433: New AR Tool, Debt Ceiling Deal Explained

ROBERT JOHNSON: 

This is Public Health Review Morning Edition for Friday, June 2, 2023. I'm Robert Johnson.

Now, today's news from the Association of State and Territorial Health Officials.

MICHAEL CRAIG: 

So the AR Investment map is an interactive web application that shows all of the different funding that CDC provides to state and local health department's academic institutions, nonprofits, or global partners both in the United States and around the world.

JOHNSON: 

The CDC's Michael Craig explains the new online tool that includes data for all 50 states, the territories, and large U.S. cities.

CRAIG: 

We have a lot of material that talks about antimicrobial resistance and what a challenge it is. The investment map helps shows how we have invested in solutions to address that complicated problem and ties the problem with the solution in a way that I think is accessible to lay audiences and to folks who are just new to these issues.

JOHNSON: 

Craig says the tool brings together the magnitude of the CDC investment in the fight against antimicrobial resistance.

CRAIG: 

So I think the biggest challenge that we face is a common one in public health, which is really trying to show the value of what we're doing and help people understand and connect the problem that we're trying to address with public health--in this case, antimicrobial resistance--with the solutions that we're trying to use to fight that problem.

JOHNSON: 

You can check out the new AR Investment map using the link in the show notes.

By now, you've likely heard there's a deal on the debt ceiling here in Washington, but do you know what that means for public health funding? ASTHO's Carolyn Mullen has the answer in today's view from Washington, D.C. report.

Carolyn Mullen, last week we saw each other in Chicago. There was no deal on the debt ceiling at that time, but here we are back in Washington seven days later and everything has changed. Tell us what's going on.

MULLEN: 

Over the holiday weekend, President Biden and Speaker McCarthy announced a bipartisan deal to raise the debt ceiling. Quite frankly, I was in Home Goods store and I read the bill text while walking through the aisles on Sunday night.

So what's in the deal is it raises the debt limit till January 1, 2025, but it sets in place caps on spending for two years. So for fiscal year 2024, non-defense discretionary spending is kept relatively level. And then for fiscal year 2025, the overall amount of funding only increases by 1%.

The legislation also makes clawbacks or revisions of COVID-19 funding. It's really important to keep in mind that it's an obligated COVID dollars that are going to be clawed back, it's not as bad as we thought it was going to be. So previously, we thought it was going to be about $4 billion clawed back from CDC. Now, it's about $1.7 billion. And a bright spot in this legislation is it actually protected funding for the Infectious Disease Rapid Response Reserve Fund. And that's funded at about $500 million, so the funding is still protected and won't be rescinded as part of this package.

JOHNSON: 

As you have spent the last week I'm sure reading through every line of the bill, is there anything that you feel that ASTHO believes ought to be clarified?

MULLEN: 

So, it's one of the most complicated pieces of legislation I've ever read in my 20-year career, and what is still unclear is what funds remain obligated from COVID and what funds are going to be rescinded. So for states that held multi-year funding--so those are grants that were awarded and they got funding for one year, but it was promised in year two, three, four, and five--it's unclear if those funds are still going to be available. So that's what we're trying to figure out.

I've had conversations and emails with the White House Office of Management and Budget, talked to some partners at federal agencies, and we're trying to get a list of which funds are going to be rescinded. It's our understanding that that won't be clear until after the bill becomes law, because included in the bill on the date of enactment, that's when the funds get rescinded. And so the Office of Management Budget needs to go through a very specific accounting of all of the unobligated funds, and hopefully they'll let us know soon which funds are going to come out of those federal accounts.

JOHNSON: 

Seems like we've avoided a federal crisis, a national crisis. So, with all of that now behind us, obviously some work to do as you have just mentioned, what's next on the congressional agenda?

MULLEN: 

It's going to be very busy next week. We actually have a state health official coming into town for a Congressional briefing on June 7. Paula Nickelson from Missouri will be talking to Congressional staff as part of a panel with CDC about public health workforce. So it's really exciting that that will happen. There also may be a hearing the following week about PAHPA reauthorization in the House, and we've submitted some state health official names for consideration for witnesses. So that is also an exciting development that will be coming soon.

JOHNSON: 

And we look forward to hearing more about all of that, Carolyn Mullen. Thanks again for joining us and have a great weekend.

MULLEN: 

Thanks so much. Have a great weekend, Robert.

JOHNSON: 

Also today, Puerto Rico is using a new toolkit to optimize its grants management work. Read more about the toolkit and how it's helping drive data-informed decisions in a new ASTHO blog article now online. There's a link in the show notes.

Finally this morning, stay ahead of the news in public health by signing up for ASTHO's Public Health Weekly email newsletter. You can join the list using the link in the show notes.

That will do it for today's newscast. We're back Monday morning with more ASTHO news and information.

I'm Robert Johnson. You're listening to Public Health Review Morning Edition. Have a great weekend.