Senator KENNEDY. Well, it has just been the drafting of the regulations and publishing them in the Register that has been the delay in this? Mr. NOVICK. I think there was much more we had to do. We looked at the methods to screen children and survey housing, at laboratory techniques for blood-lead analysis, and other methods of approach in the community to enable us to write effective regulations. Senator KENNEDY. When was the bill passed? In January 1971? Senator KENNEDY. Now we are in March 1972. The money was made available 8 months ago. What can you tell us now? Mr. NOVICK. Well, Senator, we have convened a group of community health leaders to help us draft the initial regulations and the initial approach. Senator KENNEDY. When did they meet? When were those meetings? Mr. NOVICK. The first meeting was in March or April 1971. Then, in order to gain some working experience on large-scale screening techniques, we initiated a survey of some 27 cities to gain experience with the analytical techniques. We are particularly concerned with a microtest using a few drops of blood rather than the previously used vena puncture, and to gain experience on other methods of how you get the children in for screening programs of this type. This I think has helped us to develop a better approach which we have incorporated in the regulations. I think we are now ready to move very effectively to make the grant awards. Senator KENNEDY. How many applications do you have? Mr. NOVICK. They are still coming in. I think the regional offices earlier this week had 10 applications with the understanding that approximately 20 others would be submitting applications. Senator KENNEDY. How much request? Mr. NOVICK. I do not have that. That is a running total, Senator. I will have to submit that for the record. (The information referred to follows:) Applications for lead-based paint poisoning prevention grants received by Number of formal grant applications received approval pending---- Number of draft grant applications received and under review_. 15 $5, 806, 000 20 $14,089, 000 Senator KENNEDY. Now in terms of that $712 million, can you tell us over what period of time that would be committed? Will you use that money up the next couple months? Mr. NOVICK. Yes. Senator KENNEDY. All the money will be used up by when? Mr. NOVICK. By June 30, all of it will be committed. Senator KENNEDY. What have you asked for for 1973 ? Dr. DUVAL. $9,500,000. Senator KENNEDY. Under which authority? Dr. DUVAL. Under this authority. There is of course additional authority. We have a request requesting I think an opportunity to dedicate approvimately $9 and a half million under 114(e). Senator KENNEDY. If you ask for money, $911⁄2 million under authority that is in this bill, why in your final paragraph do you say that you cannot support the enactment of S. 3080? It seems like you are using the bill to request the money, and you come to the conclusion you cannot support the bill. Dr. DUVAL. The issue of nonsupport as stated in the testimony, Mr. Chairman, only relates to the fact that the bill itself—we interpret it to duplicate authorities that we presumably already have. Senator KENNEDY. This is a fundamental basic parting of the ways that we have with the administration on these categories. Tell me, if you recognize the importance of getting some kind of assistance first of all, the screening of children, for the most part, and recognizing where the problem is, and certain housing patterns, why do you not support the proposal to do something about that, in terms of title II and III of the legislation? I know that comes from HUD, but obviously this is a program that is being sort of quarterbacked by you people, hopefully. Dr. DUVAL. Is the question, Mr. Chairman, why do we not use more of our funds to treat the houses themselves rather than the children? Senator KENNEDY. I know you say that this is HUD's problem that they have not requested it. But certainly in terms of trying to develop a coordinated approach in meeting lead paint poisoning, you screen the children or go into the various housing patterns and find out where this exists, and it seems even if you use some of the money which is made available under HEW, and you do the screening and find out where these houses exist, and not do something about it-well, as we provide in titles II and III, it seems to me only doing half the job. I am wondering from both a medical point of view why we are not getting requests by the administration in those areas? Dr. DUVAL. Mr. Chairman, there are two or three reasons which will explain the position we have taken on this. First we do feel in terms of such resources as may be available to get after the objectives of this program, each dollar spent will go farther in identifying and treating the child first, followed up by the treatment of the house. In the emergency circumstances, as you know, we do commit some of our HEW dollars to treat houses as well. Our first objective is to identify the involved homes, and then refer that list of identified homes to HUD for followup treatment. Senator KENNEDY. How much is that for treating houses? How much are you requesting? Dr. DUVAL. It is approximately an amount equal in terms of screening the dwellings; for example, in 1973 we will dedicate the same amount for the homes of children with elevated blood as we do for their protection. Senator KENNEDY. Where are you getting that money? You have used the authority in this legislation for the $72 million or at least you appropriated that, and you are using the authority for the next year for the $912 million. Where is your money for the housing? It is not under this legislation; is it? Mr. DUVAL. Yes, it is; Is it not, Mr. Novick? Mr. NOVICK. For the next fiscal year the appropriation will be under 314. Senator KENNEDY. That is public health. Dr. DUVAL. You did refer to $72 million, the authority we are sending the $72 million is under the authority of the lead base-paint bill. Senator KENNEDY. Yes; that is right. Dr. NOVICK. Now we recognize a problem of a medical emergency, where communities will find a sick child under title I, we would intend that they use a portion of the funds appropriated under this authority to delead the homes of those sick children. The regulations require the local communities to use other funds, if available, as well as code enforcement, HUD loan or grant funds but, in an emergency condition, funds under this authority can be used. Last year, when this appropriation was considered by the HouseSenate Conference Committee, a sentence was added in the conference report that the money will be used exclusively for the screening and treatment of children. I think we need to clarify that language so deleading of the homes of the victim is a part of a treatment. Senator KENNEDY. Do you utilize your neighborhood health centers at all in developing some screening programs? Dr. DUVAL. Yes. As a matter of fact now we are beginning to use more and more that is in the field, the children and youth projects, maternal child projects, the neighborhood center and so forth, and this is the primary purpose of the intradepartmental committee that I had reference to in my text, and I think it would be well for the purpose of the committee if I included the names of those persons as a part of the record. Senator KENNEDY. Good. (The information referred to follows:) Committee Members On The Department of Health, Education, and Welfare Intradepartmental Committee for Implementing the Lead-Based Paint Poisoning Prevention Act (PL 91-695) Dr. Jane S. Lin-Fu Pediatric Consultant Maternal & Child Health Service Health Administration Ms. Patricia Thoben Assistant Chief Program Evaluation Branch Division of Developmental Disabilities Social and Rehabilitation Services Dr. Elsa Schneider Office of Education Dr. Johannes Stuart Center for Disease Control Mr. Richard C. Thompson President's Committee on Mental Retardation HUD Liaison: Dr. Irwin Billick Office of the Assistant Secretary for Research & Technology |