HHS Policy on the Use of Federal Funds Michele S. Walsh, M.Ed., CHES Associate Director for Policy and Communication Division of Population Health National.

HHS Policy on the Use of Federal Funds

Michele S. Walsh, M.Ed., CHESAssociate Director for Policy and Communication

Division of Population HealthNational Center for Chronic Disease Prevention and Health Promotion

Centers for Disease Control and Prevention

NOPREN Webinar, August 10, 2015

National Center for Chronic Disease Prevention and Health PromotionDivision of Population Health

OVERVIEW

Introduction and Background Policy and Public Health Overview of Federal Restrictions Tips for Reporting Questions and Closing

DISCLAIMERS The contents of this presentation have not been formally

disseminated by the Centers for Disease Control and Prevention and should not be construed to represent any agency determination or policy.

These materials are for training and instructional use only and are not intended as a substitute for professional legal or other advice.

These slides and discussion are only meant as general guidance. As each situation is unique, please do not rely on this as legal advice on any particular set of facts.

Organizations should consult appropriate legal counsel to ensure compliance with all rules, regulations, and restriction of any funding sources.

TRUE OR FALSE?

Educating the public on personal health behaviors and choices is an activity CDC is allowed to do through use of federal funds.

Note: Whether an activity is allowable or not will be determined by the facts of a specific situation. CDC advises caution regarding the use of federal funds for certain activities, and recommends awardees contact appropriate CDC officials BEFORE engaging in those activities.

True. This is an allowable activity.

TRUE OR FALSE?

State and local government grantees can work with their own state or local government’s legislative body on policy approaches to health issues, as part of normal executive-legislative relationships.

Note: Whether an activity is allowable or not will be determined by the facts of a specific situation. CDC advises caution regarding the use of federal funds for certain activities, and recommends awardees contact appropriate CDC officials BEFORE engaging in those activities.

True. This is an allowable activity.

TRUE OR FALSE?

State university grantees can work with their own state government’s legislative body on policy approaches to health issues, as part of normal executive-legislative relationships.

Note: Whether an activity is allowable or not will be determined by the facts of a specific situation. CDC advises caution regarding the use of federal funds for certain activities, and recommends awardees contact appropriate CDC officials BEFORE engaging in those activities.

False. This is an unallowable activity.

TRUE OR FALSE?

Non-government organization (NGO) grantees can present materials to elected officials relating to public policies that may require legislative or executive action that do not include an objective or balanced presentation of evidence.

Note: Whether an activity is allowable or not will be determined by the facts of a specific situation. CDC advises caution regarding the use of federal funds for certain activities, and recommends awardees contact appropriate CDC officials BEFORE engaging in those activities.

False. This is an unallowable activity.

GOVERNMENT’S ROLE?

“Government has a responsibility to implement effective public health measures that increase the information available to the public and decision makers, protect people from harm, promote health, and create environments that support healthy behaviors.”

– Thomas Frieden, N Engl J Med 2013

FACTORS THAT AFFECT HEALTH

Socioeconomic factors

Changing the contextTo make individuals’ default

decisions healthier

Long-lasting protective interventions

Clinicalinterventions

Counseling & education

LargestImpact

SmallestImpact

Examples

Poverty, education, housing, inequality

Fluoridation, 0g trans fat, iodization, smoke-free laws

Immunizations, brief intervention, cessation of treatment, colonoscopy

Medication for high blood pressure, high cholesterol, diabetes

Eat healthy, be physically active

POLICY AND PUBLIC HEALTH

Vehicle safety

Water fluoridation

Tobacco control

EVIDENCE-BASED STRATEGIES

Policy development is a core function of public health

Conduct rigorous analyses

Identify and report on strategies and policies

Educate the public and stakeholders Policy development and education are not lobbying

Federal law prohibits the use of federal funds to lobby at the federal, state or local level

SO, WHAT IS “POLICY”?

CDC defines “Policy” as a: Law, Regulation, procedure,

administrative action, Incentive, or Voluntary practice of governments

and other institutions.

POLICY DEVELOPMENT FRAMEWORK

Proceed with

caution!

RECENT INTEREST

Congress Government Accountability Office (GAO) Office of Inspector General (OIG) Other

KEY DOCUMENTS ON LOBBYING RESTRICTIONS WITH CDC AWARD DOLLARS

AR-12

Anti-Lobbying Restrictions

for CDC Grantees

Section 503, Appropriatio

ns Act

OMB Circulars

FY 2014 APPROPRIATIONS ACTSection 503 (a) and (b)

Prohibits lobbying city councils county commissions other local legislative bodies

Includes regulations and administrative actions by state and local executive orders

FY 2014 APPROPRIATIONS ACT Section 503(c)

“The prohibitions…include any activity to advocate or promote any … tax increase, or … requirement or restriction on any legal consumer product, including its sale or marketing … .”

FEDERAL ANTI-LOBBYING PROVISIONSUNDER SECTION 503

Even when operating within legal limits, there is a need for continuing attention to:

Policy positions

Congressional intent regarding the use of appropriations

Appropriateness of grantee activities

Direct lobbying by grantees: Grantees are restricted from using federal funds to attempt to influence deliberations or actions by Federal, state, or local legislative or executive branches

SNAPSHOT IN GENERAL:WHAT IS PROHIBITED?

Grassroots lobbying: No appropriated Federal funds can be used by CDC awardees for grassroots lobbying

SNAPSHOT IN GENERAL:WHAT IS PROHIBITED?

Non-government entities (NGOs) and public and private Institutions of Higher Education (IHEs), funded by CDC may engage in a range of policy-related activities

But the allowable activities for NGOs and public and private IHEs are more constrained than state and local government grantees according to regulations.

WHAT IS ALLOWED FOR NGOS?

AN EXAMPLE OF WHAT IS ALLOWED?

Compiling and communicating results of research on health issues and policy approaches

Conducting educational campaigns

AN EXAMPLE OF WHAT IS ALLOWED?

Balanced

Widely disseminat

ed

Avoid call to action

Upon formal, written request, providing public officials with technical advice (TA) or assistance concerning evidence of program or policy effectiveness. Under previous and new OMB regulations, all IHEs and NGOs need a formal documented request from the legislative body asking for the TA.

EXAMPLE OF WHAT IS ALLOWED?

• Presenting materials relating to public policies that may require legislative or executive action that:

Do not include an objective, balanced presentation of evidence, OR

That are only made available to allies or a narrow or selective audience.

EXAMPLE OF WHAT IS PROHIBITED?

Determined by the facts of a specific situation

CDC advises caution and recommends awardees contact appropriate CDC officials BEFORE engaging in those activities.

DO NOT ASSUME YOUR ACTIVITIES ARE ALLOWABLE BASED ON THE EXAMPLES

Are you using CDC funds or other federal funds for this activity?

Do you have a written invitation from the public official? What is the purpose of meeting with the official? Time:

When are activities planned/conducted?Adoption? Implementation?

Are CDC funded communications balanced, objective and widely disseminated?

CLARIFYING QUESTIONS

Ensure that progress reported reflects activities that were completed with federal resources (e.g. your PRC funds).

Attribution: Clarify “We” statements

Ensure language in report clearly describes the role, nature, and purpose of funded activities.

Where possible, focus progress report information on the impact or outcome of grantee activities.

Provide clarifying explanations to information that could be misunderstood.

Refer to the AR-12 and CDC Guidance documents for information on Anti-Lobbying restrictions and guidance on allowable and restricted activities.

REPORTING TIPS

Questions?

Michele S. Walsh, M.Ed., CHESAssociate Director for Policy and Communication

Email: [email protected]: 770-488-5173

National Center for Chronic Disease Prevention and Health Promotion

Division of Population Health