Senator says automatic cuts would hurt preparedness grants

Jul 27, 2012 (CIDRAP News) – The federal grant program that helps states improve their public health emergency preparedness could lose more than $48 million in fiscal year 2013 funding, a 7.8% reduction, if automatic budget cuts kick in, according to a recent report from a Democrat who chairs a Senate appropriations subcommittee.

The potential impact of the cuts on Public Health Emergency Preparedness (PHEP) grants are included in a Jul 25 report from Sen. Tom Harkin, D-Ia., that outlines the impact of "sequestration" on nondefense jobs and services. Harkin is chairman of the Senate Appropriations Subcommittee on Labor, Health and Human Services, Education, and Related Agencies.

The automatic sequestered cuts were included in a bipartisan bill passed in August 2011 to raise the national debt limit. Sequestration, aimed at cutting $1.1 trillion from defense and discretionary funding over the next 10 years, was intended to spur a fiscal "supercommittee" to hammer out an alternative deficit-reduction plan. However, the group's efforts failed, which puts the onus on Congress now to find ways to address $109 billion in across-the-board cuts in store for January 2013.

Harkin's 181-page report addresses a range of grants in the departments of Health and Human Services (HHS), Education, and Labor. The HHS section also describes the projected impact of sequestration on childhood immunization grants. He wrote that most of the concerns about sequestration cuts have revolved around Pentagon spending cuts, but he asserted that cuts would also have a destructive impact on programs that affect the middle class.

"These essential government services directly touch every family in America, and they will be subject to deep, arbitrary cuts under sequestration," Harkin wrote.

The report says the Office of Management and Budget hasn't announced how it would carry out the sequestration process, if it is needed. Harkin said his estimates are based on a Sep 2011 Congressional Budget Office estimate that nonexempt nondefense discretionary programs would be subject to a 7.8% cut for 2013. However, he noted that the Center on Budget and Policy Priorities, a nonprofit group that gauges how fiscal policies affect low- and moderate-income people, has estimated that the programs could be cut by 8.4% in 2013.

The section detailing the projected impact on PHEP grants breaks down the possible sequester cut for each state and US territory and includes the 2012 fiscal year funding level. For example, Colorado would face $760,087 in cuts and North Carolina would face $1,441,144.

The CDC administers the PHEP cooperative agreements, which allow states, four major metropolitan areas, and US territories to improve their ability to respond to public health threats, such as the 2009 H1N1 pandemic. The CDC sets standards for developing preparedness capacities and provides health officials with guidance and technical assistance for meeting the goals.

On Jul 2 federal officials announced $619 million in PHEP grants, which was up slightly from $613 million in last year.

In the report's section on childhood immunization grants, Harkin projected that sequestration could cut about $14.5 million from the program in fiscal year 2013, which he said could result in 211,958 fewer children being vaccinated. The program is funded at $185.6 million this year.

The funding is allocated by a formula to states and other jurisdictions to buy and administer vaccines to poor and uninsured children. It also pays for monitoring adverse events related to vaccines. Harkin noted that the estimates are based on past purchasing histories for pertussis; measles, mumps, and rubella; influenza; and hepatitis B vaccines.

At a Jul 25 subcomittee hearing to discuss the possible impact of sequestration on the Department of Education, the group's ranking minority member, Sen. Richard Shelby, R-Ala., addressed Harkin's report and said the cuts would have a considerable impact on all parts of the federal budget, and added that such across-the-board cuts aren't the answer to the country's fiscal problems.

Though he said he appreciated the staff's work on the sequestration report, Shelby questioned the accuracy of the projections. He said the Obama Administration hasn't provided any concrete information for making the assumptions.

"For example, Congress does not know the amount of the across-the-board cut. As the Chairman’s report states, it could be anywhere between 7.8% and 8.4%," he said. "In real terms, that is a difference of $1 billion in labor/HHS program reductions."

Shelby said the real impact of sequestration isn't known, because it's unclear what programs will be exempt, and the more programs that are exempt, the higher the sequestration percentage rises for the programs affected. He added that there is too little definitive information to know if the projections for each program and state are accurate. "The only thing we do know is that agencies, programs, and states will have some flexibility to determine how reductions are taken and that all cuts will not necessarily lead to layoffs," he said.

Meanwhile, House and Senate leaders are working on an agreement to fund the government for the next 6 months, which would forestall a Sep 30 government shutdown, Politico reported yesterday. The deal would keep government funding at the same level as last year's debt-limit law, which Republicans have said is too high, but would prevent a pre-election shutdown that both parties want to avoid, according to the report.

Aides told Politico that a bipartisan funding bill could be unveiled early next week, and the House and Senate would need to approve it by Sep 30. After next week, lawmakers return home to run for re-election, the report noted.

See also:

Jul 25 Harkin sequestration impact report

Jul 25 Sen. Shelby's subcommittee hearing statement

Jul 3 CIDRAP News story "HHS awards preparedness grants, cites program alignment"

Jul 26 Politico report

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