Public Policy News – May 2021
Push for Federal Funding to Support Social Work Education
Members of Congress Express Bipartisan Support for the MFP
HHS Secretary Becerra and Education Secretary Cardona Testify on FY 2022 Budget
The 117th Congress Moves to Readdress Policing in America
CSWE Responds to NIH RFI on Equity, Diversity, and Inclusion in Biomedical and Behavioral Research
Biden Announces American Families Plan
CSWE Government Relations is pursuing its advocacy strategy for the fiscal year (FY) 2022 appropriations process, submitting funding requests to congressional champions and testimony to committees that have jurisdiction over agencies important to social work. House Appropriations Committee Chair Rosa DeLauro (D-CT) has stated that the House of Representatives will mark up the 12 annual FY 2022 spending bills in June ahead of full votes in July, setting up a fast pace after a slow start to the congressional appropriations process.
Important programs funded by congressional appropriations include the Minority Fellowship Program, Behavioral Health Workforce Education and Training program, Scholarships for Disadvantaged Students program, and Geriatrics Workforce Enhancement Program. CSWE also supports increased funding for programs that help low-income students, such as the Pell Grant and Graduate Assistance in Areas of National Need programs, and urged members of Congress to support the Public Service Loan Forgiveness program. CSWE advocated to increase funding for research at the National Institutes of Health that incorporates the social and behavioral science research necessary to better understand and address the needs of high-risk groups such as children, minority, and geriatric populations. CSWE also sought increases for the Centers for Medicare and Medicaid Services (CMS) Minority Research Grant Program, which develops capacity at minority-serving institutions to research health disparities and social determinants of health, understand the root causes of issues that lead to health disparities, and strengthen CMS programs by disseminating best practices uncovered through funding research.
Representatives G. K. Butterfield (D-NC) and John Katko (R-NY) spearheaded a “dear colleague letter” expressing support for the Substance Abuse and Mental Health Services Administration’s Minority Fellowship Program (MFP). The bipartisan letter included 37 additional signatures of congressional members. The letter states that “culturally competent behavioral health services are necessary to meet demand and behavioral health challenges facing communities across the United States, including the opioid epidemic” and “to meet this need, the MFP has been increasing the number of diverse behavioral health professionals providing culturally competent mental health and substance use disorders services to underserved populations.” CSWE and other members of the MFP Coalition have worked closely with congressional offices to cultivate champions for this program over the past several years.
The House Energy and Commerce Subcommittee on Health held a hearing with Department of Health and Human Services (HHS) Secretary Xavier Becerra and discussed a wide range of health-care issues, as well as specific proposals contained in President Biden’s budget request for fiscal year (FY) 2022. The Administration released a “skinny” budget request outlining topline numbers last month and is expected to release a full budget request on May 27.
Subcommittee Chair Anna Eshoo (D-CA) praised the Biden Administration’s commitment to getting the COVID-19 pandemic under control and commended parts of the HHS FY 2022 budget proposal important to social work. Secretary Becerra focused on the Administration’s successful mitigation of the spread of COVID-19. He discussed the increased investments in global and public health and noted that the Centers for Disease Control and Prevention will probably play a larger role in combatting future pandemics. He also noted the funding increases for violence prevention (specifically calling out domestic violence, human trafficking, torture, and gun violence), as well as mental and behavioral health funding increases.
In April Secretary Becerra testified on the same issue before the House Labor, Health and Human Services, and Education (Labor-HHS-ED) Appropriations Subcommittee. Chair Rosa DeLauro (D-CT) commended the president’s FY 2022 budget request for the HHS but emphasized the need to do more to improve failures in the nation’s public health infrastructure. She also highlighted the importance of addressing maternal and infant mortality, mental health, and supports for women in the workforce. Other topics raised at the hearing included how health equity will be prioritized through increased investments in programs that eliminate health disparities across HHS and growing support for addressing social determinants of health. Secretary of Education Miguel Cardona also testified before the Labor-HHS-ED committee on the Department of Education FY 2022 budget request. Secretary Cardona spoke about the importance of addressing the physical and mental health of students and highlighted a proposed $400 increase in the maximum Pell Grant and investments in Minority Serving Institutions.
Following the death of George Floyd, Congress took numerous actions to address police reform. In the previous Congress the extremely partisan issue made very little headway, and the bills introduced did not receive full passage. In the new Congress, House Democrats reintroduced the George Floyd Justice in Policing Act, which passed the House along party lines as it had in the previous Congress. The partisan differences regarding police reform remain, and it is unlikely the House bill will advance in the Senate. As a result, Senator Tim Scott (R-SC) and Senator Cory Booker (D-NJ) have been working together to draft a police reform bill in the Senate, and Representative Karen Bass (D-CA), lead sponsor of the House bill, has been included in those discussions. The three legislators also have discussed a compromise on the policing bill with the Department of Justice and the Problem Solvers Caucus. The Biden Administration and Congress had been pressured to pass policing laws by the 1-year anniversary of George Floyd’s death on May 25, but Republicans and Democrats remain polarized on this issue.
In the midst of the negotiations about police reform, Congress has begun to address policing and mental health through hearings. The Senate Judiciary Subcommittee on Criminal Justice and Counterterrorism held a hearing on April 22 titled “Behavioral Health and Policing: Interactions and Solutions.” Subcommittee Chair Cory Booker (D-NJ) provided opening remarks and highlighted the critical need to focus on how police should respond to those dealing with a mental health crisis and those with behavioral health issues. Booker stated, “One study of shooting data for 2015 found that people with untreated mental illness were 16 times more likely to be killed during a police encounter.” He said many officers are frustrated because they are often expected to play the role of social worker, mental health expert, and medical expert although not trained to do so. Ranking Member Tom Cotton (R-AR) emphasized that the goal should not be to reduce law enforcement but that he welcomes the partnership between police departments and mental health professionals. A witness, Major Martin Bartness, a commander of the Baltimore Police Department’s Education and Training Section, has been partnering with behavioral health professionals for more than 10 years. Bartness stated that when police co-respond with behavioral health professionals the service to the community is improved dramatically. He said the co-responder model is outstanding but not large enough.
The House Appropriations Subcommittee on Labor, Health, and Human Services, Education, and Related Agencies held a hearing on a similar topic titled “Mental Health Emergencies: Building a Robust Crisis Response System.” This hearing also highlighted the success of co-responder programs and discussed the need to hire police social workers. However, many of the witnesses highlighted the need for more training and funds to tackle the mental health emergencies they encounter as first responders.
CSWE responded to a request for input (RFI) from the National Institutes of Health (NIH) inviting comments and suggestions to advance and strengthen racial equity, diversity, and inclusion in biomedical research and advance health disparities and health equity research. This RFI is a major part of NIH’s new UNITE initiative. Throughout the response, CSWE emphasized how essential social work researchers are to advancing these efforts due to their expertise in social and behavioral health, social determinants of health, and translation and community-based research methods. To advance research on health disparities and health equity, CSWE encouraged NIH to provide more research opportunities that invest in social determinants of health and methods that serve the unique needs of underserved populations. Providing these research opportunities in turn could expand the diversity of researchers who are interested in pursuing NIH funded research.
CSWE also provided suggestions to reduce some obstacles to training and pursuing a career in biomedical and behavior research. CSWE encouraged NIH to expand programs such as the NIH Loan Repayment Program to provide support to underrepresented racial and ethnic groups that need student debt relief. Cost is a barrier particularly for students who are first-generation, from low-income communities, or juggling student and caregiving responsibilities. CSWE also suggested that NIH grant programs should recognize the need to support researchers (particularly early career researchers) such as by providing transportation, food assistance, childcare, and mechanisms to ensure a stable work/life balance. Addressing these barriers would not only expand the diversity of those entering the research workforce but also assist with retention efforts. NIH received more than 1,000 responses to this RFI; they plan to release a summary of the input this spring.
On April 28 President Biden announced a $1.8 trillion proposal, the American Families Plan, to invest in childcare, education, and health care. The American Families Plan outlines massive investments in preschool, child nutrition, community colleges, Pell Grants, and health-care spending. This plan builds on the president’s American Jobs Plan announced in late March, which focused on infrastructure, climate action, workforce development, and global competitiveness. Here are some key American Families Plan highlights for academic and health-care communities:
- $109 billion to make 2 years of community college education free
- $80 billion to increase the maximum Pell Grant by $1,400
- $62 billion for retention and completion programs at colleges that serve large numbers of low-income students
- $39 billion to subsidize tuition at historically Black colleges and universities and other minority-serving institutions
- $200 billion to expand the Affordable Care Act’s premium tax credits
- Significant tax changes for high-earners to generate $1.5 trillion to partially offset the plan costs
Further details on the American Families Plan’s proposals of interest to the education and health-care communities can be found here.
CSWE Spark is an online community designed to spark conversation, share ideas, and promote collaboration with social work faculty members and other professionals from around the world. Recent posts include funding opportunity announcements from the National Institute of Dental and Craniofacial Research (NIDCR) and the National Institutes for Mental Health (NIMH). The NIDCR will fund research on how to identify and address upstream social determinants of health that can often present as barriers to optimal oral health, impede the effectiveness of interventions, and contribute to oral health disparities in vulnerable and underserved groups. The NIMH funding opportunities encourage research focused on developing and testing system-level interventions and strategies to improve systematic risk identification, coordinated referral to, or engagement and retention in quality care for prevention of suicide ideation and behavior among Black children and adolescents and youths from underserved populations.
For advocacy and policy updates and federal agency funding opportunities relevant to social work, please visit Spark.
The Government Accountability Office (GAO), in response to a letter from Senate Finance Committee Chair Ron Wyden (D-OR), issued a report assessing patient access, provider claims, and the effect of the COVID-19 pandemic on behavioral health. Based on interviews and data from agencies within the Department of Health and Human Services, GAO found that longstanding problems with workforce adequacy, reimbursement rates, and health-system capacity to meet the needs of individuals suffering mental, behavioral, or emotional disorders were compounded by the pandemic. In 2019, prior to the pandemic, an estimated 52 million adults in the United States were reported to have a mental, behavioral, or emotional disorder, and 20 million people age 12 or older had a substance use disorder.
According to Centers for Disease Control and Prevention (CDC) survey data collected between April 2020 and February 2021, 38% of adults reported having symptoms of anxiety or depression. By comparison, CDC found that about 11% of adults reported experiencing these symptoms from January to June 2019, illustrating the increase in these conditions during the pandemic. CDC data also showed that emergency department visits for “suicide attempts and drug overdoses were 26 and 36 percent higher, respectively, for the period of mid-March through mid-October 2020 compared to the same time period in 2019.”