[Senate Report 109-91]
[From the U.S. Government Publishing Office]
Calendar No. 140
109th Congress Report
SENATE
1st Session 109-91
======================================================================
AMENDING THE PUBLIC HEALTH SERVICE ACT WITH RESPECT TO THE NATIONAL
FOUNDATION FOR THE CENTERS FOR DISEASE CONTROL AND PREVENTION
_______
June 27, 2005.--Ordered to be printed
_______
Mr. Enzi, from the Committee on Health, Education, Labor, and Pensions,
submitted the following
R E P O R T
[To accompany S. 655]
The Committee on Health, Education, Labor, and Pensions, to
which 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, reports favorably thereon with an amendment in the
nature of a substitute and recommends that the bill (as
amended) do pass.
CONTENTS
Page
I. Purpose and summary of the bill..................................1
II. Background and need for the legislation..........................2
III. Legislative history and committee action.........................3
IV. Explanation of bill and committee views..........................3
V. Cost estimate....................................................4
VI. Application of law to the legislative branch.....................5
VII. Regulatory impact statement......................................5
VIII.Section-by-section analysis......................................6
IX. Changes in existing law..........................................6
I. Purpose and Summary of the Bill
S. 655 makes several technical corrections and improvements
to Section 399G of the Public Health Service Act (PHSA), which
established the National Foundation for the Centers for Disease
Control and Prevention (CDC Foundation). Most significantly,
these corrections assure that the Foundation receives funds and
support services from the Centers for Disease Control and
Prevention (CDC) to support the CDC Foundation's administrative
and operating expenses.
II. Background and Need for the Legislation
The Foundation is a private, not-for-profit foundation
established by Congress to raise private funds to support the
work of the CDC. Authorized in 1992 and incorporated as a
nonprofit organization in Georgia 11 years ago, the Foundation
during its brief history has raised more than $100 million to
augment CDC's efforts. Over the past 5 years the Foundation has
raised on average $15 million per year to support initiatives
at CDC. This represents a 30:1 return on CDC's $500,000 per
year investment in the CDC Foundation. The funds the CDC
Foundation raises in support of CDC bring the flexibility of a
non-profit organization to build effective partnerships between
CDC and private sector corporations, foundations and
individuals to improve health and safety around the world.
The Foundation has managed more than 100 programs that have
helped CDC do more and faster work in this country and in more
than 30 countries on five continents to fight deadly infectious
and other diseases that threaten the safety and well-being of
U.S. citizens here and abroad. With an outstanding
internationally renowned Board of Directors 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 CDC.
Examples of such partnerships include:
1. 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 diseases in those countries threaten
U.S. citizens.
2. 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 U.S. citizens and each
corporations' bottom line. Members include top
executives from such corporate leaders as GE, General
Motors, IBM, UPS, Coke and Wal-Mart. In its first
meeting CDC and the corporate members agreed to begin
exchanging disease surveillance data that should help
both CDC and the corporations do their respective jobs
better.
3. Emergency Preparedness and Response Fund: After 9/
11 and the anthrax attacks, the CDC Foundation
established a special fund that enables CDC to respond
with greater flexibility during future crises when
existing government regulations might not be sufficient
to enable CDC to do all it can as possible 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.
4. Emergency Operations Center: After 9/11 CDC
Foundation Board member Bernie Marcus, a 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 opened 6 months early, just in time
to track and combat the deadly SARS threat.
5. 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 across the country.
6. 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 across
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.
7. 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 to the United States as well.
III. Legislative History and Committee Action
On March 17, 2005, Senator Isakson, for himself and Senator
Chambliss, introduced S. 655, to amend Section 399G of the PHSA
to improve the Foundation for the Centers for Disease Control
and Prevention (CDC). On April 27, 2005, the committee held an
executive session to consider S. 655. The committee approved an
amendment in the nature of a substitute offered by Senator
Enzi, and then approved S. 655, as amended, by unanimous voice
vote.
IV. Explanation of Bill and Committee Views
The operating costs for the CDC Foundation have climbed
from $300,000 when it began in 1995 to almost $3 million in
2005. In 1995, CDC's $500,000 of support was sufficient to
fully support the Foundation's operations. However, this
amount, which has been capped since the Foundation's inception,
no longer provides sufficient funds to allow the CDC Foundation
to provide the kinds of beneficial support noted in the
examples above. S. 655 will allow the CDC Director to support
the work of the Foundation beyond the $500,000 baseline up to
$1.25 million if, in the judgment of the CDC Director, an
occasion would arise that would warrant it. Such support does
not require an increased appropriation since funds would come
from existing appropriations to the CDC director's office. Such
financial support, at most, would constitute approximately half
of the operating costs of the Foundation.
The legislation would also incorporate language that would
allow 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 2
years each. This creates program implementation problems for
programs supported by private funding from organizations like
the Robert Wood Johnson and Kellogg Foundations that sometimes
can run 3 or 4 years. To remedy this, the legislation aligns
the length of any privately supported fellowships to coincide
with the duration of private funding for each such fellowship.
V. Cost Estimate
U.S. Congress,
Congressional Budget Office,
Washington, DC, May 31, 2005.
Hon. Mike Enzi,
Chairman, Committee on Health, Education, Labor, and Pensions,
U.S. Senate, Washington, DC.
Dear Mr. Chairman: The Congressional Budget Office has
prepared the enclosed cost estimate for 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.
If you wish further details on this estimate, we will be
pleased to provide them. The CBO staff contact is Tim
Gronniger.
Sincerely,
Douglas Holtz-Eakin, Director.
Enclosure.
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
Summary: S. 655 would modify the Public Health Service Act
to increase the amount of the grants the Department of Health
and Human Services is authorized to provide to the National
Foundation of the Centers for Disease Control and Prevention
(CDC) from $500,000 per year to $1,250,000 per year. The bill
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 enacting S. 655 would cost $500,000 in
2006 and $3.5 million over the 2006-2010 period, assuming
appropriation of the necessary 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. S. 655 would not affect direct 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--
-----------------------------------------------
2005 2006 2007 2008 2009 2010
----------------------------------------------------------------------------------------------------------------
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
Proposed Changes:
Estimated Authorization Level............................... 0 1 1 1 1 1
Estimated Outlays........................................... 0 1 1 1 1 1
Spending Under S. 655: \2\
Estimated Authorization Level \1\........................... 1 1 1 1 1 1
Estimated Outlays........................................... 1 1 1 1 1 1
----------------------------------------------------------------------------------------------------------------
\1\ The 2005 level is the amount appropriated for that year.
\2\ Rows 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 bill would also allow
the CDC to provide in-kind transfers and support services to
the Foundation. Under current law, the Foundation receives
$500,000 in transfers from the funds appropriated to the
Department of Health and Human Services. S. 655 would require
HHS to transfer at least that amount, and would allow the
department to transfer up to $1,250,000 to the Foundation each
year.
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 $500,000 in 2006 and $3.5
million over the 2006-2010 period, assuming the appropriation
and transfer of the necessary amounts.
Intergovernmental and private-sector impact S. 655 contains
no intergovernmental or private-sector mandates as defined in
the UMRA and would not affect the budgets of state, local, or
tribal governments.
Estimate prepared by: Federal Costs: Tim Gronniger; Impact
on State, Local, and Tribal Governments: Leo Lex; Impact on the
Private Sector: Meena Fernandes.
Estimate approved by: Peter H. Fontaine, Deputy Assistant
Director for Budget Analysis.
VI. Application of Law to the Legislative Branch
S. 655 amends section 399G of the PHSA to make improvements
to the functioning of the Foundation for the Centers for
Disease Control and Prevention, a non-profit corporation in the
State of Georgia that supports the work of the CDC. As such, it
has no application to the legislative branch.
VII. Regulatory Impact Statement
The legislation amends section 399G of the PHSA to make
improvements to the functioning of the Foundation for the
Centers for Disease Control and Prevention. It includes a
requirement that the Director of the CDC transfer no less than
$500,000 and no more than $1.25 million of the CDC's
appropriated funds to the Foundation to support its costs in
supporting the work of the CDC. Pursuant to the requirements of
paragraph 11(b) of Rule XXVI of the Standing Rules of the
Senate, the Committee has determined that the bill will not
have significant regulatory impact.
VIII. Section-by-Section Analysis
Sec. 1. National Foundation for the Centers for Disease Control and
Prevention; Acceptance of Voluntary Services; Federal Funding
Paragraph (a) makes a technical amendment to clarify that
any fellowship with the CDC Foundation will match the length of
time the endowment for that project takes.
Paragraph (b) requires 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.
Paragraph (c) makes a change to require the CDC Director to
transfer no less than $500,000 and not more than $1,250,000 to
the Foundation for operating expenses.
IX. Changes in Existing Law
In compliance with rule XXVI paragraph 12 of the Standing
Rules of the Senate, the following provides a print of the
statute or the part or section thereof to be amended or
replaced (existing law proposed to be omitted is enclosed in
the black brackets, new matter is printed in italic, existing
law in which no change is proposed is shown in roman):
Public Health Service Act
* * * * * * *
Part N--National Foundation for the Center for Disease Control and
Prevention
SEC. 399G. [280D-11] ESTABLISHMENT AND DUTIES OF FOUNDATION.
(a) In General.--* * *
* * * * * * *
(h) General Provisions.--
(1) Authority for accepting funds.--* * *
(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)
(B) * * *
[(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) Authority for annual grants.--
(A) * * *
* * * * * * *
(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).
(3) Certain restrictions.--* * *
(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.
* * * * * * *