[House Hearing, 117 Congress]
[From the U.S. Government Publishing Office]
DEPARTMENTS OF LABOR, HEALTH AND HUMAN
SERVICES, EDUCATION, AND RELATED AGENCIES
APPROPRIATIONS FOR 2023
_______________________________________________________________________
HEARINGS
BEFORE A
SUBCOMMITTEE OF THE
COMMITTEE ON APPROPRIATIONS
HOUSE OF REPRESENTATIVES
ONE HUNDRED SEVENTEENTH CONGRESS
SECOND SESSION
____________
SUBCOMMITTEE ON LABOR, HEALTH AND HUMAN SERVICES, EDUCATION, AND
RELATED AGENCIES
ROSA L. DeLAURO, Connecticut, Chair
LUCILLE ROYBAL-ALLARD, California TOM COLE, Oklahoma
BARBARA LEE, California ANDY HARRIS, Maryland
MARK POCAN, Wisconsin CHUCK FLEISCHMANN, Tennessee
KATHERINE M. CLARK, Massachusetts JAIME HERRERA BEUTLER, Washington
LOIS FRANKEL, Florida JOHN R. MOOLENAAR, Michigan
CHERI BUSTOS, Illinois BEN CLINE, Virginia
BONNIE WATSON COLEMAN, New Jersey
BRENDA L. LAWRENCE, Michigan
JOSH HARDER, California
NOTE: Under committee rules, Ms. DeLauro, as chair of the full
committee, and Ms. Granger, as ranking minority member of the full
committee, are authorized to sit as members of all subcommittees.
Stephen Steigleder, Jennifer Cama, Jaclyn Kilroy, Philip Tizzani,
Laurie Mignone, Rebecca Salay, and Trish Castaneda
Subcommittee Staff
____________
PART 5
Page
Fiscal Year 2023 Budget Request for the Department of Health
and Human Services ........................................... 1
Social and Emotional Learning and Whole Child Approaches in
K-12 Education .............................................. 141
Fiscal Year 2023 Budget Request for the Department of Education.. 181
Testimony of Interested Individuals and Organizations............ 249
[GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT]
_________
Printed for the use of the Committee on Appropriations
U.S. GOVERNMENT PUBLISHING OFFICE
48-855 WASHINGTON : 2022
COMMITTEE ON APPROPRIATIONS
----------
ROSA L. DeLAURO, Connecticut, Chair
MARCY KAPTUR, Ohio
DAVID E. PRICE, North Carolina
LUCILLE ROYBAL-ALLARD, California
SANFORD D. BISHOP, Jr., Georgia
BARBARA LEE, California
BETTY McCOLLUM, Minnesota
TIM RYAN, Ohio
C. A. DUTCH RUPPERSBERGER, Maryland
DEBBIE WASSERMAN SCHULTZ, Florida
HENRY CUELLAR, Texas
CHELLIE PINGREE, Maine
MIKE QUIGLEY, Illinois
DEREK KILMER, Washington
MATT CARTWRIGHT, Pennsylvania
GRACE MENG, New York
MARK POCAN, Wisconsin
KATHERINE M. CLARK, Massachusetts
PETE AGUILAR, California
LOIS FRANKEL, Florida
CHERI BUSTOS, Illinois
BONNIE WATSON COLEMAN, New Jersey
BRENDA L. LAWRENCE, Michigan
NORMA J. TORRES, California
CHARLIE CRIST, Florida
ANN KIRKPATRICK, Arizona
ED CASE, Hawaii
ADRIANO ESPAILLAT, New York
JOSH HARDER, California
JENNIFER WEXTON, Virginia
DAVID J. TRONE, Maryland
LAUREN UNDERWOOD, Illinois
SUSIE LEE, Nevada
KAY GRANGER, Texas
HAROLD ROGERS, Kentucky
ROBERT B. ADERHOLT, Alabama
MICHAEL K. SIMPSON, Idaho
JOHN R. CARTER, Texas
KEN CALVERT, California
TOM COLE, Oklahoma
MARIO DIAZ-BALART, Florida
STEVE WOMACK, Arkansas
CHUCK FLEISCHMANN, Tennessee
JAIME HERRERA BEUTLER, Washington
DAVID P. JOYCE, Ohio
ANDY HARRIS, Maryland
MARK E. AMODEI, Nevada
CHRIS STEWART, Utah
STEVEN M. PALAZZO, Mississippi
DAVID G. VALADAO, California
DAN NEWHOUSE, Washington
JOHN R. MOOLENAAR, Michigan
JOHN H. RUTHERFORD, Florida
BEN CLINE, Virginia
GUY RESCHENTHALER, Pennsylvania
MIKE GARCIA, California
ASHLEY HINSON, Iowa
TONY GONZALES, Texas
JULIA LETLOW, Louisiana
(ii)
DEPARTMENTS OF LABOR, HEALTH AND HUMAN SERVICES, EDUCATION, AND RELATED
AGENCIES APPROPRIATIONS FOR 2023
----------
Thursday, March 31, 2022.
DEPARTMENT OF HEALTH AND HUMAN SERVICES
WITNESS
HON. XAVIER BECERRA, SECRETARY, DEPARTMENT OF HEALTH AND HUMAN SERVICES
The Chair. Let's move forward and to bang the gavel and
call to order the hearing on fiscal year 2023, the President's
budget for the Department of Health and Human Services. A
hybrid hearing, so we need to address a few housekeeping
matters.
For the members who are joining virtually, once you start
speaking, there is a slight delay before you are displayed on
the main screen. Speaking into the microphone activates the
camera, displaying the speaker on the main screen. Do not stop
your remarks if you do not immediately see the screen switch.
If the screen does not change after several seconds, please
make sure that you are not muted.
To minimize background noise and ensure the correct speaker
is being displayed, we ask that you remain on mute unless you
have sought recognition. The chair, or an individual designated
by the chair, may mute participants' microphones when they are
not under recognition to eliminate inadvertent background
noise. Members who are virtual are responsible for muting and
unmuting themselves.
Finally, the House Rules require me to remind you that we
have set up an email address to which members can send anything
they wish to submit in writing at any of our hearings. That
email address has been provided in advance to your staff.
With that, I want to acknowledge the ranking member of the
subcommittee, Congressman Tom Cole, and all of the members of
the subcommittee who are joining today's hearing, both
virtually and in person.
And I would like to welcome my friend and former colleague
Secretary Xavier Becerra in his first in-person hearing of this
subcommittee as Secretary of the Department of Health and Human
Services. So you joined us virtually last year, of course, but
there is nothing like being in person and being able to
interact with people. So a very, very, very warm welcome this
morning.
Today, I am looking forward to discussing HHS's fiscal year
2023 budget, which builds on the historic progress we made in
the fiscal year 2022 appropriations package. In the fiscal year
2022 omnibus, we increased funding for biomedical research,
public health, behavioral health, child care and early
learning, prevention of child abuse and family violence, and
the list goes on. And through these investments, we are able to
bring transformational change to millions of hard-working
American families.
Let me take a second here before I go on to say a thank you
to my colleagues on both sides of the dais and those who are
virtual today and a really heartfelt thanks for our work
together in passing the 2022 omnibus.
And Congressman Cole, I want to say a particular thank you
to you for your good offices in all of this. I think we have a
bill that we can be enormously proud of. And I would also say
that there weren't a lot of folks who thought we were going to
get across the finish line, but we showed them.
So, and all done by March 8, on the deadline that they kept
changing on us. So, but thank you all very, very, very much for
your hard work. And again, a thanks to the staff as well for
getting us there.
And we strengthened in the omnibus bill the Centers for
Disease Control and Prevention by supporting the public health
workforce, continuing to modernize public health data systems,
creating a new funding mechanism to support core public health
activities at the State and local level. We made strong
transformational investments in maternal health, with increased
funding for NIH research on maternal mortality through the
IMPROVE Initiative, for the Health Resources and Services
Administration's Maternal and Child Health Block Grant and
Maternal Mental Health Hotline, and for the CDC's Maternal
Mortality Review Committees, just to name a few.
We expanded access to behavioral health with investments in
the 988 National Suicide Prevention Lifeline, the Mental Health
Block Grant, and in Certified Community Behavioral Health
Clinics, as well as a new pilot program to support Mental
Health Crisis Response Teams to ensure that individuals
experiencing a behavioral health crisis received the medical
treatment that they need.
In addition, for the first time in 12 years, we included
funding for member projects to support hospitals and health
clinics, mental and behavioral health projects, K-12 and higher
education programs, and job programs in our home districts. And
now, with the fiscal year 2023 budget before us, we are
strengthening these historic investments and ensuring the seeds
of change that we planted in last year's bill grow deep,
strong, and sustainable roots.
I want to be clear. My goal is to pass fiscal year 2023
appropriations bills on time, which means sending them to the
President by September 30. We have already had conversations,
and I plan to work with Ranking Member Granger, Chairman Leahy,
and Vice Chairman Shelby to reach an agreement on top-line
spending levels so each subcommittee can move forward with a
renewed sense of urgency.
In the immediate term, we need to provide additional
emergency funding to address the ongoing COVID-19 pandemic, to
purchase lifesaving vaccines, antivirals, monoclonal
antibodies, as well as continued support for the uninsured to
receive vaccination and testing at no cost.
Surgeon General Admiral Vivek H. Murthy wrote in the New
York Times on Tuesday, and I quote, ``Now, for the first time,
we cannot order enough vaccines to provide boosters for all
Americans if a fourth dose is deemed necessary in the fall. If
we need variant-specific vaccines, we will not have the funds
to secure them, deliver them, or administer them. Last week, we
were forced to cut our shipments of lifesaving monoclonal
antibodies to States by 35 percent, and we anticipate running
out of monoclonal antibodies later this spring. We will not be
able to continue making home tests available, and the critical
surveillance efforts that help us anticipate new waves and
variants will be compromised.''
Let me also add that it is equally critical to support
global vaccination efforts, both from a humanitarian
perspective and our own self-interest. Viruses do not stop at
borders on a map. No amount of domestic preparedness can
possibly contend with a continuing onslaught of new variants.
As of today, only 1 in 10 people in low-income countries
are fully vaccinated. To achieve the goal of vaccinating 70
percent of each country's population, including health workers
and the elderly, the United States must take a leadership role.
It is urgent that we act now to secure more funding to address
the ongoing pandemic before the money runs out.
I urge my colleagues on both sides of the aisle to come
together to save American lives and to save lives across the
globe. And again, it is urgent that we move in this direction.
Mr. Secretary, I am pleased to see your long-term plan for
pandemic preparedness. The President's budget includes
$82,000,000,000 over 5 years to invest in the Office of the
Assistant Secretary for Preparedness and Response, ASPR, the
CDC, the NIH, and the Food and Drug Administration to be able
to identify new potential pandemics and move quickly to develop
a vaccine and deploy it within 100 days.
We also need to tap the potential of the Advanced Research
Projects Agency for Health, otherwise known as ARPA-H, which we
created in fiscal year 2022 in the omnibus, to support
transformative research projects to address debilitating
diseases like Alzheimer's, diabetes, cancer, ALS, and many
other health conditions afflicting millions of Americans every
day.
ARPA-H has tremendous potential to develop breakthrough
technologies and advancements while continuing our important
work to reduce health disparities. However, Mr. Secretary, you
know my view on this. I must say that the decision to place
ARPA-H within the NIH I believe is a mistake and will hamper
the agency's ability to achieve these breakthroughs. I believe
that ARPA-H would be more successful in its unique mission if
it were established as an independent agency within HHS.
And I also believe that the proposed increase of only
$274,000,000 for the rest of the National Institutes of Health
is insufficient and threatens the progress this committee has
made in the past several years through significant, sustained
investments in biomedical research.
Beginning in fiscal year 2023, the President proposes to
reclassify the entire Indian Health Service budget,
approximately $9,300,000,000, as mandatory. And I look forward
to hearing more about the need and the rationale for the
proposal.
Mr. Secretary, I am happy to see the President's budget
continues to build on our investments in public health,
maternal health, behavioral health, including significant
increases for CDC's core public health capacity, as well as
increases for SAMHSA's Mental Health Block Grant, Substance Use
Prevention Block Grant, State Opioid Response Grants, Certified
Community Behavioral Health Clinics.
The budget includes targeted increases to improve mental
health services for children and youth, including increases for
Project AWARE and the National Child Traumatic Stress Network.
It includes increased funding for mental and behavioral health
workforce training, which is critically important.
These investments will help make quality care more
accessible for those suffering from mental health disorders, as
will the July rollout of the new 3-digit number, 988, for the
National Suicide Prevention Lifeline. This will be a dedicated
number for individuals in crisis to receive help immediately.
It is encouraging that this budget expands access to
healthcare services for low-income woman by providing
$400,000,000, an increase of nearly 40 percent over the 2021
enacted level, for the Title X Family Planning Program, which
will improve overall access to vital reproductive and
preventive health services and advance gender and health
equity. I will keep fighting for more money for Title X and
other reproductive health programs.
Within ACF, HHS is investing once again in refugee
resettlement programs. This administration is restoring our
reputation in the world as a country that welcomes immigrants
of all colors and faiths, as we did for Afghans in Operation
Allies Welcome and as I hope this Congress will come together
to do for Ukrainians as well.
Let me also tell you, Mr. Secretary that I expect to see
substantial progress this year in the Unaccompanied Children
Program. You know my position on this. HHS needs to build a
sufficient network of State-licensed beds and needs to shutdown
the emergency intake sites. It needs to fund the services
necessary to support these children and their sponsors as they
recover from their traumatic journey and past and as they
navigate the asylum process and understand their legal rights.
Mr. Secretary, we thank you for being here today. I look
forward to working with you over the next year and look forward
to today's discussion.
And with that, let me recognize the ranking member,
Congressman Cole, for any opening remarks.
Mr. Cole. Well, thank you, Madam Chairman.
And I am going to start as you did. I am going to be
outside my prepared remarks for a minute and do a little
lookback before we look forward. And I want to begin, you were
nice enough to thank all of us. The reality is all of us should
be thanking you and Ranking Member Granger for what you did.
I will point out this committee was ready to go to
conference at the appropriate time. All 12 bills have passed
out of this committee last year under your leadership, 9 of
them across the floor. We were ready before September 30.
And I am particularly proud of how hard you pushed over and
over again for demanding the least amount of time. First,
December and then February. But you were the leader in pushing
the Congress for getting its job done, and there is no more
important job than funding the Government across the board at
every level.
We know, Mr. Secretary, we hobble you and your colleagues
when we don't give you a budget on time. It forces you to
wonder what you are going to be operating with. It slows down a
lot of things that need to get done in a hurry. But that was
not the responsibility of this committee at all. It was, again,
ready to go to work, ready to sit down with the administration.
Our friends in the Senate I think could learn a little bit
from you, Madam Chair. As I recall, they didn't get any bills
across the floor, and they only got three out of committee. I
know everything is slower in the United States Senate. But
really? Three bills out of committee? Come on, guys. They need
to pick up the pace over there.
But I am proud of this committee. Even when I disagreed,
and of course, initially, we did. But I am also pleased, as you
pointed out, for the seventh year in a row, we got to a bill
that we both could vote for.
And again, that wouldn't have been possible without your
leadership and Chairwoman Granger's leadership. And I think we
certainly have R&D divisions around here, but we have
institutional divisions as well. And I think our institution
looked better than our counterpart on the other side of the
Rotunda, and you bear enormous responsibility for that.
So I want to associate myself with your goal of making sure
that we make this done by September 30. My guess is we will do
a CR and kick it into the end of the calendar year. But it
needs to get done, and sooner is better. On time is best. If
not, the calendar year is best. And I think, again, I will
pledge to work with you as hard as I possibly can to make sure
that that is our goal.
It is a mistake to kick it into a new Congress where we
will have new Members on both sides of the aisle, and they will
have to vote on something that they have had nothing--very
little knowledge, no participation in. And they deserve a clean
start, and frankly, the administration deserves a clean start
to the third year as well. And so we look forward to working
with you on that.
Now let me go to my formal remarks, if I may?
Mr. Secretary, it is a pleasure to have you here. And as
the chair said, it is wonderful to be back in the room and have
the interaction. Particularly good, frankly, interacting with
you, as you know our world better than any Secretary I have
dealt with. And I have dealt with some good ones on both sides
of the aisle, but it is always nice to have another member here
that understands what are the challenges we have from a
legislative standpoint, and you do.
I am glad that, again, our chair chose to hold this meeting
in our full committee room so that some members could attend in
person. I wish we could all be together in person for this
hearing, as I think the dynamic and interaction among members
is much better when we are all seated together in the same
place, rather than looking at each other through a computer
screen.
Nevertheless, Mr. Secretary, I appreciate your personal
accessibility to us as members. I have enjoyed the bipartisan
breakfasts you have been kind enough to host over the past
years. I appreciate you understanding the challenges of
legislating and having served this body yourself, and
particularly your responsiveness on the phone or things like
that, again to both sides of the aisle, have been greatly
appreciated.
Today is our annual hearing to discuss the administration's
budget proposal for fiscal year 2023. We just completed the
final funding bill for fiscal year 2022 only 3 weeks ago. So
thanks for getting us right back to work, Madam Chair.
I am hopeful it does not take as long to complete the work
on the budget this year for the coming fiscal year, and I was
glad to see a return of bipartisanship and compromise in the
bill recently completed. Although we had strong differences
going in, we were able to forge a compromise that both the
chair and I were able to support.
For more than four decades, the Labor, Health and Human
Services appropriations bill has carried the so-called Hyde
Amendment that restricts Federal taxpayer funding for abortion
under most circumstances. The fiscal year 2022 budget just
completed was only able to advance because this language was
again included.
I thank my chair for seeing the wisdom in continuing this
decades-old bipartisan compromise, although I know that she
personally disagrees with it. I am confident that the next
spending bill we negotiate will continue to include it, as I
continue to oppose any appropriations bill that seeks to weaken
pro-life protection.
Mr. Secretary, I expect under your leadership, HHS will
continue to enforce these provisions of existing law. But let
me be very friendly, but firm. No Republican will vote for a
budget, in the end, that does not have the Hyde protection, and
in the end, we know it takes a bipartisan majority in both
chambers to actually move this.
So the choice is squarely with the administration and the
majority. We will once again be confronted with a choice,
either Hyde comes back into the budget or accept a CR. And I
want to be clear on that. I am not trying to be anything else.
It is just a political reality.
Coming on the heels of such bipartisan negotiation, I am
again disappointed the Biden administration once again is
putting forward a partisan proposal that seems little more than
a lengthy liberal wish list in some areas. For example, the
budget proposes to implement partisan priorities such as
climate change, gun research, and even a new center for sexual
orientation and gender identity within the NIH.
To pay for these partisan initiatives, longstanding shared
bipartisan priorities are shortchanged. Basic biomedical
research at the NIH is essentially flat-funded, while the new
ARPA-H, which was just created this month--and which, by the
way, I supported--has not even begun to function yet, but is
proposed an enormous $4,000,000,000 increase.
I think it is a mistake to shift funding away from basic
biomedical research into a brand-new program in one year. ARPA-
H will take time to get up and running and take time to work
out the many controversial issues I know this new agency will
face. And I will have some questions about your plans on ARPA-H
this morning. I appreciate, by the way, your letter that
clarified some things about it and also made it clear that you
want to work with Congress.
This is a very new entity, and we are going to have a lot
of wrestling with tough questions--I mean this in a very
bipartisan way--to get to a structure that we all think is
producing what I know we all want it to produce. And again, I
say that as somebody that supported the creation of the
initiative and look forward to continuing to work with you on
that, Madam Chair.
Taken as a whole, I disagree strongly with the approach
taken in the administration's request. To put it simply, it
spends far too much on domestic programs, far too little on
defense. Especially now with the current situation in Eastern
Europe, America cannot afford to stand or cut back our own
defense spending. At a minimum, we need to see at least a 5
percent annual increases beyond the rate of inflation for
defense spending for the next several years. But that is a
matter for the full committee, not just this subcommittee
certainly.
The President's proposal for fiscal year 2023 for this
subcommittee amounts to a 15 percent effective increase. Coming
in when the fiscal year is already half way over, another huge
infusion of spending in these domestic programs in fiscal year
2023 is just not necessary. And I don't think it can be spent
prudently and will only serve to increase our already-growing
inflation problem, which is now near a 40-year high.
I know we are all hoping that the coronavirus pandemic,
which began over 2 years ago, may finally be winding down to a
manageable endemic disease. Despite the many challenges of the
past 2 years, Congress was able to come together 5 times in
2020 to pass emergency supplemental appropriations to help us
through the pandemic. I supported all five of those bills.
I know we are not out of the woods yet. The administration
has told us that funding for therapeutics and additional
booster shots is running low, and we do not know if new
variants are coming in the summer or the fall. Yet the
administration has also released documents showing tens of
billions of dollars, possibly as much as hundreds of billions,
in previously appropriated COVID dollars remain unobligated and
available.
And look, let me just be brutally honest here and use my
own State as an example. Under the proposed future distribution
of money, I think we have something like $187,000,000 ticketed
for Oklahoma. We have a rainy day fund that we added
$1,000,000,000 to last year. We had a tax cut last year. And I
can tell you $187,000,000 is unlikely to be spent for corona-
related purposes. We don't need the money.
And I think some of the revolt we saw on my friend's side,
again was more governors that wanted to use the money for other
purposes. And if I were comfortable they were all going to
spend it on the priorities that you have laid out in your
budget, Mr. Secretary that would be one thing. I am not.
But I am not for just throwing money away when we have got
hundreds of billions of dollars of money that can be repurposed
and aligned for this. And I know that is a political discussion
as well as a policy debate. I recognize that, and I am happy to
work with my friends on that.
But again, most of these States are in better financial
shape, quite frankly, than the United States Government is.
Most of them have reserve funds. We don't have one. Most of
them have balanced budgets. We don't have that.
So the idea of us not taking some of the money that we
wanted to lay out for coronavirus and say, no, you guys really
don't need it for other purposes, let us redirect it back, I
think is a worthy discussion to have.
Mr. Secretary, again, as I said, I urge you to repurpose
these existing funds to secure additional doses of monoclonal
antibodies and other therapies without delay. I urge you to use
the remaining COVID balances, as well as the increases we
provided in the bill just passed in the NIH and BARDA accounts,
to continue to work on the next generation of vaccines. And
hopefully, a universal coronavirus vaccine or a vaccine that
targets mucosal membranes can be developed quickly and can not
only prevent severe disease, as our current vaccines do, but
can also reduce transmissions and need for additional boosters.
Finally, I want to take this opportunity to comment on one
part of your budget, which is not under this subcommittee's
jurisdiction, but one which I wholeheartedly agree with your
proposal. And that is your proposal to move the Indian Health
Service to the mandatory side of the budget ledger. That is a
move I believe is long overdue, and it will stop the
competition for scarce resources that currently exist between
the Indian Health Service and other programs important to
Indian Country, such as the Department of Interior, the Bureau
of Indian Schools, payment in lieu of taxes reprogramming,
other programs that are important in preserving our Nation's
natural resources.
I hope this can work together to further this idea this
year. My colleagues on this subcommittee have had to hear me
probably more times than they care to since it is not directly
their jurisdiction. But having sat on Interior, the reality is
there is just not enough money in the discretionary budget to
take care of the needs of Indian health, which is already the
largest single item in the Interior Subcommittee appropriation.
I think your approach here is a wise one, and sadly, every
time we have had a Government shutdown or a delay in spending,
because the Indian Health Service is on the discretionary side
of the budget instead of the mandatory, we have disrupted
healthcare in reservations and some very poor communities. I
think this is a very far-sighted proposal for you. I know you
are going to get some stiff resistance on both sides of the
aisle for a whole variety of reasons, but I think you are on
the right track here.
And I look forward to working with you, and I appreciate
very much you advancing this proposal in your budget.
So, with that, Madam Chair, again, I look forward to
working with you in the coming year. It has been a delight for
7 years in a row. It has ended successfully 7 years in a row. I
hope it ends successfully the eighth time around.
So, with that, again, yield back to my friend, the chair.
The Chair. The eighth time is a charm. So there we go.
Thank you very, very much, Congressman Cole. Thank you for
your kind words as well. I much appreciate it, and I enjoy so
much the opportunity to work with you in these areas. As you
pointed out, we may disagree, but we are never disagreeable
about it, and we get to a conclusion. And that is really what--
that is what this job is about. It is about governing.
So, Mr. Secretary, you know the floor is now yours. Your
full written testimony will be entered into the record, and you
are recognized for 5 minutes for an opening statement, and then
we will move to questions. You know the drill.
Secretary Becerra. Madam Chair, Ranking Member Cole, and
members of the subcommittee, thank you for the opportunity to
discuss the President's fiscal year 2023 budget for the
Department of Health and Human Services. Pleased to be with you
today.
Speaking of today, 255 million Americans have received at
least one dose of the COVID-19 vaccine. Two-thirds of adults
over age 65 have gotten their booster shots. We have also
closed the gap in vaccine rates we usually see fall behind for
communities in some of our distressed areas.
It pays dividends to surge resources, including tests and
treatment, to our hardest-hit and highest-risk communities. We
think the numbers show that.
What are those numbers? Three hundred twenty-five million
free COVID-19 tests have been shipped out to Americans. Two
hundred seventy million free N95 masks have been made available
to Americans.
You all made it possible to have $186,000,000,000 available
to the Provider Relief Fund. So, so far, we have seen some
766,000 claims submitted by doctors, hospitals, community
health centers, pharmacies, labs, nursing homes, long-term care
facilities. All of them receiving some very critical support at
a very necessary time. More than 450,000 providers to date have
submitted requests for reimbursement.
Real money. Real relief. Real results.
Beyond COVID-19, today more Americans are insured for their
healthcare than ever before. That includes a record-breaking
14.5 million Americans who secure their health insurance
coverage through the Affordable Care Act.
In addition, thanks to you, we are now enforcing the new
law that protects Americans from being blindsided by surprise
medical bills. We launched Operation Allies Welcome, an HHS-led
effort that has helped over 68,000 Afghan refugees resettle in
America. We are coordinating nearly $300,000,000 in nationwide
support for the launch of the 988 National Suicide Prevention
Lifeline in July.
HHS has also made key investments to improve equity in
areas like maternal health, where we have extended Medicaid
coverage for postpartum care for a new mother and her baby from
2 months to 12 months.
The President's 2023 budget lets us build on that record of
investment in America's health. It proposes $127,000,000,000 in
total discretionary budget authority and $1,700,000,000,000 in
mandatory funding, including newly proposed mandatory funding
to provide for the Indian Health Service.
It also asks for $82,000,000,000 for the President's
pandemic preparedness proposal to get ready for whatever might
come next after COVID-19. Considering that COVID has cost this
country more than $4,500,000,000,000 in direct support from the
Federal Government so far, this is a no-brainer to prepare for
the next pandemic. The funding we are requesting will be end-
to-end, for research, development, approvals, deployment, and
effective response.
Madam Chair, budgets represent not just dollars and
investments, but our values and our priorities. This budget
turns hardship into hope and inclusion into opportunity, and it
is a commitment to finish the fight against COVID-19 and to
build a healthier America.
On that note, I want to acknowledge our collective national
failure to fund the Indian Health Service at the level needed
to meet our constitutional treaty and our trust obligations to
tribal nations in America. But even more so, to point out how
we failed to meet the elemental level of needed support to
provide fair and sufficient resources to our families in Indian
Country.
I have seen these shortfalls firsthand in my visits to
Indian Country, where more than 2.7 million patients are served
by Indian Health Services. The President's fiscal year 2023
budget takes a historic first step toward finally delivering on
our long-overdue commitments to tribal nations.
In my written testimony, I detail our proposal to convert
the IHS budget to mandatory funding, as Congressman Cole
mentioned. And we do this not only because it is necessary,
because we have to do it long term. We are so far behind, it
bolsters significantly the budgets for IHS over the next 10
years. This budget is a strong start, but we must continue to
shine a light and hold ourselves accountable on our promises.
Madam Chair, I look forward to working with you and all the
members of this subcommittee to make the President's 2023
budget a reality and to continue our efforts to improve the
health and well-being of the American people. Working together,
I am confident we can give Americans real relief, real results,
and real peace of mind.
And with that, I would be happy to answer any questions
that you may have.
The Chair. Thank you very, very much, Mr. Secretary. And
thank you for your written testimony, which was extensive and
in detail. Much appreciate the information.
I have got two or three questions, and this is around the
COVID supplemental, pandemic preparation, public health areas.
And the administration has told us that more funding is
necessary to deal with purchasing the COVID vaccines,
therapeutics, tests, including covering vaccination and testing
for the uninsured. What is the current status of the COVID-
related activities that will be reduced or eliminated without
additional funding? What are the potential consequences of
failing to maintain these efforts?
Secretary Becerra. I start by first saying thank you very
much to what Congress has provided over the last 2 years. As I
said, $4,500,000,000,000 or so in support overall for all
aspects of COVID from the Federal Government. That is a major
investment.
What we are asking for now is to finish the fight on COVID.
We are running out of the money in that Provider Relief Fund to
reimburse claims submitted by all those different types of
doctors, hospitals, and so forth.
Just to give you an idea, when we told providers that we
would have to stop accepting claims about 2 weeks ago, in a
period of about 8 days, we received over 2 million claims. And
we know that what we are going to see now is just a rush for
April 5, when we have announced that we will stop receiving
claims as well for vaccination.
The first deadline was for testing and treatment. I think
that was March 22. The new deadline for vaccination
reimbursement is April 5. We expect another surge of
applications to come then.
I am sorry. I think I said number of claims of 2.3. That is
what we estimate the number of dollars in claims that we have
received. That goes with the $2,500,000,000--or $2,000,000,000
to $2,500,000,000 in existing claims that we are processing as
well.
We had to call out these deadlines because we didn't want
people to think that they were going to be able to get
reimbursed anymore from the money that was in the Provider
Relief Fund. The Provider Relief Fund has been a tremendous
asset to so many, for the doctors, hospitals, community health
centers throughout the country. We don't think this is a time
to stop when we are getting real control over COVID.
The therapeutics, the President had us do something very
important. He had us buy in advance. And so we not only made
the commitment up front, but we were first in line because we
made the commitment up front. We can no longer do that because
we don't have the monies to make those commitments up front to
the therapeutics that we know work, that actually if you do get
COVID, you can be saved. You could be possibly spared going to
the hospital.
But those therapeutics, whether it is the antivirals or the
monoclonal antibody therapies, we need to make sure we are
purchasing and we don't have to get in the back of the line to
purchase in the future. That money to do that is running out.
We get to boosters. As we heard CDC and FDA announce, we
can do some of the boosting right now, but right now, we are
talking about those 50 years of age and older. It is going to
be tough to continue this without the resources. We hope
Congress will work with us to make sure we have them.
The Chair. Just a comment on, first of all, with regard to
CDC, their ability for surveillance and early detection. The
impact on CDC of what we are talking here about, you know, not
committing to more resources.
Secretary Becerra. Yes, well, CDC--by the way, I want to
make sure we are clear on something in terms of the President's
budget. The President's budget was essentially shaped before we
knew if you would pass the omnibus.
The Chair. Yes.
Secretary Becerra. We were having to base our projections
for 2023 on what we knew of the CR, which was funding far lower
than the omnibus that finally passed. And so when you see the
funding for CDC, it was based on where we thought we could go
from the CR funding level. Because the omnibus had funding
levels vastly better than the CR, we are certainly going to
work with you all to make sure the CDC is appropriately treated
when it comes to 2023.
But CDC has been the closest partner to our State and local
governments when it has come to addressing COVID. And if they
don't have the dollars to go out there and do the surveillance,
to go out there and communicate to communities what we are
seeing, where we see the next wave coming, it makes it very
difficult for anyone back home to get ready.
The Chair. Let me just--I am glad that the President's
budget talks about preparedness for the next pandemic, and he
has got new mandatory proposed--that is the $82,000,000,000
over 5 years. I continue to believe that we underutilize the
Defense Production Act, and that we should use the DPA to
increase global vaccine supply in the pandemic worldwide.
And I would note that only 11.5 percent of individuals in
low-income countries have been fully vaccinated, and that has
to--comment on how, in fact, that does hurt us. And under your
pandemic preparedness plans, how will the administration invoke
the Defense Production Act? How can this be used more
aggressively?
Secretary Becerra. Madam Chair, we have used every tool in
that toolbox to secure our supply chains, to ensure domestic
manufacturing. The fact that this country was able to produce a
vaccine in less than a year is proof of that. The fact that we
have been able to disperse it to hundreds of millions of
Americans to date, the fact that we have been the leader when
it comes to making sure people around the world have access to
the vaccine, especially in countries that are further behind
the process, is a testament to the work that we have done using
the tools we have.
We have engaged in, oh, couple of dozen DPA or DPA-style
actions over the course of the past year, whether, as I
mentioned, the acceleration of COVID-19 vaccination process,
whether it is getting new tests out. Remember when the
President took office, there were no at-home tests that were
available to Americans. Today, we have several that are out
there, and the President made millions of them available for
free to Americans to get tested.
We will continue to do that, working with you as best we
can.
The Chair. Thank you. I am going to ask the indulgence of
my colleagues. I want to just finish this up, if I can? I am
just going to say instead of asking a question about this, I
think that there are serious consequences if we cut off support
for low-income countries. I believe that that is going to hurt
us at home if we cannot stop COVID across the world.
And one final comment to ask you about, Mr. Secretary,
because we have put serious money into modernizing our public
health data systems and to support the public health workforce.
How does the budget request reflect the lessons that we have
been taught about the importance of public health? How does it
build on public health investments that we made in the omnibus?
Secretary Becerra. I will thank all of you here because you
made it possible for us to go to Americans rather than wait
until Americans came to us to figure out how to attack COVID.
We want to continue to do that, working closely with our
partners locally and with our State governments.
But we need to be able to have the resources to provide
them something, whether it is the data--and by the way, on the
data, as much as we need money, we also need authority. There
are some States that do a great job of providing this data on
where they stand.
The Chair. That is interesting.
Secretary Becerra. Some States don't. And it is tough when
you have got these gaps. The more authority we have to collect
this vital information, the better off every American will be
in every State.
The Chair. The authority thing is interesting, and I thank
you again, and I apologize to my colleagues for going over.
And with that, Mr. Ranking Member, the floor is yours.
Mr. Cole. Madam Chair, you are the chair. You never have to
apologize. You take the time you want.
Just quickly, and I want to make a quick point and then
get--I am going to talk mostly about--or ask questions mostly
about ARPA-H.
But remember on this COVID thing, honestly, our problem is
a lot of stuff in the American Rescue Plan didn't have much to
do with COVID. And we see that, at least from our side of the
aisle, as the number-one difficulty. There is a lot of money
out there that can be redirected here, and that ought to be one
of the options in front of Congress.
But I certainly agree with you, Mr. Secretary. You need to
have it sooner rather than later, and when we have the progress
we have had, we need to keep the pedal on the metal, so to
speak, and keep it up. I don't want to get behind the eight
ball here. But I also don't want to just say it is okay to send
money out willy-nilly to States that is supposed to be for
COVID, and it is not being used that way in many areas.
Let me ask you about ARPA, and some of these questions, to
be fair to you, you may not able to ask right now--or answer
right now, and that is okay. I just want to lay these out and
get some sense of what your initial thinking is and maybe where
we are headed.
Give you an example. I am just going to fire off about
three or four things here very quickly. Some of the things that
would come to my mind would be, literally, where is the agency
staff going to be physically located? What is the timeline for
coming--who is the Director going to be?
How will the researchers be recruited for ARPA-H? I know we
don't want to cannibalize one agency for another. How do you
envision the grants being made?
All this is a problem, and I do not blame this on you or
anybody else. But the authorizing committees didn't do their
work. Now this was the President's top priority. I agree with
him on this. But normally, that would be--other committees
would have wrestled with that. But if we are going to continue
to fund this, we are going to have to wrestle with this.
And it is particularly going to be a challenge, given the
amount of additional resources you have asked for. I just tell
you up front from my standpoint, I am not prepared to do that,
even though I am for the agency, when I have no earthly idea
who the Director is, where it is going to be located, how it is
going to give out the grants, what it is going to do.
I know what the NIH does in all those things, and I am
certainly not going to do it at the expense of literally
lowering the National Cancer Institute's budget, things like
that. So just I don't disagree with the kind of spending you
are talking about, but I do disagree with the division of labor
between NIH and ARPA-H, which seems to me like it is going to
have its hands full just getting up and running in the
remainder of the fiscal year.
So yield that back to you, Mr. Secretary.
Secretary Becerra. Congressman, you have essentially asked
the questions that we are trying to formulate answers to
ourselves. But I will tell you that we have gone pretty far
along. In announcing that we will have a Director that is under
my supervision versus NIH's Director, what we are hoping to do
is show that there will be autonomy.
At the same time, because we want it, as you have just
said, to be able to get up and running, we don't them to worry
about who is going to run HR, human resources, instead of who
is going to come up with the next innovation, we wanted to be
able to pull on those assets, that infrastructure that is
already in place.
That is where NIH comes in handy. They don't have to do the
administrative work. They don't have to do the human relations,
the payroll work, the general counsel work by standing up all
those different aspects of a new department or a new agency.
What we are going to do is house it at NIH, but actually,
physically, we are looking not to house it within NIH's own
structures. We are going to have them separate. It is going to
be a very lean and nimble team. It will be far smaller than
these agencies or the institutes you are accustomed to.
There will be program managers and including the Director
him or herself will likely not be in the job for more than just
a number of years, 3 to 5 years, because we want to make sure
that everyone knows there is a clock on what you are doing.
Unlike NIH, which does that basic research which could take a
long, long time and who knows when it will be actually
serviceable, what we are hoping out of ARPA is that these are
ideas that we could harness right away.
Again, very similar to what the Department of Defense did
with DARPA, where the Internet that we know today came out of
DARPA, those kinds of things. That is what we want our ARPA to
do. But we need to make sure it is not anchored or tethered to
doing things an older way.
The program managers that will be hired will know they are
on a short timeframe to get their work done, and then they move
on. And we are going to really have to lean on the private
sector to be partners in this because it is going to be a lean
team that really reaches out to folks who are out there doing
it right now, and we are going to do it with some support that
you all give us.
Mr. Cole. Well, I don't have much time left, but I would
ask that you keep us apprised as you make these decisions. I
think we all have a tremendous interest in this and want it to
succeed but look at it with a little bit of skepticism until we
see the structure and actually experience some success.
So, again, we communicate well back and forth. You have
made a priority of that. I appreciate that. I would ask you to
keep doing that and, as decisions are made, keep us informed.
And hopefully, Madam Chair, we will get to revisit this issue
in later hearings.
With that, Madam Chair, I yield back.
The Chair. Thank you very much.
Congresswoman Roybal-Allard.
Ms. Roybal-Allard. Secretary Becerra, thank you so much for
being with us today.
For the nearly three decades I have been in Congress, one
of my greatest frustrations has been the absence of a Federal
commitment to improve childbirth outcomes. As the husband of an
OB/GYN physician, I am sure you are aware that the U.S. spends
more per capita on childbirth than any industrialized nation,
with costs estimated to be over $50,000,000,000.
Yet in spite of this investment, we have some of the worst
maternal and infant outcomes in the developed world, including
unacceptably high rates of maternal mortality and morbidity,
infant mortality, stillbirths, pre-term births, and cesarean
deliveries. To address these critical issues, in 2015
Congresswoman Jamie Herrera Beutler and I formed the
Congressional Caucus on Maternity Care. We, together with
professional organizations and community activists, have worked
hard to highlight the challenges of America's maternity care
system and the need to make safe and effective maternity care a
national priority for all women and babies.
I extend to you a huge thank you for the $25,000,000 in
your HRSA budget to expand and diversify the midwifery
workforce. This Title VIII funding line closely mirrors one of
the two provisions in the Midwives for Moms bill that I co-lead
with Congresswomen Herrera Beutler, Katherine Clark, and Ashley
Hinson.
We all strongly believe midwives are a critical part of the
solution to improving maternity outcomes, lowering costs, and
addressing the maternity provider shortage. So I look forward
to working with you to ensure that the final Labor, HHS bill
will include this funding.
Mr. Secretary, as you know, the fiscal year 2022 omnibus
agreement includes $1,000,000 for the Office on Women's Health
to convene an Interagency Coordinating Committee on the
Promotion of Optimal Birth Outcomes. This coordinating
committee is intended to institutionalize the oversight and
coordination of Federal efforts to improve maternal and infant
health in America.
We believe this is the next logical step to build on recent
Federal efforts such as the 2020 Surgeon General's Call to
Action to Improve Maternal Health and the 2021 HHS Maternal
Health Call to Action Summit.
Mr. Secretary, when do you think the initial meeting of
this committee will take place, and will you work with
Congresswoman Herrera Beutler and me to ensure the composition
of this committee reflects the wide range of maternity care
programs, issues, initiatives across the Federal Government?
Secretary Becerra. Congresswoman, first, it is great to see
you, and thank you for your deep interest in this area. As you
mentioned, for me, it is also very important.
I would tell you that probably over the coming few weeks,
we probably can get back to you on how quickly we will actually
launch, with whom. We are right now trying to make sure that we
have put all the correct experts on this committee. It is
something that goes across many of the different agencies
within HHS. So we want to make sure that we get those who are
absolutely interested and committed to this and are the experts
to be part of this.
But we are more than committed to work with you and
Congresswoman Herrera Beutler in making sure that we address
not just the outcomes issue that we face in America for women,
but also the fact that we are now trying to take it to the next
level.
Ms. Roybal-Allard. Great. Thank you.
And how will the Office of Women's Health-led coordinating
committee engage all of the relevant agencies to stay focused
on concrete policies and actions to address the crises and
challenges in the maternity care system, and how will you
ensure this is an HHS priority?
Secretary Becerra. By having the interagency committee, we
are guaranteeing that we will have reports on a constant basis
from all these experts from our different agencies within HHS.
So we will make sure--and I will be participating as well.
As you know, the President has made maternal health a major
priority within his budget and his activities because we
understand that everyone should have a chance to start on the
right track, and making sure that both mother and baby have
that opportunity is critical. And we are going to make major
investments not just in this area, and by the way, midwifery is
critical. The doula legislation that we have seen come out of
Congress as well, all of us understand in a lot of our
communities, the promotoras are extremely important to help a
lot of families navigate the healthcare system.
We are going to make that a priority, and I personally will
make that a priority.
Ms. Roybal-Allard. And Mr. Secretary, in order to
specifically address our Nation's maternal mortality crisis,
the fiscal year 2022 omnibus also provided increased funding
for the CDC's perinatal quality collaboratives that would allow
for their expansion in all 50 States and territories. How can
PQCs be empowered to address the avoidable harms of cesarean
rates that have remained appallingly high at about one birthing
person in three for more than a decade, despite professional
guidance that this is too high?
Secretary Becerra. Congresswoman, I know the time has
expired. So I will be quick and simply say we are going to do
our part.
We have, for example, put out a proposal under Medicaid
that would allow a woman who is about to deliver have
postpartum care after delivery not just for 2 months under
Medicaid, but for a full year. Now all we need to do is get the
States to buy into that. About five States have, but we want to
see every State go there, and the President would like to see
that become a permanent program within Medicaid, where every
woman who delivers a baby under Medicaid would have up to 12
months postpartum care.
Ms. Roybal-Allard. Thank you, Mr. Secretary, and I look
forward to continuing to work with you.
Secretary Becerra. Thank you.
The Chair. Congressman Harris.
Mr. Harris. Thank you.
And thank you, Mr. Secretary, for being here. And it is
great to be back in person.
Secretary Becerra. Yes.
Mr. Harris. I think that is important for these hearings.
First of all, just a few comments. I am glad to see the
Strategic National Stockpile funding, asked for $270,000,000
additional above this year enacted. As I have said for many
years, we have plenty of kinetic stockpiles, we better have
stockpiles for some of the other threats we face, especially
given what we know about the threats of biological and chemical
weapons being used.
Second, I want to echo the ranking member's comments about
the riders that were left out of the--left out of the
President's budget. That is just completely unrealistic. These
budgets will not pass--these appropriations bills will not pass
through both chambers without those riders in place, and that
is just a reality check.
Third, I also want to comment on the ARPA-H. I have some
concern because tethering it to the NIH administratively
tethers it to the NIH academically and cerebrally. If we wanted
to increase the transitional research done at the NIH, we would
do that. ARPA-H is supposed to be a different concept, and I
think tethering it to an existing agency might muddy that
concept.
The last, my remaining time, I want to take up two issues
where the Department I think pretty clearly is not following
either the law or congressional intent. First one is the
surprise billing issue. This is something that I think before
the rule came out the beginning of the year, we had some
discussions with the Department.
We were assured that all stakeholders were taken into
account, and then it appears that really only insurance
companies were taken into account. That the rule that came out,
found illegal by a Federal court, clearly showed the
congressional intent was not the rules that came out of the
agency. So I hope that you are committed on the second go-
around to actually doing what Congress intended, which is not
to have the QPA as the basis of the arbitration, which is to
carefully define QPA not to allow insurance companies to define
in such ways that will further drive down the number of
providers.
And I will tell you in a rural area, it is hard enough to
find providers. You drive down reasonable compensation by the
surprise billing rules, you will find great difficulty in
finding those professionals to practice in those rural areas.
I want to spend the last half of my time talking about an
issue that we have spoken about before because the last time
you were in front of the subcommittee, I think we talked about
the Conscience and Religious Freedom Division of your agency
and whether or not you were going to commit the Department to
protecting conscience.
Sad to say, despite your assurances to both House and
Senate, in House and Senate testimony, it is clear that is just
not true. That urging the Department of Justice to dismiss the
case against the University of Vermont shows the Department is
not serious in protecting conscience. It is not serious in
following the law.
The Church Amendment is the law of the land. The purpose of
the executive branch is to execute the law of the land. This
was an egregious violation of 10 nurses' conscience rights in
being forced to perform abortions in clear contradiction of the
law established by Congress, and the Department decided to drop
the case--to urge the Department of Justice to drop the case.
And with a commitment that I think that--and I will quote
directly from your letter in reply, ``to continue to evaluate
the underlying complaint.'' So, in about 20 seconds, can you
tell me how the Department is continuing to evaluate the
underlying University of Vermont complaint?
Secretary Becerra. I will do best I can.
Mr. Harris. Well, then I will have to do it as a QFR
because what I want to say is that in response to that, I filed
the conscience and religious--the Conscience Protection Act,
obviously supported by the U.S. Catholic Conference of Bishops
because we think religious and conscience protection is a very
important issue.
I am just going to ask you, is the Conscience and Religious
Freedom Division funded in this year's budget request?
Secretary Becerra. Every aspect of the Civil Rights
Enforcement Section will be funded.
Mr. Harris. Okay. So it is--so you are asking for funds,
and then you are just using those funds to urge the Department
of Justice to dismiss a blatant violation of the Church
Amendment. Now I want to just reflect that 75 percent of
Americans believe that healthcare providers should not be
legally required to perform abortions.
And I will tell you, in an age--I am worried not only about
abortions, but in an age where a Supreme Court Justice
potentially doesn't know the definition of the word ``woman''
and healthcare providers are going to be asked to perform
gender mutilation surgery because some people's religious--
according to some people's conscience, that is what it is. And
by the way, if you have any question about what a woman is, I
know you are not a biologist either, give me a call. I will
tell you. It is not that complicated.
I am greatly concerned about conscience protection, and I
question why we are funding a Conscience and Religious Freedom
Division in a department that is willing to use that against
the conscience protection of Americans as the University of
Vermont lawsuit, dropping that lawsuit showed.
I yield back.
The Chair. Ms. Lee.
Ms. Lee. Good morning, Mr. Secretary. I would like to
respond to Dr. Harris, but I won't.
I am glad to see you. Thank you, Congresswoman Frankel.
First of all, thank you for your tremendous leadership, and
thank you for ensuring that health equity is an important
cornerstone in all of our HHS efforts.
With the support of our chairwoman, Congresswoman Pressley,
Senator Warren, in the fiscal year 2022 omnibus, we included
language directing HHS to submit a report that involves the
detailed plan and proposal for the development of a National
Center on Antiracism and Health Equity within the Department.
And so following up on that, I would like to know the steps
that your agency will be taking to comply with this requirement
for its development.
And secondly, just with regard to HIV and AIDS, I am really
encouraged to see that the President's budget requested
$377,000,000 increase for Ending the HIV Epidemic Initiative
and $9,800,000,000 over the next 10 years for a PrEP delivery
program to End the HIV Epidemic in the United States. So just
wanted to know how you envisioned this program being
implemented?
Next, the announcement of the new HHS Task Force on
Reproductive Health, the announcement, how will that be
implemented? What steps are being taken?
And finally, just on poverty. Congresswoman--Chairwoman
Lucille Roybal-Allard and myself, we put into the fiscal year
2022 approps bill directing the Secretary, yourself, to convene
an interagency coordinating council on both child poverty and
comprehensive supports. So I would like to know, in terms of
your views, on the development of the implementation of this
congressional directive with regard to children and the
interagency council.
Secretary Becerra. Congresswoman, great to see you, and
thank you for all the work that you have been doing.
Let me try to give you a bit of an answer, and please probe
if you would like to on any of those subjects.
First, the national center, for us that is a priority
because we know that bad health outcomes often occur not
because of just your health, but because of the social
determinants around you. And so we intend to move on that as
quickly as we can. We will keep you apprised.
We have a team that is working on that, but that was one
that you had us at hello in trying to do that one.
On--if you could tick off so I----
Ms. Lee. HIV and AIDS in terms of the HHS implementing the
program to end the AIDS epidemic by 2030.
Secretary Becerra. I think you would agree we are that
close to actually finding a cure, not just keeping people a
live, but actually finding a cure on AIDS, HIV. And we should
go the rest of the way.
And so you see the President's commitment to try to get us
the rest of the way. We intend to try to fully implement that.
We have teams at HHS that have been researching this, that have
been implementing, that have been guiding America for a long
time. They are anxious to be able to get the resources to let
that happen.
Ms. Lee. Great, great. I have a few more questions--I may
get them to you in writing--under this issue. But on the next
two questions, in terms of the announcement of the HHS Task
Force on Reproductive Healthcare, which was announced, how that
is going and being implemented?
And finally, the children's interagency council, as relates
to poverty and comprehensive supports.
Secretary Becerra. Again, that council, we are in the
process of setting that up as well. We know we have a lot of
work to do because we see how throughout the country,
reproductive healthcare rights of women are being not only
enjoined, but probably undermined. And so we want to make sure
that we are out there trying to make sure that we are
protecting their rights under the law and making sure that
their health is maintained.
And so we will aggressively move on that. We will work with
those who are interested, including those in Congress. But we
do intend to move on that one as quickly as we can.
Ms. Lee. Okay, thank you.
And the final question I had was the implementation of the
children's interagency council that Congresswoman Lucille
Roybal-Allard and myself are working on?
Secretary Becerra. The same there. We were given that
charge recently, and so we are moving forward to try to make
sure that we put in place the infrastructure to make it happen.
Again, I think this is one of those where we have, whether
it is at the Administration for Children and Families or any of
our other agencies, HRSA and all those who would have a role in
that, we are anxious to get going. We will keep you apprised
and see who is interested in working with us on that.
Ms. Lee. Great. One more follow-up, I have a minute and 20
seconds left.
Going back to HIV and AIDS. Okay, the PrEP program, in
terms of providing PrEP medication at no cost to people who
really need PrEP and don't have the resources, and wanted to
find out how does coverage of PrEP and no cost under Medicaid
fit into the administration's overall goal for PrEP?
Secretary Becerra. So I know that--well, what I can tell
you right now is that we are doing everything we can to do bulk
purchases because we know for a lot of folks it is
unaffordable. If we do bulk purchases, we can get those
treatments for far less cost. We can then make it more
available to more Americans.
We also are trying to make sure we focus on those who are
usually left behind when it comes to these types of therapies
and treatments, and we are making sure that we reach to them. I
would have to get back to you on how we would handle this
within Medicaid because you know that is not a simple process
of just turning the switch.
Ms. Lee. Okay. Look forward to hearing from you.
Okay. And finally, let me just associate myself with what
the chairwoman mentioned and said with regard to our global
COVID efforts and, in fact, remind everyone that we have got to
have the resources for the global COVID response. There are new
variants on the rise, and I just want to remind everyone that
this is a very small planet. What affects one affects all. It
is in our own interests to fund both domestic and global
immediately.
Thank you again.
Secretary Becerra. We concur.
The Chair. Mr. Fleischmann.
Mr. Fleischmann. Thank you, Madam Chair.
Mr. Secretary, good to see you this morning, sir.
Secretary Becerra. Good to see you.
Mr. Fleischmann. Mr. Secretary, I have a couple of very
important questions. So, in all respect, I am going to ask for
the most brief response in light of the time.
One of the things that concerns me the most is the
administration has announced plans to lift Title 42 within the
next 2 months. That greatly concerns me, not only in my role as
the ranking member on Homeland Appropriations, but this is
going to allow tens of thousands of illegal crossings daily on
our Southern border.
Do you support the change in this policy, and are you
concerned with the strain it will place on our healthcare
system and local hospitals, which are still struggling amid the
recovery of the COVID-19 pandemic, sir?
Secretary Becerra. Congressman, appreciate the question.
Let me try to get right to it.
A lot of folks probably don't know what Title 42 is, but it
is a law that allows us, based on public health conditions, to
impose certain conditions within the country, one of those
being at the border. Title 42 is based on healthcare
conditions, and we use Title 42 to make sure we are protecting
Americans within our country, within our borders.
Title 42 will remain in place so long as the folks at the
CDC and others, the scientists give us the facts and the
science to show that in order to protect public health, we can
and will use Title 42 to protect Americans. And so what I can
tell you is that we constantly do an analysis of where we are.
We will make a determination at some point as to whether or not
Title 42 should remain in place.
Mr. Fleischmann. Okay. So, in addition to the national
security concerns that I would have in regard to that and the
border crossings, you would understand the implications this
would have for the burden on the current healthcare system?
Secretary Becerra. I recognize everything you have said.
You just have to remember Title 42 is based on healthcare.
Mr. Fleischmann. Yes, sir. Okay. Thank you, sir.
Medicare wage index. Over the past decade, well over 100
hospitals have closed, and over the past 2 years, COVID-19 has
made healthcare access in this crisis significantly worse. It
is no coincidence that most of these hospitals have occurred in
areas with the lowest Medicare wage index rates.
Now I know you have inherited this, the administration has,
from administrations past. It is a big problem in my State of
Tennessee. Do you support, sir, a permanent legislative
solution to address the problems in the Medicare area wage
system and prevent future hospital closures, sir?
Secretary Becerra. Big question, Congressman, but I
absolutely understand the gist of it. What I will tell you--and
I will try to be brief because I know you probably have other
questions. We need to tackle this because we have seen so many
of our healthcare workforce leave, and we need to make sure
that they are in place not just for COVID and any pandemic, but
we have to make sure we have a healthcare system that doesn't
have gaps.
And so I will tell you that whether it is Medicare,
Medicaid, whether it is CHIP, whether it is the Affordable Care
Act, we have to make sure that we are promoting Americans going
into our public health workforce.
Mr. Fleischmann. So then the answer was--my question is do
you support a permanent legislative solution to this?
Secretary Becerra. Show me the legislative solution, and I
will tell you if I support it.
Mr. Fleischmann. Fair enough. Since national minimums for
reimbursement formulas seem to be working for the Medicaid
program and the Children's Health Insurance Program, do you
agree, sir, that a national minimum for the Medicare wage index
system is needed?
Secretary Becerra. Again, you point to a very important
program in Medicaid. The devil is in the detail, Congressman. I
would love to work with you on this, but the devil is in the
detail. We have to make it work not just for us, not just for
patients, but for taxpayers.
Mr. Fleischmann. Yes, sir. And for the record, so that you
know, particularly in my home State of Tennessee, the
insufficient--respectfully, insufficient reimbursements in this
are causing undue pressure, particularly on rural hospitals at
a time when they are really struggling. We have seen many
closures. So in that regard, I would ask that you and the
administration work with us to cure this.
Again, this was a patchwork system from the inception,
created years and years ago. It was politicized. And if you
will, it awards or rewards inefficiencies many times to raise
these indexes in other areas of the country, where fiscal
restraints and good policies tend to get punished for their
fiscal responsibility. And that is what we see in our State,
sir.
Secretary Becerra. Congressman, what you have said I have
heard before.
Mr. Fleischmann. Yes, sir. Thank you.
Madam Chair, I yield back.
Secretary Becerra. Thank you.
The Chair. Mr. Pocan.
Mr. Pocan. Thank you very much, Madam Chair and Ranking
Member Cole. Appreciate it.
And Secretary, thank you so much for being here.
Just this month, we celebrated the 12th anniversary of the
Affordable Care Act, and I just wanted to quickly congratulate
you on that anniversary because I know you were an instrumental
part of those bills, making sure that got signed into law, and
even as the California attorney general in defending those
laws.
A key piece of the Affordable Care Act was its protections
from discrimination for the LGBTQ+ community seeking
healthcare. Can you talk a little bit about how your team at
HHS is continuing to build on these protections and further
expanding care for this community?
And a related question, if I can? As you know, across the
country, many States are passing laws that harm youth,
especially transgender youth. I want to thank you for your
commitment to these kids and ensuring that they receive the
healthcare they need. What kind of outreach and support is HHS
providing to stakeholders in States where these attacks on
LGBTQ+ youth are taking place?
Secretary Becerra. Congressman, appreciate the question,
and it sort of goes to the question that Congressman Harris
asked earlier. I believe you are referencing Section 1557 of
the Affordable Care Act law, where it provides for protections
for Americans against any type of discrimination in the
healthcare setting.
We are going to do everything we can to make sure we are
protecting people's rights that they have under law, under the
Constitution. Whether it is the right of an LGBTQ person or
whether it is someone who is claiming that there has been a
violation of their religious freedom, we will do everything we
can within our Office of Civil Rights to protect those rights
of Americans.
We know that there are a number of individuals and families
that are under attack these days on an LGBTQ basis. We are out
there trying to inform people of their rights. We are trying to
make sure providers know of their legal obligations, and we are
ready to step in. If someone comes forward with a legitimate
complaint demonstrating facts of violation of the law, we will
jump on it.
Mr. Pocan. Great. No, I appreciate that. Thank you.
Also one thing I think that has really been highlighted
through COVID is our Nation's mental health. In one area
specifically, there was a congressional initiative around the
National Suicide Designation Act, which is going to designate a
988 number, emergency number, to be rolled out this summer.
Can you talk a little bit how your agency is looking at
educating the public on that and how this budget will provide
funding to have a broad campaign so the public can understand
this? And again, a related question. In my State of Wisconsin,
I think 89 percent of the calls are going from local crisis
centers, about 11 percent get routed to the national, just how
that support and the importance of those local crisis centers
fits into this?
Secretary Becerra. So, Congressman, as you are probably
aware, suicide is the leading cause of death of young Americans
and young adults in this country. We are in a crisis. COVID
exposed just how much mental stress so many of our families are
going through.
I believe half of American parents report that their
children are thinking of suicide. It is a crisis, and
fortunately, the President has not only decided that it is a
priority, but he is putting money behind it as well in his
budget. We have invested over $300,000,000 in trying to help
States help us patch together what is the existing set of
suicide prevention centers that are available throughout the
country.
We finally--through your good work in Congress, we now have
the ability to talk about suicide prevention by something akin
to what we think of in terms of an emergency response. Everyone
knows 911. If you are in an emergency, you call 911. Well, if
you are facing a mental health emergency, now you will get to
call 988.
And if you call 988, we want to make sure you have got not
just a supportive hand, but a professional hand ready to assist
you. And so what we are doing is we are working with States
throughout the country to make sure everyone is ready. This
will not be a national, Federal Government-run hotline. It will
be brought together by the Federal Government with the
President's support for this.
And what we are hoping to do is make sure that if you call
988, you don't find a busy signal or you don't get put on hold.
That you will actually get assistance. Because if you are
reaching out at a time when you could have gone the other
direction and just said I am just going to end this thing, we
want to make sure that when you reach out, we are there.
Mr. Pocan. A very important initiative. I don't think in 16
seconds I can ask another question fairly. So I will submit
those.
Madam Chair, I yield back.
Thank you, Mr. Secretary.
Secretary Becerra. Thank you.
The Chair. Thank you. Ms. Herrera Beutler.
Ms. Herrera Beutler. Thank you, Mr. Secretary, for being
here.
And I wanted to bring up just a quick follow-up on my
colleague's question about Title 42 and rescinding that
authority. And you made the point that it is a health-related
decision. And I agree with you, which is one of the reasons I
would ask you to help us get the administration to reconsider.
You could do a quick Google search of just drugs flowing in
from Mexico. And fentanyl, which is a huge problem in
Washington State and across this country, certainly on the west
coast. Every major newspaper has stories on how this drug,
which, as you know, is killing people, and methamphetamine are
flowing over that border.
And we can almost tell. I have met with my local law
enforcement in the middle--I am I-5, Canada to Mexico. You know
I-5. They can tell within a week of a surge, drug prices for
fentanyl drop to $3 a pill, and we see increases in overdose
deaths and hospitalizations.
So I would argue that it is, in fact, a health crisis as
well, which would give you the reason to use that Title 42
authority to gain some more control over the border. So I just
wanted to put that in your wheelhouse.
And let me start by saying Congresswoman Lucille Roybal-
Allard made several really good points about our efforts on
infant care and maternity care. And you know that the numbers
for the developed world, the U.S. is not where we should be on
both of these fronts. So I do want to say I am very grateful
that you are working to implement an extension of Medicaid for
women during that first year of life.
We know that most of the mortality incidents that happen
happen within that first--happen within that first year, not
within the first couple of weeks or 6 weeks of giving birth,
but it is most of them happen after that. So making sure that
that Medicaid coverage extends to that first year of life for
the baby and the mother to treat that is incredibly important.
We have legislation to that effect, but I am glad to see that
the administration is moving forward with that.
On the fiscal year 2022 omnibus package, Lucille and I were
able to secure $750,000 for the first-ever Stillbirth Task
Force at HHS. More than 22,000 babies are stillborn every year
in the United States, one of the worst stillbirth rates in the
developed world.
Where is HHS in the process of setting up that task force,
and how can we utilize existing programs like the Safe
Motherhood Initiative to optimize the work of this task force?
Secretary Becerra. Congresswoman, first, thank you for all
the work that you and Congresswoman Roybal-Allard have been
doing on these subjects. Small investment, big change. And I
would--we are going to work with you on that. Thank you for
making it possible. We are going to get to work as quickly as
we can on some of these things.
I can't tell you how many stories my wife has told me about
stillbirths, as an OB/GYN. That is as devastating as it gets.
And so we will do everything we can. We will include you. We
are going to try to make sure everyone understands that we have
an opportunity now to really shine a light on this and focus a
bit more.
Ms. Herrera Beutler. Great. Thank you.
Switching a little bit to telehealth. One of the silver
linings, I think, if there is that, of the pandemic was that we
recognized that we can do telehealth and do it well.
The biggest challenge--and for those of us in more rural
areas, it has been a godsend. The biggest challenge I have
heard is it has been great that CMS, there were waivers in
place to pay for it. Will those be extended?
And I know that there is a little bit not totally within
your purview, but I would like to hear you for a moment just
share what your intentions are with regard to trying to help us
make that more permanent?
Secretary Becerra. Well, first, I have to thank you all for
giving us the extension of another 5 months of the authorities
on telehealth under this public health emergency. We need more
help because we only have certain authorities to continue some
of the telehealth activities that we have engaged with.
And we are hearing from all sorts of providers and families
about what happens if they can't use telehealth. So we are
going to do what we can. We are going to stretch our
authorities as much as we can under law, but we do need
Congress to help because the statutes constrain how much we can
use telehealth. So please help us with that. Thank you for the
5-month extension.
Ms. Herrera Beutler. In my area, switching to workforce
shortages, and very quickly, obviously, we don't have enough of
anything, right? We don't have enough RNs. We don't have what
we need. Again, this is another piece where telehealth can
help.
But your budget proposes a $2,100,000,000 increase in the
HRSA workforce program. How can we ensure that we are focusing
on the entire workforce pipeline? And how can we do this in the
most expeditious manner possible?
Secretary Becerra. We have explicitly, specifically
targeted rural health as well as some of the underserved areas.
A quick example is on telehealth, you could have someone who
wants to do telehealth as a provider, as a doctor, but if you
don't have good broadband, there is a really strong chance you
are still not going to be able to take advantage of that.
So the investments in broadband that now have been made
available, the fact that we are trying to figure out how we
allow that service to cross State lines as well because there
are different standards in different States for those medical
professionals. Not to let the old way of doing business get in
the way. We are going to try to do all of that, but that is
where we will need your help to give us the authorities to go
beyond what we have done before.
Ms. Herrera Beutler. Thank you. I yield back, Madam Chair.
The Chair. Congresswoman Clark.
Ms. Clark. Thank you, Chairwoman.
And it is so wonderful to be with you, Secretary Becerra.
And I want to thank you for this budget that puts the American
family first and is concerned about their health and their
security, and it is a great piece of work.
Specifically, I want to ask you about child care. We know
we are not going to have an economic recovery. We are certainly
not going to have one that includes women unless we make
investments in child care, and I am grateful for this
administration's help with the American Rescue Plan, the
$40,000,000,000 we were able to secure to stabilize child care.
And we know we have to go further, and this budget does that.
But I specifically want to ask you about the workforce
issues. Child care providers are overwhelmingly women and women
of color. They make an average of $12 an hour caring for our
children, leaving too many of them in a position they can't
care for their own. And they have lost one out of nine jobs in
this sector.
So, specifically, how is this budget investing in that
workforce? Are there other things Congress can do to help
prioritize?
And in addition, just yesterday, I was with a healthcare
leader from my district who was telling me about how linked in
his hospital the nursing shortage and the shortage of child
care is. And I specifically want to know if the $324,000,000
for the Health Workforce Programs address the caregiving needs
of our healthcare professionals?
Secretary Becerra. Well, Congresswoman, first here I have
to thank those of you who supported the American Rescue Plan
because it made available to us billions of dollars to help a
lot of those child care workforce participants, but also the
families. We know that if we are able to get the child care
proposals in the Build Back Better agenda, that we would have
the ability to actually meaningfully tackle this, not just try
to put a band-aid over it.
It is tremendously important for the tens of millions of
families who need child care. We saw women lose jobs in numbers
never seen before because of COVID and the need to be home to
care for kids, not being able to have a child go to school.
And so I don't think there is any question that we have to
make major investments in child care, Head Start. The proposals
that have been put forward would help us go there. The
President's budget makes additional investments into child
care, but to really take this where we have got to go to the
next plateau, we hope that Congress is able to get across the
finish line in the child care proposal that is in the
President's Build Back Better agenda.
Ms. Clark. Thank you.
Next, I am also grateful for your leadership in releasing
through the ARP and the fiscal year 2021 omnibus LIHEAP
increases, a lifeline for families in Massachusetts and across
this country. But we know that due to Putin's war, the
pandemic, corporate greed, prices are still going to continue
to soar and be out of reach for way too many families.
There is an increase of $175,000,000, and I just want to
know how you are preparing for increased volatility in this
line-item, and are you working with Department of Energy to
anticipate to the best you can?
Secretary Becerra. We are hoping to work not just with the
Department of Energy, but with the Department of Education,
with the Housing and Urban Development Department so that we
can coordinate our activities. So that if there is a family in
need, it might be energy--help with energy bills. It might be
help with staying housed and not lose your home. Whatever it
is, we are going to try to make sure that we are working
together to make sure that we are tackling this.
No doubt that the dollars that you provided previously and
the dollars the President is requesting for LIHEAP will take us
a ways. And the more we are able to see success in this effort
to keep the leadership in Russia from this crazy war in Ukraine
will help us. But we are going to meet every need we can with
the dollars that you have given us because we know it could be
the difference between life and death for someone who needs
that heat or someone who has to stay away from the horrid
temperatures in the summer.
Ms. Clark. And briefly at the end of my time here, we know
that overdose deaths have increased by 30 percent, and that not
the area we want equality. Now black deaths of opioid
overdose--due to opioid overdose are exceeding those of white
people. And so I just am urging there is a program that we
helped create and I led on that helps link student loan
repayment to encourage and retain people in substance use
providers.
You have increased that account by $4,000,000. We are very
grateful to your attention to this program, but we also know
that only 8 percent of those 3,000 applicants to this STAR LRP
program last year were able to be funded. So we hope we can
continue to work with you to meet this need so we can get
people the treatment they need and deserve and reduce these
terrible rates of deaths and overdose.
Secretary Becerra. We want to give you wind underneath
those wings to make that happen because getting those
professionals out there is absolutely important.
Ms. Clark. Thank you so much.
Thank you, Madam Chairwoman.
The Chair. Mr. Moolenaar.
Mr. Moolenaar. Thank you, Madam Chair.
Good morning, Mr. Secretary, and thank you for your service
to our country.
One of your--within your statutory authority as Secretary
is not only to declare a public health emergency, but also to
terminate that decision. One of the questions I have is when do
you plan to declare an end to this public health emergency?
What scientific metrics will you use? Is there a specific rate
of transmission? How will you make that decision?
Secretary Becerra. And Congressman, I think there are a
whole bunch of folks waiting to hear this answer. So, great
question.
It will be based on the science and the facts that we are
collecting. And by the way, that goes back to the question
about data, why it is so important to collect accurately so we
make the right decisions. It will be based on the science, on
the conditions we have in the health sector.
There are a number of issues that we could--that are
obviously floating around there, but in terms of the health of
the Nation, where are we, and are we at a point of still an
emergency? We are in the process over the next couple of weeks
of getting ready to review again if we should continue the
public health emergency forward.
We have also made a commitment because we know providers
are counting on us, whether it is on the telehealth issues, to
continue to have authorities to use telehealth or not. A lot of
providers are relying on our extended authorities to do things.
And so we have committed to try to give people at least 60
days' notice if we think we are going to take down that
emergency declaration.
Mr. Moolenaar. Okay.
Secretary Becerra. What I can tell you is in the next
couple of weeks when we review it, we will assess the facts,
science, and make a determination. But we do hope to be able to
give people at least 60-day notice.
Mr. Moolenaar. Okay, thank you.
And then, with respect to the mandate, CMS has a mandate on
vaccines. You had mentioned the workforce issues. Are you aware
that people are leaving as healthcare workers because of this
mandate, and shouldn't we be allowing the medical professionals
to make that decision of how best to protect themselves and
their patients?
Secretary Becerra. I think we always want to work with and
respect what the experts in the medical field are telling us we
should try to do. We do follow the experts that we have at CDC,
NIH, FDA, and what they have told us is that keeping people
safe and especially in a medical setting like a hospital, a
nursing home, requires us to do--use every precaution we can,
whether it is a vaccine, whether it is a mask, whether it is
the social distancing or the sanitary conditions.
And so when it comes to the provisions that we put out
there in some cases requiring folks to use masks, requiring
them to get vaccinated, it is for the protection of the
American people.
Mr. Moolenaar. But are you aware that is actually creating
workforce issues where we are losing healthcare workers, the
people who have been on the frontlines, heroes, who are
deciding to leave rather than submit to this mandate?
Secretary Becerra. Congressman, I have heard some of those
stories. I would simply say if you are one of those heroes, one
of the ways you become a hero is by making sure the people you
are treating are as safe as they can be. And if you are not
vaccinated and by chance you contract it, even if you show no
sign of the illness, you might pass it on to somebody.
Mr. Moolenaar. But that is true even if you are vaccinated.
Correct?
Secretary Becerra. Less likely to happen if you are
vaccinated. Far more likely to happen if you are not.
Mr. Moolenaar. I recognize your commitment to vaccines,
vaccination. One of the concerns that has been raised is about
the level of commitment to therapeutics and making those
available, approving as many safe possible therapeutics. Are
you committed to that?
Secretary Becerra. Absolutely. Can I give you a bit of an
extended answer? Right now, a vaccine likely costs us about $25
to $30 to make available to Americans. Those antivirals, those
alone, those therapeutics probably cost us somewhere between
$500 to $750 to $1,000 a treatment.
Those monoclonal antibodies are costing us in the several
thousand dollars a piece. Thirty dollars versus several hundred
dollars versus several thousand dollars. One might keep an
American from contracting COVID. The others are trying to keep
them from dying from COVID.
We would rather do the--as we say in Spanish, ``mejor
prevenir que remediar.'' Better to prevent than to remediate.
If we spend the $30 to prevent it, rather than pay later, pay
now $30 than pay later hundreds or thousands of dollars per
American, we think it is a smart investment.
But we are going to have the therapeutics available, and
that is why we need some funding from Congress.
Mr. Moolenaar. Just so I know, the President recently
received a booster on television. How often is he going to need
a booster? How often are you going to recommend that to the
American people?
Secretary Becerra. That is up to the scientists and the
medical professionals. But just as we get vaccinated for flu on
a constant basis, what we are finding is that COVID is a--it is
a treacherous animal, and it is hard to control. We will do
what we can to keep Americans safe, and we will make sure that
if we give them a medicine, a vaccine or therapy, it will also
be safe.
Mr. Moolenaar. Thank you.
Secretary Becerra. Thank you.
Mr. Moolenaar. I yield back, Madam Chair.
The Chair. Ms. Frankel.
Ms. Frankel. Thank you, Madam Chair.
First, I want to just thank all my colleagues for the
bipartisan approach in getting this budget done. With that
said, I want to just say this, that compromise does not only
always mean agreement. In my opinion, without any personal
disrespect to any member, the Hyde Amendment is not wise. I
think it is unjust and cruel, and I believe it takes away the
freedom from people to make the most personal decisions that
they can have, and it hurts the people who have the least
amount of resources.
Let me just also just add that no patient should be denied
the care they need, and I appreciate the administration's
position on that.
So let me just add my thanks to your proposed budget. The
funding for--increased funding for Title X, child care--that is
reproductive care--to child care, maternal health, mental
health. And I think it is very important that not only are we
helping people take care of themselves, but we are reducing the
costs for people so they can take care of themselves. And I
would like to just say that I think the best defense for this
country is to have a strong economy and have people live well.
I have a couple of questions. Thanks to the--and thank you
for being here. Thanks to the Affordable Care Act, there is a
contraceptive coverage requirement really allowed millions of
people across the country to really to afford contraception,
but we have been hearing lots of stories that health insurance
companies are not complying with the law.
So, for example, they pick a couple of products that a
consumer can use, a patient can use, and not others. Or they
are actually requiring payment and cost-sharing. I wanted to
know what the Department is doing to ensure that every plan
subject to the ACA's birth control coverage requirement is
complying with the law.
Secretary Becerra. Congresswoman, thank you for the
question.
I have experience with this not only as the Secretary, but
as the former attorney general in California, where we moved to
make sure that women's rights to contraception coverage were
protected. As the Secretary, we have been working jointly with
the Department of Treasury as well as the Department of Labor
to make sure that there is clear guidance to providers on what
they are obligated to do when it comes to providing healthcare
services to Americans.
We will continue to make the case that under the ACA,
individuals, including women, are entitled to certain
protections and services, including contraception coverage. And
if someone points out to us a case where there is a provider
that is violating the law, we are prepared to take action as
well.
Ms. Frankel. Thank you for that.
And this is an issue that I hope Mr. Cole is going to join
me in in vigorously tackling. He is smiling. He knows what I am
going to talk about.
Each year, there are about 36 million falls reported among
older adults, and it is amazing what it costs our health
system. Not only cost to the individuals themselves, just in
terms of their physical, mental health, and their pocketbook,
but it costs us over $38,000,000,000 for Medicaid and Medicare,
and then another $12,000,000 just in private insurance costs or
out-of-pocket costs.
I was astonished in researching this that the Federal
Government only invests a few million--CDC $2,000,000, I think
it is--in fall prevention programs. I want to thank our
chairlady because I know we are going to have a hearing on
this. I was just wondering whether you all are doing any work
to look at this?
Secretary Becerra. So we right now have our National
Institute on Aging, the CDC, which you mentioned, as well as
our Administration for Community Living, those three agencies
within HHS have been working on these issues. We work with the
States and the local health authorities there to figure out how
we can invest in some of these activities.
But Congresswoman, as you know, at the Federal level, we
don't usually try to figure out which program is best and give
the money to that program. We work with the States to let them
decide locally which are their best programs. We try to
support, make investments in those programs, and we have done
some of the research. We try to provide that to the States, and
then, working together, we hope that with the resources that
you made available to us that we make available to them, that
they will make investments in those types of activities.
Ms. Frankel. All right. Well, I look forward to further
discussion on that.
And Madam Chair, I yield back.
The Chair. Mr. Cline.
Mr. Cline. Thank you, Madam Chair.
Thank you, Mr. Secretary, for joining us. It is good to
have you with us. It is good to be in this room in person, and
I am pleased to be a new member of the committee in this room.
But you talked about facts and science guiding your
decisions when it comes to Title 42, for example, which I would
advise we should not repeal. I think it is a policy that is
necessary to protect the public health, and I would urge you to
continue to enforce it.
But I want to talk about a different subagency that you
have, the CDC, and allowing politics to override policy and
science. A report of the Select Subcommittee on the Coronavirus
Crisis revealed that the CDC allowed the American Federation of
Teachers to rewrite critical portions of the Biden
administration's school reopening guidance. The CDC initially
planned to issue guidance that would have been more favorable
toward opening schools but reversed course after consulting
with teachers union bosses, giving favorable treatment and
access to teachers unions instead of parents and ignoring
science and the necessity of opening our schools.
And we see what that resulted in. Not just lower test
scores for our children, but also increases in depression
rates, increases in suicide rates, increases in drug and
alcohol addiction rates, increases in domestic violence in the
home.
So let me ask you first, Mr. Secretary, were you in contact
with the American Federation of Teachers about these
guidelines?
Secretary Becerra. Congressman, I would love to probe what
you said but----
Mr. Cline. ``Yes'' or ``no'' would be perfect.
Secretary Becerra. I have not been in direct touch with any
particular stakeholder just on those guidelines itself. We have
done numerous stakeholder meetings with all sorts of
organizations, individuals, governments on the issues because
that is what we always do is whether it is CDC or us, we always
consult with everyone that might be impacted.
So along the way in formulating any proposal, we speak to
anyone who might be impacted.
Mr. Cline. So the answer is ``yes'' to that.
Secretary Becerra. I didn't say that that was the answer. I
said we speak to every--if you want to characterize it
properly, Congressman--and having been in your seat before, I
would make sure no one gets misquoted.
Mr. Cline. I would love a ``yes'' or ``no'' answer to that.
Secretary Becerra. I have--we have sat down with every
stakeholder who has asked us on those particular issues.
Mr. Cline. Okay. And that includes the AFT?
Secretary Becerra. I am pretty sure it has.
Mr. Cline. Okay. Is it Department policy to keep draft
guidance confidential?
Secretary Becerra. Draft guidance is within the internal
operations of the Department.
Mr. Cline. Right. And historically in the CDC, draft
guidance has been kept confidential. Correct?
Secretary Becerra. Well, it is an internal document. It is
not something for public consumption because it is not yet
ready for prime time.
Mr. Cline. Right. So sharing it, as testified to by the
Director of the CDC for the Select Coronavirus Crisis Task
Force, they testified that it was unusual to release that
guidance to an outside group?
Secretary Becerra. I am not sure I would characterize what
happened as you have, but what I will tell you is in consulting
and meeting with stakeholders, we certainly give them some
sense of what we are looking at and ask for their guidance. How
much actually translated into what you have described? That is
where I think the facts have to answer that question.
Mr. Cline. Are you aware of other cases in which the CDC or
any other agencies under HHS have incorporated language from
outside stakeholders?
Secretary Becerra. We certainly--as I said, we offer every
stakeholder an opportunity to comment, whether it is a formal
rule that we are getting ready to promulgate or whether we are
looking to have a guidance. We always reach out. Every
administration has, at least I hope they have, to have those
who might be impacted to get their input.
Might their input help us shape the final version of that
guidance or rule? I would hope so because we are supposed to
listen to the American people.
Mr. Cline. Okay. Moving forward, would you commit to citing
those outside partners who are--who may have been consulted in
the development of these guidelines?
Secretary Becerra. Congressman that is all public record.
Mr. Cline. When you are developing these guidelines, you
just told me that it is policy to keep draft guidance
confidential.
Secretary Becerra. Oh, the draft guidelines, anything that
is still internal is internal. But when we reach out to
stakeholders that is publicly available.
Mr. Cline. Are you committed to listing those stakeholders?
Secretary Becerra. Again, as I said, it is already publicly
available. Those meetings are in the public domain.
Mr. Cline. And citing them in the development of these
types of official guideline?
Secretary Becerra. If you take a look at regulations when
they are issued, they will note the comments that have been
received, and we usually have--try to be responsive to most of
the comments that we receive as we are getting ready, for
example, to promulgate a rule. So, again, that information that
comes in from the public, when we react to it, you will see it
in writing.
Mr. Cline. Well, you didn't cite AFT when you put out those
guidelines for school reopening. So I would encourage you to be
more forthcoming.
Secretary Becerra. You have reached a lot farther along
than what I am saying we have done.
Mr. Cline. You are talking about regulations. I am talking
about guidelines where you neglected to disclose that the AFT
edited the guidelines, on the orders of the White House, and
put them forward as CDC guidelines and neglected to release the
fact that the AFT altered those guidelines.
And I am asking you if you would commit to publicizing the
fact that you allow politics to override science when it comes
to your guidelines?
Secretary Becerra. Congressman, it would be tough for me to
respond to that because I don't agree with the premise that you
have just laid out.
Mr. Cline. Well, I don't agree with what your CDC did in
promulgating those guidelines. Children died because of that.
I yield back.
The Chair. Mrs. Watson Coleman.
Mrs. Watson Coleman. Thank you, Chairman.
Secretary Becerra, it is so good to see you. It is so good
to hear the good things that are happening, and let me also
echo that I think our budget is moving--your budget requests
are moving in the right direction, even though I would like to
see some more things in some places.
From a general perspective, I am very interested in all of
those issues from mental health to suicide to maternal health.
I am particularly concerned how all of those issues impact
black women and the black community and black children. Because
as we all know, unfortunately, in this country, we represent
the bottom of the heap when it comes to the direness of all of
these issues.
So I am going to ask you some questions about that, but
before I do, I want to ask you about something that is very
disturbing to me. Recently, the CMS drafted--made a decision
impacting the access to Alzheimer's disease medication. And
this decision is delaying the availability of that medicine,
even though the FDA had already taken it through its procedures
and had deemed it ready to be more available.
And so I am wondering is there some miscommunication, is
there some new authority that CMS has? Does this represent a
redundancy? Are you at all aware of it, and do you have a
thought about addressing this issue? Because Alzheimer's
disease is something that is just so devastating to our various
communities, and the sooner we can get a handle on it, the
better.
Secretary Becerra. Congresswoman, first, I couldn't agree
with you more. I think all of us believe that in the near
future, we will probably see medicines and therapies that will
help us tackle some of these just devastating conditions and
diseases like Alzheimer's. And we want to be there. I think all
of us would like to make sure we are there as quickly as we
can.
And for that, we have to make sure we have got the science
coming along with us because we want to make sure that we are
telling people we are giving them the treatment, the medicine
that will help either cure them or stabilize them and not harm
them.
And so remember that FDA has to operate and does operate
under a different set of rules than does CMS. FDA has to tell
us if they think there is a treatment out there that might be
safe and effective and under what conditions, and FDA gives a
conditional approval to Aduhelm to provide some treatment for
some individuals who might be on the stages of--into the early
stages of Alzheimer's.
CMS has to make a very different determination. Whether or
not, now that FDA has moved on a conditional basis, that all
the 65 or so million Americans who receive Medicare services
would qualify to receive Aduhelm and have it reimbursed or have
their doctors and providers get reimbursed for having provided
it. Two very different things. Two very different analyses.
One had--FDA had----
Mrs. Watson Coleman. However----
Secretary Becerra. I am sorry.
Mrs. Watson Coleman. Can I interrupt you? Because I have so
many other questions.
Secretary Becerra. Yes.
Mrs. Watson Coleman. It seems to me that the FDA is relying
on--that we rely upon the FDA on the science, on the efficacy
of the therapy or the medication, and CMS makes a determination
as to whether or not it should be covered. The latter is
important, but the former is the determination in my mind as to
whether or not that medication should be available.
My understanding is this is an unusual step for CMS to get
into after FDA, and I would like to have more information on
that. I did send you a letter on that. I am looking forward to
a response on that. Maybe we can't answer it at all today, but
I get it that there is two lanes. But it looks like there is an
unnecessary crossover through CMS into a lane that isn't theirs
to be in in the first place.
But moving on, I am concerned about an issue that you all
have been touching upon. We know what is happening with mental
health issues in all of our communities. I am particularly
concerned about mental health and suicide and those things that
affect black youth, black women, black men. Other sort of
underserved communities.
I am interested in 988 being made publicly available and
diverse in who answers that phone, who has the capacity to
answer those questions, and making sure that everyone--and I
want to know what you all are doing to make sure that there is
wide knowledge of it and diversity in it.
And I also want to know one last thing, and that is that we
really have experienced an amazing impact on children and
adults through this pandemic. One thing that I see that I think
we need to give greater attention to is the children who have
lost their protector, the person who has taken charge of them,
who has cared for them, who has paved the way for them up as a
result of this COVID.
And I think that we need to be looking at what are the
long-term needs and how do we pay for those long-term needs so
that those children have adequate mental health support, as
well as any other support that they need?
I see that all the red lights are zero, zero, zero, which
means that I am out of time. But I have given you kind of a
flavor of where I am and where my concerns are, and I certainly
will follow up with some additional questions to you in
writing.
Thank you so much.
I yield back.
Secretary Becerra. Congresswoman, you have never stopped
letting me know where you are. So that is good.
The Chair. Congresswoman Lawrence.
Mrs. Lawrence. Hello. Thank you so much for being here. So
good to see you. I have called you a lot of things--colleague,
and now I call you my Secretary.
I want to commend the Department for more than
$250,000,000, including $8,000,000 to Michigan's Department of
Health and Human Services, to expand and restore access to
affordable Title X family planning. I just want to thank you
for that.
As previously noted, the COVID-19 pandemic has undoubtedly
had an impact on the mental health of our children across this
country. I have a unique passion for protecting foster youth,
which they are no different.
Earlier this year, I led a bipartisan, bicameral group of
my colleagues, urging your Department to determine what
resources States and territories need to ensure that every
child can have access to timely mental health services in
foster care. And we know that the CFSRs provide an opportunity
to review State child welfare systems. This includes assisting
the States by ensuring children and families achieve positive
outcomes.
However, in order to fully understand the work, we need
updated data to reflect the number of mental health screenings
and the frequency in which they are conducted. So, Secretary,
today I am asking if you will commit to reviewing the letter
from me and my colleagues and the critical information in
forthcoming CFSRs?
Secretary Becerra. Congresswoman, first, thank you for your
devotion to this issue. We are going to make a special emphasis
within the Department on foster care. Because of the resources
you all have made available, we can actually try to take States
to the next level because we know that they are behind on their
assessments.
Mrs. Lawrence. Yes.
Secretary Becerra. They haven't been providing the right
data. We have talked about how valuable data can be. Bad inputs
produces bad outputs, and so we are going to try to do as much
as we can. If you get to the point of getting this Build Back
Better, I will tell you that we will have an opportunity to do
far more.
But we are going to do what we can because we know in the
foster care system, we are seeing too many of our young people
age out and then really be in trouble. And so we would love to
work with you further on this, and thank you for that letter.
Mrs. Lawrence. Thank you so much.
Also, the pandemic has worsened America's maternal
mortality crisis. I am encouraged that the President's budget
is reflective of putting resources into it. Last year, I
introduced the Doula for VA Act to create a pilot program at
the Department of Veterans Affairs providing veterans the
access to doulas, which they have been denied.
So, Secretary, can you explain to me how the President's
budget will grow and diversify the doula workforce as well as
other proposed maternal health pilot programs?
Secretary Becerra. And Congresswoman, thank you for the
question.
As you have heard in some of the previous responses I have
given, we are making maternal health a major focus. There is no
reason why a woman in this country today should die as a result
of birth of a child. Even worse, of course, for the child as
well now going without his or her mother.
And so we are going to do everything we can. We are
encouraging States to join us. I mentioned the program where we
are going to expand access to postpartum care to one full year
instead of just 60 days. But we need States to buy in. So I
would encourage you to go back home and chat with your folks in
your State of Michigan.
Mrs. Lawrence. But I wanted to specifically encourage you
to incorporate doulas. We know, especially in low-income areas,
sometime the doulas that are in the community are the only
support system that can help nurture a woman through her
pregnancy and post pregnancy.
So my ask specifically is for please--and continue what you
are doing--and I am going to continue fighting, but I know how
important a doula component is to ensuring maternal health.
Secretary Becerra. You all are moving us in that direction
through some of the legislation that has been proposed. We
understand the importance of some of the paraprofessionals. You
don't need to have an OB/GYN like my wife in order to provide
good care.
Mrs. Lawrence. Right.
Secretary Becerra. In fact, she is one of the first ones
who will tell you that if you get a person who can give
guidance to that woman during the 9 months of pregnancy, we are
all going to be better off.
Mrs. Lawrence. And I want to just remind while I have these
2 seconds is that foster children are wards of the court. It is
on our dime and our responsibility to take care of them. They
have been through more trauma than most adults, and our
commitment to them through their mental health is extremely
important.
I thank you, and I yield back.
The Chair. Thank you.
We have been through with the first round. What I would
like to do is proceed to a very shortened second round of
questions. Secretary Becerra has a hard stop at 12:30 p.m.
So I am just going to say it is your question and allowing
time for the Secretary to answer, we are talking about within
the timeframe of about 2 minutes. So if we can. So we want to--
and thank you. Thank you, Secretary.
Let me begin by just saying that we have a shift in how we
respond to behavioral health these days. I think the 988 will
be able to direct calls to behavioral health and would deal
with mobile crisis teams and be able to respond to these
crises. And these teams are being set up around the country.
We funded these teams in two ways last year. We created a
new pilot program at SAMHSA. We funded several community
project requests for members who wanted to support these teams
in their own communities, and they are composed of people who
are trained with medical care.
An individual experiencing behavioral healthcare crisis
needs that versus law enforcement. We did a hearing here on
that several months ago, and the result has been they are
spread all over the country. Now we are going to implement this
program.
How does the request--I am concerned about States that do
not have a robust crisis care and want to be able to follow up
on how we are going to make sure that this new system in place
is really working and so forth. And how are we going to ensure
that the individuals are going to be linked with that care?
Secretary Becerra. Madam Chair, we just did another
stakeholder meeting on this. We have done several on this. We
are doing everything we can to shepherd this within the States.
I just finished having a conversation when I was in Colorado
with one of the leaders, executive leaders at the Western
Governors Association, reminding them that we are ready to work
with any State and any governor who wants to work with us to
make sure that they are ready to go.
We don't want anyone to be at the back of the bus when it
comes to how you handle this. And so we are doing everything we
can. We are providing resources.
I will say to you, and I say this to each and every member.
Help us make sure that your States are ready. Because we can't
dictate to them everything. We are trying to use the carrot,
but the stick comes when some kid calls and ends up with a busy
signal.
The Chair. Right, right. Thank you.
And we need to deal with resources, but we need to deal
with the oversight to make sure it is happening.
Secretary Becerra. Absolutely.
The Chair. With that, I recognize Congressman Cole.
Mr. Cole. Thanks very much, Madam Chair.
Mr. Secretary, I want to go back very quickly to this issue
of additional money for COVID relief because I have very little
quibble with what the Department is asking for in terms of what
the purpose is going to be. Do you have a clear understanding--
because we get all kinds of figures that are hard to nail
down--about how much unpurposed money there is in specific
accounts and what have you that could, if we could come to an
agreement, be diverted to give you the resources that you need
to tackle the problem as quickly as possible?
Secretary Becerra. Unpurposed, the numbers are fairly small
in most cases. The Provider Relief Fund, for example, we have
reached almost the $186,000,000,000 that was made available.
There is some still available that is kept to make sure that we
didn't miss any particular claims, didn't do them right.
There was some money that was going to be used, for
example, for testing. We are going to probably have to figure
out if we can reprogram, but most of that money, as far as I
can tell, has been purposed.
Mr. Cole. Is there money--and look, these are never popular
decisions to be made. I get that. But it is going out the door,
particularly to State governments. It is not being used for
COVID. It could be repurposed, quite frankly. And that is a
political problem for us, but just my understanding is there is
quite a bit of that there.
I had very little problem, honestly, with the
administration proposal or the legislative compromise on the
COVID package that was stripped out. Fine. Let us take that
money from these States where I know it is not being used for
this. This is more important. Let us do this. And I am sorry
that that honestly wasn't part of our package.
Moving forward, I think we ought to revisit that, find
another way legislatively, you know, not to bore everybody with
this stuff because everybody here knows it. But that came down
on what is called a rule vote. It wasn't a vote of the
substance of the policy. We didn't disagree with you on the
policy.
So if you could help us at least get a clearer vision of
what is available, it is our decision, not necessarily yours.
But I do think this funding issue is going to get in the way of
letting you do the things that I think you know need to get
done as a department and that we don't disagree with you. We
just got to use some of this other money that was not directly
COVID related that went out the door.
Secretary Becerra. I appreciate the way you framed it.
Mr. Cole. Okay, thank you very much.
Yield back, Madam Chair.
The Chair. Congresswoman Roybal-Allard.
Ms. Roybal-Allard. Mr. Secretary, as you know, every year,
4 million babies are born in the United States, and nearly
every one of those infants is screened by newborn screening
programs for certain serious or life-threatening hereditable
disorders and medical conditions that can be treated. And on
average, newborn screening saves or improves the lives of more
than 12,000 babies each year.
My Newborn Screening Saves Lives Act passed in 2008. It was
reauthorized in 2014, and we are currently working to get the
House-passed 2021 reauthorization bill also passed in the
Senate. The Newborn Screening Saves Lives law established
national newborn screening guidelines. It ensured the quality
of laboratory newborn screening tests and established grants to
help States expand and improve their screening programs. Also
to enable them to educate parents and healthcare providers and
improve follow-up care for infants with a condition detected
through newborn screening.
The subcommittee has recognized the critical role that both
the CDC and HRSA programs play in protecting our children and
has been providing generous increases to them each year,
including $25,800,000 for the HRSA program and $23,000,000 for
the CDC quality assurance program in last year's House bill.
Unfortunately, in the final fiscal year 2022 bill, both of
these programs received $19,000,000 appropriations for fiscal
year 2022. While this funding is, in fact, significant, it
unfortunately falls short of what is needed to meet the needs
of the CDC and HRSA screening programs.
I applaud the President's commitment to advancing maternal
and child heath, but I was disappointed to see that he
requested $19,000,000 for both the HRSA and $19,000,000 for CDC
newborn screening programs for fiscal year 2023. I hope that I
can get your commitment to work with me to ensure the viability
of these critical screening programs through robust funding in
the final fiscal year 2023 appropriations bill.
And my hope is that until this law is authorized, that you
will ensure that the lifesaving programs continue, and the
Secretary's Advisory Committee is able to make its critical----
The Chair. The gentlelady's time has expired.
Ms. Roybal-Allard. I just need a ``yes'' answer.
[Laughter.]
The Chair. I understand that. So got to get to ``yes.''
Secretary Becerra. Madam Chair, I want to give a straight
``yes,'' but what I have to say is that the funding levels that
we put in, again, as I mentioned before, were based on what we
thought we were going to have based on the continuing
resolution.
So we are absolutely committed to this. The President has
it in his budget, and CDC is committed to this program.
Ms. Roybal-Allard. Thank you.
The Chair. Thank you. Congressman Harris.
Mr. Harris. Thank you. Thank you very much.
Briefly, I just want to ask about the expansion of fetal
tissue research at HHS because this is--I am curious about
this. Because the Trump administration did not ban fetal tissue
research from extramural researchers. What they just said is
you have to come before an ethics advisory board.
Now, interestingly enough, 13 of the 14 research proposals
that came before that board actually were found not to pass
muster at the ethics advisory board. What is the thinking
behind not requiring--and again, I served on the special
Investigative Panel on Infant Lives. Some atrocities were being
committed at clinics with regards to making profit from selling
baby body parts.
That is what the panel found. You can read it. Google it,
read it. What is the thinking behind not requiring an ethics
advisory board just to review these research projects that
would use fetal tissue from aborted fetuses?
Secretary Becerra. Congressman, I am going to be real
honest with you. That was not one issue I am prepared to
respond to because I don't know the details of it, but we can
get back to you.
Mr. Harris. I would greatly appreciate that. Again, now for
intramural research, the Trump administration did ban it, and
one might argue that, well, maybe you should just have an
ethics advisory board for that, too. But my particular
question--and I appreciate you getting back to me--is about the
extramural research.
Because some of the things that came out of University of
Pittsburgh, you can read about some of those experiments. I
just think these should go to ethics advisory boards and let
the chips fall where they may.
Thank you very much.
Secretary Becerra. I appreciate that, and I will get back
to you. But I know that there are standards and protections in
place, but let me give you a thorough answer.
Mr. Harris. Thank you very much. I yield back.
The Chair. Ms. Lee.
Ms. Lee. Thank you very much.
Mr. Secretary, following up on our discussion, and you were
there with our beloved, the late supervisor Wilma Chan during
your visit to my district, my colleagues and I sent a letter--
and this was something we discussed--to HHS to lead the
National Food as Medicine pilot program using food as medicine
in a clinical setting to help our healthcare system improve
health outcomes for the underserved. And our colleague,
Congresswoman Chellie Pingree, who serves on the Ag Committee,
along with myself and our chairwoman, has championed the Food
as Medicine for many, many years.
So this pilot would be modeled after the work being done in
my home county, Alameda County, as part of the county's ALL IN
Recipe4Health initiative. But our intent, though, is that we
establish a national pilot program that could expand the
efforts of this program to integrate healthcare, regenerative
agriculture, economics, and the environment to improve health
and racial equity and food security.
And so I would like an update from you on your plans to
look at this as a national pilot, to develop a national pilot
for this.
Secretary Becerra. Congresswoman, first, thank you for
pushing that. Secretary Vilsack and I have had some
conversations about how the Department of Ag and HHS can work
together on this issue because we agree completely that food
should be considered medicine. And so we will follow up with
you on some of the details on what we are doing.
By the way, we hope you will join us in the work we are
trying to do to reduce sodium in our food products. You can buy
a bag of potato chips in the U.S., and it is probably twice as
much sodium in it as it does the same product in Europe. And we
have to make sure that we are not the place where some of these
manufacturers try to entice us into getting some of these
things that aren't good for us.
So I look forward to working with you because we agree.
Ms. Lee. And I would like to work with you on that. Thank
you.
Secretary Becerra. Yes.
The Chair. Mr. Fleischmann.
Mr. Fleischmann. Thank you, Madam Chair.
Mr. Secretary, just one topic. Last year, Mr. Secretary, we
discussed at length the issue of safely resettling
unaccompanied minors who cross our border into ORR facilities.
Secretary Becerra. Yes.
Mr. Fleischmann. The safety and well-being of children
should be of the utmost concern to the administration and to
members of the subcommittee. In my own district, a contracted
ORR facility was shut down last year after instances of sexual
battery were reported to authorities.
My question, Mr. Secretary, what since the last time we
spoke has the administration done to better oversight and
ensure safety net procedures throughout the contracting and
hiring process of these ORR facilities? And sir, how will the
President's budget request of $6,300,000,000 be used to remedy
this issue, sir?
Thank you.
Secretary Becerra. Congressman, thank you for that
question.
Because, again, we have custody of these children who have
come unaccompanied during that temporary period that they are
in the U.S. And I will tell you that we are bending over
backwards. Any time we receive a report, whether or not--we
don't try to determine if it is true or not, we report it to
local law enforcement. We report it to our inspector general's
office, and we get on it.
And as quickly as we can because, as you mentioned, most of
these are contractors that we are working with. We make sure
that they move to make sure if there is an instance where a
worker has violated rights and committed some activities that
is inappropriate, that they move on.
And so we are doing that as much as we can, and we are
doing everything we can to make sure we keep the oversight
going in these places.
Mr. Fleischmann. Thank you, sir.
My final request is that perhaps somebody on your staff
would get with me--your office has been working on a
constituent issue, and I would just like a little bit of an
update on that when it is convenient.
I thank you, sir.
Secretary Becerra. We will follow up.
Mr. Fleischmann. And I appreciate your being here today.
Secretary Becerra. Your staffer's name is--can you give me
your staffer's name so I know how to tell----
Mr. Fleischmann. Oh, sure. I would call Daniel Tidwell. I
will make him famous.
Secretary Becerra. Daniel. I will make sure my team is
listening. [Laughter.]
Mr. Fleischmann. I like him. Good to see you.
Secretary Becerra. Thank you.
The Chair. Ms. Frankel.
Ms. Frankel. Thank you. Thank you again for being here.
And I will follow up on this, but just for the record, I
wanted to say that your answer to me on enforcing the
Affordable Care Act's contraceptive coverage, it really wasn't
the best answer. So, but I will follow up on that.
I will ask you another question. Ninety percent of pregnant
women report taking a medication during their pregnancy, but
only 1 percent of clinical trials mention the word
``pregnancy'' or ``pregnant.'' The Congress did create a task
force to take a look at that.
There was a report with recommendations, and then another
report with implementation recommendations. And I am just--do
you know where we are with that?
Secretary Becerra. Congresswoman, I will have to get back
to you on that.
Ms. Frankel. Okay. Okay, then you got two things to get
back to me on now.
Secretary Becerra. Look forward to it.
Ms. Frankel. Maybe I will give you an easier question here.
I know that your budget does have some increases on the home
care and so forth. Can you tell us what that does and what that
means?
Secretary Becerra. We are going all in on home and
community-based care. We believe that every American, whether
they are going through an infirmity or whether they are in
their last days, should be able to be with loved ones through
that difficult time. And so we are making major investments in
home and community-based care. We are going to try to increase
the workforce and recognize that the workforce in those
settings has to be paid decently so that they will remain in
there.
We want to recognize in some cases family members are the
people who are caring, and just because they are family members
doesn't mean they don't deserve to be compensated where
possible. And so we are going to do everything we can to make
sure if you can be at home, we will let you stay at home.
You can't be at home, we want it to be in a setting that is
as close to your home as possible. And we applaud those who are
providing services in nursing home and other long-term care
facilities. But to the degree that we can move care to where
you live and where your loved ones are, that is what we will
try to do.
Ms. Frankel. Okay. Thank you very much.
Yield back, Madam Chair.
The Chair. Ms. Herrera Beutler.
Ms. Herrera Beutler. Thank you, Madam Chair.
I wanted to follow up on the fentanyl conversation a little
bit. In December, the DEA issued a warning about the alarming
increase of fake prescription medications obviously being laced
with fentanyl. And in Lewis County, Washington, the Joint
Narcotics Enforcement Team seized 106,000 pills suspected to be
laced with fentanyl as of September of 2021.
Mr. Secretary, what will you do to ensure that HHS
continues to work not only on the treatment, but the prevention
piece?
And I wanted to make sure you were aware many of the
traffickers in Mexico are targeting children via social media,
right? So they can access these fentanyl-laced drugs. I mean,
that is the whole new--new horrible game. What can HHS do to
increase awareness to protect our communities?
Secretary Becerra. Congresswoman, as you are probably
aware, we have changed direction in terms of our strategy. We
are not just trying to treat. We are now trying to help
prevent. And one of the ways we do that, for example, we are
letting go some of those taboos where forgetting about how
things were done in the 20th century.
A fentanyl strip, it used to be thought, well, you don't
want to give people something that helps them test to see if
the drug they are about to ingest also has fentanyl because you
are just helping them take the drug. The problem, of course, is
that too many Americans think they are taking an illicit drug
nonetheless, but not going to kill them, and lo and behold, it
is laced with fentanyl.
So we are now making--we are now supporting those local
efforts that have shown that fentanyl strips help save lives.
And so we are going to try to do what we can to prevent that
and then follow people through the process as well.
Ms. Herrera Beutler. I appreciate that. I am just going to
go out on a limb here because I know everybody in this space is
saying we need to do things like test the drugs so that someone
can ingest it safely. But I am not sold on the science behind
that yet.
I still--you know, I grew up in the ``don't do drugs.'' And
man, I can remember the commercials. I remember the message. I
remember those were the things we talked about, and I believed
it. Silly me.
And I feel like now recreational use of--in Washington
State, by 2023, you can use meth and heroin, not just
marijuana, in front of cops and not go to jail for it. And my
concern is the message we are sending to the next generation.
So I know that this is where a lot of the new talk is about
going. But that concerns me, and I want to see science on it
before we move in that direction.
Secretary Becerra. And so, Congresswoman, I don't want to
give you the impression that that is only type of prevention
work we do. We actually devote the majority of our resources to
actually prevent people from ever using drugs. We are working
closely to try to keep children, especially in the middle
schools, from getting to them. That is about the time they
start using recreationally.
And so we are doing a lot in that space, but we also don't
want to forget those who are beginning to use, keep them alive,
because hopefully we can move them in a different direction.
The Chair. Mrs. Lawrence.
Mrs. Lawrence. Thank you.
I have a question. Because we are experiencing child care
deserts. I just had a conversation with my lieutenant governor
where, when we tour the child care facilities in low-income
areas, there are waiting lists. And so, as we look at
addressing and complimenting you and the President on the Child
Care and Development Block Grant and Head Start, we need to do
something different in those areas where we know we have
challenges. And so can you talk to me about that?
In addition to that, what are we doing to ensure that we
have a workforce that can address the deserts and the shortages
that are happening in low-income areas?
Secretary Becerra. Congresswoman, this is where I hope I
can convince you that my own personal beliefs and upbringing
mean that we will have equity infused in everything we do. We
proved that when it came to the Affordable Care Act. A lot of
black and brown communities were not participating. We raised
the bar when it came to the participants, and we got the
numbers of black families and Latino families that signed up
for health insurance under ACA to levels they have never been
before.
When I came into office, the number of black and Latino
families that were getting vaccinated was well below what we
saw for white America. Today, they are almost all at the same
level, and that is because what we are doing is we are going to
where they are instead of waiting for them to come to us.
When it comes to child care, it is the same thing. Most of
the caregivers we know are people, women of color, and so we
are going to do everything we can to make sure we elevate those
caregivers and that workforce at the same time we make those
services available. So if we get the dollars to expand access
to child care, we are going to work with States to make sure
that they are also making sure they are providing that extra
care.
Mrs. Lawrence. I am going to be reaching out to you. We do
accelerators for other type of businesses and shortages that we
see. We need an accelerator to train professionals in child
care, and I will want your partnership.
Secretary Becerra. Look forward to it.
Mrs. Lawrence. Thank you.
Secretary Becerra. Look forward to talking.
The Chair. Mr. Cline.
Mr. Cline. Thank you, Madam Chair.
And Mr. Secretary, you are committed to upholding them and
enforcing the laws that are on the books in this country.
Correct?
Secretary Becerra. Correct.
Mr. Cline. Can I get a ``yes''?
Secretary Becerra. Yes.
Mr. Cline. Okay. The Title X statute itself says that
abortion is not a method of family planning, and taxpayer
dollars should not be used to fund abortion providers. Can you
tell me how it has come to pass that HHS is awarding $6,600,000
in Title X funds from the American Rescue Plan to abortion
providers?
Secretary Becerra. So, Congressman, as you probably are
aware, the services that are provided by a number of the family
planning programs go well beyond just providing contraceptive
care or abortion services. They provide the full panoply of
services that you think of in terms of family planning.
Mr. Cline. You don't view it as a disqualifier, the fact
that they provide abortions?
Secretary Becerra. If you are following the rules of the
law and you qualify, you should be able to receive the funding.
If you are providing family planning services, you should be
able to get family planning money.
Mr. Cline. Okay. I am going to move on to Title 18 of the
U.S. Code, Section 1531. Last year, you claimed there is no law
dealing specifically with the term ``partial-birth abortion.''
This drew a lot of attention and was roundly debunked.
You voted yourself against this law when it was considered
by Congress. You repeatedly committed to enforcing these laws,
as you just said. That extends particularly to laws with which
you disagree, like the laws that protect the unborn. Will you
commit to enforcing this law against partial-birth abortion?
Secretary Becerra. Without question, Congressman, I will
not only comply with the law, but enforce the law.
Mr. Cline. Thank you. I yield back.
The Chair. Thank you. I would now like to yield to
Congressman Cole for any closing remarks he may have.
Mr. Cole. Thank you.
First of all, Madam Chair, thanks for holding the hearing.
It is good to get back in person, and again, thanks for your
hard work in getting our last year's bill done and across the
line.
Mr. Secretary, thank you. As always, you are forthcoming.
We don't agree on everything. We are going to disagree very
strongly on Hyde, and I just want to underline that triple
fold. I respect the President to submit what budget, but at the
end of the day, if he wants bipartisan support that is going to
be an issue we are going to have to confront. And we are just
not movable on this.
I am very interested in the ARPA process, and I appreciate
your commitment to keep in touch with this as these decisions
are made. Count me as very skeptical that we could hit the
administration's proposed number because I just think it is
going to take longer to set this up and organize it than
perhaps you envision. And I think that money would be better
redirected toward NIH and traditional biomedical research.
Finally, I want to reiterate again thank you, thank you,
thank you for the bold stance that you took with respect to how
we fund the Indian Health Service. That is a big deal. I know
that that will actually not be a partisan fight. There will be
people on both sides against it. I think I respect fiscal
discipline. I just don't think it needs to come at the expense
of the healthcare of this population when we have made
commitments over and over again.
And your willingness to step out front and offer some bold,
new thinking. I don't think any other administration that I am
aware of on either side of the aisle has ever proposed doing
what you are proposing here. So, to my colleagues, this is a
really big deal in Indian Country, and the Secretary and the
administration are to be commended for it.
So I am hopeful that at the end of the day, because it is
sort of like the wonderful working relationship I have had over
the years with the chairwoman, we don't agree on everything,
but we get to a deal. And we have been able to do it seven
times in a row, and you are very much part of this deal-making
process obviously in this particular subcommittee. And the
administration has to sign anything we produce. So you have as
a big a seat at the table as anybody else.
But I appreciate the manner in which negotiations were done
last time, and I have had several discussions with our good
mutual friend Shalanda Young, our new OMB Director. We are very
proud of her, great Appropriations staffer. And frankly, she
helped me on a number of occasions clarify, okay, this is
really important to the President.
And even if I don't agree with the President, what is
important to him matters. And certainly when we have to come to
a cooperative deal, and again, we were able to do that.
But I just end by saying we won't always agree on
everything, but I appreciate you being here. You have been
accessible. You have been good to work with. You have been
fair. You always keep your word.
And it is a pleasure having the opportunity to work with
you again. I look forward to it in the coming year.
Yield back.
The Chair. Thank you very much.
And thank you, Mr. Secretary. It is wonderful to be with
you in person. It was virtual last year, but this is just
really in person. So I offer congratulations. So delighted you
are where you are.
I can recall so many meetings over and over again with the
two of us, and we are so like-minded on so many issues. And
oftentimes in our Democratic leadership meetings, we stood
together. So I really appreciate your remarkable professional
history and your service here in the Congress and the values
that you hold, which is what drives you in terms of the public
policy initiatives that you care about and you put forward.
And I, too, will say to my colleagues that we did work
cooperatively. In the end, we got the bill across for 2022, and
I think we made some very, very important investments in
biomedical research, public health, behavior health, child
care, early learning and so many others. And that was after
years of austerity with regard to some of these efforts.
And what you have done with this budget is that you have
now provided the opportunity to build on that success. And
whether it is through public health and maternal health,
behavioral health, all these things we talked about today, the
NIH, ARPA-H, early childhood, et cetera, the range of issues
that fall within the mission--and it is a mission--at Health
and Human Services and what you do.
We need to provide additional emergency funding. I think
there is a morality about the COVID pandemic and that it is
about lifesaving vaccines. It is about therapeutics. It is
about covering the uninsured.
And I worry about the uninsured and what will happen to
them if there isn't a funding there. And therefore, we will see
less people getting the tests and vaccinated, et cetera, which
is harmful. And I think also I would emphasize our global
efforts as well. I think we have, again, real moral leadership
to lead there.
What is really--this investment with people, and if I might
just say for a moment that for years Federal resources have
gone oftentimes to the richest 1/10 of 1 percent of the people
in this Nation, or a number of the corporations who are the
biggest corporations who don't pay their fair share of taxes or
pay taxes at all.
And for me, looking at the shift in where Federal resources
have been going and looking at the Rescue Plan, looking at the
bipartisan infrastructure plan, I know we will get to where we
are going on some package with regard to Build Back Better that
will continue this effort of looking at our Federal resources,
that they are going to children, they are going to families.
They are going to State and local governments. They are going
to small businesses, and they are going to where they need with
allowing people to have the economic opportunity for security
in their future.
And the budget you have presented reinforces all of those
efforts. So look forward to working with you and with my
colleagues both sides of the aisle as we move forward on what
we look forward to is a strong spending bill for 2023.
So thank you for your time. Thank you for your work. And
thank you for your commitment and devotion to public service.
Thanks so much. Great to be with you.
[Answers to questions submitted for the record follow:]
[GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT]
Wednesday, April 6, 2022.
SOCIAL AND EMOTIONAL LEARNING AND WHOLE CHILD APPROACHES IN K-12
EDUCATION
WITNESSES
PAMELA CANTOR, FOUNDER AND SENIOR SCIENCE ADVISER, TURNAROUND FOR
CHILDREN
LINDA DARLING-HAMMOND, PRESIDENT AND CEO, LEARNING POLICY INSTITUTE
MAX EDEN, RESEARCH FELLOW, AMERICAN ENTERPRISE INSTITUTE
TIM SHRIVER, COFOUNDER AND BOARD CHAIR, COLLABORATIVE FOR ACADEMIC,
SOCIAL, AND EMOTIONAL LEARNING
The Chair. The hearing is fully virtual this morning, so we
do have a few housekeeping matters.
For today's meeting, the chair, or staff designated by the
chair, may mute participants' microphones when they are not
under recognition for the purposes of eliminating inadvertent
background noise. Members are responsible for muting and
unmuting themselves.
If I notice when you are recognized that you haven't
unmuted yourself, I will ask the staff to send you a request to
unmute yourself. Please then accept that request so you are no
longer muted.
I remind all members and witnesses that the 5-minute clock
still applies. If there is a technology issue, we will move to
the next member until the issue is resolved, and you will
retain the balance of your time.
You will notice a clock on your screen that will show how
much time is remaining. At 1 minute remaining, the clock will
turn yellow. With 30 seconds remaining, I will gently 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
begin to recognize the next member.
In terms of speaking order, we will begin with the chair
and ranking member, then members who are present at the time
the hearing is called to order. They will be recognized in
order of seniority. And finally, members not present at the
time the hearing is called to order.
Finally, the House Rules require me to remind you that we
have set up an email address to which members can send anything
they wish to submit in writing at any of our hearings or
markups. That email address has been provided in advance to
your staff.
My gosh, there are so many rules and regulations here, as
we move forward.
I really want to welcome everyone this morning and want to
acknowledge Ranking Member Cole and all of my colleagues for
joining.
And a particular thank you to our witnesses for testifying.
Very, very excited about all of you this morning--Dr. Pamela
Cantor, Dr. Linda Darling-Hammond, Mr. Max Eden, and Dr.
Timothy Shriver. I will provide a more fulsome introduction
before their testimony, but so delighted that you could all
join us this morning for this hearing.
American author, social critic, and educator Neil Postman
once said, and I quote, ``Children are the living messages we
send to a time we will not see.'' They are quite literally the
legacy we leave behind--the legacy we leave behind us and the
surety that everything we do continues onward, making the world
a better place when we are gone.
Which is why it is not only incumbent on parents and
educators to ensure our Nation's children are primed to meet
the challenges of the future, it is also incumbent on all of
us, especially legislators, to ensure they are sufficiently
prepared not only intellectually, but emotionally and socially
as well.
Decades of adolescent development research have shown that
all aspects of a child's well-being must be supported if we are
to ensure their success. The Learning Policy Institute, which
states that, and I quote, ``A whole child approach to education
is premised on the fact that children's learning depends on a
combination of instructional, relational, and environmental
factors the child experiences, along with the cognitive,
social, and emotional approaches that influence one another as
they shape the child's growth and development.''
Fortunately, there are a variety of strategies that
instructional and school leaders can employ to support the
whole child, including social and emotional learning
interventions. The evidence base behind these interventions is
overwhelming. High-quality SEL programs that support students'
social, emotional, and cognitive development result in lasting
positive academic and life outcomes.
Four meta-analyses conducted by CASEL and researchers over
the past decade found that students participating in SEL
programs showed significantly more positive outcomes related to
academic performance and cognitive behavior. A 2021 evidence
review by the Early Intervention Foundation found that SEL
interventions are effective at enhancing students' social and
emotional skills while reducing symptoms of depression and
anxiety.
And RAND Corporation found that there are at least 60 SEL
interventions that have been evaluated that meet the evidence
requirements for the Every Student Succeeds Act, ESSA, the
elementary and secondary education law we authorized in 2015.
In fact, the evidence in support of these interventions is
so strong that a 2015 bipartisan report from American
Enterprise Institute and Brookings concluded that, and I quote,
``The Federal Government should provide resources for State and
local education authorities to implement and scale evidence-
based social and emotional learning practices and policies.''
I could not agree more. For too long, education
policymakers at the Federal level have been slow to focus
necessary attention and resources on approaches that adequately
address the holistic needs of students to drive stronger
achievement in school and beyond. And in light of the extreme
stress and hardship our country's most vulnerable students have
faced during the COVID-19 pandemic, these effective strategies
are needed more than ever.
Which is why in the first year of chairing this
subcommittee, in fiscal year 2020, we created an initiative in
the Labor-H bill on SEL and whole child approaches in K through
12 education. In the recently passed bipartisan fiscal year
2022 omnibus appropriations package, this includes $82,000,000
for evidence-based, field-initiated SEL grants that address
students' social, emotional, and cognitive needs within the
Education Innovation and Research Program. It includes
$85,000,000 for the Supporting Effective Educator Development
Program, with a priority for professional development and
pathways into teaching and school leadership that provide a
strong foundation in implementing SEL and the whole child
strategy.
And further, $100,000,000 in set-asides for school-based
mental health professional training to help local education
agencies directly increase the number of mental health
professionals in schools. And finally, there is $75,000,000 for
full-service community schools, providing comprehensive
services and expanding evidence-based models that meet the
holistic needs of children, families, and communities.
The subcommittee's work is a direct response to what has
been recommended strategies and approaches that are championed
by our witnesses today and was significantly influence by the
landmark National Commission on Social, Emotional, and Academic
Development report. We started from nearly zero for these SEL
and whole child approaches just a couple of years ago, and we
now have secured resources which have been, as I said, a long
time in coming.
And I am so pleased to have been able to work with Ranking
Member Cole, my colleagues in the House and Senate, to be able
to get this done. And so many of these efforts about promoting
social and emotional learning have come from members of this
subcommittee.
Appropriations legislation requires negotiations and
agreements from both parties in the chambers of Congress. So I
am proud that our bipartisan legislation has included the SEL
and whole child approaches initiative for the past 2 years.
The initiative was inspired by Dr. James Comer, a
psychiatrist at Yale Child Study Center, who worked with New
Haven Public Schools starting in 1968. His model for child
learning demonstrates focusing on positive school environment
and students' social and emotional needs as necessary to
promote their cognitive development and academic success.
I hope that in this hearing today, we can learn more about
the overwhelming body of evidence in support of these programs
and the Federal support that is needed. Especially eager to ask
our witnesses where it is that we need to go and where the
resources are best used.
But before we turn to our witnesses, let me yield to my
colleague, the ranking member of the subcommittee, Congressman
Cole, for any opening remarks that he may have.
Congressman Cole.
Mr. Cole. Thank you very much, Madam Chair.
And just for the purposes of housekeeping before I get into
my prepared remarks, I need to let you and the committee know I
have to leave by about 11:00 a.m. or a little before. We have a
Rules Committee meeting so we can get some stuff on the floor
and, hopefully, get home reasonably--at a reasonable time this
week. So I am sure you would rather me be there than here
anyway.
So, again, good morning, members of the subcommittee and
certainly to our testifying witnesses. I want to thank you for
being here today and look forward, as always, to our
discussion.
I will admit up front that I don't know a great deal about
the topic being discussed today. From what I have learned,
social and emotional learning is a curriculum or teaching
methodology that is intended to help students to better
comprehend their emotions and demonstrate empathy for others.
That sounds like a good thing, indeed.
But I also have a concern as to whether or not the Federal
Government or this committee has any role to play in
encouraging specific curriculum or teaching methodologies. In
fact, the U.S. Department of Education is explicitly prohibited
from dictating local school curriculum in its underlying
statutes.
And I think that is a wise decision, regardless of where
one falls on the political spectrum. Decisions about what to
teach and how to teach should be made at the State and local
level by professional educators and parents who know the
children in their communities personally, not by bureaucrats in
Washington, DC, or by advocates outside the classroom with a
political agenda to advance.
Parents and children across the country are still reeling
from what I believe was one of the biggest policy missteps of
this pandemic. That is the decision of many, if not most, of
our Nation's public schools to close for nearly 2 years.
The school closures hit the most vulnerable children the
hardest--those with disabilities, those without access to
technology, or parents who could not help them in a virtual
environment. Children in minority communities and those who
have a difficult time learning through a computer screen also
suffered. The lasting impact of the pandemic on these children
has been profound.
Now we have also seen concerning rates of mental health
issues, missed preventive care, self-harm, and ongoing lack of
engagement, not to mention lost academic and study skills. I am
glad that the importance of in-person learning is now being
recognized, and I am glad to see children back in the
classroom. Perhaps this focus on social and emotional learning
can help these children regain ground and develop a love of
learning again.
So, to that point, I am interested in learning from our
witnesses today exactly what is meant, more specifically what
social and emotional learning activities in the classroom look
like. Because from what I have been reading, there are some
critics of this particular approach.
I have read the concerns that social and emotional learning
is being used as a way to advance radical ideas about race,
gender, and sexuality that may not be welcomed by all parents.
And that even if some of the material is not objectionable,
some parents continue to raise concerns about the amount of
time that discussing feelings and current social issues as
contrasted with the time spent focused on academic subjects and
recovering lost ground.
Again, I do not believe the Federal Government should be
involved in these decisions. They properly belong with parents,
teachers, and local school boards. But as we have this hearing
today, I am interested in learning more about it from our
witnesses and seeing what role the Federal Government can
appropriately play.
I want to thank all of our witnesses for coming before us
today, sharing their time and expertise.
Thank you, Madam Chair, and I yield back the balance of my
time.
The Chair. Thank you very much, Congressman Cole.
And with that, I am delighted to welcome and introduce our
witnesses.
Dr. Pamela Cantor, founder and senior science adviser of
Turnaround for Children. And I will just make a quick comment
here. I have worked with Dr. Cantor in the past, and I can
recall, if I have got this right, Dr. Cantor, you were tasked
with taking a look at the mental health issues with regard to
children after 9/11.
And the work that you did--and while 9/11 certainly had
impact on the children, but what you found, and I think the
term you used when we spoke at that time was that it was about
grinding poverty that had much more an effect on our children
than almost anything else.
So thank you for being here.
Dr. Linda Darling-Hammond, who is president and CEO of the
Learning Policy Institute, thank you. Thank you for your body
of work in this area.
Mr. Max Eden, research fellow at the American Enterprise
Institute, and welcome to you, Mr. Eden.
And Dr. Timothy Shriver, cofounder and board chair of the
Collaborative for Academic, Social, and Emotional Learning.
And I will just also say I have years and years of a
friendship with Dr. Shriver from his days in New Haven, CT, and
he could almost be regarded as a ``townie,'' he spent so much
time there and working with Dr. Comer and devoted on his career
to dealing with educating our children.
So thank you very much for being here.
I am going to remind our witnesses that the entirety of
their written testimony will be entered into the record.
And our first witness for today will be Dr. Cantor, and
again, your full written testimony will be included, and you
are now recognized for 5 minutes for your opening statement.
Dr. Cantor. Thank you, Chairman DeLauro.
If I were to ask any teacher today, ``What are the biggest
challenges you are facing?'' the answer might be lost learning
time or the physical and emotional wellness of your students.
Or that you are just exhausted from the pandemic.
What is being asked of us today are solutions to more than
one of these challenges at the same time. Not a choice between
them, which would be a false choice. Our education system was
not designed to meet this moment.
One lecture in medical school forever changed the way that
I looked at human beings, especially children. I was taught
that there are 20,000 genes in the human genome, yet in our
lifetime, fewer than 10 percent will ever be expressed. Well,
what determines what is in that 10 percent? It is context--the
environments, experiences, and relationships in our lives.
Context determines who we become, how and what we learn, and
even the expression of our genes.
The risks and opportunities in development sit inside this
one profoundly important point, that there is no separation of
nature and nurture, biology and environment, or brain and
behavior, only a collaboration between them. This is why
developmental and learning science paints an optimistic story
of what is possible.
Children's brains and bodies and abilities are malleable to
experience because the human brain is a dynamic living
structure made up of tissue that is the most susceptible to
change from experience in the entire human body. The brain is
also malleable over time. Most of its growth happens after we
are born. So there are multiple opportunities to catch up along
the way.
The message in the science is clear. We need a new design
for our schools mapped to the way the brain grows and children
learn, a design that recognizes children as whole people,
values their assets, and supports them to master critical
knowledge and skills and to excel in many different ways.
Whole child design combines five things--positive
developmental relationships, environments filled with safety
and belonging, rich learning experiences so that students
discover what they are capable of, the intentional development
of the 21st century skills, mindsets, and habits that all
successful learners have, and integrated supports.
But when we use each of these five components together in
reinforcing in integrated ways, whole child design will
accelerate recovery from the pandemic, but also promote growth,
learning, and wellness for each and every child at the same
time. This is a context for learning that is greater than the
sum of its parts, personalized, empowering, affirming, and
transformative for each student.
Let us take this idea into the classroom. If educators
teach a math skill like long division, just a skill, some
children will learn it. But if they teach to the whole child,
educators can support students to understand it, be curious to
learn more, and be able to apply it to new situations. Students
will build analytic skills and even discover parts of
themselves they didn't know they had, like maybe I am a math
person after all.
When we ask the question, what can we do that will work
optimally for this child in this context, that question gets
you to fundamentally different answers about the way our
schools and our education system of the future needs to be
designed. This vision constitutes a transformational shift in
the purpose and potential of our learning systems and a shift
in the policies and laws that would constrain this vision.
To conclude, the message in the science and in this
testimony is optimistic. Context shapes the expression of our
development and our genetic attributes. This is the biologic
truth. And schools designed using this knowledge will be able
to see and unleash talent and potential and ensure that each
and every young person can thrive.
Thank you so much for allowing me to talk to you today.
The Chair. Thank you so much, Dr. Cantor, for your
testimony.
And our next witness is Dr. Linda Darling-Hammond. And
again, your full written testimony will be included in the
record, and you are now recognized for 5 minutes for an opening
statement.
Ms. Darling-Hammond. Thank you very much, Chair DeLauro,
Ranking Member Cole, members of the subcommittee, for your
invitation to participate in this hearing. I am honored to be
here today to discuss the Federal role in supporting whole
child practices that can support children's learning.
As Dr. Cantor noted, the latest research for neuroscience
and other disciplines shows that emotions and relationships
influence learning. Positive emotions, such as interest,
excitement, and trust in a teacher, facilitate learning.
Negative emotions, such as caused by trauma, anxiety, or self-
doubt, reduce the capacity of the brain to process information
and to learn.
Students' interpersonal skills, their ability to interact
positively with peers and adults, resolve conflicts, and work
in teams, all contribute to effective learning and lifelong
behaviors.
The Collaborative for Academic, Social, and Emotional
Learning identifies five main areas of social-emotional
competence--self-awareness, self-management, social awareness,
relationship skills, and responsible decision-making. In
addition, traits such as a growth mindset that allow us to
understand that we can improve our work with effort and that we
should not give up when we experience setbacks create
perseverance and resilience. These are skills that employers
say are among the most important for success in work and that
research demonstrates are important for success in life.
As Chair DeLauro noted, and as I describe in my written
testimony, among the hundreds of studies on this topic are
several meta-analyses that show the benefits of social-
emotional learning for students' behavior, school safety,
attitudes, grades, and test scores.
Social-emotional learning is not a specific curriculum.
Just as teachers focus on adding and subtracting in math,
regardless of what curriculum they use, they can focus on
helping students learn to work well with others and manage
themselves in many different ways from many different
curricular starting points.
A recent study from the Fordham Foundation also shows that
parents, regardless of their party affiliation, recognize the
importance of these skills. They want their children to learn
how to set and achieve goals, navigate social situations,
empathize with others, respond ethically, and manage their
emotions. The study concluded that when such programs are
described without jargon, support soars on both sides of the
aisle.
Because of this broad support, all 50 States and DC have
social-emotional learning standards for preschool students, and
at least 18 have standards for K-12 students. Teaching these
skills does not detract from academics but supports it. They
can be folded into all aspects of school, including how
conflicts are resolved on the playground, how students learn to
take a deep breath and calm themselves when something
disturbing has happened, how students develop a growth mindset
as they revise their essays in English class, and how they
learn to collaborate effectively in their science
investigations.
Research also shows that in order to thrive and learn,
children need stability in their lives, good nutrition,
healthcare, and supports when they have trauma, which creates a
toxic stress reaction that affects brain development, physical
health, learning, and behavior.
Even before the pandemic, 46 million children were exposed
each year to violence, crime, abuse, homelessness, or food
insecurity. These experiences, of course, have been exacerbated
by the pandemic, but many States and districts are,
fortunately, investing in community school approaches,
including California, Maryland, New Mexico, New York, Vermont.
These initiatives integrate education and health, mental
health, and social welfare supports. They offer expanded and
enriched learning time. They involve parents and community
organizations and wrapping around children and their needs. A
recent review of more than 140 studies found that well-
implemented community schools support improved attendance,
achievement, and attainment.
As Chair DeLauro has already noted, Congress has reported
many aspects of a whole child framework in its last annual
spending bills. To build on these foundations, I will mention
four things the Congress can do.
First, continue efforts to support States and districts
implementing social-emotional learning and whole child
approaches to education by expanding funding for the School
Safety and National Activities Program and creating competitive
grants to redesign schools around the principles that Dr.
Cantor outlined.
Second, catalyze the expansion of community school
initiatives to sustain increases in additional funding under
ESSA Titles I and IV, among other sources.
Third, increase investments in preparation and ongoing
professional development for educators under Title II of ESSA
and HEA so they can support safe, inclusive, and positive
learning environments.
And finally, promote alignment and interagency coordination
of Federal funds across the 10 departments and hundreds of
programs that are currently administered in a fragmented
manner.
Thank you for your focus on this issue and for the
opportunity to share ideas for a path forward. I am happy to
answer any questions that the members of the subcommittee have.
The Chair. Thank you very, very much, Dr. Hammond.
And our next witness is Mr. Max Eden, research fellow, and
your full testimony will be included in the record. You are now
recognized for 5 minutes for your opening statement.
Thank you, Mr. Eden, for being here.
Mr. Eden. Yes, thank you. Good morning, and thank you all
so much for the opportunity to address this very important
issue.
Social-emotional learning is a burgeoning education
industry. From November 2019 to April 2021, SEL spending
increased by 45 percent to $765,000,000. If it isn't already,
it will likely soon become a $1,000,000,000 education
subsector.
Advocates claim that SEL holds great promise, and on its
face, it sounds like a very sensible idea. But my research has
led me to be more alarmed than optimistic. For four reasons, I
fear that the costs of SEL may substantially outweigh the
benefits.
The first reason, the evidence of the benefits has been
substantially exaggerated. Advocates promote claims like $1 of
SEL spending yields $11 in return. This would be astonishing if
true, but is it really?
A clear-eyed view of the evidence suggests perhaps not. The
2017 RAND Corporation study, which examined the evidence base
for SEL, separated it by tiers of evidence. Within the top tier
for rigorous evidence, no studies demonstrated academic
benefits--academic achievement benefits.
Now, to be sure, there are plenty of less rigorously
designed studies that show positive results. Researchers can
and have retroactively attached the label of SEL onto these
studies, regardless of whether these studies involved what we
now know as SEL implementations and practices.
The merits of these studies can be debated. We can talk
about what conclusions we can and can't draw from them, but
they certainly do not rise to the level of a settled social
science that provides reliable predictive value.
Furthermore, the relevance of this literature may be
categorically questionable because of the rise of what is
called ``transformative SEL,'' and this leads us to the second
cause for concern. The concern is that SEL has become an
ideologically charged enterprise. In 2018 and 2019, SEL was
bipartisan. The notion that schools should help kids develop
competencies like self-awareness and self-management sounded
good to folks on both sides of the aisle.
Back then, however, I was somewhat skeptical of the
sustainability of what seemed to be an effort at values-free,
immoral education. But in 2019 and 2020, the Collaborative for
Academic, Social, and Emotional Learning embraced
transformative SEL, infusing the project with values. Values
derived from the left academic canon, commonly referred to as
critical race theory.
Self-awareness now involves intersectionality. Self-
management now involves resistance. CASEL's documents and its
leaders have openly embraced antiracism. As commonly defined,
antiracism amounts to an essentially totalizing ideological
commitment.
A recent Washington Post article is titled, ``In SEL, the
Right Sees Critical Race Theory'' and pointed to transformative
SEL as the cause. The reason parents see it there is because
they read it there.
Now it is, of course, an open question to what extent those
words and those statements really do filter down into classroom
practice, and it is very hard to draw an immediate
generalization. But parents have a plain facial reason for
concern that what is being called social and emotional could
prove in practice to be political and ideological.
Another big concern for parents is data security. SEL
implementation is frequently accompanied by school surveys that
ask psychological and personal questions relating to students'
mood, family life, and even their sexuality. The more extensive
and sensitive this data becomes, the more valuable it becomes
to potential hackers.
Last month, 820,000 students in New York City learned that
their data was hacked. We should expect more of this as a
matter of structural inevitability, given the increasing value
of the data collected.
Now even if we could perfectly guarantee data security and
also guarantee that no vestiges of political ideology seep into
classroom practice around SEL, there remains a fourth and
probably insuperable concern, and that concern is that SEL in
practice can tend to resemble the practice of unlicensed
therapy. My colleague Robert Pondiscio has addressed this
concern at length in an excellent report, titled ``The
Unexamined Rise of Therapeutic Education.''
Although it may not always be explicit within training
materials, in practice, it does invite teachers to play the
armchair psychologist, identifying root causes of trauma,
providing students with a schema to understand themselves, and
explaining how best to relate to others. In theory and in
practice, it also tends to blend seamlessly with a rising
emphasis on school-based mental health provision.
And while we certainly want students to be mentally
healthy, there are very good reasons why medical ethics
prohibits the practice of unlicensed therapy. Untrained adults
trying to do good can do a great deal of damage. And this is my
overriding concern with the entire SEL enterprise, that when
schools, which are still struggling to effectively teach
reading and math, extend their ambition to embrace the whole
child, they may end up doing more harm than good.
The Chair. Thank you, Mr. Eden.
And now let me ask Dr. Timothy Shriver. And just once
again, your written testimony, your full written testimony is
included in the record, and you are recognized now for 5
minutes for an opening statement.
Mr. Shriver. Thank you, Madam Chair, and thank you, Ranking
Member Cole, both of you, and all the members here.
And Congresswoman DeLauro, I am including in my background
today a picture from your home district from the New Haven
Public Schools taken some 30 years ago with Dr. James Comer in
it because he is my mentor and, in some ways, the founder of
this field.
And then, Congressman Cole, I want you to know that your
questions and concerns are valid, but these faces behind me are
the ones we, I hope, will see most in this hearing today.
I want to thank you, Madam Chair, for your longtime support
for broad, bipartisan education initiatives. Head Start, to
name one, in some ways was a precursor to the field of social
and emotional learning we are hearing about today. Parent
engagement, supports for early childhood development, social
and emotional and academic integration in these early childhood
centers.
In some ways, we are 40, 50 years of trying to figure out
how to capitalize on the broad bipartisan consensus that
emerged way back in the 1960s, and Dr. Comer himself was a
pioneer, and many others, in showing us that children develop
through these malleable interlocking systems that Dr. Cantor
and Dr. Darling-Hammond mentioned that we do not have a choice
between whether or not to support the social and emotional
development and the cognitive development. There is no
``either/or.''
Notwithstanding Mr. Eden's comments about insuperability
and the separation of these things, children--no brain ever
came to school without a body. No mind ever came to school
without wanting to matter. No search for knowledge was ever
disconnected from the search for meaning or importance or a
relevance in the world. There is no such thing as a child that
learns purely cognitively or acquires only information.
The only question we have before us and the only question I
dare say you have before you is how well we will support the
social and emotional development of children? Because it is
foundational, as Dr. Cantor has said and Dr. Darling-Hammond,
the brain science, the learning science, and to common sense.
We know this as human beings. I have seen Representative
Beutler's child there. There is no question--hi--that that
child, like all of us learns in an integrated way.
So the science is not settled. There is no question about
that. This is an early days issue. There is lots of research to
be done. There is every indication that social and emotional
learning is promising, if not effective. Mr. Eden's comments
are fine as far as they go in challenging us to make the
research more effective, but the idea that we have a choice to
turn our back on the work because we have more research to do
is, in my view, unsustainable.
In some ways, all of this comes down to how we support the
day-to-day experiences of children. Congresswoman DeLauro, we
have thought at times, I have talked about maybe we need social
and emotional learning in Congress because what we teach our
children when they have stress is we teach them how to turtle.
We say, you know, put your arms across your shoulders and drop
down into your shell and take three deep breaths, and
experience some positive self-talk and don't react too quickly.
And but you do, when you find it, you can teach this to a
first grader, how to turtle, how to manage stress. And you find
your responses are much more effective. We teach lessons on--
and you learn more, to Mr. Eden's point, and you are more
capable of paying attention, and your brain is more locked in
and your relationships are stronger.
Same thing, Congressman Cole, you brought up these very
important questions about whether this belongs. But when we
think about what it actually is, one of the lessons, for
instance, we teach to high school children is how to disagree
without being disagreeable, which is, in my understanding at
least, an extraordinarily important skill in Congress, right?
How do we disagree in a productive, meaningful way? The
citizens of this country are asking these questions of the
adults in our communities, not just of children. They are
asking it of all of us, not just of our fourth or sixth or
eighth graders.
The last focus group I did with young people about a year
ago, one of the kids said to me, you know, Mr. Shriver, we have
gotten so much better at bullying in our school, but adults are
still bullies. And so, in some ways, this field is seeding not
just the supports for children and learning, but the shifting
of the system that surrounds children and learning so that they
can be attentive to this great consensus that exists in
America.
After the pandemic, I dare say we have a very robust
consensus on the need to support the social and emotional and
mental health of our children. Parents are starving. They are
desperate. They are exhausted, and they are searching. ``Can
anyone help me support my kid? I don't know what to do next.''
Our chance is to answer that affirmatively.
Thank you, Madam Chair.
The Chair. I am on mute. Okay, there we go.
Thank you very, very much for all of your testimony.
Appreciate it, and we will get started with the questioning,
and I will kick it off.
And Dr. Shriver, you made a couple of points in this
direction that I want to ask Dr. Darling-Hammond and yourself,
and in his written testimony, Mr. Eden claims that the evidence
base for SEL has been ``vastly oversold.'' Specifically, he
called into question the validity of research supporting SEL.
Can you both respond to his assertion and speak to the
evidence base supporting social, emotional, and cognitive
learning? Dr. Hammond?
Ms. Darling-Hammond. Well, there is a substantial evidence
base, and the way we think about evidence in research is the
accrual of triangulated evidence that comes from many
difference sources that points in the same direction.
You mentioned in your earlier remarks the relatively famous
meta-analysis of 213 studies that represent 270,000 students
from urban, suburban, and rural schools that was done some
years ago, that found that students who participated in social-
emotional learning programs, that teach those things like self-
management and collaborating with others, showed greater
improvements than comparison students in their social-emotional
skills, their attitudes about themselves and others and school,
social and classroom behavior, school grades and test scores.
On average, across all those studies, averaging those that
measured achievement, an average 11 percentile gain in
achievement scores. But equally important is the fact that in
their school, there was more safety, more affirmation, less
bullying, which all of which also support the desire to go to
school, the capacity to learn well there.
After that, there was another meta-analysis that found that
benefits were sustained in the long term, showing how the
learned skills and attitudes can endure and serve as a
protective factor, both supporting academic success, but also
protecting students from mental health difficulties.
Even more recently, there was a meta-analysis of 54 studies
of classroom management programs that found that all of the
approaches have positive effects, but the most positive, the
most substantial were the interventions that focused on social-
emotional development of students, helping them learn how to be
responsible citizens of the classroom so that that could carry
over into all of their other exchanges.
You can manage a classroom by saying if you do this, you
get punished, and if you do the other thing, you will get
rewarded. And you can also manage a classroom by teaching
students how to be knowledgeable about themselves, aware of
other people, responsible citizens of the classroom. And the
second of those is what lasts into one's life and future.
Mr. Eden noted that the RAND Corporation study did not find
as much evidence of academic achievement, but I want to note
that in that study, they explicitly excluded interventions that
were focused on promoting academic achievement in disciplines
such as reading and math. They intentionally focused on those
that measured social-emotional learning outcomes.
So most of the studies they chose to review did not measure
academic achievement, but they did find that all 60 studies
improved outcomes in social-emotional learning competencies and
also improved safety climate and civil engagement and academic
achievement and attainment in about a quarter of those studies.
And ultimately, the authors of that study were confident
that there were several reasons that schools and educators
should view social and emotional learning as a priority based
on the evidence that they reviewed. So I think that there is
always more research to be done. As a researcher, I will always
say that that is true, but there is a quite substantial
evidence base already that points us in a direction that we can
act on.
The Chair. I don't know, Dr. Shriver, if you want to make a
comment about it? I also would like to try to get in a question
for also Dr. Cantor.
Mr. Shriver. Yes, maybe just very briefly, Madam Chair.
Just very briefly.
Just let me just also point out, because many members of
this committee have also been big supporters of the Special
Olympics movement and the work that Special Olympics does in
schools. Special Olympics has designed, if you will, an
intervention using social and emotional learning foundational
principles--empathy, perspective taking, moral courage,
universal values. The numbers are off the charts when you
invite children into these experiences.
So the kinds of interventions that are using these
strategies--Congressman Cole has been very supportive of this
work--they are common sense American values. I mean, we teach
Jefferson and the creativity of Franklin, and we teach the
resilience of Tubman and the search for justice of Cesar
Chavez. We ought to not just be teaching about those people,
but teaching children to be those people and to have the skills
and qualities and values that enable them to grow and develop
and to be citizens of the country. These are citizenship skills
as much as they are affective skills.
So I would just say that the data is very prominent, Madam
Chair, not just in the core research areas that are being
discussed here because that has all been mentioned here, but
also in the related programs in youth-serving organizations
that are using these principles for very positive outcomes.
The Chair. Thank you both. And what I will do because my
time has expired, I will move--when we move to a second round,
I want to engage with Dr. Cantor as well.
And with that, let me yield to my colleague Congressman
Cole.
Mr. Cole. Thank you, Madam Chair.
Let me just--and I would ask this of each of you, and we
will just move right down the line. Just to help me get a
better understanding, can you provide some examples of the
types of exercises, what they would look like in classrooms to
help students with social and emotional skills? What are some
specific examples of techniques that an instructor would use
with a student?
And I will start with you, if I may, Dr. Cantor, and we
will just sort of move down the line. I think you are on mute.
The Chair. There we go.
Dr. Cantor. So imagine that you give a student a
challenging project, academic project, and they take a look at
this project, and they have this feeling, ``I can't do it.''
And let us say even that they shut down because they are
nervous that they are not going to be able to do it or not
going to be able to do it well. What does the teacher do in
that moment that inspires that child to believe that they can
not only do the project, but do it well?
So the pedagogical techniques of a teacher in that moment
are to recognize how a student is struggling and to be able to
do the thing at that moment that enables that student to
persevere through it. Now you wouldn't call that necessarily by
the label social and emotional learning, but you would
recognize that you are teaching at that moment a student to
have a growth mindset, ``I believe in myself,'' to stick with
it, perseverance; to be able to transfer the knowledge of this
project that you have just succeeded at to other projects. So
your confidence builds that you can do other things.
I think right now the labels could be getting in our way
because I think the universals here are what do we want every
single child to believe about themselves and to be able to do?
I think that is what Tim Shriver said just a few minutes ago.
Mr. Cole. Okay. And if I can keep going, Dr. Darling-
Hammond, what would be, again, some of the techniques that in a
practical sense somebody would use in a classroom?
Ms. Darling-Hammond. Well, one of the things that a lot of
teachers use in a classroom is group work. Students get
together, and they have a project or an activity or an inquiry
that they are going into. And to do that effectively, there are
specific ways to engage in that group work that allow students
to take roles that will allow them to figure out who is doing
what, to be respectful to one another. So it would teach
specific ways to listen and to respond to each other, to be
sure people are included.
Those--all of those skills of group work and collaboration
are the social-emotional learning skills that teachers will
teach in the context of helping kids do the academic work much
more effectively. We have probably all had experiences of bad
group work and good group work, and the difference is whether
those skills were taught in the process.
Another one would be conflict resolution. Things come up.
Somebody took somebody's pencil, or something happened on the
playground. So teaching students ways to stop, listen to each
other, express their feelings or their views, and come to a
resolution--and there are some specific strategies that people
have used across schools to do that--is another example of
teaching those skills that will go on through the classroom and
into life with those students.
Mr. Cole. Well, to Dr. Shriver's point, we have plenty of
examples of bad and good group work in Congress. [Laughter.]
The Chair. Amen, amen.
Mr. Cole. And I would say our recent omnibus was good group
work. So, thank you, Madam Chair.
I don't have a lot of time left. Let me go quickly to you,
Dr. Shriver, and then to you, Mr. Eden.
Mr. Shriver. Yes, well, first of all, thanks, Congressman
Cole.
I mean, look, again some of this is common sense. I will
just give you one good example on the conflict side of things.
So being able to disagree without being disagreeable
assumes a series of skills that kids can learn. One of them is
how to presume positive intent.
So Mr. Eden and I currently don't necessarily agree on all
of these things, right? But we have spent the last 5 to 7 years
as progressive and conservative-leaning educators, trying to
learn how to presume positive intent. So that as I listen to
him, I feel like I am trying to train my ear and my mind to
identify what about his intent I can see is really in the
interest of children.
I am just using this current example because it is right in
front of us, right? So presuming positive intent is very
powerful for kids, and it is a lifelong skill. And you can
teach it.
Sorry, I am over time.
Mr. Cole. Madam Chairwoman, can I----
The Chair. That is okay.
Mr. Cole. Is it okay just to give Mr. Eden a quick chance
to add?
Mr. Eden. Yes, very quickly. I mean, one common technique
is the technique of role-playing for conflict resolution,
conflict management. The question of what is being played with
in these roles is an important question. And just from this
week talking to some educators, I came across an example of a
school counselor doing role playing with middle school students
on how to break up with a boyfriend or girlfriend.
This raises many questions about kind of the appropriate
role for adults vis-a-vis students in guiding romantic
relationships and is part and parcel of what I fear, with very
good intent, Dr. Shriver, could be an encroaching and then
passing over a boundary that parents would not want adults
speaking to their students about, would not want adults
training them with positive intent in for fear that what will
be trained would not align with their values.
Mr. Cole. Thank you very much.
Thank you for the indulgence, Madam Chair. I yield back.
The Chair. Sure. Thank you. Thank you.
Mr. Pocan? And let me mention this, Mr. Pocan. I am going
to jump off to do something in Mil-Con, which is meeting at the
same time, and get back on. So asking you to take the gavel and
to chair.
So, Congressman Pocan.
Mr. Pocan [presiding]. Absolutely, Madam Chair. Thank you,
and thanks to our witnesses.
Especially good to see Dr. Shriver. Obviously, you know I
am a big fan of Special Olympics and all the work you have done
there. So, thank you.
Mr. Shriver. Yes, sir. Thank you.
Mr. Pocan. I think my biggest question, you have talked a
lot about the effect on students, and one of the problems that
I am hearing, you know it is a national problem in our
districts, is teacher retention. Between some public policy
attacks, the last couple years under COVID, a number of
factors, we are having a hard time keeping teachers. We have
had very good applicants for some open positions, including in
the biggest city in my district, in Madison, Wisconsin.
I am just wondering how teachers look at this and if this
could be perhaps something to help stop the slide of decline
that we are having on teacher retention. So maybe for the three
doctors if you could each----
Mr. Shriver. I think Dr. Darling-Hammond is--oh, sorry.
Ms. Darling-Hammond. Maybe I will kick off because it is an
area I have spent a lot of time on.
Mr. Pocan. Thank you.
Ms. Darling-Hammond. Yes. The use of social-emotional
learning strategies actually has been found to support teacher
retention in work that has been done on that because as the
classroom and the school become more calm, more safe, more
organized, and managed through the use of those programs,
teachers get the benefit of a class that is easier to teach.
They also learn strategies that help their social and
emotional learning and confidence, which makes them more
efficacious in their work, and they can benefit themselves by
developing those strategies to maintain calm and to be able to
focus their attention in the right ways. So it is a very
helpful piece of the puzzle with respect to teacher retention.
Right now, a lot of kids are coming back to school having
experienced trauma with dysregulated behavior that is a result
of that, and it is especially important for what teachers and
other educators are experiencing right now to have these
supports.
Dr. Cantor. Another example that I could add to this is a
district that I happened to be visiting yesterday. It is
outside of San Diego, El Cajon, and what was described to me
was that this is a district with a waiting list of teachers who
want to work there.
So when you dig into why, why does this district have a
waiting list of people who want to work there? Underneath all
of that is the culture, the culture that is district wide that
is modeled by the adults and, therefore, also modeled by the
kids.
So there is a very, very powerful effect, and we know this
in other fields. The connection between culture and the
satisfaction of employees and their retention.
Mr. Pocan. Thank you.
Mr. Shriver. And Mr. Pocan, I will just one slightly, well,
related point. The great longitudinal study that some of you
may be familiar with, the Grant Study, which studied what leads
to happiness in life, you know? Now I think we are in the 80th
year of the study.
The current principal investigator, in fact, Robert
Waldinger, concludes that after millions of pages of data, they
can conclude one thing, that the quality of the relationships
is the only thing that matters to quality of life.
This work is designed to strengthen the relationships not
just for kids, but for teachers. Most of us went into teaching
because we care so deeply about children. Yes, some of us love
the Civil War or Shakespeare or poetry or language arts or
whatever, the periodic table. But most of us went into it
because we wanted to connect with kids.
And when those relationships are broken and tense and
fractured and angry and hostile, burnout is inevitable. And
then when you add to that the layers of political conflict and
aggression from outside forces, it is overwhelming. All right?
You just can't survive it.
But when the relationships are strong, my goodness, you
know, you find what you came there for, if you will. So just at
a very basic level, if you can imagine work that helps teachers
strengthen the quality of their relationships with children is
almost directly related to the quality of their capacity to
want to stay in the profession.
Mr. Pocan. Great. Thank you.
And I have 35 seconds, I don't know if one person could
answer, and I know this is a longer question. But is there any
kind of one type of student that benefits most? I know I can
clearly see benefits for every type of student, but is there a
type of student that benefits the most?
Ms. Darling-Hammond. Well, I would just----
Mr. Shriver. I will take that one. Oh.
Ms. Darling-Hammond [continuing]. Go ahead, Tim.
Mr. Shriver. I would just say the answer is this is about
every child. This is, yes, there are children who benefit in
outsized ways, but this is just good child development. It is
for every child and, therefore, really for all of us.
Mr. Pocan. Gotcha. Great. Thank you, and we got it down to
the perfect timing. Appreciate it.
Next up, I have Representative Harris. You are recognized
for 5 minutes.
Mr. Harris. Thank you very much.
And Mr. Eden, I would like to delve a little bit into your
testimony because it is interesting. You know, as a physician,
we always look at the quality, these internal and external
validations, the quality of the study and then whether it is
actually appropriate to what we are thinking about. And when we
do Preventive Services Task Force, you rate things good, fair,
poor, and then you base your recommendations on that.
So, first, it is very concerning to me that none of the
studies that have shown a benefit are highly rated. That is,
and we learned during COVID that we know the quality of
scientific information is very important. So as we approach a
$1,000,000,000 industry, it is very concerning that there are
no high-quality studies, apparently, that show a benefit.
So is that--basically, is that what your testimony
suggests?
Mr. Eden. My testimony suggests that the kind of randomized
control trial, the gold standard, what physicians recognize as
proof-of-concept, are far fewer. They are fewer and farther
between than what we are being presented, which is meta-
analytical results, right?
Mr. Harris. Sure.
Mr. Eden. This meta-analysis that is frequently referenced
that has I think 215, 213 studies----
Mr. Harris. Absolutely. And again, I understand, and it
appears that the vast majority of those, if not all of them,
are not the highest quality. And then you are making
conclusions based on relatively poor data, and this is the
whole--again, the whole purpose behind the U.S. Preventive
Services Task Force is to look at quality of data, sir.
Now of particular concern is the external validity, which
is to say that in a medical treatment if you actually change
the type of treatment or slightly modify the drug, then looking
at past studies of the past therapies and then trying to
extrapolate into the new version is absolutely scientifically
invalid. I mean, it is just, look, it might be true, but it is
scientifically invalid to extrapolate.
So your observation, which I think is borne out with what
is going on at the school level, of a radical change in what
SEL was all about occurring in the last 3 years is very
worrisome.
For instance, we have a--and this is from my State because
you actually mentioned the Parents Defending Education, I guess
the name of the organization. You go to their website, and this
is in my State, a third grade elementary school instruction
team leader and Rainbow representative in that school system
sent an email to colleagues full of excitement about plans to
incorporate LGBTQ within our elementary curriculum, explicitly
stating this would be integrated during SEL time. Well, now the
Florida law looks more important when you have a third grader
being taught LGBTQ during SEL time.
So this is kind of the camel's nose under the tent. I
understand CRT. I didn't understand its extrapolation and other
things into SEL, which is something we have to be very cautious
about because, of course, the North Harford Public School
System, again Parents Defending Education website, has gender
literacy embedded in their SEL elementary school curriculum.
Like, I am sorry, we need to--and last, but not least, I
want you to comment on this idea that we are urging--and an
important part of this is to urge students to be community
activists. Because in my district, we had a major problem a
couple years ago when one of our school superintendents urged
her students in the system to attend Black Lives Matter
rallies--now, remember Black Lives Matter is a--was an
institution founded on Marxist principles. To somehow, without
putting it in full context, urged students to attend Black
Lives Matter rallies.
Now is that the kind of community activism that you see
creeping into the new definition of SEL that CASEL is
promulgating?
Mr. Eden. It certainly can be. When you look at CASEL
documents, they say that they want a commitment to antiracism,
which, as I said, is an ideological doctrine. They said they
want justice-oriented citizens, which obviously begs the
question that we know what justice is.
And I would like to just briefly draw attention to
something Dr. Shriver said, which I think was offered with the
best intent, but falls on other ears is very alarming, right?
The question of meaning and the question of whether schools
should be in the business of providing students with meaning.
And then the question of, well, what meaning will the school
tell students their lives have?
And these concepts blend very, very subtly, right? You have
a buzzword like SEL. You have studies of various quality that
you use to validate it. You fill the buzzword with any given
concept, and you don't know. It is very hard to tell how
widespread is it that SEL is being used as a Trojan horse, but
the vector by which it can be is clear, and there are examples
of it. And it is not--it is not--it is not of a piece with the
rest of what we are hearing in this testimony from other
witnesses.
Mr. Harris. Thank you very much. We just got to get back to
reading, writing, and arithmetic.
Thank you. I yield back.
Mr. Pocan. Thank you, Representative Harris.
Representative Frankel, you are recognized for 5 minutes of
questioning.
Ms. Frankel. Yes, thank you. Good morning. Thank you to the
panelists.
Well, I want to say I am glad there has been a lot of
research on this, but I will just tell you, my common sense, as
a mother and a grandmother--and I have been around lots of
little kids my entire life and so forth. I can just say there
is no question about the importance of a healthy emotional
development.
And right now in Broward County, which is just south of me,
there is the death penalty phase of someone who killed dozens
and dozens of people in the Parkland shooting, the perfect
example of a young man who did not have good emotional
development. Now that is an extreme case, but I want to talk
about my home State of Florida because, I am telling you, we
are in a race with Texas for the craziest governor in
legislature, in my opinion.
And so let us see what they did this year. Just to let you
know, affordable housing has gone up. Flood insurance has gone
up. But that wasn't dealt with. But they did do this. They
enacted the ``Don't Say Gay'' bill and banning critical race
theory.
And I--even there is no such thing as teaching critical
race theory, but what the ban on--the ``Don't Say Gay'' bill
bans any classroom discussion on gender, gender identity, and
sexual orientation in grades K through 3, if there is any
discussion that any parent might find inappropriate in grades K
through 12, or the teachers are just all gagged up now in
Florida. I would like to have any of the panelists, if you
wanted to comment on this in terms of what that--is the
potential threat for our children?
Dr. Cantor. I would like to comment on that. One of the
things that we know from many, many, many studies on positive
youth development is that kids will struggle to learn and focus
if they do not feel safe physically, safe emotionally, and
frankly identity safe. When kids are ``othered,'' you are
setting in motion a process by which bullying can be promoted,
where kids will walk into school and be afraid that they and
their identities and their cultures are not welcomed and not
affirmed.
So there are a couple of problems with that. One, it
produces fear and anxiety walking in the school door. Second,
when kids are anxious and fearful, they can't concentrate. And
then, on top of that, you are not giving the classroom a
language for tolerance, for being able to know how to behave
around people that are different than you.
So citizenship, something that we prize in this country,
has a great deal to do with experiences with people that are
different than us.
Mr. Eden. Yes, I can----
Ms. Frankel. Yes, go ahead.
Mr. Eden [continuing]. I can make a couple of comments on
it.
I mean, that obviously was not the name of the bill at all.
It was the Parental Rights in Education bill, and I have seen
polling that suggests that the majority of Florida Democrats
agree with it. They agree that it is not appropriate to teach
sexuality, gender, gender orientation, and sexual orientation
to 5- to 9-year-olds.
This is not something that we have historically done. And
frankly, the best argument against the bill was this is not
something that we are doing, but as Mr. Harris and I were
discussing, this is something that can start to happen under
the guise of SEL and raises profound questions about how
developmentally appropriate it is to be teaching about gender
identity to kids who believe the tooth fairy is real? Do we
really know that this will help?
Do we have any studies whatsoever to suggest that this is
in their best interest over the long term? I would be very
interested in reading them. I don't believe it has. This is a
very novel development.
And I think when you have most Democrats supporting the
bill, I----
Ms. Frankel. But, Max, I would like to--listen, most
Democrats do not support it. Most normal people, if would they
understand and then be able to have discussion other than a 10-
second poll.
But I would like to see if any of the other panelists would
like to respond to your comments? And I thank you, Mr. Eden. I
do appreciate your point of view. I don't agree with it. But
would any of the panelists like to respond to that?
[No response.]
Ms. Frankel. Okay. They have given up. But anyway, thank
you very much. It was an interesting discussion.
Be careful when you go to Florida. You know what not to
say.
I yield back.
The Chair [presiding]. Okay, thank you.
Let me thank Congressman Pocan for stepping in. I really
appreciate it.
And let me now recognize Congresswoman Herrera Beutler. And
who is our little friend here?
Ms. Herrera Beutler. Oh, I was begging my husband to lock
them all out.
The Chair. Oh, God, no. No, no, no.
Ms. Herrera Beutler. They are driving me batty. I love
them, but----
The Chair. What is his name?
Ms. Herrera Beutler. That one was Ethan. Ethan that is my
5-year-old.
The Chair. Okay, lovely. That is great.
Ms. Herrera Beutler. Thank you. I appreciate that.
I can so relate with parents and pandemics and academics
and social and emotional well-being because in our house as it
implodes on a daily basis. So I find this a really interesting
conversation, and I have some questions.
Although just if I put--take my lawmaker hat off and I put
my mom hat on, I will tell you one of the reasons I think
parents are so attuned to these conversations and what
policymakers are discussing is because even just the, I don't
know, I feel like lack of just comity or graciousness with
which we are addressing some of these things causes me to say
``gosh.'' And these are--I mean, look, we are doctors and
Members of Congress and chairs of--right? These, in theory, are
the highest levels of attainment in our society, and yet we are
having major disagreements. And if we disagree, rather than
disagreeing, we are like digging at each other.
And so, when I look at that, I think how in the world could
I expect an educator with a ton of kids in her classroom, and
all those kids are like my kid, who I am like ``Just sit still.
Just, for the love of God, sit still.'' I just think that is
part of why I do have a lot of questions about whether there
is--so even if everybody agreed on what the curriculum or the
teaching here was, whether there is the infrastructure to do it
in the way that it is being proposed. So there is just a lot
of--this raises a lot of question.
I mean, obviously, my observation is we are all striving
for the same thing. We want our children to be poured into, to
be nurtured, to learn how to do--the rigor of academia, to be
able to compete on a global stage, right? They are not
competing against kids down the street like I was. They are
competing with kids in China and India who are hungry for
achievement, and our kids are dealing with parents who can't
decide what the classroom structure should be.
And I really wonder--I think we are wanting to do the right
things, but sometimes I question whether we are going to--
whether we are going to put aside our personal feelings about
some of this and do what is in the best interest of kids, which
is why I know all of you, as you have gotten into this line of
work, why you have done it, because that is your heart.
I wanted to ask--I was really--and maybe this is for Dr.
Cantor. And Mr. Eden, I think you probably also will have some
thoughts on this--about the ability of teachers within the
classroom to address the mental health issues that we know are
there. When I talk with my educational--my directors, my school
boards, they will tell you the number-one thing to worry about
right now is the mental health of their kids. They can't even
get to the academics because the mental health is in a pretty
crisis state.
One of the concerns I have is how do we get them into
mental health services, and do we think teachers really can be
trained to do this? And do we want them doing it? I have
educators who would tell me they don't.
And maybe for both of you? I would like to hear both of
your comments on that. Dr. Cantor, could we start with you?
Dr. Cantor. Sure. One of the questions that I was often
asked when I was practicing as a child psychiatrist, which I
did for about 20 years, what is the active ingredient of a
therapy? Okay, is it all the things I studied in medical
school, or is it the experience I am having with the child in
the moment in my office as I build trust with them, as I build
a relationship with them?
So if I were to say to you what can a teacher do on behalf
of the emotional well-being of every student, it is to support
knowing them, caring about them, and really having a classroom
in which every child feels known, loved, and connected with.
Now you can do that in different ways because I have also
had teachers say, ``How can I have a relationship with 30
kids?'' Well, okay. Very, very challenging. But there are
advisories, there are structures that can be put in place.
There is even group work that Linda was talking about where a
student can feel known, cared for, and loved.
Relationships are the greatest preventive mental health
intervention that there is, and they are also great for
learning. So that is the no-brainer here. That is what I would
say is in the province of teachers.
Ms. Herrera Beutler. Thank you, Doctor. Mr. Eden?
Mr. Eden. Yes, I think the distance between the studies
that we have of programs that may or may not have been reliably
evaluated and what really happens, as you said, is huge.
Frequently, what happens when I talk to teachers is, oh, we are
supposed to do SEL? Okay, let us go to Google. Let us go to
Pinterest. Let us find some things that are labeled SEL, and
let us try them.
Vast difference between whatever we might have validated
and what is actually happening under the skies, and I have also
talked to a lot of teachers who have said, ``I just want to
teach. I don't want this burden on my shoulders. I am not
trained to do this.''
Suicide prevention. That is not--what if it goes wrong?
What if we are acclimating them to these thoughts?
I think that there is a large sentiment in teachers that
just let us teach. Don't make us do more than we are already
doing.
Ms. Herrera Beutler. Thank you all very much. Appreciate
it.
Yield back, Madam Chair.
The Chair. Thank you. Congresswoman Watson Coleman.
Mrs. Watson Coleman. Thank you very much, Chairman and
Ranking Member Cole. Thank you for this. It is really
interesting. I am learning a lot, and I know I don't know a
lot.
Dr. Shriver, let me just tell you, you said something that
really stirred me, and that was presuming a positive intent
and, therefore, presuming a positive outcome.
I am really--I want to know, first of all--first of all, I
kind of agree that this is more of an approach of a teacher,
how you teach, how you interact, and how you help students
develop than it is actually being a thing that you set aside an
hour a day and work on.
I want to know, are students who are being taught to be
teachers now being taught this as a sort of a method of
teaching, an approach to teaching? Dr. Shriver, do you know?
Mr. Shriver. Yes. Yes, well, I will yield to Dr. Darling-
Hammond, whose scholarship and work in the field of teacher
education is legendary around the world.
Mrs. Watson Coleman. Okay.
Mr. Shriver. I will just say that when I was training to
teach, the answer was no. I had in three degrees in education
one class in child development, which is backwards, right? It
is indicative of a system that doesn't see the child as the
primary goal. It sees information as the primary goal. You
don't, as I said earlier, have to choose.
The next generation of teachers we believe the essential
reform effort, if we can call it that, will be to equip
teachers with intensive understanding of child development not
so that they can get embroiled in political disputes, but so
then they can adapt behavior--as Dr. Cantor said earlier--to
the situations, context, the pedagogy, the skills necessary to
help a child go from A to B in terms of their learning.
Dr. Darling-Hammond, I go to you.
Mrs. Watson Coleman. I am watching the clock. Thank you.
Thank you.
Ms. Darling-Hammond, do you have anything you want to add
to that?
Ms. Darling-Hammond. I would simply say that there is a lot
of work going on right now to infuse this kind of knowledge
base in teacher education and in leader preparation. Those are
equally important, and those are areas where congressional
investment could be helpful.
Mrs. Watson Coleman. Are we investing in current teachers
to sort of bring them up to date in this sort of holistic
emotional and, what do you call it, social and emotional
learning sort of paradigm into their--the way they teach? Are
we supporting that sufficiently? Do we need greater investment
in it?
Ms. Darling-Hammond. We invest very little in educator
preparation programs in this country from the Federal level,
and there is a need to kind of move the curriculum of teacher
and leader preparation programs to accommodate the science that
has been developed around how people learn and ensure that that
knowledge base gets to them, just in the same way as we do in
medicine and that we do in other professions.
Mrs. Watson Coleman. So I talk to you as a grandmother of a
beautiful black 9-year-old, and I want to talk to you as a
black person. The one thing I want is for children,
irrespective of their race, their color, or whatever, to feel
equally valued, to believe that they are as great and as
accomplishable as anybody else. I also want those that are not
black or of color or different to embrace the differences that
they see as opportunities and not as a negative.
And so I am wondering, and Dr. Shriver, maybe in my few
seconds left, you could tell me how we approach SEL to ensure
that there is this equity, this appreciation that we overcome
this sort of over-disciplining of black kids in schools, that
we help them all to determine the outcome of disagreements in
less disagreeable ways, how we can minimize the bullying, et
cetera.
I am very concerned about what is happening in our schools
and the kind of political pawns schools are being made under
these false pretenses of teaching CRT or whatever. It is
ridiculous. It is sickening, and I want to know how we overcome
that with approaching the SEL.
Dr. Shriver.
Mr. Shriver. Thank you. Thank you. I am not sure I am the
best to comment on it, but I will just mention very briefly
that you mentioned discipline practices that have been
disproportionately punitive toward children of color.
But discipline practices, again, this is back to the
earlier question, that have been not so successful for any kid.
We put too many kids out of school. We suspend kindergartners.
I mean, these are not good strategies for promoting
development.
So we have got things, strategies we call restorative
practices. Some people don't like them as much as others
because they think they are too lenient. But we can create
discipline strategies that are not designed to segregate and
eliminate children from the system, but rather to keep them in
the system and help them heal.
Mrs. Watson Coleman. Thank you.
Madam Chairwoman, thank you for the indulgence. I do hope
to get a second reading opportunity here because I want to
explore this beyond just the issue of discipline.
So, thank you. Thank you, Dr. Shriver.
I yield back.
The Chair. Thank you. Thank you very much.
Congressman Cline.
Mr. Cline. Thank you, Madam Chair. I want to thank our
witnesses for being with us and for the interesting
conversations that we have had.
I have learned a lot as well, and I want to reflect the
comments of Congresswoman Watson Coleman. I found it really
interesting. I am learning a lot and don't know a lot. And that
is why Members of Congress are probably in the least
appropriate place to be making decisions about the allocation
of hundreds of millions of taxpayer dollars for educational
purposes.
I was in the State of Virginia House of Delegates for 16
years, and we were much more involved in making educational
decisions about the content, about the standards of learning in
our schools, about the standards of quality in Virginia
schools. But recognizing that much of what was taught and much
of what was decided was best left to the local level, local
school boards, and to parents, ultimately, as they make the
decisions.
As I was in the State House for 16 years, I remember when
No Child Left Behind was passed, and the negative reaction not
just on the part of State legislators at the infringement over
the prerogatives of States to decide how best children should
learn in their States, but with parents who were upset about
teaching of Common Core and different concepts that were being
pushed down on localities and on parents by an overarching
Federal education bureaucracy being run out of Washington, DC.
And so I associate myself with the comments of many
colleagues on my side who are questioning the role of the
Federal Government in this process, and quite frankly, I am
falling back on my old Ronald Reagan line, ``Here we go
again.'' Because this is a perfect example of what happens when
the Washington bureaucracy creates a means by which you can
hijack local instruction and use it to push overtly political
social and emotional engineering down on students on a national
level.
So I will ask Mr. Eden, at the very least, with this
radical ideological being taught more regularly in schools, do
you believe that if there is more transparency and if these
topics are being discussed, that parents can be made aware of
what is being taught and should be made aware of what is being
taught in their child's schools?
Mr. Eden. I think they can, should, and must, right? I
mean, structurally, what SEL can do is come down as a mandate
that you kind of fill these categories of instruction, ways of
approaching children. That could be filled with
unobjectionable, positive things or could be filled with things
that many parents would object to.
And parents have a right to kind of know what is coming in.
If it is objectionable, they should be able to speak from an
informed perspective to what they object to. And if it is not,
they should be put at ease that, hey, actually in my district,
SEL doesn't do all these things. SEL is still kind of what it
primarily involved 5 to 10 years ago.
But parents can't know that unless they know that. And
local government doesn't work unless parents know what is going
on at their schools.
Mr. Cline. Well, I know that in one county in Virginia,
Loudon County, they were requiring parents to sign
nondisclosure agreements before they could review curriculum in
those Loudon County schools. And there has been an earthquake
in Virginia politics over the last year, and it has been
centered around parental rights.
Our new Governor, Glenn Youngkin, has put that at the
forefront of his administration and is pushing for more
transparency in our schools. I would look to Ohio, where they
have a Parents Right to Know Act that provides for full
parental curricular review and opt-in by the parents, not opt-
out.
So I think there are opportunities there, but they should
be taken at the State level. They shouldn't be mandated at the
Federal level unless you are talking about openness and making
sure that parents are ultimately the ones who have the control,
who have the responsibility, and not, again, a bureaucracy from
DC pushing a certain mandate down on localities.
Mr. Eden, can you speak to how social and emotional
learning may infringe on the privacy of students and families?
Mr. Eden. Yes, I mean, the story that you gave from Loudon
County, if I recall correctly, it was about access to a school
survey, in addition to curriculum. What questions are kids
being asked? Asking questions is not an inherently neutral act.
What is being done with the question that is being asked might
not be neutral.
When you ask students very personal questions to find out
things in order to affect them, that is an invasion of privacy
technically, and I think there is a role the Federal Government
could play in shoring up parental notification, kind of shoring
up the People's Protections Rights Act so that parents don't
have a situation where they don't know what their kids are
being asked and don't know what is being done with what they
are being asked.
Mr. Cline. Thank you. I yield back.
The Chair. Thank you. And I would hope at some point, our
other witnesses will get an opportunity to speak to the issue
of what is being done at the local level in a variety of
States, which is under their own jurisdiction and the efforts
that are being made that is not a Federal mandate.
Let me recognize Congressman--I have to move on to
recognize Congresswoman Bustos, but we will get to your point.
Congresswoman Bustos.
Mrs. Bustos. Thank you very much, Chair DeLauro, and thanks
for holding this hearing today.
And I am going to get hyper local here, okay? So, Dr.
Darling-Hammond, I am going to address my first question to
you, but let me have a little bit of a lead-in, okay?
I held a series of economic roundtables throughout the
district that I serve in Central and Northwestern Illinois. I
have done this for a number of years, and the more recent ones,
you know what I heard about at every single one of them? It was
about teacher shortages, okay? Hyper, hyper local here.
So, so what I did, then I made a decision to bring together
teachers, teachers aides, administrators, so we could drill
down and have a deeper conversation on this issue. And you know
what came up at every single one of them at the local level?
Social-emotional learning.
All right? So there you go. It is local.
So, but part of it, I am going to drill down then even
further about teachers, specifically. Do you know what happens
when we don't pay teachers enough or if we don't provide a
supportive environment? People don't become teachers.
Or if they do become teachers and we are not supportive or
they are overworked and underpaid, they leave. And when they
leave, we are losing staff members, and we are losing this
experience. And that all takes a toll on our kids. So, again,
drilling down further, that takes a toll on our kids.
So our schools really, as I see it, aren't equipped to
provide our students the whole learning environment that they
need. And as a result, students suffer.
So teacher shortages were worsening pre-pandemic. We knew
that. We have all seen that. And they have been made even worse
by the pandemic.
So, again, Dr. Darling-Hammond, can you please talk about
the measurable impact of teacher shortages on the academic,
social, and emotional development of children? And touch on how
the pandemic has affected these issues as well.
Ms. Darling-Hammond. Well, we know that teacher shortages
result in several things. They result in several things. They
result in courses getting canceled. They result in larger class
sizes because you can't hire enough teachers. Or they result in
people being hired into the classrooms who don't have training
to teach, and that happens at a large level. It happens
disproportionately in higher-need settings.
But I will say, for example, in California, about half the
people coming in to teaching in the last few years have been
coming in without preparation. And that means that they are
coming in not knowing how to teach math and science and
reading. It also means that they don't have the tools to
understand child development. And quite often, the
disproportionate disciplinary actions and problems like
managing a classroom also bubble up.
So children are underserved when there are teacher
shortages in substantial ways. And just to kind of loop it back
around to the questions we have been talking about, one of the
things that we need to keep teachers in the classroom and to
give them that support is the set of wraparound supports that
community schools and other whole child education strategies
can offer, which a number of districts and States are looking
into and that Congress has begun to support.
When you have health and mental health services there in
the school, when you have the social services to help kids,
then teachers can create a much more positive environment, and
they can help kids get what they need.
Teachers burn out also when they can't help kids, when they
can't meet all of the needs that they see their students
presenting because they want--that is why they are there. And
if we wrap around the teachers and the students with these
kinds of supports, you will see a much better result with
respect to teacher retention and student learning.
Mrs. Bustos. Very good. Thank you.
I am going to try to squeeze in a last question here in the
last minute.
Dr. Cantor and Dr. Shriver, if we have time for this, this
will be addressed to you. We have seen this siloed approach to
addressing certain elements of childhood development. So the
whole child approach obviously is important towards breaking
down these silos. With developing children's physical, mental,
social support all together, we are able to create a more
supportive learning environment and be able to address these
social disparities that we talked about today.
But the approach of breaking down the silos and addressing
disparities is really we see it as central to addressing social
determinants of health, and I know Chair DeLauro knew I would
try to squeeze this in. She has been incredibly supportive, as
has Ranking Member Cole, in a bill that I have called the
Social Determinants Accelerator Act.
We have got grants in that that look to empower communities
to tailor their approach to addressing these local disparities,
which may include better incorporating educational initiatives
like the whole child program.
I am out of time now. I guess I plugged my Social
Determinants Accelerator Act, and I guess I just want to make
sure that our panelists know about this, and we will have to
talk about this offline at another time.
Thank you, Chair DeLauro, for all of your support of such
an important measure, and thanks for holding the hearing today.
I yield back.
The Chair. Thank you. Is Congresswoman Lee on?
[No response.]
The Chair. Okay. I guess not. And then what we will do is
to move to a second round. And I don't know if--Congresswoman
Bustos, and thank you for getting in the social determinants. I
knew you would, but I would also like to have people respond to
you because these are really experts in the field.
Let me, I think, as Mr. Cole has had to go to the Rules
Committee, so let me ask about community schools. This is an
issue that you have some familiarity with. You had one of the
first in the Nation in New Haven, the Dr. Harry Conte Community
School, which I spent a lot of time working at and
volunteering, really volunteering time there.
So, and I wanted to ask you, Dr. Cantor, Dr. Darling-
Hammond, and Dr. Shriver, I want to ask you the question about
how the community school model can play a role in really
disrupting the effects of poverty so that our most vulnerable
kids can learn and they can thrive. And if you will, let you
talk about, Dr. Cantor, the positive environment in which kids
can thrive in community schools in this space. So let me ask
the three of you to respond.
Dr. Cantor. Thank you for giving me the opportunity to talk
about this. I am actually on the current task force for
community schools and in this next generation.
First, it emphasizes the point that Congresswoman Bustos
just mentioned, and that is that health and mental health and
well-being are essential determinants about kids and their
ability to learn in school. And we have known this forever.
And in the first generation of community schools, the big
focus was access. Have the services in school and have those
services easily available to parents, particularly parents who
work, and to take the stigma out of many of those services,
particularly mental health services.
But now community schools is doing something more. Okay, I
spoke about whole child learning and the fact that integrated
supports are an essential component of the five components of
whole child learning. So the new focus of community schools is
actually to connect the activities in support of kids, whether
they are health and mental health, and learning, engagement in
learning, in enhancing motivation, enhancing energy, and
putting kids into a position where they can feel the full power
of their capacities to learn and engage.
So the new generation of community schools is not even just
about supports. It is about supports in service to powerful
learning for each and every child.
The Chair. Dr. Darling-Hammond.
Ms. Darling-Hammond. I will just piggyback on that. I will
just say California has just invested almost $3,000,000,000 in
getting community schools launched in our highest-poverty
schools. And about a third of our schools have more than 80
percent of students who live in poverty.
And what does that mean? It means to us that in these
schools, we will have health clinics and mental health supports
and mental health professionals. The health clinics will be
sure that kids get the kind of healthcare that many of them
don't get, that they get vision testing and hearing testing and
all of the other supports.
But it will also mean that they get expanded learning time,
that there will be tutoring after school, that there will be
support for after school homework, for mentoring and a variety
of other recreation and enrichment activities for students.
It will mean that they will be able to get support from
social service providers. If a family is about to be evicted,
we have a high homelessness rate all across the country for
children, but certainly in my State. And the facilities to help
families in those regards will be there. All of these things
remove obstacles to learning.
And then we need inside the school for teachers to have
enough knowledge base about how to recognize the needs that
children have to connect them to those services that will be
readily available, and that can be transformative to the
teaching and learning process and for the retention of
teachers, as I mentioned.
The Chair. Dr. Shriver, I am going to go over my time
because I want you to have the opportunity to talk about some
of these schools because I think we have similar experiences.
Mr. Shriver. Yes. Well, having also worked at Conte school,
Congresswoman DeLauro, I think we know--again, I think there is
not a really controversial issue here. I mean, there has been a
lot of discussion on this hearing about Federal versus local.
This is a movement that started as a local movement. It is not
a top-down movement.
I mean, I don't want to disillusion Members of Congress,
but this is a movement that has been built by parents and
teachers and educators for the last 30, 40 years by communities
that wanted to add tutorial services, that wanted to support.
So I think we have like much more agreement here than we
realize.
Parental engagement. Absolutely. The picture, again, behind
me, Dr. Comer. First pillar of this work is parental
engagement. I would agree with all the members of this
committee and all the witnesses in saying that parents are
completely critical and need to be in community schools and
need to be valued and listened to and disclosed to in community
schools.
The resources that children need are at the community
level. They are not at the Federal level. So I mean, maybe
there is a specter of a Federal takeover, but count me as a
person not in favor of it. I am completely in favor of
empowering parents and local communities to be at the center of
all this work.
So I will stop there.
The Chair. Before we go on, let me just mention this. Just
piggyback on what you said, Dr. Shriver.
It was--I am just trying to think--it was in the 1960s at
the Dr. Harry Conte Community School, and I had just finished a
graduate degree at Columbia University. It may have been 1965,
1966, and I didn't have a job. So I went to volunteer my time
at the Conte school. It is a community school.
And by the way, the initiation of community school and that
concept came from Dr. Gerald Tirozzi, who wrote his doctoral
dissertation in Ann Arbor about the role of community schools
and locally what community schools could mean. That school was
open from 6:00 in the morning until 9:00 or 10:00 at night.
Everyone was in the school--mothers, fathers, grandparents.
There were sports with older kids.
Tutorial services, health services, the whole 9 yards. And
the benefit was really extraordinary. All locally based. No one
was dictating what was taught, what extracurricular activities
were, what the after school programs were, et cetera. It was
all based on local efforts.
It was almost--well, we really went backwards in terms of
education when we stopped dealing with community schools, which
is why that we are now moving to looking to the future with
community--understand the word ``community''--schools and their
ability to help to make and create a positive, a positive
environment for children and for families and for parents, and
for parents to engage with their kids and with one another and
to be able to create that overall positive relationship there.
And I am going to--Congressman Harris, Congresswoman Lee is
here. I am going to give her--I am going to recognize
Congresswoman Lee. I tried to get her in the first round. But
then we will move forward, Dr. Harris.
So, Congresswoman Barbara Lee? You are on mute. Barbara,
you are on mute.
Ms. Lee. Yes, I apologize for being late, but I was
chairing my own subcommittee. So I am so glad to be able to
just be with you for a few minutes.
And I want to thank all of our witnesses. This is such an
important, important meeting, hearing to really secure the
future for our young people in the country. And I wanted to
just--forgive me if this is a redundant question on trauma.
Just wanted to find out how the schools, how you see the
trauma that many of our young people now are experiencing as a
result of, say, gun violence in many of our communities, as a
result of being unsheltered, as a result of COVID. All of the
trauma of just living--and many communities living poor, living
as a black person, as a black-brown person, black and brown
children.
And also how can--my background is psychiatric social work,
and so I have always wanted more social workers and
psychologists in our schools and defining their roles so that
they are servicing schools and school districts, and with
teacher turnover so high and staff changing, we wanted to find
out how the Federal Government, what you think the Federal
Government should do to intervene to make sure that we sustain
levels of training that we need in our schools, as well as what
we can do to address trauma-related factors that children now
are experiencing?
Dr. Cantor. Trauma is my specialty. This is--this is the
work that I have dedicated my life to as a mental health
professional. But we have--we have a lot, a lot of kids that
have been impacted by the pandemic. So we can't say to
ourselves that the solution is every child will have a
therapist because that is unlikely to be something that we can
provide.
But one of the things that we can provide is for all of the
environments, whether they are schools or community-based
organizations, after school programs, the whole principle of
whole child design is that every single environment in which
children grow and learn can be set up to address the things
that trauma does to kids.
Trauma is about stress and stress' affect on the brain and
on learning and on kids' emotional development. You have kids
walking into environments every day that are going to be
healing places, places that reduce stress, places that provide
relationships, and places that connect kids to sources of
support. That is the response that is required today because of
the impact, the traumatic impact of the pandemic on development
and learning.
Ms. Lee. And let me ask you--I have a couple minutes left--
anyone who could answer this question, in terms of any Federal
guidelines that provide guidelines for expulsions and
disciplinary action. I, for many years, when I was in the
legislature, tried to tighten up the California code to have
some criteria for expulsions, especially of black and brown
young kids like in kindergarten, and never could get that done
for a lot of reasons.
And so I am wondering do we have new guidelines? Because we
want alternatives to suspension and disciplinary actions that
would allow--that would force kids out of school. So what are
the Federal guidelines, or are there any Federal initiatives
that would make sure that kids have alternatives and that
expulsions have some kind of criteria? If a kid is going to be
expelled, it is going to be for the right reason, which I
can't, for the life of me, determine what the right reason
would be to expel a child.
Ms. Darling-Hammond. Yes, I would love to speak to that
from both the California and Federal perspectives. The
Department of Education is right now revising and getting ready
to issue guidelines on disciplinary actions and disparities and
how they will be involved in investigating disparities as well
as guidelines for the sort of practices that involve kids in
community circles and in supports that teach them conflict
resolution and a variety of things.
In California, the zero-tolerance policies that were in
place have been eliminated. The use of suspension and expulsion
for things like sort of discretionary behaviors like willful
defiance and----
Ms. Lee. Right. Or wear hair like I wear my hair.
Ms. Darling-Hammond. Yes. Have been eliminated. The State
now looks at exclusionary discipline in its accountability
system. We have got licensing standards that require teachers
and principals to learn strategies that work to support
children in learning behavior and staying in school.
So there is a lot that both the Federal guidance can do in
this regard and that States can be picking up and can be
encouraged to pick up as ways to keep kids in school. We see
higher graduation rates. We see stronger achievement as a
result of those kinds of actions.
Ms. Lee. Thank you very much. Thank you, Madam Chair.
The Chair. Got it. Okay, Dr. Harris.
Mr. Harris. Thank you very, very much.
And Mr. Eden, I want to follow up with you because if you
read--if you go to CASEL's website and you read about things,
and I am going to read from it, it says, ``CASEL is refining a
specific form of SEL implementation that concentrates SEL
practice on transforming inequitable settings and systems and
promoting justice-oriented civic engagement, which we are
calling transformative SEL.''
So SEL is being changed. So is there any academic evidence
that transformative SEL, this new kind of SEL actually improves
academic performance? Because I mean that is, hopefully, what
the school system is all about. Because families can do a lot
of social-emotional learning and teaching. Schools have to
concentrate on academic performance.
Is there any evidence that transformative SEL improves
academic performance in a highly rated study?
Mr. Eden. Well, yes. Well, before answering that question,
I kind of would like to pose a question, which is that if we
know that SEL works from all these studies that we say that
prove that it works, well, why transform it?
As for what we know about the outcomes of transformative
SEL, given that it is based on a paper that was written in 2019
or 2018, I believe, and then adopted within about a year by the
organization, and it takes a totally different moral,
political, ideological spin to the enterprise, I would be
shocked to find that there are studies, short term or long
term, about SEL as it is now defined.
Mr. Harris. Sure, and that is totally--totally
understandable because it is brand new, and I imagine your
question was rhetorical because I think we know why. It is
because we want to change this into a--because CRT is no longer
very popular to use, people shy away from it.
By the way, Mr. Shriver, I am glad to hear that you don't
want a top-down involvement because what we learned from
COVID--and there are very few silver linings--is that parents
finally figured out what is being taught in their schools, and
they didn't like it. Parental involvement is absolutely
essential, but they didn't like what they were seeing in
schools.
Then when they tried to get information, they had to sign,
as the gentleman from Virginia said, nondisclosure agreements
to look at curriculum, something that should never, ever occur
in our public school system, but it is going on.
Anyway, so, Mr. Eden, let me talk a little bit because I
want to follow up on what my colleague from Washington State
asked about, which is this idea that you kind of are turning
teachers into therapists a little bit? Yes, with their mental
health issues, I get it. You know, I am a physician.
To actually deal with mental health issues, we have
complete residencies that take years and years. Teachers are
not equipped to do this, and yet they may be asked to do it,
and you suggest that things could go horribly wrong in a
variety of ways.
How, why do you say that? I mean, I believe that is
probably true. When you have undertrained individuals delving
into very, very serious issues, why do you say that things
could go horribly wrong?
Mr. Eden. Yes, I will go straight to the scariest thing
that scares me, which is the implementation of suicide
awareness and prevention programs, right? Now, to my knowledge,
I haven't looked at it deeply, I believe that it is possible to
implement these programs well. It would stand to reason that it
would be. But also there is a risk that that could terribly
wrong because you might normalize the thought of suicide if you
ask students repeatedly, year after year, possibly semester
after semester, in surveys or interventions, are you thinking
about hurting yourself? Are you thinking about killing
yourself? You risk normalizing those thoughts.
You risk potentially increasing the overall number of
suicides in an effort to address it. The scariest thing for me
is if that happens, will the system double down on the
intervention that might be engendering it? Will it say, oh,
wow, we have this increase in student tragedies, let us double
down in suicide prevention awareness?
I mean, that is the worst thing that can happen. But other
things is when students are kind of asking questions about who
they are, those are questions maybe best left to a therapist or
to a psychiatrist. When it reaches levels of kind of gender
dysphoria, reaches levels of extreme stress, those are things
that teachers just aren't trained and really can't be
effectively trained with anything except for pop psychology,
which frequently carries an ideological valence to it, even if
it is not intended to.
You can feed all sorts of counterproductive not--not good
thoughts into students while you are trying to help them.
Mr. Harris. Yes, it is the cart before the horse. I mean,
we can agree that that might be important, but then we have to
educate our educators to actually be therapists.
Finally, just one last thing is the privacy issue, a huge
again. This was in the State of Maryland, where they were
passing around these surveys and specifically not releasing the
surveys to parents, the questions on the surveys. Very
disturbing when it is dealing with early elementary school
children.
Anyway, I yield back, Madam Chair.
The Chair. Thank you. If I might, since CASEL was
referenced, and Dr. Shriver, you are on the board, chairman of
the board of CASEL, I wanted to give you an opportunity to
respond to the issue of transformative SEL.
Mr. Shriver. Thanks, Congresswoman. Thank you, Congressman
Harris. Yes, thank you.
So I appreciate the concern about transformative SEL. It
was a paper written, and as you pointed out, Mr. Eden, it
suggests that there are forms of SEL for certain districts
where local communities are particularly interested in the
issues that you describe. It is not a reform of the basic
science. It is a paper that describes ways to integrate certain
strategies when communities are interested in that form of SEL.
It has become very popular in many districts. It is not
inflammatory. Maybe some of the language sounds to some people
that it is triggering or in some ways of concern. But it has
been very well received as a form. Again, I just want to point
out all of these decisions are made at the local level. CASEL
is not impose--CASEL doesn't have a curriculum.
CASEL reviews and evaluates and creates knowledge of
learning systems for teachers and superintendents and parents
and others who want to look at curriculum and want to decide on
what works in their community, but CASEL is not telling people
what to teach. It is getting people guidelines about where the
evidence is, as good as the evidence is, and where the evidence
isn't.
So we are trying to create an open forum here that inspires
people to experiment and challenge and try things. The studies
that you referred to as not being about transformative SEL are
not about transformative SEL. They are about other forms of SEL
where you can look at the curricula that were in the meta-
analyses, and those are the ones that are being evaluated.
There is no secrets here. It is really--I mean, at some level,
I think, Dr. Harris, you know, your point about the comparison
to medicine I think is really important.
My mentor, Dr. James Comer, always used to say that in
medicine every doctor has a basic science. It is the human
anatomy. In education, we need a basic science, which is child
development. It is not to say that you know on all moments how
to apply the science. It is just to say we need the basic
understanding of human development as educators in order to be
able to teach math and science and reading and so on better.
So what we are trying to do is underpin the field, if you
will, the profession. Teachers should not be therapists.
Absolutely, lesson one. I mean, I learned this, again, 30
years. When problems arise--and they are in the classroom
already. I mean, we can hope that these problems aren't in the
classroom, but they are there.
What we have tried to enforce and emphasize to teachers is
when problems surface, make sure you have the capacity to
recognize them and refer the children out. Help the children to
recognize what we call help-seeking skills.
When I was a kid, when I was in trouble, I had no skills to
look for help. I didn't know how. I was embarrassed. I was
ashamed--if I was lonely, if I was angry, if I was confused, if
my peers were using drugs. What we try to do in these programs
is help children recognize when they need help. We call it
help-seeking skills.
And we try to help teachers realize when children need help
how to refer them out. We call it multi-tier systems of
support. Classrooms are not therapeutic settings, but they can
be very powerful settings for supporting development across an
array of local environments.
The Chair. Congresswoman Frankel.
Ms. Frankel. Thank you. Thank you again, everyone.
Okay. So I have with me a calculator. Now if I ask this
calculator, I don't ask it, but if I put in what is 2 plus 2,
it tells me 4. It is uneventful. If I ask my grandchild that,
depending upon his mood, I might get an answer.
So I just said a lot of this is just common sense. Of
course, a child's emotional development is important to his
education, his well-being, and to everybody else. That is not
to say, and look, I believe that parents are the most important
part of children's life or can be or should be. Unfortunately,
some children are not blessed with the love and nurturing of
parents.
But the fact of the matter is I just looked this up. The
average child spends between 3 to 6 hours a day in school,
depending upon the age. So by the time they are done with
school, it is over 14,000 hours. Hello? These children are not
robots. We better be paying attention to all aspects of their
life.
And so I don't want rant and rave all day about my
horrifying and embarrassing law in Florida, the ``Don't Say
Gay.'' Okay, I am going to go past that because we are
mourning, we are still mourning in Florida the carnage of
Parkland. The trial is going on this week. Seventeen children
and teachers killed, 17 more injured.
And not to make an excuse for the killer, but it appears
from his background that he was very--that he was bullied, that
he had a lot of what I would say emotional problems. That is
not an excuse. But it would have been nice if there had been
some intervention because it may have saved so many lives.
And that is what I really wanted to ask--I am going to
start with Dr. Cantor. If you could, just explain how this type
of by recognizing the child's emotional development, how can
this help at least point out to the powers that be that there
may be a child in trouble?
Dr. Cantor. So one of the things that Tim Shriver said a
minute ago around this idea of what is knowledge that we have,
and what is basic science? So one really crucial element of
basic science is the impact of stress on development and
learning. All of us, when we experience stress, have a biologic
reaction to it that is mediated by a hormone, a hormone that
travels to the brain and can create that fight-flight feeling.
When kids are bullied, when kids are othered, when they
don't feel safe in the environment in which they go to school,
these stress mechanisms are set off. And they will impact how a
child behaves, whether they can concentrate and learn, and
whether they are going to be able to thrive in a setting.
Now this is knowledge. This is not theory. I learned it in
the 1980s in med school. Okay? So there is nothing about this
that is new.
I also learned that the most powerful force that can
mitigate, okay, that can address this feeling of stress is
another hormone that is released because of positive
relationships that kids have. That hormone is oxytocin. So in
our bodies, we have one that raises stress and one that takes
it away.
So what do we know that releases that helpful hormone that
helps kids learn and helps them feel safe? Okay, it is an
environment in which they feel safe, have positive
relationships, know that they belong. You are actually
impacting the biology of a child and making that child able to
learn and thrive.
Okay, this is not theory. This is knowledge.
Mr. Eden. Ms. Frankel, if you don't mind?
Ms. Frankel. Thank you very much. And I yield back.
Oh, I am sorry. Did you----
Mr. Eden. Just a quick comment because I----
Ms. Frankel. Sir, no comment. I am out of time. I yield
back. Sorry.
Mr. Eden. Yes, ma'am.
The Chair. Congresswoman Watson Coleman.
Mrs. Watson Coleman. I thank you, Dr. Cantor. That was a
very interesting discussion.
So we know that we had all these problems in the schools
anyway--the bullying, the racism, the homophobic behavior even
at a very young age. Now we have kids coming back to school
from the pandemic, from the isolation, from the insecurities
that they experience at home. I even have concern about
children who have lost their caretakers, their providers during
this pandemic, and now we are bringing them back into what we
consider to be their normal routine of going to school.
What are some of the things that we need to be looking at
and doing and are we doing to address the kind of sort of
emotional condition that a child is coming back to school?
Dr. Cantor. I think that the work on whole child learning,
this was a collaboration where we sought, Linda Darling-Hammond
and I and a team of scientists, to answer the question, what do
we know from the science of learning and development that says
how should a learning environment be designed so that children
walking in the door are going to experience the conditions that
optimally support their ability to engage and perform in
school?
So those five factors in whole child design--relationships,
belonging, rich instruction, supports, and building 21st
century skills--all of that came directly out of the science of
learning and development and pointed the way toward the design
of these comprehensive environments.
We now have a playbook that can help districts implement
toward that kind of comprehensive design. We have to stop
binary solutions. We have to stop siloed solutions. You can't
do whole child design with your left hand and have harsh,
exclusionary discipline with your right hand. Okay?
These things are antithetical to each other. And we need to
build holistic design in which we solve many problems at the
same time for kids.
Mrs. Watson Coleman. Thank you. Ms. Darling-Hammond, could
you just quickly address where are we in our--in schools having
access to this sort of learning paradigm and their readiness
and willingness to engage in this approach to educating and
addressing the needs of our children?
Ms. Darling-Hammond. Yes. I think that where we started in
the beginning of the hearing around the social-emotional
learning programs that have been developed and vetted and are
accessible to schools is a part of that. About a third of the
districts that have used the American Rescue Plan Act money and
the ESSA funding have used it to put in place these kinds of
supports that enable teachers to help students process their
emotions, talk about their experiences, learn coping strategies
that allow them to work through some of what they have
experienced.
The community schools component of it, which, again, many
districts are using those funds for, are also accessing the
mental health professionals and supports that then can help
students deal with the trauma that they have experienced. But
there is a lot of effort going in, and the Federal funding has
been extremely valuable for this to help schools create this
kind of a whole child design in the curriculum and in the
support systems around them.
There is more to be done, to be sure, but we do see much
better outcomes in the places that are putting those supports
in place for students so that they can recalibrate and feel
that the school is a welcoming place where they can get the
necessary supports that they can't get otherwise.
Mrs. Watson Coleman. Thank you. Can I say that I am so
supportive of the community school design? I believe that we
could co-locate services not only for students, but for even
families.
Ms. Darling-Hammond. Yes.
Mrs. Watson Coleman. I mean, I had a visionary Governor who
believed decades ago that we could have healthcare there. We
could have job seeking there. We could have housing seeking
there.
I also believe very much that we could keep children in
school doing both academic and athletic and social involvement
after the traditional school hours, keep them off the streets.
I mean, there is just so much that we are not doing that we
should be doing in public education.
So I love hearing this. Thank you, Madam Chair, for this
opportunity, and I just look forward----
The Chair. Okay. Let me just--there is a couple points, and
then I am assuming, Dr. Harris, that in the absence of Mr.
Cole, I will yield to you for closing remarks. But I wanted to
make a couple points.
And Mr. Eden, I appreciate really--very, very much
appreciate your concerns about low-quality SEL investment.
Which is why with the committee, with the grants that we have
dealt with, they are included in what is a rigorous tiered
evidence program, the Education Innovation and Research. So to
do whatever we can to make sure that the quality of the program
is as intended, you know, and not--I would just say about
mental health issues, I would overall love to have an
overwhelming support on both sides of the aisle. I believe we
ought to have a mental health professional in every one of our
schools.
That would be a goal to have a trained mental health
professional, and one of the things we do most recently in the
Labor-H bill is to include funding for mental health
professionals. But I think particularly given what has happened
with the pandemic and the aftermath of that, I think it would
be a real investment in--a serious investment in how we would
like to see our children be able to get past the absolutely
tragedy of the last couple of years and to put mental health
professionals in every single school.
And yes, and that is something that we ought to fund to be
able to do. It would serve us well.
A last point before I recognize Mr. Harris is that this is
the issue of the local effort, and I think we are looking at
the creation of social and emotional learning that is in a
nonpartisan way. It is in a safe--it is in rural, urban,
suburban settings. And I just would mention to you the various
States that are engaged and involved. There is Georgia, Kansas,
Kentucky, Missouri, Oklahoma, Tennessee, North Carolina, North
Dakota. And these are efforts that are being made that are
grounded in what the need is on a local basis.
That is the genesis of this. At its core, it is about
what--and I think about this issue of parents and school
boards. As far as I know, and I have started to look into this,
local school boards are parents. The local school boards all
over the country include parents, and who have a vested
interest, obviously, in what happens to their kids and have
input into what is happening to their kids.
Now let me recognize Dr. Harris for closing remarks.
Mr. Harris. Thank you very much, Madam Chair.
And look, I want to thank all the panelists for your
interest in making sure that our children get educated. That is
the bottom line. That is incredibly important because, I think,
as someone pointed out that is the future. I mean, our children
are the future.
I am a grandfather of 10, father of 6. Clearly, I am very
concerned with our ability to educate the next generation.
Look, I am going to concur with the chair. We are probably
not going to agree on how to fund the mental health
professional in every school because I think that is a State
and local responsibility, but we should urge that to occur.
Because unfortunately, over the past several decades, the
schools have come to replace the families as places where
social, emotional, moral learning and teaching goes on.
Now, look, that is the hand of cards we are dealt. We could
try to put the family back in charge of some of that. But
again, that may or may not be able to occur, and until that
happens, we have to recognize that this now--and it is
different from 50 years ago and 60 years ago--that schools are
going to have to take up some of this.
I would urge us don't put the cart before the horse. We
should do some rigorous research, see what works, what doesn't,
and then train the next generation of educators for that.
Because I am afraid a lot of the educators, you know, it is
hard to teach an old dog new tricks. And a lot of educators I
think look at some of this and say this is not what I was
trained to do, and they are probably right.
So it is important to look at it, as long as we keep our
eye on the same goal, which is to make sure that our children
get educated, that their academic performance, their social,
their ability to fit in socially is achievable within our
society. That is our goal.
So I appreciate, Madam Chair, I appreciate bringing
together the panel. I always appreciate when you bring together
panels of people who are interested in just improving the lives
of our children and how our children turn out.
So, with that, I want to thank you all, and I yield back.
The Chair. Thank you.
And just in closing, I want to end where I began with the
Neil Postman quote. ``Children are the living messages we send
to a time we will not see.'' They are literally the legacy we
leave behind us, and we know that everything we do needs to be
making sure that--whether it is parents or educators, we need
to make sure that our kids can meet the challenges of the
future.
So it is incumbent on all of us, especially legislators, to
ensure that they are prepared. And that is not only
intellectually. That is emotionally and socially as well.
And I just might add I hear a lot about research and more
evidence, well, there is substantial, substantial evidence
behind, it is scientific. We are standing on very solid
scientific ground here that the interventions and the science
behind the interventions is overwhelming and that high-quality
SEL programs that support these efforts result in absolutely
positive and academic life outcomes.
And it is about the future of our children and,
particularly now, of the stress and the hardship of our most
vulnerable kids that they have faced in this pandemic.
And I was interested in, Congresswoman Watson Coleman, and
I don't have the number at my fingertips, but the number of
children who have lost their parents to COVID. What is
happening to these children, and what are we doing to address
this issue? So we are looking at the strategies that are
effective strategies, as we know, that are needed now more than
ever.
And which is why what we try to do is to engage through the
Labor, Health and Human Services, and Education Subcommittee in
addressing these issues and based on the science because we can
look at study after study after study, and we know--and we have
study after study telling us about how children learn, at what
age they are learning, et cetera. It is now for us to put into
practice the information that we know and to act on it. That is
the moral obligation that we have in this effort.
I just want to say a thank you to our witnesses today.
I wanted to thank you for not only for your testimony
today, but I want to say thanks for the years and years in your
professional lives of devoting just to looking at the science,
developing--helping to develop the science, taking the interest
to understand how we need to--the most significant impact we
can make on children is their education and where those
educational opportunities will lead them.
And it is just so critically important. It is probably the
most where we should have the greatest Federal involvement in
supporting what local government is doing and what the research
tells us are the ways in which we can transform the lives of
our kids through education and making them feel that they have
the environment, the cognitive ability, and have the social
skills to be able to succeed. And thank you for devoting your
lives to making that happen.
And with that, I am going to adjourn this hearing. Thank
you very, very, very much for your testimony this morning. It
is very appreciated. Thank you.
Thursday, April 28, 2022.
DEPARTMENT OF EDUCATION
WITNESS
HON. MIGUEL CARDONA, SECRETARY, DEPARTMENT OF EDUCATION
The Chair. I now call to order the hearing on the fiscal
year 2023 President's budget for the Department of Education.
This is a hybrid hearing, so we need to address a few
housekeeping matters.
For members joining virtually, once you start speaking,
there is a slight delay before you are displayed on the main
screen. Speaking into the microphone activates the camera,
displaying the speaker on the main screen. Do not start your
remarks if you do not immediately see the screen switch. If the
screen does not change after several seconds, please make sure
that you are not muted.
To minimize background noise and ensure the correct speaker
is being displayed, we ask that you remain on mute unless you
have sought recognition. The chair or an individual designated
by the chair may mute participants' microphones when they are
not under recognition to eliminate inadvertent background
noise. Members who are virtual are responsible for muting and
unmuting themselves.
Finally, House rules require me to remind you that we have
set up an email address to which members can send anything they
wish to submit in writing at any of our hearings. That email
address has been provided in advance to your staff.
Before I move into my remarks, I just want to acknowledge
that today is the birthday of our ranking member, Congressman
Cole. So we want to wish you all a very, very happy birthday,
Congressman Cole. We are not going to ask you anything about
age or any of those things, but we wish you a wonderful,
wonderful day.
Mr. Cole. [Inaudible.]
The Chair. And I hope there is bourbon and cigars somewhere
in the day.
Mr. Cole. Multiple times.
The Chair. Okay. This is great.
I also want to say--and I think Josh Harder may be, you
know, virtual--we want to welcome Josh back, who has been, as
he explained to me yesterday, changing diapers and staying up
late and taking on his responsibilities as a dad. So welcome
back, Josh.
So let me acknowledge the ranking member of the
subcommittee, Tom Cole, and all of the members who are joining
today's hearing both virtually and in person.
And I would very much like to welcome Secretary Miguel
Cardona to his first in-person hearing in the subcommittee as
Secretary of the Department of Education. You were with us
virtually last year, but there is nothing like being in person,
so a very, very warm welcome.
Secretary Cardona. Thank you.
The Chair. There is little more critical to our growth and
progress as a Nation than support for the educational success
of our students. If the last 2 years have proven anything, it
is that as we struggle to overcome moments of so much change,
we have a moral responsibility to ensure that our students and
the families and teachers that support them every day have the
resources to succeed and to flourish.
Schools and learning provide consistency. As educator
Horace Mann said, and I quote, ``Education, beyond all other
divides of human origin, is a great equalizer.'' And, I would
add, is a great constant in the constantly changing world.
Secretary Cardona, you have proven over the last year and
throughout your career as a Connecticut educator to be a
fighter for the programs and policies that give our students
and our teachers the certainty that they need for success.
Next week is Teacher Appreciation Week, a moment to
celebrate and to recognize you, Mr. Secretary, and the millions
of teachers around the country who dedicate their lives to
educating our students. And you and I both know the incredible
sacrifice that being an educator entails, which is why the work
that you do to support our teachers as they transform students'
lives is so crucial.
I also want to acknowledge our parents, who have struggled
to get their kids educated throughout the pandemic. And we
agree they should have a big role and a big say in their
children's education. There are some today who are trying to
divide parents and teachers, but by design, our public school
systems require significant input from local communities and
parents.
Nationwide there are 13,500 school districts with about
90,000 school board members. Around 90 percent of these school
board members are directly elected by their communities. One-
third of school board members are parents of students in
schools or preschools, with over 90 percent of those students
attending schools in the districts that their parents
represent.
I also get troubled by broader efforts to ban content. That
is divisive. The banning of books from public schools and
libraries, restricting free speech and access to books is
divisive, and it impedes the development of our children. That
also must hold at universities and in university libraries
where freedom of expression is under attack. This too limits
the growth and development of the next generation.
And we should not ally critical race theory with students
learning about our history. America has a complicated history,
but America is exceptional. American freedoms grew out of our
history dealing with Native Americans, immigration, and
slavery, and somehow we keep bending the arc toward progress
and greater equality.
Strengthening our educational system and our students'
learning begins with a strong Department of Education. So I
thank you, Mr. Secretary, for joining us to discuss the
Department's fiscal year 2023 budget. It builds on the
transformative investments we have made over the past year.
Under your and President Biden's leadership, historic progress
has already begun to improve the lives of our Nation's
students, educators, and their families.
This work began with $170,000,000,000 in the American
Rescue Plan fund that were secured by congressional Democrats
and President Biden, who moved quickly to reopen public
schools, provide emergency grants directly to students, and
assist colleges and universities in giving support to students
in need.
The Biden administration has also taken swift action to
ensure student borrowers are not denied the benefits that they
are entitled to. With improvements to the Public Service Loan
Forgiveness Program, $6,800,000,000 in loan debt has been
canceled for more than 113,000 public servants, and the
administration's new waiver for borrowers and income-driven
repayment will bring another 3.6 million Americans closer to
loan forgiveness.
And the days of the fox guarding the henhouse at the
Department are over. You have advanced strong proposed
regulations that will protect students and taxpayers from
predatory for-profit colleges, providing relief to the student
borrowers that they have defrauded. And despite bad-faith
arguments by some, you have proposed reasonable measures that
will increase accountability and transparency in the Charter
School Program.
Mr. Secretary, I applaud you and the President for your
unprecedented support of our students, public schools,
colleges, and universities. We have so much more to do as we
continue reversing decades of underinvestment in our Federal
education system, which is why I am so proud that Congress, led
by this committee, passed in a bipartisan way the 2022
government funding Omnibus bill last month, which included
historic funding, including an increase of $2,900,000,000 for
programs under the Department of Education.
I am especially proud of the $1,000,000,000 increase
included for Title I to support low-income students in our
Nation's public schools, the largest increase in over a decade
and, again, on a bipartisan basis. No child in this country
should be denied a quality of education because of where they
were born, their family's income, or their race or ethnicity.
And with an increase of $448,000,000 for special education
programs, we are also recommitting ourselves to improving the
lives of babies, children, and young adults with disabilities.
As chair of this subcommittee, I was excited as we created
an initiative on Social and Emotional Learning and whole child
approaches, which we funded now for the third year in a row. We
have included $82,000,000 for evidence-based SEL grants;
$85,000,000 for teacher and school leader development that
prioritizes SEL training; $111,000,000 for school-based mental
health professional grants; and an increase of $90,000,000 and
$75,000,000 for full-service community schools, an increase of
$45,000,000.
These programs support students' social, emotional, and
cognitive development and positively impact their academic
performance and well-being.
Earlier this year, we held a hearing on these strategies
where we examined the overwhelming evidence, the evidence based
behind these interventions, and we heard how these effective
strategies are needed now more than ever, considering the
extreme stress and hardship our country's most vulnerable
students have faced during the COVID-19 pandemic.
And to make higher education accessible to even more
students, we were proud to fight for and deliver the largest
increase in over a decade to the maximum Pell grant, a $400
increase. We delivered $96,000,000 to historically Black
colleges and universities and minority-serving institutions. We
are proud of these critical investments which will make college
more affordable for historically underserved students and their
families.
Alongside the Department of Education programs, for the
first time in 12 years, we included member funding for projects
to directly support students and educators in our home
districts. We were able to meet the needs of communities all
across our Nation through district-specific funding for
programs that support students with intellectual and
developmental disabilities, mentorship, tutoring initiatives,
college success, and learning loss programs for underserved
students.
In my own district, $2,000,000 will help the New Haven
public schools as they expand job development opportunities for
high school students interested in a career in the
manufacturing sector with a new manufacturing education and
pathways program.
As we begin the 2023 budget process, we need to build on
these critical investments to help even more students and
families to achieve that American dream, and I am pleased to
see such a strong budget request to do just that.
The President's 2023 request includes $88,300,000,000 for
the Department of Education. It is an increase of
$11,900,000,000, 16 percent above the 2022 level. It would
continue to build on the historic investments we have made in
Title I, the cornerstone of our Federal support for public
education. It provides an additional $3,000,000,000
discretionary increase to support our students and those
schools that are most in need.
The request also prioritizes support for our students with
disabilities with a $2,900,000,000 increase to IDEA Part B
grants to States for special education services, and a critical
$436,000,000 increase for IDEA grants for infants and families,
for early intervention services available to children with
disabilities age birth through two and their families. And it
supports English learners and immigrant students with a
$244,000,000 increase for English language acquisition program.
A transformative $393,000,000 increase for community schools
will provide critical comprehensive services and expand
evidence-based models that meet the holistic needs of children,
families, and communities.
Your budget recognizes the immense value of higher
education by providing key investments to make college more
affordable and accessible for low-income and minority students.
I am pleased to see a $500 increase to the discretionary Pell
grant maximum award, an additional $249,000,000 for HBCUs,
MSIs, and other underresourced institutions. We will continue
to meet the needs of low-income, first-generation students and
narrow our Nation's racial wealth gap and expand access to
employment.
Mr. Secretary, the work that you do and the rest of the
administration do day in and day out touches the lives of every
single student and educator. The investments in this budget
request and our support for our students and our teachers
ensure that our government will get one step closer to leveling
the playing field so that every child and every student has a
fair shot that allows for their God-given talent to help the
opportunities that are created where they can flourish in our
society today.
I look forward to working with you over the next year,
looking forward to our discussion this morning. And thank you
for being here today.
And, with that, let me recognize our ranking member,
Congressman Cole, who has a very strong commitment to public
education and the opportunities that it opens up and provides
for our children. And I would like to yield to the ranking
member for his opening remarks.
Mr. Cole. Well, thank you very much, Madam Chair. And you
have been so kind to wish me a happy birthday, but this is a
much more important day than my birthday. It is the first
meeting of the big four.
The Chair. That is right. That is later today.
Mr. Cole. So I wish you well later today as you sit down--
--
The Chair. Thank you.
Mr. Cole [continuing]. And I want to take----
The Chair. What do we think about bourbon and cigars for
that meeting?
Mr. Cole. I tell you what, it would go a lot better. I
would be happy to send you in with all you need if you think
that would loosen them up.
But I want to, again, take a minute before I get to my
prepared remarks and just thank you, again, for getting us
through the last process. You and Ranking Member Granger
working together I think were critical to that. I think this
committee took the leadership role, quite frankly, in pushing
the process forward, and nobody did that more than you. And I
am glad to see it is starting a little bit earlier this year
and everybody has worked together.
So I will make a commitment to, once again, try to work
with you and make sure that we get this budget done hopefully
within the fiscal year but, if not, certainly within the
calendar year. I think it would be a huge mistake for this
budget to go into next year. And that is something we should
all want to avoid.
That is not fair to the administration. It slows them up in
terms of making important decisions. It is not fair to the next
Congress. They shouldn't have to vote on appropriations bills
that they were not here to be part of.
So I take considerable pride in the fact that for 7 years
in a row you and I have managed to get this bill across the
line. It didn't matter who was chairman, didn't matter who was
ranking member, didn't matter which party controlled Congress.
It didn't matter what the administration was. We've gotten it
done under every conceivable scenario, and I would certainly
like to make it eight in a row.
And I want to thank you for being such a good negotiating
partner and such a good leader for this full committee in terms
of us forcing our sometimes slower-moving Senate colleagues to
actually do the work that they were elected to do.
Mr. Secretary, it is very good to see you this morning. And
we don't always agree, but I always find you agreeable and
professional and particularly accessible to this committee, and
I appreciate that very much. You know, COVID has been a
difficult time, but you have always made time anytime we have
had questions or comments or whatever, and I appreciate the
spirit in which you approach your job.
And, again, welcome. As the chairwoman said, it is great to
get to deal with you in person and as many of our members as
can be here in person.
I will start by, once again, expressing concern regarding
the total level of spending proposed by the administration. I
have been a longtime supporter of helping achieve better
outcomes for our students, but I fear the proposed 15 percent
increase for the Department of Education will leave the next
generation saddled with the highest national debt our Nation
has ever seen.
The fiscal year 2022 budget was just completed last month.
We know it will take some time to get those funds out the door.
A more moderate approach, in my view, is called for, especially
in this time of runaway inflation.
I would like to turn next to the topic of which I believe
is one of the greatest failures of the Federal response to the
COVID pandemic, and that is the closing of many of our Nation's
public schools for almost 2 years, and the subsequent lost
student learning and mental health issues that are flowing from
these bad decisions.
Your budget proposes increases in mental health and
counseling to help with these issues, and I appreciate that.
But the sad truth is we can never give those children back
those years of their lives, and some of these wounds may never
heal. In many cases, a growing level of learning in an
adolescent, progress a student with a disability was making, or
basic skills that were beginning to be solidified by a young
student may have been lost forever.
A recent survey conducted by the Government Accountability
Office highlighted just how widespread and profound these
losses are. Their survey discovered that nearly half of public
school teachers had students who were registered for class but
literally never showed up online. Even more disturbing,
students who never showed up came mostly from majority non-
White urban schools. These are the very students that our
Federal programs are in place to support, and I think our
country will be seeing the negative consequences from school
closures for years and years to come.
So, I certainly hope it is an experience--I know we all
share this hope--that we don't have to go through again.
I will also ask some questions this morning on what I
believe to be executive overreach on the charter schools
policy. One of the greatest benefits of the charter school
movement has been the fact that these schools are locally
developed, authorized, and operated. The Federal role in
charter schools has been one of providing limited financial
support to secure physical infrastructure and some startup
grant funding, but the Department of Education is not a
national school board or a national chartering authority.
I agree with the 18 Republican Governors who have recently
called for your department to pull back proposed regulations
that would, as they say, quote, impose a top-down, one-size-
fits-all approach and undermine the authority of parents to
choose the educational options best suited for their child,
unquote.
I would like to ask unanimous consent to submit for the
record a letter from our former colleague, now Governor Jared
Polis, which outlines very well his objections and concerns to
administration actions.
Is that all right?
The Chair. Yes, so ordered.
Mr. Cole. Thank you very much, Madam Chair.
My own State of Oklahoma has a long history in the charter
school movement, and I believe that States, not the U.S.
Department of Education, should continue to be responsible for
what charters they do or do not authorize to operate within
their jurisdiction.
I would also like to touch today on another area of
executive overreach, and that is the President's recent
decision to extend the student loan repayment pause to August
31. Not only is this inflationary, but there are also people
making literally hundreds of thousands of dollars a year who
aren't being asked to repay their student loans. I think that
is unfair. And I have introduced legislation called the, quote,
``can't Cancel Your Own Debt Act,'' to prohibit Members of
Congress from voting to forgive their own student loans. These
folks are making $174,000 a year. Even if a Member favored debt
cancellation for most people, we should not support this policy
for people making this type of salary at the expense of our
taxpayers and constituents.
Finally, I hope to discuss today another area which greatly
concerns me, and that is the politicization of programs like
civics education with controversial priorities and grant
announcements. Programs like civics education should be used to
bring our country together and focus on our own commonalities
while teaching respect for our differences. Sadly, I fear that
recent announcements put out by the administration have only
fanned the flames of controversy and division rather than heal
them. That is a disappointment.
In closing, I would like to say that as a longtime member
of this subcommittee, I understand the important role played by
domestic programs, and I certainly support increases for these
critical programs.
I was pleased to see support for special education in your
budget. We know the Federal Government has not upheld its fair
share of responsibility for ensuring education is provided for
students with a disability, and I hope we can see achieving
support for sustained increases for special education as a
bipartisan goal.
I also believe in strong support for Pell grant recipients
and the TRIO and GEAR UP Programs. Pell grants and
participation in TRIO and GEAR UP help first-generation college
students chart a course to a better future into the middle
class.
We need to continue to help these students not only enroll,
but also graduate and find good-paying jobs. Unfortunately, our
double-digit inflation is eating away at the salaries of these
recent graduates and making it more difficult for them to
establish themselves in their careers.
I also believe that we should do more to help underserved
populations and underperforming schools. I support programs to
strengthen our teachers and school leaders, and I support the
Title I program. But I also question whether simply dumping
billions of dollars into the program without careful planning
is the best way to help undo the damage caused by 2 years of
school closure.
I want to again thank you, Mr. Secretary. Again, as I said,
while we don't always agree, I do enjoy working with you, and I
do appreciate the manner in which you approach your job and
which you represent the Department.
I yield back the balance of my time, Madam Chair.
The Chair. I thank the ranking member.
And, Mr. Secretary, let me recognize you, and your full
written testimony will be entered into the record. You are
recognized for 5 minutes for your opening statement.
Thank you.
Secretary Cardona. Thank you.
Thank you, Chairwoman DeLauro, Ranking Member Cole, members
of this distinguished subcommittee. Good morning and thank you.
And, Mr. Cole, I would sing happy birthday, but the clock
is running and I have 5 minutes.
Today's hearing is about more than the President's budget
and proposed investments for the fiscal year 2023. It is about
the needs of our students and how we can meet them if we work
together.
The priorities in the budget reflect what I have learned in
my visits to 32 States across America this past year. I visited
schools in small towns, in affluent suburbs, urban and rural
communities, including Tribal communities. And I know that
addressing opportunity and achievement gaps is more important
now than ever. I met with parents in Nevada worried about their
kids catching up in the classroom. The gaps in underserved
communities are so much greater now.
Let's close those opportunity gaps by boldly investing in
our Title I schools. This is our best tool for reducing
inequities between underfunded schools and their wealthier
counterparts.
Let's also invest in full-service community schools, which
provide high-poverty communities with easier access to
services, like health and nutrition, enrichment, adult
education, and more.
Last week in New Mexico, I met with students struggling
with anxiety. They had depression, trauma from losing parents
amid the pandemic. Our children are hurting. Anxiety and
depression have doubled among youth. Teen suicide rates are up.
It is heartbreaking.
Let's do something about it. Let's invest a billion dollars
in hiring staff and building their skill set to support
students' mental health needs so they can be their best in the
classroom.
I met with superintendents and principals in red States and
in blue States trying to fill vacancies so that teachers could
spend more time providing that individualized attention that
our students need now. The teaching profession is in crisis,
and we have a solution.
Let's support and grow our educator workforce. We are
proposing a half billion dollars for education, innovation, and
research grants, including $350,000,000 for recruiting and
retaining teachers. Remember what it was like when we couldn't
open our schools because of teachers and sub shortages. Let's
not go back to that.
Let's invest in teacher quality partnership grants so more
States can stand up innovative teacher residencies and Grow
Your Own programs that prepare new and diverse candidates, like
the programs I saw in Tennessee.
What I haven't heard is an appetite from parents for sowing
division in our schools, or using our schools for culture wars,
or telling students what they can or can't read or can't learn,
or telling teachers what they can't teach, or telling any
person what they can or can't be.
I know there are some that would rather distract and divide
and spread misinformation to undermine our public schools and
gain attention, but that is not what the parents that I have
spoken to told me they want. That is not what I want.
Based on a recent survey, the overwhelming majority of
parents, teachers, principals are on the same page about what
children need in our schools. Our parents need their children
to learn.
The American Rescue Plan got us this far. Today our schools
are open for in-person learning, and our teachers are deep in
the work of recovery. Now is our opportunity to reimagine what
education can be. With your investments, let's build more
inclusive, affordable pathways to higher education and
rewarding careers for all of our students.
College enrollment has fallen by nearly a million students.
We can't afford this. Let's invest in community colleges,
historically Black colleges and universities, Hispanic-serving
institutions, Tribal colleges, and other inclusive
institutions, and let's build on the $400 Pell grant increase
you included in fiscal year 2022. We could double the Pell
grant by 2029 if we start with another bold increase of $1,775
for this upcoming year.
We know that these days a high school diploma is no longer
a ticket to the middle class. We shouldn't let any student walk
off the graduation stage without an onramp to a good-paying
job.
Therefore, we are proposing $200,000,000 for career-
connected learning so more underserved students graduate high
school with industry credentials and college credits. This is
good not only for the students but for the economy.
Look, education gave me the tools to achieve the American
dream. I grew up in a low-income community. I only had what the
public schools offered me at that time. I attended a Title I
school, and I graduated from a technical high school. I became
a first-generation college student. I am a bilingual certified
educator who benefited from quality teacher preparation and
professional development. I am a product of the investments in
this budget. Education brought the promise of the American
dream alive for me. We must renew that promise for today's
students and those to come.
This last year we fought hard against COVID. Together, this
up-coming year, let's fight complacency. Let's not accept the
culture of low expectations. Let's not return to the systems
that weren't working for all students. Who here in this room
hasn't wished for a reset button in education, a chance to take
stock of our system and reimagine what it can be?
Well, our country is at a point of inflexion. Let's use it
to reimagine education, to show the American people we can come
together, red and blue. We can come together to fight for what
is right for our students. This budget is a chance to do that.
So together, let's seize the opportunity.
Thank you.
The Chair. Thank you very much, Mr. Secretary.
And I know you have been a proponent of keeping our schools
open, and I am happy to say that it was the American Rescue
Plan that accelerated the opening of our schools nationwide.
Mr. Secretary, I strongly support the Department's modest--
what I believe are modest, good government proposals for the
2022 Charter School Program competitions. However, the National
Alliance for Public Charter Schools has been spreading wild
exaggerations and misrepresentations in opposition. This kind
of information campaign is a familiar tactic for the trade
organization. It does represent charter schools that are run by
risky, low-quality, for-profit education management
organizations.
And I would just cite a couple of the examples of the
recent expansion grants awards that were made to something
like--you know, the Torchlight Academy Charter School in North
Carolina now being shut down. Capital Collegiate Preparatory
Academy in Ohio has been passed from one for-profit operator to
another. A New York school, they have oversized fees for its
services.
So as I point out, the modest--what I believe are modest,
good government proposals for your charter school reform, what
I would like to do is to ask you, what are the new proposed
requirements in the Charter School Program and why are they
necessary?
Secretary Cardona. Thank you for the question. I appreciate
an opportunity to speak to this, because there have been some
misunderstandings and, quite frankly, some myths being spread.
I support all high-quality schools, including public
charter schools. The budget continues the Charter School
Program investment of $440,000,000. I think the proposals are
reasonable. And what they ask for is greater accountability,
transparency, and fiscal responsibility. Again, they are
proposals at this point.
And it is absolutely accurate that we do not authorize
charter schools. If anything, when using Federal dollars, we do
want there to be reasonable expectations around accountability,
transparency, and fiscal responsibility.
The Chair. Let me just--I also, to move in a similar
direction, am concerned by the proliferation of contracts
between universities and online program management companies,
OPMs. We had a Wall Street Journal investigation expose how the
University of Southern California, in a for-profit OPM known as
2U, recruited thousands of students to an expensive online
graduate program, which left student borrowers with a median
debt of $112,000 and median earnings of $52,000 2 years later.
And by the way, they received 60 percent of the program's total
revenue, because they shoulder the cost of setting up the
program by an exchange for getting a cut of the tuition. And
calculated, USC could have been generating about $142,000,000
for their for-profit company in 2021.
What will the Department do to protect students from the
OPM cost escalation and recruiting abuses? And The Wall Street
Journal did a very fine piece on this issue.
Secretary Cardona. Thank you for raising that issue. It is
really important that we maintain positive support for
students, and that we, in all the decisions we make, are
protecting our students, protecting our borrowers. We worked
really hard this last year to move forward with policies and
practices that keep our borrowers first, including borrower
defense.
But one specific thing that I want to talk to regarding
that is we reinstated our Office of Enforcement and the FSA
Office. This office was disbanded, and we brought it back to
make sure that things like that are not happening and making
sure that we are protecting our students.
We are also in communication with college presidents to
monitor situations like this because students aren't
benefiting. We are going to continue with our borrower defense,
but we are also going to make sure we are having communication
with universities so these things are not happening.
Thank you.
The Chair. I would just say with regard to that, this is
about harming student borrowers, but it is also about ripping
off Federal taxpayers.
Secretary Cardona. Right.
The Chair. Because the issue is with the--what is being
proposed are--the Federal grad plus program that exists there.
It lets students borrow as much as colleges charge, has
provided a valuable revenue stream for universities, and that
leaves students in debt and a greater proportion of revenue for
the university.
So, again, I would just like to say to you and ask the
Department to take that lead in protecting students from these
agreements, and protecting the integrity of the student loan
program for Federal taxpayers. It is about students and the
Federal dollars that we are expending, and happy to do if they
are going to good causes in that effort. So, I thank you.
Secretary Cardona. Thank you.
The Chair. And, with that, I am going to yield to my
colleague, the ranking member. And also ask my colleague, I
have to dash to the Ag subcommittee for a few minutes and I'll
be back, so I am going to ask Congresswoman Roybal-Allard to
continue to chair the meeting.
Thank you.
Ms. Roybal-Allard [presiding]. Mr. Cole.
Mr. Cole. Thank you very much, Madam Chair.
Mr. Secretary, 18 Governors sent you a letter this month
outlining their concerns with new regulations altering the
Charter School Program. Quite frankly, the regulations, in our
view, would dismantle, you know, frankly, a successful Federal,
State, and local partnership that really has enabled millions
of children to have a public education but in a setting that,
in their view and their parents' view, best fits their needs.
Will you extend the comment period for these regulations to
reflect the magnitude of the changes and to allow more time for
public input?
Secretary Cardona. Thank you, Ranking Member Cole. As I
said before, I do support high-quality public charter schools,
and I have seen examples of their effectiveness. We have had
the public comment period, and we are reviewing the comments
now. We have received the letters. So, we do have a process for
reviewing comments that have been submitted.
Mr. Cole. And I recognize that, but I would hope you would
extend that. I think, again, when you are hearing from nearly
20 Governors--and, frankly, not all Republicans. Obviously, our
friend, Mr. Polis, is not a Republican Governor, but he
certainly was a very able member of this body, very respected
Governor. So, I would ask you to at least consider that.
And, you know, I would like to know what your attitudes are
in terms of regulations that limit local control, including the
new requirement for community impact analysis, which would
mandate school districts be overenrolled, if I understand it
correctly. And, you know, why would we do that? Why wouldn't we
just let local people make their own decisions as to what is
best for their kids?
Secretary Cardona. We do agree. And I can tell you
personally I do agree, as a former district person, that local
decisions should be the ones that are driving, and I certainly
continue to support that.
What I do think we have are reasonable expectations around
getting an understanding of what the needs are in the community
as a proposal to make sure that there is interest and make sure
that the schools stay open. We want to make sure that these
schools stay open.
Mr. Cole. And I would like you to at least consider
delaying changes to the program--these are pretty major
changes--until next fiscal year, so that we can continue to
operate this year under a system everybody understands. I know
there is never a convenient time to make a change, if that is
the decision that is ultimately made, but I think it takes a
lot of time to adjust to that. And whether or not we could
implement--and, frankly, I hope we don't because, obviously, I
don't agree with a lot of these proposals--in a timely way and
give administrators and students, local school officials, an
opportunity to adjust, I think, in the timeframe is something
worth considering.
Is that something you have concerns about?
Secretary Cardona. Thank you, Mr. Cole. We will take that
into consideration and make sure that we are providing adequate
technical assistance to all of the folks we serve.
Mr. Cole. Let me ask you something that caught my eye,
because this is a very robust budget, but in two areas you
actually reduce spending, I think, by about $3,000,000 in
Indian education, about $16,000,000 in Impact Aid.
I will tell you, I have district concerns in both those
areas. We have, as you know, a large Native population in
Oklahoma; and, second, my district has two huge military
facilities that, frankly, draw a lot of kids into local
schools, but, obviously those facilities don't pay any State or
local taxes. We get that. We are very proud to have them, but
we certainly appreciate impact aid to help us offset the cost
of those students that come with the service families that are
located there or even the civilian workforce.
Secretary Cardona. Thank you for that, and I couldn't agree
with you more. I was able to visit Knob Noster High School
recently. A hundred percent of the students were military-
connected families, and let me tell you, I heard from students
directly. We need to increase Impact Aid. And that was a
community that did a great job--it was in Missouri--did a great
job using Impact Aid.
And I last week was in New Mexico in the Pueblo of Jemez
Tribal Nation, and I know the importance of funding there.
I think--well, I know the reason why it looks like a cut--
it is an artificial cut--is because the submission was done
after the 2022 allotment. So it looks like it is a cut, but it
is not. We were using 2021 numbers because the Omnibus hadn't
been passed.
Mr. Cole. Well, I certainly recognize that, because we
weren't quite as speedy as I know we all would like to be in
getting you numbers, and I just want to flag that for you
because I will be trying to work with you to get a more
appropriate number. Those are areas that have been underfunded.
Secretary Cardona. Thank you.
Mr. Cole. And, again, I appreciate the technical
difficulties that you had to face putting together your budget
before, frankly, we had finished our deliberation. So that is a
fair point.
I am close to the end of my time, Madam Chair, so let me
yield back.
Ms. Roybal-Allard. Mr. Secretary, welcome.
Secretary Cardona. Hi.
Ms. Roybal-Allard. As you know, many of our students in
higher education are facing the burden of college tuition and
rising costs of living, including food, housing, and child
care. This is especially true for the 4 million parenting
students who are pursuing a college degree or credential while
taking care of a dependent child.
According to research from The Hope Center at Temple
University, parenting students are much more likely to struggle
to find and afford enough to eat for themselves or their
families and maintain stable housing. Without proper support,
these students are at risk of dropping out of college.
And I am happy that the administration is requesting an
increase in the CCAMPIS program. Can you speak to how the
CCAMPIS program helps parenting students and how it can be used
also to help connect struggling students to more resources of
financial support, as well as programs such as SNAP, WIC, and
TANF?
Secretary Cardona. Right. Thank you for that question. The
Child Care Access Means Parents in School, or CCAMPIS, is
something that I was able to see firsthand. And I think we have
an opportunity, when I talk about reimagining education. We
must look at this as an opportunity to attract students who may
not be traditional students. There are many people during the
pandemic that had an epiphany and wanted to change their
trajectory in life, and they want to go back to school. And the
CCAMPIS program is one of those programs that I saw firsthand
allows parents to go back to college, pursue their degree,
chase that dream.
I will speak to a situation that I was able to witness
firsthand in Bergen County Community College where CCAMPIS was
being used to allow parents to attend while their children had
childcare on campus. I spoke to a young lady, Kezia, who
attended that college, and she and her husband were there, and
their twins were down the hall in a childcare center being
cared for while she was studying. And she said: This CCAMPIS,
these funds are not only allowing me to change the trajectory
of my life but that of my children, her two twins.
So I--for Kezia, she wouldn't be able to go to school if it
weren't for CCAMPIS.
I remember visiting Nevada and talking to students there in
a community college who were homeless, and the community
college was trying to help them find housing, so they were
making connections.
We have an opportunity to embrace students who
traditionally didn't think of themselves as college students in
this new wave now, and I really want to take advantage of it.
Programs like CCAMPIS make that possible.
Ms. Roybal-Allard. Now, the fiscal year 2022 Omnibus
actually lifted the cap on CCAMPIS grants, which limited an
institution to receiving only 1 percent of its Pell grant
receipts. By removing the cap, the Department of Education can
now set a higher limit of support for CCAMPIS.
How much of an increase can schools expect to receive, and
will there be any changes to the eligibility criteria?
Secretary Cardona. We are requesting $95,000,000 and we
want to make that available for as many schools as possible. I
can share more information about the criteria for that, but the
goal really is to make sure it is available to more students
across the country so more can have access to higher education.
Ms. Roybal-Allard. This year, we--you know what, I am also
very close to ending, so I won't take the prerogative of the
chair to go over my time, and I will now call on Mr.
Fleischmann.
Mr. Fleischmann. Thank you, Madam Chair, Ranking Member
Cole.
Mr. Secretary, good morning, sir.
Secretary Cardona. Good morning.
Mr. Fleischmann. Thank you for being with us in person
today. Really appreciate this.
I think we can all agree that we are glad to be back in
person, and especially to have our students back, sir, in the
classroom for in-person learning.
Secretary Cardona, the most recent data shows that 3.5
million STEM-related jobs will need to be filled by 2025 in
order to maintain a stable workforce. It is imperative that we
continue to support public-private partnerships to close the
skills gap and cultivate a diverse workforce.
Last week, I was privileged to visit the Middle Valley
Elementary School located in Hixson, Tennessee, in my district,
to observe their public-private partnership with Amazon, a
program that supports almost 175 schools with computer science
curriculum, robotics clubs, and other learning opportunities.
Actually, it was quite inspirational, very uplifting.
What is the administration doing to encourage more public-
private partnerships in STEM and computer science literacy?
Thank you, sir.
Secretary Cardona. Thank you for that question, Mr.
Fleischmann. I couldn't agree more with you that we need to do
much more. We are not doing enough currently. We need to make
sure that our students are connected to great STEM programming
within our schools, that are connected to the regional
workforce needs, connected to the 2-year programs, the 4-year
programs. I am really excited about the priority of redesigning
high schools and providing better career pathways.
We have asked in the budget for $200,000,000 for career-
connected high schools, new competitive awards that reinforce
districts like the one you visited and give them funding to
make those programs consistent and grow those programs.
We have an opportunity now to reimagine what career
pathways look like. Those are one of my priorities at the
Department of Education. Not only do we want to address
achievement disparities, we want to make sure we are connecting
our high schoolers, our college students to careers that exist
today in the STEM fields.
Mr. Fleischmann. Thank you sir.
A followup. How can we provide continued professional
development in STEM and computer science literacy for our
teachers specifically, sir?
Secretary Cardona. Right. Thank you for that. We have to
make sure that, as we are doing these public-private
partnerships, they include providing support for our educators,
giving them real-life experiences to see what the jobs look
like today, right? So I can envision having one of our teachers
partnering with one of these regional workforce partners and
having trips for the teacher to see what the site looks like
and gain skills there, or something where it is co-taught or an
after-school program for professional development for our
teachers.
Mr. Fleischmann. Thank you, sir.
And the final question for this first one here is, how
important is early exposure to STEM and computer science
curriculum to get students exposed to that early, sir?
Secretary Cardona. Yeah. It is really important that we
start early. We have to start in elementary school, and we have
to make sure that we are connecting it to real world
experiences, real world jobs. And by the time they get to
middle and high school, students should be exposed to the
different careers that there are in STEM, and there are many
and they are growing.
Mr. Fleischmann. And, Mr. Secretary, I would like to put
something on your radar, if I may, and for our other members. I
would like to encourage members on this subcommittee to
consider cosponsoring H.R. 3602, the Computer Science for All
Act. This is something that actually our distinguished
colleague, Ms. Barbara Lee, from the majority, is working with
me on. She is the lead Democrat; I am the lead Republican. The
Computer Science for All Act, which provides new grant
opportunities that would make computer science education more
accessible for all students, pre-K through 12th grade.
So, Mr. Secretary, thank you. I would like you to take a
look at that legislation, and I would appreciate members of our
subcommittee to take a look at that as well.
Thank you.
Secretary Cardona. Thank you.
Ms. Roybal-Allard. Ms. Clark.
Ms. Clark. Thank you, Madam Chair.
And welcome, Mr. Secretary. We are delighted to have you
here.
I can't thank you enough for prioritizing the mental health
and well-being of our students. In a recent survey out of
Massachusetts, 60 percent of the parents and caregivers
responded, reported at least one death in their family, 60
percent, and we know what a crisis this is. It is a compounding
crisis to one we were already facing, and I appreciate the
resources that you are putting into this.
Secretary Cardona. Thank you.
Ms. Clark. I want to specifically ask, as we are facing a
dual crisis of retaining and recruiting educators, how is your
budget also addressing the mental health needs of those
educators as you are doing so well with our students?
Secretary Cardona. Yeah. I appreciate your acknowledgment
of the crisis that we are having in mental health.
I had a lunch with Dr. Xia yesterday. We were talking about
how the crisis went from counting cases to thinking about the
impact of mental health on our students, on our staff, on our
community in general, and how we must continue to put energy
toward addressing them.
I am really proud that with ESSER--thank you for the
support of ESSER--there is a 65 percent increase already in
social workers in our schools, 17 percent increase in
counselors, but we have got a ways to go.
What we want to do is make sure that we are not just adding
one or two more counselors; that we are giving students an
opportunity to have mental health support not only during the
school day but outside of the school, parents having access to
mental health support or being able to access support through
connections with the school.
We are proposing funds in the fiscal year 2023 to really
make it more foundational in our schools. I will tell you,
Representative Clark, we had mental health issues in our
schools that were unaddressed before the pandemic. They were
just made worse. But we have a moment now to really make sure
it is a foundational support that we provide our students, and
I look forward to leading that.
Ms. Clark. Are we also going to be able to provide that to
our educators? Is that part of the plan you are working on?
Secretary Cardona. Without question. You know, we cannot
act as if only our students suffered during the pandemic. I
have spoken to teachers in all of my visits, who are doing
everything they can for their students, but are also struggling
with changes in their family or loss in their family. So making
it more accessible to our staff is going to be critical if we
expect them to be there for our students.
Ms. Clark. And speaking of staff, we know we have lost
almost 117,000 early education jobs, and I know that we have
spoken about this privately before.
Secretary Cardona. Yes.
Ms. Clark. But what strategies have you considered, are you
working on, to build a pipeline of students who are pursuing
early childhood credentials and training that are going to be
so necessary for our childcare needs of the future?
Secretary Cardona. This is an area of opportunity. Much
like Mr. Fleischmann's questions with STEM, we must really
reinvent Grow Your Own programs in our schools. I speak to
Tennessee's program. They have a program in their high schools
where students are going toward teaching, and there is a
relationship between the high school and the college.
In the budget, the request is $514,000,000, a $288,000,000
increase over the 2022 enacted level, to develop Grow Your Own
programs, to invest in these teacher preparation programs.
The shortages are real. They are going to get worse if we
don't invest in them. And as I said in my opening remarks, in
January, we dealt with school closures not because of Omicron,
but because we didn't have the staff, and we can't afford that
in this country.
Ms. Clark. In my brief 1 minute, we know how much LGBTQ
students are facing attacks that are compounding this mental
health crisis that we have been talking about. Can you tell me
about how the increased funding for your Office for Civil
Rights, what that funding will go to, and what is the level of
need and cases being reported to the OCR that you are seeing?
Secretary Cardona. A recent study by GLSEN found that LGBTQ
students are bullied 42 percent compared to 15 percent of non-
LGBTQ students. It is an issue that we are taking very
seriously. Supporting the Office for Civil Rights will help us
be more expedient in the investigations, and ensure that all
students are going to school in an inclusive environment that
sees them, respects them, and welcomes them.
Ms. Clark. Thank you.
I yield back, Madam Chair.
Ms. Roybal-Allard. Ms. Herrera Beutler.
[Audio malfunction.]
Ms. Herrera Beutler. Thank you so much, Mr. Secretary. So I
have just been--there is so many different things I wanted to
talk with you about. I am going to start--I think I am going to
start with this--let's see, I am going to start, actually, with
the proprietary schools issue because, you know, I am a huge
fan of Pell. I am a big supporter of Pell. I think it helps
nontraditional students. And I am--you know, a year-around Pell
increasing it, I think it just gives a lot of flexibility.
And one of the things that has been brought to my attention
is that there seems to be a real anti-proprietary school
ideology within the administration. And I know that there have
been bad actors, but I also know there have been really bad
actors in public, you know, school systems on the secondary
level too. So I think apples to apples, there are similar
challenges.
But when I think about the population that do take
advantage of proprietary schools, it is primarily women. It is
a lot of 40-year-old women. Maybe I am looking for a job.
Oftentimes, it can mean people of color or people who are
looking for a second career or who maybe only have a high
school degree but want to earn something more than minimum
wage. And to tell that whole block of people, Well, you don't
fit the 4-year liberal arts academics, when the 4-year schools
right now, especially the top--you know, not even the top
schools. You know, middle schools--you know, middle range
schools are not accepting--I mean, they are 50 percent
acceptance rates, and that is a good acceptance rate. It seems
to me you are cutting out a whole class of trade workers by
refusing to support their desire to attend a proprietary
school.
Could you speak to that?
Secretary Cardona. Sure. Thank you. Thank you for that.
And I agree with you. We have to create stronger career
pathways. I am really looking forward to making sure that all
schools, high schools and 2-year schools, do more there.
There are many great short-term programs that deliver great
value to students. Last week, I was at D.C. Central Kitchen----
Ms. Herrera Beutler. I am going to--I am so sorry. I am
going to cut into that really quickly just because I am going
to be cognizant of my time.
Secretary Cardona. Okay.
Ms. Herrera Beutler. Specifically, I am aware of current
rulemaking at the Department of Education, surrounding
eligibility requirements for programs authorized by Title IV,
and I have heard that cosmetology schools in my district feel
like their opinions haven't been considered in this process and
it could threaten their ability to provide financial aid to
their students.
So I guess more specifically, as that rulemaking process
moves forward, can you commit to actively at least engage with
these schools and hear from them as you are making the rules
about it?
Secretary Cardona. Certainly. We definitely will, and I
appreciate your advocacy, and we can provide a more detailed
written response also.
Ms. Herrera Beutler. I would love that.
Secretary Cardona. Happy to work with you on this.
Ms. Herrera Beutler. Thank you.
Secretary Cardona. Thank you.
Ms. Herrera Beutler. Thank you so much.
I just think the nontraditional route needs to be just as
valued. I have brothers in the trade that didn't go to a 4-year
school, and I just think it is the way we need to look at
higher education.
Another piece along that line--and I guess I am going to
switch over to the K-12 system. I received an email from some
of my--from parents in my district who said that, due to a
Federal law, they needed to submit their child's demographic
information to the school. This was a public high school. It
was my public high school district that I went to.
I know that the Office for Civil Rights has taken steps to
increase data collection on students and update definitions,
but as you can understand--I mean, this basically says, We are
getting this message--this is from the school to the parent--
because you haven't updated ethnicity information for your
student. Due to new Federal laws, yada yada, we need to keep
all this information. Of course, we are going to forward it on
to the State, but we won't put your kid's name in there, which
every parent has concerns about that privacy issue.
Could these updated data collection requirements create an
additional administrative burden for schools, and how do you
plan to keep that information private?
Secretary Cardona. Thank you. Thank you for that question.
You know, student privacy, as a father of two high
schoolers myself, I certainly want to make sure that they are
protected and their information is private and it is not
everywhere else. I believe you are referring to the CRDC
report, Civil Rights----
Ms. Herrera Beutler. I don't know. The parent didn't know.
Secretary Cardona. And I would be happy to have a followup
with you and even the school, if necessary, to make sure that
it is clear for that parent what they are asking for.
For us, ensuring that schools are providing students with
opportunities to succeed, all students, regardless of race,
gender, is critically important. So I believe it is referring
to the CRDC report. Happy to follow up with you to get more on
that.
Ms. Herrera Beutler. Okay. And I have more questions. Some
of them have to do with mental health, which I know we are
going to talk about. Hopefully, we will get a second round of
questions maybe?
Ms. Roybal-Allard. Yes.
Ms. Herrera Beutler. Okay. With that then, I will yield
back. Thank you.
Ms. Roybal-Allard. Ms. Frankel [inaudible]
Ms. Frankel.
Ms. Frankel. Oh, yeah. Hello. Yeah. Thank you.
Thank you to Mr. Secretary. I want to ask you just a
question on title IX. I know that you are working on some new
rules. Can you give us a progress report on that?
Secretary Cardona. Sure. We are working on the new rules,
and we are expecting next month that they are released in May.
So I can't really get into specifics now, but at the end of the
day, the goal is to make sure we have equal access, protect
students against discrimination, and protect students against
sexual violence.
Ms. Frankel. Okay. Thank you very much.
Just another title IX question. According to the research
for the Women's Sports Foundation and the National Women's Law
Center, girls of color have not benefited from title IX the
same way as White girls. And so Black girls face disadvantages
both based on race and gender and have lacked access to
participation in schools, sports, and other activities that are
available to boys. Any comment on that? Any efforts that your
department is going to make to remedy that?
Secretary Cardona. Thank you for the question. You know, it
is put in--title IX was put in to ensure equal access, and we
still have a ways to go. The question that I had before you--
you asked the question was about the reporting that was done,
the CRDC report. That helps us get information to ensure that,
regardless of race or place, students are getting a high-
quality education with equal access to extracurricular
activities to high-level courses. And that is why we collect
those data, to ensure that we are supporting districts,
supporting States that are maybe inadvertently creating gaps in
opportunities for students.
This is our responsibility to make sure all students in the
country have access. And looking at those data really makes
us--reinforces the important work that we are doing to collect
those data but, more importantly, to provide support to our
States and districts and make sure all students, regardless of
race, socioeconomic status, have access to high-quality
learning and high-quality after-school activities.
Ms. Frankel. So let me just do a follow-up, because I am a
big advocate for sports and children playing sports. It is not
just fun, but they learn so much----
Secretary Cardona. Right.
Ms. Frankel [continuing]. About themselves, about being
part of a team. So this year marks the 50th anniversary of
Title IX. Wow, that is unbelievable. And I know we have made a
lot of progress. Still, I think there is--research shows that
the majority of high school administrators still don't know who
their title IX coordinator is, and that 83 percent of college
coaches say they have never received formal title IX training.
So it is hard--when people are ignorant of the law,
sometimes it makes it harder to enforce it and may be partially
the reason why we still have this discrimination or lack of
activities for--especially for girls of color.
Does your department have designated funding for training
title IX coordinators, and do you have any kind of plan of
action on this effort?
Secretary Cardona. Yes. Thank you for that question. I
agree with you wholeheartedly. Cocurricular activities--and I
don't like to call them extracurricular, because they are not
extra, they are cocurricular activities--must be a part of the
experience for our students. In fact, due to the American
Rescue Plan, I put a challenge out there for every high school
student to be connected in at least one cocurricular activity,
whether it is theater, athletics, clubs. We should make sure
that every student feels connected.
And, yes, the Department of Education, as we celebrate the
50th anniversary, have several events planned. We have had
webinars. It is unfortunate those data that you shared with me
regarding the lack of understanding. We will be amplifying the
importance of it, making sure that we can reverse those data
that you shared. All athletic directors, all school leaders,
all district leaders should make it very clear who the Title IX
coordinator is but, more importantly, the purpose of Title IX
and the importance of having access for all students.
Ms. Frankel. So I--yes, I agree with you on that latter
point. So--but do you have plans to follow up to make sure that
that happens?
Secretary Cardona. Yes, we do.
Ms. Frankel. You do, okay.
Secretary Cardona. Yeah.
Ms. Frankel. I don't know--I lost you off the screen. I
don't know what happened to you.
But I will yield back. I do have another, I think,
important question, but I will yield back, if we have another
round.
Thank you so much, Mr. Secretary.
Secretary Cardona. Thank you.
The Chair [presiding]. Mr. Moolenaar, and we are following
each other at the various hearings, so--and my apologies again
to the committee. There wound up being two subcommittees that I
had to be at.
So Mr. Moolenaar.
Mr. Moolenaar. Thank you, Madam Chair. Appreciate it.
And, Mr. Secretary, good to see you again. I want to follow
up with you on some of the questions Mr. Cole had raised
regarding the charter school. And, I guess, you know, when I
read some of the comments from previous Presidents, President
Obama once said that charter schools serve as incubators of
innovation and give educators the freedom to cultivate new
teaching models and develop creative methods to meet students'
needs.
And then when you think of President Clinton when he
celebrated the passage in the Senate, the first charter
school's legislation, he said that it puts the Federal
Government squarely on the side of public school choice and
innovative charter schools.
And, you know, when I heard you speaking earlier about
transparency, accountability, fiscal responsibility, I think
everybody would be in agreement that that is important in
public education.
What I am concerned about is the proposed rule really seems
like kind of a radical departure from this idea of allowing
innovation, encouraging innovation, and specifically this
community impact analysis at the expense of people trying to
start a charter school.
My experience with charter schools is they form in a
variety of ways, but often it is parents, teachers coming
together, seeing a need that is not being met, an opportunity,
a tremendous amount of work and cost to start something up. And
by putting sort of a one-size-fits-all Federal rule that
discourages that and creates more burdens, more costs, you are
actually--whereas you may be, you know, an advocate for high-
quality charter schools, and I don't--you know, I take you at
your word on that, but what you are doing is, by this new rule,
discouraging new innovation, discouraging people to take the
risk to jump in and be part of this.
Like Mr. Cole, you know, I think that the comment period is
pretty tight. And I would just encourage you to consider
extending that, really look through to see what can be done to
encourage some of the things that you are talking about in
terms of transparency, but at the same time, not put a burden
on people who are trying to do something innovative in a
community because there is a need that is not being met. So I
would just ask you if you would consider that, think through
that, and any feedback you have on that.
Secretary Cardona. I appreciate that, Mr. Moolenaar. And,
you know, I agree that they--and I have seen great examples of
that, where people in the community come together. And we
certainly don't want to discourage innovation or interest in
this, and we do believe it is reasonable.
What we are trying to protect is against closures,
premature closures, because, you know, the need or maybe there
wasn't enough analysis done around the community need. But
without question, we do know that charter schools can serve
unique needs, and they are often incubators of innovation and
we want to continue to encourage that.
Mr. Moolenaar. But when you say premature closures, are you
talking about traditional schools or charter schools that would
open and then close?
Secretary Cardona. Correct.
Mr. Moolenaar. Okay.
Secretary Cardona. Underenrollment or it seemed like there
was an interest and then a year or 2 later they are closing
because there wasn't enough interest.
Mr. Moolenaar. Okay. Well, my experience would be, you
know, I think the flexibility that is there between authorizers
and, you know they certainly have the ability to start up. And
if there is not a market there or there is not a need, then you
kind of learn about that and you close. I understand that is
disruptive. But at the same time, in the cases where it could
be tremendously impactful, innovative, and really a good thing
in the long term for a community, you just don't want those
barriers to getting started.
Secretary Cardona. I understand. Thank you.
Mr. Moolenaar. Thank you. I yield back.
The Chair. If I could just take one second because I think
you asked an interesting question, Mr. Moolenaar. And I would
recommend an article, and I will get it to you. There was an
interesting statistic in it that more than one in four parents
who walked their kindergartner into a new charter school have
to find another school for their children by the time they
reach the fifth grade. That is about the alarming closure rate
of those schools. Over one in four closes during the first 5
years; by year 10, 40 percent are gone. Between 1999 and 2017,
nearly 1 million children were displaced due to the closure of
their schools.
So an interesting thing to follow up on to see what the
issue is, but I will share that with you.
Congresswoman Lawrence.
Mrs. Lawrence. Thank you, Madam Chair.
And thank you, Secretary for being here.
I have a question. It is a follow-up on a response you gave
on--I am very excited about the career connected learning. We
all know we have a staffing crisis, but the issue is the crisis
is present. The connected learning, what is the expectation we
can have for when we will have a trained workforce that will be
able to let us get parity with our need and with our workforce?
Secretary Cardona. Thank you for the question, Mrs.
Lawrence. I have to go back to my visit. I went to Henry Ford
Community College----
Mrs. Lawrence. Yes.
Secretary Cardona [continuing]. In Michigan, and let me
tell you, like, if there was a model I could lift up, they get
it. They understand that high schools can feed into 2-year
schools, and then the workforce partner is waiting.
I visited Groton with Congressman Courtney, and the Groton
submarine base was waiting for the graduates of those schools
who were learning how to weld with the same machines they use
on the sub base, because the partnership was there.
Unfortunately, across the country, we have pockets of
excellence. It hasn't been systematized.
So what we are trying to do is make it so that every
school--and not just technical high schools, which I am a proud
graduate of--not just technical high schools but all
comprehensive high schools have career options that are
responsive to the community needs, to the regional needs.
And I want to go a step further to say, we would expect
that districts and States have models of workforce partnership
boards with our 2-year college representatives, our 4-year
college representatives, our workforce partner representatives,
and our K-12 system so that the program feeds.
Now, students should graduate with options. Unfortunately,
in our country today, they don't. We have to do better. So the
funding for the career-connected high schools is $200 million
in new competitive awards to systematize it, so that when a
superintendent leaves, she doesn't leave with those great ideas
and the system stays there. We really have to lift--raise the
bar there across the country.
That is how we are going to become competitive. That is how
our students are going to be able to get high-paying, high-
skilled jobs earlier. They can continue with their college. In
many cases, these workforce partners are paying for the
college. So we have an opportunity here and I really want to
seize it.
Mrs. Lawrence. So my next question goes to the mental
health of our schools and our teachers, as has been mentioned.
I just visited with my governor a school that has partnered
with a community-based healthcare system that supports the
school's mental health needs.
Now, I saw that program being very, very effective, because
when we talk about putting enough staffing for mental health,
and you talk about a pocket of excellence, I really want to
encourage you to have a systematic plan to support these mental
health providers in the community, because the mental health
provider didn't have the restrictions or the normal part. They
were just there, and those--and it was referrals that were able
to be made by the school staff, nurse and social worker, and
they were in the schools and it was seamless. We--our needs for
our teachers and our parents.
And the one thing that was brought to my attention during
this meeting is that when you see the connection between mental
health of our children, the crisis there, and the crisis of the
parent, if we don't recognize that and do what we can to
support the resources as needed, it is going to become
generational.
So do you have any planning for that?
Secretary Cardona. Three things I want to accomplish as
Secretary of Education: close achievement gaps, improve career-
connected pathways, and address the mental health needs of our
students.
In Santa Fe High School, last week or 2 weeks ago in New
Mexico, I saw a program that really could be replicated where
our community partners, mental health partners were in the
school. They had space in the school, and they were connected
to a university a research university, so that is taking it to
that next level.
But what we can do, kind of going to your first question,
is not only connect our health centers to our schools and give
them space there where even parents can come in and access it
but also create a throughway for our high school students to
learn about fields in the healthcare industry and maybe even
take some courses there or learn from the health experts that
are in the building. That is another example where, as you
mentioned, pockets of excellence are not going to get us where
we need to go.
We have to systematize it. The funding request that we have
here will move that along much quicker.
Mrs. Lawrence. Okay. Thank you.
Secretary Cardona. Thank you.
Mrs. Lawrence. And I will yield back.
The Chair. Congressman Cline.
Mr. Cline. Thank you, Madam Chair.
Thank you Mr. Secretary, for joining us today. I don't know
if you saw the news this morning that the U.S. economy saw a
1.4 percent decline in Q1 GDP growth of this year. Definitely
supply chain issues and inflation are the primary drivers of
the decline that we have seen, but the pandemic policies of
this administration that include massive trillion dollar
spending packages and economic restrictions, like the ones we
saw in my home State of Virginia under Democratic-led
administrations, started this ball rolling.
$190,000,000,000 in COVID relief funds has been distributed
by your department to be spent on preparedness and learning
loss. We have all seen the stories of how some of these funds
have been spent. For example, in a Whitewater, Wisconsin school
district, the board voted to allocate almost 80 percent of
their $2,000,000 to build synthetic turf fields for the
football team.
An Iowa school district spent $100,000 of COVID relief
money to renovate the weight room and add new floors, and now
the district has recently reported more students interested in
football. That is great. But the East Lyme, Connecticut school
district spent $175,000 to address drainage problems on the
baseball field. A Pulaski County, Kentucky, school district
spent $1,000,000 in COVID relief dollars on resurfacing two
outdoor tracks.
In March 2021, the Government Accountability Office
reported that the U.S. Department of Education system for
tracking data was inadequate. Can you report on how you provide
oversight for these Federal investments to avoid this type of
waste? And how many school districts are truly prepared for the
future? What percent of funding was spent on learning loss of
students, because we saw that across the Nation? And how is
your agency using data to help understand the impact of these
harmful school closures that we saw?
Secretary Cardona. Thank you, Mr. Cline, for the question.
And I agree wholeheartedly with you that we must ensure that
these dollars are being used to address learning loss and
mental health needs, and it is something that we take very
seriously at the Department.
As a matter of fact, the GAO report that you referenced, we
instituted new protocols for oversight because we felt that the
data collection was poor, and we have to fix that mess. There
were several messes we had to fix.
With regard to ARP accountability, I have visited more than
100 sites, and the first question that I ask is, how is the ARP
money being used. We are trying to lift best practices. We have
had dozens of webinars with State chiefs, superintendents. I
have spoken to hundreds of superintendents, visited their sites
to make sure that we are very clear, learning--addressing
learning loss or missed instruction is critical, mental health
needs of our students is critical, and making sure that our
schools could be safely reopened. We are doing that. We are
going to continue to do that.
And a recent report from FutureEd reported that the
projections of spending will go $30,000,000,000 toward academic
recovery, which is exactly what you were asking for;
$26,000,000,000 of the $130,000,000,000 in the K-12 space would
go towards staffing, which include mental health support;
$26,000,000,000 for infrastructure.
And I have to say, some of the examples of what I have seen
in my visits include deferred maintenance in buildings where
air quality was really poor or the--so infrastructure is being
fixed during--with the use of the American Rescue Plan.
Schools are open today. We went from 46 percent of the
schools open when President Biden took office, 99 percent open
today because of the American Rescue Plan and their ability to
get their schools open safely.
Mr. Cline. I think that one of the things that the American
Rescue Plan also resulted in was the inflation that we are
seeing today. The Department just announced steps to further
exacerbate this problem by dealing with student loan
forgiveness.
The Federal Student Aid estimates that the changes you are
proposing will result in an immediate debt cancellation for at
least 40,000 borrowers under the Public Service Loan
Forgiveness program. More than 3.6 million borrowers will also
receive at least 3 years of additional credit toward income-
drive repayment forgiveness.
Can you tell me how the Department plans to pay for the
planning, implementation, and execution of these proposed
forgiveness programs?
Secretary Cardona. Thank you. We recognize that one of the
things we had to fix when we came in was the Public Service
Loan Forgiveness program. It was enacted in 2007, was to take
effect in 2017, and there was a 98 percent denial rate for
those who qualified for it. So only 16,000 borrowers received
forgiveness in the program.
What we ended up doing was revisiting that program, fixing
it. And as you mentioned, at least 40,000 borrowers were added
to the list of borrowers who received loan forgiveness with the
income-driven repayment changes.
We are working really hard at FSA to build up systems of
support for our students to make sure that they have the
information, and we are processing their applications as
quickly as possible.
Mr. Cline. Thank you. I yield back.
The Chair. Congresswoman Bustos.
Mrs. Bustos. All right. Thank you, Madam Chair.
Mr. Secretary, it is good to see you. You were kind enough
to come with the First Lady to Sauk Valley Community College,
which serves the congressional district that I represent in the
northern part of the State of Illinois, so thank you for that.
You know, I know you are on the road a lot and you have a
lot of conversations. I had brought up to you at the time, we
had a short discussion about teacher shortages, and that is
what I would like to talk with you about this morning.
In the budget request, I was really, really happy to see
that President Biden requested an increase in 400 TEACH grants
awarded. So these students will receive $4,000 if they commit
to teaching a high-need subject in a high-poverty school for 4
years. So really happy to see that.
And we talked about this in your visit about teacher
shortages continuing to be a major problem. I know this is
affecting a lot of States all over our country. It is a big
problem in the State of Illinois. And the Illinois State Board
of Education says that Illinois school districts have about
4,100--4,100--unfilled positions right now, and that includes
teachers, paraprofessionals, and other licensed staff.
So, Secretary Cardona, what I would like to ask you is,
what impact will the President's budget request have on teacher
shortages, such as programs like the TEACH Grant and through
investments like the Teacher Quality Partnership Grant Program?
I would love for you to address that if you could, please.
Secretary Cardona. Thank you very much. Great to see you
again.
There is $350,000,000 in the budget to propose--to support
recruitment and retention efforts. Just yesterday, I was with
the 50 State Teachers of the Year and the National Teacher of
the Year, Kurt Russell, talking about the importance of the
profession. And while it seems that the profession is under
attack at times and, you know, during the pandemic there was a
great support for teachers, now it seems like teachers are
being asked to do more and sometimes not given the respect that
they deserve for what they have done during the pandemic.
So it is a difficult time to recruit teachers, but in this
budget, there is a clear commitment to making sure that we have
enough teachers. And as mentioned with the question from Mrs.
Lawrence, we have to create Grow Your Own programs in our
districts. We have to create programs that get students
thinking about teacher--becoming a teacher earlier on. I think
of Tennessee's program where there is an apprenticeship
available for students who want to become teachers.
The funding in the budget would allow us to create systems
that help us ensure that we are not going to have teacher
shortages. I made reference earlier to January when, because of
quarantining, we didn't have enough teachers. We didn't have
enough substitutes. That is unacceptable. Our students deserve
better.
This funding will allow us to create systems to make sure
that we have pipeline programs for our teachers and programs
that are embedded in our high schools that connect to our
colleges, to ensure that we have enough teachers moving
forward, especially in those hard-to-fill areas like special
education, bilingual education. We have to be proactive about
this because it is unacceptable for students not to have highly
qualified, prepared teachers in front of their classrooms.
Mrs. Bustos. And this plays into it, kind of part two of
this in a sense, teacher salaries. Obviously, that is part of
retaining teachers. It is part of attracting people to the
profession. And as you know, the salaries are too low across
the country in many--especially in low-income districts. And in
my home State of Illinois, we are working really hard to
address this. But obviously, I think there is more that we can
do even at the Federal level to retain and to attract people to
the profession.
Last year, I introduced something that we call the
Retaining Educators Takes Added Investments Now Act. You know,
we always like to come up with these acronyms. It is called the
RETAIN Act. And along with other professions that the
legislation, the RETAIN Act, it provides fully refundable tax
credits for teachers in title I schools. So the credit starts
at $5,800 and then ramps up to $11,600 over the years to help
retain staff.
So, Mr. Secretary, how could increased title I funding help
school districts increase teacher pay and promote retention?
And then part two of that is, what investments do you think we
could put into programs that fight teacher shortages for this
fiscal year?
Secretary Cardona. Thank you for that, and I appreciate the
efforts that you are taking to help address this issue.
Imagine the headlines if we didn't have the American Rescue
Plan funds to help incentivize teachers staying in the
profession. We would be talking about schools being closed much
more, so thank you for the support of the American Rescue Plan.
I was talking to a principal yesterday who was telling me
that, in her State, the starting salary for teachers is in the
$20,000s. That is unacceptable. That is unacceptable. So we
need to do more. Pay does matter, working conditions matter,
and teacher voice matters.
And to answer your question about title I, title I gives us
the opportunity to ensure that there are enough reading
specialists, that professional development is available to help
these teachers become highly skilled in addressing achievement
disparities that exist, and ensure that teachers have a
competitive salary in urban districts or high-poverty districts
compared to their suburban counterparts. That is what title I
does.
Mrs. Bustos. All right. Thank you so much, Mr. Secretary.
My time is out, and I will yield back to our chairwoman.
Secretary Cardona. Thank you.
The Chair. Congressman Harder.
Mr. Harder. Thank you so much, Chair DeLauro, for hosting
today's hearing.
And thank you, Secretary Cardona, for being here.
I wanted to talk about doctors in the PSLF program. At the
height of COVID, the ICUs in my community were over 100 percent
capacity, not because we didn't have the bed space, but because
we didn't have the doctors to take care of people. And one of
the major contributors to that is that since the implementation
of the Public Service Loan Forgiveness program, doctors in
California and Texas have been excluded from partaking in this
program due to State laws prohibiting direct employment of
doctors by hospitals.
This disproportionately affects rural and underserved
communities like mine. We have about half of our physician
residents after they graduate who move away from our
communities to go and work in another of the 48 States that are
covered by this program.
I have sent you two letters on this. And in the fiscal year
2022 LHHS report, it urged the Department of Education to
address this regulatory exclusion through negotiated rulemaking
this year. One of the letters that I sent you was signed by 67
Members of Congress, almost the entirety of the California and
Texas delegations, telling you how important this issue is.
But I am very concerned that public documents released by
the Department of Education throughout this rulemaking process
indicate that the Department either still does not understand
how to fix this issue or is not prioritizing fixing it.
Specifically, the proposed language that has been suggested
still requires a W-2 form for their employers, which would
continue to exclude 100 percent of California and Texas
doctors, because they don't get W-2 forms even if they work at
a nonprofit hospital because they are banned from working
directly for hospitals in California and Texas.
So, Secretary Cardona, will you commit to having the
Department fix this exclusion of otherwise qualifying doctors
in California and Texas from the PSLF program this year?
Secretary Cardona. Thank you for the question,
Representative, and for your advocacy for these heroes who
during the pandemic have bent over backwards to protect lives.
As you are aware, the rule related to PSLF is under OMB
review, and we hope to publish a notice of proposed rulemaking
in the spring. And I know you have been in communication, and
my staff will continue to be in communication with you about
this issue, and I appreciate your advocacy here as we try to
work toward a solution.
Mr. Harder. Thank you. I just really want to emphasize to
you and to your team that the proposed fix does not fix this
issue, and every single physician in California and Texas will
still be excluded. And it is, frankly, a little confusing to me
that after all the whole volute that has happened because of
this problem, that the negotiated and proposed language still
falls short of our goal here.
Can I at least get your commitment that you will do
everything that you can to make sure the California and Texas
doctors who meet all other PSLF requirements receive PSLF
support?
Secretary Cardona. I understand the problem. I commit to,
number one, having a conversation with you specifically about
this to hear your perspective, although I have read the letters
and have had conversations. I want to make sure that you feel
that I am giving you my best here to support the doctors in
Texas and in California.
Mr. Harder. Well, thank you. And I just want to underscore
that this is bipartisan, bicameral. We have enormous support
around this, because it will lead to 10,000 physicians working
in underserved communities in California over the next 10
years. It is a major game changer. And especially after what we
have seen in COVID, I think now is the time to make sure that
we are getting this addressed. And I want to make sure that the
Department understands how their current proposed language
falls short.
I would like to also enter, Madam Chair, two records into--
two documents into the record: The first is my bill language
for H.R. 1133, the Stopping Doctor Shortages Act; the second
document contains three language proposals that also fix the
exclusion of qualifying California and Texas doctors from the
PSLF program without impacting other healthcare professionals
or allowing nonqualifying doctors to receive PSLF support.
We know there is good language out there. These are three
suggestions that do address this problem, and I would really
encourage the Department and the Secretary to take a good,
strong look at this. And I appreciate your effort to have a
conversation on that. I am more than willing to do that
anytime.
So thank you again, Secretary Cardona, for testifying.
And I yield back the remainder of my time.
Secretary Cardona. Thank you.
The Chair. Congresswoman Watson Coleman.
Mrs. Watson Coleman. Thank you, Madam Chair, and thank you
for holding this hearing, and it is good to see you.
Mr. Secretary, thank you very much for being here.
I am always interested in equity of opportunity, providing
the opportunities for our children to be globally educationally
competitive irrespective of where they live. I am also very
concerned about all of the sort of research that we found
lately that demonstrates that children of color, particularly
Black girls, are disciplined more than their White counterparts
for the same infractions. I am concerned that there have been
issues of discrimination because of their hair, because of
their dress codes, and things of that nature.
I am impressed that you all have actually noted the
challenge and the desire to ensure that educational opportunity
is more evenly distributed and available. New Jersey is one of
the most segregated States in the Nation when it comes to K-12
schools.
So my question to you is, while you have this commitment,
what is it that you are actually going to do or be able to do
that will positively impact the minority child's experience in
the school? What will you do to prepare teachers? What will you
do to prepare the administration? What kind of training, bias
training, et cetera, is going to be made available? And how
will you hold those institutions accountable who are not doing
the things that you expect them to do, and what measures can be
used to ensure their accountability and responsiveness?
Secretary Cardona. Thank you for the question. As I said
earlier, the focus during my time as Secretary will be to
address disparities in this country, provide better access to
college and career, and to support students' mental health
needs. As we know, they are greater now.
To your question, you know, there are several things in the
budget proposal that will support our efforts, our specific
efforts to diversify the staff in our schools, to make sure
that the professional staff in our schools represent the
beautiful diversity of this country; ensuring that title I
schools have the support that they need so that they can have
that intervention, that small group instruction, that evidence-
based--those evidence-based strategies that we know close
reading gaps and address the needs that our students have
academically.
We want to make sure that we are continuing to disaggregate
data to ensure that all students are accessing public education
adequately and equally and that they have the same
opportunities for cocurricular activities, access to AP
courses, access to higher education.
So we are monitoring these things. We are more accessible.
I said in the beginning I want our agency to be a service
agency. I want us out in the field. I want us talking to
educators, teachers, principals. And we are working with them
to make sure that we are building capacity, we are providing
greater oversight. And we are being very clear about, if you
are using Federal dollars or even if you are not using Federal
dollars, the expectation is that all students have an
opportunity to succeed.
I opened with I am a beneficiary of public schools and
everything that this budget asks for, and I expect that for all
students across the country. The budget will help us get there.
Mrs. Watson Coleman. So do the school districts and the
States understand what you expect of them? And what will happen
if they are not even achieving or attempting to achieve those
things that you think are very important and achievable that
the Federal Government supports in terms of funding?
And what is it that you actually think the Federal
Government can do tangibly to desegregate these schools? Do you
really believe that desegregated schools, particularly in the
lower-income communities, can provide all of these educational
opportunities and the innovations that are available? What can
you actually tangibly do to help desegregate?
Secretary Cardona. Thank you. First of all, I do believe
the State chiefs, the superintendents, principal groups,
teacher groups, they are aware of what we are doing, because we
are at the table with them and they are at the table with us.
And I believe we have a shared purpose. It is just a matter of
drilling down and looking at those places where it is not
working, building capacity through technical assistance, and
ensuring that the funding is being used for the right things,
but also holding them accountable and withholding funding if
the actions go against equitable outcomes. That is what we are
working on.
Mrs. Watson Coleman. Okay. Yeah. I want you to know that,
in closing, I am very supportive of community schools. And I
think the community schools that have diversity of services to
both the child and the parent and that even finds educational/
recreational opportunities and after-school hours is vitally
important to our communities, and I strongly support it. And
anything I can do to that end with you, please count on me.
Secretary Cardona. Thank you.
Mrs. Watson Coleman. Thank you. And, with that, I yield
back.
Secretary Cardona. Thank you.
The Chair. Congressman Harris.
Mr. Harris. Thank you very much. And I apologize, but we
have the Ag--as you know, because you appeared before us, we
have the Ag Subcommittee.
And, well, thank you, Mr. Secretary, for being here. I want
to follow up first on something that the gentlelady from
Washington brought up. You know, Elon Musk famously tweeted
back in December of 2021, the fact that an 18-year-old can't
take out a $10,000 business loan but can take out a $100,000
student loan tells you everything you need to know.
So I have a question for you, because, you know, the
gentlelady brought up the issue of the importance of trade
skills. And so, for instance, I met with new car dealers. They
can't find mechanics, like, literally they can't find them.
You know, when a mechanic finishes their vo-tech training,
for instance, a set of tools cost them $15,000 or $20,000.
Without that set of tools, they have got to go work for
somebody else. They can't work for themselves. Nobody is going
to lend them $15,000 or $20,000 out of school, but they have a
marketable skill, a valuable marketable skill.
Why don't we lend them money? Why do we lend the money to
go to a 4-year college to study something in the humanities
that may or may not bear any fruit and not lend the person who
just learned a skill to get started in being a vibrant part of
our economy?
Secretary Cardona. Yeah. Thank you, Dr. Harris. As a former
automotive technician student myself in high school, I had to
buy those tools----
Mr. Harris. Yep.
Secretary Cardona [continuing]. And I know what you are
talking about. And I fully support making sure we have better
access to careers. I fully support creative pathways there and
those that give students opportunities to try different
pathways that maybe don't exist now. I am fully supportive of
that.
Mr. Harris. Great. Thank you very much.
So I am going to spend the last few minutes just on the--my
concern about the charter proposed rules. And I know you have
addressed it. Again, I am sorry I couldn't listen to everything
that was said. But, you know, in Maryland, I was there on the
Education Committee in the State senate when we passed the
charter school bill. It was to help Black students in Baltimore
City. There were successful charter schools which were almost
entirely minority.
Secretary Cardona. Right.
Mr. Harris. So when you come out with, you know, a proposal
that a charter must serve a diverse population, these were
actually designed to serve a nondiverse population in Baltimore
City, a population that was underserved, that didn't have
educational choice.
When you say that, you know, the community impact analysis
has to have evidence of over enrollment of existing public
schools, that is not the issue. It is not that there aren't
public school spaces available; it is that those public schools
are failing and parents get the choice of charter schools.
So are you aware of these concerns?
Secretary Cardona. I am. And I do believe proposals are
reasonable. I said at the beginning, before you were here, you
know, I remember when I was in Connecticut, one of the last
presentations before COVID shut everything down was Stamford
Excellence Charter School. The achievement in that school was
amazing, and we lifted it up as a great example. I know in
Rhode Island there is a great learning community charter
school, involves parents in ways that we want to see across the
country. So we know there are great examples.
And my department's technical support assistance is going
to be available to help any school that wants to open to be
successful. So I think these are reasonable, but I do
understand that there is a lot of concerns. There is a lot of
misinformation and there is a lot of myths that maybe we are
not in support. I am in support of high-quality public charter
schools.
Mr. Harris. Thank you very much. So I did tune into a
little part of your commentary.
Secretary Cardona. Okay, good.
Mr. Harris. You said you support quality schools.
Secretary Cardona. I do.
Mr. Harris. And you are right, look, some charter schools
weren't quality schools, but some really are. And please don't
throw out the baby with the bathwater.
Finally, you know I am a strong advocate for the D.C.
Opportunity Scholarship Program. I am very glad that the
administration in this year's budget did not include the phase-
out language. That was very disappointing to me. This is--
again, this is a program that serves overwhelmingly minority
students where the parents have, you know, waiting lists, they
do the lotteries for this. I mean, these parents really want
this to exist, and I am glad that the administration realized
that and then took out the phase-out language.
I am also glad they didn't include the poison pill
language, the language that would, again, look at the timeline
religious exemptions through a lens that basically would
disallow a lot of the schools.
This project, this is just a great--giving parents choice
in a failing school system is a good idea, not a bad idea. I
get it, it is controversial. I get it, union opposition. Again,
I lived through it all in Maryland when I was in the State
senate. I urge you, again, to support programs like this that
are broadly supported by parents where we can demonstrate that
they are qual--that there is a quality aspect to the education.
And, again, I thank you for being here. I apologize for being
so late.
I thank the chair for her indulgence, and I yield back.
Secretary Cardona. Thank you.
The Chair. Congressman Pocan.
Mr. Pocan. Thank you, Madam Chair and Ranking Member Cole.
I also was one of those folks late because of the Agricultural
hearing. So I want to say happy birthday to Ranking Member
Cole. Hopefully there is a quality cigar in your day at some
point.
Mr. Cole. Several.
Mr. Pocan. Several. Good, good. I want to make sure.
Since a lot of the questions were asked, let me just hit a
couple points and then I will ask a few questions. One, I have
great concern on the teacher shortage issue as well. In fact,
Madam Chair, it might be good to have a special hearing on this
sometime, because I think it is such a big issue. I think the
way you broke it down on pay and conditions and teacher voice
is very accurate, and there is challenges in all three.
You know, we saw the conditions with COVID and what has
happened to teachers. We have seen places like Wisconsin where
they have attacked public employee unions. And we have watched
the devastating numbers of people not applying to go to become
teachers.
In my main school district, it used to be almost impossible
to get in as a teacher. Now, they have positions where they
only get two or three applicants for a teaching position. So
this is a real issue, and I think whatever we can do to--I
appreciate what you have in the budget, but I think there is
probably more we are also going to need to do.
Second, perhaps a little different than the ranking member
on this, on the charter programs. I really appreciate the
direction you are doing with the extra scrutiny and efforts.
Wisconsin was one of the first States to have those, back now
almost 30 years ago. Yes, there was some rough periods that we
have corrected where, you know, we gave money to people who
opened schools who said they could read a book by putting their
hand on it and all sorts of interesting ways, but we still
don't have the performance out of them. And I think when you
look at the statistics that were given by the chairwoman, you
know, I am glad we have that extra scrutiny.
Completely agree with Representative Herrera Beutler on
Pell. I went to school because I had Pell grants, and I am not
lifting the ladder up. I am trying to make sure we are going to
continue to try to double those Pell grants. Thank you for
those efforts.
And I guess where I will get to a question now is I agree
with what Representative Clark and others said about the Office
for Civil Rights budget. I am especially concerned that there
is a trend among some States to have these so-called ``Don't
Say Gay'' laws, and they are going to have some really big
impacts, again, on teachers but also on students.
And, you know, specifically in that area, are there some
strategies that you are looking at? Because I have got the
feeling you are going to have a lot of potential firings and
expulsions and others because of those laws.
Secretary Cardona. We are asking for an increase of almost
$26,000,000. Really, it is our--one of our primary
responsibilities to ensure all students have access to a school
that is inclusive, where they feel welcomed, and that is what
we heard from students, and that is what we heard from parents.
We have been listening to parents. They want their children to
feel welcomed and embraced.
And what we are finding now across the country is that we
have to be proactive to ensure that we are out there and
communicating with these educators and these policymakers that
are introducing policies that go against that. Our Office for
Civil Rights is prepared. But what we want to do is build a
culture of inclusivity. We really need to be proactive about
this. OCR alone is not going to take care of this. We need to
create a culture of acceptance and inclusion for all of our
students.
I recently visited students in Florida and parents who told
me, all I want is for my kid to come back--just like every
other parent--go back into school, make up for some lost time
during the pandemic, and feel welcome, feel accepted, and that
is under attack. And we are not going to tolerate it. We need
to support every student, including our transgender students
who are under attack in many places.
As Secretary of Education, I need them to know I have got
their back. And the Office for Civil Rights is here to support
and take investigations if we have requests for them, because
we take this very seriously. That is something that we are not
going to compromise on.
Mr. Pocan. Thank you. And then two questions around
financial aid that have been brought up from my district. One
around FAFSA. You know, there has been repeated verification
points for the issue of requiring students to apply for that
annually. I believe there might have been some relief around
that through COVID in the requirement to reapply.
Is there a way to start looking at those multiple-year
applications that you don't have to every single year apply for
it when people are looking for a 4-year degree so that you
could have less disruption?
And secondly, there was, again, some relief during COVID
around Pell grants, and to the same end, if it was possible to
have some of the relief that we had during that time period
continue. We know there is going to be negligible effects, but
there is a lot of paperwork involved, and also it holds back
some families from being able to apply on the income
verification side.
Could you address those two points?
Secretary Cardona. Sure. And, you know, they are connected
in some ways. And I have to first acknowledge the dedicated
people, career staffers in FSA, who have been working
tirelessly to, you know, work on the systems that we are trying
to improve.
What we are trying to do is work closely with our services
also to make sure that they are supported throughout this
process, while also simplifying and making sure we have the
data that we need without over--creating more paperwork or more
challenges, more obstacles to this process. We will continue to
do that, and I look forward to hearing more from you and your
team to see what we can do to continue to improve that process.
Mr. Pocan. Great. Thank you very much, Mr. Secretary.
Secretary Cardona. Thank you.
Mr. Pocan. I yield back. Thank you, Chair.
Secretary Cardona. Thank you.
The Chair. That concludes the first round of questions
here, and it appears that we have some time and that we can
allow for a 3-minute round of questions. So really for the
quality of the discussion, et cetera, is really--it is rich and
it is so critically important.
I will just say to Mr. Pocan, I love the idea of a hearing
with regard to teacher shortage, and we are going to take you
up on that and pursue it. So thank you. I think it is a very,
very big issue.
Mr. Secretary, I would like to, one, say thanks with regard
to the great work of you and your staff on borrower defense.
More than 100,000 defrauded borrowers have received loan
discharges under the borrower defense repayment provision. But
we have got another, you know, tens of thousands of additional
borrowers who are waiting for their claims to be adjudicated.
I just read the article that was handed to me coming out
today: Education Department approves $238,000,000 group
discharge for 28,000 Marinello Schools of Beauty borrowers
based on borrower defense findings.
I think it is interesting, I know my colleague, Ms. Herrera
Beutler, talked about for-profit cosmetology schools being
worried about regulation. But if you take a look at the article
and what was found here is that this was--the Department found
schools failed to train students in key elements of cosmetology
program, how to cut hair, I mean, some very basic things, so
that cracking down on these schools that do--are predators is
really critically important.
Tell me what you are--I know we are waiting for a borrower
defense rule. In the meantime, what are you trying to do to
adjudicate these outstanding defense claims for groups?
Secretary Cardona. Thank you. You mentioned today's
announcement. Prior to that, over $2,000,000,000 in relief
through borrower defense for 105,000 borrowers who were taken
advantage of, misled. We really need to send a message that we
are not going to let that slide, that these practices of taking
advantage of students trying to chase that American Dream is
something that we are going to be monitoring more closely.
I am proud of the enforcement team being brought back up
under Richard Cordray's very capable leadership. It is really
creating a new culture to make sure that the return on
investment for our students is there so that they are not
saddled with debt for the rest of their life earning low-
income.
So I mentioned borrower defense. We are feeling similarly
with income-driven repayment. We are feeling the same way with
Public Service Loan Forgiveness. A lot of attention is on broad
loan forgiveness. We are working really hard, especially this
first year, to fix systems that are broken, that were not
working for students, and borrower defense is one of those.
The Chair. Okay. And I just would mention, I mean, the
students and the taxpayers are the ones who should be worried
about what is happening here, and there is overwhelming data
that talks about what attorneys general have found----
Secretary Cardona. Yep.
The Chair [continuing]. About misleading students,
harassing students, worthless degrees, major student debt. That
has to be drummed out of the system.
Secretary Cardona. Right. Right.
The Chair. That is what we have to do. No one is saying
let's not give people technical education. It is critically
important to do that. And we can work with that, work with
businesses, we can work with community colleges and getting the
people what they need and the technical credentials to move.
But we cannot allow corruption to take advantage of our kids or
of the Federal tax dollars. Thank you, Mr. Secretary.
I now yield to the Ranking Member, Mr. Cole.
Mr. Cole. Thank you very much, Madam Chair.
I have got two quick questions, one you might want to take
for the record, but you may know off the top of your head. What
percentage of the $76,000,000,000 in Higher Education Emergency
Relief Funds remain unspent, and how does the Department plan
to make sure that that money is actually used for COVID-related
purposes?
My friend, Mr. Cline, pointed out, we certainly have some
egregious examples where people I think misused the money for
things that none of us envisioned they would spend it on.
Secretary Cardona. Thank you, Ranking Member Cole. I will
get you specific numbers. I don't have it off the top of my
head. But I will tell you, in my visits to higher education
institutions, I have seen a shift. These institutions
understand they have to meet the students where they are, in
many cases, food insecurity, housing insecurity, dealing with
some basic needs, books, not only tuition support. But I think
if it weren't for the money in the higher education space, we
would be talking about colleges closing. We would be talking
about a dropout rate that is much higher.
What I have seen anecdotally and in stories of students who
have told me, I am only here because of the funds that the
school is providing, that they wouldn't have had if it weren't
for that. So I can get more information to you, but I can tell
you firsthand----
Mr. Cole. I would appreciate it, because I agree very much
with your basic point. Look, this money was necessary and--so I
won't quibble with that. I do worry, potentially it was an
unprecedented new program.
Secretary Cardona. Right.
Mr. Cole. It is pretty easy. You don't have controls set
up. So I just want to make sure, because I have seen some
pretty egregious examples of money spent on things that I know
nobody on this committee, on either side of the dais, would
have approved of.
Second question quickly, and this may call for a longer
discussion another time, is title I, where, again, I think the
purpose of the money is a really worthy purpose. I am concerned
that over--you know, we spend a lot of title I money, and a lot
of times we don't see much difference in performance over time
in the places where--I am not disagreeing where it is targeted.
I am wondering whether or not we are doing the things we need
to actually use the money to get a better result for students.
So can you just quickly give me some of your thoughts on
that and how we can improve the performance to follow the
dollars?
Secretary Cardona. Thank you, Mr. Cole. And I agree with
you wholeheartedly. Money doesn't always mean success if it is
not being used well. That is why I am proud to be an educator
and be able to say, if these funds are being used, they better
be used for evidence-based practices.
Deputy Secretary Cindy Martin has been working really
closely with our Office of Elementary and Secondary Education
to ensure that good teaching principles, good leadership
principles are being used with these funds. We both served as
educators at different levels, and we are really interested in
making sure that there is a good return on investment not only
for the students, but for the taxpayers who are funding this.
Mr. Cole. Yeah. If you could--and my time is about up, so
you don't have to respond, but if you could get us some
information on that that shows where the dollars have actually
markedly improved performance and, you know, what are the
reasons why that worked.
Secretary Cardona. Gotcha.
Mr. Cole. In other words, what are the things we did with
the dollars that actually helped kids get a better outcome.
Secretary Cardona. Happy to do that. Thank you.
Mr. Cole. Thank you very much, Madam Chair.
The Chair. Congresswoman Roybal-Allard.
Ms. Roybal-Allard. Mr. Secretary, this year we celebrate
the 50th anniversary of the Federal TRIO Veterans Upward Bound
program, which helps military veterans prepare to reenter the
academic pipelines. A Department of Education study found low-
income and first-generation veterans who participate in the
TRIO Veterans Upward Bound program were 42 percent more likely
to complete a degree than those who did not participate in the
program.
Can you address what steps the Department is taking to
improve college access and completion for our veterans through
this program or any other program that you may have?
Secretary Cardona. Yeah. I can tell you, in some of my
visits, some of the best stories are of our veterans who had
access to higher education and their family had access to
resources for all of them to find success.
We have worked closely with veterans groups, and we have
had them in the Department telling us how we can improve
programming, how we can work together with DOD and Department
of Veterans Affairs to make sure that the communication to them
is streamlined.
We will continue to work with them and to make sure that
they have access to the programs and the benefits that are due
to them. They have served our country, and it is important for
us at the Department that they feel that we are supporting them
in their process of accessing higher education.
Ms. Roybal-Allard. I have several questions that I won't
have the time for, but I will submit them for the record.
Secretary Cardona. Please do.
Ms. Roybal-Allard. But I just do want to make one point and
that has to do with the issue that has been brought up by my
colleagues with regards to trade schools.
Secretary Cardona. Sure.
Ms. Roybal-Allard. And I just want to point out that, in
addition to the financial support and other things that have
been talked about, I think it is also important for the
Department of Education to change public attitude about going
to a 4-year college versus going to a trade school. And then
just quickly, let me just give you one example of what I am
talking about.
I was talking with some parents in my district and they
were bragging about their--of their oldest child who was going
to a 4-year college and, you know, how proud they were of them.
And when I asked about, well, what about, you know, your other
son, they were almost apologetic in telling me that that son
was going to a trade school.
And I think that there is various reasons, historical
reasons, you know, for that being the way it is, but I think it
is important that we find a way to give the same kind of status
to those who go to a 4-year college and those who get a degree
in some kind of trade school, for all the obvious reasons that
have been mentioned. And I think the Department of Education
can be helpful in helping the public and parents understand
that both have tremendous value.
Secretary Cardona. Absolutely. As a graduate of a technical
high school, I couldn't agree more. We do have more work to do
to change the culture, the stigma that is, unfortunately,
associated with it. There are high-paying, high-skilled jobs
out there.
I remember visiting a place in Michigan--I can't think of
the name of the school now, but it was a graduate program. The
students that were studying plumbing were going into jobs
making six figures when they left, with very little debt. They
are doing pretty well. We have to change the stigma, and I am
excited to do that work.
Thank you.
The Chair. Well said, both of you.
We have another member of the committee that has joined us.
Can you introduce her, Mommy?
Ms. Herrera Beutler. Say, Hi, I am Isana Mae.
Isana Mae. I am Isana Mae.
Ms. Herrera Beutler. Isana Mae.
The Chair. Okay. Well, welcome.
Ms. Herrera Beutler. Thank you.
Voice. Give her questions.
Ms. Herrera Beutler. I don't know if anybody could handle--
that would be a tough question.
I wanted to ask, kind of following up along this, you know,
I agree with the chairwoman that corruption and defrauding
students and the American taxpayer should never be tolerated. I
am in no way afraid of any kind of investigation into someone
who is a bad actor, like full stop. I do think, though, my
challenge is, is there are not similar applications of I feel
like justice being applied.
You know, one of the things that madam chair--and I agree
with this--she said, we cannot allow corruption with Federal
tax dollars, worthless degrees, and thousands of dollars in
debt.
Well, any average person watching this might think we are
talking about, you know, one of the many students who went to a
4-year liberal arts degree and has thousands of--hundreds, in
some cases, of thousand dollars in debt, and they are working
as baristas. You know, right now, we have over a million
workers that just disappeared from the economy, and your
administration that you work with is talking about forgiving
their debt, and I am thinking and we are trying to get rid of
trade schools?
One way we can make this whole thing work is if we change
the stigma, root out the bad, and apply that same level of
justice. And it was frustrating to me as this rulemaking
process is happening that I have good acting trade schools that
provide good jobs in my district who are saying, Department of
Ed won't respond to us. It is not even that they are giving us
bad information or they don't like us; it is that they won't
respond to us. That is not appropriate.
And I would like to see that same measure being applied to
our 4-year schools. Is it still true that financial aid
counselors cannot counsel a student, Yeah, you know, you are
taking out all this debt, yet your degree isn't going to help
you pay that off? Like, it has been the rule that financial aid
counselors can't actually point that out to students. I think
we need to--I agree that the system needs to be cleaned up.
Secretary Cardona. Yes.
Ms. Herrera Beutler. And let me add to that nursing.
Nursing is another area. If you are talking about forgiving
loans, I know that you are talking about the Public Health
Service Corps and the Public Service Loan Forgiveness programs.
Those are great. But if you are going to talk about widespread
forgiving of, you know, everybody's loans, there needs to--
Federal taxpayers need to have some benefit there.
So why can't we consider asking those people to serve in
high critical need areas? They are going for a psychology or
psychiatry degree, maybe help serve in a childcare desert. You
know, maybe you should put in the same 5 years of service that
a health service corps person would do to get that loan
forgiveness. I think that needs to be considered.
So that is a lot.
Secretary Cardona. I appreciate it. Thank you for sharing
that. I welcome an opportunity to have more conversation about
how you are perceiving it, what you are hearing, and how we can
at the Department of Education be more service-oriented to
those who might feel like they are not hearing from us.
Thank you.
Ms. Herrera Beutler. Thank you.
The Chair. Congresswoman Clark.
Ms. Clark. Thank you, Madam Chairman.
I was delighted to see in your budget another $616,000,000
to help simplify the FAFSA process. I think few forms for
students looking to further their education and families that
support them create more of a daunting process than that
particular form. So I would love a brief update on where you
are with that.
And, in particular, we have been looking at the issue for
homeless, foster, and justice-involved youth that even a
simplified process is still very difficult. So I would love to
hear about your strategies for helping those students enroll
and complete their postsecondary education.
Secretary Cardona. Thank you. I couldn't agree with FAFSA
simplification any more after having gone through the process
with my own son several months ago. And as you know, the
deadline was extended, but I am glad to say that homeless and
foster provisions won't have to wait another year. That will be
ready for the following year.
We can't have a program that is intending to help students
that need additional help make it so hard for them to
understand it or their parents to understand it. I can tell
you, one of my son's friends called me--called my son and said,
``Could your father help my mother with the FAFSA because she
doesn't understand it?'' And that told me--and she knew that I
am in education, so he said, ``Well, I will call him.''
The process has to be much easier. It has to be accessible
to those who need it most. There can't be barriers there that
make someone think it is easier just to forget and ignore that.
That is unacceptable. And I am glad we are moving forward
toward simplification. I wish it could be ready now, but I am
happy that for the homeless and those in foster care, they
don't have to wait another year, that theirs will be ready in
2023, 2024.
Ms. Clark. And I know this is primarily a State issue, but
one of the other factors that has come up, especially for
foster youth, but it really applies across the board for some
of our more vulnerable populations, is aging out of foster
care.
And 21 States still have not extended the age limit. But in
a recent visit to a community college, talking to the
administration and students, even with the extended age of 23,
with all the interruptions of the pandemic, the high costs of
housing, food insecurity, you know, I think we have to think
about a different way that we address these needs and help
these students finish without an arbitrary age cutoff. It just
doesn't reflect the reality of many, many students, but also
especially of homeless and former foster youth.
We need to make sure that we are--we are looking at that.
And it is often a State issue, but I am hoping we can
collaborate and think about solutions.
Secretary Cardona. Yeah, I appreciate that. And especially
now after the pandemic where so many have faced disruption that
might have taken them off course for a little bit.
I am very eager to learn more about this and maybe work
with you to hear specific examples of things we can do to help
that process along.
Thank you.
Ms. Clark. Thank you. We will follow up. Thanks, Mr.
Secretary.
I yield back.
The Chair. Ms. Frankel.
Ms. Frankel. Thank you, Mr. Secretary.
Well, the Governor of Florida has decided to be the leader
in the cultural war of extremism in our country. And I know Mr.
Pocan talked to you about the situation with what he calls the
Don't Say Gay bill, but I want to talk to you about the WOKE
bill.
The WOKE bill is aimed at limiting how schools and colleges
and businesses discuss race. It blocks any instruction that
could hint at one race feeling guilt for past actions or that
their race necessarily determines a person's status as
privileged or oppressed.
Now, I wanted to say I was at the Museum of African
American History the other day. And if anyone hasn't been
there, I just urge you to go there. And, you know, the first
exhibit that I saw had all of these slave ships and showed how
human beings were packed in these horrible, awful conditions.
And I have to say, I had very strong emotions, all kinds of
emotions, whether it was sadness, or guilt, or whatever.
And I just do not understand how--I mean, it seems to me
that, under Florida law now, children are not going to be able
to be taught about slavery. One district recently canceled a
workshop on the civil rights movement out of fear of violating
the new law.
And so, you know, what my constituents are asking me is can
the Federal Government do anything to intervene against this
craziness, this horrible effort by the State of Florida to
basically block teachers from telling the truth or have
students having any emotional feeling when they hear the facts?
Secretary Cardona. You know, we--as a lifelong educator
myself, I know the importance of making sure students feel
engaged in learning. And while the Federal Department of
Education doesn't have a role in curriculum, to me it is really
important as an educator and as a father that our students are
engaged and proactively introduced to the beautiful diversity
that has made this country the most amazing experiment in the
world. But that includes, you know, our history. That includes
parts that we are not proud of.
I trust that----
Ms. Frankel. I understand. I agree with you, but is there
anything that the Office for Civil Rights can do about this
effort in Florida?
Secretary Cardona. What the Office for Civil Rights can do
is thoroughly investigate any request for investigations around
lack of rights of students. And, you know, I can't speak
prematurely to that, but I will tell you, we do believe that
students should have quality programming, and we are concerned
with some of the policies that are less curriculum, more about
division, more about bringing politics into the schools. I said
at the onset, our schools should not be the place for cultural
wars.
Our parents want our children to recover from what was
missed during the pandemic, for the missed instruction. They
want the mental health needs of their students cared for. They
want all students to feel welcome. That is what our parents are
asking for. We are not going to get distracted going into the
cultural wars, but I also encourage our State leaders and our
local leaders to make sure that they are also in the
conversations around what our students need.
And I know that our educators and parents want the same
thing for their kids. They want their children to learn in an
environment that is inclusive, that is welcoming, and that
teaches the truth.
Ms. Frankel. Thank you. I yield back.
Thank you, Mr. Secretary.
The Chair. Congresswoman Watson Coleman.
Mrs. Watson Coleman. Thank you, Madam Chair.
Secretary, the whole notion of community schools is
something that we explored about three or four governors ago
when the Governor of Florida believed that schools should be a
community outreach. Parents can come there and get services
they need. Children get services they need. School doesn't end
at 3:00. I am so excited about those. I really believe that
they are an answer to a lot of our issues in our particularly
underserved communities.
So I thank you for the work that you all are doing. I look
forward to that expanding.
I wanted to just draw your attention to the HBCUs and the
TCCUs and the MSIs. I know that you all recognize the
significance of them, the importance of them, and that is
recognized in the budget because of the investments that you
have increased in those areas.
Could you please speak to the importance and impact of
better funding these universities that primarily care for
students of color?
Secretary Cardona. They care for students of color, but
they punch above their weight. HBCUs, for example--only 3
percent of our colleges and universities are HBCUs, yet they
are producing tenfold the percentage of Black doctors, judges,
attorneys.
So, for us, this is really about making sure that we are
supporting institutions that have historically been underfunded
and don't have the endowments in many cases that other
universities have but are producing high-quality graduates and
are contributing in positive ways to our economy.
So, for me, you know, my visits to not only HBCUs but MSIs
and HSIs and TCCUs underscore the importance of supporting
these institutions that are helping next generation of many
times first-generation college students find success and
achieve that American dream.
So it is a great investment, not only for these
institutions, but for our economy and for our country.
Mrs. Watson Coleman. I think that your budget proposal, the
President's budget proposal definitely moves in the right
direction in so many areas that are important to us, and I look
forward to working with you. And I thank you for all the work
that you have done and for the places you shared based upon
your lived experiences, which are very important and very
relevant.
Secretary Cardona. Thank you, ma'am.
Mrs. Watson Coleman. I yield back.
Secretary Cardona. Thank you.
The Chair. Thank you.
With that, I will ask the ranking member if he has any
closing statements.
Mr. Cole. Yeah, just a few. And thank you, Madam Chair, and
it is wonderful to be back here and maybe next time in our own
room, but this is still good.
And, Mr. Secretary, it is always a pleasure to have you.
I come away from our hearing with four conclusions. One, I
would ask you to really look carefully, Mr. Secretary, at this
charter school issue. We had four different members on our side
raise concerns about that, and I think they reflect what their
governors are thinking in many cases or certainly what their
constituents are. So we have a lot of concerns in that area,
and we are going to continue probably to push pretty hard on
that.
Second, I would ask you--and you acknowledged this--to look
at Impact Aid and Indian education. Again, I understand why the
numbers are a little bit lower, but I think we could probably
all agree those are areas that we want to continue to work on,
certainly Native American education. I know a lot of that is
actually in the Interior budget. That is a whole other
discussion for another time as to where that would be
appropriately funded, but we would certainly like to see some
increases there.
Third, on a very hopeful note, you know, as I draw away,
and I listened to all the comments and your testimony, I see
some terrific areas of cooperation, and they are pretty
traditional for us here. Special education is something I think
we all feel strongly about with IDEA in particular. Early
childhood has been a favorite of this committee on both sides
of the aisle for quite a few years. First-generation college
students, I think we all think that is an investment that is
not only a good investment, but helps us deal with inequities
that we know exist over time.
And finally--and your background would probably make you
especially sensitive here--career and technical education
where, again, as you pointed out in your testimony, there are
some terrific job opportunities for kids, and we need to make
sure that we don't disparage the 70 percent that choose to do
another route than the traditional 4 years, and that can often
lead to a very, very good outcome, and we don't want to miss
those opportunities.
Finally, the last thing I will say is just renew my
commitment. Probably the best gift we can get you--of course,
you want everything that you would ask for, and that is fair
enough, but the best thing we could do for you is get you
something on time and, you know, make sure that you have got
the time to implement. So I want to reiterate, I want to work
very closely with my chairwoman, whom I admire a great deal,
and try to make sure that we get this done closer to the time
so that you have got, you know, the full amount of time to
implement these things.
And we got you a budget I am pleased to have voted for, but
we got it to you awfully late, and I know that has made things
very difficult for your department. We are going to try and do
a better job. And if we don't do a better job, I can assure you
it won't be the fault of the House of Representatives or our
chair. It will be the fault of the United States Senate. So we
are going to push them pretty hard too.
So thank you.
And thank you for the hearing, Madam Chair. I yield back.
Secretary Cardona. Thank you, Ranking Member.
The Chair. Thank you very much.
And I too am committed to seeing that we can get these
bills done in time for people to be able to utilize the
resources that they need and not wait several months before
they can do that. And I want to thank the ranking member for
his assistance in getting the bill, the omnibus over the finish
line. And he knows that I welcome his support, and I will ask
for his support and help and guidance as we try to make it
through the next go-around.
And this afternoon, we will have a meeting with the four
corners. And, you know, I am optimistic about having, you know,
a good direction and one where everyone understands the need
to, you know, move quickly.
Just a couple of points. We talked about, you know, the
issue of technical schools and having youngsters be able to
really realize their dreams and their aspirations. The fact is
that 70 percent of people in the United States do not have a 4-
year college degree, nor--if you can, fine, and if you can't,
that is fine. But that means that is all the more reason why we
have to address what is important to 70 percent of the people
in this Nation.
And, you know, that is critical in making sure that those
institutions are the very best and are providing the kind of
instruction that allows them to realize those dreams and
aspirations.
I would say I understand Ms. Herrera Beutler's need, you
know. She has that little urchin there that, you know, needed
to run off with. But I would just say, because I--at the outset
in my questioning, I talked about a private institution, the
University of Southern California, and what it costs for their
master's degree program and what they are doing. So we need to
root out that kind of--you know, I call it corruption, I really
do, you know, out of wherever it is, to provide youngsters with
what they need.
And you started out--and I did as well--Mr. Secretary, that
talked about--you know, I talked about Horace Mann:
``Education, beyond all other devices of human origin, is the
great equalizer.'' Education is the great equalizer.
There isn't a person on this panel here or even out there
whose parents have said to them, ``Get yourself an education
because it is the root to success.'' You know, your family said
that to you. You know, that is what my parents told me, you
know, over and over again. And the parents sacrificed to make
sure that that happened so that we could realize our own dreams
and aspirations.
But no child should be denied a quality education because
of their parents' economic circumstances, or where they are
born, or if they have a disability, you know, or their
ethnicity, or their race, their gender. That is not who we, you
know, strive to be. And I know that that is the heart and soul
of where you are.
And so that--and as I said that education is the great
equalizer, and it is our teachers, it is our public schools,
our universities, they are more essential now than ever to be
fulfilling that effort.
Our job is--and you talked about it at the outset. You
know, the numbers are important, because we have to take a look
at what the funding is, et cetera, but what is the underlying
mission? What needs to propel us to get those opportunities out
to youngsters, whether it is K-12 or postsecondary? You know,
how do we do that?
We now have a new set of challenges as well. We have
serious mental health issues with our kids. We have people who
are struggling with hunger, housing costs with college, you
know, students. There are disparities which are there. We have
outside forces today that you don't want to create a new
dynamic around education and use teachers in many respects and
scapegoat teachers, you know. I mean, this is--it is tough. It
really is. So we have to kind of navigate our way through.
And I want to commend to you, because I think that your
background, your experience is what we critically need at this
juncture to navigate education. And, absolutely, people are not
always going to agree on everything. We will disagree. But as
the ranking member said, we do it with civility. We do it with
the goal in mind. That is where we need to go in the course of
our Nation's history. What is the goal? And on both sides of
the aisle, like they did in the past when we created a social
safety net in this country, it was Democrats and Republicans
coming together and saying, ``This is the challenge. How do we
get there?'' We want to help you get there, and that is what
our goal will be here.
And, with that, I thank you. I thank your team for all that
you do and your commitment to our youngsters' education. So
thank you.
And, with that, this hearing is adjourned.
[Answers to submitted questions for the record follow:]
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Thursday, May 26, 2022.
TESTIMONY OF INTERESTED INDIVIDUALS AND ORGANIZATIONS
The Chair. Let me begin the hearing and bang the gavel, and
let us get underway.
Again, some housekeeping issues to start with. The hearing
is fully virtual so we have to address these issues.
For the meeting, the chair, or the staff designated by the
chair, may mute participants' microphones when they are not
under recognition for the purposes of eliminating inadvertent
background noise. Members are responsible for muting and
unmuting themselves.
If I notice when you are recognized that you have not
unmuted yourself, I will ask the staff to send you a request to
unmute yourself. Please then accept that request so you are no
longer muted.
I remind all witnesses that the 5-minute clock applies
during today's public witness day. If there is a technology
issue, we will move to the next witness until the issue is
resolved, and you will retain the balance of your time.
You will notice a clock on your screen that will show how
much time is remaining. At 1 minute remaining, the clock will
turn yellow. At 30 seconds, I will gently tap the gavel to
remind witnesses that their time is almost expired. When your
time has expired, the clock will turn red, and I will begin to
recognize the next witness.
With that, I would like to acknowledge and thank our
ranking member, Tom Cole, for being here this morning, other
members of the committee.
And welcome to the Labor, HHS, Education Subcommittee's
public witness day hearing. I think we all want to express our
deep gratitude to the 24 witnesses testifying today and to all
of those who sent written testimonies for the record.
It is about your experiences and your testimonies. They are
so invaluable to us. The work that we do together to fund the
programs in this subcommittee's bill impact the lives of
Americans across our country.
At last year's public witness day hearing, I said that
today's hearing is one of the most important things the
committee does, and that has certainly rang true. With the help
of public witnesses, we developed a fiscal year 2022 bill that
has made transformative investments to tackle America's
toughest challenges.
Our bill grows educational opportunities with more funding
for high-poverty schools, for students with disabilities, and
for programs that expand access to postsecondary education. It
strengthens lifesaving biomedical research with increased
funding for the NIH. We bolster our public health
infrastructure with an increase of investment in the CDC and in
State and local governments.
We tackle the urgent health crises--maternal health, mental
health, gun violence, and substance misuse, while reducing
unacceptable health disparities. We are supporting middle-class
working families with more funding for childcare, for Head
Start, for preschool development grants. The bill creates and
sustains good-paying jobs with investments in job training,
apprenticeship programs, and worker protection. All of these
were made because of input from public witnesses.
As we draft the 2023 bill, using the President's budget
request as a starting point and direct input from stakeholders,
including all of you, we will continue to transform the lives
of Americans all across the country.
Looking forward to your testimony this morning, and I thank
you all for being here today.
And with that, please let me turn it over to our ranking
member, Congressman Cole, for any opening remarks.
Mr. Cole. Well, thank you very much, Madam Chair.
Thank you for holding this hearing. It has been a while
since we have been able to have it due the pandemic, and I, for
one, miss it a great deal.
And I invite those of you that are testifying today to not
just show up for your testimony, but if you have the time,
listen for a while. And it is an education because it will give
you a clear idea of the true range of this subcommittee, the
diversity of the topics it deals with, the sheer quantity of
requests that we get every year to address specific problems
and to come and testify.
Frankly, I don't think there is any other subcommittee that
has anything like the number of people that want to come and
participate, and it actually underscores something our chair
likes to say quite frequently, that this is the people's
subcommittee. And in many ways, it is. Because these are
usually urgent issues that affect people's daily lives that we
try to direct appropriate money toward ameliorating their
circumstances, improving their circumstances, and generally
bettering our society.
So, again, I look forward to today's hearing. And for all
of you who have come to testify, thank you very much for your
interest in the work of the committee, and thank you very much
for taking some of your time to educate us and our staff about
the things that we need to focus on. It is enormously helpful,
as the chair said, when we get down to actually putting
together the bill.
So, with that, Madam Chair, thank you again for the
hearing, and I yield back.
The Chair. Thank you.
So we will get underway with our first witness this
morning. That is Bob Lanter, who is the executive director of
the California Workforce Association.
Mr. Lanter, you are recognized.
BOB LANTER, EXECUTIVE DIRECTOR, CALIFORNIA WORKFORCE
ASSOCIATION
Mr. Lanter. Good morning, thank you.
Good morning, Chairwoman DeLauro, Ranking Member Cole, and
members of the Labor, HHS, Education Appropriations
Subcommittee. My name is Bob Lanter, and I serve as the
executive director of the California Workforce Association.
CWA is a statewide nonprofit representing the 45 local
boards, as well as a broad coalition of workforce stakeholders
in California. My testimony today will focus on the Workforce
Innovation and Opportunity Act Title I programs at the
Department of Labor--Adult, Youth, and Dislocated Worker.
The fiscal year 2023 budget request would increase funding
for the Adult, Youth, and Dislocated Worker Programs to the
fiscal year 2020 WIOA authorized levels. WIOA Title I should be
funded at least to the amounts following--Adult Employment and
Training Activities, $899,000,000; Youth Activities,
$963,000,000; Dislocated Worker Employment and Training
Activities at $1,600,000,000.
While we support this proposed increase, we know more is
desperately needed to respond to the ongoing impacts of COVID-
19 on our Nation's economy. The House recently passed a WIOA
2022 reauthorization package that includes historic investments
for these programs, beginning in fiscal year 2023, and we
strongly support those funding levels moving forward.
The Federal funding approved through this subcommittee is
the primary source that supports a national network of local
workforce development boards, led by the private sector, and
American Jobs Centers throughout each of your respective
districts. These centers and their staff serve as a critical
resource for job seekers, businesses, training providers, and
other agencies to address the economic needs of their
communities.
We thank the leaders and members of this subcommittee for
your efforts during the fiscal year 2022 appropriations
process, which provided marginal increases--about 1 percent--
for WIOA Title I programs when compared to fiscal year 2021
levels. Unfortunately, this level of Federal investment does
not address our current or future national workforce needs.
In California, during the 2021 program year, our adult and
youth formula allocations were cut by nearly 7 percent each.
Twenty other States also experienced cuts to their adult
activities during this time. This funding cut, during the
height of COVID, reduced the capacity and services for
individuals looking to re-enter the workforce, as well as
businesses desperate to hire skilled workers.
The labor market remains very fluid with record job
openings and separations, and innovative talent pipeline
development strategies are needed if we are to support business
and provide opportunities to job seekers, particularly those
working to achieve economic self-sufficiency.
One of the advantages of the Federal workforce system, as
funded by WIOA, is the ability to leverage and engage broad
stakeholders, such as education and training, business, labor
management partnerships, and economic development. Through
these networks, Federal funds, invested locally through
workforce boards, can be intentionally directed to communities
where businesses and individuals need them most.
Unfortunately, the impacts of COVID-19 hit the most
vulnerable populations earlier and longer. The effects continue
to create significant barriers to employment for minorities,
women, disabled individuals, out-of-school youth, ex-offenders,
and others.
Affordable access to childcare, transportation, food, and
housing often prevent individuals from enrolling in education
and training programs or even getting or keeping a job. This
type of support services and additional resources for them will
expedite barrier removal.
Career pathways are also developed in partnership with
business, labor, education to incorporate in-demand skills into
program delivery. Collaborations like this lead to better
outcomes in job placement, wage gain, and skill development. In
California, the High Road Training Partnership Initiative is
designed to model sector-based strategies, ranging from
transportation to healthcare to hospitality.
Earlier in this Congress, the bipartisan Infrastructure
Investment and Jobs Act was enacted as a landmark achievement
to significantly increase spending on traditional projects like
roads and bridges but also include broadband expansion and
renewable energy sectors. Local boards in California and across
the country are leading efforts to identify, train, re-train,
and connect workers to these opportunities.
The WIOA Title I programs must be funded beyond current
levels to help reach the potential needed in constructing and
advancing infrastructure projects by connecting them to our
communities' vulnerable neighborhoods.
In closing, increased Federal investments in WIOA Title I
programs will facilitate thousands of successful workforce and
economic development examples like those referenced earlier.
Providing resources that are desperately needed by workforce
stakeholders will lead individuals from unemployment and low-
wage jobs to education and careers, allowing them to become
economically self-sufficient and contribute to our Nation's
economy and the future of America.
Thank you very much, and I would be happy to take
questions.
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The Chair. Let me start with the ranking member, if he has
any questions? Or I saw Mr. Cline, if he is on?
Mr. Cole.
Mr. Cole. No, Madam Chair. I have no questions.
The Chair. Okay. I think I heard Mr. Fleischmann is on. Mr.
Fleischmann.
Mr. Fleischmann. Madam Chair, no questions. Thank you.
The Chair. And Mr. Cline.
Mr. Cline. I have no questions, Madam Chair. Thank you.
The Chair. Thank you.
I want to say a thank you to you, Mr. Lanter. We all know
the benefits of the WIOA programs and how beneficial they are
for adults, for youth, and the disadvantaged.
One of our issues will be what we will be seeing as an
allocation for the subcommittee. That has not yet been
determined. But I think you can rest assured to say that if you
have seen in the past, while it is not to the levels that you
would like and that we would like, is that we understand the
value of the programs, and our direction is to reinforce these
efforts because we know that is where the security of the
workforce and for the economic security of the people that
these programs benefit.
So thank you so much for being with us today. We really
appreciate your time and your testimony.
Mr. Lanter. Thank you, Chairwoman. Appreciate it.
The Chair. We now recognize for 5 minutes as our witness
this morning, Jodi Grant, who is executive director of the
Afterschool Alliance, Washington, DC.
Ms. Grant, it is wonderful to see you. Thank you for your
outstanding work.
JODI GRANT, EXECUTIVE DIRECTOR, AFTERSCHOOL ALLIANCE
Ms. Grant. Thank you.
Chairwoman DeLauro, Ranking Member Cole, members of the
committee, it is truly an honor to be before you today.
And on behalf of the Afterschool Alliance, the afterschool
field, families across America, thank you for increasing
funding for the Nita M. Lowey 21st Century Community Learning
Centers in fiscal year 2022. It provided vitally important
support to afterschool programs serving 1.6 million kids. We
ask you to build on that and help address the vast unmet need
for afterschool programs by providing $1,790,000,000 in fiscal
year 2023.
The Afterschool Alliance is a nonprofit that supports more
than 23,000 afterschool partners that are expanding learning
opportunities for students nationwide. They keep kids safe and
fed and offer them engaging, hands-on learning experiences that
improve school attendance, academic achievement, and graduation
rates.
During the past 2 years, COVID-19 presented afterschool
programs--and the students, families, and communities that rely
upon them--with enormous challenges. Programs faced
skyrocketing unexpected costs, serious health concerns, limited
access to school facilities during closures, staffing
shortages, and more.
But I am so proud because the afterschool field rose to
meet this challenge. Programs adjusted their schedules to
address the urgent needs of children and families by providing
meals, caring for children of essential workers all day long,
keeping students connected during remote learning, providing
safe spaces for online learning and in-person enrichment, and
so much more.
Afterschool programs are now helping young people emerge
from the pandemic strong, resilient, and hopeful. None of that
would have been possible without Federal support.
Programs operate before school, during school, during--I
mean after school, during the summer months, and they provide a
safe learning environment, enrichment, caring adults and
mentors. And 21st Century Community Learning Centers are unique
because of the collaborations that bring the best of a local
community's resources to its students.
They offer holistic supports to students of all ages that
can prepare them to be college and career ready. Community-
based organizations, nationally affiliated non-profits,
colleges, public libraries, parks and rec centers, faith-based
institutions, traditional public schools, charter schools,
museums, and others are all eligible for 21st Century Community
Learning Center funding, but the ``secret sauce'' is that all
of these entities join together to provide a quality learning
experience for pre-K through 12th grade students.
21st Century programs are helping students reconnect, re-
engage, and develop the skills they need to be successful not
just in school, but in life. And after school, students
discover their passions, be it robotics, gardening, coding, or
music, or dance. And at this moment, when so many of our youth
are struggling, afterschool programs provide so much more than
just academic and career support. They are a safe place where
kids can have healthy interactions with each other and caring
adults and, most important, a place where they belong.
But there are not nearly enough funds. States are able to
provide grants for just one in three requests for 21st Century
funding. Across 10 years, $4,000,000,000 in local grants were
denied due to insufficient funding. Before the pandemic, almost
25 million students nationwide were on the afterschool
waitlist.
Students who regularly participate in afterschool programs
improve their school attendance, health-related behaviors, and
math and reading achievement. The COVID-19 relief funds you
provided are helping students get caught up while providing
whole child supports. But too many school districts are using
those Federal COVID dollars only for academics. Without
increased funding for 21st Century, students will miss out on
the holistic afterschool and summer opportunities that can help
them navigate the challenges created and exacerbated by the
pandemic.
Additional funding will also help ensure that programs have
the resources to address staffing challenges, which is a major
and growing concern. And afterschool and summer learning
programs provide a lifeline for working parents and those
trying to get back into the workforce.
Finally, I want to end by quoting Kyla Anderson, a high
school student attending a 21st Century Community Learning
Center in Illinois. ``During the pandemic, I was social
distancing and not doing certain activities. But at my 21st
Century Community Learning Center program, I've been able to
meet new friends, communicate, and be social with others. I
wasn't a talker, but now I am. The mentors helped me stay on
top of my work and encouraged me. Without my program, I
wouldn't have the grades I do now, and I wouldn't be as social
as I am.''
I urge you to increasing funding for 21st Century Community
Learning Centers by $500,000,000 to give more young people like
Kyla opportunities to learn and to thrive.
Thank you.
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Mr. Cole. Madam Chair, I think you are on mute.
The Chair. Got it. I was just saying it is always wonderful
to hear from you, Ms. Grant. This is a program I think we are
all very excited about, and named after one of the titans of
the House, the congresswoman who chaired this committee, Nita
Lowey.
And I was so glad you mentioned dance because you know my
history of teaching in the afterschool program of teaching
dance and calligraphy. I don't do either one of them at this
time. [Laughter.]
The Chair. So, but it is one of the--you made one point,
which I just want to reinforce is, it is a quality learning
experience. And that is what we are talking about here. This is
not warehousing children, but this is really helping them,
teaching them skills, enriching their lives, and it also has
the added the benefit of helping parents who are at work.
So it is a program that is near and dear to all of our
hearts. You will keep advocating, and we will do our best to
increase the dollars for that.
And with that, let me recognize the ranking member.
Mr. Cole. Well, thank you very much, Madam Chair.
I just want to quickly associate myself with your remarks.
This is actually one of the programs that I think both sides of
the aisle really appreciates the quality of the work and the
importance of the issue. And as the chair related earlier,
obviously, we don't know where we are at yet in terms of
allocations, and there is always lots of need.
But anybody that comes in front of this committee and
advocates for a program named after our esteemed former chair
has a pretty good chance for success. Because we all think so
highly of Chair Lowey and miss her a lot, and it wouldn't
surprise me if she is watching the proceedings right now. She
keeps a pretty close eye on what we do.
But again, thank you for coming before us and advocating
for such a worthy cause.
Ms. Grant. Thank you.
The Chair. Congressman Fleischmann.
Mr. Fleischmann. Jodi, thank you so much for the
presentation, and I will just associate my comments with our
distinguished chair and ranking member.
Thank you.
The Chair. Thank you. Congressman Cline? Congressman Cline,
any questions?
Mr. Cline. No, Madam Chair.
The Chair. Okay, thank you.
Then again, Jodi, thank you very, very much. And thank you
for your enormous commitment to this effort. You have, just
over the years, just been such a cheerleader for one of the
best things that we do at the Federal level. So thanks very,
very much for being with us today.
Ms. Grant. Thank you for all your support.
The Chair. Thank you. Thank you.
Now, a pleasure for me to recognize Mark Jenkins. Mark is
the founder and executive director of the Connecticut Harm
Reduction Alliance and a United States Air Force veteran.
For the past 24 years, Mr. Jenkins has worked to deliver
innovative prevention and intervention to the most vulnerable
members across the State of Connecticut. His work has made him
a well-respected individual in his field, known for his
connections with folks on the street and in the service of
community.
Wonderful to have you with us today, Mark, to discuss
responding to the overdose crisis, supporting harm reduction
and syringe services programs through the Infectious Diseases
and the Opioid Epidemic Program at the Centers for Disease
Control and the U.S. Department of Health and Human Services
here.
Mark, you are recognized for 5 minutes.
MARK JENKINS, EXECUTIVE DIRECTOR, CONNECTICUT HARM REDUCTION
ALLIANCE
Mr. Jenkins. Thank you, Chairwoman DeLauro, Ranking Member
Cole, members of the subcommittee.
Again, my name is Mark Jenkins, and I am a service-
connected, disabled veteran of the U.S. Air Force and founder
and executive director of Connecticut Harm Reduction Alliance.
Today, I am pleased to submit testimony on behalf of the
alliance and as a member of a larger coalition of public
health, HIV, viral hepatitis, and harm reduction organizations.
First, I would like to thank the subcommittee for the
fiscal year 2022 funding increase for the CDC's Infectious
Diseases and Opioid Epidemic Program. New funds will help to
strengthen services to prevent opioid overdose deaths and
infectious diseases transmissions.
I am here today to urge you to provide $150,000,000 for the
program in fiscal year 2023. Such funding would expand access
to overdose prevention and syringe services programs, or SSPs,
which save lives and connect people urgently to needed care,
including treatment for substance use disorders.
Founded in 2014, the Connecticut Harm Reduction Alliance
offers a wide range of services to help people who use drugs
avoid overdose and live longer, healthier lives. We meet folks
where they are at, in their time, place, language, and lived
experience.
Services we provide include syringe services programs to
help prevent HIV, viral hepatitis, endocarditis, which is a
heart infection, and other infectious diseases; naloxone, a
drug that reverses opioid overdose, and overdose prevention
trainings; HIV and hepatitis C screenings; shelter and housing
referrals; COVID vaccinations; and referrals and transport to
treatment for substance use disorders.
We reach quite a lot of individuals, and last year, we
engaged approximately 3,500 participants, distributed over
4,200 doses of naloxone, and saved lives, many lives, reversing
over 300 overdoses. Our staff works to build relationships
based on trust and nonjudgmental respect.
In Connecticut, there were 1,550 deaths due to overdose in
the year 2021, an 11.9 percent increase over 2020. This is a 20
percent higher increase than the Nation's over the same period.
The U.S. overdose crisis is a true public health emergency,
where nearly 108,000 people died last year from overdose, a 74
percent increase over 2015, and deaths continue to rise in
2022.
In both Connecticut and the U.S., overdose deaths have
increased the most among black people and communities of color.
Our work must end these disparities and effectively prevent
overdose deaths.
Now, sadly, because of this crisis, both nationally and in
Connecticut, we have insufficient access to syringe service
programs. The alliance has become the State's largest
distributor of sterile syringes, yet demand has outpaced
supply, especially since funding for SSPs in Connecticut has
remained the same while demand for life-saving services has
skyrocketed.
The CDC's Infectious Diseases and Opioid Prevention Program
is the ideal place for Congress to appropriate funding to
expand access to SSPs and prevent overdose. CDC is the Nation's
expert on SSPs, and with additional funding, it could expand
access to these critical services.
In fact, new recipients of SSP services are five times more
likely to reach and enter drug treatment. Studies also confirm
that SSPs do not increase illicit drug use or crime and that
they save both lives and money. And while Congress has funded
drug prevention and treatment programs, until recently, almost
no Federal funding supported programs that work directly with
people that use drugs to help reduce the harms.
On April 6, I celebrated 25 years free from the active,
chaotic use of substance, substances that separated me from my
family and community. Today, I am a well-respected, productive
member of my community as a result of these very services. I
ask that you consider the work that really needs to be done in
allowing these services to come forward.
I thank you so much for your time and consideration of this
urgent request, and please do not hesitate to contact me if you
have any questions.
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The Chair. Well, thank you so much for powerful testimony
here. And I want to say, one, thank you for your military
service and your commitment to our country and of giving back
in so many ways.
And you are in the business saving lives. I think we all
know what this opioid crisis has meant for this country. We
also--we have been--COVID has kind of taken a little bit away
from the front burner of the opioid crisis as well, but that is
something that we have to pay attention to, and when you quote
numbers, 108,000 people died from overdose in 2021. It is up 10
percent. It is really pretty extraordinary. And thank you for
talking about the syringe services program and how beneficial
it is.
You talk about hepatitis C. It is really one of the rates
that, as you have pointed out, have increased in terms of
infectious diseases. And I was at the Centers for Disease
Control last Friday. One of the issues that we brought up,
talking about how we try to do something about it, and it would
appear that is what your efforts are about, and we thank you.
We thank you for that. We appreciate your testimony, and
you will be sure that we will give every consideration to your
efforts in hoping to increase the resources that you need to be
able to succeed.
Congressman Cole.
Mr. Cole. Thank you, Madam Chair.
I want to join you in thanking Mr. Jenkins for his service
in uniform, but also suggesting that perhaps the service, Mr.
Jenkins, you are doing now may be even more important than
that, and we appreciate it more than I can say.
This is a problem I know the chair and I have wrestled with
for many years. And we have seen that 20 straight years of
increase in death by overdoses back in the late teens. And then
we plateaued, and it actually started to come down. Then we got
hit by COVID, and we have seen an explosion since then. I think
driven by the social isolation partly with COVID and also,
frankly, the explosion of illegal drugs coming across our
Southern border.
And so the problem has exacerbated itself during these last
2 years, 2\1/2\ years, I think more than any of us anticipated.
So this is something, again, I know the chair cares deeply
about. Every member of the committee on both sides of the aisle
cares deeply about because we see it in our own communities.
So I am sure, again, we always wrestle with more need than
money, and that is just the nature of appropriations,
particularly in this area. But I can assure you that both sides
of the aisle will be interested in working together to see what
we can do to help you and others like you that are in the field
really saving lives.
And just, again, thank you very much for the work that you
are doing, the service that you are giving. But certainly, the
work that you are doing each and every day right now. It makes
a big difference, and if we can find a way to help you, we
will.
With that, thank you, Madam Chair. I yield back to you.
The Chair. Thank you. Congressman Fleischmann.
Mr. Fleischmann. Madam Chair, thank you.
Mr. Jenkins, I just want to thank you and wish you every
continued professional and personal success, sir.
Thanks.
The Chair. Thank you.
I am now pleased to introduce Jane Weintraub for your
testimony with the American Association for Dental, Oral, and
Craniofacial Research. And you are--and also, I might add, dean
of the--professor of dental public health and former dean of
the University of North Carolina at Chapel Hill, the Adams
School of Dentistry.
Ms. Weintraub, you are recognized for 5 minutes.
JANE A. WEINTRAUB, DDS, DISTINGUISHED PROFESSOR OF DENTAL
PUBLIC HEALTH AND FORMER DEAN, UNIVERSITY OF NORTH CAROLINA AT
CHAPEL HILL ADAMS SCHOOL OF DENTISTRY, AMERICAN ASSOCIATION FOR
DENTAL, ORAL, AND CRANIOFACIAL RESEARCH
Dr. Weintraub. Chair DeLauro, Ranking Member Cole, and
members of the subcommittee, thank you for the opportunity to
testify on behalf of the American Association for Dental, Oral,
and Craniofacial Research.
AADOCR represents more than 3,100 individual and 100
institutional members in the United States. Our mission is to
drive dental, oral, and craniofacial research to advance the
health and well-being of Americans.
I currently serve as president of the AADOCR. I am also a
professor and former dean at the University of North Carolina
Chapel Hill Adams School of Dentistry and an adjunct professor
at the UNC Gillings School of Global Public Health.
For fiscal year 2023, we are seeking at least $540,000,000
for the National Institute of Dental and Craniofacial Research
and a total of $49,000,000,000 NIH's base budget. Despite
NIDCR's impressive research agenda and scientific
accomplishments, the Federal Government's annual investment in
this institute has not kept pace with biomedical inflation nor
overall funding increases for NIH.
Funding of at least $540,000,000 in fiscal year 2023 would
help bring NIDCR funding into alignment with the overall NIH
appropriation and allow NIDCR to build on its myriad successes
in its mission to improve dental, oral, and craniofacial
health.
Investments in NIDCR-funded research over the past three-
quarters of a century have led to improvements in oral health
for millions of Americans and continue to show promise in areas
encompassing the prevention of dental caries, or tooth decay,
periodontal gum disease, new diagnostic methods of oral and
dental conditions, regenerative medicine, oral cancer
prevention and treatment, and in assessing the efficacy of an
HPV vaccine for oral and pharyngeal cancers.
I cannot emphasize enough how integral oral health is to
our overall health. Poor oral health can affect many activities
that may be taken for granted, including the ability to eat,
drink, swallow, smile, speak, and maintain proper nutrition.
Poor oral health also creates an economic burden that
disproportionately harms older adults, low-income and under-
resourced communities.
The oral cavity also serves as a window into many health
issues, including, but not limited to, systemic diseases such
as diabetes, HIV/AIDS, and Sjogren's autoimmune disease.
Researchers are exploring the debilitating lack of salivary
function and resulting dry mouth from radiation treatment for
head and neck cancers, common medications, and even aging.
The NIDCR played a critical role in responding to the
COVID-19 public health crisis, funding approximately $3,900,000
in high-impact coronavirus research. The institute's research
into minimizing infection risk in dental offices, the use of
biosensors to detect SARS-CoV-2 in saliva, the role of
periodontal disease in COVID-19 complications, and exploring
how the virus gets into the mouth and saliva all play a
critical role in combating COVID-19.
AADOCR is grateful for the investments Congress has made in
the NIDCR, which have allowed the institute to build its data
repository and registry in several disease and research areas
to meet the increasing need for open-source data sharing. The
institute is also poised to make significant strides in
addressing public health burdens related to pain management and
the opioid crisis.
Pain associated with dental and oral facial conditions lead
to school and work absences, costly emergency room visits, and
hospitalizations, all of which have a detrimental impact on our
economy.
Early childhood caries can be very painful for young
children and often need to be treated in a hospital operating
room, an expensive procedure. As a benefit of funding from
NIDCR, I had the opportunity to conduct a randomized clinical
trial that tested and demonstrated the efficacy of fluoride
varnish in preventing early childhood caries. This easy, low-
cost method has since become a standard of care to help prevent
this disease.
Again, I appreciate the opportunity to testify and thank
the subcommittee for its support of biomedical and dental
research so that all Americans can enjoy good oral and overall
health.
Thank you very much.
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The Chair. Well, thank you very, very much.
Let me ask the ranking member if he has any questions?
Mr. Cole. No questions, but just a quick comment to Dr.
Weintraub.
As I am sure you probably know, your profession is pretty
ably represented on our full committee by Mike Simpson from
Idaho. So I can assure you, you have a--the chairwoman will
hear directly from Mike, and you have a very strong advocate in
somebody that is, again, widely respected on both sides of the
aisle.
And I must add Mike recently won his primary. I was
grateful for that. So he is likely to be back here for the next
2 years as well.
But again, thank you for your testimony.
Dr. Weintraub. Thank you.
The Chair. Congressman Fleischmann.
Mr. Fleischmann. Thank you, Dr. Weintraub.
This is wonderful. My personal friend and a great
Tennessean, Dr. Jeannie Beauchamp, is the president of the
pediatric dentists, but we have worked--nationwide. But we have
worked very closely with dentists across the board.
So thank you for your commitment to your profession and for
this. And years ago, I was on the board of FACES in
Chattanooga, which was a nonprofit dedicated to helping
craniofacial, actually, surgeries and fund those. So thank you
for what you do.
Dr. Weintraub. Thank you.
The Chair. And again, my thanks to you, Dr. Weintraub.
You make the point about how important the research is,
especially I think since we are not covering dental care these
days and so forth. So the work that you do is particularly
important, and I also, in reading your testimony, talk about
your interest in ARPA-H and NIH, but we are going to try as we
will to balance the two in terms of doing traditional research
and then looking at the institute, which you point out, to see,
in essence, how it has been funded over the last several years.
One of the things we are going to try to do with a hearing
in the fall is we had one set of institutes come in to provide
testimony to us on budget, but we are going to try to get
additional of the institutes to come in, including the
Institute of Dental and Craniofacial Research, and hear from
them about what the update is in research.
We are really in your debt for your work, and it has often
been interesting to me that we seem to divide the body up.
There is the head, and then there is from the neck down. And
unfortunately, we don't pay enough attention to the neck up.
And thank you for being an advocate for all this, and we will
do the best we can to try to address your concerns and your
resource concerns as well.
Thank you. Thank you for being here.
Dr. Weintraub. Thank you very much.
The Chair. It really is that I would very, very much like
to welcome Dr. Marwan Haddad. He is here in his capacity as
chair of the HIV Medicine Association, but I am so proud to say
he is also medical director of the Center for Key Populations
for Community Health Center, Inc., one of the largest community
health centers in the Nation, based in Middletown, Connecticut,
which is in my district.
Thank you, Dr. Haddad, for your work to serve our
community, particularly with those who live with HIV, with
hepatitis C, LGBTQ individuals, especially during the pandemic.
That really underscored for all of us the critical need for
integrative and comprehensive healthcare.
Happy to hear from you, and you are recognized for 5
minutes for your testimony.
MARWAN HADDAD, M.D., DIRECTOR OF THE CENTER FOR KEY POPULATIONS
AT COMMUNITY HEALTH CENTER, INC., HIV MEDICINE ASSOCIATION
Dr. Haddad. Chairwoman DeLauro, Ranking Member Cole, and
members of the subcommittee, thank you for your invitation to
testify.
Again, my name is Dr. Marwan Haddad, and I serve as the
medical director of the Center for Key Populations at Community
Health Center, Inc., or CHC, in Middletown, Connecticut, one of
the largest Federally Qualified Health Centers in the State.
I am pleased to testify today on behalf of the HIV Medicine
Association of the Infectious Diseases Society of America as
the chair of the board of directors. HIVMA represents more than
5,000 physicians and other healthcare professionals around the
country on the frontlines of the HIV epidemic.
First, thank you for the increase in Federal funding in
fiscal year 2022 for a number of HIV programs, including the
Ending the HIV Epidemic Initiative and several parts of the
Ryan White HIV/AIDS Program. More than 2 years into the COVID-
19 pandemic, it has taken a very hard toll on many people with
HIV and populations at risk for HIV, increasing the demand for
HIV-related services, substance use disorder, and mental health
treatment, and services to address a rise in housing and food
insecurity.
As we continue to work to control and mitigate the impact
of COVID-19, we must accelerate progress toward ending HIV as
an epidemic by increasing Federal investments in HIV
prevention, care, research, and supportive services.
Now, when we talk about funding, things can become
abstract, and we don't always make the connection to the impact
the funding has on people. So I will share with you the story
of a patient who I just saw last week to bring to light the
importance and intersectionality of the programs under the
subcommittee's jurisdiction.
This man started to see me 7 years ago, seeking treatment
for his opioid use disorder. I learned quickly that he had HIV;
hepatitis C; mental health disorders, including depression and
PTSD, with several past suicide attempts; and was currently
unhoused because his partner kicked him out for having HIV.
He lost the support of his family after they found out he
was gay. He tried shelters, but because he was constantly
stigmatized and harassed he preferred to live under the bridge.
Over the years, we have kept him engaged in care, more on
than off, treated him with HIV medication, and despite his
housing instability and substance use, he continues to be
virologically suppressed, meaning his viral--HIV viral level is
so low, he cannot transmit it sexually to others.
If it was not for the HIV case managers, our recovery care
coordinators, and other key services, we would have lost him to
follow-up. And while it took years, he is finally housed for
the first time since I met him. He continues to experience food
insecurity but is looking for a job and optimistic about
getting rehired by a previous employer.
I cannot emphasize enough how this story and so many
stories like his highlights the importance and value of
investing in the programs under the subcommittee's jurisdiction
and how this investment directly and positively impacts their
lives. So to meet the goal of the bipartisan Ending the HIV
Epidemic Initiative of reducing new HIV infections by 90
percent over the next decade, this will require an investment
of at least $850,000,000 in new funding.
In addition, increased funding for the Ryan White program
in fiscal year 2023 across all parts is needed to ensure access
to effective HIV care and treatment nationwide and for programs
to be able to respond to the increased demand for services due
to the COVID-19 pandemic. For fiscal year 2023, we specifically
recommend a $25,500,000 increase for Part C of the program.
CHC has relied on Ryan White program funding to provide HIV
care to underserved populations for 23 years across
Connecticut. And during that time, the needs of our patients
have grown more complex.
In 2021, we saw an increase in patients with HIV unlike any
increase we have previously seen. Eighty-eight percent of new
patients had at least one clinical comorbidity, 62 percent
reported unmet mental health needs, 56 percent reported food
and housing insecurity.
Now unlike HIV care and treatment, there are currently very
limited resources to support access to pre-exposure
prophylaxis, or PrEP, for individuals who are uninsured or
underinsured. Although PrEP is highly effective at preventing
HIV infections, only 25 percent of the 1.2 million individuals
who could benefit from PrEP have been prescribed it.
Among populations heavily impacted by HIV, only 9 percent
of black individuals who can benefit from PrEP received a
prescription in 2022, and only 16 percent of Hispanic and
Latino individuals. We had two patients in the last year, both
individuals of color, who would have benefitted from PrEP, but
instead acquired HIV prior to reaching us and while trying to
access PrEP services.
HIVMA, in partnership with PrEP for All, the Federal AIDS
Policy Partnership, AIDS Budget and Appropriations Coalition,
and HIV Prevention Action Coalition is urging $400,000,000 in
funding for 2023 for a new national PrEP program within the CDC
Division of HIV Prevention.
Finally, I urge $150,000,000 in funding for the CDC to
address the infectious disease consequences of the opioid
epidemic, including through improved surveillance and
monitoring and supporting and expanding access to syringe
services programs, harm reduction, and overdose prevention.
Thank you for your time and consideration of these
requests, and I am happy to answer any questions.
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The Chair. Thank you so much, Dr. Haddad. And thank you for
your commitment to the work that you are doing. It is really
very extraordinary.
I think it just points to the fact that how valuable these
programs are. We have programs here. What we need to do is make
sure that we are investing the resources that we need to begin
to address your concerns.
I am happy to say that this committee, on a bipartisan
basis, looking to ending HIV and working with the President's
initiative, we have come together, and it is so promising. And
again, I think most of the folks here today, and clearly, in
your case, you are here saving lives. So we are very, very
grateful for that.
And the quality of the programs and the results of what you
are doing just is inspirational to all of us and gives us the
incentive to look at where we can go for the future. And
obviously, you know that depends a lot on what the funds that
are available. But we certainly know the relevance and
importance and the critical nature of all that you are doing.
So, thank you.
Congressman Cole.
Mr. Cole. Thank you, Madam Chair.
And I just want to quickly associate myself with your
remarks. I think you summed it up from a bipartisan perspective
about as well as we can. Doctor, we would love to put you out
of business.
The Chair. Right.
Mr. Cole. And if there was a way, but we would at the
stroke of a pen. But thank you for what you do, not just for
your specialty, but also more broadly, the whole community
health center movement has, honestly, been transformative in my
State.
I know 20 years ago, when I got to Congress, I think we
only had 5 of the centers in the State. We have about 60 now.
It has made an enormous difference in the quality of healthcare
for the folks that, frankly, are right at the fringes and quite
often not able to get it.
So I appreciate what you and your colleagues do to help all
of us in our respective States and districts.
So, with that, Madam Chair, I yield back.
The Chair. Thank you. Mr. Fleischmann.
Mr. Fleischmann. Thank you, Dr. Haddad. And my sentiments
exactly with the chair and the ranking member.
Thank you.
Dr. Haddad. Thank you.
The Chair. Thank you. And it gives me great pleasure to
introduce Dr. Cynthia McCurren, the board chair of the American
Association of the Colleges of Nursing. And Dr. McCurren, your
testimony, we would love to hear it, and you are recognized for
5 minutes.
CYNTHIA McCURREN, BOARD CHAIR, AMERICAN ASSOCIATION OF COLLEGES
OF NURSING
Ms. McCurren. Thank you, Chairwoman DeLauro, Ranking Member
Cole, and members of the subcommittee, for this opportunity to
provide testimony on behalf of the American Association of
Colleges of Nursing, or AACN.
I am Dr. Cynthia McCurren, and I am chair of AACN's Board
of Directors, and I am also dean and professor at the
University of Michigan-Flint School of Nursing.
On behalf of more than 850 AACN member schools, which
educate more than 565,000 students and employ more than 52,000
faculty across the country, I would like to personally thank
you for your leadership and continued support of nursing
education, our workforce, and research, especially during these
unprecedented times.
As we work to combat current public health challenges and
prepare for the future, AACN, along with 58 members of our
Nursing Community Coalition, request at least $530,000,000 for
the Title VIII nursing workforce development programs and at
least $210,000,000 for the National Institute of Nursing
Research, or NINR, in the fiscal year 2023.
From the classroom to the frontline, we have all witnessed
how critical a well-educated nursing workforce is to providing
high-quality healthcare. While AACN saw student enrollment in
entry-level baccalaureate nursing programs increase by 3.3
percent in 2021, we also saw enrollment decline in our
baccalaureate degree-completion programs and our graduate
programs at the master's and Ph.D. levels.
As we look to the future and the need for increased
enrollments to support the healthcare demands of the Nation, it
is important to recognize that more than 91,000 qualified
applications, not unique applicants, were not accepted at
schools of nursing nationwide in 2021 alone. This is in part
due to insufficient clinical placement sites, inadequate
numbers of faculty and preceptors and classroom space, as well
as budget cuts.
That is why Federal funding for nursing education and our
Title VIII programs is so important. We must support our
nursing schools, faculty, and students.
As a leader in nursing education, I have witnessed
firsthand the benefits Title VIII funding provides. From
supporting graduate education for nurses who work and live in
rural and underserved areas to training for sexual assault
nurse examiners critical in our urban and rural areas, and
promoting diversity within the profession by providing grants
to students from disadvantaged backgrounds, Title VIII nursing
workforce development programs have been and will continue to
be a short- and long-term success story and must be provided
with funding levels that reflect the population they serve.
As we prepare the next generation of nurses and the faculty
who educate them, we must also support the evidence that guides
their practice. As one of the 27 institutes and centers at the
National Institutes of Health, the National Institute for
Nursing Research, or NINR, funds nurse scientists who work
collaboratively with other health professionals to generate and
translate new findings and lead translational research that
helps address health equity and the social determinants of
health.
Bold investments in Title VIII nursing workforce
development programs and NINR are imperative, not only as we
confront existing health challenges, but as we provide
tomorrow's equitable and innovative healthcare solutions.
Therefore, AACN respectfully requests support in fiscal year
2023 of at least $530,000,000 for the Title VIII nursing
workforce development programs and at least $210,000,000 for
the National Institute of Nursing Research.
Together, we believe we can ensure that such investments
will promote and improve healthcare in America.
Thank you so much.
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The Chair. Thank you so much.
And my own experience with the nursing profession was some
30 years ago and diagnosed with ovarian cancer and spent a fair
amount of time in the hospital. And while I can applaud the
surgeons and their great work helping to save my life, it was
the nurses who came every day and who just by one look at me
could tell whether it was a good day or a bad day, and they
were always there.
So we know the nature of the profession. We are also very
conscious of--well, my view, and I will just be frank about it,
I don't think the Institute of Nursing Research gets enough
funding as I believe it should. And we will take a very, very
hard, hard look at that.
I also know that there is a very big, high debt of student
debt for folks going through the nursing program. So loan
repayment is another critically important effort. And you have
so many nurses who are ready to retire that looking at the
profession, what we need to do is seriously think about how we
are really going to strengthen nursing because we know the role
that they play, that they play like the critical role that they
played during the pandemic.
So you can be sure we are going to take a hard look at
this.
Congressman Cole.
Mr. Cole. Thank you, Madam Chair.
As in this and so many other areas, we certainly don't
disagree. I know in my own State, a number of years ago under
former Governor Fallin, we did a survey of critical needs in
our workforce. This is pre-COVID. Number one was skilled
nursing, literally.
And having dealt with, as we all have, all my providers
during this really critical time, I know how we stretch the
nursing workforce and how it has been for hospitals to get what
they need and how tough it has been on people in the
profession. We have worked really, really hard--and frankly,
how intense now the competition is not just within States, but
across State borders--to try and get that workforce.
All of which reinforces the request that you have made, and
so just thank you and your profession for what you do
selflessly. And again, these are needed skills. They are not
going to go away, and these are important investments.
And again, as the chair always points out, we don't know
what our money is now, but I can't imagine you won't rank high
on the areas that we all agree on the committee we need to
focus on.
So thank you for your testimony.
Yield back, Madam Chair.
The Chair. Thank you. Congressman Fleischmann.
Mr. Fleischmann. Thank you again, Madam Chair and Ranking
Member Cole, for your comments.
I would like to say this. In my great State of Tennessee,
we have several great colleges of nursing, and I have spoken
with the students. They are--it takes a special person to be a
nurse, but there is boundless optimism with the students that
we are producing in our State.
So thank you for what you are doing, so critically needed
and very important. So I wish you continued success.
And again, this is one of the areas of broad agreement on
this subcommittee. So thank you very much.
Ms. McCurren. Thank you. Thank you all.
The Chair. Thank you very much.
Let me now recognize our next guest, and that is Dr.
Julie--and hoping I pronounce this right--Ajinkya. Thank you,
and senior vice president and chief strategy officer with the
APIA Scholars.
And Dr. Ajinkya, please, we would love to hear from you.
JULIE AJINKYA, SENIOR VICE PRESIDENT AND CHIEF STRATEGY
OFFICER, APIA SCHOLARS
Ms. Ajinkya. Chairwoman DeLauro, Ranking Member Cole, and
members of the subcommittee, my name is Julie Ajinkya, and I am
the senior vice president of APIA Scholars, as you just
mentioned. We are an organization that is focused on
dramatically improving the educational outcomes of underserved
Asian American, Native Hawaiian, and Pacific Islander students
by ensuring access to affordable college opportunities and
student success programming.
And I am also professor of government with Cornell's Brooks
School of Public Policy.
Thank you for inviting me to submit testimony for fiscal
year 2023 appropriations on behalf of the Asian American and
Native American Pacific Islander-Serving Institutions,
otherwise known as the AANAPISI program, and the students that
it serves. Specifically, asking for an increase in funding for
AANAPISIs to $100,000,000 annually, which would allow them to
be funded at a per-institution and per-student level
commensurate with other Minority-Serving Institutions.
I would like to first begin by thanking all of you for your
commitment that you have shown to AANHPI students by increasing
spending for the AANAPISI program in fiscal year 2022. You all
made a significant down payment for these schools and
institutions by more than doubling funding for AANAPISIs
compared to the prior fiscal year, from $5,000,000 to more than
$10,000,000.
This increase in funding will allow more AANAPISIs to
better serve first-generation and low-income AANHPI students in
higher education. Indeed, nearly half of AANHPI students attend
AANAPISIs, and these colleges and universities enroll and serve
about three-quarters of all low-income AANHPI students. Given
that the AANHPI population was the fastest-growing racial group
in the U.S. over the past decade, better serving these students
is in the interest of the entire nation at large.
Today, we would like to build upon that down payment and
are requesting that you increase funding for AANAPISIs to
$100,000,000 annually, which, again, would allow them to be
funded at a per-institution and per-student level commensurate
with other MSIs, like Hispanic-Serving Institutions.
Ideally, this appropriation would be divided as $30,000,000
in discretionary funding under Title III, Part A and
$70,000,000 in mandatory funding for Title III, Part F, for a
total of $100,000,000 in AANAPISI program funding for fiscal
year 2023. This critical division would address the need for
additional mandatory funding, given current statutory barriers
that limit the amount of discretionary funding AANAPISIs can
receive if they also serve students from other underserved
populations.
This funding is critical because of the impact AANAPISIs
have on the students they serve, particularly because many of
these students are the first in their families to go to
college, come from low-income backgrounds, are often English
language learners, and are dealing with higher rates of unmet
mental health needs, particularly due to the spike in anti-
Asian hate our communities have endured during the pandemic.
We often hear from our network of students that they
appreciate their AANAPISI programs understanding their
identities and how it shapes their college experience. For
example, Kristine Jan C. Espinoza, a proud AANAPISI alum from
the University of Hawaii at Manoa, shared how attending an
AANAPISI was a critical opportunity to be mentored by AANHPI
faculty and encouraged to pursue further graduate education.
Espinoza, now a doctoral student at another AANAPISI, UNLV,
focused on researching MSIs and cherished how she felt like she
belonged on campus by being around students who looked like
her, learning from AANHPI mentors, and appreciated how even the
physical campus environment reflected cultural elements she was
familiar with.
De Anza College, an institution located in Cupertino,
California, with AANHPI students comprising nearly 40 percent
of the total enrollment, provides another instructive example.
De Anza used their AANAPISI grant to pair developmental English
with an AANHPI literature course, including wraparound supports
with an embedded counselor.
Research then showed that the students who participated in
this program passed their developmental course at a higher
rate, were more likely to transition from developmental to
college-level English, and were more likely to earn associate's
degrees, all in less time. With increased funding, more
institutions would be able to serve their students like De Anza
College has.
We are requesting the funding increase because AANAPISIs
have been chronically underfunded since their establishment and
until last year were the lowest-funded category of MSI per
capita. Disappointingly, while 165 institutions have been
identified by the Department of Education as eligible
AANAPISIs, only 30 of those institutions receive AANAPISI
funding.
Equitable funding of all 165 eligible AANAPISIs at the same
level as HSIs would require an annual funding amount of
$100,000,000. I want to make clear, however, that any increase
in AANAPISI funding should not come at the expense of other
MSIs.
Thank you for your continued support for the AANAPISI
program, and we look forward to continuing to work alongside
you and be a resource for you.
Thank you.
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The Chair. Thank you very, very much, Dr. Ajinkya.
You make a very, very strong case for the relevance, first
of all, of the education, the climate in which these--the hate
crime which people have been living, and that is particularly
focused on Asian, Pacific Islanders in the last little while.
But it is the opportunity for education that is critical. We
understand that on this committee in a bipartisan way and how
we need to make that opportunity available because we know that
education is that great equalizer, gives people the credentials
for success.
And your statistics, which we will take a hard look at, how
you described the underfunding of the educational opportunities
for AANAPISI is a very, very strong case. So we will take a
very hard look at how we are able to increase the educational
opportunities and make it possible for more to be able to get
the kind of education that they need in order to succeed and to
have our country succeed and our economy succeed.
So, with that, let me recognize our ranking member.
Mr. Cole. Thank you very much, Madam Chair.
Again, I think the committee, on a bipartisan basis,
recognizes the importance of the request and the significance
that these types of institutions play, quite frankly. And
Congress has a long history, all the way back to the founding
of Howard University, of recognizing there are unique
institutions that serve specific communities that all of the
broader community then benefit from over time. And certainly,
in my area, we had both HBCs and tribal colleges and
universities, and these things are enormously important to us.
So, again, I associate myself with the chair. We will give
it a hard look and see what we can do.
With that, yield back, Madam Chair.
The Chair. Thank you. Congressman Fleischmann.
Mr. Fleischmann. I thank the doctor for her testimony and
for shedding light on this important issue, and I will yield
back.
The Chair. Thank you.
It gives me great pleasure to offer a very, very warm
welcome to former constituents Brian Wallach. He is the co-
founder of I AM ALS and received his bachelor's degree from
Yale University. Brian is joined by his wife, Sandra Abrevaya,
who, like me, grew up in the city of New Haven.
A few years ago, while Mr. Wallach was working as an
assistant U.S. attorney, he was diagnosed with ALS. Just 37
years old. Refusing to let this shocking diagnosis deter him,
Brian partnered with Sandra to co-found I AM ALS. It is a
nonprofit organization that provides critical support and
resources to ALS patients, caregivers, and loved ones while
engaging with policymakers. They promote ALS research. They
mobilize communities to take action in this area, to spread the
word or increase awareness of ALS to millions of people.
Brian Wallach is a force, and a force along with Sandra,
and so delighted to have them with us today. He is going to
talk about funding for ALS research programs and some of the
new initiatives that will help to accelerate development of
therapies for all life-threatening neurodegenerative diseases.
With our hearts and our arms open, we welcome Brian and
Sandra Wallach.
BRIAN WALLACH, CO-FOUNDER, I AM ALS, ACCOMPANIED BY SANDRA
ABREVAYA, CO-FOUNDER, I AM ALS
Ms. Abrevaya. Thank you so much, Madam Chairwoman, for that
introduction and that background.
We are so grateful to be here today with everybody. And
thank you to you and to Ranking Member Cole and to Congressman
Fleischmann for the opportunity to speak to you once again
about the fight to end ALS.
Mr. Wallach. My name is Brian Wallach.
Ms. Abrevaya. My name is Brian Wallach. I am 41 years old,
and I have been living with ALS for almost 5 years now. I am
here today with my wife, Sandra, who is my voice.
Mr. Wallach. If truth be told----
Ms. Abrevaya. Truth be told, when I first testified before
you in 2019, I did not think that I would be alive to speak to
you today.
Mr. Wallach. I am one of the lucky ones.
Ms. Abrevaya. I am one of the lucky ones, as 90 percent of
those diagnosed in the same year as me are dead. That includes
veterans, mothers, sons, and daughters from every single
congressional district.
Thanks to you and the other amazing champions on the Hill,
we have made real progress since I first testified before you,
and you have worked to pass and fund the ACT for ALS and have
recognized that ALS should be part of the mission of the new
ARPA-H.
Mr. Wallach. Three years ago----
Ms. Abrevaya. Three years ago, you told me that you would
do everything in your power to fight for a cure, and
Chairwoman, you have kept that promise. For that, I am humbled.
But we still have miles to go before we rest.
Mr. Wallach. May is ALS Awareness Month in the U.S.
Ms. Abrevaya. May is ALS Awareness Month in the U.S. On May
12, I AM ALS and hundreds of ALS advocates gathered in DC a
mile away from the Capitol to plant thousands of flags for
those living with ALS and those we have lost. This is the
reality of ALS today.
Mr. Wallach. My name was on one of those flags.
Ms. Abrevaya. My name was on one of those flags.
Mr. Wallach. For me, my reality is----
Ms. Abrevaya. For me, my reality is that I can now barely
speak. I am mostly confined to a wheelchair, and I can no
longer raise my arm.
Mr. Wallach. But I am still here.
Ms. Abrevaya. But I am still here, and I will keep fighting
for as long as I breathe.
By passing ACT for ALS, Congress and President Biden made
clear that the FDA and NIH must act now to implement these
programs, most importantly the expanded access grant program.
As President Biden said during the December signing ceremony of
the bill, ``This law invests $100,000,000 annually for the next
5 years. And this includes issuing grants that support research
on and access to promising new therapies for patients who don't
make it into clinical trials. This means hope for patients who
would otherwise have no access to treatments that could
possibly work for them.''
Earlier this year, you approved and appropriated
$25,000,000 to make this program real, and on May 12, NINDS
released the Funding Opportunity Announcement for those funds.
Mr. Wallach. I am here today to ask you----
Ms. Abrevaya. I am here today to ask you to build upon this
momentum by fully funding ACT for ALS for the 2023 fiscal year.
Fully funding ACT for ALS means that we need to appropriate
$100,000,000 in fiscal year 2023, including $75,000,000 for the
expanded access grant program.
This funding is not only desperately, desperately needed by
those of us who are dying from ALS right now, but it will also
change the course of ALS forever. Full funding will allow NINDS
and FDA to move forward aggressively and quickly to implement
the programs in ACT for ALS. We urge the agencies to work with
the same urgency as Congress has shown, so that we can make the
hope that ACT for ALS embodies for those who have suffered in
the shadows and those who have been left to die for too long
real.
Mr. Wallach. The ALS community----
Ms. Abrevaya. The ALS community, which includes clinicians,
clinical researchers, people living with and impacted by ALS,
and advocacy organizations, we are all united in support of
expanded access programs. As NIH and FDA create and execute on
the expanded access grant program mandated by ACT for ALS, we
ask the agencies to incorporate the set of recommendations the
ALS community provided to them this month.
I also ask for your support in ensuring that ALS research
is robustly supported by NIH and by the Department of Defense.
These research programs are critical to unlocking treatments
for ALS, as well as Alzheimer's, Parkinson's, multiple
sclerosis, and beyond because all of these neurodegenerative
diseases are connected.
Thank you. Thanks to all of you, the path toward ending ALS
is clearer.
Mr. Wallach. But there is much more work ahead.
Ms. Abrevaya. But there is much more work ahead. On behalf
of the ALS community----
Mr. Wallach. Thank you.
Ms. Abrevaya [continuing]. Thank you. And I look forward to
working with you to turn ALS from always fatal to chronic, and
then to end it once and for all.
Thank you, Chairwoman.
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The Chair. Thank you, Brian and Sandra. You both always are
such a great inspiration to all of us.
And Congressman Cole will comment, Congressman Fleischmann,
and other members of the committee, even though they are--they
may not be present, but your efforts are beyond inspirational.
That is not adequate.
You have made ALS and the ravages of ALS not only on the
individual with the disease, but on the families as well, on
your family, but you have opened the eyes of this country. You
have opened the eyes of Members of Congress to what our
responsibilities are.
And here, I look at you, Brian, and we have had the chance
to talk here on several occasions, and I said to you in our
last conversation, ``You are looking good, my friend. You are
looking as good as I have ever seen you.'' And I know that
there is treatment. And I am here to tell you that we are not
going to stop fighting.
We are not going to stop fighting because you are not going
to let us, and we are not going to do it because you are that
wind beneath our wings here. And we listen to you, and it gives
us great courage to look at the dollars that we spend and where
we spend them and know that while we have conquered other
illnesses in this great country of ours, because we have great
medical facilities, that we have the opportunity, as you have
said, to make it chronic and to deal with ending.
And we will continue that research, and I promise you that
we will--that we will do that. And we have in the language of
ARPA-H that one of the neurodegenerative illnesses which they
will look at is ALS.
I was at an event last evening where I met--and I am trying
to remember his last name. First name was Roger, and I talked
to Roger about you, Brian and Sandra. He is 6 years diagnosed.
He was at this event last night in a tuxedo and just
enjoying it and so forth, still ravaged by the illness, but on
his feet. So there is hope that is out there, and we all cannot
thank you for never, ever, ever giving up hope and making sure
that we never give up hope as well.
Love you both, and thank you for what you have done in
calling attention to this ravaging disease. We are there. We
are there for you, my dear friends.
Congressman Cole.
Mr. Cole. Thank you, Madam Chair.
And Brian and Sandra, thank you. That was an extraordinary
statement. And your advocacy is, quite frankly, inspiring and
amazing and makes a difference. And for you to take the tragedy
that has fallen into your lives and turn it into something
where you can help others is really remarkably commendable.
We talk a lot in Congress about the differences and get
covered, but there are lots of things the chair and I work
together on. And we have together in 7 years, we have increased
NIH funding by 49 percent and tried to look at some of these
things as not one-shot wonders, but sustained commitment over
time that makes a difference.
ALS certainly affects my office. My chief of staff's father
has it. My district director's husband as well. So it is
something, and Sandra, I particularly was pleased to hear you
talk broadly about neurodegenerative diseases. My wife has MS.
I lost my dad to Alzheimer's.
So these things touch all of our lives, and I don't make
this remark often. I never had anybody at a town meeting come
up to me and say, you know, you guys are just spending too much
on cancer and ALS and Alzheimer's. They might be worried
overall about the budget. These are actually the places where
the American people want us to be making continual investments.
And because they see the difference and they see the impact
on their loved ones, their friends, their associates. They want
to be part of the solution. They want us to write the check
that provides hope and services and hopefully some day put some
of these things, as we have some things, in the rearview
mirror, so to speak, where they are not threatening people's
lives.
So, again, I want to commend you for your advocacy. Brian,
I want to wish you the very, very best. God bless you for
beating the odds. You clearly have a fighting spirit. And we
will continue to walk with you guys step by step because, as
the chair said, this is a commitment we all believe in very,
very deeply and a cause that we all want to continue to work on
going forward together.
With that, Madam Chair, I yield back.
The Chair. Thank you. Congressman Fleischmann.
Mr. Fleischmann. Thank you, Madam Chair and Ranking Member
Cole.
Sandra and Brian, we have seen very astute, wonderful
presentations today across the spectrum of this great
subcommittee, but your presentation today was truly the most
inspirational and outstanding. And I do thank the chair and the
ranking member for their very strong statements in support.
I am a lawyer, like you, sir, and still keep my law license
up. We have had many folks with ALS come into our office over
the years, and I will say this. Like you, they are great
fighters, and they are committed to seeing a cure for this
horrific disease. So we wish you every success.
And again, thank you for being an inspiration to so many
folks who are afflicted with this. Again, the chair and the
ranking member are absolutely right. We put these resources
into this area, and the American people support this and this
is what we ought to be doing in Congress.
So, thank you.
The Chair. Just one final word to Sandra, to you, and to
you, Brian. Oftentimes, the media reports that people in this
country believe that the Members of Congress who serve on
different sides of the aisle in different communities, that
they cannot lock arms and look at the challenges that face this
country, look at the challenges that people face.
And it is not true. We do lock arms. We do have our
differences, but we understand the nature of the challenge that
you face and that everyone with an ALS diagnosis or one of the
other neurodegenerative diseases and so forth.
And in this area, I proudly say that we come together. We
have come together to provide the resources that are necessary
in order for us to continue the research to look for that
discovery to cure, to allow people to be hopeful about what
their future is and what it can be. And the two of you, again,
your strength, your determination really pushes us forward to
make sure that we are working with you and that you are not
alone.
So, thank you. Thank you for being here today and for
testifying. God bless you both.
Mr. Wallach. Thank you so much----
Ms. Abrevaya. Thank you so much----
Mr. Wallach [continuing]. For your incredible words.
Ms. Abrevaya [continuing]. For your incredible words.
Mr. Wallach. And we look forward to building a better----
Ms. Abrevaya. And we look forward to building a better----
Mr. Wallach [continuing]. World together with you.
Ms. Abrevaya [continuing]. World together with you. Thank
you.
The Chair. Take care.
Let me now recognize Dr. Karen Knudsen, chief executive
officer for the American Cancer Society, and that is the
American Cancer Society, CAN, the Cancer Action Network.
So, Karen, thank you. I had the opportunity to meet with
Lisa this week and folks and anxious to hear your testimony. So
much appreciative of your being here.
KAREN E. KNUDSEN, CHIEF EXECUTIVE OFFICER, AMERICAN CANCER
SOCIETY AND AMERICAN CANCER SOCIETY CANCER ACTION NETWORK
Ms. Knudsen. Thank you so much for having me.
And I would just like to say, for Brian and Sandra,
absolutely incredible testimony, and I hear you on where to
pick up on that theme of the importance of research.
So I am Dr. Karen Knudsen. I am the CEO of the American
Cancer Society. We are the largest nonprofit funder of cancer
research outside the U.S. Government.
As we meet here today, one in three men and one in two
women over their lifetime will hear the words, ``You have
cancer.'' But we are also at an unprecedented time in history
where discoveries have been converted into meaningful progress
in cancer prevention, detection, treatment, and even, in some
cases, cure.
Since 1991, when there was a formidable increase in cancer
research from the U.S. Government and from the American Cancer
Society, we have declined cancer mortality rates by 32 percent,
resulting in more than 3.5 million deaths averted from cancer
due to cancer research funding. It is clear that cancer
research does, indeed, save lives. And more than ever before,
that gap between discovery and clinical intervention has
narrowed, and that has emboldened an entirely new generation of
cancer researchers to strive for better anti-cancer strategies.
Just in the last 10 years alone, we have witnessed an
entirely new class of cancer therapeutics in the form of
immunotherapy. Research also resulted in the development of a
highly effective cancer vaccine, something we sought for a long
time, against HPV-driven cancers.
And thanks to that breakthrough, right now in this country
we have the first generation of individuals vaccinated in the
U.S. who will have protection against cervical cancer and up to
50 percent of head and neck cancers that we heard about earlier
today. And similar impactful research advances have been
realized in this progress against 200 diseases that we call
cancer.
It is due to research that this cancer mortality rate is
declining, and on this basis, it is that we ask Congress to not
only maintain but increase the pace of discovery through
enhancing cancer research funding. Despite our gains, we have
much work yet to do. A subset of lethal cancers are now on the
rise and show concerning trends that do require research,
including unexplained increases in early onset colorectal
cancer and in advanced prostate cancer, just to name two.
Lung cancer remains a major challenge, accounting for 350
deaths of Americans every day. At present, cancer remains the
second-leading cause of death in the United States, with more
than 600,000 individuals predicted to die from cancer this year
alone in the U.S. The scientific community, I would opine, has
shown again and again that the investment in cancer research
yields returns in lives saved and is poised to increase the
pace of discovery.
Now, equally important is investment in research to
mitigate disparities in cancer outcomes. Right now, black men
have a twofold higher death rate from prostate cancer, stomach
cancer, and myeloma as compared to whites. Black women have a
41 percent higher death rate from breast cancer as compared to
their white counterparts.
Geographical disparities also exist. Lung cancer mortality
is three to five times higher in Kentucky versus Utah or Puerto
Rico. Cervical cancer is twice as high in Arkansas versus
Vermont.
Research is needed to help develop strategies such that all
Americans will have an equal chance to prevent, detect, and
survive cancer, an ideal to which the American Cancer Society
also strives. An essential component of this work will also
include access to clinical trials, which we all know in cancer
is the most advanced form of care. Trial funding through the
NCI is a vital resource through which Americans across the
country benefit from research breakthroughs that can be
lifesaving.
We believe that investment in cancer research is a critical
component in the investment in the health of U.S. citizens and
the population as a whole. Our progress has been remarkable,
and the U.S. scientific community stands ready to accelerate.
So on behalf of the 1.9 million Americans who will be
diagnosed with cancer this year alone, we urge the following
three recommendations. First, funding of $49,000,000,000 for
the NIH in fiscal year 2023 to allow the base budget to keep
pace with biomedical research and development price indices,
and to provide meaningful growth.
Second, a critical inclusion must be at least
$7,760,000,000 for the National Cancer Institute. Given this
explosion in impactful discoveries, NCI is experiencing a
demand for cancer research funding that is far beyond any other
institute or center. Grant success rate from the NCI dropped
from 13.7 percent in 2013 to now just above 11 percent in 2019.
This situation is unique to the NCI, at a time when cancer
researchers are making historic advances in new treatments and
therapies. And by contrast, the success rate for the whole of
NIH during that period actually rose.
Third and lastly, we asked for $462,600,000 in funding for
the CDC's Division of Cancer Prevention and Control, as they
provide key resources to States and communities to prevent
cancer by ensuring that at-risk, low-income communities have
access to prevention programs.
So I will stop there, and thank you for your attention, and
I would be happy to answer any questions.
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The Chair. Thank you very, very much, Dr. Knudsen.
I also might add that in our meeting this past week, my
meeting with some of your folks, you have an extraordinary
nationwide network of folks who are out there advocating for
what you are advocating for today. So I want to compliment you
on that effort.
We did have a hearing not that long ago with a number of
the institutes from the NIH, and the NCI was there. I am proud
to say, overall, I think over the last several years on a
bipartisan basis, this committee has provided about
$11,000,000,000 to the NIH. In terms of NCI, last year we did
$352,000,000.
We are also very much aware at that hearing about the
success rate, the grants, et cetera, and a concern about that.
But you are the second to the Federal Government in what you do
by way of research. It is clear that while we have made some
great strides, and particularly exciting about cervical cancer
because that is an area, which--I mean, we can conquer cervical
cancer. There are some it will take us many, many more years to
deal with, but we can do that, and we are on the road to doing
that.
And when you speak about the increases in lung cancer and
prostate cancer, it is very, very, very troubling. And then
there is health disparities. I think, if anything, what the
pandemic--we have known about disparities, but I think what the
pandemic has highlighted is those health disparities in a whole
variety of ways. So we are committed in this committee to
addressing these needs.
Our issue is always what is the allocation, how much are
the resources that we have. But you can be sure that when it
comes to this basic research--and I will just say one more
thing. We were all troubled, and we made this known, that
$274,000,000 to NIH in this budget versus $4,000,000,000 for
ARPA-H. And we are for ARPA-H and doing what they need to do,
but we are going to create that balance as we move forward, as
we put the bill together.
So thank you so much for being here today and for your
advocacy and for the great strength of your national
organization.
Congressman Cole.
Mr. Cole. Thank you, Madam Chair.
Dr. Knudsen, thank you for being here. That was a very
powerful and effective presentation.
Look, this is something, you are very fortunate--maybe our
chair is not, but you have a committee chaired by a survivor of
cervical cancer. So we have an intimate knowledge here, sadly,
at the expense of our chair. But we are happy she is here.
Look, I couldn't agree more with science moves at a very
uneven pace across multidisciplines, and the opportunity for
cancer is now. There is just no question about it. And the
success rates that you point to shows how much good science we
are leaving on the table, so to speak, and how tough the
decisions are, the folks we task with picking between which
grant to fund and which one not to. Probably more difficult in
your field than any other right now in research.
So, again, this committee has worked really hard over the
last 7 years at bolstering NIH. And I want to, again, associate
myself with my friend the chair's remarks about what we both
see as the imbalance between ARPA-H and NIH funding in the
President's proposal.
We both support ARPA-H. We put $1,000,000,000 there. Some
of our colleagues might even have questioned us doing that
because we didn't yet have the format, the Director, what have
you.
I know my chair is aware of this. We had good bipartisan
progress from the Energy and Commerce a couple weeks ago,
coming together to give us a framework. But again, we want to
work with the President on that. We know it is a top priority
of his, but it can't happen at the expense of our ongoing
commitment to NIH.
And again, we--both the chair and I recognize how unusual
the opportunity in front of us here is, if we can find a way to
make a commitment. So she has a lot of tough decisions to make.
We always do on this committee. But I suspect that we will
continue the tradition of doing well by the NIH.
Again, that is something that we are not only committed to,
but our two colleagues on the other side of the aisle--or other
side of the Rotunda in Senator Murray and Senator Blunt have
been extraordinarily helpful in this run of 7 years that we
have had of sustained increases above inflation for NIH. And
zeroing in on this cancer opportunity I think is really
something that we need to give every possible consideration and
support for.
So thank you for the work that you and the American Cancer
Society do and have done for many, many years. Thank you for
the advocacy. It is really important.
But again, I want to underscore the point you made so
eloquently. You have got to seize the moment sometimes, and
this is a moment in time where I think if we could find the
resources, the kind of progress we could make that you spoke
of, investment does make a difference. We do have people living
longer, and we have saved lives. And you can measure it
demonstrably.
So there is not very many cases where we have got this
direct a relationship between what we appropriate and the
difference we make in the lives of the American people. So,
again, thank you for what you do. Thank you for your advocacy,
and we look forward in continuing to work with you and the
American Cancer Society on a bipartisan basis going forward.
Yield back, Madam Chair.
The Chair. Thank you. Congressman Fleischmann.
Mr. Fleischmann. Thank you again, Madam Chair and Ranking
Member Cole.
Dr. Knudsen, one of the nice things about being an
appropriator and, of course, serving on this distinguished
subcommittee is we touch so many different areas, and it gives
us as members an opportunity to learn an awful lot. And since I
have been in Congress, I have been involved with the Cancer
Caucus. Your group has done a tremendous job.
But I did want to call out specifically Dr. Jordan Berlin
and his team at Vanderbilt. Whenever I have cancer questions--
with difficult cancers, we have made so many wonderful strides.
But there are still some cancers out there, some types of lung
cancer, some types of stomach cancers and the like, that are
still baffling.
So the key again is investment in research and continued
progress, but together, we are making this type of progress. So
thank you for your advocacy.
And again, this is going to be one of these areas where
there is going to be really unanimity. This is not--shouldn't
be an issue for appropriators, for Republicans, Democrats, or
authorizers. This should be an all-out effort by Americans, who
we represent, to defeat cancer.
So thank you for your advocacy. And Madam Chair, I will
yield back.
The Chair. Thank you. Thank you.
Let me now recognize Belinda Pettiford, president of the
Association of Maternal and Child Health Programs.
And Ms. Pettiford, you are recognized for 5 minutes for
your testimony.
BELINDA D. PETTIFORD, PRESIDENT, ASSOCIATION OF MATERNAL AND
CHILD HEALTH PROGRAMS
Ms. Pettiford. Thank you.
Chair DeLauro, Ranking Member Cole, and distinguished
subcommittee members, my name is Belinda Pettiford, and I am
grateful for this opportunity to appear before you today on
behalf of the Association of Maternal and Child Health
Programs, known as AMCHP.
I proudly serve as the board chair and president of AMCHP,
as well as chief of the Women, Infant, and Community Wellness
Section here in the Division of Public Health for the North
Carolina Department of Health and Human Services.
In fiscal year 2023, AMCHP requests that the subcommittee
fund the Title V Maternal and Child Health Services Block Grant
administered by the Health Resources and Services Agency at
$1,000,000,000, including a robust increase for the State
formula fund. We are thankful to the subcommittee for the
increases in funding for the block grant over the past several
years and for recognizing the essential role Title V plays in
improving the health and well-being of women, children,
including those with special healthcare needs, and their
families.
As you may know, the Title V block grant is driven by
evidence, flexibility, and results to ensure access to quality
maternal and child health services; reduce infant mortality,
maternal mortality, and preventable diseases and conditions;
and promote family-centered, community-based, coordinated care
for children with special healthcare needs. The block grant
funding is distributed to every State and territory by a
formula tied to the child poverty rate.
Another significant portion of the block grant is awarded
through Special Projects of Regional and National Significance,
or SPRANS, which are discretionary grants that support a range
of programs, including those to train the next generation of
leaders in MCH, to support innovation to improve maternal
health outcomes, and so much more.
In order to illustrate the far-reaching impact of Title V,
I would like to share a few examples of how the State formula
funds are being used in various States.
In Florida, the State Maternal Mortality Review Committee
identified leading causes of maternal death and issued urgent
maternal mortality messages to healthcare providers and
hospitals around obstetric hemorrhage and hypertensive
disorders to prevent future maternal deaths. In Massachusetts,
the shift to provide home visiting services in a virtual manner
ensured a new mother in crisis was able to get the counseling
she needed.
As this subcommittee's members are aware, our Nation is
facing an unprecedented shortage of infant formula. Title V
agencies around the country have been using their voices as
trusted messengers to share critical information with families
and healthcare providers about how to obtain formula, as well
as to warn of misinformation that has been spreading through
this crisis.
In North Carolina, we are closely monitoring supply,
working with the Federal Government, with manufacturers, and
retailers to get more formula on North Carolina shelves. We are
sharing information and resources and are working specifically
with our Title V MCH partners to share this information with
families.
During the past 2 years, Title V-funded programs have been
at the forefront of COVID-19 response efforts, with a
particular focus on addressing the unique impacts of the
pandemic on maternal and child health populations. The flexible
nature of the block grant made it an easily deployable source
of support for States to respond to the public health
emergency.
However, while the block grant is the backbone of our
Nation's public health infrastructure for women, children, and
families, that infrastructure has been severely strained as a
result of this pandemic. Maternal and child health programs and
the workforce need sustained, increased investment to rebuild,
to recover, and best serve the Nation's maternal and child
health populations now and into the future.
Further, our Nation has longstanding racial, ethnic,
geographic, and socioeconomic inequities in MCH outcomes. While
incremental funding increases to programs like the Title V
block grant make a difference in advancing maternal and child
health, to make transformational improvements that finally
address these inequities, we will require transformational
investments in the block grant and complementary Federal
programs that support maternal and child health, including
CDC's Safe Motherhood portfolio of programs, HRSA's Healthy
Start program, and CDC's Surveillance for Emerging Threats to
Mothers and Babies Network.
We thank you for funding the Title V Maternal and Child
Health Block Grant at $747,700,000 in fiscal year 2022 and urge
you to provide an increase to at least $1,000,000,000 in fiscal
year 2023, including a robust increase for the State formula
fund to ensure that States have the public health foundation
they need to support healthy children, healthy families, and
healthy communities now and into the future.
And I thank you so very much.
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The Chair. Thank you. Thank you very, very much for your
testimony.
I would just make some comments, but let me just ask the
ranking member if he has comments and questions and follow it
up with Congressman Fleischmann.
Mr. Cole. I don't have any questions, but I want to thank
our witness for her work. It is really important. I mean,
again, as our colleague Mr. Fleischmann said, one of the great
things about this committee is you learn a lot because it
covers so many areas.
And one of the things I was sad to learn over the course of
my service on this committee is how poorly we as a country
stack up with other countries in this area in terms of maternal
health, and then now how great the racial disparities are.
Something that we, as the chair mentioned earlier in another
context, we all knew were there, but COVID really brought it
home. And I know she will focus on this. We will focus the
committee and do the very best we can.
But I want to use this forum to also put out a challenge to
some of our friends at the State legislature. I know that in my
State, we don't fund enough in these areas, and we have some of
the worst statistics in the country, quite frankly.
And I am proud of what this committee does, and
particularly under the leadership of our chair. But we are
putting a lot of money, and I am always for having a rainy day
fund at the State level. I live in a State that is a boom-bust
State because of commodity prices in energy and agriculture,
and so that is a wise thing. But when times are good and the
Federal Government has put as much money out for a variety of
healthcare purposes as it has over the last 18 months to deal I
think very appropriately with COVID, some of that money needs
to be directed toward some of these programs in terms of
matches for what we do and what have you.
So, again, this is an area of great concern and one that I
look forward to working with the chair on as we move forward.
But thank you for working on the front lines in North Carolina
on a problem that really ought to embarrass us all as
Americans. We need to do better in maternal and infant health
than we are doing, and thanks for your efforts and thanks for
your advocacy and bringing it here in front of the committee
and making such an important case for all of us to hear.
Yield back, Madam Chair.
The Chair. Thank you. And I actually want to say thank you
for the testimony.
I think we have been talking about seizing the moment.
There is such a very big focus and interest on the issue of
maternal and child health programs, and we need to seize this
opportunity to further them. It has been really--and that we
have a heavy emphasis even in the 2022 appropriations bill, the
2022 appropriations bill, great advocacy by so many members of
our--of the Congress, our caucus, and so that that is an issue
that has been put front and center in so many ways.
And that, I assure you, will continue. But the advocacy
needs to continue because, again, the disparities that have
been demonstrated, and the issue with black women, this is
pretty extraordinary. And oftentimes, we lose track of the
serious issues that the childbirth may bring, and people just
view that, well, you are going to have a baby. Everything is
going to be okay. It is fine. But it is not the case. It is not
the case.
My own personal experience is with my stepdaughter, and 17
years ago, we thought everything was fine. And at one point, we
almost lost both my granddaughter, who is now 17 years old,
though, and her mom. And it was harrowing, and we weren't--we
had no idea that this was something that could come from a
regular pregnancy.
So, but I just tell you keep at it, keep at it at this
moment because the window is open. The window in Washington
shuts very quickly. So just continue the advocacy so that we
can really join the ranks of other countries and they are
paying attention to health and welfare of women and children,
women's and children's health in this country.
Thank you very much for your testimony.
What I would like to do is to recognize Dr. Anne Matthews
with the Rotary Foundation of Rotary International around the
issue of global polio eradication at the CDC.
Dr. Matthews.
ANNE L. MATTHEWS, CHAIR, POLIO ERADICATION ADVOCACY TASK FORCE
FOR THE UNITED STATES, THE ROTARY FOUNDATION OF ROTARY
INTERNATIONAL
Ms. Matthews. Thank you very much.
Chairwoman DeLauro, Ranking Member Cole, and members of the
subcommittee, I am here today on behalf of 300,000 members of
Rotary Clubs in the United States and to thank you for the
committee's generous support and longstanding leadership toward
a polio-free world and to also encourage continuation of
funding to support the polio eradication activities of the CDC,
the Centers for Disease Control and Prevention.
We are seeking $276,000,000 in fiscal year 2023 for CDC's
polio eradication efforts to protect the progress achieved to
date and to capitalize on unprecedented low levels of virus
transmission to end polio once and for all.
Rotary International and the CDC are spearheading partners
of the GPEI. That is the Global Polio Eradication Initiative, a
global partnership launched in 1988, which reaches the most
vulnerable children through safe, cost-effective polio
immunization.
Thanks to this committee's support, polio cases have been
reduced by more than 99.9 percent since 1988. Twenty million
people have been spared disability, and over 900,000 polio-
related deaths have been averted.
Last year, only 5 cases were recorded in the 2 remaining
endemic countries of Pakistan and Afghanistan. This low number
of cases reflects a high number of children effectively
protected through immunization.
Every year, the GPEI works to immunize 370 million children
globally. There were also 40 percent fewer cases of circulating
vaccine-derived polio virus in fewer countries in 2021, as
compared to 2020. The novel oral polio vaccine type 2 was
introduced in 2021 to accelerate progress in bringing outbreaks
under control.
This progress is encouraging, but fragile. Earlier this
year, a child from Malawi was identified with polio that is
genetically linked to virus in Pakistan, and another case has
been found in Mozambique. These cases remind us that as long as
polio exists anywhere, it is a threat to children everywhere.
Now is the time to capitalize on progress to complete polio
eradication.
CDC's work is critical to protecting the progress and
overcoming remaining challenges. CDC's Atlanta laboratories are
key to confirming both the presence and absence of polio virus.
They serve as a global reference center and training facility,
providing expertise in virology, diagnostics, and laboratory
proceedings.
CDC also contributes technical expertise through the
international assignment of technical staff to WHO and UNICEF
to provide strategic and management expertise to priority
countries. They also train and deploy public health
professionals to high-risk countries through the Stop
Transmission of Polio Program.
The $276,000,000 that Rotary is requesting will ensure that
CDC continues to provide this key technical expertise while
building country-level capacity to maintain high levels of
population immunity. This funding would also expand CDC's
capacity in three critical areas of outbreak response,
surveillance, and vaccine procurement.
The global network of 145 laboratories and trained
personnel established for polio also tracks measles, rubella,
yellow fever, meningitis, and other deadly infectious diseases,
including COVID-19, and will do so long after polio is
eradicated. Our collective investment has already saved
$27,000,000,000 in health cost since 1988, and it is estimated
that investing in polio eradication now may cumulatively save
an estimated $33,100,000,000 by the year 2100 in the form of
reduced costs in surveillance and vaccination.
We appreciate so much the help you have given and ask that
you continue to support the eradication of polio.
Thank you very much.
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The Chair. Thank you very, very much for your powerful
testimony.
First of all, let me just say that we want to say a thank
you to Rotary for the great work that Rotary does in this area
and a variety of others. They really have a tremendous network,
and they bring relief all over the United States, but also
internationally. So I compliment you and Rotary.
Sometimes we think that because there are not that many
cases in the U.S. of polio that we tend to forget the rest of
the world. But you make an absolutely brilliant case for what
we should do internationally and what we can do. Because if we
don't conquer it there, we are also at risk here. And I mean, I
think that that is clear.
And I just want to--I was at the CDC last Friday. They are
a remarkable organization, and we should do everything that we
can to make sure that they can continue in their global efforts
overall because they play such a role internationally. And I
know that the Gates Foundation plays a role in this effort as
well.
So thank you for your advocacy and your aggressive advocacy
on this. It makes a difference. Thanks very, very much.
Congressman Cole.
Mr. Cole. Thank you very much, Madam Chair.
I want to associate myself with your remarks, particularly
when it comes to thanking Rotary for what you have done over
the years to keep the focus on this disease.
I am old enough to have been part of that first generation
of children who got the polio vaccine and grew up--it is
amazing to me. I don't know that my son has ever met anybody
who had the disease. It was very common, as Dr. Matthews knows
and my friend the chair knows, when I was growing up. And so
you went to school with kids that had suffered the ravages of
this disease, and the progress we have made is astounding and
something that we can be really proud of.
And there is a couple of lessons to draw here, and that is
the importance of sustained effort over time. That if we spend
the dollars, we really can make an enormous difference. The
statistics you cited, Dr. Matthews, in terms of both the
financial and, much more importantly, the human cost and in
savings of the effort that has been made, both by Rotary
individually with all the hard work you have done and in
cooperation with the CDC.
So I really do think it is important. This is a genie that
can get out of that bottle. And as my friend the chair pointed
out, we are not safe here until it is eradicated everywhere.
And I would be remiss, finally, Madam Chair, if I didn't
give a shout-out to my old friend, Ralph Monroe, who has been a
tireless advocate for Rotary for many years. We were
secretaries of state together back in the 1990s. He has been a
tireless advocate, as I know Dr. Matthews knows, been up to
Washington many times, and just embodies the commitment of
Rotary as a service organization to do good all over the world.
He has traveled all over the world in this cause and in
this effort. And again, as the doctor knows, we are down to
some places that are pretty tough for us to get at
geographically, culturally, politically, you name it. But it is
really important that this fight be fought to the finish.
So, again, thanks for not taking your eye off the goal, so
to speak, and making sure that our committee--which I think on
a bipartisan basis, wants to finish this fight, too--stays
focused on this really, really important mission.
So thank you again, Dr. Matthews.
And Madam Chair, I yield back.
The Chair. Let me now introduce Mairead Painter, National
Association of State Long-Term Care Ombudsman Programs, and I
would just welcome you.
Mairead is a graduate of the University of St. Joseph in
West Hartford, and extensive background working to improve the
quality of life for residents who need long-term care and with
critical work with the informed choice process in Connecticut
in nursing homes. And she has been an advocate for person-
centered care.
So, Ms. Painter, thank you for your work, and we look
forward to hearing from you.
MAIREAD PAINTER, CONNECTICUT STATE LONG-TERM CARE OMBUDSMAN,
NATIONAL ASSOCIATION OF STATE LONG-TERM CARE OMBUDSMAN PROGRAMS
Ms. Painter. Hello, and thank you.
Chairwoman DeLauro, Ranking Member Cole, and distinguished
members of the subcommittee, I offer this testimony today on
behalf of residents in Connecticut long-term care facilities,
as well as in collaboration with the National Association of
State Long-Term Care Ombudsman Programs.
Some may not know what a long-term care ombudsman is or how
the work that we do assists constituents in your community. In
every State, ombudsmen work to improve the quality of life and
the quality of care for individuals residing in nursing homes,
assisted living communities, and in some States, home- and
community-based service waivers.
The individuals that we serve may be your family members, a
friend's parent, or even a veteran who served our country. No
matter who they are or how they are brought into the long-term
care system, there will be an ombudsman there from one of our
programs to support them and advocate on their behalf.
Ombudsmen respond to complaints, protect rights, and ensure
that they are treated as individuals with autonomy, choice,
independence, and access to quality healthcare. We perform all
of our activities on behalf of and at the direction of
residents while ensuring strict confidentiality.
We thank you for the support of our programs, and today, we
request funding that is directly tied to the need for resources
so that State ombudsmen can hire and train additional permanent
staff. Increasing the number of ombudsmen will enable us to
respond to residents impacted by the pandemic, to meet an
increase in demand, and to address the rise in long-term care
complaints across our country.
Over the past 3 years, residents have faced a virus that
targeted them and drastic infection control measures that
caused them to be isolated. Our offices have received thousands
of calls reporting the impact of these restrictions, and the
calls continue today.
Restrictions also paused normal State and Federal surveys
that ensure the quality of care and investigate complaints.
Today, residents are still reporting a lack of access,
oversight, and accountability.
Our program representatives make regular visits to long-
term communities to support residents. In 2020, nationally, we
had 1,700 paid staff and approximately 5,100 volunteers. This
was a significant drop from the volunteers we had in 2019, and
we anticipate a further decline this year.
These numbers are not sufficient to provide a regular
presence in the 14,000-plus nursing homes, plus thousands of
community residences, and assisted living facilities. As a
result, our representatives have had to do more with less. To
do this, we have used COVID relief funding to develop remote
outreach, trauma support, and expand our use of technology.
Ombudsmen greatly appreciate the COVID recovery funding,
and without it, we could not have accomplished this critical
work. But to continue to respond at this level and meet growing
demand for our advocacy, we need to increase stable annual
funding to recruit, hire, and train new staff and volunteers.
Last year, with 8 regional ombudsmen, 3 support staff, and
about 4 active volunteers, a Connecticut program responded to
almost 4,500 complaints, in addition to hundreds of calls for
information and consultation. That is almost the same number as
at the height of the pandemic, and we do not see things
slowing.
In addition to nursing homes, ombudsmen have been given
mandates to serve residents in assisted living but were never
provided regular annual funding to hire staff and appropriately
provide protections and outreach. We need dedicated assisted
living and home- and community-based funding to hire staff and
support residents in these settings. But the national funding
has not been there, and as a result, our programs have been
unable to adequately serve these citizens.
Increased regular annual funding will allow us to effect
change for individuals, as well as at the State, local, and
national level. Therefore, let me respectfully request that for
2023, we receive $65,000,000 for assisted living ombudsmen
services under the Title VII Older Americans Act, $70,000,000
for our current core funding under the Title VII Older
Americans Act, and $52,500,000 under the Elder Justice Act for
training and services and address increasing abuse, neglect,
and exploitation.
Current funding levels preclude ombudsman programs from
quickly responding to complaints and monitoring facilities.
Though the funds have been authorized since 2010, to date, no
Elder Justice Act funds have been appropriated for ombudsmen in
the annual appropriations process. Without our eyes/ears in
these facilities, residents are at greater risk of abuse,
neglect, exploitation, and any number of other rights
violations.
Thank you for your consideration of this request, and I
welcome any questions.
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The Chair. Well, thank you so much, and thank you for your
testimony today.
I think you really address an issue that is critically
important, one that has been--the role of an ombudsman and you
know what you can do. The strength of that role has been there,
but I think it is what happened with the pandemic is that this
was it opened up the Pandora's box. And people in assisted
living wound up being, as you pointed out, isolated, and
families without knowledge of what was going on, and the high
rate of deaths within assisted living during the pandemic is
extraordinary and really needs to be looked at.
So your role is critical, and we need to recognize that and
really take a hard look at what has been the past in terms of
funding and see where we can go. Obviously, we have
restrictions on the amount of money we have, but the points
that you make about the complaints, the abuse, and we did a
hearing about a week ago or 2 weeks ago that pointed up what is
not happening in the elder justice area and the increase in the
cases of abuse of our seniors. And so that we want you to have
what you need in order to be able to deal with the volume of
complaints.
But to be able to give our seniors and their families the
comfort of knowing that they are safe and that we--and they
have an outlet in which they can make their voices heard as
well.
So thanks for the testimony.
Congressman Cole.
Mr. Cole. Thank you. I will just again associate myself
with your remarks, Madam Chair.
I want to thank Ms. Painter for her work and work of others
like her during the COVID outbreak. It is important at all
times, but that period where that particular population is so
much at risk, what you and your colleagues did was pretty
extraordinary, saved a lot of lives.
So thank you very, very much, and thank you for your
testimony.
I yield back, Madam Chair.
The Chair. Thank you.
And now let me--hopefully, I get your name right here,
Hannah Wesolowski, chief advocacy officer for the National
Alliance on Mental Illness. And please proceed with testimony.
You are recognized for 5 minutes.
HANNAH WESOLOWSKI, CHIEF ADVOCACY OFFICER, NATIONAL ALLIANCE ON
MENTAL ILLNESS
Ms. Wesolowski. Thank you.
Chairwoman DeLauro, Ranking Member Cole, and members of the
subcommittee, on behalf of the National Alliance on Mental
Illness, I want to thank you for your bipartisan support and
commitment to mental health.
NAMI is the Nation's largest mental health organization. I
am honored to be here today to speak on behalf of people across
the country with mental health conditions and their loved ones.
The mental health challenges we face as a country are vast
and will continue to grow as we recover from and grapple with
the effects of the pandemic. If we do not invest in mental
health now, we will pay the price for decades to come. Bluntly,
our Nation is at a breaking point when it comes to mental
health.
We have an urgent youth mental health crisis, as
highlighted by our Surgeon General last year. And just this
week, we had another heart-breaking tragedy in a school. This
puts immeasurable trauma on not only the children in that
community, but kids across the country. Add to that the impact
of the last 2 years and our existing mental health crisis, and
we are facing an avalanche of need.
I urge every member of this subcommittee to think about the
children in your life--your kids, grandchildren, nieces,
nephews, neighbors. Picture the face of one child in
particular. Children like them are crying out for help, and we
need you to listen. We can make a difference if we act urgently
and in a significant way. If not, we are saying we are
satisfied with our children suffering in silence, with
sacrificing their futures.
Think back to the face you pictured. Would it be okay if
that child had to struggle in silence? There are unprecedented
numbers of children experiencing anxiety, depression, and
suicidal thoughts. More than half of parents are concerned over
their kid's mental well-being.
During the pandemic, rates of teens visiting the ER after a
suicide attempt, especially girls, skyrocketed. And 45 percent
of LGBTQ youth seriously considered suicide in the past year.
We do not have to accept this. We can do something.
Children spend much of their time in schools, which gives
us a chance to intervene early. But we have a severe shortage
of counselors, social workers, and psychologists in our school
system. The President has proposed $1,000,000,000 for the
School-Based Mental Health Services Grant Program. This funding
is desperately needed to vastly increase the number of mental
health professionals helping kids and their families get the
help they need.
But our crisis doesn't end with children. Nearly two in
five adults struggled with their mental health in 2020,
compared to about one in five before the pandemic. The
Community Mental Health Services Block Grant Program helps our
States fill needed gaps to address this growing demand. We urge
you to include the President's proposal to increase the block
grant to nearly $1,700,000,000, funding that is critical to
helping people on the ground.
While our goal is to help children and adults as early as
possible, sadly, NAMI hears every day from desperate families
with loved ones in crisis and nowhere to go for help or from
individuals who have fallen through the cracks and are trying
to piece their life back together.
In 7 weeks, 988 will be available as a nationwide hotline
for suicide and mental health crises. I applaud Congress for
the bipartisan support of this number, and NAMI is deeply
grateful to this committee for drastically increasing the
investments for the hotline and services that provide a mental
health response to people in crisis.
But even with those increases, we don't have the funding to
help everyone. Just take the call centers that will answer 988
calls. They are often staffed by volunteers.
We are asking people to volunteer their time to respond to
people calling on the worst day of their lives. While these
trained counselors are amazing, we cannot build a sustainable
system relying solely on their good will.
Because of 988, we have a once in a generation opportunity
to re-imagine how we respond to people in crisis. We cannot
miss this chance. Too many lives will be lost or ruined.
The call centers that will answer 988 calls rely on a
patchwork of inadequate funding. To meet the growing demand, we
need to fund not only the National Lifeline Network, but also
fund local call centers answering the 988 calls to ensure
culturally competent local capacity in every corner of this
country.
A fully developed crisis response system also requires
mobile response teams staffed by mental health professionals
and crisis stabilization services. Unfortunately, most people
don't have access to these services, and people are dying
because of it.
NAMI is deeply grateful for your leadership in bringing the
new Mental Health Crisis Response Pilot Partnership Program to
our communities. It will spur the availability of mobile crisis
teams as the primary in-person response to people in crisis.
But the work is not yet done. As you know, there is need
for more teams like this to serve both adults and children. We
urge you to increase funding of this program to $100,000,000 to
help people in more communities across the country.
As I wrap up, I need to recognize that I am here today to
speak on behalf of the people who cannot be here, the people
who are struggling, the parents that are trying desperately to
find help for their kids, and all those who lost their futures
because our system routinely fell short.
It is imperative that we address this crisis and make
mental health among our Nation's highest priorities, turning a
breaking point into a defining moment.
Thank you for this opportunity.
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The Chair. Thank you.
Let me, first and foremost, say that NAMI is the gold
standard. Thank you for really the years and years of work in
this area. You are extraordinary in the work that you carry on.
The issue is that mental health was an issue before the
pandemic, under the radar probably, but serious. And serious
enough to be considered a crisis, but it didn't--it didn't
manifest itself in the way to those of us who were working on
it that we had to deal with this crisis in some way in mental
health.
So, but the pandemic brought this to light. Now more than
ever we are looking at people who are struggling as a result of
so many issues that are out there. It is isolation. It is
losing a parent or grandparent, a loved one, et cetera. I don't
know how many families have been touched by the loss of
someone. With a million lives lost, it is like every family has
suffered something somewhere. That has to be addressed in a
formidable way, and we have to recognize that we need to do
that.
We are excited about the 988 line, and we also want to make
sure that we are providing the resources so that people--it
works. So that someone is not dialing the number, and there is
nobody home at the other end. So we need to make sure that that
is there, and we need to focus as a country on what is a mental
health crisis, not specifically caused by a pandemic, but a
mental health crisis in this country exacerbated by that and
high suicide rates.
And think about it. I saw a little boy this morning who
was--survived yesterday, but he was looking at his friends all
around him being killed, and how do you deal with that child?
How do you help that child to succeed?
Anyway, thank you so much for your testimony, and we will--
this is a high priority.
Congressman Cole.
Mr. Cole. Thank you very much, Madam Chair.
I want to thank our witness for being such an effective and
thoughtful advocate.
I remember a number of years ago, when I was chair of this
committee, and we passed the CURES Act. And my friend Tim
Murphy, who is no longer, sadly, in Congress but is a child
psychologist and has become an expert on post traumatic
stress--and still stays in touch with me and, ``Hey, think
about this. Think about this program.''--came by my office as a
Member who had done a lot of work on adding mental health
provisions in that. And I said this is all great, but the
authorizing committee, I am glad this is all authorized. Sadly,
my budget has been cut by $5,000,000,000 by the Budget
Committee.
Now, at the end of the day--and we have to mark up to that
number. The chair is going to have this challenge. At the end
of the day, I suspect our overall number will go up as we get
to a deal with the Senate, and we are going to need Democratic
support, and they have got some concerns in these areas that I
share. So we will do a little bit better.
But I had to say you have got to prioritize this for me a
little bit. And he said, well, if you can only do one or two
things, the most important thing is to fund the programs that
get us more mental health professionals. We simply do not have
enough people.
And I think your remarks about 988 are illustrative of
that. It is partly money, but partly we need to make those
investments in the pipeline to make sure that we have the
professionals to actually respond to the situation. And this is
one where I think we have been slower than any of us would like
to get there, but we are starting to begin to understand.
Maybe the pandemic brought it home a little bit more, and
you are quite right about that. This committee has had under
the chair's leadership multiple hearings where we have talked
about the long-term impact and people that were isolated,
whether it was in nursing homes or school kids that lost the
structure and focus in their life.
So thank you for keeping us focused on this important task,
and I will continue to work with my friend the chair, and
hopefully, we can make some progress.
With that, Madam Chair, I yield back.
The Chair. Thank you.
Thank you, and thank you for your testimony.
I would like to recognize Thomas Fleisher. Dr. Fleisher,
executive vice president of the American Academy of Allergy,
Asthma, and Immunology, you are recognized for 5 minutes for
your testimony.
THOMAS A. FLEISHER, M.D., EXECUTIVE VICE PRESIDENT, AMERICAN
ACADEMY OF ALLERGY, ASTHMA, AND IMMUNOLOGY
Dr. Fleisher. Thank you.
Chairwoman DeLauro, Ranking Member Cole, and members of the
subcommittee, thank you for the opportunity to testify on the
HHS fiscal year 2023 appropriations.
I am Tom Fleisher, executive vice president and a former
president of the American Academy of Allergy, Asthma, and
Immunology that I will refer to as AAAAI for the rest of the
talk. On behalf of our organization, I am before this
subcommittee today with three requests.
A $6,100,000 funding increase for the Consortium on Food
Allergy Research, also known as CoFAR, and supporting report
language, report language to support education and awareness
related to the need for penicillin allergy evaluation in order
to de-label non-allergic patients, and third, funding to
address antimicrobial resistance.
The AAAAI wishes to express its appreciation to the
subcommittee and to Congress for the passage of the fiscal year
2022 omnibus spending bill, which provided an additional
$3,000,000 to CoFAR, increasing its budget to $9,100,000.
Food allergies affect 32 million Americans, including 6
million children. Each year, more than 200,000 Americans
require emergency medical care for allergic reaction to foods.
That is the equivalent of one trip to the emergency room every
3 minutes.
CoFAR was established within the NIAID in 2005 and has
resulted in many advances, including the discovery of genes
associated with increased risk for peanut allergy and the most
promising potential immunotherapy treatments for egg and peanut
allergies. Additional breakthroughs, scaled across other major
food allergies, could significantly improve the quality of life
for tens of millions of patients.
The AAAAI and other stakeholders enthusiastically support
the $6,100,000 funding increase for CoFAR in fiscal year 2023
and accompanying report language, as submitted to the
subcommittee, by Representatives Ro Khanna and Anthony
Gonzalez, as well as others. This would bring CoFAR's annual
budget to $15,200,000.
CoFAR has been able to accomplish breakthroughs in the
under-researched field of food allergies. It is crucial that we
continue investing at proportional levels given the scale of
this condition, which impacts 8 to 10 percent of the U.S.
population. Further, food allergies disproportionately impact
low-income communities of color.
I would also like to speak to the growing threat of
antimicrobial resistance, which, combined with the dwindling
pipeline of new antibiotics, requires policies that prevent
inappropriate use of antibiotics. According to the CDC,
approximately 10 percent of the U.S. population self-report
being allergic to penicillin, yet 9 out of 10 of these patients
are not allergic when formally evaluated, meaning fewer than 1
percent of the population is truly allergic to penicillin. The
CDC has cited the importance of correctly identifying truly
penicillin allergic patients to decrease the use of broad-
spectrum antibiotics.
To this end, the AAAAI urges the subcommittee to include
report language that encourages the CDC and other appropriate
Federal agencies to undertake physician and patient-directed
education to heighten awareness of this important issue.
We also support CDC's work in the area of AMR. The AAAAI
supports $100,000,000 in funding for the National Healthcare
Safety Network and $397,000,000 for the Antibiotic Resistance
Solutions Initiative. These programs would benefit from
significant new resources to achieve the goals outlined in the
National Action Plan for Combating Antibiotic Resistant
Bacteria.
Thank you for your past support of food allergy research,
antimicrobial resistance, and penicillin allergy evaluation. We
appreciate your consideration of these requests for fiscal year
2023 and look forward to working with you to advance these
important health issues.
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The Chair. Thank you very, very much for really focused
testimony here and the work that the academy does. The areas
that you have outlined for years trying to deal with the issue
of antimicrobial resistance and that we need to spend time in
trying to really deal with it, and it would be interesting to
know, given the vast array of antivirals and drugs and
antibiotics that have been used throughout COVID here, of what
kind of an effect that is going to have for the future.
I am not a scientist, but you are in a position to sort
that out. So very, very big issue and one that we have focused
on the committee.
Secondly, when you talk about the food allergy research,
really incredible. I don't know if you at some time will talk
about being lactose intolerant, which it was only several years
ago that that occurred, and what one does about that. But I
watch people all of the time and have family--now my 5-year-old
grandson, it is fish. My God, he gets deathly ill.
But the work in that area I think is--I think we can--and
again, I am not a doctor and I am not a scientist, but we make
strides, and we can continue to look at this as a way in which
we can alleviate that stress, pain, or potentially death. But
this could be prevented. We can deal with prevention in this
area, which is where we ought to try to focus our attention.
And the CDC does a great job. I mean, the CDC has been
extraordinary in this effort historically. So look forward to
working with you as we go forward. And the caveat is always how
much money are we going to have?
Dr. Fleisher. Thank you.
The Chair. And that is always the way forward. But thank
you for the focus. And on penicillin as well, it is very
interesting. You do learn something every day, and through this
committee you learn something.
So, Congressman Cole.
Mr. Cole. Thank you, Madam Chair.
I know my friend the chair is trying to move us along
because we are already over time, and so I am going to keep my
remarks brief and associate myself with hers. And please don't
take the brevity of my remarks as anything other than trying to
help in terms of time because these are important topics and
interesting.
And I think my friend the chair put her finger on it. The
problem is always how much money do we have? And I noticed, Dr.
Fleisher, you were on for quite a while so you got an earful of
the number of requests that my friend the chair is going to
have to wrestle through and then put together the votes on both
sides of the aisle to get all this across and done and,
hopefully, on time.
So we are going to work with her on that, try to be as
supportive as we can, but we really appreciate your testimony.
With that, Madam Chair, I yield back.
The Chair. I thank the ranking member.
And just that I see all these people waiting, and I think
we are about an hour behind and so forth because it is so--
these issues are so critical.
But Dr. Sandra Harris-Hooker, senior vice president for
research administration, professor of pathology at Morehouse
School of Medicine. We welcome your testimony, and you are
recognized for 5 minutes.
SANDRA HARRIS-HOOKER, SENIOR VICE PRESIDENT FOR RESEARCH
ADMINISTRATION AND PROFESSOR OF PATHOLOGY, MOREHOUSE SCHOOL OF
MEDICINE
Ms. Harris-Hooker. Chair DeLauro, Ranking Member Cole, and
members of the subcommittee, good morning, and thank you for
the opportunity to present testimony in support of programs
impacting health, minority health, and health disparities.
And greetings on behalf of our president and CEO, Dr.
Valerie Montgomery Rice.
Morehouse School of Medicine is one of four historically
black medical schools. These four schools have trained
approximately half of the black physicians in this country. The
subcommittee's investments in health professions training,
medical research, and public health have been very meaningful.
They provide our institutions with resources needed to drive
improvements in health status for all Americans and help us to
provide our students with opportunities for careers in health-
related professions, which is clearly a national priority.
I would be remiss if I did not thank the subcommittee for
its responsiveness to the COVID-19 pandemic. Your commitment to
providing the resources needed to establish the Higher
Education Emergency Relief Fund has been tremendous and allowed
us to respond to the needs of our students, faculty, and staff,
as well as play a leadership role in improving public health
practices in communities nationwide.
Our complete list of funding recommendations is included in
our written testimony, but with the limited time for my oral
remarks, I want to focus on two key programs important to the
Morehouse School of Medicine and other minority health
profession schools.
The first is the Research Centers at Minority Institutions,
acronym RCMI, which is administered by the National Institute
on Minority Health and Health Disparities, NIMHD. Historically,
the RCMI program has provided the resources needed for our
schools to begin to build, with emphasis on begin to build, a
research infrastructure comparable to non-minority
institutions, allowing us to attract world-class researchers,
expand research facilities, and support cutting-edge
investigations into questions about why health disparities
still exist and how to improve the health status of each
American.
As the subcommittee has increased funding for NIMHD,
funding for the RCMI program has not grown at the same rate.
Furthermore, RCMI program funding opportunities have become
more focused on research project grants and less on capacity
building. While both of these are certainly needed, our schools
need the resources to build capacity to successfully compete
for research project grants and other funding opportunities.
As the subcommittee considers its funding recommendations,
we urge that the RCMI program be provided with a detailed level
of funding that is consistent with the growth of the NIMHD
budget. Moreover, we urge the subcommittee to re-emphasize the
historic infrastructure-building focus of the program,
including providing $15,000,000 annually--of annual funding to
support clinical and translational research infrastructure in
historically black medical schools comparable to that provided
to majority medical schools.
Funding for infrastructure for clinical research resources
and facilities is critical to advancing health equity among the
most vulnerable populations in this country.
Secondly, in March, President Biden signed the bipartisan
John Lewis NIMHD Research Endowment Revitalization Act. This
new law solved a glitch in the underlying NIMHD Research
Endowment Program statute that precluded several historically
eligible institutions, including Morehouse School of Medicine,
from even competing for this important program.
This endowment helps us to build an endowment that would
enable us to be on the average of other health professional
schools. Now that this eligibility glitch is resolved, we ask
that $50,000,000 be put into that fund.
Thank you very much for the opportunity to present this
testimony to the committee, and I am pleased to answer any
questions or provide additional information.
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The Chair. Thank you so much for your testimony.
Let me yield to Congressman Cole for any comments or
questions he may have.
Mr. Cole. Just very quickly, Madam Chair, I want to thank
Dr. Harris-Hooker for her testimony and for spotlighting what
this committee has learned during--probably knew before, but I
think is much more acutely aware of about the social disparity
in both outcomes and the unrepresentative nature of many of our
healthcare providers and how important it is to address that
imbalance going forward.
And very much appreciate the work of the medical schools
associated, the four you mentioned, with Historically Black
Colleges and Universities--what an extraordinary contribution
they have made to the country's healthcare--and what we need to
do to expand capacity, quite frankly, going forward.
So thank you for coming before us. And with that, I yield
back to the chair.
The Chair. Thank you very, very much.
And I associate my comments with those of the ranking
member. I think the historic black college medical schools and
the professional training, one of the most serious areas is
that we need to have many, many more minority medical
professionals here to deal with what has been demonstrated in
terms of the disparities that exist in our healthcare system.
So, and the training is critical, and you are equipped to
do it. You need the resources to do it, and we understand that.
And again, we will be looking at what those numbers are and
making a decision, but I thank you for the very strong
testimony and the work of the historic black medical schools.
So thank you very, very much, Dr. Hooker.
Let me now recognize Katie Ray-Jones, who is the chief
executive officer of the National Domestic Violence Hotline.
Katie, you are recognized for 5 minutes.
KATIE RAY-JONES, CHIEF EXECUTIVE OFFICER, THE NATIONAL DOMESTIC
VIOLENCE HOTLINE
Ms. Ray-Jones. Thank you.
Good afternoon, Chairwoman DeLauro, Ranking Member Cole and
distinguished subcommittee members.
Thank you for the opportunity to provide testimony on the
importance of continued Federal investment in the Hotline,
which is authorized as part of the Family Violence Prevention
and Services Act and administered by the Family Violence
Prevention Program, a program of the Family and Youth Services
Bureau under the Administration for Children and Families at
the Department of Health and Human Services.
The Hotline, established in 1996, is the only 24/7/365
national organization that directly serves victims of domestic
violence, their friends, and family via phone, chat, and text.
We are currently experiencing our highest contact volume in our
25-year history, and to help meet this overwhelming need, I am
here to request the subcommittee increase investment in the
Hotline in fiscal year 2023 to $27,000,000.
The Hotline's services are free and confidential. We have
the most comprehensive survivor resource database in the
country. Our advocates help victims and their families and
friends, whether they are in throes of an emergency, seeking
local help, or just in need of someone to talk to in that
moment.
Our expertise is routinely sought by national and regional
media; Federal, State, and local governments; service
providers, law enforcement, and nonprofit colleagues.
On December 30, 2021, a Hotline advocate answered our 6
millionth contact since our inception. Truly a bittersweet
milestone. In calendar year 2021, the Hotline over 620,000
contacts. We also knew once life returned to any kind of
normalcy from the devastating impact of COVID-19 there would be
more survivors needing support who had not felt safe to reach
out during the height of the pandemic.
Sadly, our instincts were accurate. In February 2022, the
Hotline experienced the highest monthly contact volume in our
history, 74,000 contacts reaching out for help in 28 days. Also
in February, in an effort to use their technology to help
survivors connect with our services, Google launched a new
crisis search engine optimization. After this launch, the
volume nearly doubled overnight, a powerful and somber
illustration of how many are impacted by relationship abuse and
need services or support.
We desperately need to add a record number of new advocates
on the line and implement technology advancements to manage
this kind of volume. We need to increase our impact through
loveisrespect, an initiative that engages, educates, and
empowers young people to prevent and end abusive relationships.
We also deeply value working in partnership with several
national organizations to serve victims with specialized needs.
The Hotline has worked with the National Indigenous Women's
Resource Center to help design and implement a Native-run
domestic violence helpline that provides culturally specific
assistance to Native victims of domestic violence. And in March
2017, Strong Hearts Native Helpline was launched.
In addition, the Hotline also works with Abused Deaf
Women's Advocacy Services to provide intervention, education,
information, and referrals to callers who are deaf through the
National Deaf Domestic Violence Hotline. While we are proud of
how we have expanded our reach and services in order to meet
the Hotline's primary goal of serving all survivors, we are
also aware there remain some specialized populations we have
yet to serve, such as those who choose to cause harm.
This includes about 9 percent of our total contacts who
reach out seeking information and support for changing their
harmful behaviors. With additional and specifically dedicated
funding, such as the $1,000,000 championed by Representative
Lloyd Doggett out of Texas, we hope to explore opportunities to
help abusive partners recognize their behaviors and access
support to change them.
It takes a comprehensive, multilayered national, State,
regional, and local approach to fully support survivor safety
and recovery. While we offer important emergency and support
services for victims of domestic violence, our goal is to
connect these survivors with local programs that have resources
to help victims identify shelter, transitional housing,
culturally specific programs, legal assistance, and economic
supports necessary to help them escape their abusers. We urge
the committee to also provide robust support to these
lifesaving programs.
Throughout my testimony, I have shared with you the
tremendous impact of the dedicated advocates at the Hotline. As
a result, I urge the subcommittee to continue its bipartisan
support for the Hotline in fiscal year 2023 through an
appropriation of $27,000,000. These funds would allow us to
increase staffing by hiring additional advocates and support
staff. When someone reaches out for help, we need to be able to
answer.
In conclusion, I would like to share feedback from a
survivor who called the hotline.
``This conversation has been incredible. I feel like the
tears in my heart are starting to dry up. Thank you for
supporting me and helping me reach my own solutions. I feel so
much hope and empowerment and like the healing has begun for
me.''
As you said, Chairwoman DeLauro, earlier, we need to seize
the moment. And when someone calls for help, we need to be able
to answer.
Thank you for your time, and thank you again for your
continued support for victims of domestic violence.
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The Chair. Thank you. Thank you for your advocacy.
I think we all know and you just talked and you quoted
``hope and empowerment.'' That really is key and critical to
this effort, and it has been we have moved so far with regard
to domestic violence. Again, the problem exacerbated by the
pandemic, hearing more about that. And so that we need to,
again, as I say, seize this moment to act on it and to provide
you with the trained personnel, help you with the trained
personnel because somebody on the end of that line has the
ability to empower, to save a life, and someone who isn't
trained, it can go in a different direction.
But we are there. I mean, our people are there. Again, it
is a question of what the money is going to be. But overall,
there really is a very basic understanding of what the
circumstances are and how we have to deal with that hope and
empowerment.
Congressman Cole.
Mr. Cole. Thank you very much, and I will try and be brief,
Madam Chair.
Number 1, I want to thank our witness. Very effective, very
powerful advocacy. I particularly want to thank you, as a
Native American, for the work that you have done in that area.
That is a community, as you know, that has been
disproportionately suffering from this issue.
And I want to thank two other people, too. I want to thank
the President of the United States, who, as a Senator, did
Violence Against Women Act and has been probably the foremost
champion in this area over the years. And I want to thank our
chair because we wouldn't have gotten the Violence Against
Women Act reauthorized if it hadn't been riding on the back of
our bill when we finally got an omnibus bill done.
And we had struggled, my friends on both sides of the aisle
that were supportive of that legislation, to try and work
through some of the knotty issues because how anybody can be
against that legislation is beyond me. But had not been for
this committee and our chair, that would still be lingering out
there, would not have gotten across the finish line in this
most recent omnibus bill.
So even though we are not supposed to legislate on
appropriations, sometimes we do, and it has to be with the
consent of both sides, obviously. And in this case, we got
that. But we wouldn't have it without the leadership of my
friend the chair.
But thank you again for highlighting this. Thank you for
the incredible work that your volunteers and advocates and
professionals do, helping people in an incredibly traumatic and
difficult and often isolated situation. And when they reach out
and ask for help, as my friend the chair said, it needs to be
there. And robustly and quickly, and we need to help people get
out of these situations or through them in a way that protects
them physically and emotionally and their children physically
and emotionally and, hopefully, helps anybody engaged in this
activity to find a different way to work through whatever their
issues and problems are.
But again, Madam Chair, you have been a leader here. I
appreciate it. I look forward to continuing to work with you on
it.
Yield back.
The Chair. Thank you. Thank you very much, and we will work
with you, Katie Ray.
Let me now introduce Rick Ginsberg, dean of the School of
Education at the University of Kansas, the Learning and
Education Academic Research Network of the LEARN Coalition.
Mr. Ginsberg.
RICK GINSBERG, DEAN OF THE SCHOOL OF EDUCATION, UNIVERSITY OF
KANSAS, THE LEARNING AND EDUCATION ACADEMIC RESEARCH NETWORK
(LEARN) COALITION
Mr. Ginsberg. Thank you, Chair DeLauro, Ranking Member
Cole, and members of the subcommittee. We appreciate your work
on all of our behalf.
I have been dean at the School of Education and Human
Sciences at the University of Kansas for 17 years. But in my
role as dean, I am also co-chair of the LEARN Coalition, a
coalition of 41 leading research universities of education
across the country, which supports critical investments in
research aimed at advancing the scientific understanding and
improving of learning and development.
We advocate for greater funding for these priorities across
all Federal agencies, and today, I will be speaking on the need
for increased funding towards IES and two institutes with NIH,
the National Institute of Child Health and Human Development
and the National Institute on Mental Health.
I want to start by noting that the LEARN Coalition is
deeply appreciative of the increases provided to IES and NIH in
fiscal year 2022, and we hope to build on this momentum to
continue that strengthening in fiscal year 2023.
We are also grateful for the inclusion of the report
language in fiscal year 2022 on the importance of the
administration appointing members to the National Board of
Education Sciences. Unfortunately, NBES has been unable to meet
due to lack of a quorum since 2016. We encourage the
subcommittee to continue urging the administration to fill
these important roles.
Turning to the main purpose of my testimony, I am here
today to request no less than $815,000,000 for IES overall,
with $225,000,000 dedicated to the Research, Development and
Dissemination line-item and $70,000,000 for the National Center
for Special Education Research, NCSER.
IES is essential to developing a comprehensive, reliable
evidence base, ensuring that teaching and learning practices in
our country are grounded in evidence and research. While only
12 to 15 percent of NCER and NCSER's applications have received
awards over the past several years, the number of grant
competitions offered by IES are currently severely limited due
to chronic understaffing within the agency.
Furthermore, NCSER was unable to fund all the grant
applications rated outstanding or excellent in fiscal year 2021
due to a lack of sufficient funds. Such evidence displays how
IES is currently too understaffed and too underfunded to
support the Nation's education research infrastructure.
We believe that an appropriation of $815,000,000 for IES
overall, with $225,000,000 designated for RD&D will support the
continued examination of what works and what does not work to
further our education system's curriculum, instructional
techniques, and assessments. This additional funding should
also bolster IES's work towards COVID-19 recovery.
IES is also integral to the education research training
pipeline by providing key training and grant opportunities to
increase the number of education researchers who can
successfully compete for IES-funded research. Making the case
for more IES funding, the renowned National Academy of
Sciences, Engineering, and Medicine just released a report in
March called ``The Future of Education Research in IES.''
The Academy urged Congress to increase appropriations for
IES, as it is severely underfunded despite an expanding
workload. Indeed, the Academy report recognized--and I am
quoting them here--that IES ``does not appear to be on par with
that of other scientific funding agencies,'' in terms of the
amount of the dollars.
In addition to our request for IES overall, we urge
Congress to provide $70,000,000 for special education research
through NCSER. NCSER currently has a budget that has remained
relatively flat since 2014. That is a long time. This has
negatively impacted the research that provides special
educators and administrators the evidence-based resources
needed to improve academic outcomes for students with or at
risk of disabilities.
Last, I would like to emphasize the importance of increased
NIH funding. The LEARN Coalition was disappointed that the
President's fiscal year 2023 budget request did not include a
healthy increase for the base NIH budget, but rather focused on
increased ARPA-H funding. ARPA-H funding certainly is
important, but that should supplement and not supplant NIH
funding. Specifically, we believe the two programs require
strong Federal funding.
This is why the LEARN Coalition is requesting
$2,020,000,000 for NICHD to examine brain functions and the
impact of different educational services on learning and
development. We also support an increase in funding for NIMH to
$2,570,000,000. This increase will help further understanding
of the behavioral, biological, and environmental mechanisms
necessary for developing interventions to reduce the burden of
mental and behavioral disorders and optimize learning and
development.
The LEARN Coalition believes that, collectively, these
investments in education research will drive improvements in
school, teacher, and student performance in the coming years.
Thank you again for considering these requests. I am
certainly happy to answer any questions you may have.
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The Chair. Let me yield to the ranking member for comments
or questions that he may have.
Mr. Cole. I will try to make two quick points. First of
all, number one--well, three points. Thank you for your
testimony. It is very helpful, very illuminating.
Secondly, I think it is fair to say that the chair and I
agree with you about the imbalance between NIH funding and
ARPA-H, and we say that as joint supporters of ARPA-H. And I
suspect you will see that addressed in the bill. We don't want
to lose the record that we have built up of working together in
a bipartisan fashion to steadily increase NIH funding. I think
that has paid enormous dividends for the country.
And finally, I couldn't help but note looking behind you
the very proud Kansas Jayhawk. As a fellow Big 12 guy, I want
to take this opportunity to congratulate you on that amazing
national title where you--where Coach Self and your Jayhawks
pulled off one of the great games I have ever seen in an NCAA
final. So, well done, Kansas.
So, with that, Madam Chair, yield back.
The Chair. Thank you. Thanks very, very much.
And the ranking member addressed the issue that we will try
to create the balance in NIH and with ARPA-H in terms of basic
research. But also I think it is fascinating in the testimony,
we had a hearing, it may have been yesterday--you lose track of
time around here. But where we heard that with regard to
special education teachers, that there really is such a
shortage, and they feel that grows bigger with the number of
kids that we are trying to provide an education for.
So the role of being able to increase that number or
understanding how it needs to be taught and, therefore, then
the training of professionals in this area I think could really
be helpful overall in terms of a quality education for our
kids. But it is the data, you are a little bit like--this seems
to be like the Bureau of Labor Statistics, the BLS for
education with the information that you put together, but it is
how you learn and how you teach. Basic fundamental questions of
that underlie so much of what we do in the K through 12 space
and then higher education.
So the function of your efforts are really critically
important in underlying the kind of directions that we can go
in in terms of our programming. So I thank you very, very much
for this rich testimony about a vital area with regard to
education, and thank you very much for being with us today.
Thank you.
Mr. Ginsberg. Thank you both.
The Chair. Let me introduce now Antonio Flores. Dr. Flores,
president and CEO of the Hispanic Association of Colleges and
Universities. Please, we recognize you for 5 minutes for your
testimony.
ANTONIO R. FLORES, PRESIDENT AND CEO, HISPANIC ASSOCIATION OF
COLLEGES AND UNIVERSITIES
Mr. Flores. Chair DeLauro, Ranking Member Cole, and members
of the subcommittee, thank you for the opportunity to testify
on the importance of investing equitably in Hispanic-Serving
Institutions for fiscal year 2023.
The Hispanic Association of Colleges and Universities,
HACU, was founded in 1986 and is the only national association
that represents HSIs. These 559 institutions enroll over 5
million students in the United States, the District of
Columbia, and Puerto Rico.
I urge you, respectfully, to fund Title V Parts A and B of
the Higher Education Act as follows--$250,000,000 for
Developing Hispanic-Serving Institutions, Title V, Part A, or
$67,150,000 above fiscal year 2022, and $100,000,000 for
Promoting Postbaccalaureate Opportunities for Hispanic
Americans under Title V, Part B, or $80,340,000 above fiscal
year 2022.
HSIs educate more than 5 million students annually,
including two-thirds of the estimated 3.8 million Hispanic
college students in American higher education. Most of them are
first-generation college students and come from low-income
families. They also, HSIs, enroll twice as many African
Americans as all the Historically Black Colleges and
Universities combined, more than 40 percent of all Asian
Americans in college today, and twice as many Native Americans
as all the tribal colleges and universities put together, as
well as a sizable number of non-Hispanic Whites.
Additionally, while only accounting for 16 percent of all
the colleges and universities in the country, HSIs enroll 31
percent of all the Pell recipients. Despite their great
diversity and need, HSIs remain at the bottom of the Federal
funding priorities, compared to other Minority-Serving
Institutions and HBCUs.
Federal investments are essential to strengthen our
workforce by enhancing educational attainment, especially in
STEM and other fields of national priority. The U.S. Census
Bureau reported that from 2010 to 2020, Hispanics accounted for
more than half the total growth of our national population and
are now over 63 million strong. And it has estimated that the
Hispanic population will grow by 93.5 percent from 2016 to
2060. Therefore, from 2020 to 2030, three of every four new
workers joining the American labor force will be Hispanic.
HSIs educate and train the most diverse and underserved
communities and do so with fewer Federal resources per student
than their peer institutions. As the Nation looks to rebuild
the economy after the pandemic, it is critical that Federal
investments strengthen our workforce by enhancing the
educational capacity of HSIs to pave the path of success and
opportunity for Hispanics and other underserved Americans.
As the Hispanic growth rate in K-12 enrollment continues to
accelerate, the number of Hispanic high-school graduates is
expected to increase by 49 percent between 2012 and 2028,
compared to 23 percent for Asian/Pacific Islanders and to a net
drop of 3 percent and 15 percent for blacks and whites,
respectively.
The Bureau of Labor Statistics has projected that the
Latino share of the workforce will increase dramatically from 1
in 10 in 2010 to 1 in 3 by 2050, while white workers will
decrease in number considerably. Blacks will remain at 12
percent. Asian Americans will increase from 5 to 8 percent, and
all others from 2 to 5 percent.
For America to remain competitive in the global economy, a
much better educated and trained Hispanic labor force is
required. HSIs must be placed at the top of Federal investment
priorities without further delay.
HACU and its supporters wholeheartedly commend the U.S.
Congress and the administration for funding generally HBCUs and
other Minority-Serving Institutions, and we urge them to
continue doing so. Likewise, we exhort Congress and the
President to invest with equal commitment in HSIs and their
underserved students. They truly are the future of the Nation.
On behalf of HACU and the Nation's 559 Hispanic-Serving
Institutions it represents, I thank you most sincerely for your
time and consideration of our request.
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The Chair. Thank you so much. I really appreciate your
testimony, Dr. Flores.
And really, you never sit back on what you have done, but
always to move forward. But I was very excited that what we did
in this conference committee in the 2022 bill, we increased the
HSIs about 23 percent, and it was historic in terms of that.
And I am just going to leave it with this, that it is my
intention that we continue that historic climb with regard to
HSIs.
Mr. Flores. Thank you.
The Chair. So I thank you for what you do, and really, it
is a pleasure to listen to you.
Thank you.
And with that, let me yield to Congressman Cole.
Mr. Cole. Thank you very much, Madam Chair.
And Dr. Flores, that was an excellent presentation. Really
compelling, frankly. And the statistics that you laid out are,
I think, more than informative. I think they are persuasive as
well, and I agree with the chair. These are institutions that
are doing an amazing job, and as your numbers suggest, they are
only going to become more important in the future as this
population becomes a larger percentage of our total population.
So this is an area that I know my friend and I will work on
together. I was very pleased to see the increase in the
appropriations in the 2022 bill, and I pledge to continue to
work with her to see that we try to move forward in this area.
But again, thank you for an excellent, excellent presentation.
With that, I yield back, Madam Chair.
The Chair. Thank you.
Let me recognize Janet Hamilton, the executive director of
the Council of State and Territorial Epidemiologists.
JANET HAMILTON, EXECUTIVE DIRECTOR, COUNCIL OF STATE AND
TERRITORIAL EPIDEMIOLOGISTS
Ms. Hamilton. Chair DeLauro, Ranking Member Cole, and
members of the subcommittee, thank you for the opportunity to
testify today. I am Janet Hamilton, executive director of the
Council of State and Territorial Epidemiologists, or CSTE. CSTE
represents public health epidemiologists nationwide working to
respond to emerging public health threats. For fiscal year
2023, CSTE asks that you provide at least $250,000,000 for
CDC's Data Modernization Initiative, or DMI.
Since I last testified in front of this committee 3 years
ago, we have made progress in our public health data systems,
delivering data faster to save lives, but we are not done yet.
As we saw during COVID-19, our public health data systems were
not prepared, nor is COVID-19 the last threat we will face. As
we speak, a monkey pox outbreak is spreading globally, and a
completely new threat is causing unexplained hepatitis in
children. State and local public health departments are busy
responding to these potential cases, but they cannot do this
without the key data pieces to inform the investigation.
Public health response happens at the local level, and we
must preserve the role that State, territorial, tribal, and
local health departments play in our public health data
infrastructure. Led by the CDC, State and local health
departments need a nationwide public health surveillance system
to detect and respond to the threats. To build this
infrastructure, we need the resources to support our existing
laws. All States have laws that require the reporting of
certain public health threats by physicians, hospitals, and
laboratories. It is the process by which these data are
reported that the DMI seeks to improve.
With our partners in the Data: Elemental to Health
Campaign, CSTE called on Congress to provide the first-ever
dedicated funding for public health data systems in fiscal year
2020. Thanks to this subcommittee, Congress has provided more
than $1,000,000,000 through annual and supplemental
appropriations for DMI. Data: Elemental to Health estimates
that the actual need for data modernization is at least
$7,840,000,000 over 5 years. Yes, we know that is a big number,
but we also know how important it is to get this right.
There are five key pillars of the Data Modernization
Initiative that are part of an enterprise-wide interoperable
approach. More details are available in my written testimony,
but to recap quickly, first, electronic case reporting, or ESR,
assures that when providers see patients' demographic and
clinical information, along with test results for reportable
conditions, they are rapidly shared with State and local public
health. ECR is closing health equity blind spots. Initial
implementations demonstrate over 90 percent completeness of
race and ethnicity data, far better than the 65 percent we had
without this critical tool.
State, local, tribal, and territorial health department
staff contact and interview cases and then provide the case
investigation data to the National Notifiable Disease
Surveillance System, NNDSS, the second pillar of DMI, but
resources are lacking. With COVID-19, there are numerous
examples where health department staff conduct outbreak
investigations or identify clusters from genomic sequencing but
are unable to electronically share those data with NNDSS due to
agency infrastructure shortages.
The third pillar of DMI is electronic lab reporting where
labs submit test results to public health as soon as they are
available. Test results often serve as the first piece of
information received by State and local public health to launch
a rapid response. The fourth pillar is electronic vital records
systems, which ensures real-time transmission of birth and
death data for statistical and surveillance purposes. And the
fifth pillar, the National Syndromic Surveillance Program,
helps detect, monitor, control, and prevent emerging diseases.
These five pillars are interwoven, and each plays a key
role in moving us from a sluggish, outdated, and burdensome
patchwork system to a 21st century public health data
infrastructure that provides complete, accurate, and
instantaneous data. We do not have a science problem. We have a
resource problem. To make our public health systems work now
and in the future, we need regular, sustained annual funding
for our public health surveillance systems and data workforce.
Again, we respectfully request the subcommittee provide at
least $250,000,000 for DMI in fiscal year 2023. Thank you.
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The Chair. Thank you very, very much. We put in, I guess,
$100,000,000 in the 2022 bill for data modernization. I think
we have had enough hearings, and, again, that was done on a
bipartisan basis. I think there is a recognition that we nearly
had the collapse of the CDC during the pandemic because of a
lack of public health infrastructure. So let me be succinct
with you. We are committed to doing that. Again, I was at the
CDC on Friday, and we had a report on data modernization, which
is extraordinary, and progress has already been made. We are
going to work to continue to move that forward.
And also, I want to try to take a look at introducing what
are the kinds of authorities the CDC needs to have in order to
be able to collect data on a uniform basis and have the data
reported back to the CDC in real time, and not have a patchwork
of data that is out there that is held back from the CDC. So I
will leave it there but committed to increasing that
opportunity. We have to come out of this pandemic with the
public health infrastructure so that, in fact, this doesn't
happen again with regard to the CDC. The CDC is too vital to
our, you know, healthcare system.
Congressman Cole.
Mr. Cole. Thank you very much, Madam Chair. Dr. Hamilton, I
remember the last time you testified because it was one of the
very last hearings that we had----
Ms. Hamilton. Yes.
Mr. Cole [continuing]. Before COVID hit us, and in that
sense, prophetic in the warnings that you and others were
issuing about the need to do exactly what you are here
advocating for today. And I will reiterate the chairman's
support. We think what you are doing is important. We think
these investments are critical. We think they need to be
sustained going forward, but it is always timely for you to
come back and remind us, and I will be working with the chair
so we can continue the progress we have made. I think it is
absolutely essential to the public health and well-being of the
American people going forward that we get out of this patchwork
into a much more uniform, modern, and effective system that
gives us the information we need to respond in a timely fashion
to threats that genuinely, as we saw, can quickly get out of
hand and be just devastating to our population and, honestly,
people around the world.
So, again, I don't think this is an area of any debate
between the chair and me. I think this is an area where we will
have to scratch our heads and see how we find the resources for
all these worthy causes, but there is just no question this
investment needs to be made. But thanks for coming before the
committee. Thank you for the work you and your colleagues in
public health have done and for the extraordinary performance
over the pandemic where, you know, I have just seen local
public health people do amazing things. And the data has made a
difference as Congress has tried to come together and figure
out what to do during the pandemic to both minimize the loss of
life and get us through this to the other side of it with our
economy intact and our people damaged as little as possible. So
thanks for your contributions.
I yield back, Madam Chair.
The Chair. Thank you. I recognize Ms.--let me see if I have
this right--Szilagyi.
Ms. Szilagyi. Very good.
The Chair. Okay. That is great. Thank you. President of the
American Academy of Pediatrics. Wonderful to have you with us
today. Thank you.
MOIRA SZILAGYI, PRESIDENT, AMERICAN ACADEMY OF PEDIATRICS
Dr. Szilagyi. Thank you so much. To Chairwoman DeLauro and
Ranking Member Cole, thank you so much for the opportunity to
participate in today's public witness testimony. My name is
Moira Szilagyi. I am a primary care pediatrician and president
of the American Academy of Pediatrics. On behalf of be AAP, I
thank you for all of your efforts to fund programs that are
essential for the optimal health and well-being of children.
While I address numerous programs that are important for
children's health in my written testimony, my original plan
today was to focus on three programs of particular importance:
firearm injury and mortality prevention research, the Pediatric
Subspecialty Loan Repayment Program, and the Pediatric Mental
Health Care Access Program. I plan to talk about the need to
address the serious gaps in the pediatric workforce by
increasing funding for the Pediatric Specialty Loan Replacement
Program to $30,000,000 to improve access to care for children
with special healthcare needs. This program is vital and very
much needed. And I had planned to discuss increasing funding
for the Pediatric Mental Health Care Access Grant Program to
$14,000,000 to help meet the mental health challenges facing
young people and the rates of suicide, anxiety, and depression
that have all been exacerbated by the COVID-19 pandemic,
especially among people of color. We do need to increase mental
health services for children and enhance the capacity of
pediatric primary care providers to screen, treat, and refer
children with mental health concerns.
But then we got the news about the school shooting at Robb
Elementary School in Uvalde, Texas, on Tuesday, and that is
what is at the top of my mind today: 19 students and two
teachers killed by gunfire. Just like the 10 people shot at the
Tops Supermarket in Buffalo and the one person killed and five
injured at the Irvine Taiwanese Presbyterian Church in my home
State of California just weeks ago, there is never any
justification for this kind of violence anywhere, ever, and yet
we as a Nation have been here before too many times. Columbine
High School, Sandy Hook Elementary, Marjorie Stoneman-Douglas
High School, and so many other schools have been sites of
terror, violence, and death.
Many more daily acts of gun violence do not even make the
headlines but also rob children of their childhood and families
of their children. Just visit a hospital emergency department
to see the daily toll of firearm injuries. In fact, a CDC
report published just this month showed that the U.S.
experienced a historic rise in gun deaths in 2020, and
communities of color were disproportionately harmed. As a
pediatrician, parent, and grandmother, and someone whose
personal life has been effected by gun violence, I urge you to
stand up for those killed or injured by gun violence.
The AAP was extremely grateful when this subcommittee
agreed to provide Federal funding for gun violence prevention
research in the 2020 fiscal year for the first time in 25
years, and we are tremendously appreciative of Congress
providing $25,000,000 to the CDC and NIH for firearm injury and
mortality prevention research for the last 3 fiscal years. But
if events from the past several weeks show anything, it is that
we need to do more, and one thing we need to do is increase
research on ways to reduce gun violence and disparities in gun-
related deaths, and to prevent the next shooting at a school, a
church, or another public setting.
Federally-funded public health research has a proven track
record of reducing deaths, whether from motor vehicle accidents
or smoking. The same approach should be applied to increasing
gun safety and reducing firearm-related injuries and deaths,
including suicides. Continuing and expanding CDC and NIH
research is critical to that effort. We strongly urge Congress
to increase the funding level for firearm injury and mortality
prevention research to $35,000,000 for the CDC and $25,000,000
for NIH.
We should never become accustomed to acts of gun violence.
We owe to the children in that classroom in Uvalde, the people
shopping at Tops, and the parishioners at the Irvine Taiwanese
Presbyterian Church to increase our efforts. Thank you so much
for allowing me to testify today. I look forward to continuing
this conversation.
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The Chair. I am going to yield to Congressman Cole for any
comments or questions.
Mr. Cole. Well, I want to thank the witness for her
testimony. It is very powerful and certainly very compelling
given the tragic events that we have had this week. And I want
to compliment the chair. She is the one that started this
pattern of investments in gun violence research and, I think,
has been probably the leader in Congress on that, quite
frankly. So, again, I don't know where we will end up, but
despite what some people think, this has not been a matter
where we have had any big differences, quite frankly. We
signaled that, I think, maybe in 2019, Madam Chair, when we put
language in there to try and let the CDC and the NIH know
please go ahead if you decide that, and then my friend, the
chair, followed up with an appropriation, I think, the very
next year when the hint wasn't taken. So let's just put the
money specifically there and give you an unmistakable signal.
So, you know, I don't think studying problems hurt. I think
it helps, and, again, I tip my hat to the chair for having been
a leader in this area, and I yield back.
The Chair. I thank the ranking member for really the
cooperative effort. We had hearings on this, and this is an
issue of public health, and that is how we want to try to, you
know, to deal with it. And it is no way to restrict anybody's
rights to own a firearm, but to understand, as well you pointed
out, that, you know, we have done this with automobile safety,
we have done with smoking, you know, and we have come out with
some very, very good remedies here that have cut down
automotive accidents and deaths, and the same with smoking.
There isn't any reason why not to do this. We are going to
continue. We are going to continue to do this, and every time
an event happens, like it happened 2 days ago, there is more
and more need for us to understand. For me on the education
side, I would put a mental health professional in every school
in the United States, you know. That would be, you know, a way
to help deal with our kids. But the aftermath of what happens,
I really have got in my mind's eye this little boy that I heard
this morning who survived. He is a 4th grader, and he was
shaking while he was talking about what he saw around him, you
know, with his pals, his friends, who were killed. And, you
know, what happens in that beautiful little brain? What goes
on? How can we prevent this? How can we do this?
So thank you. Thank you for your focus on this and so many
other areas that you focus on. You really provide direction for
us, and we rely on your data, your work, and your commitment,
so thanks very much. I appreciate it. Thank you.
Let me introduce Mark Anthony Figueroa, A GEAR UP alumnus,
and the National Council of Community and Education
Partnerships. And I know how the ranking member feels about the
GEAR UP Program. So, Mr. Figueroa, please, your testimony, and
you are recognized for 5 minutes.
MARK ANTHONY FIGUEROA, GEAR UP ALUMNUS, AND NATIONAL COUNCIL
FOR COMMUNITY AND EDUCATION PARTNERSHIPS
Mr. Figueroa. Thank you. Madam Chair DeLauro, Ranking
Member Cole, and distinguished members of the subcommittee,
thank you for giving me the opportunity to provide testimony on
the profound impact that the Gaining Early Awareness for
Readiness for Undergraduate Programs Initiative, better known
as GEAR UP, has had on my life. My name is Mark Anthony
Figueroa, and it is my honor and pleasure to be sharing this
testimony on behalf of the GEAR UP alumni and over 500,000 GEAR
UP students across the country.
Given the program's return on investment, I respectfully
urge the committee to appropriate $435,000,000 for GEAR UP in
fiscal year 2023 to support an additional 80,000 students
across our country so that they, too, can have the support I
received in GEAR UP.
As you may know, GEAR UP provides 6- to 7-year grants to
States and partnerships comprised of K-12, higher education,
and community-based organizations that strengthen pathways to
college and careers in low-income communities. GEAR UP exposes
students and their families, starting in the 7th grade, to
comprehensive intervention that follow them through high school
graduation and, ultimately, through the first year of
postsecondary education. GEAR UP uses early and sustained
interventions to ensure that students are successful in
rigorous courses, are knowledgeable about the steps necessary
to prepare for life beyond high school, and ultimately enroll
in a high-quality certificate, associates, or bachelor's degree
program that suits their goals. In the most recent year in
which we had a large class of graduating seniors, the
postsecondary enrollment rates of GEAR UP students were over 31
percent higher than low-income students nationally. Considering
that GEAR UP achieves this critical goal at a cost of
approximately $645 per student per year, I strongly believe
that the investment in GEAR UP pays significant dividends. GEAR
UP is a powerful catalyst for sustained community improvement.
I grew up in the eastern part of Washington State in the
city of Pasco. This part of the country is filled by passionate
Latino, and Latino immigrant, and migrant families working in
predominately agricultural fields. With long days and hard
work, preparing for higher education can be challenging and a
first for many. As a first-generation migrant student and the
eldest of six in my family, postsecondary education seemed like
a very distant, daunting, unknown land with no clear path
towards it. However, participating in the GEAR UP Program
helped me actualize my dreams of a postsecondary education
through mentors, college and career fairs, FAFSA nights, and
college admissions workshops.
Being the first in my family to pursue higher education, my
parents and I had so many questions. It is a daunting process,
especially if done alone. Nevertheless, GEAR UP was there to
support and walk us the entire way. Because of GEAR UP, I was
admitted and graduated from Washington State University. With
these experiences and the competence that GEAR UP gave me, I
was able to develop strong leadership skills, community
connections, and discovered all the ways to give back to my
community.
During my time at Washington State University, I connected
with other first-generation migrant students, and we encouraged
one another to follow our dreams. I was elected and served
student government and also helped lead a student ministry at
the intersection of faith and culture. Having led the way with
the support of GEAR UP, I am now there for my parents and five
sisters as they navigate the college-going process. Currently,
I work with local civic engagement organizations to encourage
marginalized members of my community to elevate their voices
and get involved.
As a current diversity advocate, a former high school
history teacher, a soccer coach at the high school where GEAR
UP supported me, and a graduate student pursuing a master's
degree in theology, I can attest to the truth that GEAR UP does
work. For me, none of this would have been possible without the
guidance of the GEAR UP program. Through my own achievements in
attending postsecondary education, I can see the generational
barriers in my family have been removed for future generations,
and they may find the same success that I have through
education.
While the support that GEAR UP provided me was truly
priceless, the only way that other students will be able to
access the educational experiences I had because of GEAR UP
will be to continue to increase funding. Acknowledging that I
am just one of thousands of families GEAR UP has positively
impacted highlights the impact of the GEAR UP Program. As you
take on the work of preparing for the fiscal year 2023
appropriations, I respectfully urge you to consider increasing
the investment in the GEAR UP Program to $435,000,000 so that
80,000 more students just like me can benefit from the program
as I did.
Thank you to the committee for taking time to hear my
testimony.
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The Chair. Thank you for your testimony, and you are the
face of the GEAR UP Program, and what a success story it is.
And I am going to yield to a Congressman Cole, and then I will
say something, but, Congressman Cole----
Mr. Cole. First of all, to our witness, Mr. Figueroa, I
could not have done a better job. And to our friends at GEAR
UP, you could not have had a better representative to come
before this committee. This is a program, as the chair knows,
that she and I have worked on together for 7 years. And I don't
know what the final number will be, but for 7 years in a row,
we have been able to increase this program, and you are a
shining example of why these investments pay off.
I always tell people if we can get you to and through
college, you know, you are, on average, going to make
$1,000,000 more in your lifetime. Don't worry, the Federal
Government is going to get a share of that $1,000,000. And so
this is literally a program that pays for itself, in my view,
and I often point that out in connection with TRIO, a companion
program in many ways, but that has produced over 5,000,000
college graduates for this country that probably would not have
had the opportunity to go or succeed at college. I feel the
same way about GEAR UP.
My own State is full of first-generation college students.
I am a first-generation college student, and the point you make
about families wanting to do this, you know, but not knowing
how to navigate the way, not necessarily knowing how do we
prepare, what are the things that we need to make sure that our
son or daughter does at the appropriate age so they are ready
to go. We don't want to just get them to college. We want them
to have the background to succeed, as you clearly are doing, in
higher education.
So thank you for your eloquent advocacy for this program
and for the personal example, and thanks for pointing out what
a difference the program will make, not only for you, but for
your brothers and sisters. And that is one of the big spillover
impacts of this. I just think these programs are so wise and,
again, such good investments for our country to make, not just
individually for your future, but collectively in our own
future. These things pay off big, big, big time for us, and,
again, I salute the chair. She has always been a terrific
partner in progress in this area, you know, whether she was
chair or ranking member. I know how deeply she believes in the
program, and we are going to continue to work together, and
hopefully we can continue to come up with good results.
But thank you, Madam Chair. With that, I yield back to you.
The Chair. Thank you, and last year in 2022, it was
$378,000,000, I understand it, and obviously we will take a
look at the money. But, you know, oftentimes people say, you
know, is this Federal program working, is that Federal program
working. GEAR UP works, and you are the poster child here for,
you know, the success, and, as the ranking member pointed out,
with the spillover effect. So GEAR UP will be front and center
for us as we move forward. Thank you so much for your
testimony. Thank you.
Mr. Figueroa. Thank you.
The Chair. And for your success. Thank you for what you are
doing. An M.A. in theology. Okay. This is great.
Mr. Figueroa. Yes, thank you.
The Chair. Thank you. We now have Esther Lucero, president
and CEO of the Seattle Indian Health Board. Esther, you are
recognized for 5 minutes.
ESTHER LUCERO, PRESIDENT & CEO, SEATTLE INDIAN HEALTH BOARD
Ms. Lucero. It is still morning time in the Seattle area,
so I would just say [Speaking native language]. My name is
Esther Lucero, Chair DeLauro, and it is a privilege to meet you
at least in this virtual setting. And Ranking Member Cole, it
is always a pleasure to work with you, and I am always honored
to see another native person in such a prominent role but also
with such longevity. So we are seeing each other in a different
committee this time, and I am pretty excited about that.
So let me give you a little bit of perspective on the
Seattle Indian Health Board. So we are a really unique
organization in the sense that we are deemed an urban Indian
health organization, and we were the very first urban Indian
health organization to become a federally-qualified health
center. So what that means is we see all people, but we see all
people in the native way. Now, another thing that makes us
unique is we operate the Urban Indian Health Institute, which
is one of 12 tribal epidemiology centers in the Nation, and we
are deemed a public health authority for the Indian Health Care
Improvement Act and permanently reauthorized in the Affordable
Care Act.
Now, these things are significant because what it allowed
us to do was have an incredible response to COVID, and when I
say ``incredible,'' it was truly community driven, and it was
truly culturally attuned. And I want to make sure that this
committee, in particular, recognizes the value of community
health centers. And it doesn't always place so much dependence
upon county systems or State systems in regards to being a
public health authority. The reason I say that is because we
have an incredible relationship with our 29 federally-
recognized tribes here in the State of Washington, and they
advocated so that we could actually have a more community-
centered response to COVID. And for that reason, we have 98
percent of all of our American Indians/Alaska Natives in
Seattle in the King County region who are vaccinated, and I
think that is a true testament to what we are capable of doing,
especially with the public health arm where we were able to
provide culturally-attuned education and awareness, and really
develop trust with our communities.
So the reason I bring up COVID is because we were able to
show one another what we are capable of, right? There were so
many things that we said we couldn't do, like telehealth, for
example, but we did it, right? We were able to pivot on a dime
to make sure that we could meet the needs of our people. Now,
something else that occurred through COVID is that we have seen
the most significant increase and investment in Indian Health
Service in my entire history, probably in my lifetime. And when
we think about this particular committee, Medicaid has been
used to grossly supplement an underfunded system, right? And so
when I think about that, we were actually successful at
securing 100 percent FMAP in the 2-year pilot.
And how that resulted was, it resulted in an $18,000,000
cost savings for the State of Washington, which was then
allocated to an urban Indian line item. And now we are using it
as a pilot to demonstrate the impact of traditional new
medicine as a billable service. Now, obviously, if we can
extend a 100 percent FMAP in perpetuity, then that would
actually increase our ability to provide culturally-attuned
services, which inevitably result in cost savings in the
emergency centers, right, because culture actually is
prevention and one of the best ways to overcome trauma.
Additionally, we operate a 65-bed residential treatment
program in our treatment center, which we had to push pause on
services because there was a lack of infrastructure dollars.
Now, we are about to reinstate that facility and expand it to
92 beds for a couple of reasons. One is the opioid crisis
reminded us that we have to actually adapt our environment to
not only do the traditional abstinence-based recovery programs,
but also to do medically-assisted treatment in an impatient
facility. We also have a desperate need to expand our services
to support the needs of pregnant and parenting women, and so we
have identified a site and will be purchasing that site and
rebuilding to address those needs.
Now, the reason that is significant is because another
thing we saw is finally we had investments in infrastructure
related to behavioral health, right, build expansion through
HRSA, and also, we are able to use our grant dollars to expand
in other ways. And I would like to see that continued because
the problem is that we don't have enough beds. The problem is
we don't have enough housing. The problem is we just don't have
enough resources to solve some of these things that are
exacerbated by things like the pandemic.
And so when I think about, you know, things that are really
challenges, I think about workforce development, and here we
are in the age of the great resignation, and we need a
significant investment, particularly in mental health services.
If we are going to put a mental health provider into every
single school system, like you said, Chair DeLauro, then we
must invest in our workforce. And so we are asking for a
$1,000,000,000 investment in the Indian Health Care Workforce
Development Program so that organizations like ours can
continue to really add and build to that infrastructure.
So I just want to say thank you for your support, and it is
an honor to be here with you today.
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The Chair. Thank you so much, and thank you for the
richness of the presentation, just real strong leadership in
this effort. Really, it is more than encouraging, it really is,
you know, and the ranking member can speak, you know, in a
granular basis about the Indian Health Service. It has been a
priority of his, you know. Really, I think it is historic. You
know, it is all about who he is. But I am happy to hear you say
that the increase that we did do for the IHS was historic. It
doesn't end there, but what we need to do is to try to make
sure that we don't have a separate healthcare system that is
not functioning for, you know, for the Native-American
population. It just shouldn't be. There should be parity in the
kind of health opportunities that people should have.
If it is on its own, then, for gosh sakes, let's make sure
it has the resources, it has the trained personnel, and
everything that is needed to deal with a myriad of problems
that occur, you know. We have talked about, you know, violence
against women before. We know that that is there. We are
talking about, you know, pediatric care and children. And so I
want to ask you, and I want the ranking member to speak, what
is your situation with infant formula, you know, and how you
all are handling, you know, that effort. And telehealth, how
can we help you, you know, with that? And I thank you for the
work that you did through COVID, but we need many more
conversations about the Indian Health Service and how we should
be strengthening it, and what its direction is for the future,
and where it should be. But so glad that you are there, and
thank you for such a powerful, powerful testimony.
Congressman Cole.
Mr. Cole. Thank you very much, Madam Chair, and it was a
terrific presentation. Thank you so much for making so many
important points in such a brief presentation. And I want to
thank my friend, the chair, who has been extraordinarily
helpful on these issues. There are a lot of things, of course,
and the witness and I would agree, that need to be done.
Someday we will get forward funding, just like the Veterans
Administration, with both our urban Indian health centers and
for IHS. And I was very pleased to see Secretary Becerra bring
up the idea of mandatory funding. I know that is controversial
on both sides of the aisle with our budget hawk friends, but
the reality is, this is the treaty and trust obligation that
United States willingly assumed but has never fully funded, and
we have made some progress.
I particularly want to echo what you had to say about the
outstanding job that our urban Indian health centers did and,
frankly, our tribal governments did with the resources we put
at their disposal during COVID. In my home State of Oklahoma,
the number one vaccination site was the health care center at
the University of Oklahoma in the middle of Oklahoma City. The
number two was run by the Chickasaw Nation in Ada, Oklahoma, a
town of 25,000, and, I don't know, the last count I got, it was
somewhere well over 75,000 vaccinations, and that is a while
ago. And they set it up, ran it, made it available to everybody
as most of our tribes did. You didn't have to be tribal. It was
just another network.
And, frankly, in Oklahoma, as rural as we are, having the
distribution of vaccination sites and, in many, cases given
particularly the early vaccines that had to be stored in
unusually, you know, cold temperatures, honestly, if you didn't
have Indian hospitals in these areas, there wasn't anybody else
capable of actually housing the facilities. It is one of the
reasons why, again, while they had a separate allocation, they
opened up their allocations to anybody who would show up for a
vaccination. So they became, for us, an alternative healthcare
system that served every single Oklahoman, not just tribal
members, and that gave us a lot more reach than we otherwise
would have had.
And, again, this committee, you know, wrote the check and
did great work under my friend's friends leadership, the chair,
so we are going to continue working on these problems. Our
colleague, Representative McCollum, is always a fighter on the
forward appropriations front. She has got the legislation. I
remember we both still offer it, but we would always co-sponsor
one another's bill. So we never knew who was going to be in the
majority, but we knew if we had one on both sides, we would
have a chance of moving it forward. And she has been a great,
great worker in these areas, you know, from her time as the
chair of the Interior Subcommittee. She now chairs a much
bigger committee obviously with Defense Subcommittee, but she
hasn't lost her passion and her focus on Native issues.
So we have a lot of friends on these issues in this
committee, and, again, it is an area where I am really proud to
say the effort to move forward has been bipartisan because,
again, trust and treaty obligations know no boundary on the
basis of partisanship. These are agreements we have coming
forward, and I want to thank you. You know, the job you have
done in Seattle and, frankly, through the Northwest, some of
our best, you know, urban health care centers are in the
Northwest, and the tribes there are leaning forward. They are
very, very advanced and sophisticated in the care that they
offer, and, quite frankly, offer the additional resources
beyond the Federal resources that tribes, if they are doing
well economically, invest in these facilities. I mean, that is
above and beyond.
I know certainly in the case of my own tribe, many of the
tribes in Oklahoma--Cherokees and Choctaws--run amazing systems
where they take the Federal dollars, Madam Chair, use that.
They contract directly with the Federal Government, but then
they put their own money on top of it to provide additional
resources. And, again, they don't just do that for their
tribes. If you are contracting, you know, any Native American
can show up at any Native-American facility and be eligible for
the care. You are not allowed to say, oh, we just take care of
Chickasaws here. So when they are putting in extra money, they
are putting in, quite often, to help members from tribes that
might not be quite as blessed economically as they are.
And so, yeah, I just appreciate your great work, your great
testimony. Madam Chair, thanks for indulging me on the time. I
know it has been a long day----
The Chair. Oh no, no, this is important.
Mr. Cole [continuing]. On this particular panel, and thanks
for all your help in this area. You have been spectacular.
The Chair. Thank you.
Mr. Cole. I yield back.
The Chair. Thank you. I just want to have a question.
Infant formula. How have you fared, Esther?
Ms. Lucero. It has been very challenging, but, you know, we
do what we do, which is we reach out to community, and we try
to identify where our rations are, and we try to do that
through the groups that we actually serve. So that is how we
have been able to respond is trying to pool our resources to be
able to meet the needs of our most vulnerable people. So I wish
I had a better answer but, you know, again----
The Chair. Well, we are going to keep at it. The issue at
the moment is to deal with supply, but the safety issue is
very, very critical. On that, we have to really be clear that
the product on the shelf is safe for the babies to take. And I
see my friends of the American Academy of Pediatrics, and I
think that this is woefully underreported, the number of
youngsters, babies who are going to emergency rooms with, you
know, vomiting or diarrhea. And, you know, it is directly
related to a recalled product that was contaminated.
So, again, thank you. Thank you, but keep in touch with us
on that as we go forward. That would be very, very important
information, if the distribution is getting to you, and, you
know, to the tribes. So please, please do.
Ms. Lucero. Absolutely. Thank you again so much.
The Chair. Thank you. Thank you.
Mr. Cole. Bye-bye.
Ms. Lucero. Bye.
The Chair. And let me introduce Lodriguez Murray, senior
vice president, public policy and government affairs, at the
United Negro College Fund. Lodriguez, please, your testimony,
and I recognize you for 5 minutes.
LODRIGUEZ MURRAY, SENIOR VICE PRESIDENT, PUBLIC POLICY AND
GOVERNMENT AFFAIRS, UNITED NEGRO COLLEGE FUND
Mr. Murray. Chairwoman DeLauro, Ranking Member Cole, my
name is Mr. Lodriguez Murray, senior vice president for public
policy and government affairs for UNCF, United Negro College
Fund. You may be familiar with our motto, ``A mind is a
terrible thing to waste.''
UNCF has two functions. First, we raise funds on behalf of
private historically black colleges universities, or HBCUs.
Second, we also are a significant scholarship granting
organization. Annually, UNCF awards over $100,000,000 in
scholarships to approximately 10,000 students at some 1,100
different colleges and universities. UNCF is the second-largest
private provider of scholarships in the country overall.
Additionally, we are the largest private provider of
scholarships to minorities. That means UNCF doesn't just
represent 37 member institutions or the 100-plus HBCUs, but we
really represent the concerns of low- to moderate-income
students wherever they are enrolled.
Personally, I am an HBCU and a UNCF product. When I arrived
at Morehouse College, I was a first-generation college student
and a first-generation high school graduate. Largely because of
UNCF support, I was able to graduate Morehouse nearly debt
free. This is why my testimony today is a full circle moment.
HBCUs have received a great deal of attention recently. The
coronavirus pandemic has brought much-needed attention to long
persistent disparities. HBCUs have been at the forefront of
improving education and health disparities long before the
issues have recently become vogue. For over 150 years, HBCUs
have been educating the progeny of slaves and now do more to
educate and graduate underserved students than any other group
of higher education institutions in the country.
Now, there has been an influx in funding to HBCUs. This
subcommittee and, Madam Chair, your full committee have been
responsible for funding that has stabilized many HBCUs and
allowed us to successfully navigate the coronavirus pandemic.
As much funding as has come our way, I want to be clear: as 2-
year influx cannot reverse 150 years of systemic, persistent
underfunding. Now, while we are thankful for President Biden's
requested proposed investments in HBCUs, I do want to draw your
attention to a few budget lines.
The Department of Education Strengthening HBCUs
discretionary program should be funded at no less than
$500,000,000; the Strengthening Historically Black Graduate
Institutions discretionary program, no less than $100,000,000.
We should forgive the remaining balances of institutions
currently participating in the HBCU Capital Finance Program. We
should double the Pell Grant, and we should strengthen the
pipeline of training programs at the Department of Health and
Human Services.
Now, the top funding request for HBCUs is $500,000,000 for
strengthening HBCUs, that program at the Department of
Education. That program holds particular importance in our
community because an institution can use the fund up to 17
different legislative ways, depending on the institution's
needs. Currently funded at $337,000,000, all 100 accredited
HBCUs compete for this pool of very limited resources. This
month, our institutions graduated nearly 50,000 students. Based
on that fact that our institutions provide so much of the
diverse workforce that our country values, it is our collective
view that Congress should increase the program to reflect the
value of our graduates. We recommend $500,000,000 for the
discretionary program. This is, again, HBCUs' top funding
priority.
While the President's budget was funded at the authorized
level, I must call the subcommittee's attention to one fact.
There is one single HBCU that received a funding increase last
fiscal year of $100,000,000 all by themselves. All 100-plus
HBCUs were forced to share in the collective, much smaller
$25,000,000 increase. This disparity in cap on the overall
Strengthening HBCUs Program, it has to be done away with. We
must invest $500,000,000 in this program and an additional
$100,000,000 in the Strengthening Historically Black Graduate
Institutions Program.
I want to reemphasize the HBCUs meet a national need:
bright, capable graduates who tend to come from underserved
backgrounds. However, the education they receive enables them
to become productive citizens who contribute to our country in
numerous ways, and I don't even have to mention the fact that
well over 40 percent of the CBC members, your colleagues, are
HBCU graduates. UNCF produced a report on the economic impact
of HBCUs in November 2017. UNCF found that one single
graduating class of HBCU students will earn a minimum
$130,000,000,000, collectively--one class--over their lifetime.
HBCUs collectively hire and fire like a Fortune 50 company.
Moreover, our institutions altogether have an annual economic
impact of $150,000,000,000.
HBCUs do what no other type of institution in this country
does or attempts, and for that, we hope this panel will support
us by implementing the funding requests I have made today.
Thank you, and I am happy to answer any of your questions, and
I want to commend you on such a long hearing and for your
attentiveness.
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The Chair. Thank you so much, Lodriguez, and it is great to
see you again. I was pleased to be with you. We did that by
Zoom--I lose track these days--but with Congresswoman Alma
Adams where we all gathered and so forth. Thank you for your
strong presentation, and I think we are very, very attuned to
the role that HBCUs play in our Nation and in our education,
and very, very, you know, proud that so many of our members are
graduates of HBCUs.
So what we did do in the last go-round, as you talked
about, the $363,000,000, it was about a 7-and-a-half percent
increase, and understanding we want to strengthen the HBCUs and
the number to $500,000,000. I am going to be upfront with you.
We need to know what our numbers are, you know, clearly. We
went up last year in doing this, and we made an increase. We
are committed to maintaining the strength of the HBCUs. We just
need to know where our numbers are going to come out, and how
we are going to allocate the funding. But there is, you know,
the commitment to continue to support HBCUs, you know, in the
most robust way that we possibly can. And, again, thank you for
the clarity of your testimony, and the strength of the
testimony, you know, and the strength in the last meeting we
had a well. It was a great gathering, so thank you.
And let me yield to the ranking member.
Mr. Cole. Well, thank you very much, and thank our witness.
That was an excellent and very powerful presentation, and,
frankly, quite compelling. And obviously, we have had several
representatives of different minority-serving institutions that
have testified before us today, and there is a common theme
that runs through them all, which is the disproportionate
contribution that these institutions make, and how high a
percent of, whether it is medical professionals, and I am sure
if we were talking lawyers, and obviously politicians, people
might think we have too many of those. I don't know. But it is
capped by law, so, you know, you don't have to worry about
that.
But really, these institutions are tremendous value and
have historically overperformed on limited resources. So,
again, I know that I associate with the chair's remarks. It
gets down to the numbers and what we can do, and we don't know
that yet, but, again, this is not an area where we tend to
disagree or debate. It is an area where we put our heads
together and see what can we find in common. And obviously,
there are a lot of our colleagues on both sides of the aisle
that are enormous supporters of HBCUs, and weigh in as well,
not just on the committee, but from other committees as well.
So thank you for the presentation. Thank you for your great
work for the institutions that you represent, and we look
forward to working with you going forward. I yield back, Madam
Chair.
The Chair. Thank you. Thank you very, very much. And now
let me introduce Nancy Gonzales, owner of Lil' Bears Family
Daycare, and a member of the American Federation of State,
County, and Municipal Employees, to talk about childcare and
development of block grants. And, Nancy, don't take it in any
negative way. You are the last witness today, and we are sorry
you got to wait so long, but we are delighted to hear from you,
and thank you because of the importance of the Child Care
Development Block Grant.
Ms. Gonzales. Okay.
The Chair. You are recognized for 5 minutes.
NANCY GONZALES, OWNER, LIL' BEARS FAMILY DAY CARE; AMERICAN
FEDERATION OF STATE, COUNTY AND MUNICIPAL EMPLOYEES
Ms. Gonzales. Good morning to my congressman,
Representative Josh Harder, Chairwoman DeLauro, Ranking Member
Cole, and members of subcommittee. Thank you for the
opportunity to talk about childcare investments and the need to
double funding levels for the Department of Health and Human
Services Childcare and Development Block Grant--CCDBG--and
provide $12,300,000,000 for fiscal year 2023.
I am Nancy Gonzales. I am a State-licensed family childcare
provider in Modesto, California, and the owner of Lil' Bears
Family Day Care. I am a proud union member of the 20,000-member
strong United Domestic Workers Childcare Providers United,
American Federation of State, County, and Municipal Employees.
I have been providing childcare services out of my home for the
past 16 years and have worked as a childcare provider for the
past 29 years. I care for babies and children as young as 4
months old and up to 12 years old, weekdays from 4:30 am to
6:00 p.m. I open early to help families that have long commutes
to work. Modesto is a rural area, and sometimes long commutes
are required to get to work.
It pains me to say this, but our country takes childcare
for granted. It really does. Our childcare system is broken for
families who need childcare for the underpaid, mostly black and
brown women like me, who are the majority of childcare
providers. Emergency funding has been helpful in raising rates
in some States and helping to keep childcare programs open, but
it is only a band aid for the immediate health crisis. We need
sustainable care that that comprehensively fixes childcare to
make it accessible and affordable for families and to pay
providers living wages. That will require much larger
investments.
Doubling CCDBG will make a down payment on a real childcare
system. Investments in CCDBG will help families and address
fairness and equity for providers. One of the biggest problems
for providers and why programs are closing is low pay.
Childcare providers are paid poverty-level wages. Family
childcare providers generally charge less and earn less. Family
childcare providers report that they earn $23,000 or less in a
year. Private pay is inadequate to ensure living wages.
Adequate government funding is essential to ensure providers
can earn living wages and make childcare affordable for
families.
Childcare providers like me are faced with the dilemma of
raising rates, knowing families will leave our care and be
forced to place the young children in less safe arrangements,
so I keep my rates low, but it just enough to cover everything
my own family needs. And because CCDBG funding is not enough,
the rate the State pays us does not cover the full cost of care
so we can earn a living wage. Many childcare providers are
forced to rely on public assistance. We work multiple jobs. We
can't afford health insurance or save for retirement, and we
are struggling to deal with increasing costs. In some places,
expenses are at 40 percent, while reimbursement rates have not
increased to keep up.
Supporting worthy wages for home-based childcare providers
is also an issue of equity for low-income parents, especially
those who work jobs outside of the traditional 9:00 to 5:00
hours. Most center-based childcare doesn't offer care during
these hours, and these parents depend on in-home based
childcare. And finally, family childcare is often the choice in
communities of color. After everything we endured during the
pandemic as frontline workers, childcare providers can't take
much more. Thousands of providers closed their doors during the
pandemic. Many never returned. Employers all over California
and the country are hiring for jobs that pay better and have
better benefits than being a childcare provider. That means
less childcare.
Access to care is a big problem right now. More than half
the people in the U.S. are in childcare deserts where childcare
is either unavailable or very limited. In California, the
problem is even worse, especially for low-income and Latino
families. I want to thank Congressman Harder for introducing
legislation to address the shortage of childcare providers in
these key areas.
After all the problems I described, why do I still work in
childcare? Simple: I love this work and the children I care
for. So do my fellow childcare providers, but we do have
futures and families to take care of, too. I urge you to double
CCDBG's budget to begin to create a childcare system that pays
childcare providers living wages, entices providers to join the
field and stay in, fixes childcare deserts, expands the program
to cover more families, and makes high-quality care affordable
and accessible to all families.
I appreciate Chairwoman DeLauro's leadership and others on
this committee to work on these and other ways to fund and fix
childcare. Thank you so much for your time, and have a great
day.
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The Chair. Thank you so much, and I just will, you know,
quote what you said in your testimony. It pains me as well
because our country has taken childcare for granted, and it was
demonstrated during the pandemic that it is an industry, if you
will, that nearly collapsed, you know. And as we have dealt
with an automobile industry, or hospitals, and anything else,
when that kind of thing happens, it is the role, in my view, of
the Federal Government to step in and to do something about it.
And the piece of this is that, given what happened, women
were pushed out of the workforce because, you know, their jobs
went away. There was no paid family and medical leave, so
people were staying home. Their kids were at home. We had the
childcare centers that went out of business. They just
shuttered. And so the entire childcare crisis, you know, it was
a perfect storm for understanding what was going on because the
issue of low wages has been there for childcare workers for so
long, and it is one that we need to address. But the other
piece of this is, if this economy is going to recover and women
are going to go back to work, we have got to have affordable,
accessible childcare for families. Otherwise, they are going to
stay home because you are not just going to, you know, abandon
your children. It needs to be viewed as not taking it for
granted, but it is being viewed as a cornerstone of a thriving
economy and how this economy succeeds.
And so my hope would have been, and don't know what the
vestiges of Build Back Better would be if we ever get a Build
Back Better piece of legislation. Maybe we get something, but
my hope is that, as was the case earlier, that childcare would
be the central portion of that. That is on that side of it, but
in terms of the Child Care Development Block Grant, I think we
did a $254,000,000 increase last year. I know what you are
asking for is to double the amount of money. I am not going to
lie to you. That is hard given that we don't know yet what our
numbers are going to be, but I want you to be assured that
childcare is now front and center. And as we have been saying
in a number of the presentations today, we need to seize this
opportunity. We saw what happened in this emergency, and we
cannot let that happen. We cannot let the childcare industry be
destroyed. Families rely on it. It has got to be affordable.
In the State of Connecticut, it is between $15,000 and
$18,000 per child. How many people can afford to do that, you
know? And so we have got to make it affordable. It has got to
be accessible. We have to pay wages. We trust our most precious
resource, our children, with the childcare workers, and yet we
are not willing to pay them a livable wage. So big issues that
you have brought to light. It is critical, but I am going to
just say that the advocacy on your part, you know, you need to
continue that advocacy because it is so palpable. It is there.
There are so many examples all over the country of what has
happened with childcare in the United States, and we have to
address it and address it in a very substantial way.
You know, just this last note. My mother worked in the old
sweatshops in the City of New Haven, but I went to my
grandmother's store, you know, and that was my childcare. The
fact of the matter is grandmothers, grandfathers, aunts,
uncles, everyone is in the workforce. Those days are gone.
Ms. Gonzales. Yes.
The Chair. Those days are gone, and we need to have a very
substantial childcare system in the United States. Let me yield
to the ranking member.
Mr. Cole. I don't know that I have much to add. I think our
witness can understand how passionate our chair is about this
and how knowledgeable. Look, this is something she knows a
great deal about and has made sure our committee has had robust
hearing and discussion about throughout her entire tenure as
chair, and then rose up and responded, I think, magnificently
during the coronavirus crisis when she understood what was
happening to this industry and how critical it would be to our
recovery to have it up and operational, help through a
difficult time.
So I, like the chair, don't know where we are going to end
up. If you have had the opportunity, and since you were last, I
am sure you have waited a long time. [Laughter.]
You have gotten to hear some of the requests that our chair
and our subcommittee have to deal with, and they are pretty
compelling, but we really do take this seriously. We do try and
take care of the needs really as well as we possibly can with
the resources that are entrusted to us by our colleagues. So I
don't think you need to worry that your voice won't be heard at
the table. I think your voice is sitting at the head of the
table. [Laughter.]
But thank you so much for the work that you do, and thank
you for taking the time to testify, and thanks for being so
patient with us. This is an important day for us, a big day for
us, and I am sorry you were at the very end of the line. But,
again, thank you for not being at the end of the line in terms
of what this committee does, and thank you for being patient
with us and allowing us to get through our other witnesses.
So with that, Madam Chair, I yield back.
The Chair. You know, listen, and again, we are in sync.
Thank you so much, the Ranking Member. Thank you so much,
Nancy, for your patience. And it is a long day, but as I said
at the outset, as did the ranking member, we get so much out of
this day with public witnesses, and there are a number of areas
that, you know, are new information, you know, for us, and that
gives us, you know, the opportunity to think about these areas
when we are putting the bill together. And I can commit this to
you. I cannot commit dollar amounts. We just don't know where
we are, but that there is a thoughtful process and one that
incorporates, you know, the testimony of the people who
testified here today. And with that, I am going to call this
hearing to a close.
The hearing is adjourned. Thank you.
Mr. Cole. You bet.
The Chair. Thank you, Tom.
W I T N E S S E S
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Becerra, Hon. Xavier, Secretary, Department of Health and Human
Services....................................................... 9
Cantor, Pamela, founder and senior science adviser, Turnaround
for Children................................................... 145
Cardona, Hon. Miguel, Secretary, Department of Education......... 188
Darling-Hammond, Linda, president and chief executive officer,
Learning Policy Institute...................................... 147
Eden, Max, research fellow, American Enterprise, Institute....... 148
Shriver, Tim, co-founder and board chair, Collaborative for
Academic, Social, and Emotional Learning....................... 150