Congress has begun action on spending legislation for mental illness research and services for the coming federal fiscal year that will begin on October 1. The massive FY 2004
Labor-HHS-Education Appropriations bill (nearly $138 billion) includes important increases for mental illness research and services programs, including the National Institute of Mental Health (NIMH) and the Center for Mental Health Services (CMHS). This week both the House and Senate Appropriations Committees approved the measure. The full House passed its bill on July 10 by a 215-208 margin. The Senate is scheduled to consider its bill the week of July 14.
Both the House bill (HR 2660) and the Senate bill (S 1356) are below the overall amount requested by President Bush for FY 2004 – the Senate bill by more than $440 million. The result is that while most programs and agencies funded under Labor-HHS-Education bill enjoy bipartisan support in Congress, overall constraints on discretionary spending for FY 2004 have forced freezes or actual reductions in spending levels. It also important to note that these overall limits restraining discretionary spending were agreed to by Congress this past spring in the FY 2004 budget resolution. Until the overall limits on spending imposed on the Labor-HHS-Education Appropriations bill are increased by House and Senate leaders and Bush Administration, it will be very difficult for supporters in Congress to add additional funds for FY 2004.
For programs of concern to NAMI - at both NIMH and CMHS - there are some modest increases in both the House and Senate bills. For biomedical research, both bills include small increases for the National Institutes of Health (NIH) – up to $27.67 billion in the House bill and $27.xx in the Senate bill. This is in contrast to the double-digit percentage increases that NIH received over the previous five-year period (1998 to 2003) as Congress met the goal of doubling the overall NIH budget. For CMHS, both the draft House and Senate bills hold most programs at their current levels, or in some instances actually reduce funding slightly.
As Congress moves forward on the FY 2004 appropriations process, NAMI will be pressing members of Congress and the Bush Administration on a number of key funding priorities for research and services programs. Specifically, NAMI will be asking that the final version of the Labor-HHS Appropriations bill includes:
As was noted above, both the House and Senate bills contain modest overall increases for NIH – roughly 2.5% when compared to FY 2003 funding. As noted above, this increase is far below the increase enacted NIH over the past five years. However, when certain one-time costs incurred in FY 2003 for NIH (including capital improvements and increased security) are factored out, the overall increase is closer to 7%. For NIMH, the Senate bill includes $1.4 billion for FY 2004, $58.9 million more than FY 2003. This is less than the $41.1 million increase included in the House bill – the same as proposed by President Bush for FY 2004 ($1.382 billion).
NAMI is extremely grateful for the leadership of Senator Arlen Specter (R-PA) and Tom Harkin (D-IA) in pushing for an increase for NIMH that is above President Bush’s request. At the same time, it needs to be recognized that holding increases for medical research in 2004 to 3% to 4%, as recommended in both the House and Senate bills, could have a devastating impact on the ability of NIMH (and NIH as a whole) to sustain the ongoing multi-year research grants that have been initiated over the past 2-3 years. This is especially the case with new research grants that have been initiated in conjunction with NIMH’s new research plan on mood disorders (including new research underway on bipolar disorder).
The House version of the FY 2004 Labor-HHS-Education Appropriations bills includes a modest $7 million increase in overall funding for the Center for Mental Health Services (part of the Substance Abuse and Mental Health Services Administration, SAMHSA). By contrast, the Senate bill actually cuts CMHS funding by $1.3 million, to $855.7 million. Within specific categorical programs at CMHS, there are slight differences between the House, the Senate and President Bush’s request for FY 2004. Below is a summary of funding levels for selected programs of concern to children and adults with severe mental illnesses and their families:
The House version of the FY 2004 Labor-HHS-Education bill (HR 2660) adds an additional $100 million for the Center for Substance Abuse Treatment at SAMHSA for President Bush’s "Access to Recovery" initiative. This proposal is part of the Bush Administration’s effort to expand the capacity of the public sector substance abuse treatment system and promote greater consumer choice. The program would be administered directly by CSAT, separate from the Substance Abuse Treatment and Prevention (SAPT) Block Grant and the current infrastructure of state substance abuse authorities. Instead, funding for chemical dependency treatment under the President’s proposal would flow through a voucher system and would promote greater involvement of faith-based providers. The House bill also increases the by $20.6 million, up to $1.774 billion. By contrast, the Senate bill does not include funding for the "Access to Recovery" proposal. However, the Senate bill does increase the SAPT Block grant by $46.1 million over the current levels, up to $1.8 billion.