Transcript Addressing CDC`s Policy Priorities

ADDRESSING CDC’S POLICY
PRIORITIES
John Auerbach, MBA
Associate Director for Policy
Acting Director, Office for State, Tribal, Local and Territorial Support, CDC
Craig Thomas, PhD
Director, Division of Public Health Performance Improvement
Office for State, Tribal, Local and Territorial Support, CDC
CDC Strategic Directions
Improve
health security
at home and
around the
world
Better prevent
the leading
causes of illness,
injury, disability,
and death
Strengthen public health/
health care collaboration
OADP Mission and Priorities
OADP’s mission is to identify and advance opportunities to use policy, leverage
health system transformation, and engage other sectors to improve the public’s
health.
OADP’s priorities are to
 Identify high-value prevention and public health policies and interventions
 Increase the understanding and use of credible evidence of prevention’s
impact by policy makers, health care, and public health
 Catalyze collaboration among public health, health care, and other sectors,
with special focus on those opportunities expanded by the Affordable Care Act
Three Buckets of Prevention
Traditional Clinical
Prevention
Innovative Clinical
Prevention
Total Population or
Community-Wide
Prevention
1
2
3
Increase the use of
evidence-based
services
Provide services
outside the clinical
setting
Implement
interventions that
reach whole
populations
Health Care
Public Health
Auerbach J., The 3 Buckets of Prevention. Journal of Public Health Management and Practice 2016.
http://journals.lww.com/jphmp/Citation/publishahead/The_3_Buckets_of_Prevention_.99695.aspx
Buckets 1 & 2: “6|18” Initiative
Promote adoption of evidence-based interventions in collaboration with
health care purchasers, payers, and providers
High-burden
health
conditions
6|18
Evidence-based
interventions that
can improve health
and save money
Bucket 3: Community-Wide Health Improvement
COMING SOON!
Development of a total population
6|18-like Initiative
OSTLTS Mission
Advance US public health agency
and system performance,
capacity, agility, and resilience
OSTLTS Overview

Help for capacity and performance
improvement for state, tribal, local, and
territorial public health agencies

Specialized training for new public health
officials and professionals

Guidance on using public health
law to improve public health

Targeted communication,
teleconferences, website, and assessment
tools
What We Do

Workforce development
•
•

Public Health Associate Program
National Leadership Academy for
the Public’s Health
Technical assistance
•
•
•
•
•
Funding
Public Health Law Program
Partnership support
Tribal support
Communication tools
 Performance improvement
• Accreditation
• Preventive Health and Health
Services (PHHS) Block Grant
• Prevention Status Reports
• Public health improvement
training
• Health system transformation
• Customized support to health
officials
Prevention Status Reports (PSRs)
A suite of CDC reports that highlight—for all 50 states and the District of Columbia—
the status of public health policies and practices designed to address priority public
health problems.
Alcohol-Related Harms
Motor Vehicle Injuries
Food Safety
Nutrition, Physical Activity,
and Obesity
Healthcare-Associated
Infections
Prescription Drug
Overdose
Heart Disease and
Stroke
Teen Pregnancy
HIV
Tobacco Use
Current Issues
FY 2017 Proposed Increases
Comparison to FY 2016
 Protecting Americans from
infectious diseases
• Antibiotic resistance (+$40M)
• Quarantine and migration (+$15M)
• Viral hepatitis (+$5M)
 Protecting against global and domestic
threats
• Global health protection (+$10M)
• Polio eradication (+$5M)
• Select Agent Program (+$5M)
FY 2017 Proposed Increases
Comparison to FY 2016 (continued)
 Preventing the leading causes of disease, disability,
and death
• Good health and wellness in Indian Country
(+$15M)
• Drug overdose prevention (+$10M)
• Gun violence prevention research (+$10M)
• Non-occupational noise-induced hearing loss
(+$10M)
• National Violent Death Reporting System
(+$8M)
 Monitoring health
• Building and facility improvements (+$21M)
• Laboratory safety (+$5M)
Detect and Protect—FY 2017 Proposal
Tackling our biggest drug-resistant threats
The FY 2017 President’s budget requests $200M (an increase of
$40M) to





Slow development of resistant bacteria and prevent spread of
resistant infections
Strengthen surveillance to track antibiotic resistance (AR) threats and
measure impact
Advance development and use of rapid and innovative diagnostic
tests
Accelerate research and development for new antibiotics, other
therapies, and vaccines
Support partnerships for prevention, detection, control, and research
AR Initiative: Year 2, Key Activities
CDC plans to award most FY 2017 AR Initiative funding
extramurally. In addition to sustaining AR capacities
started in FY 2016, CDC will
 Expand state public health laboratory/epidemiologic
capacity in all 50 states, six large cities & Puerto Rico to
expand use of whole genome sequencing technology to
rapidly screen food-borne bacteria for resistance
 Expand/establish state healthcare-associated infections
/AR Prevention Programs in up to 50 states (from 25
programs established in 2016), the six largest local
health departments & Puerto Rico
 Extend use of the NHSN antibiotic use reporting option
from 130 facilities in 30 states (as of December 2015)
to more than 750 facilities in all 50 states
Prescription Drug Overdose Initiative
The FY 2017 President’s budget requests an
increase of $10M to
 Fully expand efforts to promote opioid
prescribing guideline dissemination and
uptake
 Create clinical decision support tools derived
from guidelines to provide real-time
assistance with prescribing decisions in a
multitude of health care settings
 Support and identify best practices in
communities and states to prevent overdose
 Scale up successful approaches that improve
prescribing for chronic pain and reduce opioid
overdose and death
Good Health and Wellness in Indian Country Initiative
The FY 2017 President’s budget
requests an increase of $15M to
 Address leading causes of death
 Address chronic diseases,
depression and mental health,
suicide, substance use, and
motor vehicle injuries
 Incorporate culturally driven
wellness practices that build
resilience and strengthen social
and emotional well-being in
existing program
Mental Health
Public health approach to suicide prevention

Suicide rates have
increased steadily for the
past 15 years
14.0
24%
10.0
8.0
6.0
4.0
2014
2013
2012
2011
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001
0.0
2000
2.0
1999
Suicide Rate
12.0
(per 100,000 pop.)
$30 million requested (as part of HHS-wide
$500 million initiative) to
implement/evaluate comprehensive suicide
prevention programs, based on promising
models
• In partnership with injury control research
centers and state health departments
 Address key risk factors for suicidal behavior,
including substance abuse and mental illness
 Reduce likelihood that suicidal ideation will
progress to a suicide attempt, and that a
suicide attempt will lead to death
Flint, Michigan Water Crisis—What Is CDC Doing?
 Assessing the size and scope of the problem
 Communications
 Long-term monitoring
 Personnel support
 Educational outreach
Zika Virus: A New Threat

Reported for first time in Brazil in May 2015
 Evidence of transmission in Puerto Rico, USVI
& more than two dozen countries in the
Americas
• Potential for further spread with warmer weather
• Low likelihood of widespread transmission in
contiguous US states
Countries/territories with
active Zika transmission
(as of Feb. 3, 2016)

Difficult to control Aedes mosquitoes
 Research underway to understand:
• Risk of birth defects; Guillain-Barre
• Better diagnostics
• Better vector control
• Vaccine
Range of Aedes aegypti
mosquitoes in United
States
Zika virus—What Is CDC Doing?
 Working with partners to
• Educate healthcare providers and the public
about Zika
• Post travel notices and other travel-related
guidance
• Provide state and territorial health
laboratories with diagnostic tests
• Detect and report cases
• Support mosquito control programs both in
the United States and around the world
CDC Zika Emergency Supplemental Request—$828M







Support Zika preparedness in
states/territories with mosquito
populations known to transmit Zika
Enhance mosquito control through lab,
epidemiology, and surveillance capacity
in at-risk areas
Establish rapid response teams to limit
potential US clusters
Improve lab capacity and infrastructure
for Zika and other infectious diseases
Track Zika virus in communities and in
mosquitoes
Deploy targeted prevention and
education strategies




Expand Pregnancy Risk Assessment
Monitoring, improve Guillain-Barré
syndrome tracking & birth defect registries
detect risks related to Zika
Increase research into link between Zika
and microcephaly
Enhance international capacity for virus
surveillance, expand epi training,
laboratory testing, healthcare provider
training & vector surveillance/control in
high-risk countries
Improve diagnostics, including advanced
methods to refine tests
Support advanced developments for
vector control
For more information, contact CDC
1-800-CDC-INFO (232-4636)
TTY: 1-888-232-6348 www.cdc.gov