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Federal substance abuse agency won’t change funding formula



Monitor staff
Tuesday, October 31, 2017

A federal substance abuse treatment agency will not be changing the way it distributes more than a billion dollars to states to fight the opioid crisis, it announced Monday, drawing strong criticism from New Hampshire representatives who say the state is being shortchanged.

The decision comes despite appeals to the Trump administration by top New Hampshire politicians to change the distribution model, as well as a meeting between President Donald Trump and Gov. Chris Sununu last month.

The agency, the Substance Abuse and Mental Health Services Administration (SAMHSA), is responsible for distributing the money provided by the 21st Century Cures Act in December 2016. That bill was a bipartisan effort to increase funding for mental health and substance use prevention services, in part by providing block grants to states.

But under a formula established by the Obama administration’s Department of Health and Human Services, which oversees SAMHSA, the funds were distributed based on the number of people with substance abuse disorders in each state, rather than per capita concentration.

That benefits larger states like California and Texas over smaller states which might have higher rates of drug use, such as New Hampshire and West Virginia. Of the billion dollars set aside for states, New Hampshire is only set to receive $6 million over two years, despite having the second-highest rate of per capita drug overdose deaths in the country in 2015.

For months, members of the federal delegation have pressed Health and Human Services to adapt the formula to better target smaller states with acute opioid problems. At a White House meeting in September, Sununu brought up the uneven funding problem with Trump. The president reacted favorably, Sununu said.

“Oh, he got it 100 percent,” Sununu told reporters after the meeting, adding that he believed that policy changes were in the works. “No, he absolutely got it.”

But a month later, the message from the U.S. Health and Human Services was clear: The situation will stay as is.

“To ensure that the second year of funding meets the requirements of the program and the needs of individual states, HHS and SAMHSA have decided that the funding allocation formula will remain the same as the first year for all 50 states,” a news release from SAMHSA read.

The release added that the move was being made so as to meet each states’ needs based on the base volume of overdose deaths. And given that the first half of the two-year appropriation has already been distributed, the formula should stay the same to ensure continuity for state programs, SAMHSA argued.

Members of New Hampshire’s all-Democratic delegation were galled.

“This is a tremendously disappointing decision,” said Sen. Jeanne Shaheen, who urged the administration to reconsider.

“People in New Hampshire are dying every day from the opioid crisis, and this harmful decision from the Trump administration will hurt states like New Hampshire,” Sen. Maggie Hassan added.

A representative for SAMHSA did not respond to a request for comment Tuesday.

For his part, Sununu cast blame on the administration that had created the funding policy, but avoided criticizing the administration perpetuating it.

“I am encouraged to see that Senator Hassan and Senator Shaheen finally agree that the Obama administration employed a faulty and ill-advised funding formula when it released Cures Act Funding through SAMHSA last year,” the Republican governor said.

“Regardless, I will continue to work with the current administration and Cabinet members to ensure that New Hampshire gets its fair share of Federal Funds to fight the opioid epidemic.”

A representative for Hassan pushed back at Sununu’s characterization, pointing to comments made to the Monitor criticizing the funding formula in March, as well as a letter jointly written with Sen. Shaheen to then-HHS Secretary Tom Price on the topic in April.

And a spokesman for Shaheen said that in addition to the letter, she had raised concerns with Health and Human Services during President Barack Obama’s last month in office – the month that the funding formula was unveiled.

But amid partisan pot shots, one representative took a step toward a legislative fix. On Tuesday, Rep. Ann Kuster unveiled a bill with Rep. Evan Jenkins, R-W.Va., that would require that funding allocations under the 21st Century Cures Act take into account per capita drug overdose death rates.

“My home state of New Hampshire has been devastated by the opioid epidemic,” Kuster said. “We desperately need to get additional resources to those on the frontlines.”