On March 23, 2023, ASTHO President Anne Zink testified before the House Appropriations Subcommittee on Labor, Health and Human Services, Education, and Related Agencies regarding sustainable and flexible public health funding.
On March 23, 2023, ASTHO President Anne Zink testified before the U.S. House of Representatives Appropriations Subcommittee on Labor, Health and Human Services, Education, and Related Agencies.
On Jan. 14, 2020, ASTHO members from Rhode Island and Massachusetts testified before a House subcommittee on state efforts to address the opioid epidemic.
Panel of State Public Health Officials Testify on Lung Disease Outbreak WASHINGTON—Today, four state health officials are testifying on a panel before the House Energy and Commerce Subcommittee on Oversight and Investigations about the public health impacts of youth e-cigarette use and the current lung disease outbreak. The panel includes: Joneigh Khaldun, chief deputy director for health and chief medical executive, Michigan Department of Health and Human Services Elizabeth Tilson, state health director and chief medical officer, North Carolina Department of Health and Human Services Lee Norman, secretary, Kansas Department of Health and Environment Monica Bharel, commissioner, Massachusetts Department of Public Health The hearing, “Sounding the Alarm: The Public Health Threats of E-Cigarettes,” will provide members of Congress the opportunity to examine causes of the ongoing vaporizer-linked lung disease outbreak. “State and territorial public health agencies are taking a leading role in implementing strong action to protect consumers from the harms of e-cigarette use,” says Michael Fraser, CEO of ASTHO. “We are pleased that Congress highlighted their critical work today. We strongly urge Congress and the administration to take steps to strengthen oversight of e-cigarettes, increase investments in research and prevention, and to better understand health effects associated with their use, and provide increased funding for tobacco education and cessation programs.” For more information and to read the state health officials’ testimony, visit the committee’s website. ASTHO Press Release Boilerplate website yes
ASTHO Member and Delaware Health Official Karyl Rattay Testifies on Nation’s Opioid Epidemic ARLINGTON, VA—Karyl Rattay, MD, MS, director and state health officer at the Delaware Division of Public Health, testified today on the Administration’s response to the drug crisis before the United States House Committee on Oversight and Government Reform. The hearing, “The Trump Administration’s Response to the Drug Crisis, Part II,” continues the committee’s examination of national drug control efforts by ONDCP, including efforts to expand access to treatment for substance use disorder. “The opioid epidemic continues to evolve, and it remains a deadly and complicated issue. Fentanyl is now driving an alarming increase in deaths. In addition, many states are seeing emerging drug patterns and trends with methamphetamine, cocaine, and benzodiazepines, often in combination with opioids, and continue to face challenges with alcohol misuse and addiction. Addiction is plaguing our country, impacting individuals, families, schools, the workplace, and entire communities. We must address this like a chronic disease and apply evidence-based strategies to prevent addiction. Additionally, we must further expand access to effective treatment and ensure that the systems in place are engaging, comprehensive, coordinated, integrated, high-quality, and person-centered. In this respect, we need to redouble our efforts to meet people where they are in their communities, provide immediate connection to treatment following an overdose, and ensure a warm hand-off no matter the setting. We must also focus on saving more lives with naloxone and preventing the spread of infections with proven approaches like syringe service programs,” says Rattay. “Collectively, states, territories, and local health departments recognize the opioid crisis as a complex issue,” Rattay continued. “Our efforts to combat the issue cannot be accomplished without the support of federal grants. It is very important that Congress provide sustained and predictable federal funding so that states and territories can build infrastructure to combat and prevent addiction. Our work includes not only saving lives but improving the lives of people impacted by the disease of addiction.” For more information about the hearing, visit the committee’s website. ASTHO Press Release Boilerplate website yes
Supporting Governmental Public Health Should be a Congressional Priority Says Dr. Nathaniel Smith at Today’s House Appropriations Hearing ARLINGTON, VA—Nathaniel Smith, MD, MPH, director and state health officer for the Arkansas Department of Health and president-elect of the Association of State and Territorial Health Officials (ASTHO), testified today before the House Committee on Appropriations Subcommittee on Labor, Health and Human Services, Education and Related Agencies to discuss the importance of Congress providing enhanced resources for Centers for Disease Control and Prevention, HHS Office of the Assistant Secretary for Preparedness and Response, Health Resources and Services Administration, and other federal agencies to improve our nation’s health. “Governmental public health agencies work everywhere, every day to protect and improve the health of the entire U.S. population. Our work is often invisible and sometimes it is only in a crisis when the value and importance of sustained investment in public health becomes apparent. These crises unfortunately happen all too often – the current measles and hepatitis A outbreaks, the obesity and opioid epidemics, and many others, highlight the important work of disease prevention and health protection at the core of public health’s mission,” says Smith. “ASTHO urges Congress to sustain and increase funding for federal public health agencies so that state, local, tribal and territorial health departments can continue and enhance their work to prevent drug overdoses, save lives through chronic disease prevention, prepare for and respond to disasters and public health emergencies, combat infectious disease, and prevent and remediate environmental health hazards.” For more information about the hearing visit the committee’s website. To read Dr. Smith’s full written testimony, visit ASTHO’s website. ASTHO Press Release Boilerplate website yes
Current Measles Outbreaks Should Alarm Every American and Highlight the Critical Importance of Vaccination Programs ARLINGTON, VA—John Wiesman, DrPH, MPH, secretary of health at the Washington State Department of Health and immediate past president of the Association of State and Territorial Health Officials (ASTHO) testified today before the U.S. Senate Committee on Health, Education, Labor and Pensions (HELP) on the growing number of infectious disease outbreaks impacting the country. The hearing, “Vaccines Save Lives: What Is Driving Preventable Disease Outbreaks?” provided members of Congress the opportunity to discuss the current measles outbreaks affecting several states, along with children’s health and vaccinations and significant gaps in public health funding for programs to address preventable outbreaks. “Every American should be alarmed by the current measles outbreaks occurring in many states. Measles is an entirely preventable disease and we must redouble our efforts as a nation to spread the truth that vaccines save lives and address parental concerns about vaccinating their children,” says Wiesman. “No one should live in fear of contracting this disease and it is part of my mission as a public health official to protect the lives of American people. I am deeply grateful to the Senate HELP Committee for bringing broader awareness to the importance of vaccinations and better understanding the current gaps that exist in the public health system. Addressing these outbreaks will require a strong and coordinated response from federal, state, and local governments.” Wiesman recently authored an op-ed citing concerns about the nation’s public health system, which has suffered as a result of chronic underfunding as the population continues to grow. We are constantly reacting to crises rather than working to prevent them, Wiesman says. ASTHO and 80 other organizations are requesting Congress to raise CDC’s budget 22 percent by 2022 to address growing public health threats, including support for state and territorial vaccination programs, in order to protect our nation’s health system. For more information and to read Wiesman’s testimony, visit the committee’s website. ASTHO Press Release Boilerplate website yes
ASTHO Member and West Virginia Health Commissioner Rahul Gupta Testifies on Nation’s Opioid Epidemic ARLINGTON, VA—Rahul Gupta, commissioner and state health officer at the West Virginia Department of Health and Human Resources’ Bureau for Public Health, testified today on the nation’s opioid epidemic before the United States House Committee on Oversight and Government Reform. The hearing, “A Sustainable Solution to the Evolving Opioid Crisis: Revitalizing the Office of National Drug Control Policy,” provided members of Congress the opportunity to discuss reauthorizing the Office of National Drug Control Policy to elevate evidence-based initiatives to combat the current opioid crisis. The Association of State and Territorial Health Officials (ASTHO) is pleased Congress continues to address the greatest public health threat facing Americans today. The nation’s state and territorial health agencies are on the front lines combating the current substance misuse, addiction, and drug overdose crisis and it is vital that Congress and the Administration support efforts to end the epidemic. “I am grateful for the opportunity to represent West Virginia and discuss the twin challenges of overprescribing opioids for pain and the growing use of heroin, often adulterated with fentanyl. West Virginia continues to experience the highest rate of overdose fatalities in the nation and is also enduring a surge in the rate of neonatal abstinence syndrome,” says Gupta. “Collectively, states and territories recognize the opioid crisis as a public health emergency. To develop sustainable solutions to this contemporary challenge we need authentic national leadership, expanded access to evidence-based treatment, and increased focus on primary prevention strategies to avert drug use and misuse before it starts. I will continue to work tirelessly in my state to address those areas, but we rely on a strong partnership with the federal government. To implement these solutions, it is critical that we take a comprehensive, science-driven approach that combines the efforts of federal, state, and local agencies, along with other organizations and industries. The hearing today was a very important first step in that process.” For more information on the hearing, visit the committee's website. ASTHO Press Release Boilerplate website yes
Illinois Department of Public Health Director Ngozi Ezike Testifies on Lung Disease Outbreak WASHINGTON—Ngozi Ezike, MD, director of the Illinois Department of Health, testified today before the House Oversight and Reform Committee, Subcommittee on Economic and Consumer Policy on the current multistate outbreak of lung injury associated with e-cigarette product use. The hearing, “Examining the Outbreak of Lung Disease and CDC’s Urgent Warning Not to Use E-Cigarettes,” provided members of Congress the opportunity to discuss and examine the cause of the outbreak, which has affected more than 530 individuals within 38 states. The Association of State and Territorial Health Officials (ASTHO) is pleased that Congress is investigating the outbreak and supports aggressive efforts to reduce all tobacco use, including e-cigarettes and their associated liquids containing nicotine and other harmful agents. “While the negative effects of vaping and related products are yet to be fully understood, what we are certain of, is that vaping and e-cigarettes are unequivocally detrimental to the health and wellbeing of adolescents and anyone who has never smoked tobacco,” says Ezike. “Nicotine is highly addictive, and more so for the youngest of vape users. Contemporary product designs, attractive technology, and associated items, like vape wear, appeal to our youth and serve only to enable use of these products by young people. We cannot stand idly by and watch the high-tech e-cigarette erase the incredible progress of the last 10 years with enticements to vape by marketing to young people through flavors such as strawberry, watermelon, mango, and blue raspberry e-juices.” For more information and to read Ezike’s testimony, visit the committee’s website. ASTHO Press Release Boilerplate website yes
U.S. Territories Face Healthcare Cuts if Congress Does Not Address Impending Medicaid Financing Cliff ARLINGTON, VA—Association of State and Territorial Health Officials (ASTHO) member Esther Muña, MHA, chief executive officer at the Northern Mariana Islands Commonwealth Health Corporation, and other territorial health leaders from Guam, Puerto Rico, America Samoa, and the U.S. Virgin Islands testified today before the United States House Committee on Natural Resources about the impact that cuts to Medicaid would have on U.S. territory populations. “On the heels of Super Typhoon Yutu, which devastated the Commonwealth of the Northern Mariana Islands’ economy and its people, we face another crisis – our Medicaid program is unable to sustain its operations with the low statutory cap on federal contributions,” says Muña. “Low federal contributions, coupled with the exhaustion of the Patient Protection and Affordable Care Act funds this year, creates a fiscal cliff for our Medicaid program. This fiscal cliff threatens to unweave our substantial improvements over the past ten years in the delivery of healthcare, further erodes our economy, and threatens the health and well-being of our people. “I strongly urge Congress to stabilize Medicaid financing for the territories by raising or eliminating the arbitrary cap on federal dollars to the program so I can continue my work to protect and promote the health our population,” Muña continues. Unless Congress acts, the U.S. territories’ Medicaid programs will become gravely underfunded. Federal funding for Medicaid in territories is capped and it is subject to a fixed federal matching rate. For more information about the hearing, visit the committee’s website. ASTHO Press Release Boilerplate website yes
Scott Harris Testimony Regarding Sustainable and Predictable Public Health Funding Testimony Title Scott Harris 20250409 On behalf of the Association of State and Territorial Health Officials (ASTHO), I respectfully submit this testimony on FY26 appropriations for the U.S. Department of Health and Human Services (HHS). ASTHO is the national nonprofit representing state and territorial public health agencies. ASTHO's members — the chief public health officials of these agencies — are dedicated to formulating and influencing sound public health policy and assuring excellence in public health practice. We respectfully request that Congress provide sustained and predictable federal funding from the Centers for Disease Control and Prevention (CDC), the Health Resources and Services Administration (HRSA), and the Administration for Strategic Preparedness and Response (ASPR) for state and territorial health departments. The funding requests mentioned below are illustrative of the ongoing needs of our jurisdictions; we acknowledge that these levels may not be achievable in the next fiscal year. I am sincerely grateful to Congress for providing resources in FY25 to support and maintain investments in public health, ensuring our nation’s preparedness for current and emerging health threats. As a former state health official once eloquently stated, “The U.S. public health system is not a singular entity but a decentralized, uneven patchwork of federal agencies and state, local, tribal, and territorial public health authorities. As a result, the collaborative endeavor for public health is only as strong as the weakest link.” State health department budgets are a mix of state and federal funding streams. For some states, up to 80% of all funding comes from federal sources, with CDC being the single largest funder. Any disruption or decrease in federal funding will result in a significant impact on the ability of state and territorial health departments to protect and promote the health and safety of our population. Public health officials remain deeply concerned that our country faces significant challenges, including, but not limited to, the ongoing opioid overdose epidemic, chronic disease, preventing the spread of infectious diseases, rising health debt, access to health care in rural areas, and mental health crises. Furthermore, the recent abrupt cancellation of grants totaling as much as $11 billion caught state and territorial health departments by surprise; unfortunately, these actions will significantly impact our public health preparedness and response activities. Although the majority of this funding had already been spent, it was appropriated by Congress and obligated to health departments with work plans, budgets, and timelines approved by federal agencies for ongoing activities. These funds were intended not only for pandemic response, but also for mitigating key health security vulnerabilities that became apparent during the pandemic as well as strengthening our preparedness and response framework for the future. With congressional and executive branch support, these funds were being used to modernize data systems, bolster laboratory capacity, improve electronic case reporting of time-sensitive infectious disease outbreaks, improve H5N1 avian influenza and measles testing, and enhance biomedical terrorism preparedness, to name just a few examples. To meet not only the next public health emergency threat but also address our current challenges, it is critical that Congress invest in a stronger public health system by providing sustained and flexible funding that meets the needs of state, territorial, and local public health departments. America’s state and territorial public health departments work in partnership with CDC toward this goal. CDC plays a vital role in supporting communities to expand the capacity of our nation’s frontline of public health defense: our country’s state, tribal, territorial, and local public health departments. Regardless of the politics in our individual jurisdictions, state and territorial health officials are united in our mission to protect the health of our country. As the committee and incoming administration consider modernizing the federal government infrastructure, we respectfully request the following: Congress must work to sustain investments to state and territorial health departments: As Congress grapples with reducing our nation’s debt and deficit, the savings or return on investment generated by investing in public health has long been documented. Moreover, our membership relies on federal funding to address a myriad of illnesses through targeted interventions with the shared goal of preventing injury and disease. For example, in the fall of 2023, the North Carolina Department of Health and Human Services identified apple cinnamon fruit puree as the likely source of elevated blood lead levels in children. Even low levels of lead exposure in children can have long-lasting health effects, including potential brain damage and permanent reduction of IQ. Following their assessment, FDA issued a safety alert advising parents not to buy or feed the identified brand of fruit puree. Consultation: As the boots on the ground who put federal policy into action on the front lines, it is vital to consult with state and territorial health leaders about the potential impacts of funding reductions and/or administrative changes. Pausing or preventing money from going to states and territories, especially when done with little or no notice, creates disruptions and further harms our ability to rebuild trust with the public. As the recipients of numerous grant programs, we have first-hand knowledge of administrative changes that may actually benefit the system and could help reduce redundancies in the federal government. Flexibility: Federal funding mechanisms are often focused on specific programs, such as lead poisoning or food safety, and cannot be used flexibly to accomplish broad programmatic goals. We are grateful for the subcommittee’s ongoing support for public health infrastructure and capacity by funding this line at $350 million and we respectfully request $1 billion for this program at CDC in FY26. This disease-agnostic, flexible, and sustainable funding will support efforts within agencies that build capacity to detect and respond to threats both domestic and global, while improving and supporting activities in core public health capabilities, including assessment, policy, preparedness and response, community partnership, communications, equity, accountability, and performance management. Moreover, this funding will build a highly trained workforce that can be rapidly scaled to meet local, regional, or national threats. We strongly encourage Congress to prioritize flexibility in programmatic funding wherever possible to ensure the needs of the population can be met. Along with partner organizations, ASTHO supports the Data: Elemental to Health Campaign. Previously, we called on Congress to provide the first-ever dedicated funding for public health data systems and build a 21st-century public health data superhighway. Thanks to the work of this Subcommittee, Congress answered the call and provided annual funding for CDC's Public Health Data Modernization Initiative (DMI). For FY26, we request $340 million for data modernization efforts at CDC, which includes funding for the Center for Forecasting and Outbreak Analytics and the Response Ready Enterprise Data Integration platform. DMI is necessary for building a world-class data workforce and data systems to ensure we can meet the next public health emergency at full capacity. Our state and territorial health departments need robust, sustained, yearly funding to complete the foundational investment in DMI and ensure we are providing resources for public health systems and infrastructure, including at state and local health departments, to keep pace with evolving technology. States use the Preventive Health and Health Services Block Grant (Prevent Block Grant) to offset funding gaps in programs that address leading causes of death and disability. In some cases, this grant serves as seed funding for crucial, innovative projects so a state or territorial health department can meet otherwise unfunded community health goals. ASTHO respectfully requests $175 million for this program. For more than 30 years, the Prevent Block Grant has served as an essential funding source for state and territorial health agencies. CDC’s Public Health Emergency Preparedness Cooperative Agreement (PHEP) provides vital support for public health preparedness and response. ASTHO requests $1 billion for PHEP to sustain and improve governmental public health programs. Established in the aftermath of the September 11 terrorist attacks, PHEP has been a core public health preparedness program that supports 62 state, local, and territorial public health departments. The pandemic response demonstrated the need to invest in these programs to rebuild and bolster the nation’s preparedness capabilities. CDC has refreshed its strategy with critical lessons learned from COVID-19 to support public health jurisdictions with an updated response framework that prioritizes essential areas for the public to prepare for, respond to, and recover from health threats in the next five-year funding cycle that begins in the current fiscal year. Under ASPR, ASTHO is requesting $500 million for Health Care Readiness and Recovery, which includes the Hospital Preparedness Program (HPP) Cooperative Agreement. This includes developing mechanisms for effective patient movement, communicating situational awareness, and providing resource sharing across disparate health care entities. HPP allows individual health care facilities and coalitions to access a truly national response network, enabling the system to save lives and protect Americans from 21st-century health security threats.
ASTHO Urges Congress to Increase Funding for Public Health Programs ARLINGTON, VA—Today, John Wiesman, ASTHO president and secretary of health at the Washington State Department of Health, submitted written testimony to the House Labor, Health and Human Services and Education Appropriations Subcommittee urging Congress to provide increased funding to support public health programs in FY19. This funding would allow federal agencies that support state, local, and territorial public health departments to improve the health of the population by addressing the opioid epidemic, enhancing preparedness programs, and continuing services through the Preventive Health and Health Services Block Grant. “Our federal partners, including CDC and HRSA, provide a level of financial support to health departments that state budgets simply cannot fulfill on their own. We are pleased Congress recently provided the most significant increase for public health in over a decade, however, we must build upon this momentum and provide states and territories with sustained, predictable, and hopefully increased funding in FY19 and beyond. State and territorial health officials are saving lives every day and health departments rely heavily on these federal funds to achieve broad impact and sustain high levels of success. The health of our nation is a matter of national security. ASTHO and our members stand ready to assist Congress and the Administration in our shared work of protecting and promoting the public’s health.” ASTHO Press Release Boilerplate website yes