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Public Health Money Starts to Flow—but from Overhaul Law Fund Targeted by Republicans

By John Reichard, CQ HealthBeat Editor

September 13, 2010 -- Twenty-seven public health training centers across the country will receive $17 million in funding under grants announced Monday by the Department of Health and Human Services, the first wave of funding under the health care overhaul law to help reverse budget declines for public health programs, advocates say. But the money is coming out of a preventive care and public health fund that has a big target on its back, the advocates add.

The grants, which include $15.4 million from the preventive care fund established by the health care overhaul law (PL 111-148, PL 111-152), will be used to train workers to engage with the public on a wide variety of health issues.

"Whether facing public health emergencies such as natural disasters, or chronic conditions like obesity, a well-trained public health workforce is critical to ensuring the nation's health and welfare," said Mary Wakefield, the administrator of the Health Resources and Services Administration in an announcement Monday. HRSA is the agency that oversees the training centers, which are housed at nonprofit institutions, including schools of public health.

The Prevention and Public Health Fund created by the overhaul law also is expected to fund preventive care programs tailored by local communities to meet their own health care needs as well as programs to help smokers quit, among many other activities. Senate appropriators recently voted to add $750 million to the fund in fiscal 2011. It includes some $15 billion in mandatory funding over a 10-year period.

But public health groups worry that Republicans critical of the overhaul law will eliminate the fund. Sen. Mike Johanns of Nebraska, for example, is expected to offer an amendment Tuesday that would eliminate the fund to help pay for dropping a requirement that businesses file 1099 forms with the IRS to cut down on tax cheating by their vendors.

Rich Hamburg, deputy director of Trust for America's Health, said in an interview Monday that the public health training grants are "the first money that's coming available to help turn around the pretty dire situation that the public health workforce is in." The trust advocates increased funding of public health programs.

"I'm cautiously optimistic that the votes aren't there" to pass the Johanns amendment Tuesday, Hamburg said. But "I think we have to look at the long term," he added. "It's a big fund and it seems to have a bull's-eye on it. We fully expect that there will be other efforts to divert the funds. It's not going away with this one amendment."

Hamburg said some 250 public health, union, and other groups have sent a letter to senators opposing elimination of the fund. They view the Johanns amendment as just the first of repeated efforts to take money out of the fund or to eliminate it, Hamburg said.

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