00:00Thank you, Brother Chair. Great to be here. Welcome to the hearing. Much of the funding for the CDC,
00:07which I'm proud to say is based in Atlanta, flows directly to state and local health departments.
00:15But the Trump administration's massive firings at the CDC mean that many dedicated expert staff
00:22are no longer there to assist and guide state and local health officials who are trying to respond
00:29to public health threats. And many grants that were already awarded to state and local health
00:35agencies are now left in limbo, with several multi-year contracts canceled by this administration,
00:46including some contracts that were already near completion. Mr. Shirello, you're nominated to be
00:54in charge of financial resources at HHS. So please tell me, how is canceling active
01:02multi-year contracts awarded by CDC, some of which were 90 percent completed with most of the money
01:10already out the door, and efficient use of federal funding? To me, it seems unadvised
01:19a kind of summary dismissal of work that's already being done and an ideological waste of federal
01:27resources. Can you help me to understand why this makes sense? Well, Senator, thank you for the question
01:34and for your interest in the topic. What you're talking about are contracts that I have not had the
01:40opportunity to work in or understand the facts, as I've testified before. I'll follow the law when it
01:46comes to the allocation of funds and the management within the agency. So welcome to the hearing,
01:57and congratulations to you and your family. I questioned a nominee about similar contracts a couple
02:06weeks ago or last week, and I'm hearing the nominees come up here and say, I'm going to follow the law.
02:11That's good. I support that. It's basic, but it's good. But I'm asking you a management question,
02:19if this makes sense. So understanding the issues, from my perspective, requires learning about the
02:24issues and leaning into the operating divisions to understand how those decisions are made, and then
02:31evaluating the allocation of the resources. So you haven't had a chance to take a look?
02:37Well, I haven't looked at those issues. So if confirmed, will you look into these canceled CDC
02:44contracts to see if any federal funds have been wasted due to incomplete work? And will you report
02:51your findings, whatever they are, back to this committee? Yes or no? I absolutely commit to work
02:56with the committee on their inquiries relative to the work we do. Yes or no? It's a simple question,
03:02sir. Well, as I've testified, I don't know exactly the contract you're talking about, but I am going
03:07to look into the issues when, you know, should I be confirmed? You will look into the issue and report
03:12to the committee what you found. I will follow the law accordingly and report back to the committee.
03:18I take that as a yes. Well, as I said, I'll follow the customs. So let me say, I would urge you to
03:23consider the important programs at CDC that help states keep their public health programs strong,
03:30particularly in a situation where the grants were almost completed. We could begin to see the impact,
03:35it seems to me, and do some analysis. To have those grants then summarily dismissed seems more ideological
03:43than anything else. If confirmed, you will be responsible for developing and advising the
03:48secretary on the budget for HHS. Do you agree that in public health, investing dollars up front
03:55through grants and other programs can often save money down the line?
04:02Senator Warnock, I'm an antitrust lawyer and as such, I know that there's different economic incentives
04:07based on when money flows into different projects. And you want to be able to balance the incentives,
04:13particularly when you're spending public dollars, to both incentivize the outcomes that are intended by
04:20the allocated resources, but also to do so in such a way so as not to create an environment that festers
04:27for waste, fraud, and abuse. I feel like I gave you a softball question. I asked, do you think investing
04:34money up front can often save money down the line? And I think I just answered the question only in
04:40that, yes, sometimes it can. Let me give you more context. We all know that Secretary Kennedy
04:46talks a whole lot about wanting to address chronic disease, and I support that. I've seen it up close
04:52as a pastor and as a senator. But let's look at what he's done these last few months. On April 1st,
04:57Secretary Kennedy completely demolished the CDC's National Center for Chronic Disease Prevention and
05:03Health Promotion. And in the president's budget request, the center was completely zeroed out.
05:07This office ran programs at preventing Alzheimer's disease, diabetes. Let me quickly say that one
05:14dollar out of four in our country on health care is spent on people with diabetes. It's the context for
05:22which, you know, we see emerging disease and sickness. Heart disease, cancer. Do you think working to
05:29prevent Alzheimer's disease, prevent diabetes, when one dollar out of four in our health system is
05:37spent on people with diabetes? Does that feel like government waste to you? Well, I answer that by
05:44saying I support Secretary Kennedy's efforts to focus on things like waste fraud and abuse and also to
05:50make sure that the funds that are being allocated by Congress are getting to the people who most need
05:56them. And sometimes that involves reorganization or refocusing. And I look forward to getting into
06:00the position. Brother Chairman, I want to thank you for giving me some extra time. And so let me just say
06:07that an ounce of prevention is worth a pound of cure. And we literally see that in the work that CDC does.
06:16And I would hope that you would look at this, that you would take it seriously, because it's literally
06:23a matter of life and death. Not to mention the implications for the federal budget. Thank you so
06:29much. Thank you, Senator. Senator Tillis.
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