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January 2008

Public Health Funding Update – Final Numbers for FY08 Funding

On Dec. 26, 2007, President Bush signed an omnibus spending bill that wraps together 11 appropriations bills to fund government agencies in fiscal year 2008. The omnibus appropriations bill was passed after months of partisan wrangling, during which the Democrats attempted and failed to override the President's veto of a larger spending package for Labor, Health and Human Services and Education. The President had vowed to veto any bills that would cause overall spending to exceed the total included in his proposed budget.

In the final omnibus bill, $11 billion in spending was cut from earlier proposals, and a further across the board cut of 1.7 percent for all programs was enacted. The funding status of selected public health programs appears in the table below. Numbers (in millions) are rounded.

Selected Public Health Programs

(all CDC except as noted)

FY2007

President

FINAL

FY 2008

Change

from FY2007

Terrorism—Upgrading State and Local Capacity

766 M

698 M

746 M

-2.7%

Local/State PH Preparedness Cooperative Agreement*

713 M

698 M

700 M

-1.7%

Preventive Health Block Grant

99 M

0

97.3 M

-1.7%

Section 317 Immunization Prog.

453 M

425 M

468 M

+3.3%

Chronic Disease Prevention

825 M

834 M

834 M

+1.1%

Steps to a Healthier US

42.9 M

26.3 M

25.1 M

-41.4%

Maternal/Child Health Block Grant (HRSA)

693 M

693 M

666 M

-3.8%

Environmental Health/Injury Prevention

283 M

287 M

289 M

+2.3%

Environmental Public Health Tracking

23.7 M

24.0 M

23.8 M

+.7%

*Congress actually appropriated $760 million for the preparedness cooperative agreements in FY 2007. However, CDC subsequently reduced this amount, with Congressional permission, by reprogramming $39 million for domestic HIV testing and additional sums for various CDC overhead spending items. The amount that was actually sent out to grantees was $713 million, but this number masks the substantial cuts taken in FY 2007 and does not reflect the original FY 2007 Congressional appropriation.

The added Section 317 immunization funding is one of the few increases. Congress also gave the Centers for Disease Control and Prevention (CDC) an additional $19 million to increase demandfor seasonal flu vaccine. The final bill excluded a provision passed by the House of Representatives that would have restricted the use of federal funds for any flu vaccine containing thimerosal for children less than three years of age. We expect this issue will continue to arise because there is bipartisan support for a thimerosal ban.

The cut in the Steps program reflects the Administration's intent to phase out that program, with which appropriators have concurred. Overall, the one percent increase in chronic disease prevention will not compensate for inflation.

The appropriations process for Fiscal Year 2009 will soon be underway with the President's budget expected in early February. Congress is well aware that negotiations with the Administration will be as futile in an election year as they were this year. It is reasonable to predict that there will be no final action on appropriations until after the November election, and perhaps not until a new President takes office in January 2009. However, the appropriators will proceed with crafting the FY09 bills on schedule and timely, vigorous advocacy will be critical. NACCHO will keep you informed.

2007 Statements of Policy Accessible on NACCHO Website

An essential part of NACCHO's mission is to protect and improve the health of all people by promoting national policy. This is accomplished partially through the development and dissemination of policy statements on issues important to local public health.

The purposes of NACCHO policy statements are to provide local health departments with position statements on issues that may be important in their communities, as well as to communicate NACCHO's positions on these issues to policymakers, the media and the broader public. Each NACCHO policy statement is reviewed and approved by the NACCHO advisory group with the relevant expertise and then voted upon by the Board of Directors. All policy statements are reviewed and updated every three years.

The following NACCHO policy statements were approved by the Board of Directors in 2007 and can be found at http://www.naccho.org/advocacy/NACCHOpositions.cfm:

Community Health
Adolescent Health Platform
Changes to the Medicaid Program
Comprehensive HIV Testing
Enhancing the Capacity of Local Health Departments To Monitor, Prevent, Control Emerging Multi-Drug Resistant Organisms
Firearm Control
Funding for the State Children's Health Insurance Program
Immunization Infrastructure Funding
Infectious Disease Prevention and Control and Transparency Between U.S. Dept. of Agriculture and State and Local Health Departments
Local Health Department Epidemiology and Surveillance Capacities
Motorcycle Helmet Laws
Policy Action Steps on Tobacco Use Prevention and Control
Promotion of Mental Health and Prevention of Mental and Substance Abuse Disorders
School-Entry Immunization Mandates
Support For Evidence-Based Nurse Home Visitation Programs

Environmental Health
Child Lead Poisoning Prevention
Climate Change
Environmental Public Health Tracking
Mosquito Control

Public Health Infrastructure and Systems
Health Information Exchange and Interoperability
Public Health Informatics Workforce

Public Health Preparedness
Local Public Health All-Hazards Preparedness

Please contact Eli Briggs, Government Affairs Specialist, at ebriggs@naccho.orgwith any questions about the policy development process or consult the staff directory for the appropriate person to contact with questions about individual policies: http://www.naccho.org/about/staff.cfm.

Action alerts, sample letters and talking points and contact information for your Members of Congress can be found at NACCHO's Legislative Action Center.