▶ 0:07:25Okay, the committee come to order and I want to say good morning to everyone. It's my pleasure to welcome everyone to the uh subcommittee on labor, health, and human services and education and for what is our hearing to hear from outside experts and the public. Uh this is our public witness day. It's an opportunity for members of the public to come before this panel and to draw our attention to issues of importance to them.
▶ 0:07:51I look forward to hearing from our witnesses this morning as we learn more regarding the challenges facing our constituents and also communities across the country and at the end of the day what this subcommittee can do to try to be of help for witnesses. A fivem minute clock will be uh the uh countdown on the microphone box that'll be in front of you as you take the chair and you'll have one minute remaining u when the light turns yellow.
▶ 0:08:20That'll of course just be an indication a signal that you to begin to wrap up your testimony. Remember of course all of your testimony your written statement will be submitted uh to the committee and will appear in the hearing record. So uh no if you don't get to all of your comments they will be submitted for the record. Uh but before we begin, I'd like to turn to the ranking member of the um uh full committee and the subcommittee here uh Rosa Delora for any remarks that she would like to make. Thank you very much, Mr. Chairman.
▶ 0:08:49It's pleasure to join with you this morning and thank you for holding this hearing uh with our wonderful public witnesses uh to discuss the 2026 uh budget. um to our to our witnesses. Uh we just offer a welcome to you to the Labor, Health, Human Services, and Education Subcommittee of Appropriations. Uh I want to express my sincere gratitude to all of you and appreciation for the work that you do.
▶ 0:09:16Um and and and on whose behalf you do it. You're such wonderful, wonderful advocates and we thank you for the written testimonies uh for the record. Uh your your advocacy and your testimony is invaluable to us uh and to the subcommittee's bill. I have said so many times in the past. Today's hearing is really one of the most important parts of this subcommittee's process.
▶ 0:09:43The programs in labor HHS in this bill, they level the uh playing field for low-income children looking to get a good education. They equip our nation to deal with public health emergencies. They fund lifesaving biomedical research. And they help Americans get the skills that they need to be able to find a job.
▶ 0:10:05And the list goes on and on and on because the programs directly impact the lives of every American across our country, especially children, workers, middle class families, seniors.
▶ 0:10:20We are challenged these days with the uh um with the future of some of these programs um as there have been as you know um illegal freeze payments um which take funds from programs uh that I believe American families and businesses um rely on and uh especially in the area that we're looking at uh that are under the jurisdiction of the subcommittee in both education uh which we know um
▶ 0:10:51uh there is a move to uh to eliminate the department of education and really for me that's about eliminating public education which is so critical uh to our uh to our children uh and the department of health and human services is undergoing a um this rapid tr transformation with the loss of potentially up to 20,000 20,000 people.
▶ 0:11:18Um so we we know that um thousands of federal workers have been fired, billions of dollars canled in funding for education. Uh with regard to education, we would look to if you eliminate title one of education, we would lose uh 72 uh,000 uh teachers across the country. Uh and then there will be more to come.
▶ 0:11:44Um the I'm very troubled by what is happening at HHS um because of what is um the threat uh the threat to destroy um the agencies that protect America's health that includes the Center for Disease Control and Prevention, the National Institutes of Health, the Food and Drug Administration. 20,000 workers, as I've said, have been fired at HHS.
▶ 0:12:12That's 1/4 of their workforce, $12 billion in funds provided by the Congress for public health and substance abuse treatment. Um, I believe what we will see next is the Department of Labor. Um and uh already terminated funding for the Bureau of International Labor Affairs or ILAB, an agency whose mission is to ensure American workers are not put at a disadvantage by countries who violate their labor commitments under our trade agreements.
▶ 0:12:42We expect the acts to fall on the Department of Labor's worker protection agencies, the wage and hour division and OSHA that are responsible for protecting worker safety and hard-earned wages. The American people are calling our offices every day asking about this spending freeze and what has happened to already appropriated funding. American people are concerned and there is a lot of fear out there.
▶ 0:13:11Uh and we have to address that. I say these things to let you know, but I also say with great optimism that you have such a a profound role to play and your voices need to be heard very strongly and powerfully about the resources that this uh subcommittee provides for you to carry out your missions to be able to address the health needs
▶ 0:13:41of our of our families or education needs of our families or the ability for people to be gainfully employed and what their futures are going to be. That is what our job is in this subcommittee. So we welcome you because more than ever now your voices need to be heard. Thank you for being here and we look forward to your testimony. So uh thank you Mr. Chairman and I yield back.
▶ 0:14:12Thank you, ranking member uh Delaro. And I'd like to uh recognize our first witness u our first witness will be Jessica Pesator. And um I may have butchered that a little bit, but Pescator. Good. All right, we got it. All right. Well, welcome to the subcommittee and we look forward to hearing your testimony. Thank you.
▶ 0:14:38Good morning, Chairman Adhalt, Ranking Member Delaro, and distinguished members of the subcommittee. My name is Dr. Jessica Pescore, and I am an emergency medicine pharmacist, clinical toxicologist, and the clinical director of the Alabama Poison Information Center. Thank you for the opportunity to share the critical work of our nation's 53 poison centers, and thank you for your long-standing bipartisan support of the poison control centers program.
▶ 0:15:04We are especially grateful to have been reauthorized and I am here today to respectfully request a $2 million increase over current funding levels for the program in fiscal year 2026. This morning, I'd like to highlight the value of a poison center, share my cent's efforts in addressing public health risks such as unregulated and illicitly manufactured substances, and discuss some nationwide challenges.
▶ 0:15:29Poison centers provide 247 lifesaving expertise to all Americans. From concerned parents to first responders and clinicians to public health agencies. Our teams of expert nurse, pharmacist, and physician poison specialists and toxicologists deliver accurate realtime guidance on poisoning emergencies. On average, poison centers receive a call every 15 seconds.
▶ 0:15:56That means in our brief time together, 20 calls will have been managed by a poison center. In this last month alone, over 201,000 poisoning cases were handled by poison centers across the country with cases ranging from a grandparent accidentally doubling their blood pred blood pressure medication dose to a child ingesting a household cleaner to a gardener bitten by a snake to a child or excuse me to a teenager overdosing in a self harm attempt.
▶ 0:16:25But beyond our day-to-day management of these poisoning emergencies, we also function as an allhazards response program in the regions we serve. At the national level, we work together as a network to support our nation's broader public health system, including through America's poison centers. Whether a foodborne illness outbreak, natural disaster, chemical attack, or emerging public health threat, you can count on a poison center being a part of the public health response.
▶ 0:16:53We also play a crucial role in lowering health care costs in large part through our efficient triage methods which prevent unnecessary and costly emergency department visits, enabling safe home monitoring with close followup and further preserving vital hospital resources. According to a Luen Group report, for every dollar the federal government invests in poison centers, there is a saving of over $38. That equates to over $662 million saved per year.
▶ 0:17:24In Alabama, our center has collaborated with key partners, including the Alabama Department of Public Health, to safeguard our constituents from unregulated agents like teneptine, a supplement with potent opioid-like effects that was being sold at our local gas stations. Leveraging our cent's expertise and data, we informed and enabled statewide efforts to restrict access and reduce exposures 75%.
▶ 0:17:51We are also committed to combating illicitly manufactured substances of abuse like fentinil. Engaging in datadriven decision-making as well as community outreach across all levels, poison centers help to steer resource allocation and target messaging. Our centers face challenges that threaten our ability to continue this vital work. However, like many organizations, we face a growing challenge to attract and retain qualified staff.
▶ 0:18:19The critical work of poison centers highly relies on highly trained and credentialed professionals such as toxicologists and poison specialists. And while our calls remain steady, our cases continue to grow in complexity and nuance. Additionally, public risks and by our ex by extension our mission are ever evolving. Thus, our professionals must commit to lifelong learning and be supported by advancing systems in order to do so.
▶ 0:18:47Finally, we are facing a critical risk to the National Poison Data System or NPDS. An essential tool that provides real time integrated poison center data which aids in prevention and surveillance at every level with regional data uploaded every five minutes.
▶ 0:19:05NPDS rapidly detects case clusters, anomalies, and enables swift, coordinated responses to crises of any form, driving a unified escalation of efforts across the nation. Federal agencies, including the CDC, have long leveraged NPDS to provide them with real-time data and exposure monitoring. Recent federal reorganization efforts could inadvertently jeopardize this vital partnership.
▶ 0:19:34And without continued federal support, this essential data source could lapse, risking significant disruptions in our nation's healthcare network. We request the subcommittee's continued support of our program and aid in preventing unintended consequences to NPDS, ensuring your constituents and health care professionals, as well as local, state, and federal entities have access to critical real-time data.
▶ 0:20:00On behalf of the Alabama Poison Information Center, our host institution, Children's of Alabama, and each of our nation's 53 poison centers, I thank you all for the opportunity to testify before you today. Thank you. Thanks so much. I appreciate your testimony and again, all of it will be included in the record and uh I we appreciate you giving that information to us and we look forward to working with you.
▶ 0:20:28So, ranking member Lauro, thank you. I just want to say I want to thank you for the uh for the great work and applaud the work in in Alabama. And you talked regulating tinptine, right, which is a controlled substance. what you're doing is a good example of an unsafe food additive that's being marketed to the public deceptively and it's being marketed as a dietary supplement but it has uh real consequences.
▶ 0:20:58So, I thank you for doing that. And u I I just say that we want to preserve um the programs uh that uh HERSA covers as as you do and making sure that efforts like yours don't fall by the wayside. Thank you. Thank you. Okay. Next, uh we'll hear from uh Jennifer Carroll.
▶ 0:21:22Um, Jennifer, uh, is the assistant director for, uh, children services at the Community Action Partnership of North Alabama. So, uh, welcome. Glad to have you here and look forward to your testimony. Thank you for having me. Good morning, Chairman Adhalt, Ranking Member Deloro, and members of the subcommittee. I'm Jennifer Carroll, the assistant director of Community Action Partnership of North Alabama, located in Decar, Alabama.
▶ 0:21:49As you know, Head Start provides children from disadvantaged backgrounds the opportunity to enter school ready to learn while also set their setting their families on a path to achieving economic stability and self-sufficiency. Thank you for the opportunity to share my perspective on the critical value of Head Start and the need for investment in Head Start of 14.9 billion in fiscal year 2026 to support the country's most vulnerable children.
▶ 0:22:19their families and the communities they live in. Head Start has effectively implemented a multi-generation whole child whole family model. the children attending Head Start, those in poverty, in foster care, or experiencing homelessness, the children of seasonal farm workers, American Indian and Alaskan Native children, and others known to be at risk due to life circumstances benefit from comprehensive education, health, and nutrition services
▶ 0:22:49in a safe and nurturing environment. And it's not just the children. Parents and caregivers also benefit significantly from Head Start services, including employment, housing, and educational support. In other words, Head Start is a lifeline for families seeking to achieve the American dream. The Head Start model has proved to be extremely successful.
▶ 0:23:15Research shows the Head Start alumni are more likely to graduate from high school, enroll in and graduate from college, and are less likely to experience poor health, live in poverty, or need public assistance as adults.
▶ 0:23:30Additionally, parents and caregivers having benefited from goal setting, parent training, and experiencing real engagement are more likely to join the workforce or stay employed, setting them and their families on a path of self of economic self-reliance.
▶ 0:23:47Kapna's Head Start program is a fiscally responsible pro- family pro workforce solution that improves child and family outcomes, supports work, reduces dependency, and stimulates the local economy. It is funded through a smart bipartisan investment that promotes work, strengthens families, and prepares for lifelong success.
▶ 0:24:12With your continued support, we can ensure every child, every child has a strong head start and every parent has a positive pathway forward. CAPA has 426 Head Start employees and invested over $32 million in North Alabama last year and our procurement activity directly supported over 130 local businesses.
▶ 0:24:36Unlike some federal government contracts, the grants awarded to CAPNA for our 39 Head Start centers are all spent in the communities where we operate. Imagine this economic impact replicated across the 17,672 Head Start centers located across this country.
▶ 0:24:58While Head Start grant recipients are deeply appreciative of the funds Congress has previously appropriated, I'm here to discuss our request for funding in fiscal year 2026. Head Start workforce situation has improved, but early childhood education ranks in the bottom 10% of all professions for compensation, making it difficult to recruit and retain staff.
▶ 0:25:23Those staff are necessary to work with not only the more than 750,000 ch children currently enrolled, but those eligible children not being served yet. Headstart preschool reaches only 20% of eligible children and early Head Start only 13% and the nationwide weight list is estimated to exceed 170,000. At CAPA alone, the weight list exceeds,300 children.
▶ 0:25:50With that in mind, we are recommending a cost of living adjustment of 3.2% for Head Start in fiscal year 2026. This would equal $390 million. And it is critical to our programs and to the children, families, and communities where Head Start operates.
▶ 0:26:08As I noted earlier and as detailed in my written remarks, in addition to this COLA fiscal year 2026 funding of 14.9 billion dollars for Head Start would allow programs to address critical local needs and expand recruitment and development of staff for AI programs. It would also fund the demonstrated need for expansion of Head Start and facility improvements through separate competitive grants.
▶ 0:26:35But again, a 3.2% 2% cola is the most critical need for head start in fiscal year 2026. Let me end with a story that a mother whose child attends our program program recently shared. My child has been in Head Start since 2023 and the program has exceeded my expectations. The staff genuinely care about the children and families.
▶ 0:27:02My son's language and social skills have grown more than I could imagine. As a single parent and substitute, I have gained skills that help in both my career and parenting. I am so thankful for this exceptional team. This is just one This is just one child whose life has been transformed because Congress has chosen every year to invest in Head Start.
▶ 0:27:33I urge you to continue that investment in fiscal year 2026. Thank you sincerely for your consideration of this critical request. Thank you so much for your time. Yes. Thank you so much for your testimony. I know you're very passionate about this and uh thank you and that comes through and we appreciate your you sharing that with us. So u we will uh go on next to our uh Sure. Yeah.
▶ 0:28:04I just want to just say thank you. I noticed Community Action Partnership of North Alabama. Yes, ma'am. I started my my career the community action agency in the city of New Haven. one of the first in the in the nation. And the work that gets done through community action programs is is is stellar.
▶ 0:28:23And when I just say so this is going way back for a long time ago and the way that you have continued to uh play a role in the lives of people and in particularly Head Start. Yes ma'am. Head Start works. It is an unbelievable program that we need to maintain. There have been is a document that would call for the elimination of Head Start.
▶ 0:28:49Not just say to you, you don't make promises in our business as you can, but over my dead body, will they do anything to eliminate Head Start program. It is so valuable and that includes early Head Start as well. Thank you for what you do and thank you for what you've done for that one child. Yes, ma'am. Let's multiply that across this nation. Yes, ma'am. God bless you. Thank you. Thank you. Thank you.
▶ 0:29:18And thank you everybody for being here today. You know, we we had uh I think it was our first hearing uh of this committee where we had a panel talking about quote unquote the failures of public school. I mean making tried to make a case that test scores had gone down.
▶ 0:29:40And I think what was missing from that hearing was a discussion of what it takes for a child to be ready for school and to be a successful student. This is one example and you will probably hear about lots of other programs too, especially safety net programs that get children ready. And thank you very much for what you do. I think there's no question that Head Start is gives all children if it's if you have the proper Head Start. Yes, ma'am.
▶ 0:30:10It boosts them for towards success. Thank you, sir. Thank you. Thanks again. All right. Next, we will hear from Michelle Whitten. Um, thank you. Michelle Whitten is the president and CEO and co-founder of the Global Down Syndrome Foundation. Welcome to the subcommittee and uh we look forward to your testimony. Great. Thank you so much, Chairman Adhalt, Ranking Member Deloro.
▶ 0:30:39Thank you for the opportunity to testify today. My name is Michelle C Whitten and I'm the co-founder, president, and CEO of the Global Down Syndrome Foundation and the mother of two, including a 21-year-old who happens to have Down Syndrome. Like other parents of children with Down Syndrome, our family considers Sophia a gift who has transformed our lives and the lives of those around her for the better. The genesis of global is a result of NIH leadership acknowledging that its medical research priorities do not necessarily align with medical research needs.
▶ 0:31:09People with Down syndrome have a radically different disease spectrum whereby they are highly predisposed to certain diseases such as Alzheimer's, autoimmune disorders, and leukemas and highly protected from others such as solid tumor cancers and certain types of heart attack and stroke. People with Down syndrome have complex yet treatable health needs that involve almost each of NIH's 27 institutes and centers.
▶ 0:31:32Global's goal is to elongate life and improve health outcomes for children with and adults with Down syndrome by overhauling NIH's approach to funding Down Syndrome research. When Global was established in 2009, Down syndrome was the least funded genetic condition by the NIH, receiving only $22 million out of a $ 31 billion budget.
▶ 0:31:52Despite Down syndrome being the leading cause of developmental delay in the US and the world, this important goal has been supported by the brilliant Frank Stevens, David Egan, Demani Tichuana, DeAndre Dixon, who sadly passed away in 2020, and by thousands of other self- advocates, families, researchers, and local down syndrome organizations. We were fortunate that Chairman Cole and ranking member Deloro, who led the House Labor HHS subcommittee in 2017, recognized the immense potential of Down Syndrome research.
▶ 0:32:22After testifying before this subcommittee, there was bipartisan consensus that NIH was significantly underinvesting in Down syndrome research and that this research would also benefit millions of people without Down syndrome. Thus, this led to the creation of a transformative NIH down syndrome funding program called the include project.
▶ 0:32:43The include project is a real-time example of how effective and efficient NIH can be when research priorities and plans are developed in collaborative multi-institute centralized approaches. Before include, NIH's approach to Down syndrome was actually better, faster detection, and you saw that bias in the way that research dollars were funded and spent. Down syndrome research occurred almost exclusively at the NICD.
▶ 0:33:07Today, because of include, 18 of NIH's 27 institutes are investing in Down syndrome research, including 11 institutes for the very first time. Some examples of include research research at the University of Alabama Birmingham are studying optic nerve disorders in people with Down syndrome who have a higher prevalence. Researchers at the University of Michigan are identifying molecular regulators of co-orbidities and down syndrome towards treatment for many neurological disorders.
▶ 0:33:37Scientists at Vanderbilt are researching the increased risk of leukemia in children with and without Down syndrome. Texas&M researchers are using include funding to understand bone regeneration and treatment for people with Down syndrome and those with limb loss. University of Florida researchers are examining significant genomic variance underlying congenital heart disease in patients with and without Down syndrome. We can already point to advances in research and concrete outcomes resulting from include.
▶ 0:34:04Prior to include, people with Down syndrome were essentially excluded from clinical trials. Today, there are 13 clinical trials for people with Down syndrome related to autoimmune disease, Alzheimer's, cognition deficit, regression disorder, and more. include established the data coordinating center under the leadership of Dr.
▶ 0:34:22Wakina Spinosa that now has more than 9,000 participants 4,000 whole genome sequences and hundreds of data sets that attracts new investigators include has funded the Alzheimer's trial ready cohort down syndrome under the leadership of Dr. McGraphy who runs the Alzheimer's Therapeutic Research Institute at the CEK School of Medicine. There's also significant include investment in the Down Syndrome Registry and the Down Syndrome Clinical Cohort Coordinating Center.
▶ 0:34:47All of these were new and uh really contribute to the goal of increasing lifespan and proving health outcomes. People with Down syndrome clearly benefit from include goals to structurally streamline NIH research to support a holistic life-stage approach rather than by specific diseases, conditions or organs. And the restructuring reflects what science has learned about the interconnectedness of health. We are entering a new era when it comes to valuing people with Down syndrome.
▶ 0:35:13We are seeing a renaissance for Down syndrome research and witnessing the great promise and tangible results from this program. Global is closely following reports of changes in organization and reductions in workforce at NIH. We look forward to understanding how the administration will move forward with continuing the important research being done at NIH including Down syndrome research. We also look forward to working with the new NIH director Dr.
▶ 0:35:39Bachikara and our champions in Congress to ensure US leadership in the life sciences. We hope that global can continue to be a resource for this committee and the NIH in terms of supporting impactful translational science and the dedicated researchers make a making a difference for the awesome people with Down syndrome we serve. Thank you very much. Thank you. Thank you, Mr. Chairman.
▶ 0:36:10Uh I just want to u just give you a a shout out and such a warm welcome. U Michelle um the work that you are doing um and your tenacity and commitment to this effort.
▶ 0:36:27You have been responsible for Congressman Cole and I coming together and saying that we need to focus time and effort on research on Down syndrome that it is our real responsibility to do that.
▶ 0:36:47I won't forget in 2017 and I see Frank right here who has one of the most powerful powerful personal testimonies that this subcommittee has ever heard and so what you have accomplished um and we are clearly concerned uh because you talked about it was wonderful to listen to the number of universities that are really engaged in this now you know you you made it happening.
▶ 0:37:18This is what I'm saying, you know, without your you you know your the your steadfastness on it. But there is, as we know, um the the the proposed attempt to to cut $5 billion from universities to deal cap the indirect costs at 15%.
▶ 0:37:38Um, and now there's a temporary uh uh injunction to block that policy, but we cannot allow that to happen because of the vital research that you speak about, which again changes people's lives. In this subcommittee, we're not talking about tanks and helicopters and bridges and roads. We're talking about people's lives.
▶ 0:38:01And so all that you do and all that we must do to allow you to continue with that research um is uh is imperative. And I will just say and I want to shout out again to my colleague Congressman uh Cole um and and again between the the the two of us and somewhat self-serving, but overall NIH research funding related to Down syndrome in fiscal year 2024 was $133 million.
▶ 0:38:30We need to only go up from there. Thank you very very much for your testimony. Great to have you with us here, Frank, this morning. Thank you so much. Thank you. Thank you again. Oh, next uh we are going to be hearing from um Christopher Frank. Yes, welcome. Good to have you here today.
▶ 0:38:54um and um he serves as uh the uh with Alliance for Bio Security and uh we look forward to hearing your testimony. Good morning, Chairman Adhalt, Ranking Member Deloro, members of the subcommittee. I'm Chris Fick. I'm the SVP of of at Emergent and the co-chair of the Alliance for Bio Security. As a former House staffer of 11 years, it's good to be back here in my roots. uh and I appreciate the opportunity.
▶ 0:39:24The Alliance for Biocurity represents members that develop and manufacture vaccines, therapeutics, devices, and diagnostics in response to CBRN threats. Threats such as anthrax, smallox, empulism, chemical threats, and fentanyl poisoning to name a few. Because of this, I may be the only one testifying today that truly hopes that you never have to use our products, but we know that we need them. Our members aren't simply vendors selling to the government.
▶ 0:39:55We are partners responding to the needs and requirements of the government to better protect the public andor the war fighter. It's important for me to just take a moment and say thank you to this committee for a history of bipartisan support. For example, Chairman Cole recently penned an op-ed on the importance of Barta. Congressman Harris and ranking member Delaro have in the past supported amendments for increases and have each supported the other others amendments.
▶ 0:40:23Uh and importantly under the leadership of you chairman Adhalt the last number of marks have included increases uh within austere budget conditions as we went forward. The Alliance for Biocurity has submitted written testimony that recommends specific increases in funding across medical countermeasure enterprise including Barta, the special reserve fund, pan flu, the strategic national stockpile and the office of preparedness.
▶ 0:40:52This ask represents the what. But in the remaining time, I'd like to focus on the why and simply make three points. First, the importance of the public private partnership. Governments can't do this on their own. Industry needs a level of clarity and certainty to be able to better respond to meet the needs of the government to better protect the public.
▶ 0:41:13They need to have a seat at the table early on so that we can align aspirational goals with the realities of the time and leverage industry expertise and innovation. Second, need for sustainable funding. Over the years, for those of us that have been in this space for a long time, we've moved from crisis to complacency. Many of these products lack a commercial market.
▶ 0:41:38And it was Bioshield that first envisioned the need to have a process in place so that the government could actually have medical countermeasures that it needs to protect the public should the unthinkable Funding needs to be uh maintained to allow for not just the procurement of products but to maintain the capability, the capacity and the industrial base to make to manufacture these products in the future.
▶ 0:42:05Like DoD, this is fundamentally a federal responsibility and we need to think about it in the same lines as we think about our national security issues. DoD procures guns, weapons, tanks, and ships before they declare war. And we have to have that same mindset when it comes to counter measures, knowing that we need to have these measures stockpiled safely and approved before something happens so that we're ready to respond should it happen.
▶ 0:42:34Third, we need alignment and harmonization across the MCM enterprise. Regardless of where people sit in the in the org chart, coordination is required from requirements, development, procurement, stockpiling, and response in order to actually be prepared for that next event. A former member of this committee once told me that I needed to explain this so that he could explain it to the average voter in his district. Maybe Savannah, Georgia.
▶ 0:43:04Just saying. At the end of the day, the US government identifies threats through the material threat list through DHS. The MCM enterprise is then tasked with either developing or procuring medical countermeasures, vaccines, therapeutics, devices and stockpiling those against requirements that the government has set based on different scenarios.
▶ 0:43:28If we don't have funding, it simply means that we don't have the medical counter measures and in fact we're not prepared for that threat. But it doesn't make the threat go away. By funding essential programs, maintaining a strong public private partnership, and treating biod defense as a national security priority, we can protect the American lives and ensure long-term resilience against biological threats for the future. Thank you again for the opportunity.
▶ 0:43:54The Alliance for Biocurity and our members continue to stand ready to be a partner both to this committee as well as to the US government. Thank you. Thanks so much for your testimony and um ranking member Laura, do you have any comments? Yes. I I want to just say say thank you. Um because I think that um you you made the you talked about sustainable funding.
▶ 0:44:18You talked about you know a a comparable infrastructure to deal with counter measures which I think is is critical. Um but HHS has announced it is eliminating the administration for strategic preparedness and response. That's Asper. Um they're going to discontinue as an independent agency. They will transfer some of its functions and a thousand employees to what in fact would be a severely diminished CDC.
▶ 0:44:47Um I I say that BART um is going to be combined with the Advanced Research Projects Agency for Health ARP AR A R A R A R A R A R A R A R A R A R A RPA. uh at the moment there are no details uh with regard to what um you know what what will happen uh here and I'm going to ask you I I think we need to have answers to the questions in order to safeguard the um um Barta project bioshield strategic national start pile pandemic flu preparedness
▶ 0:45:17all of what uh Asper has done in the past to make sure that it has the resources it needs because uh pandm PMIC will visit us again and we need to be be prepared in other uh disasters uh and so that we we need the confidence and we need the research and the technology that that you oversee. Thank you. Thank you. Thanks, M. And thank you and good to have you back on the house side.
▶ 0:45:48All right. Next, we'll hear from Christopher Kramer uh who is the uh current president of the American College of Cardiology. and uh Dr. Kmer, good to have you here today and look forward to your testimony. Name is Dr. Christopher Kramer and I'm the president of the American College of Cardiology or ACC. I'm a practicing cardiologist and serve as chief of cardiovascular medicine at the University of Virginia.
▶ 0:46:19I'm honored to speak on behalf of the ACC's more than 60,000 cardiovascular clinicians, including cardiologists, nurses, advanced practice providers, and researchers who work every day to prevent and treat heart disease, improve patient outcomes, and transform cardiovascular care nationwide.
▶ 0:46:37The ACC has long been committed to advancing policies that support evidence-based care and promote public health in addition to working alongside lawmakers to ensure the latest science is translated into life saving practice. Today I'm here to discuss one of the most promising and urgent opportunities to save young lives fully funding the hearts act.
▶ 0:46:59The cardiomyopathy health education awareness research and training in schools or hearts act for short was passed by Congress last year with near unanimous bipartisan support in both chambers. Such consensus is rare and it sends a powerful message. Cardiac arrest is not a partisan or regional issue. It is a public health concern and we have the tools to make a difference.
▶ 0:47:23The Hearts Act ensures that public primary and secondary schools across the country can develop cardiac emergency response plans, provide training for CPR and automated external defibrillators, better known as AEDs, and through a voluntary grant program have AEDs available on site ready for use when they are needed most. While student athletes were the original focus of this bill, its benefits extend into the communities around them.
▶ 0:47:53Schools are a gathering point, a cornerstone in American public life. Having an AED nearby helps protect every person passing through a school setting, whether they be students, parents, educators, or seniors. The new law is so important because it builds upon the foundation of sustained investment in the NIH, the CDC, and HHS. The Hearts Act is not solely about providing AEDs in schools.
▶ 0:48:21It's about leveraging the power of NIH funded research to understand and prevent heart disease and utilizing valuable public health programs at the CDC and HHS to educate and protect our patients. Every year in this country, more than 2,000 young people under the age of 25 die from sudden cardiac arrest.
▶ 0:48:42Individuals experience experiencing an out of hospital sudden cardiac arrest event face a mortality rate between 70 and 90%. Many of these deaths can be prevented if the appropriate knowledge and systems are in place. Every second counts, and having access to training and easily used technology such as AEDs can mean the difference between life and death.
▶ 0:49:07We are proud and grateful to our friends in Congress for this law designed to prevent tragic cardiac events, but passing the law was just the first step. Now, we must fund it so that its promise becomes reality. The American College of Cardiology respectfully urges the subcommittee to provide full funding for the Hearts Act in fiscal year 2026, including $25 million for grants to help schools purchase AEDs and develop cardiac emergency response plans.
▶ 0:49:35$5 million for the CDC to develop risk assessments and distribute educational materials to schools and families about conditions that lead to cardiac arrest in youth. and $20 million for the NIH to conduct research into cardiammyopathy, the most prevalent cause of sudden cardiac death in young people. We cannot overstate the value of continued investment in the NIH. It is through NIH funded research that we have learned how to prevent, treat, and manage heart conditions that once seemed untouchable.
▶ 0:50:06Since 1950, death rates from cardiovascular disease have declined 60%. And the number of people in the United States dying of a heart attack each year has dropped from 1 in two in the 1950s to now 1 in 8.5. America's leadership in medical science depends on strong investments in our nation's research infrastructure and the Harts Act is a worthy and impactful addition to that legacy.
▶ 0:50:33Distinguished members of the subcommittee, the Hearts Act was passed by Congress with the unity and urgency this issue deserves. Now, with your support, we can ensure effective nationwide implementation, protecting and investing in the health and safety of our communities. On behalf of the American College of Cardiology and the thousands of patients, families, and clinicians we represent, thank you for your time, your leadership, and your commitment to building a heart-healthy future for all Americans.
▶ 0:51:03Thank you, Dr. Kramer. Thanks for your testimony this morning and appreciate you being here and sharing that with us. Thank you member. Would you like a comment? Yes. I I just would like to and I'm sure you're Thank you. Thank you very very much for the testimony and and the the work of uh of you know AEDs.
▶ 0:51:21I I I just want to reference um our colleague uh Representative Sheila Sheriff McCormack uh who was from Florida uh is the uh lead sponsor of a bill. It's HR 2370. Um, and it's expand access to defibrillators in elementary schools and secondary and secondary schools.
▶ 0:51:43Um, and uh, it would authorize up to $25 million annually for HHS to award grants to local education agencies to purchase FDA approved defibrillators for schools. Um, and the heart association, just so that you know, uh, estimates that 50% of sudden cardiac arrest victims could survive if bystanders gave CPR and used a defibrillator immediately.
▶ 0:52:11So, this is um um again saving lives and I'm delighted to I'm sure you know about the piece of legislation, but we need to have to work it see about getting $25 million doing that. So, keep up the testimony and the and the fight and the advocacy. Thanks so much. Thank you. Thank you, Dr. Kmer. Next, we'll hear from uh Ray Sadon and uh he is the president CEO of communities and schools.
▶ 0:52:42Welcome to the U subcommittee this morning. We look forward to your testimony and uh you have the floor. Thank you, Chair Adhalt, uh Ranking Member Deloro, and members of the subcommittee. Thank you for the opportunity to provide testimony regarding the fiscal year 2026 labor HHS education appropriations bill. I'm Ray Alana. I'm president and CEO of Communities in Schools.
▶ 0:53:04Growing up in San Antonio, Texas, Communities and Schools Coordinators helped me overcome barriers to become the first in my family to attend college. And today I lead the organization that opened the doors of opportunity and access to the American dream. That journey shapes my conviction in this work. every day. And today, Communities and Schools works in 3,571 schools in 29 states.
▶ 0:53:30We connect two million students annually to resources that help them overcome barriers to success. Our evidence-based model of integrated student supports places a dedicated site coordinator inside each school to serve as the vital link between students and the resources that they need. Integrated student supports isn't another program. It is the operating system that makes all other programs and funding streams work efficiently.
▶ 0:53:56Think of integrated student supports as air traffic control for student success, coordinating federal, state, and local resources, while teachers focus on classroom instruction. Our coordinators tackle chronic absenteeism, mental health concerns, and basic needs like transportation and nutrition. As our founder, Bill Milikin, described, students cannot be turned on to learning until they're turned on to living. And living can be sometimes the hardest part. At communities and schools, we've proven that being present matters.
▶ 0:54:2799% of the case managed students we work with show up and make academic and behavioral strides year after year. Our seniors graduate 96% rate, representing significant lifetime tax contributions and cost savings. Federal dollars are crucial in our integrated student supports ecosystem. Core ESA investments like Title One and Title 4 not only underwrite direct services but also unlock additional investment.
▶ 0:54:54For every federal dollar that supports integrated student supports, we leverage an additional $4 from state, local, and private resources. The strategic architecture of federal education funding matters. When title one schools implement integrated student supports, they optimize their per pupil allocation by addressing non-academic barriers. Title 4A grants become more effective when delivered through an integrated supports framework.
▶ 0:55:20And integrated student supports enables Americaore and WEOA dollars to achieve cross- sector outcomes, advancing education, workforce development, and economic mobility gains. Parents remain central in our work. Our site coordinators work directly with 3,6 360,000 families annually, ensuring their voice drives the support that their children receive. Integrated student supports honors local control by strengthening what communities are already doing.
▶ 0:55:50We see success in communities across the country. In rural Jackson County, North Carolina, community schools uh student support specialist David Collie implemented the Tarheel Charm Challenge to improve attendance and drive academic progress. In Montgomery, Alabama, community school site coordinator Kimberly Bird reduces absenteeism among 74% of her students through personalized plans and schoolwide initiatives like attendance dance competitions. Our success builds on bipartisan cooperation.
▶ 0:56:17Congress recognized integrated student supports in the bipartisan Every Student Succeeds Act of 2015. Schools implementing evidence-based integrated student supports are seeing dramatic improvements in attendance, behavior, coursework, and graduation rates. Integrated student support serves as both a standalone approach but is also a foundational pillar of a comprehensive model of including communities and schools or community schools.
▶ 0:56:43Its flexibility allows rural, suburban, and urban communities to tailor implementation to fit their specific needs while maintaining the evidence-based core that drives results. The urgency of this work cannot be overstated. Today, as 15 million classroom seats sit empty across America, these strategic appropriations represent smart fiscal stewardship that taxpayers deserve and our children need.
▶ 0:57:06I urge Congress to protect and strengthen core federal investments that support integrated student supports and community schools, specifically Title One funding, Title 4A student supports and academic enrichment grants, full service community schools, 21st century learning center allocations, project aware grants, Americanore funding, WEOA and WEOA investments. Our children deserve nothing less than the fiscally responsible approach to education.
▶ 0:57:33When we give the students the support they need, they show up for school today and ultimately they show up for America tomorrow. Thank you. Thank you so much uh for your testimony again and for being here today. Thank you Lauro. Thank you. Thank you very much, Mr. Chairman. Thank you so much uh for for your testimony.
▶ 0:57:53You know, um, again, early on in my career, I grew up in New Haven, Connecticut, and the Kante Community School was just almost across the street from our house. And while I finished my graduate degree, and I didn't have a job yet. So that I what I did was I went to volunteer at the community school, you know, every day. And what an eyeopener that was.
▶ 0:58:17That is what propelled me to introduce funding for community schools in the uh the labor HHS uh funding bill. I I this was a facility that was open from like six o'clock in the morning until 9:00 at night. There was an academic program, sports program, mothers, fathers, um grandmothers and so forth where they're interacting with kids and so forth.
▶ 0:58:41It's just beautiful um educational overall educational experience and I believe helped to strengthen the lives of of of our kids. But you must know and I'm not going to pull punches here. Uh the community schools funding for the this is 2025 I believe has been almost cut in half. It's $150 million now, but it's the attempt is to cut it in half.
▶ 0:59:06And in the 2025 bill, my colleagues on the other side of the aisle have proposed that eliminates eliminates WEOA for youth and cuts REIOA funding for adults. I'm asking you and your colleagues around the country who support community schools understand their value. Understand the value of these programs that your voices need to be heard loud and clear.
▶ 0:59:33that we can't roll back these um uh the resources that have provide these new opportunities for children and to help to transform their lives. So, I'm pleading with you to please organize and let people know how you value community schools. Title One, as I said earlier, Title One, there's cases being made to eliminate Title One. I'm not making it up.
▶ 1:00:04You can go and look. It's right there in black to eliminate title 300,000 teachers across the country. We need your help. Thank you for your testimony. Thank for the work that you're doing and thank you for making a difference in the lives of our All right.
▶ 1:00:24Uh next we will hear from uh Teresa Soal uh who is a state uh epidemiologist program director infectious disease and epidemiology section of Louisiana Department of Health. Welcome to the subcommittee. Glad to have you here and look forward to your testimony. Thank you. Chair Adhalt. Is my mic on?
▶ 1:01:03Got it. Okay. Thank you, uh, Chair Adhalt, Ranking Member Deloro, and Representative Llo, thank you for the opportunity, um, to allow me to testify before you here today. I'm Teresa, a member of the executive board of the Council of State and Territorial Epidemiologists, and I am the Louisiana Epidemiologist.
▶ 1:01:25I'm here today representing CST and its 3600 members nationwide to talk about the important work epidemiologists do to save lives every day. I want to talk about the collaboration and support we get from the CDC and specifically two essential CDC programs. the epidemiology and laboratory capacity program and public health data modernization. Epidemiologists are disease detectives.
▶ 1:01:55We work around the country to keep our community safe, stopping outbreaks and preventing every type of disease threat. Nationally, federal dollars make up more than 80% of state epidemiology budgets. In some states, like Louisiana, it's even more. 90% of my team's budget comes from CDC. Without CDC funding, we could not do our jobs.
▶ 1:02:21Key to this is CDC's epidemiology and laboratory capacity program or ELC. ELC is the only source of core infectious disease funding for epidemiologists in state and local health departments. It is what allows us to respond to new outbreaks and threats. In January, you may remember, Louisiana reported the first human death related to H5N1 or bird flu.
▶ 1:02:48ELC is the only I'm sorry, um, this patient became sick after exposure to a backyard bird flock. Our team of ELC funded epidemiologists carried out an extensive investigation including identifying and monitoring nearly 30 individuals who had been exposed to bird flu and coordinating with the hospital to prevent transmission to health care workers and other hospital patients.
▶ 1:03:15Unfortunately, last month, pandemic era resources that were allocated to states from CDC and were still being used to support our epidemiology and data modernization work efforts were cancelled unexpectedly, putting our work in danger.
▶ 1:03:33This immediate loss of existing funding and the fact that the ELC funding line has not grown since 2011 means state and local epidemiology efforts across the country are tremendously underfunded. CST estimates that an 2537 epidemiologists are needed in state health departments to meet basic public health needs. We also need to modernize our public health data systems.
▶ 1:04:03Epidemiologists depend on data. In Louisiana and public health departments across the country, we are working to get better, faster, actionable data that can help us make decisions that will keep our communities safe. I'm so proud to be joined here in DC today by my 16-year-old daughter, Elise. She and her 14-year-old brother, Gabriel, remind me why I do this. To make a difference for our kids across this country.
▶ 1:04:32Data modernization will help me protect their future. In 2021, Hurricane Ida knocked out the power in the New Orleans area. Our entire infectious disease data system was out of commission for about a week. We received no electronic notifications of diseases from healthc care providers, severely hobbling our public health response.
▶ 1:04:55Thanks to federal investments, we have started the process of moving our public health data to a modern cloud-based system that will be safe during a natural disaster. Unfortunately, these upgrades are now at risk. Many health departments have had to lay off staff or discontinue system maintenance contracts. If we stop investing now or pull back existing resources, we will be forced to move backwards. Systems have only been partially upgraded.
▶ 1:05:25They remain in dire need of security enhancements and they lack sustained trained personnel to keep operational. Cuts will leave us behind industry standards. And yes, going back to the fax machine, I am here before you today to plead for sustained resources for both ELC and data modernization.
▶ 1:05:50Specifically, CST requests that you fully fund the CDC and appropriate 340 million for data modernization and 120 million for the ELCbased funding. These dollars make our public health system more efficient, not less. They are essential to our ability to detect and respond to public health threats of all kinds.
▶ 1:06:14Foodbornne illnesses, respiratory viruses, measles, lead poisoning, opioid overdoses, occupational diseases, and more. We cannot keep Americans safe without your support for our work. Thank Thank you, Miss Ole. And I'd like to recognize our vice chair, Miss Dellores. Thank you. Thank you very, very much.
▶ 1:06:41Um, 2019, Janet Hamilton, Council of State and Territorial Epidemiologist, CSTE, testified at public witness day to request funding to establish a new effort, public health data modernization. Compelling.
▶ 1:06:59You know, when I said earlier on in my opening remarks, what people say here and the pleas that you make on your behalf often get translated into resources in order to carry out, you know, the functions that you care so deeply about. Well, that was the case.
▶ 1:07:14I introduced the uh data modernization uh uh uh program and I created that uh and I'm tabby to tell in that year's bill in 2020 the labor HHS education appropriations bill we included $50 million for this this effort. Over the next four years we increased annual funding for public health data modernization to $75 million. Significant progress.
▶ 1:07:43significant progress but you said it very eloquently. We cannot go back to machines. We cannot be it is the lifeblood data and understanding it so that we can fight disease illness in this nation and it has to be a comprehensive approach. But I'm going to be frank with you.
▶ 1:08:08Elon Musk and President Trump have fired 2400 CDC employees, 20% of the CDC workforce of 13,000 people. HHS is terminating 11 billion in supplemental funding provided to state and local health departments for public health activities including infectious disease surveillance and laboratory testing.
▶ 1:08:32And understand for everybody here, it is the laboratories that is the infrastructure that allows CDC to do what it does. And if there's no ability to be able to collect and analyze data at the local level so that you can be it's preventative as well as being responsive. That is what we're here dealing with uh today. um grant funding additional $2.9 billion.
▶ 1:09:02Uh as Doge is reportedly demanding that CS CDC slash that funding, it would illegally cut CDC's annual discretionary budget of $9.2 billion by more than 30%. We cannot undo years of improvements.
▶ 1:09:21We cannot return to a public health our public health system to a time when the sharing was so slow it was burdensome and we could not react the benefit of saving lives saving the lives of the people in this country. So again your advocacy is so welcomed and needed at this time.
▶ 1:09:46I thank you very very much for being there and helping to build that infrastructure that's so critically necessary. Thanks so much. Thank you Thank you ranking member and thank you so much Mrs. Oel for your time and for all you do for Louisianans. I appreciate you. Thank you very much. All right. We'd now like to invite Miss Sarah Shapiro. She's the executive director for the Alliance of Learning Innovation to give her testimony.
▶ 1:10:16Miss Shafi, you have five minutes. Thank you so much. There we go. Thank you, Chairman Ederhol, Ranking Member Deloro, Vice Chair Leto, and members of the subcommittee for having me today. I'm Sarah Shapiro, executive director of the Alliance for Learning Innovation, or ally.
▶ 1:10:37We're a bipartisan coalition that brings together 90 plus education nonprofits and industry leaders to advocate for building a better research and development infrastructure in education. I'm grateful for the opportunity to speak about how in fiscal year 2026, a $900 million investment in the Institute of Education Sciences or IAS and $284 million for the Education Innovation and Research Program can continue education R&D's outsized impact
▶ 1:11:08on improving student learning. America is in the middle of a critical education crisis. The nation's report card or NAPE reveals that onethird of eighth graders score below basic in reading. One quarter of fourth graders score below basic in math. These alarming data points collected by IEES reflect a significant decline in student achievement from 2019.
▶ 1:11:32This directly threatens our national security and economic At the same time, federal investments in education R&D have produced significant results over the last 20 years. For example, in 2024, Alabama adopted a literacy curriculum based on the science of reading, which is a body of evidence developed through federal investment. This investment in research helped states craft literacy initiatives with hugely impressive outcomes.
▶ 1:12:02Mississippi's ranking in fourth grade reading improved from 49th to 21st between 2013 and 2022. Louisiana's from 50th to 16th. It's amazing. Between 2019 2024, State Superintendent Carrie Wright, who led Mississippi's impressive literacy gains, is now implementing similar efforts based on the science of reading in Maryland.
▶ 1:12:27Examples like these make clear that federal support for education R&D can provide the data states need to make decisions about which programs are best for their students. This approach respects local autonomy and ensures evidence-based practices are what drive policy. Moreover, federal R&D investments help our nation sees opportunities like incorporating AI in the classroom and strengthening career pathways.
▶ 1:12:54As the executive director of Ally, I see an opportunity to work with both sides of the aisle to update our federal investments in education R&D. I'm working with partners to draft a blueprint envisioning a revitalized and rebuilt fed federal education R&D system. And we're thinking about it with three pillars. The first is that the federal government should invest in worldclass data systems to promote transparency and evidence-based decision-making in schools.
▶ 1:13:23This means leveraging the valuable work of the National Center for Education Statistics to improve transparency about K12 education. This includes bipartisan efforts like the NAPE test. The federal government can also incentivize state data systems to link information across agencies revealing how interventions impact students from birth through career. Second, the federal government should support state and local education leaders to know what works and do what works.
▶ 1:13:52uh we must leverage decades of best practices identified through federal investments, make this information broadly available and help scale these practices into classrooms. And third, the federal government should facilitate breakthroughs in education innovation to help the US retain its competitive edge. Drawing inspiration from advanced research project agencies like the def defense's DARPA, the federal government should fund cuttingedge R&D to solve education's biggest challenges.
▶ 1:14:22To realize this blueprint in fiscal year 2026, the Alliance for Learning Innovation respectfully requests at least 900 million for the Institute of Education Sciences supporting critical initiatives like NAPE, Accelerate, Transform, and Scale and Statewide Longitudinal Data Systems Grant Program. and 284 million for the education innovation and research program to advance career connected learning and emerging technologies.
▶ 1:14:49Lastly, we encourage Congress to ensure federal agencies like IIEES have the appropriate staffing levels to ensure that congressionallymandated programs reach kids. Thank you for this opportunity to present this testimony on behalf of the Alliance for Learning Innovation Coalition. Thank you, Miss Shapiro. Ranking member Dellores, thank you so much and thank you for, you know, really laying out, you know, the work that you work that you do.
▶ 1:15:17Uh um you know that there is an executive order to eliminate the Department of Education. Um and you know that um Elon Musk has fired thousands of staff from the Department of Education, as much as one half of the department's workforce.
▶ 1:15:35Musk has canceled $881 million in multi-year research contracts awarded under the Institute of Education Sciences, IEES, of which you are speaking so eloquently that has halted terminated all the scientific research that was ongoing and it impacts various education methods on student learning and how kids learn.
▶ 1:16:01I think it's probably the one area that has been the most severely cut and so every eliminated every single contract in this agency which I find troubling in this regard. It is that this is such a bipartisan effort. It really is.
▶ 1:16:19And so many of the programs that we talk about, they wouldn't have been, you know, wound up in the bill or signed into law if we didn't have bipartisan support for this because in appropriations, unless you have uh bipartisan uh and bicamel, House and Senate, Democrats and Republicans have to agree before a bill goes to the president for signature.
▶ 1:16:41And so it I'm trying to grapple with why we would take this valuable um uh e effort which we all support in some way which does the scientific research that looks at you know how our kids are learning what are the best methods what are the innovations which are the way and and and and and push it aside.
▶ 1:17:08What that means to me is that we have to fight to get it back and to to to to keep it because it is such a powerful tool that you have in the education uh in the education uh profession. So I look to you again as I've looked to others. Uh your voices uh really need to be heard. Your testimony is powerful.
▶ 1:17:28testimony needs to get to everyone so that people can understand uh what you do, how you do it, and uh what what resources you need to accomplish accomplish your goals. Thank you very very much for your work. Thank you, ranking member, and thank you, Miss Shapiro, for having today your testimony. I'd now like to call on Dr. Scott Harris.
▶ 1:18:00Thank you, Dr. Harris. Good morning. The floor is yours. Thank you very much. Uh, good morning, Ranking Member Delaro. Congresswoman Ledlo. Thank you so much for having me. I'm Scott Harris. I'm serve as Alabama State Health Officer and also currently is president of Ato, which is the Association of State and Territorial Health Officials. We represent the public health agencies of the states of DC and US territories. We're a nonpartisan organization.
▶ 1:18:26Uh but although we have members representing red and blue and purple jurisdictions, we're actually all united uh in believing that we need sustained and flexible public health funding in order to keep our country safe and healthy. I've practiced medicine in Alabama for almost 35 years. I've seen firsthand how important public health is to Alamians, uh to America. We don't just treat illness after people become ill, but actually work to prevent it.
▶ 1:18:55Um, our country, the United States, doesn't have a national system of public health. We only have a nationwide system of public health. We're a patchwork quilt of federal agencies and state health departments and local and territorial and tribal public health authorities. But public health problems don't just stop at the state border. Uh and so our nation can only be as safe and healthy as a weakest length of that patchwork quilt. Most state health departments rely very heavily on federal dollars.
▶ 1:19:24Uh in some states up to 80% of funding for state department comes for of health departments comes from federal sources mostly from CDC. In my state that number is about 70%. Uh so in my state without these federal dollars over half a million children would not have access to routine vaccinations. Uh, and this is at a time when we're seeing outbreaks and deaths from diseases like measles and hooping cough.
▶ 1:19:49Thousands of women in Alabama would not have the ability to have pepsmears or mammograms without the federal income that we have. There are over 4,000 Alamians living with HIV who would not be able to afford their medications. And these are just a few of among literally hundreds of public health programs nationwide that exist only because of congressional support. Health departments tend to work behind the scenes until there's a crisis.
▶ 1:20:14Uh, for example, recently in North Carolina, officials learned that children were being poisoned by Applesauce products contaminated with lead. Uh, once that became known, public health sprang into action around the country. Our environmentalists in Alabama found many locations that were continuing to sell these products. They're still on the shelves in spite of an FDA recall, and they were able to prevent them from being sold. They prevented children in our state from from potentially permanent neurologic damage.
▶ 1:20:43If that's a story you didn't know already, it's because public health is just out there doing its job. We we often say to people, public health may well have saved your life today, but you probably just didn't know it. The public health officials in each one of your states are working every day on many important things like measles, rural hospital closures, opioids, mental health crisis. But amid this work, we were all very shocked recently to learn overnight we had lost 11 billion in federal funding without any warning at all.
▶ 1:21:12These are funds that had already been appropriated by Congress. They had been approved by federal agencies for us to spend. They weren't just COVID dollars. They were approved to be used for many other things such as measles testing, bioteterrorism, threat preparedness, protecting communities, supporting our local hospitals. The abrupt loss of those funds will stop essential work. It will lead to thousands of layoffs of state public health employees around the country.
▶ 1:21:39We're also deeply concerned about the lack of transparency with the recent restructuring at HHS. We all share the common goal of increasing government efficiency and using our resources responsibly, but eliminating large numbers of public health professionals overnight with no advanced notice or even an explanation as to why risk the health and safety of our country. So we respectfully ask Congress for three things. First, we ask you to help sustain investments to state and territorial health departments. The return on investment generated by public health spending is clear.
▶ 1:22:09Preventing disease saves lives but also saves dollars. Secondly, we just ask you to please support us in our wish to be included in the decisions that affect us in our work. We are on the front lines implementing federal policy. We're the boots on the ground that do that work. and it's really vital that we be consulted on the impact of funding cuts or administrative changes. Finally, we ask you for flexibility in how federal funds are felt. We're so grateful to this subcommittee.
▶ 1:22:36We're so grateful to Congress for the support of public health infrastructure and capacity at 350 million for FY25. We respectfully request 1 billion to CDC in FY26. We understand the budget challenges this year, but this allows your own state health officials to make the most efficient use of federal dollars to address the public health needs in your own states. So, I sincerely appreciate the opportunity to be here today.
▶ 1:23:01Please know that ASO and its individual members stand ready to partner with Congress, to partner with the administration to keep this country safe and healthy. Thank you for your service to this country and thank you for having me today. Thank you, Dr. Harris. Ranking member Dellora. Thank you. Thank you so much, Dr. Harris, um, you've just you've just laid it out.
▶ 1:23:21And when you when you talk about 11 billion in supplemented funding to state and local health departments, including infectious disease surveillance, laboratory testing, but no warning. No warning.
▶ 1:23:37If you watch the TV last week, you saw a lineup before the Department of Health and Human Services where people were going to work and when they got there, their ID was checked and some of them were said, "You're you're no longer here. You're gone. You are gone." But it's it's the individual. Yes.
▶ 1:24:01They said, "But the work that the individual does, the repercussions, what you're talking about in terms of of health of this nation and the people of this nation." Um, I I I I have a hard time understanding it. I have to imagine you have a hard time understanding it, watching, you know, the the fruits of your labor and the people of what you're doing and how much progress that you have made. But they're going further.
▶ 1:24:29They're going to look at a 30% cut of the CDC. Um, and that, as I said earlier, state and local public health departments, they are the lifeblood. You know, I I hear day in and day out around here, let's give the money to the states. Well, hell, we're giving the money to the states. You just cut it off and said no.
▶ 1:24:58in the ability once again what this subcommittee does in so many respects is the work that you do and all of the people here is to save lives. We don't have and shouldn't have a higher priority. So I ask you and all of the ASTO officials, you have to stand up, be counted, and don't take no for an answer. Thank you.
▶ 1:25:27Thank you, ranking member, and thank you so much, Dr. Harris, for giving your today. I'd like to call up Dr. Colleen Kelly, uh, faculty member in the division of infectious diseases at Emory University School of Medicine with a secondary appointment in the department of epide epidemiology at Rolland School of Public Health. Thank you for being here today. Uh, good morning. Uh, thank you, Vice Chair Lelo and ranking member Deloro. Um, thank you for this invitation to testify. My name is Dr. Colleen Kelly.
▶ 1:25:57I'm a physician in research in the division of infectious diseases at Emory University School of Medicine as well as the Grady Health System Pon Center. I'm here today to testify on behalf of uh the HIV medicine association which I serve as chair. HIVMA represents nearly 6,000 HIV clinicians and researchers working in communities across the country and is part of the Infectious Disease Society of America. This opportunity is important to me because we stand at a crossroads that will determine the fate of millions and drive up health care costs.
▶ 1:26:28Decades of groundbreaking advancements in HIV treatment and prevention have saved lives. Yet, the programs and research that have propelled these advances are now in peril. To prevent what we fear could be a looming HIV public health crisis in our country, please consider the requests I submitted in my written statement as you make important funding decisions for fiscal year 2026.
▶ 1:26:50These requests are for sustained funding for the ending the HIV epidemic initiative, the center for disease control and prevention, the Ryan White HIV AIDS program, and research at the National Institutes of Health. As a college student in 1996, I volunteered at Connor's Nursery, which was a home for children with HIV AIDS in West Palm Beach, Florida. Many of the children were orphans due to the disease and were facing serious medical illnesses and limited life expecties themselves.
▶ 1:27:15I played with the seriously ill children while nurses fed some through feeding tubes and coaxed others to take medications that tasted horribly. I don't know what happened to them. I'm saddened to think that many uh succumb to HIV AIDS before effective treatment was available to them.
▶ 1:27:30Now almost 30 years later, I'm here before you as an HIV physician and researcher who witnesses in my Atlanta clinic daily the profound impact of our country's investment in HIV research, care, and prevention on people with HIV who are thriving as well as those who are benefiting from availability of pre-exposure prophylaxis or PREP, an HIV prevention drug.
▶ 1:27:52Our clinic serves over 6,000 people with HIV thanks to the support of the Ryan White uh program and more than 40 other clinics and community programs in Georgia alone also count on the Ryan White program to offer HIV services. Since my time volunteering at Connor's Nursery, medical research has given us the tools to end the HIV epidemic, a successful initiative started by President Trump in 2019.
▶ 1:28:16We have medications that are highly effective at suppressing virus to undetectable levels and ensuring that people, including newborns, who may be exposed to HIV do not acquire it. Due to these advances, Connor's nursery closed in 2005 because their services were no longer needed. Today, new HIV infections in the US are at the lowest levels in history. The rate of perinatal transmission during birth is now less than 1% in the US, down from 30% in the absence of HIV testing and treatment.
▶ 1:28:47Thanks to decades of bipartisan support, federal programs have fueled the remarkable transformation of HIV from a certain fatal disease to a chronic, easily managed condition for those with access to treatment. HIV can also be prevented with a daily pill for less than a dollar a day, which is important since inverting one case of HIV saves an average half a million dollar of lifetime treatment costs.
▶ 1:29:11However, we are not done yet, and we are now confronted with an alarming reality that decades of progress in the fight against HIV AIDS are being reversed. In recent weeks, we have witnessed the terminations of hundreds of HIV uh research grants and the abrupt dismantling of critical public health infrastructure and programs such as the office of infectious diseases and HIV policy, CDC's division of HIV prevention and the sexually transmitted infection lab branch at CDC, which is the only lab in
▶ 1:29:41the country that monitors for the very real threat of drugresistant gorrhea. While we acknowledge there are opportunities to make programs more efficient, decisions on how to re reduce costs without causing harm should be led by programmatic leaders informed by the constituents, providers, and communities they serve. Without widespread access to treatment, deaths from HIV AIDS will increase. Without HIV testing and prevention services, including prep, new HIV infections will surge.
▶ 1:30:12Without HIV research, pre treat treatment and prevention will not reach the people who need them and we will not find a cure for HIV. We are now facing the very real possibility that places like Connor's Nursery will be needed once again to care for orphans with HIV AIDS in the United States of America. Thank you for your time and for considering HIVMA's funding requests that are critical to sustaining progress in ending the HIV epidemic. Thank you, Dr. Kelly. Ranking member Delorea.
▶ 1:30:41Thanks very very much Dr. Dr. Kelly. Thank you for your poignant remarks. I'm reminded that I was at a hearing earlier this week um with the um state foreign operations where there was a discussion of the PEPAR program which as you know was a George Bush um a really miracle and 23 million lives saved and we're looking at potentially another you know 20 million people that
▶ 1:31:12uh that we need to be able to uh to assist. But PEPFAR is also um under the gun. And um uh so that the threat of of of of HIV with all of the of the um progress that has been made is um really pretty staggering.
▶ 1:31:35I even asked the question then if we're going to end this, what are we have we squandered all of that money that we spent uh saving lives uh in Africa and overseas? Have have we just you know because we're somehow we're not going to continue to do what we're doing. But as I see the parallel is also on the domestic side. the parallel.
▶ 1:32:03This is not just a oneoff with regard to PEP FAR where they had a problem but they corrected it but this is writ large with regard to a of uh HIV. Um u according to reports Elon Musk fired about 1/4 of CDC staff at the National Center for HIV, Viral Hepatitis, STD and Tuberculosis Prevention.
▶ 1:32:29The biggest cuts came from the division of HIV prevention. The global health center division of global HIV and TB was also reduced by roughly a fourth. Um I I know how many people have been fired from the uh division of HIV prevention or any other division of CDC. Uh we we we can't get the information. We cannot get the information. We write letters.
▶ 1:32:59It's like a tree falling in the forest. You, you know, you just don't have any response back. NIH has been cancelling research grants that support HIV AIDS research. Dr. Jean Morazzo, director of the National Institute of Allergy and Infectious Diseases, NIID, was fired last week.
▶ 1:33:20So I am concerned and deeply concerned about the cuts to HIV programs across multiple agencies and I think what we will see in that case is a reversal a deadly reversal of the progress that we made in recent decades. Just one other example, the ending. We have been funding the HIV uh HIV epidemic initi ending the HIV epidemic initiative.
▶ 1:33:49Uh that was first proposed by the first Trump administration and we have been funding that effort because the research has been so powerful and the results so powerful that we could move and using that word ending the HIV epidemic. So, and that has been a bipartisan effort.
▶ 1:34:08Uh, it included HIV prevention at CDC, HIV treatment at HERSA, HIV research at the NIH, but now the Trump administration is cancelling all of these funds. These are lifesaving activities. As I said, this is not a road, a bridge, a playground. This is lifesaving.
▶ 1:34:31So I think we have to understand the scope of what's happening here domestically and internationally and we have to gather the forces that will fight back on this because God help us if we go backward and on our watch many more people millions of people will die in the United States and all over this globe. God help us. Thank you for being here today.
▶ 1:35:00Thank you for your testimony. Thank you for your life-saving work. Thank you. Thank you, ranking member. And thank you so much, Dr. Kelly, for being with us today. I'd now like to recognize ranking member Delora for closing remarks.
▶ 1:35:17I want to thank the chair and I thank her for her good work and I know that she has interests in uh research and what we do in terms of life saving uh for children for adults where wherever it is. I I can o only go back to I I think this is such an important day uh for all of us in this committee. I said that at the outset.
▶ 1:35:42It's one of the most important parts of the subcommittee's process because so much of what you say here uh gets can get translated uh uh into uh action and resources. It has been done in the past. We all struggle with budgets and trying to address uh the issues to the best that we can.
▶ 1:36:07But we're not in the business of wholesale firing and dismantling the very foundations of our public health system, of our education system, of our ability to provide people with the training and the education that they need and ought to be gainfully employed.
▶ 1:36:38That is the scope of this committee. labor, health, human services, and education. And I think at the moment that the agencies that are included in this portfolio are the agencies that have been the most severely impacted with whatever is going on and the loss 20,000 people.
▶ 1:37:09lose the expertise, the commitment and dedication. We lose the science and the breakthroughs because researchers if they can't carry out that research are already looking to go to Canada, to go to Europe, to go to China.
▶ 1:37:33There have been three crown I believe of our public health system, NIH, the CDC and the FDA that has given us has given to the world the best finest research and innovation and ability to conquer illness and disease.
▶ 1:38:02When mindlessly and flagrantly and unlawfully strip those agencies of their ability to do their job, we are not living up to a moral responsibility that we have. That's not a responsibility. It's a moral responsibility.
▶ 1:38:26And as I said to a prior witness, God help us if we allow this to happen on our watch. I for one and I ask you to fight alongside of us because it's your work, your drive, your commitment, your expertise that is being challenged. Thank you all for being here today. Thank you for what you do and thank you for not being afraid to speak up on behalf of the work that you do.
▶ 1:38:57Really, I say this very sincerely. God bless you because you do save lives. Thank you. Thank you, Ranking Member Deloro. And a special thank you to all of our witnesses. Thank you so much for your time and all of the hard work that you do. We truly appreciate you. And with that, this hearing is adjourned. Thank you.