On June 25, Susan Monarez, nominee for Director of the Centers for Disease Control and Prevention (CDC), testified before the Senate Health, Education, Labor, and Pensions (HELP) Committee. This is the first time that a CDC Director has had to be confirmed by Congress before taking office. Dr. Monarez was first named acting director of the agency in January but had to step down when she was formally nominated for the position. She has previous experience in the federal government and is a respected scientist, though she would be the first nonphysician to lead the CDC in several decades. Dr. Monarez, in her opening statement, outlined her top three priorities if she were confirmed as CDC Director: restoring trust in public health, strengthening public health infrastructure, and evidence-based rapid decision-making. She also emphasized the important, life-saving role of public health. 

Throughout the hearing, senators from both sides of the aisle remarked on CDC’s Advisory Committee on Immunization Practices (ACIP), which was recently overhauled by HHS Secretary Robert F. Kennedy, Jr. There was bipartisan concern regarding the significant changes to the committee immediately prior to the June meeting and the potential impacts that ACIP’s decisions could have on vaccine access and coverage. Senator Cassidy (R-LA), HELP Committee Chair, expressed concern for what he called the “rushed nature” of the June ACIP meeting and emphasized the importance of a balanced perspective in the makeup of the committee which is tasked with making decisions related to vaccines. Dr. Monarez expressed support for vaccines and their role in saving lives. She also acknowledged, when asked by Senator Sanders (I-VT), that there is no scientific link between vaccines and autism. 

Senators from both sides of the aisle also spoke about the proposed cuts to Medicaid in the budget reconciliation package and the essential role that Medicaid plays in the health of people across the country. Relatedly, much discussion focused on the importance of rural health, and the importance of bolstering efforts to provide health services in rural America as the Senate’s budget reconciliation package could have an impact on rural hospitals across the country. Senator Markey (D-MA) referenced CDC’s Rural Public Health Strategic Plan and noted that access to health services in rural areas is directly correlated to public health outcomes.

In her remarks, Senator Baldwin (D-WI) expressed her serious concerns to Dr. Monarez about the firing of all the staff from CDC’s Childhood Lead Poisoning Prevention program, which occurred as part of an earlier reduction in force effort across HHS. Senator Baldwin specifically shared how this prevented the City of Milwaukee from accessing the help and resources planned for and needed to address “a lead exposure crisis in Milwaukee Public Schools.” She asked Dr. Monarez directly if she would reinstate staff in this program if confirmed, and while Dr. Monarez said she would look into staffing across many “critical public health issues” she did not to affirm a commitment to restoring Childhood Lead Poisoning Prevention staff specifically. 

Senator Hassan (D-NH) spoke of the importance of CDC’s support in local drug addiction and overdose prevention work and asked for a commitment to continuing related programs. In response, Dr. Monarez said, “CDC is moving towards getting back to its core mission of preventing, detecting and responding to infectious diseases and emerging threats.” She noted that, if confirmed, she would prioritize continuity as these programs “transition to other parts of the organization.” Similarly, Senator Collins (R-ME) said that CDC provides support and resources for important public health work related to Alzheimer’s disease in her state but noted that CDC staff who work on these programs have all been placed on leave. She indicated that this will inevitably impact the processing of grant award funds that were anticipated to go out in August and asked if Dr. Monarez would commit to getting these awards out on time. Dr. Monarez answered that she “will commit to understanding any of the impediments associated with awarding these grants,” but did not commit to a timeline for releasing funds.

The HELP Committee has not announced when it will vote on moving Dr. Monarez’s nomination to the full Senate. NACCHO Government Affairs is monitoring the process and will continue to update members through NACCHO Voice and News from Washington.