FY 2005 Budget in Brief

Departmental Management

On this page:
Departmental Management
General Departmental Management
Policy Research
Public Health and Social Services Emergency Fund (PHSSEF)
Bioterrorism Overview

Departmental Management (DM) includes funding for three appropriation accounts in the Office of the Secretary: General Departmental Management (GDM), Policy Research, and the Public Health and Social Services Emergency Fund (PHSSEF).

The FY 2005 budget request for GDM and Policy Research provides a total program level of $494 million, including appropriations of $438 million, interagency transfers of $51 million in evaluation funds, and $5 million in health care fraud and abuse funds. The FY 2005 budget request for the PHSSEF account is $2.2 billion.

General Departmental Management

The GDM account supports those activities associated with the Secretary's roles in administering and overseeing the organization, programs, and activities of the Department. These activities are carried out through 13 Staff Divisions (STAFFDIVs). The GDM budget request for FY 2005 totals $465 million, an increase of $78 million or 20.1 percent above the comparable FY 2004 level. The GDM request provides funding for the following activities:

Office of Population Affairs (OPA)/Adolescent Family Life (AFL): The AFL request of $44 million will continue to provide support for the AFL demonstration and research program authorized under Title XX of the Public Health Service (PHS) Act. Through the grants awarded under this program, AFL provides funding in three areas: care demonstration projects, prevention projects, and research projects. This request doubles abstinence-only prevention projects, as defined by the Welfare Reform legislation (P.L. 104-193) from $13 million to $26 million. Further, OPA also administers the Family Planning program under Title X of the PHS Act, which is funded through the Health Resources and Services Administration (HRSA).

National Abstinence Education Campaign: The request of $10 million will provide funding to create a campaign designed to help parents communicate with their children about the risks associated with early sexual activity.

Office of Minority Health (OMH): The OMH request of $47 million, an $8 million decrease from FY 2004, will provide funding to continue disease prevention, health promotion, service demonstration, and educational efforts that focus on health concerns that cause the high rate of death in racial and ethnic minority communities. The reduction is attributed to FY 2004 Congressional earmarks which are not continued in FY 2005.

Office on Women's Health (OWH): The OWH request of $29 million, the same as FY 2004, will provide funding to continue the advancement of women's health programs through the promotion and coordination of research, service delivery, and education – both throughout HHS agencies and offices, with other government organizations, and with consumer and health professional groups.

Office of Human Research Protections (OHRP): The OHRP request of $7 million, the same as FY 2004, will be used to accomplish the following: ensure implementation of Departmental regulations for the protection of human subjects, negotiate formal written assurances of compliance with institutions engaged in research covered by OHRP, investigate and oversee institutional compliance, and expand its public education campaign.

National Vaccine Program Office (NVPO): The NVPO request of $7 million will be used to provide leadership and coordination among Federal agencies as they work together to carry out the goals of the National Vaccine Plan. The National Vaccine Plan provides a framework, including goals, objectives, and strategies for pursuing the prevention of infectious diseases through immunizations. The NVPO is also the lead on the development of the U.S. Pandemic Influenza plan. Funds are also requested in the Public Health and Social Services Emergency Fund to ensure the Nation has the capacity to provide vaccines in a pandemic.

Commissioned Corps Readiness Force (CCRF): The CCRF request of $1 million will continue to support a cadre of approximately 1,300 active duty U.S. Public Health Service officers, qualified with special training and skills and ready to rapidly deploy in emergency situations.

Minority HIV/AIDS: The FY 2005 request includes $53 million, an increase of $3 million or 7 percent from FY 2004, to support innovative approaches to HIV/AIDS prevention and treatment in minority communities heavily impacted by this disease. These funds allow the Department to continue priority investments and public health strategies targeted to reduce the disparities and burden of HIV/AIDS in racial and ethnic minority populations.

Office of Global Health Affairs (OGHA): The OGHA request of $9 million will continue to promote the health of the world's population by advancing the Department's global strategies and partnerships. The OGHA request includes $5 million to continue support of HHS health care initiatives in Afghanistan.

Health Care IT: The request of $50 million will be used to fund State, regional, or local demonstration grants to test the feasibility of information exchange among health care settings, and other innovative information technology projects that improve health care.

Information Technology Security and Innovation Fund: The FY 2005 budget request includes $18 million, an increase of $3 million from FY 2004, to continue funding for the IT Security and Innovation Fund. Projects funded through the IT Security and Innovation Fund focus on HHS enterprise-wide investments, notably: enterprise architecture, key E-Government projects, HHS common IT infrastructure services, and on security and infrastructure to enable HHS common administrative systems.

Other General Departmental Management (GDM): The FY 2005 budget request includes $162 million, an increase of $7 million from FY 2004, to fund offices which provide leadership, policy, legal, and administrative guidance to HHS components.

Policy Research

The Policy Research account examines broad issues that cut across agency and subject lines, as well as new policy approaches developed outside the context of existing programs. The FY 2005 request for Policy Research includes $29 million to support evaluation activities. It is proposed that in FY 2005 the entire $29 million request be derived through interagency transfers of evaluation funds.

Broad-Based Research: The FY 2005 Policy Research budget request of $29 million, an $8 million increase from FY 2004, will support research on issues that cut across agency and subject lines, as well as new approaches developed outside the context of an existing program. Priority issues that will be examined are those related to: the well-being of children and youth; the outcomes of welfare reform and the status of low-income families; reform of major public-sector programs, especially Medicare and access for those who lack health insurance; promoting and expanding consumer-directed home and community-based services; nursing home quality; managed care and disability; post-acute care; employment and disability; active aging; and science policy.

Of the total $8 million increase, $2 million will be used to continue support of the National Electronic Health Information Initiative, to focus on national electronic health information systems. This initiative will accelerate the development and adoption of the technology and national standards necessary for Electronic Health Record Information Systems and their use by the health care and public health systems, as well as related support for the National Health Information Infrastructure.

In addition, $6 million will support the Current Population Survey (CPS), which is conducted by the Bureau of the Census. The CPS is the only government survey that produces annual estimates of the uninsured at the State level. Improved data will help States make informed decisions about their Medicaid, SCHIP, and other State-run insurance programs.

HHS agencies will conduct significant health services and policy research in FY 2005. This body of research covers a wide range of subjects, from assessing the quality of health care provided to the nation's elderly, to evaluating the effectiveness of programs aimed at reducing health risk behaviors among teens and other high-risk populations. The HHS Research Coordination Council (RCC), chaired by the Assistant Secretary for Planning and Evaluation, works to ensure that agencies collaborate in the conduct of health services research in order to ensure the most efficient and effective use of research resources in support of the primary mission and objectives of HHS.

Public Health and Social Services Emergency Fund (PHSSEF)

The PHSSEF provides $2.2 billion, a net $61 million increase above FY 2004. This includes $2.1 billion for bioterrorism and counterterrorism and $100 million to ensure that an adequate supply of vaccine could be produced for the Nation in the event of a pandemic. The PHSSEF is the source of funding for over half of the overall HHS terrorism budget of $4.1 billion.

Pandemic Influenza: The budget includes $100 million, an increase of $50 million, to ensure the Nation has the capacity to respond to an influenza pandemic. The influenza strains circulating usually change somewhat from year to year. Periodically, there is a major change in the virus's genetic structure resulting from a strain that can cause widespread disease and death. Three such global epidemics - called pandemics - occurred in the 20th century. Such a pandemic could cause an additional 90,000 to 300,000+ deaths in the U.S., especially if adequate vaccine were not available quickly. Once a pandemic began, it would be too late to accomplish the many key activities required to minimize this toll. Funds will be used to provide appropriate incentives for vaccine manufacturers to establish new domestic capacity using new manufacturing techniques that can be scaled up rapidly.

Bioterrorism: The HHS FY 2005 budget includes $4.1 billion for bioterrorism and counterterrorism activities. This is $154 million above FY 2004, and reflects several major changes: an inter-governmental biosurveillance initiative, a research portfolio on countermeasures against nuclear and radiological threats, and the return of both funding for and management of the Strategic National Stockpile to HHS. Funds contained in this request support activities in the Centers for Disease Control and Prevention (CDC), HRSA, Office of the Secretary, the nuclear and radiological countermeasures research at the National Institutes of Health (NIH), and the Strategic National Stockpile. In addition, both the Food and Drug Administration (FDA) and NIH receive direct appropriations for their bioterrorism activities. HHS continues to work with the Department of Homeland Security (DHS) on moving countermeasures against terrorism from the research phase to the advanced scale-up and production phase. Specifically, HHS is developing a contract for the purchase of an advanced anthrax vaccine - the first procurement to be made under the BioShield appropriations for DHS.

• Biosurveillance: the FY 2005 request introduces a new interagency biosurveillance initiative to prepare against a potential bioterrorist attack. CDC and FDA, in coordination with DHS, the Environmental Protection Agency, and the Department of Agriculture, will be working to improve the response to bioterrorism through early detection. The budget for CDC includes $130 million in FY 2005 for its role in this initiative, the largest of which is an investment of $100 million in its human health surveillance project, "BioSense." BioSense is an advanced approach to infectious disease surveillance that, unlike traditional approaches, does not rely upon mandatory or voluntary case reports from healthcare providers to public health officials, but uses automated analysis techniques on electronically available health data to highlight a potential health problem. In addition to developing better surveillance capacity, CDC will invest an additional $20 million to improve laboratory reporting capacity and to advance integration between public health and commercial laboratories, and an additional $10 million to increase the number of border health and quarantine stations from 8 to up to 25.

• Food Defense: The budget for FDA includes $246 million for bioterrorism activities. This total includes $181 million for food defense activities, which represents an increase of $65 million over FY 2004. The total food defense increase includes an additional $35 million to increase analytic surge testing capacity for biological, chemical, and radiological threat agents for the Food Emergency Response Network (FERN), $15 million for research, $7 million for domestic inspections and field exams, and $3 million to develop an Emergency Response and Operations Network. FDA will use $5 million to coordinate food surveillance activities within the biosurveillance initiative.

• National Institutes of Health: The FY 2005 request for NIH biodefense and other counterterrorism activities includes $1.7 billion, a net increase of $121 million from FY 2004. Of this total, $47 million is budgeted in the Public Health and Social Services Emergency Fund to be managed by NIH for support of targeted research activities needed to develop nuclear and radiological threat countermeasures. This research effort will improve methods for measuring radiological exposure and contamination as well as developing drugs that can be used to prevent injury from radiological exposure and developing methods or drugs to restore injured tissues and eliminate radioactive materials from contaminated tissues.

Of the bioterrorism funds directly appropriated to NIH, $1.5 billion will fund basic research on the biology of microbial agents with bioterrorism potential and the properties of the host's response applied research for the development of new or improved diagnostics, vaccines, and therapies. A complementary investment of $150 million is requested for developing this extramural capacity to conduct biodefense research - a top priority of the FY 2005 budget. The research and development of biodefense can only be performed safely and effectively in specialized and secure biocontainment research facilities. Critical research on a comprehensive range of biodefense countermeasures needed to respond to future potential bioterror attacks. Work on a second-generation anthrax vaccine has rapidly progressed to the point that a vaccine product is expected to be ready for procurement later this year through the new DHS BioShield program. DHS has been assigned responsibility to finance the procurement of biodefense medical countermeasures. HHS will continue to provide the scientific leadership needed to determine what countermeasures are needed.

• Strategic National Stockpile (SNS): The FY 2005 budget includes $400 million and reflects the Administration's plan to return the fiduciary management of the SNS to HHS. This change will better align and parallel the Federal role with the roles of the State and local public health departments, the lead agencies for planning and deployment of SNS assets. HHS has a long history of strong relationships with State and local public health officials, who rely on the scientific and clinical expertise that exists in HHS. This change will clarify for State and local officials a single Federal focal point for both strategic stockpile operations and public health emergency response.

• CDC Capacity and Anthrax Research: The FY 2005 request for the PHSSEF includes $150 million for CDC to continue to improve epidemiological expertise in the identification and control of diseases caused by terrorism, including better electronic communication; distance learning programs; and cooperative training between public health agencies and local hospitals. This request provides support for upgrading capacity at CDC, national planning efforts, oversight of inter-laboratory transfers of dangerous pathogens and toxins, laboratory safety inspections, and anthrax research. Included in this total is funding to support the expanded role of CDC in regulating transfer of select biological agents.

• HRSA Curriculum Development and Education: The FY 2005 request for the PHSSEF includes $28 million for curriculum development, the same as the FY 2004 level. This program is focused on medical curricula for instruction on the detection and treatment of diseases that can be caused by bioterrorism. The Bioterrorism Training and Curriculum Development program, first initiated in FY 2003, facilitates the training and preparation of current medical, nursing, allied health, and other health professions students.

• State and Local Preparedness: The commitment at CDC and HRSA to preparing States and hospitals to respond to public health emergencies remains strong: between FY 2002 and FY 2004, CDC invested a total of $2.9 billion in State and local preparedness and HRSA invested a total of $1.2 billion. In FY 2005, CDC has budgeted another $829 million and HRSA another $476 million.

Investments in States have markedly improved capacity: the Laboratory Response Network (LRN) now consists of 109 functional reference laboratories distributed throughout all 50 States. There are also 59 biosafety level 3 (BSL-3) laboratories located in 50 States - nearly three times the number reported in 1999. Fifty members of the LRN are now able to rule out the existence of smallpox, and 24 labs can test for the existence of the smallpox virus on a real-time basis. After several years of targeted funding from HRSA, every State, Territory, and funded municipality has a staffed hospital preparedness office and advisory committee, has completed a needs assessment, and has developed a plan of action in response to the identified needs. The FY 2005 budget requests $476 million to continue progress towards the goal of 100 percent of States developing surge capacity plans, including communication and connectivity among hospitals, outpatient facilities, public health departments, emergency medical services units, and other health care entities.

• Office of the Secretary: The FY 2005 request for the PHSSEF includes $62 million for the Office of the Secretary, the same as FY 2004.

• Office of the Assistant Secretary for Public Health and Emergency Preparedness (ASPHEP): Funding is maintained at $42 million in FY 2005. This includes funding for the ongoing operations of ASPHEP at headquarters and in the field; supports the Secretary's Emergency Response Team and the Department's International Early Warning Surveillance efforts; provides funding for bioterrorism preparedness, planning, and evaluation studies and an advance research program to promote a national bioscience research and development effort related to civilian biodefense; and to continue the development of an effective risk communication and information strategy for the public. FY 2005 will mark the second year of funding for the procurement of medical countermeasures in DHS. This procurement strategy is an unprecedented effort to manage the development and acquisition of up to $6 billion of drugs, vaccines, other biologics and supplies to be supplied to the SNS. ASPHEP has begun planning the operational structure to conduct the acquisition of vaccines and other pharmaceuticals that can be used to combat smallpox, anthrax, plague, and botulism.

• Medical Reserve Corps: Funding is maintained at $10 million in FY 2005 for the Medical Reserve Corps, the Citizen Corps component that organizes local volunteers to assist regular medical response professionals and facilities during a large-scale local emergency, such as an influenza epidemic or a hazardous materials spill. Program oversight is the responsibility of the Office of the Surgeon General. It is estimated that approximately 200 grants to small cities, rural counties, and large metropolitan areas will be awarded in FY 2004.

• CyberSecurity: The FY 2005 request for the PHSSEF includes $10 million to protect the Department's information technology infrastructure from cyber-terrorist attacks. These funds will provide continuous security monitoring for all HHS systems, assets, and services.

Bioterrorism Overview

FY 2005 Budget in Brief Home

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