89 



prevalent throughout the building and must be contained, and ultimately eliminated, 

 when any disruption to it occurs. On average, it costs us $128 a square foot to reno- 

 vate a lab module in the Clinical Center. By contrast, a typical lab renovation at facili- 

 ties designed according to modern standards, such as the Salk Institute in California, 

 costs only $50 per square foot. Besides the costs associated with asbestos removal, this 

 difference is due to the age and the limited utility capacity of the Clinical Center, and 

 by the extraordinary amount of infrastructure modifications that must be made for 

 even the smallest change or addition. For example, to add a fume hood to a laboratory 

 at the Salk Institute, mey would simply bring the hood into the laboratory and con- 

 nect it to the utility systems that run ciirectly above the unit. By contrast, under the 

 best conditions we must pull down the ceiling for the entire length of the corridor un- 

 til we find a connector of sufficient capacity to accommodate the new hood, thus dis- 

 rupting the work of a number of laboratories. Often we must undertake major 

 renovations to create the capacity needed. 



Fume hoods are but one example of the general problem that the Clinical Center 

 has with providing for technologies that require local exhaust ventilation. Deficiencies 

 in the building's air systems result is potential exposure of NIH personnel to hazard- 

 ous fumes, and in the delaying of important research. For example, a laboratory lo- 

 cated next to one of our surgery units was to be used for drug resistant TB research, 

 but because of incorrect air flow, can not be used for this or any other infectious dis- 

 ease work. 



In 1987 NIH initiated studies to examine the extent and severitv of deficiencies in 

 the CUnical Center's infrastructure systems. These studies indicated that the deficien- 

 cies were severe and widespread. Upgrading of the Clinical Center in terms of essen- 

 tial safety and health infrastructure needs was included in the FY 1991 Presidential 

 budget submission. 



In response to NIH's initial proposal to upgrade the Clinical Center and other 

 laboratory facilities, the House Committee on Appropriations requested that the Sec- 

 retary of 1-Iealth and Human Services conduct a review of these needs in cooperation 

 with other Federal agencies. The U.S. Army Corps of Engineers agreed to assess 

 NIH's Facilities Revitalization Program regarding the extent of the problems, and the 

 probable cost and time table for accomplishing the work. In their 1991 report, the 

 Army Corps of Enjgineers Review Committee substantiated the extent of the overall 

 problems identified in NIH's Facilities Revitalization Program. 



Specifically^ the review committee found that "the Clinical Center Complex is in 

 serious need or major corrective action to resolve its facilities deficiencies. The Review 

 Committee agrees that the utility systems within the Clinical Center Complex have 

 deteriorated beyond reasonable repair. The systems are no longer reliable; they violate 

 codes and regulations, and are difficult and costly to maintain; the capacity of^the sys- 

 tems has been exceeded, and they do not provide adequate flexibility for modification 

 or upgrade." The Review Committee concluded that NIH's proposed solution -- to 

 upgrade the existing Clinical Center -- was not the best solution. Further, the Com- 

 mittee concluded that total replacement of the Clinical Center Complex is the optimal 

 technical solution, although other reasonable alterations would be less costly. The 

 Corps was not asked to address whether the scope and size of the current program is 

 stiU appropriate. This question must be answered before proceeding. 



Future steps to resolve facility problems at the Clinical Center will depend on the 

 outcome of a review of the intramural research program by the new Director of NIH, 

 the Assistant Secretary for Health, and the Secretary, DHHS. This review is in re- 

 sponse to a request made in the House Report accompanying the FY 1993 Labor and 

 Health and Human Services appropriation dlU (H. Rept. 102- 708). 



CONCLUSION 



In conclusion, I believe that the future success of NIH's intramural efforts to im- 

 prove the health of the American people rests in the hands of many: dUigent scientists 

 and doctors; engineers and electricians; and ultimately those of us who allocate re- 

 sources provided by you and your colleagues. 



This concludes my prepared statement. I would be pleased to respond to your 

 questions. 



