[NYAPRS Enews] NC: President's Budget Requests Include Cuts to SAMHSA, Medicaid

Tue Feb 21 14:26:49 EST 2012

President's Budget Requests Include Cuts to SAMHSA, Medicaid; National
Council Issues Budget Analysis

National Council for Community Behavioral Healthcare  Washington D.C.,
Friday, February 17, 2012

On February 13, 2012, President Obama released his Administration's
budget requests for Fiscal Year 2013. The budget in many ways reflects
the nation's growing concern with federal spending and the national
deficit. Overall, the Substance Abuse and Mental Health Services
Administration (SAMHSA) program request for 2013 is $3.4 billion, a
$141.9 million (or 4%) decrease from FY 2012. The $3.4 billion is
comprised of $3.2 billion in actual SAMHSA budget authority (a $195.5
million drop from 2012), plus $164.8 million in PHS Evaluation funds and
$105 million from the Prevention and Public Health Fund created in the
Affordable Care Act.

SAMHSA noted in the justification
<http://echo4.bluehornet.com/ct/14875950:17821614977:m:1:1362575734:98D8
B5342A3138AB59FE68714C7F2C08:r>  for its budget request that tough
decisions had to be made, with an eye towards strategic reductions that
maintain support for key agency priorities like prevention. Overall,
this year's budget requests represent a mixed bag for SAMHSA. Many
programs have been sharply cut, while some new programs (particularly
around prevention and trauma) have been created. Still other programs
will see existing program activity maintained, though funding will not
be available to support new grants.

Caveats to Interpreting This Year's Budget Requests

It is important to note when interpreting this year's budget requests
that many apparent cuts are the result of funding being shifted among
categories and will not affect existing program activities. In some
cases, what appears to be a program cut may actually represent level
funding or even support for new program activities. For this reason, the
National Council strongly encourages you to read our 2013 budget
analysis
<http://echo4.bluehornet.com/ct/14875951:17821614977:m:1:1362575734:98D8
B5342A3138AB59FE68714C7F2C08:r>  in order to understand the impact of
this year's budget numbers on your particular programs of interest.

Key SAMHSA Requests

Among the key requests in the President's 2013 budget proposal:

*	Mental Health activities: $951.9 million (-$46.9 million vs.
FY12)
*	Substance Abuse Prevention activities: $470.4 million (-$59.8
million vs. FY12)
*	Substance Abuse Treatment activities: $1.8 billion (-$68.6
million vs. FY12)
*	Health Surveillance and Program Support (a new category of
activities): $187.7 million (+$33.4 million vs. FY12)
*	Mental Health Block Grant: $459.8 million (level to FY12)
*	Substance Abuse Block Grant: $1.45 billion (-$7.5 million vs.
the comparable portion for FY12, reflecting the shift of the 20%
prevention set-aside into a new line item for prevention grants)
*	Primary-Behavioral Health Care Integration grants: $26 million
(-$39 million vs. FY12, with all funding being shifted away from SAMHSA
budget authority and onto the Prevention and Public Health Fund created
in the Affordable Care Act)
*	Mental Health - State Prevention Grants (a new program to
support the early identification and prevention of mental illness among
youth, building off the successful Project LAUNCH): $55 million
*	Substance Abuse - State Prevention Grants (a new program to
combine existing prevention activities into a line item that - at the
direction of Congress - is used exclusively for prevention): $404.5
million
*	Grants for Adult Trauma Screening and Brief Intervention (a new
program to address trauma in common health care settings, such as
emergency departments, primary care, and OB/GYN): $2.9 million

National Council Issues Detailed Budget Analysis

Click here
<http://echo4.bluehornet.com/ct/14875951:17821614977:m:1:1362575734:98D8
B5342A3138AB59FE68714C7F2C08:r>  to read the National Council's full
analysis of the 2013 budget requests, including additional SAMHSA
programs not covered above. Our analysis peels back the layers of
complexity that accompanied the restructuring and shifting of funds in
this year's budget and provides a clear interpretation of where funding
was cut, where program activity will be maintained, and other critical
information.

Cuts to Medicaid, Medicare Proposed

In addition to the President's budget requests for specific programmatic
activities, his 2013 proposals also included a number of suggested
changes to Medicaid and Medicare. These changes are projected to save
approximately $364 billion over the next ten years. They include:

*	Creating a "blended" Medicaid and CHIP match rate, which
consolidates states' current complicated patchwork of matching formulas
into a single federal match rate for each state
*	Permanently fixing the "SGR" physician payment formula that
calls for ever-increasing pay cuts each year (and which Congress has
consistently overridden since 2002)
*	Instituting co-pays for home health Medicare services for new
beneficiaries beginning in 2017
*	Reducing the federal share of Medicare premiums and deductibles
for beneficiaries who are most able to afford it
*	Reducing waste, fraud, and abuse in Medicare, Medicaid, and the
Children's Health Insurance Program

Because Medicaid and Medicare are entitlement programs, they are not
subject to annual Congressional appropriations. Instead, were Congress
to decide that it wanted to enact the President's proposals, it would
have to introduce legislation outside of the 12 annual appropriations
bills.

For More Information

The National Council will continue to keep readers updated on the latest
news about the 2013 appropriations process through our newsletters
<http://echo4.bluehornet.com/ct/14875952:17821614977:m:1:1362575734:98D8
B5342A3138AB59FE68714C7F2C08:r> , blog
<http://echo4.bluehornet.com/ct/14875953:17821614977:m:1:1362575734:98D8
B5342A3138AB59FE68714C7F2C08:r> , and Action Alerts.
<http://echo4.bluehornet.com/ct/14875954:17821614977:m:1:1362575734:98D8
B5342A3138AB59FE68714C7F2C08:r> 

Please contact Chuck Ingoglia <mailto:chucki at thenationalcouncil.org>  or
Rebecca Farley <mailto:rebeccaf at thenationalcouncil.org>  with any
questions.

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