FY2018 Labor, Health and Human Services, Education Appropriations Summary

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Labor, Health and Human Services, Education Appropriations Summary NACCHO Priority Public Health Program Funding The Senate Appropriations Committee marked-up a bill funding the Departments of Labor, Health and Human Services (HHS) and Education for. The committee report can be found here. Below, NACCHO has provided an analysis of the bill. Please contact Eli Briggs, NACCHO Senior Director of Government Affairs, with any questions at ebriggs@naccho.org or 202-507-4194. Program ($ in millions) FY2016 FY2017 President House Senate NACCHO Request HHS Prevention and Public Health Fund (PPHF) 932 891 881 841 841 1,000 Emergency Preparedness CDC Public Health Emergency Preparedness Cooperative Agreements 660 660 551 680 660 705 ASPR Hospital Preparedness Program 255 255 227 255 255 300 ASPR Medical Reserve Corps 6 6 6 6 6 11 Infectious Disease CDC Section 317 Immunization Program (PPHF) 611 (324) CDC Core Infectious Disease 393 [Antibiotic Resistance] [160] CDC Epidemiology and Lab Capacity Grants (PPHF) Injury Prevention 607 (324) 396 [163] 521 (204) 557 (274) 235 363 (140) [163] 155 607 650 396 [163] CDC Opioid Prescription Drug Overdose Prevention 70 112 75 112 112 112 Environmental Health CDC Childhood Lead Poisoning Prevention (PPHF) 17 Public Health Capacity Building 17 17 17 CDC Preventive Health & Health Services Block 160 160 0 160 160 170 Grant (PPHF) (160) (160) (160) (160) CDC Public Health Workforce Development 52 50 45 45 50 57 Chronic Disease Prevention CDC Heart Disease and Stroke Prevention (PPHF) 160 130 * 136 130 160 (73) (73) (108) (53) CDC Diabetes Prevention (PPHF) 170 140 * 144 140 170 (73) (73) (72) (52) *Could be supported by new America s Health Block Grant 17 428 [200] 35 September 8, 2017

Opioid Abuse and Overdose Prevention Program ($ in millions) FY2016 FY2017 2018 President House Senate NACCHO Request CDC Illicit Opioid Use Risk Factors 6 14 0 14 14 14 CDC Opioid Prescription Drug 70 112 107 112 112 112 Overdose Prevention SAMHSA Opioid Prevention Grants for 15 Community Prevention SAMHSA Opioid Treatment 9 9 9 9 9 9 Programs/Regulatory Activities SAMHSA Medication-Assisted Treatment 25 56 60 56 56 60 for Prescription Drug and Opioid Addiction SAMHSA Grants to Prevent Prescription 12 12 12 12 12 26 Drug/Opioid Overdose Related Deaths DOJ Anti-Heroin Task Forces 7 0 0 0 0 10 Overview The Labor, HHS, Education Appropriations bill passed by the Senate Appropriations Committee on September 7 includes some good news for public health programs, although most programs remain stagnant at the same levels as The Committee rejected most cuts proposed by the White House, including a $109 million cut to the public health emergency preparedness program and $28 million cut to the hospital preparedness program. The committee also rejected the proposal from the White House to block grant chronic disease programs at the Centers for Disease Control and Prevention (CDC). The bill preserves funding for the Title X family planning program and teen pregnancy prevention program (TPPP) and instructs HHS to continue administering TPPP the same as in the Obama administration, after HHS announced the final two years of five year grant funding would be ended unexpectedly. However, the Racial and Ethnic Approaches to Community Health program was eliminated. The bill includes $841 million in funding for the Prevention and Public Health Fund (PPHF), which was proposed for elimination in FY2019 in the House-passed American Healthcare Act and Affordable Care Act repeal proposals under consideration in the Senate earlier this year. Centers for Disease Control and Prevention The bill provides $7.18 billion for CDC, a cut of $45 million from FY2017, including $801 million from the PPHF. NACCHO has created a chart that includes the allocation of the PPHF. Programs of interest to local health departments at CDC include the following: 2

Immunization and Respiratory Diseases - $794 million, same as The total includes $324 million from the PPHF. o Section 317 Immunization Program - $607 million, same as FY2017; $324 million from the PPHF. o Influenza Planning and Response - $188 million, same as HIV, Viral Hepatitis, STD, and TB Prevention - $1.1 billion, same as o HIV Prevention and Research - $788 million, same as HIV Prevention by Health Departments - $397 million, same as HIV Surveillance- $120 million, same as Activities to Improve Program Effectiveness- $103 million, same as FY2017 National, Regional, Local Community and other Orgs- $135 million, same as HIV Adolescent and School Health - $33 million, same as o Viral Hepatitis Prevention - $34 million, same as o STD Prevention - $152 million, same as o TB Prevention - $142 million, same as Emerging and Zoonotic Infectious Diseases $585 million, same as FY2017, including $52 million from the PPHF. o Core Infectious Diseases - $396 million, same as Antibiotic Resistance Initiative - $163 million, same as Vector-borne Diseases - $26 million, same as Emerging Infectious Diseases - $147 million, same as o Food Safety - $54 million, same as o Epidemiology and Laboratory Capacity Grants - $ million, same as FY2017, $40 million from PPHF. o National Healthcare Safety Network - $21 million, same as o Advanced Molecular Detection - $30 million, same as o Healthcare Associated Infections - $12 million from the PPHF, same as Chronic Disease Prevention and Health Promotion $1.1 billion, a cut of $50 million from FY2017, including $248 million from the PPHF. o Racial and Ethnic Approaches to Community Health eliminated, a cut of $51 million from o Tobacco - $205 million, same as FY2017, $126 million from the PPHF. o Million Hearts - $4 million from the PPHF, same as o Cancer Prevention and Control - $357 million, same as o Safe Motherhood/Infant Health - $46 million, same as Nutrition, Physical Activity, and Obesity - $50 million, same as High-Rate Obesity Counties - $10 million, same as Heart Disease and Stroke Prevention $130 million, same as FY2017; $53 million from the PPHF. Diabetes - $140 million, same as FY2017; $52 million from the PPHF. Diabetes Prevention Program - $23 million, same as School Health - $15 million, same as 3

Birth Defects, Developmental Disabilities, Disability and Health - $140 million, an increase of $2 million from Public Health and Scientific Services - $489 million, same as o Public Health Workforce Development - $50 million, same as o Surveillance, Epidemiology, and Public Health Informatics - $279 million, same as o Health Statistics - $160 million, same as Environmental Health - $181 million, same as FY2017, without $35 million in one-time multi-year lead poisoning prevention and registry funding for Flint, MI. $17 million is from the PPHF. o Environmental Health Activities $45 million, same as o Climate Change $10 million, same as o Childhood Lead Poisoning (Healthy Homes) - $17 million from the PPHF, same as o Asthma - $29 million, same as o Environmental and Health Outcome Tracking Network - $34 million, same as Injury Prevention and Control - $291 million, a $5 million increase from o Intentional Injury - $103 million, a $5 million increase from Rape Prevention - $49 million, a $5 million increase from o Unintentional Injury - $9 million, same as o National Violent Death Reporting System - $16 million, same as o Injury Prevention Activities - $29 million, same as o Prescription Drug Overdose Prevention - $112 million, same as Office of Public Health Preparedness and Response - $1.4 billion, same as o Public Health Emergency Preparedness (PHEP) $660 million, same as o Academic Centers for Public Health Preparedness - $8 million, same as o Strategic National Stockpile - $575 million, same as CDC-Wide Activities and Program Support - $274 million, same as FY2017, including $160 million from PPHF. o Public Health Leadership and Support - $114 million, same as FY2017 o Preventive Health and Health Services Block Grant - $160 million from the PPHF, same as Health Resources and Services Administration Programs of interest at the Health Resources and Services Administration (HRSA) include the following: Community Health Centers - $1.5 billion, same as $50 million is provided to expand services for the treatment, prevention, and awareness of opioid abuse. Public Health and Preventive Medicine - $17 million, same as Maternal and Child Health Block Grant - $642 million, same as Ryan White AIDS Programs $2.3 billion, same as o Part A Emergency Assistance (cities) - $656 million, same as o Part B Comprehensive Care (states) - $415 million, same as o Part B AIDS Drug Assistance Program - $900 million, same as 4

Title X Family Planning Program $287 million, same as Office of the HHS Secretary Teen Pregnancy Prevention Initiative $101 million, same as The bill also includes new bill language directing HHS to administer the program as it was during the previous Administration. Public Health and Social Services Emergency Fund Assistant Secretary for Preparedness and Response - $1.4 billion, same as o Hospital Preparedness Program - $255 million, same as o Biomedical Advanced Research and Development Authority - $512 million, same as o Project BioShield - $510 million, same as o Medical Reserve Corps - $6 million, same as o Pandemic Influenza Preparedness - $92 million, an increase of $20 million from 5