Ranking Member Cassidy Seeks Information from Stakeholders on CDC Reform

WASHINGTON – In response to the weaknesses exposed in the Centers for Disease Control and Prevention’s (CDC) response to the COVID-19 pandemic, U.S. Senator Bill Cassidy, M.D. (R-LA), ranking member of the Senate Health, Education, Labor, and Pensions (HELP) Committee, is seeking information from stakeholders on ways to reform the CDC and its practices. Specifically, Cassidy requests input on how the CDC can better coordinate with stakeholders, more effectively modernize public health data, and improve core public health activities, such as epidemiology, training programs, and its global health portfolio.

This comes in the wake of the CDC’s significant struggles to communicate health guidance to the public during the COVID-19 pandemic, and lack of transparency regarding the evidence or methodology it used to develop that guidance.

Cassidy hopes to use stakeholder feedback to identify policies for potential legislation to modernize the CDC, so it is better prepared to respond to future public health threats. The deadline to submit feedback is Friday, October 20^th. 

Read the full request here or below.  

Dear Stakeholder:

I write today to seek your input on opportunities to continue modernizing the U.S. Centers for Disease Control and Prevention (CDC).

As we all know, CDC repeatedly failed to get timely information and practical, evidence-based advice to the American people during the COVID-19 pandemic. From lack of transparency in how it developed its scientific guidance to challenges in detecting and anticipating the spread of the virus, these failures caused many Americans to lose trust in CDC and other federal institutions. CDC must reform itself not only to address these issues but to regain the public trust.

I applaud the agency on the steps it has taken to try to modernize itself, but there is more work to be done. Rather than fixate on the past, I hope to identify opportunities to better position the agency for its future as a more open, collaborative, and responsive institution, while rebuilding its relationship with and accountability to Congress. As Ranking Member of the Senate Health, Education, Labor, and Pensions (HELP) Committee, I intend to propose pragmatic, commonsense policies for legislative consideration.

To inform this work, I invite your input on the topics below, or other topics that are relevant but not mentioned. If you would like to do so, you are welcome to include proposed line edits to current law or other legislative text as a supplement to your narrative response.

Please submit comments to my staff by email at CDCModernization@help.senate.gov no later than close of business on Friday, October 20^th.

Fostering Innovation and Collaboration

1. A hallmark of successful institutions is creating and sustaining a culture of innovation. Have any specific federal agencies or government-affiliated organizations achieved this? If yes, what actions have they taken to cultivate this environment?

2. Continuous review and improvement require openness to change at all levels within the organization. How do successful organizations foster this openness? How might these strategies be applied to CDC?

3. In your view, how effectively does CDC currently leverage outside entities to bring new ideas and capabilities to its organization, such as using off-the-shelf commercial solutions instead of commissioning custom-built systems? How could this be improved?

4. What role does in-person work play in achieving organizational change? How can workers be incentivized to return to work?

5. What steps can CDC take to identify more, and engage in, external partnerships? This includes partnerships with the interagency, academia, and the private sector.

Making Data Work for Everyone

1. How can Congress improve the flow of public health data to CDC and back to states within the current system?

2. How does electronic health record (EHR) data currently factor into CDC’s data modernization efforts? Are there instances in which partnerships with integrated health care organizations or EHR vendors could provide data directly to CDC to conduct sentinel surveillance and generate insights, rather than relying solely upon data collected through health departments?

3. How could more of CDC’s datasets, methodology, and assumptions be shared quickly with outside researchers so that CDC’s analyses and conclusions can be validated or clarified?

4. CDC’s Center for Forecasting and Outbreak Analytics intends to provide information to support timely decision-making and action. How can this approach be applied across CDC, and how can CDC’s data better inform the actions of other federal, state, and local decision-makers?

5. How can the data and analyses that CDC generates be more accessible to and useful for the American people?

6. How can Congress and CDC better leverage both disease-specific and disease-agnostic data collection strategies? What are the benefits of both approaches, when should they be used, and how can we minimize potential silos between datasets?

7. What types of data collection support CDC’s core mission, and what types of data collection or data elements are less necessary?

8. How can CDC, and the Department of Health and Human Services more broadly, further improve data governance and data sharing to minimize burden on reporters and improve the utility of collected data?

9. Do you see any opportunities to improve CDC’s public health data modernization initiative and related efforts to implement public health data standards?

Improving Upon What Works Well

1. A key to CDC’s success to date has been its relationships with state and local health departments around the country. How can these relationships be better supported?

2. How can CDC’s epidemiological, laboratory, and other core public health and scientific work be encouraged further?

3. What opportunities exist to support CDC’s global health portfolio and ensure that the learnings from CDC country staff around the world are shared with others in the federal government to inform future work and drive progress?

4. How can CDC improve linkages between in-country staff and program staff in CDC’s U.S. offices? What would be the benefit of improving these linkages?

5. What opportunities exist to improve or better support CDC’s global and domestic public health training programs, such as the Field Epidemiology Training Program and the Epidemic Intelligence Service?

6. What other aspects of CDC’s work do you think are functioning well? How can Congress better support and preserve these activities?

7. Which aspects of CDC’s Moving Forward Initiative do you think are progressing well, and which could be improved? What role, if any, do you think Congress can play in helping to improve this work?

8. Is there any room for improvement in how CDC approached the Moving Forward Initiative, from a process perspective?

9. Do you believe CDC has additional challenges that were not accounted for within the Moving Forward Initiative?

10. How does CDC’s current structure either support or impede its ability to carry out its core functions?

11. How might CDC’s mission, strategic goals, and objectives be refined to better reflect and enable these core functions?

12. How could CDC better prioritize its programs to support core activities, reduce redundancy across its Centers, and ensure activities are appropriately targeted?

Mechanisms to Modernize

1. How can Congress or the Executive Branch incentivize CDC leadership and rank-and-file staff to be more collaborative with, and open to ideas from, other CDC employees, other federal agencies, the private sector, academia, and state and local officials?

2. How can Congress or the Executive Branch improve recruitment and retention of quality staff? For example, how can high-achieving staff have better opportunities to advance their careers within CDC?

3. What models exist at other federal agencies or institutions to successfully accomplish these goals?

4. What role, if any, could the CDC Foundation play in improving linkages between CDC staff and outside expertise and facilitating the exchange of ideas? If, in your view, the CDC Foundation is not well suited for this type of work, what other entity (either within CDC or elsewhere) could serve this purpose?

5. How can Congress build upon past legislative efforts to modernize CDC?

6. What other policies should Congress consider, aside from those that have already been enacted?

7. What structural, legislative, or administrative barriers impede Congress or CDC’s ability to implement these changes?

Thank you in advance for your feedback. I look forward to working with you on this important matter.

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