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S. HRG. 111–451

NOMINATIONS OF JIM ESQUEA, ELLEN

GLONINGER MURRAY, AND BRYAN SAMUELS

HEARING

BEFORE THE

COMMITTEE ON FINANCE

UNITED STATES SENATE

ONE HUNDRED ELEVENTH CONGRESS

FIRST SESSION

ON THE

NOMINATIONS OF

JIM ESQUEA, TO BE ASSISTANT SECRETARY FOR LEGISLATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES; ELLEN GLONINGER

MURRAY, TO BE ASSISTANT SECRETARY FOR RESOURCES AND TECHNOLOGY, DEPARTMENT OF HEALTH AND HUMAN SERVICES; AND

BRYAN SAMUELS, TO BE COMMISSIONER OF CHILDREN, YOUTH, AND

FAMILIES, DEPARTMENT OF HEALTH AND HUMAN SERVICES

OCTOBER 15, 2009

(

Printed for the use of the Committee on Finance

COMMITTEE ON FINANCE

MAX BAUCUS, Montana, Chairman

JOHN D. ROCKEFELLER IV, West Virginia

KENT CONRAD, North Dakota

JEFF BINGAMAN, New Mexico

JOHN F. KERRY, Massachusetts

BLANCHE L. LINCOLN, Arkansas

RON WYDEN, Oregon

CHARLES E. SCHUMER, New York

DEBBIE STABENOW, Michigan

MARIA CANTWELL, Washington

BILL NELSON, Florida

ROBERT MENENDEZ, New Jersey

THOMAS R. CARPER, Delaware

CHUCK GRASSLEY, Iowa

ORRIN G. HATCH, Utah

OLYMPIA J. SNOWE, Maine

JON KYL, Arizona

JIM BUNNING, Kentucky

MIKE CRAPO, Idaho

PAT ROBERTS, Kansas

JOHN ENSIGN, Nevada

MICHAEL B. ENZI, Wyoming

JOHN CORNYN, Texas

RUSSELL SULLIVAN, Staff Director

KOLAN DAVIS, Republican Staff Director and Chief Counsel

(II)

C O N T E N T S

OPENING STATEMENTS

Page

Baucus, Hon. Max, a U.S. Senator from Montana, chairman, Committee

on Finance ............................................................................................................ 1

Grassley, Hon. Chuck, a U.S. Senator from Iowa ................................................. 3

Conrad, Hon. Kent, a U.S. Senator from North Dakota ...................................... 7

ADMINISTRATION NOMINEES

Esquea, Jim, nominated to be Assistant Secretary for Legislation, Department

of Health and Human Services, Washington, DC ............................................. 8

Murray, Ellen Gloninger, nominated to be Assistant Secretary for Resources

and Technology, Department of Health and Human Services, Washington,

DC .......................................................................................................................... 11

Samuels, Bryan, nominated to be Commissioner of Children, Youth, and

Families, Department of Health and Human Services, Washington, DC ....... 13

WITNESS

Harkin, Hon. Tom, a U.S. Senator from Iowa ....................................................... 5

ALPHABETICAL LISTING AND APPENDIX MATERIAL

Baucus, Hon. Max:

Opening statement ........................................................................................... 1

Conrad, Hon. Kent:

Opening statement ........................................................................................... 7

Esquea, Jim:

Testimony .......................................................................................................... 8

Prepared statement .......................................................................................... 27

Biographical information ................................................................................. 29

Grassley, Hon. Chuck:

Opening statement ........................................................................................... 3

Harkin, Hon. Tom:

Testimony .......................................................................................................... 5

Murray, Ellen Gloninger:

Testimony .......................................................................................................... 11

Prepared statement .......................................................................................... 37

Biographical information ................................................................................. 39

Samuels, Bryan:

Testimony .......................................................................................................... 13

Prepared statement .......................................................................................... 48

Biographical information ................................................................................. 52

(III)

(1)

NOMINATIONS OF JIM ESQUEA, TO BE ASSISTANT SECRETARY FOR LEGISLATION,

DEPARTMENT OF HEALTH AND HUMAN

SERVICES; ELLEN GLONINGER MURRAY, TO

BE ASSISTANT SECRETARY FOR RESOURCES AND TECHNOLOGY, DEPARTMENT

OF HEALTH AND HUMAN SERVICES; AND

BRYAN SAMUELS, TO BE COMMISSIONER

OF CHILDREN, YOUTH, AND FAMILIES,

DEPARTMENT OF HEALTH AND HUMAN

SERVICES

THURSDAY, OCTOBER 15, 2009

U.S. SENATE,

COMMITTEE ON FINANCE,

Washington, DC.

The hearing was convened, pursuant to notice, at 10:08 a.m., in

room SD–215, Dirksen Senate Office Building, Hon. Max Baucus

(chairman of the committee) presiding.

Present: Senators Conrad and Grassley.

Also present: Democratic Staff: Bill Dauster, Deputy Staff Director; Ayesha Khanna, International Trade Counsel; Deidra HenrySpires, Professional Staff; Mary Baker, Detailee; and Liz Fowler,

Senior Counsel to the chairman and Chief Health Counsel. Republican Staff: Mark Hayes, Health Policy Director and Chief Health

Counsel; Michael Park, Health Policy Advisor; Kevin Courtois,

Health Staff Assistant; Nick Wyatt, Tax and Nomination Professional Staff Member; and Becky Shipp, Health Policy Advisor.

OPENING STATEMENT OF HON. MAX BAUCUS, A U.S. SENATOR

FROM MONTANA, CHAIRMAN, COMMITTEE ON FINANCE

The CHAIRMAN. The hearing will come to order.

The English novelist George Eliot said: ‘‘The reward of one duty

is the power to fulfill another.’’

To each of our witnesses today: you have ably performed duties

in public service. Your reward is that President Obama has called

on you to fulfill another duty for your country, and I counsel you

to fulfill your new duty honestly and ably, for you should wish to

do no less.

Mr. Esquea, President Obama nominated you to be Assistant

Secretary for Legislation at the Department of Health and Human

2

Services. This is not the first time that you have been called upon

to serve your country, and you have always fulfilled your duty well.

You have devoted your career to health care policy. Previously,

you served as Health Analyst at the Office of Management and

Budget. Currently, you analyze children’s health and Medicaid

issues for the Senate Budget Committee, assessing the fiscal responsibility of vital health policies considered by this Congress.

In that capacity, you have been known to occupy one of the staff

seats on this side of the dais, behind Senator Conrad. Welcome to

the other side of the dais. [Laughter.]

Your success in carrying out your duties has brought you new

duties. As Assistant Secretary for Legislation you will be responsible for developing the Department’s legislative agenda. You will

also serve as the primary link between Congress and HHS. This

task, always important, will be crucial as we work to enact and implement health care reform.

Ms. Murray, President Obama nominated you to be Assistant

Secretary of Resources and Technology at HHS. You too have been

called upon to serve your country before, and you too fulfilled your

duty well.

For 10 years you have served as Staff Director for the Senate Appropriations Subcommittee on Labor, Health and Human Services,

Education, and Related Agencies, and in this position you have

played a key role in funding HHS. Those duties have given you important insight into the costs associated with policies and programs

carried out there.

You previously served in the Budget Office and the Office of the

General Counsel at HHS. Those duties provided you with firsthand experience assessing and carrying out the department’s activities. Your success in fulfilling those duties has brought you new

duties.

As the Assistant Secretary of Resources and Technology you will

provide the Secretary of HHS with essential guidance on budget,

financial management, and information technology resources at the

Department. As HHS begins to implement health care reform, you

will play a vital role ensuring that new programs and policies

passed by the Congress have the resources that they need to start

working immediately for the American people.

Mr. Samuels, President Obama nominated you to be Commissioner of Children, Youth, and Families at HHS. This is not the

first time that you have been called upon to serve your country,

and you have fulfilled your duty very well.

You most recently were chief of staff for the Chicago public

school system. There you helped to oversee the third-largest public

school system in the country. In that role, you assessed the needs

of hundreds of thousands of school children and evaluated educational and other policies directly affecting their lives.

Before that, you served as the director of the Illinois Department

of Children and Family Services. That is the Nation’s third-largest

child welfare agency. In that capacity, you worked to implement

comprehensive assessments of all children entering care, and you

also redesigned transitional and independent living programs to

help prepare youth for transitioning to adulthood. Your success in

carrying out these duties has brought you new duties.

3

As the Commissioner of the Administration on Children, Youth,

and Families, you will administer Federal social programs that promote the growth and development of children and youth, as well

as their families.

As an alumnus of the foster care system, you have the personal

experience that will guide you as you fulfill this role, for America’s

future depends on our children and our youth. It is essential that

we ensure their welfare so that each child has the opportunity to

forge a successful life, and I compliment you, very, very deeply.

Each of you has the experience that will serve you well in the

positions for which you have been nominated, and I am sure that

you will more than ever fulfill your duties. It is imperative that you

do no less.

Congratulations to all three of you, and I look forward to hearing

your testimony.

Senator Grassley?

OPENING STATEMENT OF HON. CHUCK GRASSLEY,

A U.S. SENATOR FROM IOWA

Senator GRASSLEY. Thank you, Mr. Chairman and Senator Harkin.

I congratulate you, too, and more importantly, your willingness

to serve your country.

I am going to start with Mr. Esquea and talk about the ability

of Congress and HHS to work together for the best possible outcomes. It is very important. In your position as Assistant Secretary

for Legislation, you play a very key role, and it is a role that is especially important to me. You will be our primary contact at the

Department of Health and Human Services as we work in the Senate to write good policy, but also to fulfill our oversight responsibilities.

It is good that you will be bringing your experience working for

Congress to this position. For the last 10 years you have served

very well on the staff of the Budget Committee, a committee that

I have served on my entire time in the Congress. In that position,

you were always responsive to my questions and concerns, and I

would like to continue that sort of relationship with you in your

new position. My staff speaks very highly of you, so, if confirmed,

I ask that you maintain those qualities, and I am sure you will.

You probably already know that I take my oversight responsibilities very seriously, and I think I do it in an equal opportunity way,

the same for Republican and Democrat presidents. It does not matter who and what party is serving. I conduct vigorous oversight of

the public’s business because I believe that the public’s business

ought to be made public.

Sometimes I have trouble getting responses to my letters and

sometimes I have trouble getting accurate answers, so I hope you

will help us make sure that that happens timely and accurately.

I am confident that, if you are as responsive and thorough as you

were as a member of the Budget Committee, that there will not be

any problems in that area.

Mr. Samuels, nominated to be Commissioner of the Administration for Children, Youth, and Families, you are to be congratulated

because this is obviously a very important position. Helping young

4

people get off to a good start is good for them individually, but it

is also good for our country as we look ahead to the next generation.

If confirmed, you will oversee programs that are critical to protecting and ensuring the well-being of our Nation’s most vulnerable

children, and I cannot repeat enough the good things that the

chairman has said about making that task very important.

If confirmed, you will be tasked with implementing one of the

most far-reaching child welfare bills to be enacted in over a decade,

the bi-partisan Fostering Connections for Success in Increasing

Adoptions Act which was passed in 2008.

This law promotes adoptions, provides States with an option to

allow children to reside permanently with a relative, extends Federal payments for youth in foster care up to age 21, and allows

qualified tribes to administer their own child welfare programs.

The implementation of this bill, as well as continued implementation of the Child and Family Services Improvement Act passed in

2006, which reauthorized and improved another bill called the Safe

and Stable Families Act, will be challenging.

States are struggling with fiscal problems and may not take up

a number of options to improve child welfare that that law permits.

If that happens, it is going to be disheartening to me. If confirmed,

I look forward to working with you on strategies to encourage

States to exercise options that are currently available to improve

outcomes of children in that child welfare system.

Additionally, if confirmed, I would like to work with you to address issues related to both child welfare programs and TANF.

Congress will need to reauthorize TANF, and I would like to use

that exercise to focus on what is called child-only TANF cases. It

may be that a number of children in child-only TANF cases may

be better served by placement in foster care, relative care, or by receiving services through child welfare programs.

I am hopeful that, if confirmed, you would advance a positive

agenda, as I am sure you will, for children and youth.

And, now, to Ellen Murray. I have to save you for last, because

Senator Harkin was so dogged in making sure that we got your

name before the committee, and I am glad to have your name before the committee.

As an Iowan, I must thank Ms. Murray for her long-time service

to my home State, and for the past 10 years serving as Staff Director for the Senate Appropriations Subcommittee on Labor, Health

and Human Services, and Education for our fellow Iowan, Senator

Harkin.

In addition to serving Iowans, you have gained knowledge and

experience that I believe will serve you well in the position you

have been nominated for. We are at a point in our history where

we face serious challenges with health care.

You have all answered the President’s call, and we look forward

to working together, and I do not have any reason to believe that

you will not be confirmed positively.

The CHAIRMAN. Thank you, Senator.

I was very envious to watch the three of you: Senator Harkin,

yourself, and Ms. Murray, all Iowans together. It is kind of a bondVerDate 11-MAY-2000 10:20 Jun 03, 2010 Jkt 000000 PO 00000 Frm 00008 Fmt 6633 Sfmt 6633 56644.000 SFIN1 PsN: SFIN1
5

ing, the three of you, thinking back on Iowan experiences together

in Iowa.

In that regard, Senator Harkin, why don’t you go first? Senator

Conrad has very, very graciously deferred to you, because you probably have important business you want to take care of. So why

don’t you proceed in introducing Ms. Murray?

STATEMENT OF HON. TOM HARKIN,

A U.S. SENATOR FROM IOWA

Senator HARKIN. Thank you very much, Mr. Chairman, my colleague Senator Grassley, and my good friend Senator Conrad.

It is an honor to appear before the committee to introduce a good

friend, my long-time assistant, Ellen Murray, to serve as HHS Assistant Secretary for Resources and Technology.

As members of the committee are well aware, Ms. Murray is superbly qualified for this important position at the Department of

Health and Human Services. As has been said, for the last decade

she has served as a Staff Director for the Appropriations Subcommitee on Labor, Health and Human Services, Education, and

Related Agencies.

In that capacity, she has acquired an encyclopedic knowledge of

the programs and activities within the Department of HHS. And,

of course, she is acquainted with every line item in the Department’s budget, all of which means that she would hit the ground

running as Assistant Secretary in charge of drafting and executing

the Department’s budget.

Of course, Ms. Murray has many other formal credentials. She

earned an undergraduate degree in economics from Trinity College,

and I might just add, parenthetically, played basketball for Trinity

College along with someone else by the name of Kathleen Sebelius.

[Laughter.]

She also received a law degree from George Mason School of

Law. Prior to coming to the Senate Appropriations Committee, she

was an attorney with the HHS Office of General Counsel. Before

that, she was a Budget Specialist for the Department’s Administration for Children and Families and at the Social Security Administration.

But aside from those former credentials, I would emphasize to

the committee that Ellen Murray is a person of extraordinary personal qualities. I have worked very closely with Ellen, as has been

said, over the last decade. I have the highest respect for her competence, her intelligence, her integrity, as well as her capacity for

hard work and extremely long hours. I long ago lost track of the

number of people thanking me for the good work that Ellen did.

When you think of all the things that we have done for NIH, for

biomedical research, all of the new facilities we have invested in at

the Centers for Disease Control and Prevention, all of the flu vaccines that are being developed right now that people are lining up

and getting, and then into education, all of the different education

programs, everything from elementary and secondary through college loans, work study programs, in the whole area of workers, job

training, work safety—all of these have the fingerprints of Ellen

Murray. She has been diligent in working on every single one of

those, and then people thank me for doing it.

6

I also want to mention Ellen’s passion for public service. It is no

secret that senior appropriation staffers can move on to jobs downtown for much greater pay and far fewer hours. But that was not

Ellen’s choice. She has been devoted to her work and responsibilities here in the Senate. She believes strongly in the capacity of

government to give a hand up to people in need and to improve the

lives of all Americans, whether, as I have said, through biomedical

research or public education or workplace safety.

I would just say, I guess, that it is an honor and a privilege to

be here, although I must admit it is a bittersweet moment for me.

I know I can speak for all of us. We just hate to lose good staff,

especially staff you have come to rely on. You never have to look

over their shoulder, you never have to second-guess them, they put

in all the time and the expertise and they hand you the finished

product. It is all there and it is all done and you never have to

worry about it. So that is why you hate to lose staff like that.

But, then again, as I have said, this is again another step in her

career path and a chance for her to have even a broader impact

than what she has had before. I hope that we can continue to work

closely together as you develop the budget at HHS to coordinate

our appropriations measures along with the Department’s budget.

Parenthetically, Mr. Chairman, I might say, I was at the Kennedy Institute dinner last night, and I was at the table and Secretary Sebelius came over and engaged me in conversation. I think

the conversation went something like this. She said, ‘‘Look, I know

this is a sore point, but we really need Ellen Murray down there

in a hurry.’’ [Laughter.]

I said, ‘‘Well, fancy you should say that, because tomorrow morning she is going to be before the committee.’’ And I said, ‘‘We will

do everything we can to get her in there.’’ So, that happened just

last night.

So, Mr. Chairman, Ellen Murray is the epitome of the dedicated,

and talented, and seasoned, and compassionate public servant. I

urge committee members to send her nomination to the full Senate

with a positive recommendation so that I can keep my commitment

to Secretary Sebelius last night. I said we will do it as soon as possible.

Thank you very much, Mr. Chairman.

The CHAIRMAN. Thank you, Senator. It is a real testament to you

of your fine, fine work. I mean the whole Senate and much of the

country recognizes your excellent work, and that was what my next

point was going to be, that a lot of it clearly is Ms. Murray. [Laughter.] But your public service is unexcelled, and part of it is allowing

excellent people like Ms. Murray, if allowing is the word, to encourage them to go to an even higher, better job where she can do even

more than she is doing already. You are both to be highly commended.

Senator HARKIN. Thank you, Mr. Chairman, very much. Thank

you. I appreciate that.

The CHAIRMAN. All right. If you have to leave, Senator——

Senator HARKIN. All right. [To Ms. Murray] Don’t forget me now,

all right? [Laughter.] Thank you, Mr. Chairman.

The CHAIRMAN. All right. Ms. Murray, you can take Senator Harkin with you. [Laughter.]

7

Thank you, Senator. Thank you, very much.

Senator Conrad?

OPENING STATEMENT OF HON. KENT CONRAD,

A U.S. SENATOR FROM NORTH DAKOTA

Senator CONRAD. Mr. Chairman, as Senator Harkin is leaving, it

reminds me of when Senator Muskie was running for President. I

was on his presidential campaign staff, and one of my first assignments was to run the operation in western Iowa. I have never forgotten the first eight meals I had there. Ham was served at each

one. [Laughter.]

Mr. Chairman, Senator Grassley, members of the committee, I

am here today to offer my very strong backing to President

Obama’s nomination of Jim Esquea to serve as the Assistant Secretary for Legislation at the Department of Health and Human

Services.

Jim is truly exceptional. He is what a public servant should be.

He not only understands the most detailed elements of every program but, just as important, he understands how they impact real

people. Jim was born and raised in New York City, a long way

from North Dakota. He graduated from Wesleyan University and

received his masters in public policy and administration from Columbia University.

Many of you know Jim very well already. He has had a close

working relationship with this committee, while serving with me

and others on the Senate Budget Committee as our analyst for income security and Medicaid. He has been with the Senate Budget

Committee for 10 years. In fact, I think he is the last of the Senator Lautenberg staff members on the Budget Committee.

He has been deeply involved in many of the health issues that

we on this committee have tackled, from comprehensive health care

reform, to the CHIP reauthorization, to changes affecting unemployment insurance that were designed to help the economy earlier

this year.

I have witnessed first-hand his insightful analysis, his thoughtful

recommendations, and his warm and engaging personality, and nobody can miss that in Jim. He is a delight to have around, and I

am going to miss him, personally, very much.

While Jim is one of us, a veteran of the Hill, he also has extensive Executive Branch experiences as you referred to, Mr. Chairman. He worked in the Health Division of the Office of Management and Budget for more than 4 years. He served on the White

House committee reviewing the 1997 tobacco settlement and on the

Vice President’s 1995 Reinventing Regulations initiatives. In all of

those assignments, he served admirably.

His administrative experience, coupled with his long Hill service,

make Jim perfectly suited to be the next Assistant Secretary for

Legislation at the Department of Health and Human Services. He

will be an outstanding liaison between HHS and the Congress. He

knows the Legislative Branch, he understands our needs, and he

is respected on both sides of the aisle.

The Obama administration is extremely fortunate to attract

someone of Jim Esquea’s quality and character to this important

assignment. He is superbly qualified to serve in this position. I

8

have every confidence that Jim will make us, the President, and

the American people proud.

I fully support his nomination, and I urge the committee to act

quickly and the full Senate to confirm him expeditiously.

Mr. Chairman, thank you very much for this opportunity.

The CHAIRMAN. Well, thank you, Senator. I mean, clearly, Jim is

a good man, and I appreciate that very ringing endorsement of

him.

Senator CONRAD. Mr. Chairman, if I could just say that, while

I am here to introduce him and to endorse his confirmation, I personally cannot support his confirmation. I do not want to lose him.

[Laughter.]

The CHAIRMAN. You just know too much about him. [Laughter.]

Senator CONRAD. I will really miss Jim Esquea, as will all of the

staff of the Budget Committee and my personal staff as well. I

think it goes for every member of the Budget Committee, who

knows, likes, and respects Jim Esquea.

The CHAIRMAN. It is really true. All of us have been here for a

while over the years, great people working for us really hard, for

constituents, and for the country. Just wonderful, wonderful, hardworking people. They wonder, gosh, there could not be anybody any

better, and sure enough, something comes along where there is another opportunity for them. It is such a bittersweet revelation when

they tell you, because on one hand you want what is best for them,

and on the other hand you want to keep them because they are

doing such a great, great job. But you really do know what is best

for them is what is best for them. I just encourage them to go on,

because that is his life, it is her life, and that means the most, and

for the balance, it is positive all the way around.

To be honest, it took me a while to learn that lesson, because the

first time somebody really came to me a long time ago, I was frankly quite distraught and did not want that person to leave and tried

to persuade that person from leaving, knowing it was futile. But

since then, I have learned that the best thing to do is to encourage

them to do what is best for them, and it is better for everybody all

the way around. And I say that to Ms. Murray and also to you, Mr.

Esquea. You did not work for me or for anyone up here, Mr. Samuels, but I know you would be in the same situation.

All right. I have just a couple of points I want to make to Mr.

Esquea.

Oh yes. Excuse me. I forgot about that. I would like each of you

to give your opening statements. [Laughter.]

Tell us why you want these jobs. Why don’t you go ahead first,

Mr. Esquea?

STATEMENT OF JIM ESQUEA, NOMINATED TO BE ASSISTANT

SECRETARY FOR LEGISLATION, DEPARTMENT OF HEALTH

AND HUMAN SERVICES, WASHINGTON, DC

Mr. ESQUEA. Chairman Baucus, Senator Grassley, members of

the committee, thank you for inviting me here today to discuss my

nomination to be Assistant Secretary for Legislation at the Department of Health and Human Services.

If the committee can indulge me for a moment, I want to go

rogue here for a second, go off script, and say I would just like to

9

thank Senator Conrad for that generous introduction. It has been

a pleasure and an honor to work for him on the Budget Committee.

If confirmed, any success that I may have at HHS will be in no

small part because of what I learned from Senator Conrad, the outstanding colleagues on the Budget Committee, and the rest of the

Conrad team.

I also want to give special thanks to my family. They could not

make the trip down from the Bronx today, but I am here because

of their love and support. I especially want to thank my parents,

Hymat and Lisa. They immigrated to this country more than 40

years ago from the Dominican Republic, looking for a better way

of life. My dad owned a small bodega—grocery store—in East Harlem for a number of years and later drove a taxi cab. My mom

works on the janitorial staff of a theater in New York. They sacrificed much to ensure that their children got a good education. In

my case, they also stayed out of trouble. Truth be told, my parents

are still not quite sure what I do for a living, but they love and

support me, nonetheless. [Laughter.]

It is an honor to be nominated. I am grateful to President Obama

and Secretary Sebelius for providing me this opportunity to serve

the American people. It is especially gratifying to testify before this

committee.

As a staffer for Senator Conrad, I have had the opportunity to

work with the committee’s members and staff on a range of important issues over the years, including the reauthorization programs

like the Temporary Assistance for Needy Families program and the

Children’s Health Insurance Program, as well as the recent efforts

to reform the Nation’s health care system.

I want to commend you, Chairman Baucus, and Ranking Member Grassley, for your leadership. I also want to give special thanks

and praise to the committee’s staff, both Democratic and Republican. They have been generous, even-handed in approach, and

dedicated to excellence and good policy, and always, always a

pleasure to work with.

The Assistant Secretary for Legislation serves as a principal advisor to the Secretary with respect to all aspects of the Department’s legislative agenda and congressional liaison activities. The

agenda of the Department is driven by its main mission: protecting

the health of all Americans and providing essential human services, especially for those who are least able to help themselves.

It is a mission that the more than 65,000 employees are dedicated to fulfilling. If I am confirmed, it will be my responsibility to

work with this and other committees in support of the mission of

the Department and the Health and Human Services’ agenda in

the administration.

I believe my experience at the Office of Management and Budget

and the Senate Budget Committee will serve me well as the Assistant Secretary for Legislation.

From August 1994 to January 1999, I was a Program Examiner

at the Health Division of OMB, where I helped to guide the formulation and review of the budget for HHS public health service agencies, with my primary area of responsibility the Food and Drug Administration. Along with evaluating the HHS agency programs to

ensure program effectiveness and proper spending of funds, I also

10

helped to coordinate and develop the administration’s positions on

bills and amendments and to review congressional testimony reports for consistency with the administration positions and policies.

This experience provided me with detailed knowledge of HHS

and its agencies, as well as knowledge of how those agencies interact with Congress and provide members and congressional committees the best information possible.

For the last 10 years, I have been the analyst for Income Security, Medicaid, the Children’s Health Insurance Program, and discretionary health programs for the Senate Budget Committee. In

that position, I have assisted in developing and drafting the annual

congressional budget resolution and in making program recommendations for my areas of responsibility as they affect the Federal budget.

The position has also required me to track the cost of appropriation and authorization legislation to ensure compliance with the

budget resolution and to enforce Budget Act points of order. Because of this important responsibility, I have worked with many

member offices and committee staff to provide advice on how best

to shape and draft legislative amendments so that they are consistent with the budget resolution.

Because considerable policy depth and knowledge of the budget

are necessary in order to provide the best possible advice, I believe

my work in this area highlights one of my particular strengths, a

clear understanding of the intersection between policy and budgeting.

If confirmed, I will be your liaison to the Department. I am well

aware of how important the help and assistance of the professional

staff and the Office of the Assistant Secretary for Legislation are

to the legislative and oversight efforts of Congress.

I will work to ensure the Office continues to focus on providing

members the tactical assistance they need on legislative priorities,

answering oversight requests—again, answering oversight requests—and ensuring that members have the information necessary to meet the needs of their constituents.

I also have a particular interest in ensuring that members are

provided the most accurate information available and that it is presented in a manner that is useful. The only way information is of

any use to members and policymakers is if it is timely delivered

and clearly articulated.

Chairman Baucus, Senator Grassley, members of the committee,

thank you again for the opportunity to testify today. I am confident

that my knowledge of health policy and programs and income security programs, my familiarity with the Federal budget process, and

my experience working with congressional offices and committees

will serve me well, if I am confirmed.

I look forward to the opportunity to apply this knowledge and experience in support of the mission of the Department of Health and

Human Services, and with that I am happy to answer any questions.

The CHAIRMAN. Thank you very much, Mr. Esquea.

[The prepared statement of Mr. Esquea appears in the appendix.]

The CHAIRMAN. Ms. Murray?

11

STATEMENT OF ELLEN GLONINGER MURRAY, NOMINATED TO

BE ASSISTANT SECRETARY FOR RESOURCES AND TECHNOLOGY, DEPARTMENT OF HEALTH AND HUMAN SERVICES,

WASHINGTON, DC

Ms. MURRAY. Senator Baucus, Senator Grassley, Senator Conrad,

thank you for the opportunity to appear before you today in connection with my nomination to be Assistant Secretary for Resources

and Technology at HHS.

I am honored to be the President’s nominee for this position at

this important time in the Department’s history. Before I begin, I

just want to thank Senator Harkin for the very kind introduction,

and also thank my family for all their support, and, if I could, just

recognize them who came here today to support me.

The CHAIRMAN. We would very much like that.

Ms. MURRAY. My husband Rich, cousin David, my sister Mimi,

who drove down from Pittsburgh, and my son and his wife, Carolyn

and John Barrett.

The CHAIRMAN. Could you all stand please so we could recognize

you and acknowledge your support here? Thank you very much for

all that you have done.

[Applause.]

Ms. MURRAY. If I could, Senator, I would like to also thank my

work family, whom I spend so much time with, the staff of the subcommittee: Eric, Adrian, Mark, Lisa, and Terry are also here to

support me today. I want to thank them.

The CHAIRMAN. They are here? Why don’t you have them stand

up, all of you, her work family? Eric, there you are.

[Applause.]

Ms. MURRAY. Thank you.

The CHAIRMAN. You are welcome.

Ms. MURRAY. The Assistant Secretary for Resources and Technology at HHS is responsible for the development of the HHS annual budget, the execution of that budget, the implementation of

the Recovery Act, for grants policy and information technology policy, and for financial management, to provide for the direction and

coordination of these activities through HHS.

Mr. Chairman, I believe my education and experience qualify me

for this position. My educational background includes a degree in

economics from Trinity College and a law degree from George

Mason University School of Law. For the past 10 years, I have

been Staff Director for the Senate Appropriations Subcommittee on

Labor, Health and Human Services, Education, and Related Agencies.

In that position, I am responsible for coordinating the Senate’s

appropriation of funds to most HHS agencies, which begins with

the review of the President’s budget submitted to Congress by

HHS. I also have had a large role in the development of the HHS

section of the Recovery Act, passed by Congress earlier this year.

In addition, I have previous experience working for the Department. As an attorney with the HHS Office of General Counsel, one

of my principal responsibilities included advising the Office of

Budget on appropriation matters. I also represented OGC on a

department-wide task force on grants policies and represented the

Department at the Board of Contract Appeals.

12

As a Budget Analyst for the Administration for Children and

Families, I was not only responsible for the development of the

ACF section of the budget, but also for the execution of the final

appropriation.

In my roles both at ACF and earlier at the Social Security Administration, my responsibilities included the development of cost

estimates for mandatory HHS programs, including child support

and what was AFDC.

In summary, I have a strong understanding of the Federal budget process, including its execution. I am very familiar with the

HHS budget and the issues that surround that budget. I have experience in the areas of grant policy, and I bring a unique understanding of the Recovery Act as it relates to HHS.

I am eager to begin work as Assistant Secretary for Resources

and Technology. I cannot think of another Federal agency that does

more good than HHS. I believe in the Department’s mission, and

I look forward to tackling the many budgetary challenges that it

will face.

As members of this committee know well, we are facing years of

scarce resources. My over-arching priority as Assistant Secretary

will be to ensure that HHS can continue to fill its commitment to

promoting health and providing essential human services, even

under difficult budgetary circumstances. That will mean investing

in programs that work, eliminating those that do not, and doing

more with less.

More broadly speaking, President Obama has expressed a firm

commitment to promoting efficiency government-wide by examining

Federal budgets as a whole, rather than as a collection of unrelated

programs. I intend to take that approach at HHS by working to ensure that programs and initiatives led by each of the Department’s

many agencies complement, rather than compete with one another.

My final priority will be to ensure that the resources of HHS are

in place to facilitate the implementation of legislation to reform our

Nation’s health care system. I know that, after months of working

tirelessly, this committee recently approved legislation in this area,

and the discussions in both the Senate and the House of Representatives are ongoing. Whatever that final product looks like, I understand that the effort to implement the legislation will be an enormous undertaking.

If confirmed, I stand ready to marshal the resources of HHS in

support of the President’s and the Secretary’s effort to expand coverage and lower health care costs for the American people.

Chairman Baucus, Senator Grassley, thank you again for the opportunity to appear today and discuss my nomination. I would be

happy to answer any questions. Thank you.

The CHAIRMAN. Thank you, Ms. Murray. I will bet you have the

answers, too. [Laughter.]

[The prepared statement of Ms. Murray appears in the appendix.]

The CHAIRMAN. Mr. Samuels?

13

STATEMENT OF BRYAN SAMUELS, NOMINATED TO BE COMMISSIONER OF CHILDREN, YOUTH, AND FAMILIES, DEPARTMENT OF HEALTH AND HUMAN SERVICES, WASHINGTON, DC

Mr. SAMUELS. Good morning, Mr. Chairman, Senator Grassley.

It is my honor to appear before this committee as President

Obama’s nominee to be the Commissioner for the Administration

for Children, Youth, and Families.

It is also an honor to come before this particular committee because of your long commitment to improving the quality of life for

children who find themselves in the foster care system. I want to

assure you that I share your same commitment to these young people.

If confirmed, I will bring more than 20 years of experience working at the State and local levels to promote the social and emotional well-being of children and families.

Throughout my career, I have worked to build public systems

that produce positive results for the clients that they serve. My

commitment to public service grows largely out of my experience as

a child. I grew up in a residential home for disadvantaged children.

I was there for 111⁄2 years.

That experience has helped to shape my commitment to serving

the highest-risk youth, and it continues to reinforce my belief that

dedicated people and well-designed programs can make a dramatic

difference in the lives of the children who need them the most.

During my career, I have served as the chief of staff for the Chicago public schools, the director of Child Welfare for the State of

Illinois, deputy director of Social Services for the State of Nebraska, and assistant to the Governor for Human Services.

If confirmed as Commissioner, I hope to take advantage of my

experience as the director of the Nation’s third-largest Child Welfare Agency, with 16,000 children in custody and more than 10,000

public and private employees.

While director of Child Welfare, I worked with a team of very

committed public servants to reduce the caseload ratio from 20

cases per worker down to 14, to decrease the child welfare population by 4,000 statewide, to reduce the number of children ‘‘on

run’’ by 40 percent, and reduce the number of days they spent running away by 50 percent. We also were able to decrease the use of

residential treatment in group homes by 20 percent.

We eliminated the number of late child welfare investigations by

more than 60 percent, and we were able to decrease the distance

between the home of origin and placement in foster care from 20

miles down to less than 8 miles. It is my experience in this position

that validates my strongly held belief that administrative data,

academic research, and evidence-based interventions should play a

critical role in the way in which we make public policy and design

programs.

If confirmed, my first priority as Commissioner will be to ensure

the effective implementation of the Fostering Connections Act. The

comprehensive nature of the act gives me great confidence that we

can begin to move the child welfare system beyond solely ensuring

the protection of children and towards improving their overall wellbeing.

14

My experience at the Chicago public schools should help in the

implementation of the Act’s provisions around the improved educational outcomes for foster youth. There is no denying that education is the cornerstone to their future economic success.

For foster youth, particularly those who age out of the system,

I fervently believe that completing their high school education provides a vital, positive counterweight to the abuse, neglect, separation, and impermanence that many of them have experienced.

I also plan to work for the full implementation of the guardianship provisions, as well as the tribal 4(e) provisions. I know those

are priorities for members of this committee. As you know, the

State of Illinois participated in one of the demonstration waiver

grants around subsidized guardianship beginning in 1997, and has

since then moved more than 10,000 children into permanent homes

with guardianship agreements. I hope to share the experience of Illinois as we work to implement the Fostering Connections Act.

My second priority is to expand the availability and the use of

services that impact children with trauma and exposure to violence. There is a growing body of literature that shows the dramatic impact that trauma and violence have on the healthy development of children. One study found that adults who had more

than 4 Adverse Childhood Experiences are 4 times more likely to

experience depression, 5 times more likely to use illegal drugs, 7

times more likely to abuse alcohol, and 12 times more likely to attempt suicide.

Most children in the Child Welfare System have already experienced multiple traumatic incidents and, therefore, are at high risk

for these debilitating conditions. Despite the truism that time heals

all, this study clearly demonstrates that time alone does not heal

the experience of childhood trauma.

Finally, my third priority is to focus on strengthening families

and preventing child abuse and neglect. As the child welfare director, I learned first-hand how difficult it is to put families back together after abuse has occurred. A 2009 report from the Institute

of Medicine stated that the most effective approach to reducing the

impact of maltreatment is to prevent it from occurring.

In most cases, I believe, prevention can be done without a host

of new programs but instead by integrating empirically supported

elements into the programs and systems that ACYF already supports and funds.

In closing, Mr. Chairman, Ranking Member Grassley, I believe

that I am prepared to lead the Administration on Children, Youth,

and Families. If confirmed, I look forward to working with members of this committee to build on the most rigorous science currently available to track the results that we get for all kids and to

focus relentlessly on securing better lives for the Nation’s most atrisk children, youth, and families.

Thank you, and I welcome any questions.

The CHAIRMAN. Well, thank you, Mr. Samuels, for that very moving statement. You clearly are deeply committed, with deep experience, care, and concern. I deeply appreciate your statement.

Mr. SAMUELS. Thank you.

[The prepared statement of Mr. Samuels appears in the appendix.]

15

The CHAIRMAN. I now have some questions that are obligatory I

must ask each of you, and I will just go down the line here.

Is there anything you are aware of in your background that

might present a conflict of interest with the duties of the office to

which you have been nominated?

Ms. Murray?

Ms. MURRAY. No, sir.

The CHAIRMAN. Mr. Esquea?

Mr. ESQUEA. No.

The CHAIRMAN. Mr. Samuels?

Mr. SAMUELS. No, sir.

The CHAIRMAN. Do you know of any reason, personal or otherwise, that would in any way prevent you from fully and honorably

discharging the responsibilities of the office to which you have been

nominated?

Ms. MURRAY. No, Senator.

Mr. Esquea. No.

Mr. SAMUELS. No, sir.

The CHAIRMAN. Do you agree, without reservation, to respond to

any reasonable summons to appear and testify before any duly constituted committee of Congress if you are confirmed?

Ms. MURRAY. Yes, I do.

Mr. ESQUEA. Absolutely, Senator.

Mr. SAMUELS. Absolutely, sir.

The CHAIRMAN. Thank you.

All right. I will just go down the line here with questions. Actually, I will begin with you, Ms. Murray.

My main concern is resources, as we not only implement health

care reform, but ancillary programs that are related.

Do you have some kind of plan, some kind of strategy that helps

you have the proper amount of resources as well as the resources

that are properly targeted to where they are needed? I know it is

basically a budget question. It is what the budget submission is to

the Congress that you will have a large role in. But if you could

just tell us a little bit of what your thoughts are on how we make

sure we get the proper resources.

Ms. MURRAY. Well, Mr. Chairman, I think, of course, probably

the most important responsibility of HHS in the coming years will

be to implement health care reform, and it is going to be one of my

most important responsibilities to make sure that our budget includes sufficient resources to do so. I think to find those resources

we have to make sure that our budget makes best use of limited

Federal dollars.

First, I want to make sure that we do not duplicate programs in

HHS among the various options, so that we get the biggest bang

for the dollar. Also, that we look carefully at all of our programs

and make sure those that do not work are not funded, those that

do are, and that we find the resources to most efficiently implement whatever type of health care reform legislation comes out of

this Congress.

The CHAIRMAN. Do you have any preliminary thoughts of what

works and maybe what might be duplicative?

Ms. MURRAY. Well, I have some ideas from working with the

budget for years. I think that the Program Assessment Rating Tool

16

(PART), done by OMB, is something that we need to look at closely.

You know, for many years, we had hoped we would be able to do

just that on the Appropriations Committee, really to look at programs, look at what works and make those decisions. Unfortunately, the appropriation process had become a year-long process.

I do not believe we have done enough of it here, and I hope that

we are able to do much more of it when I am down at the Department.

The CHAIRMAN. And the concern with the year-long process, is

what?

Ms. MURRAY. We spend so much time getting the bill through

Congress that we do not have the hours to really look at the programs, to visit, to look at the outcomes, to make good decisions

about what programs should be increased, what should be eliminated, what should be reduced. As you can see in the Federal budget, many years all programs are level-funded. Obviously, some programs work better than others. We have to find out what those

programs are. We have to look at the various options of HHS and

see if there is duplication in programs, if a coordinated effort could

provide better outcomes at a lower cost.

The CHAIRMAN. Will you be able to focus a little more effectively

in your new role because you will not be doing quite the same?

Maybe you will.

Ms. MURRAY. Yes, sir. I believe I will.

The CHAIRMAN. And so you have more time on——

Ms. MURRAY. A little more time and a little more staff.

The CHAIRMAN [continuing]. On which projects, which programs

are better than other programs?

Ms. MURRAY. Yes, sir.

The CHAIRMAN. I strongly encourage you to do so and just be

strong when you are talking to OMB.

Ms. MURRAY. I will, sir.

The CHAIRMAN. All right.

Mr. Esquea, my main question is just the relationship between

the administration and Congress. Clearly, you have to work very

closely together. It is teamwork. Clearly we should not be surprised

by something HHS might do, and we should always give them a

heads up, and so forth. It works both ways when we are working

with you as well. A lot of it comes down to staff relationships, our

staffs and you and your staff at HHS.

I really do not have a question to ask, but just very, very strongly encourage you to very, very closely consult with us. You already

answered the question that Senator Grassley referred to. He believes fervently in this point, as do I, and you mention in your

statement, speed counts and prompt attention counts so much, and

that is so true. I just strongly encourage you to keep that up, just

to be a bearcat over there, just to make sure that your staff and

the whole Department responds very quickly to our requests. It

will go a long, long way to minimizing misunderstandings.

Mr. ESQUEA. I appreciate that support. I guess I would like to

paraphrase John W. Garner, a former Secretary of Health, Education, and Welfare under President Johnson, and say that what

I want, the way I want Congress to view the ASL and the office

17

of assistant secretaries is, I hope that you view them as effective,

accessible, responsive, and accountable.

In my good years here as a staffer, I have heard many stories

and I have been in rooms where people have just been utterly and

totally frustrated and confounded by an HHS response, an HHS

non-response, an HHS explanation, and I think more often than

not, it is a question of communication.

I think one of my key jobs here is to make sure, not only that

I am able to translate to the Hill what the agenda and priorities

are of the Secretary and the President, but just as important, to

translate back to the Department and the administration what the

priorities and the thinking is of the Congress. I mean there is a lot

of good thinking being done around here, and sometimes we just

do not hear each other. And my hope is that I will be an active

ASL, and that I will be hearing you loud and clear, and, hopefully,

you will be hearing what we have to say loud and clear, if confirmed.

The CHAIRMAN. Well, I sure wish you the best, because it is so

important.

Mr. Samuels, I am just, as I said, very moved by your statement.

As you were speaking, I was thinking of a young kid I mentored

a long time ago who ended up in a foster home, and it just did so

much for him. It just turned his life around.

He was in junior high when I first met him, he was failing in

school, and I just decided on the spot that I was going to mentor

this kid. He had problems. He walked up to me and he started crying. His mother was on meth, he was taken away from his mother,

and one thing led to another. Actually, his mother died of meth

consequences, but then he went into a foster home. I visited him

there and he just blossomed, he just grew up, and he referred to

the woman who ran the foster home as his mother, which to me

was moving evidence that these things are starting to happen here.

Mr. SAMUELS. Absolutely.

The CHAIRMAN. I know you are the kind of guy who is going to

keep encouraging that and I just——

Mr. SAMUELS. Yes. I fully support that. There is both, from an

emotional standpoint as well as a research standpoint, lots of evidence that successful children have somebody in their life whom

they know believes in them, and whether that is a mentor or foster

parent or just a relative, it is a critical component to their own development. So, you are absolutely right, that foster parents can be

that resource that allows a child to turn his life around or her life

around, and so that is a critical component.

One of the interesting challenges we have going forward is, in

some respects, as the Child Welfare System gets better at moving

children to adoption, we are actually losing adoptive homes where

we can place children in the future, because those homes typically

then go off-line and we have to be able to recruit additional foster

parents in order to have adequate resources to support young people.

It is an interesting challenge in the sense that, on one side, you

want to move as many children to permanence as possible, but, at

the same time, you have to redouble your efforts to recruit additional foster parents so you can support children who enter the sysVerDate 11-MAY-2000 10:20 Jun 03, 2010 Jkt 000000 PO 00000 Frm 00021 Fmt 6633 Sfmt 6633 56644.000 SFIN1 PsN: SFIN1
18

tem. It is an interesting dynamic, and it is obviously one I hope to

be able to work on with States across the country to ensure that

they have sufficient homes where they need them to support young

people as they enter the system.

The CHAIRMAN. Well, you certainly have my support.

Mr. SAMUELS. Thank you.

The CHAIRMAN. I can tell you will be very effective.

As a Montanan, I am just a little bit concerned about Indian

tribes—Native Americans—too, because sometimes they get kind of

pushed on the side. Your thoughts on how you can focus on reservation kids?

Mr. SAMUELS. Well, I tell you, I spent about 2 years in Nebraska

as a deputy director. In that role I had a chance to visit a number

of the reservations there in Nebraska, and I was first just really

shocked by some of the economic conditions that children were having to be raised in. I was struck by how little social services or

interventions are available on the reservation.

At the same time, these were very proud people. They believed

in their culture, they believed in caring for their kids, and so I

think that the work with tribes is really about a partnership. It is

about meeting them halfway and starting there and, where it is

necessary to go beyond halfway, to support their overall development.

I think the challenge we have will be not on the limited number

of reservations that have casinos and other resources, but really on

those reservations where there is no economic development, there

is no base for employment, and it is really building the capacity in

those areas. I think a lot of technical assistance will be required,

and I would anticipate being very active as we move forward with

the tribal 4(e) component of the Fostering Connections Act, because

I think it will make a huge difference for those kids on that reservation. But it is difficult work.

The CHAIRMAN. I would like you to come to Montana to see the

entire State. I do not mean every nook and cranny, but see Montana, including our reservations. I think it would be very helpful.

Mr. SAMUELS. I would welcome that opportunity.

The CHAIRMAN. Thank you. I have no further questions.

Senator Grassley?

Senator GRASSLEY. I am going to continue along the lines of

questioning I had in my opening comment about oversight. Hence,

the chairman has already brought that up to some extent, but I

wanted to repeat that I think I treat oversight the same, regardless

of which party is in charge of the Executive Branch.

I want to bring to light something that is a problem for Democrats when they are in the minority, and, obviously, Republicans

are in the minority now. Can you believe it goes back to the

Reagan administration? For some reason or other, that Republican

President maybe was irritated with minority oversight or something, so he found someone in the Justice Department to issue

some ruling that really the Executive Branch of government does

not have to pay much attention to a ranking member’s request.

If it does not come from the chairman, it does not have much

weight. So, it brings up this question.

19

The CHAIRMAN. Before you go any further, as far as I am concerned, Senator Grassley is the co-chairman, too, so any request he

has is treated—because we go back and forth, sometimes he is

chairman and sometimes I am chairman. [Laughter.]

Senator GRASSLEY. Well, he stated that before, and so I appreciate that very much. We have had this cooperative relationship

where, if need be, I would back him up and he backs me up. But

it creates a lot of complication, so I am going to ask you for this

public commitment.

If you are confirmed to serve in the positions you have been nominated for, a clear public commitment that, as a ranking member

of this committee, I will not be required to provide you with a

chairman’s letter for the Department to respond to my letters and

to provide to me the Department documents that I need to do my

work.

Would you be receptive, then, to my inquiries and will you assure

me that I will not need a chairman’s letter to get this information?

I have to ask each of you the same question.

Ms. MURRAY. Senator, I understand the importance of receiving

accurate and timely information from the Executive Branch. As a

member of the staff of the subcommittee, we face that issue all the

time and are often disappointed about the timeliness or accuracy

of information.

I pledge to you that I will do everything that I am allowed under

the law to make sure that you receive the information you need in

a timely and efficient manner.

Senator GRASSLEY. All right. Thank you.

Mr. Esquea?

Mr. ESQUEA. Senator Grassley, you are rightly famous for your

devotion to your oversight responsibilities. I, too, am a fan of congressional oversight. If confirmed, I hope to continue to be a fan of

congressional oversight. [Laughter.]

Given that, I will do all that I can, within the boundaries of law,

to make sure that you get everything that you need.

Senator GRASSLEY. Thank you.

Mr. Samuels?

Mr. SAMUELS. I will be very receptive to your request, and with

little doubt I will do everything within the boundaries of the law

to respond to your request.

Senator GRASSLEY. Unrelated to your department, another agency of government I will not mention at this point—they probably

know who I am. If they are listening, they know who I am.

I want to give you an example of where I thought an agency,

very recently, was not responsible. I am holding up a nomination.

The person who has that nomination had previously been in charge

of the agency, and we requested information way back in—let us

see, what was it—in June, I think, and, until I put the hold on it,

I never got any response whatsoever. And, just recently, we did

start getting some documents. But you can see why I do not consider these very responsive. [Laughter.]

They are all redacted. So a friend of mine who is a head of another department called me up and said, what could he do to help

so I could release this. I sent these to him, just one example that

his inquiries to the White House have not done much good yet.

20

Now, maybe this is perfectly legitimate if there is some reason of

privacy or national security, but I would at least like to know why

every word is redacted.

Another issue that I have very much of an interest in is the qui

tam. You probably know that qui tam or false claims type things

are very good to get money back to the Federal Treasury, and you

probably know that I am the author of that legislation. No, wait

a minute. I am getting ahead of myself here. I have another question on oversight before I get to that question.

This will be for all three of you. It is mostly about fair, honest

and transparent government. Congressional oversight is the

linchpin of checks and balances. Oversight of HHS programs and

activities requires a review of documents and interviews with agency officials or other employees to inform us about questions we

might have. In furtherance of our oversight responsibilities, sometimes we engage the Government Accountability Office to evaluate

HHS programs and activities and sometimes we involve the Office

of the Inspector General.

A follow-up question to the first one I asked you: would you commit to working with the Congress, Government Accountability Office, and OIG to, in a timely and constructive manner, address the

oversight and other needs of Congress, and will you encourage others to do so?

The reason I ask this question—although I probably ask it of everybody—but on the TARP legislation we set up a special Inspector

General to just oversee all that work, all that money going out, and

he has had tremendous trouble, even within his own department,

of getting information he ought to have.

Now, you can disregard what I have said about the special Inspector General, but I give you that as an example that we need

cooperation within a department or for other agencies like the Government Accountability Office to get information that maybe we

are not going to seek directly. So, I ask if we would have cooperation the same way, as I suggested in my question, of helping those

agencies or OIG to help in oversight?

Ms. MURRAY. Yes, Senator, you definitely have my cooperation.

Senator GRASSLEY. All right.

Mr. ESQUEA. Yes, Senator.

Senator GRASSLEY. Yes. All right.

Mr. SAMUELS. Absolutely.

Senator GRASSLEY. Yes, thank you.

Now I would like to go to the False Claims Act, if the three of

you would respond to this question. I said I was the author of it.

I think it has been very good, bringing $22 billion back into the

Federal Treasury.

It is my hope that all three of you would vigorously support the

False Claims Act and, particularly, the qui tam provisions.

Would you work cooperatively with the—I think I am going to

have to ask four separate questions and get responses from each

of you.

Will you work cooperatively with the Attorney General in the Department of Justice to vigorously enforce the False Claims Act?

Ms. MURRAY. Yes, sir.

Mr. ESQUEA. Yes, Senator.

21

Mr. SAMUELS. I will.

Senator GRASSLEY. Would you oppose efforts by industry groups,

including the health care industry, to weaken the False Claims Act

and the qui tam provisions of the False Claims Act? Let me give

you some background on this.

First, getting the bill passed, you are fighting the defense industry. Then the defense industry, after we got it passed, the defense

industry tried to gut it. Then when the defense industry did not

have enough support to get it gutted, they got the American Hospital Association, in the early 1990s, to get the thing gutted, and

that did not succeed.

There still are efforts to do that. I cannot be specific on recent

ones, but they never go away. There is always somebody wanting

to get at this tool that works so well. I guess I asked the question

and did not wait for the answer.

Will you oppose efforts of industry groups to weaken it?

Ms. MURRAY. Yes sir, I will.

Mr. ESQUEA. Yes, Senator.

Mr. SAMUELS. Absolutely.

Senator GRASSLEY. And I think the reason I ask that question is,

I believe that in one of the Republican administrations they had

the cooperation of the department in that effort. I do not know

whether it is your department or another department.

Would you agree to promote close working relationships between

qui tam relators and the Department of Health and Human Services for purposes of reducing fraud, waste, and abuse in Federal

health care programs?

Ms. MURRAY. Yes, sir.

Mr. ESQUEA. Yes, Senator.

Mr. SAMUELS. Yes.

Senator GRASSLEY. Thank you.

This is the last one. Would you work cooperatively with me to ensure that a bill I introduced earlier this year to restore the original

intent of FCA is reviewed and commented on by the Department

in a timely manner and with constructive input? That is not to say

you agree with the bill or not, it is just to get the information from

the Department so that is not standing in the way of our moving

the bill along.

Ms. MURRAY. Yes, Senator.

Mr. ESQUEA. We will definitely be helpful, yes.

Mr. SAMUELS. Yes, I will.

Senator GRASSLEY. Thank you.

Could I ask Mr. Samuels—can I go ahead, because this would

really be a second round? Mr. Samuels, as you know, the so-called

child-only TANF cases are increasing as a percentage of the total

welfare caseload, yet States have very little in the way of requirement to provide services to these children.

A couple questions, and I want to ask them together. Do you

share my concern that some States are shifting children into a

child-only TANF case instead of directing them to a guardianship

arrangement or even into foster care? If confirmed, how would you

plan to address or coordinate the effort within ACF to improve access to services to these children? Two separate questions. One is

not tied to the other, as far as——

22

Mr. SAMUELS. I think, first of all, I certainly share your concern

about this population. I have not spent enough time looking State

by State to see the behavior that individual States are engaged in,

but this is a population that has remained, even as the larger

TANF population has decreased. It is certainly an area where we

need to look.

I think the challenge on this is that I am not sure we know

enough about all of the kids and families that are in this child-only

population. There are a number of studies out there that would describe it as a pretty heterogeneous population, so it is not all one

kind of parent or non-parent. So, I think the first thing we need

to do is get clear on exactly who this population is.

I think the second question is, really, are the issues that these

families are facing really issues around child welfare or are they

issues around child poverty? I think, depending on who is responsible for the child, we could very easily be in a child welfare situation or we could be in a child poverty situation. I would like to explore that some with you and your staff before taking a position.

The last question I would ask in looking at this issue is: What

is the outcome we want to get for these kids and families? Because

I think, in the absence of stating up front what we want to accomplish, it is very difficult to then decide what the appropriate intervention is.

Those are the kinds of questions I would ask and that would be

the kind of conversation I would like to have with you and your

staff as this issue moves forward.

Senator GRASSLEY. Well, I would like to give you my—first of all,

I am satisfied with your answer, particularly because you said you

wanted to confer with my staff on this. I would like to answer the

question you raised about what the goals are. Obviously, we have

to have goals and they are good. For me, what I have heard from

the kids themselves, what they want is permanence. They want a

mom and dad. We ought to help them get that, and we ought to

be ashamed of the number of people who are aging out and not

having had that arrangement.

When you go through the maze that is an example of what you

have to go through when you are in this system—because I have

done that when the Wendy’s founder was alive—you come to the

conclusion that when kids who are 15 years old say that what they

want is a mom and dad, they want permanence, they do not want

to be shoved from one place to another. That is the goal that I seek,

and it is not something I thought of, it is something I have heard

from them.

Mr. SAMUELS. I think the only issue I would raise on that one

is that, when you look at the child welfare population, in all of the

work that this committee and others have done to really first make

sure that the appropriate services are available and that we reduce

the population as quickly as is appropriate, we have seen some reduction in the overall population.

As we sit here today, the child-only population is larger than the

entire child welfare system is today. There is an order of magnitude issue here of really making sure that the children in the

child-only population who are appropriate for child welfare services

are identified without assuming that all of the children in that catVerDate 11-MAY-2000 10:20 Jun 03, 2010 Jkt 000000 PO 00000 Frm 00026 Fmt 6633 Sfmt 6633 56644.000 SFIN1 PsN: SFIN1
23

egory necessarily need to be placed in the child welfare system. I

would just like to work through the details on that going forward.

Senator GRASSLEY. Well, I appreciate your sincerity.

Also, for you, if you are confirmed, you will oversee an implementation of the Success in Increasing Adoptions, or what we call the

Connection Act. That is a very expansive reform that we have

passed. You dealt with this in your opening statement, that it is

a priority for you

I would ask you to be a little more specific, because a number

of key reforms, including in this legislation, are options for States.

Of particular importance for me are the options to establish permanent kinship relationship and extend eligibility for foster care to

age 21.

If confirmed, how do you intend to work with States to ensure

that as many of them as possible take up the options provided in

the 2008 act? And if you can be specific, I would appreciate it.

Mr. SAMUELS. Sure. Let us start with me articulating where I

think the field is at. I think that the last couple of years of reductions in budgets have really had a negative impact on the child

welfare system. I think that there are States out there that are

today really struggling to meet the basic obligation they have to

children in the foster care system.

One of the things I would like to do in this position, if confirmed,

is to engage those directors again and get a much better feel for

exactly where the field is at and the kind of struggles that they are

having to just keep the basic services in place. I think that is a precursor to some of this work. As it relates to the Fostering Connections Act, in Illinois, as you know, we aggressively worked to move

children through and out of the system using kinship guardianship

as one of the major vehicles. Over a 10-year period of time we

moved about 10,000 children out of the system using that vehicle.

We have some experience there, and I would hope to apply what

we did in Illinois to the circumstances that other States have, and

to work with those States to adopt strategies. Their strategy may

look different than the one we used in Illinois. It probably will look

different. But I think I have some credibility on that issue, and I

think I can work with State directors to move that forward.

On the other side, as you also know, we have worked pretty extensively in the State of Illinois to move kids out of the system, and

part of the experience there was beginning to understand that,

even after kids leave the system, they need ongoing support. We

have really looked at that issue very closely, particularly given that

Illinois has been one of the few States that actually allowed children to stay in care to the age of 21.

What we found there is, you get dramatically better outcomes for

the kids who are allowed to stay until they are 21. I think it is a

conversation with the States about what are the options they have

available to them to really move to 21 and what are the kinds of

outcomes they can achieve for their kids by moving to 21.

I think there is a decent amount of experience. I would like to

blend it with other things that have happened in the country and

then work very closely with State directors to figure out how to

help them move forward on each of these critical areas, even if one

State’s strategy looks very different than the other. I think that is

24

probably likely to be the case, and so we will just have to work oneby-one with those States to move each of those components forward.

Senator GRASSLEY. Yes. In regard to your first statement about

States having trouble, that may now be a problem. Is it your belief

that that is directly related to the recession we are in, or do you

think there are other problems?

Mr. SAMUELS. No, I think it is the recession we are in. So you

have a number of States that just have much fewer tax revenues

coming in, and as a result they have had to make significant decreases in their overall commitment, and that is having an impact

on the child welfare system.

Senator GRASSLEY. My last question to you, and then I am done.

I am sorry to hold up the other two.

Nearly everyone in the child welfare community thinks that the

financing system is in need of serious overhaul. The eligibility

threshold goes back to former AFDC standards and that is outdated. The majority of Federal funding is directed to the least preferable outcome, which is placing children in foster care. Funding

for family preservation, including treatment for substance abuse,

continues to be insufficient. However, one of the longstanding debates in the child welfare community has been on how to restructure child welfare financing. Some favor expanding the entitlements, others argue for block grant. So, what do you see is the

greatest challenge to reforming the current child welfare financing

structure, and what ideas for reform do you bring to the position

that you have been nominated for?

Mr. SAMUELS. I think the biggest challenge is the need for more

resources. That would be the easy answer, which is that I think,

as a director of child welfare, I found myself often having to choose

between two very unattractive options in terms of what I could afford to do for kids.

I think there are a number of State directors who would simply

argue that they need access to additional resources. But given that

that is unlikely to occur, I think that—again I would like to play

with the details a little bit on this, but—I would like to look very

closely at the block granting option.

I think that the States need some flexibility. I think States take

different approaches to it. A good example is, the work that we did

in Illinois resulted in us having about 16,000 kids in care, 17,000

when I left, but today there are about 16,000. If you look at the

county of Los Angeles alone, they have almost 15,000 kids in care.

So, you take one county versus an entire State, the reality is that

each of these systems looks very different. You also have the phenomenon of States that have county-based systems, so each county

is making decisions about how to create and craft support services

for children in the child welfare system.

I think block granting is worth exploring because it would give

States the flexibility to attune what their kids need with the system that they currently have and support. I would like to take a

look at that, but it is a complex system, obviously, and there would

have to be a whole lot of discussions about what we would do to

really get the kind of results we want. I agree with you that right

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now we are funding the wrong things in terms of the kinds of outcomes we want to achieve.

Senator GRASSLEY. Thank you.

Thank you, Mr. Chairman.

The CHAIRMAN. I thank all of you for serving and wish you the

very, very, very best. There will be ups and downs as there always

are, but, basically, you will be guided through dedication to service

and helping the people that you are serving. So I just wish the

very, very best. I urge you to just go for it, give it all you have,

and work with us, because you have a committee here that wants

to work with you.

The committee is adjourned.

[Whereupon, at 11:25 a.m., the hearing was concluded.]

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