The Centers for Disease Control and Prevention (CDC)

The Centers for Disease Control and Prevention (CDC)

Updated March 27, 2023
The Centers for Disease Control and Prevention (CDC)
During the Coronavirus Disease 2019 (COVID-19)
Services Block Grant program, provide public health
pandemic, the mpox outbreak, and other recent health
funding to all states, territories, and selected local
crises, the Centers for Disease Control and Prevention
jurisdictions. Others provide funding on a competitive basis
(CDC) has served as a face of the federal government’s
to a subset of SLTT agencies. Grants to SLTT governments
public health response. CDC’s stated mission is “protect
generally fund the programs and operations of SLTT public
America from health, safety and security threats, both
health agencies. CDC administers many of its grant
foreign and in the [United States].” CDC’s mission extends
programs with SLTT agencies as cooperative agreement
beyond addressing infectious diseases—to preventing most
programs, where CDC staff have substantial involvement
of the leading causes of death, injury, and disability, along
with the grantee in program implementation. (Note: CRS
with promoting health more generally. CDC is based in the
used FY2019 data, instead of more recent FY2020-FY2022
Department of Health and Human Services (HHS) and is a
data, because the latter include substantial pandemic
U.S. Public Health Service (PHS) agency. The CDC
supplemental funding).
Director also oversees the Agency for Toxic Substances and
Preventive health services. CDC funds several state-based
Disease Registry (ATSDR), a separate operating division.
programs to provide preventive health services, such as
Organization and Programs
vaccinations and cancer screenings, generally targeted at
uninsured and underserved populations.
Two features characterize CDC’s mission and programs.
First, CDC programs tend to focus on prevention of adverse
Surveillance. Public health surveillance is “the ongoing,
health outcomes. Second, CDC programs promote health on
systematic collection, analysis, and interpretation of health-
a population and community-wide basis. CDC is organized
related data essential to planning, implementation, and
into several centers, institutes, and offices (CIOs). Some of
evaluation of public health practice.” CDC operates over
these CIOs focus on specific public health challenges (e.g.,
100 surveillance systems that collect ongoing data, which
immunization and respiratory diseases; injury prevention),
typically do not include personally identifiable information.
while others focus on public health capabilities (e.g.,
Much of the data are collected at the SLTT level, and many
surveillance and laboratory services).
CDC grants support surveillance. These data help inform an
understanding of when, how, where, and to whom disease
Activities
cases and other health events occur.
CDC CIOs administer programs focused on a wide array of
health topics, including infectious diseases, chronic
Laboratory Science. CDC manages federal laboratories
diseases, injury, disability, occupational health,
that can perform specialized testing to detect new or
environmental health, and public health emergency
unusual diseases. CDC also oversees the Laboratory
preparedness and response. Even with the range of topics, a
Response Network (LRN), a network of laboratories at the
few key activities are common across CDC programs:
federal, state, and local level that can detect biological,
chemical, and other threats, including emerging infectious
Technical Assistance to and Coordination with State,
diseases. CDC develops laboratory test kits, protocols, and
Local, Territorial, and Tribal (SLTT) Public Health
best practices, and distributes test kits and supplies to LRN
Agencies. In the U.S. federal system, many public health
and other public health laboratories. Several grants can also
laws and programs are administered at the SLTT level.
support public health laboratory operations and testing.
CDC provides leadership and coordination among public
health agencies across the country, along with assistance in
Surveys and Statistics. CDC also administers several
investigating and responding to health threats. CDC
national health surveys, like the National Health Interview
Survey. CDC’s National Center for Hea
administers several fellowship and workforce programs to
lth Statistics is one
fund staff at SLTT agencies. CDC staff may also take
of 13 principal federal statistical agencies (or units).
temporary placement positions within SLTT agencies.
Research. CDC employs researchers who inform the
Public Health Program Grants. In FY2019, CDC
science of disease prevention and health promotion. CDC
awarded 5,010 grants totaling over $5.9 billion in
experts include epidemiologists, statisticians, laboratory
obligations (including research and program grants). Grant
scientists, and infectious disease biologists, among others.
recipients included SLTT governments, nonprofit
Many CDC research publications are published in the
agency’s
organizations, foreign governments and organizations, for-
Morbidity and Mortality Weekly Report. CDC also
profit organizations, and tribal entities. The majority of the
awards some research grants and contracts to universities
grants were awarded to government entities (66%), and
and other research institutions.
state government agencies accounted for 92% of such
Education and Outreach. CDC conducts education and
grants. Some grants, such as the Immunization Cooperative
outreach to many audiences, including the general public,
Agreement program and the Preventive Health and Health
clinicians, and public health practitioners, among others.
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The Centers for Disease Control and Prevention (CDC)
CDC also regularly develops educational materials for
 National Center on Birth Defects and Developmental
SLTT agencies and health care providers. In addition, CDC
Disabilities, established in PHSA Section 317C (42
informs the science and practice of public health
U.S.C. §247b-4)
communication as a part of its mission.
 National Center for Health Statistics, established in
Guidelines and Best Practice Promotion. CDC develops
PHSA Section 306 (42 U.S.C. §242k)
public health and clinical guidelines based on its expertise
 ATSDR, established by the Comprehensive
in health science and practice. As official
Environmental Response, Compensation and Liability
recommendations, CDC guidelines are not legally binding.
Act of 1980 (CERCLA; 42 U.S.C. §§9601 et seq.)
CDC also develops and disseminates information on public
health and clinical best practices, for example, for youth
Some CDC offices are authorized in law, such as the Office
violence prevention programs or for health care provider
of Women’s Health (PHSA §310A). CDC also administers
conversations about vaccines with parents and families.
program-specific statutes throughout the PHSA and other
laws. Some of these statutes are directed at CDC (e.g.,
CDC also engages with international governments and
PHSA §2821). Others are directed at the HHS Secretary,
organizations through its global health programs. See CRS
but carried out by CDC by delegation (e.g., PHSA §318).
In Focus IF11758, U.S. Global Health Funding: FY2020-
FY2023 Appropriations
Regulations
Authorizations
CDC administers several regulations, such as those related
to medical examination of immigrants and refugees,
CDC does not have a single enabling statute that defines its
possession and use of select biological agents and toxins,
overall mission and structure. CDC’s programs are
and interstate and foreign regulations for the control of
authorized by general and program-specific laws, mostly in
communicable diseases. During the pandemic, CDC
the Public Health Service Act (PHSA). Through the
exercised its statutory authorities in new ways; one example
PREVENT Pandemics Act (P.L. 117-328; Division FF,
is discussed in CRS Legal Sidebar LSB10632, Litigation of
Title II), enacted December 2022, the position of the CDC
the CDC’s Eviction Moratorium.
Director and its responsibilities were codified. Other
provisions of the act addressed CDC strategic planning,
Appropriations
along with other programmatic and funding authorizations.
CDC receives most of its core program funding through the
General Authorizations
annual Labor, HHS, Education, and Related Agencies
Appropriations Act. ATSDR is funded by the Departments
Congressionally approved reorganization plans in 1953 (42
of the Interior, Environment, and Related Agencies
USC §3501) and 1966 (42 USC §202, note) granted
Appropriations Act. CDC also administers several
authority to determine the organization of PHS agencies to
programs that are funded by mandatory spending
the Secretary of Health, Education, and Welfare (now HHS
authorities, such as the Vaccines for Children program and
Secretary). The Secretary established CDC as the Center for
the World Trade Center Health Program. Congress has also
Disease Control in 1970, replacing the preexisting National
provided CDC with supplemental emergency funding
Communicable Disease Center. CDC received its current
during public health emergencies and other incidents.
name in 1992. Many CDC programs have remained
authorized under the general PHSA authorities of the HHS
Given that many CDC programs are based in general
Secretary, including
authorities, Congress often uses the appropriations process

to inform CDC’s programs. Appropriations reports
PHSA Section 301 (42 USC §241): Research and
accompanying CDC annual appropriations usually specify
Investigation
programmatic funding levels within CDC accounts, though
 PHSA Section 307 (42 USC §242l): International
to varying levels of detail depending on the program and
Cooperation
account. For more information on CDC funding, see CRS

Report R47207, Centers for Disease Control and
PHSA Section 310 (42 USC §242o): Health
Prevention (CDC) Funding Overview.
Conferences and Health Education Information
 PHSA Section 311 (42 USC §243): Federal-State
Considerations for Congress
Cooperation in Communicable Disease Control and
In April 2022, CDC Director Dr. Rochelle Walensky
Public Health Matters
launched a review and reform effort based on perceived

shortcomings of CDC’s pandemic response entitled Moving
PHSA Section 317 (42 USC §247b): Project Grants for
Forward. In August 2022, CDC published findings from
Preventive Health Services
the review. CDC then finalized an agency reorganization in
Program-Specific Authorizations
February 2023 (88 FR 9290). CDC’s FY2024 budget
request includes several legislative proposals for additional
Three CDC centers and institutes and ATDSR are explicitly
data and personnel authorities. In light of these
authorized in law:
developments, Congress faces many policy options: (1) take
 National Institute for Occupational Safety and
no action; (2) adopt some or all of CDC’s proposed
Health, authorized by the Occupational Safety and
authorities; and/or (3) consider other reforms to the agency.
Health Act of 1970 (29 U.S.C. §§651 et seq.)
Kavya Sekar, Analyst in Health Policy
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The Centers for Disease Control and Prevention (CDC)

IF12241

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