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Health & Human Services: 2020 Budget Primer

Feb 7

Written by: Grants Office, LLC
Friday, February 7, 2020  RssIcon

By Chris LaPage

On December 20, 2019, President Trump signed two budget bills that will fund the government through the remainder of federal fiscal year 2020 (September 30, 2020). When considering defense and non-discretionary (e.g. Medicaid, Social Security) spending, the 2020 budget tops out at about $1.4 trillion. In terms of the impact on grants, the important number is the amount of discretionary spending included in the budget. Many of these funds result in the competitive grant solicitations we all know. The 2020 budget includes almost $185 billion in domestic discretionary spending. Over half of these discretionary dollars ($94.9 billion) have been appropriated to the U.S. Department of Health & Human Services (HHS), making it the largest federal grantmaker. This represents a $4.4 billion increase over 2019 funding levels for HHS and a staggering $16.8 billion more than requested in the President’s Budget. The following is a brief primer on the appropriations included in the 2020 HHS budget and its impact on grant programming.

Health Resources & Services Administration (HRSA)

The Health Resources and Services Administration (HRSA) focuses on improving healthcare access and overcoming health professional shortages in underserved urban and rural areas. The 2020 budget includes nearly $7.3 billion for HRSA, a modest increase from 2019 and over $1 billion more than requested in the President’s Budget. HRSA generally prefers to disperse funds through a grant mechanism, which is good news for grantseekers as that means we’ll likely this increase translate to either more awards or larger award sizes.

HRSA realized a 9% increase in funding for its Bureau of Health Professions compared to 2019, for a total of nearly $1.2 billion. The additional money for health professional education and training initiatives is largely driven by a 36% increase in funding for the training of the behavioral health workforce ($102 million). Funding remained consistent for most of HRSA’s programs for nursing and physician training in primary care settings with small to modest increases in funding.

Funding for HRSA’s other priorities remained consistent with 2019 levels, including budgets for federally qualified health centers, the Ryan White HIV/AIDS Program, maternal and child health, and rural health.

Substance Abuse & Mental Health Services Administration (SAMHSA)

The Substance Abuse and Mental Health Services Administration aims to reduce the impact of substance misuse and mental illness on communities across the United States. In total, SAMHSA’s 2020 allocation of nearly $6 billion represents a small increase over 2019 funding levels. However, the budget maintains the federal government’s recent priority of investing in opioid prevention, treatment, and recovery while significantly increasing spending on mental health services. Just like HRSA, SAMHSA generally favors grants as a distribution mechanism as opposed to contracts or other alternatives.

SAMHSA has been allocated $1.64 billion in funding to address mental health services, which is a nearly 8% increase over 2019 levels. Several grant programs in this arena are seeing increases in funding between 40% and 75%. These include allocations for the Mental Health Awareness Training Grants, the Infant and Early Childhood Mental Health Grant, suicide prevention and treatment grants, criminal and juvenile justice programs, and assertive community treatment for individuals with serious mental illness.

SAMHSA allocations for substance abuse prevention and treatment are nearly identical to 2019 funding levels. There is a continued emphasis on tackling the opioid epidemic as the budget included new funding for the State Opioid Response Grants ($1.5 billion). There were some modest increases for certain programs that address opioid/substance abuse training for first responders, as well as funds targeted towards pregnant or postpartum women and building communities of recovery.

Administration for Children and Families (ACF)

The Administration for Children and Families (ACF) received more than $24 billion in the budget, which is $1.2 billion more than 2019 funding levels. The bulk of the increase is being allocated to early childhood initiatives, including $5.83 billion for the Child Care and Development Block Grants that are administered by each state. In addition, Head Start and Early Head Start funding increased by 5.5% 12.4%, respectively (combined $11.5 billion). Funding for the Community Services Block Grant (CSBG) and Social Services Block Grant (SSBG) are consistent with 2019 levels.

Other Highlights from the 2020 HHS Budget

Despite dramatic cuts proposed (nearly $5 billion) in the President’s Budget to research funding at the National Institutes of Health (NIH), Congress increased funding for NIH by nearly $2.6 billion, or $7.5 billion more than the administration requested. While all institutes and offices received increases over their 2019 funding levels, the biggest beneficiaries include the National Institute of Mental Health (8.9%), National Institute on Aging (15%) and the National Cancer Institute (8.7%).

The Centers for Disease Control and Prevention (CDC) received a small increase with a total budget of nearly $8 billion. New this year is $12.5 million dedicated to funding firearm injury and mortality prevention research. Funding for CDC surveillance activity related to the opioid epidemic remained consistent with more than $475 million in funding included. The Racial and Ethnic Approaches to Community Health (REACH) Grant Program realized a 7.2% increase in funding and tops out at nearly $60 million.

Resources

HHS Budget Bill: https://www.congress.gov/bill/116th-congress/house-bill/1865/text

Appropriations Process: https://www.senate.gov/CRSpubs/8013e37d-4a09-46f0-b1e2-c14915d498a6.pdf

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