This week, both the Senate and House of Representatives passed, and President Joe Biden is expected to soon sign, the Consolidated Appropriations Act of 2023, which provides funding for federal programs through the rest of Fiscal Year (FY) 2023. The omnibus bill comes after months of negotiation in Congress and two stop-gap funding measures needed to keep the government funded and operated at FY2022 levels through the first several months of FY2023.
Throughout the year, NACCHO worked with appropriators in Congress to advocate for strong funding for programs important to local public health, with a particular focus on cross-cutting resources to support public health infrastructure and data modernization, as prioritized in our 2022 Federal Legislative and Policy Agenda. NACCHO provided written testimony to both the House and Senate Appropriations Subcommittees on Labor, Health and Human Services, Education and Related Agencies outlining funding priorities for local health departments in FY2023, and the final funding for those programs is outlined below.
Program | FY2022 funding | NACCHO request | FY2023 funding |
Public Health Loan Repayment | N/A | $200 million | N/A |
Public Health Infrastructure and Capacity | $200 million | $1 billion | $350 million |
Public Health Emergency Preparedness Cooperative Agreement | $715 million | $1 billion | $735 million |
CDC – agency wide | $8.5 billion | $11 billion | $9.2 billion |
Data Modernization Initiative | $100 million | $250 million | $175 million |
Medical Reserve Corps | $6.24 million | $12 million | $6.24 million |
NACCHO also worked with Congress to include language to help ensure federal public health dollars make it to the local level equitably and efficiently. The final omnibus encourages the Centers for Disease Control and Prevention (CDC) to require states to fund local health departments when programmatically appropriate.
Additionally, NACCHO joined in coalition with other stakeholders to advocate for a wide range of public health programs and priorities. Those programs and their funding levels are outlined in the following table.
Program | FY2022 Funding | NACCHO request | FY2023 Funding |
Department of Health and Human Services | $108.3B | N/A | $120.7B |
Teen Pregnancy Prevention Program | $101M | $150M | $101M |
Title X | $286M | $512M | $286M |
Minority HIV/AIDS Fund | $56.9M | $60M | $60M |
Centers for Disease Control and Prevention (CDC) | $8.5B | $11B | $9.2B |
National Center for Environmental Health Programs | $228M | $402M | $247M |
Climate and Health Program | $10M | $110M | $10M |
National Center for Emerging and Zoonotic Infectious Diseases | $693M | N/A | $7512M |
Division of Vector-Borne Diseases | $54M | $58.6M | $62.6M |
Lyme Disease | $20.5M | $16.5M | $26M |
Epidemiology and Laboratory Capacity (ELC) grants | $40M | $50M | $40M |
National Center for HIV/AIDS, Viral Hepatitis, Sexually Transmitted Diseases, and Tuberculosis Prevention | $1.35B | N/A | $1.39B |
Division of HIV/AIDS Prevention | $755M | $823M | $755M |
Division of Adolescent and School Health | $36.1M | $100M | $38.1M |
Division of Viral Hepatitis | $41M | $140M | $43M |
Division of STI Prevention | $164M | $329M | $174M |
Division of Tuberculosis Elimination | $135M | $225M | $137M |
Infectious Diseases and Opioid Epidemic program | $18M | $150M | $23M |
National Center for Immunization and Respiratory Diseases (NCIRD) | $868M | N/A | $919M |
Section 317 Immunization Programs | $651M | $860M | $682M |
National Center for Chronic Disease Prevention and Health Promotion | $1.34B | N/A | $1.43B |
Racial and Ethnic Approaches to Community Health (REACH) Program | $66M | $75.5M | $69M |
Good Health and Wellness in Indian Country | $22.5M | $27M | $24M |
Office on Smoking and Health | $128M | $310M | $126M |
Social Determinants of Health | $8M | $153M | $8M |
National Center for Injury Prevention and Control | $714M | N/A | $7619M |
CDC Firearm Morbidity and Mortality Prevention Research | $12.5M | $35M | $12.5M |
Community Violence Intervention Initiative | $0 | $250M | $0 |
Agency for Toxic Substances and Disease Registry | $80.50 | $100M | $85M |
Health Resources and Services Administration | $8.85B | N/A | $9.7B |
HRSA Ryan White HIV/AIDS Program | $2.50B | $2.94B | $2.6B |
Part A of the Ryan White HIV/AIDS Program | $671M | $751.1M | $681M |
Substance Abuse and Mental Health Services Administration | $6.5B | N/A | $7.5B |
SAMHSA’s Minority HIV/AIDS Initiative Program | $119M | $160M | $119M |
National Institutes of Health | $45B | N/A | $47.5B |
HIV/AIDS research | $3.2B | $3.9B | $3.3B |
NIH Firearm Morbidity and Mortality Prevention Research | $12.5M | $25M | $12.5M |
Department of Housing and Urban Development | $56.5B | N/A | $58.2B |
Housing Opportunities for People with AIDS (HOPWA) | $450M | $600M | $499M |
In response to ongoing public health emergencies, NACCHO also called on Congress to provide emergency supplemental funding for public health activities to address COVID-19 and the mpox virus. Unfortunately, Congress did not include any new funding for those responses in the omnibus bill.
In addition to annual funding, the Consolidated Appropriations Act of 2023 incorporated a multitude of policy changes. Most notable to NACCHO is a provision authorizing the Public Health Workforce Loan Repayment Program, a NACCHO priority over the past several years.
The omnibus bill also includes provisions from the PREVENT Pandemics Act, a pandemic preparedness bill introduced by Senators Patty Murray (D-WA) and Richard Burr (R-NC) and approved by the Senate Health, Education, Labor and Pensions Committee in March. The PREVENT Pandemics Act includes provisions to strengthen preparedness and response at the local, state, and federal level; accelerate research and countermeasure discovery; modernize the supply chain; and ensure adequate supply of medical products. The bill would also make the Director of the CDC subject to Senate confirmation beginning in 2025.
The omnibus bill sustains enhanced fruit and vegetable benefits under the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) through the end of the fiscal year, a policy NACCHO supported. However, the bill did not include a comprehensive Child Nutrition Reauthorization that NACCHO and other stakeholders had urged. The legislation also makes changes to authorities at the Food and Drug Administration, including steps intended to address the infant formula crisis and to provide for safe opioid disposal.
NACCHO recognizes that our members care about many federal programs, all of which may not be mentioned above. We’re here to serve as a resource, so if you have any questions about the final appropriations bill, including how much funding specific programs received, please feel free to contact Kerry Allen, Director of Government Affairs, at [email protected].