Final Fiscal Year 2012 Omnibus Appropriations Bill Summary

Transcription

1 Final Fiscal Year 2012 Omnibus Appropriations Bill Summary On December 16 and 17, the U.S. House of Representatives and the U.S. Senate, respectively, passed the final fiscal year (FY) 2012 omnibus appropriations bill funding the bulk of the federal government through September 30, The bill included funding for the U.S. Department of Health and Human Services, which includes funding for the Centers for Disease Control and Prevention (CDC), the Assistant Secretary for Preparedness and Response (ASPR), the Health Resources and Services Administration (HRSA), and the Substance Abuse and Mental Health Services Administration (SAMHSA), among others. The bill also includes the appropriations for the Environmental Protection Agency (EPA) Clean Water and Drinking Water State Revolving Funds. On December 23, President Obama signed the bill into law; the bill is now Public Law Overall, the entire omnibus appropriations bill and the previous minibus bill, which funded the Department of Agriculture, the Food and Drug Administration, and a few other federal government agencies, complied with the discretionary funding target of $1.043 trillion set forth in the Deficit Control Act, which was signed into law in August For the Labor-HHS-Education section of the omnibus, the bill totaled $163.9 billion in discretionary resources, which is $1.4 billion, or 0.9 percent, BELOW the comparable FY 2011 funding level. The following is a chart of ASTHO s FY 2012 advocacy priorities and how they fared in the final omnibus bill. A narrative summary of these and other public health programs follows. Please note the following: The numbers provided in the chart and in the narrative below, all have been adjusted to take into account across-theboard reductions of percent in the Labor-HHS-Education portion of the omnibus and 0.16 percent in the Interior/EPA portion. The Prevention and Public Health (PPH) Fund is intact and the full $1 billion available in FY 2012 will be allocated; however, the final allocations of the PPH Fund resources have not been made. The figures for the PPH Fund listed below represent our understanding of congressional intent, but are subject to change. CDC s appropriation also includes a contract and administrative cost reduction of $20 million to be applied across its programs, projects, and activities. Final funding levels for CDC, therefore, are also subject to change.

2 ASTHO Federal Advocacy Priorities for FY 2012 ($ in millions) Program FY 11 Final FY12 President s Budget Request FY12 ASTHO Recommendation FY12 Conference 1 FY 12 Conference $s +/- % +/- FY11 FY11 CDC Total Discretionary Resources 1 6, , , , % Budget Authority 2 5, ,611.5 n/a 5, % Prevention and Public Health (PPH) Fund n/a % Transfers from prior year pandemic flu balances n/a % Public Health Service (PHS) Evaluation Tap n/a % Prevention and Public Health Fund , , , % Community Transformation Grants % National Public Health Improvement Initiative % Preventive Health and Health Services Block Grant 80.1 Eliminated % Public Health Emergency Preparedness Cooperative Agreements (CDC) % Hospital Preparedness Program (ASPR) % Section 317 Immunization program % Budget Authority n/a % PPH Fund n/a % PHS Evaluation Tap n/a % Consolidated Chronic Disease and Health Promotion Grants n/a Food Safety (CDC) % 1. The final FY 12 conference agreement does not include an allocation of PPH Fund resources, which makes comparing FY 11 to FY 12 much more complicated. The full $1 billion available through the Fund will be allocated, but it is not yet known how the funding will ultimately be spread to programs, projects, or activities. PPH Fund numbers included here represent our understanding of the agreement, but are subject to change. 2. Budget authority is "new" funding that is made available through the FY 12 bill. Often referred to as "base" funding or shortened to "BA". 3. The President's request for FY 11 and FY 12 included a transfer of resources to CDC from prior year pandemic flu funding resources that are still available for obligation. 4. Resources are available to PHS Act activities through the transfer of funds from other PHS Act appropriations.

3 Department of HHS total: The final FY 2012 omnibus provides HHS with a total of $69.7 billion in discretionary funding, which is nearly $700 million BELOW the FY 2011 level and $3.4 billion BELOW the President s budget Syringe Exchange Federal Funding Ban: The bill includes a major legislative rider that has an impact on public health. The bill reinstates the federal funding ban on syringe exchange programs. No federal funding provided in the bill may be used to carry out any program of distributing sterile needles or syringes for the hypodermic injection of any illegal drug (section 523). Prevention and Public Health (PPH) Fund: The bill is silent on the PPH Fund. Since the appropriations for the PPH Fund are provided through section 4002 of the Affordable Care Act this means that the full $1 billion available through the Fund in FY 2012 are available to be allocated by the HHS Secretary. The public health community understands that the Congress did make final FY 2012 PPH Fund allocation decisions and that information is provided in this summary. It cannot be stated enough, though, that these allocation figures are subject to change. As additional information is provided publicly, ASTHO government relations will keep the membership informed. Section 220 of Division F of the final appropriations bill requires that the Secretary of HHS establish a publicly available website to provide information regarding the uses of the PPH Fund. Not only will this require the federal government to provide more information, but each grantee will be required to submit reports to post to this website. At a minimum the following information shall be provided on the website: 1) A statement indicating the program or activity receiving funds, the operating division or office (meaning the federal entity) that will administer the funds, and the planned uses of the funds, to be posted not later than the day after the funds are transferred from the Fund to the federal administering entity. 2) Identification (along with a link to the full text) of each funding opportunity announcement, request for proposals, or other announcements or solicitations of proposals for grants, cooperative agreements, or contracts intended to be awarded using such funds, to be posted not later than the day after the announcement is made. 3) Identification of each grant, cooperative agreement, or contract with a value of $25,000 or more awarded using PPH Fund resources, including the purpose of the award and the identity of the recipient, to be posted not later than five days after the award is made. 4) A report detailing the uses of all PPH Fund resources during the fiscal year, to be posted not later than 90 days after the end of the fiscal year.

4 5) Semi-annual reports from each entity awarded a grant, cooperative agreement, or contract from PPH Fund resources with a value of $25,000 or more, summarizing the activities undertaken and identifying any sub-grants or sub-contracts awarded (including the purpose of the award and the identity of the recipient), to be posted not later than 30 days after the end of each six-month period. CDC Total: The final FY 2012 discretionary total for CDC is likely to be $6.9 billion, which is an INCREASE of $76.2 million, or 1.1 percent, over FY 2011 and an INCREASE of $28.9 million, or 0.4 percent, over the Administration s This level includes an expected allocation of $855 million from the PPH Fund. Preventive Health and Health Services (Prevent) Block Grant: FY 2011 Enacted = $80 million FY 2012 Administration request = $0 FY 2012 Final Omnibus = $80 million The funding for the Prevent Block Grant was the only item mentioned within the U.S. House of Representatives press release for the omnibus under CDC. They wrote (emphasis added): the legislation funds at $80 million the Preventive Health and Health Services Block Grant a program proposed for elimination by the President and the Senate that provides funding to states to address critical public health needs. Immunization and Respiratory Diseases: FY 2011 Enacted = $748 million FY 2012 Administration request = $722 million FY 2012 Final Omnibus = $781 million o Section 317 Immunization Program: the final FY 2012 level is likely to be $622 million, which is an INCREASE of $33 million, or 6 percent, above FY 2011 and an INCREASE of $60 million, or 11 percent above the Administration s Within the total, $190 million is expected to be derived through the PPH Fund.

5 Emerging and Zoonotic Infectious Diseases: FY 2011 Enacted = $304 million FY 2012 Administration request = $349 million FY 2012 Final Omnibus = $305 million o CDC Food Safety: the final FY 2012 bill provides $27 million, which is an INCREASE above the FY 2011 funding level of $2 million, or 7 percent, and a DECREASE of $7 million, or 21 percent, below the Administration s o Emerging Infectious Diseases/Epidemiology and Laboratory Capacity (ELC) Grants: the final FY 2012 level is likely to be $164 million, which is an INCREASE above the FY 2011 funding level of $40 million, or 32 percent, and an INCREASE of $17 million, or 11 percent above the Administration s Within the total, the full $40 million increase is expected to be derived through the PPH Fund for ELC grants. Chronic Disease Prevention and Health Promotion: FY 2011 Enacted = $1.1 billion FY 2012 Administration request = $1.2 billion FY 2012 Final Omnibus = $1.2 billion o Community Transformation Grants (CTG): the final FY 2012 level is likely to be $280 million, which is an INCREASE above the FY 2011 funding level of $135 million, or 93 percent nearly doubling this new program, and an INCREASE of $7 million, or 21.4 percent, below the Administration s All of the funding for this program is expected to be derived through the PPH Fund. While no congressional intent language is available publicly for CTG, the public health community understands that the $135 million increase is intended for a new competition focused on non-governmental organizations, school districts, local housing authorities, Indian tribes, and local transportation authorities. As it is currently understood, state and local public health agencies will not be eligible to directly apply for any new funds. ASTHO staff will be closely monitoring this and will provide additional information on CTGs as it becomes available.

6 o Consolidated Chronic Disease and Health Promotion Grants: the final FY 2012 bill did not move forward with the Administration s request to consolidate chronic disease and health promotion state grant programs. However, funding is provided for chronic disease programs in the usual, categorical manner. All of the following chronic disease categorical programs are a slight DECREASE below FY 2011 of 0.2 percent: Nutrition, Physical Activity, and Obesity: $34 million Heart Disease and Stroke: $55 million Diabetes: $65 million Arthritis: $13 million Adolescent and School Health: $14 million (the portion of this funded dedicated to HIV prevention activities was moved, at the Administration s request to the HIV/AIDS program area) Safe Motherhood/Infant Health: $44 million. o Cancer Prevention and Control: the final FY 2012 bill provides $350 million, which is an INCREASE above the FY 2011 funding level of $4 million, or 1 percent. The Administration requested to include cancer prevention and control programs in their chronic disease consolidation proposal. o Oral Health: the final FY 2012 bill provides $15 million, which is a slight DECREASE below the FY 2011 funding level of $28,000, or 0.2 percent, and a slight DECREASE of $89,000, or 0.6 percent, below the Administration s Congress included language in the statement of managers expressing their pleasure that CDC has decided to maintain the Division of Oral Health in their organizational structure. o Tobacco/Office of Smoking and Health: the final FY 2012 level is likely to be $208 million, which is an INCREASE of $50 million, or 31 percent, above FY 2011 and an INCREASE of $22 million, or 12 percent above the Administration s Within the total, $100 million is expected to be derived through the PPH Fund. Public Health Preparedness and Response: FY 2011 Enacted = $1.4 billion FY 2012 Administration request = $1.5 billion

7 FY 2012 Final Omnibus = $1.3 billion o Public Health Emergency Preparedness Cooperative Agreements: the final FY 2012 bill provides $642 million, which is an INCREASE above the FY 2011 funding level of $9 million, or 1 percent, and a slight DECREASE of $1 million, or 0.2 percent, below the Administration s o BioSense: the final FY 2012 bill provides $21 million, which is a DECREASE below the FY 2011 funding level of $13 million, or 39 percent. The Administration s budget request did not explicitly specify an amount for this activity. o Strategic National Stockpile: the final FY 2012 level is likely to be $539 million, which is a DECREASE below the FY 2011 funding level of $52 million, or 9 percent, and a DECREASE of $116 million, or 18 percent, below the Administration s Within the total, $30 million is expected to be derived through prior year pandemic influenza balances that remain available for obligation. National Public Health Improvement Initiative (NPHII): FY 2011 Enacted = $40 million FY 2012 Administration request = $40 million FY 2012 Final Omnibus = $40 million All of the funding for this program is expected to be derived through the PPH Fund. Public Health Workforce and Career Development: FY 2011 Enacted = $61 million FY 2012 Administration request = $73 million FY 2012 Final Omnibus = $61 million Within the total, $25 million is expected to be derived through the PPH Fund. HIV/AIDS, STD, Viral Hepatitis, and TB Prevention: FY 2011 Enacted = $1.1 billion

8 FY 2012 Administration request = $1.2 billion FY 2012 Final Omnibus = $1.1 billion o HIV Prevention by Health Departments: the final FY 2012 bill provides $336 million, which is a slight DECREASE below the FY 2011 funding level of $637,000, or 0.2 percent, and a DECREASE of $7 million, or 2 percent, below the Administration s o STD/STI Prevention: the final FY 2012 bill provides $154 million, which is a slight DECREASE below the FY 2011 funding level of $292,000, or 0.2 percent, and a DECREASE of $7 million, or 4 percent, below the Administration s o Viral Hepatitis Program: the final FY 2012 level is likely to be $30 million, which is an INCREASE above the FY 2011 funding level of $10 million, or 50 percent, and an INCREASE of $5 million, or 19 percent, above the Administration s Within the total, the full $10 million increase is expected to be derived through the PPH Fund to expand screening services for HIV, hepatitis, and STD/STI. Environmental Health: FY 2011 Enacted = $170 million FY 2012 Administration request = $138 million FY 2012 Final Omnibus = $140 million o Environmental Health Laboratory: the final FY 2012 bill provides $43 million, which is a slight DECREASE below the FY 2011 funding level of $81,000, or 0.2 percent, and a DECREASE of $878,000 or 2 percent, below the Administration s o Asthma: the final FY 2012 bill provides $25 million, which is a DECREASE below the FY 2011 funding level of $2 million, or 7 percent. The Administration proposed to combine this program with the Healthy Homes/Childhood Lead Poisoning program and reduce total funding by approximately half.

9 o Healthy Homes/Childhood Lead Poisoning: the final FY 2012 bill provides $2 million, which is a DECREASE below the FY 2011 funding level of $27 million, or 93 percent. Congress intends for funding to be used to maintain national level expertise and analysis only. The Administration proposed to combine this program with the asthma program and reduce total funding by approximately half. o Environmental and Health Outcome Tracking Network: the final FY 2012 level is likely to be $35 million, which is the SAME as the FY 2011 funding level and an INCREASE of $3 million, or 9 percent above the Administration s All of the funding for this program is expected to be derived through the PPH Fund. o Climate Change: the final FY 2012 bill provides $7 million, which is a slight DECREASE below the FY 2011 funding level of $14,000, or 0.2 percent, and an INCREASE of $820,000 or 11 percent, above the Administration s o Built Environment and Health Initiative: the final FY 2012 bill provides $3 million, which is a slight DECREASE below the FY 2011 funding level of $5,000, or 0.2 percent. The Administration proposed to eliminate this program. National Center for Health Statistics: FY 2011 Enacted = $169 million FY 2012 Administration request = $197 million FY 2012 Final Omnibus = $173 million Within the total, $35 million is expected to be derived through the PPH Fund. Injury Prevention and Control: FY 2011 Enacted = $144 million FY 2012 Administration request = $168 million FY 2012 Final Omnibus = $138 million

10 o Rape Prevention and Education: the final FY 2012 bill provides $39 million, which is a slight DECREASE below the FY 2011 funding level of $75,000, or 0.2 percent, and a DECREASE of $3 million, or 6 percent, below the Administration s o Youth Violence: the final FY 2012 bill provides $15 million, which is a DECREASE below the FY 2011 funding level and the Administration s request of $5 million, or 24 percent. o National Violent Death Reporting System: the final FY 2012 bill provides $3 million, which is a slight DECREASE below the FY 2011 funding level of $7,000, or 0.2 percent, and a DECREASE of $2 million, or 31 percent, below the Administration s Birth Defects, Developmental Disabilities, and Health: FY 2011 Enacted = $136 million FY 2012 Administration request = $144 million FY 2012 Final Omnibus = $138 million Hospital Preparedness Program (ASPR): the final FY 2012 bill provides $380 million, which is a DECREASE below the FY 2011 funding level of $4 million, or 1 percent, and a slight DECREASE of $719,000, or 0.2 percent, below the Administration s HRSA Programs: AIDS Drug Assistance Program: the final FY 2012 bill provides $898 million, which is an INCREASE above the FY 2011 funding level of $13 million, or 2 percent, and a DECREASE of $42 million, or 4 percent, below the Administration s On December 1, World AIDS Day, the President announced an additional $35 million for ADAP through the resources available in FY 2012 from the PPH Fund. Congress PPH Fund allocation information that the public health community received does not include this amount for ADAP. ASTHO and Affiliate staff will continue to monitor information flowing from the Administration on this program and will keep you abreast of developments.

11 Maternal and Child Health Block Grant: the final FY 2012 bill provides $645 million, which is a DECREASE below the FY 2011 funding level of $11 million, or 2 percent, and a DECREASE of $9 million, or 1 percent, below the Administration s Title X Family Planning: the final FY 2012 bill provides $297 million, which is a DECREASE below the FY 2011 funding level of $3 million, or 0.9 percent, and a DECREASE of $31 million, or 9 percent, below the Administration s SAMHSA Primary and Behavioral Health Integration: the final FY 2012 bill provides $66 million, which is a DECREASE below the FY 2011 funding level of $3 million, or 5 percent, and an INCREASE of $32 million, or 93 percent, above the Administration s Environmental Protection Agency State and Tribal Assistance Grants: Clean Water State Revolving Fund: the final FY 2012 bill provides $1.5 billion, which is a DECREASE below the FY 2011 funding level of $55 million, or 4 percent, and a DECREASE of $84 million, or 5 percent, below the Administration s Drinking Water State Revolving Fund: the final FY 2012 bill provides $918 million, which is a DECREASE below the FY 2011 funding level of $45 million, or 5 percent, and a DECREASE of $72 million, or 7 percent, below the Administration s For more information: The entire bill text can be found here: The statement of managers can be found here: (Labor-HHS-Education is Division F and Interior/EPA is Division E)