March 2009

This month, economic stimulus funds are beginning to flow out from the federal government. The Obama Administration has not made any decisions about how the public health funding from the American Recovery and Reinvestment Act will be spent. We will continue to keep you apprised of future developments.

Congress Passes FY09 Omnibus Appropriations

On March 11, President Obama signed an omnibus appropriations bill providing funding for government agencies through September. The following chart details funding for public health programs.

Selected Public Health Programs (All CDC except as noted)	FINAL FY 2008	FY09 Omnibus (+/- change from FY08)
Terrorism - Upgrading State and Local Capacity	746 M	746 M
Local/State PH Preparedness Cooperative Agreement	700 M	700 M
Preventive Health Block Grant	97.3 M	102 M (+4.7 M)
Section 317 Immunization Program	466 M	496 M (+ 30 M)
Chronic Disease Prevention	834 M	881 M (+47.9 M)
Healthy Communities	25 M	22.8 M* (-2.2 M)
Maternal/Child Health Block Grant (HRSA)	659 M	662 M (+2.9 M)
Environmental Health and Injury Prevention	289 M	331M (+42 M)
Environmental Public Health Tracking	23.8 M	31.1 M (+7.3 M)
Climate Change	--	7.5 M

* $4 million for community-based grant program focusing on poor nutrition and physical inactivity

Most public health programs received level funding, the same as or close to the FY08 level. NACCHO advocated with other public health partners for inclusion of funding for climate change at CDC. This is the first time climate change has been included as a line-item appropriation at CDC. NACCHO continues to advocate for increased funding for programs that benefit local health departments, especially in light of recent job losses and budget cuts. See below for further information about FY10 appropriations.

NACCHO Testifies on FY10 HHS Appropriations

On March 18, NACCHO Executive Director Robert M. Pestronk testified before the House Appropriations Subcommittee on Labor, Health and Human Services, and Education on FY10 appropriations for public health programs. Pestronk argued that federal funding is critical to the continued strength of local health departments (LHDs), as states and localities continue to be impacted by the economic downturn. According to NACCHO's testimony, "The nation's current recession further diminishes the ability of local health departments to measure population-wide illness and death, organize efforts to prevent disease and prolong quality of life, and to serve the public through organized programs not offered elsewhere. Repeated rounds of budget cuts and lay-offs in LHDs continue to erode capacity. Reductions in local and state tax bases further undermine these sources of support. A NACCHO survey found that in 2008, at least 7,000 LHD jobs were lost in 46 states across the country. Far more are expected this year, and many LHDs are currently reporting budget cuts in the 20 to 40% range."

You can download NACCHO's written testimony at: http://www.naccho.org/press/testimony/

NACCHO's testimony advocates for the following programs:

Chronic Disease Prevention
Preventive Health and Health Services Block Grant
Healthy Communities
Racial and Ethnic Approaches to Community Health (REACH)
Title V Maternal and Child Health Block Grant

Emergency Preparedness
Public Health Emergency Preparedness Cooperative Agreement
Advanced Practice Centers
Medical Reserve Corps

Public Health Workforce
Public Health Workforce programs

Environmental Health
Environmental Public Health Tracking
Climate Change

Health Information Technology programs for public health
CDC National Center for Public Health Informatics
Office of the National Coordinator for HIT

The appropriations process has begun with committees in both the House of Representatives and the Senate starting deliberations soon. President Obama released an outline of the FY2010 budget on February 26. This outline does not include detailed numbers, but indicates what the priorities will be for the Obama Administration. A detailed budget is expected to be released in April.

A brief description of highlights for Health and Human Services can be found at http://www.whitehouse.gov/omb/budget/. The budget outline indicates that the President's budget will include more than $600 billion in a reserve fund set aside for healthcare reform. The outline also includes the following priorities: nurse home visitation for low-income mothers, Medicaid increases, food safety at the Food and Drug Administration, HIV/AIDS prevention and treatment, and health information technology.

We will keep you posted on future developments as the appropriations process moves forward.

Public Health Advocates Nominated for FDA

On March 14, President Obama nominated Dr. Margaret Hamburg to head the U.S. Food and Drug Administration and Dr. Joshua Sharfstein as principal deputy commissioner. Dr. Hamburg's appointment requires Senate confirmation.

Dr. Hamburg has served as a vice president of the Nuclear Threat Initiative and as an assistant secretary in the Department of Health and Human Services. She has also served as New York health commissioner. Dr. Sharfstein is currently Baltimore's commissioner of health.

NACCHO congratulates both Dr. Hamburg and Dr. Sharfstein on being nominated to these important posts and looks forward to working with these public health practitioners who have first-hand experience at the local level.

The president also announced that he intends to create a Food Safety Working Group to make recommendations about upgrading our food safety laws for the 21st century, fostering coordination throughout government, and ensuring that food safety laws are enforced.