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Among Trillions in Federal Spending, Billions for Addiction Programs

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President Barack Obama this week proposed a $3.6-trillion federal budget for fiscal year 2010, an announcement that overshadowed House approval of a more immediately significant omnibus appropriations bill for FY2009 that included major funding for addiction-related programs.

The $410-billion appropriations bill, approved by the House of Representatives on Feb. 25 by a 245-178 vote, would keep the federal government running through the end of the current fiscal year (Sept. 30) and calls for increasing domestic spending by 8 percent. The measure now goes to the Senate for consideration.

The government is currently operating under a previous stopgap appropriations bill, passed last fall under a continuing resolution that expires on March 6. Technically, Congress is supposed to have a budget for the full fiscal year in place each October.

The omnibus bill includes $1.778 billion for the federal Substance Abuse Prevention and Treatment (SAPT) block grant — a modest $19.8-million increase over FY2008 — $414 million for the Center for Substance Abuse Treatment, and $201 million for the Center for Substance Abuse Prevention. The CSAT budget is $14.5 million higher than last year's, while CSAP's budget would rise $6.8 million over the 2008 appropriation.

The Drug-Free Communities Act, which provides grants to community-based anti-drug coalitions, was level-funded at $90 million.

The state grants portion of the Safe and Drug-Free Schools and Communities program within the Department of Education would receive $294.7 million, the same as last year. The National Institute on Drug Abuse (NIDA), part of the National Institutes of Health, would be funded at $1.032 billion, up $30.8 million from FY2008. The National Institute on Alcohol Abuse and Alcoholism (NIAAA) would receive $450 million, representing an increase of $14.7 million.

The House-passed measure represents solid gains for the addiction community, especially in light of the economy and compared to the budget cuts proposed last fall by the Bush administration. For example, the omnibus bill includes $5.2 million for the Recovery Community Services Program, which Bush would have eliminated.

On the other hand, the House ignored the previous administration's call to increase funding for Screening, Brief Intervention and Referral to Treatment programs, level funding the CSAT grant program at $29.1 million rather than adding $29 million as proposed by Bush (and supported by addiction-field organizations). Another Bush favorite, the National Anti-Drug Media Campaign run out of the Office of National Drug Control Policy, would get $70 million under the House budget plan, up $10 million from 2008.

Bush also has at least one legacy in the 2009 drug budget: his Access to Recovery treatment-voucher program is included in the omnibus funding bill with an appropriation of $98.9 million, up $2.4 million from 2008.

The National Association of Drug Court Professionals (NADCP) applauded House lawmakers for boosting funding for drug courts both at CSAT and the U.S. Department of Justice. Under the House bill, DOJ funding for drug courts would rise to $40 million (from $15.3 million) and CSAT funding would increase from $9.94 million last year to $23.8 million this year.

“This marks the second year in a row Federal drug court funding has increased and once signed by the President, will be the largest annual Federal appropriation in the history of drug courts,” according to NADCP CEO West Huddleston.

Obama's FY2010 Budget    

While the omnibus bill in the House has more to do with housekeeping than history, the budget plan outlined by Obama during his address to a joint session of Congress this week represents a fundamental shift away from the policies and priorities of the last eight years, if not longer.

The budget plan, which is still being drafted, calls for spending $634 billion to reform the U.S. healthcare system, largely by offering more Americans coverage similar to that now available to federal employees — including parity care for addiction and mental-health treatment.

“Because of crushing health care costs and the fact that they drag down our economy, bankrupt our families, and represent the fastest-growing part of our budget, we must make it a priority to give every single American quality, affordable health care,” said Obama on Feb. 26. “That's why this budget builds on what we have already done over the last month to expand coverage for millions more children, to computerize health records to cut waste and reduce medical errors, which save, by the way, not only tax dollars, but lives.”

“With this budget, we are making a historic commitment to comprehensive health care reform,” he added. “It's a step that will not only make families healthier and companies more competitive, but over the long term it will also help us bring down our deficit.”

Obama's budget plan, titled A New Era of Responsibility, highlights a number of priorities for the Department of Health and Human Services (HHS), but addiction treatment and prevention are not named among them. The HHS budget for FY2010 would actually decline slightly under Obama's plan — from a projected $78.4 billion this year to $76.8 billion, but that doesn't count the $22.4 billion in the recently passed economic-recovery/stimulus bill.

The budget document outlines such priorities as healthcare reform, improved health information technology, cancer research and autism research, but does not get into great detail about funding levels for HHS programs not identified as priorities. A more detailed budget should be forthcoming from the administration in the next few weeks.

However, Obama's budget for the U.S. Department of Justice, touts the president's proposal to spend $109 million on prisoner reentry programs, “including an additional $75 million to expand programs authorized by the Second Chance Act which provide counseling, job training, drug treatment, and other transitional assistance to former prisoners.”

Mental-health outreach and homelessness prevention programs are identified as priorities in the Obama budget for the Department of Veteran's Affairs, and the Department of Housing and Urban Development budget document promises $4.5 billion to “fully fund” the Community Development Block Grant.

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