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HHS FACT SHEET December 31, 1998 Contact: HHS Press Office (202) 690-6343
In 1998, the Department of Health and Human Services continued to make important progress in improving the health and welfare of all Americans. We made major investments to ensure the health of our nation's children, took steps to reduce the major disparities in health that exist between whites and racial and ethnic minorities, and we made significant strides in our fight against disease, including cancer and AIDS. Infant mortality reached an all-time low and the average life span for Americans reached an all-time high. The levels of immunizations for preschool children of all racial and ethnic groups reached nearly equal levels, wiping out a 26 percentage point difference a generation ago.
Protecting the health of our children has been a top priority of HHS, and in 1998, we approved 48 states and territorial plans under the Child Health Insurance Program, which together will provide health insurance for more than 2.5 million children in low-income families within the next three years. We also strengthened our Head Start program, initiated new regulations that require drug labels to include specific information about drug safety for children, and redoubled our efforts to reduce tobacco sales to minors.
In response to President Clinton's goal of eliminating major health disparities between whites and racial and ethnic minorities by 2010, HHS took important steps to meet these new national health objectives. We added an additional $156 million in our FY 1999 budget targeted to reducing the disproportionate burden of HIV/AIDS among racial and ethnic minority communities and awarded grants to promote diabetes prevention activities among American Indian populations.
This past year brought news of significant gains in biomedical research and in our efforts to prevent disease and promote health. We announced that for the first time in 20 years, cancer death rates declined, and AIDS dropped out of the top ten causes of death. HHS-supported researchers for the first time deciphered the entire genetic code of a multicelled organism, which holds tremendous promise for improving our understanding of a wealth of human genetic diseases. We secured a record level of funding for the National Institutes of Health, and President Clinton announced an historic increase in funding at the NIH to prevent and treat HIV-AIDS around the world, including a 33 percent increase over last year's funding to search for an AIDS vaccine. Overall, HHS will spend nearly $7.7 billion in 1999 for HIV/AIDS prevention activities.
With all of our appointees now confirmed, we will continue to build on our successes and accomplishments as we prepare for the new millennium. Improving health care access and quality, increasing food safety, enhancing our efforts to prevent and manage chronic disease, and reducing tobacco use are just a few of the priorities that we will address in the coming year.
Donna E. Shalala
PROTECTING THE HEALTH OF OUR CHILDREN AND YOUTH
In 1998, we made significant progress in improving the health of America's children by implementing the Children's Health Insurance Program, increasing immunization rates, decreasing tobacco and drug use, and implementing pediatric drug labeling regulations.
Improving Health Care for Children. In 1998, HHS worked diligently with the states to develop and implement plans to extend health care coverage to millions of uninsured children. The Children's Health Insurance Program (CHIP), which was passed in the Balanced Budget Act of 1997, provides $24 billion in set-aside funds for health insurance for low-income children. To date 48 state and territorial plans have been approved under CHIP. These CHIP plans estimate that they will cover more than 2.5 million children within the next three years.
Making Child Care More Affordable and Accessible. In January 1998, President Clinton announced his historic proposal to enhance the affordability, accessibility and quality of child care for America's working families. The $21.7 billion initiative would increase subsidies and tax credits for low to middle income families, provide new resources to states to improve the quality of child care and choices for parents and expand after school programs. In the FY 1999 budget agreement, the President secured a down payment on the proposal with $200 million for the 21st Century Learning Center program and $180 million for states to improve child care quality.
Head Start Reauthorized, Strengthened, and Expanded. On October 27, 1998, President Clinton signed bipartisan legislation that reauthorized Head Start for four more years and strengthens and expands it to better serve America's families into the 21st century. The renewal also includes the President's goal of doubling the number of infants and toddlers served in the Early Head Start program by the year 2002. Under the Clinton Administration, funding for Head Start has increased by 68 percent and enrollment has increased by over 200,000 children, reaching 830,000 children this past fiscal year. With an increase of $313 million for FY 1999 -- the amount the President requested in his budget proposal -- Head Start will continue to expand toward the goal of serving one million children by 2002.
Making Prescription Drugs Safer for Children. HHS marked an important milestone in the Administration's effort to make drugs safer and more effective for children by requiring that drug labeling have specific information on the use of new drugs and biologics in children. Without adequate information, physicians may be reluctant to prescribe certain drugs for their pediatric patients, or they may prescribe them inappropriately. The new requirements make it more likely that children will receive improved treatment because doctors will have more complete information on how drugs affect children.
Reducing Tobacco Sales to Children. In February 1998, HHS launched a major national education campaign designed to help reduce illegal sales of tobacco products to children. The campaign, an important part of the administration's comprehensive strategy to prevent youth tobacco use, informs retailers and customers that it is a federal violation to sell cigarettes or spit tobacco to anyone younger than age 18 and requires retailers to ask for photo identification from anyone younger than 27. In addition, HHS made progress in implementing the Synar Amendment, legislation that requires states to monitor retailer compliance to ensure they prohibit tobacco sales to children. SAMHSA announced that more than 60,000 retail establishments have been inspected since the final Synar regulation was enacted in 1996. Four states -- Florida, Maine, New Hampshire and Washington -- have already met the retailer compliance requirements set by the law. FDA launched an educational campaign featuring radio, print, and billboard advertisements, as well as materials for retailers to display in their stores. The campaign is designed to remind retailers, clerks and customers about the law and the retailer's risk of fines.
Improving the Chances for Children at Risk for a Permanent, Safe Home. Under the expanded authority of the Adoption and Safe Families Act signed by President Clinton in 1997, HHS approved demonstration projects in eight states this year to test new ways to protect children at risk and secure permanent homes for those in foster care. We issued new proposed child welfare regulations that will emphasize safety for children, improved well-being of children, and more accountability for children reaching permanent homes quicker. Finally, along with President and Mrs. Clinton, we announced our intent to develop a plan for expanding the use of the Internet. By putting the photos of children who are legally available for adoption on a national Internet service, the time that a child waits to find an adoptive family could be shortened.
Reducing Teen Pregnancy. In April 1998, HHS announced that the teen birth rate fell an estimated 3 percent in 1997, continuing a six-year downward trend. In addition, the teen birth rate for white, black, American Indian, Asian or Pacific Islander and Hispanic women ages 15-19 declined substantially nationwide from 1991 to 1997. In particular, the rate for black teens - until recently the highest -experienced the largest decline, down 23 percent from 1991 to 1997 to reach the lowest rate ever reported for blacks. In December 1998, we released a first-time report showing the rate of second births for teens was down by 21 percent between 1991 and 1996.
Teen Drug Use Levels Off, Declines in Some Groups. In December 1998, we released the 24th annual Monitoring the Future Survey, which showed that illicit drug use among teenagers remained stable for the second year in a row, and in some cases even decreased. The survey found general stability among the proportion of 12th graders using most illicit drugs in the past year or past month, including the most frequently used drug, marijuana. Past year use of illicit drugs among 10th graders decreased from 38.5 percent in 1997 to 35.0 percent in 1998. Past year use among 8th graders decreased from 23.6 percent in 1996 to 21.0 percent in 1998. This year's study also reported an increase in perceived risk of harm in using marijuana, which generally is predictive of a decline in marijuana use. This report is the first to find an increase in the perceived risk of marijuana use among 8th graders since 1991.
Over the past two years, HHS has re-engineered and expanded our substance abuse prevention programs, to include State Incentive Grants for Community-based Action, awarded to 19 governors to coordinate and fund local prevention efforts and Targeted Capacity Expansion Grants, awarded to 41 municipal, county, state, and tribal government substance abuse programs to help fill gaps in treatment for serious, emerging drug problems at the earliest possible stages.
FOCUSING ON WOMEN'S HEALTH
Preventing Disease in Women. Medicare expanded coverage of mammograms, pap smears, colorectal cancer screening, bone mass measurement for beneficiaries at risk for osteoporosis and other bone abnormalities, and diabetes self-management benefits. This emphasis on early detection and management of disease was a result of the President and Congress working together to expand the preventive benefits available to all Medicare beneficiaries in the Balanced Budget Act. During Breast Cancer Awareness Month in October 1998, Secretary Shalala announced new efforts to encourage mammography screening among special populations, especially to older, low income, and minority women, who tend to have the highest breast cancer mortality rates. The Health Care Financing Administration (HCFA) and the National Cancer Institute (NCI) joined in this breast cancer outreach effort. Also in 1998, the Mammography Quality Standards Act (MQSA) was reauthorized, meaning that approximately 10,000 mammography facilities in the United States have been accredited and women can have confidence that they meet uniform federal standards for mammography.
Improving Access to Health Information and Care. On November 16, 1998, HHS formally launched the National Women's Health Information Center, a combination Web site (www.4woman.gov) and toll-free hotline (1-800-994-WOMAN), which serves as a "one-stop shopping" resource for comprehensive information on women's health. Because the service is available through the Internet or via a toll-free number, women in every corner of America will now have access to accurate and timely health information. Also in 1998, we established six new National Centers of Excellence in Women's Health, specifically to focus on serving minority populations. This brings to 18 the number of centers that unite women's health research, medical training, clinical care, public health education, community outreach, and the promotion of women in academic medicine.
Joint U.S.-Israeli Conference on Women's Health. In December 1998, the Department convened the first Bi-National Israel-U.S. Conference on Women's Health to discuss and exchange information on a range of global health topics that cover the life span of women. Hundreds of women's health leaders from the two nations discussed common issues such as breast cancer, heart disease, working women's health, and prevention strategies for adolescent risky behaviors. The Secretary opened the conference by affirming HHS' commitment to advance the health of women at home and around the world and to strengthen the bond of friendship we already feel for the women of Israel.
Helping Women Use Medicines Wisely. HHS launched in March 1998 a nationwide campaign to educate women about the importance of properly using medicines. Women often are the primary caregivers for their children and, increasingly, their own parents. Frequently their own health is overlooked in the process, so by taking time to learn to use medicines wisely, women will be able to take better care of themselves and their families. The grassroots campaign, "Women's Health: Take Time to Care, Use Medicines Wisely" is primarily directed at women over 45, particularly those who are underserved. In developing the campaign HHS partnered with the National Association of Chain Drug Stores and a broad network of organizations, including the League of Women Voters, American Heart Association, National Black Nurses Association, and American Association for Retired Persons.
CONTINUING THE FIGHT AGAINST HIV/AIDS
AIDS Falls From Top Ten Causes of Death. In October 1998, the Centers for Disease Control and Prevention reported that AIDS fell from the top ten causes of death in the U.S., declining an unprecedented 47 percent from 1996 to 1997 to an age-adjusted HIV death rate of 5.9 deaths per 100,000, the lowest it has been since 1987. The decline in AIDS deaths is primarily due to the continuing impact of highly active antiretroviral therapy in helping people with HIV live longer and healthier lives.
Preventing AIDS Through Medical and Behavioral Approaches. President Clinton announced an historic increase in funding to search for an AIDS vaccine. NIH plans to spend $200 million on AIDS vaccine efforts in FY 1999, up 33 percent from FY 1998. As of June 1998, NIH-supported researchers had evaluated 23 vaccine candidates and 10 adjuvants (substances incorporated into a vaccine that boost specific immune responses to the vaccine) in 3,200 volunteers in 49 phase I/II clinical trials. On June 3, 1998, the Food and Drug Administration granted permission to VaxGen Inc. for the nation's first phase III clinical trial for an AIDS prevention vaccine. The three-year trial of the vaccine, called AIDSVAX, will include 5,000 U.S. volunteers and 2,500 volunteers in Thailand. In April, HHS determined that needle exchange programs can be an effective part of a comprehensive strategy to reduce the incidence of HIV transmission without encouraging the use of illegal drugs.
Increasing Access to AIDS Care. In 1998, HHS also increased by 70 percent the funds earmarked for the AIDS Drug Assistance Programs (ADAP), ensuring that more than 100,000 low income individuals living with HIV/AIDS receive life-saving and -sustaining drug therapies. On December 18, 1998, HHS committed $479 million to fund primary health care and support services for low-income individuals in 50 eligible metropolitan areas. Part of these funds are targeted to cities with high numbers of affected African American and Hispanic populations under a special Clinton administration initiative with the Congressional Black Caucus.
CLOSING THE GAP IN HEALTH FOR RACIAL AND ETHNIC MINORITY POPULATIONS
Initiative to Eliminate Racial and Ethnic Disparities in Health. Launched by President Clinton in a White House Radio Address on February 21, 1998, the racial disparities initiative sets a national goal of eliminating major health disparities between whites and racial and ethnic minorities by the year 2010. The initiative focuses on drawing together public and private efforts - including local communities -to eliminate the health disparities in these key areas: infant mortality, diabetes, cardiovascular disease, HIV/AIDS, cancer and adult and childhood immunizations. The President is asking Congress for $400 million over five years to develop new approaches and to build on existing strategies to address these disparities, and Congress has appropriated $65 million for the first year, Fiscal Year 1999. The announcement has been followed up by a major community outreach campaign headed by Dr. Satcher. In October 1998, Secretary Shalala announced the formation of a broad, new Departmental Minority Initiatives Steering Committee, designed to provide guidance for a number of related HHS minority health initiatives. These include the Hispanic Agenda for Action and the Asian-American and Pacific Islander Action Agenda, as well as the White House's Historically Black Colleges and Universities Initiative and the White House Initiative on Tribal Colleges and Universities.
BETTER HEALTH AND CARE FOR OLDER AMERICANS
Medicare Project to Promote Healthy Aging. In October 1998, HHS announced the Healthy Aging Project, a five-year project designed to find improved ways to slow or prevent physical disabilities in our nation's elderly. With the number of seniors expected to increase to 68 million by 2030, it is essential to identify the strategies that have been most successful in promoting a healthy aging experience. With this project, HCFA will rigorously evaluate or test some of the many programs that claim to improve health and reduce chronic disease.
Preventing Elder Abuse. According to a recent report to Congress, more than half a million older Americans suffered some form of abuse and neglect in 1996. In cases where a perpetrator of abuse and neglect is known, the perpetrator is found to be a family member in 90 percent of cases, and two-thirds of these perpetrators are adult children or spouses. On October 8, 1998, HHS announced the establishment of a new National Center on Elder Abuse designed to promote understanding among state and local networks of community workers, physicians, elderly volunteers, and others working to prevent elder abuse. The center is funded by a $1 million HHS grant and is led by the National Association of State Units on Aging. Operating as a partnership between several service and legal organizations, the center will especially expand its support of training activities, aiming at helping "senior sentinels" -- persons who work with older persons on a regular basis -- as well as medical and social service professionals to identify and respond appropriately to possible cases of elder abuse and neglect.
Improving Nursing Home Quality. On July 21, 1998, HCFA unveiled a nursing home initiative to enhance protections for nursing home residents, including tougher enforcement of nursing home rules and strengthened oversight of states nursing home quality and safety responsibilities. HCFA has implemented a new monitoring system and given new instructions to states on how to handle problem nursing homes and nursing home chains.
Lifestyle Changes May Help Elderly Eliminate Need for Blood Pressure Medication. On March 18, 1998, NIH announced that the results of a 30-month study of older Americans with high blood pressure showed that losing weight and cutting down on salt can lessen and even eliminate the need for blood pressure-lowering medications in the elderly. By modifying their own behavior, older Americans can play an important role in treating and managing their high blood pressure.
Addressing Substance Abuse Among Older Adults. On May 7, 1998, the Substance Abuse and Mental Health Services Administration (SAMHSA) released a new best practice guideline to assist the health care community in detecting and treating alcohol and medication abuse among older patients. By encouraging service providers to understand the effect that alcohol and drug abuse can have on older people, this report will provide opportunities to help older people who are in need of substance abuse treatment.
International Year of Older Persons. HHS' Administration on Aging, as head of the Federal Committee to Celebrate the International Year of Older Persons, launched the International Year of Older Persons, which began on October 1, 1998 and will last through October 1, 1999. More than 40 federal departments and agencies are involved in the planning for the International Year. Activities are planned throughout 1999 at the national, state and local level and include media roundtables and a two- day conference in June of 1999. A kick-off event featuring the Secretary was held on October 19.
PREVENTING DISEASE AND IMPROVING THE QUALITY OF HEALTH CARE
Cancer Rates Drop, Overall Quality of Life Improves. On March 12, 1998, CDC and NIH announced that the incidence and death rates for all cancers combined and for most of the top 10 types of cancer declined between 1990 and 1995, reversing an almost 20-year trend of increasing cancer cases and death in the U.S. The report showed that incidence rates declined for most age groups, for both men and women, and for most racial and ethnic groups. In October 1998, CDC reported improvements in a number of quality of life indicators. The overall infant mortality rate reached a new low of 7.1 deaths per 1,000 live births. In addition, life expectancy reached a record high of 76.5 years for those born in 1997. And the preliminary age-adjusted homicide rate continued to decline, falling 12 percent in 1997.
Improving Food Safety. In May 1998 CDC established PulseNet, a national computer network of public health laboratories that will help rapidly identify and stop episodes of foodborne illness. The new system enables epidemiologists to identify serious and wide-spread food contamination problems up to five times faster than previously possible. In July, HHS issued a new food safety regulation requiring a warning on packaged fresh fruit and vegetable juices that have not been processed to prevent, reduce or eliminate illness-causing microbes. Unprocessed juices constitute only about 2 percent of the total juice sold in the U.S., but they have been linked to increasing numbers of foodborne disease outbreaks in the past few years. These actions are part of a series of steps the Clinton administration has taken to improve the safety of foods Americans consume.
National Initiative to Prevent Skin Cancer. In May 1998, CDC launched a national, multi-year awareness initiative to prevent skin cancer among Americans. Skin cancer appears to be related to increases in voluntary sun exposure, making skin cancer largely preventable when sun protective practices and behaviors are consistently followed. The "Choose Your Cover" campaign educates, encourages and empowers young people to protect themselves from the sun's ultraviolet rays by practicing sun-safe behaviors.
Bringing Medicare and Medicaid into Compliance With the Consumer Bill of Rights. In June 1998, HHS established a series of new patient protections for the 39 million beneficiaries of Medicare to bring Medicare into compliance with the Clinton Administration's Consumer Bill of Rights. These new protections include access to emergency services when and where the need arises, patient participation in treatment decisions, and access to specialists. In addition, the 38 million Medicaid beneficiaries also are being assured essential protections in the Consumer Bill of Rights. In September 1998, HCFA published a Notice of Proposed Rulemaking adding new patient protections such as access to specialists and an expedited independent appeals process to bring the program in compliance with the patients' bill of rights, where possible.
HHS Releases Consumer Survey to Empower Medicare Beneficiaries to Make Informed Choices. On February 20, HHS launched a nationwide effort to help patients rate their health plans and to help consumers choose among plans. The effort is built on a new survey tool, the Consumer Assessment of Health Plans (CAHPS), developed by the Agency for Health Care Policy and Research, that provides a consumers-eye view of the care and service they receive from health plans. The survey asks how easily beneficiaries can access specialists and emergency care services and seeks information on the general level of consumer satisfaction. In 1998, CAHPS was adopted by the Office of Personnel Management for use by the Federal Employees Health Benefits Program to survey federal employees and report back the findings of the survey to them to help in the selection of health plans during the federal open season. CAHPS also was merged with another health care quality tool, the HEDIS Member Satisfaction Survey and will be used by the National Committee for Quality Assurance to evaluate and accredit commercial managed care plans. In 1998, HCFA used a specially developed version of CAHPS to survey Medicare enrollees in managed care plans to assess their experiences. The survey results, which will provide extensive information about Medicare managed care plans currently available, will be sent to every Medicare beneficiary in early 1999, helping them make better informed choices about their health plan options.
FIGHTING HEALTH CARE FRAUD, WASTE AND ABUSE
Redoubling Our Commitment. With leadership from HHS' inspector general, the Department-wide initiative against waste, abuse and fraud continued to make progress. On December 7, 1998, President Clinton unveiled a new legislative package as part of his FY 2000 budget that will save Medicare more than $2 billion by combating fraud, waste and abuse. The President's proposals, which will give HCFA more tools to root out fraud in the Medicare system, focus on eliminating excessive Medicare reimbursement for drugs, preventing abuse of Medicare's Partial Hospitalization Benefit, ensuring Medicare does not pay for claims owed by private insurers, empowering Medicare to purchase cost-effective high-quality health care, and requesting new authority to enhance contractor performance.
Ensuring Access to Care in Community Mental Health Centers. In September 1998, HHS took action to ensure that Medicare beneficiaries with acute mental illness get quality treatment in community mental health centers and that Medicare pays appropriately for those services. HCFA now has the authority to begin termination actions against centers that appear unable to provide Medicare's legally required core services, and will require others to come quickly into compliance. HCFA also can demand repayment of money paid inappropriately for non-covered services or ineligible beneficiaries.
Medicare Hires Special Fraud Fighters, Enlists Citizens to Report Fraud. On September 15, 1998, HHS announced that for the first time, Medicare will hire special outside contractors, or "fraud fighters," to carry out audits, conduct medical reviews and conduct programs that will expand the Clinton administration's fight against waste, fraud and abuse. These special fraud fighters will work with the Medicare Integrity Program to end criminal activities by fraudulent health care providers, ensure that Medicare pays only for medically necessary services, and identify honest errors that lead to improper payments. As a further incentive to weed out fraud and abuse, HHS announced that beginning in January 1999, it will give rewards up to $1,000 to Medicare beneficiaries and others who report fraud and abuse in the Medicare program and if their information leads directly to the recovery of Medicare money.
Fighting Fraud and Abuse Among Durable Medical Equipment Suppliers. Suppliers of durable medical equipment, such as wheelchairs, canes and other medical supplies have been an area of special vulnerability to fraud and abuse. As a result of a regulation issued by HHS in January 1998, such suppliers are now required to obtain surety bonds of at least $50,000, to assure that those who sell durable medical equipment for Medicare beneficiaries are legitimate and responsible businesses, not fly-by-night companies, inexperienced individuals without adequate resources, or even criminals who will defraud and abuse the Medicare program."
IMPROVING CUSTOMER SERVICE
Implementing the FDA Modernization Act of 1997. The FDA Modernization Act of 1997, which became law in November 1997, requires FDA to improve the regulation of food, medical products and cosmetics. By November 1998, FDA had met nearly all of the deadlines for carrying out the law's provisions and completed a number of initiatives, including: a final regulation establishing parameters for distributing sound and balanced information about "off-label" uses for marketed drugs, biological products, and medical devices; guidance on FDA's fast track programs, intended to ease the development and evaluation of new drugs and biologics to treat serious and life-threatening illnesses; and an overall FDA plan for complying with the terms of the new law, developed through a series of meetings with stakeholders across the U.S.
Online Access to Information. Throughout 1998 HHS made valuable use of the Internet by developing numerous Web sites to make information more accessible to the public. HCFA unveiled a new Web site (www.medicare.gov) that contains information for Medicare beneficiaries and others involved in making health care decisions, including Medicare Compare and preventive benefits information. The AoA launched a limited access interactive Web site (AgingNet) specifically devoted to the key members of its national aging network, the state and area agencies on aging. Through this personalized service, customized information and technical assistance can be quickly disseminated and provided to our partners throughout the country. Both NIH and AoA unveiled Spanish-language Web sites that provide resource and referral information and selected Spanish-language publications to those interested in hispanic aging and health issues.
Assuring Year 2000 Readiness. HHS finished 1998 with Year 2000 (Y2K) preparedness ahead of schedule. The majority of HHS mission-critical systems were Y2K-compliant at the end of December, three months prior to the government-wide March 31, 1999 deadline. For the particularly complex Y2K tasks in Medicare, HCFA ended the year with all internal systems fully Y2K-compliant, and 95 percent of the renovation of the code for the 78 external mission critical systems (payment systems operated by Medicare contractors) also compliant. FDA worked throughout 1998 with medical device manufacturers to gather and post information to help hospitals, doctors, and researchers ensure that medical and laboratory equipment will be ready for the date conversion, which takes place on January 1, 2000. During 1999, in addition to extra testing of computer systems, HHS will accelerate outreach activities to assure that private sector partners, providers and suppliers, know how to ensure their own Y2K readiness.
CONTINUING PROGRESS ON WELFARE REFORM
Welfare-to-Work Efforts Paying Off. An HHS report sent to Congress in August 1998 found welfare reform succeeding overall, and state have not cut benefits in "race to the bottom" that was feared. Almost every state requires personal responsibility contracts, and most states have adopted a work-first model, with 32 states expecting clients to work within six months. For the first time, half of all low-income single mothers with children under six-the population most affected by welfare policy-are working, a dramatic increase from 35 percent in 1992. State evaluations of welfare programs show employment increases of 8 to 15 percentage points. A Maryland study found that less than one half of 1 percent of families leaving welfare placed a child in foster care, and most of those families had already been under investigation for abuse and neglect.
Welfare Caseload Continues Unprecedented Decline. As of June 1998, HHS announced that welfare caseloads have declined to approximately 8.4 million recipients and slightly over 3 million families. Since January 1993, the number of recipients on welfare has dropped by more than 41 percent, including a decline of more than 30 percent since the enactment of the welfare reform law on August 22, 1996. There are 5.7 million fewer recipients on the welfare rolls since President Clinton took office, and 3.8 million fewer welfare recipients since the passage of the 1996 law. The rate of decline remains strong with nearly 2 percent reductions each month, almost double the rate for the same period in 1997.
Tracking Delinquent Parents. HHS reported that the National Directory of New Hires, a child support collection system launched in October 1997, marked a year of record achievements in collections and paternity establishments and found more than 1.2 million delinquent parents. On June 24, 1998, President Clinton signed into law the Deadbeat Parents Punishment Act of 1998. The law is based on his 1996 proposal for tougher penalties for parents who repeatedly fail to support children living in another state or who flee across state lines to avoid supporting them. On October 1, 1998, HHS started operating the Federal Case Registry, which will contain records of all parents who owe child support. Combined with the National Directory of New Hires, HHS now has the strongest child support enforcement resource in the history of the program for finding parents who are earning money, but not paying child support.
Federal Government Helps to Shrink Welfare Rolls. President Clinton announced in August 1998 that the federal government had hired 5,714 new workers off the welfare rolls, which is more than half-way to its goal of 10,000 by 2000. Nearly 80 percent of these new workers are outside the Washington, D.C. metropolitan area. HHS has hired 282 new workers from the welfare rolls and is well ahead of schedule in reaching its goal of 300 new welfare hires by 2000.