The Obama Administration issued its $3.8 trillion budget proposal for FY 2011, including a projected freeze for overall domestic discretionary spending. Included in the budget is a request for $25 million for Congress to extend for an additional six months the current higher federal Medicaid match rate for states (known as FMAP) that was enacted a year ago as part of the American Reinvestment and Recovery Act (ARRA). Included below are brief summaries of the President’s FY 2011 budget requests for mental illness research and services programs.
The President is proposing $1.541 billion for basic scientific and clinical research at the National Institute of Mental Health (NIMH). This is a $51 million increase above the current level of $1.49 billion as is in line with the overall 3.2% increase proposed across all of the 27 institutes and centers at the National Institutes of Health (NIH) – overall, the President is requesting $32.089 billion for the NIH. While this is below the expected increase in biomedical research inflation, it is a tremendous accomplishment and endorsement of the importance of investment in medical research in a budget that proposes an overall freeze in domestic discretionary spending.
Most programs at the Center for Mental Health Services at SAMHSA (the Substance Abuse and Mental Health Services Administration) are proposed for a freeze at their current FY 2010 level, including the $420 million Mental Health Block Grant program. There are however, a few exceptions. For example, the PATH program (formula grants to states for outreach and engagement services for homeless people with mental illness) is proposed for a $5 million increase, up to $70 million. Likewise, the Childrens Mental Health program is also proposed for a $5 million increase, up to $126 million. In addition, the Projects of Regional and National Significance (PRNS) program would receive a $13 million increase, up to $374 million, for service demonstration programs and capacity building. This includes $7.5 million for a homelessness prevention initiative and $6 million for suicide prevention.
In a major disappointment, the President’s budget seeks a deep reduction for the HUD Section 811 program (grants to non-profits for development of supportive housing for non-elderly people with disabilities). Specifically, the budget proposes only $90 million for HUD Section 811, compared to the current FY 2010 appropriation of $300 million. This includes the transfer of $113 million out of Section 811 to Section 8 for the cost of renewing roughly 14,000 Section 811 tenant-based rental vouchers. In addition, most of the $90 million requested by the Obama Administration for FY 2011 would be directed to renewing project-based rent subsidies for existing 811 developments, leaving only a small amount for development of new supportive housing units.
The President’s budget does request a $182 million increase for the HUD McKinney-Vento Homeless Assistance Act – boosting funding from its current level of $1.852 billion up to $2.034 billion. Most of these increased funds would be directed toward implementation of the new HEARTH Act signed into law by the President last spring that directs increased funds to the Emergency Shelter Grant (ESG) program and a new grant competition for rural and frontier areas. The budget also includes a proposal for $85 million for “special purpose” housing vouchers for targeted populations (people with disabilities and families with children) who are homeless, or at risk of homelessness.
The President's FY 2011 budget is requesting a $54.3 billion advance in appropriations for 2012 for health care, an increase of $2.8 billion over the 2011 enacted amount. The budget request includes $5.2 billion for mental health at the VA, an increase of $410 million (or 8.5 percent) over current spending, enabling expansion of inpatient, residential and outpatient mental health services, with emphasis on making mental health services part of primary care and specialty care.
In his submission, VA Secretary Shinseki noted that one-fifth of the patients seen last year in VA’s health care facilities had a mental health diagnosis, and that the department has added more than 6,000 new mental health professionals since 2005, bringing to 19,000 the number of employees dedicated to mental health care. The VA projects that the budget request would enable the department to continue expanding its programs for post-traumatic stress disorder (PTSD) and traumatic brain injury (TBI), along with the diagnosis and treatment of depression, substance abuse and other mental health problems.
The budget also proposes to continue the VA’s suicide prevention program. Since July 2007, the department’s suicide prevention hotline has received nearly 225,000 calls from Veterans, active-duty personnel and family members. The hotline is credited with saving the lives of nearly 7,000 people. Finally, the budget proposal includes $4.2 billion in 2011 to reduce and help prevent homelessness among Veterans. That breaks down into $3.4 billion for core medical services an $799 million for specific homeless programs and expanded medical care, which includes $294 million for expanded homeless initiatives.
February 3, 2010