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Proposed Cuts Undermine Indian Health, Public Health and Scientific Research

Note: This blog originally appeared on The Huffington Post.

Please welcome HHS Deputy Secretary Bill Corr to this space, who summarizes below the severe impact that proposed cuts in the Interior, Environment and Related Agencies appropriations bill will have on several HHS agencies, most significantly the Indian Health Service.

Today, the House Appropriations Committee is considering a Fiscal Year (FY) 2014 Interior, Environment and Related Agencies appropriations bill which funds the Indian Health Service (IHS), the Agency for Toxic Substances and Disease Registry (ATSDR), and the National Institute of Environmental Health Sciences (NIEHS) Superfund at HHS. While we appreciate that the Subcommittee treated IHS as a priority within the bill, the proposed IHS level would severely slow efforts to improve the delivery of health care to American Indians and Alaska Natives throughout the country. In addition, the bill includes significant reductions to ATSDR and NIEHS Superfund that would curtail research on environmental health and environmental-related diseases and undermine public health efforts related to hazardous exposures.

Indian Health Service

The bill funds IHS at $4.1 billion, a level that is below even the FY 2013 sequester level, which would severely undermine needed health care services for Tribes and Tribal communities. This funding level could result in 1,500 fewer inpatient admissions and 396,000 fewer outpatient visits provided to American Indian and Alaska Native patients. The bill would incapacitate the operations at seven newly constructed health care facilities because of a lack of resources for nearly 580 additional providers and other health care staff. Over $600 million has been invested by Tribes and the federal government into the construction of these facilities which were planned to address access to care through 500,000 outpatient visits and other services. Also, the bill would delay the construction of the Southern California Youth Regional Treatment Center, leaving the entire State of California without a direct care facility to treat American Indian/Alaska Native youth for alcohol and substance abuse. In addition, the bill does not include a specified funding amount for Contract Support Costs, which could mean the already limited amounts for services and facilities would be cut even deeper in order to fund payments sought by tribes for administrative costs.

Agency for Toxic Substances and Disease Registry

The bill provides $61 million for the Agency for Toxic Substances and Disease Registry (ATSDR), which is $11 million (or 15 percent) below the FY 2013 enacted level and $15 million (or 19 percent) below the President's Budget request. These funding levels could eliminate all extramural awards to 28 State health departments, local jurisdictions, and other partners to assess and evaluate public health hazards and provide scientific health expertise to assist the EPA and state regulatory agencies make cleanup and regulatory decisions. These cuts would affect ATSDR's ability to document, assess, and respond to human health effects associated with toxic substances.

National Institute of Environmental Health Sciences Superfund

The bill provides $64 million for the NIEHS Superfund, which is $11 million (or 15 percent) below the FY 2013 enacted level and $16 million (or 20 percent) below the President's Budget request. The decrease in funding for the NIEHS Superfund will lead to reduced support for high priority research covering the diverse areas of science needed to solve complex health and environmental issues associated with the nation's hazardous waste sites.

The President has been clear that Congress must work together to pass a budget that cuts wasteful spending while investing in jobs, the economy, and middle class families. If enacted, the proposed cuts would impair IHS's ability to meet critical health needs in Indian communities, curtail research on environmental health and environmental-related diseases, undermine public health efforts related to hazardous exposures, and adversely affect the vulnerable populations HHS serves.