National Association of Chronic Disease Director’s Testimony before the House Labor, Health and Human Services and Education Subcommittee on Appropriations March 30, 2007

Mr. Chairman and members of the Committee, thank you for the opportunity to testify before you this afternoon. My name is Cynthia Boddie-Willis; I am President of the National Association of Chronic Disease Directors. NACDD is an association of public health professionals with expertise in state-based chronic disease prevention and control. We have three priorities for 2007: expansion of the CDC Heart Disease and Stroke Prevention Program, enhancement of the CDC’s Diabetes Prevention and Control Program and preservation of the Prevention Health Services Block Grant. I am here to support these priorities.

Our first goal for 2007 is expansion of the Heart Disease and Stroke Prevention Program. This program funds state-based initiatives that address a clear and present danger to the health of our nation. The economic impact of heart disease and stroke in 2005 totaled $394 billion. This is even more intolerable because we know that much of it is preventable.

The CDC currently funds 32 states and the District of Columbia to address heart disease and stroke prevention, but they are funded at such a low level that statewide intervention is not possible. Nineteen states receive capacity-building grants to define the impact and begin a plan to address the problem. Fourteen states receive basic-implementation funding to supports enhanced activities and begin to address interventions. Heart disease and stroke are the first and third leading causes of death, yet 18 states currently receive no funding from the CDC.

Congress appropriated $44.5 million for this program for 2006. The President’s Budget Proposal for 2007 has only $43.9 million. We respectfully request a $10 million increase over the FY 2006 funding level for the Heart Disease and Stroke Prevention Program. This will allow for increasing the number of capacity-building states and the number of basic implementation states.

Our second priority, Mr. Chairman, is the Diabetes Prevention and Control Program. Over 20 million people in this country have diabetes and over 41 million people have pre-diabetes. Diabetes related costs are $132 billion per year. Scientific studies have shown unrealized opportunities to not only prevent diabetes but to prevent complications of diabetes. Our written testimony has specific examples of how this works in states. The $63 million appropriated for Diabetes Prevention and Control 2006 funds only 28 states at the basic implementation level. The NACDD respectfully requests a $10 million increase in FY 2007 to support additional states at that level.

Our third priority, Mr. Chairman, is the Preventive Health Services Block Grant, otherwise known as the Prevent Block. The elimination of the Prevent Block in the President’s FY 2007 Budget Proposal is troubling. Elimination of the Prevent Block will mean that states will experience devastating cuts in critical public health services.

NACDD has surveyed states recently to determine the extent to which the $18 million cut in FY 2006 Prevent Block funds affected their ability and that of local communities to deliver important public health services. Specific state examples are noted in our written testimony.

NACDD also has grave concerns about the proposal to allow states to reallocate up to five percent of categorical funding. This proposal incorrectly presumes both that all categorical programs are funded in every state, and that they operate with surplus resources. Neither presumption has ever been the case. States must use Prevent Block dollars where federal funds for chronic disease prevention initiatives are either grossly insufficient or non-existent.

In closing, Mr. Chairmen and members of the Committee, NACDD respectfully requests a $10 million increase over 2006 funding for the Prevent Block Grant, a $10 million increase over 2006 funding for Diabetes Prevention and Control, and a $10 million increase over 2006 funding for Heart Disease and Stroke Prevention. Thank you for the opportunity to address the committee regarding these urgent realities.