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MH Comes Up Short In Bush's Proposed Budget

Federal spending on the Department of Health and Human Services will decrease by about 1 percent in the next fiscal year if Congress approves the president's proposed budget.

President George W. Bush acted on his promise last month to cut the federal budget deficit in half in the next five years. He submitted a budget request to Congress for Fiscal 2006 that includes $214 billion in cuts in domestic discretionary (nonentitlement) programs unrelated to defense, international affairs, and homeland security over five years.

Bush's budget also includes $138 billion in reductions over the next 10 years in mandatory programs including Medicaid (see page 4), the food-stamp program, and child-care assistance to low-income working families.

Some mental health agencies, however, are in line for small increases.

Each February the president submits an annual budget request for federal spending for the next fiscal year, which begins in October. Congressional committees develop a resolution to govern the appropriations process. Once the appopriations bills are approved by the House and Senate, differences must be reconciled in conference before final passage.

Overall discretionary spending for the Department of Health and Human Services (HHS), which funds most public health research, services, and treatment, would be reduced by 1 percent to $67.2 billion, according to Nicholas Meyers, director of the APA Department of Government Relations.

Bush proposed budget increases for some HHS agencies. Compared with Fiscal 2005, the Food and Drug Administration would receive a 4 percent increase ($80 million), the Indian Health Service would receive a 2 percent increase ($72 million), and the National Institutes of Health (NIH) would receive a .7 percent increase ($195 million), according to Lizbet Boroughs, an associate director in the Department of Government Relations.

Meyers told Psychiatric News, "The president has proposed the lowest budget increase for NIH in several years. However, funds from the increase will be used to implement the NIH Road Map [Psychiatric News, April 16, 2004], which includes a strong emphasis on neuroscience research."

Bush proposed tiny budget increases over Fiscal 2005 for the National Institute of Mental Health: .41 percent, or $6 million; National Institute on Drug Abuse: .33 percent, or $3.3 million; and National Institute on Alcohol Abuse and Alcoholism: .34 percent, or $1.5 million (see table).

In contrast, the president proposed a decrease of about 1 percent ($56 million) in overall spending in Fiscal 2006 for the Substance Abuse and Mental Health Services Administration (SAMHSA).

The Center for Mental Health Services (CMHS), an agency within SAMHSA, is also slated for a budget cut, with Bush requesting a 7 percent decrease ($64 million) in Fiscal 2006 (see chart below).

"The president's cuts to CMHS are primarily confined to demonstration and best-practice grants related to youth-violence prevention and jail diversion. The president's budget cuts will not affect current grants," Boroughs said.

Nearly every CMHS program would be cut or kept at the Fiscal 2005 level in the president's budget. The only exception is a $6 million increase for the recently initiated State Incentive Grants for Transformation, designed to help states develop comprehensive mental health plans.

Funding for community grant programs for jail diversion would be cut severely, from $7 million in Fiscal 2005 to $4 million in Fiscal 2006. Bush had proposed a similar cut to the same program in his Fiscal 2005 budget, but Congress later restored the funding.

The president also proposed cutting the budget of a successful youth-violence prevention program by about a third, from $94 million to $67 million, Boroughs noted.

Bush requested no increase in funding for most CMHS programs from the current fiscal year. These programs include mental health and substance abuse block grants, comprehensive community mental health services for children and their families, youth suicide prevention, mental health services for the elderly, and projects to assist people in transition from homelessness.

The president's Fiscal 2006 budget request for HHS is posted online at <www.hhs.gov/budget/docbudget.htm>.

Related Article:

Coalition Suggests Reforms To Make Medicaid Work

Kate Mulligan
Psychiatr News 2005 40: 4-9. [Full Text]

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