1. Title of Presentation Presentation by Andrew Sperling Director of Federal Legislative Affairs National Alliance on Mental Illness (NAMI)

2. Current Federal Policy Environment 2012 as a status quo election Continued legislative gridlock Major focus on oversight and congressional investigations – including federal involvement in mental health services – House Energy & Commerce oversight hearings – GAO investigation Newtown response – Senate HELP package (S 689) – 95-2 Senate vote on April 18

3. Grand Budget Deal? Federal deficit is falling – CBO now projects it to $642 billion for 2013 v. a $1.2 trillion projection earlier this year – Higher revenue projections – Fannie/Freddie returns – Lower projected health care costs Pressure for a large deficit reduction agreement is diminishing Debt limit will not be reached until at least October

4. FY 2014 Funding for Mental Illness Research and Services Tight limits on Non-Defense Discretionary (NDD) spending remain in place Senate FY 2014 budget resolution allows for $91 billion more in discretionary funding than the House budget resolution - $1.058 trillion v. $967 billion ($17 billion less than FY 2013 cap) NDD as percentage of federal spending is now below 1963 levels More information at www.nddunited.org

5. FY 2014 Funding for Mental Illness Research and Services House budget resolution protects defense and security spending and imposes a 19% reduction on NDD below the FY 2013 post-sequestration level and 28% below FY 2010 levels Senate NDD levels are much better and undo the FY 2013 5% across-the-board sequestration cuts In the absence of a grand budget agreement, a “continuing resolution” at FY 2013 post- sequestration levels is expected

6. FY 2014 Funding for Mental Illness Research and Services NIMH FY 2014 request - $1.466 billion ($12 billion below FY 2012 with transfer to NIAID) FY 2013 sequester is resulting in 4% reductions to currently funded projects and the NIMH intramural program 529 “new and competing” grants projected for 2013 v. 584 in 2012 and fewer than 500 in 2011

7. FY 2014 Funding for Mental Illness Research and Services SAMHSA FY 2013 sequestration wiped out the increases Congress enacted to the Mental Health Block Grant in 2011 & 2012 that had boosted funding to $460 million FY 2013 post-sequestration levels – PATH - $62.8 million – Childrens MH - $111.2 million – Primary-BH Integration - $31.8 million – Suicide Prevention - $46 million

8. FY 2014 Funding for Mental Illness Housing HUD Section 811 - President’s FY 2014 budget seeks a $39 million reduction to the 811 Project-Based Rental Assistance (PRA) Demonstration – Cutting funding from $165 million in FY 2012 to $126 million – 811 produced over 3,500 new units of PSH in 2012 v. 948 units in 2010 & 2011 combined McKinney-Vento - President’s FY 2014 budget does request a $352 million increase for homeless assistance programs, up to $2.38 billion VASH – House, Senate and President are all in agreement in support of an $75 million for an additional 10,000 VASH vouchers for FY 2014 – supportive housing for homeless veterans

9. FY 2014 & FY 2015 Funding for Veterans Programs Overall Veterans Medical Care – Forward funded and NOT subject to overall limits on discretionary spending FY 2013 -- $41.508 billion v. FY 2014 enacted -- $43.557 billion FY 2015 advance appropriation included in House bill -- $45.015 billion, a 3.4% increase over FY 2014 Veterans Mental Health Care FY 2015 advance request of $7.717 billion or a 7% increase over the FY 2014 level (a $506.3 million increase) $20 million increase in the House bill for suicide prevention activities Homelessness Activities House bill allocates $1 billion through FY 2015, in addition to $5.216 billion currently available to the VA in FY 2013 and 2014 for the non-HUD portion of VASH, the per diem program and the VA domiciliary programs VA Medical Research - President’s FY 2014 request of $585.7 million, or $3.573 million above the FY 2013 level of $582.091 million

10. Thank you!