The Good, Bad and the Ugly : Health Policy and Public Health Promotion in the Fast Lane Donna Nichols, MSEd, CHES DHPE Health Policy Director Lavell Thornton, MPH, MCHES DHPE Health Policy Committee Chair DHPE Member Institute, New Orleans, LA, August, 2011

Remember When… Quote: The Major Health Problems of Our Time… …We didn’t have to worry about maintaining funds or staff? …Federal funds filled the gaps when state funds were not enough? …Being furloughed was something only the military did? …Grant writing was not a do or die proposition?

Times Have Changed…The Good National Prevention Strategy A vision of prevention that ranges from traditional clinical services to community change that addresses the policies and structures that affect healthy choices, to the social determinants of health A recognition that all agencies of the federal government have a role to play – and by extension all levels of government and all sectors of society

DHPE National Health Policy Strategy Framework Beginning in 2011, with newly assigned human and financial resources and a sharpened focus on health policy and health equity in its mission, DHPE intends to expand its efforts and accelerate its involvement in and contribution to national public health promotion policy

DHPE Health Policy Goals

DHPE Top Line Objectives Distinguish DHPE among ASTHO affiliates and national health education organizations by executing a well-designed, sufficiently resourced, and thoroughly vetted national health promotion policy strategy and collaborate as needed with other national organizations when the common good takes higher precedence and priority over any individual organizational advocacy effort.

DHPE Cross-Cutting Pillars Collaboration (Internal/External) Communication (Internal/External) Leadership***(Active Strategies)

An Exercise…The Bad Last Person(s) Standing Please Cut Off the Lights

Normal Budget Process/Timeline February: President’s budget comes out March-April-May: Budget caps resolved –Sets a cap on total discretionary spending, of which Health is one category May: a portion of that cap is designated for the bill that funds Labor, Health, and Education. July – Sept: House and Senate negotiators debate program funding levels.

National Debt Ceiling Debate…The Ugly All of the agreements to raise the debt ceiling reduce the deficit through cuts in 2-4 forms of government spending Discretionary spending caps Mandatory subsidies (farm, student loan, etc) Entitlement program changes Tax expenditures

Prevention Fund FY $750 million…The Good CDC operating plan submitted to Congress – 5/13/11 –$145 million for Community Transformation Grants –$42.2 million for Chronic Disease State Grants –$40 million for Epidemiology and Lab Capacity –$10 million for Prevention Research Centers –$14 million for community and clinical task forces –$100 million for childhood immunizations –$40.2 million for public health infrastructure

Prevention Fund FY 2012 (proposed) - $1 billion Proposed in President’s Budget on February 14th –$221 million for Community Transformation Grants –$157.7 million for Chronic Disease State Grants –$79 million for tobacco cessation –$40 million for Epidemiology and Lab Capacity –$20 million for injury prevention –$40 million for public health infrastructure –$30 million for HIV/AIDS

Prevention Fund Risk Assessment…The Ugly House voted to repeal ACA House voted to repeal Prevention Fund Successfully protected in the FY11 budget deal Debt Ceiling/FY 12 –Negotiations ongoing, GOP put out list of health cuts including $8 billion cut to Fund. Cuts in CDC base undermine value of Fund –Is Congress/Administration making a conscious trade off? –Can we maintain transformative nature of the Fund?

Congressional Recess August 8 – September 5, 2011 Ask to Members of Congress: To NOT Cut the Prevention and Public Health Fund (PPHF) Take at least one action during the recess; Schedule in-district meetings with Members of Congress Attend town hall meetings Take action online Send a letter Blog or write an op-ed or Letter-to-the-Editor Report back!

Con tact Information Lavell Thornton, MPH, CHES Health Policy Chair Donna C. Nichols, MSEd, CHES Director of Health Policy