Update: Final Fiscal Year 2022 Labor, HHS-ED Appropriations Bill Summary and Highlights
March 09, 2022
Updated March 11, 2022: Congress approved a revised version of the Consolidated Appropriations Act (H.R. 2471), which provides funding for the remainder of FY22 and averts a government shutdown. The updated version of H.R. 2471 does not include COVID-19 emergency supplemental funding after some House Democrats raised concerns about rescinding $7 billion COVID-19 relief funds allocated for state and local governments as one of the ways to pay for the emergency supplemental bill. Due to the removal of the COVID-19 supplemental funding from the final bill, it is unclear how Congress will get this funding approved, as there is no clear must-pass legislative vehicle in the near future. The ASTHO government affairs team will continue to monitor these developments closely.
Overall, the updated bill includes $8.5 billion for the Centers for Disease Control and Prevention (CDC), $8.9 billion for the Health Resources and Services Administration (HRSA), $3.2 billion for the Office of the Assistant Secretary for Preparedness and Response (ASPR), and $6.5 billion for the Substance Abuse and Mental Health Services Administration (SAMHSA).
President Biden is expected to sign this bill into law.
H.R. 2471 – Consolidated Appropriations Act, 2022
Labor, Health and Human Services, Education, and Related Agencies
Public Health Funding Highlights
Medicaid Funding for the U.S. Territories
- The bill includes an extension of the federal medical assistance percentage (FMAP) for the U.S. territories through Dec. 13, 2022, at 76% for Puerto Rico and 83% for the other territories.
- The bill also includes an increase in funding for Puerto Rico of $200 million for fiscal year 2022. The bill requires the Secretary of HHS to certify that a reimbursement floor is established for covered physician services under Medicare part B.
- The bill also requires a report on procurement processes and standards used for contracting under the Medicaid program by Dec. 1, 2022.
Centers for Disease Control and Prevention
This bill includes $8.5 billion in total for CDC, an increase of $582 million above FY21. Highlights of the bill include:
- $200 million new line item to fund public health infrastructure and capacity. The agreement establishes a new funding line to provide a stable source of resources that is not segmented by disease, condition, or activity. The agreement recognizes that the nation's public health partners need to be better equipped and more flexible to coordinate to save lives. The agreement directs that no less than 70 percent of this funding be awarded to health departments.
- $61 million, an increase of $5 million, for public health workforce initiatives.
- $8 million, a $5 million increase, for social determinants of health.
- $715 million, a $20 million increase, for the Public Health Emergency Preparedness Cooperative Agreement.
- $160 million, level funding for the Preventive Health and Health Services Block Grant.
- $100 million, an increase of $50 million, to modernize public health data surveillance and analytics at CDC, state, and local health departments. The agreement commends CDC for the progress made to date and includes an increase to advance efforts toward creating a modern, high-speed, networked public health infrastructure that will work for all diseases and conditions. The agreement recognizes that this effort is not solely about technological upgrades or about short-term solutions.
- $650 million, a $37 million increase, for the Section 317 Immunization Program.
- $20 million, a $10 million increase, for the Infectious Disease Rapid Response Reserve Fund.
- $195 million, a $20 million increase, for the Ending HIV Epidemic Initiative.
- $182 million, a $10 million increase, for antibiotic resistance.
- $54 million, a $12 million increase, for vector-borne diseases.
- $83 million, a $20 million increase, for safe motherhood and infant health programs.
- $30.5 million, a $10 million increase, for Alzheimer's Disease programs.
- $177 million, a $9.25 million increase, for birth defects, developmental disabilities, and health programs.
- $228 million, a $5.5 million increase, for the National Center on Environmental Health. This includes $10 million (level funding) for the Climate and Health program.
- $20 million, an $8 million increase, for suicide prevention
- $12.5 million, equal to level funding, to conduct research on firearm injury and mortality prevention.
- $491 million, an increase of $15 million, for opioid overdose prevention and surveillance.
- $647 million, a $54 million increase, for global health.
- $80.5 million, a $2.5 million increase, for the Agency for Toxic Substances and Disease Registry.
In addition to funding, the bill includes the following report language for CDC:
- COVID-19 tests. Directs the Secretary of HHS to establish a task force, including participation from outside stakeholders, to evaluate the shortcomings of the first COVID-19 tests and what policies, practices, and systems should be established to address these issues in the future.
- Local health department funding. The bill includes a direction that urges CDC to publicly track and report to the Committees how funds provided to state health departments are passed through to local health departments, including the amount per grant award by the local jurisdiction.
- Rural Health. The bill requests CDC to assess and submit a report within 180 days of enacting this bill on the agency's rural-focused efforts and strengthening such efforts.
Assistant Secretary for Preparedness and Response (ASPR)
The bill includes a total of $3.2 billion for ASPR, an increase of $352 million above FY21. This funding includes:
- $300 million, an increase of $13 million, for pandemic influenza.
- $745 million, an increase of $148 million, for the Biomedical Advanced Research and Development Authority (BARDA).
- $780 million, an increase of $10 million, for Project BioShield.
- $845 million, an increase of $140 million, for the Strategic National Stockpile.
- $21 million, an increase of $15 million, for the Regional Ebola and Other Special Pathogen Treatment Centers.
- $295 million, an increase of $15 million, for Hospital Preparedness formula grants.
This bill includes $6.5 billion for SAMHSA, an increase of $530 million above FY21. Highlights include:
- $2 billion, an increase of $288.8 million, for mental health, including a $100 million increase to the Mental Health Block Grant.
- $120 million, an increase of $13 million, for Project Aware.
- $81.8 million, an increase of $10 million, for the National Child Traumatic Stress Initiative.
- $101.6 million, an increase of $77.6 million, for the Suicide Lifeline to support implementing the Lifeline's new 9-8-8 number.
- $5 million to create a new Behavioral Health Crisis and 988 Coordinating Office.
- $38.8 million, an increase of $2.3 million, for Garrett Lee Smith Youth Suicide Prevention grants.
- $3.9 billion, an increase of $99.8 million, for substance use treatment. This includes funding for opioid prevention and treatment, recovery, and tribal-focused treatment efforts.
- $1.85 billion, an increase of $50 million, for the Substance Abuse Prevention and Treatment Block Grant.
- $1.53 billion, an increase of $25 million, for State Opioid Response Grants.
- $34.9 million, an increase of $2 million, for Pregnant and Postpartum Women.
- $13 million, an increase of $3 million, for Building Communities of Recovery.
- $101 million, an increase of $10 million, for Medication Assisted Treatment
- $218.2 million, an increase of $10 million, for substance abuse prevention.
- $127.4 million, an increase of $8 million, for the Strategic Prevention Framework.
- $12 million, an increase of $2 million, for the Sober Truth on Preventing Underage Drinking.
This bill includes $8.9 billion for HRSA, an increase of $1.4 billion above FY21 levels. This funding includes:
- $1.7 billion, an increase of $65 million, for community health centers.
- $1.3 billion, an increase of $72 million, for the bureau of health professions. This includes $24 million, an increase of $8 million for the Substance Use Disorder Treatment and Recovery Loan repayment program.
- $286.8 million, level funding, for Title X family planning.
- $366 million, an increase of $37 million, for rural health.
- $2.5 billion, an increase of $71 million, in the Ryan White HIV/AIDS program and specifically $125 million an increase of $20 million for the Ending the HIV Epidemic Initiative.
- $748 million, an increase of $35 million, for the Maternal and Child Health Block Grant.
Office of the Secretary
This bill includes $571 million for the Office of the Secretary, an increase of $20.5 million above FY21 levels. This funding includes:
- $64.8 million, an increase of $3 million, for the Office of Minority Health.
- $56.9 million, an increase of $1.5 million, for the Minority HIV/AIDS Initiative.
- $38.1 million, an increase of $3 million, for the Office on Women's Health
- $5 million, equal to the FY21 enacted level, for the KidneyX program.
This bill includes $6.2 billion ($3.3 billion in discretionary funding and $2.9 billion from user fees) for the FDA, an increase of $102 million above FY21 levels.
- This funding includes an increase of $29 million to address the opioid crisis, medical supply chain surveillance, rare cancers, and increasing inspections of foreign drug manufacturers.
- In addition, there is an increase of $29.5 million to respond to food outbreaks, improve the animal food inspection system, and address heavy metals in baby food.
In addition to funding, the bill includes the following report language for the FDA:
The bill includes language that would give the FDA authority to regulate any tobacco product containing nicotine that is not made or derived from tobacco. The bill also requires products containing nicotine from other sources that are also being marketed in the United States to file an application seeking authorization for their products to remain on the market within 60 days of the bill's enactment. Products not authorized within 120 days of the bill's enactment would be considered illegal.