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House Proposes Investment of $1 Billion in Public Health Infrastructure and Capacity: What it Means for Local Health Departments

Aug 13, 2021 | Silvio Renna

On July 29, the House passed a seven-bill spending minibus, that included the Labor, Health, and Human Services, Education and Related Agencies (LHHS) FY 2022 appropriations bill. The LHHS bill addresses a wide variety of policy issues and priorities, including many longstanding NACCHO policy priorities. A full summary of the bill can be found in NACCHO’s blog here. A notable addition to the bill includes a new $1 billion funding stream specifically dedicated to expanding the nation’s public health infrastructure and capacity. This is an important step and one that is a direct result of the advocacy of NACCHO, our members, and our governmental public health partners.

The new funds represent NACCHO’s efforts to foster a reinvestment in the Nation’s public health infrastructure. In report language, the Committee specifically cited a February hearing, “Ready or Not: U.S. Public Health Infrastructure,” which demonstrated the critical need for “flexible, sustainable investments in public health.” Then-NACCHO President Jennifer Kertanis testified at this hearing to discuss the importance of the public health workforce and broad-based infrastructure funding. Her testimony consistently underscored the need for sustained, predictable funding that is not tied to a specific disease or condition.

NACCHO has been persistent in its advocacy for public health infrastructure, working in coalition with other governmental stakeholder partners to inform and strengthen the Public Health Infrastructure Saves Lives Act (PHISLA) (S. 674), which is now supported by over 100 stakeholder organizations. Introduced by Senator Murray (D-WA), Chair of the Senate Health, Education, Labor, and Pensions (HELP) Committee, S. 674 would represent a massive investment in our nation’s core public health infrastructure, by dedicating $4.5 billion annually to health departments to support their core capabilities. NACCHO members have been strong partners in this work as well through activation of our Congressional Action Network as well as through nearly 150 Hill meetings with lawmakers during our most recent (virtual) Hill Week.

While we still push for full adoption of that legislation, the consistent messages shared by our members convinced lawmakers to think differently about typical appropriations and include this new investment in the FY2022 appropriations bill to provide $1 billion in flexible, disease-agnostic funds to support improvements to public health infrastructure for the upcoming fiscal year.

The inclusion of such funds in the House appropriations bill is a big step, but there is more that must be done to ensure it gets into law. The Senate has yet to act on its FY22 funding bills and the fiscal year deadline is fast approaching—ending September 30, 2021—and their appetite for this new funding stream and amount is still unclear. At this point we expect Congress to pass a continuing resolution, which would continue existing funding forward for a set period of time. The positive is that that keeps the government open. But the negative is that it does not allow for improved public health funding of a program such as this to begin. As the bill continues to move through Congress NACCHO will continue to advocate for real, lasting investment in our public health infrastructure and workforce.

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