Policy Brief

Enhance Counties' Ability to Prevent and Treat Mental Illness and Substance Abuse Disorders

Tags: Health
  • Document

    Enhance Counties' Ability to Prevent and Treat Mental Illness and Substance Abuse Disorders

    ACTION NEEDED:

    Urge your members of Congress to maintain consistent funding for substance abuse and mental health services provided through the Substance Abuse and Mental Health Services Administration (SAMHSA) and pass legislation that enhances counties’ ability to provide local systems of care. Future appropriations bills should meet or exceed FY 2021 funding levels, particularly for the Community Mental Health Services (CMHS) and Substance Abuse Prevention and Treatment (SAPT) block grants, which allow counties to direct resources to those with the most need.

    BACKGROUND:

    America’s 3,069 counties are integral to the nation’s behavioral health system. Counties annually invest $100 billion in community health systems, including behavioral health services. In 40 states plus the District of Columbia, there is at least one mental health facility operated by a regional/district authority or county, local or municipal government. Across 48 states plus the District of Columbia, there is at least one mental health facility that accepts county or local government funds as a source of payment for mental health treatment services. Through 750 behavioral health authorities and community providers, county governments plan and operate community-based services for persons with mental illnesses and substance abuse conditions. Counties also help finance Medicaid, the largest source of funding for behavioral health services in the U.S., and serve as the local safety net, administering wrap-around human services supports.

    SAMHSA, an agency of the U.S. Department of Health and Human Services (HHS), administers programs such as the Community Mental Health Services (CMHS) and Substance Abuse Prevention and Treatment (SAPT) block grants, which help counties provide direct behavioral services to those individuals in most need. Such services improve community well-being, reduce counties’ health care and justice system costs and provide savings to local taxpayers.

    Mental and behavioral health disorders remain prevalent and largely untreated. One in five adults in the U.S. experience a mental illness, with less than half receiving treatment. One in twenty-five experience a serious mental illness, with only two-thirds receiving treatment. Nearly eight percent experience a substance abuse disorder, with approximately ten percent receiving treatment. It is estimated that 9.5 million adults have both a mental health and substance abuse disorder. As of 2017, 60 percent of counties nationwide – including 80 percent or rural counties – reported not having a behavioral health worker.

    The opioid epidemic has further heightened the need for additional federal resources and reforms to help counties prevent, treat and provide recovery services for individual with substance use disorders. Legislation passed in the 115th Congress reauthorized the CMHS and SAPT block grants and created a new two-year State Targeted Response to the Opioid Crisis Grant program, which received $1.5 billion in FY 2021 appropriations. This figure builds on the $2 billion appropriated under the FY 2018 omnibus for states to address the crisis.

    In addition to new federal funding, NACo has worked closely with congressional legislators over the past few years to include key county priorities in comprehensive opioid legislation, the SUPPORT for Patients and Community Act (P.L. 115-271), including increased flexibility in the Medicaid program and federal health and justice program reauthorizations.

    The Coronavirus pandemic has also exacerbated mental health and substance use disorders, increasing the need for additional federal funding and resources. Congress provided emergency appropriations for mental health and substance use disorder services in the Coronavirus Aid, Relief, and Economic Security (CARES) Act (P.L. 116-136), the Consolidated Appropriations Act of 2021 (P.L. 116-260) and the American Rescue Plan Act of 2021 (P.L. 117-2). In total, these emergency appropriations bills provided an additional $1.27 billion for the Certified Community Behavioral Health Centers (CCHBCs) program, $3.2 billion for the SAPT block grant program and $3.2 billion for the CMHS block grant program.

    KEY TALKING POINTS

    Congress should meet or exceed FY 2021 emergency and regular appropriations levels for the Community and Mental Health Services (CMHS) Block Grant in future appropriations. The CMHS block grant is the principal federal discretionary program supporting community-based mental health services for adults and children. Counties may use block grant dollars to provide a range of services for adults and children with serious mental illnesses, including employment and housing assistance, case management (including Assertive Community Treatment), school-based support services, family and parenting education and peer support. The CMHS Block Grant received a total of $736.5 million in the FY 2021 appropriations bill passed by Congress in December 2020 and a total of $3.2 billion in emergency appropriations throughout FY 2021.

    Congress should meet or exceed FY 2021 emergency and regular appropriations levels for the Substance Abuse Prevention and Treatment (SAPT) Block Grant in future appropriations. County behavioral health authorities use the SAPT block grant to serve vulnerable, low-income populations, such as those with HIV/AIDS, pregnant and parenting women, youth and others by ensuring access to substance abuse services. An independent 2009 study of the SAPT block grant found that the program produces positive outcomes, including increased abstinence from alcohol and other drugs, increased employment and decreased criminal justice involvement. SAPT received $1.9 billion in the FY 2021 appropriations bill enacted by Congress in December 2021 and a total of $3.2 billion in emergency appropriations throughout FY 2021.

    For further information, contact Blaire Bryant at 202.942.4246 or bbryant@naco.org.

    Urge your members of Congress to maintain consistent funding for substance abuse and mental health services provided through the Substance Abuse and Mental Health Services Administration (SAMHSA) and pass legislation that enhances counties’ ability to provide local systems of care. Future appropriations bills should meet or exceed FY 2021 funding levels, particularly for the Community Mental Health Services (CMHS) and Substance Abuse Prevention and Treatment (SAPT) block grants, which allow counties to direct resources to those with the most need.
    2021-03-08
    Policy Brief
    2021-08-11

ACTION NEEDED:

Urge your members of Congress to maintain consistent funding for substance abuse and mental health services provided through the Substance Abuse and Mental Health Services Administration (SAMHSA) and pass legislation that enhances counties’ ability to provide local systems of care. Future appropriations bills should meet or exceed FY 2021 funding levels, particularly for the Community Mental Health Services (CMHS) and Substance Abuse Prevention and Treatment (SAPT) block grants, which allow counties to direct resources to those with the most need.

BACKGROUND:

America’s 3,069 counties are integral to the nation’s behavioral health system. Counties annually invest $100 billion in community health systems, including behavioral health services. In 40 states plus the District of Columbia, there is at least one mental health facility operated by a regional/district authority or county, local or municipal government. Across 48 states plus the District of Columbia, there is at least one mental health facility that accepts county or local government funds as a source of payment for mental health treatment services. Through 750 behavioral health authorities and community providers, county governments plan and operate community-based services for persons with mental illnesses and substance abuse conditions. Counties also help finance Medicaid, the largest source of funding for behavioral health services in the U.S., and serve as the local safety net, administering wrap-around human services supports.

SAMHSA, an agency of the U.S. Department of Health and Human Services (HHS), administers programs such as the Community Mental Health Services (CMHS) and Substance Abuse Prevention and Treatment (SAPT) block grants, which help counties provide direct behavioral services to those individuals in most need. Such services improve community well-being, reduce counties’ health care and justice system costs and provide savings to local taxpayers.

Mental and behavioral health disorders remain prevalent and largely untreated. One in five adults in the U.S. experience a mental illness, with less than half receiving treatment. One in twenty-five experience a serious mental illness, with only two-thirds receiving treatment. Nearly eight percent experience a substance abuse disorder, with approximately ten percent receiving treatment. It is estimated that 9.5 million adults have both a mental health and substance abuse disorder. As of 2017, 60 percent of counties nationwide – including 80 percent or rural counties – reported not having a behavioral health worker.

The opioid epidemic has further heightened the need for additional federal resources and reforms to help counties prevent, treat and provide recovery services for individual with substance use disorders. Legislation passed in the 115th Congress reauthorized the CMHS and SAPT block grants and created a new two-year State Targeted Response to the Opioid Crisis Grant program, which received $1.5 billion in FY 2021 appropriations. This figure builds on the $2 billion appropriated under the FY 2018 omnibus for states to address the crisis.

In addition to new federal funding, NACo has worked closely with congressional legislators over the past few years to include key county priorities in comprehensive opioid legislation, the SUPPORT for Patients and Community Act (P.L. 115-271), including increased flexibility in the Medicaid program and federal health and justice program reauthorizations.

The Coronavirus pandemic has also exacerbated mental health and substance use disorders, increasing the need for additional federal funding and resources. Congress provided emergency appropriations for mental health and substance use disorder services in the Coronavirus Aid, Relief, and Economic Security (CARES) Act (P.L. 116-136), the Consolidated Appropriations Act of 2021 (P.L. 116-260) and the American Rescue Plan Act of 2021 (P.L. 117-2). In total, these emergency appropriations bills provided an additional $1.27 billion for the Certified Community Behavioral Health Centers (CCHBCs) program, $3.2 billion for the SAPT block grant program and $3.2 billion for the CMHS block grant program.

KEY TALKING POINTS

Congress should meet or exceed FY 2021 emergency and regular appropriations levels for the Community and Mental Health Services (CMHS) Block Grant in future appropriations. The CMHS block grant is the principal federal discretionary program supporting community-based mental health services for adults and children. Counties may use block grant dollars to provide a range of services for adults and children with serious mental illnesses, including employment and housing assistance, case management (including Assertive Community Treatment), school-based support services, family and parenting education and peer support. The CMHS Block Grant received a total of $736.5 million in the FY 2021 appropriations bill passed by Congress in December 2020 and a total of $3.2 billion in emergency appropriations throughout FY 2021.

Congress should meet or exceed FY 2021 emergency and regular appropriations levels for the Substance Abuse Prevention and Treatment (SAPT) Block Grant in future appropriations. County behavioral health authorities use the SAPT block grant to serve vulnerable, low-income populations, such as those with HIV/AIDS, pregnant and parenting women, youth and others by ensuring access to substance abuse services. An independent 2009 study of the SAPT block grant found that the program produces positive outcomes, including increased abstinence from alcohol and other drugs, increased employment and decreased criminal justice involvement. SAPT received $1.9 billion in the FY 2021 appropriations bill enacted by Congress in December 2021 and a total of $3.2 billion in emergency appropriations throughout FY 2021.

For further information, contact Blaire Bryant at 202.942.4246 or bbryant@naco.org.

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