1. Winter SACCHO Meeting Legislative Update January 16, 2007

2. The Pandemic and All-Hazards Preparedness Act of 2006 (S. 3678) Congress passed it during the last week Congress passed it during the last week of the December 2006 lame duck session. It moved quickly and passed by unanimous consent in the Senate and four days later in the House. Clearly the bills sponsors and their House counterparts had gotten their lame ducks in a row. The bill reauthorizes HHS activities in public health emergency preparedness, including the cooperative agreement program, through 2011. The bill reauthorizes HHS activities in public health emergency preparedness, including the cooperative agreement program, through 2011.

3. To review: Sens. Burr and Kennedy engaged in a broad process of consultation with stakeholders and the Senate Health, Education, Labor and Pensions Committee reported a bill in July. To review: Sens. Burr and Kennedy engaged in a broad process of consultation with stakeholders and the Senate Health, Education, Labor and Pensions Committee reported a bill in July. The resulting bill, like any compromise, had something for everyone to like and something for everyone to hate. The resulting bill, like any compromise, had something for everyone to like and something for everyone to hate. The bill codifies much that is already occurring, such as performance standards, federal biosurveillance, limited vaccine tracking, MRC and ESAR-VHP programs. The bill codifies much that is already occurring, such as performance standards, federal biosurveillance, limited vaccine tracking, MRC and ESAR-VHP programs.

4. All-Hazards, Once and for All The very title of the bill, as well as its content, is build around the concept of all- hazards public health preparedness, as opposed to the hazard-specific approach we have seen from time to time. The very title of the bill, as well as its content, is build around the concept of all- hazards public health preparedness, as opposed to the hazard-specific approach we have seen from time to time.

5. What Would Change State matching requirement, beginning with 5% in FY09 and 10% thereafter. In-kind contributions of plant, equipment or services would be counted. State matching requirement, beginning with 5% in FY09 and 10% thereafter. In-kind contributions of plant, equipment or services would be counted. Financial penalties for states not meeting evidence-based performance standards (beginning with 10% withholding from cooperative agreement funds in FY09). Financial penalties for states not meeting evidence-based performance standards (beginning with 10% withholding from cooperative agreement funds in FY09). Maintenance of effort requirement for grantees. Maintenance of effort requirement for grantees.

6. Hospital Preparedness Program Moves out of HRSA into office of HHS Asst Secretary for Preparedness and Response Moves out of HRSA into office of HHS Asst Secretary for Preparedness and Response Eligible grantees are partnerships of hospitals and/or other health care facilities with a state and/or local government, as well as current grantees. This gives HHS the ability to make hospital preparedness grants directly, rather than going through a state, as long as the state or local health officials where the grantees are located consult in the application. Eligible grantees are partnerships of hospitals and/or other health care facilities with a state and/or local government, as well as current grantees. This gives HHS the ability to make hospital preparedness grants directly, rather than going through a state, as long as the state or local health officials where the grantees are located consult in the application.

7. Modest Improvements for LHDs Codifies existing local concurrence requirement in CDC guidance. Codifies existing local concurrence requirement in CDC guidance. Clarifies that funds may be used for existing personnel who are carrying out preparedness activities, regardless of their primary assignment, using NACCHO- drafted language. Clarifies that funds may be used for existing personnel who are carrying out preparedness activities, regardless of their primary assignment, using NACCHO- drafted language.

8. Token Approach to Workforce The original drafts of the bill established a large scholarship and loan repayment program for public health professionals – it took the language from the Hagel-Durbin workforce bill, which has never moved in Congress. The original drafts of the bill established a large scholarship and loan repayment program for public health professionals – it took the language from the Hagel-Durbin workforce bill, which has never moved in Congress. That was too much for fiscal conservatives. The final bill whittled this down to two demonstration programs in the National Health Service Corps. These still require a Congressional appropriation to become a reality. That was too much for fiscal conservatives. The final bill whittled this down to two demonstration programs in the National Health Service Corps. These still require a Congressional appropriation to become a reality.

9. Appropriations FY07: year long continuing resolution FY07: year long continuing resolution –FY06 level + limited adjustments –No earmarks; how much will be available for health? FY08: Presidents Budget – early Feb. FY08: Presidents Budget – early Feb. –Budget resolution –House/Senate Appropriations

10. Appropriations PH Preparedness for State/Local Capacity Building FY 2004$934 million FY 2005 $919 million (-15 million) FY 2006$824 million (-95 million) FY 2007$824 million (proposed) What is the effect of these cuts? Pandemic Flu – state/local FY 2006 $600 million

11. Appropriations Preventive Health Block Grant Preventive Health Block Grant FY 2005$131 million FY 2006$99 million FY 2007 $100 million (proposed)

12. Other Issues to Watch FDA Regulation of Tobacco FDA Regulation of Tobacco –Kennedy/Waxman Childrens Health Insurance Program Childrens Health Insurance Program

13. Other Issues to Watch Environmental health Environmental health –Mosquito control –Land use planning/community design –Environmental health tracking Health Information Technology Health Information Technology –Biosurveillance –Integration of networks

14. Contact Us Donna L. Brown, JD, MPH Government Affairs Counsel Senior Advisor for Public Affairs National Association of County and City Health Officials Phone: 202-783-5550, ext. 214 Email: dbrown@naccho.org Eli Briggs Senior Government Affairs Specialist National Association of County and City Health Officials Phone: 202-783-5550, ext. 229 Email: ebriggs@naccho.org