Last week, Congress reached agreement on a year-end spending bill that will provide significant funding for addiction research and substance use disorder treatment and recovery programs. NAADAC advocated strongly for number of key funding priorities and were pleased to see them included in the final package, including $12 million to establish a new Loan Repayment Program for the Substance Use Disorder Treatment Workforce and $1.5 billion for state grants to fight the opioid crisis.
President Trump signed the $1.4 trillion package, on December 20th, avoiding the threat of shutdown through fiscal year 2020 and extending the nation’s debt limit well into 2021. The following summary provides an overview of the many relevant funding items included in the final bill:
SUMMARY OF LABOR, HEALTH, AND HUMAN SERVICES, EDUCATION, AND RELATED AGENCIES FISCAL YEAR 2020 CONFERENCE REPORT
The fiscal year 2020 Departments of Labor, Health and Human Services, and Education, and Related Agencies (LHHS) Appropriations bill provides a total of $184.884 billion in discretionary budget authority – $4.911 billion more than the fiscal year 2019 level, $41.2 billion more than the President’s budget request and $4.7 billion more than the Senate bill. The total funding includes $183.042 billion in discretionary funding as well as $1.842 billion in cap adjustment funding to prevent waste, fraud, abuse and improper payments in the Medicare, Medicaid, and Social Security programs.
Opioids & Substance Use: The bill provides $3.8 billion in HHS to address opioid abuse, including: $1.5 billion to states to address the opioid epidemic and mental health; $476 million for opioid overdose surveillance and prevention at the Centers for Disease Control and Prevention (CDC); $90 million to address the needs of children affected by the opioid crisis; and $100 million to help affected rural communities.
Mental Health: The bill includes increased funding to improve mental health access, including $200 million for Certified Community Behavioral Health Clinics, a $50 million increase; $16.2 million for suicide prevention; $7 million for infant and early childhood mental health; and $102 million—a $30 million increase—for Project AWARE, which will expand efforts to identify and help children and youth in need of mental health care.
Healthcare Workforce Programs: The bill includes $1.2 billion for healthcare workforce programs, an increase of $103 million, rejecting the President’s proposal to slash $895 million from programs that train and expand access to physicians, nurses and other health care professionals nationwide. This includes $27 million to establish the Mental and Substance Use Disorder Workforce Training Demonstration, as well as $12 million to establish a new Loan Repayment Program for the Substance Use Disorder Treatment Workforce. The bill also includes increases for the Children’s Hospital Graduate Medical Education program (+$15 million) and the National Health Service Corps (+$15 million).
Division A, Title II: THE DEPARTMENT OF HEALTH AND HUMAN SERVICES
The bill includes $94.4 billion in base discretionary funding for the Department of HHS, an increase of $4.4 billion.
Mental Health – The bill provides $3.9 billion for mental health programs, an increase of $328 million, including:
- Certified Community Behavioral Health Clinics: $200 million, an increase of $50 million, for Certified Community Behavioral Health Clinics that provide a comprehensive approach to mental health care treatment;
- Project AWARE: $102 million, a $31 million increase, to support coordination between schools and State Mental Health Agencies to increase awareness of mental health among school-aged youth, train school personnel on detecting and responding to mental health issues, and connecting school-aged youth and their families with needed services;
- Mental Health Awareness Training: $23 million, an increase of $2 million, for Mental Health Awareness Training;
- Suicide Programs: $90 million, an increase of $16 million, to provide support to the suicide lifeline and grants to help identify and help those at risk of suicide;
- Behavioral Health Workforce Education & Training: $102 million, an increase of $27 million, to support new and existing workforce training programs, including $26.7 million to establish the Mental and Substance Use Disorder (SUD) Workforce Training Demonstration for grants to train professionals to provide SUD and mental health treatment;
- Pediatric Mental Health Access Grants: $10 million for Pediatric Mental Health Access Grants to expand access to behavioral health services in pediatric primary care settings;
- National Institute of Mental Health: $2 billion for mental health research at the National Institutes of Health, an increase of $161.7 million.
Rural Health Care – $318.3 million for rural health programs. The obstacles faced by patients and providers in rural communities are unique and often significantly different than those in urban areas. The bill focuses resources toward efforts and programs to help rural communities, including $29 million, an increase of $4.5 million, for telehealth. The telehealth program expands the use of telecommunications technologies within rural areas that can link rural health providers and patients with specialists.
SUMMARY OF TRANSPORTATION, HOUSING AND URBAN DEVELOPMENT, AND RELATED AGENCIES FISCAL YEAR 2020 CONFERENCE REPORT
$74.277 Billion in Total Discretionary Funding, $3.2 billion above FY2019 enacted levels.
Division H, Title II: DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT – $56.5 billion in total budgetary resources for the U.S. Department of Housing and Urban Development, which is offset by $7.4 billion in receipts from FHA/GNMA for a net funding level of $49.1 billion, and is an increase of $4.9 billion above the FY2019 enacted level.
- Community Planning and Development – The Community Development Block Grant formula program is funded at $3.4 billion; $25 million is included for a pilot program to help individuals in recovery from a substance abuse disorder become stably housed; the HOME program is funded at $1.4 billion; and the Housing Opportunities for Persons with AIDS program is funded at $410 million.