November 10, 2020
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 fiscal year 2021 Labor/HHS funding bill.
“This year’s bill targets funding toward some of the most important programs affecting the lives of nearly every American – educating our students, improving health care and paving the way for new treatments and cures, and providing workforce development opportunities,” said Blunt. “This bill includes the sixth consecutive increase for the National Institutes of Health. As we have seen first-hand this year, medical research is key to responding to diseases we have fought for years, like cancer and Alzheimer’s disease, as well as novel viruses like COVID-19. The bill continues our commitment to fighting the opioid and stimulant epidemic, which is unfortunately on the rise during the pandemic. The bill provides funding for education and early childhood programs, from helping hardworking families afford high-quality early childcare, to investing in Career and Technical Education, to making college more affordable. Finally, as our economy continues its recovery, the bill focuses investment in workforce programs, like the apprenticeship program, to ensure Americans can compete in a global economy.”
In addition to funding a range of health, education, and workforce programs, the bill includes resources to prevent waste, fraud, abuse, and improper payments in the Social Security, Medicare, and Medicaid programs.
Blunt continued, “This bill puts resources behind programs that have been, and should continue to be, a bipartisan priority. But to prioritize limited resources, we have to look at areas where we can eliminate duplicative or unnecessary spending. That means we need to continue efforts to crack down on waste, fraud, and abuse, and this bill does so. At the same time, the programs funded will help maintain U.S. competitiveness and support economic growth to improve our fiscal outlook over the long term.”
Since becoming chairman, over the last five years, Blunt has led the effort to reprioritize funding within the Labor/HHS bill, including eliminating approximately 30 programs representing over $1 billion in annual savings. This bill continues that effort, and eliminates an additional eight programs totaling $115 million to reprioritize that funding for programs that work and to address pressing needs.
Key Missouri Priorities Funded in the Bill:
Supporting Groundbreaking Medical Research and Expanding Access to Health Care Services, Including Mental and Behavioral Health Care:
National Institutes of Health (NIH): The bill includes a $2 billion increase for NIH. Since Blunt became chairman of the Labor/HHS subcommittee in 2015, NIH funding has increased by $13.6 billion, or 45%. According to data from United for Medical Research, NIH funding supported nearly 476,000 jobs and more than $81 billion in economic activity nationwide in FY2019. In Missouri, NIH funding supported $1.6 billion in new economic activity and more than 9,000 jobs. Missouri institutions received $655.6 million in NIH funding for 1,321 grants in 2019. From 2015-2019, NIH funding to Missouri institutions increased by $184 million or 38%.
Ending the HIV Epidemic: $518 million, an
increase of $207 million, to support the president’s HIV initiative and other
high priority HIV efforts to reduce the number of new HIV infections by 90% in
10 years. The majority of these resources will be targeted to 48 counties and
seven states, including Missouri, for prevention, diagnoses, research, and
response activities. Missouri received over $3.5 million in fiscal year 2020
for these efforts.
Opioid Epidemic: $3.9 billion, an
increase of $88 million, to combat the opioid epidemic. Funds are targeted
toward improving treatment and prevention efforts; finding alternative pain
medications; workforce needs, especially in our rural communities; and treating
behavioral health. Importantly, the bill gives states flexibility to use opioid
response funds on stimulants across multiple government programs. Preliminary
2020 numbers show that the challenges of this year are likely to increase the
number of opioid-involved deaths, emphasizing the need to continue these
critical investments. Under Blunt’s leadership, funding for health-related
opioid programs has increased by $3.6 billion.
Mental Health: As a critical part of both
combating opioid abuse and ensuring safety in our schools and communities, the
bill provides $4 billion, a $194 million increase, for mental health research,
treatment, and prevention, including:
Certified Community Behavioral Health
Clinics: $250 million, an increase of $50 million, for Certified Community
Behavioral Health Clinics. In 2018, Blunt targeted funding to community clinics
that provide a comprehensive approach to mental health care treatment. To date,
Missouri clinics have received $26 million in funds from this program. 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. The program was extended and expanded to two additional states in the
Project AWARE: $121 million, a $19
million increase, for the Project AWARE program that 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 connecting school-aged kids and their
families with needed services. Within this funding, the bill provides $15
million, an increase of $5 million, to address areas that have experienced
Mental Health Awareness Training: $24
million, an increase of $1 million, for Mental Health Awareness Training in
which Missouri was one of the first adopters;
Suicide Programs: $103 million, an
increase of $13 million. This increase provides support to the suicide lifeline
and grants to help identify and help those at risk of suicide;
Behavioral Health Workforce Education &
Training: $138.9 million to support workforce training programs, including
up to $29.5 million for the Mental and Substance Use Disorder (SUD) Workforce
Training Demonstration for grants to train professionals to provide SUD and
mental health treatment;
Pediatric Mental Health Access Grants:
$10 million for Pediatric Mental Health Access Grants to expand access to
behavioral health services in pediatric primary care settings; and
o National Institute of Mental Health: $2.14 billion for mental health research at NIH, an increase of $96.5 million.
Public Health Preparedness: $4.2 billion, an increase of $161 million, for HHS programs that help America’s communities and hospitals prepare for, respond to, and recover from public health and medical disasters and emergencies. These events include natural disasters, pandemic diseases, and man-made threats. Since fiscal year 2015, the committee has increased public health preparedness funding by $1.4 billion, or nearly 50%.
Alzheimer’s Research and Care: The bill increases investments in groundbreaking Alzheimer’s research and caregiver support for one of America’s most costly and prevalent diseases. The cost of caring for people with Alzheimer’s and other forms of dementia is expected to increase from $305 billion this year to $1.1 trillion by 2050, with Medicare and Medicaid paying roughly 70% of the total cost:
$3.17 billion for Alzheimer’s disease research,
an increase of $354 million. Under Blunt’s chairmanship, there has been more
than a five-fold funding increase for Alzheimer’s research;
$15 million, an increase of $5 million, for the
BOLD Infrastructure for Alzheimer’s Act to create a national public health
infrastructure to increase early detection and diagnosis and support prevention
o $27.5 million, an increase of $1 million, for expanding direct services through the Alzheimer’s disease program at the Administration for Community Living.
Community Health Centers: $1.71 billion for Community Health Centers, an increase of $87 million. 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 300 sites in Missouri, with Missouri health centers receiving over $115 million in federal grant funding to serve a total of more than 606,000 patients a year.
Medical Student Education: $50 million for Medical Student Education funding for states with the highest projected primary care physician shortages in 2025. Funding will provide supplemental grants to 2019 and 2020 grantees, including both the University of Missouri and University of Missouri-Kansas City.
Rural Health: $325.4 million for Rural Health Care programs, an increase of $7 million. The obstacles faced by patients and providers in rural communities are unique and often significantly different from those in urban areas. Funding for rural health care programs has more than doubled under Blunt’s chairmanship.
o Delta States Network Rural Development Network Grant: $27 million, an increase of $5 million, to continue a program to help underserved rural communities in the Delta identify and better address their health care needs. This includes $15 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, Mo., and Iron County Hospital in Pilot Knob, Mo., have participated in the DRCHSD program since December 2017 and Ste. Genevieve County Memorial Hospital in Ste. Genevieve, Mo. has participated since October 2019.
Children’s Hospitals Graduate Medical Education (CHGME): $355 million, a $15 million increase, for the CHGME program, which 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 received more than $13 million last year in combined funding from this program. This funding level represents an increase of $90 million for CHGME under Blunt’s chairmanship, or 34%.
Promoting State and Local Flexibility in Education, including Early Childhood Education:
Head Start: $10.7 billion, an increase of $100 million, to help all Head Start programs keep up with rising costs, maintain enrollment, and continue to provide high-quality services for children and families. Missouri Head Start programs receive more than $167 million annually and provide high-quality early childhood services to 15,000 children and their families.
Child Care and Development Block Grant (CCDBG): $5.9 billion, an increase of $50 million. Over the last three years funding for CCDBG has more than doubled, which has helped improve the safety and quality of child care programs, including increasing provider payment rates, and expand working families’ access to high-quality child care. Missouri receives over $106 million from the CCDBG annually.
Individuals with Disabilities Education Act (IDEA): $13.8 billion, an increase of $125 million, to support the educational needs of students with disabilities, which includes an increase of $7.5 million for preschool grants and an increase of $7.5 million for grants for infants and families. Missouri received approximately $262 million from these programs for this school year.
Title I Grants to Local Educational Agencies: $16.4 billion, an increase of $125 million, for grants to school districts to help all children meet challenging state academic standards. Missouri received approximately $260 million in Title I funding for this school year to support schools with a significant number or percentage of low-income students.
Impact Aid: $1.5 billion, an increase of $20 million. Missouri school districts receive approximately $28 million to help compensate for the presence of federal activities and land, including lost revenue.
STEM and Computer Science Education (CSE): $75 million, an increase of $10 million, in targeted STEM education funding, including specifically prioritizing CSE.
Career and Technical Education State Grants: $1.4 billion, an increase of $75 million. Missouri received approximately $25 million to support CTE programs across the state this school year.
Charter Schools Program: $450 million, an increase of $10 million, to help support the creation, replication, and expansion of high-quality charter schools.
Pell Grants: For the fourth year in a row, the bill increases the maximum Pell Grant award, an increase of $150, or 2.4%, for the 2021-22 school year, from $6,345 to $6,495. Approximately 90,000 students receive over $350 million in Pell Grant funding to attend Missouri colleges and universities. 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.
Preparing America’s Workforce:
Career Pathways: $10 million for an initiative at the Department of Labor to improve career pathways for students that can lead to the full-range of post-secondary college and career options.
Rural Postsecondary Education and Economic Development Program: $10 million for a new initiative to improve postsecondary access and completion among rural students by providing services for students from middle school through college and promoting partnerships between school districts, institutions of higher education, and regional economic development organizations.
Apprenticeship Opportunities: $195 million, an increase of $20 million, for the Apprenticeship Program to expand flexible and effective workforce training opportunities. Within this amount, $10 million is for Industry Recognized Apprenticeship Programs (IRAPs). Apprenticeship Missouri is one of the nation’s first IRAP standards recognition entities, responsible for ensuring high-quality standards for apprenticeships expanding to new industries, such as health care and information technology.
Veterans’ Employment and Training (VETS) Programs: $316 million, an increase of $5 million, for VETS programs. Funding supports veterans in the transition assistance program as they move into the civilian workforce and helps homeless veterans attain skills for meaningful employment.
o The bill continues to provide the Department of Labor with the necessary resources to carry out Blunt’s HIRE Vets Act, which established a tiered recognition program within the Department of Labor to award employers based on their contributions to veteran employment. Seven employers in Missouri received a HIRE Vets Medallion in 2019.
Rural Workforce Training Initiative: $40 million, an increase of $10 million, to continue the Workforce Opportunity in Rural Communities program started in 2018 under Blunt’s chairmanship to provide reemployment and training assistance in the Delta and Appalachian regions. This year, Blunt recognized three Missouri grant recipients for their awards totaling more than $3.5 million.
Workforce Training Programs: $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. Missouri received $35.6 million for training and employment services grants in 2020.
Youth Workforce Training Programs: The bill continues funding for programs that provide at-risk youth with the opportunity to gain educational and occupational skills:
Job Corps: $1.7 billion. Missouri has three Job
Corps centers located in Excelsior Springs, Puxico, and St. Louis.
o YouthBuild: $94.5 million. Missouri has four current YouthBuild grantees located in Columbia, St. Joseph, and St. Louis.
Reducing Fraud, Waste, and Abuse of Taxpayer Dollars:
Reemployment Services and Eligibility
Assessments: $200 million 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):
$807 million, an increase of $21 million, is provided by utilizing the cap
adjustment 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 billion over 10 years for the Social Security, Medicare, and Medicaid programs.
Other highlights of the bill include:
Adoption Opportunities: $46 million, an increase of $4 million, to help remove barriers to adoption and find permanent homes for children, particularly children with special needs.
Corporation for National and Community Service: $1.15 billion, an increase of $50 million, including an increase of $32 million for AmeriCorps and $8 million for Senior Corps programs. Last year, more than 1,300 AmeriCorps and 3,500 Senior Corps members helped address local needs in schools and communities across Missouri, including responding to natural disasters. Blunt has also cosponsored legislation to expand national service programs to help the nation respond to and recover from the COVID-19 pandemic.
Program Eliminations: The bill focuses funding on programs that are efficient, cost-effective, and have proven outcomes. The committee recommendation includes eight program eliminations, equating to $114.9 million in spending reductions.