With the 116th Congress drawing to a close, lawmakers passed a comprehensive government spending package this week that also provides roughly $900 billion in COVID-19 stimulus funds. The federal government is currently operating on a seven-day continuing resolution to allow time for the 5,600 page bill to be enrolled and sent to the President for consideration. However, the President has expressed concern with several provisions in the bill and requested that Congress make changes that could result in further delays.
The spending package extends funding for federal agencies through September 30, 2021, provides funding increases for programs at the Substance Abuse and Mental Health Services Administration (SAMHSA) and Health Resources and Services Administration (HRSA), and provides $4.25 billion in emergency funding for substance use disorder and mental health programs.
NAADAC members have been engaging with Congress and the administration throughout the year advocating for increased funding for addiction and mental health treatment and recovery programs. Although more resources will be needed to address the impacts of COVID-19 and the addiction crisis, we are pleased to see that this year’s funding bill includes several NAADAC priorities, along with investments in both addiction infrastructure and workforce programs, including the following:
- Substance use treatment: $3.8 billion, an increase of $17 million, including continued funding for opioid prevention and treatment, including:
- $1.7 billion for Substance Abuse Prevention and Treatment Block Grant; and
- $1.5 billion for State Opioid Response Grants.
- Substance use prevention: $208 million, an increase of $2 million.
- Health Workforce: $1.2 billion, an increase of $30 million, for HRSA’s Bureau of Health Professions programs, including:
- $112 million for the Behavioral Health Workforce Education and Training (BHWET) program, a $10 million increase that also includes an allocation of $13 million for community based experiential training for students preparing to become peer support specialists and other types of behavioral health-related paraprofessionals;
- $29.7 million for the Mental and Substance Use Disorder Workforce Training Demonstration program, with the $3 million increase being allocated for new grants to expand the number of nurse practitioners, physician assistants, health service psychologists, and social workers trained to provide mental and substance use disorder services in underserved community-based settings.
- $16 million for the Loan Repayment Program for Substance Use Disorder Treatment Workforce, a $4 million increase; and
- $16.1 million for Minority Fellowship Programs, a $2 million increase.
The bipartisan COVID-19 relief portions of the spending package also includes an additional $4.25 billion in emergency funding for substance use and mental health programs above and beyond regular FY 2021 spending, including the following:
- $1.65 billion for the Substance Abuse Prevention and Treatment Block Grant.
- $1.65 billion for the Community Mental Health Services Block Grant, with no less than 50% of funds directed to behavioral health providers.
- $600 million for Certified Community Behavioral Health Clinic (CCBHC) Expansion Grants to be allocated by SAMHSA.
- $50 million for suicide prevention programs.
- $50 million for Project AWARE.
- $240 million in emergency grants to states.
- $125 million of these allocations should be in funding to tribes
The relief package also includes the following provisions:
SUD Parity: Strengthens parity in substance use disorder and mental health benefits. While current parity laws require insurers to treat substance use disorder and mental health care the same way they treat medical or physical care, the lack of enforcement has led to significant gaps in coverage for millions of Americans suffering addiction or mental health issues. This provision incorporates elements of the Strengthening Behavioral Health Parity Act (H.R. 7539), legislation supported by NAADAC during this year’s Virtual Hill Day.
Small Business Funds: Provides additional funds for small businesses, including $284 billion for Paycheck Protection Program (PPP) loans. The program will also allow second round applications for hard hit businesses and expand the eligibility to include 501(c)(6) nonprofit organizations with as many as 300 employees.
Provider Relief Funds: Provides an additional $3 billion for hospital and health care providers. It also directs HHS to allocate not less than 85 percent of unobligated funds in the Provider Relief Fund through an application-based portal to reimburse providers for financial losses incurred in 2020.
Community Mental Health Services Demonstration: The bill extends a series of programs funded by the Centers for Medicare and Medicaid Services (CMS), including the Certified Community Behavioral Health Clinics (CCBHCs) Medicaid demonstration, until September 30, 2023. CCBHCs are designed to provide a comprehensive range of mental health and substance use disorder services to vulnerable individuals.
Telehealth: Expands access to telehealth services in Medicare to allow beneficiaries to receive mental health services via telehealth. It also appropriates funding for telehealth and broadband grant programs.
Ends Surprise Medical Billing: Includes a bipartisan compromise that will end surprise medical billing for emergency and scheduled care. Patients will be held harmless and only required to pay the in-network cost-sharing. It allows for a 30-day open negotiation period for providers and payers to settle out-of-network claims. If the provider and payer are unable to reach a negotiated agreement, they may access a binding arbitration process – referred to as Independent Dispute Resolution (IDR).
Individual Relief: The package includes $600 stimulus payments to individuals and families, $300 a week in extra unemployment benefits through March 2021, $82 billion for education programs, $73 billion for public health programs, $25 billion for rental assistance, and $13 billion for nutrition assistance programs.
As a country we must commit to building and maintaining a strong addiction workforce and infrastructure that can take on our nation’s growing crisis in a way that helps individuals with substance use disorders find the treatment and recovery services they need. NAADAC thanks you for your dedication to support those in need of addiction and mental health prevention, intervention, treatment, and recovery support! There is no question that your advocacy has helped shape these policies in Washington, D.C. We look forward to working with you next year to continue building on these accomplishments!
Background Documents
- Text of the legislative package can be found here.
- A summary of fiscal 2021 funding is available here.
- A committee report with fiscal 2021 funding allocations and justifications is available here.
- A summary of the emergency COVID-19 funding is available here.
- A summary of additional health and tax provisions is available here.