With a federal government shutdown looming, lawmakers are still at odds regarding a plan to provide current-year funding for the federal government. The House-passed measure, H.R. 1, includes deep cuts to a multitude of domestic health programs and blocks funding for the health law including the enforcement of mental health parity. President Obama has said that he will veto H.R.1. In the Senate, Democratic leadership maintains that they will not support such House-passed steep cuts to biomedical research at the National Institutes of Health, physician education and the implementation of the health reform law. The House GOP leadership and the Senate Democratic leadership are in talks regarding crafting a compromise measure to keep the government running from March 4 to March 18 giving the chambers time to negotiate spending reductions for 2011 and avert a government shutdown. The situation is very fluid and the APA will send an update early next week to advise members on the status of the negotiations.

As noted in the Action Alert sent to APA members on February 15, the House is currently debating a measure which would cut domestic spending in FY11 by nearly $90 billion. The APA is concerned that the cuts disproportionately impact federal health programs such as SAMHSA (cut by $200m), NIH (cut by $1b), and HRSA (cut by $150m), and would prohibit funding of hard-won advances in mental health parity. H.R. 1 was scheduled for Senate consideration on February 24, but due to the volume of amendments, House passage of H.R. 1 was delayed. One of the amendments defeated in the House would have reduced SAMHSA funding an additional $98m and transferred the funds to the Low-Income Heating Energy Assistance Program. The Senate plans to take up the measure this week, but Senate leadership has said the cuts in H.R.1 to health programs, education and environmental protection are too severe. The House and Senate have until March 4 to reach a compromise that averts shutting the government down when federal funding runs out.

On February 17, Senators John Kerry (D-MA) and Olympia Snowe (R-ME) reintroduced S.374, the Medicare Mental Health Inpatient Equity Act. This critical legislation eliminates the discrimination against mental illnesses that continues to exist in the Medicare program as Medicare beneficiaries are still limited to 190-days of inpatient psychiatric hospital care during their lifetime. This lifetime limit does not apply to psychiatric units in general hospitals and there is no such lifetime limit for any other Medicare specialty inpatient hospital service. Senators Kerry and Snowe have teamed up in the past to push legislation, enacted into law in 2008, to bring parity to the Medicare outpatient mental health coinsurance.

Kentucky state Rep. Jimmie Lee received the American Psychiatric Association's Jacob K. Javits Award for public service on Feb. 23 at 11 a.m. in the rotunda of the State Capitol building in Frankfort. The Javits Award recognizes a public official who has made a significant contribution to the care of people with mental illness.  The presentation of this award recognizes Lee's many years of work on behalf of those whose lives have been touched by mental illness, addictive disorders and intellectual or physical disabilities. 

Lee has served in the Kentucky legislature since 1993 and has long been a champion to underserved populations in Kentucky.  "Representative Lee has worked tirelessly to ensure that all Kentuckians have access to the medical and mental health care they need. His dedication to those in need is legendary," said Bonnie L. Cook, Executive Director, Kentucky Psychiatric Medical Association.  His work included helping to replace a 193-year old psychiatric hospital in Lexington and helping to secure funding for the state's community mental health centers and for a new crisis stabilization unit in Louisville.  Lee has sponsored bills, now enacted, to increase the level of care available for children with emotional disabilities so they do not have to be sent out of state for treatment and to establish a commission to increase services for individuals with developmental and intellectual disabilities.

The APA Javits Award is given annually, alternately to a state public servant and a federal public servant. Past recipients include former Sens. Gordon Smith (R-OR) Paul Wellstone (D-MN), and Pete Domenici (R-NM).

The President's Proposed FY12 budget outline was released on February 14. The document serves as an agenda-setting guide. The President has kept his overall budget increase to under 3 percent of currently projected FY11 spending. The President is requesting that NIH receive a $1billion increase (+28m NIMH, +$20m NIDA, +$7m NIAAA, +7m Health Disparities), $10m in new dollars for returning military and their families to improve access to care for mental health and substance use services to be administered by SAMHSA, significant increases to Indian Health Services, including a $422m increase for clinical services.  As in previous years, the Children's GME program would be eliminated in the President's budget but it is historically reinstated by Congress. In a normal budget year, Congress would spend the next several months debating, modifying, and enacting the 2012 budget with the intent of completing the process before October 1, 2011, the date when FY12 begins. However, Congress is currently wrapped up in an ongoing debate over the FY11 budget, which the previous Congress failed to enact before adjourning in December. Current debates over spending reductions are likely to be repeated once the 2011 budget is enacted and Congress turns its attention to 2012.