39–010

Calendar No. 140

109TH CONGRESS REPORT " SENATE ! 1st Session 109–91

AMENDING THE PUBLIC HEALTH SERVICE ACT WITH RESPECT TO THE NATIONAL FOUNDATION FOR THE CENTERS FOR DISEASE CONTROL AND PREVENTION 

JUNE 27, 2005.—Ordered to be printed 

Mr. ENZI, from the Committee on Health, Education, Labor, and 

Pensions, submitted the following 

R E P O R T 

[To accompany S. 655]

The Committee on Health, Education, Labor, and Pensions, to 

which was referred the bill (S. 655) to amend the Public Health 

Service Act with respect to the National Foundation for the Centers for Disease Control and Prevention, having considered the 

same, reports favorably thereon with an amendment in the nature 

of a substitute and recommends that the bill (as amended) do pass.

CONTENTS 

Page 

I. Purpose and summary of the bill ................................................................. 1

II. Background and need for the legislation ..................................................... 2

III. Legislative history and committee action .................................................... 3

IV. Explanation of bill and committee views ..................................................... 3

V. Cost estimate .................................................................................................. 4

VI. Application of law to the legislative branch ................................................ 5

VII. Regulatory impact statement ........................................................................ 5

VIII. Section-by-section analysis ............................................................................ 6

IX. Changes in existing law ................................................................................ 6

I. PURPOSE AND SUMMARY OF THE BILL

S. 655 makes several technical corrections and improvements to 

Section 399G of the Public Health Service Act (PHSA), which established the National Foundation for the Centers for Disease Control and Prevention (CDC Foundation). Most significantly, these 

corrections assure that the Foundation receives funds and support 

services from the Centers for Disease Control and Prevention 

(CDC) to support the CDC Foundation’s administrative and operating expenses. 

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II. BACKGROUND AND NEED FOR THE LEGISLATION

The Foundation is a private, not-for-profit foundation established 

by Congress to raise private funds to support the work of the CDC. 

Authorized in 1992 and incorporated as a nonprofit organization in 

Georgia 11 years ago, the Foundation during its brief history has 

raised more than $100 million to augment CDC’s efforts. Over the 

past 5 years the Foundation has raised on average $15 million per 

year to support initiatives at CDC. This represents a 30:1 return 

on CDC’s $500,000 per year investment in the CDC Foundation. 

The funds the CDC Foundation raises in support of CDC bring the 

flexibility of a non-profit organization to build effective partnerships between CDC and private sector corporations, foundations 

and individuals to improve health and safety around the world. 

The Foundation has managed more than 100 programs that have 

helped CDC do more and faster work in this country and in more 

than 30 countries on five continents to fight deadly infectious and 

other diseases that threaten the safety and well-being of U.S. citizens here and abroad. With an outstanding internationally renowned Board of Directors from the corporate, philanthropic, educational and public health sectors, the non-profit CDC Foundation 

brings accountability and flexibility to every private-sector partnership it builds on behalf of CDC. Examples of such partnerships include: 

1. Lilly International Fellowships: A series of year-long laboratory fellowships that bring laboratorians from other countries’ ministries of health to learn from CDC laboratorians and 

build relationships to prepare for when diseases in those countries threaten U.S. citizens. 

2. Corporate/CDC Roundtable on Global Health Threats:

This CDC Foundation-based roundtable brings together the 

CDC Director and her leadership team with representatives of 

10 global corporations to develop joint approaches to detecting 

and responding to global health threats that threaten U.S. citizens and each corporations’ bottom line. Members include top 

executives from such corporate leaders as GE, General Motors, 

IBM, UPS, Coke and Wal-Mart. In its first meeting CDC and 

the corporate members agreed to begin exchanging disease surveillance data that should help both CDC and the corporations 

do their respective jobs better.

3. Emergency Preparedness and Response Fund: After 9/11 

and the anthrax attacks, the CDC Foundation established a 

special fund that enables CDC to respond with greater flexibility during future crises when existing government regulations might not be sufficient to enable CDC to do all it can as 

possible to save lives. The fund provides credit cards, made 

available by the Synovus Corporation, to the administrative 

leader of each of the 15 CDC teams that have been established 

to respond to national health threats. 

4. Emergency Operations Center: After 9/11 CDC Foundation 

Board member Bernie Marcus, a co-founder of Home Depot, 

recognized the need for CDC to have a state-of-the-art Emergency Operations Center. He donated $4 million to the CDC 

Foundation as a challenge grant to encourage other United 

States corporations to help CDC build a world-class emergency 

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operations center ‘‘at the speed of business.’’ The CDC Foundation quickly contacted corporations and raised over $400,000 

worth of in-kind equipment donations from corporations like 

Dell, Motorola, and Shure. Because of the Marcus gift and 

other corporate donations, CDC’s new Emergency Operations 

Center opened 6 months early, just in time to track and combat the deadly SARS threat. 

5. Management Academy for Public Health: Using $1 million 

each from the Robert Wood Johnson Foundation, the Kellogg 

Foundation, CDC and the Health Resources and Services Administration (HRSA), the Foundation supported the establishment of a new management academy to train mid-career leaders from State and local health departments in how to manage 

people, data and dollars. The academy is now totally self-sufficient and continues to train hundreds of public health leaders 

from across the country. 

6. Mobile Breast Cancer Detection: Through a multi-million 

dollar grant from Avon, the Foundation has purchased and 

placed mobile mammography screening vans to reach underserved women in multiple States across the country. Funding 

also supports a CDC scientist to evaluate the van placement 

programs and disseminate lessons learned about best practices 

that will help other such programs across the country be most 

effective and have the best chance of becoming self-supporting. 

7. Field Disease Detection and Response Training Programs 

in Developing Countries: With privately-raised support from organizations like the World Bank, the Nuclear Threat Initiative 

and the Ellison Medical Foundation, the CDC Foundation has 

enabled CDC to establish special disease detection and/or laboratory support programs in countries like Brazil, India and 

Kenya that will help detect and control deadly infectious diseases that pose serious threats not only in those countries, but 

to the United States as well. 

III. LEGISLATIVE HISTORY AND COMMITTEE ACTION

On March 17, 2005, Senator Isakson, for himself and Senator 

Chambliss, introduced S. 655, to amend Section 399G of the PHSA 

to improve the Foundation for the Centers for Disease Control and 

Prevention (CDC). On April 27, 2005, the committee held an executive session to consider S. 655. The committee approved an amendment in the nature of a substitute offered by Senator Enzi, and 

then approved S. 655, as amended, by unanimous voice vote. 

IV. EXPLANATION OF BILL AND COMMITTEE VIEWS

The operating costs for the CDC Foundation have climbed from 

$300,000 when it began in 1995 to almost $3 million in 2005. In 

1995, CDC’s $500,000 of support was sufficient to fully support the 

Foundation’s operations. However, this amount, which has been 

capped since the Foundation’s inception, no longer provides sufficient funds to allow the CDC Foundation to provide the kinds of 

beneficial support noted in the examples above. S. 655 will allow 

the CDC Director to support the work of the Foundation beyond 

the $500,000 baseline up to $1.25 million if, in the judgment of the 

CDC Director, an occasion would arise that would warrant it. Such 

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support does not require an increased appropriation since funds 

would come from existing appropriations to the CDC director’s office. Such financial support, at most, would constitute approximately half of the operating costs of the Foundation. 

The legislation would also incorporate language that would allow 

CDC to provide facilities, utilities, and support services to the 

Foundation if ‘‘it is determined by the Director to be advantageous 

to the programs of such Centers.’’

Currently, privately supported fellows assigned to help CDC implement Foundation programs are artificially limited to 2 years 

each. This creates program implementation problems for programs 

supported by private funding from organizations like the Robert 

Wood Johnson and Kellogg Foundations that sometimes can run 3 

or 4 years. To remedy this, the legislation aligns the length of any 

privately supported fellowships to coincide with the duration of private funding for each such fellowship.

V. COST ESTIMATE

U.S. CONGRESS, 

CONGRESSIONAL BUDGET OFFICE, 

Washington, DC, May 31, 2005. 

Hon. MIKE ENZI, Chairman, Committee on Health, Education, Labor, and Pensions, 

U.S. Senate, Washington, DC. 

DEAR MR. CHAIRMAN: The Congressional Budget Office has prepared the enclosed cost estimate for S. 655, a bill to amend the 

Public Health Service Act with respect to the National Foundation 

for the Centers for Disease Control and Prevention. 

If you wish further details on this estimate, we will be pleased 

to provide them. The CBO staff contact is Tim Gronniger. 

Sincerely, 

DOUGLAS HOLTZ-EAKIN, Director. 

Enclosure. 

S. 655—A bill to amend the Public Health Service Act with respect 

to the National Foundation for the Centers for Disease Control 

and Prevention 

Summary: S. 655 would modify the Public Health Service Act to 

increase the amount of the grants the Department of Health and 

Human Services is authorized to provide to the National Foundation of the Centers for Disease Control and Prevention (CDC) from 

$500,000 per year to $1,250,000 per year. The bill also would allow 

longer terms of voluntary service to be contributed from the Foundation to the CDC and would allow sharing of equipment and support services from the CDC to the Foundation. 

CBO estimates that enacting S. 655 would cost $500,000 in 2006 

and $3.5 million over the 2006–2010 period, assuming appropriation of the necessary amounts. 

S. 655 contains no intergovernmental or private-sector mandates 

as defined in the Unfunded Mandates Reform Act (UMRA) and 

would not affect the budgets of state, local, or tribal governments. 

S. 655 would not affect direct spending or receipts. 

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Estimated Cost to the Federal Government: The estimated budgetary impact of S. 655 is shown in the following table. The costs 

of this legislation fall within budget function 550 (health).

By fiscal year, in millions of dollars—

2005 2006 2007 2008 2009 2010 

SPENDING SUBJECT TO APPROPRIATION

Spending Under Current Law: 

Estimated Authorization Level 1 ...................................................... 1 1 1 1 1 1

Estimated Outlays ........................................................................... 1 1 1 1 1 1

Proposed Changes: 

Estimated Authorization Level ......................................................... 0 1 1 1 1 1

Estimated Outlays ........................................................................... 0 1 1 1 1 1

Spending Under S. 655: 2

Estimated Authorization Level 1 ...................................................... 1 1 1 1 1 1

Estimated Outlays ........................................................................... 1 1 1 1 1 1

1 The 2005 level is the amount appropriated for that year. 

2 Rows may not sum to totals because of rounding. 

Basis of Estimate: The National Foundation for the CDC is a 

not-for-profit entity that raises private funds to support the work 

of the CDC. Under current law, CDC may accept the services of an 

individual who receives financial support from the Foundation for 

a period of up to two years. S. 655 would eliminate that two-year 

restriction. The bill would also allow the CDC to provide in-kind 

transfers and support services to the Foundation. Under current 

law, the Foundation receives $500,000 in transfers from the funds 

appropriated to the Department of Health and Human Services. S. 

655 would require HHS to transfer at least that amount, and 

would allow the department to transfer up to $1,250,000 to the 

Foundation each year. In addition to the $500,000 that CBO expects will be transferred 

to the foundation each year under current law, CBO estimates that 

S. 655 would cost $500,000 in 2006 and $3.5 million over the 2006– 2010 period, assuming the appropriation and transfer of the necessary amounts. 

Intergovernmental and private-sector impact S. 655 contains no 

intergovernmental or private-sector mandates as defined in the 

UMRA and would not affect the budgets of state, local, or tribal 

governments. 

Estimate prepared by: Federal Costs: Tim Gronniger; Impact on 

State, Local, and Tribal Governments: Leo Lex; Impact on the Private Sector: Meena Fernandes. 

Estimate approved by: Peter H. Fontaine, Deputy Assistant Director for Budget Analysis.

VI. APPLICATION OF LAW TO THE LEGISLATIVE BRANCH

S. 655 amends section 399G of the PHSA to make improvements 

to the functioning of the Foundation for the Centers for Disease 

Control and Prevention, a non-profit corporation in the State of 

Georgia that supports the work of the CDC. As such, it has no application to the legislative branch. 

VII. REGULATORY IMPACT STATEMENT

The legislation amends section 399G of the PHSA to make improvements to the functioning of the Foundation for the Centers for 

Disease Control and Prevention. It includes a requirement that the 

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Director of the CDC transfer no less than $500,000 and no more 

than $1.25 million of the CDC’s appropriated funds to the Foundation to support its costs in supporting the work of the CDC. Pursuant to the requirements of paragraph 11(b) of Rule XXVI of the 

Standing Rules of the Senate, the Committee has determined that 

the bill will not have significant regulatory impact. 

VIII. SECTION-BY-SECTION ANALYSIS

Sec. 1. National Foundation for the Centers for Disease Control and 

Prevention; Acceptance of Voluntary Services; Federal Funding 

Paragraph (a) makes a technical amendment to clarify that any 

fellowship with the CDC Foundation will match the length of time 

the endowment for that project takes. 

Paragraph (b) requires the Foundation’s annual reports to include an accounting of the use of funds transferred from the CDC 

to the Foundation for its operating expenses and that these reports 

be provided to the appropriate committees in Congress. 

Paragraph (c) makes a change to require the CDC Director to 

transfer no less than $500,000 and not more than $1,250,000 to the 

Foundation for operating expenses.

IX. CHANGES IN EXISTING LAW

In compliance with rule XXVI paragraph 12 of the Standing 

Rules of the Senate, the following provides a print of the statute 

or the part or section thereof to be amended or replaced (existing 

law proposed to be omitted is enclosed in the black brackets, new 

matter is printed in italic, existing law in which no change is proposed is shown in roman): 

Public Health Service Act 

* * * * * * * 

PART N—NATIONAL FOUNDATION FOR THE CENTER FOR DISEASE

CONTROL AND PREVENTION

SEC. 399G. ø280d–11¿ ESTABLISHMENT AND DUTIES OF FOUNDATION. 

(a) IN GENERAL.—* * * 

* * * * * * * 

(h) GENERAL PROVISIONS.—

(1) AUTHORITY FOR ACCEPTING FUNDS.—* * * 

(2) AUTHORITY FOR ACCEPTANCE OF VOLUNTARY SERVICES.—

(A) The Director of the Centers for Disease Control and 

Prevention may accept, on behalf of the Federal Government, any voluntary services provided to such Centers by 

the Foundation for the purpose of aiding or facilitating the 

work of such Centers. øIn the case of an individual, such 

Director may accept the services provided under the preceding sentence by the individual for not more than 2 

years.¿ In the case of an individual, such Director may accept the services provided under the preceding sentence by 

the individual until such time as the private funding for 

such individual ends.

* * * * * * *

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(7) REPORTS.— (A) Not later than February 1 of each fiscal year, the 

Foundation shall publish a report describing the activities 

of the Foundation during the preceding fiscal year. Each 

such report shall include for the fiscal year involved a comprehensive statement of the operations, activities, financial 

condition, and accomplishments of the Foundation, including an accounting of the use of amounts provided for under 

subsection (i) 

(B) * * *

ø(C) The Foundation shall make copies of each report 

submitted under subparagraph (A) available for public inspection, and shall upon request provide a copy of the report to any individual for a charge not exceeding the cost 

of providing the copy.¿

(C) The Foundation shall make copies of each report submitted under subparagraph (A) available— (i) for public inspection, and shall upon request provide a copy of the report to any individual for a charge 

not to exceed the cost of providing the copy; and 

(ii) to the appropriate committees of Congress. 

* * * * * * *

(i) FEDERAL FUNDING.—

(1) AUTHORITY FOR ANNUAL GRANTS.—

(A) * * *

* * * * * * *

(2) FUNDING FOR GRANTS.—

(A) For the purpose of grants under paragraph (1), there 

is authorized to be appropriated ø$500,000¿ $1,250,000 for 

each fiscal year. 

(B) For the purpose of grants under paragraph (1), the 

Secretary may for each fiscal year make available ønot 

more than $500,000¿ not less than $500,000, and not more 

than $1,250,000 from the amounts appropriated for the fiscal year for the programs of the Department of Health and 

Human Services. Such amounts may be made available 

without regard to whether amounts have been appropriated under subparagraph (A). 

(3) CERTAIN RESTRICTIONS.—***

(4) Support services.—The Director of the Centers for Disease 

Control and Prevention may provide facilities, utilities, and 

support services to the Foundation if it is determined by the Director to be advantageous to the programs of such Centers.

* * * * * * *

Æ