528: Flexible Climate Funding, New Federal Budget Deadline

ROBERT JOHNSON: 

This is the award-winning Public Health Review Morning Edition for Friday, October 20, 2023. I'm Robert Johnson. Now, today's news from the Association of State and Territorial Health Officials.

UMAIR SHAH: 

Climate change is real, climate change is here. Climate change is happening before our eyes.

JOHNSON: 

Dr. Umair Shaw from Washington State and three other leading state public health officials met with journalists during an online news conference Wednesday to discuss the public health impacts of climate change. They talked about flooding, dangerous air quality, saltwater flowing into the Mississippi River, freezing cold temperatures, and triple-digit heat. This is Dr. Mark Levine of Vermont.

MARK LEVINE: 

It's really challenging to respond to so many types of disasters using our traditional public health tools, surveillance, outreach interviews, other response activities.

JOHNSON: 

Dr. Joseph Kanter of Louisiana wants federal funding rules that are more flexible and responsive to unique and often unexpected local challenges.

JOSEPH KANTER: 

We've been saying this for a while and very thankfully over the past year, we're beginning to see funding that's a little bit more open-ended, that allows investment, that allows strategic investments in the future. We need more of that because there's no pot of money that really helps a state like mine prepare for something like this.

JOHNSON: 

Dr. Natasha Bagdasarian from Michigan agrees an effective public health response depends on funding flexibility.

NATASHA BAGDASARIAN: 

I think what you have heard here is that we have such different needs. So, the threats we are facing are very different at this moment in time, and we're going to see more emergency-type events, we'll need to pivot quickly, and if we don't have that flexibility, it will make it difficult to pivot.

JOHNSON: 

You can watch the ASTHO climate news conference using the link in the show notes.

A new deadline in Congress and CDC reform are hot topics on Capitol Hill this week. In today's View from Washington D.C. report, ASTHO's Carolyn Mullen tells us what it means for public health.

Carolyn Mullen, always good to have you here on the newscast. How are you on this wonderful Friday morning?

CAROLYN MULLEN: 

I'm great. I'm super excited for the weekend. And always a pleasure to be here with you.

JOHNSON: 

Always good to talk with you. Hey, you know, Congress is keeping you busy, as always, it was another busy week here in Washington. And I think a lot of people around the country are looking at this speaker decision that's being made or not being made. What is the latest there? What do ASTHO members need to know about all of that?

MULLEN: 

So, first and foremost, what ASTHO members need to know is no business can happen when we don't have a Speaker of the House. And for the first time in history, we don't have a speaker, and it's been lingering on for almost two weeks now. The latest rumor is Jim Jordan will be stepping aside and it seems there may be a temporary speaker put in place. McHenry seems to be in the running. We've never experienced anything like this in our nation's history. So, we're going to be taking a really close look at the resolution that the Republicans may be putting forward to put a temporary speaker in place. And the other thing to watch is whether Democrats are going to join and vote for this temporary speaker, the length of time that McHenry could be in place, and will they attach any funding bills to this resolution, so a lot TBD. But please know that the government affairs team will be actively monitoring all of the reports coming out from the House.

JOHNSON: 

Thinking about budgets and federal money, another deadline coming up regarding some sort of resolution for a way forward less than a month before we get to that shut down date of November 17. What is going on there?

MULLEN: 

So, we want to really focus on the facts here. So, as of Friday morning, the fact is, is that government funding expires on November 17. The other factors that a lot of people have forgotten about is the debt ceiling law. That happened earlier this year, included a 1% across the board cut if Congress did not pass all appropriations bills on time. So, as of today, there are no appropriations bills that have been passed. So, what it means is on April 1, current lies there will be a 1% across the board cut to all programs, projects, and activities. The goal of this provision in the debt ceiling law was to compel Congress to actually produce bills in regular order, but it seems to be having the opposite effect. No one seems to really care. And this 1% of across the board cuts would even apply to defense spending. So, what we're seeing right now is the administration is going to be putting forward an emergency supplemental bill request requesting Funding for Ukraine, Israel, Indo-Pacific, and border control. In my view, this is the last train out of the station, the only way that there's going to be additional funding because of that provision in the debt ceiling bill. So, I'm anticipating we're most likely going to have a CR for public health funding and then that across the board cut will most likely happen. But as with everything here, you know, things are pretty uncertain, things remain fluid. And that's why we come here every week and give everyone an update on what's happening in D.C.

JOHNSON: 

One thing certain, you turned in some paperwork to the Hill this week, the topic was CDC reform.

MULLEN: 

Right, so Senator Cassidy, who's the ranking member on the Senate Health, Education, Labor and Pensions Committee is requesting comments from organizations such as ASTHO on how we can better be prepared to respond to the next public health emergency and with a specific focus on CDC. In our comments, we really emphasize that no one agency, individual, or entity should be blamed for the failures of the CDC's COVID-19 response. There is a whole-of-government response and it involves state and local health departments, it involved the White House, FEMA, DOD, etc. So, we continue to push for a COVID-19 commission, a nonpartisan commission to investigate what went right, what went wrong, how can we move forward as a country. So, that's included in our comments, in addition to some very specific responses in regard to data exchange and interoperability.

JOHNSON: 

We'll look forward to seeing you next week, hopefully, or whenever there is an update to provide to the audience. We thank you for the time and we'll talk to you soon.

MULLEN: 

Thanks so much.

JOHNSON: 

Also, today, some ASTHO members have developed plans to improve coverage access and health equity for Medicaid beneficiaries, using waivers to Section 1115 of the Social Security Act. Learn more about the process and the benefits in a new ASTHO blog article now online. You can read it using the link in the show notes.

Finally, this morning, stay connected to everything happening in Congress and state capitals across the country with ASTHO's Legislative Alert emails. You can join the list using the link in the show notes.

Before we go, we'd like to remind you to follow this newscast on your podcast player and ASTHO on social media. We're on LinkedIn, Twitter, and Facebook. That'll do it for today. We're back Monday morning with more ASTHO news and information. I'm Robert Johnson. You're listening to the award-winning Public Health Review Morning Edition. Have a great weekend.