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April Newsletter
2014       
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In our April newsletter:
Please follow up if you have any questions or feedback on the items covered in this newsletter, or if we can be of help.
 
Best wishes, 
Karl Moeller, Executive Director 
 

The Senate Health, Education, Labor and Pensions Committee enjoys broad jurisdiction over national health policies and maintains a largely bipartisan approach to issues of importance to the nation. Led by Chairman Tom Harkin (D-IA) and Ranking Member Lamar Alexander (R-TN), the full committee membership includes 20 additional senators who work on three far-reaching subcommittees. Among them is a subcommittee on health, which has jurisdiction over many federal agencies and disease control and prevention programs.

 

Over the past month, CPHF worked with a bipartisan team of committee staff and with agency leadership to organize a series of meetings at the Centers for Disease Control and Prevention in Atlanta. Senior staff members covering health for senators serving the Senate HELP Committee, and key HELP Committee health staff members, received invitations this week for a two-day trip to Atlanta on May 29 and 30.

 

In addition to meeting with senior CDC staff during this comprehensive tour of the agency's Atlanta facilities, we are organizing a reception and salon dinner covering timely public health topics for the evening of May 29. A working breakfast meeting will explore how businesses, local governments and other outside groups work with the agency. Tour sponsors, CPHF member organizations, senior CDC staff and tour participants are invited to attend the reception, dinner and breakfast meeting.

 

As with past tours, The CPH Foundation invites our partner nonprofit organizations to help support this educational program. Please contact Karl Moeller to learn more, or complete this online questionnaire to pledge your support. Tour sponsors will aid in planning the tour and are encouraged to participate in the salon dinner and breakfast. A draft agenda will be posted on the "upcoming events" page of our website shortly.             

 

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CDC: The Forgotten Agency?

 

Six years ago: That was the last time a sitting director of the Centers for Disease Control and Prevention appeared before a House or Senate appropriations subcommittee to independently answer Congress' questions and testify in detail about the budgetary needs of our nation's front-line prevention and disease control agency.

 

On March 5, 2008, then-director Dr. Julie Gerberding spoke to the House subcommittee responsible for funding the CDC about the Bush administration's priorities. Our economy was beginning to sputter. President Bush was in the White House, Mr. Obama was a Senator, and health reform was a campaign issue.

 

True, the CDC has been called to simultaneously testify alongside a half-dozen other agencies since then, but the resulting hearings provide little time to discuss the needs of this nearly $7 billion agency in any detail.

 

The CDC is a very different agency than it was in 2008. A new president, a new secretary and a new CDC director are in all place. Many of the agency's top leadership positions have changed substantially. A "winnable battle" strategy for disease prevention was launched and the agency's budget lines were considerably reorganized. 

 

Funding for the agency has fallen dramatically, even while a new billion-dollar Prevention and Public Health Fund was swapped in -- like the ball and cup trick -- for some $800 million of the agency's traditional discretionary "budget authority" funding. And finally, local health departments across the country (where about 70 percent of the CDC's budget is ultimately sent) lost more than 50,000 employees.

 

While any one of these changes might be reason enough for Dr. Frieden to be asked to appear before the appropriations subcommittees that fund the CDC, neither the House Chairman of the LHHS Appropriations Subcommittee (from Georgia, where CDC is based) nor his colleagues in the Senate appear interested in a detailed public update from the CDC.

Sebelius to Congress: 
CDC Doesn't Need Funding  
 
When CDC leaders are not invited to update Congress on the health of the agency in detail, others who may not be as well informed about the state of the CDC are left to deliver the message. That point was made clear on March 13, when Secretary Kathleen Sebelius appeared before Congress to talk about the more than 28 agencies and 11 operating divisions under her direction within the Department of Health and Human Services. 

Budget Hearing - Department of Health and Human Services (LHHS Subcommittee) 
CDC Clip: LHHS Subcommittee Hearing
In the linked video here, Congresswoman Lucille Roybal-Allard asks one of the few questions about the CDC and its budget. 

Roybal-Allard questioned the secretary about the Obama administration's proposed cuts to the CDC, reminding the secretary that the president had requested $7.6 billion for the agency in 2010, (a full billion dollars more than his 2015 request before accounting for inflation). Roybal-Allard noted that this 14 percent drop in funds requested for the CDC was "stunning" and lowered the agency's budget authority to 2003 levels.   
 
In her line of questioning, Congresswoman Roybal-Allard correctly noted that these cuts include the oft-praised Prevention Fund, mandatory funding provided under the Affordable Care Act that were meant to supplement prevention budgets, not supplant the agency's core programs.   
 
Secretary Sebelius' stated (around 02:05:18 in the video) that the Prevention and Public Health Fund is not supplanting the CDC's budget but is "enhancing" the agency. She states,
 
"I would finally say that you are absolutely right, that the Prevention Fund was to not supplant old efforts but to enhance prevention efforts. I'm pleased to tell you that given Congress' activity in 2014, those effort will be dedicated to prevention efforts, not used to backfill programs and I think we would see that going forward in 2015. We have again not suggested that the Prevention Fund be used supplant CDC's Funding."

These comments fly in the face of the truth. Our updated funding chart shows the drop in support for the agency while graphically representing how the Prevention and Public Health Fund is not actually doing "more" for the CDC as advertised -- but has instead been used to replace or "supplant" cuts to the agency's budget. 
 
Also shown is the fact that only twice in the past 10 years has a president requested an increase in the CDC's budget. One of those instances came on the heals of sequestration. For his part, President Obama has, in 4 of his last 6 requests, asked for LESS funding for the CDC than Congress appropriated the prior year. 
 
chart 
 
 
When pushed by Roybal-Allard to explain the cuts to so many areas of the CDC, 
Sebelius told Congress, "[Prevention] services will go on, we just don't need the money through CDC." 
(See 01:29:35 in the video.)
 
Another View
 
In 2003, 2006 and again in 2007, then-director, Dr. Julie Gerberding wrote Congress that, in her professional judgment, Appropriators should raise the CDC budget to $15 billion to meet the true needs of the agency.   
 
By contrast, the Obama administration seems to imply, at the hearing on March 13, that having greater insurance coverage under the ACA for hospital-based clinical diagnostic services (such as breast cancer screenings and colonoscopies) and by providing coverage for childhood vaccinations through insurance companies, massive cuts to community prevention work led by the CDC can be justified.  
 
Champions for public health and prevention should listen to the March 15 testimony and ponder next steps. Perhaps it is time to agree that the ACA's Prevention and Public Health Fund -- despite the best of intentions -- has muddied the water so much that even the secretary mistakenly believes the CDC's budget is on the rise. The Prevention Fund has undoubtedly complicated the job of advocates fighting for a vibrant and cohesive national prevention infrastructure. 
 
The CDC's budget was hard to explain before the ACA, and now it's nearly impossible. 
 
The bottom line? All the great outcomes data in the world won't help strengthen public health investments if nobody really understands what the total investment is. 
 
It is also time to give the CDC an opportunity to explain, independently and to both the House and Senate, how their critical prevention and public health efforts should move forward in this very new environment. The CDC, and experts in the public health field, should investigate how the CDC should be resourced to support a vibrant disease control and prevention infrastructure.
 
Thank you, Congresswoman Roybal-Allard, for your work on behalf of public health and for asking the hard questions.

 

The U.S.-Mexico border region is a microcosm for global health. Infectious disease surveillance and detection efforts may be top of mind for most, but a host of other public health challenges present unique issues to border states.

 

Late last year we began exploring the possibility of hosting congressional leaders at a series of educational disease control and prevention-focused meetings in the region. That work was sidetracked, in part, by the federal government shutdown. Still, our partners and leadership wish to see this plan through.

 

In mid-April, our executive director will travel to New Mexico for meetings with several key partners in the region. His visit is intended to explore regional public health challenges while laying the groundwork for a possible congressional visit focused on border health topics.

 

The CPH Foundation is grateful that Senator Tom Udall's New Mexico field representative for border health is arranging a meeting in Las Cruces of interested local organizations during Mr. Moeller's visit. Senator Udall has a strong interest in border health and has crafted legislation on the issue. We look forward to developing a list of various sites, topics and the health concerns best covered during a future congressional visit.

 
To learn how you can help, please contact Alexandra Menardy at AlexandraM@CPHFoundation.org.

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Our 10-Year Anniversary

As some readers will recall, we officially began advocating for increased investments in prevention and public health on May 4, 2004. Our sister advocacy organization, The Campaign for Public Health, officially opened its doors on that date. 

This spring, we will commemorate a decade of advocacy and education in support of public health programs at an evening reception.

You can always help mark our anniversary by making a tax-deductible contribution to The CPH Foundation today. This link will take you to the contribution page of our website.
 
NOTE: Camille Bonta of Summit Health Care Consulting recently agreed to work with CPH should advocacy around prevention topics be needed. 

Highlights Video 2013 Unsung Heroes
Highlights: 2013 Unsung Heroes
Unsung Heroes: 
Highlight Video

Our 4th Annual Unsung Heroes of Public Health event honored our 2013 winners earlier this year. Excerpts from speeches by our honorees, 
Congressman 
Jim McDermott and from our distinguished guests are all covered in the short 
highlights video linked to here.

 

The full and unedited speeches given by Rep. McDermott, Bob Meyers of the National Press Foundation and others are also on our YouTube page.

 

Nomination forms for our 2014 awards will be posted on our website in the second quarter of 2014.

 

Again, a special thanks to AbbVie for supporting last year's program.

 

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APHA 

M.O.U. signed: APHA and CPHF

 

The CPH Foundation has long-enjoyed a strong partnership with the American Public Health Association. Dr. Georges Benjamin, APHA's executive director, served on our Board of Directors for many years. The organization has also provided financial support, aided our programmatic work and collaborated with us for nearly a decade.

 

We are extremely grateful for APHA's 2014 donation of two fully equipped workstations at its national office. This prime downtown space in Washington's centrally located Chinatown neighborhood will better enable CPHF to attract graduate-level interns from surrounding universities.

 

Spring/Summer Internships Open


With the agreement with APHA mentioned above, CPHF is looking for one additional spring and perhaps as many as two summer interns. Interested applicants should visit APHA's internship page to submit an application. Be sure to click on The CPH Foundation internship application -- or apply for both APHA and CPH positions if you like.

 

A Great Addition!

 

On a related note, we are pleased to welcome Alexandra Menardy as our spring/summer 2014 intern. Alexandra is a George Washington University graduate student in the masters of public health in healthy policy program who hit the ground running in our new intern workspaces at APHA's headquarters.

 

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Special Thanks to Recent Donors 

The CPH Foundation would like to publicly thank Research!America, Scientific Technologies Corporation, the National Alliance of State and Territorial AIDS Directors (NASTAD), Barbara Kornblau, Karen Goraleski, Dr. Richard Hubbard, Ilene Kline and the Qualcomm Foundation for their recent contributions.
 
New Management Structure

Mr. Moeller, our long-standing executive director, now guides CPHF through Walker Court Associates, a company he founded in January of this year.
 
The CPH Foundation Board voted to shift CPHF to this new management structure late in 2013. This change will provide more resources to programmatic activities while giving us more flexibility as an organization. Our goal in executing this change was to efficiently advance our mission during these difficult times for disease control and prevention programs. 
Contact:
Karl Moeller, Executive Director 
The Campaign for Public Health Foundation
PO Box 15305 | Washington, DC 20003
202 898 0435  |  KarlM@cphfoundation.org
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