Report Draws Attention to Looming Effects of Sequestration

“Sequestration”—that arcane term that came into the national lexicon when Congress passed the 2011 Budget Control Act mandating across-the-board cuts to government-funded programs—may have dropped from conversation, but it is still a reality, with large funding cuts scheduled to hit programs in 2016 and 2017.

Those cuts will exact a very real toll on general health and mental health programs and on Americans who rely on treatment and research that is dependent on government funding, a forum convened by the National Coalition for Health Funding (NCHF) told members of Congress during a July hearing.

At the hearing, the NCHF—of which APA is a member—also released a 64-page report titled “Faces of Austerity: How Budget Cuts Hurt America’s Health.” The report details specific programs related to access to health care, research, threat detection and response, and the health care workforce that are facing steep reductions in the near future.

APA Deputy Director of Government Relations Lizbet Boroughs told Psychiatric News that according to the Budget Control Act, there will be 6 percent across-the-board budget cuts beginning in 2016, year over year, with cumulative reductions by Fiscal 2021 of over 25 percent. “The hearing was part of an ongoing educational campaign to make members of Congress and their staffs understand that they are making decisions that will have real-life consequences for people,” she said.

Boroughs said that planned budget reductions will affect programs that provide access to community mental health care, such as transportation services for individuals with disabilities; funding for graduate medical education; and workforce programs. She noted, for instance, that the National Health Service Corps—through which psychiatrists can obtain medical school loan forgiveness by working in underserved areas—has been dramatically reduced by the ongoing sequestration budgets.

The NCHF report notes that the National Health Service Corps’ funding was already reduced by $15 million—or 5.1 percent—in 2014.

“Faces of Austerity” also highlights the effect of cuts to the Community Mental Health Block Grant (MHBG) program, administered by the Substance Abuse and Mental Health Services Administration, and the story of Daleen O’Dell, a Florida resident whose brother and son both have schizoaffective disorder. In the report, O’Dell states that when her family members have had a mental health crisis there have been few if any options for treatment in the community outside of the hospital; sometimes the county jail has been an option of last resort where she knows her son or brother will be safe.

“If Daleen and her family lived in a different state or even a different Florida county, there might be more options for access to treatment,” the report explains. “Florida currently ranks last of all 50 states and the District of Columbia in mental health funding. In 2010, Florida’s MHBG was used to fund 93 programs. In 2012, that number doubled, but the dollar amount increased by less than $700,000. In 2013, sequestration further reduced Florida’s grant by more than $1 million. Over the past 18 years, every time Daleen’s son, now 36, returned home after hospitalization or incarceration, he had few community-based options that met his needs.”

The report points out as well that a 5 percent cut to a federal program—as was required in the first year of federally mandated sequestration—may not seem like a lot but translates into a much bigger impact than that seemingly small percentage would suggest. “Federal contractors, grantees, and program beneficiaries must also cope with the cumulative effects of the federal government’s austerity measures, the erosion of the state and local funding base, and constrained contributions by the private and philanthropic sectors,” the report states. “They are, in fact, doing much more with much less than is recognized or reported. As our report demonstrates, the existing austerity frame is unsustainable and insufficient to meet our nation’s mounting health demands. Americans do feel the pain of policymakers’ budgetary decisions, and continued health cuts do more harm than good. With deficits on the decline, it’s time for Congress to lift the spending caps and address our nation’s health.” ■