SearchHealthcare Update, Parity Regulations, and Preliminary Analysis of 2010-2011 Federal Budget
On February 1st, the Obama Administration released the FY 2011 federal budget. The President's budget includes funding requests for federal drug and alcohol prevention, treatment, recovery and research programming and for programs serving people with criminal records. Under the President's FY 2011 budget, programs in the Substance Abuse and Mental Health Services Administration (SAMHSA) would receive $3.7 billion, a $110 million increase over FY 2010 funding. The 2011 fiscal year runs from October 1, 2010 through September 30, 2011.
Under the budget, the Substance Abuse Prevention and Treatment (SAPT) Block Grant would receive funding level to FY 2010. SAMHSA's Centers for Substance Abuse Prevention and Treatment, and the drug and alcohol research institutes, NIDA and NIAAA, would receive funding increases.
The FY 2011 budget does not include a funding request for the Department of Education's Safe and Drug-Free Schools and Communities (SDFSC) State Grants program. The DOE budget would consolidate six programs (including the SDFSC National program and the Alcohol Abuse Reduction program) into the new Successful, Safe, and Healthy Students program. Under the budget, new programs aimed at improving child wellness would also be established in the Center for Substance Abuse Prevention.
In addition to funding requests for current drug and alcohol programming, the President's FY 2011 budget also contains requests for new addiction treatment programming for Federally Qualified Health Centers and the Indian Health Service (IHS).
Under the President's FY 2011 budget, drug and alcohol prevention, treatment and research programming would receive the following amounts:
• The Substance Abuse Prevention and Treatment (SAPT) Block Grant would receive $1.799 billion, funding level to FY 2010. This request includes $359.72 million for the SAPT Block Grant's twenty percent set-aside for prevention activities.• The Center for Substance Abuse Treatment (CSAT) would receive $487 million, an increase of $34 million over FY 2010.
The FY 2011 funding recommendation for CSAT would include:
• $37 million for Screening, Brief Interventions and Referral to Treatment services in medical and other community settings, an increase of $8 million over FY 2010$37 million for Screening, Brief Interventions and Referral to Treatment services in medical and other community settings, an increase of $8 million over FY 2010
• $108.85 million to support a new cohort of four Access to Recovery (ATR) grants to States and tribal organizations to provide addiction treatment and recovery support services through a voucher-based system. This represents an increase of $9.9 million from FY 2010.
• $84.2 million for criminal justice programs, which represents an increase of $16.6 million over FY 2010. This portfolio includes:
$56.4 million for the Treatment Drug Courts program, which represents an increase of $12.6 million over FY 2010
$23.2 million for the Ex-offender Re-entry program, a $5 million increase over FY 2010
$5 million for the Family Dependency/Treatment Drug Courts program, funding level to FY 2010
$4.6 million for the Adult Criminal Justice Treatment program, a funding decrease of $1 million from FY 2010. This program serves individuals under the supervision of the judiciary or community justice/corrections agencies (such as probation, parole, community corrections)
• The Center for Substance Abuse Prevention (CSAP) would receive $223 million, an increase of $21 million for FY 2010.
The FY 2011 funding recommendation for CSAP would include:
• $103.5 million for Strategic Prevention Framework (SPF) State Incentive Grants, a funding decrease of $8.3 million from FY 2010
• $23 million to establish a new Prevention-Prepared Communities program which would seek to assist communities in developing and implementing effective mental illness and substance abuse prevention practices for young people 9 to 25 years of age. Program funds would also support grants to States for community prevention specialists to assist in implementation.
• $9.7 million for substance use prevention activities to be integrated into the existing Center for Mental Health Services (CMHS) Project LAUNCH program. The Project LAUNCH initiative, which would become a joint CMHS-CSAP project, seeks to help communities in developing and implementing effective mental illness and substance use prevention and health and wellness strategies for children from birth to 8 years of age
• $8 million for the STOP (Sober Truth on Preventing Underage Drinking) Act, a funding increase of $1 million from FY 2010• The National Institute on Drug Abuse (NIDA) would receive $1.0941 billion, a $34.6 million increase over FY 2010
• The National Institute on Alcohol Abuse and Alcoholism (NIAAA) would receive $474.6 million, a $12.5 million increase over last year's funding
• The FY 2011 Health Resources Services Administration (HRSA) budget includes a request for increased funding aimed at enhancing the availability and quality of addiction care at existing Federally Qualified Health Centers. The HRSA budget includes a $25 million request to fund approximately 125 service expansion grants to "expand the integration of behavioral health into existing primary health care systems." According to HRSA budget documents, these funds would be used to "add qualified and trained behavioral health counselors and other addiction specialists to enhance substance abuse care in federal supported community health centers." HRSA would collaborate with SAMHSA to provide technical assistance expertise. HRSA would also "train health counselors and other addiction specialists on performing Screening, Brief Intervention and Referral to Treatment (SBIRT)."
• The Indian Health Service (IHS) would also receive increased funds for their alcohol and drug treatment programming; under the FY 2011 budget IHS's alcohol and substance abuse portfolio would receive $205.8 million, an $11.4 million increase over FY 2010; this funding would include a new $4 million competitive grant program to hire addiction workforce professionals who would provide evidence-based and practice-based culturally competent addiction treatment services.
Under the President's FY 2011 budget, key Department of Justice programming would receive the following funding amounts:
• Programs authorized by the Second Chance Act, recently authorized legislation aimed at helping States and localities address the needs of individuals reentering the community from the criminal justice system, would receive $100 million under the FY 2011 budget, funding level to FY 2010• The Byrne Justice Grant (JAG) program, which funds programs providing a number of different prevention, education, community corrections and drug treatment services, would receive $519 million, funding level to FY 2010
• The Residential Substance Abuse Treatment (RSAT) program, which helps States and localities to develop and implement residential addiction treatment programs in State and local correctional and detention facilities, would receive $30 million, funding level to FY 2010
• Funding for the Enforcing Underage Drinking Laws (EUDL) program, which helps States to develop comprehensive and coordinated initiatives to enforce State laws that prohibit underage drinking, would be eliminated under FY 2011, a decrease of $25 million
• The FY 2011 budget would consolidate a number of programs in DOJ's Office of Justice Programs (OJP) portfolio, including the Drug Court program and the Mentally Ill Offender Treatment program, into a new Drug, Mental Health, and Problem Solving Courts program. In the FY 2011 budget, this new program would receive $57 million.
Congress will soon begin work to craft the FY 2011 budget blueprint. Work by the House and Senate Appropriations Committees to develop the annual spending bills will likely take place this spring and summer.
The President’s entire FY 2010 budget can be found at: http://www.whitehouse.gov/omb/budget/Overview/.
SAMHSA’s Congressional Justification budget documents which detail the program-level funding requests can be found at: http://samhsa.gov/Budget/FY2011/SAMHSA_FY11CJ.pdf.
HRSA’s Congressional Justification can be found at: http://www.hrsa.gov/about/budgetjustification11.pdf.
IHS’s Congressional Justification can be found at: http://www.ihs.gov/NonMedicalPrograms/BudgetFormulation/documents/IHS%20FY%202011%20Congressional%20Justification.pdf.
DOJ’s Office of Justice Programs Congressional Justification can be found at: http://www.justice.gov/jmd/2011justification/pdf/fy11-ojp-justification.pdf.