The federal budget appropriations process for FY 2007 could provide a mixed bag for substance abuse treatment providers, according to representatives of the Legal Action Center (LAC), a law and policy organization that advocates on behalf of people with histories of addiction, HIV/AIDS, or criminal records.
Federal funding for addiction prevention, treatment, and research has “done pretty well even in the tight budgets of the past couple years,” notes Paul N. Samuels, LAC director and president, “but this year is going to present a major challenge. The proposed budget, across the board, for every area, is very tight.” For example, for the second year in a row, the President has proposed eliminating all the funding for the Department of Education's Safe and Drug-Free Schools and Communities State Grants program, which funds many alcohol and drug prevention services. Samuels says that for the first time in recent memory, budget cuts have been proposed for the National Institute on Drug Abuse and the National Institute on Alcohol Abuse and Alcoholism.
On the other hand, Medicaid might be spared further cuts. “The President is proposing additional cuts to Medicaid, but I think the signals coming from the Hill are not real responsive to that,” says Alexa Eggleston, LAC's deputy director of national policy. “The Republicans in particular got beat up this past year by a lot of the advocacy groups, so I think, being an election year, they're pretty nervous about doing another round of budget cuts to programs like Medicaid.”
As LAC concentrates on keeping funding for substance abuse prevention, treatment, and research at least at current levels, it's also pushing for passage of related bills, including the Second Chance Act. The bill, Eggleston explains, would fund a state demonstration program to coordinate services (such as drug treatment, job training, and transitional housing) for people exiting the justice system. The bill also allocates funds for a review of legal barriers that people face when they leave the justice system, such as barriers to employment, educational assistance, welfare and food stamps, and housing. “This is the first time major legislation has been proposed to require a review of all these barriers across the board and report back on whether they make sense,” notes Samuels. “Not only could that be very educational, but we're hoping it also could set the stage for Congress to start repealing these really counterproductive laws.”
Eggleston says the Second Chance Act does have a chance of passing, enjoying bipartisan support in both chambers. Congress recently handed recovery advocates and the field a victory with a repeal of the ban on federally funded student loans for people who have drug-related convictions.
But what about parity legislation? Despite widespread support—Eggleston notes that one version has more than half of the House members as cosponsors—bills requiring mental health and substance abuse parity have not gone very far. Eggleston says a lack of knowledge on the topic and opposition from insurance and some business groups have stalled the legislation. Samuels says the big question is, “Can we as a field generate enough interest and pressure within Congress to move leadership to move the bill?” He adds, “We are going to need to figure out a way to get more support to push this across the finish line.”