Kansas City-area organizations that help people overcome addiction or manage mental illness learned on Jan. 13 that millions of dollars in federal funding was suddenly being withdrawn.
About 24 hours later, as organizations scrambled to fill the resulting funding gaps, the Substance Abuse and Mental Health Services Administration (SAMHSA) rescinded the grant terminations, worth almost $2 billion nationwide.
Such is the roller-coaster existence of any organization that relies on federal funding these days, said Emily Hage, president and CEO of First Call KC, a nonprofit that works to treat and prevent substance use disorder.
“It’s just constant whiplash,” she said.
What happened?
Late Jan. 13, SAMHSA, which operates under the U.S. Department of Health and Human Services, told organizations their work didn’t match the Trump administration’s priorities, so it would immediately cancel grants funding that work.
Chrissy Mayer, with DCCCA, a nonprofit based in Lawrence that provides behavioral health services, said her organization was staring down cuts totalling $1.15 million for four projects in Kansas. They included suicide prevention work and a program to provide naloxone for first responders to leave behind with families after an overdose call.
Mayer said losing the SAMHSA grants would be devastating.
“People will die from this,” she said before learning that the grants had been restored. “There will be consequences.”
Similar statements were heard across the country on Jan. 14, which likely led to the agency’s reversal on Jan. 15 when SAMHSA began notifying the organizations to disregard their previous directive.
Despite the reprieve, nonprofit leaders in the mental health and addiction treatment space said they won’t be resting easy.
“Programs like ours are always at risk,” said Erin Fraser, executive director of Benilde Hall. a Kansas City nonprofit that helps men who are transitioning out of prison. It almost lost a $400,000 grant in this week’s upheaval.
Threats of federal cuts have been almost constant in their sector since the Trump administration returned to the White House. Even though this time the cuts were reversed, most doubt this will be the end.
“I think the trend we’ve seen is, they tell us what they want to do,” Hage said, “and then they figure out how they are going to do it.”
First Call is a subrecipient on a grant to the Kansas City Municipal Court, which funds substance use treatment, screening and assessment. It also helps pay for recovery housing for participants in the city’s Wellness Court.
Benita Jones, a court spokesperson, said the SAMHSA grant the city almost lost this week totals $2 million — $400,000 annually. It is supposed to run through Sept. 29, 2028, she said.
She said in an email that the court is “actively planning for the possibility of the grant’s expiration.”
“We are evaluating which services could continue through alternative sources, pursuing additional funding opportunities, and strengthening partnerships with organizations,” she said.
That includes a partnership with Beyond the Bench KC, a nonprofit created by the Municipal Court to help participants get resources to access essential services.
”A sudden loss of these funds would have a significant negative impact on the vulnerable population we serve as the program would not be sustainable at its current scope without this support,” Jones said.
Bracing for losses
From the time word of the cuts came from SAMHSA, Centerstone, the behavioral health organization that operates Comprehensive Mental Health Services and Burrell Behavioral Health in the Kansas City area, scrambled to figure out how to minimize the effects on patients.
The organization was told it would lose 28 grants totaling more than $14 million in funding from its operations in seven states. In Missouri alone, the organization would have lost $2.9 million allocated to seven different programs, including suicide prevention work.
“In the behavioral health space, it’s not ethically responsible to just bring someone’s treatment plan to a sudden halt,” said Rance Burger, director of public relations. “We were preparing to deal with that and, case by case, establish some sort of continuum of care for hundreds of clients. It was going to create an immense challenge.”
The organization welcomed news that the grants would not, after all, be terminated, he said. But it will not rest on that news.
“We’re in an environment, as illustrated by the last 36 hours, where a lot can change in a very short period of time,” Burger said.
He said the organization was “taking a moment of self reflection” to figure out how to best prepare in case this happens again. It’s too soon to say whether that will mean relying less on federal funds in the future, Burger said.
“Patients come first for us,” he said. “So patients will come first in our reaction and our response.”
Losing its portion of its Kansas City Wellness Court grant wouldn’t have been the first blow to First Call’s funding since the Trump administration stepped back into office, Hage said.
Federal grants for prevention programs that were available in the past disappeared last year. That forced First Call to pull back on training for staff and meant it could no longer afford some support to community coalitions.
That includes a coalition led by the Kansas City School District. Hage said First Call had helped it by supplying naloxone, a medication used to reverse opioid overdoses, but without the federal funds it can no longer do that work.
Fraser of Benilde Hall said the $400,000 SAMHSA grant her organization almost lost represents its second largest funding source. It pays the salaries of staff that provide mental health counseling, case management and peer support.
When Fraser heard the funding would be eliminated, her first thought was for the people who were getting that care.
“When community based treatment services are removed, often the burden shifts to emergency rooms, shelters and law enforcement,” Fraser said. “Those systems are far more costly and less effective.”
Can’t help as much
The funding disruptions that came with the second Trump administration were especially jarring because they followed major investment in treatment and prevention programs made by the Biden administration after the COVID pandemic.
Many people credit those investments in harm reduction work, including naloxone distribution, with the declining number of opioid overdose deaths in recent years. Losing that funding threatens that progress, leaders said.
As a result of cuts that have already happened, and the ongoing threat of future cuts, First Call has worked to wean itself off federal funding over the last year, Hage said. But it’s difficult to do the work without any government funding.
First Call has made up some of the lost federal funds with money from Kansas City’s opioid settlement fund. And the organization also gets funding from a marijuana sales tax.
But federal funding, which has always been the backbone of substance use prevention and treatment work, remains important, Hage said. Private foundations that often help fund public health efforts tend to see addiction treatment and prevention programs as a government responsibility.
“There can be a stigma for fundraising for these issues,” Hage said. “There is no replacement for federal funding” in the private sector.
And the reality is that with each funding cut coming out of Washington, organizations like hers simply can’t do as much as they used to.
But as legal cannabis becomes more accepted and more available, more prevention work than ever needs to be done, Hage said. In addition, fentanyl is still a danger, despite lower rates of overdose in recent years.
“I am fearful that without all of those federal funds for prevention education and overdose prevention and treatment,” she said, “we’re going to see overdose death climb and substance use climb.”
This story was originally published by The Beacon, a fellow member of the KC Media Collective.
