CEO Update 223
Trump Administration Revokes Billions in Healthcare Program Funding & Announces HHS Restructuring
HHS has discontinued more than $11 billion in pandemic-era funding for the Centers for Disease Control and Prevention (CDC) programs and about $1 billion for Substance Abuse and Mental Health Services (SAMHSA) grants, news outlets reported this week.
“The COVID-19 pandemic is over, and HHS will no longer waste billions of taxpayer dollars responding to a non-existent pandemic that Americans moved on from years ago,” HHS said in a statement that appeared in multiple news stories, including The New York Times, AP, and NPR.
NBC first reported the news, and later The New York Times reported that SAMHSA grant funding had been scheduled to run through September 2025, while some CDC grants from the pandemic were expected to last through 2026 and 2027.
“The funds from SAMHSA were not earmarked for Covid programs, and they were intended to address mental health and substance use issues,” The New York Times reported on Wednesday. “The pandemic led to widespread loneliness, boredom and anxiety, factors that contributed to a surge in overdose deaths that reached just over 111,000 in 2022, up from about 70,000 in 2019.
Following that news, HHS on Thursday announced a major restructuring that will cut 10,000 jobs within the department and create a new agency that combines five existing HHS agencies into one, among other changes.
The new Administration for a Healthy America, or AHA, will combine the Office of the Assistant Secretary for Health (OASH), Health Resources and Services Administration (HRSA), SAMHSA, Agency for Toxic Substances and Disease Registry (ATSDR), and National Institute for Occupational Safety and Health (NIOSH) into a new, unified entity.
“The restructuring will address this and serve multiple goals without impacting critical services,” the HHS announcement said. “First, it will save taxpayers $1.8 billion per year through a reduction in workforce of about 10,000 full-time employees who are part of this most recent transformation. When combined with HHS’ other efforts, including early retirement and Fork in the Road, the restructuring results in a total downsizing from 82,000 to 62,000 full-time employees,” it continued. “Secondly, it will streamline the functions of the department. Currently, the 28 divisions of the HHS contain many redundant units. The restructuring plan will consolidate them into 15 new divisions, including a new Administration for a Healthy America, or AHA, and will centralize core functions such as Human Resources, Information Technology, Procurement, External Affairs, and Policy. Regional offices will be reduced from 10 to 5.”
NABH Sends Statement to House Veterans’ Affairs Health Subcommittee
NABH this week submitted a written statement for the record to the House Veterans’ Affairs Health Subcommittee, which held an oversight hearing Tuesday to examine the U.S. Veterans Affairs Department’s (VA) practices for mental health policies.
In it, NABH noted that NABH staff has engaged with the House Veterans’ Affairs Committee and is pleased with the Committee’s continued focus and engagement with the Trump administration to ensure both the MISSION Act of 2018 and the Sen. Elizabeth Dole 21st Century Veterans Healthcare and Benefits Improvement Act (Dole Act), (P.L. 118-210) – which became law on Jan. 2, 2025 – are implemented fully.
NABH also strongly urged policymakers to pass the Veterans’ Assuring Critical Care Expansions to Support Servicemembers (ACCESS) Act of 2025, which will 1) codify current community care access standards as the minimum access standards; 2) expand them to include all extended care services, including mental health residential rehabilitation; and 3) require the VA to ensure that veterans are screened for mental health residential rehabilitation treatment programs within 48 hours of the time the veteran or his or her provider requests admittance, among numerous other important provisions.
NABH’s statement also discussed the Community Care Program and concerns we have received from our members.
“In early 2023, NABH members who provide care to veterans through the Community Care Program sounded the alarm to NABH staff that VA gatekeepers increasingly denied clinically appropriate and timely care to veterans receiving behavioral healthcare services,” NABH’s statement said. “Members noticed a pattern of delayed care that exceeded the amount of time the MISSION Act of 2018 promises them,” it continued. “Veterans who need residential treatment services have faced waiting times for services that far exceed the 28-day limit for specialty care, making them eligible to seek community care services. And while different VA VISNs and regions operate independently, this situation is not confined to any particular geographic region. VA referrals to providers in the CCN are down more than 80% – a fact multiple NABH members have corroborated. In fact, some markets appear to have ceased third-party referrals altogether.”
Click here to read the full statement.
Experts Issue Call to Action on Contingency Management
The American Journal of Psychiatry on Wednesday published a call to action that promotes making available evidence-based contingency management (CM), an effective substance use disorder treatment. The call to action highlights the significant toll of stimulant-involved overdose deaths and underscores the need for regulatory changes and stronger financing to facilitate the uptake of this intervention.
In January, SAMHSA published an advisory that raised the annual CM incentive limit to $750 per patient from $75 per patient for entities that implement CM using funds from the State Opioid Response and Tribal Opioid Response grant programs.
Several contingency management experts in academia, as well as Sarah Wattenberg, NABH’s former director of quality and addiction services, developed the call to action.
Court Approves Delay on Trump Administration Response to Parity Lawsuit
The United States District Court for the District of Columbia on Tuesday approved the Trump administration’s request for a delay in responding to the ERISA Industry Committee’s lawsuit regarding the updated rule implementing the Mental Health Parity and Addiction Equity Act in commercial insurance plans.
The deadline to respond was originally set for March 28, and is now set for May 12.
Reserve Your Hotel Room Today for the 2025 Annual Meeting!
Please remember to reserve your hotel room today at the Salamander Washington, DC for the 2025 NABH Annual Meeting from May 12-14, 2025! The Salamander, Washington DC’s reservation cut-off date is Friday, April 18.
And please remember to register for this year’s Annual Meeting, Behavioral Health is Everyone’s Concern: Constant Care, Changing Times, if you haven’t done so yet.
We look forward to seeing you in Washington!
Fact of the Week
Public restrooms continue to be used as drug-consumption sites for the privacy restrooms offer, especially in major cities such as Boston, Chicago, and New York. A recent Health Affairsstory examines a “promising yet underrecognized” harm-duction tool for restrooms: the anti-motion sensor, which is designed to detect when a person has been motionless for an extended period of time, signaling a potential overdose and the need for assistance.
For questions or comments about this CEO Update, please contact Jessica Zigmond.