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FY2021 Federal Budget Overview

Following the release of President Trump’s FY2021 budget proposal, A Budget for America's Future, NAADAC has reviewed the Administration’s blueprint with an eye toward its priorities for prevention,  treatment and recovery services.

As always, the President’s Budget serves the function of presenting a policy vision ahead of Congress’ annual funding process and does not carry the weight of law. Already, Leader McConnell (R-KY) and Speaker Pelosi (D-CA) have indicated their commitment to last year’s negotiated budget framework as they begin to craft their own respective FY2021 appropriations bills.

With that in mind, we wanted to highlight some of the key items of interest for NAADAC members from the President’s Budget:

Food and Drug Administration (FDA): The budget requests $6.2 billion for FDA. This total includes $3.3 billion in discretionary budget authority and $2.9 billion in user fees.

Opioids - Provides $45 million for opioid activities at international mail facilities to increase enforcement.

Cannabis - Provides $5 million to support FDA regulatory activities for cannabis and cannabis derivatives. FDA will develop policies and continue to perform its existing regulatory responsibilities including review of product applications, inspections, surveillance, enforcement, and research.

Centers for Disease Control and Prevention (CDC): The budget requests $12.6 billion for CDC. This total includes $5.6 billion in discretionary budget authority, $894 million from the Prevention and Public Health Fund, and $542 million in Public Health Service Evaluation Funds.

Combating the Opioids and Methamphetamine Crisis - Continues to prioritize opioid activities at CDC, with a total funding level of $476 million. CDC is contributing to Department-wide efforts by supporting states and jurisdictions as they collect data, respond to overdoses, and provide care to those in their communities. CDC will continue to support 66 jurisdictions to build upon current progress in tracking and preventing overdose deaths.

Drug Free Communities Program - Provides $100 million to CDC to administer the Drug Free Communities Program. In FY 2019, Congress appropriated $100 million to the Office of National Drug Control Policy and provided authority to transfer resources to other federal departments and agencies.

Substance Abuse and Mental Health Services Administration (SAMHSA): The budget requests $5.7 billion for SAMHSA and prioritizes prevention and treatment for opioid use disorder, methamphetamine use disorder, addressing serious mental illness, preventing suicide, and supporting the mental health needs of students. It provides $4 billion for substance abuse prevention and treatment activities. The Budget also includes a concerning legislative proposal to align substance use disorder treatment privacy protections with the Health Insurance Portability and Accountability Act (HIPAA).  NAADAC is opposed to this direction and will continue to use its influence and work with other like-minded partners to dispel the notion that this is helpful to treatment access.

Fighting the Opioid Crisis and Expanding Efforts on Methamphetamine and Stimulants:

  • Increases funding for opioid use disorder prevention and treatment, and expands supports for individuals suffering from stimulant use disorder, including methamphetamine.
  • Requests $5.2 billion for programs across the Department to address the opioid crisis. Of that amount, $2.0 billion is specifically for SAMHSA programs that combat opioid misuse, abuse, and overdose death. The proposed disbursement prioritizes evidence-based practices, including the use of Medication-Assisted Treatment (MAT). NAADAC will continue to use its influence to prmote “Medication First” with promotion to treat the pyscho-social and special aspects of addiction.It is not a “medication only” conversation.NAADAC will work with other “like-minded” partners to dispel the notion that “medication only” is the preferred response.
  • Increases State Opioid Response program funding to $1.6 billion, or $85 million above FY 2020, for grants to States and tribes to address opioids and methamphetamine, and other stimulants.
  • Provides $70 million for drug courts to serve 7,000 clients.
  • Provides $10 million for the Drug Abuse Warning Network to continue this national public health surveillance system and to provide more accurate estimates of emerging behavioral health issues including methamphetamine use disorder.
  • Includes $16 million for programs authorized by the SUPPORT for Patients and Communities Act (SUPPORT Act) to increase access to treatment, recovery, and workforce support services. This includes $4 million for a program expands access to qualified providers by making 10 grants to accredited medical schools and teaching hospitals to develop curricula that would satisfy requirements for graduates to prescribe medication-assisted treatment.Substance Abuse Prevention and Treatment Block Grant: Provides level funding for the block grant at $1.9 billion.

Preventing Substance Abuse: Includes $97 million for substance abuse prevention efforts that will reach 26.2 million people, including demonstration programs to prevent underage drinking and expand tribal behavioral health services.

Fighting HIV/AIDS: Provides a total of $116 million for grants to community-level entities, tribes, and tribal organizations to reduce domestic HIV transmission and support those with HIV/AIDS.

Mental Health: Provides $1.7 billion for mental health activities to meet the needs of those with the most serious mental health issues.