CNN Photo: President Joe Biden signs the Consolidated Appropriations Act for Fiscal Year 2022 in the Indian Treaty Room in the Eisenhower Executive Office Building on the White House Campus in Washington, Tuesday, March 15, 2022.
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The massive bipartisan $1.5 trillion omnibus spending bill for FY ’22 signed by President Biden on March 15 contains funding that demonstrates a growing awareness and support in Congress for programs and policies to address trauma and PACEs science. The incremental nature of the legislative process makes it difficult to see progress readily but there are bright spots in this legislation to celebrate.
Reauthorization of VAWA
In addition to providing funding for FY’22, the Omnibus bill reauthorizes the Violence Against Women Act (VAWA). President Biden was a primary sponsor of the VAWA during his Senate career and spoke recently to his frustration and pleasure for this accomplishment. Here are his remarks. The VAWA supports the investigation, prosecution, and prevention of sexual violence and in the new law expands the rights of Tribes to prosecute abuse of Native women and children.
Interagency Task Force on Trauma-Informed Care
While the $1 million allocated for the Interagency Task Force on Trauma-Informed Care doesn’t even quality as “decimal dust” in a trillion dollar plus bill, it is a nod to the importance of federal agencies working together to address trauma. Back in 2018, the task force was authorized in the opioid law (The SUPPORT for Patients and Communities Act, H.R. 6, signed by President Trump on October 24, 2018) but never received funding to get it off the ground.
As reported by the new director of government affairs for the Campaign for Trauma-Informed Policy and Practice (CTIPP), Jen Curt, CTIPP is working with the Substance Abuse and Mental Health Services Administration (SAMHSA) to shape the work of the task force and to offer the expertise of the trauma network to develop best practices for trauma-informed identification, referral and support. The 2018 opioid law designates the head of SAMHSA to chair the task force, a position now held by Miriam Delphin-Rittmon, Ph.D., assistant secretary for mental health and substance use in the U.S. Department of Health and Human Services and the administrator of SAMHSA. Attached is the section of the SUPPORT Act establishing the task force.
Funding for CDC’s Injury Prevention and Control programs
The Centers for Disease Control and Prevention’s (CDC) Injury Prevention and Control activities received $715 million in funding, including $7 million for specific work related to “adverse childhood experiences.” Congress appropriated $4 million in FY ’20 and increased it to $5 million in FY ’21 to fund CDC’s program “Preventing Adverse Childhood Experiences: Data to Action (PACE-D2A) and “to inform how ACEs increase certain risk factors, such as substance abuse, suicide, mental health conditions and chronic illnesses,” according to Phyllis Ottley, PhD, associate chief of program in CDC’s Division of Violence Prevention, National Center for Injury Prevention and Control. Awardees for 3-year PACE-D2A program included the states of Massachusetts, Georgia, Connecticut, and the non-profit, Michigan Public Health Institute (MPHI). Minnesota and the Center for Health Care Strategies were added after the original start-up and the grant period is compressed to two years. PACEs Connection has reported on PACE: D2A programs in Massachusetts, the Michigan Public Health Institute, Minnesota, and Georgia. Stories about Connecticut and the Center for Health Care Strategies are in the works. The PACE: D2A initiative will end after the 3-year period and CDC will have discretion to develop other ACEs-related programs going forward.
Funding for SAMHSA Programs
A number of SAMHSA programs address trauma specifically, such as the National Child Traumatic Stress Network (NCTSN), while others have a mental health or substance use focus or deal with a specific crisis such as suicide. Here are some of those funding priorities:
National Child Traumatic Stress Network
NCTSN’s mission is “to raise the standard of care and improve access to services for traumatized children, their families and communities throughout the United States.” The NCTSN website reports that it “has grown from 17 funded centers in 2001 to 116 currently funded centers and 170 affiliate (formerly funded) centers and individuals, working in hospitals, universities, and community-based programs in 43 states and the District of Columbia.” Grantees and affiliates provide clinical services, offer education and training program, collaborate with established systems of care, engage in data collection and evaluation, and inform public policy and awareness efforts. The Omnibus bill provides $81.8 million for NCTSN, an increase of $10 million over FY’21.
Programs funded within SAMHSA’s Mental Health Programs of regional and national significance (PRNS) in addition to the $1 million for the Interagency Task Force on Trauma Informed Care include:
Project AWARE $120,001,000
The Project AWARE (Advancing Wellness and Resiliency in Education) program “builds or expands the capacity of State Educational Agencies (SEA), in partnership with State Mental Health Agencies (SMHAs) overseeing school-aged youth. By building or expanding capacity, the program advances wellness and resiliency in education by increasing mental health awareness in schools across states, territories, and tribal communities.”
Project LAUNCH $23,605,000
The purpose of Project LAUNCH (Linking Actions for Unmet Needs in Children’s Health) is “to promote the wellness of young children ages birth to 8 by addressing the physical, social, emotional, cognitive, and behavioral aspects of their development.”
Behavioral Health Crisis and 988 Coordinating Office $5,000,000
The 988 number is often described as a 911 service for mental health, replacing the current 800 number. The New York Times article “As a Crisis Hotline Grows, So Do Fears It Won’t Be Ready” summarizes the challenges ahead to improve the effectiveness of the current patchwork of close to 200 call centers. The “explanatory statement” for FY’22 law on this function says the Office of the Assistant Secretary for Mental Health and Substance Use is “to establish an office dedicated to the implementation of the 988 National Suicide Prevention Lifeline (Lifeline) and coordination of behavioral health crisis care across HHS operating divisions, including CMS (Centers for Medicare & Medicaid Services) and HRSA (Health Resources & Services Administration).
National Strategy for Suicide Prevention $23,200,000
This is only one of numerous suicide prevention programs, including the 988 initiative, in SAMHSA.
Infant and Early Childhood Mental Health $10,000,000
The agreement directs SAMHSA to continue to allow a portion of additional funds provided for technical assistance to existing grantees, to better integrate infant and early childhood mental health into State systems.
A 46-page Division-by-Division Summary of Appropriations Provisions is available here. (See pages 25-33 for Division H for Labor/HHS/Education provisions). The National Conference of State Legislatures (NCSL) has also prepared a report “2022 Omnibus Appropriations Bill: A Summary of Provisions by Federal Agency.”
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