President’s Fiscal Year 2023 Budget Proposes Large Investments in Maternal Health and Mental Health
Mom Congress
Budget of the U.S. Government
By the Mom Congress Policy Team
On March 28, the Biden-Harris Administration submitted to Congress the President’s Budget for fiscal year 2023 (FY23). Although this budget document is non-binding, it does represent key policy and programmatic priorities from the Administration.
Below are highlights from the President’s Budget that show meaningful investments in maternal health across federal government agencies. Mom Congress will continue to track the progress of these programs as Congress advances their FY23 appropriations bills.
Substance Abuse and Mental Health Services Administration (SAMHSA): $10.7 billion (+$4.6 billion compared to FY 2022)
Community Mental Health Services (CMHS) Block Grant: $1.7 billion (+$895 million compared to FY 2022) to support mental health service delivery
The CMHS Block Grant addresses the needs of adults with serious mental illness and children with serious emotional disturbances. The COVID-19 pandemic has exacerbated the needs for mental health services and supports. The proposed funding increase in funding will support state efforts to build and expand on evidence-based crisis systems, promote 24/7 access to well-trained mental health professionals, and address early intervention and prevention of mental disorders for at-risk youth and adults.
Project Linking Actions for Unmet Needs In Children’s Health (LAUNCH): $35.4 million (+11.8 million from FY 2022)
The purpose of the Project LAUNCH grant program is to promote the wellness of young children, from birth to eight years ago age, by addressing the physical, social, emotional, cognitive, and behavioral aspects of their development. As of 2021, Project LAUNCH has screened 254,190 children and parents for behavioral health concerns across a range of diverse settings. Child screenings are a critical step in the early recognition of social emotional concerns and create a pathway to prevention and treatment services. Adult screenings include screening for perinatal depression, substance use, and a range of social needs. The proposed funding increase will provide continued screening, prevention, early intervention for behavioral health issues and referrals to high quality treatment for children and families in 30 communities across the U.S.
Project AWARE: $244 million (+$137 million compared to FY 2022) to support mental health services for youth
The proposed funding increase will directly support training for teachers, parents, first responders, and other adults who interact with youth to recognize and respond to the signs of mental health and substance use issues. Additionally, this investment in Project AWARE will expand access to broader populations, including college students and adults, as well as non-traditional settings.
National Child Traumatic Stress Network (NCTSN): $150 million (+$78.1 million compared to FY 2022) to support the development and promotion of effective community practices for children and adolescents exposed to traumatic events
The proposed increase in funding will continue to support and further expand the NCTSN efforts to improve mental disorder treatment, services, and interventions for children and adolescents exposed to traumatic events through 120 grant continuations.
Infant and Early Childhood Mental Health: $38 million (+$30 million compared to FY 2022)
This grant program seeks to improve outcomes for children, from birth to 12 years of age, who are at risk for, show early signs of, or have been diagnosed with a mental illness, including a serious emotional disturbance. The proposed funding increase will expand access to a range of evidence-based and culturally appropriate infant and early childhood mental health services. Funding will support the continuation of six grants and award a new cohort of 67 grants to expand access, increase service provision, and improve outcomes for children with mental illness, including serious emotional disturbance.
Children’s Mental Health Services: $225 million (+$100 million compared to FY 2022)
Zero Suicide: $23.2 million (level funding compared to FY 2022)
Suicide Lifeline: $696.9 million (+$595.3 million compared to FY 2022)
The proposed funding amounts to nearly a 30x increase over FY 2021 funding levels and will play an essential role in advancing this crisis system.
American Indian and Alaska Native Suicide Prevention: $2.9 million (level funding compared to FY 2022)
Interagency Task Force for Trauma-Informed Care: $1 million (+$1 million compared to FY 2022)
The Task Force will use the proposed funding increase to identify, evaluate, and make recommendations regarding: (1) best practices for children and families who have experienced trauma or are at risk of experiencing trauma; and (2) ways federal agencies can better coordinate responses to families affected by substance use disorders and trauma. In addition, the proposed funds will be used to develop a website to post best practices of trauma-informed care.
Substance Abuse Prevention and Treatment (SAPT) Block Grant: $3 billion (+$1.15 billion compared to FY 2022)
State Opioid Response (SOR) Grants: $2 billion (+$500 million compared to FY 2022)
Pregnant and Postpartum Women: $49.4 million (+$16.5 million compared to FY 2022)
Since 2003, the Pregnant and Postpartum Women program (PPW) has used a family-centered approach to provide comprehensive residential substance use disorder treatment, prevention, and recovery support services for pregnant and postpartum women, their minor children, and for other family members (e.g., fathers of the children). Section 501 of the Comprehensive Addiction and Recovery Act (CARA) increased accessibility and availability of services for pregnant women by expanding the authorized purposes of the PPW program to include the provision of outpatient and intensive outpatient services for pregnant women. CARA requires that twenty-five percent of all PPW funds are required to fund the pilot.
Children and Families within SAMHSA’s Center for Substance Abuse Treatment (CSAT): $30.2 million (+$592 thousand compared to FY 2022)
Health Resources and Services Administration (HRSA):
Maternal and Child Health Block Grant: $953.7 million (+$241 million compared to FY 2022)
The MCH Block Grant program funding, combined with state investments, provides a significant funding source to improve access to and the quality of health services for mothers, children, and their families in all 50 states, the District of Columbia and other jurisdictions.
Addressing Emerging Issues and Social Determinants of Maternal Health: $55 million (new funding under the SPRANS innovation fund)
The proposed funding would aid community-based organizations to support priority tracks focused on reducing maternal mortality and adverse maternal health outcomes, particularly in areas with high rates of adverse maternal health outcomes and/or significant racial and ethnic disparities in maternal health outcomes including: maternal mental health equity, social determinants of maternal health, equity in maternal health outcomes through digital tools and expanding the use of technology-enabled collaborative learning and capacity building models for pregnant and postpartum individual.
State Maternal Health Innovation Grants: $55 million (+$32 million above FY 2022)
The proposed funding would continue to support innovation among states to improve maternal health outcomes and address disparities in maternal health.
Maternal Mental Health Hotline: $7 million (+$4 million above FY 2022)
Alliance for Innovation on Maternal Health: $15.3 million (+$6.3 million compared to FY 2022)
The proposed funding would be used to continue to expand the reach of evidence-based models of maternity care to a broader 217 array of providers and health care settings, support increasing AIM penetration in currently enrolled States, and improve systems that track, report, and improve upon maternity care services at the state, regional and national levels.
Growing and Diversifying the Doula Workforce: $20 million (new funding)
New funding to provide grants to community-based organizations to develop and/or expand programs to recruit doula candidates, support their training/certification, and then employ them as doulas to support improved birth outcomes in the community.
Pregnancy Medical Home Demonstration: $25 million (level funding compared to FY 2022)
Screening and Treatment for Maternal Depression and Related Disorders: $10 million (+$5 million compared to FY 2022)
This request builds upon the Improving Maternal Health Initiative investments to expand support for the Screening and Treatment for Maternal Depression and Related Behavioral Disorders Program to increase access for perinatal women to behavioral health care. This effort supports use of telehealth, psychiatric consultation and care coordination support, and training to expand front-line health care provider capacity to screen, assess, treat, and refer pregnant and postpartum women for maternal depression and related behavioral disorders, including in rural and medically underserved areas. This funding will help states address ongoing needs for maternal behavioral health problems as a result of the impact of COVID-19 on pregnant and postpartum women.
Implicit Bias Training Grants for Health Providers: $5 million (new funding)
The proposed funding would be used to continue to support to train providers on implicit bias with the goal of reducing racial disparities.
Behavioral Health Integration Pilot Initiative: $40 million (new funding)
The proposed funding would integrate behavioral health supports in community settings to promote the healthy social and emotional development and mental health needs of mothers, children and their families. Grants will support traditionally underserved communities, including those within Mental Health Professional Shortage Areas, to engage and train community partners to identify the mental and behavioral health needs of mothers and children, and to support children’s social and emotional development within their families. Navigators and community health workers will facilitate linkages to local resources, such as medical homes, school-based and other community health centers, community-based organizations, and local community social supports and services. This program will partner with HRSA’s Behavioral Health Workforce Education and Training (BHWET) for Paraprofessional program to support partnerships with local academic institutions that support training and placement of navigators in community settings in order to expand workforce capacity and strengthen the behavioral health workforce pipeline.
Rural Maternity and Obstetrics Management Strategies (RMOMS): $7.5 million (+$5 million compared to FY 2022)
Administration for Children and Families (ACF):
Child Care and Development Block Grant: $7.6 billion (+$1.65 billion compared to FY 2022)
Child Abuse Prevention and Treatment Act (CAPTA): $125 million (+$34.9 million compared to FY 2022)
Family Violence and Prevention Services Act (FVPSA): $491.8 million (+$309.3 million compared to FY 2021)
National Domestic Violence Hotline: $27.3 million (+$14.3 million compared to FY 2022)
National Institutes of Health (NIH):
National Institute of Mental Health (NIMH): $2.21 billion (-$6 million compared to FY 2022)
National Institute on Drug Abuse (NIDA): $1.8 billion (+$248 million compared to FY 2022)
National Institute on Alcohol Effects and Alcohol-Associated Disorders (NIAAA): $66.7 million (+$1.4 million compared to FY 2022)
Office of Research on Women’s Health: $52.6 million (+$1 million compared to FY 2022)
Office of the Secretary of Health and Human Services (HHS):
Office of Minority Health: $85.8 million (+$24 million compared to FY 2022)
Office on Women’s Health: $42 million (+$7 million compared to FY 2022)
Centers for Disease Control and Prevention (CDC):
Safe Motherhood/Infant Health: $164 million (+$101 million compared to FY 2022)
Increased funding in FY 2023 will support CDC activities related to Perinatal Quality Collaboratives (PQCs), Maternal Mortality Review Committees (MMRCs) to Promote Representative Community Engagement, Enhancing Reviews and Surveillance to Eliminate Maternal Mortality (ERASE MM), and the Pregnancy Risk Assessment Monitoring System (PRAMS). With these additional resources, CDC will expand its support for MMRCs to implement data collection and data-driven action to prevent maternal deaths and illness and promote community engagement in MMRCs to increase the diversity of a committee's membership with respect to race and ethnicity, location, and professional background.
Surveillance for Emerging Threats to Mothers and Babies: $35 million (+$25 million compared to FY 2022)
Prior investments have begun to address the serious gap in the nation’s ability to detect and respond to emerging threats to moms and babies, but there remain significant vulnerabilities that the additional investment will help address.
Mom Congress applauds the Administration for its commitment to mental health and maternal health. We will continue to advocate for increased federal funding for maternal mental health in FY 2023 and beyond.