Funding Levels for Mental Illness Research, Services and Housing in the FY 2009 "Omnibus" Appropriations Bill
Mental Illness Research
For FY 2009, the budget for the National Institute of Mental Health (NIMH) will increase to $1.45 billion – a boost of $43.4 million over the FY 2008 level (just under a 3% increase). This is the largest annual increase that NIMH has received since the end of the doubling of the overall budget of the National Institutes of Health (NIH) in 2002. This increase for FY 2009 is an important step in reversing nearly 7 years of flat budgets for the NIMH. These flat budgets have left the NIMH far below its overall FY 2002 purchasing power for new research grants. Nevertheless, this 3% increase for FY 2009 is still below the projected level of medical research inflation – the increase needed to keep pace with the growth in the cost of biomedical research.
At the same time, this increase in the FY 2009 base for NIMH is coupled with an infusion of a projected $350 million dollars as part of the Economic Stimulus and Recovery package that President Obama signed into law last week. These funds will be invested over the next two years to support basic and clinical grants (known as R01 grants), supplements to existing grants, and grants funded through a new two-year program called NIH Challenge Grants in Health and Science. The Challenge Grants program will support studies that address scientific and health research gaps that rapidly generate outcomes.
The new economic stimulus and recovery package stipulates that all stimulus money must be spent within 2 years, requiring NIH and NIMH to establish an unusually quick turnaround for high-impact, short-term projects. In addition, there will be extensive reporting requirements for these funds, so that the outcomes of this extraordinary investment can be monitored. NIH and NIMH will soon announce specific initiatives and mechanisms by which these funds will be invested. NAMI will be closely monitoring developments on these additional funds. Click here to view a message from NIMH Director Tom Insel on funding in the stimulus package.
NAMI is extremely grateful for the leadership of Senators Tom Harkin (D-IA) and Arlen Specter (R-PA) and House Appropriations Chairman David Obey (D-WI) for their leadership in securing these increased investments in biomedical research at NIH and NIMH.
Mental Illness Services
The FY 2009 Omnibus spending bill restores cuts to a range of programs at the Substance Abuse and Mental Health Services Administration (SAMHSA) and the Center for Mental Health Services (CMHS). Among the highlights for CMHS in the FY 2009 Omnibus bill are:
- Mental Health Block Grant – Funded at $420.77 million, the same as the FY 2008.
- PATH (state formula grants for outreach and engagement of homeless individuals with mental illness) – funded at $59.69 million, a $6.4 million increase over the FY 2008 level.
- Childrens’ Mental Health – $108.4 million, a $6.1 million increase over FY 2008.
- Garrett Lee Smith Suicide Prevention – Boosted to $47.1 million, or a $7 million increase over last year’s level and
- Protection & Advocacy (PAIMI) – Increased to $35.9 million ($1 million above FY 2008).
The FY 2009 Omnibus spending bill includes $75 million across SAMHSA for homeless programs, including $32.25 million at CMHS and $42.75 million at the Center for Substance Abuse Treatment. This is nearly $22 million more than the FY 2008 total. This includes funding for services in permanent supportive housing and homelessness prevention.
The FY 2009 Omnibus spending bill includes an increase of $45 million for a range of demonstration and training programs at CMHS as part of "Programs of Regional and National Significance" (PRNS) including state incentives grants, youth violence prevention and elderly services. The PRNS total also includes $7 million for a new program to integrate primary care and specialty medical services in community mental health centers and $6.7 million for jail diversion programs.
Finally, the bill includes $10 million for FY 2009 for the Bureau of Justice Assistance at the Justice Department for programs authorized under the Mentally Ill Offender Treatment and Crime Reduction Act (MIOTCRA). This includes jail diversion programs, enhanced correctional treatment, discharge planning and community reentry services, and cross-training of criminal justice and mental health professionals. This is a $3.5 million increase over the FY 2008 level.
The FY 2009 Omnibus Appropriations bill includes $250 million for HUD Section 811 program, $90 million above the amount originally recommended by former President Bush and $13 million above current FY 2008 funding. The Section 811 program provides grants to non-profit disability organizations to construct or rehabilitate community-based housing fro non-elderly people with disabilities, including serious mental illness. The program allocates funding for both capital advance grants and project-based rent subsidies to make rents affordable for people living on SSI.
For FY 2009, $161.3 million is allocated for new capital advance grants and project-based assistance and $87.1 million is allocated for renewal existing 811 tenant-based rent subsidies. In recent weeks HUD has announced the awards for new 811 grants for FY 2008. The list of these grants awards can be viewed on the HUD website.
The bill does allocate an additional $30 million for Section 8 rental vouchers targeted to non-elderly people with disabilities – the second year in a row that Congress was able to do so. In addition, language in the bill will allow HUD to more effectively target these rental vouchers to housing agencies that are working directly with human service agencies such as mental health authorities working to transition people from institutional settings into the community.
Homeless Funding: The Omnibus Appropriations bill allocates $1.677 billion for programs under the McKinney-Vento Homeless Assistance Act, $91 million more than the FY 2008 level, and $41 million more than former President Bush requested. The bill includes full funding for renewal of all expiring rent subsidies under the Shelter Plus Care program – a critical resource for permanent supportive housing targeting adults with serious mental illness and co-occurring disorders experiencing long-term chronic homelessness.
In addition, HUD last week issued awards to states and communities for the FY 2008 round of funding for McKinney-Vento programs, including grants to each local "Continuum of Care." Details on the FY 2008 awards can be viewed on the HUD website.
Finally, the bill appropriates an additional $75 million for the VASH program – a joint HUD-VA program that provides permanent supportive housing for veterans experiencing chronic homelessness. Additional information on the HUD-VA VASH program is available on the HUD website.
Social Security Administrative Funding
While funding for cash benefits for disability programs such as SSI and SSDI are considered mandatory, the administrative budget of the Social Security Administration (SSA) is still a discretionary account, dependent on annual appropriations from Congress – and therefore part of this FY 2009 Omnibus spending bill. In recent years, the administrative budget for SSA has failed to keep pace with escalating demands on the agency, especially for claims for SSI and SSDI eligibility and beneficiary appeals. The result is that many consumers have to wait years to get a hearing on a claim for eligibility or an appeal.
For FY 2009, Congress has allocated additional funds for the SSA administrative budget, known as the "Limitation of Administrative Expenses" (LAE). The bill provides $10.454 billion for the LAE, which is $708.9 million above the comparable FY 2008 level and $126.5 million more than former President Bush originally requested.
The bill also includes the following in an accompanying legislative report:
The additional funds above the request are provided to accelerate SSA's effort to reduce the backlog of disability claims and to support improvements in other SSA services offered to the public. SSA should provide a report to the Committees on Appropriations of the House of Representatives and the Senate, not later than 180 days after enactment of this Act, which identifies the specific investments and major initiatives that have or will be made to improve SSA's key services to the public.
The bill includes new language designating that from within the amounts provided for the Limitation on Administrative Expenses, not less than $264,000,000 may be used for conducting continuing disability reviews and redeterminations of eligibility under SSA's disability programs. An additional $240,000,000 is also provided for these continuing disability reviews and redeterminations of eligibility. These amounts are the same as the budget request. A report to Congress on the obligation and expenditure of these additional amounts is required.