President Donald Trump is planning to slash the budget of the Office of National Drug Control Policy, in what marks his administration’s second attempt to gut the top office responsible for coordinating the federal response to the opioid crisis.
The plan would shift the office’s two main grant programs, the High Intensity Drug Trafficking Areas grant and the Drug Free Communities Act, to the Justice and Health and Human Services departments, respectively, multiple sources in the administration and others working with the government on the opioid crisis told POLITICO.
The move would result in a reduction of about $340 million, or 95 percent of the ONDCP’s budget. Trump administration officials say the office would still serve as the White House’s drug policy shop, while the grants would be administered by larger agencies.
The proposal is the latest in a series of actions that health policy experts contend show the Trump administration isn’t serious about addressing the opioid epidemic, despite the president’s designating the substance abuse disorder a national emergency.
Trump hasn’t appointed a permanent director or “drug czar,” to lead ONDCP or asked Congress for additional funding states say is needed to tackle the crisis. The administration has also emphasized a law-and-order approach that experts say only constitutes a narrow part of the solution — one that if overemphasized could harm more struggling patients than it helps.
The White House Office of Management and Budget floated cutting the grant programs completely last year, but the plan was scrapped in the face of fierce resistance from Republican and Democratic lawmakers. This year, officials as part of the administration’s fiscal 2019 budget would shift those programs to other agencies, which critics say leaves the policy office with little power or purpose.
“I’m baffled at the idea of cutting the office or reducing it significantly and taking away its programs in the middle of an epidemic,” said Regina LaBelle, who served as ONDCP chief of staff during the Obama administration.
Lawmakers are expected to push back against the second attempt to alter the office.
Sen. Shelley Moore Capito (R-W.Va.) told POLITICO that she would “resist that move,” adding that she believes the grants should be housed at ONDCP, “within the executive branch and under the president’s purview” rather than at other agencies. Capito, who chairs the Senate appropriations subcommittee that oversees ONDCP, introduced legislation in November that authorized a modest boost to both grant programs.
Sen. Rob Portman (R-Ohio) similarly said he would fight against the proposed cuts.
An OMB spokesperson noted that the budget is not yet finalized and is subject to change, adding “the president needs ONDCP to be a strong policy council to manage his drug control priorities.” She said that “DOJ and HHS are both major grant management organizations that can look holistically at allocations across law enforcement and drug prevention and treatment resources.”
But critics question the wisdom of dramatically restructuring federal programs they say are working well.
Moving the grants out of ONDCP “reduces the prominence of these programs and puts them in the bowels of agencies that have different priorities,” said Kevin Sabet, who worked in the office during the Obama, George W. Bush and Clinton administrations. “These programs can kind of get lost.”
Being situated in the White House has made the programs “more effective and more popular,” Sabet said. “It elevates the importance of these programs. It makes them more visible on the state and local level because it’s not just another program from DOJ or HHS. It’s a program that has the White House’s signature on it and that’s important for states and localities. No other program can show a seal with the White House on it.”
HITDA funding is used to track and seize fentanyl, one of the deadliest opioids. To put these grants into a new agency would cause months of bureaucratic delays, said Andrew Kessler, who heads SlingShot Solutions, a consulting firm focused on behavioral health policy.
“It does not make practical sense. Imagine taking the responsibility of emergency response away from the CDC in the middle of the Ebola emergency. It would never happen,” he said.
Previous administrations have considered shifting the programs away from ONDCP. Most notably, former President George W. Bush proposed moving the HITDA grant to DOJ, but that effort was quashed by Congress.
Supporters of moving the grants say it would reduce overlap, since DOJ also works on drug trafficking and HHS also has substance use prevention.
Former Rep. Patrick Kennedy, a member of Trump’s opioid advisory commision, said the move goes against the panel’s recommendations, which advised fortifying the ONDCP. The panel also endorsed both grants as crucial to overall response efforts.
“It guts the two main purposes of ONDCP,” Kennedy said. “It really undermines the mission.”
And program advocates fear that shifting of these programs to other agencies could lead to changes that would make them unrecognizable.
David Kelley, congressional affairs liaison for the National HIDTA Directors Association, said if HIDTA gets moved under DOJ, U.S. attorneys would control the program and “state law enforcement voices would be lost.” Under ONDCP, federal, state and local law enforcement all have equal power and collaborate with each other on a daily basis.
“I don’t think there’s any doubt it will effectively eliminate the HIDTA program as we know it today,” Kelley said.