Archive for the 'Public Policy' category

The End of Sequestration: Not as Great as it Sounds

Apr 02 2013 :: Published in Public Policy

By Peter Kyriacopoulos, Senior Director, Public Policy, APHL

Sequestration – or the “automatic cuts” in federal funding – is dead. Long live sequestration! We will no longer go through the drama of the imposition of automatic spending cuts that occurred on March 1, 2013 – but not because Congress and the White House have reached an agreement that suspends sequestration and puts in place a balanced and responsible plan for deficit reduction.

MoneyThe automatic spending cuts feature of the Budget Control Act (BCA) was limited to the fiscal year 2013 funding cycle. In fiscal years 2014 through 2022, the mechanism for achieving the level of cuts required by BCA will instead occur behind the scenes by a reduction in the spending caps for each of those fiscal years. This means that each year the appropriations committees in Congress will have $109 billion less than the amounts they anticipated – and specifically that each year there will be at least $33 billion less for non-defense discretionary accounts, including the one that funds the department of Health and Human Services (including the Centers for Disease Control and Prevention (CDC)). The reduction in funding will vary between $33 billion and $37 billion each year, a cut of about 5.5% to 7% annually. Defense funding will be reduced to a greater extent: $54 billion each year.

The Congress has passed and the President signed into law a funding measure for the remainder of federal fiscal year 2013, and while that action avoided a shut-down of federal governmental operations past March 27, 2013, it maintained the application of the automatic spending cuts – or sequestration – for fiscal year 2013. So this means that federal agencies must now produce plans on how they will address the reduction in spending for their operations.  The reductions – each of which must occur between now and September 30, 2013 – are as follows:

  • CDC: $340 million
  • HRSA: $365 million
  • FDA: $209 million
  • Global Health: $411 million
  •  EPA: $385 million

But wait, there’s more. The House-passed budget resolution for fiscal year 2014, written by Congressman Paul Ryan, not only assumes a continuation of the reduced funding for non-defense discretionary caused by the sequester and its evolution, it also cancels the reductions in defense and transfers those cuts onto non-defense discretionary. That’s just the beginning: In total, the House-passed budget would impose an additional (in addition to sequestration for defense being transferred to non-defense) cut of $700 billion in non-defense discretionary funding over the next ten years. Thankfully, the Senate-passed budget resolution does not follow this extreme path and instead fully replaces the amount lost in the fiscal year 2013 sequester and beyond.

It is extremely unlikely that the considerable differences between the House-passed and Senate-passed budget resolutions for federal fiscal year 2014 can be resolved, and more likely that the House and the Senate will move to considering appropriations bills and other deficit reduction legislation under the direction of their specific budget resolutions – laying the groundwork for irreconcilable differences on those measures. All of which will lead to uncertainty. A rose by any other name most likely will not smell as sweet.

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What We’re Reading — Sequestration Edition

Feb 28 2013 :: Published in Public Policy, What We're Reading

By Peter Kyriacopoulos, Senior Director, Public Policy, APHL

On sequester eve, I recommend the following recent articles for those who would like to know more about the developments in federal funding. It is all but certain that sequestration will occur on March 1, 2013 and these articles describe how we got here, what may happen next, and whether there is a prospect of even greater disruption through a shutdown of the federal government on March 27. Read on!

And here’s the list of the many blog posts I’ve written on these automatic cuts — including one video:

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Sequestration State by State

Feb 25 2013 :: Published in Public Policy

By Peter Kyriacopoulos, Senior Director of Public Policy, APHL

United States of America

The White House has produced individual state fact sheets that provide some additional detail on the state-impact of the automatic spending cuts (or sequestration) that will occur starting on March 1, 2013. Click on the links below to learn more about the potential effects on your state. We will continue to share materials on the impact of the automatic spending cuts as it becomes available.
Alabama | Alaska | Arizona | Arkansas | California | Colorado | Connecticut | Delaware
District of Columbia | Florida | Georgia | Hawaii | Idaho | Illinois | Indiana | Iowa
Kansas | Kentucky | Louisiana | Maine | Maryland | Massachusetts | Michigan | Minnesota
Mississippi | Missouri | Montana | Nebraska | Nevada | New Hampshire | New Jersey
New Mexico | New York | North Carolina | North Dakota | Ohio | Oklahoma | Oregon
Pennsylvania | Rhode Island | South Carolina | South Dakota | Tennessee | Texas
Utah | Vermont | Virginia | Washington | West Virginia | Wisconsin | Wyoming

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APHL Staff Attend Presidential Address on Automatic Spending Cuts

Feb 19 2013 :: Published in Public Policy

By Peter Kyriacopoulos, Senior Director of Public Policy, APHL

President Obama Speaks on Sequestration

APHL’s executive director, Scott Becker, and senior director of public policy, Peter Kyriacopoulos, attended this morning’s Presidential address on the harm that will occur if Congress fails to act to stop the automatic spending cuts, or sequestration, scheduled for March 1, 2013 – only ten days from today.

The President reiterated that his top priority is to do everything possible to grow the economy and create good, middle-class jobs; he found it very troubling that Congress might allow a series of automatic, severe budget cuts to take place that will do the exact opposite.

The President said, “So these cuts are not smart. They are not fair.  They will hurt our economy.  They will add hundreds of thousands of Americans to the unemployment rolls.  This is not an abstraction — people will lose their jobs. The unemployment rate might tick up again.” The President specifically spoke about the impact that would be felt by first responders (police, fire and EMS) like those who joined him on the stage.

Nonetheless, without Congressional action that results from a compromise, including both reductions in federal spending and increases in taxes, these automatic cuts will occur and their impact will soon be felt – particularly as they reduce the federal funds provided to state and local governmental public health agencies and their laboratories.

The federal agencies that provide funding support for governmental public health laboratories routinely send the vast majority of their program accounts out to state and local governments – leaving only a minimal amount to manage internal operations. These same programs will be reduced most significantly because so little funding is spent on internal operations. It is not unreasonable to anticipate that funding reductions will be close to 10% come March 1, six months into federal fiscal year 2013.

This also adds to the already complicated funding picture, as the temporary spending measure currently funding federal governmental operations expires March 27, 2013. Congress has not been able to arrive at a compromise that would put in place appropriations bills to fund federal agencies.

If Congress allows the automatic cuts, they will then have almost 10% less funding available to resolve the differences in the funding levels that have already confounded them to the point of gridlock.

At this moment, it is very tough to determine a path forward that avoids the painful and ill-considered automatic spending cuts.

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Remembering Senator Inouye: A Public Health Hero

Dec 18 2012 :: Published in Public Policy

Senator Inouye

by Scott J. Becker, Executive Director, APHL

At the beginning of my career, I was fortunate to work with some great health policy leaders from the public health association community.  One of the first things I learned was that they always revered and spoke glowingly of Senator Daniel Inouye of Hawaii.  Being an inquisitive sort, I wanted to find out what was so special about this decorated war hero and man of the people of Hawaii.  I sat in on a few of his hearings and saw firsthand his gentle approach to his staff, his constituents and colleagues.  He wasn’t full of flowery language, and seemed as if he was a man of few words but many deeds.  A few years later, while working for the Association of Schools of Public Health, I was staffing the annual Hill Day and was assigned to staff the Dean of the School of Public Health from the University of Hawaii, Dean Jerrold Michael.  Turns out that he was close friends with Senator Inouye so I had an up close and personal meeting, not just the usual meet and greet.  Senator Inouye was someone who truly understood the public health mission and message.  He was intensely proud of his home state university and the work they were doing in public health.  He was personally aware of many of the initiatives ongoing in his state that improved the public’s health.  He was acutely aware because he secured its funding and was always checking in on how things were going.

Fast forward to 2007. I was taking my girls to the mall to burn off some energy on a cold winter Sunday.  As the girls ran around, I looked across the wide aisle and my eyes rested on an older man, sitting alone.  It was Senator Inouye, sitting quietly while his wife shopped.  A typical suburban scene.  My inner lobbyist came out and I darted towards him, reintroduced myself and told him how thankful we are in public health to have him on our side.  He smiled, nodded, and with a small twinkle in his eye, said that public health was really about the children and ensuring that they have a healthy future.  He graciously engaged my kids for a minute, and then was off with his wife – carrying all her purchases.  He was a regular suburban husband, who happened to be a war time hero, a champion of public health, and one of the great Senators of our day.

Thank you for leadership and passion, Senator Inouye.

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Nothing New: Sequestration Poses Serious Risk to Public Health

Oct 23 2012 :: Published in General, Public Policy

By Peter Kyriacopoulos, Senior Director of Public Policy, APHL

Congress’ frustration over its inability to effectively manage federal spending and the impact of that spending on the deficit is nothing new. The concept of imposing an automatic across-the-board spending cut once spending exceeded specific caps is nothing new. Designing this sequestration or automatic cut mechanism in such a way to encourage Congress to make appropriate decisions by providing an option that was deemed to be so objectionable that Congress would never let it occur is nothing new. Sequestration was part of the Balanced Budget and Emergency Deficit Control Act of 1985 – 26 years before the enactment of the Budget Control Act (BCA) of 2011. That law was primarily the product of three U.S. Senators: Phil Gramm, Warren Rudman and Ernest Hollings and is often referred to as Gramm-Rudman-Hollings.

Capitol Dome

In its most recent guise, as a condition for increasing the federal debt ceiling in 2011, Congress and the President agreed on the mechanics of the BCA which resurrected the Gramm-Rudman-Hollings concepts of spending caps and automatic cuts. The approaching January 2, 2013 deadline is generating considerable interest in the automatic cuts that begin on that date. One thing new included in the BCA is the creation of a special Congressional committee that was directed to produce legislation that would further reduce the federal debt by $1.2 trillion, or automatic cuts of the same amount would occur.

The BCA automatic cuts were designed to be so punitive and unacceptable that Congress would take definitive action to prevent them from ever happening – nothing new. The special Congressional committee was not able to reach agreement and produce an alternative proposal which has led to the likely imposition of the automatic cuts on January 2.

Because of this increased interest in the automatic cuts, most have forgotten the almost $1 trillion in federal spending reductions between 2012 and 2022 that are already being implemented through the spending caps included in the BCA. These caps reduced federal spending $62 billion in fiscal year 2013 and have created downward spending pressure on all federal agencies, including the Centers for Disease Control and Prevention (CDC) which supports the state and local governmental public health laboratories.

Beyond the current impact of the caps, the automatic cuts in federal spending will cause spending in fiscal year 2013 to be reduced by an additional $110 billion. These automatic cuts, will cause a $31 billion cut in domestic programs – like those operated by CDC – in fiscal year 2013 starting on January 2. There are many numbers being used to measure the size of this spending reduction, and it is not unreasonable to presume they will amount to a 10% reduction.

A reduction of this size in CDC’s funding for the governmental public health laboratory system will hit direct support for the system through the Epidemiology and Laboratory Capacity (ELC) program and through the Public Health Emergency Preparedness (PHEP) cooperative agreement; combined, these programs provide in excess of $100 million annually in direct laboratory support and a reduction on the order of $10 million will dramatically reduce the surveillance and detection capability of the laboratory system. This is before determining the amount of indirect spending by CDC on behalf of the laboratory system, which will likely be very similar.

A possible silver lining could be the timing of the PHEP and ELC grant awards, as both awards are scheduled for release later in the 2013 calendar year – conceivably giving Congress sufficient time to produce an alternative that stops the automatic cuts.

The ELC and PHEP grants are not the sole source of CDC’s direct and indirect work with the governmental public health laboratory system which includes collaborative work on newborn screening, environmental health, tuberculosis and HIV/AIDS. All of this work improves the public’s health and leads to better individual health outcomes and reduced health care expenditures by both public sector and private sector payers. It is unconscionable that the activities of CDC and its state and local governmental health laboratory partners is put being put at risk while Congress attempts to craft a solution to the size of the federal deficit. It is also reminiscent of another piece of history involving fiddles and Rome – nothing new.

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One World. One Health… and the Vector at Our Back Door

May 20 2012 :: Published in Annual Meeting, Environmental Health, Food Safety, Global Health, Infectious Diseases, Laboratory Systems and Standards, Newborn Screening and Genetics, Partners, Public Health Preparedness & Response, Public Policy

You don’t have to explain to public health laboratorians that the health of humans, animals and the environment are inextricably linked. HIV/AIDS, SARS, 2009 H1N1, West Nile Virus: laboratorians know the inner workings of these enterprising pathogens that travel (from jungle, field or suburban neighborhood, etc.) to animal hosts (chimpanzees, bats, birds, field mice, etc.) and on to us.

One World One HealthAnd they know that more of these smart bugs are coming our way. Population growth, climate change, deforestation, diminishing species diversity and changes in land use are all interfering with established patterns of interaction among people, animals and the environment. Vectors that were once in a distant forest are now at our back door. Already the majority of emerging infectious diseases affecting humans (approximately 75%) are of animal origin.

This dynamic has broad implications for public health as well as human medicine, veterinary medicine and environmental science. In a world where the interface between animals, humans and the environmental is in flux, it’s perilous for health and science professionals of any stripe to operate in professional silos. To protect the health of all species, those of us in public health must join with our colleagues in veterinary science, human medicine and environmental science to adopt a holistic approach to disease surveillance, detection and control. To put it simply, we must be about one health, not several.

At the 2012 APHL Annual Meeting, “one health” will be center stage. Participants will have the opportunity to meet leaders in the One Health movement – including James Hughes, MD; Lisa Conti, DVM, MPH; and Terry McElwain, DVM, PhD – and discuss actions required to operationalize One Health objectives. Here are a few questions to get you started with these discussions. How can we:

  • Expand and improve national and global surveillance networks, particularly those that capture the animal-human interface?
  • Enhance sentinel event coordination to detect and reduce environmental health threats?
  • Build efficient global reporting and sample submission systems to support surveillance systems?
  • Communicate the benefits of investment in surveillance? (Too often disease surveillance is viewed as an old-school public health function, one that’s not sexy enough to warrant sustained investment.)
  • More effectively employ animals as sentinels for human health—and humans as sentinels for animal disease risk?

For an introduction to the “one health” concept, see the websites of the One Health Initiative and CDC’s One Health Office.

And a parting thought: When was the last time you took your state veterinarian or your colleague in environmental science to lunch? It’s a small step, but remember: One Health is collaborative; you can split the check.

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APHL Members Take to the Hill

Mar 21 2012 :: Published in Public Policy

By Annie Carlin, Senior Specialist, Public Policy, APHL

It’s March!  Federal budget information is coming out fast and furiously.  First we had the President’s Budget Requests and Executive Agency Congressional Justifications.  Now we are starting to hear information from the House of Representatives on their proposed budget.  Amidst all the excitement, APHL members from California, New York, Iowa and Wisconsin along with APHL staff are heading to Capitol Hill on Thursday for our annual Hill Day.  We will be talking with members of Congress and their staff about public health laboratories and the importance of maintaining public health funding.  Because the country’s financial situation is, shall we say, less than ideal, it is more important than ever to advocate for funding for public health laboratories to ensure they  have what they need to accomplish their missions.

US Capitol South

APHL members will also be sharing stories from their states to emphasize the impact public health laboratory activities have on constituents.   For example, Public Health Emergency Preparedness (PHEP) funding has allowed the State Hygienic Laboratory at the University of Iowa to establish relationships with sentinel (clinical) laboratories, law enforcement agencies, HazMat teams and Civil Support Teams. These partnerships are vital to the safety of the citizens of Iowa with regard to terrorism response and public health emergencies.  PHEP is not unique to Iowa – awardees include all 50 states, four major metropolitan areas, and eight U.S. territories and freely associated states.

As we scheduled our appointments, it was heartening to hear that congressional staff members were happy to meet with us, and we were especially excited to be able to send APHL appropriations requests along to the congressional staff who work with the appropriate committees.

One exciting difference this year is that APHL made an effort to meet directly with Members of Congress in addition to their staff.  As of now, we will be meeting Senator Tom Harkin (D-Iowa) at his weekly breakfast this morning and we will be meeting with Congresswoman Doris Matsui (D-California) tomorrow morning.

Some of the programs we will be highlighting this year at Hill Day are:

The Laboratory Efficiencies Initiative (LEI)

President Obama requested that $20 million be appropriated to CDC for the Laboratory Efficiencies Initiative.  The goal is to build a sustainable public health laboratory system in the United States. State and local public health laboratories operate under intense pressures.  Deep budget cuts have affected their resilience and led to reduced laboratory testing capacity, termination of certain types of tests, and in some cases, impaired support to outbreak investigation, surveillance, and emergency response. The LEI will help public health laboratories fully implement and maintain efficient management practices, which are the foundation of a strong platform for current and future test services.

Public Health Laboratory Response

APHL members will advocate to increase CDC Public Health Emergency Preparedness (PHEP) funding for public health laboratories to prepare for and respond to all threats and to increase funding to CDC to expand public health laboratory outreach, training and coordination with sentinel clinical, including hospital, veterinary, food and environmental laboratories where threat agents may first be detected. Members will ask Congress to maintain current funding at CDC for laboratory response to incidents involving chemical threats and provide funding to CDC to improve states’ ability to detect radiological exposure in humans.

Infectious Disease Detection

APHL members will ask Congress to enhance the nation’s ability to respond to emerging disease outbreaks by increasing capacity-building at CDC, develop and deploy diagnostic tests to state and local public health laboratories, and provide technical assistance and training to state and local public health laboratory professionals.  They will ask for increased support for the Epidemiology and Laboratory Capacity (ELC) Program, to assist state laboratories and enhance national capacity to detect and prevent outbreaks of new infectious disease through the Emerging Infections Program.  HIV/AIDs funding and funding for TB laboratory infrastructure will also be highlighted.

Food Safety Surveillance

APHL members will highlight the crucial role public health laboratories play in foodborne disease surveillance and the detection of foodborne outbreaks.  Advances in testing methodologies and a highly-trained public health laboratory workforce coupled with key networks such as PulseNet and the Food Emergency Response Network (FERN) have resulted in the detection of a large number of nationwide outbreaks and subsequent food recalls.  Members will advocate for funding for the maintenance of PulseNet, which is the only national laboratory-based surveillance system in the United States that uses DNA fingerprinting technology to detect clusters of foodborne pathogens. Without this network, many large national outbreaks will never be detected.  Funding for FERN, which has been threatened in recent years with severe funding cuts and elimination, must also be maintained.  FERN provides critical surge capacity for nationwide food emergencies, ranging from natural disasters such as the Deepwater Horizon oil spill in the Gulf of Mexico in 2010 to inadvertent contamination of the food supply including the recent Listeriosis outbreak linked to cantaloupe.  APHL members will also advocate for funding to develop new technologies to respond to emerging threats, such as E. Coli O104 that sickened thousands of people in Europe, and to find new ways to conduct surveillance and detect outbreaks of pathogens given the increasing reliance on culture independent diagnostics.

Environmental Health and Biomonitoring

APHL will tell Congress that increased funding for EPA’s Homeland Security Laboratory will allow the Office of Emergency Management to maintain funding for the state chemical warfare agents program, restore support for the state radiological grant program, increase efficiency of electronic data exchange, and review, develop and validate methods for transfer to state and local labs.  They will ask that Congress provide EPA with $20 million to ensure continued function of the Water Laboratory Alliance (a nationwide laboratory network protecting our drinking water) to investigate areas to gain efficiency with regard to laboratory capacity across EPA, continue capability-building exercises related to the National Response Plan, develop and validate methods for transfer to local and state labs, build relationships between EPA, states and small water systems and to fund additional staff in the Water Security Division to carry out this work.  Members will also ask Congress to provide increased funding to CDC’s National Biomonitoring program and increased funding to support state programs, develop methods, conduct studies and issue reports on chemical exposures in people.

 

 

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Hinton State Laboratory Institute: Advocating for Crucial Public Health Funding

Feb 22 2012 :: Published in General, Public Policy

(Thank you to Senator Donnelly for his ongoing support of the Massachusetts state public health lab and for writing this thoughtful blog post.)

By Massachusetts State Senator Kenneth J. Donnelly, 4th Middlesex  District

I recently toured the Hinton State Laboratory Institute (HSLI), my state’s public health laboratory, accompanied by the Massachusetts Senate Committee on Ways and Means Chairman Stephen Brewer.  We met with Dr. Linda Han, the HSLI’s Director of Laboratory Services, and other interested stakeholders to learn about the multitude of services the HSLI provides to the residents of the Commonwealth, all on a shoestring budget.

Each year in reviewing the State’s budget and determining my budget priorities, I look for the line items that fund programs important to my district.  I look for the obvious – local aid, education funding, elderly services, programs we all know about – and the not so obvious.  The Hinton State Laboratory Institute (HSLI) is the perfect example of one of those not so obvious programs that is a crucial partner in keeping the Commonwealth safe.

The HSLI protects us from foodborne illnesses, communicable diseases and bioterrorism threats.  These are the folks that constantly monitor the mosquito population for West Nile Virus, ensuring that the only inconvenience we have from a mosquito bite is some mild itching as opposed to a potentially deadly virus.  They track movements of viruses and monitor the Commonwealth for outbreaks here at home.  They are on the front line of such diseases as tuberculosis and tracking, training and supporting medical personnel in the prevention and treatment of this serious illness.

One of the lab’s top priorities is keeping the public safe from contaminated food supplies.  Working with federal authorities, the HSLI tracks outbreaks of Salmonella and Listeria and removes contaminated foods from the market, ultimately keeping them off our families’ plates.

The Hinton State Laboratory Institute is one of only ten Level 1 Chemical Threat labs in the nation. Bioterrorism is a continuing threat in the U.S., and it is crucial that there are laboratories able to identify toxic elements threatening public safety.

The public health benefits that the HSLI provides are extensive; however, the services they are able to provide are in serious jeopardy. The lab is critically underfunded.  They have lost 26% of their staffing over the last five years, and the fiscal year 2013 budget will not provide the lab with adequate funding.   Many programs have been curtailed or cut altogether.

The doctors and researchers that Senator Brewer and I met with are tireless in their efforts to protect us from threats despite the shortage of staff and building resources.  The low level of funding is causing a major public safety concern.

This year, I will again make Hinton State Lab funding one of my top priorities.  Their service to our Commonwealth is invaluable and I will continue to advocate for increased funding, as well as bring awareness to how crucial the lab facility and staff are to protecting the people of Massachusetts.  I am fully committed to continuing my advocacy for the lab and fighting for the funding it deserves: for the safety of my district and all the residents of the state.

 

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In response to the State of the Union: What are the labs doing?

Jan 27 2012 :: Published in Environmental Health, Food Safety, Public Health Preparedness & Response, Public Policy

2012 State of Union

In his 2012 State of the Union address, President Obama described his vision for improving the economy, increasing employment and protecting the interests of the United States. The President also mentioned that he will continue his support for federal actions that protect children from mercury poisoning, ensure safe food and assure clean water (click here to see the portion of the State of the Union speech where the President says this). The nation’s governmental health laboratories play a critical role in the surveillance and detection of harmful air pollutants like mercury; contaminants like Salmonella in food and pesticide residues that have short and long-term health consequences; and pollutants in drinking water. How exactly?  Governmental health laboratories are:

  • Routinely monitoring food samples at retail stores and in the distribution chain to check for microbial pathogens and pesticide contaminants in a variety of commodities
  • Performing on-going characterization of bacterial isolates from ill people, submitting their fingerprints to the National PulseNet Database at CDC so that cases with indistinguishable patterns can be linked and investigated
  • Implementing the latest laboratory techniques to quickly and accurately confirm diagnoses, serotype isolates, and fully characterize linked  pathogens
  • Partnering with other food safety professionals who analyze laboratory findings, providing critical data to help solve outbreaks, determine root causes of contamination, and assess the impact of industry changes designed to prevent future illnesses
  • Monitoring and detecting environmental threats by conducting testing in people, air, water, soil and more
  • Conducting tests to support enforcement of water, air, food, dairy and environmental safety laws
  • Carrying out research to investigate illness trends and emerging contaminants such as pharmaceuticals
  • Conducting exposure studies to determine if environmental contaminants, such as mercury and lead, are getting into people
  • And responding to natural disasters, suspected terror events and industrial accidents, such as the 2010 Gulf Coast Oil Spill.

Beyond those items mentioned in President Obama’s State of the Union speech, labs are doing so much more:

  • They are detecting disease causing organisms and other harmful substances. The laboratories have innovative scientists that develop new methods to detect and fight infectious diseases, environmental pollutants and toxins. Remember the 2009 H1N1 pandemic? Public health laboratories tested thousands of specimens from patients and quickly provided results on whether or not a patient had H1N1 or some other form of influenza.
  • They are serving as integral members of national networks, such as the CDC’s Laboratory Response Network (LRN) where they prepare for, respond to and recover from all-hazard threats. Think anthrax 2001 – the public health laboratories in the LRN responded, testing thousands of specimens from patients as well as samples collected from the environment, and assuring first responders and the public that it was safe to reopen and enter buildings.
  • And they are providing training and conducting educational outreach to thousands of other laboratories, such as hospitals in their states. The hospitals know where to send potential threat samples and other items for specialized testing.

We are pleased to hear the President support important public health matters in this country. Mr. President, we assure you that laboratories at the state and local levels of government continue to demonstrate their ability to provide accurate and actionable information in all of these areas, and stand ready to continue their operations.

 

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