Our work shaping and reporting on national mental health policy is made possible through a capacity grant from the Perigee Fund.
On July 10, the U.S. House of Representatives Appropriations Committee debated and updated, or “marked up,” the President’s proposed 2025 budget for health programs, including “Labor HHS” or LHHS programs, of which federal maternal mental health programs are a part.
Here’s where funding for the maternal mental health programs landed in that markup:
(note that the Senate has yet to conduct its markup so these funding levels are not final and will require signature by the President in the Omnibus funding bill, generally signed in late December):
Maternal Mental Health Hotline (HRSA)
The Committee included $7,500,000, which is $500,000 above the fiscal year 2024 funding level and consistent with the President’s requested funding. The Committee noted that since its launch on Mother’s Day 2022, the hotline has served more than 30,000 women and families.
The Committee directed HRSA to coordinate with the Departments of Veterans Affairs (VA) and Defense (DOD) to increase awareness and utilization of the hotline by servicemembers, veterans, and military spouses. The Committee also directed HRSA to provide a report within 180 days detailing current data on hotline usage, caller demographics, and the most common reasons for calling the hotline.
Our Analysis
The administration requested an increase to ensure that wait times and call response times remain low, with increased utilization projections.
Funding requests were increased, and at the budget requested in the administration’s request.
Psychiatric Consultation Grants to States
Screening and Treatment for Maternal Mental Health and Substance Use Disorders Program (HRSA)
The committee included $11,500,000, which is $500,000 above the fiscal year 2024 funding level and $4,000,000 below the level requested by the President’s administration.
The Committee asked HRSA to create uniform evaluation metrics for reporting and to provide guidance to pediatric and maternal mental health consultation programs to increase collaboration among them. The Committee also requested a report from HRSA within 180 days detailing the related technical assistance that HRSA has provided.
(Of note, the Committee provided $13,000,000 for the Pediatric Mental Health Care Access (telepsychiatry) Program -which is equal to the fiscal year 2024 enacted level and the fiscal year 2025 budget request.)
Our Analysis
This program has served 20 states thus far, with 13 states receiving grants in the most recent funding cycle. The HRSA site doesn’t indicate which of these state programs have been able to sustain their consultation programs once funding ends. The HRSA website does not report how many women received support through these programs, nor whether the programs were any to support the provider in improving patient outcomes (through measurement-based screening, for example). This additional data could help HRSA provide targeted training and infrastructure support and report structural barriers to Congress (like OB/GYN billing and reimbursement for example) so that consultation can be optimized to improve outcomes.
The Policy Center has learned that at least three states have struggled to maintain operations without funding.
Our Proposal:
We believe that Congress should modify this program to become a Federal Program. Funding could be provided through a contracted entity to distribute ongoing funding to state MMH consultation sites, employ consistent best practices among sites, monitor outcomes, and report on barriers. Calls from all states could be routed to the nearest call center to enable immediate access to this critical service in all states.
Pregnant and Postpartum Women (PPW) Program
Substance Use Disorder Residential Treatment Centers (SAMSHA)
The committee included $10,00,000, level with 2024 funding and the President’s request.
Our Analysis / Proposal:
With increasing rates of maternal substance use and overdose, we believe this program should receive additional funding in 2025 and beyond. Currently, roughly 22 states receive this funding. We believe all states should be required and funded to create these SUD residential treatment programs. As such additional funding could be made to states through the Maternal Child Health Block Grant (Title VI) requiring states to fund these programs through their Block Grants.
Other appropriations indirectly related to maternal mental health include:
“Prioritizing funding for early education, childcare, child welfare, and programs for seniors and the disabled.
Maintaining the longstanding Hyde Amendment and ensuring no federal funding can be used for abortion on demand.
Eliminating funding for Title X family planning and stopping funding from going to abortion-on-demand providers, like Planned Parenthood.”
The Policy Center will continue to monitor and report on Federal appropriations for the field.
References:
https://mchb.hrsa.gov/programs-impact/national-maternal-mental-health-hotline/hotline-data
https://mchb.hrsa.gov/programs-impact/focus-areas/mental-behavioral-health