This week, Congress passed a set of bills that appropriate federal funding for Fiscal Year (FY) 2020. These bills are now with President Trump, and he is expected to sign them into law before the deadline at midnight, Friday, December 20. FY 2020 behavioral health funding prioritizes efforts to address the opioid crisis and increases funding for Certified Community Behavioral Health Clinics (CCBHCs) and behavioral health research.
The National Council is pleased to see a number of behavioral health programs receiving increased or level funding for FY 2020. Among the notable provisions in the bill are an expansion of the state opioid response grants to cover stimulants in addition to opioids, and a raise in the minimum tobacco purchasing age to 21. The legislation also includes funding for a loan repayment program for substance use treatment professionals, a program that the National Council and our members successfully fought for in 2017. The legislation would set the Department of Health and Human Services’ (HHS) budget overall at $94 billion, $16.8 billion more than was requested by President Trump in his budget proposal. The deal contains funding increases for the Substance Abuse and Mental Health Services Administration (SAMHSA), the Centers for Medicare and Medicaid Services (CMS), and the Centers for Disease Control and Prevention (CDC).
FY 2020 Behavioral Health Funding Levels Include:
|Agency||FY 2020 Funding||FY 2020 vs FY 2019|
|Substance Abuse and Mental Health Services Administration (SAMHSA)||$5.9 billion||+$112.5 million|
|Certified Community Behavioral Health Clinic (CCBHC) Expansion Grants$200 million+$50 million||$200 million||Level funding|
|Community Mental Health Services Block Grant||$722.6 million||Level funding|
|Substance Abuse Prevention and Treatment Block Grant||$1.8 billion||Level funding|
|Promoting the Integration of Primary and Behavioral Health Care (PIPBHC) Grants||$49.9 million||Level funding|
|PIPBHC Technical Assistance and Training Center||$2 million||Level funding|
|Mental Health First Aid||$22.9 million||+$2 million|
|State Opioid Response (SOR) Grants||$1.5 billion||Level funding|
|Loan Repayment Program for Substance Use Disorder Treatment Professionals (authorized by 2018 SUPPORT Act)||$12 million||+$12 million|
|National Institutes of Health (NIH)||$41.7 billion||+$2.6 billion|
In addition to funding the government through FY 2020, the deal includes several wide-ranging policy changes, including:
- CCBHCs – The deal extended the 8-state Certified Community Behavioral Health Clinic (CCBHC) Medicaid demonstration, along with a few other Medicaid programs, through May 22, 2020. The bill also provides a $50 million increase to SAMHSA’s CCBHC Expansion Grants, bringing the total allocation for CCBHC grants to $200 million. The National Council sincerely thanks Senator Blunt (R-MO) for his efforts that led to the $50 million increase in CCBHC expansion grant funding.
- State Opioid Response Grants – These grants will be expanded to cover programs that address opioids and stimulants, as opposed to solely opioids as in previous years.
- Tobacco Age Limit – Lawmakers included a provision that would raise the purchasing age for both cigarettes and e-cigarettes to 21 — marking the first major legislative action on tobacco since 2009.
- Affordable Care Act (ACA) Taxes – This deal repealed three taxes instituted by the ACA:
- The “Cadillac Tax,” a tax on high-cost health plans;
- The medical device tax, a 2.3% tax on medical device sales; and
- The health insurance tax, an annual tax on health plans.
- Medical Expense Deduction – The deal temporarily extends the 7.5% threshold for the medical expense deduction for two years, allowing all taxpayers to deduct their unreimbursed medical expenses that exceeded 7.5% of their adjusted gross income.
The funding bills will now go to President Trump to be signed into law. The White House’s previous involvement with the bills indicates that President Trump will sign, though he has made no public statement to that effect. Federal government funding expires at midnight tonight, December 20, 2019, barring Presidential action.