MEMO: Ahead of New Treatment Grant Award for 2020, Here’s How NH Received a More Than Tenfold Increase in Funding to Battle the Substance Use Crisis

February 13, 2020

**“Let me tell you, the federal delegation deserves a lot of credit, for not just getting more money but getting it done the right way... God bless you, it's a constant battle.” – Governor Chris Sununu**

**“No Money shall be drawn from the Treasury, but in Consequence of Appropriations made by Law”Article 1, Section 9, Clause 7 of the U.S. Constitution** 

**Grant funding for substance use treatment this year can be used to help those with meth and cocaine dependencies thanks to a provision that Senator Shaheen recently secured in appropriations law in December** 

Senator Jeanne Shaheen (D-NH), a senior member of the Senate Appropriations committee, has made it one of her top priorities in Congress to deliver resources to New Hampshire so that more Granite Staters can get access to substance use disorder treatment. It’s expected that the Substance Abuse and Mental Health Services Administration (SAMHSA) will soon announce the award of State Opioid Response (SOR) grants for New Hampshire for 2020 – awards that are a result of Senator Shaheen’s bipartisan efforts in the Senate. And thanks to a recent breakthrough led by Senator Shaheen, this year’s funding will also be able to be used by treatment provides to help patients who struggle with methamphetamine and cocaine use.

In addition, Shaheen not only helped establish the first grant program dedicated to opioid substance use treatment, but by working alongside New Hampshire’s federal delegation and a bipartisan group of senators from other hardest-hit states, she was instrumental in helping New Hampshire receive a more than tenfold increase in treatment funding in the years following. 

Here’s the history on how that happened: 

In 2015, in response to local law enforcement, first responders, and community organizations raising the alarm about a horrifying increase in opioid related overdoses and deaths, Shaheen is the first to call for emergency funding to tackle the opioid epidemic, and is quickly seen as the leader in Congress on delivering resources to tackle the crisis. Her legislation would have provided $600 million in funding immediately to the front lines of the epidemic. However, Republican leadership in the Senate blocked this initial proposal and a subsequent effort by Senator Shaheen.   

Undeterred, Senator Shaheen followed this effort by playing a leading role in all five major pieces of legislation dealing with opioid funding enacted by Congress since 2015; the 21st Century Cures Act, The Bipartisan Budget Act of 2018, the Fiscal Year (FY) 2018 Omnibus appropriations law, the FY2019 Health and Human Services (HHS) appropriations law, and the FY 2020 government funding bill that was signed into law in December. 

Here is a timeline of Senator Shaheen’s work on those critical initiatives which has led to New Hampshire receiving a more than tenfold increase in dollars for treatment:

  • 2016 - 2017: The 21st Century Cures Act Passes, Provides $500 Million Per Year Nationally, Including $3.1 Million Per Year for NH
    • The 21st Century Cures Act was signed into law by President Obama in December 2016-- this legislation was supported by Senator Shaheen who fought to include $1 billion in funding for grants to states for opioid treatment over the next two years-- the first significant targeted investment in opioid treatment resources by Congress. The Cures Act provided $500 million per year nationally for state grants for opioid treatment each year. Due to issues with the funding formula that was used by both the Obama and Trump administrations, this grant program yielded $3.1 million per year for New Hampshire in 2017 and 2018. Shaheen and Hassan led efforts to change the formula, so that it more sufficiently prioritized small states with high overdose death rates, like New Hampshire.

"The president doesn’t just have a checkbook in his back pocket. The last time I checked, Congress has to stand up and provide appropriations. That’s how the system works." -- Governor Chris Sununu on the need for more opioid funding

  • 2018: Bipartisan Budget Act of 2018 Sets the Stage for $6 Billion in Government-wide Investments in Opioid Response
    • Senators Shaheen and Hassan set an ambitious goal as budget negotiations began to end a government shutdown. In addition to helping secure an agreement to reopen the government, the senators successfully negotiated a big commitment to provide an additional $6 billion over two years to fight the crisis and aid law enforcement, first responders and treatment providers. Shaheen and Hassan also secured an agreement to better prioritize the hardest hit states.

“Shaheen and Hassan had pressed for $25 billion in additional funding to fight the epidemic, and according to sources, by setting the bar high, they were able to help secure the $6 billion.” – WMUR News

  • 2018: Fiscal Year 2018 Omnibus Government Funding Bill Passes, Provides $1 Billion More for Grants in 2018 in addition to the $500 Million in the Cures Act, Adding $22.9 Million More for NH
    • As a senior member of the Appropriations Committee, Shaheen ensured that the agreement reached for treatment dollars earlier in the year was reflected in 2018 appropriations legislation by providing $1 billion in addition grant funding for state opioid treatment grants.
    • In addition, to follow through on the promise to better help areas of the country with high overdose death rates, Shaheen successfully negotiated for a provision that sets aside 15 percent of this new funding exclusively for states with the highest opioid overdose death rates, like New Hampshire.
    • Also, the Trump administration agreed to change the funding formula for the remaining 85 percent of the funds to better help hardest hit states with high overdose death rates.
    • Altogether, the $500 million in 2018 funding from the Cures Act, combined with the new $1 billion in funding derived from 2018 omnibus funding bill, the 15 percent set-aside for hardest-hit states, and the change to the funding formula, delivered New Hampshire a more than sevenfold increase in opioid funding in 2018, totaling $26 million.
  • 2019: Congress Provides: $1.5 Billion Nationally, Including $34.9 Million for NH
    • The funding from the Cures Act has now expired. At Senator Shaheen’s urging, Congress, through the appropriations process, agrees to increase the State Opioid Response grant funding by $500 million to offset the Cures Act funding ending.  This maintains the total federal funding level of $1.5 billion for the state grants. However, all $1.5 billion is now subject to the 15 percent set-aside that Congress under Shaheen’s leadership established last year, where as in the previous year only $1 billion was subject to the set-aside. Due to this key change from funding provided by the Cures Act to funding provided through appropriations legislation, New Hampshire received an extra $11.99 Million, in addition to the $22.98 Million the state received later in the year, totaling $34.9 million for FY 2019. This is more than a tenfold increase from the $3.1 million New Hampshire received in FY 2017. 
  • 2019: Shaheen successfully delivers flexibility for these grant programs so that treatment providers can help those with meth and cocaine dependencies
    • Senator Shaheen introduces the Turn the Tide Act which would provide $63 billion to battle the national substance use crisis, and also would provide new flexibility to allow treatment providers to use federal funding to treat meth and cocaine dependencies, in addition to opioid misuse. Senator Shaheen was able to successfully add this flexibility component to government funding legislation that was signed into law in December and will apply to treatment grants that will soon be announced by SAMHSA. Senator Shaheen continues to advocate for the other legislative proposals in the Turn the Tide Act, encouraging Congress and the administration to back this effort. 

A Breakdown of Federal Opioid Funding For New Hampshire:

 

Year

21st Century Cures Grants (Not Subject To 15% Set Aside)

State Opioid Response (SOR) Grants (Subject to 15% Set Aside)

Total Federal Opioid Funding for NH

2017

$3.1 Million (1st year of grant program)

N/A

$3.1 Million

2018

$3.1 Million

$22.9 Million (1st year of grant program)

$26 Million

2019

NA

$34.9 Million

$34.9 Million

2020

NA

TBD

TBD