October 28, 2022
The Centers for Disease Control and Prevention (CDC)
During the Coronavirus Disease 2019 (COVID-19)
grants). Grant recipients included SLTT governments,
pandemic, the monkeypox outbreak, and other recent health
nonprofit organizations, foreign governments and
crises, the Centers for Disease Control and Prevention
organizations, for-profit organizations, and tribal entities.
(CDC) has served as a face of the federal government’s
The majority of the grants were awarded to government
public health response. CDC’s stated mission is “protect
entities (66%), and state government agencies accounted for
America from health, safety and security threats, both
92% of such grants. Grants to SLTT governments generally
foreign and in the [United States].” CDC’s mission extends
fund the programs and operations of SLTT public health
beyond addressing infectious diseases—to preventing most
agencies. CDC administers many of its grant programs with
of the leading causes of death, injury, and disability, along
SLTT agencies as cooperative agreement programs, where
with promoting health more generally. CDC is based in the
CDC staff have substantial involvement with the grantee in
Department of Health and Human Services (HHS) and is a
program implementation. (Note: CRS used FY2019 data,
U.S. Public Health Service (PHS) agency.
instead of more recent FY2020 and FY2021 data, because
the latter include substantial pandemic supplemental
Organization and Programs
funding and therefore are not reflective of typical grant
Two features characterize CDC’s mission and programs.
making practices.)
First, CDC programs tend to focus on prevention of adverse
Surveillance. Public health surveillance is “the ongoing,
health outcomes, rather than treatment or clinical care after
systematic collection, analysis, and interpretation of health-
a health issue arises. Second, CDC programs promote
related data essential to planning, implementation, and
health on a population and community-wide basis. CDC is
evaluation of public health practice.” CDC operates over
organized into several centers, institutes, and offices
100 surveillance systems that collect ongoing data, which
(CIOs). Some of these CIOs focus on specific public health
typically do not include personally identifiable information.
challenges (e.g., immunization and respiratory diseases;
Much of the data are collected at the SLTT level, and many
injury prevention), while others focus on public health
CDC grants support surveillance. These data help inform an
capabilities (e.g., surveillance and laboratory services).
understanding of when, how, where, and to whom disease
Activities
cases and other health events occur.
CDC CIOs administer public health programs focused on a
Laboratory Science. CDC manages federal laboratories
wide array of health topics, including infectious diseases,
that can perform specialized testing to detect new or
noninfectious diseases, injury, disability, occupational
unusual diseases. CDC also oversees the Laboratory
health, environmental health, and public health emergency
Response Network (LRN)—a network of laboratories at the
preparedness and response. Even with the wide range of
federal, state, and local level that can detect biological,
topics, a few key activities are common across CDC
chemical, and other threats, including emerging infectious
programs:
diseases. CDC develops laboratory test kits, protocols, and
best practices, and distributes test kits and supplies to LRN
Technical Assistance to and Coordination with State,
laboratories. Several program grants can also support public
Local, Territorial, and Tribal (SLTT) Public Health
health laboratory operations and testing.
Agencies. In the U.S. federalist system, many public health
laws and programs are administered at the SLTT level.
Surveys and Statistics. CDC also administers several
CDC provides leadership and coordination among public
national health surveys, like the National Health Interview
health agencies across the country. CDC also administers
Survey. CDC’s National Center for Health Statistics is one
several fellowship and workforce programs to fund staff at
of 12 principal federal statistical agencies (or units).
SLTT agencies. CDC staff may also take temporary
placement positions within SLTT agencies to provide
Research. CDC employs researchers who inform the
support.
science of disease prevention and health promotion. CDC
experts include epidemiologists, statisticians, laboratory
Public Health Program Grants. CDC administers many
scientists, and infectious disease biologists, among others.
public health program grants. Some grants, such as the
Many CDC research publications are published in the
Immunization Cooperative Agreement program and the
agency’s Morbidity and Mortality Weekly Report. CDC also
Preventive Health and Health Services Block Grant
awards some research grants and contracts to universities
program, provide public health funding to all states,
and other research institutions.
territories, and selected local jurisdictions. Others provide
funding on a competitive basis to a subset of SLTT
Education and Outreach. CDC conducts education and
agencies or to nonprofit or other private organizations. In
outreach to many audiences, including the general public,
FY2019, CDC awarded 5,010 grants totaling over $5.9
health care providers, and public health practitioners,
billion in obligations (including research and program
among others. CDC also regularly develops educational
materials for SLTT agencies and health care providers. In
https://crsreports.congress.gov
The Centers for Disease Control and Prevention (CDC)
addition, CDC informs the science and practice of public
Agency for Toxic Substances and Disease Registry
health communication as a part of its mission.
(ATSDR), established by the Comprehensive
Environmental Response, Compensation and Liability
Guidelines and Best Practice Promotion. CDC develops
Act of 1980 (CERCLA, the “Superfund” law; 42 U.S.C.
public health and clinical guidelines based on its expertise
§§9601 et seq.)
in health science and practice. During the COVID-19
pandemic, CDC guidance for pandemic mitigation
Some CDC offices are authorized in law, such as the Office
measures, such as masking and physical distancing,
of Women’s Health (PHSA §310A). CDC also administers
received high visibility. As official recommendations, CDC
program-specific statutes throughout the PHSA and other
guidelines are not legally binding. CDC also develops and
laws. Some of these program-specific statutes are directed
disseminates information on public health and clinical best
at CDC (e.g., PHSA §2821). Others are directed at the HHS
practices, for example, for youth violence prevention
Secretary, but carried out by CDC by delegation (e.g.,
programs or for health care provider conversations about
PHSA §318).
vaccines with parents and families.
CDC also engages with international governments and
Regulations
organizations through its global health programs. See CRS
CDC administers several regulations, such as those related
In Focus IF11758, U.S. Global Health Funding: FY2017-
to medical examination of immigrants and refugees,
FY2022 Request.
possession and use of select biological agents and toxins,
and interstate and foreign regulations for the control of
Authorizations
communicable diseases. During the pandemic, CDC
CDC was not established by an organic statute that defines
exercised its statutory authorities in new ways; one example
its overall mission and structure. Rather, the agency’s
is discussed in CRS Legal Sidebar LSB10632, Litigation of
programs are authorized by general and program-specific
the CDC’s Eviction Moratorium.
laws, mostly in the Public Health Service Act (PHSA).
Appropriations
General Authorizations
CDC receives most of its core program funding through the
Congressionally approved reorganization plans in 1953 (42
annual Labor, Health and Human Services, Education, and
USC §3501) and 1966 (42 USC §202, note) granted
Related Agencies Appropriations Act. ATSDR is funded by
authority to determine the organization of PHS agencies to
the Departments of the Interior, Environment, and Related
the Secretary of Health, Education, and Welfare (now HHS
Agencies Appropriations Act. CDC also administers several
Secretary). The Secretary established CDC as the Center for
programs that are funded by mandatory spending
Disease Control in 1970, replacing the preexisting National
authorities, such as the Vaccines for Children program and
Communicable Disease Center. CDC received its current
the World Trade Health Center Program. Congress has also
name in 1992. Many CDC programs have remained
provided CDC with supplemental emergency funding
authorized under the general PHSA authorities of the HHS
during public health emergencies and other incidents.
Secretary, including
Given that many CDC programs are based in general
PHSA Section 301 (42 USC §241): Research and
authorities, Congress often uses the appropriations process
Investigation
to inform CDC’s programs. Appropriations reports
accompanying CDC annual appropriations usually specify
PHSA Section 307 (42 USC §242l): International
programmatic funding levels within CDC accounts, though
Cooperation
to varying levels of detail depending on the program and
PHSA Section 310 (42 USC §242o): Health
account. For more information on CDC funding, see CRS
Conferences and Health Education Information
Report R47207, Centers for Disease Control and
Prevention (CDC) Funding Overview.
PHSA Section 311 (42 USC §243): Federal-State
Cooperation in Communicable Disease Control and
Considerations for Congress
Public Health Matters
In April 2022, CDC Director Dr. Rochelle Walensky
PHSA Section 317 (42 USC §247b): Project Grants for
launched an agency-wide review based on perceived
Preventive Health Services
shortcomings of CDC’s pandemic response. In August
2022, CDC announced lessons learned and next steps,
Program-Specific Authorizations
which include reorganization and potential requests for new
Four CDC centers and institutes are explicitly authorized in
authorities from Congress. Congress could accept CDC’s
law:
reorganization decisions and its proposed authorities.
Congress could also consider legislation to more formally
National Institute for Occupational Safety and
authorize CDC and its mission, responsibilities, structure,
Health, authorized by the Occupational Safety and
and activities. Some provisions addressing CDC leadership
Health Act of 1970 (29 U.S.C. §§651 et seq.)
and authorities are included in S. 3799, as amended and
National Center on Birth Defects and Developmental
ordered to be reported in March 2022 by the Senate
Disabilities, established in PHSA Section 317C (42
Committee on Health, Education, Labor, and Pensions.
U.S.C. §247b-4)
National Center for Health Statistics, established in
Kavya Sekar, Analyst in Health Policy
PHSA Section 306 (42 U.S.C. §242k)
IF12241
https://crsreports.congress.gov
The Centers for Disease Control and Prevention (CDC)
Disclaimer
This document was prepared by the Congressional Research Service (CRS). CRS serves as nonpartisan shared staff to
congressional committees and Members of Congress. It operates solely at the behest of and under the direction of Congress.
Information in a CRS Report should not be relied upon for purposes other than public understanding of information that has
been provided by CRS to Members of Congress in connection with CRS’s institutional role. CRS Reports, as a work of the
United States Government, are not subject to copyright protection in the United States. Any CRS Report may be
reproduced and distributed in its entirety without permission from CRS. However, as a CRS Report may include
copyrighted images or material from a third party, you may need to obtain the permission of the copyright holder if you
wish to copy or otherwise use copyrighted material.
https://crsreports.congress.gov | IF12241 · VERSION 1 · NEW