The Obama Administration’s Fiscal Year 2012 Health and Human Services Budget — February 2011

The U.S. Department of Health and Human Services (HHS) is the principal Federal agency charged with protecting the health of all Americans. The President’s budget for Fiscal Year 2012 calls for $79.9 billion in discretionary spending to support programs administered by HHS, which is slightly above the 2010 funding level. Within this level, the Department is taking on significant new responsibilities with the implementation of the Health Care Reform’s Affordable Care Act (ACA) and the new food safety law, as well as strengthening program integrity. Within the funds available to HHS, $6.8 billion for the Health Resources and Services Administration (HRSA), an Agency within HHS charged with increasing access to basic health care for those who are medically underserved. One of the primary goals of the HRSA budget is to improve both access to and quality of health care in rural areas, as well as increase the number of doctors, nurses, dentists and other health professionals — including psychologists — who practice in areas of the country with shortages of health professionals.

Regarding programs of importance to psychologists, the President’s budget contains funding within HRSA for the Graduate Psychology Education (GPE) Program, the National Health Service Corps (NHSC) and the Federally Qualified Health Centers (FQHC) Program, as well as funding for geriatric programs and within the Substance Abuse and Mental Health Services Administration (SAMHSA) for the Minority Fellowship Program and the Campus Suicide Prevention Program.

The President’s Budget is a proposal put forward by the Administration that demonstrates its vision for spending in the upcoming year and in the future. Congress is responsible for developing legislation to fund the government for the fiscal year ahead and this legislation must be passed by both the U.S. House of Representatives and the U.S. Senate and signed by the U.S. President.

Graduate Psychology Education (GPE) Program

For the third time, the President’s budget includes funding for the GPE Program.  The President’s FY 2011 budget included $2.9 million for GPE (the same at the FY 2010 appropriated level). The FY 2012 budget does not propose a specific amount for GPE, but includes directive language for the number of grants to be funded and includes GPE in as part of an overall funding request of $17.945 million designated for all mental health programs authorized in the ACA. It is expected, based on the language in the Budget that funding for GPE would grow from last year’s level of $2.945 million. The budget anticipates support for 17 new grants in graduate psychology education “for the development and implementation of interdisciplinary training of psychology graduate students.”

GPE was authorized as part of the ACA last year (March 2010) at a level of $10 million.  Further, thanks to strong bi-partisan support garnered by APA members who came to Capitol Hill in an effort coordinated by ED GRO, a level of $7 million  — representing APA’s full request for funding — was included in the Omnibus Appropriations for FY’11.  Sadly, that legislation did not become law and the government is instead being funded by a Continuing Resolution (CR) through March 4th. That being said, it is a significant victory for the GPE Program to be included for continuation in the Republican driven FY 2011 CR which included drastic reductions or elimination of hundreds of federal programs.

National Health Service Corps (NHSC)

The Budget invests $418 million in the National Health Service Corps (NHSC), which includes funding mandated by the ACA, to place providers in rural regions and other medically underserved areas to improve access to needed health care services. The FY 2012 proposed funding is $270 million more than the current funding level and $13 million lower than the amount in the CR. Under the NHSC, eligible health professionals, including psychologists, agree to serve in a Health Profession Shortage Area (HPSA) in exchange for college loan forgiveness. Primary Care medical, nursing and dental students have also been eligible for the NHSC Scholarship Program of which the APA Education Government Relations Office is actively seeking the inclusion of psychology graduate students. 

In FY 2010, the NHSC had field strength of 7,530 primary care clinicians. The NHSC projects that a field strength of 10,683 primary care clinicians should be available in health professional shortage areas by FY 2012 if Congress funds the program at the President’s request. Because psychologists are eligible to apply for the loan repayment program, this funding will allow increased numbers of psychologists working in underserved areas to receive monies from the NHSC.

Community Health Centers (CHCs)

Health centers are a key component of the nation’s health care safety net. There are approximately 8,000 sites and they offer comprehensive, high quality, primary and preventative health care services to all Americans regardless of ability to pay. All the health centers are HPSAs and can request NHSC participants including psychologists. Health centers will continue to be a critical element of the health system as the Nation expands insurance coverage through the ACA. In 2009, the Recovery Act (Stimulus Bill) provided $500 million to expand health center services to an additional 2 million patients. The ACA continued this progress by authorizing a total of $2.2 billion in new resources for health center services in 2011 and 2012. The Budget builds on this investment by providing an additional $2.1 billion (out of the $2.2 billion), slightly lower than the FY 2010 funded amount. If Congress funds the program at the President’s request, the health centers are estimated to serve 24 million patients, a large portion of those needing behavioral health care. In 2009, 7 million underserved persons were served by Health Centers.

Geriatric Programs

The budget includes an investment of $43 million for geriatric programs which is $10 million over the FY 2010 level and the CR. These programs include Geriatric Education Centers (GEC) Program; Geriatric Training for Physicians, Dentists, and Behavioral and Mental Health Professionals (GTPD); and the Geriatric Academic Career Awards (GACA) Program. These federal programs provide funds and train health professionals in geriatrics, primarily to accredited professional schools, including psychology programs, and also provide for faculty fellowships. Graduate programs of psychology are not eligible for the GTPD awards.

Campus Suicide Prevention and Other SAMHSA Programs

A number of programs of importance to psychology, administered by the Substance Abuse and Mental Health Services Administration were also included in the President's FY'12 Budget. The Campus Suicide Prevention program, authorized under the Garrett Lee Smith Memorial Act, was funded at a level of $4.975 million. This level represents the same amount as in the past years. The Campus Suicide Prevention Program provides support to college counseling center for education and outreach related to suicide prevention. The program currently supports 38 grants to institutions of higher education. In addition, Youth Suicide Prevention State Grants received a proposed amount of $29.738 million and the Suicide Prevention Resource Center was funded at $4.957 million. These programs were not eliminated in the House Appropriations Committee's CR for the remainder of Fiscal Year 2011.

Minority Fellowship Program (MFP)

The SAMHSA budget included $4.2 million for the Minority Fellowship Program (MFP). The program, which is currently funded at $4.2 million, was also level funded in the CR. The MFP, which began in 1973, has helped to support doctoral-level training of ethnic minority psychologists, psychiatrists, psychiatric nurses and social workers. These individuals often serve in key leadership positions in mental health and substance abuse direct services, services supervision, services substance direct services, services supervision, services research, training and administration.