Magazine article The Alcoholism Report

House ADAMHA Bill Readied for Action: No Reorganization Provisions

Magazine article The Alcoholism Report

House ADAMHA Bill Readied for Action: No Reorganization Provisions

Article excerpt

As AR went to press, the House Health Subcommittee planned to mark up a reauthorization bill for the major program authorities of the Alcohol, Drug Abuse and Mental Health Administration (ADAMHA) -- notable for its omission of the Senate-approved, and Administration-backed, provisions for the transfer of NIAAA, NIDA and NIMH and their research activities to the National Institutes of Health (NIH) (AR, September).

The Subcommittee, chaired by Rep. Henry Waxman (D-CA), was circulating copies of the 150-page draft bill for the scheduled mark-up session Oct. 30. The bill incorporates the mental health piece of the reauthorization introduced earlier -- the Community Mental Health Services Improvement Act (HR-2311) (AR, May), and contains the long-waited portion dealing with the alcohol and drug abuse authorities at ADAMHA.

Beyond ignoring the controversial shifting to NIH -- the primary thrust of the Senate bill, the ADAMHA Reorganization Act of 1991 (S-1306), the draft House measure differs in other major respects, according to highlights obtained by AR. A salient feature of the House bill would split the alcohol, drug abuse and mental services (ADMS) block into separate mental health and substance abuse block grants; and retains the current formula for distribution of substance abuse block grant funds to the states. The Senate-approved bill maintains the ADMS block and proposes a complex new formula designed to allocate more funds to rural states. The ADMS block, funded at $1.268 billion in FY-91 with about 80% allocated to substance abuse, is the major federal source of support for alcohol and drug abuse treatment and prevention services.

Time is rapidly becoming a factor in whether an ADAMHA reauthorization and/or reorganization bill can be enacted this year, with the adjournment of the First Session of the 102nd Congress now expected by Thanksgiving. If the normal procedure is followed, Waxman's subcommittee, after the mark-up, will send the bill to the full House Commerce Committee which will then report it to the floor. House floor action would send the measure to conference for ironing out of differences with the Senate bill. Before going to the White House, House and Senate would have to pass the conference report on the bill. Under a hurry-up situation, however, a reauthorization compromise could be patched together though staff negotiations, by-passing the usual legislative steps and either passed on its own on placed as a rider on other legislation going through Congress. IF no accord is reached before adjournment, the major federal alcohol, drug abuse and mental health program authorities could be carried forward unchanged into next year through the FY-92 Labor-HHS-Education appropriations. This eventuality would leave the resolution of the proposed ADAMHA changes, including the reorganization, to the election-year Second Session of the 102nd Congress.

Some mental health organizations as well as segments of the alcohol and drug abuse filed are ardently pushing for the splitting of research and services at ADAMHA by moving NIAAA, NIDA and NIMH intact to NIH, leaving the services components -- including the ADMS block, the Office for Substance Abuse Prevention (OSAP) and the Office for Treatment Improvement (OTI), to be administered by a new Alcohol, Drug Abuse and Mental Health Services Administration (ADAMHSA).

Although concerns have been expressed that the Senate bill would result in a loss of focus on alcoholism (Story below), opposition to moving NIAAA to the NIH research complex has been sporadic and lacking in cohesion. In the past, particularly when NIAAA was directly involved in funding treatment programs, the alcoholism field mounted vehement opposition to proposals shifting NIAAA to NIH, where, it was argued, the Institute's historic role as the beacon of the federal alcoholism movement would be diminished, if not extinguished.

As for the reorganization, Waxman reportedly sees no compelling reasons for the move, and views it as a low-priority issue compared with other differences between House and Senate bills. …

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