Congress Releases Massive Omnibus Spending Bill, Includes Billions in New Behavioral Health Funding
On Wednesday evening, Congressional leaders unveiled a massive $1.3 trillion omnibus spending bill that would set government funding through Sep. 30, 2018. As currently written, the 2018 omnibus boosts federal health spending by $10.1 billion, providing increases for the Substance Abuse and Mental Health Services Administration (SAMHSA), National Institutes of Health (NIH), Centers for Disease Control and Prevention (CDC) and more. Importantly, about $4 billion of the additional funding is specifically dedicated to addressing the opioid crisis. The omnibus must pass the House and Senate, then be signed by President Trump by midnight on Friday — when the government’s current funding lapses — to avoid a government shutdown.
The omnibus measure provides increased or level funding for mental health and addiction programs and rejects the cuts to key behavioral health care programs proposed in President Trump’s FY 2018 budget. The 2018 omnibus reflects a growing recognition by Members of Congress that many Americans cannot access effective mental health and addiction treatment. The National Council applauds Congress’ plan and congratulates its advocates for successfully securing new and enhanced investment in behavioral health care. A summary of funding for key programs follows:
MENTAL HEALTH & ADDICTION TREATMENT AND EDUCATION
- Certified Community Behavioral Health Clinics (CCBHCs): Includes $100 million in new funding to support the ongoing Certified Community Behavioral Health Clinic program active in eight states. This new program, spearheaded by National Council members, is dramatically expanding access to comprehensive and evidence-based mental health and addiction care.
- Primary and Behavioral Health Care Integration and Technical Assistance Center: $49.877 million, level funding compared to last year. The President’s budget proposed eliminating the program. The technical assistance center that supports integration grantees receives level funding at $1.991 million.
- Mental Health First Aid: $19.963 million, an increase of 5 million over 2017 funding level.
- Mental Health Block Grant: $701.5 million, an increase of $160 million over FY 2017 and $301.5 million more than requested in President Trump’s FY 2018 budget.
- Substance Abuse and Prevention and Treatment Block Grant: $1.858 billion, which is $3.4 million more than last year’s funding.
- Opioid State Target Response Grants (Opioid STR): The second year of $500 million in funding for this 21st Century Cures program is appropriated.
- Opioid State Response Grants (Opioid SOR): The bill creates a new grant program for states, totaling $1 billion to address the opioid crisis. This funding is in addition to the Opioid STR funds.
- $50 million must be made available to Indian tribes or organizations. 15 percent of the funding will be set-aside for states with the highest mortality rate related to opioid use disorders, but no state is to receive less than $4 million.
- Rural Communities Opioids Response: The agreement provides $130 million for a new Rural Communities Opioids Response program to support treatment for and prevention of substance use disorder, with a focus on the unique needs of rural counties including workforce development.
- Opioid Addiction and Pain Management: Includes $500 million for NIH to research opioid addiction and non-opioid alternative pain management methods and treatments.
- Synthetic Opioid Trafficking: Provides $94 million for the FDA to expand its efforts to crack down on shipments of synthetic opioids at international mail facilities.
- Opioid Use Surveillance and Public Health Monitoring: $476 million to support increased CDC opioid overdose surveillance and prevention activities at the national, state, and local level.
Note: The National Council awaits further information on how SAMHSA and other agencies will allocate the new funding for CCBHCs, Opioid STR, Opioid SOR, Rural Communities Opioids Response, and more. For more detail, stay tuned to the Capitol Connector for more detail.
A more detailed chart of mental health and addiction FY 2018 appropriations is available here.
BEHAVIORAL HEALTH WORKFORCE/JUSTICE PROGRAMS
- National Health Service Corps (NHSC): Expands eligibility for loan repayment awards through the NHSC to include substance use disorder counselors to support the support recruitment and retention of addiction health professionals in underserved areas.
- Medicare-Eligible Behavioral Health Providers: While the agreement makes no substantive policy changes in this area, the bill acknowledges the lack of mental health and addiction treatment professionals eligible to serve Medicare beneficiaries. This statement provides acknowledgment of a problem that would be addressed through the passage of the Mental Health Access Improvement Act, a longstanding priority of the National Council.
- Mentally Ill Offender Treatment and Crime Reduction Act (MIOTCRA): $30 million for MIOTCRA programs such as mental health courts, substance use courts and veterans’ courts, up from $12 million in FY 2017.
Congress is on a short timeframe to pass the omnibus. Congress must pass a spending bill by midnight on Friday (March 23rd) to avoid a government shutdown. The House passed the bill on Thursday, sending the package to the Senate where leaders will need to be careful to avoid any potential roadblocks in order to pass it before midnight. With such a short timeline, any unforeseen delay may necessitate the use of a short-term continuing resolution (CR) to avoid the government slipping into a shutdown Friday night.