The broad-based Coalition for Health Funding, with more than 200 member organizations including APA, began lobbying Congress last month to increase total federal spending on health services and research in Fiscal 2005 by 12 percent over the current fiscal year’s budget.
The coalition sends Congress an annual budget recommendation for the Department of Health and Human Services’ (HHS) programs and agencies, including the Centers for Disease Control and Prevention, National Institutes of Health (NIH), and Substance Abuse and Mental Health Services Administration (SAMHSA), according to a coalition mission statement.
The coalition’s budget recommendation excludes federal spending on Medicare, military health, and veterans health.
In a February letter, the coalition called on President Bush and members of Congress to make the public health system a funding priority.
“Our nation’s public health system will not be able to respond adequately to an unprecedented range of threats including infectious and food-borne illnesses, biological and chemical terrorism, and mental disorders and substance abuse without additional resources for the continuum of medical research, prevention, treatment, and training programs,” the coalition letter stressed.
Workforce Levels Threatened
Another threat the coalition cited is the shortage of health care professionals and other key personnel.
Lizbet Boroughs, an associate director in APA’s Department of Government Relations (DGR), told Psychiatric News, “We are concerned about a shortage of not only psychiatrists in the public sector, but also psychiatric nurses and case managers who play essential roles in caring for the mentally ill.”
The coalition emphasized that increasing discretionary funding for the public health system by 12 percent over last fiscal year is “critical to improving the health, safety, and security of our nation.” This is nearly 10 percentage points more than the president’s proposed total increase for HHS of 2.8 percent. However, the bulk of that increase would be for Medicare and Medicaid programs, leaving roughly a 1 percent increase for discretionary funding, which is less than in previous years.
In addition, in his Fiscal 2005 discretionary budget the president proposed spending $4.1 billion on bioterorrism preparedness, according to DGR. Approximately $500 million is deducted for Medicare and Medicaid savings. That leaves a discretionary funding total of $66.75 billion in Fiscal 2005, compared with $67.42 billion in this fiscal year.
Another Small Increase
The NIH is targeted for a proposed 2.7 percent increase over Fiscal 2004 ($764 million), for a total budget of $28.8 billion in the president’s budget request.
Bush recommended a 2.7 percent increase over Fiscal 2004 for the National Institute of Mental Health and the National Institute on Drug Abuse. The president’s proposed increase for the National Institute on Alcohol Abuse and Alcoholism is 2.9 percent.
The corresponding dollar increases over the current year are $39 million, $28 million, and $13 million, respectively, according to the budget review.
“Because these rates will neither keep pace with medical inflation nor the pace of research opportunities, APA, in concert with the Ad Hoc Group for Medical Research Funding, the Coalition for Health Funding, and the Mental Health Liaison Group, will call on Congress to provide additional funds,” states the coalition’s budget review.
Bush has proposed a 6 percent increase of $199 million for SAMHSA in Fiscal 2005. This would give the mental health agency a budget of $3.6 billion.
“Overall, the SAMHSA budget includes $2.5 billion (a net increase of $148 million or 6 percent) for substance abuse treatment and prevention activities,” the budget review states.
The Center for Mental Health Services (CMHS) would receive a $50.6 million increase over Fiscal 2004 in the president’s budget request. The bulk of those funds ($44 million) are designated for new State Incentive Grants for Transformation, which are designed to help states develop comprehensive mental health plans.
The president also proposed an increase of $3.6 million for the Comprehensive Community Mental Health Services for Children and Their Families Program and a $5.2 million increase in funding over last fiscal year for the Projects for Assistance in Transition from Homelessness (PATH) program. The president’s budget for the current fiscal year also included large increases for these two programs (Psychiatric News, March 6).
Boroughs praised the president for funding the new state incentive grants but said it should not come at the expense of community grant programs for jail diversion and improving mental health services to the elderly. The president’s Fiscal 2005 budget would cut $8 million in funding for these program categories. This would leave $4 million in funding for the jail-diversion program and erase all funding for mental health outreach to seniors, according to Boroughs.
“APA is aggressively lobbying members of the House Appropriations Committee to restore the funding for those two programs,” said Boroughs.
The president’s Fiscal 2005 budget request for HHS is posted online at www.hhs.gov/budget/docbudget.htm. ▪
The president’s Fiscal 2005 budget request for health and biomedical research reflects his emphasis on priorities other than health and medicine, with a few exceptions. See related column on page 47.
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