CHN: Funding for Emergencies: Lead Poisoning, Opioids and Zika

Congress has been slow to respond to several emergency situations. Although some progress appears possible in one case, emergency funding has been shot down in another and remains uncertain in still another. Legislation to assist Flint, Michigan and other communities beset by lead contamination in their water supply may be about to move in the Senate; a bill to provide resources to combat the epidemic of opioid addiction passed in the Senate but without emergency funding to carry out those efforts, so the Obama Administration is acting to provide some additional funding; and efforts to prevent a full-blown outbreak of the Zika virus in the mainland U.S. remain stalled.
As CHN noted in our February 29 Human Needs Report, Republican leaders in Congress have repeatedly insisted on finding cuts in federal spending to cover the cost of responding to emergencies like these. However, Congress is legally allowed to provide funds for emergencies without having to pay for urgently needed services and has done so many times in the past. Congress’ insistence on offsetting funding now is considered by many advocates to be short-sighted and damaging to the Americans affected by these crises.

Combatting Lead Poisoning from Paint and Water

A bill to provide nearly $250 million to assist with the repair of water infrastructure in Flint and other localities affected by lead-contaminated water may be closer to moving in the Senate. Senator Mike Lee (R-UT) is the only Senator with a ‘hold’ on the Drinking Water Safety and Infrastructure Act (S.2579), preventing it from moving forward. In addition to the continued insistence by Republicans that the bill be paid for, Sen. Lee’s concerns over when the bill will be paid for are being worked out, leaving advocates hopeful that he will release his hold and allow the bill to come up for a vote. However, the lead poisoning relief is tied to the energy bill, either because it will be an amendment to that legislation or through an agreement that allows for both bills to be taken up separately.  Senator Bill Nelson (D-FL) has placed a hold on the energy bill, out of concern that an expected amendment would make it possible for oil drilling in Florida waters, which he has long opposed. While Nelson supports the Flint funding, his objections must also be resolved before either bill moves forward. According to The Hill, the Senate may pass its legislation as an amendment to the House’s Flint bill, which did not include funding and instead focused on public education about water quality problems. How the House will respond to the Senate bill remains unclear. For more background on the Flint water crisis and the Drinking Water Safety and Infrastructure Act, see the February 29 Human Needs Report.

Advocates are also working to ensure the federal government acts to protect all children and families in federal housing programs from lead poisoning. The Coalition on Human Needs joined with the Children’s Defense Fund and other advocacy groups in urging the Department of Housing and Urban Development (HUD) to update their regulations regarding lead contamination in units it subsidizes. The groups called for HUD’s regulations to be consistent with the definitions of lead poisoning adopted by the Centers for Disease Control and Prevention (CDC), which recognizes that there is no safe level of lead in children’s blood, and for HUD to update its inspection procedures to more accurately identify lead contamination. Among other changes, the groups also called for HUD to allow families whose children exhibit lead poisoning to move to safe housing on an emergency basis; currently, these families are likely to lose their Housing Choice Voucher Program subsidy if they leave, effectively forcing them to choose between the health of their children and homelessness. These changes are also being considered as a recommendation to the Administration by the White House Advisory Council on Faith-Based and Neighborhood Partnerships, to which CHN’s executive director Deborah Weinstein was appointed by President Obama.

Senator Richard Durbin (D-IL) and Senator Robert Menendez (D-NJ) recently introduced the Lead-Safe Housing for Kids Act of 2016 to would require HUD to make similar changes; the bill was also introduced by Rep. Keith Ellison (D-MN) and others in the House. In response to a twitterstorm in connection with the bills’ introduction, HUD Secretary Julian Castro tweeted “You’ll be glad to know that HUD is updating regs to protect kids exposed to lead in HUD-assisted housing.”

Details on exact changes HUD is making aren’t yet fully clear.

Combating the Opioid Epidemic

The Senate last Thursday nearly-unanimously passed (94-1) a bill to address addiction to opioids, a class of drug that includes prescription painkillers and heroin. The Comprehensive Addiction and Recovery Act (S. 524) will allow the Department of Justice and the Department of Health and Human Services to provide grants to states to rein in prescription drug and heroin abuse, strengthen prescription drug monitoring programs, ramp up treatment and intervention programs for individuals who are addicted to opioids, and increase access to medication that can reverse overdoses.

While passage of the bill is a positive step, the Senate rejected (48-47; 60 yes votes needed) an amendment from Senator Jeanne Shaheen (D-NH) that would have provided $600 million in emergency supplemental funding to fight the crisis. Because of this, the bill authorizes the actions to fight opioid abuse but doesn’t actually provide any funding to do so. According to The Hill, the Republicans who voted against the emergency funding (five Republicans and 42 Democrats voted to allow consideration of the amendment; no Democrats voted against it) argued that the FY16 omnibus spending bill passed last fall included about $400 million to address the opioid and heroin abuse epidemic and that more could come from the FY17 appropriations process. Democrats argued that the amendment was needed to make sure money quickly got to communities dealing with this crisis now.

The day after the legislation passed the Senate, Department of Health and Human Services Secretary Sylvia Mathews Burwell announced the department’s plan to award $94 million to health centers to improve access to substance abuse services, especially in underserved communities. The money will come from Affordable Care Act funding and will help awardees hire roughly 800 providers to support nearly 124,000 new patients. President Obama’s FY17 budget requested $1 billion in new mandatory funding over two years and an additional $559 million in discretionary funding for FY17 for this fight.

It is not yet known when the House Judiciary Committee will consider legislation to fight the opioid epidemic, nor is it known if they will take up the Senate-passed measure or the House version of it, H.R. 953.

Fighting a Zika Outbreak

Congress has yet to move on a February 22nd request from the Obama Administration for $1.9 billion in emergency funding to combat the Zika virus in the U.S. GOP leaders have insisted that dollars left over from the 2014 fight against Ebola could be used for this purpose, and that any emergency funding that is approved would have to be paid for with offsetting cuts elsewhere. Democrats rejected those notions, noting that waiting for funding through the regular appropriations process would take too long to combat the disease. As CHN noted in this blog post, major cuts to public health funding have left health departments unable to deal with a serious outbreak of the Zika virus, which has a potentially disparate impact on low-income people.

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