On March 10, Congress passed a Fiscal Year 2022 omnibus appropriations bill to fund the federal government through the rest of the fiscal year, which ends on September 30. President Biden signed the bill into law the following Monday. The omnibus bill comes after months of congressional negotiations and several continuing resolutions that were needed to keep the government funded and operating at Fiscal Year 2021 levels.

Although the final bill included increases in top-line funding amounts for the Department of Health and Human Services (HHS) and its sub-agencies, funding was lower than expected based on the levels that had been included in the FY22 appropriations bills drafted in the House and Senate Appropriations Subcommittees on Labor, Health & Human Services, and Education (L-HHS). In fact, the L-HHS title of the omnibus was $55 billion less than what was included in the House bill.

Despite underwhelming funding amounts throughout the bill, the omnibus included some exciting progress on priorities in NACCHO’s 2022 Federal Legislative and Policy Agenda. The bill created a new funding line for public health infrastructure to provide resources that are not segmented by disease, condition, or activity. Though the $200 million in funding is lower than hoped for (the House and Senate Committee bills had called for $1 billion and $600 million, respectively), flexible, disease-agnostic funding to support core public health infrastructure is a NACCHO priority.

Additionally, the omnibus included important new language requested by NACCHO to help ensure federal public health dollars make it to the local level equitably and efficiently. The bill encouraged the Centers for Disease Control and Prevention (CDC) to require states to fund local health departments when programmatically appropriate and urged CDC to publicly track and report to the Appropriations Committees how funds provided to state health departments are passed through to local health departments, including amount, per grant award, by local jurisdiction. The bill also included language encouraging states to prioritize Epidemiology and Laboratory (ELC) Capacity Awards funding to local health departments, and a requirement that CDC track how Public Health Emergency Preparedness Cooperative Agreements funding is allocated to local health departments.

Funding levels for other NACCHO priorities were:

• $8.5 billion for CDC, an increase of $582 million from FY21, but less than the $1 billion requested by NACCHO.
• $715 million for the Public Health Emergency Preparedness Cooperative Agreements, a slight increase over FY21 funding, but less than the $1 billion requested by NACCHO.
• $6.24 million for the Medical Reserve Corps, an increase of $0.24 million over FY21, but less than the $12 million requested by NACCHO.
• The omnibus did not provide funding requested by NACCHO for the establishment of a public health loan repayment program.
• $100 million for the Data Modernization Initiative at CDC, a doubling of FY21 funding level. NACCHO had joined coalition partners to request at least $150 million.

Other notable public health allocations include:

CDC

• $651 million for 317 Immunization Program, an increase of $37 million from FY21
• $195 million for Ending HIV Epidemic Initiative, a $20 million increase from FY21
• $491 million for Opioid Overdose Prevention and Surveillance, an increase of $15 million from FY21
• $20 million for Infectious Disease Rapid Response Fund, a $10 million increase from FY21
• $41 million for Viral Hepatitis Prevention, an increase of $1 million from FY21
• $164 million for STD Prevention an increase of $2 million from FY21
• $182 million for Antibiotic Resistance, a $10 million increase from FY21
• $54 million for Vector-Borne Diseases, a $12 million increase from FY21
• $195 million for Emerging Infectious Diseases, an increase of $2 million from FY21
• $68 million for Food Safety Measures, an increase of $3 million from FY21
• $242 million for Tobacco Prevention and Cessation, an increase of $4 million from FY21
• $33 million for the Diabetes Prevention Program, an increase of $4 million from FY21
• $41 million for Childhood Lead Poisoning, an increase of $2 million from FY21

Assistant Secretary for Preparedness and Response (ASPR)

• $320 million for the Hospital Preparedness Program, an increase of $39 million from FY21
• $745 million for the Biomedical Advanced Research and Development Authority, an increase of $148 million from FY21
• $845 million for the Strategic National Stockpile, an increase of $140 million from FY21

Health Resources and Services Administration (HRSA)

• $1.7 billion for Community Health Centers, an increase of $65 million from FY21, with $30 million School-based Health Centers, an increase of $25 million from FY21
• $23 million for Public Health and Preventive Medicine, an increase of $6 million from FY21, including an increase of $3 million for Public Health Training Centers
• $133 million for Healthy Start, an increase of $4 million from FY21
• $2.5 billion for the Ryan White AIDS Programs, an increase of $75 million from FY21

The omnibus also appropriated $1 billion to establish the Advanced Research Projects Agency for Health (ARPA-H), President Biden’s proposed agency to focus on scientific breakthroughs for diseases such as ALS, Alzheimer’s disease, diabetes, and cancer.

The federal budget process for FY23 will begin shortly, and NACCHO will continue its advocacy for public health resources needed by local health departments to keep their communities safe and healthy. Please contact Government Affairs Director Kerry Allen at [email protected] with any questions.