[House Report 109-510]
[From the U.S. Government Publishing Office]
109th Congress Report
HOUSE OF REPRESENTATIVES
2d Session 109-510
======================================================================
AMENDING THE PUBLIC HEALTH SERVICE ACT WITH RESPECT TO THE NATIONAL
FOUNDATION FOR THE CENTERS FOR DISEASE CONTROL AND PREVENTION
_______
June 20, 2006.--Committed to the Committee of the Whole House on the
State of the Union and ordered to be printed
_______
Mr. Barton of Texas, from the Committee on Energy and Commerce,
submitted the following
R E P O R T
[To accompany S. 655]
[Including cost estimate of the Congressional Budget Office]
The Committee on Energy and Commerce, to whom was referred
the bill (S. 655) to amend the Public Health Service Act with
respect to the National Foundation for the Centers for Disease
Control and Prevention, having considered the same, report
favorably thereon with an amendment and recommend that the bill
as amended do pass.
CONTENTS
Page
Amendment........................................................ 2
Purpose and Summary.............................................. 2
Background and Need for Legislation.............................. 2
Hearings......................................................... 4
Committee Consideration.......................................... 4
Committee Votes.................................................. 4
Committee Oversight Findings..................................... 4
Statement of General Performance Goals and Objectives............ 5
New Budget Authority, Entitlement Authority, and Tax Expenditures 5
Committee Cost Estimate.......................................... 5
Congressional Budget Office Estimate............................. 5
Federal Mandates Statement....................................... 7
Advisory Committee Statement..................................... 7
Constitutional Authority Statement............................... 7
Applicability to Legislative Branch.............................. 7
Section-by-Section Analysis of the Legislation................... 7
Changes in Existing Law Made by the Bill, as Reported............ 7
Amendment
The amendment (stated in terms of the page and line numbers
of the introduced bill) is as follows:
Page 2, line 19, insert ``at the end of the second
sentence'' after ``period''.
Purpose and Summary
S. 655 amends Section 399G of the Public Health Service Act
(PHSA), the statute governing the National Foundation for the
Centers for Disease Control and Prevention (CDC Foundation).
The legislation makes several technical corrections and changes
to Section 399G that, among other things, grant increased
flexibility in the amounts of Federal funding and support
services allocated to the CDC Foundation to compensate for the
Foundation's administrative and operating expenses.
Background and Need for Legislation
Authorized by Congress in 1992 and incorporated two years
later, the CDC Foundation is a private, non-profit organization
that supports the work of the CDC. In its eleven year history,
the Foundation has raised more than $100 million in private
funds to enhance the CDC's work. Donations to the CDC
Foundation come from individuals, corporations, foundations,
and other organizations. Along with private donations, the
Federal government contributes $500,000 per year through the
CDC to help cover the Foundation's operating expenses. Over the
past five years, the CDC Foundation has raised an average of
$15 million per year to boost the work of the CDC, representing
a 30 to 1 return on CDC's $500,000 annual investment in the
Foundation. The CDC Foundation uses donated funds to bring the
flexibility of a non-profit organization to bear on the CDC's
many efforts to improve health and safety.
The CDC Foundation's mission statement is to help CDC ``do
more, faster by forging effective partnerships between CDC and
others to fight threats to health and safety.'' To this end,
the CDC Foundation has managed more than 100 programs that have
supported the CDC's work both in the United States and in over
30 countries to fight deadly infections and other diseases that
threaten the safety of U.S. citizens here and abroad. With an
outstanding, internationally renowned Board of Directors taking
its members from the corporate, philanthropic, educational, and
public health sectors, the non-profit CDC Foundation brings
accountability and flexibility to every private-sector
partnership it builds on behalf of the CDC. Examples of such
partnerships include:
Lilly International Fellowships: A series of year-
long laboratory fellowships that bring laboratorians from other
countries' ministries of health to learn from CDC laboratorians
and build relationships to prepare for when disease in those
countries threaten U.S. citizens.
Corporate/CDC Roundtable on Global Health Threats:
This CDC Foundation-based roundtable brings together the CDC
Director and her leadership team with representatives of 10
global corporations to develop joint approaches to detecting
and responding to global health threats that threaten both U.S.
citizens and economic activities. Members include top
executives from corporations such as GE, General Motors, IBM,
UPS, Coke, and Wal-Mart.
Emergency Preparedness and Response Fund: After 9/
11 and the anthrax attacks, the CDC Foundation established a
special fund that allows the CDC to respond with greater
flexibility in future crises when existing government
regulations may hinder CDC in doing all it can to save lives.
The fund provides credit cards, made available by the Synovus
Corporation, to the administrative leader of each of the 15 CDC
teams that have been established to respond to national health
threats. Credit cards provided by the fund were used by CDC
experts in the field following Hurricane Katrina to purchase
needed computers and printers.
Emergency Operations Center: After 9/11, CDC
Foundation Board member Bernie Marcus, co-founder of Home
Depot, recognized the need for CDC to have a state-of-the-art
Emergency Operations Center. He donated $4 million to the CDC
Foundation as a challenge grant to encourage other United
States corporations to help CDC build a world-class emergency
operations center ``at the speed of business.'' The CDC
Foundation quickly contacted corporations and raised over
$400,000 worth of in-kind equipment donations from corporations
like Dell, Motorola, and Shure. Because of the Marcus gift and
other corporate donations, CDC's new Emergency Operations
Center was able to open 6 months early, just in time to track
and combat the spread of the deadly severe acute respiratory
syndrome (SARS) virus.
Management Academy for Public Health: Using $1
million each from the Robert Wood Johnson Foundation, the
Kellogg Foundation, CDC, and the Health Resources and Services
Administration (HRSA), the Foundation supported the
establishment of a new management academy to train mid-career
leaders from State and local health departments in how to
manage people, data, and dollars. The academy is now totally
self-sufficient and continues to train hundreds of public
health leaders from around the country each year.
Mobile Breast Cancer Detection: Through a multi-
million dollar grant from Avon, the Foundation has purchased
and placed mobile mammography screening vans to reach
underserved women in multiple States around the country.
Funding also supports a CDC scientist to evaluate the van
placement programs and disseminate lessons learned about best
practices that will help other such programs across the country
be most effective and have the best chance of becoming self-
supporting.
Field Disease Detection and Response Training
Programs in Developing Countries: With privately-raised support
from organizations like the World Bank, the Nuclear Threat
Initiative, and the Ellison Medical Foundation, the CDC
Foundation has enabled CDC to establish special disease
detection and/or laboratory support programs in countries like
Brazil, India, and Kenya that will help detect and control
deadly infectious diseases that pose serious threats not only
in those countries but in the United States as well.
The annual operating costs for the CDC Foundation have
climbed from $300,000 when it began in 1995 to nearly $3
million in 2005. In 1995, CDC's $500,000 annual grant of
support was sufficient to cover the Foundation's operations.
However, this amount, which has been capped under current law
since the Foundation's inception, no longer provides sufficient
funds to allow the CDC Foundation to provide the kinds of
support activities noted in the examples above. S. 655 will
allow the CDC Director to support the work of the Foundation
beyond the current $500,000 baseline to up to $1.25 million if,
in the judgment of the CDC Director, an occasion arises that
warrants such increase. Such support does not require an
increased appropriation since funding would come from existing
appropriations to the CDC Director's office. Such financial
support, at most, would constitute approximately half of the
current operating costs of the Foundation.
The legislation also incorporates language that would allow
the CDC to provide facilities, utilities, and support services
to the Foundation if ``it is determined by the Director to be
advantageous to the programs of such Centers.''
Currently, privately supported fellows assigned to help CDC
implement Foundation programs are artificially limited to two
years each. This limitation creates program implementation
problems for programs supported by private funding from
organizations such as the Robert Wood Johnson Foundation and
the Kellogg Foundation that sometimes run three or four years
long. To remedy this, the legislation contains a provision
linking the length of any privately supported fellowships to
the duration of private funding for each such fellowship.
Hearings
The Committee on Energy and Commerce has not held hearings
on the legislation.
Committee Consideration
On Thursday, June 8, 2006, the Subcommittee on Health met
in open markup session and approved S. 655 for Full Committee
consideration, without amendment, by a voice vote, a quorum
being present. On Thursday, June 15, 2006, the Committee on
Energy and Commerce met in open markup session and ordered S.
655 reported to the House, amended, by a voice vote, a quorum
being present.
Committee Votes
Clause 3(b) of rule XIII of the Rules of the House of
Representatives requires the Committee to list the record votes
on the motion to report legislation and amendments thereto.
There were no record votes taken in connection with ordering S.
655, a bill to amend the Public Health Service Act with respect
to the National Foundation for the Centers for Disease Control
and Prevention, reported. A motion by Mr. Deal to order S. 655
reported to the House, amended, was agreed to by a voice vote.
Committee Oversight Findings
Pursuant to clause 3(c)(1) of rule XIII of the Rules of the
House of Representatives, the Committee has not held oversight
or legislative hearings on this legislation.
Statement of General Performance Goals and Objectives
The goals of S. 655 are to enhance the CDC Foundation's
ability to assist the CDC and to increase the accountability of
the Foundation.
New Budget Authority, Entitlement Authority, and Tax Expenditures
In compliance with clause 3(c)(2) of rule XIII of the Rules
of the House of Representatives, the Committee finds that S.
655, a bill to amend the Public Health Service Act with respect
to the National Foundation for the Centers for Disease Control
and Prevention, would result in no new or increased budget
authority, entitlement authority, or tax expenditures or
revenues.
Committee Cost Estimate
The Committee adopts as its own the cost estimate prepared
by the Director of the Congressional Budget Office pursuant to
section 402 of the Congressional Budget Act of 1974.
Congressional Budget Office Estimate
Pursuant to clause 3(c)(3) of rule XIII of the Rules of the
House of Representatives, the following is the cost estimate
provided by the Congressional Budget Office pursuant to section
402 of the Congressional Budget Act of 1974:
U.S. Congress,
Congressional Budget Office,
Washington, DC, June 19, 2006.
Hon. Joe Barton,
Chairman, Committee on Energy and Commerce,
House of Representatives, Washington, DC.
Dear Mr. Chairman: The Congressional Budget Office has
prepared the enclosed cost estimate for S. 655, an act to amend
the Public Health Service Act with respect to the National
Foundation for the Centers for Disease Control and Prevention.
If you wish further details on this estimate, we will be
pleased to provide them. The CBO staff contact is Tim
Gronniger.
Sincerely,
Donald B. Marron,
Acting Director.
Enclosure.
S. 655--An act to amend the Public Health Service Act with respect to
the National Foundation for the Centers for Disease Control and
Prevention
Summary: S. 655 would modify the Public Health Service Act
to increase the amount of the grants the Department of Health
and Human Services (HHS) is authorized to provide to the
National Foundation of the Centers for Disease Control and
Prevention (CDC) from $500,000 per year to $1.25 million per
year. The bill also would increase the amount HHS can transfer
to the Foundation from $500,000 to not less than $500,000 and
not more than $1.25 million. S. 655 also would allow longer
terms of voluntary service to be contributed from the
Foundation to the CDC and would allow sharing of equipment and
support services from the CDC to the Foundation.
CBO estimates that implementing S. 655 would cost $1
million in 2007 and $7 million over the 2007-2011 period,
assuming appropriation and transfer of the authorized amounts.
S. 655 contains no intergovernmental or private-sector
mandates as defined in the Unfunded Mandates Reform Act (UMRA)
and would not affect the budgets of state, local, or tribal
governments. Enacting S. 655 would not affect spending or
receipts.
Estimated cost to the Federal Government: The estimated
budgetary impact of S. 655 is shown in the following table. The
costs of this legislation fall within budget function 550
(health).
----------------------------------------------------------------------------------------------------------------
By fiscal year, in millions of dollars--
-----------------------------------------------
2006 2007 2008 2009 2010 2011
----------------------------------------------------------------------------------------------------------------
SPENDING SUBJECT TO APPROPRIATION
Spending Under Current Law:
Estimated Authorization Level\1\............................ 1 1 1 1 1 1
Estimated Outlays........................................... 1 1 1 1 1 1
Propsoed Changes:
Estimated Authorization Level............................... 0 2 2 2 2 2
Estimated Outlays........................................... 0 1 2 2 2 2
Spending Under S. 655:
Estimated Authorization Level\1\............................ 1 2 2 2 2 2
Estimated Outlays........................................... 1 2 2 2 2 2
----------------------------------------------------------------------------------------------------------------
\1\The 2006 level is the amount appropriated and transferred to the National Foundation for the CDC for that
year.
Note.--Components may not sum to totals because of rounding.
Basis of estimate: The National Foundation for the CDC is a
not-for-profit entity that raises private funds to support the
work of the CDC. Under current law, CDC may accept the services
of an individual who receives financial support from the
Foundation for a period of up to two years. S. 655 would
eliminate that two-year restriction. The act also would allow
the CDC to provide in-kind transfers and support services to
the Foundation. Current law authorizes both the appropriation
of $500,000 to the Foundation and the transfer to the
Foundation of $500,000 from funds appropriated to HHS. S. 655
would increase the authorized appropriation to $1.25 million a
year, and would authorize the annual transfer from HHS of at
lest $500,000 and no more than $1.25 million.
In addition to the $500,000 that CBO expects will be
transferred to the Foundation each year under current law, CBO
estimates that S. 655 would cost $1 million in 2007 and $7
million over the 2007-2011 period, assuming the appropriation
and transfer of the necessary amounts.
Intergovemental and private-sector impact: S. 655 contains
no intergovernmental or private-sector mandates as defined in
UMRA and would not affect the budgets of state, local, or
tribal governments.
Previous CBO estimate: On May 31, 2005, CBO transmitted a
cost estimate for S. 655 as reported by the Senate Committee on
Health, Education, Labor, and Pensions on April 27, 2005. That
version of the legislation does not differ significantly from
S. 655 as ordered reported by the House Committee on Energy and
Commerce. CBO's previous estimate for S. 655 did not consider
the increase in transfer authority as affecting the
authorization of future appropriations. This estimate corrects
that error. Accounting for that change increases the estimated
cost of implementing S. 655 from $3.5 millions to $7 million
over the relevant five-year periods, assuming appropriation and
transfer of necessary funds.
Estimate prepared by: Federal costs: Tim Gronniger. Impact
on state, local, and tribal governments: Leo Lex. Impact on the
private section: Meena Fernandes.
Estimate approved by: Peter H Fontaine, Deputy Assistant
Director for Budget Analysis.
Federal Mandates Statement
The Committee adopts as its own the estimate of Federal
mandates prepared by the Director of the Congressional Budget
Office pursuant to section 423 of the Unfunded Mandates Reform
Act.
Advisory Committee Statement
No Advisory committees within the meaning of section 5(b)
of the Federal Advisory Committee Act were created by this
legislation.
Constitutional Authority Statement
Pursuant to clause 3(d)(1) of rule XIII of the Rules of the
House of Representatives, the Committee finds that the
Constitutional authority for this legislation is provided in
Article I, section 8, clause 3, which grants Congress the power
to regulate commerce with foreign nations, among the several
States, and with the Indian tribes.
Applicability to Legislative Branch
The Committee finds that the legislation does not relate to
the terms and conditions of employment or access to public
services or accommodations within the meaning of section
102(b)(3) of the Congressional Accountability Act.
Section-by-Section Analysis of the Legislation
Section 1. National Foundation for the Centers for Disease Control and
Prevention; Acceptance of voluntary services; Federal funding
Section 1(a) amends Section 399G(h)(2)(A) of the Public
Health Service Act to clarify that any fellowship with the CDC
Foundation will match the length of time the endowment for that
project takes.
Section 1(b) amends Section 399G(h)(7) of the Public Health
Service Act to require the Foundation's annual reports to
include an accounting of the use of funds transferred from the
CDC to the Foundation for its operating expenses and that these
reports be provided to the appropriate committees in Congress.
Section 1(c) amends Section 399G(i) of the Public Health
Service Act by requiring the CDC Director to transfer no less
than $500,000 and not more than $1,250,000 to the Foundation
for operating expenses.
Changes in Existing Law Made by the Bill, as Reported
In compliance with clause 3(e) of rule XIII of the Rules of
the House of Representatives, changes in existing law made by
the bill, as reported, are shown as follows (existing law
proposed to be omitted is enclosed in black brackets, new
matter is printed in italic, existing law in which no change is
proposed is shown in roman):
SECTION 399G OF THE PUBLIC HEALTH SERVICE ACT
SEC. 399G. ESTABLISHMENT AND DUTIES OF FOUNDATION.
(a) * * *
* * * * * * *
(h) General Provisions.--
(1) * * *
(2) Authority for acceptance of voluntary services.--
(A) The Director of the Centers for Disease
Control and Prevention may accept, on behalf of
the Federal Government, any voluntary services
provided to such Centers by the Foundation for
the purpose of aiding or facilitating the work
of such Centers. [In the case of an individual,
such Director may accept the services provided
under the preceding sentence by the individual
for not more than 2 years.] In the case of an
individual, such Director may accept the
services provided under the preceding sentence
by the individual until such time as the
private funding for such individual ends.
* * * * * * *
(7) Reports.--
(A) Not later than February 1 of each fiscal
year, the Foundation shall publish a report
describing the activities of the Foundation
during the preceding fiscal year. Each such
report shall include for the fiscal year
involved a comprehensive statement of the
operations, activities, financial condition,
and accomplishments of the Foundation,
including an accounting of the use of amounts
provided for under subsection (i).
* * * * * * *
[(C) The Foundation shall make copies of each
report submitted under subparagraph (A)
available for public inspection, and shall upon
request provide a copy of the report to any
individual for a charge not exceeding the cost
of providing the copy.]
* * * * * * *
(C) The Foundation shall make copies of each
report submitted under subparagraph (A)
available--
(i) for public inspection, and shall
upon request provide a copy of the
report to any individual for a charge
not to exceed the cost of providing the
copy; and
(ii) to the appropriate committees of
Congress.
* * * * * * *
(i) Federal Funding.--
(1) * * *
(2) Funding for grants.--
(A) For the purpose of grants under paragraph
(1), there is authorized to be appropriated
[$500,000] $1,250,000 for each fiscal year.
(B) For the purpose of grants under paragraph
(1), the Secretary may for each fiscal year
make available [not more than $500,000] not
less than $500,000, and not more than
$1,250,000 from the amounts appropriated for
the fiscal year for the programs of the
Department of Health and Human Services. Such
amounts may be made available without regard to
whether amounts have been appropriated under
subparagraph (A).
* * * * * * *
(4) Support services.--The Director of the Centers
for Disease Control and Prevention may provide
facilities, utilities, and support services to the
Foundation if it is determined by the Director to be
advantageous to the programs of such Centers.
* * * * * * *