Director's Report to the National Advisory Council on Drug Abuse
February, 1995
Congressional Affairs
104th Congress
The 104th Congress convened at noon on January 4. Like the House, the Senate remained in session through January -- forgoing the tradition of adjourning until after the President's late January State of the Union address.
The House opened its first session of the 104th Congress by electing Newt Gingrich (R-GA) Speaker by a vote of 228-202. Changes to House rules were then adopted with mostly bipartisan support:
- limit to six consecutive years the length of time a Representative can be Chairman of a committee [committee chairman could serve unlimited terms during previous sessions] and to eight years for Speakers;
- cut committee staffs by one-third;
- ban proxy voting in committees;
- require the Congressional Budget Office to use actual spending levels, not inflation-adjusted ones, in preparing budget estimates;
- to open committee meetings to the public;
- take away budgets, staffs and offices from 26 groups including the Democratic Study Group and caucuses of Black, Hispanic and female lawmakers; and
- abolish the District of Columbia, Post Office and Civil Service, and Merchant Marine and Fishers committees.
The Senate's first session of the 104th Congress was opened by Senate Majority Leader Bob Dole (R-KS). He stated that Federal programs from A to Z will be placed under Senate scrutiny during the 104th Congress with the guiding question being: Is this program a basic function of a limited government, or is it an example of how government has lost faith in the judgments of our people and the potential of our markets? He also said "I believe that, more often than not, the answer to this question will justify less Federal involvement, fewer Federal rules and regulations, a reduction in Federal spending, and more freedom and opportunity for our States and our citizens".
In the House, some of the topics currently drawing most of the attention are revisions to the welfare system, proposals to prevent Federal unfunded mandates, and legislation for a constitutional balanced-budget amendment [all of which are part of the GOP Contract with America]. House Republicans have promised only a vote within 100 days on all 10 parts of the Contract. Even though many of the proposals included in the Contract have bi-partisan support, various divisions are emerging and it appears as if the [April 13] deadline will be difficult to meet.
Hearings/Briefings
Senator Carl Levin requested a briefing on medications development and other treatment issues. On December 20, 1994, NIDA Director, Dr. Alan Leshner presented this briefing. Other attendees included: Jackie Parker, legislative assistant to the Senator; Drs. Charles Grudzinskas and Frank Vocci, MDD; Mary McLaughlin, congressional affairs, SPB, OSPC; and Anne Houser of the NIH legislative office.
On January 17, Representative John Porter (R-IL), Chairman of the Labor/HHS Appropriations Subcommittee, visited NIH and brought some of his appropriations subcommittee members and staff. Subcommittee members accompanying the Chairman included Representatives Ernest Istook (R-FL), Henry Bonilla (R-TX), Dan Miller (R-FL), Jay Dickey (R-Ark), and Roger Wicker (R-Miss). Congressional staff included Marty Reiser (Miller), Brian Williams (Dickey), Eric Fox (Bonilla), Bill Duncan (Istook), Steve Morin (Pelosi), Christine Hamilston (Obey), and Kevin Burke of the Office of the Assistant Secretary for Legislation.
The NIH Office of AIDS Research (OAR) is developing plans for a series of congressional briefings on advances in AIDS research and treatment, with presentations by leading intramural and extramural experts in AIDS. A date had been set for the first briefing. However, it was postponed and no new date has yet been set.
Bills of Interest
By vote of 300 ayes to 132 noes, the House passed a Constitutional amendment calling for a balanced budget [H.J. Res. 1] minus the controversial three-fifths majority requirement for tax increases. The Senate continues to deliberate, with the Minority Leader, Tom Daschle (D-SD), joining the strong opposition headed by Bob Byrd (D-WV).
H.R. 11 - Introduced (as part of the Contract with America) by Representative Barbara Vucanovich, to strengthen the rights of parents. Included under Title IV of the bill is a provision (Section 401 which concerns family privacy protection) requiring Federal departments and agencies receive written parental consent before a minor submits to a survey, analysis or evaluation that reveals certain information. Specifically, the bill requires parental consent for the participation of a minor in any federally funded survey or analysis regarding (1) parental political affiliations; (2) any mental or psychological problems in the family; (3) family or individual sexual behavior and attitudes; (4) any illegal or self-incriminating behavior; (5) privileged relationships with lawyers, physicians or clergymen; (6) any household income information other than that required by law for federal program participation; (7) religious beliefs; and (8) appraisals of other individual with whom the minor has had a familial relationship. The outcome of this provision is of keen interest to researchers.
Representative Gerald Solomon (R-NY) has introduced a number of drug-testing bills including H.R. 153, a bill to amend the Public Health Service Act to establish Federal standards to ensure quality assurance of drug testing programs.
S. 18 - Introduced by Senator Arlen Specter (R-PA), entitled Health Care Assurance Act of 1995, which includes a provision authorizing $120M for FY 96 which authorizes the NIH Director to establish and implement a program for the conduct of clinical trials with respect to new drugs and disease treatments determined to be promising to the Director. In making this determination priority is to be given to those drugs and disease treatments determined (l) to be most costly to treat; (2) to have the highest mortality; or (3) to affect the greatest number of individuals. It also would establish a trust fund for medical treatment outcomes research. It would be funded through taxes relating to health insurance policies. These amounts are to be made available to the DHHS Secretary to pay for research activities related to medical treatment outcome.
S. 38 - Introduced by Senator Orrin Hatch (R-UT), new Chairman of the Judiciary Committee, to amend the Violent Crime Control and Law Enforcement Act of 1994. Section 701, Elimination of Ineffective Programs, repeals certain subtitles, under Title III which include in part, Residential Substance Abuse Treatment for State Prisoners. It also repeals Title V, Drug Courts, and Title XXVII, Presidential Summit on Violence and National Commission on Crime Prevention and Control.
S. 59 - Introduced by Daniel Inouye (D-HI), to amend the Public Health Service Act to provide health care practitioners in rural areas with training in preventive health care, including both physical and mental care.
S. 142 - Introduced by Senator Nancy Kassebaum (R-KS), new Chairman of the Labor and Human Resources Committee, to strengthen the capacity of state and local public health agencies to carry out core functions of public health, by eliminating administrative barriers and enhancing State flexibility.
Health Care Reform
Though there was no mention of health care reform included in the GOP "Contract with America," the Republicans may take up health care reform during this Congress.
New Commerce Committee Chairman, Thomas Bliley (R-VA), has said that he hopes to get a modest health care reform bill out of the House by the end of the year. He favors a bill similar to the proposal introduced during the 103rd Congress (as H.R. 3955) by the new Health & Environment Subcommittee Chairman Michael Bilirakis (R-FL). This proposal would have, in part: assured portability of health insurance coverage, allowed people to remain insured if they change jobs, but would not protect people who lose their jobs; and limited insurance companies' ability to deny coverage to applicants with pre-existing medical conditions.
On the Senate side, both Senate Finance Committee Chairman Bob Packwood (R-OR) and Majority Leader Bob Dole (R-KS) have had a longstanding interest in health care reform. Senator Dole said that he and Packwood would offer a scaled-back version of the bill they proposed in the 103rd Congress.
In this first session of the 104th Congress, Senator Phil Gramm (R-TX) has introduced S. 121, to guarantee individuals and families continued choice and control over their doctors and hospitals, to ensure that health coverage is permanent and portable, to provide equal tax treatment for all health insurance consumers, to control medical cost inflation through medical savings accounts, to reform medical liability litigation, and to reduce paperwork. Senator Tom Daschle (D-SD) introduced S. 7 to provide for health care reform through health insurance market reform and assistance for small business and families.
Other Items of Interest
- Indirect Costs
- Representatives from some of the nation's largest research institutions are said to be intensely concerned about possible limitations on Federal reimbursements of university "indirect costs." It has been reported in the specialty press that universities also fear reductions in indirect costs as part of any budget rescission package.
- Administration's Budget
- President Clinton is scheduled to submit his budget on February 7.
- War on Drugs
- Included in the Extensions of Remarks in the January 4 Congressional Record, is a statement by Representative Gerald Solomon (R-NY) that a war on drugs be re-declared. He said that the "Republican-controlled Congress will play a major role in the war on drugs. . .As a result of the Clinton administration's half-hearted effort to fight the drug war we have witnessed a dramatic increase in the use of drugs." He went on to cite statistics from the Partnership for a Drug-Free America and further stated that additional legislation was necessary. Some of this legislation included a bill to deny Federal benefits upon conviction of certain drug offenses, a bill to require mandatory drug testing for all Federal job applicants, and a bill to prohibit Federally-sponsored research involving the legalization of drugs.
- Methadone Recommendations
- The Institute of Medicine, an arm of the National Academy of Sciences, convened drug experts to study the issue of methadone. In a report released in late December, the panel concluded that methadone significantly reduces heroin use and related crime and AIDS infection transmitted by infected needles. It urged the DHHS to relax methadone restrictions and require the States to follow the rules. The report states:
"Current policy. . .puts too much emphasis on protecting society from methadone and not enough on protecting society from the epidemics of addiction, violence and infectious diseases that methadone can help reduce."
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