Late Sunday evening, leaders in Congress came to final agreement on the FY17 spending package, which if signed into law later this week, will provide dedicated and reliable funding for the federal government through September 30, 2017. The House of Representatives is slated to vote on the $1.070 trillion bill tomorrow, and the Senate is expected to take the bill up shortly after it passes the House before sending it along to President Trump’s desk to be signed into law.
The bill is almost evenly divided, providing $551 billion for defense and national security to keep Americans safe, and $518 billion for investments in education, health care, and our roads and bridges to ensure the nation’s future remains bright ‒ a $15 billion bump for both defense and nondefense spending. The FY17 omnibus package also received an $88.6 billion from a wartime savings account, known as the overseas contingency operations fund. Overall, there’s $150 million to battle the opioid crisis and improve access to mental health treatment throughout the bill, including Medication Assisted Treatment and grants to train first responders to use overdose prevention devices.
To the surprise of many, Congressional leaders were able to agree on an FY17 spending package that remains free of controversial provisions to fund the wall along the U.S.‒Mexico border, and deny federal funding to “sanctuary cities” or Planned Parenthood. It does, however, provide health insurance for retired mine workers, and injects Puerto Rico with a much-needed cash infusion to avoid a collapse of its Medicaid program. Finally, the bill contains no funding for the Affordable Care Act or the cost-sharing reduction payments to insurers.
Most importantly, the bill maintains Congress’ historic commitments to community health centers and:
- Provides $1.5 billion in discretionary 330 grant funding to ensure quality primary care access at FQHCs across the country; and
- Directs $100 million ‒ $50 million for both mental health treatment and battling opioid addiction ‒ of 330 grant dollars to ensure health centers can remain on the front lines in communities struggling with these twin challenges.
The spending package also reflects Congress’ deep interest in expanding the next generation of health center specialists and providers, and developing the health center workforce in the years to come. Specifically the bill:
- Extends Conrad 30 J-1 Visa Waiver program, which allows international physicians to remain in the U.S. after their residency if they practice in an medically underserved area for three years;
- Maintains a pipeline of diverse providers by funding Area Health Education Centers (AHECs) and the Health Careers Opportunity Program (HCOP);
- Provides a $77 million boost for HRSA, including $50 million for behavioral health workforce training;
- Encourages $800,000 for the Dental Faculty Loan Repayment Program; and
- Supports the inclusion of substance abuse and pain management education in education curriculums to stop future epidemics.
There are several other health center priorities including the Federal Tort Claims Act (FTCA), the 340B Program, telehealth expansions, and community-based health initiatives that are important to many NACHC members. The FY17 omnibus bill:
- Provides almost $100 million to replenish the FTCA judgement fund, which will ensure coverage for individuals serving at health centers against claims;
- Allocates an additional $1.5 million to expand telehealth access and create a plan to open a “Telehealth Center of Excellence” at HRSA;
- Requires HRSA to brief Congress on the 340B Program – specifically their progress on a secure website to calculate and verify 340B ceiling prices ‒ within 90 days of signing the FY17 spending bill into law;
- Ensures $22.5 million for the National Diabetes Prevention Program (NDPP), which reaches Americans with pre-diabetes; and
- Cuts $891 million from the Prevention and Public Health Fund, which ensures Americans in communities across the country have access to vaccines, lowers smoking rates, and helps prevent suicide.
For the most part, the FY17 spending bill was largely positive across the health care landscape. Most agencies and departments including the Centers for Disease Control and Prevention (CDC), Substance Abuse and Mental Health Service Administration (SAMSHA), and National Institutes of Health (NIH) saw relatively small increases in funding in the face of tight budget caps. Most observers expect the FY17 spending package to pass with ease tomorrow; however, the fight for federal funding will only become tougher as we return to lower spending levels in the FY18 budget.
Importantly, the spending deal for FY17 only addresses annual appropriations, or “discretionary” funding for the Health Centers program. The bill does not address the Health Centers Funding Cliff, which is still set to take place at the end of September without Congressional action.
As always, the Federal Affairs Team at NACHC continues to work with members of both parties in Washington to ensure leaders understand the importance of long-term funding for community health centers. Please feel free to reach out if you have additional questions, comments, or concerns about how the FY17 spending package impacts the future of health center funding.