President's Budget Request Research Articles

What drives program terminations for the federal government?

AbstractDo federal program terminations result from politics or program ineffectiveness? We used mixed methods, starting with a survey of current and former budget officials and staffers in the Office of Management and Budget, Appropriations Committees, and other Congressional committees. We followed this up using OMB budget data and the Program Assessment Rating Tool (PART). Consistent with the survey results, the President's Budget request did have an impact. Political events, particularly changes in party control of Congress, also had an impact. The influence of performance information was less clear: The PART evaluations did not seem to influence the likelihood of terminations.

Federal Funding for Health Security in FY2019

This article is the latest in an annual series analyzing federal funding for health security programs. We examine proposed funding in the President's Budget Request for FY2019, provide updated amounts for FY2018, and update actual funding amounts for FY2010 through FY2017. Building health security for the nation is the responsibility of multiple agencies in the US federal government, as well as that of state, tribal, territorial, and local governments and the private sector. This series of articles focuses on the federal government's role in health security by identifying health security-related programs in public health, health care, national security, and defense and reporting funding levels for that ongoing work.

Federal Funding for Health Security in FY2018

This article is the latest in an annual series analyzing federal funding for health security programs. It examines proposed funding in the President's Budget Request for FY2018 and provides updated amounts for FY2017 and actual funding for FY2010 through FY2016. The proposed FY2018 budget for health security-related programs represents a significant decrease in funding from prior years and previous administrations. In total, the President's proposed FY2018 budget includes $12.45 billion for health security-related programs, an estimated decrease in funding of $1.25 billion, or 9%, from the estimated $13.71 billion in FY2017 and an 11% decrease from the FY2016 actual funding level of $13.99 billion. Most FY2018 health security funding ($6.67 billion, 54%) would go to programs with multiple-hazard and preparedness goals and missions, representing a 14% decrease in this funding compared to FY2017. Radiological and nuclear security programs would receive 20% ($2.48 billion) of all health security funding, a slight decrease of 2% from the prior year. Biosecurity programs would be funded at $1.53 billion (12% of health security funding) in FY2018, a decrease of 6% compared to FY2017. Chemical security programs would represent 3% ($389.7 million) of all health security funding in FY2018, a 9% decrease from the prior year. Finally, 11% of health security funding ($1.39 billion) would be dedicated to pandemic influenza and emerging infectious diseases programs, the only category of funding to see an increase (3%) above FY2017.

NOAA's 2017 Budget Would Support Observational Infrastructure

The Obama administration's budget request includes funding for an initiative to vastly boost the number of water-monitoring sites used to forecast floods, droughts, and other hydrological impacts.

Obama 2015 Budget Would Extend Medicaid Pay Bump

Many physicians would continue to see higher payments through 2015 for treating Medicaid ­patients under President Obama's proposed budget for the upcoming fiscal year. The budget request submitted to Congress March 4 includes $5.4 ­billion to extend the Affordable Care Act (ACA) provisions that pay physicians at Medicare levels for certain primary care services to Medicaid patients. Otherwise, the increase will end this year. Under the budget proposal, nurse practitioners and physician assistants also would be eligible for the higher payment rates. “Allowing [the higher rates] to expire would result in a deep, across-the-board cut to primary care physicians who are taking care of the most vulnerable populations, at a time when millions more are becoming eligible for Medicaid,” Molly Cooke, MD, president of the American College of Physicians (ACP), said in a statement. The budget proposes $77.1 billion in discretionary spending for Health and Human Services (HHS), down $1.3 billion from 2014. This includes investments in the primary care workforce, expanded mental health services, and continued implementation of the ACA insurance marketplaces. The president's budget also calls for Medicare cuts of more than $400 billion over 10 years. Proposed in previous budgets, these include payment cuts for inpatient rehabilitation facilities, long-term care hospitals, and home health agencies; reduction in Medicare coverage of hospitals’ bad debts; reductions to indirect graduate medical education payments; and payment cuts to critical-access hospitals. In addition, the budget would introduce readmission penalties for skilled nursing facilities and strengthen the controversial Independent Payment Advisory Board (IPAB). The proposal would require the IPAB to recommend cost-cutting targets to Congress if the Medicare growth rate exceeds gross domestic product plus 0.5 percentage points. Current law sets that level at GDP plus 1 percentage point. The 2015 budget proposal would increase investment in the primary care workforce. It requests more than $5 billion over the next decade to train 13,000 new residents as part of a new competitive grant program available to teaching hospitals, children's hospitals, and community-based consortia of teaching hospitals or other health care institutions. The budget also beefs up funding for the National Health Service Corps. It includes nearly $4 billion in new funding over 6 years to increase the number of health providers in rural areas and federally funded health centers to 15,000. And it would invest $4.6 billion in community health centers in 2015 and another $8.1 billion for the next 3 years. For mental health services, the budget includes $55 million for Project AWARE, which encourages community and school officials to work together to keep schools safe, refer students to mental health services, and provide mental health “first aid” training so that teachers can detect early signs of mental illness. The budget request includes $50 million to train about 5,000 new mental health professionals, $20 million to help young adults aged 16-25 years navigate behavioral health services, and $5 million to change attitudes about people who have behavioral health needs in the workplace. The budget also provides funding for a demonstration project in Medicaid to help reduce the use of psychotropic medications prescribed to children in foster care by improving access to other mental health services. The release of the president's budget request came just weeks before the end of open enrollment in private health plans through the ACA's marketplaces. The budget includes $1.8 billion in funding for 2015 to cover the cost of running the federally facilitated marketplace. However, most of the funding – $1.2 billion – would be covered by user fees from health plans in the marketplaces. If Congress fails to provide the remaining funds, HHS officials said they could transfer monies from other agency accounts to cover marketplace costs.

NOAA Budget Request Looks Positive, Though Numbers Could Shift in Congress

The Obama administration's budget request for the National Oceanic and Atmospheric Administration (NOAA) for fiscal year (FY) 2012, which begins on 1 October, would increase the agency's funding level to $5.5 billion, up from $4.75 billion in the FY 2010 budget enacted by Congress. The budget request is $56.8 million less than the administration's FY 2011 request of $5.54 billion. However, as Eos went to press, Congress was considering a new budget continuing resolution (CR) that could fund the federal government through the end of FY 2011 at a significantly lower level than the president requested for the current year. The CR could dramatically affect NOAA's current budget, the upcoming debate over the FY 2012 budget, and high‐priority programs including the Joint Polar Satellite System (JPSS) to improve weather forecasting and climate monitoring.

Health Care Advocates Worry About Proposed '07 Budget

Back to table of contents Previous article Next article Government NewsFull AccessHealth Care Advocates Worry About Proposed '07 BudgetRich DalyRich DalySearch for more papers by this authorPublished Online:18 Aug 2006https://doi.org/10.1176/pn.41.16.0014The Senate Appropriations Committee approved a draft Fiscal 2007 Labor-HHS-Education spending bill in late July that raised the possibility that Congress may approve the primary mental health spending measure before the next fiscal year begins.The bill (S 3708) would provide $142.8 billion in health-related discretionary spending, which is $5 billion more than President Bush requested and $1.3 billion more than the Fiscal 2006 amount. The House version (HR 5647) would provide $141.9 billion for discretionary programs. The rest of the funding in both health budget bills is allocated for Medicare, Medicaid, and other entitlement programs.“While [the Senate's funding level] amounts to a modest dollar increase in health spending, it is still higher than the House's version,” said Nicholas Meyers, director of APA's Department of Government Relations.The Senate bill would provide $28.5 billion for the National Institutes of Health (NIH), an increase of $220 million over Fiscal 2006 and $200 million over the president's budget request.The House version, which also provides $28.5 billion for NIH, has been approved by that chamber's Appropriations Committee.Congressional negotiators will reconcile differences in the two versions after both chambers pass their versions of the bill.Rep. David obey (D-Wis.) criticized the proposed budget for NIH as insufficient, given a “substantial” inflation in research costs. Sen. Arlen Specter (R-Pa.) said that even in the more-generous Senate version, NIH funding is $3.78 billion below the inflation-adjusted Fiscal 2006 level.For the three mental health institutes within NIH, the Senate measure would provide $1.4 billion to the National Institute of Mental Health (NIMH), $1 billion to the National Institute on Drug Abuse, and $436 million to the National Institute on Alcohol Abuse and alcoholism. These amounts are similar to the current year's funding levels for the three institutes.The Senate bill would provide $3.34 billion for the Substance Abuse and Mental Health Services Administration (SAMHSA), an increase of $77 million over the president's budget request. SAMHSA is responsible for supporting mental health programs and alcohol and other drug abuse prevention and treatment services.The Senate bill would restore the $630 million for SAMHSA's Community Services Block Grant, which was proposed for elimination in the president's budget.Proposed Budgets for VAThe Senate Appropriations Subcommittee on Military Construction, Veterans Affairs, and Related Agencies approved a $94.3 billion Fiscal 2007 Military Construction-VA appropriations bill (HR 5385). Of that amount, $77.9 billion is earmarked for the Department of Veterans Affairs, which includes health care spending for veterans. The bill, however, does not include a proposal from the president to increase TRICARE fees for some veterans. President Bush had requested an increase in premiums for some veterans and their families in TRICARE, the program that funds health care for this population, as well as higher enrollment fees, deductibles, and prescription drug copayments for some military retirees. The House bill, which would allocate $36.5 billion for VA discretionary programs, also does not include the proposal.Both the House and Senate bills would provide $32.7 billion for the Veterans Health Administration and $3.6 billion for VA medical facilities.The House's allocation for the overall VA spending bill is $136.1 billion. It is dramatically higher than the Senate's $94.3 billion total because the House bill would fund some defense accounts that the Senate bill would not, including the Defense Health Program. Following Senate passage, negotiators will have to hammer out differences between the House and Senate versions of the bill.Family Treatment AddressedIn addition to its work on a health care funding bill, the Senate passed legislation concerning children who are placed in the child welfare system because they are affected by methamphetamine use. The Improving Outcomes for Children Affected by Methamphetamine Act of 2006 (S 3525) amends the Promoting Safe and Stable Families program to reserve $40 million for grants to create regional partnerships to improve outcomes for children affected by methamphetamine abuse or addiction. This bill was sponsored by Sen. Charles Grassley (R-Iowa), and the president is expected to sign the measure.“By emphasizing comprehensive family treatment, we are promoting a promising strategy for families to recover from meth addiction together,” Grassley said at a hearing on the bill.Information about the Labor-HHS bill is posted at<http://thomas.loc.gov/cgi-bin/bdquery/z?d109:h.r.05647:>; the Senate version of the VA spending bills is posted at<http://thomas.loc.gov/cgi-bin/bdquery/z?d109:h.r.05385:>.▪ ISSUES NewArchived

Senate Panel Backs Integrated Ocean Observation System

2007 U.S. BUDGETLast week, a Senate spending panel added $70 million to the Administration's budget request for the National Oceanic and Atmospheric Administration (NOAA) to start up the Integrated Ocean Observation System. But lobbyists for ocean science are worried that NOAA may not be in it for the long haul. ([Read more][1].) [1]: http://www.sciencemag.org/cgi/content/full/313/5785/280a

U.S. budget requests more for some science

Under the Bush Administration's budget request for Fiscal Year 2007, which was announced on 6 February, some agencies would receive deep cuts, while science funding at three others would see significant increases if Congress approves. Those agencies, the U.S. National Science Foundation (NSF),the Department of Energy's (DOE) Office of Science, and the U.S. National Institute of Standards and Technology (NIST) also would see their science budgets doubled within 10 years as part of the president's new American Competitiveness Initiative (ACI; see Eos 87(6}, 2006).However, continuing a trend of flat funding for science, U.S. federal non‐defense research and development (R&amp;D) would receive only a 1.9 percent increase under the budget request.

NIH Set for Tiny Spending Hike in 2006

U.S. BUDGETDespite a surprise legislative setback, the National Institutes of Health (NIH) appears likely to receive the president's budget request for 2006--a 0.7% increase to $28.6 billion. [(Read more.)][1] [1]: http://www.sciencemag.org/cgi/content/full/310/5752/1256b

NASA is big winner in Bush administration science budget

The Bush Administration's budget request for Fiscal Year 2006, announced on 7 February represents a mixed bag for federal science agencies. While NASA and the National Science Foundation would receive increases, funding for some other agencies, including the National Oceanic and Atmospheric Administration, would decrease. This article looks at the budgets for NASA and the Department of Energy; other agencies will be examined in forthcoming issues.NASA's FY 2006 budget request of $16.5 billion is a 2.4% overall. Guided in part by the 2004 presidential directive for expanding space exploration, the administration plans to streamline NASA's structure to 12 themes condensed into four directorates in 2006. With that shift, space science and Earth science will be combined into a broader science category, and biological and physical research and exploration systems will merge to become exploration systems. Aeronautics and education are the other two directorates, while a space operations category continues as a separate entity

APA Pleased With Budget Boost For Public MH Services

Back to table of contents Previous article Next article Government NewsFull AccessAPA Pleased With Budget Boost For Public MH ServicesChristine LehmannChristine LehmannSearch for more papers by this authorPublished Online:7 Jan 2005https://doi.org/10.1176/pn.40.1.00400022aCongress approved an increase of $46 million for the federal Center for Mental Health Services (CMHS) over its Fiscal 2004 budget, bringing its total budget to $908.6 million for Fiscal 2005. CMHS funds public mental health services within the Substance Abuse and Mental Health Services Administration (SAMHSA), and its budget represents about 30 percent of SAMHSA's program budget in Fiscal 2005. SAMHSA is part of the Department of Health and Human Services.“Overall, the appropriations bill was quite favorable to CMHS, considering that many other public health programs received less than a 3 percent increase in Fiscal 2005,” Lizbet Boroughs, an associate director in APA's Department of Government Relations, told Psychiatric News.The CMHS increase was included in the omnibus budget bill (HR 4818) that Congress passed in November and the president signed into law last month.Of the $46 million increase in the CMHS budget, $20 million is for the new State Incentive Transformation Grants (SIGs). The grants will give states the resources to develop comprehensive service plans for adults and children with mental and emotional disorders.They also “will enable states to create new partnerships among federal, state, and local governments to expand the array of available services and supports that mental health consumers and families need. These include housing, vocational rehabilitation, and educational services,” according to the “Appropriations Recommendations for FY 2005” by the Mental Health Liaison Group (MHLG). This group, of which APA is a member, represents advocates, consumers, family members, and service providers.“The funding is especially welcome since it is challenging to have new programs created and funded in this lean fiscal environment,” Boroughs said.Congress also passed an increase of $1.4 million in Fiscal 2005 for the Community Mental Health Services Performance Partnership Block Grant, bringing its total funding to $436.1 million. For Fiscal 2004, Congress had cut the block grant's funding by $2.4 million.The block grant program, which gets half of CMHS's funding, is the principal federal discretionary program supporting community-based mental health services for adults and children. “States may use block-grant dollars to provide a range of critical services including housing services and outreach to people who are homeless, employment training, case management, and peer support,” according the MHLG report.Other longstanding programs, including the Comprehensive Community Mental Health Services for Children and Their Families Program and the Projects for Assistance in Transition from Homelessness (PATH), received increases of about $1 million less in Fiscal 2005 than in Fiscal 2004.The president's budget request did not include funding for jail diversion programs and a program that provides outreach to and mental health treatment for the elderly, which had received funding in previous years.Boroughs said she and other lobbyists met several times with members of the House Appropriations Committee to educate them about the mental health needs of the elderly.Rep. Patrick Kennedy (D-R.I.), a member of the House Appropriations Subcommittee on Labor, Health and Human Services, and Education and a staunch supporter of mental health parity, “led the fight within the Appropriations Committee to restore the funds” for the mental health program for the elderly, according to a press release from Kennedy's office.As a result of these advocacy efforts, the House restored $5 million to the CMHS program for the elderly, the same amount the program had been given for the past three years.Congress also restored funding for the jail diversion program at the same $7 million level the program was funded in Fiscal 2004. Although Bush signed the Mentally Ill Offender Treatment and Crime Reduction Act of 2004 into law in October 2004 (Public Law 108-414), authorizing $50 million for Fiscal 2005, the omnibus legislation contains no new funds for the bill.The legislation, strongly supported by APA, authorizes funding for states and local communities to develop jail diversion programs and cross-train criminal justice, law enforcement, court, and mental health personnel; it also provides mental health services for ex-inmates upon re-entry into the community, according to DGR.Details of SAMHSA's Fiscal 2005 budget and programs can be accessed online at<http://thomas.loc.gov> by searching on “HR 4818.” ▪ ISSUES NewArchived

Billions for biodefense: federal agency biodefense funding, FY2001-FY2005.

Over the past several years, the United States government has spent substantial resources on preparing the nation against a bioterrorist attack. This article analyzes the civilian biodefense funding by the federal government from fiscal years 2001 through 2005, specifically analyzing the budgets and allocations for biodefense at the Department of Health and Human Services, the Department of Homeland Security, the Department of Defense, the Department of Agriculture, the Environmental Protection Agency, the National Science Foundation, and the Department of State. In total, approximately $14.5 billion has been funded for civilian biodefense through FY2004, with an additional $7.6 billion in the President's budget request for FY2005.

A Time for the Advanced National Seismic System

In his address to the Seismological Society of America at our Annual Meeting in Victoria last April, U.S. Geological Survey Director Charles (Chip) Groat gave us renewed confidence that the time for the Advanced National Seismic System (ANSS) to move from promise to reality is now. As most of you know, the ANSS will be a nationwide network of 7,000 seismographs and strong-motion instruments, both on the ground and in buildings, that will provide scientists and engineers with the digital-quality data that are so desperately needed to understand ground-motion and building-response processes. ANSS is also critical for emergency response, providing real-time information on the distribution and severity of earthquake shaking. ANSS will replace the inadequate and antiquated 30-year-old seismographic equipment that forms the backbone of most regional networks. [S]ignificant funding for ANSS has never been part of the President's budget request. The blueprint for ANSS is laid out in USGS Circular 1188, submitted to Congress in 1999 in response to a 1997 law (Public Law 105-47) that called for USGS to “provide for the assessment of regional seismic monitoring networks in the United States”, including “the need to update the infrastructures used for collecting seismological data for research and monitoring of seismic events in the U.S.” The ANSS plan is a consensus document, the product of a series of workshops on the nation's seismic monitoring needs. Preparation of the ANSS plan, and ultimately its implementation, involves not only USGS but also the entire seismic monitoring community, as well as the user communities. In an unprecedented show of unity, the seismological, engineering, and emergency-response communities from the local to the national levels all came together to forge the ANSS vision as laid down in Circular 1188. The ANSS plan requires a capital expenditure of $170 million in new equipment over a …

R&amp;D FUNDING IN DOLDRUMS

With an eye toward the new millennium, the colloquium on federal R&D funding held each spring in Washington, D.C., by the American Association for the Advancement of Science (AAAS) once again drew a critical mass of policy thinkers from academe, industry, and government. Along with a detailed report on R&D in the Administration's 2000 budget request, this year's gathering featured a look at the global knowledge economy among the forces shaping U.S. science and technology policy. The AAAS budget reporta useful and highly readable summary of the Clinton Administration's R&D proposalsincludes observations of the Administration's budget request by the National Academy of Science's Committee on Science, Engineering & Public Policy (COSEPUP). This year, the committee was sufficiently alarmed by its findings that it held a separate briefing in advance of the colloquium. The committee's concerns focus on balance in the federal R&D portfolio. Decreases in the Department of Defense's science and technology budget...

MIT's Bates Lab Gets Sudden Reprieve

NUCLEAR PHYSICS Massachusetts Institute of Technology (MIT) officials say they were “shocked” last Monday to learn that the Department of Energy (DOE) planned to end its support of the university's Bates Linear Accelerator Center. Although they knew the facility, part of the school's nuclear science laboratory, would be vulnerable in a tight budget, they were optimistic that money would be found to keep it running. But there was no mistaking the message: The shutdown was mentioned several times in the president's budget request, released on 1 February. Shock quickly turned to elation, however. Within minutes of the budget's formal release, Energy Secretary Bill Richardson was on the phone to MIT President Charles Vest explaining that the department had changed its mind. The proposed budget for fiscal year 2000 would be amended to continue support for the 30-year-old facility, the secretary told Vest, including funds for a new detector to study the magnetic properties of atomic nuclei. Instead of spending $2.5 million next year to decommission the accelerator, DOE now plans to request $14.5 million for the Bates Large Acceptance Spectrometer Torrid (BLAST) and for other experiments that will keep the lab running until 2004 or 2005. It is not clear, however, where DOE will find the additional money in a budget that holds funding for high-energy and nuclear physics essentially steady. And congressional appropriators still get the last word. By all accounts, Richardson, a former Democratic congressman from New Mexico and good friend of the president, made a unilateral decision. The original plan to close Bates followed a recommendation from DOE's Nuclear Science Advisory Committee ( Science , 16 October 1998, p. [389][1]) that other facilities should receive priority in a tight budget. Department R&D managers had accepted the advice and decided to concentrate scarce resources at the department's new flagship nuclear physics facility, the Thomas Jefferson National Accelerator Facility in Newport News, Virginia. White House budget officials had even mailed letters, in response to inquiries from concerned scientists, saying that the budget would contain money only to decommission the lab. “Bates will cease operations at the end of FY 1999,” notes DOE's FY 2000 budget document, “and fabrication of the BLAST detector is discontinued.” But even as those words were being readied for publication, says Martha Krebs, head of DOE's Office of Science, Richardson was reviewing the decision to close Bates. Krebs says she learned about the reversal for the first time on Tuesday morning—1 day after she had briefed the media on a research agenda that did not include Bates. Several factors were working in the lab's favor, she noted: “They're doing good science, they train a lot of students, and MIT is managing the facility effectively. In addition, it's the only university-based accelerator that DOE supports.” In the end, Krebs says, “the Secretary decided that [flat funding] should not be a limiting factor in whether or not to operate Bates.” Richardson's phone call meant a last-minute wardrobe change for MIT's dean of science, Robert Birgeneau, who was scheduled to be the bearer of bad tidings during a visit to the lab Tuesday afternoon. “I had picked out a black tie to reflect the somber message I would be conveying,” he says. “After President Vest called, I decided to switch to a pink shirt and brightly colored tie.” A dimmer view of the reversal comes from Claus-Konrad Gelbke of Michigan State University in East Lansing, chair of the Nuclear Science Advisory Committee. “The operation of Bates would be impossible at the president's budget request [for nuclear physics],” he says. “I just hope that they aren't planning to solve the problem by taking the money from Peter to pay Paul.” And although the new plan may be good news for the lab's 85 staff members and collaborators, even its supporters say that Richardson's sudden change of heart reflects poorly on the department's decision-making process in setting scientific priorities. “I've never seen anything like that in my 28 years here,” says one science lobbyist. “In the end, I think they did the right thing. But it makes DOE look pretty bad.” [1]: /lookup/doi/10.1126/science.282.5388.389a

Clinton budget request includes science and environment increases for many federal agencies

As part of the Clinton Administration's budget request for fiscal year 1999, a number of science and environment accounts would receive substantial increases. This article focuses on the budgets of some federal agencies, including the Environmental Protection Agency (EPA), Department of Energy (DOE), and the U.S. Geological Survey (USGS). It continues the budget survey begun in last week's issue of Eos.

New Ideas Go With the Flow

National Science Foundation director Neal Lane has taken on few new research initiatives during his 3 years at the agency's helm, but he is now trying to get three new research programs included in the president's budget request, to be released in February.

The Extramural Exocrine Pancreas Program of the U.S. National Institutes of Health

The National Institutes of Health (NIH) is the major agency in the federal government that supports both biomedical research and training in the digestive diseases as it relates to health maintenance, human development throughout life, disease prevention, and disease treatment. The present article summarizes the exocrine pancreas program in the context of digestive diseases expenditures of the NIH. This article is a follow-up review of the Pancreas Program as originally described by Roussos (Pancreas 1986;1:74-79). The period covered in this review is fiscal year (FY) 1987 to present. Data presented for FY 1987 to 1992 were provided by the NIH Data Book (U.S. Public Health Service, 1993). Fiscal data for FY 1993-FY 1994 are compiled from institutional databases. FY 1995 figures are presented from the President's budget request submitted to the Congress of the United States.

House Science Committee sets agenda

An informal briefing a few weeks ago by the House Science, Space, and Technology Committee staff provided a good overview of high‐priority science issues that they will address. The committee plans to revisit some issues as well as consider new matters of interest.There is much uncertainty about the Clinton administration's budget request, with no firm information about Space Station Freedom or budgets for the National Science Foundation, Department of Energy, or NASA. The Office of Management and Budget is assembling the new budget, which will then be sent to the agencies for review. March 23 is the current target date for release of the detailed budget document.