National Chlamydia CoalitionJanuary 26, 2012

Marc Garufi, Chief, Public Health BranchOffice of Management and Budget (OMB),

Executive Office of the President

*The following views are of the presenter only and do not represent the official position of the

Executive Office of the President.

Perspectives on OMB One of the interesting things about OMB is that it

is unexplainable to everyone who lives outside of the Beltway and misunderstood by nearly everyone who lives inside the Beltway.” Paul O'Neill, Former Treasury Secretary and OMB Deputy Director

“If I can get … support for my idea … it goes over to the supergod called the OMB. And they vote you down 9 times out of 10 just to show you who the boss is.” – Tommy Thompson, former HHS Secretary

OMB’s Mission Assists the President in overseeing the

preparation of the federal budget. Evaluates the effectiveness of agency programs,

policies, and procedures, assesses competing funding demands among agencies, and sets funding priorities.

Reviews agency reports, rules, testimony, and proposed legislation for consistency with the President's Budget.

Oversees and coordinates the Administration's procurement, financial management, information, and regulatory policies.

Budget Process Schedule

Executive Branch: September – February Congressional Branch: February - ?

Process: Budget Resolution; Authorizing Committees; Appropriations Committees

Key Players: HHS Secretary; Agency Head; OMB; White

House Councils; Stakeholders Congress: Members; staff; Stakeholders

CDC Budget 2008-2012

CDC’s 2012 Budget

STD Prevention 155 155 154School Health 40 40 30HIV/AIDS 759 760 756

FY 2010 Enacted

FY 2011 Enacted

FY 2012 Enacted

Sexual Health Funding

Health Reform: Public Health Coverage/access expansion from bottom up (Medicaid) to

middle down (Exchanges) Expansion of Preventive Benefits under Health Reform How does Public Health Change after Health Reform? In

2012, more questions than answers: Can S/L Health Departments become more like provides (e.g., billing,

electronic health records)? How significant is shift away from direct services (e.g., immunizations)? How to define Preventive Benefits? What about in case of

communicable diseases? What is public health’s continued role in assisting individuals with

connective/support services? How will public health’s role change for emergency/emerging health

crisis?

Budgeting for Public Health Post Reform Budget Control Act

Discretionary Caps Sequestration

Federal Spending for Safety Net State Budgets Federal Elections