DEPARTMENT 

of HEALTH 

and HUMAN 

SERVICES 

Fiscal Year 

2020 

Substance Abuse and Mental Health 

Services Administration 

Justification of Estimates for 

Appropriations Committees 
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ii 
 

 

 

5600 Fishers Lane • Rockville, MD 20857 

www.samhsa.gov • 1-877-SAMHSA-7 (1-877-726-4727) 

Letter from the Assistant Secretary 

I am pleased to present the Substance Abuse and Mental Health Services Administration (SAMHSA) fiscal year 

(FY) 2020 Budget Request. SAMHSA is requesting a total of $5.6 billion. As the primary federal agency 

responsible for addressing the mental and substance use disorders that affect millions of Americans, SAMHSA takes 

seriously its responsibility to ensure that the best, most evidence-based care is reaching all communities in our 

nation. Now, more than ever, we must ensure individuals living with these conditions gain access to high quality 

prevention, treatment, and recovery services. 

Consistent with the goals of the 21st Century Cures Act, SAMHSA's budget demonstrates a commitment to 

addressing pressing public health challenges, including the opioids crisis and serious mental illness (SMI). This 

budget aligns with the Administration’s priorities to address mental and substance use issues for children, adults, 

families, and communities. Through a sustained focus on implementing evidence-based practices, SAMHSA's 

budget aims to improve the lives of people across the country. 

SAMHSA’s FY 2020 budget request includes investments to: 

• Expand access to care for opioid use disorders (OUD) through continued investment in FDA-approved 

pharmacotherapies for OUD, also known as Medication-Assisted Treatment (MAT) in conjunction with 

psychosocial supports, expanded community supports, and strategies to prevent opioid abuse through 

evidence-based prevention approaches, including the use of the life-saving opioid overdose antidote, 

naloxone 

• Prioritize ensuring that individuals with SMI gain access to care over incarceration through increased 

investments in evidence-based programs, such as Assertive Community Treatment (ACT) and Assisted 

Outpatient Treatment (AOT), jail diversion programs, and a focus on addressing the needs of high utilizers 

of services through the Community Mental Health Services Block Grant 

• Expand Certified Community Behavioral Health Clinic (CCBHC) services that provide integrated mental 

health, substance use, and physical healthcare to those living with SMI, offer 24/7 crisis intervention 

services and provide access to wrap-around, evidence-based interventions that will support community 

living for those affected by mental and substance use disorders 

• Make critical investments in children's mental health programs, including essential school-based supports, 

to ensure our nation's schools provide a positive and safe learning environment for America’s youth 

• Improve access to suicide prevention services and strategies for youth, transition-aged youth, and adults at 

risk for suicide 

In FY 2020, SAMHSA maintains a strong commitment to enhancing the delivery of clinically sound, evidence-based, 

effective services. SAMHSA continues to streamline its business operations, including the provision of 

technical assistance and training, to ensure an optimization of service provision across America's communities. The 

work SAMHSA does is vital to the heath of this country. I am confident this budget supports SAMHSA's mission 

to reduce the impact of substance abuse and mental illness on America's comm unities. 

Elinore F. McCance-Katz, M.D., Ph.D. 

Assistant Secretary for Mental Health and Substance Abuse 

Behavioral Health is Essential to Health • Prevention Works • Treatment Is Effective • People Recover 

iii 
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iv 
DEPARTMENT OF HEALTH AND HUMAN SERVICES 

SUBSTANCE ABUSE AND MENTAL HEALTH SERVICES ADMINISTRATION 

Table of Contents 

Fiscal Year 2020 Budget Page 

Letter from Assistant Secretary..................................................................................................... iv 

Table of Contents........................................................................................................................... vi 

Organization Chart........................................................................................................................ vii 

A. Performance Budget Overview 

1. Introduction and Mission....................................................................................................1 

2. Overview of Budget Request .............................................................................................2 

3. Overview of Performance ..................................................................................................7 

4. All Purpose Table (APT)....................................................................................................8 

B. Budget Exhibits 

1. Appropriations Language .................................................................................................10 

2. Language Analysis ...........................................................................................................13 

3. Amounts Available for Obligation ...................................................................................17 

4. Summary of Changes .......................................................................................................18 

5. Budget Authority by Activity...........................................................................................19 

6. Authorizing Legislation....................................................................................................21 

7. Appropriations History.....................................................................................................25 

8. Appropriations Not Authorized by Law...........................................................................28 

C. Mental Health 

1. Mental Health Programs of Regional and National Significance ....................................31 

2. Children’s Mental Health Services.................................................................................115 

3. Project for Assistance in Transition from Homelessness ...............................................121 

4. Protection and Advocacy for Individuals with Mental Illness .......................................127 

5. Certified Community Behavioral Health Clinic.............................................................132 

6. Community Mental Health Services Block Grant..........................................................136 

D. Substance Abuse Prevention 

1. Substance Abuse Prevention Programs of Regional and National Significance............151 

E. Substance Abuse Treatment 

1. Substance Abuse Treatment Programs of Regional and National Significance ............189 

2. State Targeted Response to the Opioid Crisis Grants ....................................................252 

3. State Opioid Response Grants........................................................................................255 

4. Substance Abuse Prevention and Treatment Block Grant .............................................259 

v 
 

F. Health Surveillance and Program Support 

1. Health Surveillance ........................................................................................................271 

2. Drug Abuse Warning Network (DAWN) ......................................................................278 

3. Performance and Quality Information Systems .............................................................280 

4. Program Support.............................................................................................................285 

5. Public Awareness and Support.......................................................................................287 

G. Nonrecurring Expenses Fund.............................................................................................292 

H. Drug Control Budget...........................................................................................................294 

I. Supplementary Tables 

1. Budget Authority by Object Class .................................................................................318 

2. Salaries and Expenses......................................................................................................327 

3. Detail of Full-Time Equivalent Employee (FTE)..............................................................329 

4. Detail of Positions ...........................................................................................................330 

5. Programs Proposed for Elimination..................................................................................331 

6. Physician’s Comparability Allowance Worksheet ............................................................333 

J. Significant Items................................................................................................................. 334 

vi 
Organizational Structure: Substance Abuse and Mental Health Services Administratio
Page intentionally left blank 
 Introduction 

 

 

 

 

 

 

 

 

 

 

 

Prevention, treatment, and support to help people recover from mental and/or substance use 

disorders are essential strategies for the health and prosperity of individuals, families, communities, 

and the country. Individuals and families across the nation are struggling with the consequences of 

living with mental and substance use disorders. In 2017, approximately 18.7 million adults and 46.6 

million adults had a substance use or mental disorder respectively. Of these, 8.5 million adults had 

a co-occurring mental and substance use disorder. Unfortunately, the majority of those who need 

treatment do not receive it. Only 43 percent of adults with diagnosable mental health problems 

received treatment. The unmet treatment need for those with substance use disorders is even greater 

with only 8 percent of individuals receiving specialty treatment. The nation can do better. SAMHSA 

has a unique responsibility to focus on these preventable and treatable problems, which, if 

unaddressed, lead to significant individual, societal, and economic consequences. 

Mission 

SAMHSA’s mission is to reduce the impact of substance misuse and mental illness on America’s 

communities. SAMHSA accomplishes this through providing leadership and resources – programs, 

policies, information and data, funding, and personnel – to advance mental and substance use 

disorder prevention, treatment, and recovery services in order to improve individual, community, 

and public health. 

1 
Substance Abuse Prevention and Treatment Block Grant 

 

 

 

 

 

Medication Assisted Treatment for Prescription Drug and Opioid Addiction (MAT-PDOA) 

 

 

 

 

State Opioid Response Grants 

 

 

 

 

 

 

 

 

 

Overview of Budget Request 

The FY 2020 Budget Request is $5.68 billion, a decrease of $65.0 million from the FY 2019 Enacted 

budget. The budget request aims to address critical national priorities including: combating the 

nation’s opioid crisis, addressing serious mental illness, developing and implementing strategies to 

prevent suicide, and expanding school-based mental health services. 

Key Budget Highlights: 

The FY 2020 Budget Request is $1.9 billion. This funding serves as a critical safety net for substance 

misuse prevention and substance use disorder treatment services. The states and jurisdictions have 

the flexibility to plan, carry out, and evaluate prevention, treatment, and recovery services that 

address the needs of individuals, families, and communities. Recognizing that prevention is an 

integral component to reduce the effects of substance misuse on America’s communities, the statute 

requires that twenty percent of the SABG state allocation must be spent on primary prevention 

services. 

The FY 2020 Budget Request is $89.0 million. MAT refers to the use of the Food and Drug 

Administration-approved pharmacotherapies (i.e., buprenorphine products, methadone, and 

naltrexone products) in combination with evidence-based psychosocial interventions for treatment 

of opioid addiction. MAT is a safe and effective strategy for decreasing the frequency and quantity 

of opioid abuse and reducing the risk of overdose and death. MAT PDOA addresses treatment needs 

of individuals who have an opioid addiction by expanding/enhancing treatment system capacity to 

provide accessible, effective, comprehensive, coordinated/integrated, and evidence-based MAT and 

recovery support services. Recovery support services include linking patients and families to social, 

legal, housing, and other supports to improve the probability of positive outcomes. 

The FY 2020 Budget Request is $1.5 billion. This program aims to address the opioid crisis by 

increasing access to medication-assisted treatment using the three FDA-approved medications for 

the treatment of opioid use disorder, reducing unmet treatment need, and reducing opioid overdose 

related deaths through the provision of prevention, treatment and recovery activities for opioid use 

disorder (OUD) (including prescription opioids, heroin and illicit fentanyl and fentanyl analogs). 

Funding was established to award grants to states and territories via formula. The program also 

includes a 15 percent set-aside for the 10 states with the highest mortality rates related to drug 

overdose deaths. The program also includes a $50 million set-aside for tribes. SAMHSA intends to 

continue to support the Secretary’s five-prong strategy to address the opioid crisis priorities through 

regulatory activities, ongoing training, certification, and technical assistance to provider groups and 

communities impacted by the opioid crisis. This effort also includes a tailored approach to the 

delivery of technical assistance via teams of local experts of clinicians, preventionists, and recovery 

specialists. These teams work to meet the unique needs of practitioners, providers, communities, 

and states. 

2 
First Responder Training for Opioid Overdose Reversal Drugs 

 

 

 

Grants to Prevent Prescription Drug and Opioid Overdose-related Deaths 

 

Strategic Prevention Framework for Prescription Drugs (SPF Rx) 

 

 

Community Mental Health Services Block Grant 

 

 

 

 

 

Certified Community Behavioral Health Clinic Expansion Grants 

 

 

 

 

 

 

The FY 2020 Budget Request is $36.0 million. Under Section 202 of the Comprehensive Addiction 

and Recovery Act (CARA), SAMHSA is authorized to support additional efforts to prevent opioid 

overdose-related deaths by providing grants to states, local governments, and tribes to train first 

responders. The purpose of this program is to reduce the number of prescription drug/opioid 

overdose-related deaths and adverse events among individuals at risk for opioid misuse. Grantees 

will train first responders and members of other key community sectors at the local government and 

tribal levels to implement secondary prevention strategies, such as the administration of naloxone 

through FDA-approved delivery devices to reverse the respiratory depression associated with opioid 

overdose. 

The FY 2020 Budget Request is $12.0 million. The Grants to Prevent Prescription Drug and Opioid 

Overdose-related Deaths program helps states identify communities of high need and provide 

education, training, and resources to meet their specific needs. The grant funds can be used for 

purchasing overdose reversing drugs, equipping first responders with these medications, providing 

training on their use, disseminating other overdose-related death prevention strategies, and providing 

materials to assemble and disseminate overdose kits. 

The FY 2020 Budget Request is $10.0 million. SAMHSA implemented the Strategic Prevention 

Framework for Prescription Drugs to raise awareness about the dangers of sharing medications and 

to work with pharmaceutical and medical communities on the risks of overprescribing to young 

adults. SAMHSA’s program focuses on raising community awareness and bringing prescription 

drug misuse prevention activities and education to schools, communities, parents, prescribers, and 

their patients. 

The FY 2020 Budget Request is $722.6 million. This funding continues to serve as a safety net for 

mental health services for some of the nation’s most vulnerable populations. By statute, MHBG 

funds must be used to address the needs of adults with serious mental illness (SMI) and children 

with serious emotional disturbances (SED). SAMHSA will maintain the ten percent set-aside for 

evidence-based programs that address the needs of individuals with early serious mental illness, 

including psychotic disorders. The set-aside helps reduce costs to society, as intervening early helps 

prevent deterioration of functioning in individuals experiencing a first episode of serious mental 

illness. 

The FY 2020 Budget Request is $150.0 million. While effective treatment and supportive services 

exist, many individuals with mental/substance use disorders do not receive the help they need. When 

they do try to access services, they may face significant delays and/or get connected to incomplete, 

disconnected, or uncoordinated care. Even people who receive some services, such as medication 

or psychotherapy, often do not have access to the complete range of supports they need, such as help 

to get them through a crisis, manage co-occurring physical health problems, find and sustain 

employment, and maintain a safe place to live in the community. 

This grant program funding is authorized by the Public Health Service Act, but expands service 

capacity of the organizations created by Congress in the Protecting Access to Medicare Act of 2014. 

3 
Children’s Mental Health Initiative

 

 

 

 

Project AWARE 

That Act directed the creation of Certified Community Behavioral Health Clinics (CCBHCs) and 

supported their providing a comprehensive, coordinated range of services to their communities. 

Through this program, HHS has established criteria for clinics to be certified as CCBHCs. These 

criteria cover six areas that CCBHCS must address to be certified: (1) staffing; (2) availability and 

accessibility of services; (3) care coordination; (4) scope of services; (5) quality and other reporting; 

and (6) organizational authority. The CCBHC Expansion program is designed to increase access to 

and improve the quality of community mental and substance use disorder treatment services. 

CCBHCs funded under this program must provide access to services for individuals with serious 

mental illness (SMI) or substance use disorders (SUD), including opioid use disorders; children and 

adolescents with serious emotional disturbance (SED); and individuals with co-occurring mental and 

substance use disorders. SAMHSA expects that this program will improve the mental health of 

individuals across the nation by providing comprehensive community-based mental and substance 

use disorder services; treatment of co-occurring disorders; advance the integration of 

mental/substance use disorder treatment with physical health care; assimilate and utilize evidencebased practices on a more consistent basis, and promote improved access to high quality care. 

The FY 2020 Budget Request is $125.0 million. Approximately 9-13 percent of America’s youth 

are estimated to have a serious emotional disturbance (SED), the term analogous to serious mental 

illness when applied to children. Unfortunately, only 41 percent of those in need of mental health 

services actually receive treatment. CMHI provides grants to assist states, local governments, 

tribes, and territories in their efforts to deliver services and supports to meet the needs of children 

and youth with SED. The request supports the continuation of the Children’s Mental Health Services

grants to enable states and communities to design comprehensive systems of care to develop 

strategies that address the needs of children and youth with serious emotional disturbances. As part 

of this budget request, SAMHSA seeks to develop and implement services focused on individuals 

at clinical high risk for a serious mental illness. These programs will focus on the prodrome phase. 

During the prodrome phase, a disease process has begun but is not yet diagnosable. These services 

aim to address community-based interventions, which may accomplish the likelihood of 

development of serious emotional disturbances and ultimately serious mental illness. The project 

will examine the extent to which evidence-based early intervention for young people at clinical high 

risk for psychosis can be scaled up to mitigate or delay the progression of mental illness, reduce 

disability, and/or maximize recovery. These programs are expected to make it easier for affected 

individual to receive first episode of psychosis (FEP) program services should symptoms progress. 

The effort, which began in 2018, will be funded from a 10 percent set-aside of the base program. 

1 

The FY 2020 Budget Request is $101.9 million. This program, along with Healthy Transitions and 

Mental Health First Aid, is being requested in support of the Federal Commission on School Safety 

which is aimed at reducing the incidences of school violence across the country and increasing 

school-based mental health services. Project AWARE comprises the Project AWARE State and 

Local Educational Agency grants and the Mental Health Awareness Training (MHAT) grants. 

Project AWARE State Educational Agency grants are awarded to State Education Authorities 

1 Substance Abuse and Mental Health Services Administration, U.S. Department of Health and Human Services. 

(2014). Results from the 2017 National Survey on Drug Use and Health: Summary of National Findings, NSDUH 

Series H-48, HHS Publication No. (SMA) 144863. Rockville, MD: Substance Abuse and Mental Health Services 

Administration. 

4 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(SEAs) to promote comprehensive, coordinated, and integrated state efforts to make schools safer 

and increase access to mental health services. The MHAT grants train school personnel, emergency 

first responders, law enforcement, veterans, armed services members and their families to recognize 

the signs and symptoms of mental disorders, particularly serious mental illness (SMI) and/or serious 

emotional disturbances (SED). Project AWARE supports several strategies for addressing mental 

health in schools: supports for mental wellness in education settings, building awareness of mental 

health issues, and early intervention with coordinated supports. This program also supports a 

network of regional technical assistance centers which provide direct implementation training and 

TA to schools and school systems on the provision of school-based mental health services and 

establishment of positive and nurturing school environments. The program includes an increase of 

$10 million to focus on the specific needs affecting rural communities. These communities struggle 

with access to mental health services in schools and access to qualified health professionals to 

provide such services. The increased funding will support the use of technology and training to 

increase access to services; additionally, an increase of $5 million in the Healthy Transitions 

Program will add a focus on the needs of students in trade schools, colleges, including community 

colleges, and universities. 

Suicide Prevention Activities 

The FY 2020 Budget Request is $74.0 million. Suicide is a critical public health issue involving 

multiple psychological and social factors. It is one of the ten leading causes of death in the United 

States. Suicide rates have increased steadily for individuals of all ages. SAMHSA supports a full 

complement of programs which address the nation’s alarming rates of suicide. These include: the

National Strategy for Suicide Prevention, which focuses on adult suicide prevention, the Garrett Lee 

Smith State and Campus Suicide Programs, which address youth and young adult suicide, and the 

Tribal Training and Technical Assistance Center, which aims to provide needed training and TA to 

tribal communities to develop comprehensive suicide prevention strategies. Through the 

implementation of the 21st Century Cures Act, SAMHSA currently supports the Zero Suicide 

initiative aimed at reducing the rates of adult suicide prevention through the fundamental premise 

that suicide is preventable for individuals involved in the healthcare system. Since 2007, SAMHSA 

has been a partner with the U.S. Department of Veterans Affairs (VA) to enable use of the National 

Suicide Prevention Lifeline as a single entry point to help meet the special needs of veterans in crisis. 

Callers to SAMHSA’s 800-273-TALK number can press “1” to be connected to the VA’s Veterans

Crisis Line. The number is also promoted to active duty personnel, reservists, and their families 

under the name “Military Crisis Line.” SAMHSA’s public private partnership with the Action 

Alliance for suicide prevention includes a military/veterans task force which supports education and 

awareness around suicide prevention as well as efforts to engage military and veteran’s families in

accessing best practices for suicide prevention. 

5 
Assertive Community Treatment (ACT) for Adults with SMI 

 

 

Assisted Outpatient Treatment for (AOT) Individuals with SMI 

 

 

 

Drug Abuse Warning Network (DAWN) 

 

 

 

The FY 2020 Budget Request is $15.0 million. ACT is an evidence-based practice, designed as an 

integrated care approach to provide a comprehensive array of services, including medication 

management and other supportive services, directly rather than through referrals. Funding will 

support the needs of those living with SMI and technical assistance and evaluation activities. 

The FY 2020 Request level is $15.0 million. AOT is the practice of delivering outpatient treatment 

under court order to adults with SMI who meet specific criteria, such as a prior history of repeated 

hospitalizations or arrest. AOT involves petitioning local courts through a civil process to order 

individuals to enter and remain in treatment within the community for a specified period of time. 

Funding will help to identify evidence-based AOT practices that support improved outcomes, 

including outreach and engagement, clinical treatment and supportive services, and due process 

protections. 

The FY 2020 Request is $10.0 million. DAWN is the nationwide public health surveillance 

system that will improve emergency department monitoring of substance use crises, including 

those related to opioids. This program is necessary to respond effectively to the opioid and 

addiction crisis in the United States and to better inform public health, clinicians, policymakers, 

and other stakeholders to respond to emerging substance use trends. 

In addition to these key efforts, SAMHSA is also proposing a legislative change to improve the 

efficient and effective delivery of service provision for individuals across the United States seeking 

care for mental and substance use disorders. SAMHSA is proposing to more closely align 42 CFR 

Part 2 with the HIPAA Privacy regulation. The alignment will ensure that individuals seeking care 

for substance use disorders will have practitioners who are fully equipped with the information 

they need to provide more holistic care to the patient, and will give providers clear guidance 

regarding what is and is not appropriate to share. 

6 
 

 

 

 

 

 

 

 

 

 

Overview of Performance 

Consistent with the Government Performance and Results Modernization Act of 2010, the Substance 

Abuse and Mental Health Services Administration (SAMHSA) continues to refine its use of 

performance and evaluation data to measure impact and mitigate risk. Data-driven performance 

reviews help SAMHSA leadership analyze outcome data and learn the extent to which strategies 

work or need improvement. As impact is measured and reported, SAMHSA seeks to identify the 

conditions that foster success, address barriers, enable collaboration across programs, and promote 

overall efficiency. 

SAMHSA collects critical performance data on both output and outcome measures. Data on services 

programs include: diagnoses, abstinence from substance use, mental health functioning, overall 

physical health, criminal justice involvement, stable housing, social connectedness, and 

employment. Additionally, SAMHSA collects data on the numbers of people served, the numbers 

trained, and the number of training events held. 

SAMHSA also maintains its commitment to utilize these performance data to manage and monitor 

its robust portfolio of grants. In FY 2017, SAMHSA reconfigured its approach to uniform data 

collection with the successful launch and implementation of SAMHSA’s Performance

Accountability and Reporting System (SPARS). This system provides a common data and reporting 

system for all SAMHSA discretionary grantees and allows for programmatic technical assistance on 

use of the data to enhance grantee performance monitoring and improve quality of service delivery. 

In FY 2018, SAMHSA strengthened its internal evaluation ability through the creation of an Office 

of Evaluation in the Center for Behavioral Health Statistics and Quality. This Office partners with 

the National Mental Health and Substance Use Policy Laboratory to ensure that all SAMHSA 

programs are evaluated for effectiveness and that findings related to the most effective evidencebased practices to treat mental illness and substance use disorders are disseminated to the field. 

SAMHSA will continue its efforts to improve upon data collection to better inform service delivery. 

7 
8

Substance Abuse and Mental Health Services Administration

All-Purpose Table

(Dollars in thousands)

FY2018

Final 

FY2019

Enacted 

FY2020

President's 

Budget

FY2020

President's 

Budget

+/- 

FY2019

Mental Health

Programs of Regional and National Significance....................................................... $438,659 $459,661 $429,734 -$29,927

Children's Mental Health Services 125,000 125,000 125,000 --

Set-Aside for Youth in Prodrome Phase of Psychosis (non-add)................. 12,500 12,500 12,500 --

Projects for Assistance in Transition from Homelessness....................................... 64,635 64,635 64,635 --

Protection and Advocacy for Individuals with Mental Illness................................. 36,146 36,146 14,146 -22,000

Community Mental Health Services Block Grant.................................................... 722,571 722,571 722,571 --

Budget Authority (non-add)......................................................................... 701,532 701,532 701,532 --

PHS Evaluation Funds (non-add) ............................................................... 21,039 21,039 21,039 --

Certified Community Behavioral Health Clinics 100,000 150,000 150,000 --

Total. Mental Health.................................................................................................. 1,487,011 1.558.013 1,506,086 -51,227

Budget Authority (non-add)............................................................................ 1,453,972 1,524,974 1,485,047 -39,927

Prevention and Public Health Fund (non-add) ............................................. 12,000 12,000 -- -12,000

PHS Evaluation Funds (non-add)................................................................... 21,039 21,039 21,039 --

Substance Abuse Prevention

Programs of Regional and National Significance....................................................... 248,219 205,469 144,090 -61,379

Drug Free Communities ........................................................................................... -- -- 100,000 100,000

Total. Substance Abuse Pretention........................................................................... 248,219 205,469 244,090 38,621

Substance Abuse Treatment

Programs of Regional and National Significance 399,091 460,677 429,888 -30.789

State Targeted Response to the Opioid Crisis Grants 500,000 -- -- --

State Opioid Response Grants 1,000,000 1,500,000 1,500,000 --

Substance Abuse Prevention and Treatment Block Grant 1,858,079 1,858,079 1,858,079 --

Budget Authority (non-add)............................................................................ 1,778,879 1,778,879 1,778,879 -- 

PHS Evaluation Funds (non-add) ............................................................... 79,200 79,200 79,200 --

Total, Substance Abuse Treatment ......................................................................... 3,757,170 3,818,756 3,787,967 -30.789

SAT Budget Authority (non-add) .................................................................... 3,675,970 3,737,556 3,708,767 -28,789

SAT PHS Evaluation Funds (non-add).......................................................... 81,200 81,200 79,200 -2,000

Health Surveillance and Program Support

Health Surveillance and Program Support 126,258 126,258 106,885 -19,373

Data Request and Publications User Fees................................................................ 1,500 1.500 1,500 --

Public Awareness and Support.................................................................................. 13,000 13,000 11,572 -1,428

Performance and Quality Information Systems....................................................... 10,000 10,000 10,000 --

Behavioral Health Workforce Data and Development ............................................ 1,000 1,000 1,000 --

PHS Evaluation Funds (non-add) ................................................................ 1,000 1,000 1,000 --

Drug Abuse Warning Network................................................................................. 10,000 10,000 10.000 --

PHS Evaluation Funds (non-add) ............................................................... -- -- 10,000 10,000

Total. Health Surveillance and Program Support................................................. 161,758 161,758 140,957 -20,801

HSPS Budget Authority’ (non-add) ................................................................ 128,830 128,830 97,004 -31,826

HSPS PHS Evaluation Funds (non-add) ....................................................... 31,428 31,428 42,453 +11,025

Data Request and Publications User Fees(non-add)...................................... 1,500 1,500 1,500 --

TOTAL, SAMHSA Program Level......................................................................... 5,654,158 5,743,996 5,679,100 -64,896

Nonrecurring Expenses Fund (NEF)1 ..................................................................... -- 3.000 -- --

Less Funds from Other Sources:

Prevention and Public Health Fund (non-add) ........................................... -12,000 -12,000 -- +12,000

PHS Evaluation Funds................................................................................ -133,667 -133,667 -142,692 -9,025

Data Request and Publications User Fees........................................................ -1,500 -1,500 -1,500 --

TOTAL, SAMHSA Budget Authority ..................................................................... $5,506,991 $5.596.829 $5,534,908 -61,921
SAMHSA 

Budget Exhibits 

Table of Contents 

1. Appropriation Language ............................................................................................. 10 

2. Language Analysis...................................................................................................... 13 

3. Amounts Available for Obligation.............................................................................. 17 

4. Summary of Changes.................................................................................................. 18 

5. Budget Authority by Activity ..................................................................................... 19 

6. Authorizing Legislation .............................................................................................. 21 

7. Appropriations History ............................................................................................... 25 

8. Appropriations Not Authorized by Law ..................................................................... 27 

9 
 Appropriations Language 

 

 

 

SUBSTANCE ABUSE AND MENTAL HEALTH SERVICES ADMINISTRATION 

MENTAL HEALTH 

For carrying out titles III, V, and XIX of the PHS Act with respect to mental health and the 

Protection and Advocacy for Individuals with Mental Illness Act, [$1,524,974,000] 

$1,485,047,000: [Provided, That of the funds made available under this heading, $63,887,000 shall 

be for the National Child Traumatic Stress Initiative, of which $10,000,000 shall be awarded not 

later than December 1, 2018, for activities described in the joint explanatory statement 

accompanying this Act:] Provided [further], That notwithstanding section 520A(f)(2) of the PHS 

Act, no funds appropriated for carrying out section 520A shall be available for carrying out section 

1971 of the PHS Act: Provided further, That in addition to amounts provided herein, $21,039,000 

shall be available under section 241 of the PHS Act to supplement funds otherwise available for 

mental health activities and to carry out subpart I of part B of title XIX of the PHS Act to fund 

section 1920(b) technical assistance, national data, data collection and evaluation activities, and 

further that the total available under this Act for section 1920(b) activities shall not exceed 5 

percent of the amounts appropriated for subpart I of part B of title XIX: Provided further, That up 

to 10 percent of the amounts made available to carry out the Children's Mental Health Services 

program may be used to carry out demonstration grants or contracts for early interventions with 

persons not more than 25 years of age at clinical high risk of developing a first episode of 

psychosis: [Provided further, That section 520E(b)(2) of the PHS Act shall not apply to funds 

appropriated in this Act for fiscal year 2019: Provided further, That States shall expend at least 10 

percent of the amount each receives for carrying out section 1911 of the PHS Act to support 

evidence-based programs that address the needs of individuals with early serious mental illness, 

including psychotic disorders, regardless of the age of the individual at onset:] Provided further, 

That $150,000,000 shall be available until September 30, [2021] 2022 for grants to communities 

and community organizations who meet criteria for Certified Community Behavioral Health 

Clinics pursuant to section 223(a) of Public Law 113–93: Provided further, That none of the funds 

provided for section 1911 of the PHS Act shall be subject to section 241 of such Act: Provided 

further, That of the funds made available under this heading, $15,000,000 shall be available to 

carry out section 224 of the Protecting Access to Medicare Act of 2014 (Public Law 113–93; 42 

U.S.C. 290aa 22 note). 

SUBSTANCE ABUSE TREATMENT 

For carrying out titles III and V of the PHS Act with respect to substance abuse treatment 

and title XIX of such Act with respect to substance abuse treatment and prevention and the 

SUPPORT for Patients and Communities Act, [$3,737,556,000] $3,708,767,000: Provided, That 

$1,500,000,000 shall be for State Opioid Response Grants for carrying out activities pertaining to 

opioids undertaken by the State agency responsible for administering the substance abuse 

prevention and treatment block grant under subpart II of part B of title XIX of the PHS Act (42 

U.S.C. 300x–21 et seq.): Provided further, That of such amount $50,000,000 shall be made 

available to Indian Tribes or tribal organizations: Provided further, That 15 percent of the 

remaining amount shall be for the States with the highest mortality rate related to opioid use 

disorders: Provided further, That of the amounts provided for State Opioid Response Grants not 

more than 2 percent shall be available for Federal administrative expenses, training, technical 

10 
 

assistance, and evaluation: Provided further, That of the amount not reserved by the previous three 

provisos, the Secretary shall make allocations to States, territories, and the District of Columbia 

according to a formula using national survey results that the Secretary determines are the most 

objective and reliable measure of drug use and drug-related deaths: [Provided further, That the 

Secretary shall submit the formula methodology to the Committees on Appropriations of the 

House of Representatives and the Senate not less than 15 days prior to publishing a Funding 

Opportunity Announcement:] Provided further, That prevention and treatment activities funded 

through such grants may include education, treatment (including the provision of medication), 

behavioral health services for individuals in treatment programs, referral to treatment services, 

recovery support, and medical screening associated with such treatment: Provided further, That 

each State, as well as the District of Columbia, shall receive not less than $4,000,000: Provided 

further, That in addition to amounts provided herein, [the following amounts] $79,200,000 shall be 

available under section 241 of the PHS Act to supplement funds otherwise available for substance 

abuse treatment activities and [(1) $79,200,000] to carry out subpart II of part B of title XIX of the 

PHS Act to fund section 1935(b) technical assistance, national data, data collection and evaluation 

activities, and further that the total available under this Act for section 1935(b) activities shall not 

exceed 5 percent of the amounts appropriated for subpart II of part B of title XIX [; and (2) 

$2,000,000 to evaluate substance abuse treatment programs]: Provided further, That of the funds 

made available under this heading, $4,000,000 shall be available to carry out section 3203 of the 

SUPPORT for Patients and Communities Act: Provided further, That none of the funds provided 

for section 1921 of the PHS Act or State Opioid Response Grants shall be subject to section 241 of 

such Act. 

SUBSTANCE ABUSE PREVENTION 

For carrying out titles III and V of the PHS Act with respect to substance abuse prevention 

and for the Drug-Free Communities Support Program authorized by the National Narcotics 

Leadership Act of 1988, as amended, [$205,469,000] $244,090,000, of which $2,000,000 shall be 

made available as directed by section 4 of Public Law 107–82, as amended by Public Law 115–

271, and $3,000,000, to remain available until expended, shall be for activities authorized by 

section 103 of Public Law 114–198. 

11 
HEALTH SURVEILLANCE AND PROGRAM SUPPORT 

For program support and cross-cutting activities that supplement activities funded under the 

headings "Mental Health", "Substance Abuse Treatment", and "Substance Abuse Prevention" in 

carrying out titles III, V, and XIX of the PHS Act and the Protection and Advocacy for Individuals 

with Mental Illness Act in the Substance Abuse and Mental Health Services Administration, 

[$128,830,000] $97,004,000: Provided, That in addition to amounts provided herein, 

[$31,428,000] $42,453,000 shall be available under section 241 of the PHS Act to supplement 

funds available to carry out national surveys on drug abuse and mental health, to collect and 

analyze program data, and to conduct public awareness and technical assistance activities: 

Provided further, That, in addition, fees may be collected for the costs of publications, data, data 

tabulations, and data analysis completed under title V of the PHS Act and provided to a public or 

private entity upon request, which shall be credited to this appropriation and shall remain available 

until expended for such purposes: Provided further, That amounts made available in this Act for 

carrying out section 501(o) of the PHS Act shall remain available through September 30, [2020] 

2021: Provided further, That funds made available under this heading may be used to supplement 

program support funding provided under the headings "Mental Health", "Substance Abuse 

Treatment", and "Substance Abuse Prevention". 

12 
13 

Language Analysis 

Language Provision Explanation

For carrying out titles III, V, and XIX of the 

PHS Act with respect to mental health, and the 

Protection and Advocacy for Individuals with 

Mental Illness Act $1,485,047,000: [Provided, 

That of the funds made available under this 

heading, $63,887,000 shall be for the National 

Child Traumatic Stress Initiative, of which 

$10,000,000 shall be awarded not later than 

December 1, 2018, for activities described in

the joint explanator statement accompanying 

this Act:] Provided further, That

notwithstanding section 520A(f)(2) of the PHS 

Act, no funds appropriated for carrying out 

section 520A shall be available for carrying out 

section 1971 of the PHS Act:

Identifies the purpose for which funds can be 

used for mental health. Language regarding the 

National Child Traumatic Stress Initiative is 

removed because a separate funding proviso is 

unnecessary and duplicative.

Provided further, That in addition to amounts 

provided herein, $21,039,000 shall be available 

under section 241 of the PHS Act to supplement 

funds otherwise available for mental health 

activities and to carry out subpart I of part B of 

title XIX of the PHS Act to fund section 1920(b) 

technical assistance, national data, data 

collection and evaluation activities, and further 

that the total available under this Act for section 

1920(b) activities shall not exceed 5 percent of 

the amounts appropriated for subpart I of part B 

of title XIX:

Sets the amount of Public Health Service 

Evaluation Fund dollars allocated to 

supplement the budget authority for programs 

for mental health activities and programs 

authorized under title XIX as well as under titles 

III and V.

[Provided further, That section 520E(b)(2) of 

the PHS Act shall not apply to funds 

appropriated in this Act for fiscal year 2019: 

Provided further, That States shall expend at

least 10 percent of the amount each receives for 

carrying out section 1911 of the PHS Act to 

support evidence-based programs that address 

the needs of individuals with early serious 

mental illness, including psychotic disorders, 

regardless of the age of the individual at onset:]

Language is removed because a separate 

funding proviso is unnecessary and duplicative.
14 

Language Provision Explanation

Provided further, That $150,000,000 shall be 

available until September 30, [2021] 2022 for 

grants to communities and community 

organizations who meet criteria for Certified 

Community Behavioral Health Clinics pursuant 

to section 223(a) of Public Law 113–93: 

Provided further, That none of the funds 

provided for section 1911 of the PHS Act shall 

be subject to section 241 of such Act: Provided 

further, That of the funds made available under 

this heading, $15,000,000 shall be to carry out 

section 224 of the Protecting Access to 

Medicare Act of 2014 (Public Law 113–93; 42 

U.S.C. 290aa 22 note). 

Identifies the purpose and extend available time 

for which funds can be used. 

For carrying out titles III and V of the PHS Act

with respect to substance abuse treatment and 

title XIX of such Act with respect to substance 

abuse treatment and prevention and the 

SUPPORT for Patients and Communities Act, 

$3,708,767,000:

Sets out the budget authority for the Substance 

Abuse Treatment appropriation to include the 

SUPPORT for Patients and Communities Act

Provided further, That in addition to amounts 

provided herein, [the following amounts] 

$79,200,000 shall be available undersection 

241 of the PHS Act to supplement funds

otherwise available for substance abuse 

treatment activities and [: (1) $79,200,000] to 

carry out subpart II of part B of title XIX of the 

PHS Act to fund section 1935(b) technical 

assistance, national data, data collection and 

evaluation activities, and further that the total 

available under this Act for section 1935(b) 

activities shall not exceed 5 percent of the

amounts appropriated for subpart II of part B of 

title XIX [; and (2) $2,000,000 to evaluate 

substance abuse treatment programs]:

Sets the amount of Public Health Service

Evaluation Fund dollars allocated to

supplement the budget authority available for 

programs and activities authorized under title 

XIX, titles III and V, and substance abuse 

treatment activities.
15 

Language Provision Explanation

Provided further, That of the funds made 

available under this heading, $4,000,000 shall 

be available to carry out section 3203 of the

SUPPORT for Patients and Communities Act: 

Provided further, That none of the funds 

provided for section 1921 of the PHS Act or 

State Opioid Response Grants shall be subject to 

section 241 of such Act.

Includes section 3203 of the SUPPORT for 

Patients and Communities Act.

For carrying out titles III and V of the PHS 

Act with respect to substance abuse 

prevention and for the Drug-Free 

Communities Support Program authorized 

by the National Narcotics Leadership Act of 

1988, as amended, $205,469,000] 

$244,090,000, of which $2,000,000 shall be 

made available as directed by section 4 of 

Public Law 107–82, as amended by Public 

Law 115–271, and $3,000,000, to remain 

available until expended, shall be for 

activities authorized by section 103 of Public 

Law 114–198.

Identifies the purpose for which funds can be 

used for substance abuse prevention. Includes 

language to fund the Drug Free Communities 

Support Program. 

For program support and cross-cutting 

activities that supplement activities funded 

under the headings "Mental Health", 

"Substance Abuse Treatment", and "Substance 

Abuse Prevention" in carrying out titles III, V, 

and XIX of the PHS Act and the Protection and 

Advocacy for Individuals with Mental Illness

Act in the Substance Abuse and Mental Health

Services Administration, [$128,830,000] 

$97,004,000: Provided, That in addition to 

amounts provided herein, [$31,428,000] 

$42,453,000 shall be available under section 

241 of the PHS Act to supplement funds 

available to carry out national surveys on drug 

abuse and mental health, to collect and analyze 

program data, and to conduct public awareness 

and technical assistance activities:

Identifies the purpose for which funds can be 

used for health surveillance and program 

support.
16 

Language Provision Explanation

Provided further, That, in addition, fees may 

be collected for the costs of publications, data, 

data tabulations, and data analysis completed 

under title V of the PHS Act and provided to a 

public or private entity upon request, which 

shall be credited to this appropriation and shall 

remain available until expended for such 

purposes: Provided further, That amounts 

made available in this Act for carrying out 

section 501(o) of the PHS Act shall remain

available through September 30, [2020] 2021: 

Provided further, That funds made available 

under this heading may be used to supplement 

program support funding provided under the 

headings "Mental Health", "Substance Abuse 

Treatment", and "Substance Abuse

Prevention".
Amounts Available for Obligation 

(Whole dollars) 

 

 

 --

-

 -

--

 

 -

--

 

 

 -

--

 -

--

 

 

 --

- 

 -

--

 --

-

 -

--

 

 

 

FY 2018 

Final 

FY 2019 

Enacted 

FY 2020 

President's 

Budget 

General Fund Discretionary Appropriation: 

Appropriation..................................................................... 

Across-the-board reductions.............................................. 

Subtotal, Appropriation................................................... 

Rescission.......................................................................... 

Subtotal, adjusted appropriation....................................... 

Total, Discretionary Appropriation........................... 

Mandatory Appropriation: 

$5,506,991,000 $5,596,829,000 $5,534,908,000 

---

5,506,991,000 

---

5,506,991,000 

5,596,829,000 

5,596,829,000 

5,534,908,000

5,534,908,000 

5,506,991,000 5,596,829,000 5,534,908,000

Transfer from the Prevention and Public Health Funds.... 

Subtotal, adjusted mandatory appropriation...................... 

Offsetting collections from: 

Federal Source....................................................................... 

Data Request and Publications User Fees............................... 

Unobligated balance, start of year........................................... 

Unobligated balance, end of year............................................ 

Unobligated balance, lapsing................................................. 

Total obligations............................................................... 

12,000,000 12,000,000 

12,000,000 

133,667,000 

1,500,000 

--- 

---

---

12,000,000 

133,667,000 

1,500,000 

--

-

142,692,000 

1,500,000

-

--

$5,654,158,000 $5,743,996,000 $5,679,100,000 

17 

--

-
Summary of Changes 

2019 

2020 

1. Annualization of 2019 commissioned corps pay increase........... $5,226,748 +307,056

2. Annualization of 2019 civilian pay increase................................. 75,539,506 +11,843,613

Subtotal, Built-in Increases........................................................ 80,766,254 +12,150,669

B. Program:

1. Drug Free Communities.................................................................. 100,000,000 +100,000,000

Subtotal, Built-in Increases.......................................................... 100,000,000 +100,000,000

Total Increases.......................................................................... --- --- --- +112,150,669

Decreases: 

A. Built-in:

1. Absorption of built -in increases ..................................................... -12,150,669

Subtotal, Built-in Decreases........................................................ -12,150,669

B. Program:

1. Health Surveillance and Program Support...................................... 87,004,000 -31,826,000

2. Mental Health.................................................................................. 1,485,047,000 -39,927,000

3. Substance Abuse Prevention PRNS............................................... 144,090,000 -61,379,000

4.Substance Abuse Treatment ............................................................ 3,708,767,000 -28,789,000

Subtotal, Program Decreases....................................................... 5,424,908,000 -161,921,000

Total Decreases......................................................................... --- --- --- -174,071,669

Net Change........................................................................... --- $--- $--- -$61,921,000

(Whole dollars) 

Total estimated budget authority.................................................................................................................................... $5,596,829,000 

(Obligations)................................................................................................................ ....................................................... 5,596,829,000 

Total estimated budget authority.................................................................................................................................... 

................................................................................. ....................................................... 

...................................................................................... .................................................. 

 5,534,908,000 

(Obligations)............................... 5,534,908,000 

Net Change............................. -$61,921,000 

FY 2020 

PB FTE 

FY 2020 

PB BA 

FY 2020 

+/-

FY 2019 

FTE 

FY 2020 

+/-

FY 2019 

BA 

Increases: 

A. Built-in:

18 
19

Budget Authority by Activity

(Dollars in thousands) 

Program

FY 2018

Final

FY 2019

Enacted

FY 2020

President's

Budget

Mental Health

Programs of Regional and National Significance $438,659 $459,661 $429,734

Prevention and Public Health Fund (non-add) ............ 12,000 12,000 --

Children's Mental Health Services............................................. 125,000 125,000 125,000

Projects for Assistance in Transition from Homelessness .......... 64,635 64,635 64,635

Protection and Advocacy for Individuals with Mental Illness. 36,146 36,146 14,146

Community Mental Health Services Block Grant...................... 722,571 722,571 722,571

Budget Authority (non-add) ............................................ 701,532 701,532 701,532

PHS Evaluation Funds (non-add).................................. 21,039 21,039 21,039

Certified Community Behavioral Health Clinics....................... 100,000 150,000 150,000

Total, Mental Health................................................................. 1,487,011 1,558,013 1,506,086

Substance Abuse Prevention

Programs of Regional and National Significance ....................... 248,219 205,469 144,090

Drug Free Communities............................................................. -- -- 100,000

Total, Substance Abuse Prevention......................................... 248,219 205,469 244,090

Substance Abuse Treatment

Programs of Regional and National Significance ....................... 399,091 460,677 429,888

State Targeted Response to the Opioid Crisis Grants.............. 500,000 -- --

State Opioid Response Grants ................................................. 1,000,000 1,500,000 1,500,000

Substance Abuse Prevention and Treatment Block Grant... 1,858,079 1,858,079 1,858,079

Budget Authority (non-add) ............................................ 1,778,879 1,778,879 1,778,879

PHS Evaluation Funds (non-add).................................. 81,200 81,200 79,200

Total, Substance Abuse Treatment. ....................................... 3,757,170 3,818,756 3,787,967

Health Surveillance and Program Support

Health Surveillance and Program Support 126,258 126,258 106,885

Budget Authority (non-add) ............................................ 16,830 16,830 2,389

PHS Evaluation Funds (non-add).................................. 30,428 30,428 31,453

Public Awareness and Support................................................... 13,000 13,000 11,572

Performance and Quality Information Systems .......................... 10,000 10,000 10,000

Data Request and Publications User Fees................................... 1,500 1,500 1,500

Behavioral Health Workforce Data and Development................ 1,000 1,000 1,000

PHS Evaluation Funds (non-add).................................. 1,000 1,000 1,000

Drug Abuse Warning Network .................................................. 10,000 10,000 10,000

PHS Evaluation Funds (non-add).................................. -- -- 10,000

Total, Health Surveillance and Program Support. ............... 161,758 161,758 140,957

TOTAL, SAMHSA Program Level......................................... 5,654,158 5,743,996 5,679,100

Less Funds from Other Sources:

Prevention and Public Health Fund (non-add) ............ -12,000 -12,000 --

PHS Evaluation Funds.................................................. -133,667 -133,667 -142,692

Data Request and Publications User Fees .................. -1,500 -1,500 -1,500

TOTAL, SAMHSA Budget Authority..................................... $5,506,991 $5,596,829 $5,534,908

FTEs 561 611 606
 Page intentionally left blank 

20 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Substance Abuse and Mental Health Services Administration 

Program Authorizing Legislation 

(Dollars in Thousands) 

OPDIV/ 

StaffDiv Program Name 

Location of Program 

Authorization 

Legal Citation 

(US Code) 

Most Recent 

(Re)Authorizing 

Legislation 

FY 2020 

Authorization 

FY 

Auth. 

Expires 

or 

Expired 

Nature of 

Expiration 

SAMHSA Grants for the Benefit 

of Homeless 

PHS Act, Section 506 (42 U.S.C. 290aa–5) Pub. L. 114–255 $ 41,304 2022 

SAMHSA Residential Treatment 

Programs for 

Pregnant and 

Postpartum Women 

PHS Act, Section 508 (42 U.S.C. 290bb–1) Pub. L. 114–198 $ 16,900 2021 

SAMHSA Priority Substance 

Abuse Treatment 

Needs of Regional 

and National 

Significance 

PHS Act, Section 509 (42 U.S.C. 290bb–2) Pub. L. 114–255 $ 333,806 2022 

SAMHSA Substance Abuse 

Treatment Services 

for Children and 

Adolescents 

PHS Act, Section 514 (42 U.S.C. 290bb–7) Pub. L. 114–255 $ 29,605 2022 

SAMHSA Priority Substance 

Abuse Prevention 

Needs of Regional and 

National Significance 

PHS Act, Section 516 (42 U.S.C. 290bb–22) Pub. L. 114–255 $ 211,148 2022 

SAMHSA Sober Truth on 

Preventing Underage 

Drinking 

PHS Act, Section 519B (42 U.S.C. 290bb–

25b) 

Pub. L. 114–255 $ 3,000 2022 

SAMHSA Priority Mental Health 

Needs of Regional and 

National Significance 

PHS Act, Section 520A (42 U.S.C. 290bb–32) Pub. L. 114–255 $ 394,550 2022 

21 
Substance Abuse and Mental Health Services Administration 

Program Authorizing Legislation (cont.) 

(Dollars in Thousands) 

OPDIV/ 

StaffDiv Program Name 

Location of 

Program 

Authorization 

Legal Citation 

(US Code) 

Most Recent 

(Re)Authorizing 

Legislation 

FY 2020 

Authorization 

FY 

Auth. 

Expires 

or 

Expired 

Nature of 

Expiration 

SAMHSA Suicide Prevention 

Technical Assistance 

Center 

PHS Act, Section 

520C 

(42 U.S.C. 290bb–

34) 

Pub. L. 114–255 $ 5,988 2022 

SAMHSA Youth Suicide Early 

Intervention and 

Prevention Strategies 

PHS Act, Section 

520E 

(42 U.S.C. 290bb–

36) 

Pub. L. 114–255 $ 30,000 2022 

SAMHSA Mental Health and 

Substance Use Disorder 

Services on Campus 

PHS Act, Section 

520E-2 

(42 U.S.C. 290bb–

36b) 

Pub. L. 114–255 $ 7,000 2022 

SAMHSA National Suicide 

Prevention Lifeline 

Program 

PHS Act, Section 

520E-3 

(42 U.S.C. 290bb–

36c) 

Pub. L. 114–255 $ 7,198 2022 

SAMHSA Grants for Jail Diversion 

Programs 

PHS Act, Section 

520G 

(42 U.S.C. 290bb–

38) 

Pub. L. 114–255 $ 4,269 2022 

SAMHSA Mental Health 

Awareness Training 

PHS Act, Section 

520J 

(42 U.S.C. 290bb–

41) 

Pub. L. 114–255 $ 14,693 2022 

SAMHSA Promoting Integration of 

Primary and Behavioral 

Health Care 

PHS Act, Section 

520K 

(42 U.S.C. 290bb–

42) 

Pub. L. 114–255 $ 51,878 2022 

SAMHSA Adult Suicide 

Prevention 

PHS Act, Section 

520L 

(42 U.S.C. 290bb–

43) 

Pub. L. 114–255 $ 30,000 2022 

SAMHSA Assertive Community 

Treatment Grant 

Program 

PHS Act, Section 

520M 

(42 U.S.C. 290bb–

44) 

Pub. L. 114–255 $ 5,000 2022 

22 
 

Substance Abuse and Mental Health Services Administration 

Program Authorizing Legislation (cont.) 

(Dollars in Thousands) 

OPDIV/ 

StaffDiv Program Name 

Location of Program 

Authorization 

Legal Citation 

(US Code) 

Most Recent 

(Re)Authorizing 

Legislation 

FY 2020 

Authorization 

FY 

Auth. 

Expires 

or 

Expired 

Nature of 

Expiration 

SAMHSA Projects for Assistance 

in Transition From 

Homelessness 

PHS Act, Section 

535(a) 

(42 U.S.C. 290cc–

35(a)) 

Pub. L. 114–255 $ 64,635 2022 

SAMHSA First Responder 

Training 

PHS Act, Section 546 (42 U.S.C. 290ee-2) Pub. L. 114–198 $ 12,000 2021 

SAMHSA Building Communities 

of Recovery 

PHS Act, Section 547 (42 U.S.C. 290ee-2) Pub. L. 114–198 $ 1,000 2021 

SAMHSA Community Mental 

Health Services for 

Children with Serious 

Emotional 

Disturbances 

PHS Act, Section 

565(f)(1) 

(42 U.S.C. 290ff-4) Pub. L. 114–255 $ 119,026 2022 

SAMHSA National Child 

Traumatic Stress 

Initiative 

PHS Act, Section 582 (42 U.S.C. 290hh–

1) 

Pub. L. 114–255 $ 46,887 2022 

SAMHSA Community Mental 

Health Services Block 

Grants 

PHS Act, Section 

1911 

(42 U.S.C. 300x) Pub. L. 114–255 $ 532,571 2022 

SAMHSA Substance Abuse 

Prevention and 

Treatment Block 

Grants 

PHS Act, Section 

1921 

(42 U.S.C. 300x21) Pub. L. 114–255 $ 1,858,079 2022 

23 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Substance Abuse and Mental Health Services Administration 

Program Authorizing Legislation (cont.) 

(Dollars in Thousands) 

FY 

Auth. 

Expires 

or 

Expired 

OPDIV/ 

StaffDiv Program Name 

Location of Program 

Authorization 

Legal Citation 

(US Code) 

Most Recent 

(Re)Authorizing 

Legislation 

FY 2020 

Authorization 

Nature of 

Expiration 

SAMHSA Assisted Outpatient 

Treatment Grant 

Section 224 of the Protecting Access 

to Medicare Act of 2014 

(42 U.S.C. 290aa note) Pub. L. 114–255 $ 19,000 2022 

Program for 

Individuals With 

SMI 

SAMHSA Protection and 

Advocacy for 

Individuals with 

Mental Illness 

Section 117 of the Protection and 

Advocacy of Mentally Ill 

Individuals Act of 1986 

(42 U.S.C. 10827) Pub. L. 99-319 $ 19,500 2003 Expired from 

the Protection 

and Advocacy 

of Mentally 

Ill Individuals 

Act of 1986 

SAMHSA Heath Surveillance PHS Act, Section 501, 505 (42 U.S.C. 290aa, 290aa–

4) 

Pub. L. 114–255 Indefinite 

SAMHSA Public Awareness PHS Act, Section 501, 509, 516, (42 U.S.C. 290aa, 290bb- Pub. L. 114–255 Indefinite 

and Support 520A 2, 290bb-22, 290bb-32) 

SAMHSA Performance and 

Quality 

Improvement 

Systems 

PHS Act, Section 501, 509, 516, 

520A 

(42 U.S.C. 290aa, 290bb2, 290bb-22, 290bb-32) Pub. L. 114–255 Indefinite 

24 
Substance Abuse and Mental Health Services Administration 

Appropriation History Table 

(Whole dollars) 

Budget Estimate 

to Congress

House 

Allowance

Senate 

Allowance Appropriation

FY 2010

General Fund Appropriation:

Base P.L. 111-117......................... $3,393,882,000 $3,429,782,000 $3,419,438,000 $3,431,116,000 / 1

Subtotal......................................... $3,393,882,000 $3,429,782,000 $3,419,438,000 $3,431,116,000

FY 2011

General Fund Appropriation:

Base P.L. 112-10........................... $3,541,362,000 $3,565,360,000 $3,576,184,000 $3,386,311,000

Subtotal......................................... $3,541,362,000 $3,565,360,000 $3,576,184,000 $3,386,311,000

FY 2012

General Fund Appropriation:

Base P.L. 112-74........................... $3,386,903,000 $3,096,914,000 $3,354,637,000 $3,347,020,000 / 2

Subtotal......................................... $3,386,903,000 $3,096,914,000 $3,354,637,000 $3,347,020,000

FY 2013

General Fund Appropriation:

Base S.R. 112-176 ....................... $3,151,508,000 --- $3,472,213,000 $3,172,154,778 / 3

Subtotal......................................... $3,151,508,000 --- $3,472,213,000 $3,172,154,778

FY 2014

General Fund Appropriation:

Base S.R. 113-071......................... $3,347,951,097 --- $3,529,944,000 $3,434,935,000 / 4

Subtotal......................................... $3,347,951,097 --- $3,529,944,000 $3,434,935,000

FY 2015

General Fund Appropriation:

Base P.L. 113-235......................... $3,297,669,000 --- $3,431,878,000 $3,474,045,000 / 5

Subtotal......................................... $3,297,669,000 --- $3,431,878,000 $3,474,045,000

FY 2016

General Fund Appropriation:

Base P.L. 114-113......................... $3,395,663,000 $3,642,710,000 $3,314,817,000 $3,634,269,000 / 6

Subtotal......................................... $3,395,663,000 $3,642,710,000 $3,314,817,000 $3,634,269,000

FY 2017

General Fund Appropriation:

21st Century Cures Act.............. $500,000,000 / 7

Base P.L. 115-31........................... $3,488,783,000 $4,211,603,000 $3,739,577,000 $3,611,003,000 / 8

Subtotal......................................... $3,488,783,000 $4,211,603,000 $3,739,577,000 $4,111,003,000

Appropriation History Table

25 
Substance Abuse and Mental Health Services Administration 

Appropriation History Table Cont’d

 

 

 

 

 

 

 

 

 

 

 

(Whole dollars) 

FY 2018 

General Fund Appropriation: 

21st Century Cures Act.............. 

Base P.L. 115-141......................... 

Subtotal......................................... 

Budget 

Estimate to 

Congress 

Appropriation History Table (cont'd) 

$3,770,668,000 

$3,770,668,000 

House 

Allowance 

$4,193,936,000 

$4,193,936,000 

Senate 

Allowance 

$4,279,092,000 

$4,279,092,000 

Appropriation 

$500,000,000 

$4,513,327,000 

$5,013,327,000 

/7 

/9 

FY 2019 

General Fund Appropriation: 

Base P.L. 115-245......................... 

Subtotal......................................... 

$3,425,887,000 

$3,425,887,000 

$5,319,561,000 

$5,319,561,000 

$5,592,827,000 

$5,592,827,000 

$5,596,829,000 

$5,596,829,000 

/10 

FY 2020 

General Fund Appropriation: 

Base............................................... 

Subtotal......................................... 

$5,534,908,000

$5,534,908,000 

---

---

---

---

---

---

1/ Reflects a $508 thousand transfer to HHS. 

2/ Reflects a 0.189 percent across-the-board Rescission from the P.L. 112-74, and $953,809 Ryan White transfer. 

3/ Reflects the annualized level provided by the continuing resolution. 

4/ Reflects the whole year appropriation. 

5/ Reflects the whole year appropriation. 

6/ Reflects the whole year appropriation. 

7/ Reflects the additional amount provided to the Secretary of Health and Human Services to carry out the authorizations in the 21st 

Century Cures Act (Public Law 114–67), at a rate for operations of $500,000,000. 

8/ Reflects the whole year appropriation. 

9/ Reflects the Annualized Continuing Resolution. 

10/ Reflects the whole year appropriation. 

26 
Substance Abuse and Mental Health Services Administration 

Appropriations Not Authorized by Law 

 

(Whole dollars) 

Program 

Last Year of 

Authorization 

Authorization 

Level 

Appropriation 

in 

Last Year of 

Authorization 

Appropriation 

in FY 2019 

Protection and Advocacy for Individuals with Mental Illness Act 

P.L. 99-319, Sec. 117..................................... 2003 $ 19,500,000 $ 36,146,000 $ 36,146,000 

TOTAL, SAMHSA Budget Authority....... $ 19,500,000 $ 36,146,000 $ 36,146,000 

27 
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28 
SAMHSA 

Mental Health 

Table of Contents 

1. Mental Health Appropriation............................................................................................ 31 

2. Programs of Regional and National Significance (PRNS) ............................................... 32 

a) National Child Traumatic Stress Network............................................................ 33 

b) Project AWARE.................................................................................................... 37 

c) Healthy Transitions............................................................................................... 40 

d) Children and Family Programs ............................................................................. 43 

e) Consumer and Family Network Grants ................................................................ 45 

f) Project LAUNCH.................................................................................................. 47 

g) Mental Health System Transformation and Health Reform ................................. 51 

h) Primary and Behavioral Health Care Integration.................................................. 54 

i) Suicide Prevention Programs................................................................................ 57 

i. National Strategy for Suicide Prevention ....................................................... 58 

ii. Garrett Lee Smith Youth Suicide Prevention – State/Tribal and Campus...... 60 

iii. Garrett Lee Smith Suicide Prevention Resource Center................................. 62 

iv. Suicide Lifeline............................................................................................... 64 

v. American Indian/Alaska Native Suicide Prevention Initiative ....................... 67 

a. Homelessness Prevention Programs ..................................................................... 70 

b. Minority AIDS and HIV/AIDS Education ........................................................... 74 

c. Criminal and Juvenile Justice Programs ............................................................... 76 

d. Practice Improvement and Training...................................................................... 80 

e. Consumer and Consumer-Supporter TA Centers ................................................. 82 

f. Disaster Response ................................................................................................. 84 

g. Seclusion and Restraint......................................................................................... 87 

h. Assisted Outpatient Treatment for Individuals with Serious Mental Illness ........ 89 

i. Tribal Behavioral Health Grants........................................................................... 94 

j. Minority Fellowship Program............................................................................... 97 

k. Assertive Community Treatment for Individuals with Serious Mental Illness .... 99 

l. Infant and Early Childhood Mental Health......................................................... 102 

3. PRNS Mechanism Table Summary ................................................................................ 105 

4. PRNS Mechanism Table by Program, Project, and Activity.......................................... 106 

5. Grant Awards Table........................................................................................................ 114 

6. Children's Mental Health Services.................................................................................. 115 

7. Projects for Assistance in Transition from Homelessness (PATH)................................ 121 

8. Protection and Advocacy for Individuals with Mental Illness (PAIMI)......................... 127 

9. Certified Community Behaviroal Health Clinic ............................................................. 132 

10. Community Mental Health Services Block Grant (MHBG)........................................... 136 

29 
Page intentionally left blank 

30 
Programs of Regional and National Significance......................... $438,659 $459,661 $429,734 -29,927

Prevention and Public Health Fund (non -add)..................... 12,000 12,000 --- -12,000

Children's Mental Health Services................................................. 125,000 125,000 125,000 ---

Projects for Assistance in Transition From Homelessness........ 64,635 64,635 64,635 ---

Protection and Advocacy For Individuals with Mental Illness .... 36,146 36,146 14,146 -22,000

Certified Community Behavioral Health Clinics........................... 100,000 150,000 150,000 ---

Community Mental Health Services Block Grant......................... 722,571 722,571 722,571 ---

PHS Evaluation Funds (non-add)............................................. 21,039 21,039 21,039 ---

 

 

Mental Health Appropriation 

(Dollars in thousands) 

FY 2018 

Final 

FY 2019 

Enacted 

FY 2020 

President's 

Budget 

FY 2020 

President's 

Budget 

+/-

FY 2019 

Enacted 

Total, Mental Health.................................................................... $1,487,011 $1,558,013 $1,506,086 -51,927

The Mental Health FY 2020 President’s Budget is $1.506 billion, a decrease of $51.9 million from 

the FY 2019 Enacted level. The request includes $1.485 billion in Budget Authority and $21.0 

million in Public Health Service (PHS) Evaluation funds. 

31 
---

Mental Health System Transformation and Health Reform.. 3,779 3,779 3,779 ---

Primary and Behavioral Health Care Integration.................... 49,877 49,877 --- -49,877

Suicide Prevention.................................................................. 69,032 74,034 74,034 -

2,931 

Homelessness Prevention Programs....................................... 30,696 30,696 30,696 ---

Minority AIDS...................................................................... 9,224 9,224 9,224 ---

Criminal and Juvenile Justice Programs................................. 4,269 4,269 14,269 10,000 

Seclusion and Restraint.......................................................... 1,147 1,147 1,147 ---

Assisted Outpatient Treatment for Individuals with SMI.... 15,000 15,000 15,000 ---

Assertive Community Treatment for Individuals with SMI. 5,000 5,000 15,000 10,000 

Tribal Behavioral Health Grants............................................ 15,000 20,000 20,000 ---

Infant and Early Childhood Mental Health............................ 5,000 5,000 --- -5,000

Primary and Behavioral Health Care Integration TTA.......... 1,991 1,991 --- -1,991

Practice Improvement and Training....................................... 7,828 7,828 7,828 ---

Consumer and Consumer-Supporter TA Centers.................. 1,918 1,918 1,918 ---

Disaster Response.................................................................. 1,953 1,953 1,953 ---

Homelessness......................................................................... 2,296 2,296 2,296 ---

Minority Fellowship Program............................................... 8,059 8,059 --- -8,059

Programs of Regional and National Significance (PRNS) 

Mental Health Appropriation 

(Dollars in thousands) 

(Dollars in thousands)Programs of Regional and

National Significance 

FY 2018 

Final 

FY 2019 

Enacted 

FY 2020 

President's 

Budget 

FY 2020 

President's 

Budget 

+/-

FY 2019 

Enacted 

Capacity: 

National Child Traumatic Stress Network............................. 

Project AWARE..................................................................... 

Project AWARE State Grants (non-add)............................. 

Project AWARE -Rural (nonadd)....................................... 

Project AWARE - Civil Unrest (non-add)........................... 

Mental Health Awareness Training....................................... 

Healthy Transitions............................................................... 

Healthy Transitions-College Campus (non-add)................ 

Children and Family Programs............................................... 

Consumer and Family Network Grants................................. 

Project LAUNCH................................................................. 

National Strategy for Suicide Prevention (nonadd)........... 

Zero Suicide (nonadd).................................................... 

Zero Suicide -AI/AN (non-add)................................... 

Suicide Lifeline (non-add)................................................... 

GLS - Youth Suicide Prevention - States (non-add)............ 

Prevention & Public Health Fund (non-add).................... 

GLS - Youth Suicide Prevention - Campus (non-add)........ 

GLS - Suicide Prevention Resource Center (non-add)....... 

AI/AN Suicide Prevention Initiative (non-add)................... 

Subtotal, Capacity 

$53,887 

71,001 

61,001 

---

10,000 

19,963 

25,951 

---

7,229 

4,954 

23,605 

11,000 

9,000 

2,000 

7,198

35,427 

12,000 

6,488 

5,988 

$63,887 

71,001 

61,001 

---

10,000 

20,963 

25,951 

---

7,229 

4,954 

23,605 

11,200 

9,000 

2,000 

12,000 

35,427 

12,000 

6,488 

5,988 

2,931 

$63,887 

81,001 

61,001 

10,000 

10,000 

20,963 

30,951 

5,000 

7,229 

4,954 

23,605 

11,200 

9,000 

2,000 

12,000 

35,427 

---

6,488 

5,988 

2,931

10,000 

---

10,000 

---

---

5,000 

5,000 

---

---

---

-

---

---

---

---

-12,000

---

---

---

414,614 435,616 415,739 -19,877

Science and Service: 

Subtotal, Science and Service 

Total, PRNS 

24,045 24,045 13,995 -10,050

$438,659 $459,661 $429,734 -$29,927 

32 
National Child Traumatic Stress Network 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(Dollars in thousands) 

(Dollars in thousands) Programs of Regional 

and National Significance 

FY 2018 

Final 

FY 2019 

Enacted 

FY 2020 

President's 

Budget 

FY 2020 

President's 

Budget 

+/-

FY 2019 

Enacted 

National Child Traumatic Stress Network......................... $53,887 $63,887 $63,887 $---

Authorizing Legislation .............................................Section 582 of the Public Health Service Act 

FY 2020 Authorization ..................................................................................................$63,887,000 

Allocation Method ....................................Competitive Grants/Contracts/Cooperative Agreements 

Eligible Entities......................................................................... States, Local Governments, Tribes, 

Institutions of Higher Education, and Community Organizations 

Program Description and Accomplishments 

Child traumatic stress is a pervasive and potentially life changing experience that affects tens of 

thousands of children each year, and is a serious public health challenge. Child traumatic stress 

occurs when children and adolescents are exposed to traumatic events or traumatic situations that 

overwhelm their ability to cope with what they have experienced. Child traumatic stress can 

interfere with a wide range of childhood developmental capabilities, including social and educational 

functioning. There is strong evidence that the negative impact of child trauma progresses into 

adulthood and increases the likelihood of later adverse physical and behavioral health outcomes if 

not recognized and addressed early in life.2,3 Studies show that 25 percent to 80 percent or more of 

children and adolescents are exposed to traumatic events, with many exposed to multiple traumatic 

events.4 While the effects of trauma and exposure to violence are found in all child and adolescent 

populations and service sectors, it is particularly prominent among youth with mental illness and/or 

drug/alcohol addiction involved in the child welfare, and juvenile justice systems. Studies show that 

youth in foster care can have rates of Post-Traumatic Stress Disorder that are nearly double those of 

combat veterans.5 

Established in 2000, the National Child Traumatic Stress Initiative (NCTSI) aims to improve 

behavioral health services and interventions for children and adolescents exposed to traumatic 

events. SAMHSA has provided funding for a national network of grantees known as the National 

Child Traumatic Stress Network (NCTSN) to develop and promote effective community practices 

for children and adolescents exposed to a wide array of traumatic events. The NCTSN has grown 

from a collaborative network of 17 centers to 100 funded and over 160 affiliate centers located 

nationwide in universities, hospitals, and a range of diverse community-based organizations with 

2 Putnam, K.T., Harris, W.W., Putnam, F.W. (2013). Synergistic childhood adversities and complex adult 

psychopathology. Journal of Traumatic Stress, 26(4), 435-442. 3 Kerker, B.D., Zhang, J., Nadeem, E., Stein, R.E., Hurlburt, M.S., Heneghan, A., Landsverk, J., McCue Horwitz S 

(2015). Adverse childhood experiences and mental health, chronic medical conditions, and development in young 

children. Academy of Pediatrics, 13(15), 00173-00174. 4 Fairbank, J.A. (2008). The epidemiology of trauma, and trauma related disorders in children and youth. PTSD 

Research Quarterly, (19), 1050-1835. 5 Pecora, P.J., Kessler, R.C., Williams, J., O’Brien, K., Downs, A.C., English, E., Holmes, K. (2005). Improving 

family foster care: Findings from the northwest foster care alumni study. Casey Family Programs. Retrieved from 

http://www.casey.org/resources/publications/ImprovingFamilyFosterCare.htm 

33 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

thousands of national and local partners. The NCTSN’s mission is to raise the standard of care and 

improve access to evidence-based services for children experiencing trauma, their families, and 

communities. A component of this work has been the development of resources and delivery of 

training and consultation to support the development of trauma-informed child-serving systems. 

Network members work together within and across diverse settings, including a wide variety of 

governmental and non-governmental organizations. 

Data collected in FY 2017 demonstrate that the current NCTSN grantees provided evidence- based 

treatment to over 28,000 children, adolescents, and family members. Seventy- five percent reported 

positive functioning at six months, far exceeding the target of 65 percent. In addition, thousands 

more youth and families have benefited indirectly from the training and consultation provided by 

NCTSN grantees to organizations not receiving direct NCTSN funding enabling these organizations 

to deliver evidence-based trauma interventions. 

The NCTSN continues to be a principal source of child-trauma information and training for the 

nation. In FY 2017, NCTSN grantee sites provided trauma-informed training to over 200,000 

individuals. Since its inception, the NCTSN has provided training on best practices and other aspects 

of child trauma to over 1.5 million participants throughout the country. The NCTSI’s Helping Kids 

Recover and Thrive Campaign generated 100 online social media touches (e.g., Facebook, Twitter, 

etc.). This campaign informed the public about the efforts and resources available through the 

NCTSI. The NCTSI Learning Center now has over 200,000 users accessing evidence-based child 

trauma resources. 

In FY 2017, SAMHSA awarded four new grants and supported 82 grant continuations. SAMHSA 

will continue to ensure that grantees disseminate information regarding evidence-based 

interventions for the prevention and treatment of childhood trauma so more children can benefit 

from proven practices. In FY 2018, SAMHSA awarded 14 new grants and supported 86 grant 

continuations. In FY 2019, SAMHSA continues to support 100 grant continuations and provided 

supplemental awards for mental health services for unaccompanied alien children, with a special 

focus on children who were separated from a parent or family unit and subsequently classified as 

unaccompanied alien children; mental health services for children in Puerto Rico; and expand access 

to tribal populations. 

34 
 

 

Funding History 

Fiscal Year Amount 

FY 2016 $46,887,000 

FY 2017 $48,887,000 

FY 2018 $53,887,000 

FY 2019 $63,887,000 

FY 2020 $63,887,000 

Budget Request 

The FY 2020 President’s Budget is $63.9 million, the same level with the FY 2019 Enacted level. 

SAMHSA requests funding to continue support for 100 continuation and new grants for the 

improvement of mental disorder treatment, services, and interventions for children and adolescents 

exposed to traumatic events and provide trauma-informed services for children and adolescents as 

well as training. 

35 
 

 

 

 

 

 

 

 

Outputs and Outcomes Table 

Program: National Child Traumatic Stress Network 

Measure 

Year and Most Recent Result 

Target for Recent Result 

(Summary of Result) 

FY 2019 

Target 

FY 2020 

Target 

FY 2020 

Target 

+/-

FY 2019 

Target 

3.2.02a Increase the percentage of 

children receiving trauma informed 

services who report positive 

functioning at 6 month follow-up. 

(Outcome) 

FY 2018: 74.7 % 

Target: 74.8% 

(Target Not Met) 

74.8 % 74.8 % Maintain 

3.2.23 Increase the unduplicated count 

of the number of children and 

adolescents receiving trauma-informed 

services. (Outcome) 

FY 2018: 47,108 

Target: 28,419 

(Target Exceeded) 

47,108 47,108 Maintain 

3.2.24 Increase the number of childserving professionals trained in 

providing trauma-informed services. 

(Outcome) 

FY 2018: 276,791 

Target: 215,289 

(Target Exceeded) 

276,791 276,791 Maintain 

36 
 

Project AWARE.................................................................. $71,001 $71,001 $81,001 $10,000 

Project AWARE State Grants (non-add)......................... 61,001 61,001 61,001 ---

Project AWARE -Rural (non-add).................................. --- --- 10,000 10,000 

Project AWARE - Civil Unrest (non-add)....................... 10,000 10,000 10,000 ---

Mental Health Awareness Training.................................... 19,963 20,963 20,963 ---

 

 

 

 

 

 

 

 

 

 

 

 

Project AWARE 

(Dollars in thousands) 

Programs of Regional and National Significance 

FY 2018 

Final 

FY 2019 

Enacted 

FY 2020 

President's 

Budget 

FY 2020 

President's 

Budget 

+/-

FY 2019 

Enacted 

Authorizing Legislation ................Sections 501, 520A, and 520J of the Public Health Service Act 

FY 2020 Authorization ......................................................................... $394,550,000; $14,693,000 

Allocation Method .............................................................................Competitive Grants/Contracts 

Eligible Entities.......................................................................State and Local Education Agencies, 

Local Governmental Entities, Community Organizations and Provider Organizations, 

Community Colleges, Networks, National Non-Profit Organizations, 

States and Tribes 

Program Description and Accomplishments 

In any given year the percentage of young people with mental, emotional, behavioral (MEB) 

disorders is estimated to be between 14 and 20 percent. MEB disorders among young people 

interfere with their ability to accomplish normal developmental tasks such as healthy interpersonal 

relationships, succeeding in school, and transitioning to the workforce (IOM 2007). Project 

AWARE is designed to identify children and youth in need of mental health services, increase access 

to mental health treatment, and promote mental health literacy among teachers and school personnel. 

Project AWARE is made up of three components: Project AWARE State Educational Agency (SEA) 

grants, Mental Health Awareness Training (MHAT) Grants, and Resilience in Communities After 

Stress and Trauma Grants. Project AWARE State Educational Agency grants are awarded to State 

Education Authorities (SEAs) to promote comprehensive, coordinated, and integrated state efforts 

to make schools safer and increase access to mental health services. The MHAT grants train school 

personnel, emergency first responders, law enforcement, veterans, armed services members and their 

families to recognize the signs and symptoms of mental disorders, particularly serious mental illness 

(SMI) and/or serious emotional disturbances (SED). Resiliency in Communities After Stress and 

Trauma (ReCAST) grants assists high-risk youth and families and promotes resilience in 

communities that have recently faced civil unrest through implementation of evidence-based 

violence prevention, and community youth engagement programs as well as linkages to traumainformed behavioral health services. 

Project AWARE supports several strategies for addressing mental health in schools: supports for 

mental wellness in education settings, building awareness of mental health issues, and early 

intervention with coordinated supports. In FY 2017, AWARE grantees trained nearly 60,000 

teachers, parents, first responders, school resource officers, and other adults who interact with youth 

37 
 

Fiscal Year Amount 

FY 2016 $64,865,000 

FY 2017 $64,865,000 

FY 2018 $90,964,000 

FY 2019 $91,964,000 

FY 2020 $101,964,000 

 

 

 

 

 

 

 

 

to recognize and respond to the signs of mental health and substance use issues. To date, over 

300,000 at-risk youth have been identified and referred. 

In FY 2018, SAMHSA awarded 24 new AWARE SEA grants, 138 MHAT grants, 2 ReCAST grants, 

and supported the continuation of 16 grants (eight AWARE SEA and eight ReCAST grants). The 

Program also supported technical assistance to develop school-based mental health models. 

In FY 2019, SAMHSA awarded 8 new AWARE SEA and 18 new MHAT grants and support the 

continuation of 162 grants, (24 AWARE, 138 MHAT, and 2 ReCAST grants). 

Funding History 

Budget Request 

The FY 2020 President’s Budget is $101.9 million, an increase of $10.0 million from the FY 2019 

Enacted level. Funding for this program will support Project AWARE, ReCAST, MHAT grants, 

and technical assistance on the provision of school-based mental health services. Through its 

listening sessions, site visits, and Commission meetings, the Federal Commission on School Safety 

learned that mental health supports and services are lacking in schools across the country. SAMHSA 

is proposing to use this funding to continue much needed services, supports, and training related to 

school-based mental health service provision. In addition, the funding will be used to support an 

expansion of the AWARE model to rural communities. These funds will support increased access 

to services in rural schools through telehealth models, use of behavioral health aides, and linkages 

to services. Funds would also develop training within schools for school personnel in rural 

communities to recognize the signs and symptoms of mental illness in students. 

38 
 

 

 

 

 

 

 

 

Outputs and Outcomes Table 

Program: Project AWARE 

Measure 

Year and Most Recent Result 

Target for Recent Result 

(Summary of Result) 

FY 2019 

Target 

FY 2020 

Target 

FY 2020 

Target 

+/-

FY 2019 

Target 

3.2.39 Increase the number of 

individuals who have received training 

in prevention or mental health 

promotion. (Outcome) 

FY 2018: 53,343 

Target: 59,186 

(Target Not Met) 

59,186 75,166 +15,980 

39 
 

---

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Healthy Transitions 

(Dollars in thousands) 

Programs of Regional and National Significance 

FY 2018 

Final 

FY 2019 

Enacted 

FY 2020 

President's 

Budget 

FY 2020 

President's 

Budget 

+/-

FY 2019 

Enacted 

Healthy Transitions......................................................... 

Healthy Transitions-College Campus (non-add)................... 

$25,951 

---

$25,951 $30,951 

5,000 

$5,000 

5,000 

Authorizing Legislation ..........................................Section 520A of the Public Health Service Act 

FY 2020 Authorization ................................................................................................$394,550,000 

Allocation Method .............................................................................Competitive Grants/Contracts 

Eligible Entities......................................................................................................States and Tribes 

Program Description and Accomplishments 

Youth and young adults with Serious Emotional Disturbance (SED) or Serious Mental Illness (SMI), 

along with those with co-occurring mental illness and drug/alcohol addiction, face a more difficult 

transition to adulthood than do their peers. Nearly 20 percent of young adults aged 18 to 25 living 

in U.S. households had a diagnosable mental health condition in the past year. Of these, more than 

1.3 million had a disorder so serious, such as schizophrenia, bipolar disorder, and major depression, 

that it compromised their ability to function. Compared to their peers, these young people were 

significantly more likely to experience homelessness,6 be arrested,7 drop out of school,8 and be 

unemployed.9 It is important to identify these young people, develop appropriate outreach and 

engagement processes, and facilitate access to effective clinical and supportive interventions. 

Outreach and engagement are essential to these youth and young adults, and their families, as many 

are disconnected from social and other community supports. 

The Healthy Transitions program provides grants to states and tribes to improve access to mental 

disorder treatment and related support services for young people aged 16 to 25 who either have, or 

are at risk of developing, a serious mental health condition. Grantees use these funds to provide 

services and supports to address serious mental health conditions, co-occurring disorders, and risk 

for developing serious mental health conditions among youth 16 – 25 years old. This will be 

accomplished by increasing awareness, screening and detection, outreach and engagement, referrals 

to treatment, coordination of care and evidence-informed treatment for this age group. Healthy 

Transitions will increase awareness about early indications of signs and symptoms for serious mental 

health concerns; identify action strategies to use when a serious mental health concern is detected; 

provide training to provider and community groups to improve services and supports specific to this 

6 Embry, L. E., Vander Stoep, A., Evens, C., Ryan, K. D., & Pollock, A. (2009). Risk factors for homelessness in 

adolescents released from psychiatric residential treatment. Journal of the American Academy of Child and Adolescent 

Psychiatry, 39(10), 1293-1299. 7 Davis, M., Banks, S. M., Fisher, W. H., Gershenson, B.,& Grudzinskas, A. J. (2007). Arrests of adolescents clients of 

a public mental health system during adolescence and young adulthood. Psychiatric Services, 58(11), 1454-1460. 8 Planty, M., Hussar, W., Snyder, T., Provasnik, S., Kena, G., Dinkes, R., Kemp, J. (2008). The condition of education 

2008 (NCES 2008-031). 9 Newman, L., Wagner, M., Cameto, R., & Knokey, A. M. (2009). The post-high school outcomes of youth with 

disability up to 4 years after high school: A report from the national longitudinal transition study-2 (NLTSC) (NCSER 

2009-3017). Menlo Park, CA: SRI International. 

40 
 

 

 

 

 

 

 

 

 

age group; enhance peer and family supports, and develop effective services and interventions for 

youth, young adults and their families as these young people transition to adult roles and 

responsibilities. 

Program Evaluation 

FY 2017 data show significant decreases in psychological distress characteristics, and significant 

improvements in functional outcomes (e.g., reductions in days homeless and days in restrictive 

treatment settings). For example, data collected from young adults at baseline, and then at 6 month 

follow-up, showed a reduction in high psychological distress, an increase in being in excellent or 

very good health, and an increase in rates of employment (full or part-time). In addition, from 

baseline to 6-month follow-up there was a significant decrease in the number of nights young adults 

reported being homeless, a decrease in the number of nights young adults reported being hospitalized 

for mental health care, and a decrease in emergency room use for mental health care. 

In FY 2017, SAMHSA continued to support 16 continuation grants and the technical assistance and 

evaluation contracts. In FY 2018, SAMHSA awarded 10 new Healthy Transitions grants and 16 

continuation grants. In FY 2019, SAMHSA awarded 14 new Healthy Transitions grants and 10 

continuation grants. 

Funding History 

Fiscal Year Amount 

FY 2016 $19,951,000 

FY 2017 $19,951,000 

FY 2018 $25,951,000 

FY 2019 $25,951,000 

FY 2020 $30,951,000 

Budget Request 

The FY 2020 President’s Budget is $31.0 million, an increase of $5.0 million from the FY 2019 

Enacted level. SAMHSA requests funding to improve access to mental disorder treatment and 

related support services for young people aged 16 to 25 who either have, or are at risk of developing, 

a serious mental health condition. SAMHSA’s budget request will support 24 continuation grants. 

In addition, SAMHSA will add a focus on the needs experienced by students with or at risk of serious 

mental illness in rural trade schools, colleges, including community colleges, and universities. 

41 
 

 

 

 

 

 

 

 

 

 

 

Outputs and Outcomes Table 

Program: Healthy Transitions 

Measure 

Year and Most Recent Result 

Target for Recent Result 

(Summary of Result) 

FY 2019 

Target 

FY 2020 

Target 

FY 2020 

Target 

+/-

FY 2019 

Target 

3.2.34 Increase the percentage of 

clients receiving services who 

report positive functioning at sixmonth follow-up. (Outcome) 

FY 2018: 65.5 % 

Target: 66.1% 

(Target Not Met) 

66.1 % 66.1 % Maintain 

3.2.35 Increase the percentage of 

clients receiving services who had a 

permanent place to live in the 

community at six-month follow-up. 

(Outcome) 

FY 2018: 52% 

Target: 45.0 % 

(Target Exceeded) 

45 % 45 % Maintain 

3.2.36 Increase the percentage of 

clients receiving services who are 

currently employed at six-month 

follow-up. (Outcome) 

FY 2017: 66.8 % 

Target: 66.8% 

(Target Exceeded) 

66.8 % 66.8 % Maintain 

42 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Children and Family Programs 

(Dollars in thousands) 

Programs of Regional and National Significance 

FY 2018 

Final 

FY 2019 

Enacted 

FY 2020 

President's 

Budget 

FY 2020 

President's 

Budget 

+/-

FY 2019 

Enacted 

Children and Family Programs.............................................. $7,229 $7,229 $7,229 $---

Authorizing Legislation ..........................................Section 520A of the Public Health Service Act 

FY 2020 Authorization ................................................................................................$394,550,000 

Allocation Method ................................... Competitive Grants/Contracts/ Interagency Agreements 

Eligible Entities....................................................................................................................... Tribes 

Program Description and Accomplishments 

Without early identification, intervention, treatment, and support, children with Serious Emotional 

Disturbance (SED) are likely to face challenges at home, in school, and in their psychosocial 

development. It is a public health priority that these children and their families have access to 

effective, evidence-based services, and support. 

SAMHSA’s Children and Family Programs provide funding for the Circles of Care grant program. 

Initially funded in 1998, the Circles of Care Program is a three-year infrastructure/planning grant 

which seeks to promote mental disorder treatment equity by providing American Indian/Alaska 

Native (AI/AN) communities with tools and resources to design and sustain their own culturally 

competent system of care approach for children. The Circles of Care program reflects the unique 

history and needs of individual AI/AN communities and promotes the idea of building on cultural 

strengths. The program increases capacity and community readiness to address the mental health 

issues of children and their families through the provision of evidence based treatment services and 

supports. This grant program is of critical importance as there are significant mental health needs 

in AI/AN communities. For example, suicide is the second leading cause of death for Indian youth 

ages 15 to 24. Through Circles of Care, SAMHSA has improved the availability, accessibility, and 

acceptability of behavioral health services for native youth. 

Rehabilitation Research and Training Centers (RRTCs) seek to advance the current knowledge base 

by supporting research, training, technical assistance, and knowledge translation and dissemination 

activities that help youth and young adults with serious mental health conditions, including youth 

and young adults from high-risk, disadvantaged backgrounds, achieve their life goals. SAMHSA’s 

Children and Family Program supports two RRTC programs that are co-funded with the National 

Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR), 

Administration for Community Living. The first RRTC program, Transition to Adulthood Center 

for Research, at the University of Massachusetts, focuses on Transition from Post-Secondary 

Education to Employment for Youth and Young Adults with Serious Mental Health Conditions. The 

Center, conducts research and evaluative studies that contribute to career development and improved 

employment outcomes for youth and young adults with serious mental health conditions, including 

those from high-risk, disadvantaged backgrounds. The second RRTC program, Pathways to Positive 

Futures at Portland State University, focuses on Community Living and Participation for Youth and 

Young Adults with Serious Mental Health Conditions. This center conducts research and evaluative 

studies that contribute to improved community participation for youth and young adults with serious 

43 
 

 

 

 

Fiscal Year Amount 

FY 2016 $6,458,000 

FY 2017 $7,229,000 

FY 2018 $7,229,000 

FY 2019 $7,229,000 

FY 2020 $7,229,000 

 

 

 

 

 

mental health conditions. Unemployment rates for youth with mental disorders are significantly 

higher than those for youth with no disabilities. Unemployed young adults are three times more 

likely to suffer from depression, and youth without jobs are at higher risk to use alcohol and other 

drugs, and engage in risky behaviors that have negative health outcomes.10 

In FY 2017, SAMHSA awarded 13 new Circles of Care grants and the continuation of two RRTCs. 

In FY 2018, SAMHSA awarded 1 new and 13 Circles of Care continuation grants, and technical 

assistance activities. In FY 2019, SAMHSA supported 14 continuation grants and 2 RTTCs (1 new 

and 1 continuation). 

Funding History 

Budget Request 

The FY 2020 President’s Budget is $7.2 million, the same as the FY 2019 Enacted level. SAMHSA 

requests funding to enhance and improve the quality of existing services and promote the use of 

culturally competent services and support for children and youth with, or at risk for, serious mental 

health conditions and their families. This funding will be used to support 14 new Circles of Care 

grants, and two RRTCs. 

The output and outcome measures for Children and Family Programs are part of the Mental Health 

- Other Capacity Activities Outputs and Outcomes table shown on page 92. 

10 McGee RE, Thompson NJ. Unemployment and Depression Among Emerging Adults in 12 States, Behavioral Risk 

Factor Surveillance System, 2010. Prev Chronic Dis 2015; 12:140451. 

44 
 

 

Program Description and Accomplishments 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Consumer and Family Network Grants 

(Dollars in thousands) 

Programs of Regional and National Significance 

FY 2018 

Final 

FY 2019 

Enacted 

FY 2020 

President's 

Budget 

FY 2020 

President's 

Budget 

+/-

FY 2019 

Enacted 

Consumer and Family Network Grants........................... $4,954 $4,954 $4,954 $---

Authorizing Legislation ..........................................Section 520A of the Public Health Service Act 

FY 2020 Authorization ................................................................................................$394,550,000 

Allocation Method .............................................................................Competitive Grants/Contracts 

Eligible Entities.......................................................................................Community Organizations 

Across the healthcare arena, there is growing recognition and evidence that patient-centered care 

positively influences an individual’s health outcomes, improves quality and efficacy of care

received, and provides feedback to drive service and systems improvements. As with other health 

disciplines, people with SMI and their family members should have meaningful involvement in all 

aspects of their health care and treatment, including behavioral health care. 

The Consumer and Family Network Programs provide consumers, families, and youth with 

opportunities to participate meaningfully in the development of policies, programs, and quality 

assurance activities related to mental health systems across the United States. The Consumer and 

Family Network Programs support two primary grant activities: the Statewide Consumer Network 

(SCN) Program and the Statewide Family Network (FN) Program. 

The SCN grant program focuses on the needs of adults (18 years and older) with SED/SMI by 

strengthening the capabilities of statewide consumer-run organizations. These entities serve an 

important role in engaging consumers of mental health services, caregivers, and providers in 

improving and transforming the mental health and related systems in their states. This network is a 

sustainable mechanism for integrating the consumer voice in state mental health and allied systems 

to: 1) expand service system capacity; 2) support policy and program development; and 3) enhance 

peer support. This program promotes skill development with an emphasis on leadership and 

business management as well as coalition/partnership-building and economic empowerment as part 

of the recovery process for consumers. 

The SFN grant program provides education and training to increase family organizations’ capacity

for policy and service development. This is accomplished by: 1) strengthening organizational 

relationships and business management skills; 2) fostering leadership skills among families of 

children and adolescents with SED; and 3) identifying and addressing the technical assistance needs 

of children and adolescents with SED and their families. The SFN program focuses on families, 

parents, and the primary caregivers of children, youth, and young adults. 

In FY 2017, SAMHSA supported 18 SCN grant continuations, 26 SFN grant continuations, 1 new 

SCN grant, 1 new SFN grant, and technical assistance activities. 

45 
 

Fiscal Year Amount 

FY 2016 $4,954,000 

FY 2017 $4,954,000 

FY 2018 $4,954,000 

FY 2019 $4,954,000 

FY 2020 $4,954,000 

 

 

 

 

In FY 2018, SAMHSA supported 10 SCN continuations and 13 new grants, 22 SFN continuations 

and 10 new grants. In FY 2019, SAMHSA supported 14 SCN continuations and 9 new grants, 11 

SFN continuations and 15 new grants, which will support program implementation and direct TA. 

Funding History 

Budget Request 

The FY 2020 President’ Budget is $5.0 million, the same as the FY 2019 Enacted level. SAMHSA 

requests funding to continue support for 48 grants that promote consumer, family, and youth 

participation in the development of policies, programs, and quality assurance activities related to 

mental health systems reform across the United States. SAMHSA will also fund one new Statewide 

Family Network grant. 

The output and outcome measures for Consumer and Family Network Programs are part of the 

Mental Health - Other Capacity Activities Outputs and Outcomes table shown on page 92. 

46 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Project LAUNCH 

(Dollars in thousands) 

Programs of Regional and National Significance 

FY 2018 

Final 

FY 2019 

Enacted 

FY 2020 

President's 

Budget 

FY 2020 

President's 

Budget 

+/-

FY 2019 

Enacted 

Project LAUNCH............................................................ $23,605 $23,605 $23,605 $---

Authorizing Legislation............................... Section 520A of the Public Health Service Act

FY 2020 Authorization ................................................................................................$394,550,000 

Allocation Method ....................................Competitive Grants/Contracts/Cooperative Agreements 

Eligible Entities......................................................................................................States and Tribes 

Program Description and Accomplishments 

Researchers estimate that between 9.5 percent and 14.2 percent of children from birth to age five 

experience an emotional or behavioral disturbance. Studies also show that half of all lifetime cases 

of mental illness begin before age 14.11 Young children experiencing mental, emotional or 

behavioral challenges are at high risk for preschool expulsion. In fact, the rate of preschool expulsion 

rate is more than three times the expulsion rate of students in kindergarten through 12th grade. Boys 

are more than four times as likely to be expelled as girls; and African American preschoolers are 

almost twice as likely to be expelled as Caucasian preschoolers.12 School suspensions and expulsions 

have shown to increase the likeliness of later life negative outcomes. Research has shown that 

prevention and early treatment of mental disorders is more beneficial and cost-effective than waiting 

to address these issues later in life. Integrating behavioral health into primary care and early child 

care settings, increasing screening for developmental and social/emotional issues, and training 

people who interact with young children to promote optimal development and mental health are all 

critical elements to ensure children start life with the tools and skills needed to succeed. 

Established in 2008, Project Linking Actions for Unmet Needs in Children’s Health (LAUNCH) is 

a national initiative that has funded 60 sites, including states, tribes, territories, communities, and 

the District of Columbia. The purpose of the Project LAUNCH initiative is to promote the wellness 

of young children from birth to eight years of age by addressing the physical, social, emotional, 

cognitive, and behavioral aspects of their development. Project LAUNCH pays particular attention 

to the social and emotional development of young children and works to ensure that the systems that 

serve them (including early childcare and education, home visiting, and primary care) are equipped 

to promote and monitor healthy social and emotional development. The program also ensures that 

the systems intervene to prevent, recognize early signs of, and address mental, emotional, and 

behavioral disorders in early childhood and into the early elementary grades. 

Program Evaluation 

As of 2018, cumulative performance data for the program (2008-2018) indicate that: 

11 Brauner, Cheryl, and Cheryll Stephens. "Estimating the Prevalence of Early Childhood Serious 

Emotional/Behavioral Disorders: Challenges and Recommendations." Public Health Reports 121.3 (2006): 303-10. 12 Gilliam, W. (2005). Pre-kindergarteners left behind: Expulsion rates in state prekindergarten systems. Foundation 

for Child Development. 

47 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 Approximately 226,000 children and parents have been screened or assessed for behavioral 

health concerns across a range of diverse settings (e.g., primary care, child care, and home 

visiting); 

 Approximately 128,000 families have been served through home visiting programs with an 

added focus on the social/emotional and behavioral health needs of children and parents; 

 More than 91,000 community providers have been trained on social/emotional development 

and behavioral health for young children; 

 More than 180,000 individuals have received evidence-based mental health-related services, 

and 

 Approximately 10,000 new partnerships have been developed between organizations in order 

to implement prevention/promotion strategies for young children and their families. 

Program Evaluation 

A multi-site evaluation of Project LAUNCH was completed in 2018. Phase one of the evaluation 

used a meta-analytical approach to assess the implementation of the program. The findings indicated 

that grantees successfully improved community and state-level child and family-serving systems. In 

addition, grantees demonstrated improved social and academic functioning among young children, 

and 78 percent reported decreases in problem behaviors. Phase two of the multi-site evaluation 

involved a quasi-experimental design exploring whether children in 10 communities served by 

Project LAUNCH differed in social and emotional wellbeing from children in 10 sociodemographically matched communities. Results indicated that children living in Project LAUNCH 

communities received more developmental screening and supports than children living in matched 

comparison communities. Additionally, children in LAUNCH communities had less need for early 

intervention services related to attachment, initiative and other indicators of resilience, particularly 

young children ages birth to three. Parents in Project LAUNCH communities reported more 

involvement with their children and less parenting frustrations. 

In FY 2018, SAMHSA awarded 18 continuation grants, including 13 grants to states, tribes and 

territories implementing Project LAUNCH in one target community, and 5 grants that had previously 

successfully implemented Project LAUNCH in one community, and are now engaged in a project 

to replicate that work more widely. In addition, SAMHSA awarded 14 new grants to 

American Indian and Alaskan Native communities and U.S. Territories. 

In FY 2019, SAMHSA supported 14 Project LAUNCH continuation grants and 15 new Project 

LAUNCH grant. In addition, SAMHSA awarded the National Center of Excellence for Infant and 

Early Childhood Mental Health Consultation to advance the implementation of high quality infant 

and early childhood mental health consultation (IECMHC) across the nation through the 

development of tools, resources, training, and mentorship to the infant and early childhood mental 

health field. 

48 
Funding History 

 

 

 

Fiscal Year Amount 

FY 2016 $34,555,000 

FY 2017 $23,605,000 

FY 2018 $23,605,000 

FY 2019 $23,605,000 

FY 2020 $23,605,000 

Budget Request 

The FY 2020 President’s Budget is $23.6 million, the same as the FY 2019 Enacted level. This 

funding will support 29 continuation grants and National Center of Excellence for IECMHC that 

will improve health outcomes for young children and support children at high risk for mental illness 

and their families in order to prevent future disability. This funding request will provide services for 

over 14,421 individuals, training to 8,765 people, and screening for mental health or related 

intervention to 18,554 children up to eight years old. 

49 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Outputs and Outcomes Table 

Program: Project LAUNCH 

Measure 

Year and Most Recent Result 

Target for Recent Result 

(Summary of Result) 

FY 2019 

Target 

FY 2020 

Target 

FY 2020 

Target 

+/-

FY 2019 

Target 

2.3.94 Increase the number of 

persons served. (Output) FY 2017: 14,421 

Target: 38,594 

(Target Not Met) 

14,421 14,421 Maintain 

2.3.95 Increase the number of 

persons trained in mental illness 

prevention or mental health 

promotion. (Outcome) 

FY 2017: 8,765 

Target: 13,102 

(Target Not Met) 

8,765 8,765 Maintain 

2.4.00 Increase the number of 0-8 

year old children screened for mental 

health or related interventions. 

(Outcome) 

FY 2017: 18,554 

Target: 44,775 

(Target Not Met) 

18,554 18,554 Maintain 

2.4.01 Increase the number of 0-8 

year old children referred to mental 

health or related interventions. 

(Outcome) 

FY 2017: 3,652 

Target: 9,114 

(Target Not Met) 

3,652 3,652 Maintain 

50 
 

 

Program Description and Accomplishments 

 

 

 

 

 

 

 

 

 

 

 

 

Mental Health System Transformation and Health Reform 

(Dollars in thousands) 

Programs of Regional and National Significance 

FY 2018 

Final 

FY 2019 

Enacted 

FY 2020 

President's 

Budget 

FY 2020 

President's 

Budget 

+/-

FY 2019 

Enacted 

Mental Health System Transformation and Health 

Reform................................................... $3,779 $3,779 $3,779 $---

Authorizing Legislation ..........................................Section 520A of the Public Health Service Act 

FY 2020 Authorization ............................................................................................... $394,550,000 

Allocation Method .............................................................................Competitive Grants/Contracts 

Eligible Entities......................................................................................................States and Tribes 

There is a significant gap between the number of people with SMI, such as schizophrenia, bipolar 

disorder, and major depression, who want to work (66 percent) and the number of people who are 

actually employed (less than 20 percent). The benefits of steady competitive employment are 

substantial and include increased income, improved adherence with treatment for mental illness, 

enhanced self-esteem, reduced use of substances, and improved quality of life.13 The Transforming 

Lives through Supported Employment Grant program is the remaining component of the Mental 

Health System Transformation program. This program was implemented to help states foster the 

adoption and implementation of permanent transformative changes in how public mental health 

services are organized, managed, and delivered throughout the United States. 

The program began in FY 2014 as a focused effort to enhance state and community capacity to 

provide evidence-based supported employment programs for adults and youth with SMI/SED. 

These grants help people with SMI build paths to self-sufficiency and recovery rather than disability 

and dependence. They also support treatment and service providers and employers to develop and 

maintain sustained competitive employment opportunities for people with SMI, primarily using the 

evidence-based Individual Placement and Support (IPS) model of supported employment. The grant 

program helps states to identify and implement the structural and financing changes that are essential 

to make evidence-based supported employment programs sustainable statewide. FY 2017 program 

data show that 55 percent of individuals served by the program were employed at six-month followup; additionally, 74 percent reported positive functioning and 66 percent had a permanent place to 

live. 

In FY 2017 and FY 2018 SAMHSA awarded seven continuation grants and related technical 

assistance activities. In FY 2019, SAMHSA awarded seven new Transforming Lives through 

Supported Employment grants. 

d Recommendations." Public Health Reports 121.3 (2006): 303-10. 

yment. (n.d.). Retrieved August 4, 2015. 

51 
Funding History 

 

 

 

Fiscal Year Amount 

FY 2015 $3,779,000 

FY 2016 $3,779,000 

FY 2017 $3,779,000 

FY 2018 $3,779,000 

FY 2019 $3,779,000 

FY 2020 $3,779,000 

Budget Request 

The FY 2020 President’s Budget is $3.8 million, the same as the FY 2019 Enacted level. SAMHSA 

requests funding to support the continuation of seven Transforming Lives through Supported 

Employment grants to enhance state and community capacity to provide evidence-based supported 

employment programs for adults and youth with SMI/SED. 

52 
Program: Mental Health System Transformation and Health Reform 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Outputs and Outcomes Table 

Measure 

Year and Most Recent Result 

Target for Recent Result 

(Summary of Result) 

FY 2019 

Target 

FY 2020 

Target 

FY 2020 

Target 

+/-

FY 2019 

Target 

1.2.11 Increase the number of 

persons in the mental health and 

related workforce trained in specific 

mental-health related practices/ 

activities as a result of the grant. 

(Outcome) 

FY 2017: 5,262 

Target: 4,303 

(Target Exceeded) 

5,262 5,262 Maintain 

1.2.21 Increase the percentage of 

clients receiving services who report 

positive functioning at six- month 

follow-up. (Outcome) 

FY 2018: 67.1% 

Target: 74% 

(Target Not Met) 

74 % 74 % Maintain 

1.2.22 Increase the percentage of 

clients receiving services who had a 

permanent place to live in the 

community at six-month follow-up. 

(Outcome) 

FY 2018: 66.4 % 

Target: 77 % 

(Target Not Met but Improved) 

77 % 77 % Maintain 

1.2.23 Increase the percentage of 

clients receiving services who are 

currently employed at six-month 

follow-up. (Outcome) 

FY 2018: 52.8 % 

Target: 55% 

(Target Not Met) 

55 % 55 % Maintain 

53 
 

$--- -$49,877 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Primary and Behavioral Health Care Integration 

(Dollars in thousands) 

Programs of Regional and National Significance 

FY 2018 

Final 

FY 2019 

Enacted 

FY 2020 

President's 

Budget 

FY 2020 

President's 

Budget 

+/-

FY 2019 

Enacted 

Primary and Behavioral Health Care Integration............... 

Primary and Behavioral Health Care Integration TTA...... 

$49,877 

1,991 

$49,877 

1,991 --- -1,991 

Total Primary and Behavioral Health Care Integration $51,868 $51,868 $--- -$51,868 

Authorizing Legislation................................Section 520K of the Public Health Service Act

FY 2020 Authorization ..................................................................................................$51,878,000 

Allocation Method .................................................... Competitive Grants/Cooperative Agreements 

Eligible Entities............Qualified Community Mental Health Programs (FY 2017 Authorization), 

States or State Agency 

Program Description and Accomplishments 

Adults with SMI, such as schizophrenia, bipolar disorder, and major depression, experience high 

rates of morbidity and mortality. These rates are due, in large part, to elevated incidence and 

prevalence of cardiovascular disease, obesity, diabetes, hypertension, and dyslipidemia in people 

with SMI.14 Physical health problems among people with SMI affect an individual’s quality of life

and contribute to premature death. Empirical findings indicate the clear link between early mortality 

among people with SMI and the lack of access to primary care services.15 

The Primary and Behavioral Health Care Integration (PBHCI) Portfolio began in FY 2009 to address 

specifically this intersection between primary care and treatment for mental illness and co- occurring 

drug/alcohol addiction. The program supports grants to community mental health centers and states. 

This program supports the coordination and integration of primary care services and publicly funded 

community behavioral health services for individuals with SMI or co-occurring mental illness and 

drug/alcohol addiction served by the public mental health system. The PBHCI program seeks to 

improve health outcomes for people with SMI and co-occurring mental illness and drug/alcohol 

addiction by encouraging grantees to engage in necessary collaboration, expand infrastructure, and 

increase the availability of primary healthcare and wellness services for individuals with SMI or cooccurring mental illness and drug/alcohol addiction. 

In FY 2017, SAMHSA supported 61 PBHCI continuation grants and awarded three new Promoting 

Integration of Primary and Behavioral Health Care (PIPBHC) grants at $2.0 million per year to 

states, consistent with the 21st Century Cures Act. In addition, the population of focus was expanded 

to children with SED, individuals with drug/alcohol addiction and adults with any mental illness. 

The PIPBHC grant also focuses on bi-directional integration, providing support to onsite primary 

care within a behavioral health setting and onsite behavioral health care within a primary care setting. 

14 Forman-Hoffman, Muhuri, Novak, Pemberton, Ault, and Mannix (August 2014) CBHSQ Data Review: 

Psychological Distress and Mortality among Adults in the U.S. Household Population. 15 E. Chesney et al., Risks of all-cause and suicide mortality in mental disorders: a meta-review, World Psychiatry; 

2014: 13:1153-160. 

54 
 

 

Funding History 

Fiscal Year Amount 

FY 2016 $51,868,000 

FY 2017 $51,868,000 

FY 2018 $51,868,000 

FY 2019 $51,868,000 

FY 2020 ---

 

 

In FY 2018, SAMHSA supported the continuation of 59 PBHCI grants and awarded 13 new PIPBHC 

grants. In FY 2019, SAMHSA continued support for 15 PBHCI, 13 PIPBHC, and 7 new PIPBHC 

grants. SAMHSA will continue to disseminate the lessons learned from this program. 

Budget Request 

The FY 2020 President’s Budget is $0.0. SAMHSA has eliminated this program due to other funding 

sources available for integrated care. SAMHSA will continue to disseminate the lessons learned 

from this program. 

55 
 

 

 

 

 

 

 

 

 

 

Outputs and Outcomes Table 

Program: Primary & Behavioral Health Care Integration (PBHCI) 

Measure 

Year and Most Recent Result 

Target for Recent Result 

(Summary of Result) 

FY 2019 

Target 

FY 2020 

Target 

FY 2020 

Target 

+/-

FY 2019 

Target 

3.2.41 Increase the percentage of clients 

receiving services who report positive 

functioning at 6 month follow-up. 

(Outcome) 

FY 2018: 57.8 % 

Target: 54.6 % 

(Target Exceeded) 

57.8% --- -57.8% 

3.2.42 Increase the percentage of clients 

receiving services who are currently 

employed at 6 month follow-up. 

(Outcome) 

FY 2018: 27.7 % 

Target: 24.1 % 

(Target Exceeded) 

27.7% --- -27.7% 

3.2.43 Increase the percentage of clients 

receiving services who had a permanent 

place to live in the community at 6 

month follow-up. (Outcome) 

FY 2018: 70.1% 

Target: 71% 

(Target Not Met) 

70.1% --- -70.1% 

56 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Suicide Prevention Programs 

(Dollars in thousands) 

Programs of Regional and National Significance 

FY 2018 

Final 

FY 2019 

Enacted 

FY 2020 

President's 

Budget 

FY 2020 

President's 

Budget 

+/-

FY 2019 

Enacted 

Suicide 

Prevention................................................................. $69,032 $74,034 $74,034 -$ 

Suicide Lifeline (non-add)............................................... 7,198 12,000 12,000 ---

GLS - Youth Suicide Prevention - States (non-add).... 35,427 35,427 35,427 ---

Budget Authority (non-add)......................................... 23,427 23,427 35,427 12,000 

Prevention & Public Health Fund (non-add)........... 12,000 12,000 --- -12,000 

GLS - Youth Suicide Prevention - Campus (non-add) 6,488 6,488 6,488 ---

GLS - Suicide Prevention Resource Center (non-add) 5,988 5,988 5,988 ---

AI/AN Suicide Prevention Initiative (non-add)........... 2,931 2,931 2,931 ---

National Strategy for Suicide Prevention (non-add). 11,000 11,200 11,200 ---

Zero Suicide (non-add)................................................. 9,000 9,000 9,000 ---

Zero Suicide -AI/AN (non-add)............................ 2,000 2,000 2,000 ---

Program Description and Accomplishments 

SAMHSA supports the goals and objectives of the National Strategy for Suicide Prevention (NSSP) 

through the Suicide Prevention Programs highlighted below. Research has shown that implementing 

comprehensive public health approaches that make suicide prevention a priority within health and 

community systems can reduce the rates of death by suicide as well as suicide attempts. The NSSP 

supports this type of comprehensive approach and is an important step toward reducing suicide. 

Approximately 47,173 Americans died by suicide in 2017. From 1999 through 2017, the age 

adjusted suicide rate increased 33% from 10.5 to 14.0 per 100,000. According to the CDC Director 

Robert R. Redfield “The latest CDC data show that the US life expectancy has declined over the 

past few years. Tragically, this troubling trend is largely driven by deaths from drug overdose and 

suicide”. In 2008, suicide became the 10th leading cause of death in the United States and has 

remained so through 2017. Suicide is the second leading cause of death between age 10-34 and the 

fourth leading cause of death for ages 35-54, the most recent year for which there are available 

mortality data. The 2017 National Survey on Drug Use and Health reported that approximately 1.4 

million Americans age 18 and over attempted suicide, 10.6 million seriously considered suicide, and 

3.2 million made a plan. While youth have the highest rate of suicide attempts, middle-aged adults 

have the highest number of deaths by suicide nationwide, and middle aged and older adult men have 

the highest rates of death by suicide. The nation’s suicide prevention efforts must address the issues

of suicidal thoughts, plans, attempts, and deaths among adults and youth to reduce suicide in 

America. 

57 
 

$---

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

National Strategy for Suicide Prevention 

(Dollars in thousands) 

Programs of Regional and National Significance 

FY 2018 

Final 

FY 2019 

Enacted 

FY 2020 

President's 

Budget 

FY 2020 

President's 

Budget 

+/-

FY 2019 

Enacted 

National Strategy for Suicide Prevention........................ 

Zero Suicide (non-add)............................................ 

Zero Suicide -AI/AN (non-add)........................ 

$11,000 

9,000 

2,000 

$11,200 

9,000 

2,000 

$11,200 

9,000 

2,000 

---

---

Authorizing Legislation .......................................... Section 520L of the Public Health Service Act 

FY 2020 Authorization ..................................................................................................$30,000,000 

Allocation Method ............................................................................................. Competitive Grants 

Eligible Entities.......................................................Community –based primary care or behavioral 

health entity, Federally Recognized, American Indian/Alaska 

Native tribe or tribal organizations, State mental health or public health agency 

Program Description and Accomplishments 

Suicide has been increasing in the United States, particularly in adults and older adults. The CDC 

(2018) has recently reported that suicide has risen nearly 30 percent during 1999-2016 and has 

increased in 49 of the 50 states with 25 states experiencing increases over 30 percent.16 With the 

rising rates of suicide among adults, particularly middle-aged and older adults, focusing on 

preventing suicide among adults is urgently required in order to reduce suicide nationally. The baby 

boomer generation is the group that has had high rates of suicide throughout its lifecycle and is 

entering the stage of life that has historically had the highest rate of suicide. There is a risk that 

without significant targeted intervention toward adults, the number of suicides in the United States 

could continue to increase. 

The 2012 National Strategy for Suicide Prevention (NSSP) seeks to reduce the overall suicide rate 

and number of suicides in the U.S. nationally. The NSSP grant program supports states’ efforts to

implement the NSSP. While the NSSP addresses all age groups and populations with specific needs, 

the goals and objectives of the NSSP grants focus on preventing suicide and suicide attempts among 

adults over the age of 25 who comprised more than 38,000 of the more than 44,000 suicides in the 

United States in 2016. In FY 2017, SAMHSA awarded five new grants to support states in 

implementing the NSSP goals and objectives. States use NSSP funding to support efforts such as 

raising suicide awareness, establishing emergency room referral processes, and improving clinical 

care practice standards. These grants focus on preventing suicide and suicide attempts among 

working-aged adults 25 to 64 years old. 

In FY 2017, Congress appropriated $9.0 million, to implement Zero Suicide in health care systems 

including a $2.0 million tribal set aside. The Zero Suicide model is a comprehensive, multi-setting 

approach to suicide prevention in health systems. The purpose of this program is to implement 

suicide prevention and intervention programs for individuals who are 25 years of age or older by 

16Center for Disease Control and Prevention, Mortality and Morbidity Weekly Report; “Vital Signs: Trends in State 

Suicide Rates-United States, 1999-2016 and Circu7mstances Contributing to Suicide -27 States, 2015, Stone, D.M et 

all, June 8, 2018. 

58 
 

 

 

 

Fiscal Year Amount 

FY 2016 $2,000,000 

FY 2017 $11,000,000 

FY 2018 $11,000,000 

FY 2019 $11,200,000 

FY 2020 $11,200,000 

 

 

systematically applying evidence-based approaches to screening and risk assessment, developing 

care protocols, collaborating safety planning, providing evidence-based treatments, maintaining 

continuity of care during high risk periods, and improving care and outcomes for such individuals 

who are at risk for suicide being seen in health care systems. In FY 2017, SAMHSA awarded three 

new Zero Suicide grants. 

In FY 2018, SAMHSA provided support for five NSSP continuation grants, and awarded 15 new 

Zero Suicide grants. In FY 2019, SAMHSA supported the continuation of 5 NSSP grants and 15 

Zero Suicide grants. 

Funding History 

Budget Request 

The FY 2020 President’s Budget is $11.2 million, the same as the FY 2019 Enacted level. Funding 

will support 5 new NSSP grants and the continuation of 15 Zero Suicide grants. The grants support 

states in implementing the NSSP goal to prevent suicide. States use NSSP funding to support efforts 

such as raising suicide awareness, establishing emergency room referral processes, and improving 

clinical care practice standards. 

59 
 

$---

--- -12,000

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Garrett Lee Smith Youth Suicide Prevention – State/Tribal and Campus 

(Dollars in thousands) 

Programs of Regional and National Significance 

FY 2018 

Final 

FY 2019 

Enacted 

FY 2020 

President's 

Budget 

FY 2020 

President's 

Budget 

+/-

FY 2019 

Enacted 

GLS - Youth Suicide Prevention - States.................... 

Prevention & Public Health Fund (non-add).......... 

GLS - Youth Suicide Prevention - Campus................. 

$35,427 

12,000 

6,488 

$35,427 

12,000 

6,488 

$35,427 

6,488 ---

Authorizing Legislation ..................... Sections 520E and 520E-2 of the Public Health Service Act 

FY 2020 Authorization ............................................................................. $30,000,000; $7,000,000 

Allocation Method ....................................Competitive Grants/Contracts/Cooperative Agreements 

Eligible Entities......................................................................................................States and Tribes 

Program Description and Accomplishments 

In the fall of 2003, Garrett Lee Smith, son of Sen. Gordon and Sharon Smith, died by suicide in his 

apartment in Utah where he attended college. He was one day shy of 22 years old. Like most 

suicides, Garrett's came unexpectedly. As many families have tragically experienced, depression is 

not rare or peculiar, but can be deadly. It affects one in six Americans at some point. Hardly a 

family goes untouched.17 

The Garrett Lee Smith (GLS) Memorial Act authorizes SAMHSA to manage two significant youth 

suicide prevention programs and one resource center. The GLS State/Tribal Youth Suicide 

Prevention and Early Intervention Grant Program has awarded 199 grants to 50 states and the 

District of Columbia, 50 tribes or tribal organizations, and two territories. These grants develop 

and implement youth suicide prevention and early intervention strategies involving public-private 

collaboration among youth-serving institutions. The GLS Campus Suicide Prevention program has 

awarded 290 grants to 264 institutions of higher education, including tribal colleges and universities, 

to prevent suicide and suicide attempts. 

Grantees use their funds to prevent suicide in their communities, often through providing trainings 

and activities aimed at identifying youth at risk for suicide. By the end of FY 2018, over 1.4 million 

individuals had participated in over 39,000 training events or educational seminars provided by 

grantees and over 86,000 youth have been screened for suicide risk. Grantees have identified almost 

70,000 youth at risk for suicide and worked to ensure they receive appropriate services. Grantees’

efforts are reducing the likelihood of at-risk youth falling through the gaps in the system. 

Results from the national evaluation have shown that counties who implemented GLS supported 

activities had lower suicide rates than matched counties that did not in the first year following suicide 

prevention activities. 

In FY 2017, SAMHSA provided continuation funds for 42 GLS State/Tribal grants, 3 new GLS 

State/Tribal grants, 40 GLS Campus grants, 17 new GLS Campus grants, and the National Suicide 

17 http://www.jaredstory.com/garrett_smith.html 

60 
 

 

 

Funding History 

 

 

 

 

Prevention evaluation. The 17 new GLS Campus grantees utilized funding in accordance with 

changes made in the 21st Century Cures Act. 

In FY 2018, SAMHSA supported the continuation for 45 GLS State/Tribal grants, 35 GLS Campus 

grants, 24 new GLS Campus grants, and continuation of the National Suicide Prevention evaluation. 

In FY 2019, SAMHSA supported the continuation of 19 GLS State/Tribal grants, 41 GLS Campus 

grants, and awarded 26 new GLS State and Tribal grants and 19 new GLS Campus grants. 

Fiscal Year Amount 

FY 2016 $41,915,000 

FY 2017 $41,915,000 

FY 2018 $41,915,000 

FY 2019 $41,915,000 

FY 2020 $41,915,000 

Budget Request 

The FY 2020 President’s Budget is $41.9 million, the same as the FY 2019 Enacted level. 

SAMHSA requests funding for 29 State/tribal grant continuations, 43 Campus continuations, and a 

new cohort of 16 State/tribal grants to continue developing and implementing youth suicide 

prevention and early intervention strategies involving public-private collaboration among youth 

serving institutions. In addition, the funding will support a new cohort of 17 grants for the prevention 

of suicide and suicide attempts at institutions of higher education. 

61 
 

 

 

 

 

 

 

Garrett Lee Smith Suicide Prevention Resource Center 

(Dollars in thousands) 

Programs of Regional and National Significance 

FY 2018 

Final 

FY 2019 

Enacted 

FY 2020 

President's 

Budget 

FY 2020 

President's 

Budget 

+/-

FY 2019 

Enacted 

GLS - Suicide Prevention Resource Center.................. $5,988 $5,988 $5,988 $---

Authorizing Legislation ..........................................Section 520C of the Public Health Service Act 

FY 2020 Authorization ....................................................................................................$5,988,000 

Allocation Method .............................................................................Competitive Grants/Contracts 

Eligible Entities.....................................................Domestic Public and Private Nonprofit Entities, 

Tribal and Urban Indian Organizations, Community and Faith-Based Organizations 

Program Description and Accomplishments 

In addition to the above programs that build suicide prevention capacity, SAMHSA also supports 

the Suicide Prevention Resource Center (SPRC). The purpose of this program is to build national 

capacity for preventing suicide by providing technical assistance, training, and resources to assist 

states, tribes, organizations, and SAMHSA grantees to develop suicide prevention strategies 

(including programs, interventions, and policies that advance the National Strategy for Suicide 

Prevention (NSSP), with the overall goal of reducing suicides and suicidal behaviors in the nation. 

This work includes support of the public-private National Action Alliance for Suicide Prevention, 

and working to advance high-impact objectives of the NSSP. 

In FY 2018, and FY 2019 SAMHSA supported the continuation grant. 

62 
Funding History 

Fiscal Year Amount 

FY 2016 $5,988,000 

FY 2017 $5,988,000 

FY 2018 $5,988,000 

FY 2019 $5,988,000 

FY 2020 $5,988,000 

Budget Request 

 

 

 

 

 

The FY 2020 President’s Budget is $6.0 million, the same as the FY 2019 Enacted level. Funding 

will support one new grant to promote the implementation of the NSSP and enhance the nation’s

mental health infrastructure. The Suicide Prevention Resource Center will provide states, tribes, 

government agencies, private organizations, colleges and universities, and suicide survivors and 

mental health consumer groups with access to information and resources that support program 

development, intervention implementation, and adoption of policies that prevent suicide. 

63 
Suicide Lifeline 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(Dollars in thousands) 

Programs of Regional and National Significance 

FY 2018 

Final 

FY 2019 

Enacted 

FY 2020 

President's 

Budget 

FY 2020 

President's 

Budget 

+/-

FY 2019 

Enacted 

Suicide Lifeline................................................................ $7,198 $12,000 $12,000 $---

Authorizing Legislation .......................................Section 520E-3 of the Public Health Service Act 

FY 2020 Authorization ....................................................................................................$7,198,000 

Allocation Method .............................................................................Competitive Grants/Contracts 

Eligible Entities............................................................... States, Tribes, Community Organizations 

Program Description and Accomplishments 

To prevent death and injury as the result of suicide attempts, individuals need rapid access to suicide 

prevention and crisis intervention services. In calendar year 2017, the National Suicide Prevention 

Lifeline answered calls from over 2 million Americans. Calendar year call volume through Nov. 30th 

of 2018: 2,030,209. This helped provide rapid access at any time of the day or night to crisis 

intervention, and when needed, emergency response. 

Launched in FY 2005, the National Suicide Prevention Lifeline (Lifeline), 1-800-273-TALK, 

coordinates a network of 160 crisis centers across the United States by providing suicide prevention 

and crisis intervention services for individuals seeking help at any time, day or night. The Lifeline 

routes calls from anywhere in the country to a network of certified local crisis centers that can then 

link callers to local emergency, mental health, and social services resources. 

The Lifeline averaged 156,418 calls per month for a total of 1,877,020 calls answered in FY 2017. 

Monthly call volume averaged 185,367 for total of 2,224,408 calls answered in FY 2018. As of 

October and November, call volume has averaged 181,484 per month in FY 2019. 

SAMHSA evaluation studies have found that when a sample of suicidal callers who received followup calls from the Lifeline are asked, “...to what extent did calling the crisis hotline stop you from 

killing yourself?” A total of 82 percent responded either “a lot” (59 percent) or “a little” (22 percent). 

Since FY 2007, SAMHSA has collaborated with the Department of Veterans Affairs (VA) to ensure 

that veterans, service members, and their families who call the Lifeline and “press 1” have 24/7 

access to the VA’s Veterans Crisis Line. 

64 
 

 

 

 

 

 

 

 

 

Funding History 

Program Evaluation 

The Lifeline Evaluation is currently part of the National Suicide Prevention Evaluation (NSPE), 

which includes many of the programs in SAMHSA’s suicide prevention portfolio. The NSPE is an 

evaluation that assesses the impact of SAMHSA’s suicide prevention initiatives on reducing suicidal 

behavior, attempts, and mortality. 

Prior Lifeline evaluations have been the primary vehicle for collaborating with the crisis centers to 

adopt standards and guidelines based on evaluation results. These evaluation-driven standards and 

guidelines have, to date, focused on suicide risk assessment, imminent risk protocols, emergency 

intervention, and follow-up procedures and have advanced improvements in practice that are 

lifesaving. Hotline evaluation efforts will continue to focus on imminent risk and follow up for 

suicidal callers and suicidal persons accessing the crisis chat service. 

In FY 2018, SAMHSA awarded one new Suicide Lifeline grant and supported the continuation of 

six Crisis Center Follow-up grants. In FY 2019, SAMHSA supported the continuation of the Suicide 

Lifeline grant and provided a supplement of $5.4 million dollars to enhance access to the Lifeline 

and to strengthen the capacity of the Lifeline network to answer calls as rapidly as possible. 

SAMHSA awarded two new Crisis Center Follow-up grants to provide an integrated hub that: (1) 

ensures systematic follow-up of suicidal persons who contact a NSPL Crisis Center; (2) provides 

enhanced coordination of crisis stabilization, crisis respite, and hospital emergency department 

services; and (3) enhances coordination with mobile on-site crisis response. In effect, with the 

resources provided, the hub should not lose track of a person in a suicidal crisis as they interface 

with crisis systems. It is expected that this program will promote continuity of care to safeguard the 

well-being of individuals who are at risk of suicide. 

Fiscal Year Amount 

FY 2016 $7,198,000 

FY 2017 $7,198,000 

FY 2018 $7,198,000 

FY 2019 $12,000,000 

FY 2020 $12,000,000 

65 
Budget Request 

 

 

 

 

The FY 2020 President’s Budget is $12 million, the same as the FY 2019 Enacted level. SAMHSA 

is requesting funding for the continuation of the National Suicide Prevention Lifeline, which routes 

calls from anywhere in the country to a network of certified local crisis centers that can then link 

callers to local emergency, mental health, and social services resources. In addition, the funding 

will support the continuation of two National Suicide Prevention Lifeline Crisis Center Follow-up 

grants to focus on providing follow-up to suicidal people discharged from emergency rooms and 

inpatient units, and will support a crisis chat system. 

66 
 

 

 

 

 

 

 

 

 

 

 

American Indian/Alaska Native Suicide Prevention Initiative 

(Dollars in thousands) 

Programs of Regional and National Significance 

FY 2018 

Final 

FY 2019 

Enacted 

FY 2020 

President's 

Budget 

FY 2020 

President's 

Budget 

+/-

FY 2019 

Enacted 

American Indian/Alaska Native Suicide Prevention 

Initiative... $2,931 $2,931 $2,931 $---

Authorizing Legislation ..........................................Section 520A of the Public Health Service Act 

FY 2020 Authorization ................................................................................................$394,550,000 

Allocation Method ............................................................................................................. Contracts 

Eligible Entities.......................................................................................................... Not applicable 

Program Description and Accomplishments 

The Tribal Training and Technical Assistance Center (Tribal TTA Center) is an innovative training 

and technical assistance project that helps tribal communities facilitate the development and 

implementation of comprehensive and collaborative community-based prevention plans to reduce 

violence, bullying, substance abuse, and suicide among American Indian/Alaska Native (AI/AN) 

youth. These plans mobilize tribal communities’ existing social and educational resources to meet 

their goals. From 2015 to 2017, 126 tribal communities have received specialized technical 

assistance and support in suicide prevention and related areas. In addition, more than 10,860 

members of these communities received training in prevention and mental health promotion. 

In FY 2016 and FY 2017 SAMHSA supported the continuation of this five-year contract. In 

FY 2018, SAMHSA awarded a new contract to support this activity and awarded one Mental Health 

Transfer Technology Center (MHTTC) for Tribal Affairs to develop and maintain a collaborative 

network to support resource development and dissemination, training and technical assistance, and 

workforce development to the field and CMHS grant recipients. The MHTTC Tribal Affairs Center 

will coordinate and manage CMHS’s national efforts to ensure that high-quality, effective mental 

health disorder treatment and recovery support services, and evidence based practices are available 

for all individuals with mental disorders including, in particular, those with serious mental illness. 

In FY 2019, SAMHSA continued support for this activity through the existing contract and the 

continuation of the MHTTC Tribal Affairs Center. 

67 
Funding History 

Fiscal Year Amount 

FY 2016 $2,931,000 

FY 2017 $2,931,000 

FY 2018 $2,931,000 

FY 2019 $2,931,000 

FY 2020 $2,931,000 

 

 

 

 

Budget Request 

The FY 2020 President’s Budget is $2.9 million, the same as the FY 2019 Enacted level. SAMHSA 

requests funding to support the continuation of the MHTTC Tribal Affairs Center and continuation 

of the contract to provide comprehensive, broad, focused, and intensive training and technical 

assistance to federally recognized tribes and other AI/AN communities in order to address and 

prevent mental illness and alcohol/other drug addiction, prevent suicide, and promote mental health 

through the contract continuation. 

68 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Outputs and Outcomes Table 

Program: Suicide Prevention 

Measure 

Year and Most Recent Result 

Target for Recent Result 

(Summary of Result) 

FY 2019 

Target 

FY 2020 

Target 

FY 2020 

Target 

+/-

FY 2019 

Target 

2.3.59 Increase the total number of individuals 

trained in youth suicide prevention (Outcome) 

FY 2018: 77,306 

Target: 160,082 

(Target Not Met) 

77,306 77,306 Maintain 

2.3.60 Increase the total number of youth screened 

(Output) 

FY 2018: 62,542 

Target: 3,337 

(Target Exceeded) 

62,542 62,542 Maintain 

2.3.61 Increase the number of calls answered by the 

suicide hotline (Output) 

FY 2018: 2,224,408 

Target: 1,308,825 

(Target Exceeded) 

2,224,408 2,224,408 Maintain 

3.1.01 Increase the number of individuals screened 

for mental health or related interventions 

(Intermediate Outcome) 

FY 2018: Result Expected 

December 31, 2018 

Target: Set Baseline 

(Pending) 

Maintain 

3.1.02 Increase the number of individuals referred to 

mental health or related services (Intermediate 

Outcome) 

FY 2018: Result Expected 

December 31, 2018 

Target: Set Baseline 

(Pending) 

Maintain 

3.1.03 Increase the number of organizations that 

establish management information/information 

technology system links across multiple agencies 

(Intermediate Outcome) 

FY 2018: Result Expected 

December 31, 2018 

Target: Set Baseline 

(Pending) 

Maintain 

3.1.04 Increase the number of organizations or 

communities that demonstrate improved readiness 

to change their systems (Intermediate Outcome) 

FY 2018: Result Expected 

December 31, 2018 

Target: Set Baseline 

(Pending) 

Maintain 

3.2.37 Increase the number of youth referred to 

mental health or related services (Output) 

FY 2018: 13,950 

Target: 9,177 

(Target Exceeded) 

13,950 13,950 Maintain 

3.5.11 Increase the percentage of respondents who 

say calling the lifeline stopped you from killing 

yourself a lot or a little. (Outcome) 

FY 2019: Result Expected 

December 31, 2020 

Target: Set Baseline 

(Pending) 

TBD TBD TBD 

69 
 

$---

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Homelessness Prevention Programs 

(Dollars in thousands) 

Programs of Regional and National Significance 

FY 2018 

Final 

FY 2019 

Enacted 

FY 2020 

President's 

Budget 

FY 2020 

President's 

Budget 

+/-

FY 2019 

Enacted 

Homelessness Prevention Programs................................. 

Homelessness................................................................. 

$30,696 

2,296 

$30,696 

2,296 

$30,696 

2,296 ---

Authorizing Legislation ........................................ Sections 520A of the Public Health Service Act 

FY 2020 Authorization ............................................................................................... $394,550,000 

Allocation Method .............................................................................Competitive Grants/Contracts 

Eligible Entities........................................ States, Domestic Public and Community Organizations, 

Private Nonprofit Entities, and Community-based Public or Nonprofit Entities 

Program Description and Accomplishments 

While significant progress has been made over the last decade to reduce homelessness in specific 

communities and with specific populations, the number of people experiencing homelessness has 

remained high and increased in 2017 for the first time in 7 years. Many factors contribute to 

homelessness, including lack of affordable housing, foreclosures, rising housing costs, job loss, 

underemployment, mental illness, and addiction. Services are needed to link individuals to 

permanent housing and coordinate benefits, treatment, and supportive services. According to the 

U.S. Department of Housing and Urban Development, 553,742 individuals experienced 

homelessness on a given night in 2017 in the United States, there were 12 percent more people in 

the homeless population considered “chronically homeless” in 2017 (for a total of 86,962, or nearly 

16 percent), and the number of veterans experiencing homeless increased to 8 percent (40,056) of 

individuals who are homeless are veterans.18 About 20 percent of individuals experiencing 

homelessness have an SMI and 16 percent struggle with chronic substance use and misuse.19 

In FY 2011, SAMHSA initiated the Cooperative Agreements to Benefit Homeless Individuals 

(CABHI) program, jointly funded by the Center for Mental Health Services (CMHS) and Center for 

Substance Abuse Treatment (CSAT) (Treatment for Homeless line) to support treatment services 

and the development and expansion of local systems that provide permanent housing and supportive 

services. This includes integration of treatment and other critical services for individuals with SMI 

or co-occurring mental illness and drug/alcohol addiction. 

CABHI also supports coordination and planning at the local level with state or local Public Housing 

Authorities; local mental health, substance abuse treatment, and primary care provider organizations; 

the local Department of Housing and Urban Development-supported Continuum of Care (CoC) 

18 The 2017 Annual Homeless Assessment Report (AHAR) to Congress. (December 2017.). Retrieved December 3, 

2018, from https://www.hudexchange.info/resources/documents/2017-AHAR-Part-1.pdf 

19 The U.S. Department of Housing and Urban Development, 2017 CoC Homeless Populations and Subpopulations 

Reports. Available at 

https://www.hudexchange.info/resource/reportmanagement/published/CoC_PopSub_NatlTerrDC_2017.pdf 

70 
 

 

 

 

 

 

 

 

 

 

program; the state Medicaid Office; and the state Mental Health and Substance Abuse Authorities. 

This program expanded to include states as the eligible entity in 2013. 

In 2016, the CABHI program was expanded to include communities, tribal, and nonprofit 

organizations, as well as states. Funding was provided to enhance or develop the infrastructure 

needed to provide accessible, effective, comprehensive, coordinated/integrated, and evidence-based 

treatment services including, permanent supportive housing, peer supports, and other critical 

services for veterans, youth, and families experiencing homelessness or chronic homelessness and 

who also have serious mental illnesses or serious emotional disturbances, substance use disorders or 

co-occurring substance use and mental disorders. 

In FY 2018, SAMHSA initiated the CMHS-funded Treatment for Individuals Experiencing 

Homelessness (TIEH) program, to support the development and/or expansion of the local 

implementation of an infrastructure that integrates behavioral health treatment and recovery support 

services for individuals, youth, and families with a serious mental illness, serious emotional 

disturbance, or co-occurring disorder (i.e., a serious mental illness [SMI] and substance use disorder 

[SUD] or a serious emotional disturbance [SED] and SUD) who are experiencing homelessness. 

The goal of this program is to increase capacity and provide accessible, effective, comprehensive, 

coordinated, integrated, and evidence-based treatment services, peer support and other recovery 

support services, and linkages to sustainable permanent housing. 

Program Evaluation 

In FY 2016, SAMHSA supported a national evaluation to compare the effectiveness of the CABHI 

program and various models of service delivery that are used across homeless service programs 

managed by states, local governments, and community-based organizations. Recent data show that 

at six-month follow-up, 73.4 percent of individuals reported positive functioning, 23.1 percent were 

employed, and 62.1 percent had a permanent place to live. SAMHSA also supported a technical 

assistance contract to provide training and support to its homeless service providers and grantees. 

71 
 

Fiscal Year Amount 

FY 2016 $32,992,000 

FY 2017 $32,992,000 

FY 2018 $32,992,000 

FY 2019 $32,992,000 

FY 2020 $32,992,000 

In FY 2018, SAMHSA supported 46 continuation grants, a new cohort of 24 grants, and technical 

assistance activities. In FY 2019, SAMHSA supported 40 continuation grants, award a new cohort 

of 17 grants, and support TA activities. 

Funding History 

Budget Request 

The FY 2020 President’s Budget is $33.0 million, the same as the FY 2019 Enacted level. SAMHSA 

plans to support 41 continuation grants, award a new cohort of nine grants, and support TA activities. 

72 
Outputs and Outcomes Table 

 

 

 

 

 

 

 

 

 

 

 

 

Program: Homelessness Prevention Programs 

Measure 

Year and Most Recent Result 

Target for Recent Result 

(Summary of Result) 

FY 2019 

Target 

FY 2020 

Target 

FY 2020 

Target 

+/-

FY 2019 

Target 

3.4.23 Increase the number of clients 

served. (Output) 

FY 2018: 4,646 

Target: 5,100 

(Target Not Met) 

4,500 4,500 Maintain 

3.4.24 Increase the percentage of 

homeless clients receiving services 

who were currently employed or 

engaged in productive activities. 

(Outcome) 

FY 2018: 21.1 % 

Target: 30 % 

(Target Not Met) 

21 % 21% Maintain 

3.4.25 Increase the percentage of 

clients receiving services who had a 

permanent place to live in the 

community. (Outcome) 

FY 2018: 71.8 % 

Target: 33 % 

(Target Exceeded) 

71 % 71 % Maintain 

73 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Minority AIDS 

(Dollars in thousands) 

Programs of Regional and National Significance 

FY 2018 

Final 

FY 2019 

Enacted 

FY 2020 

President's 

Budget 

FY 2020 

President's 

Budget 

+/-

FY 2019 

Enacted 

Minority AIDS.................................................................. $9,224 $9,224 $9,224 $---

Authorizing Legislation ..........................................Section 520A of the Public Health Service Act 

FY 2020 Authorization ................................................................................................$394,550,000 

Allocation Method ....................................Competitive Grants/Contracts/Cooperative Agreements 

Eligible Entities..................................... Community and faith-based organizations, Tribes, Urban, 

Indian organizations, Hospitals, Public and private universities and colleges 

Program Description and Accomplishments 

The Centers for Disease Control and Prevention (CDC) reports significantly higher rates of 

HIV/AIDS among racial/ethnic minorities compared with the general population.20 African 

Americans accounted for 45 percent and Hispanics accounted for 23 percent of all HIV/AIDS cases 

diagnosed in 2013.21 Psychiatric and psychosocial complications are frequently not diagnosed nor 

addressed at the time of HIV diagnosis or through the course of the disease process. When untreated, 

these complications are associated with increased morbidity and mortality, impaired quality of life, 

and numerous medical issues such as non-adherence with the treatment regimen. 

The Minority AIDS program enhances and expands the provision of effective, culturally competent, 

HIV/AIDS-related mental health services in racial and ethnic minority communities for people living 

with or at high risk for HIV/AIDS. More than 4,600 individuals received services in FY 2017. The 

MAI program, along with many other HIV/AIDS programs across HHS, contributes to the goals of 

a new initiative to eliminate new HIV infections in our nation. Ending the HIV Epidemic: A Plan for 

America will be supported by this program through its continued assistance to vulnerable 

populations. 

In FY 2017, SAMHSA supported the continuation of 34 HIV Continuum of Care grants, and 

evaluation and technical assistance contracts. In FY 2018, SAMHSA awarded a new cohort of 18 

grants focused on individuals with mental disorders and/or co-occurring disorders living with or at 

risk for HIV/AIDS. 

In FY 2019, SAMHSA supported 18 continuation grants. 

20 Centers for Disease Control and Prevention. HIV Surveillance Report. (2013); vol. 25. Published February 2015. 

Accessed May 8, 2015 from http://www.cdc.gov/hiv/library/reports/surveillance. 21 Centers for Disease Control and Prevention. HIV Surveillance Report. (2013); vol. 25. Published February 2015. 

Accessed May 8, 2015 from http://www.cdc.gov/hiv/library/reports/surveillance. 

74 
Fiscal Year Amount 

FY 2016 $9,995,000 

FY 2017 $9,224,000 

FY 2018 $9,224,000 

FY 2019 

FY 2020 

$9,224,000 

$9,224,000 

Budget Request 

Funding History 

The FY 2020 President’s Budget is $9.2 million, the same as the FY 2019 Enacted level. SAMHSA 

will support grants focused on individuals with mental disorders and/or co-occurring disorders living 

with or at risk for HIV/AIDS. 

75 
 

Program Description and Accomplishments 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Criminal and Juvenile Justice Programs 

(Dollars in thousands) 

Programs of Regional and National Significance 

FY 2018 

Final 

FY 2019 

Enacted 

FY 2020 

President's 

Budget 

FY 2020 

President's 

Budget 

+/-

FY 2019 

Enacted 

Criminal and Juvenile Justice Programs........................ $4,269 $4,269 $14,269 $10,000 

Authorizing Legislation..................Sections 520A and 520G of the Public Health Service Act

FY 2020 Authorization ....................................................................................................$4,269,000 

Allocation Method .............................................................................Competitive Grants/Contracts 

Eligible Entities.................... Tribal Court Administrator, the Administrative Office of the Courts, 

the Single State Agency for Alcohol and Drug Abuse, the State Mental 

Health Agency, the Designated State Drug Court Coordinator, and Local 

Governmental Unit 

Data indicate that a significant number of individuals that come in contact with law enforcement and 

the criminal justice system have a mental or substance use disorder. More than half of all prison and 

jail inmates (i.e., people in state and federal prisons and local jails) meet criteria for having a mental 

health problem; 6 in 10 meet criteria for a substance abuse problem; and more than one-third meet 

criteria for having both a substance abuse and mental health problem.22 Approximately 250,000 

individuals with serious mental illness (SMI) are incarcerated at any given time—about half arrested 

for non-violent offenses, such as trespassing or disorderly conduct. In addition, during street 

encounters, police officers are almost twice as likely to arrest someone who appears to have a mental 

illness. A Chicago study of thousands of police encounters found that 47 percent of people with a 

mental illness were arrested, while only 28 percent of individuals without a mental illness were 

arrested for the same behavior.23 The costs associated with incarceration are high: state corrections 

budgets alone account for $39.0 billion in taxpayer costs.24,25 There is a clear and largely unmet need 

for effective behavioral health services and supports that are accessible before, during, and after 

incarceration and continue in the community as needed for this high-risk, population. 

In FY 2014, SAMHSA supported a second cohort of four-year Behavioral Health Treatment Court 

Collaborative grants (BHTCC) in the Mental Health and Substance Abuse Treatment appropriations. 

BHTCC supports judges and staff of specialty (e.g., drug court) and other courts within a jurisdiction 

to work together to divert adults with mental illness or co-occurring mental and substance use 

disorders from the criminal justice system. The purpose of this grant program is to allow municipal 

22 U.S. Department of Justice, Office of Justice Programs. (2006) Mental health problems of prison and jail inmates. 

Retrieved, March 25, 2011, from http://bjs.ojp.usdoj.gov/content/pub/pdf/mhppji.pdf 23 The Role of Mental Health Courts in System Reform. The Bazelon Center for Mental Health Law. 

http://heinonline.org/HOL/LandingPage?handle=hein.journals/udclr7&div=10&id=&page= 24 Pew Center on the States. (2011). State of recidivism: The revolving door of America’s prisons. Washington, DC: 

The Pew Charitable Trusts. http://www.pewtrusts.org/en/research-and-analysis/reports/0001/01/01/state-of-recidivism 25 Henrichson, C., & Delaney, R. (2012). The price of prisons: What incarceration costs taxpayers. New York: Vera 

Institute of Justice. 

76 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

courts more flexibility to collaborate with multiple criminal justice system components and local 

community treatment and recovery providers to address the behavioral health needs of adults who 

are involved with the criminal justice system. The Court Collaborative focuses on the diversion of 

adults with mental illness and co-occurring mental illness and drug/alcohol addiction, from the 

criminal justice system and includes alternatives to incarceration. The program supports community 

behavioral health services and includes a focus on veterans involved with the criminal justice system. 

In FY 2017, SAMHSA provided continuation support for 17 grants, technical assistance, and 

awarded a new evaluation contract. The BHTCC evaluation focuses on examining the clinical and 

functional outcomes of program participants with behavioral health issues. The evaluations also 

build on the findings from the first cohort and more thoroughly examine both the features of 

successful collaborations between the courts and community services as well as the clinical and 

functional outcomes of program participants. 

In FY 2018, SAMHSA awarded a new cohort of 12 Law Enforcement Behavioral Health 

Partnerships for Early Diversion (Short Title: Early Diversion) grants, which divert adults with an 

SMI or a co-occurring disorder from the criminal justice system to community-based services prior 

to arrest and booking. In addition, SAMHSA will continue support for the technical assistance and 

evaluation contracts. 

In FY 2019, SAMHSA continued support for 12 Early Diversion continuation grants and technical 

assistance and evaluation activities. 

Recent Evaluation Results 

SAMHSA completed an evaluation of the first cohort of BHTCC grantees in September 2014. 

Findings of the evaluation demonstrate that grantees built multi-agency workgroups or collaborative 

to oversee programs. Because of the grant funding, all grant recipients expanded access to specialty 

courts. Most grant recipients anticipated continuing new screening and assessment processes 

addressing a broader array of behavioral health needs after grant funding ended. Program 

innovations were divided into four main groups, including court and treatment provider 

collaboration, court and community case management, unified cross-court screening and referral, 

and meaningful peer involvement. BHTCC served over 2,99726 individuals, with 77 percent of them 

identified as having co-occurring mental illness and drug/alcohol addiction and with nearly two 

thirds reporting violence or trauma exposure in their lives. Based on performance data reporting, 

alcohol and other drug use by program participants declined by 53 percent at six months27. Nearly 

79 percent of participants either maintained good physical health or reported physical health 

improvements in the same time period28. In addition, employment rates increased from 29 percent 

to 45 percent over the first six months, with monthly mean income increasing by $217. 

26 Cohort 2 data through November 15, 2017. 27 Calculated as the change in percentage of individuals reporting alcohol or drug use from baseline to six-month 

follow-up. 28 Calculated as the percentage of individuals who either maintained a health status of excellent to good, or who had an 

improvement in health status from baseline to six-month. 

77 
Funding History 

Budget Request 

 

 

 

 

 

Fiscal Year Amount 

FY 2015 $4,296,000 

FY 2016 $4,269,000 

FY 2017 $4,269,000 

FY 2018 $4,269,000 

FY 2019 $4,269,000 

FY 2020 $14,269,000 

The FY 2020 President’s Budget is $14.2 million, an increase of $10 million from the FY 2019 

Enacted level. SAMHSA will award a new cohort of 28 grants, support the continuation of 12 grants, 

and technical assistance activities. The new cohort of 28 grants, supported by the increased funding 

will specifically address the needs of those with Serious Mental Illness. Individuals with SMI are 

more likely to become involved in the criminal justice system than those with mental illness. 

Focusing on SMI will reduce costly and counterproductive involvement in the criminal justice 

system and support better outcomes for these individuals by connecting them with needed services. 

78 
 

 

 

 

 

 

 

 

 

 

 

 

Outputs and Outcomes Table 

Program: Criminal and Juvenile Justice 

Measure 

Year and Most Recent Result 

Target for Recent Result 

(Summary of Result) 

FY 2019 

Target 

FY 2020 

Target 

FY 2020 

Target 

+/-

FY 2019 

Target 

3.5.06 Increase the percentage of 

clients receiving services who report 

positive functioning at 6 month 

follow-up. (Outcome) 

FY 2017: 50 % 

Target: 55.7 % 

(Target Not Met) 

50 % 50% Maintain 

3.5.07 Increase the percentage of 

clients receiving services who had a 

permanent place to live in the 

community at six-month follow-up. 

(Outcome) 

FY 2017: 50 % 

Target: 70.5 % 

(Target Not Met) 

50% 50% Maintain 

3.5.09 Increase the number of 

individuals screened for mental 

health or related interventions. 

(Outcome) 

FY 2017: 945 

Target: 1,448 

(Target Not Met) 

945 2,402 +1,457 

79 
Program Description and Accomplishments 

 

 

 

 

 

 

 

 

 

 

 

Practice Improvement and Training 

(Dollars in thousands) 

Programs of Regional and National Significance 

FY 2018 

Final 

FY 2019 

Enacted 

FY 2020 

President's 

Budget 

FY 2020 

President's 

Budget 

+/-

FY 2019 

Enacted 

Practice Improvement and Training............................... $7,828 $7,828 $7,828 $---

Authorizing Legislation ..........................................Section 520A of the Public Health Service Act 

FY 2020 Authorization ............................................................................................... $394,550,000 

Allocation Method .............................................................................Competitive Grants/Contracts 

Eligible Entities............. 105 Nationally Recognized Historically Black Colleges and Universities 

SAMHSA facilitates health integration by engaging in activities that support mental health system 

transformation. The Practice Improvement and Training programs address the need for 

disseminating key information, such as evidence-based mental health practices, to the mental health 

delivery system. 

The purpose of the Historically Black Colleges and Universities-Center for Excellence (HBCUCFE) program is to network the 105 HBCUs throughout the United States and promote behavioral 

health workforce development through expanding knowledge of best practices, developing 

leadership, and encouraging community partnerships that enhance the participation of African 

Americans in substance use disorder treatment and mental health professions. The comprehensive 

focus of the HBCU-CFE program simultaneously expands service capacity on campuses and in other 

treatment venues. 

In FY 2017, SAMHSA awarded one new HBCU-CFE grant to a consortium of HBCUs with a lead 

university. 

SAMHSA has worked to strengthen its clinical and science-based approach to addressing serious 

mental illness. In FY 2018, SAMHSA developed a Clinical Support Services TA Center to address 

SMI. This TA Center focuses specifically on the clinical treatment of SMI, including the use of 

medications. 

In FY 2019, SAMHSA continued support for the HBCU grant program and the Clinical Support 

Services TA Center, and the two RRTCs. 

80 
Funding History 

Fiscal Year Amount 

FY 2016 $7,828,000 

FY 2017 $7,828,000 

FY 2018 $7,828,000 

FY 2019 $7,828,000 

FY 2020 $7,828,000 

Budget Request 

 

 

The FY 2020 President’s Budget is $7.8 million, the same as the FY 2019 Enacted level. Funding 

will support the continuation of the expanded HBCU program, the continuation of the Clinical 

Support Services TA Center for SMI. 

The output and outcome measures for Practice Improvement and Training are part of the Mental 

Health - Science and Service Activities Outputs and Outcomes table shown on page 93. 

81 
 

 

Program Description and Accomplishments 

 

 

 

 

 

 

 

 

 

 

 

 

Consumer and Consumer-Supporter TA Centers 

(Dollars in thousands) 

Programs of Regional and National Significance 

FY 2018 

Final 

FY 2019 

Enacted 

FY 2020 

President's 

Budget 

FY 2020 

President's 

Budget 

+/-

FY 2019 

Enacted 

Consumer and Consumer-Supporter TA Centers.. $1,918 $1,918 $1,918 $---

Authorizing Legislation ..........................................Section 520A of the Public Health Service Act 

FY 2020 Authorization ................................................................................................$394,550,000 

Allocation Method ............................................................................................. Competitive Grants 

Eligible Entities.......................................................................................Community Organizations 

Consumer-centered services and supports, such as peer specialists, are vital to improving the quality 

and outcomes of health and behavioral healthcare services for people with mental disorders 

including SMI. First funded in 1992, the purpose of Consumer and Consumer-Supporter Technical 

Assistance (TA) Centers is to provide technical assistance to facilitate quality improvement of the 

mental health system by specific promotion of consumer-directed approaches for adults with SMI. 

Such approaches maximize consumer self-determination, promote long-term recovery, and assist 

individuals with SMI to increase their community involvement through work, school, and social 

connectedness. This program also improves collaboration among consumers, families, providers, 

and administrators. It helps to transform community mental health services into a more consumer 

and family driven model. 

Program Evaluation 

In FY 2017, the Consumer and Consumer-Supporter TA Centers provided training to over 12,000 

people. These trainings covered a range of topics that including peer support, the Wellness Recovery 

Action Plan, Emotional CPR, financial literacy, and collaborative leadership. In addition, the 

Consumer and Consumer-Supporter TA Centers provided support and expertise to consumer 

organizations that led to these organizations obtaining over $1.2 million in funding (non-grant). The 

program is responsible for nearly 359 consumers and family members holding positions within 

consumer or family organizations that participated in mental health-related planning and systems 

improvement. 

In FY 2018, and FY 2019 SAMHSA supported the continuation of five grants. 

82 
Funding History 

 

 

 

Fiscal Year Amount 

FY 2016 $1,918,000 

FY 2017 $1,918,000 

FY 2018 $1,918,000 

FY 2019 $1,918,000 

FY 2020 $1,918,000 

Budget Request 

The FY 2020 President’s Budget is $1.9 million, the same as the FY 2019 Enacted level. 

SAMHSA’s funding request will support five new grants to provide technical assistance to facilitate 

the quality improvement of the mental health system by promoting consumer-directed approaches 

for adults with SMI. 

The output and outcome measures for Consumer and Consumer-Supporter TA Centers are part of 

the Mental Health - Science and Service Activities Outputs and Outcomes table shown on page 93. 

83 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Disaster Response 

(Dollars in thousands) 

Programs of Regional and National Significance 

FY 2018 

Final 

FY 2019 

Enacted 

FY 2020 

President's 

Budget 

FY 2020 

President's 

Budget 

+/-

FY 2019 

Enacted 

Disaster Response........................................................... $1,953 $1,953 $1,953 $---

Authorizing Legislation ..........................................Section 520A of the Public Health Service Act 

FY 2020 Authorization ............................................................................................... $394,550,000 

Allocation Method .............................................................................Competitive Grants/Contracts 

Eligible Entities.......................................................Domestic Public or Private Non-Profit Entities 

Program Description and Accomplishments 

Natural and human caused disasters and emergent events like Hurricanes Irma, Maria, Harvey, 

Florence, and Michael, Typhoon Yutu, Hawaii volcano eruption, the California Wildfires, and the 

Parkland and Las Vegas shootings strike without warning. These unexpected disasters and events 

leave individuals, families, and whole communities struggling to rebuild. 

SAMHSA helps ensure that the nation is prepared to address the behavioral health needs that follow 

these disasters or events. SAMHSA focuses on three major programs: the Crisis Counseling 

Assistance and Training Program (CCP), the Disaster Distress Helpline (DDH), and Disaster 

Behavioral Health. These programs use appropriated funds to support survivors of natural and manmade disasters. 

SAMHSA, through an interagency agreement with the Federal Emergency Management Agency 

(FEMA), operates the CCP. This program assists individuals and communities in recovering from 

presidentially declared disasters through the provision of community-based behavioral health 

outreach and psycho-educational services. SAMHSA provides technical assistance, program 

guidance and monitoring, and oversight of the CCP. SAMHSA and FEMA jointly fund a Disaster 

Technical Assistance Center (DTAC) designed to provide additional technical assistance, strategic 

planning, consultation, and logistical support. SAMHSA provides Disaster Behavioral Health 

expertise around emerging public health initiatives to develop and disseminate innovative 

consultation and technologies to communities, federal partners, and other stakeholders. 

Program Evaluation 

In FY2017, the CCP Online Data Collection and Evaluation System showed the following contacts 

and encounters funded by 26 recent CCP grants, 607,292 in-person brief educational supportive 

contacts; 24,492 telephone contacts; and 11,062 email contacts. Also included are 128,762 

individual and family crisis counseling encounters (lasting 15 to 60 minutes or more) serving 

161,141 individuals and 22,016 group encounters (public education and group counseling) serving 

133,462 individuals. Group encounters including both public education and counseling were most 

often conducted with adults ages 18 to 64 (65 percent) followed by children and youth under the age 

of 18(18 percent) and adults ages 65 and older (17 percent). Group encounters most frequently 

provided information and education regarding the crisis counseling program (43 percent) followed 

84 
 

 

 

 

 

 

 

 

 

 

by community resources (35 percent) and reactions to disasters (21 percent). Group encounters also 

provided tips for problem solving (28 percent), doing positive things (27 percent), reducing negative 

thoughts (15 percent), and managing physical and emotional reactions (14 percent). Of the 187,702 

referral made during the CCP programs, the majority (79,381) were for referrals for community 

services such as housing, employment and social services, followed by 65,546 referrals for crisis 

counseling services, then 10,256 referrals for mental health treatment services. 

SAMHSA DTAC addressed and provided robust responses to 641 technical assistance requests in 

FY17 (non-CCP – 96; CCP – 545). 

SAMHSA’s Disaster Distress Helpline is a toll-free, multilingual crisis systems service available 

24/7 via telephone (1-800-985-5990) and Short Message Service (SMS) (text ‘TalkWithUs’ to

66746) to residents in the United States and its territories who are experiencing emotional distress 

resulting from disasters. In FY 2017, SAMHSA responded to nearly 14,000 calls and received over 

31,000 text messages through these services. In FY 2014, SAMHSA’s first Disaster app was created 

on Apple and Android platforms. The Disaster App provided evidence-informed and evidence-based 

resources in the Disaster Kit, along with additional partner resources and information on local mental 

health and substance use treatment facilities. It has the ability to share content anonymously and 

can function with limited Internet connectivity. 

In addition to these activities, SAMHSA funded a new cooperative agreement, Networking, 

Certifying and Training Suicide Prevention Hotlines and a National Disaster Distress Helpline in 

FY 2015. This jointly funded cooperative agreement manages, enhances, and strengthens the 

National Suicide Prevention Lifeline and supports the National Disaster Distress Helpline. 

SAMHSA continued to support for these activities in FY 2017. 

In FY 2018, SAMHSA awarded a new jointly funded cooperative for the National Suicide 

Prevention Lifeline and the National Disaster Distress Helpline and continued support for the DTAC. 

In FY 2019, SAMHSA continued support for the National Disaster Distress helpline and awarded a 

new DTAC contract. 

85 
Funding History 

 

 

Fiscal Year Amount 

FY 2016 $1,953,000 

FY 2017 $1,953,000 

FY 2018 $1,953,000 

FY 2019 $1,953,000 

FY 2020 $1,953,000 

Budget Request 

The FY 2020 President’s Budget is $2.0 million, the same as the FY 2019 Enacted level. SAMHSA 

is requesting funding to continue the support of a nationally available disaster distress crisis 

counseling telephone line and the Disaster Technical Assistance Center. 

The output and outcome measures for Disaster Response are part of the Mental Health - Science and 

Service Activities Outputs and Outcomes table shown on page 93. 

86 
Seclusion and Restraint 

 

 

 

 

 

 

(Dollars in thousands) 

Programs of Regional and National Significance 

FY 2018 

Final 

FY 2019 

Enacted 

FY 2020 

President's 

Budget 

FY 2020 

President's 

Budget 

+/-

FY 2019 

Enacted 

Seclusion and Restraint................................................. $1,147 $1,147 $1,147 $---

Authorizing Legislation ..........................................Section 520A of the Public Health Service Act 

FY 2020 Authorization ................................................................................................$394,550,000 

Allocation Method ............................................................................................................. Contracts 

Eligible Entities.........................................................................................................Not Applicable 

Program Description and Accomplishments 

People die because of the inappropriate use of seclusion and restraint practices; countless others are 

injured; and many are traumatized by coercive practices. Children with emotional and behavioral 

issues are more frequently subjected to restraints in schools than students with other disabilities, 

often leading to serious physical injuries and emotional trauma for both students and staff. Coercive 

practices, such as seclusion and restraint, impede recovery and well-being. 

In FY 2018, SAMHSA has utilized funding to contribute to a regionally-based TA effort focusing 

on issues related to the provision of services and supports for those living with mental disorders 

and/or SMI. 

In FY 2019, SAMHSA will support the continuation for the 11 MHTTC grants. 

87 
Fiscal Year Amount 

FY 2016 $1,147,000 

FY 2017 $1,147,000 

FY 2018 $1,147,000 

FY 2019 $1,147,000 

FY 2020 $1,147,000 

 

Funding History

Budget Request 

The FY 2020 President’s Budget is $1.1 million, the same as the FY 2019 Enacted level. SAMHSA’s

funding request will provide support for the continuation of the 11 MHTTC grants. 

88 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

Assisted Outpatient Treatment for Individuals with Serious Mental Illness 

(Dollars in thousands) 

Programs of Regional and National Significance 

FY 2018 

Final 

FY 2019 

Enacted 

FY 2020 

President's 

Budget 

FY 2020 

President's 

Budget 

+/-

FY 2019 

Enacted 

Assisted Outpatient Treatment for Individuals with 

Serious Mental Illness...................................... $15,000 $15,000 $15,000 $---

Authorizing Legislation ............... Section 224 of the Protecting Access to Medicare Act of 2014, 

FY 2020 Authorization ..................................................................................................$19,000,000 

Allocation Method .............................................................................Competitive Grants/Contracts 

Eligible Entities States and Communities 

Program Description and Accomplishments 

Recent data show that one in 25 Americans live with a SMI, such as schizophrenia, bipolar disorder 

and major depression. Less than half of adults with diagnosable mental disorders receive the 

treatment they need. Without access to and receipt of evidence-based mental health services, mental 

health issues can negatively affect all areas of a person’s life.

In an effort to increase access to evidence-based mental health services for individuals with SMI, in 

April 2014, Congress passed the Protecting Access to Medicare Act of 2014 (PAMA), which 

authorized a four-year pilot program to award grants for Assisted Outpatient Treatment (AOT) 

programs for individuals with SMI. This authorization was extended in the 21st Century Cures Act. 

AOT is the practice of delivering outpatient treatment under court order to adults with SMI who 

meet specific criteria, such as a prior history of non-adherence to treatment repeated hospitalizations 

or arrest. AOT involves petitioning local courts through a civil process to order individuals to enter 

and remain in treatment within the community for a specified period of time. This program will help 

to identify evidence-based AOT practices that support improved outcomes, including outreach and 

engagement, clinical treatment and supportive services, and due process protections. 

In FY 2016, SAMHSA implemented an AOT grant program and awarded 17 grants to eligible 

entities, such as a county, city, mental health system, mental health court, or any other entity with 

authority under the law of the state in which the grantee is located. This four-year pilot program is 

intended to implement and evaluate new AOT programs and identify evidence-based practices in 

order to reduce the incidence and duration of psychiatric hospitalization, homelessness, 

incarcerations, and interactions with the criminal justice system while improving the health and 

social outcomes of individuals with a SMI. This program is designed to work with families and 

courts to allow these individuals to obtain treatment while continuing to live in the community and 

their homes. Grants were awarded to applicants that have not previously implemented an AOT 

program. 

Program Evaluation 

SAMHSA has partnered with the Assistant Secretary for Planning and Evaluation to implement a 

cross-site evaluation which will assess the effectiveness and impact of the AOT grant program. 

89 
 

 

 

 

 

 

Additional program outcomes that will be evaluated will include, but are not be limited to, the rates 

of incarceration, employment, healthcare utilization, mortality, suicide, substance use, 

hospitalization, homelessness, and use of services. 

SAMHSA will continue to consult with the National Institute of Mental Health, the Attorney 

General, and the Administration for Community Living on this pilot program. In addition, 

SAMHSA will work with families and courts in the implementation of this program. 

In FY 2017, SAMHSA provided funding for the continuation of 17 grants, technical assistance, and 

the evaluation of this program. In FY 2018, SAMHSA continued funding for 15 continuation grants, 

3 new grants, and the evaluation of the program. 

In FY 2019, SAMHSA would provide funding for the continuation of 18 grants, and the evaluation 

of this program. 

Funding History 

Fiscal Year Amount 

FY 2016 $15,000,000 

FY 2017 $15,000,000 

FY 2018 $15,000,000 

FY 2019 $15,000,000 

FY 2020 $15,000,000 

Budget Request 

The FY 2020 Request level is $15.0 million, the same as the FY 2019 Enacted level. This funding 

will support a new cohort of 16 grants and three continuations grant to improve the health and social 

outcomes for individuals with SMI by providing continuation funding for the AOT grants, and the 

evaluation, and technical assistance contracts. 

90 
Program: Assisted Outpatient Treatment for Individuals with Serious Mental Illness 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Outputs and Outcomes Table 

Measure 

Year and Most Recent Result 

Target for Recent Result 

(Summary of Result) 

FY 2019 

Target 

FY 2020 

Target 

FY 2020 

Target 

+/-

FY 2019 

Target 

3.4.06 Increase the percentage of 

clients receiving services who report 

positive functioning at 6 month 

follow-up. (Outcome) 

FY 2018: 72.3 % 

Target: 76.6 % 

(Target Not Met) 

74.6 % 74.6 % Maintain 

3.4.07 Increase the percentage of 

clients receiving services who are 

maintained at six-month follow-up. 

(Outcome) 

FY 2018: 82.3 % 

Target: 81.8 % 

(Target Exceeded) 

81.8% 81.8% Maintain 

3.4.08 Increase the number of people 

in the mental health and related 

workforce trained in mental healthrelated practices/activities.(Outcome) 

FY 2017: 2,519 

Target: 756 

(Target Exceeded) 

2,519 2,519 Maintain 

3.4.09 Increase the number of 

consumers/family members who 

provide mental health-related 

services.(Outcome) 

FY 2017: 103 

Target: 52 

(Target Exceeded) 

103 103 Maintain 

91 
 

 

Outputs and Outcomes Table 

Program: Mental Health – Other Capacity Activities 1

Measure 

Year and Most Recent Result 

Target for Recent Result 

(Summary of Result) 

FY 2019 

Target 

FY 2020 

Target 

FY 2020 

Target 

+/-

FY 2019 

Target 

3.5.00 Increase the number of 

people in the mental health and 

related workforce trained in mental 

health-related practices/activities 

that are consistent with the goals of 

the grant (Output) 

FY 2018: 10,349 

Target: 10,349 

(Baseline) 

10,349 10,349 Maintain 

3.5.01 Increase the number of 

consumers/family members 

representing consumer/family 

organizations who are involved in 

ongoing mental health-related 

planning and advocacy activities as a 

result of the grant (Output) 

FY 2018: 11,536 

Target: 11,536 

(Baseline) 

11,536 11,536 Maintain 

1 Includes the following: Children and Family, Consumer and Family Network, Consumer and Consumer-Supporter TA 

Centers, Practice Improvement Training, and Disaster Response. 

92 
Program: Mental Health - Science and Service Activities 

 

 

 

 

 

 

 

 

 

 

 

 

Outputs and Outcomes Table 

Measure 

Year and Most Recent Result 

Target for Recent Result 

(Summary of Result) 

FY 2019 

Target 

FY 2020 

Target 

FY 2020 

Target 

+/-

FY 2019 

Target 

1.4.06 Increase the number of people 

trained by CMHS Science and 

Service Programs. (Output) 

FY 2018: 46,113 

Target: 40,070 

(Target Exceeded) 

46,113 46,113 Maintain 

1.4.14 Increase the number of calls 

answered by the Disaster Distress 

Hotline. (Output) 

FY 2018: 10,732 

Target: 13,889 

(Target Not Met) 

10,732 10,732 Maintain 

1.4.15 Increase the number of text 

messages answered by the Disaster 

Distress Hotline. (Output) 

FY 2018: 18,168 

Target: 31,644 

(Target Not Met) 

18,168 18,168 Maintain 

93 
Tribal Behavioral Health Grants 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(Dollars in thousands) 

Programs of Regional and National Significance 

FY 2018 

Final 

FY 2019 

Enacted 

FY 2020 

President's 

Budget 

FY 2020 

President's 

Budget 

+/-

FY 2019 

Enacted 

Tribal Behavioral Health Grants..................................... $15,000 $20,000 $20,000 $---

Authorizing Legislation ..........................................Section 520A of the Public Health Service Act 

FY 2020 Authorization ................................................................................................$394,550,000 

Allocation Method .......................................Competitive Grants/Contracts Eligible Entities Tribes 

Program Description and Accomplishments 

Suicide is the second leading cause of death among American Indian/Alaska Native (AI/AN) youth 

ages eight to 24 years. 29 Further, AI/AN high school students report higher rates of suicidal 

behaviors than the general population of U.S. high school students.30 These behaviors include 

serious thoughts of suicide, suicide plans, suicide attempts, and medical attention for a suicide 

attempt. However, the risk of suicide is not the same in all AI/AN youth demographic groups. For 

instance, AI/AN youth raised in urban settings have a smaller risk of having thoughts of suicide than 

AI/AN youth raised on tribal reservations (21 percent and 33 percent, respectively).31 

Consistent with the goals of the Tribal Behavioral Health Agenda, the Tribal Behavioral Health 

Grant (TBHG) program addresses the high incidence of substance use and suicide among AI/AN 

populations. Starting in FY 2014, this program supports tribal entities with the highest rates of 

suicide by providing effective and promising strategies that address substance abuse, trauma, and 

suicide and by promoting the mental health of AI/AN young people. 

In FY 2014, SAMHSA’s Center for Mental Health Services awarded five-year TBHG grants of up 

to $0.2 million annually to 20 tribes or tribal organizations with high rates of suicide. These fiveyear grants help grantees develop and implement a plan that addresses suicide and substance abuse, 

thereby promoting mental health among tribal youth. In addition, SAMHSA’s Tribal Training and

Technical Assistance Center (http://www.samhsa.gov/tribal-ttac) provides training and education to 

AI/AN grantees and organizations serving AI/AN populations to support their ability to achieve their 

goals. 

This initiative takes a comprehensive, culturally appropriate approach to help improve the lives of 

and opportunities for AI/AN youth. In addition to the Department of Health and Human Services, 

multiple agencies, including the Departments of Interior, Education, Housing and Urban 

29 Centers for Disease Control and Prevention. Fatal injury data, 2010. Web-based Injury Statistics Query and 

Reporting System. Available at www.cdc.gov/injury/wisqars/fatal.html. Accessed May 27, 2014. 30 Centers for Disease Control and Prevention. Youth Risk Behavior Surveillance System (YRBSS). Available at 

http://www.cdc.gov/healthyyouth/yrbs/index.htm. Accessed May 27, 2014. 31 Freedenthal, S. & Stiffman, A. R. (2004). Suicidal Behavior in Urban American Indian Adolescents: A Comparison 

with Reservation Youth in a Southwestern State. Suicide and Life-Threatening Behavior, 34(2), 160-171. 

94 
 

 

 

 

 

 

 

 

 

Fiscal Year Amount 

FY 2015 $4,988,000 

FY 2016 $15,000,000 

FY 2017 $15,000,000 

FY 2018 $15,000,000 

FY 2019 $20,000,000 

FY 2020 $20,000,000 

 

 

 

 

 

Development, Agriculture, Labor, and Justice, are working collaboratively with tribes to address 

issues facing AI/AN youth. 

In FY 2016, SAMHSA expand activities through the braided TBHG ($15.0 million in the Substance 

Abuse Prevention appropriation and $15.0 million in Mental Health appropriation) to allow tribes 

the flexibility to implement community-based strategies to address trauma, prevent substance abuse, 

and promote mental health and resiliency among youth in tribal communities. The additional FY 

2016 funding expanded these activities to approximately 90 tribes and tribal entities. With the 

expansion of the TBHG program, SAMHSA’s goal is to reduce substance use and the incidence of

suicide attempts among AI/AN youth and to address behavioral health conditions that affect learning 

in the Bureau of Indian Education-funded schools. The TBHG program will support mental health 

promotion, including trauma-informed strategies, and substance use prevention activities for highrisk AI/AN youth and their families, enhance early detection of mental illness and drug/alcohol 

addiction among AI/AN youth, and increase referral to treatment. In FY 2017, SAMHSA provided 

funding to support 81 grant continuations, 13 new grants, and the evaluation and technical assistance 

activities. 

In FY 2018, SAMHSA supported 80 grant continuations, 46 new grants, and technical assistance 

activities. In FY 2019, SAMHSA supported 106 grant continuations, 34 new grants, and technical 

assistance activities. 

Funding History 

Budget Request 

The FY 2020 President’s Budget is $20.0 million, the same as the FY 2019 Enacted level. This 

request, combined with $20.0 million in the Substance Abuse Prevention will continue support for 

140 grants that promote mental health and prevent substance use activities for high-risk AI/AN youth 

and their families. 

As a braided activity, SAMHSA will track separately any amounts spent or awarded under Tribal 

Behavioral Health Grants through the distinct appropriations and ensure that funds are used for 

purposes consistent with legislative direction and intent of these appropriations. 

95 
 Program: Tribal Behavioral Health 

 

 

 

 

 

 

 

 

 

 

Outputs and Outcomes Table 

Measure 

Year and Most Recent Result 

Target for Recent Result 

(Summary of Result) 

FY 2019 

Target 

FY 2020 

Target 

FY 2020 

Target 

+/-

FY 2019 

Target 

2.4.12 Increase the percentage of 

youth age 10 - 24 who received 

mental health or related services after 

screening, referral or attempt. 

(Output) 

FY 2017: 56 

Target: 20 

(Target Exceeded) 

56 56 Maintain 

2.4.13 Increase the number of 

programs/organizations that 

implemented specific mental-health 

related practices/activities as a result 

of the grant. (Outcome) 

FY 2017: 5,670 

Target: 296 

(Target Exceeded) 

5,670 5,670 Maintain 

96 
 

 

 

 

 

 

 

 

 

 

 

 

Minority Fellowship Program 

(Dollars in thousands) 

Programs of Regional and National Significance 

FY 2018 

Final 

FY 2019 

Enacted 

FY 2020 

President's 

Budget 

FY 2020 

President's 

Budget 

+/-

FY 2019 

Enacted 

Minority Fellowship Program.......................................... $8,059 $8,059 $--- -$8,059 

Authorizing Legislation ........................................................................ Section 597 of the PHS Act 

FY 2020 Authorization ..................................................................................................$12,669,000 

Allocation Method ................................................................................................. Grants/Contracts 

Eligible Entities......................................Organizations that represent individuals obtaining

post-baccalaureate training (including for master’s and doctoral degrees) for mental and substance

use disorder treatment professionals, including in the fields of psychiatry, nursing, social work, 

psychology, marriage and family therapy, mental health counseling, and substance use disorder 

and addiction counseling 

Program Description and Accomplishments 

SAMHSA’s Minority Fellowship Program (MFP) increases behavioral health practitioners’ 

knowledge of issues related to prevention, treatment, and recovery support for mental illness and 

drug/alcohol addiction among racial and ethnic minority populations. The program provides 

stipends to increase the number of culturally competent behavioral health professionals who teach, 

administer, conduct services research, and provide direct mental illness or substance use disorder 

treatment services for minority populations that are underserved. Since its start in 1973, the program 

has helped to enhance services for racial and ethnic minority communities through specialized 

training of mental health professionals in psychiatry, nursing, social work, and psychology. In 2006, 

the program expanded to include marriage and family therapists and later added professional 

counselors. Professional guilds receive competitively awarded grants, and then competitively award 

the stipends to post-graduate students pursuing a degree in that professional field. The MFP program 

has had a variety of foci including youth and addiction counselors. 

In FY 2018, SAMHSA awarded a new cohort of seven MFP grants and a new technical assistance 

contract. In FY 2019, SAMHSA supported seven continuation grants and the technical assistance 

contract. 

97 
Funding History 

Fiscal Year Amount 

FY 2016 $8,059,000 

FY 2017 $8,059,000 

FY 2018 $8,059,000 

FY 2019 $8,059,000 

FY 2020 ---

 

 

Budget Request 

The FY 2020 President’s Budget is $0.0 million, a decrease of $8.0 million from the FY 2019 

Enacted Budget. SAMHSA is eliminating this program because it overlaps with other federal 

activities. 

98 
 

 

 

 

 

 

 

 

 

 

 

 

Assertive Community Treatment for Adults with SMI 

(Dollars in thousands) 

Programs of Regional and National Significance 

FY 2018 

Final 

FY 2019 

Enacted 

FY 2020 

President's 

Budget 

FY 2020 

President's 

Budget 

+/-

FY 2019 

Enacted 

Assertive Community Treatment for Adults with SMI $5,000 $5,000 $15,000 $10,000 

Authorizing Legislation ........................................Sections 520M of the Public Health Service Act 

FY 2020 Authorization ....................................................................................................$5,000,000 

Allocation Method .............................................................................Competitive Grants/Contracts 

Eligible Entities............................. States, local governments, Indian tribes or tribal organizations, 

mental health systems, or health care facilities 

Program Description and Accomplishments 

The Assertive Community Treatment (ACT) for Adults with SMI program is authorized under the 

21st Century Cures Act. ACT is an evidence-based practice considered one of the most effective 

approaches to deliver services to individuals with the most severe impairments associated with SMI32 

and has been disseminated by SAMHSA for widespread use through its Evidence Based Toolkit 

series33 beginning in 2008. ACT was developed to reduce re-hospitalization and improve outcomes 

in community settings. ACT is designed as an integrated care approach to provide a comprehensive 

array of services, including medication management and other supportive services, directly rather 

than through referrals. The ACT team is composed of 10-12 multidisciplinary behavioral health 

staff, including psychiatrists, nurses, social workers, addiction counselors, employment/vocational 

supports, and peer specialists. These practitioners work together to deliver comprehensive, 

individualized, and recovery-oriented treatment and case management services to approximately 100 

people with SMI in community settings. Caseloads are approximately one staff member to every 10 

individuals. Services are provided 24 hours, 7 days a week and as long as needed, wherever they 

are needed. Teams often find they can anticipate and avoid crises. 

In FY 2018, SAMHSA awarded seven new grants to develop and/or expand fidelity-based ACT 

services to meet the needs of individuals with SMI, and reduce hospitalization, homelessness, and 

involvement in the criminal justice system while improving health and social outcomes of 

participants in the program. In FY 2019, SAMHSA supported seven continuation grants. 

32 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3589962/ 33 http://store.samhsa.gov/product/Assertive-Community-Treatment-ACT-Evidence-Based-Practices-EBPKIT/SMA08-4345 

99 
Funding History 

Fiscal Year Amount 

FY 2016 ---

FY 2017 ---

FY 2018 

$5,000,000 

FY 2019 $5,000,000 

FY 2020 $15,000,000 

 

Budget Request 

The FY 2020 President’s Budget is $15.0 million, an increase of $10.0 million from the FY 2019 

Enacted level. Funding will support the continuation of seven grants and award a new cohort of 13 

grants to advance the ACT approach to address the needs of those living with SMI and technical 

assistance and evaluation activities. 

100 
Program: Assertive Community Treatment Grants 

 

 

 

 

 

 

 

 

 

 

 

 

Outputs and Outcomes Table 

Measure 

Year and Most Recent Result 

Target for Recent Result 

(Summary of Result) 

FY 2019 

Target 

FY 2020 

Target 

FY 2020 

Target 

+/-

FY 2019 

Target 

3.4.13 Increase the percentage of 

clients receiving services who report 

positive functioning at 6 month followup. (Outcome) 

FY 2019: Result Expected 

December 31, 2019 

Target: 66.0 

(Pending) 

66.0 66.0 Maintain 

3.4.14 Increase the percentage of 

clients receiving services who are 

currently employed at 6 month followup. (Outcome) 

FY 2019: Result Expected 

December 31, 2019 

Target: 39.0 

(Pending) 

39.0 39.0 Maintain 

3.4.15 Increase the percentage of 

clients receiving services who have a 

permanent place to live in the 

community at 6 month follow-up. 

(Outcome) 

FY 2019: Result Expected 

December 31, 2019 

Target: 74.0 

(Pending) 

74.0 74.0 Maintain 

101 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Infant and Early Childhood Mental Health 

(Dollars in thousands) 

Programs of Regional and National Significance 

FY 2018 

Final 

FY 2019 

Enacted 

FY 2020 

President's 

Budget 

FY 2020 

President's 

Budget 

+/-

FY 2019 

Enacted 

Infant and Early Childhood Mental Health................... $5,000 $5,000 $--- -$5,000 

Authorization Legislation ....................................Section 399Z-2 of the Public Health Service Act 

FY 2020 Authorization ..................................................................................................$20,000,000 

Allocation Method ............................................................................................. Competitive Grants 

Eligible Entities................................................Human Services Agencies and Non-profit 

Institutions 

Program Description and Accomplishments 

Nearly one in seven US children aged 2 to 8 years has a mental, behavioral, or developmental 

disorder.34 It is also estimated that approximately 9.5 percent–14.2 percent of children birth to 5 

years old experience emotional, relational, or behavioral disturbance.35 Without proper intervention, 

these early childhood disorders can have negative impacts on all areas of a child’s development.

Young children whose social and emotional development is compromised are at higher risk for 

school problems and juvenile delinquency later in life.36 Rising rates of substance-exposure in 

infants also require more intensive early childhood services to help improve the trajectories of the 

families where substance misuse is present. 

The authorization for this program was added to the Public Health Service Act by an amendment in 

the 21st Century Cures Act. The first funding for this program was provided in FY 2018. The purpose 

of this program is to improve outcomes for children, from birth to not more than 12 years of age, 

who are at risk for, show early signs of, or have been diagnosed with a mental illness including a 

serious emotional disturbance by developing, maintaining, or enhancing infant and early childhood 

mental health promotion, intervention, and treatment services, including: 

 Programs for infants and children at significant risk of developing, showing early signs of, 

or having been diagnosed with a mental illness, including a serious emotional disturbance 

(SED) and/or symptoms that may be indicative of a developing SED in children with a 

34 Bitsko, RH, Holbrook, JR, Kaminski, J, Robinson, LR, Ghandour, R, Smith, C, Peacock, G. (2016) Health-care, 

Family and Community Factors associated with Mental, Behavioral and Developmental Disorders in Early Childhood 

– United States, 2011-2012. MMWR.; 65(9); 221-226. Available from 

https://www.cdc.gov/ncbddd/childdevelopment/features/key-finding-factors-mental-behavioral-developmental-earlychildhood.html. 

35 Brauner, C. B., & Stephens, C. B. (2006). Estimating the prevalence of early childhood serious emotional/behavioral 

disorders: Challenges and recommendations. Public Health Reports, 121(3), 303–310. Available from 

www.ncbi.nlm.nih.gov/pmc/articles/PMC1525276 

36 Jones, D. E., Greenberg, M., & Crowley, M. (2015). Early Social-Emotional Functioning and Public Health: The 

Relationship Between Kindergarten Social Competence and Future Wellness. American Journal of Public Health, 

105(11), 2283–2290. http://doi.org/10.2105/AJPH.2015.302630 

102 
 

 

 

 

 

 

 

 

history of in utero exposure to substances such as opioids, stimulants or other drugs that may 

impact development; and 

 Multi-generational therapy and other services that strengthen positive caregiving 

relationships. 

SAMHSA expects this program will increase access to a range of evidence-based and culturallyappropriate infant and early childhood mental health services, and will aid in addressing the national 

shortage of mental health professionals with infant and early childhood expertise. Because the 

wellbeing of caregivers dramatically impacts the development of infants and young children, this 

program also promotes a multigenerational approach that supports caregivers and other family 

members of infants and young children. 

Program activities include providing and ensuring access to culturally- and developmentallyappropriate mental health services; implementing mental health consultation to build capacities of 

the early childhood workforce; creating opportunities for child- and family-serving providers to 

develop greater expertise and knowledge of infant and childhood mental health; and increasing 

availability of specialized training for mental health clinicians and trainees on infant and early 

childhood promising and evidence-based practices and treatment approaches. 

In FY 2018, SAMHSA awarded 10 new grants for five-years. In FY 2019 SAMHSA supported the 

continuation of 10 grants. 

Funding History 

Fiscal Year Amount 

FY 2016 ---

FY 2017 ---

FY 2018 $5,000,000 

FY 2019 $5,000,000 

FY 2020 ---

Budget Request 

The FY 2020 Budget Request is $0.0, a decrease of $5.0 million from the FY 2019 Enacted level. 

SAMHSA is eliminating this program because it overlaps with other federal activities. 

103 
Outputs and Outcomes Table 

 Program: Infant and Early Childhood Mental Health 

 

 

 

 

 

 

 

 

 

 

 

 

 

Measure 

Year and Most Recent Result 

Target for Recent Result 

(Summary of Result) 

FY 2019 

Target 

FY 2020 

Target 

FY 2020 

Target 

+/-

FY 2019 

Target 

3.4.16 Increase the percentage of 

children receiving services who report 

positive functioning at 6 month followup. (Outcome) 

FY 2018: Result Expected 

December 31, 2019 

Target: 45 % 

(Pending) 

45 % -45% 

3.4.17 Increase the percentage of 

children receiving services who report 

positive social support at 6 month 

follow-up. (Outcome) 

FY 2018: Result Expected 

December 31, 2019 

Target: 80 % 

(Pending) 

80 % -80% 

3.4.18 Increase the number of people 

in the mental health and related 

workforce trained in specific mental 

health-related practices/activities as a 

result of the program. (Output) 

FY 2018: Result Expected 

December 31, 2019 

Target: 450 

(Pending) 

450 -450 

104 
 

SAMHSA/Mental Health 

PRNS Mechanism Table Summary 

(Dollars in thousands) 

Program Activity 

FY 2018 Final 

No. Amount 

FY 2019 

Enacted 

No. Amount 

FY 2020 

President's 

Budget 

No. Amount 

Programs of Regional & National Significance 

Grants/Cooperative Agreements 

Continuations....................................................... 

New/Competing.................................................... 

Supplements*....................................................... 

Subtotal.............................................................. 

Contracts 

Continuations....................................................... 

New/Competing.................................................... 

Subtotal.............................................................. 

Total, Mental Health PRNS 

499 199,941 

419 185,127 

105 11,375 

682 297,540 

196 102,150 

50 6,814 

739 297,173 

151 86,676 

6 5,836 

918 396,443 878 406,504 890 389,684 

11 37,878 

3 4,339 

6 34,427 

11 18,731 

10 39,550 

1 500 

14 42,216 17 53,157 11 40,050 

932 $438,659 895 $459,661 901 $429,734 

* Excluding Supplements number count to avoid duplication. 

105 
 

--- --- ---

--- --- --- --- ---

---

--- ---

--- ---

---

--- ---

--- ---

SAMHSA/Mental Health 

PRNS Mechanism Table by Program, Project, and Activity 

(Dollars in thousands) 

Programs of Regional and National Significance 

FY 2018 

Final 

No. Amount 

FY 2019 

Enacted 

No. Amount 

FY 2020 

President's 

Budget 

No. Amount 

Capacity: 

National Child Traumatic Stress Network 

Grants 

Continuations................................................................. 

New/Competing............................................................. 

Subtotal..................................................................... 

Contracts 

Continuations................................................................. 

New/Competing............................................................. 

Subtotal..................................................................... 

Total, National Child Traumatic Stress Network 

Project AWARE 

Grants 

Continuations................................................................. 

New/Competing............................................................. 

Supplements*................................................................. 

Subtotal...................................................................... 

Contracts 

Continuations................................................................. 

New/Competing............................................................. 

Subtotal...................................................................... 

Total, Project AWARE 

Healthy Transitions 

Grants 

Continuations................................................................. 

New/Competing............................................................. 

Supplements*................................................................. 

Subtotal..................................................................... 

Contracts 

Continuations................................................................. 

New/Competing............................................................. 

Subtotal...................................................................... 

Total, Healthy Transitions 

86 $44,476 

14 6,391 

100 $50,556 

4 10,000 

100 $51,680 

17 8,410 

100 50,866 104 60,556 117 60,090 

3,021 3,331 3,797 

---

--- 3,021 --- 3,331 --- 3,797 

100 53,887 

23 17,857 

164 60,970 

31 7,074 

104 63,887 

173 70,203

26 16,402 

11 300 

117 63,887 

199 85,828 

7 9,417 

---

187 85,901 199 86,904 206 95,245 

--- 5,063 

---

5,032 

--- 28 

6,719 

---

--- 5,063 --- 5,060 --- 6,719 

187 90,964 

16 13,650 

10 10,538 

15 375 

199 91,964 

10 10,498 

14 14,130 

---

206 101,964 

24 24,181 

5 5,000 

--- ---

26 24,563 24 24,628 29 29,181 

1,388 

---

1,323 

---

--- 1,770 

--- ---

--- 1,388 --- 1,323 --- 1,770 

26 25,951 24 25,951 29 30,951 

106 
 

Children and Family Programs 

Grants 

Continuations................................................................. 13 5,028 14 5,458 1 375 

New/Competing............................................................. 1 375 --- --- 14 5,681 

Subtotal........................................................................ 14 5,403 14 5,458 15 6,056 

Contracts 

Continuations................................................................. --- 1,677 --- 1,771 --- 1,173 

New/Competing............................................................. --- 148 --- --- --- ---

Subtotal........................................................................ 

Total, Children and Family Programs 

--- 1,826 --- 1,771 --- 1,173 

14 7,229 14 7,229 15 7,229 

Consumer and Family Network Grants 

Grants 

Continuations................................................................. 32 2,988 25 2,369 47 4,570 

New/Competing............................................................. 23 1,966 24 2,333 1 95 

Subtotal........................................................................ 55 4,954 49 4,701 48 4,665 

Contracts 

Continuations................................................................. --- --- --- 253 --- 289 

New/Competing............................................................. --- --- --- --- --- ---

Subtotal........................................................................ 

Total, Consumer and Family Network Grants 

--- --- --- 253 --- 289 

55 4,954 49 4,954 48 4,954 

 

 

Project LAUNCH 

Grants/Cooperative Agreements 

Continuations................................................................. 18 11,960 14 8,789 29 20,877 

New/Competing............................................................. 14 8,699 15 12,256 --- ---

Supplements*................................................................. 6 140 --- --- --- ---

Subtotal........................................................................ 32 20,799 29 21,045 29 20,877 

Contracts 

Continuations................................................................. 1 2,806 --- 1,465 1 2,728 

New/Competing............................................................. --- --- 1 1,095 --- ---

Subtotal........................................................................ 

Total, Project LAUNCH 

1 2,806 1 2,560 1 2,728 

33 23,605 30 23,605 30 23,605 

 

 

Mental Health System Transformation and Health 

Reform 

Grants 

Continuations................................................................. 7 2,545 --- --- 8 2,910 

New/Competing............................................................. --- --- 8 2,937 --- ---

Supplements*................................................................. 

Subtotal........................................................................ 

7 175 --- --- --- ---

7 2,720 8 2,937 8 2,910 

Contracts 

Continuations................................................................. --- 1,059 --- 842 --- 869 

New/Competing............................................................. 

Subtotal........................................................................ 

--- --- --- --- --- ---

--- 1,059 --- 842 --- 869 

Total, Mental Health System Transformation and 

Health Reform 7 3,779 8 3,779 8 3,779 

SAMHSA/Mental Health 

PRNS Mechanism Table by Program, Project, and Activity 

(Dollars in thousands) 

FY 2018 

Final 

FY 2019 

Enacted 

FY 2020 

President's 

Budget 

Programs of Regional and National Significance No. Amount No. Amount No. Amount 

107 
 

Continuations................................................................. 59 21,258 28 33,350 --- ---

New/Competing............................................................. 13 25,973 --- --- --- ---

Supplements*................................................................. 4 500 --- --- --- ---

--- ---

Continuations................................................................. --- 2,146 --- 2,887 --- ---

New/Competing............................................................. --- --- 7 13,640 --- ---

--- ---

--- ---

Continuations................................................................. 5 1,884 20 10,150 15 7,792 

New/Competing............................................................. 15 7,796 --- --- 5 2,287 

Supplements*................................................................. 

Subtotal........................................................................ 

15 450 15 450 --- 450 

20 10,129 20 10,600 20 10,529

--- 860 --- 600 --- 671 

--- 10 --- --- ---

--- --- ---

Continuations................................................................. 45 31,932 19 13,894 29 21,127 

New/Competing............................................................. --- --- 26 19,362 16 12,000 

Continuations................................................................. 1 3,495 --- 2,042 --- 2,300 

New/Competing............................................................. 

Subtotal........................................................................ 

--- --- --- 130 --- ---

1 3,495 --- 2,172 --- 2,300 

Continuations................................................................. 35 3,347 41 4,060 43 4,282 

New/Competing............................................................. 24 2,341 19 1,884 17 1,560 

Continuations................................................................. --- 799 --- 514 --- 645 

New/Competing............................................................. --- --- --- 30 --- ---

--- --- ---

SAMHSA/Mental Health 

PRNS Mechanism Table by Program, Project, and Activity 

(Dollars in thousands) 

Programs of Regional & National Significance 

FY 2018 

Final 

No. Amount 

FY 2019 

Enacted 

No. Amount 

FY 2020 

President's 

Budget 

No. Amount 

Primary and Behavioral Health Care Integration 

Grants 

Subtotal........................................................................ 

Contracts 

Subtotal........................................................................ 

Total, PBHCI 

National Strategy for Suicide Prevention 

Grants 

Contracts 

Continuations................................................................. 

New/Competing............................................................. 

Subtotal........................................................................ 

Total, National Strategy for Suicide Prevention 

GLS - Youth Suicide Prevention - States 

Grants 

Subtotal........................................................................ 

Contracts 

Total, GLS - States 

GLS - Youth Suicide Prevention - Campus 

Grants 

Subtotal........................................................................ 

Contracts 

Subtotal........................................................................ 

Total, GLS - Campus 

72 47,731 28 33,350 

2,146 7 16,527 ---

72 49,877 35 49,877 

871 600 671 

20 11,000 20 11,200 20 11,200 

45 31,932 45 33,255 45 33,127 

46 35,427 45 35,427 45 35,427 

59 5,689 60 5,944 60 5,843 

799 544 645 

59 6,488 60 6,488 60 6,488 

108 
109

SAMHSA/Mental Health

PRNS Mechanism Table by Program, Project, and Activity

(Dollars in thousands)

Programs of Regional & National Significance

FY 2018

Final

FY 2019

Enacted

FY 2020

President's

Budget

No. Amount No. Amount No. Amount

GLS - Suicide Prevention Resource Center

Grants

Continuations............................................................... 1 5,634 1 5,634 --- ---

New/Competing........................................................... --- --- --- --- 1 5,639

Subtotal ..................................................................... 1 5,634 1 5,634 1 5,639

Contracts

Continuations............................................................... --- 354 --- 354 --- 349

New/Competing........................................................... --- --- --- --- --- ---

Subtotal ..................................................................... --- 354 --- 354 --- 349

Total, GLS - Suicide Prevention Resource Center 1 5,988 1 5,988 1 5,988

Suicide Lifeline

Grants

Continuations............................................................... 6 670 1 5,302 3 6,035

New/Competing........................................................... 1 5,802 2 672 --- ---

Supplements* .............................................................. --- --- 1 5,414 1 5,266

Subtotal ..................................................................... 7 6,472 3 11,388 3 11,301

Contracts

Continuations............................................................... --- 726 --- 612 --- 699

New/Competing........................................................... --- --- --- --- --- ---

Subtotal ..................................................................... --- 726 --- 612 --- 699

Total, Suicide Lifeline 7 7,198 3 12,000 3 12,000

AI/AN Suicide Prevention Initiative

Grants

Continuations............................................................... --- --- 1 500 1 500

New/Competing........................................................... 1 500 --- --- --- ---

Subtotal ..................................................................... 1 500 1 500 1 500

Contracts

Continuations............................................................... --- 325 1 2,431 1 2,431

New/Competing........................................................... 1 2,106 --- --- --- ---

Subtotal ..................................................................... 1 2,431 1 2,431 1 2,431

Total, AI/AN 2 2,931 2 2,931 2 2,931

Homelessness Prevention Programs

Grants

Continuations............................................................... 46 13,295 40 17,624 41 21,732

New/Competing........................................................... 24 12,800 17 8,943 9 4,695

Supplements* .............................................................. 9 220 8 200 5 120

Subtotal ..................................................................... 70 26,315 57 26,767 50 26,547

Contracts

Continuations............................................................... 1 4,381 --- 1,569 1 4,149

New/Competing........................................................... --- --- 1 2,360 --- ---

Subtotal ..................................................................... 1 4,381 1 3,929 1 4,149

Total, Homelessness Prevention Programs 71 30,696 58 30,696 51 30,696
110

SAMHSA/Mental Health

PRNS Mechanism Table by Program, Project, and Activity

(Dollars in thousands)

Programs of Regional & National Significance

FY 2018

Final

FY 2019

Enacted

FY 2020

President's

Budget

No. Amount No. Amount No. Amount

Minority AIDS

Grants

Continuations............................................................... — — 18 8,683 18 8,686

New/Competing........................................................... 18 8,649 — — — —

Subtotal ..................................................................... 18 8,649 18 8,683 18 8,686

Contracts

Continuations............................................................... — 575 — 541 — 538

New/Competing........................................................... — — — — — —

Subtotal ..................................................................... — 575 — 541 — 538

Total, Minority AIDS 18 9,224 18 9,224 18 9,224

Criminal and Juvenile Justice Programs

Grants

Continuations............................................................... — — 12 3,689 12 3,705

New/Competing........................................................... 12 3,487 — — 25 8,487

Subtotal ..................................................................... 12 3,487 12 3,689 37 12,192

Contracts

Continuations............................................................... 2 782 1 580 1 1,577

New/Competing........................................................... — — — — 1 500

Subtotal ..................................................................... 2 782 1 580 2 2,077

Total, Criminal and Juvenile Justice Programs 14 4,269 13 4,269 39 14,269

Seclusion and Restraint

Grants

Continuations............................................................... — — 11 1,087 11 1,076

New/Competing........................................................... 11 1,087 — — — —

Subtotal ..................................................................... 11 1,087 11 1,087 11 1,076

Contracts

Continuations............................................................... — 60 — 60 — 71

New/Competing........................................................... — — — — — —

Subtotal ..................................................................... — 60 — 60 — 71

Total, Seclusion and Restraint 11 1,147 11 1,147 11 1,147

Assertive Community Treatment for Individuals with

Serious Mental Illness

Grants

Continuations............................................................... — — 7 4,733 7 4,740

New/Competing........................................................... 7 4,740 — — 13 9,386

Subtotal ..................................................................... 7 4,740 7 4,733 20 14,126

Contracts

Continuations............................................................... — — — 267 — 874

New/Competing........................................................... — 260 — — — —

Subtotal ..................................................................... — 260 — 267 — 874

Total, Assertive Community Treatment for Individuals

with Serious Mental Illness 7 5,000 7 5,000 20 15,000
111

SAMHSA/Mental Health

PRNS Mechanism Table by Program, Project, and Activity

(Dollars in thousands)

Programs of Regional & National Significance

FY 2018

Final

FY 2019

Enacted

FY 2020

President's

Budget

No. Amount No. Amount No. Amount

Assisted Outpatient Treatment for Individuals with

Serious Mental Illness

Grants

Continuations............................................................... 15 10,626 18 13,739 3 2,155

New/Competing........................................................... 3 2,187 --- --- 16 12,212

Supplements*............................................................... 18 450 15 450 --- ---

Subtotal ..................................................................... 18 13,264 18 14,189 19 14,367

Contracts

Continuations............................................................... 1 1,736 --- 786 --- 633

New/Competing........................................................... --- --- --- 25 --- ---

Subtotal ..................................................................... 1 1,736 --- 811 --- 633

Total, AOT for Individuals with SMI 19 15,000 18 15,000 19 15,000

Tribal Behavioral Health Grants

Grants

Continuations............................................................... 80 8,157 106 8,977 140 17,221

New/Competing........................................................... 46 4,303 34 8,477 --- ---

Subtotal ..................................................................... 126 12,460 140 17,454 140 17,221

Contracts

Continuations............................................................... 1 2,465 1 2,496 1 2,779

New/Competing........................................................... --- 75 --- 50 --- ---

Subtotal ..................................................................... 1 2,540 1 2,546 1 2,779

Total, Tribal Behavioral Health Grants 127 15,000 141 20,000 141 20,000

Infant and Early Childhood Mental Health

Grants

Continuations............................................................... --- --- 10 4,782 --- ---

New/Competing........................................................... 10 4,880 --- --- --- ---

Subtotal ..................................................................... 10 4,880 10 4,782 --- ---

Contracts

Continuations............................................................... --- --- --- 218 --- ---

New/Competing........................................................... --- 120 --- --- --- ---

Subtotal ..................................................................... --- 120 --- 218 --- ---

Total, Infant and Early Childhood Mental Health 10 5,000 10 5,000 --- ---

Subtotal, Capacity 906 $414,614 870 $435,616 883 $415,739
112

SAMHSA/Mental Health

PRNS Mechanism Table by Program, Project, and Activity

(Dollars in thousands)

Programs of Regional & National Significance

FY 2018

Final

FY 2019

Enacted

FY 2020

President's

Budget

No. Amount No. Amount No. Amount

Science and Service:

Primary and Behavioral Health Care Integration TA

Grants

Continuations............................................................... --- --- --- --- --- ---

New/Competing........................................................... --- --- --- 1,889 --- ---

Supplements*............................................................... --- 1,991 --- --- --- ---

Subtotal ..................................................................... --- 1,991 --- 1,889 --- ---

Contracts

Continuations............................................................... --- --- --- 102 --- ---

New/Competing........................................................... --- --- --- --- --- ---

Subtotal ..................................................................... --- --- --- 102 --- ---

Total, PBHCI TA --- 1,991 --- 1,991 --- ---

Practice Improvement & Training

Grants

Continuations............................................................... 7 2,831 1 2,643 8 5,515

New/Competing........................................................... 1 2,539 7 2,865 --- ---

Subtotal ..................................................................... 8 5,370 8 5,508 8 5,515

Contracts

Continuations............................................................... 3 2,045 1 1,734 3 2,313

New/Competing........................................................... --- 413 1 586 --- ---

Subtotal ..................................................................... 3 2,458 2 2,320 3 2,313

Total, Practice Improvement & Training 11 7,828 10 7,828 11 7,828

Consumer and Consumer-Supporter TA Centers

Grants

Continuations............................................................... 5 1,803 5 1,804 --- ---

New/Competing........................................................... --- --- --- --- 5 1,806

Subtotal ..................................................................... 5 1,803 5 1,804 5 1,806

Contracts

Continuations............................................................... --- 115 --- 114 --- 112

New/Competing........................................................... --- --- --- --- --- ---

Subtotal ..................................................................... --- 115 --- 114 --- 112

Total, CCSTAC 5 1,918 5 1,918 5 1,918

Disaster Response

Grants

Continuations............................................................... --- --- --- 828 --- 828

New/Competing........................................................... --- 828 --- --- --- ---

Subtotal ..................................................................... --- 828 --- 828 --- 828

Contracts

Continuations............................................................... 1 1,125 --- 339 1 1,125

New/Competing........................................................... --- --- 1 786 --- ---

Subtotal ..................................................................... 1 1,125 1 1,125 1 1,125

Total, Disaster Response 1 1,953 1 1,953 1 1,953
113

SAMHSA/Mental Health

PRNS Mechanism Table by Program, Project, and Activity

(Dollars in thousands)

Programs of Regional & National Significance

FY 2018

Final

FY 2019

Enacted

FY 2020

President's

Budget

No. Amount No. Amount No. Amount

Homelessness

Grants

Continuations............................................................... --- --- --- 1,356 --- 1,358

New/Competing ........................................................... --- 1,444 --- --- --- ---

Subtotal..................................................................... --- 1,444 --- 1,356 --- 1,358

Contracts

Continuations............................................................... --- 142 1 940 1 938

New/Competing ........................................................... 1 710 --- --- --- ---

Subtotal..................................................................... 1 852 1 940 1 938

Total, Homelessness 1 2,296 1 2,296 1 2,296

Minority Fellowship Program

Grants

Continuations............................................................... --- --- 7 6,833 --- ---

New/Competing ........................................................... 7 6,833 --- --- --- ---

Subtotal..................................................................... 7 6,833 7 6,833 --- ---

Contracts

Continuations............................................................... --- 730 1 1,226 --- ---

New/Competing ........................................................... 1 495 --- --- --- ---

Subtotal..................................................................... 1 1,226 1 1,226 --- ---

Total, Minority Fellowship Program 8 8,059 8 8,059 --- ---

Subtotal, Science and Service 26 24,045 25 24,045 18 13,995

Total, Mental Health PRNS 932 $438,659 895 $459,661 901 $429,734

* Excluding Supplements number count to avoid duplication.
Grant Awards Table 

(Whole dollars) 

FY 2018 

Final 

FY 2019 

Enacted 

FY 2020 President's 

Budget 

Number of Awards 918 878 890 

Average Awards $430,820 $462,476 $437,342 

Range of Awards $15,000 - $6,000,000 $15,000 - $6,000,000 $15,000 - $6,000,000 

114 
Program Description and Accomplishments 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Children’s Mental Health Services

(Dollars in thousands) 

FY 2018 

Final 

FY 2019 

Enacted 

FY 2020 

President's 

Budget 

FY 2020 

President's 

Budget 

+/-

FY 2019 

Enacted 

Budget Authority......................... $125,000 $125,000 $125,000 ---

Authorizing Legislation ........................................... Sections 561 of the Public Health Service Act 

FY 2020 Authorization ................................................................................................$119,026,000 

Allocation Method .............................................................................Competitive Grants/Contracts 

Eligible Entities.................................................States, Tribes, Communities, Territories

It is estimated that over 7.4 million children and youth in the United States have a serious mental 

disorder. Unfortunately, only 41 percent of those in need of mental health services actually receive 

treatment.37 Created in 1992, SAMHSA's Children's Mental Health Initiative (CMHI) addresses 

this gap by supporting "systems of care" (SOC) for children and youth with serious emotional 

disturbances and their families to increase their access to evidence-based treatment and supports. 

The 21st Century Cures Act reauthorized the CMHI through FY 2022. Approximately 9-13 percent 

of America’s youth are estimated to have a serious emotional disturbance (SED), the term analogous

to serious mental illness when applied to children. CMHI provides grants to assist states, local 

governments, tribes, and territories in their efforts to deliver services and supports to meet the needs 

of children and youth with SED. 

CMHI supports the development, implementation, expansion, and sustainability of comprehensive, 

community-based services that use the SOC approach. SOC is a strategic approach to the delivery 

of services and supports that incorporates family-driven, youth-guided, strength-based, and 

culturally and linguistically competent care in order to meet the physical, intellectual, emotional, 

cultural, and social needs of children and youth throughout the U.S. The SOC approach helps 

prepare children and youth for successful transition to adulthood and assumption of adult roles and 

responsibilities. Services are delivered in the least restrictive environment with evidence-supported 

treatments and interventions. Individualized care management ensures that planned services and 

supports are delivered with an appropriate, effective, family-driven, and youth-guided approach. 

This approach has demonstrated improved outcomes for children at home, at school, and in their 

communities. For example, CMHI grantee data show that suicide attempt rates significantly 

decreased within 12 months after children and youth accessed CMHI-related SOC services. The 

proportion of children and youth who received good grades (defined as an average grade of C or 

better on the previous report card) significantly increased after 12 months of services, and arrest 

37 Substance Abuse and Mental Health Services Administration, U.S. Department of Health and Human Services. 

(2014). Results from the 2013 National Survey on Drug Use and Health: Summary of National Findings, NSDUH 

Series H-48, HHS Publication No. (SMA) 144863. Rockville, MD: Substance Abuse and Mental Health Services 

Administration. 

115 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

rates significantly decreased after 12 months of children and youth beginning SOC-related services 

and supports.38 

In addition, the CMHI program seeks to address behavioral health disparities for children and youth 

with SED/Serious Mental Illness (SMI) from racial and ethnic minorities by promoting clear and 

culturally competent strategies to improve their access, use of services, and outcomes. 

SAMHSA funding ensures that grantees will continue to expand and sustain CMHI SOC values, 

principles, infrastructure, and services throughout their states, tribes, and territories. A central focus 

of these efforts is ensuring collaboration between the CMHI SOC and other child-and youth- serving 

systems (e.g., Child Welfare, Juvenile Justice, and Education). SAMHSA also strongly encourages 

efforts by CMHI SOC grantees to coordinate with other SAMHSA programs, such as those 

supported by the Community Mental Health Services Block Grant (MHBG) and Substance Abuse 

Prevention and Treatment Block Grant (SABG). 

CMHI is in the final year of the national evaluation contract for the 2015 cohort, which is designed 

to provide information on: 1) the mental health outcomes of children and youth, and their families; 

2) the implementation, process, and sustainability of SOC; and 3) critical and emerging issues in 

children’s and youth’s mental health. The evaluation includes an SOC assessment that describes the

infrastructure and an assessment of outcomes derived from direct SOC services. A service 

experience study evaluates: 1) change in service use patterns of children and their families; 2) 

differences in client satisfaction between groups of children (and their families) in the SOC 

communities who receive an evidence- based treatment and those who do not; and 3) retention in 

services. 

National program evaluation data reported annually to Congress indicate that CMHI SOCs are 

successful, resulting in many favorable outcomes for children, youth, and their families, including: 

 sustained mental disorder improvements for participating children and youth in behavioral 

health outcomes after as little as six months of program participation; 

 improvements in school attendance and achievement; 

 reductions in suicide-related behaviors; 

 decreases in the use of inpatient care and reduced costs due to fewer days in residential 

settings; and 

 significant reductions in contacts with law enforcement. 

In FY 2018, SAMHSA supported 62 continuation grants, six new grants, and two contracts. In 

FY 2019 SAMHSA would support the continuation of 49 continuation grants, 17 new grants, and 

two contracts. 

Set-aside for Early Intervention Demonstration Program for Youth and Young Adults at Clinical 

High Risk for Psychosis 

38 U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, 

(2016). The Comprehensive Community Mental Health Services for Children with Serious Emotional Disturbances 

Program, Report to Congress 2016. https://store.samhsa.gov/shin/content//PEP18-CMHI2016/PEP18-CMHI2016.pdf. 

116 
 

 

 

 

Funding History 

Fiscal Year Amount 

FY 2016 $119,026,000 

FY 2017 $119,026,000 

FY 2018 $125,000,000 

FY 2019 $125,000,000 

FY 2020 $125,000,000 

Budget Request 

 

 

 

 

In FY 2018, SAMHSA implemented the Community Programs for Outreach with Youth and Young 

Adults at Clinical High Risk for Psychosis (CHR-P) often referred to as the “prodrome phase;” which

is when a disease process has begun but is not yet diagnosable or inevitable. SAMHSA awarded 21 

grants funded from a 10 percent set-aside of the base program. 

This program will address whether community-based intervention during this phase can prevent the 

further development of serious emotional disturbances and ultimately serious mental illness. 

Grantees will focus on youth and young adults who are identified to be at clinical high risk for 

developing a fist episode of psychosis. Grantees will focus on this population in order to support 

the development and implementation of evidence-based programs providing community outreach 

and psychosocial interventions for youth and young adults in the prodrome phase of psychotic 

illness. 

In FY 2019, SAMHSA would support the continuation of the 21 grants funded from the 10 percent 

set-aside. 

The FY 2020 Budget Request is $125.0 million, the same level with FY 2019 Enacted level. The 

budget request will support the continuation of 21 demonstration grants funded under the 10 percent 

set-aside. In addition, funding will also support 40 continuation grants, a new cohort of 48 grants, 

and TA and evaluation activities. This funding will provide training to 103,858 people in the mental 

health and related workforce and serve 13,483 children with serious emotional disturbances. 

117 
Outputs and Outcomes Table 

Program: Children's Mental Health Initiative 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Measure 

Year and Most Recent Result 

Target for Recent Result 

(Summary of Result) 

FY 2019 

Target 

FY 2020 

Target 

FY 2020 

Target 

+/-

FY 2019 

Target 

3.2.16 Increase the number of 

children with severe emotional 

disturbance that are receiving 

services from the Children's Mental 

Health Initiative. (Output) 

FY 2018: 13,483 

Target: 10,187 

(Target Exceeded) 

13,483 13,483 Maintain 

3.2.25 Increase the percentage of 

children receiving services who 

report positive social support at sixmonth follow-up. (Outcome) 

FY 2018: 87.7 % 

Target: 86.1 % 

(Target Exceeded) 

87.7 % 87.7 % Maintain 

3.2.26 Increase the percentage of 

children receiving Systems of Care 

mental health services who report 

positive functioning at 6 month 

follow-up. (Outcome) 

FY 2018: 62.9% 

Target: 57.8 % 

(Target Exceeded) 

57.8 % 57.8 % Maintain 

3.2.27 Increase the number of 

people in the mental health and 

related workforce trained in specific 

mental health-related practices/ 

activities as a result of the program. 

(Output) 

FY 2018: 103,858 

Target: 81,925 

(Target Exceeded) 

103,858 103,858 Maintain 

118 
SAMHSA/Mental Health 

Children’s Mental Health Services

Mechanism Table 

Continuations....................................................... 62 $86,356 61 $84,919 61 $60,369 

New/Competing.................................................... 27 22,344 35 24,517 48 48,006 

Continuations....................................................... 1 8,607 1 8,013 1 8,937 

New/Competing.................................................... --- 5 --- --- --- ---

 

(Dollars in thousands) 

Program Activity 

FY 2018 

Final 

No. Amount 

FY 2019 

Enacted 

No. Amount 

FY 2020 

President's 

Budget 

No. Amount 

Children's Mental Health Services 

Grants/Cooperative Agreements 

Subtotal.............................................................. 

Contracts 

Subtotal.............................................................. 

Technical Assistance............................................. 

Total, Children's Mental Health Services 

89 108,700 96 109,436 109 108,375 

1 8,612 1 8,013 1 8,937 

1 7,688 1 7,551 1 7,688 

91 $125,000 98 $125,000 111 $125,000 

* Totals may not add due to rounding.

119 
Grant Awards Table 

(Whole dollars) 

FY 2018 

Final 

FY 2019 

Enacted 

FY 2020 

President's 

Budget 

Number of Awards 89 96 109 

Average Awards $1,221,352 $1,139,955 $994,270 

Range of Awards $330,000 - $2,000,000 $330,000 - $2,000,000 $330,000 - $2,000,000 

120 
 

Program Description and Accomplishments 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Projects for Assistance in Transition from Homelessness 

(Dollars in thousands) 

Programs of Regional and National Significance 

FY 2018 

Final 

FY 2019 

Enacted 

FY 2020 

President’s 

Budget 

FY 2020 

President's 

Budget 

+/-

FY 2019 

Enacted 

PATH.............................................................................. $64,635 $64,635 $64,635 $---

Authorizing Legislation ........................................ Section 535(a) of the Public Health Service Act 

FY 2020 Authorization ..................................................................................................$64,635,000 

Allocation Method ................................................................................................... Formula Grants 

Eligible Entities............................................................................................... States and Territories 

In 2018, an estimated 553,742 individuals experienced homelessness on an average night.

39 Data 

suggest that approximately 20 percent of individuals experiencing homelessness have a serious 

mental illness (SMI),40 Mental illness affects individuals’ abilities to maintain stable relationships, 

perform daily living activities, and maintain stable employment. Symptoms of mental disorders also 

often cause individuals to become estranged from family members and caregivers, leaving them 

without a support system. As a result, individuals with a mental illness are more likely to experience 

homelessness than those without mental illness and experience homelessness longer than the rest of 

the homeless population.41 

Data show that the PATH program’s efforts to identify primary care, behavioral disorder treatment, 

and housing for individuals who are chronically homeless is two to three times more cost effective 

than having them in the criminal justice system or treating them via other costly healthcare settings 

(e.g., emergency rooms, critical care units). 

In 1990, the Stewart B. McKinney Homeless Assistance Amendments Act authorized the PATH 

program to provide services to individuals who are experiencing homelessness and SMI. The PATH 

program supports 56 grants to the 50 states, the District of Columbia, Puerto Rico, Guam, American 

Samoa, the United States Virgin Islands, and the Northern Mariana Islands, as well as centralized 

activities such as technical assistance and evaluation. PATH was reauthorized by the 21st Century 

Cures Act in December 2016. PATH funds community-based outreach, mental illness and substance 

abuse treatment services, case management, assistance with accessing housing, and other supportive 

services. PATH helps to engage people with SMI into mental disorder treatment. PATH outreach 

workers specialize in engaging those who are most vulnerable in their communities and who are 

least likely to seek out services on their own. PATH’s primary goal is to bring the most vulnerable

39 The U.S. Department of Housing and Urban Development, Office of Community Planning and Development. 

(2018). The 2017 Annual Homeless Assessment Report (AHAR) to Congress, Part 1. Available 

at: https://www.hudexchange.info/resources/documents/2017-AHAR-Part1.pdf 40 The U.S. Department of Housing and Urban Development, 2017 CoC Homeless Populations and Subpopulations 

Reports. Available at 

https://www.hudexchange.info/resource/reportmanagement/published/CoC_PopSub_NatlTerrDC_2017.pdf 

41 National Alliance on Mental Illness (2004). Homelessness. Available at: 

http://www2.nami.org/Content/ContentGroups/Policy/Fact_Sheets/homelessnessPFS.pdf 

121 
 

 

 

 

 

 

 

 

 

 

 

 

 

into the service system and to connect them with the mainstream resources and supportive services 

that they need in order to access and sustain stable housing, build social connections, and access 

treatment and services to support their recovery. 

In FY 2017, the PATH program outreached to 120,048 new individuals experiencing homelessness 

and enrolled 52 percent of individuals with SMI into the PATH program (73,246 individuals). 

Overall numbers of people experiencing homelessness have been declining, specifically declining 

14% between 2010 and 2016. While the estimate of the total number of people experiencing 

homelessness on a single night was increased for the first time in 2017 in seven years - up a little 

less than 1% from 2016 to 2017, the government-wide efforts to target the most vulnerable and 

veterans may have served to reduce the number of PATH-eligible people on the streets, and therefore 

the number of people to whom PATH outreach might be directed. Additionally, 42 percent of 

enrolled individuals were experiencing a co-occurring drug/alcohol use disorders. Of those enrolled 

in PATH, 55,479 individuals received community mental health services. In addition, 7,370 

individuals received substance abuse treatment through PATH, while 11,629 individuals were 

referred by PATH to substance abuse treatment services in the community. PATH provided housing 

moving assistance to 3,394 individuals, housing eligibility determination services to 18,555 

individuals, security deposits to 2,751 individuals, residential supportive services to 7,213 

individuals and one-time rent eviction to 1,240 individuals. In addition, 20,179 PATH clients were 

referred to permanent housing assistance agencies and 13,176 PATH clients were referred to 

temporary housing agencies in their communities. The services provided by the PATH program fill 

gaps in existing community resources and play a crucial role in communities’ strategic plans to end 

homelessness. In FY 2018 and FY 2019, SAMHSA continued support for the program. 

122 
Fiscal Year Amount 

FY 2016 $64,635,000 

FY 2017 $64,635,000 

FY 2018 $64,635,000 

FY 2019 $64,635,000 

FY 2020 $64,635,000 

 

 

 

 

Funding History 

Budget Request 

The FY 2020 President’s Budget is $64.6 million, with the same as the FY 2019 Enacted Budget. 

This formula-based funding to all states will continue PATH services in over 500 communities that 

the states provide funding to in order to support outreach workers and mental health specialists that 

engage with individuals who are living with SMI or those living with both SMI and drug/alcohol 

addiction and are homeless or at imminent risk of becoming homeless. The services provided by 

the program help ensure that these individuals have an opportunity to access stable housing, improve 

their health and wellness, lead self-directed lives, and achieve their full potential. 

123 
Outputs and Outcomes Table 

Program: Projects for Assistance in Transition from Homelessness 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Measure 

Year and Most Recent Result 

Target for Recent Result 

(Summary of Result) 

FY 2019 

Target 

FY 2020 

Target 

FY 2020 

Target 

+/-

FY 2019 

Target 

3.4.15 Increase the percentage of 

enrolled homeless persons in the 

Projects for Assistance in Transition 

from Homelessness (PATH) program 

who receive community mental health 

services. (Intermediate Outcome) 

FY 2017: 55 % 

Target: 66 % 

(Target Not Met) 

55 % 55 % Maintain 

3.4.16 Increase the number of 

homeless persons contacted. 

(Outcome) 

FY 2017: 120,048 

Target: 185,524 

(Target Not Met) 

120,048 120,048 Maintain 

3.4.17 Increase the percentage of 

contacted homeless persons with 

serious mental illness who become 

enrolled in services. (Outcome) 

FY 2017: 57 % 

Target: 58 % 

(Target Not Met) 

57 % 57 % Maintain 

3.4.20 Increase the number of Projects 

for Assistance in Transition from 

Homelessness (PATH) providers 

trained on SSI/SSDI Outreach, 

Access, Recovery (SOAR) to ensure 

eligible homeless clients are receiving 

benefits. (Outcome) 

FY 2017: 2,647 

Target: 2,296 

(Target Exceeded) 

2,647 2,647 Maintain 

124 
Department of Health and Human Services 

Substance Abuse and Mental Health Services Administration 

FY 2019 DISCRETIONARY STATE/FORMULA GRANTS 

Projects for Assistance in Transition from Homelessness (PATH) 

CFDA # 93.150 

State/Territory 

FY 2018 

Final 

FY 2019 

Enacted 

FY 2020 

President's 

Budget 

FY 2020 

+/-

FY 2019 

Alabama $613,043 $613,144 $610,216 -$2,928 

Alaska 300,000 300,000 300,000 ---

Arizona 1,349,251 1,349,474 1,343,029 -6,445 

Arkansas 303,934 303,984 302,532 -1,452 

California 8,812,865 8,814,326 8,772,227 -42,099 

Colorado 1,019,092 1,019,261 1,014,392 -4,869 

Connecticut 799,350 799,483 795,664 -3,819 

Delaware 

District of 

300,000 300,000 300,000 ---

Columbia 300,000 300,000 300,000 ---

Florida 4,334,220 4,334,938 4,314,234 -20,704 

Georgia 1,669,966 1,670,242 1,662,265 -7,977 

Hawaii 300,000 300,000 300,000 ---

Idaho 300,000 300,000 300,000 ---

Illinois 2,705,121 2,705,569 2,692,646 -12,923 

Indiana 1,011,476 1,011,644 1,006,812 -4,832 

Iowa 334,549 334,605 333,007 -1,598 

Kansas 377,380 377,443 375,640 -1,803 

Kentucky 468,891 468,968 466,728 -2,240 

Louisiana 733,026 733,147 729,645 -3,502 

Maine 300,000 300,000 300,000 ---

Maryland 1,271,500 1,271,711 1,265,637 -6,074 

Massachusetts 1,558,823 1,559,081 1,551,634 -7,447 

Michigan 1,729,520 1,729,806 1,721,544 -8,262 

Minnesota 810,964 811,099 807,225 -3,874 

Mississippi 300,000 300,000 300,000 ---

Missouri 893,755 893,903 889,633 -4,270 

Montana 300,000 300,000 300,000 ---

Nebraska 300,000 300,000 300,000 ---

Nevada 615,921 616,023 613,081 -2,942 

New Hampshire 300,000 300,000 300,000 ---

125 
FY 2019 DISCRETIONARY STATE/FORMULA GRANTS 

Projects for Assistance in Transition from Homelessness (PATH) 

CFDA # 93.150 

Department of Health and Human Services 

Substance Abuse and Mental Health Services Administration 

State/Territory 

FY 2018 

Final 

FY 2019 

Enacted 

FY 2020 

President's 

Budget 

FY 2020 

+/-

FY 2019 

New Jersey 2,138,094 2,138,448 2,128,234 -10,214 

New Mexico 300,000 300,000 300,000 ---

New York 4,223,019 4,223,719 4,203,545 -20,174 

North Carolina 1,379,574 1,379,802 1,373,212 -6,590 

North Dakota 300,000 300,000 300,000 ---

Ohio 1,986,443 1,986,772 1,977,282 -9,490 

Oklahoma 452,820 452,895 450,732 -2,163 

Oregon 630,994 631,098 628,084 -3,014 

Pennsylvania 2,366,835 2,367,227 2,355,921 -11,306 

Rhode Island 300,000 300,000 300,000 ---

South Carolina 680,202 680,315 677,066 -3,249 

South Dakota 300,000 300,000 300,000 ---

Tennessee 909,746 909,896 905,550 -4,346 

Texas 4,995,434 4,996,262 4,972,399 -23,863 

Utah 591,460 591,558 588,733 -2,825 

Vermont 300,000 300,000 300,000 ---

Virginia 1,472,175 1,472,418 1,465,386 -7,032 

Washington 1,329,133 1,329,353 1,323,004 -6,349 

West Virginia 300,000 300,000 300,000 ---

Wisconsin 836,630 836,768 832,772 -3,996 

Wyoming 300,000 300,000 300,000 ---

Puerto Rico 891,096 891,244 886,987 -4,257 

Guam 50,000 50,000 50,000 ---

Virgin Islands 50,000 50,000 50,000 ---

American Samoa 

Northern Mariana 

Islands 

50,000 50,000 50,000 ---

50,000 50,000 50,000 ---

126 
 

 

 

 

 

 

 

 

 

 

 

Protection and Advocacy for Individuals with Mental Illness (PAIMI) 

(Dollars in thousands) 

(Dollars in thousands) 

FY 2018 

Final 

FY 2019 

Enacted 

FY 2020 

President's 

Budget 

FY 2020 

President's 

Budget 

+/-

FY 2019 

Enacted 

Budget Authority............................... $36,146 $36,146 $14,146 -$22,000 

Authorizing Legislation ................................................... The PAIMI Act, 42 U.S.C. 10801 et seq. 

FY 2020 Authorization .........................................................................................................$19,500 

Allocation Method ................................................................................................... Formula Grants 

Eligible Entities............................................................................................... States and Territories 

Program Description and Accomplishments 

The Protection and Advocacy for Individuals with Mental Illness (PAIMI) program ensures that the 

most vulnerable individuals with serious mental illness, especially those residing in public and 

private residential care and treatment facilities, are free from abuse, including inappropriate restraint 

and seclusion, neglect, and rights violations while receiving appropriate mental disorder treatment 

and discharge planning services. 

The Protection and Advocacy for Individuals with Mental Illness Act of 1986, as amended by the 

Children’s Health Act of 2000, extended the protections of the Developmental Disabilities (DD)

Assistance Act of 1975 to individuals with significant mental illness (adults) and significant 

emotional impairments (children/youth) at risk for abuse, neglect, and rights violations while 

residing in public and private care and treatment facilities. The PAIMI Act authorized the same 

governor-designated state protection and advocacy (P&A) systems established under the DD Act of 

1975 to receive PAIMI Program formula grant awards from SAMHSA. The PAIMI Program 

supports legal-based advocacy services that are provided by the 57 governor-designated P&A 

systems, which include states, territories, and the District of Columbia. Each system is mandated 

to: 1) ensure that the rights of individuals with mental illness who are at risk for abuse, neglect, and 

rights violations while residing in public or private care or treatment facilities are protected; 2) 

protect and advocate for the rights of these individuals through activities that ensure the enforcement 

of the Constitution and federal and state statutes; and 3) investigate incidents of abuse and/or neglect 

of individuals with mental illness. 

Program Evaluation 

In FY 2017, the 57 state PAIMI Programs: 

 Served 10,422 PAIMI-eligible individuals/clients: 2,071 children and youth (ages 0 to 18), 

7,662 adults (ages 19 to 64), and 689 older adults (age 65 and older). These individuals filed 

8704 complaints alleging abuse, neglect, and/or rights violations. 

 Resolved 78 percent of abuse allegations, 81 percent of neglect allegations, and 79 percent 

of rights violations allegations, and attained outcomes that resulted in positive change for the 

clients served. These positive outcomes included receipt of appropriate medical and mental 

disorder treatment; safer, cleaner facility environment; discharge into an appropriate 

community-based setting; and discharge from a nursing facility. 

127 
 

Funding History 

Fiscal Year Amount 

 

 

 

 

 

In FY 2017 and FY 2018, SAMHSA continued to fund 57 annual grants to states and territories as 

well as continued technical assistance activities and support for grantees. Under the FY 2019 

Enacted Budget, SAMHSA would continue support for this program. 

FY 2016 $36,146,000 

FY 2017 $36,146,000 

FY 2018 $36,146,000 

FY 2019 $36,146,000 

FY 2020 $14,146,000 

Budget Request 

The FY 2020 President’s is $14.1 million, a decrease of $22.0 million from the FY 2019 Enacted 

level. This program will continue to assist individuals with serious mental illness increase access to 

treatment. These grantees protect and advocate for the rights of individuals with mental illness and 

investigate incidents of abuse and neglect of individuals with mental illness if the incidents are 

reported to the system or if there is probable cause to believe that the incidents occurred. Reductions 

are proposed due to the need to focus realignment resources on treatment for serious mental 

illness. PAIMI programs will continue to focus on addressing abuse and neglect issues for 

vulnerable populations. 

128 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Outputs and Outcomes Table 

Program: Protection and Advocacy for Individuals with Mental Illness

Measure 

Year and Most Recent Result 

Target for Recent Result 

(Summary of Result) 

FY 2019 

Target 

FY 2020 

Target 

FY 2020 

Target 

+/-

FY 2019 

Target 

3.4.12 Increase the number of 

people served by the PAIMI 

program. (Outcome) 

FY 2017: 10,450 

Target: 15,192 

(Target Not Met) 

10,450 4,089 -6,360 

3.4.19 Increase the number 

attending public education/ 

constituency training and public 

awareness activities. (Output) 

FY 2017: 71,580 

Target: 98,441 

(Target Not Met but Improved) 

71,858 28,013 -43,566 

3.4.21 Increase percentage of 

complaints of alleged abuse, 

neglect, and rights violations 

substantiated and not withdrawn by 

the client that resulted in positive 

change through the restoration of 

client rights, expansion or 

maintenance of personal decisionmaking, elimination of other 

barriers to personal decisionmaking, as a result of Protection and 

Advocacy for Individuals with 

Mental Illness (PAIMI) 

involvement (Outcome) 

FY 2017: 66 % 

Target: 88 % 

(Target Not Met) 

66% 66 % Maintain 

129 
FY 2019 DISCRETIONARY STATE/FORMULA GRANTS 

Protection and Advocacy for Individuals with Mental Illness (PAIMI) 

CFDA # 93.138 

Department of Health and Human Services 

Substance Abuse and Mental Health Services Administration 

State/Territory 

FY 2018 

Final 

FY 2019 

Enacted 

FY 2020 

President's 

Budget 

FY 2020 

+/-

FY 2019 

Alabama $458,554 $457,665 $178,405 -$279,260 

Alaska 428,000 428,000 167,500 -260,500 

Arizona 634,205 638,784 251,865 -386,919 

Arkansas 428,000 428,000 167,500 -260,500 

California 3,101,059 3,064,413 1,194,790 -1,869,623 

Colorado 443,445 449,205 176,689 -272,516 

Connecticut 428,000 428,000 167,500 -260,500 

Delaware 

District of 

428,000 428,000 167,500 -260,500 

Columbia 428,000 428,000 167,500 -260,500 

Florida 1,761,727 1,776,069 707,190 -1,068,879 

Georgia 934,106 929,003 365,846 -563,157 

Hawaii 428,000 428,000 167,500 -260,500 

Idaho 428,000 428,000 167,500 -260,500 

Illinois 1,051,088 1,039,636 404,978 -634,658 

Indiana 592,729 590,775 231,107 -359,668 

Iowa 428,000 428,000 167,500 -260,500 

Kansas 428,000 428,000 167,500 -260,500 

Kentucky 428,000 428,000 167,500 -260,500 

Louisiana 428,000 428,000 167,500 -260,500 

Maine 428,000 428,000 167,500 -260,500 

Maryland 467,047 463,525 181,463 -282,062 

Massachusetts 502,978 502,083 196,413 -305,670 

Michigan 878,974 872,164 341,233 -530,931 

Minnesota 446,246 447,375 176,168 -271,207 

Mississippi 428,000 428,000 167,500 -260,500 

Missouri 542,302 543,808 212,351 -331,457 

Montana 428,000 428,000 167,500 -260,500 

Nebraska 428,000 428,000 167,500 -260,500 

Nevada 428,000 428,000 167,500 -260,500 

New Hampshire 428,000 428,000 167,500 -260,500 

130 
FY 2019 DISCRETIONARY STATE/FORMULA GRANTS 

Protection and Advocacy for Individuals with Mental Illness (PAIMI) 

CFDA # 93.138 

Department of Health and Human Services 

Substance Abuse and Mental Health Services Administration 

State/Territory 

FY 2018 

Final 

FY 2019 

Enacted 

FY 2020 

President's 

Budget 

FY 2020 

+/-

FY 2019 

New Jersey 675,631 671,867 263,083 -408,784 

New Mexico 428,000 428,000 167,500 -260,500 

New York 1,507,227 1,503,880 579,850 -924,030 

North Carolina 912,914 913,289 360,043 -553,246 

North Dakota 428,000 428,000 167,500 -260,500 

Ohio 1,019,501 1,016,255 396,985 -619,270 

Oklahoma 428,000 428,000 167,500 -260,500 

Oregon 428,000 428,000 167,500 -260,500 

Pennsylvania 1,051,937 1,048,742 408,369 -640,373 

Rhode Island 428,000 428,000 167,500 -260,500 

South Carolina 460,260 462,839 181,874 -280,965 

South Dakota 428,000 428,000 167,500 -260,500 

Tennessee 589,859 590,750 231,828 -358,922 

Texas 2,321,910 2,392,318 957,193 -1,435,125 

Utah 428,000 428,000 167,500 -260,500 

Vermont 428,000 428,000 167,500 -260,500 

Virginia 674,079 676,109 265,844 -410,265 

Washington 577,376 577,556 227,131 -350,425 

West Virginia 428,000 428,000 167,500 -260,500 

Wisconsin 493,292 493,546 192,754 -300,792 

Wyoming 428,000 428,000 167,500 -260,500 

Puerto Rico 528,962 511,100 201,182 -309,918 

American Samoa 229,300 229,300 89,700 -139,600 

Guam 

American Indian 

Consortium 

229,300 229,300 89,700 -139,600 

Northern Mariana 

Islands 

229,300 229,300 0 -229,300 

229,300 229,300 89,700 -139,600 

Virgin Islands 229,300 229,300 89,700 -139,600 

131 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Certified Community Behavioral Health Clinic (CCBHC) 

(Dollars in thousands) 

(Dollars in thousands) 

FY 2018 

Final 

FY 2019 

Enacted 

FY 2020 

President's 

Budget 

FY 2020 

President's 

Budget 

+/-

FY 2019 

Enacted 

Budget Authority............................... $100,000 $150,000 $150,000 ---

Authorizing Legislation ..........................................Section 520A of the Public Health Service Act 

FY 2020 Authorization ................................................................................................$150,000,000 

Allocation Method .............................................................................Competitive Grants/Contracts 

Eligible Entities.......................................Certified Community Behavioral Health Clinics,

Community-based Behavioral Health Clinics 

Program Description and Accomplishments 

It is estimated that more than 10 million adults 18 and older had a serious mental illness (SMI), more 

than 17 million adults misused prescription drugs, and about 20 million adults had an illicit drug or 

alcohol use disorder in the past year.42 While effective treatment and supportive services exist, many 

individuals with behavioral health conditions do not receive the help they need. When they do try to 

access services, they may face significant delays and/or get connected to incomplete, disconnected, 

or uncoordinated care. Even people who receive some services, such as medication or talk therapy, 

often do not have access to the complete range of supports they need, such as help to get them 

through a crisis, manage co-occurring physical health problems, find and sustain employment, and 

maintain a safe place to live in the community. 

Congress created a new approach to addressing these issues through Certified Community 

Behavioral Health Clinics (CCBHCs) as a part of the Protecting Access to Medicare Act of 2014. 

CCBHCs provide a comprehensive, coordinated range of behavioral health services to their 

communities. Through this program, HHS has established criteria for clinics to be certified as 

CCBHCs. These criteria cover six areas that CCBHCS must address to be certified: (1) staffing; 

(2) availability and accessibility of services; (3) care coordination; (4) scope of services; (5) quality 

and other reporting; and (6) organizational authority. In FY 2016, SAMHSA assisted 24 states 

through planning grants to be eligible for a CCBHC demonstration in FY 2016, and in FY 2017, 

CMS launched the demonstration program, which supports CCBHCs in eight states through a 

Medicaid prospective payment system. 

In FY 2018, SAMHSA implemented the CCBHC Expansion grant program an awarded 52 grants to 

CCBHCs within the 24 states that participated in the FY 2016 Planning Grants for Certified 

Community Behavioral Health Clinics grant program. The CCBHC Expansion program is designed 

to increase access to and improve the quality of community behavioral health services. CCBHCs 

funded under this program must provide access to services for individuals with serious mental illness 

(SMI) or substance use disorders (SUD), including opioid disorders; children and adolescents with 

serious emotional disturbance (SED); and individuals with co-occurring disorders mental and 

substance use disorders (COD). SAMHSA expects that this program will improve the behavioral 

42 SAMHSA, Center for Behavioral Health Statistics and Quality. (2017, September 7). Results 

from the 2016 National Survey on Drug Use and Health: Detailed tables. Retrieved from 

https://www.samhsa.gov/data/sites/default/files/NSDUH-DetTabs-2016/NSDUH-DetTabs-2016.pdf 

132 
 

 

 

Fiscal Year Amount 

FY 2016 ---

FY 2017 ---

FY 2018 $100,000,000 

FY 2019 $150,000,000 

FY 2020 $150,000,000 

 

health of individuals across the nation by providing comprehensive community-based mental and 

substance use disorder services; treatment of co-occurring disorders; advance the integration of 

behavioral health with physical health care; assimilate and utilize evidence-based practices on a 

more consistent basis, and promote improved access to high quality care. 

In FY 2019, SAMHSA provided funding for 52 continuation grants and fund 12 new grants. 

Funding History 

Budget Request 

The FY 2020 Budget Request is $150.0 million, the same level with FY 2019 Enacted level. 

SAMHSA requests funding to award a new cohort of 76 grants to continue the improvement of 

mental disorder treatment, services, and interventions for children and adults. 

133 
Program: Certified Community Behavioral Health Clinic 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Outputs and Outcomes Table 

Measure 

Year and Most Recent Result 

Target for Recent Result 

(Summary of Result) 

FY 2019 

Target 

FY 2020 

Target 

FY 2020 

Target 

+/-

FY 2019 

Target 

3.5.10 Increase the number served by 

the program. 

FY 2019: Result Expected 

December 31, 2019 

Target: 25,000 

(Pending) 

25,000 37,500 +12,500 

3.4.10 Increase the percentage of 

clients receiving services who report 

positive functioning at 6 months 

follow-up. (Outcome) 

FY 2019: Result Expected 

December 31, 2019 

Target: 60.0% 

(Pending) 

60.0% 60.0% Maintain 

3.4.11 Increase the percentage of 

clients receiving services who are 

currently employed at 6-month 

follow-up. (Outcome) 

FY 2019: Result Expected 

December 31, 2019 

Target: 39.0% 

(Pending) 

39.0% 39.0% Maintain 

3.4.12 Increase the percentage of 

clients receiving services who have a 

permanent place to live in the 

community at 6 month follow-up. 

(Outcome) 

FY 2019: Result Expected 

December 31, 2019 

Target: 73.0% 

(Pending) 

73.0% 73.0% Maintain 

134 
SAMHSA/Mental Health 

Certified Community Behavioral Health Clinics 

Mechanism Table 

---

--- --- --- --- ---

--- --- ---

--- --- ---

(Dollars in thousands) 

Program Activity 

FY 2018 

Final 

No. Amount 

FY 2019 

Enacted 

No. Amount 

FY 2020 

President's 

Budget 

No. Amount 

Certified Community Behavioral Health Clinics 

Grants/Cooperative Agreements 

Continuations...................................... 

New/Competing..................................... 

Subtotal..................................................... 

Contracts 

Continuations................................................... 

New/Competing................................................ 

Subtotal........................................................ 

Total, Certified Community Behavioral 

Health Clinics 

---

52 96,447 

52 $97,047 

12 23,123 

12 $23,123 

76 147,415 

52 96,447 64 120,170 88 170,538 

3,553 

4,646

--- 4,646 

3,553 4,646 4,646 

52 $100,000 64 $124,816 88 $175,184 

135 
---

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Community Mental Health Services Block Grant (MHBG) 

(Dollars in thousands) 

FY 2018 

Final 

FY 2019 

Enacted 

FY 2020 

President's 

Budget 

FY 2020 

President's 

Budget 

+/-

FY 2019 

Enacted 

Community Mental Health Services Block Grant....... 

PHS Evaluation Funds (non-add)............................. 

$722,571 

21,039 

$722,571 

21,039 

$722,571 

21,039 

---

Authorizing Legislation...............................Sections 1920 of the Public Health Service Act

FY 2020 Authorization ................................................................................................$532,571,000 

Allocation Method .....................................................................................................Formula Grant 

Eligible Entities..................States, Territories, Freely Associated States, and District of Columbia 

Program Description and Accomplishments 

Serious mental illnesses are more common in the United States than is generally realized. According 

to the 2017 National Survey on Drug Use and Health (NSDUH)43, 4.2% of adults Aged 18 and older 

had a serious mental illness in 2017– an estimated 10,360,000 individuals – 7,454,000 adults with 

SMI received services or 72% received services in 2017. 

Since 1992, the Community Mental Health Services Block Grant (MHBG) has distributed funds to 

59 eligible states and territories and freely associated states through a formula based upon specified 

economic and demographic factors.44 The MHBG distributes funds for a variety of services and for 

planning, administration, and educational activities. By statute, these services and activities must 

support community-based mental health services for children with serious emotional disturbances 

and adults with serious mental illness. MHBG services include: outpatient treatment for serious 

mental illnesses, such as schizophrenia and bipolar disorders; supported employment and supported 

housing; rehabilitation services; crisis stabilization and case management; peer specialist and 

consumer-directed services; wraparound services for children and families; jail diversion programs; 

and services for at-risk populations (e.g., individuals, who are homeless, those in rural and frontier 

areas, military families, and veterans). Through the administration of the MHBG, SAMHSA 

supports implementation of practices demonstrated and proven effective in the Mental Health 

Programs of Regional and National Significance (PRNS) portfolio. 

The MHBG continues to represent a significant “safety net” source of funding for mental health 

services for some of the most at-risk populations across the country. Together, SAMHSA’s block

grants support the provision of services and related support activities to approximately seven million 

43 Substance Abuse and Mental Health Services Administration. (2017). Key substance use and mental health indicators 

in the United States: Results from the 2016 National Survey on Drug Use and Health (HHS Publication No. SMA 17-

5044, NSDUH Series H-52). Rockville, MD: Center for Behavioral Health Statistics and Quality, Substance Abuse and 

Mental Health Services Administration. Retrieved from https://www.samhsa.gov/data/ 44 Territories include Guam, Puerto Rico, the Northern Mariana Islands, U.S. Virgin Islands and American Samoa. 

Freely Associated States, which have signed Compacts of Free Association with the United States, include the 

Republic of Palau, Federated States of Micronesia and Republic of the Marshall Islands. See 

http://www.doi.gov//oia/islands/index.cfm. Further information about the Block Grant program can be found on 

SAMHSA’s Web site at http://www.samhsa.gov/grants/block-grants 

136 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

individuals with mental and substance use conditions in any given year. The Block Grant’s

flexibility and stability have made it a vital support for public mental health systems. 

States rely on the MHBG for delivery of services and for an array of non-clinical coordination and 

support services that are not supported by Medicaid or other third party insurance to strengthen their 

service systems. The MHBG statute provides for a five percent administrative set-aside that allows 

SAMHSA to assist the states and territories in the development of their mental health systems 

through the support of technical assistance, data collection, and evaluation activities. States also use 

block grant funds, with other funding sources, to support training for staff and implementation of 

evidence-based practices and other promising practices for the treatment of mental disorders, 

improved business practices, use of health information technology, and integration of physical and 

behavioral health services. 

SAMHSA’s MHBG and Substance Abuse Prevention and Treatment Block Grant (SABG) 

applications align with changes in federal/state environments and statutes. SAMHSA offers states 

the opportunity to complete a combined application for mental health and substance abuse services, 

submit a biennial versus an annual plan, and provide information regarding their efforts to respond 

to various changes in federal and state law.45,46 Permitting MHBG recipients to submit the 

application/plan biennially reduces the burden on states. 

There are many individuals, both adolescent and adult, with co-occurring mental illness and 

drug/alcohol addiction. In recognition of this, SAMHSA strongly encourages coordination between 

MHBG programs and those supported by the SABG as well as other SAMHSA-funded efforts such 

as the systems of care for children and adolescents supported through the Children’s Mental Health 

Initiative. 

Most block grant recipients are currently reporting on National Outcome Measures (NOMS) for 

public mental health services within their state. State-level outcome data for mental health are 

currently reported by State Mental Health Authorities. The following outcomes for all people served 

by the publicly funded mental health system during 2017 show that: 

 For the 57 states and territories that reported data in the Employment Domain, 20.9 percent 

of the mental health consumers were in competitive employment; 

45 State Plan for Comprehensive Community Mental Health Services for Certain Individuals (Sec. 1912 of Title XIX, 

Part B, Subpart I of the Public Health Service (PHS) Act (42 USC § 300x-2). 46 State Plan (Sec. 1932 (b) of Title XIX, Part B, Subpart II of the Public Health Service (PHS) Act (42 USC § 300x32(b)). 

137 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 For the 58 states and territories that reported data in the Housing Domain, 82.7 percent of 

the mental health consumers were living in private residences; 

 For the 58 states and territories that reported data in the Access/Capacity Domain, state 

mental health agencies provided mental health services for approximately 23 people per 

1,000 population; 

 For the 50 states and territories that reported data in the Retention Domain, only 8.3 percent 

of the patients returned to a state psychiatric hospital within 30 days of state hospital 

discharge; and 

 For the 42 states and territories that reported data in the Perception of Care Domain, 

71 percent of adult mental health consumers improved functioning as a direct result of the 

mental health services they received. 

Mental Disorders Prevalence Data Collection, Analysis, and Dissemination 

Section 505 of the Public Health Service Act (42 U.S.C. 290aa-4) requires SAMHSA, on an annual 

basis, to collect data on the prevalence of substance use and mental illness. To accomplish this, 

SAMHSA awarded a contract in FY 2018 to design a multi-component project that would provide 

local level psychiatric epidemiology information on incidence and prevalence of select mental 

disorders, substance use disorders, and services received for those disorders. In FY 2019, SAMHSA 

awarded a new contract to pilot the Mental Disorders Prevalence Survey (MDPS) design and 

methodology on a small scale using ten catchment areas that are a mix of rural and urban areas with 

both household and non-household populations. This project will serve as a foundation for future, 

larger scale efforts to assess incidence and prevalence of such disorders on a national scale. 

Set-aside for Evidence-based Programs that Address the Needs of Individuals with Early Serious 

Mental Illness 

Starting in FY 2014, states were required to set aside five percent of their MHBG funds to support 

“evidence-based programs that address the needs of individuals with early serious mental illness, 

including psychotic disorders.”47 SAMHSA is collaborating with the National Institute of Mental 

Health and states to implement this provision. 

The majority of individuals with serious mental illness experience their first symptoms during 

adolescence or early adulthood, and there are often long delays between the initial onset of symptoms 

and receiving treatment. The consequences of delayed treatment can include loss of family and 

social supports, reduced educational achievement, incarceration, disruption of employment, 

substance abuse, increased hospitalizations, and reduced prospects for long-term recovery. 

The five percent set-aside allocated to states totaling approximately $24.2 million per year in 

FY 2014 and FY 2015 supported implementation of evidenced-based models that seek to address 

treatment of serious mental illness at an early stage through reducing symptoms and relapse rates, 

and preventing deterioration of cognitive function in individuals living with psychotic illness. In 

FY 2016, Congress increased the set-aside to 10 percent; through this funding, the number of states 

with fully implemented operating first-episode treatment programs is 52 and SAMHSA continues to 

monitor and ensure that the set-aside program is solely used to address first-episode psychosis. 

47 http://www.samhsa.gov/sites/default/files/mhbg-5-percent-set-aside-guidance.pdf 

138 
Beginning in September 2016, SAMHSA, in partnership with NIMH, initiated a 3-year evaluation 

study of the programs funded through the MHBG set-aside to ensure that funds are only used for 

programs showing strong evidence of effectiveness and target first episode of psychosis. The total 

number of people in the catchment area of the sites funded by this ten percent set-aside is 7067. This 

includes 8-10 percent of the approximate 100,000 people who are likely to develop SMI or SED in 

any given year. 

The table below identifies activities, which have been implemented with the ten percent set-aside. 

139 
 

 

 

 

 

 

 

 

 

 

 

 

State FY 2018 

10% Set 

Aside 

Allotment 

Program Description 

Alabama $994,476 Statewide EASA (Early Assessment and Support Alliance) 

program model is being developed and implemented. 

Alaska $143,298 The state is implementing a CSC program based on OnTrack in 

Wasilla. 

American 

Samoa 

$13,390 Training 2-4 peer support specialists to begin FEP outreach. 

Arizona $1,680,042 State offers four CSC programs across the state, and also funds 

NAMI to assist with family support and supported employment 

and education services. 

Arkansas $618,892 Developing portions of CSC model in thirteen locations. 

California $9,504,787 Forty-one CSC programs, from several different models, are in 

various states of development throughout CA. Thirty-seven are 

fully operational. 

Colorado $1,150,425 Implementing four CSC (OnTRACKUSA) programs, three in 

the Denver area and one in the rural northeastern portion of the 

state. 

Connecticut $716,395 State is implementing two programs based on two distinct CSC 

models (Potential and STEP). 

District of 

Columbia 

$160,626 The District of Columbia provides one CSC program, which is 

currently in the initial implementation phase of development. 

Delaware $207,118 A statewide program, CORE (Community Outreach, Referral 

and Early Intervention), has been implemented. 

Florida $4,776,016 State has implemented five CSC programs. All of these 

programs are based on the Navigate model. 

Georgia $2,278,581 State has implemented seven CSC programs. All programs are 

based on the LIGHT-ETP model. 

Guam $39,862 Staff have begun providing services in the I Fine'na program, 

which is based on OnTrackNY, and also offers ESMI services 

through the OASIS Empowerment Center. 

Hawaii $384,300 State has implemented a program with three sites in Honolulu 

based on the OnTRACK model. 

Idaho $332,296 Three CSC programs have been implemented. 

Illinois $2,607,438 State has implemented CSC programs in 14 locations 

throughout the state using the FIRST CSC program model. 

Indiana $1,215,981 State offers two programs based on the PARC model and makes 

use of a "hub and spoke" design. 

Iowa $546,479 State has three functioning CSC programs based on the 

NAVIGATE model. 

140 
 

 

 

 

 

 

 

 

 

 

 

State FY 2018 

10% Set 

Aside 

Allotment 

Program Description 

Kansas $515,357 State has one fully functional CSC program in Kansas City and is 

operationalizing a second program in Topeka. 

Kentucky $888,937 Eight EASA CSC program sites are available throughout the state, 

with one in the installation phase. State is also using the MHBG to 

support data infrastructure to track outcomes. 

Louisiana $855,200 Three sites are in the process of being implemented. These 

programs are using the Navigate CSC model. 

Maine $274,800 State has implemented one program based on the PIER Model in 

Portland. The state has also contracted with the PIER program to 

train staff at one other provider to provide FEP services. 

Marshall 

Islands 

$17,787 Marshall Islands is using the set-aside block grant funding to 

develop first episode outreach practices and protocols for 

individuals experiencing FEP. 

Maryland $1,176,708 The state has implemented four CSC programs, two in Baltimore, 

one in Gaithersburg and one in Catonsville. They are continuing 

to develop staff expertise in the FEP approaches. 

Massachusetts $1,362,350 Massachusetts has developed two CSC programs, one in Boston 

and a second in western Mass. They are using the PREP model of 

CSC. 

Michigan $2,098,521 The State has implemented four CSC programs using the 

NAVIGATE CSC model. 

Federated 

States of 

Micronesia 

$25,924 Funds are being used to train staff on the OnTrack CSC model in 

four locations. 

Minnesota $1,017,023 State has implemented two CSC programs in the Twin Cities area 

and is implementing a third program in Duluth. 

Mississippi $623,825 State is fully implementing the NAVIGATE CSC programs to 

provide training and technical assistance to four CSC teams. 

Missouri $1,143,917 Missouri has established eight sites spread throughout the state 

that provide ACT-TAY for individuals experiencing an early 

serious mental illness. 

Montana $263,000 The state is implementing the NAVIGATE model in one site for 

the state. 

Nebraska $316,957 Nebraska has implemented OnTrackUSA in two of the six 

behavioral health service regions of the state. 

141 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

State FY 2018 

10% Set 

Aside 

Allotment 

Program Description 

Nevada $742,942 Nevada has implemented two CSC programs: one in the 

Reno area, and a second program in the Las Vegas area using 

the RAISE TEAM approach. The state also funds a third 

CSC program in Carson City that follows the NAVIGATE 

model. 

New Hampshire $245,764 The state is using a NAVIGATE training team to train 

Community Mental Health Centers to establish CSC teams 

that will continue to expand beyond the training period, 

using a staged approach. One site in Nashua is in the initial 

implementation phase of development. 

New Jersey $1,896,092 New Jersey has implemented three CSC teams adhering to 

the RAISE CSC model. 

New Mexico $412,661 New Mexico is expanding access to the NAVIGATE model 

for specialty coordinated care for individuals with FEP 

through the already implemented University of New Mexico 

EARLY program. 

New York $4,208,735 New York is spending set-aside funds to expand its existing 

OnTrackNY program to two new sites, for 22 CSC sites 

statewide. These sites will serve urban, rural and lesspopulated areas. 

North Carolina $1,963,756 North Carolina supports three CSC sites currently operated 

in the state. The state supports the Quality Assurance 

Database developed by the UNC OASIS (Outreach and 

Support Intervention Services) technical assistance 

program, which is utilized by all FEP sites funded through 

the MHBG. 

North Dakota $111,957 The state is using the set-aside funds to implement CSC 

services in Fargo, which serves six counties in the state. 

Northern Mariana 

Islands 

$12,897 The Community Guidance Center is implementing a 

psychoeducation group in FY 2016 geared toward family 

education, which will help families and the community 

better identify FEP symptoms in their family or community 

leading to earlier treatment of the client. 

Ohio $2,130,363 State has implemented 14 CSC programs and is currently 

installing three more. 

142 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

State FY 2018 

10% Set 

Aside 

Allotment 

Program Description 

Oklahoma $731,494 Oklahoma has implemented two NAVIGATE CSC programs 

in Oklahoma City and Tulsa. The state also offers a “Be the

Change” program for individuals with an early serious mental 

illness in Oklahoma County. 

Oregon $964,100 The state has implemented 36 EASA CSC programs that 

currently serve all 36 counties in Oregon. 

Palau $5,240 One CSC team will be supported in a population area of 

roughly 20,000 with 1 percent need annually. 

Pennsylvania $2,376,660 Pennsylvania offers nine CSC programs in rural and urban 

areas across the state. 

Puerto Rico $886,603 Puerto Rico has implemented two CSC programs, including the 

PORTI program in San Juan, and the PROCCER program in 

Mayagüez. 

Rhode Island $250,483 Rhode Island is using the entire set-aside amount to serve 

individuals ages 16-25 experiencing a first episode of psychosis 

by enhancing the two existing treatment teams so that they will 

be able to serve additional clients. 

South Carolina $1,025,043 South Carolina is funding four programs for individuals with 

an early serious mental illness, one of which is a CSC program. 

South Dakota $147,131 State has implemented two CSC programs in Sioux Falls and 

Rapid City. They have been trained by OnTrackNY. 

Tennessee $1,394,586 Tennessee uses the MHBG funds to provide OnTrackTN to 

four sites across the state. The MHBG funds also support a 

statewide FEP learning collaborative of all four sites, that 

works to improve outcomes, provide rapid access to services 

(including those that are linguistically and culturally 

competent), increases awareness and early detection, provides 

statewide training for providers and the community, and 

increases statewide capacity to provide FEP services. In 

September 2017, the state held a conference for all providers in 

the state to learn about the CSC model and FEP in general. 

Texas $5,638,384 Texas offers 10 CSC programs in rural and urban areas across 

the state. These sites serve both indigent and Medicaid-eligible 

populations. 

143 
 

 

 

 

 

 

 

 

 

 

State FY 2018 

10% Set 

Aside 

Allotment 

Program Description 

Utah $546,282 State has implemented three CSC programs, using the PIER 

and EASA CSC Models. 

Vermont $122,035 Vermont is continuing to partner with the Vermont Cooperative 

for Practice Improvement and Innovation to facilitate the 

initiative including targeted research, implementation, 

workforce development, outreach and education. 

Virgin Islands $25,520 Virgin Islands intends to establish a CSC program according to 

the NAVIGATE model. 

Virginia $1,535,557 Virginia has established eight CSC programs that are operated 

through the state’s community service boards (CSBs). The

existing programs will continue to receive training and 

technical assistance to strengthen their clinical service delivery 

skills and to ensure fidelity to the model. 

Washington $1,631,440 Washington has established three CSC programs adhering to 

the NAVIGATE CSC Model. In addition, the state is currently 

establishing two more CSC programs. 

West Virginia $384,098 State has established one CSC program in the Wheeling area. 

Wisconsin $1,112,258 Wisconsin is continuing to fund the CSC model PROPS 

program operated by JMHC in Madison, which serves three 

rural counties north of Madison. In addition, the state is 

funding a CSC program in Milwaukee. 

Wyoming $82,089 The state is piloting two CSC programs that are currently 

serving clients. 

144 
Fiscal Year Amount 

FY 2010 420,774,000 

FY 2011 419,933,000 

FY 2012 459,756,000 

FY 2013 436,808,709 

FY 2014 482,571,000 

FY 2015 482,571,000 

FY 2016 532,571,000 

FY 2017 562,571,000 

FY 2018 722,571,000 

FY 2019 722,571,000 

FY 2020 722,571,000 

 

 

 

Funding History 

Budget Request 

The FY 2020 President’s Budget is $722.6 million, the same as the FY 2019 Enacted level. With 

this funding, SAMHSA will continue to address the needs of individuals with SMI and SED and 

will continue to maintain the ten percent set-aside for evidence-based programs that address the 

needs of individuals with early serious mental illness, including psychotic disorders. The set-aside 

funds help reduce costs to society, as intervening early helps prevent deterioration of functioning in 

individuals experiencing a first episode of serious mental illness. 

145 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Outputs and Outcomes Table 

Program: Mental Health Block Grant 

Measure 

Year and Most Recent Result 

Target for Recent Result 

(Summary of Result) 

FY 2019 

Target 

FY 2020 

Target 

FY 2020 

Target 

+/-

FY 2019 

Target 

2.3.11 Increase the number of evidence 

based practices (EBPs) implemented 

(Output) 

FY 2017: 4.7 per State 

Target: 4.5 per State 

(Target Exceeded) 

4.6 per State 4.7 per State +0.1 per State 

2.3.14 Increase the number of people 

served by the public mental health 

system (Output) 

FY 2017: 7,524,119 

Target: 7,620,000 

(Target Not Met but Improved) 

7,524,119 7,524,119 Maintain 

2.3.15 Increase the rate of consumers 

(adults) reporting positively about 

outcomes (Outcome) 

FY 2017: 78.7 % 

Target: 71.8 % 

(Target Exceeded) 

75.7 % 75.7 % Maintain 

2.3.16 Increase the rate of family 

members (children/adolescents) 

reporting positively about outcomes 

(Outcome) 

FY 2017: 73.1 % 

Target: 66.1 % 

(Target Exceeded) 

73.5 % 73.5 % Maintain 

2.3.19A: Supported Housing 

Percentage of the population accessing 

selected evidence-based programs 

among people served by state mental 

health authorities (Outcome) 

FY 2018: Result Expected 

December 31, 2019 

Target: 3.5 % 

(Pending) 

3.8 % 3.8 % Maintain 

2.3.19B Supported employment: 

Percentage of the population accessing 

selected evidence-based programs 

among people served by state mental 

health authorities (Outcome) 

FY 2019: Result Expected 

December 31, 2019 

Target: 2.2 % 

(Pending) 

2.2 % 2.3 % +0.1 % 

2.3.19C Assertive Community 

Treatment: Percentage of the 

population accessing selected 

evidence-based programs among 

people served by state mental health 

authorities (Output) 

FY 2019: Result Expected 

December 31, 2019 

Target: 2.2 % 

(Pending) 

2.2 % 2.5 % +0.3 % 

146 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Measure 

Year and Most Recent Result 

Target for Recent Result 

(Summary of Result) 

FY 2019 

Target 

FY 2020 

Target 

FY 2020 

Target 

+/-

FY 2019 

Target 

2.3.19D Family Psychoeducation Percent 

of the population accessing selected 

evidence-based programs among people 

served by state mental health authorities 

(Outcome) 

FY 2019: Result Expected 

December 31, 2019 

Target: 2.1 % 

(Pending) 

2.1 % 2.2 % +0.1 % 

2.3.19E Dual Diagnosis Treatment -

Percent of the population accessing 

selected evidence-based programs among 

people served by state mental health 

authorities. (Outcome) (Outcome) 

FY 2019: Result Expected 

December 31, 2019 

Target: 11.0 % 

(Pending) 

11.0 % 11.5 % +0.5 % 

2.3.19F Illness Self-Management - Percent 

of the population accessing selected 

evidence-based programs among people 

served by state mental health authorities. 

(Outcome) 

FY 2019: Result Expected 

December 31, 2019 

Target: 21.0 % 

(Pending) 

21.0 % 23.0 % +2 % 

2.3.19G Medication Management - Percent 

of the population accessing selected 

evidence-based programs among people 

served by state mental health authorities. 

(Outcome) 

FY 2019: Result Expected 

December 31, 2019 

Target: 33.0 

(Pending) 

33.0 35.0 +2 

2.3.19H Treatment Foster Care - Percent of 

the population accessing selected evidencebased programs among people served by 

state mental health authorities. (Outcome) 

FY 2019: Result Expected 

December 31, 2019 

Target: 1.7 % 

(Pending) 

1.7 % 1.9 % +0.2 % 

2.3.19I Multi-Systemic Therapy - Percent 

of the population accessing selected 

evidence-based programs among people 

served by state mental health authorities. 

(Outcome) 

FY 2019: Result Expected 

December 31, 2019 

Target: 4.3 % 

(Pending) 

4.3 % 4.7 % +0.4 % 

2.3.19J Functional Family Therapy -

Percent of the population accessing 

selected evidence-based programs among 

people served by state mental health 

authorities. (Outcome) 

FY 2019: Result Expected 

December 31, 2019 

Target: 7.5 % 

(Pending) 

7.5 % 8.5 % +1 % 

2.3.81 Increase the percentage of service 

population receiving any evidence based 

practice (Outcome) 

FY 2017: 19.0 % 

Target: 10.8 % 

(Target Exceeded) 

11.7 % 11.7 % Maintain 

147 
 

 

 

 

 

 

 

 

 

 

 

 

 

Department of Health and Human Services 

Substance Abuse and Mental Health Services Administration 

FY 2019 DISCRETIONARY STATE/FORMULA GRANTS 

Community Mental Health Services Block Grant Program 

CFDA # 93.959 

State/Territory 

FY 2018 

Final 

FY 2019 

Enacted 

FY 2020 

President's 

Budget 

FY 2020 

+/-

FY 2019 

Alabama $9,944,763 $9,958,277 $9,897,586 -$60,691 

Alaska 1,432,975 1,406,364 1,480,661 74,297 

Arizona 16,800,418 18,373,174 18,491,031 117,857 

Arkansas 6,188,920 5,997,576 5,985,871 -11,705 

California 95,047,871 92,715,441 91,818,654 -896,787 

Colorado 11,504,252 13,189,237 13,281,880 92,643 

Connecticut 7,163,951 6,690,546 6,760,070 69,524 

Delaware 

District Of 

Columbia 

2,071,177 1,598,527 1,582,088 -16,439 

1,606,255 1,605,650 1,602,772 -2,878 

Florida 47,760,158 44,999,189 45,271,355 272,166 

Georgia 22,785,809 22,053,331 21,990,485 -62,846 

Hawaii 3,843,000 3,604,901 3,533,063 -71,838 

Idaho 3,322,957 3,907,763 3,957,181 49,418 

Illinois 26,074,382 24,824,212 24,462,318 -361,894 

Indiana 12,159,809 12,193,343 12,127,509 -65,834 

Iowa 5,464,792 5,377,612 5,271,090 -106,522 

Kansas 5,153,574 4,996,496 4,987,655 -8,841 

Kentucky 8,889,372 8,922,528 8,894,128 -28,400 

Louisiana 8,551,996 9,818,107 9,778,932 -39,175 

Maine 2,747,999 2,719,188 2,699,115 -20,073 

Maryland 11,767,081 13,542,317 13,546,678 4,361 

Massachusetts 13,623,503 14,040,737 13,980,983 -59,754 

Michigan 20,985,212 20,363,260 20,190,984 -172,276 

Minnesota 10,170,229 10,320,508 10,357,154 36,646 

Mississippi 6,238,247 6,272,319 6,219,108 -53,211 

Missouri 11,439,169 11,531,537 11,520,551 -10,986 

Montana 2,096,555 2,051,241 2,054,542 3,301 

Nebraska 3,169,571 3,093,092 3,068,752 -24,340 

Nevada 

New 

Hampshire 

7,429,423 7,201,123 7,278,660 77,537 

2,457,638 2,421,717 2,403,986 -17,731 

148 
FY 2019 DISCRETIONARY STATE/FORMULA GRANTS 

Community Mental Health Services Block Grant Program 

CFDA # 93.959 

 

 

 

 

 

 

 

 

 

Department of Health and Human Services 

Substance Abuse and Mental Health Services Administration 

State/Territory 

FY 2018 

Final 

FY 2019 

Enacted 

FY 2020 

President's 

Budget 

FY 2020 

+/-

FY 2019 

New Jersey 18,960,917 19,289,480 19,359,855 70,375 

New Mexico 4,126,614 4,037,621 4,070,142 32,521 

New York 42,087,347 40,625,021 40,453,444 -171,577 

North Carolina 19,637,560 19,769,701 19,798,360 28,659 

North Dakota 1,119,569 1,041,461 1,070,171 28,710 

Ohio 21,303,633 21,363,628 21,212,133 -151,495 

Oklahoma 7,314,940 7,224,242 7,293,899 69,657 

Oregon 9,641,002 10,560,923 10,605,839 44,916 

Pennsylvania 23,766,601 22,707,223 22,529,713 -177,510 

Rhode Island 2,504,828 2,592,959 2,567,098 -25,861 

South Carolina 10,250,425 10,306,043 10,284,563 -21,480 

South Dakota 1,471,329 1,449,042 1,446,584 -2,458 

Tennessee 13,945,858 13,143,779 13,109,242 -34,537 

Texas 56,383,842 57,879,672 59,365,847 1,486,175 

Utah 5,462,823 6,051,844 6,090,522 38,678 

Vermont 1,220,345 1,188,649 1,175,360 -13,289 

Virginia 15,355,573 17,127,156 17,188,057 60,901 

Washington 16,314,403 16,048,884 16,049,343 459 

West Virginia 3,840,977 3,750,048 3,705,338 -44,710 

Wisconsin 11,122,581 11,896,020 11,791,675 -104,345 

Wyoming 

American 

Samoa 

820,891 792,403 812,236 19,833 

133,896 134,316 134,594 278 

Guam 

Northern 

398,624 429,733 437,353 7,620 

Marianas 128,971 135,240 136,578 1,338 

Puerto Rico 8,866,032 8,783,994 8,759,247 -24,747 

Palau 

Marshall 

Islands 

52,395 54,965 56,005 1,040 

177,872 188,930 194,791 5,861 

Micronesia 259,243 269,633 272,293 2,660 

Virgin Islands 255,197 276,820 280,321 3,501 

149 
SAMHSA 

Substance Abuse Prevention 

 Table of Contents 

1. Substance Abuse Prevention Appropriation ......................................................................... 151 

2. Programs of Regional and National Significance (PRNS) ................................................... 152 

a) Strategic Prevention Framework..................................................................................... 153 

b) Federal Drug-Free Workplace ........................................................................................ 157 

c) Minority AIDS ................................................................................................................ 160 

d) Sober Truth on Preventing Underage Drinking Act (Stop Act) ..................................... 163 

e) Center for the Application of Prevention Technologies ................................................. 166 

f) Science and Service Program Coordination ................................................................... 169 

g) Tribal Behavioral Health Grants..................................................................................... 171 

h) Grants to Prevent Prescription Drug/Opioid Overdose Related Deaths ......................... 174 

i) First Responder Training for Opioid Overdose Reversal Drugs .................................... 176 

j) Minority Fellowship Program......................................................................................... 178 

3. PRNS Mechanism Table Summary ...................................................................................... 180 

4. PRNS Mechanism Table by Program, Project, and Activity................................................ 181 

5. Grant Awards Table.............................................................................................................. 184 

6. Drug Free Communities ..............................................................................185 

150 
 

Substance Abuse Prevention Appropriation 

(Dollars in thousands) 

Program Activities 

FY 2018 

Final 

FY 2019 

Enacted 

FY 2020 

President's 

Budget 

FY 2020 

President's 

Budget 

+/-

FY 2019 

Enacted 

Programs of Regional and National Significance.................. 

Drug Free Communities1 .......................................

$248,219 

---

$205,469 

---

$144,090 

100,000 

-$61,379 

100,000 

Total, Substance Abuse Prevention $248,219 $205,469 $244,090 $38,621 

The Substance Abuse Prevention FY 2020 Budget Request is $244.1 million, an increase of $38.6 

million from the FY 2019 Enacted Budget. 

151 
 

Strategic Prevention Framework.......................................... $119,484 $119,484 $58,426 -$61,058 

Strategic Prevention Framework Rx (non-add)........... 10,000 10,000 10,000 ---

Federal Drug-Free Workplace............................................. 4,894 4,894 4,894 ---

First Responder Training (CARA)....................................... 36,000 --- --- ---

Improving Access to Overdose Treatment (CARA)........... 1,000 --- --- ---

Minority AIDS..................................................................... 41,205 41,205 41,205 ---

Sober Truth Preventing Underage Drinking Act 

(STOP Act)........................................................................ 7,000 8,000 8,000 ---

Grants to Prevent Prescription Drug/Opioid Overdose 

Related Deaths.................................................................... 12,000 --- --- ---

Tribal Behavioral Health Grants.......................................... 15,000 20,000 20,000 ---

 

 

 

Programs of Regional and National Significance (PRNS) 

Substance Abuse Prevention Appropriation 

(Dollars in Thousands) 

Programs of Regional & National Significance 

FY 2018 

Final 

FY 2019 

Enacted 

FY 2020 

President's 

Budget 

FY 2020 

President's 

Budget 

+/-

FY 2019 

Enacted 

Capacity: 

Subtotal, Capacity 

Science and Service: 

236,583 193,583 132,525 -61,058

Center for the Application of Prevention Technologies.... 7,493 7,493 7,493 ---

SAP Minority Fellowship Program...................................... 71 321 --- -$321 

Science and Service Program Coordination......................... 4,072 4,072 4,072 ---

Subtotal, Science and Service 11,636 11,886 11,565 -$321 

Total, PRNS $248,219 $205,469 $144,090 -$61,379 

Authorizing Legislation............................................................... ......Sections 516 of the PHS Act 

FY 2020 Authorization ................................................................................................$211,148,000 

Allocation Method ....................................Competitive Grants/Cooperative Agreements/Contracts 

Eligible Entities............................................................States, political subdivisions of 

 States, Federally Recognized 

 American Indian/Alaska Native tribe or tribal organizations, 

 Indian Health Service-operated and contracted health facilities 

 and programs, public or private nonprofit entities 

152 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Strategic Prevention Framework 

(Dollars in thousands) 

Programs of Regional & National Significance 

FY 2018 

Final 

FY 2019 

Enacted 

FY 2020 

President's 

Budget 

FY 2020 

President's 

Budget 

+/-

FY 2019 

Enacted 

Strategic Prevention Framework.......................................... 

Strategic Prevention Framework Rx (non-add)................. 

$119,484 

$10,000 

$119,484 

$10,000 

$58,426 

10,000 

-$61,058 

0 

Authorizing Legislation ........................................................................ Section 516 of the PHS Act 

FY 2020 Authorization ................................................................................................$211,148,000 

Allocation Method ....................................Competitive Grants/Cooperative Agreements/Contracts 

Eligible Entities.................................................................................. States, Tribes, and Territories 

Program Description and Accomplishments 

Strategic Prevention Framework (SPF) 

Drug and alcohol use are significant public health problems. Youth and adolescents who use alcohol 

and drugs face an increased risk of poor school performance, criminal justice involvement, the 

development of a drug/alcohol addiction, risky sexual behavior, illnesses such as HIV and hepatitis, 

depression and anxiety, and injury and death. The immediate and long-term risks and negative 

outcomes associated with adolescent drug and alcohol use underscore the need for effective 

prevention and treatment programs. 

Youth and adolescents use a variety of substances. In 2017, an estimated 30.4 million Americans 

aged 12 or older used illicit drugs in the past 30 days. The illicit drug use estimate for 2017 continues 

to be driven primarily by marijuana use and the misuse of prescription pain relievers, with 25.9 

million individuals who currently use marijuana aged 12 or older (i.e., past 30 day use) and 3.2 

million people aged 12 or older who reported current misuse of prescription pain relievers.48 

Since its inception, the Strategic Prevention Framework – Partnerships for Success (SPF-PFS) 

program has addressed underage drinking among youth and young adults age 12 to 20 and has 

allowed states to prioritize state-identified top data driven substance abuse target areas. 

Data show that states and communities receiving PFS funding have made improvements in reducing 

the impact of substance abuse. The 2017 National Survey on Drug Use and Health (NSDUH) shows 

that underage alcohol use (i.e., people aged 12 to 20) and binge and heavy drinking use among young 

adults aged 18 to 25, have declined over time but remain a concern. In 2016, 19.7 percent of 

underage people reported current use of alcohol, 11.9 percent reported binge drinking, and 

2.5 percent reported heavy alcohol use. Compared to the previous year’s NSDUH, the bingedrinking rate declined from 12.1 percent to 11.9 percent, and the rate of heavy drinking declined 

from 2.8 percent to 2.5 percent. In 2017, 6.5 percent of adolescents aged 12 to 17 were currently 

48 Substance Abuse and Mental Health Services Administration. (2018). Key substance use and mental health 

indicators in the United States: Results from the 2017 National Survey on Drug Use and Health (HHS Publication No. 

SMA 18-5068, NSDUH Series H-53). Rockville, MD: Center for Behavioral Health Statistics and Quality, Substance 

Abuse and Mental Health Services Administration. Retrieved from https://www.samhsa.gov/data/ 

153 
49 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

using marijuana. This means that approximately 1.9 million adolescents used marijuana in the past 

month.

In 2017, the program specifically addressed underage drinking and prescription drug misuse among 

youth and young adults and also encouraged grantees to address issues related to marijuana and 

heroin use. 

The cross-site evaluation for the PFS program addresses the following questions: 

1) Was the implementation of PFS program associated with a reduction in underage drinking 

and/or prescription drug misuse? 

2) Did variability in the total level of funding from all sources relate to outcomes? Did 

variability in the total level of PFS funding relate to outcomes, above and beyond other 

funding available to communities? 

3) What intervention type, combinations of interventions, and dosages of interventions were 

related to outcomes at the grantee level? What intervention type, combinations of 

interventions, and dosages of interventions were related to outcomes at the community 

level? 

4) Were some types and combinations of interventions within communities more 

cost- effective than other interventions? 

5) How does variability in factors (strategy selection and implementation, infrastructure, 

geography, demography, sub-recipient selection, Training/Technical Assistance, barriers 

to implementation) relate to outcomes across funded communities? 

In FY 2018, SAMHSA funded 74 SPF grant continuations and 29 new grants. In 2019, SAMHSA 

plans to support 62 Strategic Prevention Framework grant continuations and 21 new grants. The 

SPF PFS grant program addresses one of the Nation’s top substance abuse prevention priorities: 

underage drinking among persons aged 9 to 20. At their discretion, states/tribes may also use grant 

funds to target up to two additional, data-driven substance abuse prevention priorities, such as the 

use of marijuana, cocaine, or methamphetamine, etc. by individuals ages 9 and above. SPF-PFS is 

designed to ensure that prevention strategies and messages reach the populations most impacted by 

substance abuse. The program extends current established cross-agency and community-level 

partnerships by connecting substance abuse prevention programming to departments of social 

services and their community service providers. This includes working with populations 

disproportionately impacted by the consequences of substance use; i.e., children entering the foster 

care system, transitional youth, and individuals who support persons with substance abuse issues 

(women, families, parents, caregivers, and young adults). SAMHSA plans to support SPF PFS at a 

reduced rate in FY 2020. 

Strategic Prevention Framework for Prescription Drugs (SPF Rx) 

Since 1999, the age-adjusted drug-poisoning death rate has more than tripled, from 6.1 per 100,000 

in 1999 to 16.3 per 100,000 in 2015. In the U.S., misuse of prescription drugs, including opioids is 

49 Substance Abuse and Mental Health Services Administration. (2018). Key substance use and mental health indicators 

in the United States: Results from the 2017 National Survey on Drug Use and Health (HHS Publication No. SMA 18-

5068, NSDUH Series H-53). Rockville, MD: Center for Behavioral Health Statistics and Quality, Substance Abuse and 

Mental Health Services Administration. Retrieved from https://www.samhsa.gov/data/ 

154 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

responsible for much of the recent increase in drug-poisoning deaths.50 For example, drug overdose 

deaths from synthetic opioids other than methadone, which include drugs such as fentanyl 

(pharmaceutical and illicit) and tramadol, increased from 8% in 2010 to 42% in 2017. While the 

percent of drug overdose deaths from natural and semisynthetic opioid analgesics, which include 

drugs such as oxycodone and hydrocodone, decreased from 2010 to 2017, they are still high at 

22%51 . 

The Strategic Prevention Framework for Prescription Drugs assists grantees in developing capacity 

and expertise in the use of data from state run prescription drug monitoring programs (PDMP). 

Grantees have also raised awareness about the dangers of sharing medications and work with 

pharmaceutical and medical communities on the risks of overprescribing to young adults. 

SAMHSA’s program focuses on raising community awareness and bringing prescription drug use

prevention activities and education to schools, communities, parents, prescribers, and their patients. 

SAMHSA tracks reductions in opioid overdoses and the incorporation of prescription drug 

monitoring data into needs assessments and strategic plans as indicators of program success. 

SAMHSA plans to maintain this level of support for SPF Rx through FY 2020. 

Funding History 

Fiscal Year Amount 

FY 2016 $119,484,000 

FY 2017 $119,484,000 

FY 2018 $119,484,000 

FY 2019 $119,484,000 

FY 2020 $58,426,000 

Budget Request 

The FY 2020 Budget Request is $58.4 million, a decrease of $61.1 million from the FY 2019 

Enacted Budget. Funding for the SPF Rx program will be maintained in its entirety ($10.0 million) 

for 26 continuation grants. Funding will support SPF PFS continuation grants at a reduced rate, 

technical assistance, and evaluation to build capacity to address prescription drug misuse and 

overdose prevention efforts, in conjunction with other state and local partners. 

50 Centers for Disease Control and Prevention. NCHS Data on Drug Poisoning Deaths. 

https://www.cdc.gov/nchs/data/factsheets/factsheet_drug_poisoning.pdf. 51 Centers for Disease Control and Prevention. NCHS Data on Drug Poisoning Deaths. 

https://www.cdc.gov/nchs/data/factsheets/factsheet_drug_poisoning.pdf. 

155 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Outputs and Outcomes Table 

Program: Partnerships for Success 

Measure 

Year and Most Recent Result 

Target for Recent Result 

(Summary of Result) 

FY 2019 

Target 

FY 2020 

Target 

FY 2020 

Target 

+/-

FY 2019 

Target 

2.3.79 Increase the number of EBPs 

implemented by sub-recipient 

communities (Output) 

FY 2016: 531 

Target: 650 

(Target Not Met but Improved) 

531 531 Maintain 

2.3.80 Increase the number of subrecipient communities that 

improved on one or more targeted 

NOMs indicators. (Outcome) 

FY 2016: 552 

Target: 142 

(Target Exceeded) 

552 552 Maintain 

Program: Strategic Prevention Framework Rx 

Measure 

Year and Most Recent Result 

Target for Recent Result 

(Summary of Result) 

FY 2019 

Target 

FY 2020 

Target 

FY 2020 

Target 

+/-

FY 2019 

Target 

3.3.12 Increase the percent of funded 

states reporting reductions in opioid 

overdoses. (Outcome) 

FY 2017: 69 % 

Target: 55 % 

(Target Exceeded) 

69 % 69 % Maintain 

TBD Increase percent of grantees that 

reported taking steps to enhance 

access to and use of PDMP data at the 

grantee level. (Outcome) 

FY 2018: 85.0 

Target: 85.0 

(Baseline) 

85.0 85.0 Maintain 

156 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Federal Drug-Free Workplace 

(Dollars in thousands) 

Programs of Regional & National Significance 

FY 2018 

Final 

FY 2019 

Enacted 

FY 2020 

President's 

Budget 

FY 2020 

President's 

Budget 

+/-

FY 2019 

Enacted 

Federal Drug-Free Workplace.............................................. $4,894 $4,894 $4,894 $---

Authorizing Legislation ........................................................................ Section 516 of the PHS Act 

FY 2020 Authorization ................................................................................................$211,148,000 

Allocation Method .................................................................. Inter-Agency Agreements/Contracts 

Eligible Entities...................................................................... Federal Agencies, Regulated Entities 

(e.g., Department of Transportation, Nuclear Regulatory Commission), 

HHS- Certified Laboratories 

Program Descriptions and Accomplishments 

Alcohol and other drug misuse are widespread and have a variety of negative consequences, 

particularly in the workplace. Employers with successful drug-free workplace programs report 

decreases in absenteeism, accidents, downtime, turnover, and theft; increases in productivity; and 

overall improved morale. They also report better health status among many employees and family 

members and decreased use of medical benefits. Some organizations with drug-free workplace 

programs qualify for incentives, for example, decreased premium costs for certain kinds of 

insurance, such as Workers’ Compensation. 

In 1986, the President signed an Executive Order mandating that all federal agencies be drug-free. 

In 1988, Congress passed the Drug-Free Workplace Act. 

The Federal Drug-Free Workplace Programs (DFWP) ensure employees in national security, public 

health, and public safety positions are tested for the use of illegal drugs and the misuse of prescription 

drugs and ensure the laboratories that perform this drug testing are inspected and certified by HHS. 

Through this program, the federal government is able to avoid lost productivity and reduce 

absenteeism, injuries, and fatalities. 

SAMHSA implements the Federal Drug-Free Workplace Programs, which consist of two principal 

activities mandated by Executive Order (E.O.) 12564 and Public Law (P.L.) 100-71. These include: 

1) oversight of the Federal Drug-Free Workplace Programs, aimed at the elimination of the use of 

illegal drugs and the misuse of prescription drugs within Executive Branch agencies and the 

federally-regulated industries, and 2) oversight of the National Laboratory Certification Program 

(NLCP), which certifies laboratories to conduct forensic drug testing for federal agencies and 

federally-regulated industries; the private sector also uses the HHS-Certified Laboratories. 

First signed on September 15, 1986, E.O. 12564 requires the head of each executive agency to 

establish a comprehensive Drug-Free Workplace Plan that includes supervisor/employee education, 

an employee assistance program, and a random testing component to test the use of illegal substances 

and the misuse of prescription drugs by federal employees in safety-sensitive positions. 

157 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

The Supplemental Appropriations Act, 1987 (Public Law 100-71) included language which requires 

HHS to: 1) certify that each Executive Branch agency has developed a plan for achieving a drugfree workplace, and 2) publish mandatory guidelines that establish comprehensive standards for 

laboratory drug testing procedures, specify the drugs for which federal employees may be tested, 

and establish standards and procedures for periodic review and certification of laboratories to 

perform drug testing for federal agencies. 

Since 1987, SAMHSA has funded the Drug-Free Workplace drug testing activities including the 

NLCP and the Drug Testing Advisory Board (DTAB). These activities will continue in FY 2018 

under the NLCP contract. The NLCP oversees the certification of the labs that perform drug testing 

under the Drug-Free Workplace Programs. DTAB will continue to provide recommendations to the 

Assistant Secretary for Mental Health and Substance Use based on an ongoing review of the 

direction, scope, balance, and emphasis of SAMHSA’s drug testing activities and the NLCP.

On January 10, 2012, SAMHSA approved the DTAB’s recommendations to revise the mandatory

guidelines to include oral fluid as an alternative specimen to urine as well as include additional 

Schedule II prescription drug medications (e.g., oxycodone, oxymorphone, hydrocodone and 

hydromorphone). These mandatory guidelines using oral fluid are currently pending OMB review. 

On August 7, 2015, SAMHSA approved the DTAB’s recommendations to pursue hair as an

alternative specimen in the Mandatory Guidelines for Federal Workplace Drug Testing Programs. 

The proposed Mandatory Guidelines using hair is currently under review with SAMHSA. 

CSAP’s Workplace Helpline supports the drug-free workplace program. The helpline is a toll free 

telephone service (800-WORKPLACE) that answers questions from federal agencies, the public and 

private sectors about drug testing in the workplace. 

Continued funding for the Federal Drug-Free Workplace Programs has ensured the testing of federal 

employees in national security, public health, and public safety positions for the use of illegal drugs, 

the misuse of prescription drugs, and the inspection certification of HHS-certified laboratories for 

the past four years. 

Funding History 

Fiscal Year Amount 

FY 2016 $4,894,000 

FY 2017 $4,894,000 

FY 2018 $4,894,000 

FY 2019 $4,894,000 

FY 2020 $4,894,000 

158 
 

 

 

 

 

 

 

 

Budget Request 

The FY 2020 Budget Request is $4.9 million, level with the FY 2019 Enacted Budget. In FY 2020, 

SAMHSA will continue oversight of the Executive Branch Agencies’ Federal Drug-Free Workplace 

Programs. This includes review of Federal Drug-Free Workplace plans from those federal agencies 

that perform federal employee testing, random testing of those designated testing positions of 

national security, public health, and public safety, and testing for illegal drug use and the misuse of 

prescription drugs. SAMHSA will continue its oversight role for the inspection and certification of 

the HHS-certified laboratories. 

SAMHSA will continue/add the below items to its drug testing portfolio: 

 DTAB continued evaluation of the scientific supportability of hair as an alternative 

specimen to urine and oral fluids in the Mandatory Guidelines for Federal Workplace Drug 

Testing Programs; 

 Continued use of subject matter experts and partnering with other federal agencies to 

establish the scientific standards set out in the mandatory guidelines; 

 Implementation of the final Mandatory Guidelines using oral fluid and provide guidance on 

the implementation; 

 Research of hair as an alternative specimen for scientific supportability and inclusion in the 

Mandatory Guidelines; 

 Technical and scientific leadership for federal agencies on marijuana testing. 

159 
 

Program Description and Accomplishments 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Minority AIDS 

(Dollars in thousands) 

Programs of Regional & National Significance 

FY 2018 

Final 

FY 2019 

Enacted 

FY 2020 

President's 

Budget 

FY 2020 

President's 

Budget 

+/-

FY 2019 

Enacted 

Minority AIDS....................................................................... $41,205 $41,205 $41,205 $---

Authorizing Legislation ........................................................................ Section 516 of the PHS Act 

FY 2020 Authorization ................................................................................................$211,148,000 

Allocation Method ....................................Competitive Grants/Cooperative Agreements/Contracts 

Eligible Entities................................Local Government Entities, Community-based Organization, 

Minority Serving Institutions, 

and Institutions of Higher Education 

The update to the 2020 National HIV/AIDS Strategy for the United States reports that the HIV 

epidemic still exists and the needs of people living with HIV and those who are at-risk for infection 

continue to evolve. It also notes that to be effective, the federal response must adapt in order to 

respond to changing needs and funding levels as well as new threats, such as those presented by the 52 53 opioid crisis. Approximately 39,000 people become infected with HIV each year. In addition, 

because HIV and viral hepatitis share common modes of transmission, one third of HIV infected 

individuals are also infected with hepatitis C.

54 Hepatitis C cases are also increasing because of the 

use of injection drugs. 

The Minority AIDS program supports activities that assist grantees in building a solid foundation 

for delivering and sustaining quality and accessible state-of-the-science substance misuse and HIV 

prevention services. The program aims to engage community-level domestic public and private nonprofit entities, tribes, and tribal organizations in order to prevent and reduce the onset of substance 

misuse and transmission of HIV/AIDS among at-risk populations, including racial/ethnic minority 

youth and young adults, ages 13 to 24. SAMHSA works with college and university clinics/wellness 

centers and community-based providers that can provide comprehensive substance abuse and HIV 

prevention strategies. These strategies combine education and awareness programs, social 

marketing campaigns, and HIV and viral hepatitis testing services in non-traditional settings with 

substance misuse and HIV prevention programming for the population of focus. Because of the high 

rate of HIV/AIDS and hepatitis co-morbidity, this program includes viral hepatitis prevention and 

education training. The MAI program, along with many other HIV/AIDS programs across HHS, 

contributes to the goals of a new initiative to eliminate new HIV infections in our nation. Ending the 

HIV Epidemic: A Plan for America will be supported by this program through its continued 

assistance to vulnerable populations. 

52 National HIV/AIDS Strategy for the United States: Update in 2020 53 CDC: HIV in the United States at a Glance: https://www.cdc.gov/hiv/pdf/statistics/overview/cdc-hiv-usataglance.pdf 

54 U.S. Department of Health and Human Services: Secretary’s Minority AIDS Initiative Fund: 2017: HIV BASICS: 

Staying in HIV Care: Other Related Health Issues: Hepatitis B & C: Hepatitis B Virus and Hepatitis C Virus Infection, 

https://www.hiv.gov/hiv-basics/staying-in-hiv-care/other-related-health-issues/hepatitis-b-and-c 

160 
 

 

Fiscal Year Amount 

FY 2016 $41,205,000 

FY 2017 $40,405,000 

FY 2018 $41,205,000 

FY 2019 $41,205,000 

FY2020 $41,205,000 

SAMHSA has helped to prevent HIV and hepatitis infection acquired through substance abuse and 

misuse. SAMHSA’s Minority AIDS and viral hepatitis prevention programs have included a focus 

on community-based organizations and minority serving institutions and a focus on the continuum 

of care. SAMHSA supported 105 grant continuations and 37 new grant awards in FY 2018. 

In FY 2019, SAMHSA will support 85 grant continuations and 50 new grant award. 

Funding History 

Budget Request 

The FY 2020 Budget Request is $41.2 million, level with the FY 2019 Enacted Budget. SAMHSA 

plans to support 135 grants for Minority AIDS in FY 2020. 

161 
 

 

 

 

 

 

 

 

Outputs and Outcomes Table 

Program: Minority AIDS Initiative 

Measure 

Year and Most Recent Result 

Target for Recent Result 

(Summary of Result) 

FY 2019 

Target 

FY 2020 

Target 

FY 2020 

Target 

+/-

FY 2019 

Target 

2.3.56 Increase the number of 

program participants exposed to 

substance abuse prevention education 

services. (Output) 

FY 2018: 6,777 

Target: 2,580 

(Target Exceeded) 

6,777 6,777 Maintain 

2.3.85a Increase the number of 

persons tested for HIV through the 

Minority AIDS Initiative prevention 

activities. (Output) 

FY 2018: 31,811 

Target: 21,137 

(Target Exceeded) 

31,811 31,811 Maintain 

162 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Sober Truth on Preventing Underage Drinking Act (STOP Act) 

(Dollars in thousands) 

Programs of Regional & National Significance 

FY 2018 

Final 

FY 2019 

Enacted 

FY 2020 

President's 

Budget 

FY 2020 

President's 

Budget 

+/-

FY 2019 

Enacted 

Sober Truth on Preventing Underage Drinking Act 

(STOP Act)....................................................... $7,000 $8,000 $8,000 $---

Authorizing Legislation ......................................................................Section 519B of the PHS Act 

FY 2020 Authorization ....................................................................................................$3,000,000 

Allocation Method .............................................................................Competitive Grants/Contracts 

Eligible Entities............................................ Current and former Drug-Free Communities grantees 

Program Description and Accomplishments 

Underage drinking is a serious public health problem in the United States. Alcohol is the most widely 

used substance of abuse among America’s youth, and drinking by young people poses enormous 

health and safety risks. The consequences of underage drinking can affect everyone—regardless of 

age or drinking status. We all feel the effects of the aggressive behavior, property damage, injuries, 

violence, and deaths that can result from underage drinking. This is not simply a problem for some 

families—it is a nationwide concern. 55 

The Sober Truth on Preventing Underage Drinking Act (STOP Act) of 2006 (Public Law 109 - 422) 

was the nation’s first comprehensive legislation on underage drinking. One of the primary 

components of the STOP Act is the community-based coalition enhancement grant program, which 

provides up to $50,000 per year over four years to current or former grantees under the Drug Free 

Communities Act of 1997 to prevent and reduce alcohol use among youth under the age of 21. The 

STOP Act grant program enables organizations to strengthen collaboration and coordination among 

stakeholders to achieve a reduction in underage drinking in their communities. The STOP Act was 

reauthorized in the 21st Century Cures Act. 

In 2017, there were 140.6 million Americans aged 12 or older who reported current use of alcohol, 

including 66.6 million who reported binge alcohol use in the past month and 16.7 million who 

reported heavy alcohol use in the past month. Individuals with past month binge drinking and heavy 

alcohol use represented 24.5 and 6.1 percent of people aged 12 or older, respectively. 

FY 2016 data showed that 82 percent of coalitions report at least 5 percent improvement in the 

30-day use of alcohol in at least two grades. 

In FY 2017, SAMHSA provided funding for 81 STOP Act grant continuations and 17 new grants. 

In FY 2018, SAMHSA provided funding for 98 STOP Act continuation grants. SAMHSA will 

provide funding for 97 continuation grants in FY 2019. 

55 National Institute on Alcohol Abuse and Alcoholism (NIAAA) Rockville, MD: Underage Drinking. Retrieved from 

https://pubs.niaaa.nih.gov/publications/UnderageDrinking/UnderageFact.htm. 

163 
Fiscal Year Amount 

FY 2016 $7,000,000 

FY 2017 $7,000,000 

FY 2018 $7,000,000 

FY 2019 $8,000,000 

FY 2020 $8,000,000 

 

Funding History 

Budget Request 

The FY 2020 Budget Request is $8.0 million, level with the FY 2019 Enacted Budget. In FY 2020, 

SAMHSA will support 97 STOP Act grant continuations. This funding will continue to strengthen 

SAMHSA’s commitment to reduce and prevent underage drinking.

164 
Program: Sober Truth on Preventing Underage Drinking (STOP Act) 

 

 

 

 

 

 

 

Outputs and Outcomes Table 

Measure 

Year and Most Recent Result 

Target for Recent Result 

(Summary of Result) 

FY 2019 

Target 

FY 2020 

Target 

FY 2020 

Target 

+/-

FY 2019 

Target 

3.3.01 Increase the percent of 

coalitions that report at least 5% 

improvement in the past 30-day use of 

alcohol in at least two grades. 

(Outcome) 

FY 2017: 57.7 % 

Target: 62 % 

(Target Not Met) 

57.7% 57.7 % Maintain 

3.3.02 Increase the percent of 

coalitions that report improvement in 

youth perception of risk from alcohol 

in at least two grades. (Outcome) 

FY 2017: 75 % 

Target: 70 % 

(Target Exceeded) 

75 % 75% Maintain 

165 
 

 

 

 

 

 

 

 

 

 

 

Center for the Application of Prevention Technologies 

(Dollars in thousands) 

Programs of Regional & National Significance 

FY 2018 

Final 

FY 2019 

Enacted 

FY 2020 

President's 

Budget 

FY 2020 

President's 

Budget 

+/-

FY 2019 

Enacted 

Center for the Application of Prevention Technologies..... $7,493 $7,493 $7,493 $---

Authorizing Legislation ........................................................................ Section 516 of the PHS Act 

FY 2020 Authorization ................................................................................................$211,148,000 

Allocation Method ............................................................................................................. Contracts 

Eligible Entities...................................................................................Domestic and Public Entities 

Program Description and Accomplishments 

In 2019, CAPT changed how it delivered services and began providing science-based training and 

technical assistance through Prevention Technology Transfer Centers (PTTC) cooperative 

agreements. SAMHSA leadership established the PTTC the previous year to expand and improve 

implementation and delivery of effective substance abuse prevention interventions, and provide 

training and technical assistance services to the substance abuse prevention field. 

It does this by developing and disseminating tools and strategies needed to improve the quality 

of substance abuse prevention efforts; providing intensive technical assistance and learning 

resources to prevention professionals in order to improve their understanding of prevention 

science, epidemiological data, and implementation of evidence-based and promising practices; 

and, developing tools and resources to engage the next generation of prevention professionals. 

166 
Fiscal Year Amount 

FY 2016 $7,493,000 

FY 2017 $7,493,000 

FY 2018 $7,493,000 

FY 2019 $7,493,000 

FY 2020 $7,493,000 

Budget Request 

Funding History 

The FY 2020 Budget Request is $7.5 million, level with the FY 2019 Enacted Budget. Prevention 

T/TA services are being conducted by the PTTCs. 

167 
Program: Center for the Application of Prevention Technologies (CAPT) 

 

 

 

 

 

 

Outputs and Outcomes Table 

Measure 

Year and Most Recent Result 

Target for Recent Result 

(Summary of Result) 

FY 2019 

Target 

FY 2020 

Target 

FY 2020 

Target 

+/-

FY 2019 

Target 

1.4.14 Number of people trained. 

(Output) 

FY 2018: Result Expected 

December 31, 2019 

Target: Set Baseline 

(Pending) 

Maintain 

1.4.15 Percentage using information 

from training to change their practice. 

(Output) 

FY 2018: Result Expected 

December 31, 2019 

Target: Set Baseline 

(Pending) 

Maintain 

168 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Science and Service Program Coordination 

(Dollars in thousands) 

Programs of Regional & National Significance 

FY 2018 

Final 

FY 2019 

Enacted 

FY 2020 

President's 

Budget 

FY 2020 

President's 

Budget 

+/-

FY 2019 

Enacted 

Science and Service Program Coordination....................... $4,072 $4,072 $4,072 $---

Authorizing Legislation ........................................................................ Section 516 of the PHS Act 

FY 2020 Authorization ................................................................................................$211,148,000 

Allocation Method ............................................................................................................. Contracts 

Eligible Entities...................................................................................Domestic and Public Entities 

Program Description and Accomplishments 

SAMHSA has made prevention of underage drinking a priority because of its potential impact on 

the health and well-being of young people and their communities. Over the past decade, there has 

been a steady decline of drinking by adolescents and young adults. Trend data report similar declines 

in underage binge and heavy drinking. In 2017, 140.5 million Americans aged 12 or older reported 

current use of alcohol, 66.6 million reported binge drinking and 16.7 million reported heavy 

drinking.56 

The Science and Service Program Coordination program funds the provision of technical assistance 

and training to states, tribes, communities, and grantees around substance abuse prevention. 

Specifically, the program supports the Tribal Training and Technical Assistance Center and the 

Underage Drinking Prevention Education Initiatives (UADPEI). 

The Tribal Training and Technical Assistance Center is an innovative training and technical 

assistance project that helps tribal communities facilitate the development and implementation of 

comprehensive and collaborative community-based prevention plans to reduce violence, bullying, 

substance abuse, and suicide among American Indian/Alaska Native (AI/AN) youth, in support of 

the HHS Tribal Health and Well-Being Coordination. These plans mobilize tribal communities’

existing social and educational resources to meet their goals. 

The UADPEI efforts engage parents and other caregivers, schools, communities, all levels of 

government, all social systems that interface with youth, and youth themselves in a coordinated 

national effort to prevent and reduce underage drinking and its consequences. Through this initiative, 

families, their children, and other youth-serving organizations have been reached through Town Hall 

Meetings, technical assistance, trainings, and a variety of tools and materials. 

In FY 2016, the last year Town Halls were offered, community-based organizations registered to 

host 1,500 events. These events were held in all 50 states, the District of Columbia, and three 

territories. An estimated 300,000 people participated in events, either in person or virtually. 

56 Substance Abuse and Mental Health Services Administration. (2018). Key substance use and mental health 

indicators in the United States: Results from the 2017 National Survey on Drug Use and Health (HHS Publication No. 

SMA 18-5068, NSDUH Series H-53). Rockville, MD: Center for Behavioral Health Statistics and Quality, Substance 

Abuse and Mental Health Services Administration. Retrieved from http://www.samhsa.gov/data. 

169 
 

 

Funding History 

 

 

SAMHSA garnered 1.9 million social media impressions through the #Communities Talk and also 

reached an estimated 2.3 million people through traditional media promoting Communities Talk. 

SAMHSA responded to 3,000 requests for technical assistance in planning, promoting, hosting, and 

evaluating events. SAMHSA will continue to fund two contracts to support these activities. 

Fiscal Year Amount 

FY 2016 $4,072,000 

FY 2017 $4,072,000 

FY 2018 $4,072,000 

FY 2019 $4,072,000 

FY 2020 $4,072,000 

Budget Request 

The FY 2020 Budget Request is $4.1 million, level with the FY 2019 Enacted Budget. This funding 

will support SAMHSA’s substance abuse prevention efforts and include a focus on preventing 

underage drinking and providing technical assistance and training to American Indians/Alaska 

Native communities. 

170 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Tribal Behavioral Health Grants 

(Dollars in thousands) 

Programs of Regional & National Significance 

FY 2018 

Final 

FY 2019 

Enacted 

FY 2020 

President's 

Budget 

FY 2020 

President's 

Budget 

+/-

FY 2019 

Enacted 

Tribal Behavioral Health Grants........................................ $15,000 $20,000 $20,000 $---

Authorizing Legislation ........................................................................ Section 516 of the PHS Act 

FY 2020 Authorization ................................................................................................$211,148,000 

Allocation Method ................................................................................................. Grants/Contracts 

Eligible Entities....................................................................................................................... Tribes 

Program Description and Accomplishments 

Suicide is the second leading cause of death among American Indian/Alaska Native (AI/AN) youth 

ages eight to 24 years.57 Further, AI/AN high school students report higher rates of suicidal 

behaviors than the general population of U.S. high school students.58 These behaviors include 

serious thoughts of suicide, suicide plans, suicide attempts, and medical attention for a suicide 

attempt. However, the risk of suicide is not the same in all AI/AN youth demographic groups. For 

instance, AI/AN youth raised in urban settings have a smaller risk of having thoughts of suicide than 

AI/AN youth raised on tribal reservations (21 percent and 33 percent, respectively).59 

Consistent with the goals of the Tribal Behavioral Health Agenda, the Tribal Behavioral Health 

Grant (TBHG) program addresses the high incidence of substance use and suicide among AI/AN 

populations. Starting in FY 2014, this program supports tribal entities with the highest rates of 

suicide by providing effective and promising strategies that address substance abuse, trauma, and 

suicide and by promoting the mental health of AI/AN young people. 

In FY 2014, SAMHSA’s Center for Mental Health Services awarded five-year TBHG grants of up 

to $0.2 million annually to 20 tribes or tribal organizations with high rates of suicide. These fiveyear grants help grantees develop and implement a plan that addresses suicide and substance abuse, 

thereby promoting mental health among tribal youth. In addition, SAMHSA’s Tribal Training and

Technical Assistance Center (http://www.samhsa.gov/tribal-ttac) provides training and education to 

AI/AN grantees and organizations serving AI/AN populations to support their ability to achieve their 

goals. An evaluation component allows grantees and SAMHSA to work collaboratively to monitor 

progress and learn from each other. 

In FY 2016, SAMHSA expanded the TBHG program to include a Native youth initiative focused 

on removing possible barriers to success for Native youth. This initiative takes a comprehensive, 

culturally appropriate approach to help improve the lives of and opportunities for AI/AN youth. In 

57 Centers for Disease Control and Prevention. Fatal injury data, 2010. Web-based Injury Statistics Query and 

Reporting System. Available at www.cdc.gov/injury/wisqars/fatal.html. Accessed May 27, 2014. 58 Centers for Disease Control and Prevention. Youth Risk Behavior Surveillance System (YRBSS). Available at 

http://www.cdc.gov/healthyyouth/yrbs/index.htm. Accessed May 27, 2014. 

59 Freedenthal, S. & Stiffman, A. R. (2004). Suicidal Behavior in Urban American Indian Adolescents: A Comparison 

with Reservation Youth in a Southwestern State. Suicide and Life-Threatening Behavior, 34(2), 160-171. 

171 
 

 

 

 

 

 

 

 

 

 

 

 

Fiscal Year Amount 

FY 2016 $15,000,000 

FY 2017 $14,450,000 

FY 2018 $15,000,000 

FY 2019 $20,000,000 

FY 2020 $20,000,000 

 

 

 

 

addition to the Department of Health and Human Services, multiple agencies, including the 

Departments of Interior, Education, Housing and Urban Development, Agriculture, Labor, and 

Justice, are working collaboratively with tribes to address issues facing AI/AN youth. This funding 

allows SAMHSA to expand activities through the braided TBHG ($20.0 million in the Substance 

Abuse Prevention appropriation and $20.0 million in Mental Health appropriation) to allow tribes 

the flexibility to implement community-based strategies to address trauma, prevent substance abuse, 

and promote mental health and resiliency among youth in tribal communities. The additional FY 

2016 funding expanded these activities to approximately 90 tribes and tribal entities. With the 

expansion of the TBHG program, SAMHSA’s goal is to reduce substance use and the incidence of

suicide attempts among AI/AN youth and to address behavioral health conditions that affect learning 

in the Bureau of Indian Education-funded schools. The TBHG program will support mental health 

promotion, including trauma-informed strategies, and substance use prevention activities for highrisk AI/AN youth and their families, enhance early detection of mental illness and drug/alcohol 

addiction among AI/AN youth, and increase referral to treatment. 

In FY 2018, SAMHSA provided funding to support 82 grant continuations and 46 new grant awards. 

In FY 2019, SAMHSA will provide funding to support 128 grant continuations and approximately 

51 new grant awards. 

Funding History 

Budget Request 

The FY 2020 Budget Request is $20.0 million, level with the FY 2019 Enacted Budget. This request, 

along with $20.0 million in the Center of Mental Health Services will continue to support 

approximately 179 grants that promote mental health and prevent substance use activities for highrisk AI/AN youth and their families. 

As a braided activity, SAMHSA will track separately any amounts spent or awarded under Tribal 

Behavioral Health Grants through the distinct appropriations and ensure that funds are used for 

purposes consistent with legislative direction and intent of these appropriations. 

172 
 

 

 

 

 

 

 

 

 

 

Outputs and Outcomes Table 

Program: Tribal Behavioral Health Grants60 

Measure 

Year and Most Recent Result 

Target for Recent Result 

(Summary of Result) 

FY 2019 

Target 

FY 2020 

Target 

FY 2020 

Target 

+/-

FY 2019 

Target 

2.4.12 Increase the percentage of youth 

age 10 - 24 who received mental health 

or related services after screening, 

referral or attempt. (Output) 

FY 2017: 56 

Target: 20 

(Target Exceeded) 

56 56 Maintain 

2.4.13 Increase the number of 

programs/organizations that 

implemented specific mental-health 

related practices/activities as a result of 

the grant. (Outcome) 

FY 2017: 5,670 

Target: 296 

(Target Exceeded) 

5,670 5,670 Maintain 

60 This is a combined total performance for CMHS and CSAP. 

173 
 

 

 

Fiscal Year Amount 

FY 2016 $12,000,000 

FY 2017 $12,000,000 

FY 2018 $12,000,000 

FY 2019 --- 

FY 2020 --- 

 

 

Grants to Prevent Prescription Drug/Opioid Overdose Related Deaths 

(Dollars in thousands) 

Programs of Regional & National Significance 

FY 2018 

Final 

FY 2019 

Enacted 

FY 2020 

President's 

Budget 

FY 2020 

President's 

Budget 

+/-

FY 2019 

Enacted 

Grants to Prevent Prescription Drug/ Opioid Overdose 

Related Deaths.......................................................... $12,000 $--- $--- $---

Authorizing Legislation ............................................. Section 516 and Section 546 of the PHS Act 

FY 2020 Authorization ..................................................................................Expired at the of 2020 

Allocation Method ............................................................................Competitive Grants, Contracts 

Eligible Entities...........................................States, local government entities, federally recognized 

 American Indian/Alaska Native tribe or tribal organizations 

Program Description and Accomplishments 

This program is continued in the Center for Substance Abuse Treatment, as directed by Congress. 

For information on this program in FY 2019 and FY 2020, please see page 240. 

Funding History 

Budget Request 

The FY 2020 Budget Request is $0.0 million in this Center, level with the FY 2019 Enacted Budget. 

As stated above Congress appropriated funding for this program under the Center for Substance 

Abuse Treatment, and details are provided in that chapter of this document. 

174 
 

 

 

 

 

 

 

 

 

Outputs and Outcomes Table 

Program: Prescription Drug/Opioid Overdose Related Death/First Responder Training 

Measure 

Year and Most Recent Result 

Target for Recent Result 

(Summary of Result) 

FY 2019 

Target 

FY 2020 

Target 

FY 2020 

Target 

+/-

FY 2019 

Target 

5.0 Number of Naloxone (or other 

FDA-approved) kits distributed. 

(Output) 

FY 2018: 44,348.0 

Target: 20,000.0 

(Target Exceeded) 

Maintain 

5.1 Number of lay persons trained 

how to administer Naloxone (or other 

FDA approved drug or device). 

(Output) 

FY 2018: 20,036.0 

Target: 2,000.0 

(Target Exceeded) 

Maintain 

Note: Congress appropriated funding for this program under the Center for Substance Abuse Treatment. 

175 
 

 

 

 

Fiscal Year Amount 

FY 2016 ---

FY 2017 

FY 2018 

FY 2019 

$12,000,000 

 

 

$36,000,000

---

FY 2020 ---

 

 

 

First Responder Training for Opioid Overdose Reversal Drugs 

(Dollars in thousands) 

Programs of Regional & National Significance 

FY 2018 

Final 

FY 2019 

Enacted 

FY 2020 

President's 

Budget 

FY 2020 

President's 

Budget 

+/-

FY 2019 

Enacted 

First Responder Training (CARA) ......................................... $36,000 $--- $--- $---

Authorizing Legislation.........................................................................Section 546 of the PHS Act 

FY 2020 Authorization .......................................................................... Expired at the end of 2020 

Allocation Method............................................................................................Competitive Grants

Eligible entities...............................States, local government entities, federally recognized 

American Indian/Alaska Native tribe or tribal organizations 

Program Description and Accomplishments 

This program is continued in the Center for Substance Abuse Treatment, as directed by Congress. 

For information on this program in FY 2019 and FY 2020, please see page 238. 

Funding History 

Budget Request 

The FY 2020 Budget Request is $0.0 million, level with the FY 2019 Enacted Budget. As with 

previous chapter. Congress appropriated funding for this program under Substance Abuse 

Treatment 

176 
 

 

 

 

 

 

 

 

 

Outputs and Outcomes Table 

Program: First Responder Training (CARA) 

Measure 

Year and Most Recent Result 

Target for Recent Result 

(Summary of Result) 

FY 2019 

Target 

FY 2020 

Target 

FY 2020 

Target 

+/-

FY 2019 

Target 

TBD Number of Naloxone (or other 

FDA-approved) kits distributed. 

(Output) 

FY 2018: 30,313.0 

Target: 30,313.0 

(Baseline) 

Maintain 

TBD Number of first responders 

trained how to administer Naloxone 

(or other FDA approved drug or 

device). (Output) 

FY 2018: 5,983.0 

Target: 5,983.0 

(Baseline) 

Maintain 

Note: Congress appropriated funding for this program under the Center for Substance Abuse Treatment. 

177 
 

 

 

 

 

 

 

 

 

 

 

Minority Fellowship Program 

(Dollars in thousands) 

Programs of Regional & National Significance 

FY 2018 

Final 

FY 2019 

Enacted 

FY 2020 

President's 

Budget 

FY 2020 

President's 

Budget 

+/-

FY 2019 

Enacted 

Minority Fellowship Program.................................................. $71 $321 $--- -$321 

Authorizing Legislation ........................................................................ Section 597 of the PHS Act 

FY 2020 Authorization ..................................................................................................$12,669,000 

Allocation Method ................................................................................................. Grants/Contracts 

Eligible Entities..... Organizations that represent individuals obtaining post-baccalaureate training 

(including for master’s and doctoral degrees) for mental and substance use disorder treatment 

professionals, including in the fields of psychiatry, nursing, social work, psychology, marriage and 

family therapy, mental health counseling, and substance use disorder and addiction counseling 

Program Description and Accomplishments 

SAMHSA’s Minority Fellowship Program (MFP) increases behavioral health practitioners’ 

knowledge of issues related to prevention, treatment, and recovery support for mental illness and 

drug/alcohol addiction among racial and ethnic minority populations. The program provides 

stipends to increase the number of culturally competent behavioral health professionals who teach, 

administer, conduct services research, and provide direct mental illness or substance use disorder 

treatment services for minority populations that are underserved. Since its start in 1973, the program 

has helped to enhance services for racial and ethnic minority communities through specialized 

training of mental health professionals in psychiatry, nursing, social work, and psychology. In 2006, 

the program expanded to include marriage and family therapists and later added professional 

counselors. Professional guilds receive competitively awarded grants, and then competitively award 

the stipends to post-graduate students pursuing a degree in that professional field. In FY 2018, 

SAMHSA funded seven continuation grants. SAMHSA received additional funding to support the 

seven grants in FY 2019. 

178 
Fiscal Year Amount 

FY 2016 $71,000 

FY 2017 $71,000 

FY 2018 $71,000 

FY 2019 $321,000 

FY 2020 ---

 

Funding History 

Budget Request 

The FY 2020 Budget Request is $0.0, a decrease of $0.3 million from the FY 2019 Enacted Budget. 

The funding for this program was discontinued. 

179 
 

Continuations............................................................... 403 124,091 457 134,894 491 104,839 

New/Competing........................................................... 159 88,064 128 44,763 31 14,536 

Continuations............................................................... 21 29,518 20 24,939 22 24,714 

New.............................................................................. 6 6,546 1 873 

SAMHSA/Substance Abuse Prevention 

PRNS Mechanism Table Summary 

(Dollars in thousands) 

Programs of Regional & National Significance 

FY 2018 

Final 

No. Amount 

FY 2019 

Enacted 

No. Amount 

FY 2020 

President's 

Budget 

No. Amount 

Grants 

Subtotal.................................................................... 562 212,155 585 179,657 522 119,376 

Contracts 

Subtotal.................................................................... 27 36,064 21 25,812 22 24,714 

Total, Substance Abuse Prevention PRNS 589 $248,219 606 $205,469 544 $144,090 

180 
181

SAMHSA/Substance Abuse Prevention

PRNS Mechanism Table by Program, Project, and Activity

(Dollars in thousands)

Programs of Regional & National Significance

FY 2018

Final

FY 2019

Enacted

FY 2020

President's

Budget

No. Amount No. Amount No. Amount

Grants to Prevent Prescription Drug/Opioid Overdose

Related Deaths

Grants

Continuations..................................................................... 13 10,815 --- --- --- ---

New ..................................................................................... --- --- --- --- --- ---

Subtotal .......................................................................... 13 10,815 --- --- --- ---

Contracts

Continuations..................................................................... 1 1,185 --- --- --- ---

New ..................................................................................... --- --- --- --- --- ---

Subtotal .......................................................................... 1 1,185 --- --- --- ---

Total, Grants to Prevent Prescription Drug/ Opioid

Overdose Related Deaths 14 12,000

Tribal Behavioral Health Grants

Grants

Continuations..................................................................... 73 6,427 119 13,350 169 17,525

New/Competing.................................................................. 46 6,455 50 4,321 --- ---

Subtotal .......................................................................... 119 12,882 169 17,671 169 17,525

Contracts

Continuations..................................................................... 2 2,118 1 2,329 1 2,475

Subtotal .......................................................................... 2 2,118 1 2,329 1 2,475

Total, Tribal Behavioral Health Grants 121 15,000 170 20,000 170 20,000

First Responder Training (CARA)

Grants

Continuations..................................................................... 21 11,329 --- --- --- ---

New/Competing.................................................................. 28 22,643 --- --- --- ---

Subtotal .......................................................................... 49 33,972 0 --- 0 ---

Contracts

Continuations..................................................................... 1 2,028 --- --- --- ---

Subtotal .......................................................................... 1 2,028 --- --- --- ---

Total, First Responder Training (CARA) 50 36,000 --- --- --- ---

Improving Access to Overdose Treatment

Grants

Continuations..................................................................... 5 948 --- --- --- ---

Subtotal .......................................................................... 5 948 --- --- --- ---

Contracts

Continuations..................................................................... --- 52 --- --- --- ---

Subtotal .......................................................................... --- 52 --- --- --- ---

Total, Improving Access to Overdose Treatment 5 1,000 --- --- --- ---

Subtotal, Capacity 565 236,583 560 193,583 528 132,525
182

SAMHSA/Substance Abuse Prevention

PRNS Mechanism Table by Program, Project, and Activity

(Dollars in thousands)

Programs of Regional & National Significance

FY 2018

Final

FY 2019

Enacted

FY 2020

President's

Budget

No. Amount No. Amount No. Amount

Grants to Prevent Prescription Drug/Opioid Overdose

Related Deaths

Grants

Continuations..................................................................... 13 10,815 --- --- --- ---

New ..................................................................................... --- --- --- --- --- ---

Subtotal .......................................................................... 13 10,815 --- --- --- ---

Contracts

Continuations..................................................................... 1 1,185 --- --- --- ---

New ..................................................................................... --- --- --- --- --- ---

Subtotal .......................................................................... 1 1,185 --- --- --- ---

Total, Grants to Prevent Prescription Drug/ Opioid

Overdose Related Deaths 14 12,000

Tribal Behavioral Health Grants

Grants

Continuations..................................................................... 73 6,427 119 13,350 169 17,525

New/Competing.................................................................. 46 6,455 50 4,321 --- ---

Subtotal .......................................................................... 119 12,882 169 17,671 169 17,525

Contracts

Continuations..................................................................... 2 2,118 1 2,329 1 2,475

Subtotal .......................................................................... 2 2,118 1 2,329 1 2,475

Total, Tribal Behavioral Health Grants 121 15,000 170 20,000 170 20,000

First Responder Training (CARA)

Grants

Continuations..................................................................... 21 11,329 --- --- --- ---

New/Competing.................................................................. 28 22,643 --- --- --- ---

Subtotal .......................................................................... 49 33,972 0 --- 0 ---

Contracts

Continuations..................................................................... 1 2,028 --- --- --- ---

Subtotal .......................................................................... 1 2,028 --- --- --- ---

Total, First Responder Training (CARA) 50 36,000 --- --- --- ---

Improving Access to Overdose Treatment

Grants

Continuations..................................................................... 5 948 --- --- --- ---

Subtotal .......................................................................... 5 948 --- --- --- ---

Contracts

Continuations..................................................................... --- 52 --- --- --- ---

Subtotal .......................................................................... --- 52 --- --- --- ---

Total, Improving Access to Overdose Treatment 5 1,000 --- --- --- ---

Subtotal, Capacity 565 236,583 560 193,583 528 132,525

--- --- --- ---
183

SAMHSA/Substance Abuse Prevention

PRNS Mechanism Table by Program, Project, and Activity

(Dollars in thousands)

Programs of Regional & National Significance

FY 2018

Final

FY 2019

Enacted

FY 2020

President's

Budget

No. Amount No. Amount No. Amount

Science and Service:

Center for the Application of Prevention Technologies

Grants

Continuations..................................................................... --- --- 12 7,111 12 7,056

New/Competing .................................................................. --- --- --- --- --- ---

Subtotal........................................................................... --- --- 12 7,111 12 7,056

Contracts

Continuations..................................................................... 1 7,493 --- 382 --- 437

New/Competing .................................................................. --- --- --- --- --- ---

Subtotal........................................................................... 1 7,493 --- 382 --- 437

Total, Center for the Application Prevention Technologies 1 7,493 12 7,493 12 7,493

SAP Minority Fellowship Program

Grants

Continuations..................................................................... --- --- --- 66 --- ---

New/Competing .................................................................. 7 66 30 239 --- ---

Subtotal........................................................................... 7 66 30 305 --- ---

Contracts

Continuations..................................................................... --- 1 --- 16 --- ---

New/Competing .................................................................. --- 4 --- --- --- ---

Subtotal........................................................................... --- 5 --- 16 --- ---

Total, SAP Minority Fellowship Program 7 71 30 321 --- ---

Science & Service Program Coordination

Grants

Continuations..................................................................... 12 --- --- --- --- ---

New/Competing .................................................................. --- 2,355 --- --- --- ---

Subtotal........................................................................... 12 2,355 --- --- --- ---

Contracts

Continuations..................................................................... 4 1,717 4 4,072 4 4,072

New...................................................................................... --- --- --- --- --- ---

Subtotal........................................................................... 4 1,717 4 4,072 4 4,072

Total, Science & Service Program Coordination 16 4,072 4 4,072 4 4,072

Subtotal, Science and Service 24 11,636 46 11,886 16 11,565

Total, Substance Abuse Prevention 589 $248,219 606 $205,469 544 $144,090
 

Grant Awards Table 

(Whole dollars) 

FY 2018 

Final 

FY 2019 

Enacted 

FY 2020 

President's 

Budget 

Number of Awards 562 585 522 

Average Award $377,500 $307,106 $228,689 

Range of Awards $50,000 - $2,300,000 $50,000 - $2,300,000 $50,000 - $2,300,000 

184 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Drug Free Communities 

(Dollars in thousands) 

Programs of Regional & National Significance 

FY 2018 

Final 

FY 2019 

Enacted 

FY 2020 

President's 

Budget 

FY 2020 

President’s

Budget 

+/-

FY 2019 

Enacted 

Drug Free Communities1 ............................................ $--- $--- $100,000 $100,000 1 Drug Free Communities was funded in the Office of National Drug Control Policy at $97.0 million in 2017 and at 

$96.3 million under the FY 2018 Annualized CR. 

Authorizing Legislation .......................Drug-Free Communities Act of 1997 (Public Law 105-20) 

FY 2019 Authorization .................................................................................................... Permanent 

Allocation Method ....................................Competitive Grants/Cooperative Agreements/Contracts 

Eligible Entities.................................................................................. States, Tribes, and Territories 

Program Description and Accomplishments 

The Drug-Free Communities (DFC) Act of 1997 created the DFC Support Program (Public Law 

105-20). By statute, the DFC Support Program has two goals: 

 Establish and strengthen collaboration among communities, public and private non-profit 

agencies, as well as federal, state, local, and tribal governments to support the efforts of 

community coalitions working to prevent and reduce substance abuse among youth. 

 Reduce substance abuse among youth and, over time, reduce substance abuse among adults 

by addressing the factors in a community that increase the risk of substance abuse and 

promoting the factors that minimize the risk of substance abuse. 

The goal of the program is to establish and strengthen collaboration among communities, public and 

private non-profit agencies, as well as federal, state, local, and tribal governments to support the 

efforts of community coalitions working to prevent and reduce substance abuse among youth. In 

addition, the program aims to reduce substance abuse among youth and, over time, reduce substance 

abuse among adults by addressing the factors in a community that increase the risk of substance 

abuse and promoting the factors that minimize the risk of substance abuse. Five- year grants of up 

to $125,000 are awarded to new recipients each year. Recipients are eligible to apply for funding 

for a second five-year period, which is designated as a competing continuation grant. 

The program also includes the Drug Free Communities Mentoring (DFC-M) Program. The purpose 

of this program is to provide grant funds to existing DFC recipients so they may serve as mentors to 

newly-formed and/or developing coalitions that have never received a DFC grant. It is the intent of 

the DFC-M Program that, at the end of the Mentoring grant, each Mentee coalition will meet all of 

the statutory eligibility requirements of the DFC Support Program and be fully prepared to compete 

for a DFC grant on their own. DFC-M grants are awarded for two years for up to $75,000. Eligible 

applicants are coalitions that have been in existence for at least five years, have an active DFC grant 

at the time of the award, and are in good standing. 

185 
 

 

 

Funding History 

Fiscal Year Amount 

FY 2016 ---

FY 2017 ---

FY 2018 ---

FY 2019 ---

FY 2020 $100,000,000 

Budget Request 

The FY 2020 President’s Budget Request is $100.0 million. This activity was funded at $99 million 

in the Office of National Drug Control Policy (ONDCP) under the 2019 Annualized CR. SAMHSA 

has administered this program for several years on behalf of ONDCP. The FY 2020 Budget proposes 

to directly appropriate these funds to SAMHSA to streamline program management and create 

administrative efficiencies. Funding will be used to continue both the DFC and DFC-Mentoring 

programs. 

186 
SAMHSA 

Substance Abuse Treatment 

Table of Contents 

1. Substance Abuse Treatment Appropriation .......................................................................... 189 

2. Programs of Regional and National Significance (PRNS) ................................................... 190 

a) Opioid Treatment Programs/Regulatory Activities....................................................... 191 

b) Screening, Brief Intervention and Referral to Treatment.............................................. 194 

c) Targeted Capacity Expansion-General.......................................................................... 197 

d) Pregnant and Postpartum Women ................................................................................. 203 

e) Recovery Community Services Program ...................................................................... 208 

f) Children and Families ................................................................................................... 211 

g) Treatment Systems for Homeless.................................................................................. 215 

h) Minority AIDS .............................................................................................................. 219 

i) Criminal Justice Activities ............................................................................................ 221 

j) Building Communities of Recovery.............................................................................. 229 

k) Minority Fellowship Program ............................................................................................... 231 

l) Addiction Technology Transfer Centers ....................................................................... 233 

m) Improving Access to Overdose Treatment .................................................................... 236 

n) First Responder Training for Opioid Overdose Reversal Drug .................................... 238 

o) Grants to Prevent Prescription Drug/Opioid Overdose Related Deaths........................ 240 

p) Grants to Develop Curricular for DATA Act Waivers ................................................. 243 

3. PRNS Mechanism Table Summary ...................................................................................... 245 

4. PRNS Mechanism Table by Program, Project, and Activity................................................ 246 

5. Grant Award Table ............................................................................................................... 251 

6. State Targeted Response to the Opioid Crisis Grants........................................................... 252 

7. State Opioid Response Grants .............................................................................................. 255 

8. Substance Abuse Prevention and Treatment Block Grant.................................................... 259 

187 
Page intentionally left blank 

188 
Substance Abuse Treatment Appropriation 

(Dollars in thousands) 

-$30,789 

-2,000

Budget Authority (non-add)............................................... 

 

 

FY 2018 

Final 

FY 2019 

Enacted 

FY 2020 

President's 

Budget 

FY 2020 

President's 

Budget 

+/-

FY 2019 

Enacted 

Programs of Regional and National Significance................ 

PHS Evaluation Funds (non-add)................................... 

State Targeted Response to the Opioid Crisis Grants.......... 

State Opioid Response Grants............................................. 

Substance Abuse Prevention and Treatment Block Grant... 

PHS Evaluation Funds (non-add)................................... 

Total, Substance Abuse Treatment.................................. 

$399,091 

2,000 

500,000 

1,000,000 

1,858,079 

1,778,879 

79,200 

$460,677 

2,000 

---

1,500,000 

1,858,079 

1,778,879 

79,200 

$429,888 

---

---

1,500,000 

1,858,079 

1,778,879 

79,200 

---

---

---

---

---

$3,757,170 $3,818,756 $3,787,967 -$30,789 

The Substance Abuse Treatment FY 2020 President’s Budget is $3.8 billion, a decrease of $30.7

million from the FY 2019 Enacted level. The request includes $3.7 billion in Budget Authority and 

$79.2 million in Public Health Service (PHS) Evaluation funds 

189 
190

Programs of Regional and National Significance (PRNS) 

Substance Abuse Treatment Appropriation

(Dollars in thousands)

Programs of Regional and National Significance

FY 2018

Final

FY 2019

Enacted

FY 2020

President's

Budget

FY 2020

President's

Budget

+/- 

FY 2019

Enacted

Capacity:

Opioid Treatment Programs/Regulatory Activities............................. $8,724 $8,724 $8,724 ---

Screening, Brief Intervention and Referral to Treatment................... 24,700 30,000 --- -30,000

Budget Authority (non-add)............................................................ 22,700 28,000 --- -28,000

PHS Evaluation Funds (non-add)................................................... 2,000 2,000 --- -2,000

Targeted Capacity Expansion-General ............................................... 95,192 100,192 100,192 ---

Other Targeted Capacity Expansion ............................................. 11,192 11,192 11,192 ---

MAT for Prescription Drug and Opioid Addiction (non-add) ....... 84,000 89,000 89,000 ---

Pregnant and Postpartum Women....................................................... 29,931 29,931 29,931 ---

Recovery Community Services Program............................................ 2,434 2,434 2,434 ---

Improving Access to Overdose Treatment......................................... --- 1,000 1,000 ---

Building Communities of Recovery ................................................... 5,000 6,000 6,000 ---

Children and Families........................................................................ 29,605 29,605 29,605 ---

Treatment Systems for Homeless ...................................................... 36,386 36,386 36,386 ---

Minority AIDS.................................................................................... 64,534 65,570 65,570 ---

Criminal Justice Activities.................................................................. 89,000 89,000 89,000 ---

Other Criminal Justice Activities (non-add).................................. 19,000 19,000 19,000 ---

Drug Court Activities (non-add)...................................................... 70,000 70,000 70,000 ---

Grants to Prevent Prescription Drug/Opioid Overdose-Related Deaths --- 12,000 12,000 ---

Grants to Develop Curricula for DATA Act Waivers......................... --- --- 4,000 4,000

First Responder Training (CARA)...................................................... --- 36,000 36,000 ---

First Responder Training (non-add).............................................. --- 18,000 18,000 ---

Rural Set-Aside (non-add)............................................................. --- 18,000 18,000 ---

Subtotal, Capacity 385,506 446,842 420,842 -26,000

Science and Service:

SAT Minority Fellowship Programs................................................... 4,539 4,789 --- -4,789

Addiction Technology Transfer Centers............................................. 9,046 9,046 9,046 ---

Subtotal, Science and Service 13,585 13,835 9,046 -4,789

Total, PRNS $399,091 $460,677 $429,888 -$30,789

Authorizing Legislation ............................................. Section 509 of the Public Health Service Act

FY 2020 Authorization ................................................................................................ $333,806,000 

Allocation Method .................................... Competitive Grants/Cooperative Agreements/Contracts

Eligible Entities ............ States, local governments, Communities, Federal Recognized, American

Indian/Alaska Native tribes or tribal organization, Indian Health Service-operated and contracted

health facilities and programs, public or private nonprofit entities 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Opioid Treatment Programs/Regulatory Activities 

(Dollars in thousands) 

Programs of Regional & National Significance 

FY 2018 

Final 

FY 2019 

Enacted 

FY 2020 

President's 

Budget 

FY 2020 

President's 

Budget 

+/-

FY 2019 

Enacted 

Opioid Treatment Programs/Regulatory Activities............. $8,724 $8,724 $8,724 $---

Authorizing Legislation .............................................Section 509 of the Public Health Service Act 

FY 2020 Authorization ................................................................................................$333,806,000 

Allocation Method ....................................Competitive Grants/Contracts/Cooperative Agreements 

Eligible Entities.............................................................. American Society of Addiction Medicine, 

American Academy of Addiction Psychiatry, American Medical Association, 

American Osteopathic Association, American Psychiatric Association, 

American Dental Association 

Domestic Medical Schools, Physician Assistant Schools, and Schools of Nursing 

Program Description and Accomplishments 

The misuse of prescription opioid pain relievers and illicit opioids, such as heroin, is causing 

suffering, sickness, overdose, and death in the United States at epidemic levels.61 Communities 

across the nation also face the risk that individuals who inject opioids will contract and spread 

Human Immunodeficiency Virus (HIV) and hepatitis C.62 The underlying cause of these problems 

is increasing rates of opioid abuse.63,64 

With increasing incidence of opioid abuse, there is a corresponding increase in admissions for 

treatment of opioid abuse.65 Medication-assisted treatment (MAT) refers to the use of the Food and 

Drug Administration (FDA) approved pharmacotherapies (i.e., buprenorphine products, methadone, 

and naltrexone products) in combination with evidence-based psychosocial interventions for 

61 U.S. Department of Health and Human Services. Addressing prescription drug abuse in the United States: current 

activities and future opportunities. 2013. Retrieved from 

www.cdc.gov/drugoverdose/pdf/hhs_prescription_drug_abuse_report_09.2013.pdf 

62 Substance Abuse and Mental Health Services Administration. Associations of nonmedical pain reliever use and 

initiation of heroin use in the United States. 2013. Retrieved from 

https://www.samhsa.gov/data/sites/default/files/DR006/DR006/nonmedical-pain-reliever-use-2013.htm 63 Johnson EM, Lanier WA, Merrill RM, et al. Unintentional prescription opioid-related overdose deaths: description 

of decedents by next of kin or best contact, Utah, 2008-2009. J Gen Intern Med. 2013;28(4): 522-9. 64 Bohnert AS, Valenstein M, Bair MJ, et al. Association between opioid prescribing patterns and opioid overdoserelated deaths. JAMA. 2011;305(13):1315-1321. doi:10.1001/jama.2011.370. 65 Paulozzi LJ, Jones CM, Mack KA, Rudd RA. Vital signs: overdoses of prescription opioid pain relievers – United 

States, 1999-2008. MMWR Morb Mortal Wkly Rep. 2011;60(43): 1487-92. 

191 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

treatment of opioid use disorders. MAT is a safe and effective strategy for decreasing the frequency 

and quantity of opioid use and reducing the risk of overdose and death. 

Approximately one million Americans need, but do not access, treatment for an opioid addiction.66 

OTPs are the only means of providing medication-assisted treatment (MAT) with methadone. 

Buprenorphine can be prescribed in an office setting by physicians who have received a waiver under 

the Drug Addiction Treatment Act of 2000 (DATA 2000) provision of the Controlled Substances 

Act. Most physicians with a waiver to prescribe buprenorphine do not treat the maximum allowable 

number of patients. 

In November 2016, the implementation of Section 303 of the Comprehensive Addiction and 

Recovery Act (CARA) enabled the Department of Health and Human Services (HHS) to announce 

that nurse practitioners (NPs) and physician assistants (PAs) could immediately begin taking the 24 

hours of required training to prescribe buprenorphine for the treatment of opioid addiction. CARA 

expanded prescribing privileges to NPs and PAs for five years (until October 1, 2021). With the 

passage of the Substance Use Disorder Prevention that Promotes Opioid Recovery and Treatment 

for Patients and Communities (SUPPORT) Act in October 2018, the five-year limit on prescribing 

privileges for NPs and PAs was removed. Additionally, the SUPPORT Act expanded prescribing 

privileges to Clinical Nurse Specialists (CNSs), Certified Registered Nurse Anesthetists (CRNSs), 

and Certified Nurse Midwives (CNMs) until October 1, 2023. 

SAMHSA is responsible for regulating and certifying approximately 1,630 OTPs to use opioid 

agonist treatment medications and processing DATA waivers for physicians and nurse practitioners 

and physician assistants, who wish to treat opioid abuse with buprenorphine. SAMHSA reviews 

new and renewal applications for OTPs and oversees their accreditation. OTPs are required to be 

accredited as a condition of certification. SAMHSA’s regulation of OTPs plays a critical role in 

expanding access and maintaining quality. Accrediting organizations must be approved by 

SAMHSA to fulfill this function and this approval must be renewed every five years. SAMHSA 

monitors the accrediting bodies for quality assurance and improvement by making 20 to 25 site visits 

to recently-accredited programs each year; additionally, SAMHSA conducts unannounced OTP site 

visits to investigate complaints and determine compliance with Federal regulations in 42 CFR Part 

8. 

SAMHSA implements DATA 2000 in coordination with the Drug Enforcement Administration. 

This includes approving waivers for qualified practitioners to provide medication-assisted treatment 

in office-based settings. More than 57,000 practitioners have been granted waivers since 2001. 

Waiver processing is conducted under a contract entitled DATA Waiver Processing and Support 

Project. As of January 12, 2019, SAMHSA has certified 33,927 physicians to treat up to 30 patients, 

9,722 to treat up to 100 patients, and 4,605 to treat up to 275 patients. 

In addition, as of January 12, 2019, SAMHSA had approved 8,786 NPs and 2,257 PAs to begin 

prescribing buprenorphine. Through a cooperative agreement and a supplement, SAMHSA supports 

the Providers’ Clinical Support System (PCSS), which provides education, training and clinical 

mentoring to primary care providers who wish to treat opioid use disorder. 

66 Jones, C. M. (2013). Heroin use and heroin use risk behaviors among nonmedical users of prescription opioid pain 

relievers, United States, 2002-2004 and 2008-2010. Drug and Alcohol Dependence, 132(1-2):95-100. 

192 
 

 

 

 

 

 

Fiscal Year Amount 

FY 2016 $8,724,000 

FY 2017 $8,724,000 

FY 2018 $8,724,000 

FY 2019 $8,724,000 

FY 2020 $8,724,000 

 

In FY 2018, SAMHSA funded 24 Provider’s Clinical Support System – Universities grant. The 

purpose of this program is to expand and/or enhance access to medication-assisted treatment (MAT) 

services through ensuring the education and training of students in the medical, physician assistant 

and nurse practitioner fields. 

SAMHSA funded three Grants to Enhance Drug Addiction Treatment Act of 2000 (DATA 200) 

Waiver Training in FY 2018. The program is designed to develop a DATA 2000 Waiver Curriculum 

for office-based treatment of opioid use disorders (OUD) with FDA-approved schedule III opioid 

agonist medications that is consistent with the new Comprehensive Addiction and Recovery Act 

(CARA) requirements, and provide information on all FDA-approved medications for treatment of 

OUD. 

In FY 2019, SAMHSA anticipates funding a new PCSS grant award, new and continuation PCSSUniversities grant awards, and two contract continuation awards. 

Funding History 

Budget Request 

The FY 2020 President’s Budget request is $8.7 million, level with the FY 2019 Enacted level. 

SAMHSA intends to continue to support the Secretary’s five-prong strategy to address the opioid 

crisis priorities through regulatory activities, ongoing training, certification, and technical assistance 

to provider groups and communities impacted by the opioid crisis. 

193 
 

 

---

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Screening, Brief Intervention, and Referral to Treatment 

(Dollars in thousands) 

Programs of Regional & National Significance 

FY 2018 

Final 

FY 2019 

Enacted 

FY 2020 

President's 

Budget 

FY 2020 

President's 

Budget 

+/-

FY 2019 

Enacted 

Screening, Brief Intervention and Referral to Treatment 

Budget Authority (non-add)...................................... 

PHS Evaluation Funds (non-add).................................. 

$24,700 

22,700 

2,000 

$30,000 

28,000 

2,000 

$---

---

-$30,000 

-28,000

-2,000

Authorizing Legislation .............................................Section 509 of the Public Health Service Act 

FY 2020 Authorization................................................................................................$333,806,000 

Allocation Method.................................... Competitive Grants/Contracts/Cooperative Agreements 

Eligible Entities ......................................Single State Authority and Health Departments in States, 

Territories, the District of Columbia, 

Federally Recognized American Indian/Alaska Native Tribes or Tribal Organizations, 

Domestic Public and Private Non-Profit Entities, and 

Public and Private Universities Colleges 

Program Description and Accomplishments 

Among individuals age 12 or older, 30.5 million (11.2 percent) use illicit drugs, 66.6 million (47.4 

percent of current alcohol users) binge drink, and 16.7 million (25.1 percent of current alcohol users) 

drink heavily.67 This imposes a great cost on society by compromising individual health and 

potentially causing injury to others. The National Institute on Drug Abuse found that misuse of 

illicit drugs, tobacco and alcohol costs society $740 billion each year.68 Of the individuals who need 

treatment for substance abuse, only 10.8 percent receive treatment in a specialty treatment facility.69 

The vast majority of those meeting criteria for having a drug/alcohol addiction have not been 

diagnosed. 

In 2003, SAMHSA started the Screening, Brief Intervention and Referral to Treatment (SBIRT) 

program, which is intended to help primary care physicians identify individuals who misuse 

substances and help them intervene early with education, brief treatment, or referral to specialty 

treatment. The program’s goal is to increase the number of individuals who receive treatment and

reduce the rate of substance misuse. Studies have shown that this approach is effective in helping 

reduce harmful alcohol consumption.70,71,72 

The SBIRT program seeks to increase the use of SBIRT in medical settings by promoting wide 

dissemination and adoption of the practice across the spectrum of primary care services. To achieve 

this, SAMHSA awards state implementation grants to encourage adoption of SBIRT by healthcare 

providers in each state. SAMHSA also supports the SBIRT Student Training grant programs. 

67Center for Behavioral Health Statistics and Quality. (2017). Key substance use and mental health indicators in the 

United States: Results from the 2015 National Survey on Drug Use and Health (HHS Publication No. SMA 16-4984, 

NSDUH Series H-51). Retrieved from http://www.samhsa.gov/data/ 

194 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

The SBIRT program requires state grant recipients to implement the model in all primary care 

settings, as well as hospitals, trauma centers, federally qualified health centers, and other relevant 

health care settings. Recipients may use funds to screen for substance use and co-occurring mental 

illness and drug/alcohol addiction. They can support evidence-based client-centered interventions, 

such as Motivational Interviewing, brief treatment, and referral to specialty care for individuals 

exhibiting addiction symptoms. 

The SBIRT training program helps train a wide range of medical providers to incorporate SBIRT as 

part of their ongoing practice. This includes physicians, nurses, counselors, social workers, health 

promotion advocates, health educators, and others. A SAMHSA-funded cross-site evaluation found 

that allied health professionals, rather than the physicians themselves, were more likely to implement 

SBIRT with their patients.73 The SBIRT Student Training and Health Professionals Training grant 

programs support SBIRT training efforts for medical students, medical residents, nurses, social 

workers, psychologists, pharmacists, dentists, and physician assistants. These efforts aim to develop 

further the primary healthcare workforce in substance abuse treatment and services. 

Program Evaluation 

SAMHSA has demonstrated the effectiveness of SBIRT and continues to disseminate SBIRT 

practices. In 2018, SAMHSA data showed well over 3 million individuals have received screening 

and/or intervention through the SBIRT initiative since 2003.74 Of those screened, roughly, 33.9 

percent were determined to be at risk, another 25 percent were referred for brief treatment, and an 

additional 37.5 percent were referred to specialty treatment.75 

In FY 2018, SAMHSA funded eight continuation state cooperative agreements and fifteen new 

SBIRT state grants to support program implementation, 12 SBIRT continuation training grants, and 

a supplement for direct technical assistance. 

68 National Institute on Drug Abuse (2017), Trends and Statistics, http://www.drugabuse.gov/related-topics/trendsstatistics. 

69 Center for Behavioral Health Statistics and Quality. (2016). Key substance use and mental health indicators in the 

United States: Results from the 2015 National Survey on Drug Use and Health (HHS Publication No. SMA 16-4984, 

NSDUH Series H-51). Retrieved from http://www.samhsa.gov/data/ 70 Bertholet, N., Daeppen, J.-B., Wietlisbach, V., Fleming, M., & Burnand, B. (2005). Reduction of alcohol 

consumption by brief alcohol intervention in primary care: systematic review and meta-analysis. Archives of Internal 

Medicine 165, 986–995. 71 Kahan, M., Wilson, L., & Becker, L. (1995). Effectiveness of physician-based interventions with problem drinkers: 

A review. Canadian Medical Association Journal, 152, 851–859. 72 Wilk, A.I., Jensen, N.M., and Havighurst, T.C. (1997). Meta-analysis of randomized control trails addressing brief 

interventions in heavy alcohol drinkers. Journal of General Medicine, 12 (5), 274-283. 73 RTI International (2009). RTI International to Evaluate Comprehensive Substance Abuse Intervention Programs for 

SAMHSA. 

74SAMHSA’s Performance Accountability and Reporting System, (2018). http://www.samhsa-gpra.samhsa.gov/ 75 SAMHSA’s Performance Accountability and Reporting System, (2018). http://www.samhsa-gpra.samhsa.gov/ 

195 
Fiscal Year Amount 

FY 2016 $46,889,000 

FY 2017 $30,000,000 

FY 2018 $24,700,000 

FY 2019 $30,000,000 

FY 2020 ---

 

 

 

Outputs and Outcomes Table 

 

 

 

 

 

 

Funding History 

Budget Request 

The FY 2020 President’s Budget Request is $0.0 million, a decrease of $30.0 million from the 

FY 2019 Enacted level. The three new SBIRT state grants that were awarded in FY 2018 were multiyear funded and will continue to operate without need for additional appropriations through the end 

of FY 2021. 

Program: Screening, Brief Intervention and Referral to Treatment 

Measure 

Year and Most Recent Result 

Target for Recent Result 

(Summary of Result) 

FY 2019 

Target 

FY 2020 

Target 

FY 2020 

Target 

+/-

FY 2019 

Target 

1.2.40 Increase the number of clients 

served. (Output) 

FY 2017: 182,851 

Target: 300,000 

(Target Not Met) 

182,851 182,851 Maintain 

1.2.41 Increase the percentage of 

clients receiving services who had no 

past month substance use. (Outcome) 

FY 2017: 34.8 % 

Target: 36 % 

(Target Not Met but Improved) 

34% 34% Maintain 

196 
 

 

Program Description and Accomplishments 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Targeted Capacity Expansion-General 

(Dollars in thousands) 

Programs of Regional & National Significance 

FY 2018 

Final 

FY 2019 

Enacted 

FY 2020 

President's 

Budget 

FY 2020 

President's 

Budget 

+/-

FY 2019 

Enacted 

Targeted Capacity Expansion-General............................... 

Other Targeted Capacity Expansion.......................... 

MAT for Prescription Drug and Opioid Addiction 

(non-add)............ 

$95,192 

11,192 

84,000 

$100,192 

11,192 

89,000 

$100,192 

11,192 

89,000 

$---

---

---

Authorizing Legislation ........................................... Sections 509 of the Public Health Service Act 

FY 2020 Authorization ................................................................................................$333,806,000 

Allocation Method ....................................Competitive Grants/Contracts/Cooperative Agreements 

Eligible Entities........................................Domestic Public and Private Non-Profit Entities, States, 

Opioid Medication-Assisted SPF Rx Treatment Service Providers, Outpatient Substance Abuse 

Providers, Community Mental Health Centers, Federally Qualified Health Centers, 

SAMHSA Certified Opioid Treatment Programs, and 

Licensed Outpatient Substance Abuse Treatment Programs 

Urgent, unmet, and emerging substance abuse treatment and recovery support service capacity needs 

remain a critical issue for the nation. In an effort to assist communities in overcoming these barriers, 

SAMHSA initiated the Targeted Capacity Expansion (TCE) program. The program provides rapid, 

strategic, comprehensive, and integrated community-based responses to gaps in and capacity for 

substance abuse treatment and recovery support services. Examples of such needs include limited 

or no access to medication-assisted treatment (MAT) for opioid use disorders; lack of resources 

needed to adopt and implement health information technology (HIT) in substance abuse treatment 

settings; and short supply of trained and qualified peer recovery coaches to assist individuals in the 

recovery process. 

Medication-Assisted Treatment for Prescription Drug and Opioid Addiction (MAT PDOA) 

MAT refers to the use of the Food and Drug Administration-approved pharmacotherapies 

(i.e., buprenorphine products, methadone, and naltrexone products) in combination with 

evidence- based psychosocial interventions for treatment of opioid addiction. MAT is a safe and 

effective strategy for decreasing the frequency and quantity of opioid abuse and reducing the risk of 

overdose and death. 

Drug overdose death continues to increase in the U.S., with over 70,000 lethal drug overdoses in 

2017, a record number of overdose deaths and an increase from 52,404 in 2015; among these deaths, 

over 47,000 (68 percent) involved an opioid, an increase from 33,091 (63 percent) in 2015. Opioid 

addiction is driving this alarming trend, with over 29,000 overdose deaths related to synthetic opioids 

other than methadone, and nearly 16,000 overdose deaths related to heroin in 2017. The rate of drug 

overdose deaths involving synthetic opioids other than methadone tripled between 2015 and 2017. 

Heroin overdose death rates have more than tripled since 2010, from 1.0 per 100,000 in 2010 to 4.9 

per 100,000 in 2016. Despite these troubling statistics, significant gaps persist between treatment 

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needs and capacity. In 2012, 48 states and the District of Columbia reported levels of opioid 

addiction that were higher than their rates of MAT capacity. Furthermore, 38 states reported that at 

least 75 percent of their opioid treatment programs (OTPs) were operating at 80 percent or greater 

capacity. 76 

MAT PDOA addresses treatment needs of individuals who have an opioid addiction by 

expanding/enhancing treatment system capacity to provide accessible, effective, comprehensive, 

coordinated/integrated, and evidence-based MAT and recovery support services. Recovery support 

services include linking patients and families to social, legal, housing, and other supports to improve 

retention in MAT to increase the probability of positive outcomes. 

Program Evaluation 

In FY 2016, SAMHSA funded 11 continuation state grants, 11 new state grants, as well as one 

contract. The 22 grantees in FY 2016 represent all 10 HHS regions. In 2017, approximately 3,100 

individuals were served through the MAT-PDOA program; at six-month follow-up, 60 percent of 

individuals served reported abstinence from illicit drug use, at 6 month follow up equaling the 60 

percent target. In FY 2017, SAMHSA multi-year funded five grants and annually funded one new 

grant, 23 continuations and one continuing technical assistance contract. 

In FY 2018, SAMHSA supported up to 128 new MAT PDOA, 11 continuation MAT-PDOA grants 

to support program implementation, and supplement for direct technical assistance. 

Targeted Capacity Expansion-Technology Assisted Care (TCE-TAC) 

Access to treatment remains inadequate for underserved populations living with drug/alcohol 

addiction and/or co-occurring mental illness and drug/alcohol addiction, such as those living in rural 

areas. A key component of this access challenge relates to a lack of dependable transportation and 

many organizations experience significant financial constraints in serving these rural 

populations. SAMHSA believes that behavioral healthcare providers who use health information 

technology (HIT) can help patients improve their access to necessary care and prevention services. 

For example, tele-health and tele-psychiatry can bring addiction medicine providers to clients in 

areas without local specialists. Web-based tools can improve communication and help deliver muchneeded support and education. Health information technology approaches can also enable providers 

to document and coordinate better mental and substance abuse treatment services directly or via telepsychiatry or telemedicine with families and other providers and specialists. 

SAMHSA established the TCE-TAC grant program to address the lack of resources in the field 

necessary to adopt and implement health information technologies, including electronic health 

records (EHRs), smart phones, tablets, web-based technologies and applications to support 

tele- psychiatry and telemedicine. The program also addresses the behavioral healthcare providers’

need to expand and/or enhance their ability to communicate effectively with individuals in treatment, 

as well as monitor their health to ensure treatment and prevention services are available when and 

where needed. 

TCE-TAC and its predecessor program, Targeted Capacity Expansion-Health Information 

Technology (TCE-HIT), have improved care delivery in 48 behavioral healthcare organizations 

across 23 states. In FY 2017, the TCE-TAC program included 12 additional grantees bringing the 

76Jones, C. M., Campopiano, M., Baldwin, G., McCance-Katz, E. (2015). National and state treatment need and 

capacity for opioid agonist medication-assisted treatment. American Journal of Public Health, 105(8), e55-c63. 

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total number of grantees since 2011 to 60 behavioral healthcare organizations. Grantees have 

deployed all of the above-mentioned technologies to provide substance abuse treatment services 

directly or via remote service delivery (i.e., tele-psychiatry and telemedicine). In FY 2017, the TCETAC and TCE- HIT programs served roughly 882 individuals. As of August 2018, TCE-TAC 

program served roughly 981 unduplicated individuals, an increase of 99 individuals from the 

previous year. More specifically, there were 580 men (59.1 percent) and 400 (40.8 percent) women 

served. Health information technology clearly holds great potential for increasing access to treatment 

services and providing reliable exposure to meaningful health information for underserved 

individuals with mental illness and alcohol/drug addiction. Providing the means to sustain this 

technology is likely to be an ongoing challenge for these and similarly situated organizations. 

In FY 2016, SAMHSA funded 13 new TCE-TAC grants to enhance or expand the capacity of 

treatment providers to serve individuals who are traditionally underserved and to help achieve and 

maintain recovery and to improve the overall quality of life for those being served. In FY 2017, 

SAMHSA supported continued funding for the 13 TCE-TAC grant awards. These awards support 

the continuous development and deployment of unique advanced technology solutions to serve more 

clients with fewer resources. In FY 2018, SAMHSA funded 13 TCE-TAC grant awards for 

implementation and supplement for direct technical assistance. 

Targeted Capacity Expansion-Peer to Peer (TCE-PTP) 

Peer support is built on the premise that individuals in recovery from drug/alcohol addiction can be 

of great value through the sharing of their recovery experiences with those attempting to achieve 

and sustain recovery. Peer recovery support services, as an adjunct to clinical treatment, extend the 

reach of treatment beyond the clinical setting into the everyday environment of those seeking to 

achieve or sustain recovery from drug/alcohol addiction. Peer support and peer recovery support 

services have been shown to reduce healthcare costs. Additionally, the overall message from 

research studies conducted to date is that recovery support service adjuncts appear to be helpful over 

and above treatment alone. 

There is a growing need to train and certify existing peer providers to address the increasing demand 

and diverse settings in which peer providers are employed. Since 2002, SAMHSA has awarded over 

105 grants to community-based organizations to provide peer recovery support services to 

individuals in or seeking recovery from drug/alcohol addiction and their families. The primary 

objective of these services is to help individuals and families in search of recovery to obtain much 

needed support, sustain clinical treatment gains, engage in healthy community living, and improve 

overall quality of life. This grant program incorporates a peer-to-peer model, which capitalizes on 

the expertise of those individuals with similar lived experience. 

The TCE-PTP program has reached over 11,000 individuals and their families. Significant strides 

have been made in helping program participants secure and maintain sobriety, cultivate employment 

and educational opportunities, enhance their sense of social connection, improve their housing 

stability and decrease their criminal justice involvement. 

Program Evaluation 

Since the program’s inception, TCE-peer-to-peer has helped individuals gain and maintain sobriety, 

and improve their education/employment opportunities as well has their housing stability. Recent 

data suggests that, program participants saw a 67 percent improvement in number of jobs and/or 

educational goals obtained as a function of participating in the program. Similarly, program 

199 
 

 

participants were able to increase their housing stability by 48 percent by moving from homelessness 

shelters or shared living environments to more stable housing. 

In FY 2018, SAMHSA funded 17 continuation TCE-PTP grants. In FY 2019, SAMHSA funded 17 

continuations and 3 new TEC Peer to Peer grants. All of these grantees received supplements of 

$25,000 for direct technical assistance. 

The output and outcome measures for Targeted Capacity Expansion-General are part of the 

Treatment - Other Capacity Activities Outputs and Outcomes table shown on page 226. 

Funding History 

Fiscal Year Amount 

FY 2016 $36,303,000 

FY 2017 $67,192,000 

FY 2018 $95,192,000 

FY 2019 $100,192,000 

FY 2020 $100,192,000 

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Budget Request 

The FY 2020 President’s Budget request is $100.1 million, level with the FY 2019 Enacted level. 

In FY 2020, SAMHSA intends to fund 3 continuation grants and 17 new grants. 

The MAT-PDOA continuation grants expect to increase the number of individuals receiving services 

with pharmacotherapies approved by the Food and Drug Administration for the treatment of opioid 

use disorder (OUD); increase the number of individuals receiving integrated care; decrease the illicit 

opioid drug use at 6-month follow-up; and decrease prescription opioid use in a non-prescribed 

manner at 6-month follow-up. 

The new MAT-PDOA grants purpose is to expand/enhance access to medication-assisted treatment 

(MAT) services for persons with an opioid use disorder (OUD) seeking or receiving MAT. This 

program’s focus is on funding organizations and tribes/tribal organizations within states identified 

as having the highest rates of primary treatment admissions for heroin and opioids per capita and 

includes those states with the most dramatic increases for heroin and opioids, based on SAMHSA’s 

2015 Treatment Episode Data Set (TEDS). The desired outcomes include: 1) an increase in the 

number of individuals with OUD receiving MAT 3) a decrease in illicit opioid drug use and 

prescription opioid misuse at six-month follow-up. 

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Outputs and Outcomes Tables 

Program: Medication-Assisted Treatment for Prescription Drug and Opioid Addiction 

Measure 

Year and Most Recent Result 

Target for Recent Result 

(Summary of Result) 

FY 2019 

Target 

FY 2020 

Target 

FY 2020 

Target 

+/-

FY 2019 

Target 

1.3.01 Increase the number of 

admissions for Medication Assisted 

Treatment. (Output) 

FY 2017: 2,230 

Target: 1,400 

(Target Exceeded) 

2,230 2,500 +270 

1.3.02 Increase number of clients 

receiving integrated care. (Output) 

FY 2017: 1,301 

Target: 1,100 

(Target Exceeded) 

1,301 1,800 +499 

1.3.03 Decrease illicit drug use at 6-

month follow-up. (Outcome) 

FY 2017: 62 % 

Target: 60 % 

(Target Exceeded) 

62 % 62% Maintain 

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Pregnant and Postpartum Women 

(Dollars in thousands) 

Programs of Regional & National Significance 

FY 2018 

Final 

FY 2019 

Enacted 

FY 2020 

President's 

Budget 

FY 2020 

President's 

Budget 

+/-

FY 2019 

Enacted 

Pregnant and Postpartum Women........................................ $29,931 $29,931 $29,931 $---

Authorizing Legislation..................................Section 508 of the Public Health Service Act 

FY 2020 Authorization ..................................................................................................$16,900,000 

Allocation Method ....................................Competitive Grants/Contracts/Cooperative Agreements 

Eligible Entities.................................................... Domestic Public and Private Non-Profit Entities 

Program Description and Accomplishments 

From 1992 to 2012, a steady four percent of women admitted to treatment for drug/alcohol addiction 

were pregnant. From FY 2003 through FY 2015, 28.4 percent of pregnant and postpartum women 

who had custody of their children at intake reported illegal drug use in the past 30 days.

77 Since 

many traditional substance abuse treatment programs do not allow for the inclusion of children, a 

woman may be torn between the need to care for her dependent children and her need for treatment.78 

The nation’s opioid crisis has also added to this challenge for many pregnant and parenting women. 

The proportion of pregnant women entering treatment who reported any prescription opioid misuse 

increased substantially from two percent in 1992 to 28 percent in 2012, an increase of 173 percent, 

from 351 to 6,087 women.79 The proportion of pregnant women who entered treatment and reported 

prescription opioids as their primary substance use increased from one percent in 1992 to 19 percent 

in 2012, an increase of 344 percent, from 124 to 4,268 women.80 

Since 2003, the Pregnant and Postpartum Women program (PPW) has used a family-centered 

approach to provide comprehensive residential substance abuse treatment, prevention, and recovery 

support services for pregnant and postpartum women, their minor children, and for other family 

members (e.g., fathers of the children). The family-centered approach includes partnering with 

others to leverage diverse funding streams, encouraging the use of evidence-based practices, 

supporting innovation, and developing workforce capacity to meet the needs of these families. The 

PPW program provides services not covered under most public and private insurance. 

Services Available: 

Based on an in-depth review of cross-site evaluation and performance data in FY 2014, SAMHSA 

built the current PPW program model on an evidence-based approach for serving pregnant and postpartum women in need of residential substance abuse treatment. The PPW family-centered approach 

77 Internal SAMHSA performance data 78 Center for Substance Abuse Treatment. Substance Abuse Treatment: Addressing the Specific Needs of Women. 

Treatment Improvement Protocol (TIP) Series 51. HHS Publication No. (SMA) 09-4426. Rockville, MD: Substance 

Abuse and Mental Health Services Administration, 2009. 

79 Martin, C. E., Longinaker, N., & Terplan, M. (2015). Recent trends in treatment admissions for prescription opioid 

abuse during pregnancy. Journal of substance abuse treatment, 48(1), 37-42. 80 Ibid. 

203 
 

 

 

 

 

 

 

 

 

 

 

 

 

includes a variety of services and case management for women, children, and families. Services 

provided to women include: outreach; engagement; pre-treatment; screening and assessment; 

detoxification; substance misuse education; treatment; relapse-prevention; healthcare services, 

including mental health services; postpartum health care, including attention to depression, anxiety, 

and medication needs; parenting education and interventions; home management and life skills 

training, education, testing, and counseling; and treatment of hepatitis, HIV/AIDS, and other 

sexually transmitted diseases. 

Services available to children include screening and developmental diagnostic assessments 

addressing social, emotional, cognitive, and physical well-being; and interventions related to mental, 

emotional, and behavioral wellness. 

Services for families include family-focused programs to support family strengthening, including, 

involvement with the child’s other parent. The PPW program also supports tobacco use counseling 

and interventions, screening and assessment for Fetal Alcohol Syndrome Disorders, and a traumainformed approach. 

Recent Achievements: 

In FY 2016, SAMHSA funded two new residential treatment grants, 25 residential treatment grant 

continuations, and one Addiction Technology Transfer Center (ATTC) supplement grant 

continuation. That same year SAMHSA convened a PPW Family-Centered Summit. The Summit’s 

purpose was to elicit recommendations from experts in the area of women’s substance abuse

treatment services and family-centered care to inform the expansion of CSAT’s PPW program to 

incorporate a wider range of family-centered services for pregnant and postpartum women and their 

minor children. This includes the expansion of treatment modalities to go beyond residential 

treatment and include intensive outpatient and outpatient treatment with or without housing 

components. SAMHSA has reviewed the recommendations from the Summit and is taking them 

into consideration in determining the future direction of the PPW Program, including the 

development of service requirements for the PPW program expansion effort to support wide-scale 

adoption of the family-centered approach. 

In FY 2017, SAMHSA funded 19 new residential treatment grants, seven residential treatment grant 

continuations, and three contracts. 

In FY 2018, SAMHSA funded 19 new PPW residential treatment grants and 2 continuation PPW 

grants for program implementation, and supplement for direct technical assistance. 

In FY 2019, SAMHSA funded 40 residential treatment continuation grants, two residential treatment 

grant continuations, and supplement for direct technical assistance. 

Pregnant and Postpartum Women Pilot 

Aims 

An aim of the Comprehensive Addiction and Recovery Act (CARA) is to address substance abuse 

and addiction across the country through the implementation of prevention, treatment, and recovery 

programs. Section 501 of that act increases accessibility and availability of services for pregnant 

women by expanding the authorized purposes of the Pregnant and Postpartum Women program to 

204 
 

 

 

 

 

 

 

 

include the provision of outpatient and intensive outpatient services for pregnant women. 

Historically, the PPW program has only supported the provision of residential treatment services. 

Program Evaluation 

In FY 2017, SAMHSA began a three-year PPW cross-site evaluation to examine the effectiveness 

of the PPW Pilot Program. The evaluation results will be used broadly to improve the collective 

understanding about effective components of the continuum of care for pregnant and postpartum 

women with a primary diagnosis of a substance use disorder, including whether the PPW Pilot 

Program is an effective approach to increase access to the use of medication-assisted treatment. 

New Grants 

Also in FY 2017, SAMHSA funded three new state PPW pilot grants to: 1) support family-based 

services for pregnant and postpartum women with a primary diagnosis of a substance use disorder, 

including opioid disorders; 2) help state substance abuse agencies address the continuum of care, 

including services provided to women in nonresidential-based settings; and 3) promote a 

coordinated, effective and efficient state system managed by state substance abuse agencies by 

encouraging new approaches and models of service delivery. An evaluation of this program is 

underway to determine the effectiveness of the pilot. 

In FY 2018, SAMHSA funded three new state PPW pilot grants and three continuation state PPW 

pilot grants for program implementation, supplement for direct technical assistance, and one 

continuation evaluation contract. 

In FY 2019, SAMHSA funded six continuations grants. No new grants were funded. 

205 
Fiscal Year Amount 

FY 2016 $15,931,000 

FY 2017 $19,931,000 

FY 2018 $29,931,000 

FY 2019 $29,931,000 

FY 2020 $29,931,000 

 

Funding History 

Budget Request 

The FY 2020 President’s Budget request is $29.9 million, level with the FY 2019 Enacted level. 

SAMHSA intends to fund 42 residential treatment grant continuations and three new PPW Pilot 

grants to provide an array of services and supports to pregnant women and their children. 

206 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Outputs and Outcomes Tables

Program: Pregnant and Postpartum Women Program 

Measure 

Year and Most Recent Result 

Target for Recent Result 

(Summary of Result) 

FY 2019 

Target 

FY 2020 

Target 

FY 2020 

Target 

+/-

FY 2019 

Target 

1.2.84 Increase the number of 

admissions of women who are 

currently pregnant or have a child to 

substance abuse treatment programs. 

(Output) 

FY 2018: 801 

Target: 1,159 

(Target Not Met) 

800 925 Maintain 

1.2.85 Percentage of PPW clients 

reporting no drug use in the past 

month at six month follow-up. 

(Outcome) 

FY 2018: 90.6% 

Target: 80% 

(Target Exceeded) 

90% 90% Maintain 

1.2.86 Increase the percentage of PPW 

clients who reported substance misuse 

at intake, percent who report reduction 

in substance misuse at six month 

follow-up. (Outcome) 

FY 2018: 87.1% 

Target: 80% 

(Target Exceeded) 

85% 87% Maintain 

1.2.87 Increase the percentage of PPW 

clients who reported child/children not 

living with client at intake, percent 

who report child/children is living 

with client at six month follow-up. 

(Outcome) 

FY 2018: 45.5% 

Target: 75% 

(Target Not Met) 

50% 55% Maintain 

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Recovery Community Services Program 

(Dollars in thousands) 

Programs of Regional & National Significance 

FY 2018 

Final 

FY 2019 

Enacted 

FY 2020 

President's 

Budget 

FY 2020 

President's 

Budget 

+/-

FY 2019 

Enacted 

Recovery Community Services Program............................. $2,434 $2,434 $2,434 $---

Authorizing Legislation .............................................Section 509 of the Public Health Service Act 

FY 2020 Authorization ................................................................................................$333,806,000 

Allocation Method ....................................Competitive Grants/Contracts/Cooperative Agreements 

Eligible Entities.......................................................... Family/Consumer Controlled Organizations, 

Domestic Public and Private Non-Profit Organizations in States, Territories, and Tribes, Recovery 

Community Organizations of Domestic Private Non-Profit Entities in States, Territories, and Tribal 

Organizations 

Program Description and Accomplishments 

An estimated 23 million people in the United States are in recovery from addiction to alcohol and 

other drugs.81 As public education increases, there is broader acknowledgement of addiction as a 

treatable condition that needs to be managed over the course of a lifetime. More people in recovery 

are now willing to be open about their own recovery and to share their experience to help others 

attempting to achieve recovery. Through the use of their lived experience, individuals in recovery 

can provide support and hope to those newly seeking recovery. 

Since 1998, SAMHSA has recognized the value of supporting recovery through peers and other 

recovery supports, and has provided funding through the Recovery Community Services Program 

(RCSP). RCSP was designed to assist recovery communities strengthen their infrastructure and 

provide peer recovery support services to those in or seeking recovery from alcohol/other drug 

addiction across the nation. The delivery of recovery support services by people in recovery is 

known as peer recovery support services (PRSS). PRSS are a strong component in helping 

individuals and families address substance abuse in the context of chronic disease management, 

especially when delivered by a Peer (often known as a Recovery Coach, Peer Specialist, or Peer 

Mentor). SAMHSA initiated RCSP to help build an infrastructure for PRSS programs to support 

the development and expansion of peer recovery services. These peer services are most frequently 

offered by Recovery Community Organizations (RCOs), that now number over one hundred in the 

U.S. alone. 

Though the RCSP was a services program from 2002-2010, it was evident that this approach needed 

to be taken system-wide to have a larger effect. Many states recognize the value of addiction peer 

recovery services; however, further efforts are required to realize the potential of these services and 

supports at a system-wide level. The infusion of these services into state systems ensures the wide 

scale adoption of peer recovery support. By developing a workforce of trained and certified peers 

and engaging recovery community organizations in the full continuum of treatment and recovery 

81 Partnership for Drug Free Kids, March, 20152012. Retrieved from http://www.drugfree.org/newsroom/survey-tenpercent-of-american-adults-report-being-in-recovery-from-substance-abuse-or-addiction 

208 
 

 

 

 

 

 

 

 

 

 

 

 

 

services, states have the ability to enhance their systems to ensure holistic approaches to care. 

SAMHSA supports this state system development effort through the RCSP Statewide Network grant 

program. Since the inception of the RCSP, over 120 grants have been awarded to RCOs to expand 

PRSS locally and lay the groundwork for a national network of PRSS programs. 

Recovery Community Services Program Statewide Network (RCSP-SN) 

The RCSP-SN grant program supports a statewide approach to enhance the presence of people with 

lived experience in recovery from drug/alcohol addiction as key partners in state systems, as well as 

building a peer workforce. Activities include collaborating on local and state workforce 

development, developing linkages with other organizations that promote recovery throughout the 

state, and participating in policy, planning, and program development discussions at the state, 

community, and local level. Involving recovery community leaders and key stakeholders in 

decision-making helps states to design peer services and PRSS programs that are authentic to the 

recovery experience, complementary to clinical practice, demonstrate strong recovery outcomes, and 

are sustainable over time. Additionally, the statewide networks help to ensure the development of a 

trained, qualified, and effectively supervised peer workforce. 

Workforce outcomes for the program include the amount of training provided, the number of people 

trained, trainee satisfaction, and the usefulness of information presented. Other key outcomes 

include: the number of RCOs that have been linked across the state; the number of state-sponsored 

events where participation of the statewide network occurred; the effects of linkages with behavioral 

health and other health systems; the outcomes of program activities on raising awareness about 

addiction peer recovery support; and the number of policy/program discussions which included 

addiction peer recovery support as a result of project efforts. 

In FY 2018, SAMHSA funded 10 continuation RCSP-SN grants with an additional three grantees 

to begin in FY 2019. Moreover, these grantees have received supplements for direct technical 

assistance for $25,000. 

The output and outcome measures for Recovery Community Services Program are part of the 

Treatment - Other Capacity Activities Outputs and Outcomes table shown on page 226. 

209 
Fiscal Year Amount 

FY 2016 $2,434,000 

FY 2017 $2,434,000 

FY 2018 $2,434,000 

FY 2019 $2,434,000 

FY 2020 $2,434,000 

 

Funding History 

Budget Request 

The FY 2020 President’s Budget request is $2.4 million, level with the FY 2019 Enacted level. 

SAMHSA intends to fund the continuation of 10 RCSP Statewide Network grants and TA activities 

to continue the efforts of building addiction recovery networks throughout the nation and the 

collaboration among peer-run organizations. 

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Children and Families 

(Dollars in thousands) 

Programs of Regional & National Significance 

FY 2018 

Final 

FY 2019 

Enacted 

FY 2020 

President's 

Budget 

FY 2020 

President's 

Budget 

+/-

FY 2019 

Enacted 

Children and Families......................................................... $29,605 $29,605 $29,605 $---

Authorizing Legislation ............................. Sections 509 and 514 of the Public Health Service Act 

FY 2020 Authorization ..................................................................................................$29,605,000 

Allocation Method ....................................Competitive Grants/Contracts/Cooperative Agreements 

Eligible Entities............................................................................. Single States Agencies in States, 

Territories, District of Columbia, public and private non-profit entities, 

Federally Recognized American Indian/Alaska Native Tribes Tribal Organizations, and health 

facilities or programs operated by or in accordance with a contract or grant with the 

Indian Health Service 

Program Description and Accomplishments 

Substance abuse plays a significant role in the lives of many children and youth (ages 12 to 25) 

throughout the nation. In 2015, approximately nine percent of adolescents between the ages of 12 

and 17 and 22 percent of youth between the ages of 18 and 25 reported current illicit drug use. Three 

percent of adolescents between the ages of 12 and 17, and 11 percent of youth between the ages of 

18 and 25 met the criteria for an alcohol use disorder. Many of these youth have co- occurring 

mental and substance use disorders. In 2015, six percent of youth ages 18-15 had co-occurring 

mental illness and substance use disorders.82 Most substance abuse begins during adolescence, 

making this developmental period a critical time for intervention. Approximately four percent of 

admissions to substance abuse treatment facilities were adolescents in 2015.83 Sixty-one percent of 

infants and 41 percent of older children involved in the child welfare system have at least one parent 

who is using alcohol or other drugs.84 On average, 32 percent of children are removed from home 

care as a result of parental alcohol or other drug use.85 

SAMHSA’s Children and Families program makes appropriate treatment available to youth and 

their families/caregivers to reduce the impact of substance abuse and/or co-occurring mental and 

substance abuse on communities in the U.S. 

Substance Abuse Treatment for Youth 

In 2015, less than 7 percent of adolescents ages 12 to 17 and 8 percent of youth ages 18 to 25 who 

needed treatment received the needed treatment at a specialty facility.86 Youth have psychological, 

developmental, and emotional needs that are distinct from adults. The neurological and 

developmental differences between youth and adults require tailored treatment and recovery 

approaches for youth with alcohol/other drug addiction. 

82 Center for Behavioral Health Statistics and Quality. (2016). 2015 National Survey on Drug Use and Health: Detailed 

Tables. 

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SAMHSA’s programs to treat youth with addiction and/or co-occurring substance abuse and mental 

disorders address gaps in service delivery by providing services for youth and their families and 

primary caregivers using effective evidence-based, family-centered practices. SAMHSA supports a 

youth treatment grant initiative at the state, territorial, and tribal levels. The populations of focus for 

the initiatives are adolescents (ages 12 to 17), transition-aged youth (ages 18 to 25), and their families 

and caregivers. 

This initiative helps to further the use of, and access to, effective evidence-based family-centered 

treatment approaches for youth with alcohol/other drug addiction. It supports training across 

participating states and collaboration between local community-based providers and their state, 

tribal, or territorial infrastructure. The services provided include evidence-based assessment and 

treatment interventions appropriate for adolescents and transition age youths. 

In FY 2017, SAMHSA funded 12 new youth treatment implementation grants and one new contract. 

SAMHSA also funded 14 grant continuations and two continuing contracts. 

In FY 2018, SAMHSA developed a new grant program called Enhancement and Expansion of 

Treatment and Recovery Services for Adolescents, Transitional Aged Youth, and their Families 

(Youth and Family TREE). Its purpose is to enhance and expand comprehensive treatment, early 

intervention, and recovery support services for adolescents (ages 12-18), transitional aged youth 

(ages 16-25), and their families/primary caregivers with SUD and/or co-occurring substance use and 

mental disorders. Eligibility includes public and private non-profit entities. Youth and Family 

TREE is focused on: increasing the unduplicated number of individuals served with evidence-based 

services and practices; increasing abstinence from the use of opioids, alcohol, marijuana, and other 

substances; increasing access, engagement, and retention in treatment, including medication assisted 

treatment; improving parenting skills and family functioning; improving mental health; and 

increasing access to health services for underserved populations, specifically federally recognized 

American Indian/Alaskan Native tribes and tribal organizations. 

In FY 2018, SAMHSA funded 35 new Youth and Family TREE grants, 14 continuing youth 

treatment implementation grants for program implementation, and supplement for direct technical 

assistance. Note that 11 of the 35 new grants are federally recognized American Indian/Alaskan 

Native tribes and tribal organizations. 

Addressing Child Abuse and Neglect 

83 Substance Abuse and Mental Health Services Administration, Center for Behavioral Health Statistics and Quality. 

Treatment Episode Data Set (TEDS): 2005-2015. National Admissions to Substance Abuse Treatment Services. BHSIS 

Series S-91, HHS Publication No. (SMA) 17-5037. Rockville, MD: Substance Abuse and Mental Health Services 

Administration, 2017. 

84 Wulczyn, F., Ernst, M., & Fisher, P. (2011). Who are the infants in out-of-home care? An epidemiological 

and developmental snapshot. Chicago: Chapin Hall at the University of Chicago. Retrieved from 

http://www.chapinhall.org/sites/default/files/publications/06_08_11_Issue%20Brief_F_1.pdf 

85 US Department of Health and Human Services. Administration for Children and Families, Administration on 

Children, Youth and Families, Children’s Bureau.(2016). The AFCARS report: Preliminary FY 2015 estimates as of 

June 2016 (No. 23). Washington, DC: Author. Research and Evaluation, Administration for Children and Families, 

US Department of Health and Human Services. 

212 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

SAMHSA and the Administration for Children and Families collaborate to address child abuse and 

neglect by supporting a National Center on Substance Abuse and Child Welfare (NCSACW). 

NCSACW provides training and technical assistance to improve collaborative practices among 

agencies and organizations that serve families affected by substance use disorders and involvement 

with child welfare services. From January 2018 through November 2018, NCSACW responded to 

562 requests for technical assistance and facilitated 55 events (including site visits, conference 

presentations, and webinars and virtual trainings) attended by an estimated 4,730 participants. 

The NCSACW website receives approximately 60,000 visitors per year and features resources, 

reports, guidance documents, webinar recordings, and videos. NCSACW provides three web-based 

tutorials on serving families affected by substance use disorders for three audiences: substance use 

disorder treatment, child welfare, and court professionals. From 2007 through October 2018, there 

were 38,952 tutorial completions with a 97 percent completion rate. NCSACW provides a child 

welfare training toolkit entitled Helping Child Welfare Workers Support Families with Substance 

Use, Mental, and Co-Occurring Disorders Training Package to educate child welfare professionals 

about substance use and mental health disorders among families involved in the child welfare system 

and is currently revising the content of this training toolkit to highlight new research and best 

practices, working with families affected by opioid use disorders and developing Plans of Safe Care. 

NCSACW’s activities have assisted professionals throughout the nation to improve cross-system 

collaboration and meet child welfare requirements for timely child permanency decisions. 

NCSACW continues to provide training and technical assistance to tribes, state agencies, and 

communities to develop collaborative approaches to the treatment of pregnant women with opioid 

use disorders and their infants and families. Since August 2016, NCSACW has disseminated 

SAMHSA’s A Collaborative Approach to the Treatment of Pregnant Women with Opioid Use

Disorders: Practice and Policy Considerations for Child Welfare, Collaborating Medical and Service 

Providers to child welfare, substance use treatment, dependency court, and medical professionals. 

The publication has been downloaded over 2,700 times from the NCSACW website from its 2016 

release through October 2018. In addition, the NCSACW is providing In-Depth TA (IDTA) on 

addressing the needs of pregnant and parenting women with opioid and other substance use disorders 

and their infants and families to the five states. Since September 2016, NCSACW has responded to 

652 TA requests on Plans of Safe Care, the provisions related to prenatal substance exposure in the 

Child Abuse and Prevention Treatment Act (CAPTA), and infants with prenatal substance exposure. 

In May 2018, NCSACW facilitated a Tri-Regional Convening focused on pregnant and parenting 

women with substance use disorders and changes to the Child Abuse Prevention and Treatment Act 

(CAPTA) by the Comprehensive Addiction and Recovery Act (CARA) regarding identification, 

notification and monitoring of plans of safe care for infants affected by substance abuse, withdrawal 

symptoms or fetal alcohol spectrum disorders. NCSACW used their TA tool A Planning Guide: 

Steps to Support a Comprehensive Approach to Plans of Safe Care to support the 17 state teams 

from Regions 4, 6 & 7 in action planning for development or enhancement of collaborative 

approaches to Plans of Safe Care. 

In FY 2018 and FY 2019, SAMHSA provided continuation support for the NCSACW technical 

assistance contract. 

The output and outcome measures for Children and Families are part of the Treatment - Other 

Capacity Activities Outputs and Outcomes table shown on page 226. 

213 
 

 

Funding History 

Fiscal Year Amount 

FY 2016 $29,605,000 

FY 2017 $29,605,000 

FY 2018 $29,605,000 

FY 2019 $29,605,000 

FY 2020 $29,605,000 

Budget Request 

The FY 2020 President’s Budget request is $29.6 million, level with the FY 2019 Enacted level. 

SAMHSA intends to fund 44 new youth treatment grants and 47 youth treatment grants 

continuations. These funds will continue to address the gaps in substance abuse treatment by 

providing services for youth, their families, and caregivers. These funds will also continue to support 

for the NCSACW technical assistant contract. 

214 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Treatment Systems for Homeless 

(Dollars in thousands) 

Programs of Regional & National Significance 

FY 2018 

Final 

FY 2019 

Enacted 

FY 2020 

President's 

Budget 

FY 2020 

President's 

Budget 

+/-

FY 2019 

Enacted 

Treatment Systems for Homeless........................................ $36,386 $36,386 $36,386 $---

Authorizing Legislation .............................................Section 506 of the Public Health Service Act 

FY 2020 Authorization ..................................................................................................$41,304,000 

Allocation Method .............................................................................Competitive Grants/Contracts 

Eligible Entities........................................ States, Domestic Public and Community Organizations, 

Private Nonprofit Entities, and Community-based Public or Nonprofit Entities 

Program Description and Accomplishments 

SAMHSA’s Treatment Systems for Homeless portfolio supports services for those with

alcohol/other drug addiction and who are experiencing homelessness, including youth, veterans, and 

families. 

The number of individuals experiencing chronic homelessness declined by 26 percent, or over 

31,173 people, between 2007 and 2018.87 On a single night in January 2018, 552,830 people were 

experiencing homelessness in the United States. Of these individuals, 96,913 were experiencing 

chronic homelessness, 111,122 had severe mental illness, 86,647 were affected by chronic substance 

abuse, and 37,878 were veterans.88 

Many factors contribute to the problem of homelessness, including lack of affordable housing, 

foreclosures, rising housing costs, job loss, underemployment, mental illness, and drug/alcohol 

addiction. The progress made to date in reducing homelessness points to improvement in services, 

as well as the effectiveness of collaboration across all levels, from the federal government to state 

governments and community systems. The U.S. Interagency Council on Homelessness, in which 

HHS participates, has set aggressive goals to prevent and end homelessness. These goals include 

ending homelessness among veterans, people with disabilities, families with children, 

unaccompanied youth, and all other individuals. The services and support offered through 

SAMHSA’s Treatment Systems for Homeless programs are crucial to achieving these goals. 

SAMHSA manages the following Treatment Systems for Homelessness grant programs: 

Cooperative Agreement to Benefit Homeless Individuals (CABHI) 

87 The U.S Department of Housing and Urban Development, Office of Community Planning and Development (2018). 

The 2018 Annual Homeless Assessment Report (AHAR) to Congress, Part 1. Retrieved from 

https://www.hudexchange.info/resources/documents/2018-AHAR-Part-1.pdf 88 U.S. Department of Housing and Urban Development (HUD) 2018 Continuum of Care (CoC) Homeless 

Populations and Subpopulations Report – Retrieve from 

https://www.hudexchange.info/resource/reportmanagement/published/CoC_PopSub_NatlTerrDC_2018.pdf 

215 
 

 

 

 

 

 

 

 

In FY 2011, SAMHSA initiated the Cooperative Agreement to Benefit Homeless Individuals 

(CABHI) program, jointly funded by the Center for Mental Health Services (CMHS) and the Center 

for Substance Abuse Treatment (CSAT) (Treatment for Homeless line) to support treatment services 

and the development and expansion of local systems that provide permanent housing and supportive 

services. This includes integration of treatment and other critical services for individuals with SMI 

or co-occurring mental illness and drug/alcohol addiction. 

In FY 2017, CSAT and CMHS jointly funded the CABHI program which was expended to allow 

states, local governments and local communities to apply. SAMHSA funded 16 new CABHI grants 

and 30 CABHI continuation grants. In FY 2018, SAMHSA funded 46 CABHI continuation grants 

with grant supplements for direct technical assistance. In FY 2019, SAMHSA plans to fund 16 

CABHI continuation grants with grant supplements for direct technical assistance. 

Program Evaluation 

Based on FY 2018 data for CABHI programs, 62.8 percent of clients report abstinence from 

substance use at a six-month follow- up, while approximately 26.7 percent of clients report being 

employed or engaged in productive activities and 50.9 percent of clients report having a permanent 

place to live in the community.89 

Grants for the Benefit of Homeless Individuals (GBHI) 

In FY 2017, CSAT funded the GBHI program (last funded in FY 2010). The purpose of this program 

is to support the development and/or expansion of local implementation of a community 

infrastructure that integrates behavioral health treatment and services for alcohol/other drug 

addiction and co-occurring mental illness and alcohol/other drug addiction, permanent housing, and 

other critical services for individuals (including youth) and families experiencing homelessness. 

In FY 2017, SAMHSA funded 17 new GBHI grants and seven GBHI-Services in Supportive 

Housing continuation grants (requires placement in permanent housing for enrolled individuals). 

In FY 2018, SAMHSA funded 33 new GBHI grants and 17 GBHI continuation grants with grant 

supplements for direct technical assistance. In FY 2019, SAMHSA funded 21 new GBHI grants and 

plans to fund 50 continuation grants with grant supplements for direct technical assistance (new and 

continuation grants). 

Program Evaluation 

Based on FY 2018 data for GBHI programs, 51.9 percent of clients report abstinence from substance 

use at a six-month follow- up, while approximately 25.6 percent of clients report being employed or 

engaged in productive activities and 43.0 percent of clients report having a permanent place to live 

in the community.90 

In addition, SAMHSA funded two contracts (national evaluation and technical assistance) in FY 

2017 and one contract for national technical assistance in FY 2018. SAMHSA plans to fund one 

contract for national technical assistance in FY 2019. 

89 SPARS. (2018). Retrieved from www.samhsa-gpra.samhsa.gov. 

90 SPARS. (2018). Retrieved from www.samhsa-gpra.samhsa.gov. 

216 
Fiscal Year Amount 

FY 2016 $41,304,000 

FY 2017 $36,386,000 

FY 2018 $36,386,000 

FY 2019 $36,386,000 

FY 2020 $36,386,000 

 

 

 

The output and outcome measures for Treatment Systems for Homeless are part of the TreatmentOther Capacity Activities Outputs and Outcomes table shown on page 226. 

Funding History 

Budget Request 

The FY 2020 President’s Budget request is $36.4 million, level with the FY 2019 Enacted level. 

SAMHSA intends to fund 71 GBHI continuation grants with grant supplements for direct technical 

assistance. SAMHSA also plans to award 21 new GBHI grants and one contract for technical 

assistance. 

217 
 

 

 

 

 

 

 

 

 

 

 

Outputs and Outcomes Table 

Program: Treatment System for Homelessness (GBHI) 

Measure 

Year and Most Recent Result 

Target for Recent Result 

(Summary of Result) 

FY 2019 

Target 

FY 2020 

Target 

FY 2020 

Target 

+/-

FY 2019 

Target 

3.4.23 Increase the number of clients 

served. (Output) 

FY 2017: 6,544 

Target: 5,100 

(Target Exceeded) 

6,544 6,544 Maintain 

3.4.24 Increase the percentage of 

homeless clients receiving services 

who were currently employed or 

engaged in productive activities. 

(Outcome) 

FY 2017: 22 % 

Target: 30 % 

(Target Not Met) 

22 % 22 % Maintain 

3.4.25 Increase the percentage of 

clients receiving services who had a 

permanent place to live in the 

community. (Outcome) 

FY 2017: 61.6 % 

Target: 33 % 

(Target Exceeded) 

61.6 % 61.6 % Maintain 

218 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Minority AIDS 

(Dollars in Thousands) 

Programs of Regional & National Significance 

FY 2018 

Final 

FY 2019 

Enacted 

FY 2020 

President's 

Budget 

FY 2020 

President's 

Budget 

+/-

FY 2019 

Enacted 

Minority AIDS..................................................................... $64,534 $65,570 $65,570 $---

Authorizing Legislation...................................Section 509 of the Public Health Service Act 

FY 2020 Authorization ................................................................................................$333,806,000 

Allocation Method ....................................Competitive Grants/Contracts/Cooperative Agreements 

Eligible Entities.................................................... Domestic Public and Private Non-Profit Entities 

Program Description and Accomplishments 

SAMHSA’s Minority AIDS Initiative (MAI) funded programs are making a significant 

contribution in addressing HIV and hepatitis infection by facilitating the development and 

expansion of culturally competent and effective community-based treatment systems for substance 

use and co-occurring mental disorder treatment within racial and ethnic minority communities. The 

purpose of the Targeted Capacity Expansion-HIV program is to increase engagement in care for 

racial and ethnic minority individuals with substance use disorders (SUD) and/or co-occurring 

substance use and mental disorders (COD) who are at risk for HIV or HIV positive that receive HIV 

services/treatment. Populations of focus for the TCE-HIV programs include African American, 

Hispanic/Latina, and other racial/ethnic minority women ages 18 years and older; black young 

men who have sex with men (YMSM) (ages 18-29); other high-risk populations such as Latino 

YMSM and men who have sex with men (MSM) (ages 30 years and older); and gay, bisexual, and 

transgender individuals who have a SUD or COD, are HIV positive or at risk for HIV/AIDS and 

hepatitis. The MAI program, along with many other HIV/AIDS programs across HHS, contributes 

to the goals of a new initiative to eliminate new HIV infections in our nation. Ending the HIV 

Epidemic: A Plan for America will be supported by this program through its continued assistance to 

vulnerable populations. 

Between FY 2000 to FY 2018, the TCE-HIV program served 146,741 clients. Significant steps have 

been taken to increase abstinence, employment and educational opportunities, social connectedness 

and housing stability. In FY 2018, the percentage of clients who reported that they did not use 

alcohol or illegal drugs within the past 30 days increased by 50.6 percent between intake to 6-mont 

follow-up (N=797). Between intake and six-month follow-up, the percentage of clients who 

reported no arrests within the past 30 days increased by 5.1 percent (N=795). In addition, the 

percentage of clients who were employed or attending school increased by 37.4 percent between 

intake to 6-month follow-up (N=797). Those clients who reported social connected decreased by 

219 
 

 

Fiscal Year Amount 

FY 2016 $65,570,000 

FY 2017 $65,125,000 

FY 2018 $64,534,000 

FY 2019 $65,570,000 

FY 2020 $65,570,000 

 

 

3.6 percent from intake to 6-month follow-up (N=793). The percentage of clients who reported 

housing stability increased by 23.1 percent between intake to 6-month follow-up (N=799)91. 

The 13 new TCE-HIV grants awarded in FY 2018 were multi-year funded and will continue through 

the end of FY 2021. In FY 2019, SAMHSA plans to fund 24 new TCE-HIV grants, 95 TCE-HIV 

continuation grants and approximately 119 supplements for direct technical assistance. 

Funding History 

Budget Request 

The FY 2020 President’s Budget request is $65.6 million, level with the FY 2019 Enacted level. 

In 2019, SAMHSA plans to fund continuation grants. 

22 SAMHSA. (2018, December). CSAT GPRA Modernization Act Discretionary Services Tools. Retrieved from 

https://www.samhsa.gov/grants/gpra-measurement-tools/csat-gpra/csat-gpra-discretionary-services 

220 
Criminal Justice Activities 

 

 

 

 

 

 

 

 

 

 

 

 

(Dollars in thousands) 

Programs of Regional & National Significance 

FY 2018 

Final 

FY 2019 

Enacted 

FY 2020 

President's 

Budget 

FY 2020 

President's 

Budget 

+/-

FY 2019 

Enacted 

Criminal Justice Activities..................................................... 

Other Criminal Justice Activities (non-add).................. 

Drug Court Activities (non-add)........................................ 

$89,000 

19,000 

70,000 

$89,000 

19,000 

70,000 

$89,000 

19,000 

70,000 

---

---

---

Authorizing Legislation .............................................Section 509 of the Public Health Service Act 

FY 2020 Authorization ................................................................................................$333,806,000 

Allocation Method ....................................Competitive Grants/Contracts/Cooperative Agreements 

Eligible Entities............................... Domestic Public and Private Non-Profit Entities, Operational 

Individual Misdemeanor and Felony Adult Criminal Courts, 

Municipal Courts, Tribal, State, Local Government Proxies, 

Government with Direct Involvement with Adult Criminal Courts, 

Tribal Organizations and Individual Adult Tribal Healing to Wellness Courts, and 

Individual Juvenile Treatment Drug Courts 

Program Description and Accomplishments 

SAMHSA’s Criminal Justice portfolio includes several grant programs that focus on diversion, 

alternatives to incarceration, drug courts, and re-entry from incarceration for adolescents and adults 

with drug/alcohol addiction and/or co-occurring drug/alcohol addiction and mental illness. 

Drug Courts 

According to a 2006 Bureau of Justice Statistics (BJS) report, approximately 74 percent of state 

prisoners, 63 percent of federal prisoners, and 76 percent of jail inmates met the criteria for a mental 

disorder. An estimated 42 percent of state prisoners and 49 percent of jail inmates met the criteria 

for both a mental illness and drug/alcohol addiction.92 According to BJS, there were 10.6 million 

jail admissions in 2016.

93 At mid-year 2016, city and county jails held over 740,000 individuals.94 

Although the corrections system faced a decline in its prison population for the third consecutive 

year, more than 1.5 million Americans were incarcerated in 2016.95 In 2016, the rate of 

imprisonment for adult Americans was 450 per 100,000 U.S. residents.

96 

92 James, D. J., & Glaze, L. E. (2006). Highlights mental health problems of prison and jail inmates. Retrieved from 

https://www.bjs.gov/index.cfm?ty=pbdetail&iid=789 

93 Zeng, Z. (2018). Jail Inmates in 2016. Washington, D.C.: Bureau of Justice Statistics. Available: 

https://www.bjs.gov/content/pub/pdf/ji16.pdf 

94 Ibid. 

95 Carson, E. A. (2018). Prisoners in 2016. Washington, D.C.: Bureau of Justice Statistics. Available: 

https://www.bjs.gov/content/pub/pdf/p16.pdf 

96 Ibid. 

221 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

The criminal justice system was the major source of referrals to substance abuse treatment, with 

probation or parole referrals representing the largest proportion of criminal justice system referrals 

to treatment.97 

Most probation or parole referrals to treatment were men between the ages of 18 and 44. The most 

common substances reported by these referrals were alcohol, marijuana, and methamphetamine.98 

Drug courts are designed to combine the sanctioning power of courts with effective treatment 

services for a range of populations with circumstances, such as alcohol and/or other drug use, child 

abuse/neglect, criminal behavior, or people with mental illness. Drug courts represent the 

coordinated efforts of the judiciary, prosecution, defense bar, probation, law enforcement, mental 

health, social service, and treatment communities to intervene and break the cycle of substance 

misuse, addiction, and crime. Stakeholders work together to give individual clients the opportunity 

to improve their lives, including recovery from substance drug/alcohol addiction, and develop the 

capacity and skills to become fully-functioning parents, employees, and citizens. 

Many drug courts lack sufficient funding or the ability to implement evidence-based practices for 

substance abuse treatment and recovery services.99 Through its Treatment Drug Court grant 

programs, SAMHSA seeks to reduce this gap in treatment services while also improving treatment 

services by requiring that evidence-based practices be used. SAMHSA’s interest is to support and 

shape treatment drug courts that serve clients with drug/alcohol addiction in the respective problemsolving court models as long as the court meets all the elements required for drug courts. The intent 

is to meet the treatment needs of clients using evidence-based practices consistent with the disease 

model and the problem-solving model, rather than with the traditional court case-processing model. 

A long-term goal of this program is to build sustainable systems of care for individuals needing 

treatment drug court services. SAMHSA’s Treatment Drug Court grant programs seek to address 

behavioral health disparities among racial and ethnic minorities by encouraging the implementation 

of strategies to decrease the differences in access, service use, and outcomes among the racial and 

ethnic minority populations served. 

SAMHSA’s Adult Drug Court programs support a variety of services including direct treatment 

services for diverse populations, wraparound and recovery support services such as recovery housing 

and peer recovery support services designed to improve access and retention, drug testing for illicit 

substances, educational support, relapse prevention and long-term management, and HIV and viral 

hepatitis B and C testing conducted in accordance with state and local requirements. SAMHSA’s

Adult Drug Court grant programs are encouraged to use part of their annual award to provide 

medication-assisted treatment and are required to ensure that drug courts funded by SAMHSAfunded drug courts cannot deny the use of Food and Drug Administration (FDA)-approved 

medications for opioid addiction to drug court clients. Drug court judges, however, retain judicial 

discretion in cases where specified conditions for pharmacotherapy provisions were not met. 

97 Substance Abuse and Mental Health Services Administration, Center for Behavioral Health Statistics and Quality. 

Treatment Episode Data Set (TEDS): 2005-2015. National Admissions to Substance Abuse Treatment Services. 

BHSIS Series S-91, HHS Publication No. (SMA) 17-5037. Rockville, MD: Substance Abuse and Mental Health 

Services Administration, 2017. 

98 SAMHSA. (2015). Criminal and Juvenile Justice. Retrieved from http://www.samhsa.gov/criminal-juvenile-justice 99 SAMHSA's GAINS Center for Behavioral Health and Justice Transformation. (n.d.). Adult Mental Health 

Treatment Courts Database. Retrieved from http://gainscenter.samhsa.gov/judgescourts/courtsjudges.asp 

222 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

These grant programs use existing evidence from numerous studies to support current programs and 

new proposals. There have been more than 125 evaluation and research studies of the effectiveness 

of drug courts in addition to Government Accountability Office reports. SAMHSA requires 

evidence-based practices from federal inventories to be used. SAMHSA also has regular 

communications with the National Association of Drug Court Professionals to obtain and 

incorporate the latest findings and field expertise. 

Program Evaluation 

Performance data show that these grant programs are effective in improving the lives of drug court 

participants. Based on FY 2018 SAMHSA data, 4,841 clients received services through SAMHSA’s

Adult Treatment Drug Court Programs. Of these clients at six-month follow-up, 90.1 percent 

reported that they did not use alcohol or illegal drugs within the past 30 days. Additionally, there 

was a 1.2 percent increase from intake that had no involvement with the criminal justice system, a 

35.4 percent increase of adult clients that were either employed or attending school, and 41.2 percent 

increase in clients who had a permanent place to live in the community. 

In FY 2018, SAMHSA funded 86 new drug court grants, 101 drug court grant continuations, and 

one contract. 

In FY 2019, SAMHSA plans to fund 25 new drug court grants, at least 5 will be to Tribes/Tribal 

organizations pending sufficient applications, and 117 drug court grant continuations, and one 

contract. 

Criminal Justice Other/Offender Reentry Program 

In addition to the drug court portfolio, SAMHSA supports the Offender Reentry Program (ORP) 

grants, as well as other criminal justice activities, such as a regional and national criminal justice 

technical support contract. Studies show that only about 10 percent of individuals involved with the 

criminal justice system who are in need of substance abuse treatment receive it as part of their justice 

system supervision. Approximately one-half of the institutional treatment provided is educational 

programming.100 During the past decade, awareness of the need for a continuum of care of services 

for adult offenders has grown as states and local communities have struggled with the increasing 

number of these individuals returning to the community after release from correctional confinement. 

ORP grants provide screening, assessment, comprehensive treatment, and recovery support services 

for diverse populations reentering the community from incarceration. ORP grant services include 

screening, comprehensive individual assessment for substance use and/or co-occurring mental 

disorders, program and case management, and alcohol and other drug treatment. Other supported 

services include wraparound and recovery support services such as recovery housing and peer 

recovery support designed to improve access and retention, drug testing for illicit substances, 

educational support, relapse prevention and long-term management, and HIV and viral hepatitis B 

and C testing conducted in accordance with state and local requirements. SAMHSA’s ORP grants 

are encouraged to use part of their annual award to provide medication-assisted treatment with FDAapproved medications. 

Performance data show that these grant programs are effective in improving the lives of Offender 

Reentry Program court participants. Based on FY 2018 SAMHSA data, 1644 clients received 

100 Taxman FS, Perdoni ML, Harrison LD. (2007). Drug treatment services for adult offenders: The state of the state. 

Journal of Substance Abuse Treatment 32(3), 239-254. 

223 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

services through SAMHSA’s Offender Re-entry Programs. Of these clients at six-month follow-up, 

71.7 percent reported that they did not use alcohol or illegal drugs within the past 30 days. 

Additionally, there was an 8.7 percent increase from intake that had no involvement with the criminal 

justice system, a 159.9 percent increase of adult clients that were either employed or attending 

school, and 144 percent increase in clients who had a permanent place to live in the community. 

In FY 2019, SAMHSA funded one new ORP grant and 32 ORP grant continuations. 

Family Treatment Drug Courts 

The purpose of the Family Treatment Drug Court (FTDC) program is to expand substance use 

disorder (SUD) treatment services in existing family treatment drug courts, which use the family 

treatment drug court model in order to provide alcohol and drug treatment (including recovery 

support services, screening, assessment, case management, and program coordination) to parents 

with a SUD and/or co-occurring SUD and mental disorders, who have had a dependency petition 

filed against them or are at risk of such filing. FTDCs are expected to provide a coordinated, multisystem approach designed to combine the sanctioning power of treatment drug courts with effective 

treatment services promoting successful family preservation and reunification. FTDCs assist 

participants in reducing the rates of substance misuse, the severity of SUDs and co-occurring 

disorders, and decreasing out of home placements for children through family reunification and 

preservation. This should also decrease the number of parents or guardians whose parental rights 

have been or will be terminated. 

Based on FY 2018 SAMHSA data, 1,178 clients received services through SAMHSA’s Family Drug

Court Programs. Of these clients at six-month follow-up, 84.8 percent reported that they did not use 

alcohol or illegal drugs within the past 30 days. Additionally, there was a 1.9 percent increase from 

intake that had no involvement with the criminal justice system, a 40.9 percent increase of adult 

clients that were either employed or attending school, and 28.9 percent increase in clients who had 

a permanent place to live in the community. 

In FY 2019, SAMHSA will fund 25 new FTDC grants, at least five will be to Tribes/Tribal 

organizations pending sufficient applications, and 33 FTDC grant continuations. 

Behavioral Health Treatment Court Collaborative Program 

In FY 2014, SAMHSA supported a second cohort of four-year Behavioral Health Treatment Court 

Collaborative grants (BHTCC) in the Mental Health and Substance Abuse Treatment appropriations. 

BHTCC supports judges and staff of specialty (e.g., drug court) and other courts within a jurisdiction 

to work together to divert adults with mental illness and/or alcohol/other drug addiction from the 

criminal justice system. The purpose of this grant program is to allow municipal courts more 

flexibility to collaborate with multiple criminal justice system components and local community 

treatment and recovery providers to address the behavioral health needs of adults who are involved 

with the criminal justice system. The court collaborative grant program focuses on adults and 

veterans with behavioral health problems, including serious mental illness, from the criminal justice 

system, including alternatives to incarceration. 

Program Evaluation 

SAMHSA completed an evaluation of the first cohort of BHTCC grantees in September 2014 and 

is conducting an evaluation of the second cohort of 17 grantees that will be completed September 

2018. Performance data show that the BHTCC grant programs are effective in improving the lives 

224 
 

Fiscal Year Amount 

FY 2016 $78,000,000 

FY 2017 $74,000,000 

FY 2018 $89,000,000 

FY 2019 $89,000,000 

FY 2020 $89,000,000 

 

of drug court participants. Based on FY 2017 SAMHSA data, 1,142 clients received services 

through the BHTCC Program. Of these clients at six-month follow-up, 26 percent reported that they 

did not use alcohol or illegal drugs within the past 30 days. Additionally, there was an 11 percent 

increase from intake that had no involvement with the criminal justice system, 60 percent increase 

of adult clients that were either employed or attending school, and 23 increase in clients who had a 

permanent place to live in the community. 

In FY 2018, SAMHSA funded 17 continuation grants for the fourth and final grant year and the 

evaluation contract. 

In FY 2019, there is no plan to fund BHTCC grants. 

Funding History 

Budget Request 

The FY 2020 President’s Budget request is $89.0 million, level with the FY 2019 Enacted level. 

SAMHSA intends to support 34 new drug court grants, 135 drug court continuation grants, and one 

contract. SAMHSA intends to fund three new and 21 continuation ORP grants. 

225 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Outputs and Outcomes Table 

Program: Criminal Justice - Drug Courts 

Measure 

Year and Most Recent Result 

Target for Recent Result 

(Summary of Result) 

FY 2019 

Target 

FY 2020 

Target 

FY 2020 

Target 

+/-

FY 2019 

Target 

1.2.72 Increase the percentage of adult 

clients receiving services who were 

currently employed or engaged in 

productive activities. (Outcome) 

FY 2017: 64.1 % 

Target: 55 % 

(Target Exceeded) 

64.1 % 64.1 % Maintain 

1.2.73 Increase the percentage of adult 

clients receiving services who had a 

permanent place to live in the 

community. (Outcome) 

FY 2017: 46 % 

Target: 41 % 

(Target Exceeded) 

46 % 46 % Maintain 

1.2.74 Increase the percentage of adult 

clients receiving services who had no 

involvement with the criminal justice 

system. (Outcome) 

FY 2017: 93.7 % 

Target: 91 % 

(Target Exceeded) 

93.7 % 93.7 % Maintain 

1.2.76 Increase the percentage of adult 

clients receiving services who had no 

past month substance use. (Outcome) 

FY 2017: 86.1 % 

Target: 71 % 

(Target Exceeded) 

86.1 % 86.1 % Maintain 

1.2.79 Increase the number of adult 

clients served. (Output) 

FY 2017: 8,597 

Target: 5,500 

(Target Exceeded) 

8,597 9,500 +903 

226 
 

 

 

 

 

 

 

 

 

 

 

 

Outputs and Outcomes Table 

Program: Criminal Justice - Ex-Offender Re-Entry Program 

Measure 

Year and Most Recent Result 

Target for Recent Result 

(Summary of Result) 

FY 2019 

Target 

FY 2020 

Target 

FY 2020 

Target 

+/-

FY 2019 

Target 

1.2.80 Increase the number of clients 

served. (Outcome) 

FY 2017: 1,218 

Target: 2,000101 

(Target Not Met) 

2,000 2,000 Maintain 

1.2.81 Increase the percentage of 

clients who had no past month 

substance use. (Outcome) 

FY 2017: 70 % 

Target: 74 %102 

(Target Not Met) 

74 % 74 % Maintain 

1.2.84 Increase the percentage of 

clients receiving services who had no 

involvement with the criminal justice 

system. (Outcome) 

FY 2017: 93.3 % 

Target: 94 % 

(Target Not Met but Improved) 

93.3 % 93.3 % Maintain 

101Decrease in target from prior year level reflects a decrease in funding and changes in data trends. 102Decrease in target from prior year level reflects a decrease in funding and changes in data trends. 

227 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Outputs and Outcomes Table 

Program: Treatment - Other Capacity 

Measure 

Year and Most Recent Result 

Target for Recent Result 

(Summary of Result) 

FY 2019 

Target 

FY 2020 

Target 

FY 2020 

Target 

+/-

FY 2019 

Target 

1.2.25 Increase the percentage of 

adults receiving services who had no 

past month substance use. (Outcome) 

FY 2017: 65.6 % 

Target: 60 % 

(Target Exceeded) 

65.6 % 65.6 % Maintain 

1.2.26 Increase the number of clients 

served. (Output) 

FY 2017: 20,310 

Target: 30,000 

(Target Not Met) 

20,310 20,310 Maintain 

1.2.27 Increase the percentage of 

adults receiving services who were 

currently employed or engaged in 

productive activities. (Outcome) 

FY 2017: 45.6 % 

Target: 43 % 

(Target Exceeded) 

45.6 % 45.6 % Maintain 

1.2.28 Increase the percentage of 

adults receiving services who had a 

permanent place to live in the 

community. (Outcome) 

FY 2017: 46.6 % 

Target: 47 % 

(Target Not Met but Improved) 

47 % 47 % Maintain 

1.2.29 Increase the percentage of 

adults receiving services who had no 

involvement with the criminal justice 

system. (Outcome) 

FY 2018: 97.6 % 

Target: 97.5 % 

(Target Exceeded) 

97.5 % 97.5 % Maintain 

Note: Contributing grant programs are Criminal Justice Activities, Targeted Capacity Expansion: Medication Assisted 

Treatment – Prescription Drug and Opioid Addiction and Peer-to-Peer, HIV Programs, Minority AIDS, Treatment 

Systems for Homeless, Screening, Brief Intervention, Referral and Treatment, Pregnant Postpartum Women, Children 

and Families, and Recovery Community Services Program. 

228 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Building Communities of Recovery (BCOR) 

(Dollars in thousands) 

Programs of Regional & National Significance 

FY 2018 

Final 

FY 2019 

Enacted 

FY 2020 

President's 

Budget 

FY 2020 

President's 

Budget 

+/-

FY 2019 

Enacted 

Building Communities of Recovery.................................... $5,000 $6,000 $6,000 $---

Authorizing Legislation .Section 302 of the Comprehensive Addiction and Recovery Act of 2016 

FY 2020 Authorization ....................................................................................................$1,000,000 

Allocation Method ................................................................................................. Grants/Contracts 

Eligible Entities...................................Primary care, child welfare system, criminal justice system 

Program Description and Accomplishments 

Peer services play a vital role in assisting individuals in achieving recovery from substance use 

disorders. Recovery Community Organizations (RCOs) are central to the delivery of those services. 

In FY 2017, SAMHSA funded a new cohort of grant through the Comprehensive Addiction 

Recovery Act (CARA) Building Communities of Recovery program. The purpose of this program 

is to mobilize resources within and outside of the recovery community to increase the prevalence 

and quality of long-term recovery support from drug/alcohol addiction. These grants are intended to 

support the development, enhancement, expansion, and delivery of recovery support services (RSS) 

as well as promotion of and education about recovery. Programs are designed to be overseen by 

people in recovery from SUDs who reflect the community served. 

Grants support linkages between recovery networks and a variety of other organizations, systems, 

and communities, including primary care, other recovery networks, child welfare system, criminal 

justice system, housing services and employment systems. Grantees will also work to reduce 

negative attitude, discrimination, and prejudice around addiction and addiction recovery. 

In FY 2018, SAMHSA funded 8 new grants, and provided continuation awards to 19 grants which 

began in FY 2019, for a total of 27 BCOR grants. Moreover, these grantees have received 

supplements of $25,000 each to support their direct technical assistance needs. 

In FY 2019, SAMHSA plans to fund 27 continuation awards for $5 million. 

229 
Fiscal Year Amount 

FY 2016 ---

FY 2017 

FY 2018 

FY 2019 

FY 2020 

$3,000,000 

 

 

 

$5,000,000 

$6,000,000

$6,000,000 

 

 

 

 

 

 

 

 

 

 

 

 

Funding History 

Budget Request 

The FY 2020 President’s Budget request is $6.0 million, level with the FY 2019 Enacted level. 

These funds will support six new grants and 15 continuation grants the Building Communities of 

Recovery Program to develop, expand, and enhance recovery support services. 

Outputs and Outcomes Tables 

Program: Building Communities for Recovery 

Measure 

Year and Most Recent Result 

Target for Recent Result 

(Summary of Result) 

FY 2019 

Target 

FY 2020 

Target 

FY 2020 

Target 

+/-

FY 2019 

Target 

1.2.80 Increase in number of clients 

receiving recovery services. (Output) 

FY 2018: 271 

Target: 500 

(Target Not Met) 

270 270 Maintain 

1.2.81 Percent of clients who report 

not having stable housing at baseline 

who report having stable housing at 

six-month follow-up. (Outcome) 

FY 2018 46.9% 

Target: 48% 

(Target Not Met) 

48% 48% Maintain 

1.2.82 Percent of clients who report 

not being employed (full-time or parttime) or in school at baseline who 

report having employment or being in 

school at follow-up. (Outcome) 

FY 2018 70.7% 

Target: 71% 

(Target Not Met) 

71% 71% Maintain 

230 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Minority Fellowship Program 

(Dollars in thousands) 

Science and Service 

FY 2018 

Final 

FY 2019 

Enacted 

FY 2020 

President's 

Budget 

FY 2020 

President's 

Budget 

+/-

FY 2019 

Enacted 

SAT Minority Fellowship Program.................................... $4,539 $4,789 $--- -$4,789 

Authorizing Legislation .............................................Section 597 of the Public Health Service Act 

FY 2020 Authorization ..................................................................................................$12,669,000 

Allocation Method ................................................................................................. Grants/Contracts 

Eligible Entities..... Organizations that represent individuals obtaining post-baccalaureate training 

(including for master’s and doctoral degrees) for mental and substance use disorder treatment 

professionals, including in the fields of psychiatry, nursing, social work, psychology, marriage and 

family therapy, mental health counseling, and substance use disorder and addiction counseling 

Program Description and Accomplishments 

SAMHSA’s Minority Fellowship Program (MFP) increases behavioral health practitioners’ 

knowledge of issues related to prevention, treatment, and recovery support for mental illness and 

drug/alcohol addiction among racial and ethnic minority populations. The mental health and 

substance use needs of racial and ethnic minority communities in the United States have been 

historically underserved due to a variety of factors. These include a limited number of postbaccalaureate (including master’s and doctoral level) trained professionals in psychiatry, 

psychology, nursing, social work, marriage and family therapy, mental health counseling, and 

substance use and addictions counseling who are equipped with the skills and cultural competencies 

needed to deliver effective services. Since its start in 1973, the program has helped to enhance 

services for racial and ethnic minority communities through specialized training of mental health 

professionals in psychiatry, nursing, social work, and psychology. In 2006, the program expanded 

to include marriage and family therapists and later added professional counselors specializing in 

addiction. In FY 2018, an additional program was created to address specialized training in addiction 

psychiatry, psychology, and addiction medicine. Professional guilds receive competitively awarded 

grants, and then competitively award the stipends to graduate and post-graduate students pursuing a 

degree in corresponding professional fields. 

In FY 2018, SAMHSA funded seven new grants in a program jointly administered by the Center for 

Substance Abuse Treatment (CSAT) and the Center for Mental Health Services (CMHS) at 

SAMHSA. CSAT also funded one additional grant for to support the program that specializes in 

Fellowships for addiction psychiatry, psychology, and addiction medicine. 

Combined, these programs will support fellowships for hundreds of students as well as support 

additional training through webinars on culturally appropriate services to thousands of students. 

In FY 2018, SAMHSA funded eight new MFP grants including the new Center for Substance Abuse 

Treatment grant and one MFP technical assistance contract. In FY 2019 these eight grants will be 

continued. 

231 
Fiscal Year Amount 

FY 2016 $3,539,000

FY 2017 $3,539,000

FY 2018 $4,539,000

FY 2019 $4,789,000

FY 2020 ---

 

 

Funding History 

 

 

 

Budget Request 

The FY 2020 President’s Budget request is $0.0 million, a decrease of 4.8 million from the FY 2019 

Enacted level. This program is discontinued in FY 2020, because it overlaps with other federal 

activities. 

232 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Addiction Technology Transfer Centers 

(Dollars in thousands) 

Science and Service 

FY 2018 

Final 

FY 2019 

Enacted 

FY 2020 

President's 

Budget 

FY 2020 

President's 

Budget 

+/-

FY 2019 

Enacted 

Addiction Technology Transfer Centers................................. $9,046 $9,046 $9,046 $---

Authorizing Legislation .............................................Section 509 of the Public Health Service Act 

FY 2019 Authorization ................................................................................................$333,806,000 

Allocation Method ....................................Competitive Grants/Contracts/Cooperative Agreements 

Eligible Entities.................................................... Domestic Public and Private Non-Profit Entities 

Program Description and Accomplishments 

Misuse of, and addiction to alcohol, tobacco, and illicit drugs cost Americans more than $700 billion 

a year in increased healthcare costs, crime, and lost productivity.103, 104 Recently, the nation’s attention

has been on the increase misuse of opioids. The majority of drug overdose deaths (more than six 

out of ten) involved an opioid.105 Alcohol/other drug addiction is treatable and research has led to 

development of medications and evidence-based psychosocial interventions that help people achieve 

recovery and resume productive lives. One critical need is to help recruit, train, and support 

treatment providers in the use of evidence-based practices. 

The Addiction Technology Transfer Center Network (ATTC Network) is one of SAMHSA’s proven

models for building behavioral health capacity in health systems and communities through the 

sharing and transfer of expertise. SAMHSA supports the ATTC Network to develop and provide 

low or no cost training opportunities using evidence-based teaching, technologies, implementation, 

coaching, and information dissemination to behavioral health professionals. During the last cycle 

of the ATTC program (FY 2011 - 2016), the ATTC network supported the completion of over 430 

events (technical assistance, webinars, onsite training, presentations etc.) benefiting over 128,000 

health professionals. Overall, over 94 percent of participants reported satisfaction with the quality 

of the training or technical assistance they received from the ATTC Network. There is a critical and 

rising need for practitioners to reflect the diversity of their client population in terms of 

characteristics, such as age, race/ethnicity, and sexual orientation. Existing diversity requires 

recruitment of new professionals from a variety of backgrounds.106 

103 National Institute for Drugs and Alcohol. (2015). Trends and Statistics. Retrieved from NIH/NIDA: 

http://www.drugabuse.gov/related-topics/trends-statistics 104 National Institute for Drugs and Alcohol. (2015). Trends and Statistics. Retrieved from NIH/NIDA: 

http://www.drugabuse.gov/related-topics/trends-statistics 105 Rudd RA, Seth P, David F, Scholl L. Increases in Drug and Opioid-Involved Overdose Deaths — United States, 

2010–2015. MMWR Morb Mortal Wkly Rep. ePub: 16 December 2016 106 Ryan, O., Murphy, D., Krom, L. (2012). Vital Signs: Taking the Pulse of the Addiction Treatment Workforce, A 

National Report, Version 1. Kansas City, MO: Addiction Technology Transfer Center National Office in residence at 

the University of Missouri-Kansas City. Retrieved from http://www.attcnetwork.org/documents/VitalSignsReport.pdf 

233 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Treating persons with drug/alcohol addiction is difficult and challenging. Pay and benefits often do 

not fully reflect the difficulty of this work. Burnout and turnover are significant challenges for 

providers and their employing organizations and may impede patient recovery. 

Faced with an average annual staff turnover rate of 18.5 percent, substance use disorder treatment 

programs deal with significant challenges to fill open positions.107 Common hurdles for many abuse 

treatment facilities include difficulty retaining and recruiting qualified individuals, the need for a 

diverse workforce capable of working in integrated settings, and the perception that drug/alcohol 

addiction is not a valid health issue (i.e., that addiction is a ‘choice’).108 

To address the gaps in workforce, the ATTC Network supports national and regional activities 

focused on improving the skills of substance abuse treatment and other healthcare professionals. 

The ATTC Network decreases the gap in time between the release of new scientific findings and the 

adoption of these interventions by front-line substance abuse treatment clinicians. ATTC grantees 

develop evidence-based and promising practices for addiction treatment/recovery professionals, 

public health/mental health personnel, institutional and community corrections professionals, 

nurses, and other health professions. The ATTC Network dissemination models include technical 

assistance, training and an extensive array of web-based resources created to translate the latest 

science for adoption into practice by the substance abuse treatment workforce. Using a systems 

change approach, the goal is to improve organizations and systems of care, enhancing access, 

engagement, and outcomes in a continuous quality improvement framework. 

In FY 2016, the ATTC Network included 10 Regional Centers, four National Focus Area Centers, 

and a Network Coordinating Office. In FY 2017, a new cohort of grants was awarded to 10 Regional 

Centers and one Coordinating Center. 

In FY 2018, SAMHSA funded one new AI/AN and eleven continuation grants in the ATTC program. 

In FY 2019, SAMHSA plans to fund 12 continuation grants. Together, the members of the ATTC 

Network will continue to provide technical assistance, workforce training, support meetings, and the 

collaboration with other HHS agencies, the SAMHSA Regional Administrators, and other partners. 

107 Ryan, O., Murphy, D., Krom, L. (2012). Vital Signs: Taking the Pulse of the Addiction Treatment Workforce, A 

National Report, Version 1. Kansas City, MO: Addiction Technology Transfer Center National Office in residence at 

the University of Missouri-Kansas City. Retrieved from http://www.attcnetwork.org/documents/VitalSignsReport.pdf 108 Ryan, O., Murphy, D., Krom, L. (2012). Vital Signs: Taking the Pulse of the Addiction Treatment Workforce, A 

National Report, Version 1. Kansas City, MO: Addiction Technology Transfer Center National Office in residence at 

the University of Missouri-Kansas City. Retrieved from http://www.attcnetwork.org/documents/VitalSignsReport.pdf 

234 
Fiscal Year Amount 

FY 2016 $9,046,000

FY 2017 $9,046,000

FY 2018 $9,046,000

FY 2019 $9,046,000

FY 2020 $9,046,000

 

 

Funding History

Budget Request 

The FY 2020 President’s Budget Request is $9.0 million, level with the FY 2019 Enacted level. 

SAMHSA plans to fund twelve continuation grants. Funding will allow the ATTC grantees to 

disseminate evidence-based, promising practices to addiction treatment and recovery professionals, 

public health and mental health personnel, institutional and community corrections professionals, 

and other related disciplines. 

235 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Improving Access to Overdose Treatment 

(Dollars in thousands) 

Programs of Regional & National Significance 

FY 2018 

Final 

FY 2019 

Enacted 

FY 2020 

President's 

Budget 

FY 2020 

President's 

Budget 

+/-

FY 2019 

Enacted 

Improving Access to Overdose Treatment........................ $--- $1,000 $1,000 $---

Authorizing Legislation .Section 302 of the Comprehensive Addiction and Recovery Act of 2016 

FY 2020 Authorization ..................................................................................................$12,000,000 

Allocation Method ................................................................................................. Grants/Contracts 

Eligible Entities...................................Primary care, child welfare system, criminal justice system 

Program Description and Accomplishments 

Drug overdose deaths and opioid-involved deaths continue to increase in the United States. In 2016, 

there were more than 63,600 drug overdose deaths in the United States. Opioids prescription and 

illicit are the main driver of drug overdose deaths. 116 Americans die every day from an opioid 

overdose. Opioid overdose deaths were five times higher in 2016 than 1999.109 In 2013, SAMHSA 

released the Opioid Overdose Prevention Toolkit to help reduce the number of opioid-related 

overdose deaths and adverse events. The Improving Access to Overdose Treatment (CARA) grant 

program utilizes this toolkit and other resources to help grantees train and provide resources to health 

care providers and pharmacists on the prescribing of drugs or devices approved or cleared under the 

Federal Food, Drug, and Cosmetic Act for emergency treatment of known or suspected opioid 

overdose. 

Further, the Improving Access to Overdose Treatment (CARA) grant program addresses the opioid 

crisis by increasing access to treatment, reducing unmet treatment need, and reducing opioid 

overdose related deaths through the provision of prevention, treatment, and recovery activities for 

opioid use disorder (including prescription opioids as well as illicit drugs such as heroin). 

SAMHSA awarded one (1) Improving Access to Overdose Treatment (CARA) grant in FY 2017. 

The grantee partners with other prescribers at the community level to develop best practices for 

prescribing and co-prescribing FDA-approved overdose reversal drugs. After developing best 

practices, the grantee will train other prescribers in key community sectors as well as individuals 

who support persons at high risk for overdose. This grant program also ensures the grantee 

establishes protocols to connect patients who have experienced a drug overdose with appropriate 

treatment, including medication-assisted treatment and appropriate counseling and behavioral 

therapies. 

In FY 2018 and FY 2019, SAMHSA continues to award one continuation grant. 

109 (Hedegaard H, Warner M, Miniño AM. Drug overdose deaths in the United States, 1999–2016. NCHS Data Brief, 

no 294. Hyattsville, MD: National Center for Health Statistics. 2017/ CDC. Wide-ranging online data for 

epidemiologic research (WONDER). Atlanta, GA: CDC, National Center for Health Statistics; 2016. Available at 

http://wonder.cdc.gov. 

236 
Fiscal Year Amount 

FY 2016 ---

FY 2017

FY 2018 ---

$1,000,000

FY 2019

FY 2020

$1,000,000

$1,000,000

Budget Request 

 

Funding History 

The FY 2020 President’s Budget request is $1.0 million, level with the FY 2019 Enacted level. 

SAMHSA plans to support three grants to continue increasing access to treatment, reducing unmet 

treatment need, and reducing opioid overdose related deaths through the provision of prevention, 

treatment, and recovery activities for opioid use disorder. 

237 
 

 

 

 

 

 

 

 

 

 

 

First Responder Training for Opioid Overdose Reversal Drugs 

(Dollars in thousands) 

Programs of Regional & National Significance 

FY 2018 

Final 

FY 2019 

Enacted 

FY 2020 

President's 

Budget 

FY 2020 

President's 

Budget 

+/-

FY 2019 

Enacted 

First Responder Training............................................... 

First Responder Training (non-add)....................... 

Rural Set-Aside (non-add).......................................... 

$---

---

---

$36,000 

18,000 

18,000 

$36,000 

18,000 

18,000 

---

---

---

Authorizing Legislation ........................................................................ Section 546 of the PHS Act 

FY 2020 Authorization .................................................................................................$12,000,000 

Allocation Method..............................................................................................Competitive Grants 

Eligible entities..................................States, local government entities, federally recognized 

 American Indian/Alaska Native tribe or tribal organizations 

Program Description and Accomplishments 

Under Section 202 of the Comprehensive Addiction and Recovery Act (CARA), SAMHSA is 

authorized to support additional efforts to prevent opioid overdose-related deaths by providing grants 

to train first responders. In FY 2017, SAMHSA funded 21 new grants for the First Responder CARA 

grant program (FR-CARA). The purpose of this program is to allow first responders and members 

of other key community sectors to administer a drug or device approved or cleared under the Federal 

Food, Drug, and Cosmetic Act for emergency treatment of known or suspected opioid overdose. 

Grantees will train and provide resources to first responders and members of other key community 

sectors at the state, tribal, and local governmental levels on carrying and administering a drug or 

device approved or cleared under the Federal Food, Drug, and Cosmetic Act for emergency 

treatment of known or suspected opioid overdose. Grantees will also establish processes, protocols, 

and mechanisms for referral to appropriate treatment and recovery communities. This program 

includes a broader eligibility than the previously referenced state-based Grants to Prevent Opioid 

Overdose-related Death program. The program allows for much needed services to reach local and 

tribal areas. Additionally, in FY 2017, the First Responder Training program also included a setaside to address the critical needs of rural populations. 

Training, technical assistance, and evaluation activities are also being supported to assist grantees, 

determine best practices, and assess program outcomes. In FY 2019, Congress appropriated funding 

for this program under Substance Abuse Treatment to continue to support the continuation grants. 

238 
Fiscal Year Amount 

FY 2016 ---

FY 20171 

FY 20181 

$12,000,000

$36,000,000

 

FY 2019 $36,000,000 

FY 2020 $36,000,000

 

 

 

 

 

 

 

 

 

 

Funding History 

1. This activity was funding under the Substance Abuse Prevention appropriation in 2017 and 

2018. 

Budget Request 

The FY 2020 President’s Budget request is $36.0 million, level with the FY 2019 Enacted level. 

This funding will provide 49 continuations grants and approximately 25 new awards to support the 

continuation of training, technical assistance and evaluation activities to address the opioid crisis in 

this country. 

Outputs and Outcomes Table 

Program: First Responder Training-CARA 

Measure 

Year and Most Recent Result 

Target for Recent Result 

(Summary of Result) 

FY 2019 

Target 

FY 2020 

Target 

FY 2020 

Target 

+/-

FY 2019 

Target 

TBD Number of Naloxone (or other 

FDA-approved) kits distributed. 

(Output) 

FY 2018: 30,313.0 

Target: 30,313.0 

(Baseline) 

30,313.0 30,313.0 Maintain 

TBD Number of first responders 

trained how to administer Naloxone 

(or other FDA approved drug or 

device). (Output) 

FY 2018: 5,983.0 

Target: 5,983.0 

(Baseline) 

5,983.0 5,983.0 Maintain 

239 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Grants to Prevent Prescription Drug/Opioid Overdose Related Deaths 

(Dollars in thousands) 

Programs of Regional & National Significance 

FY 2018 

Final 

FY 2019 

Enacted 

FY 2020 

President's 

Budget 

FY 2020 

President's 

Budget 

+/-

FY 2019 

Enacted 

Grants to Prevent Prescription Drug/Opioid OverdoseRelated Deaths... $--- $12,000 $12,000 $---

*FY 2018 Final was included in the Center for Substance Abuse Prevention (CSAP) Chapter. 

Authorizing Legislation ............................................. Section 516 and Section 546 of the PHS Act 

FY 2020 Authorization ..................................................................................................$12,000,000 

Allocation Method ............................................................................Competitive Grants, Contracts 

Eligible Entities...........................................States, local government entities, federally recognized 

 American Indian/Alaska Native tribe or tribal organizations 

Program Description and Accomplishments 

Opioid overdose is a significant contributor to accidental deaths among those who use, misuse, or 

abuse illicit and prescription opioids (including synthetics such as fentanyl).110 Opioids include 

illegal drugs such as heroin, as well as prescription medications used to treat pain. These prescription 

medications include morphine, codeine, methadone, oxycodone (Oxycontin, Percodan, Percocet), 

hydrocodone (Vicodin, Lortab, Norco), fentanyl (Duragesic, Fentora), hydromorphone (Dilaudid, 

Exalgo), and buprenorphine (Subutex, Suboxone). Opioids bind to specific receptors in the brain, 

spinal cord, and gastrointestinal tract and reduce the body’s perception of pain. As opioids reduce

pain, they induce a slight sense of euphoria, which can lead to overuse. 

In 2018, SAMHSA revised its Opioid Overdose Prevention Toolkit, a resource which has been vital 

in helping reduce the number of opioid-related overdose deaths and adverse events. The Toolkit 

was the first federal resource that includes safety and prevention information for individuals at risk 

for overdose. The toolkit provides information on how to recognize and respond appropriately to 

overdose, identifies specific drug-use behaviors to avoid, and describes the role of overdose 

reversing drugs in preventing death from an overdose. A growing evidence base suggests that 

overdose reversal drugs are a cost-effective method to reducing opioid overdose deaths. 

As the rates of prescription drug abuse, heroin abuse, illicit synthetic opioid abuse, overdoses, and 

opioid-related overdose deaths increase, communities are searching for ways to reduce the death rate 

from opioid-related overdoses. 

In FY 2016, SAMHSA awarded 12 grants to states for the Grants to Prevent Prescription Drug and 

Opioid Overdose-related Deaths program, which helps states identify communities of high need and 

provide education, training, and resources necessary to meet their specific needs. The grant funds 

can be used for purchasing overdose reversing drugs, equipping first responders with them, 

providing training on their use, and developing other overdose-related death prevention strategies, 

110 National Institute on Drug Use (NIDA). America’s Addiction to Opioids: Heroin and Prescription Drug Abuse.

(2014) Available from URL: http://www.drugabuse.gov/about-nida/legislative-activities/testimony-tocongress/2015/americas-addiction-to-opioids-heroin-prescription-drug-abuse#_ftnref4 

240 
 

 

 

 

Fiscal Year Amount 

FY 2016 $12,000,000 

FY 2017 $12,000,000 

FY 2018 $12,000,000 

FY 2019 $12,000,000 

FY 2020 $12,000,000 

 

 

 

 

 

and providing materials to assemble and disseminate overdose kits. These grantees are also required 

to develop a dissemination plan and a training course tailored to meet the needs of first responders 

in the communities within their state. The course uses SAMHSA’s Opioid Overdose Prevention

Toolkit as a guide and includes a comprehensive prevention program that will focus on prevention, 

treatment, and recovery services in order to decrease the likelihood of drug overdose recurrence. 

Beginning in FY 2019, Congress appropriated funding for this program to the Center for Substance 

Abuse Treatment instead of the Center for Substance Abuse Prevention to continue support of 12 

grants. 

Funding History 

*FY 2018 was included in the CSAP Chapter. 

Budget Request 

The FY 2020 President’s Budget request is $12.0 million, level with the FY 2019 Enacted 

level. This funding will provide continuation grants to 12 states to reduce the number of opioid 

overdose-related deaths. Funding will help states purchase overdose reversing drugs, equip first 

responders in high-risk communities, support education on the use of naloxone and other overdoserelated death prevention strategies, provide the necessary materials to assemble overdose kits, and 

cover expenses incurred from dissemination efforts. 

241 
 

 

 

 

 

 

 

 

Outputs and Outcomes Table 

Program: PDO/Naloxone 

Measure 

Year and Most Recent Result 

Target for Recent Result 

(Summary of Result) 

FY 2019 

Target 

FY 2020 

Target 

FY 2020 

Target 

+/-

FY 2019 

Target 

5.0 Number of Naloxone (or other 

FDA-approved) kits distributed. 

(Output) 

FY 2018: 44,348.0 

Target: 20,000.0 

(Target Exceeded) 

44,348.0 44,348.0 Maintain 

5.1 Number of lay persons trained 

how to administer Naloxone (or other 

FDA approved drug or device). 

(Output) 

FY 2018: 20,036.0 

Target: 2,000.0 

(Target Exceeded) 

20,036.0 20,036.0 Maintain 

242 
 Grants to Develop Curricular for DATA Act Waivers 

 

 

 

 

 

 

 

(Dollars in thousands) 

Programs of Regional & National Significance 

FY 2018 

Final 

FY 2019 

Enacted 

FY 2020 

President's 

Budget 

FY 2020 

President's 

Budget 

+/-

FY 2019 

Enacted 

Grants to Develop Curricula for DATA Act Waivers........ $--- $--- $4,000 $4,000 

Authorizing Legislation ........... Section 3203 of the SUPPORT for Patients and Communities Act 

FY 2020 Authorization ....................................................................................................$4,000,000 

Allocation Method ............................................................................................. Competitive Grants 

Eligible Entities......Medical school, physician assistant schools, and schools of nursing (programs 

for nurse practitioners will be focus) 

Program Description and Accomplishments 

The purpose of this new program, which is authorized by section 3203 of the SUPPORT for Patients 

and Communities Act, is to provide grants to enhance access to substance use disorder treatment. 

This is done by giving grants to accredited schools of allopathic medicine or osteopathic medicine 

and teaching hospitals located in the United States to support the development of curricula that meet 

the requirements from an accredited school of allopathic medicine or osteopathic medicine in the 

United States. 

243 
 

 

 

 

Funding History 

Fiscal Year Amount 

FY 2016 ---

FY 2017 ---

FY 2018 ---

FY 2019 ---

FY 2020 $4,000,000 

Budget Request 

The FY 2020 President’s Budget request is $4.0 million, an increase of $4.0 million from the 

FY 2019 Enacted level. This funding will support 117 grants. 

244 
 

Continuations......................................................... 

New/Competing...................................................... 

 

Continuations......................................................... 

 

 

SAMHSA/Substance Abuse Treatment 

PRNS Mechanism Table Summary 

(Dollars in thousands) 

Program Activity 

FY 2018 

Final 

No. Amount 

FY 2019 

Enacted 

No. Amount 

FY 2020 

President's 

Budget 

No. Amount 

Grants/Cooperative Agreements: 

Supplements............................................................. 

376 $166,040 

297 197,067 

--- 8,470 

558 $316,071 

164 87,971 

--- 8,519 

762 $344,135 

99 35,710 

--- 3,195 

Subtotal................................................................. 673 371,577 722 412,562 861 383,040 

Contracts: 

New/Competing...................................................... 

26 26,876 

11 2,065 

17 28,131 

33 19,984 

7 27,853 

2 18,995 

Subtotal................................................................. 37 28,941 50 48,115 9 46,848 

Total, Substance Abuse Treatment 710 $399,091 772 $460,677 870 $429,888 

245 
246

SAMHSA/Substance Abuse Treatment

PRNS Mechanism Table by Program, Project, and Activity

(Dollars in thousands)

Programs of Regional & National Significance

FY 2018

Final

FY 2019

Enacted

FY 2020

President's

Budget

No Amount No Amount No Amount

Capacity:

Opioid Treatment Programs/Regulatory Activities

Grants

Continuations.......................................................................... 1 $1,399 29 $4,391 40 $6,057

New/Competing ....................................................................... 28 3,976 11 1,650 --- ---

Supplements*........................................................................... 1 1,000 --- --- --- ---

Subtotal.................................................................................. 29 6,375 40 6,041 40 6,057

Contracts 652

Continuations.......................................................................... 2 1,668 2 2,393 1 1,228

New/Competing ....................................................................... 4 682 3 290 1 1,439

Subtotal.................................................................................. 6 2,349 5 2,683 2 2,667

Total, Opioid Treatment Programs/Regulatory Activities 35 8,724 45 8,724 42 8,724

Screening, Brief Intervention and Referral to Treatment

Grants

Continuations.......................................................................... 20 11,233 8 13,266 --- ---

New/Competing ....................................................................... 3 10,884 13 14,413 --- ---

Supplements*........................................................................... 8 200 8 200 --- ---

Subtotal.................................................................................. 23 22,317 21 27,879 --- ---

Contracts

Continuations.......................................................................... 1 1,563 1 1,760 --- ---

New/Competing ....................................................................... --- 820 --- 361 --- ---

Subtotal.................................................................................. 1 2,383 1 2,121 --- ---

Total, Screening, Brief Intervention and Referral to

Treatment 24 24,700 22 30,000 --- ---

Targeted Capacity Expansion

Grants

Continuations.......................................................................... 31 21,159 6 69,446 169 83,935

New/Competing ....................................................................... 6 67,982 30 23,165 18 6,026

Supplements*........................................................................... 32 1,225 32 1,700 --- 1,550

Subtotal.................................................................................. 37 90,366 36 94,311 187 91,511

Contracts

Continuations.......................................................................... 18 5,115 6 5,253 --- 6,059

New/Competing ....................................................................... 6 -289 30 628 --- 2,621

Supplements*........................................................................... 21 --- 32 --- --- ---

Subtotal.................................................................................. 24 4,826 36 5,881 --- 8,681

Total, Targeted Capacity Expansion 61 95,192 72 100,192 187 100,192
247

SAMHSA/Substance Abuse Treatment

PRNS Mechanism Table by Program, Project, and Activity

(Dollars in thousands)

Programs of Regional & National Significance

FY 2018

Final

FY 2019

Enacted

FY 2020

President's

Budget

No Amount No Amount No Amount

Pregnant and Postpartum Women

Grants

Continuations.......................................................................... 24 14,041 44 25,691 43 23,333

New/Competing....................................................................... 22 12,786 2 1,048 3 3,278

Supplements*........................................................................... 46 1,150 46 1,150 --- 1,125

Subtotal ................................................................................. 46 27,977 46 27,889 46 27,736

Contracts

Continuations........................................................................... --- 1,608 --- 1,569 --- 1,814

New/Competing....................................................................... --- 346 --- 473 --- 381

Subtotal ................................................................................. --- 1,954 --- 2,042 --- 2,195

Total, Pregnant and Postpartum Women 46 29,931 46 29,931 46 29,931

Recovery Community Services Program

Grants

Continuations........................................................................... 10 1,496 13 1,949 3 450

New/Competing....................................................................... 3 450 --- --- 9 1,350

Supplements **....................................................................... 13 325 13 325 --- ---

Subtotal ................................................................................. 13 2,271 13 2,274 12 1,800

Contracts

Continuations........................................................................... --- 131 --- 128 2 554

New/Competing....................................................................... --- 32 --- 33 --- 80

Subtotal ................................................................................. --- 163 --- 160 2 634

Total, Recovery Community Services Program 13 2,434 13 2,434 14 2,434

Children and Families

Grants

Continuations........................................................................... 13 9,914 42 24,083 46 26,255

New/Competing....................................................................... 31 16,106 4 2,117 --- ---

Supplements *.......................................................................... 14 350 --- 300 --- ---

Subtotal ................................................................................. 44 26,370 46 26,500 46 26,255

Contracts

Continuations........................................................................... 1 2,941 1 2,866 1 3,255

New/Competing....................................................................... --- 294 --- 239 --- 95

Subtotal ................................................................................. 1 3,235 1 3,105 1 3,350

Total, Children and Families 45 29,605 47 29,605 47 29,605
248

SAMHSA/Substance Abuse Treatment

PRNS Mechanism Table by Program, Project, and Activity

(Dollars in thousands)

Programs of Regional & National Significance

FY 2018

Final

FY 2019

Enacted

FY 2020

President's

Budget

No Amount No Amount No Amount

Treatment Systems for Homeless

Grants

Continuations ......................................................................... 63 20,089 66 24,783 70 27,577

New/Competing...................................................................... 33 13,088 21 8,049 16 4,888

Supplements * ..................................................................... 94 720 87 790 20 520

Subtotal .............................................................................. 96 33,897 87 33,621 86 32,985

Contracts

Continuations ......................................................................... 1 2,702 1 2,537 — 2,205

New/Competing...................................................................... — -213 — 228 1 1,196

Subtotal .............................................................................. 1 2,489 1 2,765 1 3,401

Total, Treatment Systems for Homeless 97 36,386 88 36,386 87 36,386

Minority AIDS

Grants

Continuations ........................................................................ 82 40,476 95 46,886 119 58,895

New/Competing...................................................................... 36 17,663 24 12,000 — —

Supplements * ...................................................................... 113 2,825 — 2,975 — —

Subtotal .............................................................................. 118 60,964 119 61,861 119 58,895

Contracts

Continuations .......................................................................... 1 3,523 1 3,438 — 3,822

New/Competing....................................................................... — 47 — 271 — 2,853

Subtotal ................................................................................. 1 3,570 1 3,709 — 6,675

Total, Minority AIDS 119 64,534 120 65,570 119 65,570

Criminal Justice Activities

Grants

Continuations .......................................................................... 111 35,930 167 60,637 167 65,530

New/Competing....................................................................... 107 45,924 51 21,050 48 15,442

Supplements * ......................................................................... — — — — — —

Subtotal ................................................................................. 218 81,854 218 81,687 215 80,972

Contracts

Continuations .......................................................................... 2 6,598 2 6,616 1 6,939

New/Competing....................................................................... — 548 — 697 — 1,089

Subtotal ................................................................................. 2 7,146 2 7,313 1 8,028

Total, Criminal Justice Activities 220 89,000 220 89,000 216 89,000

Improving Access to Overdose Treatment

Grants

Continuations .......................................................................... 5 973 5 948 12 952

New/Competing....................................................................... — — — -80 — 19

Supplements * ......................................................................... — — 5 104 — —

Subtotal ................................................................................. 5 973 5 972 12 971

Contracts

Continuations .......................................................................... — 27 — 27 — 29

New/Competing....................................................................... — — — — — —

Subtotal ................................................................................. — 27 — 28 — 29

Total, IATOT 5 — 5 1,000 12 1,000
249

SAMHSA/Substance Abuse Treatment

PRNS Mechanism Table by Program, Project, and Activity

(Dollars in thousands)

Programs of Regional & National Significance

FY 2018

Final

FY 2019

Enacted

FY 2020

President's

Budget

No Amount No Amount No Amount

Building Communities of Recovery

Grants

Continuations......................................................................... 5 814 24 4,490 19 3,675

New/Competing..................................................................... 19 3,666 --- 518 5 825

Supplements * ..................................................................... 27 675 27 675 --- ---

Subtotal ............................................................................. 24 5,155 24 5,683 24 4,500

Contracts

Continuations......................................................................... --- 269 --- 315 --- 361

New/Competing..................................................................... --- 3 --- 3 --- 1,139

Subtotal ............................................................................. --- 271 --- 317 --- 1,500

Total, Building Communities of Recovery 24 5,000 24 6,000 24 6,000

Grants to Prevent Prescription Drug/Opioid OverdoesRelated Deaths

Grants

Continuations......................................................................... --- --- 12 11,262 12 11,349

Supplements * ...................................................................... --- --- --- 300 --- ---

Subtotal ............................................................................. --- --- 12 11,562 12 11,349

Contracts

Continuations......................................................................... --- --- 1 157 1 469

New/Competing..................................................................... --- --- --- 281 --- 181

Subtotal ............................................................................. --- --- 1 438 1 651

Total, Grants to Prevent Prescription Drug/Opioid

Overdoes-Related Deaths — — 13 12,000 13 12,000

First Responder Training (CARA)

Grants

Continuations......................................................................... --- --- 35 19,216 50 27,717

New/Competing..................................................................... --- --- --- --- --- ---

Subtotal ............................................................................. --- --- 35 19,216 50 27,717

Contracts

Continuations......................................................................... --- --- 1 209 1 570

New/Competing..................................................................... --- --- --- 16,575 --- 7,713

Subtotal ............................................................................. --- --- 1 16,784 1 8,283

Total, First Responder Training (CARA) --- --- 36 36,000 51 36,000

Grants to Develop Curricula for DATA Act Waivers

Grants

Continuations......................................................................... --- --- --- --- --- ---

New/Competing..................................................................... --- --- --- --- --- 3,883

Subtotal ............................................................................. --- --- --- --- --- 3,883

Contracts

Continuations........................................................................ --- --- --- --- --- ---

New/Competing..................................................................... --- --- --- --- --- 117

Subtotal .............................................................................. --- --- --- --- --- ---

Total, Grants to Develop Curricula for DATA Act

Waivers --- --- --- --- --- 4,000

Total, Capacity 689 385,506 751 446,842 858 420,842
250

SAMHSA/Substance Abuse Treatment

PRNS Mechanism Table by Program, Project, and Activity

(Dollars in thousands)

Science and Service

FY 2018

Final

FY 2019

Enacted

FY 2020

President's

Budget

No Amount No Amount No Amount

Addiction Technology Transfer Centers

Grants

Continuations.......................................................................... 11 8,515 12 9,025 12 8,408

New/Competing ....................................................................... 1 500 — — — —

Subtotal.................................................................................. 12 9,015 12 9,025 12 8,408

Contracts

Continuations.......................................................................... — 487 — 474 — 548

New/Competing ....................................................................... — -456 — -454 — 90

Subtotal.................................................................................. — 31 — 21 — 638

Total, Addiction Technology Transfer Centers 12 9,046 12 9,046 12 9,046

SAT Minority Fellowship Program

Grants

Continuations.......................................................................... — — — — — —

New/Competing ....................................................................... 8 4,043 8 4,042 — —

Subtotal.................................................................................. 8 4,043 8 4,042 — —

Contracts

Continuations.......................................................................... — 244 1 389 — —

New/Competing ....................................................................... 1 252 — 358 — —

Subtotal.................................................................................. 1 496 1 747 — —

Total, Minority Fellowship Program (MF) 9 4,539 9 4,789 — —

Subtotal, Science and Service: 21 13,585 21 13,835 12 9,046

Total, Substance Abuse Treatment PRNS 710 399,091 772 460,677 870 429,888

* Excluding Supplements number count to avoid duplication.
Grant Awards Table 

(Whole Dollars) 

FY 2018 

Final 

FY 2019 

Enacted 

FY 2020 

President's 

Budget 

Number of Awards 673 722 861 

Average Award $552,119.83 $571,415.09 $444,877.81 

Range of Awards $300,000-$600,000 $300,000-$600,000 $300,000-$600,000 

251 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

State Targeted Response to the Opioid Crisis 

(Dollars in thousands) 

Program 

FY 2018 

Final 

FY 2019 

Enacted 

FY 2020 

President's 

Budget 

FY 2020 

President's 

Budget 

+/-

FY 2019 

Enacted 

State Targeted Response to the Opioid Crisis Grants............ $500,000 $--- $--- $---

Authorizing Legislation ...............................................Section 1003 of the 21st Century, Cures Act 

FY 2020 Authorization ............................................................................expired at the end of 2020 

Allocation Method ..................................................................................................................Grants 

Eligible Entities......................................................................................................States/Territories 

Program Description and Accomplishments 

Opioid abuse continues to cause a significant crisis across the nation. According to the CDC, drug 

overdose related deaths numbered more than 70,000 in 2017, with opioids accounting for more than 

47,000 of that number. As misuse and abuse of synthetic opioids has continued to rise, Americans 

are dealing with the devastating consequences that accompany this use including: loss of 

employment, social connectedness, increased criminal justice involvement, injury, and death. 

The State Targeted Response to the Opioid Crisis Grant Program (Opioid STR) was authorized under 

Section 1003 of the 21st Century Cures Act in 2016. The program aims to address the opioid crisis 

by increasing access to treatment, reducing unmet treatment need, and reducing opioid overdose 

related deaths through the provision of prevention, treatment, and recovery activities for opioid 

addiction. 

Grantees are required to: use epidemiological data to demonstrate the critical gaps in availability of 

treatment for opioid addiction in geographic, demographic, and service level terms; utilize evidencebased implementation strategies to identify which system design models will most rapidly address 

the gaps in their systems of care; implement prevention strategies; deliver evidence based treatment 

interventions including medication and psychosocial interventions; deliver recovery support 

services; and report progress toward increasing availability of treatment for opioid addiction and 

reducing opioid-related overdose deaths. 

The Opioid STR grants have helped states target these resources to address the particular problems 

they are facing with respect to opioids. States have applied lessons learned from the first and second 

year of this program and have identified ways to maximize impact and efficiency. States have 

quickly implemented a wide range of evidence-based prevention, treatment, and recovery 

interventions that respond to the unique needs in their communities 

In FY 2018, Opioid STR grants were awarded via formula to all 50 states, the District of Columbia, 

Puerto Rico, the Virgin Islands, Northern Marianas, Micronesia, Palau, and American Samoa. Funds 

were used to support a cross-site evaluation to demonstrate program effectiveness and technical 

assistance activities. 

252 
 

Funding History 

Fiscal Year Amount 

FY 2016 ---

FY 2017 $500,000,000 

FY 2018 $500,000,000 

FY 2019 ---

FY 2020 ---

Budget Request 

The FY 2020 President’s Budget Request is $0.0 million, level from the FY 2019 Enacted. However, 

the opioid work is moving forward under the State Opioid Response (SOR), funded at $1.5 billion 

in FY 2019. SAMHSA also requests $1.5 billion in the FY 2020 President’s Budget for the SOR

grants. 

. 

253 
 

 

 

 

 

 

 

 

 

 

Outputs and Outcomes Tables 

Program: Opioid-State Targeted Response 

Measure 

Year and Most Recent Result 

Target for Recent Result 

(Summary of Result) 

FY 2019 

Target 

FY 2020 

Target 

FY 2020 

Target 

+/-

FY 2019 

Target 

1.2.60 Increase in the number of 

admissions for OUD treatment. 

(Output) 

FY 2017: 121,781 

Target: 118,000.0 

(Target Exceeded) 

122,000.0 122,000.0 Maintain 

1.2.61 Increase in number of clients 

receiving recovery services. (Output) 

FY 2017: 33,602 

Target: 33,000.0 

(Target Exceeded) 

34,000.0 34,000.0 Maintain 

1.2.62 Increase number of 

practitioners receiving training for 

opioid use disorder treatment. 

(Output) 

FY 2017: 163,467 

Target: 31,600.0 

(Target Exceeded) 

164,000.0 164,000.0 Maintain 

254 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

State Opioid Response Grants 

(Dollars in thousands) 

Program 

FY 2018 

Final 

FY 2019 

Enacted 

FY 2020 

President's 

Budget 

FY 2020 

President's 

Budget 

+/-

FY 2019 

Enacted 

State Opioid Response Grants........................................ $1,000,000 $1,500,000 $1,500,000 $---

Authorizing Legislation .............................................Section 509 of the Public Health Service Act 

FY 2020 Authorization ................................................................................................$333,806,000 

Allocation Method ....................................Competitive Grants/Contracts/Cooperative Agreements 

Eligible Entities................................................. Limited to Single State Agencies (SSAs) and U.S. 

Territories 

Program Description & Accomplishments 

The State Opioid Response Grants (SOR) program was established by Congress in 2018 in order to 

address the public health crisis caused by escalating opioid misuse and addiction across the nation. 

According to the CDC, opioid related deaths numbered more than 70,000 in 2017, with opioids 

accounting for more than 47,000 of that number. The SOR program will provide resources to states, 

territories, and tribes to continue and enhance the development of comprehensive strategies focused 

upon preventing, intervening, and promoting recovery from problems related to opioid abuse. 

This program aims to address the opioid crisis by increasing access to medication-assisted treatment 

using the three FDA-approved medications for the treatment of opioid use disorder, reducing unmet 

treatment need, and reducing opioid overdose related deaths through the provision of prevention, 

treatment and recovery activities for opioid use disorder (OUD) (including prescription opioids, 

heroin and illicit fentanyl and fentanyl analogs). This program awarded grants to 56 states and 

territories via formula, and to tribal recipients. The program includes a 15 percent set-aside for the 

10 states with the highest mortality rate related to drug overdose deaths and a $50 million set-aside 

for tribes. 

The SOR program requires grantees to : use epidemiological data to demonstrate the critical gaps in 

availability of treatment for OUDs in geographic, demographic, and service level terms; utilize 

evidence-based implementation strategies to identify which system design models will most rapidly 

and adequately address the gaps in their systems of care; deliver evidence-based treatment 

interventions that include medication(s) FDA-approved specifically for the treatment of OUD, and 

psychosocial interventions; report progress toward increasing availability of medication-assisted 

treatment for OUD and reducing opioid-related overdose deaths. 

The program supplements activities pertaining to opioids currently undertaken by the state agency 

and will support a comprehensive response to the opioid epidemic. The program identifies gaps and 

resources, while building upon existing substance use prevention and treatment activities as well as 

community-based recovery support services. Grantees are required to describe how they will expand 

access to treatment and recovery support services. Grantees are required to describe how they will 

advance substance misuse prevention in coordination with other federal efforts. 

255 
 

 

 

 

 

 

 

 

Grantees must use funding to supplement and not supplant existing opioid prevention, treatment, 

and recovery activities in their state. Grantees are required to describe how they will improve 

retention in care, using a chronic care model or other innovative model that has been shown to 

improve retention in care. 

Funding History 

Fiscal Year Amount 

FY 2016 ---

FY 2017 ---

FY 2018 $1,000,000,000 

FY 2019 $1,500,000,000 

FY 2020 $1,500,000,000 

Budget Request 

The FY 2020 President’s Budget request is $1.5 billion, level with the FY 2019 Enacted level. The 

program will continue to support States and territories, including a 15 percent set-aside for the 10 

states with the highest mortality rates related to drug overdose deaths. The program will include a 

$50 million set-aside for tribes. SAMHSA intends to continue to support the Secretary’s five- prong 

strategy to address the opioid crisis priorities through regulatory activities, ongoing training, 

certification, and technical assistance to states, provider groups and communities impacted by the 

opioid crisis. 

256 
 

 

 

 

 

 

 

 

 

 

 

 

Outputs and Outcomes Table 

Program: State Opioid Response Grants 

Measure 

Year and Most Recent Result 

Target for Recent Result 

(Summary of Result) 

FY 2019 

Target 

FY 2020 

Target 

FY 2020 

Target 

+/-

FY 2019 

Target 

1.2.70 Increase in the number of 

admissions for OUD treatment. 

(Output) 

FY 2018: Result Expected 

December 31, 2019 

Target: Set Baseline 

(Pending) 

Maintain 

1.2.71 Increase in number of clients 

receiving recovery services (Output). 

FY 2018: Result Expected 

December 31, 2019 

Target: Set Baseline 

(Pending) 

Maintain 

1.2.72 Increase number of 

practitioners receiving training. 

(Output) 

FY 2018: Result Expected 

December 31, 2019 

Target: Set Baseline 

(Pending) 

Maintain 

1.2.73 Decrease in illicit drug us at 6 

months follow-up. (Output) 

FY 2018: Result Expected 

December 31, 2019 

Target: Set Baseline 

(Pending) 

Maintain 

Note: SOR performance target is being developed. Please refer to the STR O&O table for performance results. 

257 
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258 
$---

 Budget Authority (non-add)......................................... 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Substance Abuse Prevention and Treatment Block Grant

(Dollars in thousands) 

Program 

FY 2018 

Final 

FY 2019 

Enacted 

FY 2020 

President's 

Budget 

FY 2020 

President's 

Budget 

+/-

FY 2019 

Enacted 

Substance Abuse Prevention and Treatment Block Grant 

PHS Evaluation Funds (non-add)............................. 

$1,858,079 

1,778,879 

79,200 

$1,858,079 

1,778,879 

79,200 

$1,858,079 

1,778,879 

79,200 

---

---

Authorizing Legislation ...........................................Section 1935 of the Public Health Service Act 

FY 2020 Authorization .............................................................................................$1,858,079,000 

Allocation Method ................................................................................................... Formula Grants 

Eligible Entities........................States, Territories, Freely Associated States, District of Columbia, 

and the Red Lake Band of Chippewa Indians of Minnesota 

Program Description and Accomplishments 

The Substance Abuse Prevention and Treatment Block Grant (SABG) program distributes funds to 

60 eligible states, territories and freely associated states111, the District of Columbia, and the Red 

Lake Band of Chippewa Indians of Minnesota (referred to collectively as states) to plan, carry out, 

and evaluate substance abuse prevention and treatment, and recovery support services for 

individuals, families, and communities impacted by substance abuse and misuse. The SABG’s 

overall goal is to support and expand substance abuse prevention and treatment services while 

providing maximum flexibility to grantees. 

The authorizing legislation and implementing regulation governing the SABG includes a number of 

prescriptive performance and expenditure requirements as well as explicit expenditure prohibitions. 

The states and jurisdictions have the flexibility to plan, carry out, and evaluate substance abuse 

treatment and recovery support services that reflect comments received from individuals, families 

and communities during the development of their respective biennial plans and the results of such 

plans are reflected in their respective annual reports. The legislation and regulation prioritizes two 

populations to be served with SABG funds: (1) substance using pregnant women and women with 

dependent children; and (2) persons who inject drugs. Although the legislation and regulation 

prioritizes such individuals, the states and jurisdictions have the flexibility to prioritize other 

underserved populations as determined by anecdotal and empirical data. For example, most states 

and jurisdictions prioritize substance abuse treatment and recovery support services for adolescents 

and transitional age youth. Some states and jurisdictions are also developing peer-to-peer recovery 

support services to facilitate individuals’ entry to substance abuse treatment services and to promote 

and support individuals in early recovery. States and jurisdictions frequently partner with other 

executive branch departments, e.g., education, human services, justice and public health, to 

coordinate services for individuals and families impacted by substance abuse and misuse. 

111 Territories include Guam, Puerto Rico, the Northern Mariana Islands, U.S. Virgin Islands and American Samoa. 

Freely Associated States, which have signed Compacts of Free Association with the United States, include the 

Republic of Palau, Federated States of Micronesia and Republic of the Marshall Islands. Retrieved from 

http://www.doi.gov//oia/islands/index.cfm 

259 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

The SABG is critically important because it provides the states and their respective SABG subrecipients, including, but not limited to, administrative service organizations, county and municipal 

governments, and prevention and treatment providers, the flexibility to respond to local and/or 

regional emergent issues impacting health, public health, and public safety through a consistent 

federal funding stream. SABG accounts for approximately 32 percent of total state substance abuse 

agency funding and 23 percent of total state substance abuse prevention and public health funding.112 

Individuals and families without health coverage or whose health insurance benefit will not cover 

certain services (e.g., recovery support) rely on services funded by the SABG. Block grant funds 

are being leveraged by states, along with other funding sources, to support training for staff and 

implementation of evidence-based practices for the prevention of substance misuse and the treatment 

of drug/alcohol addiction, improved business practices such as facilitating enrollment in appropriate 

health coverage and use of health information technology and integration of physical and behavioral 

health.113 SAMHSA encourages states to use block grant resources to support and not supplant 

services that are covered through commercial and public insurer plans. 

SAMHSA block grant funds are directed toward four purposes: 

 Fund priority treatment and support services for individuals without insurance or for whom 

coverage is terminated for short periods of time. 

 Fund those priority treatment and support services not covered by Medicaid, Medicare, or 

private insurance for low-income individuals and that demonstrate success in improving 

outcomes and/or supporting recovery. 

 Fund primary prevention for individuals not identified as needing treatment (which may 

include universal programs that are targeted to the general public or a whole population group 

that has not been identified on the basis of individual risk, selective activities that are targeted 

to individuals or a subgroup of the population whose risk of developing a disorder is 

significantly higher than average, and indicated prevention activities that are targeted to 

individuals in high-risk environments, identified as having minimal but detectable signs or 

symptoms foreshadowing disorder or having biological markers indicating predisposition for 

disorder but not yet meeting diagnostic levels). 

 Collect performance and outcome data to determine the ongoing effectiveness of behavioral 

disorder treatment, and recovery support services and to plan the implementation of new 

services on a nationwide basis. 

SAMHSA also encourages the states to use their block grants to: (1) allow the pursuit of recovery 

through personal choice and many pathways; (2) encourage providers to assess performance based 

on outcomes that demonstrate client successes; and (3) expand capacity by increasing the number 

and types of providers who deliver clinical treatment and/or recovery support services. 

In addition to the states’ and jurisdictions’ plans and reports, the authorizing legislation provides 

SAMHSA with significant resources to support targeted technical assistance to the SABG grantees 

and their respective sub-recipients, i.e., community- and faith-based organizations approved by the 

112 SABG State Agency Reported Expenditures by Target Activity Within Source of Funds, State/Jurisdiction 

Selection: All States/Jurisdictions (2015) 

113 Case Studies of Three Policy Areas and Early State Innovators: 2014 State Profiles of Mental Health and 

Substance Use Disorder Agencies. HHS Publication in Press. Rockville, MD: Substance Abuse and Mental Health 

Services Administration. (2015). 

260 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

states and jurisdictions to provide substance abuse treatment and recovery support services. 

SAMHSA’s Knowledge Application Program (KAP) (http://www.samhsa.gov/kap) produces the 

Technical Assistance Public Series that provide practical guidance and information related to the 

delivery of substance abuse treatment services and related public health services to individuals and 

families. The KAP also produces the Treatment Improvement Protocol Series, a growing library of 

best practice guidelines, which are produced by a consensus-development process based on the 

experience and knowledge of clinical, research, and administrative experts. 

Funding Allocations and Requirements 

SABG funds are distributed114 through a formula grant that provides funding based on specified 

economic and demographic factors and is administered by SAMHSA’s Centers for Substance Abuse

Treatment (CSAT) and Center for Substance Abuse Prevention (CSAP). Of the amounts 

appropriated for the SABG program, 95 percent are distributed to states through a formula included 

in the authorizing legislation. Factors used to calculate the allotments include total personal income, 

resident population, total population data for territories, total taxable resources, and a cost of services 

index factor. The SABG also includes “hold harmless” provisions that limit fluctuations in

allotments as the total block grant appropriation changes from year to year. 

Maintenance of Effort: The SABG requires states to maintain its expenditures for certain substance 

abuse prevention and treatment activities at a level that is no less than the state’s average

expenditures for the previous two years. 

Funding Set-Asides and Other Requirements: The authorizing legislation and implementation 

regulation for the SABG includes specific funding set-asides, including 20 percent for primary 

prevention (see below), and five percent for early intervention service for HIV for designated 

states.115 The statute also includes performance requirements for the treatment of substance-using 

pregnant women and women with dependent children, and provides states with the flexibility to 

expend a combination of federal and non-federal funds. There are also requirements and potential 

penalty reduction of the block grant allotment if the state fails to enact and enforce laws prohibiting 

the sale or distribution of tobacco products to individuals under the age of 18. 

Coordination of Efforts: SAMHSA emphasizes that block grant recipients should coordinate and 

partner with government agencies, nonprofit organizations, consumers and families and providers 

to support integrated and coordinated services and programs. SAMHSA provides targeted technical 

assistance for SABG grantees through a technical assistance contract. 

Performance and Evaluation 

SAMHSA is undertaking a series of agency-wide efforts designed to develop a set of common 

performance, quality, and cost measures to demonstrate the impact of SAMHSA’s programs. 

Ultimately, SAMHSA and its state partners will collaborate to develop a streamlined behavioral 

health data system that complements other existing systems (e.g., Medicaid administrative and 

billing data systems, state mental health and substance abuse treatment data systems), ensures 

114 Block Grants and Formula Grants: A Guide for Allocation Calculations; 2007 Department of Health and Human 

Services, SAMHSA. 

115 Substance Abuse and Mental Health Services Administration. (2015). Block Grant Laws and Regulations. 

Retrieved from http://www.samhsa.gov/grants/block-grants/laws-regulations. 

261 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

consistency in the use of measures, and provides a more complete perspective of the delivery of 

mental and substance abuse treatment services. 

An independent evaluation of the SABG demonstrated how states leveraged the statutory 

requirements to expand existing or establish new treatment capacity in underserved areas of states 

and territories and to improve coordination of services with other state systems.116 SAMHSA data 

show that on average, the SABG has been successful in expanding treatment capacity by annually 

supporting approximately two million117 admissions to treatment programs receiving public funding. 

Outcome data for the Block Grant program show positive results as reported through Behavioral 

Health Services Information System/Treatment Episode Data Set (TEDS) administered by 

SAMHSA’s Center for Behavioral Health Statistics and Quality. In FY 2015, at discharge, clients 

demonstrated above average abstinence rates from both illegal drug (55 percent) and alcohol 

(75.5 percent) use. State substance abuse authorities reported the following outcomes for services 

provided during FY 2016, the most recent year for which data is available: 

State substance abuse authorities reported the following outcomes for services118 provided during 

FY 2017, the most recent year for which data is available: 

 For the 50 states, American Samoa, the District of Columbia, Guam, Micronesia, Northern 

Marianas, and Puerto Rico that reported data concerning abstinence from alcohol use, 56 of 

the 56 identified improvements in client abstinence; 

 Similarly, for the 55 states, American Samoa, the District of Columbia, Guam, Northern 

Marianas, and Puerto Rico that reported data concerning the abstinence from drug use, 55 of 

55 identified improvements in client abstinence; 

 For the 49 states, American Samoa, the District of Columbia, Guam, Marshall Islands, 

Micronesia, Northern Marianas, the District of Columbia, Palau, Puerto Rico, and Red Lake 

that reported employments data, 50 of 58 identified improvements in client employment; 

 For the 49 states, American Samoa, the District of Columbia, Guam, Micronesia, Northern 

Marianas, Palau, Puerto Rico, and Red Lake that reported criminal justice data, 50 of 57 

reported an increase in clients with no arrests based on data reported to TEDS; 

 For the 49 states, American Samoa, the District of Columbia, Guam, Northern Marianas, 

Palau, and Red Lake that reported housing data, 49 of 55 identified improvements in stable 

housing for clients based on data reported to TEDS; and 

 For the 44 states, the District of Columbia, Guam, Puerto Rico, and Red Lake that reported 

recovery support data, 45 states out of 48 identified improvements in client engagement in 

recovery support programs. 

20 Percent Primary Prevention Set-Aside 

SAMHSA is responsible for managing the 20 percent primary prevention set-aside of the SABG. 

The 20 percent set-aside requires SABG grantees to spend at least 20 percent of their SABG 

116 Substance Abuse and Mental health Administration. Retrieved from 

https://www.samhsa.gov/sites/default/files/grants/sapt-bg-evaluation-final-report.pdf. 117 Source: Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services 

Administration, Treatment Episode Data Set (TEDS). Data received through 01 May 2018. 

118 Services include services from Short-term residential, Long-term residential, Outpatient, and Intensive outpatient 

only. 

262 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

expenditures to develop and implement a comprehensive substance abuse prevention program, 

which includes a broad array of prevention strategies directed at individuals not identified to be in 

need of treatment.119 The prevention set-aside is one of SAMHSA’s main vehicles for supporting

SAMHSA’s initiatives aimed at preventing substance abuse and mental illness. The 20 percent setaside is focused only on substance abuse prevention. States use these funds to develop infrastructure 

and capacity and to fund programs specific to primary substance abuse prevention. Some states rely 

solely on the 20 percent set-aside to fund their prevention systems while others use the funds to 

target gaps and enhance existing program efforts. 

States are encouraged to make prevention a top priority, taking advantage of recent science, best 

practices in community coordination, proven planning processes, and the findings articulated by the 

Institute of Medicine report, Preventing Mental, Emotional, and Behavioral Disorders Among 

Young People.120 SAMHSA regularly works with states to improve their accountability systems for 

prevention and to establish necessary reporting capacities. 

Synar 

The Synar program is the set of actions put in place by states, with the support of the federal 

government, to implement the requirements of the Synar Amendment. The Synar Amendment 

requires states to ensure tobacco is not sold to individuals under age 18.121 The Amendment was 

developed in the context of a growing body of evidence about the health problems related to tobacco 

use by youth, as well as evidence about the ease with which youth could purchase tobacco products 

through retail sources. The Synar program is a critical component of the success of youth tobacco 

use prevention efforts. SAMHSA is charged with overseeing states’ implementation of the Synar

requirements and provides technical assistance to states on both the Synar requirements and youth 

tobacco access issues in general. 

While the national weighted retailer violation rate declined steadily from the program’s baseline

year in FY 1997 through FY 2011, the rate has increased slightly since FY 2012. One of the greatest 

predictors of a state's retailer violation rate is the amount and reach of their enforcement efforts. As 

states have faced budget shortfalls, some have scaled back their enforcement programs and this may 

be contributing to the increase in the rate of tobacco sales to youth. Also, under the Synar program, 

SAMHSA encourages states to include in their inspections the types of tobacco products most often 

used by youth in their states. As states have expanded the types of tobacco products included in 

their Synar inspections, some states are reporting that retailers are sometimes more likely to sell noncigarette tobacco products, including smokeless tobacco, to youth. These factors are likely 

contributing to the overall increase in the national weighted retailer violation rate. SAMHSA is 

addressing this increase by providing technical assistance to states, as well as examining Synar data 

in order to provide states with guidance on best practices including enforcement, merchant 

education, and community mobilization. 

119 Substance Abuse and Mental Health Services Administration (2015). Substance Abuse Prevention and Treatment 

Block Grant. Retrieved from http://www.samhsa.gov/grants/block-grants/sabg 120 "Front Matter." Preventing Mental, Emotional, and Behavioral Disorders Among Young People: Progress and 

Possibilities. Washington, DC: The National Academies Press, 2009. Retrieved from 

https://www.ncbi.nlm.nih.gov/books/NBK32775/. 121 Substance Abuse and Mental Health Services Administration (2015). Synar Program. Retrieved from 

http://www.samhsa.gov/synar 

263 
Fiscal Year Amount 

FY 2010 

 

 

 

 

 

 

 

 

 

 

1,454,713,000

FY 2011 1,782,528,000

FY 2012 1,800,332,000

FY 2013 1,710,306,376

FY 2014 1,815,443,000

FY 2015 1,819,856,000

FY 2016 1,858,079,000

FY 2017 1,858,079,000

FY 2018 1,858,079,000

FY 2019 1,858,079,000

FY 2020 1,858,079,000

 

 

 

Funding History 

Budget Request 

The FY 2020 President’s Budget request is $1.9 billion, level with the FY 2019 Enacted level. 

SABG funds will continue to serve as a source of safety net funding, including assistance to states 

in addressing the opioid epidemic, and will continue to support certain services (e.g., recovery 

support services) not covered by commercial insurance and non-clinical activities and services that 

address the critical needs of state substance abuse prevention and treatment service systems. 

264 
Substance Abuse and Mental Health Services Administration

FY 2020 Substance Abuse Prevention and Treatment Block Grant Final 

Allotments

Appropriation Amount $1,858,079,000, State-Territory Total $1,760,148,598

State/Territory

FY 2018

Final

FY 2019

Enacted

FY 2020

President's

Budget

FY 2020

+/-

FY 2019

Alabama $23,091,917 $23,093,030 $23,086,709 -$6,321

Alaska 5,889,694 5,889,978 5,888,366 -1,612

Arizona 40,379,307 40,432,857 40,421,789 -11,068

Arkansas 13,525,921 13,526,573 13,522,870 -3,703

California 254,441,548 254,453,810 254,384,161 -69,649

Colorado 28,780,376 28,919,201 28,911,285 -7,916

Connecticut 18,214,143 18,215,021 18,210,035 -4,986

Delaware 6,968,530 6,968,866 6,966,958 -1,908

District Of Columbia 6,968,530 6,968,866 6,966,958 -1,908

Florida 111,391,028 111,396,395 111,365,902 -30,493

Georgia 57,158,236 57,160,990 57,145,343 -15,647

Hawaii 8,583,122 8,583,536 8,581,186 -2,350

Idaho 8,536,737 8,537,148 8,534,811 -2,337

Illinois 67,652,901 67,656,161 67,637,641 -18,520

Indiana 32,249,482 32,251,036 32,242,208 -8,828

Iowa 13,094,727 13,095,358 13,091,773 -3,585

Kansas 11,900,916 11,901,489 11,898,231 -3,258

Kentucky 20,380,520 20,381,502 20,375,923 -5,579

Louisiana 25,029,067 25,030,273 25,023,421 -6,852

Maine 6,968,530 6,968,866 6,966,958 -1,908

Maryland 34,083,574 34,085,216 34,075,886 -9,330

Massachusetts 39,849,281 39,851,201 39,840,292 -10,909

Michigan 56,058,757 56,061,458 56,046,112 -15,346

Minnesota 24,104,577 24,105,738 24,099,139 -6,599

Mississippi 13,805,016 13,805,681 13,801,902 -3,779

Missouri 26,551,271 26,552,550 26,545,282 -7,268

Montana 6,968,530 6,968,866 6,966,958 -1,908

Nebraska 7,642,045 7,642,413 7,640,321 -2,092

Nevada 17,005,184 17,006,003 17,001,348 -4,655
State/Territory

FY 2018 

Final

FY 2019 

Enacted

FY 2020

President's 

Budget

FY 2020

+/FY 

2019

New Hampshire 6,968,530 6,968,866 6,966,958 -1,908

New Jersey 48,069,255 48,071,571 48,058,412 -13,159

New Mexico 9,566,121 9,566,582 9,563,963 -2,619

New York 111,841,839 111,847,228 111,816,612 -30,616

North Carolina 44,996,647 44,998,815 44,986,497 -12,318

North Dakota 6,534,236 6,534,551 6,532,762 -1,789

Ohio 64,542,533 64,545,643 64,527,975 -17,668

Oklahoma 17,151,147 17,151,973 17,147,278 -4,695

Oregon 20,580,513 20,581,505 20,575,871 -5,634

Pennsylvania 59,106,425 59,109,273 59,093,093 -16,180

Rhode Island 7,599,276 7,599,642 7,597,562 -2,080

South Carolina 23,720,271 23,721,414 23,714,921 -6,493

South Dakota 6,042,347 6,042,638 6,040,984 -1,654

Tennessee 31,981,615 31,983,156 31,974,401 -8,755

Texas 144,723,914 144,730,887 144,691,269 -39,618

Utah 16,590,328 16,591,127 16,586,585 -4,542

Vermont 6,460,555 6,460,866 6,459,097 -1,769

Virginia 41,984,325 41,986,348 41,974,855 -11,493

Washington 37,788,643 37,790,464 37,780,119 -10,345

West Virginia 8,433,568 8,433,974 8,431,665 -2,309

Wisconsin 27,200,848 27,202,159 27,194,713 -7,446

Wyoming 4,198,001 4,198,203 4,197,054 -1,149

Red Lake Indians 594,089 594,118 593,955 -163

American Samoa 344,188 345,273 345,976 703

Guam 1,024,684 1,104,675 1,124,221 19,546

Northern Marianas 331,527 347,649 351,075 3,426

Puerto Rico 22,790,599 22,580,187 22,515,780 -64,407

Palau 134,684 141,293 143,962 2,669

Marshall Islands 457,230 485,666 500,713 15,047

Micronesia 666,397 693,121 699,933 6,812

Virgin Islands 655,998 711,594 720,569 8,975

266
 

 

 

 

 

 

 

 

 

 

 

 

 

 

Outputs and Outcomes Tables 

Program: Prevention Set-Aside 

Measure 

Year and Most Recent Result 

Target for Recent Result 

(Summary of Result) 

FY 2019 

Target 

FY 2020 

Target 

FY 2020 

Target 

+/-

FY 2019 

Target 

2.3.63 Increase the percent of states 

showing an increase in state level 

estimates of survey respondents who 

rate the risk of substance abuse as 

moderate or great (age 12-17). 

(Outcome) 

FY 2017: 37.3 % 

Target: 

(Set Baseline) 

37.3 % 37.3 % Maintain 

2.3.65 Increase the percent of states 

showing a decrease in state level 

estimates of percent of survey 

respondents who report 30 day use of 

alcohol (age 12-20). (Outcome) 

FY 2017: 53 % 

Target: 63 % 

(Target Not Met) 

53 % 53 % Maintain 

2.3.67 Increase the percent of states 

showing a decrease in state level 

estimates of percent of survey 

respondents who report 30 day use of 

other illicit drugs (age 12-17). 

(Outcome) 

FY 2017: 51 % 

Target: 

(Set Baseline) 

51 % 51 % Maintain 

2.3.68 Increase the percent of states 

showing a decrease in state level 

estimates of percent of survey 

respondents who report 30 day use of 

other illicit drugs (age 18+). 

(Outcome) 

FY 2017: 20 % 

Target: 

(Set Baseline) 

25% 25 % Maintain 

267 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Outputs and Outcomes Tables 

Program: Treatment Activities 

Measure 

Year and Most Recent Result 

Target for Recent Result 

(Summary of Result) 

FY 2019 

Target 

FY 2020 

Target 

FY 2020 

Target 

+/-

FY 2019 

Target 

1.2.43 Increase the number of 

admissions to substance abuse 

treatment programs receiving public 

funding. (Output) 

FY 2015: 1,806,941 

Target: 1,937,960 

(Target Not Met) 

1,880,000 1,880,000 Maintain 

1.2.48 Percentage of clients reporting 

no drug use in the past month at 

discharge. (Outcome) 

FY 2016: 69.6 % 

Target: 74 % 

(Target Not Met) 

74 % 74 % Maintain 

1.2.49 Increase the percentage of 

clients reporting no alcohol use in the 

past month at discharge. (Outcome) 

FY 2016: 83.1 % 

Target: 78 % 

(Target Exceeded) 

78 % 78 % Maintain 

1.2.50 Increase the percentage of 

clients reporting being employed/in 

school at discharge. (Outcome) 

FY 2016: 35.7 % 

Target: 43 % 

(Target Not Met) 

40 % 40 % Maintain 

1.2.51 Increase the percentage of 

clients reporting no involvement with 

the Criminal Justice System. 

(Outcome) 

FY 2016: 93.2 % 

Target: 92 % 

(Target Exceeded) 

92 % 92 % Maintain 

1.2.85 Increase the percentage of 

clients receiving services who had a 

permanent place to live in the 

community. (Outcome) 

FY 2016: 88.9 % 

Target: 92 % 

(Target Not Met) 

92 % 92 % Maintain 

268 
SAMHSA 

Health Surveillance and Program Support 

Table of Contents 

1. Health Surveillance ........................................................................................................ 271 

2. Drug Abuse Warning Network ...................................................................................... 278 

3. Performance and Quality Information Systems.............................................................. 280 

4. Program Support ............................................................................................................. 285 

5. Public Awareness Support .............................................................................................. 287 

269 
Page intentionally left blank 

270 
-$13,416 

-14,441

 

 

 

 

Health Surveillance 

(Dollars in thousands) 

Program Activity 

FY 2018 

Final 

FY 2019 

Enacted 

FY 2020 

President's 

Budget 

FY 2020 

President's 

Budget 

+/-

FY 2019 

Enacted 

Health Surveillance..................................................... 

Budget Authority (non-add).................................... 

PHS Evaluation Funds (non-add).......................... 

$47,258 

16,830 

30,428 

$47,258 

16,830 

30,428 

$33,842 

2,389 

31,453 1,025

Data Request and Publication User Fees..................... $1,500 $1,500 $1,500 $---

Authorizing Legislation ............................. Sections 501 and 505 of the Public Health Service Act 

FY 2020 Authorization ......................................................................................................Indefinite 

Allocation Method .................................................................. Federal/Intramural, Contracts, Other 

Eligible Entities.........................................................................................................Not Applicable 

Program Description and Accomplishments 

The Health Surveillance funding primarily supports the activities of the Center for Behavioral Health 

Statistics and Quality (CBHSQ). The detailed funding for each activity along with a detailed 

narrative description of each project follows. 

271 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Resources by Activity/Program 

(Dollars in thousands) 

FY 2018 

Final 

FY 2019 

Enacted 

FY 2020 

President's 

Budget 

FY 2020 

President's 

Budget 

+/-

FY 2019 

Enacted 

Health Surveillance and Program Support Appropriation 

Health Surveillance 

Population Data Collection, Analysis, and Dissemination............... $12,517 $15,008 $14,191 -$817 

PHS Evaluation (non add)............................................................. 5,656 8,575 12,133 3,558 

Treatment Services Data Collection, Analysis, and Dissemination. 13,711 14,620 11,522 -3,098 

PHS Evaluation (non add)............................................................ 13,706 11,517 11,522 5 

Behavioral Health Data Dissemination............................................. 3,706 4,065 596 -3,469 

PHS Evaluation (non add)............................................................. 297 402 596 194 

Performance Measurement/Systems................................................. 471 476 --- -476 

PHS Evaluation (non add)............................................................. 167 --- --- ---

Program Evaluations.......................................................................... 1,427 --- --- ---

PHS Evaluation (non add)............................................................. 1,427 --- --- ---

Evidence-Based Programs/Practices................................................. 793 --- --- ---

Innovation and Logistical Services Support..................................... 6,929 4,847 --- -4,847 

PHS Evaluation (non add)............................................................ 3,415 2,726 --- -2,726 

Support............................................................................................. 7,704 8,242 7,533 -710 

PHS Evaluation (non add)............................................................ 5,760 7,208 7,202 -6 

Total Health Surveillance $47,258 $47,258 $33,842 -$13,416 

Overview 

The Center for Behavioral Health Statistics and Quality is the government’s lead agency for 

behavioral health statistics. Authorized by Section 505 of the Public Health Service Act, which was 

reauthorized and amended by Section 6004 of the 21st Century Cures Act, CBHSQ performs 

activities that: (1) coordinate SAMHSA’s integrated data strategy, including collecting data each

year; (2) provide statistical and analytical support for SAMHSA’s activities; (3) manage a core set 

of performance metrics to evaluate activities supported by SAMHSA; (4) coordinate with the 

Assistant Secretary, the Assistant Secretary for Planning and Evaluation, National Mental Health 

and Substance Use Policy Lab, and SAMHSA’s Chief Medical Officer, as appropriate, to improve

the quality of data collection services and evaluations of SAMHSA activities. CBHSQ was recently 

reorganized to ensure compliance with the requirements set forth in the 21st Century Cures Act, 

including the establishment of the Office of Evaluation. 

CBHSQ activities are integrated and cross over multiple funding lines. CBHSQ receives funding 

for Health Surveillance (HS), Drug Abuse Warning Network (DAWN), and Performance and 

Quality Information Systems (PQIS) within the Health Surveillance and Program Support 

appropriation (HSPS) funding sources and the Substance Abuse Treatment appropriation from Block 

Grant Set Aside (BGSA) funding sources. In addition, in FY2018, CBHSQ received funding from 

the Mental Health Block Grant Set Aside to fund the Mental Disorder Prevalence Study. Programs 

are often funded from several sources. (A table detailing All Funding Sources follows the PQIS 

272 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

section). Under Health Surveillance, CBHSQ work includes Population Data Collection, Analysis, 

and Dissemination; Treatment Services Data Collection, Analysis, and Dissemination; and 

Behavioral Health Data Dissemination. Under PQIS, CBHSQ activities include 

Performance Measurement/Systems, Behavioral Health Data Dissemination, and Evidence-Based 

Programs/Practices. 

The total funding amount for CBHSQ (from all sources) in FY 2019 Enacted Budget is 

$122.9 million, including $67.3 million from Health Surveillance and Program Support (HSPS) 

Appropriation and $55.6 million from the Substance Abuse Treatment (SAT) Appropriation. 

Population Data Collection, Analysis, and Dissemination 

Section 505 of the Public Health Service Act (42 USC 290aa-4) requires SAMHSA to annually 

collect prevalence data on substance use and mental illness. To accomplish this, SAMHSA 

administers the National Survey on Drug Use and Health (NSDUH). NSDUH is an annual collection 

of behavioral health data on approximately 67,500 persons aged 12 or older of the U.S. civilian, noninstitutionalized population. NSDUH is the nation’s primary source of statistical information on the 

use of illicit drugs, alcohol, and tobacco, certain mental health issues, co-occurring drug/alcohol 

addiction and mental illness, and treatment for substance abuse and mental health issues. NSDUH 

data provide estimates at the national, state, and sub-state level and among demographic, 

socioeconomic or geographic subgroups, as well as trend estimates over time. NSDUH data provide 

states the opportunity to focus on their leading public health challenges through the release of statespecific data. Each year, three simultaneous NSDUH activities are ongoing: planning for future 

surveys, collecting data on over 67,500 persons in the current year survey, and analysis and 

dissemination of data from previous collections. 

The data from the FY 2017 NSDUH estimates that 30.5 million Americans aged 12 or older, or 11.2 

percent were current (past month) illicit drug users. 122 Also, from the 2017 NSDUH, 18.9 percent of 

adults ages 18 and older had any mental illness in the past year (46.6 million) and 4.5 percent (11.2 

million) of adults had serious mental illness. 

In FY 2018, SAMHSA began a NSDUH redesign to ensure the survey is clinically up-to-date 

through alignment of questions to the Diagnostic and Statistical Manual of Mental Disorders, Fifth 

Edition (DSM-5). Other potential areas for the next possible redesign include, but are not limited 

to, electronic cigarettes, illicitly manufactured fentanyl, synthetic marijuana, and harmonizes the 

substance abuse and mental health treatment measures to produce national estimates. 

SAMHSA included recovery questions for FY 2018, and plans to include medication-assisted 

treatment questions and kratom questions for FY 2019, and vaping, synthetics use, and craving and 

withdrawal questions from DSM-5 for FY 2020. 

124Substance Abuse and Mental Health Services Administration. (2018). Key substance use and mental health 

indicators in the United States: Results from the 2017 National Survey on Drug Use and Health (HHS Publication No. 

SMA 18-5068, NSDUH Series H-53). Rockville, MD: Center for Behavioral Health Statistics and Quality, Substance 

Abuse and Mental Health Services Administration. Retrieved from https://www.samhsa.gov/data/ 

273 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

NSDUH data are disseminated through public-use files made available online on the Substance 

Abuse and Mental Health Data Archive (SAMHDA) and restricted use data files are available at the 

National Center for Health Statistics (NCHS) Research Data Centers (RDCs) using an application 

process. Collectively, in FY 2017 and FY 2018, approximately 200 reports and articles were written 

by external researchers using SAMHDA data. In FY 2018, over 100,000 NSDUH download events 

for SAMHDA occurred and around 140,000 page views on the NSDUH webpages; in FY 2019, the 

same volume is anticipated. CBHSQ staff also responded to almost 700 requests for NSDUH data 

in FY 2018, including those from other Federal agencies, state and local governments, the media, 

researchers, and the public. 

Treatment Services Data Collection, Analysis, and Dissemination 

Section 505 of the Public Health Service Act (42.U.S.C. 290aa-4) requires SAMHSA to collect data 

on mental illness and substance abuse treatment services. For this purpose, SAMHSA’s CBHSQ 

developed the Behavioral Health Services Information System (BHSIS). Data collected through the 

BHSIS provides information to the public on treatment services through the Behavioral Health 

Treatment Services Locator, part of the National Treatment Referral Service. The Locator provides 

accurate, timely, and regularly updated information on mental health and substance abuse treatment 

facilities across the country. BHSIS includes multiple data collection programs and information 

resources. BHSIS data collections comprise: (1) the National Mental Health Services Survey (NMHSS) which provides information on all public and private specialty mental health disorder 

treatment facilities in the United States; in 2018, the overall response rate was 90 percent; (2) the 

National Survey of Substance Abuse Treatment Services (N-SSATS) which provides information 

on all public and private substance abuse treatment facilities in the United States; in 2018, the overall 

response rate was 90 percent; (3) the Treatment Episode Data Set (TEDS) which provides 

demographic and services information on publicly funded admissions and discharges from substance 

abuse treatment; (4) the Mental Health Treatment Episode Data Set (MH-TEDS) and the Mental 

Health Client Level Data (MH-CLD) which provide demographic and services information on 

publicly funded admissions and discharges of clients in mental health treatment; and (5) the Uniform 

Reporting System (URS) which provides a set of standardized data tables submitted annually by 

states and territories as part of their Mental Health Block Grant (annual implementation reports. 

SAMHSA will be reviewing and updating N-SSATS and N-MHSS questions for the 2019 and 2020 

surveys. 

Another element of the BHSIS is the Inventory of Behavioral Health Services (I-BHS) which 

provides a listing of all known mental health and substance abuse treatment facilities, including 

active, inactive, open and closed facilities. As of July 2018, I-BHS had identified 20,452 active 

substance abuse treatment facilities and 14,331 active mental health treatment facilities in the United 

States and its territories. 

In FY 2017, the Behavioral Health Treatment Services Locator was accessed more than 2.7 million 

times by individuals, families, community groups, and organizations to identify appropriate 

treatment services. Also in FY 2018, researchers downloaded over 4,000 BHSIS public-use datasets. 

CBHSQ staff responded to over 100 requests for BHSIS data. In June 2018, data users accessed 

over 270 web pages for URS tables. 

In FY 2020, SAMHSA will award a new BHSIS contract for the annual N-SSATS and N-MHSS 

and TEDS, MH-CLD, URS and Locator. The Behavioral Health Treatment Services Locator is part 

274 
 

 

 

 

 

 

 

 

 

 

Fiscal Year Amount 

FY 2016 $47,258,000 

FY 2017 $47,258,000 

FY 2018 $47,258,000 

FY 2019 $47,258,000 

FY 2020 $33,842,000 

 

 

 

of the National Treatment Referral Routing Service, which is required by Section 9006 of the 21st 

Century Cures Act. 

Behavioral Health Data Dissemination 

OMB’s Open Data Policy Memorandum (M-13-13) requires the Federal Government to make data 

it collects accessible and usable through dissemination activities. This is accomplished by providing 

access to data through Substance Abuse and Mental Health Data Archive (SAMHDA) and National 

Center for Health Statistics (NCHS) Research Data Centers (RDC). 

SAMHDA makes public-use data files available to anyone for download, in a variety of formats. 

Once downloaded, a user can use their own software to manipulate and explore the data. From July 

2017 through June 2018, users downloaded over 120,000 Public Use Files (PUF) from SAMHDA 

and generated over 20,000 tables utilizing a web-based analytic tool. Through SAMHDA, CBHSQ 

provides access to public and restricted-use data through a web-based analytic tool. The analytic 

tool was launched in April 2017 and allows researchers to generate tables based on this data. 

In an effort to broaden researcher access to restricted-use micro-level data, SAMHSA collaborated 

with the National Center for Health Statistics (NCHS) to host SAMHSA restricted-use micro data 

at NCHS Research Data Centers (RDCs). Providing access to SAMHSA restricted-use data through 

the NCHS RDCs promote broader researcher access to these data and ensuring that researchers can 

access restricted-use data for important public health research. 

The Analytical Support Contract will continue to provide support for these activities as well as 

support for ad hoc requests, short- and long-term analyses, special requests, and evaluation activities. 

Funding History 

Budget Request 

The FY 2020 Request is $33.8 million, which is a decrease of $13.4 million from the FY 2019 

Enacted Budget. This funding will support the continuation of the NSDUH, BHSIS, SAMHDA, 

access to restricted-use data and the Analytic Support Center contracts. In FY 2020, SAMHSA will 

plan to roll out the results of the 2019 NSDUH survey, field the 2020 survey, plan for the 2021 

survey, and will continue to explore options for a future NSDUH redesign. 

275 
Mechanism Table for Health Surveillance 

(Dollars in thousands) 

Program Activity 

FY 2018 

Final 

No. Amount 

FY 2019 

Enacted 

No. Amount 

FY 2020 

President's 

Budget 

No. Amount 

Health Surveillance 

Contracts 

Continuations........................................................................ 

New/Competing.................................................................... 

1 $43,642 

--- 3,616 

1 $47,258 

--- ---

1 $33,842 

--- ---

Subtotal............................................................................. 1 47,258 1 47,258 1 33,842 

Total, Health Surveillance 1 47,258 1 47,258 1 33,842 

276 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Outputs and Outcomes Table 

Program: National Survey on Drug Use and Health 

Measure 

Year and Most Recent Result 

Target for Recent Result 

(Summary of Result) 

FY 2019 

Target 

FY 2020 

Target 

FY 2020 

Target 

+/-

FY 2019 

Target 

2.3.19L Percentage of adults with 

Serious Mental Illness (SMI) 

receiving mental health services 

(Outcome) 

FY 2018: Result Expected 

December 31, 2019 

Target: 66.0 % 

(Pending) 

68.0 % 71.0 % +3 % 

2.3.19M Percentage of people who 

meet criteria for needing substance 

use treatment who receive treatment 

from a specialty substance use 

disorder treatment provider (Outcome) 

FY 2018: Result Expected 

December 31, 2019 

Target: 11.5 % 

(Pending) 

12.0 % 12.5 % +0.5 % 

2.3.19N Past year prescription pain 

reliever misuse (age 12 and older) 

(Outcome) 

FY 2018: Result Expected 

December 31, 2019 

Target: 9,500,000.0 

(Pending) 

9,500,000.0 9,500,000.0 Maintain 

2.3.19O Percent of youth ages 12-17 

who experienced major depressive 

episodes with severe impairment in 

the past year receiving treatment for 

depression. (Outcome) 

FY 2018: Result Expected 

December 31, 2019 

Target: 43.0 % 

(Pending) 

45.0 % 50.0 % +5 % 

277 
$---

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Drug Abuse Warning Network (DAWN) 

(Dollars in thousands) 

Program Activity 

FY 2018 

Final 

FY 2019 

Enacted 

FY 2020 

President's 

Budget 

FY 2020 

President's 

Budget 

+/-

FY 2019 

Enacted 

Drug Abuse Warning Network................................ 

PHS Evaluation Funds (non-add).................... 

$10,000 

---

$10,000 

---

$10,000 

10,000 $10,000 

Authorizing Legislation Section 505 of the Public Health Service Act 

FY 2020 Authorization ..................................................................................................$10,000,000 

Allocation Method ............................................................................................................. Contracts 

Eligible Entities.........................................................................................................Not Applicable 

Program Description and Accomplishments 

SAMHSA re-established DAWN as a nationwide public health surveillance system to monitor 

emergency department visits related to recent substance use, including those related to opioids. 

Authorized by the 21st Century Cures Act, this program is necessary to respond effectively to the 

opioid and addiction crisis in the United States and to better inform public health, clinicians, 

policymakers, and other stakeholders to respond to emerging substance use trends. 

By using data collected directly from ED records, DAWN is able to capture detailed information 

about the substances involved in ED visits and will serve as an early warning system for the 

emergence of new and novel psychoactive substances. DAWN will seek to identify any sudden 

increases in visits involving specific substances in its hospitals and will monitor the geographic, 

temporal and demographic characteristics of drug-related ED visits. Unlike other public health 

surveillance systems, DAWN captures both ED visits that are directly caused by drugs, such as 

overdoses, and those in which drugs are a contributing factor but not the direct cause of the ED visit, 

such as motor vehicle crashes where the driver had mixed medications with alcohol. These criteria 

encompass all types of drug-related events, from substance use and misuse to substance-related 

suicide attempts, accidental ingestion and adverse reactions to pharmaceuticals. The detailed 

information collected by DAWN can be used to assess health hazards associated with specific 

substances, and monitor the impact of drug use, misuse, and abuse on the Nation's health care system. 

There are several important improvements for the new DAWN including timeliness of data, data 

available at more frequent intervals, and data collected from a wider range of geographic area types, 

278 
 

Fiscal Year Amount 

FY 2016 ---

FY 2017 ---

FY 2018 

FY 2019 

FY 2020 

$10,000,000

$10,000,000

$10,000,000

Mechanism Table for Drug Abuse Warning Network 

---

including urban, suburban and rural areas. Having data available more quickly means that DAWN 

can serve as a true “early warning” system and inform public health response efforts in local areas. 

DAWN data are abstracted from hospital emergency department records. Hospital participation is 

voluntary. 

Funding History 

Budget Request 

The FY 2020 President’s Budget is $10.0 million, which is level with the FY 2019 Enacted Budget. 

This funding will support the continuation of a contract awarded in FY 2018. 

(Dollars in thousands) 

Program Activity 

FY 2018 

Final 

No. Amount 

FY 2019 

Enacted 

No. Amount 

FY 2020 

President's 

Budget 

No. Amount 

Drug Abuse Warning Network 

Contracts 

Continuations..................................................................... 

New/Competing.................................................................. 

---

1 10,000 

1 10,000 

--- ---

1 10,000 

--- ---

Subtotal........................................................................... 1 10,000 1 10,000 1 10,000 

Total, Drug Abuse Warning Network 1 10,000 1 10,000 1 10,000 

279 
 

 

Performance and Quality Information Systems 

Resources by Activity/Program 

 

-$760 

-760

-556

-556

-837

-837

Performance and Quality Information Systems 

(Dollars in thousands) 

Program Activity 

FY 2018 

Final 

FY 2019 

Enacted 

FY 2020 

President's 

Budget 

FY 2020 

President's 

Budget 

+/-

FY 2019 

Enacted 

Performance and Quality Information Systems.......... $10,000 $10,000 $10,000 $---

Authorizing Legislation .................. Sections 501, 505, 509, 516, 520A, and 543A of the PHS Act 

FY 2020 Authorization ......................................................................................................Indefinite 

Allocation Method ............................................................................................................. Contracts 

Eligible Entities.........................................................................................................Not Applicable 

Program Description and Accomplishments 

The Performance and Quality Information Systems (PQIS) funding primarily supports the activities 

of the Center for Behavioral Health Statistics and Quality (CBHSQ). The detailed funding for each 

activity along with a detailed narrative description of each project follows. 

(Dollars in thousands) 

FY 2018 

Final 

FY 2019 

Enacted 

FY 2020 

President's 

Budget 

FY 2020 

President's 

Budget 

+/-

FY 2019 

Enacted 

Performance and Quality Information Systems 

Performance Measurement/Systems 

SAMHSA Performance Accountability Reports System (SPARS)... 

Evidence-Based Programs/Practices 

Evidence Based Resource Center........................................................ 

Behavioral Health Data Dissemination 

Analytic Support Center (ASC)........................................................ 

Drug Abuse Warning Network (DAWN) 

DAWN.............................................................................................. 

Innovation and Logistical Services Support 

Innovation and Logistical Services Support..................................... 

Support 

Operations............................................................................................ 

$7,516 

7,516 

2,000 

2,000 

---

---

---

---

---

---

484 

484 

$6,782 

6,782 

732 

732 

---

---

1,039 

1,039 

837 

837 

610 

610 

$6,022 

6,022 

741 

741 

2,069 

2,069 

483 

483 

---

---

685 

685 

8

8 

2,069 

2,069 

75

75 

Total Performance and Quality Information Systems $10,000 $10,000 $10,000 $---

280 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Performance Measurement and Performance Systems 

SAMHSA collects data on key output and outcome measures to monitor and manage grantee 

performance, improve the quality of services provided, and inform program evaluations. 

These data previously were collected by legacy systems, including Data Collection, Analyses, and 

Reporting (DCAR); Prevention Management Reporting and Training System (PMRTS); Services 

Accountability Improvement System (SAIS); and the Transformation Accountability System 

(TRAC). These legacy systems were migrated to a single system, SAMHSA’s Performance

Accountability and Reporting System (SPARS), in FY 2017 to meet SAMHSA’s vision of a more

efficient, holistic approach to its performance data collection. 

Data collected through SPARS are used to monitor the progress of SAMHSA’s discretionary grants, 

serve as a decision-making tool on funding, and improve the quality of services provided through 

the programs. SAMHSA will continue to implement the 21st Century Cures Act and make any 

necessary changes to improve the performance metrics used and to evaluate effectiveness of 

SAMHSA programs including updating client level data collection tools and modernizing SPARS 

data collections system for FY 2018 and FY 2019. Modernization activities will result in capturing 

real-time data using clinical diagnostic tools to document impact and effectiveness and develop 

benchmarks for performance evaluation. 

Program Evaluations 

The new Office of Evaluation (OE) will be responsible for providing centralized planning and 

management of program evaluation across SAMHSA in partnership with program originating 

Centers, providing oversight and management of agency quality improvement and performance 

management activities and for advancing agency goals and objectives relating to program 

evaluation, performance measurements, and quality improvement. Activities include development 

of evaluation language for funding announcements to ensure a clear statement of evaluation 

objectives, development and implementation of standard measures for evaluating program 

performance and improvement of services, the design of SAMHSA program evaluations in 

collaboration with the relevant Centers, identification of a set of performance indicators to monitor 

each SAMHSA program and the development of periodic evaluation reports for use in agency 

planning, program change, and reporting to departmental and external organizations. The OE will 

be working collaboratively with the National Mental Health and Substance Use Policy Lab 

(NMHSUPL) and the Office of the Chief Medical Officer to provide support for SAMHSA 

evaluations. 

National Resource Center for Evidence-based Programs and Practices 

Section 7002 of the 21st Century Cures Act requires that SAMHSA shall, as appropriate, improve 

access to reliable and valid information on evidence-based programs and practices, including 

information on the strength of evidence associated with such programs and practices related to 

mental illness and drug/alcohol addiction for states, local communities, non-profit entities, and other 

stakeholders, by posting on SAMHSA’s website information on evidence-based programs and 

practices that have been reviewed. 

281 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

In FY 2018, SAMHSA ended its existing approach to its National Registry of Evidence-based 

Programs and Practices (NREPP). That process lacked scientific rigor and resulted in some 

programs with a weak evidence base listed on the registry. SAMHSA is committed to the 

identification and implementation of EBPs across communities. In FY 2018, funding supported 

efforts by SAMHSA’s newly authorized National Mental Health and Substance Use Policy Lab

(NMHSUPL) to develop a scientifically rigorous approach to the implementation of the new 

Evidence-Based Programs Resource Center. 

In April 2018, SAMHSA launched a new Evidence Based Practice Resource Center (EBPRC). This 

new Resource Center, which is managed by the NMHSUPL, aims to provide communities, 

clinicians, policy-makers and others in the field with the information and tools they need to 

incorporate evidence-based practices into their communities or clinical settings. As part of this 

effort, SAMHSA plans to develop and disseminate additional resources such as new or updated 

Treatment Improvement Protocols, guidance documents, clinical practice policies, toolkits, and 

other actionable materials that incorporate the latest scientific evidence on mental health and 

substance use and address priority areas where more information or guidance are needed to help the 

field move forward. This new approach enables SAMHSA to more quickly develop and disseminate 

expert consensus on the latest prevention, treatment, and recovery science; collaborate with experts 

in the field to rapidly translate science into action; and provide communities and practitioners with 

tools to facilitate comprehensive needs assessment, match interventions to those needs, support 

implementation, and evaluate and incorporate continuous quality improvement into their prevention, 

treatment, and recovery efforts. This new strategy coupled with SAMHSA’s new regional and

locally-based training and technical assistance efforts will help to ensure that communities and 

practitioners are equipped to bring about the improvements in mental health and substance use 

prevention, treatment, and recovery our Nation requires. 

Behavioral Health Quality Measures 

Behavioral health quality activities are housed within CBHSQ. The Center, in collaboration with 

the Office of the Chief Medical Officer, provides oversight of the agency’s quality improvement 

efforts, including the identification of gaps in behavioral health quality measurement and the 

adoption and implementation of behavioral health quality measures. This work includes 

partnerships with the Center for Medicare & Medicaid Services (CMS) and the Assistant Secretary 

for Planning and Evaluation (ASPE), among other Federal partners, in quality measure work. 

CBHSQ serves as the SAMHSA lead to the National Quality Forum (NQF) as well as participates 

as a Federal advisor for other agencies conducting measure development work, including CMS and 

ASPE. CBHSQ also participates on the Measures Application Partnership, a group convened to 

guide HHS on measure adoption. 

CBHSQ staff provides internal collaborations across SAMHSA, advising on quality measure issues 

and identifying key next steps. CBHSQ staff regularly consults with other Federal agencies, the 

NQF, and other key stakeholders regarding behavioral health quality indicators, including barriers 

to and facilitators of data collection, tracking, and reporting. SAMHSA should continue its 

behavioral health quality measure activities through ongoing identification of behavioral health 

measurement gaps and the capacity to address such gaps. 

282 
Fiscal Year Amount 

FY 2016 $12,918,000 

FY 2017 $10,000,000 

FY 2018 $10,000,000 

FY 2019 $10,000,000 

FY 2020 $10,000,000 

 

 

 

Funding History 

Budget Request 

The FY 2020 President’s Budget is $10.0 million, which is level with the FY 2019 Enacted Budget. 

SAMHSA will use these funds to continue performance management, quality improvement, and 

program evaluation activities. This funding will ensure that SAMHSA continues a strong focus on 

developing and implementing evidence-based practices and programs and continues emphasis on 

performance management for quality improvement and program monitoring. 

Mechanism Table for Performance and Quality Information Systems 

(Dollars in thousands) 

Program Activity 

FY 2018 

Final 

No. Amount 

FY 2019 

Enacted 

No. Amount 

FY 2020 

President's 

Budget 

No. Amount 

Performance and Quality Information Systems 

Contracts 

Continuations................................................................. 

New/Competing.............................................................. 

1 8,000 

1 2,000 

2 10,000 

--- ---

2 10,000 

--- ---

Subtotal........................................................................ 2 10,000 2 10,000 2 10,000 

Total, Performance and Quality Information Systems 2 10,000 2 10,000 2 10,000 

283 
284

The following table provides a detailed description of all funding sources supporting CBHSQ

activities.

Center for Behavioral Health Statistics and Quality

Breakout by Activity/Program (all sources)

(Dollars in thousands)

FY 2018

Final

FY 2019

Enacted

FY 2020

President's

Budget

FY 2020

President's

Budget

+/-

FY 2019

Enacted

Substance Abuse Treatment Appropriation

Substance Abuse Block Grant Set Aside

Population Data Collection, Analysis, and Dissemination ................................................. $47,347 $45,052 $41,656 -$3,396

PHS Evaluation (non add)..................................................................................... 47,347 45,052 41,656 -3,396

Treatment Services Data Collection, Analysis, and Dissemination ................................... 5,162 4,596 7,724 3,128

PHS Evaluation (non add)..................................................................................... 5,162 4,596 7,724 3,128

Behavioral Health Data Dissemination.............................................................................. 1,096 835 902 67

PHS Evaluation (non add)..................................................................................... 1,096 835 902 67

Innovation and Logistical Services Support....................................................................... 397 --- --- ---

PHS Evaluation (non add)..................................................................................... 397 --- --- ---

Support ............................................................................................................................... 4,577 5,118 5,304 186

PHS Evaluation (non add)..................................................................................... 4,577 5,118 5,304 186

Total Substance Abuse Block Grant Set Aside 58,578 55,601 55,586 -15

Total Substance Abuse Treatment PHS Evaluation 58,578 55,601 55,586 -15

Health Surveillance and Program Support Appropriation

Health Surveillance

Population Data Collection, Analysis, and Dissemination ................................................. 12,517 15,008 14,191 -817

PHS Evaluation (non add)..................................................................................... 5,656 8,575 12,133 3,558

Treatment Services Data Collection, Analysis, and Dissemination.................................... 13,711 14,620 11,522 -3,098

PHS Evaluation (non add)..................................................................................... 13,706 11,517 11,522 5

Behavioral Health Data Dissemination.............................................................................. 3,706 4,065 596 -3,469

PHS Evaluation (non add)..................................................................................... 297 402 596 194

Performance Measurement/Systems................................................................................... 471 476 --- -476

PHS Evaluation (non add)..................................................................................... 167 --- --- ---

Pro gram Evaluations .......................................................................................................... 1,427 --- --- ---

PHS Evaluation (non add)..................................................................................... 1,427 --- --- ---

Evidence-Based Programs/Practices................................................................................... 793 --- --- ---

PHS Evaluation (non add)..................................................................................... --- --- --- ---

Innovation and Logistical Services Support....................................................................... 6,929 4,847 --- -4,847

PHS Evaluation (non add)..................................................................................... 3,415 2,726 --- -2,726

Support ............................................................................................................................... 7,704 8,242 7,533 -710

PHS Evaluation (non add)..................................................................................... 5,760 7,208 7,202 -6

Total Health Surveillance 47,258 47,258 33,842 -8,569

Drug Abuse Warning Network 10,000 10,000 --- -10,000

PHS Evaluation (non add)..................................................................................... --- --- 10,000 10,000

Total Drug Abuse Warning Network 10,000 10,000 10,000 ---

Performance and Quality Information Systems

Performance Measurement/Systems................................................................................... 7,516 6,782 6,022 -760

Program Evaluations ........................................................................................................... --- --- --- ---

Evidence-Based Programs/Practices................................................................................... 2,000 732 741 8

Behavioral Health Data Dissemination.............................................................................. --- --- 2,069 2,069

Innovation and Logistical Services Support....................................................................... --- 837 --- -837

DAWN................................................................................................................................. --- 1,039 483 -556

Support ............................................................................................................................... 484 610 685 75

Total Performance and Quality Information S ys tems 10,000 10,000 10,000 ---

Behavioral Health Workforce Data and Development

Behavioral Health Workforce Data Development .............................................................. 1,000 1,000 1,000 ---

PHS Evaluation (non add)..................................................................................... 1,000 1,000 1,000 ---

Total Behavioral Health Workforce Data and Development 1,000 1,000 1,000 ---

Total Health Surveillance and Program Support 68,258 68,258 54,842 -8,569

Total Health Surveillance and Program Support PHS Evaluation 31,428 31,428 42,453 11,025

Total Substance Abuse Block Grant Set Aside and

Health Surveillance and Program Support $126,836 $123,859 $110,428 -$13,431
 

 

 

 

 

Fiscal Year Amount 

FY 2016 $79,559,000 

FY 2017 $77,000,000 

FY 2018 $79,000,000 

FY 2019 $79,000,000 

FY 2020 $73,043,000 

Program Support 

(Dollars in thousands) 

Program Activity 

FY 2018 

Final 

FY 2019 

Enacted 

FY 2020 

President's 

Budget 

FY 2020 

President's 

Budget 

+/-

FY 2019 

Enacted 

Program Support......................................................... $79,000 $79,000 $73,043 -$5,957 

Authorizing Legislation .............................................Section 501 of the Public Health Service Act 

FY 2020 Authorization ..................................................................................................$73,043,000 

Allocation Method ....................................................... Direct Federal/Intramural, Contracts, Other 

Eligible Entities.........................................................................................................Not Applicable 

Program Description and Accomplishments 

The Program Support budget supports the majority of SAMHSA staff who plan, direct, and 

administer SAMHSA’s programs, as well as business operations and processes, information 

technology, and overhead expenses, such as rent, utilities, and miscellaneous charges. In addition, 

this budget supports the Unified Financial Management System, which covers administrative 

activities such as human resources, information technology, and the centralized services provided 

by HHS and the Program Support Center. 

SAMHSA supported 561 Full Time Equivalents (FTEs) in FY 2018. SAMHSA is in the process of 

adding additional FTEs in to support staffing for areas such as the Office of the Chief Medical 

Officer and Cures implementation. Staff positions that are not covered through the Health 

Surveillance and Program Support appropriation are funded with Substance Abuse Prevention and 

Treatment and Mental Health Block Grant set-asides for activities associated with technical 

assistance, data collection, and evaluation. 

SAMHSA applies an estimated internal administrative charge for overhead expenses to all programs, 

projects, and activities. 

Funding History 

285 
 

 

--- --- ---

--- ---

--- --- ---

--- ---

Budget Request 

The FY 2020 President’s Budget is $73.0 million, which is a decrease of $6.0 million from the 

FY 2019 Enacted Budget. This level of funding will continue to cover personnel, overhead costs 

associated with 5600 Fishers Lane, including rent, the Federal Acquisition Service loan repayment 

program, and security charges. 

Mechanism Table for Program Support 

(Dollars in thousands)

Program Activity 

FY 2018 

Final 

No. Amount 

FY 2019 

Enacted 

No. Amount 

FY 2020 

President's 

Budget 

No. Amount 

Program Support 

Contracts 

Continuations........................................................................ 

New/Competing.................................................................... 

79,000 

--- ---

79,000 

---

73,043 

---

Subtotal............................................................................. 79,000 79,000 73,043 

Total, Program Support 79,000 --- 79,000 73,043 

286 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Public Awareness and Support 

(Dollars in thousands) 

Program Activity 

FY 2018 

Final 

FY 2019 

Enacted 

FY 2020 

President's 

Budget 

FY 2020 

President's 

Budget 

+/-

FY 2019 

Enacted 

Public Awareness and Support................................ $13,000 $13,000 $11,572 -$1,428 

Authorizing Legislation Sections 501, 509, 516, and 520A of the Public Health Service Act 

FY 2020 Authorization ......................................................................................................Indefinite 

Allocation Method ............................................................................................................. Contracts 

Eligible Entities.........................................................................................................Not Applicable 

Program Description and Accomplishments 

A part of SAMHSA’s mission is to raise the public’s understanding of mental illness and 

drug/alcohol addiction, serve as an expert on substance use and mental health issues, lead public 

health efforts to advance the health of the nation, and inform and equip the healthcare workforce. 

SAMHSA’s Office of Communications (OC) staff ensure that the vital information, publications, 

and training materials produced through SAMHSA’s Centers and Offices are available to the 

healthcare workforce, people in treatment and recovery, people in crisis or in areas affected by 

disasters, SAMHSA grantees, and the general public. OC staff communicate substance use and 

mental health information and products through various channels such as reaching the media via email, press releases, and news bulletins; communicating via social media platforms such as Twitter, 

Facebook, and YouTube; posting messages on the samhsa.gov website; uploading documents on the 

SAMHSA Store (managed through the Public Engagement Platform contract), issuing e-blasts to 

subscribers; and answering inquiries through the Contact Center’s National Helpline. In addition, 

the OC staff manage SAMHSA events to interact with stakeholders, media organizations and the 

general public and assist in the development and execution of materials, products, and campaigns. 

The OC media team evaluates and acts upon media inquiries; develops and issues press releases, 

news bulletins, and media advisories; provides in-house media support to the Centers and Offices, 

including traveling to events; builds relationships with representatives of the media; identifies and 

seeks corrections to inaccuracies about SAMHSA in media products, when necessary; works to add 

SAMHSA’s life-saving resources to journalistic and entertainment products; supports broad HHS 

and administration communications priorities; and collaborates with other departmental OpDivs. 

OC manages SAMHSA’s social media presence on channels such as Facebook, Twitter, and 

YouTube. In addition to print and traditional media, social media messaging is now incorporated in 

communications plans and is employed daily to communicate behavioral health messages and 

resources. OC has staff who specialize in monitoring social media conversations, writing social 

media messages, participating in twitter chats, and writing and posting blogs on SAMHSA.gov. This 

also includes a close collaboration within SAMHSA when a disaster occurs to quickly disseminate 

287 
 

 

 

 

 

 

 

 

 

 

 

Fiscal Year Amount 

FY 2016 $15,571,000 

FY 2017 $13,000,000 

FY 2018 $13,000,000 

FY 2019 $13,000,000 

FY 2020 $11,572,000 

 

press releases and social media featuring SAMHSA’s Disaster Distress Helpline and links to relevant 

SAMHSA resources. 

OC is responsible for managing the SAMHSA.gov website via the Web Management and Support 

contract. The contract provides enterprise-wide content and technical support for SAMHSA.gov and 

other related public-facing websites. Key activities include website operations and maintenance 

updates, development and enhancements, and Section 508 remediation. On a daily basis OC staff 

add, update, and manage content for the SAMHSA website, in addition to technical maintenance 

and enhancements as needed. 

OC manages two other contracts: the Public Engagement Platform (PEP) contract and the Contact 

Center contract. The PEP is a large-scale information dissemination program. PEP provides the 

public and other stakeholders with one-stop, quick access to mental and substance use disorder 

prevention, treatment, and recovery information, materials, and services. It operates a customeroriented order fulfillment/distribution center, which includes an online store (store.SAMHSA.gov) 

and warehouse, the SAMHSA listserv and subscriber database system, and mobile applications. 

The Contact Center contract supports the National Helpline (1-800-662-HELP) and the 1-877-

SAMHSA-7 line. The National Helpline provides free, confidential treatment referral and 

information services in English and Spanish for individuals and families facing mental illness and/or 

substance use disorders. It is operational 365 days-a-year, 24/7. The 1-877-SAMHSA-7 line is the 

single point of entry for SAMHSA’s information services and is operated Monday through Friday,

8:00 am to 8:00 pm (except for federal holidays). 

Funding History 

Budget Request 

The FY 2020 President’s Budget is $11.6 million, which is level with the FY 2019 Enacted Budget. 

Funds for Public Awareness and Support will allow SAMHSA to manage media relationships, 

maintain its web and social media presence, manage critical helplines, and deliver publications and 

resources. 

288 
--- ---

 

Mechanism Table for Public Awareness and Support 

(Dollars in thousands) 

Program Activity 

FY 2018 

Final 

No. Amount 

FY 2019 

Enacted 

No. Amount 

FY 2020 

President's 

Budget 

No. Amount 

Public Awareness and Support 

Contracts 

Continuations............................................................... 

New/Competing........................................................... 

3 13,000 

---

1 3,537 

4 9,463 

5 11,572 

---

Subtotal..................................................................... 3 13,000 5 13,000 5 11,572 

Total, Public Awareness and Support 3 13,000 5 13,000 5 11,572 

289 
 

 

 

 

 

 

 

 

 

Outputs and Outcomes Table 

Program: Public Awareness and Support 

Measure 

Year and Most Recent Result 

Target for Recent Result 

(Summary of Result) 

FY 2019 

Target 

FY 2020 

Target 

FY 2020 

Target 

+/-

FY 2019 

Target 

4.4.12 Increase the number of 

individuals referred for behavioral 

health treatment resources. (Output) 

FY 2017: 794,108 

Target: 752,096 

(Target Exceeded) 

794,108 794,108 Maintain 

4.4.13 Increase the total number of 

interactions through phone inquiries, 

e-blasts, dissemination of SAMHSA 

publications, and total website hits. 

(Output) 

FY 2017: 44,567,523 

Target: 33,430,000 

(Target Exceeded) 

44,567,523 44,567,523 Maintain 

290 
SAMHSA 

FY2020 CJ Nonrecurring Expenses 

Table of Contents 

1. NEF ................................................................................................................................ 292 

291 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Nonrecurring Expenses Fund 

Budget Summary 

(Dollars in Thousands) 

FY 2018

/2 

FY 2019 

/3 /4 

FY 2020 

/5 

Notification /1 -- $3,000 TBD 

Authorizing Legislation: 

Authorization...............Section 223 of Division G of the Consolidated Appropriations Act, 2008 

Allocation Method...................................................Direct Federal, Competitive Contract 

Program Description and Accomplishments 

The Nonrecurring Expenses Fund (NEF) permits HHS to transfer unobligated balances of expired 

discretionary funds from FY 2008 and subsequent years into the NEF account. Congress authorized 

use of the funds for capital acquisitions necessary for the operation of the Department, specifically 

information technology (IT) and facilities infrastructure acquisitions. 

SAMHSA’s Center for Behavioral Health Statistics and Quality (CBHSQ) manages the National 

Survey on Drug Use and Health (NSDUH), which provides information on the incidence and 

prevalence of substance use and mental illness required by Section 505 of the Public Health Service 

Act (42 USC 290aa4). Section 505 of the Public Health Service Act also requires that these data 

must be collected annually. Data are annually collected from approximately 67,500 individuals aged 

12 or older from across all 50 states and the District of Columbia. 

The project associated with this NEF request is for the purchase of new field interviewer (FI) data 

collection equipment to be deployed on the 2020 NSDUH. Given the size and scope of NSDUH the 

fleet of FI data collection equipment typically needs refreshed every 5 years. The most recent refresh 

was deployed on the 2015 NSDUH. 

FY 2019 funding supports a timely purchase of the new equipment in the spring of 2019. This will 

ensure there is sufficient time to configure the equipment (e.g., security requirements and data 

collection software) before distributing it to FIs prior to their attendance at the annual veteran field 

interviewer training (that will include time to train on the new equipment) and beginning 2020 

NSDUH data collection in early January 2020. 

SAMHSA’s Center for Behavioral Health Statistics and Quality (CBHSQ) manages SAMHSA’s

data webpage allowing public access to multiple datasets. The CBHSQ Data Webpage team has 

identified additional tasks not originally planned or budgeted within the current contract; however, 

in order to bring all CBHSQ data sites up to current HHS security policy and requirements this will 

necessitate a contract modification to incorporate the following tasks: 1) Migration of CBHSQ 

archived data sets from an old website that is no longer supported, 2) migration of the BHSIS website 

to the new CBHSQ data website, 3) updating of the new CBHSQ data website to the current version 

of the site framework platform, and 4) implementation of an enhance website search software 

including the latest color palette as directed by SAMHSA leadership. 

292 
 

 

 

 

 

 

 

 

 

In order to migrate the DASIS/BHSIS site (located outside SAMHSA) to the SAMHSA Cloud a 

content inventory will be completed and any data not duplicated will be migrated to the CBHSQ 

data site within the SAMHSA cloud and the DASIS/BHSIS website will be decommissioned. The 

DASIS/BHSIS site currently houses a tool, Quick Statistics that must also be migrated to the CBHSQ 

data website. The tool is used by multiple stakeholders both within the Government and external 

researchers. This tool allows users to view pre-statistics prior to full data releases. In addition, the 

SAMHSA/CBHSQ archive, which previously resided on a physical server that has since been 

decommissioned and moved temporarily to a cloud server for security reasons, also needs to be 

migrated. The temporary cloud server solution is not permanent because it does not have any support 

for it to remain active. The archive contains all SAMHSA/CBHSQ reports and files prior to 2010, 

and are not currently available on the Data Webpage or integrated into the site or search, and so are 

currently unavailable for the public in one place. This migration is necessary to meet security 

requirements and technological requirements from SAMHSA and HHS. 

293 
294

Drug Control Program 

Department of Health and Human Services

Substance Abuse and Mental Health Services Administration

(Dollars in thousands)

Resource Summary

FY 2018 

Final

FY 2019

Enacted

FY 2020 

President's

Budget

Drug Resources by Decision Unit and Function

Programs of Regional and National Significance

Substance Abuse Prevention.................................................. $248.219 $205.469 $144.09

Substance Abuse Treatment .................................................. 399.091 460.677 429.888

Total Programs of Regional and National Significance .............. 647.31 666.146 573.978

Drug Free Communities ........................................................... --- --- 100,000

State Targeted Response to the Opioid Crisis Grants .............. 500,000 --- ---

State Opioid Response Grants.................................................. 1,000,000 1,500,000 1,500,000

Substance Abuse Prevention and Treatment Block Grant1

Prevention................................................................................ 371.616 371.616 371.616

Treatment................................................................................. 1,486.463 1,486.463 1,486.463

Total, Substance Abuse Prevention and Treatment Block Grant. 1,858.079 1,858.079 1,858.079

Health Surveillance and Program Support2

Prevention .............................................................................. 23.437 23.209 20.438

Treatment................................................................................. 93.748 92.837 81.753

Total, Health Surveillance and Program Support........................ 117.185 116.046 102.192

Total Funding .............................................................................. $4,122.574 $4,140.271 $4,134.249

Drug Resources Personnel Summary

Total FTEs 409 440 441

Drug Resources as a Percent of Budget

Total Agency Budget $5,654.158 $5,743.996 $5,679.1

Drug Resources Percentage 73.0% 72.1% 73.0% 1 The Substance Abuse Prevention and Treatment Block Grant is split 20% to the Prevention function and 80% to the Treatment

function.

2 The Health Surveillance and Program Support Appropriation funded activities are split between Mental Health and Substance

Abuse as follows: The Drug Abuse Warning Network is allocated fully to substance abuse. Program Support, Health

Surveillance and PQIS are split the same proportion as drug control to the overall SAMHSA budget as defined by the substance

abuse portions divided by the mental health and substance abuse portions combined. Public Awareness and Support, Behavioral

Health Workforce Data and Development and Data Request and Publication User Fees are allocated 50% to drug control

activities. The drug control total for HSPS after these calculations is allocated between Prevention (20%) and Treatment (80%).
295

Drug Budget Split between Prevention and Treatment

(Dollars in thousands)

Substance Abuse Prevention

FY 2018

Final

FY 2019

Enacted

FY 2020

President's

Budget

Programs of Regional and National Significance (PRNS)

Strategic Prevention Framework .............................................................. $119,484 $119,484 $58,426

Strategic Prevention Framework Rx (non-add) ................................... 10,000 10,000 10,000

Budget Authority (non-add)............................................................... 109,484 109,484 48,426

Federal Drug-Free Workplace.................................................................. 4,894 4,894 4,894

Minority AIDS .......................................................................................... 41,205 41,205 41,205

Sober Truth on Preventing Underage Drinking ....................................... 7,000 8,000 8,000

Center for the Application of Prevention Technologies........................... 7,493 7,493 7,493

Budget Authority (non-add)............................................................... 7,493 7,493 7,493

Science and Service Program Coordination ............................................. 4,072 4,072 4,072

Grants to Prevent Prescription Drug/Opioid Overdose Related Deaths.... 12,000 --- ---

Tribal Behavioral Health Grants .............................................................. 15,000 20,000 20,000

First Responder Training.......................................................................... 36,000 --- ---

SAP Minority Fellowship Program.......................................................... 71 321 ---

Improving Access to Overdose Treatment ............................................... 1,000 --- ---

Total, Substance Abuse Prevention PRNS 248,219 205,469 144,090

Drug Free Communities --- --- 100,000

Substance Abuse Prevention and Treatment Block Grant1 371,616 371,616 371,616

PHS Evaluation Funds (non-add) ..................................................... 15,840 15,840 15,840

Total, Substance Abuse Prevention and Treatment Block Grant 371,616 371,616 371,616

Health Surveillance and Program Support2

Health Surveillance 6,897 6,818 4,931

Budget Authority (non-add)............................................................... 2,456 2,428 348

PHS Evaluation Funds (non-add) ..................................................... 4,441 4,390 4,583

Program Support ...................................................................................... 11,530 11,398 10,643

Public Awareness and Support.................................................................. 1,300 1,300 1,157

Performance and Quality Information Systems........................................ 1,460 1,443 1,457

Behavioral Health Workforce Data and Development............................. 100 100 100

PHS Evaluation Funds (non-add) ..................................................... 100 100 100

Drug Abuse Warning Network.................................................................. 2,000 2,000 2,000

PHS Evaluation Funds (non-add) ..................................................... 2,000 2,000 2,000

Data Request/Publication User Fees......................................................... 150 150 150

Total, Health Surveillance and Program Support 23,437 23,209 20,438

Total, Substance Abuse Prevention $643,272 $600,294 $636,144 1The Substance Abuse Prevention and Treatment Block Grant is split 20% to the Prevention function and 80% to the Treatment function. 2 The Health Surveillance and Program Support Appropriation funded activities are split between Mental Health and Substance Abuse

as follows: The Drug Abuse Warning Network is allocated fully to substance abuse. Program Support, Health Surveillance and PQIS are

split the same proportion as drug control to the overall SAMHSA budget as defined by the substance abuse portions divided by the

mental health and substance abuse portions combined. Public Awareness and Support, Behavioral Health Workforce Data and

Development and Data Request and Publication User Fees are allocated 50% to drug control activities. The drug control total for HSPS

after these calculations is allocated between Prevention (20%) and Treatment (80%).
296

Drug Budget Split between Prevention and Treatment (Continued)

(Dollars in thousands)

Substance Abuse Treatment

FY 2018

Final

FY 2019

Enacted

FY 2020

President's

Budget

Programs of Regional and National Significance (PRNS)

Opioid Treatment Programs/Regulatory Activities............................. $8,724 $8,724 $8,724

Screening, Brief Intervention and Referral to Treatment .................... 24,700 30,000 ---

Budget Authority (non-add)................................................................ 22,700 28,000 ---

PHS Evaluation Funds (non-add)...................................................... 2,000 2,000 ---

Targeted Capacity Expansion.............................................................. 95,192 100,192 100,192

Medication-Assisted Treatment for Prescription Drug and Opioid

Addiction (non-add) ........................................................................ 84,000 89,000 89,000

Pregnant and Postpartum Women ....................................................... 29,931 29,931 29,931

Improving Access to Overdose Treatment .......................................... --- 1,000 1,000

Recovery Community Services Program ............................................ 2,434 2,434 2,434

Children and Family Programs............................................................ 29,605 29,605 29,605

Treatment Systems for Homeless........................................................ 36,386 36,386 36,386

Minority AIDS ..................................................................................... 64,534 65,570 65,570

SAT Minority Fellowship Program..................................................... 4,539 4,789 ---

Criminal Justice Activities .................................................................. 89,000 89,000 89,000

Addiction Technology Transfer Centers ............................................. 9,046 9,046 9,046

Building Communities of Recovery.................................................... 5,000 6,000 6,000

Grants to Prevent Prescription Drug/Opioid Overdose Related Deaths --- 12,000 12,000

Grants to Develop Curricula for DATA Act Waivers......................... --- --- 4,000

First Responder Training..................................................................... --- 36,000 36,000

Total, Substance Abuse Treatment PRNS 399,091 460,677 429,888

State Targeted Response to the Opioid Crisis Grants 500,000 --- ---

State Opioid Response Grants 1,000,000 1,500,000 1,500,000

Substance Abuse Prevention and Treatment Block Grant1 1,486,463 1,486,463 1,486,463

PHS Evaluation Funds (non-add)...................................................... 63,360 63,360 63,360

Total, Substance Abuse Prevention and Treatment Block Grant 1,486,463 1,486,463 1,486,463

Health Surveillance and Program Support2

Health Surveillance 27,589 27,273 19,724

PHS Evaluation Funds (non-add)...................................................... 17,764 17,561 18,332

Program Support ................................................................................. 46,120 45,592 42,572

Public Awareness and Support............................................................. 5,200 5,200 4,629

Performance and Quality Information Systems................................... 5,838 5,771 5,828

Behavioral Health Workforce Data and Development........................ 400 400 400

PHS Evaluation Funds (non-add)...................................................... 400 400 400

Drug Abuse Warning Network............................................................. 8,000 8,000 8,000

PHS Evaluation Funds (non-add)...................................................... 8,000 8,000 8,000

Data Request/Publication User Fees ................................................... 600 600 600

Total, Health Surveillance and Program Support 93,748 92,837 81,753

Total, Substance Abuse Treatment $3,479,302 $3,539,977 $3,498,105 1 The Substance Abuse Prevention and Treatment Block Grant is split 20% to the Prevention function and 80% to the Treatment function.

2 The Health Surveillance and Program Support Appropriation funded activities are split between Mental Health and Substance Abuse as

follows: The Drug Abuse Warning Network is allocated fully to substance abuse. Program Support, Health Surveillance and PQIS are

split the same proportion as drug control to the overall SAMHSA budget as defined by the substance abuse portions divided by the

mental health and substance abuse portions combined. Public Awareness and Support, Behavioral Health Workforce Data and

Development and Data Request and Publication User Fees are allocated 50% to drug control activities. The drug control total for HSPS

after these calculations is allocated between Prevention (20%) and Treatment (80%).
Mission 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

The Substance Abuse and Mental Health Services Administration’s (SAMHSA) mission is to reduce

the impact of substance abuse and mental illness on America’s communities. SAMHSA supports 

the President’s National Drug Control Strategy through a broad range of programs focusing on 

prevention, treatment and recovery from substance abuse. Major programs for FY 2020 will include 

the Substance Abuse Prevention and Treatment Block Grant, Drug Free Communities, State Opioid 

Response Grants, competitive grant programs reflecting Programs of Regional and National 

Significance (PRNS) and Health Surveillance and Program Support. SAMHSA’s Centers for

Substance Abuse Prevention (CSAP) and Substance Abuse Treatment (CSAT) as well as through 

SAMHSA’s Center for Behavioral Health Statistics and Quality (CBHSQ) and the Office of 

Communications administer these programs. 

Methodology 

SAMHSA distributes drug control funding into two functions: prevention and treatment. Both 

functions include a portion of funding from the Health Surveillance and Program Support (HSPS) 

appropriation. 

The portion of the Health Surveillance and Program Support account attributed to the Drug Budget 

uses the following calculations: 

 The Drug Abuse Warning Network is allocated fully to substance abuse. 

 The Health Surveillance, Program Support, Drug Abuse Warning Network, and PQIS 

portions of the HSPS appropriation are divided between Mental Health and Substance 

Abuse using the same percentages splits as between the Mental Health and Substance 

Abuse (Prevention and Treatment) appropriation amounts. 

o The Drug Control portion is then split 20 percent/80 percent into the two functions, 

prevention and treatment, respectively. 

 The Public Awareness and Support, Behavioral Health Workforce Data and Development, 

and Data Request and Publication User Fees portion of the HSPS appropriation is divided 

evenly between Mental Health and Substance Abuse. 

o The Drug Control portion is then split 20 percent/80 percent into the two functions, 

prevention and treatment, respectively. 

The prevention function also includes all of the Substance Abuse Prevention appropriation, 

including the Substance Abuse Prevention Programs of Regional and National Significance, Drug 

Free Communities, and 20 percent of the Substance Abuse Prevention and Treatment Block Grant 

funds specifically appropriated for prevention activities from the Substance Abuse Treatment 

appropriation. 

The treatment function also includes the Substance Abuse Treatment appropriation, including the 

Substance Abuse Treatment Programs of Regional and National Significance, State Opioid 

Response Grants, and 80 percent of the Substance Abuse Prevention and Treatment Block Grant 

funds. 

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Budget Summary 

In FY 2020, SAMHSA requests a total of $4.1 billion for drug control activities, a decrease of $6.0 

million from the FY 2019 Enacted. 

The budget directs resources to activities that have demonstrated improved health outcomes and that 

increase service capacity. SAMHSA has three major drug-related decision units: Substance Abuse 

Prevention, Substance Abuse Treatment, and Health Surveillance and Program Support. Each 

decision unit is discussed below: 

Substance Abuse Prevention 

Drug Free Communities 

FY 2020 Request: $100.0 million 

(Reflects a $100.0 million increase FY 2019 Enacted) 

The Drug-Free Communities (DFC) Act of 1997 created the DFC Support Program (Public Law 

105-20). By statute, the DFC Support Program has two goals: 

 Establish and strengthen collaboration among communities, public and private non-profit 

agencies, as well as federal, state, local, and tribal governments to support the efforts of 

community coalitions working to prevent and reduce substance abuse among youth. 

 Reduce substance abuse among youth and, over time, reduce substance abuse among adults 

by addressing the factors in a community that increase the risk of substance abuse and 

promoting the factors that minimize the risk of substance abuse. 

The goal of the program is to establish and strengthen collaboration among communities, public and 

private non-profit agencies, as well as federal, state, local, and tribal governments to support the 

efforts of community coalitions working to prevent and reduce substance abuse among youth. In 

addition, the program aims to reduce substance abuse among youth and, over time, reduce substance 

abuse among adults by addressing the factors in a community that increase the risk of substance 

abuse and promoting the factors that minimize the risk of substance abuse. 

See page 185 in the CSAP chapter for the start of the full description of this program. 

Budget Request 

The FY 2020 President’s Budget Request is $100 million, funding for this activity was appropriated 

to the Office of National Drug Control Policy in 2019. Funding will be used to continue both the 

DFC and DFC-Mentoring programs. 

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Strategic Prevention Framework for Prescription Drugs (PRNS non-add) 

 

 

 

 

 

 

 

 

 

 

 

Programs of Regional and National Significance 

Strategic Prevention Framework (PRNS non-add) 

FY 2020 Request: $58.4 million 

(Reflects a $61.1 million decrease from the FY 2019 Enacted) 

SAMHSA’s Strategic Prevention Framework (SPF) grant programs support activities to help

grantees build a solid foundation for delivering and sustaining effective substance abuse prevention 

services and reducing substance abuse problems. The Strategic Prevention Framework –

Partnerships for Success program addresses underage drinking among youth and young adults age 

12 to 20 and allows states to prioritize State-identified top data driven substance abuse target areas. 

See page 153 in the CSAP chapter for the start of the full description of this program. 

Due to alarming trends related to prescription drug misuse and overdoses involving opioids, 

SAMHSA is prioritizing efforts to address prescription drug misuse. SAMHSA implemented the 

Strategic Prevention Framework for Prescription Drugs to raise awareness about the dangers of 

sharing medications and to work with pharmaceutical and medical communities on the risks of 

overprescribing to young adults. SAMHSA’s program focuses on raising community awareness and 

bringing prescription drug use prevention activities and education to schools, communities, parents, 

prescribers, and their patients. SAMHSA tracks reductions in opioid overdoses and the 

incorporation of prescription drug monitoring data into needs assessments and strategic plans as 

indicators of program success. SAMHSA plans to maintain this level of support for SPF Rx through 

FY 2020. 

See page 154 in the CSAP chapter for the start of the full description of this program. 

Budget Request 

The FY 2020 President’s Budget request is $58.4 million, a decrease of $61.1 million from the 

FY 2019 Enacted. Funding for the SPF Rx program will be maintained in its entirety ($10.0 million) 

for 26 continuation grants. Funding will support SPF PFS continuation grants at a reduced rate, 

technical assistance, and evaluation to build capacity to address prescription drug misuse and 

overdose prevention efforts, in conjunction with other state and local partners. 

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Federal Drug-Free Workplace (PRNS non-add) 

FY 2020 Request: $4.9 million 

(Reflects level funding from the FY 2019 Enacted) 

SAMHSA’s activities related to the Federal Drug-Free Workplace support two principal activities 

mandated by Executive Order (E.O.) 12564 and Public Law (P.L.) 100-71. This 

include: 1)oversight of the Federal Drug-Free Workplace, aimed at the elimination of illicit drug 

use within Executive Branch agencies and the federally-regulated industries; and 2) oversight of the 

National Laboratory Certification Program (NLCP), which certifies laboratories to conduct forensic 

drug testing for federal agencies, federally-regulated industries; the private sector also uses the HHSCertified Laboratories. 

See page 157 in the CSAP chapter for the start of the full description of this program. 

Budget Request 

The FY 2020 President’s Budget request is $4.9 million, level with the FY 2019 Enacted. In 

FY 2020, SAMHSA will continue oversight of the Executive Branch Agencies’ Federal Drug-Free 

Workplace Programs. This includes review of Federal Drug-Free Workplace plans from those 

federal agencies that perform federal employee testing, random testing of those designated testing 

positions of national security, public health, and public safety, and testing for illegal drug use and 

the misuse of prescription drugs. SAMHSA will continue its oversight role for the inspection and 

certification of the HHS-certified laboratories. 

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Sober Truth on Preventing Underage Drinking (PRNS non-add) 

FY 2020 Request: $8.0 million 

(Reflects level funding from the FY 2019 Enacted) 

The Sober Truth on Preventing Underage Drinking Act (STOP Act) of 2006 (Public Law 109 - 422) 

was the nation’s first comprehensive legislation on underage drinking. One of the primary

components of the STOP Act is the community-based coalition enhancement grant program, which 

provides up to $50,000 per year over four years to current or former grantees under the Drug Free 

Communities Act of 1997 to prevent and reduce alcohol use among youth under the age of 21. The 

STOP Act grant program enables organizations to strengthen collaboration and coordination among 

stakeholders to achieve a reduction in underage drinking in their communities. The STOP Act was 

reauthorized in the 21st Century Cures Act. 

See page 163 in the CSAP chapter for the start of the full description of this program. 

Budget Request 

The FY 2020 President’s Budget request is $8.0 million, level with the FY 2019 Enacted. In 

FY 2020, SAMHSA will support 97 STOP Act grant continuations. This funding will continue to 

strengthen SAMHSA’s commitment to reduce and prevent underage drinking. 

Centers for the Application of Prevention Technologies (PRNS non-add) 

FY 2020 Request: $7.5 million 

(Reflects level funding from the FY 2019 Enacted) 

The Center for the Application of Prevention Technologies (CAPT) program provides state-of-theart training and technical assistance to build the capacity of SAMHSA grantees and develop the 

skills, knowledge, and expertise of the prevention workforce. The program builds capacity and 

promotes the development of substance abuse prevention professionals in the behavioral health field 

through three core strategies: 1) establishing technical assistance networks using local experts; 2) 

developing and delivering targeted training and technical assistance activities; and 3) using 

communication media such as teleconference and video conferencing, online events, and web-based 

support. These activities help ensure the delivery of effective prevention programs and practices 

and the development of accountability systems for performance measurement and management, and 

supported knowledge sharing and collaboration among SAMHSA grantees. In FY 2017 and 

FY 2018, funding continued to support the delivery of technical assistance and workforce 

development to the prevention field, including T/TA for State Targeted Response grants, Grants to 

Prevent Prescription Drug/Opioid Overdose Related Deaths, and First Responders. The CAPT 

continued to provide effective wide-ranging T/TA to the prevention field through its five regional 

T/TA centers. The CAPT changed the method of service delivery in October 2018. Future 

prevention T/TA services are being provided by the SAMHSA Prevention Technology Transfer 

Centers (PTTCs). 

See page 166 in the CSAP chapter for the start of the full description of this program. 

301 
 

 

 

 

 

 

 

 

 

 

Budget Request 

The FY 2020 President’s Budget request is $7.5 million, level with the FY 2019 Enacted. Prevention 

T/TA services are being conducted by the PTTCs. 

Science and Service Program Coordination (PRNS non-add) 

FY 2020 Request: $4.1 million 

(Reflects level funding from the FY 2019 Enacted) 

The Science and Service Program Coordination program funds the provision of technical assistance 

and training to states, tribes, communities, and grantees around substance abuse prevention. 

Specifically, the program supports the Tribal Training and Technical Assistance Center and the 

Underage Drinking Prevention Education Initiatives (UADPEI). 

See page 169 in the CSAP chapter for the start of the full description of this program. 

Budget Request 

The FY 2020 President’s Budget request is $4.1 million, level with the FY 2019 Enacted. This 

funding will support SAMHSA’s substance abuse prevention efforts and include a focus on

preventing underage drinking and providing technical assistance and training to American 

Indians/Alaska Native communities. 

Tribal Behavioral Health Grants (PRNS non-add) 

FY 2020 Request: $20.0 million 

(Reflects level funding from the FY 2019 Enacted) 

SAMHSA’s Tribal Behavioral Health Grants (TBHG) program addresses the high incidence of 

substance abuse and suicide among AI/AN populations. Starting in FY 2014, this program supports 

tribal entities with the highest rates of suicide by providing effective and promising strategies that 

address substance abuse, trauma, and suicide and by promoting the mental health of AI/AN young 

people. 

See page 171 in the CSAP chapter for the start of the full description of this program. 

Budget Request 

The FY 2020 President’s Budget request is $20.0 million, level with the FY 2019 Enacted. This 

request, along with $20.0 million in the Center of Mental Health Services will continue to support 

approximately 179 grants that promote mental health and prevent substance use activities for highrisk AI/AN youth and their families. 

302 
Performance 

Prevention: Selected Measures of Performance

Program

SPF: Partnerships for Success FY 2016 

Target

FY 2016 

Achieved

» Increase the number of sub-recipient communities that 

improved one or more targeted NOMs indicators 

142 552

» Increase the number of EBPs implemented by sub-recipient 

communities

650 531

SPF: Rx 

FY 2017

Target

FY 2017 

Achieved

» Increase the percent of funded states reporting reductions in opioid 

overdoses 

55% 69%

STOP Act 

FY 2017

Target

FY 2017 

Achieved

» Increase the percent of coalitions that report at least a 5

percent improvement in the past 30-day use of alcohol in at

least 2 grades 

62.0% 57.7%

» Increase the percent of coalitions that report improvement in

youth perception of risk from alcohol in at least two grades 

70% 75%

Center for the Application of Prevention Technologies FY 2017

Target

FY 2017 

Achieved

» Increase the percent of participants who agree or strongly 

agree that the training or TA provided increased their 

capacity to do substance abuse prevention work

90% 95%

» Increase the percent of participants who agree or strongly 

agree that the training or TA provided increased their

organization’s capacity to do substance abuse prevention 

work

92% 99%

» Increase the number of individuals trained by the CAPT 9,000 14,021

Tribal Behavioral Health Grants FY 2017

Target

FY 2017 

Achieved

» Increase the number of programs/organizations that

implemented specific mental health-related 

practices/activities as a result of the grant 

296 5,749 

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Substance Abuse Treatment 

Grants to Develop for DATA Act Waivers 

FY 2020 Request: $4.0 million 

(Reflects $4.0 million increase from the FY 2019 Enacted) 

The purpose of this new program, which is authorized by section 3203 of the SUPPORT for Patients 

and Communities Act, is to provide grants to enhance access to substance use disorder treatment. 

This is done by giving grants to accredited schools of allopathic medicine or osteopathic medicine 

and teaching hospitals located in the United States to support the development of curricula that meet 

the requirements from an accredited school of allopathic medicine or osteopathic medicine in the 

United States. 

See page 243 in the CSAT chapter for the start of the full description of this program. 

Budget Request 

The FY 2020 President’s Budget request is $4.0 million, an increase of $4.0 million from the 

FY 2019 Enacted level. 

Substance Abuse Prevention and Treatment Block Grant 

FY 2020 President’s Budget: $1.9 billion 

(Reflects level funding from the FY 2019 Enacted) 

The Substance Abuse Prevention and Treatment Block Grant (SABG) program distributes funds to 

60 eligible states, territories and freely associated states, the District of Columbia, and the Red Lake 

Band of Chippewa Indians of Minnesota (referred to collectively as states) to plan, carry out, and 

evaluate substance use disorder prevention, treatment, and recovery support services for individuals, 

families, and communities impacted by substance misuse and substance use disorders. The SABG’s 

overall goal is to support and expand substance abuse prevention and treatment services while 

providing maximum flexibility to grantees. 

See page 259 in the CSAT chapter for the start of the full description of this program. 

Budget Request 

The FY 2020 President’s Budget request is $1.9 billion, level with the FY 2019 Enacted. SABG 

funds will continue to serve as a source of safety net funding, including assistance to states in 

addressing the opioid epidemic, and will continue to support certain services (e.g., recovery support 

services) not covered by commercial insurance and non-clinical activities and services that address 

the critical needs of state substance abuse prevention and treatment service systems. 

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Performance 

SAMHSA is undertaking a series of agency-wide efforts designed to develop a set of common 

performance, quality, and cost measures to demonstrate the impact of SAMHSA’s programs.

Ultimately, SAMHSA and its state partners will collaborate to develop a streamlined behavioral 

health data system that complements other existing systems (e.g., Medicaid administrative and billing 

data systems, and state mental health and substance abuse treatment data systems), ensures 

consistency in the use of measures, and provides a more complete perspective of the delivery of 

mental illness and substance abuse treatment services. 

An independent evaluation of the SABG demonstrated how states have leveraged the statutory 

requirements of this Block Grant program to expand existing or establish new treatment capacity in 

underserved areas of states and territories and to improve coordination of services with other state 

systems.123 SAMHSA data show that the SABG has been successful in expanding treatment capacity 

by supporting approximately two million124 admissions to treatment programs receiving public 

funding. Outcome data for the Block Grant program show positive results as reported through 

Behavioral Health Services Information System/Treatment Episode Data Set (TEDS) administered 

by SAMHSA’s Center for Behavioral Health Statistics and Quality. In FY 2015, at discharge, clients

demonstrated high abstinence rates from both illegal drug (70 percent) and alcohol (83 percent) use. 

State substance abuse authorities reported the following outcomes for services provided during 

FY 2015, the most recent year for which data is available: 

State substance abuse authorities reported the following outcomes for services provided during 

FY 2016, the most recent year for which data is available: 

 For the 50 states and the District of Columbia that reported data concerning abstinence from 

alcohol use, all 51 identified improvements in client abstinence; 

 Similarly, for the 50 states and D.C. that reported data concerning the abstinence from drug 

use, 50 of 51 identified improvements in client abstinence; 

 For the 50 states and D.C. that reported employments data, 45 of 50 identified 

improvements in client employment; 

 For the 50 states and D.C. that reported criminal justice data, 47 of 51 reported an increase 

in clients with no arrests based on data reported to TEDS; 

 For the 50 states and D.C. that reported housing data, 48 of 51 identified improvements in 

stable housing for clients based on data reported to TEDS; and 

 For the 50 states and D.C that reported recovery support data, 51 states out of 51 identified 

improvements in client engagement in recovery support programs. At intake clients who 

were engaged in recovery support programs increased from 29 percent to 44.8 percent at 

discharge. 

123Substance Abuse and Mental health Administration. Retrieved from 

http://tie.samhsa.gov/SAPT2010.html#Evaluation. 124 Substance Abuse and Mental Health Services Administration (2015). Clients Level Data / TEDS. Retrieved from 

http://www.samhsa.gov/data/client-level-data-teds 

305 
 

 

 

 

-

20 Percent Prevention Set-Aside 

SAMHSA is responsible for managing the 20 percent prevention set-aside of the SABG. The 20 

percent set-aside requires SABG grantees to spend at least 20 percent of their SABG award to 

develop and implement a comprehensive prevention program, which includes a broad array of 

prevention strategies directed at individuals not identified to be in need of treatment. The prevention 

set-aside is one of SAMHSA’s main vehicles for supporting SAMHSA’s Strategic Initiative for the

Prevention of Substance Abuse and Mental Illness. The 20 percent set-aside is focused only on 

substance use prevention. States use these funds to develop infrastructure and capacity and to fund 

programs specific to primary substance abuse prevention. Some states rely solely on the 20 percent 

set-aside to fund their prevention systems while others use the funds to target gaps and enhance 

existing program efforts. 

States are encouraged to make prevention a top priority, taking advantage of recent science, best 

practices in community coordination, proven planning processes, and the findings articulated by the 

Institute of Medicine report, Preventing Mental, Emotional, and Behavioral Disorders Among 

Young People. SAMHSA regularly works with states to improve their accountability systems for 

prevention and to establish necessary reporting capacities. 

Substance Abuse Prevention and Treatment Block Grant: 

Selected Measures of Performance 

FY 2017 FY 2017 

Prevention Set Aside Target Achieved 

» Increase the percent of states showing a decrease in state 

level estimates of percent of survey respondents to report 30 

day use of other illicit drugs (age 12 – 17) 

Baseline 

» Increase the percent of states showing a decrease in state Baseline 

level estimates of percent of survey respondents who report 

30 days use of other illicit drugs (age 18+) 

51.0% 

20.0% 

FY 2016 

Treatment Activities Target 

FY 2016 

Achieved 

» Percentage of clients reporting no drug use in the past 

month at discharge. 

74.0% 

» Increase the percentage of clients reporting being 

employed/in school at discharge. 

43.0% 

» Increase the percentage of clients reporting no involvement 

with the criminal justice system. 

92.0% 

» Increase the percentage of clients receiving services who had 

a permanent place to live in the community. 

92.0% 

69.6% 

35.7% 

93.2% 

88.9% 

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State Opioid Response 

FY 2020 Request: $1.5 billion 

(Reflects a level funding from the FY 2019 Enacted) 

Substance Abuse and Mental Health Services Administration established the State Opioid Response 

Grants (SOR) program in FY 2018. This program aims to address the opioid crisis by increasing 

access to medication-assisted treatment using the three FDA-approved medications for the treatment 

of opioid use disorder, reducing unmet treatment need, and reducing opioid overdose related deaths 

through the provision of prevention, treatment and recovery activities for opioid use disorder (OUD) 

(including prescription opioids, heroin and illicit fentanyl and fentanyl analogs). Funding was 

established to award up to 59 discretionary grants. These grants are awarded to states and territories 

via formula. The program also includes a 15 percent set-aside for the 10 states with the highest 

mortality rate related to drug overdose deaths. In addition, the program will provide $50 million to 

tribes. 

See page 255 in the CSAT chapter for the start of the full description of this program. 

Budget Request 

The FY 2020 President’s Budget request is $1.5 billion, level with the FY 2019 Enacted level. 

SAMHSA intends to continue to support the Secretary’s five- prong strategy to address the opioid 

crisis priorities through regulatory activities, ongoing training, certification, and technical assistance 

to states, provider groups and communities impacted by the opioid crisis. 

Programs of Regional and National Significance 

Targeted Capacity Expansion (PRNS non-add) 

FY 2020 Request: $100.2 million 

(Reflects level funding from the FY 2019 Enacted) 

The Targeted Capacity Expansion (TCE) program provides rapid, strategic, comprehensive, and 

integrated community-based responses to gaps in and capacity for SUD treatment and recovery 

support services. Examples of such needs include limited or no access to medication-assisted 

treatment (MAT) for opioid use disorders; lack of resources needed to adopt and implement health 

information technologies (HIT) in SUD treatment settings; and short supply of trained and qualified 

peer recovery coaches to assist individuals in the recovery process. 

See page 197 in the CSAT chapter for the start of the full description of this program. 

307 
 

 

 

 

 

 

 

Budget Request 

The FY 2020 President’s Budget request is $100.1 million, level with the FY 2019 Enacted. In 

FY 2020, SAMHSA intends to fund 3 continuation grants and 17 new grants. 

Opioid Treatment Programs/Regulatory Activities (PRNS non-add) 

FY 2020 Request: $8.7 million 

(Reflects level funding from the FY 2019 Enacted) 

As part of its regulatory responsibility, SAMHSA certifies Opioid Treatment Programs that use 

methadone, buprenorphine, or buprenorphine/naloxone to treat patients with opioid dependence. 

SAMHSA carries out this responsibility by enforcing regulations established by an accreditationbased system. This is accomplished in coordination with the Drug Enforcement Administration, 

states, territories, and the District of Columbia. SAMHSA also funds the Opioid Treatment 

Programs Medical Education and Supporting Services project aimed at preparing Opioid Treatment 

Programs to achieve accreditation and providing technical assistance and clinical training to enhance 

program clinical activities. Additionally, SAMHSA funds grants and contracts that support the 

regulatory oversight and monitoring activities of Opioid Treatment Programs. 

See page 191 in the CSAT chapter for the start of the full description of this program. 

Budget Request 

The FY 2020 President’s Budget request is $8.7 million, level with the FY 2019 Enacted. SAMHSA 

intends to continue to support the Secretary’s five-prong strategy to address the opioid crisis 

priorities through regulatory activities, ongoing training, certification, and technical assistance to 

provider groups and communities impacted by the opioid crisis. 

Treatment Systems for Homeless (PRNS non-add) 

FY 2020 Request: $36.4 million 

(Reflects level funding from the FY 2019 Enacted) 

SAMHSA’s Treatment Systems for Homeless portfolio supports services for those with substance

use disorders and who are experiencing homelessness, including veterans, and those experiencing 

chronic homelessness. 

See page 215 in the CSAT chapter for the start of the full description of this program. 

Budget Request 

The FY 2020 President’s Budget request is $36.4 million, level with the FY 2019 Enacted. 

SAMHSA intends to fund 71 GBHI continuation grants with grant supplements for direct technical 

assistance. SAMHSA also plans to award 21 new GBHI grants and one contract for technical 

assistance. 

308 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Pregnant and Postpartum Women (PRNS non-add) 

FY 2020 Request: $29.9 million 

(Reflects level funding from the FY 2019 Enacted) 

The Pregnant and Postpartum Women Pilot, Comprehensive Addiction and Recovery Act (CARA) 

address the substance use and addiction across the country through the implementation of 

prevention, treatment, and recovery programs. In FY 2017, SAMHSA funded three new state PPW 

pilot grants to: 1) support family-based services for pregnant and postpartum women with a primary 

diagnosis of a substance use disorder, including opioid disorders; 2) help state substance abuse 

agencies address the continuum of care, including services provided to women in nonresidentialbased settings; and 3) promote a coordinated, effective and efficient state system managed by state 

substance abuse agencies by encouraging new approaches and models of service delivery. An 

evaluation of this program is underway to determine the effectiveness of the pilot. In FY 2018, 

SAMHSA funded three new state PPW pilot grants and three continuation state PPW pilot grants 

for program implementation, supplement for direct technical assistance, and one continuation 

evaluation contract. In FY 2019, SAMHSA funded six continuations grants. No new grants were 

funded. 

See page 203 in the CSAT chapter for the start of the full description of this program. 

Budget Request 

The FY 2020 President’s Budget request is $29.9 million, level with the FY 2019 Enacted. 

SAMHSA intends to fund 42 residential treatment grant continuations and three new PPW Pilot 

grants to provide an array of services and supports to pregnant women and their children. 

Building Communities of Recovery (PRNS non-add) 

FY 2020 Request: $6.0 million 

(Reflects level funding from the FY 2019 Enacted) 

In FY 2017, SAMHSA funded a new cohort of grant through the Comprehensive Addiction 

Recovery Act (CARA) Building Communities of Recovery program. The purpose of this program 

is to mobilize resources within and outside of the recovery community to increase the prevalence 

and quality of long-term recovery support from drug/alcohol addiction. These grants are intended to 

support the development, enhancement, expansion, and delivery of recovery support services (RSS) 

as well as promotion of and education about recovery. Programs are designed to be overseen by 

people in recovery from SUDs who reflect the community served. Grants support linkages between 

recovery networks and a variety of other organizations, systems, and communities, including: 

primary care, other recovery networks, child welfare system, criminal justice system, housing 

services and employment systems. Grantees will also work to reduce negative attitude, 

discrimination, and prejudice around addiction and addiction recovery. In FY 2018, SAMHSA 

funded 8 new grants, and 19 grants which began in FY 2019, for a total of 27 BCOR grants. 

Moreover, these grantees have received supplements of $25,000 each to support their direct technical 

assistance needs. 

See page 229 in the CSAT chapter for the start of the full description of this program. 

309 
 

 

 

 

 

 

 

 

 

 

 

Budget Request 

The FY 2020 President’s Budget request is $6.0 million, level with the FY 2019 Enacted. These 

funds will support six new grants and 15 continuation grants the Building Communities of Recovery 

Program to develop, expand, and enhance recovery support services. 

Criminal Justice Activities (PRNS non-add) 

FY 2020 Request: $89.0 million 

(Reflects level funding from the FY 2019 Enacted) 

SAMHSA’s Criminal Justice portfolio includes several grant programs that focus on diversion, 

alternatives to incarceration, drug courts, and re-entry from incarceration for adolescents and adults 

with substance use disorders and/or co-occurring substance use and mental disorders. This includes 

Treatment Drug Courts and the Offender Re-Entry Programs. 

Drug Court Activities 

FY 2020 Request: $70.0 million 

(Reflects level funding from the FY 2019 Enacted) 

SAMHSA’s Adult Drug Court programs support a variety of services including direct treatment

services for diverse populations, wraparound/recovery support services designed to improve access 

and retention, drug testing for illicit substances, education support, relapse prevention and long-term 

management, pharmacotherapy), and HIV testing conducted in accordance with state and local 

requirements. The program seeks to address behavioral health disparities among racial and ethnic 

minorities by encouraging the implementation of strategies to decrease the differences in access, 

service use, and outcomes among the racial and ethnic minority populations served. In FY 2019, 

SAMHSA will fund 25 new FTDC grants, at least five will be to Tribes/Tribal organizations pending 

sufficient applications, and 33 FTDC grant continuations. 

310 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

See page 221 in the CSAT chapter for the start of the full description of this program. 

Ex-Offender Re-Entry Program 

FY 2020 Request: $19.0 million 

(Reflects level funding from the FY 2019 Enacted) 

In addition to the drug court portfolio, SAMHSA supports Offender Reentry Program (ORP) grants, 

as well as other criminal justice activities, such as evaluation and behavioral health contracts. These 

grants will provide screening, assessment, comprehensive treatment, and recovery support services 

for diverse populations reentering the community from incarceration. Other supported services 

include wraparound and recovery support services such as recovery housing and peer recovery 

support designed to improve access and retention, drug testing for illicit substances, educational 

support, relapse prevention and long-term management, and HIV and viral hepatitis B and C testing 

conducted in accordance with state and local requirements. In FY 2019, SAMHSA funded one new 

ORP grant and 32 ORP grant continuations. 

See page 223 in the CSAT chapter for the start of the full description of this program. 

Budget Request 

The FY 2020 President’s Budget request is $89.0 million, level with the FY 2019 Enacted. 

SAMHSA intends to support 34 new drug court grants, 135 drug court continuation grants, and one 

contract. SAMHSA intends to fund three new and 21 continuation ORP grants. 

First Responder Training (PRNS non-add) 

FY 2020 President’s Budget: $36.0 million 

(Reflects level funding from the FY 2019 Enacted) 

First Responder Training Comprehensive Addiction and Recovery Act (CARA), SAMHSA is 

authorized to support additional efforts to prevent opioid overdose-related deaths by providing grants 

to train first responders. In FY 2017, SAMHSA funded 21 grants for the First Responder grant 

program (FR). The purpose of this program is to allow first responders and members of other key 

community sectors to administer a drug or device approved or cleared under the Federal Food, Drug, 

and Cosmetic Act for emergency treatment of known or suspected opioid overdose. Grantees will 

train and provide resources to first responders and members of other key community sectors at the 

state, tribal, and local governmental levels on carrying and administering a drug or device approved 

or cleared under the Federal Food, Drug, and Cosmetic Act for emergency treatment of known or 

suspected opioid overdose. Grantees will also establish processes, protocols, and mechanisms for 

referral to appropriate treatment and recovery communities. Training, technical assistance, and 

evaluation activities are also being supported to assist grantees, determine best practices, and assess 

program outcomes. In FY 2018, funding supported 21 continuation grants and an additional 28 new 

grants to address the opioid crisis in this country. In FY 2019, funding for this program was 

appropriated under Substance Abuse Treatment to continue to support the continuation grants. 

See page 238 in the CSAT chapter for the start of the full description of this program. 

311 
 

 

 

 

 

 

 

 

 

 

 

 

Budget Request 

The FY 2020 President’s Budget request is $36.0 million, level with the FY 2019 Enacted. This 

funding will provide 49 continuations grants and approximately 25 new awards to support the 

continuation of training, technical assistance and evaluation activities to address the opioid crisis in 

this country. 

Grants to Prevent Prescription Drug/Opioid Overdose Related Deaths (PRNS non-add) 

FY 2020 President’s Budget: $12.0 million 

(Reflects level funding from the FY 2019 Enacted) 

Opioid overdose is a significant contributor to accidental deaths among those who use, misuse, or 

abuse illicit and prescription opioids (including synthetics), such as fentanyl). SAMHSA’s Grants

to Prevent Prescription Drug/Opioid Overdose Related Deaths program seeks to help states identify 

communities of high need, and provide education, training, and resources necessary to tailor the 

overdose kits to meet their specific needs. Grantees can use the funds to purchase naloxone, equip 

first responders with naloxone and other overdose death prevention strategies, support education on 

these strategies, provide materials to assemble and disseminate overdose kits. In FY 2019, funding 

for this program was appropriated under Substance Abuse Treatment to continue support of the 12 

grants. 

See page 240 in the CSAT chapter for the start of the full description of this program. 

Budget Request 

The FY 2020 President’s Budget request is $12.0 million, level with the FY 2019 Enacted. This 

funding will provide continuation grants to 12 states to reduce the number of opioid overdose-related 

deaths. Funding will help states purchase overdose reversing drugs, equip first responders in highrisk communities, support education on the use of naloxone and other overdose-related death 

prevention strategies, provide the necessary materials to assemble overdose kits, and cover expenses 

incurred from dissemination efforts. 

312 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Other PRNS Treatment Programs (PRNS non-add) 

FY 2020 Request: $42.1 million 

(Reflects level funding from the FY 2019 Enacted) 

The FY 2020 President’s Budget request includes resources of $42.1 million for several other 

Treatment Capacity programs including: Recovery Community Services Program; Children and 

Families; Improving Access to Overdose Treatment; and Addiction Technology Transfer Centers. 

The FY 2020 President’s Budget includes funds for continuing grants and contracts in these 

programs. Grant funding will enhance overall drug treatment quality by incentivizing treatment and 

service providers to achieve specific performance targets. Examples of grant awards could include 

supplements for treatment and service providers who are able to connect higher proportions of 

detoxified patients with continuing recovery-oriented treatment; or for outpatient providers who are 

able to successfully retain greater proportions of patients in active treatment participation for longer 

periods. 

Performance 

In the table below are selected measures of performance related to Treatment Programs of Regional 

and National Significance. The Treatment for Prescription Drug and Opioid Addiction exceeded its 

target outcome for reducing illicit drug use, but also surpassed its goals of increasing the number of 

clients receiving integrated care and the number of admissions for medication-assisted treatment. 

Though the target for the SBIRT outcome was not met, the program’s performance has improved.

The drug court program not only exceeded its outcome goals, including for a reduction in past month 

drug use, but also exceeded its goals for the number of clients served. In FY 2017, more than 8,500 

adult clients were served by the adult drug court grant. 

Treatment: Selected Measures of Performance 

FY 2017 

Treatment: Prescription Drug and Opioid Addiction Target 

FY 2017 

Achieved 

» Decrease illicit drug use at 6-month follow-up 60.0% 62.0% 

FY 2017 

SBIRT Target 

FY 2017 

Achieved 

» Increase the percentage of clients receiving services who had 36.0% 

no past-month substance use 

34.8% 

FY 2017 

Criminal Justice Target 

FY 2017 

Achieved 

» Drug Courts: Increase the percentage of adult clients receiving 71.0% 

services who had no past month substance use 

» Offender Reentry: Increase the percentage of adult clients 

receiving services who had no past month substance use 

74.0%

86.1% 

70.0% 

313 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Health Surveillance and Program Support Appropriation 

The FY 2020 President’s Budget is $102.2 million, a decrease of $13.9 million from the FY 2019 

Enacted, which represents the Substance Abuse portion of the Health Surveillance and Program 

Support appropriation and supports staffing and activities to administer SAMHSA programs as 

described below. 

Health Surveillance and Program Support 

FY 2020 Request: $77.8 million 

(Reflects a $13.2 million decrease from the FY 2019 Enacted) 

Health Surveillance and Program Support (HSPS) provides funding for personnel costs, building 

and facilities, equipment, supplies, administrative costs, and associated overhead to support 

SAMHSA programmatic activities, as well as provide funding for SAMHSA national data collection 

and survey systems, funding to support the Center for Disease Control and Prevention’s National

Health Information Survey, and the data archive. This request represents the total funding available 

for these activities first divided between Mental Health and Substance Abuse using the same 

percentages splits that exist between the Mental Health and Substance Abuse (Prevention and 

Treatment) appropriation amounts. The Drug Control portion is then split 20 percent/80 percent into 

the two functions, prevention and treatment, respectively. 

See page 271 in the HSPS chapter for the start of the full description of this program. 

Budget Request 

The FY 2020 President’s Budget request is $77.8 million, a decrease of $13.2 million from the 

FY 2019 Enacted. Health Surveillance funding will support the continuation of the NSDUH, 

BHSIS, SAMHDA, access to restricted-use data and the Analytic Support Center contracts as well 

as operations and payroll Program Support funding will continue to cover overhead costs associated 

with 5600 Fishers Lane, including rent, the Federal Acquisition Service loan repayment program, 

and security charges. 

Public Awareness and Support 

FY 2020 Request: $5.8 million 

(Reflects a $0.7 million decrease from the FY 2019 Enacted) 

Public Awareness and Support provides funding to support the unified communications approach to 

increase awareness of behavioral health, mental disorders and substance abuse issues. This 

represents the total funding available for these activities first divided evenly between Mental Health 

and Substance Abuse. The Drug Control portion is then split 20 percent/80 percent into the two 

functions, prevention and treatment, respectively. 

See page 287 in the HSPS chapter for the start of the full description of this program. 

314 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Budget Request 

The FY 2020 President’s Budget request is $5.8 million, a decrease of $0.7 million from the FY 2019 

Enacted. Funds for Public Awareness and Support will allow SAMHSA to continue to manage 

media relationships, maintain its web and social media presence, manage critical helplines, deliver 

publications, and provide other critical resources to support behavioral health and other health. 

Performance and Quality Information Systems 

FY 2020 Request: $7.2 million 

(Reflects level funding from the FY 2019 Enacted) 

Performance and Quality Information Systems provides funding to support SAMHSA’s 

Performance Accountability and Reporting System (SPARs) related activities, as well as provide 

support for the National Registry of Evidence-based Programs and Practices that will reduce the 

backlog of interventions accepted but not reviewed under the previous contract. SPARS will provide 

a common data and reporting system for all SAMHSA discretionary grantees and allow 

programmatic technical assistance (TA) on use of the data to enhance grantee performance 

monitoring and improve quality of service delivery. This request represents the total funding 

available for these activities first split into Mental Health and Substance Abuse using the same 

percentages splits as between the Mental Health and Substance Abuse (Prevention and Treatment) 

appropriation amounts. The Drug Control portion is then split 20 percent/80 percent into the two 

functions, prevention and treatment, respectively. 

See page 280 in the HSPS chapter for the start of the full description of this program. 

Budget Request 

The FY 2020 President’s Budget request is $7.2 million, level with the FY 2019 Enacted. SAMHSA 

will use these funds to continue its performance management, quality improvement, and program 

evaluation activities. This funding will ensure that SAMHSA continues a strong focus on 

developing and implementing evidence-based practices and programs and continues its emphasis on 

performance management for quality improvement and program monitoring. 

Drug Abuse Warning Network 

FY 2020 Request: $10.0 million 

(Reflects level funding from the FY 2019 Enacted) 

SAMHSA will re-establish DAWN, as a nationwide public health surveillance system that will 

improve emergency department monitoring of substance use crises, including those related to 

opioids. Authorized by the 21st Century Cures Act, this program is necessary to respond effectively 

to the opioid and addiction crisis in the United States and to better inform public health, clinicians, 

policymakers, and other stakeholders to respond to emerging substance use trends. This request 

represents the total funding available for these activities. The Drug Abuse Warning Network is 

allocated fully to substance abuse. 

315 
 

 

 

See page 276 in the HSPS chapter for the start of the full description of this program. 

Budget Request 

The FY 2020 President’s Budget request is $10.0 million, level with the FY 2019 Enacted. This 

funding will support the continuation of a contract awarded in 2018. 

Data Request and Publication User Fees 

FY 2020 Request: $750,000 

(Reflects level funding from the FY 2019 Enacted) 

The FY 2020 President’s Budget request is $750,000, level with the FY 2019 Enacted. SAMHSA 

will collect and retain fees for extraordinary data and publications requests. This represents the total 

funding estimated for these activities first divided evenly between Mental Health and Substance 

Abuse. The Drug Control portion is then split 20 percent/80 percent into the two functions, 

prevention and treatment, respectively. 

Performance 

Health Surveillance and Program Support: Selected Measures of Performance 

FY 2017 

Target 

FY 2017 

Public Awareness and Support Achieved 

» Increase the number of individuals referred for behavioral 

health treatment resources. 

752,096 794,108 

» Increase the total number of interactions through phone 

inquiries, e-blasts, dissemination of SAMHSA publications, and 

total website hits. 

33,430,000 44,567,523 

316 
 SAMHSA 

Supplementary Tables 

Table of Contents 

1. Budget Authority by Object Class .................................................................................. 318 

2. Salaries and Expenses ..................................................................................................... 327 

3. Detail of Full-Time Equivalent (FTE) Employment ...................................................... 329 

4. Details of Positions ......................................................................................................... 330 

5. Programs Proposed for Elimination................................................................................ 331 

6. Physicians’ Comparability Allowance (PCA) Worksheet.............................................. 333 

317 
Budget Authority by Object Classification Tables

Substance Abuse and Mental Health Services Administration

Total Budget Authority - Object Class

(Dollars in thousands)

Object Class - Direct Budget Authority1,2

FY 2018

Final

FY 2019

Enacted

FY 2020

President's

Budget

Personnel compensation:

Full-time permanent (11.1)........................................... $47,740 $47,086 $47,086

Other than full-time permanent (11.3)......................... 2,015 2,018 2,018

Other personnel compensation (11.5)........................... 1,253 1,234 1,234

Military personnel (11.7).............................................. 3,299 3,383 3,488

Special personnel services payments (11.8) ................. 18 18 18

Subtotal personnel compensation: 54,325 53,740 53,844

Civilian benefits (12.1)................................................. 15,556 15,910 15,635

Military benefits (12.2)................................................. 1,738 1,782 1,838

Subtotal Pay Costs: 71,619 71,432 71,317

Travel and transportation of persons (21.0).................. 1,059 1,076 1,096

Transportation of things (22.0)..................................... 18 18 19 

Rental payments to GSA (23.1).................................... 6,524 6,628 6,754

Rental payments to Others (23.2)................................. 3 3 3

Communication, utilities, and misc. charges (23.3)...... 395 401 409

Printing and reproduction (24.0) .................................. 393 399 367

Other Contractual Services:

Advisory and assistance services (25.1)....................... 32,803 33,328 33,891

Other services (25.2) .................................................... 130,942 131,598 99,901

Purchase of Goods & Svcs. from Govt. Accts (25.3).. 35,886 36,461 36,953

Operation and maintenance of facilities (25.4)............ 212 216 220

Research and Development Contracts (25.5) ............... --- --- ---

Operation and maintenance of equipment (25.7)......... 113 114 117

Subtotal Other Contractual Services: 199,957 201,717 171,082

Supplies and materials (26.0) ....................................... 325 330 336

Equipment (31.0).......................................................... 166 169 172

Grants, subsidies, and contributions (41.0) .................. 5,238,533 5,326,656 5,283,353

Interest and dividends (43.0)........................................ --- --- ---

Subtotal Non-Pay Costs 5,447,372 5,537,397 5,463,591

Total Direct Obligations $5,518,991 $5,608,829 $5,534,908 1 Does not include PHS EVAL Funds.

2 Includes Prevention and Public Health Funds.

318
Substance Abuse and Mental Health Services Administration

Mental Health Services

Budget Authority - Object Class

(Dollars in thousands)

Object Class - Direct Budget Authority1,2

FY 2018

Final

FY 2019

Enacted

FY 2020

President's

Budget

Personnel compensation:

Full-time permanent (11.1) $1,361 $1,367 $1,367

Other than full-time permanent (11.3).......................... 26 26 26

Other personnel compensation (11.5)........................... 17 17 17

Military personnel (11.7).............................................. --- --- ---

Special personnel services payments (11.8) ................ --- --- ---

Subtotal personnel compensation: 1,404 1,411 1,411

Civilian benefits (12.1)................................................. 444 446 446

Military benefits (12.2)................................................. --- --- ---

Subtotal Pay Costs: 1,848 1,857 1,857

Travel and transportation of persons (21.0)................. 262 266 271

Transportation of things (22.0)..................................... --- --- ---

Rental payments to GSA (23.1).................................... --- --- ---

Rental payments to Others (23.2) ................................. --- --- ---

Communication, utilities, and misc. charges (23.3)...... 391 397 404

Printing and reproduction (24.0)................................... 58 59 61

Other Contractual Services: --- --- ---

Advisory and assistance services (25.1) ....................... 15,332 15,578 15,874

Other services (25.2)..................................................... 38,364 38,978 39,718

Purchase of Goods & Svcs. from Govt. Accts (25.3)... 13,214 13,426 13,681

Operation and maintenance of facilities (25.4)............. 198 201 205

Research and Development Contracts (25.5)................ --- --- ---

Operation and maintenance of equipment (25.7).......... 107 109 111

Subtotal Other Contractual Services: 67,216 68,291 69,589

Supplies and materials (26.0) ....................................... 76 77 79

Equipment (31.0).......................................................... 101 103 105

Grants, subsidies, and contributions (41.0).................. 1,396,020 1,465,923 1,412,682

Interest and dividends (43.0) ........................................ --- --- ---

Subtotal Non-Pay Costs 1,464,124 1,535,117 1,483,190

Total Direct Obligations $1,465,972 $1,536,974 $1,485,047 1 Does not include PHS EVAL Funds.

2 Includes Prevention and Public Health Funds.

319
320

Substance Abuse and Mental Health Services Administration

Substance Abuse Prevention

Budget Authority - Object Class

(Dollars in thousands)

Object Class - Direct Budget Authority1,2

FY 2018

Final

FY 2019

Enacted

FY 2020

President's

Budget

Personnel compensation:

Full-time permanent (11.1)........................................... $--- $--- $---

Other than full-time permanent (11.3).......................... --- --- ---

Other personnel compensation (11.5)........................... --- --- ---

Military personnel (11.7).............................................. --- --- ---

Special personnel services payments (11.8) ................. --- --- ---

Subtotal personnel compensation: --- --- ---

Civilian benefits (12.1)................................................. --- --- ---

Military benefits (12.2).................................................. --- --- ---

Subtotal Pay Costs: --- --- ---

Travel and transportation of persons (21.0).................. --- --- ---

Transportation of things (22.0)..................................... --- --- ---

Rental payments to GSA (23.1).................................... --- --- ---

Rental payments to Others (23.2) .................................. --- --- ---

Communication, utilities, and misc. charges (23.3)...... --- --- ---

Printing and reproduction (24.0)................................... 259 263 228

Other Contractual Services: --- --- ---

Advisory and assistance services (25.1) ....................... 6,205 6,305 6,355

Other services (25.2)..................................................... 22,314 22,671 22,102

Purchase of Goods & Svcs. from Govt. Accts (25.3)... 6,617 6,723 6,651

Operation and maintenance of facilities (25.4)............. --- --- ---

Research and Development Contracts (25.5)................ --- --- ---

Operation and maintenance of equipment (25.7).......... --- --- ---

Subtotal Other Contractual Services: 35,137 35,699 35,107

Supplies and materials (26.0)........................................ 8 8 9 

Equipment (31.0).......................................................... --- --- ---

Grants, subsidies, and contributions (41.0)................... 212,815 169,498 208,746

Interest and dividends (43.0) ........................................ --- --- ---

Subtotal Non-Pay Costs 248,219 205,469 244,090

Total Direct Obligations 248,219 205,469 244,090 1 Does not include PHS EVAL Funds.

2 Includes Prevention and Public Health Funds.
321

Substance Abuse and Mental Health Services Administration

Substance Abuse Treatment

Budget Authority - Object Class

(Dollars in thousands)

Object Class - Direct Budget Authority1,2

FY 2018

Final

FY 2019

Enacted

FY 2020

President's

Budget

Personnel compensation:

Full-time permanent (11.1)........................................... $3,978 $3,117 $3,117

Other than full-time permanent (11.3).......................... 89 83 83

Other personnel compensation (11.5)........................... 78 54 54

Military personnel (11.7).............................................. --- --- ---

Special personnel services payments (11.8) ................. --- --- ---

Subtotal personnel compensation: 4,146 3,254 3,254

Civilian benefits (12.1)................................................. 1,010 1,295 1,020

Military benefits (12.2).................................................. --- --- ---

Subtotal Pay Costs : 5,156 4,548 4,274

Travel and transportation of persons (21.0).................. 99 101 103

Transportation of things (22.0)..................................... --- --- ---

Rental payments to GSA (23.1).................................... 138 140 143

Rental payments to Others (23.2) .................................. --- --- ---

Communication, utilities, and misc. charges (23.3)...... 4 4 4

Printing and reproduction (24.0)................................... 10 10 10

Other Contractual Services: --- --- ---

Advisory and assistance services (25.1) ....................... 10,086 10,247 10,442

Other services (25.2)..................................................... 17,211 17,486 17,818

Purchase of Goods & Svcs. from Govt. Accts (25.3)... 13,537 13,753 14,014

Operation and maintenance of facilities (25.4)............. 14 15 15

Research and Development Contracts (25.5)................ --- --- ---

Operation and maintenance of equipment (25.7).......... --- --- ---

Subtotal Other Contractual Services: 40,847 41,501 42,289

Supplies and materials (26.0)........................................ 16 16 16

Equipment (31.0).......................................................... 3 3 3

Grants, subsidies, and contributions (41.0)................... 3,629,698 3,691,234 3,661,925

Interest and dividends (43.0) ........................................ --- --- ---

Subtotal Non-Pay Costs 3,670,814 3,733,008 3,704,493

Total Direct Obligations $3,675,970 $3,737,556 $3,708,767 1 Does not include PHS EVAL Funds.

2 Includes Prevention and Public Health Funds.
322

Substance Abuse and Mental Health Services Administration

Health Surveillance and Program Support

Budget Authority - Object Class

(Dollars in thousands)

Object Class - Direct Budget Authority1,2

FY 2018

Final

FY 2019

Enacted

FY 2020

President's

Budget

Personnel compensation:

Full-time permanent (11.1)........................................... $42,401 $42,602 $42,602

Other than full-time permanent (11.3).......................... 1,900 1,909 1,909

Other personnel compensation (11.5)........................... 1,158 1,163 1,163

Military personnel (11.7).............................................. 3,299 3,383 3,488

Special personnel services payments (11.8) ................. 18 18 18

Subtotal personnel compensation: 48,775 49,075 49,180

Civilian benefits (12.1)................................................. 14,102 14,169 14,169

Military benefits (12.2).................................................. 1,738 1,782 1,838

Subtotal Pay Costs: 64,615 65,026 65,186

Travel and transportation of persons (21.0).................. 698 709 723

Transportation of things (22.0)..................................... 18 18 18

Rental payments to GSA (23.1).................................... 6,386 6,488 6,612

Rental payments to Others (23.2) .................................. 3 3 3

Communication, utilities, and misc. charges (23.3)...... 1 1 1

Printing and reproduction (24.0)................................... 66 67 68

Other Contractual Services: --- --- ---

Advisory and assistance services (25.1) ....................... 1,180 1,198 1,221

Other services (25.2)..................................................... 53,054 52,463 20,262

Purchase of Goods & Svcs. from Govt. Accts (25.3)... 2,518 2,559 2,607

Operation and maintenance of facilities (25.4)............. --- --- — 

Research and Development Contracts (25.5)................ --- --- ---

Operation and maintenance of equipment (25.7).......... 6 6 6

Subtotal Other Contractual Services: 56,757 56,226 24,096

Supplies and materials (26.0)........................................ 225 228 233

Equipment (31.0).......................................................... 63 64 65

Grants, subsidies, and contributions (41.0)................... --- --- ---

Interest and dividends (43.0) ........................................ --- --- ---

Subtotal Non-Pay Costs 64,215 63,804 31,818

Total Direct Obligations $128,830 $128,830 $97,004 1 Does not include PHS EVAL Funds.

2 Includes Prevention and Public Health Funds.
323

Substance Abuse and Mental Health Services Administration

Total PHS Evaluation Funds - Object Class

(Dollars in thousands)

Object Class - PHS Evaluation Funds

FY 2018

Final

FY 2019

Enacted

FY 2020

President's

Budget

Personnel Compensation:

Full Time Permanent (11.1)........................................... $9,790 $9,971 $9,971

Other than Full-Time Permanent (11.3)........................ 543 552 552

Other Personnel Compensation (11.5) .......................... 205 208 208

Military Personnel Compensation (11.7) ...................... 484 343 459

Special personnel services payments (11.8)..................... --- --- ---

Subtotal Personnel Compensation: 11,022 11,075 11,190

Civilian Personnel Benefits (12.1)................................. 3,236 3,297 3,304

Military Personnel Benefits (12.2) ............................... 252 285 240

Subtotal Pay Costs : 14,511 14,657 14,734

Travel (21.0)................................................................. 22 22 22

Transportation of things (22.0)..................................... --- --- ---

Rental payments to GSA (23.1).................................... --- --- ---

Communications, Utilities and Misc. Charges (23.3)... --- --- ---

Printing and Reproduction (24.0) ................................. 100 102 102

Other Contractual Services: 175 178 178

Advisory and assistance services (25.1) ....................... --- --- ---

Other services (25.2) .................................................... 102,131 103,283 114,713

Purchase of Goods & Svcs. from Govt. Accts (25.3)... 1,273 1,294 1,298

Operation and maintenance of equipment (25.7).......... --- --- ---

Subtotal Other Contractual Services: .......................... 103,405 104,577 116,011

Supplies and Materials (26.0)....................................... 79 80 81

Equipment (31.0).......................................................... 1 1 1

Grants, Subsidies, and Contributions (41.0).................. 15,550 14,228 11,741

Subtotal Non-Pay Costs 119,156 119,010 127,959

Total Reimbursable Obligations $133,667 $133,667 $142,692
324

Substance Abuse and Mental Health Services Administration

Mental Health Services

PHS Evaluation Funds - Object Class

(Dollars in thousands)

Object Class - PHS Evaluation

FY 2018

Final

FY 

2019 

Enacted

FY 2020

President's

Budget

Personnel compensation:

Full-time permanent (11.1)........................................... $1,570 $1,578 $1,578

Other than full-time permanent (11.3).......................... --- --- ---

Other personnel compensation (11.5)........................... 23 24 24

Military personnel (11.7).............................................. 104 107 110

Special personnel services payments (11.8) ................. --- --- ---

Subtotal personnel compensation: 1,698 1,708 1,711

Civilian benefits (12.1)................................................. 535 537 540

Military benefits (12.2)................................................. 60 61 63

Subtotal Pay Costs: 2,292 2,306 2,314

Travel and transportation of persons (21.0).................. 7 7 7

Transportation of things (22.0)..................................... --- --- ---

Rental payments to GSA (23.1).................................... --- --- ---

Communication, utilities, and misc. charges (23.3)...... --- --- ---

Printing and reproduction (24.0) .................................. --- --- ---

Other Contractual Services: --- --- ---

Advisory and assistance services (25.1) ....................... --- --- ---

Other services (25.2) .................................................... 13,872 14,094 14,362

Purchase of Goods & Svcs. from Govt. Accts (25.3).. 50 51 52

Operation and maintenance of equipment (25.7).......... --- --- ---

Subtotal Other Contractual Services: 13,922 14,145 14,414

Supplies and materials (26.0) ....................................... 76 77 79

Equipment (31.0).......................................................... --- --- ---

Grants, subsidies, and contributions (41.0)................... 4,742 4,503 4,225

Subtotal Non-Pay Costs 18,747 18,733 18,725

Total Reimbursable Obligations $21,039 $21,039 $21,039
325

Substance Abuse and Mental Health Services Administration

Substance Abuse Treatment

PHS Evaluation Funds - Object Class

(Dollars in thousands)

Object Class - PHS Evaluation

FY 2018

Final

FY 

2019 

Enacted

FY 2020

President's

Budget

Personnel compensation:

Full-time permanent (11.1)......................................... $2,952 $2,966 $2,966

Other than full-time permanent (11.3)........................ 94 94 94

Other personnel compensation (11.5)........................ 60 61 61

Military personnel (11.7)............................................ 170 174 180

Special personnel services payments (11.8)............... --- --- ---

Subtotal personnel compensation: 3,276 3,295 3,300

Civilian benefits (12.1).............................................. 943 947 952

Military benefits (12.2) .............................................. 92 95 98

Subtotal Pay Costs : 4,311 4,337 4,350

Travel and transportation of persons (21.0)................ 14 14 14

Transportation of things (22.0).................................. --- --- ---

Rental payments to GSA (23.1).................................. --- --- ---

Communication, utilities, and misc. charges (23.3).... --- --- ---

Printing and reproduction (24.0) ................................ 100 102 102

Other Contractual Services: --- --- ---

Advisory and assistance services (25.1)..................... --- --- ---

Other services (25.2) ................................................. 65,694 66,745 66,942

Purchase of Goods & Svcs. from Govt. Accts (25.3) 272 276 277

Operation and maintenance of equipment (25.7) ....... --- --- ---

Subtotal Other Contractual Services: 65,965 67,021 67,219

Supplies and materials (26.0) .................................... 1 1 1

Equipment (31.0)........................................................ 1 1 1

Grants, subsidies, and contributions (41.0) ................ 10,808 9,725 7,514

Subtotal Non-Pay Costs 76,889 76,863 74,851

Total Reimbursable Obligations $81,200 $81,200 $79,200
326

Substance Abuse and Mental Health Services Administration

Health Surveillance and Program Support

PHS Evaluation Funds - Object Class

(Dollars in thousands)

Object Class - PHS Evaluation

FY 2018

Final

FY 2019

Enacted

FY 2020

President's

Budget

Personnel compensation:

Full-time permanent (11.1) ............................................ $5,268 $5,428 $5,428

Other than full-time permanent (11.3)............................ 450 458 458

Other personnel compensation (11.5)............................. 121 124 124

Military personnel (11.7)................................................ 210 63 169

Special personnel services payments (11.8) ................... --- --- ---

Subtotal personnel compensation: 6,049 6,072 6,179

Civilian benefits (12.1)................................................... 1,759 1,813 1,813

Military benefits (12.2).................................................... 100 129 79

Subtotal Pay Costs : 7,908 8,014 8,071

Travel and transportation of persons (21.0).................... 1 1 1

Transportation of things (22.0)....................................... --- --- ---

Rental payments to GSA (23.1)...................................... --- --- ---

Communication, utilities, and misc. charges (23.3)........ --- --- ---

Printing and reproduction (24.0)..................................... --- --- ---

Other Contractual Services: 175 178 178

Advisory and assistance services (25.1) ......................... --- --- ---

Other services (25.2)....................................................... 22,565 22,444 33,409

Purchase of Goods & Svcs. from Govt. Accts (25.3) ..... 952 967 970

Operation and maintenance of equipment (25.7)............ --- --- ---

Subtotal Other Contractual Services: 23,517 23,411 34,379

Supplies and materials (26.0) ......................................... 2 2 2

Equipment (31.0)............................................................ --- --- ---

Grants, subsidies, and contributions (41.0)..................... --- --- ---

Subtotal Non-Pay Costs 23,520 23,414 34,382

Total Reimbursable Obligations $31,428 $31,428 $42,453
327

Substance Abuse and Mental Health Services Administration

Salaries and Expenses Tables

Direct Budget Authority - Object Class

(Dollars in thousands)

Object Class - Direct Budget Authority1,2

FY 2018

Final

FY 2019

Enacted

FY 2020

President's

Budget

Personnel compensation:

Full-time permanent (11.1) ........................................... $47,740 $47,086 $47,086

Other than full-time permanent (11.3) .......................... 2,015 2,018 2,018

Other personnel compensation (11.5) .......................... 1,253 1,234 1,234

Military personnel (11.7) .............................................. 3,299 3,383 3,488

Special personnel services payments (11.8).................. 18 18 18

Subtotal personnel compensation 54,325 53,740 53,844

Civilian benefits (12.1) ................................................ 15,556 15,910 15,635

Military benefits (12.2) ................................................. 1,738 1,782 1,838

Subtotal Pay Costs: 71,619 71,432 71,317

Travel (21.0) ................................................................. 1,059 1,076 1,096

Transportation of things (22.0) .................................... 18 18 19 

Rental payments to Others (23.2).................................. 3 3 3

Communication, utilities, and misc. charges (23.3) ...... 395 401 409

Printing and reproduction (24.0)................................... 393 399 367

Other Contractual Services:

Advisory and assistance services (25.1)........................ 32,803 33,328 33,891

Other services (25.2).................................................... 130,942 131,598 99,901

Purchase of Goods & Svcs. from Govt. Accts (25.3)... 35,886 36,461 36,953

Operation and maintenance of facilities (25.4) ............. 212 216 220

Research and Development Contracts (25.5)................ --- --- ---

Operation and maintenance of equipment (25.7) .......... 113 114 117

Subtotal Other Contractual Services: 199,957 201,717 171,082

Supplies and materials (26.0)....................................... 325 330 336

Subtotal Non-Pay Costs 202,149 203,944 173,311

Total Salary and Expenses 273,768 275,376 244,628

Rental Payments to GSA (23.1).................................... 6,524 6,628 6,754

Grand Total, Salaries & Expenses and Rent $280,292 $282,004 $251,383

Direct FTE................................................................... 455 505 510 1 Does not include PHS EVAL Funds.

2 Includes Prevention and Public Health Funds.
328

Substance Abuse and Mental Health Services Administration

Salaries and Expenses Tables

PHS Evaluation Funds - Object Class

(Dollars in thousands)

Object Class1

FY 2018

Final

FY 2019

Enacted

FY 2020

President's

Budget

Personnel compensation:

Full-time permanent (11.1)....................................... $9,790 $9,971 $9,971

Other than full-time permanent (11.3)..................... 543 552 552

Other personnel compensation (11.5)...................... 205 208 208

Military personnel (11.7)......................................... 484 343 459

Special personnel services payments (11.8) ............ --- --- ---

Subtotal personnel compensation 11,022 11,075 11,190

Civilian benefits (12.1)............................................ 3,236 3,297 3,304

Military benefits (12.2)............................................ 252 285 240

Subtotal Pay Costs: 14,511 14,657 14,734

Travel (21.0)............................................................ 22 22 22

Transportation of things (22.0)................................ --- --- ---

Rental payments to Others (23.2) ............................ --- --- ---

Communication, utilities, and misc. charges (23.3). --- --- ---

Printing and reproduction (24.0).............................. 100 102 102

Other Contractual Services:

Advisory and assistance services (25.1) ................... --- --- ---

Other services (25.2)................................................ 102,131 103,283 114,713

Purch. Goods & Svcs. Govt. Accts (25.3) ............... 1,273 1,294 1,298

Operation and maintenance of facilities (25.4)........ --- --- ---

Research and Development Contracts (25.5)............ --- --- ---

Operation and maintenance of equipment (25.7)..... --- — ---

Subtotal Other Contractual Services: 103,405 104,577 116,011

Supplies and materials (26.0)................................... 79 80 81

Subtotal Non-Pay Costs 103,605 104,781 116,217

Total Salary and Expenses 118,116 119,438 130,951

Rental Payments to GSA (23.1)............................... --- --- ---

Grand Total, Salaries & Expenses and Rent $118,116 $119,438 $130,951

Reimbursable FTE.............................................. 106 106 96 1 Does not include Other reimbursable FTEs (30) and associated Object Class cost.
329

Detail of Full Time Equivalent Employee (FTE)

FY 2018

Final

Civilian

FY 2018

Final

Military

FY 2018

Final

Total

FY 2019

Est.

Civilian

FY 2019

Est.

Military

FY 2019

Est.

Total

FY 2020

Est.

Civilian

FY 2020

Est.

Military

FY 2020

Est.

Total

Health Surveillance and Program Support...

Direct: ........................................................ 391 31 422 421 31 452 418 30 448

Reimbursable: ............................................ 30 1 30 38 3 41 39 4 43

Total: ....................................................... 421 31 453 459 34 493 457 34 491

Mental Health Services................................

Direct: ........................................................ 13 0 13 13 0 13 13 0 13

Reimbursable: ............................................ 17 1 18 20 3 23 20 2 22

Total: ....................................................... 30 1 31 33 3 36 33 2 35

Substance Abuse Prevention ........................

Direct: ........................................................ 0 0 0 0 0 0 0 0 0

Reimbursable: ............................................ 20 2 21 21 2 23 21 1 22

Total: ....................................................... 20 2 21 21 2 23 21 1 22

Substance Abuse Treatment........................

Direct: ........................................................ 32 0 32 32 1 33 32 1 33

Reimbursable: ............................................ 23 2 25 25 1 26 24 1 25

Total: ....................................................... 55 2 57 57 2 59 56 2 58

SAMHSA FTE Total............................. 525 36 561 570 41 611 567 39 606
Substance Abuse and Mental Health Administration

Detail of Positions

FY 2018

Final

FY 2019

Enacted

FY 2020 President's

Budget

Executive Level IV 1 1 1

Subtotal 1 1 1

Total - Exec Level Salaries $155,500 $155,500 $155,500

SES 14 20 20

Subtotal 14 20 20

Total, SES salaries $3,255,827 $4,651,181 $4,651,181

GM/GS-15/EE 64 64 64

GM/GS-14 122 122 122

GM/GS-13 205 205 205

GS-12 54 54 54

GS-11 21 23 27

GS-10 1 1 1

GS-09 20 25 25

GS-08 18 18 16

GS-07 16 23 20

GS-06 11 11 9

GS-05 3 3 3

GS-04 0 0 0

GS-03 0 0 0

GS-02 0 0 0

GS-01 0 0 0

Subtotal 510 549 546

Total, GS salaries $76,038,085 $81,852,762 $81,405,479

CC-08/09 0 1 1

CC-07 0 0 0

CC-06 17 17 18

CC-05 8 10 9

CC-04 7 11 9

CC-03 4 2 2

CC-02 0 0 0

CC-01 0 0 0

Subtotal 36 41 39

Total, CC salaries $5,773,068 $6,745,830 $6,615,685

Total Positions1 561 611 606

Average ES level ES ES ES

Average ES salary $155,500 $155,500 $155,500

Average SES level SES SES SES

Average SES salary $232,559 $232,559 $232,559

Average GS grade 13.5 13.6 13.6

Average GS salary $149,094 $149,094 $149,094

Average CC level 5 5 5

Average CC salaries $160,363 $164,532 $169,633

330
Programs Proposed for Elimination

The following table shows the programs proposed for elimination in the FY 2020 Budget Request. 

Terminations of these programs total $100.0 million across the three appropriations: Mental Health, 

Substance Abuse Prevention, and Substance Abuse Treatment.

The following is a brief summary of the program and rational for the elimination proposal.

(Dollars in thousands)

Program

FY 2019

Enacted

Primary and Behavioral Health Care Integration.............. 49,877

Primary and Behavioral Health Care Integration.............. 1,991

Minority Fellowship Program......................................... 13,169

Infant and Early Childhood Mental Health...................... 5,000

Screening, Brief Intervention and Referral to Treatment... 30,000

Total $100,037

Primary and Behavioral Health Care Integration

The Primary and Behavioral Health Care Integration (PBHCI) program began in FY 2009 to address 

specifically this intersection between primary care and mental disorder treatment. The program 

supports two activities: grants to community mental health centers and the PBHCI Training and 

Technical Assistance (TTA) Center, which is co-funded through a competitive cooperative 

agreement with the Health Resources and Services Administration (HRSA). These two activities 

collectively support the coordination and integration of primary care services into publicly funded 

community behavioral health settings for individuals with SMI and/or people with co-occurring 

disorders served by the public mental health system. PBHCI seeks to improve health outcomes for 

people with SMI by encouraging grantees to engage in necessary collaboration, expand 

infrastructure, and increase the availability of primary healthcare and wellness services for 

individuals with mental illness.

The Primary and Behavioral Healthcare Integration ($51.9 million) program is being proposed for 

elimination, as this program is potentially fundable through other sources of funds including the 

Substance Abuse Block Grant and Certified Community Behavioral health Center funding. 

SAMHSA will continue to disseminate the lessons learned from this program.

Minority Fellowship Program 

SAMHSA’s Minority Fellowship Program (MFP) increases behavioral health practitioners’ 

knowledge of issues related to prevention, treatment, and recovery support for mental illness and 

drug/alcohol addiction among racial and ethnic minority populations. The program provides stipends 

to funding increases the number of culturally competent behavioral health professionals who teach, 

administer, conduct services research, and provide direct mental illness or substance abuse treatment 

services for minority populations that are underserved. This will result in improved quality of mental 

and substance abuse prevention and increased treatment delivered to ethnic minorities. Since its start 

in 1973, the program has helped to enhance services for racial and ethnic minority communities 

through specialized training of mental health professionals in psychiatry, nursing, social work, and 

psychology. In 2006, the program expanded to include marriage and family therapists and later

331 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

added professional counselors. These individuals often serve in key leadership positions in mental 

illness and substance abuse treatment services, services supervision, services research, training, and 

administration. Professional guilds receive competitively awarded grants, and then competitively 

award the stipends to post-graduate students pursuing a degree in that professional field. In FY 2018 

and FY 2019, SAMHSA funded seven continuation grants. 

SAMHSA is proposing to eliminate the MFP in Mental Health, Substance Abuse Prevention and 

Substance Abuse Treatment ($13.2 million) because it overlaps with other federal activities. 

Screening, Brief Intervention and Referral to Treatment (SBIRT) 

In 2003, SAMHSA started the Screening, Brief Intervention and Referral to Treatment (SBIRT) 

program, which is intended to help primary care physicians identify individuals who misuse 

substances and help them intervene early with education, brief treatment, or referral to specialty 

treatment. The program’s goal is to increase the number of individuals who receive treatment and

reduce the rate of substance misuse. The SBIRT program seeks to increase the use of SBIRT in 

medical settings by promoting wide dissemination and adoption of the practice across the spectrum 

of primary care services. To achieve this, SAMHSA awards state implementation grants to 

encourage adoption of SBIRT by healthcare providers in each state. SAMHSA has demonstrated the 

effectiveness of SBIRT and continues to disseminate SBIRT practices. 

SAMHSA is proposing to eliminate the SBIRT program ($30.0 million) as significant knowledge 

has been developed and disseminated for this program and it has been brought to scale in hundreds 

of communities across the nation. SAMHSA will continue to disseminate SBIRT program 

information as necessary. 

Infant and Early Childhood Mental Health 

SAMHSA expects this program will increase access to a range of evidence-based and culturallyappropriate infant and early childhood mental health services, and will aid in addressing the national 

shortage of mental health professionals with infant and early childhood expertise. Because the 

wellbeing of caregivers dramatically impacts the development of infants and young children, this 

program also promotes a multigenerational approach that supports caregivers and other family 

members of infants and young children. 

Program activities include providing and ensuring access to culturally- and developmentallyappropriate mental health services; implementing mental health consultation to build capacities of 

the early childhood workforce; creating opportunities for child- and family-serving providers to 

develop greater expertise and knowledge of infant and childhood mental health; and increasing 

availability of specialized training for mental health clinicians and trainees on infant and early 

childhood promising and evidence-based practices and treatment approaches. In FY 2018, 

SAMHSA awarded 10 new grants for five-years. In FY 2019 SAMHSA supported the continuation 

of 10 grants. 

SAMSHA is proposing to eliminate the Infant Early Childhood Mental Health program ($5.0 

million) because it overlaps with other federal activities. 

332 
Table 1

PY 2018

Final

CY 2019 

Enacted

BY 2020

President's 

Budget

1 1 1

--- --- ---

1 1 1

$145,148 $148,967 $148,967

$16,000 $16,000 $16,000

Category I Clinical Position --- --- ---

Category II Research Position --- --- ---

Category III Occupational Health --- --- ---

Category IV-A Disability Evaluation --- --- ---

Category IV-B Health and Medical Admin. 1 1 1

 Physicians’ Comparability Allowance (PCA) Worksheet

1) Number of Physicians Receiving PCAs

5) Average Annual PCA Payment

4) Average Annual PCA Physician Pay (without PCA payment)

3) Number of Physicians with Multi-Year PCA Agreements

2) Number of Physicians with One-Year PCA Agreements

6) Number of Physicians

Receiving PCAs by Category

(non-add)

Substance Abuse and Mental Health Services Administration

10) Explain the degree to which recruitment and retention problems were alleviated in your agency through the use of PCAs in

the prior fiscal year.

We have to offer PCAs because our salaries are not competitive with the private sector (e.g., we might offer 75% of a physician's 

salary on the outside). In addition, physicians of interest to SAMHSA often have income from consulting as well. The PCA is the 

only way to raise the government income so as to make the offer acceptable. 

11) Provide any additional information that may be useful in planning PCA staffing levels and amounts in your agency.

N/A

7) If applicable, list and explain the necessity of any additional physician categories designated by your agency (for categories

other than I through IV-B). Provide the number of PCA agreements per additional category for the PY, CY and BY.

N/A

8) Provide the maximum annual PCA amount paid to each category of physician in your agency and explain the reasoning for

these amounts by category.

$30.000.00 - based on years of education, experience, and the position held by the incumbent. Amount is required to retain the 

employee.

9) Explain the recruitment and retention problem(s) for each category of physician in your agency (this should demonstrate that

a current need continues to persist).

We have to offer PCAs because our salaries are not competitive with the private sector.

333
SAMHSA FY20 CJ Significant Items 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Senate Appropriations Committee, Labor/HHS/Education Subcommittee, C. Rept. 115-952 

 

House Appropriations Committee, Labor/HHS/Education Subcommittee (S. Rept. 115-289) 

1. Certified Community Behavioral Health Clinics.—The bill includes $150,000,000, an 

increase of $50,000,000, to provide grants to clinics certified by their State to provide 

treatment for those with mental health illness. The Committee expects SAMHSA will continue 

to provide competitive grants to those areas also impacted by the opioid crisis. (Page 9, S. 

Rept. 115-289) 

Action taken or to be taken 

In FY 2018, SAMHSA awarded funding to 52 Certified Community Behavioral Health 

Clinics and will fund an additional 12 CCBHCs in FY 2019. 

2. Mental Health Awareness Training.—The Committee provides $21,963,000, an increase 

of $2,000,000 to continue existing activities, including Mental Health First Aid. The 

Committee is pleased with the progress of the Mental Health First Aid program. Mental 

Health First Aid has trained more than 1,000,000 Americans to recognize the signs and 

symptoms of common mental disorders and the recent inclusion of the program in the 

International Association of Chiefs of Police One Mind Campaign. In continuing competitive 

funding opportunities, SAMHSA is directed to include as eligible grantees local law 

enforcement agencies, fire departments, and emergency medical units with a special 

emphasis on training for crisis de-escalation techniques. SAMHSA is also encouraged to 

allow training for veterans, armed services personnel and their family members within the 

Mental Health First Aid program. (Page 128, S. Rept. 115-289) 

Action taken or to be taken 

In FY 2018, SAMHSA awarded funding to 138 entities, including local law enforcement, 

fire departments, and emergency medical units. The funding opportunity announcement was 

designed to train individuals (e.g., school personnel, emergency first responders, law 

enforcement, veterans, armed services members and their families) to recognize the signs 

and symptoms of mental disorders, particularly serious mental illness (SMI) and/or serious 

emotional disturbance (SED); (2) establish linkages with school- and/or community-based 

mental health agencies to refer individuals with the signs or symptoms of mental illness to 

appropriate services; (3) train emergency services personnel, veterans, law enforcement, fire 

department personnel, and others to identify persons with a mental disorder and employ crisis 

de-escalation techniques. In FY 2019, SAMHSA awarded funding to an additional 18 

Mental Health Awareness Training applicants. 

3. National Traumatic Stress Network - In order to award funds not later than December 1, 

2018, the conferees direct SAMHSA to take administrative action that would provide 

supplemental awards to existing grantees in the National Child Traumatic Stress Network 

334 
 

 

 

 

 

 

 

 

 

 

 

 

 

who have already received Federal funding through a competitive process. (Page 38, C. 

Rept. 115-952) 

Action taken or to be taken 

SAMHSA made supplemental awards to National Child Traumatic Stress Network grantees 

for the purpose of providing mental health services for unaccompanied alien children, with 

a special focus on children who were separated from a parent or family unit and subsequently 

classified as unaccompanied alien children; mental health services for children in Puerto 

Rico; and expand NCTSI access to tribal populations. 

4. State Opioids response grants. - The conferees direct SAMHSA to adhere to the directives 

under this heading in Senate Report 115-289. (Page 41, C. Rept. 115-952) 

Action taken or to be taken 

SAMHSA received $1.5 billion in FY 2019 Enacted and requested the same amount in 

FY 2020 President’s Budget for grants to States to address the opioid crisis. SAMHSA 

adhered to the directives as in Senate Report 115-289 

Senate Appropriations Committee, Labor/HHS/Education Subcommittee, H. Rept. 115-862 

5. Where permitted in the authorizing statute, the Committee directs SAMHSA when issuing 

new funding opportunity announcements, to include as an eligible applicant: States, political 

subdivisions of States (local government/ communities/ municipalities), Indian Tribes or 

Tribal organizations, or other public or nonprofit entities or organizations. The Committee 

encourages SAMHSA to provide outreach and technical assistance to ensure the maximum 

level of awareness and participation in new grant announcements. 

Action taken or to be taken 

In 2018, in response to requests for technical assistance received from the field, SAMHSA 

published on its website a manual entitled, “Developing a Competitive SAMHSA Grant

Application.” SAMHSA conducted 12 webinars throughout the past year, with over one

thousand individuals participating, to highlight key points addressed in the manual. 

Widespread notifications were sent out to inform individuals about the webinars, including 

current grant recipients, state officials, SAMHSA staff, and non-funded applicants. Feedback 

received on the manual and webinars has been overwhelmingly positive. Additional webinars 

will be planned for the coming year 

6. Mental Health Awareness Training.—The Committee is pleased with the progress of the 

Mental Health Awareness Training program which has trained more than one million 

Americans to recognize the signs and symptoms of common mental disorders. In continuing 

competitive funding opportunities, SAMHSA is directed to include as eligible grantees local 

law enforcement agencies, fire departments, and emergency medical units with a special 

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emphasis on training for crisis de-escalation techniques. SAMHSA is also encouraged to 

allow training for veterans, armed services personnel, and their family members. Consistent 

with the authorization, funds are directed to support grants for evidence-based programs 

that provide training and education on recognizing the signs and symptoms of mental illness, 

resources available in the community for individuals with a mental illness, and safely deescalating crisis situations involving individuals with a mental illness. (Page 79, H. Rept. 

115-862) 

Action taken or to be taken 

SAMHSA included eligible grantees as directed and issued a Funding Opportunity 

Announcement to include SAMHSA included eligible grantees as directed and issued a 

Funding Opportunity Announcement (FOA) to include local law enforcement agencies, fire 

departments, and emergency medical units with a special emphasis on training for crisis deescalation techniques. In addition, the FOA include training for veterans, armed services 

personnel, and their family members. SAMHSA awarded funding to 138 entities, including 

local law enforcement, fire departments, and emergency medical units 

applicants. 

7. Medical Provider Education on Opioid Treatment. - The Committee provides 

$24,000,000 for carrying out medical and other healthcare practitioner education. The 

Committee directs SAMHSA to provide grants to medical schools, schools of nursing, social 

work, physician assistants, and other colleges and universities to ensure that training in the 

field of substance use disorders, including opioid use disorders, is incorporated into the 

standard curriculum of the university programs. Activities should include both didactic and 

hands on training for students. Funds should support Drug Addiction Treatment Act of 2000 

waiver training for designated practitioners to be able to engage in office based treatment 

for substance use disorders, including opioid use disorders. The Committee expects training 

and practice requirements to be consistent with section 303(g) (2) of the Controlled 

Substances Act, including diversion control, relapse prevention, overdose reversal, 

detoxification, and the clinical use of FDA-approved medications. These grants are expected 

to generate a well-equipped workforce to address the behavioral health needs of individuals 

across the country and ultimately close the substance use disorder treatment gap. (Page 81, 

H. Rept. 115-862) 

Action taken or to be taken 

SAMHSA was not appropriated this funding 

8. Targeted Capacity Expansion. - The Center for Substance Abuse Treatment is directed to 

include as an allowable use medication-assisted treatment and other clinically appropriate 

services to achieve and maintain abstinence from all opioids and heroin and prioritize 

treatment regimens that are less susceptible to diversion for illicit purposes. Further, for the 

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additional funds, the Committee directs SAMHSA to prioritize grants from nonprofit 

organizations and political subdivisions of States. (Page 82, H. Rept. 115-862) 

Action taken or to be taken 

The Center for Substance Abuse Treatment (CSAT) expanded eligibility for funding for 

Targeted Capacity Expansion: Medication Assisted Treatment in FY 2019. Expanded 

eligibility included states, political subdivisions in states or nonprofit organizations within 

the states identified with having the highest primary treatment admissions for heroin and 

opioids per capita and included those with the most dramatic increases for heroin and opioids. 

Required activities included: MAT using one of the FDA-approved medications for the 

maintenance treatment of opioid use disorder (OUD), provision of comprehensive OUD 

psychosocial services, and establishment/implementation of a plan to mitigate the risk of 

diversion of methadone or buprenorphine ensuring the appropriate use/dose of medication 

by patients. With the additional funds of $5 million, SAMHSA prioritized grants from 

nonprofit organizations and political subdivisions of States. SAMHSA funded 23 nonprofit 

organizations and political subdivisions of States for a total of $11,203,387.00 and seven 

AI/AN tribes/tribal organizations for a total of $5,088,385. 

9. Pregnant Women - Substance use during pregnancy, particularly the misuse of opioids, has 

increased in parallel with the national rate of opioid misuse. While much attention has been 

paid to the negative impacts of opioid use on the fetus and newborn, less attention has been 

given to the pregnant woman. The Committee encourages cross-HHS collaboration between 

research and public health programs, as well as engagement with health care providers and 

patients to ensure that the care and treatment of pregnant women with substance use disorder 

is considered and included in any national efforts to address the opioid epidemic. The 

Committee requests an update on these efforts in the fiscal year 2020 Congressional 

Justification. (Page 83, H. Rept. 115-862) 

Action taken or to be taken 

In FY 2017, SAMHSA began a three-year PPW cross-site evaluation to examine the 

effectiveness of the PPW Pilot Program. An aim of the Comprehensive Addiction and 

Recovery Act (CARA) is to address substance abuse and addiction across the country 

through the implementation of prevention, treatment, and recovery programs. Section 501 

of that act increases accessibility and availability of services for pregnant women by 

expanding the authorized purposes of the Pregnant and Postpartum Women program to 

include the provision of outpatient and intensive outpatient services for pregnant women. 

Historically, the PPW program has only supported the provision of residential treatment 

services. These funds will continue to address the gaps in substance abuse treatment by 

providing services for youth, their families, and caregivers. SAMHSA requested $29 million 

in the FY 2020 President’s Budget, the same amount with FY 2019 Enacted level. SAMHSA 

intends to fund 38 residential treatment grant continuations, three PPW Pilot continuation 

grants and 2 new PPW Pilot grants to provide a continuum of services and supports to 

pregnant women and their children. 

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10. Drug Courts - The Committee continues to direct SAMHSA to ensure that all funding 

appropriated for Drug Treatment Courts is allocated to serve people diagnosed with a 

substance use disorder as their primary condition. The Committee directs SAMHSA to ensure 

that all drug treatment court grant recipients work directly with the corresponding State 

substance abuse agency in the planning, implementation, and evaluation of the grant. The 

Committee further directs SAMHSA to expand training and technical assistance to drug 

treatment court grant recipients. (Page 83, H. Rept. 115-862) 

Action taken or to be taken 

SAMHSA adhered to the directives in H. Rept. 115-862. SAMHSA’s funding

announcements state that grant funds must be used to serve people diagnosed with a SUD as 

their primary condition. Government project officers monitor compliance with this 

requirement throughout the grant lifecycle. SAMHSA’s Adult Treatment Drug Court grant 

programs are encouraged to work with the corresponding State Substance Abuse Agency in 

the planning, implementation, and evaluation of their grants. 

11. Implant Delivery Opioid Deterrent Treatment - The Committee requests an update in the 

fiscal year 2020 Congressional Justification on SAMHSA’s efforts to increase patient 

coverage for opioid deterrent treatments and expand access of medication assisted 

treatment, including. (Page 84, H. Rept. 115-862) 

Action taken or to be taken 

SAMHSA was not appropriated this funding 

12. Infectious Disease and the Opioid Epidemic - The Committee notes that the prevalence of 

hepatitis C and human immunodeficiency virus (HIV) have increased along with the opioid 

epidemic. New research suggests that awareness of one’s infection status can help limit

ongoing opioid abuse. The Committee supports efforts to address the overlapping public 

health challenges of hepatitis C and HIV, and requests an update in the fiscal year 2020 

Congressional Justification on efforts to promote screening and rapid-testing activities for 

affected communities. (Page 84, H. Rept. 115-862) 

Action taken or to be taken 

SAMHSA HIV/AIDS programming is fully funded at the FY 2019 Enacted level and 

proposes continuation and 23 new grant programs in FY 2020. SAMHSA requires all clients 

and their drug-using and/or sexual partners must be offered HIV rapid preliminary antibody 

testing at enrollment, including rapid fourth-generation HIV diagnostic testing. It is also 

required, for all clients who are considered to be at risk for viral hepatitis (B and C), to be 

tested in accordance with state and local requirements, either onsite or through referral. 

Grantees may use up to five percent of annual award funds for hepatitis testing and services. 

A plan for case management is provided for clients who test positive for HIV and/or Hepatitis 

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that includes comprehensive assessment of the client's needs, development of an individualized 

service plan and referrals and linkages to follow-up care and treatment. 

13. Prescription Digital Therapeutics - The Committee recognizes that the emerging field of 

prescription digital therapeutics is bringing to market clinically validated, Food and Drug 

Administration cleared software treatments that improve clinical outcomes for patients 

living with substance and opioid use disorders. Given the opportunity to increase abstinence 

and reduce relapse among the over 21 million American estimated to be struggling with these 

disorders, the Committee requests that SAMHSA update the January 2015 Federal 

Guidelines for Opioid Treatment Programs and consider the role that prescription digital 

therapeutics can play as part of evidence-based treatment standards, and in particular their 

potential role in meeting the counseling services requirements under 42 CFR 8.12(f). The 

Committee requests that SAMHSA include an update on this effort in the fiscal year 2020 

Congressional Justification. (Page 84, H. Rept. 115-862) 

Action taken or to be taken 

SAMHSA was not appropriated this funding 

14. Center for the Application of Prevention Technologies - The Committee directs the 

Secretary to expand eligibility for grants under SAMHSA Prevention Programs of Regional 

and National Significance and the corresponding services provided by the Center for the 

Application of Prevention Technologies to private, non-profit, regional organizations, 

including faith-based organizations. The broad coalitions orchestrated by these regional 

organizations are uniquely positioned to supplement the work already being done by the 

State, Tribal and community organizations currently authorized for such grants. (Page 85, 

H. Rept. 115-862) 

Action taken or to be taken 

The eligibility requirements for CSAP’s FY 2019 Programs of Regional and National 

Significance have not been expanded with the exception of the programs identified below: 

The eligibility requirements for FY 2019 Strategic Prevention Framework Partnerships for 

Success (SPF PFS) grant have been expanded to include domestic public or private nonprofit entities. The services provided by the Center for the Application of Prevention 

Technologies (CAPT) contract have been replaced by the Prevention Technology Transfer 

Center (PTTC) cooperative agreement. The eligibility requirements of the PTTC include all 

organizations requested for expansion. The eligibility requirements for the Minority Aids 

Initiative (MAI) grants include all of the organizations referenced above. 

Senate Appropriations Committee, Labor/HHS/Education Subcommittee, S. Rept. 115-290 

15. Community Mental Health Services Block Grant - The Committee recommendation 

continues bill language requiring that at least 10 percent of the funds for the MHBG program 

be set-aside for evidence-based programs that address the needs of individuals with early 

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serious mental illness, including psychotic disorders. The Committee commends SAMHSA 

for its collaboration with NIMH on the implementation of this set-aside. The Committee notes 

that it usually takes 14–17 years to translate research findings into practice and hopes that 

the joint effort between NIMH and SAMHSA may be a model for how to reduce this 

timeframe. The Committee directs SAMHSA to continue its collaboration with NIMH to 

ensure that funds from this set-aside are only used for programs showing strong evidence of 

effectiveness and that target the first episode of psychosis. SAMHSA shall not expand the use 

of the set-aside to programs outside of the first episode psychosis. The Committee directs 

SAMHSA to include in the fiscal year 2020 CJ a detailed table showing at a minimum each 

State’s allotment, name of the program being implemented, and a short description of the

program. (Page 129, S. Rept. 115-290) 

Action taken or to be taken 

SAMHSA continues to collaborate with NIMH on addressing the needs of individuals with 

early serious mental illness, including psychotic disorders and funds from the set-aside are 

only used for programs showing strong evidence of effectiveness and target first episode 

psychosis (FEP). The purpose of this program is to identify youth and young adults, not 

more than 25 years old and at clinical high risk for psychosis, and provide evidence-based 

interventions to prevent the onset of psychosis or lessen the severity of psychotic disorders. 

SAMHSA is collaborating with NIMH on the evaluation of this program. A total of 250 FEP 

programs have been established. This document includes a detailed table on page 138 

showing each State’s allotment, name of the program being implemented, and a short 

description of the program. 

Senate Appropriations Committee, Labor/HHS/Education Subcommittee, S. Rept. 115-291 

16. Children’s Mental Health Services - The Committee recommends $125,000,000 for the 

Children’s Mental Health Services program. This program provides grants and technical 

assistance to support comprehensive, community based systems of care for children and 

adolescents with serious emotional, behavioral, or mental disorders. Grantees must provide 

matching funds and services must be coordinated with the educational, juvenile justice, child 

welfare, and primary healthcare systems. The Committee continues to include a 10 percent 

set-aside for an early intervention demonstration program with persons not more than 25 

years of age at clinical high risk of developing a first episode psychosis. SAMHSA is directed 

to work with NIMH on the implementation of this set-aside. (Page 129, S. Rept. 115-291) 

Action taken or to be taken 

The Children’s Mental Health Services program provides grants and technical assistance to 

support comprehensive, community-based systems of care for children and adolescents with 

serious emotional, behavioral, or mental disorders. Grantees must provide matching funds 

and services must be coordinated with the educational, juvenile justice, child welfare, and 

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primary healthcare systems. As part of the 10 percent set-aside, SAMHSA issued a Funding 

Opportunity Announcement for an early intervention demonstration program for individuals 

not more than 25 years of age at clinical high risk of developing a first episode psychosis. 

SAMHSA will continue to collaborate with NIMH on the implementation of this program. 

In FY 2019, SAMHSA will support the continuation of the grants under the 10 percent setaside. 

Senate Appropriations Committee, Labor/HHS/Education Subcommittee, S. Rept. 115-292 

17. Combatting Opioid Abuse.—The Committee provides $12,000,000 within PRNS for grants 

to prevent opioid overdose related deaths. This program will help States equip and train first 

responders and other community partners with the use of devices that rapidly reverse the 

effects of opioids. The agreement also provides $36,000,000 for First Responder Training 

grants. Of this amount, $18,000,000 is set aside for rural communities with high rates of 

substance abuse. SAMHSA is directed to ensure applicants outline how proposed activities 

in the grant would work with treatment and recovery communities in addition to first 

responders. The Committee has moved this program out of the PRNS account in the Center 

of Substance Abuse Prevention into the PRNS account of the Center for Substance Abuse 

Treatment. The Committee believes the funding should be in CSAT to best ensure that, after 

an overdose is reversed through the use of naloxone, these individuals are given access to a 

recovery coaching and referral to treatment. 

(Page 129, S. Rept. 115-292) 

Action taken or to be taken 

SAMHSA will continue to award grants to Combat Opioid Abuse consistent with prior years 

and the report language. In addition, SAMHSA has complied with direction related to First 

Responder Training grants and the placement of certain programs in CSAT instead of CSAP. 

Senate Appropriations Committee, Labor/HHS/Education Subcommittee, S. Rept. 115-293 

18. Drug Courts - SAMHSA is directed to ensure that drug court funding is allocated to serve 

people diagnosed with a substance use disorder as their primary condition. SAMHSA is 

further directed to ensure that all drug court grant recipients work with the corresponding 

State substance abuse agency in the planning, implementation, and evaluation of the grant. 

SAMHSA should expand training and technical assistance to drug treatment court grant 

recipients to ensure evidence-based practices are fully implemented. (Page 129, S. Rept. 

115-293) 

Action taken or to be taken 

SAMHSA complied with the directives in S. Rept. 115-293. SAMHSA ensures that drug 

court funding is allocated to serve people diagnosed with a substance use disorder as their 

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primary condition. SAMHSA’s Adult Drug Court grant programs are encouraged to work 

with the corresponding State Substance Abuse Agency in the planning, implementation, and 

evaluation of their grants. SAMHSA provides regional and national Training and Technical 

Assistance (T/TA) to drug court grantees on evidence based practices. 

Senate Appropriations Committee, Labor/HHS/Education Subcommittee, S. Rept. 115-294 

19. Medication-Assisted Treatment for Prescription Drug and Opioid Addiction - The 

Committee includes $84,000,000 for Medication Assisted Treatment. SAMHSA is directed to 

include as an allowable use Medication Assisted Treatment and other clinically appropriate 

services to achieve and maintain abstinence from all opioids and heroin. SAMHSA is 

directed to give preference in grant awards to treatment regimens that are less susceptible 

to diversion for illicit purposes. These grants should target States with the highest age 

adjusted rates of admissions, including those that have demonstrated a dramatic age 

adjusted increase in admissions for the treatment of opioid use disorders. The Committee 

continues to direct CSAT to ensure that these grants include as an allowable use the support 

of medication assisted treatment and other clinically appropriate services to achieve and 

maintain abstinence from all opioids and heroin and prioritize treatment regimens that are 

less susceptible to diversion for illicit purposes. (Page 130, S. Rept. 115-294) 

Action taken or to be taken 

All FY 2019 Medication Assisted Treatment and Opioid Addiction grants contain languagerequiring MAT using one of the FDA-approved medications for the maintenance treatment 

of opioid use disorder (OUD), provision of comprehensive OUD psychosocial services, and 

establishment/implementation of a plan to mitigate the risk of diversion of methadone or 

buprenorphine ensuring the appropriate use/dose of medication by patients. SAMHSA 

funded 23 grants to political subdivisions in states or nonprofit organizations within the states 

identified with having the highest primary treatment admissions for heroin and opioids per 

capita, and includes those with the most dramatic increases for heroin and opioids. 

20. Opioid Grants.—The Committee recognizes the work moving forward under the SOR 

program and the State Targeted Response to the Opioid Abuse Crisis grant program. The 

Committee directs SAMHSA to ensure these resources are aligned with the State plan 

developed by each State’s alcohol and drug agency as defined by the agency that manages 

the SAPT Block Grant. This will ensure continuity of funding and coordination of efforts 

within each State system. 

(Page 132, S. Rept. 115-294) 

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Action taken or to be taken 

SAMHSA required that STR strategic plans and SABG plans submitted by each State 

reflected alignment and coordination of SUD and opioid specific activities. SAMHSA 

monitors STR and SOR grantees to coordinate implementation activities with the Single 

State Agency responsible for the SABG Program and the substance use service delivery 

system. The SOR program provides resources to states, territories, and tribes to continue 

and enhance the development of comprehensive strategies focused upon preventing, 

intervening, and promoting recovery from problems related to opioid abuse as a part of the 

state’s overall SUD strategy. 

21. Substance Abuse Treatment Block Grants - The Committee directs that all of the money 

appropriated explicitly for Substance Abuse Prevention purposes both in CSAP’s PRNS lines 

as well as the funding from the 20 percent prevention set-aside in the SABG be used only for 

bona fide substance abuse prevention activities and not for any other purpose to ensure the 

work in school-based settings is as robust as possible. (Page 134, S. Rept. 115-294) 

Action taken or to be taken 

All of CSAP’s appropriated funding for PRNS as well as the 20 percent prevention set-aside 

in the Substance Abuse Prevention Block Grant (SABG) are used solely to carry out 

prevention activities. Of those programs, the following PRNS lines support work in school 

based settings to at least some degree: Strategic Prevention Framework (SPF), Minority 

AIDS, Tribal Behavioral Health Grants, Sober Truth on Preventing Underage Drinking 

(STOP Act), Science and Service Program Coordination, and the 20 percent prevention setaside in the SABG. 

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