District of Columbia appropriations for 1994 : hearings before a subcommittee of the Committee on Appropriations, House of Representatives, One Hundred Third Congress, first session

1152 Pages·1993·35 MB·English

by  United States. Congress. House. Committee on Appropriations. Subcommittee on District of Columbia Appropriations

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
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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)
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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
[phone]
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.