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  6. Summary of FY24 Senate LHHS Appropriations Bill

Summary of FY24 Senate LHHS Appropriations Bill

July 27, 2023

On July 27, the Senate Labor Health and Human Services and Education (LHHS) appropriations committee successfully marked up its version of the FY24 LHHS appropriation bill. It is important to note that the proposed funding levels in this bill are higher than the levels that were included as part of the House LHHS appropriations subcommittee markup that occurred earlier this month. Please remember that the proposed funding levels within the bill are also subject to change, as both chambers are expected to engage in negotiations for a final bill before the end of the current federal fiscal year on September 30, 2023.

The committee did release the legislative text of the bill, and ASTHO's government affairs team will be conducting a detailed analysis in the coming days. The summary below was provided to the committee. The Senate’s bill is considered to be a high watermark for funding when compared to the House LHHS subcommittee’s bill. There are considerable differences between both bills that will require reconciliation and negotiation on both sides.

Outlook

Both the Senate and House are scheduled to go on recess in August and are expected to be back on Capitol Hill in early September, with limited legislative days before the expiration of FY23 funding.

While we are hopeful that Congress will pass a continuing resolution to fund the federal government past September 30, if final appropriations bills are not completed, the threat of a government shutdown cannot be ruled out. It is also important to again point to the real possibility of a 1% across-the-board cut if Congress is unable to pass all 12 appropriation bills prior to the end of the calendar year.

ASTHO’s government affairs team will continue to advocate on behalf of state and territorial public health departments, encouraging Congress to increase funding for state and territorial public health priorities.

The full committee summary is available for review.

Excerpts from Committee Summary

Protects Essential Health Care Programs

The bill protects essential funding to address public health threats, improve healthcare access and affordability, and strengthen the healthcare workforce.

This includes:

  • $1.86 billion for Community Health Centers, including $55 million for school-based health centers.
  • $1.4 billion for Health Professions Workforce Development.
  • $1.2 billion for the core Maternal and Child Health programs.
  • $341 million for the Improving Maternal Health Initiative to combat the unacceptable levels of maternal mortality.
  • $4.1 billion for the Centers for Medicare and Medicaid’s administrative needs.

The bill also includes $350 million for Public Health Infrastructure and Capacity, maintaining the 75% increase secured in fiscal year 2023 to bolster public health infrastructure and rebuild the workforce at the state and local level to be ready to respond to emerging public health threats.

The bill includes $616 million for the Ending HIV Epidemic Initiative, a $3 million increase, which provides high-need jurisdictions with prevention and treatment services for people at high risk for HIV transmission. This includes $223 million within the Centers for Disease Control and Prevention’s (CDC) Domestic HIV/AIDS Prevention and Research programs to develop and deploy innovative data management solutions, increase access to PrEP, and better detect and respond to HIV clusters.

The bill also protects funding for reproductive health programs such as Title X and the Teen Pregnancy Prevention Program.

Pandemic Preparedness and Biodefense

The bill includes $3.67 billion for the Administration for Strategic Preparedness and Response (ASPR), including a $20 million increase for the Biomedical Advanced Research and Development Authority (BARDA) and $75 million to establish a new program in manufacturing and production to ensure that critical resources including medical countermeasures and ancillary supplies are manufactured in the United States. It protects funding for critical programs, including the Strategic National Stockpile (SNS), Project Bioshield, and the National Disaster Medical System (NDMS).

Substance Use Prevention and Treatment

The bill builds upon key investments made in fiscal year 2023 to address the rising toll of opioid overdoses fueled by fentanyl and improve access to substance use disorder treatment and prevention.

The bill provides over $5 billion for opioid treatment and prevention, a more than $125 million increase over fiscal year 2023. This includes an additional:

  • $40 million for the Substance Use Prevention, Treatment, and Recovery Services Block Grant.
  • $20 million for the State Opioid Response grants.
  • $10 million for the Rural Communities Opioid Response Program.
  • $20 million for NIH opioid research programs.

Mental Health

The bill provides $35 million more for the Mental Health Block Grant over fiscal year 2023 and includes $172 million for the Behavioral Health Workforce Education and Training Program, a $19 million increase over fiscal year 2023, to expand community-based clinical training and for repayment of education loans for individuals working in either a Mental Health Professional Shortage Area or where the overdose death rate exceeds the national average.

Additionally, the bill provides $400 million for Certified Community Behavioral Health Clinics, a $15 million increase over fiscal year 2023, and an $18 million increase over fiscal year 2023 for the 988 Suicide Prevention Lifeline, building on the nearly $400 million increase in fiscal year 2023.

The bill also includes over $100 million in investments within the Department of Education to address the shortage of school-based mental health professionals in our nation’s K-12 schools.