475: Health Data Modernization, Senate Appropriations Bill

JANSON SILVERS: 

This is the award-winning Public Health Review Morning Edition for Friday, August 4, 2023. I'm Janson Silvers. Now, today's news from the Association of State and Territorial Health Officials.

ANNE ZINK: 

We talk about public health being data-driven. And it's really hard to be data-driven if you don't have data.

SILVERS: 

As new health challenges arise, modern agile systems are key to any response. That's the message ASTHO is driving with its new public health data modernization policy statement. ASTHO president Anne Zink says right now, many states still aren't equipped.

ZINK: 

If public health does not have the data it needs to do its job, we can't have data-informed decisions. And so being able to modernize our systems to be able to accept data as well as get data back, and having the analytic tools to get information out of that data is going to be incredibly important. Many states have been still using faxes. I know my state still uses faxes to receive data.

SILVERS: 

Zink says it will take funding to modernize systems. And surprisingly, technology itself is the least of Zink's worries.

ZINK:  

This is not a technological challenge. This is a policy challenge, and we really encourage state health officials, local health officials, community partners, to engage in both the funding as well as the policy aspects of data modernization to make sure that we have secure data that is able to be regularly transferred in order to promote health.

SILVERS: 

Zink hopes the policy statement will move things forward.

ZINK: 

One of the advantages of ASTHO's policy statements is it gives us all set talking points that have been created by all the states and territories. What's our commonality? What do we all think are important to be able to move forward? It helps us to clearly articulate that message with stakeholders, federal partners, be it at State Legislature, or be it at the CDC, on what do state health department's really need for this space.

SILVERS: 

Find the full policy statement by using the link in the show notes.

The Senate has released its Labor, Health, and Human Services Education and Related Agencies appropriations bill for 2024. ASTHO's Carolyn Mullen tells all about it, in this week's View from Washington report.

As always, it's a pleasure to be joined by Carolyn Mullen today, thank you so much for sitting down with us and giving us the news from the Hill.

CAROLYN MULLEN: 

It's great to be with you today.

SILVERS: 

So, I know that last week the Senate released the latest fiscal year 24 LHHS bill, and now that you and the team have had time to review it, can you kind of just tell us what's in that legislation?

MULLEN: 

Well, before I get started, I really want to give a shout out and thank you to Jeffrey Ekoma on my team who went through line by line in the legislation to take a deep dive analysis on the pros and cons of this bill. So thank you, Jeffrey. But overall, this Senate bill provides mostly level funding for programs, projects, and activities that ASTHO care about. Most of these CDC programs in particular were level funded, some plus ups, and some decreases. Overall, CDC's budget is a proposed cut of about $20 million. And when we do a deep dive, it appears that most of those cuts were from the Infectious Disease Rapid Response Reserve Fund. And it decreases funding by about $25 million there. So, $10 million for IDRF. We're not too worried about that cut, because that fund gets replenished every year. And it doesn't go directly out to states unless there's an emergency. But for other ASTHO priorities, there's about $350 million for public health infrastructure, which is level funding, $8 million for social determinants of health level funding, and then $160 million for data modernization, and that's a redirection of about $15 million. And in the report language, that $15 million was shifted to the public health preparedness and response for the Response Ready Enterprise Data Integration platform. And we are digging in deeper here to better understand congressional intent and what this could mean for the D&I programs on the ground. But again, as a reminder, this bill is not final and there's still a lot of negotiation that needs to happen. On the Health Resources and Services Administration side, it appears the top line there is a cut of about $600 million. But again, when we dug deeper into it, that's pretty much a significant cut of their congressional earmark funds. One of the proposed cuts we are looking into is a $10 million decrease for the Maternal and Child Health Block Grant special projects of regional and national significance. There's about a $10 million decrease. So, we'll be working with our partners at MCHIP to better understand if this cut does happen and what it could mean for programs and organizations on the ground. But again, overall, pretty much level funding in the Senate Bill, which is the high watermark compared to the devastating cuts that were included in the House Bill, and we still have a long way to go here.

SILVERS: 

And with that level funding, I know you guys said, you know, you're still looking at intent for several things. But is there any reason why there's level funding in the Senate for most programs?

MULLEN: 

So, going back to the debt ceiling negotiations, and then the bill that was signed into law, the reason why there's not a lot of additional resources available, is because the overall top line funding levels for all discretionary programs was kept level in that law. So, it's really challenging to see huge increases in any programs without significant decreases. So, we view the Senate Bill, in light of all of this as not that bad, of course, we would want more for public health funding. But considering the overall amount of funding that's available, we view it as a good starting point for negotiations moving forward.

SILVERS: 

And lastly, just looking forward over the next few weeks, what will ASTHO be focused on during the next six or so weeks?

MULLEN: 

So, Congress is in recess for the next six weeks, which affords us a really great opportunity to connect with members of Congress on the Hill, to better understand more about why there were some of these proposed cuts in the Senate bills, specifically a redirection of funds, and advocate for the final bill and negotiations to bolster some of the programs that we care about, such as infrastructure and data modernization, but also get some more insights on what is in that mysterious House Bill, that we haven't seen the report language, we aren't quite sure what's in there. But we need to better understand that there are other outright elimination of programs so that when we go to Congress and talk to them about the final package, we want to make sure we're making the case for all public health funding. So, we're flying a little blind because the House hasn't released their bill yet. So, we hope to get some more insights from our congressional champions on how we can help them as we go into the final stretch, which will be a really busy September before funding expires for the fiscal year.

JANSON SILVERS: 

Well, we'll look forward to hearing more on that House bill and hearing more from you in the future. Thank you so much, again, for joining us today.

MULLEN: 

Thanks for having me.

SILVERS: 

If you have a minute, please take the time to give us a review. We'd like to know what you think.

That'll do it for today's newscast. We're back Monday morning with more ASTHO news and information. I'm Janson Silvers, you're listening to the award-winning Public Health Review Morning Edition. Have a great weekend.