Vantage Policy Watch Week of September 29, 2025
- jameliahand
- Sep 29
- 3 min read
Focus: Substance Use & Mental Health Impacts
What’s Happening This Week
Shutdown Risks Loom
Congress remains deadlocked, and without a deal, funding halts after Tuesday, September 30. A shutdown would freeze or delay SAMHSA grants, new block-grant disbursements, and oversight staff needed to monitor compliance and distribute funds. Agencies have already circulated contingency plans outlining furloughs and service slowdowns.
Many SAMHSA and DOJ programs set to start October 1 may be unable to launch.
HHS contingency staffing plan shows how behavioral health services would be triaged.
Reuters reports that 62% of substance use funding (about $2.6 billion) has not yet been obligated, raising the risk that treatment providers could face payment delays or gaps
Budget Cuts on the Horizon
The FY 2026 budget proposal continues to move through Congress, carrying deep cuts to behavioral health infrastructure:
Behavioral Health Block Grants face reductions that would hit states already struggling with overdose and suicide rates.
Parity Enforcement: Cuts to CMS and EBSA oversight threaten enforcement of the Mental Health Parity and Addiction Equity Act, making it easier for insurers to limit coverage.
SAMHSA Consolidation: The proposal would fold SAMHSA into a new Administration for a Healthy America (AHA), raising concerns about loss of behavioral health visibility and expertise.
APA Services warns that access to mental health care could decline if these proposals advance.
Grant Reductions Already Announced
Earlier this month, the DOJ cut $88 million in behavioral health, substance use, and co-response grants. Many of these grants fund partnerships between law enforcement and treatment providers, peer support services, and alternatives to incarceration.
Brennan Center analysis highlights the public safety consequences, warning that cuts undermine deflection and diversion programs.
Providers relying on these grants should anticipate further reductions and prepare for program modifications or suspensions.
Drug Pricing Watch
The Global Benchmark for Efficient Drug Pricing (GLOBE) pilot has been sent to the White House for review. If advanced, this framework could reshape how drug pricing is negotiated in the U.S., with implications for psychiatric medications and medications for opioid use disorder (MOUD).
Reuters reports the program may lower costs but faces heavy lobbying from pharmaceutical groups.
At the same time, the administration has already reversed or paused earlier drug pricing reforms, leaving the future of affordability uncertain.
Access to MOUD and psychiatric medications remains central to treatment equity, especially for marginalized communities.
✅ Action Steps for Providers This Week
1. Check Grant Status
Verify whether federal/state behavioral health or SUD grants are obligated or pending.
Develop contingency plans for operations if payments stall.
2. Safeguard Clinical Operations
Identify essential services (988 crisis line, MOUD delivery, peer support).
Prepare staffing and financial backup plans for at least 2–3 weeks without reimbursements.
3. Review Contracts & Insurance Agreements
Audit for potential parity violations or new restrictions.
Document denials or limitations in real time, these can be used in advocacy or appeals.
4. Scenario Plan for Patients
Draft communication templates to reassure clients that care will continue.
Map local partners (food banks, housing, pharmacy access) for patient referrals if federal supports stall.
5. Monitor Drug Pricing Developments
Stay alert for CMS or White House announcements on the GLOBE pilot.
Communicate with pharmacy partners to anticipate formulary or cost changes.
How Vantage Can Help
Continuity Planning: Map essential services, build financial safeguards, and ensure no patient misses care during funding gaps.
Grant Risk Analysis: Track obligations and compliance risks, preparing proactive strategies if federal dollars are delayed or reduced.
Parity & Compliance Reviews: Audit payor agreements to ensure compliance with parity laws and strengthen advocacy for coverage.
Crisis Communications: Provide ready-to-use patient and community messaging to protect trust and reassure continuity of care.
Strategic Advocacy: Equip leaders with data, stories, and policy framing to push back against cuts and highlight frontline impacts.
Behavioral health and SUD services cannot be left to the uncertainty of politics. Planning ahead is the only way to protect patients, programs, and communities. Contact Vantage Clinical Consulting LLC for strategies that keep care continuous, compliant, and community-focused.
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