President’s 2016 Budget Proposes $44.6 Million Increase for SAMHSA, Reversal of Sequestration Cuts
The Substance Abuse and Mental Health Services Administration would see a $44.6 million increase in its funding for 2016 under the budget proposal released this week by President Obama. The $4 trillion budget also lifts spending caps imposed in 2011 and restores more than $70 billion in sequestration cuts while achieving $399 billion in health care savings, according to the White House.
Overall, the SAMHSA budget would rise to $3.7 billion in fiscal year 2016, compared to $3.66 billion in 2015. This amount includes:
- $1.820 billion for the Substance Abuse Prevention and Treatment Block Grant, level funding vs. FY 2015. The budget continues to emphasize the importance of the 20 percent set-aside to support prevention activities.
- $211 million for the Center for Substance Abuse Prevention, a $35.7 million increase vs. FY 2015.
- $20 million for Primary Care-Addiction Services Integration, a new program to support integration of primary care services in addiction treatment settings to support high rates of physical comorbidities among this population. The Obama Administration first proposed this program in FY 2015, but Congress did not enact it.
- $30 million for Screening, Brief Intervention and Referral to Treatment (SBIRT), a $17 million cut vs. FY 2015.
- $12 million in Grants to Prevent Prescription Drug/Opioid Related Deaths, a new program to promote the use of naloxone to prevent overdose deaths.
- $10 million in new funding for Crisis Systems, an initiative to support states and communities in developing robust addiction and mental health crisis-response systems. Funding would be used to provide grants to entities for coordinating effective crisis response with ongoing outpatient services and supports.
- $15 million for Mental Health First Aid under the President’s Now is the Time initiative, level funding vs. FY 2015.
- $4 million in new funding for Veterans Mental Health First Aid, a new initiative to provide information and support to veterans and family members affected by mental illness and addictions.
- $26 million for Primary Care-Behavioral Health Integration grants, a decrease of $23 million vs. FY 2015. The funding cut would be used to support a new program for Primary Care-Addiction Services Integration.
- $482.5 million for the Mental Health Services Block Grant, level funding vs. FY 2015. The budget continues to call for a 5 percent set-aside to support early intervention in psychosis.
The SAMHSA budget request also includes a $2 million increase for suicide prevention activities, level funding for Children’s Mental Health Services, $10 million in new funding for peer professional workforce development, and a $16 million cut for Criminal Justice Activities such as drug courts and ex-offender re-entry grants, among other changes.
Changes to Medicare Include End to 190-day Inpatient Psychiatric Limit
Also of interest to mental health and addiction groups, the budget proposes to end the 190-day lifetime limit on inpatient psychiatric services in Medicare, a policy long decried by mental health providers, consumers and advocates. According to the White House, the budget achieves nearly $400 billion in health care savings, primarily by permitting the federal government to negotiate drug prices with manufacturers in Medicare Part D; by raising Medicare premiums for wealthier seniors, and by adjusting payment updates for certain post-acute care providers. In addition, the budget proposal calls on Congress to enact a four-year extension of the Children’s Health Insurance Program (CHIP), currently set to expire this year. It would also do away with the Sustainable Growth Rate formula that perennially threatens Medicare physician payment rates, replacing it with new payment models that incentivize efficient care delivery.
Increases Proposed for NIH
The President’s budget includes a proposed $31.3 billion increase for the National Institutes of Health. Every agency within NIH would receive a funding increase, including the National Institute for Mental Health, the National Institute on Drug Abuse, and the National Institute on Alcohol Abuse and Alcoholism. This includes $135 million (an increase of $70 million) for the Brain Research through Advancing Innovative Neurotechnologies (BRAIN) Initiative, a research initiative to revolutionize the understanding of the human brain.
Next Steps for the Budget
The President’s budget is essentially dead on arrival in the Republican-controlled Congress, where lawmakers have indicated they plan to use the annual spending process to attack key administration priorities such as the Affordable Care Act. Yet, it remains unclear whether Republicans will be able to reach a consensus on other priorities; for example, Obama’s proposal to reverse sequestration cuts (including those imposed on defense programs) may drive a wedge between fiscal hawks and defense hawks among the GOP.
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