Performance-based government funding may be the wave of the future, but Congress still isn't quite ready to base its budgetary decisions on formalized performance measures, as the FY2008 budget process makes clear.

The Senate voted 75-19 on Oct. 23 to approve the budget for the Department of Health and Human Services, Education and Related Agencies, which includes funding for all programs within the Substance Abuse and Mental Health Services Administration (SAMHSA), the National Institute on Health research agencies (the National Institute on Drug Abuse and the National Institute of Alcohol Abuse and Alcoholism), and the Department of Education's Safe and Drug-Free Schools and Communities (SDFS) program.

The $149-billion Senate-approved budget calls for spending a total of $5.4 billion more in 2008 than 2007, and also exceeds President Bush's budget request by $9.8 billion.

Following the vote, the White House issued a statement threatening to veto the bill, accusing the Democrat-led Congress of "failing to identify priorities, increasing spending, and avoiding the hard choices."

The Senate measure still must be reconciled with the House appropriations bill before any legislation is sent to the president. House and Senate members met this week to discuss the bill, and a conference report is expected within days. A vote on the bill could be held as early as Tuesday.

"Ineffective" Block Grant

During the budget debate, the Senate voted 68-21 to table a proposed amendment that would have required a 10-percent cut to all programs rated "ineffective" by the federal Program Assessment Rating Tool (PART), administered by the Office of Management and Budget. That would have included the centerpiece, $1.758-billion substance abuse prevention and treatment (SAPT) block grant. Also rejected was the Bush administration's plan to cut 5 percent of SAPT block grant funding for states that fail to report National Outcome Measures (NOM) data to the federal government. About 40 percent of states now voluntarily provide outcomes data to SAMHSA.

"The Committee strongly opposes this proposal and believes that punitive policies could threaten or interrupt service delivery," the appropriations panel said in its budget report.

Sen. Tom Harkin (D-Iowa), chair of the Senate Appropriations Subcommittee on Labor, HHS and Education helped lead opposition to the PART amendment introduced by Sen. Allard (R-Colo.). Harkin said the poor PART scores were the result of poor federal investment in some cases and also could hurt programs serving vulnerable populations.

Still, the Senate failed to follow the House of Representatives' lead in recommending a $35-million increase in the SAPT block grant, instead recommending that the FY2008 funding remain the same as in 2007.

The National Association of State Alcohol and Drug Abuse Directors (NASADAD) disputed the "ineffective" PART score laid on the SAPT block grant. "States have worked diligently with SAMHSA to report a more consistent set of core measures for prevention and treatment services through the NOM initiative," NASADAD noted in a budget summary. "The launch of a more standardized set of data represents another tool in educating stakeholders on the effectiveness of the SAPT Block Grant." NASADAD also defended the block grant by releasing a state-by-state outcomes list that highlighted treatment admissions, abstinence rates, and declines in criminal behavior.

Increases in Research Funding

The SAMHSA budget approved by the Senate allocates $425.6 million to the Center for Substance Abuse Treatment, up $26.7 million over 2007 and $73.5 million more than the Bush administration's request. The appropriation includes $98 million for the Access to Recovery program -- a favorite of the administration -- of which $25 million is set aside for methamphetamine treatment. CSAT's Screening and Brief Intervention and Referral to Treatment (SBIRT) program is level funded at $29.8 million, and the budget for treatment drug-court grants would be increased from $10 million to $31.8 million.

The $197.1 million budget approved by the Senate for the Center for Substance Abuse Prevention (CSAP) represents a $4.2 million increase over 2007, and is $40.6 million more than the president's budget request. The CSAP budget includes level funding for the $105.5 million State Prevention Framework State Incentive Grants and the $9.8 million Fetal Alcohol Spectrum Disorders Center for Excellence, as well as $1 million to continue the national media campaign authorized under the Sober Truth on Prevention Underage Drinking Act and $3 million in assistance for community coalitions fighting underage alcohol use.

The steady erosion of funding for the SDFS program would continue under the Senate's budget, which would cut funding for school-based prevention programs to $300 million, $46.5 million less than in 2007. That's still better than the administration's budget, however, which called for slashing $200 million from the program.

The Senate called for adding $22 million to the billion-dollar NIDA budget, relatively in line with the administration's proposal. NIAAA would get $445.7 million in FY2008, up $9.8 million from 2007 and again in general agreement with the Bush administration's budget plan.

However, the Senate disagreed with the administration's plan to eliminate the Centers for the Application of Prevention Technologies (CAPTs) and also declined to cut a proposed $1.7 million from the Addiction Technology Transfer Centers -- both regional resource centers that help translate addiction research into practice.