1 Centers for Disease Control and Prevention FY 2010 Budget May 14, 2009

2 CDC/ATSDR FY 2010 President’s Budget Total Funding Level: $10.1 billion, $22.5 million below FY 2009 ActivityFY 2010 PB FY /- FY 2009 CDC Discretionary *$6.7 billion +$31.6 million CDC Mandatory$3.4 billion($54.1) million – Vaccines for Children$3.3 billion($54.1 million) – EEOICPA$55.3 million$0 Total CDC/ATSDR $10.1 billion ($22.5) million CDC’s FY 2010 President’s Budget *includes PHS Evaluation Transfers, Supplementals and ATSDR

3 FY 2010 President Budget’s (Dollars in Thousands) Budget Activity/Description FY 2008 Actual FY 2009 Appropriation FY 2010 President’s Budget FY /- FY 2009 Infectious Diseases Control$149,925$157,426$168,741$11,315 HIV/AIDS, STD and TB Prevention$1,002,130$1,006,375$1,060,299$53,924 Immunization$684,634$716,048$717,460$1,412 Zoonotic, Vector-Borne, and Enteric Disease$67,846$ 67,978$73,122$5,144 Chronic Disease and Health Promotion$833,827$881,686$896,239$14,553 Birth Defects, Developmental Disabilities, Disability and Health $127,366$138,022$142,016$3,994 Prev Health and Health Services Block Grant$97,270$102,000$102,034$34 Health Information and Service$276,778$279,356$291,784$12,428 Injury Prevention and Control$134,837$145,242$148,615$3,373 Environmental Health$154,486$185,415$186,401$986 Occupational Safety and Health$381,954$360,059$368,388$8,329

4 FY 2010 President’s Budget (Dollars in Thousands) Budget Activity/Description FY 2008 Actual FY 2009 Appropriation FY 2010 President’s Budget FY /- FY 2009 Global Health$302,371$308,824$319,134$10,310 Terrorism$1,479,455$1,514,657$1,546,809$32,152 Public Health Research$31,000 $31,170$170 Public Health Improvement and Leadership$224,899$209,136$188,586($20,550) Buildings and Facilities$55,022$151,500$30,000($121,500) Business Services Support$371,847$ 359,877$ 372,662$12,785 PHS Evaluation Transfer (non-add)$325,673$ 331,251$ 300,852($399) ATSDR$74,039 $ 76,792$2,753 Vaccines for Children$2,719,702$ 3,377,911$3,323,770($54,141) EEOICPA$0$55,358 $0 User Fees$2,226 $ 0 TOTAL, CDC/ATSDR Program Level $9,171,614$10,124,135$10,101,606($22,529)

5 Budget Overview of Increases * Autism+$1.6 million Business Services and Support (BSS)+$12.7 million Domestic Violence+$3.1 million Emerging Infectious Diseases+11.1 million Food Safety+4.4 million Global Immunization Program+$10.1 million Health Statistics+$13.9 million HIV/AIDS Research and Domestic+$53.0 million Nanotechnology+$5.0 Million Navajo Nation Uranium Studies+$2.0 million * Includes Pay Raise

6 Budget Overview of Increases * Paralysis Resource Center+$2.0 million Pay Raise+19.7 million Public Health Emergency Preparedness (PHEP) Cooperative Agreement +$14.5 million Racial and Ethnic Approach to Community Health (REACH) +$4.1 million Safe Motherhood/Infant Health+$5.1 million School Health+$5.1 million Strategic National Stockpile (SNS)+$25.4 million * Includes Pay Raise

7 Budget Overview of Decreases ** Mind-body Research Program Health Marketing Congressional Projects (PHIL) Buildings and Facilities Anthrax ($1.5 million) ($3.0 million) ($22.0 million) ($121.5 million) ($7.8 million) * *Does not include Pay Raise

8 Increased Investments

9 Decreased Investments

10 HIV/AIDS +$53.0 million Increased resources in FY 2010 will be used to reduce HIV infections, increase access to care, and reduce health disparities. –Approximately $27 million will support efforts of state and local health departments to test 600,000 persons with HIV and identify 6,000 new HIV infections per year, with an emphasis on African Americans, Hispanics and MSM of all races and ethnicities. –Approximately $11 million will support efforts of state and local health departments to provide and evaluate active referral and linkage to care or other supportive services to at least 5,000 people living with HIV/AIDS or their partners; and support the delivery and evaluation of behavioral interventions to more than 2,000 newly and previously diagnosed people living with HIV. –Remaining funds will be used to promote program collaboration and service integration to prevent HIV, STDs, viral hepatitis, and TB; increase the capacity of health departments and CBOs to deliver effective evidence-based HIV prevention interventions to high-risk populations.

11 Chronic Disease Prevention, Health Promotion and Genomics million School Health (+5.1 million) –CDC will fund 10 additional state education agencies (22 states and one tribe currently funded) to assist these agencies in meeting the health and safety needs of their K-12 students. Safe Motherhood – Prevention of Teen Pregnancy (+5.1 million) –Increase will support the President’s initiative to prevent teen pregnancies. CDC will expand its current teen pregnancy prevention efforts to promote evidence-based interventions. Racial and Ethnic Approach to Community Health (REACH) (+4.1 million) –REACH will fund 12 to 15 additional communities at $200,000-$250,000 for two -year planning grants. The REACH program promotes the ongoing development and dissemination of innovative and effective strategies that respond to the unique needs of diverse communities. Seven out of every ten American deaths are from chronic diseases each year. About one- fourth of people with chronic conditions have one or more daily activity limitations.

12 Public Health Emergency Preparedness Cooperative Agreement (PHEP) +$14.5 million Increased resources in FY 2010 will be used to provide additional funding to state and local health departments through the PHEP Cooperative agreement. During FY 2010, the PHEP cooperative agreement will continue to provide technical assistance and resources to public health departments to improve their emergency preparedness and response capabilities.

13 National Center for Health Statistics +$13.9 Million These include: –Collecting a full 12 months of core birth and death data from states –Conducting the National Health Information Survey (NHIS) in at least 30,625 households covering 76,562 persons and redesigning a new sample for NHIS to ensure it accurately reflects the shifting U.S. population –Conducting nationally representative surveys of health care providers in physician offices, community health centers, hospital outpatient and emergency departments, and other selected settings; and maintaining continuous field operations for the National Health and Nutrition Examination Survey (NHANES) –Maintaining timely release of data files; the quality of reports released in print and on the internet; and the number and quality of data access tools that ensure data are available in easily accessible forms Increased resources in FY 2010 will be used to fully fund all sample sizes and surveys and will reinstate the reductions in operational capacity that have been implemented in the past several years.

14 Increased resources in FY 2010 will be used to support the President’s Initiative for autism surveillance activities to include a broader age-range of target populations and support efforts of the Study to Explore Early Development (SEED) to address public concern over the causes of autism and other developmental disabilities. Autism +$1.6 million CDC’s leadership in the area of autism is focused on understanding rates and trends, advancing public health research into risk and protective factors, improving early detection and diagnosis, and increasing awareness among the public and private healthcare providers.

15 National Center for Health Marketing ($3.0 million) This reduction will maintain full funding for, and will not have a negative impact on, key communication tools: –the Community Guide –the Morbidity and Mortality Weekly Report –the CDC website The FY 2010 Health Marketing budget will continue to fund CDC priority prevention areas.

16 Additional Budget Information

17 Questions and Answers