Federal Budget Update: Omnibus Results

March 15, 2022

President Biden has signed into law the Consolidated Appropriations Act, 2022. The omnibus spending package includes billions of dollars in support for crucial, life-saving mental health and substance use services. The National Council for Mental Wellbeing along with the NYS Council for Community Behavioral Healthcare and its’  members across the country advocated diligently for a number of these funding priorities, including additional funding for Certified Community Behavioral Health Clinic (CCBHC) Expansion Grants, the creation of a new Behavioral Health Crisis Coordinating Office at Substance Abuse and Mental Health Services Administration, as well as critically necessary resources for the National Suicide Prevention Lifeline.

Context:  Congress has cleared the $1.5T Omnibus bills (discussed below) and now the country is at FY22 spending levels through September 30 (end of the federal fiscal year).  Biden FY2023 Budget proposal expected out at the end of March.
Additional Notes: The next expiration date for the federal Public Health Emergency is April 16  however it is likely to be extended through mid-July. The Medicare Teleheath flexibilities (discussed in note below) will end 151 days AFTER the end of the (federal) PHE.  This includes Medicare audio-only AND it also pertains to the recent (Medicare) federal regulation that requires a provider to see a Medicare client in person every 6 months if you want to continue to bill Medicare for telehealth visits.  Again, this regulation would take effect 151 days AFTER the end of the federal PHE. 

Key mental health and substance use treatment provisions in the bill include:

  • Telehealth in Medicare: The Consolidated Appropriations Act, 2022 makes several changes aimed at expanding and extending telehealth flexibilities, including:
    • The removal of geographic requirements and expansion of originating sites for telehealth services; an expansion of practitioners eligible to furnish telehealth services – to include occupational therapists, physical therapists, speech-language pathologists, and audiologists; a delay to the in-person requirements under Medicare for mental health services furnished through telehealth and telecommunications technology; and an authorization for the furnishing of audio-only telehealth services.
    • Each of the aforementioned changes would be effective for 151 days after the conclusion of the COVID-19 Public Health Emergency.
  • Substance Abuse and Mental Health Services Administration (SAMHSA): $6.5 billion in funding for SAMHSA – an increase of $530 million above the FY 2021 enacted level. SAMHSA funding includes:
    • A $100 million increase to the Mental Health Block Grant (MHBG), including an increase to the mental health crisis systems set-aside in the MHBG to five percent of the total.
    • $3.9 billion for substance use treatment, including continued funding for opioid prevention and treatment, recovery, and tribal focused treatment efforts. This includes $1.85 billion for the Substance Abuse Prevention and Treatment Block Grant (SABG); $1.525 billion for State Opioid Response Grants; $34.9 million for Pregnant & Postpartum Women; $13 million for Building Communities of Recovery; and $101 million for Medication Assisted Treatment.
    • $315 million to fund Certified Community Behavioral Health Clinics Expansion Grants.
    • Includes $101.6 million for the National Suicide Prevention Lifeline (Lifeline) to support the implementation of the Lifeline’s new 988 number and $38.8 million for Garrett Lee Smith Youth Suicide Prevention grants.
    • Provides $5 million to establish an office dedicated to the implementation of the 988 Lifeline and coordination of crisis care across Department of Health and Human Services operating divisions, including Centers for Medicare & Medicaid Services (CMS) and HRSA. The office will support technical assistance and coordination of the nation’s crisis care network, the implementation of the 988 Lifeline, and the development of a crisis care system with the objective of expanding crisis care services and follow-up care, including through services provided by, Community Mental Health Centers, CCBHCs, and other community providers.
    • Increases for mental health resources for children and youth, including $120 million for Project AWARE; $81.8 million for the National Child Traumatic Stress Initiative; and $10 million for Infant and Early Childhood Mental Health.
    • Creates a new Mental Health Crisis Response Partnership Pilot Program, which will provide $10 million to help communities create mobile behavioral health crisis response teams.
  • Health Resources and Services Administration (HRSA) – $8.9 billion for HRSA, an increase of $1.4 billion above the 2021 enacted level. The amount includes:
    • $1.3 billion for HRSA’s Bureau of Health Professions programs to support health workforce development, including $24 million for the Substance Use Disorder Treatment and Recovery Loan Repayment Program.
    • $1 billion for programs to improve maternal and child health, including $6.5 million for Screening and Treatment for Maternal Depression and Related Disorders.
    • $366 million for Rural Health Programs.