District of Columbia appropriations for 1994 : hearings before a subcommittee of the Committee on Appropriations, House of Representatives, One Hundred Third Congress, first session PDF
Preview District of Columbia appropriations for 1994 : hearings before a subcommittee of the Committee on Appropriations, House of Representatives, One Hundred Third Congress, first session
DISTRICT OF COLUMBIA APPROPRIATIONS > ;-,:: FOR 1994 Y 4.AP 6/1 :D 63/994/PT.3 District of Colunbia Appropriations... rTyT/^iO BEFORE A SUBCOMMITTEE OF THE COMMITTEE ON APPROPRIATIONS HOUSE OF REPRESENTATIVES ONE HUNDRED THIRD CONGRESS FIRST SESSION SUBCOMMITTEE ON DISTRICT OF COLUMBIA APPROPRIATIONS JULIAN C. DIXON, California, Chairman LOUIS STOKES, Ohio JAMES T. WALSH, New York RICHARD J. DURBIN, Illinois ERNEST J. ISTOOK, Jr., Oklahoma MARCY KAPTUR, Ohio HENRY BONILIA, Texas DAVID E. SKAGGS, Colorado NANCY PELOSI, California AMERICO S. Miconi, StaffAssistant PART 3 (Pages 2423-3496) Page Testimony ofMembers ofCongress, Citizens and Organizations ofthe District ofColumbia 2423 Appendix: Capital Outlay Program 3161 Budget Amendment for Fiscal Year 1994 3365 Supplemental II Budget for Fiscal Year 1993 3457 0K > so Printed for the use of the Coinnntt^w(tatt|Qnriations DISTRICT OF COLUMBIA APPROPRIATIONS FOR 1994 HEARINGS BEFORE A SUBCOMMITTEE OF THE COMMITTEE ON APPROPRIATIONS HOUSE OP REPRESENTATIVES ONE HUNDRED THIRD CONGRESS FIRST SESSION SUBCOMMITTEE ON DISTRICT OF COLUMBIA APPROPRIATIONS JULIAN C. DIXON, California, Chairman LOUIS STOKES, Ohio JAMES T. WALSH, New York RICHARD J. DURBESf, Illinois ERNEST J. ISTOOK, Jr., Oklahoma MARCY KAPTUR, Ohio HENRY BONILLA, Texas DAVID E. SKAGGS, Colorado NANCY PELOSI, California AMERICO S. MlCONI, StaffAssistant PART 3 (Pages 2423-3496) Page Testimony ofMembers ofCongress, Citizens and Organizations ofthe District ofColumbia 2423 Appendix: Capital Outlay Program 3161 Budget Amendment for Fiscal Year 1994 3365 Supplemental II Budget for Fiscal Year 1993 3457 Printed for the use of the Committee on Appropriations U.S. GOVERNMENT PRINTING OFFICE 72-883 WASHINGTON 1993 : ForsalebytheU.S.GovernmentPrintingOffice SuperintendentofDocuments,CongressionalSalesOffice,Washington,DC 20402 ISBN 0-16-041635-3 72-883 O—93- COMMITTEE ON APPROPRIATIONS WILLIAM H. NATCHER, Kentucky, Chairman JAMIE L. WHITTEN, Mississippi, JOSEPH M. McDADE, Pennsylvania Vice Chairman JOHN T. MYERS, Indiana NEAL SMITH, Iowa C. W. BILL YOUNG, Florida SIDNEY R. YATES, Illinois RALPH REGULA, Ohio DAVID R. OBEY, Wisconsin BOB LIVINGSTON, Louisiana LOUIS STOKES, Ohio JERRY LEWIS, California TOM BEVILL, Alabama JOHN EDWARD PORTER, Illinois JOHN P. MURTHA, Pennsylvania HAROLD ROGERS, Kentucky CHARLES WILSON, Texas JOE SKEEN, New Mexico NORMAN D. DICKS, Washington FRANK R. WOLF, Virginia MARTIN OLAV SABO, Minnesota TOM DELAY, Texas JULIAN C. DIXON California JIM KOLBE, Arizona VIC FAZIO, Califor,nia DEAN A. GALLO, New Jersey W. G. (BILL) HEFNER, North Carolina BARBARA F. VUCANOVICH, Nevada STENY H. HOYER, Maryland JIM LIGHTFOOT, Iowa BOB CARR, Michigan RON PACKARD, California RICHARD J. DURBIN, Illinois SONNY CALLAHAN, Alabama RONALD D. COLEMAN, Texas HELEN DELICH BENTLEY, Maryland ALAN B. MOLLOHAN, West Virginia JAMES T. WALSH, New York JIM CHAPMAN, Texas CHARLES H. TAYLOR, North Carolina MARCY KAPTUR, Ohio DAVID L. HOBSON, Ohio DAVID E. SKAGGS, Colorado ERNEST J. ISTOOK, Jr., Oklahoma DAVID E. PRICE, North Carolina HENRY BONILLA, Texas NANCY PELOSI, California PETER J. VISCLOSKY, Indiana THOMAS M. FOGLIETTA, Pennsylvania ESTEBAN EDWARD TORRES, California GEORGE (BUDDY) DARDEN, Georgia NITA M. LOWEY, New York RAY THORNTON, Arkansas JOSE E. SERRANO, New York ROSA L. DsLAURO, Connecticut JAMES P. MORAN, Virginia DOUGLAS "PETE" PETERSON, Florida JOHN W. OLVER, Massachusetts ED PASTOR, Arizona CARRIE P. MEEK, Florida Frederick G. Mohrman, Clerk and StaffDirector (n> DISTRICT OF COLUMBIA APPROPRIATIONS FOR FISCAL YEAR 1994 TESTIMONY OF MEMBERS OF CONGRESS, CITIZENS AND ORGANIZATIONS OF THE DISTRICT OF COLUMBIA — [Clerk's NOTE. The following hearings were joint hearings of the Subcommittees on District of Columbia Appropriations of the House of Representatives and the Senate. The hearings were held in the United States Capitol, room H-301, from 10:00 a.m. to ap- proximately 4:00 p.m. on Wednesday, May 5, 1993, from 10:00 a.m. to 11:30 a.m., Thursday, May 6, 1993, and from 10:00 a.m. to ap- proximately 2:00 p.m. on Tuesday, May 11, 1993. Hearings with of- ficials of the District of Columbia government commenced Wednes- day, May 12, 1993 and were completed Wednesday, June 9, 1993. Their testimony appears in volumes 1 and 2 of these printed hear- ings.] Wednesday, May 5, 1993. Opening Remarks of Chairman Julian C. Ddcon Mr. Dlxon. The D.C. Committee on Appropriations will come to order. Let me first introduce our new Ranking Member, Jim Walsh from New York. Mr. Walsh, about three or four years ago, the sub- committee decided that we would hear testimony from Members and outside witnesses prior to hearing from District officials pri- marily because Members and outside witnesses came forward with issues dealing with the budget. Prior to that time, we would hear from Members and public witnesses after we received testimony from District officials and therefore we could not follow up on is- sues raised by Members and the public. We had no time to ask the department head or the person testifying about these issues. So, we decided that we would always start with outside witnesses prior to hearing from District officials. We will have testimony from the Mayor and Council Chairman next Wednesday, May 12. JOINT HEARINGS WITH SENATE And secondly, it has been an informal practice that the Senate and the House have joined for a hearing on the outside witnesses so that both Houses could have the benefit of the testimony that (2423) 2424 is given. I would anticipate members of the Senate subcommittee would bejoining us at some time this morning. I have a 1:00 o'clock appointment so I would like to adhere to the schedule pretty rigidly. We are allotting 10 minutes for each out- side witness or organization. Wednesday, May 5, 1993. CHILDREN'S NATIONAL MEDICAL CENTER NATIONALCHILD PROTECTION,TRAUMAANDRESEARCHCENTER WITNESSES C. RICHARD BEYDA, CHAIRMAN, FOUNDATION BOARD, CHILDREN'S NATIONALMEDICALCENTER ROBERT MALSON, VICE CHAIRMAN, BOARD OF DHtECTORS, CfflL- DREN'SNATIONALMEDICALCENTER MARTIN EICHELBERGER, M.D., DHtECTOR, TRAUMA SERVICES, CIHL- DREN'SNATIONALMEDICALCENTER Mr. DrxON. Our first witness this morning is Robert Malson, who is with the Children's National Medical Center. Mr. Malson is Vice Chairman ofthe Board ofDirectors. Mr. Malson. Good morning Mr. Chairman. Mr. Dixon. Excuse me. I did not introduce Mr. Bonilla over there and I am very sorry. Mr. Bonilla. That is okay. Thank you, Mr. Chairman. Mr. Dkon. He also is a new member ofthe Committee. Mr. Malson. Mr. Malson. Good morning, Mr. Chairman, Mr. Walsh, Mr. Bonilla. Mr. Richard Beyda is the Chairman of the Foundation Board of Children's National Medical Center and I would like to have him start offthis morning. Opening Statement of C. Richard Beyda Mr. Beyda. Thank you. Accompanying me today in addition to Bob is Dr. Martin Eichelberger, who is one of our distinguished surgeons and a director ofour trauma services. We are returning to the Committee today with deep appreciation for your commitment to Children's and to the children and families of the District we have been serving for so many years. We are grateful for your service on this subcommittee and for the time and effort that you dedicate to understanding the issues of the District ofColumbia. We have been the beneficiary of your counsel and support in child protection issues for the last four years and we salute your leadership and interest in addressing this growing problem ofchild victimization in our Nation's capital and the region. We are in the process offinalizing the last phases ofour Child Protection Trauma and Research Center, which is on our campus addressing the causes ofchild victimization. This pilot program will serve as a national demonstration model for the country by providing economical and efficient health care delivery systems to victimized children and their families in urban areas. The key components of our center include child abuse pre- 2425 vention and protection, trauma emergency medical care service, pe- diatric AIDS-HIV treatment, substance abuse and critical care. Since 1989 we have worked with the public and private sectors for support of constructing and equipping our center. Phase one is basically completed, and that includes our research center. That has been done through the help of this committee and through funds raised through private fund-raising efforts. We are at a criti- cal crossroads now because we are about to complete the center and we return today to ask for your continued leadership and sup- port. During our testimony this morning we will give you a brief progress report of our stewardship of the resources you have pro- vided to date and to let you know ofthe strides we have completed in moving forward with the center, and to ask your consideration offiscal year 1994 funding to complete our project. We would like to submit our written testimony later and ask at this time that Mr. Malson perhaps could report to you about those that are affected in terms ofthe protection and prevention that we are dealing with. PREPARED STATEMENT OF C. RICHARD BEYDA Mr. Dixon. Yes, your entire statement will be submitted for the record. [The prepared statement referred to follows:] 2426 2 (Meter* NationalMedicalCenter. I11MichiganAvenue,N.W Washington,DC.20010-2970 (202)745-5000 TESTIMONYOF MR. C. RICHARDBEYDA, ChildrensHospM CHAIRMAN, FOUNDATIONBOARD Children'sResearchInstitute MR ROBERTA. MALSON, Children'sHospitalFoundation VICECHAIRMAN, HOSPITALBOARD Children'sFacultyAssociates DR. MARTINEICHELBERGER, Child Ventures DIRECTOROFTRAUMASERVICES CHILDREN'SNATIONALMEDICALCENTER WASHINGTON, D.C. PRESENTEDTO THEDISTRICTOFCOLUMBIASUBCOMMITTEE OFTHEHOUSEANDSENATEAPPROPRIATIONSCOMMITTEE WASHINGTON, D.C. MAY5, 1993 ChairmanKohl,ChairmanDixon,anddistinguishedmembersoftheHouseandSenate DistrictofColumbiaAppropriationsSubcommittee, weappreciatetheopportunitytopresent ourtestimonytoyouthismorning. IamC. RichardBeyda,ChairmanoftheFoundation BoardofChildren'sNationalMedicalCenter(Children'sDCHospital). Iamaccompanied byMr. RobertA. Malson, ViceChairmanoftheHospital Board,andDr. Martin Eichelberger, DirectorofTraumaServicesatChildren'sHospital. WereturntotheDistrictofColumbiaSubcommitteethismorningwithdeep appreciationforyourlongstandingcommitmenttoChildren'sHospital,andtothechildren andfamiliesinthegreaterWashingtonmetropolitanarea. Weareverygrateful foryour serviceonthisparticularSubcommittee,andthegeneroustimeandeffortyoudedicateto understandingtheissuesandchallengescurrentlyconfrontingtheDistrictofColumbia. Children'sNationalMedicalCenterhasbeenthebeneficiaryofthisSubcommittee'scounsel andsupportonchildprotectionissuesforthelastfouryears,andwesaluteyouforyour leadershipinaddressingthegrowingproblemofchildvictimizationinournation'scapital andthroughoutthecountry. Asmanyofyouareaware,Children'sNational MedicalCenterisintheprocessof finalizingthelastphasesofitsNationalChildProtection, TraumaandResearchCenter gearedtoaddressingtherootcausesofchildvictimization. Thispilotprogramwillserveasa nationaldemonstrationmodel forthecountrybyprovidingeconomicalandefficienthealth DepartmentofPediatrics TheGeorgeWashingtonUniversity MedicalCenter 2427 caredeliverysystemstovictimizedchildrenandtheirfamiliesinurbanareas. Key componentsoftheCenterincludechildabusepreventionandprotection, traumaemergency medical care, pediatricAIDS/HIVtreatment,substanceabuseandcriticalcare. Since 1989,Children'sNationalMedicalCenterhasworkedtoattractpublicand privatesupportfortheconstructionandequippingoftheNationalChildProtection,Trauma andResearchCenter. PhaseoneoftheCenterhasbeencompletedasaresultofthe successful private-publicpartnershipwhichthehospital hasachievedthroughthehelpofthe DistrictofColumbiaSubcommittee,andthroughitsprivatefundraisingefforts. Children's Hospital isrequestingfederalsupportinFY 1994tocompletethefinal phasesofthis demonstrationCenter. Thecommunityoutreachandadvocacyprogramsgearedtopreventionofchildabuse andtraumainjuryareanintegral partofthehospital'sdemonstrationCenter,andhavebeen enthusiasticallyendorsedbytheDistrictofColumbiaSubcommittee. Itisnosecretthatthe lackofpreventivemeasuresinareaspertainingtochildhealthandwell-beingcostthisnation billionsofdollarsonanannualbasis. Lastweek, theU.S. AdvisoryBoardonChildAbuse andNeglectissuedastatementcitingtheneedforthefightagainstchildabusetoshiftinthe directionofmorepreventionprograms. AstudywhichtheU.S. BoardonChildAbuseand Neglectrecentlyconducted, foundincidentsofchildabusesteadilyrisingbyanaverageofsix percentannually. ItisclearthattheDistrictofColumbiamustinvestinservicesandsupportsthatwill preventchildvictimizationproblemsfromintensifyingandthatwill reducecostly expendituresforcrisisandremedialcare. Apreventiveinvestmentagendaisthekeyto servingourcity'slong-termfiscal health. AsarecentreportissuedbytheChildren'sDefenseFundpointsout, Washington, DC isacityofdisturbingcontrasts. Thehealthandwell-beingofchildreninthenation'scapital lagsbehindtherestofthenation. AninfantbornintheDistrictislesslikelytosurviveuntil hisorherfirstbirthdaythanababyborninCubaorJamaica. Homicideistheleadingkiller ofDistrictyouthagesonethrough 19,accountingforalmost60percentofalldeathsinthis agegroupin 1989. Between 1985and 1989conditionsworsenedforthenation'sandthe District'schildrenandfamilies. Thenumberofchildrenreportedabusedandneglected increasedby61 percent; thenumberofjuvenilesarrestedforhomicideincreasedby320 percent. Thedemandforpubliclysupportedshelterforhomelessfamiliesmorethantripled. Indevelopingbothitslong-rangeandshort-rangeplansforresearchanddevelopment, Children'sHospitalwishedtorespondtotheoverwhelmingneedinthecommunityfor preventionprogramsandeducationandadvocacyinitiativeswhichwillhaveasignificant impactonpublicandprivateeffortstoreversethesestartlingstatistics. Buildingonthesolid foundationofitscurrentchildprotectionprogram,Children'sHospital iswell-positionedto beanationaldemonstrationmodel forchildprotectionissues. 2428 Children'sNational MedicalCenter'sDivisionofChildProtectionisthelargest pediatric, hospital-basedprograminthenationfortreatmentofyoungvictimsofphysical abuse, sexualabuseandneglect. In 1992alone,Children'snationallyrecognizedDivisionof ChildProtectiontreatedover2,000casesofphysicalandsexualabuse, neglectandother formsofchildmaltreatment. Whiletreatingchildrenandtheirfamilieswhohavealready experiencedthemultipleandoftendevastatingconsequencesofchildabuseorneglect, hospitalstafffocusonhowabusecanbereducedandprevented. Acommunity-basedcenter, ProjectREACH, wasbegunin 1986toextendparentingeducationandothermental health servicesintothesoutheastquadrantofWashington,anareawithhighunemployment,poverty andotherstatistical indiceswhichplacelargenumbersofchildrenatrisk. Divisionstaffhave alsobroughtparentingskillssessionstoashelterforhomelesswomen, toparentsata neighborhoodschoolandtoadolescentmothersatateencenter. ThroughtheservicesofferedbytheNationalChildProtection,TraumaandResearch Center,Children'sHospital willstrengthenthebreadthandscopeofitscurrentprogramsto theregionalcommunity. Currently,Children'shasseveralmodel programsworthyof replicationinotherhospitalsthroughoutthecountry. Theseinclude: * Intensifiedcommunityadvocacyandpublicawarenessprogramsforthe preventionofinjuryandmaltreatment; * Preventionprogramsandtechniquesgearedtostemmingtherisingtideofdrug andalcoholabuseamongadolescents;andinnovativemodelsforservice deliverytohigh-riskmothers; * Enhancementoftraumaresponsecapabilitiesincludinganewhelicopter landingpadandreceivingfacility,andanaggressiveresearchprogramgeared tothestudyofchildrenwhohavesufferedfromtraumaticheadinjuries; * Modelpatientcare, research, familycounsellingandcommunityeducation initiatives, manyofwhichareundertakenbyan interdisciplinaryteam dedicatedexclusivelytoHIVpatientsandtheirfamilies; * Amodel informationsystem, includingaregisterforvictimizationreportsfrom all DistrictofColumbia, MarylandandVirginiahospitals, tofacilitate identificationandarticulationofabusedchildren'sneeds. OnecomponentoftheCenter'sprogramwill includeacontinuumofcareforthe medically/sociallyfragilechild. Theultimategoal isforthechildtoreturnhome,andbe caredforbyfamilymembers. Thiscanbeachievedthroughtheprovisionofappropriate family-orientedinterimcare. ThenewCenterwillprovidethefacilitiesnecessaryfor deliveringtransitionalcarethroughparentaleducationandmedicalcareinahomelike environment.
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