What’s Happening?
On March 27, the U.S. Department of Health and Human Services (HHS) announced an extensive restructuring, including a reduction in workforce of about 10,000 full-time employees and a consolidation of their 28 divisions into 15 new divisions, one of which will be a new Administration for a Healthy America, or AHA. Regional offices will be reduced from 10 to five.
We are actively working to understand the implications of these major changes. Below is a summary of what we know to date. As we learn more specific details, we will update you, and please reach out to us with questions.
What is Changing?
The restructuring includes the following actions:
- The creation of the Administration for a Healthy America (AHA): the new division will combine multiple agencies — the Office of the Assistant Secretary for Health (OASH), the Health Resources and Services Administration (HRSA), the Substance Abuse and Mental Health Services Administration (SAMHSA), the Agency for Toxic Substances and Disease Registry (ATSDR), and the National Institute for Occupational Safety and Health (NIOSH) — into a single new entity.
- The reorganization of the Administration for Community Living (ACL): critical programs that support older adults and people of all ages with disabilities will be integrated into other HHS agencies, including the Administration for Children and Families (ACF), the Office of the Assistant Secretary for Planning and Evaluation (ASPE), and the Centers for Medicare and Medicaid Services (CMS).
At the same time, HHS is also “discontinuing” $12 billion in existing grants from SAMHSA and the Centers for Disease Control and Prevention (CDC) that were being used for tracking infectious diseases, mental health services, addiction treatment and other urgent health issues, and which were originally allocated during the COVID-19 pandemic. Specifically:
- $1 billion from SAMHSA to states to address mental health and substance use disorder, which was to be spent by September.
- The grants in question were authorized and appropriated by Congress, and their termination may lead to new lawsuits. Several states said they were exploring legal options.
What Do We Know About the Potential Impact of the Announcement?
- The ACL serves as a hub across HHS and with other Departments to coordinate services and supports critical to disabled people and older adults, such as Long-term Services and Supports (LTSS) and affordable housing, facilitating federal, state and local cross-sector partnerships focused on efficient use of limited resources. As we learn more about these changes, we will continue to provide updates since we recognize the potential impacts to many network members.
- SAMHSA, which is charged with advancing behavioral health and improving the lives of people with mental health needs and substance use disorder (SUD), will reportedly see a cut of upwards of 50% of its staff as it is consolidated into the new AHA. Network members who receive grant funding directly through SAMHSA may be impacted.
- Among the cuts to agency staff will be 300 employees of the Centers for Medicare and Medicaid Services (CMS.)
What Happens Next?
- HHS is continuing to make updates on its more specific plans for the restructuring and how existing divisions, programs, and funding will be impacted.
- We will be especially monitoring for more details about the nature of the changes to ACL, SAMHSA, and CMS, and what they mean for the federal funding landscape.
Much is unclear and unknown, but Lutheran Services in America is actively working to understand more about how these changes will impact our network and those we work with. Please reach out with any questions to Sue Polis, Vice President of Government Relations & Advocacy, or Sarah Dobson, Senior Director of Public Policy and Advocacy.
