WALKING THE HILL! 

Speaking up for public health and alcohol, tobacco and other drug funding

Leonard Lamkin, MPA

A few members of the ATOD Section strolled up to Capitol Hill to speak with their Congress members and/or staff after the Mid-Year meeting.  The advocacy effort focused on:

1.    Support the Prevention and Public Health Fund - The fund was created as part of the Health Reform Act signed into law by President Obama.  It establishes “The Fund” administered by the HHS Office of the Secretary to provide for “expanded and sustained national investment in prevention and public health programs.”  The Fund can be used for any program authorized by the Public Health Service Act over fiscal year 2008 levels for “prevention, wellness, and public health activities.”  House and Senate Appropriations Committees may also allocate funds through appropriations legislation.

Update: The FY2011 Continuing Resolution did not specify allocations for the Prevention and Public Health Fund. In February 2011, HHS announced it intended to distribute the Prevention Fund as follows: Community Prevention - $298 million; Clinical Prevention - $182 million; Public Health Infrastructure - $137 million; and Research and Tracking - $133 million.

For more information on the announcement, please visit:

http://www.hhs.gov/news/press/2011pres/02/20110209b.html

Our effort was focused on educating members of Congress and their staff on the importance of this fund.

2.    Support Public Health Funding - Stop the proposed cuts to CDC.  We spoke with the Congressional staff about the important role of CDC. We also discussed proposed cutting in overall public health funding. Emphasis was placed on public health workforce development and the need to maintain or increase funding which will allow colleges/universities to educate a nursing workforce that is equipped to deal with the emerging issues which are related to health reform and mental health parity.

Our effort was to support increased funding for CDC and no public health cuts. Note: Freshman Republican Senator Kirk of Illinois, who usually supports funding for NIH and CDC, was proposing a 10 percent cut in all federal agencies including these which he considers to be important according to his staff person.

3.    Creation of the Addictions Institute – Our Section has serious concerns about the placement of population based research and programs into the proposed merger of NIAAA, NIDA and various tobacco research projects at NIH into one new addiction institute. The proposal would divest population level tobacco research from NCI.  The fact that the word “tobacco” does not appear in the announcement shows that there is still an opportunity to keep population-level and policy work at NCI where it belongs.  Part of our effort was to educate members of Congress and their staffs about population based efforts for tobacco, alcohol and drugs as well as what the cuts in intervention and treatment dollars would mean for their districts.  For more information see the editorial by Seffrin, et al. (on April 18, 2011) “Tobacco and NIH: More than Addiction” at http://tobaccocontrol.bmj.com/search?fulltext=seffrin&submit=yes&x=0&y=0.

4.    Other: Prescription drop-off program - The Office of National Control Drug Policy and the Drug Enforcement Administration have launched prescription drop off dates. The problem is that the current law only allows for DEA agents to accept expired prescription drugs.  A change in the law to pharmacists would allow for more expired drugs to be disposed of properly.  This is an important issue for three public health reasons: (1) expired medications pose a potential health risk/patient safety for not only our seniors but all who take regular medications; (2) the medicine cabinet has become a place for adolescents and young adults to access medications for illegal use; and lastly (3) medications thrown down the drain/toilet can pose a risk to our drinking supply.

5.    Other: Flavored cigars – Michael Byron explained his concern that the 2009 legislation gives the FDA control over tobacco banned fruit/candy flavoring in cigarettes, where they are used rarely, but allowed them to stay in use in little cigars, where they are much more common.  Staff were presented with some examples of these products and were told of concerns that brightly-packaged apple and strawberry flavored cigars would certainly appeal to underage youth.  Staff said the issue will be relayed to Congressman Cummings (D-Md.) and see whether he might want to get involved. This issue was also raised with Congressman Davis (D-Ill.).

Other thoughts for the future:

1. Perhaps the most useful thing we could do would be to meet with Republicans and any Democrats who are more on the fence about the APHA’s issues; in many of our meetings we were preaching to the choir.  
2. Reconsider the paradigm we are using to address member of Congress.  We are dealing with a new Congress.  Many see no role for the federal government. Congressman Royce is an example: His constituency has voted him into office for 10 terms.  I believe we need to strategize better to better reach these types of Congress members where they live - we need to influence their constituency.

We need all of our Section Members:

1. To sign up for action alerts – http://action.apha.org/site/PageNavigator/Advocacy.
2. Get to know their federal elected office holders.
3. Visit them either in D.C. or back home at their offices, town halls, etc.
4. Then thank them for their time and remind them of the issue (follow-up).

SPEAK UP FOR PUBLIC HEALTH AND ALCOHOL, TOBACCO AND OTHER DRUG FUNDING!

Note: Thank you to all who took part in the Hill Visits: Vanessa Millar; Michael Byron; Lawrence Brown; Leonard Lamkin, and Kathye Gorosh.