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Posted By Victoria Barahona, CRD Associates,
Tuesday, September 30, 2025
Updated: Tuesday, September 30, 2025
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It has been a busy September for CSTE and lawmakers in Washington, DC. Here is a quick update on what’s going on and some of CSTE’s recent educational efforts of policy makers.
This fall, CSTE prioritized engaging with legislators to provide education about what applied epidemiologists in states and jurisdictions do every day to protect the health of communities. As we near the end of the federal fiscal year, Congress has yet
to come to an agreement on Fiscal Year (FY) 2026 funding and health departments across jurisdictions continued to face uncertainty in accessing appropriated FY 2025 funding. CSTE members met recently with congressional offices to ensure they understand
how critical federal funding – specifically CDC funding - is to state, territorial, local, and Tribal (STLT) public health efforts—epidemiology programs are funded 90-95% from CDC. Congress must now make critical decisions on FY 2026, funding and
efforts like public health data modernization and the Epidemiology and Laboratory Capacity (ELC) program need substantial investment. CSTE talked about progress in both of those areas and how the work is making a difference in STLT to responding to
health threats everyday. CSTE also discussed the need to ensure the health and safety of the public health workforce and the importance of maintaining the scientific integrity of CDC.
Zooming out, Congress returned from August recess facing a tight deadline in the bigger funding picture: funding for Fiscal Year (FY) 2026 must be approved before October 1—tomorrow—to avoid a government shutdown. Reminder, the appropriations process
provides federal funding for all federal government agencies and programs, including the CDC and other federal health agencies. If Congress fails to pass a spending package by midnight tonight, federal funding will lapse, and many programs could pause,
creating uncertainty for public health departments across the country.
With the risk of a shutdown on the table, CSTE prioritized additional education for policymakers—particularly members of the House and Senate Appropriations Committees—to emphasize the importance of sustained federal public health funding. CSTE shared
information about how federal dollars support disease surveillance, outbreak response, and workforce capacity across every jurisdiction.
CSTE met with 34 offices—including several key leadership offices—to highlight the consequences of delayed awards, reduced capacity, and funding uncertainty. We reminded Congress that about 80 percent of STLT health department’s budgets come from the
CDC. CSTE also shared real-world examples from the field and strengthened relationships with congressional offices, educating staff on the critical role applied epidemiologists and other public health workers play in keeping communities safe.
So, where do things stand on FY 2026 appropriations? Both the House and Senate released their versions of the Labor, Health and Human Services (LHHS) appropriations bills earlier this year. The Senate proposed a bipartisan bill with strong overall funding
for CDC, while the House bill is detrimental to CDC overall, it includes key increases for priority programs such as Public Health Data Modernization and the Epidemiology and Laboratory Capacity (ELC) program. Despite this progress through committee
action, the process is not far enough along to pass final bills before the end of the fiscal year.
On September 19, the House narrowly passed a short-term continuing resolution (CR) that would keep the government running through late November and continue certain health programs, including telehealth and community health centers. Democrats proposed
an alternative CR that included additional health care protections—including extending subsidies for Affordable Care Act health plans. As expected, both the House-passed CR and the Democratic alternative failed to advance in the Senate.
With tonight’s deadline, the risk of a government shutdown is very real. Adding to the uncertainty, House Republican leadership announced that members will not return to Washington until the Senate passes their CR bill, leaving little opportunity for
negotiation and prompting blame-shifting among lawmakers. To complicate matters further, federal agencies have been told to prepare lists of employees who could be furloughed or laid off if the government closes. While this may be a negotiating tactic,
real lives and real jobs are in the balance.
As the process moves forward, CSTE urges Congress to avoid a shutdown to allow for ongoing negotiations for final FY 2026 funding that includes robust overall funding for CDC and retains the House’s proposed increases for data modernization and ELC. The
road ahead remains uncertain, but CSTE will continue communicating with lawmakers to ensure Congress understands the real-world impact a government shutdown would have on public health efforts in every community across the country.
Victoria Barahona is Senior Policy Associate at CRD Associates, LLC, which represents CSTE’s interests on Capitol Hill in Washington, DC.
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Posted By Victoria Barahona, CRD Associates,
Thursday, August 14, 2025
Updated: Thursday, August 14, 2025
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We’re more than halfway through the year, and there has been no shortage of action on Capitol Hill. Here’s what you need to know.
First, let’s talk about the budget reconciliation bill, also known as the One Big Beautiful Bill (H.R. 1). But before we get into what’s in it, a
quick detour on how it got through Congress.
Budget reconciliation is a legislative fast-track that lets Congress pass certain tax, spending, or debt bills with just a simple majority in the Senate—bypassing the usual 60-vote threshold require to avoid a filibuster.
After months of negotiation, Congress passed the bill and on July 4, President Trump signed the $4.5 trillion package into law, pairing major tax cuts with new investments in border security and defense. To help pay for it, the bill includes $1.2 trillion
in cuts to programs like Medicaid, food assistance, and student loans—sparking heated debate.
The margins were razor-thin: Vice President JD Vance broke a tie in the Senate, and House Speaker Mike Johnson (R-LA) barely rallied enough party support for passage. No Democrats backed the bill.
Second, let’s talk about rescissions. After passing the budget reconciliation bill, Congress took a short Fourth of July break, but came back to a tight deadline: they had just 10 days to act on President Trump’s rescissions package.
So, what is a rescissions package, exactly? It’s a formal request from the administration to cancel funding that Congress had already approved. If lawmakers agree to the President’s proposal, that money is pulled back and can’t be spent by the agency
to which it was allocated.
There are rules, of course. Once a President submits a rescission request, Congress has 45 continuous days of congressional session to approve, amend, or reject it. In this case, lawmakers returned from recess with the clock ticking and managed to get
it done just in time.
Passage of the recissions package was by no means a guarantee. The bill narrowly passed the House in June but was amended significantly to make it through the Senate. The package targeted cuts to foreign aid and public broadcasting. Although the rescissions
package didn’t impact public health funding, it raised broader concerns. Some argue that pulling back already-approved federal funds sets a troubling precedent—one that could undermine confidence in the budget process and complicate future negotiations.
Since this recissions packaged passed, the White House has made it clear they would like to send a second round of cuts to Congress for approval. Early reports suggest this bill could target education funding.
Third and finally, with reconciliation and rescissions behind them, Congress shifted its focus to the FY 2026 appropriations process. Before the August recess, the House Appropriations Committee moved forward on most of its spending bills—leaving
the politically charged Labor, Health and Human Services, Education, and Related Agencies (Labor-HHS) bill, which includes funding for the Centers for Disease Control and Prevention (CDC) on hold.
The delay has left health advocates uneasy—especially after the President released his FY 2026 Budget Request back in May. While the President’s budget is nonbinding (Congress holds the power of the purse), it outlines the Administration’s funding priorities
and often helps shape the policy debate on Capitol Hill. The Administration proposed $4.3 billion for the CDC—a $5 million decrease from FY 2025—and called for the elimination of several key public health initiatives, including the Global Health Program,
the National Center for Chronic Disease Prevention and Health Promotion, and the Prevention and Public Health Fund, which is the nation’s first mandatory fund dedicated to public health.
The Senate, meanwhile, advanced its Labor-HHS bill with a decisive 26–3 vote at the end of July, largely ignoring the White House’s proposed cuts and restructuring proposal. The Senate bill includes $9.15 billion for the CDC—a $70 million decrease from
FY 2025—and allocates $160 million for Public Health Data Modernization, a $15 million cut from FY 2025. The Epidemiology and Laboratory Capacity (ELC) program received level funding at $40 million, while the Centers for Forecasting and Analytics
(CFA) and Response Ready Enterprise Data Integration (RREDI) were funded at $50 million.
All of this sets up a jam-packed fall season, with a government funding deadline looming on September 30. If Congress can’t agree on a full-year spending package by then, they’ll need a continuing resolution (CR) to keep the lights on and the government
running. There are already rumors about a CR through December and even the possibility of yearlong CR, which raises additional concerns about Congress’ ability to enforce its spending allocations.
With big decisions still ahead and the clock ticking toward September 30, all eyes will be on Congress when lawmakers return this fall. In the meantime, CSTE will continue working to ensure lawmakers understand the real-world impact these proposed cuts
would have on public health efforts in every jurisdiction across the country.
Victoria Barahona is Senior Policy Associate at CRD Associates, LLC, which represents CSTE’s interests on Capitol Hill in Washington, DC.
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Posted By Ben Warden,
Wednesday, June 4, 2025
Updated: Monday, June 2, 2025
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More than a Bed: How #CSTE2025 Partner AYA Youth Collective Fights Housing Instability by Building Relationships First
Each year, CSTE supports an organization or cause that is local to our Annual Conference host city. This year’s partnership is with the AYA Youth Collective of Grand Rapids, Michigan. Read today’s blog to hear about their great work—and afterwards, please consider donating in celebration of #CSTE2025. Our donation goal is in sight, and any funds raised beyond that will be a massive contribution to this amazing nonprofit.
AYA Youth Collective (AYA) is an organization providing circles of support for youth facing homelessness in Michigan. Housing insecurity is complex, and AYA has worked for years to address its many dimensions. As a
result, they have created more connective, cohesive experiences for young people on their journey toward housing and stability. AYA stands for “As You Are,” and they are committed to providing resources and authentic relationships for every youth
who walks through their door. We recently sat down with AYA’s Advancement Manager, Nokomis Clarey-Schultz, to learn more about their work.
How did the AYA Youth Collective get started?
AYA originated as two separate nonprofits, 3:11 Youth Housing and HQ. HQ was a drop-in center and 3:11 Youth Housing was a housing program. Both cared deeply about supporting youth with housing instability. After years of doing combined events together,
they decided that it was natural to merge so that the drop-in center would have a direct path to the housing program. And more hands working together is never a bad thing.
Walk us through the process of how you help an individual facing housing instability.
When they come in, we first get an understanding of what's going on in their life. We figure out if they’re sleeping outside, in a shelter, or transitional housing. Are they at risk of being kicked out of their home? Questions like that. There's really
no requirement for getting resources in our space. You don't have to be sleeping outside. You don't have to be sleeping in a shelter. There's really so many different levels of stability, and so we meet them where they are on that journey.
Everyone needs something different, so we start in a different place with everybody. Maybe it’s getting them something to eat or letting them take a shower or getting them a backpack for their stuff or a change of clothes. From there, we can start to
say, “Hey, do you have Medicaid and food assistance? If you don't have those things, we can help.”
What are the specifics of AYA’s housing program?
Our housing program is special and unique. We've got 12 homes in Grand Rapids. We just broke ground on our 13th home, which is super exciting. We've had those other 12 for a long time, and so we're building a really cool new approach to housing with micro
units. It's like a hotel; there's a kitchenette, your own bathroom and bedroom, and also a larger communal space.
In our housing program, in all of the homes, they're duplexes, so half the house is youth, the other half is a mentor. The mentor is somebody with lived experience. It can really be anybody that just cares deeply about supporting youth. We have people
that are teachers or accountants or just therapists or people that care.
Switching gears, let’s talk about AYA’s drop-in services. On your website, it mentions help with vital document recovery, legal assistance, etc. How do those services play a role in helping an individual who’s facing housing instability?
I like to remind people that we're still dealing with 14 to 24 year olds. Most of them don't have access to their vital documents and most of that age in general are learning how to be a grown-up for the first time. They are learning how to make meals
and to go grocery shopping. They are learning how to navigate the city. They're figuring out what it's like to have a job for the first or second or third time.
Vital documents are extremely important. Transportation is also huge for literally everything. Employment, housing, school, social life—you must have some sort of transportation. So, we work with another nonprofit in the area called Upcycle Bikes to provide
our youth with free bikes, helmets, and locks. We also have the bus passes available. For some of them, the difference between having a job and keeping a job is just having transportation to get to work.
We have a ton of basic needs here that we provide for our youth when it comes to backpacks and clothes. We also have free laundry at our drop-in center. Laundry is huge for dignity. If you work in food service, which a lot of our youth do, you must have
a clean uniform to keep that job.
Thank you so much for your time today. What are the best ways people can help with the issue of housing instability where they live?
Every city, every town, every state, every country—everybody has people that are experiencing housing instability. I would say a huge one is just advocating for those in your community. Being a good neighbor, learning your communities, learning the people
in it, looking for other organizations in your area. Becoming a recurring donor somewhere is honestly one of the most helpful things. With AYA, if someone can give $5 to $10 a month, that makes a huge difference because we know we're going to get
that continuously.
Advocacy is huge. Reading, learning, advocating for your neighbors, advocating for the people in your community that are being overlooked, and making sure that you acknowledge those folks as well. When you see people on the side of the road, say hello,
wave, make them feel like humans. That's really important.
Learn more about AYA Youth Collective and make a donation today.
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Posted By Ben Warden,
Tuesday, April 8, 2025
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Leading the Way Q&A: Facing Change at her Health Department, Allison Smith Turned to CSTE
By Ben Warden, CSTE Staff
Allison Smith, MPH is Chief Epidemiologist for the Dutchess County (NY) Department of Mental Health. While she initially sought out CSTE LEAD to help broaden stakeholder engagement during an increase of STI rates, the program also helped
her navigate an uncertain time when the structure of her health department changed.
We recently spoke with Allison about her experience and how LEAD helped her manage the shake-ups and challenges she faced. (This interview has been edited for length and clarity.)
What first made you interested in public health?
I feel like this is a common story with a lot of my epi colleagues [laughs]. When I started off college and undergrad, I wanted to be a physician. I realized about halfway through
that it wasn't for me. But I was always interested in epidemiology from a medical perspective, and I was more interested in research as a position.
My biochemistry professor covered John Snow and epi basics over the course of a week. I remember sitting there thinking, "Ooh, that's it. That's what I wanted to do." I just didn't really have a concrete name for it. No one had ever really told me about
it. I went to grad school right after undergrad, and it was fortunately a great fit. (After grad school, Smith worked at the NYC Department of Health and Mental Hygiene before taking a position near where she grew up in Dutchess County, New York.)
How did you find out about CSTE LEAD?
I can’t remember exactly, but it was from a forwarded email or just from bouncing around the [CSTE] website. I remember looking at it and having an “aha” moment of this being the next step for
someone who's been in the field for almost 10 years. I'm supervising, but I'm not technically management.
[CSTE LEAD] is specifically tailored to someone with an epi background, which I thought was great because most of my supervisors that I've had personally have not been epis. So really putting together those leadership skills in epi I thought was the right
thing to do for someone in my position.
Can you tell us a little about your project?
We had increased STI rates in our region and wanted to bring in alternative data sources and different data sets from our regional health information organizations. One example would be
bringing health educators or nurses out to areas facing high STI rates to give education or prophylaxis, or whatever was needed.
But I was thrown a curveball when it was announced that our department was splitting into two separate departments. There would be a Department of Mental Health, as well as a Department of Health. It then morphed into navigating that situation as well.
What was your specific end goal?
Really, it became integrating the epi bio[statistics] team into other divisions across the department. We were normally called when people were like, "Hey, I think I'm noticing an uptick in chlamydia."
Or, "Hey, we got a call about someone getting sick, they think it might be implicating this restaurant." Or, "Hey, I just need data on breast cancer rates." Anything like that. Now, I think the team is much more involved in those conversations from
the get-go so they can actually provide their input and feedback because not everyone thinks like an epidemiologist.
Would you say you met that goal?
I think I was pretty successful, and I think it's growing a little more. I think the LEAD program strengthened my leadership skills, but I like to think I kind of [also] maybe pushed a little into
the folks I was supervising, so they feel a little more empowered to take on those roles too.
Do you have any advice for those thinking about applying to CSTE LEAD?
Do it. Especially after seeing all my peers’ final presentations, because one of all of our takeaways was the flexibility needed. Learning to move and roll with
the punches, so to speak. I think having that flexibility in mind and just knowing that you are going to be studying and gaining these skills throughout the program, that's only going to strengthen you as an epi. It is focused on epis, but I think
the skills can be applied to anyone, and I think the way it is delivered is really well done.
Interested in receiving similar epi-related guidance? Learn more about CSTE LEAD!
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Posted By Ben Warden,
Tuesday, April 8, 2025
Updated: Monday, April 7, 2025
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On Eve of Retirement, CSTE’s Annie Fine Reflects on A Remarkable Career
By Ben Warden, CSTE Staff
CSTE Chief Science and Surveillance Officer Annie Fine, MD, began her career as a pediatrician in an under-resourced area of Northern California with elevated crime rates. As violence permeated the community for months, Dr. Fine kept thinking about what could be done upstream to prevent tragic outcomes.
It was just that: a thought. Until a particularly gut-wrenching day drove her towards a career change to public health. After prescribing amoxicillin for a 10-month-old with an ear infection, the mother got up to leave. Fine noticed she was on crutches.
“I asked what happened, and the mom said, ‘Oh, I was shot in a drive-by. And so was he.’ So the 10-month-old still had a bullet in him,” Fine said. “I thought, ‘Here I am handing out amoxicillin, but the real problems facing these people and this community are violence and the social milieu that they're living in.”
The experience was the catalyst for Dr. Fine to leave patient care and begin her long, storied career in public health. She was accepted into CDC's Epidemic Intelligence Service (EIS) program, a two-year, post-graduate training program in applied epidemiology where participants gain experience investigating and responding to public health threats. Although tackling violence prevention was an initial inspiration for her change, Fine switched her focus to infectious diseases, which was a major need and focus of CDC at the time.
“I ended up being assigned to New York City and going into communicable disease,” Fine said. “Which was something I was quite interested in.” Fine ended up spending 25 years at the NYC Department of Health, facing everything from 9/11, anthrax, SARS and many other crises. “While going through all of those emergencies it became very clear that we did not have good data systems,” Fine said. “We didn't have good ways to integrate the epidemiologic sides of the data that we were collecting with the laboratory data that we needed. The systems just were not efficient at all.”
Fine was then tasked to create a better system for use in large-scale emergencies. She looked to a software system already in use by the Massachusetts Department of Public Health and built a flexible infrastructure that was able to link epidemiology investigations and cases with lab results, all in one system.
“That was a giant learning experience and something I'm really proud of,” Fine said. “We then used that system to respond to Ebola, to Zika, to Legionnaires' disease in the South Bronx, which was a large outbreak in 2015. And then also finally to COVID, too.” Fine said that building the system meant New York City was better prepared than most to handle the early days of COVID. But the sheer scale of the outbreak still made it incredibly challenging and overwhelming. “None of us were prepared for the scale, the number of people that died so quickly and the lack of personal protective equipment and the lack of diagnostics,” she said.
After guiding New York City through the worst pandemic in modern times, Annie decided to make a professional change. In June 2021, she accepted a position with CSTE as its first-ever Chief Science and Surveillance Officer. She longed to bring her on-the-ground experience to the national level. “The ability to impact national level policy and help build capacity across all country was just such a great challenge and inspiring opportunity,” she said. “I was hoping to bring my frontline experience of what it actually takes to make systems work and how to use the data.”
Reflecting on her time at CSTE, Annie lauded the growth of her team, as well as the broader membership and community of CSTE. When asked about specific accomplishments she’s most proud of, Annie mentions the Stories from the Field project, the Electronic Case Reporting Workgroup and the National Syndromic Surveillance Program Community of Practice.
Fine recently announced her retirement, but will stay with CSTE in a part-time role. As changes and uncertainty still swirl around public health, Fine’s message to younger colleagues in the field is simple: Hang in there. “Public health needs are not going to go away,” Fine said. “It may look different, and it may be organized and funded differently. But hang in there, because science and epidemiology are still going to be needed.”
Through decades of dedication, Annie has not only helped advance our understanding of public health but also inspired countless colleagues and future scientists. Her work has saved lives, shaped policies, and strengthened communities, leaving a lasting impact that will resonate for years to come. CSTE—and health writ large—will miss her tremendously.
“Going into public health was literally the best decision I ever made,” she said. “I love the work, and I love the people.”
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Posted By Ben Warden,
Monday, April 7, 2025
Updated: Monday, April 7, 2025
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Leaning on LEAD: How Lea Hamner Built an Epi Team with a Little Help from CSTE
By Ben Warden, CSTE Staff
Growing up, Lea Hamner didn’t have to go far to learn about the importance of public health. It was a regular topic at her dinner table.
“I actually was born into public health,” she said. Hamner’s mother
worked for the U.S. Agency for International Development (USAID) in the Philippines and Peru. Lea grew up abroad, immersed in her mother’s projects and passion.
“The talk around the dinner table was very interesting because
my mom was doing her dissertation on HIV prevention practices in sex workers in Peru,” Hamner said.
“So, I was 11 and I was doing arts and crafts at Christmas with the people she was working with. Just growing up with public health
being central to my mother's life meant that I was just a lot more cognizant of social determinants of health right off the bat.”
Despite her family connections to a public health career, Hamner initially thought she would study
pre-med at college. But she soon realized patient care wasn’t what she wanted to focus on.
Her next thought was to follow in her mother’s footsteps and travel abroad to work in global health. But after an internship with Partners
in Health in Guatemala, she decided her public health focus should be on her own community in Washington state and not thousands of miles away.
“I wanted to come back to my own community and be a part of the people who are actually
living out the policies and experiencing it firsthand,” she said. After college, Hamner moved to Washington state and began her infectious disease epidemiology career working in tuberculosis (TB) at Public Health-Seattle &
King County.
“It was a phenomenal place to start my career to really understand how complex things can get and how adaptable you need to be,” Hamner said.
In addition to TB, Hamner broadened her scope
after being hired as the first county epidemiologist in Skagit County, WA. She tackled a myriad of epi issues, including infectious diseases, opioid overdoses and maternal child health. She was then named operations section chief for Skagit County’s
(WA) COVID-19 response.
[Did You Know?: Skagit County, Washington borders where the first COVID case in the U.S. was identified]
In 2022, she moved across the country to build an epi program from scratch
once more: this time spanning 23 independent town health departments as a contract epidemiologist in Cape Cod, Martha’s Vineyad, and Nantcuket. Hamner jumped at the chance but quickly surmised that she needed some leadership advice and expertise.
Enter CSTE LEAD, a 12-month leadership program for mid-career epidemiologists looking for professional networking, mentorship, and skill-building.
“I did [CSTE’s] Early Career Professionals’
mentorship program and it was invaluable to me when I was starting off my career as an epidemiologist,” Hamner said. “I was just waiting for my opportunity to apply again for another mentorship opportunity and then I found out about LEAD from the
CSTE website.”
Hamner’s goals in joining the program were to talk to other epis who have had similar experience in building a department and the common issues they faced. Through the coaching, mentorship, and courses of CSTE
LEAD, Hamner learned how to navigate challenges more easily than if she was left to her own devices.
“I would've probably gone crazy if I didn't have CSTE LEAD,” she said. “I would've been in dire straits trying to negotiate all of
those different stakeholders [and] all of those different priorities without tools about how to have tough conversations.”
Hamner urges others in her position as a new epi leader to run, not walk, to CSTE LEAD.
The program helped her master challenges like stakeholder engagement, consensus building, managing up-and-down on strategic planning, and public health communications.
“It really is an incredible opportunity to engage with epidemiologists
outside of your organization,” Hamner said.
“Anyone who really wants to invest in their career and invest in their own personal growth would benefit from applying.”
Is CSTE LEAD right for you? Learn more about the program and how to apply to the next cohort!
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Posted By Ben Warden, CSTE,
Wednesday, March 5, 2025
Updated: Tuesday, March 4, 2025
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Expanding the “One Health” Approach to Epidemiology a Key Priority for 2024-2025 CSTE President Katie Brown
By Ben Warden, CSTE Staff
Current CSTE President Catherine (Katie) M. Brown, DVM, MSc, MPH had practiced as a veterinarian for ten years when she decided to go back to school and study public health.
While taking an “Intro to Epidemiology” course, Katie learned about John Snow, a 19th century physician who successfully traced a rampant Cholera outbreak in London and is considered the “father of modern epidemiology.” Inspired by the story,
Katie had an “a-ha” moment and realized what she wanted to do with the rest of her career.
“I remember driving home that night and calling my parents and saying, ‘This is what I want to do. Epidemiology is where it’s at.’"
She now serves as the State Epidemiologist and State Public Health Veterinarian in Massachusetts and was elected CSTE President last summer for a one-year term.
"Throughout my career at the state health department, our administration has continued to promote engagement with CSTE. I believe they agree that it contributes to our national public health voice and allows for information sharing that serves the
greater good of the department and country. I’ve found that to be absolutely true and I'm grateful for it."
Unsurprisingly, as both a vet and an epi, Katie’s presidential priorities reflect both of those professional passions. Particularly in finding common ground between both disciplines, otherwise known as a “OneHealth” approach to public health.
CDC defines OneHealth as “a collaborative, multisectoral, and transdisciplinary approach — working at the local, regional, national, and global levels — with the goal of achieving optimal health outcomes recognizing the interconnection between people,
animals, plants, and their shared environment.”
Brown’s first presidential priority is to strengthen the working relationship between CSTE and the National Association of State Public Health Veterinarians (NASPHV). Both organizations have been important to her professionally, but it wasn’t until
the recent H5N1 outbreak that she realized how much stronger each could be if they continue to combine efforts.
“The fact that I became President at the same time of this H5N1 outbreak made me realize I was being gifted this opportunity to really help explain to people in a very tangible way why it's so important that we look at both animal health and human
health.”
That sentiment also led to Brown’s second priority as CSTE President: creating a CSTE “OneHealth” Applied Epidemiology Fellowship (AEF).
The origins of this priority came from when she was finishing her master’s degree. Brown learned about AEF, a CSTE program giving recent or soon to be graduates real world experience working in health departments. She thought it would be a great opportunity
and was enticed by a particular chance to also work with a state veterinarian in addition to epidemiologists.
“What really drew me in was the fact that there was a posting at the New York Department of Health that was with the State Public Health Veterinarian,” Brown said. “So that's almost a One Health Fellowship and what made me apply.”
[Fun Fact! Brown is the first former AEF fellow to become CSTE President]
Brown’s experience as an “almost” OneHealth AEF fellow inspired her to push to formalize an opportunity for individuals like her offering a similar experience.
“I want to be able to build on my experience and try to create a One Health Fellowship that expands a little bit and recognizes that fellows need to work with not only the health department, but also have ties to veterinarians and agriculture departments.”
As a longtime member of CSTE, Brown has seen the organization grow exponentially during the last few years. This growth has inspired another presidential priority of hers: reshaping the CSTE Position Statement process.
In case you’re unaware, position statements allow CSTE members to standardize surveillance case definitions, maintain the Nationally Notifiable Condition List, and address policy issues that could affect state or local law, rules or regulations. Position
statements are submitted each spring and then discussed and voted on by the CSTE membership at the Annual Conference in June.
Brown says her goal is to meld the existing member-driven approach with an organization-wide strategic framework.
“It used to be easier for individual members to drive issues,” she said. “But now we need to combine that with an overall strategic approach.”
That means recognizing that CSTE members generally have the same issues of concern and address it from their own viewpoint and experiences. Those valuable insights could then be distilled into policy that reflects CSTE as policy body.
“It's recognizing that there are different lenses that all of us apply to the same set of problems, and we need to combine those together in order to come up with the best path forward,” Brown said.
To summarize Brown’s presidential priorities in a word would be growth. The growth of applied epidemiology to further include animal and environmental concerns, an especially timely issue given the current H5N1 Outbreak. Also, the growth of CSTE Fellowships
to reflect this change. And finally, the growth of CSTE itself and the importance of having a unified, organizational-wide voice in the position statement process.
As 2025 rolls along, Brown will continue to lead CSTE and work on these crucial priorities.
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Posted By Posted by Victoria Barahona, Senior Policy Associate, CRD Associates,
Thursday, October 17, 2024
Updated: Thursday, October 17, 2024
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Last month, CSTE’s leadership and two CSTE Board Members traveled to Washington, D.C. to participate in an educational congressional briefing titled “Public Health Academy: The Power of Public Health Data.” This event is a popular series with congressional
staff and is co-hosted by the Coalition for Health Funding, CDC Foundation,
and the Centers for Disease Control and Prevention (CDC).
CSTE is a member of the Coalition for Health Funding—an 86-member organization representing patients, consumers, health providers, professionals, and researchers. Through this membership, CSTE was provided the lead opportunity to educate members of Congress
and their staff on the critical role public health data plays in addressing the nation’s most pressing health challenges.
Representative Rosa DeLauro (D-CT), Ranking Member of the House Committee on Appropriations, opened the event with remarks recognizing CSTE for being at the forefront of public health data modernization and for spearheading the initial recognition of
the need and call to action to address the root causes. Representative DeLauro expressed her strong support for public health funding, highlighting its importance in ensuring the nation’s preparedness for health threats.
Theresa Sokol, Louisiana State Epidemiologist and CSTE Board Member, was a notable panelist at the event. She provided first-hand experience of how data modernization in public health directly improves the public health response to acute and emerging
threats at the state level, including how electronic case reporting and syndromic surveillance (two key pillars of data modernization efforts) enable more rapid detection and shorten the time to take immediate actions that ultimately save lives.
Other distinguished speakers at the event included Senator Tammy Baldwin (D-WI), Chair of the Senate Appropriations Subcommittee on Labor, Health and Human Services, and Education; Dr. Mandy Cohen, Director of the CDC; Judy Faulkner, Founder and CEO of
Epic Systems; Dr. Jennifer Layden, Director of CDC’s Office of Public Health Data, Surveillance, and Technology; and Dr. Dylan George, Director of CDC’s Center for Forecasting and Outbreak Analytics. Their insights underscored the critical role of
data modernization in advancing public health capabilities.
The briefing highlighted the need for sustained funding for data modernization with an emphasis on the progress that has been made to date from current investments. The importance of electronic case reporting was a central theme as timely, high-quality
data forms the foundation for public health response. Another key area was focused on educating attendees about how critical CDC’s funding is to state, Tribal, local, and territorial (STLT) health departments and how cuts to CDC’s budget directly
impact STLT, as approximately 80% of CDC’s funding goes to STLT agencies. The event featured an engaging trivia game, where staffers and panelists interacted and tested their knowledge on facts about public health data, fostering a collaborative,
educational, and fun atmosphere.
The following day, CSTE leadership and CSTE Board Members Teresa Sokol and Dr. Sarah Lyon-Callo had the opportunity to meet with members of the House and Senate Appropriations Committees, where they discussed why Public Health Data Modernization
is so important to STLT health departments: It is a long-term commitment to building and maintaining world class public health data systems and a workforce that meets the nation’s ongoing need to safeguard health. Additionally, they provided education
on how data modernization dollars are being used to help people and communities to thrive by rapidly detecting, identifying, tracking, and responding to daily public health threats of all types. Simply put, data modernization is improving how STLT health departments can make informed decisions and know if the decisions made are making a difference to slow or prevent the spread.
The CSTE National Office has asked Congress to endorse the budget allocation in the FY 2025 Senate Labor-HHS appropriations bill of at least $195 million for Public Health Data Modernization, and at least $70 million for the Center for Forecasting and
Outbreak Analytics and the Response Ready Enterprise Data Integration platform. To address the unmet needs of health departments, CSTE also asked Congress to increase ELC’s base funding line to $120 million, which supports nimble response ready epidemiologists
in STLT. The CDC funding is especially important for applied epidemiology work in STLT public health jurisdictions, most of which receive more than 80% of funding for epidemiology personnel and activities through federal funding.
Of note, since CSTE’s visit to Washington, Congress passed a continuing resolution (CR) to fund the government through December 20, 2024. This temporary measure ensures that federal agencies, including those critical to public health, continue to operate
while budget negotiations are ongoing for final FY 2025 numbers. The CR has not only prevented a government shutdown, but now allows more time for Congress to finalize appropriations for the FY25, including the crucial funding for Public Health Data
Modernization, the Center for Forecasting and Outbreak Analytics, and the ELC program. Congress is now in a six-week recess to focus on campaigning before the November 5th election.
The congressional briefing and subsequent meetings highlighted the critical importance of public health data modernization and the need for sustained investment in public health infrastructure — and the critical role of applied epidemiologists. CSTE’s
efforts highlighted the essential role of timely, high-quality data in protecting public health and responding to emerging threats.
Victoria Barahona is Senior Policy Associate at CRD Associates, LLC, which represents CSTE’s interests on Capitol Hill in Washington, DC.
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Posted By CSTE National Office,
Monday, October 7, 2024
Updated: Thursday, October 3, 2024
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For more than 20 years, CSTE has regularly conducted Epidemiology Capacity Assessments (ECAs) to track the state of our applied epi workforce in state and territorial health departments. These assessments illustrate what—or rather, who—is needed to respond
to emerging health threats, and where we’re at risk of falling behind.
The latest ECA, our eighth overall, was just released and reflects data gathered from January–April 2024. Spoiler alert: The number of applied epidemiologists
working today will drop drastically once COVID-19 era funding runs out.
As always, the lessons learned from the ECA are paramount to CSTE’s outreach and education efforts towards policymakers. For example, data from past ECAs have been shared as testimony in Congressional hearings to support greater funding for epidemiologists
in public health.
The ECA also helps us monitor changes in the applied epidemiology workforce, including the number of epidemiologists presently working, the number of epidemiologists still needed, and the skills most sought after in state, Tribal, local, and territorial
(STLT) health departments.
We encourage you to take a deep dive into the findings and recommendations of the latest ECA here. But for now, here’s a quick summary of the top takeaways:
What We Have
For the first time, we have data from all 50 states, D.C., and territories! A total of 5,706 epidemiologists work in the 50 states and D.C., a 38% increase over the 4,135 reported in 2021.
What We'll Lose
If federal pandemic-era funding expires as planned, state health departments could lose 1,020 epidemiologists—nearly one-fifth of the current epidemiology workforce.
What We Need
State Epidemiologists said they need nearly 2,537 additional epidemiologists to reach full capacity in the three Essential Public Health Services (EPHS). This would be a 44% increase over current levels, for a total of 8,243 epidemiologists.
We are on the cusp of losing all the gains in the applied epi workforce that have occurred during COVID-19. And in 2024, 83% of funds for state and territorial epidemiology activities were provided by the federal government. These two points alone mean
that flexible, diverse funding is needed for our workforce, which will allow agencies to prioritize jurisdictional needs, enhance job security, and respond proactively to the next public health emergency.
For further reading, check out Big Cities Health Coalition (BCHC)’s local Epidemiology Capacity Assessment, also released today. The ECA was tailored for big city health department use and administered to the 35 BCHC jurisdictions.
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Posted By Victoria Barahona, CRD Associates,
Monday, July 22, 2024
Updated: Friday, July 19, 2024
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In a significant development for the upcoming fiscal year, the House Appropriations Committee (HAC) passed its FY 2025 Labor, Health, and Human Services, Education, and Related Agencies (Labor-HHS) appropriations bill.
The bill was released on June 26, followed by the accompanying report (a document that outlines the Committee’s intentions) on July 9. On July 10,
the HAC considered the bill during a full committee meeting. It was a long and contentious discussion, lasting nearly six hours and filled with extensive debates. The atmosphere was far from harmonious. Democrats criticized the legislation, pointing
out that the majority had excluded at least $60 billion in non-defense funding (which includes public health) that both parties had agreed to in last summer’s debt ceiling agreement. The bill passed out of committee by a party-line vote of 31 to 25.
Now, let’s take a closer look at the House’s bill. The proposed funding levels fall short of addressing the needs of our public health system. Reducing critical investments in public health, as this bill does, is a shortsighted, ineffective, and
irresponsible approach to tackling the broader fiscal challenges our country faces. A particularly alarming example are the deep cuts (about 22 percent) to the Centers for Disease Control and Prevention (CDC). The cuts indicate a push to refocus the
CDC toward infectious diseases at the expense of other equally important public health efforts. While this version of the bill will not become law, as proposed, these cuts would devastate public health infrastructure and reduce crucial investments
for public health response.
Below are some key takeaways:
Centers for Disease Control and Prevention (CDC)
- A 22% decrease overall, $2.3 billion less than the President’s FY25 budget request, and $1.8 billion below the FY24 enacted level.
- $780.7 million for emerging and zoonotic infectious diseases, an increase of about $20 million from the FY24 enacted level. One important note is that $15 million of the increase is allocated to myotic diseases, while $8.5 million is designated for prion diseases.
- Eliminates critical efforts, such as the Opioid Overdose Prevention program.
- Ends the HIV Epidemic initiative.
- Eliminates the Center for Forecasting and Analytics.
- Eliminates the Center for Injury Prevention and Control.
- Eliminates the Climate and Health program and Tobacco Prevention and Control Program.
- Reduces funding for CDC's global health program.
More detail on topline agency numbers from the House proposal as they compare to current funding levels for FY24 is detailed below:
Centers for Disease Control and Prevention
- Final FY24: $9,222,090,000
- House FY25: $7,446,058,000
Epidemiology and Laboratory Capacity (ELC)
- Final FY24: $40,000,000
- House FY25: $40,000,000
Public Health Data Modernization
- Final FY24: $175,000,000
- House FY25: $175,000,000
Center for Forecasting and Outbreak Analytics
- Final FY24: $55,000,000 (combined with the Response Ready Enterprise Data Integration platform)
- House FY25: $0
With the bad news out of the way, all hope is not lost. The House majority intends to bring their bill to the floor the week of July 29, but with a razor
thin majority and the inclusion of controversial funding levels and policy riders, it is not certain they will have the votes to pass it. It is also important
to remember that the Senate usually approaches its appropriations process in a bipartisan way, so funding levels are far from final.
Now is where you come in. Now is a time to make it clear to members of Congress that continued investment in public health is crucial. The Senate Appropriations
Committee has not yet released its Labor-HHS bill, but the Committee is scheduled to resume consideration of FY25 proposals the week of July 22 when Congress returns from a one-week recess.
The voices of those directly impacted by public health policies are crucial in shaping a healthier future for our communities. You can make a difference
by reaching out (in your personal capacity) to your legislators to let them know public health is something important and valued by their constituents.
CSTE has partnered with the American Public Health Association to provide an opportunity for you to submit a message to your members of Congress,
urging them to support increased funding for critical public health agencies and programs as they develop the FY25 Labor-HHS bill. It takes just a few
minutes to submit a letter (draft provided)
through the platform which will automatically route your letter to your representative. Be sure to complete the form by July 31. Feel free to share
the link to APHA’s take-action site
with other supporters of public health.
Additionally, including local stories about how investments in public health have positively
impacted your community and challenges that could arise from disinvestment are valuable. Hearing from their own constituents about their priorities will
influence decisions on Capitol Hill.
As always, CSTE will keep representing your needs in Congress including robust funding of the public health system and will keep you informed as
the appropriations process continues to unfold.
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