Omnibus Budget Bill Includes Important Provisions Supporting Public Health, APA Says
Includes funding for key programs aimed at opioid crisis, increasing mental health workforce
WASHINGTON — The American Psychological Association commended congressional leaders for crafting a budget that puts public health over politics.
“This budget comes not a moment too soon for communities that have been devastated by the opioid epidemic and suicide,” said APA CEO Arthur C. Evans Jr., PhD. “We are grateful that Congress set aside partisan differences and made strides to restore and enhance the budgets for critical science, education and public health programs.”
A $3 billion increase to the National Institutes of Health “will accelerate our fundamental understanding of such challenging health conditions as Alzheimer’s disease, substance use and pain, giving patients alternatives to pharmacological treatments,” Evans said.
The budget recognizes that mental health is essential to the nation’s public health, for children in schools, families in crisis and veterans, said APA President Jessica Henderson Daniel, PhD. The investment in expanding the pipeline of mental health providers is critically needed, she added.
“Lives will be saved by these investments, but lives will continue to be lost if we don’t sustain our efforts,” Daniel said. “We look forward to continuing our efforts with Congress as we work on further bipartisan solutions to this multifaceted problem.”
The omnibus bill pays significant attention to gun violence prevention, including new authorizations at the Department of Justice (DOJ) for evidence-based school safety programs that train school personnel and law enforcement how to respond to children in crisis, and to improve reporting of domestic violence and felony convictions to the National Instant Criminal Background Check System. The bill also clarifies that the Centers for Disease Control and Prevention (CDC) has the authority to conduct research on the causes of gun violence and makes investments through the Department of Education in community and school-based violence prevention programs. Unfortunately, the bill uses research and evaluation funds from the Comprehensive School Safety Initiative to fund the DOJ programs and does not provide new dedicated funding for gun violence prevention research or prevention programs at CDC. However, Congress did provide funding for nationwide expansion of the National Violent Death Reporting System.
Evans praised the inclusion of resources to address the significant mental health workforce shortages across the country. “More than 100 million people live in areas without access to mental health providers, which is why investments in workforce training, expansion of the National Health Service Corps and telehealth strategies will get help to people where they live,” he said.
In a stepped-up effort to prevent veteran suicide, the omnibus would require that all veterans with other than honorable discharges be screened for mental health problems before their departure, and the Veterans Administration would guarantee and pay for access to mental health care, without a time limit, for those who served at least 100 days, experienced sexual assault or trauma or worked as drone operators.
APA worked with congressional appropriators to address other shared priorities, including:
- $700 million for the Mental Health Block Grant, $160 million above last year's amount, and $1.9 billion for the Substance Abuse Block Grant, the same amount as last year.
- $1.1 billion for states — a $700 million increase — to support a grant program that would provide mental health services in schools, as well as expand technology and STEM education.
- A $52 million increase for behavioral workforce education and training at the Health Resources and Services Administration.
- $350 million to support the Public Service Loan Forgiveness Program.
- $1 million increase for the Minority Fellowship Program within the Substance Abuse and Mental Health Services Administration to create new fellowships for psychologists and addiction medicine to address the needs of individuals with substance use disorders.
“Researchers and providers, including psychologists, who want to make a difference are counting on loan repayment through the National Health Service Corps or the National Institutes of Health and on public service loan forgiveness,” Evans said. “Our communities can’t wait, and our students can’t wait.”
In addition, appropriators agreed with APA and other scientific societies that NIH’s new policy of naming nearly all research involving humans as “clinical trials” should be suspended and renegotiated. Many APA scientists had raised concerns about the new policy.
Also of note, the National Science Foundation received an additional $295 million, for a total of $7.8 billion, including an additional $301 million for research and related activities aimed at keeping pace with scientific investment with China and other nations.
The Agency for Healthcare Research and Quality received an additional $10 million, for a total of $334 million, despite efforts by the administration to defund the agency and integrate it with NIH.
Other notable provisions in the bill include:
- $30 million for mental health courts and adult and juvenile collaboration program grants, as authorized by the Mentally Ill Offender Treatment and Crime Reduction Reauthorization and Improvement Act. These funds are aimed at addressing the mental health needs of juvenile and adult offenders. APA helped enact the program and has continued to advocate for funding increases.
- A $35.5 million increase, to $282.5 million, in total juvenile justice funding, including $8 million for opioid-affected youth.
- A $17 million increase, to $85 million, for Second Chance Act funding to aid people re-entering the community after serving time in jail or prison.
- A $6 million increase, to $42 million, for the Department of Justice’s National Institute of Justice.
- $8.3 billion for CDC, a $1 billion increase over 2017, as well as $475 million for opioid prescription drug overdose prevention activities.
- $613 million for the Department of Education’s Institute of Education Sciences, an $8 million increase from the 2017 of $605 million.
- $2.5 million for the recently launched National Training Center on Police-Based Responses to Individuals with Mental Illness and Developmental Disabilities.
Kim I. Mills