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All’s Well That Ends Well: CSTE Priorities Fare Well in Year-End Spending Bill

Posted By Emily J. Holubowich , Monday, January 4, 2016
Updated: Monday, January 4, 2016

Emily Holubowich, Senior Vice President at CRD Associates, is CSTE’s Washington representative and leads our advocacy efforts in the nation’s capital.

After a couple of fiscal “close calls” this fall—shutdown threats, last-minute budget negotiations, and a couple of stopgap spending measures to keep the government running—Congress ultimately passed and the President quickly signed the Consolidated Appropriations Act of 2015 before heading home for the holidays. This trillion-dollar spending measure provided appropriations for all “discretionary” government functions, including those administered by the Department of Health and Human Services.

In the end, public health fared well, all things considered. The Centers for Disease Control and Prevention (CDC) received nearly $7.2 billion in the “omnibus” spending bill for fiscal year (FY) 2016. That’s a $277.7 million (four percent) increase over FY 2015 levels. This funding includes nearly $6.3 billion in discretionary budget authority, as well as more than $892 million in mandatory Prevention and Public Health Fund (PPHF) dollars and $15 million from the Public Health and Social Services Emergency Fund.

The overall increase in funding should translate into good news for state and territorial epidemiologists. The National Center for Emerging and Zoonotic Infectious Diseases (NCEZID) received nearly $580 million, including $52 million from PPHF. This funding level represents a $175 million (43 percent) increase over FY 2015. Within NCEZID, the antibiotic resistance (AR) initiative would receive $160 million in new funding; less than the President’s requested $264 million for CDC. Based on the President’s budget request submitted to Congress in early 2015, we would expect much of the NCEZID funding, including AR, to support core infectious disease surveillance capacity at state and local health departments through Epidemiology and Laboratory Capacity (ELC) grants. This funding would be in addition to $40 million from the mandatory PPHF provided to ELC grants for the fifth consecutive year in the omnibus. The final spending measure requires CDC to submit to Congress a detailed spend plan for AR within 60 days of the legislation’s enactment, so more specific information about ELC funding and the bill’s impact on states and territories will be available soon.

Among our other NCEZID appropriations priorities, food safety received increased funding ($52 million) and advanced molecular detection was flat funded ($30 million).

The Public Health Workforce program, through which the CDC/CSTE Applied Epidemiology Fellowship receives funding, is also provided flat funding of $52.2 million and no supplemental PPHF funding. The appropriations bills do not specify how much funding would be dedicated to the Applied Epidemiology Fellowship program per se, but with flat funding of the program we might expect flat funding for our fellows. The President had requested a $15.2-million increase in budget authority for Public Health Workforce, as well as $36.2 million in PPHF. Three years ago, Congress eliminated $15 million in PPHF dollars for Public Health Workforce in the wake of sequestration.

Some other notable items related to public health:

  • The National Center for Injury Prevention and Control received $70 million to combat the opioid epidemic, a $50 million increase over FY 2015 levels.
  • National Center for Environmental Health budget was increased by $2.9 million over FY 2015 and most of the cuts proposed in earlier spending legislation were restored with the exception of the $2.8-million “Built Environment and Health Initiative,” which was eliminated.
  • Funding for CDC’s tobacco programs sustained a $6.5 million cut compared to FY 2015, but was mostly restored after being cut by $100 million in proposed spending bills.

With the enactment of FY 2016 spending legislation, legislators will begin work in earnest on FY 2017 spending legislation when they return to Washington in January. CSTE will once again partner with the Association of Public Health Laboratories and other colleagues in the public health community to advocate for our key priorities—strong support for disease monitoring and for training the next generation of epidemiologists. In addition, our executive leaders are travelling to Washington in early February to discuss our funding requests with key decision-makers in Congress and the administration. Until then, we anxiously await the release of the President’s final budget request of the administration, expected to be released the first week in February, to see what the White House has in store for disease surveillance.

For more information about funding levels for your specific priorities, please click here for a copy of the omnibus spending legislation, and click here for a copy of the accompanying report that provides more detailed instructions about public health funding levels and intended purposes.

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