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Mixed Bag for NCHS, Vital Records Funding (…Again)

Emily J. Holubowich, MPP, Senior Vice President, Cavarocchi Ruscio Dennis Associates

Congress has left our nation's capital for seven weeks of conventions and campaigning, but not before a flurry of activity on the appropriations front. Both the House and Senate Appropriations Committees have approved spending legislation for the Department of Health and Human Services, and within it, the National Center for Health Statistics (NCHS). Once again, it's a mixed bag for vital statistics funding.

To review, in February the President requested (see pages 270-278, here) flat funding of $160.4 million to maintain NCHS's capacity to support ongoing health and health care surveys, and to support the National Vital Statistics System (NVSS). Within these activities, the administration planned to continue efforts to improve the timeliness and quality of vital statistics for further use in the Centers for Disease Control and Prevention (CDC) Surveillance Strategy, and "to continue working with states and partners on strategies to expand electronic death reporting to provide faster, better quality data on deaths of public health importance, including prescription drug overdose deaths."

The House Appropriations Committee accepted the President's request for flat funding, and offered accompanying language relevant to NVSS:

National Vital Statistics System (NVSS).—The Committee continues support for the NVSS which provides data on births, deaths, and fetal deaths. The Committee is aware most States now or will soon have operational electronic birth and death registration systems, an essential tool in monitoring public health and fighting waste, fraud, and abuse in Federal entitlement programs. The Committee requests CDC ensure the modernization of the CDC system to ensure interoperability with state systems.

The Senate Appropriations Committee, on the other hand, cuts NCHS's budget by about $4.3 million. On a positive note, it provides language directing NCHS to prioritize vital statistics modernization:

Modernizing Vital Statistics-While most States now or will soon have operational electronic birth and death registration systems, many do not have the resources to maximize electronic death reporting or to modernize their systems to keep pace with new technology. The Committee encourages CDC to support States in upgrading antiquated systems and improving the quality and accuracy of vital statistics reporting.

What happens next is anyone's guess. Political and fiscal dynamics make it unlikely that either chamber's "Labor-HHS" spending bill will see any floor time. With just four working weeks remaining before the September 30 fiscal year's end—and the recess for the November elections—the best-case scenario is a short-term continuing resolution to keep the government running. Worst-case scenario: a six-month continuing resolution that kicks the can until March. And in the end, all Congress may be able to accomplish is a year-long continuing resolution at current levels if passing final spending legislation proves too hard in the lame duck scramble. It wouldn't be the first time; Congress has passed year-long continuing resolutions in the last two presidential election cycles.

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