Emily J. Holubowich, Senior Vice President at CRD Associates, is NAPHSIS's Washington representative and leads our advocacy efforts in the nation's capital.
For more than a decade, NAPHSIS has worked alongside our partners in the data user community to convince lawmakers of the need to modernize the vital statistics system. Despite the overall fiscal and political toxicity in Washington, lawmakers from both parties have recognized the value of more, better, and faster data for both public health and administrative purposes. The budget of the National Center for Health Statistics (NCHS) has slowly and steadily increased, and in each year, we’ve seen Congress prioritize funding for the vital statistics infrastructure. As a result, today nearly all vital records jurisdictions have implemented electronic birth and death registration systems.
This year, however, we face a battle unlike any we’ve seen. The funding available for health programs writ large is currently about 12 percent below fiscal year (FY) 2010 levels. Without action from Congress, sequestration will return in FY 2018 and further decrease the available funding for health and other domestic programs. If President Donald Trump had his way, funding for the Department of Health and Human Services would be cut by another 18 percent below current levels. We won’t know what specifically he has in store for NCHS and other programs until mid-May when his detailed budget proposal is released. Finally, lawmakers may continue efforts to repeal the Prevention and Public Health Fund as part of efforts to repeal the Affordable Care Act – or to pay for other priorities, TBD. The loss of the Prevention Fund would result in a 12 percent cut to the Centers for Disease Control and Prevention’s budget—a loss that would have ripple effects through the agency, including at NCHS.
Competition for such limited resources will be fierce on Capitol Hill, which is why NAPHSIS is planning to ramp up its activities advocating on behalf of vital records jurisdictions. For example, in addition to our leadership position the Friends of NCHS and advocating for the agency’s funding overall, NAPHSIS is seeking funding to modernize the STEVE (State and Territorial Exchange of Vital Events) system and improve how we share vital statistics amongst the states and with our federal partners (see letter here). After nearly ten years, STEVE’s antiquated architecture cannot keep pace with technological advances and user needs and must be replaced.
The path forward on federal funding is far from certain, but if there’s any certainty it’s this: “if you’re not at the table, you’re on the table.” In the current climate, preventing budget cuts is just as important as securing increases. NAPHSIS will be on the frontline fighting to preserve funding for vital records jurisdictions, and seeking out opportunities to increase funding whenever and wherever possible.