State and Territorial Health Officials Convene First On-site Hill Day Since COVID
March 18, 2024 | Catherine Jones, Alex Wheatley, Dulce Maria Mendoza
A cornerstone of ASTHO’s 2024 Spring Leadership Forum was Hill Day, which took place on Feb. 28. This year heralded the return of in-person discussions after three long years of virtual meetings with House and Senate offices and committees. In spite of the nail-biting backdrop of FY24 appropriation deadlines, ASTHO’s annual connection with federal lawmakers was a resounding success. While congressional members and appropriators negotiated and crunched budgets behind closed doors, state and territorial health officials were on hand for countless conversations along the hallowed marble corridors. Such conversations have already borne fruit; WIC, for example, was fully funded for FY24.
Incidentally, research shows that in-person meetings with members of Congress are the most effective means of communication as information and ideas can be exchanged in real-time (no need to raise your emoji hand) and create lasting relationships.
Engaging with Federal Agencies and the Hill
To kick off the week, on Monday, Feb. 26, ASTHO’s Board of Directors met with leadership from the White House Office of Pandemic and Preparedness Response Policy (OPPR), HRSA, Administration for Strategic Preparedness and Response (ASPR), FDA, and SAMSHA. Discussions focused on the public health priorities of these agencies and learning how the different entities can best support and collaborate with state and territorial health officials. Broad topics covered workforce shortages, maternal health issues, Paxlovid and COVID tests, medical supply chain disruptions, drug shortages, naloxone distribution, telehealth, behavioral and mental health workforce, HIV/AIDS funding, and emergency preparedness, such as stockpiles, coordinated responses and communications.
On Tuesday, Feb. 27, ASTHO facilitated a panel with members of the Office of Management and Budget (OMB), CDC, and Cornerstone Government Affairs which gave insight into the confounding sausage-making process of the budget cycle. It also included highlights of CDC’s policy priorities: (1) readiness and response (investing in core capabilities), (2) young families (childhood immunization, adverse childhood experiences, maternal and child health, and nutrition), (3) mental health, suicide, and opioid overdose, and (4) their Moving Forward work on data and other infrastructure. Conversations touched on sustained funding as opposed to boom and bust dollars for the Public Health Infrastructure Grant (PHIG), and state health officials were encouraged to share success stories with their representatives on how disease-agnostic PHIG dollars are being utilized at state and local levels.
On Wednesday, ASTHO’s official Hill Day, state health officials discussed with Congressional staff the ongoing need to address annual appropriations funding for public health priorities, including requests to fully fund the WIC program at more than $7 billion in FY24, allocating $1 billion for PHIG in FY25 to support core public health capabilities (e.g., assessment, policy, preparedness and response, community partnership, communications, equity, accountability, and performance management). Moreover, funding will support agencies in their efforts to invest in and retain a highly trained workforce that is ready to support emerging public health threats.
Facilitating “Island Hill Day”
Fifteen ASTHO island health leaders, representing all eight U.S. territories and freely associated states (T/FAS), traveled more than 1,000 miles to amplify their unique legislative and administrative priorities (with two participants traveling more than 8,000 miles!). Island Hill Day events targeted two areas for legislative change: achieving territorial Medicaid funding parity and securing critical health financing for the FAS through renegotiated Compacts of Free Association (COFA). Island leaders also met with federal agencies and academic partners to discuss data, health equity, and workforce development priorities.
Leaders discussed COFA with the Senate and House Energy and Natural Resources committees, and then pivoted to the House Energy and Commerce and Senate Finance committees, where territorial Medicaid issues took center stage. These committees have been critical partners toward achieving island health equity. Island leaders used Hill Day to educate committee staff about the impact of COFA and Medicaid funding, as well as to highlight emerging trends and priorities in island jurisdiction health systems. With limited T/FAS representation in Congress, Hill Day is a particularly valuable opportunity to make connections and amplify island voices on Capitol Hill.
ASTHO’s Work Continues After Hill Day
While the Spring Leadership Forum and Hill Day may be over, ASTHO will continue working virtually and in-person to advocate for public health priorities, appropriations, and vital resources for public health departments. ASTHO will share its annual appropriations book in the coming weeks; Federal agencies and OPPR will continue to work with ASTHO and its members to ensure that we are prepared and equipped for the next national health emergency, whatever it may be. Stay tuned for updates as appropriation negotiations move to the second CR tier deadline of March 22 and President Biden’s FY25 budget goes under the legislative microscope.