DEPARTMENT OF HEALTH AND HUMAN SERVICES 

OFFICE OF INSPECTOR GENERAL 

W;\ SH I!\'CTOi\, UC 	 20201 

JON~ 6 2015 

TO: 	 Pamela S. Hyde 

Administrator 

Substance Abuse and Mental Health Services Administration 

FROM: Suzanne Mm-rin 

Deputy Inspect<H" General 

for EN·aiuation and Inspections 

SUBJECT: 	 "tvlemorandum Report: SAMHSA Has Improved Outcome Reportingfor 

th e Substance Abuse Prevention and Treatment Block Grant, 

OEI-04-12-00160 

This memorandum report provides information about the reporting of national outcome 

measures (NOMs) for the Substance Abuse and Mental Health Services Administration ' s 

(SAMHSA) largest grant program , the Substance Abuse Prevention and Treatment Block 

Grant (SABG). SAMHSA's effmis to improve outcome measurement for the SABG 

program achieved nearly complete repmiing compliance by the grantees in our review. 

SAMHSA's use of existing data sources to populate data fields for grantees, as well as its 

oversight of and technical assistance to grantees on outcome measurement, may have 

contributed to this success. 

To more efficiently evaluate the SABG program's performance, SAMHSA has proposed 

substantial changes to the SABG application for fiscal years (FY s) 2016 and 2017. 

Therefore, we offer no recommendations but are providing this information for 

SAMHSA ' s consideration as it develops and implements its planned changes. 

SUMMARY 

SAMHSA leads public health effmis to improve the quality and availability of prevention 

and treatment services for substance abuse and mental illness. One such effort is the 

SABG program, which provides over $1.7 billion each FY to States, tenitories, and tribes 

(hereinafter referred to collectively as "grantees") to prevent and treat substance abuse. 1 

We collected information and documentation from SAMHSA and from the SABG 

applications for FYs 2011 and 2012 from 10 purposively selected grantees. We found 

1 U.S. Department of Health and Human Services' (HHS) Budge ts in Brieffrom FY 2002 to FY 2015 . 

Accessed at http ://www .hh s. gov/budget/ on December 3, 2014. 
 

 

 

 

Page 2 – Pamela S. Hyde 

that SAMHSA had developed outcome measures to assess the performance of its 

programs, including the SABG program. Of the 10 selected grantees, all but 1 had data 

in their applications regarding all measures related to treatment and prevention. The 

remaining grantee did not have data for one of the seven treatment measures; it stated that 

it was developing a new system to adequately collect data for that measure. However, 

that grantee did have data for all prevention measures. Further, SAMHSA conducted 

onsite reviews and provided technical assistance to grantees, in part to improve the 

reporting of outcomes. 

SAMHSA has proposed substantial changes to its application for FYs 2016–2017 to more 

efficiently evaluate the SABG program’s performance. Therefore, we offer no 

recommendations but are providing this information for SAMHSA’s consideration as it 

develops and implements these changes. We encourage SAMHSA to continue working 

with grantees to improve their capabilities for reporting and collecting data—in 

particular, those capabilities related to outcome measurement. 

BACKGROUND 

SAMHSA is required to collect performance data and analyze the effectiveness of its 

programs.2

 In recent years, SAMHSA reports that it has made significant strides in 

improving performance and outcome measurement for its block grant programs, 

including the SABG program. In particular, according to SAMHSA, it has streamlined 

performance reporting and management, validated data quality, linked different data 

sources, and promoted evidence-based decisionmaking.3 Additionally, SAMHSA 

continues to be committed to improving the data collection of performance and outcome 

measures, and it has made efforts to streamline and reduce reporting burden while 

enhancing the access and use of available data without overburdening grantees or 

SAMHSA’s infrastructure.4 

Substance Abuse Prevention and Treatment Block Grant 

The SABG was established in 1992 to provide funding to grantees for planning, carrying 

out, and evaluating activities to prevent and treat substance abuse.5

 Within SAMHSA, 

the Center for Substance Abuse Prevention (CSAP) and the Center for Substance Abuse 

Treatment (CSAT) administer the SABG program. 

2

 HHS is required to report on the performance of the entire Department each year (5 U.S.C. § 306), and 

each HHS Operating Division, such as SAMSHA, provides information to that report. See, e.g., FY 2013 

HHS Annual Performance Report and Performance Plan (February 2012). 3

 SAMHSA, Fiscal Year 2016 Justification of Estimates for Appropriations Committees, p. 15. Accessed 

at http://www.samhsa.gov/sites/default/files/samhsa-fy2016-congressional-justification.pdf on May 12, 

2015. 

4 Ibid., p. 15. 

5

 P.L. No. 102-321, Title II, § 202 (amending Title XIX, Part B of the Public Health Service Act (PHSA) to 

add a new Subpart B (42 U.S.C. §§ 300x-21 – 300x-35)). Grantees administer the SABG subject to the 

restrictions in Title XIX of the PHSA (42 U.S.C. §§ 300x-21 et seq.) and implementing regulations found 

at 45 CFR pt. 96. 

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Each grantee must apply annually for SABG funds and can submit applications 

electronically through the Web Block Grant Application System.6

 Grantees must have 

the flexibility to distribute SABG funds to subrecipients (e.g., local government entities 

and community- and faith-based organizations).7

 Grantees and subrecipients must 

deliver (1) substance abuse prevention activities to individuals and communities impacted 

by substance abuse and (2) substance use disorder treatment and recovery support 

services to impacted individuals and families.8 As part of its application, each grantee is 

also required to submit to SAMHSA an annual report that describes its progress in 

meeting prevention and treatment goals, objectives, and activities.9 

SAMHSA’s Onsite Reviews of SABG Grantees 

SAMHSA is required to conduct onsite grantee reviews to monitor SABG expenditures 

in at least 10 States, territories, or tribes each FY.10 Within SAMHSA, CSAP and CSAT 

conduct these onsite reviews to ensure that grantees comply with SABG program 

requirements and receive any technical assistance needed to improve the delivery of 

substance abuse services. 

If CSAP identifies noncompliance with SABG program requirements during its onsite 

reviews, it requires grantees to take followup action. For example, if a grantee fails to 

make its SABG plan available to the public for comment or to correctly report 

information to SAMHSA, CSAP requires the grantee to take followup action.11 CSAP 

also suggests potential enhancements to grantees if it identifies any areas for 

improvement. 

In its onsite reviews, CSAT assesses grantees’ compliance with SABG program 

requirements and identifies needs for technical assistance. If grantees need technical 

assistance related to data, CSAT refers the issue to the Center for Behavioral Health 

Statistics and Quality (CBHSQ), which has primary responsibility for the collection, 

analysis, and dissemination of SAMHSA’s behavioral health data. Regardless of whether 

CSAT identifies any grantee needs for data-related technical assistance, grantees can also 

solicit assistance and support directly from CBHSQ. 

6

 SAMHSA, Substance Abuse Prevention and Treatment Block Grant, last updated February 2015. 

Accessed at http://www.samhsa.gov/grants/block-grants/sabg on May 12, 2015. 7

 Ibid. 

8

 Ibid. 

9

 Section 1942 of the PHSA (42 U.S.C. § 300x-52) and the implementing regulation at 45 CFR 

§ 96.122(f)(1)(ii). In the application, SABG grantees use information for the fiscal year 3 years prior to the 

fiscal year for which the grantee is applying for SABG funds to describe progress made in meeting 

prevention and treatment goals, objectives, and activities. 

10 Section 1945(g) of the PHSA (42 U.S.C. § 300x-55(g)).
 11 These PHSA requirements are found at sections 1922 (a)(1) (42 U.S.C. § 300x-22(a)(1)), 1941 (42
 

U.S.C. § 300x-51) and 1942 (42 U.S.C. § 300x-52)). 

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Historical Concerns with SAMHSA’s Performance and Outcome Measurement 

In 2004, the Government Accountability Office (GAO) reported that SAMHSA had not 

identified necessary strategies to achieve and measure its long-term goals.12 In addition, 

in 2003, the Office of Management and Budget (OMB)—using the Program Assessment 

Rating Tool—had rated the SABG program as ineffective, giving it a score of 8 percent 

on program results and accountability.13 

METHODOLOGY 

From the 60 grantees that received SABG funding in FYs 2011 and 2012, we purposively 

selected for each of the 10 HHS regions the grantee that had the highest amount of 

funding in those two years in that region.14, 15 These 10 selected grantees, shown in 

Appendix A, collectively accounted for 50 percent of SABG funding in both FYs 2011 

and 2012. We collected information and documentation from each of the 10 selected 

grantees. In particular, we collected and reviewed their SABG applications for FYs 2011 

and 2012. We determined the completeness of the outcome data that the grantees 

reported in their applications, but we did not verify the accuracy of these data. 

Additionally, we collected information and documentation from SAMHSA. In particular, 

we collected and reviewed documentation related to all onsite reviews that CSAT and 

CSAP conducted in FYs 2011 and 2012.16 We then determined for each grantee whether 

CSAP required followup action and/or suggested potential enhancements that were 

specifically related to outcome measures.17 Additionally, we determined for each grantee 

whether CSAT identified technical assistance needs related to outcome measures. We 

also determined whether CBHSQ provided technical assistance to grantees in FYs 2011 

and 2012. 

This study was conducted in accordance with the Quality Standards for Inspection and 

Evaluation issued by the Council of the Inspectors General on Integrity and Efficiency. 

12 GAO, Substance Abuse and Mental Health Services Administration: Planning for Program Changes and
 

Future Workforce Needs is Incomplete, GAO-04-683. Accessed at http://www.gao.gov/products/GAO-04-

683 on May 13, 2015. 13 OMB, Detailed Information on the Substance Abuse Prevention and Treatment Block Grant Assessment, 

2003. Accessed at http://georgewbush-whitehouse.archives.gov/omb/expectmore/detail/
 

10001066.2003.html on May 20, 2015. The Program Assessment Rating Tool, which rated Federal
 

programs on their effectiveness, was instituted in 2002 and discontinued in 2009. 14 SABG grantees consisted of 50 States, 8 territories, 1 tribe, and the District of Columbia. 15 HHS, HHS Region Map, June 2006 (last reviewed). Accessed at 

http://www.hhs.gov/about/regionmap.html on May 13, 2015. 16 Five of the ten selected SABG grantees for which we reviewed applications had received an onsite 

review from CSAP and/or CSAT in FYs 2011 or 2012. 

17 For one grantee, CSAP suggested a potential enhancement that was already included in a followup action 

that CSAP was requiring the grantee to take. To avoid duplication, we included the required followup
 

action in our analysis and did not include the potential enhancement. 

SAMHSA Has Improved Outcome Reporting for SABG (OEI-04-12-00160) 
 

Page 5 – Pamela S. Hyde 

RESULTS 

SAMHSA developed outcome measures to assess its programs’ performance 

In conjunction with States and other stakeholders, SAMHSA developed NOMs to assess 

performance and improve accountability of its programs. As shown in Table 1, NOMs 

are composed of domains, outcomes, and measures. The domain for each NOM has an 

expected outcome, as well as treatment and/or prevention measures that are used to 

determine whether the expected outcome was achieved. In their SABG applications for 

FYs 2011 and 2012, grantees were required to report on eight NOM domains. 

Specifically, they reported data for 7 treatment measures and 13 prevention measures, and 

these data were used to determine whether the expected outcome for each NOM domain 

was achieved. 

Table 1: NOMs’ Domains, Outcomes, and Measures, FYs 2011 and 2012 

NOM Domain Outcome Treatment 

Measures 

Prevention 

Measures 

1 Reduced 

Morbidity 

Abstinence From 

Drug/Alcohol Use 

Clients with no alcohol use at 

admission versus discharge 

30-day use 

Perception of risk/harm of use 

Clients with no drug use at 

admission versus discharge 

Age of first use 

Perception of disapproval/attitudes 

2 Employment/ 

Education 

Increased/Retained 

Employment or 

Return to/Stay in 

School 

Clients employed or in school at 

admission versus discharge 

Perception of workplace policy 

Average daily school attendance 

rate 

3 Crime and 

Criminal Justice 

Decreased Criminal 

Justice Involvement 

Clients without arrests (prior 

30 days) at admission versus 

discharge 

Alcohol-related traffic fatalities 

Alcohol- and drug-related arrests 

4 Stability in 

Housing 

Increased Stability in 

Housing 

Clients being in stable housing 

situation at admission versus 

discharge 

Not applicable* 

5 Social 

Connectedness 

Increased Social 

Supports/Social 

Connectedness 

Clients participating in self-help 

and/or support groups at 

admission versus discharge 

Family communication around 

drug and alcohol use 

6 Access/Capacity 

Increased Access to 

Services (Service 

Capacity) 

Not applicable* Number of persons served by age, 

gender, race and ethnicity 

7 Retention 

Increased Retention 

in TreatmentSubstance Abuse 

Length of stay from admission 

to discharge 

Number of evidence-based 

programs and strategies 

Percentage of youth seeing, 

reading, watching, or listening to a 

prevention message 

8 Use of EvidenceBased Practices 

Use of EvidenceBased Practices Not applicable* Number of evidence-based 

programs and strategies 

*Treatment or prevention measure was under development in FYs 2011 or 2012. 

Note: The Employment/Education domain has three prevention measures; however, one of these prevention measures—alcohol-, tobacco-,
 

and other drug-related suspensions and expulsions—was under development in FYs 2011 and 2012. 

Source: OIG review of FY 2011 and 2012 SABG applications for selected grantees, 2015. 

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To reduce grantees’ data collection and reporting burden, SAMHSA may pre-fill data 

fields associated with certain treatment and prevention measures in applications using 

available data. For treatment measures, data fields in the Web Block Grant Application 

System are automatically populated using aggregated State data contained in the 

Treatment Episode Data Set (TEDS). TEDS is a national client-level database on 

substance abuse treatment. It compiles data extracts from States’ systems using a 

predetermined format and, if necessary, converts State data elements to standard TEDS 

data definitions.18 SAMHSA uses TEDS to measure program performance, as well as to 

conduct comparisons and identify trends related to substance abuse treatment, at the 

national or State level. 

For most prevention measures, data fields in the Web Block Grant Application System 

are automatically populated using data from the National Survey on Drug Use and 

Health, the National Center for Education Statistics’ National Public Education Finance 

Survey, the National Highway Traffic Safety Administration Fatality Analysis Reporting 

System, and the Federal Bureau of Investigation Uniform Crime Reports.19 The National 

Survey on Drug Use and Health is an annual survey of the United States civilian 

noninstitutional population aged 12 and older that provides national and State-level 

estimates on the use of tobacco products, alcohol, and illicit drugs, and on mental 

health.20 For the remaining prevention measures, grantees provide the data in the 

application, which SAMHSA uses to monitor trends in grantee-level prevention 

outcomes and to identify technical assistance needs. 

Of the 10 selected SABG grantees, all but one had data in their FY 2011 and 2012 

applications for all required treatment and prevention measures 

Of the 10 selected SABG grantees, 9 had data in their FY 2011 and 2012 applications for 

all treatment and prevention measures. The remaining selected grantee did not have data 

in its application for one of the seven treatment measures, but it had data for all 

13 prevention measures. In its FY 2011 and 2012 applications, this grantee stated that it 

was developing a new system to adequately collect the treatment-measure-related data 

that its application was lacking at that time. 

SAMHSA conducted onsite reviews and provided technical assistance to SABG 

grantees, in part, to improve outcome reporting 

SAMHSA conducted onsite reviews for a total of 28 grantees in FY 2011 and 15 grantees 

in FY 2012.21 Within SAMHSA, CSAP and CSAT conduct onsite reviews to ensure that 

18 SAMHSA, Treatment Episode Data Set (TEDS) State Instruction Manual with State TEDS Submission 

System (STSS) Guide, Version 3.2, May 2014. Accessed at 

http://wwwdasis.samhsa.gov/dasis2/manuals/teds_manual.pdf on May 13, 2015. 

19 SAMHSA, SABG Uniform Application, FYs 2011 and 2012. See also SAMHSA, Detailed Key Findings 

from the Independent Evaluation of the SAPT Block Grant Program, June 2009, p. 8. 20 Section 505 of the PHSA (42 U.S.C. § 290aa-4); the National Survey on Drug Use and Health, About the 

Survey. Accessed at https://nsduhweb.rti.org/respweb/project_description.html on May 14, 2015. The 

survey is funded by SAMHSA and conducted by Research Triangle Institute. 

21 Three grantees in FY 2011 and four grantees in FY 2012 received onsite reviews from both CSAP and 

CSAT. 

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grantees comply with SABG program requirements and receive any technical assistance 

needed to improve the delivery of substance abuse services. 

CSAP conducted onsite reviews in FYs 2011 and 2012 for 26 grantees. In FY 2011, 

CSAP required three grantees to take followup actions regarding deficiencies with data 

collection and reporting of prevention NOMs. During these onsite reviews, CSAP also 

identified potential enhancements to improve the data collection and/or reporting of 

prevention NOMs for 11 grantees, and most grantees indicated that they would pursue 

implementation of these potential enhancements. 

In addition, CSAT conducted onsite reviews in FYs 2011 and 2012 for 24 grantees and 

identified technical assistance needs, though none of these needs were related to 

treatment NOMs. CBHSQ provided ongoing technical assistance to grantees related to 

treatment NOMs during our review period. 

CSAP required followup actions and suggested potential enhancements related to 

prevention NOMs. CSAP requires followup action of grantees when its onsite reviews 

identify noncompliance with SABG program requirements, such as failing to correctly 

report information to SAMHSA. Most of the 26 grantees for which CSAP conducted 

onsite reviews in FYs 2011 and 2012 complied with data collection and reporting 

requirements of prevention NOMs. However, CSAP required followup action for three 

grantees in FY 2011 related to deficiencies with the collection of data for and the 

reporting of prevention NOMs. It did not require followup action for this reason for any 

grantees in FY 2012. 

Of the three grantees for which CSAP required followup actions, one was not collecting 

and reporting data for prevention measures associated with all programs funded through 

the portion of the SABG that is set aside for primary prevention strategies for substance 

abuse.22 In this case, CSAP required the grantee to report in its applications the data for 

all SABG-funded prevention programs for the next compliance year and all subsequent 

years. This grantee did so in its subsequent application. Another grantee reported on all 

but one prevention measure in its application, and CSAP required it to report on all 

prevention measures. This grantee did so in its subsequent applications. The remaining 

grantee did not report data for all prevention measures. As a result, CSAP required it to 

report these data in subsequent applications. This grantee is working toward taking this 

action by enhancing its data collection system to ensure that it accurately and completely 

reports on all prevention measures. 

CSAP suggests potential enhancements to grantees if it identifies any areas for 

improvement during onsite reviews; grantees’ implementation of these potential 

enhancements is voluntary. In FYs 2011 and 2012, CSAP suggested 15 potential 

enhancements to 11 grantees to improve the data collection and/or reporting of 

prevention NOMs. Table 2 categorizes the types of NOM-related potential enhancements 

that CSAP suggested to grantees. 

22 Grantees are required to spend no less than 20 percent of SABG funds on primary prevention strategies 

for substance abuse. 45 CFR §§ 96.124–96.125. 

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Table 2: Categorization of Potential Enhancements Related to Data Collection and/or 

Reporting of Prevention NOMs, FYs 2011 and 2012 

Category 

Number of Potential 

Enhancements 

FY 2011 FY 2012 

Enhancing system that collects data for and reports on 

prevention NOMs 6 3 

Accurately reporting data for prevention NOMs in 

applications 2 1 

Increasing subrecipient ability to collect and report data for 

prevention NOMs 2 0 

Developing quality assurance process to ensure correct 

reporting for prevention NOMs 1 0 

 Total 11 4 

Source: OIG review of CSAP documentation from FY 2011 and 2012 onsite reviews of grantees, 2015. 

In FY 2011, CSAP suggested to 8 grantees 11 potential enhancements related to the data 

collection and/or reporting of prevention NOMs. For five grantees, CSAP suggested one 

potential enhancement per grantee; all but one indicated that they would pursue 

implementation. For the remaining three grantees, CSAP suggested two NOM-related 

potential enhancements per grantee. One of these grantees indicated that it would pursue 

implementation for both potential enhancements, one did so for one of the two potential 

enhancements, and the remaining grantee indicated that it would take no action regarding 

either potential enhancement. 

In FY 2012, CSAP suggested to three grantees four potential enhancements related to the 

data collection and/or reporting of prevention NOMs. All three grantees indicated that 

they would pursue implementation of these potential enhancements. 

CSAT conducted onsite reviews, and CBHSQ provided ongoing technical assistance 

related to treatment NOMs. CSAT conducted site visits in FYs 2011 and 2012 for 

24 grantees and identified technical assistance needs; however, none of these needs were 

related to treatment NOMs. Additionally, when CSAT conducted these grantee site visits, 

it compiled information on grantees’ readiness to report on NOMs. All 24 grantees 

collected or planned to collect data for treatment NOMs that were defined in FYs 2011 

and 2012. 

In addition, in FYs 2011 and 2012, CBHSQ provided ongoing technical assistance and 

support to grantees related to treatment NOMs by, for example, responding to questions 

related to data reporting and submission in TEDS, consulting with grantees on 

approaches to capture and report data given the grantees’ service delivery structures and 

computer systems, and bringing together grantees that have similar issues so that they can 

confer with and assist one another. CBHSQ provided this technical assistance and 

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Page 9 – Pamela S. Hyde 

support through various methods, including conference/phone calls, emails, Webinars, 

and instruction manuals. 

CONCLUSION 

SAMHSA’s efforts to improve outcome measurement for the SABG program achieved 

nearly complete reporting compliance by the grantees in our review. SAMHSA’s use of 

existing data sources to populate data fields for grantees, as well as SAMHSA’s oversight 

of and technical assistance to grantees on outcome measurement, may have contributed to 

this success. Of the 10 selected grantees in our review, all but 1 had data in their 

applications for FYs 2011 and 2012 regarding all measures related to treatment and 

prevention. The remaining grantee did not have data for one of the seven treatment 

measures; it stated that it was developing a new system to adequately collect data for that 

measure. However, that grantee did have data for all prevention measures. Further, 

SAMHSA conducted onsite reviews and provided technical assistance to grantees, in part 

to improve the reporting of outcomes. In addition, SAMHSA continues to improve the 

data collection of performance and outcome measures and has made efforts to streamline 

and reduce reporting burden while enhancing access and use of available data. 

To more efficiently evaluate the SABG program’s performance, SAMHSA has proposed 

changes to the SABG application for FYs 2016 and 2017—specifically, client-level 

measures that will build upon existing data systems, namely TEDS.23 Although some of 

these measures overlap with the treatment and prevention measures that grantees reported 

in their SABG applications for FYs 2011 and 2012, some measures are new and some 

existing measures have been revised. The deadline for grantees to provide feedback to 

SAMHSA on these proposed changes was May 1, 2015. 

Because SAMHSA has proposed these substantial changes to the SABG application, we 

offer no recommendations but are providing this information for SAMHSA’s 

consideration as it develops and implements its planned changes. We encourage 

SAMHSA to continue working with grantees to improve their capabilities for reporting 

and collecting data—in particular, those capabilities related to outcome measurement. 

This report is being issued directly in final form because it contains no recommendations. 

If you have comments or questions about this report, please provide them within 60 days. 

Please refer to report number OEI-04-12-00160 in all correspondence. 

23 SAMHSA, Provide Feedback on Proposed Client-Level Measures for Block Grant Programs. Accessed 

at http://store.samhsa.gov/blockgrant/feedback/index.html on March 13, 2015. 

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APPENDIX A 

SABG Funding by Selected Grantee, FYs 2011 and 2012 

Grantee and HHS Region 

FY 2011 FY 2012 

SABG Funding Percentage of 

SABG Funding SABG Funding Percentage of SABG Funding 

California (Region IX) $249,428,956 14.7% $248,892,428 14.7% 

Texas (Region VI) $135,246,934 8.0% $134,956,016 8.0% 

New York (Region II) $114,884,455 6.8% $114,637,337 6.8% 

Florida (Region IV) $99,796,302 5.9% $99,581,639 5.9% 

Illinois (Region V) $69,493,373 4.1% $69,343,892 4.1% 

Pennsylvania (Region III) $58,766,078 3.5% $58,639,671 3.5% 

Washington (Region X) $34,787,819 2.1% $34,712,990 2.1% 

Massachusetts (Region I) $34,146,666 2.0% $34,073,216 2.0% 

Colorado (Region VIII) $26,159,532 1.5% $26,103,262 1.5% 

Missouri (Region VII) $26,016,004 1.5% $25,960,043 1.5%

 Total (Selected Grantees) $848,726,119 50.1% $846,900,494 50.1%

 Total (All Grantees) $1,693,519,655 100.0% $1,689,876,866 100.0% 

Source: SAMHSA, Department of Health and Human Services FY 2013 Substance Abuse and Mental Health Services 

Administration Justification of Estimates for Appropriations Committees, pp. 156–157. 

SAMHSA Has Improved Outcome Reporting for SABG (OEI-04-12-00160)