March 3, 2017

The Honorable Donald J. Trump President of the of America The White House 1600 Pennsylvania Avenue, NW Washington, DC 20500

Dear President Trump:

On behalf of the more than 500 undersigned organizations, we are writing to warn of the dire consequences of repealing the Prevention and Public Health Fund (the Prevention Fund), authorized under the Affordable Care Act. Repealing the Prevention Fund without a corresponding increase in the allocation for the Labor-Health and Human Services-Education appropriations bill would leave a funding gap for essential public health programs, and could also foretell deep cuts for other critical programs funded in the bill.

Today, more than 12 percent of the Centers for Disease Control and Prevention (CDC) budget is supplied through Prevention Fund investments. This includes core public health programs that provide essential funds to help states keep communities healthy and safe, such as the 317 immunization program, epidemiology and laboratory capacity grants, the entire Preventive Health and Health Services (Prevent) Block Grant program, cancer screenings, chronic disease prevention and other critically important programs. For example, the Prevent Block Grant provides all 50 states, the District of Columbia, two American Indian tribes, and eight U.S. territories with flexible funding to address their unique public health issues at the state and community level.

Despite the growing and geographically disparate burden of largely preventable diseases, health threats such as the opioid epidemic, and emerging infectious disease outbreaks such as the Zika virus, federal disease prevention and public health programs remain critically underfunded. Public health spending is still below pre-recession levels, having remained relatively flat for years. The CDC’s budget authority has actually decreased by 11.4 percent since FY 2010 adjusted for inflation, and the Prevention Fund has helped to make up the difference.

Discretionary programs, including public health, education, and job training programs funded through the Labor-Health and Human Services-Education (LHHS) appropriations spending bill have been cut dramatically and disproportionately in recent years as lawmakers have worked to reduce the deficit, even though experts across the political spectrum agree these programs are not a driving factor behind our nation’s mid- and long term fiscal challenges. Eliminating the Prevention Fund would be disastrous to the CDC budget and programs, and to the LHHS bill as a whole, leaving a nearly $1 billion budget hole which would be impossible to fill under current discretionary spending caps.

Funding prevention not only saves lives but it saves money. A comprehensive study of evidence-based prevention programs found that every dollar invested yields $5.60 in savings. There are many provisions of the Affordable Care Act aimed at promoting health and prevention, but the Prevention Fund is particularly important – a dedicated investment in prevention and public health activities to counteract the much larger bill – $3.2 trillion and growing – we pay every year as a country to treat illness and disease.

We urge you to maintain funding made possible by the Prevention and Public Health Fund and safeguard funding for the CDC and other programs under the Labor-HHS-Education spending bill.

Sincerely,

1965 American Association on Health and Disability Ability360 American Cancer Society Cancer Action Network Academy of Geriatric Physical Therapy American College of Cardiology Academy of and Dietetics American College of Clinical Pharmacy Action for Healthy Kids (AFHK) American College of Preventive Medicine Active Living By Design American College of Sports Medicine Active Transportation Alliance American Council on Exercise Ad Hoc Group for Medical Research American Diabetes Association ADAP Advocacy Association (aaa+) American Federation of State, and Addiction Connections Resource Municipal Employees Adult Congenital Heart Association American Foundation for Suicide Prevention Advancement Project California American Heart Association Advocate Good Shepherd Hospital American Immunization Registry Association Advocates for Better Children's Diets American Indian/Alaska Native/Native Hawaiian African American Health Alliance APHA Caucus AIDS Alliance for Women, Infants, The American Academy of HIV Medicine Children, Youth & Families American Lung Association The AIDS Institute American Medical Student Association AIDS Research Consortium of Atlanta American Organization of Nurse Executives AIDS United American Psychological Association Allamakee County Public Health American Public Health Association American Academy of HIV Medicine American School Health Association American Academy of Pediatrics American Sexual Health Association American Association for Dental Research American Society for Nutrition American Association for the Study of American Society of Hematology Liver Diseases American Society of Tropical Medicine & Hygiene American Association of Colleges of Nursing American STD Association American Association of Colleges of Pharmacy American Thoracic Society American Association of Naturopathic Ann & Robert H. Lurie Foundation Physicians APICAT for Healthy Communities American Association of Neuromuscular & APLA Health Electrodiagnostic Medicine The Arc Arizona Center for Law in the Public Interest Big Cities Health Coalition Arizona Health Care Association Alliance for Community Health Arizona Medical Association Boston Public Health Commission The Arizona Partnership for Immunization Boston Senior Home Care Arizona Public Health Association School of Public Health Arizona Rural Health Association Boulder County Public Health Arkansas Public Health Association The Bronx Health Link Asian & Pacific Islander American Bronx Health REACH Health Forum California Public Health Association-North Asian Services In Action California WIC Association Association for Clinical and Translational California WIC Association Science Cambridge Health Alliance Association for Prevention Teaching Campaign for Tobacco-Free Kids and Research Camptonville Community Partnership Association for Professionals in Cancer Council of the Pacific Islands Infection Control and Epidemiology Canyon Ranch Center for Prevention & Association of Accredited Naturopathic Health Promotion Medical Colleges Cedar County Public Health Association of Accredited Public Health Center for Behavioral Epidemiology & Programs Community Health Association of American Cancer Institutes Center for Health and Learning Association of American Medical Colleges Center for Health Promotion and Disease Prevention Association of Community Health Nursing Center for Science in the Public Interest Educators Center in the Park Association of Maternal & Child Health Central California Asthma Collaborative Programs Central Jersey Family Health Consortium Association of Montana Public Health Officials Central Michigan District Health Department Association of Public Health Laboratories Central Michigan Regional Rural Health Network Association of Public Health Nurses Centralina Area Agency on Aging Association of Centro Multicultural La Familia Professionals Cerro Gordo County Department of Public Health Association of Schools and Programs of Chalk Talk Science Project Public Health ChangeLab Solutions Association of State and Territorial Health Commons Officials Childhood Prevention Coalition (WA State) Association of State Public Health Nutritionists Children and Adults with Attention Deficit Association of University Centers on Hyperactivity Disorder (CHADD) Disabilities Children's Environmental Health Network Asthma and Allergy Foundation of America Children's Health Fund Atrius Health Children's Mental Health Network Authority Health City-County Health District Barnes ON THE MOVE Partnership Clinical Research Forum Behavioral Health Leadership Institute Coalition for Clinical and Translational Science Benzie Leelanau District Health Department Coalition for Health Funding (Benzonia, MI) Coalition for Healthy School Food Berean Wellness & Community Support Center Coconino County Public Health Services District College of Public Health and Human Sciences, Dorchester County Health Department Oregon State University Duxbury Council On Aging Colorado Association of Local Public Health Dystonia Medical Research Foundation Officials Early Impact Virginia Colorado Association of School Nurses Edna Bennett Pierce Prevention Center, Colorado Children's Immunization Coalition Penn State University Colorado Public Health Association Ehrens Consulting Commissioned Officers Association of the Elder Options U.S. Public Health Service, Inc. 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National Recreation and Park Association NAPHSIS: National Association for National Resource Center on Domestic Violence Public Health Statistics and Information Systems The National Viral Hepatitis Roundtable Nashville CARES National WIC Association National AHEC Organization Native Health National Alliance of State & Territorial AIDS NC SOPHE Advocacy Committee Directors Nebraska Association of Local Health Directors National Alopecia Areata Foundation Nemours Children's Health System National Association for Health and Fitness NephCure Kidney International National Association of Area Agencies on Nevada Public Health Association Aging Wellness Foundation National Association of Chronic Disease New Jersey Public Health Association Directors New Mexico Public Health Association National Association of Counties The New York Academy of Medicine National Association of County and City New York State Association of County Health Officials Health Officials Newington Senior and Disabled Center National Association of School Nurses NICHQ (National Institute for Children's Health Quality) National Association of Social Workers NIRSA: Leaders in Collegiate Recreation National Birth Defects Prevention Network NJ YMCA State Alliance National Birth Equity Collaborative North American Quitline Consortium National Blood Clot Alliance North Carolina Alliance for Health National Center for Disaster Preparedness North Carolina Society of Public Health Education National Center for Health Care Northern Illinois Public Health Consortium The National Commission for Health Nurse of South Carolina Education Credentialing, Inc OASIS Institute National Coalition for Promoting Physical Ohio Public Health Association Activity Oklahoma Public Health Association National Coalition of STD Directors Olympic Area Agency on Aging ON THE MOVE, a community public Rural Center for AIDS/STD Prevention at the health partnership IU School of Public Health Bloomington Oregon Public Health Association S2AY Rural Health Network, Inc. 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Preventive Cardiovascular Nurses Association Senior Resources - Agency on Aging Primary Care Development Corporation Senior Services of Snohomish County Primary Care Medicine & Public Health Senior Services of Southeastern Virginia Synergy SeniorsPlus Prism Health North Texas Sexuality Information and Education Council of the U.S. Project Inform Shelby County Schools Coordinated School Health Project Mend-A-House Shoals Community Clinic Promoting Healthy Sickle Cell Disease Association/PDVC Protecting Arizona's Family Coalition Sigma Xi, The Scientific Research Honor Society Public Health Advocates Sleep Research Society Public Health Association of Nebraska Society for Public Health Education Public Health Association of New York City Society for the Advancement of Violence and Injury Public Health Delta & Menominee Counties Research (SAVIR) Public Health Foundation The Society for Healthcare Epidemiology of America Public Health Institute Society of Behavioral Medicine Public Health Solutions South Alabama Regional Planning Commission Pulmonary Fibrosis Advocates South Carolina Tobacco-Free Collaborative Pulmonary Hypertension Association Southeast Ohio Breastfeeding Coalition PureView Health Center Southern California Public Health Association Quality Home Care Services Southern California Society for Public Health Education Racial and Ethnic Health Disparities Coalition Southern HIV/AIDS Strategy Initiative (SASI) Rails-to-Trails Conservancy Southwest Human Development, Inc. 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