The FY 2009 funding process continues to move forward in Congress.  In early June, both the U.S. House and Senate approved the budget resolution, which is $21 billion over the President’s overall budget request.  The budget resolution serves as a blueprint for Congress that contains a spending cap for discretionary programs and gives direction to the Appropriations Committees about how much money they can allocate during the annual funding process. 

Following approval of the budget resolution, the House and Senate Appropriations Committees have begun review of the annual spending bills.

• The House Labor, Health and Human Services, and Education (Labor HHS) Appropriations Subcommittee, whose spending bill includes funding for alcohol and drug prevention, treatment, recovery and research programming, reviewed and approved its FY 2009 spending bill on June 19^th.  Although the Subcommittee will not release details about program spending levels until the full House Appropriations Committee reviews the Labor HHS bill on June 25^th, at the Subcommittee mark-up session Committee Chairman David Obey (D-WI) did express that funding for substance abuse and mental health services would receive $80 million in increased funding over FY 2008.  In addition, Chairman Obey asserted that the House Labor HHS bill would increase funding for the National Institutes of Health (NIH) by $1.2 billion over FY 2008. 

• The Senate Labor HHS Appropriations Subcommittee is scheduled to review its bill during the week of June 23^rd with full Committee review expected shortly thereafter.

• Review of additional funding bills, including the Commerce, Justice, and Science (CJS) spending bill which funds Department of Justice programs such as the Second Chance Act, Byrne grants, drug courts and Residential Substance Abuse Treatment (RSAT), has also begun.  The full Senate Appropriations Committee approved its CJS bill on June 19^th.  The House CJS Subcommittee approved its bill on June 12^th and the full House Appropriations Committee is scheduled to review the CJS bill during the week of June 23^rd.

Timing for the rest of the funding process remains unclear.  Since there will be a new Congress and Administration in January, many expect that Congress will approve a short-term Continuing Resolution (CR) that will maintain federal program spending at FY 2008 levels until February or March 2009 rather than completing the FY 2009 spending bills during this Congressional session.  Updates on the FY 2009 funding process can be found at:  http://thomas.loc.gov/home/approp/app09.html

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Update on Medicaid Moratorium Legislation: Full U.S. House Passes Emergency Supplemental Funding Bill with Provisions to Delay Six Medicaid Rules

Legislation to place a one-year moratorium on implementation of several regulations proposed by the Centers for Medicare and Medicaid Services (CMS) that seek to cut the costs of the program to the federal government continues to move forward in Congress.

After brokering an agreement with the White House, the full U.S. House of Representatives passed a supplemental war spending bill in two parts on June 19^th.  The domestic spending portion of the supplemental bill delays by one year six of the proposed seven CMS Medicaid regulations; the package includes delay of CMS rules on targeted case management and the rehabilitation services option.  The bill would not block a regulation that would limit federal funding for hospital outpatient services.  The domestic spending portion of the supplemental spending bill was approved by the full House with a 416 to 12 veto-proof vote.

The full U.S. Senate is expected to vote on the supplemental bill, including those Medicaid moratorium provisions, during the week of June 23^rd. 

The CMS regulations at issue seek to limit certain types of services reimbursable under Medicaid provided by addiction treatment, mental health treatment and other healthcare providers. Reimbursement payments under Medicaid for targeted case management, rehabilitation, school-based transportation and outreach, hospital outpatient and other services provided through the health care system would be restricted under the proposed rules. 

Full text and status of the supplemental war spending bill can be found at: http://thomas.loc.gov/home/approp/app08.html. 

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Bills Aimed at Improving Drug and Alcohol Addiction Treatment Services for Veterans Approved by the House and the Senate

Recently, both the U.S. House and Senate have been working on a number of bills aimed at strengthening substance use disorder and mental health treatment services for veterans. 

• On May 20^th, the full U.S. House approved H.R. 5554, the “Veterans Substance Use Disorders Prevention and Treatment Act of 2008.”  Introduced by Congressman Michael Michaud (D-ME), H.R. 5554 seeks to expand and improve health care services available to veterans from the Department of Veterans Affairs (VA) for substance use disorders.

• On June 3^rd, the full U.S. Senate passed similar legislation, the “Veterans Mental Health Improvements Act,” introduced by Senator Daniel Akaka (D-HI) and four co-sponsors.  S. 2162 combines a number of smaller bills that seek to address substance use disorder and mental health treatment needs of veterans. 

H.R. 5554, approved by the House, would require that each VA medical center provide ready access to a full continuum of care for substance use disorders for veterans in need of such care.  Under the legislation, this continuum of care is defined as including:

• Screenings for substance use disorder in all settings
• Detoxification and stabilization services
• Intensive outpatient care services
• Relapse prevention services
• Outpatient counseling services
• Residential substance use disorder treatment for veterans with severe recurring substance abuse or substance dependence
• Pharmacological treatment to reduce cravings, including opioid substitution therapy
• Coordination with groups providing peer to peer counseling
• Short-term, early interventions for substance use disorders
• Marital and family counseling

Additionally, H.R. 5554 would require that the VA Secretary provide for outreach to veterans who served in Operation Enduring Freedom or Operation Iraqi Freedom to increase awareness of the availability of care, treatment and services from the VA for substance use disorders.  H.R. 5554 also would authorize a $1.5 million per year pilot program to test the feasibility of providing veterans who seek treatment for substance use disorders access to a computer-based self-assessment, education, and specified treatment program through a secure Internet website operated by the VA.  

S. 2162, approved by the Senate, contains many similar provisions for treatment options for veterans, and also includes additional sections not present in H.R. 5554.  The Senate bill would authorize the establishment of national centers of excellence on post-traumatic stress disorder (PTSD) and substance use disorders to provide comprehensive inpatient or residential treatment and recovery services for veterans diagnosed with both PTSD and a substance user disorder.  Additionally, S. 2162 would create a pilot program to provide veterans of the war in Iraq and Afghanistan with peer outreach and support services and other mental health services.  The pilot program locations would be rural areas which lack access to comprehensive mental health services through the Department of Veterans Affairs.  S. 2162 would create a research program on co-morbid post-traumatic stress disorder and substance use disorders. 

S. 2162 would also authorize a pilot program to assess the feasibility of providing readjustment and transition assistance to veterans and their families.  This would include assistance for veterans and their families in coping with the challenges associated with making the transition from military to civilian life.  

It is expected that the House and Senate will meet in conference committee in the next several weeks to discuss both pieces of legislation.  The text of both bills can be found at http://thomas.loc.gov/.

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Legislation to Restore Access to Food Stamps to People with Felony Drug Convictions Introduced in the House

Recently, legislation seeking to repeal federal policy prohibiting people who were convicted of a drug felony offense from receiving food stamps was introduced in the U.S. House of Representatives.  The “Food Assistance to Improve Reintegration Act of 2008” (FAIR Act), H.R. 5802, was introduced in April by Representative Barbara Lee (D-CA) and has 48 co-sponsors.

Current law, found in the Personal Responsibility and Work Opportunity Reconciliation Act of 1996 (PRWORA), prohibits anyone convicted of a drug-related felony from receiving both federally-funded cash assistance through the Temporary Assistance for Needy Families (TANF) program and food stamps unless States opt out or modify the ban.  Currently, 14 states still have a lifetime ban which disqualifies individuals from receiving food stamps if they were convicted of a state or federal felony drug offense; 22 states have modified the ban; and 17 states have opted out of the ban.

In a statement on the bill’s introduction, Representative Lee expressed that passing H.R. 5802 would help many women with children who are subject to the lifetime food stamps’ ban.  In these comments, Congresswoman Lee asserted that, “reversing this wrong is a move towards breaking the cycle of incarceration and promoting healthy families.”

The FAIR Act was introduced on April 15, 2008.  H.R. 5802 was referred to the House Committee on Agriculture where it awaits review.  The full text and status of the bill can be found at http://thomas.loc.gov/.

For further information, please contact: Gabrielle de la Gueronniere, Deputy Director for National Policy, at gdelagueronniere@lac-dc.org or Nisha Thakker, Policy Associate, at nthakker@lac.org.