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109th Congress                                                   Report
                        HOUSE OF REPRESENTATIVES
 2d Session                                                     109-510

======================================================================



 
  AMENDING THE PUBLIC HEALTH SERVICE ACT WITH RESPECT TO THE NATIONAL 
     FOUNDATION FOR THE CENTERS FOR DISEASE CONTROL AND PREVENTION

                                _______
                                

 June 20, 2006.--Committed to the Committee of the Whole House on the 
              State of the Union and ordered to be printed

                                _______
                                

    Mr. Barton of Texas, from the Committee on Energy and Commerce, 
                        submitted the following

                              R E P O R T

                         [To accompany S. 655]

      [Including cost estimate of the Congressional Budget Office]

    The Committee on Energy and Commerce, to whom was referred 
the bill (S. 655) to amend the Public Health Service Act with 
respect to the National Foundation for the Centers for Disease 
Control and Prevention, having considered the same, report 
favorably thereon with an amendment and recommend that the bill 
as amended do pass.

                                CONTENTS

                                                                   Page
Amendment........................................................     2
Purpose and Summary..............................................     2
Background and Need for Legislation..............................     2
Hearings.........................................................     4
Committee Consideration..........................................     4
Committee Votes..................................................     4
Committee Oversight Findings.....................................     4
Statement of General Performance Goals and Objectives............     5
New Budget Authority, Entitlement Authority, and Tax Expenditures     5
Committee Cost Estimate..........................................     5
Congressional Budget Office Estimate.............................     5
Federal Mandates Statement.......................................     7
Advisory Committee Statement.....................................     7
Constitutional Authority Statement...............................     7
Applicability to Legislative Branch..............................     7
Section-by-Section Analysis of the Legislation...................     7
Changes in Existing Law Made by the Bill, as Reported............     7

                               Amendment

    The amendment (stated in terms of the page and line numbers 
of the introduced bill) is as follows:
    Page 2, line 19, insert ``at the end of the second 
sentence'' after ``period''.

                          Purpose and Summary

    S. 655 amends Section 399G of the Public Health Service Act 
(PHSA), the statute governing the National Foundation for the 
Centers for Disease Control and Prevention (CDC Foundation). 
The legislation makes several technical corrections and changes 
to Section 399G that, among other things, grant increased 
flexibility in the amounts of Federal funding and support 
services allocated to the CDC Foundation to compensate for the 
Foundation's administrative and operating expenses.

                  Background and Need for Legislation

    Authorized by Congress in 1992 and incorporated two years 
later, the CDC Foundation is a private, non-profit organization 
that supports the work of the CDC. In its eleven year history, 
the Foundation has raised more than $100 million in private 
funds to enhance the CDC's work. Donations to the CDC 
Foundation come from individuals, corporations, foundations, 
and other organizations. Along with private donations, the 
Federal government contributes $500,000 per year through the 
CDC to help cover the Foundation's operating expenses. Over the 
past five years, the CDC Foundation has raised an average of 
$15 million per year to boost the work of the CDC, representing 
a 30 to 1 return on CDC's $500,000 annual investment in the 
Foundation. The CDC Foundation uses donated funds to bring the 
flexibility of a non-profit organization to bear on the CDC's 
many efforts to improve health and safety.
    The CDC Foundation's mission statement is to help CDC ``do 
more, faster by forging effective partnerships between CDC and 
others to fight threats to health and safety.'' To this end, 
the CDC Foundation has managed more than 100 programs that have 
supported the CDC's work both in the United States and in over 
30 countries to fight deadly infections and other diseases that 
threaten the safety of U.S. citizens here and abroad. With an 
outstanding, internationally renowned Board of Directors taking 
its members from the corporate, philanthropic, educational, and 
public health sectors, the non-profit CDC Foundation brings 
accountability and flexibility to every private-sector 
partnership it builds on behalf of the CDC. Examples of such 
partnerships include:
     Lilly International Fellowships: A series of year-
long laboratory fellowships that bring laboratorians from other 
countries' ministries of health to learn from CDC laboratorians 
and build relationships to prepare for when disease in those 
countries threaten U.S. citizens.
     Corporate/CDC Roundtable on Global Health Threats: 
This CDC Foundation-based roundtable brings together the CDC 
Director and her leadership team with representatives of 10 
global corporations to develop joint approaches to detecting 
and responding to global health threats that threaten both U.S. 
citizens and economic activities. Members include top 
executives from corporations such as GE, General Motors, IBM, 
UPS, Coke, and Wal-Mart.
     Emergency Preparedness and Response Fund: After 9/
11 and the anthrax attacks, the CDC Foundation established a 
special fund that allows the CDC to respond with greater 
flexibility in future crises when existing government 
regulations may hinder CDC in doing all it can to save lives. 
The fund provides credit cards, made available by the Synovus 
Corporation, to the administrative leader of each of the 15 CDC 
teams that have been established to respond to national health 
threats. Credit cards provided by the fund were used by CDC 
experts in the field following Hurricane Katrina to purchase 
needed computers and printers.
     Emergency Operations Center: After 9/11, CDC 
Foundation Board member Bernie Marcus, co-founder of Home 
Depot, recognized the need for CDC to have a state-of-the-art 
Emergency Operations Center. He donated $4 million to the CDC 
Foundation as a challenge grant to encourage other United 
States corporations to help CDC build a world-class emergency 
operations center ``at the speed of business.'' The CDC 
Foundation quickly contacted corporations and raised over 
$400,000 worth of in-kind equipment donations from corporations 
like Dell, Motorola, and Shure. Because of the Marcus gift and 
other corporate donations, CDC's new Emergency Operations 
Center was able to open 6 months early, just in time to track 
and combat the spread of the deadly severe acute respiratory 
syndrome (SARS) virus.
     Management Academy for Public Health: Using $1 
million each from the Robert Wood Johnson Foundation, the 
Kellogg Foundation, CDC, and the Health Resources and Services 
Administration (HRSA), the Foundation supported the 
establishment of a new management academy to train mid-career 
leaders from State and local health departments in how to 
manage people, data, and dollars. The academy is now totally 
self-sufficient and continues to train hundreds of public 
health leaders from around the country each year.
     Mobile Breast Cancer Detection: Through a multi-
million dollar grant from Avon, the Foundation has purchased 
and placed mobile mammography screening vans to reach 
underserved women in multiple States around the country. 
Funding also supports a CDC scientist to evaluate the van 
placement programs and disseminate lessons learned about best 
practices that will help other such programs across the country 
be most effective and have the best chance of becoming self-
supporting.
     Field Disease Detection and Response Training 
Programs in Developing Countries: With privately-raised support 
from organizations like the World Bank, the Nuclear Threat 
Initiative, and the Ellison Medical Foundation, the CDC 
Foundation has enabled CDC to establish special disease 
detection and/or laboratory support programs in countries like 
Brazil, India, and Kenya that will help detect and control 
deadly infectious diseases that pose serious threats not only 
in those countries but in the United States as well.
    The annual operating costs for the CDC Foundation have 
climbed from $300,000 when it began in 1995 to nearly $3 
million in 2005. In 1995, CDC's $500,000 annual grant of 
support was sufficient to cover the Foundation's operations. 
However, this amount, which has been capped under current law 
since the Foundation's inception, no longer provides sufficient 
funds to allow the CDC Foundation to provide the kinds of 
support activities noted in the examples above. S. 655 will 
allow the CDC Director to support the work of the Foundation 
beyond the current $500,000 baseline to up to $1.25 million if, 
in the judgment of the CDC Director, an occasion arises that 
warrants such increase. Such support does not require an 
increased appropriation since funding would come from existing 
appropriations to the CDC Director's office. Such financial 
support, at most, would constitute approximately half of the 
current operating costs of the Foundation.
    The legislation also incorporates language that would allow 
the CDC to provide facilities, utilities, and support services 
to the Foundation if ``it is determined by the Director to be 
advantageous to the programs of such Centers.''
    Currently, privately supported fellows assigned to help CDC 
implement Foundation programs are artificially limited to two 
years each. This limitation creates program implementation 
problems for programs supported by private funding from 
organizations such as the Robert Wood Johnson Foundation and 
the Kellogg Foundation that sometimes run three or four years 
long. To remedy this, the legislation contains a provision 
linking the length of any privately supported fellowships to 
the duration of private funding for each such fellowship.

                                Hearings

    The Committee on Energy and Commerce has not held hearings 
on the legislation.

                        Committee Consideration

    On Thursday, June 8, 2006, the Subcommittee on Health met 
in open markup session and approved S. 655 for Full Committee 
consideration, without amendment, by a voice vote, a quorum 
being present. On Thursday, June 15, 2006, the Committee on 
Energy and Commerce met in open markup session and ordered S. 
655 reported to the House, amended, by a voice vote, a quorum 
being present.

                            Committee Votes

    Clause 3(b) of rule XIII of the Rules of the House of 
Representatives requires the Committee to list the record votes 
on the motion to report legislation and amendments thereto. 
There were no record votes taken in connection with ordering S. 
655, a bill to amend the Public Health Service Act with respect 
to the National Foundation for the Centers for Disease Control 
and Prevention, reported. A motion by Mr. Deal to order S. 655 
reported to the House, amended, was agreed to by a voice vote.

                      Committee Oversight Findings

    Pursuant to clause 3(c)(1) of rule XIII of the Rules of the 
House of Representatives, the Committee has not held oversight 
or legislative hearings on this legislation.

         Statement of General Performance Goals and Objectives

    The goals of S. 655 are to enhance the CDC Foundation's 
ability to assist the CDC and to increase the accountability of 
the Foundation.

   New Budget Authority, Entitlement Authority, and Tax Expenditures

    In compliance with clause 3(c)(2) of rule XIII of the Rules 
of the House of Representatives, the Committee finds that S. 
655, a bill to amend the Public Health Service Act with respect 
to the National Foundation for the Centers for Disease Control 
and Prevention, would result in no new or increased budget 
authority, entitlement authority, or tax expenditures or 
revenues.

                        Committee Cost Estimate

    The Committee adopts as its own the cost estimate prepared 
by the Director of the Congressional Budget Office pursuant to 
section 402 of the Congressional Budget Act of 1974.

                  Congressional Budget Office Estimate

    Pursuant to clause 3(c)(3) of rule XIII of the Rules of the 
House of Representatives, the following is the cost estimate 
provided by the Congressional Budget Office pursuant to section 
402 of the Congressional Budget Act of 1974:

                                     U.S. Congress,
                               Congressional Budget Office,
                                     Washington, DC, June 19, 2006.
Hon. Joe Barton,
Chairman, Committee on Energy and Commerce,
House of Representatives, Washington, DC.
    Dear Mr. Chairman: The Congressional Budget Office has 
prepared the enclosed cost estimate for S. 655, an act to amend 
the Public Health Service Act with respect to the National 
Foundation for the Centers for Disease Control and Prevention.
    If you wish further details on this estimate, we will be 
pleased to provide them. The CBO staff contact is Tim 
Gronniger.
            Sincerely,
                                          Donald B. Marron,
                                                   Acting Director.
    Enclosure.

S. 655--An act to amend the Public Health Service Act with respect to 
        the National Foundation for the Centers for Disease Control and 
        Prevention

    Summary: S. 655 would modify the Public Health Service Act 
to increase the amount of the grants the Department of Health 
and Human Services (HHS) is authorized to provide to the 
National Foundation of the Centers for Disease Control and 
Prevention (CDC) from $500,000 per year to $1.25 million per 
year. The bill also would increase the amount HHS can transfer 
to the Foundation from $500,000 to not less than $500,000 and 
not more than $1.25 million. S. 655 also would allow longer 
terms of voluntary service to be contributed from the 
Foundation to the CDC and would allow sharing of equipment and 
support services from the CDC to the Foundation.
    CBO estimates that implementing S. 655 would cost $1 
million in 2007 and $7 million over the 2007-2011 period, 
assuming appropriation and transfer of the authorized amounts.
    S. 655 contains no intergovernmental or private-sector 
mandates as defined in the Unfunded Mandates Reform Act (UMRA) 
and would not affect the budgets of state, local, or tribal 
governments. Enacting S. 655 would not affect spending or 
receipts.
    Estimated cost to the Federal Government: The estimated 
budgetary impact of S. 655 is shown in the following table. The 
costs of this legislation fall within budget function 550 
(health).

----------------------------------------------------------------------------------------------------------------
                                                                     By fiscal year, in millions of dollars--
                                                                 -----------------------------------------------
                                                                   2006    2007    2008    2009    2010    2011
----------------------------------------------------------------------------------------------------------------
                                        SPENDING SUBJECT TO APPROPRIATION

Spending Under Current Law:
    Estimated Authorization Level\1\............................       1       1       1       1       1       1
    Estimated Outlays...........................................       1       1       1       1       1       1
Propsoed Changes:
    Estimated Authorization Level...............................       0       2       2       2       2       2
    Estimated Outlays...........................................       0       1       2       2       2       2
Spending Under S. 655:
    Estimated Authorization Level\1\............................       1       2       2       2       2       2
    Estimated Outlays...........................................       1       2       2       2       2       2
----------------------------------------------------------------------------------------------------------------
\1\The 2006 level is the amount appropriated and transferred to the National Foundation for the CDC for that
  year.
Note.--Components may not sum to totals because of rounding.

    Basis of estimate: The National Foundation for the CDC is a 
not-for-profit entity that raises private funds to support the 
work of the CDC. Under current law, CDC may accept the services 
of an individual who receives financial support from the 
Foundation for a period of up to two years. S. 655 would 
eliminate that two-year restriction. The act also would allow 
the CDC to provide in-kind transfers and support services to 
the Foundation. Current law authorizes both the appropriation 
of $500,000 to the Foundation and the transfer to the 
Foundation of $500,000 from funds appropriated to HHS. S. 655 
would increase the authorized appropriation to $1.25 million a 
year, and would authorize the annual transfer from HHS of at 
lest $500,000 and no more than $1.25 million.
    In addition to the $500,000 that CBO expects will be 
transferred to the Foundation each year under current law, CBO 
estimates that S. 655 would cost $1 million in 2007 and $7 
million over the 2007-2011 period, assuming the appropriation 
and transfer of the necessary amounts.
    Intergovemental and private-sector impact: S. 655 contains 
no intergovernmental or private-sector mandates as defined in 
UMRA and would not affect the budgets of state, local, or 
tribal governments.
    Previous CBO estimate: On May 31, 2005, CBO transmitted a 
cost estimate for S. 655 as reported by the Senate Committee on 
Health, Education, Labor, and Pensions on April 27, 2005. That 
version of the legislation does not differ significantly from 
S. 655 as ordered reported by the House Committee on Energy and 
Commerce. CBO's previous estimate for S. 655 did not consider 
the increase in transfer authority as affecting the 
authorization of future appropriations. This estimate corrects 
that error. Accounting for that change increases the estimated 
cost of implementing S. 655 from $3.5 millions to $7 million 
over the relevant five-year periods, assuming appropriation and 
transfer of necessary funds.
    Estimate prepared by: Federal costs: Tim Gronniger. Impact 
on state, local, and tribal governments: Leo Lex. Impact on the 
private section: Meena Fernandes.
    Estimate approved by: Peter H Fontaine, Deputy Assistant 
Director for Budget Analysis.

                       Federal Mandates Statement

    The Committee adopts as its own the estimate of Federal 
mandates prepared by the Director of the Congressional Budget 
Office pursuant to section 423 of the Unfunded Mandates Reform 
Act.

                      Advisory Committee Statement

    No Advisory committees within the meaning of section 5(b) 
of the Federal Advisory Committee Act were created by this 
legislation.

                   Constitutional Authority Statement

    Pursuant to clause 3(d)(1) of rule XIII of the Rules of the 
House of Representatives, the Committee finds that the 
Constitutional authority for this legislation is provided in 
Article I, section 8, clause 3, which grants Congress the power 
to regulate commerce with foreign nations, among the several 
States, and with the Indian tribes.

                  Applicability to Legislative Branch

    The Committee finds that the legislation does not relate to 
the terms and conditions of employment or access to public 
services or accommodations within the meaning of section 
102(b)(3) of the Congressional Accountability Act.

             Section-by-Section Analysis of the Legislation


Section 1. National Foundation for the Centers for Disease Control and 
        Prevention; Acceptance of voluntary services; Federal funding

    Section 1(a) amends Section 399G(h)(2)(A) of the Public 
Health Service Act to clarify that any fellowship with the CDC 
Foundation will match the length of time the endowment for that 
project takes.
    Section 1(b) amends Section 399G(h)(7) of the Public Health 
Service Act to require the Foundation's annual reports to 
include an accounting of the use of funds transferred from the 
CDC to the Foundation for its operating expenses and that these 
reports be provided to the appropriate committees in Congress.
    Section 1(c) amends Section 399G(i) of the Public Health 
Service Act by requiring the CDC Director to transfer no less 
than $500,000 and not more than $1,250,000 to the Foundation 
for operating expenses.

         Changes in Existing Law Made by the Bill, as Reported

  In compliance with clause 3(e) of rule XIII of the Rules of 
the House of Representatives, changes in existing law made by 
the bill, as reported, are shown as follows (existing law 
proposed to be omitted is enclosed in black brackets, new 
matter is printed in italic, existing law in which no change is 
proposed is shown in roman):

             SECTION 399G OF THE PUBLIC HEALTH SERVICE ACT


SEC. 399G. ESTABLISHMENT AND DUTIES OF FOUNDATION.

  (a) * * *

           *       *       *       *       *       *       *

  (h) General Provisions.--
          (1) * * *
          (2) Authority for acceptance of voluntary services.--
                  (A) The Director of the Centers for Disease 
                Control and Prevention may accept, on behalf of 
                the Federal Government, any voluntary services 
                provided to such Centers by the Foundation for 
                the purpose of aiding or facilitating the work 
                of such Centers. [In the case of an individual, 
                such Director may accept the services provided 
                under the preceding sentence by the individual 
                for not more than 2 years.] In the case of an 
                individual, such Director may accept the 
                services provided under the preceding sentence 
                by the individual until such time as the 
                private funding for such individual ends.

           *       *       *       *       *       *       *

          (7) Reports.--
                  (A) Not later than February 1 of each fiscal 
                year, the Foundation shall publish a report 
                describing the activities of the Foundation 
                during the preceding fiscal year. Each such 
                report shall include for the fiscal year 
                involved a comprehensive statement of the 
                operations, activities, financial condition, 
                and accomplishments of the Foundation, 
                including an accounting of the use of amounts 
                provided for under subsection (i).

           *       *       *       *       *       *       *

                  [(C) The Foundation shall make copies of each 
                report submitted under subparagraph (A) 
                available for public inspection, and shall upon 
                request provide a copy of the report to any 
                individual for a charge not exceeding the cost 
                of providing the copy.]

           *       *       *       *       *       *       *

                  (C) The Foundation shall make copies of each 
                report submitted under subparagraph (A) 
                available--
                          (i) for public inspection, and shall 
                        upon request provide a copy of the 
                        report to any individual for a charge 
                        not to exceed the cost of providing the 
                        copy; and
                          (ii) to the appropriate committees of 
                        Congress.

           *       *       *       *       *       *       *

  (i) Federal Funding.--
          (1) * * *
          (2) Funding for grants.--
                  (A) For the purpose of grants under paragraph 
                (1), there is authorized to be appropriated 
                [$500,000] $1,250,000 for each fiscal year.
                  (B) For the purpose of grants under paragraph 
                (1), the Secretary may for each fiscal year 
                make available [not more than $500,000] not 
                less than $500,000, and not more than 
                $1,250,000 from the amounts appropriated for 
                the fiscal year for the programs of the 
                Department of Health and Human Services. Such 
                amounts may be made available without regard to 
                whether amounts have been appropriated under 
                subparagraph (A).

           *       *       *       *       *       *       *

          (4) Support services.--The Director of the Centers 
        for Disease Control and Prevention may provide 
        facilities, utilities, and support services to the 
        Foundation if it is determined by the Director to be 
        advantageous to the programs of such Centers.

           *       *       *       *       *       *       *