Congress Passes Bill to Fund Entire Government: What it Means for Occupational Therapy

John Ray, AOTA Legislative Representative

Last week, the House and Senate overwhelmingly passed a spending package to fund all parts of the federal government for the rest of fiscal year 2014. The measure, frequently referred to as the “omnibus” as it contains all 12 of the annual appropriations bills that fund the different parts of the government, was crafted around the spending caps negotiated by Congressman Paul Ryan (R-Wisconsin) and Senator Patty Murray (D-Washington) at the end of last year. This bill ensures that the government will be fully funded through September, 2014.

Importantly, this funding bill rolls back of a large portion of the “sequester,” the automatic across the board spending cuts to all federal agencies that went into effect last year. Many programs and agencies important to Occupational Therapy saw the majority of funding from last year’s cuts restored, and a few received increased funding.

Mental Health

The Omnibus bill included significant investments in the area of mental health. Much of this spending is for the President’s “Now is the Time” initiative on mental health. Of particular interest for occupational therapy is $35 million for behavioral health workforce training and a $47 million increase to state mental health block grants to be used for identification and treatment of early psychosis. Several evidence-based early psychosis programs that contain occupational therapy services as a key component, should qualify as programs that will be eligible for this new funding. Two other initiatives of interest include $50 million for the Primary Care Behavioral Health Initiative, which seeks to integrate primary care and behavioral health, and $20 million for the Healthy Transitions Initiative. AOTA will carefully monitor the implementation of these new programs and advocate for the inclusion of occupational therapy in their implantation.

Early Childhood Education

Early childhood education programs, which were severely impacted by sequester cuts, will see big increases in the new bill. Head Start will receive an increase of $1.1 billion from 2013, and $500 million of this appropriation will go towards expanding Early Head Start, a program that targets children up to age 3 in low-income families. The bill also creates a new competitive grant under the “Race to the Top” program for states to develop or expand preschool programs and other early learning activities for 4-year-olds from low-income families. States can then award sub-grants to local school districts and Head Start and other child care programs.

General and Special Education Funding

Title I education grants, which are provided to schools with large populations of low-income students, received a $625 million increase from last year’s sequestration levels of funding. Programs under The Individuals with Disabilities Education Act (IDEA) received nearly $500 million in additional funds over sequester levels. These final spending levels are below the funding levels for 2012 and early 2013, but are a marked increased over levels during sequestration.

In 2013, AOTA participated in a survey with the National Coalition on Personnel Shortages in Special Education and Related Services (NCPSSERS). This survey showed the effect of the funding cuts on services and just how crucial these additional resources are. 80% of respondents reported they have “too few personnel to meet the needs of students with disabilities” and saw the impact with an increase in caseload and class size; lack of funding to purchase resources such as assistive technology; and reduced professional development opportunities. The $500 million increase over post-sequester funding for special education, provides funding for hiring over 6,000 new special education staff and other much needed resources.

Funding for the National Institutes of Health

The National Institutes of Health receives an increase of nearly $1 billion from the level impacted by the sequester in 2013. While still below 2012 and early 2013 levels, this new funding level is a start to restoring research funding that has been significantly reduced in recent years.


AOTA continues to be a strong advocate for funding the rehabilitation research, mental health, general education and IDEA, and early education programs. This budget is a significant step forward from the funding levels for these programs and agencies in 2013, as well as a return to the regular budgeting process in Congress for the first time in several years. As Congress begins to make their tough budget decisions for 2015, AOTA will work hard to ensure appropriate funding for programs and agencies important to our members.