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tv   HHS Secretary Becerra Testifies on Presidents 2022 Budget Request  CSPAN  April 15, 2021 10:03am-12:19pm EDT

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climate agreement. he's revoked the keystone xl pipeline permit. moratorium on oil and gas drilling on federal lands. and conservativing at least 30% of federal land and oceans by 2030, trying to double the offshore wind production by 2030. these executive announcements and decisions made so far by the presidency, what's your reaction to these efforts to far on the energy front, congressman? >> look, it's sort of a mixed bag. some of the things in regard to continuing to promote renewable energy, sure, absolutely. but some of the efforts to distort or intentionally sandbag our conventional energy resources is a big mistake. let me explain. there's one country in the world that has reduced emissions more than the next 12 emissions reducing countries combined.
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let me say that again. there's one country in the world that's reduced emissions more than the next 12 emissions reducing emission countries combined. it's the united states. this is a trend that continued under the obama administration, the trump administration -- live on cspan3, testimony from health and human services secretary xavier becerra on president biden's 2022 budget request. live coverage on cspan3. >> for the purposes of eliminating background noise. members are responsible for muting and unmuting themselves. if i have noticed that you have not unmuted yourself, i would ask you if you would like the staff to unmute you. if you indicate approval by nodding, staff will unmute your microphone. i remind all members the 5 minute clock still applies. if there's a technology issue we
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move to the next member until the issue is resolved. you will notice a clock on your screen that shows how much time is remaining. at 1 minute remaining the clock turns yellow. at 30 seconds remaining, i will tap the gavel to remind members that their time is almost expired. when your time has expired the clock will turn red and i will recognize the next member. we'll begin with the chair and ranking member. then members present at the time the hearing is called to order will be recognized in order of seniority and finally members not present at the time will be called. house rules require me to remind you we have set up an email address that which house members can send anything they wish in writing. that email address has been provided in advance to your staff. and with that, i would like to acknowledge the ranking member of the subcommittee, congressman
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tom cole and all the members of the subcommittee on both sides of the isle joining today's hearing. i would like to congratulate and welcome, former colleague and dear friend, secretary xavier becerra to his first hearing as the secretary of the department of health and human services. we're looking forward to discussing hhs's budget priorities. the response to the covid-19 pandemic as well as the biden/harris administration's overall response to the many long standing problems and inequities in our health care system that this pandemic has underscored and exacerbated this past year. this is the subcommittee's first budget hearing on the biden/harris administration's 2022 budget request. in the coming weeks we'll hold
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budget hearings with the department of education on april 26th. secretary marty walsh, department of labor on april 28th. and francis collins along with other directors in may and rochelle walensky. in may the subcommittee will hold a hearing with public witnesses as well as a hearing for house members to highlight their requests for 2022. the subcommittee will circulate further information in the coming weeks on hearings in may. most of the dates and details have been confirmed. mr. secretary as i'm sure you're well aware, you are taking over leadership of one of the most important departments in the federal government. and it is an immensely critical time for this country as we recover from public health and economic emergencies. this administration has made a
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strong start and you certainly deserve credit for the many public health and economic recoveies that are currently taking shape. this administration increased daily vaccine doses to more than 3 million doses a day, which puts us on the way of achieving the president's goal of 200 million doses in his first 100 days. tuesday's news of the pause on the johnson & johnson vaccine may complicate the efforts but we must have confidence in all of our vaccines as we combat covid-19. i'm grateful this administration is committed to following the science. president biden took action to respond to the economic crisis by proposing the american rescue plan, a $1.9 trillion relief plan to help american families. most recently the president proposed a plan to rebuild the nation's infrastructure,
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including the care economy, which forms the backbone of the overall economy. the president's proposal includes an additional $25 billion for child care, $400 billion for home and community based care, including resources and support for the millions of workers, mostly women of color, who provide these important care services for our loved ones. this investment will build on the $50 billion that the congress provided for children through the american rescue plan and the december emergency supplemental appropriations bill. now the administration is once again taking the lead by submitting a 2022 budget request for hhs with investments for health and human services that would improve the lives of millions of american families. the investments are vital after a decade of sequestration and constraints we are beginning to address the needs of our
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nation's families, children and under served communities. we are beginning to address short falls in our health and human services program through the american jobs plan, the forthcoming american family plan and annual discretionary prop rations. many of the issues that have come all the more apparent in the wake of the pandemic, issues like child care crisis, mental health crisis and gun violence crisis had reached a breaking point before the pandemic began. which is i'm pleased to see the administration is doubling funding for gun violence prevention research, which is a priority i fought for and succeeded in securing for the first time in 20 years in 2019. this budget proposal and this administration's response to the covid-19 pandemic is certainly a great step in the right direction but we are not running a mile here. we are running a marathon. our public health infrastructure utterly collapsed under the
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weight of this pandemic and while this budget addresses some of the failures that occurred in the system, there's still more work to be done. we need to consider how we're going to address the failures that caused 700 american women to die in childbirth each year, how do we address the failures that led to 1 in 20 u.s. adults suffering from a serious mental healt -- mental illness. how do we address that which pushes women out of the workforce every day because they cannot afford child care. this budget has $10.7 billion to address the opioid epidemic. and includes $19.8 billion for hhs's child care and early education program. increase of $2.9 billion to expand access to quality, affordable child care, head start and preschool. it includes $1.6 billion to
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address the mental health crisis as well as $1.2 million for maternal health. they're desperately needed to address critical programs and i'm confident this budget moves in the right direction. combined with the american jobs plan and family plan, this budget improves the live of the american people. mr. secretary it's time to be ambitious we need a role of government that invests to give us a bet erfuture. let me focus on women's health. thank you for releasing proposed regulations this week to end the title 10 gag rule. this action will ensure that people across the country have access to affordable reproductive health care and life saving cancer screenings. more than 1,000 health centers left the program due to the gag rule. in my state of connecticut, new haven is the only place in the state where people can access title 10 providers.
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we look forward to the rule being swiftly finalized so we can begin to repair the damage of the past four years. i hope you build on this progress by dropping the height amendment from your full budget. time has come to reckon with the status quo and view this issue through the lens of racial equity. as i said before, while the bill has carried the hyde amendment every year since 1976, 2021 is the last year. the hyde amendment is a discriminatory policy, denies low income women access to abortion and that particularly hits low income women of color. the inequities of our country's health care system exposed by the covid-19 pandemic all further expose the impact of the hide amendment. now is the time to empower all women to make deeply personal life decisions without politicians inserting themselves into the doctor's office.
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i want to raise the issue of the unaccompanied children in our care at the mexico border. i want to recognize you inherited a difficult and challenging situation as a record number of children are fleeing traumatic circumstances and seeking to be reuniied with family in the united states. i'm encouraged with your commitment to turn this program into its mission of human services program. i will continue to push for a more transparent program. oversight and monitoring of these facilities, especially with the large numbers of children will be more important than ever. and i want to emphasize, as i have emphasized for many years, the need for hhs to comply with the flores agreement and provide legal services, health and education services and post release services for these children. the trump administration tried to turn hhs into an immigration
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enforcement agency. they separated children from their families, we need to do better. i'm committed to working with you to ensure you have the resources to take care of these children, which includes housing them in state licensed shelters that meet all the standards of care, placing them with sponsors as quickly and safely as possible. we have made progress in the recent months but there is still more to do at a time when the covid-19 pandemic has only exposed the already sere yousz failures in our public health system, it is time to be ambitious. it is time to meet the moment. it is time to do whatever it is that we cannot only to put our country back on track but also to build the infrastructure for the future and chart a better and a more equitable course forward for all americans. and i, and i know the committee, looks forward to working with you over the next year and
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beyond. and we look forward to today's discussion. with that, i would like to recognize the ranking member of the subcommittee, congressman cole, for any opening remarks. >> thank you, very much madame chair. before i begin my scripted remarks i want to welcome our friend and former colleague to this position. i couldn't be more pleased, other than, of course, had there been a republican secretary. but that aside, the secretary and i, madame chair, had the good fortune of serving together with our late colleague sam johnson for many years on the smithsonian board. and as everybody on this panel knows on both sides of the aisle, he's a person of unquestioned ability, a person of genuine integrity and decency. while he holds strong views, which i respect, some of which i agree with, some of which he knows i do not. when you serve together you sort
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of know where everybody stands. but he's also got a practicing politicians fine sense of the possible he was a great legislature when he was here. i can tell you from my experience on this committee, mr. secretary, whether it was under democratic or republican majorities or whether it were democratic or republican secretaries, this committee has been very supportive of whoever the secretary of hhs is. we know, as the chairwoman indicated, how vast your responsibilities are and how important they are to the american people. i don't know if we can do this this time, probably not because i think your budget request is an ambitious budget request which i applaud, quite frankly. but we've given secretaries the last two administrations more money than they asked for because we thought they had more problems maybe than they understood coming into these jobs. and again as our chairwoman indicated you're coming in at a
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challenging time. i want you to know upfront we recognize that, recognize we know there will be areas we differ, i'll mention some of those in my formal remarks. but again i know you're somebody we can work with and somebody who understands how we work. so i'm very delighted that the president made the decision to choose you and why you made the decision to leave a wonderful position in california and come back here, you have to explain to us over a drink some time, but it is good to have you back. with that, mr. secretary i want to welcome you to your first hearing with our subcommittee. hopefully we can meet in person at the next one. the department of health and human services has broad responsibility covering every aspect of daily life. this is a monumental responsibility brought to light for everyone to see over the past year. i want to start by acknowledging the hard work and unwavering commitment of the employees of
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the health and human services department. against nearly insurmountable odds the agency faced a pandemic and one year later efforts of your agency left our nation on the way to having every willing adult vaccinated. another remarkable achievement for the united states. despite the challenges of the past year, i was proud to see congress come together five times to pass emergency supplemental appropriations to help us through the pandemic. i'm therefore disappointed that the majority's chosen to abandon this bipartisan course in fair of a partisan, with a wish list replete with items unrelated to the pandemic or public health. the president pledged an administration of unity but it's begun with division. i hope we can return to a
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process that recognizes the role of bipartisan and i look forward to the release of the complete budget materials next month. your agency oversees health care for our seniors and native americans and provides the foundation for core investments in public health and emergency preparedness, national institute of health provides the critical, basic research leading to bio medical innovations, spawning new therapies, treatments and medications for countless diseases. the supports under your purview enables those with mental health orubstance abuse to have options available. the humanitarian crisis at the southern border and the clear need to prepare for the next pandemic. however, i disagree with the approach taken in the administration's overall budget
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request. to putd it simply it spends far too much on domestic programs and far too little on defense. with china and russia building up their militaries and becoming more aggressive, america cannot afford to stand still or cut back on defense spending. we need to see a 3 to 5% increase beyond the rate of defense spending over the next several years. that may require adjustments in domestic spending requests. looking at the domestic program, several in the subcommittee, the budget proposal like the most recent coronavirus relief package and infrastructure proposal spends more than our nation can afford. much of the spending is not necessary. our economic recovery is well under way and many of the proposed program increases while well intentioned are not warranted on the scale requested. i do agree with the president that we need to invest more in the areas of public health and
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bio medical research. in resent years the subcommittee spent more than requested in these areas. and i think the pandemic has demonstrated the wisdom of that investment. to keep america safe and healthy, the united states needs to fund the national institute of health, centers for disease control and prevention and other related programs. i note that you made those proposals, mr. secretary in your budget. we now have faced a pandemic in our lifetime, let's use this to leave the future better prepared. i believe the nih made us better positioned to address the challenges of coronavirus. we cannot let that commitment to sustained increases waiver. like our national security, american leadership in bio medical research cannot be compromised. i was disappointed to see no mention of the bio medical
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advanced research development authority in the budget released last week. but i would expect to see that when we see a fuller budget. the success of operation warp speed to develop, produce and distribute multiple safe and highly effective vaccine candidates in less than a year is unprecedented in medical history. we need to ensure that barta continues the key role. our country needs to respond to any event to protect the health of the nation. i want to mention one other important issue as it relates to this bill and your agency. for more than four decades, across multiple administrations, language has been included in the appropriation bill that restricts federal taxpayer funding for abortion under most circumstances. this reflects a balance on
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strongly held feelings on abortions in this country. our bills have been able to advance with this balance in place. i will oppose any bill that seeks to weaken pro-life protections or eliminating hyde policies. i expect under your leadership hhs will continue to enforce those provisions of existing law. i look forward to our discussion today and thank you for coming before us. again, it's a genuine pleasure to have you back. and i think a good choice by the president of the united states to persuade you to come and serve again. so welcome and look forward to hearing your remarks. >> let me thank the ranking member and join you in welcoming the secretary and many, many hours we spent at all kinds of meetings and leadership
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meetings, et cetera, and with a -- and here with a deliberate purpose in focussing on how, in fact, we could use the institution of the congress to provide opportunity to people to make sure that people all over this nation get a better chance at a better life and understanding that this is a place where it can get done. and that, the role of the federal government is imperative. and especially at times a great crisis where the challenges are so overwhelming for the people of our country. so delighted that you are here. could not be more pleased and looking forward to the great working relationship. and with that, mr. secretary, your full written testimony will be entered into the record.
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you are now recognized for five minutes for your opening statement. thank you. >> madame chairwoman, and members of the committee, it's a great pleasure. i thank you for this opportunity to appear before you to discuss the president's fiscal year 2022, discretionary hhs budget. i understand the five minute rule. i know you know the subject matter of this hearing so well. so let me try to be brief. the covid-19 pandemic demonstrated how health inequities and lack of federal funding leave communities vulnerable to crisis. we must ensure that hhs has the resources to achieve its mission and protect the health of our communities. the budget that the president has put forward places our agency, hhs, in the right place to achieve that outcome. for hhs, the budget proposes
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$131.7 billion in discretionary budget authority. $119.5 billion of which is for activities funded by this subcommittee. this $25 billion increase from fiscal year 2021 appropriations, invests in behavioral health among other very important priorities. to start, the budget makes significant investments in our preparedness and response capabilities for the next public health crisis. $500 million for the strategic national stockpile which served a critical role in the covid-19 response. it invests $1.6 billion in cdc, the largest budget increase in almost two decades. with these 2022 investmentments, cdc will address preparedness within the united states and
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strengthen global health security. in addition, it provides funding increases to address violence in our communities. $489 million to support and protect domestic violence survivors and 66 million for victims of human trafficking and survivors of torture. gun violence very much a public health issue and one that impacts communities of color is addressed by doubling both the cdc and the national institute of health funding levels for firearm violence prevention research. cdc will also receive $100 million to start a new community-based violence intervention initiative to implement evidence based intervengss at the local level to ensure that hhs is equitably serving all americans, the discretionary request invests over $200 million to reduce maternal mortality and morbidity which affects women of color.
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two it funds a range of rural health care programs and expands the pipeline of rural health care providers. it includes a $2.2 billion increase in advance appropriations for the indian health services program within hhs. and four, it increases funding where the hhs office of civil rights by 24%. the budget also provides 340 million dollar to the title ten family planning program to improve access to vital services and to advance gender equity. to help build the best possible future for our children the budget provides $19.8 billion for the department's early care and education programs, including $11.9 billion for head start and $7.4 billion for the child care and development block grant. the budget invests in improvements to the child welfare system, particularly to address racial inequity.
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it provides $100 million to new competitive grants to advance reforms that the reduce the overrepresentation of children of families of color. the president's budget also takes action to address the epidemic of opioids and other substance abuse. investing $10.7 billion across hhs and increasing access to opioid use disorder, and expanding the provider workforce, particularly in underserved areas. and in a historic investment, the budget provides $1.6 billion to the community mental health services block program to respond to the strain on our country's system. to support innovation and research, the budget increases funding for nih by $9 billion, 6.5 of which will go to publish the advanced research project's
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agency for health with an initial focus on cancer and other diseases such as diabetes and alzheimer's. this investment in research and development will help research and speed application and implementation of health break throughs. finally, given the magnitude of hhs's work and the tax dollars used to fund it, it's critical to ensure our funds are used appropriately. this request invests in integrity and looks at fraud and ways to prevent it. i want to thank the committee in inviting me to discuss the budget and thank the staff at hhs for the hard work fighting covid-19 and to help their fellow americans. to build back a prosperous america we need a healthy america and president biden's request builds on that vision.
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thank you. >> thank you mr. secretary. very excited before i ask my first question, let me mention something. the 2022 budget blueprint is strong funding for public health, child care, early health, mental health, we look forward to seeing the details of the president's budget next month and the role of government that invests in a better future. there's one initiative that you mentioned that i'm looking forward to learning about, your proposal to allocate $6.5 billion to establish, if you will, arpa h, it appears to be a novel approach in supporting innovation to address key problems in health and medical research, critical we strike a balance between this new approach and investments in basic research and fundamental discovery at the nih. once the budget is released,
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this committee will hold a hearing and have discussions about the arpah program. so i want to hold those questions at the moment until we get to the nih hearing. let me turn to another issue. mr. secretary, your budget includes 4.3 billion for the office of refugee resettlement. i believe this reflects the administration's intention to restore the nation's capacity to care for refugees, including the unaccompanied children program which we know is stressed right now. you inherited a broken graduation system. you also inherited a record number of children fleeing circumstances in central america seeking asylum. i know you're committed to doing what is right for these children. so a couple of questions here, mr. secretary. i've repeatedly pushed hhs to focus on placing children with sponsors as quickly and simply as possible. i commend you for rescinding the
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previous administration's harmful memorandum of agreement with dhs so sponsors are no longer afraid they will be deported if they sponsor these children. what else are you doing to safely expedite placement of these children with their family? >> madame chair, thank you for the question. and thank you for your comments about the work we're doing on this issue. there's nothing more important than children at hhs we take seriously our responsibility to not only provide the right care and health but to make sure that we pass this child onto a responsible sponsor, these migrant children that we are encountering at the border. so what we're doing is, in that process of receiving that child from the department of homeland security, customs and border patrol and to the point we can find a responsible response or for that child, we are providing the care that's required.
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typically that means offering that child a licensed care facility to be in, temporarily, until we find that sponsor. and as that child is working through the immigration process to determine what will happen with regard to their status. while they are with us, we are hoping to provide them not only with the medical services you would expect for any child but also the care, which would include educational, recreational services, with the influx of minors at the border, the -- those ancillary services of education and recreational service to become more taxing, more difficult, because the spaces that we're finding are fewer and fewer to be found and so what we are trying to do is make sure we provide each and every child with every opportunity to receive not just the health and well being care that they -- we would expect for any child but also the types of
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services we would want to provide for any child as we pass them onto a sponsor. and we're working hard to move these children responsibly into the care of a vetted sponsor we have to be careful, make sure we put them in the hands of someone who will be responsible and make sure we get them there as quickly as possible. >> thank you, mr. secretary. just a couple of other points in this area. i know we have set up emergency intake sites and that is a new concept. and one of the issues is that because of the record number of children and the pandemic, that has reduced the capacity at state licensed shelters. where we had 13,000 bed that was immediately cut to half or less than half, because of the precautions. so with the intake sites and the precautions we're taking there, standards of care and you've spoken about that.
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let me just emphasize that i said for many years the need for hhs to comply with the flores agreement so the legal services, health and education services, postrelease services for the children are in order. let me ask this one other question here. we have so many kids arriving at the same time, i'm concerned that children may have to wait for case managers. while they're in the emergency intake sites. what is the plan to address the shortage of case managers at those intake sites and provider networks? >> madame chair, you characterized this properly. there has been an influx. we are finding that we are placing some of these children temporarily in the emergency sites. they still offer the basic services we would expect for any child and we are trying to increase the number of intake workers that can help process
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these children so we can get them placed. you can imagine, it is a task to make sure that we get people who are doing the proper vetting the background checks of the sponsors to get the kids placed. we do the medical check, we do everything we can to make sure that while they're in our care, their health care needs are addressed. when we pass them on to a responsible, vetted sponsor we are making sure they will continue to get the care they deserve. so we have increased the number of intake workers that we have. we have actually called for volunteers throughout the federal government workforce to help us in this regard. we've been very fortunate, several thousand federal workers have stepped to the plate. and we are pushing really hard with our contractors that we typically able to use to do this work to increase their capacity as well. so everyone is trying to team up but it is difficult, as you mentioned when we came in, the
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infrastructure, the architecture to do this work had in many ways been dismantled. so not only was the agency not equipped to deal with the previous up ticks in numbers of kids, but to see the increased number made it almost impossible. >> thank you. i apologize to my colleagues for going over time. and i just would finally say, i want to reiterate that we're willing to provide the necessary funding for this program. like you, we want to ensure that the children have the services that they deserve. and i know that you are clear as we are, that it is -- what we want to do is move to state licensed facilities for children as quickly as we can and to get them to a sponsor as quickly as we can. thank you and again, my apologies to my colleagues for running over the time.
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congressman cole. >> madame chair, you're the chair of the subcommittee, i don't think you have to apologize to anybody when you take some time. let me start -- this is actually prompted, mr. secretary, it's a little off script but some things you said in your testimony that i want to agree with and offer you some thoughts on. and thafs your advocacy for increase over the indian health service. that's the one area we don't have jurisdiction over. that's with our friends on the interior subcommittee but you're spot on in terms of the need and the importance of forward funding those programs to protect them like we do the veterans program. i would commend to you and this committee the challenge they have in the natural resources department -- excuse me, subcommittee, is simple. they don't have the money. they have the national park system, epa, they have a huge
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range and this is the most important part of our health care system funded solely by discretionary dollars so we need to look at funding to community health care centers which used to be funded by federal dollars, that's been renewed every time it's come up for renewal. there's a jurisdictional problem here, a problem we have in congress not having it in a single area, a lot more discretionary dollars, and then there's this idea that we're going to fund a major health program with solely appropriated dollars which we don't do for anybody else, the only reason it is that way, that i can figure out, it is the first health program that we funded before medicare, medicaid and the mandatory programs and we forgot about it and put it to the side.
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i'd love to have the opportunity on another occasion to talk to you and address this and find out ways to work together. i appreciate the proposals that you put forward here. let me move quickly now to barta and ask you some things that i may be asking for an advanced peek at your full budget but i think that agency has done an important job. we had the infectious disease response fund, something the chairwoman and i worked on together to both establish and she's been fullsome in funding that. i'm curious about what your plans are in that regard? >> first on indian health services, i'll be making a call. i know your level of interest, your expertise on this subject matter. indian country is aware of your expertise and support. and we will be discussing with
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indian country the issue of mandatory funding. i appreciate your words because it will take a bipartisan effort to make sure we move in the right direction to finally fulfill our trust responsibilities, our treaty responsibilities to indian country so i would look forward to working with you on that. on barta, i think we're on the same path. we recognize how important it is to knowing how to get to the next level and to avoid these types of pandemics, doing the research and development that's necessary. i will tell you that i'll look forward to sitting with you to discuss that as well. because barta is an agency that's small compared to others but a mighty lift every time it does something right. look forward to working with you on that. >> very good. i welcome that call and i think we can make those efforts bipartisan. let me ask you something on the weldon clause. as you know, that's basically a -- means we don't force
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providers to provide services against their faith. this is, i know, a difficult question, it's a tricky question, but i'm just curious, will you commit to the subcommittee, particularly not to reduce the conscious division that we have in the office of civil rights? that's where we protect people's ability to not be forced to render services that they don't believe in? >> congressman, as you stated yourself, some of these issues, while we agree on many paths to take on some of these issues, sometimes there are some disagreements. on this issue, where i can tell you that we can agree is that my responsibility is to follow the law. and you all will decide what that law looks like, whether through appropriation measures or legislation you'll pass. i can guarantee you at hhs we will follow the law. where it comes to measures and where we will go where we have
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some discretion what i will tell you, we will take input from all parties trying to make sure we move forward at the executive or administrative level responding to all concerns. i can guarantee you this, congressman. we will follow the law. >> i know you will. i draw considerable comfort from that, and i know this is an area that we will disagree with. the chairwoman and i disagree on this area. i really want to work to keep those disagreements where we can still have a bipartisan outcome and a bipartisan budget. that's the danger here. everybody around this table knows that it is. >> so i look forward to continuing our discussion on that, welcome. it's good to have you in the position. i know there's going to be a lot of areas we can cooperate. i take great pleasure in looking at the nih budget, your cdc budget and those areas, you
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know, we agree -- at least i agree very much with what you're trying to accomplish there. and i think you've taken some of the hard lessons of the last year and responded to them well. the stockpile is another area i think you're on the right track. so i yield back and look forward to the rest of the hearing. >> thank you. let me recognize congresswoman watson-coleman. the congresswoman has a hearing, i believe, at 11:00. so congresswoman watson-coleman you're recognized. >> thank you. first of all, congratulations, mr. secretary. it is good to see you here. yours is such an important agency when it comes to the health and well being from our infants to our retiring adults
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from the womb to the tomb and i can't think of a better person to head that agency. one of the important issues to me -- actually, all the issues that have been discussed already are important to me. but through the lens of equity and the disparities with -- regarding minorities, particularly black and brown communities and women, i am interested in knowing how we're going to accomplish the narrative throughout your budget as well as the president's presentations to us when it comes to ensuring that everyone is treated with dignity and respect and the resources needed to ensure that are allocated appropriately. so i want to talk a little bit about maternal and infant mortality and morbidity because that is a huge issue and there's a demonstrated disparity that negatively impacts black women in particular.
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my first lady, tammy murphy, under her leadership and her husband's leadership, has been engaging on this issue and assembled experts to recommend on things dealing with bias, explicit bias, ensuring there are more providers, et cetera. i want to invite you, virtually or in person to have a conversation, me, of course, so you might look at what we're doing and look at it as some best practices because i think this is important. for me all the good intentions in the world are great but i'm really focussing on accountabilities and what is actually going to impact the well being of the people that we're targeting. so with regard to that, i wanted to just share that with you. the whole issue of mental health. i'm telling you, this budget it
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is very encouraging for me. it signals help is here. help is more than just a concept. it is here. and i want to make sure that you have an understanding of what's on my mind. first of all, i did a -- an emergency task force on black youth suicide and mental health because we saw there was an uptick in that community. and i -- a report resulted in that and some recommendations. i need you to take a look at that, and hopefully be able to support us in those recommendations but both in resources and in practice. the nih has been talking to us, we've been talking to them, because we're concerned there's not enough research in the area that impacts minorities in this situation, there's not been enough stakeholders discussions, not enough people reviewing grants and there's not been enough allocations of grant money to those issues that have
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been identified by people who were expert in the areas and have community relationships. so i'd like very much to know if you had any discussions with nih, if you know of anything that they're doing right now with regard to making sure that there is greater conversation among the various stakeholders and if we are going to be able to move forward in ensuring greater diversity in nih, in the conversations that take place and in the kind of review of grants and areas of grants? >> congresswoman, first it's a pleasure to be here with you, take your questions and know your spirit hasn't changed. so absolutely, i look forward to working with you on all these things. i had conversations with the various agencies within hhs and
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i made it clear, equity will permeate everything you do. when it comes to nih whether it's the data and the studies and surveys or whether it's the participation rates we want to make sure it incorporates everyone, we don't want anyone left out. so i look forward to hearing the thoughts you have. we are putting more than $200 million into the issue of maternal mortality, it's especially high for black women and alaska native women as well. so we're going to make sure that what we do is put resources behind what we say and we look -- >> can i just say -- just say in closing that the office of rights is so vitally important that's where we look for accountability. so i look forward to subsequent confers with you specifically mr. secretary regarding how are we going to hold the offices within your department
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accountable in ensuring that the civil rights and the pursuit of equity is actually happening? and i think thank you. i yield back. and madame chair and ranking member, thank you for allowing many e to ask questions out of turn. >> let me recognize now congressman harris. >> thank you, madame chair, welcome secretary. first off, i do want to echo what the ranking member said about ni -- i'm glad you're willing to enforce the law as written, including the church amendments, the weldon amendment, one that's very important conscious protection. as a health care provider myself, something that i think is very important to enforce those current laws. let me just move on to surprise billing. one concern that's raised we
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passed the no surprises act but there's concern among stakeholders that input may be bypassed by issuing a final rule instead of a proposed rule giving them time to comment. so i would like you to commit to give ample time to participate by ensuring there will be a proposed rule with a 60 day comment period on this? >> congressman harris, coming from a background as the attorney general where it was always important to take input whenever we would do rule making or take any action, in court or otherwise, i can guarantee you at hhs before we take action we'll take the comments necessary, hear from the stakeholders to make sure what we're doing is based on the facts, the science and the law. i can guarantee you, sir, you will find we have gone through a robust process to get there. >> thank you very much. with regards to health security
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and the sns, i'm glad to see that the appropriations, the suggested budget is $905 million for sns, i want to thank you the chair for supporting my amendment two years ago to bring it to that level. but there's an interesting statement in the budget proposal that implies that it's not just going to be simply stockpiling expired material but that's not what the sns ever did, it's not just about restocking expired material. so i take it we're going to continue to look not only to restock what needs to be restocked among expired material but then, of course, to expand into areas we think are forward looking in terms of what we need to do, according to the plans that have been put forward, is that right? >> congressman you're right. we're going to learn from our experiences with covid and the rest to move forward and be
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prepared. >> obviously, renewing some of the stockpile is some of that but i'm sure that was inarticulately written in the budget plan. now, i'm just going to spend the last two minutes talking about nih and a concern i have, and i want to know what your vision is for arpah because if it's not -- if if it's a vision of merely doing advanced translational research, then ncats should have done that. we have the ability within nih to do that already. but that would move nih further away from basic research, which i think is the main role of nih. because we know that other corporate entities, other businesses, they may do some of the -- some of the non-basic research but they're not going to do basic research. so is arpah -- what's your vision for what arpah is going
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to be? >> congressman, we're trying to move beyond just the basic research to be able to have transformational results. we've seen, the clearest example is these vaccines for covid. we've seen how quickly the private sector, working with the government sector can move. so we want to be able to continue that basic research that has made america the place to go to when it comes to these discoveries, but we want to trigger transformation faster. that's what we need to do is be prepared. what we have with arpah is an opportunity to combine the best we have, and then make it click. while the law -- it's still fully in development and the concept is there we think we can help make things click faster by putting additional money into
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that row search and development and lets us get something from the idea to practice. >> that's my point. that's called translational science we have a center in nih for that, pointing specifically to vaccines, what made it possible with the mrna vaccines we invested in the science at nih for over a decade. again, if it's a new translational center, it's just going to do -- my feeling it would duplicate what we have. so i would urge that basic science be an important part of the effort at nih. i yield back, madame chair. >> thank the gentlemen. with that, let me recognize congresswoman lucille. >> mr. secretary, it is so good to see you. like other colleagues i've had the privilege of serving with you not only in the house but also the california state
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legislature. and i want to join with comments made by others that we could not be better served than to have you as our secretary of hhs. i i'd like to begin by thanking you and president biden for including a request for $200 million to fund a maternal mortality issue, because more needs to be done to address the maternal mortality crisis in this country, where the hardest hit groups are black, latino, native american and alaskan natives. and mothers and babies experience different outcomes based on where they live. there was a -- a plan put together in recognition of the disparities of maternal health last december by the surgeon
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general and the call to action to improve maternal health, and hhs rolled out the healthy action plan and the plan outlines three specific targets to improve the nation's maternal health outcomes by 2025 and they are to reduce the maternal mortality rate by 50%, reduce lower see softwarian deliveries by 20%. is it your intention, as secretary of hhs, to continue this work that was underway in the past administration? >> congresswoman, thank you for the question. that's an easy one. of course. and you know so very well from knowing me for so many years that we think it's a priority. i know you think it's a
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priority. but my wife, if i were to go home, who is a maternal fetal medical specialist would not let me in the house if i didn't consider this a priority. not only are women allowed to live a healthy life, we need to ensure that children are allowed to grow up and be healthy as well. >> i have another hopefully easy question here. since the initial passage in 2008 of the newborn saves lives act, it's helped for newborns born each year and you know the newborn screening act codified the advisory committee on orders in newborn children to help address the vast discrepancies between the number and quality of state screening tests because of this committee's work, today 49 states and the district of
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columbia screen for at least 31 of 35 currently recommended core conditions. in september 2019, the reauthorization of the newborn screening law expired. and it is my hope that it will be reauthorized this congress. unfortunately, the previous administration suspended the activities of the advisory committee, which is preventing it from completing its work. as secretary, you have the authority, which is reinforced in the 2014 newborn screening reauthorization, to deem the advisory committee a secretary yal advisory committee and continue its charter. given the role it plays in our screening system, will you use this authority and when will you extend the term of the committee until reauthorization occurs? >> congresswoman, i fully understand the value of that
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type of work that has to be done. what i can tell you is that while a decision hasn't made i can get back to you as quickly as possible on the course of action we will take administratively. but without a doubt i think what we want to do is move forward, not step backwards. >> i look backward to working with you on this, because this committee, advisory committee, is absolutely essential in doing the work of protecting newborn babies. >> i appreciate and agree. >> congressman fleischmann. let me ask, have you concluded? >> i have, yes. thank you. >> congressman fleischmann. >> thank you, madame chair. mr. secretary, congratulations sir on your appointment and confirmation, wish you ever success in your endeavors, thank you for your service in the great people's house prior to this. i had hoped to actually speak
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with you personally before this, i have a constituent issue, major, that i would ask you to call me perhaps after this. but i wanted to delve in on some very important issues. there's a crisis at the border, sir, that includes an unprecedented number of unaccompanied minors, once the children are on u.s. soil we have a responsibility, sir, i think to treat them with compassion regardless of their legal status. the administration is relocating these children to o.r.r. facilities across the united states, one of which is located in my hometown of chattanooga, tennessee and it's predicted that hhs will need an additional 3,400 beds by september to prevent children from waiting in over crowded border patrol stations. given the surge of unaccompanied minors, what funding levels do you anticipate are necessary in
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order to operate and maintain hhs detention facilities for the o.r.r. program, sir? >> congressman, thank you for the question. very important subject. before i get to that, let me just make sure we connect at some point soon with regard to the issue that you mentioned. >> thank you, sir. >> i apologize we haven't had an opportunity to connect earlier. >> yes, sir. >> on the issue of the unaccompanied migrant children, we are expanding our capacities as quickly as we safely can. and that's the operative word is safely. we're not going to jeopardize any child, we're not going to do things in a way that add to the trauma the child has already experienced. and it is a challenge because unlike adults and unlike any circumstance we've seen before, we have to do this right. we're going to make sure at hhs, when we have a responsibility we do it as we're supposed to under the law. and our role is health and human services and that's what we're
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going to do is provide health and human services to these children while they're in our possession. we have continued to expand our bed capacity far beyond the capacity that existed even three months ago, far beyond the capacity that ever existed under any other administration but we have challenges still. and the team is working really hard, the fact that several thousand of these kids are in our care and they continue to be provided the kind of care that we would want to see for any child is a testament to the hard work being performed at the department of health and human services. the type of resources we'll need far beyond what has been provided in the past. our request is, i believe it was, 3.4 billion for this coming fiscal year. we believe that we're able to receive your support, funding support, we should be able to address this, again, as the law requires us to do it at hhs.
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>> yes, sir. thank you for your response. what steps has the administration taken to ensure transparency throughout the hhs contracting process, sir? >> we are -- we will be reporting obviously to congress on that activity. we are trying to make sure that all of our work is done with licensed facility operators. we are trying to make sure when we operate a site that's more of an emergency site that we are working with our local partners to make sure that the contracts are within the framework of what we've done in the past. i think what you'll find is that you will have eyes into this. we have to respect, obviously, the prief si of children. they are minors. so access to the facilities where they are is different from access to -- for adults. what we will make sure is we operate in a transparent manner. the most important thing we can do is make sure you're apprised and the american people are
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apprised of what we're doing. at the end of the day we want everyone to see it. at hhs we believe in our mission on health and human services for these children. >> thank you, sir. consistent with that, i would ask that as we had situations like that in chattanooga that the administration be transparent and let us know what's going on in our districts. i know my time is running short, mr. secretary, i want to let you know i plan to submit several questions for the record addressing cms designations for ems transport services affecting at lo of our rural areas. a 190 day cap on inpatient psychiatric services which i think needs to be extended, covid relief for assisted living facilities and some other areas. but again, i thank you for your service, i wish you every success and look forward to hearing from you, sir. >> look forward to hearing -- calling you soon. >> yes, sir.
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>> congresswoman lee. >> thank you very much, good morning. first of all mr. secretary i have to society myself with all the remarks made and congratulations to you. first of all, we've had the privilege to call you assemblyman, mr. chair, mr. attorney general, and now mr. secretary. so it's awesome. good to see you, and thank you for your leadership. i have several questions. i'll try to summarize these questions very quickly because this department, with your heading, is so critical to the survival and -- not only survival but our young people, especially thriving in this country. and so, thank you so much for taking this on. a couple of things. i hope, and we sent a letter to re-establish the white house office on national aids policy you know i've been working on hiv and aids forever.
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so i'm glad to see the budget includes $670 million for funding the end of the hiv epidemic. so i want to be sure that the strategies that you employ in collaboration with other agencies will help us reach that goal of eradicating hiv and aids by 2030. so as it relates to hiv and hepatitis in all populations, all geographic areas you know it disproportionately impacts people of color and people living in the south so i want to know how you're going to help us achieve that goal. secondly with regard to public health and i want to follow-up with congresswoman coleman's line of question as it relates to disparities. i have a bill to declare racism as a public health issue. cdc has embarked on many
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provisions of our bill and their declaration that racism is a public health issues. as you look at disparities and equity, i wanted to find out do you have a lens of how we dismantle those structures and systems that are institutionalized that present racist outcomes as it relates to the disparities that we have to address in many ways through your agency? so it's not only equity but it's about disrupting those institutions that have -- are the barriers to equity. and on the -- i had the privilege to go to el paso with the delegation and i wanted to follow-up on the questions with regard to the children. and specifically with regard to those who are in the customs and border patrol. in el paso, of course, and everywhere we have been we're told we know our border patrol employees are there to patrol the border, not to take care of children. and so, they are asking us for
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more help, more case managers so they could be freed up to do their jobs. i know your overall plans, are we going to make sure in the customs and border patrol customs and agencies that we hopefully transition in case managers to help relieve the burden? if we have a second round i'll ask you my other questions. so good to see you. >> congresswoman, always a joy to be able to chat with you and work with you on all the subjects you mentioned, i'm looking forward to that and your guidance on how we move on some of the issues. i think you sense that we have a real chance to move on some of those first issues you discussed because we're putting money behind these efforts so i'm looking forward to work with you on that. let me spend a moment on the unaccompanied minor, migrant children. we have to remember that our mission is separate and apart and different from the
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department of homeland security's mission. in fact, we make sure that it's clear. our role is to care for these kids. dhs and customs border patrol is in the mission and in the business of trying to protect the border. so within 72 hours, they are supposed to hand to us any child that they have so that that child gets the care that, by law, is required. that's become a challenge because of the numbers that have come through. i believe cbp and the department of homeland security have done a good job making sure they're handing us a child ready for our care. it has to be quicker, though. we have to make sure it's clear there are different roles we play. as you know, we have to make sure we don't cross outside of our own lane. and so that's what makes it difficult. but we're trying to break down the barriers to ensure our
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principle interest is the well being of that child. i want to thank the department of homeland security and the custom and border patrol officers and personnel for working with us to make that transition as smooth as possible. it's still a work in progress but our interest is the care of the kids. >> my second round i'll go back to the other questions. thank you. >> thank you. congresswoman herrara butler. >> thank you. i wanted to follow up on the unaccompanied minor questions. what role, if any, do you mr. secretary, in facilitating migrant travel including expenses once individuals are released into the interior of this country. >> great to see you again. important question. we have authority to provide for transportation resources to make sure these children are united.
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once we've identified a responsible sponsor to make sure that the reuniting occurs as quickly as possible. so what we try to do is reserve our resources for the actual care but we don't want to continue to see a child languish in our care if there's a responsible sponsor. so sometimes it's more efficient and cost-effective to help make that transportation work so the child is united as quickly as possible. >> on that piece, are you aware that the fbi vetting of sponsors for these kids has ceased in many indications as a result of the overwhelming caseload. which i know your concern is these kids' care, as is mine, that's why i'm asking this. and i've heard reports of kids being told, say you have family in new jersey, they get sent to new jersey and a trafficker there says you work off the cost of your fees. this makes me sick.
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so to hear the fbi vetting is not actually always taking place, means we could be helping traffic children. am i way off here? >> you raised a really important, legitimate concern. but this is one of the -- i'm glad you mentioned this and asked the question. because this is one of the issues that takes the time in trying to transfer this child into responsible sponsor hands. we have to make sure that spnsor is truly responsible. there have been cases in the past, none that i'm aware of in the time i've been secretary. but there has been times in the past where a child has handed up in the hands of someone who has trafficked them for sex or labor. what takes a while, it's unfortunate because we like to place these children in responsible hands as quickly as possible, we have to verify. we're working with the agencies that help us do those checks and back grounds.
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we will not let go of a child unless we have confirmation purposes under the law that we can let go of this child to a responsible sponsor. >> does hhs confirm whether these kids are covid negative before they're put on planes to travel across the country? >> all these children are tested so we know what their status is on covid-19. remember, sometimes it can take up to two weeks before a diagnosis actually -- a test can tell you whether or not it's accurate, but what we have always done is make sure we test these children as quickly as we can once they are in our care. >> thank you for that. obviously there are more questions there but i want to transition a little bit and say thank you for your investment and leadership on both the maternal mortality issue, which i know my colleague mentioned, but also on the opioids and the mental health piece.
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obviously the pandemic had a large impact on mental health. and it's increased the use of drugs and alcohol, especially opioids and in my home district, the rate of drug overdose deaths have increased by 43% in the first half of 2020 and for all of washington state there was a 38% increase in drug overdose deaths in the first half of this year -- or last year. so synthetic opioids, fentanyl, played a role in that increase. i wanted to see how hhs is going to target -- you focus on supporting populations with unique needs, people in rural areas, underserved. i wanted to see how you plan to target that. >> thank you for the question. i think we all agree we have to jump on this issue, the opioid addiction and actually, substance misuse and addiction that comes from it because we have seen how covid has stressed everyone and actually made these circumstances even more difficult.
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and so, we're making a major investment in addressing opioid and other substance use issues and what can i tell you is this, we want to make sure we're targeting -- i know from my work as a state ag that we're on the verge of reaching a major settlement with a number of these opioid manufacturers to get money for abatement purposes. we want to make sure we're working with a state and local partners to make sure that we combine our moneys with their moneys to make it most effective. we're going to work with them the way they see fit to use resources, and make sure we're concentrating on getting the type of treatment that helps someone move off these very addictive drugs. >> thank you for that, mr. secretary. madame chair, i yield back. >> thank you. >> congressman pokan. >> thank you, madame chair. mr. secretary, it's good to hear that. i remember the day you got the offer from the governor to
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become attorney general, i was sad to see you leave. glad to see you back in federal government in a more significant role. you guys did an amazing job in investing in people in this budget, the best cdc budget in 20 years, investing in hiv, opioids, nih research, on and on. thank you for doing that. i have four things that i'm going to -- because i know you know how it goes in five minutes. i'm going to ask my four questions and let you answer them as you know best. first of all, fetal tissue research ban. the last administration put a ban in place, this is something that's very important in my district where we do a lot of research, the university of wisconsin, madison, i'd be curious about the removal of the federal restrictions impozed by the last administration.
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also the last administration allowed for discrimination with agencies contracting, i'd love to know if there's any plans for notification of nonenforcement and any new rule making to provide for nondiscrimination in hhs programs. third area, i got four of these, i'm going to go as fast as i can, mr. secretary, an issue around opioid and preventing opioid abuse, the former hhs, a while back, had proposed putting a plant that's helped a lot of people get off of opioids as a schedule one in the last administration, actually the assistant secretary did the right thing, admiral giourix sent a letter rescinding their view it should be a schedule one drug because we had money for research and research is coming through well, it's helping people not just with opioids but
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we have a family friend using it for another autoimmune disease. would love to know we're going to continue to do research, love to know if you can continue that commitment. finally, just curious on the office of refugee resettlement, specifically refugees coming in. i hear from a number of agencies that have had people they were going to help relocate in my district. i know the president was going to have an executive order to help improve the numbers coming in and because that has not been signed yet, i'm curious what the status on that -- i have one agency very aggressively asking me, in my district, about this issue and i'd love to get back to them. again, so glad you're secretary, and i look forward to working with you during this administration. >> congressman, great to see you again. as usual, i'm not going to have enough time to get to everything that you're championing. let me try to do this.
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i'll try to make sure i respond, where i don't get to it -- on the fetal tissue research band, nih will be making an announcement i believe tomorrow, so keep your ears open for that. we believe we have to do the research that it takes to make sure we're incorporating innovation and getting all of those types of treatments and therapies out there to the people. on the issue of nondiscrimination. as you know, congressman from the work we did together i'm all about making sure we treat everyone fairly. any time we see signs of discrimination we want to take action. so we want to enforce nondiscrimination laws. i can commit to you that as secretary of hhs, i'm going to be on that. on that for sure. opioids, i have to get back to you on where we are on that issue. let me put it to you this way. when you have a president
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willing to commit over $10 million in his budget to tackle opioid, you know he's serious. so we're not going to do anything that undermines our ability to really go after the scourge of opioids and what gets people caught up in this addiction. o.r.r. if you can frame again what the question was, i've forgotten it. >> the president was going to do an executive order so we could have a larger number of refugees coming in, we had people in my district, agencies ready and then people sell their goods ready to come here and now we're in a holding area. >> briefly, i can tell you that the plan is to increase the number of refugees we accept in this country to a number we haven't seen in a number of years. and all of that will depend on what you all do to help us have the resources to be able to accommodate some of these folks fleeing from death, persecution and violence. we look forward to working with you on that one.
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>> great. you did it. you're impressive mr. secretary. i yield back, madame chair. >> congressman molinar. >> can't hear you. >> okay. that should be good. good morning, and congratulations and welcome back, secretary, in your new role. i just wanted to highlight something. recently along with my colleagues in the michigan delegation we sent a bipartisan letter to president biden requesting a surge in vaccine allocation to our state that is estimated to prevent 10,000 hospitalizations and save 1200 lives. i believe you may have also received a question from governor whitmer on this. and so far, as far as we can tell, that has not been granted. we do appreciate your efforts to
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send more therapeutics and boots on the ground. but i'm wondering if you would consider a modification in the strategy and grant this vaccine request given michigan's situation right now. >> congressman, thank you for the question. let me give you a sense. given the work that the administration has done, i mean i'm even impressed at what president biden has accomplished when it comes to the vaccine. when you can vaccinate more than 3 million americans. as we go forward most of us were wondering how many people could get vaccinated a day. if someone said we could get $3 million americans vaccinated in a day, i wouldn't have believed it. we hit 4 million over the weekend. so it's impressive. the president has made sure we have the supply we need to get shots in arms to 300 million
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americans, essentially the adult population by i think now every state is offering vaccination administration to every adult, not just those over a particular age. so we're moving in that direction. how we can address those states or those regions where there is a disturbing increase is something we can take a look at and we can work with you. we have to make sure we don't get off the plan of making sure the vaccine is available everywhere where it's needed. as you can imagine, if we start to focus only in certain particular regions we'll have that disparate treatment of other regions so we want to work with everyone to make them available. work with the states and local governments to make sure they handle that administration. we have sites that are federally operated to make sure we're reaching everyone. but we're always open to conversation about how to do this best and fast and making
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sure we incorporate all americans. what i can say to you is i'd be willing to chat with you more about this to ensure as we move forward every american will have access to that vaccine. >> thank you. and we look forward to working with you on this. you know, i was concerned. i think that cdc had come out and said maybe michigan should shutdown again and i don't think that was a real viable option, but i do think increasing vaccines, increasing the therapeutics would be helpful. appreciate your willingness to work with us on this. also, just, you know, my district is predominantly rural. and one of the things during this covid pandemic is we've seen the importance of telemedicine and the value in that. and i'm wondering if, as secretary, if you'll be able to continue to allow flexibility and incorporation of
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telemedicine so that we can continue to grow that. obviously rural broad band is a huge issue in some of the rural areas. but i think some of the rules you're going to be involved in advancing telemedicine can be critical in helping our rural communities? >> congressman, because you touched on an important point i hope you will be in touch on that matter because what we have learned, especially from covid, is that telehealth has been a god send. it has helped so many americans have access to the kind of care that for them is difficult under normal circumstances, almost impossible under covid. so we're going to try to apply those lessons going forward on dealing with telemedicine. you probably have good thoughts, a lot of constituents who are stakeholders who have a lot of good ideas. we hope you'll reach out and
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provide some of that. moving forward we want to make sure we remove every barrier we can from americans accessing the quality health care they're entitled to. >> thank you. and in closing thank you for being here. i8d like to add my voice to those who expressed concern about repealing the hyde amendment. i think this is something where when i consider how children are affected by abortion and -- including children of color, i think this is very much the wrong direction and hoping we can work towards a bipartisan effort on this. >> thank you, madame chair. >> thank you. congresswoman clark. >> thank you, madame chair. and it is such a delight to have you, secretary becerra. i associate myself with the comments about how excited we are for your leadership and the incredible work we can do
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together on on behalf of the american people. on a personal level you were the first member of congress after i won my special election to invite me to washington. so i'm delighted to be here for your first appropriations hearing. just really welcome back. and we are so excited to have you. one of the issues that is so pressing for american people, and especially for american women is the child care crisis. we know that one out of four women have left the workforce since the pandemic. specifically because they are not able to find care for their children. so as we look at a study from hhs in 2016, that said, if we triple the child care development block grant from 16 numbers, which would be $8 billion, we could bring
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652,000 women back into the workforce. can you elaborate on how you see this connection? especially for low income women and how you view child care as economic infrastructure. >> congresswoman, first, forgive me if i'm smiling so much. i feel like i'm attending a family reunion. >> we do, too. >> it's nice to see so many familiar faces. i know how hard you all work. even as was mentioned, sometimes we're not going to agree but there is a relationship you develop with colleagues. and i so much appreciate the chance to be back and work with you. even on the tough issues we don't necessarily agree from the beginning. on the issue of child care, the president's making a major investment in child care, including the block grant for child care, more than
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$7 billion, he understands not only how important it is to care for kids, look at the work he's done addressing migrant children at the border. clearly the work we're doing for kids here in america he is on it. what i will tell you is this, we're going to make sure money is well used, work with you to partner we're doing everything we can to deal with the care that a child needs. at the end of the day you hit on it. if we don't do this, the economic vitality of our country will never reach the pinnacle because so many women will be left with the inability to really blossom within their career. so not just for the kids but all those talented americans who would be out there productively working we have to make sure child care is taken care of. >> thank you. and you mentioned the incredible investment that the administration has already helped us make through the america rescue plan.
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can you tell us a little bit about how that distribution is going over that funding? are there areas where we can be helpful in helping make sure that that funding gets to child care providers efficiently. and are you concerned about the need for more discretionary funding to offset a potential cliff after states exhaust that stabilization funding? >> yeah. you -- those cliff issues are always difficult. and that's where we're going to need to partner with you to make sure we don't find families reaching that cliff. so i look forward to working with congress to make sure that we continue to have some predictability. the certainty that families need on how they can budget forward and protect their children and be out there working. in terms of how the resources are being distributed, once again we'll need your help to ensure we're doing this right. we'll do oversight and
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accountability. but whether some of this money goes out based on formulas that determine where the kids are and how it goes out. others will be based on grant funding. but at the end of the day, and this is where i put out for a second my hat as former attorney general. we expect accountability. we're going to bird dog this, because it is so essential that e we provide the oversight to ensure the dollars reach the child. so we'll look forward to working with you in a partnership because i know you want to make sure that the moneys you allocate to us are well spent and we all want to make sure whether it's the child or the parent, we have allowed them to be as prosperous and productive as possible. >> thank you so much. i yield back. >> thank you. >> congressman cline. >> thank you, madame chair. thank you mr. secretary for appearing today.
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i wanted to circle back to the crisis at the border and, in particular, regarding the unaccompanied children program under hhs super vision. you talked about accountability and i think this administration is advocating its responsibility when it comes to not only making sure that our border is secure but caring adequately for those coming across because of the rhetoric on immigration policies we have seen spikes in illegal border crossings, record numbers coming as a direct result of the changes of the policies in this administration. so we have high numbers of children placed in in the unaccompanied children program. a startling number of whom have tested positive for covid-19 after being transferred out of border stations, sparking concerns over overcrowded facilities that may allow the virus to spread. you have several facilities
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being operated, some of which are in nonprofits, other accommodations, for example march 1st to march 30th, there was a total of 647 covid-19 cases in 40 out of 50 texas office of resettlement operations. these were self-reported positive covid-19 cases in migrant children in care. at the springs texas facility, 10 to 11% of kids have tested positive for covid-19. there were 766 unaccompanied migrant minors at the site which has 952 beds at the time. i think what we're seeing is the failure by this administration and by your agency to adequately care for these children and to prevent them from contracting covid-19 and passing it on once they are released into the
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interior of this country. so i'd like to hear from you what this administration is planning to do to ensure that people coming across this border, whether legally or illegally, do not have the conversation and they are stopped at the border before they are entering this country illegally if they do to prevent americans from contracting this deadly virus? >> congressman cline, thank you for the question. and the spirit in which you asked the question, i appreciate that. i think -- i actually have heard from everyone the same thing. we have the interests of these children at heart. regardless of what their ultimate outcome is, they're home or able to stay here, the concern we have at hhs is while they're in this our care we do it right, under the law, and we provide the health and human service they expect. so let me respond to some of the
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points you make because it is important we make sure when it comes to covid, whether it's the kids or anyone within the american family that we're doing all to protect them. the reason you can cite those different numbers is because hhs is being transparent. we're not trying to hide anything. we want folks to know what we are doing, how we're doing it and we want you to see it, because it's important. we're not interested in hiding anything about the care for the kids. it's important for us that people see it. when you hide things, it's because you're not doing it by law. we are going to do everything by law. when it comes to covid, testing, we test every one of these children. we do not release any child who has been -- we certainly do not release a child who's covid positive out into the community. we also provide care for kids who are covid positive. we make sure they are not
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comingling with kids who were covid negative, which is an additional responsibility and burden for us because it means less space. we are able to put fewer kids in licensed facilities because of covid today. so the type of facilities that would have been available before to deal with the unaccompanied migrant children, no longer available at those capacities. we're having to deal with fewer licensed beds but more kids. so you can see how it's become a challenge but we're doing it and we're doing it safely, protecting these kids and protecting the american public. and at the end of the day our job is to protect and offer care and to do it according to the law. >> i only have a couple of seconds left. i just wanted to close -- shift over to the issue of fetal tissue research. i hope you're going to continue the trump administration policy and that's your announcement
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tomorrow. one last question if i might. do you consider the 1973 roe versus wade decision to be settled law? >> congressman, i believe roe v wade has given women the opportunity to exercise their rights to provide for their health and i hope we continue to see that roe v wade was a compromise in how we can make sure women, their rights are not violated when it comes to how they get their health care. >> you would agree it's settled law? >> i have no argument that it's an important legal precedent that we must abide by and make sure women have the access to health care that they need. >> the reason i ask is because the hyde amendment was passed only three years later. so that should be considered settled law as well. thank you, madame chair. >> congresswoman frankel.
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>> hello, okay. let me see if i see myself. okay. there we go. hello, mr. secretary. it's so nice to see you, congratulations. i just -- i'd like to just start with a couple of comments and then -- before i get to my questions. just following up on representative clark's discussion on day care. the day care industry is in crisis. and even before the pandemic costs were too high for parents and the pay was too low for the workers. now with this pandemic, getting parents back to work, especially the women of this country, which have been -- women workers have been hit very hard, just keeping in p mind that parents cannot get back to work if they don't have safe, nurturing places for their children. so it's so important that we
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consider child care, not only as advancing our children but advancing jobs. as to the hyde amendment, to me the hyde amendment is the all the mall form of discrimination against low income women. i won't say anything more about that, other than that. as to title ten, thank you to the biden administration for the new rule reversing trump's, what i call a suffocating gag rule that puts so many women at risk of not getting -- over a million, million and a half couldn't get basic primary care and putting women at risk for abortions in unsafe conditions, death related to pregnancy and increased stds not even being able to get a mammogram. now to my questions. the affordable care acts birth
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control mandate ensures that women will have coverage for one of each type of birth control method approved by the fda by requiring employer sponsored plans to cover birth control without a co-pay. in may of 2017, president trump signed an executive order, setting religion to discriminate against people seeking reproductive care. this allowed employers to deny birth control coverage by claiming, in some instances, they had religious or moral objections to methods of birth control. i agree and say that a type of birth control that a woman uses should be her decision not her employers'. will the obama rules that still ensures women that these
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employers could access contraception through their insurance company or third party administration you restored, and can you explain the reasons. >> congresswoman frankel great to be with you and thank you for having the spirit and fire. but you're not going to like my answer here because i am recused to responding to answers on this subject because of my previous role as the attorney general of california where i was involved in litigation on this subject. so while i have a team at hhs working on these matters, i have to keep myself distanced from them because i had a role that was very obvious where i was as the attorney general for california on this matter. >> well -- >> forgive me. >> at least i thank you for being on the correct side of this issue. and just wish your folks the
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best in reversing this order. so let me get onto another subject quickly. every day in the united states, 10,000 people turn 65 and the number of older adults are going to more than double over the next several decades. that's a lot. around -- i read an article that said 70% of 65-year-olds will need some long-term support before they die but have not done any planning. they think their kids are going to take care of them or their grandchildren, who knows if that's true but if it is it's going to take lots of people out of the work place. so question is, i've seen, there's a big request for home and community based services to help older adults and individuals. could you just tell us how this funding is going to be used and the biden administration
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concept? >> absolutely. for those of us who are baby boomers, we see the value in having our government believe that we have to continue -- or have that continuity of care. we are going to try to make sure this president and this administration are making major investments to try to make sure that care givers of some of our family members are able to stay where they are, make a living as well. so, whether it's providing $550 million for home and community based services, which is an increase of 158 million over the previous fiscal year, we are making sure that we make those types of opportunities available to families. we want to make sure that older americans continue to receive access to the nutrition that they have come to rely on when it's hard for them to afford it, so we make additional investments in some of the nutrition programs for our
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seniors. and we continue to make every effort to try to make sure that everyone under the age of 65 and doesn't yet qualify for medicare can qualify to have access to health care, whether it's through the affordable care acts exchanges or perhaps through some of the proposals that the president is gearing up that would help a lot of our older americans who are not yet medicare ole jiblt have access to the kind of care they need. i could go into more details but we know the importance of meals on wheels for so many seniors but it's also making sure that some of the care givers are able to do the work and can afford to keep that as a living. >> thank you. i yield back, madame chair. >> thank you. congresswoman boostos -- yeah. >> yeah, i'm on. thank you, madame chair. and mr. secretary it is great to
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see you. i will echo the kind words of my colleagues and how pleased we are you're serving in the biden cabinet. you're going to do remarkably well. we know that. i'd like to cover the centers for disease control social determinants of health program. i want to throw out my thanks to the chairwoman and the ranking member. with them, we have been able to stand up a $3 million program based on legislation that we wrote out of my office called the social determinants accelerator act. it provides grants to state and local governments to have plans to combat issues like food deserts, long drive times to doctors that you see in rural congressional districts, and they're negatively impacting health outcomes for people. i cannot tell you the level of
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excitement i feel when president biden announces a $153 million request for the program this fiscal year. so mr. secretary, a few questions. first of all, as part of last year's funding bill, we directed health and human services to create a social determinants interagency council made up of representatives from health and human services, education, labor and many others to help communities applying for these grants. if you could, do you know the status of the council as it stands right now? >> great to be with you. believe it or not, i don't. and i'm going to admit i don't, but i will check with my team because as i said to everyone beforehand, we're going to be on this one. so i will get back to you quickly on that. >> okay. we will wait to hear back from you. it makes me feel good that you're committed to making sure that that gets up and running and if it hasn't already, i
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don't know the status either. because it's a bill that we wrote out of our office, very interested in knowing that. >> you had me at hello on that one. >> okay. all right. look forward to talking with you more about it. talking more to you about it. so when will local communities, if you know the answer to this, if you know when local communities would be able to apply for the $3 million worth of social determinants grants. we have heard from many of our communities in the congressional district that i serve in central and western and northern illinois about their interests in being able to apply for grants. anything you can make let us know about that? >> you are really getting granular on me, and as much as i did a lot of homework to prepare, i can't give you the answer on that, congresswoman, and i can make sure my team is
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taking notes and we will get back to you as quick as we can, and $3 million for a lot of communities will make a lot of differences, so we'll get back to you on that. >> let's shift to a bigger picture. with president biden's announcement of the $350 billion in his initial budget, i am guessing you have been involved in those discussions with president biden. can you talk a little bit about how you envision that working? what are the next steps? what would you like to see happen with this $153 million? you probably even know how the 153 million number came to be, but if you could talk about that from a bigger picture perfective? >> thank you for that. i hope to approach this by, one,
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can't use a cookie cutter. what works in one community may not being work in another. two, you have to look in every corner, and there are communities trapped and if you missed them you have not dealt with social health care, so make sure you turn over ever stone. three, we're not going to know how to best do this with washington, d.c., and that means partnering with the local communities to ask them, looking to the people who are respected and the leaders in the community to help guide us on how we're going to do this work. they're going to know we are lapsing and not doing the best we can when it comes to social communities that have been left behind, so turning to respective leaders, and making sure we don't assume that the communities in that corner of
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the region were already addressed, and making sure that we're doing this in a way we partner with everybody who understands this and were the experts, and we should be able to come up with a good way to address this. at the end of the day as i said to other questions, to me accountability is so important. i want to make sure we delivered on our dollars and i want to make sure if somebody gets that money they deliver on the dollar as well. taxpayers deserve that. >> again, mr. secretary, thank you so much for your commitment to this. i look very much forward to working with you and i know you have gotten many invitations already but would love for you to come to our district and see how so many struggles and thank you. madam chair, i yield back.
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>> congressman harder. >> specifically i think that covid has exposed some of the cracks that have existed for a long time in our health care system. one of those is the provider shortage, aespecially in rural areas when we had zero icu bed capacity in many months for our state, and it's because we didn't have the doctors, the nurses the health care workers necessary to get people the care they needed. the rescue plan we passed a couple weeks ago had funding for
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100,000 new public health care workers, and we wanted to see how that is super charging the capacity needs we have across our country. >> congressman harder, great to see you on this committee and doing great work. when the president sought to get those 100,000 public health workers out there it was to make sure that on covid we were on it and would not have a shortage of personnel to keep us from getting americans access to the testing and now to the vaccines, so principally right now the effort is to make sure no community doesn't get the service they need when it comes to dealing with the pandemic because they have a shortage of personnel, so how those 100,000 public health workers will be distributed is based on the needs of those communities, and i know your district, was know
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well, and you are right. the aspects to the american rescue plan that will help places like your district because whether it's the increased number of residency slots that are going to be able now to provide those newest doctors out there providing services, health care services for the training they are getting, or in the case of your area, the new university that will provide services to a lot of folks and maybe in the future have a medical school, and those kinds of things, and those are the investments we want to make to make sure we are servicing and not forgetting folks that live in the central valley of california. >> absolutely. on the health care workers specifically, there was a note from the administration that there was a desire to make at least some of these workers a permanent improvement on the capacity of our public health system across the country. i didn't see a lot on that in
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the sort of blueprint of the budget. is that something you anticipate flushing out and can you give us any detail on how you would anticipate funding those public health care workers going forward? >> no question many of these workers can become permanent and help many of the communities. i know a lot of areas in rural america would be desperate to have some of the folks become permanent workers in their areas. quite honestly we would have to partner with you because we have to figure out a way in working with our local leaders we can make those positions permanent, and so that takesing partnerships with the state and local leaders to make that happen. >> absolutely. one other of the challenges, we focused on nurses and doctors as you know and mentioned the central valley as half of the doctors per capita that the rest of the country has, and i have
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been working a long time on trying to expanded the public service loan forgiveness programs that would include california and texas, as it does not include that today, and it affects your agency and making sure we have health care available to everybody across the country would love your support to include california and texas, which would lead to 10,000 positions coming just to our state and areas of need. more broadly is there anything else we could be doing to accelerate some of the areas we are talking about to get positions like in the valley? >> if that's an open invitation for suggestions, the most important thing is to make sure the local stakeholders don't wait until they know there's going to be money to let us know. plant the seed now because i don't think most people believe the american rescue plan would have been out there and doing so
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much good so quickly, so plant the seed now with hhs and let us know where there's a need so when we are ready to launch we don't forget places like the central valley. >> thank you for your leadership and working with us. i yield my time back, madam chair? >> congresswoman lawrence. >> thank you. i just fell. i have a couple questions for you. i am so pressuretive of the skinny budget and all that president biden has done, and president biden has stated that we have a gun violence epidemic in this country and we must address it. we are going through the very troubling time in dealing with
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violence from police, seeing so often that it's mental health that is that needed but the only response we have is a police officer pulling up and discharging a weapon. can you please let me know how the department will use increased funding to promote partnerships between mental health providers and law enforcement? we know there are so many people who are imprisoned right now who instead of needing to be incarcerated need mental health and your department is going to be very, very important in that role. the other issue i would like for you to address, every one has talked to you about the need for mental health, and as our children are being confronted with such a different reality that generations of children have never experienced the
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number of suicide rates and everything has increased, so we must infuse an education of a mental health component and that's not optional in my view at this time. i feel you can be a leader in this and also provide it. my last point is, everybody has talked to you about mental health. what are we doing to incentivize young people going into college for mental health, and there's a shortage of mental health students, and i want to tell you that and i am excited with you in this role and i look forward
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to working with you. are you there, mr. secretary? >> there we go. how about now? i was just saying, congresswoman, good to see you again. let me try and respond quickly to the issues. gun violence. we all know it's about 40,000 americans die from firearm injuries as a result of our lack of action on this every year. it's the third leading cause of death for americans age 10 to 34, the third leading cause of death. >> wow. >> so president biden has made it very clear, this is a public health crisis and we have to address it. that's why he's made sure we are in our budget providing $100 million to the center for disease control and prevention to start a new community-based violence intervention initiative that will work at the local
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level for those that want to deal with the gun violence crisis. we know we need to do more with regard to domestic and gender based violence, and he's made an estimate close to $5 million to support and protect domestic violence survivors. we know 1 in 4 women, and by the way, 1 in 10 men have experienced physical violence or stalking at some point, and so we are making real commitments. it's one thing to talk it and it's another thing to walk it and i think the president made very clear that we want to try and address these things. when it comes to mental health, congresswoman, as you know, this is one of those areas where we never -- none of us have ever fully come through to match our words, and i think president biden has made a major commitment here to start to fund the services that we need to deal with mental health
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conditions that a lot of americans are suffering from, especially during this time of the pandemic. i think you will find this budget is more than just numbers, it's a statement on values by the president from the united states. >> do you have any plan on how we are going to get more mental health professionals so we can meet the need going unaddressed right now? >> know that a lot of those current mental health professionals would talk about a more commensurate salary to get more people interested that in work, and the way we lag behind in customary health care issues, we have not seen what we would like, so hopefully we can make that happen. >> thank you. >> thank you. we're coming to noon, mr.
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secretary, and i want to alert my colleagues that we don't have time -- we would all love to have a second round in which we will be unable to do, but i just want to make a comment before i yield to the ranking member for any comments or question or closing but i close, but what an incredible discussion today, and that's testament to your commitment and expertise and your approach to dealing with difficult issues, the difficult issues we are facing today. i would also just say that we thank you for your clarity and also for your candor. if you can't answer a question, you can't. if you disagree on something or maybe potentially disagree to
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lay that out, but it really has been so forthright, mr. secretary, and the way in which hearings which should go forth in this effort, and i want to say at the same time to my colleagues on both sides of the aisle, i thank you for the expertise that you bring and the questions that you bring for what has been just an extraordinary exchange and done in a manner that be fits the significant challenges we face today, and we need to be wherever we are coming from, wherever that interests we can come together. i found in a book that i wrote four years ago when this country was formulating a social safety net that it was crafted by
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legislators on both sides of the aisle, democrats and republicans, who understood the nature of the problems that we face today, that we faced then and the challenges and whatever their political disposition, they came together and they forged an agreement and legislation that has accrued to the benefit of the american people, and i know it's your hope and it's our hope that that's the same kind of ability that we can bring to the challenges we all face today. with that let me just yield to my ranking member, congressman cole, for any comments and any further questions and to close and then i will close. >> thank you, madam chair. i want to associate myself with your remarks about the nature of the hearing we have had today and that reflects mr. secretary,
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a great deal of confidence in you on both sides of the aisle, and we know who you are and have had a chance to work with you and when we differ we do so respectfully, and i hope in listening to the committee -- i love the appropriations committee. i really tell people, i don't care if you are on the left or the right, the appropriators are dealmakers in the end. that's not true of all of our members on other committees. they may be on the left or right and they are what i like to call shirts and skins committee, you find out pretty quickly where the everybody is at and the lines and sides don't change. certainly the discussion we had about here, the indian health
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service and forward funding proposals, there's a lot there, and there's other areas where we have shown we can work together and other parts of your department, everything from early childhood and first generation college students, a lot of this is under your purview, and again, it's a broad swath of responsibility. so some under and some not, but there's a lot here that we can find common ground on. i appreciate your respectful manner in which we talked about hide, and i don't do this in a way to start a fight but i do remember one occasion where it was a live issue, and my friend, the chairman and i were involved in the negotiation with our friends in the senate and one of
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our good friends at the senate, and i had a speaker at the time that was interested in this, and i will leave them all unnamed and my friend on the other side of the aisle, he said tom you can have a deal or fight but you can't have them both, and i took that back to the speaker, and i reported that and i said, what do you want, and he said i want a deal. four years i was chairman -- i'm very proud of this, and when we got to the end of the day and the negotiations, the ranking member voted for passage because we worked towards a deal. in the two years that she chaired this sub committee we ended up in the same place, and i voted for final passage as well. i would very much like to get to the point where i can do that
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again, and so the commitment i will make to you, i will work towards that end, but, again, just as i understand their positions that put my friends in awkward standards, they can't violate their standards, and the same is true on our side, and this is a committee that wants to work together. it's the first thing i worked out when i was fortunate enough to chair it, and iah was one of them and early childhood was another one, and first generation college students on the education size was another one. and i hope you noticed -- i certainly did, i thought all the questions by all members were thoughtful and respectful and asked in a good spirit. i think they are trying to figure out how they can work with you. i do think the range of
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responsibility should have our exception, and i sometimes think we ought to rename your title ought to be secretary for bio defense, because that's a big part of your deal. i look on what we do here as every bit important as defending the american people as what is done by the department of defense, and i think this pandemic has demonstrated that by everybody else. losing half a million people a year is an indication of the critical work that this sub committee does and your agency does for the american people. i take the responsibility like that. i don't see this as just a dollar and cents game. i see these as programs that really protect the american people and are absolutely indispensable. i also see them as programs that improve the quality and address some of the disparities that you and other members have dealt
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with for many years and worked hard and there's a lot left to do. i just end by welcoming you to your new position of responsibility and letting you know the door is always open, and we want to work with you and we want you to be very successful in what you are doing, and i am quite certain this sub committee will try and find common ground with you and try to help you achieve some of the goals you have laid out that i think all of us in a bipartisan sense would agree are for the good of the country, and in many cases for the good of humanity. again, some of the agencies impact our country first and foremost, but this committee has -- this sub committee has the ability to do good all over the world, some of the work you will do with the cdc and nih and cooperating with people all over
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the world important the pandemic will enrich the lives for all of humanity, and we look forward to working with you. for that, madam chair, i yield back. >> thank you. i think we share sentiments on the secretary and his knowledge and his goodwill and look forward to working with you as we go forward. mr. secretary, let me just make two points and then i will close. i wanted to ask you, for a commitment, i have serious concerns about the strategic national stockpile. i think we need to review the management, the missions scale and the transparency of this very, very, very important federal asset. and i would like to have your commitment that you will task your team with beginning a rethinking of the strategic
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national stockpile so we can move forward and the american people can continue to have confidence in this asset. i say that because i asked over and over and over again in the last several years for an accounting because we put -- we appropriated serious, serious dollars believing that this was and it really is a national asset without any response and without knowing what was there and so forth and so on, so i would very much love to have your commitment on that effort. the other point is with regard to the unaccompanied children -- and i know you are working in this direction with regard to a long-term plan, and we want to move as quickly as we can to help these children and the administration, i know, is developing that long-term strategy and given your comments
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today that children who ensure that those children in our custody are housed in state licensed shelters and are treated with respect and are placed as quickly and safely as possible with sponsors, and i know those are the values that you bring to this issue. if i might just say that i'm really pleased with the 2022 budget for hhs. it includes strong funding increases for public health, biomedical research, child care, early learning, mental health, maternal health, and so many other areas. for me we are finally moving towards a budget and a role for government that invests to give us a better future. we're moving towards a budget in a role for government that elevates our education, and our health care institutions so that ordinary citizens have the increasing prospect for success,
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and it tilts the playing field so normal citizens have a better shot at life and that parents understand that their children can get a better shot at the american dream. above all it says that poverty is unacceptable. it's unacceptable and that we have this institution and this sub committee has the capacity to abolish it. mr. secretary, thank you for who you are and your public service, and with that i am supposed to bang a gavel which i do not have, so i will bang the phone, and this hearing is adjourned. thank you. c-span is your unfiltered view of government. we're funded by these television companies and more, including charter communications. broadband is a force for empowerment. that's why charter has invested
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billions. a billion infrastructure. charter is connecting us. charter communications supports c-span along with these other providers. transportation secretary pete buttigieg testifies on thursday before a house appropriations sub committee. watch live at 2:00 p.m. eastern on c-span 3, online at, or listen live with the c-span radio app. joining us next is public correspondent, ac thompson, also on "american insurrection," and ac thompson, welcome to washington journal. >> thank you for having


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