Ji<:AMH.SA


5600 Fishers Lane • Rockville, MO 20857 

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

SEP 1 6 2016 

TO: Executive branch department, division, office and bureau directors responsible 

for the administration of the Substance Abuse Prevention and Treatment Block 

Grant (SABG) 

FROM: Director, Center for Substance Abuse Treatment, Substance Abuse and Mental 

Health Services Administration 

SUBJECT: Amendment to FY 2016-2017 Uniform Application 

The Consolidated Appropriations Act of2016 (Pub.L.114-113), Division H. Section 520 

authorized the use of federal funds for activities and services related to the implementation of 

syringe services programs for persons who inject drugs. Section 520 reads as follows: 

Notwithstanding any other provisions ofthis Act, no funds appropriated in this Act 

shall be used to purchase sterile needles or syringes for the hypodermic injection ofany 

illegal drug: Provided, the limitation does no! apply to the use offundsfor elements of 

a program other than making such purchases ifthe relevant slate or local health 

department, in consultation with the Centers for Disease Control and Prevenlion, 

def ermines that the state or local jurisdiclion, as applicable, is experiencing or is al 

risk for a significant increase in hepatitis infections or an HIV owbreak due 10 injection 

drug use, and such program is operating in accordance with stale and local law. 

The Substance Abuse and Mental Health Services Administration (SAMHSA), Center for 

Substance Abuse Treatment (CSA T), in collaboration with SAMHSA 's Office of Policy, 

Planning and Innovation and the United States Department of Health and Human Services' 

(HHS) Office of HIV/AIDS and Infectious Disease Policy (OHIDP), recently released guidance 

to SAMHSA 's discretionary and formula grant recipients regarding the use of federal fiscal year 

(FY) 2016 funds for the purpose ofestablishing new syringe service programs (SSP) or 

expanding the capacity of existing SSPs. The guidance is consistent with the March 29 guidance 

released by HHS/OHIDP. 

The FY 2016-2017 Unifonn Application, Section III, Behavioral Health Assessment and Plan. 

Subsection C, Environmental Factors and Plan was submitted on or before October I, 2015 by 

all states and jurisdictions pursuant to section 1932(a) ofTitle XIX, Part B, Subpart II of the 

Public Health Service (PHS) Act (42 U.SC. § 300x-32(a)). Most, but not all, of the biennial 

behavioral health assessments and plans have been approved by SAMHSA. Therefore, 

SAMHSA cannot require a state or jurisdiction to modify approved biennial plans. 

•++aa-.--c:.:.....;-_ _ 

Behavioral Health is Essential To Health • Prevention Works • Treatment is Effective • People Recover 
Page 2 

Section III. Behavioral Health Assessment and Plan, Subsection C, Environmental Factors and 

Plan does not require states orjurisdictions to provide a detailed description in their respective 

biennial plans regarding how they will fulfill the assurances of compliance with the funding 

agreements pursuant to Sections l 923(a)(b), 1927 and 1928 ofTitle XIX, Part B, Subpart II of 

the PHS Act (42 U.S.C. § 300x-23(a)(b), 300x-27 and 300x-28) and 45 CFR 96.126(a)(e), 

45 CFR 96.131 (a) and 45 CFR 96.132( c), as such sections apply to persons who inject drugs. 

In order to provide states and jurisdictions with the opportunity to amend their respective 

biennial plans to incorporate SSPs, SAMHSA is proposing to amend Section III, Subpart C 

to include a new subsection (23. Syringe Services Programs), which will provide states and 

jurisdictions with a standard framework designed to collect information necessary to facilitate 

comment from any person pursuant to Section 1941 ofTitle XIX, Part 8, Subpart III ofthe 

PHS Act (42 U.S.C. § 300x-5 l) regarding states· and jurisdictions· plans to repurpose SABG 

funds for SSPs. The standard framework will also provide SAMHSA ·s CSAT with information 

necessary to make a determination that states· or jurisdictions· plans to repurpose SABG funds 

for SSPs are consistent with the guidance described above. 

The Web-based Block Grant Application System (BGAS) will be revised to include the proposed 

standard framework, including any additions/deletions based on comments received during the 

60-day comment period, to allow states and jurisdictions to prepare and submit an amendment 

electronically. The receipt date for states' and jurisdictions· amendment to their respective 

biennial plan, subject to approval by the Office of Management and Budget (0MB), Office of 

Information and Regulatory Affairs (OIRA), will be due no later than sixty (60) days after the 

receipt ofthe OMB/OIRA Notice of Action. 

Thank you for your efforts to provide pretreatment services to persons who inject drugs and to 

reduce the transmission ofcommunicable diseases su

2: ,., 

ch as hepatitis and HIV to such persons 

through linkages to primary care and access to substance use disorder treatment and recovery 

services. I encourage you to review the proposed amendment and provide comments, as 

appropriate, to SA BG-SSP(c, samhsa. hhs.go\ . 

/,i L

Kimberly liol Ph.D. 

Director 

Center for Substance Abuse Treatment 

Behavioral Health is Essential To Health • Prevention Works • Treatment is Effective • People Recover