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Rebecca Farley

Director, Policy & Advocacy, National Council for Behavioral Health

Senate Committee Releases Proposed 2015 Healthcare Appropriations; SAMHSA Sustains Small Cuts

July 31, 2014 | Federal Budget | Comments
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Funding for the Substance Abuse and Mental Health Services Administration (SAMHSA) in fiscal year 2015 would sustain a 1.5 percent cut under the Senate Appropriation Committee’s budget recommendations, released online earlier this week. Overall, the committee recommends $3.577 billion for SAMHSA, a decrease of $53 million from 2014 but $10 million more than President Obama’s budget request.

These recommendations were not voted on and approved by the full committee as would be done during a typical appropriations process. Instead, the committee has published its top-line numbers along with the subcommittee report providing line-item detail – an indication of how difficult it has been for Congress to adhere to “regular order” in crafting the annual appropriations bills. The committee proposal represents a negotiating point for future discussions between the House and Senate on the 2015 budget.

Key items from the subcommittee report include:

  • $1.815 billion for the Substance Abuse Prevention and Treatment Block Grant, a decrease of $4.4 million vs. FY 2014
  • $482.6 million for the Community Mental Health Services Block Grant, a decrease of $1.1 million vs. FY 2014 (the report instructs SAMHSA to carry on the 5 percent set-aside of block grant monies to be used for early intervention activities)
  • $15 million for Mental Health First Aid, level to FY 2014
  • $50 million for Primary-Behavioral Healthcare Integration, level to FY 2014
  • $8.7 million for Opioid Treatment Programs, level to FY 2014
  • $47 million for Screening, Brief Intervention, and Referral to Treatment, level to FY 2014

The committee also recommends a $10 million increase for Targeted Capacity Expansion (TCE) grants under the Center for Substance Abuse Treatment, instructing SAMHSA to ensure that $12 million of TCE funding is used for expanding treatment services to Americans with heroin or opioid dependence. The committee specifies that these grants must include as an allowable use “the support of medication-assisted treatment and other clinically appropriate services” and should be made available first to states with the highest rates of treatment admissions for heroin and opioid abuse.

In recent weeks, congressional leaders have quietly acknowledged the likelihood that they will be unable to take final action on 2015 appropriations before the start of the fiscal year on October 1, 2014. Major divides between House Republicans and Senate Democrats on top-line numbers for the Department of Health and Human Services – among other agencies – have complicated budget negotiations in a midterm election year.

If Congress does not enact all twelve annual spending bills before October 1, it will likely pass a continuing resolution to continue current year funding into the new year and prevent a repeat of last October’s government shutdown.