September 2006

Public Health Funding Update
Congress reconvened on September 5 after its August recess with only one of the 12 annual appropriations bills completed.  As reported previously in Notes from Washington, the House and Senate Appropriations Committees have both passed versions of the Labor-Health and Human Services-Education (L-HHS) appropriations bills for Fiscal Year 2007.  Most programs in the bills received level funding (close to FY06 levels).  Funding for public health preparedness for state and local health departments remains far below FY05 levels.  A chart showing the status of House and Senate Appropriations action and further details on spending levels can be found at http://thomas.loc.gov/home/approp/app07.html

The possibility of House and Senate passage of the L-HHS bills prior to the November elections is unlikely, with controversial minimum wage increase legislation still attached to the bill in the House.  In addition, the L-HHS bill in the Senate still lacks $2 billion that was passed in the Senate budget resolution.  However, the fiscal year 2006 Emergency Supplemental bill contained a "deeming resolution" that forced the Senate to make significant spending cuts in domestic programs. NACCHO, in collaboration with many other health care associations, is pressing hard for the $2 billion to be added to the appropriations bill.  Senators Specter (R-PA) and Harkin (D-IA), Chairman and Ranking Member of the Senate health appropriations subcommittee, have circulated a letter to their colleagues asking for the additional $2 billion to bring the bill back to FY05 levels.  Go to NACCHO’s Legislative Action Center http://congress.nw.dc.us/naccho/home/ for more information about how you can take action.

If the L-HHS bill is not passed before Congress adjourns September 29, the bill will be attached to an omnibus appropriations bill combining several different departments when members of Congress return after the November elections for a “lame duck” session.  In the event that the new fiscal year starts October 1 without the appropriations bills being completed, Congress will pass a continuing resolution to keep government programs funded at current levels. 

**This fall will be a critical time for activity on public health appropriations. Watch your inbox for action alerts or check NACCHO’s Legislative Action Center (http://congress.nw.dc.us/naccho/home/) for updates.

Ryan White CARE Act Moves Toward Reauthorization
On September 20, the House Energy and Commerce Committee passed the Ryan White HIV/AIDS Treatment Modernization Act of 2006, reauthorizing the Ryan White CARE Act.  The CARE Act is the nation’s largest federal grant program targeted toward people living with HIV/AIDS and a critical source of care and treatment for this population.  A version of CARE Act reauthorization was already passed by the Senate Health, Education, Labor and Pensions (HELP) Committee.

The bill would create a new requirement for Title I-IV grants, available to eligible metropolitan areas.  These grants would need to be spent 75% on core medical services and 25% on support services.

NACCHO has opposed the Early Diagnosis Grant Program included in the bill.  It would divert $30 million from HIV/AIDS prevention efforts in the Centers for Disease Control and Prevention and would be targeted toward the states to implement new HIV testing policies, especially mandatory testing for newborns.  This provision would reduce the amount of funds available to the CDC for HIV/AIDS prevention and produce a detrimental effect on local public health prevention efforts that are already underfunded.  To redirect prevention dollars for use in prescribed testing activities will limit the flexibility to respond to local prevention needs.

NACCHO has recommended the following changes to the Early Diagnosis Grant Program:
enable award of testing grants to jurisdictions that comply with either of the two categories, conducting voluntary opt-out testing of pregnant women and universal testing of newborns or voluntary opt-out testing of clients at STD clinics and voluntary opt-out testing of clients at substance abuse treatment centers and target the use of funds for "treatment of mothers infected with HIV/AIDS" instead to"treatment for pregnant women to prevent perinatal transmission." 

USDA Releases Revised Rules for WIC Food Packages
The U.S. Department of Agriculture has released a new proposed list of foods that will be eligible for vouchers under the Women, Infants and Children program.  The proposed list includes more fresh produce and grains.

Comments must be postmarked or sent electronically on or before November 6, 2006.   More information is available at http://www.fns.usda.gov/wic/regspublished/foodpackagesrevisions-proposedrule.htm.

Federal Support Ending for Kids’ Physical Activity Campaign
Federal funding for a popular campaign effective in increasing children’s physical activity will end in September, after five years.

The program, called VERB, included innovative marketing to kids to find their own “verb,” or physical exercise.  Advertisements were aired on children’s shows such as “SpongeBob SquarePants” and through distribution of 500,000 yellow balls that are tracked on the program website to catalogue how children are using them.

VERB was funded through the Centers for Disease Control and Prevention and has received $339 million.  Congress failed to include funding for the program in the Fiscal Year 2006 budget for CDC.

More information about VERB is available at www.verbnow.com.

House and Senate Pass Legislation Supporting Electronic Health Records
Both the House and the Senate have passed legislation to promote the use of electronic health records by health care providers (H.R. 4157/S. 1418).  However, a conference committee has not yet been appointed to reconcile differences between the two bills. 

Both bills include demonstration grants to help with startup costs for health information technology.  The Senate bill authorizes $250 million for grants for to help health care providers to purchase health information technology systems; the House bill authorizes $40 million for this purpose.  The House bill would also provide grants to improve the coordination of health care for uninsured, underinsured, and medically underserved individuals.

The House bill requires the Dept. of Health and Human Services to conduct a study of health information exchange, including any benefits in the areas of public health preparedness and response or the promotion of wellness, disease prevention, and chronic disease management.

The House bill also provides “anti-kickback” protections for hospitals that transfer software to physicians for use in exchanging electronic medical records.  Some House Republicans believe these protections should be stronger.  This issue may be a barrier to reconciling the two bills in conference committee.

***Remember to visit http://capwiz.com/naccho/home/ for all the latest legislative news from Washington.***