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Investing in Whole Health, Containing CostsFY 2015 Substance Use and Mental Health Appropriations

The Substance Abuse and Mental Health Services Administration (SAMHSA) is the lead agency providing targeted funding for states to implement proven and effective services for individuals with substance use or mental health conditions. These programs reduce expensive hospitalizations, emergency department usage, and involvement with the criminal justice system. Access to behavioral health services is key to improving Americans’ health and containing U.S. healthcare costs.

Likewise, federal investments in basic scientific and clinical research through the National Institutes of Health drive innovation in mental health and substance use treatment. These scientific advances and the development of improved treatments and supports have shown that behavioral health disorders can be prevented and treated effectively, helping millions of Americans get back on their feet and achieve better health.

Why Do We Need Increased Investments in Behavioral Health Programs and Research?Years of sustained funding cuts continue to harm Americans’ ability to access evidence-based treatments and lifesaving services and supports. States cut nearly $5 billion from mental health funding during the recession, while the FY 2013 sequester left an estimated 373,000 children and adults with mental illness without treatment. As many as 8,900 homeless persons with serious mental illness no longer receive services through the SAMHSA PATH program. The National Institute of Mental Health and National Institute on Drug Abuse have seen reductions as large as 20 percent for new research grants for such critical priorities as opiate addiction and early intervention in schizophrenia.

The National Council and Hill Day partners urge Congress to support the following recommendations.

SAMHSA: Substance Abuse Prevention and Treatment Block Grant The SAPT Block Grant remains the foundation of the publicly supported substance use prevention and treatment system, serving 2.5 million people in every state and territory every year. Continued strong federal support through the SAPT Block Grant is critically important given that nearly 90 percent of people with a substance use disorder do not receive treatment for their condition. Strong SAPT Block Grant funding is essential to effectively preventing youth alcohol and drug use, treating substance use disorders, and providing recovery supports to help people stay well over their lifetime.

>> SAPT Block Grant request for FY 2015: $1.879 billion ($60 million increase vs. FY 2014)

Please support

appropriations for

the mental health

and substance use

priorities outlined in

this fact sheet.

REQUEST

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SAMHSA: Mental Health Block GrantServices funded by the Mental Health Block Grant include supported employment, supported housing, rehabilitation services, crisis stabilization, peer specialist and consumer-directed services, wraparound services for children and families, jail diversion programs, and services for special populations (people who are homeless, live in rural and frontier areas, and military families). The majority of these services are currently not broadly covered under private insurance and medicaid. The Mental Health Block Grant also includes a five percent set-aside to focus on evidence-based practices to address the needs of individuals with early serious mental illness.

>> Mental Health Block Grant request for FY 2015: $532.1 million ($48 million increase vs. FY 2014)

SAMHSA: Strategic Prevention Framework Grants – Prescription Drug Abuse and Overdose PreventionPresident Obama proposed a new initiative for 2015 to combat the prescription drug abuse epidemic, jointly funded by the Centers for Disease Control and Prevention and the Substance Abuse and Mental Health Services Administration (SAMHSA). Within SAMHSA, this program (SPF-Rx) would invest $10 million in grants to states to enhance, implement, and evaluate strategies to prevent prescription drug misuse and abuse, and to improve collaboration on the risks of overprescribing.

>> SPF-Rx request for FY 2015: $10 million (level to President Obama’s budget request)

SAMHSA: Primary and Behavioral Health Care IntegrationThe PBHCI program supports community behavioral health and primary care organizations that partner to provide essential primary care services to adults with serious mental illnesses. Because of this program, more than 33,000 people with serious mental illnesses and substance use disorders are screened and treated at 100 grantee sites for diabetes, heart disease, and other common and deadly illnesses in an effort to stem the alarming early death rate from these health conditions in this population. Essential to the success of PBHCI is the technical assistance offered by the SAMHSA-HRSA Center for Integrated Health Solutions (CIHS), funded by SAMHSA as “Primary and Behavioral Health Care Integration TA.” Services provided by CIHS support rapid and successful implementation of grant activities – but technical assistance funding has not kept pace with the steadily growing number of grantees.

>> PBHCI request for FY 2015: $50 million (level to FY 2014)

>> PBHCI-TA request for FY 2015: $2.5 million ($500,000 increase vs. FY 2014 to accommodate the increasing number of grantees

needing assistance)

SAMHSA: Mental Health First AidEach year, more than one in five Americans will experience a substance use or mental health condition. Yet, as a society, our lack of awareness about these conditions – and the available community resources – often prevent people from getting appropriate treatment and support. Mental Health First Aid is a public education program that helps participants identify, understand, and respond to signs of mental illnesses and substance use. The course teaches a 5-step action plan to reach out to a person in crisis and connect them with help. Mental Health First Aid funding appropriated in the 2014 budget will be used to support training activities for local and state education agencies, an important audience and one that should be expanded in future years’ appropriations.

>> Mental Health First Aid request for FY 2015: $20 million ($5 million

increase vs. FY 2014).

>> Committee language request: The National Council and Hill Day partners request the following proposed committee report language indicating that Mental Health First Aid trainings may be provided to a comprehensive range of audiences: “Consistent with a broad public safety approach, the Committee directs that eligible grantees be expanded to include veteran service organizations, local law enforcement and corrections agencies, fire departments, emergency medical services units, hospital systems, and institutions of higher

education among other entities.”

SAMHSA: Primary Care and Addiction Services IntegrationThe $20 million proposed Primary Care and Addiction Services Integration (PCASI) grant program would help to ensure that people with substance use disorders can have all of their complex co-occurring health care needs met more effectively. By co-locating primary and specialty care medical services, this program will improve the rate at which people with substance use disorders are successfully referred to primary care services. This effort draws on lessons from the successful Primary and

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Behavioral Health Care Integration (PBHCI) program and will ensure states have the capacity to meaningfully use electronic health records to improve the integration of primary care and substance use services.

>> PCASI request for FY 2015: $20 million (level to President Obama’s budget request)

SAMHSA: Peer Professionals WorkforceBecause of their lived experience with behavioral health conditions and ability to foster connections with individuals accessing care, peers have a unique role in the delivery of prevention and recovery support services. This new initiative proposed in President Obama’s 2015 budget will increase the behavioral health workforce by 1,200 peer professionals, including recovery coaches, mental health/addiction specialists, prevention specialists, and pre-Master’s level addiction counselors working with an emphasis on youth ages 16-25.

>> Peer Professionals Workforce request for FY 2015: $10 million (level to President Obama’s budget request)

NIH: Mental Health and Addictions Research Scientific advances have led to astounding discoveries about the nature of the brain and the roots of behavioral health disorders. Continued investments in basic scientific and applied research will aid in developing rapid, effective treatments that target the core pathophysiology of these conditions, while new diagnostic markers will facilitate early identification and intervention. NIDA and NIMH have the research tools they need – but Institutes must have sufficient funding resources to realize this ambitious vision of finding cures to these disabling illnesses. President Obama proposed restoring the sequester cuts to vital research programs, a move that would restore the capacity of NIDA and NIMH to fund new and competing grants.

>> Overall NIH request for FY 2015: $32 billion ($1.1 billion increase vs. FY 2014)

>> NIMH request for FY 2015: $1.44 billion ($23.3 million increase vs. FY 2014)

>> NIDA request for FY 2015: $1.086 billion ($71.1 million increase vs. FY 2014)

HUD: Supportive Housing to Promote Recoveryand IntegrationAccess to decent, safe, and affordable housing and supportive services is critical for long-term recovery from substance use disorders and mental illnesses. Department of Housing and Urban Development programs such as the Section 811 Project-Based Rental Assistance (PRA) demonstration

and the McKinney-Vento permanent supportive housing programs are proven effective models that promote recovery and cost savings. President Obama proposed a $34 million increase for the Section 811 PRA program, boosting funding to $160 million. However, with escalating costs to renew project-based operating subsidies for existing 811 units, only $25 million would be available for development of new PRA units. For McKinney-Vento Homeless Assistance Grants funding, the President proposed a $301 million increase, renewing the commitment to end chronic homelessness nationally by the end of 2016.

>> Section 811 PRA request for FY 2015: $235 million ($99 million increase vs. FY 2014 to fund as many 3,500 new PRA units)

>> Homeless Assistance Grants request for FY 2015: $2.4 billion ($301 million increase vs. FY 2014)

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