July 2010

As the temperature rises in Washington, DC, public health and prevention continue to be hot topics at the Administration level and in Congress. Some of the highlights can be found below.

Child Nutrition Reauthorization Moves forward; Help Needed to Urge Further Action

On July 15, the House Education and Labor Committee passed the Improving Nutrition for America's Children Act of 2010, a bill to reauthorize and expand child nutrition programs. The bill includes the following changes:

• Improves the quality of school meals by requiring an increase in reimbursement for school lunch for the first time in more than 30 years.
• Strengthens local school wellness policies by providing the Secretary authority to oversee local wellness policies to promote improved implementation and transparency, and requiring opportunities for public input.
• Increases efficiency, improves program administration, support services, and program access, and modernizes the WIC program by extending period of certification for children, increasing support for breastfeeding, and transitioning from paper food vouchers to an electronic benefit program.
• Helps communities establish local farm to school networks, establishes school gardens, and encourages more local foods in school cafeterias.
• Ensures school meals are safe for all students by extending food safety requirements to all areas in which school food is stored, prepared, and served.

The Senate Agriculture Committee has already passed their child nutrition reauthorization bill, which awaits action on the Senate floor. The Senate bill costs approximately $4.5 million over ten years, and the House bill costs $8 million.

With time running out in this election year for action in both houses of Congress, NACCHO has prepared action alerts urging leaders in the House and Senate to take action on this legislation without delay. These action alerts are available at NACCHO's Legislative Action Center where you can quickly personalize a letter and fax it to your Senators and Members of Congress. Please contact Eli Briggs, NACCHO Government Affairs Specialist, with any questions.

Details of Public Health and Prevention Fund Investments Announced

In June, the Department of Health and Human Services (HHS) announced the allocation of funds from the Prevention and Public Health Fund created by health reform legislation in the Patient Protection and Affordable Care Act (ACA). Of the $500 million in mandatory funding available in FY10, $250 will go to primary care workforce development, and $250 million will be invested in public health and prevention.

The $250 million investment in prevention and public health will go to the following:

• Community and Clinical Prevention: $126 million will support federal, state, and community prevention initiatives; the integration of primary care services into publicly funded community-based behavioral health settings; obesity prevention and fitness; and tobacco cessation.
• Public Health Infrastructure: $70 million (see below).
• Research and Tracking: $31 million for data collection and analysis; to support the Task Force on Community Preventive Services; and to improve transparency and public involvement in the Clinical Preventive Services Task Force.
• Public Health Training: $23 million to expand the Centers for Disease Control and Prevention's (CDC) public health workforce programs and public health training centers.

A grant announcement was released in July regarding the five-year "Strengthening Public Health Infrastructure for Improved Health Outcomes" cooperative agreement program. This program is designed to support innovative changes that improve the quality, effectiveness, and efficiency of the public health infrastructure and support the delivery of public health services and programs as specified within ACA.

In FY10, $42.5 million will be awarded  in cooperative agreements on a competitive basis. Eligible applicants include all 50 states, Washington, DC, nine large local health departments supporting cities with populations of one million or more (Chicago, Dallas, Houston, Los Angeles, New York City, Philadelphia, Phoenix, San Antonio, San Diego), five U.S. Territories, three U.S. affiliated Pacific islands, and up to seven federally-recognized tribes with an established public health department structure (or their equivalent) that provides public health services. In total, $212.5 million will be available over five years.

The deadline to submit an application is Aug. 9, 2010. More information and details about how to apply can be found here.  NACCHO has urged local health departments ineligible to apply and SACCHOs  to work with their states to strengthen applications for this competitive process. 

NACCHO Members Provide Input for National Prevention Strategy

At NACCHO Annual 2010, NACCHO members had an opportunity to give input to the Administration’s National Prevention, Health Promotion, and Public Health Council. Andrew Rein, Associate Director for Policy, CDC, moderated a listening session where attendees provided input for the National Prevention Strategy.

Future listening sessions are planned and individuals can give their input by e-mail. 

The ACA also directs the President to establish an Advisory Group on Prevention, Health Promotion, and Integrative and Public Health. NACCHO has submitted the name of Board member Herminia Palacio, MD, Director of Harris County (TX) Public Health and Environmental Services as its recommendation for nomination to this Advisory Group.

Preventive Health Services Regulations Announced

The Departments of Health and Human Services (HHS), Labor, and the Treasury issued new regulations in July requiring new private health plans to cover evidence-based preventive services and eliminate cost sharing requirements for such services starting Sept. 23.

Specifically, these recommendations include the following:

• Evidence-based preventive services: The U.S. Preventive Services Task Force rates preventive services based on the strength of the scientific evidence documenting their benefits. Preventive services with a “grade” of A or B, like breast and colon cancer screenings, screening for vitamin deficiencies during pregnancy, screenings for diabetes, high cholesterol, and high blood pressure, and tobacco cessation counseling will be covered under these rules. 
• Routine vaccines: Health plans will cover a set of standard vaccines recommended by the Advisory Committee on Immunization Practices.
• Prevention for children: Health plans will cover preventive care for children recommended under the Bright Futures guidelines, developed by the Health Resources and Services Administration with the American Academy of Pediatrics. The types of services that will be covered include regular pediatrician visits, vision and hearing screening, developmental assessments, immunizations, and screening and counseling to address obesity and help children maintain a healthy weight. 
• Prevention for women: Health plans will cover preventive care provided to women under both the Task Force recommendations and new guidelines being developed by an independent group of experts which are expected to be issued by Aug. 1, 2011.

More information can be found here.

Input Sought for Menu Labeling Regulations

The ACA requires chain restaurants with 20 or more locations that offer substantially the same menu items to list calorie content information on menus and menu boards. Other nutrition information—total calories, total fat, saturated fat, cholesterol, sodium, total carbohydrates, complex carbohydrates, sugars, dietary fiber, and total protein—must be made available in writing on request. The ACA also requires vending machine operators who own or operate 20 or more vending machines to disclose the calorie content of their items.

FDA is asking for input on a collection of specific issues before it drafts a proposed regulation. These issues include options for implementation of new regulations, including inspection and enforcement of such regulations. Since local health departments will surely be involved in the local implementation of FDA rules, now is the time to raise questions and concerns for the agency to address.

Comments will be accepted until Sept. 7. More information is available here.