State and Federal Budget Issues
Details on Proposed Mental Illness Research and Services Funding for FY 2010
National Institute of Mental Health (NIMH)
HR 3293 proposes $1.502 billion for research funding at the NIMH, which is $51.775 million above the current FY 2009 allocation, and $27.59 million above the President’s FY 2010 request. This 3.4% proposed increase is slightly above the 3% average increase for Institutes across the entire National Institutes of Health (NIH). Overall, the House bill proposes a $941.76 million increase for the NIH, boosting funding to $31.259 billion.
The House bill differs significantly from the President’s request for NIH funding. It rejects the President’s proposal to limit increases at most NIH Institutes to less than 2% for FY 2010, while giving a much larger increase to the National Cancer Institute. Instead, the House bill allows for an increase at NIMH, and many of other NIH Institutes, close to the projected 3.5% biomedical research inflation level.
NAMI is extremely grateful to House Labor-HHS Appropriations Subcommittee Chairman David Obey (D-WI) and Ranking Member Todd Tiahrt (R-KS) for proposing a more equitable allocation for biomedical research, based more on public health burden and scientific opportunity, rather than favoring a few specific diseases.
This proposed increase for FY 2010, when combined with the additional projected $368 million that NIMH is receiving from the American Recovery and Reinvestment Act (ARRA) economic stimulus package, represents a major step toward reversing the flat budgets that have been in place since 2003.
Substance Abuse and Mental Health Services Administration (SAMHSA)
HR 3293 includes important increases for a number of programs at SAMHSA’s Center for Mental Health Services (CMHS). This includes increases for the PATH and Childrens Mental Health programs, as well as an initiative for integration of mental health and primary care targeted to individuals with serious mental illness. Included below is a summary of funding at CMHS:
- Mental Health Block Grant – Funded at $420.774 million, the same as FY 2009
- PATH – Proposed for an $8.36 million increase, boosting funding to $68.047 million, more than $1 million more than the President requested. PATH funds a formula grant program to the states for outreach and engagement of homeless individuals with mental illness. This increase would allow the program to serve an additional 11,000 homeless individuals with serious mental illness.
- Childrens’ Mental Health – Funded at $125.3 million in the House bill, or $16.94 million more than the current FY 2009 level – the same as the President proposed.
- Garrett Lee Smith Suicide Prevention – The House bill proposes to freeze youth suicide prevention programs under the Garrett Lee Smith Act at $34.7 million. This includes $29.74 million for competitive state grants and $4.975 million for college campus grants.
- Protection & Advocacy – Funding for the PAIMI program is proposed for a $1 million increase, up to $36.88 million.
- Mental Health Transformation Grants – The House bill proposes continuation of both state incentive grants ($26 million) and mental health transformation grants ($5.9 million) at current FY 2009 levels.
- Primary Care Integration – The House bill includes a $7 million increase for "Primary and Behavioral Health Integration" boosting funding to $14 million. These grants are designed to increase primary care capacity in specialty mental health settings (e.g., CMHCs) to address medical co-morbidities experienced by individuals living with serious mental illness. This initiative is in response to studies revealing 25 years of lower life expectancy experienced by people with serious mental illness as a result of medical co-morbidities. There was an overwhelming response to the $7 million made available for FY 2009 for this initiative.
Department of Justice Mentally Ill Offender Program
A separate spending bill funding the Justice Department for FY 2010 (HR 2847) includes $12 million for programs under the Mentally Ill Offender Treatment and Crime Reduction Act (MIOTCRA, P.L. 108-414). This includes funding for a range of programs including pre-booking diversion, training of law enforcement and post sentence re-entry. HR 2847 also includes $114 million for programs under the Second Chance Act.
Social Security Administration
While the vast majority of Social Security spending is mandatory, the Labor-HHS Appropriations bill does include administrative spending to cover the cost of implementing entitlement programs such as SSI and SSDI. The Limitation on Administrative Expenses (LAE) budget is important this year as SSA struggles to cope with an unprecedented backlog in disability claimant appeals. Without continued increases for the overall LAE, it is estimated that SSA will not be able to make progress in clearing this backlog.
HR 3293 includes $11.4465 billion for SSA’s LAE account – equal to the President’s FY 2010 request. This represents an increase of $993 million over the FY 2009 level. The Subcommittee’s press release stated, "and $11.4 billion for the Social Security Administration, which provides the single largest dollar increase in the bill and the request – to help the agency process a rising number of retirement and disability claims, make progress in reducing the backlog of disability hearings, and improve services to the public."
July 24, 2009