1. Andrew S. Rein Associate Director for Policy Centers for Disease Control and Prevention April 20, 2011 National Tribal Health Reform Implementation Summit The Affordable Care Act and Public Health

2. More Than Coverage, Quality, and Cost… The Affordable Care Act is a Real Opportunity for Public Health

3. Public Health Pillars of the Affordable Care Act  Preventive services without cost sharing  Policies and programs  Prevention and Public Health Fund  National Prevention Strategy

4. More People Will Have Access to Preventive Services  Preventive services covered with no cost sharing  USPSTF, ACIP, Bright Futures, and women’s health guidelines and recommendations  Private insurance, Medicare  Incentive for states to include in Medicaid  Medicare wellness visit  Review medical history, current care  Health risk assessment  Routine measurements, e.g., BMI

5. Nationwide Menu Labeling Puts Information in Consumers’ Hands  Calories listed on menus and menu boards  Restaurants and retail food establishments with 20 or more locations  Other nutrient information (e.g., saturated fat, cholesterol, sodium, carbohydrates, sugars, fiber, protein) available in writing upon request  Calories listed for vending machine items  Operators who own or operate 20 or more machines

6. Prevention and Public Health Fund Provides Sustainable Funding  Grows from $500m to $2b annually  2010  $250m for primary care workforce  $250m for prevention and public health  2011  $750m for community and clinical prevention, public health infrastructure, and research and tracking 201020112012201320142015-19 $500m$750m$1b$1.25b$1.5b$2b

7. PPHF Prevents Disease, Improves Health, and Saves Money  Empower communities to prevent the leading causes of death – heart attacks, cancer, stroke, injuries, and more  Improve health protection agencies’ capacity to detect and control threats  Identify and monitor health system’s successes and challenges

8. PPHF – CDC FY10 Investments Investment areaAmount NPHII$50m CPPW$36.4m HIV$30.3m ELC / EIP$20m Healthcare surveillance$19.8m Tobacco media$9.5m Public health workforce$7.5m Tobacco quit lines$5m Community Guide$5m ARRA evaluation$4m ARRA media$4m Total$191m

9. CDC FY10 PPHF Funding to Tribes

10. PPHF – Prevent Leading Causes of Death  Empower communities to prevent heart attacks, cancer, stroke, injuries, and more  Communities Putting Prevention to Work  Increase tobacco cessation and reduce initiation  Curb HIV epidemic through enhanced laboratory capacity, surveillance, testing, care and treatment, and prevention  Community Transformation Grants  Chronic Disease Grants  Immunization

11.  Critical to stop outbreaks and prepare for and stop natural or terrorist disasters  State and local detection and response  Increase capacity to use resources efficiently  Epi and lab capacity to detect and respond  Test for food borne diseases, flu, etc., and analyze data quickly  Skilled workforce to address complex public health demands  Front line workers, epidemiologists and more – next generation leaders  Healthcare Associated Infections  Reduce infections, save lives and reduce costs of treatment and unnecessary hospital readmission PPHF – Strengthen Public Health Detection and Response

12. PPHF – Produce information for Action  Know what prevention programs work and track health system performance—increase health value of our health investments  Community Guide  Identify and promote what works  Healthcare Surveillance  Improve access to accurate and timely data on obesity and physical activity, changes in heart attack and stroke care and prevention and more  Prevention Research

13.  Opportunity to prioritize and align prevention efforts across the federal government and the nation  Chaired by the Surgeon General  Council members: 17 federal departments  Advisory Group: 15 non-federal members appointed National Prevention, Health Promotion, and Public Health Council

14. Council Members Bureau of Indian AffairsDepartment of Labor Corporation for National and Community Service Department of Transportation Department of AgricultureDepartment of Veterans Affairs Department of DefenseEnvironmental Protection Agency Department of EducationFederal Trade Commission Department of Health and Human Services Office of Management and Budget Department of Homeland SecurityOffice of National Drug Control Policy Department of Housing and Urban Development White House Domestic Policy Council Department of Justice

15. National Prevention Council: Charge  Develop the National Prevention Strategy  Provide ongoing leadership and coordination of federal prevention and health promotion efforts  Produce an Annual Status Report

16.  Identify goals, priorities, and actions for improving health  Ground activities in evidence-based practices  Align and focus federal prevention and health promotion activities  Align with existing national efforts, such as: –Let’s Move! –Healthy People 2020 –National Quality Strategy –America’s Great Outdoor Initiative National Prevention Strategy

17.  Work across sectors  Catalyze public and private partnerships:  Federal, state, tribal, local, and territorial  Private, non-profit, faith, community, labor  Focus on where people live, learn, work, and play  Community, worksite, institutions, etc.  Promote healthy development and behaviors throughout all stages of life  Eliminate disparities Approach

18. Stakeholder Engagement  National conferences  Stakeholder input sessions  Outreach calls  HHS Regional meetings  Council website: www.healthcare.gov/nationalpreventioncouncil

19. Working together to improve the health and quality of life for individuals, families, and communities by moving the nation from a focus on sickness and disease to one based on wellness and prevention. Draft Vision

20. Draft Goal and Pillars  Americans Living Healthier and Longer  Healthy Communities  Preventive Clinical and Community Efforts  Empowered Individuals  Eliminate Health Disparities

21. Draft Priorities  Healthy Physical, Social and Economic Environments  Prevention and Public Health Capacity  Quality Clinical Preventive Services  Tobacco-Free Living  Preventing Excessive Alcohol and Other Substance Abuse  Healthy Eating  Active Living  Injury-Free Living  Sexual Health  Mental and Emotional Wellbeing

22. Thank you! For more information go to: www.healthcare.gov www.healthcare.gov