Fiscal Year 2010 Budget in Brief

Centers for Disease Control and Prevention

(dollars in millions)

*American Recovery and Reinvestment Act of 2009 (Recovery Act)

The mission of the Centers for Disease Control and Prevention is to promote health and quality of life by preventing and controlling disease, injury, and disability.

The FY 2010 Budget request for the Centers for Disease Control and Prevention (CDC) and the Agency for Toxic Substances and Disease Registry (ATSDR) is $10.1 billion, a decrease of $23 million from FY 2009. CDC is the primary Federal agency for conducting and supporting public health protection through promotion, prevention, preparedness, and research. The FY 2010 Budget request increases support for domestic HIV/AIDS prevention and treatment; for surveys and statistical analysis that are critical to public health programs at the Federal, State, and local level; for efforts to reduce health disparities, to detect and prevent autism, to prevent teen pregnancies and domestic violence; to detect emerging infectious disease; for global immunizations; and for the Strategic National Stockpile (SNS). The FY 2010 Budget request also includes reductions primarily focused on one-time projects funded in FY 2009.

In FY 2010, CDC will continue implementing Recovery Act activities for which CDC received funds in FY 2009. Specifically, CDC’s continued implementation activities support expanded access to immunizations, the reduction of healthcare-associated infections, and community-based prevention and wellness activities.

PROTECTING THE NATION AGAINST INFECTIOUS AGENTS

The FY 2010 Budget includes a total of $2 billion in discretionary funding and $3.3 billion in mandatory funding for Infectious Diseases, including HIV/AIDS and immunization services for children and adults.

HIV/AIDS, Viral Hepatitis, STD and TB Prevention: The FY 2010 Budget provides $1.1 billion, $54 million above FY 2009, to develop, implement, and evaluate effective domestic prevention programs for HIV/AIDS, Viral Hepatitis, Sexually Transmitted Diseases (STD), and Tuberculosis (TB) Prevention.

The FY 2010 Budget request provides $744 million including pay, $53 million above FY 2009, for domestic HIV/AIDS prevention as part of an HHS initiative on HIV/AIDS prevention and treatment. This initiative provides increased resources to reduce HIV infections, increase access to care, and reduce health disparities. This increase will support CDC’s domestic HIV/AIDS surveillance and testing, prevention research, capacity building and technical assistance, prevention interventions, and program evaluation and policy development. The increased resources for the initiative provide additional support for domestic HIV/AIDS testing through health departments and community-based settings to reduce the number of people infected that do not know their status.

In addition, the FY 2010 Budget requests $315 million for Viral Hepatitis, STD and TB prevention programs to support prevention, control services, surveillance, and research.

Immunization and Respiratory Diseases: Children can now be protected from more vaccine preventable diseases than ever before due to advances in biotechnology. In 1985, vaccines for seven diseases were available and recommended for routine use in children in the United States. Now, vaccines for 16 diseases are available and routinely recommended for children and adolescents. CDC's $4 billion immunization program has two components: the mandatory Vaccines for Children (VFC) program and the discretionary Section 317 program. The VFC program provides vaccines at no cost to children 18 years of age or younger who are Medicaid eligible, uninsured, American Indians and Alaska Natives, or who receive their immunizations at Federally qualified health centers and have health insurance that does not include coverage for vaccines. Vaccines provided through the VFC program represent 43 percent of all childhood vaccines for 0-6 year olds and 26 percent of adolescent vaccines for 7-18 year olds purchased in the United States.

The discretionary Section 317 program provides funds to support State immunization infrastructure and operational costs as well as many of the vaccines public health departments provide to individuals not eligible for VFC, including adults. The FY 2010 Budget includes $558 million for the Section 317 program. In FY 2010, CDC will also continue implementation of Recovery Act investments in the Section 317 program begun in FY 2009 to expand access to vaccines and vaccination services.

Zoonotic, Vector-Borne, and Enteric Diseases: The FY 2010 Budget includes $73 million, $5 million above FY 2009, to provide national and international scientific and programmatic leadership for zoonotic, vector-borne, and enteric diseases. CDC identifies, investigates, diagnoses, treats and prevents diseases that are communicable from animals, pathogens, fungi, food and water to humans, including West Nile Virus, Lyme Disease and other special pathogens. This investment includes $32 million, $4 million above FY 2009, to facilitate improved data collection with Federal partners to investigate food-borne outbreaks more quickly and improve food safety.

Prevention, Detection, and Control of Infectious Diseases: The FY 2010 Budget requests $169 million, $11 million above FY 2009, to enhance CDC’s ability to limit the impact of infectious diseases by detecting disease emergencies and outbreaks and providing epidemiological and operational response during these events.

In FY 2010, CDC will continue implementing healthcare-associated infection reduction strategies with Recovery Act funding provided in FY 2009. This investment will build upon the existing healthcare associated infection activities of CDC to leverage the National Health Care Safety Network and support the dissemination of HHS evidence-based practices within hospitals to reduce these infections and save lives.

PROMOTING HEALTH AND PREVENTING CHRONIC DISEASE

The FY 2010 Budget for Health Promotion includes $1 billion, $19 million above FY 2009, for Health Promotion. The FY 2010 Budget includes $896 million, $15 million above FY 2009, for the Chronic Disease Prevention, Health Promotion, and Genomics activities and includes $142 million, $4 million above FY 2009, for Birth Defects, Developmental Disabilities, Disability and Health. These increased investments are key components of efforts to reform health care by enhancing early detection practices, surveillance, and prevention research. Chronic diseases are among the most prevalent, costly, and preventable of all health problems. Statistics show that the causes of 70 percent of birth defects and 75 percent of developmental disabilities are unknown. CDC works to identify and address the causes of birth defects and developmental disabilities and supports the development and evaluation of prevention and intervention strategies. Furthermore, CDC aims to prevent death and disability from chronic diseases; promote maternal, infant, and adolescent health; promote healthy personal behaviors and integrate genomics into public health research, policy, and programs.

Specifically, the increased FY 2010 investments in Health Promotion augment autism efforts at CDC, such as research, screenings, and treatment, and supports public awareness activities. This increase is part of a Presidential initiative to expand support for children, families, and communities affected by autism spectrum disorders. The FY 2010 Budget includes increased funds to HRSA and NIH to support the initiative across HHS. The increased investment will also support CDC activities in adolescent and school health and will support paralysis research related to the recently enacted Christopher and Dana Reeves Paralysis Act.

In addition, the increased FY 2010 investment in Health Promotion supports Presidential initiatives on the prevention of teen pregnancies. With these funds, CDC will engage local communities in developing, implementing, and evaluating strategies and interventions to increase the capacity of national organizations and State teen pregnancy prevention coalitions to select, implement, and evaluate science-based approaches to prevent teen pregnancies.

In FY 2010, CDC will also continue Recovery Act investments to build communities’ capacities to implement evidence-based prevention and wellness strategies that reduce the burden of chronic disease.

USING HEALTH INFORMATION AND SERVICE FOR PUBLIC HEALTH

The Budget for Health Information and Service includes $292 million, $12 million above FY 2009, for Health Statistics, Health Marketing, and Public Health Informatics. The FY 2010 Budget for Health Statistics includes $138 million, $14 million above FY 2009, to obtain and use statistics to understand health problems, recognize emerging trends, identify risk factors, and guide programs and policy. With all surveys and sample sizes funded, CDC will maintain its FY 2009 enhancements to national survey systems to ensure data availability on key national health indicators such as diet and nutrition, blood pressure, and mental health.

Public health informatics uses information systems and information technology to prevent diseases, disability, and other public health threats. The Public Health Informatics Budget request includes $71 million to continue efforts to define the needs for public health information systems, develop the standards that allow these systems to work together effectively, and design information systems and software that extend the capabilities of public health.

The FY 2010 Budget includes $83 million including pay, decrease of $2 million from FY 2009, for Health Marketing activities to focus resources on key health marketing activities that have demonstrated success, such as the CDC community guide and website.

ENVIRONMENTAL HEALTH AND INJURY PREVENTION AND CONTROL

The Budget includes $335 million, $4 million above FY 2009, for Environmental Health and Injury Prevention and Control activities. CDC’s Environmental Health programs protect human health by preventing disability, disease, and death from environmental causes. The FY 2010 Budget provides $186 million to maintain CDC’s level of assistance to States and local health agencies to build their capacities to address environmental health problems.

The FY 2010 Budget request includes $148 million, an increase of $3 million above FY 2009, for efforts to reduce premature deaths, disability, and the medical costs associated with injuries and violence, such as residential fire deaths, teen driving, traumatic brain injury, and child abuse and neglect cause. With this increased investment, CDC will enhance its activities to reduce domestic violence. Using the best available evidence, CDC will enhance its support of the identification of risk factors, the evaluation of prevention strategies, and the use of prevention approaches.

IMPROVING PREPAREDNESS AND RESPONSE TO TERRORISM

The Budget includes $1.5 billion, a net increase of $32 million, for CDC’s terrorism preparedness and emergency response activities. The bioterrorism budget supports the Strategic National Stockpile (SNS), biosurveillance, and State and local preparedness efforts.

Strategic National Stockpile: The Budget focuses on ensuring a sufficient supply of countermeasures and other medical supplies to protect and care for victims of a bioterrorism attack or other public health emergency. The Budget includes $596 million for the SNS, an increase of $25 million, to finance the procurement of critical pharmaceuticals and vaccines needed to protect Americans from threat agents and support the capacity to deliver drugs, vaccines, and supplies anywhere in the Nation within 12 hours.

State and Local Preparedness: In FY 2010, $761 million is requested for State and local preparedness efforts, $15 million above FY 2009, bringing the total investment to over $7.5 billion since September 11, 2001. The Budget request also includes $30 million for the Centers for Public Health Preparedness, which is a network of 27 universities working with States and collaborating with one another to develop and support the public health emergency preparedness-related knowledge and skills of first responders and other public health professionals.

Biosurveillance: The FY 2010 Budget includes $34 million for BioSense, CDC’s human health surveillance system. The funds will build on the progress made to date and help CDC implement connections with emerging Regional Health Information Organizations and Health Information Exchanges to implement case-based surveillance. The Budget provides $27 million to support the continued development of 20 domestic quarantine stations, which help CDC prevent the spread of diseases that represent a significant public health risk. The Budget also includes $8 million for continued real-time lab reporting.

Upgrading CDC Capacity: The FY 2010 Budget request includes $121 million, the same as FY 2009, for upgrading CDC capacity. These funds continue support of the Laboratory Response Network, the Select Agent Program, and research and surveillance on potential emergency situations such as biothreat agent releases. In addition, these programs ensure the ongoing evaluation and improvements of surveillance, laboratory science, research, and support throughout CDC and its grantees while continuing to advance public health preparedness and response capabilities through technical assistance, resource allocation, planning tools, education and training.

ADVANCING OCCUPATIONAL SAFETY AND HEALTH

The FY 2010 Budget provides $424 million for Occupational Safety and Health programs, $8 million above FY 2009. The National Institute for Occupational Safety and Health (NIOSH) is the primary Federal entity responsible for conducting research and making recommendations for the prevention of work-related illness and injury. NIOSH translates knowledge gained from research into products and services that improve workers' safety and health in settings from corporate offices to construction sites and coal mines. The increased investment of $5 million will support research on nanotechnology related to occupational health. Within the total for Occupational Safety and Health, $55 million in mandatory funding is included for CDC’s role in the Energy Employees Occupational Illness Compensation Program.

The Budget also includes $71 million to support treatment and monitoring services for responders of the World Trade Center (WTC) attacks and for non responders in the community directly affected by the attacks. Additional program expenses will be supported with funds from prior years. Currently, CDC funds six clinical centers and two data and coordination centers throughout the New York City metropolitan area. Based on the current spending rates and estimated carryover funds, HHS estimates that the FY 2010 Budget contains sufficient funding to support health care for those affected by WTC attacks.

GLOBAL HEALTH

The FY 2010 Budget includes $319 million, $10 million above FY 2009, for Global Health programs to protect the U.S. and world populations from emerging global threats. The additional investment of $10 million supports CDC’s global immunization program to protect American children from vaccine-preventable diseases imported into the United States or acquired abroad. The FY 2010 Budget maintains support for CDC’s other global health programs, including the Global AIDS program, which plays a vital role in CDC’s implementation of its responsibilities under the President’s Emergency Plan for AIDS Relief and the Global Disease Detection Program, which is designed to protect the health of Americans and the global community by rapidly detecting and responding to infectious disease outbreaks and other emerging health threats.

SUPPORTING PUBLIC HEALTH RESEARCH

Public Health Research provides evidence to support specific programs, practices, and policies that affect health decisions made by the American public and those responsible for health policies and programs. With funding of $31 million for health protection research, CDC is building a cadre of health protection researchers, research training programs, and centers of excellence that enable multidisciplinary approaches to public health practice.

PREVENTIVE HEALTH AND HEALTH SERVICES BLOCK GRANT

The FY 2010 Budget provides $102 million, the same as FY 2009, for the Preventive Health and Health Services Block Grant. These funds will support primary prevention activities and health services in States and local communities.

MANAGING CDC’S INFRASTRUCTURE AND HUMAN CAPITAL

The FY 2010 Budget includes $591 million in administrative and infrastructure activities to support CDC mission critical efforts. The In addition, the FY 2010 Budget provides an increase of $22 million for pay, which is distributed across the CDC budget.

Business Services Support: CDC has improved and achieved efficiencies in its business and management operations and will continue to find ways to achieve higher performance at lower costs. The FY 2010 Budget includes $373 million, $13 million above FY 2009, for agency-wide operating costs, such as rent, utilities, and security.

Public Health Improvement and Leadership: The FY 2010 President's Budget includes $189 million, $21 million below FY 2009, for Public Health Improvement and Leadership. The decrease reflects the elimination of $21 million in one-time Congressional projects included in FY 2009. CDC’s Public Health Improvement and Leadership activities support cross cutting areas in CDC to ensure the effectiveness of public health programs and science. These funds also support CDC’s public health workforce development program, which focuses on ensuring a competent and sustainable workforce prepared to meet current and emerging health promotion and protection priorities.

Buildings and Facilities: CDC has made remarkable progress on its 10-year Master Plan through its investments to build and upgrade facilities and laboratories. CDC’s FY 2010 Budget for Buildings and Facilities is $30 million, a decrease of $122 million below FY 2009. This funding, coupled with unobligated balances, will allow CDC to conduct repairs and improvements and finish construction of priority infectious and environmental health labs.

AGENCY FOR TOXIC SUBSTANCES AND DISEASE REGISTRY (ATSDR)

The Budget request for ATSDR is $77 million, $3 million above FY 2009. Managed as part of CDC, ATSDR is the lead agency responsible for public health activities related to toxic substance exposures. The increase in FY 2010 supports epidemiologic studies of health conditions caused by non-occupational exposures to uranium released from past mining and milling operations on the Navajo Nation. Created in 1980 by the Comprehensive Environmental Response, Compensation and Liability Act – ATSDR leads Federal public health efforts at Superfund and other sites with known or potential toxic exposures. The Agency’s mission is to use the best science, take responsive action, and provide trustworthy health information to prevent and mitigate harmful exposures and related disease. ATSDR continues to be at the forefront in protecting people from acute toxic exposures that occur from hazardous leaks and spills, environment-related poisonings, and natural and terrorism-related disasters.

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