DEPARTMENT 

of HEALTH 

and HUMAN 

SERVICES 

Fiscal Year 

2023 

Substance use And Mental Health 

Services Administration 

Justification of Estimates for 

Appropriations Committees 
SAMHSA 

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SAMHSA 

Letter from Assistant Secretary 

I am pleased to present the Substance use And Mental Health Services Administration (SAMHSA) fiscal year (FY) 

2023 Budget Request. SAMHSA is requesting a total of $10.7 billion. As the primary federal agency responsible for 

addressing the mental and substance use disorders that affect millions of Americans, SAMHSA takes seriously its 

responsibility to ensure that the best evidence-based care reaches all communities in our nation. Now, more than ever, 

we must ensure individuals living with these conditions gain access to high quality and equitable prevention, 

intervention, treatment, and recovery services. 

SAMHSA’s budget demonstrates a commitment to addressing pressing public health challenges, including the opioids 

crisis and serious mental illness. This budget aligns with the Administration’s priorities to address mental and 

substance use disorders in children, adults, families, and communities. Through a sustained focus on implementing 

evidence-based practices, SAMHSA’s budget aims to improve the lives of people across the United States and its 

territories. 

SAMHSA’s FY 2023 budget request includes investments to: 

• Expand the National Suicide Prevention Lifeline and transform America’s behavioral health crisis care 

system to one that saves lives by serving anyone, at any time, from anywhere across the nation; 

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

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

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

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

naloxone; 

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

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

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

of services through the Community Mental Health Services Block Grant; 

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

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

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

living for those affected by mental and substance use disorders; 

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

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

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

risk for suicide. 

In FY 2023, SAMHSA maintains a strong commitment to enhancing the delivery of clinically sound, evidence-based, 

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

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

SAMHSA does is vital to the health of this country. I am confident this budget supports SAMHSA’s mission to reduce 

the impact of substance use and mental illness on America’s communities. 

Assistant Secretary for 

Substance use And Mental Health Services Administration 

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SAMHSA 

Table of Contents 

Fiscal Year 2023 Budget Page 

Letter from Assistant Secretary ................................................................................................. iii 

Table of Contents ......................................................................................................................... iv 

Organizational Structure ............................................................................................................ vi 

Performance Budget Overview Executive Summary ................................................................ 1 

1. Introduction......................................................................................................................... 1 

2. Mission................................................................................................................................ 1 

3. Overview of Performance ................................................................................................. 14 

4. All-Purpose Table ............................................................................................................. 15 

Budget Exhibits ........................................................................................................................... 16 

1. Appropriation Language ................................................................................................... 17 

2. Language Analysis............................................................................................................ 21 

3. Amounts Available for Obligation.................................................................................... 26 

4. Summary of Changes........................................................................................................ 27 

5. Budget Authority by Activity ........................................................................................... 28 

6. Authorizing Legislation .................................................................................................... 29 

7. Appropriations History ..................................................................................................... 32 

8. Appropriations Not Authorized by Law ........................................................................... 34 

Mental Health.............................................................................................................................. 35 

1. Summary of the Request................................................................................................... 36 

2. Programs of Regional and National Significance (PRNS) ............................................... 37 

3. PRNS Mechanism Table................................................................................................. 117 

4. Grant Awards Table........................................................................................................ 125 

5. Children’s Mental Health Services ................................................................................. 126 

6. Projects for Assistance in Transition from Homelessness.............................................. 132 

7. Protection and Advocacy for Individuals with Mental Illness (PAIMI)......................... 138 

8. Certified Community Behavioral Health Clinic (CCBHC)............................................ 145 

9. Program: Certified Community Behavioral Health Clinic ............................................. 150 

10. Community Mental Health Services Block Grant (MHBG)........................................... 152 

Substance Use Prevention Services ......................................................................................... 169 

1. Summary of the Request................................................................................................. 170 

2. Programs of Regional and National Significance (PRNS) ............................................. 171 

3. PRNS Mechanism Table................................................................................................. 215 

4. Grant Awards Table........................................................................................................ 219 

Substance Use Services ............................................................................................................. 220 

1. Summary of the Request................................................................................................. 221 

2. Programs of Regional and National Significance (PRNS) ............................................. 223 

3. Program: Treatment-Targeted Capacity Expansion: Other ........................................... 237 
SAMHSA-Performance Budget Overview 

4. PRNS Mechanism Table................................................................................................. 283 

5. Grant Awards Table........................................................................................................ 291 

6. State Opioid Response Grants ........................................................................................ 292 

7. Substance Abuse Prevention and Treatment Block Grant.............................................. 300 

Health Surveillance and Program Support ............................................................................ 313 

1. Summary of the Request................................................................................................. 315 

2. Health Surveillance......................................................................................................... 316 

3. Drug Abuse Warning Network (DAWN)....................................................................... 325 

4. Performance and Quality Information Systems.............................................................. 329 

5. Program Support ............................................................................................................. 335 

6. Public Awareness and Support ....................................................................................... 338 

Drug Control Budget ................................................................................................................ 343 

Supplementary Tables.............................................................................................................. 363 

1. Budget Authority by Object Class .................................................................................. 364 

2. Salaries and Expenses..................................................................................................... 373 

3. Details of Full-Time Equivalent Employment................................................................ 375 

4. Detail of Positions........................................................................................................... 376 

5. Physicians’ Comparability Allowance Worksheet ......................................................... 377 

Significant Items........................................................................................................................ 378 

Proposed Law............................................................................................................................ 384 

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SAMHSA 

Organizational Structure 

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SAMHSA-Performance Budget Overview 

Performance Budget Overview Executive Summary 

Introduction 

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

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

communities, and the country. Individuals and families across the nation are struggling with the 

consequences of living with mental and substance use disorders. In 2020, the National Survey on 

Drug Use and Health (NSDUH) data estimated 59.3 million Americans aged 12 or older, or 21.4 

percent, were past year illicit drug users. In addition, an estimated 21.0 percent of adults ages 18 

and older had any mental illness in the past year (52.9 million) and 5.6 percent (14.2 million) of 

adults had serious mental illness. SAMHSA has a unique responsibility to focus on these 

preventable and treatable conditions, which, if unaddressed, lead to significant individual, societal, 

and economic consequences. 

Mission 

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

communities. SAMHSA accomplishes this through providing leadership and resources – 

programs, policies, information and data, funding, and personnel – to advance mental and 

substance use disorder prevention, treatment, and recovery services to improve individual, 

community, and public health. 

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SAMHSA-Performance Budget Overview 

Overview of the Budget Request 

The FY 2023 President’s Budget request is $10.7 billion, an increase of $4.6 billion from the FY 

2022 Annualized Continuing Resolution. 

The budget request aims to address critical national priorities including enhancing access to suicide 

prevention and crisis care, preventing combating the nation’s overdose epidemic and using 

performance measures, data, and evaluation, investing in substance use prevention, and 

implementing strategies to prevent suicide—including critical investments in the National Suicide 

Prevention Lifeline and crisis response infrastructure. 

988 and Behavioral Health Crisis Services 

Suicide and other behavioral health crises are critical public health issues involving multiple 

psychological and social factors. Since 2005, the National Suicide Prevention Lifeline (Lifeline) 

has been providing support to individuals in emotional distress through the number 1-800-273-

TALK. The National Suicide Hotline Designation Act of 2020 designated a new three-digit 

number (988) to ensure easy, universal access to crisis services. By July 16, 2022, individuals will 

be able to access 988 through calls, chats, and texts. 

The creation of 988 is a once-in-a-lifetime opportunity to strengthen and expand the Lifeline and 

transform America’s behavioral health crisis care system to one that saves lives by serving anyone, 

at any time, from anywhere across the nation. SAMHSA sees 988 as the linchpin and catalyst for 

a transformed behavioral health crisis care system in the same way that 911 spurred the growth of 

emergency medical services in the United States. The behavioral health crisis care system that 

SAMHSA envisions aims to: 

• Enhance access to crisis care services for people with suicidal ideations or experiencing 

behavioral health crisis through the use of an easily remembered 3-digit number; 

• Reduce reliance on the police by linking the behavioral health crisis care centers with 

mobile crisis teams; 

• Reduce deadly gaps in the existing Lifeline services by enabling the behavioral health 

crisis care centers to stay in contact and follow up with those in crisis; 

• Relieve emergency room over-crowding/boarding by providing needed evaluation and 

crisis intervention in the community whenever possible; and 

• Better meet the behavioral health care needs of all people experiencing crises in a way 

that reduces stigma and encourages people at risk and their family members to seek help 

in the future. 

The FY 2023 Budget Request for 988 and Behavioral Health Crisis Services is $696.9 million. 

The budget proposes an historic investment in the 988 program to ensure there is sufficient funding 

to support call center response. This funding will consolidate and support the Lifeline 

infrastructure including national back-up services; align with expansion of local crisis capacity 

across the continuum of care; promote ongoing federal direction and leadership through 

coordination, standards setting, technical assistance and evaluation; and facilitate partner 

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engagement, audience research, content and strategy development to ensure that there is public 

awareness of the health benefits of 988, particularly for populations at high risk of suicide. 

Community Mental Health Services Block Grant (MHBG) 

The FY 2023 Budget Request is $1.7 billion, an increase of $895 million from the FY 2022 

Annualized Continuing Resolution. The MHBG addresses the needs of adults with serious mental 

illness (SMI) and children with serious emotional disturbances (SED) and the COVID-19 

pandemic has exacerbated needs for these mental health services. Stress and anxiety about the 

pandemic, coupled with job losses, losses of income, medical insurance, childcare, and the loss of 

loved ones have taken a toll on Americans’ mental health, created new barriers for those seeking 

mental health care, and further increased the need for strategic priorities within the MHBG. 

First, the MHBG budget request maintains the 10 percent set-aside for evidence-based programs 

that address the needs of individuals with early SMI, including psychotic disorders. The set-aside 

helps reduce costs to society, as intervening early helps prevent deterioration of functioning in 

individuals experiencing a first episode of SMI. Second, the MHBG budget request increases the 

set-aside for crisis care from 5 percent to 10 percent. This increase will direct funding to support 

state efforts to build and expand much needed evidence-based crisis systems to address the needs 

of individuals in mental health crisis in a high quality, expeditious manner. Further development 

of these evidence-based crisis systems will promote 24/7 access to well-trained mental health 

professionals in the time of acute mental health crisis. Finally, the MHBG budget request creates 

a new 10 percent set-aside to support evidence-based programs that address early intervention and 

prevention of mental disorders for at-risk youth and adults. States will be required to use this setaside for evidence-based prevention and early intervention programs to improve outcomes for 

youth and adults who are at risk to developing SMI or SED. These programs are expected to 

include early identification and intervention strategies that help to prevent the worsening of SMI 

and SED symptoms, including relapse, and increase protective factors in an individual’s life. With 

these critical investments, the MHBG will continue to serve as an invaluable safety net for mental 

health services for some of the nation’s most vulnerable populations. 

Community Mental Health Centers (CMHCs) 

The FY 2023 Budget Request is $413 million in mandatory funding, an increase of $413 million 

from the FY 2022 Annualized Continuing Resolution. The CMHC program aims to increase 

access to high quality, comprehensive mental health services in communities across the United 

States. The budget directs $4.1 billion in mandatory funding to this program over 10 years. This 

historic investment would further expand the range, quality, and capacity of services in CMHCs, 

building on the $825 million in funding directed to CMHCs in the Coronavirus Response and 

Relief Supplemental Appropriations. The funding will be used to standardize the continuum of 

behavioral health services in CMHCs, incorporating a crisis care continuum (i.e., crisis residential, 

crisis stabilization and mobile crisis teams); integrate care (i.e., integrate screening, treatment, 

and/or referral for substance use disorders with medical care); and deliver recovery support 

services (i.e., case management, peer support, and family support approaches). This proposal 

would ensure that these critical centers have sustainable funding to support the behavioral health 

needs in their communities. 

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SAMHSA-Performance Budget Overview 

Youth Mental Health Activities 

• Project AWARE 

The FY 2023 Budget Request is $244 million, an increase of $137 million from the FY 2022 

Annualized Continuing Resolution. The proposed increase in funding for this program will 

continue to support Project AWARE State Grants, ReCAST grants, and technical assistance 

on the provision of school-based mental health services. This funding will directly support 

training for teachers, parents, first responders, and other adults who interact with youth to 

recognize and respond to the signs of mental health and substance use issues. Additionally, 

this investment in Project AWARE will expand access to broader populations, including 

college students and adults, as well as non-traditional settings. 

• Mental Health Awareness Training 

The FY 2023 Budget Request is $64.0 million, an increase of $40.0 million from the FY 2022 

Annualized Continuing Resolution. The Mental Health Awareness Training (MHAT) grants 

train school personnel, emergency first responders, law enforcement, veterans, armed services 

members, and their families how to recognize the signs and symptoms of mental disorders such 

as serious mental illness and/or serious emotional disturbances. The proposed funding increase 

will support 168 continuation grants and award a new cohort of 325 grants. The budget will 

also expand eligible populations for this program to include college students and adults, and to 

broaden applicable settings for trainings to include non-educational, non-health care settings. 

• Healthy Transitions 

The FY 2023 Budget request is $61.4 million, an increase of $32.0 million from the FY 2022 

Annualized Continuing Resolution. The Healthy Transitions program provides grants to states 

and tribes to improve access to mental disorder treatment and related support services for 

young people aged 16 to 25 who either have, or are at risk of developing, a serious mental 

health condition. This program increases awareness about early indications of signs and 

symptoms for serious mental health concerns; identifies action strategies to use when a serious 

mental health concern is detected; provides training to provider and community groups to 

improve services and supports specific to this age group; enhances peer and family supports, 

and develops effective services and interventions for youth, young adults and their families as 

these young people transition to adult roles and responsibilities. The proposed increase in 

funding will support 18 continuation grants and fund a new cohort of 41 grants. Funding will 

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. 

• National Child Traumatic Stress Network 

The FY 2023 Budget request is $150.0 million, an increase of $78.1 million from the FY 2022 

Annualized Continuing Resolution. Child traumatic stress is a pervasive and potentially life 

changing experience that affects tens of thousands of children each year and is a serious public 

health challenge. This traumatic stress occurs when children and adolescents are exposed to 

traumatic events or traumatic situations that overwhelm their ability to cope with what they 

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SAMHSA-Performance Budget Overview 

have experienced and can interfere with a wide range of childhood developmental capabilities, 

including social and educational functioning. The National Child Traumatic Stress Network 

(NCTSN) a national network of grantees who develop and promote effective community 

practices for children and adolescents exposed to a wide array of traumatic events. Since its 

inception, NCTSN has grown to 140 funded centers and over 160 affiliate (formerly funded) 

centers and individuals located nationwide in universities, hospitals, and a range of diverse 

community-based organizations with thousands of national and local partners. The proposed 

increase in funding will continue to support and further expand the NCTSN efforts to improve 

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

to traumatic events through 120 grant continuations (118 grant from annual appropriation and 

two grants from American Rescue Plan Act) and 171 new grants. 

• Project LAUNCH 

The FY 2023 Budget request is $35.4 million, an increase of $12.0 million from the FY 2022 

Annualized Continuing Resolution. Project Launch promotes 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. It pays particular attention to the social and emotional 

development of young children and works to ensure that the systems that serve them (including 

childcare and education, home visiting, and primary care) are equipped to promote and monitor 

healthy social and emotional development. As of 2021, more than 254,190 children and 

parents have been screened or assessed for behavioral health concerns. The proposed funding 

increase will provide continued screening, prevention, early intervention for behavioral health 

issues and referrals to high quality treatment for children and families in 30 communities across 

the U.S. 

• Children’s Mental Health Services 

The FY 2023 Budget request is $225.0 million, an increase of $100.0 million from the FY 

2022 Annualized Continuing Resolution. In 1992, SAMHSA created the Children’s Mental 

Health Initiative (CMHI) which provides "systems of care" (SOC) for children and youth with 

serious emotional disturbances (SED) and their families. SOC helps prepare children and 

youth for successful transition to adulthood and assumption of adult roles and responsibilities 

by delivering services in the least restrictive environment with evidence-supported treatments 

and interventions. In FY 2018, SAMHSA created the Community Programs for Outreach with 

Youth and Young Adults at Clinical High Risk for Psychosis (CHR-P) to help prevent the 

development of psychosis for youth and young adults who are identified to be at clinical high 

risk for developing a fist episode of psychosis. The proposed funding increase will allow 

SAMHSA to support the continuation of 19 CHR-P grants and award a new cohort of 35 grants. 

In addition, funding will support 48 CMHI continuation grants, a new cohort of 82 CMHI 

grants, and a technical assistance center. 

• Garrett Lee Smith (GLS)- Youth Suicide Prevention-Campus 

The FY 2023 Budget request is $11.5 million, an increase of $5.0 million from the FY 2022 

Annualized Continuing Resolution. The purpose of this program is to develop a 

comprehensive public health and evidence-based approach to enhance mental health services 

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for all college students, including those at risk for suicide, depression, serious mental illness 

(SMI)/serious emotional disturbances (SED), and/or substance use disorders. The proposed 

funding increase will support 62 GLS Campus grants to continue developing and implementing 

youth suicide prevention and early intervention strategies involving public-private 

collaboration among youth serving institutions as well as to support suicide prevention among 

institutions of higher learning. 

• Tribal Behavioral Health Grants (TBHG) 

The FY 2023 Budget request is $23.2 million, an increase of $2.5 million from the FY 2022 

Annualized Continuing Resolution. Consistent with the goals of the Tribal Behavioral Health 

Agenda, the TBHG program addresses the high incidence of substance use and suicide among 

AI/AN populations. The program supports tribal entities with the highest rates of suicide by 

providing effective and promising strategies that address substance use, trauma, and suicide 

and by promoting the mental health of AI/AN young people. The proposed funding increase, 

combined with $23.6 million in the Substance Use Prevention Services, will support technical 

assistance activities, 78 continuation grants and award a new cohort of 38 grants that promote 

mental health and prevent substance use activities for high-risk AI/AN youth and their families. 

• Infant and Early Childhood Mental Health 

The FY 2023 Budget request is $38.0 million, an increase of $30.0 million from the FY 2022 

Annualized Continuing Resolution. The Infant and Early Childhood Mental Health Grant 

Program seeks improve outcomes for children, from birth to 12 years of age, who are at risk 

for, show early signs of, or have been diagnosed with a mental illness, including a serious 

emotional disturbance (SED). The program provides service provision to children and 

families, mental health consultation to early childhood programs such as Head Start, and 

training early childhood providers and clinicians to identify and treat behavioral health 

disorders of early childhood, including in children with a history of in utero exposure to 

substances such as opioids, stimulants or other drugs that may impact development, and 

through the implementation of evidence-based multigenerational treatment approaches that 

strengthen caregiving relationships. The proposed funding increase will increase access to a 

range of evidence-based and culturally appropriate infant and early childhood mental health 

services. Funding will support the continuation of six grants and award a new cohort of 67 

grants to expand access, increase service provision, and improve outcomes for children with 

mental illness, including serious emotional disturbance (SED). 

• Interagency Task Force on Trauma-Informed Care 

The FY 2023 Budget request is $1.0 million, an increase of $1.0 million from the FY 2022 

Annualized Continuing Resolution. The creation of an Interagency Task Force on TraumaInformed Care was mandated in the Substance Use-Disorder Prevention that Promotes Opioid 

Recovery and Treatment for Patients and Communities (SUPPORT) Act of 2018 which 

required SAMHSA to lead an interagency task force in the development of an operating plan 

to implement a National Strategy for Trauma-informed Care. The SUPPORT Act includes a 

bipartisan commitment to supporting children and families who experience trauma and adverse 

childhood experiences (ACEs), including trauma from substance misuse. The Task Force will 

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use the funds to identify, evaluate, and make recommendations regarding: (1) best practices 

for children and families who have experienced trauma or are at risk of experiencing trauma; 

and (2) ways federal agencies can better coordinate responses to families affected by substance 

use disorders and trauma. In addition, the proposed funds will be used to develop a website to 

post best practices of trauma-informed care. 

Primary and Behavioral Health Care Integration (PBHCI) 

The FY 2023 President’s Budget request is $103.0 million, an increase of $50.0 million from the 

FY 2022 Annualized Continuing Resolution. The (PBHCI) program is designed to improve health 

outcomes for people with a serious mental illness (SMI) and co-occurring mental illness and 

drug/alcohol addiction by encouraging grantees to engage in necessary collaboration, expand 

infrastructure, and increase the availability of primary healthcare and wellness services for 

individuals with SMI or co-occurring mental illness and drug/alcohol addiction. The proposed 

funds increase will fund a new cohort of 37 Promoting Integration of Primary and Behavioral 

Health Care (PIPBHC) grants to fully integrate primary and behavioral healthcare, improve 

integrated care models for primary care and behavioral health care, and promote and offer 

integrated care services related to screening, diagnosis, prevention, and treatment of mental and 

substance use disorders, and co-occurring physical health conditions and chronic diseases. The 

increase will also continue to fund the National Center of Excellence for Integrated Health 

Solutions (CIHS) grant which provides high quality, evidence-based treatment for individuals with 

co-occurring physical and mental health conditions, including substance use disorders, as well as 

technical assistance and training for communities, individual practitioners, providers, and states 

on evidence-based and effective strategies to address the integration of primary and mental health 

care for individuals with mental disorders or co-occurring mental and substance use disorders. 

Homeless Programs -Mental Health 

• Homelessness Prevention Programs 

The FY 2023 President’s Budget request is $36.0 million, an increase of $5.0 million from the 

FY 2022 Annualized Continuing Resolution. With this funding, SAMHSA will support 24 

Treatment for Individuals Experiencing Homelessness continuation grants, one Homeless and 

Housing Resource Network continuation grant, and technical assistance activities to increase 

capacity and provide accessible, effective, comprehensive, coordinated, integrated, and 

evidence-based treatment services, peer support and other recovery support services, and 

linkages to sustainable and permanent housing. Grantees will expand access to treatment and 

connect homeless individuals experiencing Serious Mental Illness with safe, secure housing. 

• Projects for Assistance in Transition from Homelessness (PATH) 

The FY 2023 Budget request is $70.0 million, an increase of $5.0 million from the FY 2022 

Annualized Continuing Resolution. The PATH program supports states, the District of 

Columbia, Puerto Rico, Guam, American Samoa, the United States Virgin Islands, and the 

Northern Mariana Islands by bringing individuals with a serious mental illness (SMI) or SMI 

with a co-occurring substance use disorder into the service system and connecting them with 

mainstream resources and supportive services that they need to access and sustain stable 

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housing, build social connections, and access treatment and services to support their recovery. 

The proposed funds increase will be used to establish a pilot program with HUD for PATH 

grantees to partner with public housing agencies, and to encourage grantees to use existing 

PATH outreach and engagement mechanisms to identify, qualify, and select individuals and 

initiate housing support services to meet the individuals’ needs. The pilot program would be 

structured to address chronic homelessness among individuals with SMI through a pairing of 

housing vouchers with linked wraparound recovery supports and mitigate the increased needs 

in states and territories with high rates of homelessness. 

Criminal and Juvenile Justice Programs 

The FY 2023 Budget Request is $56 million, an increase of $50 million from the FY 2022 

Annualized Continuing Resolution. Data indicate that a significant number of individuals who 

come in contact with law enforcement and the criminal justice system have a mental or substance 

use disorder. The proposed increase will address the unmet treatment needs of incarcerated 

individuals and allow these individuals to continue to access services from the same communitybased providers post-incarceration for a seamless transition of care once they are released. The 

needs of individuals returning to society include the social determinants of recovery (i.e., housing, 

employment, access to health care) and other supportive resources for successful transition from 

incarceration. Special importance will be paid towards ensuring a commitment to racial and 

economic justice, trauma-informed approaches, as well as cultural awareness. SAMHSA will also 

improve the response to people with mental illness across local criminal justice and court systems, 

including through specialty mental health court programs, by expanding the number of 

opportunities for diversion for non-violent offenders when appropriate. This funding will help 

people who need treatment get the care they need, decrease recidivism, and increase public safety. 

Minority Fellowship Program 

The FY 2023 Budget Request is $14 million, an increase of $4.0 million from the FY 2022 

Annualized Continuing Resolution. The Minority Fellowship Program (MFP) increases 

behavioral health practitioners’ knowledge of issues related to prevention, treatment, and recovery 

support for mental illness and drug/alcohol addiction among racial and ethnic minority 

populations. The program provides stipends to increase the number of culturally competent 

behavioral health professionals who teach, administer, conduct services research, and provide 

direct mental illness or substance use disorder treatment services for minority populations that are 

underserved. The proposed funding increase will support two continuations and ten new grants, 

which will provide training resources for approximately 6,500 behavioral health providers. 

Practice Improvement and Training 

The FY 2023 Budget Request is $10 million, an increase of $2 million for the FY 2022 Annualized 

Continuing Resolution. Under the Practice Improvement and Training program, SAMHSA funds 

the Historically Black Colleges and Universities- Center for Excellence (HBCU-CFE) grant which 

promotes 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 Clinical Support Services TA Center specifically focuses on the clinical 

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treatment of serious mental illness (SMI), including the use of medications. The proposed funding 

increase will support the continuation of both HBCU-CFE and Clinical Support Services TA 

Center and supplemental funding for the school safety program. 

Certified Community Behavioral Health Clinics (CCBHCs) Expansion Grants 

The FY 2023 Budget Request is $553 million, an increase of $303 million from the FY 2022 

Annualized Continuing Resolution. While effective treatment and supportive services exist, many 

individuals with mental/substance use disorders do not receive the help they need. The CCBHC 

Expansion program is designed to increase access and improve the quality of community mental 

and substance use disorder treatment services by providing comprehensive community-based 

mental and substance use disorder services; treatment of co-occurring disorders; advance the 

integration of mental/substance use disorder treatment with physical health care; assimilate and 

utilize evidence-based practices on a more consistent basis and promote improved access to high 

quality care. This funding will support a new cohort of 226 grants, which will further improve 

access to high-quality mental health services for individuals across the nation. 

State Opioid Response Grants 

The FY 2023 Budget Request is $2.0 billion, an increase of $500 million from the FY 2022 

Annualized Continuing Resolution. Of this amount, $75.0 million is set-aside for tribes. Overdose 

deaths have accelerated during the COVID-19 pandemic. The Centers for Disease Control and 

Prevention (CDC) provisional data estimates more than 104,000 drug overdose deaths in the 

United States in the 12-months ending in September 2021, the highest number ever recorded in a 

12-month period. This grant program aims to address the overdose epidemic by increasing access 

to treatment using FDA-approved medications for the treatment of opioid use disorder (OUD), 

reducing unmet treatment needs, and reducing overdose related deaths through the provision of 

prevention, treatment, and recovery activities for OUD, including prescription opioids, heroin and 

illicit fentanyl, and fentanyl analogs. A primary strategy to reduce overdose deaths in the State 

Opioid Response (SOR) program, that will continue in FY 2023, is education on, and purchase 

and distribution of naloxone, a proven medication that reverses opioid-related overdoses to save 

lives. While some states have reported data indicating challenges accessing low-cost naloxone 

and distribution impediments, as of December 16, 2021, states reported that 3,829,217 naloxone 

kits were distributed, and naloxone was used to reverse approximately 307,956 overdoses. 

Funding is awarded to states and territories via a formula. The program includes a 15 percent setaside for the states with the highest mortality rates related to drug overdose deaths. States and 

communities across the country are also dealing with rising rates of stimulant use and its negative 

health, social, and economic consequences. SAMHSA will continue to support the expansion of 

the SOR grants to include methamphetamine and other stimulants, giving states and tribes 

flexibility to address their unique community needs. In the FY 2022 funding announcement, the 

SOR program will require a comprehensive needs assessment with accompanying strategies to 

include a focus on naloxone distribution and saturation particularly in areas with high rates of 

overdose mortality.1 

1 Irvine MA, Oller D, Boggis J, Bishop B, Coombs D, Wheeler E, Doe-Simkins M, Walley AY, Marshall BDL, Bratberg J, Green TC. Estimating 

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SAMHSA-Performance Budget Overview 

Substance Abuse Prevention and Treatment Block Grant (SABG) 

The FY 2023 Budget Request is $3.0 billion, which is an increase of $1.2 billion from FY 2022 

Annualized Continuing Resolution. This Budget Request builds on investments in the Coronavirus 

Response and Relief Supplemental Appropriations Act and the American Rescue Plan Act. SABG 

helps states in addressing the opioid epidemic and other substance use treatment and prevention 

needs through support of prevention, treatment, and other services (e.g., recovery support services) 

not covered by commercial insurance and non-clinical activities and services that address the 

critical needs of state substance use prevention and treatment service systems. Response to the 

overdose epidemic must encompass a comprehensive range of actions from acute short-term 

individual-focused responses to overdose to long-term, continuous evidence-based treatments and 

broader community recovery responses. Substance use disorder is a chronic illness, and recovery 

often is a life-long process where external community and social determinants of health play a 

vital role in its sustainability. The Budget Request includes a 10 percent set-aside within the SABG 

for recovery support services to significantly expand the upstream and downstream continuum of 

care. The Budget Request also uses HIV cases as opposed to AIDS cases to calculate the HIV-set 

aside. 

Substance use Services Programs of Regional and National Significance (PRNS) 

The FY 2023 Budget Request is $564 million, which is an increase of $70 million above the FY 

2022 Annualized Continuing Resolution. The FY 2023 Budget includes increased funding for 

opioid treatment and recovery support activities, services, naloxone training and distribution, 

services for pregnant and postpartum women, and workforce training to expand access to 

evidence-based treatment and recovery support services. 

Strategic Prevention Framework 

The FY 2023 Budget Request is $127 million, which is an increase of $7 million above the FY 

2022 CR. The increase will support 266 new and continuing PFS grants as well as 30 new and 

continuing SPF Rx grants. 

Federal Drug-Free Workplace 

The FY 2023 Budget Request is $5.1 million, an increase of $245,000 from the FY 2022 

Annualized Continuing Resolution. SAMHSA’s activities related to the Federal Drug-Free 

Workplace support two principal activities mandated by Executive Order (E.O.) 12564 and Public 

Law (P.L.) 10071. This includes: 1) oversight of the Federal Drug-Free Workplace, aimed at the 

elimination of illicit drug use within Executive Branch agencies and the federally regulated 

industries; and 2) oversight of the National Laboratory Certification Program (NLCP), which 

certifies laboratories to conduct forensic drug testing for federal agencies and, federally regulated 

industries. The private sector also uses the HHS certified laboratories. The proposed increase in 

funding will be utilized to implement the new mandatory guidelines for oral fluid and hair in the 

naloxone need in the USA across fentanyl, heroin, and prescription opioid epidemics: a modelling study. Lancet Public Health. 2022 Feb 10:S2468-

2667(21)00304-2. doi: 10.1016/S2468-2667(21)00304-2. Epub ahead of print. PMID: 35151372. 

10 
 

 

 

 

 

 

 

 

 

SAMHSA-Performance Budget Overview 

federally regulated drug testing program. This increase will allow SAMHSA to continue oversight 

of the Executive Branch Agencies’ Federal Drug-Free Workplace programs and to operationalize 

the newly authorized specimen and new drug testing program for oral fluid, a first in over 30 years. 

This will include the review of the Federal Drug-Free Workplace Program and policy changes 

from those federal agencies that perform federal employee drug testing for testing designated 

positions of national security, public health, and public safety including testing for illegal drug use 

and the misuse of prescription drugs. 

Center for the Application of Prevention Technologies 

The FY 2023 Budget Request is $12.0 million, an increase of $5.0 million from the FY 2022 

Annualized Continuing Resolution. In 2019, SAMHSA funded the Prevention Technology 

Transfer Centers (PTTC) cooperative agreements. The purpose of the PTTC Network is to 

improve implementation and delivery of effective substance misuse prevention interventions and 

provide training and technical assistance services to the substance misuse prevention field. This 

is accomplished by developing and disseminating tools and strategies needed to improve the 

quality of substance misuse prevention efforts; providing intensive technical assistance and 

learning resources to prevention professionals to improve their understanding of prevention 

science, epidemiological data, and implementation of evidence-based and promising practices; and 

developing tools and resources to engage the next generation of prevention professionals. The 

increase in funding will support tailored state-of-the-art substance use prevention technical 

assistance to states, communities, Tribes, and territories, to strengthen grantee programs and help 

to advance evidence-based prevention efforts to reduce youth substance use. 

Realigning Programs from Treatment to Prevention 

SAMHSA funds four opioid prevention programs that address the overdose epidemic – the 

Strategic Prevention Framework for Prescription Drugs (SPF-Rx), Grants to Prevent Prescription 

Drug/Opioid Overdose Related Deaths (PDO), First Responder Training for Opioid Overdose 

Reversal Drugs First Responders-Comprehensive Addiction and Recovery Act Grants (FRCARA), and Improving Access to Overdose Treatment (ODTx). These four programs are key 

components of the public health response to the overdose epidemic. They use a combination of 

community-based public health prevention and harm reduction strategies across the prevention 

continuum to mitigate the impact of the overdose epidemic within communities. These 

community-based public health prevention efforts serve high-risk populations outside of substance 

use treatment facilities, primarily individual clients who have been diagnosed with a substance use 

disorder. In 2019, the funding for PDO, FR-CARA, and ODTx programs was realigned from 

Substance Use Prevention Services (CSUPS) to Substance Use Services (CSUS); however, 

CSUPS retained the administration of the programs. Since 2019, the effort to coordinate both the 

administration and the funding across two centers has been challenging. The budget proposes to 

realign these programs back to CSUPS to reduce the administrative burden to manage these 

programs. Realigning the programs will allow CSUPS to optimally manage the programs and 

ensure funding is targeted and complimentary to meeting the needs of the community-based 

organizations leading these critical prevention and harm reduction efforts. 

The FY 2023 Budget Request for the Improving Access to Overdose Treatment (ODTx) program 

is $1.5 million, an increase of $500,000 from the FY 2022 Annualized Continuing Resolution. 

This grant program provides resources to train and support health care providers and pharmacists 

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SAMHSA-Performance Budget Overview 

on the prescribing of FDA approved drugs or devices for the emergency treatment of known or 

suspected opioid overdose. The additional funds will support expanding the resources to an 

additional health care providers and pharmacists. 

The FY 2023 Budget Request for the Grants to Prevent Prescription Drug/Opioid OverdoseRelated Deaths (PDO) program is $18.0 million, an increase of $6 million from the FY 2022 

Annualized Continuing Resolution. This program helps states identify communities of high need 

and provide education, training, and resources necessary to meet their specific needs. 

The FY 2023 Budget Request for First Responder Training for Opioid Overdose-Related Drugs 

(FR-CARA) program is $68.0 million, an increase of $26.0 million from the FY 2022 Annualized 

Continuing Resolution. The FR-CARA program provides funding to state, Tribal and local 

governments to train and equip first responders to administer naloxone. The program to date has 

supported the purchasing and distribution of over 210,000 naloxone kits and has trained nearly 

105,000 first responders who have administered naloxone over 83,000 times. The additional funds 

will support expanding the program to an additional seven communities. 

Health Surveillance and Program Support 

• Health Surveillance 

The FY 2023 Budget Request is $53.3, an increase of $6.0 million from the FY 2022 

Annualized Continuing Resolution. The Health Surveillance funding primarily supports the 

activities of the Center for Behavioral Health Statistics and Quality (CBHSQ). Under Health 

Surveillance, CBHSQ’s work includes Population Data Collection, Analysis, and 

Dissemination; Treatment Services Data Collection, Analysis, and Dissemination; and 

Behavioral Health Data Dissemination. Section 505 of the Public Health Service Act 

(42.U.S.C. 290aa-4) requires SAMHSA to collect data on mental health and substance use 

disorder treatment services. For this purpose, CBHSQ developed the Behavioral Health 

Services Information System (BHSIS). Data collected through BHSIS provides information 

to the public on treatment services through the Behavioral Health Treatment Services Locator, 

which is part of the National Treatment Referral Service. The Locator provides accurate, 

timely, and regularly updated information on mental health and substance use disorder 

treatment facilities across the country. The increase in funding will allow CBHSQ to increase 

the scope of the eligible substance use and mental health treatment facilities for the National 

Substance Use and Mental Health Services Survey (N-SUMHSS), to include certified 

community behavioral health centers (CCBHCs). Expanding the eligible universe of substance 

use and mental health providers will increase access across culturally diverse populations by 

making comprehensive information readily available to the public. This investment will also 

include a needs assessment for determining and addressing gaps of facilities not covered with 

the survey. 

• Program Support 

The FY 2023 Budget Request is $83.3 million, an increase of $4.3 million from the FY 2022 

Annualized Continuing Resolution. The Program Support budget funds SAMHSA staff who 

plan, direct, and administer SAMHSA’s programs, as well as business operations and 

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SAMHSA-Performance Budget Overview 

processes, information technology, and overhead expenses, such as rent, utilities, and 

miscellaneous charges. In addition, this budget supports the Unified Financial Management 

System (UFMS), which covers administrative activities such as human resources, information 

technology, and the centralized services provided by HHS and the Program Support Center. 

The proposed increase in funds will allow SAMHSA to meet projected program administrative 

and operational management costs. 

Drug Abuse Warning Network (DAWN) 

The FY 2023 Budget Request is $20.0 million, an increase of $10.0 million from the FY 2022 

Annualized Continuing Resolution. SAMHSA re-established DAWN in 2018 as a nationwide 

public health surveillance system to monitor emergency department (ED) visits related to recent 

substance use, including those related to opioids. Authorized by the 21st Century Cures Act, 

DAWN provides necessary information such as patient demographic details and substances used 

to respond effectively to the overdose epidemic and addiction crises in the United States and to 

better inform public health, clinicians, policymakers, and other stakeholders to respond to 

emerging substance use trends. This budget proposal will include several important improvements 

for the DAWN program, including timeliness of data, data available at more frequent intervals, 

and data abstracted from a wider range of geographic area types—urban, suburban, and rural. The 

proposed funds increase will be used to build on the existing infrastructure and expand the number 

of surveillance hospital sites and the information DAWN collects from each site to include 

toxicology reports. In addition, the budget request will increase publicly available information 

from DAWN, including data on emerging trends of major metropolitan regions and other 

geographic variables such as urban and rural. 

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SAMHSA-Performance Budget Overview 

Overview of Performance 

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

Substance use And Mental Health Services Administration (SAMHSA) continues to refine its use 

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

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

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

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

overall efficiency. 

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

services programs include diagnoses, abstinence from substance use, mental health functioning, 

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

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

trained, and the number of training events held. 

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

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

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

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

reporting system for all SAMHSA discretionary grantees and allows for programmatic technical 

assistance on use of the data to enhance grantee performance monitoring and improve the qualityof-service delivery. In FY 2018, SAMHSA strengthened its internal evaluation ability through the 

creation of an Office of Evaluation in the Center for Behavioral Health Statistics and Quality. This 

Office partners with the National Mental Health and Substance Use Policy Laboratory to ensure 

that SAMHSA programs are evaluated for effectiveness and that findings related to the most 

effective evidence-based practices to treat mental illness and substance use disorders are 

disseminated to the field. SAMHSA will continue its efforts to improve upon data collection to 

better inform service delivery. 

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SAMHSA-Performance Budget Overview 

All-Purpose Table 

(Dollars in millions)

Account and Program Name 

FY 2021 FY 2022 FY 2023 

 Final/1 COVID-19 

Supplemental/2 CR /3 President's Budget 

President's 

Budget +/- FY 

2022 CR 

CMHS 

Programs of Regional and National Significance................................. $ 556.392 $ 60.000 $ 636.544 $ 1,679.874 $ +1,043.330 

Children's Mental Health Services.................................................. 125.000 -- 125.000 225.000 +100.000 

Set-Aside for Youth in Prodrome Phase of Psychosis (non-add).... 12.500 -- 12.500 22.500 +10.000 

Projects for Assistance in Transition from Homelessness................. 64.635 -- 64.635 69.635 +5.000 

Protection and Advocacy for Individuals with Mental Illness............ 36.146 -- 36.146 36.146 --

Community Mental Health Centers................................................. -- -- -- 412.500 +412.500 

Community Mental Health Services Block Grant............................. 755.571 1,500.000 757.571 1,652.571 +895.000 

Budget Authority (non-add)......................................................... 734.532 1,500.000 736.532 1,631.532 895.000 

PHS Evaluation Funds (non-add)................................................ 21.039 -- 21.039 21.039 --

Certified Community Behavioral Health Clinics............................... 249.249 420.000 250.000 552.500 +302.500 

Total, Mental Health ..................................................................... 1,786.993 1,980.000 1,869.896 4,628.226 +2,758.330 

Budget Authority (non-add)........................................................... 1,753.954 -- 1,836.857 4,182.687 2,345.830 

Prevention and Public Health Fund (non-add)................................ 12.000 -- 12.000 12.000 --

PHS Evaluation Funds (non-add).................................................. 21.039 -- 21.039 21.039 --

Community Mental Health Centers................................................ -- -- -- 412.500 412.500 

CSUPS 

Programs of Regional and National Significance................................. 208.219 -- 208.219 311.912 +103.693 

Subtotal, Programs of Regional and National Significance 208.219 -- 208.219 311.912 +103.693 

Total, Substance Use Prevention.................................................... 208.219 -- 208.219 311.912 103.693 

CSUS 

Programs of Regional and National Significance................................. 495.117 -- 496.677 566.364 +69.687 

PHS Evaluation Funds (non-add)................................................ 2.000 -- 2.000 2.000 --

State Opioid Response Grants........................................................ 1,498.030 -- 1,500.000 2,000.000 +500.000 

Set-Aside for Tribes (non-add).................................................. 50.000 -- 50.000 75.000 +25.000 

Substance Abuse Prevention and Treatment Block Grant.................. 1,849.654 1,500.000 1,858.079 3,008.079 +1,150.000 

Budget Authority (non-add)......................................................... 1,770.454 1,500.000 1,778.879 2,928.879 1,150.000 

PHS Evaluation Funds (non-add)................................................ 79.200 -- 79.200 79.200 --

Total, Substance Use Services........................................................ 3,842.801 1,500.000 3,854.756 5,574.443 +1,719.687 

SAT Budget Authority (non-add).................................................... 3,761.601 -- 3,773.556 5,493.243 1,719.687 

SAT PHS Evaluation Funds (non-add)............................................ 81.200 -- 81.200 81.200 --

Health Surveillance and Program Support 

Health Surveillance and Program Support 125.941 -- 126.258 136.613 10.355 

Congressional Earmarks................................................................. -- -- -- -- --

Data Request and Publications User Fees........................................ 1.500 -- 1.500 1.500 --

Public Awareness and Support....................................................... 12.961 -- 13.000 13.260 +0.260 

Budget Authority (non-add)......................................................... 12.961 -- 13.000 13.260 0.260 

Performance and Quality Information Systems................................. 9.970 -- 10.000 10.200 +0.200 

Budget Authority (non-add)......................................................... 9.970 -- 10.000 10.200 0.200 

Behavioral Health Workforce Data and Development ...................... 1.024 -- 1.000 1.000 --

PHS Evaluation Funds (non-add)................................................ 1.024 -- 1.000 1.000 --

Drug Abuse Warning Network........................................................ 10.000 -- 10.000 20.000 +10.000 

PHS Evaluation Funds (non-add)................................................ -- -- -- --

Community-Based Funding for Local Substance use Disorder Services -- 30.000 -- -- --

Community-Based Funding for Local Behavioral Health Needs........ -- 50.000 -- -- --

COVID-19 Supplemental............................................................... -- 4,250.000 -- -- --

Total, Health Surveillance and Program Support.......................... 161.396 4,250.000 161.758 182.573 +20.815 

HSPS Budget Authority (non-add).................................................. 128.443 4,250.000 128.830 149.645 20.815 

HSPS PHS Evaluation Funds (non-add)......................................... 31.452 -- 31.428 31.428 --

Data Request and Publications User Fees(non-add)....................... 1.500 -- 1.500 1.500 --

TOTAL, SAMHSA Program Level................................................ 5,999.410 7,810.000 6,094.629 10,697.154 +4,602.525 

Nonrecurring Expenses Fund (NEF).............................................. 

Less Funds from Other Sources: 

Community Mental Health Centers............................................. -- -- -- -412.500 -412.500 

Prevention and Public Health Fund (non-add)............................. -12.000 -- -12.000 -12.000 --

PHS Evaluation Funds............................................................... -133.691 -- -133.667 -133.667 --

Data Request and Publications User Fees................................... -1.500 -- -1.500 -1.500 --

TOTAL, SAMHSA Budget Authority............................................. 5,852.218 7,810.000 5,947.462 10,137.487 +4,190.025 

1/ Initial FY 2021 appropriation reduced to fund Secretary's Transfer 

2/ This column includes both supplemental funding and mandatory funds appropriated in the American Rescue Plan Act of 2021, P.L. 117-2 post-transfer and post-reallocation 

and the supplemental appropriation in the Consolidated Appropriations Act, 2021 (P.L. 116-260) 

3/ Reflects the annualized amounts provided in the continuing resolution ending 2/18/2022 

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SAMHSA-Budget Exhibits 

Budget Exhibits 

Table of Contents 

1. Appropriation Language ............................................................................................. 17 

2. Language Analysis...................................................................................................... 21 

3. Amounts Available for Obligation.............................................................................. 26 

4. Summary of Changes.................................................................................................. 27 

5. Budget Authority by Activity ..................................................................................... 28 

6. Authorizing Legislation .............................................................................................. 29 

7. Appropriations History ............................................................................................... 32 

8. Appropriations Not Authorized by Law ..................................................................... 34 

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SAMHSA-Budget Exhibits 

Appropriation Language 

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, $4,182,687,000: Provided 

further, That notwithstanding section 520A(f)(2) of the PHS Act, no funds appropriated for 

carrying out section 520A shall be available for carrying out section 1971 of the PHS Act: 

Provided further, That in addition to amounts provided herein, $21,039,000 shall be available 

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

activities and to carry out subpart I of part B of title XIX of the PHS Act to fund section 1920(b) 

technical assistance, national data, data collection and evaluation activities, and further that the 

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

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

available under this heading for subpart I of part B of title XIX of the PHS Act, not less than 10 

percent shall be used to support evidence-based crisis systems: Provided further, That up to 10 

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

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

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

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

this Act for fiscal year 2023: Provided further, That $552,500,000 shall be available until 

September 30, 2024 for grants to communities and community organizations who meet criteria for 

Certified Community Behavioral Health Clinics pursuant to section 223(a) of Public Law 113–93: 

Provided further, That none of the funds provided for section 1911 of the PHS Act shall be subject 

to section 241 of such Act: Provided further, That of the funds made available under this heading, 

$21,420,000 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 notwithstanding sections 

1911(b) and 1912 of the PHS Act, amounts made available under this heading for subpart I of part 

B of title XIX of such Act shall also be available to support evidence-based programs that address 

early intervention and prevention of mental disorders among at-risk children and adults: Provided 

further, That States shall expend at least 10 percent of the amount each receives for carrying out 

section 1911 of the PHS Act to support evidence-based programs that address early intervention 

and prevention of mental disorders for at-risk youth and adults: Provided further, That 

notwithstanding section 1912 of the PHS Act, the plan described in such section and section 

1911(b) of the PHS Act shall also include the evidence-based programs described in the previous 

proviso pursuant to plan criteria established by the Secretary. 

SUBSTANCE USE SERVICES 

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

XIX of such Act with respect to substance use treatment and prevention, and the SUPPORT for 

Patients and Communities Act, $5,493,243,000: Provided, That $2,000,000,000 shall be for State 

Opioid Response Grants for carrying out activities pertaining to opioids and stimulants 

undertaken by the State agency responsible for administering the substance use prevention and 

treatment block grant under subpart II of part B of title XIX of the PHS Act (42 U.S.C. 300x–21 

et seq.): Provided further, That of such amount $75,000,000 shall be made available to Indian 

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SAMHSA-Budget Exhibits 

Tribes or tribal organizations: Provided further, That 15 percent of the remaining amount shall 

be for the States with the highest mortality rate related to opioid use disorders: Provided further, 

That of the amounts provided for State Opioid Response Grants not more than 2 percent shall be 

available for Federal administrative expenses, training, technical assistance, and evaluation: 

Provided further, That of the amount not reserved by the previous three provisos, the Secretary 

shall make allocations to States, territories, and the District of Columbia according to a formula 

using national survey results that the Secretary determines are the most objective and reliable 

measure of drug use and drug-related deaths: Provided further, That prevention and treatment 

activities funded through such grants may include education, treatment (including the provision 

of medication), behavioral health services for individuals in treatment programs, referral to 

treatment services, recovery support, and medical screening associated with such treatment: 

Provided further, That each State, as well as the District of Columbia, shall receive not less than 

$4,000,000: Provided further, That in addition to amounts provided herein, the following amounts 

shall be available under section 241 of the PHS Act: (1) $79,200,000 to supplement funds 

otherwise available for substance use treatment activities 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 use treatment programs: Provided further, That for 

purposes of calculating the HIV set-aside under subpart II of part B of title XIX, the rate of cases 

of HIV shall be used instead of the rate of cases of AIDS: Provided further, That each State that 

receives funds appropriated under this heading in this Act for carrying out subpart II of part B of 

title XIX of the PHS Act shall expend not less than 10 percent of such funds for recovery support 

services: Provided further, That none of the funds provided for section 1921 of the PHS Act or 

State Opioid Response Grants shall be subject to section 241 of such Act. 

SUBSTANCE USE PREVENTION SERVICES 

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

$311,912,000. 

HEALTH SURVEILLANCE AND PROGRAM SUPPORT 

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

headings "Mental Health", "Substance Use Services", and "Substance Use Prevention Services" 

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 use And Mental Health Administration, 

$149,645,000: Provided, That in addition to amounts provided herein, $31,428,000 shall be 

available under section 241 of the PHS Act to supplement funds available to carry out national 

surveys on drug abuse and mental health, to collect and analyze program data, and to conduct 

public awareness and technical assistance activities: Provided further, That, in addition, fees may 

be collected for the costs of publications, data, data tabulations, and data analysis completed 

under title V of the PHS Act and provided to a public or private entity upon request, which shall 

be credited to this appropriation and shall remain available until expended for such purposes: 

Provided further, That amounts made available in this Act for carrying out section 501(o) of the 

PHS Act shall remain available through September 30, 2023: Provided further, That funds made 

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SAMHSA-Budget Exhibits 

available under this heading may be used to supplement program support funding provided under 

the headings "Mental Health", "Substance Abuse Treatment", and "Substance Abuse Prevention". 

General Provisions 

SEC. 245. (a) The Public Health Service Act (42 U.S.C. 201 et seq.) is amended – 

(1) by striking "Substance Abuse and Mental Health Services Administration" each place it 

appears and inserting "Substance use And Mental Health Services Administration"; 

(2) by striking "Center for Substance Abuse Treatment" each place it appears and inserting 

"Center for Substance Use Services"; and 

(3) by striking "Center for Substance Abuse Prevention" each place it appears and inserting 

"Center for Substance Use Prevention Services". 

(b) Title V of the Public Health Service Act (42 U.S.C. 290aa et seq.) is amended – 

(1) in the title heading, by striking "SUBSTANCE ABUSE AND MENTAL HEALTH 

SERVICES ADMINISTRATION" and inserting "SUBSTANCE USE AND MENTAL HEALTH 

SERVICES ADMINISTRATION"; 

(2) in section 501 – 

(A) in the section heading, by striking "SUBSTANCE ABUSE AND MENTAL HEALTH 

SERVICES ADMINISTRATION" and inserting "SUBSTANCE USE AND MENTAL HEALTH 

SERVICES ADMINISTRATION"; and 

(B) in subsection (a), by striking "(hereafter referred to in this title as the Administration)" and 

inserting "(hereafter referred to in this title as SAMHSA or the Administration)"; 

(3) in section 507, in the section heading, by striking "CENTER FOR SUBSTANCE ABUSE 

TREATMENT" and inserting "CENTER FOR SUBSTANCE USE SERVICES"; 

(4) in section 513(a), in the subsection heading, by striking "CENTER FOR SUBSTANCE 

ABUSE TREATMENT" and inserting "CENTER FOR SUBSTANCE USE SERVICES"; and 

(5) in section 515, in the section heading, by striking "CENTER FOR SUBSTANCE ABUSE 

PREVENTION" and inserting "CENTER FOR SUBSTANCE USE PREVENTION SERVICES". 

(c) Section 1932(b)(3) of the Public Health Service Act (42 U.S.C. 300x–32(b)(3)) is amended in 

the paragraph heading by striking "CENTER FOR SUBSTANCE ABUSE PREVENTION" and 

inserting "CENTER FOR SUBSTANCE USE PREVENTION SERVICES". 

(d) Section 1935(b)(2) of the Public Health Service Act (42 U.S.C. 300x–35(b)(2)) is amended in 

the paragraph heading by striking "CENTER FOR SUBSTANCE ABUSE PREVENTION" and 

inserting "CENTER FOR SUBSTANCE USE PREVENTION SERVICES". 

19 
 

 

SAMHSA-Budget Exhibits 

(e) The Indian Alcohol and Substance Abuse Prevention and Treatment Act of 1986 (25 U.S.C. 

2401 et seq.) is amended by striking "Substance Abuse and Mental Health Services 

Administration" each place it appears and inserting "Substance use And Mental Health Services 

Administration". 

(f) The Social Security Act is amended in sections 1861, 1866F, and 1945 (42 U.S.C. 1395x, 

1395cc–6, 1396w–4) by striking "Substance Abuse and Mental Health Services Administration" 

each place it appears and inserting "Substance use And Mental Health Services Administration". 

(g) Section 105(a)(7)(C)(i)(III) of the Child Abuse Prevention and Treatment Act (42 U.S.C. 

5106(a)(7)(C)(i)(III)) is amended by striking "Substance Abuse and Mental Health Services 

Administration" and inserting "Substance use And Mental Health Services Administration". 

(h) Except as provided in paragraph (2), any reference in any law, regulation, map, document, 

paper, or other record of the United States – 

(1) to the Substance Abuse and Mental Health Services Administration shall be considered to be a 

reference to the Substance use And Mental Health Services Administration; 

(2) to the Center for Substance Abuse Treatment of such Administration shall be treated as a 

reference to the Center for Substance Use Services of such Administration; and 

(3) to the Center for Substance Abuse Prevention of such Administration shall be treated as a 

reference to the Center for Substance Use Prevention Services of such Administration. 

(i) Paragraph (1) shall not be construed to alter or affect section 6001(d) of the 21st Century Cures 

Act (42 U.S.C. 290aa note), providing that a reference to the Administrator of the Substance 

Abuse and Mental Health Services Administration shall be construed to be a reference to the 

Assistant Secretary for Mental Health and Substance Use. 

20 
 

SAMHSA-Budget Exhibits 

Language Analysis 

Language Provision Explanation 

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

Act with respect to mental health, and the Protection 

and Advocacy for Individuals with Mental Illness 

Act, $4,182,687,000: 

Identifies the purpose for which funds 

can be used for mental health. Language 

regarding the National Child Traumatic 

Stress Initiative is removed because a 

separate funding provision is 

unnecessary and duplicative. 

Provided further, That in addition to amounts 

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

under section 241 of the PHS Act to supplement 

funds otherwise available for mental health 

activities and to carry out subpart I of part B of title 

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

assistance, national data, data collection and 

evaluation activities, and further that the total 

available under this Act for section 1920(b) 

activities shall not exceed 5 percent of the amounts 

appropriated for subpart I of part B of title XIX: 

Sets the amount of Public Health Service 

Evaluation Fund dollars allocated to 

supplement the budget authority for 

programs for mental health activities and 

programs authorized under title XIX as 

well as under title III and V. 

Provided further, That of the funds made available 

under this heading for subpart I of part B of title XIX 

of the PHS Act, not less than 10 percent shall be used 

to support evidence-based crisis systems: 

Increases the set-aside in the Community 

Mental Health Services Block Grant for 

crisis services to 10 percent. 

21 
 

SAMHSA-Budget Exhibits 

Language Provision Explanation 

Provided further, That notwithstanding sections Includes a 10-percent set-aside for 

1911(b) and 1912 of the PHS Act, amounts made evidence-based programs that address 

available under this heading for subpart I of part B early intervention and prevention of 

of title XIX of such Act shall also be available to mental disorders for at-risk youth and 

support evidence-based programs that address early adults. 

intervention and prevention of mental disorders 

among at-risk children and adults: Provided further, 

That States shall expend at least 10 percent of the 

amount each receives for carrying out section 1911 

of the PHS Act to support evidence-based programs 

that address early intervention and prevention of 

mental disorders for at-risk youth and adults: 

Provided further, That notwithstanding section 1912 

of the PHS Act, the plan described in such section 

and section 1911(b) of the PHS Act shall also 

include the evidence-based programs described in 

the previous proviso pursuant to plan criteria 

established by the Secretary. 

Provided further, That in addition to amounts Sets the amount of Public Health Service 

provided herein, the following amounts shall be Evaluation Fund dollars allocated to 

available under section 241 of the PHS Act: (1) supplement the budget authority 

$79,200,000 to supplement funds otherwise available for programs and activities 

available for substance abuse treatment activities to authorized under title XIX, titles III and 

carry out subpart II of part B of title XIX of the PHS V, and substance abuse treatment 

Act to fund section 1935(b) technical assistance, activities. 

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; 

Provided further, That for purposes of calculating 

the HIV set-aside under subpart II of part B of title 

XIX, the rate of cases of HIV shall be used instead 

of the rate of cases of AIDS: 

Uses HIV cases as opposed to AIDS 

cases to calculate the HIV set-aside in the 

Substance Abuse Prevention and 

Treatment Block Grant. 

22 
 

 

 

 

 

 

SAMHSA-Budget Exhibits 

Language Provision Explanation 

Provided, That in addition to amounts provided Sets the amount of Public Health Service 

herein, $31,428,000 shall be available under section Evaluation Fund dollars allocated to 

241 of the PHS Act to supplement funds available to supplement the budget authority 

carry out national surveys on drug abuse and mental available for programs and activities 

health, to collect and analyze program data, and to authorized under title XIX, titles III and 

conduct public awareness and technical assistance V. 

activities 

SEC. 245. (a) The Public Health Service Act (42 

U.S.C. 201 et seq.) is amended – 

(1) by striking "Substance Abuse and Mental 

Health Services Administration" each place it 

appears and inserting "Substance use And Mental 

Health Services Administration"; 

Changes the name of the Substance 

Abuse and Mental Health Services 

Administration to the Substance use And 

Mental Health Services Administration. 

Changes the name of the Center for 

Substance Abuse Treatment to the 

Center for Substance Use Services. 

(2) by striking "Center for Substance Abuse 

Treatment" each place it appears and inserting 

"Center for Substance Use Services"; and 

Changes the name of the Center for 

Substance Abuse Prevention to the 

Center for Substance Use Prevention 

(3) by striking "Center for Substance Abuse 

Prevention" each place it appears and inserting 

"Center for Substance Use Prevention Services". 

(b) Title V of the Public Health Service Act (42 

U.S.C. 290aa et seq.) is amended – 

(1) in the title heading, by striking "SUBSTANCE 

ABUSE AND MENTAL HEALTH SERVICES 

ADMINISTRATION" and inserting "SUBSTANCE 

USE AND MENTAL HEALTH SERVICES 

ADMINISTRATION"; 

(2) in section 501 – 

(A) in the section heading, by striking "SUBSTANCE 

ABUSE AND MENTAL HEALTH SERVICES 

ADMINISTRATION" and inserting "SUBSTANCE 

USE AND MENTAL HEALTH SERVICES 

ADMINISTRATION"; and 

(B) in subsection (a), by striking "(hereafter referred 

to in this title as the Administration)" and inserting 

Services. 

23 
 

SAMHSA-Budget Exhibits 

Language Provision Explanation 

"(hereafter referred to in this title as SAMHSA or the 

Administration)"; 

(3) in section 507, in the section heading, by striking 

"CENTER FOR SUBSTANCE ABUSE 

TREATMENT" and inserting "CENTER FOR 

SUBSTANCE USE SERVICES"; 

(4) in section 513(a), in the subsection heading, by 

striking "CENTER FOR SUBSTANCE ABUSE 

TREATMENT" and inserting "CENTER FOR 

SUBSTANCE USE SERVICES"; and 

(5) in section 515, in the section heading, by striking 

"CENTER FOR SUBSTANCE ABUSE 

PREVENTION" and inserting "CENTER FOR 

SUBSTANCE USE PREVENTION SERVICES". 

(c) Section 1932(b)(3) of the Public Health Service 

Act (42 U.S.C. 300x–32(b)(3)) is amended in the 

paragraph heading by striking "CENTER FOR 

SUBSTANCE ABUSE PREVENTION" and inserting 

"CENTER FOR SUBSTANCE USE PREVENTION 

SERVICES". 

(d) Section 1935(b)(2) of the Public Health Service 

Act (42 U.S.C. 300x–35(b)(2)) is amended in the 

paragraph heading by striking "CENTER FOR 

SUBSTANCE ABUSE PREVENTION" and inserting 

"CENTER FOR SUBSTANCE USE PREVENTION 

SERVICES". 

(e) The Indian Alcohol and Substance Abuse 

Prevention and Treatment Act of 1986 (25 U.S.C. 

2401 et seq.) is amended by striking "Substance 

Abuse and Mental Health Services Administration" 

each place it appears and inserting "Substance use 

And Mental Health Services Administration". 

(f) The Social Security Act is amended in sections 

1861, 1866F, and 1945 (42 U.S.C. 1395x, 1395cc– 

6, 1396w–4) by striking "Substance Abuse and 

Mental Health Services Administration" each place 

it appears and inserting "Substance use And Mental 

Health Services Administration". 

24 
 

 

 

 

SAMHSA-Budget Exhibits 

Language Provision Explanation 

(g) Section 105(a)(7)(C)(i)(III) of the Child Abuse 

Prevention and Treatment Act (42 U.S.C. 

5106(a)(7)(C)(i)(III)) is amended by striking 

"Substance Abuse and Mental Health Services 

Administration" and inserting "Substance use And 

Mental Health Services Administration". 

(h) Except as provided in paragraph (2), any 

reference in any law, regulation, map, document, 

paper, or other record of the United States – 

(1) to the Substance Abuse and Mental Health 

Services Administration shall be considered to be a 

reference to the Substance use And Mental Health 

Services Administration; 

(2) to the Center for Substance Abuse Treatment of 

such Administration shall be treated as a reference 

to the Center for Substance Use Services of such 

Administration; and 

(3) to the Center for Substance Abuse Prevention of 

such Administration shall be treated as a reference 

to the Center for Substance Use Prevention Services 

of such Administration. 

(i) Paragraph (1) shall not be construed to alter or 

affect section 6001(d) of the 21st Century Cures Act 

(42 U.S.C. 290aa note), providing that a reference 

to the Administrator of the Substance Abuse and 

Mental Health Services Administration shall be 

construed to be a reference to the Assistant 

Secretary for Mental Health and Substance Use. 

25 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

SAMHSA-Budget Exhibits 

Amounts Available for Obligation 

(Whole dollars) 

FY 2021 

Final 

FY 2022

 CR 

FY 2022 

President's 

Budget 

General Fund Discretionary Appropriation: 

Appropriation ................................................................ $5,852,218,000 $5,947,462,000 $10,137,487,000 

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

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

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

---

5,852,218,000 

5,852,218,000 

---

5,947,462,000 

5,947,462,000 

---

10,137,487,000 

10,137,487,000 

Subtotal, adjusted appropriation.................................. 5,852,218,000 5,947,462,000 10,137,487,000 

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

Mandatory Appropriation: 

5,852,218,000 5,947,462,000 10,137,487,000 

Transfer from the Prevention and Public Health Funds 12,000,000 12,000,000 12,000,000 

Community Mental Health Centers (CMHC)................ --- --- 412,500,000 

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

Offsetting collections from: 

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

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

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

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

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

12,000,000 

133,667,000 

1,500,000 

---

---

---

12,000,000 

133,667,000 

1,500,000 

---

---

---

424,500,000 

133,667,000 

1,500,000 

---

---

---

Total obligations........................................................... $5,999,385,000 $6,094,629,000 $10,697,154,000 

26 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

SAMHSA-Budget Exhibits 

Summary of Changes 

2022 CR..................................................................................................................................................................... 

Total estimated budget authority................................................................................................................................ $5,947,462,000 

(Obligations).............................................................................................................................................................. 

2023 President's Budget............................................................................................................................................. 

5,947,462,000 

Total estimated budget authority................................................................................................................................ 10,137,487,000 

(Obligations).............................................................................................................................................................. 10,137,487,000 

Net Change.............................................................................................................................................................. +$4,190,025,000 

Increases: 

A. Built-in: 

1. Annualization of 2022 commissioned corps pay increase.... 

2. Annualization of 2022 civilian pay increase........................ 

Subtotal, Built-in Increases................................................. 

A. Program: 

FY 2022 FY 2022 FY 2023 

FY 2023 

+/-

FY 2022 

FY 2023 

+/-

FY 2022 

CR PB FTE PB BA FTE BA 

$6,334,569 

93,169,919 

---

---

$6,477,097 ---

---

+142,528 

95,280,218 +2,110,299 

99,504,488 --- 101,757,315 --- +2,252,827 

1. Mental Health....................................................................... 1,836,857,000 81 4,182,687,000 77 +2,345,830,000 

2. Substance Use Prevention..................................................... 208,219,000 --- 311,912,000 --- +103,693,000 

3.Substance Use Services......................................................... 3,773,556,000 131 5,493,243,000 122 +1,719,687,000 

4. Health Surveillance and Program Support............................ 

Subtotal, Program Increases............................................... 

Total Increases................................................................. 

Decreases: 

A. Built-in: 

128,830,000 438 149,645,000 526 +20,815,000 

5,947,462,000 650 10,137,487,000 725 +4,190,025,000 

--- --- --- +4,192,277,827 

1. Absorption of built-in increases .......................................... 

Subtotal, Built-in Decreases................................................ 

B. Program: 

1. Grants to Prevent Prescription Drug/Opioid Overdose-

 Related Deaths 

2. First Responder Training (CARA)....................................... 

3. Substance Use Prevention..................................................... 

4.Substance Use Services......................................................... 

Subtotal, Program Decreases............................................. 

Total Decreases................................................................ 

Net Change.................................................................... 

--- -2,252,827 

---

---

---

---

---

---

---

---

---

---

---

---

---

$---

---

---

---

---

---

---

$---

---

---

---

---

---

---

---

$---

-2,252,827 

---

---

---

---

---

-2,252,827 

+$4,190,025,000 

27 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

SAMHSA-Budget Exhibits 

Budget Authority by Activity 

FY 2021 

Final FY 2022 CR 

FY2023 

President's 

Budget 

Mental Health 

Programs of Regional and National Significance.................... 

Children's Mental Health Services...................................... 

Set-Aside for Youth in Prodrome Phase of Psychosis (non-add) 

Projects for Assistance in Transition from Homelessness..... 

Protection and Advocacy for Individuals with Mental Illness 

Community Mental Health Centers (CMHC)....................... 

Community Mental Health Services Block Grant................ 

Budget Authority (non-add)......................................................... 

PHS Evaluation Funds (non-add)................................................ 

Certified Community Behavioral Health Clinics.................. 

Total, Mental Health ........................................................ 

Substance Use Prevention 

$556,392 

125,000 

12,500 

64,635 

36,146 

--

755,571 

734,532 

21,039 

249,249 

$636,544 

125,000 

12,500 

64,635 

36,146 

--

757,571 

736,532 

21,039 

250,000 

$1,679,874 

225,000 

22,500 

69,635 

36,146 

412,500 

1,652,571 

1,631,532 

21,039 

552,500 

1,786,993 1,869,896 4,628,226 

Programs of Regional and National Significance.................... 208,219 208,219 311,912 

Total, Substance Use Prevention....................................... 

Substance Use Services 

208,219 208,219 311,912 

Programs of Regional and National Significance.................... 495,117 496,677 566,364 

State Opioid Response Grants........................................... 1,498,030 1,500,000 2,000,000 

Set-Aside for Tribes (non-add)................................................. 50,000 50,000 75,000 

Substance Abuse Prevention and Treatment Block Grant..... 1,849,654 1,858,079 3,008,079 

Budget Authority (non-add)......................................................... 1,770,454 1,778,879 2,928,879 

PHS Evaluation Funds (non-add)................................................ 

Total, Substance Use Services........................................... 

Health Surveillance and Program Support 

Health Surveillance and Program Support 

Subtotal, Health Surveillance and Program Support 

79,200 79,200 79,200 

3,842,801 

125,941 

3,854,756 

126,258 

5,574,443 

136,613 

125,941 126,258 136,613 

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

Public Awareness and Support.......................................... 12,961 13,000 13,260 

Performance and Quality Information Systems.................... 9,970 10,000 10,200 

Behavioral Health Workforce Data and Development ......... 1,024 1,000 1,000 

PHS Evaluation Funds (non-add)................................................ 1,024 1,000 1,000 

Drug Abuse Warning Network........................................... 

Total, Health Surveillance and Program Support.............. 

10,000 10,000 20,000 

161,396 161,758 182,573 

TOTAL, SAMHSA Program Level.................................................. 5,999,410 6,094,629 10,697,154 

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

Less Funds from Other Sources: 

Community Mental Health Centers (CMHC).............................. -- -- -412,500 

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

PHS Evaluation Funds................................................................. -133,691 -133,667 -133,667 

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

TOTAL, SAMHSA Budget Authority.............................................. $5,852,219 $5,947,462 $10,137,487 

FTEs 472 650 725 

28 
 

 

 

 

 

 

 

 

 

 

 

SAMHSA-Budget Exhibits 

Substance use And Mental Health Services Administration 

Authorizing Legislation 

Activity 

FY 2022 Amount 

Authorized 

FY 2022 Amount 

Appropriated 

FY 2023 

Amount 

Authorized 

FY 2023 

President's 

Budget 

1. Grants for the Benefit of Homeless 

PHS Act, Section 506............................................. 

2. Residential Substance Use Services Programs for 

Pregnant and Postpartum Women

PHS Act, Section 508............................................. 

3. Priority Substance Use Services Needs of 

Regional and National Significance 

PHS Act, Section 509............................................. 

4. Substance Use Services for Children and 

Adolescents 

PHS Act, Section 514............................................. 

5. Priority Substance Use Prevention Needs of 

Regional and National Significance 

PHS Act, Section 516................................................ 

6. Sober Truth on Preventing Underage Drinking 

PHS Act, Section 519B.............................................. 

7. Priority Mental Health Needs of Regional and 

National Significance 

PHS Act, Section 520A............................................. 

8. Suicide Prevention Technical Assistance Center 

PHS Act, Section 520C.............................................. 

9. Youth Suicide Early Intervention and Prevention 

Strategies 

PHS Act, Section 520E.............................................. 

10. Mental Health and Substance Use Disorder 

Services on Campus 

PHS Act, Section 520E-2........................................... 

11. 988 and Behavioral Health Crisis Services 

PHS Act, Section 520A............................................. 

$ 41,304,000 

 $ 29,931,000 

$ 333,806,000 

$ 29,605,000 

$ 211,148,000 

$ 7,000,000 

$ 394,550,000 

$ 5,988,000 

$ 30,000,000 

$ 7,000,000 

$ -

$ 36,386,000 

 $ 32,931,000 

$ 496,677,000 

$ 29,605,000 

$ 208,219,000 

$ 10,000,000 

$ 636,544,000 

$ 9,000,000 

$ 36,427,000 

$ 6,488,000 

$ -

$ -

 $ 29,931,000 

$ -

$ -

$ -

$ -

$ -

$ -

$ -

$ -

$ -

$ 37,114,000 

 $ 49,397,000 

$ 568,364,000 

$ 30,197,000 

$ 299,167,000 

$ 10,000,000 

$ 1,191,456,000 

$ 9,000,000 

$ 36,427,000 

$ 6,488,000 

$ 669,901,000 

29 
 

 

 

 

 

 

 

 

SAMHSA-Budget Exhibits 

Authorizing Legislation (continued) 

Activity 

FY 2022 

Amount 

Authorized 

FY 2022 

Amount 

Appropriated 

FY 2023 

Amount 

Authorized 

FY 2023 

President's 

Budget 

12. Grants for Jail Diversion Programs 

PHS Act, Section 520G.............................................. 

13. Mental Health Awareness Training 

PHS Act, Section 520J............................................... 

14. Integration Incentive Grants and Cooperative 

Agreements 

PHS Act, Section 520K.............................................. 

15. Adult Suicide Prevention 

PHS Act, Section 520L.............................................. 

16. Assertive Community Treatment Grant Program 

PHS Act, Section 520M............................................. 

17. Projects for Assistance in Transition From 

Homelessness 

PHS Act, Sections 521-535(a).................................... 

18. First Responder Training 

PHS Act, Section 546................................................ 

19. Building Communities of Recovery 

PHS Act, Section 547................................................ 

20. Community Mental Health Services for Children 

with Serious Emotional Disturbances 

PHS Act, Sections 561-565(ff)................................... 

21. Grants to Address the Problems of Persons Who 

Experience Violence Related Stress 

PHS Act, Section 582................................................ 

$ 

$ 

$ 

$ 

$ 

$ 

$ 

$ 

$ 

$ 

4,269,000 

14,693,000 

51,878,000 

30,000,000 

5,000,000 

64,635,000 

36,000,000 

5,000,000 

119,026,000 

63,887,000 

$ 6,269,000 

$ 23,963,000 

$ 54,868,000 

$ 23,200,000 

$ 9,000,000 

$ 64,635,000 

$ 42,000,000 

$ 10,000,000 

$ 125,000,000 

$ 71,887,000 

$ -

$ -

$ -

$ -

$ -

$ -

$ 36,000,000 

$ 5,000,000 

$ -

$ 63,887,000 

$ 51,394,000 

$ 35,945,000 

$ 54,868,000 

$ 23,200,000 

$ 9,000,000 

$ 64,635,000 

$ 63,000,000 

$ 20,000,000 

$ 125,000,000 

$ 81,887,000 

30 
 

 

 

 

 

SAMHSA-Budget Exhibits 

Authorizing Legislation (continued) 

Activity 

FY 2022 

Amount 

Authorized 

FY 2022 

Amount 

Appropriated 

FY 2023 

Amount 

Authorized 

FY 2023 

President's 

Budget 

22. Community Mental Health Services Block Grants 

PHS Act, Section 1911-1920...................................... 

23. Substance Abuse Prevention and Treatment Block 

Grants 

PHS Act, Section 1921-1935...................................... 

24. Assisted Outpatient Treatment Grant Program for 

Individuals With SMI 

Section 224 of the Protecting Access to Medicare Act 

of 

2014......................................................... 

25. Protection and Advocacy for Individuals with 

Mental Illness* 

Section 117 of the Protection and Advocacy of 

Mentally Ill Individuals Act of 1986..................... 

26. Heath Surveillance 

PHS Act, Section 501, 505......................................... 

27. Public Awareness and Support

PHS Act, Section 501, 509, 516, 520A........................ 

28. Performance and Quality Improvement Systems

PHS Act, Section 501, 509, 516, 520A........................ 

$ 532,571,000 

$ 1,858,079,000 

$ 18,000,000 

$ -

Permanent 

 Indefinite

 Indefinite

$ 757,571,000 

$ 1,858,079,000 

$ 21,000,000 

$ 36,146,000 

$ 126,258,000 

 $ 13,000,000 

 $ 10,000,000 

$ -

$ -

$ -

$ -

$ 130,913,000 

 $ 13,260,000 

 $ 10,200,000 

$ 1,582,571,000 

$ 2,833,244,000 

$ 21,420,000 

$ 36,146,000 

$ 130,913,000 

 $ 13,260,000 

 $ 10,200,000 

29. Drug Abuse Warning Network 

PHS Act, Section 505................................................ 

Permanent $ 10,000,000 $ 15,000,000 $ 15,000,000 

* Sunset date: 2003 

31 
SAMHSA-Budget Exhibits 

Appropriations History 

Appropriation History Table 

Budget Estimate Senate 

to Congress House Allowance Allowance Appropriation 

FY 2014 

General Fund Appropriation: 

Base S.R. 113-071......................................................................... $3,347,951,097 --- $3,529,944,000 $3,434,935,000 /1 

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

FY 2015 

General Fund Appropriation: 

Base P.L. 113-235......................................................................... $3,297,669,000 --- $3,431,878,000 $3,474,045,000 /2 

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

FY 2016 

General Fund Appropriation: 

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

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

FY 2017 

General Fund Appropriation: 

21st Century Cures Act.................................................................. $500,000,000 /4 

Base P.L. 115-31........................................................................... $3,488,783,000 $4,211,603,000 $3,739,577,000 $3,611,003,000 /5 

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

FY 2018 

General Fund Appropriation: 

21st Century Cures Act.................................................................. $500,000,000 /6 

Base P.L. 115-141......................................................................... $3,770,668,000 $4,193,936,000 $4,279,092,000 $4,513,327,000 /7 

Subtotal.......................................................................................... $3,770,668,000 $4,193,936,000 $4,279,092,000 $5,013,327,000 

FY 2019 

General Fund Appropriation: 

Base P.L. 115-245......................................................................... $3,425,887,000 $5,319,561,000 $5,592,827,000 $5,596,829,000 /8 

Subtotal.......................................................................................... $3,425,887,000 $5,319,561,000 $5,592,827,000 $5,596,829,000 

FY 2020 

General Fund Appropriation: 

CARES Act P.L. 116-136.............................................................. --- --- --- $425,000,000 /9 

Base P.L. 116-94........................................................................... $5,534,908,000 $5,870,996,000 $5,856,496,000 $5,736,829,000 /10 

Subtotal.......................................................................................... $5,534,908,000 $5,870,996,000 $5,856,496,000 $5,736,829,000 

FY 2021 

General Fund Appropriation: 

American Rescue Plan Act of 2021 P.L. 117-2............................. --- --- --- $3,560,000,000 /11 

Coronavirus Emergency Reponse and Relief Act P.L. 116-260.... --- --- --- $4,250,000,000 /11 

Base P.L. 116-260......................................................................... $5,597,651,000 $5,830,829,000 $5,853,840,000 $5,869,841,000 /12 

Subtotal.......................................................................................... $5,597,651,000 $5,830,829,000 $5,853,840,000 $13,679,841,000 

32 
SAMHSA-Budget Exhibits 

Appropriations History 

Appropriation History Table (cont'd) 

Budget Estimate Senate 

to Congress House Allowance Allowance Appropriation 

FY 2022 

General Fund Appropriation: 

Base............................................................................................... $9,586,844,000 $8,943,945,000 $8,957,412,000 $5,947,462,000 /13 

Subtotal.......................................................................................... $9,586,844,000 $8,943,945,000 $8,957,412,000 $5,947,462,000 

FY 2023 

General Fund Appropriation: 

Base............................................................................................... $10,137,487,000 --- --- /14 ---

Subtotal.......................................................................................... $10,137,487,000 --- --- ---

1/ Reflects the whole year appropriation. 

2/ Reflects the whole year appropriation. 

3/ Reflects the whole year appropriation. 

4/ Reflects the additional amount provided to the Secretary of Health and Human Services to carry out the authorizations in the 21st Century Cures Act (Public Law 114–67), at a rate for operations of 

$500,000,000. 

5/ Reflects the whole year appropriation. 

6/ Reflects the additional amount provided to the Secretary of Health and Human Services to carry out the authorizations in the 21st Century Cures Act (Public Law 114–67), at a rate for operations of 

$500,000,000. 

7/ Reflects the Annualized Continuing Resolution. 

8/ Reflects the whole year approation 

9/ Reflects supplemental fundig. 

10/ Reflects the whole year approation 

11/ Reflects supplemental fundig. 

12/ Reflects the whole year approation 

13/ Reflects the Annualized Continuing Resolution. 

14/ Reflects the whole year approation 

33 
 

 

SAMHSA-Budget Exhibits 

Appropriations Not Authorized by Law 

Appropriations in 

Last Year of Authorization Last Year of Appropriations 

Program Authorization Level Authorization in FY 2022 

Protection and Advocacy for Individuals with Mental Illness Act 

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

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

34 
 

 

SAMHSA-Mental Health 

Mental Health 

Table of Contents 

1. Summary of the Request................................................................................................... 36 

2. Programs of Regional and National Significance (PRNS) ............................................... 37 

a) National Child Traumatic Stress Network............................................................ 38 

b) Project AWARE.................................................................................................... 42 

c) Mental Health Awareness Training ...................................................................... 45 

d) Healthy Transitions............................................................................................... 47 

e) Children and Family Programs ............................................................................. 50 

f) Consumer and Family Network Grants ................................................................ 52 

g) Project LAUNCH.................................................................................................. 54 

h) Mental Health System Transformation and Health Reform ................................. 58 

i) Primary and Behavioral Health Care Integration.................................................. 61 

j) Suicide Prevention Programs................................................................................ 65 

k) Homelessness Prevention Programs ..................................................................... 80 

l) Minority AIDS...................................................................................................... 83 

m) Criminal and Juvenile Justice Programs............................................................... 86 

n) Practice Improvement and Training...................................................................... 90 

o) Consumer and Consumer-Supporter TA Centers ................................................. 92 

p) Disaster Response ................................................................................................. 94 

q) Seclusion and Restraint......................................................................................... 96 

r) Assisted Outpatient Treatment for Individuals with Serious Mental Illness ...... 101 

s) Tribal Behavioral Health Grants......................................................................... 106 

t) Minority Fellowship Program............................................................................. 109 

u) Infant and Early Childhood Mental Health......................................................... 111 

v) Interagency Task Force on Trauma-Informed Care............................................ 115 

3. PRNS Mechanism Table................................................................................................. 117 

4. Grant Awards Table........................................................................................................ 125 

5. Children’s Mental Health Services ................................................................................. 126 

6. Projects for Assistance in Transition from Homelessness.............................................. 132 

7. Protection and Advocacy for Individuals with Mental Illness (PAIMI)......................... 138 

8. Community Mental Health Centers (CMHC)................................................................. 143 

9. Certified Community Behavioral Health Clinic (CCBHC)............................................ 145 

10. Community Mental Health Services Block Grant (MHBG)........................................... 152 

35 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

SAMHSA-Mental Health 

Mental Health 

Summary of the Request 

(Dollars in thousands) 

FY 2021 FY 2022 FY 2023 

Final COVID-19 

Supplemental/1 

CR President's 

Budget 

FY 2023 +/-

FY 2022 

Programs of Regional and National Significance........................ 

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

Children's Mental Health Services............................................. 

Projects for Assistance in Transition From Homelessness......... 

Protection and Advocacy For Individuals with Mental Illness... 

Certified Community Behavioral Health Clinics........................ 

Community Mental Health Centers.............................................. 

Community Mental Health Services Block Grant........................ 

PHS Evaluation Funds (non-add).......................................... 

$556,392 

12,000 

125,000 

64,635 

36,146 

249,249 

---

755,571 

21,039 

$170,000 

---

---

---

---

1,020,000 

---

3,150,000 

---

$636,544 

12,000 

125,000 

64,635 

36,146 

250,000 

---

757,571 

21,039 

$1,679,874 

12,000 

225,000 

69,635 

36,146 

552,500 

412,500 

1,652,571 

21,039 

$1,043,330 

---

100,000 

5,000 

---

302,500 

412,500 

895,000 

---

Total, Mental Health................................................................ 1,786,993 4,340,000 1,869,896 4,628,226 2,758,330 

FTE............................................................................................ 81 77 

1/Supplemental funding was appropriated under HSPS but funds were allocated to Mental Heatlth to execute. 

The Mental Health FY 2023 President’s Budget request is $4.2 billion, an increase of $2.3 billion 

from the FY 2022 Annualized Continuing Resolution. 

SAMHSA’s Center for Mental Health Services (CMHS) manages over 40 formula and 

discretionary grant programs with approximately 2,500 grantee programs throughout the US. The 

programming, which covers the lifespan, funds interventions in the full range of the public health 

model, from mental health promotion, through prevention, case identification/screening, early 

intervention, treatment, and recovery support services. There is a strong emphasis on increasing 

access to quality mental health treatment and recovery services. A portion of CMHS’ 

programming, particularly the programming focused on mental health promotion, prevention, and 

case identification, apply to children and adults experiencing Any Mental Illness (AMI) and to 

mental wellness. However, much of the programming is targeted towards supporting and treating 

adults with Serious Mental Illness (SMI) and children with Serious Emotional Disturbance (SED). 

CMHS’s grant programs support direct services, infrastructure development, capacity building, 

and technical assistance to enhance the behavioral health system for all Americans. Several grant 

programs involve multiple systems beyond the behavioral health system, such as the primary 

healthcare, school, child welfare, criminal and juvenile justice, and housing systems. Because of 

the complexity of the issues covered in the multiple-system grant programs, CMHS collaborates 

with federal partners to ensure alignment. This inter-agency collaboration also contributes to 

SAMHSA’s overall efforts to address the need for an integrated, comprehensive crisis response 

and intervention system, as charged by Congress. In addition, CMHS’s grant programs are also 

integral to SAMHSA’s core near-term priorities to promote access to suicide prevention and the 

HHS Strategic Plan FY 2022-2026 objectives to bolster the health workforce, strengthen early 

childhood development and expand opportunities, expand access to high-quality services and 

resources, support those who have experienced trauma or violence, and prioritize evidence-based 

practices. 

36 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

SAMHSA-Mental Health 

Mental Health 

Programs of Regional and National Significance (PRNS) 

(Dollars in thousands) 

 Programs of Regional & National Significance 

FY 2021 FY 2022 FY 2023

Final 

COVID-19 

Supplemental /1 CR 

President's 

Budget /2 

FY 2023 +/- 

FY 2022 

Capacity 

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

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

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

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

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

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

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

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

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

MH System Transformation and Health Reform................................... 

Primary and Behavioral Health Care Integration.................................. 

Suicide Prevention Programs................................................................ 

988 and Behavioral Health Crisis Services .................................... 

Suicide Lifeline................................................................................. 

National Strategy for Suicide Prevention........................................ 

Zero Suicide (non-add).................................................................. 

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

All Other NSSP (non-add)............................................................. 

GLS - Youth Suicide Prevention - States.......................................... 

Budget Authority (non-add)........................................................... 

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

GLS - Youth Suicide Prevention - Campus...................................... 

GLS - Suicide Prevention Resource Center..................................... 

AI/AN Suicide Prevention Initiative................................................. 

Homelessness Prevention Programs..................................................... 

Minority AIDS...................................................................................... 

Criminal and Juvenile Justice Programs............................................... 

Seclusion & Restraint........................................................................... 

Assisted Outpatient Treatment for Individuals with SMI...................... 

Assertive Community Treatment for Individuals with SMI................... 

Tribal Behavioral Health Grants.......................................................... 

Infant and Early Childhood Mental Health............................................ 

Interagency Task Force on Trauma-Informed Care............................... 

Subtotal, Capacity 

$71,671 

105,118 

92,618 

12,500 

23,963 

29,451 

7,229 

4,971 

23,509 

3,779 

52,377 

102,046 

---

24,000 

23,200 

21,200 

2,400 

2,000 

36,427 

24,427 

12,000 

6,488 

9,000 

2,931 

30,741 

9,224 

6,269 

1,147 

20,937 

9,000 

20,881 

8,096 

--

530,408 

$20,000 

80,000 

---

---

---

---

---

---

---

---

---

70,000 

---

32,000 

18,000 

---

---

---

17,600 

---

---

2,400 

---

---

---

---

---

---

---

---

---

---

---

170,000 

$71,887 

107,001 

94,501 

12,500 

23,963 

29,451 

7,229 

4,954 

23,605 

3,779 

52,877 

179,667 

---

101,621 

23,200 

21,200 

2,400 

2,000 

36,427 

24,427 

12,000 

6,488 

9,000 

2,931 

30,696 

9,224 

6,269 

1,147 

21,000 

9,000 

20,750 

8,000 

---

610,499 

$150,000 

244,000 

225,250 

18,750 

64,000 

61,400 

7,229 

4,954 

35,408 

3,779 

102,877 

779,947 

696,901 

--

23,200 

21,200 

2,400 

2,000 

36,427 

24,427 

12,000 

11,488 

9,000 

2,931 

35,696 

9,224 

56,394 

1,147 

21,420 

9,000 

23,250 

37,500 

1,000 

1,648,225 

$78,113 

136,999 

130,749 

6,250 

40,037 

31,949 

---

---

11,803 

---

50,000 

600,280 

696,901 

-101,621 

---

---

---

---

---

---

---

5,000 

---

---

5,000 

---

50,125 

---

420 

--

2,500 

29,500 

1,000 

1,037,726 

Science and Service: 

Primary and Behavioral Health Care Integration TTA.......................... 

Practice Improvement and Training...................................................... 

Consumer and Consumer Support TA Centers...................................... 

Disaster Response................................................................................ 

Homelessness....................................................................................... 

MH Minority Fellowship Program....................................................... 

Subtotal, Science and Service 

Total, PRNS 

1,991 

7,828 

1,901 

1,953 

2,251 

10,059 

---

---

---

---

---

---

---

1,991 

7,828 

1,918 

1,953 

2,296 

10,059 

1,991 

9,828 

1,918 

1,953 

2,296 

13,663 

---

2,000 

---

---

---

3,604 

25,984 26,045 31,649 5,604 

556,392 170,000 636,544 1,679,874 1,043,330 1/ Supplemental funds includes funding from the American Rescue Plan and the Cooronavirus Emergency Response and Relief Act. 

2/ The Suicide Lifeline was realigned to 988 Programs in FY 2023. 

37 
 

 

 

 

 

 

SAMHSA-Mental Health 

National Child Traumatic Stress Network 

(Dollars in thousands) 

FY 2021 FY 2022 FY 2023

 Programs of Regional & National Significance Final 

COVID-19 

Supplemental CR 

President's 

Budget 

FY 2023 +/-

FY 2022 

National Child Traumatic Stress Network..................................................... $71,671 $20,000 $71,887 $150,000 $78,113 

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

FY 2023 Authorization ..................................................................................................$63,887,000 

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

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

Institutions of Higher Education, and Community Organizations 

Program Description and Accomplishments 

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

thousands of children each year and is a serious public health challenge. This 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 and 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 may lead to early childhood 

mental health, chronic medical, and social development problems - if not recognized and addressed 

early in life.2 A recent study of 6000 adolescents in the United States found that 62 percent of 

youths experienced at least one traumatic event in their lifetime, including interpersonal violence, 

serious accidents or injuries, natural disaster, and death of a loved one; 19 percent have 

experienced three or more such events 3. Adding to the current body of knowledge, another recent 

study highlighted that adolescents between 13-19 self-reported experiencing at least one traumatic 

event during childhood and adolescence resulting in youth emotional and behavioral problems. 

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

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

drug/alcohol addiction involved in the child welfare, and juvenile justice systems. There is also a 

higher prevalence rates of complex trauma exposure for children in the welfare system. A study 

examining trauma histories, including complex trauma exposure (physical abuse, sexual abuse, 

emotional abuse, neglect, domestic violence), posttraumatic stress, and behavioral and emotional 

problems of 2, 251 youth in foster care found that 70.4% of the sample reported at least two of the 

traumas that constitute complex trauma and 11.7% of the sample reported all 5 types.4 

2 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. 3 McLaughlin, K. A., Koenen, K. C., Hill, E. D., Petukhova, M., Sampson, N. A., Zaslavsky, A. M., & Kessler, R. 

C. (2013). Trauma exposure and posttraumatic stress disorder in a national sample of adolescents. Journal of the 

American Academy of Child & Adolescent Psychiatry, 52(8), 815-830. 4 Greeson, J. K. P., Briggs, E. C., Kisiel, C. L., Layne, C. M., Ake, G. S., III, Ko, S. J., ...Fairbank, J. A. (2011). 

Complex trauma and mental health in children and adolescents placed in foster care: findings from the National Child 

Traumatic Stress Network. Child Welfare, 90(6), 91-10. 

38 
 

 

 

 

SAMHSA-Mental Health 

To address this challenge, SAMHSA funds a national network of grantees known as the National 

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

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

from a collaborative network of 17 centers to 140 funded and over 160 affiliate (formerly funded) 

centers and individuals located nationwide in universities, hospitals, and a range of diverse 

community-based organizations with thousands of national and local partners. The NCTSN’s 

mission is to raise the standard of care and improve access to evidence-based services for children 

experiencing trauma, their families, and communities. A component of this work has been the 

development of resources and delivery of training and consultation to support the development of 

trauma-informed child-serving systems. Network members work together within and across 

diverse settings, including a wide variety of governmental and non-governmental organizations. 

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

nation. In FY 2021, NCTSN grantee sites in this virtual environment, provided trauma-informed 

training to over 409,782 people. Since its inception, the NCTSN has provided training on best 

practices and other aspects of child trauma to over 2 million participants throughout the country. 

The NCTSI Learning Center now has over 430,000 users accessing evidence-based child trauma 

resource. 

Data collected in FY 2021 demonstrate that the current NCTSN grantees provided screening to 

over 95,612 individuals and evidence-based treatment to 56,228 children, adolescents, and family 

members. Over eighty-one percent reported healthy overall at six months. In addition, thousands 

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

NCTSN grantees to organizations that deliver evidence-based trauma interventions to various 

communities throughout the country. 

In FY 2021, SAMHSA supported 34 grant continuations and awarded a new cohort of 106 grants 

(97 grants from annual appropriations, 7 grants from COVID Relief Supplemental Appropriations 

Act and two grants from American Rescue Plan Act.) In FY 2022 Annualized CR, SAMHSA 

plans to support 129 grant continuations (127 grants from annual appropriations and 2 grants from 

American Rescue Plan Act) and award a new cohort of 4 grants. 

4 Darnell, D., Flaster, A., Hendricks, K., Kerbrat, A., & Comtois, K. A. (2019). Adolescent clinical populations 

and associations between trauma and behavioral and emotional problems. Psychological Trauma: Theory, Research, 

Practice, and Policy, 11(3), 266–273. 

39 
 

 

 

SAMHSA-Mental Health 

Five Year Funding Table 

Fiscal Year Amount 

COVID-19 

Supplemental 

Funding 

FY 2019 $63,887,000 

FY 2020 $68,887,000 

FY 2021 Final $71,671,178 $20,000,000 

FY 2022 CR $71,887,000 

FY 2023 President's Budget $150,000,000 

Budget Request 

The FY 2023 President’s Budget request is $150.0 million, an increase of $78.1 million from the 

FY 2022 Annualized Continuing Resolution. SAMHSA plans to support 120 grant continuations 

(118 grant from annual appropriation and two grants from American Rescue Plan Act) and 171 

new grants for the improvement of mental disorder treatment, services, and interventions for 

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

children and adolescents as well as training for the child-serving workforce. With the purposed 

increase in funds, SAMHSA estimates the number of individuals served will nearly double to 

16,000 and the number of people in the mental health and related workforce will increase to 

250,000. 

40 
 

SAMHSA-Mental Health 

Outputs and Outcomes Table 

Program: National Child Traumatic Stress Network (NCTSN) 

Measure Year and Most Recent 

Result / 

Target for Recent Result / 

(Summary of Result) 

FY 2022 

Target 

FY 2023 

Target 

FY 2023 

Target 

+/-FY 2022 

Target 

3.2.02a Percentage of 

children receiving trauma 

informed services who 

report positive 

functioning at 6-month 

follow-up (Outcome) 

FY 2021: 75.9 % 

Target: 

70 % 

(Target Exceeded) 

70 % 70 % Maintain 

3.2.23 Unduplicated 

count of the number of 

children and adolescents 

receiving traumainformed services 

(Outcome) 

FY 2021: 40,369 

Target: 

59,023 

(Target Exceeded) 

80,000 80,000 Maintain 

3.2.39 Number of childserving professionals 

trained in providing 

trauma-informed services 

(Outcome) 

FY 2021: 549,381 

Target: 

276,791 

(Target Exceeded) 

900,000 900,000 Maintain 

41 
 

 

 

 

 

 

 

SAMHSA-Mental Health 

Project AWARE 

(Dollars in thousands) 

 Programs of Regional & National Significance 

FY 2021 FY 2022 FY 2023

Final 

COVID-19 

Supplemental CR 

President's 

Budget 

FY 2023 +/-

FY 2022 

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

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

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

$105,118 

92,618 

12,500 

$80,000 

---

---

$107,001 

94,501 

12,500 

$244,000 

225,250 

18,750 

$136,999

130,749

6,250 

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

FY 2023 Authorization ................................................................................................................. $0 

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 

Mental health challenges are, and have been, of grave concern for children and youth. Surveys of 

young people in 2019 show increases in feelings of sadness or hopelessness – one in three high 

school students and half of the female students reported persistent feelings of sadness or 

hopelessness which is an overall increase of 40% from 2009. In addition, early estimates from 

the National Center for Health Statistics suggest there were more than 6,600 deaths by suicide 

among youth between the ages of 10-24 in 2020. 5 Project AWARE is designed to identify children 

and youth in need of mental health services in their school. Schools are often safe places where 

children and youth feel supported. Schools can increase access to mental health treatment by 

increasing the mental health literacy of school personnel, developing screening procedures, and 

develop robust referral pathways to community-based services. 

Project AWARE is made up of two components: Project AWARE State Education Agency (SEA) 

grants and Resilience in Communities after Stress and Trauma (ReCAST) grants. 

Currently, Project AWARE SEA grants are awarded to State Education Agencies to promote 

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

to mental health services. The program also includes a focus on the specific needs affecting rural 

communities. These communities struggle with access to mental health services in schools and 

access to qualified health professionals to provide such services. 

In FY 2021, Project AWARE grantees trained 189,865 teachers, parents, first responders, school 

resource officers, and other adults who interact with youth to recognize and respond to the signs 

of mental health and substance use issues. The grantees also referred 43,734 school-aged youth to 

mental health and related services. 

5 https://www.hhs.gov/sites/default/files/surgeon-general-youth-mental-health-advisory.pdf 

42 
 

 

 

 

 

 

 

 

 

 

SAMHSA-Mental Health 

ReCAST grants promote resilience in high-risk youth, families, and communities that have 

recently faced civil unrest through implementation of evidence-based violence prevention 

programs, community youth engagement programs, and trauma-informed behavioral health 

services. ReCAST aims to develop culturally responsive approaches with community-based 

partners to address the mental health services needs of children and youth. 

In FY 2021, ReCAST grantees trained 2,940 members of the mental health workforce in trauma 

informed approaches. Additionally, 22,280 community stakeholders were trained in traumainformed approaches, including violence prevention and mental health literacy. ReCAST grantees 

provided 16,984 at-risk youth and their family members with high-quality trauma-informed mental 

health services. Over 1,400 new partnerships were established among local municipal 

organizations and community agencies to support high-risk youth and their families. 

In FY 2021, SAMHSA supported 42 continuation grants (39 AWARE and three ReCAST grants) 

and a new cohort of 30 grants (10 AWARE, nine ReCAST and 11 AWARE from COVID Relief 

Supplemental Appropriations Act funding). In FY 2022 Annualized CR, SAMHSA will support 

59 continuation grants (49 AWARE and 10 ReCAST) and a new cohort of 3 grants from American 

Rescue Plan Act. 

Five Year Funding Table 

Fiscal Year Amount 

COVID-19 

Supplemental 

Funding 

FY 2019 $71,001,000 

FY 2020 $102,001,000 

FY 2021 Final $105,117,728 $80,000,000 

FY 2022 CR $107,001,000 

FY 2023 President's Budget $244,000,000 

Budget Request 

The FY 2023 President’s Budget request is $244.0 million, an increase of $136.9 million from the 

FY 2022 Annualized Continuing Resolution. Funding for this program will support 88 new Project 

AWARE State Grants, 1 new ReCAST grant, and technical assistance on the provision of schoolbased mental health services. The funding increase will expand the program’s targeted population 

to include college students and adults and expand the program’s training settings to include noneducational and non-health care sites. It is expected that the increase in funding for Project 

AWARE will help to identify and refer approximately 80,000 school-aged youth to mental health 

and related services; and to train approximately 500,000 mental health and mental health-related 

professionals on evidence-based mental health practices. 

43 
 

SAMHSA-Mental Health 

Outputs and Outcomes Table 

Program: Project AWARE 

Measure Year and Most Recent 

Result / 

Target for Recent Result / 

(Summary of Result) 

FY 2022 

Target 

FY 2023 

Target 

FY 2023 

Target 

+/-FY 2022 

Target 

3.2.39 Number of 

individuals who have 

received training in 

prevention or mental 

health promotion 

(Outcome) 

FY 2021: 226,020.0 

Target: 

215,000.0 

(Target Exceeded) 

240,000 500,000 Increase 

3.2.51 Number of 

individuals referred to 

mental health or related 

interventions (Output) 

FY 2021: 43,744.0 

Target: 

37,000.0 

(Target Exceeded) 

43,000.0 80,000.0 Increase 

44 
 

 

 

 

SAMHSA-Mental Health 

Mental Health Awareness Training 

(Dollars in thousands) 

 Programs of Regional & National Significance 

FY 2021 FY 2022 FY 2023 

Final 

COVID-19 

Supplemental CR 

President's 

Budget 

FY 2023 +/-

FY 2022 

Mental Health Awareness Training............................................................... $23,963 $--- $23,963 $64,000 $40,037

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

FY 2023 Authorization ..................................................................................................................$0 

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 

Mental health literacy is an individual’s knowledge and beliefs about mental health disorders that 

assist in the recognition, management, and prevention of mental health challenges and concerns6

. 

There is an interrelationship between mental health knowledge and stigma where the lack of 

knowledge is a driver of negative attitudes. 7 The Mental Health Awareness Training (MHAT) 

grants train school personnel, emergency first responders, law enforcement, veterans, armed 

services members, and their families how to recognize the signs and symptoms of mental disorders 

such as serious mental illness and/or serious emotional disturbances. In addition, MHAT grant 

program provides training on how to create a supportive and compassionate culture and assist 

others in accessing treatment if needed. 

In FY 2021, MHAT grantees trained 38,830 individuals in mental health or related professions, 

first responders, law enforcement personnel, and family/student support clinical and nonclinical 

workers (e.g., case workers and community outreach workers) in mental health literacy programs. 

Grantees provided mental health literacy training to 79.582 school personnel (including support, 

administrative, and clerical staff) and community members. Also, 125,62 individuals have been 

referred to mental health services and supports as a result of the MHAT grant. 

In FY 2021, SAMHSA supported 33 continuation grants and awarded a new cohort of 145 grants. 

In FY 2022 Annualized CR, SAMHSA will support 160 continuation grants and award a new 

cohort of 23 grants. 

6 Can J Psychiatry, 2016 Mar; 61(3): 154-158. 7 Can J Psychiatry, 2016 Mar; 61(3): 154-158. 

45 
 

 

 

 

 

 

 

SAMHSA-Mental Health 

Five Year Funding Table 

Fiscal Year Amount COVID-19 

Supplemental Funding 

FY 2019 $20,963,000 

FY 2020 $22,963,000 

FY 2021 Final $23,963,000 

FY 2022 CR $23,963,000 

FY 2023 President's Budget $64,000,000 

Budget Request 

The FY 2023 President’s Budget request is $64.0 million, an increase of $40.0 million from the 

FY 2022 Annualized Continuing Resolution. Funding for this program will support 168 

continuation grants and award a new cohort of 325 grants. The budget will expand eligible 

populations for this program to include college students and adults, and to broaden applicable 

settings for trainings to include non-educational, non-health care settings. With the purposed 

increase in funding, it is estimated the number of individuals referred to mental health and related 

services will near 300,000 and the number of individuals trained to recognize the signs and 

symptoms of mental illness will increase to 200,000. 

46 
 

 

 

 

 

 

SAMHSA-Mental Health 

Healthy Transitions 

(Dollars in thousands) 

 Programs of Regional & National Significance 

FY 2021 FY 2022 FY 2023

Final 

COVID-19 

Supplemental CR 

President's 

Budget 

FY 2023 +/-

FY 2022 

Healthy Transitions........................................................................................ $29,451 $--- $29,451 $61,400 $31,949 

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

FY 2023 Authorization ..................................................................................................................$0 

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

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

Program Description and Accomplishments 

Youth and young adults with Serious Emotional Disturbance or Serious Mental Illness, along with 

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

to adulthood than do their peers. In the 2020 National Survey on Drug Use and Health (NSDUH) 

through the Substance Abuse and Mental Health Services Administration (SAMHSA) just over 30 

percent of young adults, aged 18 to 25 living in U.S. households had a diagnosable mental health 

condition in the past year. Of these, more than 9.7 percent had a serious disorder, such as 

schizophrenia, bipolar disorder, and major depression, that compromised their ability to function. 

This age group had the highest prevalence of serious mental illness compared to adults aged 26-

49 (6.9%) and those aged 50 and older (3.4%)8

. Compared to their peers, these young people were 

significantly more likely to experience homelessness,9 be arrested,10 drop out of school,11 and be 

unemployed.12 It is important to identify these young people, develop appropriate outreach and 

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

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

are disconnected from social and other community supports. 

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

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

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

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

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

8 https://www.nimh.nih.gov/health/statistics/mental-illness 9 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. 10 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. 

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

education 2008 (NCES 2008-031). 12 Newman, L., Wagner, M., Cameto, R., & Knokey, A. M. (2009). The post-high school outcomes of youth with 

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

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

47 
 

 

 

 

 

 

 

SAMHSA-Mental Health 

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

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

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

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

concern is detected; provide training to provider and community groups to improve services and 

supports specific to this age group; enhance peer and family supports, and develop effective 

services and interventions for youth, young adults and their families as these young people 

transition to adult roles and responsibilities. Since 2014, a total of 9,097 youth in 22 states, five 

territories, and six tribes have been served. 

FY 2021 data for grantee participants showed an 18.3 percent decrease in psychological distress, 

a 32.9 percent improvement in functional outcomes, an 8.6 percent increase in being in excellent 

or in very good health, and a 65.9 percent rate of employment (full or part-time). In addition, from 

baseline to 6-month follow-up there was an 18.2 percent increase in the number of nights young 

adults had a stable place to live. 

In FY 2021, SAMHSA supported 27 grant continuations and awarded a new cohort of one grant. 

In FY 2022 Annualized CR, SAMHSA will support 28 grant continuations. 

Five Year Funding Table 

Fiscal Year Amount 

COVID-19 

Supplemental 

Funding 

FY 2019 $25,951,000 

FY 2020 $28,951,000 

FY 2021 Final $29,451,000 

FY 2022 CR $29,451,000 

FY 2023 President's Budget $61,400,000 

Budget Request 

The FY 2023 President’s Budget request is $61.4 million, an increase of $31.9 million from the 

FY 2022 Annualized Continuing Resolution. This budget will support 18 continuation grants and 

fund a new cohort of 41 grants. Funding will 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. It is expected that the number of young people 

served by this program will increase to 1,500 and there will be an increase in the available supports 

and services needed to support this population. 

48 
 

SAMHSA-Mental Health 

Outputs and Outcomes Table 

Program: Healthy Transitions 

Measure Year and Most Recent 

Result / 

Target for Recent Result / 

(Summary of Result) 

FY 2022 

Target 

FY 2023 

Target 

FY 2023 

Target 

+/-FY 2022 

Target 

3.2.34 Percentage of 

clients receiving services 

who report positive 

functioning at 6-month 

follow-up. (Outcome) 

FY 2021: 65.1 % 

Target: 

58.6 % 

(Target Exceeded) 

58.6 % 58.6 % Maintain 

3.2.35 Percentage of 

clients receiving services 

who had a permanent 

place to live in the 

community at 6-month 

follow-up. (Outcome) 

FY 2021: 51 % 

Target: 

35 % 

(Target Exceeded) 

35 % 35 % Maintain 

3.2.36 Percentage of 

clients receiving services 

who are currently 

employed at 6-month 

follow-up. (Outcome) 

FY 2021: 65.4 % 

Target: 

34 % 

(Target Exceeded) 

65 % 65 % Maintain 

49 
 

 

 

 

SAMHSA-Mental Health 

Children and Family Programs 

(Dollars in thousands) 

 Programs of Regional & National Significance 

FY 2021 FY 2022 FY 2023

Final 

COVID-19 

Supplemental CR 

President's 

Budget 

FY 2023 +/-

FY 2022 

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

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

FY 2023 Authorization ..................................................................................................................$0 

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

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

Program Description and Accomplishments 

Without early identification, intervention, treatment, and support, children with serious emotional 

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

development. It is a public health priority that these children and their families have access to 

effective, evidence-based services, and support. 

SAMHSA’s Children and Family Programs provide funding for the Circles of Care grant program. 

Initially funded in 1998, the Circles of Care Program is a three-year infrastructure/planning grant 

that seeks to promote mental disorder treatment equity by providing American Indian/Alaska 

Native (AI/AN) communities with tools and resources to design and sustain their own culturally 

competent system of care approach for children. The Circles of Care program reflects the unique 

history and needs of individual AI/AN communities and promotes the idea of building on cultural 

strengths. The program increases capacity and community readiness to address the mental health 

needs, such as SED, for children and their families through the provision of evidence-based 

treatment services and support. This grant program is of critical importance as there are significant 

mental health needs in AI/AN communities and has improved the availability, accessibility, and 

acceptability of behavioral health services for native youth. 

In FY 2021, SAMHSA supported 18 continuation grants, awarded three new grants, and 1,581 

individuals received training in mental health practices and activities that aligned with the goals of 

the program. In FY 2022 Annualized CR, SAMHSA will support 21 continuation grants and 

award one new grant. 

50 
 

 

 

 

 

 

SAMHSA-Mental Health 

Five Year Funding Table 

Fiscal Year Amount 

COVID-19 

Supplemental 

Funding 

FY 2019 $7,229,000 

FY 2020 $7,229,000 

FY 2021 Final $7,229,000 

FY 2022 CR $7,229,000 

FY 2023 President's Budget $7,229,000 

Budget Request 

The FY 2023 President’s Budget request is $7.2 million, level with the FY 2022 Annualized 

Continuing Resolution. This funding will support four Circles of Care continuation grants and 

award a new cohort of 18 grants. Funding will 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. 

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 104. 

51 
 

 

SAMHSA-Mental Health 

Consumer and Family Network Grants 

(Dollars in thousands) 

FY 2021 FY 2022 FY 2023

 Programs of Regional & National Significance Final 

COVID-19 

Supplemental CR 

President's 

Budget 

FY 2023 +/-

FY 2022 

Consumer and Family Network Grants.......................................................... $4,971 $--- $4,954 $4,954 $---

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

FY 2023 Authorization ..................................................................................................................$0 

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

Eligible Entities.......................................................................................Community Organizations 

Program Description and Accomplishments 

Across the healthcare arena, there is growing recognition and evidence that client-centered care 

positively influences an individual’s health outcomes, improves quality and efficacy of care 

received, and provides feedback to drive service and systems improvements. As with other health 

disciplines, people with serious mental illness (SMI) and their family members should have 

meaningful involvement in all aspects of their health care and treatment, including behavioral 

health care. 

The Consumer and Family Network Programs provide consumers, families, and youth with 

opportunities to participate meaningfully in the development of policies, programs, and quality 

assurance activities related to mental health systems across the United States. The Consumer and 

Family Network Programs support two primary grant programs, the Statewide Consumer Network 

(SCN) Program and the Statewide Family Network (SFN) Program. 

The SCN grant program focuses on the needs of adults (18 years and older) with SMI by 

strengthening the capabilities of statewide consumer-run organizations. These entities serve an 

important role in engaging consumers of mental health services, caregivers, policy makers, 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 on coalition/partnership-building and 

economic empowerment, as part of the recovery process for consumers. 

The SFN grant program provides education and training to increase family organizations’ capacity 

for policy and service development. This is accomplished by: (1) strengthening organizational 

relationships and business management skills; (2) fostering leadership skills among families of 

children and adolescents with serious emotional disturbance (SED); and (3) identifying and 

addressing the technical assistance needs of children and adolescents with SED and their families. 

The SFN program focuses on families, parents, and the primary caregivers of children, youth, and 

young adults. 

52 
 

 

 

 

 

 

SAMHSA-Mental Health 

In FY 2021, SAMHSA supported eight SCN and 17 SFN grant continuations and awarded a new 

cohort of 12 SCN and13 SFN grants. The SCN grantees trained 8,823 individuals in the mental 

health and related workforce and SFN grantees trained 18,373 individuals in the mental health and 

related workforce. In addition, 5,648 consumers and family members were involved in ongoing 

mental health-related planning and advocacy activities. In FY 2022 Annualized CR, SAMSHA 

will support 12 SCN and 13 SFN grant continuations and award a new cohort of eight SCN and 

17 SFN. 

Five Year Funding Table 

Fiscal Year Amount COVID-19 

Supplemental Funding 

FY 2019 $4,954,000 

FY 2020 $4,954,000 

FY 2021 Final $4,970,508 

FY 2022 CR $4,954,000 

FY 2023 President's Budget $4,954,000 

Budget Request 

The FY 2023 President’s Budget request is $4.9 million, level with the FY 2022 Annualized 

Continuing Resolution. Funds will be used for 47 continuation grants that promote consumer, 

family, and youth participation in the development of policies, programs, and quality assurance 

activities related to mental health systems reform across the United States. 

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 104. 

53 
 

 

 

 

SAMHSA-Mental Health 

Project LAUNCH 

(Dollars in thousands) 

FY 2021 FY 2022 FY 2023

 Programs of Regional & National Significance Final 

COVID-19 

Supplemental CR 

President's 

Budget 

FY 2023 +/-

FY 2022 

Project LAUNCH ......................................................................................... $23,509 $--- $23,605 $35,408 $11,803 

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

FY 2023 Authorization ..................................................................................................................$0 

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

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

Program Description and Accomplishments 

Researchers estimate that between 9.5 percent and 14.2 percent of children from birth to age five 

experience an emotional or behavioral disturbance and that half of all lifetime cases of mental 

illness begin before age 14.13 Young children experiencing mental, emotional, behavioral 

challenges are also at high risk for preschool expulsion. In fact, 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; and African American preschoolers are 

almost twice as likely to be expelled as Caucasian preschoolers.14 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 childcare settings, increasing screening for developmental and social/emotional issues, and 

training people who interact with young children to promote optimal development and mental 

health are all critical elements to ensure children start life with the tools and skills needed to 

succeed. 

In 2008, Project Linking Actions for Unmet Needs in Children’s Health (LAUNCH) began as a 

national initiative. 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 childcare and education, home visiting, and primary care) are 

equipped to promote and monitor healthy social and emotional development. The program also 

ensures that the systems intervene to prevent, recognize early signs of, and address mental, 

emotional, and behavioral disorders in early childhood and into the early elementary grades. 

Project LAUNCH now includes grantees in 38 states, 23 tribal entities, four US territories, three 

Alaska/native communities, and the District of Columbia, and five alumni Project LAUNCH 

13 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. 14 Gilliam, W. (2005). Pre-kindergarteners left behind: Expulsion rates in state prekindergarten systems. Foundation 

for Child Development. 

54 
 

 

 

SAMHSA-Mental Health 

Expansion state grantees. The five alumni state grantees engaged in replication of successful 

Project LAUNCH prevention strategies in new communities within the respective state. All 

grantees are funded for a total of four or five years. 

Well-established Project LAUNCH grantees were able to pivot during the COVID-19 pandemic 

because they had implemented their chosen evidence-based intervention prior to the initial lock 

down. Many continued to offer services through telehealth modalities. They were also able to 

provide training for professionals who had not been able to attend previously due to transportation 

and scheduling challenges. As of 2021, cumulative performance data for Project LAUNCH (2008-

2021) indicate that more than 254,190 children and parents have been screened or assessed for 

behavioral health concerns across a range of diverse settings (e.g., primary care, childcare, and 

home visiting). Child screenings are a critical step in the early recognition of social emotional 

concerns and create a pathway to prevention and treatment services. Adult screenings include 

screening for perinatal depression, substance use, and a range of social needs. More than 110,799 

community providers have been trained on milestones of social/emotional development, early 

detection of behavioral health issues, and best practices for mental health treatment. Over 215,520 

children and parents/caregivers have received evidence-based mental health-related services 

through the grant program, and approximately 11,431 new partnerships have been developed 

between organizations to improve care coordination and access to quality mental health services 

for young children and families. 

A multi-site evaluation of Project LAUNCH was completed in 2018 

(https://www.acf.hhs.gov/opre/research/project/cross-site-evaluation-of-project-launch-linkingactions-for-unmet-needs-in). Phase one of the evaluation used a meta-analytical approach to 

assess the implementation of the program. The findings indicated that grantees successfully 

improved community- and state-level child and family-serving systems. In addition, grantees 

demonstrated improved social and academic functioning among young children, and over 75 

percent reported decreases in problem behaviors. Phase two of the multi-site evaluation involved 

a quasi-experimental design, exploring whether children in 10 communities served by Project 

LAUNCH differed in social and emotional wellbeing from children in 10 socio-demographically 

matched communities. Results indicated that children living in Project LAUNCH communities 

received more developmental screening and supports than children living in matched comparison 

communities. Additionally, children served in LAUNCH communities had less need for early 

intervention services related to attachment, initiative, and other indicators of resilience, 

particularly for young children ages birth to three. Parents in Project LAUNCH communities 

reported more involvement with their children and less parenting frustrations. 

In FY 2021, SAMHSA supported 30 continuation grants and the Center of Excellence- Infant and 

Early Childhood Mental Health (CoE-IECMHC). In FY 2022 Annualized CR, SAMHSA will 

support 30 continuation grants and the CoE-IECMHC. 

55 
 

 

 

 

 

 

SAMHSA-Mental Health 

Five Year Funding Table 

Fiscal Year Amount 

COVID-19 

Supplemental 

Funding 

FY 2019 $23,605,000 

FY 2020 $23,605,000 

FY 2021 Final $23,508,709 

FY 2022 CR $23,605,000 

FY 2023 President's Budget $35,408,000 

Budget Request 

The FY 2023 President’s Budget request is $35.4 million, an increase of $11.8 million from the 

FY 2022 Annualized Continuing Resolution. This funding will support 16 continuation grants, 

award a new cohort of 24 grants and the CoE-IECMHC to improve health outcomes for young 

children and support children at high risk for mental illness and their families to prevent future 

disability. This funding will provide continued screening, prevention, early intervention for 

behavioral health issues and referrals to high quality treatment for children and families in 30 

communities across the U.S. through the CoE-IECMHC. With the purposed increase in funding, 

it is expected that the number of young children screened for mental health disorders will increase 

to nearly 11,000, and the number of young children referred to mental health and related services 

will increase to 7,000. 

56 
 

 

 

SAMHSA-Mental Health 

Outputs and Outcomes Table 

Program: Mental Health-Project LAUNCH 

Measure Year and Most Recent 

Result / 

Target for Recent Result / 

(Summary of Result) 

FY 2022 

Target 

FY 2023 

Target 

FY 2023 

Target 

+/-FY 2022 

Target 

2.3.94 Number of persons 

served (Output) 

FY 2021: 5,743 

Target: 

9,370 

(Target Not Met) 

6,000 7,000 Increase 

2.3.95 Number of persons 

trained in mental illness 

prevention or mental 

health promotion 

(Outcome) 

FY 2021: 8,201 

Target: 

5,953 

(Target Exceeded) 

8,300 10,000 Increase 

2.4.00 Number of 0–8-

year-old children 

screened for mental 

health or related 

interventions (Outcome) 

FY 2021: 8,573 

Target: 

8,700 

(Target Not Met) 

8,573 10,000 Increase 

2.4.01 Number of 0–8-

year-old children referred 

to mental health or 

related interventions 

(Outcome) 

FY 2021: 3,614 

Target: 

2,160 

(Target Exceeded) 

3,614 5,000 Increase 

57 
 

 

 

 

 

SAMHSA-Mental Health 

Mental Health System Transformation and Health Reform 

(Dollars in thousands) 

FY 2021 FY 2022 FY 2023

 Programs of Regional & National Significance Final 

COVID-19 

Supplemental CR 

President's 

Budget 

FY 2023 +/-

FY 2022 

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

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

FY 2023 Authorization ..................................................................................................................$0 

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

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

Program Description and Accomplishments 

There is a significant gap between the number of people with serious mental illness (SMI), such 

as schizophrenia, bipolar disorder, and major depression, who want to work (66 percent) and the 

number of these individuals who are employed (less than 20 percent). The benefits of steady 

competitive employment for this population are substantial and include increased income, 

improved adherence with treatment for mental illness, enhanced self-esteem, reduced use of 

substances, and improved quality of life.15 

In FY 2014, the Transforming Lives through Supported Employment Grant program was 

implemented, within the Mental Health System Transformation program, to help states foster the 

adoption and implementation of permanent transformative changes in how public mental health 

services are organized, managed, and delivered throughout the United States. This program aims 

to enhance state and community capacity to provide evidence-based supported employment 

programs for adults and youth with SMI or serious emotional disturbance (SED). These grants 

help people achieve their goals for competitive employment, building paths to self-sufficiency and 

recovery. They also support treatment and service providers and employers to prioritize 

employment as a standard of care by developing and maintaining sustained competitive 

employment opportunities for people with SMI or SED, primarily using the evidence-based 

Individual Placement and Support (IPS) model of supported employment. The grant program 

helps states to identify and implement the structural and financing changes that are essential to 

make evidence-based supported employment programs sustainable statewide. 

FY 2021 program data show that 3,584 people in the mental health and related workforce were 

trained and 82 programs or organizations collaborated, coordinated, or shared resources with other 

organizations as a result of the grant. In addition, over 50 percent of individuals served by the 

program were employed or in school at six-month follow-up; while 75 percent reported positive 

functioning and 54.7 percent had a stable place to live. 

In FY 2021 and FY 2022 Annualized CR, SAMHSA will fund seven grant continuations. 

10 IPS Supported Employment: The Evidence-based Practice for Employment. (n.d.). Retrieved August 4, 2015 

58 
 

 

 

 

 

SAMHSA-Mental Health 

Five Year Funding Table 

Fiscal Year Amount 

COVID-19 

Supplemental 

Funding 

FY 2019 $3,779,000 

FY 2020 $3,779,000 

FY 2021 Final $3,779,000 

FY 2022 CR $3,779,000 

FY 2023 President's Budget $3,779,000 

Budget Request 

The FY 2023 President’s Budget request is $3.7 million, level with the FY 2022 Annualized 

Continuing Resolution. Funding will support the continuation of seven Transforming Lives 

through Supported Employment grants that will enhance state and community capacity to provide 

evidence-based supported employment programs and mutually compatible and supportive 

evidence-based practices for adults and youth with SMI/SED and co-occurring mental and 

substance use disorders. 

59 
 

SAMHSA-Mental Health 

Outputs and Outcomes Table 

Program: Mental Health System Transformation Grants and Health Reform 

Measure Year and Most Recent 

Result / 

Target for Recent Result / 

(Summary of Result) 

FY 2022 

Target 

FY 2023 

Target 

FY 2023 

Target 

+/-FY 2022 

Target 

1.2.11 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 2021: 352 

Target: 

3,574 

(Target Not Met but 

Improved) 

350 350 Maintain 

1.2.21 Percentage of 

clients receiving services 

who report positive 

functioning at 6-month 

follow-up. (Outcome) 

FY 2021: 69.2 % 

Target: 

62.7 % 

(Target Exceeded) 

62.7 % 62.7 % Maintain 

1.2.22 Percentage of 

clients receiving services 

who had a permanent 

place to live in the 

community at 6-month 

follow-up. (Outcome) 

FY 2021: 51.5 % 

Target: 

54 % 

(Target Not Met) 

54 % 54 % Maintain 

1.2.23 Percentage of 

clients receiving services 

who are currently 

employed at 6-month 

follow-up. (Outcome) 

FY 2021: 48.5 % 

Target: 

31.6 % 

(Target Exceeded) 

31.6 % 31.6 % Maintain 

60 
 

 

 

 

 

 

SAMHSA-Mental Health 

Primary and Behavioral Health Care Integration 

(Dollars in thousands) 

 Programs of Regional & National Significance 

FY 2021 FY 2022 FY 2023

Final 

COVID-19 

Supplemental CR 

President's 

Budget 

FY 2023 +/-

FY 2022 

Primary and Behavioral Health Care Integration........................................... $54,368 

52,377 

1,991 

$---

---

---

$54,868 

52,877 

1,991 

$104,868 

102,877 

1,991 

$50,000 

50,000 

-

Primary and Behavioral Health Care Integration...................................... 

Primary and Behavioral Health Care Integration TTA............................... 

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

FY 2023 Authorization ..................................................................................................................$0 

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

Eligible Entities.....................................................Qualified Community Mental Health Programs, 

....................................................................................................................... States or State Agency 

Program Description and Accomplishments 

Adults with serious mental illness (SMI), such as schizophrenia, bipolar disorder, and major 

depression, experience high rates of morbidity and mortality. These rates are due, in large part, to 

elevated incidence and prevalence of cardiovascular disease, obesity, diabetes, hypertension, and 

dyslipidemia in people with SMI.16 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.17 There is also a need to improve capacity to identify and treat mental disorders in 

primary care and other physical health care settings. The majority of people with mental disorders 

receive medical treatment in emergency rooms and primary care clinics, unfortunately between 60 

and 70 percent of these individuals are discharged without receiving behavioral health care.18 

The Primary and Behavioral Health Care Integration (PBHCI) Portfolio began in FY 2009 to 

address this intersection between primary care and treatment for mental illness and co-occurring 

disorders. This portfolio includes grants to states and community mental health centers. Across 

several cohorts, the PBHCI program supported the coordination and integration of primary care 

services and publicly funded community behavioral health services for individuals with SMI or 

co-occurring mental illness and drug/alcohol addiction served by the public mental health system. 

The PBHCI program was designed to improve health outcomes for people with SMI and cooccurring mental illness and drug/alcohol addiction by encouraging grantees to engage in 

necessary collaboration, expand infrastructure, and increase the availability of primary healthcare 

and wellness services for individuals with SMI or co-occurring mental illness and drug/alcohol 

addiction. 

16 Forman-Hoffman, Muhuri, Novak, Pemberton, Ault, and Mannix (August 2014) CBHSQ Data Review: 

Psychological Distress and Mortality among Adults in the U.S. Household Population. 

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

2014: 13:1153-160. 18 Klein, S., and M. Hostetter. 2014. In focus: Integrating behavioral health and primary care. New York: The 

Commonwealth Fund. 

61 
 

 

SAMHSA-Mental Health 

In FY 2017, SAMHSA awarded the first cohort of the Promoting Integration of Primary and 

Behavioral Health Care (PIPBHC) cooperative agreement grant program. The purpose of the 

PIPBHC program is to: (1) promote full integration and collaboration in clinical practice between 

primary and behavioral healthcare; (2) support the improvement of integrated care models for 

primary care and behavioral health care to improve the overall wellness and physical health status 

of adults with a serious mental illness (SMI) or children with a serious emotional disturbance 

(SED); and (3) promote and offer integrated care services related to screening, diagnosis, 

prevention, and treatment of mental and substance use disorders, and co-occurring physical health 

conditions and chronic diseases. In FY 2021, the PIPBHC grant program served over 12,028 

consumers and provided training to over 9,000 individuals in the mental health and related 

workforce. 

The percent of PIPBHC participants feeling healthy overall increased by 13 percent from intake 

to 6 months of program participation. 63.5% of program participants reported functioning in 

everyday life at 6 months, a 10 percent improvement above intake. 

In FY 2019, SAMHSA funded a new technical assistance grant, the National Center of Excellence 

for Integrated Health Solutions (CIHS), for up to $1,889,486 a year for up to five years. The 

purpose of this program is to advance the implementation of high quality, evidence-based 

treatment for individuals with co-occurring physical and mental health conditions, including 

substance use disorders. The program includes technical assistance and training for communities, 

individual practitioners, providers, and states on evidence-based and effective strategies to address 

the integration of primary and mental health care for individuals with mental disorders or cooccurring mental and substance use disorders. 

In 2020, CIHS provided training to 23,880 individuals in the mental health and related workforce. 

Of those, 88 percent of these individuals were able to demonstrate improvement in knowledge, 

attitudes, and beliefs related to prevention and mental health promotion. 

In FY 2021, SAMHSA supported one PBHCI and 23 PIPBHC grant continuations, one CHIS grant 

continuation, and awarded a new PIPBHC grant. In FY 2022 Annualized CR, SAMHSA will 

support 24 PIPBHC grant continuations, one CHIS grant continuation and a new PIPBHC grants. 

62 
 

 

 

 

 

SAMHSA-Mental Health 

Five Year Funding Table 

Fiscal Year Amount 

COVID-19 

Supplemental 

Funding 

FY 2019 $43,437,734 

FY 2020 $51,868,000 

FY 2021 Final $54,368,001 

FY 2022 CR $54,868,000 

FY 2023 President's Budget $104,868,000 

Budget Request 

The FY 2023 President’s Budget request is $104.9 million, an increase of $50.0 million from the 

FY 2022 Annualized Continuing Resolution. Funding will support the continuation of 12 PIPBHC 

grants and one CIHS grant. The funding will also fund a new cohort of 37 PIPBHC grants. The 

purposed increase in funding will result in nearly 19,000 individuals in the mental health and 

related workforce trained in mental health practices and activities; and the number of individuals 

served will increase to 10,000. 

63 
 

 

 

 

 

 

 

 

SAMHSA-Mental Health 

Outputs and Outcomes Table 

Program: Primary & Behavioral Health Care Integration (PBHCI) 

Measure Year and Most Recent 

Result / 

Target for Recent Result / 

(Summary of Result) 

FY 2022 

Target 

FY 2023 

Target 

FY 2023 

Target 

+/-FY 2022 

Target 

3.2.41 Increase the 

percentage of clients 

receiving services who 

report positive 

functioning at 6-month 

follow-up. (Outcome) 

FY 2021: 63.8 % 

Target: 

59 % 

(Target Exceeded) 

63 % 63% Maintain 

3.2.42 Increase the 

percentage of clients 

receiving services who 

are currently employed at 

6-month follow-up. 

(Outcome) 

FY 2021: 44.5 % 

Target: 

27.7 % 

(Target Exceeded) 

44 % 44 % 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 2021: 75.5 % 

Target: 

68 % 

(Target Exceeded) 

75 % 75 % Maintain 

64 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

SAMHSA-Mental Health 

Suicide Prevention Programs 

(Dollars in thousands) 

 Programs of Regional & National Significance 

FY 2021 FY 2022 FY 2023

Final 

COVID-19 

Supplemental CR 

President's 

Budget 

FY 2023 +/-

FY 2022 

Suicide Prevention......................................................................................... 

988 and Behavioral Health Crisis Services................................................ 

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

National Strategy for Suicide Prevention (non-add)................................... 

 Zero Suicide (non-add).............................................................................. 

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

 All Other National Strategy for Suicide Prevention (non-add)................. 

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

 Budget Authority (non-add)....................................................................... 

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

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

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

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

$102,046 

---

24,000 

23,200 

21,200 

2,400 

2,400 

36,427 

24,427 

12,000 

6,488 

9,000 

2,931 

$70,000 

---

32,000 

18,000 

---

---

---

17,600 

---

---

2,400 

---

---

$179,667 

---

101,621 

23,200 

21,200 

2,400 

2,400 

36,427 

24,427 

12,000 

6,488 

9,000 

2,931 

$779,947 

696,901 

-

23,200 

21,200 

2,400 

2,400 

36,427 

24,427 

12,000 

11,488 

9,000 

2,931 

$600,280 

696,901 

(101,621) 

---

---

---

---

---

---

---

5,000 

---

---

Program Description 

Approximately 45,979 Americans died by suicide in 202019 .. From 1999 through 2019, the age 

adjusted suicide rate increased by over 30 percent from 10.5 to 13.9 per 100,00020 . Suicide rates 

among youth age 5-24 in 2020 were highest among American Indian/Alaska Natives, followed by 

suicide among white youth. However, while suicide among whites decreased in 2020, suicide 

among blacks and American Indian/Alaska Natives increased. Suicide increased in 2020 among 

youth and young adults age 10-34, but decreased among those older than 35, except for an increase 

in those over 8521 . Approximately 52.8% of all suicides in the United states, among youth and 

adults, utilized a firearm. The 2020 National Survey on Drug Use and Health reported that 

approximately 1.42 million Americans age 18 and over attempted suicide over the previous 12 

months, 12.2 million seriously considered suicide, and 3.2 million made a plan. Among youth age 

12-17 in 2020, 629,000 attempted suicide, 3 million seriously considered suicide, and 1.3 million 

made a suicide plan. The pandemic has magnified both suicide risk and increased overall 

reporting of depression and anxiety. In a CDC survey from February-March 2021, nearly twothirds of adults with disabilities reported symptoms of at least one mental health condition or 

substance use in the past month. Even more alarming, serious thoughts of suicide were about 2.5 

times as high among adults with disabilities as those without disabilities, with 31% of individuals 

with disabilities reporting that they seriously thought about trying to kill themselves within the 30 

days prior to survey. 

19 https://www.cdc.gov/mmwr/volumes/71/wr/mm7108a5.htm. 20 https://www.cdc.gov/nchs/data/vsrr/VSRR016.pdf 

21 https://www.cdc.gov/injury/wisqars/index.html. 

65 
SAMHSA-Mental Health 

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. Accordingly, SAMHSA supports a comprehensive portfolio of suicide 

prevention programs including the backbone of the portfolio, 988 and Behavioral Health Crisis 

Services (which subsumes the Suicide Lifeline), the National Strategy for Suicide Prevention, and 

targeted interventions for populations at higher risk of suicide such as the Garrett Lee Smith and 

the AI/NA programs. 

66 
 

 

 

SAMHSA-Mental Health 

988 and Behavioral Health Crisis Services 

(Dollars in thousands) 

FY 2021 FY 2022 FY 2023 

 Programs of Regional & National Significance Final 

COVID-19 

Supplemental CR 

President's 

Budget 

FY 2023 +/-

FY 2022 

988 and Behavioral Health Crisis Services.................................................. 

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

$---

24,000 

$---

32,000 

$---

101,621 

$696,901 

---

$696,901 

(101,621)

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

FY 2023 Authorization ..................................................................................................................$0 

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

Eligible Entities............................................................... States, Tribes, Community Organizations 

Program Description and Accomplishments 

Program Background 

To prevent death and injury as the result of suicide attempts, individuals need rapid access to 

suicide prevention and crisis intervention services. “988 Behavioral Health and Crisis Services” 

represents an unprecedented investment in critical, life-saving resources for individuals in crisis. 

On July 16, 2020, the Federal Communications Commission issued a final order designating 988 

as the new, three-digit number for suicide prevention and mental health crises. On October 17, 

2020, the National Suicide Hotline Designation Act of 2020 (Public Law 116-172) was signed into 

law, incorporating 988 into statute as the new number for individuals in crisis. As the National 

Hotline Designation Act mandates, all 988 contacts will be directed to the National Suicide 

Prevention Lifeline, which supports individuals in crisis through a network of roughly 200 crisis 

centers. 988 will continue to include a "Press 1" connection to the VA Crisis Line -- which offers 

24/7 access to veterans, service members, and their families -- and a "Press 2" connection to the 

Spanish crisis subnetwork. 

While some telecommunication providers have already made 988 operational, this new number 

will become available to all Americans using any cell phone, land line, or voice over internet 

device by July 16, 2022. As awareness of 988 spreads, SAMHSA expects Lifeline contact volume 

– and the need for subsequent crisis services – to increase significantly. 

SAMSHSA recognizes 988 implementation and anticipated service uptake as a once-in-a-lifetime 

opportunity to strengthen and transform America’s behavioral health crisis care system to one that 

saves lives by serving anyone, at any time, from anywhere across the nation. SAMHSA also 

recognizes the demand still far exceeds capacity. As of December 2020, the Lifeline only had 

sufficient capacity to address approximately 85% of calls, 56% of texts, and 30% of chats. This 

means there were hundreds of thousands of Americans who sought help and were unable to 

connect with a trained counselor. With implementation of 988, SAMHSA anticipates the contact 

volume—including calls, texts, and chats—to increase from a projected 3.3 million in FY 2022 to 

approximately 7.6 million by FY 2023. The budget proposes an historic investment in the 988 

program to ensure there is sufficient funding to support call center response. 

67 
 

 

 

 

 

 

 

 

 

 

 

 

 

SAMHSA-Mental Health 

Accomplishments 

In FY 2020, call volume averaged 194,729 per month for a total of 2,336,743 contacts. 7,542 

individuals were screened for mental health and suicidal concerns, 1,055 individuals were referred 

to services, and 84.1 percent received services. Analysis of the contacts indicated that most 

individuals who accessed a counselor through the chat system experienced reductions in both 

suicidal ideation and emotional distress. In FY 2021, call volume averaged 208,147 per month for 

a total of 2,497,765 contacts. 

Five Year Funding Table- Suicide Lifeline 

Fiscal Year Amount 

COVID-19 

Supplemental 

Funding 

FY 2019 $12,000,000 

FY 2020 $19,000,000 

FY 2021 Final $24,000,000 $32,000,000 

FY 2022 CR $101,621,000 

FY 2023 President's Budget $---

Five Year Funding Table- 988 and Behavioral Health Crisis Services 

Fiscal Year Amount 

COVID-19 

Supplemental 

Funding 

FY 2019 $---

FY 2020 $---

FY 2021 Final $---

FY 2022 CR $---

FY 2023 President's Budget $696,901,000 

Budget Request 

The FY 2023 President’s Budget request is $696.9 million. The proposed allocation for FY 2023 

represents a historic investment in suicide prevention and behavioral health crisis services. This 

funding level would ensure that 988 can respond to 100% of contacts in FY 2023. FY 2021 federal 

funds to the Lifeline totaled $24 million, while FY 2022 federal funding (including workforce 

funds from the American Rescue Plan) totaled $282 million. The FY 2023 proposed allocation 

amounts to nearly a 30x increase over FY 2021 funding levels. This funding will play an essential 

role in advancing the four areas to begin transforming the crisis system to meet the once-in-alifetime opportunity of 988 by: 

• Strengthening network operations through the Lifeline grant -- Historically, Federal 

funding for the Lifeline has been dedicated to supporting the Lifeline administrator 

and centralized network functions, such as: staffing for backup call centers, core 

68 
 

 

 

SAMHSA-Mental Health 

chat/text centers, and specialized services; data and telephony infrastructure; 

standards, training, and quality improvement; evaluation and oversight. The FY 2023 

investment further increases the capacity and performance of these key network 

infrastructure components and functions to the standard required for the projected 

contacts anticipated in FY 2023 and support collaborative efforts with partner 

organizations to improve local routing of contacts. 

• Enhancing local capacity through partnerships in behavioral health crisis response --

Local center capacity is critical to ensuring that individuals in crisis receive responses 

that are tailored to the service system where they are located and that services across 

the continuum are linked and coordinated. 

• Establishing and maintaining a 988 and Behavioral Health Crisis Coordination Office 

-- Coordination will support 988 implementation and broader crisis system 

transformation. Coordination activities will include technical assistance to states, and 

crisis centers; strategic planning, performance management, evaluation, and 

oversight; and formal partnerships, convenings, and cross-entity coordination. 

• Supporting public awareness with targeted 988 national messaging -- The 988 code 

will provide a universal, easy-to-remember, three-digit phone number and connect 

people in crisis with life-saving resources. As 988 launches, SAMHSA anticipates 

the need and additional costs to educate the public on services covered by 988. 

69 
 

 

 

 

 

 

 

 

SAMHSA-Mental Health 

National Strategy for Suicide Prevention 

(Dollars in thousands) 

FY 2021 FY 2022 FY 2023

 Programs of Regional & National Significance Final 

COVID-19 

Supplemental CR 

President's 

Budget 

FY 2023 +/-

FY 2022 

National Strategy for Suicide Prevention....................................................... 

Zero Suicide (non-add)................................................................................ 

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

 All Other National Strategy for Suicide Prevention (non-add).......................... 

$23,200 

18,800 

2,400 

2,000 

$18,000 

---

---

---

$23,200 

18,800 

2,400 

2,000 

$23,200 

18,800 

2,400 

2,000 

$---

---

---

---

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

FY 2023 Authorization ..................................................................................................................$0 

Allocation Method ............................................................................................. Competitive Grants 

Eligible Entities.................................Community –based primary care or behavioral health entity, 

...................... Federally Recognized, American Indian/Alaska Native tribe or tribal organizations, 

...................................................................................... State mental health or public health agency 

Program Description and Accomplishments 

Suicide has been increasing in the United States, particularly in adults and older adults. Suicide 

rates rose by over 30 percent during 1999-2019. With the rising rates of suicide among adults, 

particularly middle-aged and older adults, focusing on preventing suicide among adults is urgently 

required to reduce suicides nationally. The baby boomer generation has had high rates of suicide 

throughout the generational lifecycle and is entering the stage of life that has historically had the 

highest rate of suicide. Very limited suicide prevention work has been directed toward older adults 

who have the highest rates of suicide. 

The National Strategy for Suicide Prevention (NSSP) grant program supports the efforts of states, 

tribes, primary and behavioral healthcare organizations, public health agencies, and emergency 

departments to implement the NSSP. While the NSSP addresses all age groups and populations 

with specific needs, the goals, and objectives of the NSSP grants focus on preventing suicide and 

suicide attempts among adults over the age of 25 who comprised more than 39,000 of the more 

than 45,000 suicides in the United States in 2020. 

The Zero Suicide program funds a comprehensive, multi-setting approach to suicide prevention in 

health systems and tribes. The purpose of this program is to implement suicide prevention and 

intervention programs for individuals who are 25 years of age or older by systematically applying 

evidence-based approaches to screening and risk assessment, developing care protocols, 

collaborating for safety planning, providing evidence-based treatments, maintaining continuity of 

care during high-risk periods, and improving care and outcomes for such individuals who are at 

risk for suicide being seen in health care systems. 

In FY 2021, SAMHSA supported the continuation of five NSSP grants, 30 Zero Suicide 

continuation grants, and a new cohort of 10 Zero Suicide grants, and 26 COVID Emergency 

Response Suicide Prevention grants. In FY 2022 Annualized CR, SAMHSA will support the 

continuation of five NSSP grants and 40 Zero Suicide continuation grants. 

70 
 

 

 

 

SAMHSA-Mental Health 

Five Year Funding Table 

Fiscal Year Amount 

COVID-19 

Supplemental 

Funding 

FY 2019 $11,200,000 

FY 2020 $18,200,000 

FY 2021 Final $23,200,000 $18,000,000 

FY 2022 CR $23,200,000 

FY 2023 President's Budget $23,200,000 

Budget Request 

The FY 2023 President’s Budget request is $23.2 million, level with the FY 2022 Annualized 

Continuing Resolution. This funding will support 25 Zero Suicide continuation grants, award a 

new cohort of five NSSP and 21 new Zero Suicide grants. The grants support states, tribe, and 

provider organizations in implementing the NSSP goal to prevent suicide. Grantees use NSSP 

funding to support efforts such as raising suicide awareness, establishing emergency room referral 

processes, and improving clinical care practice standards. 

71 
 

 

 

SAMHSA-Mental Health 

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

(Dollars in thousands) 

 Programs of Regional & National Significance 

FY 2021 FY 2022 FY 2023

Final 

COVID-19 

Supplemental CR 

President's 

Budget 

FY 2023 +/-

FY 2022 

GLS - Youth Suicide Prevention - States....................................................... 

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

GLS - Youth Suicide Prevention - Campus.................................................... 

$36,427 

12,000 

6,488 

$17,600 

---

2,400 

$36,427 

12,000 

6,488 

$36,427 

12,000 

11,488 

$---

---

5,000 

Authorizing Legislation ..................... Sections 520E and 520E-2 of the Public Health Service Act 

FY 2023 Authorization ........................................................................................................... $0; $0 

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

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

Program Description and Accomplishments 

In the fall of 2003, Garrett Lee Smith, son of Sen. Gordon and Sharon Smith died by suicide in 

his apartment in Utah where he attended college. He was one day shy of 22 years old. Like most 

suicides, Garrett's came unexpectedly. As many families have tragically experienced, depression 

is not rare or peculiar, but can be deadly. Depression affects one in six Americans at some point 

and very few families are untouched.22 

The Garrett Lee Smith (GLS) Memorial Act authorizes SAMHSA to manage two significant youth 

suicide prevention grant programs and one resource center. The GLS State/Tribal Youth Suicide 

Prevention and Early Intervention Grant Program has awarded 230 grants to 50 states and the 

District of Columbia, 63 unique tribes/tribal organizations, and two territories. These grants 

develop and implement youth suicide prevention and early intervention strategies involving 

public-private collaboration among youth-serving institutions. 

Performance Evaluation 

Previous evaluation results have shown that in the year following suicide prevention activities, 

counties who implemented GLS-supported activities had lower rates of suicide attempts among 

youth than matched counties that did not. This impact was maintained for two years and the impact 

was directly related to years of continued funding. More than 50 percent of the counties in America 

have received at least one year of funding since the program started in 2005. 

In FY 2021, SAMHSA supported 44 GLS State/Tribal continuation grants, 38 GLS Campus 

continuation grants, and awarded a new cohort of six GLS State and Tribal grants and 25 GLS 

Campus grants. In additional, SAMSHA funded eight new GLS Campus grants through American 

Rescue Plan Act funds. 30,722 youth were screened for suicide risk, 15,614 were referred to 

services and 60.2% received services after referral. Grantees’ efforts are reducing the likelihood 

of at-risk youth falling through the gaps in the system. 

22 http://www.jaredstory.com/garrett_smith.html 

72 
 

 

 

 

SAMHSA-Mental Health 

In FY 2022, the program purpose was modified to reflect a more comprehensive approach to 

suicide prevention, not just on pathology. The comprehensive approach model identifies students 

at risk, increases help-seeking behaviors, provides substance use disorder and mental health 

services, and promotes social connectedness. 

In FY 2022 Annualized CR, SAMHSA will support 46 GLS State/Tribal continuation grants, 49 

GLS Campus continuation grants (41 grants from annual appropriations and eight grants from 

American Rescue Plan Act funds) and award a new cohort of five GLS State and Tribal grants 

(one grant from annual appropriations and four grants from American Rescue Plan Act funds) and 

21 GLS Campus grants. 

Five Year Funding Table 

Fiscal Year Amount 

COVID-19 

Supplemental 

Funding 

FY 2019 $41,915,000 

FY 2020 $41,915,000 

FY 2021 Final $42,915,000 $20,000,000 

FY 2022 CR $42,915,000 

FY 2023 President's Budget $47,915,000 

Budget Request 

The FY 2023 President’s Budget request is 47.9 million, an increase of $5.0 million from the FY 

2022 Annualized Continuing Resolution. Funds will support the continuation of 47 GLS 

State/Tribal grants and 54 GLS Campus grants (46 grants from annual appropriation and eight 

grants from American Rescue Plan Act funds), and a new cohort of 62 GLS Campus grants to 

continue developing and implementing youth suicide prevention and early intervention strategies 

involving public-private collaboration among youth serving institutions as well as to support 

suicide prevention among institutions of higher learning. 

73 
 

SAMHSA-Mental Health 

Garrett Lee Smith Suicide Prevention Resource Center 

(Dollars in thousands) 

FY 2021 FY 2022 FY 2023

 Programs of Regional & National Significance Final 

COVID-19 

Supplemental CR 

President's 

Budget 

FY 2023 +/-

FY 2022 

GLS - Suicide Prevention Resource Center................................................... $9,000 $--- $9,000 $9,000 $---

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

FY 2023 Authorization ..................................................................................................................$0 

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

Eligible Entities.....................................................Domestic Public and Private Nonprofit Entities, 

......................Tribal and Urban Indian Organizations, Community and Faith-Based Organizations 

Program Description and Accomplishments 

In addition to the above programs that build suicide prevention capacity, SAMHSA also supports 

the Suicide Prevention Resource Center (SPRC). The purpose of this program is to build national 

capacity for preventing suicide by providing technical assistance, training, and resources to assist 

states, tribes, organizations, and SAMHSA grantees to develop suicide prevention strategies 

(including programs, interventions, and policies that advance the National Strategy for Suicide 

Prevention (NSSP)), with the overall goal of reducing suicides and suicidal behaviors in the nation. 

This work includes support of the public-private National Action Alliance for Suicide Prevention 

and working to advance high-impact objectives of the NSSP. 

SAMHSA’s SPRC has played an important role in transforming suicide prevention and treatment 

across the lifespan, particularly for those at high risk for suicide. Efforts to advance suicide 

prevention include: 

• Developing and promoting the adoption of evidence-based resources, tools, and online 

trainings to support strategic, comprehensive, best practice suicide prevention programs 

around the country; 

• Building the capacity of suicide prevention programs nationwide by providing consultation, 

training, and resources to states, AI/AN communities, colleges and universities, health 

systems, and organizations serving groups at higher risk for suicide; 

• Improving care for those at risk for suicide, including promoting the Zero Suicide model for 

safer suicide care in health and behavioral health care systems; and 

• Providing leadership and operational support, which brings together more than 250 national 

partners from the public and private sectors to advance implementation of the goals and 

objectives of the National Strategy. 

SAMHSA’s SPRC provides free online courses to prepare the clinical workforce to address suicide 

risk in effective ways. In FY 2021, a total of 11,606 individuals received training through the 

SPRC. SPRC delivered four webinars focusing on the needs of the clinical workforce, delivered 

two webinars focused on aspects of the Zero Suicide model, and developed videos to support 

improved suicide prevention efforts through telehealth to improve care provided during the 

COVID-19 pandemic. 

74 
 

 

 

 

 

 

 

 

SAMHSA-Mental Health 

SAMHSA’s SPRC worked with state agencies, communities, and organizations in all 50 states, 

the District of Columbia, several U.S. territories, and over 140 SAMHSA grantees to build 

leadership, capacity, and coordination for strategic, evidence-based suicide prevention across the 

country. 

In addition, SAMHSA’s SPRC collaborates closely with national and regional TA centers that 

focus on issues related to suicide prevention, such as mental health, injury prevention, substance 

use prevention and treatment, violence prevention, and others. SPRC’s collaborations include 

contacts with the coordinating offices of SAMHSA’s Mental Health Technology Transfer Centers 

(TTCs), Prevention TTCs, and Addiction TTCs; Service Member, Veterans, and their Families TA 

Center; Center for Integrated Health Solutions; and HRSA’s National Center for Fatality Review 

and Prevention. 

In FY 2021, approximately 15,723 individuals were exposed to mental health awareness 

messaging through SPRC, which included downloading resources from SPRC’s website. In FY 

2022 Annualized CR, SAMHSA will support one grant continuation, and provide $1 million 

supplement. 

Five Year Funding Table 

Fiscal Year Amount 

COVID-19 

Supplemental 

Funding 

FY 2019 $5,988,000 

FY 2020 $7,988,000 

FY 2021 Final $9,000,000 

FY 2022 CR $9,000,000 

FY 2023 President's Budget $9,000,000 

Budget Request 

The FY 2023 President’s Budget request is $9.0 million, level with the FY 2022 Annualized 

Continuing Resolution. This funding will support one continuation grant. The Suicide Prevention 

Resource Center will provide states, tribes, government agencies, private organizations, colleges 

and universities, and suicide survivors and mental health consumer groups with access to 

information and resources that support program development, intervention implementation, and 

adoption of policies that prevent suicide. 

75 
 

 

 

SAMHSA-Mental Health 

American Indian/Alaska Native Suicide Prevention Initiative 

(Dollars in thousands) 

 Programs of Regional & National Significance 

FY 2021 FY 2022 FY 2023

Final 

COVID-19 

Supplemental CR 

President's 

Budget 

FY 2023 +/-

FY 2022 

American Indian/Alaska Native Suicide Prevention Initiative...................... $2,931 $--- $2,931 $2,931 $---

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

FY 2023 Authorization ..................................................................................................................$0 

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 misuse, and suicide among American Indian/Alaska Native (AI/AN) 

youth. These plans mobilize tribal communities’ existing social and educational resources to meet 

their goals. 

From 2015 to 2020, 486 tribal communities have received specialized technical assistance and 

support in suicide prevention and related areas. In addition, more than 20,965 members of these 

communities received training in prevention and mental health promotion. 

In FY 2018, SAMHSA awarded a new contract to support this activity and awarded one Mental 

Health Transfer Technology Center (MHTTC) for Tribal Affairs to develop and maintain a 

collaborative network to support resource development and dissemination, training and technical 

assistance, and workforce development to the field and CMHS grant recipients. The MHTTC 

Tribal Affairs Center will coordinate and manage CMHS’s national efforts to ensure that highquality, effective mental health disorder treatment and recovery support services, and evidencebased practices are available for all individuals with mental disorders including those with serious 

mental illness. 

In FY 2021, SAMHSA funded a new contract and the existing continuation of the MHTTC Tribal 

Affairs Center. In FY 2022 Annualized CR, SAMHSA will continue to fund the existing contract 

and MHTTC Tribal Affairs Center. 

76 
 

 

 

 

 

SAMHSA-Mental Health 

Five Year Funding Table 

Fiscal Year Amount 

COVID-19 

Supplemental 

Funding 

FY 2019 $2,931,000 

FY 2020 $2,931,000 

FY 2021 Final $2,931,000 

FY 2022 CR $2,931,000 

FY 2023 President's Budget $2,931,000 

Budget Request 

The FY 2023 President’s Budget request is $2.9 million, level with the FY 2022 Annualized 

Continuing Resolution. This funding will fund the new MHTTC Tribal Affairs Center and 

continuation of the contract to provide comprehensive, broad, focused, and intensive training and 

technical assistance to federally recognized tribes and other AI/AN communities to address and 

prevent mental illness and alcohol/other drug addiction, prevent suicide, and promote mental 

health through the contract continuation. 

77 
 

 

 

SAMHSA-Mental Health 

Outputs and Outcomes Table 

Program: Suicide Prevention 

Measure Year and Most Recent 

Result / 

Target for Recent Result / 

(Summary of Result) 

FY 2022 

Target 

FY 2023 

Target 

FY 2023 

Target 

+/-FY 2022 

Target 

2.3.59 Number of 

individuals trained in 

youth suicide 

prevention (Outcome) 

FY 2021: 118,062 

Target: 

73,000 

(Target Exceeded) 

118,000 118,000 Maintain 

2.3.60 Number of youth 

screened (Output) 

FY 2021: 64,453 

Target: 

137,790 

(Target Not Met) 

64,000 64,000 Maintain 

2.3.61 Number of calls 

answered by the suicide 

hotline (Output)/1 

FY 2021: 2,396,885 

Target: 

2,186,000 

2,186,000 

2.3.62 Number of calls, 

chats, and texts 

answered by 988 and 

Behavioral Health 

Crisis Services 

(Output) 

FY 2021: 3,324,484 3,324,484 7,600,000 +4,275,516 

3.1.01 Number of 

individuals screened for 

mental health or related 

interventions 

(Intermediate Outcome) 

FY 2021: 1,357,653.0 

Target: 

798,525.0 

(Target Exceeded) 

1,350,000.0 1,350,000.0 Maintain 

3.1.02 Number of 

individuals referred to 

mental health or related 

services (Intermediate 

Outcome) 

FY 2021: 81,553.0 

Target: 

110,000.0 

(Target Not Met) 

81,000.0 81,000.0 Maintain 

3.1.03 Number of 

organizations that 

establish management 

information/informatio 

n technology system 

links across multiple 

agencies (Intermediate 

Outcome) 

FY 2021: 13.0 

Target: 

3.0 

(Target Exceeded) 

3.0 3.0 Maintain 

78 
SAMHSA-Mental Health 

Measure Year and Most Recent 

Result / 

Target for Recent Result / 

(Summary of Result) 

FY 2022 

Target 

FY 2023 

Target 

FY 2023 

Target 

+/-FY 2022 

Target 

3.1.04 Number of 

organizations or 

communities that 

demonstrate improved 

readiness to change 

their systems 

(Intermediate Outcome) 

FY 2021: 7.0 

Target: 

71.0 

(Target Not Met) 

Discontinued Discontinued N/A 

3.5.11 Percent of 

respondents who say 

calling the lifeline 

stopped you from 

killing yourself a lot or 

a little (Outcome) 

FY 2021: 86.0 

Target: 

76.0 

(Target Exceeded) 

76.0 76.0 Maintain 

1/ Outcome 2.3.61 ends and is subsumed by 2.3.62 

79 
 

 

 

 

 

 

 

 

 

 

 

 

 

SAMHSA-Mental Health 

Homelessness Prevention Programs 

(Dollars in thousands) 

FY 2021 FY 2022 FY 2023

 Programs of Regional & National Significance Final 

COVID-19 

Supplemental CR 

President's 

Budget 

FY 2023 +/-

FY 2022

 Homelessness............................................................................................... 

Homelessness Prevention Programs............................................................ 

Homelessness............................................................................................... 

$32,992 

30,741 

2,251 

$---

---

---

$32,992 

30,696 

2,296 

$37,992 

35,696 

2,296 

$5,000 

5,000 

---

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

FY 2023 Authorization ..................................................................................................................$0 

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

Eligible Entities........................................ States, Domestic Public and Community Organizations, 

.............................. Private Nonprofit Entities, and Community-based Public or Nonprofit Entities 

Program Description and Accomplishments 

Although 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 between 2019 and 2020 increased by just 2.2 percent (12,751 people). Many factors 

contribute to homelessness, such as lack of affordable housing, foreclosures, rising housing costs, 

job loss, underemployment, domestic violence, mental illness, and addiction, and most of these 

factors have been exacerbated by the COVID-19 pandemic. According to HUD, 580,466 

individuals experienced homelessness on any given night in 2020 in the United States.23 In 

addition, the number of individuals experiencing chronic homelessness was 105,583.24 The 

number of veterans experiencing homelessness was 37,252.25 About 20 percent of individuals 

experiencing homelessness have a serious mental illness (SMI) and 15 percent struggle with 

chronic substance use and misuse.26 

In FY 2018, SAMHSA initiated the CMHS-funded Treatment for Individuals Experiencing 

Homelessness (TIEH) program, to support the development and/or expansion of the local 

implementation of an infrastructure that integrates behavioral health treatment and recovery 

support services for individuals, youth, and families with a serious mental illness (SMI), serious 

emotional disturbance (SED), or co-occurring disorder (i.e., SMI and substance use disorder 

[SUD] or a SED and SUD) who are experiencing homelessness. The goal of the TIEH program 

is to increase capacity and provide accessible, effective, comprehensive, coordinated, integrated, 

and evidence-based treatment services, peer support and other recovery support services, and 

linkages to sustainable permanent housing. 

23.Ibid. 

24.Ibid. 

25 Ibid. 26 The U.S. Department of Housing and Urban Development, 2017 CoC Homeless Populations and Subpopulations 

Reports. 

Available at https://www.hudexchange.info/resource/reportmanagement/published/CoC_PopSub_NatlTerrDC_2017 

.pdf 

80 
 

 

 

 

 

 

 

 

 

 

SAMHSA-Mental Health 

In FY 2021, SAMHSA supported 48 TIEH, one HHRC grant continuations and technical 

assistance activities. In FY 2022 Annualized CR, SAMHSA will support 48 TIEH, one HHRC 

grant continuations, and technical assistance activities. The FY 2021 TIEH data shows 4,451 

individuals were served by the program, the number of individuals who were homeless decreased 

by 40.8 percent, and the rate of improvement in social connectedness increased by about 4 percent. 

The data also shows that 12,283 individuals were screened for mental health or mental health 

related interventions. 

Five Year Funding Table 

Fiscal Year Amount 

COVID-19 

Supplemental 

Funding 

FY 2019 $32,992,000 

FY 2020 $32,992,000 

FY 2021 Final $32,992,000 

FY 2022 CR $32,992,000 

FY 2023 President's Budget $37,992,000 

Budget Request 

The FY 2023 President’s Budget request is $37.9 million, an increase of $5.0 million from the FY 

2022 Annualized Continuing Resolution. With this funding, SAMHSA will support 24 TIEH 

continuation grants, one HHRC continuation grant and technical assistance activities to increase 

capacity and provide accessible, effective, comprehensive, coordinated, integrated, and evidencebased treatment services, peer support and other recovery support services, and linkages to 

sustainable and permanent housing. Grantees will expand access to treatment and connect 

homeless individuals experiencing Serious Mental Illness with safe, secure housing. In addition, 

SAMHSA will award a new cohort of 35 TIEH grants and the number of individuals served will 

increase to 7,000. 

81 
 

 

 

SAMHSA-Mental Health 

Outputs and Outcomes Table 

Program: Homelessness Prevention Programs 

Measure Year and Most Recent 

Result / 

Target for Recent Result / 

(Summary of Result) 

FY 2022 

Target 

FY 2023 

Target 

FY 2023 

Target 

+/-FY 2022 

Target 

3.4.23 The number of 

clients served (Output) 

FY 2021: 4003 

Target: 

3634 

(Target Exceeded) 

4003 7000 +3997 

3.4.24 Percentage of 

homeless clients 

receiving services who 

were currently employed 

or engaged in productive 

activities (Outcome) 

FY 2021: 35.9 % 

Target: 

34.4 % 

(Target Exceeded) 

35.9 % 36.9 % +1 percentage 

point(s) 

3.4.25 Percentage of 

clients receiving services 

who had a permanent 

place to live in the 

community (Outcome) 

FY 2021: 30.9 % 

Target: 

30.3 % 

(Target Exceeded) 

30.9 % 41.9 % +11 percentage 

point(s) 

82 
 

 

 

 

 

SAMHSA-Mental Health 

Minority AIDS 

(Dollars in thousands) 

FY 2021 FY 2022 FY 2023

 Programs of Regional & National Significance Final 

COVID-19 

Supplemental CR 

President's 

Budget 

FY 2023 +/-

FY 2022 

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

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

FY 2023 Authorization ..................................................................................................................$0 

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 

Adults with serious mental illness (SMI) receiving public specialty mental health services are not 

tested for HIV regularly27 MAI-SI makes HIV testing and treatment, PrEP and PEP, and Hepatitis 

vaccination and treatment available to this underserved population. The Centers for Disease 

Control and Prevention (CDC) reports significantly higher rates of HIV/AIDS among racial/ethnic 

minorities compared with the general population. Only 7 percent of people with severe mental 

illness receive HIV testing and there are significant racial disparities. Asians/Pacific Islanders 

were 53 percent less likely, and blacks were 82 percent more likely to be tested. African 

Americans accounted for 45 percent and Hispanics accounted for 23 percent of all HIV/AIDS 

cases diagnosed in 2013.28 Psychiatric and psychosocial complications are frequently not 

diagnosed nor addressed at the time of HIV diagnosis or through the course of the disease process. 

When untreated, these complications are associated with increased morbidity and mortality, 

impaired quality of life, and numerous medical issues such as non-adherence with the treatment 

regimen. 

The Minority AIDS Initiative - Service Integration grant program (MAI-SI) is designed to meet 

the health needs of these vulnerable individuals. The MAI-SI program enhances and expands the 

provision of effective, culturally appropriate, HIV/AIDS-related mental health services in racial 

and ethnic minority communities for people with a mental illness who are living with or at high 

risk for HIV/AIDS. The goal of this grant program is to reduce the incidence of HIV and improve 

overall health outcomes for individuals with mental health disorders or co-occurring disorder. The 

population of focus is individuals with a mental illness or co-occurring disorder living with or at 

risk for HIV and/or hepatitis in at-risk populations, including racial and ethnic minority 

communities. Grant recipients provide evidence-based mental and substance use disorder (SUD) 

treatment and practices that are trauma-informed and recovery-oriented. Grantees also implement 

outreach strategies to inform individuals of available behavioral health services and HIV and 

27 https://pubmed.ncbi.nlm.nih.gov/28093055/ 28 Centers for Disease Control and Prevention. HIV Surveillance Report. (2013); vol. 25. Published February 2015. 

Accessed May 8, 2015 from http://www.cdc.gov/hiv/library/reports/surveillance. 

83 
 

 

 

 

 

 

SAMHSA-Mental Health 

hepatitis primary care and prevention services develop formal partnership with HIV treatment and 

care providers such as Ryan White providers to strengthen integration of care through case 

management and offer peer support and case management services to coordinate all aspects of 

care. 

In FY 2021, SAMHSA supported 18 grant continuations. The FY 2021 data show that 78.4 percent 

of individuals receiving services are not experiencing serious psychological distress; 5.9 percent 

reported an increase in everyday functioning; and 76.1 percent of individuals were being retained 

in the community. In FY 2022 Annualized CR, SAMHSA will award a new cohort of 18 grants. 

Five Year Funding Table 

Fiscal Year Amount 

COVID-19 

Supplemental 

Funding 

FY 2019 $9,224,000 

FY 2020 $9,224,000 

FY 2021 Final $9,224,000 

FY 2022 CR $9,224,000 

FY 2023 President's Budget $9,224,000 

Budget Request 

The FY 2023 President’s Budget request $9.2 million, level with the FY 2022 Annualized 

Continuing Resolution. SAMHSA will continue to support 18 continuation grants focused on 

individuals with mental disorders and/or co-occurring disorders living with or at risk for 

HIV/AIDS. 

84 
 

SAMHSA-Mental Health 

Outputs and Outcomes Table 

Program: Minority AIDS Initiative Service Integration 

Measure Year and Most Recent 

Result / 

Target for Recent Result / 

(Summary of Result) 

FY 2022 

Target 

FY 2023 

Target 

FY 2023 

Target 

+/-FY 2022 

Target 

3.5.02 Percentage of 

clients receiving services 

who report positive 

functioning at 6-month 

follow-up. (Outcome) 

FY 2021: 66.3 

Target: 

67.0 

(Target Not Met) 

66.0 66.0 Maintain 

3.5.03 Percentage of 

clients receiving services 

who had a permanent 

place to live in the 

community at six-month 

follow-up. (Outcome) 

FY 2021: 64.5 

Target: 

62.0 

(Target Exceeded) 

62.0 62.0 Maintain 

3.5.04 Percentage of 

clients receiving services 

who are currently 

employed at six-month 

follow-up. (Outcome) 

FY 2021: 45.4 

Target: 

38.7 

(Target Exceeded) 

38.7 38.7 Maintain 

85 
 

 

 

 

 

 

 

 

 

 

 

 

SAMHSA-Mental Health 

Criminal and Juvenile Justice Programs 

(Dollars in thousands) 

FY 2021 FY 2022 FY 2023

 Programs of Regional & National Significance Final 

COVID-19 

Supplemental CR 

President's 

Budget 

FY 2023 +/-

FY 2022 

Criminal and Juvenile Justice Programs........................................................ $6,269 $--- $6,269 $56,394 $50,125 

Authorizing Legislation ........................................ Sections 520G of the Public Health Service Act 

FY 2023 Authorization ..................................................................................................................$0 

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 Units 

Program Description and Accomplishments 

Data indicate that a significant number of individuals that come in contact with law enforcement 

and the criminal justice system have a mental or substance use disorder. More than half of all 

prison and jail inmates (i.e., people in state and federal prisons and local jails) meet criteria for 

having a mental health problem; 6 in 10 meet criteria for a substance abuse problem; and more 

than one-third meet criteria for having both a substance abuse and mental health problem.29 

Approximately 250,000 individuals with serious mental illness (SMI) are incarcerated at any given 

time—about half arrested for non-violent offenses, such as trespassing or disorderly conduct. In 

addition, during street encounters, police officers are almost twice as likely to arrest someone who 

appears to have a mental illness. A Chicago study of thousands of police encounters found that 

47 percent of people with a mental illness were arrested, while only 28 percent of individuals 

without a mental illness were arrested for the same behavior.30 The costs associated with 

incarceration are high: state corrections budgets alone account for $39.0 billion in taxpayer 

costs.31,32 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. 

The purpose of SAMHSA’s Early Diversion grants is to establish or expand programs that divert 

adults with a SMI or a co-occurring disorder (COD) from the criminal justice system to 

community-based services prior to arrest and booking. Special consideration is given to applicants 

proposing to use grant funding to support early diversion services for veterans. 

29 U.S. Department of Justice, Office of Justice Programs. (2006) Mental health problems of prison and jail 

inmates. Retrieved, March 25, 2011, from http://bjs.ojp.usdoj.gov/content/pub/pdf/mhppji.pdf 30 The Role of Mental Health Courts in System Reform. (2003) The Bazelon Center for Mental Health Law. 

http://heinonline.org/HOL/LandingPage?handle=hein.journals/udclr7&div=10&id=&page= 31 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 

32 Henrichson, C., & Delaney, R. (2012). The price of prisons: What incarceration costs taxpayers. New York: 

Vera Institute of Justice. 

86 
 

 

 

SAMHSA-Mental Health 

Performance Evaluation 

SAMHSA completed an evaluation of the first cohort of Behavioral Health Treatment Courts 

Collaborative (BHTCC) grantees in September 2014. Findings of the evaluation demonstrate that 

grantees built multi-agency workgroups or collaborative to oversee programs. Because of the 

grant funding, all grant recipients expanded access to specialty courts. Most grant recipients 

anticipated continuing new screening and assessment processes addressing a broader array of 

behavioral health needs after grant funding ended. Program innovations were divided into four 

main groups, including court and treatment provider collaboration, court and community case 

management, unified cross-court screening and referral, and meaningful peer involvement. 

BHTCC served over 2,99733 individuals, with 77 percent of them identified as having co-occurring 

mental illness and drug/alcohol addiction and with nearly two thirds reporting violence or trauma 

exposure in their lives. Based on performance data reporting, alcohol and other drug use by 

program participants declined by 53 percent at six months34 . Nearly 79 percent of participants 

either maintained good physical health or reported physical health improvements in the same time 

period. In addition, employment rates increased from 29 percent to 45 percent over the first six 

months, with monthly mean income increasing by $217. 

In FY 2021, SAMHSA supported 17 grant continuations and conducted technical assistance 

activities. 82.9 percent of individuals served by this program reported that they were experiencing 

no serious psychological stress, and this represents an increase of 41.8 percent from baseline. 

Retention in the community increased from 29.6 percent to 70.4 percent, and 96.6 percent of 

individuals had no involvement with the criminal justice system. 

In FY 2022 Annualized CR, SAMHSA will support 17 grant continuations and conduct technical 

assistance activities. 

33 Cohort 2 data through November 15, 2017 34 Calculated as the change in percentage of individuals reporting alcohol or drug use from baseline to six-month 

follow-up. 

87 
 

 

 

 

 

 

 

SAMHSA-Mental Health 

Five Year Funding Table 

Fiscal Year Amount 

COVID-19 

Supplemental 

Funding 

FY 2019 $3,692,147 

FY 2020 $6,269,000 

FY 2021 Final $6,269,000 

FY 2022 CR $6,269,000 

FY 2023 President's Budget $56,394,000 

Budget Request 

The FY 2023 President’s Budget request is $56.3 million, an increase of $50.1 million from the 

FY 2022 Annualized Continuing Resolution. SAMHSA will award a new cohort of up to 126 

grants to support provision of services (screening, assessment, treatment, and linkage to services) 

to individuals by community-based behavioral health providers, both within jails and prisons, as 

well as after release and during reentry. This funding will establish pre-release relationships with 

community mental health providers and key stakeholders. This activity will address the unmet 

treatment needs of incarcerated individuals and allow these individuals to continue to access 

services from the same community-based providers post-incarceration for a seamless transition of 

care once they are released. The needs of individuals returning to society include the social 

determinants of recovery (i.e., housing, employment, access to health care) and other supportive 

resources for successful transition from incarceration. Special importance will be paid towards 

ensuring a commitment to racial and economic justice, trauma-informed approaches, as well as 

cultural awareness. SAMHSA will also improve the response to people with mental illness across 

local criminal justice and court systems, including through specialty mental health court programs, 

by expanding the number of opportunities for diversion for non-violent offenders when 

appropriate. This funding will help people who need treatment get the care they need, decrease 

recidivism, and increase public safety. SAMHSA will also support the continuation of six Early 

Diversion grants; 26 new grants to improve reentry into the community and access to treatment 

for people involved in the criminal justice system and one new grant for this program; and award 

a continuation contract for the technical assistance center. 

This proposed increase aligns with the Administration’s goal to address the unmet mental health 

treatment needs among incarcerated youth and adults and ensure their successful transition into 

the community post-incarceration. The needs of individuals returning to society include the social 

determinants of recovery (i.e., housing, employment, access to health care) and other supportive 

resources for successful transition from incarceration. 

88 
 

 

 

SAMHSA-Mental Health 

Outputs and Outcomes Table 

Program: Criminal and Juvenile Justice 

Measure Year and Most Recent 

Result / 

Target for Recent Result / 

(Summary of Result) 

FY 2022 

Target 

FY 2023 

Target 

FY 2023 

Target 

+/-FY 2022 

Target 

3.5.06 Percentage of 

clients receiving services 

who report positive 

functioning at 6-month 

follow-up (Outcome) 

FY 2021: 59.9 

Target: 

40.0 

(Target Exceeded) 

40.0 40.0 Maintain 

3.5.07 Percentage of 

clients receiving services 

who had a permanent 

place to live in the 

community at six-month 

follow-up. (Outcome) 

FY 2021: 46.2 

Target: 

40.0 

(Target Exceeded) 

40.0 40.0 Maintain 

3.5.08 Increase the 

percentage of clients 

receiving services who 

are currently employed at 

six-month follow-up. 

(Outcome) 

FY 2017: 50.0 

Target: 

50.0 

(Baseline) 

Not Defined Not Defined Maintain 

3.5.09 Number of 

individuals screened for 

mental health or related 

interventions. (Output) 

FY 2021: 2,741.0 

Target: 

2,700.0 

(Target Exceeded) 

2,700.0 100,000 Increase 

89 
 

 

 

 

 

 

 

 

 

 

 

SAMHSA-Mental Health 

Practice Improvement and Training 

(Dollars in thousands) 

FY 2021 FY 2022 FY 2023

 Programs of Regional & National Significance Final 

COVID-19 

Supplemental CR 

President's 

Budget 

FY 2023 +/-

FY 2022 

Practice Improvement and Training............................................................... $7,828 $--- $7,828 $9,828 $2,000 

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

FY 2023 Authorization ..................................................................................................................$0 

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

Eligible Entities............. 105 Nationally Recognized Historically Black Colleges and Universities 

Program Description and Accomplishments 

The Practice Improvement and Training (PIT) programs address the need for disseminating key 

information, such as evidence-based mental health practices, to the mental health delivery system. 

The purpose of the Historically Black Colleges and Universities-Center for Excellence (HBCUCFE) PIT 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. 

SAMHSA has worked to strengthen its clinical and science-based approach to addressing serious 

mental illness. In FY 2018, SAMHSA developed a Clinical Support Services TA Center to address 

SMI. This TA Center focuses specifically on the clinical treatment of SMI, including the use of 

medications. 

In FY 2021 and FY 2022 Annualized CR, SAMHSA will fund the HBCU grant program and the 

Clinical Support Services TA Center. 

Five Year Funding Table 

Fiscal Year Amount 

COVID-19 

Supplemental 

Funding 

FY 2019 $7,828,000 

FY 2020 $7,828,000 

FY 2021 Final $7,828,000 

FY 2022 CR $7,828,000 

FY 2023 President's Budget $9,828,000 

90 
 

SAMHSA-Mental Health 

Budget Request 

The FY 2023 President’s Budget request is $9.8 million, an increase of $2.0 million from the FY 

2022 Annualized Continuing Resolution. The purposed funding increase will be targeted to the 

HBCU-CFE program, support continuation of the Clinical Support Services TA Center for SMI 

and provide supplemental funding for the school safety program. 

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 105. 

91 
 

 

 

SAMHSA-Mental Health 

Consumer and Consumer-Supporter TA Centers 

(Dollars in thousands) 

FY 2021 FY 2022 FY 2023

 Programs of Regional & National Significance Final 

COVID-19 

Supplemental CR 

President's 

Budget 

FY 2023 +/-

FY 2022 

Consumer and Consumer-Supporter Technical Assistance Centers............... $1,901 $--- $1,918 $1,918 $---

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

FY 2023 Authorization ..................................................................................................................$0 

Allocation Method ............................................................................................. Competitive Grants 

Eligible Entities........................................................................................Community Organizations 

Program Description and Accomplishments 

Consumer-centered services and supports, such as peer specialists, are key to improving the quality 

and outcomes of health and behavioral healthcare services for people with mental disorders 

including serious mental illness (SMI). Such approaches maximize consumer self-determination, 

promote long-term recovery, and assist individuals with SMI to increase their community 

involvement through work, school, and social connectedness. 

First funded in 1992, the Consumer and Consumer-Supporter Technical Assistance (TA) Centers 

provide technical assistance to facilitate quality improvement of the mental health system by the 

specific promotion of consumer-directed approaches for adults with SMI. This program also 

improves collaboration among consumers, families, providers, and administrators and helps to 

transform community mental health services into a more consumer and family driven model. 

In FY 2021, the Consumer and Consumer-Supporter TA Centers provided training to 

approximately 30,043 people. These trainings covered a range of topics, including peer support, 

the Wellness Recovery Action Plan, Emotional CPR, financial literacy, and collaborative 

leadership. In addition, the Consumer and Consumer-Supporter TA Centers provided support and 

expertise to consumer organizations that led to these organizations obtaining over $334 thousand 

in funding (non-grant). 

In FY 2021 and FY 2022 Annualized CR, SAMHSA will support five grant continuations. 

92 
 

 

 

 

 

 

 

SAMHSA-Mental Health 

Five Year Funding Table 

Fiscal Year Amount 

COVID-19 

Supplemental 

Funding 

FY 2019 $1,918,000 

FY 2020 $1,918,000 

FY 2021 Final $1,901,492 

FY 2022 CR $1,918,000 

FY 2023 President's Budget $1,918,000 

Budget Request 

The FY 2023 President’s Budget request is $1.9 million, level with the FY 2022 Annualized 

Continuing Resolution. SAMHSA’s funding request will support five continuation grants to 

provide technical assistance to facilitate the quality improvement of the mental health system by 

promoting consumer-directed approaches for adults with SMI. 

The output and outcome measures for Consumer and Consumer-Supporter TA Centers are part of 

the Mental Health - Science and Service Activities Outputs and Outcomes table shown on page 

105. 

93 
 

 

 

 

 

 

SAMHSA-Mental Health 

Disaster Response 

(Dollars in thousands) 

FY 2021 FY 2022 FY 2023

 Programs of Regional & National Significance Final 

COVID-19 

Supplemental CR 

President's 

Budget 

FY 2023 +/-

FY 2022 

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

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

FY 2023 Authorization ..................................................................................................................$0 

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

Eligible Entities.......................................................Domestic Public or Private Non-Profit Entities 

Program Description and Accomplishments 

Natural and human caused disasters and emergent events, such as the COVID-19 pandemic, 

wildfires in California, Colorado, and Washington; hurricanes and tropical storms along the coast; 

and midwestern floods and tornadoes; strike without warning. These unexpected disasters and 

events leave individuals, families, and whole communities struggling to rebuild. SAMHSA 

ensures that the nation is prepared to address, as well as respond to, the behavioral health needs 

that follow these disasters or events by funding three major programs: the Disaster Distress 

Helpline (DDH), the Crisis Counseling Assistance and Training Program (CCP), and the Disaster 

Technical Assistance Center (DTAC). These programs provide disaster behavioral health 

expertise around natural disasters, and emerging public health initiatives to develop and 

disseminate innovative consultation and technologies to communities, federal partners, and other 

stakeholders. 

SAMHSA’s DDH, the nation’s first permanent hotline dedicated to providing immediate disaster 

crisis counseling. The DDH 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. SAMHSA operates the CCP through an interagency agreement with the Federal 

Emergency Management Agency (FEMA). This program assists individuals and communities to 

recover from presidentially declared disasters through the provision of community-based 

behavioral health outreach and psycho-educational services. SAMHSA provides technical 

assistance, program guidance and monitoring, and oversight of the CCP. The DTAC is funded by 

SAMHSA and FEMA and designed to provide additional technical assistance, strategic planning, 

consultation, and logistical support. 

In FY 2020, SAMHSA responded to over 48,000 calls and received close to 120,000 text messages 

to the DDH. SAMHSA has seen an over 300 percent increase in its DDH call volume this year 

during the Covid-19 pandemic, compared to the year prior. In addition, SAMHSA’s Disaster App 

(available on Apple and android platforms) provides evidence-informed and evidence-based 

resources in the Disaster Kit, along with additional partner resources and information on local 

mental health and substance use treatment facilities. It can share content anonymously and can 

function with limited Internet connectivity. 

94 
 

 

 

 

 

 

 

 

 

 

 

 

 

SAMHSA-Mental Health 

In FY 2021, the CCP Online Data Collection and Evaluation System showed the following 

contacts and encounters funded by 65 CCP grants: 

• 2,723,064 in-person brief educational supportive contacts, 

• 1,394,968 telephone/hotline contacts and 1,907,412 e-mail contacts, 

• 583,620 individual and family crisis counseling encounters (lasting 15 to 60 minutes or 

more) serving 757,223 individuals, and 

• 5,0297 group encounters (public education and group counseling) serving 861,134 

individuals. 

Analysis of the data show individual and family crisis counseling encounters were most often 

conducted with adults ages 40 to 64 (42 percent) followed by adults ages 18-39 (26 percent) and 

adults ages (23 percent). Individual and family encounters occurred most often with female (58 

percent) disaster survivors and most (50 percent) were conducted in Spanish due to two large CCP 

grants running in Puerto Rico. The three most common risk factors reported by counseling 

participants were past trauma (20 percent), other financial loss (17 percent), and prolonged 

separation from family (14 percent). Across the four major health concern categories (behavioral, 

emotional, physical, and cognitive), the highest number of reported disaster event reactions fell 

within the emotional category and was “anxious/fearful” (n = 335,526). The next most prevalent 

reaction was “extreme change in activity level” (n= 249,039) under the behavioral category. 

In FY 2021, SAMHSA funded one new National DDH grant and continue to support the DTAC 

contract. In FY 2022 Annualized CR, SAMHSA will support National Disaster Distress Helpline 

continuation grant and DTAC continuation contract. 

Five Year Funding Table 

Fiscal Year Amount 

COVID-19 

Supplemental 

Funding 

FY 2019 $1,953,000 

FY 2020 $1,953,000 

FY 2021 Final $1,953,000 

FY 2022 CR $1,953,000 

FY 2023 President's Budget $1,953,000 

Budget Request 

The FY 2023 President’s Budget request is $1.9 million, level with the FY 2022 Annualized 

Continuing Resolution Funding will continue the support of a nationally available disaster distress 

crisis counseling telephone line and the Disaster Technical Assistance Center. 

The output and outcome measures for Disaster Response are part of the Mental Health - Science 

and Service Activities Outputs and Outcomes table shown on page 105. 

95 
 

 

 

 

 

 

 

 

 

SAMHSA-Mental Health 

Seclusion and Restraint 

(Dollars in thousands) 

FY 2021 FY 2022 FY 2023

 Programs of Regional & National Significance Final 

COVID-19 

Supplemental CR 

President's 

Budget 

FY 2023 +/-

FY 2022 

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

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

FY 2023 Authorization ..................................................................................................................$0 

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 people are traumatized by coercive practices. Children with emotional and 

behavioral issues are more frequently subjected to restraints in schools than students with other 

disabilities, often leading to serious physical injuries and emotional trauma for both students and 

staff. Coercive practices, such as seclusion and restraint, impede recovery and well-being. 

In 2018, SAMSHA funded a regionally based technical assistance effort focused on providing 

supports and services for individuals living with mental disorders and/or Serious Mental Illness 

(SMI). The purpose of the Mental Health Technology Transfer Center (MHTTC) Network is to 

disseminate and implement evidence-based practices for treating mental disorders into the field. 

The MHTTC Network includes 10 Regional Centers, a National American Indian and Alaska 

Native Center, a National Hispanic and Latino Center, and a Network Coordinating Office. The 

collaborative network supports resource development and dissemination, training and technical 

assistance, and workforce development for the mental health field. It works with systems, 

organizations, and treatment practitioners involved in the delivery of mental health services to 

strengthen their capacity to deliver effective evidence-based practices to individuals. 

In FY 2021 and FY 2022 Annualized CR, SAMHSA will fund 11 MHTTC continuation grants. 

Five Year Funding Table 

Fiscal Year Amount 

COVID-19 

Supplemental 

Funding 

FY 2019 $1,147,000 

FY 2020 $1,147,000 

FY 2021 Final $1,147,000 

FY 2022 CR $1,147,000 

FY 2023 President's Budget $1,147,000 

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SAMHSA-Mental Health 

Budget Request 

The FY 2023 President’s Budget request $1.1 million, level with the FY 2022 Annualized 

Continuing Resolution. SAMHSA’s funding request will provide support for the new cohort of 

the 11 MHTTC grants. 

97 
 

 

 

 

SAMHSA-Mental Health 

Assertive Community Treatment for Individuals with Serious Mental Illness 

(Dollars in thousands) 

FY 2021 FY 2022 FY 2023

 Programs of Regional & National Significance Final 

COVID-19 

Supplemental CR 

President's 

Budget 

FY 2023 +/-

FY 2022 

Assertive Community Treatment for Adults with SMI................................... $9,000 $--- $9,000 $9,000 $---

Authorizing Legislation ........................................Sections 520M of the Public Health Service Act 

FY 2023 Authorization ..................................................................................................................$0 

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

Eligible Entities............................ States, local governments, Indian tribes, or tribal organizations, 

..................................................................................mental health systems, or health care facilities 

Program Description and Accomplishments 

The Assertive Community Treatment (ACT) for Individuals with SMI program is authorized under 

the 21st Century Cures Act. ACT is an evidence-based practice considered to be one of the most 

effective approaches to deliver services to individuals with the most severe impairments associated 

with SMI35 and has been disseminated by SAMHSA for widespread use through its Evidencebased Toolkit series36 beginning in 2008. ACT was developed to reduce re-hospitalization and 

improve outcomes in community settings. It is designed as an approach to provide a 

comprehensive array of services, including medication management and other recovery support 

services, directly rather than through referrals. An ACT team is composed of 10-12 

multidisciplinary behavioral health staff, including psychiatrists, nurses, social workers, addiction 

counselors, employment/vocational supports, and peer specialists. These practitioners work 

together to deliver team-based, comprehensive, individualized, and recovery-oriented treatment 

and case management services to approximately 100 people with SMI in community settings. 

Caseloads are one staff member to every 10 individuals. Services are provided 24 hours, 7 days a 

week and for as long as needed, wherever they are needed. Teams often find they can anticipate 

and avoid crises. 

FY 2021 data indicated that 67.4 percent of individuals served by the ACT program reported 

positive functioning in everyday life in comparison to 51.8 percent reported at baseline. 

Individuals served by the ACT program had greater retention in the community at six-month 

reassessment (83.7 percent) than reported at baseline (52.9percent). In addition, the percent of 

individuals who had a stable place to live increased to 67.3 percent, a 31.3 increase at the time of 

the six-month reassessment. Data also showed that 432 individuals in the mental health workforce 

received training in mental health practices consistent with the goals of the program. 

35 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3589962/ 36 http://store.samhsa.gov/product/Assertive-Community-Treatment-ACT-Evidence-Based-Practices-EBPKIT/SMA08-4345 

98 
 

 

 

 

 

 

SAMHSA-Mental Health 

In FY 2021, SAMHSA supported 10 grant continuations and funded a new cohort of two ACT 

grants. 

In FY 2022 Annualized CR, SAMHSA will support 12 grant continuations and fund a new cohort 

of one ACT grants. 

Five Year Funding Table 

Fiscal Year Amount 

COVID-19 

Supplemental 

Funding 

FY 2019 $5,000,000 

FY 2020 $7,000,000 

FY 2021 Final $9,000,000 

FY 2022 CR $9,000,000 

FY 2023 President's Budget $9,000,000 

Budget Request 

The FY 2023 President’s Budget request $9.0 million, level with the FY 2022 Annualized 

Continuing Resolution. This funding will support the continuation of six grants to advance the 

ACT approach to address the needs of those living with SMI and award a new cohort of seven 

ACT grants. 

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SAMHSA-Mental Health 

Outputs and Outcomes Table 

Program: Assertive Community Treatment Grants 

Measure Year and Most Recent 

Result / 

Target for Recent Result / 

(Summary of Result) 

FY 2022 

Target 

FY 2023 

Target 

FY 2023 

Target 

+/-FY 2022 

Target 

3.4.13 Percentage of 

clients receiving services 

who report positive 

functioning at 6-month 

follow-up. (Outcome) 

FY 2021: 54.1 

Target: 

61.0 

(Target Not Met) 

54.0 54.0 Maintain 

3.4.14 Percentage of 

clients receiving services 

who are currently 

employed at 6-month 

follow-up. (Outcome) 

FY 2021: 17.0 

Target: 

23.0 

(Target Not Met) 

17.0 17.0 Maintain 

3.4.15 Percentage of 

clients receiving services 

who have a permanent 

place to live in the 

community at 6-month 

follow-up. (Outcome) 

FY 2021: 67.9 

Target: 

64.0 

(Target Exceeded) 

64.0 64.0 Maintain 

100 
 

 

 

SAMHSA-Mental Health 

Assisted Outpatient Treatment for Individuals with Serious Mental Illness 

(Dollars in thousands) 

FY 2021 FY 2022 FY 2023

 Programs of Regional & National Significance Final 

COVID-19 

Supplemental CR 

President's 

Budget 

FY 2023 +/-

FY 2022 

Assisted Outpatient Treatment for Individuals with Serious Mental Illness.. $20,937 $--- $21,000 $21,420 $420 

Authorizing Legislation ................ Section 224 of the Protecting Access to Medicare Act of 2014 

FY 2023 Authorization ..................................................................................................................$0 

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

Eligible Entities.....................................................................States and communities 

Program Description and Accomplishments 

Recent data show that one in 25 Americans live with a serious mental illness (SMI), such as 

schizophrenia, bipolar disorder, and major depression. Less than half of adults with diagnosable 

mental disorders receive the treatment they need. Without access to and receipt of evidence-based 

mental health services, mental health issues can negatively affect all areas of a person’s life. 

To increase access to evidence-based mental health services for individuals with SMI, in April 

2014, Congress passed the Protecting Access to Medicare Act of 2014 (PAMA), which authorized 

a four-year pilot program to award grants for Assisted Outpatient Treatment (AOT) programs for 

individuals with SMI. This authorization was extended in the 21st Century Cures Act. AOT is the 

practice of delivering outpatient treatment under a civil court order to adults with SMI who meet 

specific state civil commitment AOT criteria, such as a prior history of non-adherence to treatment 

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

to order individuals to enter and remain in treatment within the community for a specified period 

of time. This grant program will help to identify evidence-based AOT practices that support 

improved outcomes, including outreach and engagement, clinical treatment and supportive 

services, and due process protections. 

In FY 2016, SAMHSA implemented the AOT grant program and awarded 17 grants to eligible 

entities, such as a county, city, mental health system, mental health court, or any other entity with 

authority under the law of the state in which the grantee is located. This four-year program is 

intended to implement and evaluate new AOT programs and identify evidence-based practices that 

are effective in reducing disability by reducing the incidence and duration of psychiatric 

hospitalization, homelessness, incarcerations, and interactions with the criminal justice system 

while improving the health and social outcomes of individuals with a SMI. This program is 

designed to work with families and courts to allow these individuals to obtain treatment while 

continuing to live in the community and their homes. Grants were awarded to applicants that have 

not previously implemented an AOT program. In FY 2021, the AOT grant program served over 

500 consumers and provided training to 509 individuals in the mental health and related workforce. 

101 
 

 

 

 

 

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Grantee performance data from SAMHSA’s Performance Accountability Reporting System 

(SPARS) was used to capture outcomes in the four areas listed below: 

1. Cost savings and public health outcomes including substance misuse, hospitalization, and use 

of services 

• 9.8 percent of AOT program participants reported spending at least one day in the 

hospital for mental health care in the past 30 days at their most recent reassessment 

compared to 65.3 percent at intake. 

• 7.3 percent of AOT program participants reported spending at least one day in the 

emergency department for a psychiatric or emotional problem in the past 30 days at 

their most recent reassessment compared to 33.2 percent at intake. 

• 25 percent of AOT program participants reported using illegal substances 30 days 

before their most recent reassessment compared to 33.3 percent at intake. 

2. Rates of Incarceration 

• 7.1 percent of AOT program participants reported spending one or more nights in a 

correctional facility in the past 30 days at their most recent reassessment compared to 

12.7 percent at intake. 

3. Rates of Homelessness 

• 7.0 percent of AOT program participants reported spending one or more homeless 

nights in the past 30 days at their most recent reassessment compared to 13.6 percent 

at intake. 

4. Patient and family satisfaction with program participation 

• 91.8 percent of AOT program participants agreed or strongly agreed with the statement 

“I liked the services I received here” at their most recent reassessment. 

In FY 2021, SAMHSA supported 20 grant continuations and awarded a new cohort of three grants. 

In FY 2022 Annualized CR, SAMHSA will support 20 grant continuations and award a new cohort 

of three grants. 

Five Year Funding Table 

Fiscal Year Amount 

COVID-19 

Supplemental 

Funding 

FY 2019 $15,000,000 

FY 2020 $19,000,000 

FY 2021 Final $20,936,953 

FY 2022 CR $21,000,000 

FY 2023 President's Budget $21,420,000 

Budget Request 

The FY 2023 President’s Budget request is $21.4 million, an increase of $420,000.0 from the FY 

2022 Annualized Continuing Resolution. This funding will support 23 grant continuations to 

improve the health and social outcomes for individuals with SMI and continuation of the technical 

assistance center. 

102 
 

 

 

 

 

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Outputs and Outcomes Table 

Program: Assisted Outpatient Treatment for Individuals with Serious Mental Illness 

Measure Year and Most Recent 

Result / 

Target for Recent Result / 

(Summary of Result) 

FY 2022 

Target 

FY 2023 

Target 

FY 2023 

Target 

+/-FY 2022 

Target 

3.4.06 Percentage of 

clients receiving services 

who report positive 

functioning at 6-month 

follow-up. (Outcome) 

FY 2021: 71.0 

Target: 

70.0 

(Target Exceeded) 

70.0 70.0 Maintain 

3.4.07 Percentage of 

clients receiving services 

who are maintained at 

six-month follow-up. 

(Outcome) 

FY 2021: 85.8 

Target: 

89.0 

(Target Not Met) 

86.0 86.0 Maintain 

3.4.08 Number of people 

in the mental health and 

related workforce trained 

in mental health-related 

practices/activities. 

(Output) 

FY 2021: 509.0 

Target: 

2,700.0 

(Target Not Met) 

Discontinued Discontinued N/A 

*3.4.09 Number of 

consumers/family 

members who provide 

mental health-related 

services. (Output) 

FY 2021: 31.0 

Target: 

72.0 

(Target Not Met) 

Discontinued Discontinued N/A 

* Trained consumer/family members providing mental health-related services can assist in the 

attainment of treatment goals and promote improved role functioning in the home and in 

community settings. The number of consumers/family members providing mental-health related 

services reflects the AOT program’s access to these services, which could be a potential indicator 

of overall positive AOT outcomes for individuals with serious mental illness. 

103 
 

 

SAMHSA-Mental Health 

Outputs and Outcomes Table 

Program: Mental Health – Other Capacity Activities 37 

Measure Year and Most Recent 

Result / 

Target for Recent Result / 

(Summary of Result) 

FY 2022 

Target 

FY 2023 

Target 

FY 2023 

Target 

+/-FY 2022 

Target 

3.5.00 Number of people 

in the mental health and 

related workforce trained 

in mental health-related 

practices/activities that 

are consistent with the 

goals of the grant 

(Output) 

FY 2021: 28,869.0 

Target: 

28,746.0 

(Target Exceeded) 

28,746.0 28,746.0 Maintain 

3.5.01 Number of 

consumers/family 

members representing 

consumer/family 

organizations who are 

involved in ongoing 

mental health-related 

planning and advocacy 

activities as a result of the 

grant (Output) 

FY 2021: 6,669.0 

Target: 

12,334.0 

(Target Not Met) 

6,669.0 6,669.0 Maintain 

37 Includes the following: Children and Family, Consumer and Family Network, Consumer and Consumer-Supporter 

TA Centers, Practice Improvement Training, and Disaster Response. 

104 
 

SAMHSA-Mental Health 

Outputs and Outcomes Table 

Program: Mental Health - Science and Service Activities 

Measure Year and Most Recent 

Result / 

Target for Recent Result / 

(Summary of Result) 

FY 2022 

Target 

FY 2023 

Target 

FY 2023 

Target 

+/-FY 2022 

Target 

1.4.06 Number of people 

trained by CMHS 

Science and Service 

Programs (Output) 

FY 2021: 1,706 

Target: 

30,983 

(Target Not Met) 

30,983 30,983 Maintain 

1.4.14 Number of calls 

answered by the Disaster 

Distress Hotline (Output) 

FY 2021: 38,631 

Target: 

56,700 

(Target Not Met) 

56,700 56,700 Maintain 

1.4.15 Number of text 

messages answered by 

the Disaster Distress 

Hotline (Output) 

FY 2020: 117,042 

Target: 

18,468 

(Target Exceeded) 

117,000 117,000 Maintain 

105 
 

 

 

SAMHSA-Mental Health 

Tribal Behavioral Health Grants 

(Dollars in thousands) 

FY 2021 FY 2022 FY 2023

 Programs of Regional & National Significance Final 

COVID-19 

Supplemental CR 

President's 

Budget 

FY 2023 +/-

FY 2022 

Tribal Behavioral Health Grants................................................................... $20,881 $--- $20,750 $23,250 $2,500 

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

FY 2023 Authorization ..................................................................................................................$0 

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

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

Program Description and Accomplishments 

Suicide is a leading cause of death among American Indian/Alaska Native (AI/AN) youth and 

young adults ages ten to 14 years.38 For American Indian/Alaska Native Youth age 10-19, the 

unadjusted suicide rate is more than three times the rate for the nation as a whole. Further, AI/AN 

high school students report higher rates of suicidal behaviors than the general population of U.S. 

high school students.39 These behaviors include serious thoughts of suicide, suicide plans, suicide 

attempts, and medical attention for a suicide attempt. However, the risk of suicide is not the same 

in all AI/AN youth demographic groups. For instance, AI/AN youth raised in urban settings have 

a smaller risk of having thoughts of suicide than AI/AN youth raised on tribal reservations (21 

percent and 33 percent, respectively).40 

Consistent with the goals of the Tribal Behavioral Health Agenda, the Tribal Behavioral Health 

Grant (TBHG/Native Connections (NC) 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 use, trauma, and suicide and by promoting the mental health of AI/AN young people. 

The first cohort of TBHG/NC grants was provided 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 misuse, thereby promoting mental health among tribal youth. In addition, 

SAMHSA’s Tribal Training and Technical Assistance Center (http://www.samhsa.gov/tribal-ttac) 

provides training and education to AI/AN grantees and organizations serving AI/AN populations 

to support their ability to achieve their goals. 

This initiative takes a comprehensive, culturally appropriate approach to help improve the lives of 

and opportunities for AI/AN youth. In addition to the Department of Health and Human Services, 

38 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. 39 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. 40 Freedenthal, S. & Stiffman, A. R. (2004). Suicidal Behavior in Urban American Indian Adolescents: A 

Comparison with Reservation Youth in a Southwestern State. Suicide and Life-Threatening Behavior, 34(2), 160-

171. 

106 
 

 

 

 

 

 

SAMHSA-Mental Health 

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. 

In FY 2016, SAMHSA expanded activities through the braided TBHG/NC funding ($15.0 million 

in the Substance Use Prevention Services appropriation and $15.0 million in Mental Health 

appropriation) to allow tribes the flexibility to implement community-based strategies to address 

trauma, prevent substance misuse, and promote mental health and resiliency among youth in tribal 

communities. 

In FY 2021, SAMHSA supported 124 grant continuations and awarded a new cohort of 29 grants 

and technical assistance activities. In FY 2022 Annualized CR, SAMHSA will support 140 grant 

continuations and award a new cohort of six grants and technical assistance activities. 

Five Year Funding Table 

Fiscal Year Amount 

COVID-19 

Supplemental 

Funding 

FY 2019 $20,000,000 

FY 2020 $20,000,000 

FY 2021 Final $20,881,047 

FY 2022 CR $20,750,000 

FY 2023 President's Budget $23,250,000 

Budget Request 

The FY 2023 President’s Budget request is $23.2 million, an increase of $2.5 million from the FY 

2022 Annualized Continuing Resolution. The purposed increase, combined with $23.6 million in 

the Substance Use Prevention Services will support technical assistance activities, 78 continuation 

grants and award a new cohort of 38 grants that promote mental health and prevent substance use 

activities for high-risk AI/AN youth and their families. The increase in funding will result in an 

increase in the number of individuals contacted through program outreach efforts to nearly 

600,000. 

As a braided activity, SAMHSA is tracking 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. 

107 
 

SAMHSA-Mental Health 

Outputs and Outcomes Table 

Program: Tribal Behavioral Health 

Measure Year and Most Recent 

Result / 

Target for Recent Result / 

(Summary of Result) 

FY 2022 

Target 

FY 2023 

Target 

FY 2023 

Target 

+/-FY 2022 

Target 

2.4.12 Percentage of 

youth age 10 - 24 who 

received mental health or 

related services after 

screening, referral, or 

attempt (Output) 

FY 2021: 338 

Target: 

47 

(Target Exceeded) 

33 33 Maintain 

2.4.17 Number of youth 

with mental health or 

substance use disorders 

who are contacted 

through program 

outreach efforts (Output) 

FY 2021: 570,655.0 

Target: 

570,655.0 

(Baseline) 

570,655.0 600,000 Increase 

108 
 

 

 

SAMHSA-Mental Health 

Minority Fellowship Program 

(Dollars in thousands) 

FY 2021 FY 2022 FY 2023

 Programs of Regional & National Significance Final 

COVID-19 

Supplemental CR 

President's 

Budget 

FY 2023 +/-

FY 2022 

Minority Fellowship Program....................................................................... $10,059 $--- $10,059 $13,663 $3,604 

Authorizing Legislation ........................................................................ Section 597 of the PHS Act 

FY 2023 Authorization ..................................................................................................................$0 

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

Eligible Entities..................................................Organizations that represent individuals obtaining 

...............post-baccalaureate training (including for master’s and doctoral degrees) for mental and 

substance use disorder treatment professionals, including in the fields of psychiatry, nursing, 

.......................... social work, psychology, marriage and family therapy, mental health counseling, 

........................................................................and substance use disorder and addiction counseling 

Program Description and Accomplishments 

SAMHSA’s Minority Fellowship Program (MFP) increases behavioral health practitioners’ 

knowledge of issues related to prevention, treatment, and recovery support for mental illness and 

drug/alcohol addiction among racial and ethnic minority populations. The program provides 

stipends to increase the number of culturally competent behavioral health professionals who teach, 

administer, conduct services research, and provide direct mental illness or substance use disorder 

treatment services for minority populations that are underserved. Since its start in 1973, the 

program has helped to enhance services for racial and ethnic minority communities through 

specialized training of mental health professionals in psychiatry, nursing, social work, marriage 

and family therapy, mental health counseling, psychology; and substance use/addiction 

counseling. In 2006, the program expanded to include marriage and family therapists and later 

added professional counselors. Professional guilds receive competitively awarded grants, and then 

competitively award the stipends to post-graduate students pursuing a degree in that professional 

field. The MFP program has had a variety of focus including youth and addiction counselors. 

In FY 2021, SAMHSA supported eight grant continuations and exercised the option year on the 

MFP the technical assistance contract. In FY 2022 Annualized CR, SAMHSA will support eight 

grant continuations, the technical assistance contract and award a new cohort of one grant, 

109 
 

 

 

 

 

 

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Five Year Funding Table 

Fiscal Year Amount 

COVID-19 

Supplemental 

Funding 

FY 2019 $8,059,000 

FY 2020 $9,059,000 

FY 2021 Final $10,059,000 

FY 2022 CR $10,059,000 

FY 2023 President's Budget $13,663,000 

Budget Request 

The FY 2023 President’s Budget request is $13.6 million, an increase of $3.6 million from the FY 

2022 Annualized Continuing Resolution. The purposed funding will support two continuation 

grants, award a new cohort of 10 grants and the technical assistance contract. The increase in 

funding will increase the number of trained behavioral health providers to 6,500. 

110 
 

 

 

 

 

 

 

 

 

SAMHSA-Mental Health 

Infant and Early Childhood Mental Health 

(Dollars in thousands) 

FY 2021 FY 2022 FY 2023

 Programs of Regional & National Significance Final 

COVID-19 

Supplemental CR 

President's 

Budget 

FY 2023 +/-

FY 2022 

Infant and Early Childhood Mental Health..................................................... $8,096 $--- $8,000 $37,500 $29,500 

Authorization Legislation ....................................Section 399Z-2 of the Public Health Service Act 

FY 2023 Authorization ..................................................................................................................$0 

Allocation Method ............................................................................................. Competitive Grants 

Eligible Entities.................................Human Services Agencies and Non-profit Institutions 

Program Description and Accomplishments 

Nearly one in seven US children aged 2 to 8 years has a mental, behavioral, or developmental 

disorder.41 It is also estimated that approximately 9.5 to 14.2 percent of children birth to 5 years 

old experience emotional, relational, or behavioral disturbance.42 The national prevalence of 

children with a mental health disorder who did not receive treatment or counseling from a mental 

health provider is 49.4 percent 43 . Without proper intervention, these early childhood disorders 

can have negative impacts on all areas of a child’s development. Young children whose social and 

emotional development is compromised are at higher risk for school problems and juvenile 

delinquency later in life.44 Rising rates of substance-exposure in infants also require more 

intensive early childhood services to help improve the trajectories of the families where substance 

misuse is present. 

The authorization for this program was added to the Public Health Service Act by an amendment 

in the 21st Century Cures Act. The first funding for this program was provided in FY 2018. The 

purpose of this program is to improve outcomes for children, from birth to 12 years of age, who 

are at risk for, show early signs of, or have been diagnosed with a mental illness, including a 

serious emotional disturbance. Grantees improve outcomes for children through service provision 

to children and families, mental health consultation to early childhood programs such as Head 

Start, and training early childhood providers and clinicians to identify and treat behavioral health 

disorders of early childhood, including in children with a history of in utero exposure to substances 

41 Bitsko, RH, Holbrook, JR, Kaminski, J, Robinson, LR, Ghandour, R, Smith, C, Peacock, G. (2016) Health-care, 

Family and Community Factors associated with Mental, Behavioral and Developmental Disorders in Early Childhood 

–United States, 2011-2012. MMWR.; 65(9); 221-226. Available from 

https://www.cdc.gov/ncbddd/childdevelopment/features/key-finding-factors-mental-behavioral-developmentalearly-childhood.html. 42 Brauner, C. B., & Stephens, C. B. (2006). Estimating the prevalence of early childhood serious 

emotional/behavioral disorders: Challenges and recommendations. Public Health Reports, 121(3), 303–310. 

Available from www.ncbi.nlm.nih.gov/pmc/articles/PMC1525276 

43 https://jamanetwork.com/journals/jamapediatrics/fullarticle/2724377 44 Jones, D. E., Greenberg, M., & Crowley, M. (2015). Early Social-Emotional Functioning and Public Health: The 

Relationship Between Kindergarten Social Competence and Future Wellness. American Journal of Public Health, 

105(11), 2283–2290. http://doi.org/10.2105/AJPH.2015.302630 

111 
 

 

 

 

SAMHSA-Mental Health 

such as opioids, stimulants or other drugs that may impact development, and through the 

implementation of evidence-based multigenerational treatment approaches that strengthen 

caregiving relationships. 

Infant Early Childhood Mental Health Consultation is a prevention-based approach that pairs a 

mental health consultant with adults who work with infants and young children in the different 

settings where they learn and grow, such as childcare, preschool, home visiting, early intervention, 

and their home. Mental health consultation equips caregivers to facilitate children’s health social 

and emotional development. 

SAMHSA expects this program will increase access to a range of evidence-based and culturally 

appropriate infant and early childhood mental health services and will aid in addressing the 

national shortage of mental health professionals with infant and early childhood expertise. 

Because the wellbeing of caregivers dramatically impacts the development of infants and young 

children, this program also promotes a multigenerational approach that supports caregivers and 

other family members of infants and young children. 

In FY 2021, grantees accomplished the following: 

• Trained 4,003 clinicians and early childhood providers on evidence-based mental health 

treatments for infants and young children; 

• Screened and assessed 9,883 young children for developmental and behavioral disorders 

(including screening parents for behavioral health issues such as depression and substance 

misuse); 

• Referred 3,551 children and parents for treatment; and 

• Provided infant and early childhood mental health treatment (including multigenerational 

therapies) to 5,009 children and families. 

Technical Assistance: 

SAMSHA provides technical assistance to communities, states, territories, tribal communities, and 

grantees through the Center of Excellence for Infant & Early Childhood Mental Health 

Consultation. They also provide professional development to individual mental health consultants 

to increase access to high quality mental health consultation throughout the country. 

In FY 2021, SAMHSA supported 13 grant continuations and provided supplement to support 

COE-CMHC technical assistance. 

In FY 2022 Annualized CR, SAMHSA will support 13 grant continuations and award a new cohort 

of two grans. 

112 
 

 

 

 

 

 

SAMHSA-Mental Health 

Five Year Funding Table 

Fiscal Year Amount 

COVID-19 

Supplemental 

Funding 

FY 2019 $5,000,000 

FY 2020 $7,000,000 

FY 2021 Final $8,096,291 

FY 2022 CR $8,000,000 

FY 2023 President's Budget $37,500,000 

Budget Request 

The FY 2023 President’s Budget request is $37.5 million, an increase of $29.5 million from the 

FY 2022 Annualized Continuing Resolution. The purposed funding will support the continuation 

of six grants and award a new cohort of 67 grants to increase access to a range of evidence-based 

and culturally appropriate infant and early childhood mental health services. With this significant 

increase in funding, it is expected that the number of children screened for mental health disorders 

will double to nearly 20,000; and the number of children subsequently referred to mental health 

and related services will increase to 7,000. 

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SAMHSA-Mental Health 

Outputs and Outcomes Table 

Program: Infant and Early Childhood Mental Health Grant Program 

Measure Year and Most Recent 

Result / 

Target for Recent Result / 

(Summary of Result) 

FY 2022 

Target 

FY 2023 

Target 

FY 2023 

Target 

+/-FY 2022 

Target 

3.4.16 Number of 

children screened for 

mental health or related 

interventions (Output) 

FY 2021: 9,883.0 

Target: 

4,719.0 

(Target Exceeded) 

9,883.0 18,000 Increase 

3.4.17 Number of 

children referred to 

mental health or related 

interventions (Output) 

FY 2021: 3,551.0 

Target: 

2,339.0 

(Target Exceeded) 

3,500.0 7,000 Increase 

3.4.18 Number of people 

in the mental health and 

related workforce trained 

in specific mental healthrelated practices/activities 

as a result of the 

program. (Output) 

FY 2021: 5,099.0 

Target: 

3,537.0 

(Target Exceeded) 

5,000.0 14,000 Increase 

114 
 

 

 

 

 

 

 

 

SAMHSA-Mental Health 

Interagency Task Force on Trauma-Informed Care 

(Dollars in thousands) 

FY 2021 FY 2022 FY 2023 

 Programs of Regional & National Significance Final 

COVID-19 

Supplemental CR 

President's 

Budget 

FY 2023 +/-

FY 2022 

Interagency Task Force on Trauma-Informed Care........................................ $--- $--- $--- $1,000 $1,000

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

FY 2023 Authorization ..................................................................................................$81,887,000 

Allocation Method ...............................................................................................................Contract 

Eligible Entities.......................................................Domestic Public or Private Non-Profit Entities 

Program Description and Accomplishments 

The creation of an Interagency Task Force on Trauma-Informed Care was mandated in the 

Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients 

and Communities Act (SUPPORT for Patients and Communities Act) (P.L. 115-271). The 

SUPPORT for Patients and Communities Act is a comprehensive piece of legislation devoted to 

combatting substance use and the overdose epidemic, including a bipartisan commitment to 

supporting children and families who experience trauma and adverse childhood experiences 

(ACEs), including trauma from substance misuse. 

Trauma-informed care is essential to ensure that people receive the necessary behavioral health 

treatment and support services for their substance use/misuse, to restore their mental health and 

well-being, and enhance their resilience. When considering trauma-informed care resources and 

interventions, it is important to acknowledge the changes that have occurred in the United States 

since the passage of the SUPPORT Act in 2018. The COVID-19 pandemic and its associated 

health, social, and economic challenges; the national conversation on racial inequality, systemic 

racism, and injustice; and the increase in children arriving unaccompanied at the border have 

created a heightened need for attention to the adversities faced by children, youth, families, and 

communities. 

Under the SUPPORT Act, Congress required SAMHSA to lead an interagency task force in the 

development of an operating plan to implement a National Strategy for Trauma-informed Care. 

Broadly, the Task Force has been identifying, evaluating, and making recommendations regarding: 

(1) best practices for children and families who have experienced trauma or are at risk of 

experiencing trauma; and (2) ways federal agencies can better coordinate responses to families 

affected by substance use disorders and trauma. 

Based on the requirements from the SUPPORT Act, the Task Force developed a National Strategy 

grounded in four pillars: best practices, research, data, and federal coordination. The SUPPORT 

Act also compelled the drafting of a plan that operationalizes the national strategy through an 

operating plan. 

The budget request is necessary to meet the legislation requirements which includes the following: 

leading the Task Force; identification and evaluation of trauma-informed resources for practice 

115 
 

 

 

 

 

 

SAMHSA-Mental Health 

and data collection to then make recommendations to the general public and to federal agencies 

through an internet website; ongoing solicitation of input from stakeholders to inform the work; 

and coordinate federal agencies in their integration of trauma-informed principles and 

interventions into their ongoing work. 

Implementation of the National Strategy is a phased approach. Phase One is focused on planning 

and laying the groundwork (Year 1); Phase Two is focused on delivering value to stakeholders 

(Years 2 and 3); and Phase Three is focused on sustainability (Years 4 and 5). 

Five Year Funding Table 

Fiscal Year Amount COVID-19 

Supplemental Funding 

FY 2019 $---

FY 2020 $---

FY 2021 Final $---

FY 2022 CR $---

FY 2023 President's Budget $1,000,000 

Budget Request 

The FY 2023 President’s Budget request is $1.0 million, an increase of $1.0 million from the FY 

2022 Annualized Continuing Resolution. SAMHSA requests funding to support the development 

of a website to post best practices of trauma-informed care. 

116 
 

SAMHSA-Mental Health 

PRNS Mechanism Table 

Summary 

(Dollars in thousands) 

Program Activity 

FY 2021 

Final 

FY 2022 

CR 

FY 2023 

President's Budget 

Programs of Regional & National Significance 

Grants/Cooperative Agreements 

Continuations..................................................................... 

New/Competing................................................................. 

Supplements*.....................................................................

634 

368 

 ---

$367.84 

137.15 

8.48

894 

106 

 ---

$487.64 

105.78 

0.68

729 

1,266 

 ---

$374.25 

1,228.51 

 ---

Subtotal........................................................................... 1,002 513.47 1,000 594.10 1,995 1,602.76 

Contracts 

Continuations..................................................................... 

New/Competing................................................................. 

4 

3 

35.92 

5.22

7 

 ---

38.94 

3,500 

6 

1 

51.80 

25,323 

Subtotal........................................................................... 7 41.14 7 42.44 7 77.12 

Total, Mental Health PRNS 1,009 $554.61 1,007 $636.54 2,002 $1,679.87 

117 
SAMHSA-Mental Health 

PRNS Mechanism Table 

Program, Project, and Activity 

(Dollars in thousands) 

Programs of Regional & National Significance 

FY 2021 

Final 

FY 2022 

CR 

FY 2023 

President's Budget 

Capacity: 

National Child Traumatic Stress Network 

Grants 

Continuations........................................................................... 

New/Competing....................................................................... 

Supplements*...........................................................................

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

Contracts 

Continuations...........................................................................

New/Competing.......................................................................

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

Total, National Child Traumatic Stress Network 

Project AWARE 

Grants 

Continuations........................................................................... 

New/Competing....................................................................... 

Supplements*...........................................................................

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

Contracts 

Continuations...........................................................................

New/Competing.......................................................................

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

Total, Project AWARE 

Healthy Transitions 

Grants 

Continuations........................................................................... 

New/Competing....................................................................... 

Supplements*...........................................................................

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

Contracts 

Continuations...........................................................................

New/Competing.......................................................................

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

Total, Healthy Transitions 

Children and Family Programs 

Grants 

Continuations........................................................................... 

New/Competing....................................................................... 

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

Contracts 

Continuations...........................................................................

New/Competing.......................................................................

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

Total, Children and Family Programs 

Consumer and Family Network Grants 

Grants 

Continuations........................................................................... 

New/Competing....................................................................... 

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

Contracts 

Continuations...........................................................................

New/Competing.......................................................................

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

Total, Consumer and Family Network Grants 

34 

97 

 ---

$16.15 

51.83 

 ---

127 

4 

 ---

$66.00 

2.00 

 ---

118 

171 

 ---

$61.89 

82.24 

 ---

131 67.98 131 68.00 289 144.13 

 ---

 ---

3.69

 ---

 ---

 ---

3.89

 ---

 ---

 ---

5.87 

 ---

 --- 3.69 --- 3.89 --- 5.87 

131 

72 

164 

 ---

71.67 

75.17 

44.58 

 ---

131 

219 

19 

 ---

71.89 

119.60 

2.37 

0.05

289 

210 

414 

 ---

150.00 

91.01 

202.44 

 ---

236 119.76 238 122.01 624 293.45 

 ---

 ---

9.33

 ---

 ---

 ---

6.45

2,500

 ---

 ---

14.55 

 ---

 --- 9.33 --- 8.95 --- 14.55 

236 

27 

1 

 ---

129.08 

26.95 

1,000

 ---

238 

28 

 ---

 ---

130.96 

28.00 

 ---

 ---

624 

18 

41 

 ---

308.00 

17.43 

41.57 

 ---

28 27.95 28 28.00 59 59.00 

 ---

 ---

1.45

50

 ---

 ---

1.45

 ---

 ---

 ---

2.40 

 ---

 --- 1.50 --- 1.45 --- 2.40 

28 

18 

3 

29.45 

5.94 

0.93 

28 

21 

1 

29.45 

6.47 

406 

59 

4 

19 

61.40 

0.93 

6,016 

21 6.87 22 6.87 23 6.95 

 ---

 ---

0.36

 ---

 ---

 ---

0.36

 ---

 ---

 ---

0.28 

 ---

 --- 0.36 --- 0.36 --- 0.28 

21 

25 

25 

7.23 

2.37 

2.36 

22 

25 

25 

7.23 

2.36 

2.35

23 

47 

 ---

7.23 

4.76 

 ---

50 4.73 50 4.71 47 4.76 

 ---

 ---

0.24

 ---

 ---

 ---

0.24

 ---

 ---

 ---

0.19 

 ---

 --- 0.24 --- 0.24 --- 0.19 

50 4.97 50 4.95 47 4.95 

118 
SAMHSA-Mental Health 

PRNS Mechanism Table 

Program, Project, and Activity 

(Dollars in thousands) 

Programs of Regional & National Significance 

o 

FY 2021 

Final 

FY 2022 

CR 

FY 2023 

President's Budget 

Project LAUNCH 

Grants 

Continuations........................................................................... 

New/Competing.......................................................................

Supplements*...........................................................................

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

Contracts 

Continuations...........................................................................

New/Competing.......................................................................

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

Total, Project LAUNCH 

Mental Health System Transformation and Health Reform 

Grants 

Continuations........................................................................... 

New/Competing.......................................................................

Supplements*...........................................................................

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

Contracts 

Continuations...........................................................................

New/Competing.......................................................................

Subtotal................................................................................. y 

Reform 

Programs of Regional & National Significance 

31 

 ---

 ---

22.22 

 ---

 ---

31 

 ---

 ---

22.39 

 ---

 ---

17 

24 

 ---

13.59 

20,434 

 ---

31 22.22 31 22.39 41 34.02 

 ---

 ---

1.29

 ---

 ---

 ---

1.21

 ---

 ---

 ---

1.39 

 ---

 --- 1.29 --- 1.21 --- 1.39 

31 

3 

 ---

 ---

23.51 

3.59 

 ---

 ---

31 

3 

 ---

 ---

23.61 

3.59 

 ---

 ---

41 

3 

 ---

 ---

35.41 

2.69 

944 

 ---

3 3.59 3 3.59 3 3.63 

 ---

 ---

0.19

 ---

 ---

 ---

0.19

 ---

 ---

 ---

0.15 

 ---

 --- 0.19 --- 0.19 --- 0.15 

3 3.78 3 3.78 3 3.78 

No. Amount No. Amount No. Amount 

Primary and Behavioral Health Care Integration 

Grants 

Continuations........................................................................... 

New/Competing....................................................................... 

Supplements*...........................................................................

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

Contracts 

Continuations...........................................................................

New/Competing.......................................................................

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

Total, PBHCI 

National Strategy for Suicide Prevention 

Grants 

Continuations........................................................................... 

New/Competing....................................................................... 

Supplements*...........................................................................

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

Contracts 

Continuations...........................................................................

New/Competing.......................................................................

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

Total, National Strategy for Suicide Prevention 

GLS - Youth Suicide Prevention - States 

Grants 

Continuations........................................................................... 

New/Competing....................................................................... 

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

Contracts 

Continuations...........................................................................

New/Competing.......................................................................

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

Total, GLS - States 

24 

1 

 ---

47.73 

2.00 

 ---

24 

1 

 ---

47.77 

2.25 

 ---

12 

37 

 ---

24.48 

74.37 

 ---

25 49.73 25 50.02 49 98.85 

 ---

 ---

2.64

 ---

 ---

 ---

2.85

 ---

 ---

 ---

4.03 

 ---

 --- 2.64 --- 2.85 --- 4.03 

25 

35 

10 

 ---

52.38 

16.77 

4.84

0.45

25 

45 

 ---

 ---

52.88 

21.50 

 ---

0.38

49 

25 

26 

 ---

102.88 

11.86 

10,427 

 ---

45 22.06 45 21.88 51 22.29 

 ---

 ---

1.14

 ---

 ---

 ---

1.32

 ---

 ---

 ---

0.91 

 ---

 --- 1.14 --- 1.32 --- 0.91 

45 

43 

6 

23.20 

30.18 

4.31 

45 

46 

1 

23.20 

32.56 

1.07

51 

47 

 ---

23.20 

34.00 

 ---

49 34.49 47 33.63 47 34.00 

 ---

 ---

1.94

 ---

 ---

 ---

1.79

1,000

 ---

 ---

2.43 

 ---

 --- 1.94 --- 2.79 --- 2.43 

49 36.43 47 36.43 47 36.43 

119 
SAMHSA-Mental Health 

PRNS Mechanism Table 

Program, Project, and Activity 

(Dollars in thousands) 

Programs of Regional & National Significance 

GLS - Youth Suicide Prevention - Campus 

Grants 

Continuations........................................................................... 37 3.63 41 4.04 46 4.66 

New/Competing....................................................................... 25 2.52 21 2.13 62 6.31 

Subtotal................................................................................. 62 6.15 62 6.17 108 10.96 

Contracts 

Continuations........................................................................... --- 0.32 --- 0.32 --- 0.52 

New/Competing....................................................................... --- 14 --- --- --- ---

Subtotal................................................................................. --- 0.33 --- 0.32 --- 0.52 

Total, GLS - Campus 62 6.49 62 6.49 108 11.49 

Programs of Regional & National Significance o No. Amount No. Amount No. Amount 

GLS - Suicide Prevention Resource Center 

Grants 

Continuations........................................................................... 1 7.59 1 7.59 1 7.59 

New/Competing....................................................................... --- 0.00 --- 0.97 --- 1.06 

Subtotal................................................................................. 1 7.59 1 8.56 1 8.65 

Contracts 

Continuations........................................................................... --- 0.44 --- 0.44 --- 0.35 

New/Competing....................................................................... --- --- --- --- --- ---

Subtotal................................................................................. --- 0.44 --- 0.44 --- 0.35 

Total, GLS - Suicide Prevention Resource Center 1 8.03 1 9.00 1 9.00 

Suicide Lifeline 

Grants 

Continuations........................................................................... 2 0.67 1 21.97 --- ---

New/Competing....................................................................... 1 15.15 3 77.67 --- ---

Supplements*........................................................................... --- 7.00 --- --- --- ---

Subtotal................................................................................. 3 22.82 4 99.64 --- ---

Contracts 

Continuations........................................................................... --- 1.18 --- 1.98 --- ---

New/Competing....................................................................... --- --- --- --- --- ---

Subtotal................................................................................. --- 1.18 --- 1.98 --- ---

Total, Suicide Lifeline 3 24.00 4 101.62 --- 0.00 

AI/AN Suicide Prevention Initiative 

Grants 

Continuations........................................................................... 1 0.50 1 0.50 --- ---

New/Competing....................................................................... --- --- --- --- 1 500 

Subtotal................................................................................. 1 0.50 1 0.50 1 0.50 

Contracts 

Continuations........................................................................... --- 0.19 1 2.43 1 2.43 

New/Competing....................................................................... 1 2.24 --- --- --- ---

Subtotal................................................................................. 1 2.43 1 2.43 1 2.43 

Total, AI/AN 2 2.93 2 2.93 2 2.93 

Homelessness Prevention Programs 

Grants 

Continuations........................................................................... 48 26.79 48 26.75 24 13.92 

New/Competing....................................................................... --- --- --- --- 35 18.12 

Supplements*........................................................................... --- --- --- 256 --- ---

Subtotal................................................................................. 48 26.79 48 27.01 59 32.04 

Contracts 

Continuations........................................................................... 1 3.61 1 3.69 1 3.65 

New/Competing....................................................................... --- --- --- --- --- ---

Subtotal................................................................................. 1 3.61 1 3.69 1 3.65 

Total, Homelessness Prevention Programs 49 30.40 49 30.70 60 35.70 

FY 2022 

CR 

FY 2021 

Final 

FY 2023 

President's Budget 

120 
SAMHSA-Mental Health 

PRNS Mechanism Table 

Program, Project, and Activity 

(Dollars in thousands) 

Programs of Regional & National Significance 

Minority AIDS 

Grants 

Continuations........................................................................... 18 8.73 --- --- 18 8,863 

New/Competing....................................................................... --- --- 18 8.77 --- ---

Subtotal................................................................................. 18 8.73 18 8.77 18 8.86 

Contracts 

Continuations........................................................................... --- 0.49 --- 0.45 --- 0.36 

New/Competing....................................................................... --- --- --- --- --- ---

Subtotal................................................................................. --- 0.49 --- 0.45 --- 0.36 

Total, Minority AIDS 18 9.22 18 9.22 18 9.22 

Criminal and Juvenile Justice Programs 

Grants 

Continuations........................................................................... 17 5.38 17 5.46 6 1.96 

New/Competing....................................................................... --- --- --- --- 26 52.03 

Subtotal................................................................................. 17 5.38 17 5.46 32 54.00 

Contracts 

Continuations........................................................................... --- 0.35 1 0.81 1 2.40 

New/Competing....................................................................... 1 0.55 --- --- --- ---

Subtotal................................................................................. 1 0.89 1 0.81 1 2.40 

Total, Criminal and Juvenile Justice Programs 18 6.27 18 6.27 33 56.39 

Seclusion and Restraint 

Grants 

Continuations........................................................................... 11 1.08 11 1.09 --- ---

New/Competing....................................................................... --- --- --- --- 11 1,102 

Subtotal................................................................................. 11 1.08 11 1.09 11 1.10 

Contracts 

Continuations........................................................................... --- 0.07 --- 0.06 --- 0.04 

New/Competing....................................................................... --- --- --- --- --- ---

Subtotal................................................................................. --- 0.07 --- 0.06 --- 0.04 

Total, Seclusion and Restraint 11 1.15 11 1.15 11 1.15 

Programs of Regional & National Significance No. Amount No. Amount No. Amount 

Interagency Task Force on Trauma-Informed Care 

Grants 

Continuations........................................................................... --- --- --- --- --- ---

New/Competing....................................................................... --- --- --- --- --- 961 

Supplements*........................................................................... --- --- --- --- --- ---

Subtotal................................................................................. --- --- --- --- --- 961 

Contracts 

Continuations........................................................................... --- --- --- --- --- ---

New/Competing....................................................................... --- --- --- --- --- 39 

Subtotal................................................................................. --- --- --- --- --- 39 

Total, Interagency Task Force on Trauma-Informed Care --- --- --- --- --- 1,000 

988 and Behavioral Health Crisis Services 

Grants 

Continuations........................................................................... --- --- --- --- 3 22,640 

New/Competing....................................................................... --- --- --- --- 275 646,988 

Supplements*........................................................................... --- --- --- --- --- ---

Subtotal................................................................................. --- --- --- --- 278 669,628 

Contracts 

Continuations........................................................................... --- --- --- --- --- 4,566 

New/Competing....................................................................... --- --- --- --- --- 22,707 

Subtotal................................................................................. --- --- --- --- --- 27,273 

Total, 988 and Behavioral Health Crisis Services --- --- --- --- 278 696,901 

FY 2021 

Final 

FY 2023 

President's Budget 

FY 2022 

CR 

121 
SAMHSA-Mental Health 

PRNS Mechanism Table 

Program, Project, and Activity 

(Dollars in thousands) 

Programs of Regional & National Significance 

FY 2021 

Final 

FY 2022 

CR 

FY 2023 

President's Budget 

Assertive Community Treatment for Individuals with SMI 

Grants 

Continuations........................................................................... 

New/Competing....................................................................... 

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

Contracts 

Continuations...........................................................................

New/Competing.......................................................................

Subtotal................................................................................. , y 

Serious Mental Illness 

Assisted Outpatient Treatment for Individuals with SMI 

Grants 

Continuations........................................................................... 

New/Competing....................................................................... 

Supplements*...........................................................................

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

Contracts 

Continuations...........................................................................

New/Competing.......................................................................

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

Total, AOT for Individuals with SMI 

Tribal Behavioral Health Grants 

Grants 

Continuations........................................................................... 

New/Competing....................................................................... 

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

Contracts 

Continuations...........................................................................

New/Competing....................................................................... 

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

Total, Tribal Behavioral Health Grants 

Infant and Early Childhood Mental Health 

Grants 

Continuations........................................................................... 

New/Competing....................................................................... 

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

Contracts 

Continuations...........................................................................

New/Competing.......................................................................

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

Total, Infant and Early Childhood Mental Health 

10 

2 

6.74 

1.36 

12 

1 

8.17 

0.39 

6 

7 

3.84 

4.80 

12 8.09 13 8.56 13 8.65 

 ---

 ---

0.44

 ---

 ---

 ---

0.44

 ---

 ---

 ---

0.35 

 ---

 --- 0.44 --- 0.44 --- 0.35 

12 

20 

3 

 ---

8.54 

17.22 

2.40 

0.08

13 

20 

3 

 ---

9.00 

17.62 

2.28

 ---

13 

23 

 ---

 ---

9.00 

20.46 

 ---

 ---

23 19.69 23 19.89 23 20.46 

 ---

 ---

0.67

0.57

 ---

 ---

1.11

 ---

 ---

 ---

0.96 

 ---

 --- 1.24 --- 1.11 --- 0.96 

23 

124 

29 

20.94 

16.61 

1.45 

23 

140 

6 

21.00 

17.11 

0.99 

23 

78 

38 

21.42 

13.77 

6.83 

153 18.06 146 18.09 116 20.61 

 ---

1 

1.02 

1.80

1 

 ---

2.66 

 ---

1 

 ---

2.64 

 ---

1 2.82 1 2.66 1 2.64 

154 

13 

1 

20.88 

6.30 

1.40 

147 

13 

2 

20.75 

6.41 

1.20 

117 

6 

67 

23.25 

2.43 

33.60 

14 7.70 15 7.61 73 36.03 

 ---

 ---

0.39

 ---

 ---

 ---

0.39

 ---

 ---

 ---

1.47 

 ---

 --- 0.39 --- 0.39 --- 1.47 

14 8.10 15 8.00 73 37.50 

122 
SAMHSA-Mental Health 

PRNS Mechanism Table 

Program, Project, and Activity 

(Dollars in thousands) 

Programs of Regional & National Significance 

Science and Service: 

Primary and Behavioral Health Care Integration TA 

Grants 

Continuations........................................................................... 1 1.89 1 1.89 1 1.91 

New/Competing....................................................................... --- --- --- --- --- ---

Supplements*........................................................................... --- --- --- --- --- ---

Subtotal................................................................................. 1 1.89 1 1.89 1 1.91 

Contracts 

Continuations........................................................................... --- 0.10 --- 0.10 --- 0.08 

New/Competing....................................................................... --- --- --- --- --- ---

Subtotal................................................................................. --- 0.10 --- 0.10 --- 0.08 

Total, PBHCI TA 1 1.99 1 1.99 1 1.99 

Practice Improvement & Training 

Grants 

Continuations........................................................................... 5 5.46 5 5.60 4 2.96 

New/Competing....................................................................... --- --- --- --- 1 4,049 

Supplements*........................................................................... --- --- --- --- --- ---

Subtotal................................................................................. 5 5.46 5 5.60 5 7.01 

Contracts 

Continuations........................................................................... 1 2.36 1 2.23 1 0.65 

New/Competing....................................................................... --- --- --- --- --- 2,174 

Subtotal................................................................................. 1 2.36 1 2.23 1 2.82 

Total, Practice Improvement & Training 6 7.83 6 7.83 6 9.83 

Consumer and Consumer-Supporter TA Centers 

Grants 

Continuations........................................................................... 5 1.81 5 1.81 5 1.84 

New/Competing....................................................................... --- --- --- --- --- ---

Subtotal................................................................................. 5 1.81 5 1.81 5 1.84 

Contracts 

Continuations........................................................................... --- 0.10 --- 0.11 --- 0.08 

New/Competing....................................................................... --- --- --- --- --- ---

Subtotal................................................................................. --- 0.10 --- 0.11 --- 0.08 

Total, CCSTAC 5 1.90 5 1.92 5 1.92 

Disaster Response 

Grants 

Continuations........................................................................... --- --- --- 1.04 --- 1.03 

New/Competing....................................................................... --- 1.04 --- --- --- ---

Subtotal................................................................................. --- 1.04 --- 1.04 --- 1.03 

Contracts 

Continuations........................................................................... 1 0.91 1 0.91 1 0.92 

New/Competing....................................................................... --- --- --- --- --- ---

Subtotal................................................................................. 1 0.91 1 0.91 1 0.92 

Total, Disaster Response 1 1.95 1 1.95 1 1.95 

FY 2021 

Final 

FY 2022 

CR 

FY 2023 

President's Budget 

123 
SAMHSA-Mental Health 

PRNS Mechanism Table 

Program, Project, and Activity 

(Dollars in thousands) 

Programs of Regional & National Significance 

FY 2021 

Final 

FY 2022 

CR 

FY 2023 

President's Budget 

Science and Service: 

Homelessness 

Grants 

Continuations........................................................................... 

New/Competing.......................................................................

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

Contracts 

Continuations...........................................................................

New/Competing.......................................................................

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

Total, Homelessness 

Minority Fellowship Program 

Grants 

Continuations........................................................................... 

New/Competing.......................................................................

Supplements*...........................................................................

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

Contracts 

Continuations........................................................................... 

New/Competing.......................................................................

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

Total, Minority Fellowship Program 

Subtotal, Science and Service 

1 

 ---

2.14 

 ---

1 

 ---

2.15 

 ---

1 

 ---

0.79 

1,415 

1 2.14 1 2.15 1 2.21 

 ---

 ---

0.11

 ---

 ---

 ---

0.14

 ---

 ---

 ---

0.09 

 ---

 --- 0.11 --- 0.14 --- 0.09 

1 

8 

 ---

 ---

2.25 

8.22 

 ---

0.95

1 

8 

1 

 ---

2.30 

8.22 

0.94 

 ---

1 

2 

10 

 ---

2.30 

2.93 

9.80 

 ---

8 9.17 9 9.16 12 12.73 

1 

 ---

0.89 

 ---

1 

 ---

0.90

 ---

 ---

1 

0.53 

402 

1 0.89 1 0.90 1 0.94 

9 10.06 10 10.06 13 13.66 

23 25.98 24 26.05 27 31.65 

Total, Mental Health PRNS 1,009 $554.61 1,007 $636.54 1,997 $1,679.87 

124 
SAMHSA-Mental Health 

Grant Awards Table 

(Whole dollars)

 FY 2021 

Final 

 FY 2022 

CR 

 FY 2023 

President's Budget 

Number of Awards 1002 1004 1836 

Average Awards $512,446 $593,953 $872,785 

Range of Awards $15,000 - $6,000,000 $20,000 - $10,000,000 $20,000 - $10,000,000 

125 
 

 

 

 

 

SAMHSA-Mental Health 

Children’s Mental Health Services 

(Dollars in thousands) 

FY 2021 FY 2022 FY 2023 

Program Name Final 

COVID-19 

Supplemental CR 

President's 

Budget 

FY 2023 +/-

FY 2022 

Children's Mental Health Services................................................................ $125,000 $--- $125,000 $225,000 $100,000 

Authorizing Legislation ........................................... Sections 561 of the Public Health Service Act 

FY 2023 Authorization ..................................................................................................................$0 

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

Eligible Entities................................................................. States, Tribes, Communities, Territories 

Program Description and Accomplishments 

It is estimated that 49.5 percent of adolescent in the United States have a serious mental disorder. 

Of those with any mental disorder 22.2% had a severe impairment. Unfortunately, only 41 percent 

of those in need of mental health services receive treatment.45 Created in 1992, SAMHSA's 

Children's Mental Health Initiative (CMHI) addresses this gap by supporting "systems of care" 

(SOC) for children and youth with serious emotional disturbances (SED) and their families to 

increase their access to evidence-based treatment and supports. 

The 21st Century Cures Act reauthorized the CMHI through FY 2022. Based on diagnostic 

interview data from National Comorbidity Survey Adolescent Supplement (NCS-A), Figure 5 

shows lifetime prevalence of any mental disorder among U.S. adolescents aged 13-18.46 CMHI 

provides grants to assist states, local governments, tribes, and territories in their efforts to deliver 

services and supports to meet the needs of children and youth with SED. 

CMHI supports the development, implementation, expansion, and sustainability of 

comprehensive, community-based services that use the SOC approach. SOC is a strategic 

approach to the delivery of services and supports that incorporates family-driven, youth-guided, 

strength-based, and culturally and linguistically competent care to meet the physical, intellectual, 

emotional, cultural, and social needs of children and youth throughout the U.S. The SOC approach 

helps prepare children and youth for successful transition to adulthood and assumption of adult 

roles and responsibilities. Services are delivered in the least restrictive environment with 

evidence-supported treatments and interventions. Individualized care management ensures that 

planned services and supports are delivered with an appropriate, effective, family-driven, and 

youth-guided approach. This approach has demonstrated improved outcomes for children at home, 

at school, and in their communities. For example, CMHI grantee data show that suicide attempt 

rates significantly decreased within 12 months after children and youth accessed CMHI-related 

SOC services. The proportion of children and youth who received good grades (defined as an 

average grade of C or better on the previous report card) significantly increased after 12 months 

of services, and arrest rates significantly decreased after 12 months of children and youth 

45 https://www.nimh.nih.gov/health/statistics/mental-illness. 

46 https://www.nimh.nih.gov/health/statistics/mental-illness. 

126 
 

 

 

 

SAMHSA-Mental Health 

beginning SOC-related services and supports.47 In addition, the CMHI program seeks to address 

behavioral health disparities for children and youth with SED/Serious Mental Illness (SMI) from 

racial and ethnic minorities by promoting clear and culturally competent strategies to improve their 

access, use of services, and outcomes. 

SAMHSA funding ensures that grantees will continue to expand and sustain CMHI SOC values, 

principles, infrastructure, and services throughout their states, tribes, and territories. A central 

focus of these efforts is ensuring collaboration between the CMHI SOC and other child-and youthserving systems (e.g., Child Welfare, Juvenile Justice, and Education). SAMHSA also strongly 

encourages efforts by CMHI SOC grantees to coordinate with other SAMHSA programs, such as 

those supported by the Community Mental Health Services Block Grant (MHBG) and Substance 

Abuse Prevention and Treatment Block Grant (SABG). 

CMHI is in the final year of the national evaluation contract for the 2015 cohort. The evaluation 

is designed to provide information on: (1) the mental health outcomes of children and youth, and 

their families; (2) the implementation, process, and sustainability of SOC; and (3) critical and 

emerging issues in children’s and youth’s mental health. The evaluation includes an SOC 

assessment that describes the infrastructure and an assessment of outcomes derived from direct 

SOC services. A service experience study evaluates: (1) change in service use patterns of children 

and their families; (2) differences in client satisfaction between groups of children (and their 

families) in the SOC communities who receive an evidence-based treatment and those who do not; 

and (3) retention in services. 

The Annual Report to Congress for this program provides national data indicating that CMHI 

SOCs are successful and result in many favorable outcomes for children, youth, and their families, 

including the following: 

• Significant, overall improvement in mental, emotional, and behavioral functioning from 

intake to follow-up. 

o 12% decrease in total symptoms. 

o 12% decrease for externalizing symptoms. 

o 15% decrease for internalizing symptoms. 

o 11% decrease for attention problems. 

• Significant overall functional improvement from intake to follow-up: Impairment rate 

decreased from 21.9% to 18.2%, improvement by 3.7%. 

• Improvement in Overall Health: More children, youth, and young adults were healthy 

overall at follow-up (87.6%) compared to intake (81.5%), which represents a significant 

positive percent change of 7.46%. 

47 U.S. Department of Health and Human Services, Substance use And Mental Health Services Administration, 

(2016). The Comprehensive Community Mental Health Services for Children with Serious Emotional 

Disturbances Program, Report to Congress 2016. https://store.samhsa.gov/shin/content//PEP18-

CMHI2016/PEP18-CMHI2016.pdf. 

127 
 

 

SAMHSA-Mental Health 

• Improvement in Everyday Functioning: Children, youth, and young adults functioning 

in everyday life significantly improved at follow-up (67.6%) compared to intake (41.2%), 

which represents a positive change of 64.0%. 

• Improvement in Psychological Distress: More children, youth, and young adults reported 

no serious psychological distress at follow-up (89.1%) compared to intake (75.8%), which 

represents a positive change of 17.5%. 

• Improvement in Illegal Substance Use: More children, youth, and young adults reported that 

they were not using illegal substances at follow-up (78.8%) compared to intake (74.0%), which 

represents a positive change of 6.6%. 

• Improvement in Retention in Community: More children, youth, and young adults were 

retained in the community at follow-up (92.0%) compared to intake (85.3%), which represents 

a 10.4%. 

• Improvement in Education/Employment: More children, youth, and young adults were 

attending school regularly or were currently employed at follow-up (90.4%) compared to 

intake (83.3%), which represents an 8.5% improvement. 

• Improvement in Social Connectedness: More children, youth, and young adults reported 

being more socially connected at follow-up (89.2%) compared to intake (76.1%), which 

represents a significant positive percent change of 17.3%. 

In FY 2021, SAMHSA supported 63 continuation grants, and awarded a new cohort of 12 grants, 

and a technical assistance center. In FY 2022 Annualized CR, SAMHSA will support 68 

continuation grants, award a new cohort of six grants, and a technical assistance center. 

Set-aside for Early Intervention Demonstration Program for Youth and Young Adults at Clinical 

High Risk for Psychosis 

In FY 2018, SAMHSA implemented the Community Programs for Outreach with Youth and 

Young Adults at Clinical High Risk for Psychosis (CHR-P) often referred to as the “prodrome 

phase;” which is when a disease process has begun but is not yet diagnosable or inevitable. 

SAMHSA awarded 21 grants funded from a 10 percent set-aside of the base CMHI program. The 

program addresses if community-based intervention during this phase can prevent the development 

of psychosis. Grantees focus on youth and young adults who are identified to be at clinical high 

risk for developing a fist episode of psychosis. Grantees focus on this population to support the 

development and implementation of evidence-based programs providing community outreach and 

psychosocial interventions for youth and young adults in the prodrome phase of psychotic illness. 

In FY 2021, SAMHSA supported 21 continuation grants. In FY 2022 Annualized CR, SAMHSA 

will award a new cohort of 19 grants. 

128 
 

 

 

 

 

 

SAMHSA-Mental Health 

Five Year Funding Table 

Fiscal Year Amount 

COVID-19 

Supplemental 

Funding 

FY 2019 $125,000,000 

FY 2020 $125,000,000 

FY 2021 Final $125,000,000 

FY 2022 CR $125,000,000 

FY 2023 President's Budget $225,000,000 

Budget Request 

The FY 2023 President’s Budget request is $225.0 million, an increase of $100.0 million from the 

FY 2022 Annualized Continuing Resolution. The purposed budget increase will support the 

continuations of 19 Clinical High Risk for psychosis (CHR-P) grants and award a new cohort of 

35 grants under the 10 percent set-aside. In addition, funding will support 48 CMHI continuation 

grants, a new cohort of 82 CMHI grants, and a technical assistance center. With this increase in 

funding, SAMHSA expects that the number of children served will nearly double to 30,000; and 

the number of peopled trained in mental health activities and practices will increase to 100,000. 

129 
 

SAMHSA-Mental Health 

Outputs and Outcomes Table 

Program: Children's Mental Health Services 

Measure Year and Most Recent 

Result / 

Target for Recent Result / 

(Summary of Result) 

FY 2022 

Target 

FY 2023 

Target 

FY 2023 

Target 

+/-FY 2022 

Target 

3.2.16 Number of 

children with severe 

emotional disturbance 

that are receiving services 

from the Children's 

Mental Health Initiative 

(Output) 

FY 2021: 9,047 

Target: 

11,300 

(Target Not Met) 

10,000 30,000 Increase 

3.2.25 Percentage of 

children receiving 

services who report 

positive social support at 

6-month follow-up 

(Outcome) 

FY 2021: 88.3 % 

Target: 

77.0 % 

(Target Exceeded) 

77.0 % 77.0 % Maintain 

3.2.26 Percentage of 

children receiving 

Systems of Care mental 

health services who 

report positive 

functioning at 6-month 

follow-up (Outcome) 

FY 2021: 64.7 % 

Target: 

63.4 % 

(Target Exceeded) 

63.4 % 63.4 % Maintain 

3.2.27 Number of people 

in the mental health and 

related workforce trained 

in specific mental healthrelated practices/activities 

as a result of the program 

(Output) 

FY 2021: 52,242 

Target: 

54,500 

(Target Not Met) 

54,500 100,000 Increase 

130 
 

SAMHSA-Mental Health 

Children’s Mental Health Services 

Mechanism Table 

(Dollars in thousands) 

Program Activity 

FY 2021 

Final

FY 2022 

CR 

FY 2023 

President's Budget 

Children's Mental Health Services 

Grants/Cooperative Agreements 

Continuations..................................................................... 

New/Competing................................................................. 

85 

12 

$98.46 

19.83 

69 

25 

$99.08 

19.69 

70 

117 

$77.80 

137.44 

Subtotal........................................................................... 97 118.29 94 118.77 187 215.24 

Contracts 

Continuations.....................................................................

New/Competing.................................................................

 ---

 ---

6.71

 ---

 ---

 ---

6.23

 ---

 ---

 ---

9.76 

 ---

Subtotal........................................................................... --- 6.71 --- 6.23 --- 9.76 

Total, Children's Mental Health Services 97 $125.00 94 $125.00 187 $225.00 

Grant Awards Table 

(Whole dollars) 

 FY 2021 

Final 

 FY 2022 

CR 

 FY 2023 

President's Budget 

Number of Awards 97 94 187 

Average Awards $1,219,466 $1,263,507 $1,148,387 

Range of Awards $330,000 - $2,000,000 $330,000 - $2,000,000 $330,000 - $2,000,000 

131 
 

 

 

SAMHSA-Mental Health 

Projects for Assistance in Transition from Homelessness 

(Dollars in thousands) 

FY 2021 FY 2022 FY 2023 

Program Name Final 

COVID-19 

Supplemental CR 

President's 

Budget 

FY 2023 +/-

FY 2022 

PATH............................................................................................................ $64,635 $--- $64,635 $69,635 $5,000 

Authorizing Legislation ........................................ Section 535(a) of the Public Health Service Act 

FY 2023 Authorization ..................................................................................................................$0 

Allocation Method ................................................................................................... Formula Grants 

Eligible Entities............................................................................................... States and Territories 

Program Description and Accomplishments 

The Projects for Assistance in Transition from Homelessness (PATH) program was originally 

authorized by the Stewart B. McKinney Homeless Assistance Amendments Act of 1990 and has 

been reauthorized as part of the Public Health Service Act. The PATH program supports 56 grants 

to the 50 states, the District of Columbia, Puerto Rico, Guam, American Samoa, the United States 

Virgin Islands, and the Northern Mariana Islands, as well as centralized activities such as technical 

assistance and evaluation. 

PATH was reauthorized by the 21st Century Cures Act in December 2016. PATH funds 

community-based outreach, mental illness and substance use disorder treatment services, case 

management, assistance with accessing housing, and other supportive services. PATH engages 

people with SMI into mental disorder treatment as well as persons with SMI with a co-occurring 

substance use disorder. PATH outreach workers are specialized 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 these individuals into the service system and to connect them with the 

mainstream resources and supportive services that they need to access and sustain stable housing, 

build social connections, and access treatment and services to support their recovery. 

In 2020, an estimated 580,466 individuals experienced homelessness on an average night, an 

increase of 2.2 percent, from 201948 The U.S. Department of Housing and Urban Development 

(HUD) defines a person as homeless if he or she “lacks a fixed, regular, and adequate nighttime 

residence”. On a single night each year, communities count and report their homeless population 

to HUD, including people who are unsheltered (in places not intended for human habitation such 

as sidewalks, parks, cars, or abandoned buildings) and people who are sheltered (in emergency 

shelters or transitional programs).49 Data suggest that approximately 20 percent of individuals 

48 The U.S. Department of Housing and Urban Development, Office of Community Planning and Development. 

(2020). The 2020 Annual Homeless Assessment Report (AHAR) to Congress, Part 1. Available 

at: https://www.huduser.gov/portal/sites/default/files/pdf2020-AHAR-Part-1.pdf 49 The U.S. Department of Housing and Urban Development, Office of Community Planning and Development. 

(2020). The 2020 Annual Homeless Assessment Report (AHAR) to Congress, Part 1. Available 

at: https://www.huduser.gov/portal/sites/default/files/pdf/2020-AHAR-Part-1.pdf 

132 
 

 

 

 

 

SAMHSA-Mental Health 

experiencing homelessness have a serious mental illness (SMI).50 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. 

PATH program’s efforts to identify primary care, behavioral disorder treatment, and housing for 

individuals who experience chronic homelessness is two to three times more cost effective than 

having them in the criminal justice system or treating them via other costly healthcare settings 

(e.g., emergency rooms, critical care units). 

Government wide efforts to target the most vulnerable, including people experiencing chronic 

homelessness and veterans, may have served to reduce the number of people on the streets. In 

2010, 106,107 of the people identified in the Point in Time (PIT) survey administered annually by 

HUD were experiencing chronic homelessness. By 2016, the number of people experiencing 

chronic homelessness was at its lowest, at 77,486. The following year, 2017, the number of 

individuals with chronic patterns of homelessness increased to 86.705. In 2018, the number 

increased to 88,640 followed by another increase in to 96,141 in 2019. Since 2011 that the number 

of people with chronic patterns of homelessness exceeded 100,000. The number of people 

experiencing chronic homelessness in 2020 increased to 110,528, approximately 15 percent from 

2019. The recent increase was driven by a considerable increase in the number of sheltered 

individuals with chronic patterns of homelessness.51 

Veterans were first tracked in the 2011 Continuum of Care Homeless Assistance Programs report 

on homeless populations and subpopulations. That year, 65,455 veterans were identified during 

the PIT. By 2020, that number had dropped to 37,253 or by 57 percent. This may be attributed to 

the additional resources created at the federal level to address veteran homelessness. 

In FY 2020, PATH program staff contacted 115,686 persons experiencing homelessness; of those 

60,039 were actively enrolled in PATH at some point during the reporting period. 

Of the 60,039 people who were actively enrolled in PATH in 2020, 23,346 were experiencing cooccurring drug/alcohol use disorders. Of those enrolled in PATH, 25,960 were receiving 

community mental health services, 5,238 received substance use disorder treatment and 6,191 

received referrals to substance use disorder treatment services in the community. PATH provided 

housing/moving assistance to 2,456 individuals, housing eligibility determination services to 

13,302 individuals, and one-time rent eviction support services to 1,060 individuals. In addition, 

50 The U.S. Department of Housing and Urban Development, 2020 CoC Homeless Populations and Subpopulations 

Reports Available at 

https://www.hudexchange.info/resource/reportmanagement/published/CoC_PopSub_NatlTerrDC_2020.pdf 51 The U.S. Department of Housing and Urban Development, Office of Community Planning and Development. 

(2020). The 2020 Annual Homeless Assessment Report (AHAR) to Congress, Part 1. Available 

at: https://www.huduser.gov/portal/sites/default/files *-s/pdf/2020-AHAR-Part-1.pdf 

133 
 

 

 

 

 

 

 

 

SAMHSA-Mental Health 

13,642 PATH clients were referred to permanent housing and of those, 6,610 were able to attain 

permanent housing. Of the 12,186 PATH clients who were referred to temporary housing, 7,286 

attained the temporary housing. Services provided by the PATH program fill gaps in existing 

community resources and play a crucial role in communities’ strategic plans to end homelessness. 

Five Year Funding Table 

Fiscal Year Amount 

COVID-19 

Supplemental 

Funding 

FY 2019 $64,635,000 

FY 2020 $64,635,000 

FY 2021 Final $64,635,000 

FY 2022 CR $64,635,000 

FY 2023 President's Budget $69,635,000 

Budget Request 

The FY 2023 President’s Budget request is $69.6 million, an increase of $5.0 million from the FY 

2022 Annualized Continuing Resolution. This formula-based funding to all fifty states, the 

District of Columbia, the Commonwealth of Puerto Rico, the U.S. Virgin Islands, Guam, 

American Samoa, and the Commonwealth of the Northern Mariana Islands will continue to 

provide PATH services in over 450 communities to support outreach workers and mental health 

specialists who engage with individuals living with SMI or those living with both SMI and 

drug/alcohol addiction and are homeless or at imminent risk of becoming homeless. The services 

provided by the program 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. The 

estimated number of homeless individuals has risen over the past two years. The purposed increase 

in funding will help to compensate providers for the rising cost of services for up to 9,000 

additional individuals. The proposed funds increase will also be used to establish a pilot program 

with HUD for PATH grantees to partner with public housing agencies, and to encourage grantees 

to use existing PATH outreach and engagement mechanisms to identify, qualify, and select 

individuals and initiate housing support services to meet the individuals’ needs. The pilot program 

would be structured to address chronic homelessness among individuals with SMI through a 

pairing of housing vouchers with linked wraparound recovery supports and mitigate the increased 

needs in states and territories with high rates of homelessness. 

134 
 

SAMHSA-Mental Health 

Outputs and Outcomes Table 

Program: Projects for Assistance in Transition from Homelessness 

Measure Year and Most Recent 

Result / 

Target for Recent Result / 

(Summary of Result) 

FY 2022 

Target 

FY 2023 

Target 

FY 2023 

Target 

+/-FY 2022 

Target 

3.4.15 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 2020: 64 % 

Target: 

64 % 

(Target Met) 

64 % 64 % Maintain 

3.4.16 Number of 

homeless persons 

contacted (Outcome) 

FY 2020: 127,256 

Target: 

125,000 

(Target Exceeded) 

127,256 127,256 Maintain 

3.4.17 Percentage of 

contacted homeless 

persons with serious 

mental illness who 

become enrolled in 

services (Outcome) 

FY 2020: 57 % 

Target: 

57 % 

(Target Met) 

57 % 57 % Maintain 

3.4.20 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 2020: 2,647 

Target: 

2,214 

(Target Exceeded) 

2,647 2,647 Maintain 

135 
 

 

SAMHSA-Mental Health 

FY 2023 PATH Formula Grant Provisional Allotments 

Appropriation Amount $69,635,000, State-Territory Total $66,424,568 

CFDA # 93.150 

FY 2021 FY 2022 FY 2023 FY 2023 +/- 

State or Territory Final CR President's Budget FY 2022 

Alabama $613,059 $613,059 $665,438 $52,379 

Alaska $300,000 $300,000 $300,000 $0 

Arizona $1,349,288 $1,349,288 $1,464,569 $115,281 

Arkansas $303,942 $303,942 $329,910 $25,968 

California $8,813,107 $8,813,107 $9,566,088 $752,981 

Colorado $1,019,120 $1,019,120 $1,106,192 $87,072 

Connecticut $799,372 $799,372 $867,670 $68,298 

Delaware $300,000 $300,000 $300,000 $0 

District of Columbia $300,000 $300,000 $300,000 $0 

Florida $4,334,339 $4,334,339 $4,704,659 $370,320 

Georgia $1,670,011 $1,670,011 $1,812,695 $142,684 

Hawaii $300,000 $300,000 $300,000 $0 

Idaho $300,000 $300,000 $300,000 $0 

Illinois $2,705,195 $2,705,195 $2,936,323 $231,128 

Indiana $1,011,504 $1,011,504 $1,097,925 $86,421 

Iowa $334,559 $334,559 $363,143 $28,584 

Kansas $377,391 $377,391 $409,634 $32,243 

Kentucky $468,904 $468,904 $508,966 $40,062 

Louisiana $733,046 $733,046 $795,676 $62,630 

Maine $300,000 $300,000 $300,000 $0 

Maryland $1,271,535 $1,271,535 $1,380,173 $108,638 

Massachusetts $1,558,865 $1,558,865 $1,692,053 $133,188 

Michigan $1,729,567 $1,729,567 $1,877,339 $147,772 

Minnesota $810,987 $810,987 $880,276 $69,289 

Mississippi $300,000 $300,000 $300,000 $0 

Missouri $893,779 $893,779 $970,143 $76,364 

Montana $300,000 $300,000 $300,000 $0 

Nebraska $300,000 $300,000 $300,000 $0 

Nevada $615,938 $615,938 $668,563 $52,625 

New Hampshire $300,000 $300,000 $300,000 $0 

New Jersey $2,138,153 $2,138,153 $2,320,833 $182,680 

136 
 

 

SAMHSA-Mental Health 

FY 2023 PATH Formula Grant Provisional Allotments 

Appropriation Amount $69,635,000, State-Territory Total $66,424,568 

CFDA # 93.150 

State or Territory 

FY 2021 

Final 

FY 2022 

CR 

FY 2023 

President's Budget 

FY 2023 +/- 

FY 2022 

New Mexico $300,000 $300,000 $316,713 $16,713 

New York $4,223,135 $4,223,135 $4,583,954 $360,819 

North Carolina $1,379,612 $1,379,612 $1,497,484 $117,872 

North Dakota $300,000 $300,000 $300,000 $0 

Ohio $1,986,497 $1,986,497 $2,156,221 $169,724 

Oklahoma $452,833 $452,833 $491,522 $38,689 

Oregon $631,011 $631,011 $684,923 $53,912 

Pennsylvania $2,366,900 $2,366,900 $2,569,125 $202,225 

Rhode Island $300,000 $300,000 $300,000 $0 

South Carolina $680,221 $680,221 $738,338 $58,117 

South Dakota $300,000 $300,000 $300,000 $0 

Tennessee $909,771 $909,771 $987,500 $77,729 

Texas $4,995,571 $4,995,571 $5,422,386 $426,815 

Utah $591,476 $591,476 $642,011 $50,535 

Vermont $300,000 $300,000 $300,000 $0 

Virginia $1,472,215 $1,472,215 $1,597,999 $125,784 

Washington $1,329,170 $1,329,170 $1,442,732 $113,562 

West Virginia $300,000 $300,000 $300,000 $0 

Wisconsin $836,653 $836,653 $908,135 $71,482 

Wyoming $300,000 $300,000 $300,000 $0 

Puerto Rico $891,121 $891,121 $967,257 $76,136 

Guam $50,000 $50,000 $50,000 $0 

Virgin Islands $50,000 $50,000 $50,000 $0 

American Samoa $50,000 $50,000 $50,000 $0 

Northern Mariana Islands $50,000 $50,000 $50,000 $0 

137 
 

 

 

 

 

 

 

SAMHSA-Mental Health 

Protection and Advocacy for Individuals with Mental Illness (PAIMI) 

(Dollars in thousands) 

FY 2021 FY 2022 FY 2023 

Program Name Final 

COVID-19 

Supplemental CR 

President's 

Budget 

FY 2023 +/-

FY 2022 

PAIMI............................................................................................................ $36,146 $--- $36,146 $36,146 $---

Authorizing Legislation .................................................. The PAIMI Act, 42 U.S.C. 10801 et seq. 

FY 2023 Authorization ..................................................................................................................$0 

Allocation Method ................................................................................................... Formula Grants 

Eligible Entities............................................................................................... States and Territories 

Program Description and Accomplishments 

The Protection and Advocacy for Individuals with Mental Illness (PAIMI) Program ensures that 

the most vulnerable individuals with significant mental illness and significant emotional 

impairment, especially those residing in public and private residential care and treatment facilities, 

are free from abuse, including inappropriate restraint and seclusion, neglect, and rights violations 

while receiving appropriate mental disorder treatment and discharge planning services. 

The Protection and Advocacy for Individuals with Mental Illness Act of 1986, as amended by the 

Children’s Health Act of 2000, extended the protections of the Developmental Disabilities (DD) 

Assistance Act of 1975 to individuals with significant mental illness (adults) and significant 

emotional impairments (children/youth) at risk for abuse, neglect, and rights violations while 

residing in public or private care treatment facilities; or living in a community setting, including 

their own homes. The PAIMI Act authorized the same governor-designated state protection and 

advocacy (P&A) systems established under the DD Assistance 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 governordesignated P&A systems, which include states, territories, and the District of Columbia. Each 

system is mandated to: (1) ensure that the rights of individuals with mental illness who are at risk 

of abuse, neglect, and rights violations while residing in public or private care or treatment 

facilities or living in a community setting 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. The priority for services is individuals who are an in-patient or resident of public or private 

care and treatment facilities for individuals with mental illness. 

In FY 2021, the 57 state PAIMI Programs: 

• Served 8,876 PAIMI-eligible individuals/clients: 340 ages 0 to 10, 1,632 ages 11 to 22, 6,199 

age 23-64, 619 age 65 and older, and 48 individuals whose age is unknown. Grantees helped 

these individuals file 6,773 complaints alleging abuse, neglect, and/or rights violations. 

• Resolved 94 percent of abuse allegations, 88 percent of neglect allegations, and 96 percent of 

rights violations allegations, and attained outcomes that resulted in positive change for the 

138 
 

 

 

 

 

 

 

SAMHSA-Mental Health 

clients served. These positive outcomes included receipt of appropriate medical and mental 

disorder treatment; safer, cleaner facility environment; discharge into an appropriate 

community-based setting; and discharge from a nursing facility. 

In FY 2022 Annualized CR, SAMHSA will fund 57 annual grants to states and territories as well 

as the training and technical assistance activities for the grantees. 

Five Year Funding Table 

Fiscal Year Amount 

COVID-19 

Supplemental 

Funding 

FY 2019 $36,146,000 

FY 2020 $36,146,000 

FY 2021 Final $36,146,000 

FY 2022 CR $36,146,000 

FY 2023 President's Budget $36,146,000 

Budget Request 

The FY 2023 President’s Budget request is $36.1 million, level with the FY 2022 Annualized 

Continuing Resolution. PAIMI programs will continue to focus on addressing abuse and neglect 

issues for vulnerable populations and advocate for the rights of individuals with mental illness as 

well as continue to assist individuals with serious mental illness increase access to treatment. 

139 
 

SAMHSA-Mental Health 

Outputs and Outcomes Table 

Program: Protection and Advocacy for Individuals with Mental Illness 

Measure Year and Most Recent 

Result / 

Target for Recent Result / 

(Summary of Result) 

FY 2022 

Target 

FY 2023 

Target 

FY 2023 

Target 

+/-FY 2022 

Target 

3.4.12 Number of people FY 2020: 9,821 9,821 9,821 Maintain 

served by the PAIMI 

program (Outcome) Target: 

10,450 

(Target Not Met) 

3.4.19 Number attending 

public 

education/constituency 

training and public 

awareness activities 

(Output) 

FY 2020: 267,308 

Target: 

100,000 

(Target Exceeded) 

267,308 267,308 Maintain 

3.4.21 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 

decision-making, 

elimination of other 

barriers to personal 

decision-making, as a 

result of Protection and 

Advocacy for Individuals 

with Mental Illness 

(PAIMI) involvement 

(Outcome) 

FY 2020: 93 % 

Target: 

89 % 

(Target Exceeded) 

93 % 93 % Maintain 

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SAMHSA-Mental Health 

FY 2023 PAIMI Formula Grant Provisional Allotments 

Appropriation Amount $36,146,000, State-Territory Total $35,365,112 

CFDA # 93.150 

FY 2021 FY 2022 FY 2023 FY 2023 +/-

State or Territory Final CR President's Budget FY 2022 

Alabama $458,033 $456,384 $457,398 $1,014 

Alaska $428,000 $428,000 $428,000 $0 

Arizona $654,516 $661,988 $665,448 $3,460 

Arkansas $428,000 $428,000 $428,000 $0 

California $3,019,439 $2,993,976 $2,976,996 -$16,980 

Colorado $451,860 $453,843 $459,010 $5,167 

Connecticut $428,000 $428,000 $428,000 $0 

Delaware $428,000 $428,000 $428,000 $0 

District of Columbia $428,000 $428,000 $428,000 $0 

Florida $1,823,324 $1,825,096 $1,835,828 $10,732 

Georgia $936,003 $942,067 $939,161 -$2,906 

Hawaii $428,000 $428,000 $428,000 $0 

Idaho $428,000 $428,000 $428,000 $0 

Illinois $1,024,388 $1,017,767 $1,001,172 -$16,595 

Indiana $590,974 $594,469 $591,468 -$3,001 

Iowa $428,000 $428,000 $428,000 $0 

Kansas $428,000 $428,000 $428,000 $0 

Kentucky $428,000 $428,000 $428,000 $0 

Louisiana $428,000 $428,000 $428,000 $0 

Maine $428,000 $428,000 $428,000 $0 

Maryland $461,915 $464,394 $468,379 $3,985 

Massachusetts $499,913 $498,368 $496,635 -$1,733 

Michigan $870,556 $876,669 $861,231 -$15,438 

Minnesota $448,602 $452,702 $453,162 $460 

Mississippi $428,000 $428,000 $428,000 $0 

Missouri $537,485 $542,077 $539,884 -$2,193 

Montana $428,000 $428,000 $428,000 $0 

Nebraska $428,000 $428,000 $428,000 $0 

Nevada $428,000 $428,000 $428,000 $0 

New Hampshire $428,000 $428,000 $428,000 $0 

New Jersey $658,968 $656,531 $658,267 $1,736 

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SAMHSA-Mental Health 

FY 2023 PAIMI Formula Grant Provisional Allotments 

Appropriation Amount $36,146,000, State-Territory Total $35,365,112 

CFDA # 93.150 

State or Territory 

FY 2021 

Final 

FY 2022 

CR 

FY 2023 

President's Budget 

FY 2023 +/-

FY 2022 

New Mexico $428,000 $428,000 $428,000 $0 

New York $1,441,606 $1,427,056 $1,424,514 -$2,542 

North Carolina $927,784 $935,436 $943,889 $8,453 

North Dakota $428,000 $428,000 $428,000 $0 

Ohio $1,014,623 $1,015,695 $1,006,710 -$8,985 

Oklahoma $428,000 $428,000 $428,000 $0 

Oregon $428,000 $428,000 $428,000 $0 

Pennsylvania $1,035,077 $1,034,444 $1,026,388 -$8,056 

Rhode Island $428,000 $428,000 $428,000 $0 

South Carolina $467,601 $471,722 $476,366 $4,644 

South Dakota $428,000 $428,000 $428,000 $0 

Tennessee $599,542 $602,991 $608,463 $5,472 

Texas $2,449,916 $2,454,782 $2,492,569 $37,787 

Utah $428,000 $428,000 $428,000 $0 

Vermont $428,000 $428,000 $428,000 $0 

Virginia $679,379 $680,626 $688,369 $7,743 

Washington $581,605 $584,446 $593,716 $9,270 

West Virginia $428,000 $428,000 $428,000 $0 

Wisconsin $490,174 $490,983 $493,057 $2,074 

Wyoming $428,000 $428,000 $428,000 $0 

Puerto Rico $507,319 $496,090 $504,532 $8,442 

American Samoa $229,300 $229,300 $229,300 $0 

Guam $229,300 $229,300 $229,300 $0 

American Indian Consortium $229,300 $229,300 $229,300 $0 

Northern Mariana Islands $229,300 $229,300 $229,300 $0 

Virgin Islands $229,300 $229,300 $229,300 $0 

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Community Mental Health Centers................................................................ $

SAMHSA-Mental Health 

Community Mental Health Centers (CMHC) 

(Dollars in thousands) 

Program Name

FY 2021 FY 2022 FY 2023

Final

COVID-19 

Supplemental CR

President's

Budget

FY 2023 +/-

FY 2022

Community Mental Health Centers................................................................ $--- $--- $--- $412,500 $---

Authorizing Legislation .............................................Section 330 of the Public Health Service Act 

FY 2023 Authorization ..................................................................................................................$0 

Allocation Method ..................................................................................................................Grants 

Program Description and Accomplishments 

SAMHSA proposes a new mandatory funding toward Community Mental Health Centers 

(CMHCs) to expand and improve the quality of services available to people with mental illness. 

The funding will be provided through 50 states and 6 territories by utilizing the Mental Health 

Block Grant formula. CMHCs have informally existed in communities across America for 

decades but lack standards or consistency in the services available. As part of the application, 

SAMHSA will require state behavioral health authorities to submit a description for their intended 

use of funds for the fiscal year of the amounts. This program is intended to offer an opportunity 

to increase the quality of mental health services in communities across the United States. 

CMHC funding to states will require the providers to develop a continuum of behavioral health 

services plan, which incorporates a crisis care continuum (i.e., crisis residential, crisis stabilization, 

and mobile crisis teams); screening, treatment, and/or referral for substance use disorders and 

medical conditions; outpatient mental health services regardless of ability to pay; and recovery 

support services (i.e., case management; peer support, and family support approaches). 

Establishment of long-term support for CMHCs will directly increase the scope and quality of 

behavioral health services in CMHCs funded by the program, establish a higher standard as a target 

for all CMHCs and address the incomplete and inconsistent service array in much of America. 

Five Year Funding Table 

Fiscal Year Amount 

COVID-19 

Supplemental 

Funding 

FY 2019 $---

FY 2020 $---

FY 2021 Final $---

FY 2022 CR $---

FY 2023 President's Budget $412,500,000 

Budget Request 

The FY 2023 President’s Budget request is $413 million, an increase of $413 million from the FY 

2022 Annualized Continuing Resolution. The funding increase will be used to further develop the 

quality and continuum of behavioral health services in CMHCs, expanding access to crisis care, 

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SAMHSA-Mental Health 

integrated care, and other recovery support services in communities across America. It is estimated 

that these services will directly benefit at least 20,000 individuals per year, providing an improved 

level of treatment and support to meet the increase behavioral health services needs in local 

communities. 

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SAMHSA-Mental Health 

Certified Community Behavioral Health Clinic (CCBHC) 

(Dollars in thousands) 

FY 2021 FY 2022 FY 2023 

Program Name Final 

COVID-19 

Supplemental CR 

President's 

Budget 

FY 2023 +/-

FY 2022 

Certified Community Behavioral Health Clinic............................................. $249,249 $1,020,000 $250,000 $552,500 $302,500 

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

FY 2023 Authorization ..................................................................................................................$0 

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

Eligible Entities....................................................Certified Community Behavioral Health Clinics, 

...................................................................................Community-Based Behavioral Health Clinics 

Program Description and Accomplishments 

More than 14 million adults 18 and older had a serious mental illness (SMI), more than 16 million 

adults misused prescription drugs, and about 40.3 million individuals aged 12 or older had an illicit 

drug or alcohol use disorder in the past year.52 While effective treatment and supportive services 

exist, many individuals with behavioral health conditions do not receive the help they need. When 

they do try to access services, they often face significant delays and/or have access to limited 

services. Too often, services are incomplete and are not effectively coordinated care. Even people 

who receive some services, such as medication or psychotherapy, often do not have access to the 

range of supports they need, such as crisis management and recovery supports that include 

supported employment, supported housing and addressing, manage co-occurring physical health 

problems. 

Congress created a new approach to addressing these issues by creating the Certified Community 

Behavioral Health Clinics (CCBHC) model as a part of the Protecting Access to Medicare Act of 

2014 (PAMA). CCBHC’s ensure access to and coordination of care so that individuals receive 

timely diagnosis, treatment, and recovery support services. As required in PAMA, HHS 

established criteria for clinics to be certified as CCBHCs in 2015. These criteria cover six areas 

that CCBHCs must address to be certified: (1) staffing; (2) availability and accessibility of 

services; (3) care coordination; (4) scope of services; (5) quality and other reporting; and (6) 

organizational authority. In FY 2016, SAMHSA assisted 24 states through planning grants to be 

eligible for a CCBHC demonstration, and in FY 2017, CMS selected eight states to participate in 

a two-year CCBHC demonstration program. This demonstration program has been extended by 

Congress until 2023 and expanded to include two additional states. The CMS funded 

demonstration program is separate from the SAMHSA-funded CCBHC-E program in terms of 

source of funding. Through the CMS Medicaid prospective payment system CCBHC 

demonstration clinics are reimbursed for the care and services provided to Medicaid beneficiaries. 

In 2018, SAMHSA established the CBHC-Expansion (CCBHC-E) grant program. SAMHSA’s 

CCBHC-E program is separate from the Medicaid Demonstration program, though some clinics 

participate in both programs. The CCBHC-E program is designed to increase access to and 

52 SAMHSA, Center for Behavioral Health Statistics and Quality. (2017, September 7). Results from the 2016 National Survey on Drug Use and 

Health: Detailed tables. Retrieved from https://www.samhsa.gov/data/sites/default/files/NSDUH-DetTabs-2016/NSDUH-DetTabs-2016.pdf 

145 
 

 

 

SAMHSA-Mental Health 

improve the quality of community behavioral health services by supporting the CCBHC model. 

Grant funding for the CCBHC-E program is provided directly to the certified clinics. Since 2020, 

applicants from all states can apply for CCBHC-E funding and the program is not restricted to the 

nine states participating in the Medicaid Demonstration nor the 24 states that received planning 

grants. As of August 30, 2021, CCBHC-E clinics are in 42 states, the District of Columbia, Puerto 

Rico, and Guam. CCBHCs funded under this program must provide access to services for 

individuals with serious mental illness (SMI) or substance use disorders (SUD), including opioid 

disorders; children and adolescents with serious emotional disturbance (SED); and individuals 

with co-occurring mental and substance use disorders (COD). Crisis services are a required 

element of the CCBHC model. The CCBHC-E program is intended to improve the behavioral 

health of individuals across the nation by providing increased access to a comprehensive range of 

services. These include community-based mental and substance use disorder services; treatment 

of co-occurring disorders; primary care screening and monitoring; and use of evidence-based 

practices chosen to meet community need. Data from intake to most recent reassessment for 

individuals served in the CCBHC program demonstrate that as of March 2022, clients have a 72-

percent reduction in hospitalization and a 69-percent reduction in Emergency Department visits. 

Additionally, the data demonstrates that 12 percent had an increase in employment or started going 

to school, and a 25-percent increase in mental health functioning in everyday life. 

In FY 2021, SAMHSA supported 102 continuation grants, awarded a new cohort of 31 grants (22 

grants from annual appropriations and 9 grants from FY2019 Recovery funds), and a new Training 

and Technical Assistance Center. In addition, SAMHSA awarded 203 grants using funding from 

the Coronavirus Response and Relief Supplemental Appropriations Act and the American Rescue 

Plan Act. In FY 2022 Annualized CR, SAMHSA will support 70 continuation grants (30 grants 

from annual appropriation and 40 from the American Rescue Plan Act), award a new cohort of 

246 grants (180 grants from annual appropriations and 66 grants from American Rescue Plan Act), 

and continue the technical training assistance center grant. 

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SAMHSA-Mental Health 

The table below provides a demographic breakdown of the clients served by the CCBHCs in FY 

2020. 

Demographics % 

Race 

American Indian 1.1% 

Asian 1.2% 

Black 17% 

Native Hawaiian/ Alaska Native 0.4% 

White 67.1% 

Ethnicity 

Hispanic 14.3% 

Non-Hispanic 84.0% 

Gender 

Male 44.7% 

Female 54.1% 

Transgender 0.6% 

Other 0.6% 

Age 

5 and under 0.6% 

5 through 9 4.2% 

10 through 12 4.1% 

13 through 15 5.7% 

16 through 25 17.2% 

26 through 34 19.5% 

45 through 54 17.7% 

55 through 64 12.0% 

65 through 74 3.5% 

75 through 84 0.6% 

85 through 94 0.1% 

95 and older 0.0% 

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SAMHSA-Mental Health 

The table below includes the amount of CCBHC-E funding awarded to community behavioral 

health clinics in each state in FY 2020. The total awards also include COVID-19 supplemental 

funding that was appropriated to Health Surveillance and Program Support 

States Total FY 2020 

Award 

Alaska $6,000,000 

Arkansas $7,784,113 

California $13,995,620 

Colorado $6,000,000 

Connecticut $19,663,642 

Florida $5,983,150 

Georgia $2,000,000 

Illinois $16,000,000 

Indiana $16,803,613 

Iowa $17,835,330 

Kansas $1,999,817 

Kentucky $12,000,000 

Maryland $2,000,000 

Massachusetts $31,744,118 

Michigan $58,113,289 

Minnesota $3,947,094 

Missouri $13,835,917 

Nebraska $3,999,607 

Nevada $0 

New Jersey $26,019,053 

New York $91,644,691 

North Carolina $8,844,709 

Ohio $6,000,000 

Oklahoma $13,822,801 

Oregon $7,340,879 

Pennsylvania $12,098,008 

Rhode Island $7,695,402 

Tennessee $8,000,000 

Texas $26,362,333 

Virginia $7,971,825 

Washington $5,991,182 

West Virginia $3,999,871 

Wisconsin $4,000,000 

Since 2018, CCBHC-E grantees have served over 276,000 individuals. CCBHC-E grantees have 

increased the availability of critical services, improved staffing and training, reduced wait times, 

enhanced the integration of physical and behavioral health care, expanded addiction treatment 

capacity including Medication Assisted Treatment (MAT) for opioid use disorder. 

148 
 

 

 

 

SAMHSA-Mental Health 

Five Year Funding Table 

Fiscal Year Amount 

COVID-19 

Supplemental 

Funding 

FY 2019 $150,000,000 

FY 2020 $200,000,000 

FY 2021 Final $249,249,440 $1,020,000,000 

FY 2022 CR $250,000,000 

FY 2023 President's Budget $552,500,000 

Budget Request 

The FY 2023 President’s Budget request is $552.0 million, an increase of $302.5 million from the 

FY 2022 Annualized Continuing Resolution. The purposed funding increase will support 152 

continuation grants, a new cohort of 226 grants and technical training assistance center grant to 

continue the improvement of mental disorder treatment, services, and interventions for children 

and adults. With this increase in funding, SAMHSA expects that the number of individuals served 

will increase to 350,000. 

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SAMHSA-Mental Health 

Outputs and Outcomes Table 

Program: Certified Community Behavioral Health Clinic 

Measure Year and Most Recent 

Result / 

Target for Recent Result / 

(Summary of Result) 

FY 2022 

Target 

FY 2023 

Target 

FY 2023 

Target 

+/-FY 2022 

Target 

3.4.10 Percentage of 

clients receiving services 

who report positive 

functioning at 6 months 

follow-up. (Outcome) 

FY 2021: 57.8 

Target: 

56.0 

(Target Exceeded) 

56.0 56.0 Maintain 

3.4.11 Percentage of 

clients receiving services 

who are currently 

employed at 6-month 

follow-up. (Outcome) 

FY 2021: 47.2 

Target: 

36.0 

(Target Exceeded) 

36.0 36.0 Maintain 

3.4.12 Percentage of 

clients receiving services 

who have a permanent 

place to live in the 

community at 6-month 

follow-up. (Outcome) 

FY 2021: 71.9 

Target: 

65.0 

(Target Exceeded) 

65.0 65.0 Maintain 

3.5.10 Number of 

individuals served by the 

program (Output) 

FY 2021: 188,224.0 

Target: 

85,000.0 

(Target Exceeded) 

188,000.0 350,000 Increase 

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SAMHSA-Mental Health 

Certified Community Behavioral Health Clinics 

Mechanism Table 

(Dollars in thousands) 

Program Activity 

FY 2021 

Final 

FY 2022 

CR

FY 2023 

President's Budget 

Certified Community Behavioral Health Clinics 

Grants/Cooperative Agreements 

Continuations..................................................................... 

New/Competing................................................................. 

102 

23 

$195.62 

44.35 

31 

181 

$58.70 

180.59 

152 

226 

$307.67 

225.76 

Subtotal........................................................................... 125 239.97 212 239.29 378 533.44 

Contracts 

Continuations.....................................................................

New/Competing.................................................................

 ---

 ---

8.62

0.66

 ---

 ---

7.71

3,000

 ---

 ---

19.06 

 ---

Subtotal........................................................................... --- 9.28 --- 10.71 --- 19.06 

Total, Certified Community Behavioral Health Clinics 125 $249.25 212 $250.00 378 $552.50 

Grant Awards Table 

(Whole dollars) 

 FY 2021 

Final 

 FY 2022 

CR 

 FY 2023 

President's Budget 

Number of Awards 125 212 378 

Average Awards $1,919,758 $1,130,923 $1,410,833 

Range of Awards $886,998-$2,000,000 $1,000,000-$2,000,000 $1,000,000-$2,000,000 

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SAMHSA-Mental Health 

Community Mental Health Services Block Grant (MHBG) 

(Dollars in thousands) 

Program Name 

FY 2021 FY 2022 FY 2023 

Final 

COVID-19 

Supplemental CR 

President's 

Budget 

FY 2023 +/-

FY 2022 

Community Mental Health Services Block Grant.......................................... 

Budget Authority (non-add)......................................................................... 

PHS Evaluation Funds (non-add)................................................................ 

$755,571 

734,532 

21,039 

$3,150,000 

---

---

$757,571 

736,532 

21,039 

$1,652,571 

1,631,532 

21,039 

$895,000 

895,000 

---

Authorizing Legislation ......................................... Sections 1911 of the Public Health Service Act 

FY 2023 Authorization ..................................................................................................................$0 

Allocation Method .....................................................................................................Formula Grant 

Eligible Entities..................States, Territories, Freely Associated States, and District of Columbia 

Program Description and Accomplishments 

There is renewed focus and increased awareness of the importance of psychological well-being of 

Americans during and after the COVID-9 pandemic. Serious mental illnesses are common in the 

United States. According to the 2020 National Survey on Drug Use and Health (NSDUH)53, 5.6% 

of adults aged 18 and older had a serious mental illness in 2020 (an estimated 14200,000 

individuals) and only 9,133,000 adults with SMI received services (64.5% received services in 

2020). Studies and research indicate increased risk of COVID-19 mortality among individuals 

with mental illness54 . The COVID-19 pandemic is also associated with high levels of 

psychological distress among general population55, specifically among people with SMI and 

SED56 . 

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.57 The MHBG distributes funds can be used for a 

53 Substance Abuse and Mental Health Services Administration. (2021). Key substance use and mental health 

indicators in the United States: Results from the 2020 National Survey on Drug Use and Health (HHS Publication 

No. PEP21-07-003, NSDUH Series H-56). Rockville, MD: Center for Behavioral Health Statistics and Quality, 

Substance use And Mental Health Services Administration. Retrieved from https://www.samhsa.gov/data/ 54 Bitan, D. T., Kridin, K., Cohen, A. D., & Weinstein, O. (2021). COVID-19 hospitalization, mortality, 

vaccination, and postvaccination trends among people with schizophrenia in Israel: a longitudinal cohort study. The 

Lancet Psychiatry. 55 Xiong, J., Lipsitz, O., Nasri, F., Lui, L. M., Gill, H., Phan, L., ... & McIntyre, R. S. (2020). Impact of COVID19 pandemic on mental health in the general population: A systematic review. Journal of affective disorders. 56 Dickerson, F., Katsafanas, E., Newman, T., Origoni, A., Rowe, K., Squire, A., ... & Yolken, R. (2021). 

Experiences of Persons With Serious Mental Illness During the COVID-19 Pandemic. Psychiatric Services, appips.

57 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 

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SAMHSA-Mental Health 

variety of behavioral health services and for planning, administration, and educational activities. 

By statute, these services and activities must support community-based mental health services for 

children with serious emotional disturbances and adults with serious mental illness. MHBG 

services include: outpatient treatment for persons with serious mental illnesses, such as 

schizophrenia and bipolar disorders; supported employment and supported housing; rehabilitation 

services; crisis stabilization and case management; peer specialist and consumer-directed services; 

wraparound services for children and families; jail diversion programs; and services for at-risk 

populations (e.g., individuals, who experience homelessness, those in rural and frontier areas, 

military families, and veterans). Through the administration of the MHBG, SAMHSA supports 

the implementation of practices demonstrated and proven effective in the Mental Health Programs 

of Regional and National Significance (PRNS) portfolio. 

The MHBG continues to represent a significant “safety net” source of funding for mental health 

services for some of the most at-risk populations across the country. Together, SAMHSA’s block 

grants support the provision of services and related support activities to more than eight million 

individuals with mental and substance use conditions in any given year. The MHBG’s flexibility 

and stability have made it a vital support for public mental health systems. States rely on the 

MHBG for delivery of services and for an array of non-clinical coordination and support services 

that are not supported by Medicaid or other third-party insurance to strengthen their service. 

The MHBG statute provides for a five percent administrative set-aside that allows SAMHSA to 

assist the states and territories in the development of their mental health systems through the 

support of technical assistance, data collection, and evaluation activities. States also use block 

grant funds, with other funding sources, to support training for staff and implementation of 

evidence-based practices and other promising practices for the treatment of mental disorders, 

improved business practices, use of health information technology, and integration of physical and 

behavioral health services. 

SAMHSA’s MHBG and Substance Abuse Prevention and Treatment Block Grant (SABG) 

applications align with changes in federal/state environments and statutes. SAMHSA offers states 

the opportunity to complete a combined application for mental health and substance abuse 

services, submit a biennial plan, and provide information regarding their efforts to respond to 

various changes in federal and state law.58,59 

There are many individuals, both adolescent and adult, with co-occurring mental illness and 

drug/alcohol addiction. In recognition of this, SAMHSA strongly encourages coordination 

between MHBG programs and those supported by the SABG as well as other SAMHSA-funded 

efforts such as the systems of care for children and adolescents supported through the Children’s 

Mental Health Initiative. 

http://www.doi.gov//oia/islands/index.cfm. Further information about the Block Grant program can be found on 

SAMHSA’s Web site at http://www.samhsa.gov/grants/block-grants 

58 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). 59 State Plan (Sec. 1932 (b) of Title XIX, Part B, Subpart II of the Public Health Service (PHS) Act (42 USC § 

300x-32(b)). 

153 
 

 

SAMHSA-Mental Health 

According to the 2021 National Outcome Measures (NOMS) Report, the MHBG served 8,013,396 

clients through the State Mental Health Systems. The table below provides 2021 demographics 

on the clients served. 

Mental Health Block Grant Demographics 

Adults 5,774,536 

Children 2,212,706 

Female 52.2% 

Male 47.7% 

Age 

0-12 15.56% 

13-17 12% 

18-20 4.7% 

20-24 5.6% 

25-44 31.9% 

45-64 24% 

65-74 3.9% 

75+ 1.6% 

75+ 0.03% 

The table below provides data on the FY 2020 evidence-based treatment services utilized by clients 

served by the MHBG. 

Evidence-based Treatment Services Utilized 

Adults 

Supported Housing 2.3% 

Supported Employment 1.9% 

Assertive Community Treatment 1.8% 

Family Psychoeducation 3.1% 

Dual Diagnosis Treatment 9.5% 

Illness Self-Management 19.1% 

Medications Management 31.3% 

Children 

Therapeutic Foster Care 1.7% 

Multi-systemic Therapy 4.1% 

Functional Family Therapy 5.8% 

Most block grant recipients are currently reporting on 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 2020 show that: 

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SAMHSA-Mental Health 

• For the 57 states and territories that reported data in the Employment Domain, 23.6 percent of 

the mental health consumers were in competitive employment; 

• For the 57 states and territories that reported data in the Housing Domain,84.7 percent of the 

mental health consumers were living in private residences; 

• For the 58 states and territories that reported data in the Access/Capacity Domain, state mental 

health agencies provided mental health services for approximately 24.58 people per 1,000 

population; 

• For the 48 states and territories that reported data in the Retention Domain, only 9.2 percent of 

the patients returned to a state psychiatric hospital within 30 days of state hospital discharge; 

and 

• For the 49 states and territories that reported data in the Perception of Care Domain, 79.6 

percent of adult mental health consumers improved functioning as a direct result of the mental 

health services they received. 

Beginning in September 2016, SAMHSA, in partnership with National Institute of Mental Health 

(NIMH) and the Office of the Assistant Secretary for Planning and Evaluation (ASPE), initiated a 

3-year evaluation study of the First Episode Psychosis programs funded through the MHBG setaside to ascertain the effectiveness of these programs. The study, which focused on services in 36 

diverse programs, collected clinical outcome data and conducted fidelity assessments. The results 

indicate that these evidence-based programs lead to statistically significant improvements in the 

health and well-being of individuals who participate in them, including reductions in 

hospitalization (-79%) and emergency room visits (-71%), criminal justice involvement (-41%), 

suicide attempts (-66%), and reductions in homelessness (-35%). 

Mental Disorders Prevalence Data Collection, Analysis, and Dissemination 

Section 505 of the Public Health Service Act (42 U.S.C. 290aa-4) requires SAMHSA, on an annual 

basis, to collect data on the prevalence of substance use and mental illness. To accomplish this, 

SAMHSA awarded a contract in FY 2018 to design a multi-component project that would provide 

local level psychiatric epidemiology information on incidence and prevalence of select mental 

disorders, substance use disorders, and services received for those disorders. 

In FY 2019, SAMHSA awarded a new contract to pilot the Mental Disorders Prevalence Survey 

(MDPS) design and methodology on a small scale using ten catchment areas that are a mix of rural 

and urban areas with both household and non-household populations. This project will serve as a 

foundation for future, larger scale efforts to assess incidence and prevalence of such disorders on 

a national scale. 

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SAMHSA-Mental Health 

Crisis Services Set-Aside 

The budget proposes that states will be required to set-aside 10 percent, an increase of 5 percent, 

of their total allocation for evidence-based crisis care programs that address the needs of 

individuals with serious mental illnesses and children with serious mental and emotional 

disturbances. The set-aside will fund some or all of a set of core crisis care elements including 

centrally deployed 24/7 mobile crisis units, short-term residential crisis stabilization beds, 

evidence-based protocols for delivering services to individuals with suicide risk, and regional or 

State-wide crisis call centers coordinating in real time. 

A fully developed crisis response system is responsive any time and any place. SAMHSA expects 

that states will build on the emerging and growing body of evidence for effective communitybased crisis-intervention and response systems. SAMHSA recognizes that the development of 

fully accessible and responsive crises services involves complex problem solving with multiple 

entities and systems including a partnership between mental health and law enforcement. 

SAMHSA anticipates that 988 will play a critical role in such fully developed crisis systems. 

SAMHSA also recognizes that strategic crisis services implementation can result in better care and 

cost savings through the reduction in avoidable emergency department visits, psychiatric 

admissions, police engagement, arrests, incarcerations and 911 calls. SAMHSA views effective 

implementation of 988 as a catalyst for this crisis service development and transformation. 

As the nation moves towards full availability of 988 as the new national suicide prevention and 

mental health crisis hotline number by July 2022, SAMHSA has emphasized to states the 

importance of preparing for 988 implementation, and that the MHBG crisis set aside can be used 

to support local Lifeline call centers who provide regional or statewide coverage and coordinate 

in real time. SAMSHA continues to partner with states on the crisis set aside through the provision 

of technical assistance on the use of funds, requests for information on specific allocations of 

funding across the crisis continuum of care, and recommended changes to the data reporting 

system. 

Set-aside for Evidence-based Programs that Address the Needs of Individuals with Early Serious 

Mental Illness 

States are required to set aside ten percent of their MHBG funds to support “evidence-based 

programs that address the needs of individuals with early serious mental illness, including 

psychotic disorders.”60 This totaled $68.5 million in FY 2020. SAMHSA is collaborating with 

the NIMH 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 use, increased hospitalizations, and reduced prospects for long-term 

recovery. 

60 http://www.samhsa.gov/sites/default/files/mhbg-5-percent-set-aside-guidance.pdf 

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SAMHSA-Mental Health 

Through this funding, 50 states, DC and Puerto Rico implemented fully operating first-episode 

treatment programs and SAMHSA continues to monitor and ensure that the set-aside program is 

solely used to address first-episode psychosis. 

Set-aside for Early Intervention and Prevention of Mental Disorders Among At-Risk Children and 

Adults 

The FY 2023 budget proposes a new set-aside that would require states to expend at least 10 

percent of MHBG for evidence-based prevention and early intervention programs to improve 

outcomes for at-risk youth and adults who are at risk to develop serious mental illness (SMI) or 

serious emotional disturbance (SED)through prevention, education, screening, and early 

identification. This investment will expand funding to support earlier identification and prevention 

of mental health disorders and further support targeted services for youth and prevent more serious 

symptoms further on in a person’s life. 

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The table below identifies activities, which have been implemented with the 10 percent set-aside 

for First Episode Psychosis (FEP)/Early Serious Mental Illness (ESMI). 

State FY 2021 10% 

Set Aside 

Allotment 

Program Description 

Alabama $1,039,379 State uses the EASA and OnTrack USA. Services are delivered 

through a Coordinated Specialty Care Team that is reflective of 

the demographic mix of the community. 

Alaska $162,654 Use the OnTrAK model. The staffing structure highlights the 

realities of the Mat-Su Borough in size, scope, and incidence rate 

leading to the development of a task-based team approach focused 

on outcome. 

American 

Samoa 

$14,131 AS has adopted the Assertive Community Treatment (ACT) 

model for community mental health services for use with 

individuals with FEP. 

Arkansas $629,052 State ESMI/FEP program is contractually assigned to the 

Community Mental Health Centers. Evidenced-based treatment 

models are utilized for each client newly diagnosed with 

psychosis. 

California $9,419,007 State allocates MHBG funds to 57 local county subrecipients who 

administer their own Mental Health Plans that are unique to their 

particular geographic and population circumstances each year and 

utilize models, such as Portland Identification and Early Referral 

(PIER). 

Colorado $1,413,144 Providers have implemented CSC models with high fidelity. 

Connecticut $697,199 State implemented four programs based on two distinct CSC 

models (Potential and STEP). 

District of 

Columbia 

$170,233 The District’s early intervention program (EIP), the Youth 

Blossom program at Community Connections, is utilizing CSC 

model offers early treatment to young adults (age 16-25) 

experiencing their first psychotic break. 

Delaware $167,577 A statewide program, Community Outreach, Referral and Early 

Intervention (CORE)) has been implemented. 

Florida $4,776,058 The State of Florida currently has 7 Coordinated Specialty Care 

teams. Six of the seven utilize the NAVIGATE model and one 

utilizes the OnTrack model. 

Georgia $2,300,633 State has now implemented ten (10) Coordinated Specialty Care 

teams around the state. All programs are based on the LIGHTETP model. 

Guam $46,645 State has begun providing services in the I Fine'na program, which 

is based on OnTrackNY, and offers Early Serious Mental Illness 

(ESMI) services through the OASIS Empowerment Center. 

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SAMHSA-Mental Health 

State FY 2021 10% 

Set Aside 

Allotment 

Program Description 

Hawaii $362,111 State has implemented a program with three sites in Honolulu 

based on the OnTRACK model. 

Idaho $424,052 Four CSC programs have been implemented Idaho is 

implementing the STAR (Strength Through Active Recovery) 

program to provide FEP treatment based on the On-Track CSC 

treatment model. 

Indiana $1,288,471 State offers three programs based on the Prevention and Recovery 

Care (PARC) model and makes use of a "hub and spoke" design. 

Iowa $564,139 State has three functioning CSC programs based on the 

NAVIGATE model. 

Kansas $525,176 There are three teams in Kansas. The eligibility age was raised 

from 15 to 25-years-old to 15 to 36-years-old to increase access 

to women. 

Kentucky $934,076 Eight EASA CSC program sites are available throughout the state, 

with one in the installation phase. State is also using the MHBG 

to support data infrastructure to track outcomes. 

Louisiana $1,042,026 Six sites have been implemented. These programs are using the 

Navigate CSC model. 

Maine $282,072 State has implemented one program, Maine Medical 

Center/Portland Identification and Early Referral Program, based 

on the PIER Model in Portland. The state has also contracted with 

the PIER program to train staff at one other provider to provide 

FEP services. 

Marshall 

Islands 

$21,042 Use the set aside funding to develop first episode outreach 

practices and protocols for individuals experiencing FEP. 

Maryland $1,400,957 The state has implemented four CSC programs, two in Baltimore, 

one in Gaithersburg and one in Catonsville. 

Massachusetts $1,440,213 Seven Community Clinics with comprehensive specialized FEP 

services are in operation, and 3 outpatient hospital sites. 

Michigan $2,111,464 The State has implemented six CSC programs using the 

NAVIGATE CSC model. 

Federated 

States of 

Micronesia 

$28,815 Funds are being used to train staff on the OnTrack CSC model in 

four locations. The state also has developed outreach and 

screening processes in schools and in the community in Majuro, 

Ebeye and Outer Islands. 

Minnesota $1,089,245 State has implemented three CSC programs using the Navigate 

model. 

Missouri $1,210,697 State has established ten sites spread throughout the state that 

159 
 

 

SAMHSA-Mental Health 

State FY 2021 10% 

Set Aside 

Allotment 

Program Description 

provide Assertive Community Treatment for Transitional Age 

Youth (ACT-TAY) for individuals experiencing an early serious 

mental illness. 

Montana $220,246 The state has implemented the NAVIGATE model in one site. 

Nebraska $330,252 The state has implemented OnTrackUSA in two of the six 

behavioral health service regions of the state. 

Nevada $760,827 The state has implemented three CSC programs: in the Reno area 

and Las Vegas area using the Recovery After Initial 

Schizophrenic Episode (RAISE) TEAM approach and a third 

CSC program in Carson City that follows the NAVIGATE model. 

New 

Hampshire 

$253,468 State currently has one FEP program at the Greater Nashua 

Mental Health Center (GNMHC), utilizing the NAVIGATE 

model. 

New Jersey $1,970,795 State has implemented three CSC teams that provide CSC service 

in all 21 NJ counties. 

New Mexico $437,403 State is expanding access to the NAVIGATE model for specialty 

coordinated care for individuals with FEP through the already 

implemented University of New Mexico EARLY program. 

New York $4,032,160 State is spending set-aside funds to expand its existing 

OnTrackNY program to two new sites, for 22 CSC sites statewide. 

North Carolina $2,092,398 North Carolina supports four CSC for FEP programs. 

North Dakota $124,874 State implemented CSC services in Fargo, which serves six 

counties in the state. 

Northern 

Mariana 

Islands 

$14,456 The Community Guidance Center implemented a 

psychoeducation group geared toward family education, which 

will help families and the community better identify FEP 

symptoms in their family or community leading to earlier 

treatment of the client. 

Oklahoma $791,316 State indicates they have expanded to 14 CSC and ESMI 

programs. 

Oregon $1,140,559 Oregon is integrating Coordinated Specialty Care teams in all 

counties using a standard model of care supported by the EASA 

Center for Excellence at Oregon Health & Science University and 

Portland State University. 

160 
 

 

 

 

 

 

SAMHSA-Mental Health 

State FY 2021 10% 

Set Aside 

Allotment 

Program Description 

Palau $5,982 Supports one CSC team. 

Pennsylvania $2,359,765 State has 14 Coordinated Specialty Care Programs for First 

Episode Psychosis, serving 20 counties. 

Puerto Rico $915,984 Puerto Rico has implemented two Coordinated Specialty Care 

Programs using the OnTrack model. 

Rhode Island $267,129 Rhode Island will continue to use the entire set-aside amount to 

serve individual ages 16-25 experience a first episode of 

psychosis in the two CSC community health care centers. 

South Carolina $1,082,125 State is funding four programs for individuals with an early 

serious mental illness, one of which uses the NAVIGATE model. 

South Dakota $155,104 State has implemented two CSC programs in Sioux Falls and 

Rapid City. They have been trained by OnTrackNY. 

Tennessee $1,374,292 State uses the MHBG funds to provide OnTrackTN in five sites 

across the state. 

Texas $6,489,575 State offers 24 CSC programs in rural and urban. These sites 

serve both indigent and Medicaid-eligible populations. 

Utah $649,072 State has 5 programs in total, all funded by MHBG. Four are FEP 

programs that follow the RAISE model, and one is an ESMI 

program for Latinx youth (14-25). 

Vermont $123,198 State continues to partner with Vermont Corporative for Practice 

Improvement and Innovation to facilitate the initiative including 

targeted, research, implementation, workforce development, 

outreach, and education. 

Virginia $1,802,793 Eight (8) Virginia community services boards (CSBs) operate 

CSC programs. 

Washington $1,672,613 State operates nine sites using the New Journeys model based on 

the NAVIGATE model. 

West Virginia $391,866 State has seven provider sites utilizing the FIRST CSC model 

ESMI services to fidelity. 

Wisconsin $1,240,805 State is continuing to fund the CSC model PROPS program 

operated by JMHC in Madison, which serves three rural counties 

north of Madison. In addition, the state is funding a CSC program 

in Milwaukee. 

Wyoming $91,246 The state has two providers providing CSC FEP programs: 

Southwest Counseling Service 

Yellowstone Behavioral Health Center. 

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SAMHSA-Mental Health 

10 Year Funding Table 

Fiscal Year Amount 

COVID-19 

Supplemental 

Funding 

FY 2014 $482,571,000 

FY 2015 $482,571,000 

FY 2016 $532,571,000 

FY 2017 $562,571,000 

FY 2018 $722,571,000 

FY 2019 $722,571,000 

FY 2020 $722,571,000 

FY 2021 Final $755,571,000 $3,150,000,000 

FY 2022 CR $757,571,000 

FY 2023 President's Budget $1,652,571,000 

Budget Request 

The FY 2023 President’s Budget request is $1.6 billion, an increase of $895.0 million from the FY 

2022 Annualized Continuing Resolution. With this funding, SAMHSA will continue to address 

the needs of individuals with SMI and SED and will continue 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. 

The Budget also increases the set-aside for crisis intervention services from $75 million (5 percent 

of the FY 2022 Annualized Continuing Resolution funding level) to 10 percent. Increasing this 

set-aside will further support state efforts to build much needed crisis systems to address the needs 

of individuals in mental health crisis in a high quality, expeditious manner. The development of 

these services will promote 24/7 access to well-trained mental health professionals in the time of 

acute mental health crisis. This expansion of crisis services will play a critical role when the new 

national suicide prevention and mental health crisis hotline number (988) go live July 2022. 

SAMHSA is anticipating an increase demand in crisis related services, including aftercare. This 

increase in the crisis services set-aside will directly support the states in developing and or 

enhancing the 24/7 mobile crisis teams, crisis stabilization programs and local Lifeline call centers 

who provide regional or statewide coverage and coordinate in real time. SAMHSA also 

encourages states to use funding above 10 percent to invest in crisis response services. 

Set-aside for Early Intervention and Prevention of Mental Disorders Among Youth and Adults 

The FY 2023 budget proposes a new set-aside that would require states to spend at least 10 percent 

of MHBG funds to support early intervention and prevention for at-risk youth and adults. This 

investment will expand funding to support earlier identification and prevention of mental health 

162 
 

SAMHSA-Mental Health 

disorders and further support targeted services for youth and prevent more serious symptoms 

further on in a person’s life. Early intervention and prevention programs can reduce risk factors 

and increase protective factors in an individual’s life, which can decrease the likelihood of 

developing a mental health condition, reduce negative outcomes such as substance use, worsening 

symptoms, loss of employment, and justice involvement. With these critical investments, the 

MHBG continues will continue to serve as an invaluable safety net for mental health services for 

some of the nation’s most vulnerable populations. 

163 
SAMHSA-Mental Health 

Outputs and Outcomes Table 

Program: Mental Health Block Grant 

Measure Year and Most Recent 

Result /1 

Target for Recent Result / 

(Summary of Result) 

FY 2022 

Target 

FY 2023 

Target 

FY 2023 

Target 

+/-FY 2022 

Target 

2.3.11 Number of 

evidence-based practices 

(EBPs) implemented 

(Output) 

FY 2020: 5.0 per State 

Target: 

5.0 per State 

(Target Met) 

5.0 per State 5.0 per State Maintain 

2.3.14 Number of people 

served by the public 

mental health system 

(Output) 

FY 2020: 8,013,396 

Target: 

7,808,416 

(Target Exceeded) 

8,013,396 8,013,396 Maintain 

2.3.15 Rate of consumers 

(adults) reporting 

positively about 

outcomes (Outcome) 

FY 2020: 79.6 % 

Target: 

75.4 % 

(Target Exceeded) 

75.4 % 75.4 % Maintain 

2.3.16 Rate of family 

members 

(children/adolescents) 

reporting positively about 

outcomes (Outcome) 

FY 2020: 74.6 % 

Target: 

72 % 

(Target Exceeded) 

72.3 % 72.3 % Maintain 

2.3.19A: Supported 

Housing Supported 

Housing: Percentage of 

the population accessing 

selected evidence-based 

programs among people 

served by state mental 

health authorities 

(Outcome) 

FY 2020: 2.3 % 

Target: 

3.1 % 

(Target Not Met) 

2.3 % 2.3 % Maintain 

164 
 

 

SAMHSA-Mental Health 

Measure Year and Most Recent 

Result /1 

Target for Recent Result / 

(Summary of Result) 

FY 2022 

Target 

FY 2023 

Target 

FY 2023 

Target 

+/-FY 2022 

Target 

2.3.19B Supported 

Employment: Percentage 

of the population 

accessing selected 

evidence-based programs 

among people served by 

state mental health 

authorities (Outcome) 

FY 2020: 1.9 % 

Target: 

2.0 % 

(Target Not Met) 

1.9 % 1.9 % Maintain 

2.3.19C Assertive 

Community Treatment: 

Percentage of the 

population accessing 

selected evidence-based 

programs among people 

served by state mental 

health authorities 

(Output) 

FY 2020: 1.8 % 

Target: 

1.9 % 

(Target Not Met) 

1.9 % 1.9 % Maintain 

2.3.19D Family 

Psychoeducation: Percent 

of the population 

accessing selected 

evidence-based programs 

among people served by 

state mental health 

authorities (Outcome) 

FY 2020: 3.1 % 

Target: 

2.4 % 

(Target Exceeded) 

3.1 % 3.1 % Maintain 

2.3.19E Dual Diagnosis 

Treatment: Percent of the 

population accessing 

selected evidence-based 

programs among people 

served by state mental 

health authorities. 

(Outcome) (Outcome) 

FY 2020: 9.5 % 

Target: 

10.4 % 

(Target Not Met) 

9.5 % 9.5 % Maintain 

2.3.19F Illness SelfManagement: Percent of 

the population accessing 

selected evidence-based 

programs among people 

served by state mental 

health authorities. 

(Outcome) 

FY 2020: 19.1 % 

Target: 

18.0 % 

(Target Exceeded) 

19.1 % 19.1 % Maintain 

165 
 

SAMHSA-Mental Health 

Measure Year and Most Recent 

Result /1 

Target for Recent Result / 

(Summary of Result) 

FY 2022 

Target 

FY 2023 

Target 

FY 2023 

Target 

+/-FY 2022 

Target 

2.3.19G Medication 

Management: Percent of 

the population accessing 

selected evidence-based 

programs among people 

served by state mental 

health authorities. 

(Outcome) 

FY 2020: 31.3 

Target: 

31.0 

(Target Exceeded) 

31.0 31.0 Maintain 

2.3.19H Treatment Foster 

Care: Percent of the 

population accessing 

selected evidence-based 

programs among people 

served by state mental 

health authorities. 

(Outcome) 

FY 2020: 1.7 % 

Target: 

0.7 % 

(Target Exceeded) 

1.7 % 1.7 % Maintain 

2.3.19I Multi-Systemic 

Therapy: Percent of the 

population accessing 

selected evidence-based 

programs among people 

served by state mental 

health authorities. 

(Outcome) 

FY 2020: 4.1 % 

Target: 

4.2 % 

(Target Not Met) 

4.1 % 4.1 % Maintain 

2.3.19J Functional 

Family Therapy: Percent 

of the population 

accessing selected 

evidence-based programs 

among people served by 

state mental health 

authorities. (Outcome) 

FY 2020: 5.8 % 

Target: 

5.9 % 

(Target Not Met) 

5.8 % 5.8 % Maintain 

2.3.81 Percentage of 

service population 

receiving any evidencebased practice (Outcome) 

FY 2020: 10.1 % 

Target: 

10.1 % 

(Target Met) 

10.1 % 10.1 % Maintain 

1/Performance data for FY 2021 will be available later in June 2022. 

166 
 

 

 

 

 

 

 

SAMHSA-Mental Health 

FY 2023 Mental Health Block Grant Provisional Allotments 

Appropriation $1,652,571,000, State-Territory Total $1,567,373,326 

FY 2021 FY 2022 FY 2023 FY 2023 +/-

State or Territory Final CR President's Budget FY 2022 

Alabama $10,393,794 $10,546,174 $23,091,599 $12,545,425 

Alaska $1,626,540 $1,770,303 $3,879,759 $2,109,456 

Arizona $19,762,210 $17,893,192 $39,782,552 $21,889,360 

Arkansas $6,290,522 $6,366,821 $14,021,755 $7,654,934 

California $94,190,067 $94,286,334 $203,287,869 $109,001,535 

Colorado $14,131,439 $14,165,355 $31,125,992 $16,960,637 

Connecticut $6,971,987 $7,417,738 $16,082,392 $8,664,654 

Delaware $1,675,774 $1,521,185 $3,410,444 $1,889,259 

District Of Columbia $1,702,334 $1,752,862 $3,910,973 $2,158,111 

Florida $47,760,577 $49,315,472 $107,612,081 $58,296,609 

Georgia $23,006,325 $22,105,857 $48,386,438 $26,280,581 

Hawaii $3,621,113 $3,626,810 $7,849,820 $4,223,010 

Idaho $4,240,521 $3,919,827 $8,728,135 $4,808,308 

Illinois $25,297,546 $22,725,236 $49,253,523 $26,528,287 

Indiana $12,884,705 $14,391,336 $31,510,279 $17,118,943 

Iowa $5,641,385 $5,772,631 $12,718,882 $6,946,251 

Kansas $5,251,758 $5,321,252 $11,513,127 $6,191,875 

Kentucky $9,340,762 $9,445,007 $20,677,271 $11,232,264 

Louisiana $10,420,263 $9,439,727 $20,638,980 $11,199,253 

Maine $2,820,718 $2,861,437 $6,286,600 $3,425,163 

Maryland $14,009,566 $12,210,962 $26,648,600 $14,437,638 

Massachusetts $14,402,129 $15,439,387 $33,557,313 $18,117,926 

Michigan $21,114,635 $20,996,793 $45,963,887 $24,967,094 

Minnesota $10,892,453 $11,711,181 $25,557,222 $13,846,041 

Mississippi $6,575,274 $6,627,048 $14,445,289 $7,818,241 

Missouri $12,106,967 $12,342,068 $26,988,043 $14,645,975 

Montana $2,202,462 $2,623,107 $5,768,088 $3,144,981 

Nebraska $3,302,524 $3,377,353 $7,377,271 $3,999,918 

Nevada $7,608,268 $8,199,608 $18,297,146 $10,097,538 

New Hampshire $2,534,678 $2,416,860 $5,337,360 $2,920,500 

New Jersey $19,707,954 $19,881,419 $43,706,644 $23,825,225 

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SAMHSA-Mental Health 

FY 2023 Mental Health Block Grant Provisional Allotments 

Appropriation $1,652,571,000, State-Territory Total $1,567,373,326 

State or Territory 

FY 2021 

Final 

FY 2022 

CR 

FY 2023 

President's Budget 

FY 2023 +/-

FY 2022 

New Mexico $4,374,034 $4,440,579 $9,719,256 $5,278,677 

New York $40,321,601 $41,983,741 $89,629,190 $47,645,449 

North Carolina $20,923,981 $21,432,740 $47,208,184 $25,775,444 

North Dakota $1,248,738 $1,295,433 $2,820,963 $1,525,530 

Ohio $22,426,204 $22,702,498 $49,618,168 $26,915,670 

Oklahoma $7,913,159 $8,073,660 $17,833,968 $9,760,308 

Oregon $11,405,593 $11,485,143 $25,107,062 $13,621,919 

Pennsylvania $23,597,645 $24,423,260 $53,226,711 $28,803,451 

Rhode Island $2,671,294 $2,535,702 $5,556,408 $3,020,706 

South Carolina 10,821,253 $11,046,026 $24,370,358 $13,324,332 

South Dakota $1,551,040 $1,581,242 $3,481,329 $1,900,087 

Tennessee $13,742,918 $15,174,278 $33,433,161 $18,258,883 

Texas $64,895,752 $59,066,336 $130,144,366 $71,078,030 

Utah $6,490,722 $8,111,607 $17,828,532 $9,716,925 

Vermont $1,231,981 $1,248,749 $2,748,343 $1,499,594 

Virginia $18,027,933 $18,375,120 $40,326,459 $21,951,339 

Washington $16,726,128 $17,667,663 $38,493,979 $20,826,316 

West Virginia $3,918,663 $3,915,907 $8,473,761 $4,557,854 

Wisconsin $12,408,047 $11,116,952 $24,341,064 $13,224,112 

Wyoming $912,460 $949,418 $2,086,130 $1,136,712 

State Subtotal $707,096,396 $707,096,396 $1,543,862,726 $836,766,330 

American Samoa $141,308 $141,383 $295,860 $154,477 

Guam $466,446 $474,183 $1,051,846 $577,663 

Northern Marianas $144,556 $145,847 $323,696 $177,849 

Puerto Rico $9,159,843 $9,137,697 $19,917,141 $10,779,444 

Palau $59,820 $60,913 $134,420 $73,507 

Marshall Islands $210,419 $216,611 $485,323 $268,712 

Micronesia $288,152 $290,626 $638,765 $348,139 

Virgin Islands $297,421 $300,705 $663,549 $362,844 

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SAMHSA-Substance Use Prevention Services 

Substance Use Prevention Services 

Table of Contents 

1. Summary of the Request................................................................................................. 170 

2. Programs of Regional and National Significance (PRNS) ............................................. 171 

a) Strategic Prevention Framework......................................................................... 172 

b) Federal Drug-Free Workplace ............................................................................ 178 

c) Minority AIDS.................................................................................................... 182 

d) Sober Truth on Preventing Underage Drinking Act (STOP Act)....................... 186 

e) Center for the Application of Prevention Technologies ..................................... 191 

f) Science and Service Program Coordination ....................................................... 194 

g) Tribal Behavioral Health Grants......................................................................... 199 

h) First Responder Training for Opioid Overdose Reversal Drugs ........................ 204 

i) Improving Access to Overdose Treatment ......................................................... 208 

j) Grants to Prevent Prescription Drug/Opioid Overdose Related Deaths ............. 211 

3. PRNS Mechanism Table................................................................................................. 215 

4. Grant Awards Table........................................................................................................ 219 

169 
 

 

 

 

 

 

 

 

SAMHSA-Substance Use Prevention Services 

Substance Use Prevention Services 

Summary of the Request 

(Dollars in thousands) 

FY 2021 FY 2022 FY 2023 

Programs of Regional & National Significance Final

 COVID-19 

Supplemental CR 

President's 

Budget 

FY 2023 +/-

FY 2022 

Total, Substance Use Prevention Services............... $208,219 $--- $208,219 $311,912 $103,693 

The Substance Use Prevention Services FY 2023 President’s Budget request is $311.9, an increase 

of $103.6 million from the FY 2022 Annualized Continuing Resolution. 

SAMHSA’s substance use prevention programs reach across the lifespan, and across the substance 

use continuum, with the goal of reaching people wherever they are, to reduce the harmful impacts 

of substance misuse on their lives, on their families, and in their communities. The Center for 

Substance Use Prevention Services (CSUPS) does this primarily by supporting the efforts of 

States, Tribes, and communities to deliver a range of evidence-based, community public health 

programming, especially focusing on high-risk, underserved populations. 

Broadly reaching young people early in life with primary prevention services has the greatest 

return on investment in reducing the lifelong negative impacts of alcohol and substance misuse on 

individuals, families, and communities. That is why over 85 percent of SAMHSA’s prevention 

resources are dedicated to youth-focused, primary prevention services, which aim to lay the 

foundation for lifelong healthy decisions for the approximately 75 million young people under 18 

in the US. 

On the other end of the spectrum, SAMHSA’s prevention programs have a significant investment 

in opioid and overdose prevention programs. The spike in overdose deaths the country is 

experiencing during the pandemic demonstrates the need to continue to focus on reaching 

vulnerable populations with prevention and harm reduction services that often serve as the gateway 

to eventually helping people recover or enroll in treatment services. 

SAMHSA’s prevention programs: 1) protect and strengthen equitable access to high quality and 

affordable healthcare; 2) expand equitable access to comprehensive, community-based, 

innovative, and culturally competent healthcare services while addressing social determinants of 

health; 3) enhance youth-focused promotion of healthy behaviors to reduce occurrence and 

disparities in preventable injury, illness, and death, 4) strengthen social well-being, equity and 

economic resilience; and 5) increase safeguards to empower families and communities to prevent 

and respond to neglect, abuse, and violence, while supporting those who have experienced trauma 

or violence. 

170 
 

 

SAMHSA-Substance Use Prevention Services 

Substance Use Prevention Services 

Programs of Regional and National Significance (PRNS) 

(Dollars in Thousands) 

Programs of Regional & National Significance 

FY 2021 FY 2022 FY 2023 

Final

 COVID-19 

Supplemental CR 

President's 

Budget 

FY 2023 +/-

FY 2022 

Capacity: 

Strategic Prevention Framework......................................................................... 

 Non-SPF Rx (non-add)................................................................................. 

Budget Authority (non-add)....................................................................... 

PHS Evaluation Funds (non-add).............................................................

Strategic Prevention Framework Rx (non-add)............................................ 

Budget Authority (non-add)....................................................................... 

PHS Evaluation Funds (non-add).............................................................

Federal Drug-Free Workplace............................................................................ 

Sober Truth on Preventing Underage Drinking Act (STOP Act) 

PHS Evaluation Funds (non-add).............................................................

Community-based Coalition Enhancement Grants (non-add).................. 

National Adult-Oriented Media Public Service Campaign (non-add)..... 

ICC on the Prevention of Underaged Drinking (non-add)....................... 

Tribal Behavioral Health Grants......................................................................... 

PHS Evaluation Funds (non-add).................................................................

Minority AIDS.................................................................................................... 

PHS Evaluation Funds (non-add).............................................................

Improving Access to Overdose Treatment..........................................................

Grants to Prevent Prescription Drug/Opioid Overdose Related Deaths..............

At-Home Prescription Drug Disposal Demonstration and Evalualtion (New)....

First Responder Training (CARA)......................................................................

First Responder Training (non-add) ........................................................

Rural Set-Aside (non-add).........................................................................

Subtotal, Capacity 

Science and Service: 

$119,952 

109,952

109,952

 ---

10,000

10,000

 ---

4,921

10,032

 ---

6,953

2,049

1,029

20,642

 ---

40,705

 ---

 ---

 ---

 ---

 ---

 ---

 ---

$---

 ---

 ---

 ---

 ---

 ---

 ---

 ---

 ---

 ---

 ---

 ---

 ---

 ---

 ---

 ---

 ---

 ---

 ---

 ---

 ---

 ---

 ---

$119,484 

109,484 

109,484 

 ---

10,000 

10,000 

 ---

4,894 

10,000 

 ---

7,000 

2,000 

1,000 

20,750 

 ---

41,205 

 ---

 ---

 ---

 ---

 ---

 ---

 ---

$126,674 

111,674 

111,674 

 ---

15,000 

15,000 

5,139 

10,000

 ---

7,000

2,000

1,000

23,665 

 ---

42,029 

 ---

1,500 

18,000 

 ---

67,500 

43,500 

24,000 

$7,190

$2,190 

$2,190 

 ---

$5,000 

$5,000 

 ---

$245 

 ---

 ---

 ---

 ---

 ---

$2,915 

 ---

$824 

 ---

1,500 

18,000 

 ---

67,500 

43,500 

24,000 

196,252 --- 196,333 294,507 98,174 

Center for the Application of Prevention Technologies...................................... 7,493 --- 7,493 11,993 $4,500 

SAP Minority Fellowship Program..................................................................... 321 --- 321 1,340 $1,019 

Science and Service Program Coordination........................................................ 

Subtotal, Science and Service 

Total, PRNS 

4,153 --- 4,072 4,072 ---

11,967 --- 11,886 17,405 5,519 

$208,219 --- $208,219 $311,912 $103,693 

171 
 

 

 

 

 

 

SAMHSA-Substance Use Prevention Services 

Strategic Prevention Framework 

(Dollars in thousands) 

Programs of Regional & National Significance 

FY 2021 FY 2022 FY 2023 

Final 

COVID-19 

Supplemental CR 

President's 

Budget 

FY 2023 +/-

FY 2022 

Strategic Prevention Framework............................................................ 

 Non-SPF Rx (non-add)................................................................ 

 Budget Authority (non-add)....................................................... 

 PHS Evaluation Funds (non-add).............................................. 

Strategic Prevention Framework Rx (non-add)........................... 

 Budget Authority (non-add)........................................................ 

 PHS Evaluation Funds (non-add).............................................. 

$119,952 

109,952 

109,952 

---

10,000 

10,000 

---

$---

---

---

---

---

---

---

$119,484 

109,484 

109,484 

---

10,000 

10,000 

---

$126,674 

111,674 

111,674 

---

15,000 

15,000 

---

$7,190

2,190

2,190

---

5,000

5,000

---

Authorizing Legislation .......................................................................................... Section 516 of the PHS Act 

FY 2023 Authorization ......................................................................................................................................... $0 

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

Eligible Entities........................................................States, political subdivisions of States, 

.............................Federally Recognized American Indian/Alaska Native tribe, or tribal organizations, 

...................................... Indian Health Service-operated and contracted health facilities and programs, 

........................................................................................................... public or private nonprofit entities 

Program Description and Accomplishments 

Strategic Prevention Framework (SPF) 

Drug and alcohol use are significant public health challenges. Youth and adolescents who use 

alcohol and drugs face an increased risk of poor school performance, criminal justice involvement, 

the development of a drug/alcohol addiction, risky sexual behavior, illnesses such as HIV and 

hepatitis, depression and anxiety, and injury and death. The immediate and long-term risks and 

negative outcomes associated with youth and adolescent drug and alcohol use underscore the need 

for effective prevention and treatment programs. 

Youth and adolescents use a variety of substances. Among people aged 12 or older in 2020, 59.3 

million people used illicit drugs in the past year. The most commonly used illicit drug in the past 

year was marijuana, which was used by 49.6 million people. The second most common type of 

illicit drug use in the past year was the misuse of prescription pain relievers, which were misused 

by 9.3 million people. The 2020 National Survey on Drug Use and Health (NSDUH)61 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 2020, 16.1 percent of 

underage people reported current use of alcohol, 9.2 percent reported binge drinking, and 1.8 

percent reported heavy alcohol use. 

61 Substance use And Mental Health Services Administration. (2019). Key substance use and mental health indicators 

in the United States: Results from the 2018 National Survey on Drug Use and Health (HHS Publication No. PEP 19-

5068, NSDUH Series H-54). Rockville MD 20857 Retrieved from http://www.samhsa.gov/data. 

172 
 

 

 

SAMHSA-Substance Use Prevention Services 

Among people aged 12 or older, past month binge alcohol was 22.2 percent in 2020. Among 

people aged 12 or older, the percentage who were past month heavy alcohol users was 6.4 percent 

(or 17.7 million people) in 2020. 

The Strategic Prevention Framework – Partnerships for Success (SPF-PFS) program helps states, 

tribes, and communities address locally identified prevention priorities through a data-driven 

process. Common priorities include underage drinking among youth and young adults age 12 to 

20, marijuana, or prescription drug misuse. SPF-PFS is designed to ensure that prevention 

strategies and messages reach the populations most impacted by substance misuse. The program 

extends current established cross-agency and community-level partnerships by connecting 

substance misuse prevention programming to departments of social services and their community 

service providers. This includes working with populations disproportionately impacted by the 

consequences of substance use, i.e., children entering the foster care system, transition age youth, 

and individuals who support persons with substance use issues (e.g., women, families, parents, 

caregivers, and young adults). 

In 2021 the SPF-PFS program supported a total of 97 new and continuing grants to state, 

community, and tribal organizations to address underage drinking among youth and young adults 

ages 9 to 20 and allow communities, at their discretion, to use funds to target up to two additional 

data driven substance misuse prevention priorities addressing ages 9 and above. 

In FY 2021, SAMHSA awarded 5 new grants and supported the continuation of 230 grants to state, 

tribal, and community organizations for preventing the onset and reducing the progression of 

substance use and its related challenges while strengthening prevention capacity and infrastructure 

at the community and state levels. In FY 2022 Continuing Resolution, SAMHSA will fund 235 

continuing and 4 new PFS grants as well as 21 continuing and 8 new SPF Rx grants. In FY 2023, 

SAMHSA will support the continuation of 237 PFS grants as well as 54 new grants. 

Strategic Prevention Framework for Prescription Drugs (SPF Rx) 

Provisional data from CDC’s National Center for Health Statistics indicate that there were an 

estimated 100,306 drug overdose deaths in the United States during 12-month period ending in 

April 2021, an increase of 28.5 percent from the 78,056 deaths during the same period the year 

before.

62 This was nearly three times that of traffic accident deaths and twice that of gun deaths 

during the same period63 . During 2020, black overdose deaths increased 45 percent, nearly 

doubling the growth rate of white overdose deaths. Overdose deaths from synthetic opioids 

(primarily fentanyl) and psychostimulants such as methamphetamine also increased in the 12-

month period ending in April 2021. Cocaine deaths also increased, as did deaths from natural and 

semi-synthetic opioids (such as prescription pain medication). 

62 Centers for Disease Control and Prevention. (2021, November 17). Drug overdose deaths in the U.S. top 

100,000 annually. Centers for Disease Control and Prevention. Retrieved February 18, 2022, from 

https://www.cdc.gov/nchs/pressroom/nchs_press_releases/2021/20211117.htm

63 Drug overdose deaths hit record high. News. (2021, November 19). Retrieved February 18, 2022, from 

https://www.hsph.harvard.edu/news/hsph-in-the-news/drug-overdose-deaths-hit-record-high/ 

173 
 

 

 

 

 

 

 

 

SAMHSA-Substance Use Prevention Services 

The percentage of all U.S. deaths in 2020 attributable to overdoses has grown from 1.9 percent to 

2.8 percent since 2015.64 

The Strategic Prevention Framework for Prescription Drugs (SPF-Rx) assists grantees in 

developing capacity and expertise in the use of data from state run prescription drug monitoring 

programs (PDMP). Grantees have also raised awareness about the dangers of sharing medications 

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

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

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

their patients. SAMHSA tracks reductions in opioid overdoses and the incorporation of 

prescription drug monitoring data into needs assessments and strategic plans as indicators of 

program success. 

Accomplishments 

In FY 2020, grantees in 234 communities reported improvements in one or more targeted national 

outcome measure (NOMs) indicators as a result of implementing more than 1,400 evidence-based 

interventions. Fifteen (15) states and fourteen (14) tribal communities focused on alcohol use and 

at least one other substance, and many focused their prevention efforts on racial, ethnic, sexual, 

and gender subpopulations. 

The Government Performance and Results Act (GPRA) requires reporting for the Strategic 

Prevention Framework for Prescription Drug (SPF-Rx) program for two measures. The number 

of funded states/tribes that incorporate Prescription Drug Monitoring Program (PDMP) data into 

their strategic plans, and the number of funded states/tribes reporting reductions in opioid 

overdoses. 

Since the start of the SPF-Rx program, grantees and their sub-recipients have implemented a total 

of 565 interventions. By the end of FY 2020, 372 of these interventions remained active. The 

most dramatic growth was in the first years of the program, as grantees added sub-recipients and 

they, in turn, developed their interventions. In FY 2020, 25 grantees and 130 sub-recipients 

reported 396 active interventions. The 396 grantee- and sub-recipient-level interventions active in 

FY 2019 most often involved the CSUPS Strategies of information dissemination (198 

interventions or 50 percent) and environmental strategies (115 interventions or 29 percent). 

Regarding interventions implemented, over a third of both grantees and their sub-recipients 

targeted the entire population in the jurisdictions they represent (i.e., the state, the county, the tribal 

community). The medical community in particular is often a focus for information and training. 

Of the 372 prevention interventions that were active in FY 2020, the three most common 

intervention service types were media campaigns, prescription drug safe storage and/or disposal, 

and training/educating environmental influencers. 

64 Baumgartner, JC and Radley DC, “The Drug Overdose Mortality Toll in 2020 and Near-Term Actions for 

Addressing It,” To the Point (blog), July 15, 2021, updated Aug. 16, 2021. https://doi.org/10.26099/gb4y-r129 

174 
 

 

 

SAMHSA-Substance Use Prevention Services 

The reach of the program interventions into their communities has been impressive. Without 

addressing duplicative counting of individuals receiving multiple interventions, the 396 active 

interventions in FY 2020 reached a total of 12.2 million individuals across the grantee and subrecipient sites. This total is impacted by a small number of interventions that reached a large 

number of individuals, notably the media campaigns. Over 33 million persons were indirectly 

reached through multiple channels, and over 122,000 were directly reached through trainings, 

prevention education programs, substance free activities, and screenings. 

One important aspect of community-level interventions is partnership with community agencies 

and stakeholders to create and execute their interventions. Of the 155 sub-recipients and singlecommunity grantees reporting in FY 2020, 89 percent recruited new community partners as a result 

of the funding, nearly 54 percent incorporated their goals and activities into other organizations 

and professional groups, and approximately 53 percent developed ongoing partnerships and 

structures to go beyond the grant funding to continue prevention activities. 

One of the goals of the SPF-Rx program is to increase PDMP-related infrastructure and improve 

PDMP use. In grantee-level interviews conducted in the first and second years of the project, SPFRx project directors reported PDMP data availability as a common challenge. These issues have 

improved: In FY 2020, both grantees and sub-recipients reported that PDMP data became less of 

a challenge for them in terms of quality, analysis/reporting, and ease of use. Many of the subrecipients, who as a group have the greatest challenges in accessing PDMP data, reported that their 

access problems decreased; from72 percent of sub-recipients reporting they had no access to 

PDMP data prior to SPF Rx funding to only 27 percent reporting any problems accessing PDMP 

data by FY 2020. 

Five Year Funding Table 

Fiscal Year Amount 

COVID-19 

Supplemental 

Funding 

FY 2019 $119,484,000 

FY 2020 $119,484,000 

FY 2021 Final $119,952,000 

FY 2022 CR $119,484,000 

FY 2023 President's Budget $126,674,000 

Budget Request 

The FY 2023 President’s Budget request is $126.6 million, an increase of $7.2 million from the 

FY 2022 Annualized Continuing Resolution. The increase will support 266 new and continuing 

PFS grants as well as 30 new and continuing SPF Rx grants. 

175 
 

 

 

 

SAMHSA-Substance Use Prevention Services 

Outputs and Outcomes Table 

Program: Partnerships for Success 

Measure Year and Most Recent 

Result / 

Target for Recent Result / 

(Summary of Result) 

FY 2022 

Target 

FY 2023 

Target 

FY 2023 

Target 

+/-FY 2022 

Target 

2.3.79 Number of EBPs 

implemented by subrecipient communities 

(Output) 

FY 2020: 1,421 

Target: 

1,414 

(Target Exceeded) 

Discontinued Discontinued N/A 

2.3.80 Number of subrecipient communities 

that improved on one or 

more targeted NOMs 

indicators (Outcome) 

FY 2020: 234 

Target: 

315 

(Target Not Met) 

Discontinued Discontinued N/A 

2.3.81 Increase in the 

percent of grantees that 

report at least 5% 

improvement in the past 

30 day use of targeted 

substance in target 

population (Outcome) 

FY 2021: Result Expected 

Dec 31, 2021 

Target: 

Set Baseline 

(Pending) 

Maintain 

Baseline 

Maintain 

Baseline 

Maintain 

2.3.82 Increase in percent 

of grantees that report 

improvement of 

perception of risk from 

targeted substance use in 

target population. 

(Outcome) 

FY 2021: Result Expected 

Dec 31, 2021 

Target: 

Set Baseline 

(Pending) 

Maintain 

Baseline 

Maintain 

Baseline 

Maintain 

176 
 

SAMHSA-Substance Use Prevention Services 

Program: Strategic Prevention Framework Rx 

Measure Year and Most Recent 

Result / 

Target for Recent Result / 

(Summary of Result) 

FY 2022 

Target 

FY 2023 

Target 

FY 2023 

Target 

+/-FY 2022 

Target 

3.3.12 Percent of funded 

states reporting 

reductions in opioid 

overdoses (Outcome) 

FY 2021: 75 % 

Target: 

62 % 

(Target Exceeded) 

75 % 75 % Maintain 

177 
 

 

 

 

SAMHSA-Substance Use Prevention Services 

Federal Drug-Free Workplace 

(Dollars in thousands) 

FY 2021 FY 2022 FY 2023 

Programs of Regional & National Significance Final 

COVID-19 

Supplemental CR 

President's 

Budget 

FY 2023 +/-

FY 2022 

Federal Drug-Free Workplace............................................................... $4,921 $--- $4,894 $5,139 $245 

Authorizing Legislation ...................................................................................... Section 516 of the PHS Act 

FY 2023 Authorization ..................................................................................................................$0 

Allocation Method................................................................................Inter-Agency Agreements/Contracts 

Eligible Entities ................................................................................... Federal Agencies, Regulated Entities 

..........................................(e.g., Department of Transportation, Nuclear Regulatory Commission), 

..............................................................................................................HHS- Certified Laboratories 

Program Descriptions and Accomplishments 

The use of illicit, prescription, and over-the counter drugs, including polysubstance use, is 

widespread and has a variety of negative consequences, particularly in the workplace. The Federal 

Drug-Free Workplace program continues to examine emerging issues especially among young 

adults and high-risk workplaces such as: increased legal/illegal opioid/synthetic opioid use and 

polysubstance use leading to injuries, overdoses, and death. Employers with successful drug-free 

workplace programs report decreases in absenteeism, accidents, downtime, turnover, and theft; 

increases in productivity; and overall improved morale. Additionally, they report better health 

status among many employees and family members and decreased use of medical benefits. Many 

organizations with drug-free workplace programs qualify for health care incentives, for example, 

decreased premium costs for certain kinds of insurance, such as Workers’ Compensation. 

The Federal Drug-Free Workplace Programs (DFWP) ensure employees in national security, 

public health, and public safety positions are tested for the use of illegal drugs and the misuse of 

prescription drugs and ensure the laboratories that perform this regulated drug testing are inspected 

and certified by HHS. The DFWP helps individuals refrain from using illegal drugs and 

demonstrates that illegal drug use will not be tolerated in the federal workplace. The DFWP 

achieves this through policies and procedures including drug testing which allows for the drug 

testing of all executive branch agency employees. A key program aim is to eliminate illicit drug 

use in federal workplaces and oversee the National Laboratory Certification Program (NLCP), 

which certifies laboratories to conduct forensic drug testing for federal agencies and federally 

regulated industries. 

The program publishes mandatory guidelines to establish the scientific and technical regulatory 

aspects of the program, which includes specifying the drugs to be tested for and setting laboratory 

certification standards through the NLCP. Another key responsibility of the program is the 

development and oversight of the federal Custody and Control Form (CCF), the standardized 

OMB-approved form for specimen collectors to document the collection and forensic chain of 

custody of specimens at the collection site, for certified laboratories to report results, and for 

Medical Review Officers (MROs) to document and report verified results. SAMHSA allows the 

use of the CCF as a paper or electronic form. 

178 
 

SAMHSA-Substance Use Prevention Services 

Additionally, the DFWP helps reduce health insurance costs, improves attendance and employee 

productivity, provides a safer workplace with reduced accidents, and provides employee assistance 

programs (EAP) services to employees with substance use disorders. 

The benefits of this program include: 

• Implementation of urine, oral fluid, and hair drug testing programs with a federally supported 

performance testing program and a partial federally supported laboratory inspection program. 

• Certification of laboratories across the nation to conduct federal and federally regulated drug 

tests which may include urine, oral fluid, and hair, 

• Examining changes in drug testing methodologies, changes in law, and new and emerging 

issues related to marijuana (e.g., increased potency and use), cannabidiol (CBD) (e.g., 

increased availability due to the 2018 Farm Bill and possible risk of testing positive for 

marijuana), opioids, synthetic drugs, polysubstance use/misuse, and hair/oral fluid drug 

testing. 

• Continued use of subject matter experts and partnerships with other federal agencies to 

establish the scientific standards set out in the mandatory guidelines. 

• Proposing hair as an alternative specimen, subject to the legal and scientific supportability of 

this matrix for use in federal workplace drug testing programs. 

• Technical and scientific leadership for federal agencies on workplace drug testing; and 

• Analysis of and guidance on emerging issues (e.g., opioids/synthetic opiates; polysubstance 

use; young adults, high-risk workplaces). 

• Certification of federal agency Drug-Free Workplace Program plans and standardization of the 

DFWP among executive branch agencies to ensure consistency and comprehensive 

implementation of the DFWP across all executive branch agencies. 

SAMHSA implements the DFWP, 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 NLCP, which certifies laboratories to conduct forensic drug testing for federal 

agencies and federally regulated industries. The private sector also uses HHS-certified 

laboratories. 

Since 1987, SAMHSA has funded the Drug-Free Workplace drug testing activities including the 

NLCP and the Drug Testing Advisory Board (DTAB). In FY 2019, SAMHSA issued mandatory 

guidelines for oral fluid. Testing activities continued in FY 2020 under the NLCP contract, which 

oversees the certification of the labs that perform federally regulated drug testing under the DFWP. 

In FY 2020, SAMHSA issued the proposed mandatory guidelines using hair in accordance with 

the DTAB recommendations to allow oral fluid and to pursue the use of hair as alternative 

specimens to urine. DTAB will continue to provide recommendations to the Assistant Secretary 

for Mental Health and Substance Use based on an ongoing review of the direction, scope, balance, 

and emphasis of SAMHSA’s drug testing activities and the NLCP. 

179 
 

 

SAMHSA-Substance Use Prevention Services 

CSUPS’s Workplace Helpline supports the drug-free workplace program. The helpline is a tollfree telephone service (800-WORKPLACE) that answers questions from federal agencies, the 

public and private sectors about drug testing in the workplace. 

Funding for the Federal Drug-Free Workplace Programs ensures the testing of federal employees 

in national security, public health, and public safety positions for the use of illegal drugs, the 

misuse of prescription drugs, and the inspection and certification of HHS-certified laboratories for 

the past 33 years. The Quest Drug Testing Index (DTI) shows the continued decrease of synthetic 

opioid positivity in the federally regulated drug testing program since the implementation in 

January of 2020. 

Five Year Funding Table 

Fiscal Year Amount 

COVID-19 

Supplemental 

Funding 

FY 2019 $4,894,000 

FY 2020 $4,894,000 

FY 2021 Final $4,921,000 

FY 2022 CR $4,894,000 

FY 2023 President's Budget $5,139,000 

Budget Request 

The FY 2023 President’s Budget request is $5.1 million, an increase of $245,000 from the FY 

2022 Annualized Continuing Resolution. The increase supports the Division of Workplace 

Programs implementing the new Mandatory Guidelines for oral fluid and the proposing hair in the 

federally regulated drug testing program. This will include costs associated with laboratory 

proficiency testing specimens, application fees, inspector training, HHS pre-inspections for 

applicant laboratories, and HHS laboratory certification for new oral fluid testing laboratories. 

Along with the implementation of the new oral fluid testing program, SAMHSA will continue to 

pursue the implementation of hair and oversight of the Executive Branch Agencies’ DFWP. This 

will review of Federal Drug-Free Workplace plans and implementation of oral fluid for those 

federal agencies that perform federal employee testing of those designated testing positions of 

national security, public health, and public safety, and testing for illegal drug use and the misuse 

of prescription drugs. SAMHSA will continue its oversight role for the inspection and certification 

of the HHS-certified laboratories. 

180 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

SAMHSA-Substance Use Prevention Services 

Outputs and Outcomes Table 

Program: Federal Drug-Free Workplace 

Measure Year and Most Recent 

Result / 

Target for Recent Result / 

(Summary of Result) 

FY 2022 

Target 

FY 2023 

Target 

FY 2023 

Target 

+/-FY 2022 

Target 

6.0 Number of HHS 

Certified Labs (Output) 

FY 2021: 23.0 certified labs 

Target: 

26.0 certified labs 

(Target Not Met). 

26.0 certified 

labs 

26.0 certified 

labs 

Maintain 

181 
 

 

 

 

 

 

SAMHSA-Substance Use Prevention Services 

Minority AIDS 

(Dollars in thousands) 

FY 2021 FY 2022 FY 2023 

Programs of Regional & National Significance Final

 COVID-19 

Supplemental CR 

President's 

Budget 

FY 2023 +/-

FY 2022 

Minority AIDS....................................................................................... $40,705 $--- $41,205 $42,029 $824 

Authorizing Legislation ...................................................................................... Section 516 of the PHS Act 

FY 2023 Authorization........................................................................................................................................ $0 

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

Eligible Entities ..................................... Local Government Entities, Community-based Organization, 

................................................ Minority Serving Institutions, and Institutions of Higher Education 

Program Description and Accomplishments 

The needs of people living with HIV and those who are at-risk for infection continue to evolve. 

Approximately 1.2 million people in the U.S. have HIV and about 13 percent don’t know it and 

need testing. In 2019, nearly 37,000 people received an HIV diagnosis in the United States. HIV 

continues to disproportionally affect racial and ethnic minorities and gay, bisexual, and other men 

who have sex with men65 . In addition, because HIV and viral hepatitis share common modes of 

transmission, one third of HIV infected individuals are also infected with hepatitis C.66 The use of 

injection drugs is driving the increase in Hepatitis C cases. 

The Minority AIDS program supports activities that build a strong foundation for delivering and 

sustaining high-quality and accessible substance misuse and HIV prevention services. The 

program aims to engage community-level domestic public and private non-profit entities, tribes, 

and tribal organizations 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. The MAI program, along with many other HIV/AIDS programs across HHS, 

contributes to the goal to end the HIV epidemic in the United States. 

65 Centers for Disease Control and Prevention. Estimated HIV incidence and prevalence in the United States, 2015– 

2019. HIV Surveillance Supplemental Report 2021;26(No.1). http://www.cdc.gov/ hiv/library/reports/hivsurveillance.html. Published May 2021. Accessed 18 February 2022. 66 U.S. Department of Health and Human Services: Secretary’s Minority AIDS Initiative Fund: 2017: HIV 

BASICS: Staying in HIV Care: Other Related Health Issues: Hepatitis B & C: Hepatitis B Virus and Hepatitis C 

Virus Infection, https://www.hiv.gov/hiv-basics/staying-in-hiv-care/other-related-health-issues/hepatitis-b-and-c 

182 
 

 

 

 

 

SAMHSA-Substance Use Prevention Services 

SAMHSA has helped to prevent HIV and hepatitis infection acquired through substance use and 

misuse. SAMHSA’s Minority AIDS and viral hepatitis prevention programs have included a focus 

on community-based organizations and minority serving institutions and a focus on the continuum 

of care. 

In FY 2021, SAMHSA funded 144 continuing and 37 new grant awards. In FY 2022 Continuing 

Resolution, SAMHSA will fund 161 continuing and 27 new grants. 

Based on the latest data available, 14,876 persons received an HIV test in FY 2021 using grant 

funds, and of this number, 4,774 people were tested for the first time. Grantees purchased 30,465 

HIV test kits with grant funds and referred 67 percent of the people who tested positive for HIV 

to treatment. Participants averaged about 5 direct service encounters, with an average duration of 

85 minutes per encounter. MAI grantees provided referrals to 3,176 participants for additional 

services, comprising 7,257 total referrals. 11,577 participants responded to surveys, with the 

findings summarized below: 

• At least 7,642 participants received substance misuse prevention education services (66 

percent of survey respondents). 

• 50.0 percent of participants who reported binge drinking at baseline reported abstinence at 

follow-up. 

• The percentage of participants rating tobacco use once to twice weekly as a great risk increased 

39.6percent from baseline to follow-up. 

• The percentage of participants rating non-prescription opioid use once to twice weekly as a 

great risk increased 29 percent from baseline to follow-up. 

• 85 percent of participants rated taking a prescription opioid without a prescription once to twice 

weekly as a great risk at follow-up, a 16.6 percent increase from baseline. 

• 56.5 percent of participants rated binge drinking once to twice weekly a great risk at followup, a 34 percent increase from baseline. 

• 62 percent of participants strongly agreed they would refuse if someone wanted to have sex 

without a condom at follow-up, with 32 percent reporting a higher level of agreement at followup compared to baseline. 

Five Year Funding Table 

Fiscal Year Amount 

COVID-19 

Supplemental 

Funding 

FY 2019 $41,205,000 

FY 2020 $41,205,000 

FY 2021 Final $40,705,000 

FY 2022 CR $41,205,000 

FY 2023 President's Budget $42,029,000 

183 
SAMHSA-Substance Use Prevention Services 

Budget Request 

The FY 2023 President’s Budget request is $42.0 million, an increase of $824,000 from the FY 

2022 Continuing Resolution. The increase will support 154 continuing and 46 new grants. 

184 
SAMHSA-Substance Use Prevention Services 

Outputs and Outcomes Table 

Program: Minority AIDS Initiative 

Measure Year and Most Recent 

Result / 

Target for Recent Result 

/ 

(Summary of Result) 

FY 2022 

Target 

FY 2023 

Target 

FY 2023 

Target 

+/-FY 2022 

Target 

2.3.56 Number of 

program participants 

exposed to substance 

abuse prevention 

education services 

(Output) 

FY 2021: 2,605 

Target: 

8,345 

(Target Not Met) 

8,345 8,345 Maintain 

2.3.85a Number of 

persons tested for HIV 

through the Minority 

AIDS Initiative 

prevention activities 

(Output) 

FY 2021: 13,314 

Target: 

31,514 

(Target Not Met) 

31,514 31,514 Maintain 

2.3.90 Percentage of 

program participants 

who reported reduced 

binge drinking at 

follow-up. (Outcome) 

FY 2021: 72 % 

Target: 

64 % 

(Target Exceeded) 

64 % 64 % Maintain 

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Sober Truth on Preventing Underage Drinking Act (STOP Act) 

(Dollars in thousands) 

FY 2021 FY 2022 FY 2023 

Programs of Regional & National Significance Final 

COVID-19 

Supplemental CR 

President's 

Budget 

FY 2023 +/-

FY 2022 

Sober Truth on Preventing Underage Drinking Act $10,032 $--- $10,000 $10,000 $---

Authorizing Legislation....................................................................................Section 519B of the PHS Act 

FY 2023 Authorization........................................................................................................................................ $0 

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

Eligible Entities......................................................Current and former Drug Free Communities grantees 

Program Description and Accomplishments 

Among Americans under age 21, underage drinking is one of our nation’s significant public health 

challenges, and its associated problems have profound negative consequences not just for underage 

drinkers, but also for their families, their communities, and society as a whole. Alcohol continues 

to be the most widely used substance of misuse among America’s youth, and a higher proportion 

use alcohol than use tobacco or other drugs. Annually, alcohol is a factor in the deaths of 

approximately 3,500 youths in the United States, shortening their lives by an average of 60 years. 

Every day an estimated 2,125 children ages 12 through 14 begin using alcohol. Among 12- to 20-

year-olds, 18.8 percent reported using alcohol in the last month. These young people face a 

number of harmful potential consequences, including death or injury, impaired brain function, 

decreased academic performance, and increased risk of developing an alcohol use disorder later in 

life.67 

The Sober Truth on Preventing Underage Drinking Act (STOP Act) of 2006 (Public Law 114-255) 

was the nation’s first comprehensive legislation on underage drinking. The STOP Act was 

reauthorized in 2016 as part of the 21st Century Cures Act (Public Law 114-255). The Act states, 

“A multi-faceted effort is needed to more successfully address the problem of underage drinking 

in the United States. A coordinated approach to prevention, intervention, treatment, enforcement, 

and research is key to making progress. This Act recognizes the need for a focused national effort, 

and addresses particulars of the federal portion of that effort, as well as federal support for state 

activities.” 

In keeping with the STOP Act’s language calling for a multi-faceted, coordinated approach, the 

Interagency Coordinating Committee for the Prevention of Underage Drinking (ICCPUD) 

developed a Comprehensive Plan in 2006, with updates in 2018, and a pending update for 2021. 

67 U.S. Department of Health and Human Services. (December 2020). Report to Congress on the Prevention and 

Reduction of Underage Drinking, Rockville, MD: Substance use And Mental Health Services Administration 

Retrieved from www.stopalcoholabuse.gov. (National Survey on Drug Use and Health [NSDUH]; Center for 

Behavioral Health Statistics and Quality [CBHSQ], 2019c) 

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The plan includes consensus recommendations from the federal agency members as well as for all 

interested parties identified in the STOP Act, and established the following overarching goals and 

objectives: 

1. Strengthen a national commitment to address the problem of underage drinking. 

2. Reduce demand for, the availability of, and access to alcohol by persons under the age of 21. 

3. Use research, evaluation, and scientific surveillance to improve the effectiveness of policies, 

programs, and practices designed to prevent and reduce underage drinking. 

The STOP Act requires the HHS Secretary, in collaboration with other federal officials enumerated 

in the Act, to “formally establish and enhance the efforts of the ICCPUD that began operating in 

2004.” In 2006, SAMHSA assumed leadership as the HHS Secretary’s designee. 

The STOP Act calls for data and information on individual state performance and the enforcement 

of drinking laws, steps to reduce alcohol’s availability to youth under the age of 21, research on 

underage drinking, and resources for local community efforts. The STOP Act also calls for four 

annual reports to Congress, which are developed under contract ($1 million/year): a report on the 

prevention and reduction of underage drinking, a report on state performance and best practices 

for the prevention and reduction of underage drinking, and a report series on state underage 

drinking prevention and enforcement activities. 

A report on the evaluation of the adult oriented national media campaign to prevent underage 

drinking that includes the production, broadcasting, and effectiveness of the campaign – also 

known as “Talk They Hear You.” The community-based coalition enhancement grant program 

provides up to $50,000 per year over four years to current or former grantees under the Drug-Free 

Communities Act of 1997 to prevent and reduce alcohol use among youth under the age of 21. 

The STOP Act grant program enables organizations to strengthen collaboration and coordination 

among stakeholders to achieve a reduction in underage drinking in their communities. 

The national media campaign to prevent underage drinking, — “Talk They Hear You.” (TTHY) 

responds to directives set forth in Section 2(d) of the STOP Act ($2 million/year), to produce and 

oversee an adult-oriented national media campaign to provide parents and caregivers of youth 

under the age of 21 with information and resources to discuss the issue of alcohol with their 

children. The ICCPUD will continue to guide the development process of the national media 

campaign, and subsequent evaluation, which is included as Chapter 5 of the Report to Congress 

annually. 

In FY 2021, SAMHSA funded 16 new grants and 117 continuing grants. In FY 2022, SAMHSA 

intends to fund 133 continuation awards. In FY 2023, SAMHSA plans to award 113 continuing 

and 23 new grant awards. 

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FY 2017 data showed that 58 percent of coalitions report at least 5 percent improvement in the 30-

day use of alcohol in at least two grades, and 75 percent of coalitions reported improvement in 

youth perception of risk from alcohol in at least two grades. 

Under ICCPUD’s leadership, SAMHSA’s Center for Substance Use Prevention Services 

developed the TTHY campaign in response to directives set forth in Section 2(d) of the STOP Act, 

requiring the HHS Secretary to fund and oversee a national adult-oriented media public service 

campaign and to report annually on the production, broadcasting, and evaluation of this campaign. 

ICCPUD has been instrumental in the overall development of TTHY, using input from experts and 

organizations representing a wide range of parties, including public health advocacy groups, the 

alcohol industry, ICCPUD member agencies, the U.S. Congress, and subject matter experts 

(SMEs). TTHY addresses all three of the core goals laid out in ICCPUD’s “Preventing & 

Reducing Underage Drinking 2021 Comprehensive Plan,” as well as several topics for ICCPUD 

consideration and recommendations for new activities 

To maintain its lasting message and keep it consistent and relevant over time, the TTHY campaign 

trademarked its logo in 2016, making it the official property of HHS. This trademark instills trust 

in the campaign, lends credibility to TTHY materials, and promotes consistency when 

organizations implement TTHY in their communities. 

The TTHY earned media campaign “Definition of earned media: Earned media, also referred to 

as media relations, word-of-mouth, public relations, or publicity, is an unpaid brand mention or 

recognition, such as a news article, published interview, or online review by a third party. In 

addition, earned media can also refer to a byline or article written by someone associated with the 

brand that is published by a third party.” (Top Rank Marketing, n.d.) has yielded approximately a 

$15-to-$1 return on investment for every dollar invested. Key strategies of the earned media 

campaign were to (1) secure prominent campaign coverage in several major media outlets and (2) 

leverage regional relationships in communities through town hall meetings and public health 

observances (e.g., SAMHSA’s Prevention Day and National Prevention Week) to further educate 

parents and caregivers of children under 21 about why and how they should talk with their kids 

about the dangers of underage drinking and other substance use. The campaign also hosts 

community engagement meetings throughout the year to interact with local groups who are 

implementing the campaign locally and to learn specific details about their prevention efforts. 

Since the campaign’s inception, initial investment costs for development and implementation have 

been a little more than $1.1 million per year, totaling nearly $15 million over a 13-year period. 

Earned media outreach efforts have generated an estimated $223.19 million in earned media 

placements on major networks and affiliates—with television, print, and radio PSAs having 

collectively garnered 18.1 billion impressions in all 50 states and in more than 300 cities. 

Distribution is augmented by community engagement, with groups such as the Community AntiDrug Coalitions of America and the National Prevention Network, which have direct access to 

parents and caregivers. To date the campaign has licensed 1,395 partner organizations that are 

implementing TTHY to varying degrees in communities across the country. 

Supporting the development and justification of the TTHY campaign involves a complex interplay 

of formative, process, and outcomes evaluation efforts. Evaluation findings to date suggest that 

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SAMHSA has met many markers for early success, including strongly resonating with intended 

TTHY audiences. The growing body of evidence presented in the Report to Congress for the 

Prevention and Reduction of Underage Drinking U.S. Department of Health and Human Services. 

(December 2020). Report to Congress on the Prevention and Reduction of Underage Drinking, 

Rockville, MD: Substance use And Mental Health Services Administration Retrieved 

from www.stopalcoholabuse.gov. (National Survey on Drug Use and Health [NSDUH]; Center 

for Behavioral Health Statistics and Quality [CBHSQ], 2019c) supports that key campaign 

messages serve as important cues to action that increase both the plans and actions of parents to 

talk with their children about underage drinking and other substance use. There is further evidence 

to suggest that TTHY increases parents’ confidence not only in talking with their children about 

underage drinking and other substance use but also in the behavioral efficacy of that action. 

In meeting the requirements of the STOP Act, SAMHSA, under the leadership of ICCPUD, will 

continue to garner support for program efficacy over the next year and implement evaluation plans 

for the upcoming 2022–2023 campaign evaluation cycle, which includes an evaluation of the 

usability, reach, and effectiveness of the TTHY mobile app and Screen4Success self-screening a 

referral management system; the initial development of a complementary youth campaign that 

includes message testing and audience segmentation analysis; and the beginning of a multi-year 

evaluation of the student assistance- and school health and wellness-focused training with 

formative, outcome, and long-term impact evaluation methodologies that can be adopted by 

schools and districts. The formative measures will assess how well the curriculums are being 

implemented, and the outcome and impact measures will look to the impact on the target 

audiences, the students. Armed with data from this and future efforts, SAMHSA will persist in its 

work to estimate overall campaign impact as well as to ensure that the TTHY campaign evolves 

in ways that resonate with its primary target audiences and meet the needs of the U.S. population 

at large. 

Five Year Funding Table 

Fiscal Year Amount 

COVID-19 

Supplemental 

Funding 

FY 2019 $8,000,000 

FY 2020 $9,000,000 

FY 2021 Final $10,032,000 

FY 2022 CR $10,000,000 

FY 2023 President's Budget $10,000,000 

Budget Request 

The FY 2023 President’s Budget request is $10.0 million, level with the FY 2022 Annualized 

Continuing Resolution and will support 111 continuing and 23 new grant awards. 

189 
 

 

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Outputs and Outcomes Table 

Program: Sober Truth on Preventing Underage Drinking (STOP Act) 

Measure Year and Most Recent 

Result / 

Target for Recent Result 

/ 

(Summary of Result) 

FY 2022 

Target 

FY 2023 

Target 

FY 2023 

Target 

+/-FY 2022 

Target 

3.3.01 Percent of 

coalitions that report at 

least 5% improvement 

in the past 30-day use 

of alcohol in at least 

two grades (Outcome) 

FY 2021: 83 % 

Target: 

57.7 % 

(Target Exceeded) 

83 % 83 % Maintain 

3.3.02 Percent of 

coalitions that report 

improvement in youth 

perception of risk from 

alcohol in at least two 

grades (Outcome) 

FY 2021: 55 % 

Target: 

62 % 

(Target Not Met but 

Improved) 

75 % 75 % Maintain 

190 
 

 

 

SAMHSA-Substance Use Prevention Services 

Center for the Application of Prevention Technologies 

(Dollars in thousands) 

FY 2021 FY 2022 FY 2023 

Programs of Regional & National Significance Final

 COVID-19 

Supplemental CR 

President's 

Budget 

FY 2023 +/-

FY 2022 

Center for the Application of Prevention Technologies......................... $7,493 $--- $7,493 $11,993 $4,500 

Authorizing Legislation........................................................................................Section 516 of the PHS Act 

FY 2023 Authorization........................................................................................................................................ $0 

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

Eligible Entities....................................................................................................Domestic and Public Entities 

Program Description and Accomplishments 

In 2019, SAMHSA funded the Prevention Technology Transfer Centers (PTTC) cooperative 

agreements. The PTTC Network is comprised of 10 Domestic Regional Centers, 1 National 

American Indian and Alaska Native PTTC, 1 National Hispanic and Latino PTTC, and Network 

Coordinating Office. Together the Network serves the 50 U.S. states, the District of Columbia, 

Puerto Rico, the U.S. Virgin Islands, and the Pacific Islands of Guam, American Samoa, Palau, 

the Marshall Islands, Micronesia, and the Mariana Islands. 

The purpose of the PTTC Network is to improve implementation and delivery of effective 

substance use prevention interventions and provide training and technical assistance services to 

the substance misuse prevention field. This is accomplished by developing and disseminating 

tools and strategies needed to improve the quality of substance misuse prevention efforts; 

providing intensive technical assistance and learning resources to prevention professionals to 

improve their understanding of prevention science, epidemiological data, and implementation of 

evidence-based and promising practices; and developing tools and resources to engage the next 

generation of prevention professionals. 

To date, the PTTC has delivered over 2,590 events and provided training/technical assistance to 

over 102,200 participants. The PTTC Network has developed many resources focusing on six 

priority areas: Community coalitions and collaborators; Building Health Equity and Inclusion; 

Data-informed decisions; Implementation Science; Cannabis Prevention; and Workforce 

Development. New products and resources addressing these specific areas have been developed 

and implemented 

Together, the PTTC Network created a free online cultural competency program to support 

providers to improve the quality of care provided to clients from diverse backgrounds. The goal 

of this e-learning program is to help behavioral health professionals increase their cultural and 

linguistic competency. In response to COVID-19 pandemic, the PTTC Network developed several 

resources focused on “Bringing Prevention Virtual” to assist prevention professionals as they 

transition to delivering services and programming from face-to-face to virtual settings. 

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SAMHSA-Substance Use Prevention Services 

Among several events implemented and resources developed, the PTTC Network collaborates 

with the ATTC and the MHTTC to create a robust list of “Community Engagement Resources”. 

Providing equitable mental health and substance use prevention, treatment, and recovery services 

means engaging with all communities to make sure all people feel welcome and supported. 

Five Year Funding Table 

Fiscal Year Amount 

COVID-19 

Supplemental 

Funding 

FY 2019 $7,493,000 

FY 2020 $7,493,000 

FY 2021 Final $7,493,000 

FY 2022 CR $7,493,000 

FY 2023 President's Budget $11,993,000 

Budget Request 

The FY 2023 President’s Budget request is $11.9 million, an increase of $4.5 million from the FY 

2022 Annualized Continuing Resolution. The proposed funding increase will fund 13 new PTTC 

awards. The increase will allow the establishment of tailored state-of-the-art substance use 

prevention technical assistance to states, communities, Tribe, or territories, to strengthen grantee 

programs Prevention T/TA services are being conducted by the PTTCs. The funding will also 

support the HHS priority of advancing the goal of ending the opioid crisis and the ONDCP Drug 

Policy Priority of supporting evidence-based prevention efforts to reduce youth substance use. 

The increase in funding would be used to support supplemental funding to the existing PTTCs. 

192 
 

SAMHSA-Substance Use Prevention Services 

Outputs and Outcomes Table 

Program: Center for the Application of Prevention Technologies 

Measure Year and Most Recent 

Result / 

Target for Recent Result / 

(Summary of Result) 

FY 2022 

Target 

FY 2023 

Target 

FY 2023 

Target 

+/-FY 2022 

Target 

1.4.14 Number of people 

trained (Output) 

FY 2021: 39,774.0 

Target: 

70,400.0 

(Target Not Met) 

39,774.0 39,774.0 Maintain 

1.4.15 Percentage 

expecting to use 

information from training 

to change their practice. 

(Outcome) 

FY 2021: 85.0 

Target: 

69.0 

(Target Exceeded) 

90.0 90.0 Maintain 

193 
 

 

 

SAMHSA-Substance Use Prevention Services 

Science and Service Program Coordination 

(Dollars in thousands) 

FY 2021 FY 2022 FY 2023 

Programs of Regional & National Significance Final

 COVID-19 

Supplemental CR 

President's 

Budget 

FY 2023 +/-

FY 2022 

Science and Service Program Coordination........................................... $4,153 $--- $4,072 $4,072 $---

Authorizing Legislation........................................................................................Section 516 of the PHS Act 

FY 2023 Authorization........................................................................................................................................ $0 

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

Eligible Entities....................................................................................................Domestic and Public Entities 

Program Description and Accomplishments 

SAMHSA has made preventing underage drinking a priority because of its potential impact on the 

health and well-being of young people and their communities. Over the past decade, there has 

been a steady decline of drinking by adolescents and young adults. Trend data report similar 

declines in underage binge and heavy drinking. In 2020, 138.5 million Americans aged 12 or older 

reported current use of alcohol, 61.6 million reported binge drinking and 17.7 million reported 

heavy drinking.68 Alcohol continues to be the most widely used substance of abuse among 

American youth, and a higher proportion use alcohol than use tobacco, marijuana, or other drugs.69 

The Science and Service Program Coordination program funds the provision of technical 

assistance and training to states, tribes, communities, and grantees around substance misuse 

prevention. Specifically, the program supports the Tribal Training and Technical Assistance 

Center (TTTAC) and the Underage Drinking Prevention Education Initiatives (UADPEI). 

The TTTAC is an innovative training and technical assistance (TTA) project that helps tribal 

communities facilitate the development and implementation of comprehensive and collaborative 

community-based prevention plans to reduce violence, bullying, substance misuse, and suicide 

among American Indian/Alaska Native (AI/AN) youth, in support of the HHS Tribal Health and 

Well-Being Coordination. These plans mobilize tribal communities’ existing social and 

educational resources to meet their goals. 

The UADPEI efforts engage parents and other caregivers, schools, communities, all levels of 

government, all social systems that interface with youth, and youth themselves in a coordinated 

national effort to prevent and reduce underage drinking and its consequences. 

68 Substance use And Mental Health Services Administration. (2021). Key substance use and mental health 

indicators in the United States: Results from the 2020 National Survey on Drug Use and Health (HHS Publication 

No. PEP21-07-01-003, NSDUH Series H-56). Rockville, MD: Center for Behavioral Health Statistics and Quality, 

Substance use And Mental Health Services Administration. Retrieved from http://www.samhsa.gov/data 69 U.S. Department of Health and Human Services (HHS), SAMHSA. (2018). Report to Congress on the 

Prevention and Reduction of Underage Drinking. Retrieved from 

https://www.stopalcoholabuse.gov/resources/reporttocongress/rtc2018.aspx 

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The UADPEI heavily promotes the adoption of evidence-based policies, programs, and practices 

by developing materials, resources, and other engagement tools to strengthen community-based 

prevention efforts on underage drinking and other substances. The initiative collaborates with 

other federal agencies on underage drinking prevention strategy implementation through ICCPUD 

and the StopAlcoholAbuse.gov website. 

As part of its work to support SAMHSA and ICCPUD, the UADPEI develops new resources for 

prevention professionals that call out important trends from the NSDUH and emphasize new ways 

to approach underage and problem drinking prevention. These types of resources are audience 

specific and range from data visualizations and parent guides to the College Drinking: Prevention 

Perspectives (CD: PP) videos and discussion guides. CD: PP videos highlight evidence-based 

underage drinking prevention strategies at institutions of higher education, including historically 

black colleges and universities (HBCUs) while the discussion guides provide campus communities 

an opportunity to think critically about how these strategies can be adapted and modified to fit 

their own needs. 

The UADPEI also engages families, youth, youth-serving organizations, and institutions of higher 

education in initiatives such as SAMHSA’s Communities Talk to Prevent Underage Drinking. 

2021 Communities Talk to Prevent Underage Drinking 

Approximately every two years, SAMHSA distributes Communities Talk planning stipends to 

community-based organizations (CBOs), institutions of higher education (IHEs), and statewide or 

state-based organizations to plan activities that raise awareness and educate youth, families, and 

communities about the potentially harmful consequences of underage and problem drinking among 

individuals 12 to 25 years old. 

Given the public health concerns and requirements associated with the COVID-19 pandemic, 

SAMHSA provided additional guidance for groups participating in the initiative to account for 

COVID-related impacts on community gatherings. As a result, the 2021 cycle of Communities 

Talk encouraged organizers to implement prevention activities that shared important messages 

about underage drinking while accounting for social distancing guidelines, the limited capacity of 

prevention professionals, and the new realities associated with underage and problem drinking. 

To do this, SAMHSA gathered insights from community- and state-level prevention professionals, 

including those working in colleges and universities. Key changes to the initiative include 

additional support and resources for virtual activities (webinars, Public Services Announcements, 

interactive social media campaigns, etc.) and new messaging that creates a stronger link between 

overall wellness during the pandemic and substance use prevention. 

During the 2021 stipend cycle, CBOs and IHEs registered to host events and activities in all 50 

states, the District of Columbia, and the territories of Guam, Puerto Rico, and the U.S. Virgin 

Islands. With the support of revised and/or new tools and resources developed by SAMHSA, such 

as a “How to Register” video and a virtual activity toolkit, community-based organizers hosted 

innovative gatherings including: 

195 
 

 

 

 

SAMHSA-Substance Use Prevention Services 

• The Midwest Asian Health Association worked alongside the McKinley Park Underage 

Drinking and Other Substance Use Prevention Services (McK-UDOS) Coalition to host a 

virtual activity to discuss prevention strategies with their community. 

• The New Britain Local Prevention Council (NBLPC) ran a weeklong social media 

campaign highlighting the testimonies of youth in their community as they shared why they 

chose not to engage in substance use. 

• The Geneseo Healthy Campus and Community Coalition, in partnership with local college 

students, held an in-person event to educate middle school and high school students on the 

effects of underage drinking and substance misuse. 

In 2021, SAMHSA reached its goal of 1,000 organizations hosting underage drinking prevention 

events, distributing 1,003 stipends for this cycle. More than 101 IHEs also participated in the 

2021 Communities Talk cycle, with 15 Historically Black Colleges and Universities; 12 Hispanicserving institutions; and 5 Tribal-serving and Native American-Serving Non-Tribal institutions. 

The 2021 stipend cycle also demonstrated high involvement from key federal and national 

organizations, with a high number of stipend recipients coming from the following groups: 

• National Association of State Alcohol and Drug Abuse Directors’ National Prevention 

Network 

• Office of National Drug Control Policy’s Drug-Free Communities 

• Students Against Drunk Driving 

• Boys & Girls Clubs of America 

• American College Health Association 

Tribal Training and Technical Assistance Contract (TTAC) 

During FY 2020, GPRA data was collected from a total of 541 TTA participant questionnaires. 

The participant questionnaire results indicated an overall positive response to the TTA provided 

onsite and virtually. Respondents reported that the TTA improved their individual capacity and 

their organization’s capacity to do prevention work. Overall, about 95 percent of participants 

reported TTA was useful and improved capacity for themselves and their organizations. 

The total 541 TTA reported above also comprises the following FY 2020 activities. During FY 

2020, the Tribal TTA Center team reported data on 9 Broad TTA events, 12 Focused TTA events, 

31 Intensive TTA events, and 15 Opioids TTA events. The TTA Center collected GPRA measures 

on Onsite Broad TTA events serving a total of 123 participants representing 26 AI/AN 

communities over 10 days and 3 events. Six virtual Broad TTA events served a total of 244 

participants. Onsite Focused TTA events served a total of 123 participants representing 73 AI/AN 

communities over 19 days and 6 events. Seven Focused virtual TTA events served a total of 56 

participants. Intensive Virtual TA served 298 participants through 22 events and Intensive training 

served a total of 334 participants across 9 events. Onsite Opioids TTA events served a total of 309 

participants representing 105 AI/AN communities over 15 days and 7 events. Eight Opioids virtual 

TTA events served a total of 397 participants. 

196 
SAMHSA-Substance Use Prevention Services 

Five Year Funding Table 

Fiscal Year Amount 

COVID-19 

Supplemental 

Funding 

FY 2019 $4,072,000 

FY 2020 $4,072,000 

FY 2021 Final $4,153,000 

FY 2022 CR $4,072,000 

FY 2023 President's Budget $4,072,000 

Budget Request 

The FY 2023 President’s Budget request is $4.0 million, level with the FY 2022 Annualized 

Continuing Resolution. 

197 
 

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Outputs and Outcomes Table 

Program: Prevention - Science and Service Activities 

Measure Year and Most Recent 

Result / 

Target for Recent Result 

/ 

(Summary of Result) 

FY 2022 

Target 

FY 2023 

Target 

FY 2023 

Target 

+/-FY 2022 

Target 

2.3.100 Number of 

organizations or 

communities that 

demonstrate improved 

readiness to change 

their systems (Output) 

FY 2020: 5.0 

organizations 

Target: 

5.0 organizations 

(Target Met) 

5.0 

organizations 

5.0 

organizations 

Maintain 

198 
 

 

SAMHSA-Substance Use Prevention Services 

Tribal Behavioral Health Grants 

(Dollars in thousands) 

FY 2021 FY 2022 FY 2023 

Programs of Regional & National Significance Final

 COVID-19 

Supplemental CR 

President's 

Budget 

FY 2023 +/-

FY 2022 

Tribal Behavioral Health Grants............................................................ $20,642 $--- $20,750 $23,665 $2,915 

Authorizing Legislation........................................................................................Section 516 of the PHS Act 

FY 2023 Authorization........................................................................................................................................ $0 

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

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

Program Description and Accomplishments 

Suicide is a leading cause of death among American Indian/Alaska Native (AI/AN) youth and 

young adults ages ten to 14 years.70 For American Indian/Alaska Native Youth age 10-19, the 

unadjusted suicide rate is more than three times the rate for the nation as a whole. Further, AI/AN 

high school student report higher rates of suicidal behaviors than the general population of U.S. 

high school students.71 These behaviors include serious thoughts of suicide, suicide plans, suicide 

attempts, and medical attention for a suicide attempt. However, the risk of suicide is not the same 

in all AI/AN youth demographic groups. For instance, AI/AN youth raised in urban settings have 

a smaller risk of having thoughts of suicide than AI/AN youth raised on tribal reservations (21 

percent and 33 percent, respectively).72 

Consistent with the goals of the Tribal Behavioral Health Agenda, the Tribal Behavioral Health 

Grant (TBHG/Native Connections (NC) 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 use, trauma, and suicide and by promoting the mental health of AI/AN young people. 

The first cohort of TBHG/NC grants was provided 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 misuse, thereby promoting mental health among tribal youth. In addition, 

SAMHSA’s Tribal Training and Technical Assistance Center (http://www.samhsa.gov/tribal-ttac) 

provides training and education to AI/AN grantees and organizations serving AI/AN populations 

to support their ability to achieve their goals. 

This initiative takes a comprehensive, culturally appropriate approach to help improve the lives of 

and opportunities for AI/AN youth. In addition to the Department of Health and Human Services, 

70 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. 71 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. 72 Freedenthal, S. & Stiffman, A. R. (2004). Suicidal Behavior in Urban American Indian Adolescents: A 

Comparison with Reservation Youth in a Southwestern State. Suicide and Life-Threatening Behavior, 34(2), 160-

171. 

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SAMHSA-Substance Use Prevention 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. 

In FY 2016, SAMHSA expanded activities through the braided TBHG/NC funding ($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 misuse, and promote mental health and resiliency among youth in tribal 

communities. 

In FY 2021, SAMHSA supported 124 grant continuations and awarded a new cohort of 29 grants 

and technical assistance activities. In FY 2022 Annualized CR, SAMHSA will support 140 grant 

continuations and award a new cohort of six grants and technical assistance activities. 

Five Year Funding Table 

Fiscal Year Amount 

COVID-19 

Supplemental 

Funding 

FY 2019 $20,750,000 

FY 2020 $20,000,000 

FY 2021 Final $20,642,000 

FY 2022 CR $20,750,000 

FY 2023 President's Budget $23,665,000 

Budget Request 

The FY 2023 President’s Budget request is $23.6 million, an increase of $2.9 million from the FY 

2022 Annualized Continuing Resolution. The increase will support technical assistance activities, 

78 continuation grants and award a new cohort of 38 grants that promote mental health and prevent 

substance use activities for high-risk AI/AN youth and their families. The increase in funding will 

result in an increase in the number of individuals contacted through program outreach efforts to 

nearly 600,000. 

As a braided activity with the Mental Health appropriation, SAMHSA is tracking 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. 

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SAMHSA-Substance Use Prevention Services 

Outputs and Outcomes Table 

Program: Tribal Behavioral Health Grants 

Measure Year and Most Recent 

Result / 

Target for Recent Result / 

(Summary of Result) 

FY 2022 

Target 

FY 2023 

Target 

FY 2023 

Target 

+/-FY 2022 

Target 

2.4.12 Percentage of 

youth age 10 - 24 who 

received mental health or 

related services after 

screening, referral, or 

attempt (Output) 

FY 2021: 338 

Target: 

47 

(Target Exceeded) 

33 33 Maintain 

2.4.17 Number of youths 

with mental health or 

substance use disorders 

who are contacted 

through program 

outreach efforts (Output) 

FY 2021: 570,655.0 

Target: 

570,655.0 

(Baseline) 

570,655.0 644,840 Increase 

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SAMHSA-Substance Use Prevention Services 

Minority Fellowship Program 

(Dollars in thousands) 

FY 2021 FY 2022 FY 2023 

Programs of Regional & National Significance Final

 COVID-19 

Supplemental CR 

President's 

Budget 

FY 2023 +/-

FY 2022 

Minority Fellowship Program................................................................ $321 $--- $321 $1,340 $1,019 

Authorizing Legislation........................................................................................Section 597 of the PHS Act 

FY 2023 Authorization........................................................................................................................................ $0 

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

Eligible Entities.......Organizations that represent individuals obtaining post baccalaureate training 

...... (including for master’s and doctoral degrees) for mental and substance use disorder treatment 

.....................................professionals in the fields of psychiatry, nursing, social work, psychology, 

................................................................... marriage and family therapy, mental health counseling, 

.......................................................................and substance use disorder and addiction counseling. 

Program Description and Accomplishments 

SAMHSA’s Minority Fellowship Program (MFP) increases behavioral health practitioners’ 

knowledge of issues related to prevention, treatment, and recovery support for mental illness and 

drug/alcohol addiction among racial and ethnic minority populations. The program provides 

stipends to increase the number of culturally competent behavioral health professionals who teach, 

administer, conduct services research, and provide direct mental illness or substance use disorder 

treatment services for minority populations that are underserved. Since its start in 1973, the 

program has helped to enhance services for racial and ethnic minority communities through 

specialized training of mental health professionals in psychiatry, nursing, social work, marriage 

and family therapy, mental health counseling, psychology; and substance use/addiction 

counseling. In 2006, the program expanded to include marriage and family therapists and later 

added professional counselors. Professional guilds receive competitively awarded grants, and then 

competitively award the stipends to post-graduate students pursuing a degree in that professional 

field. The MFP program has had a variety of focus including youth and addiction counselors. 

In FY 2021, SAMHSA supported eight grant continuations and exercised the option year on the 

MFP the technical assistance contract. In FY 2022 Annualized CR, SAMHSA will support eight 

grant continuations, the technical assistance contract and award a new cohort of one grant, 

Five Year Funding Table 

Fiscal Year Amount 

COVID-19 

Supplemental 

Funding 

FY 2019 $321,000 

FY 2020 $321,000 

FY 2021 Final $321,000 

FY 2022 CR $321,000 

FY 2023 President's Budget $1,340,000 

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SAMHSA-Substance Use Prevention Services 

Budget Request 

The FY 2023 President’s Budget request is $1.3 million, an increase of $1.0 million from the FY 

2022 Annualized Continuing Resolution. The proposed funding increase will support two 

continuation grants, as well as a new cohort of 10 grants and the technical assistance contract. 

With this increase in funding, the number of trained behavioral health providers will increase to 

6,500. 

203 
 

 

 

 

 

 

 

 

SAMHSA-Substance Use Prevention Services 

First Responder Training for Opioid Overdose Reversal Drugs 

(Dollars in thousands) 

FY 2021 FY 2022 FY 2023 

Programs of Regional & National Significance Final

 COVID-19 

Supplemental CR 

President's 

Budget 

FY 2023 +/-

FY 2022 

First Responder Training (CARA)......................................................... 

First Responder Training (non-add) ........................................... 

Rural Set-Aside (non-add)............................................................ 

$---

---

---

$---

---

---

$---

---

---

$67,500 

43,500 

24,000 

$67,500 

43,500 

24,000 1/ This activity were funded in FY 2021 and in FY2022 CR in the Center for Substance Use Services.. 

Authorizing Legislation ........................................................................ Section 546 of the PHS Act 

FY 2023 Authorization........................................................................................................................................ $0 

Allocation Method............................................................................................Competitive Grants 

Eligible Entities.............................................................................States, local government entities, 

.......................... federally recognized American Indian/Alaska Native tribe or tribal organizations 

Program Description and Accomplishments 

SAMHSA’s First Responders – Comprehensive Addiction and Recovery Act (FR-CARA) 

program is an important part of the US government’s response to the opioid crisis. The FR-CARA 

program trains and equips firefighters, law enforcement officers, paramedics, emergency medical 

technicians, and other legally organized and recognized volunteer organizations in a position to 

respond to adverse opioid-related incidents. This program also establishes processes, protocols, 

and mechanisms for referral to appropriate treatment and recovery communities. FR-CARA's 

broader eligibility and rural-set asides ensure that much needed services reach rural and tribal 

areas. 

Training, technical assistance, and evaluation activities are also being supported to assist grantees, 

determine best practices, and assess program outcomes. In FY 2021, SAMHSA awarded 67 grants 

to states, rural, and tribal organizations. Approximately 52 percent of the funds went to rural 

entities hit particularly hard by the overdose epidemic. 

To date, grantees report having trained 124,392 first responders and community members on the 

use of naloxone or other FDA approved drugs or devices, and how to respond to overdose 

emergencies. The program has equipped these communities with 306,759 FDA-approved 

overdose reversal kits since the start of the program. Of these, 125,679 doses have been 

administered to treat suspected overdose cases, resulting in more than 38,406 confirmed overdose 

reversals. 

Rural Emergency Medical Services Training Grant 

SAMHSA recognizes the great need for emergency services in rural areas and the critical role 

EMS personnel serve across the country. In FY 2020 SAMHSA funded the first Rural Emergency 

Medical Services Training Grant (EMS Training) cohort. The purpose of this one-year grant 

program is to recruit and train emergency medical services (EMS) personnel in rural areas. 

In 2021 SAMHSA funded 49 continuing and 48 new grants to ensure that EMS personnel are 

trained on mental and substance use disorders and care for people with such disorders in 

204 
 

 

 

SAMHSA-Substance Use Prevention Services 

emergency situations. During the first 6 months of this program the grantees recruited almost 400 

EMS staff and enrolled over 1,900 EMS personnel in various types of training. 

In FY 2022 SAMHSA will fund 42 continuing grants and 48 new grants. 

Five Year Funding Table 

Fiscal Year Amount 

COVID-19 

Supplemental 

Funding 

FY 2019 $---

FY 2020 $---

FY 2021 Final $---

FY 2022 CR $---

FY 2023 President's Budget $67,500,000 1/ This activity was funded in the Center for Substance Use Services in FY 2019 - 2022 CR. The 

2022 CR level is $42,000,000. 

Budget Request 

The FY 2023 President’s Budget Request is $67.5 million, an increase of 25.5 million over the FY 

2022 Annualized Continuing Resolution. The budget proposes to realign this program from the 

Center for Substance use Services to Center for Substance use Prevention. First Responder 

Training for Opioid Overdose Reversal Drugs (FR-CARA) is a key component of the public health 

response to the overdose epidemic. It uses a combination of community-based public health 

prevention and harm reduction strategies across the prevention continuum to mitigate the impact 

of the overdose epidemic within communities. These community-based public health prevention 

efforts serve the high-risk population outside of substance use treatment facilities, which focus on 

individual clients who have been diagnosed with a substance use disorder. 

In 2019, the funding for FR-CARA was realigned from Substance use Prevention Services 

(CSUPS) to Substance use Services (CSUS), however, CSUPS retained the administration of the 

program. Since 2019, the effort to coordinate both the administration and the funding across two 

centers has been challenging, therefore SAMHSA believes realigning this program back to CSUPS 

will reduce the burden on both centers to manage one program. Realigning the program will allow 

CSUPS to manage the program and ensure funding is targeted and complimentary to meeting the 

needs of the community-based organizations leading these critical prevention and harm reduction 

efforts. 

The overdose epidemic has reached heights never seen before by taking the most Americans lives 

ever seen in a 12-month period. CDC provisional data indicates death by overdose increased by 

nearly 30 percent in 2020. There is a critical need for additional prevention funding to expand the 

reach of prevention services to high need communities. SAMHSA will utilize multiple sources of 

data (including, but not limited to, previous program, morbidity, and mortality data) to identify 

priority communities and populations in greatest need of funding. FR-CARA will continue to 

prevent overdoses with increasing access to overdose prevention that includes purchasing, training, 

and equipping first responders and community members with Naloxone and other FDA-approved 

overdose reversal devices. Additionally, this program will increase access for individuals treat 

205 
 

SAMHSA-Substance Use Prevention Services 

with naloxone for overdose to low threshold Buprenorphine accompanied by psychosocial support 

services that address the multifaceted challenges a person experiences after an overdose that 

includes follow-up support with the goal of facilitating referral and linkage with a warm hand off 

to Medication Assisted Treatment. 

SAMHSA plans to use the increase in funds to award 26 continuation grants and 88 new grants. 

In addition, SAMHSA plans to fund 27 new Rural Emergency Medical Services Training Grants. 

The additional funding to FR-CARA allows SAMHSA to increase much needed support to combat 

the nation’s opioid overdose epidemic. This program is critical to preventing death by overdose. 

Expanding the FR-CARA program will allow SAMHSA to fund more programs that expand 

organizational and workforce capacity. SAMHSA will support grant programs in enhancing 

linkage to care for people at risk for opioid overdose and implementing innovative prevention 

activities. More grant recipients will result in more programs equipped to address the challenges 

(i.e., access to care, service utilization, continuum of care, psycho-social needs, lack of funding) 

unique to their communities required to save lives. As of November 2021, these funds have 

supported over 34,400 overdose reversals, 26,000 trainings and 113,000 individuals trained. 

206 
 

 

SAMHSA-Substance Use Prevention Services 

Outputs and Outcomes Table 

Program: First Responder Training-CARA 

Measure Year and Most Recent 

Result / 

Target for Recent Result 

/ 

(Summary of Result) 

FY 2022 

Target 

FY 2023 

Target 

FY 2023 

Target 

+/-FY 2022 

Target 

5.0.1 Number of FDAapproved overdose 

reversing medication 

kits distributed. 

(Output) 

FY 2021: 85,827 

Target: 

73,845 

(Target Exceeded) 

171,831.0 171,831.0 Maintain 

5.1.1 Number of first 

responders trained how 

to administer FDAapproved overdose 

reversing medication 

kits (Output) 

FY 2021: 12,100 

Target: 

16,759.0 

(Target Not Met) 

44,155.0 44,155.0 Maintain 

207 
 

 

 

 

 

 

SAMHSA-Substance Use Prevention Services 

Improving Access to Overdose Treatment 

(Dollars in thousands) 

FY 2021 FY 2022 FY 2023 

Programs of Regional & National Significance Final

 COVID-19 

Supplemental CR 

President's 

Budget 

FY 2023 +/-

FY 2022 

Improving Access to Overdose Treatment............................................. $--- $--- $--- $1,500 $1,500 1/ This activity were funded in FY 2021 and in FY2022 CR in the Center for Substance Use Services.. 

Authorizing Legislation .Section 302 of the Comprehensive Addiction and Recovery Act of 2016 

FY 2023 Authorization........................................................................................................................................ $0 

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

Eligible Entities...................................Primary care, child welfare system, criminal justice system 

Program Description and Accomplishments 

Provisional data from CDC’s National Center for Health Statistics indicate that there were an 

estimated 100,306 drug overdose deaths in the United States during 12-month period ending in 

April 2021, an increase of 28.5 percent from the 78,056 deaths during the same period the year 

before. 

As part of SAMHSA’s response, the Opioid Overdose Prevention Toolkit was developed to help 

reduce the number of opioid-related overdose deaths and adverse events. SAMHSA’s Improving 

Access to Overdose Treatment (ODTx) grant program utilizes this toolkit and other resources to 

help grantees train and support health care providers and pharmacists on the prescribing of FDA 

approved drugs or devices for the emergency treatment of known or suspected opioid overdose. 

In addition, the ODTx program addresses the opioid crisis by increasing access to treatment, 

reducing unmet treatment need, and reducing opioid overdose related deaths through the provision 

of prevention, treatment, and recovery activities for opioid use disorder (including prescription 

opioids as well as illicit drugs such as heroin). 

In FY 2022, 22 programs or best practices were developed for prescribing or co-prescribing FDAapproved opioid-overdose reversal drugs or devices. These best practices were used to train 595 

pharmacists and health care providers. 

In FY 2021, SAMHSA funded five continuation grants and intends to fund the continuation grants 

in FY 2022. In FY 2023, SAMHSA plans to fund two programs that will utilize a Training of 

Training model that leverages existing training models with proven success in reaching the 

recipient’s population of focus for broad dissemination across the country and to rapidly expand 

workforce capacity in addressing the significant increase in overdose deaths. 

208 
 

 

SAMHSA-Substance Use Prevention Services 

Five Year Funding Table 

Fiscal Year Amount 

COVID-19 

Supplemental 

Funding 

FY 2019 $---

FY 2020 $---

FY 2021 Final $---

FY 2022 CR $---

FY 2023 President's Budget $1,500,000 1/ This activity was funded in the Center for Substance Use Services in FY 2019 - 2022 CR. The 

2022 CR level is $1,000,000. 

Budget Request 

The FY 2023 President’s Budget request is $1.5 million, an increase of $1.5 million. The budget 

proposes to realign this program from the Center for Substance use Services to Center for 

Substance use Prevention, and overall is an increase of $500,000 from the FY 2022 Annualized 

Continuing Resolution in the previous center. SAMHSA will support 2 continuation grants and 

approximately 5 new grants to continue increasing access to treatment, reducing unmet treatment 

need, and reducing opioid overdose related deaths through the provision of prevention, treatment, 

and recovery activities for opioid use disorder. 

The ODTx program is a key component of the public health response to the overdose epidemic. It 

uses a combination of community-based public health prevention and harm reduction strategies 

across the prevention continuum to mitigate the impact of the overdose epidemic within 

communities. These community-based public health prevention efforts serve the high-risk 

population outside of substance use treatment facilities, which focus on individual clients who 

have been diagnosed with a substance use disorder. In 2019, the funding for the ODTx program 

was realigned from Substance Use Prevention Services (CSUPS) to Substance Use Services 

(CSUS), however, CSUPS retained the administration of the program. Since 2019, the effort to 

coordinate both the administration and the funding across two centers has been challenging, 

therefore SAMHSA believes realigning this program back to CSUPS will reduce the burden on 

both centers to manage one program. Realigning the program will allow CSUPS to be able to 

manage the program and ensure funding is targeted and complimentary to meeting the needs of 

the community-based organizations leading these critical prevention and harm reduction efforts 

209 
 

 

 

SAMHSA-Substance Use Prevention Services 

Outputs and Outcomes Table 

Program: Improving Access to Overdose Treatment (ODTx) 

Measure Year and Most Recent 

Result / 

Target for Recent Result / 

(Summary of Result) 

FY 2022 

Target 

FY 2023 

Target 

FY 2023 

Target 

+/-FY 2022 

Target 

5.2.1 Number trained on 

prescribing FDAapproved opioidoverdose reversal drugs 

or devices for emergency 

treatment of known or 

suspected opioid 

overdose. (Output) 

FY 2021: 595.0 

Target: 

2,141.0 

(Target Not Met) 

2,141.0 2,141.0 Maintain 

210 
 

 

 

 

 

 

 

SAMHSA-Substance Use Prevention Services 

Grants to Prevent Prescription Drug/Opioid Overdose Related Deaths 

(Dollars in thousands) 

FY 2021 FY 2022 FY 2023 

Programs of Regional & National Significance Final

 COVID-19 

Supplemental CR 

President's 

Budget 

FY 2023 +/-

FY 2022 

Grants to Prevent Prescription Drug/Opioid Overdose-Related Deaths $--- $--- $--- $18,000 $18,000 1/ This activity were funded in FY 2021 and in FY2022 CR in the Center for Substance Use Services.. 

Authorizing Legislation ............................................ Section 516 and Section 546 of the PHS Act 

FY 2023 Authorization ............................................................................................$0, $36,000,000 

Allocation Method ............................................................................Competitive Grants, Contracts 

Eligible Entities.............................................................................States, local government entities, 

.......................... federally recognized American Indian/Alaska Native tribe or tribal organizations 

Program Description and Accomplishments 

Opioid overdose remains a significant contributor to accidental deaths among those who use, 

misuse, or abuse illicit and prescription opioids (including synthetics such as fentanyl).73 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. While national data showed that overall numbers of overdose deaths and opioid 

involved deaths were beginning to decrease, provisional data from CDC’s National Center for 

Health Statistics indicate that there were an estimated 100,306 drug overdose deaths in the United 

States during 12-month period ending in April 2021, an increase of 28.5 percent from the 78,056 

deaths during the same period the year before. The highest number of overdose deaths ever 

recorded in a 12-month period, according to recent provisional data from CDC. Provisional CDC 

data also indicate that 37 of 38 states reporting synthetic opioid data reported increases in overdose 

deaths tied to synthetic opioid use.74 Fentanyl has been a significant driver of this increase. 

SAMHSA supports 13 grants to 13 states for the Grants to Prevent Prescription Drug and Opioid 

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

provide education, training, and resources necessary to meet their specific needs. The grant funds 

can be used for purchasing overdose reversing drugs, equipping first responders with them, 

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

providing materials to assemble and disseminate overdose kits. 

These grantees are also required to develop a dissemination plan and a training course tailored to 

73 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 74 Centers for Disease Control (CDC). Overdose Deaths Accelerating During COVID-19. (2020) Available from 

URL: https://www.cdc.gov/media/releases/2020/p1218-overdose-deaths-covid19.html#:~:text=37%20of%20the%2038%20U.S.,in%20synthetic%20opioid%2Dinvolved%20deaths. 

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SAMHSA-Substance Use Prevention Services 

meet the needs of first responders in their communities. 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 to decrease the likelihood of drug 

overdose recurrence. 

In FY 2021, SAMHSA funded 13 new grants. Grantees reported that they held 7,383 training 

sessions and trained 27,266 on naloxone administration or on other opioid-overdose related topics. 

This number exceeded the 2021 target of 22,279 people trained. Grantees held virtual trainings 

during the pandemic, which also increased their capacity to reach a broader and harder to reach 

audiences. SAMHSA estimates that this number of people will also be served in each of FY 2021 

and FY 2022. Throughout FY 2021, grantees have acquired and distributed 73,104 Naloxone or 

other FDA-approved kits, which surpasses our previous target of 45,088. Due to the kits purchased 

and trainings held, grantees have successfully conducted 4,236 opioid overdose reversals. 

In FY 2022, SAMHSA intends to fund up to seven new grants. 

Five Year Funding Table 

Fiscal Year Amount 

COVID-19 

Supplemental 

Funding 

FY 2019 $---

FY 2020 $---

FY 2021 Final $---

FY 2022 CR $---

FY 2023 President's Budget $18,000,000 

1/ This activity was funded in the Center for Substance Use Services in FY 2019 - 2022 CR. The 

2022 CR level is $12,000,000. 

Budget Request 

The FY 2023 President’s Budget request is $18.0 million. The budget proposes to realign this 

program from the Center for Substance use Services to Center for Substance use Prevention, an 

overall increase of $6 million above the FY 2022 Annualized Continuing Resolution of $12.0 

million in the previous Center. FY 2023 funds will support 13 continuing and approximately 7 

new grant awards. This funding will help states purchase overdose reversing drugs, equip first 

responders in high-risk communities, support education on the use of naloxone and other overdoserelated death prevention strategies, provide the necessary materials to assemble overdose kits, and 

cover expenses incurred from dissemination efforts. 

The Grants to Prevent Prescription Drug and Opioid Overdose-related Deaths program is a key 

component of the public health response to the overdose epidemic. It uses a combination of 

community-based public health prevention and harm reduction strategies across the prevention 

continuum to mitigate the impact of the overdose epidemic within communities. These 

community-based public health prevention efforts serve the high-risk population outside of 

substance use treatment facilities, which focus on individual clients who have been diagnosed with 

a substance use disorder. 

212 
 

 

SAMHSA-Substance Use Prevention Services 

In 2019, the funding for the program was realigned from Substance Use Prevention Services 

(CSUPS) to Substance Use Services (CSUS), however, CSUPS retained the administration of the 

program. Since 2019, the effort to coordinate both the administration and the funding across two 

centers has been challenging, therefore SAMHSA believes realigning this program back to CSUPS 

will reduce the burden on both centers to manage one program. Realigning the program will allow 

CSUPS to be able to manage the program and ensure funding is targeted and complimentary to 

meeting the needs of the community-based organizations leading these critical prevention and 

harm reduction efforts. 

213 
 

SAMHSA-Substance Use Prevention Services 

Outputs and Outcomes Table 

Program: PDO/Naloxone 

Measure Year and Most Recent 

Result / 

Target for Recent Result 

/ 

(Summary of Result) 

FY 2022 

Target 

FY 2023 

Target 

FY 2023 

Target 

+/-FY 2022 

Target 

5.0 Number of 

Naloxone (or other 

FDA-approved) kits 

distributed (Output) 

FY 2021: 73,104.0 

Target: 

45,088.0 

(Target Exceeded) 

73,104.0 73,104.0 Maintain 

5.1 Number of lay 

persons trained how to 

administer Naloxone 

(or other FDA 

approved drug or 

device). (Output) 

FY 2021: 27,266.0 

Target: 

22,279.0 

(Target Exceeded) 

27,266.0 27,266.0 Maintain 

214 
SAMHSA-Substance Use Prevention Services 

PRNS Mechanism Table 

Summary 

(Dollars in thousands) 

Programs of Regional & National Significance 

FY 2021 

Final 

FY 2022 

CR 

FY 2023 

President's 

Budget 

No. Amount No. Amount No. Amount 

Grants 

Continuations..................................................................... 

New/Competing................................................................. 

Supplements.......................................................................

641 $157,215 

108 25,586 

 --- ---

713 $172,381 

50 10,967 

 --- ---

658 $151,881 

298 132,565 

 --- ---

Subtotal.......................................................................... 749 182,801 763 183,349 956 284,446 

Contracts 

Continuations..................................................................... 

New................................................................................... 

11 21,069 

4 4,349 

8 16,241 

5 8,630

14 26,576 

 --- 890 

Subtotal.......................................................................... 15 25,418 13 24,870 14 27,466 

Total, Substance Use Prevention PRNS 764 $208,219 776 $208,219 970 $311,912 

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SAMHSA-Substance Use Prevention Services 

PRNS Mechanism Table 

Program, Project, and Activity 

(Dollars in thousands) 

Programs of Regional & National Significance 

FY 2021 

Final 

FY 2022 

CR 

FY 2023 

President's 

Budget 

No. Amount No. Amount No. Amount 

Capacity: 

Strategic Prevention Framework 

Grants 

Continuations..................................................................... 

New/Competing................................................................. 

Supplements.......................................................................

Subtotal 

Contracts 

Continuations..................................................................... 

New................................................................................... 

Subtotal 

Total, Strategic Prevention Framework 

Federal Drug-Free Workplace 

Contracts 

Continuations..................................................................... 

New...................................................................................

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

Total, Federal Drug-Free Workplace 

Minority AIDS 

Grants 

Continuations..................................................................... 

New/Competing................................................................. 

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

Contracts 

Continuations.....................................................................

New...................................................................................

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

Total, Minority AIDS 

Sober Truth on Preventing Underage Drinking Act 

Grants 

Continuations..................................................................... 

New/Competing................................................................. 

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

Contracts 

Continuations..................................................................... 

New...................................................................................

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

Total, Sober Truth on Preventing Underage Drinking Act 

230 $99,770 

26 11,818 

 --- ---

256 $107,337 

12 4,241 

 --- ---

237 $74,245 

59 45,224 

 --- ---

256 111,588 268 111,578 296 119,469 

3 7,100 

1 1,264 

1 6,894 

2 1,012

3 7,205 

 --- ---

4 8,364 3 7,906 3 7,205 

260 119,952 

5 4,892 

 --- 29 

271 119,484 

3 1,429 

1 3,465

299 126,674 

4 4,383 

 --- 756 

5 4,921 4 4,894 4 5,139 

5 4,921 

147 31,276 

37 7,392 

4 4,894 

161 33,855 

27 5,321 

4 5,139 

154 30,916 

46 9,468 

184 38,668 188 39,176 200 40,384 

 --- 2,029

 --- 8

 --- 2,029

 --- ---

 --- 1,645 

 --- ---

 --- 2,037 --- 2,029 --- 1,645 

184 40,705 

117 5,806 

16 808

188 41,205 

133 6,611 

 --- -28 

200 42,029 

111 5,509 

23 1,165 

133 6,613 133 6,583 134 6,674 

2 3,419 

 --- ---

1 1,470 

1 1,947

2 3,326 

 --- ---

2 3,419 2 3,417 2 3,326 

135 10,032 135 10,000 136 10,000 

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SAMHSA-Substance Use Prevention Services 

PRNS Mechanism Table 

Program, Project, and Activity 

(Dollars in thousands) 

Programs of Regional & National Significance 

FY 2021 

Final 

FY 2022 

Enacted 

FY 2023 

President's 

Budget 

No. Amount No. Amount No. Amount 

Tribal Behavioral Health Grants 

Grants 

Continuations..................................................................... 

New/Competing................................................................. 

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

Contracts 

Continuations.....................................................................

New/Competing................................................................. 

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

Total, Tribal Behavioral Health Grants 

Improving Access to Overdose Treatment 

Grants 

Continuations.....................................................................

New/Competing.................................................................

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

Contracts 

Continuations.....................................................................

New/Competing.................................................................

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

Total, Improving Access to Overdose Treatment

Grants to Prevent Prescription Drug/Opioid Overdose 

Grants 

Continuations.....................................................................

New/Competing.................................................................

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

Contracts 

Continuations.....................................................................

New/Competing.................................................................

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

Total, Grants to Prevent Prescription Drug/Opioid

First Responder Training (CARA) 

Grants 

Continuations.....................................................................

New/Competing.................................................................

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

Contracts 

Continuations.....................................................................

New/Competing.................................................................

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

Total, First Responder Training (CARA)

124 12,538 

29 5,569 

141 16,781 

11 1,433 

106 12,192 

30 9,033 

153 18,107 152 18,214 136 21,225 

 --- 1,022 

1 1,513

1 2,536 

 --- ---

1 2,440 

 --- ---

1 2,535 1 2,536 1 2,440 

154 20,642 

 --- ---

 --- ---

153 20,750 

 --- ---

 --- ---

137 23,665 

2 406 

5 1,036 

 --- --- --- --- 7 1,441 

 --- ---

 --- ---

 --- ---

 --- ---

 --- 59 

 --- ---

 --- --- --- --- --- 59 

 --- ---

 --- ---

 --- ---

 --- ---

 --- ---

 --- ---

7 1,500 

20 17,230 

 --- ---

 --- --- --- --- 20 17,230 

 --- ---

 --- ---

 --- ---

 --- ---

 --- 704 

 --- 66 

 --- --- --- --- --- 770 

 --- --- --- --- 20 18,000 

 --- ---

 --- ---

 --- ---

 --- ---

26 10,792 

115 54,066 

 --- --- --- --- 141 64,858 

 --- ---

 --- ---

 --- ---

 --- ---

 --- 2,642 

 --- ---

 --- --- --- --- --- 2,642 

 --- --- --- --- 141 67,500 

217 
SAMHSA-Substance Use Prevention Services 

PRNS Mechanism Table 

Program, Project, and Activity 

(Dollars in thousands) 

Science and Service: 

FY 2021 

Final 

FY 2022 

Enacted 

FY 2023 

President's 

Budget 

No. Amount No. Amount No. Amount 

Center for the Application of Prevention Technologies 

Grants 

Continuations..................................................................... 

New/Competing.................................................................

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

Contracts 

Continuations.....................................................................

New/Competing.................................................................

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

Total, Center for the Application of Prevention Technol 

SAP Minority Fellowship Program 

Grants 

Continuations..................................................................... 

New/Competing.................................................................

Supplements*.....................................................................

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

Contracts 

Continuations.....................................................................

New/Competing.................................................................

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

Total, SAP Minority Fellowship Program 

Science & Service Program Coordination 

Grants 

Continuations..................................................................... 

New/Competing.................................................................

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

Contracts 

Continuations..................................................................... 

New................................................................................... 

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

Total, Science & Service Program Coordination 

Subtotal, Science and Service 

13 7,124 

 --- ---

13 7,124

 --- ---

 --- ---

13 11,524 

13 7,124 13 7,124 13 11,524 

 --- 369

 --- ---

 --- 369

 --- ---

 --- 469 

 --- ---

 --- 369 --- 369 --- 469 

13 7,493 

8 305 

 --- ---

 --- ---

13 7,493 

8 305 

 --- ---

 --- ---

13 11,993 

1 239 

7 1,049 

 --- ---

8 305 8 305 8 1,288 

 --- 16

 --- 313

 --- 16

 ---

 --- 52 

 --- ---

--- 16 --- 16 --- 52 

8 321 

2 396 

 --- ---

8 321 

1 368 

 --- ---

8 1,340 

1 352 

 --- ---

2 396 1 368 1 352 

1 2,223 

2 1,534 

2 1,498 

1 2,205

4 3,651 

 --- 69 

3 3,757 3 3,704 4 3,720 

5 4,153 4 4,072 5 4,072 

26 11,967 25 11,886 26 17,405 

Total, Substance Use Prevention 764 $208,219 776 $208,219 970 $311,912 

218 
SAMHSA-Substance Use Prevention Services 

Grant Awards Table 

(Whole dollars) 

FY 2021 Final FY 2022 CR FY 2023 

President's Budget 

Number of Awards 749 763 956 

Average Award $244,061 $240,300 $297,538 

Range of Awards $50,000 - $2,300,000 $50,000 - $2,300,000 $50,000 - $2,300,001 

219 
 

 

SAMHSA-Substance Use Services 

Substance Use Services 

Table of Contents 

1. Summary of the Request................................................................................................. 221 

2. Programs of Regional and National Significance (PRNS) ............................................. 223 

a) Opioid Treatment Programs/Regulatory Activities ............................................ 224 

b) Screening, Brief Intervention, and Referral to Treatment .................................. 228 

c) Targeted Capacity Expansion-General ............................................................... 232 

d) Pregnant and Postpartum Women....................................................................... 238 

e) Recovery Community Services Program............................................................ 242 

f) Children and Families......................................................................................... 244 

g) Treatment Systems for Homeless ....................................................................... 247 

h) Minority AIDS.................................................................................................... 250 

i) Criminal Justice Activities.................................................................................. 253 

j) Building Communities of Recovery (BCOR)..................................................... 262 

k) Minority Fellowship Program............................................................................. 265 

l) Improving Access to Overdose Treatment ......................................................... 270 

m) First Responder Training for Opioid Overdose Reversal Drugs ........................ 270 

n) Grants to Prevent Prescription Drug/Opioid Overdose Related Deaths ............. 270 

o) Peer Support Technical Assistance Center ......................................................... 271 

p) Emergency Department Alternatives to Opioids ................................................ 274 

q) Comprehensive Opioid Recovery Centers.......................................................... 279 

r) Opioid Response Grants ..................................................................................... 282 

3. PRNS Mechanism Table................................................................................................. 283 

4. Grant Awards Table........................................................................................................ 291 

5. State Opioid Response Grants ........................................................................................ 292 

6. Substance Abuse Prevention and Treatment Block Grant.............................................. 300 

220 
 

 

 

SAMHSA-Substance Use Services 

Substance Use Services 

Summary of the Request 

(Dollars in thousands) 

FY 2021 FY 2022 FY 2023 

Final

 COVID-19 

Supplemental/ 

1 CR 

President's 

Budget 

FY 2023 

+/- FY 2022 

Programs of Regional and National Significance.................. 

PHS Evaluation Funds (non-add).......................................... 

State Opioid Response Grants............................................... 

Set-Aside for Tribes (non-add)............................................. 

Substance Use Prevention and Treatment Block Grant.......... 

 Budget Authority (non-add)................................................. 

PHS Evaluation Funds (non-add).......................................... 

$495,117

2,000 

1,498,030 

50,000 

1,849,654 

1,770,454 

79,200 

 $---

---

---

---

3,150,000 

3,150,000 

---

$496,677 

2,000 

1,500,000 

50,000 

1,858,079 

1,778,879 

79,200 

$566,364 

2,000 

2,000,000 

75,000 

3,008,079 

2,928,879 

79,200 

69,687 

---

500,000 

25,000 

1,150,000

1,150,000 

---

Total, Substance Use Services $3,842,801 $3,150,000 $3,854,756 $5,574,443 $1,719,687 

FTE 37 131 122 -9 

1/Supplemental funding was appropriated in HSPS but allocated to SUS to execute. 

The Substance Use Services FY 2023 President’s Budget Request is $5.6 billion, an increase of 

$1.7 billion from the FY 2022 Annualized Continuing Resolution. 

SAMHSA’s Center for Substance Use Services (CSUS) manages over 269 formula and 

discretionary grant programs with approximately 1,214 grantee entities throughout the nation. 

The Center’s programs fund interventions across the continuum of care from prevention to harm 

reduction, treatment, and recovery services, with the broad goals of saving and improving lives, 

and recognizing the often long-term nature of substance use disorders The budget 

proposes increasing access to quality care and services for substance use disorders and addressing 

the overdose crisis for individuals, families, and communities —especially as it relates to opioid 

and stimulant use disorders. 

CSUS’s budget focuses on continuing investments not only in individuals and families impacted 

by substance use across the lifespan but also across diverse communities including pregnant and 

post-partum people and their children, individuals with substance use disorders who encounter the 

criminal justice system, and individuals specifically seeking treatment and recovery support 

services for heroin, fentanyl, and other opioids. SAMHSA’s substance use disorder budget funds 

direct services, infrastructure development, system capacity building, and training and technical 

assistance efforts for service integration, quality improvement, and workforce development. 

CSUS’s programs involve multiple systems beyond the specialty behavioral health system, such 

as primary healthcare, school, child welfare, criminal and juvenile justice, and housing systems. 

Programs central to CSUS’s direct services and encompassing the majority of the Center’s current 

and proposed budgets, include the State Opioid Response (SOR) and Tribal Opioid Response 

(TOR) grants as well as the Substance Abuse Prevention and Treatment Block Grants (SAPT BG). 

The $5.0 billion of proposed funds across these three programs provide a foundation for states, 

tribes, tribal nations, and territories to create a safety net of substance use disorder care across 

harm reduction, treatment, and recovery support services. Additional CSUS programs support 

direct funding to behavioral health workforce and community organizations to expand and enhance 

treatment and recovery support services in different settings and for a range of priority populations. 

221 
 

 

 

 

 

 

SAMHSA-Substance Use Services 

This allows grant recipients to focus on meeting their community’s unique needs. Workforce 

shortages is one of the greater challenges facing many behavioral health providers today. CSUS 

grants provide significant training and technical assistance opportunities to connect health 

professional students and practitioners with the behavioral health and addiction medicine/addiction 

psychiatry field. Funding also supports innovative delivery of pharmacologic therapies for opioid 

use disorder under CSUS’s regulatory framework. With the COVID-19 pandemic driving 

regulatory flexibility, CSUS is identifying lessons learned to apply to revisions of regulations that 

may further improve access to care, maximize the current workforce, and help attract other 

practitioners to the field. 

CSUS’s programs prevent overdose; promote children and youth behavioral health; integrate 

primary and substance use disorder health care; and uses performance measures, data, and 

evaluation to guide decision-making. CSUS’s strategies aim to improve access and reduce barriers 

to quality care and reduce the stigma of substance use disorders, which often prevents individuals 

from receiving needed services to promote recovery. 

CSUS’s programs support the framework of a coordinated, integrated continuous care model of 

substance use disorder services. To achieve this, the programs work to: 1) drive the integration of 

behavioral health into the healthcare system to strengthen and expand access to mental and 

substance use disorder treatment and recovery services for individuals and families; 2) bolster the 

health workforce to ensure delivery of quality services and care; 3) enhance the promotion of 

healthy behaviors to reduce occurrence and disparities in preventable injury, illness, and 

death; expand access to high-quality services and resources for older adults and people with 

disabilities, and their caregivers to support increased independence and quality of life; and 4) 

improve the design, delivery, and outcomes of HHS programs by prioritizing science, evidence, 

and inclusion (due to the emphasis on funding programs using evidence-based practices). 

222 
 

SAMHSA-Substance Use Services 

Substance Use Services 

Programs of Regional and National Significance (PRNS) 

(Dollars in thousands) 

Programs of Regional and National Significance 

FY 2021 FY 2022 FY 2023 

Final 

COVID-19 

Supplemental CR 

President's 

Budget 

FY 2023 +/-

FY 2022 

Capacity: 

Opioid Treatment Programs/Regulatory Activities 

Screening, Brief Intervention and Referral to Treatment 

Budget Authority (non-add)......................................................................... 

PHS Evaluation Funds (non-add)................................................................ 

Targeted Capacity Expansion-General............................................................. 

Other Targeted Capacity Expansion.......................................................... 

MAT for Prescription Drug and Opioid Addiction (non-add).................... 

 MAT for Prescription Drug and Opioid Addiction (Tribes)(non-add) 

Pregnant and Postpartum Women...................................................................... 

Recovery Community Services Program.......................................................... 

Improving Access to Overdose Treatment2..................................................... 

Building Communities of Recovery.................................................................. 

Children and Families...................................................................................... 

Treatment Systems for Homeless...................................................................... 

Minority AIDS.................................................................................................. 

Criminal Justice Activities............................................................................... 

Other Criminal Justice Activities (non-add)............................................... 

Drug Court Activities(non-add)................................................................... 

Grants to Prevent Prescription Drug/Opioid Overdose-Related Deaths2......... 

Peer Support TA Center................................................................................... 

Treatment, Recovery, and Workforce Support.................................................. 

Emergency Department Alternatives to Opioids............................................... 

Grants to Develop Curricula for DATA Act Waivers 

Opioid Response Grants.................................................................................. 

Comprehensive Opioid Recovery Centers....................................................... 

First Responder Training (CARA)2................................................................. 

First Responder Training (non-add)........................................................... 

Rural Set-Aside (non-add)........................................................................... 

Subtotal, Capacity 

$7,216

29,698 

27,698 

2,000 

102,331 

11,331 

91,000 

11,000 

32,767 

2,512 

1,068 

10,013 

29,479 

36,386 

65,561 

89,000 

18,981 

70,019 

11,833 

999 

6,089 

5,908 

---

3,000 

3,614 

42,389 

18,000 

24,000 

 $---

---

---

---

---

---

---

---

---

---

---

---

---

---

---

---

---

---

---

---

---

---

---

---

---

---

---

---

$8,724 

30,000 

28,000 

2,000 

102,192 

11,192 

91,000 

11,000 

32,931 

2,434 

1,000 

10,000 

29,605 

36,386 

65,570 

89,000 

19,000 

70,000 

12,000 

1,000 

6,000 

6,000 

---

3,000 

4,000 

42,000 

18,000 

24,000 

$13,086 

30,560 

28,560 

2,000 

147,916 

11,416 

136,500 

16,500 

49,397 

5,151 

---

20,000 

30,197 

37,114 

66,881 

124,380 

19,380 

105,000 

---

1,500 

9,000 

9,000 

---

---

6,000 

---

---

---

$4,362 

560 

560 

---

45,724 

224 

45,500

5,500 

16,466 

2,717 

 -1,000 

10,000 

592 

728 

1,311 

35,380 

380 

35,000 

 -12,000 

500 

3,000 

3,000 

---

 -3,000 

2,000 

 -42,000 

 -18,000 

 -24,000 

479,864 --- 481,842 550,182 68,340 

Science and Service: 

SAT Minority Fellowship Programs................................................................ 

Addiction Technology Transfer Centers........................................................... 

Subtotal, Science and Service 

5,789 

9,465 

---

---

5,789 

9,046 

7,136 

9,046 

1,347 

---

15,254 --- 14,835 16,182 1,347 

Total, PRNS $495,117 $--- $496,677 $566,364 $69,687 

223 
 

 

 

 

 

SAMHSA-Substance Use Services 

Opioid Treatment Programs/Regulatory Activities 

(Dollars in thousands) 

FY 2021 FY 2022 FY 2023 

Programs of Regional & National Significance Final 

COVID-19 

Supplemental CR 

President's 

Budget 

FY 2023 

+/- FY 2022 

Opioid Treatment Programs/Regulatory Activities............... $7,216 $--- $8,724 $13,086 $4,362 

Authorizing Legislation .............................................Section 509 of the Public Health Service Act 

FY 2023 Authorization ..................................................................................................................$0 

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

Eligible Entities.............................................................. American Society of Addiction Medicine, 

...............American Academy of Addiction Psychiatry, American Medical Association, American 

...........Osteopathic Association, American Psychiatric Association, American Dental Association 

..........................Domestic Medical Schools, Physician Assistant Schools, and Schools of Nursing 

Program Description and Accomplishments 

Our nation faces a crisis of overdose deaths from opioids, including heroin, illicit fentanyl, and 

prescription opioids. These deaths represent a fraction of the total number of Americans harmed 

by opioid misuse and opioid use disorder (OUD). An estimated 1.4 million Americans have OUD 

related to opioid painkillers and 438 thousand have heroin-related OUD.75 Expanding access to 

medication for opioid use disorder (MOUD) is an important public health strategy and is central 

to the U.S. Department of Health and Human Services Overdose Prevention Strategy.76 

A focus of SAMHSA’s budget is closing the gap between the number of people needing treatment 

for OUD and the capacity to treat them with MOUD. MOUD refers to the use of the Food and 

Drug Administration (FDA) approved medications (e.g., buprenorphine, methadone, and 

naltrexone products) to treat opioid use disorder. These medications are often used in combination 

with additional evidence-based treatment and recovery support services. 

Critical policy tools SAMHSA employs to expand access to MOUD include: 

• Oversight of Opioid Treatment Programs (OTPs)--the only means of providing MOUD 

with methadone; 

• Provision of waivers to allow qualified health care practitioners to provide MOUD with 

buprenorphine in an office-based setting such as primary care; and 

• Education and training of health care students and practitioners for treatment of OUD, 

including MOUD, via universities and professional organizations. 

75 Center for Behavioral Health Statistics and Quality. (2020). Results from the 2019 National Survey on Drug Use 

and Health: Detailed tables. Rockville, MD: Substance use And Mental Health Services Administration. Retrieved 

May 21, 2021, from www.samhsa.gov/data/

76 Overdose Prevention Strategy. https://www.hhs.gov/overdose-prevention/treatment. 2021 

224 
 

 

 

 

 

 

 

 

SAMHSA-Substance Use Services 

MOUD in Opioid Treatment Programs 

OTPs are critical to expanding access to OUD treatment. SAMHSA is responsible for regulating 

and certifying the country's OTPs. Oversight of the OTP certification process includes oversight 

of the various accrediting organizations, or accrediting bodies (ABs) and their review of OTPs. 

SAMHSA also provides direct support (information and technical assistance) to OTPs, healthcare 

systems and states regarding certification, accreditation and MOUD treatment. 

During 2021 alone, 94 new OTPs were certified and 27 either closed or merged with other OTPs, 

bringing the total number of OTPs in this country to 1895 serving over 650,000 clients. This is a 

significant increase from in 2010, when there were 1,216 OTPs and in 2017 when there were 1371. 

Accrediting organizations must be approved by SAMHSA, and SAMHSA monitors these for 

quality assurance and improvement by making site visits to a percentage of programs that received 

accreditation review within that year. Currently, CSUS holds agreements with six accrediting 

bodies serving the nation’s OTPs. 

SAMHSA meets regularly with the state opioid treatment authorities (SOTAs) that provide 

oversight of OTPs in their respective state. SAMHSA provides technical assistance, guidance and 

support for issues related to MOUD, such as assisting state officials in evaluating state 

requirements and adherence to the federal regulations for OTPs and promoting evidence-based 

substance use disorder treatment and related care through discussion of scientific strategies 

implementation and review of the standards applied by the Accrediting Bodies. 

These responsibilities and interactions enable SAMHSA to address barriers to treatment and 

promote means of expanding access to services. For example, on March 16, 2020, SAMHSA 

issued an exemption to OTPs whereby a state could request “a blanket exception for all stable 

patients in an OTP to receive 28 days of Take-Home doses of the patient’s medication for opioid 

use disorder” or “up to 14 days of Take-Home medication for those patients who are less stable”. 

Almost two years since this exemption was granted, states, OTPs, and other stakeholders report 

that this has resulted in increased treatment engagement and improved patient satisfaction with 

care.77 Given this positive evidence, SAMHSA granted OTPs an extension of this exemption, 

effective upon the expiration of the COVID-19 Public Health Emergency78 . 

To address geographic and sociodemographic barriers to accessing OTP services, SAMHSA 

issued guidance on mobile and non-mobile medication units following the June 28, 2021, 

publication of the Drug Enforcement Administration final rule allowing OTPs the option of adding 

a mobile component to their existing registration. This will expand the reach of OTPs, improve 

geographic access, and enhance the provision of treatment to disparate populations.79 

77 Amram O, Amiri S, Panwala V, Lutz R, Joudrey PJ, Socias E. The impact of relaxation of methadone take-home 

protocols on treatment outcomes in the COVID-19 era. Am J Drug Alcohol Abuse. 2021 Oct 20:1-8. doi: 

10.1080/00952990.2021.1979991. Epub ahead of print. PMID: 34670453. 78 Methadone Take-Home Flexibilities Extension Guidance https://www.samhsa.gov/medication-assistedtreatment/statutes-regulations-guidelines/methadone-guidance 79 Letter to State Substance Abuse Directors on mobile medication untis: 

225 
 

 

SAMHSA-Substance Use Services 

MOUD in Office-Based Health Care Settings 

Buprenorphine can be prescribed in an office setting by qualified health care practitioners who 

have received a waiver under the Drug Addiction Treatment Act of 2000 (DATA 2000). Initially, 

only physicians were allowed to provide office based MOUD treatment with buprenorphine. In 

November 2016, the Comprehensive Addiction and Recovery Act (CARA) widened the field to 

allow nurse practitioners (NPs) and physician assistants (PAs) to prescribe buprenorphine This 

was followed in October 2018 by the Substance Use Disorder Prevention that Promotes Opioid 

Recovery and Treatment for Patients and Communities (SUPPORT) Act which made this 

allowance permanent and expanded prescribing privileges to Clinical Nurse Specialists (CNSs), 

Certified Registered Nurse Anesthetists (CRNAs), and Certified Nurse Midwives (CNMs) until 

October 1, 2023. 

Recognizing increasing deaths from opioid overdose during the pandemic, HHS released Revised 

Practice Guidelines for the Administration of Buprenorphine for Treating Opioid Use Disorder. 

Effective April 28, 2021, the guidelines exempt eligible providers from federal certification 

requirements related to training, counseling, and providing ancillary services and allows them to 

obtain a waiver treat up to 30 patients at any given time with buprenorphine80 . These requirements 

have been cited as a barrier to obtaining a waiver, and the Practice Guidelines are designed to 

expand access to treatment while also reducing stigma around treatment activities. As of April 28, 

2021, there were a total of 97,880 practitioners certified to prescribe buprenorphine. That number 

increased to a total of over 116,600 by February 1, 2022. During this period of April-February, 

SAMHSA certified more than 18,000 more practitioners to prescribe buprenorphine for OUD. 

MOUD Education and Training of Providers 

Medical students and physicians play a pivotal role in educating their patients and colleagues about 

substance use and substance use disorders; screening, diagnosing, and treating patients; and 

modeling positive attitudes to reduce the stigma attached to substance use disorders (SUD). A 

lack of preparedness has been identified as a barrier in the provision of buprenorphine to patients 

with opioid use disorder by early career family physicians81, and a lack of appropriate education 

has also been shown to foster negative attitudes towards the provision of MOUD. 82 

Comprehensive and uniform training on SUDs, and treatment and recovery modalities have the 

potential to overcome these deficits and positively impact graduates and their patients. SAMHSA 

promotes provider education through its grants and programs, including the Provider’s Clinical 

https://www.samhsa.gov/sites/default/files/2021-letter-state-authorities-mobile.pdf August 2021 

OTP Directors, SOTAs and State Directors on mobile medication untis: 

https://www.samhsa.gov/sites/default/files/2021-letter-mobile-component.pdf September 2021 80 Revised practice guidelines. Federal Register, Vol. 86, No. 80, April 28, 2021. 

https://www.govinfo.gov/content/pkg/FR-2021-04-28/pdf/2021-08961.pdf

81 DeFlavio JR, Rolin SA, Nordstrom BR, Kazal LA, Jr. Analysis of barriers to adoption of buprenorphine 

maintenance therapy by family physicians. Rural & Remote Health. 201515:3019. 

82 Mackey K, Veazie S, Anderson J, Bourne D, and Peterson K. Evidence Brief: Barriers and Facilitators to Use of 

Medications for Opioid Use Disorder. Washington, DC: Evidence Synthesis Program, Health Services Research and 

Development Service, Office of Research and Development, Department of Veterans Affairs. 2019 

226 
 

 

 

 

 

 

 

SAMHSA-Substance Use Services 

Support System (PCSS) – Universities and PCSS-MAT. PCSS-U promotes SUD education in 

professional schools and aims to engage students in treating OUD upon graduation. The PCSSMAT program expands the number of licensed providers completing training requirements for 

prescribing MOUD and provides mentoring and other supports for practitioners treating OUD. 

There remains a significant need to increase the number of healthcare providers prepared to address 

the nation’s need for increased access to care and treatment for opioid and other substance use 

disorders. The PCSS programs will continue to provide up-to-date and evidence-based 

information to support the training of health professionals and to address the complex issues of 

addiction. 

The number of students trained to prescribe MOUD by PCSS-U and PCSS-MAT programs 

CY End PCSS-U PCSS-MAT 

2019 2160 28,921 

2020 7115 47,179 

2021 6064 35,196 

Total 15, 339 111,296 

In FY 2021, SAMHSA funded 27 new grants, one PCSS-MAT continuation grant and two 

contracts. 

In FY 2022, SAMHSA anticipates funding six new and 27 continuation PCSS-U grants, 

supplemental funding for PCSS-MAT, and two contracts. 

Five Year Funding Table 

Fiscal Year Amount 

COVID-19 

Supplemental 

Funding 

FY 2019 $8,724,000 

FY 2020 $8,724,000 

FY 2021 Final $7,215,668 

FY 2022 CR $8,724,000 

FY 2023 President's Budget $13,086,000 

Budget Request 

The FY 2023 President’s Budget request is $13.1 million, an increase of 4.4 million from the FY 

2022 Annualized Continuing Resolution. SAMHSA will award 17 new and 33 continuation 

PCSS-U grants, two new PCSS-MAT grants, and two contracts. 

227 
 

 

 

 

 

SAMHSA-Substance Use Services 

Screening, Brief Intervention, and Referral to Treatment 

(Dollars in thousands) 

FY 2021 FY 2022 FY 2023 

Programs of Regional & National Significance Final

 COVID-19 

Supplemental CR 

President's 

Budget 

FY 2023 

+/- FY 2022 

Screening, Brief Intervention and Referral to Treatment....... 

Budget Authority (non-add).......................................... 

PHS Evaluation Funds (non-add).................................... 

$29,698

27,698

2,000

 $---

 ---

 ---

$30,000 

28,000 

2,000 

$30,560 

28,560 

2,000

$560 

560 

 ---

Authorizing Legislation .............................................Section 509 of the Public Health Service Act 

FY 2023 Authorization ..................................................................................................................$0 

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

Eligible Entities...................................... Single State Authority and Health Departments in States, 

.........Territories, the District of Columbia, Federally Recognized American Indian/Alaska Native 

...........................Tribes or Tribal Organizations, Domestic Public and Private Non-Profit Entities, 

............................................................................. and Public and Private Universities and Colleges 

Program Description and Accomplishments 

Among individuals aged 12 or older in 2020, 162.5 million (58.7 percent) used tobacco, alcohol, 

or an illicit drug in the past month. 83 Among the 138.5 million current alcohol users age 12 or 

older, 61.6 million (44.4 percent) were binge drinkers. Among past month binge drinkers, 17.7 

million people (28.8 percent of current binge drinkers and 12.8 percent of current alcohol users) 

were past month heavy drinkers. This imposes a great cost on society by compromising individual 

health and potentially causing injury to others. The National Institute on Drug Abuse found that 

misuse of illicit drugs, tobacco, and alcohol costs society $740 billion each year (September 15, 

2020). 84 Of the individuals who need treatment for substance use disorder, only 10 percent 

received specialty treatment for their condition.3 The vast majority meeting criteria for having a 

drug/alcohol substance use disorder have not been diagnosed. 

In 2003, SAMHSA started the Screening, Brief Intervention and Referral to Treatment (SBIRT) 

program, which includes state implementation grants intended to help primary care physicians 

identify individuals who misuse substances and help them intervene early with education, brief 

treatment, or referral to specialty treatment if that is needed. The program’s goals are to reduce 

the rate of substance misuse, intervene early to prevent progression to more severe illness, and 

increase the number of individuals with a substance use disorder who receive treatment. Studies 85,86,87 have long shown that this approach is effective in helping reduce harmful alcohol consumption.

83 2020 NSDUH Annual National Report https://www.samhsa.gov/data/report/2020-nsduh-annual-national-report 84 National Institute on Drug Abuse (2017), Trends and Statistics, http://www.drugabuse.gov/related-topics/trendsstatistics. 

85 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. 86 Kahan, M., Wilson, L., & Becker, L. (1995). Effectiveness of physician-based interventions with problem 

drinkers: A review. Canadian Medical Association Journal, 152, 851–859. 87 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. 

228 
 

 

SAMHSA-Substance Use Services 

The SBIRT program requires state grant recipients to implement the model in all primary care 

settings, as well as hospitals, trauma centers, federally qualified health centers, and other relevant 

health care settings. Recipients may use funds to screen for substance use and co-occurring mental 

illness and drug/alcohol substance use disorder. They can support evidence-based client-centered 

interventions, such as Motivational Interviewing, brief treatment, and referral to specialty care for 

individuals exhibiting symptoms of substance use disorder. The population of focus is adults and 

adolescents seeking medical attention and intervention in primary care and other health care 

settings. 

The SBIRT Student Training and Health Professionals Training grant programs support SBIRT 

training efforts for medical students, medical residents, nurses, social workers, psychologists, 

pharmacists, dentists, and physician assistants. These efforts aim to develop further the primary 

healthcare workforce in substance use disorder treatment and services. 

Below represents the six National Outcome Measures (NOMS) for CSUS. The NOMS are based 

in GPRA survey instruments for all discretionary grant programs. These data help SAMHSA 

create a national picture of substance misuse to build evidence to support program outcomes 

associated with SAMHSA grants. 

During FY 2021, 143,482 clients were served in the SBIRT program. Based on 143,482 client 

intakes assessments, and 1,654 client six-month follow-up reassessments, the following National 

Outcome Measures are reported: 

Screening, Brief Intervention and 

Referral to Treatment (SBIRT) 

At Intake At 6-months % increase in the 

number of clients 

reporting 

(n=143,482) (n=1,654) 

No past 30-day use alcohol/illegal drugs 5.20% 45.70% 779.50% 

No past 30-day arrest 98.10% 99.40% 13.20% 

Past 30-day employment or school 

attendance 

33.90% 41.40% 22.20% 

No past 30-day experience with alcohol or 

drug related health, behavioral, or social 

consequences 

24.20% 53.40% 120.70% 

Past 30-day socially connectedness 60.20% 70.00% 16.30% 

Past 30-day permanent place to live in the 

community 

63.60% 55.10% -13.40% 

Source SAMHSA’ Performance Accountability and Reporting System (SPARS). Data current as of December 7, 

2021. Limitations: There are several limitations to the program evaluation including (but not limited to) incomplete 

data, self-report, and selection bias. 

In FY 2021, SBIRT funded 11 new grants and 16 continuations. 

In FY 2022, SBIRT anticipates funding 27 continuation grants. 

229 
 

 

 

 

 

SAMHSA-Substance Use Services 

Five Year Funding Table 

Fiscal Year Amount 

COVID-19 

Supplemental 

Funding 

FY 2019 $27,854,000 

FY 2020 $30,000,000 

FY 2021 Final $29,698,399 

FY 2022 CR $30,000,000 

FY 2023 President's Budget $30,560,000 

Budget Request 

The FY 2023 President’s Budget request is $30.6 million, an increase of $560,000 from the FY 

2022 Annualized Continuing Resolution. SAMHSA plans to award four new grants and 24 

continuations. 

230 
 

 

SAMHSA-Substance Use Services 

Outputs and Outcomes Table 

Program: Screening, Brief Intervention and Referral to Treatment 

Measure Year and Most Recent 

Result / 

Target for Recent Result / 

(Summary of Result) 

FY 2022 

Target 

FY 2023 

Target 

FY 2023 

Target 

+/-FY 2022 

Target 

1.2.40 The number of 

clients served (Output) 

FY 2021: 143,482 

Target: 

78,000 

(Target Exceeded) 

143,482 144,917 +1,435 

1.2.41 Percentage of 

clients receiving 

services who had no 

past month substance 

use (Outcome) 

FY 2021: 45.7 % 

Target: 

41 % 

(Target Exceeded) 

45.7 % 46.7 % +1% point(s) 

231 
 

 

 

 

SAMHSA-Substance Use Services 

Targeted Capacity Expansion-General 

(Dollars in thousands) 

FY 2021 FY 2022 FY 2023 

Programs of Regional & National Significance Final

 COVID-19 

Supplemental CR 

President's 

Budget 

FY 2023 

+/- FY 2022 

Targeted Capacity Expansion-General.................................. 

Other Targeted Capacity Expansion............................ 

MAT for Prescription Drug and Opioid Addiction (nonMAT for Prescription Drug and Opioid Addiction 

$102,331

11,331 

91,000 

11,000 

 $---

---

---

---

$102,192 

11,192 

91,000 

11,000 

$147,916 

11,416 

136,500 

16,500 

$45,724 

224 

45,500 

5,500 

Authorizing Legislation ........................................... Sections 509 of the Public Health Service Act 

FY 2023 Authorization ..................................................................................................................$0 

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

Eligible Entities........................................Domestic Public and Private Non-Profit Entities, States, 

................................................. Opioid Medication-Assisted SPF Rx Treatment Service Providers, 

....................................... Outpatient Substance use Providers, Community Mental Health Centers, 

............Federally Qualified Health Centers, SAMHSA Certified Opioid Treatment Programs, and 

....................................................................Licensed Outpatient Substance Use Services Programs 

Program Description and Accomplishments 

Urgent, unmet, and emerging substance use disorder treatment and recovery support service 

capacity needs remain a critical issue for the nation. To assist communities in overcoming these 

barriers, SAMHSA initiated the Targeted Capacity Expansion (TCE) program. The programs 

provide rapid, strategic, comprehensive, and integrated community-based responses to gaps in and 

capacity for substance use disorder treatment and recovery support services. Examples of such 

needs include limited or no access to medication for opioid use disorders (MOUD); lack of 

resources needed to adopt and implement health information technology (HIT) in substance use 

disorder 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) 

The MAT-PDOA program addresses treatment needs of individuals who have an opioid use 

disorder (OUD) by expanding/enhancing treatment system capacity to provide accessible, 

effective, comprehensive, coordinated/integrated, and evidence-based Medications for OUD 

(MOUD) and recovery support services. 

MOUD refers to the use of the Food and Drug Administration-approved pharmacotherapies (i.e., 

buprenorphine products, methadone, and naltrexone products) for the treatment of OUD. 

Medications are often combined with evidence-based psychosocial interventions tailored to an 

individual’s needs. This approach is a safe and effective strategy for decreasing the frequency and 

quantity of opioid misuse and reducing the risk of overdose and death. Recovery support services 

include linking patients and families to social, legal, housing, and other supports to improve 

retention in care and increase the probability of positive outcomes. 

Among people aged 12 or older in 2020, 3.4 percent (or 9.5 million people) misused opioids in the 

232 
 

 

 

SAMHSA-Substance Use Services 

past year.88 CDC provisional data indicates that there were an estimated 100,306 drug overdose 

deaths in the United States during 12-month period ending in April 2021, an increase of 28.5 

percent from the 78,056 deaths during the same period the year before. Synthetic opioids, 

including illicitly manufactured fentanyl, were involved in 64 percent of >100,000 estimated U.S. 

drug overdose deaths during May 2020–April 2021. Despite gains, opioid overdose deaths 

increased in 2021 by 26 percent underscoring the risks of potent illicit synthetic opioids and need 

to continue to engage people in a continuum of harm reduction, treatment, and recovery services.89 

The aim of the state MAT-PDOA continuation grants is to increase the number of individuals 

receiving services with FDA-approved MOUD; increase the number of individuals receiving 

integrated care; decrease the illicit opioid drug use at 6-month follow-up; and decrease prescription 

opioid use in a non-prescribed manner at 6-month follow-up. 

During FY 2021, 12,641 clients were served in the MAT-PDOA program. Based on 12,461 client 

intakes assessments, and 3,453 client six-month follow-up reassessments, the following National 

Outcome Measures are reported: 

Medication-Assisted Treatment for 

Prescription Drug and Opioid Addiction 

(MAT-PDOA) 

At Intake At 6-months % increase in the 

number of clients 

reporting (n=12,461) (n=3,453) 

No past 30-day use alcohol/illegal drugs 38.50% 60.70% 57.60% 

No past 30-day arrest 93.40% 97.80% 4.80% 

Past 30-day employment or school 

attendance 

39.90% 43.30% 44.90% 

No past 30-day experience with alcohol or 

drug related health, behavioral, or social 

consequences 

56.70% 77.20% 36.20% 

Past 30-day socially connectedness 86.40% 89.70% 3.80% 

Past 30-day permanent place to live in the 

community 

42.80% 50.40% 17.80% 

Source SAMHSA’ Performance Accountability and Reporting System (SPARS). Data current as of December 7, 

2021. Limitations: There are several limitations to the program evaluation including (but not limited to) incomplete 

data, self-report, and selection bias. 

In FY 2021, SAMHSA funded 127 new and 30 continuation grants. 

In FY 2022, SAMHSA anticipates funding 30 new grants for five years and 122 continuation 

grants (five of these grants are on a 3-year grant cycle and 117 are on a five-year grant cycle). 

https://www.samhsa.gov/data/sites/default/files/reports/rpt35325/NSDUHFFRPDFWHTMLFiles2020/2020NSDUH 

FFR1PDFW102121.pdf

89 https://www.cdc.gov/nchs/pressroom/nchs_press_releases/2021/20211117.htm 

233 

88 
 

SAMHSA-Substance Use Services 

Targeted Capacity Expansion – Special Projects 

In FY 2019, SAMHSA funded 23 grantees through the inaugural Targeted Capacity ExpansionSpecial Projects program. The purpose of this program is to develop and implement targeted 

strategies for the provision of substance use disorder (SUD) or co-occurring disorder treatment to 

support an underserved population or unmet need identified by the community. It enables a 

community to identify the specific need or population it wishes to assist through the provision of 

evidence-based substance use disorder treatment and/or recovery support services. In FY 2021, 

SAMHSA funded 23 continuation grants (3-year cycle) and three new grantees. 

The initial TCE- Special Projects notice of funding opportunity received a substantial number of 

applications due to its flexibility in allowing grantees to identify the community and/or unmet need 

to be addressed in their community. The flexibility resulted in a cohort that is implementing 

projects focused on various areas or underserved populations such as: opioid use disorder, 

methamphetamine use disorder, co-occurring disorders, recovery housing, those engaged in the 

criminal justice system, pregnant and post-partum women, LGBTQ+, and youth. 

During FY 2021, 2,533 clients were served in the TCE-SP program. Based on 2,533 client intakes 

assessments, and 1,388 client six-month follow-up reassessments, the following National Outcome 

Measures are reported: 

TCE-SP At Intake At 6-months % increase in the 

number of clients 

reporting (n=2,533) (n=1,388) 

No past 30-day use alcohol/illegal drugs 47.40% 62.40% 31.70% 

No past 30-day arrest 96.30% 98.70% 2.50% 

Past 30-day employment or school 

attendance 

47.30% 61.30% 29.70% 

No past 30-day experience with alcohol or 

drug related health, behavioral, or social 

consequences 

80.20% 89.60% 11.70% 

Past 30-day socially connectedness 66.50% 68.20% 2.50% 

Past 30-day permanent place to live in the 

community 

45.40% 51.90% 14.30% 

Source SAMHSA’ Performance Accountability and Reporting System (SPARS). Data current as of December 7, 

2021. Limitations: There are several limitations to the program evaluation including (but not limited to) incomplete 

data, self-report, and selection bias. 

In FY 2021, SAMHSA funded three new and 23 continuation TCE-SP grants. In FY 2022, 

SAMHSA anticipates funding 22 new and three continuation TCE-SP grants. 

234 
 

 

 

 

 

SAMHSA-Substance Use Services 

Five Year Funding Table 

Fiscal Year Amount 

COVID-19 

Supplemental 

Funding 

FY 2019 $100,192,000 

FY 2020 $100,192,000 

FY 2021 Final $102,331,321 

FY 2022 CR $102,192,000 

FY 2023 President's Budget $147,916,000 

Budget Request 

The FY 2023 President’s Budget request is $147.9 million, an increase of $45.7 million from the 

FY 2022 Annualized Continuing Resolution. SAMHSA continues to support the TCE-Special 

Projects and MAT PDOA grants. SAMHSA will fund 25 continuation TCE-Special Projects 

grants. Also, SAMHSA plans to fund 56 new and 157 MAT PDOA continuation grants, making 

MAT services accessible to 40 percent more individuals suffering from OUD. 

235 
 

 

SAMHSA-Substance Use Services 

Outputs and Outcomes Table 

Program: Medication-Assisted Treatment for Prescription Drug and Opioid Addiction 

Measure Year and Most Recent 

Result / 

Target for Recent Result / 

(Summary of Result) 

FY 2022 

Target 

FY 2023 

Target 

FY 2023 

Target 

+/-FY 2022 

Target 

1.3.01 Number of 

admissions for 

Medication Assisted 

Treatment (Output) 

FY 2021: 12461 

Target: 

2500 

(Target Exceeded) 

12461 12586 +125 

1.3.03 Illicit drug use at 

6-month follow-up 

(Outcome) 

FY 2021: 61 % 

Target: 

67 % 

(Target Exceeded) 

61 % 62 % +1 % point(s) 

236 
SAMHSA-Substance Use Services 

Program: Treatment-Targeted Capacity Expansion: Other 

Measure Year and Most Recent 

Result / 

Target for Recent Result / 

(Summary of Result) 

FY 2022 

Target 

FY 2023 

Target 

FY 2023 

Target 

+/-FY 2022 

Target 

1.2.25 Percentage of 

adults receiving 

services who had no 

past month substance 

use (Outcome) 

FY 2021: 62 % 

Target: 

63 % 

(Target Not Met) 

62 % 63 % +1 percentage 

point(s) 

1.2.26 Number of 

clients served (Output) 

FY 2021: 2,815 

Target: 

1,357 

(Target Exceeded) 

2,815 2,844 +29 

1.2.27 Percentage of 

adults receiving 

services who were 

currently employed or 

engaged in productive 

activities (Outcome) 

FY 2021: 59.1 % 

Target: 

48 % 

(Target Exceeded) 

59.1 % 60.1 % +1 percentage 

point(s) 

1.2.28 Percentage of 

adults receiving 

services who had a 

permanent place to live 

in the community 

(Outcome) 

FY 2021: 53.3 % 

Target: 

54 % 

(Target Not Met) 

53.3 % 54.3 % +1 percentage 

point(s) 

1.2.29 The percentage 

of adults receiving 

services who had no 

involvement with the 

criminal justice system 

(Outcome) 

FY 2021: 98.7 % 

Target: 

98 % 

(Target Exceeded) 

98.7 % 99.7 % +1 percentage 

point(s) 

237 
 

 

 

 

SAMHSA-Substance Use Services 

Pregnant and Postpartum Women 

(Dollars in thousands) 

FY 2021 FY 2022 FY 2023 

Programs of Regional & National Significance Final

 COVID-19 

Supplemental CR 

President's 

Budget 

FY 2023 

+/- FY 2022 

Pregnant and Postpartum Women........................................... $32,767 $--- $32,931 $49,397 $16,466 

Authorizing Legislation.................................. Section 508 of the Public Health Service Act 

FY 2023 Authorization ..................................................................................................$29,931,000 

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

Eligible Entities.................................................... Domestic Public and Private Non-Profit Entities 

Program Description and Accomplishments 

Since 2003, the Pregnant and Postpartum Women program (PPW) has used a family-centered 

approach to provide comprehensive residential substance use disorder treatment, prevention, and 

recovery support services for pregnant and postpartum women, their minor children, and for other 

family members (e.g., fathers of the children). Section 501 of the Comprehensive Addiction and 

Recovery Act (CARA) increased accessibility and availability of services for pregnant women by 

expanding the authorized purposes of the PPW program to include the provision of outpatient and 

intensive outpatient services for pregnant women. CARA requires that twenty-five percent of all 

PPW funds are required to fund the pilot. 

The PPW program provides services not covered under most public and private insurance. 

Pregnant and Postpartum Women – Residential Treatment (PPW-R) 

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. The PPW familycentered approach includes a variety of services and case management for women, children, and 

families. Services provided to women include: outreach; engagement; screening and assessment; 

withdrawal management; substance misuse education; substance use disorder treatment; relapseprevention; 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 

linkages to treatment of hepatitis, HIV/AIDS, and other sexually transmitted diseases. 

Services available to children include screening and developmental diagnostic assessments 

addressing social, emotional, cognitive, and physical well-being; and interventions related to 

mental, emotional, and behavioral wellness. 

Services for families are family-focused programs that support family strengthening and 

reunification, 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. 

238 
 

 

 

SAMHSA-Substance Use Services 

In FY 2021, SAMHSA funded 43 continuation residential treatment grants and supplements for 

direct technical assistance. In FY 2022, SAMHSA anticipates funding 19 new residential 

treatment grants and 24 continuation grants, and supplements for direct technical assistance. 

The PPW program has demonstrated benefits in the following: increasing access to medications 

for substance use disorders, mental disorders, and primary health conditions; integrating peer 

recovery approaches to engage and retain women in care; incorporating home visiting as part of 

the continuum of care, and as a key strategy to extend services to support recovery; and providing 

opportunities to increase access to care for diverse populations of women, particularly for those 

living in rural and remote locations in southern states. 

In FY 2021, the PPW program served 1,312 women. Of the women served: 

• 37.7 percent used methamphetamine, 

• 31.5 percent used marijuana, 

• 18.5 percent used heroin 

• 18.3 percent used alcohol 

• 14.9 percent used cocaine/crack 

Based on 1,312 client intake assessments, and 425 client six-month follow-up reassessments the 

following National Outcome Measures are reported: 

Pregnant and Postpartum Women -

Residential 

At Intake At 6-months % increase in the 

number of clients 

reporting (n=1,312) (n=425) 

No past 30-day use alcohol/illegal drugs 32.10% 86.10% 168.70% 

No past 30-day arrest 86.50% 98.60% 13.90% 

Past 30-day employment or school 

attendance 

8.00% 35.30% 341.20% 

No past 30-day experience with alcohol or 

drug related health, behavioral, or social 

consequences 

40.20% 82.30% 104.80% 

Past 30-day socially connectedness 90.80% 94.80% 4.40% 

Past 30-day permanent place to live in the 

community 

19.60% 27.40% 39.80% 

Source SAMHSA’ Performance Accountability and Reporting System (SPARS). Data current as of February 11, 

2022. Limitations: There are several limitations to the program evaluation including (but not limited to) incomplete 

data, self-report, and selection bias. 

Pregnant and Postpartum Women – Pilot (PPW-PLT) 

Section 501 of the Comprehensive Addiction and Recovery Act (CARA) increased accessibility 

and availability of services for pregnant women by expanding the authorized purposes of the PPW 

program to include the provision of outpatient and intensive outpatient services for pregnant 

women. CARA requires that twenty-five percent of all PPW funds are required to fund the pilot. 

Historically, the PPW program has only supported the provision of residential treatment services. 

239 
 

 

 

 

 

 

 

 

 

 

SAMHSA-Substance Use Services 

In FY 2021, SAMHSA funded four new and five PPW-PLT continuation grants. In FY 2022, 

SAMHSA anticipates funding nine PPW-PLT continuation grants. 

In FY 2021, the PPW Pilot program served 392 women: 

• 24.1 percent used marijuana or hashish 

• 11.5 percent used methamphetamines 

• 10.8 percent used alcohol 

• 5.8 percent used cocaine/crack 5.0 percent used heroin 

Based on 392 client intakes assessments, and 107 client six-month follow-up reassessments the following National 

Outcome Measures are reported: 

Pregnant and Postpartum Women - Pilot At Intake At 6-months % increase in the 

number of clients 

reporting (n=392) (n=107) 

No past 30-day use alcohol/illegal drugs 55.20% 79.20% 43.10% 

No past 30-day arrest 95.30% 98.10% 2.90% 

Past 30-day employment or school 

attendance 

22.60% 43.40% 91.70% 

No past 30-day experience with alcohol or 

drug related health, behavioral, or social 

consequences 

80.60% 99.00% 22.80% 

Past 30-day socially connectedness 92.50% 93.40% 1.00% 

Past 30-day permanent place to live in the 

community 

36.40% 43.00% 17.90% 

Source SAMHSA’ Performance Accountability and Reporting System (SPARS). Data current as of February 11, 

2022. Limitations: There are several limitations to the program evaluation including (but not limited to) incomplete 

data, self-report, and selection bias. 

Five Year Funding Table 

Fiscal Year Amount 

COVID-19 

Supplemental 

Funding 

FY 2019 $29,931,000 

FY 2020 $31,931,000 

FY 2021 Final $32,766,850 

FY 2022 CR $32,931,000 

FY 2023 President's Budget $49,397,000 

Budget Request 

The FY 2023 President’s Budget request is $49.4 million, an increase of $16.5 million from the 

FY 2022 Annualized Continuing Resolution. SAMHSA plans to award eight new PPW- pilot 

grants, four pilot continuation grants; 42 new residential treatment grants, and 26 residential 

treatment continuation grants to provide an array of services and supports to pregnant women and 

their families. 

240 
 

 

 

SAMHSA-Substance Use Services 

Outputs and Outcomes Table 

Program: Pregnant and Postpartum Women Program 

Measure Year and Most Recent 

Result / 

Target for Recent Result / 

(Summary of Result) 

FY 2022 

Target 

FY 2023 

Target 

FY 2023 

Target 

+/-FY 2022 

Target 

1.2.84 Number of 

admissions of women who 

are currently pregnant or 

have a child to Substance 

Use Services programs 

(Output) 

FY 2021: 1,312 

Target: 

1,700.0 

(Target Not Met) 

1,312 1,929.0 +617 

1.2.85 Percentage of PPW 

clients reporting no drug use 

in the past month at sixmonth follow-up (Outcome) 

FY 2021: 86.8 % 

Target: 

90.0 

(Target Not Met) 

86.8 % 87.0 % +0.2 % 

1.2.86 Percentage of PPW 

clients who reported 

substance misuse at intake, 

percent who report reduction 

in substance misuse at sixmonth follow-up (Outcome) 

FY 2021: 78.6 % 

Target: 

94.0 % 

(Target Not Met) 

78.9 % 79.6 % +0.7 % 

1.2.87 Percentage of PPW 

clients who reported 

child/children not living 

with client at intake, percent 

who report child/children is 

living with client at sixmonth follow-up (Outcome) 

FY 2021: 49.9 % 

Target: 

55.0 % 

(Target Not Met) 

50.0 % 51.0 % +1 % 

1.2.88 Number of PPW-PLT 

women who are currently 

pregnant or have a child 

who receive SUD and 

related treatment services 

(Outcome) 

FY 2021: 392.0 

Target: 

380.0 

(Target Exceeded) 

394.0 576.0 +182 

241 
 

 

 

 

 

SAMHSA-Substance Use Services 

Recovery Community Services Program 

(Dollars in thousands) 

FY 2021 FY 2022 FY 2023 

Programs of Regional & National Significance Final

 COVID-19 

Supplemental CR 

President's 

Budget 

FY 2023 

+/- FY 2022 

Recovery Community Services Program............................... $2,512 $--- $2,434 $5,151 $2,717 

Authorizing Legislation .............................................Section 509 of the Public Health Service Act 

FY 2023 Authorization ..................................................................................................................$0 

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

Eligible Entities.......................................................... Family/Consumer Controlled Organizations, 

...............Domestic Public and Private Non-Profit Organizations in States, Territories, and Tribes, 

Recovery Community Organizations of Domestic Private Non-Profit Entities in States, 

.................................................................................................Territories, and Tribal Organizations 

Program Description and Accomplishments 

In 2020, 40.3 million people aged 12 or older had an SUD in the past year, including 28.3 million 

with alcohol use disorder, 18.4 million with an illicit drug use disorder, and 6.5 million with both 

alcohol use disorder and an illicit drug use disorder.90 As public education increases, there is 

broader acknowledgement of substance use disorder as a treatable condition that can be 

successfully managed over the course of a lifetime with the appropriate resources. More people 

in recovery are now willing to be open about their own recovery and to share their experience to 

help others attempting to achieve recovery. Through the use of their lived experience, individuals 

in recovery can provide support and hope to those newly seeking recovery. 

RCSP was designed to assist recovery communities to strengthen their infrastructure and provide 

peer recovery support services to those in or seeking recovery from substance use disorders across 

the nation. The delivery of recovery support services (RSS) by people in recovery is known as 

peer recovery support services (PRSS). SAMHSA initiated the RCSP to help build an 

infrastructure for PRSS programs to support the development and expansion of peer recovery 

services. These peer services are most frequently offered by Recovery Community Organizations 

(RCOs). 

Though the RCSP was a services program from 2002-2010, it was evident that this approach 

needed to be taken system-wide to have a broader effect. The infusion of these services into state 

systems ensures the wide scale adoption of peer recovery support. By developing a workforce of 

trained and certified peers, and engaging RCOs in the full continuum of treatment and recovery 

services, states have the ability to enhance their systems to ensure holistic approaches to care. 

90 Substance use And Mental Health Services Administration. (2019). 2018 National Survey on Drug Use and 

Health: Methodological summary and definitions. Rockville, MD: Center for Behavioral Health Statistics and 

Quality, Substance use And Mental Health Services Administration. Retrieved from https://www.samhsa.gov/data/ 

242 
 

 

 

 

 

 

 

SAMHSA-Substance Use Services 

During 2021, 615 clients were served in the RCSP-Services program. Based on 615 client intakes 

assessments, and 432 client six-month follow-up reassessments the following National Outcome 

Measures are reported: 

Recovery Community Services Program 

(RCSP) - Services 

At Intake At 6-months % increase in the 

number of clients 

reporting 

(n=615) (n=432) 

No past 30-day use alcohol/illegal drugs 68.40% 78.00% 14.00% 

No past 30-day arrest 96.50% 98.40% 1.90% 

Past 30-day employment or school attendance 34.00% 55.30% 62.60% 

No past 30-day experience with alcohol or drug 

related health, behavioral, or social 

consequences 

79.60% 85.50% 7.40% 

Past 30-day socially connectedness 91.80% 90.70% -1.30% 

Past 30-day permanent place to live in the 

community 51.60% 60.50% 17.10% 

Source SAMHSA’ Performance Accountability and Reporting System (SPARS). Data current as of February 11, 

2022. Limitations: There are several limitations to the program evaluation including (but not limited to) incomplete 

data, self-report, and selection bias. 

In FY 2021, SAMHSA funded two new RCSP and six continuation RCSP grants. In FY 2022, 

SAMHSA anticipates funding eight RCSP continuation grants. 

Five Year Funding Table 

Fiscal Year Amount 

COVID-19 

Supplemental 

Funding 

FY 2019 $2,434,000 

FY 2020 $2,434,000 

FY 2021 Final $2,512,107 

FY 2022 CR $2,434,000 

FY 2023 President's Budget $5,151,000 

Budget Request 

The FY 2023 President’s Budget request is $5.2 million, an increase of $2.7 million from the 

FY 2022 Annualized Continuing Resolution. SAMHSA plans to award four new and eight 

continuation RCSP grants, and four new RCSP-Statewide Network (SN) grants. SAMHSA starts 

supporting the RCSP-SN program again in FY 2023. This will allow SAMHSA to continue the 

efforts of building substance use disorder recovery networks throughout the nation and the 

collaboration among peer-run organizations. 

243 
 

 

 

 

SAMHSA-Substance Use Services 

Children and Families 

(Dollars in thousands) 

FY 2021 FY 2022 FY 2023 

Programs of Regional & National Significance Final

 COVID-19 

Supplemental CR 

President's 

Budget 

FY 2023 

+/- FY 2022 

Children and Families........................................................... $29,479 $--- $29,605 $30,197 $592 

Authorizing Legislation ............................. Sections 509 and 514 of the Public Health Service Act 

FY 2023 Authorization ............................................................................................................$0, $0 

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

Eligible Entities...............................................................................Single State Agencies in States, 

..........................................Territories, District of Columbia, public and private non-profit entities, 

...................... Federally Recognized American Indian/Alaska Native Tribes Tribal Organizations, 

........................... and health facilities or programs operated by or in accordance with a contract or 

................................................................................................. grant with the Indian Health Service 

Program Description and Accomplishments 

SAMHSA’s programs to treat youth with substance use and co-occurring substance use and mental 

disorders address gaps in service delivery. SAMHSA supports a youth treatment initiative to 

further the use of, and access to, evidence-based family-focused models for youth with alcohol 

and/or other substance use. In addition, it supports training across participating states and 

collaboration between local community-based providers and their state, tribal, or territorial 

infrastructure. The services provided include evidence-based assessment, treatment, prevention, 

and harm reduction interventions appropriate for adolescents and transition-age youths. 

Services for Adolescents, Transitional Aged Youth, and their Families (YFTREE) 

During FY 2021, 1,706 clients were served through the YFTREE Program. Based on 1,706 client 

intakes assessments, and 757 client six-month follow-up reassessments the following National 

Outcome Measures are reported: 

Youth and Family Tree (YFTREE) 

At Intake At 6-months % increase in the 

number of clients 

reporting (n=1,706) (n=757) 

No past 30-day use alcohol/illegal drugs 38.70% 61.00% 57.60% 

No past 30-day arrest 94.10% 97.90% 4.00% 

Past 30-day employment or school attendance 71.40% 78.40% 9.80% 

No past 30-day experience with alcohol or drug 

related health, behavioral, or social 

consequences 

75.90% 85.70% 12.80% 

Past 30-day socially connectedness 75.50% 78.70% 4.20% 

Past 30-day permanent place to live in the 

community 57.50% 63.60% 10.60% 

Source: SAMHSA’ Performance Accountability and Reporting System (SPARS). Retrieved February 11, 2021, from 

http://spars.samhsa.gov. Limitations: There are several limitations to the program evaluation including (but not 

limited to) incomplete data, self-report, and selection bias. 

244 
 

 

 

 

 

 

SAMHSA-Substance Use Services 

National Center on Substance Abuse and Child Welfare 

SAMHSA and the Administration for Children and Families (ACF) collaborate to support the 

National Center on Substance Abuse and Child Welfare (NCSACW). NCSACW provides training 

and technical assistance (TA) to improve collaborative practices among agencies and organizations 

that serve families affected by substance use disorders and involvement with child welfare 

services. This interagency agreement was established in 2002 and has been in place ever since. 

It is important to note that in early 2021, ACF made the decision to have the NCSACW program 

operate out of their Op-Div to include the NCSACW website which SAMHSA currently hosts. In 

March 2022, ACF will start management of a 5-year contract to support the NCSACW program. 

SAMHSA/CSUS will continue to partner with ACF in this effort bringing along CSUPS as a 

partner in this interagency agreement. 

In FY 2021, SAMHSA funded 18 new and 35 Youth and Family Tree (YFTREE) continuation 

grants. In FY 2022, SAMHSA anticipates funding 53 continuation grants. 

Five Year Funding Table 

Fiscal Year Amount 

COVID-19 

Supplemental 

Funding 

FY 2019 $29,605,000 

FY 2020 $29,605,000 

FY 2021 Final $29,479,473 

FY 2022 CR $29,605,000 

FY 2023 President's Budget $30,197,000 

Budget Request 

The FY 2023 President’s Budget request is $30.2 million, an increase of $592,000 from the FY 

2022 Annualized Continuing Resolution. SAMHSA plans to award 31 new and 22 continuation 

Youth and Family Tree grants. These grants will continue to support states and tribes who have 

not previously received funds under this initiative, and to address the gaps in substance use disorder 

treatment by providing services for youth, their families, and caregivers. 

245 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

SAMHSA-Substance Use Services 

Outputs and Outcomes Table 

Program: Enhancement and Expansion of Treatment and Recovery for Adolescents, 

Transitional Aged Youth, and their Families 

Measure Year and Most Recent 

Result / 

Target for Recent Result 

/ 

(Summary of Result) 

FY 2021 

Target 

FY 2023 

Target 

FY 2023 

Target 

+/-FY 2021 

Target 

2.00.2 Percentage of 

adults receiving 

services who had no 

past substance use 

(Outcome) 

FY 2021: 60.9% 

Target: 

58.2 % 

Target Met 

62% 63% +1% 

2.00.3 Number of 

clients served (Output) 

FY 2021: 1,706 

Target: 

1,889.0 

Target Not Met 

1,706 1,723 1% 

2.00.4 Percentage of 

adults receiving 

services who were 

currently employed or 

engaged in productive 

activities (Outcome) 

FY 2021: 78.4% 

Target: 

79.0 % 

(Baseline) Target Not Met 

79.0 % 80.0 % +1% 

2.00.5 Percentage of 

adults receiving 

services who had a 

permanent place to live 

in the community 

(Outcome) 

FY 2021: 63.6% 

Target: 

63.0 % 

Target Met 

64% 65% +1% 

2.00.6 Percentage of 

adults receiving 

services who had no 

involvement with the 

criminal justice system 

(Outcome) 

FY 2021: 97.9% 

Target: 

98.0 % 

Target Met 

99% 100% +1% 

246 
 

 

 

 

 

 

SAMHSA-Substance Use Services 

Treatment Systems for Homeless 

(Dollars in thousands) 

FY 2021 FY 2022 FY 2023 

Programs of Regional & National Significance Final

 COVID-19 

Supplemental CR 

President's 

Budget 

FY 2023 

+/- FY 2022 

Treatment Systems for Homeless........................................... $36,386 $--- $36,386 $37,114 $728 

Authorizing Legislation .............................................Section 506 of the Public Health Service Act 

FY 2023 Authorization ..................................................................................................................$0 

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

Eligible Entities........................................ States, Domestic Public and Community Organizations, 

.............................. Private Nonprofit Entities, and Community-based Public or Nonprofit Entities 

Program Description and Accomplishments 

On a single night in January 2020, 580,466 people were experiencing homelessness in the United 

States. Of these, 120,323 were experiencing chronic homelessness, 120,642 had severe mental 

illness, 98,646 were affected by chronic substance use, and 37,252 were veterans.91 Many factors 

contribute to the problem of homelessness, including lack of affordable housing, foreclosures, 

rising housing costs, job loss, underemployment, mental illness, and drug/alcohol misuse. The 

U.S. Interagency Council on Homelessness, in which HHS participates, has set aggressive goals 

to prevent and end homelessness. These goals include ending homelessness among veterans, 

people with disabilities, families with children, families, youth, and all other individuals. 

SAMHSA’s Treatment Systems for Homeless portfolio supports services for those with substance 

use disorders or co-occurring mental and substance use disorders who are experiencing 

homelessness, including youth, veterans, and families. The services and support offered through 

SAMHSA’s Treatment Systems for Homeless programs are crucial to achieving U.S. Interagency 

Council on Homelessness’s goals. 

SAMHSA manages the following Treatment Systems for Homeless grant programs: 

Grants for the Benefit of Homeless Individuals (GBHI) 

The GBHI program supports the development and/or expansion of local implementation of a 

community infrastructure that integrates treatment and recovery support services for substance use 

disorders or co-occurring mental and substance use disorders, permanent housing, and other 

critical services for individuals (including youth) and families experiencing homelessness. 

91 U.S. Department of Housing and Urban Development (HUD) 2020 Continuum of Care (CoC) Homeless 

Assistance Programs Homeless Populations and Subpopulations Report – Retrieve from 

https://files.hudexchange.info/reports/published/CoC_PopSub_NatlTerrDC_2020.pdf 

247 
 

 

 

 

 

 

 

SAMHSA-Substance Use Services 

In FY 2021, 4,003 clients were served through the GBHI Program. Based on 4,003 client intakes 

assessments, and 1,733 client six-month follow-up reassessments the following National Outcome 

Measures are reported: 

Grants for the Benefit of Homeless 

Individuals (GBHI) 

At Intake At 6-months % increase in the 

number of clients 

reporting 

(n=4,003) (n=1,733) 

No past 30-day use alcohol/illegal drugs 43.60% 55.60% 30.70% 

No past 30-day arrest 96.50% 96.80% 0.30% 

Past 30-day employment or school attendance 20.50% 35.90% 74.80% 

No past 30-day experience with alcohol or drug 

related health, behavioral, or social 

consequences 

68.80% 79.20% 15.10% 

Past 30-day socially connectedness 70.80% 77.70% 9.70% 

Past 30-day permanent place to live in the 

community 9.30% 30.90% 232.50% 

Source: SAMHSA’ Performance Accountability and Reporting System (SPARS). Retrieved December 3, 2021, from 

http://spars.samhsa.gov. Limitations: There are several limitations to the program evaluation including (but not 

limited to) incomplete data, self-report, and selection bias. 

In FY 2021, SAMHSA funded 85 continuations grants and supplements for direct technical 

assistance for 72 of the 85 continuation grants. 

In FY 2022, SAMHSA anticipates funding 17 new grants and 68 continuation grants and 

supplements for direct technical assistance for 55 of the 68 continuation grants. 

Five Year Funding Table 

Fiscal Year Amount 

COVID-19 

Supplemental 

Funding 

FY 2019 $36,386,000 

FY 2020 $36,386,000 

FY 2021 Final $36,386,000 

FY 2022 CR $36,386,000 

FY 2023 President's Budget $37,114,000 

Budget Request 

The FY 2023 President’s Budget request is $37.1 million, an increase of $728,000 from the FY 

2022 Annualized Continuing Resolution. SAMHSA intends to fund 37 new and 52 GBHI 

continuation grants with grant supplements for direct technical assistance for 22 of the 55 

continuation grants. SAMHSA plans to support grants to provide services to nearly 5,000 people 

experiencing homelessness. 

248 
 

 

SAMHSA-Substance Use Services 

Outputs and Outcomes Table 

Program: Treatment System for Homelessness (GBHI) 

Measure Year and Most Recent 

Result / 

Target for Recent Result / 

(Summary of Result) 

FY 2022 

Target 

FY 2023 

Target 

FY 2023 

Target 

+/-FY 2022 

Target 

3.4.23 The number of 

clients served (Output) 

FY 2021: 4003 

Target: 

3634 

(Target Exceeded) 

4003 4043 +40 

3.4.24 Percentage of 

homeless clients 

receiving services who 

were currently employed 

or engaged in productive 

activities (Outcome) 

FY 2021: 35.9 % 

Target: 

34.4 % 

(Target Exceeded) 

35.9 % 36.9 % +1% point(s) 

3.4.25 Percentage of 

clients receiving services 

who had a permanent 

place to live in the 

community (Outcome) 

FY 2021: 30.9 % 

Target: 

30.3 % 

(Target Exceeded) 

30.9 % 41.9 % +11%point(s) 

249 
 

 

 

SAMHSA-Substance Use Services 

Minority AIDS 

(Dollars in Thousands) 

FY 2021 FY 2022 FY 2023 

Programs of Regional & National Significance Final

 COVID-19 

Supplemental CR 

President's 

Budget 

FY 2023 

+/- FY 2022 

Minority AIDS....................................................................... $65,561 $--- $65,570 $66,881 $1,311 

Authorizing Legislation.................................. Section 509 of the Public Health Service Act 

FY 2023 Authorization ..................................................................................................................$0 

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

Eligible Entities.................................................... Domestic Public and Private Non-Profit Entities 

Program Description and Accomplishments 

The purpose of the Minority AIDS or Targeted Capacity Expansion for Substance Abuse 

Treatment and HIV/AIDS Services (TCE-HIV) program is to increase engagement in care for 

racial and ethnic minority individuals with substance use disorders (SUD) and/or co-occurring 

substance use and mental disorders (COD) who are at risk for or living with HIV/AIDS and receive 

HIV services and treatment. Populations of focus for the TCE-HIV programs include African 

American, Hispanic/Latina, and other racial/ethnic minority women ages 18 years and older; 

black young men who have sex with men (YMSM) (ages 18-29); other high-risk populations such 

as Latino YMSM and men who have sex with men (MSM) (ages 30 years and older); and gay, 

bisexual, and transgender individuals who have a SUD or COD, are HIV positive or at risk for 

HIV/AIDS and hepatitis. 

In FY 2021, 9,984 clients were served through SAMHSA’s TCE-HIV Program. Based on 9,984 

client intakes assessments, and 3,982 client six-month follow-up reassessments the following 

National Outcome Measures are reported: 

Minority AIDS 

At Intake At 6-months % increase in the 

number of clients 

reporting 

(n=9,984) (n=3,982) 

No past 30-day use alcohol/illegal drugs 28.90% 50.10% 73.20% 

No past 30-day arrest 96.80% 98.70% 1.90% 

Past 30-day employment or school attendance 41.40% 55.40% 33.80% 

No past 30-day experience with alcohol or drug 

related health, behavioral, or social 

consequences 

63.60% 81.00% 27.30% 

Past 30-day socially connectedness 67.40% 72.20% 7.10% 

Past 30-day permanent place to live in the 

community 48.60% 55.60% 14.40% 

Source: SAMHSA’ Performance Accountability and Reporting System (SPARS). Retrieved December 13, 2021, from 

http://spars.samhsa.gov. Limitations: There are several limitations to the program evaluation including (but not limited to) 

incomplete data, self-report, and selection bias. 

250 
 

 

 

 

 

 

SAMHSA-Substance Use Services 

In FY 2021, SAMHSA funded 121 TCE-HIV continuation grants and supplements for direct 

technical assistance. 

In FY 2022, SAMHSA anticipates funding 61 new and 62 TCE-HIV continuation grants. 

Five Year Funding Table 

Fiscal Year Amount 

COVID-19 

Supplemental 

Funding 

FY 2019 $65,570,000 

FY 2020 $65,570,000 

FY 2021 Final $65,560,870 

FY 2022 CR $65,570,000 

FY 2023 President's Budget $66,881,000 

Budget Request 

The FY 2023 President’s Budget request is $66.9 million, an increase of $1.3 million from the FY 

2022 Annualized Continuing Resolution. SAMHSA plans to award 41 new grants and 87 TCEHIV continuation grants. 

251 
 

 

 

 

SAMHSA-Substance Use Services 

Outputs and Outcomes Table 

Program: Treatment: Minority AIDS Initiative- Targeted Capacity Expansion-HIV 

Measure Year and Most Recent 

Result / 

Target for Recent Result 

/ 

(Summary of Result) 

FY 2022 

Target 

FY 2023 

Target 

FY 2023 

Target 

+/-FY 2022 

Target 

2.1.11 Percentage of 

adults receiving 

services who had no 

past month substance 

use at 6-month followup (Outcome) 

FY 2021: 50.1 

Target: 

47.9 

(Target Exceeded) 

50.1 51.1 +1 

2.1.12 Number of 

clients served (Output) 

FY 2021: 9,984.0 

Target: 

8,388.0 

(Target Exceeded) 

9,984.0 10,084.0 +100 

2.1.13 Percentage of 

adults receiving 

services who were 

currently employed or 

engaged in productive 

activities at 6-month 

follow-up (Outcome) 

FY 2021: 55.4 

Target: 

44.0 

(Target Exceeded) 

55.4 56.4 +1 

2.1.14 Percentage of 

adults receiving 

services who had a 

permanent place to live 

in the community at 6-

month follow-up 

(Outcome) 

FY 2021: 55.6 

Target: 

54.0 

(Target Exceeded) 

55.6 56.6 +1 

2.1.15 Percentage of 

adults receiving 

services who had no 

involvement with the 

criminal justice system 

at 6-month follow-up 

(Outcome) 

FY 2021: 98.7 

Target: 

99.0 

(Target Not Met) 

98.7 99.7 +1 

252 
 

 

 

 

SAMHSA-Substance Use Services 

Criminal Justice Activities 

(Dollars in thousands) 

FY 2021 FY 2022 FY 2023 

Programs of Regional & National Significance Final

 COVID-19 

Supplemental CR 

President's 

Budget 

FY 2023 

+/- FY 2022 

Criminal Justice Activities.................................................... 

Other Criminal Justice Activities (non-add)................ 

Drug Court Activities (non-add)...................................... 

$89,000

18,981 

70,019 

 $---

---

---

$89,000 

19,000 

70,000 

$124,380 

19,380 

105,000 

$35,380 

380 

35,000 

Authorizing Legislation .............................................Section 509 of the Public Health Service Act 

FY 2023 Authorization ..................................................................................................................$0 

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

Eligible Entities............................... Domestic Public and Private Non-Profit Entities, Operational 

............................. Individual Misdemeanor and Felony Adult Criminal Courts, Municipal Courts, 

.......... Tribal, State, Local Government Proxies, Government with Direct Involvement with Adult 

.. Criminal Courts, Tribal Organizations, and Individual Adult Tribal Healing to Wellness Courts, 

.... and Public or private universities and colleges and Community- and faith-based organizations. 

Program Description and Accomplishments 

SAMHSA’s Criminal Justice portfolio includes several grant programs that focus on diversion, 

alternatives to incarceration, drug courts, and re-entry from incarceration for adolescents and 

adults with drug/alcohol misuse and/or co-occurring drug/alcohol misuse and mental illness. 

Referral Source for Substance Use Disorder Treatment 

The criminal justice system is a major source of referrals to substance use disorder treatment, with 

probation or parole referrals representing the largest proportion of criminal justice system referrals 

to treatment.92 Most probation or parole referrals to treatment are men between the ages of 18 and 

44. The most common substances reported by these referrals are alcohol, marijuana, and 

methamphetamine.93 

Drug Courts 

More than half (58 percent) of state prisoners and two-thirds (63 percent) of sentenced jail inmates 

met diagnostic criteria for a substance use disorder (using Diagnostic and Statistical Manual 

92 Substance use And Mental Health Services Administration, Center for Behavioral Health Statistics and Quality. 

Treatment Episode Data Set (TEDS): 2005-2015. National Admissions to Substance Abuse Treatment Services. 

BHSIS Series S-91, HHS Publication No. (SMA) 17-5037. Rockville, MD: Substance Abuse and Mental Health 

Services Administration, 2017. 

93 SAMHSA. (2015). Criminal and Juvenile Justice. Retrieved from http://www.samhsa.gov/criminal-juvenilejustice 

253 
 

 

 

 

 

SAMHSA-Substance Use Services 

Version IV), according to data collected 2007-2009.94 An estimated 42 percent of state prisoners 

and 49 percent of jail inmates met the criteria for both a mental illness and a substance use 

disorder.95 

Drug Court Purpose 

Drug courts are designed to combine the sanctioning power of courts with effective treatment 

services for a range of populations with circumstances that have put them in contact with the 

criminal justice system. This could be circumstances related to alcohol and/or other drug use 

and/or mental illness. Drug courts represent the coordinated efforts of the judiciary, prosecution, 

defense bar, probation, law enforcement, mental health, social service, and substance use disorder 

treatment communities to intervene and break the cycle of substance use disorder and crime. 

Drug Court Services 

SAMHSA’s Adult Treatment Drug Court (ATDC) programs support a variety of services 

including direct treatment services for diverse populations, wraparound, and recovery support 

services such as recovery housing and peer recovery support services designed to improve access 

to and retention in care, drug test monitoring for illicit substances, educational support, relapse 

prevention and long-term management skills development, and HIV and viral hepatitis B and C 

testing conducted in accordance with state and local requirements. 

Medications for Opioid Use Disorder (MOUD) 

SAMHSA’s grant programs are encouraged to use part of their annual award to provide 

Medications for Opioid Use Disorder (MOUD) and are required to ensure that drug courts funded 

by SAMHSA not deny the use of Food and Drug Administration (FDA)-approved medications for 

opioid use disorder by drug court clients. Drug courts funded in FY 2021 are required to provide 

MOUD services, with judicial discretion in certain situations. Practitioners involved in the drug 

court program who are eligible by law to obtain a Drug Abuse Treatment Act (DATA) waiver 

must do so. 

SAMHSA requires the use of evidence-based practices from federal resource access points. 

SAMHSA also has regular communications with the National Association of Drug Court 

Professionals to obtain and incorporate the latest findings and field expertise. 

94 Bronson, J., Stroop, J., Zimmer, S. & Berzofshi, M., (2017). Drug Use, Dependence, and Abuse Among State 

prisoners and jail Inmates, 2007-2009. Washington, D.C.: Bureau of Justice Statistics. Available: 

https://www.bjs.gov/content/pub/pdf/dudaspji0709.pdf

95 James, D. J., & Glaze, L. E. (2006). Highlights mental health problems of prison and jail inmates. Retrieved 

from https://www.bjs.gov/index.cfm?ty=pbdetail&iid=789 

254 
SAMHSA-Substance Use Services 

In FY 2021, 5,148 clients were served through SAMHSA’s Adult Treatment Drug Court 

Programs. Based on 5,148 client intakes assessments, and 3,029 client six-month follow-up 

reassessments the following National Outcome Measures are reported: 

Adult Treatment Drug Courts 

At Intake At 6-months % increase in the 

number of clients 

reporting 

(n=5,148) (n=3,029) 

No past 30-day use alcohol/illegal drugs 63.10% 85.10% 35.00% 

No past 30-day arrest 89.31% 95.10% 6.80% 

Past 30-day employment or school attendance 43.60% 63.80% 46.20% 

No past 30-day experience with alcohol or drug 

related health, behavioral, or social 

consequences 

79.10% 91.70% 16.00% 

Past 30-day socially connectedness 88.80% 94.40% 6.30% 

Past 30-day permanent place to live in the 

community 35.90% 46.40% 29.30% 

Source: SAMHSA’ Performance Accountability and Reporting System (SPARS). Retrieved February 11, 2022, from 

http://spars.samhsa.gov. Limitations: There are several limitations to the program evaluation including (but not 

limited to) incomplete data, self-report, and selection bias. 

Criminal Justice Drug Court and Reentry funded programs expand and enhance substance use 

disorder (SUD) treatment services to adults involved in the Criminal Justice system. They provide 

recovery support services, screening, assessment, case management, and program coordination to 

individuals to facilitate successful reentry to their communities. The desired outcome is to break 

the cycle of criminal behavior, alcohol and/or drug use, and incarceration or other penalties, and 

encourage stable work and home environments. 

Family Treatment Drug Courts 

The purpose of the Family Treatment Drug Court (FTDC) program is to expand substance use 

disorder (SUD) treatment services in existing family treatment drug courts, which use the family 

treatment drug court model in order to provide alcohol and drug treatment (including recovery 

support services, screening, assessment, case management, and program coordination) to parents 

with a SUD and/or co-occurring SUD and mental disorders, who have had a dependency petition 

filed against them or are at risk of such filing. 

In FY 2021, 1,277 clients were served through SAMHSA’s Family Drug Court programs. Based 

on 1,277 client intakes assessments, and 764 client six-month follow-up reassessments the 

following National Outcome Measures are reported: 

255 
 

 

SAMHSA-Substance Use Services 

Family Treatment Drug Courts 

At Intake At 6-months % increase in the 

number of clients 

reporting 

(n=1,277) (n=764) 

No past 30-day use alcohol/illegal drugs 53.50% 78.70% 47.30% 

No past 30-day arrest 94.90% 97.10% 2.20% 

Past 30-day employment or school attendance 35.80% 51.90% 45.00% 

No past 30-day experience with alcohol or drug 

related health, behavioral, or social 

consequences 

68.90% 81.30% 17.90% 

Past 30-day socially connectedness 94.10% 95.90% 1.80% 

Past 30-day permanent place to live in the 

community 47.90% 54.60% 13.90% 

Source: SAMHSA’ Performance Accountability and Reporting System (SPARS). Retrieved February 11, 2022, from 

http://spars.samhsa.gov. Limitations: There are several limitations to the program evaluation including (but not 

limited to) incomplete data, self-report, and selection bias. 

In FY 2021, SAMHSA funded two new and 179 continuation ATDC and FTDC grants, and one 

contract. 

In FY 2022, SAMHSA anticipates funding 15 new and 166 continuation ATDC and FTDC grants, 

and one contract. 

Reentry 

Across the country, more than 600,000 Americans are released from prisons and jails every year, 

and more than 4.5 million are serving a community supervision sentence.96 For these individuals, 

transitioning back to their communities following incarceration can be a challenge for a number 

of reasons. Often, when individuals are released, they face several critical barriers to successful 

reentry that they will need to overcome. Some have substance use issues, others have no place to 

live, and a criminal record makes it difficult for many to find a job.97 For most, it is only a matter 

of time before they return to prison. According to the Bureau of Justice Statistics, 68 percent of 

state prisoners are rearrested within three years of their release.98 

Other Criminal Justice /Offender Reentry Program 

In addition to the drug court portfolio, SAMHSA supports the Offender Reentry Program (ORP) 

grants, as well as other criminal justice activities, such as a regional and national criminal justice 

96 Danielle Kaeble and Lauren Glaze, Correctional Populations in the United States, 2015, Bulletin, Washington, 

DC: U.S. Department of Justice, Bureau of Justice Statistics, December 2016, NCJ 250374, https://www.bjs.gov/ 

content/pub/pdf/cpus15.pdf

97 Blair Ames, “NIJ-Funded Research Examines What Works for Successful Reentry,” NIJ Journal 281, November 

2019, https:// nij.ojp.gov/topics/articles/nij-funded-researchexamines-what-works-successful-reentry. 98 Mariel Alper, Matthew R. Durose, and Joshua Markman, 2018 Update on Prisoner Recidivism: A 9-Year Followup Period (2005-2014), Special Report, Washington, DC: U.S. Department of Justice, Bureau of Justice Statistics, 

May 2018, NCJ 250975, https://www.bjs.gov/content/pub/ pdf/18upr9yfup0514.pdf. 

256 
 

 

SAMHSA-Substance Use Services 

technical support contract. Studies show that only about 10 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.99 ORP grants provide screening, assessment, comprehensive 

treatment, and recovery support services for diverse populations reentering the community from 

incarceration. Other supported services include wraparound and recovery support services such 

as recovery housing and peer recovery support designed to improve access to and retention in care, 

drug test monitoring for illicit substances, educational support, relapse prevention and long-term 

management skills development, and HIV and viral hepatitis B and C testing conducted in 

accordance with state and local requirements. SAMHSA’s ORP grants are encouraged to use part 

of their annual award to provide treatment with FDA-approved medications. 

Performance data show that these grant programs are effective in improving the lives of Offender 

Reentry Program court participants. 

In FY 2021, 2,109 clients were served through SAMHSA’s Offender Re-entry Program. Based 

on 2,109 client intakes assessments, and 836 client six-month follow-up reassessments the 

following National Outcome Measures are reported: 

Offender Re-Entry Program 

At Intake At 6-months % increase in the 

number of clients 

reporting 

(n=2,109) (n=836) 

No past 30-day use alcohol/illegal drugs 44.30% 79.20% 78.90% 

No past 30-day arrest 84.20% 96.10% 14.20% 

Past 30-day employment or school attendance 20.70% 51.20% 147.40% 

No past 30-day experience with alcohol or drug 

related health, behavioral, or social 

consequences 

69.80% 89.90% 28.70% 

Past 30-day socially connectedness 80.70% 82.90% 2.70% 

Past 30-day permanent place to live in the 

community 11.80% 29.30% 149.00% 

Source: SAMHSA’ Performance Accountability and Reporting System (SPARS). Retrieved December 3, 2021, from 

http://spars.samhsa.gov. Limitations: There are several limitations to the program evaluation including (but not 

limited to) incomplete data, self-report, and selection bias. 

In FY 2021, SAMHSA funded 33 ORP continuation grants. 

In FY 2022, SAMHSA anticipates funding 33 ORP continuation grants and one contract. 

99 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. 

257 
 

 

 

 

 

 

SAMHSA-Substance Use Services 

Five Year Funding Table 

Fiscal Year Amount 

COVID-19 

Supplemental 

Funding 

FY 2019 $89,000,000 

FY 2020 $89,000,000 

FY 2021 Final $89,000,000 

FY 2022 CR $89,000,000 

FY 2023 President's Budget $124,380,000 

Budget Request 

The FY 2023 President’s Budget request is $124.4 million, an increase of $35.4 million from the 

FY 2022 Annualized Continuing Resolution. SAMHSA plans to support 167 new and 96 drug 

court continuation grants, and 21 new and 12 continuation ORP grants, and one contract. At least 

20 awards will be made to tribes/tribal organizations, and at least 20 awards will be made to 

FTDCs, pending sufficient application volume from these groups. 

258 
SAMHSA-Substance Use Services 

Outputs and Outcomes Table 

Program: Criminal Justice – Drug Courts 

Measure Year and Most Recent 

Result / 

Target for Recent Result / 

(Summary of Result) 

FY 2022 

Target 

FY 2023 

Target 

FY 2023 

Target 

+/-FY 2022 

Target 

1.2.72 Percentage of 

adult clients receiving 

services who were 

currently employed or 

engaged in productive 

activities (Outcome) 

FY 2021: 61.4 % 

Target: 

60.1 % 

(Target Exceeded) 

61.4 % 62.4 % +1 % point(s) 

1.2.73 Percentage of 

adult clients receiving 

services who had a 

permanent place to live in 

the community 

(Outcome) 

FY 2021: 48 % 

Target: 

47.3 % 

(Target Exceeded) 

48 % 49 % +1 % point(s) 

1.2.74 Percentage of 

adult clients receiving 

services who had no 

involvement with the 

criminal justice system 

(Outcome) 

FY 2021: 95.5 % 

Target: 

96 % 

(Target Not Met) 

95.5 % 96.5 % +1 % point(s) 

1.2.76 Percentage of 

adult clients receiving 

services who had no past 

month substance use 

(Outcome) 

FY 2021: 83.9 % 

Target: 

87.3 % 

(Target Not Met) 

83.9 % 84.9 % +1 % point(s) 

1.2.79 Number of adult 

clients served (Output) 

FY 2021: 6,425 

Target: 

6,960 

(Target Not Met) 

6,425 6,489 Increase 

259 
 

 

 

SAMHSA-Substance Use Services 

Outputs and Outcomes Table 

Program: Criminal Justice – Ex-Offender Re-Entry Program 

Measure Year and Most Recent 

Result / 

Target for Recent Result / 

(Summary of Result) 

FY 2022 

Target 

FY 2023 

Target 

FY 2023 

Target 

+/-FY 2022 

Target 

1.2.80 Number of clients 

served (Outcome) 

FY 2021: 2,109 

Target: 

1,661 

(Target Exceeded) 

2,109 2,130 +21 

1.2.81 Percentage of 

clients who had no past 

month substance use 

(Outcome) 

FY 2021: 79.2 % 

Target: 

77.4 % 

(Target Exceeded) 

79.2 % 80.2 % +1 % point(s) 

1.2.84 Percentage of 

clients receiving services 

who had no involvement 

with the criminal justice 

system (Outcome) 

FY 2021: 96.1 % 

Target: 

95 % 

(Target Exceeded) 

96.1 % 97.1 % +1 % point(s) 

260 
 

SAMHSA-Substance Use Services 

Outputs and Outcomes Table 

Program: Treatment – Other Capacity 

Measure Year and Most Recent 

Result / 

Target for Recent Result / 

(Summary of Result) 

FY 2022 

Target 

FY 2023 

Target 

FY 2023 

Target 

+/-FY 2022 

Target 

1.2.25 Percentage of 

adults receiving services 

who had no past month 

substance use (Outcome) 

FY 2021: 62 % 

Target: 

63 % 

(Target Not Met) 

62 % 63 % +1 % point(s) 

1.2.26 Number of clients 

served (Output) 

FY 2021: 2,815 

Target: 

1,357 

(Target Exceeded) 

2,815 2,844 +29 

1.2.27 Percentage of 

adults receiving services 

who were currently 

employed or engaged in 

productive activities 

(Outcome) 

FY 2021: 59.1 % 

Target: 

48 % 

(Target Exceeded) 

59.1 % 60.1 % +1 % point(s) 

1.2.28 Percentage of 

adults receiving services 

who had a permanent 

place to live in the 

community (Outcome) 

FY 2021: 53.3 % 

Target: 

54 % 

(Target Not Met) 

53.3 % 54.3 % +1 % point(s) 

1.2.29 The percentage of 

adults receiving services 

who had no involvement 

with the criminal justice 

system (Outcome) 

FY 2021: 98.7 % 

Target: 

98 % 

(Target Exceeded) 

98.7 % 99.7 % +1 % point(s) 

261 
 

 

 

SAMHSA-Substance Use Services 

Building Communities of Recovery (BCOR) 

(Dollars in thousands) 

FY 2021 FY 2022 FY 2023 

Programs of Regional & National Significance Final

 COVID-19 

Supplemental CR 

President's 

Budget 

FY 2023 

+/- FY 2022 

Building Communities of Recovery....................................... $10,013 $--- $10,000 $20,000 $10,000 

Authorizing Legislation .Section 302 of the Comprehensive Addiction and Recovery Act of 2016 

FY 2023 Authorization ....................................................................................................$5,000,000 

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

Eligible Entities.Recovery Community Organizations (RCOs) that are domestic private nonprofit 

.............entities in states, territories, or tribes that are led and governed by representatives of local 

............communities of recovery. Only organizations controlled and managed by members of the 

..........................................................................addiction recovery community are eligible to apply 

Program Description and Accomplishments 

Peer services play a vital role in assisting individuals in achieving recovery from substance use 

disorders. Recovery Community Organizations (RCOs) are central to the delivery of those 

services. In FY 2017, SAMHSA funded the first new cohort of grants through the Comprehensive 

Addiction Recovery Act (CARA) Building Communities of Recovery (BCOR) program. The 

purpose of this program is to mobilize resources within and outside of the recovery community to 

increase the prevalence and quality of long-term recovery support from drug/alcohol misuse. 

Programs are designed to be overseen by individuals in recovery from SUDs who reflect the 

community served. 

BCOR grants support linkages between recovery networks and a variety of other organizations, 

systems, and communities. These include primary care, specifically hospital emergency 

departments, other recovery networks such as recovery community centers, the child welfare 

system, the criminal justice system, recovery housing services, and education/employment 

systems. They are managed and implemented primarily by individuals with lived experience and 

who are in recovery from substance use disorders and who reflect the community being served. 

Grantees are using funds to 1) build connections and linkages between recovery networks, between 

RCOs, and other Recovery Support Services (RSS); 2) reduce the stigma associated with substance 

use disorder and recovery; and 3) conduct public education and outreach on issues relating to 

substance use disorder and recovery. 

262 
 

 

 

 

 

 

SAMHSA-Substance Use Services 

In FY 2021, 2,942 clients were served through SAMHSA’s BCOR Program. Based on 2,942 client 

intakes assessments, and 1,215 client six-month follow-up reassessments the following National 

Outcome Measures are reported: 

Building Communities of Recovery (BCOR) 

At Intake At 6-months % increase in the 

number of clients 

reporting 

(n=2,942) (n=1,215) 

No past 30-day use alcohol/illegal drugs 63.60% 78.10% 22.90% 

No past 30-day arrest 97.30% 98.70% 1.40% 

Past 30-day employment or school attendance 33.40% 65.60% 96.30% 

No past 30-day experience with alcohol or drug 

related health, behavioral, or social 

consequences 

68.60% 72.50% 5.60% 

Past 30-day socially connectedness 81.10% 87.00% 7.30% 

Past 30-day permanent place to live in the 

community 27.80% 35.40% 27.50% 

Source: SAMHSA’ Performance Accountability and Reporting System (SPARS). Retrieved December 3, 2021, from 

http://spars.samhsa.gov. Limitations: There are several limitations to the program evaluation including (but not 

limited to) incomplete data, self-report, and selection bias. 

In FY 2021, SAMHSA funded 31 new and 18 BCOR continuation grants. 

In FY 2022, SAMHSA anticipates funding 5 new and 44 BCOR continuation grants. 

Five Year Funding Table 

Fiscal Year Amount 

COVID-19 

Supplemental 

Funding 

FY 2019 $6,000,000 

FY 2020 $10,000,000 

FY 2021 Final $10,012,768 

FY 2022 CR $10,000,000 

FY 2023 President's Budget $20,000,000 

Budget Request 

The FY 2023 President’s Budget request is $20.0 million, an increase of $10.0 million from the 

FY 2022 Annualized Continuing Resolution. SAMHSA plans to support 40 new grants and 36 

continuation grants for the BCOR program to develop, expand, and enhance recovery support 

services. The BCOR program supports linkages between recovery networks and a variety of 

organizations, including primary care, other recovery networks, the child welfare system, the 

criminal justice system, housing services, and education/employment systems. 

263 
 

 

 

SAMHSA-Substance Use Services 

Outputs and Outcomes Table 

Program: Building Communities for Recovery 

Measure Year and Most Recent 

Result / 

Target for Recent Result / 

(Summary of Result) 

FY 2022 

Target 

FY 2023 

Target 

FY 2023 

Target 

+/-FY 2022 

Target 

1.2.80 Number of clients 

receiving recovery 

services (Output) 

FY 2021: 2,942.0 

Target: 

1,175.0 

(Target Exceeded) 

2,942.0 2,972.0 +30 

1.2.81 Clients who report 

not having stable housing 

at baseline who report 

having stable housing at 

six-month follow-up 

(Outcome) 

FY 2021: 35.4 

Target: 

47.4 

(Target Not Met) 

35.4 36.4 +1 

1.2.82 Percent of clients 

who report not being 

employed (full-time or 

part-time) or in school at 

baseline who report 

having employment or 

being in school at followup (Outcome) 

FY 2021: 65.6 

Target: 

64.5 

(Target Exceeded) 

65.6 66.6 +1 

264 
 

 

 

 

 

 

SAMHSA-Substance Use Services 

Minority Fellowship Program 

(Dollars in thousands) 

FY 2021 FY 2022 FY 2023 

Programs of Regional & National Significance Final

 COVID-19 

Supplemental CR 

President's 

Budget 

FY 2023 

+/- FY 2022 

Minority Fellowship Program .............................................. $5,789 $--- $5,789 $7,136 $1,347 

Authorizing Legislation .............................................Section 597 of the Public Health Service Act 

FY 2023 Authorization ..................................................................................................................$0 

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

Eligible Entities..... Organizations that represent individuals obtaining post-baccalaureate training 

...... (including for master’s and doctoral degrees) for mental and substance use disorder treatment 

........................................ professionals, including in the fields of psychiatry, nursing, social work, 

........................................ psychology, marriage and family therapy, mental health counseling, and 

...............................................................................substance use disorder and addiction counseling 

Program Description and Accomplishments 

SAMHSA’s Minority Fellowship Program (MFP) increases behavioral health practitioners’ 

knowledge of issues related to prevention, treatment, and recovery support for mental illness and 

substance use disorders among racial and ethnic minority populations. Since its start in 1973, the 

program has helped to enhance services for racial and ethnic minority communities through 

specialized training of mental health professionals in psychiatry, nursing, social work, and 

psychology. In 2006, the program expanded to include marriage and family therapists and later 

added professional counselors specializing in substance use disorder. In FY 2018, an additional 

program was created to address specialized training in addiction psychiatry, psychology, and 

addiction medicine. Professional guilds receive competitively awarded grants, and then 

competitively award the stipends to graduate and post-graduate students pursuing a degree in 

corresponding professional fields. 

This program is jointly administered by the Center for Substance Use Services (CSUS), the Center 

for Substance Use Prevention Services (CSUPS), and the Center for Mental Health Services 

(CMHS) at SAMHSA. CSUS also funded one additional grant to support the program that 

specializes in fellowships for addiction psychiatry, psychology, and addiction medicine. 

Combined, these programs will support fellowships for hundreds of students as well as support 

additional training through webinars on culturally appropriate services to thousands of students. 

In FY 2021, SAMHSA funded nine MFP continuation grants with the supplemental funding for 

eight continuation grants, and one contract. 

In FY 2022, SAMHSA anticipates funding nine MFP continuation grants and the supplemental 

funding for eight continuation grants, and one contract. 

265 
 

 

 

 

 

SAMHSA-Substance Use Services 

Five Year Funding Table 

Fiscal Year Amount 

COVID-19 

Supplemental 

Funding 

FY 2019 $4,789,000 

FY 2020 $4,789,000 

FY 2021 Final $5,789,007 

FY 2022 CR $5,789,000 

FY 2023 President's Budget $7,136,000 

Budget Request 

The FY 2023 President’s Budget request is $7.1 million, an increase of $1.3 million from the FY 

2022 Annualized Continuing Resolution. The purposed funding will support two continuation 

grants, award a new cohort of 10 grants and the technical assistance contract. The increase in 

funding will increase the number of trained behavioral health providers to 6,500. 

266 
 

 

 

 

 

SAMHSA-Substance Use Services 

Addiction Technology Transfer Centers 

(Dollars in thousands) 

FY 2021 FY 2022 FY 2023 

Programs of Regional & National Significance Final

 COVID-19 

Supplemental CR 

President's 

Budget 

FY 2023 

+/- FY 2022 

Addiction Technology Transfer Centers................................ $9,465 $--- $9,046 $9,046 ---

Authorizing Legislation .............................................Section 509 of the Public Health Service Act 

FY 2023 Authorization ..................................................................................................................$0 

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

Eligible Entities.................................................... Domestic Public and Private Non-Profit Entities 

Program Description and Accomplishments 

The estimated cost of substance use in the United States - including illegal drugs, alcohol, and 

tobacco - is more than $740 billion a year and growing.100 Substance misuse in the U.S. costs 

society in increased healthcare costs, crime, and lost productivity. In recent years, the nation’s 

attention has been on the increased misuse and lethal consequences of opioids. New CDC data 

documents that estimated overdose deaths from opioids increased to 75,673 in the 12-month period 

ending in April 2021, up from 56,064 the year before.101 Illicitly manufactured fentanyl is driving 

the majority of deaths but mortality rates due to cocaine and psychostimulants such as 

methamphetamine have also increased, both with and without the presence of fentanyl. The 

misuse of opioids and opioid use disorder - including prescription pain relievers, heroin, and 

synthetic opioids such as fentanyl - is a serious national crisis that affects public health as well as 

social and economic welfare that likely is exacerbated by the ongoing COVID-19 pandemic. The 

country will be dealing with the repercussions of the pandemic’s effect on substance use disorder 

for years to come. In the midst of these ongoing challenges, there is a critical need to recruit, train, 

and support treatment providers in the use of evidence-based practices. 

The purpose of the Technology Transfer Centers (TTCs) is to develop and strengthen the 

specialized behavioral healthcare and primary healthcare workforce that provides the continuum 

of prevention, harm reduction, treatment, and recovery support services for substance use disorder 

(SUD) and mental illness. The program’s mission is to help people and organizations to 

incorporate effective evidence-based practices into all of these services. Together, the TTC 

network, that includes the Addiction Technology Transfer Centers, serves the 50 states, the District 

of Columbia, Puerto Rico, the U.S. Virgin Islands, the Pacific Islands of Guam, American Samoa, 

Palau, the Marshall Islands, Micronesia, and the Mariana Islands. 

After over 28 years of conducting training workshops, translating research into bite-size pieces for 

curricula or stand-alone products, and creating opportunities for performance feedback to enhance 

skill development, the Addiction Technology Transfer Centers (ATTCs) are improving and 

updating their programs to offer novel training and technical assistance (TA) options that include 

multiple learning components in new delivery formats focused on changing practices. In response 

100 (NIDA, Trends and Statistics. Published online, updated Feb. 2020) 101 https://www.cdc.gov/nchs/pressroom/nchs_press_releases/2021/20211117.htm 

267 
 

 

 

 

 

 

 

 

SAMHSA-Substance Use Services 

to the COVID-19 pandemic, the ATTC program has developed and implemented many alternative 

ways to deliver training and technical assistance. A robust virtual platform has been used to 

support healthcare professionals with telehealth strategies and many adaptations of evidence-based 

interventions for the virtual settings. The ATTC centers will continue the response to the 

differential impact of the pandemic by addressing the needs of providers and continuing to develop 

resources to help to address the needs of all communities. 

To date, under the current cycle (2017-2022), the 13 ATTCs combined have delivered over 6,300 

training and technical assistance (TA) events for over 200,000 healthcare professionals and 

paraprofessionals who deliver services for patients with substance use disorders. Participant 

satisfaction rates were consistently high, with over 90 percent of attendees reporting that they were 

satisfied with their training or TA events. 

In FY 2021, SAMHSA funded 12 continuation grants in the ATTC program (year 5 of the current 

cycle), and the network will continue to focus on delivering training and technical assistance for 

providers who are serving patients with substance use disorders by improving their capacity and 

understanding of evidence -based practices, especially practices that are effective in combating the 

opioid crisis. 

In FY 2022, SAMHSA anticipates providing a 12-month cost extension for all 12 ATTC centers 

to line up the end of the program cycle with the Mental Health and Prevention Technology Transfer 

Centers which will complete their Year 5 cycle in September 2023. 

Building on a rich history, the ATTC Network continuously strives to improve the quality of 

substance use disorder treatment and recovery services by facilitating alliances among front line 

counselors, treatment and recovery services agency administrators, faith-based organizations, 

policy makers, the health and mental health communities, consumers, and other stakeholders. The 

ATTC Network continues to respond to the emerging needs of the field by connecting providers 

to the latest research and information through activities such as skills training, academic education, 

online and distance education, conferences, workshops, and publications. 

Five Year Funding Table 

Fiscal Year Amount 

COVID-19 

Supplemental 

Funding 

FY 2019 $9,046,000 

FY 2020 $9,046,000 

FY 2021 Final $9,464,818 

FY 2022 CR $9,046,000 

FY 2023 President's Budget $9,046,000 

268 
SAMHSA-Substance Use Services 

Budget Request 

The FY 2023 President’s Budget request is $9.0 million, level with the FY 2022 Annualized 

Continuing Resolution. SAMHSA plans to fund 12 new grants. Funding will allow the ATTC 

grantees to disseminate evidence-based, promising practices to substance use disorder treatment 

and recovery professionals, public health and mental health personnel, institutional and community 

corrections professionals, and other related disciplines. 

269 
 

 

 

SAMHSA-Substance Use Services 

Improving Access to Overdose Treatment 

This program is being moved to the CSUPS chapter. 

First Responder Training for Opioid Overdose Reversal Drugs 

This program is being moved to the CSUPS chapter. 

Grants to Prevent Prescription Drug/Opioid Overdose Related Deaths 

This program is being moved to the CSUPS chapter. 

270 
 

 

 

 

 

 

 

SAMHSA-Substance Use Services 

Peer Support Technical Assistance Center 

(Dollars in thousands) 

FY 2021 FY 2022 FY 2023 

Programs of Regional & National Significance Final

 COVID-19 

Supplemental CR 

President's 

Budget 

FY 2023 

+/- FY 2022 

Peer Support TA Center........................................................ $999 $--- $1,000 $1,500 $500 

Authorizing Legislation .. Section 7152 of the SUPPORT for Patients and Communities Act (Sec. 

..........................................................................................547A of the PHS Act) 

FY 2023 Authorization ....................................................................................................$1,000,000 

Allocation Method ............................................................................................. Competitive Grants 

Eligible Entities.......................................................................Recovery Community Organizations 

Program Description and Accomplishments 

The purpose of the National Peer-Run Training and Technical Assistance Center for Addiction 

Recovery Support (Peer Support Technical Assistance Center) which is authorized by section 7152 

of the SUPPORT for Patients and Communities Act (P.L. 115-271), is to enhance the field of peer 

recovery support services by providing training and technical assistance for recovery community 

organizations (RCOs), as well as peer support networks. The technical assistance is related to 

training, translation and interpretation services, data collection, capacity building, and evaluation 

and improvement of the effectiveness of such services provided by recovery community 

organizations and peer support networks. 

Since its implementation, the Peer Support Technical Assistance Center has implemented 24 

events serving over 5,400 participants with over 90 percent satisfaction with the overall quality of 

the events. 

In FY 2021, SAMHSA funded one continuation grant. 

In FY 2022, SAMHSA anticipates funding one continuation grant. 

Five Year Funding Table 

Fiscal Year Amount 

COVID-19 

Supplemental 

Funding 

FY 2019 $---

FY 2020 $1,000,000 

FY 2021 Final $999,033 

FY 2022 CR $1,000,000 

FY 2023 President's Budget $1,500,000 

271 
SAMHSA-Substance Use Services 

Budget Request 

The FY 2023 President’s Budget request is $1.5 million, an increase of $500,000 from the FY 

2022 Annualized Continuing Resolution. SAMHSA continues to support the existing grantee in 

this program and requests to increase the funding available for the grantee. 

272 
 

SAMHSA-Substance Use Services 

Outputs and Outcomes Table 

Program: Peer Support Technical Assistance Center 

Measure Year and Most Recent 

Result / 

Target for Recent Result / 

(Summary of Result) 

*FY 2022 

Target 

FY 2023 

Target 

FY 2023 

Target 

+/-FY 2022 

Target 

1.1.0 Number of people 

train for the support of 

the recovery community 

organizations and peer 

support networks 

(Output) 

FY 2021: 4,766 

Target: 2,000 

(Target Exceeded) 

5,000.0 2,000.0 +3,000 

1.2.0 Number trained on 

technical assistance, 

translation and 

interpretation services, 

data collection, capacity 

building, and evaluation 

and improvement of the 

effectiveness of such 

services provided by 

recovery community 

organizations (Output) 

FY 2021: 174 

Target: 

100.0 

(Target Exceeded) 

300.0 300.0 Maintain 

*Note: the target for FY 2022 has been maintained, may be increased 1-2% based on FY 2021 actuals. 

273 
 

 

 

 

 

 

 

 

SAMHSA-Substance Use Services 

Emergency Department Alternatives to Opioids 

(Dollars in thousands) 

FY 2021 FY 2022 FY 2023 

Programs of Regional & National Significance Final

 COVID-19 

Supplemental CR 

President's 

Budget 

FY 2023 

+/- FY 2022 

Emergency Department Alternatives to Opioids $5,908 $--- $6,000 $9,000 $3,000 

Authorizing Legislation ........... Section 7091 of the SUPPORT for Patients and Communities Act 

FY 2023 Authorization ..................................................................................................................$0 

Allocation Method ............................................................................................. Competitive Grants 

Eligible Entities...................................................................Hospitals and Emergency Departments 

Program Description and Accomplishments 

The purpose of this new program, which is authorized by section 7091 of the SUPPORT for 

Patients and Communities Act (P.L. 115-271) is to provide funding to hospitals and emergency 

departments, including freestanding emergency departments, to develop, implement, enhance, or 

study alternative pain management protocols and treatments that limit the use and prescribing of 

opioids in emergency departments. In addition, these funds are used to target common painful 

conditions, train providers and other hospital personnel to recognize the presence of an opioid use 

disorder, initiate treatment as appropriate, and provide alternatives to opioids for patients with 

painful conditions. 

In FY 2021, SAMHSA funded two new grants and 10 continuation grants. 

In FY 2022, SAMHSA anticipates funding 12 continuation grants. 

Five Year Funding Table 

Fiscal Year Amount 

COVID-19 

Supplemental 

Funding 

FY 2019 $---

FY 2020 $5,000,000 

FY 2021 Final $5,908,042 

FY 2022 CR $6,000,000 

FY 2023 President's Budget $9,000,000 

Budget Request 

The FY 2023 President’s Budget request is $9.0 million, an increase of $3.0 million from the FY 

2022 Annualized Continuing Resolution. SAMHSA plans to award two new and 16 continuation 

grants. 

274 
 

SAMHSA-Substance Use Services 

Outputs and Outcomes Table 

Program: Emergency Department Alternative to Opioids 

Measure *Year and Most Recent 

Result / 

Target for Recent Result / 

(Summary of Result) 

FY 2022 

Target 

FY 2023 

Target 

FY 2023 

Target 

+/-FY 2022 

Target 

1.60.1 Number of 

providers trained on nonopioids therapies. 

(Output) 

FY 2021: 2,468 

Target: 1,020 

(Target Exceeded) 

2,468 2,493 +25 

1.60.2 Number of 

patients who received 

non-opioid therapies. 

(Output) 

FY 2021: 113,563 

Target: 8,364 

(Target Exceeded) 

113,563 114,698 +1,135 

*Note: the target for FY 2022 has been maintained, may be increased 1-2% based on FY 2021 actuals. The difference 

between FY 2020 and FY 2022, reflect the increase in funding between FY 2021 and FY 2022. 

275 
 

 

 

SAMHSA-Substance Use Services 

Treatment, Recovery, and Workforce Support 

(Dollars in thousands) 

FY 2021 FY 2022 FY 2023 

Programs of Regional & National Significance Final

 COVID-19 

Supplemental CR 

President's 

Budget 

FY 2023 

+/- FY 2022 

Treatment, Recovery, and Workforce Support...................... $6,089 $--- $6,000 $9,000 $3,000 

Authorizing Legislation ........... Section 7183 of the SUPPORT for Patients and Communities Act 

FY 2023 Authorization ....................................................................................................$5,000,000 

Allocation Method ............................................................................................. Competitive Grants 

Eligible Entities.................................................................. SSAs, Tribes and Tribal Organizations, 

........................................................................................................... Entities that offer treatment or 

.........................................other services following a drug overdose (e.g., emergency departments) 

Program Description and Accomplishments 

The Treatment, Recovery and Workforce Support (TRWS) grants program was established by the 

Support Act in 2018 to address the public health crisis caused by escalating opioid misuse and 

substance use disorder across the nation. The Workforce Support program aims to implement 

evidence-based programs to support individuals in substance use disorder treatment and recovery 

to live independently and participate in the workforce. Eligible entities are those that provide 

treatment or recovery services for individuals with substance use disorders and partner with one 

or more local or state stakeholders, which may include local employers, community organizations, 

the local workforce development board, local and state governments, and Indian tribes or tribal 

organizations, to support recovery, independent living, and participation in the workforce. 

During 2021, 820 clients were served in the Workforce Support. Based on 820 client intakes 

assessments, and 221 client six-month follow-up reassessments the following National Outcome 

Measures are reported: 

Workforce Support 

At Intake At 6-months % increase in the 

number of clients 

reporting (n=820) (n=221) 

No past 30-day use alcohol/illegal drugs 85.10% 86.40% 1.60% 

No past 30-day arrest 99.10% 98.60% -0.50% 

Past 30-day employment or school attendance 24.00% 73.30% 205.70% 

No past 30-day experience with alcohol or drug 

related health, behavioral, or social 

consequences 

91.80% 91.80% 0.00% 

Past 30-day socially connectedness 95.90% 98.60% 2.80% 

Past 30-day permanent place to live in the 

community 25.80% 41.60% 61.40% 

Source SAMHSA’ Performance Accountability and Reporting System (SPARS). Data current as of February 11, 

2022. Limitations: There are several limitations to the program evaluation including (but not limited to) incomplete 

data, self-report, and selection bias. 

276 
 

 

 

 

 

 

SAMHSA-Substance Use Services 

The Workforce Support initiative will continue implementing evidence-base programs supporting 

individuals in substance use disorder treatment and recovery to live independently and participate 

in the workforce with sustained employment during 2022 and 2023. 

In FY 2021, SAMHSA funded four new and eight TRWS continuation grants. 

In FY 2022, SAMHSA anticipates funding 12 TRWS continuation grants. 

Five Year Funding Table 

Fiscal Year Amount 

COVID-19 

Supplemental 

Funding 

FY 2019 $---

FY 2020 $4,000,000 

FY 2021 Final $6,089,298 

FY 2022 CR $6,000,000 

FY 2023 President's Budget $9,000,000 

Budget Request 

The FY 2023 President’s Budget request is $9.0 million, an increase of $3.0 million from the FY 

2022 Annualized Continuing Resolution. SAMHSA plans to award six new and 12 continuation 

grants. 

277 
 

SAMHSA-Substance Use Services 

Outputs and Outcomes Table 

Program: Treatment, Recovery, and Workforce Support 

Measure Year and Most Recent 

Result / 

Target for Recent Result / 

(Summary of Result) 

FY 2022 

Target 

FY 2023 

Target 

FY 2023 

Target 

+/-FY 2022 

Target 

1.21.1 Number of people 

participate in the 

workforce (Output) 

FY 2021: 820.0 

Target: 

820.0 

(Baseline) 

820.0 820.0 Maintain 

1.21.2 Number of clients 

who report having stable 

housing at six-month 

follow-up (Outcome) 

FY 2021: 229.0 

Target: 

229.0 

(Baseline) 

229.0 229.0 Maintain 

278 
 

 

 

 

 

 

 

SAMHSA-Substance Use Services 

Comprehensive Opioid Recovery Centers 

(Dollars in thousands) 

FY 2021 FY 2022 FY 2023 

Programs of Regional & National Significance Final

 COVID-19 

Supplemental CR 

President's 

Budget 

FY 2023 

+/- FY 2022 

Comprehensive Opioid Recovery Center.............................. $3,614 $--- $4,000 $6,000 $2,000 

Authorizing Legislation ...........Section 7121 of the SUPPORT Act (Section 552 of the PHS Act) 

FY 2023 Authorization ..................................................................................................$10,000,000 

Allocation Method ............................................................................................. Competitive Grants 

Eligible Entities. Public and private nonprofit entities (that provide treatment for individuals with 

substance use disorders). 

Program Description and Accomplishments 

This program provides grants to nonprofit substance use disorder treatment organizations to 

operate comprehensive centers which provide a full spectrum of treatment and recovery support 

services for opioid use disorders. Grantees are required to provide outreach and the full continuum 

of treatment services including MOUD; counseling; treatment for mental disorders; testing for 

infectious diseases, residential treatment, and intensive outpatient services; recovery housing; peer 

recovery support services; job training, job placement assistance, and continuing education; and 

family support services such as childcare, family counseling, and parenting interventions. 

Grantees must utilize third party and other revenue to the extent possible. Grantees are required 

to report client-level data, including demographic characteristics, substance use, assessment, 

services received, types of MOUD received, length of stay in treatment, employment status, 

criminal justice involvement, and housing. 

The CoRC Grantees have been utilizing funding to expand access to comprehensive services in a 

variety of ways, from improving the system of comprehensive MOUD care at the county level, 

improving follow up with clients who have experienced overdose reversals and removing barriers 

to MOUD in residential treatment to engaging special populations, such as homeless persons, 

people on probation, and LGBTQ services, and meeting the needs of underserved areas. 

In FY 2021, SAMHSA funded two new and two continuation grants. There remains a need to 

expand comprehensive, recovery-oriented services. In FY 2022, SAMHSA anticipates funding 

four continuation grants. 

Five Year Funding Table 

Fiscal Year Amount 

COVID-19 

Supplemental 

Funding 

FY 2019 $---

FY 2020 $---

FY 2021 Final $3,613,766 

FY 2022 CR $4,000,000 

FY 2023 President's Budget $6,000,000 

279 
SAMHSA-Substance Use Services 

Budget Request 

The FY 2023 President’s Budget request is $6.0 million, an increase of $2.0 million from the FY 

2022 Annualized Continuing Resolution. SAMHSA plans to support two new and four 

continuation grants. These funds will provide critical comprehensive care services, including 

long-term care and support services utilizing the full range of FDA-approved medications and 

evidence-based services and will cover the costs of critical linkage and system development not 

currently covered by other sources of funding. These funds will extend the reach of MOUD 

treatment and recovery support services to address the overdose epidemic across systems and 

regional locations, reducing scattered, uncoordinated treatment efforts, and expanding access to 

care for people with special needs and/or in rural areas. 

280 
 

 

 

 

 

SAMHSA-Substance Use Services 

Outputs and Outcomes Table 

Program: Comprehensive Opioid Recovery Centers 

Measure Year and Most Recent 

Result / 

Target for Recent Result / 

(Summary of Result) 

FY 2022 

Target 

FY 2023 

Target 

FY 2023 

Target 

+/-FY 2022 

Target 

1.1.1 Number of clients 

served with MOUD 

(Output) 

FY 2021: 258.0 

Target: 

258.0 

(Baseline) 

258.0 261.0 +3 

1.2.1 Percentage of adults 

receiving services who 

had no past month 

substance use at 6-month 

follow-up (Output) 

FY 2021: 89.2 % 

Target: 

89.2 % 

(Baseline) 

89.2 % 90.2 % +1 % 

1.3.1 Percentage of adults 

receiving services who 

were currently employed 

or engaged in productive 

activities at 6-month 

follow-up (Outcome) 

FY 2021: 64.9% 

Target: 

64.9% 

(Baseline) 

64.9% 65.9% +1 % 

1.4.1 Number of adults 

receiving recovery 

housing and community 

based and peer recovery 

support services at 6-

month follow-up 

(Output) 

FY 2021: 24.3 

Target: 

24.3 

(Baseline) 

24.3 25.3 +1 

281 
 

 

SAMHSA-Substance Use Services 

Opioid Response Grants 

(Dollars in thousands) 

FY 2021 FY 2022 FY 2023 

Programs of Regional & National Significance Final

 COVID-19 

Supplemental CR 

President's 

Budget 

FY 2023 

+/- FY 2022 

Opioids Response Grants...................................................... $3,000 $--- $3,000 $--- -$3,000 

Authorizing Legislation .............................................Section 509 of the Public Health Service Act 

FY 2023 Authorization ..................................................................................................................$0 

Allocation Method ............................................................................................. Competitive Grants 

Eligible Entities.................................................Limited to Single State Agencies (SSAs), Existing 

.................................................................................... USDA Cooperative Extension Grantees, and 

.............................................................................U.S. Territories, Tribes, and tribal organizations. 

The Opioid Response Grants program is included in the State Opioid Response (SOR) narrative 

section on page 292. 

282 
SAMHSA-Substance Use Services 

PRNS Mechanism Table 

Summary 

(Dollars in thousands) 

FY 2021 

Final 

FY 2022 

CR 

FY 2023 

President's 

Budget 

Programs of Regional & National Significance No. Amount No. Amount No. Amount 

Continuations........................................................................................... 

New/Competing....................................................................................... 

Supplements............................................................................................. 

691 $324,064 

295 140,027 

8 5,387

746 $352,857 

223 103,984 

 --- 13,202

603 $285,146 

526 252,696 

 --- 295 

Subtotal................................................................................................. 994 469,478 969 470,044 1,129 538,137 

Contracts 

Continuations........................................................................................... 

New......................................................................................................... 

3 23,612 

1 2,028

3 22,939 

 --- 3,695 

2 24,880 

2 3,347 

Subtotal................................................................................................. 4 25,640 3 26,633 4 28,227 

Total, Substance Use Services PRNS 998 $495,117 972 $496,677 1,133 $566,364 

283 
SAMHSA-Substance Use Services 

PRNS Mechanism Table 

Program, Project, and Activity 

(Dollars in thousands) 

Programs of Regional & National Significance 

FY 2021 

Final 

FY 2022 

CR 

FY 2023 

President's 

Budget 

No. Amount No. Amount No. Amount 

Capacity: 

Opioid Treatment Programs/Regulatory Activities

 Grants 

Continuations........................................................................................... 

New/Competing....................................................................................... 

Supplements*........................................................................................... 

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

 Contracts 

Continuations........................................................................................... 

New/Competing....................................................................................... 

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

Total, Opioid Treatment Programs/Regulatory Activities 

Screening, Brief Intervention and Referral to Treatment

 Grants 

Continuations........................................................................................... 

New/Competing....................................................................................... 

Supplements*........................................................................................... 

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

 Contracts 

Continuations........................................................................................... 

New/Competing....................................................................................... 

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

Total, Screening, Brief Intervention and Referral to Treatment 

Targeted Capacity Expansion

 Grants 

Continuations........................................................................................... 

New/Competing....................................................................................... 

Supplements*........................................................................................... 

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

 Contracts 

Continuations........................................................................................... 

New/Competing....................................................................................... 

Supplements*........................................................................................... 

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

Total, Targeted Capacity Expansion 

1 $2,000 

27 3,951 

--- ---

27 $3,956 

6 1,400 

--- 2,000 

33 $5,354 

19 6,200 

--- ---

28 5,951 33 7,356 52 11,554

2 1,265 

--- ---

2 1,301 

--- 67 

1 648 

1 883 

2 1,265 2 1,368 2 1,532 

30 7,216 35 8,724 54 13,086 

16 17,562 

11 10,637 

--- ---

27 28,209 

--- ---

--- ---

24 25,156 

4 3,980 

--- ---

27 28,200 27 28,209 28 29,136

--- 1,484 

--- 15 

--- 1,429 

--- 362 

--- 1,214 

--- 210 

--- 1,499 --- 1,791 --- 1,424 

27 29,698 27 30,000 28 30,560 

53 24,121 

130 72,430 

--- ---

125 65,840 

52 30,825 

--- ---

182 98,225 

56 42,600 

--- ---

183 96,551 177 96,665 238 140,825

--- 5,687 

--- 92 

--- ---

--- 5,532 

--- -6 

--- ---

--- 6,574 

--- 516 

--- ---

--- 5,780 --- 5,527 --- 7,091 

183 102,331 177 102,192 238 147,916 

284 
SAMHSA-Substance Use Services 

PRNS Mechanism Table 

Program, Project, and Activity 

(Dollars in thousands) 

Programs of Regional & National Significance 

FY 2021 

Final 

FY 2022 

CR 

FY 2023 

President's 

Budget 

No. Amount No. Amount No. Amount 

Pregnant and Postpartum Women 

 Grants 

Continuations........................................................................................... 

New/Competing....................................................................................... 

Supplements*........................................................................................... 

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

 Contracts 

Continuations........................................................................................... 

New/Competing....................................................................................... 

Supplements*........................................................................................... 

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

Total, Pregnant and Postpartum Women 

Recovery Community Services Program

 Grants 

Continuations........................................................................................... 

New/Competing....................................................................................... 

Supplements **........................................................................................ 

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

 Contracts 

Continuations........................................................................................... 

New/Competing....................................................................................... 

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

Total, Recovery Community Services Program 

Children and Families

 Grants 

Continuations........................................................................................... 

New/Competing....................................................................................... 

Supplements *.......................................................................................... 

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

 Contracts 

Continuations........................................................................................... 

New/Competing....................................................................................... 

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

Total, Children and Families 

48 $26,515 

4 3,600 

--- 975 

33 $20,661 

19 10,000 

--- 500 

30 $17,529 

51 29,800 

--- 75 

52 31,090 52 31,161 81 47,404

--- 1,677 

--- ---

--- ---

--- 1,622 

--- 148 

--- ---

--- 1,986 

--- 7 

--- ---

--- 1,677 --- 1,770 --- 1,993 

52 32,767 52 32,931 81 49,397 

6 1,788 

2 600 

--- ---

8 2,399 

--- ---

--- ---

8 2,399 

8 2,480 

--- ---

8 2,387 8 2,399 16 4,879

--- 124 

---

--- 120 

--- -85 

--- 208 

--- 64 

--- 125 --- 35 --- 272 

8 2,512 8 2,434 16 5,151 

35 18,266 

18 9,650 

--- ---

53 28,111 

--- ---

--- ---

22 11,770 

31 17,000 

--- ---

53 27,916 53 28,111 53 28,770

--- 1,512 

--- 52 

--- 1,458 

--- 36 

--- 1,254 

--- 174 

--- 1,564 --- 1,494 --- 1,427 

53 29,479 53 29,605 53 30,197 

285 
 

SAMHSA-Substance Use Services 

PRNS Mechanism Table 

Program, Project, and Activity 

(Dollars in thousands) 

Programs of Regional & National Significance 

FY 2021 

Final 

FY 2022 

CR 

FY 2023 

President's 

Budget 

No. Amount No. Amount No. Amount 

Treatment Systems for Homeless

 Grants 

Continuations........................................................................................... 

New/Competing....................................................................................... 

Supplements *.......................................................................................... 

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

 Contracts 

Continuations........................................................................................... 

New/Competing....................................................................................... 

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

Total, Treatment Systems for Homeless 

Minority AIDS

 Grants 

Continuations........................................................................................... 

New/Competing....................................................................................... 

Supplements *.......................................................................................... 

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

 Contracts 

Continuations........................................................................................... 

New/Competing....................................................................................... 

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

Total, Minority AIDS 

Criminal Justice Activities

 Grants 

Continuations........................................................................................... 

New/Competing....................................................................................... 

Supplements *.......................................................................................... 

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

 Contracts 

Continuations........................................................................................... 

New/Competing....................................................................................... 

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

Total, Criminal Justice Activities 

Improving Access to Overdose Treatment

 Grants 

Continuations........................................................................................... 

New/Competing....................................................................................... 

Supplements *.......................................................................................... 

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

 Contracts 

Continuations........................................................................................... 

New/Competing....................................................................................... 

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

Total, Improving Access to Overdose Treatment 

85 $33,796 

--- ---

--- 720 

68 $27,045 

17 6,800 

--- 550 

52 $20,758 

37 14,600 

--- 220 

85 34,516 85 34,395 89 35,578

--- 1,859 

--- 12 

--- 1,792 

--- 199 

--- 1,531 

--- 5 

--- 1,870 --- 1,991 --- 1,536 

85 36,386 85 36,386 89 37,114 

121 59,809 

--- ---

--- 2,375 

62 30,678 

61 30,500 

--- 900 

87 43,489 

41 20,500 

--- ---

121 62,184 123 62,078 128 63,989

--- 3,350 

--- 27 

--- 3,229 

--- 263 

--- 2,775 

--- 117 

--- 3,377 --- 3,492 --- 2,892 

121 65,561 123 65,570 128 66,881 

212 81,880 

2 786 

--- ---

199 76,766 

15 6,000 

--- ---

110 42,073 

188 75,675 

--- ---

214 82,666 214 82,766 298 117,748

--- 4,544 

1 1,790 

0 4,383 

--- 1,851 

1 6,630 

--- 3 

1 6,334 0 6,234 1 6,632 

215 89,000 214 89,000 299 124,380 

5 913 

--- ---

--- 104 

5 917 

--- ---

--- 104 

--- ---

--- ---

--- ---

5 1,017 5 1,021 --- ---

--- 51 

--- ---

--- 49 

--- -70 

--- ---

--- ---

--- 51 --- -21 --- ---

5 1,068 5 1,000 --- ---

286 
 

SAMHSA-Substance Use Services 

PRNS Mechanism Table 

Program, Project, and Activity 

(Dollars in thousands) 

Programs of Regional & National Significance 

FY 2021 

Final 

FY 2022 

CR 

FY 2023 

President's 

Budget 

No. Amount No. Amount No. Amount 

Building Communities of Recovery

 Grants 

Continuations........................................................................................... 

New/Competing....................................................................................... 

Supplements *.......................................................................................... 

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

 Contracts 

Continuations........................................................................................... 

New/Competing....................................................................................... 

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

Total,Building Communities of Recovery 

Grants to Prevent Prescription Drug/Opioid Overdoes-Related 

Deaths

 Grants 

Continuations........................................................................................... 

New/Competing....................................................................................... 

Supplements *.......................................................................................... 

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

 Contracts 

Continuations........................................................................................... 

New/Competing....................................................................................... 

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

Total, Grants to Prevent Prescription Drug/Opioid OverdoesRelated Deaths 

First Responder Training (CARA)

 Grants 

Continuations........................................................................................... 

New/Competing....................................................................................... 

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

 Contracts 

Continuations........................................................................................... 

New/Competing....................................................................................... 

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

Total, First Responder Training (CARA) 

18 $3,472 

31 6,039 

--- ---

44 $8,541 

5 959 

--- ---

36 $7,108 

40 12,096 

--- ---

49 9,511 49 9,500 76 19,204

--- 502 

--- ---

--- 492 

--- 8 

--- 796 

--- ---

--- 502 --- 500 --- 796 

49 10,013 49 10,000 76 20,000 

--- 591 

13 11,042 

--- 200 

13 11,633 

--- ---

--- ---

--- ---

--- ---

--- ---

13 11,833 13 11,633 --- ---

--- ---

--- ---

--- ---

--- 367 

--- ---

--- ---

--- --- --- 367 --- ---

13 11,833 13 12,000 --- ---

49 28,601 

48 13,788 

42 24,384 

48 17,500 

--- ---

--- ---

97 42,389 90 41,884 --- ---

--- ---

--- ---

--- ---

--- 116 

--- ---

--- ---

--- --- --- 116 --- ---

97 42,389 90 42,000 --- ---

287 
 

SAMHSA-Substance Use Services 

PRNS Mechanism Table 

Program, Project, and Activity 

(Dollars in thousands) 

Programs of Regional & National Significance 

FY 2021 

Final 

FY 2022 

CR 

FY 2023 

President's 

Budget 

No. Amount No. Amount No. Amount 

Peer Support TA Center

 Grants 

Continuations........................................................................................... 

New/Competing....................................................................................... 

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

 Contracts 

Continuations........................................................................................... 

New/Competing....................................................................................... 

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

 Total, Peer Support TA Centers 

Treatment, Recovery, and Workforce Support

 Grants 

Continuations........................................................................................... 

New/Competing....................................................................................... 

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

 Contracts 

Continuations........................................................................................... 

New/Competing....................................................................................... 

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

Total, Treatment, Recovery, and Workforce Support 

Emergency Department Alternatives to Opioids

 Grants 

Continuations........................................................................................... 

New/Competing....................................................................................... 

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

 Contracts 

Continuations........................................................................................... 

New/Competing....................................................................................... 

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

Total, Emergency Department Alternatives to Opioids 

1 $950 

--- ---

1 $950 

--- ---

1 $950 

--- ---

1 950 1 950 1 950

--- 49 

--- ---

--- 49 

--- 1 

--- 59 

--- 492 

--- 49 --- 50 --- 550

1 999 1 1,000 1 1,500 

8 3,989 

4 1,951 

12 5,911 

--- ---

12 5,937 

6 2,900 

12 5,940 12 5,911 18 8,837

--- 149 

--- ---

--- 149 

--- -60 

--- 130 

--- 32 

--- 149 --- 89 --- 163 

12 6,089 12 6,000 18 9,000 

10 4,753 

2 1,000 

12 5,764 

--- ---

2 1,000 

16 7,800 

12 5,753 12 5,764 18 8,800

--- 149 

--- 6 

--- 149 

--- 87 

--- 130 

--- 70 

--- 155 --- 236 --- 200 

12 5,908 12 6,000 18 9,000 

288 
 

SAMHSA-Substance Use Services 

PRNS Mechanism Table 

Program, Project, and Activity 

(Dollars in thousands) 

Programs of Regional & National Significance 

FY 2021 

Final 

FY 2022 

CR 

FY 2023 

President's 

Budget 

No. Amount No. Amount No. Amount 

Opioid Response Grants

 Grants 

Continuations...........................................................................................

New/Competing....................................................................................... 

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

 Contracts 

Continuations........................................................................................... 

New/Competing....................................................................................... 

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

Total, Opioid Response Grants 

Comprehensive Opioid Recovery Centers

 Grants 

Continuations........................................................................................... 

New/Competing....................................................................................... 

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

 Contracts 

Continuations........................................................................................... 

New/Competing....................................................................................... 

Subtotal 

 $--- $ ---

1 2,852 

1 $2,852

--- ---

 $--- $ ---

--- ---

1 2,852 1 2,852 --- ---

--- 148 

--- ---

--- 148 

--- ---

--- ---

--- ---

--- 148 --- 148 --- ---

1 3,000 1 3,000 --- ---

2 1,699 

2 1,700 

4 3,399 

--- ---

4 3,399 

2 1,700 

4 3,399 4 3,399 6 5,099

--- 215 

--- ---

--- 197 

--- 404 

--- 272 

--- 629 

--- 215 --- 601 --- 901 

Total, Comprehensive Opioid Recovery Centers 4 3,614 4 4,000 6 6,000 

Total, Capacity 968 479,864 961 481,842 1,104 550,182 

289 
SAMHSA-Substance Use Services 

PRNS Mechanism Table 

Program, Project, and Activity 

(Dollars in thousands) 

Science and Service 

FY 2021 

Final 

FY 2022 

CR 

FY 2023 

President's 

Budget 

No. Amount No. Amount No. Amount 

Addiction Technology Transfer Centers

 Grants 

Continuations........................................................................................... 

New/Competing....................................................................................... 

Supplements *.......................................................................................... 

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

 Contracts 

Continuations........................................................................................... 

New/Competing....................................................................................... 

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

 Total, Addiction Technology Transfer Centers 

SAT Minority Fellowship Program

 Grants 

Continuations........................................................................................... 

New/Competing....................................................................................... 

Supplements *.......................................................................................... 

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

 Contracts 

Continuations........................................................................................... 

New/Competing....................................................................................... 

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

Total, Minority Fellowship Program (MF) 

Subtotal, Science and Service: 

12 $9,019 

--- ---

--- ---

1 $500

--- ---

11 8,101 

 $--- $ ---

12 8,665 

--- ---

12 9,019 1 8,601 12 8,665

--- 445 

--- ---

--- 445 

--- ---

--- 380 

--- 1 

--- 445 --- 445 --- 381

12 9,465 1 9,046 12 9,046 

9 4,340 

--- ---

8 1,012 

9 4,340 

--- ---

--- 1,048 

--- ---

15.385 6,700 

--- ---

17 5,353 9 5,388 15 6,700

1 403 

--- 33 

1 395 

--- 6 

--- 292 

1 144 

1 436 1 401 1 436 

18 5,789 10 5,789 16 7,136 

30 15,254 11 14,835 28 16,182 

Total, Substance Use Services PRNS 998 $495,117 972 $496,677 1,133 $566,364 

* Excluding Supplements number count to avoid duplication. 

290 
SAMHSA-Substance Use Services 

Grant Awards Table 

(Whole Dollars) 

FY 2021 

Final 

FY 2022 

CR 

FY 2023 

President's Budget 

Number of Awards 994 969 1,129 

Average Award $472,455 $485,150 $476,853 

Range of Awards $300,000-$600,000 $300,000-$600,000 $300,000-$600,000 

291 
 

 

 

 

 

SAMHSA-Substance Use Services 

State Opioid Response Grants 

(Dollars in thousands) 

FY 2021 FY 2022 FY 2023 

Programs of Regional & National Significance Final

 COVID-19 

Supplemental CR 

President's 

Budget 

FY 2023 

+/- FY 2022 

State Opioid Response Grants............................................... 

Set-Aside for Tribes (non-add)..................................... 

$1,498,030

50,000 

 $---

---

$1,500,000 

50,000 

$2,000,000 

75,000 

$500,000 

25,000 

Authorizing Legislation .............................................Section 509 of the Public Health Service Act 

FY 2023 Authorization ..................................................................................................................$0 

Allocation Method ............................................................................................. Competitive Grants 

Eligible Entities................ Limited to Single State Agencies (SSAs), Existing USDA Cooperative 

.........................................................................................Extension Grantees, and U.S. Territories, 

.................Tribes and tribal organizations are eligible to apply to set-aside funds described below. 

Program Description & Accomplishments 

The State Opioid Response Grants (SOR) program, and its Tribal Opioid Response (TOR) 

component, were established by Congress in 2018 to address the public health crisis caused by 

escalating opioid misuse and substance use disorder across the nation. According to the Centers 

for Disease Control and Prevention (CDC) provisional data, more than 104,000 people died of a 

drug overdose in the United States in the 12 months ending in September 2021, the highest number 

ever recorded in a 12-month period.102 Illicitly manufactured fentanyl is driving the majority of 

deaths but mortality rates due to cocaine and psychostimulants such as methamphetamine have 

also increased, both with and without the presence of fentanyl. As in other areas, the COVID-19 

years have seen an exacerbation of health disparities in overdoses. During 2020, overdose deaths 

among African Americans increased 45 percent, nearly twice the growth rate of overdose deaths 

among White individuals. 

The SOR program provides resources to states, territories, and tribes to continue and enhance the 

development of comprehensive strategies focused upon preventing, intervening, and promoting 

recovery from issues related to opioid misuse, and increasingly stimulant misuse. This program 

aims to address the overdose crisis by increasing access to - the three FDA-approved medications 

for the treatment of opioid use disorder, reducing unmet treatment need, and reducing opioidrelated overdose deaths through the provision of prevention, harm reduction, treatment, and 

recovery activities for opioid use disorder (OUD) (including prescription opioids, heroin and illicit 

fentanyl and fentanyl analogs) and stimulant use disorder as so elected by states. In FY 2018, 

SAMHSA started awarding base grants to 57 states and territories via a formula. In addition, the 

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

overdose deaths. 

The SOR program requires grantees to: use epidemiological data to demonstrate the critical gaps 

in availability of treatment for OUDs, and stimulant use disorder if they so choose, in geographic, 

demographic, and service level terms; utilize evidence-based implementation strategies to identify 

102 https://www.cdc.gov/nchs/nvss/vsrr/drug-overdose-data.htm 

292 
 

 

 

 

 

SAMHSA-Substance Use Services 

which system design models will most rapidly and adequately address the gaps in their systems of 

care; deliver evidence-based treatment interventions that include medication(s) FDA-approved 

specifically for the treatment of OUD, and psychosocial interventions, including contingency 

management for stimulant use disorder if this is an included focus; report progress toward 

increasing availability of medication for opioid use disorder (MOUD) and reducing opioid-related 

overdose deaths, and the purchase and distribution of naloxone. The program supplements 

activities pertaining to opioids currently undertaken by the state agency and supports a 

comprehensive response to the overdose epidemic. The program identifies gaps and resources, 

while building upon existing substance use prevention, including naloxone purchase and 

distribution, harm reduction, and treatment activities as well as community-based recovery support 

services. A primary strategy to reduce overdose deaths in the SOR program, that will continue in 

FY 23, is education on, and purchase and distribution of naloxone, a proven medication that 

reverses opioid-related overdoses to save lives. While some states have reported data indicating 

challenges accessing low-cost naloxone and distribution impediments, as of December 16, 2021, 

states reported that 3,829,217 naloxone kits were distributed, and naloxone was used to reverse 

approximately 307,956 overdoses. 

In addition to the grant program, SAMHSA supports a robust technical assistance and training 

effort to enhance education across the country to address the overdose crisis. This effort is 

available not only to SOR and TOR grantees but to all of their sub-recipients and affiliated entities. 

A key component of this technical assistance is local teams of multi-disciplinary experts on the 

ground in every state. Comprised of a range of clinicians, preventionists, and recovery specialists, 

these teams and the technical expertise and educational resources they bring provide training not 

just to individual practitioners but also to individuals and families, healthcare practices, and law 

enforcement, criminal justice groups, and other community-based organizations. Providing this 

training ensures that local response to the opioid and substance use crisis is tailored to local needs. 

The SOR Evaluation Report to Congress was submitted to the Congress in October 2021. Since 

the SOR program began, approximately 971,372 patients have received treatment services, 

including 409,086 who have received an FDA-approved medication for opioid use disorder 

(MOUD). Of that number, 166,091 received methadone, 218,518 received buprenorphine, and 

24,477 received naltrexone. Through the SOR program, 686,998 patients received recovery 

support services.103 

While some grantees have reported data indicating challenges accessing low-cost naloxone and 

distribution impediments, as of December 16, 2021, grantees reported in the SPARs system, 

3,829,217 naloxone kits were distributed.104 Grantees also reported using naloxone to reverse 

approximately 307,956 overdoses. 105 

103 Data is from the FY 2018 SOR cohort, including no-cost extensions, Performance Progress Reports (September 

30, 2018-September 29, 2021); and the FY 2020 SOR cohort annual Performance Progress Reports (September 30, 

2020 to September 29, 2021).

104 Data reported is based on GPRA data generated in SPARs on December 16, 2021 for the number of naloxone kits 

distributed. 

105 Data is from the FY 2018 SOR cohort, including no-cost extensions, Performance Progress Reports (September 

293 
 

 

 

SAMHSA-Substance Use Services 

Tribal Opioid Response Grants 

The Tribal Opioid Response Grants (TOR) program addresses the public health crisis caused by 

escalating opioid misuse and substance use disorder across tribal communities. The program aims 

to address the overdose crisis in tribal communities by increasing access to culturally appropriate 

and evidence-based treatment, including MOUD using one of the three FDA-approved 

medications for the treatment of OUD. The intent of this program is to reduce unmet treatment 

need and overdose related deaths through the provision of prevention, harm reduction, treatment 

and recovery activities for OUD and stimulant misuse including methamphetamine and cocaine. 

According to the Centers for Disease Control and Prevention, American Indians, and Alaska 

Natives (AI/AN) had the highest drug overdose death rates per 100,000 standard population in 

2019. The rate for the American Indian and Alaska Native population was 41.2 percent higher 

than the national rate. 

American Indian and Alaska Native communities experience high rates of physical, emotional, 

and historical trauma and significant socioeconomic disparities, which may contribute to higher 

rates of drug misuse in the tribal communities. The TOR program addresses the gaps in prevention, 

harm reduction, treatment, and recovery identified by the tribes and support strategies to purchase 

and disseminate naloxone and provide training on its use to first responders and other tribal 

members. 

Rural Opioids Technical Assistance- Regional Centers (ROTA-R) Cooperative Agreements 

The purpose of this SAMHSA program is to develop and disseminate training and technical 

assistance on addressing opioid and other stimulant issues affecting rural communities. Recipients 

are expected to facilitate the identification of model programs, develop and update materials 

related to the prevention, harm reduction, treatment, and recovery activities for Opioid Use 

Disorder (OUD) and/or Stimulant Use Disorder, and ensure that high-quality training is provided. 

In 2017, the Centers for Disease Control and Prevention (CDC) announced that the rates of drug 

overdose deaths were rising in rural areas, surpassing rates in urban areas. Moreover, a 2017 

survey by two leading farm groups, the National Farmers Union, and the American Farm Bureau 

Federation, found that nearly 50 percent of rural Americans, and 74 percent of farmers, have been 

directly impacted by opioid misuse. 

In FY 2021, SAMHSA funded 57 SOR, 16 ROTA continuation grants, 41 new TOR, and 40 

TOR continuation grants and continues to support technical assistance and training grants. 

In FY 2022, SAMHSA anticipates funding 59 SOR, 10 ROTA new cooperative agreements, 150 

new TOR, and continues to support technical assistance and training grants. 

From 2018 to 2021, SAMHSA has funded three cohorts of ROTA grantees. Together, they have 

implemented over 3,800 events and served over 105,000 community members, including 

30, 2018- September 29, 2021); and the FY 2020 SOR cohort annual Performance Progress Reports (September 30, 

2020 to September 29, 2021). 

294 
SAMHSA-Substance Use Services 

providers, in rural areas. SAMHSA continues to develop and disseminate training and technical 

assistance for rural communities addressing opioid and stimulant issues affecting their 

communities. 

Client Outcomes 

The data highlights the following positive client outcomes between intake and 6-month follow-up. 

• The percentage of clients who abstained from alcohol or illegal drugs increased by 

49.9%. 

• The percentage of clients who were not arrested in the past 30 days increased by 3.9%., 

Of note, 92.7% of clients had no criminal justice involvement at intake. 

• The percentage of clients who experienced no alcohol or illegal drug-related health, 

behavioral or social consequences106 in the previous 30 days increased by 34.0%. 

• The percentage of clients who were socially connected increased by 6.0%. 

• The percentage of clients who had a permanent place to live in the community increased 

by 27.5%. 

• The percentage of clients who were currently employed or attending school increased by 

53.8%. 

Data highlights the following positive mental health outcomes reported by SOR clients: 

• The percentage of clients who reported experiencing depression decreased by 22.7%. 

• The percentage of clients who reported experiencing anxiety decreased by 19.3%. 

• The percentage of clients who reported experiencing hallucination decreased by 45.0%. 

• The percentage of clients who reported having trouble understanding, concentrating, or 

remembering decreased by 33.2%. 

• The percentage of clients who reported having trouble controlling violent behavior 

decreased by 39.0%. 

• The percentage of clients who reported attempting to commit suicide decreased by 

54.5%. 

• The percentage of clients who reported being prescribed medication for psychological or 

emotional problems decreased by 4.5%. 

SOR clients reported decreased use of emergency departments for urgent treatment of mental or 

emotional difficulties or alcohol and/or substance misuse as well as decreased numbers of hospital 

admissions for these conditions following six months of program participation. 

The data below highlights the declines between intake and 6-month follow-up. 

• The percentage of clients who reported seeking care in an emergency department for 

mental and emotional difficulties decreased from intake to 6-month follow-up by 69.6%. 

106 Defined as experiencing stress, reduction or cessation of important activities, and emotional problems as a result 

of substance use. 

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• The percentage of clients who reported seeking care in an emergency department for 

alcohol and/or substance use declined from intake to 6-month follow-up declined by 

89.3%. 

Five Year Funding Table 

Fiscal Year Amount 

COVID-19 

Supplemental 

Funding 

FY 2019 $1,500,000,000 

FY 2020 $1,500,000,000 

FY 2021 Final $1,498,030,000 

FY 2022 CR $1,500,000,000 

FY 2023 President's Budget $2,000,000,000 

Budget Request 

The FY 2023 President’s Budget request is $2.0 billion, an increase of $500.0 million from the FY 

2022 Annualized Continuing Resolution. These budgets include $75.0 million for TOR, an 

increase of $25.0 million from the FY 2022 Annualized Continuing Resolution. SAMHSA plans 

to fund 59 new SOR grants to continue to support states and territories, including a 15 percent setaside for states with the highest mortality rates related to drug overdose deaths. The allowable 

uses of this program will continue to include state efforts to address stimulants, including 

methamphetamine, and cocaine. Stimulants are an increasing source of concern and are 

responsible for more deaths than opioids in a growing number of states, even as opioid overdose 

deaths are continuing to increase. The increase of $500.0 million will enhance states’ ability to 

address stimulants, as well as other issues related to the overdose epidemic that have been 

compounded due to COVID-19. 

Based on an assessment of a state’s naloxone purchasing and distribution, states will utilize SOR 

grant dollars to target naloxone to underserved areas and organizations. SAMHSA will assist 

states in the identification of underserved communities and agencies and require states to submit 

a plan as part of their SOR grant application with measurable targets and outcomes for the 

acquisition and distribution of naloxone. 

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Outputs and Outcomes Table 

Program: State Opioid Response Grants 

Measure Year and Most Recent 

Result / 

Target for Recent Result / 

(Summary of Result) 

FY 2022 

Target 

FY 2023 

Target 

FY 2023 

Target 

+/-FY 2022 

Target 

1.2.70 Number of 

admissions for OUD 

treatment (Output) 

FY 2021: 127,500.0 

Target: 

90,487.0 

(Target Exceeded) 

127,500.0 133,875.0 +6,375 

1.2.71 number of clients 

receiving recovery 

services (Output) 

FY 2021: 49,180.0 

Target: 

38,147.0 

(Target Exceeded) 

38,147.0 51,639.0 +13,492 

1.2.73 Illicit drug use at 6 

months follow-up 

(Output) 

FY 2021: 69.8 

Target: 

70.0 

(Target Not Met) 

70.0 73.3 +3.3 

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Substance Abuse and Mental Health Services Administration 

FY2023 State Opioid Response Grant Provisional Allotments 

Appropriation Amount $2,000,000,000, State-Territory Total $1,960,000,000 

CFDA # 93.959 

State or Territory 

FY 2021 

Final 

FY 2022 

CR 

FY 2023 

President's Budget 

FY 2023 +/-

FY 2022 

Alabama $16,086,041 $16,079,227 $21,395,996 $5,316,769 

Alaska $4,000,922 $4,000,000 $4,000,000 $0 

Arizona $31,606,462 $31,593,073 $45,757,439 $14,164,366 

Arkansas $10,761,139 $10,756,580 $9,575,212 -$1,181,368 

California $105,864,578 $105,819,731 $167,683,802 $61,864,071 

Colorado $20,842,436 $20,833,943 $28,946,115 $8,112,172 

Connecticut $14,215,214 $14,209,192 $19,360,193 $5,151,001 

Delaware $36,792,330 $36,789,643 $47,021,741 $10,232,098 

District Of Columbia $23,821,155 $23,819,356 $32,953,947 $9,134,591 

Florida $100,170,437 $100,128,003 $138,646,471 $38,518,468 

Georgia $29,276,244 $29,263,842 $40,782,451 $11,518,609 

Hawaii $4,001,647 $4,000,000 $5,030,471 $1,030,471 

Idaho $7,849,021 $7,845,696 $8,788,714 $943,018 

Illinois $36,780,089 $36,764,508 $48,005,969 $11,241,461 

Indiana $28,822,022 $28,809,812 $46,358,763 $17,548,951 

Iowa $8,981,573 $8,977,768 $13,843,563 $4,865,795 

Kansas $8,277,029 $8,273,523 $11,493,322 $3,219,799 

Kentucky $35,483,406 $35,473,903 $51,375,151 $15,901,248 

Louisiana $17,262,461 $17,255,148 $28,705,672 $11,450,524 

Maine $6,255,970 $6,253,320 $8,218,495 $1,965,175 

Maryland $50,751,132 $50,739,768 $63,405,258 $12,665,490 

Massachusetts $56,963,164 $56,945,944 $62,033,907 $5,087,963 

Michigan $36,440,925 $36,425,488 $38,825,055 $2,399,567 

Minnesota $11,230,464 $11,225,707 $12,908,266 $1,682,559 

Mississippi $7,161,998 $7,158,964 $8,474,706 $1,315,742 

Missouri $25,007,072 $25,007,072 $25,221,721 $214,649 

Montana $4,001,491 $4,000,000 $5,678,667 $1,678,667 

Nebraska $4,442,605 $4,440,723 $5,879,179 $1,438,456 

Nevada $16,536,539 $16,529,534 $17,129,745 $600,211 

New Hampshire $28,134,889 $28,132,184 $35,743,505 $7,611,321 

New Jersey $65,969,842 $65,948,806 $91,425,177 $25,476,371 

298 
 

 

 

 

 

 

 

 

 

 

 

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Substance Abuse and Mental Health Services Administration 

FY2023 State Opioid Response Grant Provisional Allotments 

Appropriation Amount $2,000,000,000, State-Territory Total $1,960,000,000 

CFDA # 93.959 

New Mexico $7,533,719 $7,530,528 $11,925,668 $4,395,140 

New York $56,235,022 $56,211,200 $64,806,153 $8,594,953 

North Carolina $35,149,381 $35,134,491 $55,009,603 $19,875,112 

North Dakota $4,000,773 $4,000,000 $4,000,000 $0 

Ohio $96,228,429 $96,196,878 $139,849,683 $43,652,805 

Oklahoma $15,973,401 $15,966,634 $14,772,777 -$1,193,857 

Oregon $15,301,349 $15,294,867 $15,605,933 $311,066 

Pennsylvania $79,828,525 $79,803,922 $100,979,904 $21,175,982 

Rhode Island $4,393,836 $4,391,975 $5,170,873 $778,898 

South Carolina $17,939,482 $17,931,882 $18,391,048 $459,166 

South Dakota $4,001,239 $4,000,000 $4,000,000 $0 

Tennessee $30,117,291 $30,104,533 $41,364,454 $11,259,921 

Texas $52,194,013 $52,171,902 $63,533,710 $11,361,808 

Utah $10,721,130 $10,716,588 $14,532,119 $3,815,531 

Vermont $4,001,424 $4,000,000 $4,000,000 $0 

Virginia $27,640,634 $27,628,925 $35,910,464 $8,281,539 

Washington $27,173,792 $27,162,281 $46,710,387 $19,548,106 

West Virginia $43,761,652 $43,756,934 $55,922,311 $12,165,377 

Wisconsin $16,728,087 $16,721,001 $22,133,738 $5,412,737 

Wyoming $4,000,587 $4,000,000 $4,000,000 $0 

State Subtotal $1,406,714,063 $1,406,224,999 $1,867,287,500 $461,062,501 

American Samoa $250,000 $250,000 $250,000 $0 

Guam $250,000 $250,000 $250,000 $0 

Northern Marianas $250,000 $250,000 $250,000 $0 

Puerto Rico $12,025,000 $12,025,000 $15,962,500 $3,937,500 

Palau $0 $250,000 $250,000 $0 

Marshall Islands $0 $250,000 $250,000 $0 

Micronesia $250,000 $250,000 $250,000 $0 

Virgin Islands $250,000 $250,000 $250,000 $0 

Indian Tribes $50,000,000 $50,000,000 $75,000,000 $25,000,000 

Territory Subtotal $63,275,000 $63,775,000 $92,712,500 $28,937,500 

Total State-Territory $1,469,989,063 $1,469,999,999 $1,960,000,000 $490,000,001 

Total Administrative $28,040,937 $30,000,001 $40,000,000 $9,999,999 

Total Appropriation $1,498,030,000 $1,500,000,000 $2,000,000,000 $500,000,000 

Note: These are the estimated numbers. 

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Substance Abuse Prevention and Treatment Block Grant 

(Dollars in thousands) 

FY 2021 FY 2022 FY 2023 

Programs of Regional & National Significance Final

 COVID-19 

Supplemental CR 

President's 

Budget 

FY 2023 

+/- FY 2022 

Substance Abuse Prevention and Treatment Block Grant 

Budget Authority (non-add).......................................... 

PHS Evaluation Funds (non-add).................................... 

$1,849,654 

1,770,454 

79,200 

$3,150,000 

3,150,000 

---

$1,858,079 

1,778,879 

79,200 

$3,008,079 

2,928,879 

79,200 

$1,150,000 

1,150,000 

---

Authorizing Legislation ...........................................Section 1935 of the Public Health Service Act 

FY 2023 Authorization ..................................................................................................................$0 

Allocation Method ................................................................................................... Formula Grants 

Eligible Entities........................States, Territories, Freely Associated States, District of Columbia, 

............................................................. and the Red Lake Band of Chippewa Indians of Minnesota 

Program Description and Accomplishments 

The Substance Abuse Prevention and Treatment Block Grant program (SABG) is a formula grant 

which funds 60 eligible states, territories and freely associated states, the District of Columbia, and 

the Red Lake Band of Chippewa Indians (referred to collectively as states). SABG grantees plan, 

implement, and evaluate substance use disorder (SUD) prevention, treatment, and recovery 

support services based on the specific needs of their state systems and populations. Ninety-five 

percent of SABG funding is distributed to states through a formula that allocates funds based on 

specified economic and demographic factors and provisions that limit fluctuations in allotments as 

the total SABG appropriation changes from year to year. 

The goal of the SABG program is to ensure that individuals, their families, and communities have 

access to the range of substance use-related prevention, treatment, harm reduction, and recovery 

support services necessary to improve individual outcomes and reduce the impact of substance 

misuse on America’s communities. 

Target Services and Populations 

The SABG program’s authorizing statute and regulations afford states flexibility to identify and 

deliver substance use-related services to meet their state-specific needs while also ensuring 

attention to critical prevention-focused public health issues. However, certain service areas and 

populations are required to be addressed to receive SABG funds. The following services and target 

populations must be addressed using program funds: 

1. Primary prevention services; 

2. Tuberculosis (TB) services involving TB screening, counseling, and referral for medical 

evaluation and treatment; 

3. Early intervention services for HIV/AIDS; 

4. Services for substance using pregnant women and women with dependent children; and 

5. Services for persons who inject drugs. 

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States must also comply with the Synar Amendment to receive their full SABG funding. The 

Synar Amendment requires states to enact and enforce laws prohibiting the sale or distribution of 

tobacco products to individuals under the federal legal age of sale. 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 program is a critical component of the success 

of youth and young adult tobacco use prevention efforts. SAMHSA is charged with overseeing 

states’ implementation of the Synar requirements and provides consultation to states to ensure 

compliance with the Synar requirements. States that fail to enact and enforce laws prohibiting the 

sale or distribution of tobacco products to individuals under the federal age of sale may face a 

potential penalty reduction of their block grant allotment. 

Despite these requirements, the consistent federal funding and administrative flexibility of the 

SABG program enables states to respond to local and/or regional emergent SUD issues impacting 

health, public health, and public safety. States use program resources to fund their respective 

SABG sub-recipients, including, but not limited to, administrative service organizations, 

county, and municipal governments, as well as prevention, treatment, and recovery support service 

providers directly. Moreover, states have the flexibility to prioritize other underserved populations 

as determined by anecdotal and empirical data. For example, nearly one-third of states prioritized 

SUD treatment and recovery support services for adolescents and transitional age youth in FY 

2022 and FY 2023. 

Funding Set-Asides 

The authorizing legislation and implementing regulations for the SABG include a maintenance of 

effort requirement, and specific funding set-asides, including 20 percent set-aside for primary 

prevention, a newly established 10 percent recovery support services set-aside, and five percent 

set-aside for early intervention services for HIV for designated states. 

Maintenance of Effort (MOE): 

A state must maintain its expenditures for certain SUD prevention and treatment activities at a 

level that is no less than the state’s average expenditures for the previous two years. Additionally, 

the statute requires states to maintain the FY 1994 level of expenditures for treatment of substanceusing pregnant women and women with dependent children. The statute and regulation provide 

states with the flexibility to expend a combination of federal and non-federal funds for women’s 

services. 

Primary Prevention Set-Aside 

The 20 percent set-aside requires SABG grantees to spend at least 20 percent of their SABG funds 

to develop and implement a comprehensive substance misuse prevention program, which includes 

a broad array of prevention strategies directed at individuals not identified to need treatment. The 

prevention set-aside is one of SAMHSA’s main vehicles aimed at preventing substance misuse 

and allows states to develop prevention infrastructure and capacity. A thriving prevention 

infrastructure will achieve and maintain long-term results by ensuring that states have the 

necessary supports in place to conduct needs assessments, develop strategic plans, provide 

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culturally appropriate services, capture data to make data driven decisions on how prevention 

resources should be allocated throughout communities in their state, and evaluate process and 

outcome data. 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. SAMHSA 

regularly works with states to improve their accountability systems for prevention and to establish 

necessary reporting capacities. 

Recovery Support Services Set-Aside 

The FY 2023 budget includes a 10 percent set-aside for non-clinical recovery support services. 

The set-aside requires that least 10 percent of grantees’ SABG expenditures be used for recovery 

community organizations, peer recovery support services, and other recovery support services. 

Recovery support systems partner people in recovery from mental and substance use disorders, as 

well as their family members, with recovery services. These services may include recovery 

housing, recovery community centers, recovery schools, recovery industries, and recovery 

ministries. These programs utilize individual, community, and system-level approaches to 

increase the four dimensions of recovery as defined by SAMHSA: 

1. Health (access to quality health and SUD treatment); 

2. Home (housing with needed supports); 

3. Purpose (education, employment, and other pursuits); and 

4. Community (peer, family, and other social supports)23 

States can use these funds to develop local recovery community support institutions, provide 

system navigation resources and supports, and collaborate and coordinate with local private, 

public, non-profit, and faith community response efforts. SAMHSA anticipates that this set-aside 

will help increase access to recovery support services across the country and complement the 

existing efforts to respond to the ongoing overdose crisis that has accelerated during the COVID19 pandemic. 

Key Accomplishments 

Having a robust SUD services system is more critical than ever. An estimated 100,306 people 

died from drug overdose related deaths during 12-month period ending in April 2021, an increase 

of 28.5% from the same period the year before.

107 Moreover significant health disparities exist and 

were exacerbated by the COVID-19 pandemic. During 2020, overdose deaths among Black 

Americans increased 45 percent, nearly doubling the growth rate of that for White people.1 

Individuals and families without health coverage or whose health insurance benefit will not cover 

certain services rely heavily on the SABG as the source of funding for their SUD care. In FY2021, 

the SABG accounted for approximately 19 percent of total state substance use agency funding 

107 CDC/National Center for Health Statistics 

https://www.hsph.harvard.edu/news/hsph-in-the-news/drug-overdose-deaths-hit-record-high/ 

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SAMHSA-Substance Use Services 

compared to approximately 24 percent supported by state Medicaid dollars.108 

States leverage SABG funds in several different ways. In some states, block grant dollars serve 

as the foundation for prevention and priority treatment and recovery support services for 

individuals without insurance or for whom coverage is terminated for short periods of time. Other 

states rely on the SABG to complement services covered by Medicaid, Medicare, and private 

insurance by supporting non-covered SUD prevention, treatment, and recovery support services 

as well as training for staff and implementation of improved business practices. 

The COVID-19 pandemic brought extraordinary pressures and opportunities for the SABG. 

In FY 2021, the COVID-19 and American Rescue Plan (ARP) supplemental funding added to the 

SABG program enabled grantees to provide much needed support for targeted housing and 

recovery support services. Both service areas have been integral to undergirding the substance use 

disorder treatment services that have been provided to clients at all levels of care at a time when 

the need for the continuum of care is at an all-time high. Services have also been adapted to 

address health and safety concerns related to COVID-19. There has been extensive adoption of 

telehealth services to provide continuous accessibility of services to clients and communities 

during the pandemic. Grantees have also been encouraged to use SABG funds to strengthen the 

crisis continuum of care, and to expand mobile substance use disorder services, including mobile 

medication services to reach persons with Opioid Use Disorder. Plans for FY 2023 are to continue 

strengthening service accessibility and quality, while expanding services to under-served 

populations, including the expansion of recovery support services with the newly established 

recovery support services set-aside. 

Importantly, SABG funds are also directed towards the collection of performance and outcome 

data to determine the ongoing effectiveness of supported activities and provide states and the 

federal government the grounding to plan the implementation of new evidence-based services. At 

this critical moment in our country’s substance use crisis, it is imperative that our response truly 

evolve from an acute, short-term, individual-focused treatment response to a broader community 

recovery response. Addiction is a chronic illness, and recovery often is a life-long process where 

the healthcare system, external community, and social determinants of health play vital roles in its 

sustainability. Modernizing the data component for the SABG will be a significant focus for 

FY2023. 

Performance and Evaluation 

The SABG program enables the development of comprehensive statewide systems of care that 

provide a broad continuum of SUD services and supports encompassing prevention, treatment, 

and recovery support services for all individuals who need them. Among the target populations 

for outreach and intervention are pregnant and postpartum women, persons who inject drugs, 

108 Web Block Grant Application System (WebBGAS) FY 2021 SABG State Agency Reported Expenditures by 

Target Activity Within Source of Funds, State/Jurisdiction Selection: All States/Jurisdictions. The numerator for 

this estimate is total Medicaid expenditures for report year 2021 (n= $2,128,032,758) and the denominator is the 

total state funding (all sources of funds) (n= $8,798,119,384). The denominator includes SABG, Medicaid, and 

other federal funding expenditures. 

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SAMHSA-Substance Use Services 

persons at risk for HIV, justice-involved populations, people with co-occurring mental disorders, 

and persons experiencing homelessness and housing instability. Therefore, to assess the 

performance of the SABG program in achieving its goals, SAMHSA must measure the impact of 

the program on individual client outcomes as well as enhancements to state SUD care delivery 

systems. 

Specifically, SAMHSA will assess the extent to which the SABG program: 

• Contributes to positive effects on the health and quality of life of individuals with SUD as 

demonstrated by positive client outcomes in the treatment domains of the National 

Outcomes Measures (NOMs); 

• Improves state prevention and treatment systems’ infrastructure and capacity resulting in 

an increase in services, development and implementation of evidence-based practices, 

development and collection of specific outcome measures, and development and 

maintenance of state data management systems; 

• Aids states in leveraging requirements, resources, and federal guidance to sustain and 

improve state systems further emphasizing the importance of the SABG in the 

development of the same; and 

• Contributes to the development and maintenance of successful state collaborations with 

other agencies and stakeholders concerned with preventing and treating SUD. 

In FY 2022 -2023, SAMHSA is undertaking an agency-wide effort designed to develop a data 

strategy that will set the stage for a modernized set of common performance, evaluation, and 

quality metrics with which to assess the effectiveness of SAMHSA’s grant programs. 

SABG SUD Treatment Outcomes 

SAMHSA data shows that, on average, the SABG program has been successful in expanding 

treatment capacity by annually supporting approximately two million109 admissions to treatment 

programs receiving public funding. Outcome data for the SABG program show positive results as 

reported through the Behavioral Health Services Information System/Treatment Episode Data Set 

(TEDS) administered by SAMHSA’s Center for Behavioral Health Statistics and Quality. In the 

FY 2021 SABG Annual Report, which reflects State Fiscal Year (SFY) 2020 data, at discharge, 

clients reported increased abstinence rates from both illegal drug (16.9 percent increase) and 

alcohol (10.2 percent increase) use. 

In addition, in the FY 2021 SABG Annual Report, state substance use authorities reported the 

following outcomes for services provided during state fiscal year (SFY) 2020, the most recent year 

for which data is available: 

• For participating states and territories, 46 of the 59 jurisdictions identified improvements 

in client abstinence from alcohol use 

• Similarly, for participating states and territories, 40 of 59 jurisdictions identified 

109 Web Block Grant Application System (WebBGAS) FY 2015 - 2021 SABG Treatment Utilization Matrix 

Admissions & Persons Served, State/Jurisdiction Selection: All States/Jurisdictions. 

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improvements in client abstinence from drug use 

• For participating states and territories, 52 of 59 jurisdictions identified improvements in 

client employment 

• For participating states and territories, 53 of 59 jurisdictions reported an increase in 

clients with no arrests 

• For participating states and territories, 51 of 59 jurisdictions identified improvements in 

stable housing for clients 

• For participating states and territories, 52 states out of 59 jurisdictions identified 

improvements in client engagement in recovery support services 

In FY 2021, states expended: 

• $381,801,078 (23 percent of total SABG funds expended) for primary prevention 

activities 

• $195,405 (0.01 percent) for tuberculosis services 

• $18,256,336 (1.1 percent) for early intervention services for HIV 

• $93,232,920 (5.62 percent) for state-level administration. 

All states admitted 7,252,145 total clients, specifically: 

• 262,394 persons admitted to withdrawal management services; 

• 448,728 persons admitted to residential treatment levels of care; 

• 4,888,360 persons admitted to ambulatory services; and 

• 1,652,663 persons received outpatient treatment that included medications for 

opioid use disorder 

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FY 2021 SABG Demographics110111 

Total Persons Served (Adults and Children) 1,758,392 

Female 39.3% 

Male 60.7% 

Race 

White 66.6% 

Blacks or African Americans 18.7% 

American Indian/Alaska Natives 0.8% 

Asians 0.4% 

Native Hawaiian/Other Pacific Islanders 0.5% 

Unknown 11.2% 

Multi-Racial 2.3% 

Ethnicity 

Not Hispanic or Latino 84.9% 

Hispanic or Latino 15.1% 

Age 

17 and Under 4.7% 

18 - 24 10.8% 

25 - 44 56.1% 

45 - 64 26.0% 

65 and Over 2.4% 

Synar Program Outcomes 

While the national weighted retailer violation rate declined steadily from 40.1 percent in the 

program’s baseline year in FY 1997 through FY 2011, the rate increased from an all-time low of 

8.5 percent in FY 2011 to 9.6 percent in FY 2018. In FY 2019 and FY 2020, the national weighted 

retailer violation rate was 7.6 and 8.4, respectively. One of the greatest predictors of a state's 

retailer violation rate is the amount and reach of their enforcement efforts. As states have faced 

budget shortfalls, some have scaled back their enforcement programs and this may be contributing 

to the higher rates of tobacco sales to youth and young adults. Also, under the Synar program, 

SAMHSA encourages states to include in their inspections the types of tobacco products most 

often used by youth and young adults 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 and 

young adults. Several states increased the age for tobacco sales from 18 to 21 prior to the federal 

law change in December 2019. These factors are likely contributing to the fluctuating national 

110 Source: FY 2020 SABG Report – Table 10 - Treatment Utilization Matrix has been used to reflect official total 

number of persons served. Kentucky did not supply data. Historically, Table 10 has been used to reflect official 

numbers of persons served. Furthermore, the table does not break out persons served by age or gender. The total 

reflects adults and children served. 

111 Source: FY 2020 SABG Report - Table 11 – Unduplicated Count of Persons Served for Alcohol and Other Drug 

Use. Kentucky did not supply data. Table 11 is the only table that collects gender and age data. Hence, gender and 

age percentages are calculated based on data from Table 11. 

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SAMHSA-Substance Use Services 

weighted retailer violation rate. SAMHSA is addressing this by providing consultation to states, 

as well as examining Synar data to provide states with guidance on best practices including 

enforcement, merchant education, and community mobilization. 

Technical Assistance 

In addition to the states and jurisdictions’ plans and reports, authorizing legislation provides 

SAMHSA with resources to support technical assistance to the SABG grantees and their subrecipients to ensure that they can effectively provide prevention, substance use disorder treatment, 

and recovery support services. SAMHSA’s Knowledge Application Program (KAP) 

(https://www.samhsa.gov/kap) produces the Technical Assistance Publication Series that provide 

practical guidance and information related to the delivery of SUD treatment services and related 

public health services to individuals and families. The KAP also produces the Treatment 

Improvement Protocol Series, a growing library of best practice guidelines, which are produced 

by a consensus-development process based on the experience and knowledge of clinical, research, 

and administrative experts. SAMHSA is also re-developing a two-pronged quality assurance and 

individualized, state-specific technical assistance program to provide additional support to states 

in their implementation of the SABG grant program. 

10 Year Funding Table 

Fiscal Year Amount 

COVID-19 

Supplemental 

Funding 

FY 2014 $1,815,443,000 

FY 2015 $1,819,856,000 

FY 2016 $1,858,079,000 

FY 2017 $1,857,079,000 

FY 2018 $1,858,079,000 

FY 2019 $1,858,079,000 

FY 2020 $1,858,079,000 

FY 2021 Final $1,849,653,876 $1,500,000,000 

FY 2022 CR $1,858,079,000 

FY 2023 President's Budget $3,008,079,000 

Budget Request 

The FY 2023 President’s Budget request is $3.0 billion, an increase of $1.2 billion from the FY 

2022 Annualized Continuing Resolution. SAMHSA plans to continue serving as a source of 

safety-net funding, including providing assistance to states in addressing and evaluating activities 

to prevent, reduce harm, treat, and provide recovery support services for individuals, families, and 

communities that are adversely impacted by substance use disorders (SUDs), and related 

conditions such as opioid use disorder. The need and demand for treatment and recovery support 

services for SUDs continues to grow, as exacerbated by the coronavirus pandemic. SAMHSA will 

continue to assist states and jurisdictions in planning for, expanding, enhancing, and building 

307 
 

SAMHSA-Substance Use Services 

capacity in their service systems to address these evolving needs. Continued Medicaid expansion 

and additional out-year funding to assist in responding to the COVID-19 pandemic (i.e., 

Coronavirus Response and Relief Supplement and American Rescue Plan) will bolster the SABG 

allowing the program to continue to serve as a safety net for vulnerable populations that rely on 

public funding to pay for specialty substance use disorder prevention, treatment, harm reduction, 

and recovery support services. States will continue to use the Coronavirus Response and Relief 

Supplement and American Rescue Plan funding through FY 2023 and FY 2025, respectively, as 

states expand their SUD infrastructure to address unmet service needs. 

The Budget also includes new language that would use HIV cases as opposed to AIDS cases to 

calculate the HIV-set-aside. 

308 
 

 

 

SAMHSA-Substance Use Services 

Outputs and Outcomes Table 

Program: Prevention Set-Aside 

Measure Year and Most Recent 

Result / 

Target for Recent Result / 

(Summary of Result) 

FY 2022 

Target 

FY 2023 

Target 

FY 2023 

Target 

+/-FY 2022 

Target 

2.3.63 Percent of states 

showing an increase in 

state level estimates of 

survey respondents 

who rate the risk of 

substance abuse as 

moderate or great (age 

12-17) (Outcome) 

FY 2020: 41.1 % 

Target: 

37.3 % 

(Target Exceeded) 

41.1 % 41.1 % Maintain 

2.3.65 Percent of states 

showing a decrease in 

state level estimates of 

percent of survey 

respondents who report 

30 day use of alcohol 

(age 12-17) (Outcome) 

FY 2020: 51.8 % 

Target: 

53 % 

(Target Not Met) 

67.5 % 67.5 % Maintain 

2.3.67 Percent of states 

showing a decrease in 

state level estimates of 

percent of survey 

respondents who report 

30 day use of other 

illicit drugs (age 12-17) 

(Outcome) 

FY 2021: 50 % 

Target: 

63 % 

(Target Not Met) 

63 % 63 % Maintain 

2.3.68 Percent of states 

showing a decrease in 

state level estimates of 

percent of survey 

respondents who report 

30 day use of other 

illicit drugs (age 18+) 

(Outcome) 

FY 2021: 48.2 % 

Target: 

43 % 

(Target Exceeded) 

48 % 48 % Maintain 

309 
 

 

 

 

SAMHSA-Substance Use Services 

Outputs and Outcomes Tables 

Program: Treatment Activities 

Measure Year and Most Recent 

Result / 

Target for Recent Result / 

(Summary of Result) 

FY 2022 

Target 

FY 2023 

Target 

FY 2023 

Target 

+/-FY 2022 

Target 

1.2.43 Number of 

admissions to substance 

abuse treatment programs 

receiving public funding 

(Output) 

FY 2021: 1,419,631 

Target: 

2,065,199 

(Target Not Met) 

1,419,631 1,448,024 +28,393 

1.2.48 Percentage of clients 

reporting no drug use in the 

past month at discharge 

(Outcome) 

FY 2021: 50.4 % 

Target: 

55.7 % 

(Target Not Met) 

50.4 % 52.4 % +2 %point(s) 

1.2.49 Percentage of clients 

reporting no alcohol use in 

the past month at discharge 

(Outcome) 

FY 2021: 76.6 % 

Target: 

77.3 % 

(Target Not Met) 

76.6 % 78.6 % +2 %point(s) 

1.2.50 Percentage of clients 

reporting being employed/in 

school at discharge 

(Outcome) 

FY 2021: 34.4 % 

Target: 

36 % 

(Target Not Met) 

34.4 % 36.4 % +2 %point(s) 

1.2.51 Percentage of clients 

reporting no involvement 

with the Criminal Justice 

System (Outcome) 

FY 2021: 93.8 % 

Target: 

95.5 % 

(Target Not Met but Improved) 

93.8 % 95.8 % +2 %point(s) 

1.2.85 Percentage of clients 

receiving services who had a 

permanent place to live in 

the community (Outcome) 

FY 2021: 90.9 % 

Target: 

89 % 

(Target Exceeded) 

90.9 % 92.9 % +2 %point(s) 

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SAMHSA-Substance Use Services 

FY 2023 Substance Abuse Prevention and Treatment Block Grant Final Allotment 

Appropriation Amount $3,008,079,00, State-Territory Total $2,852,998,623 

CFDA # 93.95 

State 

FY 2021 

Final 

FY 2022 

CR 

President's 

Budget 

FY 2023 +/- 

FY 2022 

Alabama $63,424,428 $23,434,686 $38,266,630 $14,831,944 

Alaska $16,176,677 $6,967,796 $11,280,296 $4,312,500 

Arizona $111,208,980 $44,772,475 $74,150,539 $29,378,064 

Arkansas $37,150,396 $13,571,345 $22,373,504 $8,802,159 

California $698,851,021 $243,141,334 $389,242,924 $146,101,590 

Colorado $79,425,864 $34,296,371 $56,159,881 $21,863,510 

Connecticut $50,027,098 $19,677,313 $31,720,781 $12,043,468 

Delaware $19,139,816 $6,967,796 $11,280,296 $4,312,500 

District Of Columbia $19,139,816 $6,967,796 $11,280,296 $4,312,500 

Florida $305,947,412 $111,499,562 $181,074,441 $69,574,879 

Georgia $156,991,228 $53,653,261 $87,879,185 $34,225,924 

Hawaii $23,574,467 $7,963,016 $12,795,880 $4,832,864 

Idaho $23,447,064 $8,567,768 $14,254,461 $5,686,693 

Illinois $185,815,955 $58,712,563 $90,813,195 $32,100,632 

Indiana $88,576,664 $35,085,997 $57,287,825 $22,201,828 

Iowa $35,966,072 $13,255,993 $21,886,021 $8,630,028 

Kansas $32,687,142 $12,468,529 $20,115,653 $7,647,124 

Kentucky $55,977,286 $20,176,790 $33,009,377 $12,832,587 

Louisiana $68,745,018 $21,721,473 $35,207,770 $13,486,297 

Maine $19,139,816 $6,967,796 $11,280,296 $4,312,500 

Maryland $93,614,194 $29,879,916 $48,509,506 $18,629,590 

Massachusetts $109,450,326 $42,188,762 $68,279,675 $26,090,913 

Michigan $153,971,391 $50,372,507 $81,684,594 $31,312,087 

Minnesota $66,205,806 $25,551,488 $41,460,402 $15,908,914

 Red Lake Indians $1,631,730 $629,750 $1,021,847 $392,097 

Mississippi $37,916,958 $13,458,457 $21,887,743 $8,429,286 

Missouri $72,925,914 $27,576,234 $45,002,740 $17,426,506 

Montana $19,139,816 $6,967,796 $11,280,296 $4,312,500 

Nebraska $20,989,696 $8,036,723 $13,139,005 $5,102,282 

Nevada $46,706,560 $19,136,280 $31,834,759 $12,698,479 

New Hampshire $19,139,816 $6,967,796 $11,280,296 $4,312,500 

311 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

SAMHSA-Substance Use Services 

FY 2023 Substance Abuse Prevention and Treatment Block Grant Final Allotment 

Appropriation Amount $3,008,079,00, State-Territory Total $2,852,998,623 

CFDA # 93.959 

State 

FY 2021 

Final 

FY 2022 

CR 

FY 2023 

President's 

Budget 

FY 2023 +/-

FY 2022 

New Jersey $132,027,368 $49,278,700 $80,657,322 $31,378,622 

New Mexico $26,274,377 $9,850,657 $16,092,523 $6,241,866 

New York $307,185,612 $102,046,191 $161,554,589 $59,508,398 

North Carolina $123,588,118 $49,304,909 $81,158,058 $31,853,149 

North Dakota $17,946,981 $6,967,796 $11,280,296 $4,312,500 

Ohio $177,272,994 $56,013,230 $84,386,513 $28,373,283 

Oklahoma $47,107,464 $17,925,568 $29,659,426 $11,733,858 

Oregon $56,526,589 $25,009,809 $40,599,423 $15,589,614 

Pennsylvania $162,342,141 $56,425,585 $91,144,615 $34,719,030 

Rhode Island $20,872,227 $7,006,529 $11,344,396 $4,337,867 

South Carolina $65,150,271 $24,653,736 $40,516,658 $15,862,922 

South Dakota $16,595,954 $6,967,796 $11,280,296 $4,312,500 

Tennessee $87,840,939 $33,847,505 $55,616,665 $21,769,160 

Texas $397,499,759 $153,071,838 $252,716,230 $99,644,392 

Utah $45,567,115 $23,953,142 $39,550,175 $15,597,033 

Vermont $17,744,605 $6,967,796 $11,280,296 $4,312,500 

Virginia $115,314,454 $44,918,349 $73,752,263 $28,833,914 

Washington $103,790,564 $40,202,205 $65,086,197 $24,883,992 

West Virginia $23,163,698 $7,717,136 $12,508,205 $4,791,069 

Wisconsin $74,710,048 $25,685,791 $41,999,088 $16,313,297 

Wyoming $11,530,258 $5,831,326 $11,280,296 $5,448,970 

American Samoa $951,884 $346,768 $538,536 $191,768 

Guam $3,142,083 $1,163,019 $1,914,614 $751,595 

Northern 

Marianas $973,759 $357,717 $589,205 $231,488 

Puerto Rico $61,702,702 $22,411,845 $36,254,016 $13,842,171 

Palau $402,957 $149,400 $244,677 $95,277 

Marshall Islands $1,417,432 $531,277 $883,405 $352,128 

Micronesia $1,941,056 $712,812 $1,162,707 $449,895 

Virgin Islands $2,003,497 $737,532 $1,207,819 $470,287 

312 
 

SAMHSA-Substance Use Services 

Health Surveillance and Program Support 

Table of Contents 

1. Summary of the Request................................................................................................. 315 

2. Health Surveillance......................................................................................................... 316 

3. Drug Abuse Warning Network (DAWN)....................................................................... 325 

4. Performance and Quality Information Systems.............................................................. 329 

5. Program Support ............................................................................................................. 335 

6. Public Awareness and Support ....................................................................................... 338 

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SAMHSA-Health Surveillance and Program Support 

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314 
 

 

 

 

 

 

 

 

 

 

 

SAMHSA-Health Surveillance and Program Support 

Summary of the Request 

Health Surveillance and Program Support Appropriation 

(Dollars in thousands) 

Program Name 

FY 2021 FY 2022 FY 2023 

Final COVID-19 

Supplemental CR President's Budget 

FY 2023 +/-

FY 2022 

Health Surveillance and Program Support 

PHS Evaluation Funds (non-add)......................................................... 

Data Request/Publications User Fees ........................................................ 

Public Awareness and Support.................................................................. 

Performance and Quality Information Systems........................................... 

Behavioral Health Workforce Data and Development............................... 

PHS Evaluation Funds (non-add)......................................................... 

Drug Abuse Warning Network................................................................... 

PHS Evaluation Funds (non-add)......................................................... 

Community-Based Funding for Local Substance use Disorder Services 

Community-Based Funding for Local Behavioral Health Needs............. 

COVID-19 Supplemental........................................................................... 

Certified Community Behavioral Health Clinics - COVID-19............. 

Suicide Prevention - COVID-19........................................................... 

Emergency Response - COVID-19........................................................ 

Community Mental Health Services Block Grant................................. 

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

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

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

Total, Health Surveillance and Program Support ................................. 

$125,916 

30,404 

1,500 

12,961 

9,970 

1,024 

1,024 

10,000 

---

---

---

---

---

---

---

---

---

---

---

$---

---

---

---

---

---

---

---

---

30,000 

50,000 

240,000 

-

-

240,000 

-

-

-

-

$126,258 

30,428 

1,500 

13,000 

10,000 

1,000 

1,000 

10,000 

---

---

---

---

---

---

---

---

---

---

---

$136,613 

30,428 

1,500 

13,260 

10,200 

1,000 

1,000 

20,000 

---

---

---

---

---

---

---

---

---

---

---

$10,355 

---

---

260 

200 

---

---

10,000 

---

---

---

---

---

---

---

---

---

---

---

$161,371 320,000 $161,758 $182,573 $20,815 

The Health Surveillance and Program Support FY 2023 President’s Budget Request is $182.6 

million, an increase of $20.8 million from the FY 2022 Annualized Continuing Resolution. 

315 
 

 

 

 

SAMHSA-Health Surveillance and Program Support 

Health Surveillance 

(Dollars in thousands) 

FY 2021 FY 2022 FY 2023 

Program Name Final 

COVID-19 

Supplemental CR 

President's 

Budget 

FY 2023 +/-

FY 2022 

Health Surveillance....................................................................... 

Budget Authority (non-add)...................................................... 

PHS Evaluation Funds (non-add)............................................. 

$47,179 

16,751

30,428

$---

 ---

 ---

$47,258 

16,830 

30,428 

$53,295 

22,867 

30,428

$6,037 

6,037 

 ---

Authorizing Legislation ............................. Sections 501 and 505 of the Public Health Service Act 

FY 2023 Authorization .................................................................................................... Permanent 

Allocation Method ..................................................... Federal/Intramural, Contracts, Grants, Other 

Eligible Entities.........................................................................................................Not Applicable 

Program Description and Accomplishments 

SAMHSA's Center for Behavioral Health Statistics and Quality (CBHSQ) is the lead Federal 

government agency for behavioral health data and research. Behavioral health data collected 

includes prevalence of mental health conditions and substance use disorders, behavioral health 

service provision and use, and evaluation data. 

SAMHSA maintains multiple data collection systems and surveys on key topics in U.S. behavioral 

health. In FY 2021, the SAMHSA Data web page and Substance Abuse and Mental Health Data 

Archive (SAMHDA) received over 1.9 million page views overall, with over 65% of the traffic 

consisting of new visitors to the website. There were over 249,000 total files downloaded from 

SAMHSA and SAMHDA in FY 2021. NSDUH webpages within SAMHSA and SAMHDA 

received over 691,000 page views and over 175,000 downloads in FY 2021. 

It is imperative that SAMHSA’s data collections continue to collect relevant and timely data. 

SAMHSA’s 2020 NSDUH data show 4.9 percent of adults aged 18 or older had serious thoughts 

of suicide, 1.3 percent made a suicide plan, and 0.5 percent attempted suicide in the past year. 

Among adolescents 12 to 17, 12 percent had serious thoughts of suicide, 5.3 percent made a suicide 

plan, and 2.5 percent attempted suicide in the past year. The findings vary among adults by race 

and ethnicity. Non-Hispanic adults of two or more races had higher prevalence of serious thoughts 

of suicide. These findings, which are helping to inform the 988 Behavioral Health and Crisis 

Services, as well as other SAMHSA programs, are a crucial example of SAMHSA using data to 

inform policy. 

SAMHSA’s data collections and evaluation plans: 1) restore trust and accelerate advancements in 

science and research for all; and 2) improve data collection, use, and evaluation, to increase 

evidence-based knowledge that leads to better health outcomes, reduced health disparities, and 

improved social well-being, equity, and economic resilience. SAMHSA continues to ensure that 

evaluations across the agency are conducted with rigor, independence, and transparency. 

SAMHSA’s DAWN strengthens surveillance, epidemiology, and laboratory capacity to 

understand and equitably address diseases and conditions. SAMHSA continues to work on 

modernizing data collections and systems, while also reducing burden, maintaining scientific 

integrity, and increasing data access. The detailed funding for each activity along with a detailed 

narrative description of each project follows below. 

316 
 

 

 

 

 

SAMHSA-Health Surveillance and Program Support 

Health Surveillance 

Resources by Activity/Program 

(Dollars in thousands) 

Program Name 

FY 2021 FY 2022 FY 2023 

Final 

COVID-19 

Supplemental CR 

President's 

Budget 

FY 2023 +/-

FY 2022 

Health Surveillance 

Population Data Collection, Analyis, and Dissemination $12,487 $--- $15,102 $6,925 -$8,177 

National Survey on Drug Use and Health (NSDUH)............................. 11,237 --- 12,857 6,925 -5,932 

Treatment Services Data Collection, Analysis, and Dissemination 10,066 --- 10,150 15,193 5,043 

Behavioral Health Services Information System (BHSIS)..................... 10,066 --- 10,150 15,193 5,043 

Behavioral Health Data Dissemination 1,872 --- 1,903 2,174 272 

Substance Abuse and Mental Health Data Archive (SAMHDA)............ 1,332 --- 1,349 2,174 825 

Analytic Support Center (ASC)............................................................... 541 --- 553 --- -553 

Performance Measurement/Systems 3,443 --- 2,475 2,474 -

SAMHSA Performance Accountability Reports System (SPARS)........... 979 --- --- --- ---

WebBGAS................................................................................................ 477 --- 487 487 -

Evidence-Based Programs/Practices 264 --- --- --- ---

Evidence Based Resource Center........................................................... 264 --- --- --- ---

Drug Abuse Warning Network 2,781 --- 5,134 --- -5,134 

PHS Evaluation (non add)................................................................ 236 --- 1,881 --- -1,881 

Support 16,266 --- 12,494 26,529 14,034 

Operations.............................................................................................. 16,266 --- 12,494 26,529 14,034 

Total Health Surveillance $47,179 $--- $47,258 $53,295 $6,037 

Overview 

The Center for Behavioral Health Statistics and Quality (CBHSQ) is the government’s lead agency 

for behavioral health statistics. Authorized by Section 505 of the Public Health Service Act, which 

was reauthorized and amended by Section 6004 of the 21st Century Cures Act, CBHSQ performs 

activities that: (1) coordinate SAMHSA’s integrated data strategy, including collecting data each 

year; (2) provide statistical and analytical support for SAMHSA’s activities; (3) manage a core set 

of performance metrics to evaluate activities supported by SAMHSA; (4) coordinate with the 

Assistant Secretary, the Assistant Secretary for Planning and Evaluation, SAMHSA’s National 

Mental Health and Substance Use Policy Lab, and SAMHSA’s Chief Medical Officer, as 

appropriate, to improve the quality of data collection services and evaluations of SAMHSA 

activities. 

CBHSQ activities cross over multiple funding lines. CBHSQ receives funding for Health 

Surveillance (HS), the DAWN, and Performance and Quality Information Systems (PQIS) within 

the Health Surveillance and Program Support appropriation (HSPS) and the Substance Abuse 

Prevention and Treatment Block Grant’s technical assistance set aside (SABG) funding sources. 

Programs are often funded from several sources. (A table detailing all funding sources can be 

found after the PQIS section). Under Health Surveillance, CBHSQ’s work includes Population 

Data Collection, Analysis, and Dissemination; Treatment Services Data Collection, Analysis, and 

Dissemination; and Behavioral Health Data Dissemination. Under PQIS, CBHSQ activities 

include Performance Measurement/Systems, Behavioral Health Data Dissemination, and 

Evidence-Based Programs/Practices. 

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SAMHSA-Health Surveillance and Program Support 

Population Data Collection, Analysis, and Dissemination 

NSDUH: Section 505 of the Public Health Service Act (42 USC 290aa-4) requires SAMHSA to 

annually collect prevalence data on substance use and mental illness. To accomplish this data 

collection, SAMHSA administers NSDUH. NSDUH is an annual collection of behavioral health 

data on approximately 67,500 persons aged 12 or older of the U.S. civilian, non-institutionalized 

population. NSDUH is the nation’s primary source of statistical information on the use of illicit 

drugs, alcohol, tobacco, certain mental health issues, co-occurring drug/alcohol addiction and 

mental illness, and treatment for mental and substance use disorders. NSDUH data provide 

estimates at the national, state, and sub-state level and among demographic, socioeconomic, or 

geographic subgroups, as well as trend estimates over time. State-specific NSDUH data provide 

states the opportunity to focus on their leading public health challenges. Each year, three 

simultaneous NSDUH activities are ongoing: planning for future surveys, collecting data on over 

67,500 persons in the current year survey, and analysis and dissemination of data from previous 

collections. 

SAMHSA is continuously improving the quality of the NSDUH questionnaire, to ensure collection 

of the highest quality data and to address emerging and critical data needs related to mental health 

and substance use behaviors. In 2019, SAMHSA included medication-assisted treatment (MAT) 

and perceived recovery questions in the survey. In 2020, questions about vaping, including vaping 

nicotine or tobacco, were added. In addition, in Quarter 4 2020 the NSDUH questionnaire added 

items to assess impact of the COVID-19 pandemic on mental health and substance use. COVID19 questions were added to assess changes in substance use frequency due to COVID-19, the use 

of telehealth for treatment, and suicidal ideation and behavior related to COVID-19 among both 

youth and adults. In 2021, questions were expanded to include vaping marijuana and other 

flavorings and non-prescription fentanyl use. In addition, the substance use disorder (SUD) 

module was updated to assess SUD using DSM-5 criteria. 

From January to March 2020, NSDUH was conducted face-to-face. NSDUH data collection was 

suspended in March 2020 due to the COVID-19 pandemic. When data collection resumed in 

October 2020, SAMHSA responded quickly by implementing a new web survey mode in addition 

to face-to-face interviews in areas that were deemed safe. 

In 2020, 40.3 million people aged 12 or older (or 14.5 percent) had an SUD in the past year, 

including 28.3 million who had alcohol use disorder, 18.4 million who had an illicit drug use 

disorder, and 6.5 million people who had both alcohol use disorder and an illicit drug use disorder. 

Among adults aged 18 or older in 2020, 21.0 percent (or 52.9 million people) had any mental 

illness (AMI) and 5.6 percent (or 14.2 million people) had serious mental illness (SMI) in the past 

year. 

SAMHSA is committed to facilitating broader data use and dissemination. NSDUH data are 

released in three different formats: person-level analytic files, interactive online tools, and databased products. Person-level data are optimal for complex analyses and are released in two 

different versions: public use- and restricted-use files. Public-use files are available at SAMHSA’s 

web pages, while restricted-use files are accessible through Federal Statistical Research Data 

Centers (FSRDCs). The public can readily access NSDUH data via SAMHSA’s interactive online 

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SAMHSA-Health Surveillance and Program Support 

tools, specifically designed for customized analyses of substance use and mental health indicators, 

without needing to download any data. In addition, SAMHSA disseminates data-based products 

in the form of annual reports, data visualizations, slide decks, data tables and other types of reports. 

In FY 2021, the SAMHSA Data web page and Substance Abuse and Mental Health Data Archive 

(SAMHDA) received over 1.9 million page views overall, with over 65% of the traffic consisting 

of new visitors to the website. There were over 249,000 total files downloaded from SAMHSA 

and SAMHDA in FY 2021. NSDUH webpages within SAMHSA and SAMHDA received over 

691,000 page views and over 175,000 downloads in FY 2021. 

Treatment Services Data Collection, Analysis, and Dissemination 

Section 505 of the Public Health Service Act (42.U.S.C. 290aa-4) requires SAMHSA to collect 

data on mental health and substance use disorder treatment services. For this purpose, CBHSQ 

developed the BHSIS. Data collected through BHSIS provides information to the public on 

treatment services through the Behavioral Health Treatment Services Locator, which is part of the 

National Treatment Referral Service. The Locator provides accurate, timely, and regularly 

updated information on mental health and substance use disorder treatment facilities across the 

country. 

BHSIS includes multiple data collection programs and information resources. The data collections 

comprise: 

1) The National Substance Use and Mental Health Services Survey (N-SUMHSS), which 

provides information on all public and private specialty mental health disorder treatment 

facilities and substance use disorder treatment facilities in the United States; 

2) The Treatment Episode Data Set (TEDS), which provides demographic, clinical, and substance 

use characteristics on publicly funded admissions and discharges from substance use disorder 

treatment facilities; 

3) The Mental Health Treatment Episode Data Set (MH-TEDS) and the Mental Health Client 

Level Data (MH-CLD), which provide demographic characteristics and outcomes of 

individuals served by state mental health agencies (SMHAs) for mental health treatment; and 

4) The Uniform Reporting System (URS), which provides a set of standardized data tables 

submitted annually by states and territories as part of their Mental Health Block Grant annual 

implementation reports. 

In 2021, SAMHSA combined two surveys, the National Mental Health Services Survey (NMHSS) and the National Survey of Substance Use Services (N-SSATS), into the N-SUMHSS. 

The primary aim for combining the surveys was to reduce respondent burden and duplication of 

effort for facilities that provide both substance use and mental health treatment services and thus 

respond to both surveys. This streamlining of the two surveys will also improve overall quality of 

the data, which serve as the principal data source for the SAMHSA Behavioral Health Treatment 

Locator (https://findtreatment.samhsa.gov). 

In FY 2023, SAMHSA proposes $5.7 million of additional funding for N-SUMHSS to increase 

the scope of eligible substance use and mental health treatment facilities, to include Certified 

Community Behavioral Health Clinics (CCBHCs), to improve access across culturally diverse 

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SAMHSA-Health Surveillance and Program Support 

populations through the Behavior Health Treatment Services Locator. N-SUMHSS collects 

descriptive data on the location, insurance type accepted, services provided, and other operational 

characteristics. Although the N-SUMHSS census includes many specialty substance use facilities 

and mental health treatment facilities in the scope of the sampling frame, it does not capture the 

comprehensive scope of behavioral health providers. CCBHCs that currently provide treatment 

for substance use disorder and some limited integrated mental health services would not be 

captured in N-SUMHSS but with the proposed increase in funding, N-SUMHSS would capture 

the data from CCBHCs. 

This proposed increase in funding would (1) increase N-SUMHSS’ operational capacity in order 

to double the number of facility respondents (currently about 33,000), (2) provide resources for 

the first comprehensive needs assessment since the mid-1990s for determining and addressing 

"gaps" for facilities not currently eligible for the survey, (3) expand the data dissemination to 

include state and region-specific reports and evaluations for the provision of treatment services 

and underserved populations. 

In FY 2021, the Behavioral Treatment Locator homepage received more than 950,000-page views, 

while the locator map had over 1.1 million-page views from individuals, families, community 

groups, and organizations, to identify appropriate treatment services. 

In FY 2021, the data webpage received over 1.5 million-page views. Through this webpage the 

public downloaded more than 32,000 BHSIS publications, including 7,051 downloads of TEDS 

publications, 6,445 downloads of N-MHSS publications, 7,930of N-SSATS publications, and 

8,574 URS tables. In FY 2020, SAMHSA awarded a new BHSIS contract that includes the NSUMHSS, TEDS, MH-CLD, MH-TEDS, URS, and the Behavioral Health Treatment Locator. 

Behavioral Health Data Dissemination 

The SAMHDA makes public-use data files, available in a variety of formats, that anyone can 

download and use their software to analyze and explore. Through SAMHDA, CBHSQ provides 

access to a data visualization tool and to public- and restricted-use data through a web-based 

analytic tool. The analytic tool was launched in April 2017 and allows researchers to generate 

tables based on these data through an online interface. 

Historically, CBHSQ has managed two separate websites/interfaces for data dissemination to the 

public. There is a data webpage, which makes reports, survey information, and supporting 

documentation available. This site currently resides at https://www.samhsa.gov/data/. There is 

also a data archive, SAMHDA, which makes public-use files and analytic tools available. This 

site currently resides at https://datafiles.samhsa.gov/. While SAMHDA’s target population is 

researchers, the analytic tools available for access can be useful to various public audiences. 

SAMHSA removed overlapping functions and combined the SAMHDA and data webpage into a 

single contract in FY 2020. 

SAMHSA has also been conducting user testing and through the implementation of user centric 

design, launched a refresh of SAMHDA in FY 2021, which allowed for easier access to a wider 

audience and promoted increased use and access to behavioral health data. 

320 
 

 

 

 

 

 

 

 

 

 

SAMHSA-Health Surveillance and Program Support 

In a united effort to support broader use of restricted-use NSDUH data, SAMHSA collaborates 

with other federal agencies. Researchers apply for, and obtain access to, restricted-use NSDUH 

data via FSRDCs. SAMHSA promotes data use by aiding researchers in navigating resources, 

accessing relevant substance use and mental health indicators, and completing important public 

health investigations, while also protecting privacy and minimizing disclosure risk. 

Buprenorphine Waiver Notification (BWNS) 

Beginning in August 2020, CBHSQ assumed data management of the inventory of practitioners 

certified to provide MAT to individuals with Opioid Use conditions. SAMHSA implements 

DATA 2000 in coordination with the Drug Enforcement Administration (DEA), including 

approving waivers for qualified practitioners to provide MAT in office-based settings. As of 

January 2022, there were over 116,607 practitioners with an active waiver to prescribe 

buprenorphine to patients with OUDs. Among these practitioners, 71 percent can treat up to 30 

patients, 22 percent can treat up to 100 patients, and 7 percent can treat up to 275 patients. Almost 

three quarters of practitioners with waivers are physicians (70 percent), while advanced practice 

registered nurses (APRNs) and physician assistants (PAs) comprise 24 percent and 6 percent, 

respectively, of waivered practitioners. 

Five Year Funding Table 

Fiscal Year Amount 

COVID-19 

Supplemental 

Funding 

FY 2019 $47,258,000 

FY 2020 $47,258,000 

FY 2021 Final $47,154,285 

FY 2022 CR $47,258,000 

FY 2023 President's Budget $53,295,000 

Budget Request 

The FY 2023 President’s Budget request is $53.3 million, an increase of $6.0 million from the FY 

2022 Annualized Continuing Resolution. 

The budget proposes an increase of $6.0 million in FY 2023 to enhance and expand the scope of 

the N-SUMHSS to ensure it collects the most up-to-date, accurate, and useful data for assessing 

the nature and extent of services provided across all active substance use and mental health 

treatment facilities in the United States. Additional funds would be used to: 

• Increase the operational capacity and scope of the N-SUMHSS to double the number of 

facility respondents (currently about 33,000) and collect facility information from 

Certified Community Behavioral Health Clinics (CCBHCs) for inclusion in the Behavioral 

Health Treatment Services Locator; 

• Conduct a new, comprehensive needs assessment of the N-SUMHSS to identify “gaps” in 

the survey methodology and develop inclusion criteria for addressing facilities that are 

321 
 

SAMHSA-Health Surveillance and Program Support 

currently ineligible or serving SAMHSA’s priority populations; and 

• Expand the N-SUMHSS data dissemination to include state and region-specific reports as 

well as evaluations of underserved populations. 

It is critical to modify and expand the N-SUMHSS data collection efforts as the landscape of 

behavioral health providers and availability of treatment services continues to evolve. Although 

the N-SUMHSS census includes many specialty substance use facilities and mental health 

treatment facilities in the scope of the sampling frame, it does not capture the comprehensive scope 

of behavioral health providers, including CCBHCs. 

With the addition of CCBHCs and other community-based treatment facilities as well as an 

enhanced data dissemination, the N-SUMHSS will be more capable of informing the public on 

trends and access in both treatment services and utilization, which can assist policymakers and 

state and local governments to forecast and address potential deficits in treatment. For example, 

descriptive data from the N-SUMHSS on all active substance use treatment facilities and client 

counts within a small geographical area would enable a state or local government to target its 

limited resources during a public health emergency such as the opioid crisis. The additional data 

on CCBHCs will also benefit individuals seeking treatment, particularly vulnerable individuals 

with low access to care or those with the most serious mental illnesses and substance use disorders. 

322 
 

SAMHSA-Health Surveillance and Program Support 

Mechanism Table 

Health Surveillance 

(Dollars in thousands) 

Program Activity 

FY 2021 

Final 

FY 2022 

CR 

FY 2023 

President's 

Budget 

Health Surveillance 

Grants 

Continuations............................................................................

New/Competing........................................................................

 ---

 ---

$---

 ---

 ---

 ---

$---

---

 ---

 ---

$---

---

Subtotal................................................................................. --- --- --- --- --- ---

Contracts 

Continuations............................................................................ 

New/Competing........................................................................

22 

 ---

47,154

---

 ---

 ---

47,258

---

 ---

 ---

53,295 

---

Subtotal................................................................................. 22 47,154 --- 47,258 --- 53,295 

Total, Health Surveillance 22 47,154 --- 47,258 --- 53,295 

323 
 

 

SAMHSA-Health Surveillance and Program Support 

Outputs and Outcomes Table 

Program: National Survey on Drug Use and Health 

Measure Year and Most Recent 

Result / 

Target for Recent Result / 

(Summary of Result) 

FY 2022 

Target 

FY 2023 

Target 

FY 2023 

Target 

+/-FY 2022 

Target 

2.3.19L Percentage of 

adults with Serious 

Mental Illness (SMI) 

receiving mental health 

services (Outcome) 

FY 2020: 64.5 % 

Target: 

71.0 % 

(Target Not Met) 

64.5 % 64.5 % Maintain 

2.3.19M Percentage of 

people who meet criteria 

for needing substance use 

treatment who receive 

treatment from a 

specialty substance use 

disorder treatment 

provider (Outcome) 

FY 2020: 6.5 % 

Target: 

11.1 % 

(Target Not Met) 

6.5 % 6.5 % Maintain 

2.3.19N Past year 

prescription pain reliever 

misuse (age 12 and older) 

(Outcome) 

FY 2020: 9,300,000.0 

Target: 

9,500,000.0 

(Target Exceeded) 

9,300,000.0 9,300,000.0 Maintain 

2.3.19O Percent of youth 

ages 12-17 who 

experienced major 

depressive episodes with 

severe impairment in the 

past year receiving 

treatment for depression. 

(Outcome) 

FY 2020: 46.9 % 

Target: 

50.0 % 

(Target Not Met) 

46.9 % 46.9 % Maintain 

324 
 

 

 

 

 

SAMHSA-Health Surveillance and Program Support 

Drug Abuse Warning Network (DAWN) 

(Dollars in thousands) 

FY 2021 FY 2022 FY 2023 

Program Name Final 

COVID-19 

Supplemental CR 

President's 

Budget 

FY 2023 +/-

FY 2022 

Drug Abuse Warning Network....................................................... 

PHS Evaluation Funds (non-add).............................................

$10,000 

 ---

$---

 ---

$10,000 

 ---

$20,000 

 ---

$10,000 

 ---

Authorizing Legislation.................................. Section 505 of the Public Health Service Act 

FY 2023 Authorization ..................................................................................................................$0 

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

Eligible Entities.........................................................................................................Not Applicable 

Program Description and Accomplishments 

SAMHSA re-established DAWN in 2018 as a nationwide public health surveillance system to 

monitor emergency department (ED) visits related to recent substance use, including those related 

to opioids. Authorized by the 21st Century Cures Act, DAWN provides necessary information 

such as patient demographic details and substances used to respond effectively to the opioid and 

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

and other stakeholders to respond to emerging substance use trends. There are several important 

improvements for the new DAWN, including timeliness of data, data available at more frequent 

intervals, and data abstracted from a wider range of geographic area types— urban, suburban, and 

rural. Having data available more quickly means that DAWN can serve as a true “early warning” 

system and inform local public health response efforts. 

DAWN data are abstracted from hospital ED records. Hospital participation is optional. 

SAMHSA is currently abstracting data from 52 hospitals and is recruiting a new hospital, 

achieving 98% of the target rate. By using data abstracted directly from ED records, DAWN 

captures detailed information about the substances involved in ED visits, and serves as an early 

warning system for the emergence of new and novel psychoactive substances. It monitors the 

geographic, temporal, and demographic characteristics of drug-related ED visits. Unlike other 

public health surveillance systems, DAWN captures both ED visits that are directly caused by 

drugs, such as overdoses, and those in which drugs are a contributing factor but not the direct cause 

of the ED visit, such as a motor vehicle crash involving a driver who had combined medications 

with alcohol. These criteria encompass all types of drug-related events, from substance use and 

misuse to substance-related suicide attempts. In CY 2021, DAWN surveillance of ED visits was 

expanded to include those visits to due to alcohol use by individuals 21 years and older. Complete 

implementation of this critical data abstraction expansion was completed in Q2 of FY 2021. The 

detailed information captured by DAWN is used to assess health hazards associated with specific 

substances and monitor the impact of drug use and misuse on the Nation's health care system. As 

of January 2022, the DAWN surveillance system has reviewed more than 3,396,448 ED records 

from 53 participating hospitals (26 urban, 11 suburban, and 16 rural) and abstracted over 257,711 

DAWN cases (7.6 percent of total ED records reviewed). 

Preliminary analysis demonstrates that the most common substances associated with DAWN cases 

are alcohol (122,390 cases, 47.5 percent), illicit substances (98,516 cases, 38.2 percent) and 

325 
 

 

 

 

 

SAMHSA-Health Surveillance and Program Support 

Central Nervous System (CNS) agents (42,804 cases, 16.6 percent); among illicit drugs, stimulants 

were the most commonly associated with DAWN cases, with the majority involving 

methamphetamine. 

The increase in funding in FY 2023 will build on the existing infrastructure and expand the number 

of surveillance hospital sites and the information DAWN collects from each site to include 

toxicology reports. In addition, the budget will allow an increase to publicly available information 

from DAWN, including data on emerging trends of major metropolitan regions with higher drug 

related mortality rates and other geographic variables such as urban and rural. The increase in 

funding helps improve SAMHSA’s ability to perform public health surveillance by increasing the 

number of hospitals, providing a more comprehensive dissemination strategy, and expanding the 

available information to include the toxicology reports. It will equip SAMHSA to play a larger 

role in COVID-19 recovery strategic planning within HHS using DAWN’s ED data of adverse 

reactions of COVID-19 vaccines. 

Five Year Funding Table 

Fiscal Year Amount 

COVID-19 

Supplemental 

Funding 

FY 2019 $10,000,000 

FY 2020 $10,000,000 

FY 2021 Final $10,000,000 

FY 2022 CR $10,000,000 

FY 2023 President's Budget $20,000,000 

Budget Request 

The FY 2023 President’s Budget request is $20.0 million, an increase of $10.0 million from the 

FY 2022 Annualized Continuing Resolution. 

SAMHSA proposes an increase of $10.0 million in FY 2023 to expand the capacity of DAWN to 

ensure it continues to collect comprehensive, useful data on ED visits related to substance use. 

With additional data elements and improved data collection and dissemination methods, DAWN 

will be able to inform public health stakeholders, clinicians, and policymakers on emerging 

substance use trends in a more timely and accurate manner. Additional funds would be used to: 

• Recruit and manage additional hospitals for participation in the DAWN system, 

particularly hospitals in counties with high potential for ED visits related to substance use. 

Based on these high-risk areas, SAMHSA has targeted 5 sentinel hospitals for recruitment 

in order to enhance monitoring of potential drug-related outbreaks and 10 more hospitals 

to the probability sample-based hospital frame to release national estimates; 

• Expand the DAWN data abstraction system to include toxicology results from ED visits 

related to substance use at each participating hospital. Toxicology reports are critical to 

minimize misclassification of drugs and monitor adverse effects of pharmaceuticals across 

geography and over time (including adverse effects of COVID-19 vaccines); 

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SAMHSA-Health Surveillance and Program Support 

• Enhance the dissemination of DAWN data for public use by including data on emerging 

substance use trends in major metropolitan regions with high drug-related mortality rates 

as well as data for a wider range of geographic area types such as urban, suburban, and 

rural. 

With an increase in funding to DAWN, SAMHSA will have an increased capability to perform 

public health surveillance of hospital ED visits related to substance use and provide a more 

comprehensive dissemination of the data abstracted from the DAWN system. Additional resources 

for DAWN are critical to increase hospital participation and accuracy of reporting, which would 

increase the amount of detailed information available on potential outbreaks related to new and 

novel psychoactive substances. Relevant stakeholders would be able to utilize this information to 

monitor substance use trends and allocate limited resources for a public health response. 

327 
 

SAMHSA-Health Surveillance and Program Support 

Mechanism Table 

Drug Abuse Warning Network 

(Dollars in thousands) 

Program Activity 

FY 2021 

Final 

FY 2022 

CR 

FY 2023 

President's 

Budget 

Drug Abuse Warning Network 

Contracts 

Continuations............................................................................ 

New/Competing........................................................................

1 

 ---

10,000 

---

1 

 ---

10,000 

---

1 

 ---

20,000 

---

Subtotal................................................................................. 1 10,000 1 10,000 1 20,000 

Total, Drug Abuse Warning Network 1 10,000 1 10,000 1 20,000 

328 
 

 

 

 

 

SAMHSA-Health Surveillance and Program Support 

Performance and Quality Information Systems 

(Dollars in thousands) 

FY 2021 FY 2022 FY 2023 

Program Name Final 

COVID-19 

Supplemental CR 

President's 

Budget 

FY 2023 +/-

FY 2022 

Performance and Quality Information Systems............................... $9,970 $--- $10,000 $10,200 $200 

Authorizing Legislation .................. Sections 501, 505, 509, 516, 520A, and 543A of the PHS Act 

FY 2023 Authorization ......................................................................................................Indefinite 

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

Eligible Entities.........................................................................................................Not Applicable 

Program Description and Accomplishments 

The PQIS funding primarily supports the activities of CBHSQ. The detailed narrative description 

of each project follows. 

Program Name 

FY 2021 FY 2022 FY 2023 

Final 

COVID-19 

Supplemental CR 

President's 

Budget 

FY 2023 +/-

FY 2022 

Performance and Quality Information Systems 

Performance Measurement and Performance Systems........................ 

 SAMHSA Performance Accountability Reports System (SPARS)... 

Evidence-Based Programs/Practices.................................................. 

 Evidence Based Resource Center.................................................. 

Support............................................................................................... 

 Operations...................................................................................... 

$6,273

6,898 

1,789 

1,789 

1,908 

1,908 

 $---

---

---

---

---

---

$5,963 

5,963 

2,110 

2,110 

1,927 

1,927 

$7,338 

7,338 

2,110 

2,110 

752

752

$1,374

1,374 

---

---

 -1,174

 -1,174 

Total Performance and Quality Information Systems $9,970 $ --- $10,000 $10,200 $200 

Performance Measurement and Performance Systems 

SAMHSA collects data on key output and outcome measures to monitor and manage discretionary 

grant performance, improve the quality of treatment services, and inform the public and 

stakeholders on the impact of financial investments. SAMHSA collects these data in the SPARS. 

Data collected and analyzed through SPARS allow SAMHSA to monitor the progress of 

discretionary grants, support data-informed decision-making for funding, and provide an 

understanding of the services delivered through the programs. SAMHSA continues to implement 

the 21st Century Cures Act through continuously monitoring 

In addition, CBHSQ’s Office of Evaluation (OE) provides support to the three program centers, 

CMHS, CSUS, CSUPS, the Office of Tribal Affairs and Policy (OTAP), and the Office of 

Intergovernmental and External Affairs grantees and project officers, by initiating enhancements 

to the SPARS system. These enhancements improve data visualization options for examination 

of demographic data on both adult and youth participants for a single year or for multiple years of 

funding. 

The OE SPARS team provides technical support, grantee and staff training, and help-desk 

329 
 

 

SAMHSA-Health Surveillance and Program Support 

assistance to ensure SAMHSA effectively manages its grant portfolio and provides timely, 

accurate information to policy makers and stakeholders. In FY 2020 and FY 2021, OE offered 

Office Hours and Learning Labs to members of program centers and OTAP to support the use of 

data in all decision-making and to encourage rigorous monitoring of program data. During these 

two years, OE has completed over 60 Office Hour and 64 Learning Lab events. 

The CBHSQ’s OE is responsible for providing centralized planning and management of program 

evaluation activity across SAMHSA, including the evaluation reports for PATH, Garret Lee Smith 

programs, and the PPW-PLT program. In partnership with the program centers, OE provides 

oversight and management of agency quality improvement and performance management 

activities and advances agency goals and objectives relating to performance measurements and 

quality improvement. In FY 2020, CBHSQ in partnership with CMHS acquired management of 

the PATH Data Exchange (PDX) and in FY2021, CBHSQ’s OE completed a triannual report 

summarizing outcomes from the PATH program over 2017, 2018 and 2019. 

OE identifies and maintains performance indicators to monitor each SAMHSA program, and 

develops periodic evaluation reports for use in agency planning, program change, and reporting to 

departmental and external organizations. In FY 2020, OE developed over 40 Program Profiles for 

grant programs administered by SAMHSA. Currently, OE is developing an updated set of 

program and topical profiles in collaboration with program centers. These documents offer 

stakeholders an overview of the goal of each program, as well as a summary of the demographic 

and program outcome data associated with each grant program. OE works collaboratively with 

the National Mental Health and Substance Use Policy Laboratory and the Office of the Chief 

Medical Officer to provide support for SAMHSA evaluation activities. 

The Center provides oversight of the agency’s quality improvement efforts, including the 

identification of gaps in behavioral health quality measurement and the adoption and 

implementation of behavioral health quality measures. This work includes partnerships with the 

Center for Medicare & Medicaid Services (CMS) and the Assistant Secretary for Planning and 

Evaluation (ASPE), among other federal partners, in quality measures work. CBHSQ serves as 

the SAMHSA lead to the National Quality Forum (NQF), as well as participates as a federal 

advisor for other agencies conducting measure development work, including CMS and ASPE. 

CBHSQ also participates in the Measures Application Partnership, a group convened to guide HHS 

on measures adoption. 

CBHSQ staff provides internal collaborations across SAMHSA, advising on quality measure 

issues and identifying key next steps. CBHSQ staff regularly consult with other federal agencies, 

the NQF, and other key stakeholders regarding behavioral health quality indicators, including 

barriers to and facilitators of data collection, tracking, and reporting. SAMHSA continues its 

behavioral health quality measure activities through ongoing identification of behavioral health 

measurement gaps and the capacity to address such gaps. 

330 
 

 

 

 

 

 

SAMHSA-Health Surveillance and Program Support 

Evidence-Based Practice Resource Center (EBPRC) 

Section 7002 of the 21st Century Cures Act directs SAMHSA to promote access to reliable and 

valid information on evidence-based programs and practices and share information on the strength 

of evidence associated with such programs and practices related to mental illness and drug/alcohol 

addiction. To fulfill this charge, SAMHSA has developed the Evidence-Based Practices Resource 

Center (EBPRC), which provides information on evidence-based programs and practices to states, 

local communities, non-profit entities, and other stakeholders. 

The EBPRC, which is managed by the National Mental Health and Substance Use Policy 

Laboratory (NMHSUPL), provides communities, clinicians, policymakers, and others in the field 

with the information and tools that they need to incorporate evidence-based practices in their 

communities or clinical settings. As part of this effort, SAMHSA develops and disseminates 

resources, such as new or updated guidebooks, Treatment Improvement Protocols, guidance 

documents, clinical practice policies, toolkits, systematic reviews, data reports, and other 

actionable materials that incorporate the latest scientific evidence on mental health and substance 

use. This approach enables SAMHSA to quickly develop and disseminate expert consensus on 

the latest prevention, treatment, and recovery sciences in areas needing more information. The 

EBPRC currently includes 155 resources. SAMHSA expects to add at least 15 more resources 

over the next two years to the EBPRC, including five SAMHSA-developed Guidebooks each year. 

SAMHSA convenes bimonthly committee meetings with staff from across the agency to review 

potential new resources on different topics related to mental illness and substance use for inclusion 

in EBPRC. The EBPRC enables SAMHSA to collaborate with experts in the field, to rapidly 

translate science into action. The EBPRC provides communities and practitioners with tools to 

facilitate comprehensive needs assessment, matches interventions to those needs, supports 

implementation, and incorporates continuous quality improvement into its prevention, treatment, 

and recovery efforts. This strategy, coupled with SAMHSA’s regional and locally based training 

and technical assistance efforts, ensures that communities and practitioners are equipped to bring 

about the improvements in mental health and substance use prevention, treatment, and recovery 

that our Nation requires. The EBPRC website has recently been updated with new content and 

improvements to its functionality, which will enable a broad audience to easily access needed 

materials. 

Five Year Funding Table 

Fiscal Year Amount 

COVID-19 

Supplemental 

Funding 

FY 2019 $10,000,000 

FY 2020 $10,000,000 

FY 2021 Final $9,969,596 

FY 2022 CR $10,000,000 

FY 2023 President’s Budget $10,200,000 

331 
SAMHSA-Health Surveillance and Program Support 

Budget Request 

The FY 2023 President’s Budget request is $10.2 million, an increase of $200,000 from the FY 

2022 Annualized Continuing Resolution. SAMHSA will use these funds for modernization efforts 

and continuation of the SPARS and EBPRC contracts. 

332 
SAMHSA-Health Surveillance and Program Support 

Mechanism Table 

Performance and Quality Information Systems 

(Dollars in thousands) 

Program Activity 

FY 2021 

Final 

FY 2022 

CR 

FY 2023 

President's 

Budget 

Performance and Quality Information Systems 

Contracts 

Continuations............................................................................ 

New/Competing........................................................................ 

1 

1 

3,696 

6,273

2 

 ---

10,000 

---

2 

 ---

10,200 

---

Subtotal................................................................................. 2 9,970 2 10,000 2 10,200 

333 
SAMHSA-Health Surveillance and Program Support 

The following table provides a detailed description of all funding sources supporting CBHSQ 

activities. 

Center for Behavioral Health Statistics and Quality 

Breakout by Activity/Program (all sources) 

(Dollars in thousands) 

Program Name 

FY 2021 FY 2022 FY 2023 

Final 

COVID-19 

Supplemental CR 

President's 

Budget 

FY 2023 +/-

FY 2022 

Substance Use Services Appropriation 

Substance Abuse Block Grant Set Aside 

Population Data Collection, Analysis, and Dissemination.................... 

PHS Evaluation (non add)............................................................... 

Treatment Services Data Collection, Analysis, and Dissemination ..... 

Budget Authority (non add)............................................................. 

PHS Evaluation (non add)............................................................... 

Behavioral Health Data Dissemination................................................. 

PHS Evaluation (non add)............................................................... 

Support ................................................................................................. 

PHS Evaluation (non add)............................................................... 

$45,380 

45,380 

6,871 

---

6,871 

357 

357 

2,996 

2,996 

$ ---

---

---

---

---

---

---

---

---

$45,893 

45,893 

5,916 

---

5,916 

357 

357 

3,438 

3,438 

$52,824 

52,824 

40,931 

19,243 

21,687 

357 

357 

4,202 

4,202 

$6,931 

6,931 

35,015 

19,243 

15,772 

---

---

764 

764 

Total Substance Abuse Block Grant Set Aside 

Total Substance Use Services PHS Evaluation 

55,603 

55,603 

---

---

55,603 

55,603 

98,314 

79,070 

42,710 

23,467 

Health Surveillance and Program Support Appropriation 

Health Surveillance 

Population Data Collection, Analysis, and Dissemination.................... 

PHS Evaluation (non add)................................................................ 

Treatment Services Data Collection, Analysis, and Dissemination...... 

PHS Evaluation (non add)................................................................ 

Behavioral Health Data Dissemination................................................. 

PHS Evaluation (non add)................................................................ 

Performance Measurement/Systems...................................................... 

PHS Evaluation (non add)................................................................ 

Evidence-Based Programs/Practices.................................................... 

Drug Abuse Warning Network.............................................................. 

PHS Evaluation (non add)................................................................ 

Support.................................................................................................. 

PHS Evaluation (non add)................................................................ 

12,487 

11,237 

10,066 

9,155 

1,872 

1,332 

3,443 

3,137 

264 

2,781 

236 

16,266 

5,330 

---

---

---

---

---

---

---

---

---

---

---

---

---

15,102 

12,857 

10,150 

10,150 

1,903 

1,349 

2,475 

2,162 

---

5,134 

1,881 

12,494 

2,029 

6,925

6,925

15,193 

9,493

2,174 

2,174 

2,474 

2,162 

---

---

---

26,529 

9,674 

 -8,177 

 -5,932 

5,043 

 -657 

272 

825 

---

---

---

 -5,134 

 -1,881 

14,034 

7,645 

Total Health Surveillance 47,179 --- 47,258 53,295 6,037 

Drug Abuse Warning Network 

PHS Evaluation (non add)................................................................ 

10,000 

---

---

---

10,000 

---

20,000 

---

10,000 

---

Total Drug Abuse Warning Network 10,000 --- 10,000 20,000 10,000 

Performance and Quality Information Systems 

Performance Measurement/Systems...................................................... 

Evidence-Based Programs/Practices.................................................... 

Behavioral Health Data Dissemination................................................. 

DAWN.................................................................................................. 

Support.................................................................................................. 

6,273 

1,789 

---

---

1,908 

---

---

---

---

---

5,963 

2,110 

---

---

1,927 

7,338 

2,110 

---

---

752

1,374 

---

---

---

 -1,174 

Total Performance and Quality Information Systems 9,970 --- 10,000 10,200 200 

Behavioral Health Workforce Data and Development 

Behavioral Health Workforce Data Development................................. 

PHS Evaluation (non add)................................................................ 

1,000 

1,000 

---

---

1,000 

1,000 

1,000 

1,000 

---

---

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

Total Health Surveillance and Program Support 

Total Health Surveillance and Program Support PHS Evaluation 

68,149 

31,428 

---

---

68,258 

31,428 

84,495 

31,428 

16,237 

---

Total Center for Behavioral Health Statistics and Quality $123,752 $ --- $123,861 $182,809 $58,947 

334 
 

 

 

 

SAMHSA-Health Surveillance and Program Support 

Program Support 

(Dollars in thousands) 

FY 2021 FY 2022 FY 2023 

Program Name Final 

COVID-19 

Supplemental CR 

President's 

Budget 

FY 2023 +/-

FY 2022 

Program Support............................................................................ $78,762 $--- $79,000 $83,318 $4,318 

FTE 420 438 526 88 

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

FY 2023 Authorization ..................................................................................................................$0 

Allocation Method .......................................... Direct Federal/Intramural, Contracts, Grants, Other 

Eligible Entities.........................................................................................................Not Applicable 

Program Description and Accomplishments 

The Program Support budget supports the majority of SAMHSA staff who plan, direct, and 

administer SAMHSA’s programs, as well as business operations and processes, information 

technology, and overhead expenses, such as rent and utilities. In addition, this budget supports the 

Unified Financial Management System (UFMS), which covers administrative activities such as 

human resources, information technology, financial integrity, and the centralized services provided 

by HHS and the Program Support Center. 

SAMHSA supported 472 Full Time Equivalents (FTEs) in FY 2021. SAMHSA’s FTE increase 

in FY 2022 and FY 2023 will balance the supervisory to employee ratio as well as mitigate the 

workload of SAMHSA’s Government Program Officers and Grant’s Management Specialists. 

Staff positions that are not covered through the Health Surveillance and Program Support 

appropriation are funded with Substance Use Prevention Services and Treatment and Mental 

Health Block Grant set-asides for activities associated with technical assistance, data collection, 

and evaluation. 

FY 2023 CJ FTE By Bureau 

HR Center/Offie FY 2021 Final FY 2022 CR 

FY 2023 

President's 

Budget 

CBHSQ 40 71 74 

CMHS 85 113 120 

CSAP 54 65 89 

CSAT 69 104 105 

OAS 54 76 100 

OC 12 16 17 

OFR 115 143 153 

OMTO 37 50 55 

PLAB 6 12 12 

Grand Total 472 650 725 

335 
 

 

 

 

 

 

SAMHSA-Health Surveillance and Program Support 

SAMHSA applies an estimated internal administrative charge for overhead expenses to all 

programs, projects, and activities. 

Five Year Funding Table 

Fiscal Year Amount 

COVID-19 

Supplemental 

Funding 

FY 2019 $79,000,000 

FY 2020 $79,000,000 

FY 2021 Final $78,762,000 

FY 2022 CR $79,000,000 

FY 2023 President's Budget $83,318,000 

Budget Request 

The FY 2023 President’s Budget request is $83.3 million, an increase of $4.3 million from the FY 

2022 Annualized Continuing Resolution. SAMHSA will continue to support staff to administer 

and manage SAMHSA’s diverse array of programs. At this funding level, SAMHSA will also 

ensure the agency can efficiently and effectively respond to the evolving and growing opioid crisis, 

as well as provide the significant resources, technical assistance, and leadership within the mental 

health and behavioral health public health sphere. This level of funding will also continue to cover 

overhead costs associated with 5600 Fishers Lane, including rent, the Federal Acquisition Service 

loan repayment program, and security charges. 

336 
 

SAMHSA-Health Surveillance and Program Support 

Mechanism Table 

Program Support 

(Dollars in thousands) 

Program Activity 

FY 2021 

Final 

FY 2022 

CR 

FY 2023 

President's 

Budget 

Program Support 

Grants 

Continuations............................................................................ 

New/Competing........................................................................

21 

 ---

2,787 

---

1 

8 

800 

1,987 

1 

8 

800 

1,987 

Subtotal................................................................................. 21 2,787 9 2,787 9 2,787 

Contracts 

Continuations............................................................................

New/Competing........................................................................

 ---

 ---

75,975

---

 ---

 ---

76,213

---

 ---

 ---

80,531 

---

Subtotal................................................................................. --- 75,975 --- 76,213 --- 80,531 

Total, Program Support 21 78,762 9 79,000 9 83,318 

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SAMHSA-Health Surveillance and Program Support 

Public Awareness and Support 

(Dollars in thousands) 

FY 2021 FY 2022 FY 2023 

Program Name Final 

COVID-19 

Supplemental CR 

President's 

Budget 

FY 2023 +/-

FY 2022 

Public Awareness and Support...................................................... $12,961 $--- $13,000 $13,260 $260 

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

FY 2023 Authorization ......................................................................................................Indefinite 

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

Eligible Entities.........................................................................................................Not Applicable 

Program Description and Accomplishments 

Part of SAMHSA’s mission is to increase public’s awareness and understanding of mental and 

substance use disorder, serve as an expert on mental health and substance use disorders, lead public 

health efforts to advance the behavioral health of the nation, and inform and equip the healthcare 

workforce. SAMHSA’s Office of Communications (OC) staff ensure that the vital information, 

publications, and training materials produced through SAMHSA’s Centers and Offices are 

available to the healthcare workforce, people in treatment and recovery, people in crisis or in areas 

affected by disasters, SAMHSA grantees, and the public. OC staff use various channels to 

communicate this information. These channels include online print, radio, and television media; 

social media platforms; the SAMHSA.gov website; the SAMHSA Store, the subscription-based eblast system; and inquiries received through the National Helpline. In addition, the OC staff 

manage SAMHSA events to interact with stakeholders, media organizations, and the public and 

assist in the development and execution of materials, products, and campaigns. 

The OC media team evaluates and acts upon media inquiries; develops and issues press releases, 

news bulletins, and media advisories; and provides in-house media support to the Centers and 

Offices. The team builds relationships with representatives of the media; identifies and seeks 

corrections to inaccuracies about SAMHSA in media products, when necessary; works to add 

SAMHSA’s life-saving resources to journalistic and entertainment products; supports broad HHS 

and administration communications priorities; and collaborates with other departmental Op-Divs. 

The media team collaborates with SAMHSA staff when a disaster occurs to quickly disseminate 

press releases and social media featuring SAMHSA’s Disaster Distress Helpline and links to 

relevant SAMHSA resources. 

The OC digital team manages SAMHSA’s social media presence on Facebook, Twitter, LinkedIn, 

Instagram, and YouTube. In addition to print and traditional media, social media messaging is 

now incorporated in communications plans and is employed daily to communicate messages about 

SAMHSA news and resources. The OC has staff who specialize in monitoring social media 

conversations, creating content, participating in Twitter chats and Facebook Live sessions, and 

writing and posting blogs on SAMHSA.gov. The OC is responsible for managing the 

SAMHSA.gov website, which provides enterprise-wide content and related public-facing websites 

and supports Section 508 activities. 

The OC also manages the Public Engagement Platform (PEP) and the Contact Center. The PEP 

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SAMHSA-Health Surveillance and Program Support 

is a large-scale information dissemination program. PEP provides the public and other 

stakeholders with one-stop, quick access to mental and substance use disorder prevention, 

treatment, and recovery information, materials, and services. It operates a customer-oriented order 

fulfillment/distribution center, which includes an online store (store.SAMHSA.gov) and 

warehouse, the SAMHSA listserv and subscriber database system, and mobile applications. 

The Contact Center supports the National Helpline (1-800-662-HELP) and the 1-877-SAMHSA7 line. The National Helpline provides free, confidential treatment referral and information 

services in English and Spanish for individuals and families facing mental illness and/or substance 

use disorders. It is operational 365 days-a-year, 24/7. The 1-877-SAMHSA-7 line is the single 

point of entry for SAMHSA’s information services and is operated Monday through Friday, 8:00 

am to 8:00 pm (except for federal holidays). 

The OC manages the SAMHSA Public Awareness and Support Activities contract that enables the 

agency to develop and disseminate public service announcements (PSAs) for television and radio 

and other materials for a broad range of platforms. Topics, audiences, and formats range but all 

phases from creative concepts to storyboards as well as focus group testing are included. As an 

example, the OC has issued, with the assistance of this contract, PSAs targeted at providers on the 

use of naltrexone for opioid use disorder and the public on the importance of seeking specialized 

treatment for mental health issues and reminding people with substance use disorders that there is 

hope and treatment available. This contract also enables SAMHSA to develop and conduct a 

variety of national informational campaigns. 

The OC manages the Materials Development and Editing Support (MDES), which provides 

communication support to the OC and in turn to the rest of SAMHSA. The communications 

support includes services such as media outreach, publications, digital products, speechwriting, 

graphics, copyediting, and meeting/event logistics. 

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Five Year Funding Table 

Fiscal Year Amount 

COVID-19 

Supplemental 

Funding 

FY 2019 $13,000,000 

FY 2020 $13,000,000 

FY 2021 Final $12,961,000 

FY 2022 CR $13,000,000 

FY 2023 President’s Budget $13,260,000 

Budget Request 

The FY 2023 President’s Budget request is $13.3 million, an increase of $260,000 from the FY 

2022 Annualized Continuing Resolution. SAMHSA intends to fund 5 contracts that will allow 

SAMHSA to manage media relationships, maintain its web and social media presence, manage 

critical helplines, deliver publications and resources, produce, and deliver PSAs, and conduct 

national campaigns. 

340 
 

SAMHSA-Health Surveillance and Program Support 

Mechanism Table 

Public Awareness and Support 

(Dollars in thousands) 

Program Activity 

FY 2021 

Final 

FY 2022 

CR 

FY 2023 

President's 

Budget 

Public Awareness and Support 

Contracts 

Continuations............................................................................ 

New/Competing........................................................................ 

3 

3 

6,154 

6,807 

5 

2 

7,955 

5,045 

6 

1 

10,541 

2,719 

Subtotal................................................................................. 6 12,961 7 13,000 7 13,260 

Total, Public Awareness and Support 6 12,961 7 13,000 7 13,260 

341 
 

 

 

 

 

SAMHSA-Health Surveillance and Program Support 

Outputs and Outcomes Table 

Program: Public Awareness and Support 

Measure Year and Most Recent 

Result / 

Target for Recent Result / 

(Summary of Result) 

FY 2022 

Target 

FY 2023 

Target 

FY 2023 

Target 

+/-FY 2022 

Target 

4.4.12 The number of 

individuals referred for 

behavioral health 

treatment resources. 

(Output) 

FY 2021: 1,023,496 

Target: 

667,783 

(Target Exceeded) 

1,023,496 1,054,200 +30,704 

4.4.13 The total number 

of interactions through 

phone inquiries, e-blasts, 

dissemination of 

SAMHSA publications, 

and total website hits 

(Output) 

FY 2021: 59,441,622 

Target: 

55,238,274 

(Target Exceeded) 

59,441,622 61,224,900 +1,783,278 

342 
 

 

SAMHSA-Drug Control Budget 

Drug Control Budget 

DEPARTMENT OF HEALTH AND HUMAN SERVICES 

Substance use And Mental Health Services Administration 

(Dollars in millions) 

Resource Summary 

FY 2021 

Final 

FY 2021 

COVID-19 

Supplemental 

FY 2022 

CR 

FY 2023 

President's 

Budget 

Drug Resources by Decision Unit and Function 

Programs of Regional and National Significance 

Substance Use Prevention Services............................................................... $208.22 $.00 $208.22 $311.91 

Substance Use Services................................................................................. 495.12 30.00 496.68 566.36 

Total Programs of Regional and National Significance..................................... 703.34 30.00 704.90 878.28 

State Opioid Response Grants....................................... 

Substance Abuse Prevention and Treatment Block Grant1 

1,498.03 - 1,500.00 2,000.00 

Prevention...................................................................................................... 369.93 630.00 371.62 601.62 

Treatment....................................................................................................... 1,479.72 2,520.00 1,486.46 2,406.46 

Total, Substance Abuse Prevention and Treatment Block Grant........................ 

Health Surveillance and Program Support2 

1,849.65 3,150.00 1,858.08 3,008.08 

Prevention...................................................................................................... 22.41 .00 22.21 22.01 

Treatment....................................................................................................... 89.63 .00 88.85 88.06 

Total, Health Surveillance and Program Support.............................................. 112.03 .00 111.06 110.07 

Total Funding....................................................................................................... 4,163.06 3,180.00 4,174.04 5,996.43 

Drug Resources Personnel Summary 

Total FTEs3 

Drug Resources as a Percent of Budget 

267 - 316 318 

Total Agency Budget 5,999.39 3,180.00 6,094.63 10,697.15 

Drug Resources Percentage 69.4% 100.0% 68.5% 56.1% 

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: The Drug Abuse Warning Network is allocated fully to substance abuse. Program Support, Health Surveillance and PQIS are split 

the same proportion as drug control to the overall SAMHSA budget as defined by the substance abuse portions divided by the mental health 

and substance abuse portions combined. Public Awareness and Support, Behavioral Health Workforce Data and Development and Data 

Request, and Publication User Fees are allocated 50% to drug control activities. The drug control total for HSPS after these calculations is 

allocated between Prevention (20%) and Treatment (80%). 

3

Only Direct FTEs included in total 

343 
 

SAMHSA-Drug Control Budget 

Drug Budget Split between Prevention and Treatment FY 2021-2023 

(Dollars in millions) 

Substance Use Prevention Services

 FY 2021 

Final 

 FY 2021 

COVID-19 

Supplemental

 FY 2022 

CR 

 FY 2023 

President's 

Budget 

 Programs of Regional and National Significance (PRNS) 

Strategic Prevention Framework............................................................................................ $119.95 $119.48 $126.67 

Strategic Prevention Framework Rx (non-add)............................................................... 10.00 10.00 15.00 

Budget Authority (non-add)........................................................................................... 10.00 10.00 15.00 

PHS Evaluation Funds (non-add)................................................................................. - - -

Federal Drug-Free Workplace............................................................................................... 4.92 4.89 5.14 

Minority AIDS....................................................................................................................... 40.71 41.21 42.03 

Sober Truth on Preventing Underage Drinking ..................................................................... 10.03 10.00 10.00 

Center for the Application of Prevention Technologies......................................................... 7.49 7.49 11.99 

Science and Service Program Coordination........................................................................... 4.15 4.07 4.07 

First Responder Training (CARA)3 

.......................................................................... .00 .00 67.50 

Grants to Prevent Prescription Drug/Opioid Overdose-Related Deaths3 

.................. .00 .00 18.00 

Improving Access to Overdose Treatment3 

............................................................... .00 .00 1.50 

Tribal Behavioral Health Grants............................................................................................ 20.64 20.75 23.67 

SAP Minority Fellowship Program........................................................................................ .32 .32 1.34 

Total, Substance Use Prevention Services PRNS 208.22 .00 208.22 311.91 

Substance Abuse Prevention and Treatment Block Grant1 

 PHS Evaluation Funds (non-add) 

Total, Substance Abuse Prevention and Treatment Block Grant 

369.93 

15.84 

630.00 371.62 

15.84 

601.62

15.84 

369.93 630.00 371.62 601.62 

Health Surveillance and Program Support2 

Health Surveillance and Program Support 17.47 17.29 15.30 

Health Surveillance............................................................................................................ 6.54 6.47 5.97 

Budget Authority (non-add)........................................................................................... 2.32 2.31 2.56 

PHS Evaluation Funds (non-add)................................................................................. 4.22 4.17 3.41 

Program Support................................................................................................................. 10.93 10.82 9.33 

Public Awareness and Support.............................................................................................. 1.30 1.30 1.33 

Performance and Quality Information Systems....................................................................... 1.38 1.37 1.14 

Behavioral Health Workforce Data and Development........................................................... .10 .10 .10 

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

Drug Abuse Warning Network............................................................................................... 2.00 2.00 4.00 

Data Request/Publication User Fees...................................................................................... .15 .15 .15 

Total, Health Surveillance and Program Support 22.41 .00 22.21 22.01 

Total, Substance Use Prevention Services 600.56 630.00 602.05 935.54 

1 The Substance Abuse Prevention and Treatment Block Grant is split 20% to the Prevention function and 80% to the Treatment function. 

2 The Health Surveillance and Program Support Appropriation funded activities are split between Mental Health and Substance Abuse as follows: The 

Drug Abuse Warning Network is allocated fully to substance abuse. Program Support, Health Surveillance and PQIS are split the same proportion as 

drug control to the overall SAMHSA budget as defined by the substance abuse portions divided by the mental health and substance abuse portions 

combined. Public Awareness and Support, Behavioral Health Workforce Data and Development and Data Request, and Publication User Fees are 

allocated 50% to drug control activities. The drug control total for HSPS after these calculations is allocated between Prevention (20%) and Treatment 

(80%). 

3 Programs are being realigned from Treatment to Prevention in FY 2023, therefore FY 2022 President's budget is zero.

344 
SAMHSA-Drug Control Budget 

Drug Budget Split between Prevention and Treatment FY 2021-2023 

(Dollars in millions) 

Substance Use Services

 FY 2021 

Final 

 FY 2021 

COVID-19 

Supplemental

 FY 2022 

CR 

 FY 2023 

President's 

Budget 

 Programs of Regional and National Significance (PRNS) 

Opioid Treatment Programs/Regulatory Activities................................................................ $7.22 $8.72 $13.09 

Screening, Brief Intervention and Referral to Treatment ....................................................... 29.70 30.00 30.56 

Budget Authority (non-add).............................................................................................. 27.70 28.00 28.56 

PHS Evaluation Funds (non-add)..................................................................................... 2.00 2.00 2.00

 Targeted Capacity Expansion 102.33 102.19 147.92

 Medication-Assisted Treatment for Prescription Drug and Opioid Addiction (nonadd)...................................................................... 91.00 91.00 136.50 

Pregnant and Postpartum Women........................................................................................... 32.77 32.93 49.40 

Improving Access to Overdose Treatment3 

............................................................... 1.07 1.00 .00 

Recovery Community Services Program................................................................................ 2.51 2.43 5.15 

Children and Family Programs............................................................................................... 29.48 29.61 30.20 

Treatment Systems for Homeless .......................................................................................... 36.39 36.39 37.11 

Minority AIDS ...................................................................................................................... 65.56 65.57 66.88 

SAT Minority Fellowship Program....................................................................................... 5.79 5.79 7.14 

Criminal Justice Activities..................................................................................................... 89.00 89.00 124.38 

Addiction Technology Transfer Centers................................................................................ 9.46 9.05 9.05 

Building Communities of Recovery....................................................................................... 10.01 10.00 20.00 

Peer Support TA Center......................................................................................................... 1.00 1.00 1.50 

Treatment, Recovery, and Workforce Support....................................................................... 6.09 6.00 9.00 

Emergency Department Alternatives to Opioids.................................................................... 5.91 6.00 9.00 

Grants to Prevent Prescription Drug/Opioid Overdose Related Deaths3 

................... 11.83 12.00 .00 

Opioid Response Grants....................................................................................................... 3.00 3.00 .00 

Comprehensive Opioid Recovery Centers............................................................................ 3.61 4.00 6.00 

Community Based Funding for Local Substance use Disorder Services............................... .00 30.00 .00 .00 

First Responder Training (CARA)3 

........................................................................... 42.39 42.00 .00 

Total, Substance Use Services PRNS 

State Opioid Response Grants............................................................................................... 

495.12 30.00 496.68 566.36 

1,498.03 1,500.00 2,000.00 

Substance Abuse Prevention and Treatment Block Grant1 

PHS Evaluation Funds (non-add)..................................................................................... 

1,479.72 

63.36 

2,520.00 

.00 

1,486.46 

63.36 

2,406.46 

63.36 

Total, Substance Abuse Prevention and Treatment Block Grant 

Health Surveillance and Program Support2 

1,479.72 2,520.00 1,486.46 2,406.46 

Health Surveillance and Program Support $69.90 $69.17 $61.18 

Health Surveillance............................................................................................................ 26.18 25.89 23.87 

Budget Authority (non-add)........................................................................................... 9.30 9.22 10.24 

PHS Evaluation Funds (non-add)................................................................................. 16.88 16.67 13.63 

Program Support................................................................................................................. 43.72 43.28 37.31 

Public Awareness and Support.............................................................................................. 5.18 5.20 5.30 

Performance and Quality Information Systems....................................................................... 5.53 5.48 4.57 

Behavioral Health Workforce Data and Development........................................................... .41 .40 .40 

PHS Evaluation Funds (non-add)..................................................................................... .41 .40 .40 

Drug Abuse Warning Network............................................................................................... 8.00 8.00 16.00 

Data Request/Publication User Fees...................................................................................... .60 .60 .60 

Total, Health Surveillance and Program Support 89.63 .00 88.85 88.06 

Total, Substance Use Services 3,562.50 2,550.00 3,571.99 5,060.88

1 The Substance Abuse Prevention and Treatment Block Grant is split 20% to the Prevention function and 80% to the Treatment function. 

2 The Health Surveillance and Program Support Appropriation funded activities are split between Mental Health and Substance Abuse as follows: The 

Drug Abuse Warning Network is allocated fully to substance abuse. Program Support, Health Surveillance and PQIS are split the same proportion as 

drug control to the overall SAMHSA budget as defined by the substance abuse portions divided by the mental health and substance abuse portions 

combined. Public Awareness and Support, Behavioral Health Workforce Data and Development and Data Request, and Publication User Fees are 

allocated 50% to drug control activities. The drug control total for HSPS after these calculations is allocated between Prevention (20%) and Treatment 

(80%). 

3 Programs are being realigned from Treatment to Prevention in FY 2023. 

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SAMHSA-Drug Control Budget 

METHODOLOGY 

SAMHSA distributes drug control funding into two functions: prevention and treatment. Both 

functions include a portion of funding from the HSPS appropriation. Within the program 20 

percent is prevention and 80 percent treatment. 

The portion of the HSPS account attributed to the Drug Budget uses the following calculations: 

• The Drug Abuse Warning Network is allocated fully to Substance Use Prevention Services 

and treatment. 

• The Health Surveillance, Program Support, and PQIS portions of the HSPS appropriation are 

divided between Mental Health and Substance Abuse using the same percentage splits as 

between the Mental Health and Substance Abuse (Prevention and Treatment) appropriation 

amounts. 

o The Drug Control portion is then split 20 percent/80 percent into the two functions, 

prevention, and treatment, respectively. 

• The Public Awareness and Support, Behavioral Health Workforce Data and Development, and 

Data Request and Publication User Fees portion of the HSPS appropriation is divided evenly 

between Mental Health and Substance Abuse. 

o The Drug Control portion is then split 20 percent/80 percent into the two functions, 

prevention, and treatment, respectively. 

The prevention function also includes all the Substance Use Prevention Services appropriation, 

including the Substance Use Prevention Services PRNS, and 20 percent of the SABG funds 

specifically appropriated for prevention activities from the Substance Use Services appropriation. 

The treatment function also includes the Substance Use Services appropriation, including the 

Substance Use Services PRNS, SOR grants, and 80 percent of the SABG funds. 

EQUITY 

The Office of Behavioral Health Equity (OBHE) coordinates SAMHSA’s efforts to reduce mental 

and/or substance use disorders across a spectrum of under resourced populations by advancing 

equity. The SAMHSA Office of Behavioral Health Equity (OBHE) was established in accordance 

with Section 10334(b) of the Patient Protection and Affordable Care Act (ACA) of 2010. OBHE 

advances behavioral health equity by reducing disparities in racial, ethnic, LGBTQIA+, and other 

under-resourced communities across the country by improving access to quality services and 

supports that enables all to thrive, participate, and contribute to healthier communities. OBHE is 

organized around 5 key public-facing strategic domains on policy, data, quality practice and 

workforce development, communication, and technical assistance. OBHE also has one internal 

facing strategy area focused on infrastructure. For the next three years, OBHE’s efforts are focused 

on the promotion of behavioral health equity for a targeted population: under resourced racial and 

ethnic minority, LGBTQIA+, Mixed race, and poor rural white residents. 

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OBHE currently funds two sperate contracts from The National Network to Eliminate Disparities 

in Behavioral Health (NNED) and NNEDLearn. OBHE Flagship Initiatives includes the Disparity 

Impact Statement (DIS), Elevate Community Based Organizations (CBOs), The NNED, and CoE 

LGBT. Additionally, OBHE conducts a monthly SAMHSA-wide Equity Cross-Cutting 

workgroup that addresses topics like Diversity Equity and Inclusion (DEI) that also includes 

SAMHSA’s key Offices and Centers. OBHE also works closely with the Agency for Healthcare 

Research and Quality's (AHRQ) to co-produce racial/ethnic/LGBTQ small reports data snap shots. 

OBHE also serves on President Biden’s Equity driven Executive Order (EO) workgroups (EO 

13985, 13995, 14021, and others) and other trans-HHS workgroups such as NIH’s SDoH as well 

as serve on NASEM Forum on Mental Health and Substance Use Disorders. 

Disparity Impact Statement 2.0 Initiative 

SAMHSA’s Disparity Impact Statement 2.0 Initiative seeks to improve the current mechanism to 

ensure that the investments made by SAMHSA to its grantees reach all Americans in need of 

behavioral health services- no matter their race, ethnicity, social economic status, or sexual 

orientation. This Initiative will involve analyzing how the current DIS is implemented across the 

agency, the capacity of SAMHSA to expand the DIS across a greater segment of its investments 

and programs, and the necessary changes needed to update the current DIS components and 

framework. This Initiative will also provide guidance to SAMHSA to facilitate the development 

of clear guidance for grantees on the purpose and expectations for targeting and addressing 

behavioral health disparities in their communities, provide clear instruction on how to submit an 

appropriate DIS to SAMHSA, and determine the most effective method to report, monitor and 

evaluate DIS impact to ensure effectiveness. 

Elevate CBOs Initiative 

Elevate CBOs is an overarching policy-driven initiative at SAMHSA's Office of Behavioral Health 

Equity to build capacity, increase the visibility, and highlight the unique role of CBOs serving 

under-resourced communities in behavioral health. Community-based organizations (CBOs) play 

an important role when serving their respective communities. CBOs work at the local level to 

maintain community morale and cohesion, build connection between officials at various levels of 

government with community and provide critical services to the community. 

The National Network to Eliminate Disparities in Behavioral Health (NNED) 

NNED is a virtual network of community-based organizations across the U.S. focused on the 

mental health and substance use issues of diverse racial, ethnic, cultural, and sexual minority 

communities. Using data informed approach, the NNED supports information sharing, training, 

and technical assistance towards the goal of promoting behavioral health equity. It is currently 

funded by SAMHSA and managed by SAMHSA’s Office of Behavioral Health Equity (OBHE). 

NNED opportunities include NNEDLearn, Partner Central, and NNEDshare. NNEDLearn is an 

annual intensive training for NNED members from community-based organizations to develop 

their skills in evidence-supported and culturally appropriate practices for mental illness and 

substance use. Partner Central is a private space for NNED members to search for communitybased organizations in the network to build partnerships to achieve a shared goal. NNEDshare is 

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SAMHSA-Drug Control Budget 

a collaborative online space for NNED members and the public to share resources and intervention 

efforts to improve the delivery of behavioral health care interventions in diverse populations. 

LGBTQ+ Behavioral Health Equity Center of Excellence 

The Center of Excellence on LGBTQ+ Behavioral Health Equity (CoE LGBTQ+ BHE) will 

provide behavioral health practitioners with vital information on supporting the population of 

people identifying as lesbian, gay, bisexual, transgender, queer, questioning, intersex, two-spirit, 

and other diverse sexual orientations, gender identities and expressions (LGBTQ+). Research 

shows that LGBTQ+ populations of all ages disproportionately experience more instances of 

mental health and substance use disorders, suicidality, and poorer wellbeing outcomes compared 

to their heterosexual and cisgender peers. The CoE LGBTQ+ BHE’s mission is to bring 

information and resources to the behavioral health field to enhance culturally responsive care and 

decrease disparities for this population. 

BUDGET REQUEST 

The FY 2023 President’s Budget Request is $6.0 billion, an increase of $1.8 billion from the FY 

2022 Annualized Continuing Resolution. 

The budget directs resources to activities that have demonstrated improved health outcomes and 

that increase service capacity. SAMHSA has three major drug-related portfolios, and attendant 

decision units: Substance Use Prevention Services, Substance Use Services, and Health 

Surveillance and Program Support. 

Each decision unit is discussed below: 

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SAMHSA-Drug Control Budget 

Substance Use Prevention Services 

Programs of Regional and National Significance 

Strategic Prevention Framework 

FY 2023 Budget Request: $126.7 million, an increase of $7.2 from the FY 2022 Annualized 

Continuing Resolution. 

SAMHSA’s Strategic Prevention Framework (SPF) grant programs support activities to help 

grantees build a solid foundation for delivering and sustaining effective Substance Use Prevention 

Services and reducing substance abuse problems. The Strategic Prevention Framework – 

Partnerships for Success (SPF-PFS) program addresses underage drinking among youth and young 

adults age 12 to 20 and allows states to prioritize state-identified top data driven substance abuse 

target areas. To accelerate the healing of our youth and communities, SAMHSA is proposing to 

sustain the Strategic Prevention Framework-Partnerships for Success (SPF-PFS) program with the 

provision of augmented guidance and technical assistance to all grantees. Funding will provide 

communities with much needed resources to implement prevention programming, including 

evidence-based programs, awareness campaigns, targeted strategies to address disparities, 

developing and maintaining data systems, hiring prevention staff, and other activities. 

Strategic Prevention Framework for Prescription Drugs 

Due to alarming trends related to prescription drug misuse and overdoses involving opioids, 

SAMHSA is prioritizing efforts to address prescription drug misuse. SAMHSA implemented the 

Strategic Prevention Framework for Prescription Drugs (SPF-Rx) to raise awareness about the 

dangers of sharing medications and to work with pharmaceutical and medical communities on the 

risks of overprescribing to young adults. SAMHSA’s program focuses on raising community 

awareness and bringing prescription drug use prevention activities and education to schools, 

communities, parents, prescribers, and their patients. SAMHSA tracks reductions in opioid 

overdoses and the incorporation of prescription drug monitoring data into needs assessments and 

strategic plans as indicators of program success. The SPF-Rx programs are currently being 

implemented in 18 states and three Tribes. 

Federal Drug-Free Workplace 

FY 2023 Budget Request: $5.1 million, an increase of $245,000 from the FY 2022 Annualized 

Continuing Resolution. 

SAMHSA’s activities related to the Federal Drug-Free Workplace support two principal activities 

mandated by Executive Order (E.O.) 12564 and Public Law (P.L.) 100-71. This includes: 1) 

oversight of the Federal Drug-Free Workplace, aimed at the elimination of illicit drug use within 

Executive Branch agencies and the federally regulated industries; and 2) oversight of the National 

Laboratory Certification Program (NLCP), which certifies laboratories to conduct forensic drug 

testing for federal agencies, federally regulated industries; the private sector also uses the HHSCertified Laboratories. The increase in funding is based on the implementation of the new 

mandatory guidelines for oral fluid and hair in the federally regulated drug testing program. This 

increase will allow SAMHSA to continue oversight of the Executive Branch Agencies’ Federal 

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SAMHSA-Drug Control Budget 

Drug-Free Workplace programs and to operationalize the newly authorized specimen and new 

drug testing program for oral fluid, a first in over 30 years. 

SAMHSA will continue oversight of the Executive Branch Agencies’ Federal Drug-Free 

Workplace Programs. This includes review of Federal Drug-Free Workplace plans from those 

federal agencies that perform federal employee testing, random testing of those designated testing 

positions of national security, public health, and public safety, and testing for illegal drug use and 

the misuse of prescription drugs. SAMHSA will continue its oversight role for the inspection and 

certification of the HHS-certified laboratories. 

Sober Truth on Preventing Underage Drinking 

FY 2023 Budget Request: $10.0 million, level with the FY 2022 Annualized Continuing 

Resolution. 

The Sober Truth on Preventing Underage Drinking Act (STOP Act) of 2006 (Public Law 109 -

422) was the nation’s first comprehensive legislation on underage drinking. One of the primary 

components of the STOP Act is the community-based coalition enhancement grant program, which 

provides up to $50,000 per year over four years to current or former grantees under the Drug Free 

Communities Act of 1997 to prevent and reduce alcohol use among youth under the age of 21. 

The STOP Act grant program enables organizations to strengthen collaboration and coordination 

among stakeholders to achieve a reduction in underage drinking in their communities. The STOP 

Act was reauthorized in the 21st Century Cures Act. SAMHSA, under the leadership of the 

Interagency Coordinating Committee for the Prevention of Underage Drinking (ICCPUD), 

continue to garner support for program efficacy over the next year and implement evaluation plans 

for the upcoming 2022–2023 campaign evaluation cycle, which includes an evaluation of the 

usability, reach, and effectiveness of the TTHY mobile app and Screen4Success self-screening a 

referral management system; the initial development of a complementary youth campaign that 

includes message testing and audience segmentation analysis; and the beginning of a multi-year 

evaluation of the student assistance- and school health and wellness-focused training with 

formative, outcome, and long-term impact evaluation methodologies that can be adopted by 

schools and districts. 

Tribal Behavioral Health Grants 

FY 2023 Budget Request: $23.7 million, an increase of $2.9 million from the FY 2022 

Annualized Continuing Resolution. 

SAMHSA’s Tribal Behavioral Health Grants (TBHG) program addresses the high incidence of 

substance abuse and suicide among AI/AN populations. Starting in FY 2014, this program 

supports tribal entities with the highest rates of suicide by providing effective and promising 

strategies that address substance abuse, trauma, and suicide and by promoting the mental health of 

AI/AN young people. In FY 2016, SAMHSA expanded activities through the braided TBHG/NC 

funding to allow tribes the flexibility to implement community-based strategies to address trauma, 

prevent substance misuse, and promote mental health and resiliency among youth in tribal 

communities. 

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This request, along with $23.1 million in the Center of Mental Health Services will continue to 

support grants that promote mental health and prevent substance use activities for high-risk AI/AN 

youth and their families. 

Centers for the Application of Prevention Technologies 

FY 2023 Budget Request: $12.0 million, an increase of $4.5 million from the FY 2022 

Annualized Continuing Resolution. 

In 2019, Center for the Application of Prevention Technologies (CAPT) changed how it delivered 

services and began providing science-based training and technical assistance through Prevention 

Technology Transfer Centers (PTTC) cooperative agreements. SAMHSA leadership established 

the PTTC the previous year to expand and improve implementation and delivery of effective 

Substance Use Prevention Services interventions and provide training and technical assistance 

services to the Substance Use Prevention Services field. The PTTC does this by developing 

and disseminating tools and strategies needed to improve the quality of Substance Use 

Prevention Services efforts; providing intensive technical assistance and learning resources 

to prevention professionals to improve their understanding of prevention science, 

epidemiological data, and implementation of evidence-based and promising practices; and 

developing tools and resources to engage the next generation of prevention professionals. 

The increase in funding will allow the establishment of tailored state-of-the-art substance use 

prevention technical assistance to states, communities, Tribe, or territories, to strengthen grantee 

programs. The capacity to provide direct technical assistance was not available in the previous 

fiscal year. Grantees and the field have expressed challenges with this loss of technical assistance 

capacity. This funding will support the HHS priority of advancing the goal of ending the opioid 

crisis and the ONDCP Drug Policy Priority of supporting evidence-based prevention efforts to 

reduce youth substance use. 

Science and Service Program Coordination 

FY 2023 Budget Request: $4.1 million, level with the FY 2022 Annualized Continuing 

Resolution. 

The Science and Service Program Coordination program funds the provision of technical 

assistance and training to states, tribes, communities, and grantees around Substance Use 

Prevention Services. Specifically, the program supports the Tribal Training and Technical 

Assistance Center and the Underage Drinking Prevention Education Initiatives (UADPEI). 

This funding will support SAMHSA’s Substance Use Prevention Services efforts and include a 

focus on preventing underage drinking and providing technical assistance and training to American 

Indians/Alaska Native communities. 

Improving Access to Overdose Treatment 

(program being realigned from Treatment to Prevention in FY 2023) 

FY 2023 Budget Request: $1.5 million, an increase of $500,000 from the FY 2022 Annualized 

Continuing Resolution. 

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As part of SAMHSA’s response to the increase in the number of opioid-related overdose deaths, 

the Opioid Overdose Prevention Toolkit was developed to help reduce the number of opioidrelated overdose deaths and adverse events. SAMHSA’s Improving Access to Overdose 

Treatment (ODTx) grant program utilizes this toolkit and other resources to help grantees train 

and support health care providers and pharmacists on the prescribing of FDA approved drugs or 

devices for the emergency treatment of known or suspected opioid overdose. In addition, the 

ODTx program addresses the opioid crisis by increasing access to treatment, reducing unmet 

treatment need, and reducing opioid overdose related deaths through the provision of prevention, 

treatment, and recovery activities for opioid use disorder (including prescription opioids as well as 

illicit drugs such as heroin). FY 2023 funds will continue increasing access to treatment, reducing 

unmet treatment need, and reducing opioid overdose related deaths through the provision of 

prevention, treatment, and recovery activities for opioid use disorder. 

Grants to Prevent Prescription Drug/Opioid Overdose Related Deaths 

(program being realigned from Treatment to Prevention in FY 2023) 

FY 2023 Budget Request: $18.0 million, level with the FY 2022 Annualized Continuing 

Resolution. 

Opioid overdose is a significant contributor to accidental deaths among those who use, misuse, or 

abuse illicit and prescription opioids (including synthetics), such as fentanyl. SAMHSA’s Grants 

to Prevent Prescription Drug/Opioid Overdose Related Deaths program seeks to help states 

identify communities of high need, and provide education, training, and resources necessary to 

tailor the overdose kits to meet their specific needs. Grantees can use the funds to purchase 

naloxone, equip first responders with naloxone and other overdose death prevention strategies, 

support education on these strategies, provide materials to assemble and disseminate overdose kits. 

FY 2023 funds will continue to help states purchase overdose reversing drugs, equip first 

responders in high-risk communities, support education on the use of naloxone and other overdoserelated death prevention strategies, provide the necessary materials to assemble overdose kits, and 

cover expenses incurred from dissemination efforts. 

First Responder Training 

(program being realigned from Treatment to Prevention in FY 2023) 

FY 2023 Budget Request: $63.0 million, an increase of $26.0 million from the FY 2022 

Annualized Continuing Resolution. 

First Responder Training supports efforts to help first responders and members of other key 

community sectors to administer a drug or device approved or cleared under the Federal Food, 

Drug, and Cosmetic Act for emergency treatment of known or suspected opioid overdose. 

Grantees train and provide resources to first responders and members of other key community 

sectors at the state, tribal, and local governmental levels on carrying and administering a drug or 

device approved or cleared under the Federal Food, Drug, and Cosmetic Act for emergency 

treatment of known or suspected opioid overdose. Grantees also establish processes, protocols, 

and mechanisms for referral to appropriate treatment and recovery communities. Training, 

technical assistance, and evaluation activities are also being supported to assist grantees, determine 

best practices, and assess program outcomes. The FR-CARA program provides funding to state, 

Tribal and local governments to train and equip first responders to administer naloxone. To date, 

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grantees report having trained 124,392 first responders and community members on the use of 

naloxone or other FDA approved drugs or devices, and how to respond to overdose emergencies. 

The program has equipped these communities with 306,759 FDA-approved overdose reversal kits 

since the start of the program. Of these, 125,679 doses have been administered to treat suspected 

overdose cases, resulting in more than 38,406 confirmed overdose reversals. The additional funds 

will support expanding the program to an additional 7 communities. 

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Substance Use Services 

Substance Abuse Prevention and Treatment Block Grant: 

FY 2023 Budget Request: $3.0 billion, an increase of $1.2 billion from the FY 2022 

Annualized Continuing Resolution. 

The goal of the SABG program is to ensure that individuals, their families, and communities have 

access to the range of substance use-related prevention, treatment, harm reduction, and recovery 

support services necessary to improve individual outcomes and reduce the impact of substance 

misuse on America’s communities. SABG grantees plan, implement, and evaluate substance use 

disorder (SUD) prevention, treatment, and recovery support services based on the specific needs 

of their state systems and populations. 

The SABG program enables the development of comprehensive statewide systems of care that 

provide a broad continuum of SUD services and supports encompassing prevention, treatment, 

and recovery support services for all individuals who need them. Funding will aid in having a 

positive effect on the health and quality of life of individuals with SUD as demonstrated by positive 

client outcomes in the treatment domains of the National Outcomes Measures (NOMs); improve 

state prevention and treatment systems’ infrastructure and capacity resulting in an increase in 

services, development and implementation of evidence-based practices, development and 

collection of specific outcome measures, and development and maintenance of state data 

management systems; aid states in leveraging requirements, resources, and federal guidance to 

sustain and improve state systems further emphasizing the importance of the SABG in the 

development of the same; and contribute to the development and maintenance of successful state 

collaborations with other agencies and stakeholders concerned with preventing and treating SUD. 

It is imperative that our addiction crisis response evolves from an acute short-term individualfocused treatment response to a broader community recovery response. Addiction is a chronic 

illness, and recovery often is a life-long process where external community and social determinants 

of health play a vital role in its sustainability. Starting in FY 2022, a new 10 percent set aside 

within the SABG for non-clinical recovery support services. The set-aside requires that least 10 

percent of grantees’ SABG expenditures be used for recovery community organizations, peer 

recovery support services, and other recovery support services. These services may include 

recovery housing, recovery community centers, recovery schools, recovery industries, and 

recovery ministries; develop strategies and educational campaigns, trainings, and events to reduce 

addiction/recovery-related stigma and discrimination at the local level; provide addiction treatment 

and recovery resources and support system navigation; make accessible peer recovery support 

services that support diverse populations and are inclusive of all pathways to recovery; and 

collaborate and coordinate with local private and non-profit clinical health care providers, the faith 

community, city, county, state, and federal public health agencies, and criminal justice response 

efforts. SAMHSA anticipates that this set-aside will help increase access to recovery support 

services across the country and complement the existing efforts to respond to the ongoing overdose 

crisis that has accelerated during the COVID-19 pandemic. 

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State Opioid Response 

FY 2023 Budget Request: $2.0 billion, an increase of $500 million from the FY 2022 

Annualized Continuing Resolution. 

Substance use And Mental Health Services Administration established the State Opioid Response 

Grants (SOR) program in FY 2018. This program aims to address the opioid crisis by increasing 

access to treatment that includes the three FDA-approved medications for the treatment of opioid 

use disorder, reducing unmet treatment needs, and reducing opioid overdose related deaths through 

the provision of prevention, treatment, and recovery activities for opioid use disorder (OUD) 

(including prescription opioids, heroin and illicit fentanyl and fentanyl analogs). Funding is 

awarded grants to states and territories via formula. The program also includes a 15 percent setaside for the states with the highest mortality rates related to drug overdose deaths. The program 

also includes a $75 million set-aside for tribes. Given the varying nature of substance misuse 

across the United States, the budget continues to allow the use of State Opioid Response grants to 

include methamphetamine and other stimulants, giving states and tribes flexibility to address their 

unique community needs. States and communities across the country are dealing with rising rates 

of stimulant use and its negative health, social, and economic consequences. The funding increase 

in FY 2023 will allow the program to continue to include state efforts to address stimulants, 

including methamphetamine, and cocaine. Stimulants are an increasing source of concern and are 

responsible for more deaths than opioids in a growing number of states, even as opioid overdose 

deaths are continuing to increase. The increase will also enhance states’ ability to address 

stimulants, as well as other issues related to the overdose epidemic that have been compounded 

due to COVID-19. A primary strategy to reduce overdose deaths in the SOR program, that will 

continue in FY 2023, is education on, and purchase and distribution of naloxone, a proven 

medication that reverses opioid-related overdoses to save lives. In the FY 2022 funding 

announcement, the SOR program will require a comprehensive needs assessment with 

accompanying strategies to include a focus on naloxone distribution and saturation particularly in 

areas with high rates of overdose mortality.112 

Programs of Regional and National Significance 

Opioid Treatment Programs/Regulatory Activities 

FY 2023 Budget Request: $13.1 million, an increase of $4.4 million from the FY 2022 

Annualized Continuing Resolution. 

As part of its regulatory responsibility, SAMHSA certifies Opioid Treatment Programs that use 

methadone, buprenorphine, or buprenorphine/naloxone to treat patients with opioid dependence. 

SAMHSA carries out this responsibility by enforcing regulations established by an accreditationbased system. This is accomplished in coordination with the Drug Enforcement Administration, 

states, territories, and the District of Columbia. SAMHSA also funds the Opioid Treatment 

Programs Medical Education and Supporting Services project aimed at preparing Opioid 

Treatment Programs to achieve accreditation and providing technical assistance and clinical 

112 Irvine MA, Oller D, Boggis J, Bishop B, Coombs D, Wheeler E, Doe-Simkins M, Walley AY, Marshall BDL, Bratberg J, Green TC. 

Estimating naloxone need in the USA across fentanyl, heroin, and prescription opioid epidemics: a modelling study. Lancet Public Health. 2022 

Feb 10:S2468-2667(21)00304-2. doi: 10.1016/S2468-2667(21)00304-2. Epub ahead of print. PMID: 35151372. 

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SAMHSA-Drug Control Budget 

training to enhance program clinical activities. Additionally, SAMHSA funds grants and contracts 

that support the regulatory oversight and monitoring activities of Opioid Treatment Programs. 

This request supports the Secretary’s five-prong strategy to address the opioid crisis priorities. In 

this program, this is through regulatory activities, ongoing training, certification, and technical 

assistance to provider groups and communities impacted by the opioid crisis. The funding increase 

in FY 2023 will allow SAMHSA to continue to award new and continuation Provider’s Clinical 

Support System- Universities (PCSS-U) grants and Provider’s Clinical Support System -

Medication Assisted Treatment Grant (PCSS-MAT) to address the nation’s need for increased 

access to care and treatment for opioid and other substance use disorders. 

Targeted Capacity Expansion 

The FY 2023 Budget Request: $148 million, an increase of $46.0 million from the FY 2022 

Annualized Continuing Resolution. 

The Targeted Capacity Expansion (TCE) program provides rapid, strategic, comprehensive, and 

integrated community-based responses to gaps in and capacity for SUD treatment and recovery 

support services. Examples of such needs include limited or no access to medication-assisted 

treatment (MAT) for opioid use disorders; lack of resources needed to adopt and implement health 

information technologies (HIT) in SUD treatment settings; and short supply of trained and 

qualified peer recovery coaches to assist individuals in the recovery process. The funding increase 

in FY 2023 will allow SAMHSA to continue to fund TCE-Special Projects and MAT PDOA grants 

which will make MAT services accessible to 40 percent more individuals suffering from OUD. 

Treatment Systems for Homeless 

The FY 2023 Budget Request: $37.1 million, an increase of $73,000 from the FY 2022 

Annualized Continuing Resolution. 

SAMHSA’s Treatment Systems for Homeless portfolio supports services for those with substance 

use disorders or co-occurring mental and substance use disorders who are experiencing 

homelessness, including youth, veterans, and families. SAMHSA’s Treatment Systems for 

Homeless programs are crucial to achieving reducing homelessness for nearly 5,000 people. In 

FY 2021, 4,003 clients were served through SAMHSA’s Grants for the Benefit of Homeless 

Individuals (GBHI) program. The increase in FY 2023 will continue to fund new and continuing 

GBHI grants with grant supplements for direct technical assistance to about 22 of the 55 

continuation grants. 

Pregnant and Postpartum Women 

FY 2023 Budget Request: $49.4 million, an increase of $16.5 million from the FY 2022 

Annualized Continuing Resolution. 

The Pregnant and Postpartum Women supports grants for residential treatment and the Pregnant 

and Postpartum Women Pilot, authorized in the Comprehensive Addiction and Recovery Act 

(CARA), helps state substance abuse agencies address the continuum of care, including services 

provided to women in nonresidential-based settings and promote a coordinated, effective, and 

efficient state system managed by state substance abuse agencies by encouraging new approaches 

and models of service delivery. The PPW program provides services not covered under most 

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SAMHSA-Drug Control Budget 

public and private insurance. In FY 2020, SAMHSA funded new state PPW pilot grants and 

continuation state PPW pilot grants for program implementation, supplement for direct technical 

assistance, and continuation evaluation contract to provide an array of services and supports to 

pregnant women and their children. During FY 2021, 392 clients were served in the PPW-PLT 

program. The funding increase in FY 2023 will allow SAMHSA to continue to fund state PPW 

pilot grants, pilot continuation grants, and residential treatment grants. 

Building Communities of Recovery 

FY 2023 Budget Request: $49.4 million, an increase of $16.5 million from the FY 2022 

Annualized Continuing Resolution. 

The purpose of this program is to mobilize resources within and outside of the recovery community 

to increase the prevalence and quality of long-term recovery support from drug/alcohol misuse. 

Programs are designed to be overseen by individuals in recovery from SUDs who reflect the 

community served. These grants are intended to support the development, enhancement, 

expansion, and delivery of Recovery Support Services (RSS) as well as promotion of, and 

education about recovery. Programs are designed to be overseen by people in recovery from 

substance use disorders who reflect the community served. Grants support linkages between 

recovery networks and a variety of other organizations, systems, and communities, including 

primary care, other recovery networks, child welfare system, criminal justice system, housing 

services and employment systems. The funding increase in FY 2023 will continue to support new 

and continuation grants to develop, expand, and enhance recovery support services. 

Criminal Justice Activities 

FY 2023 Budget Request: $124.4 million, an increase of $35.4 million from the FY 2022 

Annualized Continuing Resolution. 

SAMHSA’s Criminal Justice portfolio includes several grant programs that focus on diversion, 

alternatives to incarceration, drug courts, and re-entry from incarceration for adolescents and 

adults with substance use disorders and/or co-occurring substance use and mental disorders. This 

includes Treatment Drug Courts and the Offender Re-Entry Programs. 

Drug Court Activities 

SAMHSA’s Adult Drug Court programs support a variety of services including direct treatment 

services for diverse populations, wraparound, and recovery support services such as recovery 

housing and peer recovery support services designed to improve access and retention, drug testing 

for illicit substances, educational support, relapse prevention and long-term management, and HIV 

and viral hepatitis B and C testing conducted in accordance with state and local requirements. The 

program seeks to address behavioral health disparities among racial and ethnic minorities by 

encouraging the implementation of strategies to decrease the differences in access, service use, 

and outcomes among the racial and ethnic minority populations served. 

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Ex-Offender Re-Entry 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. These grants will provide screening, assessment, comprehensive treatment, and 

recovery support services for diverse populations reentering the community from incarceration. 

Other supported services include wraparound and recovery support services such as recovery 

housing and peer recovery support designed to improve access and retention, drug testing for illicit 

substances, educational support, relapse prevention and long-term management, and HIV and viral 

hepatitis B and C testing conducted in accordance with state and local requirements. SAMHSA’s 

ORP grants are encouraged to use part of their annual award to provide medication-assisted 

treatment with FDA-approved medications. 

The funding increase in FY 2023 will continue to support new and continuing drug court grants, 

ORP grants, and one contract. From these, at least 20 awards will be made to tribes/tribal 

organizations. 

Peer Support Technical Assistance Center 

FY 2023 Budget Request: $1.5 million, an increase of $500,000 from the FY 2022 Annualized 

Continuing Resolution. 

The program is authorized by section 7152 of the SUPPORT for Patients and Communities Act 

(P.L. 115-271), is to provide funding for the creation of a National Peer-Run Training and 

Technical Assistance Center for Addiction Recovery Support, or the Center. The Center provides 

training and technical assistance and support to recovery community organizations (RCOs), and 

peer support networks. The technical assistance is related to training, translation and interpretation 

services, data collection, capacity building, and evaluation and improvement of the effectiveness 

of such services provided by recovery community organizations and peer support networks. Since 

its implementation, the Peer Support Technical Assistance Center has implemented 24 events 

serving over 5,400 participants with over 90 percent satisfaction with the overall quality of the 

events. The increase in FY 2023 will continue to support the existing grantee in this program. 

Treatment, Recovery, and Workforce Support 

FY 2023 Budget Request: $9.0 million, an increase of $3.0 million from FY 2022 Annualized 

Continuing Resolution. 

The program is authorized by section 7081 of the SUPPORT for Patients and Communities Act, 

is to support the implementation of evidence-based programs for care and treatment of individuals 

after a drug overdose, as appropriate, which may include utilizing recovery coaches, establishing 

policies and procedures that address the provision overdose reversal medication and FDAapproved medications to treat substance use disorders, and establishing integrated models of care 

for individuals who have experienced a non-fatal drug overdose. SAMHSA is directed, in 

consultation with the Secretary of Labor, to award competitive grants to entities to carry out 

evidence- based programs to support individuals in substance use disorder treatment and recovery 

to live independently and participate in the workforce. The funding increase in FY 2023 will 

continue to fund new and continuation grants. 

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SAMHSA-Drug Control Budget 

Emergency Department Alternatives to Opioids 

FY 2023 Budget Request: $9.0 million, an increase of $3.0 million from FY 2022 Annualized 

Continuing Resolution. 

The program is authorized by section 7091 of the SUPPORT for Patients and Communities Act 

(P.L. 115-271) is to provide funding to hospitals and emergency departments, including 

freestanding emergency departments, to develop, implement, enhance, or study alternative pain 

management protocols and treatments that limit the use and prescribing of opioids in emergency 

departments. In addition, the program seeks to target common painful conditions, train providers 

and other hospital personnel, and provide alternatives to opioids for patients with painful 

conditions. The funding increase in FY 2023 will continue to fund new and continuing grants. 

Other PRNS Treatment Programs 

FY 2023 Budget Request: $50.4 million, an increase of $5.3 million from FY 2022 Annualized 

Continuing Resolution. 

The budget request includes resources for several Treatment Capacity programs including: 

Recovery Community Services Program; Children and Families; Addiction Technology Transfer 

Centers; and Comprehensive Opioid Recovery Centers. The 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 recoveryoriented treatment; or for outpatient providers who are able to successfully retain greater 

proportions of patients in active treatment participation for longer periods. 

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SAMHSA-Drug Control Budget 

Health Surveillance and Program Support Appropriation 

The FY 2023 Budget Request is $113.4 million, an increase of $15.0 million from the FY 2022 

Annualized Continuing Resolution. The budget request represents the Substance Abuse portion 

of the Health Surveillance and Program Support appropriation and supports staffing and activities 

to administer SAMHSA programs as described below. 

Health Surveillance and Program Support 

FY 2023 Budget Request: $80.0 million, an increase of $5.0 million from the FY 2022 

Annualized Continuing Resolution. 

Health Surveillance and Program Support (HSPS) provides funding for personnel costs, building 

and facilities, equipment, supplies, administrative costs, and associated overhead to support 

SAMHSA programmatic activities, as well as provide funding for SAMHSA national data 

collection and survey systems, funding to support the Center for Disease Control and Prevention’s 

National Health Information Survey, and the data archive. This request represents the total funding 

available for these activities first divided between Mental Health and Substance Abuse using the 

same percentages splits that exist between the Mental Health and Substance Abuse (Prevention 

and Treatment) appropriation amounts. The Drug Control portion is then split 20 percent/80 

percent into the two functions, prevention, and treatment, respectively. 

SAMHSA intends to continue funding the continuation of the NSDUH, BHSIS, SAMHDA, and 

EBPRC contracts 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. The increase in funding in FY 2023 will allow CBHSQ to increase 

the scope of the eligible substance use and mental health treatment facilities for the National 

Substance Use and Mental Health Services Survey (N-SUMHSS), including certified community 

behavioral health centers and licensed substance use and mental health group practices. Expanding 

the eligible universe of substance use and mental health providers will increase access across 

culturally diverse populations by making comprehensive information readily available to the 

public. The FY 2023 funding increase to Program Support will allow SAMHSA to hire additional 

FTE to balance the supervisory to employee ratio as well as the workload of SAMHSA’s Grant’s 

Management Specialists. 

Public Awareness and Support 

FY 2023 Budget Request: $7.0 million, level with the FY 2022 Annualized Continuing 

Resolution. 

Public Awareness and Support provides funding to support the unified communications approach 

to increase awareness of behavioral health, mental disorders, and substance abuse issues. This 

represents the total funding available for these activities first divided evenly between Mental 

Health and Substance Abuse. The Drug Control portion is then split 20 percent/80 percent into 

the two functions, prevention, and treatment, respectively. The funding for Public Awareness and 

Support will support contracts that will allow SAMHSA to manage media relationships, maintain 

its web and social media presence, manage critical helplines, and deliver publications and 

resources. 

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Performance and Quality Information Systems 

FY 2023 Budget Request: $6.0 million, a decrease of $1.0 million from the FY 2022 

Annualized Continuing Resolution. 

Performance and Quality Information Systems provides funding to support SAMHSA’s 

Performance Accountability and Reporting System (SPARs) related activities, as well as provide 

support for the National Registry of Evidence-based Programs and Practices that will reduce the 

backlog of interventions accepted but not reviewed under the previous contract. SPARS will 

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

programmatic technical assistance (TA) on use of the data to enhance grantee performance 

monitoring and improve quality of service delivery. This request represents the total funding 

available for these activities first split into Mental Health and Substance Abuse using the same 

percentages splits as between the Mental Health and Substance Abuse (Prevention and Treatment) 

appropriation amounts. The Drug Control portion is then split 20 percent/80 percent into the two 

functions, prevention, and treatment, respectively. 

SAMHSA will use these funds to continue its performance management, quality improvement, 

and activities. This funding will ensure that SAMHSA continues a strong focus on developing 

and implementing evidence-based practices and programs and continues its emphasis on 

performance management for quality improvement and program monitoring. 

Behavioral Health Workforce Data and Development 

FY 2023 Budget Request: $0.5 million, level with the FY 2022 Annualized Continuing 

Resolution. 

The purpose of this program is to provide comprehensive data and analysis on individuals who 

comprise the prevention and treatment fields to address mental and substance use disorders. The 

goal of the program is to provide valid data on the existing practitioners and usable information to 

SAMHSA on which to make policy and planning decisions. 

Drug Abuse Warning Network 

FY 2023 Budget Request: $20.0 million, an increase of $10.0 million from FY 2022 

Annualized Continuing Resolution. 

DAWN is a nationwide public health surveillance system that will improve emergency department 

monitoring of substance use crises, including those related to opioids. Authorized by the 21st 

Century Cures Act, this program is necessary to respond effectively to the opioid and addiction 

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

stakeholders to respond to emerging substance use trends. This request represents the total funding 

available for these activities. The Drug Abuse Warning Network is allocated fully to substance 

abuse. This funding will continue to support contract to fund the expansion of additional hospitals 

for FY 2022 to inform stimulant abuse prevention and response strategies. DAWN’s expansion to 

additional hospitals will allow for SAMHSA DAWN data-based estimates to be more 

generalizable and more representative across the country and will also allow SAMHSA to produce 

more accurate and complete assessment of geographic patterns (e.g., substance use disparities in 

urban, suburban, and rural areas) and temporal trends (e.g., emerging, or new substance misuse or 

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abuse) in substance use related ED visits in the United States. In addition, the budget request will 

increase publicly available information from DAWN, including data on emerging trends of major 

metropolitan regions and other geographic variables such as urban and rural. 

Data Request and Publication User Fees 

FY 2023 Budget Request: $0.75 million, level with the FY 2022 Annualized Continuing 

Resolution. 

SAMHSA will collect and retain fees for extraordinary data and publications requests. This 

represents the total funding estimated for these activities first divided evenly between Mental 

Health and Substance Abuse. The Drug Control portion is then split 20 percent/80 percent into 

the two functions, prevention, and treatment, respectively. 

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SAMHSA-Supplementary Tables 

Supplementary Tables 

Table of Contents 

1. Budget Authority by Object Class .................................................................................. 364 

2. Salaries and Expenses..................................................................................................... 373 

3. Details of Full-Time Equivalent Employment................................................................ 375 

4. Detail of Positions........................................................................................................... 376 

5. Physicians’ Comparability Allowance Worksheet ......................................................... 377 

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SAMHSA-Supplementary Tables 

Budget Authority by Object Class 

Substance use And Mental Health Services Administration 

Summary Direct Budget Authority 

(Dollars in Thousands) 

Object Class - Direct Budget Authority1,2 

FY 2021 

Final 

FY 2022 

CR 

FY 2023 

President's 

Budget 

Personnel compensation: 

Full-time permanent (11.1)................................................... 

Other than full-time permanent (11.3).................................. 

Other personnel compensation (11.5)................................... 

Military personnel (11.7)..................................................... 

Special personnel services payments (11.8) ....................... 

Subtotal personnel compensation: 

Civilian benefits (12.1)........................................................ 

Military benefits (12.2)........................................................ 

Subtotal Pay Costs: 

Travel and transportation of persons (21.0)......................... 

Transportation of things (22.0)............................................. 

Rental payments to GSA (23.1)............................................ 

Rental payments to Others (23.2).........................................

Communication, utilities, and misc. charges (23.3).............. 

Printing and reproduction (24.0).......................................... 

Other Contractual Services: 

Advisory and assistance services (25.1)........................... 

Other services (25.2)........................................................ 

 Purchase of Goods & Svcs. from Govt. Accts (25.3)....... 

Operation and maintenance of facilities (25.4)................. 

Research and Development Contracts (25.5)....................

Operation and maintenance of equipment (25.7)............... 

Subtotal Other Contractual Services: 

Supplies and materials (26.0).............................................. 

Equipment (31.0).................................................................. 

Grants, subsidies, and contributions (41.0).......................... 

Interest and dividends (43.0)................................................

$48,082 

2,061 

1,260 

3,401 

18 

$48,563 

2,081 

1,273 

3,503 

19 

$50,019 

2,144 

1,311 

3,598 

19 

54,823 55,439 57,092 

15,961 

1,792 

16,137 

1,846 

16,791 

1,896 

72,575 73,422 75,778 

59 

2 

6,766 

 --- 

463 

1,347 

36,407 

183,097 

31,583 

47 

 --- 

1,080 

60 

2 

6,875 

 --- 

470 

1,369 

36,990 

184,653 

32,089 

48 

 --- 

1,098 

61 

2 

7,005 

 --- 

479 

1,395 

37,692 

193,724 

32,698 

49 

 --- 

1,119 

252,215 254,877 265,282 

60 

68 

5,518,661 

 --- 

61 

70 

5,610,259 

 --- 

62 

71 

9,787,351 

 --- 

Subtotal Non-Pay Costs 5,779,642 5,874,041 10,061,709 

Total Direct Obligations $5,852,217 $5,947,463 $10,137,487 1

 Does not include PHS Evaluation Funds. 

2

 Does not include Prevention and Public Health Funds. 

364 
SAMHSA-Supplementary Tables 

Budget Authority by Object Class 

Substance use And Mental Health Services Administration 

Mental Health 

(Dollars in Thousands) 

Object Class - Direct Budget Authority1 

FY 2021 

Final 

FY 2022 

CR 

FY 2023 

President's 

Budget 

Personnel compensation: 

Full-time permanent (11.1).............................................. 

Other than full-time permanent (11.3).............................. 

Other personnel compensation (11.5).............................. 

Military personnel (11.7).................................................

Special personnel services payments (11.8) ...................

Subtotal personnel compensation: 

Civilian benefits (12.1).................................................... 

Military benefits (12.2)....................................................

Subtotal Pay Costs: 

Travel and transportation of persons (21.0).....................

Transportation of things (22.0)........................................ 

Rental payments to GSA (23.1)....................................... 

Rental payments to Others (23.2).....................................

Communication, utilities, and misc. charges (23.3)......... 

Printing and reproduction (24.0)...................................... 

Other Contractual Services:

Advisory and assistance services (25.1)......................... 

Other services (25.2)....................................................... 

 Purchase of Goods & Svcs. from Govt. Accts (25.3)..... 

Operation and maintenance of facilities (25.4)................

Research and Development Contracts (25.5)...................

Operation and maintenance of equipment (25.7).............. 

Subtotal Other Contractual Services: 

Supplies and materials (26.0).......................................... 

Equipment (31.0)............................................................. 

Grants, subsidies, and contributions (41.0)...................... 

Interest and dividends (43.0)...........................................

$1,396 

27 

18 

 --- 

 --- 

$1,410 

27 

18 

 --- 

 --- 

$1,453 

28 

18 

 --- 

 --- 

1,441 1,455 1,499 

456 

 --- 

460 

 --- 

470 

 --- 

1,896 1,915 1,969 

 --- 

2 

483 

 --- 

394 

155 

17,889 

48,858 

11,575 

 --- 

 --- 

399 

 --- 

2 

491 

 --- 

400 

157 

 --- 

18,175 

49,640 

11,760 

 --- 

 --- 

405 

 --- 

2 

500 

 --- 

408 

160 

 --- 

18,521 

50,583 

11,984 

 --- 

 --- 

413 

78,721 79,981 81,501 

16 

16 

1,672,270 

 --- 

17 

16 

1,753,877 

 --- 

17 

16 

4,098,114 

 --- 

Subtotal Non-Pay Costs 1,752,057 1,834,941 4,180,718 

Total Direct Obligations $1,753,954 $1,836,857 $4,182,687 1

 Does not include PHS Evaluation Funds. 

365 
SAMHSA-Supplementary Tables 

Budget Authority by Object Class 

Substance use And Mental Health Services Administration 

Substance Use Prevention Services 

(Dollars in Thousands) 

Object Class - Direct Budget Authority1 

FY 2021 

Final 

FY 2022 

CR 

FY 2023 

President's 

Budget 

Personnel compensation: 

Full-time permanent (11.1)...............................................

Other than full-time permanent (11.3)..............................

Other personnel compensation (11.5)...............................

Military personnel (11.7).................................................

Special personnel services payments (11.8) ...................

Subtotal personnel compensation:

Civilian benefits (12.1)....................................................

Military benefits (12.2)....................................................

Subtotal Pay Costs:

Travel and transportation of persons (21.0).....................

Transportation of things (22.0).........................................

Rental payments to GSA (23.1)........................................

Rental payments to Others (23.2).....................................

Communication, utilities, and misc. charges (23.3)..........

Printing and reproduction (24.0)......................................

Other Contractual Services: 

Advisory and assistance services (25.1).......................... 

Other services (25.2)....................................................... 

 Purchase of Goods & Svcs. from Govt. Accts (25.3)...... 

Operation and maintenance of facilities (25.4)................

Research and Development Contracts (25.5)...................

Operation and maintenance of equipment (25.7)..............

Subtotal Other Contractual Services: 

Supplies and materials (26.0).......................................... 

Equipment (31.0)..............................................................

Grants, subsidies, and contributions (41.0)...................... 

Interest and dividends (43.0)............................................

 $--- 

 --- 

 --- 

 --- 

 --- 

 $--- 

 --- 

 --- 

 --- 

 --- 

 $--- 

 --- 

 --- 

 --- 

 --- 

 --- --- --- 

 --- 

 --- 

 --- 

 --- 

 --- 

 --- 

 --- --- --- 

 --- 

 --- 

 --- 

 --- 

 --- 

 --- 

5,205 

15,277 

4,045 

 --- 

 --- 

 --- 

 --- 

 --- 

 --- 

 --- 

 --- 

 --- 

5,289 

15,521 

4,110 

 --- 

 --- 

 --- 

 --- 

 --- 

 --- 

 --- 

 --- 

 --- 

5,389 

15,816 

4,188 

 --- 

 --- 

 --- 

24,527 24,920 25,393 

1 

 --- 

183,691 

 --- 

1 

 --- 

183,298 

 --- 

1 

 --- 

286,518 

 --- 

Subtotal Non-Pay Costs 208,219 208,219 311,912 

Total Direct Obligations $208,219 $208,219 $311,912 1

 Does not include PHS Evaluation Funds. 

366 
 

SAMHSA-Supplementary Tables 

Budget Authority by Object Class 

Substance use And Mental Health Services Administration 

Substance Use Services 

(Dollars in Thousands) 

Object Class - Direct Budget Authority1 

FY 2021 

Final 

FY 2022 

CR 

FY 2023 

President's 

Budget 

Personnel compensation: 

Full-time permanent (11.1)............................................... 

Other than full-time permanent (11.3).............................. 

Other personnel compensation (11.5)............................... 

Military personnel (11.7).................................................

Special personnel services payments (11.8) ...................

Subtotal personnel compensation: 

Civilian benefits (12.1).................................................... 

Military benefits (12.2)....................................................

Subtotal Pay Costs: 

Travel and transportation of persons (21.0).....................

Transportation of things (22.0)......................................... 

Rental payments to GSA (23.1)........................................ 

Rental payments to Others (23.2).....................................

Communication, utilities, and misc. charges (23.3).......... 

Printing and reproduction (24.0)...................................... 

Other Contractual Services: 

Advisory and assistance services (25.1).......................... 

Other services (25.2)....................................................... 

 Purchase of Goods & Svcs. from Govt. Accts (25.3)...... 

Operation and maintenance of facilities (25.4)................ 

Research and Development Contracts (25.5)...................

Operation and maintenance of equipment (25.7).............. 

Subtotal Other Contractual Services: 

Supplies and materials (26.0)..........................................

Equipment (31.0)..............................................................

Grants, subsidies, and contributions (41.0)...................... 

Interest and dividends (43.0)............................................

$3,182 

85 

55 

 --- 

 --- 

$3,214 

86 

55 

 --- 

 --- 

$3,311 

89 

57 

 --- 

 --- 

3,323 3,356 3,456 

1,037 

 --- 

1,064 

 --- 

1,107 

 --- 

4,359 4,419 4,564 

 --- 

191 

 --- 

2 

952 

12,067 

72,867 

11,940 

47 

 --- 

408 

 --- 

194 

 --- 

2 

967 

12,260 

74,033 

12,131 

48 

 --- 

414 

 --- 

198 

 --- 

2 

985 

12,493 

75,440 

12,362 

49 

 --- 

422 

97,329 98,887 100,765 

 --- 

 --- 

3,658,768 

 --- 

 --- 

 --- 

3,669,087 

 --- 

 --- 

 --- 

5,386,729 

 --- 

Subtotal Non-Pay Costs 3,757,242 3,769,137 5,488,679 

Total Direct Obligations $3,761,601 $3,773,556 $5,493,243 1

 Does not include PHS Evaluation Funds. 

367 
SAMHSA-Supplementary Tables 

Budget Authority by Object Class 

Substance use And Mental Health Services Administration 

Health Surveillance and Program Support 

(Dollars in Thousands) 

Object Class - Direct Budget Authority1 

FY 2021 

Final 

FY 2022 

CR 

FY 2023 

President's 

Budget 

Personnel compensation: 

Full-time permanent (11.1)............................................... 

Other than full-time permanent (11.3).............................. 

Other personnel compensation (11.5)............................... 

Military personnel (11.7)................................................. 

Special personnel services payments (11.8) ................... 

Subtotal personnel compensation: 

Civilian benefits (12.1).................................................... 

Military benefits (12.2).................................................... 

Subtotal Pay Costs: 

Travel and transportation of persons (21.0)..................... 

Transportation of things (22.0)......................................... 

Rental payments to GSA (23.1)........................................ 

Rental payments to Others (23.2).....................................

Communication, utilities, and misc. charges (23.3).......... 

Printing and reproduction (24.0)...................................... 

Other Contractual Services: 

Advisory and assistance services (25.1).......................... 

Other services (25.2)....................................................... 

 Purchase of Goods & Svcs. from Govt. Accts (25.3)...... 

Operation and maintenance of facilities (25.4)................

Research and Development Contracts (25.5)...................

Operation and maintenance of equipment (25.7).............. 

Subtotal Other Contractual Services: 

Supplies and materials (26.0).......................................... 

$43,503 

1,949 

1,188 

3,401 

18 

$43,938 

1,969 

1,200 

3,503 

19 

$45,256 

2,028 

1,235 

3,598 

19 

50,060 50,628 52,137 

14,468 

1,792 

14,613 

1,846 

15,214 

1,896 

66,320 67,087 69,246 

59 

6,092 

 --- 

66 

241 

1,246 

46,094 

4,023 

 --- 

 --- 

274 

60 

6,189 

 --- 

67 

245 

1,266 

45,458 

4,088 

 --- 

 --- 

278 

61 

6,307 

 --- 

69 

249 

1,290 

51,885 

4,165 

 --- 

 --- 

283 

51,637 51,089 57,623 

43 43 44 

Equipment (31.0).............................................................. 53 54 55 

Grants, subsidies, and contributions (41.0)...................... 3,932 3,995 15,991 

Interest and dividends (43.0)............................................ --- --- --- 

Subtotal Non-Pay Costs 62,123 61,743 80,400 

Total Direct Obligations $128,443 $128,830 $149,645 1

 Does not include PHS Evaluation Funds. 

368 
SAMHSA-Supplementary Tables 

Budget Authority by Object Class 

Substance use And Mental Health Services Administration 

Summary PHS Evaluation Funds 

(Dollars in Thousands) 

Object Class - PHS Evaluation Funds 

FY 2021 

Final 

FY 2022 

CR 

FY 2023 

President's 

Budget 

Personnel Compensation:

 Full Time Permanent (11.1)............................................. 

 Other than Full-Time Permanent (11.3)........................... 

 Other Personnel Compensation (11.5)............................. 

 Military Personnel Compensation (11.7)......................... 

Special personnel services payments (11.8) ...................

Subtotal Personnel Compensation: 

 Civilian Personnel Benefits (12.1).................................. 

 Military Personnel Benefits (12.2) ................................ 

Subtotal Pay Costs: 

Travel (21.0)................................................................... 

Transportation of things (22.0)........................................

Rental payments to GSA (23.1).......................................

Communications, Utilities and Misc. Charges (23.3).......

Printing and Reproduction (24.0)..................................... 

Other Contractual Services:

Advisory and assistance services (25.1).........................

Other services (25.2)....................................................... 

 Purchase of Goods & Svcs. from Govt. Accts (25.3)..... 

Operation and maintenance of equipment (25.7).............. 

 Subtotal Other Contractual Services:............................ 

Supplies and Materials (26.0)......................................... 

Equipment (31.0)............................................................. 

Grants, Subsidies, and Contributions (41.0)..................... 

$7,960 

466 

185 

345 

 --- 

$8,040 

470 

186 

356 

 --- 

$8,214 

477 

190 

365 

 --- 

8,956 9,052 9,246 

2,610 

181 

1,571 

161 

2,731 

191 

11,747 10,785 12,169 

 --- 

 --- 

 --- 

614 

 --- 

 --- 

91,655 

2,438 

152 

 --- 

 --- 

 --- 

625 

 --- 

 --- 

89,387 

2,477 

155 

 --- 

 --- 

 --- 

625 

 --- 

 --- 

87,755 

1,790 

155 

94,246 92,019 89,699 

18 

40 

27,001 

18 

41 

25,813 

18 

41 

25,208 

Subtotal Non-Pay Costs 121,920 118,516 115,592 

Total PHS Evaluation Funds $133,667 $129,301 $127,760 

369 
 

SAMHSA-Supplementary Tables 

Budget Authority by Object Class 

Substance use And Mental Health Services Administration 

Mental Health 

(Dollars in Thousands) 

Object Class - PHS Evaluation 

FY 2021 

Final 

FY 2022 

CR 

FY 2023 

President's 

Budget 

Personnel compensation: 

Full-time permanent (11.1).............................................. 

Other than full-time permanent (11.3)..............................

Other personnel compensation (11.5).............................. 

Military personnel (11.7)................................................ 

Special personnel services payments (11.8) ...................

Subtotal personnel compensation: 

Civilian benefits (12.1)................................................... 

Military benefits (12.2)................................................... 

Subtotal Pay Costs: 

Travel and transportation of persons (21.0)....................

Transportation of things (22.0)........................................

Rental payments to GSA (23.1).......................................

Communication, utilities, and misc. charges (23.3).........

Printing and reproduction (24.0)......................................

Other Contractual Services:

Advisory and assistance services (25.1).........................

Other services (25.2)....................................................... 

 Purchase of Goods & Svcs. from Govt. Accts (25.3)..... 

Operation and maintenance of equipment (25.7)..............

Subtotal Other Contractual Services: 

Supplies and materials (26.0)..........................................

Equipment (31.0).............................................................

Grants, subsidies, and contributions (41.0)..................... 

$1,611 $1,627 $1,676 

 --- --- --- 

24 24 25 

107 110 113 

 --- --- --- 

1,742 1,762 1,814 

549 554 571 

62 63 65 

2,352 2,379 2,450 

 --- --- --- 

 --- --- --- 

 --- --- --- 

 --- --- --- 

 --- --- --- 

 --- --- --- 

 --- --- --- 

12,087 12,280 12,513 

53 54 55 

 --- --- --- 

12,140 12,334 12,569 

 - - - 

 --- --- --- 

6,547 6,325 6,021 

Subtotal Non-Pay Costs 18,687 18,660 18,589 

Total PHS Evaluation Funds $21,039 $21,039 $21,039 

370 
 

SAMHSA-Supplementary Tables 

Budget Authority by Object Class 

Substance use And Mental Health Services Administration 

Substance Use Services 

(Dollars in Thousands) 

Object Class - PHS Evaluation 

FY 2021 

Final 

FY 2022 

CR 

FY 2023 

President's 

Budget 

Personnel compensation: 

Full-time permanent (11.1)............................................ 

Other than full-time permanent (11.3)............................ 

Other personnel compensation (11.5)............................ 

Military personnel (11.7).............................................. 

Special personnel services payments (11.8) ................

Subtotal personnel compensation: 

Civilian benefits (12.1)................................................. 

Military benefits (12.2)................................................. 

Subtotal Pay Costs: 

Travel and transportation of persons (21.0)..................

Transportation of things (22.0)......................................

Rental payments to GSA (23.1).....................................

Communication, utilities, and misc. charges (23.3).......

Printing and reproduction (24.0)................................... 

Other Contractual Services:

Advisory and assistance services (25.1).......................

Other services (25.2)..................................................... 

 Purchase of Goods & Svcs. from Govt. Accts (25.3)... 

Operation and maintenance of equipment (25.7)........... 

Subtotal Other Contractual Services: 

Supplies and materials (26.0)........................................

Equipment (31.0)...........................................................

Grants, subsidies, and contributions (41.0)................... 

$3,029 $3,059 $3,151 

96 97 100 

62 63 64 

175 180 185 

 --- --- --- 

3,362 3,399 3,500 

967 992 1,022 

95 98 101 

4,424 4,489 4,623 

 --- --- --- 

 --- --- --- 

 --- --- --- 

 --- --- --- 

399 406 407 

 --- --- 

 --- --- --- 

61,439 62,422 62,606 

265 269 270 

5 5 5 

61,708 62,696 62,881 

 --- --- --- 

 --- --- --- 

14,668 13,609 13,289 

Subtotal Non-Pay Costs 76,776 76,710 76,577 

Total PHS Evaluation Funds $81,200 $81,200 $81,200 

371 
 

SAMHSA-Supplementary Tables 

Budget Authority by Object Class 

Substance use And Mental Health Services Administration 

Health Surveillance and Program Support 

(Dollars in Thousands) 

Object Class - PHS Evaluation 

FY 2021 

Final 

FY 2022 

CR 

FY 2023 

President's 

Budget 

Personnel compensation: 

Full-time permanent (11.1)................................................ 

Other than full-time permanent (11.3)................................ 

Other personnel compensation (11.5)................................ 

Military personnel (11.7)................................................... 

Special personnel services payments (11.8) .....................

Subtotal personnel compensation: 

Civilian benefits (12.1)...................................................... 

Military benefits (12.2)...................................................... 

Subtotal Pay Costs: 

Travel and transportation of persons (21.0)....................... 

Transportation of things (22.0)...........................................

Rental payments to GSA (23.1)..........................................

Communication, utilities, and misc. charges (23.3)............

Printing and reproduction (24.0)........................................ 

Other Contractual Services: 

Advisory and assistance services (25.1)............................

Other services (25.2)......................................................... 

 Purchase of Goods & Svcs. from Govt. Accts (25.3)........ 

Operation and maintenance of equipment (25.7)................ 

Subtotal Other Contractual Services: 

Supplies and materials (26.0)............................................ 

Equipment (31.0)............................................................... 

Grants, subsidies, and contributions (41.0)........................ 

$3,321 $3,354 $3,387 

370 374 377 

99 100 101 

63 65 67 

 --- --- --- 

3,852 3,892 3,932 

1,095 25 1,139 

24 --- 26 

4,971 3,917 5,096 

 --- --- --- 

 --- --- --- 

 --- --- --- 

215 218 219 

 --- --- --- 

18,130 14,685 12,636 

2,120 2,154 1,464 

147 150 150 

20,397 16,989 14,251 

18 18 18 

40 41 41 

5,786 5,879 5,896 

Subtotal Non-Pay Costs 26,457 23,145 20,426 

Total Reimbursable Obligations $31,428 $27,062 $25,522 

372 
 

 

SAMHSA-Supplementary Tables 

Salaries and Expenses 

(Dollars in Thousands) 

Object Class - Direct Budget Authority1,2 

FY 2021 

Final 

FY 2022 

CR 

FY 2023 

President's 

Budget 

Personnel compensation: 

Full-time permanent (11.1)................................................... 

Other than full-time permanent (11.3)................................... 

Other personnel compensation (11.5)................................... 

Military personnel (11.7)..................................................... 

Special personnel services payments (11.8) ........................ 

Subtotal personnel compensation 

Civilian benefits (12.1)........................................................ 

Military benefits (12.2)........................................................ 

Subtotal Pay Costs: 

Travel (21.0)........................................................................ 

Transportation of things (22.0)............................................. 

Rental payments to Others (23.2)..........................................

Communication, utilities, and misc. charges (23.3).............. 

Printing and reproduction (24.0)........................................... 

Other Contractual Services: 

Advisory and assistance services (25.1)........................... 

Other services (25.2)......................................................... 

Purchase of Goods & Svcs. from Govt. Accts (25.3)........ 

Operation and maintenance of facilities (25.4).................. 

Research and Development Contracts (25.5).....................

Operation and maintenance of equipment (25.7)................ 

Subtotal Other Contractual Services: 

Supplies and materials (26.0)............................................... 

Subtotal Non-Pay Costs 

Total Salary and Expenses 

Rental Payments to GSA (23.1)............................................ 

Grand Total, Salaries & Expenses and Rent 

Direct FTE....................................................... 

$48,082 

2,061 

1,260 

3,401 

18 

$48,563 

2,081 

1,273 

3,503 

19 

$50,019 

2,144 

1,311 

3,598 

19 

54,823 55,439 57,092 

15,961 

1,792 

16,137 

1,846 

16,791 

1,896 

72,575 73,422 75,778 

59 

2 

 --- 

463 

1,347 

36,407 

183,097 

31,583 

47 

 --- 

1,080 

60 

2 

 --- 

470 

1,369 

36,990 

184,653 

32,089 

48 

 --- 

1,098 

61 

2 

 --- 

479 

1,395 

37,692 

193,724 

32,698 

49 

 --- 

1,119 

252,215 254,877 265,282 

60 

254,146 

61 

256,839 

62 

267,282 

326,722 330,260 343,060 

6,766 6,875 7,005 

$333,488 $337,135 $350,065 

414 492 599 

1

 Does not include PHS Evaluation Funds. 

2

 Does not include Prevention and Public Health Funds. 

373 
 

 

 

 

SAMHSA-Supplementary Tables 

Salaries and Expenses 

(Dollars in Thousands) 

Object Class - PHS Evaluation 

FY 2021 

Final 

FY 2022 

CR 

FY 2023 

President's 

Budget 

Personnel compensation: 

Full-time permanent (11.1).......................................... 

Other than full-time permanent (11.3)......................... 

Other personnel compensation (11.5).......................... 

Military personnel (11.7)............................................ 

Special personnel services payments (11.8) ..............

Subtotal personnel compensation 

Civilian benefits (12.1)............................................... 

Military benefits (12.2)............................................... 

Subtotal Pay Costs: 

Travel (21.0)............................................................... 

Transportation of things (22.0)....................................

Rental payments to Others (23.2)................................

Communication, utilities, and misc. charges (23.3).....

Printing and reproduction (24.0)................................. 

Other Contractual Services: 

Advisory and assistance services (25.1).....................

Other services (25.2).................................................. 

Purch. Goods & Svcs. Govt. Accts (25.3)................... 

Operation and maintenance of facilities (25.4)........... 

Research and Development Contracts (25.5)..............

Operation and maintenance of equipment (25.7)......... 

Subtotal Other Contractual Services: 

Supplies and materials (26.0)..................................... 

Subtotal Non-Pay Costs 

Total Salary and Expenses 

Rental Payments to GSA (23.1)...................................

Grand Total, Salaries & Expenses and Rent 

Reimbursable FTE...................................... 

$7,960 

466 

185 

345 

 --- 

$8,040 

470 

186 

356 

 --- 

$8,214 

477 

190 

365 

 --- 

8,956 9,052 9,246 

2,610 

181 

1,571 

161 

2,731 

191 

11,747 10,785 12,169 

 --- 

 --- 

 --- 

614 

 --- 

91,655 

2,438 

152 

 --- 

18 

 --- 

 --- 

 --- 

625 

 --- 

89,387 

2,477 

155 

 --- 

18 

 --- 

 --- 

 --- 

625 

 --- 

87,755 

1,790 

155 

 --- 

18 

94,263 92,037 89,717 

18 

94,896 

18 

92,679 

18 

90,361 

106,643 103,465 102,530 

 --- --- --- 

$106,643 $103,465 $102,530 

58 158 126 

374 
 

 

 

 

 

 

 

SAMHSA-Supplementary Tables 

Details of Full-Time Equivalent Employment 

FY 2021 

Actual 

Civilian 

FY 2021 

Actual 

Military 

FY 2021 

Actual 

Total 

FY 2022 

Est. 

Civilian 

FY 2022 

Est. 

Military 

FY 2022 

Est. 

Total 

FY 2023 

Est. 

Civilian 

FY 2023 

Est. 

Military 

FY 2023 

Est. Total 

Health Surveillance and Program Support...........

 Direct:................................................................ 

 Reimbursable:.................................................... 

 Total:.............................................................. 

Mental Health Services........................................

 Direct:................................................................ 

 Reimbursable:.................................................... 

 Total:.............................................................. 

Substance Abuse Prevention................................

 Direct:................................................................ 

 Reimbursable:.................................................... 

 Total:.............................................................. 

Substance Abuse Treatment.................................

 Direct:................................................................ 

 Reimbursable:.................................................... 

 Total:.............................................................. 

360 

31 

391 

--

14 

14 

--

--

--

25 

10 

35 

28 

1 

29 

--

1 

1 

--

--

--

1 

1 

2 

388 

32 

420 

--

15 

15 

--

--

--

26 

11 

37 

357 

50 

407 

20 

57 

77 

--

--

--

85 

41 

126 

26 

5 

31 

--

4 

4 

--

--

--

4 

1 

5 

383 

55 

438 

20 

61 

81 

--

--

--

89 

42 

131 

468 

27 

495 

14 

59 

73 

--

--

--

86 

31 

117 

27 

4 

31 

--

4 

4 

--

--

--

4 

1 

5 

495

31

526 

14

63

77 

--

--

--

90

32

122 

SAMHSA FTE Total........................ 440 32 472 610 40 650 685 40 725 

375 
 

 

 

 

 

 

 

 

 

 

 

SAMHSA-Supplementary Tables 

Detail of Positions 

FY 2021

 Final 

FY 2022 

CR 

FY 2023

 President's Budget 

Executive Level IV 

Subtotal 

1 1 1 

1 1 1 

Total - Exec Level Salaries 

SES 

Subtotal 

$216,278 

6 

$176,300 

20 

$176,300 

20 

6 20 20 

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 

Average EX level 

Average EX salary 

Average SES level 

Average SES salary 

Average GS grade 

Average GS salary 

Average CC level 

Average CC salaries 

$1,625,311 

56 

100 

160 

42 

30 

--

10 

11 

19 

3 

2 

--

--

--

--

$5,417,705 

64 

134 

217 

65 

27 

1 

27 

18 

22 

11 

3 

--

--

--

--

$5,417,705 

70 

147 

260 

62 

37 

1 

33 

18 

22 

11 

3 

--

--

--

--

433 589 664 

$71,207,679 

--

--

15 

5 

9 

3 

--

--

$99,056,106 

1 

--

18 

9 

9 

3 

--

--

$114,198,673 

1 

--

18 

9 

9 

3 

--

--

32 40 40 

$4,956,142 $6,334,569 $6,477,097 

472 650 725 

ES 

$216,278 

SES 

$270,885 

13.7 

$164,452 

5 

$154,879 

ES 

$176,300 

SES 

$270,885 

13.7 

$168,177 

5 

$158,364 

ES 

$176,300 

SES 

$270,885 

13.7 

$171,986 

5 

$161,927 

376 
 

 

 

 

 

 

 

 

 

 

 

SAMHSA-Supplementary Tables 

Physicians’ Comparability Allowance Worksheet 

1) Department and component: 

HHS/Substance use And Mental Health Services Administration 

2) Explain the recruitment and retention problem(s) justifying the need for the PCA pay authority. 

(Please include any staffing data to support your explanation, such as number and duration of unfilled 

positions and number of accessions and separations per fiscal year.) 

We have to offer PCAs because our salaries are not competitive with the private sector. 

3-4) Please complete the table below with details of the PCA agreement for the following years: 

FY 2021 

(Final) 

FY 2022 

(Enacted) 

FY 2023 

(President’s Budget) 

3a) Number of Physicians Receiving PCAs 1 1 1 

3b) Number of Physicians with One-Year PCA Agreements - - -

3c) Number of Physicians with Multi-Year PCA Agreements 1 1 1 

4a) Average Annual PCA Physician Pay (without PCA payment) 157,709 157,709 180.102 

4b) Average Annual PCA Payment 16,000 16,000 16,000 

5) Explain the degree to which recruitment and retention problems were alleviated in your agency through the 

use of PCAs in the prior fiscal year. 

(Please include any staffing data to support your explanation, such as number and duration of unfilled 

positions and number of accessions and separations per 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 to make 

the offer acceptable. 

6) Provide any additional information that may be useful in planning PCA staffing levels and amounts in your 

agency. 

N/A 

377 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

SAMHSA – Significant Items 

Significant Items 

House Appropriations Committee, Labor/HHS/Education Subcommittee (H. Rept. 117-96) 

1. Behavioral Health Crisis Coordinating Office: The office will support technical assistance, data analysis 

and evaluation functions in order to develop a crisis care system encompassing nationwide standards with 

the objective of expanding the capacity of and access to local crisis call centers, mobile crisis care, crisis 

stabilization, psychiatric emergency services, and rapid post crisis follow up, provided by the National Suicide 

Prevention and Mental Health Crisis Response System, Community Mental Health Centers, Certified 

Community Behavioral Health Clinics and other community mental health and substance use disorder (SUD) 

providers. The Committee directs the Secretary to include a multi-year plan in the fiscal year 2023 

Congressional Budget Justification out lining a nationwide crisis care system plan of action. 

Actions Taken or to be taken 

Within the proposed FY 2023 CJ, SAMHSA has included a Behavioral Health Crisis Coordinating Office as part 

of the consolidated 988 and Behavioral Health Crisis Services program. The Office will support standards setting, 

technical assistance and ongoing performance evaluation. Given the significant challenges associated with the 

upcoming transition to 988 in July of 2022, the workplan is focused on needed activities across the coming year 

(high level view attached). SAMHSA is concurrently working on a longer-term national roadmap to drive Office 

activities. 

January 2022 February 2022 March 2022 

Key 

milestones 

 Jan 1: CMS Issues SHO for mobile crisis (released at 

end of last year) • Feb 4: RFP responses for new sub-contracted centers 

are due back to Vibrant [Crisis centers, Vibrant] 

• Mar 7: Finalize contracts for 47 centers (12 BUC, 30 

chat/text, 5 SL) [Vibrant] 

 Jan 4: Delivered Reports to Congress on Resources 

and Training and Access for High Risk Populations 

(training report delivered last year) 

 Jan 11-13: SAMHSA/CMS national convening for 

states on financing options across the crisis 

continuum [SAMHSA] 

 Jan 13: Release of Mobile Crisis Funding Guidance 

for States and Policy Recommendations for Federal 

Government (TAC) 

 Jan 21: Final 988 State Planning Grant Documents 

Completed [States, Vibrant] 

 Jan 25: Release of 2022 Mental Health Parity and 

Addiction Equity Act Report to Congress [DoL] 

 State/Territory NOFO Applications Due [States, 

SAMHSA] 

 Jan 31: Establishment of Lifeline KPIs and Hiring 

Milestones [SAMHSA] 

 Jan 31: Development of draft data and evaluation 

plan for 988 and crisis services [SAMHSA] 

 Jan 31: Updated Communications and Engagement 

• Feb 8: External convening 1 focused on 988 

readiness criteria [SAMHSA, NASMHPD] 

• Feb 28: Completion of HHS/ASPA rollout plan to 

announce 988 state awards [SAMHSA] 

• Feb 28: Finalize data and evaluation plan through 

BHCC subgroup [SAMHSA] 

• Feb 28: Draft data dashboard for 988 and crisis 

services [SAMHSA] 

• Feb 28: Completion of white paper on 988 and 

Substance Use Crisis Care Implementation 

Considerations [SAMHSA, NASADAD] 

• Feb 28: Completion of draft operational playbooks 

for states, territories, tribes on advancing readiness 

for crisis services [External convening] 

• Feb 28: Completion of high-level vision for crisis 

services [SAMHSA] 

• Feb 28: Launch of formative research on populations 

• Mar 7: Updated network agreements with existing 

Lifeline centers [Vibrant] 

• Mar 7: Recruitment and hiring begins of staff to 

support new infrastructure and subcontracted center 

investments [Vibrant] 

• Mar 15 (tentative): External convening 2 on federal 

crisis vision and operational playbooks 

• Mar 31: Revisions of quality measures for clinical 

quality assurance [Vibrant] 

• Mar 31: Holding Tribal listening sessions [SAMHSA] 

• Mar 31: Development of crisis services inventory / 

landscape mapping across federal agencies, as part 

of WH IPC on 988 and Crisis Care [SAMHSA, IPC] 

• Mar 31: Publication of youth crisis service 

companion document [SAMHSA] 

• Mar 31: Action Alliance to post online 988 Messaging 

Framework– a product of the national messaging 

task force that SAMHSA co-led with Vibrant 

Emotional Health [Action Alliance] 

Plan at high risk of suicide [SAMHSA, Vibrant] 

 Jan 31: Release of National Mobile Crisis Survey 

[Vibrant] 

 Jan 31: Launch of Unified Platform Technical 

Advisory Committee [Vibrant] 

 Jan 31: Launch of 988-911 Community of Practice 

[Vibrant] 

 Jan 31: Press release of Crisis Compendium paper 

series (NASMHPD) 

 Jan 31: Release of Toolkit for Community Responder 

Programs (Co-responder consortium) 

378 
 

 

 

 

 

 

 

SAMHSA – Significant Items 

2. Infant and Early Childhood Mental Health: The Committee urges SAMHSA to expand grants to entities 

such as State agencies, tribal communities, and university or medical centers that are in different stages of 

developing infant and early childhood mental health services. These entities should have the capacity to lead 

partners in systems-level change as well as building or enhancing the basic components of such early 

childhood services, including an appropriately trained workforce. The Committee is pleased with SAMHSA’s 

use of a portion of funding to provide technical assistance to existing grantees to better integrate infant and 

early childhood mental health into state systems and encourages that work to continue. 

Actions Taken or to be taken 

The Infant and Early Childhood Mental Health grants are statutorily limited to human services agencies or nonprofits organizations that (1) employ licensed mental health professionals who have specialized training and 

experience in infant and early childhood mental health assessment, diagnosis, and treatment OR is accredited or 

approved by the appropriate state agency to provide promotion, prevention, and/or treatment services; AND (2) 

provides infant and early childhood mental health services that are evidence-based or that have been scientifically 

demonstrated to show promise but would benefit from further applied development. States, tribal communities, 

and universities/medical centers can apply for funding if they can also meet the statutory eligibility requirements. 

3. Screening, Brief Intervention, and Referral to Treatment (SBIRT): The Committee urges SAMHSA to 

continue working to ensure SBIRT screening is more widely adopted by health providers, and directs this 

increase be used for implementing grants to pediatric health care providers in accordance with the 

specifications outlined in Section 9016 of P.L. 114–255, Sober Truth in Preventing Underage Drinking 

Reauthorization. Training grants should focus on screening for underage drinking, opioid use, and other 

drug use, and be managed by CSUS within the existing SBIRT program. 

Actions Taken or to be taken 

SAMHSA continues to support the SBIRT program. The purpose of this program is to implement screening, 

brief intervention, and referral to treatment services for children, adolescents, and/or adults in primary care and 

community health settings with a focus on screening for underage drinking, opioid use, and other substance use. 

In fact, in the FY 2021 SBIRT funding opportunity SAMHSA reserved at least $2 million of the funding for 

applicants providing services specifically in pediatric health care settings. We plan to apply this strategy in future 

funding opportunities. 

4. NSPL Text-Based Crisis Support Capabilities: Given the high number of individuals whose cell phone 

number does not match the cell phone area code in their area, the regional model that is in place for routing 

telephone calls to a local crisis center may not be necessary for texters in crisis. Furthermore, both the 

Veterans Crisis Line and the Disaster Distress Hotline have employed national backup centers to receive 

texts. As SAMHSA considers making text-based crisis support capabilities available to members of the public, 

the Committee directs SAMHSA to avoid duplicating existing capabilities to the extent possible. The 

Committee directs SAMHSA to coordinate and work with existing text and chat providers that have the 

technology to triage text conversations based upon severity of risk, to improve risk assessment and response 

capacity. 

Actions Taken or to be taken 

The 988 and Behavioral Health Crisis Services administrator is in the process of increasing its network to include 

providers with expertise in chat and text response and plans to leverage existing capabilities to the extent possible 

while assuring consistent quality and user experience. Additionally, with additional funding through SAMHSA, 

the administrator has issued a Request for Proposals from providers to expand chat and text response. 

379 
 

 

 

 

 

SAMHSA – Significant Items 

5. NSPL Partnerships: As SAMHSA considers partnerships to administer 988, the Committee encourages 

SAMHSA to consider partnering with non-profit or academic institutions with first-hand experience 

administering a national network of local behavioral health crisis call services to ensure the highest level of 

quality and efficiency. 

Actions Taken or to be taken 

SAMHSA has awarded a Cooperative Agreement in 2021 to Vibrant Emotional Health, which has over 15 years 

of experience administrating the national network of crisis centers. SAMHSA and Vibrant Emotional Health are 

both engaged with a number of additional organizations with national scope to continue to drive performance 

improvement, particularly for populations at high risk of suicide. 

6. Evidence-Based Programs for People Experiencing Homelessness: The Committee encourages SAMHSA 

to prioritize the development of evidence-based programs and treatments specifically tailored for those with 

alcohol and substance use disorder and who are at a high risk of becoming homeless, and to consider grant 

applications that include targeting resources to address SUD within the homeless population. 

Actions Taken or to be taken 

SAMHSA currently funds 68 Grants for the Benefit of Homeless Individuals projects. The purpose for this 

program is to support the development and/or expansion of local implementation of a community infrastructure 

that integrates substance use disorder treatment, housing services and other critical services for individuals 

(including youth) and families experiencing homelessness. SAMHSA continues to ensure all funding 

appropriated for this program is allocated to use evidence-based practices for delivering direct treatment to 

individuals with alcohol or other substance use disorders who are experiencing homelessness. 

7. National Recovery Month: The Committee recognizes SAMHSA as an important leader in National 

Recovery Month and encourages SAMHSA to maintain a leadership role in these efforts. 

Actions Taken or to be taken 

National Recovery Month is a national observance to promote and support new evidence-based treatment and 

recovery practices, the emergence of a strong and proud recovery community, and the dedication of service 

providers and community members across the nation who make recovery in all its forms possible. SAMHSA will 

continue to serve as a leader for this important observance. 

8. Recovery Housing: In order to increase the availability of high-quality recovery housing, the Committee 

encourages SAMHSA to collaborate with other Federal agencies, including HUD, the Department of Labor, 

the Department of Justice, and the Bureau of Indian Affairs, to coordinate activities across the Federal 

government and develop recommendations to improve policies on recovery housing. 

Actions Taken or to be taken 

SAMHSA strongly believes that recovery housing is an important component in the substance use disorder (SUD) 

treatment and recovery continuum of care and SAMHSA is currently prioritizing recovery housing as an 

allowable expenditure in many of its FY 2022 funding opportunities. 

Providing individuals with a safe and stable place to live can potentially be the foundation for a lifetime of 

recovery. While recovery residences vary widely in structure, all are centered on peer support and a connection 

to services that promote long-term recovery and are safe, healthy, family-like substance-free living environments 

that support individuals in recovery. It is important to note that substance-free does not prohibit prescribed 

medications taken as directed by a licensed practitioner, such as pharmacotherapies specifically approved by the 

380 
 

SAMHSA – Significant Items 

Food and Drug Administration (FDA) for treatment of opioid use disorder. SAMHSA continues to collaborate 

and coordinate with other Federal agencies to improve policies on recovery housing. For example, SAMHSA 

collaborated and provided recommendations to HUD on their recovery housing program required by Section 8071 

SUPPORT Act. SAMHSA also is exploring future strategies in FY 2023 to collaborate with other federal 

agencies to expand high-quality recovery housing and other recovery services. 

9. Data Collection for SUD Grants to States: A December 2020 GAO report examining SUD grants to States 

found that SAMHSA does not have consistent, relevant, and timely data on the number of individuals provided 

treatment and recovery support through the SABG, State Targeted Response to the Opioid Crisis Grant (STR), 

and SOR programs. The Committee recognizes the challenges the lack of data poses in evaluating the 

effectiveness of these grants and encourages SAMHSA to adopt GAO’s recommendation to identify and 

implement changes to their data collection efforts to improve the consistency, relevance, and timeliness of 

data collected on the number of individuals who receive substance use disorder treatment and recovery 

support services with funding from the SABG and SOR programs. 

Actions Taken or to be taken 

SAMHSA has begun its efforts to improve the consistency, relevance, and timeliness of the data it collects on 

individuals served by the SOR grant and SABG programs. Currently, SAMHSA is taking a multi-prong approach 

to evaluate the SABG program, guided by the December 2020 GAO report "Substance Use Disorder: Reliable 

Data Needed for Substance Abuse Prevention and Treatment Block Grant Program". Based on GAO's 

recommendations, SAMHSA has initiated an assessment of the quality of grantees’ self-reported data. This 

includes conducting quantitative and qualitative analysis to understand reliability issues associated with grantees’ 

self-reported data, barriers to data collection, and identify potential alternative data sources and methodological 

approaches to address data gaps. This effort is expected to result in a set of recommendations in August 2022 for 

implementing changes to the SABG program's data collection efforts to improve the consistency and relevance 

of the data collected. Improving the data quality for the SABG program is an important first step in a longer-term 

process of evaluating the impact of the overall program. 

Although the GAO recommendation to improve the data was focused on SABG, SAMHSA also revised in FY 

2022 its program performance tool improve the consistency of data for the SOR grant program. The revisions 

will improve the quality of the data collected as well as ensure more timely collection of the data. In addition to 

data on the purchase and distribution of Naloxone overdose kits, the revised tool will also collect consistent data 

on overdose reversals, fentanyl test strips purchase and distribution, education of school-aged children, first 

responders, and key community sectors on opioid and/or stimulant misuse, and outreach activities that target 

underserved and/or diverse populations. This data will be used to strengthen program monitoring rather than 

evaluation. SAMHSA is separately planning efforts to evaluate the SOR program. 

10. Substance Use Disorder Response in Rural America: The Committee encourages SAMHSA to support 

initiatives to advance SUD objectives in rural areas, specifically focusing on addressing the needs of 

individuals with SUD in rural and medically- underserved areas, and programs that stress a comprehensive 

community-based approach involving academic institutions, health care providers, and local criminal justice 

systems. 

Actions Taken or to be taken 

SAMHSA funded 59 grants for the Rural Emergency Medical Service (EMS) Training program in FY 2020 and 

FY 2021 and it plans to award a new cohort of 27 grants in FY 2022. The purpose of this program is to recruit 

381 
 

 

 

SAMHSA – Significant Items 

and train EMS personnel in rural areas with a focus on addressing both mental and substance use disorders. 

SAMHSA recognizes the great need for emergency services in rural areas and the critical role EMS personnel 

serve across the country. 

SAMHSA funded 29 grants in FY 2020 for the Rural Opioid Technical Assistance (ROTA) program, and it plans 

to fund 10 new grants in FY 2022. The purpose of this program is to develop and disseminate training and 

technical assistance on addressing opioid and other stimulant issues affecting rural communities. It is expected 

that recipients will facilitate the identification of model programs, develop and update materials related to the 

prevention, harm reduction, treatment, and recovery activities for opioid use disorder (OUD) and/or stimulant use 

disorder, and ensure that high-quality training is provided for communities and providers in rural areas. 

11. Opioid Use Disorder Relapse: The Committee recognizes that relapse might occur after opioid use disorder 

treatment. The Committee appreciates SAMHSA’s efforts to address this by emphasizing the importance of 

adherence to evidence-based practices that have been demonstrated to reduce the risk of relapse to opioid 

dependence and encourages SAMHSA to disseminate and emphasize implementation of these practices in all 

settings where treatment is offered, including rehabilitation and criminal justice settings. 

Actions Taken or to be taken 

SAMHSA approaches opioid use disorder (OUD) through a long-term, continuous care lens that is grounded in 

the science of substance use disorders as health conditions and similar, in many ways, to other chronic conditions 

such as diabetes. SAMHSA therefore recognizes that recurrence can and does happen along the trajectory of 

people’s lives as they live with OUD. However, SAMHSA does not view recurrence as a failure or loss of hope. 

Evidence-based practices supported by SAMHSA, such as naloxone and fentanyl test strip distribution, save lives 

when recurrence happens. The continuum of treatment that includes FDA-approved medications for opioid use 

disorder and recovery support services reduces recurrence risk – and is strongly supported and promoted by 

SAMHSA in all treatment settings, across grant programs, and through multiple publications. In FY2022, 

SAMHSA’s Center for Substance Use Services (CSUS) began including and emphasizing the continuum of harm 

reduction, evidence-based treatment, and recovery support services in most of its Notice of Funding Opportunities 

focused on OUD and will continue this approach in FY2023. 

12. Criminal Justice Activities: The Committee encourages SAMHSA to prioritize funding for centers that 

provide assistance to those with severe mental health needs who are at risk of recidivism. These mental health 

centers can provide, but are not limited to, the following services: crisis care, residential treatment, outpatient 

mental health and primary care services, and community re-entry supports. The Committee also encourages 

SAMHSA to prioritize applications from areas with high rates of uninsured individuals, poverty, and substance 

use disorders. 

Actions Taken or to be taken 

CSAT continues to fund its Drug Court grants and its Offender Reentry programs. These programs are designed 

to serve individuals with substance use disorders (SUDs) as their primary diagnosis. These grants may also serve 

individuals with co-occurring SUDs and mental disorders. However, CMHS’s criminal justice portfolio focuses 

on individuals with mental disorders and co-occurring SUDs as a primary population of focus. In FY 2018, 

CMHS awarded Law Enforcement Behavioral Health Partnerships for Early Diversion (Short Title: Early 

Diversion) grants. Early Diversion participants are individuals with Serious Mental Illness (SMI) or a Cooccurring Disorder (COD). The program is intended to divert participants from arrest and booking, thereby 

382 
 

 

SAMHSA – Significant Items 

keeping them out of the criminal justice system. Many participants are homeless and repeat offenders without 

insurance or a source of income. In FY 2022, SAMHSA proposed a new program within CMHS to focus on the 

needs of individuals returning to the community from jails and prisons. This continues to be a priority for FY 

2023 as SAMHSA seeks to develop community systems that reduce criminal justice system involvement for 

people with SMI and SUD and promote public safety, recovery, stability in the community, and address 

disparities. 

13. Project AWARE: The Committee encourages SAMHSA to sustain and strengthen its grant and other 

programs that support school-based and campus-based services aimed at preventing and treating mental health 

challenges experienced by younger Americans. 

Actions Taken or to be taken 

SAMHSA continues to support Project AWARE grantees during the pandemic’s virtual learning environment 

and, more recently, students’ subsequent return to the classroom. AWARE grantees e to provide robust mental 

health awareness, mental health services, and suicide prevention training programs to school personnel and 

community members that interact with school-aged youth. This allows for early identification, screening, and 

brief intervention services and supports to be provided to the young person and their family in the schools and 

needed referral for more in-depth clinical treatment before mental health concerns become more serious. 

SAMHSA believes that early identification is critical in preventing more serious behavioral health challenges. 

383 
SAMHSA – Proposed Law 

Proposed Law 

Renames Substance Abuse and Mental Health Services Administration, Center for Substance Abuse 

Treatment, and Center for Substance Abuse Prevention. 

SEC.__. (a) The Public Health Service Act (42 U.S.C. 201 et seq.) is amended— 

(1) by striking “Substance Abuse and Mental Health Services Administration” each place it 

appears and inserting “Substance use And Mental Health Services Administration”; 

(2) by striking “Center for Substance Abuse Treatment” each place it appears and inserting “Center 

for Substance Use Services”; and 

(3) by striking “Center for Substance Abuse Prevention” each place it appears and inserting 

“Center for Substance Use Prevention Services”. 

(b) Title V of the Public Health Service Act (42 U.S.C. 290aa et seq.) is amended— 

(1) in the title heading, by striking “SUBSTANCE ABUSE AND MENTAL HEALTH 

SERVICES ADMINISTRATION” and inserting “SUBSTANCE USE AND MENTAL HEALTH 

SERVICES ADMINISTRATION”; 

(2) in section 501— 

(A) in the section heading, by striking “SUBSTANCE ABUSE AND MENTAL HEALTH 

SERVICES ADMINISTRATION” and inserting “SUBSTANCE USE AND MENTAL HEALTH 

SERVICES ADMINISTRATION”; and 

(B) in subsection (a), by striking “(hereafter referred to in this title as the ‘Administration’)” 

and inserting “(hereafter referred to in this title as ‘SAMHSA’ or the ‘Administration’)”; 

(3) in section 507, in the section heading, by striking “CENTER FOR SUBSTANCE ABUSE 

TREATMENT” and inserting “CENTER FOR SUBSTANCE USE SERVICES”; 

(4) in section 513(a), in the subsection heading, by striking “CENTER FOR SUBSTANCE ABUSE 

TREATMENT” and inserting “CENTER FOR SUBSTANCE USE SERVICES”; and 

(5) in section 515, in the section heading, by striking “CENTER FOR SUBSTANCE ABUSE 

PREVENTION” and inserting “CENTER FOR SUBSTANCE USE PREVENTION SERVICES”. 

384 
SAMHSA – Proposed Law 

(c) Section 1932(b)(3) of the Public Health Service Act (42 U.S.C. 300x-32(b)(3)) is amended in the 

paragraph heading by striking “CENTER FOR SUBSTANCE ABUSE PREVENTION” and inserting “CENTER FOR 

SUBSTANCE USE PREVENTION SERVICES”. 

(d) Section 1935(b)(2) of the Public Health Service Act (42 U.S.C. 300x-35(b)(2)) is amended in the 

paragraph heading by striking “CENTER FOR SUBSTANCE ABUSE PREVENTION” and inserting “CENTER FOR 

SUBSTANCE USE PREVENTION SERVICES”. 

(e) The Indian Alcohol and Substance Abuse Prevention and Treatment Act of 1986 (25 U.S.C. 2401 et 

seq.) is amended by striking “Substance Abuse and Mental Health Services Administration” each place it appears 

and inserting “Substance use And Mental Health Services Administration”. 

(f) The Social Security Act is amended in sections 1861, 1866F, and 1945 (42 U.S.C. 1395x, 1395cc-6, 

1396w-4) by striking “Substance Abuse and Mental Health Services Administration” each place it appears and 

inserting “Substance use And Mental Health Services Administration”. 

(g) Section 105(a)(7)(C)(i)(III) of the Child Abuse Prevention and Treatment Act (42 U.S.C. 

5106(a)(7)(C)(i)(III)) is amended by striking “Substance Abuse and Mental Health Services Administration” and 

inserting “Substance use And Mental Health Services Administration”. 

(h)(1) Except as provided in paragraph (2), any reference in any law, regulation, map, document, paper, 

or other record of the United States— 

(A) to the Substance Abuse and Mental Health Services Administration shall be considered to be a 

reference to the Substance use And Mental Health Services Administration; 

(B) to the Center for Substance Abuse Treatment of such Administration shall be treated as a reference to 

the Center for Substance Use Services of such Administration; and 

(C) to the Center for Substance Abuse Prevention of such Administration shall be treated as a reference 

to the Center for Substance Use Prevention Services of such Administration. 

(2) Paragraph (1) shall not be construed to alter or affect section 6001(d) of the 21st Century Cures Act 

(42 U.S.C. 290aa note), providing that a reference to the Administrator of the Substance Abuse and Mental Health 

Services Administration shall be construed to be a reference to the Assistant Secretary for Mental Health and 

Substance Use. 

385