DEPARTMENT 

of HEALTH

and HUMAN

SERVICES

Fiscal Year

2017

Justification of Estimates for 

Appropriations Committees

Substance Abuse and Mental Health

Services Administration
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DEPARTMENT OF HEALTH AND HUMAN SERVICES 

SUBSTANCE ABUSE AND MENTAL HEALTH SERVICES ADMINISTRATION

Table of Contents

Fiscal Year 2017 Budget Page

Letter from the Administrator ........................................................................................................ iii

Table of Contents .............................................................................................................................v 

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

A. Executive Summary

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

2. Overview of Budget Request .............................................................................................3 

3. Overview of Performance.................................................................................................15 

4. Discretionary All-Purpose Table ......................................................................................17 

B. Now is the Time ......................................................................................................................19 

C. Budget Exhibits

1. Appropriations Language .................................................................................................33 

2. Language Analysis ...........................................................................................................38 

3. Amounts Available for Obligation ...................................................................................44 

4. Summary of Changes .......................................................................................................45 

5. Authorizing Legislation ....................................................................................................47 

6. Appropriations History .....................................................................................................49 

7. Appropriations Not Authorized by Law ...........................................................................51 

D. Mental Health Services

1. Mental Health Appropriation ...........................................................................................55 

2. Mental Health Programs of Regional and National Significance ....................................56 

3. Children’s Mental Health Services .................................................................................127 

4. Projects for Assistance in Transition from Homelessness Grants ..................................133 

5. Protection and Advocacy for Individuals with Mental Illness .......................................139 

6. Community Mental Health Services Block Grant ..........................................................145 

7. Evidence-based Early Interventions ...............................................................................153 

E. Substance Abuse Prevention

1. Substance Abuse Prevention Appropriation ...................................................................157 

2. Substance Abuse Prevention Programs of Regional and National Significance ............158 

F. Substance Abuse Treatment

1. Substance Abuse Treatment Appropriation....................................................................195 

2. Substance Abuse Treatment Programs of Regional and National Significance .............196 

3. State Targeted Response Cooperative Agreements ........................................................253 

4. Substance Abuse Prevention and Treatment Block Grant .............................................255 
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G. Health Surveillance and Program Support

1. Health Surveillance and Program Support .....................................................................269 

2. Public Awareness and Support .......................................................................................275 

3. Performance and Quality Information Systems ..............................................................281 

4. Agency-Wide Initiatives .................................................................................................285 

H. Center for Behavioral Health Statistics and Quality ........................................................291 

I. Drug Control Budget ...........................................................................................................303 

J. Prevention and Public Health Fund ...................................................................................321 

K. Supplementary Tables

1. Budget Authority by Object Class ...................................................................................329 

2. Salaries and Expenses ......................................................................................................339 

3. Detail of Full-Time Equivalent Employee (FTE) ............................................................341 

4. Detail of Positions ............................................................................................................342 

5. Programs Proposed for Elimination .................................................................................343 

6. Federal Employment Funded by the Patient Protection and Affordable Care Act ..........344 

7. Physician’s Comparability Allowance Worksheet ..........................................................345 

L. Significant Items ...................................................................................................................347 

M. SAMHSA-Specific Requirements .......................................................................................363 
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Performance Budget Overview 

Introduction

Now, more than ever, the need to face mental health and substance misuse is critical to the 

nation’s future. 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. Half of all Americans will meet criteria for a mental or 

substance use disorder during their lives. Unfortunately, of the estimated 43.7 million adults 

with a mental illness1 and 20.3 million adults with a substance use disorder in the past year,1

many did not receive needed care. Only 41 percent of adults with diagnosable mental health 

problems received treatment.1 Similarly, only 11 percent of people with a substance use disorder 

received treatment at a specialty substance abuse treatment facility.1 The nation can do better. 

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

which, if unaddressed, come with extraordinary individual, societal, and economic consequences. 

Mission

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

communities. SAMHSA accomplishes this mission through partnerships, policies, and programs 

that build resilience, improve access to quality treatment options, and facilitate recovery for 

people with, or at risk for, mental and/or substance use disorders. 

1 Substance Abuse and Mental Health Services Administration, Results from the National Survey on Drug Use and 

Health: Mental Health Findings, NSDUH Series Rockville, MD: Substances Abuse and Mental Health Services 

Administration, 2014.
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Overview of Budget Request

Behavioral health conditions take an exacting toll on individuals, communities, and society. 

They are primary drivers of disability,2 impose a substantial economic burden on society,3,4,5

inflict great costs on the healthcare system,6 and lead to early death.7 They demand a sustained 

and concerted approach. 

This Budget Request seeks to advance SAMHSA’s mission to reduce the impact of substance 

abuse and mental illness on America’s communities in several areas.

The Budget addresses the opioid (a class of drugs that includes prescription painkillers and 

heroin) overdose epidemic through a $920.0 million investment in new mandatory funding over 

the next two years to help individuals seek treatment, successfully complete treatment, and 

sustain recovery. States will receive funds based on the severity of the epidemic and on the 

strength of their strategy to respond to it. States can use these funds to expand treatment capacity 

and make services more affordable to those who cannot afford it. This funding is part of the 

Administration’s $1.0 billion initiative to expand access to treatment for opioid use disorders by 

helping all Americans who want treatment to access it and get the help they need.

Additionally, the Budget advances the United States behavioral health system while addressing 

pressing behavioral health issues through investments in the development of crisis systems, 

strategies to utilize Assisted Outpatient Treatment, and early intervention for individuals with 

serious mental illness through a new $230.0 million investment of mandatory funds that is part of 

the Administration’s $500.0 million two-year initiative to increase access to mental health 

services.

The Budget Request strategically and directly addresses the serious and preventable public health

problem of suicide. In 2013, over 41,000 people died by suicide. Deaths by suicide exceeded 

deaths by homicide, HIV, opioid overdoses, or traffic incidents. Building on SAMHSA’s current 

efforts to address this tragic reality, the Budget includes a new $26.0 million program that uses 

evidence-based strategies to reduce the number of suicides in America, with a particular focus on 

adults 45 to 64 years of age, the age group that has had the sharpest rate increase since 2000. 

2 Murray, C. J., Abraham, J., Ali, M. K., Alvarado, M., Atkinson, C., Baddour, L. M. & Gutierrez, H. R. (2013).

The state of US health, 1990-2010: burden of diseases, injuries, and risk factors. Jama, 310(6), 591-606.

3 The Global Economic Burden of Non-Communicable Diseases, World Economic Forum, 2011, 

http://www3.weforum.org/docs/WEF_Harvard_HE_GlobalEconomicBurdenNonCommunicableDiseases_2011.pdf. 4 

TR Insel, Assessing the Costs of Serious Mental Illness, Am J Psychiatry, 2008 June; 165(6): 663-665. 

5 Department of Justice National Drug Threat Assessment 2011, The Economic Impact of Illicit Drug Use on

American Society, 2011, U.S. Department of Justice,

http://www.justice.gov/archive/ndic/pubs44/44731/44731p.pdf. 

6 Goodell, S., Druss, B. G., Walker, E. R., & MAT, M. (2011). Mental disorders and medical comorbidity. Robert

Wood Johnson Foundation, 2.

7 E. Chesney et al., Risks of all-cause and suicide mortality in mental disorders: a meta-review, World Psychiatry;

2014: 13:1153-160.
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Key Policy and Budget Priorities

SAMHSA’s FY 2017 Budget Request seeks to accomplish two goals: 1) to support the 

systematic development of the behavioral healthcare system and 2) to address pressing 

behavioral health issues facing our nation. 

SAMHSA will address the first goal by including funding in the Budget Request to support the 

priorities outlined in SAMHSA’s strategic plan, Leading Change 2.0: Advancing the Behavioral 

Health of the Nation 2015–2018. By building on the areas identified in Leading Change 2.0, 

SAMHSA will support the development of the United States behavioral health system in areas 

identified through planning and engagement with stakeholders. Leading Change 2.0 focuses on 

six areas: Prevention of Substance Abuse and Mental Illness; Health Care and Health Systems 

Integration; Trauma and Justice; Recovery Support; Health Information Technology; and 

Workforce Development.

SAMHSA’s Budget addresses the second goal through new investments that address critical 

public health needs, which demand immediate attention, including the opioid overdose epidemic, 

care for individuals with serious mental illness, rising suicides among older adults and Native 

youth, and the need for better-coordinated crisis systems to address behavioral health crises.

Summary of Budget Request and Themes

I. Advancing SAMHSA’s Strategic Priorities

Prevention of Substance Abuse and Mental Illness – The Budget Request maintains a strong 

focus on prevention through existing programs that develop the capacity of states, communities, 

primary care providers, early childhood systems, and school systems to prevent the onset of 

substance use and promote mental health and wellness. These efforts continue to respond to 

public health priorities, including a focus on the prevention of suicide, opioid misuse, and the 

prevalence of underage drinking. This Budget supports national action and increased suicide 

prevention efforts as well as more resources for the prevention of prescription drug misuse. The 

Budget Request also includes funds to build awareness about behavioral health issues in schools 

and communities, including a special focus on communities, which have recently experienced 

civil unrest, through the Project Advancing Wellness and Resilience in Education (AWARE) 

program. The Budget Request also maintains the Mental Health Block Grant set-aside for 

evidence-based programs that address the treatment and support services needs of individuals 

with early serious mental illness, including psychotic disorders. It also includes funding to help 

people in the prodrome phase of psychosis. This funding would support and evaluate community

programs for outreach and intervention with youth and young adults showing symptoms of being 

at risk for psychosis. Promising research shows that this early intervention can assist in 

preventing development of certain serious mental illnesses, such as schizophrenia or bipolar

disorder. 

Health Care and Health Systems Integration – The Budget Request supports a range of 

initiatives designed to help the behavioral health system adapt to broader system changes. It
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invests in programs designed to integrate primary care and physical health services into mental 

health settings, provides coordinated and integrated care for people with mental and substance 

use disorders and HIV and/or viral hepatitis, and supports states and providers to adapt to a 

changing healthcare landscape. This Request includes $50.1 million for the Medication-Assisted 

Treatment for Prescription Drug and Opioid Addiction (MAT PDOA) program. Building upon 

the effort started in FY 2015, this expanded program will provide integrated care including 

MAT, psychosocial interventions, and HIV and Hepatitis C screening for individuals with opioid

use disorders. 

Trauma and Justice – The Budget Request maintains investments in systems designed to 

improve trauma-informed care for children and youth, and efforts to promote care that recognize 

and respond to trauma. These programs and other SAMHSA efforts build on SAMHSA's 

publication “Concept of Trauma and Guidance for a Trauma-Informed Approach” which 

introduces a concept of trauma and offers a framework for how an organization, system, or 

service sector can become trauma-informed. The Budget Request also supports a variety of 

programs to address the needs of people with mental and substance use disorders who are 

involved in, or are at risk of, involvement in the criminal justice system.

Recovery Support – The Budget Request maintains a variety of programs designed to meet the 

needs of people in recovery from mental and substance use disorders. These include efforts to 

provide help from peer providers and families with lived experience of recovery from mental 

and/or substance use disorders. Programs engage and respond to the self-identified needs and 

help find individual pathways to recovery. As part of state and community efforts to improve 

crisis response and follow-up to promote safety and stability, the Budget funds the Assisted 

Outpatient Treatment (AOT) program established in the Protecting Access to Medicare Act of 

2014 and funded for the first time in FY 2016. This program will test the effectiveness and build 

best practices around AOT to inform the national conversation that is taking place on this 

important topic. 

Health Information Technology – The Budget Request continues SAMHSA’s focus on 

supporting the increased use of health information technology through its grant programs. 

SAMHSA will advance new approaches to manage and transfer behavioral health information 

while protecting privacy. This includes efforts to assist the field to use the latest technology and 

integrate services while complying with federal law governing the disclosure of information 

about substance use disorder treatment.

Workforce Development – Workforce development continues to be a key priority for 

SAMHSA. In this Budget Request, SAMHSA continues investments in training for behavioral 

health professionals, including programs to train peer providers and increase the number of 

culturally competent behavioral health professionals available to serve underserved populations. 

SAMHSA’s Budget continues data development efforts to understand better the behavioral

health workforce needs.
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II. Meeting Pressing Public Health Challenges

In addition to strengthening the behavioral health field by addressing strategic priorities, 

SAMHSA is committed to meeting current behavioral health challenges facing the United States. 

As a result, this Budget Request proposes new efforts to address the opioid overdose epidemic, 

engage individuals with serious mental illness into care, prevent suicide, continues a strong focus 

on building better systems to help people, including those with a serious mental illness, having a 

behavioral health crisis, and expands the development of the healthcare workforce.

Opioid Overdose: Death from overdose of opioids, a class of drugs that includes prescription 

painkillers and heroin, have taken a heartbreaking toll on too many Americans. The Budget for 

SAMHSA supports the Administration’s initiative to address alarming increase in opioid 

addiction and overdose deaths seen over the past decade. The Budget includes $920.0 million in 

new mandatory funding over the next two years to help individuals seek treatment, successfully 

complete treatment, and sustain recovery. States will receive funds based on the severity of the 

epidemic and on the strength of their strategy to respond to it. States can use these funds to 

expand treatment capacity and make services more affordable to those who cannot afford it. In 

addition to these mandatory funds, SAMHSA’s Budget expands the Medication-Assisted 

Treatment for Prescription Drug and Opioid Addiction (MAT PDOA) program to serve a total of 

46 States and funding for a new demonstration program related to expanding the types of 

providers permitted to prescribe buprenorphine. These programs directly align with the goal of 

expanding access to MAT, one of three primary goals the Department of Health and Human 

Services has articulated in its call to action to address the prescription drug and opioid crisis.

Serious Mental Illness: As part of the Administration’s initiative to increases access to mental 

health services, the Budget invests $230.0 million in new mandatory resources over the next two 

years to engage individuals with serious mental illness into care. Research has found that 

individuals with psychosis often do not receive appropriate treatment for that condition for over a 

year. This delay in treatment worsens long-term outcomes for people experiencing these 

conditions affecting their behavioral health, physical health, and achievement of education and 

employment goals

Suicide: Between 1999 and 2013, the suicide rate in the United States rose from 10.46 to 13.02 

per 100,000 people.8 41,149 Americans died by suicide in 2013, making suicide the 10th leading 

cause of death in the country above homicide, HIV, opioid overdoses, and traffic deaths.9,10 

Addressing this growing problem demands new resources and an approach that addresses 

populations at highest need. Currently, people aged 45 to 64 are at the highest risk for suicide 

followed by people ages 85 or older.11 When compared to the general population, people 

between ages 45 and 59 have the highest numbers of suicide and those between ages 50 and 59 

8 CDC, Fatal Injury Reports, http://webappa.cdc.gov/sasweb/ncipc/mortrate10_us.html 9 CDC, Deaths, Final Data for 2013, Detailed Tables, http://www.cdc.gov/nchs/data/nvsr/nvsr64/nvsr64_02.pdf 10 NHTSA Early Estimate of Motor Vehicle Traffic Fatalities for the First Half (Jan-Jun) of 2014, http://wwwnrd.nhtsa.dot.gov/Pubs/812093.pdf

11 CDC, Fatal Injury Reports, http://webappa.cdc.gov/sasweb/ncipc/mortrate10_us.html
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have the highest rates of suicide. However, many of the current suicide prevention resources 

focus on youth and young adults. In addition, systems that have the best chance of intervening to 

prevent suicide, such as primary care, are not often involved in suicide prevention efforts.

Recognizing the urgency of addressing this issue, SAMHSA proposes to target the problem 

proactively through the new $26.0 million Zero Suicide initiative. This new program will build 

on the National Strategy for Suicide Prevention’s recommendation for a comprehensive, multisetting approach to suicide prevention by incorporating both a strong community effort and a 

strong health systems effort. This proposal is based on a successful model that has prevented 

suicides by changing the culture and capacity of health systems by identifying those at risk and 

ensuring they are served with evidence-based approaches and follow-up care. This program can 

be a central part of the response to this growing concern. This effort will also include a 

$5.2 million set-aside to focus specifically on the issue of suicide as it relates to tribal 

populations. 

Crisis Systems: In addition to focused efforts to address the suicide problem in the nation, 

SAMHSA, through the Increasing Crisis Access Response Efforts (ICARE) grant program, will 

address the need to build, fund, and sustain crisis systems capable of preventing and deescalating behavioral health crises as well as connecting individuals and families with needed 

post-crisis services to prevent recurrence of the crisis situation.

III. Supporting HHS Tribal Health and Well-Being Coordination

American Indians and Alaska Natives (AI/ANs) bear a disproportionate burden of death, disease, 

disability, and injury compared to other racial and ethnic groups in the United States. For 

example, AI/ANs have a higher prevalence of obesity than their white counterparts do 

(33.9 percent versus 23.3 percent for men and 35.5 percent versus 21 percent for women), and 

are more than twice as likely to have diagnosed diabetes as non-Hispanic whites (16.1 percent to

7.1 percent). There has also been increasing concern over the persistently high rates of suicide, 

particularly among AI/AN youth. The most recently available death certificate data show the 

overall age-adjusted suicide rate for the AI/AN population was 18.3 per 100,000 in 2013, 

compared to 13.8 per 100,000 in the population overall. These and other health problems are 

driven by higher rates of poverty, unemployment, and low educational achievement, which in 

turn are linked to key risk behaviors, like alcohol and tobacco use.

For FY 2017, the Department of Health and Human Services (HHS) is articulating a departmentwide Tribal Health and Well-Being Coordination Plan that calls on several HHS agencies - the 

Indian Health Service, Administration for Children and Families, SAMHSA, Health Resources 

and Services Administration, and the Centers for Disease Control and Prevention - to collaborate 

to improve health outcomes for AI/AN populations. SAMHSA’s suicide prevention activities in 

support of this plan include the Garrett Lee Smith suicide prevention program, a set-aside for 

tribes in Zero Suicide, and the Tribal Behavioral Health Grant program.
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The cross-cutting priorities for the initiative are:

• Building capacity and sustainable infrastructure in AI/AN communities.

• Improving access to and quality of health and human services in AI/AN communities.

• Strengthening connection to culture, language and life ways to build resilience and

promote health and healthful behaviors, especially among AI/AN youth and young

adults.

To ensure the greatest impact for these programs, available funding will target tribes with the 

highest need, either as direct awardees or as recipients of resources, support and technical 

assistance from funded tribal organizations and Tribal Epidemiology Centers (TECs). The 

agencies will define targeted outcomes and strive to streamline application and reporting 

requirements to ensure that increased burden is not placed on AI/AN communities.

Budget Request

SAMHSA’s Budget Request for FY 2017 of $4.3 billion reflects a $590.2 million increase from 

the FY 2016 Enacted Level.

Program Increases:

State Targeted Response Cooperative Agreements (+$920.0 million, Mandatory) 

The FY 2017 Budget Request includes a total of $920.0 million for the State Targeted Response 

Cooperative Agreements program ($460.0 million in FY 2017 and $460.0 million in FY 2018). 

This new effort would close the treatment gap in substance use disorder treatment by addressing 

commonly cited barriers to treatment through reducing the cost of treatment, expanding access to 

treatment, engaging patients in treatment, and addressing negative attitudes associated with 

accessing treatment. This funding is part of the Administration’s $1.0 billion two-year initiative 

to expand access to treatment to reduce prescription drug abuse and heroin use.

Evidence-based Early Interventions (+$230.0 million, Mandatory) 

The FY 2017 Budget Request includes a total of $230.0 million in mandatory funding for the 

Evidence-based Early Intervention Services ($115.0 million in FY 2017 and $115.0 million in 

FY 2018). Working in collaboration with set-aside funded activities, this new formula grant 

would provide additional funds to enable all states to establish supports and services for early 

intervention and enable states that already have programs to expand further their 

efforts. SAMHSA would administer this new formula grant program to support evidence-based 

early intervention. Plans include a minimum of $700,000 to each state and a tribal set-aside. This 

funding is part of the Administration’s $500.0 million initiative to increase access to mental 

health care.

Suicide Prevention: National Strategy on Suicide Prevention (+$28.0 million)

The FY 2017 Budget Request is $30.0 million, an increase of $28.0 million from the FY 2016 

Enacted Level. The proposed funding for this initiative will support the expansion of the

National Strategy on Suicide Prevention program and create a new $26.0 million Zero Suicide 

program. This program includes a $5.2 million set-aside for tribes to address the high rates of 
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suicides among American Indian/Alaska Natives. While American Indian/Alaska Natives have 

the highest rates of youth suicide among any ethnic group, these rates remain highly elevated 

well into adulthood. 

The program focuses on the critical need to address the risk of suicide for adults and older adults. 

It comprises two components. The first component, Zero Suicide in Behavioral Health Care, will

provide nine grants to states to embed the Zero Suicide model throughout their behavioral 

healthcare systems including within Accountable Care Organizations. The foundational belief of 

Zero Suicide is that suicide deaths for adults under care within health and behavioral health 

systems are preventable. It presents both a bold goal and an aspirational challenge. The 

programmatic approach of Zero Suicide is based on the realization that suicidal individuals often 

fall through cracks in a fragmented, and sometimes distracted, healthcare system. Specifically, 

this program will support implementation of post-discharge follow-up protocols for individuals 

at risk of suicide and provide suicide-specific treatment approaches. This component of the 

initiative would focus on statewide efforts to reduce suicide among those adults receiving care 

through the state’s public behavioral health system.

The second component, Comprehensive State/Community Suicide Prevention, will provide 

seven grants to allow states to engage communities and organizations in a comprehensive effort 

to identify persons at risk for suicide and link them to needed services. Care systems that have 

adopted these approaches have been successful in reducing suicides. States with large (over 

1,000) numbers of deaths by suicide, and states with high rates, but smaller numbers of suicides, 

will be eligible for these grants. Grant recipients will implement and evaluate evidence-based 

suicide prevention activities in the full spectrum of potential community and clinical suicide 

prevention settings including primary care, emergency rooms, schools/educational settings, the 

workplace, faith communities, and justice settings. A similar comprehensive approach fully 

implementing the Scottish National Strategy led to an 18 percent reduction in deaths by suicide 

in Scotland, including reductions among adult males who make up a significant majority of 

suicides in Scotland, as they do in the United States.

Crisis Systems (+$10.0 million)

The FY 2017 Budget Request is $10.0 million for Crisis Systems, an increase of $10.0 million 

from the FY 2016 Enacted Level. This includes $5.0 million in the Mental Health appropriation 

and $5.0 million in the Substance Abuse Treatment appropriation. The Increasing Crisis Access 

Response Efforts (ICARE) program helps communities build, fund, and sustain crisis systems 

capable of preventing and de-escalating behavioral health crises as well as connecting 

individuals, including those with serious mental illness, and families with needed post-crisis 

services.

Targeted Capacity Expansion: Medication-Assisted Treatment for Prescription Drug and Opioid 

Addiction (MAT PDOA) (+$25.1 million)

The FY 2017 Budget Requests $50.1 million, an increase of $25.1 million from the FY 2016 

Enacted Level, to focus on medication-assisted treatment (MAT) expansion/enhancement efforts. 

The funding will enable SAMHSA to support 23 new MAT PDOA state grants at $1.0 million to 

expand/enhance MAT utilizing FDA-approved medications in combination with psychosocial 

services, recovery support services, and coordination/integration of HIV/hepatitis C direct
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services. The program will target states that demonstrated a dramatic increase in treatment 

admissions for opioid use disorders and that experienced the highest rates of treatment 

admissions for opioid use disorders. Program outcomes include length of stay in treatment, first 

time treatment admissions, the number of people receiving MAT, the number of people receiving 

recovery support/relapse prevention services, and the number of MAT providers. SAMHSA will 

also track client-level outcomes such as abstinence from substance use, housing, employment 

and criminal justice status and social connectedness. Ultimately, individuals with opioid use 

disorders will have increased access to effective, comprehensive, coordinated care that will serve 

to foster recovery.

Cohort Monitoring and Evaluation of Medication-Assisted Treatment (+$30.0 million, 

mandatory) 

The FY 2017 Budget Request includes a total of $30.0 million for the Cohort Monitoring and 

Evaluation of Medication-Assisted Treatment, ($15.0 million in FY 2017 and $15.0 million in 

FY 2018). This is an increase of $15.0 million from the FY 2016 Enacted Level. Public health 

and substance abuse treatment agencies will evaluate the short, medium, and long-term outcomes 

of substance abuse treatment programs in order to increase effectiveness reducing opioid use 

disorders, overdose, and death. Under this proposal, SAMHSA will work with other research 

agencies within the Department of Health and Human Services and will prospectively monitor 

the treatment outcomes of patients with opioid addiction entering medication-assisted treatment 

programs. This demonstration will provide valuable insight into the effectiveness of treatment 

programs employing medication-assisted treatment under real-world conditions and help identify 

opportunities to improve treatment for patients with opioid addiction. Systematic information on 

the outcomes of patients who undergo medication-assisted treatment is currently lacking. Cohort 

monitoring is commonly used to monitor treatment of patients with infectious diseases, such as 

tuberculosis treatment, and drives accountability for patient outcomes; a similar approach could 

be useful to improving addiction treatment. This funding is part of the Administration’s $1.0 

billion two-year initiative to increase access to treatment for prescription drug abuse and heroin 

use 

Buprenorphine-Prescribing Authority Demonstration (+$10.0 million)

The FY 2017 Budget Request includes $10.0 million for a new program, BuprenorphinePrescribing Authority Demonstration. SAMHSA intends to implement a services research 

demonstration project that will test the safety and effectiveness of allowing prescribing 

buprenorphine, a medication used to treat opioid use disorders, by non-physician advance 

practice providers in accordance with the providers’ prescribing authority under state law. 

Currently only physicians are allowed to prescribe buprenorphine. Expanding prescribing 

authority to advance practice providers could increase the availability of MAT services. 

SAMHSA will collaborate with professional organizations that represent advance practice 

nurses, physician assistants, and other non-physician advance practice providers as well as 

addiction psychiatrists and primary care physicians to determine the appropriate training and 

supervision requirements for advance practice providers in order to assure patient safety and 

well-being while minimizing diversion of buprenorphine. 

This demonstration project will target populations and geographic areas most affected by both 

high-need and limited access to DATA-waived physicians. SAMHSA will solicit Input from
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stakeholders as needed to assure the project results in a feasible implementation strategy for 

increasing access to buprenorphine treatment in the targeted areas. SAMHSA will use a 

continuous quality improvement model to monitor the patient-level safety and effectiveness of 

the project. Impact of the project will be assessed using community-level measures such as 

overdose mortality, incidence of HIV and acute hepatitis C infections, and Drug Enforcement 

Agency reported drug seizures.

In FY 2017, SAMHSA plans to award seven new grants for up to three years and one evaluation 

and technical assistance contract for three years.

In addition, other efforts are underway to ensure access to buprenorphine. In 2015, the Secretary 

of the Department of Health and Human Services announced the development of an update to the 

regulation of buprenorphine. SAMHSA has led this rulemaking effort for the Department and is 

working in close partnership with the other HHS components and federal agencies.

Project Advancing Wellness and Resilience in Education (AWARE) (+$7.1 million)

The FY 2017 Budget Request is $72.0 million, an increase of $7.1 million from the FY 2016 

Enacted Level. As part of the President’s Now is the Time (NITT) initiative, this program seeks to

raise awareness about mental health issues and connects young people who have behavioral 

health issues and their families with needed services. SAMHSA requests funding to support a 

new cohort of Project AWARE State Educational Agency awards, continuation grants to raise 

awareness and expand care in communities with civil unrest, 20 continuation Project AWARE 

SEA awards, 70 continuation Mental Health First Aid awards, NITT technical assistance, and 

evaluation contracts. This funding will serve over four million children. The increase represents 

a reallocation of funds from Youth Violence Prevention to Project AWARE. The reallocation of 

these funds will enable SAMHSA to avoid duplication among programs with like purposes. 

Project AWARE also addresses the Administration’s multi-agency Native Youth priority related 

to Improving Education Outcomes and Like Outcomes for Native Youth, in support of the HHS 

Tribal Health and Well-Being Coordination. 

Agency-Wide Initiatives (+$10.0 million)

The FY 2017 Budget Request includes a total of $22.7 million for Agency-Wide Initiatives, an 

increase of $10.0 million from the FY 2016 Enacted Level. The $10.0 million increase in 

funding will support the development of a new Peer Professional Workforce Development 

program. The program aims to increase the number of trained peers, recovery coaches, mental 

health/addiction specialists, prevention specialists, and pre-Masters level addiction counselors 

working with young people ages 16 to 25. It will provide tuition support and further the capacity 

of community colleges to develop and sustain behavioral health paraprofessional training and 

education programs. The funding will support up to 19 grants.

Program Decreases:

Youth Violence Prevention (-$23.1 million)
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The FY 2017 Budget Request proposes eliminating the Youth Violence Prevention program in 

FY 2017. SAMHSA is requesting to reallocate funding from this program to Now is the Time 

Project Advancing Wellness and Resilience in Education (NITT Project AWARE). The 

reallocation of these funds to NITT Project AWARE will continue to bring to scale program 

activities, practices, and lessons learned in the youth violence prevention arena and address 

current and emerging issues. The reallocation of these funds will enable SAMHSA to avoid 

duplication among programs with like purposes. 

Primary and Behavioral Health Care Integration (-$23.9 million)

The FY 2017 Budget Request is $26.0 million, a decrease of $23.9 million from the FY 2016 

Enacted Level. This funding will continue to support the coordination and integration of primary 

care services into publicly funded community behavioral health settings. The decrease in funding 

will not result in the termination of any existing grants. 

Screening, Brief Intervention and Referral to Treatment (SBIRT) (-$16.9 million)

The FY 2017 Budget Request is $30.0 million, a decrease of $16.9 million from the FY 2016 

Enacted Level. The SBIRT program helps reduce the number of individuals who misuse drugs 

and alcohol and intervenes early to ensure individuals improve their health and overall quality of 

life. With the increasing adoption of SBIRT in healthcare settings, the Budget redirects resources

to other priority treatment activities.

Treatment Systems for Homeless (-$4.9 million)

The FY 2017 Budget Request is $36.4 million, a decrease of $4.9 million from the FY 2016 

Enacted Level. This decrease will not result in termination of any grant continuations nor will it 

significantly affect SAMHSA’s ability to implement its homeless programs. 

Criminal Justice Activities (-$16.1 million)

The FY 2017 Budget Request is $61.9 million ($50.0 million for Drug Courts and $11.9 million 

for Other Criminal Justice Activities), a decrease of $16.1 million from the FY 2016 Enacted 

Level. SAMHSA proposes to focus this portfolio more strategically to explore new approaches 

and a variety of models within the drug court umbrella.

Addiction Technology Transfer Centers (ATTC) (-$1.0 million)

The FY 2017 Budget Request is $8.1 million, a decrease of $1.0 million from the FY 2016 

Enacted Level. In FY 2017, SAMHSA plans to fund a new cohort of 15 five-year ATTC grants. 

SAMHSA expects the ATTCs to sponsor over 1,000 events involving more than 30,000 unique 

participants in FY 2017. In addition to the number of participants, event topics and contact hours, 

other metrics to be collected include participant satisfaction measures such as self- assessed skill 

levels both pre and post training. Funding will allow the 15 ATTCs to disseminate evidencebased, promising practices to addiction treatment and recovery professionals, public health and 

mental health personnel, institutional and community corrections professionals, and other related

disciplines.

Program Support (-$2.0 million)

The FY 2017 Budget Request is $77.6 million, a decrease of $2.0 million from the FY 2016 

Enacted Level. This level of funding will continue to cover overhead costs associated with
13

5600 Fishers Lane, including rent, the Federal Acquisition Service loan repayment program, and 

security charges.

In FY 2017, SAMHSA plans to support 665 FTEs with funding from the Mental Health, 

Substance Abuse Treatment, and Health Surveillance and Program Support appropriations. 

Public Awareness and Support (-$2.1 million)

The FY 2017 Budget Request is $13.5 million, a decrease of $2.1 million from the FY 2016 

Enacted Level. These funds will allow SAMHSA to maintain and update its web presence, 

develop innovative mobile apps, expand SAMHSA’s presence on social media, and provide 

other critical resources to support the behavioral health field. SAMHSA will continue to 

collaborate with other agencies. These efforts will allow SAMHSA to broaden the reach of its 

four key messages – behavioral health is essential to health, prevention works, treatment is 

effective, and people recover. For example, through the National Outreach, Public Education and

Engagement Initiative contract, SAMHSA will work with the Center for Disease Control and 

Prevention to disseminate information about prescriber guidelines on the dangers of prescription 

drug misuse.

$2.0 million of the reduced funding is because SAMHSA no longer needs the one-time funding 

for the effort “Science of Changing Social Norms.” The lessons learned through the program in 

FY 2016 and SAMHSA’s work with the National Academies’ Board on Behavioral, Cognitive, 

and Sensory Sciences will inform SAMHSA’s other communications efforts and programs in 

FY 2017 and beyond. 
14

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15

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 from what 

works and does not work. 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.

One example of SAMHSA’s contributions to an HHS Agency Priority Goal is its work to reduce 

tobacco use. SAMHSA’s National Survey on Drug Use and Health (NSDUH) provides tobacco

use prevalence data to help monitor tobacco rates and trends by various populations, including: 

• In 2014, 3.8 percent of children and adolescents aged 12 to 17 years who had not 

previously smoked cigarettes in their lifetime, first smoked cigarettes in the past 

12 months.

• These data represent a decline from 2009 to 2014; the percentage of past year initiates of 

cigarette use, ages 12-17, decreased from 6.2 percent to 3.8 percent.

NSDUH data also indicate that adults with mental or substance use disorders account for 

40 percent of all cigarettes smoked. To address the high prevalence of tobacco use by this 

population, SAMHSA has been working with state behavioral health systems. In June 2014, 

SAMHSA conducted a State Policy Academy for Tobacco Control in Behavioral Health, which 

provided an opportunity for behavioral health leadership teams in participating states to build a 

collaborative action planning process to address the high rate of tobacco use by people with 

mental and/or substance use disorders. 

SAMHSA reports performance information for 18 of the 21 HHS 2014-2018 Strategic Plan goals 

and objectives, HHS’s Annual Performance Plan and Report, as well as the HHS Summary of 

Findings (also called the “Strategic Reviews”), which includes evidence of progress and 

leadership. SAMHSA continues to participate in an HHS agency priority goal to reduce cigarette

smoking and is discussing contributions to three additional agency priority goals.

SAMHSA provides data, analyses, and reports that help states and communities address the 

complex challenges associated with substance abuse and mental illness, such as disaster relief. 

SAMHSA responded to 15 different types of disasters during 2014 and 2015 including civil 

unrest, floods, suicide clusters, and fires. SAMHSA was in immediate contact with community 

and state behavioral health leaders, providing resources, subject matter experts, technical 

assistance, and counseling services via SAMHSA’s Disaster Distress Helpline (DDH). The DDH

is a national, toll-free, multilingual, and confidential crisis support service available to all 

residents in the United States and its territories.

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

robust portfolio of grants. Due to technical difficulties with the existing Common Data Platform, 

SAMHSA is reconfiguring its approach to uniform data collection with the implementation of 
16

SAMHSA’s Performance Accountability and Reporting System (SPARS). This will provide a 

common data and reporting system for all SAMHSA discretionary grantees and allow for 

programmatic technical assistance on use of the data to enhance grantee performance monitoring 

and improve quality of service delivery.
17

All-Purpose Table

Substance Abuse and Mental Health Services Administration

(Dollars in thousands)

Program Activities

FY20151,2

Final

FY2016

Enacted

FY2017

President's 

Budget

FY2017

+/- 

FY2016

Now is the Time Presidential Initiative

Mental Health:

Project AWARE.................................................................................................................... $54,865 $64,865 $71,964 +$7,099

Project AWARE State Grants (non-add)................................................................... 39,902 49,902 57,001 +7,099

Mental Health First Aid (non-add)............................................................................ 14,963 14,963 14,963 ---

Healthy Transitions.............................................................................................................. 19,951 19,951 19,951 ---

Public Awareness and Support.......................................................................................... --- 2,000 --- -2,000

Science of Changing Social Norms............................................................................ --- 2,000 --- -2,000

Health Surveillance andProgram Support:

Behavioral Health Workforce.............................................................................................. 6,246 6,246 16,246 +10,000

Minority Fellowship Program - Youth/Addiction Counselors (non-add).......... 5,246 5,246 5,246 ---

SAMHSA-HRSABHWETGrantProgram1(non-add)............................................. --- --- --- ---

PeerProfessional WorkforceDevelopment(non-add)........................................... --- --- 10,000 +10,000

Behavioral Health Workforce Data and Development (non-add)....................... 1,000 1,000 1,000 ---

TOTAL 2 (information only -- amounts includedbelow) 81,062 93,062 108,161 +15,099

Mental Health:

Programs of Regional and National Significance............................................................. 370,538 406,550 406,388 -162

Prevention and Public Health Fund (non-add)......................................................... 12,000 12,000 10,000 -2,000

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

Children's Mental Health Services..................................................................................... 117,026 119,026 119,026 ---

ProjectsforAssistance inTransitionfromHomelessness............................................. 64,635 64,635 64,635 ---

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

Evidence-based Early Interventions (Mandatory)........................................................ --- --- 115,000 +115,000

Community Mental Health Services BlockGrant............................................................. 482,571 532,571 532,571 ---

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

Total, Mental Health........................................................................................................... 1,070,916 1,158,928 1,273,766 +114,838

Substance AbusePrevention:

Programs of Regional and National Significance............................................................. 175,148 211,148 211,148 ---

PHS Evaluation Funds (non-add)................................................................................ --- --- 16,468 +16,468

Total, Substance AbusePrevention.................................................................................. 175,148 211,148 211,148 ---

Substance Abuse Treatment:

Programs of Regional and National Significance............................................................. 361,463 333,806 343,269 +9,463

Mandatory Funds (non-add)......................................................................................... --- --- 15,000 +15,000

PHS Evaluation Funds (non-add)................................................................................ 2,000 2,000 30,000 +28,000

State Targeted Response Cooperative Agreements (Mandatory)................................ --- --- 460,000 +460,000

Substance Abuse Prevention and Treatment BlockGrant............................................. 1,819,856 1,858,079 1,858,079 ---

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

Total, Substance Abuse Treatment................................................................................... 2,181,319 2,191,885 2,661,348 +469,463

1 Entries reflect the transfer of funding associated with the Behavioral Health Workforce Expansion and Training programfromSAMHSA to 

HRSA. HRSA and SAMHSA will continue to work together to implement this program.
18

All-Purpose Table

Substance Abuse and Mental Health Services Administration

(continued) 

(Dollars in thousands)

Program Activities

FY20151,2

Final

FY2016

Enacted

FY2017

President's 

Budget

FY2017

+/- 

FY2016

Health Surveillance andProgram Support:

Health Surveillance and Program Support: ...................................................................... 119,260 126,817 124,817 -2,000

PreventionandPublicHealthFund(non-add)......................................................... --- --- 17,830 +17,830

PHS Evaluation Funds(non-add)................................................................................ 30,428 30,428 29,428 -1,000

Public Awareness and Support.......................................................................................... 13,482 15,571 13,482 -2,089

PHS Evaluation Funds(non-add)................................................................................ --- --- 13,482 +13,482

Performance and Quality Information Systems................................................................ 12,918 12,918 12,918 ---

PHS Evaluation Funds(non-add)................................................................................ --- --- 12,918 +12,918

Agency-Wide Initiatives1,2.................................................................................................. 11,669 12,669 22,669 +10,000

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

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

Total, Health Surveillance and Program Support.......................................................... 158,829 169,475 175,386 +5,911

TOTAL, SAMHSA ProgramLevel................................................................................... 3,586,212 3,731,436 4,321,648 +590,212

Less Cohort Monitoring and Evaluation of MAT Outcomes (Mandatory ............. --- --- 15,000 +15,000

LessEvidence-basedEarlyInterventions(Mandatory)............................................... --- --- 115,000 +115,000

Less State Targeted Response Cooperative Agreements (Mandatory)..................... --- --- 460,000 +460,000

Less PHS Evaluation Funds.............................................................................................. 133,667 133,667 213,535 +79,868

Less Prevention and Public Health Funds..................................................................... 12,000 12,000 27,830 +15,830

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

TOTAL, SAMHSA BudgetAuthority.............................................................................. $3,439,045 $3,584,269 $3,488,783 -$95,486

FTEs 614 665 665 ---

1 Entries reflect the transfer of funding associated with the Behavioral Health Workforce Expansion and Training programfromSAMHSA to 

HRSA. HRSA and SAMHSA will continue to work together to implement this program. 2 The Minority Fellowship Programbudgets fromthe Mental Health, Substance Abuse Prevention, and Substance Abuse Treatment

appropriations have been comparably adjusted in this table to be in line with the FY 2017 Budget Request. These are reflected in the Health 

Surveillance and Program Support appropriation under the Agency-Wide Initiatives Workforce program. 
19

NOW IS THE TIME

The Administration’s plan to protect our children and our communities by reducing gun violence 

and increasing access to mental health services.

(Dollars in thousands)

Program Activities

FY 2015

Final

FY 2016

Enacted

FY 2017

President's 

Budget

FY 2017

+/- 

FY 2016

Now istheTime PresidentialInitiative

Mental Health:

Project AWARE............................................................................................ $54,865 $64,865 $71,964 +$7,099

Project AWARE State Educational Agency Grants (non-add)............... 39,902 49,902 57,001 +7,099

Mental Health First Aid (non-add)......................................................... 14,963 14,963 14,963 ---

Healthy Transitions......................................................................................... 19,951 19,951 19,951 ---

Health Surveillance and ProgramSupport:

Public Awareness and Support....................................................................... --- 2,000 --- -2,000

Science of Changing Social Norms......................................................... --- 2,000 --- -2,000

Behavioral Health Workforce......................................................................... 6,246 6,246 16,246 +10,000

Minority Fellowship Program-Youth/Addiction Counselors(non-add)... 5,246 5,246 5,246 ---

SAMHSA-HRSA BHWET Grant Program1 (non-add)............................ --- --- --- ---

Peer Professional Workforce Development (non-add)........................... --- --- 10,000 +10,000

Behavioral Health Workforce Data and Development (non-add).......... 1,000 1,000 1,000 ---

TOTAL 1 $81,062 $93,062 $108,161 +$15,099

1 Table reflects the transfer of funding associated with the Behavioral Health Workforce Expansion and Training program from SAMHSA to HRSA. 

HRSA and SAMHSA will continue to work together to implement this program.

Authorizing Legislation .......Sections 501, 505, 509, 516 and 520A the Public Health Service Act 

FY 2017 Authorization .........................................................................................................Expired 

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

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

Local Governmental Entities, Community Organizations and Provider Organizations 

SAMHSA’s Now is the Time (NITT) activities support the President’s plan, in response to the 

tragedy at Sandy Hook Elementary School, to improve access to mental health services for 

young people. SAMHSA-supported activities under this initiative are helping teachers and other 

adults who interact with youth recognize signs of mental illness, improve referrals, and increase 

access to mental health services for young people aged 16 to 25. In addition, SAMHSA is 

funding the training of thousands of additional behavioral health professionals with a focus on

serving students and young adults. Given that the majority of mental disorders begin before 

age 24, these efforts support early interventions that help get young people get treated early and 

therefore can help forestall the impact of untreated serious mental illness, such as disability.12,13 

The FY 2017 Budget Request includes $108.2 million for Now is the Time. This is a 

$15.1 million increase over the FY 2016 Enacted Level of $93.1 million. The FY 2017 Budget 

Request includes an increase from the FY 2016 Enacted Level for both the Project AWARE 

(Advancing Wellness and Resilience in Education) program and the Behavioral Health 

Workforce program and the elimination of the Science of Changing Social Norms initiative.

12 Stafford, M.R., Jackson, H., Mayo-Wilson, E., Morrison, A.P. & Kendall, T. (2013). Early interventions to 

prevent psychosis; systematic review and meta-analysis. BMJ. 346(f185), 1-13. 13 Goldstein, A.B., Heinssen, R.K. & Azrin, S.T, (2015). Accelerating science-to-practice for early psychosis.

Psychiatric Services. 66(7), p.665. 
20

Project AWARE

(Dollars in thousands)

Programs of Regional & NationalSignificance

FY2015

Final

FY2016

Enacted

FY2017

President's 

Budget

FY2017

+/- 

FY2016

Project AWARE............................................................................... $54,865 $64,865 $71,964 +$7,099

Project AWAREStateEducationalAgencyGrants(non-add)... 39,902 49,902 57,001 +7,099

Mental Health First Aid (non-add)............................................. 14,963 14,963 14,963 ---

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

FY 2017 Authorization .........................................................................................................Expired 

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 FY 2014, in response to the tragedy at Sandy Hook Elementary School and as part of the 

President’s Now is the Time initiative, SAMHSA provided $54.9 million to support Project 

AWARE (Advancing Wellness and Resilience in Education) to increase awareness of mental 

health issues and connect young people who have behavioral health issues and their families with 

needed services. SAMHSA collaborates with the Departments of Education and Justice in the 

development, implementation, and management of this initiative to maximize coordination and 

avoid duplication of efforts.

Project AWARE has multiple components. The first component, Project AWARE State 

Educational Agency (SEA) grants, is built on the highly successful Safe Schools/Healthy 

Students model, which is intended to create safe and supportive schools and 

communities. SAMHSA awarded these grants to 20 SEAs to promote comprehensive, 

coordinated, and integrated state efforts to make schools safer and increase access to mental 

health services.

The second component, Mental Health First Aid (MHFA), supports widespread dissemination of 

the MHFA curriculum. The MHFA curriculum prepares teachers and other individuals who work 

with youth to help schools and communities understand, recognize, and respond to signs of 

mental and/or substance use disorders in children and youth, including how to talk to adolescents 

and families experiencing these problems so that they are more willing to seek treatment. The 

target for the first year of the program was 750,000 individuals trained or served. In FY 2015, 

given a diverse grantee pool made up of both urban and rural school districts, the MHFA 

program trained or served nearly 4.5 million individuals. As a result, SAMHSA has increased the

target for future years.

In FY 2014, SAMHSA funded 20 Project AWARE SEA awards and 100 MHFA Local 

Educational Agencies (LEAs) multi-year awards to grantees who applied for Department of 

Education School Climate Change awards. The project period for Project AWARE SEA awards
21

is five years and the project period for MHFA awards is two years. In FY 2015, SAMHSA 

provided continuation support for these Project AWARE SEA grants. In addition, SAMHSA 

awarded 70 new MHFA grants to community organizations to support the training of teachers 

and a broad array of actors who interact with youth through their programs at the community 

level, including parents, law enforcement, faith-based leaders, and other adults.

In FY 2016, SAMHSA is supporting the continuation of 90 grants (20 AWARE SEA grants and 

70 MHFA Community grants) and related contracts. In addition, SAMHSA is awarding a new 

cohort of up to six grants to communities that have recently faced civil unrest. These grants will 

focus on high-risk youth and families in communities and surrounding areas that have 

experienced significant exposure to trauma. They will support evidence-based violence 

prevention and community youth engagement programs as well as linkages to trauma-informed 

behavioral health services. SAMHSA will prioritize funding grants from communities that have 

formed partnerships between key stakeholders including State and local governments (including 

multiple cities and counties if impacted); public or private universities and colleges; and nonprofit community- and faith-based organizations. SAMHSA is coordinating extensively with the 

Department of Education in the administration of this grant program.

Funding History

Fiscal Year Amount

FY 2013 ---

FY 2014 $54,865,000

FY 2015 $54,865,000

FY 2016 $64,865,000

FY 2017 $71,964,000

Budget Request

The FY 2017 Budget Request is $72.0 million, an increase of $7.1 million from the FY 2016 

Enacted Level. As part of the President’s Now is the Time initiative, this program seeks to raise 

awareness about mental health issues and connects young people who have behavioral health 

issues and their families with needed services. SAMHSA requests funding to support a new 

cohort of Project AWARE State Educational Agency awards, continuation grants to raise 

awareness and expand care in communities with civil unrest, 20 continuation Project AWARE 

SEA awards, 70 continuation MHFA awards, NITT technical assistance, and evaluation 

contracts. SAMHSA has a target to serve over four million children. The increase represents a 

reallocation of funds from Youth Violence Prevention to Project AWARE. The reallocation of 

these funds will enable SAMHSA to avoid duplication among programs with like purposes. 

Project AWARE is a program that also addresses the Administration’s multi-agency Native 

Youth priority related to Improving Education Outcomes and Like Outcomes for Native Youth, 

in support of the HHS Tribal Health and Well-Being Coordination. 
22

Healthy Transitions

(Dollars in thousands)

Programs of Regional & National Significance

FY 2015

Final

FY 2016

Enacted

FY 2017

President's 

Budget

FY 2017

+/- 

FY 2016

Healthy Transitions..................................................... $19,951 $19,951 $19,951 $---

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

FY 2017 Authorization .........................................................................................................Expired 

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

Eligible Entities...................................................................................................... States andTribes

Program Description and Accomplishments

Youth and young adults with serious mental illness, along with those with co-occurring mental 

and substance use disorders, 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 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,14 be arrested,15 drop out of school,16 and be unemployed.17 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 support. 

In FY 2014, SAMHSA provided $20.0 million for Healthy Transitions within the Now is the 

Time (NITT) initiative. The Healthy Transitions program awarded five-year grants to 17 states 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. 

Individuals who are 16 to 25 years old are at high risk of developing a mental illness or

substance use disorder and are at high risk for suicide. Unfortunately, these youth are among the 

least likely to seek help.18 Through this program, states are expanding services, developing 

14 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. 15 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. 16 Planty, M., Hussar, W., Snyder, T., Provasnik, S., Kena, G., Dinkes, R., Kemp, J. (2008). The condition of 

education 2008 (NCES 2008-031). 17 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: SRIInternational. 18 IOM (Institute of Medicine) and NRC (National Research Council). (2015), p. 56. Investing in the health and

well-being of young adults. Washington, D.C.: The National Academies Press.
23

family and youth networks for information sharing and peer support, and disseminating best 

practices for services for these young individuals. 

Grantees in their first year of the award have developed and built capacity within their states and 

local communities to deliver services. The NITT technical assistance and evaluation contracts 

have been providing training and technical assistance to grantees in order to meet grant 

requirements successfully.

In FY 2015, SAMHSA supported 17 NITT Healthy Transitions continuation grants and the NITT 

technical assistance and evaluation contracts. In FY 2016, SAMHSA will continue to support the

continuation grants and the NITT technical assistance and evaluation contracts.

Funding History

Fiscal Year Amount

FY 2013 ---

FY 2014 $19,951,000

FY 2015 $19,951,000

FY 2016 $19,951,000

FY 2017 $19,951,000

Budget Request

The FY 2017 Budget Request is $20.0 million, the same as the FY 2016 Enacted Level. 

SAMHSA’s request will support fourth-year continuation funding for the 17 NITT Healthy 

Transition grant recipients. In addition, this funding will support the NITT technical assistance 

and evaluation contracts. SAMHSA expects to refer up to 6,000 transition-aged youth with 

serious mental health conditions to related services through the Healthy Transitions program.

Healthy Transitions is a program that also addresses the Administration’s multi-agency Native 

Youth priority related to Improving Education Outcomes and Like Outcomes for Native Youth, 

in support of the HHS Tribal Health and Well-Being Coordination. 
24

Science of Changing Social Norms

(Dollars in thousands)

Programs of Regional & National Significance

FY 2015

Final

FY 2016

Enacted

FY 2017

President's 

Budget

FY 2017

+/- 

FY 2016

Science of Changing SocialNorms............................. $--- $2,000 $--- -$2,000

Authorizing Legislation........................................... Sections 501 of the Public Health Service Act 

FY 2017 Authorization .........................................................................................................Expired 

Allocation Method............................................................................................................. Contracts

Eligible Entities...........................................................................................................................N/A 

Program Description

The “Science of Changing Social Norms: Building the Evidence Base” laid fundamental 

groundwork upon which SAMHSA continues to build in FY 2016. In FY 2016, SAMHSA is 

beginning the next phase of the Science of Changing Social Norms program. Through this 

effort, SAMHSA will inform the development and testing of an array of messages designed to 

raise public awareness of the importance of behavioral health, promote health literacy to reduce 

the negative perceptions and attitudes about behavioral health issues, and help Americans make 

behavioral health a priority for public health action. Going forward, SAMHSA will use the 

insight gained through this effort to inform our communications about the importance of 

behavioral health.

Funding History

Fiscal Year Amount

FY 2013 ---

FY 2014 ---

FY 2015 ---

FY 2016 $2,000,000

FY 2017 ---

Budget Request

The FY 2017 Budget Request is $0.0 million, a decrease of $2.0 million from the FY 2016 

Enacted Level. The reduction is because the one-time evaluation is no longer needed. The 

lessons learned through the program in FY 2016 and SAMHSA’s work with the National 

Academies’ Board on Behavioral, Cognitive, and Sensory Sciences will inform SAMHSA’s 

other communications efforts and programs in FY 2017 and beyond. 
25

Behavioral Health Workforce

(Dollars in thousands)

Program Activity

FY 2015

Final

FY 2016

Enacted

FY2017

President's 

Budget

FY2017

+/- 

FY2016

BehavioralHealthWorkforce.................................... $6,246 $6,246 $16,246 +$10,000

Minority Fellowship Program-Youth/Addiction

Counselors (non-add)....................................... 5,246 5,246 5,246 ---

SAMHSA-HRSA BHWET Grant Program1

(non-add)......................................................... --- --- --- ---

Peer Professional WorkforceDevelopment

(non-add)............................................................ --- --- 10,000 +10,000

Behavioral Health Workforce Dataand

Development(non-add)................................... 1,000 1,000 1,000 ---

1The table reflects the transfer of funding associated with the Behavioral Health Workforce Expansion and Training 

(BHWET) programfromSAMHSA to HRSA. HRSA and SAMHSA will continue to work together to implement this 

program.

Authorizing Legislation........... Section 501, 509, 516, and 520A of the Public Health Service Act 

FY 2017 Authorization .........................................................................................................Expired 

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

Eligible Entities....................... Community Colleges, Universities, States, National Organizations 

Program Description and Accomplishments

SAMHSA’s workforce activities help train additional behavioral health professionals to work 

with students and young adults with mental illnesses and other behavioral health problems. 

These activities include SAMHSA’s Minority Fellowship Program-Youth/Addiction Counselors, 

a Peer Professional Workforce Development program, and the Behavioral Health Workforce 

Data and Development program.

Minority Fellowship Program Expansion-Youth (MFP-Y) and Addiction Counselors (MFP-AC) 

In FY 2014, additional funding expanded the MFP to support master’s level trained behavioral 

health professionals in the fields of psychology, social work, professional counseling, marriage 

and family therapy, and nursing serving children, adolescents, and populations in transition to 

adulthood (aged 16 to 25). The purpose of the program expansion, the Minority Fellowship 

Program-Youth (MFP-Y), is to reduce health disparities and improve behavioral healthcare 

outcomes for racially and ethnically diverse populations. 

To do this, the program aims to increase the number of culturally competent master’s level 

behavioral health professionals serving children, adolescents, and populations in transition to 

adulthood (aged 16 to 25) in an effort to increase access to, and the quality of, behavioral health 

care for this age group. The expansion program uses the existing infrastructure of the MFP to 

expand the program to support 960 master’s level trained behavioral health providers. Grants are 

competitively awarded to professional guilds, which then competitively award the stipends to 

post-graduate students pursuing a degree in that professional field.

In addition, in FY 2014, funding expanded the MFP to support master’s level addiction 

counselors (MFP-AC). The purpose of the four-year grant program is to reduce health
26

disparities and improve behavioral healthcare outcomes for racially and ethnically diverse 

populations by increasing the number of culturally competent master’s level addiction counselors 

available to underserved minority populations with a specific focus on transition age youth (ages 

16 to 25) in public and private non-profit sectors. MFP-AC grants are supporting students 

pursuing master’s level degrees in addiction/substance abuse counseling, with the goal of 

increasing the number of masters-level addiction counselors across the nation by approximately 

300 counselors. As is the case with MFP and MFP-Y, grants are competitively awarded to 

professional guilds, who then competitively award the stipends to post-graduate students 

pursuing a degree in that professional field.

The FY 2015 Budget provided $5.3 million in funding for MFP grants. The FY 2016 Enacted 

Level of $5.3 million sustains and strengthens the expansion program.

Funding History

Fiscal Year Amount

FY 2013 ---

FY 2014 $5,246,000

FY 2015 $5,246,000

FY 2016 $5,246,000

FY 2017 $5,246,000

Budget Request

The FY 2017 Budget Request includes $5.3 million, which is the same as the FY 2016 Enacted 

Level. This funding will provide continued support for five MFP-Y grants, two MFP-AC grants, 

and three technical assistance and evaluation support contracts.

Behavioral Health Workforce Data and Development 

As of June 2014, there were more than 4,000 Mental Health Professional Shortage Areas in the 

United States, containing nearly a third of the American population, or 96 million people. Recent 

data indicate that almost 90 percent of persons with substance use disorders do not receive the 

services they need19 and over half of those with any mental illness do not receive needed 

treatment.20

The President’s Now is the Time initiative support new activities to expand the behavioral health 

workforce. In FY 2015, new workforce investments provided support for 2,116 new behavioral 

health professionals. To ensure the existing workforce investments would achieve desired 

outcomes, SAMHSA workforce activities in FY 2015 included $1.0 million to collaborate with

19 Substance Abuse and Mental Health Services Administration, Results from the 2013 National Survey on Drug Use 

and Health: Summary of National Findings, NSDUH Series H-48, HHS Publication No. (SMA) 14-4863. Rockville, 

MD: Substance Abuse and Mental Health Services Administration, 2014. 20 Substance Abuse and Mental Health Services Administration, Results from the 2013 National Survey on Drug Use 

and Health: Mental Health Findings, NSDUH Series H-49, HHS Publication No. (SMA) 14-4887. Rockville, MD:

Substance Abuse and Mental Health Services Administration, 2014.
27

HRSA on the Behavioral Health Minimum Data Set to develop consistent data collection 

methods to identify and track behavioral health workforce needs. In FY 2015 and in FY 2016, 

SAMHSA will continue to work with HRSA to develop a consistent and common data set and to 

develop clear goals and objectives to meet the national behavioral health workforce needs in 

America.

Funding History

Fiscal Year Amount

FY 2013 ---

FY 2014 ---

FY 2015

FY 2016

$1,000,000

$1,000,000

FY 2017 $1,000,000

Budget Request

The FY 2017 Budget Request of $1.0 million is level with the FY 2016 Enacted Level. These 

funds will allow SAMHSA to continue collaborating with HRSA. These efforts will focus 

analytical and research projects in three behavioral health workforce focus areas: 1) expanded 

application of standardized minimum data set with state and professional organizations; 2) 

workforce modeling and projections to understand what behavioral health services are being 

provided, by whom and in what settings; and 3) development of certification/licensing/scope of 

practice framework for each state.

Peer Professional Workforce Development

The Peer Professional Workforce Development program will fund grants to provide tuition 

support and further the capacity of community colleges to develop and sustain behavioral health 

paraprofessional training and education programs. The Peer Professional Workforce 

Development program’s goal is to increase the number of trained peers, recovery coaches, 

mental health/addiction specialists, prevention specialists, and pre-masters-level addiction 

counselors working with young people ages 16 to 25. Because they have lived with behavioral 

health conditions, the entry-level providers supported by this program will play a significant role 

in the delivery of prevention, outreach, engagement, and recovery support services. Studies 

show that individuals with a substance use disorder who regularly engage in peer-delivered 

interventions are more likely to abstain from substance misuse. Evidence also shows the 

effectiveness of those with mental disorders and their families in supporting their peers. The 

Behavioral Health Workforce Education and Training program, described below, focuses on 

supporting clinical internships, field placements, and certificate program completion across a 

range of professional and paraprofessional disciplines. In contrast, the Peer Professional 

Workforce Development program will focus on helping communities develop the infrastructure 

to train and certify peers, or people with lived experience with mental illness and/or substance 

use conditions, as behavioral health providers. 
28

Funding History

Fiscal Year Amount

FY 2013 ---

FY 2014 ---

FY 2015 ---

FY 2016 ---

FY 2017 $10,000,000

Budget Request

The FY 2017 Budget Request of $10.0 million reflects an increase of $10.0 million from the 

FY 2016 Enacted Level. These funds will support the development of the new Peer Professional 

Workforce Development program. The program aims to increase the number of trained peers, 

recovery coaches, mental health/addiction specialists, prevention specialists, and pre-Masters 

level addiction counselors working with young people ages 16 to 25. It will provide tuition 

support and further the capacity of community colleges to develop and sustain behavioral health 

paraprofessional training and education programs. The funding will support up to 19 grants.

SAMHSA-HRSA Behavioral Health Workforce Education and Training (BHWET) Grant 

Program

In FY 2014, as part of the President’s Now is the Time initiative, SAMHSA and the Health 

Resources and Services Administration (HRSA) began collaboration on the Behavioral Health 

Workforce Education and Training Grant Program. The purpose of this program is to increase 

the clinical service capacity of the behavioral health workforce by supporting training for 

masters-level social workers, professional counselors, psychologists, marriage and family 

therapists, psychology doctoral interns, as well as behavioral health paraprofessionals. In 

FY 2014 through FY 2016, SAMHSA requested and Congress appropriated this funding to 

SAMHSA and HRSA carried out the program under a reimbursable agreement. In FY 2017, 

HHS is requesting that HRSA receive the funding for this program. SAMHSA has comparably 

adjusted impacted tables to avoid confusion. This is in line with HRSA’s current authorities and 

will aid in streamlining efforts. SAMHSA and HRSA will continue to collaborate to sustain and 

strengthen the HRSA-SAMHSA partnership and the behavioral health workforce. 
29

Outputs and Outcomes Table

Program: Now is the Time

NOTE: SAMHSA makes grant awards toward the end of the year. Therefore, the FY 2017 targets are based on the 

FY 2016 Enacted Level and the FY 2018 targets are based on the FY 2017 President’sBudget.

Measure

Year and Most Recent Result

Target for Recent Result 

(Summary of Result)

FY 2017

Target

FY 2018

Target

FY 2018

Target

+/- 

FY 2017

Target

3.2.18 Increase the number of 

children served. (Output)

FY 2015: 4,696,119

Target: 750,000 

(Target exceeded)

4,696,119 4,696,119 Maintain

3.2.34 Increase the percentage of 

clients receiving services who 

report positive functioning at 6- 

month follow-up. (Outcome)

FY 2015: 66%

Target: 64% 

(Target exceeded)

64% 64% Maintain

3.2.36 Increase the percentage of 

clients receiving services who are 

currently employed at 6-month 

follow-up. (Outcome)

FY 2015: 56%

Target: 56 % 

(Target met)

56% 56% Maintain

4.4.20 Increase the Minority 

Fellowship awards. (Outcome)

FY 2016: Result Expected 

December 31, 2016

Target: 1,260 

(Pending)

1,260 1,260 Maintain

4.4.21 Increase the Peer 

Professional Workforce 

Development. (Outcome)

FY 2016: Result Expected 

December 31, 2016

Target: 1,200 

(Pending)

1,200 1,200 Maintain

4.4.22 Increase Behavioral Health 

Workforce Education and Training. 

(Outcome)

FY 2015: 2,116

Target: 3,700 

(Target not met)

3,700 3,700 Maintain
30

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31

SAMHSA

Budget Exhibits 

Table of Contents

1. Appropriations Language................................................................................................. 33

2. Language Analysis........................................................................................................... 38

3. Amounts Available for Obligation................................................................................... 44

4. Summary of Changes ....................................................................................................... 45

5. Authorizing Legislation ................................................................................................... 47

6. Appropriations History .................................................................................................... 49

7. Appropriations Not Authorized by Law .......................................................................... 51
32

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33

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, [$1,133,948,000]

$1,117,727,000: Provided, 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]

$31,039,000 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 section 520E(b)(2) of the PHS Act shall not apply to funds appropriated in this Act 

for fiscal year [2016] 2017: [Provided further, That of the amount appropriated under this 

heading, $46,887,000 shall be for the National Child Traumatic Stress Initiative as described in 

section 582 of the PHS Act:] Provided further, That notwithstanding section 565(b)(1) of the 

PHS Act, technical assistance may be provided to a public entity to establish or operate a system 

of comprehensive community mental health services to children with a serious emotional 

disturbance, without regard to whether the public entity receives a grant under section 561(a) of 

such Act: 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] 

mental health prevention and treatment practices to address the needs of individuals with early
34

serious mental illness, including psychotic disorders, regardless of the age of the individual at 

onset: 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): 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. 

SUBSTANCE ABUSE TREATMENT

For carrying out titles III [,] and V [, and XIX] of the PHS Act with respect to substance abuse 

treatment and [section 1922(a) of the PHS Act] title XIX of such Act with respect to substance 

abuse treatment and prevention, [$2,114,224,000] $2,077,148,000: Provided, That in addition to 

amounts provided herein, [the following amounts] $109,200,000 shall be available under section 

241 of the PHS Act [: (1) $79,200,000] to supplement funds otherwise available for substance 

abuse treatment activities and 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 none of the funds provided 

for section 1921 of the PHS Act shall be subject to section 241 of such Act: Provided further, 

That notwithstanding section 508 of the PHS Act, up to 25 percent of the amounts made
35

available to carry out such section may be used to carry out demonstration grants to provide 

intensive outpatient services and treatment as well as any of the services listed in section 508(d). 

SUBSTANCE ABUSE PREVENTION

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

[$211,219,000] $194,680,000: Provided, That in addition to amounts provided herein,

$16,468,000 shall be available under section 241 of the PHS Act to supplement funds otherwise 

available for substance abuse prevention activities. 

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 (“SAMHSA”), [$174,878,000] $99,228,000: Provided, That in addition to 

amounts provided herein, [$31,428,000] $56,828,000 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(m) of the PHS Act shall remain available 

through September 30, [2017] 2018: Provided further, That funds made available under this 

heading may be used to supplement program support funding provided under the headings
36

"Mental Health", "Substance Abuse Treatment", and "Substance Abuse Prevention": Provided 

further, That the Administrator may transfer discretionary funds (pursuant to the Balanced 

Budget and Emergency Deficit Control Act of 1985) which are appropriated for the current 

fiscal year for SAMHSA in this Act between any of the accounts of SAMHSA with notification to 

the Committees on Appropriations of both Houses of Congress at least 15 days in advance of any 

transfer, but no such account shall be decreased by more than 3 percent by any such transfer. 

(Department of Health and Human Services Appropriations Act, 2016.)

GENERAL PROVISIONS

SEC. 225. Notwithstanding subparagraph (B)(i) of section 303(g)(2) of the Controlled 

Substances Act (21 U.S.C. 823(g)(2)), the Secretary of Health and Human Services may, using 

amounts made available in this Act to carry out title V of the Public Health Service Act, establish 

and carry out a demonstration through fiscal year 2021 in which, for purposes of prescribing 

buprenorphine under such section 303(g)(2), the term "practitioner" shall be deemed to include 

non-physician providers authorized to prescribe buprenorphine by the jurisdiction in which the 

provider is licensed who meet such criteria as determined appropriate by the Secretary, in 

consultation with the Attorney General, for participation in the project. In implementing this 

demonstration project, the Secretary and Attorney General shall not be subject to the 

requirements of 5 U.S.C. 553. The Secretary may enter into grants, contracts, or cooperative 

agreements with one or more research institutions, and public and nonprofit entities to assist in 

carrying out such demonstration. In addition, amounts available for this fiscal year in other Acts 

to the Attorney General for carrying out section 303 of the Controlled Substances Act shall also 

be available to the Attorney General to facilitate and support the efficient operation of the 

demonstration under this section. Any authority for a provider to prescribe buprenorphine that
37

results from participating in this demonstration project shall end no later than the date such 

provider ceases to participate in this demonstration. (Department of Health and Human Services 

Appropriations Act, 2016.)
38

Language Analysis

Language Provision Explanation

Provided further, That in addition to amounts 

provided herein, [$21,039,000] $31,039,000 

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,

Sets the amount of Public Health Service 

Evaluation Fund dollars allocated to supplement 

the budget authority for programs and activities 

authorized under title XIX as well as under titles 

III and V. This change would allow PHS 

Evaluation funds to be used to fund the Crisis 

Systems and Tribal Behavioral Health Grants 

programs in addition to activities supported in 

FY 2016. These evaluation efforts will enable the 

gathering and dissemination of best practices.

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

PHS Act shall not apply to funds appropriated in 

this Act for fiscal year [2016] 2017: 

Because all states will have received a grant 

under the Garrett Lee Smith Youth Suicide 

Prevention statewide program and the original 

purpose of the restriction in 520E (b) (2) has 

been served, this language would allow the 

program to continue by allowing states to receive 

a second grant. 

[Provided further, That of the amount 

appropriated under this heading, $46,887,000 

shall be for the National Child Traumatic Stress 

Initiative as described in section 582 of the PHS

Act:]

It is not necessary to have specific statutory 

earmark for this activity, which is funded in the 

Budget at $46,887,000. This statutory earmark 

increases the administrative burden of the

program. 
39

Language Provision Explanation

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] mental 

health prevention and treatment practices to 

address the needs of individuals with early 

serious mental illness, including psychotic 

disorders, regardless of the age of the individual 

at onset: 

States must use at least 10 percent of their 

Community Mental Health Services Block Grant 

award to support evidence-based mental health 

promotion and treatment practices with respect to 

individuals with early serious mental illness.

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. 

This provision permits SAMHSA to set aside up 

to 10 percent of CMHS for a demonstration with 

flexibility which would help address youth 

(which addresses 75% of first time psychotic 

episodes) instead of only children (which 

represent less than 50% of first time psychotic 

episodes) in the prodrome phase, which evidence 

indicates may prevent the further development of

serious emotional disturbances and ultimately 

serious mental illness.

For carrying out titles III [,] and V [, and XIX] of 

the PHS Act with respect to substance abuse 

treatment and [section 1922(a) of the PHS Act] 

title XIX of such Act with respect to substance 

abuse treatment and prevention, 

Sets out the budget authority for the Substance 

Abuse Treatment appropriation. 
40

Language Provision Explanation

Provided, That in addition to amounts provided 

herein, [the following amounts]

$109,200,000 shall be available under section 

241 of the PHS Act [: (1) $79,200,000] to 

supplement funds otherwise available for 

substance abuse treatment activities and 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

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 as well as 

under titles III and V. These evaluation efforts 

will enable the gathering and dissemination of 

best practices.

[; and (2) $2,000,000 to evaluate substance 

abuse treatment programs]: 

The provision previously mentioned eliminates 

the need for this separate proviso as the amount

is included in the $109,200,000.

Provided further, That notwithstanding section 

508 of the PHS Act, up to 25 percent of the 

amounts made available to carry out such section 

may be used to carry out demonstration grants to 

provide intensive outpatient services and 

treatment as well as any of the services listed in 

section 508(d). 

This provision would permit up to 25 percent of 

the Pregnant and Postpartum Women funding to 

be used for a subset of new grantees to pay 

directly for a wider range of required and 

optional family-centered services for pregnant 

and postpartum women and their minor children 

including intensive out-patient and out-patient 

treatment with housing components. In addition, 

certain grantees would be able to utilize funding 

to develop a collaborative infrastructure that is 

capable of building the region's long-term 

capacity to
41

Language Provision Explanation

meet the comprehensive substance abuse 

treatment needs of pregnant and post-partum 

women, as well as the needs of her infant, other 

children, and the family.

Provided, That in addition to amounts provided 

herein, $16,468,000 shall be available under 

section 241 of the PHS Act to supplement funds 

otherwise available for substance abuse 

prevention activities. 

Sets the amount of Public Health Service 

Evaluation Fund dollars allocated to supplement 

the budget authority available for programs and 

activities authorized under titles III and V. This 

change would allow PHS Evaluation funds to be 

used to fund the Center for the Application of 

Prevention Technologies and Strategic 

Prevention Framework Rx programs. These 

evaluation efforts will enable the gathering and 

dissemination of best practices. 

Provided further, That amounts made available 

in this Act for carrying out section 501(m) of the 

PHS Act shall remain available through 

September 30, [2017] 2018: 

SAMHSA’s existing emergency authority allows 

it to tap certain programs up to one percent for 

emergency response grants. SAMHSA’s ability 

to respond to disasters which occur at the end of 

the year, which is hurricane season, is hampered 

by low available balances. To ensure programs 

are only tapped to the extent necessary and to 

ensure that SAMHSA’s emergency response is 

agile, this proviso allows funds tapped to be 

carried over one additional fiscal year, and only 

for the same purpose. This technical change 

updates the year.
42

Language Provision Explanation

Provided further, That the Administrator may 

transfer discretionary funds (pursuant to the 

Balanced Budget and Emergency Deficit Control 

Act of 1985) which are appropriated for the 

current fiscal year for SAMHSA in this Act 

between any of the accounts of SAMHSA with 

notification to the Committees on Appropriations 

of both Houses of Congress at least 15 days in 

advance of any transfer, but no such account 

shall be decreased by more than 3 percent by 

any such transfer.

Establishes a permissive authority to transfer a 

small portion of funds between any of the 

SAMHSA accounts in order to ensure that 

multiple accounts are not a barrier to the efficient 

administration of the agency, or appropriate 

responsiveness to emerging issues with 

congressional notification.

SEC. 225. Notwithstanding subparagraph (B)(i) 

of section 303(g)(2) of the Controlled Substances

Act (21 U.S.C. 823(g)(2)), the Secretary of 

Health and Human Services may, using amounts 

made available in this Act to carry out title V of 

the Public Health Service Act, establish and 

carry out a demonstration through fiscal year 

2021 in which, for purposes of prescribing 

buprenorphine under such section 303(g)(2), the 

term "practitioner" shall be deemed to include 

non-physician providers authorized to prescribe 

buprenorphine by the jurisdiction in which the 

provider is licensed who meet such criteria as

determined appropriate by the Secretary, in 

consultation with the Attorney General, for 

participation in the project. In implementing this 

demonstration project, the Secretary and 

Attorney General shall not be subject to the

This provision permits the Secretary to establish 

a buprenorphine demonstration project that 

permits non-physician providers to prescribe 

buprenorphine if such providers are allowed 

under State law. For purposes of carrying out this 

demonstration project, the Attorney General and 

Secretary are not subject to APA notice and 

comment rulemaking requirements. For nonphysician providers who received authority to 

prescribe buprenorphine from the demonstration, 

that authority would end once their participation 

in the demonstration project ends. 
43

requirements of 5 U.S.C. 553. The Secretary may 

enter into grants, contracts, or cooperative 

agreements with one or more research 

institutions, and public and nonprofit entities to 

assist in carrying out such demonstration. In 

addition, amounts available for this fiscal year in 

other Acts to the Attorney General for carrying 

out section 303 of the Controlled Substances Act 

shall also be available to the Attorney General to 

facilitate and support the efficient operation of 

the demonstration under this section. Any 

authority for a provider to prescribe 

buprenorphine that results from participating in 

this demonstration project shall end no later 

than the date such provider ceases to participate 

in this demonstration. (Department of Health 

and Human Services Appropriations Act, 2016.)
44

Amounts Available for Obligation

(Whole dollars)

FY 2015

Actual

FY 2016

Enacted

FY 2017

President's 

Budget

General Fund Discretionary Appropriation:

Appropriation (L/HHS, Ag, or, Interior).............................................................................. $3,474,045,000 $3,634,269,000 $3,488,783,000

Across-the-board reductions (L/HHS, Ag, or Interior)........................................................ --- --- ---

Subtotal, Appropriation (L/HHS, Ag, or Interior)............................................................. 3,474,045,000 3,634,269,000 3,488,783,000

Comparable transfer to: Health Resources and ServicesAdministration................................ (35,000,000) (50,000,000) ---

Subtotal, adjusted general fund discr. appropriation.......................................................... (35,000,000) (50,000,000) ---

Total, Discretionary Appropriation........................................................................... 3,439,045,000 3,584,269,000 3,488,783,000

Mandatory Appropriation:

Behavioral Health Initiative.................................................................................................. --- --- 115,000,000

Expanding Access to Treatment to Reduce Prescription Drug Abuse and Heroin Use........... --- --- 475,000,000

Transfer from the Prevention and Public Health Funds......................................................... 12,000,000 12,000,000 27,830,000

Subtotal, adjusted mandatory appropriation...................................................................... 12,000,000 12,000,000 617,830,000

Offsetting collections from:

Federal Source...................................................................................................................... 133,667,000 133,667,000 213,535,000

Data Request and Publications UserFees............................................................................... 1,500,000 1,500,000 1,500,000

Unobligated balance, start of year.......................................................................................... 172,000 790,000 ---

Unobligated balance, end of year........................................................................................... 1,338,000 1,219,776 1,170,947

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

Total obligations.............................................................................................................. $3,586,212,000 $3,731,436,000 $4,321,648,000
45

Summary of Changes

(Whole dollars)

2016

Totalestimated budget authority...................................................................................................................................

(Obligations)......................................................................................................................................................................

$3,584,269,000 

3,584,269,000

2017

Totalestimated budget authority...................................................................................................................................

(Obligations)......................................................................................................................................................................

3,488,783,000

3,488,783,000

Net Change..................................................................................................................................................................... -$95,486,000

Increases: FY2017

PB FTE

FY2017

PB BA

FY2017

+/-

FY2016

FTE

FY2017

+/-

FY2016

BA

A.Built-in:

1.Annualization of 2017commissioned corps pay increase.......... --- $69,560 --- +$69,560

2. Annualization of 2017 civilian pay increase.................................. --- 821,408 --- +821,408

Subtotal,Built-inIncreases............................................................ --- 890,968 --- +890,968

A. Program:

1. Agency-Wide Initiatives.................................................................. --- 22,669,000 --- +10,000,000

Subtotal, ProgramIncreases.......................................................... --- 22,669,000 --- +10,000,000

Total Increases.............................................................................. --- --- --- +10,890,968

Decreases:

A.Built-in: --- --- --- ---

1.Absorption of built-in increases.................................................... --- --- --- -890,968

Subtotal, Built-inDecreases.......................................................... --- --- --- -890,968

A. Program:

1. Mental Health PRNS......................................................................... --- 1,117,727,000 --- -8,162,000

2. Substance Abuse Prevention PRNS.............................................. --- 194,680,000 --- -16,468,000

3. Substance Abuse TreatmentPRNS................................................ --- 2,077,148,000 --- -33,537,000

4.HealthSurveillance........................................................................... --- --- --- -16,830,000

5.ProgramSupport................................................................................ --- 77,559,000 --- -2,000,000

6. Public Awareness and Support....................................................... --- --- --- -15,571,000

7.Performance and Quality Information Systems............................ --- --- --- -12,918,000

Subtotal, ProgramDecreases........................................................ --- 3,467,114,000 --- -105,486,000

Total Decreases............................................................................ --- --- --- -106,376,968

Net Change................................................................................ $--- $--- $--- -$95,486,000
46

Summary of Changes (Continued) 

(Whole dollars)

2016

Total estimated mandatory..............................................................................................................................................

(Obligations)......................................................................................................................................................................

$12,000,000 

12,000,000

2017

Total estimated mandatory..............................................................................................................................................

(Obligations)......................................................................................................................................................................

617,830,000

617,830,000

Net Change..................................................................................................................................................................... +$605,830,000

Increases:

FY2017

PB FTE

FY2017

PB

Mandatory

FY2017

+/-

FY2016

FTE

FY2017

+/-

FY2016

Mandatory

A. Program:

1.MentalHealth.................................................................................... --- --- --- ---

2. Substance AbuseTreatment........................................................... --- --- --- ---

3.HealthSurveillance........................................................................... --- 17,830,000 --- +17,830,000

Subtotal,ProgramIncreases.......................................................... --- 590,000,000 --- +607,830,000

Decreases:

A. Program:

1. Mental Health PRNS......................................................................... --- 10,000,000 --- -2,000,000

Subtotal, ProgramDecreases........................................................ --- 10,000,000 --- -2,000,000

Net Change................................................................................ --- $600,000,000 --- +$605,830,000
47

Authorizing Legislation

(Whole dollars)

Program Description/PHS Act:

FY 2016

Amount 

Authorized

FY 2016

Appropriations 

Act

FY 2017

Amount 

Authorized

FY 2017

President's

Budget

Grants for the Benefit of Homeless

Individuals Sec.

506........................................ Expired $41,304,000 Expired $36,386,000

Residential Treatment Programsfor

Pregnant and Postpartum Women

Sec. 508......................................

Expired $15,931,000 Expired $15,931,000

Priority Substance Abuse Treatment

Needs of Regional and National

Significance Sec. 509*...............

Expired $244,966,000 Expired $216,347,000

Substance Abuse Treatment Services

for Children and Adolescents

Sec. 514*.................................

Expired $29,605,000 Expired $29,605,000

Priority Substance Abuse Prevention

Needs of Regional and National 

Significance Sec. 516*............... Expired $204,148,000 Expired $187,680,000

Programs to Reduce Underage

Drinking Sec. 519B*.................. Expired $ 7,000,000 Expired $ 7,000,000

Priority Mental Health Needs of 

Regionaland National Significance

Sec. 520A*....................................

Expired $219,515,000 Expired $256,325,000

Youth Interagency Research, Training,

and Technical Assistance Centers

Sec. 520C*....................................

Expired $5,988,000 Expired $5,988,000

Suicide Prevention for Children and

Youth Sec. 520E*..................... Expired $23,427,000 Expired $25,427,000

Sec. 520E2*................................. Expired $6,488,000 Expired $6,488,000

Grants for Jail Diversion Programs

Sec. 520G*.................................... Expired $4,269,000 Expired $4,269,000

Awards for Co-locating Primary and 

Specialty Care in Community-based Mental 

Health Settings Sec.520K*...............

Expired $49,877,000 Expired $26,004,000

PATH Grants to States

Sec. 535(a).................................... Expired $64,635,000 Expired $64,635,000

Community Mental Health Services for

Children with Serious Emotional 

Disturbances Sec. 565 (f)...............

Expired $119,026,000 Expired $119,026,000

Children and Violence Program

Sec. 581*.................................... Expired $23,099,000 Expired 0

Grants for Persons who Experience

Violence Related Stress Sec. 582..... Expired $46,887,000 Expired $46,887,000

Community Mental Health Services

Block Grants Sec. 1920(a)............ Expired $511,532,000 Expired $511,532,000

Substance Abuse Prevention and

Treatment Block Grants Sec. 1935(a) Expired $1,778,879,000 Expired $1,778,879,000
48

Authorizing Legislation (Continued) 

(Whole dollars)

Other Legislation/Program Description

FY 2016

Amount 

Authorized

FY 2016

Appropriations 

Act

FY 2017

Amount 

Authorized

FY 2017

President's

Budget

Protecting Access to Medicare Act of 2014 

P.L. 113-93, Sec. 224..................... $15,000,000 $15,000,000 $15,000,000 $15,000,000

Protection and Advocacy for

Individuals with Mental Illness Act P.L. 

99-319,Sec. 117........................ Expired $36,146,000 Expired $36,146,000

Health Surveillance and Program

Support Program Management, Sec.

501............... Indefinite $79,559,000 Indefinite $77,559,000

Total, Program Management............... Indefinite $79,559,000 Indefinite $77,559,000

Heath Surveillance, Sec. 501, 505............ Indefinite $16,830,000 Indefinite

0

Public Awareness and Support (FY12)...... Indefinite $15,571,000 Indefinite

0

PQIS (FY12)...................................... Indefinite $12,918,000 Indefinite

0

Agency-Wide Initiatives......................... Indefinite $11,669,000 Indefinite $21,669,000

TOTAL, SAMHSA Budget Authority... $15,000,000 $3,584,269,000 $15,000,000 $3,488,783,000

Mandatory Legislation/Program Description

FY 2016

Amount 

Authorized

FY 2016

Appropriations 

Act

FY 2017

Amount 

Authorized

FY 2017

President's

Budget

Prevention and Public Health Fund P.L. 111-

148, Sec. 4002..................... N/A $12,000,000 N/A $27,830,000

Mental Health Initiative..................... N/A 0 N/A $115,000,000

Expanding Access to Treatment to Reduce 

Prescription Drug Abuse and Heroin Use ... N/A 0 N/A $475,000,000

TOTAL,SAMHSAMandatory... 0 $12,000,000 0 $617,830,000

*Denotes programs that were authorized in the Children's Health Act of 2000. We have the authority to carryout these programs in

our general authorities in Section 507, 516, and 520A.
49

Appropriations History

(Whole dollars)

Budget Estimate

to Congress

House

Allowance

Senate

Allowance Appropriation

FY 2008

General Fund Appropriation:

Base................................................. $3,167,589,000 $3,393,841,000 $3,404,798,000 $3,291,543,000

P.L. 110-161

Rescission (P.L. 110-161)............... --- --- --- -$57,503,000

Subtotal............................................ $3,167,589,000 $3,393,841,000 $3,404,798,000 $3,234,040,000

FY 2009

General Fund Appropriation:

Base................................................. $3,024,967,000 $3,303,265,000 $3,257,647,000 $3,334,906,000

P.L. 111-8 

Subtotal............................................ $3,024,967,000 $3,303,265,000 $3,257,647,000 $3,334,906,000

FY 2010

General Fund Appropriation:

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

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

P.L. 111-117 

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

FY 2011

General Fund Appropriation:

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

P.L. 112-10 

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

FY 2012

General Fund Appropriation:

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

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

P.L. 112-74 

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

FY 2013

General Fund Appropriation:

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

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

S.R. 112-176 

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

FY 2014

General Fund Appropriation:

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

S.R. 113-071

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

1/

2/

3/

4/

5/

1/ Reflects a 1.7 percent across-the-board Rescission from the P.L. 110-161. 

2/ Reflects a $508 thousand transfer to HHS.

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

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

5/ Reflects the whole year appropriation. 
50

Appropriations History (continued) 

(Whole dollars)

Budget Estimate House Senate

to Congress Allowance Allowanc Appropriation

FY 2015

General Fund Appropriation:

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

P.L. 113-235 

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

FY 2016

General Fund Appropriation:

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

P.L. 114-113 

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

FY 2017

General Fund Appropriation:

Base................................................. $3,488,783,000 --- --- ---

Subtotal............................................ $3,488,783,000 --- --- ---

6/ 

7/ 

6/ Reflects the whole year appropriation.

7/ Reflects the whole year appropriation.
51

Appropriations Not Authorized by Law

(Whole dollars)

Program Last Year of 

Authorization

Authorization 

Level

Appropriations in 

Last Year of 

Authorization

Appropriations in 

FY 2016

Grants for the Benefit of Homeless Individuals Sec. 

506..................................................................

2003

$ 50,000,000 $ 16,700,000 $41,304,000

ResidentialTreatment Programsfor Pregnant andPostpartum

Women Sec. 508..................................................................

2003

SSAN $0 $15,931,000

Priority Substance Abuse Treatment Needs Sec. 

509*................................................................

2003

$ 300,000,000 $ 322,994,000 $244,966,000

Substance Abuse Treatment Services for Children and

Adolescents Sec. 514*..................................................

2003

$ 40,000,000 $ 20,000,000 $29,605,000

Priority Substance Abuse Prevention Needs of Regional and 

National Significance Sec. 516*...............................................

2003

$ 300,000,000 $ 138,399,000 $204,148,000

Priority Mental Health Needs of Regional and National

Significance Sec. 520A*...............................................

2003

$ 300,000,000 $ 94,289,000 $219,515,000

Youth InteragencyResearch,Training, andTechnicalAssistance

Centers Sec. 520C*.............................................................

2007

$ 5,000,000 $ 3,960,000 $5,988,000

Suicide Prevention for Children and Youth Sec. 520E (GLS - 

State Grants)................................

2007

$ 30,000,000 $ 17,829,000 $ 23,427,000

Sec. 520E2 (GLS-Campus Grants)............................

2007

$ 5,000,000 $ 4,950,000 $6,488,000

Sec. 520G*..............................................................

2003

$ 10,000,000 $ 6,043,000 $4,269,000

Awards for Co-locating Primary and SpecialtyCare in

Community-basedMentalHealth Settings Sec. 

520K*.............................................

2014

$ 50,000,000 $ 50,000,000 $ 49,877,000

PATH Grants to States

Sec. 535(a)..............................................................

2003

$ 75,000,000 $ 46,855,000 $ 64,635,000

Community Mental Health Services for Children with Serious 

EmotionalDisturbances Sec. 565 (f)...........................................

2003 $ 100,000,000

$ 96,694,000

$119,026,000

Children and ViolenceProgram

Sec. 581*................................................................

2003 $ 100,000,000

$ 83,035,000 $ 23,099,000

Grants for Persons who Experience Violence Related Stress 

Sec. 582 * .............................................................. 2003 $ 50,000,000 $ 20,000,000 $ 46,887,000

Community Mental Health Services Block Grants 

Sec. 1920(a)............................................................ 2003 $ 450,000,000 $ 433,000,000 $511,532,000

Substance Abuse Prevention and Treatment BlockGrants 

Sec. 1935(a)............................................................ 2003 $2,000,000,000 $1,785,000,000 $1,778,879,000

Other Legislation/Program Description

Protection and Advocacy for Individuals with MentalIllness Act 

P.L. 99-319, Sec. 117............................................... 2003 $ 19,500,000 $ 32,500,000 $ 36,146,000

TOTAL, SAMHSA Budget Authority.................. $3,889,500,000 $3,174,664,000 $3,425,722,000

MandatoryLegislation/ProgramDescription

Prevention and Public Health Fund

Suicide Prevention for Children andYouth

Sec. 520E (GLS - State Grants)............................. 2007 $ 30,000,000 $ 17,829,000 $ 12,000,000

TOTAL, SAMHSA Mandatory............................. $ 30,000,000 $ 17,829,000 $ 12,000,000

*Denotes programs that were authorized in the Children's Health Act of 2000. SAMHSA has the authority to carryout

these programs in our general authorities in Section 507, 516 and 520A.

**Congress authorized two provisions as section514.
52

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53

SAMHSA

Mental Health 

Table of Contents

1. Mental Health Appropriation .................................................................................................. 55 

2. Programs of Regional and National Significance (PRNS) ..................................................... 56 

a) Seclusion and Restraint ..................................................................................................... 58 

b) Youth Violence Prevention ............................................................................................... 59 

c) Project AWARE................................................................................................................ 61 

d) Healthy Transitions ........................................................................................................... 66 

e) National Child Traumatic Stress Network ........................................................................ 69 

f) Children and Family Programs ......................................................................................... 72 

g) Consumer and Family Network Grants ............................................................................ 74 

h) Project LAUNCH.............................................................................................................. 76 

i) Mental Health System Transformation and Health Reform ............................................. 79 

j) Primary and Behavioral Health Care Integration .............................................................. 82 

k) Suicide Prevention Programs ............................................................................................ 85 

i. National Strategy for Suicide Prevention .................................................................... 86 

ii. Suicide Lifeline .......................................................................................................... 89 

iii. Garrett Lee Smith Youth Suicide Prevention – State/Tribal and Campus .................. 91 

iv. Garrett Lee Smith Suicide Prevention Resource Center ............................................. 92 

v. American Indian/Alaska Native Suicide Prevention Initiative ................................... 93 

l) Homelessness Prevention Programs ................................................................................. 96 

m) Minority AIDS and HIV/AIDS Education........................................................................ 99 

n) Criminal and Juvenile Justice Programs ......................................................................... 101 

o) Practice Improvement and Training ................................................................................ 103 

p) Consumer and Consumer-Supporter TA Centers ........................................................... 105 

q) Disaster Response ........................................................................................................... 107 

r) Tribal Behavioral Health Grants ..................................................................................... 109 

s) Crisis Systems ................................................................................................................. 112 

t) Assisted Outpatient Treatment for Individuals with Serious Mental Illness .................. 115 

3. PRNS Mechanism Table Summary ...................................................................................... 119 

4. PRNS Mechanism Table by Program, Project, and Activity ................................................ 120 

5. Grant Awards Table .............................................................................................................. 126 

6. Children's Mental Health Services ........................................................................................ 127 

7. Projects for Assistance in Transition from Homelessness .................................................... 133 

8. Protection and Advocacy for Individuals with Mental Illness .............................................. 139 

9. Community Mental Health Services Block Grant ................................................................ 145 

10. Evidence-based Eearly Interventions .................................................................................... 153 
54

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55

Mental Health Appropriation

(Dollars in thousands)

ProgramActivities

FY2015

Final

FY2016

Enacted

FY2017

President's 

Budget

FY2017

+/- 

FY2016

Programs ofRegionaland NationalSignificance........................ $370,538 $406,550 $406,388 -$162

Prevention and Public Health Fund (non-add).................. 12,000 12,000 10,000 -2,000

PHSEvaluationFunds(non-add)....................................... --- --- 10,000 +10,000

Children’s Mental Health Services............................................ 117,026 119,026 119,026 ---

Projectsfor Assistance inTransitionFromHomelessness.......... 64,635 64,635 64,635 ---

Protection and Advocacy For Individuals withMentalIllness.... 36,146 36,146 36,146 ---

Evidence-based Early Interventions (Mandatory)..................... --- --- 115,000 +115,000

CommunityMentalHealthServicesBlockGrant....................... 482,571 532,571 532,571 ---

PHSEvaluationFunds(non-add)....................................... 21,039 21,039 21,039 ---

Total, Mental Health1........................................................... $1,070,916 $1,158,928 $1,273,766 +$114,838

1 The Minority Fellowship Program budget appears in the Health Surveillance and Program Support appropriation, Agencywide Initiatives Workforce program. This is consistent with the FY 2017 Budget Request.

The Mental Health FY 2017 Budget Request is $1.3 billion, an increase of $114.8 million from 

the FY 2016 Enacted Level. The request includes $1.2 billion in Budget Authority, of which

$115.0 is mandatory funding, $31.0 million in PHS Evaluation Funds, and $10.0 million in 

Prevention and Public Health Funds. 
56

Programs of Regional and National Significance (PRNS)

Mental Health Appropriation

(Dollars in thousands)

Programs of Regional & National Significance

FY 2015

Final

FY 2016

Enacted

FY 2017

President's 

Budget

FY 2017

+/- 

FY 2016

CAPACITY

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

Youth Violence Prevention.................................................. 23,099 23,099 --- -23,099

Project AWARE................................................................. 54,865 64,865 71,964 +7,099

Project AWARE State Grants (non-add)....................... 39,902 49,902 57,001 +7,099

Mental Health First Aid (non-add)................................. 14,963 14,963 14,963 ---

Healthy Transitions.............................................................. 19,951 19,951 19,951 ---

National Child Traumatic StressNetwork............................ 45,887 46,887 46,887 ---

Children and Family Programs............................................. 6,458 6,458 6,458 ---

Consumer and Family Network Grants................................ 4,954 4,954 4,954 ---

Project LAUNCH............................................................. 34,555 34,555 34,555 ---

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

Primary and Behavioral Health Care Integration................... 49,877 49,877 26,004 -23,873

Suicide Prevention............................................................... 60,032 60,032 88,032 +28,000

National Strategy for Suicide Prevention (non-add)..... 2,000 2,000 30,000 +28,000

Zero Suicide (non-add).............................................. --- --- 26,000 +26,000

AI/AN set-aside (non-add)....................................... --- --- 5,200 +5,200

Suicide Lifeline (non-add).............................................. 7,198 7,198 7,198 ---

GLS - Youth Suicide Prevention - States (non-add)....... 35,427 35,427 35,427 ---

Prevention & Public Health Fund (non-add)............ 12,000 12,000 10,000 -2,000

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 ---

Tribal Behavioral HealthGrants........................................... 4,988 15,000 15,000 ---

PHS Evaluation Funds (non-add)............................. --- --- 5,000 +5,000

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

Minority AIDS .................................................................... 9,224 9,224 15,935 +6,711

Crisis Systems..................................................................... --- --- 5,000 +5,000

PHS Evaluation Funds (non-add)............................. --- --- 5,000 +5,000

Criminal and Juvenile Justice Programs................................ 4,269 4,269 4,269 ---

Assisted Outpatient Treatment for Individuals with

Serious Mental Illness......................................................... --- 15,000 15,000 ---

Subtotal, Capacity 353,781 389,793 389,631 -162
57

Programs of Regional and National Significance (PRNS)

Mental Health Appropriation

(continued) 

(Dollars in thousands)

Programs of Regional & National Significance

FY 2015

Final

FY 2016

Enacted

FY 2017

President's 

Budget

FY 2017

+/- 

FY 2016

SCIENCE AND SERVICE

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

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

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

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

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

HIV/AIDS Education.......................................................... 771 771 771 ---

Subtotal, Science and Service 16,757 16,757 16,757 ---

TOTAL, PRNS1,2 $370,538 $406,550 $406,388 -$162

1 The Total PRNS in FY 2015 and FY 2016 includes $12.0 million in Prevention and Public Health Funds. The Total 

PRNS in FY 2017 includes $10.0 million in Prevention and Public Health Funds. 2 The Minority Fellowship Program budget appears in the Health Surveillance and Program Support appropriation,

Agency-wide Initiatives Workforce program. This is consistent with the FY 2017 Budget Request.

Authorizing Legislation................................................. Sections 501, 520A, 520C, 520E, 520E-2, 

520K, 581, and 582 of the Public Health Service Act 

and Sec. 224 of the Protecting Access to Medicare Act of 2014 

FY 2017 Authorization .........................................................................................................Expired 

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

Eligible Entities........................ States, Tribes, Provider Organizations, Community Organizations 
58

Seclusion and Restraint

(Dollars in thousands)

Programs of Regional & NationalSignificance

FY2015

Final

FY2016

Enacted

FY2017

President's 

Budget

FY2017

+/- 

FY2016

SeclusionandRestraint.................................................................. $1,147 $1,147 $1,147 $---

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

FY 2017 Authorization .........................................................................................................Expired 

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 problems 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 wellbeing. 

Through SAMHSA’s National Technical Assistance Center: Promoting Alternatives to 

Seclusion and Restraint Through Trauma-Informed Practices, evidence-based approaches to care 

have been developed, proven effective, and implemented to reduce or eliminate the use of 

traumatizing practices. This program provides technical assistance to states/tribes and 

communities in their efforts to implement best practices to reduce and ultimately eliminate the 

use of restraints and seclusion in institutional and community-based settings that provide services 

to individuals with mental and/or substance use disorders. This initiative focuses on the mental 

health delivery system and other service sectors, including criminal justice systems, schools, and 

child welfare organizations, that may use coercive practices with people who have mental and/or 

substance use disorders. 

SAMHSA awarded a five-year contract in FY 2013 to design, assess, and implement a technical 

assistance strategy to assist publicly funded systems, agencies, and organizations across the 

nation in addressing two high priority and interrelated objectives. The first objective is to

promote alternatives to and the elimination of restraint, seclusion, and other coercive practices. 

The second objective is to develop and implement training and technical assistance on 

SAMHSA’s concept of trauma,21 key principles, and practice guidance for a trauma-informed 

approach,22 and enhance recognition that both organizational and cultural changes are necessary 

to sustain efforts to eliminate the use of seclusion and restraints. In addition, the contract

21 Individual trauma results from an event, series of events, or set of circumstances that is experienced by an 

individual as physically or emotionally harmful or threatening and that has lasting adverse effects on the individual's 

functioning and physical, social, emotional, or spiritual well-being. 22 Substance Abuse and Mental Health Services Administration. SAMHSA’s Concept of Trauma and Guidance for a 

Trauma-Informed Approach. HHS Publication No. (SMA) 14-4884. Rockville, MD: Substance Abuse andMental

Health Services Administration, 2014.
59

facilitates dissemination of trauma-informed practices across multiple service settings. In FY

2015, SAMHSA supported the continuation of this contract. In FY 2016, SAMHSA continues to 

support this contract.

Funding History

Fiscal Year Amount

FY 2013 $2,121,167

FY 2014 $1,147,000

FY 2015 $1,147,000

FY 2016 $1,147,000

FY 2017 $1,147,000

Budget Request

The FY 2017 Budget Request is $1.1 million, the same level as the FY 2016 Enacted Level. 

SAMHSA’s funding request will allow continued support of a contract to disseminate traumainformed practices across multiple service settings. These efforts will help advance the goal of 

reducing and eliminating the use of seclusion, restraint, and other traumatizing practices in 

service systems and treatment agencies.

Youth Violence Prevention

(Dollars in thousands)

Programs of Regional & NationalSignificance

FY2015

Final

FY2016

Enacted

FY2017

President's 

Budget

FY2017

+/- 

FY2016

Youth ViolencePrevention............................................................. $23,099 $23,099 $--- -$23,099

Authorizing Legislation............................ Section 501 and 520A of the Public Health Service Act 

FY 2017 Authorization .........................................................................................................Expired 

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

Eligible Entities.................................. State Education Agencies, State Mental Health Authorities,

Tribes and Territories

Program Description and Accomplishments

Although dimensions of youth violence have decreased in parts of the country, youth violence 

remains a public health problem in the United States. Studies show that fewer students are 

engaging in fights.23 The percent of high school students who have been in a physical fight 

decreased from 32.8 percent in 2011 to 24.7 percent in 2013.24 Fights on school property also 

decreased during the past five years, with 11 percent of high school students having been in a 

fight on school property in 2011, compared to 8 percent in 2013. However, other indicators of 

23 The 2013 Youth Risk Behavior Surveillance System – United States complete reference 24 The 2013 Youth Risk Behavior Surveillance System – United States complete reference
60

violence have not significantly improved in recent years. Nationwide, in 2013, 17.9 percent of 

students had carried a weapon (e.g., gun, knife, or club) on at least one day during the 30 days 

before the survey. In 2013, an estimated 20 percent of high school students reported being 

bullied on school property. 

The Safe Schools/Healthy Students (SS/HS) Initiative is a discretionary grant program that seeks 

to create healthy learning environments that help students thrive, succeed in school, and build 

healthy relationships. For more than a decade, the SS/HS Initiative has successfully decreased 

violence and increased the number of students receiving mental health services, supporting 

programs in more than 300 local school districts.25 The initiative implements an enhanced, 

coordinated, and comprehensive plan of activities, programs, and services that promote healthy 

childhood development, prevent violence, and prevent alcohol and drug use. Grantees are 

required to develop local strategic plans that address five required elements: 1) safe school 

environments and violence prevention activities; 2) alcohol, tobacco, and other drug prevention 

activities; 3) student behavioral, social, and emotional supports; 4) mental health services; and

5) early childhood social and emotional learning programs.

In addition to the SS/HS grants, SAMHSA has supported an ongoing SS/HS State Program 

evaluation. The final SS/HS evaluation report will be completed in September 2017. This 

evaluation will focus on four areas:

1) Assessing the extent to which comprehensive school violence prevention

initiatives, guided by the SS/HS framework, are implemented at the state and

community level;

2) Determining the breadth and volume of activities necessary to achieve

coordination across multiple service systems;

3) Identifying and describing the elements or activities associated with improved

child wellness; and

4) Estimating the extent to which states and communities improve access to

mental health services for target populations and reduce subpopulation disparities

in access, services, and outcomes.

In FY 2014, SAMHSA provided continuation funds for eight four-year grants through the SS/HS 

Planning, Local Education Agency and Local Community program grants (SS/HS State 

program). In FY 2015, SAMHSA provided continuation funds for the third year for these same 

grants and contracts. In FY 2016, SAMHSA is funding the final year of these grants and 

contracts.

25 http://www.samhsa.gov/safe-schools-healthy-students
61

Funding History

Fiscal Year Amount

FY 2013 $21,944,947

FY 2014 $23,099,000

FY 2015 $23,099,000

FY 2016 $23,099,000

FY 2017 ---

Budget Request

The FY 2017 Budget Request is $0.0 million, a decrease of $23.1 million from the FY 2016 

Enacted Level. SAMHSA is requesting to reallocate funding from this program to Now is the 

Time Project Advancing Wellness and Resilience in Education (NITT Project AWARE). The 

reallocation of funds to NITT Project AWARE will continue to bring to scale program activities, 

practices, and lessons learned in the youth violence prevention arena and address current and 

emerging issues. The reallocation of funds will also enable SAMHSA to avoid duplication 

among programs with like purposes. 

Project AWARE

(Dollars in thousands)

Programs of Regional & National Significance

FY2015

Final

FY2016

Enacted

FY2017

President's 

Budget

FY2017

+/- 

FY2016

ProjectAWARE............................................................................ $54,865 $64,865 $71,964 +$7,099

Project AWARE State Educational Agency Grants(non-add). 39,902 49,902 57,001 +7,099

MentalHealthFirst Aid (non-add)............................................ 14,963 14,963 14,963 ---

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

FY 2017 Authorization .........................................................................................................Expired 

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

With half of all mental health disorders showing first signs before a person turns 14 years old, 

and three quarters of mental health disorders beginning before age 24, to meaningfully affect the 

rates of mental disorders in our Nation, it is essential to begin screening, referring, and treating 

children and youth early. According to 2013 NSDUH data, one in 10 adolescents had a major 

depressive episode in the past year. Of those, only 38.1 percent received treatment or counseling. 

We know that overall, less than one in five children and adolescents with a diagnosable mental 

health problems receive the treatment they need.
62

Children and youth continue to face significant issues while at school and in the community. 

Youth Risk Behavior Survey data from 2013 show that many high school students engage in 

risky behaviors associated with the leading causes of death among youth and young adults, 

including 19.6 percent being bullied on school property, 8 percent attempting suicide, and over 7 

percent not attending school because they felt unsafe at school or on their way there.

The AWARE grant programs provide critical funding to states and school districts to not only 

train adults to understand the signs and symptoms of youth experiencing a mental health crisis or 

at risk of developing mental disorders, but also to create and maintain essential infrastructures 

needed to support screening, early identification, referral, and receipt of care. These grants also 

provide funding to support the implementation of evidence-based programs to support the socialemotional development of children, and to create schools and communities where they feel safe

and can thrive. 

In FY 2014, in response to the tragedy at Sandy Hook Elementary School and as part of the 

President’s Now is the Time initiative, SAMHSA provided $54.9 million to support Project 

AWARE (Advancing Wellness and Resilience in Education) to increase awareness of mental 

health issues and connect young people who have behavioral health issues and their families with 

needed services. SAMHSA collaborates with the Departments of Education and Justice in the 

development, implementation, and management of this initiative to maximize coordination and 

avoid duplication of efforts.

Project AWARE has multiple components. The first component, Project AWARE State 

Educational Agency (SEA) grants, is built on the highly successful Safe Schools/Healthy 

Students model. The Safe Schools/Healthy Students seeks to create safe and supportive schools 

and communities. SAMHSA awarded these grants to 20 SEAs to promote comprehensive, 

coordinated, and integrated state efforts to make schools safer and increase access to mental 

health services.

The second component, Mental Health First Aid (MHFA), supports widespread dissemination of 

the MHFA curriculum. The MHFA curriculum prepares teachers and other individuals who work

with youth to help schools and communities understand, recognize, and respond to signs of 

mental and/or substance use disorders in children and youth, including how to talk to adolescents 

and families experiencing these problems so that they are more willing to seek treatment. The 

target for the first year of the program was 750,000 individuals trained or served. This original 

baseline target was an estimate of the population SAMHSA anticipated the grantees to reach. In 

FY 2015, given a diverse grantee pool made up of both urban and rural school districts, the 

4.5 million individuals trained or served greatly exceed the anticipated target.

In FY 2014, SAMHSA funded 20 Project AWARE SEA awards and 100 MHFA Local 

Educational Agencies (LEAs) multi-year awards to grantees who applied for Department of 

Education School Climate Change awards. The project period for Project AWARE SEA awards 

is five years and the project period for MHFA awards is two years. In FY 2015, SAMHSA 

provided continuation support for these Project AWARE SEA grants. In addition, SAMHSA 

awarded 70 new MHFA grants to community organizations to support the training of teachers
63

and a broad array of actors who interact with youth through their programs at the community 

level, including parents, law enforcement, faith-based leaders, and other adults.

In FY 2016, SAMHSA is supporting the continuation of 90 grants (20 AWARE SEA grants and 

70 MHFA Community grants) and related contracts. In addition, SAMHSA is awarding a new 

cohort of up to six grants to communities that have recently faced civil unrest. These grants will 

focus on high-risk youth and families in communities and surrounding areas that have 

experienced significant exposure to trauma. They will support evidence-based violence 

prevention and community youth engagement programs as well as linkages to trauma-informed 

behavioral health services. SAMHSA will prioritize funding grants from communities that have 

formed partnerships between key stakeholders including state and local governments (including 

multiple cities and counties if impacted); public or private universities and colleges; and nonprofit community- and faith-based organizations. SAMHSA is coordinating extensively with the 

Department of Education in the administration of this grant program.

Funding History

Fiscal Year Amount

FY 2013 ---

FY 2014 $54,865,000

FY 2015 $54,865,000

FY 2016 $64,865,000

FY 2017 $71,964,000

Budget Request

The FY 2017 Budget Request is $72.0 million, an increase of $7.1 million from the FY 2016 

Enacted Level. As part of the President’s Now is the Time initiative, this program seeks to raise 

awareness about mental health issues and connects young people who have behavioral health 

issues and their families with needed services. SAMHSA requests funding to support a new 

cohort of Project AWARE State Educational Agency awards, continuation grants to raise 

awareness and expand care in communities with civil unrest, 20 continuation Project AWARE 

SEA awards, 70 continuation Mental Health First Aid awards, NITT technical assistance, and 

evaluation contracts. SAMHSA has a target to serve over four million children. The increase 

represents a reallocation of funds from Youth Violence Prevention to Project AWARE. The 

reallocation of these funds will enable SAMHSA to avoid duplication among programs with like 

purposes. 

Project AWARE is a program that also addresses the Administration’s multi-agency Native 

Youth priority related to Improving Education Outcomes and Like Outcomes for Native Youth, 

in support of the HHS Tribal Health and Well-Being Coordination. 
64

Outputs and Outcomes Table

Program: Project AWARE

NOTE: SAMHSA makes grant awards towards the end of the year. Therefore, the FY 2017 targets are based on the 

FY 2016 Enacted Level and the FY 2018 targets are based on the FY 2017 President’sBudget.

Measure

Year and Most Recent Result

Target for Recent Result 

(Summary of Result)

FY 2017

Target

FY 2018

Target

FY 2018

Target

+/- 

FY 2017

Target

3.2.18 Increase the number of 

children served. (Output)

FY 2015: 4,696,119

Target: 750,000 

(Target exceeded)

4,696,119 4,696,119 Maintain

3.2.19 Increase the number of 

children referred to mental health or 

related services. (Output)

FY 2015: 16,508

Target: Set baseline 

(Pending)

16,508 16,508 Maintain

3.2.39 Increase the number of 

individuals who have received 

training in prevention or mental 

health promotion. (Outcome)

FY 2015: 145,356

Target: Set baseline 

(Pending)

145,356 145,356 Maintain
65

Outputs and Outcomes Table

Program: Safe Schools Healthy Students State and Tribal 1

NOTE: SAMHSA makes grant awards towards the end of the year. Therefore, the FY 2017 targets are based on the 

FY 2016 Enacted Level and the FY 2018 targets are based on the FY 2017 President’sBudget.

1 This table reflects the outputs and outcomes of both Youth Violence Prevention and the Project Aware.

Measure

Year and Most Recent Result

Target for Recent Result 

(Summary of Result)

FY 2017

Target

FY 2018

Target

FY 2018

Target

+/- 

FY 2017

Target

3.2.45 Increase the number of 

organizations collaborating and 

sharing resources with other 

organizations as a result of the 

grant. (Output)

FY 2015: 76

Target: 73 

(Target exceeded)

76 76 Maintain

3.2.46 Increase the number of 

individuals who receive training in 

prevention or mental health 

promotion. (Intermediate Outcome)

FY 2015: 4,787

Target: 680 

(Target exceeded)

4,787 4,787 Maintain

3.2.47 Increase the number of 

people in mental health and related 

workforce trained in mental healthrelated practices/activities that are 

consistent with the goals of the 

grant. (Output)

FY 2015: 2,070

Target: 737 

(Target exceeded)

2,070 2,070 Maintain

3.2.48 Increase the number of state 

and local policy changes completed 

as a result of the grant. (Output)

FY 2015: 12

Target: 2

(Target exceeded)

12 12 Maintain

3.2.49 Increase the number of 

organizations that entered into a 

formal written inter/intra 

organizational agreements (such as 

an MOU) to improve mental health 

related practices/activities that are 

consistent with the goals of the 

grant. (Output)

FY 2015: 52

Target: 52 

(Target met)

52 52 Maintain

3.2.50 Reduce the percentage of 

middle and high school students 

who report current alcohol use in 

the past 30 days. (Intermediate 

Outcome)

FY 2015: 25.0%

Target: 18.1% 

Target exceeded

25.0% 25.0% Maintain
66

Healthy Transitions

(Dollars in thousands)

Programs of Regional & NationalSignificance

FY2015

Final

FY2016

Enacted

FY2017

President's 

Budget

FY2017

+/- 

FY2016

HealthyTransitions......................................................................... $19,951 $19,951 $19,951 $---

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

FY 2017 Authorization .........................................................................................................Expired 

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

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

Program Description and Accomplishments

Youth and young adults with serious mental illness, along with those with co-occurring mental 

and substance use disorders, 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 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,26 be arrested,27 drop out of school,28 and be unemployed.29 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. 

In FY 2014, SAMHSA provided $20.0 million for Healthy Transitions within the Now is the 

Time (NITT) initiative. The Healthy Transitions program awarded five-year grants to 17 states 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. 

Individuals who are 16 to 25 years old are at high risk of developing a mental illness or 

substance use disorder and are at high risk for suicide. Unfortunately, these youth are among the 

least likely to seek help.30 Through this program, states are expanding services, developing 

26 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. 27 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. 28 Planty, M., Hussar, W., Snyder, T., Provasnik, S., Kena, G., Dinkes, R., Kemp, J. (2008). The condition of 

education 2008 (NCES 2008-031).

29 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: SRIInternational. 30 IOM (Institute of Medicine) and NRC (National Research Council). (2015), p. 56. Investing in the health and

well-being of young adults. Washington, D.C.: The National Academies Press.
67

family and youth networks for information sharing and peer support, and disseminating best 

practices for services for these young individuals. 

Grantees in their first year of the award have developed and built capacity within their states and 

local communities to deliver services. The NITT technical assistance and evaluation contracts 

have been providing training and technical assistance to grantees in order to meet grant 

requirements successfully.

In FY 2015, SAMHSA supported 17 NITT Healthy Transitions continuation grants and the NITT 

technical assistance and evaluation contracts. In FY 2016, SAMHSA will continue to support the

continuation grants and the NITT technical assistance and evaluation contracts.

Funding History

Fiscal Year Amount

FY 2013 ---

FY 2014 $19,951,000

FY 2015 $19,951,000

FY 2016 $19,951,000

FY 2017 $19,951,000

Budget Request

The FY 2017 Budget Request is $20.0 million, the same as the FY 2016 Enacted Level. 

SAMHSA’s request will support fourth-year continuation funding for the 17 NITT Healthy 

Transition grant recipients. In addition, this funding will support the NITT technical assistance 

and evaluation contracts. SAMHSA expects to refer up to 6,000 transition aged youth with 

serious mental health conditions to related services through the Healthy Transitions program.

Healthy Transitions is a program that also addresses the Administration’s multi-agency Native 

Youth priority related to Improving Education Outcomes and Like Outcomes for Native Youth, 

in support of the HHS Tribal Health and Well-Being Coordination. 
68

Outputs and Outcomes Table

Program: Healthy Transitions

NOTE: SAMHSA makes grant awards towards the end of the year. Therefore, the FY 2017 targets are based on the 

FY 2016 Enacted Level and the FY 2018 targets are based on the FY 2017 President’sBudget.

Measure

Year and Most Recent Result

Target for Recent Result/ 

(Summary of Result)

FY 2017

Target

FY 2018

Target

FY 2018

Target

+/- 

FY 2017

Target

3.2.34 Increase the percentage of 

clients receiving services who 

report positive functioning at 6- 

month follow-up. (Outcome)

FY 2015: 66.0%

Target: 64.0% 

(Target exceeded)

64.0% 64.0% Maintain

3.2.35 Increase the percentage of 

clients receiving services who had a 

permanent place to live in the 

community at 6-month follow-up. 

(Outcome)

FY 2015: 40.0%

Target: 36.0% 

(Target exceeded)

36.0% 36.0% Maintain

3.2.36 Increase the percentage of 

clients receiving services who are 

currently employed at 6-month 

follow-up. (Outcome)

FY 2015: 56.0%

Target: 56.0% 

(Target met)

56.0% 56.0% Maintain
69

National Child Traumatic Stress Network

(Dollars in thousands)

Programs of Regional & NationalSignificance

FY2015

Final

FY2016

Enacted

FY2017

President's 

Budget

FY2017

+/- 

FY2016

NationalChildTraumaticStressNetwork....................................... $45,887 $46,887 $46,887 $---

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

FY 2017 Authorization .........................................................................................................Expired 

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

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. 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.31,32 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.33 

While the effects of trauma and exposure to violence are found in all service sectors, it is 

particularly prominent among youth with mental and/or substance use disorders 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.34

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. The NCTSI 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 sites to more than 165 funded and 

affiliate centers located nationwide in universities, hospitals, and other diverse community-based 

organizations, with thousands of national and local partners. The NCTSN’s mission is to raise

31 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. 32 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. 33 Fairbank, J.A. (2008). The epidemiology of trauma, and trauma related disorders in children and youth. PTSD 

Research Quarterly, (19), 1050-1835. 34 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
70

the standard of care and improve access to evidence-based services for children experiencing 

trauma, their families, and communities. A rapidly expanding 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. The SAMHSA-funded National Center 

for Child Traumatic Stress (NCCTS) recipient, UCLA’s Neuropsychiatric Institute, partners with 

Duke University Medical Center. Network members work together within and across diverse 

settings, including a wide variety of governmental and non-governmental organizations. 

Data collected in FY 2014 demonstrate that the current NCTSN grantees have provided traumainformed treatment to over 40,000 children, adolescents and family members. 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 2015, NCTSN grantee sites provided training to nearly 150,000 individuals. Since 

its inception, the NCTSN has provided training on best practices and other aspects of child 

trauma to over one million participants throughout the country. The NCTSI’s newly created 

Helping Kids Recover and Thrive Campaign generated 100 online social media outlets 

(e.g., Facebook, Twitter, etc.) and by way of various platforms reached more than 1.5 million 

people nationwide. This campaign informed the public about the efforts and resources available 

through the NCTSI. Since the end of May 2015 through early August 2015, an audience of over 

38 million has viewed the English and/or Spanish public service announcements (PSA) – 

“Notice” and “Bounce.” The radio PSAs have aired over 21,000 times reaching an audience of 

over 70.0 million listeners.

In FY 2015, SAMHSA supported 78 NCTSI continuation grants and continued to build on the 

robust work of the NCTSN and improve and enhance the capacity of the NCTSI to deliver 

effective interventions and core trauma practices. Recipients of these grants include community 

providers and research organizations with expertise in child trauma. In FY 2016, SAMHSA is 

awarding up to 83 new five-year NCTSI grants for the program. SAMHSA will continue to 

encourage grantees to disseminate more broadly information regarding evidence-based 

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

from proven practices.

Funding History

Fiscal Year Amount

FY 2013 $43,322,351

FY 2014 $45,887,000

FY 2015 $45,887,000

FY 2016 $46,887,000

FY 2017 $46,887,000
71

Budget Request

The FY 2017 Budget Request is $46.9 million, the same as the FY 2016 Enacted Level. 

SAMHSA requests funding to continue support for the improvement of mental disorder 

treatment, services, and interventions for children and adolescents exposed to traumatic events 

and plans to provide trauma-informed services for over 48,000 children and adolescents as well 

as train over 225,000 individuals. 

The National Child Traumatic Stress Initiative is a program that addresses the Administration’s 

multi-agency Native Youth priority providing Support for the Implementation of the Indian

Child Welfare Act, in support of the HHS Tribal Health and Well-Being Coordination. 

Outputs and Outcomes Table 

Program: National Child Traumatic Stress Network

NOTE: SAMHSA makes grant awards towards the end of the year. Therefore, the FY 2017 targets are based on the 

FY 2016 Enacted Level and the FY 2018 targets are based on the FY 2017 President’sBudget.

Measure

Year and Most Recent Result

Target for Recent Result 

(Summary of Result)

FY 2017

Target

FY 2018

Target

FY 2017

Target

+/- 

FY 2018

Target

3.2.02a Increase the percentage of 

children receiving trauma informed 

services who report positive 

functioning at 6-month follow-up. 

(Outcome)

FY 2015: 74.4%

Target: 65.9% 

(Target exceeded)

77.0% 77.0% Maintain

3.2.23 Increase the unduplicated 

count of the number of children and 

adolescents receiving traumainformed services. (Outcome)

FY 2015: 29,579

Target: 2,309 

(Target exceeded)

48,872 48,872 Maintain

3.2.24 Increase the number of childserving professionals trained in 

providing trauma-informed services. 

(Outcome)

FY 2015: 146,621

Target: 171,270 

(Target not met)

225,710 225,710 Maintain
72

Children and Family Programs

(Dollars in thousands)

Programs of Regional & NationalSignificance

FY2015

Final

FY2016

Enacted

FY2017

President's 

Budget

FY2017

+/- 

FY2016

Children and Family Programs........................................................ $6,458 $6,458 $6,458 $---

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

FY 2017 Authorization .........................................................................................................Expired 

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

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

Program Description and Accomplishments

Youth of all ethnicities, races, and from all regions of the United States may be at risk for 

experiencing mental disorders.35 Without early identification, intervention, treatment, and 

support, children with serious emotional disturbances (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 eliminate mental health disparities 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. Circles of Care 

reflect 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. 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 residing in Indian 

Health Service (IHS) service areas and the rate of death by suicide for this cohort is four times

higher than the national average.36 Through Circles of Care, SAMHSA has improved the 

availability, accessibility, and acceptability of behavioral health services for native youth. For 

example, data from the previous cohort of grantees show that over 3,000 consumer/family 

members were involved in ongoing mental health related planning activities and there were 

4,300 peer-to-peer collaborations. In the last cohort of grantees, all four tribes that applied for a 

SAMHSA Systems of Care grant received funding, which supported those tribes in

implementing the model they developed through Circles of Care. At the end of the three-year 

grant, Circles of Care grantees are able to position themselves to get funding to provide 

expanded services and support. The success of former grantees demonstrates that this program 

assists tribes to compete successfully for longer term federal funding to serve their youth with 

serious mental disorders and their families.

35 Centers for Disease Control and Prevention (2013). Mental Health Surveillance Among Children – United States, 

2005-2011. MMWR 2013; 62 (Suppl 2): 1-35. 36 Department of Health and Human Services, Indian Health Service (2014). Trends in Indian Health 2014 Edition 

(Released March 2015). ISSN 1095 2896.
73

Rehabilitation Research and Training Centers (RRTCs) seek to advance the current knowledge 

base by supporting research, training, technical assistance, and knowledge translation 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. The first, RRTC on Transition to 

Employment for Youth and Young Adults with Serious Mental Health Conditions will conduct 

research and evaluative studies that contribute to improved employment outcomes for youth and 

young adults with serious mental health conditions, including those from high-risk, 

disadvantaged backgrounds. The second program, RRTC on Community Living and 

Participation for Youth and Young Adults with Serious Mental Health Conditions will conduct 

research and evaluative studies that contribute to improved community participation for youth 

and young adults with SMHC. Unemployment rates for youth with mental disorders are 

significantly higher than 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, 

drugs, and engage in risky behaviors that have negative health outcomes.37

In FY 2015, SAMHSA provided continuation support for the second year of 11 three-year 

Circles of Care grants to AI/AN communities and two RRTCs.

In FY 2016, SAMHSA is supporting 11 Circles of Care grants, as well as the two RRTCs.

Funding History

Fiscal Year Amount

FY 2013 $6,460,794

FY 2014 $6,458,000

FY 2015 $6,458,000

FY 2016 $6,458,000

FY 2017 $6,458,000

Budget Request

The FY 2017 Budget Request is $6.5 million, the same as the FY 2016 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.

SAMHSA’s Children and Family Programs address the Administration’s multi-agency Native 

Youth priority related to Improving Education Outcomes and Like Outcomes for Native Youth, 

in support of the HHS Tribal Health and Well-Being Coordination. 

37 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.
74

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 117. 

Consumer and Family Network Grants

(Dollars in thousands)

Programs of Regional & NationalSignificance

FY2015

Final

FY2016

Enacted

FY2017

President's 

Budget

FY2017

+/- 

FY2016

Consumer and FamilyNetwork Grants........................................... $4,954 $4,954 $4,954 $---

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

FY 2017 Authorization .........................................................................................................Expired 

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

Eligible Entities....................................................................................... Community Organizations 

Program Description and Accomplishments

Consumers, including those living with serious mental illness, should have meaningful 

involvement in all aspects of their health care and treatment, including behavioral health care. 

There is growing recognition and evidence that consumer-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. 

The Consumer and Family Network Programs support SAMHSA’s Recovery Support Strategic 

Initiative by providing 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 three grant activities: the Statewide Consumer Network Program, the Statewide Family 

Network Program, and the Statewide Peer Network Development Program for Recovery and 

Resiliency.

The Statewide Consumer Network Grant Program focuses on the needs of adults (18 years and 

older) with serious mental illness 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 Statewide Family Network 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 serious emotional disturbances; 
75

and 3) identifying and addressing the technical assistance needs of children and adolescents with 

serious emotional disturbances and their families. The Statewide Family Network Program 

focuses on families, parents, and the primary caregivers of children, youth, and young adults. 

The Statewide Peer Network Development Program for Recovery and Resiliency began in FY 

2014 and builds the capacity of statewide consumer-run, family member-run, and addiction 

recovery community organizations to promote infrastructure development across the mental 

health and addiction recovery communities.

Funding for this program comes from SAMHSA’s Mental Health appropriation and the 

Substance Abuse Treatment appropriation to allow for collaborative partnerships across the 

mental and substance use disorder fields. SAMHSA tracks any braided amounts spent or

awarded under their distinct appropriations and ensures that funds are used for purposes 

consistent with legislative direction and intent of the appropriations. Eligible applicants for this 

program were those organizations that had an existing mental health or addiction statewide 

network award from SAMHSA.

In FY 2015, SAMHSA provided continuation funds for 12 Statewide Consumer Network grants, 

26 Statewide Family Network grants, and a technical assistance contract. In addition, SAMHSA 

awarded a new cohort of Statewide Consumer Network, Statewide Family Network, and 

Statewide Peer Network Development grants. All grants were awarded to consumer-oriented 

community organizations. In FY 2016, SAMHSA plans to support nine Statewide Consumer 

Network continuation and eight new Statewide Consumer Network grants, five Statewide Family 

Network grant continuations, 21 new Statewide Family Network grants, and a technical 

assistance activity.

Funding History

Fiscal Year Amount

FY 2013 $6,140,243

FY 2014 $4,954,000

FY 2015 $4,954,000

FY 2016 $4,954,000

FY 2017 $4,954,000

Budget Request

The FY 2017 Budget Request is $5.0 million, the same as the FY 2016 Enacted Level. 

SAMHSA requests funding to continue support for these grant programs that promote consumer, 

family, and youth participation in the development of policies, programs, and quality assurance 

activities related to mental health systems reform across America.

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 117. 
76

Project LAUNCH

(Dollars in thousands)

Programs of Regional & National Significance

FY2015

Final

FY2016

Enacted

FY2017

President's 

Budget

FY2017

+/- 

FY2016

Project LAUNCH......................................................................... $34,555 $34,555 $34,555 $---

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

FY 2017 Authorization .........................................................................................................Expired 

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 age five or under 

experience an emotional or behavioral disturbance. Studies also show that half of all lifetime 

cases of mental illness begin before age 14.38 The 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 are. African American preschoolers are almost twice as 

likely to be expelled as Caucasian preschoolers are.39 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 childcare settings, increasing screening for developmental and social/emotional issues, and 

training people who interact with young children to help them feel safe, secure, and cared for are 

all critical elements to ensure children start life with the tools and skills needed to succeed.

Further, when children are struggling with social-emotional challenges, these issues need to be 

identified as early as possible and families must have access to resources and services that are 

appropriate and effective.

Established in 2008, Project Linking Actions for Unmet Needs in Children’s Health (LAUNCH) 

is a national initiative that has funded 55 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 child care 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 mental, emotional, 

and behavioral disorders in early childhood and into the early elementary grades.

38 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. 

39 Gilliam, W. (2005). Pre-kindergarteners left behind: Expulsion rates in state prekindergarten systems. Foundation 

for Child Development.
77

As of 2014, performance data for the program found: 

• Approximately 145,000 children and parents were assessed on social and emotional 

functioning and screened for behavioral health issues in diverse settings (e.g., primary 

care, childcare, and home visiting);

• Project LAUNCH-supported home visiting and family strengthening programs have 

served nearly 2,300 families;

• Approximately 51,000 community providers have been trained on social-emotional and 

behavioral health for young children; 

• Over 116,000 individuals received evidence-based mental health services; and 

• Project LAUNCH data indicates that nearly 2,600 new organizations are collaborating, 

coordinating, and sharing resources to implement prevention/promotion strategies for 

young children. 

The multi-site evaluation of Project LAUNCH is ongoing. Phase one of the evaluation used a 

meta-analytical approach to assess the implementation of Project LAUNCH. The findings 

indicate that grantees successfully achieved three goals: 1) improvements to the local child 

services system in the LAUNCH communities; 2) improvements to the state child services

system; and 3) enhancements to the child and family services in the communities. In addition, 

Project LAUNCH grantees have reported improved social and academic functioning among the 

targeted population, and 78 percent have reported decreases in problem behaviors among the 

targeted population. As the program expands to new states and territories, the current phase of 

the multi-site evaluation has evolved to a quasi-experimental design to assess better the impact of 

Project LAUNCH around the following: social and emotional development of children; 

externalizing and internalizing behaviors of children; family relationships and mental health 

status of parents; cognitive development of children; and physical health of children. 

In FY 2015, SAMHSA supported 31 five-year continuation grants, five new four-year grants, 

and technical assistance and evaluation activities. The new grant cohort provides support to 

states and tribes that have successfully implemented Project LAUNCH with the goal of 

expanding the work beyond the pilot communities to additional communities across the states 

and tribes. In FY 2016, SAMHSA is supporting 36 continuation grants and two continuation 

contracts.

Funding History

Fiscal Year Amount

FY 2013 $32,828,505

FY 2014 $34,555,000

FY 2015 $34,555,000

FY 2016 $34,555,000

FY 2017 $34,555,000
78

Budget Request

The FY 2017 Budget Request is $34.6 million, the same as the FY 2016 Enacted Level. This 

funding will support 25 five-year continuation grants, 15 new grants, and contract activities that 

will improve health outcomes for young children. This funding request will provide services for 

over 38,000 individuals, training to 13,102 people, and screening for mental health or related 

intervention to 44,775 children up to eight years old. 

Project LAUNCH is a program that also addresses the Administration’s multi-agency Native 

Youth priority related to Improving Education Outcomes and Like Outcomes for Native Youth, 

in support of the HHS Tribal Health and Well-Being Coordination. 

Outputs and Outcomes Table 

Program: Mental Health-Project LAUNCH

NOTE: SAMHSA makes grant awards towards the end of the year. Therefore, the FY 2017 targets are based on the 

FY 2016 Enacted Level and the FY 2018 targets are based on the FY 2017 President’sBudget.

Measure

Year and Most Recent Result 

Target for Recent Result

(Summary of Result)

FY 2017

Target

FY 2018

Target

FY 2018

Target

+/- 

FY 2017

Target

2.3.94 Increase the number of 

persons served. (Output)

FY 2015: 17,607

Target: 32,232 

(Target not met)

38,594 38,594 Maintain

2.3.95 Increase the number of 

persons trained in mental illness 

prevention or mental health 

promotion. (Outcome)

FY 2015: 10,360

Target: 13,102

(Target not met but improved)

13,102 13,102 Maintain

2.4.00 Increase the number of 0 to 8 

year old children screened for 

mental health or related 

interventions. (Outcome)

FY 2015: 21,914

Target: 44,775 

(Target not met)

44,775 44,775 Maintain

2.4.01 Increase the number of 0 to 8 

year old children referred to mental 

health or related interventions. 

(Outcome)

FY 2015: 3,783

Target: 9,114 

(Target not met)

9,114 9,114 Maintain
79

Mental Health System Transformation and Health Reform

(Dollars in thousands)

Programs of Regional & NationalSignificance

FY2015

Final

FY2016

Enacted

FY2017

President's 

Budget

FY2017

+/- 

FY2016

Mental Health System Transformation and HealthReform............... $3,779 $3,779 $3,779 $---

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

FY 2017 Authorization .........................................................................................................Expired 

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

Eligible Entities...................................................................................................... States andTribes

Program Description and Accomplishments

There is a significant gap between the number of people with serious mental illness, 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 

mental disorder treatment, enhanced self-esteem, reduced use of substances, and improved 

quality of life.40 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 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 serious 

mental illnesses/serious emotional disturbances (SMI/SED). These grants help people with 

serious mental illnesses build paths to self-sufficiency and recovery rather than disability and 

dependence. They also support mental health consumers, treatment and service providers, and 

employers to develop and maintain sustained competitive employment circumstances for people 

with serious mental illness. The grant program helps states to identify and implement the 

structural and financing changes that are essential to make supported employment programs 

sustainable and statewide.

In FY 2014, SAMHSA awarded seven five-year Transforming Lives through Supported 

Employment grants. In FY 2015, SAMHSA provided continuation funds for these grantees. In 

FY 2015, grantees developed strategic plans, participated in a learning community, received 

training on the Individual Placement and Support (IPS) supported employment model, completed 

hiring, and began service delivery in most of the sites. In FY 2016, SAMHSA is supporting the 

continuation of these grants and related technical assistance.

40 IPS Supported Employment: The Evidence-Based Practice for Employment. (n.d.). Retrieved August 4, 2015.
80

Funding History

Fiscal Year Amount

FY 2013 $10,448,347

FY 2014 $10,556,000

FY 2015 $3,779,000

FY 2016 $3,779,000

FY 2017 $3,779,000

Budget Request

The FY 2017 Budget Request is $3.8 million, the same as the FY 2016 Enacted Level. 

SAMHSA requests funding to support the continuation of seven five-year Transforming Lives 

Through Supported Employment grants to enhance state and community capacity to provide 

evidence-based supported employment programs for adults and youth with serious mental 

illnesses/emotional disturbances and technical assistance to the grantees.
81

Outputs and Outcomes Table

Program: Mental Health System Transformation Grants

NOTE: SAMHSA makes grant awards towards the end ofthe year. Therefore, the FY 2017 targets are based on the 

FY 2016 Enacted Level and the FY 2018 targets are based on the FY 2017 President’sBudget.

1 These measures are being retired and replaced with new Supported Employment measures.

Measure1

Year and Most Recent Result

Target for Recent Result 

(Summary of Result)

FY 2017

Target

FY 2018

Target

FY 2018

Target

+/- 

FY 2017

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 2014: 4,259

Target: 1,488 

(Target exceeded)

4,303 4,303 Maintain

1.2.21 Increase the percentage of 

clients receiving services who 

report positive functioning at 6- 

month follow-up. (Outcome)

FY 2014: 57.1%

Target: 52.1% 

(Target exceeded)

52.1% 52.1% Maintain

1.2.22 Increase the percentage of 

clients receiving services who had a 

permanent place to live in the 

community at 6-month follow-up. 

(Outcome)

FY 2014: 76.7%

Target: 73.7% 

(Target exceeded)

73.7% 73.7% Maintain

1.2.23 Increase the percentage of 

clients receiving services who are 

currently employed at 6-month 

follow-up. (Outcome)

FY 2014: 32.2%

Target: 30.7% 

(Target exceeded)

30.7% 30.7% Maintain
82

Primary and Behavioral Health Care Integration

(Dollars in thousands)

Programs of Regional & National Significance

FY2015

Final

FY2016

Enacted

FY2017

President's 

Budget

FY2017

+/- 

FY2016

Primary and Behavioral Health Care Integration.............................. $49,877 $49,877 $26,004 -$23,873

Authorizing Legislation ........................Sections 520A and 520K of the Public Health Service Act 

FY 2017 Authorization .........................................................................................................Expired 

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

Eligible Entities...................................................... Qualified Community Mental Health Programs

Program Description and Accomplishments

The high rates of morbidity and mortality among adults with serious mental illnesses (SMI) such 

as schizophrenia, bipolar disorder, and major depression are alarming. These rates are due, in 

large part, to elevated incidence and prevalence of cardiovascular disease, obesity, diabetes, 

hypertension, and dyslipidemia in people with SMI.41 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.42

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 health care and 

wellness services for individuals with mental illness. Collaboration between primary care and 

behavioral health organizations, as well as information technology entities, is crucial to the 

success of this program.

As of September 2015, SAMHSA has awarded 186 PBHCI grants. In FY 2015, the PBHCI grant

program served more than 16,000 consumers. Functioning, social connectedness, and housing 

measures were consistently positive because of this intervention. An initial cross-site evaluation 

done in September 2013 examined the impact of the PBHCI grants on physical health outcomes. 

The results show increased receipt of integrated services and modest improvement in physical 

health outcomes. These physical health outcomes included improved blood pressure 

41 Forman-Hoffman, Muhuri, Novak, Pemberton, Ault, and Mannix (August 2014) CBHSQ Data Review: 

Psychological Distress and Mortality among Adults in the U.S. HouseholdPopulation. 42 E. Chesney et al., Risks of all-cause and suicide mortality in mental disorders: a meta-review, World Psychiatry; 

2014: 13:1153-160.
83

measures by 19 percent, improved body mass index (BMI) levels by 43 percent, and improved 

cholesterol levels by 38 percent. The evaluation also identified decreases in hospitalization rates 

for individuals screened at intake from 6.2 percent to 2.7 percent after one year. An additional 

PBCHI evaluation project, funded by the HHS Office of the Assistant Secretary for Planning and 

Evaluation, is currently examining the impact of the program on consumers’ use of medical 

services and their total healthcare costs as reflected in archival data from Medicaid/Medicare. 

The FY 2015 PBHCI grant application included programmatic enhancements because of these 

evaluation findings. In FY 2015, SAMHSA awarded a new PBHCI evaluation contract that 

builds on recommendations from the FY 2013 evaluation and seeks to use a more comprehensive 

approach to determine the impact of the PBHCI grants on the health of the clientsserved.

PBHCI activities also include the braided Minority AIDS Initiative HIV Continuum of Care pilot 

program, which supports behavioral health screening, primary prevention, and treatment for 

racial/ethnic minority populations with or at high risk for mental and substance use disorders and 

HIV/AIDS. This includes HIV/AIDS integrated programs that either can co-locate or have fully 

integrated HIV/AIDS prevention and medical care services with behavioral health services.

In FY 2015, SAMHSA supported 16 continuation grants, a new cohort of 60 PBHCI grants, and 

one technical assistance contract that is co-funded with HRSA. An evaluation contract in the 

Health Surveillance and Program Support appropriation supported the PBHCI evaluation. In FY 

2016, SAMHSA is awarding a new cohort of grants to support the coordination and integration 

of primary care services into publicly funded community behavioral health settings.

Funding History

Fiscal Year Amount

FY 2013 $30,633,567

FY 2014 $51,868,000

FY 2015 $51,868,000

FY 2016 $51,868,000

FY 2017 $26,004,000

Budget Request

The FY 2017 Budget Request is $26.0 million, a decrease of $23.9 million from the FY 2016 

Enacted Level. This funding will continue to support the coordination and integration of primary 

care services into publicly funded community behavioral health settings. The decrease in funding 

will not result in the termination of any existing grants. 
84

Outputs and Outcomes Table

Program: Primary & Behavioral Health Care Integration (PBHCI)

NOTE: SAMHSA makes grant awards towards the end of the year. Therefore, the FY 2017 targets are based onthe 

FY 2016 Enacted Level and the FY 2018 targets are based on the FY 2017 President’sBudget.

Measure

Year and Most Recent Result

Target for Recent Result 

(Summary of Result)

FY 2017

Target

FY 2018

Target

FY 2018

Target

+/- 

FY 2017

Target

3.2.40 Increase the number of 

clients served. (Output)

FY 2015: 16,641

Target: 21,100 

(Target not met)

56,552 30,528 -26,024

3.2.41 Increase the percentage of 

clients receiving services who 

report positive functioning at 6- 

month follow-up. (Outcome)

FY 2015: 57.0%

Target: 49.9% 

(Target exceeded)

49.9% 49.9% Maintain

3.2.42 Increase the percentage of 

clients receiving services who are 

currently employed at 6-month 

follow-up. (Outcome)

FY 2015: 20.1%

Target: 22.1% 

(Target not met)

22.1% 22.1% Maintain

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 2015: 73.4%

Target: 65.7% 

(Target exceeded)

65.7% 65.7% Maintain
85

Suicide Prevention Programs

(Dollars in thousands)

Programs of Regional & National Significance

FY2015

Final

FY2016

Enacted

FY2017

President's 

Budget

FY2017

+/- 

FY2016

Suicide Prevention.......................................................................... $60,032 $60,032 $88,032 +$28,000

National Strategy for Suicide Prevention (non-add)................. 2,000 2,000 30,000 +28,000

Zero Suicide ( non-add).......................................................... --- --- 26,000 +26,000

AI/AN set-aside (non-add).................................................. --- --- 5,200 +5,200

Suicide Lifeline (non-add).......................................................... 7,198 7,198 7,198 ---

GLS - Youth Suicide Prevention - States(non-add).................. 35,427 35,427 35,427 ---

Prevention & Public Health Fund (non-add)..................... 12,000 12,000 10,000 -2,000

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/ANSuicidePrevention Initiative (non-add)......................... 2,931 2,931 2,931 ---

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. Through these programs, 

SAMHSA also supports HHS’s Arc of Keeping People Healthy and Safe. 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 41,000 Americans die by suicide each year. One American dies by suicide every

12.8 minutes.43 In 2008, suicide became the 10th leading cause of death in the United States and 

remained so through 2013, the most recent year for which there are available mortality data. For 

2013, SAMHSA’s National Survey on Drug Use and Health reported that approximately

1.3 million Americans age 18 and over attempted suicide, 9.3 million seriously considered 

suicide, and 2.7 million made a plan. While youth have the highest rates of suicide attempts, 

middle-aged adults have the highest number of deaths by suicide nationwide, and older adults 

have the highest rates of death by suicide. The nation’s suicide prevention efforts must go 

beyond youth and address the issues of suicidal thoughts, plans, attempts, and deaths among 

adults. 

43 American Association of Suicidology. (2015). USA Suicide 2013 Official Final Data. Accessed May 8, 2015, 

fromhttp://www.suicidology.org/portals/14/docs/resources/factsheets/2013datapgsv3.pdf.
86

National Strategy for Suicide Prevention

(Dollars in thousands)

Programs of Regional & National Significance

FY2015

Final

FY2016

Enacted

FY2017

President's 

Budget

FY2017

+/- 

FY2016

National Strategy for Suicide Prevention......................................... $2,000 $2,000 $30,000 +$28,000

Authorizing Legislation ........................Sections 520A and 520C of the Public Health Service Act 

FY 2017 Authorization .........................................................................................................Expired 

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

Eligible Entities............................................... State Mental Health Authorities, States, Territories,

Tribes, and the District of Columbia 

Program Description and Accomplishments

Suicide has been increasing in the United States, particularly in adults and older adults. Suicide is

the fifth leading cause of death among middle-aged adults (ages 35 to 64 years).44 In 2013, 

suicide among working-aged adults (25 to 64) accounted for almost 70 percent of all suicides, 

and from 1999 to 2010, the suicide rate among individuals age 35 to 64 increased by nearly 

30 percent.45 Additionally, the highest rates of suicide are seen among men who are 80 or older. 

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 this population, the number 

of suicides in the United States could dramatically increase. The nation’s suicide prevention 

efforts must go beyond youth and address the issues of suicidal thoughts, plans, attempts, and 

deaths among adults. 

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 (e.g. military families; lesbian, gay, bisexual, and transgender individuals; and 

Native American youth), the goals and objectives of the NSSP grants are focused on preventing 

suicide and suicide attempts among working-aged adults, 25 to 64 years old, the age group 

whose deaths by suicide outnumber all others. In FY 2014, SAMHSA awarded four 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 2015, 

SAMHSA provided continuation funds for these four grants. In FY 2016, SAMHSA is 

supporting the continuation of these four grants.

44 Centers for Disease Control and Prevention (CDC) Vital Signs: Suicide among adults aged 35–64 years – United 

States, 1999–2010. MMWR Morbidity Mortality Weekly Report. 2013; 62 (17):321–325. 45 ibid
87

50,000 $46,903

45,000 41,149

40,000

35,000

30,000 28,655

25,000

20,000

Suicides by Age

FY2015 Funding

15,000 $13,186

10,000 7,215

5,264

5,000 $2,000

$0

0

10 to 24 25 to 64

Age Group

65+ Lifespan

Funding History

Fiscal Year Amount

FY 2013 ---

FY 2014 $2,000,000

FY 2015 $2,000,000

FY 2016 $2,000,000

FY 2017 $30,000,000

Budget Request

The FY 2017 Budget Request is $30.0 million, an increase of $28.0 million from the FY 2016 

Enacted Level. The proposed increase in funding will support $2.0 million in NSSP grants and 

$26.0 million in Zero Suicide grants, including a $5.2 million set-aside for tribes. As shown in 

the graph below, the amount of funding available and the number of suicides by age groups have 

not corresponded in the past. Consistent with the National Strategy for Suicide Prevention’s 

recommendation to focus on the lifespan, this funding will augment existing youth-focused 

funding. $1.2 million will support technical assistance and an evaluation contract.

Suicides by Age versus Suicide Funding

(Dollars in thousands)

To reduce the tragic number of deaths by suicide, the number of people at risk for suicide who 

receive effective behavioral health care needs to increase significantly. For this to occur, two 

overarching goals must be achieved. More Americans at risk must be able to access and be 

S

uicides 2013
88

engaged in mental and substance use disorder treatment, and the treatment they receive must be 

effective and based on the most recent science. The first requires a stronger and more systematic 

community approach. The second requires a stronger and more systematic health system 

response. For those at risk of suicide but who are not receiving mental health care, effective 

strategies for getting them into treatment are required. For those at risk of suicide who are 

receiving mental health care, that care must be more effective, more systematic, and more 

science-based. These two major requirements necessitate the two pronged approach described 

below and comprise the new Zero Suicide program.

The first component, Zero Suicide in Behavioral Health Care, will provide nine grants to states 

to embed the Zero Suicide model throughout their behavioral healthcare systems including 

within Accountable Care Organizations. Zero Suicide implementation has been successful in 

decreasing suicide rates. One example of a successful comprehensive approach was the Air 

Force Suicide Prevention Program that reduced suicide among pilots by 30 percent in the 1990’s. 

The foundational belief of Zero Suicide is that suicide deaths for adults under care within health 

and behavioral health systems are preventable. It presents both a bold goal and an aspirational 

challenge. The programmatic approach of Zero Suicide is based on the realization that suicidal 

individuals often fall through cracks in a fragmented, and sometimes distracted, healthcare 

system. A systematic approach to quality improvement in these settings is both available and 

necessary. Specifically, this program will support implementation of post-discharge follow-up 

protocols for individuals at risk of suicide and provide suicide-specific treatment approaches. 

This component of the initiative would focus on statewide efforts to reduce suicide among those 

adults receiving care through the state’s public behavioral health system.

The second component, Comprehensive State/Community Suicide Prevention, will provide 

seven grants to allow states to engage communities and organizations in a comprehensive effort 

to identify persons at risk for suicide and link them to needed services. Care systems that have 

adopted these approaches have been successful in reducing suicides.46,47,48,49,50,51 States with 

large (over 1,000) numbers of deaths by suicide, and states with high rates, but smaller numbers 

of suicides, will be eligible for these grants. Grant recipients will implement and evaluate these 

evidence-based suicide prevention activities in the full spectrum of potential community and 

clinical suicide prevention settings including primary care, emergency rooms, 

schools/educational settings, the workplace, faith communities, and justice settings. The 

initiative will be coordinated with Centers for Disease Control and Prevention’s National Violent 

Death Reporting System and Injury Control Research Center for Suicide Prevention, National

46 Knox, Litts, Talcott, Feig & Caine (2003), Risk of suicide and related adverse outcomes after exposure to suicide 

prevention program in the US Air Force: cohort study, BMJ 2003; 327 (7428):1376. 47 Coffey CE Building a system of perfect depression care in behavioral health Jt Comm J Qual Patient Saf, 2007,

: 33(4):193-199. 48 While D, Bickley, H, Roscoe A et al; Implementation of mental health service recommendations in England and 

Wales and suicide rates, 1997-2006: a cross sectional and before and after observational study, Lancet, 2012:379 

(9820):1005-1012.

49 May PA, Serna P, Hurt, L, Debruyn. LM Outcome evaluation of a public health approach to suicide prevention 

in an American Indian tribal nation AM J Public Health 2005; 95 (7) :1238-1244. 50 Suicide Prevention Strategy 2013-2016. 51 Scottish Government, Edinburgh 2013.
89

Institute of Mental Health, Health Resources and Services Administration (Federally Qualified 

Health Centers), Department of Veterans Affairs (outreach to veterans not receiving Veterans 

Health Administration healthcare), and Department of Defense. A similar comprehensive 

approach fully implementing the Scottish National Strategy led to an 18 percent reduction in 

deaths by suicide in Scotland, including reductions among adult males who make up a significant 

majority of suicides in Scotland, as they do in the United States.

Eligible entities for component one, focusing on health including behavioral healthcare systems, 

will include State Mental Health Authorities in states, territories, and the District of Columbia, 

tribes, and healthcare systems. Eligible entities for component two, addressing multi-sector 

approaches to suicide prevention will include State Mental Health Authorities in state, territories, 

and the District of Columbia, and tribes with identified high-risk communities.

The National Strategy for Suicide Prevention addresses the Administration’s multi-agency 

Native Youth priority to Reduce Teen Suicide, in support of the HHS Tribal Health and WellBeing Coordination. 

Suicide Lifeline

(Dollars in thousands)

Programs of Regional & NationalSignificance

FY2015

Final

FY2016

Enacted

FY2017

President's 

Budget

FY2017

+/- 

FY2016

Suicide Lifeline............................................................................... $7,198 $7,198 $7,198 $---

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

FY 2017 Authorization .........................................................................................................Expired 

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 2014, the National Suicide Prevention 

Lifeline answered calls from over 1.3 million Americans. 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 164 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 112,475 calls per month through November 2014, including a peak of 

133,762 calls in August 2014. SAMHSA evaluation studies have found that when a sample of 

suicidal callers to the Lifeline are asked, “...to what extent did calling the crisis hotline stop you 

from killing yourself?” 69 percent respond “a lot” and 21.6 percent respond “a little.” 
90

Since FY 2007, SAMHSA has collaborated with the Department of Veterans Affairs to ensure 

that veterans calling the Lifeline have 24/7 access to a specialized veterans’ suicide prevention 

hotline. In FY 2014, more than 35,500 callers per month that pressed “one” were seamlessly 

connected to the veterans’ crisis line. The Lifeline also responds to calls from active duty 

military and their families. SAMHSA is in the process of developing a suicide hotline outcome 

measure to determine the number of people who contacted the Lifeline who believe the call 

prevented them from taking their lives.

The Lifeline Evaluation is a part of the National Suicide Prevention Evaluation (NSPE), which 

includes all of the programs in SAMHSA’s suicide prevention portfolio. The NSPE is an 

evaluation that will assess the effect of SAMHSA’s suicide prevention initiatives on reducing 

suicide attempts and mortality due to suicide. The NSPE also provides training and technical 

assistance to grantees related to evaluation, data collection, and surveillance.

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, emergency intervention, and 

follow-up protocols and have driven forward improvements in practice that are potentially 

lifesaving.

In FY 2015, SAMHSA awarded 12 crisis center follow-up continuation grants, continued 

support for the evaluation contract, and awarded a new three-year Lifeline grant. In FY 2016, 

SAMHSA is awarding six new crisis center follow-up grants and the continuation of the Lifeline 

grant.

Funding History

Fiscal Year Amount

FY 2013 $6,085,275

FY 2014 $7,198,000

FY 2015 $7,198,000

FY 2016 $7,198,000

FY 2017 $7,198,000

Budget Request

The FY 2017 Budget Request is $7.2 million, the same as the FY 2016 Enacted Level. 

SAMHSA is requesting funding to continue to support 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 National Suicide Prevention Lifeline Crisis Center grants to 

focus on providing follow up to suicidal people discharged from emergency rooms and inpatient 

units, and will support a crisis chat system.
91

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

(Dollars in thousands)

Programs of Regional & National Significance

FY2015

Final

FY2016

Enacted

FY2017

President's 

Budget

FY2017

+/- 

FY2016

GLS - Youth Suicide Prevention -States........................................ $35,427 $35,427 $35,427 $---

Prevention &Public HealthFund (non-add).......................... 12,000 12,000 10,000 -2,000

GLS - YouthSuicide Prevention- Campus..................................... 6,488 6,488 6,488 ---

Authorizing Legislation..................... Sections 520E and 520E-2 of the Public Health Service Act 

FY 2017 Authorization .........................................................................................................Expired 

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

Eligible Entities............................................... States, Tribes, and Institutions of Higher Education 

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.52

The Garrett Lee Smith (GLS) Memorial Act (Public Law 108-355) 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 

180 grants to 50 states and the District of Columbia, 47 tribes or tribal organizations, and 

one territory. 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 190 grants to 175 institutions of 

higher education, including tribal colleges and universities, to prevent suicide and suicide 

attempts.

Grantees often use their funds to provide suicide prevention training in their communities. As of 

June 2014, 747,108 individuals participated in 25,608 training events or educational seminars 

provided by grantees. The most common approach was gatekeeper training, designed to help 

trainees recognize suicide risk in young people, address the immediate needs of these 

individuals, and refer young people to appropriate services. About one third of trainees received 

training through campus-sponsored courses and educational seminars. More than 64 percent of 

trainees participated in state-sponsored training activities and 6.7 percent in tribal-sponsored 

training activities.

Results from the congressionally mandated cross-site evaluation have shown that counties who 

implemented GLS supported activities had lower suicide rates than matched counties that did not 

in the first (but not the second) year following suicide prevention activities.

52 http://www.jaredstory.com/garrett_smith.html
92

In FY 2015, SAMHSA provided continuation funds for 33 GLS State/Tribal grants and 33 GLS 

Campus grants and awarded new cohorts of 12 grants for GLS State/Tribal and 22 grants for 

GLS Campus programs. In FY 2016, SAMHSA is supporting 38 continuation and four new GLS 

State/Tribal grants and 37 continuation and 16 new GLS Campus grants as well as the National 

Suicide Prevention Evaluation. 

Funding History

Fiscal Year Amount

FY 2013 $41,323,126

FY 2014 $41,915,000

FY 2015 $41,915,000

FY 2016 $41,915,000

FY 2017 $41,915,000

Budget Request

The FY 2017 Budget Request is $41.9 million, the same as the FY 2016 Enacted Level. 

SAMHSA requests funding 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 prevention of suicide and suicide attempts at 

institutions of higher education and the National Suicide Prevention Evaluation. 

Garrett Lee Smith Youth Suicide Prevention – State/Tribal and Campus addresses the 

Administration’s multi-agency Native Youth priority to Reduce Teen Suicide, in support of the 

HHS Tribal Health and Well-Being Coordination. 

Garrett Lee Smith Suicide Prevention Resource Center

(Dollars in thousands)

Programs of Regional & National Significance

FY2015

Final

FY2016

Enacted

FY2017

President's 

Budget

FY2017

+/- 

FY2016

GLS - Suicide Prevention Resource Center..................................... $5,988 $5,988 $5,988 $---

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

FY 2017 Authorization.........................................................................................................Expired 

Allocation Method............................................................................................. Competitive Grants

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
93

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 2015, SAMHSA awarded a new five-year SPRC grant. In FY 2016, SAMHSA will 

support the continuation of this grant. 

Funding History

Fiscal Year Amount

FY 2013 $5,338,840

FY 2014 $5,988,000

FY 2015 $5,988,000

FY 2016 $5,988,000

FY 2017 $5,988,000

Budget Request

The FY 2017 Budget Request is $6.0 million, the same as the FY 2016 Enacted Level. Funding 

will continue 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 survivor and mental health 

consumer groups with access to information and resources that support program development, 

intervention implementation, and adoption of policies that prevent suicide.

American Indian/Alaska Native Suicide Prevention Initiative

(Dollars in thousands)

Programs of Regional & National Significance

FY2015

Final

FY2016

Enacted

FY2017

President's 

Budget

FY2017

+/- 

FY2016

AI/AN Suicide Prevention Initiative................................................. $2,931 $2,931 $2,931 $---

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

FY 2017 Authorization .........................................................................................................Expired 

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
94

(AI/AN) youth. These plans mobilize tribal communities’ existing social and educational 

resources to meet their goals. As of 2015, 65 tribal communities have received specialized 

technical assistance and support in suicide prevention and related areas. In addition, more than 

9,200 members of these communities received training in prevention and mental health 

promotion. 

In FY 2015, SAMHSA supported the continuation of this five-year contract. In FY 2016, 

SAMHSA will continue support for this activity through the existing contract.

Funding History

Fiscal Year Amount

FY 2013 $2,784,738

FY 2014 $2,931,000

FY 2015 $2,931,000

FY 2016 $2,931,000

FY 2017 $2,931,000

Budget Request

The FY 2017 Budget Request is $2.9 million, the same level as the FY 2016 Enacted Level. 

SAMHSA requests funding to support 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 and substance use disorders, prevent suicide, and promote mental 

health through the contract continuation. 

The American Indian/Alaska Native Suicide Prevention program addresses the Administration’s

multi-agency Native Youth priority to Improve Education Outcomes and Like Outcomes for 

Native Youth and Reduce Teen Suicide, in support of the HHS Tribal Health and Well-Being 

Coordination. 
95

Outputs and Outcomes Table

Program: Suicide Prevention

NOTE: SAMHSA makes grant awards towards the end of the year. Therefore, the FY 2017 targets are based onthe 

FY 2016 Enacted Level and the FY 2018 targets are based on the FY 2017 President’sBudget.

Measure

Year and Most Recent Result

Target for Recent Result 

(Summary of Result)

FY 2017

Target

FY 2018

Target

FY 2018

Target

+/- 

FY 2017

Target

2.3.59 Increase the total number of 

individuals trained in youth suicide 

prevention. (Outcome)

FY 2015: 131,909

Target: 161,000 

(Target not met)

160,082 160,082 Maintain

2.3.60 Increase the total number of 

youth screened. (Output)

FY 2015: 7,100

Target: 73,996 

(Target not met)

94,214 94,214 Maintain

2.3.61 Increase the number of calls 

answered by the suicide hotline. 

(Output)

FY 2015: 1,502,573

Target: 989,994 

(Target exceeded)

1,308,825 1,308,825 Maintain

3.1.01 Increase the number of 

individuals screened for mental health 

or related interventions. (Intermediate 

Outcome)

FY 2016: Result expected 

December 31, 2016

Target: Set baseline 

(Pending)

N/A N/A N/A

3.1.02 Increase the number of 

individuals referred to mental health or 

related services. (Intermediate 

Outcome)

FY 2016: Result expected 

December 31, 2016

Target: Set baseline 

(Pending)

N/A N/A N/A

3.1.03 Increase the number of 

organizations that establish 

management information/information 

technology system links across 

multiple agencies. (Intermediate 

Outcome)

FY 2016: Result expected 

December 31, 2016

Target: Set baseline 

(Pending)

N/A N/A N/A

3.1.04 Increase the number of 

organizations or communities that 

demonstrate improved readiness to 

change their systems. (Intermediate 

Outcome)

FY 2016: Result expected 

December 31, 2016

Target: Set baseline 

(Pending)

N/A N/A N/A

3.2.37 Increase the number of 

individuals referred to mental health or 

related services.

(Output)

FY 2015: 5,588

Target: 5,911 

(Target not met)

9,177 9,177 Maintain
96

Homelessness Prevention Programs

(Dollars in thousands)

Programs of Regional & NationalSignificance

FY2015

Final

FY2016

Enacted

FY2017

President's 

Budget

FY2017

+/- 

FY2016

HomelessnessPreventionPrograms................................................ $30,696 $30,696 $30,696 $---

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

Authorizing Legislation.......................... Sections 520A and 506 of the Public Health Service Act 

FY 2017 Authorization .........................................................................................................Expired 

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

Eligible Entities........................................ States, Domestic Public and Community Organizations, 

Private Nonprofit Entities, 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 at unacceptably high levels. 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, mainstream 

benefits, treatment, and supportive services. According to the National Alliance to End 

Homelessness, over 570,000 individuals experienced homelessness on any given night in the 

United States, about 15 percent (84,291) of the homeless population are considered “chronically 

homeless,” and about nine percent (49,933) of homeless people are veterans.53 Approximately 

26 percent of individuals experiencing homelessness have a serious mental illness, 50 percent 

struggle with substance use disorders, and 66 percent of the chronically homeless population has 

a substance use disorder or other chronic health condition.54,55

The U.S. Interagency Council on Homelessness, in which HHS participates, has set aggressive 

goals to permanently house and address the needs of those who are chronically homeless and/or 

who are veterans and homeless. Two SAMHSA programs are helping to support the U.S. 

Interagency Council on Homelessness’ strategic goal of ending homelessness: Services in 

Supportive Housing (SSH) and Cooperative Agreements to Benefit Homeless Individuals 

(CABHI).

In FY 2011, SAMHSA initiated the CABHI program, jointly funded by the Center for Mental 

Health Services (CMHS) and Center for Substance Abuse Treatment (CSAT) to support 

treatment and the development and expansion of local systems that provide permanent housing 

53 Snapshot of Homelessness. (n.d.). Retrieved August 21, 2015, from 

http://www.endhomelessness.org/pages/snapshot 

54 United State Interagency Council on Homelessness. Substance Abuse. Available at 

https://www.usich.gov/news/substance_abuse

55 Office of National Drug Control Policy. Integrate Treatment for Substance Use Disorders into Mainstream Health

Care and Expand Support for Recovery. 

Available at: https://www.whitehouse.gov/ondcp/chapter-integrate-treatment-for-substance-use-disorders
97

and supportive services. This includes integration of treatment and other critical services for 

individuals with serious mental illness and substance use disorders. Target populations for this 

program include veterans and individuals with serious mental illness and/or substance use 

disorders. Through this program, SAMHSA supports HHS’s Arc of Keeping People Healthy 

and Safe. CABHI also supports coordination and planning at the local level with state or local 

Public Housing Authorities; local mental health, substance misuse, and primary care provider 

organizations; the local Department of Housing and Urban Development-supported Continuum 

of Care (CoC) program (designed to promote community-wide commitment to the goal of 

ending homelessness; provide funding for efforts by nonprofit providers, and state and local 

governments); the state Medicaid Office; and the state Mental Health and Substance Abuse 

Authorities. Data show that between intake and six-month follow up, abstinence from substance 

use increased by six percent, injection drug use decreased by 22 percent, and stability in housing 

increased by 49.8 percent. In FY 2015, SAMHSA supported 10 CABHI continuation grants to 

community-based public or non-profit entities.

In FY 2013, SAMHSA initiated the CABHI-States program, also funded jointly by CSAT and 

CMHS, which builds on the CABHI program by working with states to provide accessible, 

effective, comprehensive, coordinated/integrated, and evidence-based treatment services. 

CABHI-States supports services for individuals with serious mental illness and/or substance use 

disorders who experience chronic homelessness and/or veterans who experience homelessness. 

It also provides peer supports and enhancement or development of a statewide plan to ensure 

sustained collaboration across public health and housing systems that will result in short-term 

and long-term strategies to support behavioral health services for individuals who experience 

chronic homelessness. The grantees work with state and local Public Housing Authorities and 

state Medicaid agencies to develop systematic, cost-effective, and integrated approaches to 

housing and mental and/or substance use disorder treatment and services for individuals with 

mental and/or substance use disorders experiencing homelessness. In FY 2015, SAMHSA 

supported a new cohort of nine grants for CABHI-States grantees. SAMHSA also made funds 

available to existing grantees to enhance and expand the services they were providing. 

In FY 2015, SAMHSA also supported a national evaluation contract to compare the 

effectiveness of programs and various models of service delivery that are used across homeless 

service programs. SAMHSA also supported a technical assistance contract to provide training 

and support to its homeless services grantees. In 2016, SAMHSA will continue its CABHI 

efforts with up to 47 grants to states, local governments, and community-based organizations and 

corresponding TA and evaluation activities.

Funding History

Fiscal Year Amount

FY 2013 $31,343,438

FY 2014 $32,992,000

FY 2015 $32,992,000

FY 2016 $32,992,000

FY 2017 $32,992,000
98

Budget Request

The FY 2017 Budget Request is $33.0 million, the same as the FY 2016 Enacted Level. This 

funding will continue to develop and enhance the infrastructure of states and their treatment 

service systems to increase capacity to provide accessible, effective, comprehensive, and 

evidence-based treatment services for individuals with serious mental illness and/or co-occurring 

disorders, experiencing homelessness. It will also increase access to permanent housing and 

provide other critical services for those who experience homelessness. In addition, funding is 

requested to continue to assist providers in delivering housing and recovery support services for 

individuals who are experiencing homelessness as well as mental illness and substance use 

disorders. The budget request will provide services and support for approximately 5,000

individuals. 

Outputs and Outcomes Table 

Program: Mental Health Homelessness Prevention Programs

NOTE: SAMHSA makes grant awards towards the end of the year. Therefore, the FY 2017 targets are based on the 

FY 2016 Enacted Level and the FY 2018 targets are based on the FY 2017 President’sBudget.

Measure

Year and Most Recent Result 

Target for Recent Result

(Summary of Result)

FY 2017

Target

FY 2018

Target

FY 2018

Target

+/- 

FY 2017

Target

3.4.01 Increase the number of 

clients served. (Output)

FY 2015: 2,432

Target: 4,959 

(Target not met)

4,959 4,959 Maintain

3.4.02 Increase the percentage of 

adults with severe mental illness 

receiving homeless supportservices 

who report positive functioning at

6-month follow-up. (Outcome)

FY 2015: 70.8%

Target: 66.1% 

(Target exceeded)

66.1% 66.1% Maintain

3.4.03 Increase the percentage of 

adults receiving services who were 

currently employed at 6-month 

follow-up. (Outcome)

FY 2015: 26.5%

Target: 26.0% 

(Target exceeded)

26.0% 26.0% Maintain

3.4.05 Increase the percentage of 

adults receiving services who had a 

permanent place to live in the 

community at 6-month follow-up. 

(Outcome)

FY 2015: 84.5%

Target: 81.2% 

(Target exceeded)

81.2% 81.2% Maintain
99

Minority AIDS and HIV/AIDS Education

(Dollars in thousands)

Programs of Regional & NationalSignificance

FY2015

Final

FY2016

Enacted

FY2017

President's 

Budget

FY2017

+/- 

FY2016

Minority AIDS...............................................................................

HIV/AIDS Education.....................................................................

$9,224

771

$9,224

771

$15,935

771

+$6,711

---

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

FY 2017 Authorization .........................................................................................................Expired 

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

Minority AIDS

The Centers for Disease Control and Prevention (CDC) reports significantly higher rates of 

HIV/AIDS among racial/ethnic minorities compared with the general population.56 African 

Americans accounted for 45 percent and Hispanics accounted for 23 percent of all HIV/AIDS 

cases diagnosed in 2013.57 Psychiatric and psychosocial complications are frequently not 

diagnosed or 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 5,800 individuals received 

services in FY 2014. 

In FY 2014, SAMHSA’s Centers for Mental Health Services, Substance Abuse Prevention, and 

Substance Abuse Treatment supported the Minority AIDS Initiative Continuum of Care Pilot 

(MAI CoC). The MAI CoC supports behavioral health screening, primary prevention, and 

treatment for racial/ethnic minority populations with or at high risk for mental and substance use 

disorders and HIV/AIDS. MAI CoC supports substance use disorder (SUD) treatment, primary 

prevention/treatment service programs, community mental health programs, and HIV/AIDS 

integrated programs that either can co-locate or have fully integrated HIV/AIDS prevention and 

medical care services. This program also provides primary prevention services for SUD and 

HIV/AIDS in local communities served by behavioral health programs. Of those with SMI such 

as schizophrenia, bipolar disorder, and major depression, approximately 20 percent are infected 

with the hepatitis C virus and 23 percent are infected with the hepatitis B virus. In addition, 

56 Centers for Disease Control and Prevention. HIV Surveillance Report. (2013); vol. 25. Published February 2015. 

Accessed May 8, 2015 fromhttp://www.cdc.gov/hiv/library/reports/surveillance. 57 Centers for Disease Control and Prevention. HIV Surveillance Report. (2013); vol. 25. Published February 2015. 

Accessed May 8, 2015 fromhttp://www.cdc.gov/hiv/library/reports/surveillance.
100

between 14 percent and 36 percent of those who misuse alcohol are infected with the hepatitis C 

virus.58,59

SAMHSA supports a consolidated evaluation of its HIV/AIDS programs. This comprehensive 

process and outcome evaluation will assess the degree to which SAMHSA is providing effective 

and efficient mental and substance use disorder services and prevention programs to those with 

and at risk of HIV/AIDS. The evaluation results will help inform program development and 

refine the approach used in SAMHSA’s HIV portfolio. 

In FY 2014, SAMHSA awarded 34 four-year HIV Continuum of Care grants and a technical 

assistance contract. In FY 2015, SAMHSA funded the continuation of 34 HIV Continuum of 

Care grants, a technical assistance contract, and awarded a new evaluation contract. In FY 2016, 

SAMHSA is supporting the continuation of 34 HIV Continuum of Care grants, and evaluation 

and technical assistance contracts.

The Mental Health Care Provider Education in HIV/AIDS Education 

The Mental Health Care Provider Education in HIV/AIDS Education program disseminates 

knowledge and training on the treatment of the neuropsychiatric and psychological 

complications of HIV/AIDS. Front-line providers, including psychiatrists, psychologists, social 

workers, primary care practitioners, and medical students receive thistraining.

Funding History

Fiscal Year Amount

FY 2013 $9,571,658

FY 2014 $9,995,000

FY 2015 $9,995,000

FY 2016 $9,995,000

FY 2017 $16,706,000

Budget Request

The FY 2017 Budget Request is $16.7 million, an increase of $6.7 million from the FY 2016 

Enacted Level. This represents a shift in funding from the Substance Abuse Treatment 

appropriation. This increase in funding will allow for the award of a new cohort of MAI

Continuum of Care (CoC) grantees that will address the holistic behavioral health needs of those 

living with HIV. Three SAMHSA Centers, CMHS, CSAT, and CSAP, will jointly administer the

program. This funding will continue to enhance and expand the provision of effective, culturally 

competent, HIV/AIDS-related mental health services in minority communities for

58 Bhattacharya R, Shuhart MC. Hepatitis C and alcohol: interactions, outcomes, and implications. J Clin 

Gastroenterol. 2003;36(3):242-52.

59 Rosenberg et al. Prevalence of HIV, Hepatitis B, and Hepatitis C in People With Severe Mental Illness. Am J Public 

Health. 2001;91:(31–37).
101

people living with HIV/AIDS. In addition, the funding will support continuation HIV

Continuum of Care grants, evaluation, and technical assistance contracts.

The output and outcome measures for the Minority AIDS Initiative are part of the Mental Health

- Other Capacity Activities outputs and outcomes table shown on page 117. 

Criminal and Juvenile Justice Programs

(Dollars in thousands)

Programs of Regional & National Significance

FY2015

Final

FY2016

Enacted

FY2017

President's 

Budget

FY2017

+/- 

FY2016

Criminal and Juvenile Justice Programs............................................ $4,269 $4,269 $4,269 $---

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

FY 2017 Authorization .........................................................................................................Expired 

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

Program Description and Accomplishments

Studies of people involved in the criminal justice system have documented higher rates of cooccurring psychiatric and substance use disorders than those of the general population.60 

Approximately 15 percent of people in the justice system with substance use disorders and 30 

percent with mental illness receive treatment.61 Inadequate resources to address behavioral 

health conditions place millions of individuals at greater risk for parole or probation failure and 

re-incarceration at substantial human, social, and economic cost to society. Of inmates released 

from prison, 43 percent commit a new crime or a technical violation within three years of 

release. The costs associated with incarceration are high: state corrections budgets alone account 

for $39.0 billion in taxpayer costs.62,63 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. 

60 Steadman, HJ, Osher, FC, Robbins, PC, Case, BF, & Samuels, S. (2009). Prevalence of serious mental illness 

among jail inmates. Psychiatric Services, 60(6), 761-765. 61 Cloud, D., (2014). On life support: Public health in the age of mass incarceration. New York: Vera Institute of 

Justice. http://www.vera.org/sites/default/files/resources/downloads/on-life-support-public-health-massincarceration-report.pdf 62 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-ofrecidivism; 63 Henrichson, C., & Delaney, R. (2012). The price of prisons: What incarceration costs taxpayers. New York:Vera

Institute of Justice.
102

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 and/or substance use disorders 

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 focuses on the 

diversion of adults with behavioral health problems, including serious mental illness, from the 

criminal justice system, including alternatives to incarceration. The program supports community 

behavioral health services for individuals with mental and/or substance disorders and includes a 

focus on veterans involved with the criminal justice system.

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 1,400 individuals, with twothirds of them identified as having co-occurring mental and substance use disorders and with 54 

percent reporting significant trauma exposure in their lives. BHTCCs provided an array of 

services, including clinical case management, mental and substance use disorder treatment 

services, trauma-specific treatment, peer support, and more. Based on Transformation 

Accountability System (TRAC) reporting data, program participants experienced improvements 

in mental health and reductions in substance use. Mental health problems declined by 20 percent 

in the first six months while alcohol and drug use declined by 60 percent over the same period. 

Nearly 74 percent of participants reported physical health improvements at six months. In 

addition, employment rates increased from 36 percent to 45 percent over the first six months, 

with monthly median income increasing by $298.64

In FY 2015, SAMHSA provided continuation support for the second year of 17 four-year grants, 

continued technical assistance, and awarded a new evaluation contract. The new BHTCC 

evaluation focuses on examining the clinical and functional outcomes of program participants 

with behavioral health issues. The new BHTCC evaluation is building on the findings from the 

first cohort and more deeply 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 2016, SAMHSA is continuing support for these grants and the evaluation. 

64 Advocates for Human Potential. (2014). Evaluation of the Adult Treatment Court Collaborative Program: Final 

evaluation report. Albany, NY: Author.
103

Funding History

Fiscal Year Amount

FY 2013 $5,876,801

FY 2014 $4,296,000

FY 2015 $4,296,000

FY 2016 $4,296,000

FY 2017 $4,296,000

Budget Request

The FY 2017 Budget Request is $4.3 million, the same as the FY 2016 Enacted Level. 

SAMHSA request will continue to provide comprehensive treatment and recovery support 

services for adolescents and adults with co-occurring mental and substance use disorders who 

come into contact with the criminal justice system, as well as offenders re-entering the 

community. 

Behavioral Health Treatment Court Collaborative Grants program also addresses the 

Administration’s multi-agency Native Youth priority to Increase Tribal Control of Criminal 

Justice, in support of the HHS Tribal Health and Well-Being Coordination. 

The output and outcome measures for Criminal and Juvenile Justice Programs are part of the 

Mental Health - Other Capacity Activities outputs and outcomes table shown on page 117. 

Practice Improvement and Training

(Dollars in thousands)

Programs of Regional & NationalSignificance

FY2015

Final

FY2016

Enacted

FY2017

President's 

Budget

FY2017

+/- 

FY2016

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

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

FY 2017 Authorization .........................................................................................................Expired 

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

Eligible Entities............. 105 Nationally Recognized Historically Black Colleges and Universities

Program Description and Accomplishments

SAMHSA facilitates health integration by engaging in activities that support mental health 

system transformation and reform. 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 through these activities: the Historically Black Colleges and 

Universities Center for Excellence in Behavioral Health (HBCU-CFE) program, the 

Rehabilitation Research and Training Centers (RRTCs), the Transforming Lives through 
104

Supported Employment Grant Program, the Recovery into Practice, and Programs to Achieve 

Wellness.

The purpose of the HBCU-CFE 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 2014, SAMHSA awarded a three-year new HBCU-Center for Excellence grant to a 

consortium of HBCUs with a lead university. SAMHSA is continuing this effort in FY 2015 and 

FY 2016. 

RRTCs seek to advance the current knowledge base by supporting research, training, technical 

assistance, and knowledge translation 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. The RRTCs are funded in partnership with the 

Administration for Community Living’s National Institute on Disability, Independent Living, 

and Rehabilitation Research. Currently there are two RRTCs funded for up to five years. The 

first program, RRTC on Improving Employment Outcomes for Persons with Mental Illness will 

conduct research activities and evaluation studies on improving employment outcomes of 

individuals with serious mental illness. The second program, RRTC on Self-Directed Care to 

Promote Recovery, Health and Wellness for Individuals with Serious Mental Illness, will 

conduct research and evaluation studies to develop, adapt, and enhance self-directed models of 

medical, mental health, and nonmedical services designed to improve health, recovery and 

employment outcomes for individuals with serious mental illness.

In FY 2015, SAMHSA continued funding for the two RRTCs and will continue this funding in 

FY 2016. 

The Recovery into Practice contract supports the expansion and integration of recovery-oriented 

care delivered by mental health providers through training and education, policy and analysis, 

and materials development. The effort crosses professional mental health disciplines (e.g., 

psychiatry, psychology, nursing, social work, peer specialists, primary care, and substance use 

and addiction) to provide training on what recovery-oriented care is and how to implement it, to 

hold meetings with stakeholders, to establish collaborative relations with provider, consumer, 

and family leaders, and to conduct research and literature reviews on the current state of 

recovery-oriented care, knowledge and attitudes.

In FY 2015, SAMHSA supported the continuation of the Recovery into Practice contract. In FY

2016, SAMHSA will continue support of this contract.

In addition, in FY 2015, SAMHSA awarded a new contract for Programs to Achieve Wellness 

that promotes and facilitates wellness initiatives for people with, or at risk for, mental disorders, 

including those with the most serious mental illnesses and with co-occurring substance use 
105

disorders. Research indicates alarming health disparities between people with serious mental 

and/or substance use disorders and the general population. These individuals are likely to die 

decades earlier, mostly due to preventable, chronic medical conditions. The median reduction in 

life expectancy among those with mental illness was 10.1 years.65 The project engages people 

with mental and/or substance use disorders, national organizations, communities, states, and 

tribes in the promotion of evidence-based tools for wellness. In FY 2016, SAMHSA plans to 

continue to fund this contract.

Funding History

Fiscal Year Amount

FY 2013 $7,413,110

FY 2014 $7,828,000

FY 2015 $7,828,000

FY 2016 $7,828,000

FY 2017 $7,828,000

Budget Request

The FY 2017 Budget Request is $7.8 million, the same level as the FY 2016 Enacted 

Level. SAMHSA requests funding to address the need for disseminating key information, such 

as evidence-based mental health practices, to the mental health delivery system and engage in 

activities that support mental health system transformation and reform.

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 118. 

Consumer and Consumer-Supporter TA Centers

(Dollars in thousands)

Programs of Regional & National Significance

FY2015

Final

FY2016

Enacted

FY2017

President's 

Budget

FY2017

+/- 

FY2016

Consumer and Consumer Supporter Technical Assistance Centers.. $1,918 $1,918 $1,918 $---

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

FY 2017 Authorization .........................................................................................................Expired 

Allocation Method ............................................................................................. Competitive Grants

Eligible Entities....................................................................................... Community Organizations 

65 Walker ER, McGee RE, Druss BG. Mortality in Mental Disorders and Global Disease Burden Implications: A 

Systematic Review and Meta-analysis. JAMA Psychiatry. 2015 Feb 11. doi:10.1001/jamapsychiatry.2014.2502.
106

Program Description and Accomplishments

Consumer-centered services and supports are vital to improving the quality and outcomes of 

health and behavioral healthcare services for people with mental disorders including serious 

mental illnesses.

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 serious 

mental illnesses (SMI). Such approaches maximize consumer self-determination, promote longterm recovery, and assist individuals with serious mental illness to increase their community 

involvement through work, school, and social connectedness. This decreases their dependence on

a variety of social service programs and reduces unnecessary or inappropriate psychiatric 

hospitalization. This program also improves collaboration among consumers, families, 

advocates, providers, and administrators. It helps to transform community mental health services 

into a more consumer and family driven model. 

In FY 2014, the Consumer and Consumer-Supporter Technical Assistance Centers provided 

training to more than 9,500 individuals. Because of this funding, more than 1,700 consumers 

and family members participated in mental health-related planning and systems improvement. 

In the first six months of FY 2015, Consumer and Consumer-Supporter TA Centers facilitated 

peer-led technical assistance and presentations for over 2,500 participants throughout the U.S. 

The Centers also facilitated 77 webinars and trainings for over 9,000 participants on a range of 

topics that included Employment Strategy; Exemplary Peer Groups; Olmstead Implementation 

and the Americans with Disabilities Act; Engagement Skills; and Strategic Planning. 

In FY 2015, SAMHSA awarded a new cohort of five regionally focused Consumer and 

Consumer-Supporter TA Centers for the period of five years. These grants continue in FY 2016. 

Funding History

Fiscal Year Amount

FY 2013 $1,875,102

FY 2014 $1,918,000

FY 2015 $1,918,000

FY 2016 $1,918,000

FY 2017 $1,918,000

Budget Request

The FY 2017 Budget Request is $1.9 million, the same as the FY 2016 Enacted Level. 

SAMHSA’s funding request will continue support of these grants to provide technical 

assistance
107

to facilitate the quality improvement of the mental health system by promoting consumerdirected approaches for adults with serious mental illness.

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 118. 

Disaster Response

(Dollars in thousands)

Programs of Regional & NationalSignificance

FY2015

Final

FY2016

Enacted

FY2017

President's 

Budget

FY2017

+/- 

FY2016

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

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

FY 2017 Authorization .........................................................................................................Expired 

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

Eligible Entities........................................................ Domestic Public or Private Nonprofit Entities

Program Description and Accomplishments

Disasters like Hurricane Sandy, the Oregon and Washington mudslides, the Iowa and Oklahoma 

tornados, and the Boston Marathon bombing strike without warning. These unexpected disasters 

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 a natural or man-made disaster. SAMHSA focuses on three major programs: the Crisis 

Counseling Assistance and Training Program (CCP), the Disaster Distress Helpline (DDH), and 

the use of any allocated supplemental funds to support survivors of natural and man-made 

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 behaviorally 

oriented 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’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 2014, the Disaster Distress Helpline received calls from 

6,436 individuals and 7,848 text messages from 720 users.
108

Periodically, SAMHSA receives additional funding to help survivors of a particular emergency 

or disaster. In FY 2013, SAMHSA received a total of $7.5 million in supplemental funds to 

assist the survivors of Hurricane Sandy. Efforts focused on providing mental and substance use 

disorder treatment, restoring the capability of medication-assisted substance use disorder 

treatment services in the impacted areas, ensuring the operation of the Disaster Distress Helpline, 

and conducting resiliency training with educators. 

In FY 2014, SAMHSA continued to support the Disaster Distress Helpline by the providing 

crisis counseling services across the nation. Funding continued to support the Disaster Technical 

Assistance Center in the provision of technical assistance, consultation, and information 

dissemination. These services assist SAMHSA in advancing state and local capacity to deliver 

effective behavioral health services that are well integrated with traditional public health and 

disaster recovery efforts. SAMHSA continued support for these activities in FY 2015. In 

addition, SAMHSA funded a new cooperative agreement, Networking, Certifying and Training 

Suicide Prevention Hotlines and a National and a National Disaster Distress Helpline. This 

jointly funded cooperative agreement will manage, enhance, and strengthen the National Suicide 

Prevention Lifeline and support Disaster Distress Helpline. SAMHSA is continuing support for 

these activities in FY 2016. 

Funding History

Fiscal Year Amount

FY 2013 $996,982

FY 2014 $1,953,000

FY 2015 $1,953,000

FY 2016 $1,953,000

FY 2017 $1,953,000

Budget Request

The FY 2017 Budget Request is $2.0 million, the same as the FY 2016 Enacted Level. 

SAMHSA is requesting funding to continue the support of a nationally available disaster distress 

crisis counseling telephone line through a connection to local crisis lines throughout the country 

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 118. 
109

Tribal Behavioral Health Grants

(Dollars in thousands)

Programs of Regional & NationalSignificance

FY2015

Final

FY2016

Enacted

FY2017

President's 

Budget

FY2017

+/- 

FY2016

TribalBehavioralHealthGrants......................................................

PHSEvaluationFunds(non-add)...........................................

$4,988

---

$15,000

---

$15,000

5,000

$---

+5,000

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

FY 2017 Authorization .........................................................................................................Expired 

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 8 to 24 years.66 Further, AI/AN high school students report higher rates of suicidal 

behaviors than the general population of U.S. high school students.67 These behaviors include 

serious thoughts of suicide, making suicide plans, attempting suicide, and getting 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 

suicide than AI/AN youth raised on tribal reservations (21 percent and 33 percent, 

respectively).68

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 

five-year 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) AI/AN grantees 

and organizations and providers 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. SAMHSA has incorporated lessons learned to 

enhance this program and other national efforts to reduce suicide and substance use and support 

positive mental health among AI/AN youth. SAMHSA continued the support of this program in 

FY 2015. Grantees completed their needs assessments in FY 2015 and are working with

66 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. 67 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. 68 http://www.suicidology.org/Portals/14/docs/Resources/FactSheets/2011/AI-AN2011.pdf
110

SAMHSA to turn their assessments into action plans to be implemented in FY 2016. These 

action plans will report baseline data in FY 2017. 

In FY 2016, as part of Generation Indigenous,69 a White House-supported youth initiative 

focused on removing possible barriers to success for AI/AN youth, SAMHSA proposed an 

expansion of 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 

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 ($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 expands these activities to approximately 103 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 high-risk AI/AN youth and their families, enhance early 

detection of mental and substance use disorders among AI/AN youth, and increase referral to 

treatment.

Funding History

Fiscal Year Amount

FY 2013 ---

FY 2014 $4,988,000

FY 2015 $4,988,000

FY 2016 $15,000,000

FY 2017 $15,000,000

Budget Request

The FY 2017 Budget Request is $30.0 million, the same as the FY 2016 Enacted Budget. This 

request includes $15.0 million in the Mental Health appropriation and $15.0 million in the 

Substance Abuse Prevention appropriation. This funding will continue support for programs that 

promote mental health and prevent substance use activities for high-risk AI/AN youth and their 

families.

69 For additional information on this White House sponsored initiative see: http://genindigenous.com/
111

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. 

The Tribal Behavioral Health Grants program addresses the Administration’s multi-agency 

Native Youth priority to Reduce Teen Suicide, in support of the HHS Tribal Health and WellBeing Coordination. 

Outputs and Outcomes Table 

Program: Tribal Behavioral Health

NOTE: SAMHSA makes grant awards towards the end of the year. Therefore, the FY 2017 targets are based on the 

FY 2016 Enacted Level and the FY 2018 targets are based on the FY 2017 President’sBudget.

Measure

Year and Most Recent Result

Target for Recent Result 

(Summary of Result)

FY 2017

Target

FY 2018

Target

FY 2018

Target

+/- 

FY 2017

Target

2.4.10 Increase the number of 

grantees reporting a decrease in 

underage drinking in their 

community. (Output)

FY 2016: Result expected 

December 31, 2016

Target: Set baseline 

(Pending)

2.4.11 Increase the number of 

participants receiving evidencebased mental health -related 

services as a result of the grant. 

(Output)

FY 2016: Result expected 

December 31, 2016

Target: Set baseline 

(Pending)

2.4.12 Increase the number of youth 

age 10 - 24 who received mental 

health or related services after 

screening, referral or attempt. 

(Output)

FY 2016: Result expected 

December 31, 2016

Target: Set baseline 

(Pending)

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 2016: Result expected 

December 31, 2016

Target: Set baseline 

(Pending)
112

Crisis Systems

(Dollars in thousands)

Programs of Regional & National Significance

FY2015

Final

FY2016

Enacted

FY2017

President's 

Budget

FY2017

+/- 

FY2016

Crisis Systems................................................................................

PHS Evaluation Funds(non-add)...........................................

$---

---

$---

---

$5,000

5,000

+$5,000

+5,000

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

FY 2017 Authorization .........................................................................................................Expired 

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

Eligible Entities...........................................................................................States and Communities

Program Description and Accomplishments

Behavioral health crises are critical times for intervention and treatment and key times to engage 

individuals in on-going treatment and recovery. Such crises often cause great disruption for 

individuals and those around them, including family members, teachers, law enforcement, and 

employers. Communities throughout America currently lack the capacity to provide needed 

services when children, young adults, and their family members experience behavioral health 

crises. For too many, the only resource available is hospital emergency departments that are not 

equipped to address their behavioral health needs and often where they experience long stays and 

unnecessary inpatient care. The number of patients with mental health and substance use 

conditions treated in emergency rooms (ER) has been on the rise for more than a decade.70 In 

2007, 12.0 million ER visits involved a diagnosis related to mental health and/or substance use 

conditions, which accounted for 12.5 percent of all ER visits in the United States, or one out of 

every eight ER visits. Mental health and substance use related ER visits were two and a half 

times more likely to result in hospital admissions than ER visits related to non- mental health and 

substance use related ER visits that resulted in hospitalization. Medicare was billed most 

frequently for mental health and substance use-related ER visits (30.1 percent), followed by 

private insurance (25.7 percent), uninsured (20.6 percent), and Medicaid (19.8 percent).71

Comprehensive crisis systems can be challenging to conceive and fund. These often require 

coordination among multiple systems, such as 911 lines and other facets of emergency response 

systems; first responders including police and EMT; emergency room and primary health care; 

court systems; multiple payers; social service providers; and behavioral healthcare providers. 

Comprehensive crisis systems also have to be designed, funded, and staffed to address and 

manage a range of ages, family situations, locations and crisis-situations, including various 

presenting conditions, such as serious mental illness (SMI). Well-managed crisis interventions 

can result in positive outcomes for the individual, family, and community, including increased 

understanding of mental and substance use disorders. Poorly managed crisis situations can result

70 Larkin, G.L., Claassen, C.A., Edmond, J.A., Pelletier, A.J., and Camargo, C.A. Trends in U.S. Emergency 

Department Visits for Mental Health Conditions, 1992 to 2001. Psychiatric Services. 2005; 56:671-677 71 Owens, P., Mutter, R., & Stocks, C. (n.d.). Mental Health and Substance Abuse-Related Emergency Department 

Visits among Adults, 2007. Retrieved August 21, 2015, fromhttp://www.hcups.ahrq.gov/reports/statbriefs/sb92.pdf
113

in frustration, increased health and social services system costs, and negative outcomes for all 

involved, including potential harm to the individual experiencing the crisis or others. 

While there are models of comprehensive crisis response systems that are operating successfully, 

these comprehensive systems are the exception. More commonly, law enforcement and 

emergency room personnel respond to public safety and health situations without the benefit of 

the range of services and support needed to prevent, manage, and follow up on behavioral health 

crises. Inadequate crisis response systems can result in harm to the individual in crisis, law 

enforcement, or others; unnecessary use of scarce and costly emergency room and inpatient 

settings; and inappropriate use of jails and criminal justice resources.

Funding History

Fiscal Year Amount

FY 2013 ---

FY 2014 ---

FY 2015 ---

FY 2016 ---

FY 2017 $5,000,000

Budget Request

The FY 2017 Budget Request includes a total of $10.0 million, an increase of $10.0 million for 

the FY 2016 Enacted Level. This includes $5.0 million in the Mental Health appropriation and 

$5.0 million in the Substance Abuse Treatment appropriation. This program will help 

communities build, fund, and sustain crisis systems capable of preventing and de-escalating 

behavioral health crises as well as connecting individuals, including those with serious mental 

illness, and families with needed post-crisis services. 

In FY 2017, SAMHSA plans to provide Increasing Access Response Efforts (ICARE) grant 

opportunities to states and communities to develop and/or adopt sustainable, comprehensive, and 

coordinated community-based crisis response systems for children, youth and adults with mental 

health and/or addiction problems. Whether individuals receive services voluntarily or by court 

order, the ICARE initiative will help to reduce costly and unnecessary use of hospital emergency 

department and inpatient services. This initiative will also support the integration and expansion 

of services to fill gaps and enhance coordination within the comprehensive continuum of the 

crisis response services, while minimizing the risk for re-traumatization of individuals and 

families served. This activity will help communities build, fund, and sustain crisis systems. The 

crisis systems will be capable of preventing and de-escalating behavioral health crises. They will 

also help connect individuals including those with serious mental illness, and families with 

needed post-crisis services in order to prevent recurrence of the crisis situation. In many 

incidences, responses to these situations by emergency medical responders and behavioral 

healthcare providers are under-coordinated and un-sustained. These grants will help mitigate the 

demand for inpatient beds by people with serious mental illnesses and substance use disorders by 

coordinating effective crisis response with ongoing outpatient services and supports. 
114

As a braided activity, SAMHSA will track separately any amounts spent or awarded under Crisis 

Systems through its distinct appropriation and ensure that funds are used for purposes consistent 

with legislative direction and intent of that appropriation. 

Outputs and Outcomes Tables

Program: Crisis Systems: Increasing Access Response Efforts(ICARE)

NOTE: SAMHSA makes grant awards towards the end of the year. Therefore, the FY 2017 targets are based on the 

FY 2016 Enacted Level and the FY 2018 targets are based on the FY 2017 President’sBudget.

Measure

Year and Most Recent Result

Target for Recent Result 

(Summary of Result)

FY 2017

Target

FY 2018

Target

FY 2018

Target

+/- 

FY 2017

Target

3.1.05 Increase the number of 

organizations that entered into 

formal written inter/intra 

organizational agreements. 

(Outcome)

FY 2016: Result expected 

December 31, 2016

Target: Set baseline 

(Pending)

3.1.06 Increase the percentage of 

clients receiving services who 

report positive functioning at 6- 

month follow-up. (Outcome)

FY 2016: Result expected 

December 31, 2016

Target: Set baseline 

(Pending)

3.1.07 Increase the number of 

individuals referred to mental health 

or related services. (Outcome)

FY 2016: Result expected 

December 31, 2016

Target: Set baseline 

(Pending)
115

Assisted Outpatient Treatment for Individuals with Serious MentalIllness

(Dollars in thousands)

Programs of Regional & National Significance

FY2015

Final

FY2016

Enacted

FY2017

President's 

Budget

FY2017

+/- 

FY2016

AssistedOutpatientTreatmentforIndividualswithSeriousMental 

Illness..................................................................................... $--- $15,000 $15,000 $---

Authorizing Legislation ................. Section 224 of the Protecting Access to Medicare Act of 2014 

FY 2017 Authorization .........................................................................................................Expired 

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

Eligible Entities...........................................................................................States and Communities

Program Description and Accomplishments

Recent data show that one in five American adults experience a mental health issue and one in 

25 Americans live with a serious mental illness, such as schizophrenia, bipolar disorder and/or 

major depression. Less than half of adults with diagnosable mental health problems receive the 

treatment they need. Without access to and receipt of evidence-based mental health services, 

mental health related challenges 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 

serious mental illness, 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 serious mental illness. AOT is the 

practice of delivering outpatient treatment under court order to adults with serious mental illness 

who meet specific criteria such as a prior history of repeated hospitalizations or arrest. AOT 

involves petitioning local courts 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 is implementing an AOT grant program through awarding approximately 

20 cooperative agreements for up to $1,000,000 each to support the implementation of Section 

224 of PAMA, the Assisted Outpatient Treatment Grant Programs for Individuals with Serious 

Mental Illness pilot program. The goal of the pilot is to improve the health and social outcomes 

for the individuals served in the program, such as increasing healthcare utilization, improving 

behavioral health and other health outcomes, and reducing rates of homelessness and 

incarceration. The AOT grant program will prepare and execute evidence-based, recovery 

oriented, and person-centered treatment plans with consumer input, provide case management 

and evidence-based services that support the individual and the treatment plan, ensure 

individuals are made aware of criteria for AOT completion, and ensure appropriate referrals to 

medical and social services providers based on the individual’s needs.

Grants will be awarded 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
116

located. Grants will only be awarded to applicants that have not previously implemented an AOT

program. 

Grantees will be required to participate in a cross site evaluation which will assess the 

effectiveness and impact of the AOT grant programs. Additional program outcomes that will be 

evaluated will include, but are not be limited to, health and social outcomes such as the rates of 

incarceration, employment, health care utilization, mortality, suicide, substance use, 

hospitalization, homelessness, and use of services.

SAMHSA will consult with the National Institute of Mental Health, the Attorney General, and 

the Administration for Community Living as part of this pilot grant program. In addition, 

SAMHSA will work with families and courts in the implementation of this program. 

Annual reports will be made to Congress at the end of each fiscal year beginning in 2016 and 

ending in 2018. These reports will include any cost savings and public health outcomes; rates of 

incarceration; rates of homelessness; and individual and family satisfaction with program 

participation.

Funding History

Fiscal Year Amount

FY 2013 ---

FY 2014 ---

FY 2015 ---

FY 2016 $15,000,000

FY 2017 $15,000,000

Budget Request

The FY 2017 Budget Request includes $15.0 million, the same as the FY 2016 Enacted Level. 

SAMHSA plans to award twelve grants at approximately $1.0 million each. The remaining funds

will be used to support technical assistance and evaluation of the grant program. This funding 

will continue to improve the health and social outcomes for individuals with serious mental 

illness by providing continuation funding for the AOT grants, evaluation and technical 

assistance.
117

Outputs and Outcomes Table

Program: Mental Health - Other Capacity Activities1

NOTE: SAMHSA makes grant awards towards the end of the year. Therefore, the FY 2017 targets are based onthe 

FY 2016 Enacted Level and the FY 2018 targets are based on the FY 2017 President’sBudget.

1

Includes the following: Law Enforcement and Behavioral Health Partnerships for Early Diversion, Jail Diversion 

and Trauma Recovery Program-Priority to Veterans, Minority AIDS Initiative Targeted Capacity Expansion and 

Primary and Behavioral Health Care Integration.

Measure

Year and Most Recent Result

Target for Recent Result 

(Summary of Result)

FY 2017

Target

FY 2018

Target

FY 2018

Target

+/- 

FY 2017

Target

1.2.05 Increase the percentage of 

clients receiving services who 

report positive functioning at 6- 

month follow-up. (Outcome)

FY 2015: 59.0%

Target: 55.7% 

(Target exceeded)

55.7% 55.7% Maintain

1.2.82 Increase the percentage of 

clients receiving services who had a 

permanent place to live in the 

community at 6-month follow-up. 

(Outcome)

FY 2015: 62.5%

Target: 70.5%

(Target not met but improved)

70.5% 70.5% Maintain

1.2.83 Increase the percentage of 

clients receiving services who are 

currently employed at 6-month 

follow-up. (Outcome)

FY 2015: 47.5%

Target: 22.2% 

(Target exceeded)

47.5% 47.5% Maintain

1.2.88 Increase the number of 

individuals screened for mental 

health or related interventions. 

(Outcome)

FY 2015: 29,745

Target: 20,341 

(Target exceeded)

29,813 24,709 -5,104
118

Outputs and Outcomes Table

Program: Mental Health - Science and Service Activities

NOTE: SAMHSA makes grant awards towards the end of the year. Therefore, the FY 2017 targets are based onthe 

FY 2016 Enacted Level and the FY 2018 targets are based on the FY 2017 President’sBudget.

1

Results are preliminary and will be updated when additional data is available. 2

Target aggregates CSAT and CMHS Science and Service individuals trained and CSAP CAPT individuals trained.

Measure

Year and Most Recent Result

Target for Recent Result 

(Summary of Result)

FY 2017

Target

FY 2018

Target

FY 2018

Target

+/- 

FY 2017

Target

1.4.06 Increase the number of 

people trained by CMHS Science 

and Service Programs. (Output)

FY 2015: 27,297

Target: 18,827 

(Target exceeded)

16,271 16,271 Maintain

1.4.09 Increase the number of 

individuals trained by SAMHSA's 

Science and Services Program. 

(Output)

FY 2015: 38,9411

Target: 110,000 

(Target not met)

40,9472 40,947 Maintain

1.4.14 Increase the number of calls 

answered by the Disaster Distress 

Hotline. (Output)

FY 2015: 3,260

Target: 6,436 

(Target not met)

3,228 3,228 Maintain

1.4.15 Increase the number of text 

messages answered by the Disaster 

Distress Hotline. (Output)

FY 2015: 15,044

Target: 4,131 

(Target exceeded)

4,131 4,131 Maintain
119

SAMHSA/Mental Health 

PRNS Mechanism Table Summary

(Dollars in thousands)

Program Activity

FY2015

Final 

No. Amount

FY2016

Enacted 

No. Amount

FY2017

President's 

Budget

No. Amount

Programs of Regional & National Significance

Grants/Cooperative Agreements

Continuations....................................................... 390 $211,629 411 $219,913 594 $275,319

New/Competing.................................................. 221 98,484 269 119,949 99 62,948

Subtotal............................................................. 611 310,112 680 339,862 693 338,268

Contracts

Continuations....................................................... 22 55,778 24 54,619 29 63,364

New/Competing.................................................. 7 4,648 7 12,068 4 4,756

Subtotal............................................................. 29 60,426 31 66,688 33 68,120

Total, Mental HealthPRNS1 640 $370,538 711 $406,550 726 $406,388

1 The Total PRNS in FY 2015 and FY 2016 includes $12.0 million in Prevention and Public Health Funds. 

The Total PRNS in FY 2017 includes $10.0 million in Prevention and Public Health Funds.
120

SAMHSA/Mental Health

PRNS Mechanism Table by Program, Project, and Activity

(Dollars in thousands)

Programs of Regional & NationalSignificance

FY2015

Final

No. Amount

FY2016

Enacted 

No. Amount

FY2017

President's 

Budget

No. Amount

CAPACITY:

Seclusion and Restraint

Grants

Continuations................................................................ --- $--- --- $--- --- $---

New/Competing........................................................... --- --- --- --- --- ---

Subtotal..................................................................... --- --- --- --- --- ---

Contracts

Continuations................................................................ 1 1,147 1 1,147 1 1,147

New/Competing........................................................... --- --- --- --- --- ---

Subtotal..................................................................... 1 1,147 1 1,147 1 1,147

Total,SeclusionandRestraint 1 1,147 1 1,147 1 1,147

Youth ViolencePrevention

Grants

Continuations................................................................ 8 19,795 8 20,087 --- ---

New/Competing........................................................... --- --- --- --- --- ---

Subtotal..................................................................... 8 19,795 8 20,087 --- ---

Contracts

Continuations................................................................ 2 3,091 2 3,012 --- ---

New/Competing........................................................... 1 213 --- --- --- ---

Subtotal..................................................................... 3 3,304 2 3,012 --- ---

Total, YouthViolence Prevention 11 23,099 10 23,099 --- ---

ProjectAWARE

Grants

Continuations................................................................ 20 40,304 90 44,839 95 58,481

New/Competing........................................................... 70 8,545 6 11,781 2 4,720

Subtotal..................................................................... 90 48,849 96 56,619 97 63,201

Contracts

Continuations................................................................ 2 5,477 2 6,546 3 8,763

New/Competing........................................................... 1 539 1 1,700 --- ---

Subtotal..................................................................... 3 6,016 3 8,246 3 8,763

Total, ProjectAWARE 93 54,865 99 64,865 100 71,964

NationalChildTraumaticStress Network

Grants

Continuations................................................................ 78 42,705 --- --- 83 43,726

New/Competing........................................................... --- --- 83 43,784 --- ---

Subtotal..................................................................... 78 42,705 83 43,784 83 43,726

Contracts

Continuations................................................................ --- 3,182 --- 3,103 --- 3,161

New/Competing........................................................... --- --- --- --- --- ---

Subtotal..................................................................... --- 3,182 --- 3,103 --- 3,161

Total,NationalChildTraumaticStress Network 78 45,887 83 46,887 83 46,887
121

SAMHSA/Mental Health

PRNS Mechanism Table by Program, Project, and Activity

(Dollars in thousands)

Programs of Regional & National Significance

FY 2015

Final

No. Amount

FY 2016

Enacted 

No. Amount

FY 2017

President's 

Budget

No. Amount

Children and Family Programs

Grants

Continuations................................................................ 11 4,375 11 4,383 --- ---

New/Competing........................................................... --- --- --- --- 11 4,560

Subtotal..................................................................... 11 4,375 11 4,383 11 4,560

Contracts

Continuations................................................................ 2 2,083 2 2,075 2 1,898

New/Competing........................................................... --- --- --- --- --- ---

Subtotal..................................................................... 2 2,083 2 2,075 2 1,898

Total, Children and Family Programs 13 6,458 13 6,458 13 6,458

Healthy Transitions

Grants

Continuations................................................................ 17 17,567 17 16,932 17 16,929

New/Competing........................................................... --- --- --- --- --- ---

Subtotal..................................................................... 17 17,567 17 16,932 17 16,929

Contracts

Continuations................................................................ --- 2,384 --- 2,194 --- 3,022

New/Competing........................................................... --- --- --- 825 --- ---

Subtotal..................................................................... --- 2,384 --- 3,019 --- 3,022

Total, Healthy Transitions 17 19,951 17 19,951 17 19,951

Consumer and Family Network Grants

Grants

Continuations................................................................ 38 2,621 14 1,330 43 4,092

New/Competing........................................................... 22 1,719 37 3,162 2 200

Subtotal..................................................................... 60 4,340 51 4,492 45 4,292

Contracts

Continuations................................................................ --- 520 --- 311 --- 462

New/Competing........................................................... --- 94 --- 150 2 200

Subtotal..................................................................... --- 614 --- 462 2 662

Total, Consumer and Family Network Grants 60 4,954 51 4,954 47 4,954

Project LAUNCH

Grants/Cooperative Agreements

Continuations................................................................ 31 25,744 36 29,492 25 18,448

New/Competing........................................................... 5 3,387 --- --- 15 10,950

Subtotal..................................................................... 36 29,131 36 29,492 40 29,399

Contracts

Continuations................................................................ 1 4,251 2 5,063 1 5,156

New/Competing........................................................... 1 1,173 --- --- --- ---

Subtotal..................................................................... 2 5,424 2 5,063 1 5,156

Total, Project LAUNCH 38 34,555 38 34,555 41 34,555

Mental Health System Transformation and Health

Reform

Grants

Continuations................................................................ 7 2,637 7 2,633 7 2,643

New/Competing........................................................... --- --- --- --- --- ---

Subtotal..................................................................... 7 2,637 7 2,633 7 2,643

Contracts

Continuations................................................................ --- 997 --- 235 1 1,136

New/Competing........................................................... 1 145 --- 911 --- ---

Subtotal..................................................................... 1 1,142 --- 1,146 1 1,136

Total, Mental Health System Transformation and

Health Reform 8 3,779 7 3,779 8 3,779
122

SAMHSA/Mental Health

PRNS Mechanism Table by Program, Project, and Activity

(Dollars in thousands)

Programs of Regional & National Significance

FY 2015

Final

No. Amount

FY 2016

Enacted 

No. Amount

FY 2017

President's 

Budget

No. Amount

Primary and Behavioral Health Care Integration

Grants

Continuations................................................................ 16 6,179 53 21,019 60 24,186

New/Competing........................................................... 60 40,668 27 25,754 --- ---

Subtotal..................................................................... 76 46,847 80 46,773 60 24,186

Contracts

Continuations................................................................ --- 3,030 --- 3,104 --- 1,818

New/Competing........................................................... --- --- --- --- --- ---

Subtotal..................................................................... --- 3,030 --- 3,104 --- 1,818

Total, PBHCI 76 49,877 80 49,877 60 26,004

National Strategy for Suicide Prevention

Grants

Continuations................................................................ 4 1,879 4 1,880 --- ---

New/Competing........................................................... --- --- --- --- 16 26,000

Subtotal..................................................................... 4 1,879 4 1,880 16 26,000

Contracts

Continuations................................................................ --- 121 --- 120 --- ---

New/Competing........................................................... --- --- --- --- 2 4,000

Subtotal..................................................................... --- 121 --- 120 2 4,000

Total, National Strategy for Suicide Prevention 4 2,000 4 2,000 18 30,000

Suicide Lifeline

Grants

Continuations................................................................ 12 690 1 5,288 7 5,978

New/Competing........................................................... 1 5,288 6 690 --- ---

Subtotal..................................................................... 13 5,978 7 5,978 7 5,978

Contracts

Continuations................................................................ --- 1,220 --- 1,220 --- 1,220

New/Competing........................................................... --- --- --- --- --- ---

Subtotal..................................................................... --- 1,220 --- 1,220 --- 1,220

Total, Suicide Lifeline 13 7,198 7 7,198 7 7,198

GLS - Youth Suicide Prevention - States

Grants

Continuations................................................................ 33 22,110 38 27,765 42 30,664

New/Competing........................................................... 12 8,705 4 2,891 --- ---

Subtotal..................................................................... 45 30,814 42 30,656 42 30,664

Contracts

Continuations................................................................ 1 4,613 1 4,771 1 4,763

New/Competing........................................................... --- --- --- --- --- ---

Subtotal..................................................................... 1 4,613 1 4,771 1 4,763

Total, GLS - States 46 35,427 43 35,427 43 35,427

GLS - Youth Suicide Prevention - Campus

Grants

Continuations................................................................ 33 3,184 37 3,513 39 3,830

New/Competing........................................................... 22 2,085 17 1,759 14 1,481

Subtotal..................................................................... 55 5,270 54 5,272 53 5,311

Contracts

Continuations................................................................ --- 1,218 --- 1,216 --- 1,177

New/Competing........................................................... --- --- --- --- --- ---

Subtotal..................................................................... --- 1,218 --- 1,216 --- 1,177

Total, GLS - Campus 55 6,488 54 6,488 53 6,488
123

SAMHSA/Mental Health

PRNS Mechanism Table by Program, Project, and Activity

(Dollars in thousands)

Programs of Regional & National Significance

FY 2015

Final

No. Amount

FY 2016

Enacted 

No. Amount

FY 2017

President's 

Budget

No. Amount

GLS - Suicide Prevention Resource Center

Grants

Continuations................................................................ --- --- 1 5,634 1 5,634

New/Competing........................................................... 1 5,634 --- --- --- ---

Subtotal..................................................................... 1 5,634 1 5,634 1 5,634

Contracts

Continuations................................................................ --- --- --- 354 --- 354

New/Competing........................................................... --- 354 --- --- --- ---

Subtotal..................................................................... --- 354 --- 354 --- 354

Total, GLS - Suicide Prevention Resource Center 1 5,988 1 5,988 1 5,988

AI/AN Suicide Prevention Initiative

Grants

Continuations................................................................ --- --- --- --- --- ---

New/Competing........................................................... --- --- --- --- --- ---

Subtotal..................................................................... --- --- --- --- --- ---

Contracts

Continuations................................................................ 1 2,788 1 2,931 1 2,931

New/Competing........................................................... 1 143 --- --- --- ---

Subtotal..................................................................... 2 2,931 1 2,931 1 2,931

Total, AI/AN 2 2,931 1 2,931 1 2,931

Homelessness Prevention Programs

Grants

Continuations................................................................ 10 4,217 17 14,758 39 20,010

New/Competing........................................................... 23 19,730 30 9,800 6 4,523

Subtotal..................................................................... 33 23,946 47 24,558 45 24,533

Contracts

Continuations................................................................ 3 6,687 2 4,507 3 6,163

New/Competing........................................................... --- 63 1 1,631 --- ---

Subtotal..................................................................... 3 6,750 3 6,138 3 6,163

Total, Homelessness Prevention Programs 36 30,696 50 30,696 48 30,696

Minority AIDS

Grants

Continuations................................................................ 34 7,752 34 7,751 34 7,753

New/Competing........................................................... --- --- --- --- 30 6,187

Subtotal..................................................................... 34 7,752 34 7,751 64 13,940

Contracts

Continuations................................................................ --- 962 1 1,473 1 1,995

New/Competing........................................................... --- 510 --- --- --- ---

Subtotal..................................................................... --- 1,472 1 1,473 1 1,995

Total, Minority AIDS 34 9,224 35 9,224 65 15,935

Crisis Systems

Grants

Continuations................................................................ --- --- --- --- --- ---

New/Competing........................................................... --- --- --- --- 3 4,328

Subtotal..................................................................... --- --- --- --- 3 4,328

Contracts

Continuations................................................................ --- --- --- --- --- ---

New/Competing........................................................... --- --- --- --- --- 672

Subtotal..................................................................... --- --- --- --- --- 672

Total, Crisis Systems --- --- --- --- 3 5,000
124

SAMHSA/Mental Health

PRNS Mechanism Table by Program, Project, and Activity

(Dollars in thousands)

Programs of Regional & NationalSignificance

FY 2015

Final

No. Amount

FY 2016

Enacted 

No. Amount

FY 2017

President's 

Budget

No. Amount

Criminal and Juvenile Justice Programs

Grants

Continuations................................................................ 17 2,907 17 2,912 17 2,921

New/Competing........................................................... --- --- --- --- --- ---

Subtotal..................................................................... 17 2,907 17 2,912 17 2,921

Contracts

Continuations................................................................ 1 975 1 777 2 1,348

New/Competing........................................................... 1 387 1 579 --- ---

Subtotal..................................................................... 2 1,362 2 1,357 2 1,348

Total, Criminal and Juvenile Justice Programs 19 4,269 19 4,269 19 4,269

Tribal Behavioral HealthGrants

Grants

Continuations................................................................ 20 3,811 20 3,818 67 11,580

New/Competing........................................................... --- --- 47 7,762 --- ---

Subtotal..................................................................... 20 3,811 67 11,580 67 11,580

Contracts

Continuations................................................................ --- 1,177 --- 1,756 --- 3,420

New/Competing........................................................... --- --- --- 1,664 --- ---

Subtotal..................................................................... --- 1,177 --- 3,420 --- 3,420

Total, Tribal Behavioral Health Grants 20 4,988 67 15,000 67 15,000

Assisted Outpatient Treatment for Individuals with

Serious Mental Illness

Grants

Continuations................................................................ --- --- --- --- 12 12,567

New/Competing........................................................... --- --- 12 12,567 --- ---

Subtotal..................................................................... --- --- 12 12,567 12 12,567

Contracts

Continuations................................................................ --- --- --- --- 2 2,433

New/Competing........................................................... --- --- 2 2,433 --- ---

Subtotal..................................................................... --- --- 2 2,433 2 2,433

Total, Assisted Outpatient Treatment for

Individuals with Serious Mental Illness --- --- 14 15,000 14 15,000

Subtotal, CAPACITY 625 $353,781 694 $389,793 709 $389,631

SCIENCE AND SERVICE:

Practice ImprovementTraining

Grants

Continuations................................................................ 1 3,151 1 3,156 1 3,157

New/Competing........................................................... --- --- --- --- --- ---

Subtotal..................................................................... 1 3,151 1 3,156 1 3,157

Contracts

Continuations................................................................ 4 4,309 6 3,952 7 4,671

New/Competing........................................................... 1 368 1 720 --- ---

Subtotal..................................................................... 5 4,677 7 4,672 7 4,671

Total, Practice Improvement Training 6 7,828 8 7,828 8 7,828

Consumer and Consumer Supporter TA Centers

Grants

Continuations................................................................ --- --- 5 1,799 5 1,796

New/Competing........................................................... 5 1,800 --- --- --- ---

Subtotal..................................................................... 5 1,800 5 1,799 5 1,796

Contracts

Continuations................................................................ --- --- --- 119 --- 122

New/Competing........................................................... --- 118 --- --- --- ---

Subtotal..................................................................... --- 118 --- 119 --- 122

Total, CCSTAC 5 1,918 5 1,918 5 1,918
125

SAMHSA/Mental Health

PRNS Mechanism Table by Program, Project, and Activity

(Dollars in thousands)

Programs of Regional & National Significance

FY2015

Final

No. Amount

FY2016

Enacted 

No. Amount

FY2017

President's 

Budget

No. Amount

Primary andBehavioral Health Care Integration TA

Grants

Continuations................................................................ --- --- --- --- --- ---

New/Competing........................................................... --- --- --- --- --- ---

Subtotal..................................................................... --- --- --- --- --- ---

Contracts

Continuations................................................................ 1 1,929 1 1,991 1 1,991

New/Competing........................................................... --- 62 --- --- --- ---

Subtotal..................................................................... 1 1,991 1 1,991 1 1,991

Total, PBHCI TA 1 1,991 1 1,991 1 1,991

Disaster Response

Grants

Continuations................................................................ --- --- --- 923 --- 923

New/Competing........................................................... --- 923 --- --- --- ---

Subtotal..................................................................... --- 923 --- 923 --- 923

Contracts

Continuations................................................................ 1 1,030 1 1,030 1 1,030

New/Competing........................................................... --- --- --- --- --- ---

Subtotal..................................................................... 1 1,030 1 1,030 1 1,030

Total, Disaster Response 1 1,953 1 1,953 1 1,953

Homelessness

Grants

Continuations................................................................ --- --- --- --- --- ---

New/Competing........................................................... --- --- --- --- --- ---

Subtotal..................................................................... --- --- --- --- --- ---

Contracts

Continuations................................................................ 1 1,817 --- 745 1 2,296

New/Competing........................................................... --- 479 1 1,551 --- ---

Subtotal..................................................................... 1 2,296 1 2,296 1 2,296

Total, Homelessness 1 2,296 1 2,296 1 2,296

HIV/AIDS Education

Grants

Continuations................................................................ --- --- --- --- --- ---

New/Competing........................................................... --- --- --- --- --- ---

Subtotal..................................................................... --- --- --- --- --- ---

Contracts

Continuations................................................................ 1 771 1 867 1 887

New/Competing........................................................... --- --- --- -96 --- -116

Subtotal..................................................................... 1 771 1 771 1 771

Total, HIV/AIDS 1 771 1 771 1 771

Subtotal, SCIENCE AND SERVICE 15 16,757 17 16,757 17 16,757

TOTAL, MH PRNS1 640 $370,538 711 $406,550 726 $406,388

1 The Minority Fellowship Program budget appears in the Health Surveillance and Program Support appropriation, 

Agency-wide Initiatives Workforce program. This is consistent with the FY 2017 Budget Request.
126

Grant Awards Table

(Whole dollars)

FY 2015

Final

FY 2016

Enacted

FY 2017

President's 

Budget

Number of Awards 611 680 693

Average Awards $507,549 $499,798 $488,296

Range ofAwards $15,000 - $6,000,000 $15,000 - $6,000,000 $15,000 - $6,000,000
127

Children’s Mental Health Services

(Dollars in thousands)

ProgramActivity

FY2015

Final

FY2016

Enacted

FY2017

President's

Budget

FY2017

+/-

FY2016

Budget Authority..................................................................... $117,026 $119,026 $119,026 $---

10% set-aside for youth in prodrome phase of

psychosis (non-add)........................................................ --- --- 11,903 +11,903

Authorizing Legislation ................................ Sections 561 to 565 of the Public Health Service Act 

FY 2017 Authorization .........................................................................................................Expired

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

Eligible Entities................................................................. States, Tribes, Communities, Territories

Program Description and Accomplishments

It is estimated that over 7.4 million children and youth in the United States have a serious mental 

disorder. Unfortunately, only 50 percent of those in need of mental health services actually 

receive treatment.72 Authorized 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. Approximately nine percent to 13 percent of America’s youth are 

estimated to have a serious emotional disturbance (SED). CMHI provides grants to assist states, 

local governments, tribes and territories in their efforts to deliver services and support to meet 

the needs of children and youth with SED.

CMHI supports the development and implementation of comprehensive, community-based 

services that use the SOC approach. The SOC approach 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 evidencesupported treatments and interventions. Individualized care management ensures that planned 

services and supports are delivered appropriately, effectively, and with a 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 suicide attempt rates fell over 38 percent 

within 12 months after children and youth accessed CMHI-related SOC services. In addition, 

school suspensions/expulsions fell over 42 percent and unlawful behavior fell over 40 percent 

within 18 months of children and youth beginning SOC-related services and supports.

72 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 ofNational Findings, NSDUH 

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

Administration.
128

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 use, and 

outcomes.

In FY 2011, SAMHSA first awarded SOC Expansion Planning grants to bring systems of care to 

scale from community to statewide focus, where the grantee develops a comprehensive strategic 

plan for improving and expanding services and supports broadly throughout a state or political 

subdivision of a state, tribe, or territory. In FY 2012, SAMHSA first funded SOC Expansion 

Implementation grants to assist states, tribes and larger geographic areas in implementing their 

strategic plans to expand the SOC approach to improve outcomes for children and youth with 

serious mental disorders and their families.

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 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), and support coordinated planning and 

funding efforts.

CMHI has an ongoing national evaluation, 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 youths’ mental 

health. The evaluation includes a 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) whether children and families stay in 

services longer in communities that achieve higher service and SOC ratings.

With the growth of the program, the evaluation process continues to gather data from children 

and families involved in SOCs and documents the ways in which different cohorts of grantees 

have changed over the years. In addition to infrastructure and service evaluation, a sector and 

comparison study is evaluating differences in outcomes between SOC eligible youth involved in 

education, juvenile justice, and child welfare systems and similar youth not enrolled in SOC 

services. The evaluation continues to monitor the outcomes of children, youth and families 

through various data profile reports, and continuous quality improvement reports. The evaluation

has added activities to assess the associated costs and cost savings of the SOC approach, and 

provides technical assistance to grantees to promote family engagement in the evaluation. 

Evaluation activities also help determine the grantees ability to sustain the program at the end of 

federal funding.
129

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 2015, SAMHSA supported 54 continuation grants (nine six-year grants and 45 four-year 

grants). Also, SAMHSA awarded 24 four-year new SOC Expansion and Sustainability 

Cooperative Agreements that focused on sustainable financing, cross-agency collaboration, the 

creation of policy and infrastructure, and the development and implementation of services and 

supports. In addition, SAMHSA supported one new technical assistance contract and one new 

evaluation contract.

In FY 2016, SAMHSA plans to support 47 continuation grants, 53 new grants, and five 

contracts.

Funding History

Fiscal Year Amount

FY 2013 $111,430,194

FY 2014 $117,026,000

FY 2015 $117,026,000

FY 2016 $119,026,000

FY 2017 $119,026,000

Budget Request

The FY 2017 Budget Request is $119.0 million, the same as the FY 2016 Enacted Level. As 

part of this budget request, SAMHSA seeks to develop and implement a services research 

demonstration effort based on the North American Prodrome Longitudinal Study funded by the 

National Institute on Mental Health. During the prodrome phase, a disease process has begun 

but is not yet diagnosable or inevitable. Intervention during this phase is critical and may 

prevent the further development of serious emotional disturbances and ultimately serious mental 

illness. It is important to take action during this stage to mitigate or delay the progression of 

mental illness, reduce disability, and maximize recovery. The new effort will be funded from a 

10 percent set-aside of the base program, and will focus on youth and young adults who are 

identified to be at clinical high risk for developing a first episode of psychosis. The grantees will 

focus on this population in order to support the development and implementation of evidencebased programs providing community outreach and psychosocial interventions for youth and
130

young adults in the prodrome phase of psychotic illness. The Budget includes new appropriations

language for the 10 percent set-aside.

SAMHSA is requesting funding to support 86 continuation grants, 14 new grants and 

five continuation contracts. This funding will provide training to 5,101 people in the mental 

health and related workforce and serve 6,610 children with serious emotional disturbances.

SAMHSA/Mental Health 

Mechanism Table

(Dollars in thousands)

Program Activity

FY 2015

Final 

No. Amount

FY 2016

Enacted 

No. Amount

FY 2017

President's 

Budget

No. Amount

Children's Mental Health Services

Grants/Cooperative Agreements

Continuations....................................................... 54 $49,115 47 $44,915 86 $84,144

New/Competing.................................................. 24 47,669 53 52,805 14 13,500

Subtotal............................................................. 78 96,784 100 97,720 100 97,644

Contracts

Continuations....................................................... 2 9,599 2 12,276 2 12,359

New/Competing.................................................. 1 1,626 --- --- --- ---

Subtotal............................................................. 3 11,224 2 12,276 2 12,359

Technical Assistance.............................................. 3 9,018 3 9,030 3 9,023

Total, Children's Mental Health Services 84 $117,026 105 $119,026 105 $119,026

* Totals may not add due to rounding.
131

Outputs and Outcomes Table

Program: Children's Mental Health Services

NOTE: SAMHSA makes grant awards towards the end of the year. Therefore, the FY 2017 targets are based onthe 

FY 2016 Enacted Level and the FY 2018 targets are based on the FY 2017 President’sBudget.

Measure

Year and Most Recent Result

Target for Recent Result 

(Summary of Result)

FY 2017

Target

FY 2018

Target

FY 2018

Target

+/-

FY 2017

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 2015: 13,595

Target: 6,610 

(Target exceeded)

13,595 13,595 Maintain

3.2.25 Increase the percentage of 

children receiving services who 

report positive social support at 6 

month follow-up. (Outcome)

FY 2015: 87.4%

Target: 87.6% 

(Target not met)

87.6% 87.6% 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 2015: 64.5%

Target: 62.7% 

(Target exceeded)

62.7% 62.7% 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 2015: 4,800

Target: 5,101 

(Target not met)

5,101 5,101 Maintain
132

Grant Awards Table

(Whole dollars)

FY2015

Final

FY2016

Enacted

FY2017

President's

Budget

Number ofAwards 78 100 100

Average Awards $1,240,818 $977,202 $976,440

Range ofAwards $330,000- $2,000,000 $330,000- $2,000,000 $330,000- $2,000,000
133

Projects for Assistance in Transition from Homelessness

(Dollars in thousands)

ProgramActivity

FY2015

Final

FY2016

Enacted

FY2017

President's 

Budget

FY2017

+/- 

FY2016

Budget Authority..................................................................... $64,635 $64,635 $64,635 $---

Authorizing Legislation .............................................Section 521 of the Public Health Service Act 

FY 2017 Authorization .........................................................................................................Expired 

Allocation Method ................................................................................................... Formula Grants

Eligible Entities............................................................................................... States and Territories

Program Description and Accomplishments

On an average night, an estimate of 578,424 individuals experience homelessness.73 Data 

suggest that approximately 26 percent of individuals experiencing homelessness have a serious 

mental illness (SMI), and that 30 percent of the chronically homeless population (individuals or 

families with a disabling condition who have been experiencing homelessness for longer than 

one year or more than four times in the past three years) has a serious mental illness.74,75,76 

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.77

The United States Interagency Council on Homelessness estimates that the national public cost 

of chronic homelessness is $3.7 to $4.7 billion per year,78 and the human costs are untold. Data 

show that funding the Projects for Assistance in Transition from Homelessness (PATH) 

program, which includes identifying and connecting a person experiencing chronic homelessness 

to primary medical and behavioral health treatment and services, and housing them, is two to

73 The U.S. Department of Housing and Urban Development, Office of Community Planning and Development.

(2014). The 2014 Annual Homeless Assessment Report (AHAR) to Congress, Part 1. Available

at: https://www.hudexchange.info/resources/documents/2014-AHAR-Part1.pdf

74 The U.S. Department of Housing and Urban Development, Office of Community Planning and Development.

(2010). The 2010 Annual Homeless Assessment Report (AHAR) to Congress. Available

at:https://www.hudexchange.info/resources/documents/2010HomelessAssessmentReport.pdf

75 National Alliance on Mental Illness. Mental Health by the Numbers. Available at: https://www.nami.org/LearnMore/Mental-Health-By-the-Numbers

76 Office of National Drug Control Policy. Integrate Treatment for Substance Use Disorders into Mainstream Health

Care and Expand Support for Recovery. Available at: https://www.whitehouse.gov/ondcp/chapter-integratetreatment-for-substance-use-disorders

77 National Alliance on Mental Illness (2004). Homelessness. Available at: 

http://www2.nami.org/Template.cfm?Section=security&template=/ContentManagement/

ContentDisplay.cfm&ContentID=47556

78 United States Interagency Council on Homelessness (2014). The True Cost of Doing Nothing. Available at: http://

usich.gov/blog/the-true-cost-of-doing-nothing
134

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 funds community-based 

outreach, mental and substance use disorder treatment services, case management, assistance 

with accessing housing, and other supportive services. 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 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 2014, the PATH program outreached to 185,524 individuals experiencing homelessness 

and enrolled 63 percent of individuals with a SMI into the PATH program (80,411 individuals). 

Additionally, 52 percent of enrolled individuals were experiencing a co-occurring substance use 

disorder. Of those enrolled in PATH, 62,632 individuals received community mental health 

services. 12,446 individuals received substance use treatment through PATH, while 17,318 

individuals were referred by PATH to substance use treatment services in the community. In 

addition, PATH assisted 17,474 individuals with addressing complex housing needs and referred 

27,881 individuals to housing assistance 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.

Funding History

Fiscal Year Amount

FY 2013 $61,405,176

FY 2014 $64,635,000

FY 2015 $64,635,000

FY 2016 $64,635,000

FY 2017 $64,635,000

Budget Request

The FY 2017 Budget Request is $64.6 million, level from the FY 2016 Enacted Level. 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 suffering from SMI or those suffering from SMI and from 

substance use disorders 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.
135

Outputs and Outcomes Table

Program: Projects for Assistance in Transition from Homelessness

NOTE: SAMHSA makes grant awards towards the end of the year. Therefore, the FY 2017 targets are based onthe 

FY 2016 Enacted Level and the FY 2018 targets are based on the FY 2017 President’s Budget.

Measure

Year and Most Recent Result

Target for Recent Result 

(Summary of Result)

FY 2017

Target

FY 2018

Target

FY 2018

Target

+/- 

FY 2017

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 2014: 64.0%

Target: 47.0% 

(Target exceeded)

66.0% 66.0% Maintain

3.4.16 Increase the number of 

homeless persons contacted. 

(Outcome)

FY 2014: 185,524

Target: 182,000 

(Target exceeded)

185,524 185,524 Maintain

3.4.17 Increase the percentage of 

contacted homeless persons with 

serious mental illness who become 

enrolled in services. (Outcome)

FY 2014: 58.0%

Target: 55.0% 

(Target exceeded)

58.0% 58.0% 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. 

(Output)

FY 2015: 1,676

Target: 4,360 

(Target not met)

2,296 2,296 Maintain
136

Department of Health and Human Services 

Substance Abuse and Mental Health Services Administration 

FY 2017 DISCRETIONARY STATE/FORMULA GRANTS

Projects for Assistance in Transition from Homelessness(PATH) 

CFDA # 93.150

State/Territory FY 2015

Actual

FY 2016

Enacted

FY 2017

President's

Budget

FY 2017 

(+/-) 

FY 2016

Alabama $613,000 $609,000 $609,000 $---

Alaska 300,000 300,000 300,000 ---

Arizona 1,349,000 1,341,000 1,341,000 ---

Arkansas 304,000 302,000 302,000 ---

California 8,809,000 8,760,000 8,760,000 ---

Colorado 1,019,000 1,013,000 1,013,000 ---

Connecticut 799,000 795,000 795,000 ---

Delaware 300,000 300,000 300,000 ---

District of Columbia 300,000 300,000 300,000 ---

Florida 4,332,000 4,308,000 4,308,000 ---

Georgia 1,669,000 1,660,000 1,660,000 ---

Hawaii 300,000 300,000 300,000 ---

Idaho 300,000 300,000 300,000 ---

Illinois 2,704,000 2,689,000 2,689,000 ---

Indiana 1,011,000 1,005,000 1,005,000 ---

Iowa 334,000 333,000 333,000 ---

Kansas 377,000 375,000 375,000 ---

Kentucky 469,000 466,000 466,000 ---

Louisiana 733,000 729,000 729,000 ---

Maine 300,000 300,000 300,000 ---

Maryland 1,271,000 1,264,000 1,264,000 ---

Massachusetts 1,558,000 1,550,000 1,550,000 ---

Michigan 1,729,000 1,719,000 1,719,000 ---

Minnesota 811,000 806,000 806,000 ---

Mississippi 300,000 300,000 300,000 ---

Missouri 893,000 888,000 888,000 ---

Montana 300,000 300,000 300,000 ---

Nebraska 300,000 300,000 300,000 ---

Nevada 616,000 612,000 612,000 ---

New Hampshire 300,000 300,000 300,000 ---
137

Department of Health and Human Services 

Substance Abuse and Mental Health Services Administration 

FY 2017 DISCRETIONARY STATE/FORMULA GRANTS

Projects for Assistance in Transition from Homelessness(PATH) 

CFDA # 93.150

State/Territory FY 2015

Actual

FY 2016

Enacted

FY 2017

President's 

Budget

FY 2017 

(+/-) 

FY 2016

New Jersey $2,137,000 $2,125,000 $2,125,000 $---

NewMexico 300,000 300,000 300,000 ---

NewYork 4,221,000 4,198,000 4,198,000 ---

North Carolina 1,379,000 1,371,000 1,371,000 ---

North Dakota 300,000 300,000 300,000 ---

Ohio 1,986,000 1,975,000 1,975,000 ---

Oklahoma 453,000 450,000 450,000 ---

Oregon 631,000 627,000 627,000 ---

Pennsylvania 2,366,000 2,353,000 2,353,000 ---

Rhode Island 300,000 300,000 300,000 ---

South Carolina 680,000 676,000 676,000 ---

South Dakota 300,000 300,000 300,000 ---

Tennessee 909,000 904,000 904,000 ---

Texas 4,993,000 4,966,000 4,966,000 ---

Utah 591,000 588,000 588,000 ---

Vermont 300,000 300,000 300,000 ---

Virginia 1,471,000 1,463,000 1,463,000 ---

Washington 1,329,000 1,321,000 1,321,000 ---

West Virginia 300,000 300,000 300,000 ---

Wisconsin 836,000 832,000 832,000 ---

Wyoming 300,000 300,000 300,000 ---

American Samoa 50,000 50,000 50,000 ---

Guam 50,000 50,000 50,000 ---

Northern Marianas 50,000 50,000 50,000 ---

Puerto Rico 891,000 886,000 886,000 ---

Virgin Islands 50,000 50,000 50,000 ---
138

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139

Protection and Advocacy for Individuals with Mental Illness(PAIMI)

(Dollars in thousands)

ProgramActivity

FY2015

Final

FY2016

Enacted

FY2017

President's

Budget

FY2017

+/- 

FY2016

Budget Authority..................................................................... $36,146 $36,146 $36,146 $---

Authorizing Legislation ................................................... The PAIMI Act, 42 U.S.C. 10801 et seq. 

FY 2017 Authorization .........................................................................................................Expired 

Allocation Method ................................................................................................... Formula Grants

Eligible Entities............................................................................................... States and Territories

Program Description and Accomplishments

The Protection and Advocacy for Individuals with Mental Illness (PAIMI) program is highly 

effective ensuring 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. The program 

ensures individuals receive the appropriate mental disorder treatment and discharge planning 

services they will need to facilitate their recovery and subsequent placement into the least 

restrictive, appropriate, community-based setting.

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 located in each state, territory, and the District of Columbia (Mayor). 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.

In FY 2014, the most recent data available, the PAIMI program met its target by successfully 

resolving complaints of alleged abuse, neglect, and rights violations 86.1 percent of the time.

In FY 2014, the 57 state PAIMI Programs:

• Served 13,936 PAIMI-eligible individuals/clients: 2,889 children and youth (ages 

0 to 18) and 10,284 adults (ages 19 to 64), and 763 older adults (age 65 and older). These 

individuals filed 11,454 complaints alleging abuse, neglect, and/or rights violations. 

• Of the closed 11,454 complaints: 3,290 of the allegations were not substantiated, lacked 

legal merit, or were withdrawn by the client; 8,304 were substantiated, including 1,632 
140

for abuse, 1,449 for neglect, and 5,223 for rights violation allegations.

• Resolved 89 percent of abuse, 81 percent of neglect allegations, and 89 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 health treatment; safer, cleaner facility environment; discharge into an appropriate 

community-based setting; and discharge from a nursing facility.

In FY 2014, SAMHSA continued to fund 57 annual grants to states and territories as well as 

continued technical assistance activities and support for grantees. This funding is level in FY 

2015 and FY 2016. 

Funding History

Fiscal Year Amount

FY 2013 $34,342,895

FY 2014 $36,146,000

FY 2015 $36,146,000

FY 2016 $36,146,000

FY 2017 $36,146,000

Budget Request

The FY 2017 Budget Request is $36.1 million. This is the same as the FY 2016 Enacted Level. 

Funding will support the continuation of the PAIMI grants in order to serve the same number of 

individuals, approximately 15,000, as in past years. These grantees protect and advocate 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. As in years past, PAIMI will also train and educate 

individuals on key topics such as seclusion and restraint or Olmstead implementation, or reach 

through contact with individuals who may be homeless or in state psychiatric hospitals 

approximately 140,000 individuals through the program.
141

Outputs and Outcomes Table

Program: Protection & Advocacy

NOTE: SAMHSA makes grant awards towards the end of the year. Therefore, the FY 2017 targets are based onthe 

FY 2016 Enacted Level and the FY 2018 targets are based on the FY 2017 President’sBudget.

Measure

Year and Most Recent Result

Target for Recent Result 

(Summary of Result)

FY 2017

Target

FY 2018

Target

FY 2018

Target

+/- 

FY 2017

Target

3.4.12 Increase the number of 

people served by the PAIMI 

program. (Outcome)

FY 2014: 13,936

Target: 16,499 

(Target not met)

15,192 15,192 Maintain

3.4.19 Increase the number 

attending public 

education/constituency training and 

public awareness activities. 

(Output)

FY 2014: 82,246

Target: 92,953 

(Target not met)

139,427 139,427 Maintain

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 2014: 72.6%

Target: 87.0% 

(Target not met )

88.0% 88.0% Maintain
142

Department of Health and Human Services 

Substance Abuse and Mental Health Services Administration 

FY 2017 DISCRETIONARY STATE/FORMULA GRANTS

Protection and Advocacy for Individuals with Mental Illness(PAIMI) 

CFDA # 93.138

State/Territory FY 2015

Actual

FY 2016

Enacted

FY 2017

President's 

Budget

FY 2017 

(+/-) 

FY 2016

Alabama $456,090 $456,202 $453,927 -$2,275

Alaska 428,000 428,000 428,000 ---

Arizona 616,908 620,810 626,647 +5,837

Arkansas 428,000 428,000 428,000 ---

California 3,156,787 3,133,536 3,140,455 +6,919

Colorado 433,624 437,326 438,135 +809

Connecticut 428,000 428,000 428,000 ---

Delaware 428,000 428,000 428,000 ---

District ofColumbia 428,000 428,000 428,000 ---

Florida 1,704,717 1,724,396 1,738,618 +14,222

Georgia 917,657 924,616 925,855 +1,239

Hawaii 428,000 428,000 428,000 ---

Idaho 428,000 428,000 428,000 ---

Illinois 1,075,584 1,068,437 1,066,611 -1,826

Indiana 599,111 601,509 600,014 -1,495

Iowa 428,000 428,000 428,000 ---

Kansas 428,000 428,000 428,000 ---

Kentucky 428,000 428,000 428,000 ---

Louisiana 428,000 428,000 428,000 ---

Maine 428,000 428,000 428,000 ---

Maryland 456,617 461,758 466,079 +4,321

Massachusetts 506,963 507,383 507,635 +252

Michigan 903,618 900,554 887,745 -12,809

Minnesota 444,348 447,204 445,862 -1,342

Mississippi 428,000 428,000 428,000 ---

Missouri 544,367 538,623 537,067 -1,556

Montana 428,000 428,000 428,000 ---

Nebraska 428,000 428,000 428,000 ---

Nevada 428,000 428,000 428,000 ---

New Hampshire 428,000 428,000 428,000 ---
143

Department of Health and Human Services 

Substance Abuse and Mental Health Services Administration 

FY 2017 DISCRETIONARY STATE/FORMULA GRANTS

Protection and Advocacy for Individuals with Mental Illness(PAIMI) 

CFDA # 93.138

State/Territory FY 2015

Actual

FY 2016

Enacted

FY 2017

President's 

Budget

FY 2017 

(+/-) 

FY 2016

New Jersey $681,414 $684,418 $678,274 -$6,144

NewMexico 428,000 428,000 428,000 ---

New York 1,525,779 1,522,543 1,522,025 -518

North Carolina 896,314 900,754 909,421 +8,667

North Dakota 428,000 428,000 428,000 ---

Ohio 1,031,064 1,026,130 1,019,427 -6,703

Oklahoma 428,000 428,000 428,000 ---

Oregon 428,000 428,000 428,000 ---

Pennsylvania 1,074,746 1,068,002 1,058,493 -9,509

Rhode Island 428,000 428,000 428,000 ---

South Carolina 452,783 455,079 457,932 +2,853

South Dakota 428,000 428,000 428,000 ---

Tennessee 586,600 587,219 588,845 +1,626

Texas 2,255,157 2,268,331 2,278,827 +10,496

Utah 428,000 428,000 428,000 ---

Vermont 428,000 428,000 428,000 ---

Virginia 666,587 672,622 671,615 -1,007

Washington 574,891 573,924 573,555 -369

West Virginia 428,000 428,000 428,000 ---

Wisconsin 498,588 496,018 494,780 -1,238

Wyoming 428,000 428,000 428,000 ---

American Samoa 229,300 229,300 229,300 ---

Guam 229,300 229,300 229,300 ---

Northern Marianas 229,300 229,300 229,300 ---

Puerto Rico 551,889 538,623 528,173 -10,450

Virgin Islands 229,300 229,300 229,300 ---

American Indian Con 229,300 229,300 229,300 ---
144

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145

Community Mental Health Services Block Grant (MHBG)

(Dollars in thousands)

ProgramActivity

FY2015

Final

FY2016

Enacted

FY2017

President's 

Budget

FY2017

+/- 

FY2016

CommunityMentalHealthServicesBlockGrant....................

PHSEvaluationFunds(non-add)...............................

$482,571

21,039

$532,571

21,039

$532,571

21,039

$---

---

Authorizing Legislation ...........................................Section 1911 of the Public Health Service Act 

FY 2017 Authorization .........................................................................................................Expired 

Allocation Method .....................................................................................................Formula Grant

Eligible Entities.........................States, Territories, Freely Associated States, District of Columbia 

Program Description and Accomplishments

Behavioral health problems are more common in the United States than is generally realized. 

According to the 2014 Behavioral Health Barometer: United States, approximately 4.2 percent 

of U.S. adults (an estimated 10.0 million individuals) reported having serious mental illness 

(SMI) within the year prior to being surveyed.79,80 Nearly a third of these individuals did not 

receive any services in the year before being surveyed.81

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.82 Recipients of MHBG funds must develop 

comprehensive community mental health service plans and support Mental Health Planning 

Councils that include consumers of mental health services and family members. The MHBG 

distributes funds for a variety of services and for planning, administration, and educational

activities. 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 vulnerable 

populations (e.g., individuals, who are homeless, those in rural and frontier areas, military

79 Substance Abuse and Mental Health Services Administration, Results from the 2013 National 

Survey on Drug Use and Health: Mental Health Findings, NSDUH Series H-49, HHS 

Publication No. (SMA) 14-4887. Rockville, MD: Substance Abuse and Mental Health Services 

Administration, 2014. 80 Substance Abuse and Mental Health Services Administration. Behavioral Health Barometer: United States, 2014. 

HHS Publication No. SMA–15–4895. Rockville, MD: Substance Abuse and Mental Health ServicesAdministration 81 Substance Abuse and Mental Health Services Administration, Results from the 2013 National Survey on Drug

Use and Health: Mental Health Findings, NSDUH Series H-49, HHS Publication No. (SMA) 14-4887.Rockville, 

MD: Substance Abuse and Mental Health Services Administration, 2014. 82 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 foundon 

SAMHSA’s Web site at http://www.samhsa.gov/grants/block-grants
146

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 vulnerable populations across the country. Together, SAMHSA’s 

block grants support the provision of services and related support activities to approximately 

seven million 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 critical 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. For example, planning, coordination, needs 

assessment, quality assurance, program development, training, and evaluation are all important 

activities that are necessary to develop and maintain an effective public health system for mental 

health services but not generally supported by Medicaid or other programs. The MHBG statute 

requires a five percent set-aside of the MHBG allocation 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 and use of health information technology and integration of physical and behavioral 

health services.

SAMHSA encourages states to use block grant resources to support and not supplant services 

that commercial and public insurer plans cover. SAMHSA’s MHBG and Substance Abuse 

Prevention and Treatment Block Grant (SABG) applications aligns with changes in federal/state 

environments, including the impacts of the Affordable Care Act, the Mental Health Parity and 

Addiction Equity Act (MHPAEA), and the Tribal Law and Order Act (TLOA). The new design 

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.83,84 Permitting MHBG recipients 

to submit the application/plan biennially reduces the burden on states.

States received the FY 2016 to FY 2017 Block Grant Application on July 1, 2015 to further 

efforts to have states use and report the opportunities offered under various federal initiatives. 

The FY 2016 and FY 2017 Block Grant Application continues to allow states to submit one 

application for both the mental health and substance abuse block grants as well as a biennial plan 

for the state mental and substance use disorder treatment systems. This application also reflects 

the Affordable Care Act’s strong emphasis on coordinated and integrated care along with the 

83 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). 84 State Plan (Sec. 1932 (b) of Title XIX, Part B, Subpart II of the Public Health Service (PHS) Act (42 USC § 300x32(b)).
147

need to improve services for persons facing behavioral health crises. Under the application, 

SAMHSA Block Grant funds have four purposes: 

1) To fund priority treatment and support services for individuals without insurance or for 

whom coverage is terminated for short periods of time;

2) To 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;

3) For the Substance Abuse Prevention and Treatment Block Grant: to fund primary 

prevention-universal, selective, and indicated prevention activities and services for 

individuals not identified as needing treatment; and

4) To collect performance and outcome data to determine the ongoing effectiveness of 

behavioral health promotion, treatment, and recovery support services and to plan the 

implementation of new services on a nationwide basis.

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 has been working with states and state representative organizations to identify and 

implement a core set of measures, which include approved quality measures, to assess outcomes 

and quality in programming. This effort has sought to both guide and align the measurement 

requirements of other major service purchasers, such as Medicaid and Medicare, and thus 

facilitate efficiencies in state reporting of behavioral health quality measures to federal entities. 

It is anticipated that once implemented, states will develop an implementation plan – both 

general to all states and unique to their particular state – regarding the specifics and realities of 

how these measures are being collected and reported, as well as how this effort is being 

coordinated with required reporting activities from Medicaid, Medicare, and other public payers.

There are many individuals, both adolescent and adult, with co-occurring mental illness and 

substance use disorders. In recognition of this, SAMHSA strongly encourages coordination 

between MHBG programs and those supported by the Substance Abuse Prevention and 

Treatment Block Grant (SABG) as well as other SAMHSA-funded efforts such as the systems of

care for children and adolescents supported through the Child 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 2014 show that:

• For the 57 states and territories that reported data in the Employment Domain,

17.9 percent of the mental health consumers were in competitive employment;

• For the 58 states and territories that reported data in the Housing Domain, 78.8 percent of 

the mental health consumers were living in private residences;
148

• For the 59 states and territories that reported data in the Access/Capacity Domain, state 

mental health agencies provided mental health services for approximately 22 people per 

1,000 population; 

• For the 51 states and territories that reported data in the Retention Domain, only 

8.2 percent of the patients returned to a state psychiatric hospital within 30 days of state 

hospital discharge; and

• For the 50 states and territories that reported data in the Perception of Care Domain, 

70.9 percent of adult mental health consumers improved functioning as a direct result of 

the mental health services they received.

An independent evaluation of the MHBG demonstrated that funds allow states to explore new 

innovations and strategies; target emerging needs with special programs; pay for recoveryfocused and consumer-centered services not covered by commercial insurance, Medicaid, or 

Medicare; and create the administrative, organizational, or service delivery linkages that foster a 

community-based, transformed system of mental health services. The program study is complete 

and the final report is available on the SAMHSA website 

(http://store.samhsa.gov/shin/content//SMA10-4610/SMA10-4610.pdf).

Set-aside for Evidence-based Programs That Address 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.”85 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 promising 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. The additional funds

provided to the MHBG program fully offset the increase in the set aside.

85 http://www.samhsa.gov/sites/default/files/mhbg-5-percent-set-aside-guidance.pdf
149

Funding History

Fiscal Year Amount

FY 2013 $436,808,709

FY 2014 $482,571,000

FY 2015 $482,571,000

FY 2016 $532,571,000

FY 2017 $532,571,000

Budget Request

The FY 2017 Budget Request is $532.6 million, the same as the FY 2016 Enacted Level. 

SAMHSA proposes to support the continuation of the Community Mental Health Services Block 

Grant and plans to serve 7,620,000 adults with serious mental illness and children with serious 

emotional disturbances through the public mental health system. In FY 2017, SAMHSA 

proposes to maintain the 10 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.
150

Outputs and Outcomes Table

Program: Mental Health Block Grant

NOTE: SAMHSA makes grant awards towards the end of the year. Therefore, the FY 2017 targets are based onthe 

FY 2016 Enacted Level and the FY 2018 targets are based on the FY 2017 President’sBudget.

Measure

Year and Most Recent Result

Target for Recent Result 

(Summary of Result)

FY 2017

Target

FY 2018

Target

FY 2018

Target

+/- 

FY 2017

Target

2.3.11 Increase the number of 

evidence-based practices (EBPs) 

implemented. (Output)

FY 2014: 4.3 per State 

Target: 4.2 per State

(Target exceeded)

4.5 per 

State

4.5 per 

State

Maintain

2.3.14 Increase the number of 

people served by the public mental 

health system. (Output)

FY 2014: 7,296,842

Target: 6,340,320 

(Target exceeded)

7,620,000 7,620,000 Maintain

2.3.15 Increase the rate of 

consumers (adults) reporting 

positively about outcomes. 

(Outcome)

FY 2014: 71.3%

Target: 72.0%

(Target not m but improved)

71.8% 71.8% Maintain

2.3.16 Increase the rate of family 

members (children/adolescents) 

reporting positively about 

outcomes. (Outcome)

FY 2014: 67.3%

Target: 67.0% 

(Target exceeded)

66.1% 66.1% Maintain

2.3.81 Increase the percentage of 

service population receiving any 

evidence-based practice. 

(Outcome)

FY 2014: 10.8%

Target: 7.2% 

(Target exceeded)

10.8% 10.8% Maintain
151

Department of Health and Human Services 

Substance Abuse and Mental Health Services Administration 

FY 2017 DISCRETIONARY STATE/FORMULA GRANTS

Community Mental Health Services Block Grant Program 

CFDA #93.958

State/Territory

FY2015

Actual

FY2016

Enacted

FY2017

President's

Budget

FY2017 

(+/-)

FY2016

Alabama $6,646,898 $7,351,221 $7,352,060 +$839

Alaska 793,287 972,230 1,070,196 +97,966

Arizona 10,737,941 11,639,880 12,226,159 +586,279

Arkansas 4,227,658 4,483,965 4,557,692 +73,727

California 63,093,869 69,180,482 70,226,872 +1,046,390

Colorado 6,900,325 8,482,852 8,373,549 -109,303

Connecticut 4,785,704 5,237,154 5,299,684 +62,530

Delaware 1,042,835 1,417,398 1,524,264 +106,866

District of Columbia 927,814 1,057,109 1,158,138 +101,029

Florida 31,701,900 33,793,628 34,752,383 +958,755

Georgia 14,325,637 17,179,928 16,682,768 -497,160

Hawaii 2,368,691 2,636,917 2,823,874 +186,957

Idaho 2,561,105 2,378,674 2,436,321 +57,647

Illinois 17,158,047 19,839,321 19,434,267 -405,054

Indiana 8,381,873 9,110,702 9,024,235 -86,467

Iowa 3,686,277 4,067,863 4,051,196 -16,667

Kansas 3,454,659 3,771,945 3,811,757 +39,812

Kentucky 6,357,925 6,628,893 6,589,016 -39,877

Louisiana 5,513,361 6,183,159 6,182,022 -1,137

Maine 1,802,317 2,009,425 2,028,145 +18,720

Maryland 9,032,488 8,532,072 8,643,115 +111,043

Massachusetts 9,971,207 10,493,458 10,070,209 -423,249

Michigan 14,515,920 16,018,438 15,626,940 -391,498

Minnesota 7,089,713 7,862,764 7,551,467 -311,297

Mississippi 4,187,582 4,674,359 4,623,816 -50,543

Missouri 7,793,723 8,562,000 8,473,492 -88,508

Montana 1,359,717 1,497,654 1,545,887 +48,233

Nebraska 2,103,021 2,325,306 2,337,539 +12,233

Nevada 4,651,021 5,075,524 5,395,342 +319,818

New Hampshire 1,841,227 1,808,281 1,813,702 +5,421
152

Department of Health and Human Services 

Substance Abuse and Mental Health Services Administration 

FY 2017 DISCRETIONARY STATE/FORMULA GRANTS

Community Mental Health Services Block Grant Program 

CFDA #93.958

State/Territory

FY2015

Actual

FY2016

Enacted

FY2017

President's

Budget

FY2017 

(+/-)

FY2016

New Jersey $12,975,405 $14,331,474 $13,992,766 -$338,708

New Mexico 2,791,090 2,995,653 3,080,291 +84,638

New York 28,236,385 32,425,192 31,373,445 -1,051,747

North Carolina 12,834,233 14,308,507 14,347,012 +38,505

North Dakota 816,996 879,581 889,532 +9,951

Ohio 15,076,166 16,292,879 15,897,769 -395,110

Oklahoma 4,978,056 5,434,052 5,483,485 +49,433

Oregon 5,983,509 6,726,815 6,885,888 +159,073

Pennsylvania 16,252,021 17,997,348 17,761,900 -235,448

Rhode Island 1,749,226 1,862,535 1,856,552 -5,983

South Carolina 6,656,055 7,435,778 7,495,762 +59,984

South Dakota 947,022 1,051,067 1,083,411 +32,344

Tennessee 8,802,254 10,325,846 10,311,592 -14,254

Texas 36,712,474 40,925,451 41,153,437 +227,986

Utah 3,490,243 3,858,877 3,972,584 +113,707

Vermont 821,044 896,094 905,085 +8,991

Virginia 11,372,201 11,578,454 11,244,868 -333,586

Washington 10,443,964 11,606,420 11,908,638 +302,218

West Virginia 2,646,507 2,906,084 2,889,218 -16,866

Wisconsin 7,274,287 8,440,552 8,267,157 -173,395

Wyoming 535,764 543,194 607,956 +64,762

American Samoa 88,293 98,148 98,343 +195

Guam 256,962 287,665 290,429 +2,764

Marshall Islands 110,039 125,103 128,046 +2,943

Micronesia 171,112 190,316 190,638 +322

Northern Marianas 82,585 91,782 92,870 +1,088

Palau 50,000 50,000 50,000 ---

Puerto Rico 5,930,860 6,539,088 6,531,728 -7,360

Virgin Islands 169,164 187,864 187,912 +48
153

Evidence-based Early Interventions

(Dollars in thousands)

Program Activity

FY 2015

Final

FY 2016

Enacted

FY 2017

President's 

Budget

FY 2017

+/- 

FY 2016

Evidence-based Early Interventions (Mandatory) .................. --- --- $115,000 +$115,000

Authorizing Legislation ......................................................................................New Authorization 

FY 2017 Authorization .......................................................................................New Authorization 

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

Eligible Entities................................................................. States, Tribes, Communities, Territories

Program Description and Accomplishments

Less than half of children and adults with diagnosable mental health problems receive the 

treatment they need. As part of the Administration’s $500.0 million initiative to increase access 

to mental health services, this effort would help engage individuals with serious mental illness in 

care. 

This proposal will fund a new formula grant for states to support evidence-based early 

intervention programs for individuals with serious mental illnesses (SMI). Significant delays in 

the identification and treatment of SMI are common; for example, research has repeatedly found 

that individuals with psychosis often do not receive appropriate treatment for that condition for 

over a year. This delay in treatment worsens long-term outcomes for people experiencing these 

conditions affecting their behavioral health, physical health, and achievement of education and 

employment goals. The five percent set-aside in the Community Mental Health Services Block 

Grant for early intervention programs required by Congress through the FY 2014 and FY 2015 

appropriations laws has been very effective in increasing the availability of programs to engage 

people with SMI in care earlier than has generally been the case. The FY 2016 appropriations 

law increases the set-aside to 10 percent. As of 2016, 32 states have established early 

intervention programs, compared to two states that had such programs in 2008. Many of these 

new programs build on recent research funded by NIMH, namely the Recovery After an Initial 

Schizophrenia Episode (RAISE) project. Participants in this study showed improvements in both 

symptoms and quality of life and were more likely to be working or going to school. However, 

in a significant number of states, even with the increase of the set-aside to 10 percent, the amount 

of funding provided will be insufficient to establish and operate even one early intervention 

program, which generally requires about $700,000 a year. Working in collaboration with setaside funded activities, this new formula grant would provide additional funds to enable all states 

to establish supports and services for early intervention and enable states that already have 

programs to expand their efforts. SAMHSA would administer this new formula grant program to

support evidence-based early intervention services. SAMHSA plans to award a minimum of 

$700,000 to each state and a tribal set-aside.
154

Funding History

Fiscal Year Amount

FY 2013 ---

FY 2014 ---

FY 2015 ---

FY 2016 ---

FY 2017 $115,000,000

Budget Request

The FY 2017 Budget Request is $230.0 million in new mandatory funding, as part of the 

Administration’s $500.0 million initiative to increase access to mental health care. This includes 

$115.0 million in FY 2017 and FY 2018. Working in collaboration with set-aside funded 

activities, this new formula grant would provide additional funds to enable all states to establish 

supports and services for early intervention and enable states that already have programs to 

further expand their efforts. SAMHSA would administer this new formula grant program to 

support evidence-based early intervention services. Plans include a minimum of $700,000 to 

each state and a tribal set-aside. This request is part of the Administration’s $500.0 million twoyear initiative to improve mental health services and to engage individuals with serious mental 

illness into care.
155

SAMHSA

Substance Abuse Prevention 

Table of Contents

1. Substance Abuse Prevention Appropriation ........................................................................ 157

2. Programs of Regional and National Significance (PRNS) .................................................. 158

a) Strategic Prevention Framework..................................................................................... 159

b) Federal Drug-Free Workplace ........................................................................................ 165

c) Minority AIDS ................................................................................................................ 167

d) Sober Truth on Preventing Underage Drinking Act (Stop Act)...................................... 171

e) Fetal Alcohol Spectrum Disorders (FASD).................................................................... 174

f) Center for the Application of Prevention Technologies................................................. 176

g) Science and Service Program Coordination ................................................................... 180

h) Tribal Behavioral Health Grants..................................................................................... 181

i) Grants to Prevent Prescription Drug/Opioid Overdose Related Deaths......................... 185

3. PRNS Mechanism Table Summary ..................................................................................... 188

4. PRNS Mechanism Table by Program, Project, and Activity............................................... 189
156

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157

Substance Abuse Prevention Appropriation

(Dollars in thousands)

Program Activities

FY2015

Final

FY2016

Enacted

FY2017

President's 

Budget

FY2017

+/- 

FY2016

Programs of Regional and NationalSignificance.... $175,148 $211,148 $211,148 $---

PHS Evaluation Funds(non-add).................. --- --- 16,468 +16,468

Total, Substance Abuse Prevention1............... $175,148 $211,148 $211,148 $--- 1 The Minority Fellowship Program budget appears in the Health Surveillance and Program Support appropriation, 

Agency-wide Initiatives Workforce program. This is consistent with the FY 2017 Budget Request.

The Substance Abuse Prevention appropriation FY 2017 Budget Request of $211.1 million is 

level with the FY 2016 Enacted level. The request includes $194.6 million in Budget Authority 

and $16.5 million in PHS Evaluation Funds. 
158

Programs of Regional and National Significance (PRNS)

Substance Abuse Prevention Appropriation

(Dollars in thousands)

Programs of Regional & National Significance

FY2015

Final

FY2016

Enacted

FY2017

President's 

Budget

FY2017

+/- 

FY2016

CAPACITY

Strategic PreventionFramework........................................................... $109,484 $119,484 $119,484 $---

Strategic Prevention Framework Rx (non-add)............................. --- 10,000 10,000 ---

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

GrantstoPreventPrescriptionDrug/OpioidOverdoseRelatedDeaths.. --- 12,000 12,000 ---

FederalDrug-FreeWorkplace............................................................. 4,894 4,894 4,894 ---

MinorityAIDS..................................................................................... 41,205 41,205 41,205 ---

SoberTruthonPreventingUnderageDrinkingAct(StopAct)............. 7,000 7,000 7,000 ---

Tribal Behavioral HealthGrants............................................................ --- 15,000 15,000 ---

Subtotal, Capacity 162,583 199,583 199,583 ---

SCIENCE AND SERVICE

FetalAlcoholSpectrumDisorder.......................................................... 1,000 --- --- ---

Center for the Application of Prevention Technologies .......................... 7,493 7,493 7,493 ---

PHS Evaluations Funds(non-add).............................................. --- --- 6,468 +6,468

Science and Service ProgramCoordination........................................... 4,072 4,072 4,072 ---

Subtotal, Science and Service 12,565 11,565 11,565 ---

TOTAL, PRNS 1 $175,148 $211,148 $211,148 $---

1 TheMinorityFellowshipProgrambudgetappearsintheHealthSurveillanceandProgramSupportappropriation,Agency-wideInitiatives 

Workforceprogram. ThisisconsistentwiththeFY2017BudgetRequest.

Authorizing Legislation ................................................. Sections 516, 519B, 519D of the PHS Act 

FY 2017 Authorization .........................................................................................................Expired 

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

Eligible Entities...................... States, Tribes, Communities, and Private Non-Profit Organizations 
159

Strategic Prevention Framework

(Dollars in thousands)

Programs of Regional & NationalSignificance

FY2015

Final

FY2016

Enacted

FY2017

President's 

Budget

FY2017

+/- 

FY2016

Strategic Prevention Framework............................................................ $109,484 $119,484 $119,484 $---

Strategic Prevention Framework Rx (non-add).............................. --- 10,000 10,000 ---

PHS Evaluations Funds(non-add).................................................. --- --- 10,000 +10,000

Authorizing Legislation ........................................................................ Section 516 of the PHS Act 

FY 2017 Authorization .........................................................................................................Expired 

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 substance use disorder, risky sexual behavior, illnesses such 

as HIV and hepatitis, depression and anxiety, and injury and death. The immediate and longterm 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 FY 2014, 27.0 million people ages 12 or 

older used an illicit drug in the past 30 days, which corresponds to about 1 in 10 Americans 

(10.2 percent). In the same year, an estimated 4.3 million people ages 12 or older reported 

current nonmedical use of prescription pain relievers.86 The Strategic Prevention Framework – 

State Incentive Grant (SPF-SIG) program is a prevention and intervention tool, which provides a 

foundation for the success of the Strategic Prevention Framework - Partnerships for Success

(SPF-PFS) program. Initiated in FY 2009, the SPF-SIG program was an infrastructure and

service delivery grant program that supported 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 two of the 

nation’s top substance use prevention priorities: underage drinking among youth and young 

adults age 12 to 20 and prescription drug misuse among individuals ages 12 to 25. Additionally, 

this program allows states to address other substance use issues such as heroin, marijuana, and 

inhalants. 

Data show that states and communities receiving Partnerships For Success funding have made 

improvements in reducing the impact of substance use. The 2014 National Survey on Drug 

Use

86 Substance Abuse and Mental Health Services Administration, Results from the 2013 National

Survey on Drug Use and Health: Summary of National Findings, NSDUH Series H-48, HHS PublicationNo. 

(SMA) 14-4863. Rockville, MD: Substance Abuse and Mental Health Services Administration, 2014.
160

and Health (NSDUH) report 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 2014, 22.8 percent of underage people reported current use of alcohol, 

13.8 percent reported binge drinking, and 3.4 percent reported heavy alcohol use. The bingedrinking rate declined from 19.3 percent to 14.2 percent, and the rate of heavy drinking declined 

from 6.2 percent to 3.7 percent.87

In addition, the overall rate of non-medical use of prescription drugs such as pain relievers, 

tranquilizers, stimulants, and sedatives, has remained nearly constant over the last two years. In 

2014, the percent of people aged 12 or older who reported current nonmedical use of pain 

relievers (1.6 percent) was lower than the percentages in most years from 2002 to 2012, but was 

similar to the percentage in 2013.88 Prescription drug and opioid misuse continues to be a 

concern, as overdose deaths increase. These data highlight the continued need for targeted

strategies geared toward educating families about the dangers of prescription drug and opioid 

interactions, educating consumers and prescribers about the dangers of high-risk prescribing, 

ensuring proper training of first responders, and implementing drug take back programs.

Trends in substance use often coincide with trends in perceived risk. If individuals believe using 

a particular substance is risky, they will be less likely to use it, and vice versa. Given the 

influence of perceived risk on use, perceived risk is an important factor to monitor. 

Over the past five years, the perceived risk related to marijuana use has decreased. Between 

2007 and 2013, the percentage of youth aged 12 to 17 who believe there is a great risk in 

smoking marijuana once a month decreased from 34.4 percent to 24.2 percent. During the same 

time period, the number of youth who perceived great risk in smoking marijuana once or twice a 

week also decreased from 54.6 percent to 39.5 percent. As the perceived risk has decreased, the 

percentage of youth that used marijuana in the past month has increased from 6.7 percent to

7.1 percent.89

This correlation between perceived risk and substance use informed the design and 

implementation of SAMHSA’s FY 2015 Partnerships For Success program. As in 2014, the 

program continued to address underage drinking and prescription drug misuse among youth and 

young adults. However, in FY 2015, grantees were also encouraged to address issues related to 

marijuana and heroin use. 

Preliminary findings from the cross-site evaluation for the Partnership For Success program will 

be available in September 2016. The evaluation is addressing the following questions: 

87 Substance Abuse and Mental Health Services Administration, Results from the 2013 National

Survey on Drug Use and Health: Summary of National Findings, NSDUH Series H-48, HHS Publication No. 

(SMA) 14-4863. Rockville, MD: Substance Abuse and Mental Health Services Administration, 2014.

88 Substance Abuse and Mental Health Services Administration, Results from the 2013 National

Survey on Drug Use and Health: Summary of National Findings, NSDUH Series H-48, HHS Publication No. 

(SMA) 14-4863. Rockville, MD: Substance Abuse and Mental Health Services Administration, 2014. 

89 http://www.samhsa.gov/data/sites/default/files/NSDUHresultsPDFWHTML2013/Web/

NSDUHresults2013.pdf
161

1) Was the implementation of Partnerships For Success 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 Partnerships For Success 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 costeffective 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 2015, SAMHSA funded 38 new Strategic Prevention Framework grants and 34 grant 

continuations. In FY 2016, SAMHSA is supporting 63 Strategic Prevention Framework grant 

continuations. 

Strategic Prevention Framework for Prescription Drugs (SPF Rx)

Drug overdose death rates have increased five-fold since 1980.90 Since 2000, the drug overdose 

death rates have continued to increase and have more than doubled.91 In 2009, drug overdose 

deaths outnumbered deaths due to motor vehicle crashes for the first time. In the U.S., misuse of 

prescription drugs, including opioid-analgesic pain relievers, is responsible for much of the 

recent increase in drug-poisoning deaths.92 Opioid painkillers were involved in 30 percent of 

drug overdose deaths where a drug was specified in 1999, compared to nearly 70 percent in

In 2011, opioid analgesics were involved in 41 percent of drug poisoning deaths (16,917 

deaths). In 2013, opioid analgesics-related deaths decreased to 37 percent (16,235 deaths). 

Historically, CDC has programmatically characterized all opioid pain reliever deaths (natural and 

semisynthetic opioids, methadone, and other synthetic opioids) as "prescription" opioid 

overdoses.94 Between 2013 and 2014, the age-adjusted rate of death involving methadone 

remained unchanged; however, the age-adjusted rate of death involving natural and 

semisynthetic opioid pain relievers, heroin, and synthetic opioids, other than

90 Warner M, Chen LH, Makuc DM, Anderson RN, Miniño AM. Drug poisoning deaths in the United States, 1980– 

2008. NCHS data brief, no 81. Hyattsville, MD: National Center for Health Statistics.2011.

91 Centers for Disease Control and Prevention. NCHS Data on Drug Poisoning Deaths. NCHS Fact Sheet. June 

2015. Hyattsville, MD: National Center for Health Statistics. 2015. Available at

http://www.cdc.gov/nchs/data/factsheets/factsheet_drug_poisoning.pdf.

92 Paulozzi LJ. Prescription drug overdoses: A review. J. Safety Res 43(4):283–9. 2012.

93 Centers for Disease Control and Prevention. NCHS Data on Drug Poisoning Deaths. NCHS Fact Sheet. June 

2015. Hyattsville, MD: National Center for Health Statistics. 2015. Available at 

http://www.cdc.gov/nchs/data/factsheets/factsheet_drug_poisoning.pdf.

94 Paulozzi LJ, Jones C, Mack K, Rudd R. Vital signs: overdoses of prescription opioid pain relievers—United

States, 1999–2008. MMWR Morb Mortal Wkly Rep 2011; 60:1487–92.
162

methadone (e.g., fentanyl) increased 9 percent, 26 percent, and 80 percent, respectively.95 

Prescription opioid-related overdose deaths now outnumber overdose deaths involving all illicit 

drugs combined.96 Due to these alarming trends, SAMHSA is prioritizing efforts to address 

prescription drug misuse and overdose deaths.

According to the 2014 NSDUH survey, 2.5 percent or 6.5 million individuals in the U.S. who are 

12 or older used prescription drugs non-medically in the past month, including (1.6 percent) use 

of pain relievers, (0.7 percent) use of tranquilizers, (0.6 percent) use of stimulants, and 

(0.1 percent) use of sedatives. Rates of non-medical use of prescription drugs in the past month 

are highest (4.8 percent) among individuals who are 18 to 25 years old. According to the 

Treatment Episode Data Set, in 2012, nearly 10 percent of individuals who entered substance use 

disorder treatment facilities reported pain relievers (non-heroin opioids/synthetics) as the primary 

substance of abuse.97

Funding for SAMHSA and the Centers for Disease Control and Prevention (CDC) in FY 2015 

was part of a strategic effort to address non-medical use of prescription drugs as well as opioid 

overdoses. Leveraging the strengths and capabilities of each agency, SAMHSA and CDC 

coordinated to ensure alignment with HHS’s policy and plan for prevention of opioid-related 

overdoses and deaths involving multiple operating divisions and offices. CDC provided funding 

to states to address opioid prescribing on multiple fronts, and SAMHSA provided funding to 

states for the prevention of prescription drug misuse in high priority age groups (including young 

and middle-aged adults) and the public through the Strategic Prevention Framework –

Partnership For Success program.

In FY 2016, SAMHSA is implementing 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 will also focus on raising community awareness and bringing prescription 

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

their patients. SAMHSA will also track reductions in opioid overdoses and the incorporation of 

Prescription Drug Monitoring Program (PDMP) data into needs assessments and strategic plans 

as indicators of program success. SMAHSA plans to award up to 29 grants.

95 Rose A. Rudd, MSPH; Noah Aleshire, JD; Jon E. Zibbell, PhD; R. Matthew Gladden, PhD ; Increases in Drug and 

Opioid Overdose Deaths — United States, 2000–2014, Morbidity and Mortality Weekly. Report. 2016; 

64(50):1378- 1382. 96 Centers for Disease Control and Prevention. Vitalsigns [database]. Atlanta, GA: US Department of Health and 

Human Services, Centers for Disease Control and Prevention; 2015. Available at 

http://www.cdc.gov/drugoverdose/data/overdose.html 97http://www.samhsa.gov/data/sites/default/files/2002_2012_TEDS_National/2002_2012_Treatment_Episode_Data

_Set_National_Tables.htm
163

Funding History

Fiscal Year Amount

FY 2013 $107,901,699

FY 2014 $109,484,000

FY 2015 $109,484,000

FY 2016 $119,484,000

FY 2017 $119,484,000

Budget Request

The FY 2017 Budget Request is $119.5 million with $109.5 million from Budget Authority and

$10.0 million from Public Health Service Evaluation Funds. This is the same as the FY 2016 

Enacted Level. Funding will support up to 29 Strategic Prevention Framework for Prescription 

Drugs continuation grants, technical assistance, and evaluation to build capacity to address 

prescription drug misuse and overdose prevention efforts, in conjunction with other state and 

local partners. In FY 2017, SAMHSA will also support the continuation of 70 Strategic 

Prevention Framework - Partnerships For Success grants to decrease the impact of underage 

drinking and prescription drug misuse while lessening the progression of emergent issues such as 

heroin and marijuana use.

Outputs and Outcomes Tables 

Program: Partnerships for Success

NOTE: SAMHSA makes grant awards towards the end of the year. Therefore, the FY 2017 targets are based on the 

FY 2016 Enacted Level and the FY 2018 targets are based on the FY 2017 President’sBudget.

1 Preliminary estimate. 2 Estimate, data available in March, 2016.

Measure

Year and Most Recent Result 

Target for Recent Result

(Summary of Result)

FY 2017

Target

FY 2018

Target

FY 2018

Target

+/-

FY 2017

Target

2.3.78 Increase the number of 

communities who report an increase 

in prevention activities that are 

supported by collaboration and 

leveraging of funding streams. 

(Output)

FY 2014: 891

Target: 50 

(Target not met)

200 200 Maintain

2.3.79 Increase the number of EBPs 

implemented by sub-recipient 

communities. (Output)

FY 2014: 582

Target: 950 

(Target not met)

1,400 1,400 Maintain

2.3.80 Increase the number of subrecipient communities that 

improved on one or more targeted 

NOMs indicators. (Outcome)

FY 2013: 45

Target: 50

(Target not met but improved)

200 200 Maintain
164

Outputs and Outcomes Tables

Program: Strategic Prevention Framework Rx

NOTE: SAMHSA makes grant awards towards the end of the year. Therefore, the FY 2017 targets are based on the 

FY 2016 Enacted Level and the FY 2018 targets are based on the FY 2017 President’sBudget.

Measure

Year and Most Recent Result

Target for Recent Result 

(Summary of Result)

FY 2017

Target

FY 2018

Target

FY 2018

Target

+/-

FY 2017

Target

3.3.11 Increase the percent of 

funded states that incorporate 

PDMP data into their needs 

assessments in developing their 

strategic plans. (Outcome)

FY 2016: Result expected 

August 31, 2017

Target: 100.0% 

(Pending)

100.0% 100.0% Maintain

3.3.12 Increase the percent of 

funded states reporting reductions in 

opioid overdoses. (Outcome)

FY 2016: Result expected 

August 31, 2017

Target: 55.0% 

(Pending)

55.0% 55.0% Maintain
165

Federal Drug-Free Workplace

(Dollars in thousands)

Programs of Regional & National Significance

FY2015

Final

FY2016

Enacted

FY2017

President's 

Budget

FY2017

+/-

FY2016

Federal Drug-Free Workplace............................................................... $4,894 $4,894 $4,894 $---

Authorizing Legislation ........................................................................ Section 516 of the PHS Act 

FY 2017 Authorization .........................................................................................................Expired

Allocation Method .................................................................. Inter-AgencyAgreements/Contracts

Eligible Entities...................................................................... Federal Agencies, RegulatedEntities 

(e.g., Department of Transportation, Nuclear Regulatory Commission),

HHS- Certified Laboratories

Program Descriptions and Accomplishments

Alcohol and other drug use is widespread and has 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 drugfree. 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, 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.
166

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 drug-free 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.

SAMHSA funded the Drug-Free Workplace drug testing activities in FY 2014 and FY 2015. 

These activities will continue in FY 2016 under the NLCP contract. The NLCP oversees the 

certification of the labs that perform drug testing under the Drug-Free Workplace Programs. The 

Drug Testing Advisory Board (DTAB) provides recommendations to the SAMHSA 

Administrator 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). CSAP’s 

Workplace Helpline supports the drug-free workplace program. The helpline is a toll-free 

telephone service (800-WORKPLACE) that answers questions from the public and private 

sectors about drug testing in the workplace.

In FY 2015 and FY 2016, continued funding for the Federal Drug-Free Workplace Programs 

ensured the testing of federal employees in national security, public health, and public safety 

positions for the use of illegal, the misuse of prescription drugs, and the inspection certification 

of HHS-certified laboratories.

Funding History

Fiscal Year Amount

FY 2013 $5,251,583

FY 2014 $4,894,000

FY 2015 $4,894,000

FY 2016 $4,894,000

FY 2017 $4,894,000

Budget Request

The FY 2017 Budget Request of $4.9 million is the same as the FY 2016 Enacted Level. In 

FY 2017, SAMHSA will continue oversight of the Executive Branch Agencies’ Federal DrugFree Workplace Programs. This includes review of Federal Drug-Free Workplace plans from 

those federal agencies that perform federal employee testing, perform random testing of those 

designed testing positions of national security, public health, and public safety, and perform 

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.
167

SAMHSA will continue/add the below items to its drug testing portfolio:

• DTAB’s 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 Urine Specimen Mandatory Guidelines;

• Implementation of the final Oral Fluid Specimen Mandatory Guidelines;

• Development of a Marijuana Toolkit for public use;

• Technical and scientific leadership for federal agencies on marijuana testing; and

• Updates to the DFWP website.

Minority AIDS

(Dollars in thousands)

Programs of Regional & National Significance

FY 2015

Final

FY 2016

Enacted

FY 2017

President's 

Budget

FY 2017

+/-

FY 2016

Minority AIDS....................................................................................... $41,205 $41,205 $41,205 $---

Authorizing Legislation ........................................................................ Section 516 of the PHS Act 

FY 2017 Authorization .........................................................................................................Expired

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

Eligible Entities................................Local Government Entities, Community-based Organization,

Minority Serving Institutions, 

and Institutions of Higher Education

Program Description and Accomplishments

The update to the 2010 National HIV/AIDS Strategy for the United States reports that there is 

still an HIV epidemic, which remains a major health issue for the United States. It also notes that

people across the nation deserve access to tools and education to prevent HIV transmission.98 in

1995, 44 percent of the public indicated that HIV/AIDS was the most urgent health problem 

facing the U.S., compared to only six percent in 2009. Approximately 50,000 people become 

infected each year, meaning that more Americans are living with HIV than ever before. In 

addition, because HIV and viral hepatitis share common modes of transmission, one third of HIV 

infected individuals are also infected with hepatitis C.99 This suggests that the U.S. is facing an 

era of rising infections, greater challenges in serving people who are living with HIV, and higher 

healthcare costs.

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

98 National HIV/AIDS Strategy for the United States: Update to 2020 99 Action Plan for the Prevention, Care and Treatment of Viral Hepatitis, 

http://www.hhs.gov/ash/initiatives/hepatitis/
168

HIV prevention services. The program aims to engage community-level domestic public and 

private non-profit 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 misuse 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.

SAMHSA helps to prevent HIV and hepatitis infection acquired through substance misuse and 

other means. SAMHSA’s Minority AIDS programs address incidence, care, disparities and 

coordination, and provide counseling to reduce risk. The program emphasizes that all grantees 

must be prepared to serve the community in which they are located. The Ready-To-Respond 

Initiative provides funding to expand knowledge and experience about blended substance misuse 

and HIV prevention practices for at-risk minority populations. The Capacity-Building Initiative 

supports grantees in building a solid foundation for delivering evidence-based substance abuse 

and HIV prevention services. The program aims to engage community organizations, tribes and 

tribal organizations to prevent and reduce the onset of substance use and the transmission of 

HIV/AIDS among at-risk individuals, including, racial/ethnic minority youth and young adults, 

ages 13 to 24. SAMHSA’s Minority Serving Institutions (MSI) in Partnerships with CommunityBased Organizations (MSI CBO) program supports grants to MSIs. The MSI CBO program 

focuses on preventing and reducing substance use and the transmission of HIV/AIDS and 

hepatitis C virus infections among minority young adults ages 18 to 24 on campus and in the 

surrounding communities.

In 2014, the preliminary results of a cross-site evaluation of SAMHSA’s Minority AIDS 

programs show that participants who received individual-based services had significant 

improvement from baseline to exit in several areas. The changes from baseline to exit are as 

follows:

1) HIV/AIDS knowledge (Cohort 9: 18.1 percent; Cohort 10: 9.5 percent);

2) Sexual Self-Efficacy (Cohort 9: 10.8 percent; Cohort 10: 6.5 percent);

3) Perceived risk of harm from unprotected vaginal sex (Cohort 9: 7.7 percent; 

Cohort 10: 5.6 percent);

4) Perceived risk of harm from unprotected anal sex (Cohort 9: 6.1 percent; Cohort 10:

6.1 percent); and

5) Perceived risk of harm from unprotected oral sex (Cohort 9: 12.8 percent; Cohort 10:

11.6 percent).

The cross-site evaluation examined program inputs, outputs, outcomes, and the relationships 

among them. The evaluation found that participants who received Protocol-Based Counseling 

(PBC) through these programs were more likely to show decreases in past 30-day use of illicit 

drugs (excluding marijuana), increases in protected oral and vaginal sex, and increases in sexual 

self-efficacy when compared to participants who did not receive PBC. The evaluation also 

found that participants who received Comprehensive Risk Counseling Services through 

CSAP’s
169

Minority AIDS programs were more likely to increase their perception of risk of harm from 

using marijuana when compared to participants who did not receive thisintervention.

In FY 2014, SAMHSA’s Centers for Mental Health Services, Substance Abuse Prevention, and 

Substance Abuse Treatment supported the Minority AIDs Continuum of Care pilot. The 

Minority AIDS Continuum of Care program supports mental/substance use disorder screening,

primary prevention, and treatment for racial/ethnic minority populations with or at high risk for 

mental and substance use disorders and HIV/AIDS. Minority AIDS Continuum of Care grants 

support substance use disorder treatment, primary prevention/treatment service programs, 

community mental health programs, and HIV/AIDS integrated programs that either can co-locate 

or have fully integrated HIV/AIDS prevention and medical care services. This program also 

provides primary prevention services for SUD and HIV/AIDS in local communities served by 

behavioral health programs. In addition, approximately 20 percent and 23 percent of those with 

Serious Mental Illness such as schizophrenia, bipolar disorder, and major depression are infected

with hepatitis C virus and hepatitis B virus, respectively, while between 14 percent and 

36 percent of those who misuse alcohol are infected with the hepatitis C virus.100,101

SAMHSA supports a consolidated evaluation of its HIV/AIDS programs. This comprehensive 

process and outcome evaluation will assess the degree to which SAMHSA is providing effective 

and efficient mental and substance use disorder services and prevention programs to those with 

and at risk of HIV/AIDS. The evaluation results will help inform program development and 

refine the approach used in SAMHSA’s HIV portfolio.

In FY 2015, SAMHSA funded the continuation of 34 Minority AIDS Continuum of Care grants, 

a technical assistance contract, and awarded a new evaluation contract. SAMHSA also provided 

funding for 34 new grants under the MSI CBO program and 54 new grants under the HIV 

Capacity-Building Initiative program. These funds supported an array of activities to assist 

grantees in building a solid foundation for delivering and sustaining quality and accessible state 

of the science substance use and HIV prevention services.

In FY 2016, SAMHSA plans to support 131 grant continuations and 31 Minority AIDS

Continuum of Care new grants. Funding will also support a technical assistance and evaluation 

efforts.

100Bhattacharya R, Shuhart MC. Hepatitis C and alcohol: interactions, outcomes, and implications. JClin 

Gastroenterol. 2003;36(3):242-52. 101 Rosenberg et al. Prevalence of HIV, Hepatitis B, and Hepatitis C in People With Severe Mental Illness. Am J 

Public Health. 2001;91:(31–37).
170

Funding History

Fiscal Year Amount

FY 2013 $40,995,653

FY 2014 $41,205,000

FY 2015 $41,205,000

FY 2016 $41,205,000

FY 2017 $41,205,000

Budget Request

The FY 2017 Budget Request of $41.2 million is the same as the FY 2016 Enacted Level. 

SAMHSA will support up to 148 grant continuations and 70 new grants to assist grantees in 

building a solid foundation for delivering integrated evidence-based substance use, HIV and viral 

hepatitis prevention services that are in alignment with the National HIV/AIDS Strategy. These 

funds continue to address a critical public health problem and provide lifesaving prevention 

services, including testing for HIV.

Outputs and Outcomes Table

Program: Minority AIDS

NOTE: SAMHSA makes grant awards towards the end of the year. Therefore, the FY 2017 targets are based on the 

FY 2016 Enacted Level and the FY 2018 targets are based on the FY 2017 President’sBudget.

1

The 2014 actuals reflect the closeout of HIV Cohort 7.

Measure

Year and Most Recent Result

Target for Recent Result 

(Summary of Result)

FY 2017

Target

FY 2018

Target

FY 2018

Target

+/-

FY 2017

Target

2.3.56 Increase the number of 

program participants exposed to 

substance abuse prevention 

education services. (Output)

FY 2014: 3,5071

Target: 3,891 

(Target not met)

2,580 2,580 Maintain

2.3.83 Increase the percent of 

program participants who report no 

use of alcohol at pre-test who 

remain non-users at post-test (all 

ages). (Outcome)

FY 2014: 88.7%

Target: 91.2% 

(Target not met)

85.7% 85.7% Maintain

2.3.85a Increase the number of 

persons tested for HIV through the 

Minority AIDS Initiative 

prevention activities. (Outcome)

FY 2014: 20,386

Target: 32,975 

(Target not met)

21,137 21,137 Maintain
171

Sober Truth on Preventing Underage Drinking Act (Stop Act)

(Dollars in thousands)

Programs of Regional & National Significance

FY 2015

Final

FY 2016

Enacted

FY 2017

President's 

Budget

FY 2017

+/-

FY 2016

Sober Truth on Preventing Underage Drinking (STOP Act).................... $7,000 $7,000 $7,000 $---

Authorizing Legislation ......................................................................Section 519B of the PHS Act 

FY 2017 Authorization .........................................................................................................Expired

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

Eligible Entities............................................ Current and former Drug-Free Communitiesgrantees

Program Description and Accomplishments

Underage drinking continues to be a national concern. It disrupts the lives of individuals and 

families and imposes great costs on communities. Alcohol-related consequences include 

impairments in cognitive abilities (e.g., decision-making and impulse control) and motor skills 

(e.g., balance and hand-eye coordination), death, injury, physical and sexual assault, unsafe sex, 

health problems, suicide attempts, memory loss and more.102 Those who report getting drunk at 

least once a week have a higher likelihood of becoming injured and needing medical treatment, 

causing injury in traffic crashes, and being taken advantage of sexually.103 Twenty-five percent 

of college students report academic consequences of their drinking, including missing class, 

falling behind in class, doing poorly on exams, and receiving lower grades overall.104

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.

Strong prevention efforts are necessary to continue to address underage drinking. These efforts 

have proven effective. Over the past decade, a large number of evaluation studies have 

demonstrated the far-reaching effects of prevention interventions in reducing alcohol, tobacco, 

and other drug abuse as well as delinquent behaviors; violence; and other mental, emotional, and 

behavioral health problems.105 Indeed, rates of current, binge, and heavy alcohol use among 

12 to 20 year-olds have declined from 2002 to 2013.106 Findings from the 2013 National Survey 

on Drug Use and Health (NSDUH) indicate that the rate of current alcohol use among 12 to 

20 year-olds decreased from 28.8 percent in 2002 to 22.7 percent in 2013. The binge-drinking

102 Chaloupka, Grossman, & Saffer, 2002; O'Brien et al., 2013; A. White & Hingson, 2013 103 A. White & Hingson, 2013 104 A. White & Hingson, 2013 105 e.g., Calear & Christensen, 2010; Lemstra et al., 2010; Ttofi & Farrington, 2011 106 SAMHSA, 2014
172

rate in that age group declined from 19.3 percent to 14.2 percent and the rate of heavy drinking 

declined from 6.2 percent to 3.7 percent.

In both FY 2011 and FY 2012, SAMHSA conducted program evaluations of the STOP ACT 

grant program. The findings indicated that the program is accomplishing its intended goal of 

enhancing underage drinking prevention efforts in coalition communities around the country. In 

mid-2014, SAMHSA began conducting a retrospective national cross-site evaluation of the

STOP ACT grant program. SAMHSA awarded 97 grant continuations in FY 2015 and will 

award 97 grant continuations in FY 2016. Data on outcomes will be available in FY 2016.

Funding History

Fiscal Year Amount

FY 2013 $6,993,928

FY 2014 $6,983,000

FY 2015 $7,000,000

FY 2016 $7,000,000

FY 2017 $7,000,000

Budget Request

The FY 2017 Budget Request of $7.0 million is level with the FY 2016 Enacted Level. In 2017, 

SAMHSA will support 79 new STOP Act grants. This funding will continue and deepen 

SAMHSA’s commitment to reduce and prevent underage drinking.
173

Outputs and Outcomes Table

Program: Sober Truth on Preventing Underage Drinking (Stop Act)1

NOTE: SAMHSA makes grant awards towards the end of the year. Therefore, the FY 2017 targets are based on the 

FY 2016 Enacted Level and the FY 2018 targets are based on the FY 2017 President’sBudget.

1 FY 2015 data available in August 2016.

Measure

Year and Most Recent Result

Target for Recent Result 

(Summary of Result)

FY 2017

Target

FY 2018

Target

FY 2018

Target

+/-

FY 2017

Target

3.3.01 Percentage of coalitions that 

report at least 5 percent 

improvement in the past 30-day use 

of alcohol in at least two grades. 

(Outcome)

FY 2014: 43.8%

Target: 40.0% 

(Target exceeded)

45.0% 45.0% Maintain

3.3.02 Percentage of coalitions that 

report improvement in youth 

perception of risk from alcohol in at 

least two grades. (Outcome)

FY 2014: 30.0%

Target: 60.9% 

(Target not met)

45.0% 45.0% Maintain

3.3.03 Percentage of coalitions that 

report improvement in youth 

perception of parental disapproval 

on the use of alcohol in at least two 

grades. (Outcome)

FY 2014: 33.3%

Target: 54.5% 

(Target not met )

45.0% 45.0% Maintain
174

Fetal Alcohol Spectrum Disorders (FASD)

(Dollars in thousands)

ProgramsofRegional&NationalSignificance

FY 2015

Final

FY 2016

Enacted

FY 2017

President's 

Budget

FY 2017

+/-

FY 2016

Fetal Alcohol Spectrum Disorder........................................................... $1,000 $--- $--- $---

Authorizing Legislation ........................................................................ Section 516 of the PHS Act 

FY 2017 Authorization .........................................................................................................Expired

Allocation Method .............................................................................................................Contracts

Eligible Entities................................................................................... Domestic and PublicEntities

Program Description and Accomplishments

Fetal alcohol spectrum disorders (FASD) are a group of conditions that can occur in an 

individual whose mother consumed alcohol during pregnancy. These effects can include a mix 

of physical problems and problems with behavior and learning. The prevalence of the full 

spectrum of FASD in the general U.S. population is estimated at 9.1 per 1,000 live births,107 

although this estimate is based on passive surveillance. A recent study based on active 

surveillance of in-school reviews suggest that the national rate could potentially be closer to 

50 per 1,000.108 In addition, studies among foster and adoptive youth109 indicate that 

misdiagnosis of individuals with FASD may further disguise the true prevalence.

SAMHSA’s FASD Center for Excellence (CFE) focuses on preventing FASD among women of 

childbearing age and improving the quality of life for individuals and families affected by these 

disorders. The FASD CFE uses a comprehensive approach across the lifespan to work toward 

reducing the number of infants exposed to alcohol prenatally, increasing the functioning of 

individuals who have a FASD, and addressing the challenges of individuals and families affected 

by FASD.

As part of these efforts, the FASD CFE established a website that provides the public with 

information and resources on the prevention of FASD. Products can be downloaded and used by 

primary care, behavioral health care, and other providers to educate women of child-bearing age, 

individuals, and their families about the dangers of drinking while pregnant to prevent new and 

recurring alcohol-exposed pregnancies. The website has resources like the FASD Treatment 

Improvement Protocol 58 (TIP 58) that reviews alcohol screening tools and interventions for use 

with pregnant women and women of childbearing age to prevent FASD and accomplish

107 May, P. A., Gossage, J. P., Kalberg, W. O., Robinson, L. K., Buckley, D., Manning, M., & Hoyme, H. E. (2009). 

Prevalence and epidemiologic characteristics of FASD from various research methods with an emphasis on recent 

in-school studies. Developmental Disabilities Research Reviews, 15(3), 176-192. 108 May, P. A., Baete, A., Russo, J., Elliott, A. J., Blankenship, J., Kalberg, W. O., Buckley, D., Brooks, M., Hasken, 

J., Abdul-Rahman, O., Adam, M. P., Robinson, L. K., Manning, M., Hoyme, E. (2014). Prevalence and 

characteristics of Fetal Alcohol Spectrum Disorders. Pediatrics, 134(5), 854-866.

109 Chasnoff, I. J., Wells, A. M., & King, L. (2015). Misdiagnosis and missed diagnoses in foster and adoptive 

children with prenatal alcohol exposure. Pediatrics, 135(2), 264-270.
175

outcomes that achieve a better quality of life for individuals with FASD. TIP 58 also outlines 

methods for identifying individuals with a FASD and modifying treatment accordingly to guide 

professionals in how to screen an individual for a FASD so that appropriate referrals are made 

for an intervention or diagnosis to achieve successful outcomes and better quality of life. The 

Tools for Success curriculum educates Juvenile Justice system professionals on understanding 

the challenges facing individuals with a FASD so individuals receive appropriate care and 

support within justice systems to limit undue suffering. “FASD: The Basics” is an educational 

presentation created to provide the latest and most accurate FASD information. It covers the 

history of FASD discovery, examines cause and effects of FASD, and discusses the methods and 

resources for diagnosis, treatment and FASD prevention. The presentation is used by families 

and others who support individuals with a FASD to better understand the mental and physical 

challenges of such individuals and their families, so that appropriate care is given at home, in 

academic institutions, and in communities.

FASD CFE also convenes an expert panel that provides guidance and recommendations about 

best practices for healthcare providers and social service organizations. The FASD CFE has 

organized a Self-Advocates with FASD Network (comprising young adults with FASD) and a 

Birth Mothers Network that advocates for services, provides mutual support, and works to 

improve the quality of life for people with FASD. In addition, the FASD CFE collaborated with 

the National Institute on Alcohol Abuse and Alcoholism’s Interagency Coordinating Committee 

on FASD to advance new research and best practices on FASD. The FASD CFE also 

coordinated and collaborated with organizations such as the National Organization on Fetal 

Alcohol Syndrome to develop curricula for juvenile justice systems and certified addictions 

counselors, and provided ongoing support to the National Association of FASD State 

Coordinators to integrate FASD services into existing healthcare systems. The FASD CFE 

convened 10 “Building FASD State Systems” conferences to facilitate the development of 

comprehensive systems of care for people affected by FASD. Finally, the FASD CFE also 

established a Native Communities Initiative to address FASD in American Indian/Alaska Native 

(AI/AN)/Native Hawaiian populations.

In FY 2014 and FY 2015, the CFE provided technical assistance and training to other federal and 

national partners to assist them in developing evidence-based prevention, intervention, and 

treatment approaches. The FASD CFE focuses on women of child-bearing age, individuals and 

families affected by FASD, states, local communities, AI/AN communities, military families, 

and health, social service, and faith-based providers who study and/or provide services for 

individuals affected by FASD. In FY 2016, this program is eliminated but strategies to ensure 

women are educated on the risks of FASD will continue through other efforts.
176

Funding History

Fiscal Year Amount

FY 2013 $1,103,511

FY 2014 $998,000

FY 2015 $1,000,000

FY 2016 ---

FY 2017 ---

Budget Request

The FY 2017 Budget Request of $0.0 million is the same as the 2016 Enacted Budget and 

represents the elimination of funding for the program. SAMHSA will continue to focus on the 

prevention of alcohol misuse through other existing substance abuse prevention programs and 

work with CDC and other federal partners on issues related to FASD.

Center for the Application of Prevention Technologies

(Dollars in thousands)

ProgramsofRegional&NationalSignificance

FY2015

Final

FY2016

Enacted

FY2017

President's 

Budget

FY2017

+/-

FY2016

CenterfortheApplicationofPreventionTechnologies(CAPT)...............

PHS Evaluations Funds(non-add)..................................................

$7,493

---

$7,493

---

$7,493

6,468

$---

+6,468

Authorizing Legislation ........................................................................ Section 516 of the PHS Act 

FY 2017 Authorization .........................................................................................................Expired

Allocation Method .............................................................................................................Contracts

Eligible Entities................................................................................... Domestic and PublicEntities

Program Description and Accomplishments

Generating high quality performance data on the effectiveness of prevention programming from 

states and communities is an ongoing challenge. As grantees (states and communities) move 

toward greater accountability for achieving and documenting results, greater reliance on data to 

inform and guide program management and decision-making and enhanced capacity to meet 

higher expectations for documented performance from SAMHSA and other federally funded 

programs are required.

SAMHSA’s Center for the Application of Prevention Technologies (CAPT) program provides 

state-of-the-art 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
177

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.

During FY 2013, the program completed a comprehensive revision and update of its flagship 

Substance Abuse Prevention Skills Training (SAPST), which offers participants 31 training

hours toward certification as a Substance Abuse Prevention Specialist. The CAPT also 

developed a Pacific Islander and Native American adaptation of the training for six additional 

training hour credits. The CAPT continues to develop behavioral health indicators, related 

training products and technical assistance products. These products focus on shared risk and 

protective factors to promote collaboration across substance abuse and mental health disciplines 

within the behavioral health field.

The program is increasing emphasis on virtual or distance forms of service delivery and relying 

more heavily on webinars and online training. In FY 2013, 88 percent of those served 

(approximately 7,700 individuals) reported that the training increased their capacity to do 

prevention work and 100 percent reported that it increased their organizational capacity. In FY

2014, the CAPT delivered its foundational SAPST “Training of Trainers” to 296 participants 

who delivered the SAPST 31 times to 1,153 participants in 28 states. Also in FY 2014, the CAPT

program developed a series of self-paced courses to increase the capacity of community- level 

grantees to use epidemiological data to guide their prevention planning efforts, as well as 

webinars and coaching consultations to help grantees identify risk and protective factors and 

appropriate strategies to address emerging prevention needs such as prescription drug misuse and 

youth marijuana use. In FY 2015, the CAPT supported the organizational capacity of high-need 

communities to address health disparities and achieve benchmarks identified in SAMHSA’s 

Partnerships for Success program. CAPT continues to strengthen the prevention workforce, 

overall, by increasing the availability of interactive virtual trainings on using epidemiological 

data and risk and protective factors to guide implementation of effective prevention strategies for 

prescription drug misuse and opioid abuse and overdose, binge drinking in college populations 

and underage drinking.

In FY 2016, funding will continue to support the delivery of technical assistance and workforce 

development to the prevention field.
178

Funding History

Fiscal Year Amount

FY 2013 $8,097,521

FY 2014 $7,493,000

FY 2015 $7,493,000

FY 2016 $7,493,000

FY 2017 $7,493,000

Budget Request

The FY 2017 Budget Request of $7.5 million is the same as the FY 2016 Enacted Level. The 

program will provide technical assistance and training to over 7,500 individuals in the prevention 

field.
179

Outputs and Outcomes Table

Program: Center for the Application of Prevention Technologies(CAPT)

NOTE: SAMHSA makes grant awards towards the end of the year. Therefore, the FY 2017 targets are based on the 

FY 2016 Enacted Level and the FY 2018 targets are based on the FY 2017 President’sBudget.

1

Results are preliminary. 2 Target aggregates CSAT and CMHS Science and Service individuals trained and CSAP CAPT individuals trained.

Measure

Year and Most Recent Result 

Target for Recent Result

(Summary of Result)

FY 2017

Target

FY 2018

Target

FY 2018

Target

+/-

FY2017

Target

1.4.09 Increase the number of 

individuals trained by SAMHSA's 

Science and Services Program. 

(Output)

FY 2015: 38,9411

Target: 110,000 

(Target not met)

40,9472 40,947 Maintain

1.4.11 Prevention: increase the 

number of individuals trained by the 

CAPT. (Output)

FY 2014: 9,146

Target: 5,216 

(Target exceeded)

5,216 5,216 Maintain

1.4.12 Increase the percent of 

participants that agree or strongly 

agree that the training or TA 

provided increased their capacity to 

do substance abuse prevention 

work. (Outcome)

FY 2014: 91.0%

Target: 90.0% 

(Target exceeded)

90.0% 90.0% Maintain

1.4.13 Increase the percent of 

participants that agree or strongly 

agree that the training or TA 

provided increased their 

organization's capacity to do 

substance abuse prevention work. 

(Outcome)

FY 2014: 100.0%

Target: 92.0% 

(Target exceeded)

95.0% 95.0% Maintain
180

Science and Service Program Coordination

(Dollars in thousands)

Programs of Regional & NationalSignificance

FY2015

Final

FY2016

Enacted

FY2017

President's 

Budget

FY2017

+/-

FY2016

Science and Service ProgramCoordination............................................ $4,072 $4,072 $4,072 $---

Authorizing Legislation ........................................................................ Section 516 of the PHS Act 

FY 2017 Authorization .........................................................................................................Expired

Allocation Method .............................................................................................................Contracts

Eligible Entities................................................................................... Domestic and PublicEntities

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 in past-month, or current drinking by adolescents and young adults. 

Trend data reports similar declines in underage binge and heavy drinking. In fact, among 8th to 

12th grade students, rates of current, binge, and heavy drinking have declined to record lows. 

Yet, alcohol remains the drug of choice for individuals between the ages of 12 to 20 years. 

There are 8.7 million adolescent and transition age youth that drink. Risky and heavy drinking 

among college students remains unacceptably high.

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. As of FY 2015, 65 

tribal communities have received specialized technical assistance and support in suicide 

prevention and related areas. In addition, more than 9,200 members of these communities 

received training in prevention and mental health promotion.

The Underage Drinking Prevention Education Initiatives 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. Efficiencies have been achieved from the growing focus on 

train-the-trainer models rather than training of individuals. In addition, since the Town Hall 

Meetings under the Underage Drinking Prevention Education Initiatives occur biennially, 

numbers served increase in the years the meetings occur and decrease in alternate years.
181

In FY 2014, community-based organizations registered to host 1,345 events. These events were 

held in all 50 states, the District of Columbia, and five territories. Approximately 1,160 

individuals attended live online training webinars and SAMHSA responded to 1,301 requests 

for technical assistance in planning, promoting, hosting, and evaluating events. Science and 

Service performance data for FY 2013 show that 16,177 people were trained and almost 9,000 

received technical assistance. In FY 2015, SAMHSA continued funding of four contracts. In FY 

2016, SAMHSA will fund three contracts to support these activities.

Funding History

Fiscal Year Amount

FY 2013 $5,168,406

FY 2014 $4,072,000

FY 2015 $4,072,000

FY 2016 $4,072,000

FY 2017 $4,072,000

Budget Request

The FY 2017 Budget Request of $4.1 million is the same as the FY 2016 Enacted Level. These 

funds will support SAMHSA’s top strategic initiative, prevention of substance abuse and mental 

illness, which includes a focus on preventing underage drinking and on American Indians/Alaska 

Natives through the provision of technical assistance.

The Science and Service Program Coordination addresses the Administration’s multi-agency 

Native Youth priority related to Improving Education Outcomes and Like Outcomes for Native 

Youth, in support of the HHS Tribal Health and Well-Being Coordination.

Tribal Behavioral Health Grants

(Dollars in thousands)

ProgramsofRegional&NationalSignificance

FY 2015

Final

FY 2016

Enacted

FY 2017

President's 

Budget

FY 2017

+/-

FY 2016

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

Authorizing Legislation ........................................................................ Section 516 of the PHS Act 

FY 2017 Authorization .........................................................................................................Expired

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

Eligible Entities....................................................................................................................... Tribes
182

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.110 Further, AI/AN high school students report higher rates of 

suicidal behaviors than the general population of U.S. high school students.111 These behaviors 

include serious thoughts of suicide, making suicide plans, attempting suicide, and getting 

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 suicide than AI/AN youth raised on tribal reservations (21 percent and 33 percent, 

respectively).112

The 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.

In FY 2014, SAMHSA’s Center for Mental Health Services awarded Tribal Behavioral Health 

grants up to $0.2 million annually for a total of five years to 20 tribes or tribal organizations with 

high rates of suicide. These five-year 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 technical assistance to AI/AN grantees and 

organizations and providers 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. SAMHSA has incorporated lessons learned to 

enhance this program and other national efforts to reduce suicide and substance abuse and 

support positive mental health among AI/AN youth. SAMHSA continued the support of this 

program in FY 2015. Grantees completed their needs assessments in FY 2015 and are working 

with SAMHSA to turn their assessments into action plans to be implemented in FY 2016. These 

action plans will report baseline data in FY 2017.

In FY 2016, as part of Generation Indigenous,113 a White House-supported youth initiative 

focused on removing possible barriers to success for AI/AN youth, SAMHSA proposed an 

expansion of its TBHG program. This initiative takes a comprehensive, culturally appropriate 

approach to help improve the lives of and opportunities for AI/AN youth. In addition to HHS, 

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

110 Centers for Disease Control and Prevention. Fatal injury data, 2010. Web-based Injury Statistics Query and 

Reporting System. Available at http://www.cdc.gov/injury/wisqars/fatal.html. 111 Centers for Disease Control and Prevention. Youth Risk Behavior Surveillance System (YRBSS). Available at 

http://www.cdc.gov/healthyyouth/yrbs/index.htm.

112 http://www.suicidology.org/Portals/14/docs/Resources/FactSheets/2011/AI-AN2011.pdf 113 For additional information on this White House sponsored initiative see: http://genindigenous.com/
183

braided TBHG ($15.0 million in Prevention; $15.0 million in Mental Health) 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 expands these activities to approximately 103 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 care, and substance use prevention 

activities for high-risk AI/AN youth and their families, enhance early detection of mental and 

substance use disorders among AI/AN youth, and increase referral to treatment.

Funding History

Fiscal Year Amount

FY 2013 ---

FY 2014 ---

FY 2015 ---

FY 2016 $15,000,000

FY 2017 $15,000,000

Budget Request

The FY 2017 Budget Request for the Tribal Behavioral Health Grant program is $30.0 million, 

including $15.0 million in the Mental Health appropriation and $15.0 million in the Substance 

Abuse Prevention appropriation. This is level with the FY 2016 Enacted Level. This request 

will continue support for programs that promote mental health and prevent substance use 

activities for high-risk AI/AN youth and their families.

Tribal Behavioral Health Grants is a program that addresses the Administration’s multi-agency 

Native Youth priority to Reduce Teen Suicide, in support of the HHS Tribal Health and WellBeing Coordination.
184

Outputs and Outcomes Table

Program: Tribal Behavioral Health

NOTE: SAMHSA makes grant awards towards the end of the year. Therefore, the FY 2017 targets are based on the 

FY 2016 Enacted Level and the FY 2018 targets are based on the FY 2017 President’sBudget.

Measure

Year and Most Recent Result

Target for Recent Result 

(Summary of Result)

FY 2017

Target

FY 2018

Target

FY 2018

Target

+/-

FY 2017

Target

2.4.10 Increase the number of 

grantees reporting a decrease in 

underage drinking in their 

community. (Output)

FY 2016: Result expected 

December 31, 2016

Target: Set baseline 

(Pending)

2.4.11 Increase the number of 

participants receiving evidencebased mental health -related 

services as a result of the grant. 

(Output)

FY 2016: Result expected 

December 31, 2016

Target: Set baseline 

(Pending)

2.4.12 Increase the number of youth 

age 10-24 who received mental 

health or related services after 

screening, referral or attempt. 

(Output)

FY 2016: Result expected 

December 31, 2016

Target: Set baseline 

(Pending)

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 2016: Result expected 

December 31, 2016

Target: Set baseline 

(Pending)
185

Grants to Prevent Prescription Drug/Opioid Overdose Related Deaths

(Dollars in thousands)

ProgramsofRegional&NationalSignificance

FY 2015

Final

FY 2016

Enacted

FY 2017

President's 

Budget

FY 2017

+/-

FY 2016

GrantstoPreventPrescriptionDrug/OpioidOverdoseRelatedDeaths.... $--- $12,000 $12,000 $---

Authorizing Legislation ........................................................................ Section 516 of the PHS Act 

FY 2017 Authorization .........................................................................................................Expired

Allocation Method ............................................................................Competitive Grants, Contracts 

Eligible Entities........................................................................................................................States

Program Description and Accomplishments

Opioid overdose is a significant contributor to accidental deaths among those who use, misuse, 

or abuse illicit and prescription opioids. Overdose from prescription opioids accounted for 

71 percent of all deaths related to pharmaceutical overdose in 2013.114 In 2014, 29,467 

Americans died because of an overdose involving prescription opioids or heroin, nearly five 

times the number of opioid overdose-related deaths in 2000.115 During this same period (from 

2000 to 2013) the number of opioid prescriptions in the Unites States rose from 126 million to 

207 million, almost doubling.116

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 2013, SAMHSA released the Opioid Overdose Prevention Toolkit to help reduce the number 

of opioid-related overdose deaths and adverse events. Developed by the Association of State and 

Territorial Health Officials, the National Association of State Alcohol and Drug Abuse Directors, 

the American Association for the Treatment of Opioid Dependence and SAMHSA, 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 naloxone in preventing death from an overdose. Naloxone is an opioid antagonist that

114 Centers for Disease Control and Prevention (CDC). Prescription Drug Overdose in the United States: Fact Sheet. 

(2015) Available from URL: http://www.cdc.gov/homeandrecreationalsafety/overdose/facts.html. 115 National Institute on Drug Use (NIDA). Overdose Death Rates. (2015) Available from URL: 

http://www.drugabuse.gov/related-topics/trends-statistics/overdose-death-rates. 116 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
186

reverses the effects of opioids, including respiratory depression. A growing evidence base 

suggests that naloxone is a cost-effective method to reduce opioid overdose deaths.

The Toolkit is one of the most downloaded SAMHSA publications with approximately 10,500 

downloads per month. The toolkit provides evidence-based guidance for using safe prescribing 

practices, identifying patients at risk for overdose, engaging patients in prevention and riskreduction efforts, and accessing addiction treatment. It gives communities and local governments 

the material to develop policies and practices in order to prevent and respond appropriately to 

opioid-related overdose.

As the rates of prescription drug misuse, heroin use, 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 is providing $12.0 million for Grants to Prevent Prescription 

Drug/Opioid Overdose Related Deaths. These grants will help states identify communities of 

high need and to provide education, training, and resources necessary to tailor the overdose kits 

to meet their specific needs. The grant funds could be used for purchasing naloxone, equipping 

first responders with naloxone, and providing training on other overdose death prevention 

strategies, supporting education on these strategies, and providing materials to assemble and 

disseminate overdose kits. This grant program aligns with the Department of Health and Human 

Services Secretary’s 2015 Opioid Initiative, which includes the expanded use of naloxone to treat 

opioid overdoses as well as opioid prescribing practices and the expanded use of medicationassisted treatment to reduce opioid use disorders and overdose.

These grantees are 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. The Centers for Disease Control and 

Prevention (CDC) will evaluate this grant program for its efficacy in reducing overdose deaths 

from opioids.

Funding History

Fiscal Year Amount

FY 2013 ---

FY 2014 ---

FY 2015 ---

FY 2016 $12,000,000

FY 2017 $12,000,000

Budget Request

The FY 2017 Budget Request is $12.0 million, the same as the FY 2016 Enacted Level. This 

funding will provide continuation grants to 10 states to reduce the number of opioid overdoserelated deaths. Funding will help states purchase naloxone, equip first responders in high-risk 

communities, support education on the use of naloxone and other overdose death prevention
187

strategies, provide the necessary materials to assemble overdose kits, and cover expenses 

incurred from dissemination efforts.

The FY 2017 Budget Request includes funding for a naloxone-related program within both 

SAMHSA and HRSA. HRSA and SAMHSA request funding ($10.0 million and $12.0 million, 

respectively) to implement opioid related activities, and will continue to coordinate efforts to 

ensure that duplication is avoided.
188

SAMHSA/Center for Substance Abuse Prevention 

PRNS Mechanism Table Summary

(Dollars in thousands)

Programs of Regional & National Significance

FY2015

Final

No. Amount

FY2016

Enacted

No. Amount

FY2017

President's 

Budget

No. Amount

Grants

Continuations........................................................ 198 $70,108 291 $129,255 367 $159,291

New/Competing................................................... 121 64,492 160 39,730 149 9,850

Supplements......................................................... --- --- --- --- --- ---

Subtotal............................................................. 319 134,600 451 168,985 516 169,141

Contracts

Continuations........................................................ 24 29,850 21 37,227 24 37,376

New..................................................................... 5 10,697 5 4,936 1 4,631

Subtotal............................................................. 29 40,548 26 42,163 25 42,007

Total, Substance Abuse Prevention PRNS1 348 $175,148 477 $211,148 541 $211,148

1 The Minority Fellowship Program budget appears in the Health Surveillance and Program Support appropriation, Agencywide Initiatives Workforce program. This is consistent with the FY 2017 Budget Request.
189

SAMHSA/Center for Substance Abuse Prevention 

PRNS Mechanism Table by Program, Project, and Activity

(Dollars in thousands)

Programs of Regional & National Significance

FY2015

Final

No. Amount

FY2016

Enacted

No. Amount

FY2017

President's 

Budget

No. Amount

CAPACITY:

StrategicPreventionFramework

Grants

Continuations........................................................ 34 $53,564 63 $93,527 131 $102,937

New/Competing................................................... 38 39,127 59 9,520 --- ---

Supplements......................................................... --- --- --- --- --- ---

Subtotal............................................................. 72 92,691 122 103,047 131 102,937

Contracts

Continuations........................................................ 11 14,469 6 13,785 9 15,819

New..................................................................... 1 2,324 4 2,653 --- 728

Subtotal............................................................. 12 16,793 10 16,437 9 16,547

Total, Strategic PreventionFramework 84 109,484 132 119,484 140 119,484

Grants to Prevent PrescriptionDrug/Opioid

Overdose RelatedDeaths

Grants

Continuations........................................................ --- --- --- --- 10 11,239

New..................................................................... --- --- 10 11,253 --- ---

Subtotal............................................................. --- --- 10 11,253 10 11,239

Contracts

Continuations........................................................ --- --- --- --- --- 761

New..................................................................... --- --- --- 747 --- ---

Subtotal............................................................. --- --- --- 747 --- 761

Total, Grants to Prevent PrescriptionDrug/

OpioidOverdose RelatedDeaths --- --- 10 12,000 10 12,000

Federal Drug-FreeWorkplace

Contracts

Continuations........................................................ 4 4,751 4 4,291 6 4,421

New..................................................................... 1 143 1 603 --- 473

Subtotal............................................................. 5 4,894 5 4,894 6 4,894

Total, Federal Drug-FreeWorkplace 5 4,894 5 4,894 6 4,894
190

SAMHSA/Center for Substance Abuse Prevention 

PRNS Mechanism Table by Program, Project, and Activity

(Dollars in thousands)

Programs of Regional & National Significance

FY2015

Final

No. Amount

FY2016

Enacted

No. Amount

FY2017

President's 

Budget

No. Amount

MinorityAIDS

Grants

Continuations........................................................ 67 11,968 131 31,078 148 30,215

New/Competing................................................... 88 25,307 31 4,890 70 6,123

Subtotal............................................................. 155 37,276 162 35,968 218 36,339

Contracts

Continuations........................................................ 3 3,783 4 5,237 4 4,866

New..................................................................... 1 146 --- --- --- ---

Subtotal............................................................. 4 3,929 4 5,237 4 4,866

Total, MinorityAIDS 159 41,205 166 41,205 222 41,205

SoberTruthonPreventing Underage Drinking

Act

Grants

Continuations........................................................ 97 4,576 97 4,651 18 853

New/Competing................................................... --- 58 --- --- 79 3,727

Subtotal............................................................. 97 4,633 97 4,651 97 4,579

Contracts

Continuations........................................................ 1 1,367 2 2,349 2 2,421

New..................................................................... 1 1,000 --- --- --- ---

Subtotal............................................................. 2 2,367 2 2,349 2 2,421

Total, SoberTruthon Preventing Underage

Drinking Act 99 7,000 99 7,000 99 7,000

TribalBehavioralHealthGrants

Grants

Continuations........................................................ --- --- --- --- 60 14,048

New/Competing................................................... --- --- 60 14,067 --- ---

Subtotal............................................................. --- --- 60 14,067 60 14,048

Contracts

Continuations........................................................ --- --- --- --- --- 951,863

New/Competing................................................... --- --- --- 933 --- ---

Subtotal............................................................. --- --- --- 933 --- 952

Total, TribalBehavioralHealthGrants --- --- 60 15,000 60 15,000

Subtotal,CAPACITY 347 $162,583 472 $199,583 537 $199,583
191

SAMHSA/Center for Substance Abuse Prevention 

PRNS Mechanism Table by Program, Project, and Activity

(Dollars in thousands)

ProgramsofRegional&NationalSignificance

FY 2015

Final

No. Amount

FY 2016

Enacted

No. Amount

FY 2017

President's 

Budget

No. Amount

SCIENCE AND SERVICE:

Fetal Alcohol Spectrum Disorder

Contracts

Continuations........................................................ 1 $966 --- --- --- ---

New..................................................................... --- 34 --- --- --- ---

Subtotal............................................................. 1 1,000 --- --- --- ---

Total,FetalAlcoholSpectrumDisorder 1 1,000 --- --- --- ---

CenterfortheApplicationofPrevention

Technologies

Contracts

Continuations........................................................ --- 443 1 7,493 1 7,493

New..................................................................... 1 7,050 --- --- --- ---

Subtotal............................................................. 1 7,493 1 7,493 1 7,493

Total,CenterfortheApplicationof

Prevention Technologies 1 7,493 1 7,493 1 7,493

Science &Service ProgramCoordination

Contracts

Continuations........................................................ 4 4,072 4 4,072 2 643

New..................................................................... --- --- --- --- 1 3,429

Subtotal............................................................. 4 4,072 4 4,072 3 4,072

Total, Science & ServiceProgram

Coordination 4 4,072 4 4,072 3 4,072

Subtotal,SCIENCEANDSERVICE 6 12,565 5 11,565 4 11,565

TOTAL, CSAP1 353 $175,148 477 $211,148 541 $211,148

1 The Minority Fellowship Programbudget appears in the Health Surveillance and ProgramSupport appropriation, Agencywide Initiatives Workforce program. This is consistent with the FY 2017 Budget Request.
192

Grant Awards Table

(Whole dollars)

FY2015

Final

FY2016

Enacted

FY 2017 President's 

Budget

Number of Awards 324 451 516

Average Awards $415,433 $374,690 $327,793

Range of Awards $50,000 - $2,300,000 $50,000 - $2,300,000 $50,000 - $2,300,000
193

SAMHSA

Substance Abuse Treatment 

Table of Contents

1. Substance Abuse Treatment Appropriation .........................................................................195

2. Programs of Regional and National Significance (PRNS) ..................................................196

a) Opioid Treatment Programs/Regulatory Activities ........................................................ 197

b) Screening, Brief Intervention and Referral to Treatment ............................................... 200

c) Targeted Capacity Expansion ......................................................................................... 204

d) Cohort Monitoring and Evaluation of Medication-Assisted Treatment Outcomes........ 209

e) Buprenorphine-Prescribing Authority Demonstration.................................................... 210

f) Pregnant and Postpartum Women................................................................................... 212

g) Strengthening Treatment Access and Retention............................................................. 214

h) Recovery Community Services Program........................................................................ 216

i) Access to Recovery......................................................................................................... 218

j) Children and Families..................................................................................................... 221

k) Treatment Systems for Homeless ................................................................................... 223

l) Minority AIDS ................................................................................................................ 228

m) Criminal Justice Activities.............................................................................................. 231

n) Crisis Systems................................................................................................................. 238

o) Addiction Technology Transfer Centers......................................................................... 241

p) Special Initiatives/Outreach............................................................................................ 243

3. PRNS Mechanism Table Summary .....................................................................................247

4. PRNS Mechanism Table by Program, Project, and Activity...............................................248

5. State Targeted Response Cooperative Agreements.............................................................253

6. Substance Abuse Prevention and Treatment Block Grant...................................................255
194

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195

Substance Abuse Treatment Appropriation

(Dollars in thousands)

Program Activities

FY 2015

Final

FY 2016

Enacted

FY 2017

President's 

Budget

FY 2017

+/-

FY 2016

Programs of Regional and National Significance................. $361,463 $333,806 $343,269 +$9,463

Mandatory Funds (non-add)........................................ --- --- 15,000 +15,000

PHS Evaluation Funds (non-add)............................... 2,000 2,000 30,000 +28,000

State Targeted Response Cooperative Agreements

(Mandatory)..................................................................... --- --- 460,000 +460,000

Substance Abuse Prevention and Treatment Block Grant... 1,819,856 1,858,079 1,858,079 ---

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

Total, Substance Abuse Treatment1............................. $2,181,319 $2,191,885 $2,661,348 +$469,463

1 The Minority Fellowship Program budget appears in the Health Surveillance and Program Support appropriation, 

Agency-wide Initiatives Workforce program. This is consistent with the FY 2017 Budget Request.

The Substance Abuse Treatment FY 2017 Budget Request is $2.7 billion. This is an increase of

$469.5 million from the FY 2016 Enacted Level. The request includes $2.6 billion in Budget 

Authority, of which $475.0 million is mandatory funding, and $109.2 million in Public Health 

Service (PHS) Evaluation funds.
196

Programs of Regional and National Significance (PRNS)

Substance Abuse Treatment Appropriation

(Dollars in thousands)

Programs of Regional & NationalSignificance

FY2015

Final

FY2016

Enacted

FY2017

President's 

Budget

FY2017

+/-

FY2016

CAPACITY:

Opioid Treatment Programs/Regulatory Activities..................... $8,724 $8,724 $8,724 $---

Screening, Brief Intervention and Referral to Treatment............. 46,889 46,889 30,000 -16,889

PHSEvaluationFunds(non-add).................................... 2,000 2,000 30,000 +28,000

Targeted CapactyExpansion.................................................... 23,223 36,303 61,303 +25,000

Medication-Assisted Treatment forPrescription Drug

andOpioidAddiction(non-add)....................................... 12,000 25,000 50,080 +25,080

Cohort Monitoring and Evaluation ofMedication-Assisted

Treatment Outcomes (Mandatory).......................................... --- --- 15,000 +15,000

Buprenorphine-Prescribing Authority Demonstration................. --- --- 10,000 +10,000

Pregnant and Postpartum Women............................................ 15,931 15,931 15,931 ---

Strengthening Treatment Access and Retention......................... 1,000 --- --- ---

RecoveryCommunityServicesProgram................................... 2,434 2,434 2,434 ---

Access To Recovery................................................................ 38,223 --- --- ---

Children and Families............................................................... 29,605 29,605 29,605 ---

Treatment Systems for Homeless.............................................. 41,386 41,304 36,386 -4,918

Minority AIDS......................................................................... 65,570 65,570 58,859 -6,711

Criminal JusticeActivities......................................................... 78,000 78,000 61,946 -16,054

CrisisSystems......................................................................... --- --- 5,000 +5,000

Subtotal, Capacity 350,985 324,760 335,188 10,428

SCIENCE AND SERVICE:

AddictionTechnologyTransferCenters.................................... 9,046 9,046 8,081 -965

Special Initiatives/ Outreach..................................................... 1,432 --- --- ---

Subtotal, Science andService 10,478 9,046 8,081 -965

TOTAL, PRNS1 $361,463 $333,806 $343,269 +$9,463

1

TheMinorityFellowshipProgrambudget appearsintheHealthSurveillanceandProgramSupportappropriation,Agency-wide 

InitiativesWorkforceprogram. ThisisconsistentwiththeFY2017BudgetRequest.
197

Opioid Treatment Programs/Regulatory Activities

(Dollars in thousands)

Programs of Regional & NationalSignificance

FY2015

Final

FY2016

Enacted

FY2017

President's 

Budget

FY2017

+/-

FY2016

Opioid Treatment Programs/RegulatoryActivities................. $8,724 $8,724 $8,724 $---

Authorizing Legislation .............................................Section 509 of the Public Health Service Act 

Authorization ........................................................................................................................Expired

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 and States

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.117 Communities 

across the nation also face the risk that individuals who inject opioids will contract and spread 

HIV and hepatitis C.118 The underlying cause of these problems is increasing rates of opioid use 

disorders.119,120 With increasing incidence of opioid use disorders, there is a corresponding 

increase in admissions for treatment of opioid use disorders121 medication-assisted treatment 

(MAT) is the use of FDA-approved medications (i.e. buprenorphine, methadone, extendedrelease injectable naltrexone) in combination with counseling and behavioral therapies to provide 

a whole-patient approach to the treatment of substance use disorders, including 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 use 

disorder.122 A search of SAMHSA’s behavioral health treatment locator reveals only

20.0 percent of surveyed facilities offer MAT for individuals with opioid use disorders. The 

majority of the 1,400 opioid treatment programs (OTPs) which provide supervised dosing of

117 U.S. Department of Health and Human Services. Addressing prescription drug abuse in the United States: 

current activities and future opportunities. 2013. Available at: 

http://www.cdc.gov/homeandrecreationalsafety/overdose/hhs_rx_abuse.html

118 Substance Abuse and Mental Health Services Administration. Associations of nonmedical pain reliever use and 

initiation of heroin use in the United States. 2013. Available at: 

http://samhsa.gov/data/2k13/DataReview/DR006/nonmedical-pain-reliever-use-2013.htm

119 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. 120 Bohnert AS, Valenstein M, Bair MJ, et al. Association between opioid prescribing patterns and opioidoverdoserelated deaths. JAMA. 2011; 305(13):1315-1321. doi:10.1001/jama.2011.370. 121 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): 1487-92 122 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.
198

methadone - and sometimes buprenorphine - are at or near capacity. OTPs are the only means of 

providing medication assisted treatment (MAT) with methadone. Buprenorphine can be 

prescribed in an office-based 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, but some physicians who attempt to meet the unmet need for treatment by 

serving more individuals are prevented from doing so due to the patient limit on prescribing 

buprenorphine.

SAMHSA is responsible for regulating OTPs and processing waivers for physicians who wish to 

treat opioid use disorders with buprenorphine. SAMHSA reviews new and renewal applications 

for OTPs and oversees their accreditation. Opioid Treatment Programs 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 24 site 

visits to recently-accredited programs each year. SAMHSA conducts unannounced OTP site 

visits to investigate complaints. In addition to regulating OTPs, SAMHSA provides training and 

technical support through a contract entitled, Medical Education and Support Services for Opioid 

Treatment Programs. The goal is to provide trainings for OTP staff, on-site consultations for 

programs with deficiencies or unique challenges, and annual training for State Opioid Treatment 

Authorities. The Federal Opioid Treatment Program Standards, a document published in early 

2015, was developed with support from this contract and these activities continue for FY 2016. 

The contract will be re-competed for FY 2017.

SAMHSA also implements DATA 2000 in coordination with Drug Enforcement Agency. This 

includes approving waivers for qualified practitioners to provide medication-assisted treatment in 

office-based settings. More than 30,000 practitioners have been granted waivers since 2001. 

Approximately a third of these practitioners can treat up to 100 patients each. Waiver processing 

is conducted under a contract entitled DATA Waiver Processing and Support Project. In FY 

2016, SAMHSA will publish a review and update regarding oral use of buprenorphine and begin 

developing a similar technical advisory for potential new formulations.

SAMHSA has two cooperative agreements with the American Academy of Addiction Psychiatry 

that provide education, training, and mentors to providers. One program focuses on the safe and 

appropriate use of opioids for pain. In FY 2015, this effort offered 10 new live webinars and 

10 live follow-up question and answer sessions. A total of 2,621 people were trained in these and

other activities.

The second program focuses on medication-assisted treatment for opioid use disorders. In FY 

2015, this effort provided 17 live webinars and 12 new on-line modules and involved 22,399 

physicians and other health professionals. The cooperative agreement for these activities is being 

re-competed for a one-year extension in FY 2016. In addition, SAMHSA is supporting 14 

contacts in FY 2016.
199

SAMHSA has supported the education of addiction treatment program staff on the subject of 

hepatitis by funding a three-year supplement to the Addiction Technology Transfer Center 

Network. FY 2016 is the last year of funding for this activity, which will continue training 

medical and behavioral healthcare staff with a focus on federally qualified health centers. 

Through the Behavioral Health Information Technology and Standards contract, SAMHSA 

funded a competition that resulted in three new mobile applications for overdose prevention, and 

successfully demonstrated the ability to assure continuity of care for OTP patients via a health 

information exchange while fully respecting patient privacy. In FY 2016, SAMHSA is building 

on the success of these activities by conducting a demonstration project using health information 

technology for care coordination with OTPs to include new programs and software vendors.

SAMHSA’s Preventing Prescription Drug Abuse and Overdose technical assistance contract has 

provided live, free, continuing medical education (CME) across the country on safe and 

appropriate opioid prescribing making a special effort to reach isolated areas. CME courses have 

been offered in conjunction with annual meetings of various national organizations including, in 

2015, the Association of American Indian Physicians and the National Rural Institute on Alcohol 

and Drug Abuse. This contract supported the publication of two brief guides for clinicians: 

“Clinical Use of Extended-Released Injectable Naltrexone in the Treatment of Opioid Use 

Disorder” and “Alcohol Brief Guide – Medication for the Treatment of Alcohol Use Disorder” 

which SAMHSA developed in coordination with the National Institutes of Health. Both of these 

will be produced in a “pocket” version in FY 2016. This contract is also being used to develop 

SAMHSA’s guidance document on the management of pregnant and parenting opioid dependent 

women and their infants. In 2015, the Rand-UCLA Appropriateness Method was used to review 

the evidence and formulate recommendations. A report is forthcoming, and in 2016, this report 

will be converted into a patient-centered, multi-disciplinary clinical guide. Additional activities 

for FY 2016 under this contract include CME training in Indiana, Virginia, Minnesota, Vermont, 

California, Missouri, and Alabama. SAMHSA funded seven contracts supporting technical 

assistance and logistics in FY 2016.

Funding History

Fiscal Year Amount

FY 2013 $12,421,373

FY 2014 $8,724,000

FY 2015 $8,724,000

FY 2016 $8,724,000

FY 2017 $8,724,000

Budget Request

The FY 2017 Budget Request is $8.7 million, the same as the FY 2016 Enacted Level. In FY 

2017, SAMHSA proposes funding pilot regional MAT Centers of Excellence in two HHS 

regions. The Centers of Excellence will provide community-specific training and technical 

assistance to support the delivery of quality services in areas of MAT expansion and facilitate 

program development through stakeholder collaboration. SAMHSA plans to continue PCSS

MAT to support professional development and expansion of a well-trained workforce,
200

capable of delivering high quality MAT for all FDA approved medications, in a manner that 

complements the efforts of the MAT Centers of Excellence. In addition, SAMHSA intends to 

support technical assistance contracts including the Data Waiver Processing and Support 

contract.

Screening, Brief Intervention and Referral to Treatment

(Dollars in thousands)

Programs of Regional & NationalSignificance

FY2015

Final

FY2016

Enacted

FY2017

President's

Budget

FY2017

+/-

FY2016

Screening, BriefIntervention and Referralto Treatment......... $46,889 $46,889 $30,000 -$16,889

PHSEvaluationFunds(non-add)................................... 2,000 2,000 30,000 +28,000

Authorizing Legislation .............................................Section 509 of the Public Health Service Act 

FY 2017 Authorization .........................................................................................................Expired

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

Eligible Entities...................................... Single State Authority and Health Departments in States,

Territories and the District of Columbia, 

Federally Recognized American Indian/Alaska Native Tribe or Tribal Organizations,

Domestic Public and Private Non-Profit Entities, 

Public and Private Universities Colleges

Program Description and Accomplishments

A high number of individuals misuse illicit drugs and alcohol. Of all individuals age 12 or older,

24.6 million (9.6 percent) use illicit drugs, 60.1 million (22.9 percent) binge drink, and

16.5 million (6.3 percent) drink heavily.123 This increases the cost to society by compromising 

individual health and potentially causing injury to others. The National Institute on Drug Abuse 

found that misuse of illicit drugs and alcohol costs society $417.0 billion each year.124 Of the 

individuals who need treatment for substance use disorders, only 10 percent receive help.125 The 

vast majority of those meeting criteria for having a substance use disorder (SUD) do not believe 

they need treatment.

SAMHSA’s Screening, Brief Intervention and Referral to Treatment (SBIRT) program, started in

2003. SBIRT is intended to help primary care physicians identify individuals who misuse 

substances and help them intervene early with intervention, SUD treatment, or referral to 

treatment. The program’s goal is to increase the number of individuals who receive treatment

123 Substance Abuse and Mental Health Services Administration, Results from the 2013 National

Survey on Drug Use and Health: Summary of National Findings, NSDUH Series H-48, HHS Publication No. 

(SMA) 14-4863. Rockville, MD: Substance Abuse and Mental Health Services Administration, 2014. 124 National Institute on Drug Abuse (2015), Trends and Statistics, http://www.drugabuse.gov/related-topics/trendsstatistics.

125 Substance Abuse and Mental Health Services Administration, Results from the 2013 National Survey on Drug 

Use and Health: Summary of National Findings, NSDUH Series H-48, HHS Publication No. (SMA) 14-4863.

Rockville, MD: Substance Abuse and Mental Health Services Administration, 2014.
201

and reduce the rate of substance misuse. Studies have shown that this approach is effective in 

helping reduce harmful alcohol consumption.126,127,128

The SBIRT program seeks to increase its use 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 demonstrate the utility of the 

SBIRT approach and encourage wider adoption of SBIRT by healthcare providers. SAMHSA 

also supports the SBIRT Medical Residents and Health Professionals Training grant programs.

The SBIRT program requires state grant recipients to implement the model in all primary care 

settings, including hospitals, trauma centers, federally qualified health centers, and other relevant 

settings. Recipients may use funds to screen for substance use and co-occurring mental and 

substance use disorders. They can support evidence-based client-centered interventions such as 

motivational interviewing, brief treatment, and referral to specialty care for individuals 

exhibiting SUD 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 

implementing SBIRT with their patients.129 The SBIRT Medical Residents and Health 

Professionals Training grant programs support SBIRT training efforts for psychologists, 

pharmacists, dentists, and physician assistants. These efforts aim to develop further the primary 

healthcare workforce in SUD treatment and services.

SAMHSA has demonstrated the effectiveness of SBIRT and continues to disseminate SBIRT 

practices. As of 2015, SAMHSA data show roughly 2.0 million individuals have received 

screening and/or intervention through this initiative.130 Of those screened, roughly 15 percent 

were determined to be at risk, another 2.5 percent were referred for brief treatment, and an 

additional 2.5 percent are referred to specialty treatment.131 As of 2015, about 600 medical 

residents and 14,500 nonresidents (e.g. physician assistants, psychologists, and social workers) 

have been trained in SBIRT practices.132

126 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. 127 Kahan, M., Wilson, L., & Becker, L. (1995). Effectiveness of physician-based interventions with problem 

drinkers: A review. Canadian Medical Association Journal, 152, 851–859. 128 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.

129 RTI International (2009). RTI International to Evaluate Comprehensive Substance Abuse Intervention Programs 

for SAMHSA. http://www.rti.org/newsroom/news.cfm?obj=070E322D-5056-B172-B8E8D0FB9C898DB7 130 Services Accountability Improvement System, (2015) 131 Services Accountability Improvement System, (2015) 132 Services Accountability Improvement System, (2015)
202

In FY 2015, SAMHSA funded 63 SBIRT Student Training grants to institutions of higher 

learning to develop a workforce of residents, physician assistants, social workers, nurses, 

dentists, psychologists, and pharmacists. SAMHSA also funded 24 continuation grants including 

nine state SBIRT continuation grants, 13 SBIRT Medical Professional Training continuation 

grants, and two SBIRT Medical Professional Training continuation grants. SAMHSA also 

supported funding of six contracts.

In FY 2016, SAMHSA is supporting 61 grant continuations (three state SBIRT, two SBIRT 

Medical Professional Training grants, and 56 Student Training grants), eight new State SBIRT 

grants, 12 new SBIRT Student Training grants, and one contract to continue integrating SBIRT 

into general medical and primary care settings.

Funding History

Fiscal Year Amount

FY 2013 $47,463,653

FY 2014 $46,889,000

FY 2015 $46,889,000

FY 2016 $46,889,000

FY 2017 $30,000,000

Budget Request

The FY 2017 Budget Request is $30.0 million, a decrease of $16.9 million from the FY 2016 

Enacted Level. As health care providers increasingly adopt the SBIRT model, the Budget 

prioritizes other substance use disorder treatment activities. SAMHSA plans to fund 

continuations grants for three state SBIRT, nine SBIRT Student Training grants, and 56 SBIRT 

Medical Professional Training grants. These grantees provide alcohol and drug screening. Many 

grantees also provide depression screening; grantees will be able to explore the addition of 

trauma screening in their programs. Lessons learned from these efforts will be used to develop an

implementation package for SBIRT to encourage its development and sustainability across 

healthcare settings. SAMHSA will support the efforts to screen approximately 145,000 

individuals per year and refer approximately 20 percent of these individuals for treatment using 

the SBIRT approach.
203

Outputs and Outcomes Table

Program: Screening, Brief Intervention and Referral to Treatment

NOTE: SAMHSA makes grant awards towards the end of the year. Therefore, the FY 2017 targets are based on the 

FY 2016 Enacted Level and the FY 2018 targets are based on the FY 2017 President’sBudget.

Measure

Year and Most Recent Result

Target for Recent Result 

(Summary of Result)

FY 2017

Target

FY 2018

Target

FY 2018

Target

+/-

FY 2017

Target

1.2.40 Increase the number of 

clients served. (Output)

FY 2015: 331,111

Target: 52,510 

(Target exceeded)

143,783 143,783 Maintain

1.2.41 Increase the percentage of 

clients receiving services who had 

no past month substance use. 

(Outcome)

FY 2015: 29.6%

Target: 36.0%

(Target not met but improved)

36.0% 36.0% Maintain
204

Targeted Capacity Expansion

(Dollars in thousands)

Programs of Regional & National Significance

FY 2015

Final

FY 2016

Enacted

FY 2017

President's 

Budget

FY 2017

+/-

FY 2016

Targeted Capacity Expansion............................................... $23,223 $36,303 $61,303 +$25,000

Medication-Assisted Treatment for Prescription Drug

and Opioid Addiction (non-add)....................................

12,000 25,000 50,080 +25,080

Authorizing Legislation ........................................... Sections 509 of the Public Health Service Act 

FY 2017 Authorization .........................................................................................................Expired

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

Eligible Entities........................................Domestic Public and Private Non-Profit Entities, States, 

Opioid Medication-Assisted Treatment Service Providers, Outpatient Substance Abuse 

Providers, Community Mental Health Centers, and Federally Qualified Health Centers,

SAMHSA Certified Opioid Treatment Programs, 

Licensed Outpatient Substance Abuse Treatment Programs

Program Description and Accomplishments

Urgent, unmet, and emerging substance use disorder (SUD) treatment and recovery support 

service capacity needs remain a critical issue for the nation. These needs not being addressed 

lead to a host of individual, societal, and community consequences. In an effort to assist 

communities in overcoming these barriers, the Targeted Capacity Expansion (TCE) program was 

initiated. The program provides rapid, strategic, comprehensive, and integrated communitybased responses to gaps in and capacity of 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 (HITs) in SUD 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/naloxone, methadone, and injectable extended release naltrexone) in 

combination with evidence-based behavioral therapies for 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.

In 2010, drug overdoses overtook traffic accidents, guns, and falls, as a cause of death, totaling 

more than 38,329 overall deaths, 30,006 of which were unintentional.133 On average, 105 people 

die every day as a result of a drug overdose; 52 from overdose of prescription painkillers.134,135

133 CDC. (2010). Compressed Mortality File Underlying Cause-of-Death Wide-ranging OnLine Data for 

Epidemiologic Research (WONDER) on Mortality. Retrieved fromhttp://wonder.cdc.gov/mortsql.html. 134 CDC. (2015). National vital statistics system mortality data. Retrieved from http://www.cdc.gov/nchs/deaths.htm 135 http://www.cdc.gov/nchs/data/health_policy/AADR_drug_poisoning_involving_OA_Heroin_US_2000-2014.pdf
205

Heroin overdose deaths have also increased with 8,200 people dying in 2013.136 Overdose 

deaths involving opioid pain relievers quadrupled from 1999 to 2013. From 2002 to 2013, 

heroin overdose deaths have nearly quadrupled with 8,200 people dying in 2013.137 Heroin 

overdose death rates increased by 26% from 2013 to 2014 and have more than tripled since 

2010, from 1.0 per 100,000 in 2010 to 3.4 per 100,000 in 2014.138 Despite these troubling 

statistics, significant gaps persist between treatment need and capacity. In 2012, 48 states and 

the District of Columbia reported levels of opioid use disorder 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.139

MAT PDOA addresses treatment needs of individuals who have an opioid use disorder by 

expanding/enhancing treatment system capacity to provide accessible, effective, comprehensive, 

coordinated/integrated, and evidence-based MAT and recovery support services.

The program aim of expanding and enhancing MAT and recovery support services aligns well 

with the goals of the U.S. Department of Health and Human Services comprehensive strategy to 

address the opioid public health crisis across. Targeting states with the highest rates and dramatic 

increases in primary treatment admissions of opioid use disorders, the FY 2015 program 

supported 11 state grants at $1.0 million annually for three years. The funds enabled the 11 

states to expand access to MAT and recovery support services in approximately 22 

communities with the greatest need. The program outcomes include increasing length of stay in 

treatment, first time treatment admissions, the number of people receiving MAT, the number of

people receiving recovery support/relapse prevention services, and the number of MAT 

providers. SAMHSA also used $1.0 million to support a contract that provides training and 

technical assistance to grantees.

In FY 2016, SAMHSA will use $11.5 million for 11 new state grants to expand MAT and 

recovery support services and coordinate and integrate direct services for HIV and hepatitis C; 

these grants will prioritize treatment regimens that are less susceptible to diversion for illicit 

purposes. SAMHSA will use a total of $2.5 million to provide training and technical assistance 

to new and continuing grantees. SAMHSA will also support continued funding for 11 state 

grants.

Targeted Capacity Expansion

The TCE program supports numerous efforts including the provision of peer-to-peer addiction 

recovery services, the use of technology-assisted care, and the delivery of Medication Assisted 

Treatment.

136 CDC. (2015). Vital Signs: Today’s Heroin Epidemic. Retrieved from 

http://wonder.cdc.gov/wonder/help/mcd.html

137 CDC. (2015). Vital Signs: Today’s Heroin Epidemic. Retrieved from 

http://wonder.cdc.gov/wonder/help/mcd.html

138 Rose A. Rudd, MSPH1; Noah Aleshire, JD1; Jon E. Zibbell, PhD1; R. Matthew Gladden, PhD1, Increases in 

Drug and Opioid Overdose Deaths — United States, 2000–2014, Morbidity and Mortality Weekly Report. January 

1, 2016 / 64(50); 1378-82.

139Jones, C. M., Campopiano, M., Baldwin, G., McCance-Katz, E. (2015). National and state treatment needand

capacity for opioid agonist medication-assisted treatment. American Journal of Public Health, 105(8), e55-c63.
206

Targeted Capacity Expansion-Technology Assisted Care (TCE-TAC)

Access to treatment still remains inadequate for underserved populations living with substance 

use disorders and/or co-occurring mental and substance use disorders, such as those living in 

rural and extremely rural areas. A key component of this access challenge relates to a lack of 

dependable transportation but many organizations experience significant financial constraints in 

serving these populations. SAMHSA believes providers who use health information technologies

can help patients improve their access to necessary care and prevention services. For example, 

telehealth and telepsychiatry can bring addiction medicine providers to clients in areas without 

local specialists and web-based tools can improve communication and help deliver much-needed 

support and education. Health information technologies can also enable providers to document 

and coordinate better care 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, and web-based technologies and applications, 

telemedicine, and telepsychiatry. 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 track and manage 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) have affected 48 behavioral healthcare organizations across 23 states. Grantees 

have deployed all of the above mentioned technologies to provide substance use disorder 

treatment services directly or via remote service delivery (i.e., telemedicine). In FY 2014, the 

TCE-TAC and TCE- HIT programs served roughly 3,500 individuals.

In FY 2015, SAMHSA funded 13 TCE-TAC continuation awards. In FY 2016, SAMHSA is 

funding 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.

Targeted Capacity Expansion-Peer to Peer (TCE-PTP)

Peer support is built on the premise that individuals in recovery from substance use disorders 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, 

extends the reach of treatment beyond the clinical setting into the everyday environment of those 

seeking to achieve or sustain recovery from substance use disorders. Peer support and peer 

recovery support services have been shown to reduce healthcare costs.140 There is currently a

short supply of adequately trained peer support providers to work both in treatment and 

community-based settings. There is also a growing need to train and certify existing peer 

providers to address the growing demand and diverse settings in which peer providers are 

employed. Since 2002, SAMHSA has awarded over 75 grants to community-based organizations 

to provide peer recovery support services to individuals in or seeking recovery from substance 

use disorders and their families. The primary objective of these services is to

140 OPTUM. (2013). Innovations in Consumer-Centered, Recovery-Oriented Care.
207

help individuals and families 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 5,600 individuals and their families. Significant strides 

have been made in increasing abstinence, work and educational opportunities, social

connections, housing stability, housing support, and decreasing criminal justice involvement. In 

FY 2013, the percentage of people who were employed or currently attending school increased 

from 16.4 percent at intake to 34.2 percent at six-month follow-up and abstinence in the past 30 

days from alcohol and drug use improved from 71.2 percent at intake to 86.8 percent at sixmonth follow-up. In addition, the percentage of individuals reporting stability in housing 

improved from 46.5 percent at intake to 56.5 percent at six-month follow-up.

In FY 2015, SAMHSA funded 16 continuation grants and in FY 2016, SAMHSA is supporting 

15 new TCE peer-to-peer grants. Additionally, SAMHSA supported two contracts in FY 2015 

and FY 2016.

Funding History

Fiscal Year Amount

FY 2013 $26,516,495

FY 2014 $13,223,000

FY 2015 $23,223,000

FY 2016 $36,303,000

FY 2017 $61,303,000

Budget Request

The FY 2017 Budget Request includes a total of $61.3 million, an increase of $25.0 million from 

the FY 2016 Enacted Level. SAMHSA plans to fund 51 continuation grants. This includes 

22 MAT PDOA, 13 TCE-TAC, and 16 TCE-PTP grants.

The FY 2017 Budget Request for the MAT PDOA grant program is $50.1 million, an increase of

$25.1 million from the FY 2016 Enacted Level. The $25.1 million increase will focus 

specifically on MAT expansion/enhancement efforts. The funding will enable SAMHSA to 

support 23 new MAT PDOA state grants at $1.0 million to expand/enhance MAT utilizing FDAapproved medications in combination with psychosocial services, recovery support services, and 

coordination/integration of HIV/hepatitis-C direct services. This funding will increase the 

number of States receiving MAT PDOA grants from 22 to 45. The program will target states that 

demonstrated a dramatic increase in treatment admissions for opioid use disorders and that 

experienced the highest rates of treatment admissions for opioid use disorders. Program 

outcomes include length of stay in treatment, first time treatment admissions, the number of 

people receiving MAT, the number of people receiving recovery support/relapse prevention 

services, and the number of MAT providers. SAMHSA will also track client-level outcomes 

such as abstinence from substance use, housing, employment and criminal justice status and
208

social connectedness.Ultimately, individuals with opioid use disorders will have increased 

access to effective, comprehensive, coordinated care that will serve to foster recovery.

Outputs and Outcomes Table

Program: Medication-Assisted Treatment for Prescription Drug and Opioid Addiction 

NOTE: SAMHSA makes grant awards towards the end of the year. Therefore, the FY 2017 targets are based on the 

FY 2016 Enacted Level and the FY 2018 targets are based on the FY 2017 President’sBudget.

Measure

Year and Most Recent Result

Target for Recent Result 

(Summary of Result)

FY 2017

Target

FY 2018

Target

FY 2018

Target

+/-

FY 2017

Target

1.3.01 Increase the number of 

admissions for Medication Assisted 

Treatment. (Output)

FY 2016: Result expected 

Dec 31, 2016

Target: Set baseline 

(Pending)

1.3.02 Increase number of clients 

receiving integrated care. (Output)

FY 2016: Result expected 

Dec 31, 2016

Target: Set baseline 

(Pending)

1.3.03 Decrease illicit drug use at 

6-month follow-up. (Outcome)

FY 2016: Result expected 

Dec 31, 2016

Target: Set baseline 

(Pending)
209

Cohort Monitoring and Evaluation of Medication-Assisted Treatment Outcomes

(Dollars in thousands)

Programs of Regional & National Significance

FY 2015

Final

FY 2016

Enacted

FY 2017

President's 

Budget

FY 2017

+/-

FY 2016

Cohort Monitoring and Evaluation of Medication-Assisted 

Treatment Outcomes (Mandatory)................................... $--- $--- $15,000 +$15,000

Authorizing Legislation ......................................................................................New Authorization

FY 2017 Authorization .......................................................................................New Authorization

Allocation Method ....................................................................Contracts/Cooperative Agreements

Eligible Entities..................................................................Public and Private nonprofit institutions

Program Description and Accomplishments

As part of the Administration’s two-year initiative to expand access to treatment for prescription 

drug abuse and heroin use, the Budget proposes the Cohort Monitoring and Evaluation of 

Medication-Assisted Treatment Outcomes. Public and substance abuse treatment agencies will 

evaluate the short, medium, and long-term outcomes of substance abuse treatment programs in 

order to increase effectiveness reducing opioid use disorders, overdose, and death. Under this 

proposal, SAMHSA will work with other research agencies within the Department of Health and 

Human Services and will prospectively monitor the treatment outcomes of patients with opioid 

addiction entering medication-assisted treatment programs. This demonstration will provide 

valuable insight into the effectiveness of treatment programs employing medication-assisted 

treatment under real-world conditions and help identify opportunities to improve treatment for 

patients with opioid addiction. Systematic information on the outcomes of patients who undergo 

medication-assisted treatment is currently lacking. Cohort monitoring is commonly used to 

monitor treatment of patients with infectious diseases, such as tuberculosis treatment, and drives 

accountability for patient outcomes; a similar approach could be useful to improving addiction 

treatment.

Funding History

Fiscal Year Amount

FY 2013 ---

FY 2014 ---

FY 2015 ---

FY 2016 ---

FY 2017 $15,000,000

Budget Request

The FY 2017 Budget Request includes $30.0 million in mandatory funding ($15.0 million in 

FY 2017 and $15.0 million in FY 2018) for the new program, Cohort Monitoring and Evaluation 

of MAT Outcomes. These funds would evaluate the outcomes of substance abuse treatment 

programs. This effort intends to increase MAT effectiveness by reducing opioid use disorders,
210

overdose, and death. This funding is part of the Administration’s $1.0 billion initiative to 

increase access to treatment for prescription drug abuse and heroin use.

Buprenorphine-Prescribing Authority Demonstration

(Dollars in thousands)

Programs of Regional & NationalSignificance

FY2015

Final

FY2016

Enacted

FY2017

President's 

Budget

FY2017

+/-

FY2016

Buprenorphine-Prescribing Authority Demonstration............ $--- $--- $10,000 +$10,000

Authorizing Legislation .............................................Section 509 of the Public Health Service Act 

FY 2017 Authorization .........................................................................................................Expired

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

Eligible Entities..................................................................Public and Private nonprofit institutions

Program Description and Accomplishments

Access to medication assisted treatment is widely considered to be inadequate to meet the current 

need for the treatment of opioid use disorder.141 Buprenorphine, in various formulations, is a 

Schedule III prescription drug approved by the Food and Drug Administration (FDA) for the 

treatment of opioid use disorder. Its effectiveness in treating addiction and reducing mortality is 

well established. The Drug Addiction Treatment Act of 2000 (DATA 2000) excludes the 

prescription of buprenorphine by advance practice nurses, physician assistants, and other nonphysician advance practice providers, even if they are authorized to prescribe controlled 

Schedule III substances by the jurisdiction in which they are licensed.142 To improve the public 

health response to the national crisis of opioid use disorder and overdose deaths, the Budget 

explores alternative approaches to improving access to treatment through a services research

demonstration program to determine the safety and effectiveness of prescribing buprenorphine 

by non-physician advance practice providers in accordance with the provider’s prescribing 

authority under state law. In all cases, training will be provided to minimize risk of diversion.

141 Jones, 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. 142 Health Resources and Services Administration (2015), Health of the Workforce. 

http://bhpr.hrsa.gov/healthworkforce/supplydemand/usworkforce/chartbook
211

Funding History

Fiscal Year Amount

FY 2013 ---

FY 2014 ---

FY 2015 ---

FY 2016 ---

FY 2017 $10,000,000

Budget Request

The FY 2017 Budget Request is $10.0 million, an increase of $10.0 million from the FY 2016 

Enacted Level for Buprenorphine-Prescribing Authority Demonstration, a new program. 

SAMHSA intends to implement a services research demonstration project that will test the safety 

and effectiveness of allowing prescribing buprenorphine by non-physician advance practice 

providers in accordance with the providers’ prescribing authority under state law. SAMHSA 

will collaborate with professional organizations that represent advance practice nurses, physician 

assistants, and other non-physician advance practice providers as well as addiction psychiatrists 

and primary care physicians to determine the appropriate training and supervision requirements 

for advance practice providers in order to assure patient safety and well-being while minimizing 

diversion of buprenorphine.

This demonstration project will target populations and geographic areas most affected by both 

high-need and limited access to physicians with buprenorphine prescribing authority. Input from 

stakeholders will be solicited as needed to assure the project results in a feasible implementation 

strategy for increasing access to buprenorphine treatment in the targeted areas. In coordination 

with the Drug Enforcement Agency (DEA), the impact of the project will be assessed using 

community-level measures such as overdose mortality, incidence of HIV and acute hepatitis C 

infections, and DEA reported drug seizures. For the purposes of this demonstration, SAMHSA 

has proposed changes to the general provision to allow inclusion of non-physician providers in 

the demonstration.

In FY 2017, SAMHSA plans to award seven new grants for up to three years and one evaluation 

and technical assistance contract for three years.
212

Pregnant and Postpartum Women

(Dollars in thousands)

Programs of Regional & NationalSignificance

FY2015

Final

FY2016

Enacted

FY2017

President's 

Budget

FY2017

+/- 

FY2016

Pregnant and PostpartumWomen........................................ $15,931 $15,931 $15,931 $---

Authorizing Legislation .............................................Section 508 of the Public Health Service Act 

FY 2017 Authorization .........................................................................................................Expired 

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

Eligible Entities.................................................... Domestic Public and Private Non-Profit Entities

Program Description and Accomplishments

Two percent of mothers living with children under the age of 18 reported symptoms that meet 

the clinical criteria for misuse of or dependence on illicit drugs or prescription drugs.143 Since 

many traditional substance use disorder 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 the need 

for treatment.144 Since 2003, SAMHSA has supported comprehensive residential substance use 

disorder treatment, prevention, and recovery support services for pregnant and postpartum 

women, their minor children, and services for other family members (e.g., fathers of the 

children) through the Pregnant and Postpartum Women program (PPW). SAMHSA has 

successfully implemented a family-centered approach in the PPW program, which has evolved 

over time. This 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 family-centered approach includes a variety of services and case management for 

women, children, and families. Services provided to women include: outreach; engagement; pretreatment; 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 and education; testing; counseling; and 

treatment of hepatitis, HIV/AIDS, and other sexually transmitted diseases. Services available to 

children include screening and developmental diagnostic assessments regarding social, 

emotional, cognitive, and physical well-being prevention assessments; 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 trauma-informed approach. 

143 National Institute on Drug Abuse. (2010). Substance Abuse Evaluated Among Women With Children. Retrieved 

from NIDANotes: http://www.drugabuse.gov/news-events/nida-notes/2010/12/substance-abuse-evaluated-amongwomen-children 144 Women and Treatment, Office of National Drug Control Policy, http://www.whitehouse.gov/ondcp/womentreatment
213

The PPW program provides essential services not covered under most public and private 

insurance. 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 post-partum women in need of residential substance use disorder treatment.

In FY 2015, SAMHSA supported six new three-year PPW program grant awards totaling

$3.0 million and the continuation of 19 PPW grants totaling $9.5 million. In addition, SAMHSA 

supported one new two-year Addiction Technology Transfer Center (ATTC) supplemental grant, 

which develops curriculum materials and disseminates the PPW program family-centered model 

to organizations and providers outside the grant program. SAMHSA funded seven contracts to 

continue support of comprehensive substance use disorder prevention, treatment, and recovery 

support services for women. A new five-year SAMHSA-funded evaluation of the PPW program 

started in FY 2015, assessing the effectiveness of the PPW program, documenting best practices 

and lessons learned, disseminating lessons learned that could be applied in other programs, and 

guiding programmatic and policy changes. The cross-site evaluation includes a process and 

outcome evaluation based on data from biannual and quarterly progress reports, local 

evaluations, Government Performance and Results Act of 2010 data, and other qualitative or 

quantitative data. In FY 2015, SAMHSA also developed and began implementing a two-year 

action plan to inform and guide the development of the PPW program in FY 2017 to ensure a 

wider uptake of a family-centered approach. SAMHSA is studying sustained models of care, 

developing training curricula, and planning for a state policy academy in order to support this 

effort.

In FY 2016, SAMHSA is supporting 26 three-year residential treatment grant continuations, one 

ATTC supplement grant continuation to continue support for comprehensive substance use 

disorder prevention, treatment, and recovery support services for women, their minor children, 

and family members. SAMHSA expects that these funds will support services for additional 

individuals, including 950 women, 1,900 children, and 1,000 other family members.

Funding History

Fiscal Year Amount

FY 2013 $15,634,445

FY 2014 $15,931,000

FY 2015 $15,931,000

FY 2016 $15,931,000

FY 2017 $15,931,000

Budget Request

The FY 2017 Budget Request is $15.9 million and is the same as the FY 2016 Enacted Level. In 

FY 2017, SAMHSA anticipates funding innovation grants, which will test different models for 

family-centered treatment programs, including outpatient treatment programs, which can be 

evaluated, replicated, and taken to scale by various organizations. These grants will help reduce 

the effects of substance use disorders; co-occurring depression, anxiety, and other mental health
214

issues; and trauma on pregnant and postpartum women, their minor children, and other family 

members. SAMHSA anticipates funding for two to five grants to reflect a range of local 

community-based organizations as well as grants to states, territories, and tribes.

The innovation grants will provide grantees with the flexibility to select different configurations 

of required and optional family-centered services for pregnant and postpartum women and their 

minor children, including, as today, residential treatment and intensive out-patient treatment. 

Grantees will be allowed to develop a comprehensive package of services tailored to their local 

needs. Innovation grantees will be required to partner with one or more agencies involved with 

pregnant and postpartum women and infants who need substance use disorder treatment services, 

including primary health care agencies, child welfare, housing, and criminal justice to establish 

mutually-beneficial and sustainable partnerships. The Budget includes new appropriations 

language to allow the program to deliver outpatient treatmentservices.

In FY 2017, SAMHSA will also support six three-year residential treatment grant continuations 

and five contracts to increase access and availability to comprehensive, coordinated, and 

integrated treatment, and recovery support services for women, their minor children, and family 

members.

Strengthening Treatment Access and Retention

(Dollars in thousands)

Programs of Regional & National Significance

FY2015

Final

FY2016

Enacted

FY2017

President's 

Budget

FY2017

+/-

FY2016

Strengthening Treatment Access and Retention................... $1,000 $--- $--- $---

Authorizing Legislation .............................................Section 509 of the Public Health Service Act 

FY 2017 Authorization .........................................................................................................Expired

Allocation Method .............................................................................................................Contracts

Eligible Entities.......................................................................Domestic Public and Private Entities

Program Description and Accomplishments

Millions of previously uninsured people with mental and substance use disorders have gained 

health insurance coverage to treat these disorders because of the insurance expansions under the 

Affordable Care Act.145 There is an urgent need for behavioral healthcare providers to develop 

the business operations capacity needed to function efficiently in this redesigned healthcare 

services environment. Historically, substance use disorder treatment providers have served as

the primary source of treatment to the nation’s low income and vulnerable populations.

145 Substance Abuse and Mental Health Services Administration. Projections of National Expenditures for 

Treatment of Mental and Substance Use Disorders, 2010–2020. HHS Publication No. SMA-14-4883. Rockville, 

MD: Substance Abuse and Mental Health Services Administration, 2014.
215

SAMHSA’s Strengthening Treatment Access and Retention (STAR) program supports 

behavioral healthcare providers in their efforts to upgrade their business operations capacity in a 

changing health care marketplace. Treatment providers receive intensive training and support 

through coach-facilitated peer learning networks. Since 2012, SAMHSA has provided training 

to more than 1,500 provider organizations through 100 learning networks. In FY 2014, 

SAMHSA supported two State-level learning networks and converted the learning network 

curriculum modules to an online self-paced learning program, providing Continuing Education 

Units (CEUs) to participants. Roughly 450 individuals registered for courses in the first two 

months following the announcement of the new offering. Over 85 percent of learning network 

participants reported that they are better prepared to make changes to business practices in their 

organizations because of this training.

In FY 2015, SAMHSA supported one contract under the STAR program for the continuation of 

the provider business operations learning network contract. Due to the program’s elimination in 

FY 2016, SAMHSA will incorporate these learning networks into other financing efforts rather 

than support these networks as stand-alone efforts.

Funding History

Fiscal Year Amount

FY 2013 $1,584,387

FY 2014 $1,664,000

FY 2015 $1,000,000

FY 2016 ---

FY 2017 ---

Budget Request

The FY 2017 Budget Request of $0.0 is the same as the 2016 Enacted Level, representing the 

elimination of funding for the program. Much of the technical assistance provided to behavioral 

health industry treatment providers for business operations will be incorporated into other 

contracts with more focus on not only the opportunities under the Affordable Care Act but also 

through partnerships and shared business practices.
216

Recovery Community Services Program

(Dollars in thousands)

Programs of Regional & NationalSignificance

FY2015

Final

FY2016

Enacted

FY2017

President's

Budget

FY2017

+/- 

FY2016

Recovery Community Services Program............................. $2,434 $2,434 $2,434 $---

Authorizing Legislation .............................................Section 509 of the Public Health Service Act 

FY 2017 Authorization .........................................................................................................Expired 

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 Tribes

Program Description and Accomplishments

An estimated 23 million people in the United States are in recovery from addiction to alcohol 

and other drugs.146 Since 1998, SAMHSA has recognized the value of individuals in recovery in 

addressing substance use disorders. People in recovery can assist others by providing peer social 

support to persons in or seeking recovery from substance use disorders. The delivery of recovery 

support services by people in recovery is known as peer recovery support services (PRSS). PRSS 

can be a strong component in helping individuals and families address substance use disorders in 

the context of chronic disease management. PRSS programs are often provided by recovery 

community organizations (RCOs) that are led by people in recovery and have missions

to assist others in recovery. SAMHSA initiated the Recovery Community Services Program 

(RCSP) to help build an infrastructure for PRSS programs and RCOs to support the development 

and expansion of peer recovery services. Since the inception of the RCSP, over 74 RCOs and 

other organizations have received funding to expand PRSS locally and lay the groundwork for a 

national network of PRSS programs.

Though the RCSP was a services program, 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 is critical in 

ensuring 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 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. 

146 Partnership for Drug Free Kids, March, 2015. http://www.drugfree.org/newsroom/survey-ten-percent-ofamerican-adults-report-being-in-recovery-from-substance-abuse-or-addiction
217

Recovery Community Services Program Statewide Network (RCSP-SN)

The FY 2014 RCSP-SN grant program utilized prior evaluation data to support a new statewide 

approach to enhance the presence of people with lived experience in recovery from substance use 

disorders as key partners in state systems. Key activities include collaborating on local and state 

workforce-development activities, 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 will help states to design peer services and PRSS programs 

that are authentic to the recovery experience, complimentary to clinical practice, demonstrate 

strong recovery outcomes, and are sustainable over time. Additionally, the statewide networks 

can help to ensure the development of a trained, qualified, and aptly supervised peer workforce.

Key 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 2015, SAMHSA funded the continuation of the 10 grants and plans to continue the 

funding for those grants in FY 2016. In addition, SAMHSA has funded supporting technical 

assistance contracts for all three cohorts of grantees.

Statewide Peer Networks for Recovery and Resiliency (SPN-RR)

To ensure collaboration across the mental and substance use disorder programs, SAMHSAs 

Centers for Mental Health Services (CMHS) and Substance Abuse Treatment (CSAT) funded 

nine braided SPN-RR grants ($0.4 million in CMHS and $0.4 million in CSAT). Through this 

grant program, it is expected that the increased involvement of individuals in recovery from 

mental and substance use disorders will improve access to and increase the quality of behavioral 

health systems, services, treatment, and recovery supports statewide. This program addresses the 

need for people in recovery from mental and/or substance use disorders to be an integral part of 

the treatment system and to build the capacity of statewide consumer-run, family member-run, 

and addiction recovery community services organizations to promote a combined infrastructure 

development across the mental health and addiction recovery communities. SAMHSA tracks 

any braided amounts spent or awarded under their distinct appropriations and ensures that funds 

are used for purposes consistent with legislative direction and intent of the appropriations. 

Eligible applicants for this program were those organizations that had an existing mental health 

or addiction statewide network award from SAMHSA.

In FY 2015, SAMHSA funded eight new one-year SPN-RR grants. Funding also supported a 

technical assistance integrated contract. In FY 2016, SAMHSA is supporting eight new one-year 

grants.
218

Funding History

Fiscal Year Amount

FY 2013 $2,445,461

FY 2014 $2,434,000

FY 2015 $2,434,000

FY 2016 $2,434,000

FY 2017 $2,434,000

Budget Request

The FY 2017 Budget Request is $2.4 million, the same as the FY 2016 Enacted Level. 

SAMHSA plans to support a new cohort of 10 State Network grants and technical assistance to 

continue the efforts of building addiction recovery networks throughout the nation and the 

collaboration among peer-run organizations working toward mental and substance use disorders 

service integration.

Access to Recovery

(Dollars in thousands)

Programs of Regional & National Significance

FY2015

Final

FY2016

Enacted

FY2017

President's

Budget

FY2017

+/-

FY2016

AccesstoRecovery........................................................... $38,223 $ --- $ --- $---

Authorizing Legislation .............................................Section 509 of the Public Health Service Act 

FY 2017 Authorization .........................................................................................................Expired

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

Eligible Entities............................. States, Territories, District of Columbia, FederallyRecognized

American Indian/Alaska Native Tribes and Tribal Organizations

Program Description and Accomplishments

Access to Recovery (ATR) is a grant program that promotes person-centered care and choice of 

services and providers and supports states/tribes in developing expanded provider networks, 

including faith-based and secular providers, to provide comprehensive substance use disorder 

treatment and recovery support services. Since 2004, the ATR program has served over 650,000 

clients through 75 grantees. From 2010 to 2014, ATR data showed increases in the number of

clients employed post treatment, improved numbers of clients with stable housing post treatment, 

and a dramatic increase in abstinence from alcohol and/or illegal drugs.147

147 Substance Abuse and Mental Health Services Administration. (2014). Accomplishment and Lessons from the 

ATR Program FY 2010 -2014. Rockville, MD: Substance Abuse and Mental Health ServicesAdministration.
219

Through ATR, providers work with clients to link them to coverage for treatment services, where 

appropriate. Under ATR, states and tribal organizations are required to establish provider 

networks and develop a voucher-based mechanism to ensure client choice of treatment providers. 

ATR grant funds also support linkages between clients and treatment providers through state 

health information exchanges that ensure coordination and non-duplication of services and 

include traditional and non-traditional providers, such as faith-based and peer providers.

Performance data show increased functioning of clients receiving services through ATR. In FY 

2013, ATR clients who were employed or currently attending school improved from

30.3 percent at intake to 49.6 percent at six-month follow-up; abstinence from alcohol and drug 

use for the past 30 days improved from 68 percent at intake to 83.5 percent at six-month followup; and those who reported stability in housing improved from 34.9 percent at intake to

45.6 percent at six-month follow-up.

Beginning in FY 2014, the ATR program encouraged grantees to seek reimbursement from thirdparty payers for services covered by other sources, such as Medicaid, employer-based health 

coverage and Marketplace plans. Grantees were encouraged to focus on services that are likely 

not covered by insurance such as supportive services and direct services for those who are 

ineligible for insurance or unable to acquire such health coverage.

In FY 2014, SAMHSA awarded six fully funded three-year grants. These grants were funded 

with Prevention and Public Health Funds. In addition, funds supported one contract. In FY 

2015, SAMHSA fully funded five additional grants. This support helps to increase the adoption 

and implementation of integrated, peer-driven, recovery support, services, and systems for 

people with substance use disorders and mental health problems.

The FY 2016 Enacted Level eliminates funding for ATR. Many of the clinical services provided 

under ATR are now covered by public and private insurance. In addition, some states are now 

assisting in sustaining recovery support services and client choice with Substance Abuse 

Prevention and Treatment Block Grant funding. SAMHSA has identified successful substance 

use disorder treatment and recovery oriented systems of care models and will continue to offer 

technical assistance to states and tribes/tribal entities that want to maintain and develop further 

this activity. Multi-year funding continued for six ATR grants funded in FY 2014 and five ATR 

grants funded in FY 2015. The 11 ATR grant recipients will serve a minimum of 50,000 

individuals.

Funding History

Fiscal Year Amount

FY 2013 $93,127,920

FY 2014 $50,000,000

FY 2015 $38,223,000

FY 2016 ---

FY 2017 ---
220

Budget Request

The FY 2017 Budget Request of $0.0 is level with the 2016 Enacted Level, representing the 

elimination of funding for the ATR program. Many of the clinical services provided under ATR 

are now covered by public and private insurance. In addition, states are able to assist in

sustaining recovery support services and client choice with Substance Abuse Prevention and 

Treatment Block Grant funding. However, multi-year funding for five ATR grants awarded in 

FY 2015 will continue to provide services through FY 2017.

Outputs and Outcomes Table

Program: Access to Recovery

NOTE: SAMHSA makes grant awards towards the end of the year. Therefore, the FY 2017 targets are based on the 

FY 2016 Enacted Level and the FY 2018 targets are based on the FY 2017 President’sBudget.

1

The target change is based on resources and previous performance. 2

The program ends in FY 2017.

Measure

Year and Most Recent Result

Target for Recent Result 

(Summary of Result)

FY 2017

Target1

FY 2018

Target2

FY 2018

Target

+/-

FY 2017

Target

1.2.32 Increase the number of 

clients gaining access to treatment. 

(Output)

FY 2015: 25,645

Target: 11,150 

(Target exceeded)

8,000

1.2.33 Increase the percentage of 

adults receiving services who had 

no past month substance use. 

(Outcome)

FY 2015: 84.1%

Target: 80.0% 

(Target exceeded)

80.0%

1.2.35 Increase the percentage of 

adults receiving services who had 

no/reduced involvement with the 

criminal justice system. (Outcome)

FY 2015: 97.0%

Target: 93.0% 

(Target exceeded)

93.0%

1.2.36 Increase the percentage of 

adults receiving services who had 

improved social support. 

(Outcome)

FY 2015: 91.7%

Target: 88.0% 

(Target exceeded)

88.0%
221

Children and Families

(Dollars in thousands)

Programs of Regional & National Significance

FY2015

Final

FY2016

Enacted

FY2017

President's

Budget

FY2017

+/-

FY2016

Children and Families......................................................... $29,605 $29,605 $29,605 $---

Authorizing Legislation .............................................Section 514 of the Public Health Service Act 

FY 2017 Authorization .........................................................................................................Expired

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

Eligible Entities.................. Single State Agencies in States, Territories, and Districtof Columbia,

Federally Recognized American Indian/Alaska Native Tribes and Tribal Organizations

Program Description and Accomplishments

Substance use plays a significant role in the lives of children and youth (ages 12 to 25) 

throughout the nation. In 2013, 8.8 percent of youth between the ages of 12 and 17 and

21.5 percent of youth between the ages of 18 and 25 reported currently using illicit drugs.148 On 

average, 31 percent of children are removed from home care due to parental alcohol and/or drug 

use; this rate increases to 41 percent for children under the age of one. SAMHSA’s Children and 

Families programs make appropriate treatment available to youth and their families/caregivers to 

reduce the impact of substance use and/or co-occurring substance use and mental disorders on 

America’s communities.

Treatment for Youth with Substance Use Disorders (SUDs)

In 2013, less than 10 percent of youth (ages 12 to 25) with an illicit drug or alcohol use problem 

received the needed treatment at a specialty facility. Although data show that the number of 

youth with illicit drug or alcohol use problems has declined since 2002, there is still a significant 

percent that are not receiving treatment.149 Adolescents constitute 7.4 percent of total admissions 

to the public substance use disorder (SUD) treatment system.150 Youth have psychological, 

developmental, and emotional strengths and needs, which are distinct from the adults who make 

up the majority of the SUD treatment and recovery population. The neurological and 

developmental differences between youth and adults require tailored treatment and recovery 

approaches for youth with SUDs.

SAMHSA’s programs to treat youth with SUDs and/or co-occurring substance use 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), transitional-aged youth 

(ages 18 to 25), and their families and caregivers.

148 2013 National Survey on Drug Use and Health (NSDUH) 

149 2013 National Survey on Drug Use and Health (NSDUH) 150 2012 TEDS Report,CBHSQ
222

The initiative helps to further the use of, and access to, effective evidence-based family-centered 

treatment approaches for youth with SUDs and/or co-occurring substance use and mental 

disorders. The initiative includes statewide training and collaboration between local communitybased providers and their state, tribal, or territorial infrastructure. The services provided include 

evidence-based assessment and treatment interventions, which increase the availability of 

appropriate treatment for youth with SUDs.

From FY 2012 to FY 2014, these programs served approximately 2,500 individuals with 

approximately 56 percent of clients reporting being abstinent from substance use and 80 percent 

employed or engaged in productive activities. Since FY 2012, the initiative has assisted in 

developing or strengthening the infrastructures in 24 states, territories, and tribes, which resulted 

in the development of policies to increase access to treatment for youth with SUDs, an expanded 

trained workforce, the dissemination of evidence-based family centered practices, and the 

implementation of financial mechanisms to fund treatment for youth with SUDs.

In FY 2015, SAMHSA began a new five-year evaluation to assess the effectiveness of the 

initiative, document best practices, and disseminate lessons learned, and guide programmatic and 

policy changes. SAMHSA also restructured the initiative into two separate approaches in order 

to distinguish planning and implementation efforts. With this change, SAMHSA is supporting a 

two-year youth treatment planning grant and a three-year youth treatment implementation grant. 

The planning grant is designed to support infrastructure development only. It supports states, 

territories, and tribes in strengthening their existing infrastructure through the development a 

comprehensive strategic plan to improve treatment for adolescents and/or transitional aged youth 

with SUD and/or co-occurring substance use and mental disorders. The implementation grant is 

infrastructure and direct services. It further strengthens the existing state, territory, and tribal 

infrastructure system and provides direct treatment services for adolescents and/or transitional 

aged youth and their families/care givers with SUDs and/or co-occurring substance use and 

mental disorders.

Addressing Child Abuse and Neglect

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 works across agencies to provide technical assistance and training to 

professionals in order to meet the needs of families affected by parental substance use. From 

September 2014 through March 2015, NCSACW disseminated over 3,200 informational 

materials, which includes reports, guidance documents, presentations from conferences and 

webinars, research articles, tools kits, and grantee site-specific tools. NCSACW facilitated 30 

events, attended by an estimated 1,881 participants, with an average of 62 attendees per event. 

NCSACW monitored and provided support to trainees on web-based tutorials. Since 2007, 

26,639 users have completed the NCSACW’s tutorials. NCSACW’s activities have assisted 

professionals throughout the nation in improving cross system collaboration and being better 

prepared to meet child welfare mandates for timely child permanency decisions. NCSACW 

continues to provide support and technical assistance and training to state agencies developing 

collaborative approaches to the treatment of pregnant women with opioid use disorders. Online 

tutorials and website content are being updated. NCSACW will conduct an evaluation of 

SAMHSA’s FY 2015 Family Drug Treatment Court grant program.
223

In FY 2015, SAMHSA funded the continuation of 11 youth treatment grants, four contracts, 

13 new two-year youth treatment planning grants, and 11 new three-year youth treatment 

implementation grants.

In FY 2016, SAMHSA is maintaining FY 2015 activities by supporting 32 grant continuations 

(11 for youth treatment grants, 10 for youth treatment planning grants, and 11 for youth 

treatment implementation) and three contracts. SAMHSA also intends to fund two new youth 

treatment implementation grants and one new contract to support treatment for youth with SUD.

Funding History

Fiscal Year Amount

FY 2013 $29,018,408

FY 2014 $29,605,000

FY 2015 $29,605,000

FY 2016 $29,605,000

FY 2017 $29,605,000

Budget Request

The FY 2017 Budget Request is $29.6 million, the same as the FY 2016 Enacted Level. 

SAMHSA plans to support 14 grant continuations (13 for youth treatment implementation grants

and one youth treatment grant) and three contracts. In FY 2017, SAMHSA also intends to fund 

10 new youth treatment planning grants and 10 new youth treatment implementation grants. 

These funds will continue to address the gaps in substance use disorder treatment by providing 

services for youth, their families, and caregivers.

Treatment Systems for Homeless

(Dollars in thousands)

Programs of Regional & National Significance

FY2015

Final

FY2016

Enacted

FY2017

President's

Budget

FY2017

+/-

FY2016

Treatment Systems for Homeless........................................ $41,386 $41,304 $36,386 -$4,918

Authorizing Legislation ............................... Section 506 and 509 of the Public Health Service Act 

FY 2017 Authorization .........................................................................................................Expired

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

Eligible Entities.............. Domestic Community-Based Public and Private Non-Profit Entities and 

State Mental Health Authorities and Single State Authorities for Substance Abuse in Partnership

Program Description and Accomplishments

SAMHSA’s Treatment Systems for Homeless portfolio supports services for those with 

substance use disorders or co-occurring mental and substance use disorders. These activities
224

target those who experience homelessness, including veterans, and those experiencing chronic 

homelessness.

Between 2007 and 2014, homelessness in the United States declined by 11 percent, while 

chronic homelessness declined by 30 percent.151 Chronic homelessness is defined as individuals 

or families with a disabling condition who have been without housing for longer than one year or 

more than four times in the past three years. Despite this progress, the number of people 

experiencing homelessness remains at unacceptably high levels. On a given night in January 

2014, 578,242 individuals were experiencing homelessness. Of these individuals, 99,434 were 

experiencing chronic homelessness, 117,084 had severe mental illness, 116,770 were affected by 

chronic substance misuse, and 49,933 were veterans.152

Many factors contribute to the problem of homelessness, including lack of affordable housing, 

foreclosures, rising housing costs, job loss, underemployment, mental illness, and 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: 

preventing and ending homelessness among veterans by 2015; preventing and ending chronic 

homelessness by 2017; preventing and ending homelessness for families, youth, and children by 

2020; and setting a path to ending homelessness for all individuals. The services and support 

offered through SAMHSA’s Treatment Systems for Homeless programs are crucial to achieving 

these goals.

SAMHSA’s homelessness programs are a component of its Recovery Support Strategic 

Initiative. One of the goals of this Strategic Initiative is to increase access to permanent housing 

for individuals with mental illness and/or substance use disorders and their families. SAMHSA 

manages five Treatment Systems for Homelessness grant programs:

Grants for the Benefit of Homeless Individuals - Services in Supportive Housing (GBHI-SSH)

In FY 2008, SAMHSA initiated the GBHI-SSH to provide treatment services within a permanent 

supportive housing approach for those who experience chronic homelessness. In addition to 

strengthening substance use disorder treatment and co-occurring mental and substance use 

disorder treatment, this program requires placement in permanent housing for enrolled 

individuals. In FY 2014, SAMHSA expanded the focus to include veterans who experience 

homelessness.

151 The U.S. Department of Housing and Urban Development, Office of Community Planning and Development. 

(2014). The 2014 Annual Homeless Assessment Report (AHAR) to Congress, Part 1. Available

at: https://www.hudexchange.info/resources/documents/2014-AHAR-Part1.pdf 152 U.S. Department of Housing and Urban Development (HUD) 2014 Continuum of Care (CoC) Homeless 

Assistance Programs-Homeless Populations and Subpopulations Report. Available

at:https://www.hudexchange.info/resource/reportmanagement/published/CoC_PopSub_NatlTerrDC_2014.pdf
225

Cooperative Agreements to Benefit Homeless Individuals(CABHI)

In FY 2011, SAMHSA initiated the Cooperative Agreements to Benefit Homeless Individuals 

(CABHI) program, jointly funded by Center for Substance Abuse Treatment (CSAT) and Center 

for Mental Health Services (CMHS) to support treatment and the development and/or expansion 

of local systems that provide permanent housing and supportive services. This includes 

integration of treatment and other critical services for individuals with serious mental illness and 

substance use disorders. Target populations for this program include veterans and individuals 

with serious mental illness and/or substance use disorders. Through this program, SAMHSA 

supports HHS’s Arc of Keeping People Healthy and Safe. CABHI also supports coordination 

and planning at the local level with state or local Public Housing Authorities; local mental health, 

substance misuse, and primary care provider organizations; the local Department of Housing and 

Urban Development-supported Continuum of Care (CoC) program (designed to promote 

community-wide commitment to the goal of ending homelessness; provide funding for efforts by 

nonprofit providers, and state and local governments); the state Medicaid Office; and the state 

Mental Health and Substance Abuse Authorities.

Cooperative Agreements to Benefit Homeless Individuals for States (CABHI-States)

In FY 2013, SAMHSA initiated the CABHI-States program, funded jointly by CSAT and

CMHS, which builds on the CABHI program by working with states to provide accessible, 

effective, comprehensive, coordinated/integrated, and evidence-based treatment services. 

CABHI-States supports services for individuals with serious mental illness and/or substance use 

disorders who experience chronic homelessness and/or veterans who experience homelessness. 

It also provides peer supports and enhancement or development of a statewide plan to ensure 

sustained collaboration across public health and housing systems that will result in short-term 

and long-term strategies to support behavioral health services for individuals who experience 

chronic homelessness. The grantees work with state and local Public Housing Authorities and 

state Medicaid agencies to develop systematic, cost-effective, and integrated approaches to 

housing and behavioral health treatment and services for individuals with mental and/or 

substance use disorders experiencing homelessness. This program was further enhanced in 

FY 2015 with the implementation of CABHI State Enhancement grants, which enabled CABHIState grantees to build upon their programs.

Based on FY 2014 data for CSAT funded programs, 65.1 percent of clients in Treatment 

Systems for Homeless-supported programs report abstinence from substance use at a six-month 

follow up, while approximately 31 percent of clients report being employed or engaged in 

productive activities and 45.8 percent of clients report having a permanent place to live in the 

community.153

In FY 2015, SAMHSA supported 31 new grants (nine CABHI-States, 14 CABHI-States 

Enhancements, and eight for GBHI-SSH). SAMHSA also supported 36 continuation grants 

(10 CABHI-States and 26 GBHI-SSH). Additional funds supported three contracts for national 

evaluation and technical assistance.

153 Services Accountability Improvement System (SAIS); www.samhsa-gpra.samhsa.gov ; 2014.
226

In FY 2016, SAMHSA supports 30 new CABHI grants to states, local governments, and 

community based organizations and 51 continuation grants (32 GBHI-SSH, seven CABHI-States 

Enhancements, and 12 CABHI-States). Additional funds support cross-center contracts for 

national evaluation and technical assistance.

Funding History

Fiscal Year Amount

FY 2013 $39,396,853

FY 2014 $41,386,000

FY 2015 $41,386,000

FY 2016 $41,304,000

FY 2017 $36,386,000

Budget Request

The FY 2017 Budget Request is $36.4 million, a decrease of $4.9 million from the FY 2016 

Enacted Level. This decrease will not result in the termination of any grant continuations. In 

FY 2017, the Grants for the Benefit of Homeless Individuals-Services in Supportive Housing 

ends. SAMHSA plans to offset this cohort with a new CABHI-State cohort. Therefore, it will 

not significantly affect SAMHSA’s ability to implement its Homelessness programs. SAMHSA 

plans to support annual Cooperative Agreements to Benefit Homeless Individuals for StatesEnhancement (CABHI-States Enhancement) and Grants for the Benefit of Homeless Individuals 

(GBHI) grant continuations and continue to expand programs and support homeless programs 

through the support of new grants. SAMHSA plans to award 38 continuation grants; 23 for 

CABHI-State, seven for CABHI-States Enhancement and eight for GBHI-SSH. SAMHSA also 

plans to award 15 new CABHI grants. Additional funds will support the continuation of crosscenter contracts for national evaluation and technical assistance.
227

Outputs and Outcomes Table

Program: Treatment Systems for Homeless

NOTE: SAMHSA makes grant awards towards the end of the year. Therefore, the FY 2017 targets are based on the 

FY 2016 Enacted Level and the FY 2018 targets are based on the FY 2017 President’sBudget.

Measure

Year and Most Recent Result

Target for Recent Result 

(Summary of Result)

FY 2017

Target

FY 2018

Target

FY 2018

Target

+/-

FY 2017

Target

3.4.22 Increase the percentage of 

clients receiving services who had 

no past month substance use. 

(Outcome)

FY 2015: 65.2%

Target: 66.4%

(Target not met but improved)

63.7% 63.7% Maintain

3.4.23 Increase the number of 

clients served. (Output)

FY 2015: 4360

Target: 5800

(Target not met but improved)

5100 5100 Maintain

3.4.24 Increase the percentage of 

homeless clients receiving services 

who were currently employed or 

engaged in productive activities. 

(Outcome)

FY 2015: 30.2%

Target: 31.7% 

(Target not met)

30.0% 30.0% Maintain

3.4.25 Increase the percentage of 

clients receiving services who had a 

permanent place to live in the 

community. (Outcome)

FY 2015: 46.1%

Target: 33.0% 

(Target exceeded)

33.0% 33.0% Maintain
228

Minority AIDS

(Dollars in thousands)

Programs of Regional & NationalSignificance

FY2015

Final

FY2016

Enacted

FY2017

President's

Budget

FY2017

+/- 

FY2016

Minority AIDS................................................................... $65,570 $65,570 $58,859 -$6,711

Authorizing Legislation .............................................Section 509 of the Public Health Service Act 

FY 2017 Authorization .........................................................................................................Expired 

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

Eligible Entities.................................................... Domestic Public and Private Non-Profit Entities

Program Description and Accomplishments

At the end of 2011, 23 percent of all people living with HIV/AIDS in the United States were 

women; a disproportionate percent of the women living with HIV are Black/African American 

and Hispanic/Latina women.154 According to recent data, young men who have sex with men 

are also particularly affected by HIV, representing 25 percent of all new HIV infections.155 In 

addition, the Department of Health and Human Services’ Hepatitis Action Plan notes that people 

with HIV also are disproportionately affected by viral hepatitis and related adverse health 

conditions.156

Three of SAMHSA’s Minority AIDS Initiative (MAI) programs address HIV and hepatitis 

infection by facilitating the development and expansion of culturally competent and effective 

community-based treatment systems for substance use disorder (SUD) and co-occurring 

substance use and mental disorders treatment within racial and ethnic minority communities. 

The goals of the MAI program are to reduce the impact of behavioral health issues, reduce the 

risk for and incidence of HIV and hepatitis, and increase access to HIV and hepatitis testing and 

treatment for these individuals in states with the highest HIV prevalence rates (at or above 270 

per 100,000). 

154 Center for Disease Control and prevention. (2015). HIV Among Women. Retrieved from CDC.gov:

http://www.cdc.gov/hiv/group/gender/women/indez/html

155 Center for Disease Control and prevention. (2011). New multiyear data show annual HIV infections in U.S.

relatively stable. Retrieved from CDC.gov:

http://www.cdc.gov/nchhstp/newsroom/2011/HIVIncidencePressRelease.html

156 Health and Human Services. (2015). Combating the Silent Epidemic of Viral Hepatitis: Action Plan for the

Prevention, Care and Treatment of Viral Hepatitis. Retrieved from HHS.gov:

http://www.hhs.gov/ash/initiatives/hepatitis/

www.whitehouse.gov/sites/default/files/uploads/NHAS.pdf. (n.d.). Retrieved fromWhitehouse.gov: 

www.whitehouse.gov/sites/default/files/uploads/NHAS.pdf
229

Targeted Capacity Expansion Program (TCE): Substance Use Disorder Treatment for 

Racial/Ethnic Minority Populations at High-Risk for HIV/AIDS (TCE-HIV): High Risk 

Populations)

Under SAMHSA’s TCE-HIV program, grantees are required to provide substance use and/or cooccurring substance use and mental disorders treatment and recovery support services and 

HIV/AIDS testing and case management services. In addition, grantees must enhance 

infrastructure and capacity to improve their community’s response to HIV/AIDS by increasing 

access to care and services for racial and ethnic minorities at high risk for or living with 

HIV/AIDS. Target populations include young men who have sex with men, ages 18 to 29, adult 

heterosexual women and men, and men who have sex with men, ages 30 and older.

In the first half of FY 2014, grantees served nearly 4,000 new clients. Client demographics 

reported included 58.8 percent Black/African American, 55.4 percent Hispanic/Latino,

3.11 percent American Indian, and less than 2 percent Asian/Pacific Islanders. More than 1,600 

clients have been tested for hepatitis B virus and HCV. Those who tested positive were referred 

for confirmatory testing and treatment services. About 70 percent of clients reported reductions 

in unprotected sexual contact with an individual who is or was HIV positive or has AIDS.157

In FY 2015, SAMHSA funded 74 TCE-HIV: High Risk continuation grants, 26 new grant 

awards, and supported three contracts. In FY 2016, SAMHSA supported 78 grant continuations, 

23 new grants, and three contracts. These grants are expected to reduce the negative impact of 

behavioral health problems; increase access to and retention in treatment for behavioral health 

conditions; reduce the risk of HIV; reduce new HIV and viral hepatitis infections by increasing 

HIV and viral hepatitis testing and diagnosis; and increase provisions of or linkage to HIV care 

including antiretroviral therapy.

Targeted Capacity Expansion: Substance Abuse Treatment for Racial/Ethnic Minority Women 

at High Risk for HIV/AIDS (TCE-HIV: Minority Women)

The populations of focus for this program are African American, Hispanic/Latina, and other 

racial/ethnic minority women ages 18 years and older who have substance use or co-occurring 

substance use and mental disorders and are living with or at risk for HIV/AIDS and 

hepatitis. Grantees are expected to address the impact of violence and trauma on women’s 

increased risk of SUD and HIV infection, and provide comprehensive evidence-based traumainformed care services that consider the individuals adverse life experiences within the context of

their culture, history, and experience of traumatic events.

By August, 2014, grantees had enrolled approximately 3,000 clients in SUD treatment. Nearly 

2,400 clients self-reported traumatic experiences and 66.3 percent of them were referred to 

trauma-support services. Program effectiveness was demonstrated by client reports of reduced 

unprotected sexual contact with an individual intoxicated on some substance (25.9 percent) and 

quality of life improvements in such categories as employment and education (30 percent).158

157 Services Accountability Improvement System (SAIS), 2014 158 Services Accountability Improvement System (SAIS), 2014
230

In FY 2015, SAMHSA supported five grant continuations and supporting contracts. SAMHSA 

will continue to support five grant continuations and supporting contracts in FY 2016.

Minority AIDS Initiative Continuum of Care Pilot- Integration of HIV Prevention and Medical 

Care into Mental Health and Substance Abuse Treatment Programs for Racial/Ethnic Minority 

Populations at High Risk for Mental and Substance Use Disorders and HIV (MAI CoC Pilot: 

Integration of HIV Medical Care into BH Programs or “MAI-CoC”)

In FY 2014, SAMHSA’s Centers for Mental Health Services, Substance Abuse Prevention, and

Substance Abuse Treatment supported the MAI Continuum of Care Pilot (MAI CoC). This grant 

supports substance use disorder (SUD) treatment, primary prevention/treatment service

programs, community mental health programs, and HIV/AIDS integrated programs that either 

can co-locate or have fully integrated HIV/AIDS prevention and medical care services for 

racial/ethnic minority populations. This program also provides primary prevention services for 

SUD and HIV/AIDS in local communities served by behavioral health programs. In addition, 

approximately 20 percent and 23 percent of those with Serious Mental Illness such as 

schizophrenia, bipolar disorder, and major depression are infected with hepatitis C virus and 

hepatitis B virus, respectively, while between 14 and 36 percent of those who misuse alcohol are

infected with hepatitis C virus.159,160

SAMHSA currently supports an ongoing consolidated evaluation of its HIV/AIDS programs. 

This comprehensive process and outcome evaluation will assess the degree to which SAMHSA 

is providing effective and efficient mental and substance use disorder services and prevention 

programs to those with and at risk of HIV/AIDS. The evaluation results will help inform 

program development and refine the approach used in SAMHSA’s HIV portfolio, including the 

programs described in this section.

In FY 2015 SAMHSA funded the continuation of 34 HIV MAI CoC grants and supported 

technical assistance efforts. SAMHSA continues to support these 34 programs in FY 2016.

Funding History

Fiscal Year Amount

FY 2013 $61,918,238

FY 2014 $65,570,000

FY 2015 $65,570,000

FY 2016 $65,570,000

FY 2017 $58,859,000

159Bhattacharya R, Shuhart MC. Hepatitis C and alcohol: interactions, outcomes, and implications. JClin 

Gastroenterol. 2003;36(3):242-52. 160 Rosenberg et al. Prevalence of HIV, Hepatitis B, and Hepatitis C in People With Severe Mental Illness. Am J 

Public Health. 2001;91:(31–37).
231

Budget Request

The FY 2017 Budget Request is $58.9 million, a decrease of $6.7 million from the FY 2016 

Enacted Level. This represents a shift in funding to the Mental Health appropriation. In FY

2017, this shift in funding will allow for the award of a new cohort of MAI Continuum of Care 

(COC) grantees that will address the holistic behavioral health needs of those living with HIV. 

Three SAMHSA Centers will jointly administer the program. This funding will continue to

enhance and expand the provision of effective, culturally competent, HIV/AIDS-related mental

health services in minority communities for people living with HIV/AIDS. SAMHSA also plans 

to fund 86 grant continuations and support three contracts for evaluation and technical assistance. 

SAMHSA will also award 57 new TCE-HIV grants. SAMHSA also plans to award five new 

TCE-HIV: Minority Women grants. With these efforts, SAMHSA expects to serve 4,500 clients 

through the TCE-HIV: High Risk Population program and 3,000 clients in the TCE-HIV 

Minority Women program.

Criminal Justice Activities

(Dollars in thousands)

Programs of Regional & NationalSignificance

FY2015

Final

FY2016

Enacted

FY2017

President's

Budget

FY2017

+/-

FY2016

Criminal Justice Activities................................................... $78,000 $78,000 $61,946 -$16,054

Authorizing Legislation .............................................Section 509 of the Public Health Service Act 

FY 2017 Authorization .........................................................................................................Expired

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 and 

Government with Direct Involvement with Adult Criminal Courts,

Tribal Organizations and Individual Adult Tribal Healing to Wellness Courts,

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 substance use disorders and/or co-occurring substance use and mental disorders.

Drug Courts

Many individuals who come in contact with law enforcement and the criminal or juvenile justice 

systems have a mental and/or substance use disorder. For example, more than 80 percent of state 

prisoners, 72 percent of federal prisoners, and 82 percent of jail inmates meet the criteria for 

having either a mental health or substance use issue. Studies have found that for youth in the 

juvenile justice system, 50 percent to 70 percent met the criteria for a mental disorder and 

60 percent met the criteria for a substance use disorder. Of those youth with co-occurring mental
232

and substance use issues, almost 30 percent experienced severe disorders that impaired their 

ability to function.161 The criminal justice system was the major source of referrals to substance 

use treatment, with probation or parole treatment admissions representing the largest proportion 

of criminal justice system referrals.162 Of the probation or parole admissions, most were males 

between the ages of 18 and 44.163 The most common substances reported by these referrals were 

alcohol, marijuana, and methamphetamine. Similarly, in SAMHSA’s adolescent substance use 

disorder treatment grant programs, juvenile justice is the most frequent referring agency. 

Although the prevalence of substance use disorders is high, only about 10 percent of those 

involved in the justice system received treatment and recovery services.

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 drug use, child 

abuse/neglect or criminal behavior, mental illness, and veterans’ issues. Drug courts represent 

the coordinated efforts of the judiciary, prosecution, defense bar, probation, law enforcement, 

mental health, social service, and treatment communities to actively 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 use disorders, 

and develop the capacity and skills to become fully-functioning parents, employees, and citizens.

Of the almost 2,900 drug courts for adults, juveniles and those in the family dependency in 

existence in 2015, many lack sufficient funding for substance use disorder treatment and 

recovery services.164 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 substance use disorders in the respective problem-solving court 

models as long as the court meets all the elements required for drug courts. The intent is to meet

the clinical needs of clients and ensure clients are treated 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 Adult Drug Court programs support a variety of services including, direct treatment 

services for diverse populations at risk, wraparound/recovery support services designed to 

improve access and retention, drug testing for illicit substances required for supervision, 

treatment compliance, and therapeutic intervention, education support, relapse prevention and 

long-term management, medication-assisted treatment (MAT), 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

161 SAMHSA. (2015). Criminal and Juvenile Justice. Retrieved from Topics: http://www.samhsa.gov/criminaljuvenile-justice

162 2012 Client Level Data/TEDS CBHSQ. http://www.samhsa.gov/data/client-level-data-teds 

163 SAMHSA. (2015). Criminal and Juvenile Justice. Retrieved from Topics: http://www.samhsa.gov/criminaljuvenile-justice

164 SAMHSA's GAINS Center for Behavioral Health and Justice Transformation. (n.d.). Adult Mental Health

Treatment Courts Database. Retrieved from Judges andCourts:

http://gainscenter.samhsa.gov/judgescourts/courtsjudges.asp
233

decrease the differences in access, service use, and outcomes among the racial and ethnic 

minority populations served.

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’s funding opportunity announcements require evidence-based practices to be used 

from federal inventories, including SAMHSA’s National Registry of Evidence-Based Programs 

and Practices. SAMHSA also has regular communications with the National Association of 

Drug Court Professionals to obtain and incorporate the latest findings and field expertise.

Performance data show that these grant programs are effective in improving the lives of drug 

court participants. In FY 2014, 7,064 clients received services through the Drug Court Programs. 

Of these, 59.8 percent of adult clients were either employed or engaged in productive activities. 

Of the adult clients who received services, 42.2 percent had a permanent place to live in the 

community, 85.6 percent had no past month substance use, and 91.2 percent had no involvement 

with the criminal justice system thirty days prior to intake.

In FY 2015, SAMHSA supported the continuation of 103 drug court grants, 10 new adult and 

family drug court grants, and 49 new Treatment Drug Courts. Additionally, SAMHSA conducted

a performance evaluation of the FY 2015 Family Treatment Drug Court (FTDC) grant program. 

The purpose of this evaluation is to measure the performance of each FY 2015 FTDC grantee, 

including assessing the progress of children, parents, and family functioning after receiving 

SAMHSA funding.

In FY 2015, SAMHSA’s Adult Drug Court grant programs were required to ensure that drug 

courts funded by SAMHSA could not deny the use of FDA-approved medications for MAT to 

drug court clients. Drug court judges, however, retained judicial discretion in cases where 

specified conditions for MAT provision were not met.

In FY 2016, SAMHSA is funding 123 drug court grant continuations, one contract, and 61 new 

Drug Court grants, with enhancements such as the inclusion of peer navigators, including new 

BJA jointly funded drug court grants.

Criminal Justice Other/Offender Reentry Program

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.

Studies show that only 8.3 percent of individuals involved with the criminal justice system who 

are in need of substance use disorder treatment receive it as part of their justice system 

supervision. Approximately one-half of the institutional treatment provided is educational 

programming.165 Over the past decade, awareness of the need for a continuum of care of

165 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.
234

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 offenders reentering the community from incarceration. ORP services include 

screening, comprehensive individual assessment for substance use and/or co- occurring mental 

disorders, case management, program management, referrals related to substance use disorder 

treatment for clients, alcohol and drug treatment, wraparound services drug testing, and relapse 

prevention and long-term management support.

In FY 2014, 2,232 clients received services through the Offender Reentry Program with 79 

percent of clients reporting no substance use in the past month. Nearly 94 percent of clients receiving 

services had no involvement with the criminal justice system at the time of the evaluation.

In FY 2015, SAMHSA supported 13 ORP grant continuations, four contracts, and eighteen new ORP 

grants that will implement the Risk-Needs- Responsivity Simulation Tool to implement best 

practices and opioid overdose prevention programs.

166

In FY 2016, SAMHSA is funding 10 ORP grant continuations, 12 new ORP grants, and two 

contracts.

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 and/or substance use disorders 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 focuses on adults with behavioral health problems, including serious 

mental illness, from the criminal justice system, including alternatives to incarceration. The program 

supports community behavioral health services for individuals with mental and/or substance 

disorders and includes a focus on veterans involved with the criminal justice system.

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. Over 1,400 individuals were served through the

166 George Mason University (2011). Risk-Needs-Responsivity (RNR) Simulation Tools. Retrieved from: Center for 

Advancing Correctional Excellence!:http://www.gmuace.org/research_rnr.html
235

BHTCC, with two-thirds of them identified as having co-occurring mental and substance use 

disorder treatment services, trauma-specific treatment, peer support, and more. Based on 

Transformation Accountability System (TRAC) reporting data, program participants experienced 

improvements in mental health and reductions in substance use. Mental health problems declined

by 20 percent in the first six months while alcohol and drug use declined by 60 percent over the 

same period. 74 percent of participants reported physical health improvements at six

months. In addition, employment rates increased from 36 percent to 45 percent over the first six 

months, with monthly median income increasing by $298.167

In FY 2015, SAMHSA provided continuation support for the second year of 17 four-year grants, 

continued technical assistance, and awarded a new evaluation contract. The new BHTCC 

evaluation focuses on examining the clinical and functional outcomes of program participants 

with behavioral health issues. The new BHTCC evaluation is building on the findings from the 

first cohort and more deeply 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 2016, SAMHSA continues support for these grants and the evaluation.

Funding History

Fiscal Year Amount

FY 2013 $63,558,000

FY 2014 $74,816,000

FY 2015 $78,000,000

FY 2016 $78,000,000

FY 2017 $61,946,000

Budget Request

The FY 2017 Budget Request is $61.9 million ($50.0 million for Drug Courts and $11.9 million 

for Other Criminal Justice Activities), a $16.1 million decrease from the FY 2016 Enacted Level.

SAMHSA plans to support 91 Drug Court continuations grants, five contracts, and 63 Drug 

Court new grants. These programs will continue to provide comprehensive treatment and 

recovery support services for adolescents and adults with substance use disorders who come into 

contact with the criminal justice system, as well as offenders re-entering the community. 

SAMHSA proposes to use this program to explore promising new approaches and identify 

potential models for replication. Through the Criminal Justice Drug Court grant program over

4,000 clients will be served in FY 2017, equal to the number served by the FY 2016 cohort.

SAMHSA plans to support 27 Offender Reentry Program (ORP) continuation grants and one

contract. Through the Other Criminal Justice/ORP grant program, 2,000 clients will be served in 

FY 2017. SAMHSA will not continue funding for 13 ORP grants that awarded in FY 2016.

167 Advocates for Human Potential. (2014). Evaluation of the Adult Treatment Court Collaborative Program: Final 

evaluation report. Albany, NY: Author.
236

The Criminal Justice Activities under the Drug Courts, Offender Re-Entry, and Behavioral 

Health Treatment Court Collaborative programs address the Administration’s multi-agency 

Native Youth priority to Increase Tribal Control of Criminal Justice, in support of the HHS 

Tribal Health and Well-Being Coordination.

Outputs and Outcomes Table 

Program: Criminal Justice - Drug Courts

NOTE: SAMHSA makes grant awards towards the end of the year. Therefore, the FY 2017 targets are based on the 

FY 2016 Enacted Level and the FY 2018 targets are based on the FY 2017 President’sBudget.

Measure

Year and Most Recent Result

Target for Recent Result 

(Summary of Result)

FY 2017

Target

FY 2018

Target

FY 2018

Target

+/-

FY 2017

Target

1.2.72 Increase the percentage of 

adult clients receiving services who 

were currently employed or 

engaged in productive activities. 

(Outcome)

FY 2015: 58.9%

Target: 55.0% 

(Target exceeded)

55.0% 55.0% Maintain

1.2.73 Increase the percentage of 

adult clients receiving services who 

had a permanent place to live in the 

community. (Outcome)

FY 2015: 43.8%

Target: 41.0% 

(Target exceeded)

41.0% 41.0% Maintain

1.2.74 Increase the percentage of 

adult clients receiving services who 

had no involvement with the 

criminal justice system. (Outcome)

FY 2015: 91.8%

Target: 91.0% 

(Target exceeded)

91.0% 91.0% Maintain

1.2.76 Increase the percentage of 

adult clients receiving services who 

had no past month substance use. 

(Outcome)

FY 2015: 85.1%

Target: 71.0% 

(Target exceeded)

71.0% 71.0% Maintain

1.2.79 Increase the number of adult 

clients served. (Output)

FY 2015: 5,497

Target: 4,413 

(Target exceeded)

4,369 4,369 Maintain
237

Outputs and Outcomes Tables

Program: Criminal Justice - Ex-Offender Re-Entry Program

NOTE: SAMHSA makes grant awards towards the end of the year. Therefore, the FY 2017 targets are based on the 

FY 2016 Enacted Level and the FY 2018 targets are based on the FY 2017 President’sBudget.

1,2 Decrease in target from prior year level reflects a decrease in funding and changes in datatrends.

Program: Criminal Justice - Teen Courts 1

NOTE: SAMHSA makes grant awards towards the end of the year. Therefore, the FY 2017 targets are based on the 

FY 2016 Enacted Level and the FY 2018 targets are based on the FY 2017 President’sBudget.

1 These measures are retired.

Measure

Year and Most Recent Result

Target for Recent Result 

(Summary of Result)

FY 2017

Target

FY 2018

Target

FY 2018

Target

+/-

FY 2017

Target

1.2.80 Increase the number of 

clients served. (Outcome)

FY 2015: 1,366

Target: 2,500 

(Target not met)

2,0001 2,000 Maintain

1.2.81 Increase the percentage of 

clients who had no past month 

substance use. (Outcome)

FY 2015: 75.2%

Target: 80.0% 

(Target not met)

73.0 %2 73.0 % Maintain

1.2.84 Increase the percentage of 

clients receiving services who had 

no involvement with the criminal 

justice system. (Outcome)

FY 2015: 94.8%

Target: 94.9%

(Target not met but improved)

94.0 % 94.0 % Maintain

Measure

Year and Most Recent Result 

Target for Recent Result

(Summary of Result)

FY 2017

Target

FY 2018

Target

FY 2018

Target

+/-

FY 2017

Target

1.2.89 Number of teen court clients 

served. (Output)

FY 2014: 852

Target: 852 

(Baseline)

600 300 -300

1.2.90 Increase the percentage of 

teen court clients receiving services 

who had no involvement with the 

criminal justice system. (Outcome)

FY 2014: 99.4%

Target: 99.4% 

(Target met)

90.0% 90.0% Maintain

1.2.91 Increase the percentage of 

teen court clients receiving services 

who had no past month substance 

use. (Outcome)

FY 2014: 70.1%

Target: 70.1% 

(Target met)

88.0% 60.0% -28.0%
238

Crisis Systems

(Dollars in thousands)

Programs of Regional & NationalSignificance

FY2015

Final

FY2016

Enacted

FY2017

President's

Budget

FY2017

+/-

FY2016

Crisis Systems.................................................................... $--- $--- $5,000 +$5,000

Authorizing Legislation .......................... Sections 520A and 509 of the Public Health Service Act 

FY 2017 Authorization .........................................................................................................Expired

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

Eligible Entities...........................................................................................States and Communities

Program Description and Accomplishments

The times in which individuals experience crises from mental and substance use disorders are 

prime for intervention and treatment and key to engagement in ongoing treatment and recovery. 

Such crises often cause great disruption for individuals and those around them, including family 

members, teachers, law enforcement, and employers. Many communities currently lack the 

capacity to provide needed services when children, young adults, and their family members 

experience behavioral health crises. For too many, the only resources available are hospital 

emergency departments, which are ill-equipped to provide appropriate and affordable behavioral 

health care. The number of patients with mental health and substance abuse conditions treated in 

emergency rooms (ER) has been on the rise for more than a decade.168 In 2007, 12.0 million ER 

visits involved a diagnosis related to mental health and/or substance use conditions, which 

accounted for 12.5 percent of all ER visits in the United States, or one out of every eight ER 

visits. Behavioral health related ER visits were two and a half times more likely to result in

hospital admissions than ER visits related to non-behavioral health related ER visits that resulted 

in hospitalization. Medicare was billed most frequently for behavioral health-related ER visits 

(30.1 percent), followed by private insurance (25.7 percent), uninsured (20.6 percent), and 

Medicaid (19.8 percent).169

Comprehensive crisis systems can be challenging to conceive and fund. These often require 

coordination among multiple systems, such as 911 lines and other facets of emergency response 

systems; first responders including police and emergency medical technicians, emergency room 

and primary health care; court systems; multiple payers; social service providers; and behavioral 

healthcare providers. Comprehensive crisis systems also have to be designed, funded, and staffed

to address and manage a range of crisis-situations, including various presenting conditions 

including serious mental illness (SMI), ages, family situations, and locations. Well- managed 

crisis interventions can result in positive outcomes for the individual, family, and community, 

including increased understanding of mental and substance use disorders. In contrast, poorly

managed crisis situations can result in frustration, increased health and social

168 Larkin, G.L., Claassen, C.A., Edmond, J.A., Pelletier, A.J., and Camargo, C.A. Trends in U.S. Emergency 

Department Visits for Mental Health Conditions, 1992 to 2001. Psychiatric Services. 2005; 56:671-677

169 Owens, P., Mutter, R., & Stocks, C. (n.d.). Mental Health and Substance Abuse-Related Emergency Department 

Visits among Adults, 2007. Retrieved August 21, 2015, fromhttp://www.hcups.ahrq.gov/reports/statbriefs/sb92.pdf
239

services system costs, and negative outcomes for all involved, including potential harm to the 

individual experiencing the crisis or others.

While there are models of comprehensive crisis response systems that are operating successfully, 

these comprehensive systems are the exception. More commonly, law enforcement and 

emergency room personnel respond to public safety and health situations without the benefit of 

the range of services and support needed to prevent, manage, and follow up on behavioral health 

crises. Inadequate crisis response systems can result in harm to the individual in crisis, law 

enforcement, or others; unnecessary use of scarce and costly emergency room and inpatient 

settings; and inappropriate use of jails and criminal justice resources.

Funding History

Fiscal Year Amount

FY 2013 ---

FY 2014 ---

FY 2015 ---

FY 2016 ---

FY 2017 $5,000,000

Budget Request

The FY 2017 Budget Request is $10.0 million, an increase of $10.0 million from the FY 2016 

Enacted Level. This includes $5.0 million from the Substance Abuse Treatment appropriation 

and $5.0 million from the Mental Health appropriation.

In FY 2017, SAMHSA plans to award three grants to states and communities to develop and/or 

adopt sustainable, comprehensive, and coordinated community-based crisis response systems for 

children, youth, and adults with mental health and/or addiction problems including those with 

SMI. The Increasing Crisis Access Response Efforts initiative will help reduce costly and 

unnecessary use of hospital emergency department and inpatient services. This effort will 

support the integration and expansion of services to fill gaps and enhance coordination within the 

comprehensive continuum of the crisis response services, while minimizing the risk for retraumatization of individuals and families served.

This activity will help communities build, fund, and sustain crisis systems. The crisis systems 

will be capable of preventing and de-escalating behavioral health crises. They will also help 

connect individuals and families with needed post-crisis services in order to prevent recurrence 

of the crisis situation. In many incidences, responses to these situations by emergency medical 

responders and behavioral healthcare providers are under-coordinated and un-sustained. These 

grants are expected to help mitigate the demand for inpatient beds by people with serious mental 

illnesses and substance use disorders by coordinating effective crisis response with ongoing 

outpatient services and support.
240

As a braided activity, SAMHSA will track separately any amounts spent or awarded under Crisis 

Systems through the distinct appropriations and ensure that funds are used for purposes 

consistent with legislative direction and intent of each appropriation.

Outputs and Outcomes Tables

Program: Crisis Systems

NOTE: SAMHSA makes grant awards towards the end of the year. Therefore, the FY 2017 targets are based on the 

FY 2016 Enacted Level and the FY 2018 targets are based on the FY 2017 President’sBudget.

Measure

Year and Most Recent Result

Target for Recent Result 

(Summary of Result)

FY 2017

Target

FY 2018

Target

FY 2018

Target

+/-

FY 2017

Target

3.1.05 Increase the number of 

organizations that entered into 

formal written inter/intra 

organizational agreements. 

(Outcome)

FY 2016: Result expected 

Dec 31, 2016

Target: Set baseline 

(Pending)

3.1.06 Increase the percentage of 

clients receiving services who 

report positive functioning at

6 month follow-up. (Outcome)

FY 2016: Result expected 

Dec 31, 2016

Target: Set baseline 

(Pending)

3.1.07 Increase the number of 

individuals referred to mental health 

or related services. (Outcome)

FY 2016: Result expected 

Dec 31, 2016

Target: Set baseline 

(Pending)
241

Addiction Technology Transfer Centers

(Dollars in thousands)

Programs of Regional & National Significance

FY2015

Final

FY2016

Enacted

FY2017

President's 

Budget

FY2017

+/-

FY2016

Addiction Technology Transfer Centers.............................. $9,046 $9,046 $8,081 -$965

Authorizing Legislation .............................................Section 509 of the Public Health Service Act 

FY 2017 Authorization .........................................................................................................Expired

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

$700.0 billion a year in increased healthcare costs, crime, and lost productivity.170, 171

Addiction is a treatable disease and research in the science of addiction and the treatment of 

substance use disorders has led to development of evidence-based practices that help people 

achieve recovery and resume productive lives. One critical need, however, is to help recruit, 

train, and support treatment providers. SAMHSA supports training to help foster use of 

evidence-based practices and prepare providers to work in an increasingly challenging, 

integrated care environment.

SAMHSA supports the Addiction Technology Transfer Center Network (ATTC Network) to 

develop and provide low or no cost training opportunities, including online training, to 

behavioral health professionals. The ATTC Network currently includes 10 Regional Centers, 

four National Focus Area Centers, and a Network Coordinating Office.

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, young professionals from a variety of backgrounds.172

Treating persons with substance use disorders 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 clinical directors face 

significant challenges filling open positions.173 Common hurdles for many

170 National Institute for Drugs and Alcohol. (2015). Trends and Statistics. Retrieved from NIH/NIDA: 

http://www.drugabuse.gov/related-topics/trends-statistics 171 ibid 172 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 inresidence

at the University of Missouri-Kansas City. Available at: 

http://www.attcnetwork.org/documents/VitalSignsReport.pdf 173 ibid
242

substance use disorder treatment facilities include difficulty retaining and recruiting qualified 

individuals, the need for a young, diverse racial/ethnic workforce capable of working in 

integrated settings, and the perception that substance use disorders are not a valid health issue 

(i.e., that addiction is a ‘choice’).174

To address the gaps in workforce, the ATTC Network supports national and regional activities 

focused on training substance use disorder and other healthcare professionals. The ATTC 

Network decreases the gap in time between the release of new scientific findings and evidencebased practices to the implementation of these interventions by front-line substance use disorder 

clinicians. The ATTCs disseminate evidence-based and promising practices to addiction 

treatment/recovery professionals, public health/mental health personnel, institutional and 

community corrections professionals, and other related disciplines. The ATTC Network 

dissemination models include technical assistance, training events, a growing catalog of 

educational and training materials, and an extensive array of web-based resources created to 

translate the latest science for adoption into practice by the substance use disorder workforce.

In FY 2014, SAMHSA funded 10 ATTC grants to support programs in each of the 10 HHS 

regions to provide technical assistance, workforce training, and support collaboration with the 

Health Resources and Services Administration (HRSA), the Centers for Medicare & Medicaid 

Services (CMS), the Administration for Children and Families (ACF), and the SAMHSA 

Regional Administrators as well as other partners. Five awards support one national and four 

focus area ATTCs, which also provide technical assistance and workforce training. FY 2014 

data show that the ATTCs trained approximately 38,600 providers and held a total of 

1,216 events, including training sessions, meetings, and technical assistance. Overall, 

approximately 90 percent of participants report implementing improvements in treatment 

methods on the basis of information and training provided by the ATTC Network.175

In FY 2015, SAMHSA supported the 15 three-year continuation ATTC grant awards. In FY

2016, SAMHSA will support these 15 continuation ATTC grant awards. The recipients are 

expected to conduct over one thousand events (training sessions, meetings and technical 

assistance), with more than 30,000 unique participants. SAMHSA will evaluate the program and 

plans to collect metrics including number of participants, event topics, contact hours, and 

participant self-assessed skill levels both pre and post training.

174 ibid 175 Services Accountability Improvement System. (2014); www.samhsa-gpra.samhsa.gov
243

Funding History

Fiscal Year Amount

FY 2013 $9,008,366

FY 2014 $9,024,000

FY 2015 $9,046,000

FY 2016 $9,046,000

FY 2017 $8,081,000

Budget Request

The FY 2017 Budget Request is $8.1 million, a decrease of $1.0 million from the FY 2016 

Enacted Level. In FY 2017, SAMHSA plans to fund a new cohort of 15 five-year ATTC grants. 

SAMHSA expects the ATTC grantees to sponsor over 1,000 events involving more than 30,000 

unique participants in FY 2017. In addition to the number of participants, event topics and 

contact hours, other metrics to be collected include participant satisfaction measures such as selfassessed skill levels both pre and post training. Funding will allow the 15 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.

Special Initiatives/Outreach

(Dollars in thousands)

Programs of Regional & NationalSignificance

FY2015

Final

FY2016

Enacted

FY2017

President's

Budget

FY2017

+/- 

FY2016

Special Initiatives/Outreach................................................. $1,432 $--- $--- $---

Authorizing Legislation .............................................Section 509 of the Public Health Service Act 

FY 2017 Authorization .........................................................................................................Expired 

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

Eligible Entities............. 105 Nationally Recognized Historically Black Colleges and Universities

Program Description and Accomplishments

Although there are ongoing efforts to promote diversity and culturally competent care, the 

behavioral health system is not meeting the needs of many minorities seeking behavioral health 

care.176 The current workforce needs additional training to adequately address the situation.177

176 NAMI. (n.d.), Multicultural Action Center. 

http://www2.nami.org/Find-Support/Diverse-Communities

177 Mental Health America, http://www.mentalhealthamerica.net/positions/cultural-competence, African-Americans, 

NAMI, https://www.nami.org/Find-Support/Diverse-Communities/African-Americans. 
244

According to the Surgeon General’s report titled “Mental Health, United States 2010”, African 

Americans represent 19.2 percent of all psychiatrists, 5.1 percent of all psychologists, and

17.5 percent of social workers in the U.S. of the individuals clinically-trained as mental health 

professionals.

Communities of color often struggle with how to discuss and address issues related to mental and 

substance use disorders. The Historically Black Colleges and Universities-Center for Excellence 

(HBCU-CFE) recognizes there are service gaps related to mental and substance use disorders. In 

addition, many factors affect access to behavioral health care and workforce development. For 

those HBCUs located in rural areas, barriers include affordability, availability, and geographic 

location, lack of transportation, lack of insurance, and lack of culturally-appropriate services 

within the community. In recent years, there has been a growing awareness of the importance of 

promoting behavioral health on college campuses. Students report depression and anxiety among

top impediments to academic performance.178 However, students may not be aware of available 

resources or how to access critical services. Therefore, it is important to develop innovative 

strategies to engage students in behavioral health awareness and health promotion.

SAMHSA, through its Special Initiatives/Outreach, supports the HBCU-CFE at Morehouse 

School of Medicine (http://hbcucfe.net/). This innovative national resource center is dedicated to 

continuing the effort to network the 105 HBCUs throughout the United States. The Center 

promotes workforce development by cultivating leaders and disseminating of best practices in 

order to increase the participation of African-Americans in the behavioral health professions. 

The HBCU-CFE also supports a policy academy that focuses on workforce and leadership 

development, cross-systems collaboration, cultural competence, and eliminating disparities. The 

HBCU-CFE collaborates with other HHS agencies, including the Office of Minority Health. The 

HBCU-CFE has increased services to an underserved population, African-American college 

students and faculty, while also heightening interest in behavioral health services and careers.

In FY 2014, SAMHSA awarded one contract for Project LIFT (Leadership Initiatives for 

Tomorrow), which supports emerging leaders in underserved communities, and one grant for the 

HBCU-CFE. In addition, SAMHSA made 30 behavioral health capacity expansion sub-awards 

to support and promote opportunities for HBCUs to foster careers in behavioral health through 

internships; expansion of culturally appropriate, evidence-based, emerging best and practices; 

screening and referral services for students at risk of behavioral health issues; and behavioral 

health promotion and prevention activities.

According to the March 2015 HBCU-CFE Quarterly Report to SAMHSA, data revealed that 

74 percent of the HBCU-CFE internships were completed in local and community-based 

organizations providing substance use disorder treatment services. In addition, 64 percent of 

HBCU grantees reported an increase in involvement in mental health initiatives on campus. 

Because of their program, Xavier University of Louisiana received SAMHSA’s 2013 Recovery

Month Annual Event Award.

179

178 American College Health Association-National Health Assessment II: Reference Group Data Report Spring, 

2012. Retrieved from ACHA NCHA:http://www.acha-ncha.org/reports_acha-nchaii.html

179 Services Accountability Improvement System. (2014); www.samhsa-gpra.samhsa.gov
245

In FY 2015, SAMHSA awarded the continuation of one Project LIFT contract and one HBCUCFE grant award. In addition, SAMHSA funded 34 behavioral health capacity expansion awards 

to HBCUs. This funding helps to promote behavioral health literacy on the HBCU campuses. 

Recipients also participate in one of the four “Check Yourself” initiatives that support Mental 

Health First Aid, Kognito, eCHECKUP TO GO, and myStudent Body online assessments. FY 

2015 programs will also provide 28 paid student internships and one Human Service Student 

internship. These undergraduate and graduate students participate in on-campus prevention 

initiatives and complete 3000 internship hours.

Other funding to the HBCU-CFE will support five peer educator interns to assist with the 

Question, Persuade, Refer Gatekeeper Suicide Prevention Training. This program targets 

freshmen and sophomores in order to increase awareness and expose students to evidence-based 

practices. The training provides tools to help students recognize the warning signs of a suicide 

crisis and how to question, persuade, and refer someone to get help. In FY 2016, these activities 

will be phased out but SAMHSA will ensure that workforce development activities for 

communities of color remain a priority through other funded initiatives.

Funding History

Fiscal Year Amount

FY 2013 $1,991,589

FY 2014 $1,432,000

FY 2015 $1,432,000

FY 2016 ---

FY 2017 ---

Budget Request

The FY 2017 Budget Request is $0.0 and is the same as the FY 2016 Enacted Level. This 

represents the elimination of the program. SAMHSA recognizes the importance of expanding the

workforce to support community behavioral health needs, especially for communities of color

and has ensured that workforce development is included in all relevant grants.
246

Outputs and Outcomes Table

Program: Treatment - Other Capacity1

NOTE: SAMHSA makes grant awards towards the end of the year. Therefore, the FY 2017 targets are based on the 

FY 2016 Enacted Level and the FY 2018 targets are based on the FY 2017 President’sBudget.

1

These measures include data from HIV/AIDS Outreach, Pregnant & Postpartum Women, Recovery Community 

Services Program - Services, Recovery-Oriented Systems of Care, SAT-ED, TCE/HIV, Targeted Capacity 

Expansion, Targeted Capacity Expansion- Health Information Technology, Targeted Capacity Expansion- Peer to 

Peer, Targeted Capacity Expansion- Technology Assisted Care, and Crisis Supportprograms.

Measure

Year and Most Recent Result

Target for Recent Result 

(Summary of Result)

FY 2017

Target

FY 2018

Target

FY 2018

Target

+/-

FY 2017

Target

1.2.25 Increase the percentage of 

adults receiving services who had 

no past month substance use. 

(Outcome)

FY 2015: 64.9%

Target: 60.0% 

(Target exceeded)

60.0% 60.0% Maintain

1.2.26 Increase the number of 

clients served. (Output)

FY 2015: 16,725

Target: 30,849 

(Target not met)

31,000 31,000 Maintain

1.2.27 Increase the percentage of 

adults receiving services who were 

currently employed or engaged in 

productive activities. (Outcome)

FY 2015: 43.8%

Target: 45.0% 

(Target not met)

43.0% 43.0% Maintain

1.2.28 Increase the percentage of 

adults receiving services who had a 

permanent place to live in the 

community. (Outcome)

FY 2015: 50.1%

Target: 47.0% 

(Target exceeded)

47.0% 47.0% Maintain

1.2.29 Increase the percentage of 

adults receiving services who had 

no involvement with the criminal 

justice system. (Outcome)

FY 2015: 96.9%

Target: 93.0% 

(Target exceeded)

93.0% 93.0% Maintain
247

SAMHSA/Substance Abuse Treatment 

PRNS Mechanism Table Summary

(Dollars in thousands)

Programs of Regional & National Significance

FY 2015

Final

No. Amount

FY 2016

Enacted

No. Amount

FY 2017

President's 

Budget

No. Amount

Grants/Cooperative Agreements:

Continuations.................................................... 395 157,849 476 196,748 390 155,444

New/Competing................................................ 253 147,179 195 84,081 235 120,068

Subtotal.......................................................... 648 305,028 671 280,829 625 275,512

Contracts:

Continuations.................................................... 17 42,712 13 35,896 15 46,719

New/Competing................................................ 14 13,723 8 17,081 3 21,038

Subtotal.......................................................... 31 56,435 21 52,977 18 67,757

Total, Substance Abuse Treatment 1 679 $361,463 692 $333,806 643 $343,269

1 The Minority Fellowship Program budget appears in the Health Surveillance and Program Support appropriation, 

Agency-wide Initiatives Workforce program. This is consistent with the FY 2017 Budget Request.
248

SAMHSA/Substance Abuse Treatment

PRNS Mechanism Table by Program, Project, and Activity

(Dollars in thousands)

Programs of Regional & NationalSignificance

FY 2015

Final

No. Amount

FY 2016

Enacted

No. Amount

FY 2017

President's 

Budget

No. Amount

CAPACITY:

OpioidTreatmentPrograms/RegulatoryActivities

Grants

Continuations...................................................................................... 3 $2,400 2 $1,397 1 $1,000

New/Competing.................................................................................. --- --- 1 1,000 2 1,400

Subtotal............................................................................................ 3 2,400 3 2,397 3 2,400

Contracts

Continuations...................................................................................... 3 5,135 2 1,711 5 5,154

New/Competing.................................................................................. 4 1,190 5 4,615 --- 1,170

Subtotal............................................................................................ 7 6,324 7 6,327 5 6,324

Total, OpioidTreatment Programs/RegulatoryActivities 10 8,724 10 8,724 8 8,724

Screening, BriefIntervention and Referral to Treatment

Grants

Continuations...................................................................................... 24 18,236 61 23,233 68 25,348

New/Competing.................................................................................. 64 21,320 20 16,747 --- ---

Subtotal............................................................................................ 88 39,556 81 39,980 68 25,348

Contracts

Continuations...................................................................................... 2 7,097 1 5,853 1 4,438

New/Competing.................................................................................. 4 236 --- 1,056 1 214

Subtotal............................................................................................ 6 7,333 1 6,909 2 4,652

Total, Screening, BriefIntervention and Referral to Treatment 94 46,889 82 46,889 70 30,000

Targeted Capacity Expansion - General

Grants

Continuations...................................................................................... 30 7,672 12 10,715 51 29,204

New/Competing.................................................................................. 11 10,706 39 18,409 23 23,865

Subtotal............................................................................................ 41 18,377 51 29,124 74 53,069

Contracts

Continuations...................................................................................... 1 2,710 2 4,485 1 7,418

New/Competing.................................................................................. 1 2,136 --- 2,694 --- 816

Subtotal............................................................................................ 2 4,846 2 7,179 1 8,234

Total, Targeted Capacity Expansion - General 43 23,223 53 36,303 75 61,303

Cohort Monitoring andEvaluation ofMedication-Assisted

Treatment Outcomes

Grants

Continuations...................................................................................... --- --- --- --- --- ---

New/Competing.................................................................................. --- --- --- --- --- ---

Subtotal............................................................................................ --- --- --- --- --- ---

Contracts

Continuations...................................................................................... --- --- --- --- --- ---

New/Competing.................................................................................. --- --- --- --- 1 15,000

Subtotal............................................................................................ --- --- --- --- 1 15,000

Total, Cohort Monitoring andEvaluation ofMedication-Assisted

Treatment Outcomes --- --- --- --- 1 15,000

Buprenorphine-Prescribing Authority Demonstration

Grants

Continuations...................................................................................... --- --- --- --- --- ---

New/Competing.................................................................................. --- --- --- --- 7 7,865

Subtotal............................................................................................ --- --- --- --- 7 7,865

Contracts

Continuations...................................................................................... --- --- --- --- --- 635

New/Competing.................................................................................. --- --- --- --- 1 1,500

Subtotal............................................................................................ --- --- --- --- 1 2,135

Total,Buprenorphine-PrescribingAuthorityDemonstration --- --- --- --- 8 10,000
249

SAMHSA/Substance Abuse Treatment

PRNS Mechanism Table by Program, Project, and Activity

(Dollars in thousands)

Programs of Regional & National Significance

FY 2015

Final

No. Amount

FY 2016

Enacted

No. Amount

FY 2017

President's 

Budget

No. Amount

Pregnant & Postpartum Women

Grants

Continuations...................................................................................... 19 9,482 26 12,793 6 3,048

New/Competing.................................................................................. 7 3,393 --- --- 20 9,750

Subtotal............................................................................................ 26 12,875 26 12,793 26 12,798

Contracts

Continuations...................................................................................... --- 1,218 --- 2,674 --- 3,133

New/Competing.................................................................................. --- 1,838 --- 464 --- ---

Subtotal............................................................................................ --- 3,056 --- 3,138 --- 3,133

Total, Pregnant & Postpartum Women 26 $15,931 26 $15,931 26 $15,931

Strengthening Treatment Access and Retention

Contracts

Continuations...................................................................................... 1 990 --- --- --- ---

New/Competing.................................................................................. --- 10 --- --- --- ---

Subtotal............................................................................................ 1 1,000 --- --- --- ---

Total, Strengthening Treatment Access and Retention 1 1,000 --- --- --- ---

Recovery Community Services Program

Grants

Continuations...................................................................................... 10 1,000 10 1,000 8 400

New/Competing.................................................................................. 8 398 8 400 10 1,000

Subtotal............................................................................................ 18 1,398 18 1,400 18 1,400

Contracts

Continuations...................................................................................... --- 986 --- 1,017 --- 273

New/Competing.................................................................................. --- 50 --- 17 --- 761

Subtotal............................................................................................ --- 1,036 --- 1,034 --- 1,034

Total, Recovery Community Services Program 18 2,434 18 2,434 18 2,434

Access to Recovery

Grants

Continuations...................................................................................... --- --- --- --- --- ---

New/Competing.................................................................................. 5 35,424 --- --- --- ---

Subtotal............................................................................................ 5 35,424 --- --- --- ---

Contracts

Continuations...................................................................................... --- 2,261 --- --- --- ---

New/Competing.................................................................................. --- 538 --- --- --- ---

Subtotal............................................................................................ --- 2,799 --- --- --- ---

Total, Access to Recovery 5 38,223 --- --- --- ---

Children and Families

Grants

Continuations...................................................................................... 11 $9,407 32 $20,673 14 $11,174

New/Competing.................................................................................. 24 12,432 2 1,600 20 11,092

Subtotal............................................................................................ 35 21,839 34 22,273 34 22,266

Contracts

Continuations...................................................................................... 2 4,607 3 4,891 3 5,943

New/Competing.................................................................................. 2 3,158 1 2,441 --- 1,396

Subtotal............................................................................................ 4 7,766 4 7,332 3 7,339

Total, Children and Families 39 29,605 38 29,605 37 29,605
250

SAMHSA/Substance Abuse Treatment

PRNS Mechanism Table by Program, Project, and Activity

(Dollars in thousands)

Programs of Regional & National Significance

FY 2015

Final

No. Amount

FY 2016

Enacted

No. Amount

FY 2017

President's 

Budget

No. Amount

Treatment Systems for Homeless

Grants

Continuations...................................................................................... 36 15,487 51 27,108 38 26,053

New/Competing.................................................................................. 31 21,141 30 9,776 15 6,038

Subtotal............................................................................................ 67 36,628 81 36,884 53 32,091

Contracts

Continuations...................................................................................... 3 4,720 --- 2,623 1 4,295

New/Competing.................................................................................. --- 37 --- 1,797 --- ---

Subtotal............................................................................................ 3 4,758 --- 4,420 1 4,295

Total, Treatment Systems for Homeless 70 41,386 81 41,304 54 36,386

Minority AIDS

Grants

Continuations...................................................................................... 113 46,038 117 47,609 86 23,822

New/Competing.................................................................................. 26 13,358 22 11,698 57 28,683

Subtotal............................................................................................ 139 59,397 139 59,306 143 52,505

Contracts

Continuations...................................................................................... 2 4,578 3 5,570 3 6,280

New/Competing.................................................................................. 1 1,595 --- 694 --- 73

Subtotal............................................................................................ 3 6,173 3 6,264 3 6,354

Total, Minority AIDS 142 65,570 142 65,570 146 58,859

Criminal Justice Activities

Grants

Continuations...................................................................................... 133 39,230 150 43,775 118 35,395

New/Competing.................................................................................. 77 29,006 73 24,450 63 18,294

Subtotal............................................................................................ 210 68,236 223 68,225 181 53,689

Contracts

Continuations...................................................................................... 2 6,945 2 6,508 1 8,148

New/Competing.................................................................................. 2 2,819 2 3,268 --- 109

Subtotal............................................................................................ 4 9,764 4 9,775 1 8,257

Total, Criminal Justice Activities 214 78,000 227 78,000 182 61,946

Crisis Systems

Grants

Continuations...................................................................................... --- --- --- --- --- ---

New/Competing.................................................................................. --- --- --- --- 3 4,512

Subtotal............................................................................................ --- --- --- --- 3 4,512

Contracts

Continuations...................................................................................... --- --- --- --- --- 488

New/Competing.................................................................................. --- --- --- --- --- ---

Subtotal............................................................................................ --- --- --- --- --- 488

Total, Crisis Systems --- --- --- --- 3 5,000

Subtotal, CAPACITY 662 $350,985 677 $324,760 628 $335,188
251

SAMHSA/Substance Abuse Treatment

PRNS Mechanism Table by Program, Project, and Activity

(Dollars in thousands)

Programs of Regional & National Significance

FY2015

Final

No. Amount

FY2016

Enacted

No. Amount

FY2017

President's 

Budget

No. Amount

SCIENCE ANDSERVICE:

Addiction Technology Transfer Centers

Grants

Continuations...................................................................................... 15 8,598 15 8,447 --- ---

New/Competing.................................................................................. --- --- --- --- 15 7,568

Subtotal............................................................................................ 15 8,598 15 8,447 15 7,568

Contracts

Continuations...................................................................................... --- 398 --- 563 --- 513

New/Competing.................................................................................. --- 50 --- 36 --- ---

Subtotal............................................................................................ --- 448 --- 599 --- 513

Total, Addiction Technology TransferCenters 15 9,046 15 9,046 15 8,081

Special Initiatives/Outreach

Grants

Continuations...................................................................................... 1 300 --- --- --- ---

New/Competing.................................................................................. --- --- --- --- --- ---

Subtotal............................................................................................ 1 300 --- --- --- ---

Contracts

Continuations...................................................................................... 1 1,067 --- --- --- ---

New/Competing.................................................................................. --- 65 --- --- --- ---

Subtotal............................................................................................ 1 1,132 --- --- --- ---

Total, SpecialInitiatives/Outreach 2 1,432 --- --- --- ---

Subtotal, SCIENCE AND SERVICE 17 10,478 15 9,046 15 8,081

Total, CSAT PRNS 1 679 $361,463 692 $333,806 643 $343,269

1

The Minority Fellowship Program budget appears in the Health Surveillance and Program Support appropriation, Agency-wide Initiatives 

Workforce program. This is consistent with the FY 2017 Budget Request.
252

Grant Awards Table

(Whole dollars)

FY2015

Final

FY2016

Enacted

FY 2017President's 

Budget

Number ofAwards 648 671 625

Average Award $470,722 $418,523 $440,819

Range of Awards $300,000-$7,575,000 $300,000-$600,000 $300,000-$600,000
253

State Targeted Response Cooperative Agreements

(Dollars in thousands)

ProgramActivity

FY2015

Final

FY2016

Enacted

FY2017

President's 

Budget

FY2017

+/-

FY2016

State Targeted Response Cooperative Agreements 

(Mandatory)...................................................................... $--- $--- $460,000 +$460,000

Authorizing Legislation ..........................................................................................New Legislation

FY 2017 Authorization ...........................................................................................New Legislation

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

Death from overdose of opioids, a class of drugs that includes prescription pain relievers and 

heroin, has taken a heartbreaking toll on too many Americans. In 2014, 28,647 deaths were 

related to overdose of opioids. Americans are abusing opioids and too few are getting treatment. 

Individuals who want to but do not undergo treatment often report cost and lack of access as 

reasons why they do not get treatment.

The State Targeted Response Cooperative Agreements program is a new two-year program to 

address commonly cited barriers to receiving treatment. This funding is part of the 

Administration’s $1.0 billion Expanding Access to Treatment Initiative to address opioid misuse 

epidemic by helping all Americans who want treatment to access it and get the help they need. 

These cooperative agreements will be awarded to states based on need and the strength of their 

strategies proposed to close the opioid use disorder treatment gap. Proposed strategies must be 

evidence-based and focused on the main factors preventing individuals from seeking and 

successfully completing treatment, and achieving recovery. States would be required to track and 

regularly report progress toward closing the opioid use disorder treatment gap and reducing 

opioid-related overdose deaths based upon measures developed in collaboration with HHS. 

Eligible activities would include but not be limited to:

• Addressing commonly cited barriers to receiving treatment by reducing the cost of 

treatment, expanding access to treatment, engaging patients in treatment, and addressing 

stigmas associated with accessing treatment;

• Training and certifying opioid use disorder treatment providers like physicians, nurses, 

counselors, social workers, care coordinators and case managers;

• Supporting innovative delivery of Medication Assisted Treatment;

• Eliminating or reducing treatment costs for under- and uninsured patients;

• Providing treatment transition and coverage for patients reentering communities from 

criminal justice settings or other rehabilitative settings;

• Enhancing prevention using evidence-based methods proven to reduce the number of 

persons with opioid use disorders;

• Supporting innovative telehealth in rural and underserved areas to increase the capacity 

of communities to support behavioral health; and
254

• Integrating health IT programs, including enhancing clinical decision tools, to support 

identification of patients with opioid use disorder and engage them in treatment.

A portion of the funds would be used to support an evaluation.

Funding History

Fiscal Year Amount

FY 2013 ---

FY 2014 ---

FY 2015 ---

FY 2016 ---

FY 2017 $460,000,000

Budget Request

The FY 2017 Budget Request is $920.0 million ($460.0 million in FY 2017 and $460.0 million 

in FY 2018). This new effort will address commonly cited barriers to receiving treatment. This 

funding is part of the Administration’s $1.0 billion initiative to increase access to treatment for 

prescription drug abuse and heroin use. This funding will help all those who seek treatment, 

access it and get the help they need.
255

Substance Abuse Prevention and Treatment Block Grant

(Dollars in thousands)

Program Activity

FY 2015

Final

FY 2016

Enacted

FY 2017

President's 

Budget

FY 2017

+/-

FY 2016

Substance AbusePreventionand TreatmentBlockGrant......... $1,819,856 $1,858,079 $1,858,079 $ ---

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

Authorizing Legislation .....................Sections 1921-1935 of the Title XIX, Part B, Subpart II and 

Section 1941-1956 of Title XIX, Part B, Subpart III of the Public Health Service Act

FY 2017 Authorization .........................................................................................................Expired

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

Roughly 24 million Americans who are 12 and over, including 2.2 million adolescents (aged 

12 to 17) reported illicit drug use in 2013. Roughly 60 million Americans age 12 and over 

reported past month binge drinking in 2013, including 1.6 million adolescents. While

22.7 million Americans met the criteria for needing treatment due to a substance use disorder, 

only 2.5 million received treatment at a specialized facility.180

The Substance Abuse Prevention and Treatment Block Grant (SABG) program distributes funds 

to 60 eligible states, territories and freely associated states181, 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 use disorder 

prevention and treatment services while providing maximum flexibility to grantees.

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

180 Substance use and mental health estimates from the 2013 National Survey on Drug Use and Health,

Sept. 4, 2014, http://www.samhsa.gov/data/sites/default/files/NSDUH-SR200-RecoveryMonth-2014/NSDUHSR200-RecoveryMonth-2014.htm. - 181 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 withthe 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
Services, SAMHSA.

256

public health funding.182 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 substance use disorders, improved business

practices such as facilitating enrollment in appropriate health coverage and use of health 

information technology and integration of physical and behavioral health.183 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:

1) To fund priority treatment and support services for individuals without insurance or for 

whom coverage is terminated for short periods of time;

2) To 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;

3) To fund primary prevention for individuals not identified as needing treatment 

(universal programs that reach everyone in a group being served regardless of risk, 

selective interventions that serve people at elevated risk of substance misuse or a 

substance use disorder, and indicated prevention interventions that serve people who 

exhibit some symptoms of a substance use disorder, but do not yet meet criteria for a 

diagnosis); and

4) To collect performance and outcome data to determine the ongoing effectiveness of 

behavioral health promotion, 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 recovery to be pursued 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.

Funding Allocations and Requirements

SABG funds are distributed184 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 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

182 SABG State Agency Reported Expenditures by Target Activity Within Source of Funds, State/Jurisdiction 

Selection: All States/Jurisdictions (2015) 183 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. 184 Block Grants and Formula Grants: A Guide for Allocation Calculations; 2007 Department of Health and Human
257

personal income, state population data by age groups (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. While maintenance of effort (MOE) 

requirements can be important tools for maximizing the effectiveness of Federal funds, the way 

the SABG requirement is currently structured makes it a challenge for SAMHSA to administer. 

For example, timing requirements on when penalties must be assessed precede when SAMHSA 

receives final State data that demonstrates compliance. In addition, States are currently unable to 

claim credit for substance abuse prevention and treatment efforts that occur outside of the Single 

State Agency (defined as the agency within the State that has primary responsibility for 

administering SABG funds). For example, substance abuse prevention and treatment activities 

conducted by State Education Agencies and State Departments of Justice do not count toward the 

MOE. Finally, the State penalties for non-compliance with the MOE can exceed the size of the 

State SABG allotment. In FY 2017, SAMHSA proposes to work with Congress, states, and other 

stakeholders to explore how technical changes to maintenance of effort (MOE) authorities could 

improve its effectiveness. Potential improvements that could be considered include: the year in 

which a final decision is made on non-compliance; whether the MOE should be calculated based 

on statewide spending; and whether more flexibility to set alternative penalties would improve 

State compliance.

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.185 The statute also includes performance requirements for the treatment of substanceusing 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 recipient fails to prohibit and 

enforce sale of tobacco products to individuals under the age of 18.

Application Process

States prepare and submit to SAMHSA for approval an application, which includes a behavioral 

health assessment and plan that describes how the grantees and their respective SABG subrecipients intend to expend SABG funds. SAMHSA block grant application aligns with changes 

in federal/state environments, including the impacts of the Affordable Care Act, the Mental 

Health Parity and Addiction Equity Act (MHPAEA), and the Tribal Law and Order Act (TLOA). 

States have the opportunity to complete a combined application for mental health and substance

use disorder services, submit a biennial versus an annual plan,186,187 and provide information

185 Substance Abuse and Mental Health Services Administration. (2015). Block Grant Laws and Regulations.

Retrieved from SAMHSA: http://www.samhsa.gov/grants/block-grants/laws-regulations. 186 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 Act (42 USC § 300x-2)).
258

regarding their efforts to respond to various changes in federal and state law. Submitting the 

application/plan biennially reduces the burden on states to prepare and submit an 

application/plan every year.

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.

Recent Updates: Guidance to states regarding the use of SABG funds for naloxone was sent out 

on April 2, 2014. Additionally, in July 2014, the Centers for Medicare & Medicaid Services, in 

collaboration with SAMHSA, the Centers for Disease Control and Prevention and the National 

Institutes of Health disseminated an Informational Bulletin, “Medication Assisted Treatment for 

Substance Use Disorders.”188

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, and state mental health and substance use disorder data systems), ensures 

consistency in the use of measures, and provides a more complete perspective of the delivery of 

mental and substance use disorder 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.189 SAMHSA data shows that the SABG has been successful in expanding 

treatment capacity by supporting approximately two million190 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 2012, at discharge, clients demonstrated high abstinence rates from both illegal drug 

(73.4 percent) and alcohol (81.6 percent) use. State substance abuse authorities reported the

following outcomes for services provided during FY 2012, the most recent year for which data is 

available:

187 State Plan (Sec. 1932 (b) of Title XIX, Part B, Subpart II of the Public Health Service (PHS) Act (42 USC § 

300x-32(b)). 188 Centers for Medicare & Medicaid. (n.d.). Federal Policy Guidance. Retrieved from Medicaid.gov: 

http://www.medicaid.gov/federal-policy-guidance/federal-policy-guidance.html 189 http://tie.samhsa.gov/SAPT2010.html#Evaluation. 190 Substance Abuse and Mental Health Services Administration (2015). Clients Level Data / TEDS. Retrieved from 

SAMHSA.gov: http://www.samhsa.gov/data/client-level-data-teds
259

• For the 50 states191 and the District of Columbia that reported data concerning abstinence 

from alcohol use, 50 of 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, 49 of 50 identified 

improvements in client employment;

• For the 50 states and D.C. that reported criminal justice data, 45 of 51 reported an 

increase in clients with no arrests based on data reported to TEDS; and

• For the 49 states and D.C. that reported housing data, 44 of 50 identified improvements in 

stable housing for clients based on data reported to TEDS.

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.192 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.193 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 18.194 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

191 Source: West Virginia numbers have been included in the text, but they appear lower than expected.

192 Substance Abuse and Mental Health Services Administration (2015). Substance Abuse Prevention and Treatment 

Block Grant. Retrieved from SAMHSA.gov:http://www.samhsa.gov/grants/block-grants/sabg

193"Front Matter." Preventing Mental, Emotional, and Behavioral Disorders Among Young People: Progress and 

Possibilities. Washington, DC: The National Academies Press, 2009.http://www.iom.edu/Reports/2009/PreventingMental-Emotional-and-Behavioral-Disorders-Among-Young-People-Progress-and-Possibilities.aspx.

194 Substance Abuse and Mental Health Services Administration (2015). Synar Program. Retrieved from

SAMHSA.gov: http://www.samhsa.gov/synar
260

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 on 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 non-cigarette 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.

Funding History

Fiscal Year Amount

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

Budget Request

The FY 2017 Budget Request is $1.9 billion and is level with the FY 2016 Enacted Level. 

Despite the wide scale opportunity to obtain insurance coverage created by the Affordable Care 

Act, significant gaps in coverage, as well as the subsequent reliance on the public behavioral 

health safety net remain. The SABG helps address this gap. SABG funds will also continue to 

support certain services (e.g., recovery support efforts) 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.
261

Outputs and Outcomes Table

Program: Treatment Activities1

NOTE: SAMHSA makes grant awards towards the end of the year. Therefore, the FY 2017 targets are based on the 

FY 2016 Enacted Level and the FY 2018 targets are based on the FY 2017 President’sBudget.

1

Targets revised based on data trends.

Measure

Year and Most Recent Result

Target for Recent Result 

(Summary of Result)

FY 2017

Target

FY 2018

Target

FY 2018

Target

+/-

FY 2017

Target

1.2.43 Increase the number of 

admissions to substance abuse 

treatment programs receiving public 

funding. (Output)

FY 2014: 1,879,641

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 2015: 72.3%

Target: 74.0% 

(Target not met)

74.0% 74.0% Maintain

1.2.49 Increase the percentage of 

clients reporting no alcohol use in 

the past month at discharge. 

(Outcome)

FY 2015: 83.6%

Target: 78.0% 

(Target exceeded)

78.0% 78.0% Maintain

1.2.50 Increase the percentage of 

clients reporting being employed/in 

school at discharge. (Outcome)

FY 2014: 36.6%

Target: 43.0% 

(Target not met)

40.0% 40.0% Maintain

1.2.51 Increase the percentage of 

clients reporting no involvement 

with the Criminal Justice System. 

(Outcome)

FY 2014: 94.6%

Target: 92.0% 

(Target exceeded)

92.0% 92.0% Maintain

1.2.85 Increase the percentage of 

clients receiving services who had a 

permanent place to live in the 

community. (Outcome)

FY 2014: 91.6%

Target: 92.0% 

(Target not met)

92.0% 92.0% Maintain
262

Outputs and Outcomes Table

Program: Synar Amendment

NOTE: SAMHSA makes grant awards towards the end of the year. Therefore, the FY 2017 targets are based on the 

FY 2016 Enacted Level and the FY 2018 targets are based on the FY 2017 President’sBudget.

Measure

Year and Most Recent Result

Target for Recent Result 

(Summary of Result)

FY 2017

Target

FY 2018

Target

FY 2018

Target

+/-

FY 2017

Target

2.3.49 Increase the number of States 

and Territories (including Puerto 

Rico) whose retail sales violation 

rate is at or below 20%. (Outcome)

FY 2014: 49

Target: 52 

(Target not met)

52 52 Maintain

2.3.62 Increase the number of States 

(excluding Puerto Rico) reporting 

retail tobacco sales violation rates 

below 10%. (Outcome)

FY 2014: 30

Target: 34

(Target not met but improved)

33 33 Maintain
263

Outputs and Outcomes Table

Program: Prevention Set-Aside

NOTE: SAMHSA makes grant awards towards the end of the year. Therefore, the FY 2017 targets are based on the 

FY 2016 Enacted Level and the FY 2018 targets are based on the FY 2017 President’sBudget.

1

Virginia and West Virginia estimates were suppressed due to lowprecision.

Measure

Year and Most Recent Result

Target for Recent Result 

(Summary of Result)

FY 2017

Target

FY 2018

Target

FY 2018

Target

+/ 

FY 2017

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 to 17). 

(Outcome)

FY 2014: 35.3%1

(Historical actual)

22.0% 22.0% Maintain

2.3.65 Increase the percent ofstates 

showing a decrease in state level 

estimates of percent of survey 

respondents who report 30 day use 

of alcohol (age 12 to 20). 

(Outcome)

FY 2014: 71.0%

Target: 57.0% 

(Target exceeded)

67.5% 67.5% Maintain

2.3.67 Increase the percent ofstates 

showing a decrease in state level 

estimates of percent of survey 

respondents who report 30 day use 

of other illicit drugs (age 12 to 17). 

(Outcome)

FY 2014: 49.0%

Target: 59.0% 

(Target not met)

63.0% 63.0% Maintain

2.3.68 Increase the percent ofstates 

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 2014: 24.0%

Target: 37.3% 

(Target not met)

43.0% 43.0% Maintain
264

DEPARTMENT OF HEALTH AND HUMAN SERVICES

Substance Abuse and Mental Health Services Administration 

FY 2017 DISCRETIONARTY STATE/FORMULA GRANTS

Substance Abuse Prevention and Treatment Block Grant (SABG) 

CFDA #93.959

State/Territory

FY2015

Actual

FY2016

Enacted

FY2017

President's

Budget

FY2017 

(+/-)

FY2016

Alabama $22,940,958 $23,089,486 $23,089,486 $---

Alaska 5,539,999 5,889,074 $5,889,074 ---

Arizona 39,546,174 40,187,732 $40,187,732 ---

Arkansas 13,437,498 13,524,497 $13,524,497 ---

California 250,323,608 254,414,759 $254,414,759 ---

Colorado 25,300,234 28,777,345 $28,777,345 ---

Connecticut 17,596,359 18,212,225 $18,212,225 ---

Delaware 6,824,460 6,967,796 $6,967,796 ---

District Of Columbia 6,824,460 6,967,796 $6,967,796 ---

Florida 110,662,825 111,379,297 $111,379,297 ---

Georgia 51,162,012 57,152,217 $57,152,217 ---

Hawaii 8,212,595 8,469,866 $8,469,866 ---

Idaho 8,480,929 8,535,838 $8,535,838 ---

Illinois 67,210,630 67,645,777 $67,645,777 ---

Indiana 32,038,656 32,246,086 $32,246,086 ---

Iowa 13,009,122 13,093,348 $13,093,348 ---

Kansas 11,823,116 11,899,663 $11,899,663 ---

Kentucky 20,247,285 20,378,373 $20,378,373 ---

Louisiana 24,865,443 25,026,431 $25,026,431 ---

Maine 6,824,460 6,967,796 $6,967,796 ---

Maryland 33,860,758 34,079,985 $34,079,985 ---

Massachusetts 39,588,772 39,845,084 $39,845,084 ---

Michigan 55,692,281 56,052,853 $56,052,853 ---

Minnesota 23,946,997 24,102,039 $24,102,039 ---

Mississippi 13,714,768 13,803,562 $13,803,562 ---

Missouri 26,363,508 26,548,475 $26,548,475 ---

Montana 6,824,460 6,967,796 $6,967,796 ---

Nebraska 7,592,087 7,641,241 $7,641,241 ---

Nevada 16,698,170 16,890,047 $16,890,047 ---

New Hampshire 6,824,460 6,967,796 $6,967,796 ---
265

DEPARTMENT OF HEALTH AND HUMAN SERVICES

Substance Abuse and Mental Health Services Administration 

FY 2017 DISCRETIONARTY STATE/FORMULA GRANTS

Substance Abuse Prevention and Treatment Block Grant (SABG) 

CFDA #93.959

State/Territory

FY2015

Actual

FY2016

Enacted

FY2017

President's

Budget

FY2017 

(+/-)

FY2016

New Jersey $46,379,126 $48,064,193 $48,064,193 $---

New Mexico 9,503,584 9,565,114 $9,565,114 ---

New York 111,110,689 111,830,061 $111,830,061 ---

North Carolina 43,374,576 44,991,909 $44,991,909 ---

North Dakota 6,146,271 6,533,547 $6,533,547 ---

Ohio 64,120,596 64,535,736 $64,535,736 ---

Oklahoma 17,039,024 17,149,341 $17,149,341 ---

Oregon 20,024,554 20,578,346 $20,578,346 ---

Pennsylvania 58,720,026 59,100,201 $59,100,201 ---

Rhode Island 7,549,597 7,598,476 $7,598,476 ---

South Carolina 23,164,181 23,717,773 $23,717,773 ---

South Dakota 5,683,588 6,041,710 $6,041,710 ---

Tennessee 29,359,704 31,978,247 $31,978,247 ---

Texas 139,837,820 144,708,674 $144,708,674 ---

Utah 16,481,871 16,588,581 $16,588,581 ---

Vermont 6,076,965 6,459,874 $6,459,874 ---

Virginia 41,709,858 41,979,903 $41,979,903 ---

Washington 37,296,200 37,784,663 $37,784,663 ---

West Virginia 8,378,435 8,432,680 $8,432,680 ---

Wisconsin 27,023,026 27,197,983 $27,197,983 ---

Wyoming 3,948,749 4,197,559 $4,197,559 ---

Red Lake Indians 590,206 594,027 $594,027 ---

American Samoa 333,546 342,788 $343,454 +666

Guam 970,730 1,004,691 $1,014,297 +9,606

Northern Marianas 311,984 320,555 $324,340 +3,785

Puerto Rico 22,405,098 22,838,224 $22,811,437 -26,787

Palau 127,671 132,231 $133,471 +1,240

Marshall Islands 415,696 436,931 $447,189 +10,258

Micronesia 646,411 664,690 $665,784 +1,094

Virgin Islands 639,053 656,127 $656,265 +138
266

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267

SAMHSA

Health Surveillance and Program Support 

Table of Contents

1. Health Surveillance and Program Support............................................................................ 269

2. Public Awareness and Support ............................................................................................. 273

3. Performance and Quality Information Systems.................................................................... 281

4. Agency-Wide Initiatives....................................................................................................... 285
268

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269

Health Surveillance

(Dollars in thousands)

Program Activity

FY2015

Final

FY2016

Enacted

FY2017

President's 

Budget

FY2017

+/-

FY2016

Health Surveillance..................................................................... $47,258 $47,258 $47,258 $---

PHS Evaluation Funds (non-add)..................................... 30,428 30,428 29,428 -1,000

Prevention and Public Health Fund (non-add)................. --- --- 17,830 +17,830

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 2017 Authorization .........................................................................................................Expired

Allocation Method .................................................................. Federal/Intramural, Contracts, Other 

Eligible Entities......................................................................................................... NotApplicable

Program Description and Accomplishments

Federal, state, and local authorities and other healthcare stakeholders use data and reports drawn 

from SAMHSA’s national surveys to inform behavioral health policy. Information on behavioral

health at the community level serves to identify current and emerging problems and highlight 

opportunities for progress that may vary from larger geographical areas. When communities 

have access to surveillance data over time, they can then direct targeted prevention efforts to the 

most vulnerable populations.

The Health Surveillance budget supports many of the critical behavioral health data systems, 

national surveys, and surveillance activities for the Department of Health and Human Services 

(HHS) undertaken by SAMHSA’s Center for Behavioral Health Statistics and Quality (CBHSQ), 

the government’s lead agency for behavioral health statistics. Key activities are highlighted 

below. For a complete description on CBHSQ activities and funding from across SAMHSA’s 

appropriations, see the Performance Quality and Information Systemstab.

• The National Survey on Drug Use and Health (NSDUH)195 serves as the nation’s primary 

source for information on the prevalence of substance use and mental health and related 

health conditions. In FY 2013, SAMHSA awarded a new NSDUH contract to finance 

annual surveys through FY 2017. SAMHSA supported the NSDUH surveys at

$52.7 million in FY 2015, and is funding the FY 2016 NSDUH surveys at the same level. 

Of this amount, $13.8 million is from Health Surveillance, with the remaining amount 

supported by the Substance Abuse Treatment appropriation. The Mental Health 

Appropriation provides an additional $1.0 million each year for evaluation of mental 

health elements.

• The Community Behavioral Health Data Initiative (CDI) coordinates three separate 

existing data efforts and creates new opportunities for cross-agency and public-private

195 NSDUH data are collected under SAMHSA’s legislative mandate; see 42 U.S.C. 290aa-4.
270

partnerships to address critical public health questions. These data efforts include the 

Community Early Warning and Monitoring System (C-EMS), SAMHSA’s Emergency 

Department Surveillance System (SEDSS) (formerly the Drug Abuse Warning Network 

(DAWN)), and the Program Studies on Treatment and Recovery (PSTAR). Data from 

other agencies such as the Center for Medicare and Medicaid Services (CMS) and the 

Agency for Healthcare Research and Quality (AHRQ) can augment this coordinated 

initiative and then be reported by regional and community type. Moreover, the 

longitudinal nature of these data will allow those evaluating the effectiveness of services 

and policies in a community to measure the impact and outcomes of those interventions.

• Emergency Department (ED) data remain an important component of public health 

because ED data provides a picture of the most urgent behavioral and other health issues 

in the community. ED data are an excellent tool for monitoring trends in mental health 

and substance use and related conditions across the nation. ED data also provide 

important surveillance for targeting emerging behavioral health issues. SAMHSA’s 

Emergency Department Surveillance System collects data from hospitals in a variety of 

communities and provides a summary of visits by patients with mental health conditions 

and substance use problems. By collaborating with the Centers for Disease Control and 

Prevention’s (CDC) National Center for Health Statistics (NCHS), SAMHSA has an 

opportunity to understand more comprehensively the nature and course of behavioral 

health presentations to emergency departments, including those related to both mental 

health and substance use.

• The Behavioral Health Services Information System (BHSIS)196 is the primary source of 

data on substance use and mental disorder treatment facilities and treatment admissions. 

BHSIS also provides information for people who need help finding mental and/or 

substance use disorder treatment through the BHSIS Behavioral Health Treatment 

Services Locator. Every year individuals, families, community groups, and organizations 

use the Treatment Services Locator more than two million times to identify appropriate 

treatment services. SAMHSA’s Treatment Services Locator 

(https://findtreatment.samhsa.gov/) provides accurate, timely, and regularly updated 

information on mental and substance use treatment facilities across the country. The base 

cost of BHSIS is $21.0 million for FY 2015, FY 2016 and FY 2017. Of this,

$17.0 million is from Health Surveillance appropriation and $4.0 million is from 

Substance Abuse Treatment Block Grant appropriation. SAMHSA will fund basic BHSIS

operations in FY 2017 at the same levels as FY 2015 and FY 2016. In addition, the 

Mental Health Appropriation provides $7.5 million for a behavioral health services 

facility survey. This funding ensures a holistic approach to data collection related to 

behavioral health and allows for the inclusion of mental health services facility data in the 

BHSIS survey.

• The Analytic Support Center (ASC) that undertakes a number of analytic and scientific 

research on practice-related topics in response to requests from SAMHSA centers, HHS

196 BHSIS data are collected under SAMHSA’s legislative mandate; see 42 U.S.C. 290aa-4.

.
271

agencies, the Office of National Drug Control Policy, and the Department of Justice. 

ASC’s funding includes a total of $2.5 million for FY 2015 and $3.0 million for FY 2016 

with $2.0 million supported from Health Surveillance appropriation.

Funding History

Fiscal Year Amount

FY 2013 $45,421,000

FY 2014 $47,258,000

FY 2015

FY 2016

$47,258,000

$47,258,000

FY 2017 $47,258,000

Budget Request

The FY 2017 Budget Request is $47.3 million. This is the same as the FY 2016 Enacted Level. 

This includes $29.4 million from PHS Evaluation Funds and $17.8 million from Prevention and 

Public Health Funds. This funding will support the continuation of the NSDUH, NREPP, 

BHSIS, C-EMS, and the Analytic Support Center contracts.

Health Surveillance funding in FY 2017 includes $2.3 million for Operations and $7.2 million to 

support the administrative costs of CBHSQ personnel, programs, and interagency agreements.

Mechanism Table for Health Surveillance

(Dollars in thousands)

Program Activity

FY2015

Final 

No. Amount

FY2016

Enacted 

No. Amount

FY2017

President's 

Budget

No. Amount

Health Surveillance

Contracts

Continuations.............................................................................. 4 $41,100 3 $36,194 3 $33,463

New/Competing......................................................................... 4 6,158 1 11,064 --- 13,795

Subtotal................................................................................... 8 47,258 4 47,258 3 47,258

Total,HealthSurveillance 8 $47,258 4 $47,258 3 $47,258
272

Program Support

(Dollars in thousands)

Program Activity

FY2015

Final

FY2016

Enacted

FY2017

President's 

Budget

FY2017

+/-

FY2016

Program Support........................................................................ $72,002 $79,559 $77,559 -$2,000

Authorizing Legislation .............................................Section 501 of the Public Health Service Act 

FY 2017 Authorization .........................................................................................................Expired

Allocation Method ....................................................... Direct Federal/Intramural, Contracts, Other 

Eligible Entities......................................................................................................... NotApplicable

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 614 Full Time Equivalents (FTEs) in FY 2015 and projects that the number 

of FTE will grow to 665 in FY 2016. The Program Support appropriation supported 491 of these 

FTEs. Staff positions that are not covered through the Health Surveillance and Program Support 

appropriation are funded with Substance Abuse Prevention and Treatment Block Grant set-aside 

for activities associated with technical assistance, data collection and evaluation, and from other 

program lines for activities directly relating to the administration of those particular programs.

SAMHSA applies an estimated internal administrative charge for overhead expenses to all 

programs, projects, and activities.

Funding History

Fiscal Year Amount

FY 2013 $77,997,779

FY 2014 $72,002,000

FY 2015

FY 2016

$72,002,000

$79,559,000

FY 2017 $77,559,000

Budget Request

The FY 2017 Budget Request is $77.6 million, a decrease of $2.0 million from the FY 2016 

Enacted Level. This level of funding will continue to cover overhead costs associated with 5600 

Fishers Lane, including rent, the Federal Acquisition Service loan repayment program, and 

security charges.
273

In FY 2017, SAMHSA plans to support 665 FTEs with funding from the Mental Health, 

Substance Abuse Treatment, and Health Surveillance and Program Support appropriations. 

Funding types include Budget Authority, PHS Evaluation, and other reimbursables.

Mechanism Table for Program Support

(Dollars in thousands)

Program Activity

FY2015

Final 

No. Amount

FY2016

Enacted 

No. Amount

FY2017

President's 

Budget

No. Amount

Program Support

Contracts

Continuations.............................................................................. --- $72,002 --- $79,559 --- $77,559

New/Competing......................................................................... --- --- --- --- --- ---

Subtotal................................................................................... --- 72,002 --- 79,559 --- 77,559

Total,ProgramSupport --- $72,002 --- $79,559 --- $77,559
274

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275

Public Awareness and Support

(Dollars in thousands)

Program Activity

FY2015

Final

FY2016

Enacted

FY2017

President's 

Budget

FY2017

+/-

FY2016

Program Level........................................................................... $13,482 $15,571 $13,482 -$2,089

PHS Evaluation Funds ( non-add)......................................... --- --- 13,482 +13,482

Authorizing Legislation ......... Sections 501, 509, 516, and 520A of the Public Health Service Act 

FY 2017 Authorization .........................................................................................................Expired

Allocation Method ...........................................................................................Grants and Contracts

Eligible Entities......................................................................................................... NotApplicable

Program Description and Accomplishments

The behavioral healthcare system is critical to the overall health of the nation. A study funded 

by the National Institutes of Health and SAMHSA197 estimated that at some point in their lives, 

almost half of all Americans will experience symptoms of a mental and/or substance use 

disorder. In addition, half of all lifetime cases of mental and substance use disorders begin by age

14 and three-fourths by age 24.198 For these reasons, it is important to identify issues early and 

help individuals get the treatment they need as soon as possible. Fortunately, because of the 

Affordable Care Act and the implementation of the Mental Health Parity and Addiction Equity 

Act, more people than ever before have access to mental health care and substance use disorder 

treatment. Communities are increasingly engaging in prevention strategies and approaches that 

are effective in supporting the behavioral health and wellness of their residents, particularly

children and young adults. An important part of SAMHSA’s mission is to raise the public’s 

understanding of mental and substance use disorders, serve as an expert on behavioral health 

issues, and lead public health efforts to advance the behavioral health of the nation.

Collaborating Across Agencies

SAMHSA collaborates with other agencies to promote awareness of behavioral health. For 

example, SAMHSA coordinates with the Centers for Disease Control and Prevention (CDC) to 

promote the Million Hearts Campaign and prescriber guidelines for opioids under the Materials 

Development and Marketing Support (MDMS) contract. SAMHSA also supports the National 

Outreach, Public Education, and Engagement Initiative (NOPEEI) contract, which provides 

communications support for national outreach and public education initiatives across a variety of 

behavioral health topics, including a national effort to support recovery from mental and 

substance use disorders.

197 Kessler, R. C., Berglund, P., Demler, O., Jin, R., Merikangas, K. R., & Walters, E. E. (2005). Lifetime prevalence 

and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. Archives of 

general psychiatry, 62(6), 593-602.

198 Ibid.
276

Providing Critical Resources to the Behavioral Health Community 

SAMHSA’s strategic communications plan ensures that the vital information and training 

materials produced through SAMHSA’s centers and offices are available to the behavioral and 

healthcare community through the Public Engagement Platform (PEP), which manages 

SAMHSA’s print and online information resources. The Public Engagement Platform provides a 

customer-oriented fulfillment system, including an online store, call-in contact center,

warehouse, email updates, exhibit program, and strategic collaborations to fulfill the educational 

and training needs of the public and health service providers. The various channels of 

communication managed by SAMHSA generated more than 34 million customer interactions in 

FY 2015, disseminated over 26 million copies of SAMHSA publications, and referred over 

565,000 people to treatment. 

SAMHSA is also responsible for managing the Disaster Distress Helpline to provide information 

and counseling referral to the public after tragic events. SAMHSA quickly mobilizes in the 

aftermath of a disaster to deliver behavioral health information and support services for 

responders and survivors. For example, in response to severe storms and flooding in Texas, 

SAMHSA disseminated an e-blast on June 8, 2015, less than 24 hours after the disaster occurred, 

to over 100,000 recipients. The e-blast featured SAMHSA’s Disaster Distress Helpline and a 

link to download SAMHSA’s mobile app for behavioral health first responders. 

Over the last several years, SAMHSA has leveraged mobile technology to increase the reach of 

its resources by launching multiple mobile apps. Each app has had a greater reach than the ones 

that preceded it. For example, to further support behavioral health first responders, SAMHSA 

developed and launched the behavioral health disaster response mobile app 

(http://www.store.samhsa.gov/apps/disaster/) that allows behavioral health first responders to 

zero in on the exact location to respond to a disaster and easily access and share behavioral 

health resources, updated in real-time, with those most in need at the site of a disaster. Since its 

launch, there have been more than 12,600 downloads of the behavioral health disaster response 

app, and more than 18,600 down loads of “Know Bullying,” a mobile app released in FY 2014 

(http://store.samhsa.gov/apps/bullying/) that gives parents and caregivers the tools they need to 

talk to their children about bullying. This app has been downloaded over times. In February of 

2015, SAMHSA launched the “Suicide Safe” app (http://store.samhsa.gov/apps/suicidesafe/) for 

primary care and behavioral health providers. The Suicide Safe app is designed to help primary 

care and behavioral health providers address suicide risk and integrate suicide prevention 

strategies in patient care. “Suicide Safe” has been downloaded over 28,900 times since its 

launch. In the future, SAMHSA will continue to innovate in these new platforms by launching 

additional mobile apps to address other important behavioral health topics. 

SAMHSA will continue to provide critical information resources in a timely fashion, and access 

to emergency response networks, for the public and the behavioral health workforce. 

Leveraging SAMHSA’s Online Presence

Available 24/7, SAMHSA.gov is the public’s primary access point for behavioral health 

information from the federal government. SAMHSA’s website and social media presence on

channels such as Facebook, Twitter, and YouTube are critical to efforts to engage with citizens 

about behavioral health. The increasingly effective reach of these online channels is
277

demonstrated by the fact that the number of people following SAMHSA on Twitter has increased 

more than 680 percent (from 7,000 to over 55,000) since 2013, and “likes” of SAMHSA’s 

Facebook page have increased from 20,000 to over 57,000 during the same time period.

In the course of prioritizing the internet as a strategic business initiative and communications 

asset, SAMHSA consolidated and modernized SAMHSA’s web presence. Through an ongoing 

focused effort (Project Evolve), almost 90 disparate websites created for various SAMHSAsponsored campaigns and programs are being consolidated under SAMHSA.gov, and will be 

completed in FY 2016. SAMHSA’s focused efforts ensure that the agency speaks to the nation 

with a unified voice. Project Evolve will also help eliminate multiple web development and 

maintenance efforts, resulting in lower overall operating costs, greater efficiency, increased 

effectiveness, and improved service for visitors to SAMHSA’s website.

SAMHSA’s Role as a Leader in Behavioral Health Data and Surveillance

A key goal of SAMHSA’s Public Awareness and Support effort is to make certain that valuable 

behavioral health data reach the widest number of Americans, enabling them to make informed 

decisions about the health and wellbeing of their loved ones and themselves. SAMHSA shares 

this vital information through the aforementioned vehicles (e.g. MDMS, PEP, the Web, and 

social media) and other program operations. These include press releases issued by SAMHSA to 

highlight recent findings from the National Survey on Drug Use and Health and SAMHSA’s 

Behavioral Health Barometer. These surveys provide data on behavioral health problems at the 

national level, by geographic region, and for each of the 50 states and the District of Columbia. 

SAMHSA has also completed an agency-wide Strategic Communications Plan to increase the 

utility and reach of its data reports and other public education materials.

As part of the President’s Now is the Time effort, SAMHSA charged the National Academies’

Board on Behavioral, Cognitive, and Sensory Sciences to research the current state of social 

norms regarding behavioral health and to create a consensus report including recommendations 

on positively impacting those norms. This effort, “Science of Changing Social Norms: Building 

the Evidence Base” laid fundamental groundwork, which SAMHSA continues to build in FY

2016. In FY 2016, SAMHSA is beginning the next phase of the “Science of Changing Social

Norms” program. Through this effort, SAMHSA will inform the development and testing of an 

array of messages designed to raise public awareness of the importance of behavioral health, 

promote health literacy to reduce the negative perceptions and attitudes about behavioral health 

issues, and help Americans make behavioral health a priority for public health action. Going 

forward, SAMHSA will use the insight gained through this effort to inform our communications 

about the importance of behavioral health.
278

Funding History

Fiscal Year Amount

FY 2013 $13,545,351

FY 2014 $13,482,000

FY 2015

FY 2016

$13,482,000

$15,571,000

FY 2017 $13,482,000

Budget Request

The FY 2017 Budget Request is $13.5 million, a reduction of $2.1 million from the FY 2016 

Enacted Level. The $2.0 million reduction is because the one-time finding for the effort “Science 

of Changing Social Norms” is no longer needed. The lessons learned through the program in FY 

2016 and SAMHSA’s work with the National Academies’ Board on Behavioral, Cognitive, and 

Sensory Sciences will inform SAMHSA’s other communications efforts and programs in FY 

2017 and beyond. Funds for Public Awareness and Support will allow SAMHSA to maintain and 

update its web presence, develop innovative mobile apps, expand its presence on social media, 

and provide other critical resources to support behavioral health and other health. SAMHSA will 

continue to collaborate with other agencies. These efforts will allow SAMHSA to broaden the 

reach of its four key messages; behavioral health is essential to health, prevention works, 

treatment is effective, and people recover. For example, through the National Outreach, Public 

Education and Engagement Initiative contract, SAMHSA will work with the CDC to disseminate 

information about prescriber guidelines on the dangers of prescription drug misuse.

Mechanism Table for Public Awareness and Support

(Dollars in thousands)

Program Activity

FY2015

Final 

No. Amount

FY2016

Enacted 

No. Amount

FY2017

President's 

Budget

No. Amount

Public Awareness andSupport

Grants

Continuations.............................................................................. --- $--- --- $--- --- $---

New/Competing......................................................................... --- --- --- --- --- ---

Subtotal................................................................................... --- --- --- --- --- ---

Contracts

Continuations.............................................................................. 5 11,020 5 12,093 5 5,794

New/Competing......................................................................... 1 2,462 2 3,478 1 7,688

Subtotal................................................................................... 6 13,482 7 15,571 6 13,482

Total, Public Awareness andSupport 6 $13,482 7 $15,571 6 $13,482
279

Outputs and Outcomes Table 

Program: Public Awareness and Support

Measure

Year and Most Recent Result

Target for Recent Result 

(Summary of Result)

FY 2016

Target

FY 2017

Target

FY 2017

Target

+/-

FY 2016

Target

4.4.12 Increase the number of 

individuals referred for behavioral 

health treatment resources. 

(Output)

FY 2015: 565,925

Target: 310,000 

(Target exceeded)

400,000 400,000 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 2015: 34,151,612

Target: 30,325,334

(Target exceeded)

33,000,000 34,300,00 +1,300,000
280

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281

Performance and Quality Information Systems

(Dollars in thousands)

ProgramActivity

FY 2015

Final

FY 2016

Enacted

FY 2017

President's 

Budget

FY 2017

+/-

FY 2016

Program Level............................................................................

PHS Evaluation Funds (non-add).........................................

$12,918

---

$12,918

---

$12,918

12,918

$---

+12,918

Authorizing Legislation ......... Sections 501, 509, 516, and 520A of the Public Health Service Act 

FY 2017 Authorization .........................................................................................................Expired

Allocation Method .............................................................................................................Contracts

Eligible Entities......................................................................................................... NotApplicable

Program Description and Accomplishments

Performance and Quality Information Systems (PQIS) provide continuous support for the 

performance measurement efforts including quality improvement activities. This program 

promotes greater efficiencies in the collection, analysis, and reporting of data and other 

information. The program will facilitate accountability, clarity in outcomes measures, and 

improvements in the quality and accessibility of data and other information for use by program 

staff, grantees, and the public.

In FY 2015 and FY 2016, funding will continue to support the National Registry of Evidencebased Programs and Practices (NREPP). NREPP (http://www.samhsa.gov/nrepp) is a 

searchable online system that provides states, tribes, local governments, and communities with 

tools for identifying and implementing evidence-based mental health promotion, substance abuse 

prevention, and mental and substance use disorder treatment interventions. SAMHSA is 

implementing changes to NREPP to address enhanced rigor and highlight promising practices 

that are of a particular importance to vulnerable populations. These changes to the review 

process will bring NREPP into alignment with other government registries of evidence-based 

programs and practices.

SAMHSA requests continued funding for Performance and Quality Information Systems to 

address the need for a uniform data collection and reporting system for SAMHSA management 

and staff. In FY 2015, funding to phase in the implementation of SAMHSA’s common data 

platform (CDP) was $5.0 million. In FY 2016 and FY 2017, SAMHSA will combine this funding 

with Grantee Data Technical Assistance funding for a total of $10.9 million. This approach will 

allow for the funding of a single common data platform, including programmatic training and 

technical assistance, known as SAMHSA’s Performance Accountability and Reporting System 

(SPARS). SPARS will provide a common data and reporting system for all SAMHSA 

discretionary grantees and allow for programmatic technical assistance on the use of data to 

enhance grantee performance monitoring and improve the quality of service delivery. These 

funds will provide SAMHSA’s management and staff with the ability to analyze program data at 

multiple levels (state, program, community, etc.), provide tailored, real-time information about 

the progress and activity of each grantee, and provide data to grantees to support them in the 

efficient and effective implementation of projects.
282

PQIS funding also supports operations ($2.6 million in FY 2015 and $1.5 million in FY 2016). 

The operations budget funds the administrative and support costs for CBHSQ programs, and 

interagency agreements.

Funding History

Fiscal Year Amount

FY 2013 $8,803,289

FY 2014 $12,918,000

FY 2015

FY 2016

$12,918,000

$12,918,000

FY 2017 $12,918,000

Budget Request

The FY 2017 Budget Request is $12.9 million, the same as the FY 2016 Enacted Level. 

SAMHSA will use these funds to continue support for operations at $1.5 million, NREPP at $1.5 

million, and SPARS at $10.9 million. This funding will support system development, training, 

and technical assistance.

Mechanism Table for Performance and Quality Information Systems

(Dollars in thousands)

Program Activity

FY2015

Final 

No. Amount

FY2016

Enacted 

No. Amount

FY2017

President's 

Budget

No. Amount

Performance andQuality InformationSystems

Grants

Continuations.............................................................................. --- $--- --- $--- --- $---

New/Competing......................................................................... --- --- --- --- --- ---

Subtotal................................................................................... --- --- --- --- --- ---

Contracts

Continuations.............................................................................. 3 12,918 3 12,918 3 12,918

New/Competing......................................................................... --- --- --- --- --- ---

Subtotal................................................................................... 3 12,918 3 12,918 3 12,918

Total,Performance andQuality InformationSystems 3 $12,918 3 $12,918 3 $12,918
283

Outputs and Outcomes Table 

Program: Performance and Quality Information Systems

1 FY 2015 data was not collected because of technical and programmatic changes associated with thewebsite.

Measure

Year and Most Recent Result 

Target for Recent Result

(Summary of Result)

FY 2016

Target

FY 2017

Target

FY 2017

Target

+/-

FY 2016

Target

4.4.10 Increase the combined count 

of webpage hits, hits to the locator, 

and hits to Substance Abuse and 

Mental Health Data Archive 

(SAMHDA) for SAMHSAsupported data sets. (Output)

FY 2014: 1,745,1331

Target: 1,882,149 

(Target not met)

1,700,000 1,700,000 Maintain

4.4.11 Increase the number of 

evidence-based programs or 

practices in review. (Output)

FY 2015: 45

Target: 55 

(Target not met)

55 55 Maintain
284

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285

Agency-Wide Initiatives

(Dollars in thousands)

Program Activity

FY2015

Final

FY2016

Enacted

FY2017

President's 

Budget

FY2017

+/-

FY2016

Agency-wide Initiatives1............................................................. $11,669 $12,669 $22,669 +$10,000

Behavioral Health Workforce (non-add)............................... 11,669 12,669 22,669 +10,000

Minority Fellowship Program (non-add)............................ 10,669 11,669 11,669 ---

Minority Fellowship Program-Base (non-add)............... 5,423 6,423 6,423 ---

Counselors ( non-add)..................................................... 5,246 5,246 5,246 ---

Peer Professional Workforce Development (non-add)....... --- --- 10,000 +10,000

Behavioral Health Workforce Data and Development (nonadd)........................................................................... 1,000 1,000 1,000 ---

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

1 Totals in FY2015(-$35.0million) and FY2016(-$50.0million) are comparably adjusted to reflect the transfer of the BehavioralHealth 

WorkforceExpansion and Training programfromSAMHSA to HRSAin FY2017.

Authorizing Legislation .........Sections 501, 509, 516, and 520A of the Public Health Service Act 

FY 2017 Authorization .........................................................................................................Expired

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

Eligible Entities....................... Community Colleges, Universities, States, National Organizations

Program Description and Accomplishments

Behavioral Health Workforce

As SAMHSA implements the Leading Change 2.0 Strategic Initiatives for 2015-2018, the 

Strategic Initiative on Workforce Development provides the opportunity for a concerted focus on 

developing and expanding the behavioral health workforce.

The mental health-related and substance use-related service needs of racial and ethnic minority 

communities within the United States have been historically under–addressed due to a variety of 

factors. These include a limited number of trained practitioners who are equipped with the 

language skills or cultural competency training needed to deliver effective services for this 

population. SAMHSA’s Minority Fellowship Program (MFP) increases behavioral health 

practitioners’ knowledge of issues related to prevention, treatment, and recovery support for 

mental and substance use disorders 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 health 

or substance use disorder services for minority populations that are underserved. This will result 

in improved quality of mental and substance use disorder 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 added professional counselors. 

These individuals often serve in key leadership positions in mental and substance use disorder
286

services, services supervision, services research, training, and administration. Professional 

guilds receive competitively awarded grants, and then competitively award the stipends to postgraduate students pursuing a degree in that professional field. In FY 2015, SAMHSA funded six 

continuation grants and plans to fund these again in FY2016.

In previous years, program activities were spread through three of SAMHSA’s centers. To 

improve the administration of these workforce programs, SAMHSA has realigned the programs 

within a unified approach under Agency-Wide Initiatives. The focus on building the components 

of the mental health, substance use prevention and substance use disorder treatment workforce 

will be maintained through enhanced collaborative efforts between SAMHSA’s centers.

Minority Fellowship Program Expansion-Youth (MFP-Y) and Addiction Counselors (MFP-AC) 

Begun FY 2014, MFP-Y this effort is a component of MFP that support master’s level trained 

behavioral health professionals in the fields of psychology, social work, professional counseling, 

marriage and family therapy, and nursing serving children, adolescents, and populations in 

transition to adulthood (aged 16 to 25). The purpose of the program expansion, the Minority 

Fellowship Program-Youth (MFP-Y), is to reduce health disparities and improve behavioral 

healthcare outcomes for racially and ethnically diverse youth and young adults.

To do this, the program aims to increase the number of culturally competent master’s level 

behavioral health professionals serving children, adolescents, and populations in transition to 

adulthood (aged 16 to 25) in an effort to increase access to, and the quality of, behavioral health 

care for this age group. The expansion program uses the existing infrastructure of the MFP to 

expand the program to support 960 master’s level trained behavioral health providers. Grants are

competitively awarded to professional guilds, which then competitively award the stipends to 

post-graduate students pursuing a degree in that professional field.

MFP-AC is a component of MPP to support master’s level addiction counselors (MFP-AC) for 

youth and young adults. The purpose of the four-year grant program is to reduce health 

disparities and improve behavioral healthcare outcomes for racially and ethnically diverse 

populations by increasing the number of culturally competent master’s level addiction counselors 

available to underserved minority populations with a specific focus on transition age youth (ages 

16 to 25) in public and private non-profit sectors. MFP-AC grants are supporting students 

pursuing master’s level degrees in addiction/substance abuse counseling, with the goal of 

increasing the number of masters-level addiction counselors across the nation by approximately 

300 counselors. As is the case with MFP and MFP-Y, grants are competitively awarded to 

professional guilds, who then competitively award the stipends to post-graduate students 

pursuing a degree in that professional field.

The FY 2015 Budget provided $10.7 million in funding for MFP grants. The FY 2016 Enacted 

Level of $11.7 million sustains and strengthens the expansion program.
287

Funding History

Fiscal Year Amount

FY 2013 $5,436,000

FY 2014 $10,669,000

FY 2015

FY 2016

$10,669,000

$11,669,000

FY 2017 $11,669,000

Budget Request

The FY 2017 Budget Request is $11.7 million, which is level with the FY 2016 Enacted Level. 

The funding will provide continued support for both base and expansion activities. The funds 

will support six MFPs, five MFP-Y, two MFP-AC grants, and three technical assistance and 

evaluation support contracts.

Peer Professional Workforce Development

The Peer Professional Workforce Development program will fund grants to provide tuition 

support and further the capacity of community colleges to develop and sustain behavioral health 

paraprofessional training and education programs. The Peer Professional Workforce 

Development program’s goal is to increase the number of trained peers, recovery coaches, 

mental health/addiction specialists, prevention specialists, and pre-masters-level addiction 

counselors working with young people ages 16 to 25. Because they have lived with behavioral 

health conditions, the entry-level providers supported by this program will play a significant role 

in the delivery of prevention, outreach, engagement, and recovery support services. Evidence has

found that individuals with a substance use disorder who regularly engage in peer-delivered 

interventions are more likely to abstain from substance misuse. Similar evidence has shown the 

effectiveness of those with mental disorders and their families in supporting their peers. While 

the Behavioral Health Workforce Education and Training program (described below) focuses on 

supporting clinical internships, field placements, and certificate program completion across a 

range of professional and paraprofessional disciplines (some of whom may be peers), the Peer 

Professional Workforce Development program will focus on helping communities develop the 

infrastructure to train and certify peers, or people with lived experience with mental illness 

and/or substance use conditions, as behavioral health providers.

Funding History

Fiscal Year Amount

FY 2013 ---

FY 2014 ---

FY 2015 ---

FY 2016 ---

FY 2017 $10,000,000
288

Budget Request

The FY 2017 Budget Request of $10.0 million reflects an increase of $10.0 million from the 

FY 2016 Enacted Level. These funds will support the development of the new Peer Professional 

Workforce Development program. The program aims to increase the number of trained peers, 

recovery coaches, mental health/addiction specialists, prevention specialists, and pre-Masters 

level addiction counselors working with young people ages 16 to 25. It will provide tuition 

support and further the capacity of community colleges to develop and sustain behavioral health 

paraprofessional training and education programs. The funding will support up to 19 grants.

SAMHSA-HRSA Behavioral Health Workforce Education and Training (BHWET) Grant 

Program

In FY 2014, as part of the President’s Now is the Time initiative, SAMHSA and the Health 

Resources and Services Administration (HRSA) began collaboration on the Behavioral Health 

Workforce Education and Training Grant Program. The purpose of this program is to increase 

the clinical service capacity of the behavioral health workforce by supporting training for 

masters-level social workers, professional counselors, psychologists, marriage and family 

therapists, psychology doctoral interns, as well as behavioral health paraprofessionals. In 

FY 2014, FY 2015 and FY 2016, SAMHSA requested and Congress appropriated this funding to

SAMHSA. During this time, HRSA carried out the program under a reimbursable agreement. In 

FY 2017, HHS is requesting that HRSA receive the funding for this program. This is in line with 

HRSA’s current authorities and will aid in streamlining efforts. SAMHSA and HRSA will 

continue to collaborate to sustain and strengthen the HRSA-SAMHSA partnership and the 

behavioral health workforce. SAMHSA has comparably adjusted impacted tables.

Behavioral Health Workforce Data and Development

As of June 2014, there were more than 4,000 Mental Health Professional Shortage Areas 

(HPSAs) in the United States, containing nearly a third of the American population, or 

96 million people. Recent data indicate that almost 90 percent of persons with substance use 

disorders do not receive the services they need199 and over half of those with mental illness do 

not receive needed treatment.200

The President’s Now is the Time initiative supports new activities to expand the behavioral health 

workforce. In FY 2015, new workforce investments provided support for 2,116 new behavioral 

health professionals. To ensure the existing workforce investments would achieve desired 

outcomes, SAMHSA workforce activities in FY 2015 included $1.0 million to collaborate with 

HRSA on the Behavioral Health Minimum Data Set to develop consistent data collection 

methods to identify and track behavioral health workforce needs. In FY 2016, SAMHSA

199 Substance Abuse and Mental Health Services Administration, Results from the 2013 National Survey on Drug 

Use and Health: Summary of National Findings, NSDUH Series H-48, HHS Publication No. (SMA) 14-4863.

Rockville, MD: Substance Abuse and Mental Health Services Administration, 2014. 200 Substance Abuse and Mental Health Services Administration, Results from the 2013 National Survey on Drug 

Use and Health: Mental Health Findings, NSDUH Series H-49, HHS Publication No. (SMA) 14-4887.Rockville,

MD: Substance Abuse and Mental Health Services Administration, 2014.
289

continues to work with HRSA to develop a consistent and common data set and to develop clear 

goals and objectives to meet the national behavioral health workforce needs in America.

Funding History

Fiscal Year Amount

FY 2013 ---

FY 2014 ---

FY 2015

FY 2016

$1,000,000

$1,000,000

FY 2017 $1,000,000

Budget Request

The FY 2017 Budget Request of $1.0 million is level with the FY 2016 Enacted Level. These 

funds will allow SAMHSA to continue collaborating with HRSA. These efforts will focus 

analytical and research projects in three behavioral health workforce focus areas: 1) expanded 

application of standardized minimum data set with state and professional organizations;

2) workforce modeling and projections to understand what behavioral health services are being 

provided, by whom and in what settings; and 3) development of certification/licensing/scope of 

practice framework for each state.
290

Mechanism Table for Agency-Wide Initiatives

(Dollars in thousand)

Program Activity 

Agency-Wide Initiatives

FY2015

Final 

No. Amount

FY2016

Enacted 

No. Amount

FY2017

President's 

Budget

No. Amount

Behavioral Health Workforce:

MinorityFellowshipProgram-Base1

Grants

Continuations.............................................................................. 6 $4,796 6 $4,770 6 $4,755

New/Competing......................................................................... --- --- 2 1,000 2 1,000

Subtotal................................................................................... 6 4,796 8 5,770 8 5,755

Contracts

Continuations.............................................................................. 1 627 1 653 1 668

New/Competing......................................................................... --- --- --- --- --- ---

Subtotal................................................................................... 1 627 1 653 1 668

Total, MFP-Base 7 5,423 9 6,423 9 6,423

Minority Fellowship Program-Youth/Addiction Counselors

Grants

Continuations.............................................................................. 7 4,261 7 4,261 7 4,261

New/Competing......................................................................... --- --- --- --- --- ---

Subtotal................................................................................... 7 4,261 7 4,261 7 4,261

Contracts

Continuations.............................................................................. 2 985 2 985 2 985

New/Competing......................................................................... --- --- --- --- --- ---

Subtotal................................................................................... 2 985 2 985 2 985

Total, MFP-Youth/Addiction Counselors 9 5,246 9 5,246 9 5,246

Peer Professional Workforce Development

Grants

Continuations.............................................................................. --- --- --- --- --- ---

New/Competing......................................................................... --- --- --- --- 19 9,343

Subtotal................................................................................... --- --- --- --- 19 9,343

Contracts

Continuations.............................................................................. --- --- --- --- --- ---

New/Competing......................................................................... --- --- --- --- --- 657

Subtotal................................................................................... --- --- --- --- --- 657

Total,PPWD --- $--- --- $--- 19 $10,000

BehavioralHealthWorkforceDataandDevelopment

Grants

Continuations.............................................................................. --- --- --- --- --- ---

New/Competing......................................................................... --- --- --- --- --- ---

Subtotal................................................................................... --- --- --- --- --- ---

Contracts

Continuations.............................................................................. --- --- 1 1,000 1 1,000

New/Competing......................................................................... 1 1,000 --- --- --- ---

Subtotal................................................................................... 1 1,000 1 1,000 1 1,000

Total,BehavioralHealthWorkforceData andDevelopment 1 1,000 1 1,000 1 1,000

Subtotal, Behavioral Health Workforce 17 11,669 19 12,669 38 22,669

Total, Agency-Wide2 17 $11,669 19 $12,669 38 $22,669

1 The Minority Fellowship Program budget appears in the Health Surveillance and Program Support appropriation, Agency-wide 

Initiatives Workforce program. This is consistent with the FY 2017 Budget Request.

2 Reflects the transfer of funding associated with the Behavioral Health Workforce Expansion and Training program from SAMHSA 

to HRSA. HRSA and SAMHSA will continue to work together to implement this program.
291

SAMHSA

Center for Behavioral Health Statistics and Quality (CBHSQ) 

Table of Contents

1. SAMHSA/Center for Behavioral Health Statistics and Quality (CBHSQ).................... 293

2. Surveillance and Data Collection.................................................................................... 296

3. Evaluation ....................................................................................................................... 299

4. Statistical and Analytic Support...................................................................................... 300

5. Services Systems Research ............................................................................................. 300

6. Performance and Quality Information Systems.............................................................. 300

7. Agency-Wide Initiatives................................................................................................. 301
292

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293

SAMHSA

Center for Behavioral Health Statistics and Quality

(Dollars in thousands)

ProgramActivity

FY2015

Final

FY2016

Enacted

FY2017

President's 

Budget

FY2017

+/-

FY2016

Substance Abuse Treatment Appropriation 

Substance Abuse Block Grant Set Aside 

BudgetAuthority

NationalSurveyon DrugUse and Health.................................. $1,626 $698 $698 ---

Total BudgetAuthority 1,626 698 698 ---

PHS Evaluation Funds 43,689 38,233 38,233 --- Analytic Support Center........................................................................ 562 1,000 1,000 ---

BehavioralHealthServicesInformationSystem...................................... 4,413 3,972 3,972 ---

Substance Abuse and Mental Health DataArchive ................................. 2,035 1,291 1,291 ---

Community Behavioral Health Data Initiative.......................................... 1,500 5,750 5,750 ---

SAMHSA’s Emergency Department Surveillance System (non-add 1,500 4,500 4,500 ---

Program Studies on Treatment and Recovery (non-add)................. --- 1,250 1,250 ---

Data Collection and Evaluation Activities................................................. 296 --- --- ---

Operations............................................................................................. 187 305 305 ---

Payroll................................................................................................... 4,987 7,122 7,122 ---

Total PHS EvaluationFunds 57,670 57,674 57,674 ---

Total Substance Abuse Block Grant Set Aside 59,296 58,372 58,372 ---

Health Surveillance and Program SupportAppropriation

HealthSurveillance

BudgetAuthority

NationalSurveyon DrugUse and Health............................................... 2,405 13,795 --- -13,795

Community BehavioralHealth Data Initiative........................................... 2,000 1,778 --- -1,778

Community Early Warning and Monitoring System (non-add)...... 2,000 1,778 --- -1,778

Common Data Platform.......................................................................... 1,800 --- --- ---

Data Collection and Evaluation Activities................................................. 6,374 --- --- ---

InnovationandLogisticalServicesSupport............................................. 1,334 --- --- ---

Content Management............................................................................. 1,230 --- --- ---

Operations............................................................................................. 1,687 1,257 --- -1,257

Total BudgetAuthority 16,830 16,830 --- -16,830

PHS Evaluation Funds

NationalRegistryforEvidenceBased Programs and Practices................. 2,212 2,043 1,103 -940

BehavioralHealthServicesInformationSystem...................................... 16,668 17,028 17,028 ---

Analytic Support Center........................................................................ 2,000 2,020 1,012 -1,008

Community BehavioralHealth Data Initiative........................................... 1,000 1,222 2,011 +789

Community Early Warning and Monitoring System (non-add)...... 1,000 1,222 2,011 +789

InnovationandLogisticalServicesSupport............................................. 846 --- --- ---

Content Management............................................................................. 973 --- --- ---

Operations............................................................................................. 1,497 1,118 1,162 +44

Payroll................................................................................................... 5,232 6,998 7,112 +114

Total PHS EvaluationFunds 30,428 30,428 29,428 -1,000

Prevention and Public HealthFund

Analytic Support Center........................................................................ --- --- 1,008 +1,008

NationalSurveyon DrugUse and Health............................................... --- --- 13,795 +13,795

NationalRegistryforEvidenceBased Programs and Practices................. --- --- 904 +904

Community Behavioral Health Data Initiative........................................... --- --- 989 +989

Community Early Warning and Monitoring System (non-add)...... --- --- 989 +989

Operations............................................................................................. --- --- 1,134 +1,134

Total PreventionandPublic HealthFund --- --- 17,830 +17,830

Total HealthSurveillance 47,258 47,258 47,258 ---
294

SAMHSA/Center for Behavioral Health Statistics and Quality (CBHSQ)

(Dollars in thousands)

ProgramActivity

FY2015

Final

FY2016

Enacted

FY2017

President's 

Budget

FY2017

+/-

FY2016

Performance and Quality Information Systems

Budget Authority

National Registry for Evidence Based Programs and Practices................ 330 1,463 --- -1,463

CommonDataPlatform.......................................................................... 3,590 10,000 --- -10,000

Grantee DataTechnicalAssistance ........................................................ 3,185 --- --- ---

Data Collection and Evaluation Activities................................................. 2,005 --- --- ---

InnovationandLogisticalServicesSupport............................................. 376 --- --- ---

Content Management............................................................................. 881 --- --- ---

Operations............................................................................................. 2,551 1,455 --- -1,455

Total BudgetAuthority 12,918 12,918 --- -12,918

PHS Evaluation Funds

NationalRegistryforEvidenceBased Programs and Practices................. --- --- 1,498 +1,498

CommonDataPlatform.......................................................................... --- --- 10,000 +10,000

Operations............................................................................................. --- --- 1,420 +1,420

Total PHS Evaluation Funds --- --- 12,918 +12,918

Total Performance and Quality Information Systems 12,918 12,918 12,918 ---

Agency-Wide Initiatives

PHS Evaluation Funds

BehavioralHealthWorkforceDataandDevelopment.............................. 940 967 966 -1

Operations............................................................................................. 60 33 34 +1

Total Agency-Wide Initiatives 1,000 1,000 1,000 ---

Total HealthSurveillance and Program Support 61,176 61,176 61,176 ---

Total Substance Abuse Block Grant Set Aside and

Health Surveillance and ProgramSupport $120,472 $119,548 $119,548 $---
295

Resources by Activity

(Dollars in thousands)

Program Activity

FY 2015

Final

FY 2016

Enacted

FY 2017

President's 

Budget

FY 2017

+/-

FY 2016

National Survey on Drug Use and Health................................................ $47,721 $52,727 $52,727 $---

Behavioral Health Services Information System ...................................... 21,081 21,000 21,000 ---

CBHSQ Logistics and Analytic Support Center ..................................... 2,562 3,020 3,020 ---

Substance Abuse and Mental Health Data Archive ................................. 2,035 1,291 1,291 ---

Common Data Platform.......................................................................... 5,390 10,000 10,000 ---

Grantee Data Development Technical Assistance.................................... 3,185 --- --- ---

National Registry for Evidence Based Programs and Practices................ 2,542 3,505 3,505 ---

Community Behavioral Health Data Initiative........................................... 4,500 8,750 8,750 ---

Community Early Warning and Monitoring System (non-add)............. 3,000 3,000 3,000 ---

SAMHSA’s Emergency Department Surveillance System (non-add)..... 1,500 4,500 4,500 ---

Program Studies on Treatment and Recovery (non-add)................... --- 1,250 1,250 ---

Behavioral Health Workforce Data andDevelopment............................. 940 967 966 -1

Data Collection and EvaluationActivities................................................ 8,676 --- --- ---

Innovation and Logistical Services Support............................................. 2,555 --- --- ---

Content Management............................................................................. 3,084 --- --- ---

Operations............................................................................................. 5,982 4,169 4,056 -113

Payroll................................................................................................... 10,219 14,120 14,234 +114

Total ProgramActivities $120,472 $119,548 $119,548 $---

Authorizing Legislation ...........................................Sections 501, 505, 1911, 1921 of the PHS Act 

FY 2017 Authorization .........................................................................................................Expired

Allocation Method .............................................................................................................Contracts

Eligible Entities......................................................................................................... NotApplicable

Overview

This section provides a detail breakout of SAMHSA’s surveillance efforts. It is not additive to 

the Health Surveillance and Program Support appropriation. However, this chapter helps 

highlight the important data collection, analysis and management activities that SAMHSA 

undertakes for the Department of Health and Human Services (HHS).

Program Description and Accomplishments

Collecting, analyzing and reporting health data are activities necessary for tracking and 

evaluating trends in all aspects of health, including behavioral health.201 Data from large national 

surveys allow researchers, practitioners and leaders to assess the status and identify long-term 

trends in behavioral health. These data are also critical for evaluating the impact of federally 

funded programs.

The Center for Behavioral Health Statistics and Quality (CBHSQ) is the government’s lead 

agency for behavioral health statistics. CBHSQ performs a variety of activities including 

surveillance and data collection; evaluation; statistical and analytic support; service systems 

research; and performance and quality information systems. In addition, CBHSQ is responsible

201 Thacker, S.; Berkelman, R. Public health surveillance in the United States. Epidemiologic Reviews. 1988; 

10:164-90.
296

for establishing baselines, tracking trends over time, and evaluating the impact of SAMHSA’s 

behavioral health programs. By creating an integrated data strategy and a national framework 

for quality improvement in behavioral healthcare data, CBHSQ helps inform policy, measure 

program impacts, and lead efforts to improve quality of services and outcomes for individuals, 

families, communities, and tribal communities. CBHSQ’s efforts improve accountability and 

transparency in the development and dissemination of information to support the behavioral 

healthcare delivery system.

Surveillance and Data Collection

SAMHSA manages a number of critical behavioral health data systems for the Department of 

Health and Human Services (HHS) that provide high quality data on the incidence and 

prevalence of mental and substance use disorders, the use of emergency and specialty care, and 

more recently, local indicators of behavioral health status of communities.

National Surveillance and Data Collection

The National Survey on Drug Use and Health (NSDUH) collects information under SAMHSA’s 

legislative mandate202 on the prevalence of substance use and mental disorders and related health 

conditions for the nation. The current NSDUH contract which will support annual surveys 

through FY 2017, and will be re-competed in FY 2017. CBHSQ is working to expand the scope 

of behavioral health data collection by developing definitions that take into account new mental 

disorder criteria specified in the Diagnostic and Statistical Manual, – Fifth Edition (DSM-5). 

Also, CBHSQ partnered with the Office of the Assistant Secretary for Planning and Evaluation 

and the Institute of Medicine for guidance on collection of data about other behavioral health 

issues (including trauma, recovery, serious emotional disturbance among children and adult 

disorders with impairment) through extramural data collection initiatives or possibly through

NSDUH. In response to Congressional recommendations, CBHSQ is exploring the feasibility of 

conducting a NSDUH-like survey in Puerto Rico, the U.S. Virgin Islands, and other U.S. 

territories.

In future years, NSDUH will undergo a redesign to address the latest topics. Potential topics 

include but are not limited to electronic cigarettes, synthetic marijuana, alignment of treatment 

questions for substance use and mental health, revision of questions to align with DSM-5, adult 

disorders with functional impairment, serious emotional disturbance in children, trauma, and 

recovery.

In FY 2015, funding for NSDUH and NSDUH-related activities was $47.7 million. An 

additional $1.0 million from the Mental Health appropriation funded evaluation of mental health 

services. SAMHSA intends to continue $52.7 million in funding for the current FY 2016 

NSDUH contract and a new contract in FY 2017.

Behavioral Health Services Information System (BHSIS)

Each year millions of Americans receive treatment for mental and substance use disorders. In 

order to improve the care provided to these clients and to broaden the availability of treatment

202 See 42 U.S.C. 290aa-4.
297

options, SAMHSA and state and local governments need information about the nature and extent 

of the services being provided. BHSIS is the primary source of data on substance use and mental 

disorder treatment facilities and treatment admissions. In addition, people requiring mental 

and/or substance use disorder treatment need assistance finding resources to aid them in getting 

appropriate care. The BHSIS program includes the Behavioral Health Treatment Services 

Locator. The Services Locator is accessed more than two million times a year by individuals, 

families, community groups, and organizations to identify appropriate treatmentservices.

In FY 2015, CBHSQ continued to explore the potential for integrating buprenorphine providers 

and National Health Service Corps Facilities into the Treatment Services Locator. In addition, 

SAMHSA implemented a new coordinated strategy for conducting the substance use and mental 

health facility surveys in FY 2014. The base cost of BHSIS is $21.0 million in FY 2015, 

FY 2016 and FY 2017. Of this, $17.0 million is from Health Surveillance appropriation and

$4.0 million is from Substance Abuse Treatment Block Grant appropriation. SAMHSA will 

fund basic BHSIS operations in FY 2017 at the same levels as FY 2015 and FY 2016. In 

addition, the Mental Health appropriation provides $7.5 million for a behavioral health services 

facility survey. This funding ensures a holistic approach to data collection related to behavioral 

health and allows for the inclusion of mental health services facility data in the BHSIS survey.

Community Behavioral Health Data Initiative (CDI)

SAMHSA uses data collected from local communities to design and deliver programs and 

services. These data are an important component of a strong public health infrastructure. 

Information on behavioral and physical health at the community level serves to identify current 

and emerging problems and highlight opportunities for progress that may vary from larger 

geographical areas. Importantly, when communities have access to surveillance data over time, 

communities can then direct targeted prevention efforts at the most vulnerable populations.

Under the Community Behavioral Health Data Initiative (CDI) structure, SAMHSA more closely 

coordinates three separate existing data efforts to create new opportunities for cross-agency and 

public-private partnerships to address critical public health questions and use more effectively 

existing or decreasing resources. The three separate existing data efforts are the Community 

Early Warning and Monitoring System (C-EMS), SAMHSA’s Emergency Department 

Surveillance System (SEDSS), and the Program Studies on Treatment and Recovery (PSTAR). 

Data from this coordinated initiative can be augmented with data from other agencies, such as 

the Center for Medicare and Medicaid Services (CMS) and the Agency for Healthcare Research 

and Quality (AHRQ), and then be reported by region and community type. Moreover, the 

longitudinal nature of these data will allow those evaluating the effectiveness of services and 

policies in a community to measure the impact and outcomes of those interventions.

In FY 2016, CBHSQ plans to initiate the next phase of this activity through an agreement with 

the Council of State and Territorial Epidemiologists (CSTE). CSTE is responsible for 

establishing national case definitions for most infectious diseases and is also working on mental 

health and substance use indicators with the intent of establishing a national surveillance system 

similar to the National Notifiable Diseases Surveillance System used by CDC. Working with 

CSTE on this activity enhances the probability of a successful launch of a community level 

surveillance system for mental health and substance use indicators.
298

In FY 2015, CDI’s funding of $4.5 million supported the development and integration of the CEMS and SEDSS data collection programs. In FY 2016 and FY 2017, funding for CDI is level at

$8.8 million. This includes $3.0 million to support C-EMS, $4.5 million for SEDSS, which will

support its development and hospital recruitment, and $1.3 million for PSTAR

Community Early Warning and Monitoring System (C-EMS)

The foundation of SAMHSA’s community-based work, C-EMS, provided the basis for 

community data development in FY 2015. In collaboration with AHRQ, CBHSQ will further 

develop these data system of community-level data collection related to emergency departments. 

This expanded collaboration will engage additional federal partners including the Centers for 

Disease Control and Prevention /Office of State, Tribal, Local and Territorial Support, and bring 

in a new external partner, the CSTE, to apply data from resources at the local, state, and national 

levels to populate a database available to communities to develop data tables and reports for use 

in surveillance of local behavioral health status.

SAMHSA will consider developing data toolkits with survey measures and instructions in the 

use of these measures, as well as technical assistance in sampling and survey deployment, to 

assist communities interested in conducting local behavioral/public health surveillance. These 

data may be uploaded to a community behavioral health database that SAMHSA and 

contributing communities may use to understand community behavioral health needs and 

changes over time. SAMHSA provided $3.0 million in FY 2015 and plans to provide level 

funding through FY 2017 to expand the current efforts by including other community data 

resources to develop and collect community-level data.

SAMHSA’s Emergency Department Surveillance System (SEDSS)

Emergency Department (ED) data remain an important component of public health data because 

they provide a picture of the most urgent behavioral and other health issues in the community. 

ED data are an excellent tool for monitoring trends in mental and substance use disorders and 

related conditions. When examined across the nation, they provide important surveillance for

targeting emerging behavioral health issues. SAMHSA has authority to collect emergency 

department data.203 SAMHSAs Emergency Department Surveillance System collects data from 

hospitals in a variety of communities and provides a summary of visits by patients with mental 

health conditions and substance use problems. This data is vital for understanding the nature and 

number of visits made to emergency departments in the United States for substance use and 

mental disorders.204 By collaborating with the Centers for Disease Control’s National Center for 

Health Statistics, SAMHSA has an opportunity to understand more comprehensively the nature 

and course of behavioral health presentations to emergency departments. To implement fully 

data collection efforts, SAMHSA provided $1.5 million in FY 2015, and intends to provide

$4.5 million in FY 2016 and FY 2017. As SEDSS continues, SAMHSA will also consider other 

recruitment protocols to increase hospital participation.

203 See 42 U.S.C. 290aa-4. 204 Lucas A. Johnson, Rebecca L. Johnson, Ray-Bernard Portier, Current “Legal Highs”, The Journal of Emergency 

Medicine, Volume 44, Issue 6, June 2013, Pages 1108-1115,http://dx.doi.org/10.1016/j.jemermed.2012.09.147.
299

Program Studies on Treatment and Recovery (PSTAR)

The Affordable Care Act is changing how behavioral health services are financed and is 

increasing treatment for certain populations with mental and substance use disorders that had not 

previously been treated in primary care and behavioral health specialty programs (e.g., youth 

involved in the criminal justice system, and individuals with co-occurring mental health, 

substance use, and physical health conditions).

To analyze newly emerging trends and to understand the full impact of these changes in service 

delivery, CBHSQ is implementing the Program Studies on Treatment and Recovery (PSTAR). 

PSTAR will collect data on: 1) the organization and structure of care delivery; 2) the 

accessibility, availability, and continuity of care; 3) the quality and effectiveness of treatment; 

and 4) the financing and cost of behavioral health services.

In FY 2015, SAMHSA awarded a new contract, the Analytic Support Center, which includes 

support for a feasibility study to assess the best and most cost-effective ways to implement the 

PSTAR program. Of special interest is furthering an understanding of how local variations may 

affect special populations of interest (e.g., veterans, minorities, and individuals with co-occurring 

conditions).

It is expected that PSTAR will become a public health resource that works in concert with the 

other data initiatives under the CDI, other facility data systems, and ongoing analytic projects 

within CBHSQ to respond to critical questions related to health insurance coverage, parity, 

program effectiveness, financing, and access.

The results of a FY 2014 feasibility study of options for implementing the PSTAR survey 

indicated that the initiation of the project will be more incremental than originally envisioned. In 

FY 2016 and FY 2017, PSTAR funding is $1.3 million per year.

Evaluation

Consistent with the Administration’s increased emphasis on the use of rigorous and independent 

program evaluation to determine if programs achieve intended outcomes at a reasonable cost, 

SAMHSA’s evaluation efforts continue to support the systematic collection of data to assess its 

investments in discretionary and block grant programs. CBHSQ continues to conduct a review of

all of SAMHSA’s evaluation activities. This process helps SAMHSA identify evaluations that

could benefit from in-house evaluation expertise. Since the implementation of SAMHSA’s 

evaluation policy, for all new SAMHSA program evaluations, CBHSQ meets with program staff 

and the SAMHSA Evaluation Team to gather information about planned evaluation activities, 

program objectives, and budget estimates for evaluation. During this period, CBHSQ reviews 

the planned grant or contract language to ensure there is sufficient description of evaluation and 

data collection plans. CBHSQ’s role in the evaluation activities varies and may include:

1) conducting an evaluation; 2) co-directing an evaluation using a contractor to gather data and 

assist with report writing; or 3) serving as a consultant as needed on evaluations that are directed 

by an originating center within SAMHSA. With these activities, CBHSQ is actively engaged in 

evaluation, design, and implementation.
300

During FY 2015, CBHSQ provided additional recommendations to implement fully the 

evaluation policy, develop its evaluation staff, and expand availability of information developed 

through evaluations for program use and public awareness of the impact of SAMHSA’s program 

efforts.

In FY 2016 and FY 2017, CBHSQ will continue implementation of the evaluation guidance and 

begin to provide training in evaluation design to relevant SAMHSA staff, continue to convene 

the SET, and look for ways to collaborate within SAMHSA to establish more rigorous evaluation 

activity at the agency.

Statistical and Analytic Support

CBHSQ Analytic Support Center (ASC) conducts analytic and scientific research on behavioral 

health policy and practices.

The ongoing Substance Abuse and Mental Health Data Archive (SAMHDA) serves as 

SAMHSA’s primary repository for public access data files. Funding for the new SAMHDA 

contract for FY 2016 and FY 2017 is $1.3 million per year. SAMHDA provides free access and 

on-line analytic tools to the public. Resources are also used to sustain a program for providing 

limited public access to files restricted for privacy or other reasons, serving to expand the use 

and application of data collected under SAMHSA’s other surveys.

Funding also supports positions focused on analyzing and reporting on data collected within 

CBHSQ, the rest of SAMHSA, and HHS, as well as identifying and analyzing information from 

other data sets that may help inform the work of SAMHSA. SAMHSA employees also respond 

to requests for data and explanations of existing data points; prepare internal reports; support 

SAMHSA staff in the development of materials that require statistical information; and prepare 

short reports, data spotlights, and manuscripts for publication. These staff support data needs by 

serving on workgroups that require data analysis as part of their function and prepare data 

requests for departmental activities. Particularly important is the inclusion of the Health 

Economics and Financing Team that focuses on studies related to cost and financing trends as 

health care delivery models change. Some of these positions have been created by in-sourcing 

tasks that are most appropriately done by federal staff, are less expensive than contract staff, 

and/or are mission critical and thus improve SAMHSA’s capacity to respond to data and 

information needs relevant to SAMHSA’s mission.

The budget also includes authority for an estimated $1.5 million in user fees for extraordinary 

data and publication requests.

Services Systems Research

SAMHSA’s practice-based service systems research program complements efforts in its sister 

agencies of the National Institutes of Health, the Agency for Healthcare Research and Quality, 

and Center for Disease Control and Prevention. This provides pilot data for full-scale research 

proposals to the National Institutes of Health or other practice settings in which to test models 

developed through these agencies’ research efforts. The program focuses thematically on critical
301

gaps in knowledge about prevention, wellness, treatment, and recovery services for individuals, 

families, and communities at risk for or experiencing mental illnesses, substance use disorders, 

and related chronic conditions. Of particular interest to SAMHSA are issues of quality, cost, 

access to, and outcomes of behavioral health services both in the primary and specialty care 

service sectors. SAMHSA focuses significant attention on developing analyses that enhance 

understanding of the economic and cost implications of changes in health insurance access for 

behavioral health care within the larger SAMHSA analytic agenda coordinated through CBHSQ. 

A team of health economists and health services researchers focus on cost and finance studies 

related to behavioral health.

Performance and Quality Information Systems

SAMHSA requests continued funding for Performance and Quality Information Systems to 

address the need for uniform data collection and reporting system for SAMHSA management 

and staff. In FY 2015, funding to phase in the implementation of SAMHSA’s Common Data 

Platform (CDP) was $5.0 million. In FY 2016 and FY 2017, SAMHSA will combine this

funding with Grantee Data technical assistance (TA) funding for a total of $10.9 million. 

Funding will be used for this single common data platform, which will also include 

programmatic training and technical assistance, SAMHSA’s Performance Accountability and 

Reporting System (SPARS), will provide a common data and reporting system for all SAMHSA 

discretionary grantees and allow for programmatic TA on use of the data to enhance grantee 

performance monitoring and improve quality of service delivery. These funds will provide a 

uniform data collection and reporting system for SAMHSA management and staff.

SAMHSA’s National Registry of Evidence-based Programs and Practices (NREPP) is a 

searchable online system that provides states, tribes, local governments, and communities with 

tools for identifying and implementing evidence-based mental health promotion, substance abuse 

prevention, and mental and substance use disorder treatment interventions. SAMHSA is 

implementing changes to NREPP to address enhanced rigor and highlight promising practices 

that are of a particular importance to vulnerable populations. These changes to the review 

process will bring NREPP into alignment with other government registries of evidence-based 

programs and practices.

Agency-Wide Initiatives

Behavioral Health Workforce Data and Development

As of June 2014, there were more than 4,000 Mental Health Professional Shortage Areas in the 

United States, which include nearly a third of the American population, or 96 million people. 

Recent data indicate that almost 90 percent of persons with substance use disorders do not
302

receive the services they need205 and over half of those with any mental illness do not receive 

needed treatment.206

The President’s Now is the Time initiative supports new activities to expand the behavioral health 

workforce. In FY 2015, new workforce investments provided support for approximately 3,500

new behavioral health professionals. To ensure the existing workforce investments would 

achieve desired outcomes, SAMHSA workforce activities in FY 2015 included $1.0 million to 

collaborate with HRSA on the Behavioral Health Minimum Data Set to develop consistent data 

collection methods to identify and track behavioral health workforce needs. In FY 2015, 

SAMHSA has worked with HRSA to develop a consistent and common data set and to develop 

clear goals and objectives to meet the national behavioral health workforce needs in America. 

SAMHSA intends to continue funding in FY 2016 and FY 2017 at the same level as FY 2015.

The FY 2017 Budget Request of $1.0 million for Behavioral Health Workforce Data and 

Development is level with the FY 2016 Enacted Budget. These funds will allow SAMHSA to 

continue collaborating with HRSA in order to focus analytical and research projects in three 

behavioral health workforce focus areas: 1) expanded application of standardized minimum data 

set with state and professional organizations; 2) workforce modeling and projections to 

understand what behavioral health services are being provided, by whom, and in what settings; 

and 3) development of certification/licensing/scope of practice framework for each state.

205 Substance Abuse and Mental Health Services Administration, Results from the 2013 National Survey on Drug 

Use and Health: Summary of National Findings, NSDUH Series H-48, HHS Publication No. (SMA) 14-4863.

Rockville, MD: Substance Abuse and Mental Health Services Administration, 2014. 206 Substance Abuse and Mental Health Services Administration, Results from the 2013 National Survey on Drug 

Use and Health: Mental Health Findings, NSDUH Series H-49, HHS Publication No. (SMA) 14-4887.Rockville,

MD: Substance Abuse and Mental Health Services Administration, 2014.
303

Department of Health and Human Services 

Substance Abuse and Mental Health Services Administration

(Dollars in millions)

Resource Summary

FY2015

Final

FY2016

Enacted

FY2017

President's 

Budget

Drug Resources by Decision Unit and Function 

Programs ofRegionaland NationalSignificance

Substance Abuse Prevention............................................ $175.148 $211.148 $211.148

Substance Abuse Treatment............................................. 361.463 333.806 343.269

TotalPrograms ofRegionaland NationalSignificance........ 536.611 544.954 554.417

State Targeted Response Cooperative Agreements 

(Mandatory)....................................................................... --- --- 460.000

Substance Abuse Prevention and Treatment BlockGrant1

Prevention...................................................................... 363.971 371.616 371.616

Treatment........................................................................ 1,455.885 1,486.463 1,486.463

Total, Substance Abuse Prevention and Treatment Block 1,819.856 1,858.079 1,858.079

HealthSurveillance and ProgramSupport2,3

Prevention.......................................................................

20.841 21.828 22.849

Treatment........................................................................ 83.163 87.112 91.398

Total, HealthSurveillance and ProgramSupport.................. 104.003 108.940 114.247

Total Funding................................................................... $2,460.470 $2,511.973 $2,986.743

Drug Resources PersonnelSummary

TotalFTEs 421 448 460

DrugResources as a Percent ofBudget

Total AgencyBudget $3,586.212 $3,731.436 $4,321.648

Drug Resources Percentage 68.6% 67.3% 69.1% 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: Program Support, Health Surveillance and PQIS are split the same percentage split as 

between MH/SA appropriations. PAS, Agency-wide, and Data Request and Publication User Fees are split 50/50 

between MH/SA. The resulting Substance Abuse total is then divided between Prevention (20%) and Treatment

3 Totals are comparably adjusted in FY 2015 (-$35.0 million) and FY 2016 (-$50.0 million) to reflect the transfer of the 

Behavioral Health Workforce Expansion and Training program from SAMHSA to HRSA in FY 2017.
304

Drug Budget Split between Prevention and Treatment

(Dollars in thousands)

Substance Abuse Prevention

FY2015

Final

FY2016

Enacted

FY2017

President's 

Budget

Programs of Regional andNational Significance (PRNS)

Strategic Prevention Framework................................................................... $109,484 $119,484 $119,484

StrategicPreventionFramework Rx (non-add)..................................... --- 10,000 10,000

Budget Authority (non-add)................................................................. 109,484 119,484 109,484

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

FederalDrug-FreeWorkplace...................................................................... 4,894 4,894 4,894

MinorityAIDS.............................................................................................. 41,205 41,205 41,205

SoberTruthonPreventingUnderage Drinking ............................................. 7,000 7,000 7,000

Fetal Alcohol Syndrome Disorder................................................................. 1,000 --- ---

Center for the Application of Prevention Technologies................................... 7,493 7,493 7,493

Budget Authority (non-add)................................................................. 7,493 7,493 1,025

PHS Evaluation Funds (non-add)........................................................ --- --- 6,468

Science and Service Program Coordination................................................... 4,072 4,072 4,072

Grantsto PreventPrescriptionDrug/OpioidOverdoseRelated Deaths........... --- 12,000 12,000

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

Total, Substance Abuse PreventionPRNS 175,148 211,148 211,148

Substance Abuse Prevention and Treatment BlockGrant1 363,971 371,616 371,616

PHS Evaluation Funds (non-add)........................................................ 15,840 15,840 15,840

Total, Substance Abuse PreventionandTreatmentBlock Grant 363,971 371,616 371,616

Health Surveillance andProgramSupport2,3,4

HealthSurveillance 6,498 6,376 6,548

PreventionandPublicHealthFund(non-add).................................... --- --- 2,470

Budget Authority (non-add)................................................................. 2,314 2,271 ---

PHS Evaluation Funds (non-add)........................................................ 4,184 4,106 4,077

ProgramSupport.......................................................................................... 9,901 10,735 10,746

Public Awareness and Support...................................................................... 1,348 1,557 1,348

PHS Evaluation Funds (non-add)........................................................ --- --- 1,348

Performance and Quality Information Systems............................................... 1,776 1,743 1,790

PHS Evaluation Funds (non-add)........................................................ --- --- 1,790

Agency Wide Initiatives ................................................................................ 1,167 1,267 2,267

PHS Evaluation Funds (non-add)........................................................ 100 100 100

Data Request/Publication User Fees.............................................................. 150 150 150

Total, HealthSurveillance andProgramSupport 20,841 21,828 22,849

Total, Substance Abuse Prevention $559,960 $604,592 $605,613

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: ProgramSupport, Health Surveillance and PQIS are split the same percentage split as between MH/SA appropriations. PAS,

Agency-wide, and Data Request and Publication User Fees are split 50/50 between MH/SA. The resulting Substance Abuse amount is then 

divided between Prevention (20%) and Treatment(80%).

3

The FY2015Final and FY2016Enacted levels for Agency-Wide Initiatives are comparably adjusted to the FY2017President's Budget. 

They show the Minority Fellowship Program(MFP)in the HSPS appropriation.

4 Totals for Agency-Wide Initiatives in FY2015 (-$35.0million) and FY2016 (-$50.0million) are comparably adjusted to reflect the transfer of 

the BehavioralHealth Workforce Expansion and Training programfromSAMHSA to HRSA in FY2017.
305

Drug Budget Split between Prevention and Treatment (Continued)

(Dollars in thousands)

Substance Abuse Treatment

FY2015

Final

FY2016

Enacted

FY2017

President's 

Budget

Programs of Regional andNational Significance (PRNS)

Opioid Treatment Programs/Regulatory Activities.......................................... $8,724 $8,724 $8,724

PrescriptionDrugandOpioidMedication-AssistedTreatment.......................

Screening,BriefInterventionandReferralto Treatment................................. 46,889 46,889 30,000

Budget Authority (non-add)................................................................. 44,889 44,889 ---

PHSEvaluationFunds(non-add)........................................................ 2,000 2,000 30,000

Target Capacity Expansion............................................................................ 23,223 36,303 61,303

Medication-Assisted Treatment for Prescription Drug and Opioid

Addiction (non-add)................................................................................ 12,000 25,000 50,080

Cohort Monitoringand EvaluationofMedication-Assisted Treatment

Outcomes (Mandatory)................................................................................ --- --- 15,000

Buprenorphine-Prescribing Authority Demonstration...................................... --- --- 10,000

Pregnant & Postpartum Women.................................................................... 15,931 15,931 15,931

Strengthening Treatment Access and Retention.............................................. 1,000 ---

Recovery Community Services Program........................................................ 2,434 2,434 2,434

AccesstoRecovery..................................................................................... 38,223 --- ---

Children and Family Programs....................................................................... 29,605 29,605 29,605

TreatmentSystemsforHomeless.................................................................. 41,386 41,304 36,386

Minority AIDS ............................................................................................. 65,570 65,570 58,859

Criminal Justice Activities.............................................................................. 78,000 78,000 61,946

Addiction Technology Transfer Centers......................................................... 9,046 9,046 8,081

Minority Fellowship Program........................................................................ --- --- ---

CrisisSystems.............................................................................................. --- --- 5,000

Special Initiatives/Outreach .......................................................................... 1,432 --- ---

Total, Substance Abuse Treatment PRNS 361,463 333,806 343,269

State TargetedResponse Cooperative Agreements (Mandatory) .......... --- --- 460,000

Substance Abuse Prevention andTreatment Block Grant1 1,455,885 1,486,463 1,486,463

PHSEvaluationFunds(non-add)........................................................ 63,360 63,360 63,360

Total, Substance Abuse Prevention andTreatment Block Grant 1,455,885 1,486,463 1,486,463

Health Surveillance andProgramSupport2,3,4

HealthSurveillance 25,993 25,506 26,192

Prevention andPublic Health Fund (non-add).................................... --- --- 9,882

Budget Authority (non-add)................................................................. 13,464 13,464 ---

PHSEvaluationFunds(non-add)........................................................ 16,736 16,422 16,310

Program Support.......................................................................................... 39,603 42,939 42,986

Public Awareness and Support...................................................................... 5,393 6,228 5,393

PHSEvaluationFunds(non-add)........................................................ --- --- 5,393

Performance and Quality Information Systems............................................... 7,105 6,972 7,160

PHSEvaluationFunds(non-add)........................................................ --- --- 7,160

AgencyWideInitiatives................................................................................ 4,668 5,068 9,068

PHSEvaluationFunds(non-add)........................................................ 400 400 400

DataRequest/PublicationUserFees.............................................................. 600 600 600

Total, Health Surveillance andProgramSupport 83,163 87,112 91,398

Total, Substance Abuse Treatment $1,900,510 $1,907,382 $2,381,130

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: ProgramSupport, Health Surveillance and PQIS are split the same percentage split as between MH/SA appropriations. PAS,

Agency-wide, and Data Request and Publication User Fees are split 50/50 between MH/SA. The resulting Substance Abuse amount is then 

divided between Prevention (20%) and Treatment (80%).

3

The FY2015 Final and FY2016 Enacted levels for Agency-Wide Initiatives are comparably adjusted to the FY2017 President's Budget. 

They show the Minority Fellowship Program(MFP) in the HSPS appropriation.

4 Totals for Agency-Wide Initiatives in FY2015 (-$35.0million) and FY2016 (-$50.0million) are comparably adjusted to reflect the transfer of 

the Behavioral Health Workforce Expansion and Training programfromSAMHSA to HRSA in FY2017.
306

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 

2017 will include the Substance Abuse Prevention and Treatment Block Grant, the new 

mandatory State Targeted Response Cooperative Agreements, 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 Health Surveillance, Program Support, 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 Substance Abuse portion is then split 20 percent/80 percent into the two 

functions, prevention and treatment, respectively.

• The PAS and Agency-wide portions of the HSPS appropriation are divided evenly 

between Mental Health and Substance Abuse.

o The Substance Abuse 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, 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, 80 percent of the 

Substance Abuse Prevention and Treatment Block Grant funds, and the State Targeted Response 

Cooperative Agreements (Mandatory) funding.

Budget Summary

In FY 2017, SAMHSA requests a total of $3.0 billion for drug control activities, an increase of

$472.0 million from the FY 2016 Enacted Level. 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
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Treatment, and Health Surveillance and Program Support. Each decision unit is discussed 

below:

Substance Abuse Prevention

Substance Abuse Prevention Programs of Regional and National Significance 

Total FY 2017 Request: $211.1 million

(Reflects level funding from the FY 2016 Enacted Level)

The Substance Abuse Prevention Programs of Regional and National Significance (PRNS) 

support states and communities in carrying out an array of activities to improve the quality and 

availability of prevention services. The FY 2017 Budget Request for SAMHSA’s Substance 

Abuse Prevention PRNS includes $211.1 million, which covers the eight programmatic activities 

described below.

Strategic Prevention Framework (PRNS non-add)

Total FY 2017 Request: $119.5 million

(Reflects level funding from the FY 2016 Enacted Level)

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 program goals include: 

reducing substance abuse-related problems; preventing the onset and reducing the progression of 

substance use disorders; strengthening prevention capacity and infrastructure at the state and 

community levels in support of prevention; and leveraging, redirecting, and realigning statewide 

funding streams for substance abuse prevention. Through the SPF program, SAMHSA will 

continue to address the nation’s top emerging substance abuse priorities, such as prescription 

drugs, other opioids, underage drinking, marijuana, heroin, and intoxicative inhalants.

See page 159 in the CSAP chapter for the start of the full description of this program.

Strategic Prevention Framework for Prescription Drugs (PRNS non-add)

Due to alarming trends related to prescription drug misuse and overdoses involving opioids, 

SAMHSA is prioritizing efforts to address prescription drug misuse. SAMHSA’s Strategic 

Prevention Framework for Prescription Drugs (SPF Rx) will raise 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 will also focus on raising community 

awareness and bringing prescription drug abuse prevention activities and education to schools, 

communities, parents, prescribers, and their patients.

See page 161 in the CSAP chapter for the start of the full description of these efforts.

Budget Request

The FY 2017 Budget Request is $119.5 million with $109.5 million from Budget Authority and

$10.0 million from Public Health Service (PHS) Evaluation Funds. This is level with the FY 

2016 Enacted Level. Funding will support up to 20 grant continuations and nine state SPF Rx 

continuation grants, technical assistance, and evaluation to build capacity to address prescription

drug misuse and overdose prevention efforts, in conjunction with other state and
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local partners. In FY 2017, SAMHSA will also support the continuation of 70 Strategic 

Prevention Framework Partnership for Success grants to decrease the impact of underage 

drinking and prescription drug misuse while lessening the progression of emergent issues such as 

heroin and marijuana use.

Federal Drug-Free Workplace (PRNS non-add)

Total FY 2017 Request: $4.9 million

(Reflects level funding from the FY 2016 Enacted Level)

SAMHSA’s activities related to the Federal Drug-Free Workplace support to 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 regulated industry; and 2) oversight of the 

National Laboratory Certification Program, which certifies laboratories to conduct forensic drug 

testing for federal agencies, federally regulated industries and the private sector.

See page 165 in the CSAP chapter for the start of the full description of this program.

Budget Request

The FY 2017 Budget Request of $4.9 million is the same as the FY 2016 Enacted Level. In 

FY 2017, SAMHSA will continue oversight of the Executive Branch Agencies’ Federal DrugFree Workplace activities and the National Laboratory Certification Program.

Minority AIDS (PRNS non-add)

Total FY 2017 Request: $41.2 million

(Reflects level funding from the FY 2016 Enacted Level)

The purpose of the Minority AIDS grant program is to facilitate the development and expansion 

of culturally competent and effective community-based treatment systems for substance use and 

co-occurring substance use and mental disorders within racial and ethnic minority communities. 

The goals of the program are to reduce the impact of behavioral health problems, reduce HIV 

risk and incidence, and increase access to treatment for individuals with co-existing behavioral 

health, HIV, and Hepatitis conditions.

See page 167 in the CSAP chapter for the start of the full description of this program.

Budget Request

The FY 2017 Budget Request of $41.2 million is the same as the FY 2016 Enacted Level. 

SAMHSA will support up to 148 grant continuations and 70 new grants to assist grantees in 

building a solid foundation for delivering integrated evidence-based substance use, HIV and viral 

hepatitis prevention services that are in alignment with the National HIV/AIDS Strategy. These 

funds continue to address a critical public health problem and provide lifesaving prevention 

services, including testing for HIV.
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Sober Truth on Preventing Underage Drinking (PRNS non-add)

Total FY 2017 Request: $7.0 million

(Reflects level funding from the FY 2016 Enacted Level)

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 

aimed at preventing and reducing alcohol use among youth under age 21.

See page 171 in the CSAP chapter for the start of the full description of this program.

Budget Request

The FY 2017 Budget Request of $7.0 million is level with the FY 2016 Enacted Level. In 2017, 

SAMHSA will support 79 new STOP Act grants. This funding effort will continue and deepen 

SAMHSA’s commitment to reduce and prevent underage drinking.

Centers for the Application of Prevention Technologies (PRNS non-add)

Total FY 2017 Request: $7.5 million

(Reflects level funding from the FY 2016 Enacted Level)

The Center for the Application of Prevention Technologies (CAPT) program provides state-ofthe-art training and technical assistance to build the capacity of SAMHSA grantees and develop 

the skills, knowledge, and expertise of the prevention workforce. CAPT 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.

See page 176 in the CSAP chapter for the start of the full description of this program.

Budget Request

The FY 2017 Budget Request of $7.5 million is the same as the FY 2016 Enacted Level. The 

program will provide technical assistance and training to over 7,500 individuals in the prevention 

field.
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Science and Service Program Coordination (PRNS non-add)

Total FY 2017 Request: $4.1 million

(Reflects level funding from the FY 2016 Enacted Level)

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. These contracts support the Tribal Training and Technical Assistance (TTA) Center 

and the Underage Drinking Prevention Education Initiatives (UADPEI). The TTA Center 

provides comprehensive, broad, focused, and/or intensive training to communities seeking to 

address and prevent mental and substance use disorders, suicide, and promote mental health.

See pages 180 in the CSAP chapter for the start of the full description of this program.

Budget Request

The FY 2017 Budget Request of $4.1 million is level with the FY 2016 Enacted Level. These 

funds will support SAMHSA’s top strategic initiative, prevention of substance abuse and mental 

illness, which includes a focus on preventing underage drinking and on American Indians/Alaska 

Natives through the provision of technical assistance.

Tribal Behavioral Health Grants (PRNS non-add)

Total FY 2017 Request: $15.0 million

(Reflects level funding from the FY 2016 Enacted Level)

SAMHSA’s Tribal Behavioral Health Grants focus on mental and substance use disorders and 

suicides among Native youth.

See page 181 in the CSAP chapter for the start of the full description of this program.

Budget Request

The FY 2017 Budget Request for the Tribal Behavioral Health Grant program is $30.0 million, 

including $15.0 million in the Mental Health appropriation and $15.0 million in the Substance 

Abuse Prevention appropriation. This is level with the FY 2016 Enacted Level. This request 

will continue support for programs that promote mental health and prevent substance use 

activities for high-risk AI/AN youth and their families.

Grants to Prevent Prescription Drug/Opioid Overdose Related Deaths (PRNS non-add)

Total FY 2017 Request: $12.0 million

(Reflects level funding from the FY 2016 Enacted Level)

Opioid-related overdose is a significant contributor to accidental deaths among those who use, 

misuse, or abuse illicit and prescription opioids. 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.

See page 185 in the CSAP chapter for the start of the full description of this program.
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Budget Request

The FY 2017 Budget Request is $12.0 million, the same as the FY 2016 Enacted Level. This 

funding will provide continuation grants to 10 states to reduce the number of opioid overdoserelated deaths.

Substance Abuse Treatment

Substance Abuse Treatment Programs of Regional and National Significance 

Total FY 2017 Request: $343.3 million

(Reflects $9.5 million increase from the FY 2016 Enacted Level)

The Substance Abuse Treatment Programs of Regional and National Significance (PRNS) 

support states and communities in carrying out an array of activities to improve the quality and 

availability of services in priority areas. The FY 2017 Budget Request for SAMHSA’s Substance

Abuse Treatment PRNS includes $343.3 million, which covers 17 programmatic activities, an 

increase of $9.5 million from the FY 2016 Enacted Level. Specific PRNS activities are described

below.

Opioid Treatment Programs/Regulatory Activities (PRNS non-add)

FY 2017 Request: $8.7 million

(Reflects level funding from the FY 2016 Enacted Level)

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.

See page 197 in the CSAT chapter for the start of the full description of this program.

Budget Request

The FY 2017 Budget Request is $8.7 million, the same as the FY 2016 Enacted Level. In 

FY 2017, SAMHSA proposes funding pilot regional medication-assisted treatment (MAT) 

Centers of Excellence in two HHS regions. The Centers of Excellence will provide communityspecific training and technical assistance to support the delivery of quality services in areas of 

MAT expansion and facilitate program development through stakeholder collaboration. 

SAMHSA plans to continue PCSS-MAT to support professional development and expansion of a 

well-trained workforce, capable of delivering high quality MAT for all FDA approved 

medications, in a manner that complements the efforts of the MAT Centers of Excellence. In 

addition, SAMHSA intends to support technical assistance contracts including the Data Waiver 

Processing and Support contract.

Screening, Brief Intervention and Referral to Treatment (PRNS non-add)

FY 2017 Request: $30.0 million

(Reflects $16.9 million decrease from the FY 2016 Enacted Level)

The Screening, Brief Intervention and Referral to Treatment (SBIRT) program requires state 

grant recipients to implement the SBIRT model at all levels of primary care and medical 

facilities, including hospitals, trauma centers, Federally Qualified Health Centers, and other
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relevant settings. Research and clinical experience support the use of SBIRT to intervene early 

with alcohol and other substance use disorders, which leads to early referral and treatment. The 

purpose of the SBIRT training grants is to develop primary care practices in order to enhance the 

delivery system that includes SBIRT as a part of standard medical practice. This program 

provides medical residents, students of dentistry, physician assistants, and pharmacists, nurses, 

social workers, counselors the opportunity to learn the elements of SBIRT and incorporate them 

as part of their permanent practice.

See page 200 in the CSAT chapter for the start of the full description of this program.

Budget Request

The FY 2017 Budget Request is $30.0 million, a decrease of $16.9 million from the FY 2016 

Enacted Level.

Targeted Capacity Expansion (PRNS non-add)

FY 2017 Request: $61.3 million

(Reflects $25.0 million increase from the FY 2016 Enacted Level)

The Targeted Capacity Expansion (TCE) program began in FY 1998 to help communities 

expand or enhance their ability to provide rapid, strategic, comprehensive, integrated, and 

community-based responses to a specific and well-documented substance abuse capacity 

problem. As part of these efforts, SAMHSA’s Medication-Assisted Treatment for Prescription 

Drug and Opioid Addiction (MAT PDOA) seeks to expand or enhance MAT and other clinically 

appropriate services for persons with opioid use disorders.

See page 204 in the CSAT chapter for the start of the full description of this program.

Budget Request

The FY 2017 Budget Request includes a total of $61.3 million, an increase of $25.0 million from 

the FY 2016 Enacted Level. This amount includes $50.1 million for the MAT PDOA grant 

program, an increase of $25.1 million from the FY 2016 Enacted Level. The $25.1 million 

increase will focus specifically on MAT expansion/enhancement efforts. The funding will enable 

SAMHSA to support 23 new MAT PDOA state grants at $1.0 million to expand or enhance 

MAT utilizing FDA-approved medications in combination with psychosocial services, recovery 

support services, and coordination/integration of HIV/hepatitis C direct services. The program 

will target states that demonstrated a dramatic increase in treatment admissions for opioid use 

disorders and that experienced the highest rates of treatment admissions for opioid use disorders.

Cohort Monitoring and Evaluation of MAT Outcomes (Mandatory; PRNS non-add) 

FY 2017 Request: $30.0 million (FY 2017: $15.0 million, FY 2018: $15 million)

Public health and substance abuse treatment agencies will evaluate the short, medium, and longterm outcomes of substance abuse treatment programs in order to increase effectiveness reducing 

opioid use disorders, overdose, and death. This proposal would prospectively monitor the 

treatment outcomes of patients with opioid addiction entering medication-assisted treatment 

programs, providing valuable insight into the effectiveness of treatment programs employing 

different treatment modalities under real-world conditions and help identify opportunities to
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improve treatment for patients with opioid addiction. Systematic information on the outcomes of 

patients who undergo medication-assisted treatment is currently lacking. Cohort monitoring is 

commonly used to monitor treatment of patients with infectious diseases, such as tuberculosis 

treatment, and drives accountability for patient outcomes; a similar approach could be useful to 

improving addiction treatment. This funding is part of the Administration’s $1.0 billion 

initiative to address prescription drug abuse and heroin use.

See page 209 in the CSAT chapter for the start of the full description of this program.

Budget Request

The FY 2017 Budget Request is $30.0 million in new mandatory funds. This includes

$15.0 million in FY 2017 and $15.0 million in FY 2018 for a new program, Cohort Monitoring 

and Evaluation of Medication-Assisted Treatment Outcomes. These funds would evaluate the 

outcomes of substance abuse treatment programs. This effort intends to increase MAT 

effectiveness by reducing opioid use disorders, overdose, and death.

Buprenorphine-Prescribing Authority Demonstration (PRNS non-add)

FY 2017 Request: $10.0 million

(New program in FY 2017: Reflects $10.0 million increase from the FY 2016 Enacted 

Level)

Access to medication-assisted treatment is widely considered inadequate to meet the current need 

for the treatment of opioid use disorder.207 The Food and Drug Administration has approved 

Buprenorphine, in various formulations, for the treatment of opioid use disorder. Its effectiveness

in treating addiction and reducing mortality is well established. The Drug Addiction Treatment

Act of 2000 (DATA 2000) excludes the prescription of buprenorphine by

advance practice nurses (APNs), physician assistants (PAs), and other non-physician advance 

practice providers authorized to prescribe controlled schedule III substances by the jurisdiction in 

which the practitioner is licensed.208 To improve the public health response to the national crisis 

of opioid use disorder and overdose deaths, SAMHSA is proposing a services research

demonstration program to determine the safety and effectiveness of alternative approaches to 

improving access to buprenorphine by allowing non-physician advance practice providers 

prescribing authority, in accordance with state law. In all cases, training will be provided to 

minimize risk of diversion.

See page 210 in the CSAT chapter for the start of the full description of this program.

Budget Request

The FY 2017 Budget Request includes $10.0 million for a new program, BuprenorphinePrescribing Authority Demonstration. SAMHSA intends to implement a services research 

demonstration project that will test the safety and effectiveness of allowing non- physician

advance practice provider’s buprenorphine prescribing authority, in accordance with

207 Jones, 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. 208 Health Resources and Services Administration (2015), Health of the Workforce. 

http://bhpr.hrsa.gov/healthworkforce/supplydemand/usworkforce/chartbook
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state law. SAMHSA will collaborate with professional organizations that represent APNs, PAs, 

and other non-physician advance practice providers as well as addiction psychiatrists and 

primary care physicians to determine the appropriate training and supervision requirements for 

advance practice providers in order to assure patient safety and well-being while minimizing 

diversion of buprenorphine.

Treatment Systems for Homeless (PRNS non-add)

FY 2017 Request: $36.4 million

(Reflects $4.9 million decrease from the FY 2016 Enacted Level)

SAMHSA’s Treatment Systems for Homeless portfolio supports services, including short-term 

residential treatment and medication-assisted treatment, to those with substance use disorders or 

co-occurring substance use and mental disorders. These programs to address homelessness do 

not fund housing, but complement HUD’s activities by supporting an array of integrated 

behavioral health treatment and recovery-oriented services and supports, including outreach, 

engagement, intensive case management, treatment for mental and/or substance use disorders, 

enrollment in mainstream benefits (Medicaid, SSI/SSDI, SNAP, etc.), and employment readiness 

services.

See page 223 in the CSAT chapter for the start of the full description of this program.

Budget Request

The FY 2017 Budget Request is $36.4 million, a decrease of $4.9 million from the FY 2016 

Enacted Level.

Minority AIDS – Treatment (PRNS non-add)

FY 2017 Request: $58.9 million

(Reflects $6.7 million decrease from FY 2016 Enacted Level)

The purpose of the Minority AIDS grant program is to facilitate the development and expansion 

of culturally competent and effective community-based treatment systems for substance use and 

co-occurring substance use and mental disorders within racial and ethnic minority communities. 

The goals of the program are to reduce the impact of behavioral health problems, reduce HIV 

risk and incidence, and increase access to treatment for individuals with co-existing behavioral 

health, HIV, and Hepatitis conditions.

See page 228 in the CSAT chapter for the start of the full description of this program.

Budget Request

The FY 2017 Budget Request is $58.9 million, a decrease of $6.7 million from the FY 2016 

Enacted Level. This represents a shift in funding to the Mental Health appropriation. In 

FY 2017, this shift in funding will allow for the award of a new cohort of Minority AIDS 

Continuum of Care (CoC) grantees that will address the holistic behavioral health needs of those 

living with HIV. Three SAMHSA Centers will jointly administer the program. This funding 

will continue to enhance and expand the provision of effective, culturally competent, HIV/AIDSrelated mental health services in minority communities for people living with HIV/AIDS. 

SAMHSA also plans to fund 86 grant continuations and support three contracts for evaluation 

and technical assistance. SAMHSA will also award 57 new TCE-HIV grants. SAMHSA also
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plans to award five new TCE-HIV: Minority Women grants. With these efforts, SAMHSA 

expects to serve 4,500 clients through the TCE-HIV: High Risk Population program and 3,000 

clients in the TCE-HIV Minority Women program.

Criminal Justice Activities (PRNS non-add)

FY 2017 Request: $61.9 million

(Reflects $16.1 million decrease from the FY 2016 Enacted Level)

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.

See page 231 in the CSAT chapter for the start of the full description of this program. 

Drug Court Activities

FY 2017 Request: $50.0 million

(Reflects level funding from the FY 2016 Enacted Level)

SAMHSA plans to support 91 Drug Court continuations grants, five contracts, and 63 Drug 

Court new grants. These programs will continue to provide comprehensive treatment and 

recovery support services for adolescents and adults with substance use disorders who come into 

contact with the criminal justice system, as well as offenders re-entering the community. 

SAMHSA proposes to use this program to explore promising new approaches and identify 

potential models for replication. The Criminal Justice Drug Court grant program will serve over 

4,000 clients in FY 2017, equal to the number served by the FY 2016 cohort.

See page 231 in the CSAT chapter for the start of the full description of this program. 

Ex-Offender Re-Entry Program

FY 2017 Request: $11.9 million

(Reflects $16.1 million decrease from the FY 2016 Enacted Level)

SAMHSA plans to support 27 Offender Reentry Program continuation grants and one contract. 

The Other Criminal Justice/ Offender Reentry Program will serve 2,000 clients in FY 2017.

See page 233 in the CSAT chapter for the start of the full description of this program.

Crisis Systems (PRNS non-add)

FY 2017 Request: $5.0 million

(Reflects $5.0 million increase from the FY 2016 Enacted Level)

Behavioral health crises are critical times for intervention and treatment and to engage 

individuals in on-going treatment and the pursuit of recovery. Such crises often cause great 

disruption for individuals and those around them, including family members, teachers, law 

enforcement, and employers. This program seeks to increase the engagement with and 

functioning of individuals in crisis, increased support for families and caregivers, decreased use 

of emergency room and inpatient care, and increased understanding by the community of 

behavioral health issues and those who experience a behavioral health crisis.
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See page 238 in the CSAT chapter for the start of the full description of this program.

Budget Request

The FY 2017 Budget Request is $10.0 million, an increase of $10.0 million from the FY 2016 

Enacted Level. This includes $5.0 million from the Substance Abuse Treatment appropriation 

and $5.0 million from the Mental Health appropriation.

In FY 2017, SAMHSA plans to award three grants to states and communities to develop and/or 

adopt sustainable, comprehensive, and coordinated community-based crisis response systems for 

children, youth, and adults with mental health and/or addiction problems including those with 

SMI. This effort will support the integration and expansion of services to fill gaps and enhance 

coordination within the comprehensive continuum of the crisis response services, while 

minimizing the risk for re-traumatization of individuals and familiesserved.

Other PRNS Treatment Programs (PRNS non-add)

FY 2017 Request: $56.1 million

(Reflects level funding from the FY 2016 Enacted Level)

The FY 2017 budget includes resources of $56.1 million for several other Treatment Capacity 

programs including: Pregnant and Postpartum Women; Recovery Community Services Program; 

Children and Families; and Addiction Technology Transfer Centers. The FY 2017 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.

State Targeted Response Cooperative Agreements (Mandatory)

FY 2017 Request: $920.0 million. (FY 2017: $460.0 million, FY 2018: $460.0 million)

The State Targeted Response Cooperative Agreements program will award grants to states based 

on their need and the strength of the strategies proposed to close the opioid use disorder

treatment gap. Proposed strategies must be evidence-based and focused on the main factors 

preventing individuals from seeking and successfully completing treatment, and achieving 

recovery. This new effort would address commonly cited barriers to receiving treatment by 

reducing the cost of treatment, expanding access to treatment, engaging patients in treatment, and 

addressing stigmas associated with accessing treatment.

See page 253 in the CSAT chapter for the start of the full description of this program.

Budget Request

The FY 2017 Budget Request is $920.0 million in new mandatory funds as; $460.0 million in 

FY 2017 and $460.0 million in FY 2018. This is part of the Administration’s $1.0 billion 

Expanding Access to Treatment Initiative to address opioid misuse epidemic by helping all 

Americans who want treatment to access treatment and get the help they need. This new grant 

effort would address commonly cited barriers to receiving treatment by reducing the cost of
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treatment, expanding access to treatment, engaging patients in treatment, and addressing stigmas 

associated with accessing treatment. This funding is part of the Administration’s $1.0 billion 

two-year initiative to increase access to treatment for prescription drug abuse and heroin use.

Substance Abuse Prevention and Treatment Block Grant 

FY 2017 Request: $1.9 billion

(Reflects level funding from the FY 2016 Enacted Level)

The Substance Abuse Prevention and Treatment Block Grant Program (SABG) 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 to plan, carry out, and evaluate substance abuse 

prevention, treatment and recovery support services provided for individuals, families, and 

communities impacted by substance abuse and substance use disorders.

See page 255 in the CSAT chapter for the start of the full description of this program.

Budget Request

The FY 2017 Budget Request is $1.9 billion and is level with the FY 2016 Enacted Level. 

Despite the wide-scale opportunity to obtain insurance coverage created by the Affordable Care 

Act, significant gaps in coverage, as well as the subsequent reliance on the public behavioral 

health safety net remain. The SABG helps address this gap. SABG funds will also continue to 

support certain services (e.g., recovery support efforts) 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.

Health Surveillance and Program Support Appropriation

The FY 2017 Request is $114.2 million, 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 (PRNS non-add)

FY 2017 Request: $86.4 million

(Reflects $0.9 million increase from the FY 2016 Enacted Level)

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 Substance Abuse portion is then 

split 20 percent/80 percent into the two functions, prevention and treatment, respectively.
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See page 269 in the HSPS chapter for the start of the full description of this program.

Budget Request

The FY 2017 Budget Request is $86.4 million, an increase of $0.9 million from the FY 2016 

Enacted Level. Health Surveillance funding will support the continuation of the NSDUH, 

NREPP, BHSIS, C-EMS, 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 2017 Request: $6.7 million

(Reflects $1.0 million decrease from the FY 2016 Enacted Level)

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 Substance Abuse portion is then split 20 percent/80 percent 

into the two functions, prevention and treatment, respectively.

See page 275 in the HSPS chapter for the start of the full description of this program.

Budget Request

The FY 2017 request of $6.7 million will support the President’s Now is the Time initiative and 

will allow SAMHSA to continue to streamline its web presence, develop innovative mobile apps, 

expand its presence on social media, and provide other critical resources to support behavioral 

health and other health.

Performance and Quality Information Systems 

FY 2017 Request: $8.9 million

(Reflects a decrease of $.2 million from the FY 2016 Enacted Level)

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 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 

Substance Abuse portion is then split 20 percent/80 percent into the two functions, prevention 

and treatment, respectively.

See page 281 in the HSPS chapter for the start of the full description of this program.
319

Budget Request

The FY 2017 Budget Request is $8.9 million, a decrease of $.2 million from the FY 2016 

Enacted Level. SAMHSA will use these funds for system development, training and TA to 

support operations, NREPP, and SPARS.

Agency-Wide Initiatives

FY 2017 Request: $11.3 million

(Reflects $5.0 million increase from the FY 2016 Enacted Level)

Agency-Wide Initiatives provides funding for across Agency initiatives such as Minority 

Fellowship Program which improves the quality of mental health and substance abuse prevention 

and treatment delivered to ethnic minorities by providing stipends to post-graduate students and 

other Behavioral Health Workforce programs. This represents the total funding available for 

these activities first divided evenly between Mental Health and Substance Abuse. The Substance 

Abuse portion is then split 20 percent/80 percent into the two functions, prevention and 

treatment, respectively.

Behavioral Health Workforce

Minority Fellowship Program

As SAMHSA implements the Leading Change 2.0 Strategic Initiatives for 2015-2018, the new 

Strategic Initiative on Workforce Development provides the opportunity for a concerted focus on 

developing the behavioral health workforce. To increase the visibility of this issue and to 

manage and administer workforce programs more efficiently, SAMHSA is realigning the 

Minority Fellowship Program (MFP) to Agency-Wide Initiatives.

See page 285 in the HSPS chapter for the start of the full description of this program. 

Peer Professional Workforce Development

The Peer Professional Workforce Development program’s goal is to increase the number of

trained peers, recovery coaches, mental health/addiction specialists, prevention specialists, and 

pre-masters-level addiction counselors working with youth ages 16 to 25.

See page 287 in the HSPS chapter for the start of the full description of this program. 

Behavioral Health Workforce Data and Development

As a result of the Affordable Care Act and the Mental Health Parity and Addictions Equity Act, 

more than 60 million Americans have received first-time or expanded access to coverage for 

services for mental and substance use disorders.

See page 288 in the HSPS chapter for the start of the full description of this program.

Budget Request

The FY 2017 Budget Request is $11.3 million, an increase of $5.0 million from the FY 2016 

Enacted Level. This funding will continue support for the Minority Fellowship Program. The 

request also includes an increase for a new program entitled Peer Professional Workforce 

Development, which will award up to 19 grants to provide tuition support and further the
320

capacity of community colleges to develop and sustain behavioral health paraprofessional 

training and education programs.

Data Request and Publication User Fees 

FY 2017 Request: $0.8 million

(Reflects level funding from the FY 2016 Enacted Level)

The FY 2017 Budget Request is $0.8 million and is equal to the FY 2016 Enacted Level. 

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 Substance Abuse portion is then split 20 percent/80 percent 

into the two functions, prevention and treatment, respectively.
321

SAMHSA

Prevention and Public Health Fund 

Table of Contents

1. Summary of the Request................................................................................................. 323

2. Suicide Prevention: GLS Youth Suicide Prevention-States ........................................... 324

3. Health Surveillance......................................................................................................... 324
322

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323

Prevention and Public Health Fund 

Summary of the Request

(Dollars in thousands)

Prevention andPublic Health Fund

FY2015

Final

FY2016

Enacted

FY2017

President's 

Budget

FY2017

+/-

FY2016

GLS - Youth Suicide Prevention-States............................................... $12,000 $12,000 $10,000 -$2,000

Health Surveillance.............................................................................. --- --- 17,830 +17,830

Total, Prevention and Public HealthFund $12,000 $12,000 $27,830 +$15,830

Budget Request

The FY 2017 Budget Request for the Prevention and Public Health Fund is $27.8 million, an 

increase of $15.8 million from the FY 2016 Enacted Level. The FY 2017 Prevention and Public 

Health Fund request includes the following:

• $10.0 million for Suicide Prevention, and

• $17.8 million for Health Surveillance
324

Suicide Prevention: GLS Youth Suicide Prevention-States

Program Description and Accomplishments

The Garrett Lee Smith (GLS) Memorial Act (Public Law 108-355) authorizes SAMHSA to 

manage two significant youth suicide prevention programs and one resource center. These 

grants develop and implement youth suicide prevention and early intervention strategies 

involving public-private collaboration among youth-serving institutions.

For a complete description of the GLS Youth Suicide Prevention-States program, see page 91.

Funding History

Fiscal Total PPHF

Year Amount Funds

FY 2013 $32,448,000 ---

FY 2014 $35,427,000 $5,800,000

FY 2015 $35,427,000 $12,000,000

FY 2016 $35,427,000 $12,000,000

FY 2017 $35,427,000 $10,000,000

Budget Request

The FY 2017 Budget Request is $35.4 million and is the same as the FY 2016 Enacted Level. 

This includes $25.4 million from Budget Authority and $10.0 million from the Prevention and 

Public Health Fund. This is a $2.0 million decrease in Prevention and Public Health Funds 

relative to FY 2016 Enacted Level. SAMHSA requests funding 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 prevention 

of suicide and suicide attempts at institutions of higher education and the National Suicide 

Prevention Evaluation.

Health Surveillance

Program Description and Accomplishments

The Health Surveillance budget supports many of the critical behavioral health data systems, 

national surveys, and surveillance activities for Health and Human Services undertaken by 

SAMHSA to support SAMHSA grantees, the field, and the public.

For a complete description of the programs supported by Health Surveillance budget, see page

269.
325

Funding History

Fiscal

Year

Total

Amount

PPHF

Funds

FY 2013 $45,421,000 $14,733,000

FY 2014 $47,258,000 ---

FY 2015 $47,258,000 ---

FY 2016 $47,258,000 ---

FY 2017 $47,258,000 $17,830,000

Budget Request

The FY 2017 Budget Request is $47.3 million. This is the same as the FY 2016 Enacted Level. 

This includes $29.4 million from PHS Evaluation Funds and $17.8 million from Prevention and 

Public Health Funds. This funding will support the continuation of the National Survey on Drug 

Use and Health, National Registry of Evidence-based Programs and Practices, Behavioral Health 

Services Information System, Community Early Warning and Monitoring System, and the 

Analytic Support Center contracts.
326

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327

SAMHSA

Supplementary Tables 

Table of Contents

1. Budget Authority by Object Classification Tables............................................................... 329

2. Salaries and Expenses Tables ............................................................................................... 339

3. Detail of Full Time Equivalent Employee (FTE) ................................................................. 341

4. Detail of Positions................................................................................................................. 342

5. Programs Proposed for Elimination...................................................................................... 343

6. FTEs Funded by the Affordable Care Act ............................................................................ 344

7. Physicians’ Comparability Allowance (PCA) Worksheet.................................................... 345
328

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329

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 Authority1,2,3,4,5

FY2015

Final

FY2016

Enacted

FY2017

President's 

Budget

FY2017

+/-

FY2016

Personnel compensation:

Full-time permanent (11.1)................................................ $46,871 $51,338 $52,159 +$821

Other than full-time permanent (11.3)............................. 2,449 2,649 2,692 +42

Other personnel compensation (11.5)............................ 568 626 636 +10

Military personnel (11.7).................................................. 3,667 4,347 4,417 +70

Special personnel services payments (11.8)................. 230 --- --- ---

Subtotal personnel compensation: 53,786 58,960 59,904 +943

Civilian benefits (12.1)...................................................... 14,882 16,264 16,752 +488

Military benefits (12.2)...................................................... 1,898 2,252 2,320 +68

Subtotal Pay Costs: 70,566 77,477 78,976 +1,499

Travel and transportation of persons ( 21.0).................. 1,223 1,130 628 -502

Transportation of things (22.0)....................................... 15 35 16 -19

Rental payments to GSA (23.1)....................................... 9,765 9,824 6,116 -3,708

Rental payments to Others (23.2).................................... --- 217 --- -217

Communication, utilities, and misc. charges (23.3)....... 523 496 521 +25

Printing and reproduction (24.0)..................................... 2,029 1,678 1,497 -181

Other Contractual Services:

Advisory and assistance services (25.1)....................... 29,337 37,750 50,205 +12,455

Other services (25.2)......................................................... 167,398 171,667 142,902 -28,765

Purchase of Goods & Svcs. from Govt. Accts (25.3)... 32,366 34,516 28,935 -5,580

Operation and maintenance of facilities (25.4).............. 1,650 1,568 1,493 -75

Research and Development Contracts (25.5)................ --- --- --- ---

Operation and maintenance of equipment (25.7).......... 142 220 174 -46

Subtotal Other Contractual Services: 230,893 245,720 223,708 -22,012

Supplies and materials (26.0)........................................... 2,305 679 296 -384

Equipment (31.0)................................................................ 434 393 278 -115

Grants, subsidies, and contributions (41.0)................... 3,133,292 3,258,621 3,794,578 +535,957

Interest and dividends (43.0)........................................... --- --- --- ---

Subtotal Non-Pay Costs 3,380,479 3,518,792 4,027,637 +508,845

Total Direct Obligations $3,451,045 $3,596,269 $4,106,613 +$510,344 1 Does not include PHS EVAL Funds.

2 Includes Prevention and Public Health Funds and Mandatory Funds. 3 Does not include user fees.

4 The Minority Fellowship Program budget appears in the Health Surveillance and Program Support 

appropriation, Agency-wide Initiatives Workforce program. This is consistent with the FY 2017 Budget 

Request.

5 Reflects the transfer of funding associated with the Behavioral Health Workforce Expansion and Training 

program from SAMHSA to HRSA. HRSA and SAMHSA will continue to work together to implement this 

program.
330

Substance Abuse and Mental Health Services Administration 

Mental Health Services

Budget Authority – Object Class

(Dollars in thousands)

Object Class - Direct Budget Authority1,2,3

FY 2015

Final

FY 2016

Enacted

FY 2017

President's 

Budget

FY 2017

+/-

FY 2016

Personnel compensation:

Full-time permanent (11.1)................................................ $784 $970 $986 +$16

Other than full-time permanent (11.3)............................. 85 106 107 +2

Other personnel compensation (11.5)............................ 6 8 8 ---

Military personnel (11.7).................................................. --- --- --- ---

Special personnel services payments (11.8) ................. --- --- --- ---

Subtotal personnel compensation: 875 1,083 1,101 +17

Civilian benefits (12.1)...................................................... 272 337 347 +10

Military benefits (12.2)...................................................... --- --- --- ---

Subtotal Pay Costs: 1,147 1,421 1,448 +27

Travel and transportation of persons (21.0).................. 56 176 177 +1

Transportation of things (22.0)....................................... --- --- --- ---

Rental payments to GSA (23.1)....................................... 2,732 1,135 220 -916

Rental payments to Others (23.2).................................... --- 82 --- -82

Communication, utilities, and misc. charges (23.3)....... --- 188 204 +16

Printing and reproduction (24.0)..................................... 165 297 299 +2

Other Contractual Services:

Advisory and assistance services (25.1)....................... 14,006 18,051 18,166 +115

Other services (25.2)......................................................... 56,405 60,190 60,572 +382

Purchase of Goods & Svcs. from Govt. Accts (25.3)... 14,000 16,437 16,542 +104

Operation and maintenance of facilities (25.4).............. --- 770 775 +5

Research and Development Contracts (25.5)................ --- --- --- ---

Operation and maintenance of equipment (25.7).......... 2 10 10 ---

Subtotal Other Contractual Services: 84,413 95,458 96,064 +606

Supplies and materials (26.0)........................................... --- --- --- ---

Equipment (31.0)................................................................ 103 106 107 +1

Grants, subsidies, and contributions (41.0)................... 961,261 1,039,026 1,144,209 +105,183

Interest and dividends (43.0)........................................... --- --- --- ---

Subtotal Non-Pay Costs 1,048,730 1,136,468 1,241,279 +104,811

Total Direct Obligations $1,049,877 $1,137,889 $1,242,727 +$104,838 1 Does not include PHS EVAL Funds. 2 Includes Prevention and Public Health Funds and Mandatory Funds. 3 The Minority Fellowship Program budget appears in the Health Surveillance and Program Support 

appropriation, Agency-wide Initiatives Workforce program. This is consistent with the FY 2017 Budget 

Request.
331

Substance Abuse and Mental Health Services Administration 

Substance Abuse Prevention

Budget Authority – Object Class

(Dollars in thousands)

Object Class - Direct Budget Authority1,2,3

FY 2015

Final

FY 2016

Enacted

FY 2017

President's 

Budget

FY 2017

+/-

FY 2016

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)....................................... --- 5 4 -1

Rental payments to GSA (23.1)....................................... 1,281 416 81 -335

Rental payments to Others (23.2).................................... --- 30 --- -30

Communication, utilities, and misc. charges (23.3)....... 4 69 75 +6

Printing and reproduction (24.0)..................................... 478 457 367 -90

Other Contractual Services:

Advisory and assistance services (25.1)....................... 4,380 4,366 3,505 -862

Other services (25.2)......................................................... 32,814 33,535 26,916 -6,619

Purchase of Goods & Svcs. from Govt. Accts (25.3)... 1,580 2,925 2,348 -577

Operation and maintenance of facilities (25.4).............. 10 69 55 -14

Research and Development Contracts (25.5)................ --- --- --- ---

Operation and maintenance of equipment (25.7).......... --- 146 117 -29

Subtotal Other Contractual Services: 38,784 41,042 32,941 -8,101

Supplies and materials (26.0)........................................... --- 4 3 -1

Equipment (31.0)................................................................ --- 140 113 -28

Grants, subsidies, and contributions (41.0)................... 134,600 168,985 161,096 -7,889

Interest and dividends (43.0)........................................... --- --- --- ---

Subtotal Non-Pay Costs 175,148 211,148 194,680 -16,468

Total Direct Obligations $175,148 $211,148 $194,680 -$16,468 1 Does not include PHS EVAL Funds. 2 Includes Prevention and Public Health Funds and Mandatory Funds. 3 The Minority Fellowship Program budget appears in the Health Surveillance and Program Support 

appropriation, Agency-wide Initiatives Workforce program. This is consistent with the FY 2017 Budget 

Request.
332

Substance Abuse and Mental Health Services Administration 

Substance Abuse Treatment

Budget Authority – Object Class

(Dollars in thousands)

Object Class - Direct Budget Authority1,2,3

FY 2015

Final

FY 2016

Enacted

FY 2017

President's 

Budget

FY 2017

+/-

FY 2016

Personnel compensation:

Full-time permanent (11.1)................................................ $2,839 $2,479 $2,519 +$40

Other than full-time permanent (11.3)............................. 315 275 280 +4

Other personnel compensation (11.5)............................ 16 14 15 +1

Military personnel (11.7).................................................. 129 130 132 +2

Special personnel services payments (11.8) ................. --- --- --- ---

Subtotal personnel compensation: 3,299 2,899 2,945 +46

Civilian benefits (12.1)...................................................... 1,005 877 904 +26

Military benefits (12.2)...................................................... 51 52 54 +2

Subtotal Pay Costs: 4,355 3,828 3,903 +74

Travel and transportation of persons (21.0).................. 158 134 130 -4

Transportation of things (22.0)....................................... 2 --- --- ---

Rental payments to GSA (23.1)....................................... 3,827 1,007 191 -816

Rental payments to Others (23.2).................................... --- 73 --- -73

Communication, utilities, and misc. charges (23.3)....... 519 167 178 +11

Printing and reproduction (24.0)..................................... 1,302 814 788 -26

Other Contractual Services:

Advisory and assistance services (25.1)....................... 9,050 13,569 28,137 +14,568

Other services (25.2)......................................................... 41,539 42,645 41,289 -1,356

Purchase of Goods & Svcs. from Govt. Accts (25.3)... 8,845 7,127 6,901 -227

Operation and maintenance of facilities (25.4).............. 1,617 654 634 -21

Research and Development Contracts (25.5)................ --- --- --- ---

Operation and maintenance of equipment (25.7).......... 140 37 36 -1

Subtotal Other Contractual Services: 61,191 64,034 76,997 +12,964

Supplies and materials (26.0)........................................... 161 49 47 -2

Equipment (31.0)................................................................ 230 2 2 ---

Grants, subsidies, and contributions (41.0)................... 2,028,374 2,040,578 2,469,913 +429,335

Interest and dividends (43.0)........................................... --- --- --- ---

Subtotal Non-Pay Costs 2,095,764 2,106,857 2,548,245 +441,389

Total Direct Obligations $2,100,119 $2,110,685 $2,552,148 +$441,463 1 Does not include PHS EVAL Funds. 2 Includes Prevention and Public Health Funds and Mandatory Funds.

3 The Minority Fellowship Program budget appears in the Health Surveillance and Program Support 

appropriation, Agency-wide Initiatives Workforce program. This is consistent with the FY 2017 Budget 

Request.
333

Substance Abuse and Mental Health Services Administration 

Health Surveillance and Program Support

Budget Authority – Object Class

(Dollars in thousands)

Object Class - Direct Budget Authority1,2,3,4,5

FY2015

Final

FY2016

Enacted

FY2017

President's 

Budget

FY2017

+/-

FY2016

Personnel compensation:

Full-time permanent (11.1)................................................ $43,248 $47,888 $48,655 +$766

Other than full-time permanent (11.3)............................. 2,049 2,269 2,305 +36

Other personnel compensation (11.5)............................ 545 604 614 +10

Military personnel (11.7).................................................. 3,539 4,217 4,285 +67

Special personnel services payments (11.8) ................. 230 --- --- ---

Subtotal personnel compensation: 49,611 54,978 55,858 +880

Civilian benefits (12.1)...................................................... 13,606 15,050 15,501 +451

Military benefits (12.2)...................................................... 1,846 2,200 2,266 +66

Subtotal Pay Costs: 65,063 72,228 73,625 +1,397

Travel and transportation of persons (21.0).................. 1,009 820 321 -499

Transportation of things (22.0)....................................... 14 30 12 -18

Rental payments to GSA (23.1)....................................... 1,924 7,266 5,625 -1,641

Rental payments to Others (23.2).................................... --- 32 --- -32

Communication, utilities, and misc. charges (23.3)....... --- 72 63 -9

Printing and reproduction (24.0)..................................... 85 110 43 -67

Other Contractual Services:

Advisory and assistance services (25.1)....................... 1,900 1,764 397 -1,367

Other services (25.2)......................................................... 36,641 35,297 14,125 -21,172

Purchase of Goods & Svcs. from Govt. Accts (25.3)... 7,941 8,025 3,145 -4,881

Operation and maintenance of facilities (25.4).............. 23 75 29 -45

Research and Development Contracts (25.5)................ --- --- --- ---

Operation and maintenance of equipment (25.7).......... --- 26 10 -16

Subtotal Other Contractual Services: 46,505 45,187 17,707 -27,480

Supplies and materials (26.0)........................................... 2,144 627 246 -381

Equipment (31.0)................................................................ 101 145 57 -88

Grants, subsidies, and contributions (41.0)................... 9,057 10,031 19,360 +9,329

Interest and dividends (43.0)........................................... --- --- --- ---

Subtotal Non-Pay Costs 60,838 64,319 43,433 -20,886

Total Direct Obligations $125,901 $136,547 $117,058 -$19,489 1 Does not include PHS EVAL Funds. 2 Includes Prevention and Public Health Funds and Mandatory Funds. 3 Does not include user fees.

4 The Minority Fellowship Program budget appears in the Health Surveillance and Program Support 

appropriation, Agency-wide Initiatives Workforce program. This is consistent with the FY 2017 Budget 

Request.

5 Reflects the transfer of funding associated with the Behavioral Health Workforce Expansion and Training 

program from SAMHSA to HRSA. HRSA and SAMHSA will continue to work together to implement this 

program.
334

Substance Abuse and Mental Health Services Administration 

Total PHS Evaluation Funds – Object Class

(Dollars in thousands)

Object Class - PHS Evaluation Funds

FY 2015

Final

FY 2016

Enacted

FY 2017

President's 

Budget

FY 2017

+/-

FY 2016

Personnel Compensation:

Full Time Permanent (11.1)................................................ $8,128 $9,385 $9,535 +$150

Other than Full-Time Permanent (11.3)........................... 537 322 607 +285

Other Personnel Compensation (11.5)............................ 94 67 111 +44

Military Personnel Compensation (11.7)........................ 948 774 787 +12

Special personnel services payments (11.8).................... 143 --- --- ---

Subtotal Personnel Compensation: 9,850 10,548 11,040 +491

Civilian Personnel Benefits (12.1).................................... 2,599 2,994 3,084 +90

Military Personnel Benefits (12.2) ................................. 514 419 432 +13

Subtotal Pay Costs: 12,963 13,961 14,555 +594

Travel (21.0)....................................................................... 73 51 568 +517

Transportation of things (22.0)....................................... 10 --- --- ---

Rental payments to GSA (23.1)....................................... 360 --- --- ---

Communications, Utilities and Misc. Charges (23.3)... 100 --- --- ---

Printing and Reproduction (24.0).................................... 416 391 394 +4

Other Contractual Services:

Advisory and assistance services (25.1)....................... --- --- 1,300 +1,300

Other services (25.2)......................................................... 113,775 113,426 143,988 +30,562

Purchase of Goods & Svcs. from Govt. Accts (25.3)... 3,102 5,796 8,791 +2,996

Operation and maintenance of equipment (25.7).......... 7 5 9 +4

Subtotal Other Contractual Services:............................. 116,884 119,227 154,089 +34,862

Supplies and Materials (26.0).......................................... 7 8 8 +1

Equipment (31.0)................................................................ 40 29 56 +26

Grants, Subsidies, and Contributions (41.0)................... 2,815 --- 43,865 +43,865

Subtotal Non-Pay Costs 120,704 119,706 198,980 +79,274

Total Reimbursable Obligations $133,667 $133,667 $213,535 +$79,868
335

Substance Abuse and Mental Health Services Administration 

Mental Health Services

PHS Evaluation Funds – Object Class

(Dollars in thousands)

Object Class - PHS Evaluation

FY 2015

Final

FY 2016

Enacted

FY 2017

President's 

Budget

FY 2017

+/-

FY 2016

Personnel compensation:

Full-time permanent (11.1)................................................ $1,585 $1,720 $1,748 +$28

Other than full-time permanent (11.3)............................. 2 2 2 ---

Other personnel compensation (11.5)............................ 14 15 16 +1

Military personnel (11.7).................................................. 295 199 202 +3

Special personnel services payments (11.8) ................. --- --- --- ---

Subtotal personnel compensation: 1,895 1,936 1,967 +31

Civilian benefits (12.1)...................................................... 482 523 539 +16

Military benefits (12.2)...................................................... 161 109 112 +3

Subtotal Pay Costs: 2,538 2,568 2,618 +50

Travel and transportation of persons (21.0).................. 16 38 41 +4

Transportation of things (22.0)....................................... --- --- --- ---

Rental payments to GSA (23.1)....................................... --- --- --- ---

Communication, utilities, and misc. charges (23.3)....... --- --- --- ---

Printing and reproduction (24.0)..................................... 22 28 31 +3

Other Contractual Services:

Advisory and assistance services (25.1)....................... --- --- --- ---

Other services (25.2)......................................................... 18,457 18,398 20,195 +1,797

Purchase of Goods & Svcs. from Govt. Accts (25.3)... --- --- --- ---

Operation and maintenance of equipment (25.7).......... --- --- --- ---

Subtotal Other Contractual Services: 18,457 18,398 20,195 +1,797

Supplies and materials (26.0)........................................... 6 8 8 +1

Equipment (31.0)................................................................ --- --- --- ---

Grants, subsidies, and contributions (41.0)................... --- --- 8,146 +8,146

Subtotal Non-Pay Costs 18,501 18,471 28,421 +9,950

Total Reimbursable Obligations $21,039 $21,039 $31,039 +$10,000
336

Substance Abuse and Mental Health Services Administration 

Substance Abuse Prevention

PHS Evaluation Funds – Object Class

(Dollars in thousands)

Object Class - PHS Evaluation

FY 2015

Final

FY 2016

Enacted

FY 2017

President's 

Budget

FY 2017

+/-

FY 2016

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)....................................... --- --- --- ---

Communication, utilities, and misc. charges (23.3)....... --- --- --- ---

Printing and reproduction (24.0).................................... --- --- --- ---

Other Contractual Services:

Advisory and assistance services (25.1).......................

--- --- 8,423 +8,423

Other services ( 25.2)......................................................... --- --- --- ---

Purchase of Goods & Svcs. from Govt. Accts (25.3)... --- --- --- ---

Operation and maintenance of equipment (25.7).......... --- --- 8,423 +8,423

Subtotal Other Contractual Services: --- --- --- ---

Supplies and materials (26.0) --- --- --- ---

Equipment (31.0) --- --- 8,045 +8,045

Subtotal Non-Pay Costs --- --- 16,468 +16,468

Total Reimbursable Obligations $--- $--- $16,468 +$16,468
337

Substance Abuse and Mental Health Services Administration 

Substance Abuse Treatment

PHS Evaluation Funds – Object Class

(Dollars in thousands)

Object Class - PHS Evaluation

FY 2015

Final

FY 2016

Enacted

FY 2017

President's 

Budget

FY 2017

+/-

FY 2016

Personnel compensation:

Full-time permanent ( 11.1).............................................. $3,461 $4,383 $4,453 +$70

Other than full-time permanent (11.3)........................... 127 161 164 +3

Other personnel compensation (11.5).......................... 41 52 53 +1

Military personnel (11.7)................................................ 227 230 233 +4

Special personnel services payments (11.8) .............. 143 --- --- ---

Subtotal personnel compensation: 3,999 4,825 4,903 +77

Civilian benefits ( 12.1).................................................... 1,073 1,359 1,400 +41

Military benefits ( 12.2)................................................... 121 122 126 +4

Subtotal Pay Costs: 5,193 6,307 6,428 +122

Travel and transportation of persons (21.0)............... 9 --- --- ---

Transportation of things (22.0)..................................... 10 --- --- ---

Rental payments to GSA (23.1)..................................... --- --- --- ---

Communication, utilities, and misc. charges (23.3).... --- --- --- ---

Printing and reproduction (24.0)................................... 393 363 364 +1

Other Contractual Services:

Advisory and assistance services (25.1)..................... --- --- --- ---

Other services (25.2)....................................................... 72,625 71,883 72,079 +196

Purchase of Goods & Svcs. from Govt. Accts (25.3). 1,798 2,644 2,651 +7

Operation and maintenance of equipment (25.7)........ 7 2 2 +

Subtotal Other Contractual Services: 74,430 74,529 74,732 +203

Supplies and materials (26.0)......................................... --- --- --- ---

Equipment (31.0).............................................................. 3 2 2 ---

Grants, subsidies, and contributions ( 41.0)................ 1,162 --- 27,674 +27,674

Subtotal Non-Pay Costs 76,007 74,893 102,772 +27,878

Total Reimbursable Obligations $81,200 $81,200 $109,200 +$28,000
338

Substance Abuse and Mental Health Services Administration 

Health Surveillance and Program Support

PHS Evaluation Funds – Object Class

(Dollars in thousands)

Object Class - PHS Evaluation

FY2015

Final

FY2016

Enacted

FY2017

President's 

Budget

FY2017

+/-

FY2016

Personnel compensation:

Full-time permanent (11.1).................................................. $3,082 $3,282 $3,334 +$53

Other than full-time permanent (11.3)............................... 408 159 441 +282

Other personnel compensation (11.5).............................. 39 --- 43 +43

Military personnel (11.7).................................................... 427 346 351 +6

Special personnel services payments (11.8) ................... --- --- --- ---

Subtotal personnel compensation: 3,956 3,787 4,170 +383

Civilian benefits (12.1)........................................................ 1,044 1,112 1,145 +33

Military benefits (12.2)........................................................ 232 188 193 +6

Subtotal Pay Costs: 5,232 5,086 5,508 +422

Travel and transportation of persons (21.0).................... 48 14 526 +513

Transportation of things (22.0)......................................... --- --- --- ---

Rental payments to GSA (23.1)......................................... 360 --- --- ---

Communication, utilities, and misc. charges (23.3)......... 100 --- --- ---

Printing and reproduction (24.0)....................................... --- --- --- ---

Other Contractual Services:

Advisory and assistance services (25.1)......................... --- --- 1,300 +1,300

Other services (25.2)........................................................... 22,693 23,145 43,291 +20,147

Purchase of Goods & Svcs. from Govt. Accts (25.3)..... 1,304 3,152 6,140 +2,989

Operation and maintenance of equipment (25.7)............ --- 4 8 +4

Subtotal Other Contractual Services: 23,997 26,300 50,739 +24,439

Supplies and materials (26.0)............................................. 1 --- --- ---

Equipment (31.0).................................................................. 37 28 54 +26

Grants, subsidies, and contributions (41.0)..................... 1,653 --- --- ---

Subtotal Non-Pay Costs 26,196 26,342 51,320 +24,978

Total Reimbursable Obligations $31,428 $31,428 $56,828 +$25,400
339

Substance Abuse and Mental Health Services Administration 

Salaries and Expenses Tables

Direct Budget Authority – Object Class

(Dollars in thousands)

Object Class - Direct BudgetAuthority1,2,3,4,5

FY2015

Final

FY2016

Enacted

FY2017

President's 

Budget

FY2017

+/-

FY2016

Personnel compensation:

Full-time permanent (11.1)................................................ $46,871 $51,338 $52,159 +$821

Other than full-time permanent (11.3)............................. 2,449 2,649 2,692 +42

Other personnel compensation (11.5)............................. 568 626 636 +10

Military personnel (11.7)................................................... 3,667 4,347 4,417 +70

Special personnel services payments (11.8) ................. 230 --- --- ---

Subtotal personnel compensation 53,786 58,960 59,904 +943

Civilian benefits (12.1)....................................................... 14,882 16,264 16,752 +488

Military benefits (12.2)...................................................... 1,898 2,252 2,320 +68

Subtotal Pay Costs: 70,566 77,477 78,976 +1,499

Travel (21.0)........................................................................ 1,223 1,130 628 -502

Transportation of things (22.0)........................................ 15 35 16 -19

Rental payments to Others (23.2).................................... --- 217 --- -217

Communication, utilities, and misc. charges(23.3)....... 523 496 521 +25

Printing and reproduction (24.0)...................................... 2,029 1,678 1,497 -181

Other Contractual Services:

Advisory and assistance services (25.1)....................... 29,337 37,750 50,205 +12,455

Other services (25.2).......................................................... 167,398 171,667 142,902 -28,765

Purchase of Goods & Svcs. fromGovt. Accts (25.3)... 32,366 34,516 28,935 -5,580

Operation and maintenance of facilities (25.4).............. 1,650 1,568 1,493 -75

Research and Development Contracts (25.5)................ --- --- --- ---

Operation and maintenance of equipment (25.7).......... 142 220 174 -46

Subtotal Other Contractual Services: 230,893 245,720 223,708 -22,012

Supplies and materials (26.0)............................................ 2,305 679 296 -384

Subtotal Non-Pay Costs 236,988 249,954 226,665 -23,289

Total Salary andExpenses 307,554 327,431 305,641 -21,790

Rental Payments to GSA (23.1)........................................ 9,765 9,824 6,116 -3,708

Grand Total, Salaries & Expenses and Rent $317,319 $337,255 $311,757 -$25,498

Direct FTE............................................................................... 492 535 535 ---

1 Does not include PHS EVALFunds.

2 Includes Prevention and Public Health Funds and Mandatory Funds.

3 Does not include user fees. 4 The Minority Fellowship Program budget appears in the Health Surveillance and Program Support 

appropriation, Agency-wide Initiatives Workforce program. This is consistent with the FY 2017 Budget

Request.

5 Reflects the transfer of funding associated with the Behavioral Health Workforce Expansion and Training 

program from SAMHSA to HRSA. HRSA and SAMHSA will continue to work together to implement this 

program.
340

Substance Abuse and Mental Health Services Administration 

Salaries and Expenses Tables

PHS Evaluation Funds – Object Class

(Dollars in thousands)

Object Class1

FY2015

Final

FY2016

Enacted

FY2017

President's 

Budget

FY2017

+/-

FY2016

Personnel compensation:

Full-time permanent(11.1)........................................... $8,128 $9,385 $9,535 +$150

Otherthan full-time permanent (11.3)........................ 537 322 607 +285

Other personnel compensation (11.5)....................... 94 67 111 +44

Military personnel(11.7)............................................. 948 774 787 +12

Special personnelservices payments (11.8)............ 143 --- --- ---

Subtotal personnelcompensation 9,850 10,548 11,040 +491

Civilian benefits(12.1)................................................. 2,599 2,994 3,084 +90

Military benefits(12.2)................................................. 514 419 432 +13

Subtotal PayCosts: 12,963 13,961 14,555 +594

Travel (21.0)................................................................... 73 51 568 +517

Transportation of things (22.0).................................. 10 --- --- ---

Rental payments to Others(23.2)............................... --- --- --- ---

Communication, utilities, and misc. charges (23.3).. 100 --- --- ---

Printing and reproduction (24.0)................................ 416 391 394 +4

Other ContractualServices:

Advisory and assistance services(25.1).................. --- --- 1,300 +1,300

Other services(25.2).................................................... 113,775 113,426 143,988 +30,562

Purch. Goods & Svcs. Govt. Accts (25.3)................. 3,102 5,796 8,791 +2,996

Operation and maintenance of facilities (25.4)......... --- --- --- ---

Research and Development Contracts (25.5)........... --- --- --- ---

Operation and maintenance of equipment (25.7)..... 7 5 9 +4

Subtotal Other ContractualServices: 116,884 119,227 154,089 +34,862

Supplies and materials(26.0)...................................... 7 8 8 +1

SubtotalNon-PayCosts 117,489 119,676 155,059 +35,383

Total Salary andExpenses 130,452 133,638 169,614 +35,976

RentalPayments to GSA (23.1).................................. 360 --- --- ---

GrandTotal, Salaries & Expenses andRent $130,813 $133,638 $169,614 +$35,976

Reimbursable FTE1....................................................... 92 100 100 --- 1 Does not include Other reimbursable FTEs (30) and associated Object Class Cost.
341

Detail of Full Time Equivalent Employee (FTE)

FY 2015 FY 2015 FY 2015

Actual Actual Actual 

Civilian Military Total

FY 2016 FY 2016 FY2016

Est. Est. Est. 

Civilian Military Total

FY 2017 FY 2017 FY2017

Est. Est. Est. 

Civilian Military Total

Health Surveillance and Program Support...

Direct:.............................................................. 419 34 453 458 40 498 458 40 498

Reimbursable:................................................. 39 9 48 41 7 48 41 7 48

Total:............................................................. 458 43 501 499 47 546 499 47 546

Mental Health Services...................................

Direct:.............................................................. 9 0 9 11 0 11 11 0 11

Reimbursable:................................................. 18 4 22 19 3 22 19 3 22

Total:............................................................. 27 4 31 30 3 33 30 3 33

Substance Abuse Prevention........................

Direct:.............................................................. 0 0 0 0 0 0 0 0 0

Reimbursable:................................................. 16 2 18 17 3 20 17 3 20

Total:............................................................. 16 2 18 17 3 20 17 3 20

Substance Abuse Treatment.........................

Direct:.............................................................. 29 1 30 25 1 26 25 1 26

Reimbursable:................................................. 31 3 34 37 3 40 37 3 40

Total:............................................................. 60 4 64 62 4 66 62 4 66

OPDIV FTETotal............................................ 561 53 614 608 57 665 608 57 665
1 This figure represents on-board staff.

342

Detail of Positions

FY 2015

Final

FY 2016

Enacted

FY 2017

President's 

Budget

Executive Level IV 

Subtotal

1 1 1

1 1 1

Total - Exec Level Salaries 

SES

Subtotal

$155,500

13

$155,500

16

$155,500

18

13 16 18

Total, SES salaries 

GM/GS-15/EE 

GM/GS-14

GM/GS-13

GS-12

GS-11

GS-10

GS-09

GS-08

GS-07

GS-06

GS-05

GS-04

GS-03

GS-02

GS-01

Subtotal 

Total, GS salaries

CC-08/09 

CC-07 

CC-06 

CC-05

CC-04 

CC-03 

CC-02 

CC-01

Subtotal

Total, CC salaries 

Total Positions 1

Average ES level 

Average ES salary 

Average SES level 

Average SES salary

Average GS grade 

Average GS salary 

Average CC level 

Average CC salaries

$2,894,871

72

128

208

52

20

1

11

22

20

10

4

0

0

0

0

$3,609,236

74

125

227

69

20

3

14

22

19

14

4

0

0

0

0

$4,125,357

74

125

227

69

21

3

14

21

17

14

4

0

0

0

0

548 591 589

$56,965,048

1

0

16

19

18

4

0

0

$62,649,324

1

0

16

20

16

4

0

0

$63,767,618

1

0

16

20

16

4

0

0

58 57 57

$5,526,494 $5,431,209 $5,518,109

620 665 665

ES

$155,500

SES

$222,682

13.5

$103,951

5.2

$95,284

ES

$155,500

SES

$225,577

13.6

$106,006

5.2

$95,284

ES

$155,500

SES

$229,186

13.6

$108,264

5.2

$96,809
343

Programs Proposed for Elimination

The following table shows the programs proposed for elimination in the FY 2017 Budget 

Request. Termination of this program allows SAMHSA to redirect approximately $23.1 million 

from the FY 2016 Enacted Level to continue activities for mental health programs that have 

demonstrated success when addressing youth violence. The following is a brief summary of the 

program and rationale for its elimination.

(Dollars in thousands)

Program

FY 2016

Enacted

Youth Violence Prevention $23,099

Youth Violence Prevention

SAMHSA’s Youth Violence Prevention program uses the Safe Schools/Healthy Students 

(SS/HS) Initiative to reduce violence. SS/HS is a discretionary grant program that seeks to 

create healthy learning environments that help students thrive, succeed in school, and build 

healthy relationships. For more than a decade, the SS/HS Initiative has successfully decreased 

violence and increased the number of students receiving mental health services, supporting 

programs in more than 300 local school districts.209 The initiative implements an enhanced, 

coordinated, and comprehensive plan of activities, programs, and services that promote healthy 

childhood development, prevent violence, and prevent alcohol and drug use.

The FY 2017 Budget Request proposes eliminating the youth violence prevention program in FY

2017. SAMHSA is requesting to reallocate funding from this program to Now is the TimeProject Advancing Wellness and Resilience in Education (NITT-Project AWARE). The 

reallocation of these funds to NITT-Project AWARE will continue to bring to scale program 

activities, practices, and lessons learned in the youth violence prevention arena and address 

current and emerging issues. The reallocation of these funds will enable SAMHSA to avoid 

duplication among programs with like purposes. 

209 http://www.samhsa.gov/grants/block-grants/sabg
344

FTEs Funded by the Affordable Care Act

Substance Abuse and Mental Health Services Administration

(Dollars in thousands)

Program Section

FY2013 FY2014 FY2015 FY2016 FY2017

Total FTEs CEs Total FTEs CEs Total FTEs CEs Total FTEs CEs Total FTEs CEs

Primary and BehavioralHealth

Care Integration

Discretionary

Mandatory 4002 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

Suicide Prevention

Discretionary

Mandatory 4002 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

Health Surveillance

Discretionary

Mandatory 4002 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
345

$30.000.00 - based on years of education, experience, and the position held by the incumbent. Amount is required to retain the 

employee.

Physicians’ Comparability Allowance (PCA) Worksheet

Substance Abuse and Mental Health Services Administration

(Whole dollars)

PY2015

(Actual)

CY20161

(Estimates)

BY2017

(Estimates)

1) Number of Physicians ReceivingPCAs 5 5 5

2) Number of Physicians with One-Year PCAAgreements --- --- ---

3) Number of Physicians with Multi-Year PCA Agreements 5 5 5

4) Average AnnualPCA Physician Pay (without PCA payment) $144,342 $144,342 $144,342

5) Average Annual PCA Payment $18,600 $18,600 $18,600

Category I ClinicalPosition --- --- ---

6) Number of Physicians Category II Research Position --- --- ---

Receiving PCAs byCategory Category III Occupational Health --- --- ---

(non-add) Category IV-A DisabilityEvaluation --- --- ---

Category IV-B Health and MedicalAdmin. 5 5 5

1

FY 2016 data will be approved during the FY 2017 Budget cycle .

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 andBY.

8) Provide the maximumannualPCA amount paid to each category of physician in your agency and explain the reasoning for 

these amounts by category.

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).

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 additionalinformation that may be usefulin planning PCA staffing levels and amounts in your agency.

N/A

SAMHSA currently has two medical officer vacancies. The GS position was vacated on 6/3/2015 and the SES position was 

vacated on 10/3/2014. The SES slot request package was prepared for Departmental approval. Management is evaluating the GS 

position due to a reorganization.

N/A
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347

Substance Abuse and Mental Health Services Administration 

SIGNIFICANT ITEMS IN OMNIBUS, HOUSE, AND SENATE REPORTS

FY 2016 Consolidated Appropriations Act Report Language 

(Omnibus – PL 114-113)

Item – Pages 43-44

Mental Health Programs – SAMHSA is directed to work with the Government Accountability 

Office (GAO) in implementing the recommendations provided in GAO reports GA0-15-113 and 

GA0-15-405, issued in February and May of 2015, respectively. The agreement directs 

SAMHSA to provide a detailed update and timeline on the progress of these recommendations 

90 days after enactment of this Act. Furthermore, the agreement directs SAMHSA to develop a 

grants compliance plan that will ensure that SAMHSA's grants process is in accordance with the 

Department's grants manual. The compliance plan shall include periodic, and random, internal 

audits of grant files to confirm all the necessary documentation is accounted for and that the 

compliance plan is meeting its objectives. SAMHSA shall provide any additional grants training 

necessary to prevent these issues from arising in the future.

Action taken or to be taken

SAMHSA is taking concrete steps to implement the recommendations provided in GAO reports 

GA0-15-113 (serious mental illness) and GA0-15-405 (grants management).

SAMHSA is undertaking extensive efforts to enhance the management of its grant programs. 

These activities are in keeping with best practices and lessons learned over the last several years 

related to the implementation of strong grants management and business operations. These 

efforts include:

• Continuous quality improvement,

• Developing and updating policies and procedures,

• Updating its Government Project Officer Handbook which highlights the importance of 

sound documentation in grant files,

• Implementing periodic sampling of grant files to ensure completeness, accuracy, and 

timeliness of documentation,

• Implementing new systems to manage grants and collect performance data, and

• Implementing staff training.

Item – Page 44

Mental Health Block Grants – The agreement directs SAMHSA to continue its collaboration 

with National Institute of Mental Health (NIMH) to ensure that funds from the set-aside are only 

used for programs showing strong evidence of effectiveness and targets the first episode of 

psychosis. SAMHSA shall not expand the use of the set-aside to programs outside of those that 

address first episode psychosis. Within six months after enactment of this Act, the agreement
348

directs SAMHSA to provide a detailed table showing at a minimum each State's allotment, name 

of the program being implemented, and a short description of the program.

Action taken or to be taken

SAMHSA supports states’ efforts to address the identification and referral of individuals 

experiencing first episode psychosis (FEP) in order to substantially reduce the duration of 

untreated psychosis. SAMHSA has been involved for some time in an ongoing collaboration 

with NIMH directed toward the goals of the FEP model.

SAMHSA will continue to work with NIMH to assure that states have access to information 

relating research-based early intervention programs to address serious mental illness. SAMHSA 

continues to work closely with NIMH support and collaboration, which has been recognized on 

several occasions for the positive outcomes of this joint relationship. Further, SAMHSA will 

provide Congress with a detailed table showing at a minimum each state's allotment, name of the 

program being implemented, and a short description of the program.

Item – Pages 44-45

Project AWARE – Of the amount provided for Project AWARE, the agreement provides an 

additional $10,000,000 for discretionary grants to communities that have recently faced civil 

unrest. These grants should focus on high risk youth and family populations in these 

communities and surrounding areas that have experienced significant exposure to trauma and can 

benefit from additional evidence-based violence prevention and community youth engagement 

programs as well as linkages to trauma-informed behavioral health services. SAMHSA should 

prioritize funding grants from communities that have formed partnerships between key 

stakeholders including State and local governments (including multiple cities and counties if 

impacted); public or private universities and colleges; and non-profit community- and faithbased organizations. The agreement includes related funding in the Department of Education. 

The Department of Education and SAMHSA should coordinate extensively in the administration 

of these resources.

Action taken or to be taken

SAMHSA will ensure that the Funding Opportunity Announcement (FOA) for these new Project 

AWARE grants to communities that have recently faced civil unrest focus on high risk youth and 

family populations in these communities and surrounding areas that have experienced significant 

exposure to trauma and can benefit from additional evidence-based violence prevention and 

community youth engagement programs as well as linkages to trauma-informed behavioral

health services. In addition, SAMHSA will work with the Department of Education to coordinate

the administration of this funding.
349

Item – Page 45

Childhood Trauma – The agreement encourages SAMHSA to more broadly disseminate 

information regarding evidence-based interventions for the prevention and treatment of 

childhood trauma so more children can benefit from proven practices.

Action taken or to be taken

SAMHSA will continue to build on the strong work of the National Child Traumatic Stress

Initiative (NCTSI) Network and will improve and enhance the capacity of the NCTSI to deliver 

core practices developed by the NCTSN to children and youth in need. SAMHSA will more 

broadly disseminate information on effective interventions and preventions for childhood trauma 

through a multilayered approach that includes increased outreach and marketing to providers, 

researchers, family members, and consumers for in person training, web-based information and 

training, webinars, technical assistance, and through direct assistance.

Data collected through FY 2013 demonstrate that the current grantees in the NCTSN have 

provided trauma-informed treatment to nearly 25,000 children, adolescents, and family members. 

Based on these capacity-building efforts, SAMHSA projects that number to grow to over 40,000 

individuals served in FY 2016, and will continue striving to reach more children and families in 

need.

Item – Pages 45-46

Assisted Outpatient Treatment – The agreement includes $15,000,000 to implement section 224 

of the Protecting Access to Medicare Act of 2014 (Public Law 113-93), the Assisted Outpatient 

Treatment Grant Program for Individuals with Serious Mental Illness. The agreement requests a 

report in the FY 2017 budget request on planned uses of this funding.

Action taken or to be taken

SAMHSA includes in its FY 2017 Budget Justification to Congress a report on how it plans to 

implement section 224 of the Protecting Access to Medicare Act of 2014. SAMHSA will release 

a Funding Opportunity Announcement in FY 2016 for Section 224, the Assisted Outpatient 

Treatment Grant Program for Individuals with Serious Mental Illness. Grants will be up to

$1.0 million per year for the implementation of Assisted Outpatient Treatment programs. 

SAMHSA plans to award up to 20 grants.

Item – Page 47-48

Targeted Capacity Expansion – The funding provided will increase the number of States that 

receive funding from 11 to 22, and SAMHSA should target States with the highest rates of 

admissions and that have demonstrated a dramatic increase in admissions for the treatment of 

opioid use disorders. The United States has seen a 500 percent increase in admissions for 

treatment for prescription drug abuse since 2000. Moreover, according to a recent study, 28 

states saw an increase in admissions for treatment for heroin dependence during the past two
350

years. 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.

Since the passage of the Drug Addiction Treatment Act of 2000, SAMHSA has led the nation in 

educating physicians, patients and treatment systems on the use of medication-assisted treatment. 

To keep pace with advancements in science and research, the agreement directs SAMHSA to 

update all of its public-facing information and treatment locators such that all evidence-based 

innovations in counseling, recovery support, and abstinence-based relapse prevention 

medication-assisted treatments are fully incorporated.

Action taken or to be taken

SAMHSA, through the Center for Substance Abuse Treatment, will release a Funding 

Opportunity Announcement for grants to states to expand medication-assisted treatment services 

for persons with opioid use disorder. The program will target those states experiencing: the 

highest rates of primary treatment admissions for heroin and opiates per capita; and a dramatic 

increase in admissions for treatment of opiates and heroin in recent years. SAMHSA will 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.

As requested, SAMHSA will update all of its public-facing information and treatment locators 

such that all evidence-based innovations in counseling, recovery support, and abstinence-based 

relapse prevention medication-assisted treatments are fully incorporated.

Item – Page 48

Criminal Justice Activities – SAMHSA is directed to ensure that all Drug Treatment 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 treatment court grant recipients 

work directly with the corresponding State substance abuse agency in the planning, 

implementation, and evaluation of the grant. SAMHSA is further directed to expand training and 

technical assistance to drug treatment court grant recipients to ensure evidence-based practices 

are fully implemented.

Action taken or to be taken

SAMHSA’s FY 2016 Drug Treatment Court grant funding will continue to be utilized to provide 

services for individuals “diagnosed with a substance use disorder as their primary condition.” 

Additionally, Drug Treatment Court applicants are required to include a letter of support from 

the State Substance Abuse Agency Director or designated representative that provides support 

for the application and confirms that the proposal conforms to the framework of the state strategy 

of substance abuse treatment.” Additionally, in FY 2016, SAMHSA will continue to provide
351

technical assistance to its drug treatment court grantees to highlight evidence-based practices and 

ensure effective service provision.

Item – Page 49

Substance Abuse Prevention – The agreement directs that all of the funding appropriated 

explicitly for substance abuse prevention purposes both in the Center for Substance Abuse 

Prevention'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 programs and not for any other 

purpose.

Action taken or to be taken

SAMHSA can confirm that substance abuse prevention funds in both CSAP’s PRNS line and 

funding from the 20 percent prevention set-aside in the Substance Abuse Prevention and 

Treatment Block Grant are used solely to fund substance abuse prevention programs and 

strategies.

Specifically, the FY 2015-2016 SABG Block Grant application states, as per statute, that “the 

20% set aside funds of the SABG Block Grant must be used only for substance abuse primary 

prevention activities by the state.” SAMHSA’s State Project Officers monitor state expenditures 

to confirm that states are spending at least 20 percent of the total SABG award on primary 

substance abuse prevention programs, practices and strategies. Similarly, grantees funded 

through PRNS lines are also required to expend grant funds on substance abuse prevention 

strategies and infrastructure development. SAMHSA’s Project Officers also monitor these grant 

expenditures to ensure that grant funds are spent appropriately and on allowable items.

Item – Page 50

Combating Opioid Abuse – The agreement provides $12,000,000 for discretionary grants to 

States to prevent opioid overdose-related deaths. This program will help States equip and train 

first responders with the use of devices that rapidly reverse the effects of opioids. 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. Furthermore, the agreement 

provides $10,000,000 for the Strategic Prevention Framework Rx program to increase awareness 

of opioid abuse and misuse in communities. SAMHSA shall collaborate with CDC to implement 

the most effective outreach strategy and to reduce duplication of activities.

Action taken or to be taken

SAMHSA appreciates Congress providing funding for Grants to Prevent Prescription 

Drug/Opioid Overdose Related Deaths. These grantees will be required to develop a 

dissemination plan and a training course tailored to meet the needs of their community. The 

course would use SAMHSA’s Opioid Overdose Prevention Toolkit as a guide, and include a 

comprehensive prevention program, which will focus on prevention, treatment and recovery 

services to decrease the likelihood of drug overdose recurrence.
352

SAMHSA will continue its collaboration with CDC to implement the most effective outreach 

strategies and reduce any duplication of activities. The two agencies are coordinating to ensure 

that the efforts are aligned with HHS’s recently established policy and plan for prevention of 

Opioid-Related Overdoses and Deaths involving multiple Operating Divisions and offices.

SAMHSA’s Strategic Prevention Framework for Prescription Drugs will raise 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 will also focus on raising 

community awareness and bringing prescription drug abuse prevention activities and education 

to schools, communities, parents, prescribers, and their patients.

Item – Page 50

Overdose Fatality Prevention – SAMHSA is urged to take steps to encourage and support the 

use of Substance Abuse and Prevention Block Grant funds for opioid safety education and 

training, including initiatives that improve access for licensed health care professionals, 

including paramedics, to emergency devices used to rapidly reverse the effects of opioid 

overdoses. Such initiatives should incorporate robust evidence-based intervention training, and 

facilitate linkage to treatment and recovery services.

Action taken or to be taken

Addressing the issue of prescription drug abuse and misuse as well as preventing opioid 

overdose deaths is a top priority for SAMHSA. In terms of grants to prevent prescription 

drug/opioid overdose related deaths, Congress funded in FY 2016 a $12.0 million grant program 

that has the potential to significantly reduce the number of opioid-related overdose deaths. This 

funding will help states purchase naloxone, equip first responders in high-risk communities, 

support education on the use of naloxone and other overdose death prevention strategies, provide 

the necessary materials to assemble overdose kits, as well as cover expenses incurred from 

dissemination efforts. SAMHSA’s Opioid Overdose Prevention Toolkit should be used as the 

guide for the development of a comprehensive strategy that will include evidence-based 

programs to intervene and prevent the likelihood of drug overdose recurrence. The Centers for 

Disease Control and Prevention will evaluate this grant program for its efficacy in reducing 

overdose deaths from opioids.

In addition, state agencies that administer the Substance Abuse Block Grant may use the block 

grant funds (other than primary prevention set-aside funds) to purchase naloxone and the 

necessary materials to assemble overdose kits and to cover the costs associated with the 

dissemination of such kits.

SAMHSA will continue to encourage states to use their block grant funds for opioid safety 

education and training. This would include initiatives to improve access for licensed health care 

professionals, including paramedics, to emergency devices used to rapidly reverse the effects of 

opioid overdoses. SAMHSA has advised states that the Substance Abuse Block Grant funds can 

be used to purchase naloxone and the necessary materials to assemble overdose kits and to cover 

the costs associated with the dissemination of such kits.
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Item – Pages 51-52

Behavioral Workforce Education and Training – The agreement directs SAMHSA to share 

information concerning pending grant opportunity announcements with State licensing 

organizations and all the relevant professional associations. Furthermore, SAMHSA is directed 

to ensure that funding is distributed relatively equally among the participating health professions 

and to consider strategies such as issuing separate funding opportunity announcements for each 

participating health profession. In addition, the agreement directs SAMHSA to include doctoral 

psychology schools in the funding opportunities to support doctoral level students completing 

their practicums, which are necessary to move on to internships. Awards shall be given to 

meritorious applications for doctoral psychology interns first, before doctoral psychology 

schools applying to support practicums.

Action taken or to be taken

In FY 2016, SAMHSA will work with the Health Resources Services Administration, who 

administers the Behavioral Health Workforce Education and Training Grant Program, to ensure 

that the Funding Opportunity Announcement adequately addresses the issues raised by the 

Committee.

FY 2016 Senate Appropriations Committee Report Language 

(S.Rept. 114-74)

Item – Page 109

Substance Abuse and Mental Health Services Administration – The Committee urges 

SAMHSA to continue to prioritize all HIV/AIDS funding to target racial and ethnic minority 

communities.

Action taken or to be taken

SAMHSA will continue to prioritize its HIV/AIDS funding to target racial and ethnic minority 

communities. SAMHSA currently funds projects under the Minority AIDS Initiative that 

implement the goals of the National HIV/AIDS Strategy. The Center for Substance Abuse 

Prevention provides funding for substance abuse prevention services and HIV testing programs. 

Tow Centers, the Center for Substance Abuse Treatment and the Center for Mental Health 

Services, fund projects that support substance abuse/mental health treatment services, HIV 

testing, and referral to quality HIV care.

Item – Page 110

Mental Health – The Committee directs the administrator of SAMHSA to work with GAO in 

implementing the recommendations provided in the GAO reports. The Committee expects a 

detailed update and timeline on the progress of these recommendations 90 days after enactment 

of this act. Furthermore, the Committee directs SAMHSA to develop a grants compliance plan
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that will ensure that SAMHSA’s grants process is in accordance with the Department’s grants 

manual. The compliance plan shall include periodic, and random, internal audits of grant files to 

confirm all the necessary documentation are accounted for and that the compliance plan is 

meeting its objectives. Furthermore, SAMHSA shall provide any additional grants training 

necessary to prevent these issues from arising in the future.

Action taken or to be taken

See response to the Omnibus Report Language for “Mental Health Programs” on page 347.

Item – Page 111

Access to Mental Health Services for Veterans – The Committee is aware of the success 

achieved in localities that use locally customized web portals to assist veterans struggling with 

mental and substance use issues. These portals provide veterans with a directory of local mental 

health providers and services in addition to all military and Veterans’ Affairs funded programs. 

They also provide quick access to local crisis intervention and emergency care programs; 

comprehensive job search and support; a peer social networking platform, and personal health 

records. The Committee encourages SAMHSA to expand and maintain the capacity of locally 

customized internet-based Web portals nationwide.

Action taken or to be taken

SAMHSA encourages all our grantees to address the behavioral health needs of returning 

veterans and their families in designing and developing their programs and to consider 

prioritizing this population for services where appropriate. SAMHSA will continue to encourage 

its grantees to utilize and provide technical assistance regarding locally-customized web portals 

that assist veterans and their families with finding behavioral health treatment and support.

Item – Page 111

Primary and Behavioral Healthcare Integration – The Committee continues to direct 

SAMHSA to ensure that new Integration grants awarded for fiscal year 2016 are funded under 

the authorities in section 520K of the PHS Act.

Action taken or to be taken

SAMHSA will ensure that new Primary and Behavioral Healthcare Integration grants awarded 

for FY 2016 are funded under the authorities in section 520K of the PHS Act.

Item – Pages 111-112

Community Mental Health Services Block Grant – 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 targets the first episode of psychosis. 

SAMHSA shall not expand the use of the set-aside to programs outside of the first episode
355

psychosis. The Committee directs SAMHSA to include in the fiscal year 2017 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.

Action taken or to be taken

See response to the Omnibus Report Language for “Mental Health Block Grants” on page 347.

Item – Page 113

Oral Fluid Guidelines – The Committee commends SAMHSA for the progress made on issuing 

oral fluid guidelines for the Federal Workplace Drug Testing Programs and supports the 

development of oral fluid as an alternative specimen for drug testing. The Committee urges 

SAMHSA to publish the guidelines expeditiously and to implement the guidelines in partnership 

with stakeholders.

Action taken or to be taken

The Proposed Oral Fluid Mandatory Guidelines for the Federal Workplace Drug Testing 

Programs were published in the Federal Register in May 2015. SAMHSA has reviewed 

comments and revisions have been completed for the issuance/implementation in early 2017. An 

interagency forum and planning meeting was held in September 2015 to discuss the state of the 

science regarding drugged driving testing standards, standard cutoff concentrations for point of 

collection devices, and the feasibility of using oral fluid for roadside testing.

Item – Page 113

Addiction Technology Transfer Centers – The Committee continues to direct SAMHSA to 

ensure that ATTCs maintain a primary focus on addiction treatment and recovery services.

Action taken or to be taken

The ATTCs will continue to maintain primary focus on addiction treatment and recovery.

Item – Page 113

Combating Opioid Abuse – Of the amount provided for Targeted Capacity Expansion, the 

Committee recommendation includes $18,000,000 for discretionary grants to States for the 

purpose of expanding treatment services to those with heroin or opioid dependence. The 

Committee directs CSAT to ensure that these grants include as an allowable use the support of 

medication-assisted treatment and other clinically appropriate services. These grants should 

target States with the highest rates of admissions and that have demonstrated a dramatic increase 

in admissions for the treatment of opioid use disorders.
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Action taken or to be taken

See response to the Omnibus Report Language for “Targeted Capacity Expansion” on page 349.

Item – Pages 113-114

Drug Treatment 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 expects CSAT to ensure that 

non-State substance abuse agency applicants for any drug treatment court grant in its portfolio 

continue to demonstrate extensive evidence of working directly and extensively with the 

corresponding State substance abuse agency in the planning, implementation, and evaluation of 

the grant.

Action taken or to be taken

See response to the Omnibus Report Language for “Criminal Justice Activities” on page 350.

Item – Page 114

Screening, Brief Intervention, and Referral to Treatment – The Committee continues to direct 

SAMHSA to ensure that funds provided for SBIRT are used for existing evidence-based models 

of providing early intervention and treatment services to those at risk of developing substance 

abuse disorders.

Action taken or to be taken

The SBIRT program requires grant recipients to implement the SBIRT model at all levels of 

primary care and medical facilities, including hospitals, trauma centers, Federally Qualified 

Health Centers, and other relevant settings. Research and clinical experience support the use of 

SBIRT to intervene early with alcohol and other substance use disorders, which leads to early 

referral and treatment. SBIRT also identifies individuals with more serious conditions and 

diverts them from costly emergency services to general practitioners. Funds may be used for 

screening of substance use and co-occurring disorders, evidence-based client-centered brief 

interventions such as motivational interviewing, and brief treatment and referral to specialty care 

for individuals exhibiting signs of dependency. Evaluation findings also indicate that the value 

of SBIRT is that it makes an “invisible” clinical issue visible by providing the tools to identify 

and address alcohol and drug use disorders at every point in public health, from primary care to 

specialty care.

Item – Page 114

Substance Abuse Prevention and Treatment Block Grant - To increase transparency, the 

Committee directs SAMHSA to include in their fiscal year 2017 CJ details on where SAMHSA 

acquires the data used for the formula and how SAMHSA utilizes this information to make 

funding level determinations. It is imperative that SAMHSA uses the most recent and accurate
357

data available and should work with States to better understand the best sources for this 

information. SAMHSA shall also include an evaluation on whether the current formula should be

updated in the future.

Action taken or to be taken

The Office of Applied Studies (OAS) at SAMHSA annually determines the allocation of funding 

to states and territories for the Substance Abuse Prevention and Treatment Block Grant (SABG), 

and the Mental Health Services Block Grant (MHBG). The allocations are made in accordance 

with SAMHSA’s legislative authorities. Over time, the underlying bases of the calculations, 

particularly that for SABG and MHBG, have undergone changes primarily because of changes in 

legislation. SAMHSA’s guidebook: Block Grants and Formula Grants: A Guide for Allotment 

Calculations presents the formulas for the SABG and MHBG allotment calculations and reflects 

the rules laid out in the initial legislation or subsequent reauthorizations.

In general, the methodology of allotment determination for the programs involves following 

three common steps: 1) setting aside a certain percentage of the appropriated amount for 

SAMHSA’s use to cover the costs of data collection, technical assistance, and program 

evaluation; 2) calculating baseline allotments based on certain factors; and 3) adjusting the 

allotments, if necessary, so that statutory minimum allotment constraints are satisfied.

For the SABG, state baseline allotment calculations, when warranted, are based on the relative 

share of the Population-at-Risk, Cost-of-Services, and Fiscal Capacity Indexes, while the 

territory allotments are based solely on the relative share of the population. For the MHBG, 

similar factors are used in state and territory allotment calculations, except that the Population-atRisk Index is replaced by the Weighted Population-at-Risk in state baseline allotment 

calculations, and different statutory minimum allotments apply.

It is important to note that baseline allotments are not necessarily the final allotments, and may 

require adjustment so that the statutory minimum allotment constraints are satisfied. Statutory 

minimum allotments vary across calculations and are not the same for state and territories in 

each calculation.

Item – Page 114

Substance Abuse Prevention – The Committee directs that all of the money appropriated 

explicitly for substance abuse prevention purposes in both 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 programs and strategies and not for any other purposes.

Action taken or to be taken

See response to the Omnibus Report Language for “Substance Abuse Prevention” on page 351.
358

Item – Page 115

Combating Opioid Abuse – The Committee provides $6,000,000 for grants to prevent opioid 

overdose related deaths. As part of the new initiative to Combat Opioid Abuse, this new program 

will help States equip and train first responders with the use of devices that rapidly reverse the 

effects of opioids. The Committee directs SAMHSA to ensure applicants outline how proposed 

activities in the grant would work with treatment and recovery communities in addition to first

responders.

Action taken or to be taken

See response to the Omnibus Report Language for “Combating Opioid Abuse” on page 351.

Item – Page 115

Strategic Prevention Framework State Incentive Grant (SPF-SIG) and Partnerships for 

Success (PFS) – The Committee intends that these two programs continue to focus exclusively 

on: addressing State- and community-level indicators of alcohol, tobacco, and drug use; targeting 

and implementing appropriate universal prevention strategies; building infrastructure and 

capacity; and preventing substance use and abuse.

Action taken or to be taken

The SPF-SIG and PFS programs will continue to address the nation’s top emerging substance 

abuse priorities, such as prescription opioid drugs and other opioids, underage drinking, 

marijuana, and intoxicative inhalants using appropriate prevention strategies as well as providing 

support for grantees to strengthen substance abuse prevention infrastructure and capacity using 

the strategic prevention framework. Applicants for the FY 2016 PFS cohort will also be 

encouraged to address these issues or other emergent, data driven substance abuse prevention 

targets. SAMHSA will not use any SPF funds for the Building Behavioral Health Coalitions 

initiative.

Item – Page 115

STOP Act – The Committee directs that all funds appropriated for STOP Act community-based 

coalition enhancement grants, shall be used for making grants to eligible communities, and not 

for any other purposes or activities.

Action taken or to be taken

SAMHSA ensures that the Sober Truth on the Prevention of Underage Drinking Act grant 

program’s funds are used for making grants to eligible communities and not for any other 

purpose or activities.
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Item – Page 116

Behavioral Health Workforce Education and Training – The Committee directs SAMHSA and 

HRSA to ensure that funding is distributed relatively equally among the participating health 

professions, including paraprofessionals, master’s level social workers, counselors, marriage and 

family therapists, and doctoral psychology interns. The Committee directs SAMHSA and HRSA 

to consider other strategies to achieve this relative distribution such as issuing separate funding 

opportunity announcements for each participating health profession. In addition, the Committee 

directs SAMHSA and HRSA to include doctoral psychology schools in the funding opportunities 

to support doctoral level students completing their practicums which are necessary to move on to 

internships. SAMHSA and HRSA shall award meritorious applications for doctoral psychology 

interns first, before doctoral psychology schools applying to support practicums.

Action taken or to be taken

See the response to the Omnibus Report Language for “Behavioral Health Workforce Education 

and Training” on page 353.

FY 2016 House Appropriations Committee Report Language 

(H.Rept. 114-195)

Item – Page 83

Childhood Trauma – The Committee encourages SAMHSA to more broadly disseminate 

information regarding evidence-based interventions for the prevention and treatment of 

childhood trauma so more children can benefit from proven practices.

Action taken or to be taken

See response to the Omnibus Report Language for “Childhood Trauma” on page 349.

Item – Page 83

Mental Health First Aid – The Committee directs SAMHSA to make competitive funding 

opportunities for this program available to all qualified community mental health education 

programs. Consistent with a broad public safety approach, SAMHSA is directed to include as 

eligible grantees local law enforcement agencies, fire departments, emergency medical services 

units and hospital systems. SAMHSA is encouraged to allow training for veterans, armed 

services personnel and their family members within the Mental Health First Aid program.

Action taken or to be taken

Under Project AWARE, Mental Health First Aid funding will promote widespread dissemination 

of the Mental Health First Aid curriculum. Youth Mental Health First Aid prepares teachers and 

other individuals who work with youth to help schools and communities to understand,
360

recognize, and respond to signs of mental illness or substance abuse in children and youth. In 

2014, SAMHSA awarded Mental Health First Aid funds through competitive grants to State 

Education Agencies and Local Education Agencies. Grant recipients will be required to work 

with their respective mental health and juvenile justice counterparts, as well as other communitybased organizations, to ensure that teachers and a broad array of community actors receive 

training in the Youth Mental Health First Aid model.

In FY 2015, SAMHSA awarded $8.6 million in Project AWARE-Community grants. The 

purpose of this program is to support the training of teachers and a broad array of actors who 

interact with youth through their programs at the community level, including parents, law 

enforcement, faith-based leaders, and other adults, in Mental Health First Aid or Youth Mental 

Health First Aid.

Item – Page 84

Tribal Behavioral Health Grant – The Committee expects SAMHSA to ensure that the activities

conducted under the American Indian and Alaskan Native Suicide Prevention program are 

effectively coordinated with the Tribal Behavioral Health Grants. These two grant programs 

must work as an integrated whole to accomplish the goal of reducing suicides and drug abuse 

amongst Native American youth. Prior to the announcement of the TBHG grant opportunities, 

SAMHSA is directed to brief the Committee regarding the criteria for grant awards. Following 

the award of the grants, SAMHSA is directed to provide a briefing within 120 days to review the 

progress made and any unforeseen challenges that arise.

Action taken or to be taken

SAMHSA will work to ensure that that Committee is briefed on the criteria for grant awards of 

the Tribal Behavioral Health Grants prior to the Funding Opportunity Announcement and on 

progress made and any unforeseen challenges that arise post-award.

Item – Page 84

Mental Health Block Grant – The Committee expects SAMHSA to continue its collaboration 

with the National Institute of Mental Health to encourage States to use this block grant funding 

to support programs that demonstrate strong evidence of effectiveness.

Action taken or to be taken

See response to the Omnibus Report Language for “Mental Health Black Grants” on page 347.

Item – Page 85

Addiction Technology Transfer Centers (ATTCs) – The Committee once again rejects the 

Administration’s request to reduce funding for the ATTCs. SAMHSA is directed to ensure that

ATTCs maintain a primary focus on addiction treatment and recovery services.
361

Action taken or to be taken

See response to the Senate Report Language for “Addiction Technology Transfer Centers” on 

page 355.

Item – Pages 85-86

Targeted Capacity Expansion – The Committee expects SAMHSA to provide a briefing within 

45 days of enactment regarding how it intends to execute these activities and carry out the two 

mandates described below.

The United States has seen a 500 percent increase in admissions to treatment for prescription 

drug abuse since 2000. Moreover, according to a recent study, 28 states saw an increase in 

admissions to treatment for heroin dependence during the past two years. The fiscal year 2015 

Consolidated and Further Continuing Appropriations Act provided funding for Targeted 

Capacity Expansion specifically for prescription drug and heroin treatment. 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.

Since the passage of the Drug Addiction Treatment Act of 2000, SAMHSA has led the nation in 

educating physicians, patients and treatment systems on the use of medication-assisted treatment.

To keep pace with advancements in science and research, SAMHSA is directed to update all of 

its public-facing information and treatment locators such that all evidence-based innovations in 

counseling, recovery support, and abstinence-based relapse prevention medication-assisted 

treatments are fully incorporated.

Action taken or to be taken

See response to the Omnibus Report Language for “Targeted Capacity Expansion” on page 349.

Item – Page 86

Drug Treatment 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. SAMHSA is directed 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 SAHMHSA to expand training and technical assistance to drug treatment court grant 

recipients to ensure evidence-based practices are fully implemented.

Action taken or to be taken

See response to the Omnibus Report Language for “Criminal Justice Activities” on pages 350.
362

Item – Page 86

Oral Fluid Drug Testing – The Committee supports the development of oral fluid as an 

alternative specimen for drug testing and commends SAMHSA for the progress made to issue 

oral fluid guidelines for the Federal Workplace Drug Testing Programs. The Committee urges 

SAMHSA to publish the guidelines expeditiously and to implement the guidelines in partnership 

with stakeholders.

Action taken or to be taken

See response to the Senate Report Language for “Oral Fluid Guidelines” on page 355.

Item – Page 87

Mental and Behavioral Health Education and Training Program – The Committee directs 

SAMHSA to share information concerning pending grant opportunity announcements with State 

licensing organizations and all the relevant professional associations.

Action taken or to be taken

See response to the Omnibus Report Language for “Behavioral Health Workforce Education and 

Training” on page 353.
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SAMHSA

SAMHSA-Specific Requirements 

Table of Contents

1. HIV Continuum of Care........................................................................................................ 364
364

HIV Continuum of Care

SAMHSA Strengthening HIV Continuum of Care through Behavioral Health/Substance Abuse 

& Primary Care Integration Grants should show how SAMHSA intends to build new evidence 

and strengthen capacity for rigorous evaluation and data analytics.

The National HIV/AIDS Strategy and Implementation Plan

SAMHSA currently funds projects under the Minority AIDS Initiative (MAI) that implement the 

goals of the National HIV/AIDS Strategy. The Center for Substance Abuse Prevention (CSAP) 

provides funding for substance abuse prevention services and HIV testing programs. The Center 

for Substance Abuse Treatment (CSAT) and the Center for Mental Health Services (CMHS) 

funded projects that support substance abuse/mental health treatment services, HIV testing and 

referral to quality HIV care.

In 2011, SAMHSA joined with the Department of Health and Human Services’ (HHS) Office of

HIV/AIDS and Infectious Disease Policy and other HHS agencies to better coordinate a national 

response to the HIV epidemic under the “HHS 12 Cities Project”. Consistent with this 

coordinated effort, SAMHSA funded 11 cooperative agreements from FY 2011-FY 2014 under 

the Minority AIDS Initiative-Targeted Capacity Expansion: Integrated Behavioral 

Health/Primary Care Network Cooperative Agreements (MAI-TCE Program). The purpose of 

this program is to facilitate the development and expansion of culturally competent and effective 

integrated behavioral health and primary care networks, which include HIV services and medical 

treatment, within racial and ethnic minority communities in the 12 Metropolitan Statistical Areas 

(MSAs) and Metropolitan Divisions (MDs) most impacted by HIV/AIDS.

In FY 2014, SAMHSA’s CMHS, CSAP, and CSAT supported a pilot HIV Continuum of Care 

grant program. The purpose of this jointly funded program is to integrate care (behavioral health 

treatment, prevention, and HIV medical care services) for racial/ethnic minority populations at

high risk for behavioral health disorders and high risk for or living with HIV. This includes 

substance use prevention and treatment service programs, community mental health programs, 

and HIV integrated programs that either can co-locate or have fully integrated HIV prevention 

and medical care services. In addition, this program provides substance use and HIV primary 

prevention services in local communities served by the behavioral health program. Because of 

the significant co-morbidity of viral hepatitis with HIV infection and since viral hepatitis occurs 

in up to 20 percent of those with either substance use disorders or serious mental illness, 

five percent of the allocated funds support services to prevent, screen, test, and refer to treatment

as clinically appropriate those at risk for or living with viral hepatitis.

In FY 2014, SAMHSA’s Centers for Mental Health Services, Substance Abuse Prevention, and 

Substance Abuse Treatment supported the MAI Continuum of Care Pilot (MAI CoC). The 

MAI CoC supports behavioral health screening, primary prevention, and treatment for racial and 

ethnic minority populations with or at high risk for mental and substance use disorders and 

HIV/AIDS. MAI CoC supports substance use disorder (SUD) treatment, primary prevention and 

treatment service programs, community mental health programs, and HIV/AIDS integrated 

programs that either can co-locate or have fully integrated HIV/AIDS prevention and medical 

care services. This program also provides primary prevention services for SUD and HIV/AIDS 

in local communities served by behavioral health programs. In addition, approximately 20
365

percent and 23 percent of those with SMI such as schizophrenia, bipolar disorder, and major 

depression are infected with hepatitis C virus and hepatitis B virus, respectively, while between 

14 and 36 percent of those who misuse alcohol are infected with hepatitis C virus.210,211

SAMHSA supports a consolidated evaluation of its HIV/AIDS programs. This comprehensive 

process and outcome evaluation will assess the degree to which SAMHSA is providing effective 

and efficient mental and substance use disorder services and prevention programs to those with 

and at risk of HIV/AIDS. The evaluation results will help inform program development and 

refine the approach used in SAMHSA’s HIV portfolio.

In FY 2014, SAMHSA awarded 34 four-year HIV Continuum of Care grants and a technical 

assistance contract. In FY 2015, SAMHSA funded the continuation of 34 HIV Continuum of 

Care grants, a technical assistance contract, and awarded a new evaluation contract. In FY 2016, 

SAMHSA supports the continuation of 34 HIV Continuum of Care grants, and evaluation and 

technical assistance contracts.

The primary purpose of the HIV Consolidated Evaluation is to conduct a comprehensive process 

and outcome evaluation of all SAMHSA HIV programs that entails in-depth evaluation 

development and implementation of a cooperative agreement for a period of four years. The 

evaluation results will be used to inform program development and refine the approach used in 

SAMHSA’s HIV portfolio.

Expected outcomes for the HIV Continuum of Care programs include: 1) increased HIV testing 

to identify behavioral health clients who are unaware of their HIV status; 2) increased diagnosis 

of HIV among behavioral health clients; 3) increased number of clients who are linked to HIV 

medical care; 4) increased number of behavioral health clients who are retained in care;

5) increased number of behavioral health clients who are receiving antiretroviral therapy (ART);

6) improved adherence to behavioral treatment and ART; 7) increased number of behavioral 

health clients who have sustained viral suppression; and 8) increased adherence and retention in 

behavioral health (both substance use and mental disorders) treatment.

Data generated from the HIV Continuum of Care grant program will help to inform SAMHSA’s 

efforts to continue the co-location and integration of HIV/primary care with either substance use 

or community mental health treatment programs. By integrating HIV care into behavioral health 

settings, people living with HIV/AIDS and mental and substance use disorders (M/SUDs) will 

have greater access to treatment for these conditions. Integrated care programs developed as a 

result of this grant program will make it possible for behavioral health and HIV care needs to be 

addressed in one setting. This will result in effective, person-centered, treatment that will reduce 

the risk of HIV transmission, improve outcomes for those living with HIV/AIDS, and ultimately 

reduce new infections.

210 Bhattacharya R, Shuhart MC. Hepatitis C and alcohol: interactions, outcomes, and implications. J Clin 

Gastroenterol. 2003; 36(3):242-52. 211 Rosenberg et al. Prevalence of HIV, Hepatitis B, and Hepatitis C in People With Severe Mental Illness. Am J 

Public Health. 2001; 91:(31-37).
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