Prevention Matters

The three committees in the U.S. House of Representatives that are crafting a health reform bill today released a "discussion draft" of the legislation they are about to propose. The 852- page discussion draft is designed to provide “quality affordable health care for all Americans and controls health care cost growth." In brief, provisions in the discussion draft would:

• Expand the capacity of two independent, advisory task forces — the U.S. Preventive Services Task Force (USPSTF) and the Task Force on Community Preventive Services (TFCPS) — to undertake rigorous, systematic reviews of existing science to recommend the adoption of proven and effective services.
• Provide new investments in the science of prevention to further expand the base of information available for evaluation by the task forces.
• Deliver clinical preventive services by including USPSTF‐recommended services in Medicaid and insurance available in the Health Insurance Exchange.
• Eliminate cost‐sharing on recommended preventive services delivered by Medicare, Medicaid, and insurance available in the Health Insurance Exchange.
• Deliver community preventive services by investing in state, territorial, and local public health infrastructure andby providing grants to implement TFCPS‐recommended services.

Meanwhile, here's a more detailed rundown of provisions within Title III, which covers the creation of the Prevention and Wellness Trust Fund and program allocations. The key provisions include:

(Section 2301; page 797) Establishes Prevention and Wellness Trust funded at $2.4 Billion in FY2010 and rising to $3.5 Billion in FY2014. The trust makes funding available for the following areas:

• $30 million in each of FY 2010-2014 to fund the activities of the Clinical and Community Preventive Services Task Force.
• $100 million in FY 2010 for prevention and wellness research and rising to $300 million in FY2014.
• $1.1 billion in FY 2010 for community-based prevention and wellness services and rising to $1.6 billion in FY2014.
• $800 million in FY2010 for core public health infrastructure and activities for state and local health departments rising to $1.3 Billion in FY2014.
• $350 million in each of FY2010-2014 for core public health infrastructure and activities for CDC.

(Section 3121; Page 800) Prevention and Wellness Strategy. A national strategy to improve the Nation’s health through evidenced-based clinical and community-based prevention and wellness activities, including core public health infrastructure improvement activities. Strategy will work to address unmet prevention and wellness needs AND unanswered research questions on prevention and wellness.

(Section 3131, page 802) Task Force on Clinical Preventive Services. Revises and strengthens the Task Force under the authority of the Agency for Healthcare Research and Quality. Authority will include a clinical prevention stakeholders board to advise the Task Force on developing, updating, publishing, and disseminating evidence-based recommendations on the use of clinical preventive services.

(Section 3132, page 807) Task Force on Community Preventive Services. Codifies in Federal statute, under the CDC, a permanent task force to review scientific evidence related to the benefits, effectiveness, appropriateness, and costs of community preventive services for the purpose of developing, updating, publishing, and disseminating evidence-based recommendations on the use of community preventive services. A community prevention stakeholders board is established to advise the Task Force on developing, updating, publishing, and disseminating evidence-based recommendations on the use of community preventive services

Subtitle D – Prevention and Wellness Research

(Section 3141, page 813) Requires that prevention and wellness research undertaken by CDC and NIH be informed by the national prevention strategy and the Task Force (Preventive/Community)recommendations.

(Section 3142, page 813) Authorizes CDC to make prevention and wellness research grants.

(Section 3151, page 814) Authorizes CDC to make community-based prevention and wellness services grants. 50% of funding is reserved for services “whose primary purpose is to achieve a measurable reduction in one or more health disparities.”

(Section 3161, page 818) Authorizes a new program of Core Public Health Infrastructure and activities for State and local health departments.

(Section 3162, page 822) Authorizes a program of Core Public Health Infrastructure and Activities for the CDC.