President Obama on December 16signed into law the omnibus fiscal year 2015 appropriations bill to fund most of the federal government until September 30, 2015. The House passed the bill on December 11 (219-206) and the Senate on December 13 (56-40). Under the agreement, the Department of Homeland Security is funded through a continuing resolution until February 27.

Under the earlier Ryan-Murray budget agreement in December 2013, domestic discretionary funding in fiscal year 2015 was held close to the FY 2014 level, leaving no funds for program increases. All of the key accounts important to ASPPH were level funded.

Agency Funding Levels:

The National Institutes of Health received an appropriation of $30.084 billion, an increase of $149.696 million or +0.5%. Program level funding at the Centers for Disease Control and Prevention was set at $6.926 billion, an increase of $21.443 million or +0.31%. The Agency for Healthcare Research and Quality received an appropriation of $363.698 million, a decrease of $7.3 million or -0.2%. However, AHRQ is directly funded in FY 2015, rather than through an assessment tap transfer. The agency also will receive an additional $106 million in FY 2015 from the Patient-Centered Outcomes Research Trust Fund (PCORTF) transfer mandated by the Affordable Care Act, making AHRQ’s total program level $470 million, an increase of approximately $6 million over FY 2014.

ASPPH’s Program Priorities:

In addition to the funding levels for the major research agencies, ASPPH’s advocacy agenda focuses on specific programs within CDC and HRSA. All of ASPPH’s priorities were funded in FY 2015. These programs are:

•  CDC Prevention Research Centers: $25,461,000 (level)

•  CDC Centers for Public Health Preparedness: $8,018,000 (level)

•  CDC NIOSH Education and Research Centers $27,445,000 (level)

•  CDC NIOSH Agricultural Forestry and Fishing Centers $24,000,000 (level)

The HRSA Public Health Training Centers and Public Health Traineeships appear to be level-funded, with the two budget lines combined under the heading Public Health Workforce Development, which is funded at $22 million, but has $10 million in set-asides – leaving $12 million for the PHTC and PHT programs.

Ebola Funding:

The agreement provides a total of $5.3 billion in Ebola emergency spending, of which $2.742 billion goes to HHS agencies and $1.771 billion to the CDC. The funding will remain available until Sept. 30, 2019.

Within the CDC allocation for Ebola, the agreement categorized funding to the following broad categories:

Domestic

• Public Health Emergency Preparedness – $155 Million
• State and Local – $255 Million
• Worker Training – $10 Million
•  Migration/Quarantine – $114 Million
•   Other – $37 Million

International Response and Preparedness – $1.2 Billion

Other Budget Items of Interest:

• The Congress fully allocated the Prevention and Public Health Fund (PPHF), now $927 million after sequestration.  The PPHF was created by the Affordable Care Act.
• Language in the explanatory statement accompanying the bill includes the following text in the section funding the CDC Prevention Research Centers: “The agreement directs CDC to ensure that any funds used to support Special Interest Projects will be competitively awarded through an open process that is available to all qualified entities, including nonprofit organizations, small businesses, and for-profit organizations.”
• The agreement explicitly rejects the Administration’s proposal to provide AHRQ with $15 million to fund investigator-initiated grants in the field of health economics.
• The salary cap on most Public Health Service grants remains at Executive Level II ($181,500 in calendar year 2014).
• The HHS Office of Inspector General is ordered to conduct a formal review of the Office of Human Research Protections.
• President’s Emergency Plan for AIDS Relief (PEPFAR) received a $300 million increase to $4.3 billion. The program had been cut by $600 million since 2011.
• The final agreement includes the Senate-passed rider concerning school lunches, rather than the more restrictive House language. Under the provision, states could exempt some schools from a requirement that went into effect July 1 that requires all grains in school meals to be whole-grain rich. Exemptions could be given to schools that “demonstrate hardship, including financial hardship, in procuring specific whole grain products which are acceptable to the students and compliant with the whole grain-rich requirements.” The spending bill also would freeze sodium restrictions “until the latest scientific research establishes the reduction is beneficial for children.”