WASHINGTON - U.S. Senator Roy Blunt (Mo.), Chairman of the Appropriations Subcommittee on Labor, Health and Human Services, Education, and Related Agencies (Labor/HHS), today released the chairman's mark of the FY2020 Labor/HHS funding bill, which includes several Missouri priorities. The Labor/HHS bill is part of a legislative package of funding bills the Senate is expected to begin consideration of this week.
“This bill funds a wide range of programs that have one thing in common: improving the quality of life for every American. I’m proud that we continue our pattern of increasing funding for groundbreaking medical research at the National Institutes of Health. The $3 billion NIH increase in this bill marks a 40 percent increase over the past five years, paving the way for new advances that are giving hope to millions of families. This bill continues the fight against the opioid epidemic and provides states more flexibility to tackle other types of addiction that are claiming lives every day. For the millions of people who struggle with a mental health issue, the bill directs resources toward certified community behavioral health clinics, mental health programs in schools, and suicide prevention programs,” said Blunt. “This year, we’ve started a new initiative in the bill to ensure that high-school age kids have the ability to pursue a full-range of post-secondary options – whether it’s attending a four-year university, a community college, or entering an apprenticeship program – to help them not just get a job, but build a career. We have also once again increased the maximum Pell Grant award and continued eligibility for Year-Round Pell, and maintained investments in core elementary and secondary education programs.”
In addition to funding a range of priorities involving health, education, and workforce training programs, the bill includes resources to prevent waste, fraud, abuse, and improper payments in the Social Security, Medicare, and Medicaid programs.
Blunt continued, “Missourians work too hard to see their taxpayer dollars wasted in Washington. We always need to look for ways to prioritize the most valuable programs, cut back where we can, and crack down on waste, fraud, and abuse. Over the past five years, our subcommittee has eliminated more than three dozen ineffective or duplicative programs, and the resources provided in this bill will save taxpayers billions over the next decade. This bill reflects numerous priorities that have had broad support on both sides of the aisle, and I’ll continue working with our entire Appropriations Committee to move it forward.”
Key Missouri Priorities Funded in the Bill:
Department of Health and Human Services
- $42.1 Billion to Support Groundbreaking Medical Research at the National Institutes of Health (NIH): The bill includes a $3 billion increase for NIH, bringing the overall funding level to $42.1 billion. Under Blunt’s Labor/HHS chairmanship, NIH funding has increased by $12 billion, or 40%. Missouri institutions received $605.5 million in NIH funding in 2018. From 2015-2018, NIH funding to Missouri institutions increased by more than $130 million. The NIH increase includes:
- $2.82 Billion for Alzheimer’s Disease Research, a $350 million increase. Currently, Medicare and Medicaid spend $195 billion caring for those with Alzheimer’s, making it the most expensive disease in America. Since Blunt became subcommittee chair five years ago, Alzheimer’s disease research funding has more than quadrupled, increasing from $631 million to $2.82 billion.
- $6.35 Billion for Cancer Research, a $210.8 million increase. The bill provides $50 million in new funding for the President’s Childhood Cancer Data program to connect and integrate multiple childhood cancer data sources. The bill also provides $25 million for the Childhood Cancer Survivorship, Treatment, Access, and Research (STAR) Act, which Blunt cosponsored and was signed into law last year. The STAR Act is a bipartisan, comprehensive bill to expand opportunities for childhood cancer research, improve efforts to identify and track incidence of childhood cancer, and enhance the quality of life for childhood cancer survivors.
- $500 Million for the BRAIN Initiative, a $71 million increase. The BRAIN Initiative is developing a more complete understanding of brain function, which could help millions of people who suffer from a wide variety of neurological and psychiatric disorders, including Alzheimer's disease.
- $500 Million for the All of Us Precision Medicine Initiative, a $161 million increase. This study will enroll one million Americans to take into account differences in biology, lifestyle, and environment to discover new paths towards delivering individualized precision medicine.
- $100 Million for Next Generation Researchers: For the first time, the bill includes specific funding to support the next generation of NIH researchers. This funding will expand activities to improve and accelerate the transition of new researchers to independent careers and continue to enhance workforce diversity. This will bring the total NIH funding to support young researchers to $748.8 million in FY2020.
- $589.4 Million for the Clinical and Translational Science Awards (CTSA), a $29.7 million increase. Washington University’s CTSA is part of the national program aimed at accelerating discoveries toward better health.
- $165 Million for Research on the Universal Flu Vaccine, a $25 million increase, in targeted funding to advance progress toward a universal flu vaccine. Under Blunt’s leadership, funding for a universal flu vaccine has more than quadrupled in the last three years. St. Louis University is part of NIH’s Vaccine and Treatment Evaluation Units working on a universal flu vaccine.
- $600 Million to Combat Antibiotic Resistance, a $50 million increase, to expand efforts to develop new antibiotics, create rapid diagnostic tests, and build a national genome sequence database on all reported resistant human infections. Antibiotics have been used to successfully treat patients for more than 70 years, but over time, the drugs have become less effective as organisms adapt to the drugs designed to kill them.
- $5 Million to Combat Foreign Threats to Research: The bill includes $5 million for NIH to continue its work with HHS’ Office of National Security to combat foreign threats to the research infrastructure. At a Labor/HHS subcommittee hearing in April, Blunt discussed China’s Thousand Talents program, which is aimed at recruiting NIH-funded researchers to steal intellectual property, cheat the peer-review system, establish shadow laboratories in China, and help the Chinese government obtain confidential information about NIH research grants.
- $12.6 Million for the Gabriella Miller Kids First Research Act: The Gabriella Miller Kids First Act, which was signed into law in 2014, created a dedicated fund for pediatric medical research. The bill provides the resources authorized under the law, and prioritizes funding for pediatric cancer research.
- National Academies Study on Organ Allocation Policies: The bill includes funding for a new National Academies of Sciences, Engineering, and Medicine study on organ allocation policies, particularly related to livers. Blunt has led efforts against the Organ Procurement and Transplantation Network’s move to change the liver allocation policy. The new policy could lead to a 32% drop in liver transplants in Missouri.
- $3.9 Billion to Fight the Opioid Epidemic: The bill includes $3.9 billion, an increase of $70 million, to continue combatting the opioid epidemic. Under Blunt’s leadership, funding for health-related opioid programs has increased by $3.6 billion. The opioid-related funding includes:
- $1.5 Billion for State Opioid Response Grants: Blunt first secured funding for this critical resource in 2018. The bill provides additional flexibility to states by allowing them to use grant dollars to address stimulants. Missouri has received over $46 million from this program in the past two years to address the opioid crisis. Read more here.
- $200 Million for Community Health Centers: To support and enhance behavioral health, mental health, and substance use disorder services.
- $110 Million for Rural Communities: To improve access to substance use disorder services and reduce access to care barriers in rural areas. In August, Blunt announced that Missouri received $8 million in Rural Communities Opioid Response Program Grants.
- $476 Million at the Centers for Disease Control and Prevention: For opioid overdose prevention and surveillance, as well as a public awareness campaign. In addition, the bill includes $10 million, a $5 million increase, to combat infectious diseases directly related to opioid use.
- $801 Million for Opioid and Pain-Related Research: The bill continues $801 million for research on opioid addiction, development of opioids alternatives, pain management, and addiction treatment. If patients with acute or chronic pain do not have reasonable access to non-addictive pain medications or alternative treatments, it will be difficult to get the opioid crisis under control. This includes $500 million in dedicated funding provided to the National Institute of Neurological Disorders and Stroke and the National Institute on Drug Abuse.
- $60 Million for Child Abuse Prevention and Treatment Programs: To support the development and implementation of plans of safe care for infants affected by substance abuse.
- $40 Million for Children In, or at Risk for Entering, the Foster Care System: To support mental health and substance abuse prevention and treatment programs.
- $3.7 Billion to Expand Access to Mental and Behavioral Health Care: As a critical part of both combating opioid abuse and ensuring safety in our schools and communities, the bill provides $3.7 billion, a $305 million increase, for mental health research, treatment, and prevention, including:
- $200 Million for Certified Community Behavioral Health Clinics, a $50 million increase. This was a new discretionary grant program Blunt began in 2018 to target funding for specific community clinics that provide a comprehensive approach to mental health care treatment. Blunt has led efforts to expand access to mental health care, including through his Excellence In Mental Health Act, which created a pilot program in Missouri and seven other states to advance progress toward treating mental health like all other health.
- $103 Million for Project AWARE, a $32 million increase. This program supports coordination between schools and State Mental Health Agencies to increase awareness of mental health among school-aged kids, train school personnel on detecting and responding to mental health issues, and connect school-aged kids and their families with needed services.
- $22 Million for Mental Health Awareness Training, an increase of $1 million, for Mental Health Awareness Training.
- $88 Million for Suicide Prevention Programs, a $14 million increase, to provide support to the suicide lifeline and grants to help identify and help those at risk of suicide.
- $5 Million for a New Mental and Substance Use Disorder Workforce Training Demonstration Program: The bill includes $5 million for a new grant program to help medical institutions and community health centers train professionals to provide substance use disorder and mental health treatment in underserved communities.
- $10 Million for Pediatric Mental Health Access Grants: To expand access to behavioral health services in pediatric primary care settings.
- $2.08 Billion for the National Institute of Mental Health, an increase of $200 million, for mental health research at NIH.
- $1.63 Billion for Community Health Centers: As co-chair of the Community Health Center caucus, Blunt has introduced legislation to reauthorize and increase mandatory funding for the program. There are more than 260 sites in Missouri, with Missouri health centers receiving over $100 million in federal grant funding to serve a total of 585,000 patients a year.
- $311.8 Million for Rural Health Care Programs: The obstacles faced by patients and providers in rural communities are unique and often significantly different from those in urban areas. The bill focuses resources toward efforts and programs to help rural communities, including:
- $26.5 Million for Telehealth, a $2 million increase. The Telehealth program expands the use of telecommunications technologies within rural areas that can link rural health providers and patients with specialists; and
- $22 Million for Delta States Network Rural Development Network Grants, a $2 million increase, to support the Health Resources and Services Administration’s collaboration with the Delta Regional Authority to continue a program to help underserved rural communities identify and better address their health care needs. This includes $10 million for the Delta Region Community Health Systems Development (DRCHSD) program, which started under Blunt’s chairmanship, to help small rural hospitals improve their financial and operational stability. Pemiscot County Memorial Hospital in Hayti, Iron County Hospital in Pilot Knob, and Madison Medical Center in Fredericktown have participated in the DRCHSD program.
- $340 Million for Children’s Hospitals Graduate Medical Education (CHGME), a $15 million increase. The CHGME program protects children’s access to high quality medical care by providing freestanding children’s hospitals with funding to support the training of pediatric providers. In Missouri, Children’s Mercy Hospital in Kansas City and St. Louis Children’s Hospital in St. Louis both receive approximately $6 million a year each in funding from this program. This funding level represents an increase of $75 million for CHGME under Blunt’s chairmanship the last four years, or 20%.
- $266 Million to Support the President’s HIV Initiative, an increase of $210 million, to reduce the number of new HIV infections by 90% in 10 years. These resources will be provided to 48 counties and seven states, including Missouri, for prevention, diagnoses, research, and response activities.
- $10.1 Billion for Head Start, an increase of $50 million, to help all Head Start programs keep up with costs, recruit and retain highly qualified staff, maintain enrollment, and provide high-quality early childhood services for children and families.
- $5.3 Billion for the Child Care and Development Block Grant, an increase of $25 million, which builds on the historic increase provided in recent years to help states fully implement the 2014 reauthorization of the CCDBG Act. This will help states improve the quality of child care programs, including increasing provider rates and ensuring health and safety standards are met, and expand working families’ access to quality, affordable child care.
- $250 Million for Preschool Development Grants: To improve the coordination and quality of existing early childhood programs.
Department of Education
- Elementary and Secondary Education: The bill prioritizes funding that provides the most flexibility to states and school districts to decide how to best use limited resources to meet the educational needs of students and families, while addressing important priorities, including:
- $1.5 billion, an increase of $25 million, for Impact Aid;
- $1.2 billion, an increase of $50 million, for Student Support and Academic Enrichment Grants, which support a wide range of activities including STEM education and school safety;
- $105 million, an increase of $10 million, for School Safety National Activities, which support evidence-based activities to improve school safety, prevent violence, and improve school climates;
- $460 million, an increase of $20 million, for Charter Schools; and
- Maintains funding for core elementary and secondary education programs including Title I Grants to Local Educational Agencies, Title II Supporting Effective Instruction State Grants, and IDEA.
- College Affordability and Completion:
- Pell Grants: For a third year in a row, the bill increases the maximum Pell Grant award – from $6,195 to $6,330 for the 2020-2021 school year, an increase of 2.2% or $135 based on inflation. The bill continues support for year-round Pell Grants, which help students complete post-secondary education programs faster and enter or re-enter the workforce sooner. Blunt successfully led efforts to restore eligibility for year-round Pell Grants in the FY2017 omnibus appropriations bill.
- Campus-Based Student Aid: The bill maintains the significant increases provided in recent years and includes $840 million for Supplemental Educational Opportunity Grants and $1.1 billion for Federal Work Study.
- TRIO: The bill includes $1.1 billion for TRIO to help low-income and first generation students enter and complete college. Over the last five years as chairman of Labor/HHS, Senator Blunt has helped increase funding by more than 26%.
- New Career Pathways Initiative – Education Department: The bill includes $10 million for a new initiative to help school districts, institutions of higher education, and area Career and Technical Education schools implement a wide-range of activities, such as aligning curriculums with academic standards and occupational licensing and credentialing, and providing direct services to students, with the goal of improving pathways for students beginning in high school that can lead to the full-range of post-secondary college and career options.
Department of Labor
- $10 Million for New Career Pathways Initiative – Labor Department: The bill includes $10 million for a new youth career pathways demonstration program at the Department of Labor to improve workforce readiness, employment and training opportunities, and provide early exposure to multiple career pathways.
- $170 Million for the Apprenticeship Program, a $10 million increase over FY2019 and an $80 million increase since Congress began funding this program in FY2016. Blunt previously spoke on the Senate floor to underscore the importance of apprenticeships in preparing a 21st Century workforce.
- $306 Million Veterans Employment and Training (VETS), a $6 million increase. VETS provides intensive employment services to veterans and eligible spouses, transitioning service members, and disabled veterans. This increased funding will support veterans in the transition assistance program as they move into the civilian workforce and allow the Department of Labor to implement reforms required by the 2019 National Defense Authorization Act and assist military spouses in addressing occupational and credentialing barriers.
- $30 Million for Rural Workforce Training: Funding is provided to continue the Workforce Opportunity in Rural Communities program started in 2018 under Blunt’s chairmanship. The program provides reemployment and training assistance to dislocated workers in the Delta and Appalachian regions.
- $2.8 Billion for State Workforce Training Programs: These funds are distributed by formula to states and localities to meet each state’s unique job training and reemployment needs.
- $1.7 Billion for Job Corps and $89.5 Million for YouthBuild: Both programs provide at-risk youth with the opportunity to gain educational and occupational skills. Missouri has three Job Corps centers, located in Excelsior Springs, Puxico, and St. Louis, and four current YouthBuild grantees located in Columbia, St. Joseph, and St. Louis.
Oversight and Accountability
- Reemployment Services and Eligibility Assessments: $175 million is provided to conduct enhanced, in-person assessments to accelerate the reemployment of Unemployment Compensation recipients in order to reduce the duration of their time receiving benefits and the likelihood of exhausting benefit coverage. These actions would also help protect the integrity of the Unemployment Insurance Trust Fund by reducing improper payments. This program has been shown to save $2.60 for every $1.00 spent.
- Health Care Fraud and Abuse Control (HCFAC): $786 million is provided by utilizing the cap adjustment provided in the Budget Control Act. For every $1.00 spent on HCFAC, $2.00 is recovered by the U.S. Treasury. This will create over $10.2 billion in savings to the Treasury over 10 years.
- Preventing Social Security Disability Fraud, Abuse, and Improper Payments: $1.6 billion is provided to support periodic reviews to ensure that individuals receiving Social Security disability benefits are still eligible under program rules. This funding is estimated to save approximately $9.6 billion over 10 years for the Social Security, Medicare, and Medicaid programs.
- Program Eliminations: A tight budget environment requires tough choices and a critical review of all programs in the bill, even those that have been funded for decades. The committee recommendation includes 5 program eliminations, equating to $113.5 million in spending reductions. Additionally, the Committee recommends $393 million in other program reductions.