JUANA SUMMERS, HOST:
The Trump administration disrupted the country's mental health and addiction treatment systems this week. Late Tuesday night, it abruptly cut more than $2 billion in grants that funded all sorts of programs, only to reverse that decision under public pressure 24 hours later. The whiplash leaves health care providers confused and worried about the future. NPR's Debbie Elliott joins us now from Montgomery, Alabama, where she has been speaking with people affected. Hi there.
DEBBIE ELLIOTT, BYLINE: Hi.
SUMMERS: Debbie, we'll get your reaction out in the field in a moment. But first, this story has just been moving so quickly. Catch us up on what we need to know.
ELLIOTT: OK, so NPR's addiction correspondent Brian Mann first broke this story when he started hearing about these termination letters that were going out Tuesday night from the Substance Abuse and Mental Health Services Administration, also known as SAMHSA. The letter said these programs were not aligned with the president's priorities. Now, that sent shock waves through the public health system, which then ramped up political pressure. And by yesterday, the Trump administration rescinded the cuts. However, there's been no official word as to why - why the cuts in the first place or why the rollback.
SUMMERS: Very interesting. So tell us what kind of services are affected by this?
ELLIOTT: You know, a whole host of things. Particularly here in Alabama, it included drug courts, Narcan distribution, substance abuse prevention programs in schools, the healthy women and healthy baby program, HIV treatment, housing assistance and suicide intervention. This is funding that went to both the state mental health department and to the nonprofits who actually do the fieldwork.
Nichole Dawsey is executive director of the Addiction Prevention Coalition in Birmingham, and she's just reeling, really - worried that she was going to lose a quarter of her budget and staff. She said she was making phone calls, and no one either at the federal agency, SAMHSA, or in Alabama's congressional delegation had any clue as to what was happening. She described it as complete chaos and says everything feels different as a result.
NICHOLE DAWSEY: We are really taking a hard look at the services that we provide and what we are deeming mission-critical. I will also say that the impact is hope too, as cheesy as that sounds. We were able to come together yesterday and say, this is unacceptable.
ELLIOTT: She says, because the administration reversed course, that shows that democracy can work. However, she remains uncertain whether this could happen again because she's been through it again. You know, early last year, she had her federal grants paused and then resumed again.
SUMMERS: I mean, it sounds like, Debbie, you're hearing relief but also a bit of uncertainty. What could this all mean for the future?
ELLIOTT: You know, that's the question providers are asking. Leah Nelson is someone I spoke with. She's a researcher at the Public Affairs Research Council of Alabama. She has a personal interest, she says, because she's in long-term mental health recovery herself. She says both Alabama and the nation as a whole had been making significant strides in recent years to reduce overdose deaths, for instance. And she says a big reason for that is the infrastructure that was funded by SAMHSA - what she says is an essential federal agency.
LEAH NELSON: It's not just that funding was going to end discrete programs. It's like, we all know the federal government funds federal highways. This is like if DOT stopped funding federal highways. That is how big of a deal what happened, or almost happened, yesterday was.
SUMMERS: Wow, that's really striking to hear. Debbie, last thing, what are you hearing from workers out in the field and the people who receive this care?
ELLIOTT: You know, I talked this morning with Randy Hall (ph). He is in recovery, and now he works with drug offenders in Birmingham. That program was among those targeted, and he's really got a cynical view. He's convinced the chaos this week is a signal that public health infrastructure is under threat. And he says that will put vulnerable lives at risk.
SUMMERS: NPR national correspondent Debbie Elliott, thank you.
ELLIOTT: Thank you.
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