
Mr. Cole. I thank the gentlelady.
And in the interest of time, if I can, I am going to move
to like 2 minutes apiece so we have an opportunity to get more
people in. And I will go first.
IMPROVING WORKFORCE MOBILITY
We have had some discussion today, Mr. Secretary, about the
skills gap, and I appreciate you focusing on that. As we all
know, part of the problem is not just a training problem, quite
often it is a location problem. We have people literally that
are caught in inner cities or caught in depressed rural areas
or Indian reservations where literally you can train them but
the jobs that they need probably aren't going to be there.
I am just curious as to what efforts can be made in
addition to the training, in your view, to try and, if you
will, match people with available jobs. It may sometimes
require them to move. Those are tough personal decisions, given
family considerations and those sorts of things, but sometimes,
again, getting the training, there is not enough. So do we do
anything or should we do anything that would actually make it--
facilitate a move for somebody if there is a job at the other
end of it?
Secretary Acosta. Well, Mr. Chairman, you raised an
important issue because the workforce has become a bit less--
you know, I have seen information, I don't want to attest to
its accuracy, but I have seen information that the workforce is
a bit less mobile.
This morning before this hearing I was at a breakfast and I
was talking with some businesses that are engaged in
apprenticeships. And one of the issues that we are talking
about is now that we have online--increasing use of online
education, is there a possibility that apprenticeships can
start with some kind of online education so that individuals
know if they move, they have a job. In other words, if you
complete A, B, and C, and you then move, you have a job waiting
for you.
Because it is, I think, unrealistic to expect people to
move in the hopes of a job, and it is hard for them to have a
job in another locality without actually physically being
there. So apprenticeships may provide, through the online
education system, a mechanism for doing that.
Mr. Cole. Well, thank you very much on that. And we would
look forward to working with you on that kind of issue. I think
it is an important thing to think through.
With that, I want to go to the ranking member of the full
committee for 2 minutes--oh, I am sorry, I misunderstood. So we
will go to the ranking member of the subcommittee.
Ms. DeLauro. Thank you very much, Mr. Chairman.
MERGING OFCCP WITH EEOC
Mr. Secretary, the budget proposes to eliminate the Office
of Federal Contract Compliance Programs, merging it with the
Equal Employment Opportunity Commission, EEOC, which I said at
the outset I am opposed to.
OFCCP has an important mission. It ensures that taxpayer
dollars do not support discriminatory employment practices. It
ensures that Federal contractors are held to a higher standard
in their hiring practices, given that contractors are funded
with taxpayer dollars.
I know you understand this because I have here, as when you
were chair of the ABA's Hispanic Commission, you are familiar
with the barriers that minorities and women encounter in the
workplace and you have spoken eloquently about those issues.
EEOC, on the other hand, responds to individual complaints
of employment discrimination. There is now a backlog of 70,000
cases. Adding the duties of the OFCCP, cutting its budget by
$17,000,000, flat funding the EEOC, only exacerbates EEOC's
backlog while eroding nondiscrimination in the Federal
contractor workforce.
REDRAFTING EXECUTIVE ORDER 11246
OFCCP enforces Executive Order 11246, prohibit employment
discrimination on the basis of race, religion, color, sex,
national origin, sexual orientation, gender identity. It
ensures that employees can't be punished for discussing pay
levels, which is important because many women and minorities
aren't even aware that they are being paid less for doing the
same.
Now, the budget request calls for a redrafted Executive
Order 11246. Know where that order is, whether or not it is
being redrafted?
But the questions that come to me from that: Are you
planning to allow Federal contractors to discriminate in their
hiring, using taxpayer dollars based on race or sex, religion?
What about sexual orientation and gender identity? Are you
going to remove or revise the requirement that Federal
contractors take proactive steps to promote diversity and
workplace fairness? Are you going to remove or revise
protections for workers who discuss their pay with colleagues?
Tell me what a redrafted Executive Order 11246 is going to
include.
Secretary Acosta. So, Congresswoman, there are multiple
questions in there. I cannot predict what a redrafted order
that I haven't seen a draft of, if there is, in fact, a draft,
would include. But what I can tell you is, from my knowledge of
the policy, the answer--the short answer to your question is
no.
Ms. DeLauro. Okay. I understand that and you said something
about that earlier, I guess, to my colleague, Ms. Clark. But,
Mr. Secretary, you are the Secretary of the Department of
Labor. That redrafted executive order, if it is----
Secretary Acosta. Congresswoman, with respect, I think--I
think I said.
Ms. DeLauro. Are you going to help to redraft it?
Secretary Acosta. Congresswoman, with respect, I think I
said the answer--the short answer to all those questions is no,
it will not. So I think that----
Ms. DeLauro. So we have your word----
Mr. Cole. The gentlelady's time has expired.
Ms. DeLauro [continuing]. That Federal contractors are not
going to be able to discriminate based on the issues that are
out there now.
Thank you, Mr. Chairman.
Mr. Cole. Thank you.
I now go to my good friend from Maryland, Mr. Harris.
Mr. Harris. Thank you very much, Mr. Chairman.
H-2B VISAS
I am kind of glad we brought up the issue of the potential
security problems when Presidents are exposed to H-2B workers
somewhere. It is kind of interesting.
Just so you know, Mr. Secretary, and I will follow up with
the Secret Service, but, you know, the last President in his
last term played 47.5 rounds of golf per year--this is from
Golf Digest--306 rounds total for his Presidency. But he
actually accelerated things the second half.
And the National Golf Course Owners Association has a place
on their web page where they say: We really depend on H-2B
workers because golf in some places is very seasonal. So I will
follow up with the Secret Service to see if the President,
while he was spending, roughly--by the way, 47.5 rounds per
year is about 20 percent of your workday time over the course
of the year on a golf course.
I personally would rather have a President spending his
time at what is deemed the winter White House. But other
Presidents choose to spend 20 percent of their professional
time on a golf course. I hope the last President wasn't
threatening his security because H-2B workers are employed by
golf courses.
OVERTIME RULE AND INFLATION
Onto probably a more serious matter than whether the
Presidents are exposing themselves to danger when H-2B workers
are present. I just want to follow up a little bit about the
overtime issue because I neglected to ask you your opinion on
the inflation issue with regards to automatic inflator of that
overtime threshold, because I don't think statute allows that.
Does--thank you. I appreciate being allowed to ask questions
without noise coming from the other side of the dais.
Do you intend to adhere to statute and allow Congress to
decide when that threshold should be increased, or could it do
an automatic inflator? And with that, I yield back awaiting
your answer.
Secretary Acosta. Congressman, it is always my intent to
adhere to statute. You know, again, as I said, it would not be
appropriate for me to prejudge any future regulation, but it is
always my intent to adhere to statute.
Mr. Cole. Thank you, Mr. Secretary.
With that, we go to the ranking member of the full
committee.
WOMEN IN STEM OCCUPATIONS
Mrs. Lowey. Well, thank you so much, Mr. Chairman.
By the way, Dr. Harris, I don't play golf at all, but this
President owns the golf course, not only in New Jersey, not
only in the Bronx, but several in Westchester County, and
certainly Mar-a-Lago. So I will stay away from the golf issue.
What I would like to ask you is about women in STEM
programs. By the year 2020, two out of three jobs will require
education and training beyond high school. Women make up just a
little over a third of growing middle-skill jobs, Those jobs
that require less than a bachelor's degree but more than a high
school diploma. And while STEM jobs are driving economic growth
and offer jobs with family-sustaining wages, women are only 29
percent of workers in information technology and they make up
fewer than 10 percent of workers in advanced manufacturing or
transportation, distribution and logistic occupations.
So I really want to work with you to make sure that women
have the access to these jobs of the future. But your budget
cuts the core workforce development programs by a staggering 40
percent. And given the magnitude of these cuts, how can the
administration meet the needs of the workforce? And what impact
would your budget have on women trying to gain the skills
necessary for these middle-skill jobs?
Secretary Acosta. So, Congresswoman, I was smiling when you
started your question because it brought up a really nice
memory. In our family we have something called Science Sunday.
I have two wonderful little girls, and every Sunday we do
something around science. So we started at ages 5 and 7 with an
earthworm and proceeded all the way up to a frog dissection.
And I do that because I think from really young it is
important to expose them to science, because along the way I
think society will push back, and I want to develop that as
much as I can, as early as I can. And so it is something I am
very personally committed to, and I think it is very important.
The budget makes very hard choices, and the budget makes
choices that are tradeoffs. And within those choices we are
going to work, and we are going to work hard, to address the
needs that you raise because they matter. And I should say,
that is not just within the workforce, but that is starting at
an early age, starting when someone is 5 years old, because
that is when you really, really get them interested in these
issues.
And so I am with you. I agree with you. And that is
something that we will do.
Mrs. Lowey. Well, I appreciate that, and I also agree with
you that it is starts early, because I visit schools all
throughout my district on a regular basis, as I know many of us
do, and I always ask the class about the science programs. And
so much depends on the teacher. Not everyone is fortunate
enough to have you as a dad.
So supporting these programs, making sure we are supporting
our schools in science training, in apprenticeship programs,
all the issues we talk about, are important. So we don't really
have to make those cuts, we can look very carefully, and I know
we will work together with our chairman to prevent cuts in
really important programs that we fund in this committee.
Thank you.
Mr. Cole. I thank the gentlelady.
I think if everybody can stick to 2 minutes, everybody is
going to get a second question. I think Ms. Clark would be the
most grateful member here for that.
Mr. Secretary, you will have a quick version of the
political equivalent of Murderers Row, but they are
professional and polite.
With that, I am going to go with Ms. Roybal-Allard.
OFCCP ENFORCEMENT
Ms. Roybal-Allard. Mr. Secretary, I want to go back to the
question as to whether or not government contractors should be
able to use forced arbitration clauses. I am concerned that
allowing forced arbitration to continue as the President has
done will conceal corporate cultures where sexual harassment,
sexual assault, and discrimination may be rampant. What happens
is when corporations are legally able to keep sex
discrimination claims out of the courts and off the public
record protections for victims are often weakened.
In the absence of the Fair Pay and Safe Workplaces orders,
what are your plans to protect victims of sexual harassment,
sexual assault, and discrimination from retaliation by their
employers?
Secretary Acosta. So, Congresswoman, first, I think there
are a few parts to that question.
First, with respect to arbitration, I believe that it is
Federal policy to favor arbitration as a general matter because
arbitration results in fast resolution of issues, and that is a
policy that has been in place for a number of years throughout
administrations.
Secondly, as to the Department of Labor-specific plans, we
will enforce the laws and we will enforce them fully. OFCCP
certainly has authority around gender issues and enforcement.
There is also, beyond the Department of Labor, enforcement
authority within contracting, disbarment is certainly an option
for employers that are bad actors in the contracting process,
which you referenced.
And, finally, let me say that above and beyond that, we
shouldn't necessarily assume that arbitration is going to
result in bad results, because arbitration does have a long
history. And, again, as a general matter, it is something that
this Congress has favored.
Ms. Roybal-Allard. The issue isn't just arbitration.
Mr. Cole. The gentlelady----
Ms. Roybal-Allard. The issue is about forced arbitration.
Mr. Cole. The gentlelady will hold. I really am serious. I
want to give everybody a chance that stayed here a long time.
So with that, I want to go to Ms. Lee.
DOL BUDGET PROPOSAL
Ms. Lee. Okay. Mr. Secretary, let me just say that, once
again, it appears that most Cabinet members are okay with these
huge cuts, including yourself, which, again, I have to refer to
Steve Bannon's notion that you all are really deconstructing
the administrative state. This budget shows that. A 16 percent
cut is outrageous.
Here now you are trying to merge the Equal Opportunity
Commission, the EEOC, that enforces discrimination laws, with
the Office of Federal Contract Compliance. And to merge these
two and to reduce the budget overall, the NAACP and the U.S.
Chamber of Commerce both oppose this. These entities usually
don't agree with each other. And so why would you, again,
reduce--merge these important agencies, given what we know
about discrimination in America?
OFCCP AND EEOC MERGER
Secretary Acosta. So, Congresswoman, the budget is making,
as I said before, hard decisions. And as an administration,
those are decisions that have to be made.
With respect to the specific question regarding the merger
of the OFCCP and EEOC, as it proceeds, one of the issues that
we are going to have to look at--and it is going to require
separate legislation, because they are agencies that have two
different functions. They overlap in many ways, but they also
have separate authorities.
One proceeds from the contracting authority and is, in
essence, an auditing agency. The other one is charged with
antidiscrimination law enforcement and proceeds based on
complaints. And that is a distinction that is important.
So while overall there will be cost savings by the merger,
and the budget shows that it actually doesn't reduce the
enforcement, it reduces--the cost savings all come from
streamlining a process by the merging, certainly in that
process it is going to be important to, when it is legislated,
if it is legislated, understand that there are different----
Ms. Lee. So our Department of Labor is going to allow now
discrimination to run rampant in the workplace in the country
with Federal contractors, and it is outrageous.
Secretary Acosta. Congresswoman, with respect, I don't
think that is the case.
Ms. Lee. I think it is.
Mr. Cole. With that, we will move on to Mr. Pocan.
Mr. Pocan. Great. Thank you, Mr. Chairman.
WISCONSIN BIG STEP APPRENTICESHIP PROGRAM
So with your sincere interest in apprenticeships, let me
extend an invitation to you to come to Wisconsin. There is a
program in Milwaukee and Madison called BIG STEP, it is part of
the Wisconsin Regional Training Partnership that takes a lot of
underserved populations to get them into the trades. They are
doing a great job, they have been around for over a decade.
When I was in legislature a decade ago I helped find them
some funding. I think it could be a national example for you
and I would love to show that to you. Summer is a good time to
come to Wisconsin, not winter. I would love to have you there.
MAINTAINING DOL STANDARDS AND 2018 BUDGET CUTS
Two quick questions so I don't get into Ms. Clark's time.
One, just would ask just to see if you could make sure that we
can commit to defend and maintain and implement the silica
standard to protect people from exposure to silica.
Second is just a concern in the budget about the cuts to
the Bureau of International Labor Affairs and the grants for
that department being eliminated. It seems like from
conversations that the President has had he understands the
connection to working standards overseas, what they mean to
labor and trade agreements here. But those cuts, I think, could
be detrimental.
I would just like to have you answer those two questions.
Secretary Acosta. Certainly. Let me first respond with
respect to the silica. I believe that the enforcement on that
has been delayed until September 23 to allow for compliance for
general industry and maritime, but I think that that is
proceeding.
And I apologize, I got distracted with respect to the
second part to your question.
Mr. Pocan. On the ILAB funding, the cuts.
Secretary Acosta. Yes. So with respect to the ILAB funding,
the cuts that are being--that are within the budget are focused
almost entirely on foreign grants. And so it would not reduce
the enforcement part of ILAB that focuses on trade enforcement.
The cuts focus on the grants that are given to foreign
governments, to assist foreign governments in compliance and to
sort of act as training for foreign governments. With respect
to the enforcement part of ILAB, that would virtually remain
unchanged.
And happy to go to Wisconsin.
Mr. Cole. For the last questions of the day, Ms. Clark from
Massachusetts.
MAINTAINING OFCCP CORE FUNCTIONS
Ms. Clark. Thank you, Chairman. I want to go back also to
the OFCCP and putting this together. I think the real concern
is that the EEOC responds to complaints that are made and the
OFCCP proactively audits companies to make sure that they are
complying with discrimination.
In the priorities that you have set forth, you have
specifically said that the OFCCP will continue to focus on pay
discrimination. There is no mention of discrimination based on
race, religion, gender, sexual orientation, gender identity, or
national origin. Is the Department of Labor still asking the
OFCCP to do that work?
Secretary Acosta. So, A, absolutely. Are you referring to
the priorities set forth in--which document are you referring
to? Because the answer is absolutely.
Ms. Clark. Okay.
Secretary Acosta. So the second point that I would make is
the two agencies are different in nature. And the point that I
was making when your earlier colleague asked her question is
that any merger necessarily should, in fact, take into account
that one is, in essence, an auditing agency and the other is,
in essence, a complaint-based agency. And, therefore, while
there is overlapping purpose, there are different mechanisms
for enforcement and investigation, and that is an important
distinction.
Ms. Clark. I understand your testimony. Those will both be
preserved, the proactive auditing and the complaint response
that we currently have. Is that correct?
Secretary Acosta. Yes.
Ms. Clark. Yes. Okay.
So just a quick example. In April, OFCCP reached a
$1,700,000 settlement with Palantir Technologies over
allegations of anti-Asian-people hiring practices and
discrimination. Is that the type of proactive case you will
continue to pursue, even when putting these two together?
Secretary Acosta. So, Congresswoman, I am not familiar with
that example. But, again, my understanding of the proposal is
that it is a streamlining proposal and not a change-of-nature
proposal, and that is something that will have to be addressed
when there is legislation that unifies these.
Closing Remarks
The Chairman. I thank the gentlelady.
Mr. Secretary, thank you very much for being with us today.
It was a very informative, complete, and thorough hearing. We
appreciate your forthcoming manner and the cooperative style
you displayed, and we look forward to working with you as we go
forward.
With that, the hearing is adjourned.
Secretary Acosta. Thank you.
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