DEPARTMENT 

of HEALTH

and HUMAN 

SERVICES

Fiscal Year

2014

Justification of 

Estimates for 

Appropriations Committees

Substance Abuse and Mental Health 

Services Administration
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DEPARTMENT OF HEALTH AND HUMAN SERVICES

SUBSTANCE ABUSE AND MENTAL HEALTH SERVICES ADMINISTRATION

Table of Contents

Fiscal Year 2014 Budget Page

Letter from Administrator

Table of Contents

Organization Chart

A. Executive Summary

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

2. Overview of Budget Request ......................................................................................... 5

3. Overview of Performance ..............................................................................................13

4. All Purpose Table ..........................................................................................................19

B. NOW IS THE TIME.........................................................................................................29

C. Budget Exhibits

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

2. Language Analysis ....................................................................................................... 37

3. Amounts Available for Obligation ................................................................................ 41

4. Summary of Changes.................................................................................................... 42

5. Budget Authority by Activity........................................................................................ 43

6. Authorizing Legislation ................................................................................................ 44

7. Appropriation History................................................................................................... 46

8. Appropriations Not Authorized by Law ........................................................................ 48

D. Mental Health Services 

1. Mental Health Programs of Regional and National Significance ................................... 51

2. Children’s Mental Health Services................................................................................ 87

3. PATH Homeless Grants................................................................................................ 93

4. PAIMI.......................................................................................................................... 99

5. Community Mental Health Services Block Grant.........................................................105

E. Substance Abuse Prevention

1. Substance Abuse Prevention Programs of Regional and National Significance ............119

F. Substance Abuse Treatment

1. Substance Abuse Treatment Programs of Regional and National Significance .............139

2. Substance Abuse Prevention and Treatment Block Grant.............................................175

G. Health Surveillance and Program Support 

1. Health Surveillance and Program Support....................................................................191

2. Public Awareness and Support.....................................................................................195

3. Performance and Quality Information Systems ............................................................201
4. Agency-Wide Initiatives............................................................................................. 205

H. Center for Behavioral Health Statistics and Quality .................................................... 209

I. Drug Control Budget...................................................................................................... 221

J. Prevention and Public Health Fund .............................................................................. 249

K. Supplementary Tables

1. Budget Authority by Object Class............................................................................... 263

2. Salaries and Expenses................................................................................................. 267

3. Detail of Full-Time Equivalent Employee (FTE) ........................................................ 268

4. Detail of Positions ...................................................................................................... 269

5. Programs Proposed for Elimination ............................................................................ 270 

6. Federal Employment Funded by the Patient Protection and Affordable Care Act ........ 271

7. FY 2014 Budget by Strategic Goal ............................................................................. 272

8. Physicians’ Comparability Allowance Worksheet....................................................... 273

9. Mechanism by Summary Level of Activity Tables...................................................... 274

L. Significant Items in Appropriations Committee Reports ............................................. 289

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1

SAMHSA Overview

Individuals and families cannot be healthy without positive mental health, freedom from 

addiction and the absence of abuse of substances. Prevention, treatment, and recovery support 

services for behavioral health are essential components of health service systems and 

community-wide strategies that work to improve health status and lower costs for individuals, 

families, businesses, and governments. Substance abuse, addiction, poor emotional health, and 

mental illnesses take a toll on individuals, families, and communities. They cost money, and 

they cost lives, as do physical illnesses, particularly when we do not prevent, or manage them 

effectively. The presence of substance abuse and mental illness exacerbates the cost of treating 

co-morbid physical diseases and results in some of the highest disability burdens in the world.

SAMHSA has a unique responsibility to focus the nation’s health and human services agendas 

on these preventable and treatable problems stemming from disease, trauma, inadequate access 

to appropriate care, and insufficient community and family supports.

Vision

SAMHSA provides leadership and devotes its resources – programs, policies, information and 

data, contracts and grants – toward helping the nation act on the knowledge that:

Behavioral Health is essential for health.

Prevention works.

Treatment is effective.

People recover from mental and substance use disorders.

Mission

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

communities. By providing leadership, voice, funding, and standards, SAMHSA has the 

expertise and facilitates the collaboration needed to achieve its vision. SAMHSA accomplishes 

this mission through partnerships, policies, and programs that build resilience and facilitate 

recovery for people with or at risk for mental and/or substance use disorders. SAMHSA-funded 

services help individuals pursue recovery, avoid the abuse of drugs or alcohol, and prevent or 

reduce the impact of mental illnesses.
2

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3

Eight Strategic Initiatives

Behavioral health is an essential part of health service systems and community-wide strategies 

that work to improve health status and lower costs for families, businesses, and governments. 

Through practice improvement in the delivery and financing of prevention, treatment, and 

recovery support services, SAMHSA with its partners can advance behavioral health and protect 

the nation’s health. In order to achieve this goal, SAMHSA has identified eight Strategic 

Initiatives to focus SAMHSA’s work on improving lives and capitalizing on emerging 

opportunities. The eight Strategic Initiatives are described below.

1 Prevention of Substance Abuse and Mental Illness 

Creating communities where individuals, families, schools, faith-based organizations, and 

workplaces take action to promote emotional health and reduce the likelihood of mental 

illness, substance abuse including tobacco, and suicide. This Initiative will include a 

focus on the nation’s high-risk youth, youth in tribal communities, and military families. 

2 Trauma and Justice

Reducing the pervasive, harmful, and costly health impact of violence and trauma by 

integrating trauma-informed approaches throughout health, behavioral health, and related 

systems and addressing the behavioral health needs of people involved in or at risk of 

involvement in the criminal and juvenile justice systems. 

3 Military Families 

Supporting America’s service men and women—active duty, National Guard, Reserve, 

and veteran—together with their families and communities by leading efforts to ensure 

that needed behavioral health services are accessible and that outcomes are positive. 

4 Recovery Support

Partnering with people in recovery from mental and substance use disorders and family 

members to guide the behavioral health system and promote individual-, program-, and 

system-level approaches that foster health and resilience; increase housing to support 

recovery, employment, education, and other necessary supports; and reduce 

discriminatory barriers. 

5 Health Reform 

Increasing access to appropriate high quality prevention, treatment, and recovery 

services; reducing disparities that currently exist between the availability of services for 

mental and substance use disorders compared with the availability of services for other 
4

medical conditions; and supporting integrated, coordinated care, especially for people 

with behavioral health and other co-occurring health conditions such as HIV/AIDS. 

6 Health Information Technology

Ensuring that the behavioral health system, including states, community providers, and 

peer and prevention specialists, fully participates with the general health care delivery 

system in the adoption of health information technology (Health IT) and interoperable 

electronic health records (EHRs). 

7 Data, Outcomes, and Quality

Realizing an integrated data strategy and a national framework for quality improvement 

in behavioral health care that will inform policy, measure program impact, and lead to 

improved quality of services and outcomes for individuals, families, and communities. 

8 Public Awareness and Support 

Increasing the understanding of mental and substance use disorders and the many 

pathways to recovery to achieve the full potential of prevention, help people recognize 

mental and substance use disorders and seek assistance with the same urgency as any 

other health condition, and make recovery the expectation.
5

Overview of the Budget Request

The SAMHSA FY 2014 President’s Budget Request for its Total Program Level is $3.572 

billion, an increase of $3.5 million from the FY 2012 funding level. This FY 2014 Total 

Program Level of $3.572 billion includes $3.348 billion in Budget Authority (an increase of $0.9

million from the FY 2012 funding level), $164.8 million in PHS Evaluation funds (an increase of 

$35.1 million from the FY 2012 funding level), and $58 million in Prevention Fund resources (a 

decrease of $34.0 million from the FY 2012 funding level). The budget continues to reflect $1.5 

million for user fees for extraordinary data and publication requests not currently able to be 

fulfilled. The FY 2014 Budget Request presents four appropriations consistent with the 

Consolidated Appropriations Act, 2012, and the FY 2013 President’s Budget: Mental Health, 

Substance Abuse Prevention, Substance Abuse Treatment, and Health Surveillance and Program 

Support. 

The SAMHSA FY 2014 Budget Request operates in an efficient manner with demonstrated 

accountability, as directed by leadership in SAMHSA, HHS, and the Administration. At the 

same time, SAMHSA’s Budget Request reflects an emerging and dynamic healthcare 

environment marked by the implementation of significant aspects of the Affordable Care Act. 

The FY 2014 budget request also reflects the Administration’s commitment to address the 

behavioral health needs of youths and their families in the wake of the Newtown, Connecticut 

tragedy at Sandy Hook Elementary School. The SAMHSA FY 2014 Budget Request mirrors 

ongoing internal and external changes which have resulted in integrated data and operating 

structures, uniform guidance, and braided funding strategies. SAMHSA has increased both 

programmatic and fiscal efficiencies through assessing its internal workforce and through the 

coordination of funding streams to deliver improved program outcomes. 

Programmatic Priorities

SAMHSA’s Strategic Initiatives continue to guide its work and Budget Requests. A focused 

approach to increasing evidence-based substance abuse prevention and mental health promotion 

practices on a national scale is a paramount goal. In addition, this request includes $45.3 million

for initiatives that recognize the complex needs of the people and communities we serve, as well 

as in the interest of effectiveness and efficiency, by braiding funding from multiple sources into 

one grant announcement. In order to help the field better accommodate this complexity, several 

of these activities will be jointly funded across two or more appropriations. In these cases, a 

single grantee may receive dollars from multiple funding streams, but these distinct funding 

streams are ―braided‖ rather than ―blended‖; that is, funds are tracked separately and used for 

purposes and objectives consistent with legislative direction and intent. In the case of jointly 

funded grants, programs also will be jointly administered and the grants themselves will reflect a 

ratio of activity (e.g., percent of clients served, number of people trained, etc.) proportional to 

and consistent with those funding lines.

For example, the Mental Health and Substance Abuse Treatment appropriations will jointly fund 

the Statewide Network Development for Recovery and Resiliency program. Drawing funds 

from Consumer and Family Network Grants in the Center for Mental Health Services (CMHS) 
6

and Recovery Community Services Program in the Center for Substance Abuse Treatment 

(CSAT), funds will be available for Statewide Consumer Networks, Family Networks, and 

Addiction Recovery Networks along with a supplement for those grantees who wish to create a 

broader network that partners between mental health and substance use; as well as links with 

other health care related groups.

 

Prevention of Substance Abuse and Mental Illness

SAMHSA is proposing, in FY 2014, a new effort, Project AWARE (Advancing Wellness and 

Resilience in Education) to improve mental health awareness, increase referrals to services and

for those who need help, improve school safety, reduce substance abuse, and improve mental 

health outcomes for approximately 750,000 students every year. SAMHSA also proposes to 

support implementation of the newly updated National Strategy for Suicide Prevention for a 

nationally coordinated, locally driven effort to bring down the tenth leading cause of death in the 

U.S.

In the FY 2014 Budget Request, the 20 percent Substance Abuse Prevention set aside funds are 

retained in the Substance Abuse Prevention and Treatment Block Grant (SABG). Funding for 

the Strategic Prevention Framework (SPF) is continued for additional Partnership for Success 

(PFS) grants to promote state-wide implementation of the SPF--an evidence-based, data-driven 

approach to substance abuse prevention--with a focus on underage drinking and prescription 

drug abuse. In the FY 2014 PFS programs, SAMHSA will encourage grantees to take exposure 

to trauma into consideration as one of the leading risk factors for substance abuse and will 

expand eligibility to include federally-recognized tribes that have completed a SPF-State 

Incentive Grant. 

Trauma and Justice

Grants for Adult Trauma Screening and Brief Intervention remain a high priority in FY 2014. 

SAMHSA will award grants to develop or identify safe and effective tools for healthcare 

providers to meet the recommendation in the 2011 Institute of Medicine report Clinical 

Preventive Services for Women, recommendation for universal screening of women and 

adolescent girls for intimate partner violence, which includes screening for past experiences of 

violence and abuse. The Mental Health and Substance Abuse Treatment Appropriations will 

jointly fund new Behavioral Health Treatment Court Collaboratives (BHTCC) grants. The 

National Child Traumatic Stress Initiative and Drug Court grant programs are close to levelfunded with the FY 2012 funding level and SAMHSA maintains its strong partnership with the 

Administration for Children and Families and CMS to address HHS’s High-Priority Goal on 

improving trauma services for children and youth in child welfare.

Recovery Support

In FY 2014, SAMHSA is proposing a new competitive grant program, Healthy Transitions, for 

states to support youth with mental health and substance abuse problems and their families as 

they move from programs and systems that serve the under 18 population (e.g., education, CHIP, 
7

juvenile justice, child welfare, children’s mental health) into service systems and/or benefit 

programs geared toward adults. 

Access to Recovery (ATR) grants will continue to offer vouchers to extend meaningful choice 

for services and supports by individuals in need of addictions treatment or recovery supports. In 

FY 2014, ATR funds are reduced and will place greater emphasis on recovery supports and 

clinical services not covered by other payers, or expected to be supported through the expansion 

of public and private insurance coverage. Focus areas will include recovery coaching, job 

training, and employment coaching specifically for individuals on the path to recovery from 

addiction. ATR will assist providers and clients to participate in the Medicaid insurance 

marketplace and to bill for services eligible for reimbursement. ATR will continue to foster the 

collaboration between faith-based providers and other community providers to enhance recovery.

Health Reform

In anticipation of the continuing changes and improvements brought about by the Affordable 

Care Act, SAMHSA has been, and will continue preparing, and guiding the behavioral health 

community through health reform implementation. Vulnerable populations, such as individuals

who are homeless and those with co-occurring mental and substance use disorders, continue to 

shape SAMHSA’s educational and outreach, eligibility and enrollment efforts. Simultaneously, 

efforts to increase primary and behavioral health care integration are ongoing, including 

technical assistance for tribes on integration. 

SAMHSA has invested significant time and resources in the review and updating of business 

practices and processes while leveraging resources to provide technical assistance and innovative 

collaborations. SAMHSA has also embedded health reform readiness activities regarding 

enrollment and billing into existing grants and initiatives. The FY 2014/2015 Block Grant 

Applications have been revised, a new grants management tool has been launched, and 

SAMHSA project officer training continues.

The Block Grant programs remain key programs in the SAMHSA portfolio for implementation 

of health reform in FY 2014. The Budget maintains the Community Mental Health Services 

Block Grant (MHBG) and increases the Substance Abuse Prevention and Treatment Block Grant 

(SABG) to support states in an effective transition in the first year of the Affordable Care Act, 

which will include expanded coverage for mental health and substance abuse treatment services. 

The Budget also proposes funding within the Block Grants to encourage States to build provider 

capacity to bill public and private insurance and to promote the adoption of evidence-based 

programs.

Beginning in 2010, SAMHSA undertook a major redesign of the planning section of the 

application process for the block grants. SAMHSA provided states with guidance on the 

direction of block grant funds during health reform implementation. Specific priority areas 

included treatment and support services for individuals not currently covered by other insurers, 

essential services not covered by other insurers, and primary prevention efforts along with a 

mandate to collect performance and outcome data to increase accuracy and accountability. 
8

As highlighted by Congress in FY 2012, there is a critical need to expand and strengthen the 

behavioral health workforce. In an initial attempt to meet the demands of the Medicaid and 

insurance Marketplace expansion populations, SAMHSA has consulted with the Health 

Resources and Services Administration (HRSA) to develop this FY 2014 Budget Request in a 

manner that complements HRSA’s ongoing professional workforce programs. SAMHSA 

proposes to bolster the behavioral health system’s prevention, treatment, and recovery support 

capacity by developing career ladder educational opportunities through community colleges and 

states who will train, certify, and reimburse for the services of an expanded prevention, peer, and 

paraprofessional workforce. Training will include key issues relevant to youth 16 to 25 years of 

age. In addition, new funds support an expansion of the Minority Fellowship Program as part of 

the support for the President’s plan to respond to the Sandy Hook Elementary School tragedy. 

This new program will strengthen the behavioral health workforce by increasing the number of 

trained peers, recovery coaches, mental health/addiction specialists, prevention specialists, and 

pre-Master’s level addiction counselors working with an emphasis on transition age youth. 

These entry-level providers play a significant role in the delivery of prevention and recovery 

support services. 

The SAMHSA FY 2014 Budget Request prioritizes essential health reform activities to assure 

individuals with behavioral health needs have full access to the benefits afforded through 

expanded coverage. Additionally, SAMHSA stands ready to participate fully in and assist the 

Administration, our federal partners, and state partners with critical undertakings related to the 

implementation of parity, the expansion of Medicaid, benchmark plans, and essential health 

benefits within state health insurance marketplaces.

Health Information Technology

Working closely with the Office of the National Coordinator, the Centers for Medicare and 

Medicaid Services, the National Institutes of Health, and other public and private sector partners, 

SAMHSA will continue to advance standards around privacy, consent, and interoperability for 

behavioral health records, as well as advance comprehensive approaches to Continuity of Care 

Documents that fully and appropriately integrate behavioral health data. The FY 2014 Budget 

Request outlines a jointly funded effort for standards development and technical assistance using 

set aside funds from both the SABG and MHBG. 

Data, Outcomes, and Quality

In FY 2014, the Health Surveillance and Program Support appropriation will fully phase in both 

the Common Data Platform, SAMHSA’s integrated grant performance management system, as 

well as an interagency agreement with the Centers for Disease Control and Prevention (CDC) for 

the Drug Abuse Warning Network (DAWN). The new National Survey on Drug Use and Health 

(NSDUH) contract will be awarded in FY 2013 and data collection will begin in CY 2014 for the 

new survey. SAMHSA will continue to advance quality improvement and emphasize improving 

meaningful outcomes for people, families, and communities by promoting the National 

Behavioral Health Quality Framework and National Behavioral Health Barometer with its 

federal partners, states, and other stakeholders.
9

Public Awareness and Support

The sense of shame and secrecy associated with mental illness and addiction prevents too many 

people from seeking help. In January 2013, the President directed Secretaries Sebelius and 

Duncan to launch a national dialogue about mental illness with young people who have 

experienced mental illness, members of the faith community, foundations, and school and 

business leaders. SAMHSA will be collaborating with public and private partners to facilitate a 

National Dialogue on Mental Health in the spring of 2013 to raise awareness and reduce negative 

attitudes. 

Consistent with the President’s directive for streamlining federal websites and SAMHSA’s 

critical role in providing high quality, up-to-date information and materials for the public and the 

behavioral health field, the Public Awareness and Support Initiative will focus on the continued 

consolidation and modernization of SAMHSA’s web presence. Public Awareness and Support 

funds will be used to support the development of quality content and the use of modern 

communications platforms to increase efficiencies in SAMHSA’s web-based communication 

with the long-term goals of improving customer satisfaction and achieving cost savings. 

The FY 2014 Budget Request prioritizes essential investments which require the programmatic 

expertise and leadership of SAMHSA’s highly trained staff, who are dedicated to improving 

behavioral health in the nation. As SAMHSA continues its commitment to be an efficient, 

effective steward of the American people’s resources, it will manage resources from the 

Prevention Fund, the PHS Evaluation Fund, as well as appropriated Budget Authority with 

utmost care and integrity. Maintaining critical agency investments in FY 2014 will allow 

SAMHSA to build capacity in states, territories, tribes and communities to protect and promote 

behavioral health in America. This request reflects the Administration’s priorities and the 

Department of Health and Human Services’ key goals that prepare the nation for a new era in 

health care and reduce the burden of substance abuse and mental illnesses on America’s 

communities.

Program Increases:

Project AWARE (+55 million)

In an effort to support the Administration’s response to the tragedy at Sandy Hook Elementary 

School, $55 million is requested to support Project AWARE, (Advancing Wellness and 

Resilience in Education) to increase awareness of mental health issues and connect young people 

with behavioral health issues and their families with needed services. SAMHSA will partner 

with the Departments of Education and Justice in the development, implementation and 

management of this initiative to maximize coordination and avoid duplication of efforts. 

Project AWARE proposes two components: Project AWARE State Grants ($40.0 million) build

on the Safe Schools/Healthy Students State Planning and Community Pilot Program which is 

intended to create safe and supportive schools and communities. For more than a decade, the 

Safe Schools/Healthy Students Initiative has successfully decreased violence and increased the 

number of students receiving mental health services. Project AWARE grants will be braided 
10

with funds from Education and Justice to support 20 grants to State Education Authorities 

(SEAs) that will promote a comprehensive, coordinated and integrated program with the goal of 

making schools safer and increasing access to mental health services. The SEAs will be required 

to partner with the State Mental Health and Law Enforcement agencies to establish Interagency 

State Management Teams, conduct environmental needs assessments, develop a state plan with 

an evaluation mechanism, and develop the mechanisms to coordinate funding, service delivery, 

systems improvement, and data collection. In addition, each SEA will be required to identify 

three high-need Local Education Authorities (LEAs) as pilot communities that will receive subawards to implement comprehensive and coordinated school safety and mental health programs. 

SAMHSA expects that these 20 State grants will promote data driven models in 60 LEAs 

(reaching 1000-1500 schools).

The second component, Mental Health First Aid (MHFA) ($15.0 million) proposes widespread 

dissemination of the Mental Health First Aid curriculum and supports training to reach 750,000 

students to identify mental illness early and refer them to treatment. MHFA prepares teachers 

and other individuals who work with youth to help schools and communities to understand, 

recognize, and respond to signs of mental illness or substance abuse in children and youth, 

including how to talk to adolescents and families experiencing these problems so they are more 

willing to seek treatment. The Budget proposes that $10.0 million of the Project AWARE –

MHFA funds will be braided with Education and Justice funds to support competitive grants to 

LEAs with the goal of making schools safer and providing mental health literacy training. An 

Interagency Supervisory Team (IST) will work together to provide oversight and guidance to 

both the state and local initiatives. The additional $5.0 million proposed for MHFA will be 

braided with the 20 SEA grants to support MHFA training in the 20 SEAs and 60 LEAs subgrantees implementing Project AWARE. 

Healthy Transition (+$25 million)

The FY 2014 Budget includes $25.0 million for a new Healthy Transitions Program, to assist 16 

to 25 year-olds with mental illnesses and their families to access and navigate behavioral health 

treatment systems. Compared with their peers, young adults, aged 18-25 with mental health 

conditions are more likely to experience homelessness, be arrested, drop out of school and be 

underemployed. Compared to all other chronic health conditions, mental disorders produce the 

greatest disability burden within this age group. Furthermore, 18-25 year-olds with mental 

health conditions are significantly less likely to receive mental health services than other adults. 

This new demonstration grant program for states proposes innovative approaches to provide

support for transition-age youth with mental health and/or co-occurring substance abuse 

disorders and their families. States will take steps to expand services for these young 

individuals, develop family and youth networks for information sharing and peer support, and

disseminate best practices for services to youth ages 16-25. The $25.0 million would support 5-

year grants to 19 states.

Behavioral Health Workforce (+$50 million)

The FY 2014 Budget includes $50.0 million for workforce activities to help train more than 

5,000 additional professionals to work with students and young adults with mental illnesses and 

other behavioral health problems. The proposal includes $35.0 million for a jointly administered 

activity with HRSA to expand the Mental and Behavioral Health Education and Training 
11

(MBHET) Grant Program, $10.0 million for SAMHSA’s Peer Professionals training program; 

and $5.0 million for the expansion of SAMHSA’s Minority Fellowship Program as described 

below.

Suicide Prevention - National Strategy for Suicide Prevention (NSSP) (+$2 million)

The FY 2014 request for Suicide Prevention includes $2.0 million to assist states in further 

establishing evidence-based suicide prevention efforts that support the goals and objectives of 

the NSSP. The requested $2.0 million will support directly the recommendations of the NSSP 

and allow for the implementation of elements of the Plan that are not currently being addressed

in any other national initiative. The funding will be utilized to develop and test nationwide 

efforts such as suicide awareness, provider credentialing changes, emergency room referral 

processes, clinical care practice standards, practitioner training regarding depression and suicide 

screening techniques, and technical assistance for those community human services and health 

workers most likely to encounter those who may be thinking about suicide.

Disaster Response (+$1.9 million) 

The FY 2014 request includes support for a nationally available disaster distress crisis 

counseling telephone line through a connection to local crisis lines throughout the country. The 

need for this initiative has been documented through the Assistant Secretary for Preparedness 

and Response after various emergency conditions throughout the world and also in use after U.S. 

disasters that did not rise to the level of presidentially declared emergencies (therefore not 

qualifying for FEMA-coordinated Stafford Act Funding). 

Substance Abuse Block Grant (+$19.5 million)

The FY 2014 request for the Substance Abuse Block Grant is $1.820 billion. This includes 

$1.748 billion in Budget Authority and $71.7 million in PHS Evaluation funds. This represents 

an increase of $27 million in Budget Authority and a decrease of $7.5 million in PHS Evaluation 

funds resulting in an overall net increase of $19.5 million for the SABG from the FY 2012 

funding level. 

Program Decreases:

Consumer and Family Network Grants: (-$1.3 million)

The FY 2014 request for Consumer and Family Network Grants is $5 million. This is a decrease 

of $1.3 million for the FY 2012 funding level and will support the Consumer and Family 

Network Grants for the Statewide Network Development for Recovery and Resiliency, including 

support for braided partnership supplements with funding in the Substance Abuse Treatment 

appropriation.

Primary and Behavioral Health Care Integration (-$39.7 million)

The FY 2014 request for Primary and Behavioral Health Care Integration (PBHCI) is $28.0 

million. This is a decrease of $39.7 million from the FY 2012 funding level that included funding 

from the Prevention Fund and Affordable Care Act. The FY 2012 funding from the Prevention 

Fund resources allowed SAMHSA to strategically fully fund multi-year grants in 2012 and they 

will continue to be monitored in FY 2013.
12

Suicide Prevention Programs: (-$8.0 million)

The FY 2014 request for Suicide Programs is $50.0 million. This is a decrease of $8.0 million 

and is attributed primarily to the reduction of funding from the Prevention Fund, which allowed 

SAMHSA to strategically fully fund multi-year grants in FY 2012. These reductions include -

$4.3 million for GLS State/Tribal, -$4.2 million in GLS Campus, -$0.7 million in Suicide 

Prevention Resource Center and -$0.9 million in Suicide Lifeline. Combined with an increase in 

the National Strategy for Suicide Prevention (+$2.0 million) and level funding for AI/AN 

Suicide Prevention Initiative, this results in a net reduction of -$8.0 million in Suicide Programs.

Seclusion and Restraint: (-$1.3 million)

The FY 2014 request for Seclusion and Restraint is $1.2 million. This is a decrease of $1.3

million from the FY 2012 funding level. A new contract in this program area is expected to 

focus on the reduction of seclusion and restraint through the implementation of core strategies in 

a trauma-informed context.

Fetal Alcohol Spectrum Disorder (-$8.8 million)

The FY 2014 request for Fetal Alcohol Spectrum Disorder is $1 million. This is a decrease of 

$8.8 million from the FY 2012 funding level. In 2012, SAMHSA awarded a new FASD Center 

for Excellence contract to work toward the prevention of FASD in communities throughout the 

nation. The request will continue to support technical assistance efforts to support new methods 

for screening and providing preventative services to women of child bearing age. 

Screening, Brief Intervention and Referral to Treatment (-$23.2 million)

The FY 2014 request for Screening, Brief Intervention and Referral to Treatment is $30 million, 

all funded from the Prevention Fund. This reflects a decrease of $23.2 million from the FY 2012 

funding level. While overall funding for this program is reduced in FY 2014, it will allow for the 

continuation of all grant programs and the funding of 16 new grants and support of one contract. 

This funding level will further support the integration and use of the SBIRT model with state and 

tribal primary and other health care related settings.

Targeted Capacity Expansion – General: (-$14.7 million)

The FY 2014 request for Targeted Capacity Expansion – General is $13.3 million. This is a 

decrease of $14.7 million from the FY 2012 funding level. While overall funding for this 

program is reduced in FY 2014, this funding level will allow the continuations for all grant 

programs and related support contracts.

Access to Recovery: (-$33.3 million)

The FY 2014 request for Access to Recovery is $65.0 million. This is a decrease of $33.3

million from the FY 2012 funding level. While the overall funding is reduced in FY 2014 the 

program will continue to build on the expansion and adoption of voucher based payment 

mechanisms. SAMHSA plans to award 19 three-year grants of $3.2 million annually.

Program Support: (-4.2 million)

A total of $72.7 million is requested for Program Support, reflecting a decrease of $4.2 million. 

Savings will be generated through administrative efficiencies. 
13

Overview of Performance Section

SAMHSA reduces the impact of substance abuse and mental illness in America’s communities 

by demonstrating that prevention works, treatment is effective, and people recover. SAMHSA

uses performance management as an operational tool, consistent with the Government 

Performance and Results Act of 1993 (GPRA), to advance productivity, efficiency, and 

effectiveness, including rapid response in times of national emergency. Consistent with the 

GPRA Modernization Act of 2010 and related regulations, SAMHSA is expanding the 

integration of performance results with evaluation data, and other sources of evidence. 

Performance goals and measurement are powerful tools that advance effective, efficient and 

productive government.

In a time of limited resources and fiscal restraint, SAMHSA continues to meet the challenges of 

a changing health care environment, offering leadership to states and other community 

stakeholders as they embark on health reform. During FY 2012, SAMHSA demonstrated 

progress in each of its eight Strategic Initiatives (SIs), which guide the Agency’s vision 

(http://www.samhsa.gov/About/strategy.aspx). Each SI has action steps that link SAMHSA’s 

programs to the FY 2010 – FY 2015 HHS Strategic Plan, the inaugural FY 2013 HHS 

Performance Plan, the HHS High Priority Performance Goal (HPG) to reduce cigarette smoking, 

an HHS effort to increase the percentage of children receiving trauma informed services, and 

response to emergency situations, such as hurricane relief. Within the initial FY 2013 HHS 

Performance Report, SAMHSA is responsible for eleven measures related to the services 

provided to diverse populations and groups, including children receiving mental health services 

and those who access a suicide hotline. 

Performance Management

SAMHSA uses a data-driven performance management approach to achieve measurable impact. 

SAMHSA emphasizes action to assist low performing programs through Center performance 

review boards and similar initiatives based on the grantee continuation process. Performance 

management activities are aided by implementation of tools, such as the National Behavioral 

Health Quality Framework (NBHQF), designed to integrate performance, evaluation, and other 

sources of evidence. The NBHQF facilitates communication within SAMHSA and with federal 

partners, states, networks, and non-governmental groups. As implementation continues, 

SAMHSA’s NBHQF will track the population-based indicators needed to monitor trends and 

promote use of the latest available evidence. 

In addition to centralized GPRA reporting at the Agency level, each of SAMHSA’s program 

Centers currently operates their own performance management system. SAMHSA’s Center for 

Behavioral Health Statistics and Quality (CBHSQ) is leading the development of a common data 

platform designed to streamline performance reporting and management, validate data quality, 

and assure evidence-based decision-making. 

SAMHSA plays a key role in federal drug control efforts and contributes to the National Drug 

Control Budget. This budget provides a reliable, accurate, and transparent accounting of federal 

funding directed to the President’s drug control efforts. This is reflected in the National Drug 
14

Control Strategy: FY 2013 Budget and Performance Summary 

(http://www.whitehouse.gov/sites/default/files/ondcp/fy2013_drug_control_budget_and_perform

ance_summary.pdf). A wide array of SAMHSA’s funding supports drug control efforts, 

including programs awarded directly to providers. These programs collectively advance specific 

treatment methods, modalities, and services to targeted groups and include SAMHSA’s 

Substance Abuse Treatment Block Grant (SABG). This formula‐based funding to states expands 

substance abuse treatment services, while providing maximum flexibility. For example, grants 

support the delivery of treatment while also allowing states to access funding for prevention 

services. 

Highlights of SAMHSA Accomplishments:

SAMHSA quickly responds when disasters strike and communities are in need and serves as the 

voice of behavioral health when federal response efforts engage, such as hurricane relief.

SAMHSA provides resources that quickly aid states and communities in providing and 

coordinating behavioral health treatment, crisis counseling, disaster distress help-lines, resiliency 

training for educators and many other services. For example, soon after Hurricane Sandy, 

SAMHSA responded with additional support to the Disaster Distress Helpline, as well as other 

response teams from other agencies. A list can be found here: (http://www.samhsa.gov/dtac/ 

dbhis/dbhis_hurricane_links.asp#specific). The impact of these resources is measured and 

evaluated in similar ways to all other SAMHSA programs.

SAMHSA’s Health Information Technology (Health IT) activities address integration of 

behavioral health into broader federal efforts designed to implement the Health Information 

Technology for Economic and Clinical Health (HITECH) Act, a part of the American Recovery 

and Reinvestment Act of 2009 (ARRA) and the Affordable Care Act, including advancement of 

standards and the use of Electronic Health Records. Through these efforts, SAMHSA promotes 

the adoption of Health IT with the goal of improving health care, advancing health outcomes, 

and reducing costs.

SAMHSA links the goals of the National HIV/AIDS Strategy (to reduce HIV incidence, increase 

access to care and optimize health outcomes for people living with HIV, and reduce HIV-related 

health disparities) to behavioral health. SAMHSA resources are directed to high-risk populations 

through state and local health departments to facilitate the development and expansion of 

culturally competent and effective integrated behavioral health and primary care networks in an 

effort to reduce the impact of behavioral health problems, HIV risk and incidence, and HIVrelated health disparities in these areas.

SAMHSA also participates actively in the Secretary’s Program Integrity Initiative by conducting 

risk assessments on SAMHSA’s major programs. In FY 2012, risk assessments were conducted 

on the Community Mental Health Services Block Grant (MHBG) program, the Access to 

Recovery (ATR) program, and the Sober Truth On Preventing Underage Drinking (STOP Act) 

program. Risk assessments were conducted in FY 2013 for the Projects for Assistance in 

Transition from Homelessness (PATH) and Substance Abuse Block Grant (SABG) formula 

programs.
15

On September 10, 2012, the National Action Alliance for Suicide Prevention (Action Alliance) 

released an ambitious national strategy to reduce the number of deaths by suicide. The strategy 

was called for by Health and Human Services (HHS) Secretary Kathleen Sebelius and former 

Department of Defense Secretary Robert Gates when they launched the Action Alliance on Sept. 

10, 2010. The 2012 National Strategy for Suicide Prevention, a report from the U.S. Surgeon 

General and the Action Alliance, details 13 goals and 60 objectives for reducing suicides over 

the next 10 years. The Action Alliance, co-chaired by Gordon Smith, chief executive of the 

National Association of Broadcasters, and Army Secretary John McHugh, highlights four 

immediate priority is to reduce the number of suicides: integrating suicide prevention into health 

care policies; encouraging the transformation of health care systems to prevent suicide; changing 

the way the public talks about suicide and suicide prevention; and improving the quality of data 

on suicidal behaviors to develop increasingly effective prevention efforts.

Administrative Efficiencies

1) Grants and Contracts Restructuring to Effect Priority Programmatic Changes – SAMHSA 

created a uniform block grant application; inventoried and reviewed all grants and contracts to 

align RFAs/RFPs with the SIs; braided funding across SAMHSA or with other OpDivs/federal 

agencies where appropriate; and consolidated multiple contracts into similar priority areas or 

brought those functions in-house to increase efficiency and improve capacity. Examples are:

a. Primary Behavioral Health Care Integration (PBHCI) TA Center – Launched the

SAMHSA/HRSA jointly funded Center for Integrated Health Solutions (CIHS) to 

focus on models, technical assistance and workforce issues in bi-directional 

integration of primary care and behavioral health (BH); developed ideas with 

CMS and HRSA for enhancement of these efforts.

b. Housing/Homelessness and Recovery Supports TA Centers – Braided funding 

across SAMHSA to create two consolidated and consistent technical assistance 

(TA) Centers addressing recovery support issues.

c. HIV/AIDS Grants – Braided multiple funding streams to create a focus on the 

CDC 12-cities approach, consistent with HHS’ HIV/AIDS Implementation 

Strategy.

2) Budget Management – SAMHSA managed the budget to provide strong fiscal oversight and 

focus on SIs such as prevention (including for tribes), trauma and justice, military families, 

Health IT for BH providers, and other high-priority areas and to implement a theory of change 

that would use limited funding for innovative grants to test approaches for improvement of the 

nation’s behavioral health system; planned for real and anticipated reductions in available 

resources at the state/territory/tribe and federal levels.

a. Trauma – SAMHSA incorporated concepts of trauma-informed and traumaspecific care in multiple grant programs; brought together multiple TA centers to 

discuss a common approach and models; developed a conceptual approach for 

Grants for Adult Trauma Screening and Brief Intervention (GATSBI) proposed 

for FY 2013.

b. Prevention – SAMHSA created a focus on prevention of behavioral health 

conditions through development of a draft paper on prevention concepts, 

inclusion of prevention in multiple grants, contracts and publications, and 
16

development of a Strategic Prevention Framework Expansion (SPF-E) grant 

program for interested states/territories and tribes to take this evidence-based 

prevention approach to scale.

c. Health Information Technology (Health IT) Grants – SAMHSA provided 

supplemental grant funding for Primary and Behavioral Health Care Integration 

(PBHCI) grantees to purchase or expand interoperable electronic health record 

(EHR) systems; provided additional grant funding for other Health IT approaches 

through the Targeted Capacity Expansion (TCE) grant program; partnered with 

ONC on privacy standards and prescription drug monitoring.

3) Office of Indian Alcohol and Substance Abuse (OIASA) – As required by TLOA, 

SAMHSA established this new Office to lead interagency coordination efforts.

4) Office of Behavioral Health Equity (OBHE) – SAMHSA established this new Office 

using a team approach with staff throughout SAMHSA, to provide input and guidance to 

SI Leads and Executive Leadership about BH disparities for ethnic minorities, Tribal 

members, LGBTQ individuals, and women and girls.

Behavioral Health Prevention, Treatment and Recovery System Improvement

SAMHSA uses performance data to assure that resources directly address behavioral health 

disparities. Minority AIDS grants are awarded to community-based organizations through three 

different programs. The collective output from these programs enhances and expands provision 

of effective, culturally competent HIV-AIDS services related to behavioral health and associated 

risk factors. In the Minority AIDS Initiative (MAI), led by SAMHSA’s Center for Substance 

Abuse Prevention (CSAP), implementation of evidence-based substance abuse and HIV 

prevention interventions are supported, including HIV testing that specifically targets high risk 

populations. All grantees use SAMHSA’s Strategic Prevention Framework for assessing 

community needs. During FY 2011, targets were met or exceeded for all measures, including the 

number of people served who were exposed to substance abuse prevention education services 

and the percent of those served who reported no use of alcohol or illicit drugs at pre-test and then 

remained non-users at post-test. Additional data demonstrates that SAMHSA grant programs 

serve hard-to-reach populations. For example, results from the cross-site evaluation of the CSAP 

Minority AIDS Initiative grants showed that grantees served larger proportions of Hispanics and 

African Americans (28.6 percent and 66.4 percent, respectively) than are represented in the 

general population (14.6 percent and 12.6 percent, respectively). In addition, grantees also served 

other minority populations such as lesbian, gay, bisexual, and transgender (LGBT) youth and 

adults; homeless adults; and individuals who lacked health coverage at program entry. 

SAMHSA uses a focused approach to increase use of evidence-based 

substance abuse prevention and mental health promotion practices. 

Performance efforts document improvement resulting from services for 

military families, young children, and those exposed to trauma. For FY 2011, 

performance targets for the Mental Health Block Grants (MHBG) were met or 

exceeded for the number of evidence-based practices implemented and the 

percentage of the service population receiving any evidence-based practice.

SAMHSA addresses homelessness through a number of programs, including 

the Cooperative Agreement to Benefit Homeless Individuals (CABHI) 
17

program. Through such services, SAMHSA supports behavioral health by 

promoting transition into permanent supportive housing. Performance results 

are encouraging, overall, but leave room for improvement. Targets were 

exceeded for the number served, number employed, number housed, and the 

number receiving mental health services. Challenges continue in terms of 

social connectedness and improved functioning as well as enrollment of those 

with serious mental illness. 

Cross-Agency Collaborations

1) Active Participation in Health Reform Implementation – SAMHSA articulated health 

reform as a central organizing context for all SAMHSA activities and helped to position 

BH as a central construct within HHS’ health reform implementation efforts; redesigned 

SAMHSA’s two block grant applications into a single uniform application offering 

states/territories more flexibility while encouraging and supporting them to plan for and 

implement a recovery-oriented good and modern service delivery system as health reform 

continues to evolve. Efforts included:

a. Behavioral Health Services Definitions – Based on the Good and Modern 

Services Paper developed in FY 2010, SAMHSA began to develop service 

definitions for use within SAMHSA programs, CMS and other payers, and to 

develop a baseline of spending of block grant funds by states/territories.

b. Technical Assistance/Training – SAMHSA provided multiple webinars, 

workshops, speeches and stakeholder meetings regarding aspects of health reform 

and its impact on BH systems, providers and service recipients.

c. Affordable Care Act Implementation – SAMHSA participated in all aspects of 

implementation focusing especially on preparing states/territories and other BH 

actors for 2014, responding to all health reform related regulations and guidance 

documents, representing SAMHSA and BH in essential benefits planning, and 

developing a working group on enrollment strategies to begin preparing 

stakeholders for the next phase of health reform implementation.

2) Building Strategic Partnerships and Increasing Awareness of BH – SAMHSA created or built 

upon relationships and collaborative work with other HHS OPDIVS, STAFFDIVS, and other 

federal agencies, with 25 new and creative projects to advance the nation’s behavioral in systems 

served or functions performed by these other entities, making SAMHSA a valuable partner and 

increasing the visibility of BH as an essential part of health. Examples include:

a. Behavioral Health Coordinating Council (BHCC) – With OASH, SAMHSA cochaired and helped manage this Secretary’s council and subcommittees to address 

cross-HHS BH policy issues such as common definitions of terms, response to 

ONDCP prescription drug abuse plan, PBHCI implementation issues with CMS, 

BH measures for Phase 2 and 3 of meaningful use, BH budget cross-cut, drinking 

on college campuses, BH workforce and quality.

b. Tribal Law and Order Act (TLOA) Implementation – SAMHSA worked with 

DOJ, DOI/BIA and IHS to engage in Tribal consultations and planning for 

development and implementation of the Memorandum of Agreement (MOA) 

signed by the three Secretaries on July 29, 2011; drafted guidelines for Tribal 
18

Action Plans (TAPs); and testified with other Departments before the Senate 

Indian Affairs Committee regarding status of TLOA implementation.

c. Interagency Coordinating Council on Prevention of Underage Drinking 

(ICCPUD) – SAMHSA re-engaged multiple departments’ principals to direct 

staff work across departments/agencies to begin work on a National Strategy for 

the Prevention of Underage Drinking.

d. National Action Alliance for Suicide Prevention – SAMHSA worked with public 

and private partners to help determine policy goals, strategies for the updated 

Surgeon General’s National Strategy for Suicide Prevention (NSSP), and 

elements of a presentation to CMS about how to address suicide in Medicaid, 

Medicare and health reform.

e. Olmstead – SAMHSA worked with OCR, Office of Disability, ASPE, CMS and 

behavioral health stakeholders to design an approach to assist states to address 

community-based service needs of people in institutional settings.
19

Discretionary All-Purpose Table

Substance Abuse and Mental Health Services Administration

(Dollars in Thousands)

FY 2012 FY 2013 FY 2014 FY 2014

Actual Annualized 

CR 1/

President's 

Budget

+/- 

FY 2012

Now is the Time Presidential Initiatives

Mental Health: 

Project AWARE......................................................................................... $--- $--- $55,000 +$55,000

Project AWARE State Grants (non-add).......................................... --- --- 40,000 +40,000

Mental Health First Aid (non-add)................................................... --- --- 15,000 +15,000

Healthy Transitions................................................................................... --- --- 25,000 +25,000

Health Surveillance and Program Support:

Workforce.................................................................................................... --- --- 50,000 +50,000

Minority Fellowship Program Expansion (non-add)................... --- --- 5,000 +5,000

Mental Health Workforce Expansion (non-add)............................ --- --- 35,000 +35,000

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

TOTAL 2/..................................................................................................... --- --- $130,000 +130,000

Mental Health: 

Programs of Regional and National Significance.................................... 315,666 272,323 361,277 +45,611

Prevention and Public Health Fund (non-add)................................ 45,000 N/A 28,000 -17,000

Children's Mental Health Services............................................................ 117,315 118,300 117,315 ---

Projects for Assistance in Transition from Homelessness.................... 64,794 65,191 64,794 ---

Protection and Advocacy for Individuals with Mental Illness............. 36,238 36,460 36,238 ---

Community Mental Health Services Block Grant.................................... 459,756 462,570 459,756 ---

PHS Evaluation Funds (non-add)....................................................... 21,039 21,168 21,039 ---

Total, Mental Health .................................................................................. 993,770 954,844 1,039,380 +45,610

Substance Abuse Prevention: 

Programs of Regional and National Significance.................................... 185,885 187,076 175,560 -10,325

Total, Substance Abuse Prevention......................................................... 185,885 187,076 175,560 -10,325

Substance Abuse Treatment: 

Programs of Regional and National Significance.................................... 428,697 402,751 334,794 -93,903

Prevention and Public Health Fund (non-add)................................ 29,000 N/A 30,000 +1,000

PHS Evaluation Funds (non-add)....................................................... 2,000 2,012 --- -2,000

Substance Abuse Prevention and Treatment Block Grant.................... 1,800,332 1,811,350 1,819,856 +19,524

PHS Evaluation Funds (non-add)....................................................... 79,200 79,685 71,724 -7,476

Total, Substance Abuse Treatment.......................................................... 2,229,029 2,214,101 2,154,650 -74,379

Health Surveillance and Program Support:

Health Surveillance and Program Support:.............................................. 124,318 106,968 120,157 -4,161

Prevention and Public Health Fund (non-add)................................ 18,000 N/A --- -18,000

PHS Evaluation Funds (non-add)....................................................... 27,428 27,596 45,428 +18,000

Public Awareness and Support................................................................. 13,545 13,628 13,571 +26

PHS Evaluation Funds (non-add)....................................................... --- --- 13,571 +13,571

Performance and Quality Information Systems....................................... 12,940 13,051 12,996 +56

PHS Evaluation Funds (non-add)....................................................... --- --- 12,996 +12,996

Agency-Wide Initiatives............................................................................ 9,200 9,256 54,395 +45,195

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

Total, Health Surveillance/Program Support........................................ 160,003 142,903 202,619 +42,616

TOTAL, SAMHSA Discretionary PL..................................................... 3,568,687 3,498,924 3,572,209 +3,523

Less PHS Evaluation Funds..................................................................... 129,667 130,461 164,758 +35,091

Less Prevention and Public Health Funds............................................ 92,000 N/A 58,000 -34,000

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

TOTAL, SAMHSA Budget Authority..................................................... $3,347,020 $3,368,463 $3,347,951 +932

FTEs 590 631 655 +65

2/ A total of $130 million is requested to address the behavioral health needs of transition age youth and their families in the 

wake of the Newtown, Connecticut tragedy at Sandy Hook Elementary School.

Program Activities

1/ The FY 2013 Prevention Fund resources are reflected in the Office of the Secretary.
20

Summary of the Request

SAMHSA

The SAMHSA FY 2014 President’s Budget Request for its total program level is $3.572 billion, 

an increase of $3.5 million from the FY 2012 funding level. This FY 2014 Total Program Level 

of $3.572 billion includes $3.348 billion in Budget Authority (an increase of $0.9 million from 

the FY 2012 funding level), $164.8 million in PHS Evaluation funds (an increase of $35.1

million from the FY 2012 funding level), and $58 million in Prevention Fund resources (a 

decrease of $34.0 million from the FY 2012 funding level). The budget continues to reflect $1.5 

million for user fees (new in the FY 2013 President’s Budget) for extraordinary data and 

publication requests not currently able to be fulfilled. The FY 2014 President’s Budget Request 

is divided among four appropriations consistent with the FY 2012 Consolidated Appropriations 

Act and the FY 2013 President’s Budget: (1) Mental Health, (2) Substance Abuse Prevention, 

(3) Substance Abuse Treatment, and (4) Health Surveillance and Program Support. The Budget 

Request includes $1.039 billion for Mental Health appropriation (an increase of $45.6 million

from the FY 2012 funding level), $175.6 million for Substance Abuse Prevention (a decrease of 

$10.3 million) from the FY 2012 funding level, $2.155 billion for Substance Abuse Treatment (a 

decrease of $74.4 million from the FY 2012 funding level), $202.6 million for Health 

Surveillance and Program Support (an increase of $42.6 million from the FY 2012 funding 

level). 

The FY 2014 President’s Budget Request includes $130 million in SAMHSA to support the 

Administration’s response to the Sandy Hook tragedy. This includes:

$55 million for Project AWARE to improve mental health awareness, increase referrals 

to behavioral health services and support systems, including $40 million for Project 

AWARE State Grants and $15 million for Mental Health First Aid.

$25 million for Healthy Transitions to support youth ages 16 to 25 with mental health and 

substance abuse problems and their families.

$50 million for Behavioral Health Workforce activities, which includes $35 million for a 

jointly administered activity with HRSA to expand the Mental and Behavioral Health 

Education and Training (MBHET) Grant Program, $10 million for SAMSHA’s Peer 

Professionals Workforce Development training program; and $5 million for the 

expansion of SAMHSA’s Minority Fellowship Program - Youth.
21

FY 2014 Braided Programs

(Dollars in Thousands)

FY 2014

Braided Programs 

President's 

Budget

Statewide Network Development for Recovery and Resiliency $1,800

Mental Health: Consumer and Family Network Grants (non-add)...................... 400

Substance Abuse Treatment: Recovery Community Services Program (non-add) 1,400

Transforming Lives through Supported Employment Grant Program 5,000

Mental Health: MH System Transformation and Health Reform (non-add)......... 1,987

Mental Health: Practice Improvement and Training (non-add)........................... 3,013

Housing and Homelessness 28,617

Mental Health: Homelessness Prevention Program (non-add)............................ 18,759

Substance Abuse Treatment: Treatment Systems for Homeless (non-add)............ 9,858

Behavioral Health Treatment Court Collaboratives 4,434

Mental Health: Criminal and Juvenile Justice Program (non-add)..................... 2,250

Substance Abuse Treatment: Criminal Justice Activities (non-add)..................... 2,184

Health Information Technologies 5,477

Mental Health Block Grant Set Aside (non-add)................................................. 2,200

Substance Abuse Prevention and Treatment Block Grant Set Aside (non-add)... 3,277

Total, Braided Programs $45,328

The FY 2014 President’s Budget Request includes $45.3 million for five braided programs 

within and between the Mental Health and Substance Abuse Treatment appropriations. Any 

amounts spent or awarded will be tracked as distinct funding streams and will only be used for 

purposes consistent with legislative direction and intent. Braided programs include:

$1.8 million including $0.4 million from the Mental Health appropriation (Consumer and

Family Network Grants) and $1.4 million from the Substance Abuse Treatment 

appropriation (Recovery Community Services Program) for the Statewide Network 

Development for Recovery and Resiliency program supplements. 

$5.0 million from the Mental Health appropriation (Mental Health System 

Transformation and Health Reform and Practice Improvement and Training) for the 

Transforming Lives through Supported Employment Grant Program. 

$28.6 million including $18.8 million from the Mental Health appropriation 

(Homelessness Prevention Program) and $9.9 million from the Substance Abuse 

Treatment appropriation (Treatment Systems for Homeless) for a joint initiative with 

SAMHSA, the Department of Housing and Urban Development and the Centers for 

Medicare and Medicaid Services on homelessness. 

$4.4 million including $2.3 million from the Mental Health appropriation (Criminal and 

Juvenile Justice Programs) and $2.2 million from the Substance Abuse Treatment 

appropriation (Criminal Justice Activities) for the Behavioral Health Treatment Court 

Collaboratives (BHTCC). 

$5.5 million, including $2.2 million from the Mental Health Block Grant Set Aside and 

$3.3 million from the Substance Abuse Prevention and Treatment Block Grant Set Aside 
22

for supporting states to adopt health information technology, including the use of intra 

and interoperable electronic health records.
23

Mental Health Appropriation

The FY 2014 Budget requests $1.039 billion Mental Health priorities, an increase of $45.6

million from the FY 2012 funding level, which include $990.3 million in Budget Authority (an 

increase of $62.6 million from the FY 2012 funding level), $21.0 million in PHS Evaluation 

funds (the same as the FY 2012 funding level), and $28.0 million in Prevention Fund resources 

(a decrease of $17 million from the FY 2012 funding level). The following mental health

priorities are requested: 

$361.3 million for Programs of Regional and National Significance (PRNS) which represents a

$45.6 million increase from the FY 2012 funding level and will provide support for the following 

key PRNS programs:

$55 million for Project AWARE (Advancing Wellness and Resilience in Education) 

which includes $40 million for Project AWARE State Grants and $15 million for Mental 

Health First Aid. This program will support the Administration’s response to the tragedy 

at Sandy Hook Elementary by providing support for increased access to vital mental 

health services and related supports.

$25 million for Healthy Transitions to support the Administration’s efforts to address the 

tragedy at Sandy Hook Elementary by providing support to 16 to 25-year-olds with 

mental illnesses and their families. This new competitive grant program for states 

proposes innovative approaches to providing support for transition-age youth with mental 

health conditions and/or substance abuse disorders and their families.

$45.7 million for the National Child Traumatic Stress Network, which is a minor 

increase from the FY 2012 funding level, to continue support for a national network of 

grantees which develop and promote effective community practices for children and 

families exposed to a wide array of traumatic events.

$34.6 million for Project LAUNCH, the same as the FY 2012 funding level, to support 

the implementation of evidence-based practices that promote wellness and resilience of 

young children.

$28 million for PBHCI, which represents a reduction of $39.7 million from the FY 2012 

funding level, to continue coordination and integration of primary care services into 

publicly funded community behavioral health settings.

$50 million for Suicide Prevention projects, which is a $8.0 million reduction from the 

FY 2012 funding level and includes $2 million to support the National Strategy for 

Suicide Prevention to expand technical assistance efforts for the adoption of available of 

evidence-based suicide prevention strategies. 
24

$2.9 million for Disaster Response, which is a $1.9 million increase from the FY 2012 

funding level and includes support for a disaster distress helpline.

$2.9 million for Grants for Adult Trauma Screening and Brief Intervention which 

represents a $2.9 million increase from FY 2012 funding level, to support grants focused 

on advancing the knowledge base to address trauma screening and brief interventions for 

women in primary health care settings.

$117.3 million in all other PRNS programs including Seclusion and Restraint ($1.1

million), Youth Violence ($23.2 million), Children and Family Programs ($6.5 million), 

Consumer and Family Network Grants ($5 million), Mental Health Transformation 

($10.6 million), Homelessness Prevention Program ($30.8 million), Minority AIDS 

($22.8 million), Criminal and Juvenile Justice ($4.3 million), Practice Improvement and 

Training ($7.9 million), Consumer and Consumer Supporter TA Centers ($1.9 million), 

Homelessness ($2.3 million) and HIV/AID Education ($0.773 million). 

$117.3 million for Children’s Mental Health Services, which is the same as the FY 2012 funding 

level, to continue to support the development of comprehensive, community-based systems of 

care.

$64.8 million for PATH Homeless Formula Grants, which is the same as the FY 2012 funding 

level to continue to address the critical behavioral health needs of individuals with serious mental 

illness and/or a co-occurring substance use disorder who are experiencing homelessness or are at 

risk for homelessness.

$36.2 million for the Protection and Advocacy of Individuals with Mental Illness (PAIMI), 

which is the same as the FY 2012 funding level. 

$459.8 million for the MHBG, which is the same as the FY 2012 funding level. This includes 

$438.7 million in Budget Authority and $21.0 million in PHS Funds. In FY 2014, states will be 

expected to expend at least 3 percent of the state allocations to encourage providers in building 

capacity for third party billing and/or assist individuals to enroll in insurance for which they are 

eligible and expend at least 5 percent of the state allocations to implement evidence-based mental 

health promotion and mental illness prevention and treatment. 

The Minority Fellowship Program (MFP) has been consolidated within the Health Surveillance 

and Program Support (HSPS) appropriation as an agency-wide activity within the Behavioral 

Health Workforce program. This streamlines the management of the program, which was 

previously funded through three separate appropriations. 
25

Substance Abuse Prevention Appropriation

The FY 2014 Budget requests $175.6 million from Budget Authority for Substance Abuse 

Prevention priorities, a $10.3 million decrease from the FY 2012 funding level, and includes the 

following key prevention priorities:

$109.8 million the Strategic Prevention Framework, which is the same level of funding from FY 

2012 funding level, to support national efforts of reducing substance-abuse related problems, 

preventing the onset and reducing the progression of substance abuse, strengthening the capacity 

and infrastructure at the state and community level in support of prevention and leveraging, 

redirecting and realigning state-wide funding streams for prevention.

$4.9 million for Mandatory Drug Testing, a minor decrease ($0.290 million) from FY 2012 

funding level, to support a critical nationwide prevention program supporting Executive Order 

12564 and Public Law 100-71 which provide oversight of the Federal Drug-Free Workplace 

program and the National Laboratory Certification program. 

$41.3 million for Minority AIDS, which is the same as the FY 2012 funding level to continue to 

support substance abuse prevention efforts for people at risk for HIV/AIDS.

$7.0 million for the Sober Truth on Prevention Underage Drinking Act (STOP Act, which is an 

increase ($0.013 million) from FY 2012 funding level, to continue to support the nation’s first 

comprehensive legislation addressing the prevention of underage drinking which enables 

organizations to strengthen collaboration and coordination to achieve a reduction in underage 

drinking at a community level.

$1.0 million for Fetal Alcohol Spectrum Disorder, which is a $8.8 million decrease from FY 

2012 funding level, to support technical assistance efforts to support new methods for screening 

and providing preventative services to women of child bearing age. 

$11.6 million in all other PRNS programs including Center for the Application of Prevention 

Technologies ($7.5 million) and Science and Service Program Coordination ($4.1 million). 

The Minority Fellowship Programs (MFP) has been consolidated into the Health Surveillance 

and Program Support (HSPS) appropriation as an agency-wide activity within the Behavioral 

Health Workforce program. This streamlines the management of the program, which was 

previously funded through three separate appropriations. 
26

Substance Abuse Treatment Appropriation

The FY 2014 Budget requests $2.155 billion for Substance Abuse Treatment activities, a 

decrease of $74.4 million from the FY 2012 funding level. The request includes $2.053 billion 

in Budget Authority, (a decrease of $65.9 million) $71.7 million in PHS Evaluation funds (a 

decrease of $9.5 million from the FY 2012 funding level), and $30.0 million in Prevention Fund

(PPHF) resources (an increase of $1.0 million from the FY 2012 funding level). 

This request includes $334.8 million for Programs of Regional and National Significance 

(PRNS) which represents a $93.9 million decrease from the FY 2012 funding level and will 

provide support for the following key PRNS programs:

$8.8 million for Opioid Treatment Programs/Regulatory Activities, which is a slight

($0.140 million) decrease from the FY 2012 funding level, to continue support for 

SAMHSA’s regulatory and monitoring activities for opioid treatment programs.

$30.0 million in Prevention Fund resources for Screening and Brief Intervention and 

Referral to Treatment (a decrease of $23.2 million for FY 2012 funding level) to continue 

to support the expansion and enhancement of integrated screening, brief intervention, 

referral and treatment services within general medicine and primary care settings. 

$16 million for Pregnant and Postpartum Women, which is the same as the FY 2012 

funding level, to continue to support gender and culturally specific treatment service grants 

for pregnant, postpartum, and other parenting women. 

$2.6 million for Recovery Community Services Program, of which $1.8 million will 

provide support for the Statewide Network Development for Recovery and Resiliency 

Initiative, of which $0.4 million will be braided for partnership supplements with funding 

in the Mental Health appropriation. Any braided amounts spent or awarded will be tracked 

as distinct funding streams and will only be used for purposes consistent with legislative 

direction and intent.

$65.0 million for Access to Recovery (a decrease of $33.3 million from FY 2012 funding 

level) to continue to support voucher programs that expand substance abuse treatment 

capacity and promote choice among clinical treatment and recovery support providers.

$41.6 million for Treatment Systems for Homeless of which $9.9 million is directed for a

braided program with funding from the Mental Health appropriation for a joint initiative 

with SAMHSA, the Department of Housing and Urban Development, and the Centers for

Medicare and Medicaid Services on homelessness. Any braided amounts spent or awarded 

will be tracked as distinct funding streams and will only be used for purposes consistent 

with legislative direction and intent.
27

$52.4 million for Minority AIDS, a $13.5 million reduction from the FY 2012 funding 

level. Although a reduction in the Substance Abuse appropriation, the total SAMHSA 

support for Minority AIDS is funded at the FY 2012 funding level. 

$65.1 million in Criminal Justice Activities of which $2.2 million is directed for a braided 

program with funding from the Mental Health appropriation for the Behavioral Health 

Treatment Court Collaboratives. Any braided amounts spent or awarded will be tracked as 

distinct funding streams and will only be used for purposes consistent with legislative 

direction and intent.

$54.0 million in all other PRNS programs including TCE-General ($13.3 million), 

Strengthen Treatment Access and Retention ($1.0 million), Children and Families ($29.7

million), Addiction Technology Transfer Centers ($8.1 million), and Special 

Initiatives/Outreach ($1.4 million). 

$1.820 billion for the Substance Abuse Block Grant (SABG) in FY 2014. This represents a $27 

million increase in Budget Authority from the FY 2012 funding level and a $7.5 million decrease 

in PHS Evaluation funds from the FY 2012 funding level resulting in a net increase for the 

SABG of $19.5 million from the FY 2012 funding level. In FY 2014, states will be expected to 

expend at least 3 percent of the state allocations to encourage providers in building capacity for 

third party billing and/or assist individuals to enroll in insurance for which they are eligible.

The Minority Fellowship Program (MFP) has been consolidated and is now funded within the 

Health Surveillance and Program Support (HSPS) appropriation as an agency-wide activity 

within the Behavioral Health Workforce program. This streamlines the management of the 

program, which was previously funded through three separate appropriations. 
28

Health Surveillance and Program Support

The FY 2014 Budget requests a total of $202.6 million for Health Surveillance and Program 

Support, a $42.6 million increase from the FY 2012 funding level, and includes the following 

key priorities: 

$47.4 million for Health Surveillance activities, reflecting level funding from FY 2012. The 

source of part of the funding for CBHSQ within HSPS has shifted from the Prevention Fund

(PPHF) to the Public Health Service Evaluation Fund (PHS). Funding from HSPS reflects the 

phasing out of Legacy data collection and analysis programs and the full implementation of the 

Common Data Platform and the expansion of the new BHSIS contract.

$72.7 million for Program Support, a decrease of $4.2 million from the FY 2012 funding level. 

Savings will be generated through administrative efficiencies. Sufficient funds are available to 

staff up to 655 FTE, an increase of 3.8 percent over the FY 2013 projections, reflecting full 

annualization of SAMHSA's in sourcing initiative. 

$13.6 million for Public Awareness and Support (PAS), a $0.026 million increase from the FY 

2012 funding level. The increase of $13.6 million in PHS evaluation is offset by the decrease of 

$13.6 million of Budget Authority from the FY 2012 funding level. These funds will be used to 

continue work on the Public Engagement Platform, Project Evolve, the Federal Digital Strategy, 

the Knowledge Management System, and the Public Awareness and Support Initiative. In 

addition, funds will support a National Dialogue on Mental Health aimed at educating Americans 

about the impact of mental illness on children and youth adults.

$13.0 million is requested for Performance and Quality Information Systems (PQIS), an increase 

of $0.056 million from the FY 2012 funding level. An increase of $13.0 million in PHS 

evaluation is offset by the decrease of $13.0 million of Budget Authority to reflect the transfer to 

a different source of funding. These funds will be used to fully fund the new Common Data 

Platform which will be awarded in FY 2013 and fully implemented in 2014. 

$54.4 million is requested for Agency Wide Initiatives, a net increase of $45.2 million from the 

FY 2012 funding level (a reduction of $3.5 million for activities under Military Families). The 

FY 2014 Budget request includes: an increase of $35 million for a jointly administered activity 

with HRSA to expand the Mental and Behavioral Health Education and Training (MBHET) 

Grant Program, an increase of $10 million for Peer Professionals, and an increase of $5 million 

for Minority Fellowship Program Expansion. In addition, the Budget request also includes the 

core Minority Fellowship Program activity, an increase of $4.4 million, which was realigned 

from all three centers to the HSPS appropriation. 

This request includes an estimated $1.5 million in Data Request and Publication User Fees. Fees 

will be collected for extraordinary data and publications user requests not otherwise able to be 

fulfilled within existing resources. 
29

NOW IS THE TIME

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

increasing access to mental health services.

(Dollars in thousands)

FY 2012 FY 2013 FY 2014 FY 2014

Actual Annualized 

CR 1/

President's 

Budget

+/- 

FY 2012

Now is the Time Presidential Initiatives

Mental Health: 

Project AWARE......................................................................... $ --- $ --- $55,000 +$55,000

Project AWARE State Grants (non-add).......................... --- --- 40,000 +40,000

Mental Health First Aid (non-add).................................. --- --- 15,000 +15,000

Healthy Transitions................................................................... --- --- 25,000 +25,000

Health Surveillance and Program Support:

Workforce.................................................................................... --- --- 50,000 +50,000

Minority Fellowship Program Expansion (non-add)... --- --- 5,000 +5,000

Mental Health Workforce Expansion (non-add)........... --- --- 35,000 +35,000

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

TOTAL.......................................................................................... $ --- $ --- $130,000 +$130,000

Program Activities

The FY 2014 Budget request reflects the Administration’s commitment to the President’s Plan, 

Now is the Time1to increase access to mental health services. The FY 2014 Budget includes 

funding to expand mental health services to help teachers recognize signs of mental illness in 

students early, improve referrals and access to mental health services for young people ages 16-

25, and help train 5,000 more mental health professionals with a focus on serving students and 

young adults. This package includes:

Project AWARE

In an effort to support the Administration’s response to the tragedy at Sandy Hook Elementary 

School, $55 million is requested to support Project AWARE, (Advancing Wellness and 

Resilience in Education) to increase awareness of mental health issues and connect young people 

with behavioral health issues and their families with needed services. SAMHSA will partner 

with the Departments of Education and Justice in the development, implementation and 

management of this initiative to maximize coordination and avoid duplication of efforts. 

Project AWARE proposes two components: Project AWARE State Grants ($40.0 million) build

on the Safe Schools/Healthy Students State Planning and Community Pilot Program which is 

 

1

Plan can be found at: http://www.whitehouse.gov/sites/default/files/docs/wh_now_is_the_time_full.pdf or

http://www.whitehouse.gov/issues/preventing-gun-violence
30

intended to create safe and supportive schools and communities. For more than a decade, the 

Safe Schools/Healthy Students Initiative has successfully decreased violence and increased the 

number of students receiving mental health services. Project AWARE grants will be braided 

with funds from Education and Justice to support 20 grants to State Education Authorities 

(SEAs) that will promote a comprehensive, coordinated and integrated program with the goal of 

making schools safer and increasing access to mental health services. The SEAs will be required 

to partner with the State Mental Health and Law Enforcement agencies to establish Interagency 

State Management Teams, conduct environmental needs assessments, develop a state plan with 

an evaluation mechanism, and develop the mechanisms to coordinate funding, service delivery, 

systems improvement, and data collection. In addition, each SEA will be required to identify 

three high-need Local Education Authorities (LEAs) as pilot communities that will receive subawards to implement comprehensive and coordinated school safety and mental health programs. 

SAMHSA expects that these 20 State grants will promote data driven models in 60 LEAs 

(reaching 1000-1500 schools).

The second component, Mental Health First Aid (MHFA) ($15.0 million) proposes widespread 

dissemination of the Mental Health First Aid curriculum and supports training to reach 750,000 

students to identify mental illness early and refer them to treatment. MHFA prepares teachers 

and other individuals who work with youth to help schools and communities to understand, 

recognize, and respond to signs of mental illness or substance abuse in children and youth, 

including how to talk to adolescents and families experiencing these problems so they are more 

willing to seek treatment. The Budget proposes that $10.0 million of the Project AWARE –

MHFA funds will be braided with Education and Justice funds to support competitive grants to 

LEAs with the goal of making schools safer and providing mental health literacy training. An 

Interagency Supervisory Team (IST) will work together to provide oversight and guidance to 

both the state and local initiatives. The additional $5.0 million proposed for MHFA will be 

braided with the 20 SEA grants to support MHFA training in the 20 SEAs and 60 LEAs subgrantees implementing Project AWARE. 

Healthy Transitions

The FY 2014 Budget includes $25.0 million for a new Healthy Transitions Program, to assist 16 

to 25 year-olds with mental illnesses and their families to access and navigate behavioral health 

treatment systems. Compared with their peers, young adults, aged 18-25 with mental health 

conditions are more likely to experience homelessness, be arrested, drop out of school and be 

underemployed. Compared to all other chronic health conditions, mental disorders produce the 

greatest disability burden within this age group. Furthermore, 18-25 year-olds with mental 

health conditions are significantly less likely to receive mental health services than other adults. 

This new demonstration grant program for states proposes innovative approaches to provide

support for transition-age youth with mental health and/or co-occurring substance abuse 

disorders and their families. States will take steps to expand services for these young 

individuals, develop family and youth networks for information sharing and peer support, and

disseminate best practices for services to youth ages 16-25. The $25.0 million would support 5-

year grants to 19 states.
31

Behavioral Health Workforce

The FY 2014 Budget includes $50.0 million for workforce activities to help train more than 

5,000 additional professionals to work with students and young adults with mental illnesses and 

other behavioral health problems. The proposal includes $35.0 million for a jointly administered 

activity with HRSA to expand the Mental and Behavioral Health Education and Training 

(MBHET) Grant Program, $10.0 million for SAMHSA’s Peer Professionals training program; 

and $5.0 million for the expansion of SAMHSA’s Minority Fellowship Program as described 

below.

SAMHSA-HRSA Mental and Behavioral Health

Education and Training (MBHET) Grant Program

In FY 2014, SAMHSA will collaborate with HRSA in expanding the Mental and Behavioral 

Education and Training (MBHET) Grant Program. This expansion will increase the clinical 

service capacity of the behavioral health workforce by supporting training for Master’s level 

social workers, psychologists and marriage and family therapists as well as behavioral health 

paraprofessionals. This effort is critical to ensure that the behavioral health workforce is able to 

meet the needs of high need and high demand populations, including rural, vulnerable, and 

underserved populations. In FY 2014, the program will include an emphasis on training to 

address the needs of children, adolescents, and transition-age youth (ages 16-25) and their 

families. SAMHSA requests $35.0 million in FY 2014 for the SAMHSA-HRSA expansion of 

the MBHET grant program and will help increase the behavioral health workforce by 3,950.

Peer Professionals Workforce Development

For FY 2014, SAMHSA requests $10.0 million to strengthen the behavioral health workforce by 

increasing the number of trained peers, recovery coaches, mental health/addiction specialists, 

prevention specialists, and pre-Master’s level addiction counselors working with an emphasis on 

youth ages 16-25. Because of their lived experience with behavioral health conditions, and being 

able to build trust and foster connections with individuals accessing care, these entry entry-level 

providers play a significant role in the delivery of prevention and recovery support services. 

SAMHSA plans to award up to 19 grant awards to community colleges or community college 

networks, states and national organizations. These funds will provide tuition support and further 

establish the capacity of community colleges to develop and sustain behavioral health 

paraprofessional training and education.

Minority Fellowship Program – Youth (MFP-Y)

For FY 2014, SAMHSA requests $5.0 million for the Minority Fellowship Program (MFP-Y) to 

provide stipends to graduate students to increase the number of culturally competent behavioral 

health professionals who provide direct mental health and/or co-occurring substance abuse 

services to underserved minority populations. MFP-Y would utilize the existing infrastructure of 

the MFP to expand the focus of the program to support master’s level trained behavioral health 

providers in the fields of psychology, social work, professional counseling, marriage and family 

therapy, and nursing. This support would increase the number of providers who are available to 
32

provide clinical services to underserved, at-risk children, adolescents, and populations 

transitioning to adulthood (ages 16 – 25) in an effort to increase access to, and quality of,

behavioral health services for this age group. 
33

Appropriations Language

SUBSTANCE ABUSE AND MENTAL HEALTH SERVICES ADMINISTRATION

MENTAL HEALTH

For carrying out titles III and V of the PHS Act with respect to mental health, subpart I of part B 

of title XIX of such Act, and the Protection and Advocacy for Individuals with Mental Illness Act, 

$990,341,000, of which $438,717,000 shall be for carrying out section 1911 of the PHS Act: 

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

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

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

under section 241 of the PHS Act to carry out subpart I of part B of title XIX of the PHS Act to 

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

activities, and further that the total available under this Act for section 1920(b) activities shall 

not exceed 5 percent of the amounts appropriated for subpart I of part B of title XIX: Provided 

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

Act for fiscal year 2014: Provided further, That notwithstanding section 565(b)(1) of the PHS 

Act, technical assistance may be provided to communities that wish to establish programs for 

comprehensive mental health services for children with serious emotional disturbances, 

irrespective of whether the communities have a grant under section 561(a) of such Act: Provided 

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

out section 1911 of the PHS Act to assist providers in building capacity to bill third party 

insurance or assist individuals in enrolling in insurance for which they are eligible: Provided 

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

out section 1911 of the PHS Act to support effective evidence-based mental health prevention 
34

and treatment practices: Provided further, That any State receiving two percent or more of the 

total amount distributed for carrying out section 1911 of the PHS Act shall expend the amounts 

described in the two immediately preceding provisos through competitive subawards. Note.-- A 

full year 2013 appropriation for this account was not enacted at the time the budget was 

prepared; therefore, this account is operating under a continuing resolution (P.L. 112-175). The 

amounts included for 2013 reflect the annualized level provided by the continuing resolution.

SUBSTANCE ABUSE TREATMENT

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

subpart II of part B of title XIX of such Act, $2,052,926,000, of which $1,748,132,000 shall be 

for carrying out section 1921 of the PHS Act: Provided, That in addition to amounts provided 

herein, $71,724,000 shall be available under section 241 of the PHS Act 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: Provided further, That States shall expend at least 3 percent of the amount 

each receives for carrying out section 1921 of the PHS Act to assist providers in building 

capacity to bill third party insurance or assist individuals in enrolling in insurance for which 

they are eligible: Provided further, That any State receiving 1 percent or more of the total 

amount distributed for carrying out section 1921 of the PHS Act shall expend the amounts 

described in the immediately preceding proviso through competitive subawards. Note.--A fullyear 2013 appropriation for this account was not enacted at the time the budget was prepared; 

therefore, this account is operating under a continuing resolution (P.L. 112-175). The amounts 

included for 2013 reflect the annualized level provided by the continuing resolution.
35

SUBSTANCE ABUSE PREVENTION

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

$175,560,000. Note.--A full-year 2013 appropriation for this account was not enacted at the 

time the budget was prepared; therefore, this account is operating under a continuing resolution 

(P.L. 112-175). The amounts included for 2013 reflect the annualized level provided by the 

continuing resolution.

HEALTH SURVEILLANCE AND PROGRAM SUPPORT

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

headings ``Mental Health'', ``Substance Abuse Treatment'', and ``Substance Abuse Prevention'' 

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

Individuals with Mental Illness Act in the Substance Abuse and Mental Health Services 

Administration, $129,124,000: Provided, That in addition to amounts provided herein, 

$71,995,000 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 funds made available under this heading 

may be used to supplement program support funding provided under the headings ``Mental 

Health'', ``Substance Abuse Treatment'', and ``Substance Abuse Prevention'': Provided further, 

That the Administrator may transfer funds between any of the accounts of SAMHSA with 
36

notification to the Committees on Appropriations of both Houses of Congress at least 15 days in 

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

such transfer. Note.--A full-year 2013 appropriation for this account was not enacted at the time 

the budget was prepared; therefore, this account is operating under a continuing resolution (P.L. 

112-175). The amounts included for 2013 reflect the annualized level provided by the continuing 

resolution.
37

Language Analysis

Language Provision Explanation

For carrying out titles III and V of the PHS Act 

with respect to mental health, subpart I of part 

B of title XIX of such Act $990,341,000, ...of 

which $438,717,000 shall be for carrying out 

section 1911 of the PHS Act

This change conforms this language to new 

Substance Abuse Treatment Account language, 

which now provides a clearer direction to carry 

out the entirety of the Community Mental 

Health Block Grant with Mental Health 

Account funds and the entirety of the SABG 

with Substance Abuse Treatment funds. This 

change also specifies the amount for the block 

grant, which is necessary given the new 

language.

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

the PHS Act shall not apply to funds 

appropriated under this Act for fiscal year 

2014.

Because nearly all states have received a grant 

under the Garrett Lee Smith Youth Suicide 

Prevention state-sponsored statewide program

and the original purpose of this language has 

been served, this language would allow states 

to receive more than one grant.

Provided further, That notwithstanding section 

565(b)(1) of the PHS Act, technical assistance 

may be provided to communities that wish to 

establish such programs irrespective of 

whether the communities have a grant under 

section 561(a).

SAMHSA’s goal is the promotion of the use of 

system of care model, and it is hoped that nongrantee communities will pick up and 

implement the evidence based model, then 

SAMHSA should provide TA to communities 

whether they have a current grant or not; 

therefore., this grant would permit technical 

assistance to communities that wish to 

establish Systems of Care programs even 

though the community may not have a grant.
38

For carrying out titles III and V the PHS Act 

with respect to substance abuse treatment, and 

subpart II of part B of tile XIX of such Act, , 

$2,052,926,000, of which $1,748,132,000 shall 

be for carrying out section 1921 of the PHS 

Act:

This change makes clear that the legislative 

intent, despite “title...XIX with respect to 

substance abuse treatment”, is that the 

Substance Abuse Prevention and Treatment 

Block Grant should be used for both 

prevention and treatment.

Provided further, That states shall expend at 

least three percent of the amount for carrying 

out section 1911 of the PHS Act to award 

competitive grants that assist providers in 

building capacity to bill third party insurance 

and/or assist individuals to enroll in insurance 

for which they are eligible: 

This would ensure that States use at least three

percent of their Community Mental Health 

Services Block Grant award to assist providers 

with enrolling eligible individuals in insurance 

and billing third party insurance.

Provided further, That states shall expend at 

least five percent of the amount for carrying 

out section 1911 of the PHS Act to support the 

most effective evidence-based mental health 

promotion and mental illness prevention 

approaches

States must use at least five percent of their 

Community Mental Health Services Block 

Grant award to support effective evidencebased mental health promotion and mental 

illness prevention approaches.

Provided further, That any State receiving two

percent or more of the total amount distributed 

for carrying out section 1911 of the PHS Act 

shall expend the amounts described in the two 

immediately preceding provisos through 

competitive subawards.

This would ensure that funds are awarded 

competitively.

Provided further, That states shall expend at 

least three percent of the amount for carrying 

out section 1921 of the PHS Act to award 

This would ensure that States use at least three

percent of their Substance Abuse Block grant 

award to assist providers with enrolling 
39

competitive grants that assist providers in 

building capacity to bill third party insurance 

and/or assist individuals to enroll in insurance 

for which they are eligible.

eligible individuals in insurance and billing 

third party insurance.

Provided further, That any State receiving one

percent or more of the total amount distributed 

for carrying out section 1921 of the PHS Act 

shall expend the amounts described in the two 

immediately preceding proviso through 

competitive subawards.

This would ensure that funds are awarded 

competitively, while providing flexibility to 

States for which a three percent or five percent 

portion of their block grant allocation would be 

inefficient or ineffective in such a form. The 

trigger is one percent in the case of the 

Substance Abuse Block Grant to acknowledge 

the larger size compared to the Mental Health 

Block Grant.

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

This section allows for fees to be collected for 

data and publications which would otherwise 

not be fulfilled because they incur especially 

onerous costs upon SAMHSA, and for those 

fees to be available for the same appropriation 

until expended.

Provided further, That funds made available 

under this heading may be used to supplement 

program support funding provided under the 

headings “Mental Health”, “Substance Abuse 

Treatment”, and “Substance Abuse 

Prevention”: Provided further, That the 

Administrator may transfer funds between any 

Establishes more clearly that the Program 

Support account can be used to supplement or 

transfer between accounts.
40

of the accounts of SAMHSA with notification to 

the Committees on Appropriations of both 

Houses of Congress at least 15 days in 

advance of any transfer, but no such account 

shall be decreased by more than three percent 

by any such transfer.
41

Substance Abuse and Mental Health Services Administration

Amounts Available for Obligation

FY 2012 Actual

FY 2013 Annualized 

CR

FY 2014 

President's Budget

Appropriation:

Labor/HHS/Ed-Annual Appropriation............................... 3,354,313,000 3,498,924,000 3,572,209,000

Across the Board Reduction (P.L. 112-74 Sec. 527)......... (6,340,000) --- ---

Subtotal, adjusted appropriation........................................ 3,347,973,000 3,498,924,000 3,572,209,000

Real Transfer to: Office of the Secretary............................ (954,000) --- ---

Offsetting Collections from:

 Federal Sources.................................................................. 129,667,000 130,460,562 164,758,000

 Data Request and Publications User Fees..................... --- --- 1,500,000

Unobligated balance start of year....................................... 3,579,000 175,000 ---

Unobligated balance end of year........................................ 801,000 699,785 714,442

Unobligated balance expiring.............................................. --- --- ---

Total obligations................................................................... $3,481,066,000 $3,630,259,347 $3,739,181,442
42

Summary of Changes

(Dollars in Thousands)

2012

$ 3,347,019,540 

 3,347,019,540

2014

 3,347,951,097

 3,347,951,097

+$931,557

FY 2014 

President's 

Budget

FY 2014 

President's 

Budget

FY 2014 

+/- 

FY 2012

FY 2014 

+/- 

FY 2012

FTE BA FTE BA 

Increases:

 A. Built-in:

1. Annualization of Personnel Costs .................................. --- 74,729 --- +684

2. Annualized Civilian Pay Increase................................................... --- 74,729 --- +668

3. Annualized Commission Corp Pay Increase................................................... --- 74,729 --- +85

4. One additional compensable day................................................. --- 74,729 --- +293

Subtotal, Built-in Increases................................................ --- 74,729 --- +1,730

A. Program:

1. Mental Health PRNS........................................................... --- 333,277 --- +62,611

2. Children's Mental Health Services......................................... --- 117,315 --- ---

3. Substance Abuse Block Grant.............................................. --- 1,748,132 --- +27,000

4. Agency-wide Initiatives........................................................ --- 54,395 --- +45,195

Subtotal, Program Increases.............................................. --- 2,253,119 --- +134,807

Total Increases................................................................ --- 2,327,848 --- +136,537

Decreases:

A. Built-in:

1. ........................................................................................... --- --- --- ---

2. ........................................................................................... --- --- --- ---

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

A. Program:

1. Substance Abuse Prevention PRNS...................................... --- 175,560 --- -10,325

2. Substance Abuse Treatment PRNS...................................... --- 304,794 --- -92,903

3. Health Surveillance and Program Support.............................. --- 74,729 --- -4,161

4. Program Support.................................................................. --- --- --- -1,730

5. Public Awareness and Support............................................. --- --- --- -13,545

6. Performance and Quality Information Systems...................... --- --- --- -12,940

Subtotal, Program Decreases............................................. --- 555,083 --- -135,604

Total Decreases............................................................... --- --- --- -135,604

Net Change.................................................................... --- $2,327,848 --- $932

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

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

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

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

(Obligations)........................................................................................................................................
43

Budget Authority by Activity

(Dollars in Thousands)

FY 2012 FY 2013 FY 2014 FY 2014

Actual Annualized 

CR 1/

President's 

Budget

+/- 

FY 2012

1. Mental Health: 

Programs of Regional and National Significance.................. $315,666 $272,323 $361,277 +$45,611

Project AWARE (non-add) 2/........................................ --- --- 55,000 +55,000

Healthy Transitions (non-add) 2/.................................. --- --- 25,000 +25,000

Prevention and Public Health Fund (non-add)............. 45,000 N/A 28,000 -17,000

Children's Mental Health Services...................................... 117,315 118,300 117,315 ---

Projects for Assistance in Transition from Homelessness..... 64,794 65,191 64,794 ---

Protection and Advocacy for Individuals with Mental Illness. 36,238 36,460 36,238 ---

Community Mental Health Services Block Grant................. 459,756 462,570 459,756 ---

PHS Evaluation Funds (non-add)................................. 21,039 21,168 21,039 ---

Total, Mental Health ..................................................... 993,770 954,844 1,039,380 +45,610

2. Substance Abuse Prevention: 

Programs of Regional and National Significance.................. 185,885 187,076 175,560 -10,325

Total, Substance Abuse Prevention............................... 185,885 187,076 175,560 -10,325

3. Substance Abuse Treatment: 

Programs of Regional and National Significance.................. 428,697 402,751 334,794 -93,903

Prevention and Public Health Fund (non-add)............. 29,000 N/A 30,000 +1,000

PHS Evaluation Funds (non-add)................................. 2,000 2,012 --- -2,000

Substance Abuse Prevention and Treatment Block Grant..... 1,800,332 1,811,350 1,819,856 +19,524

PHS Evaluation Funds (non-add)................................. 79,200 79,685 71,724 -7,476

Total, Substance Abuse Treatment................................ 2,229,029 2,214,101 2,154,650 -74,379

4. Health Surveillance and Program Support:

Health Surveillance............................................................ 124,318 106,968 120,157 -4,161

Prevention and Public Health Fund (non-add)............. 18,000 N/A --- -18,000

PHS Evaluation Funds (non-add)................................. 27,428 27,596 45,428 +18,000

Public Awareness and Support........................................... 13,545 13,628 13,571 +26

PHS Evaluation Funds (non-add)................................. --- --- 13,571 +13,571

Performance and Quality Information Systems.................... 12,940 13,051 12,996 +55,587

PHS Evaluation Funds (non-add)................................. --- --- 12,996 +12,996

Agency-Wide Initiatives..................................................... 9,200 9,256 54,395 +45,195

Workforce (non-add) 2/................................................ --- --- 50,000 +50,000

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

Total, Health Surveillance/Program Support................. 160,003 142,903 202,619 +42,616

TOTAL, SAMHSA Discretionary PL............................ 3,568,687 3,498,924 3,572,209 +3,523

Less PHS Evaluation Funds............................................ 129,667 130,461 164,758 +35,091

Less Prevention and Public Health Funds....................... 92,000 N/A 58,000 -34,000

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

TOTAL, SAMHSA Budget Authority........................... $3,347,020 $3,368,463 $3,347,951 +$932

FTEs 590 631 655 +65

2/ A total of $130 million is requested to address the behavioral health needs of transition age youth and their 

families in the wake of the Newtown, Connecticut tragedy at Sandy Hook Elementary School.

Program Activities

1/ The FY 2013 Prevention Fund resources are reflected in the Office of the Secretary.
44

Authorizing Legislation

FY 2012 

Amount 

Authorized FY 2012 Actual

FY 2014 

Amount 

Authorized

FY 2014 

President's 

Budget

NASPER

Sec. 399O.............................................. Expired $0 Expired $0

Grants for the Benefit of Homeless

 Individuals

Sec. 506................................................ Expired $41,571,281 Expired $41,571,000

Residential Treatment Programs for

 Pregnant and Postpartum Women

Sec. 508................................................ Expired $15,969,760 Expired $15,970,000

Priority Substance Abuse Treatment Needs

 of Regional and National Significance

Sec. 509*.............................................. Expired $309,535,762 Expired $217,575,000

Substance Abuse Treatment Services 

 for Children and Adolescents

Sec. 514*...................................................Expired $30,620,019 Expired $29,678,000

Priority Substance Abuse Prevention

 Needs of Regional and National

 Significance

Sec. 516*.............................................................. Expired $169,095,712 Expired $168,560,080

Programs to Reduce Underage Drinking

Sec. 519B*............................................... Expired $ 6,986,770 Expired $ 7,000,000

Centers of Excellence on Services for

 Individuals with FAS and Alcohol-related

 Birth Defects and Treatment for

 Individuals with Such Conditions and

 Their Families

Sec. 519D*..................................................... Expired $9,802,438 Expired 0

Prevention of Methamphetamine and

 Inhalant Abuse and Addiction

Sec. 519E*.............................................. Expired 0 Expired 0

Priority Mental Health Needs of Regional and

 National Significance

Sec. 520A*...................................................Expired $155,530,492 Expired $220,531,318

National Centers of Excellence for Depression

Sec. 520B...................................................Expired 0 0 0

Youth Interagency Research, Training,

 and Technical Assistance Centers

Sec. 520C*................................................. Expired $4,947,631 Expired $4,947,631

Suicide Prevention for Children and Youth

Sec. 520E1*.................................................... Expired $29,681,795 Expired $29,681,795

Sec. 520E2*............................................. Expired $4,965,597 Expired $4,965,597

Grants for Jail Diversion Programs

Sec. 520G*.......................................... Expired $6,671,367 Expired $4,281,000

SSAN = Such Sums as Necessary
45

Authorizing Legislation

FY 2012 

Amount 

Authorized FY 2012 Actual

FY 2014 

Amount 

Authorized

FY 2014 

President's 

Budget

Awards for Co-locating Primary and Specialty Care

 in Community-based Mental Health Settings

Sec. 520K............................................. SSAN 0 SSAN 0

PATH Grants to States

Sec. 535(a)............................................. Expired $64,794,307 Expired $64,794,000

Community Mental Health Services for

 Children with Serious Emotional Disturbances

Sec. 565 (f).......................................... Expired $117,314,524 Expired $117,314,524

Children and Violence Program

Sec. 581*.................................................. Expired $23,156,152 Expired $23,156,152

Grants for Persons who Experience Violence

 Related Stress

Sec. 582 **........................................... Expired $45,713,438 Expired $45,714,000

Community Mental Health Services

 Block Grants

Sec. 1920(a)......................................... Expired $438,717,254 Expired $438,717,000

Substance Abuse Prevention and Treatment

 Block Grants

Sec. 1935(a)......................................................Expired $1,721,131,901 Expired $1,748,132,000

Other Legislation/Program Description

Protection and Advocacy for Individuals

 with Mental Illness Act

P.L. 99-319, Sec. 117......................................Expired $36,238,380 Expired $36,238,000

Health Surveillance and Program Support

 Program Management, Sec. 501.......................... Indefinite $77,787,971 Indefinite $71,569,000

 SEH Workers' Compensation Fund

P.L. 98-621............................................ Indefinite $1,160,000 Indefinite $1,160,000

Total, Program Management...................... 0 $76,889,616 0 $72,729,000

Heath Surveillance...................... Indefinite $2,000,000 Indefinite $2,000,000

Public Awareness and Suppport (FY12)...................... Indefinite $13,545,351 Indefinite 0

PQIS(FY12)...................... Indefinite $12,940,413 Indefinite 0

Agency-Wide Initiatives...................... 0 $9,199,580 0 $54,395,000

Indian Health Care Improvement Reauthorization 

and Extension Act of 2009

Substance Abuse and Mental Health 

Services Administration Grants

Sec. 724 ...................................... SSAN 0 SSAN 0

Indian Youth Life Skills Development

Demonstration Program

Sec. 726...................................... $1,000,000 0 $1,000,000 0

TOTAL, SAMHSA Budget Authority.......................................... $1,000,000 $3,347,019,540 0 $3,347,951,097

SSAN = Such Sums as Necessary

* Denotes programs that were authorized in the Children's Health Act of 2000. We have the authority to carryout Denotes programs that were authorized in the Children's Health Act of 2000. We have the authority to carryout

these programs in our general authorities in Section 507, 516 and 520A.
46

Appropriation History
47

Appropriation History

Budget Estimate 

to Congress House Allowance Senate Allowance Appropriation

FY 2010

General Fund Appropriation:

Base................................................. $ 3,393,882,000 $ 3,429,782,000 $3,419,438,000 $ 3,431,116,000 7/

P.L. 111-117

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

FY 2011

General Fund Appropriation:

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

P.L. 112-10

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

FY 2012

General Fund Appropriation:

Base................................................. $ 3,386,903,000 $ 3,096,914,000 $ 3,354,637,000 $3,347,020,000 8/

P.L. 112-74

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

FY 2013

General Fund Appropriation:

Base................................................. $ 3,151,508,000 $ - $ 3,472,213,000 $ 3,368,463,000 9/

S.R. 112-176

Subtotal............................................ $ 3,151,508,000 $ - $ 3,472,213,000 $ 3,368,463,000

FY 2014

General Fund Appropriation:

Base................................................. $ 3,347,951,097 

Subtotal............................................ $ 3,347,951,097 
48

Appropriations Not Authorized by Law

Program

Last Year of 

Authorization

Authorization 

Level

Appropriations 

in Last Year of 

Authorization

Appropriations 

in FY 2014

Grants for the Benefit of Homeless Individuals 

Sec. 506.................................................................. 2003 $ 50,000,000 $ 16,700,000 $ 41,571,000

Residential Treatment Programs for

 Pregnant and Postpartum Women

Sec. 508.................................................................. 2003 SSAN $0 $ 15,970,000

Priority Substance Abuse Treatment Needs

 of Regional and National Significance

Sec. 509*................................................................ 2003 $ 300,000,000 $ 322,994,000 $ 217,575,000

Substance Abuse Treatment Services 

 for Children and Adolescents

Sec. 514*................................................................ 2003 $ 40,000,000 $ 20,000,000 $ 29,678,000

Priority Substance Abuse Prevention

 Needs of Regional and National Significance

Sec. 516*................................................................ 2003 $ 300,000,000 $ 138,399,000 $ 167,560,080

Centers of Excellence on Services for Individuals with FAS

 and Alcohol-related Birth Defects and Treatment for

 Individuals with Such Conditions and Their Families

Sec. 519D*.............................................................. 2003 $ 5,000,000 $ 2,416,000 $ 1,000,000

Priority Mental Health Needs of Regional and

 National Significance

Sec. 520A*.............................................................. 2003 $ 300,000,000 $ 94,289,000 $ 220,531,318

Youth Interagency Research, Training,

 and Technical Assistance Centers

Sec. 520C*.............................................................. 2007 $ 5,000,000 $ 3,960,000 $ 4,947,631

Suicide Prevention for Children and Youth

Sec. 520E (GLS - State Grants)................................ 2007 $ 30,000,000 $ 17,829,000 $ 29,681,795

Sec. 520E2 (GLS-Campus Grants)............................ 2007 $ 5,000,000 $ 4,950,000 $ 4,965,597

Grants for Jail Diversion Programs

Sec. 520G*.............................................................. 2003 $ 10,000,000 $ 6,043,000 $ 4,281,000

PATH Grants to States

Sec. 535(a).............................................................. 2003 $ 75,000,000 $ 46,855,000 $ 64,794,000

Community Mental Health Services for

 Children with Serious Emotional Disturbances

Sec. 565 (f)............................................................. 2003 $ 100,000,000 $ 96,694,000 $ 117,314,524

Children and Violence Program

Sec. 581*................................................................ 2003 $ 100,000,000 $ 83,035,000 $ 23,156,152

Grants for Persons who Experience Violence Related Stress

Sec. 582 *.............................................................. 2003 $ 50,000,000 $ 20,000,000 $ 45,714,000

Community Mental Health Services Block Grants

Sec. 1920(a)............................................................ 2003 $ 450,000,000 $ 433,000,000 $ 438,717,000

Substance Abuse Prevention and Treatment Block Grants

Sec. 1935(a)............................................................ 2003 $ 2,000,000,000 $ 1,785,000,000 $ 1,748,132,000

Other Legislation/Program Description

Protection and Advocacy for Individuals with Mental Illness Act

P.L. 99-319, Sec. 117............................................... 2003 $ 19,500,000 $ 32,500,000 $ 36,238,000

TOTAL, SAMHSA Budget Authority.................. $ 4,222,500,000 $ 3,142,664,000 $ 3,211,827,097

**Congress authorized two provisions as section 514.

*Denotes programs that were authorized in the Children's Health Act of 2000. SAMHSA has the authority to carryout 

these programs in our general authorities in Section 507, 516 and 520A. 
49

SAMHSA

Mental Health

Table of Contents

SAMHSA/Mental Health Page

1) SAMHSA/Programs of Regional and National Significance.................................................51

a) Seclusion & Restraint ....................................................................................................52

b) Youth Violence Prevention............................................................................................52

c) National Child Traumatic Stress Initiative .....................................................................53

d) Children and Family Programs ......................................................................................56

e) Consumer & Family Network Programs .......................................................................56

f) Project LAUNCH ..........................................................................................................58

g) Mental Health System Transformation and Health Reform ............................................58

h) Primary & Behavioral Health Care Integration (PBHCI)................................................59

i) Suicide Prevention.........................................................................................................60

i) National Suicide Prevention Lifeline........................................................................60

ii) GLS Youth Suicide Prevention ................................................................................61

iii) Suicide Prevention Resource Center.........................................................................62

iv) AI/AN Suicide Prevention .......................................................................................63

j) Homelessness Prevention and Housing Program............................................................63

k) Minority AIDS ..............................................................................................................64

l) Criminal and Juvenile Justice Programs.........................................................................65

m) Practice Improvement/Training......................................................................................66

n) Consumer and Consumer-Supporter TA Centers............................................................67

o) Disaster Response..........................................................................................................68

p) PRNS Mechanism Table by APT...................................................................................78

q) PRNS Mechanism Table by SLOA..............................................................................274

2) Children‟s Mental Health Services.....................................................................................87

3) Projects for Assistance in Transition from Homelessness ...................................................93

4) Protection and Advocacy for Individuals with Mental Illness .............................................99

5) Community Mental Health Services Block Grant .............................................................105
50

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51

SAMHSA/Programs of Regional and National Significance

Mental Health Services

(Dollars in thousands)

FY 2012 FY 2013 FY 2014 FY 2014 

FY 2013

Programs of Regional & National Significance

Actual Annualized 

CR

President's 

Budget

+/- 

FY 2012

CAPACITY

Seclusion and Restraint.................................................... $2,444 $2,459 $1,149 -$1,295

Youth Violence Prevention............................................... 23,156 23,298 23,156 ---

Project AWARE............................................................. --- --- 55,000 +55,000

Project AWARE State Grants (non-add)...................... --- --- 40,000 +40,000

Mental Health First Aid (non-add).............................. --- --- 15,000 +15,000

Healthy Transitions.......................................................... --- --- 25,000 +25,000

National Child Traumatic Stress Initiative.......................... 45,713 45,993 45,714 +1

Children and Family Programs.......................................... 6,474 6,513 6,474 ---

Consumer and Family Network Grants.............................. 6,224 6,262 4,966 -1,258

Project LAUNCH .......................................................... 34,640 34,852 34,640 ---

MH System Transformation and Health Reform................ 10,603 10,668 10,603 ---

Primary and Behavioral Health Care Integration................ 65,749 30,937 26,004 -39,744

Prevention & Public Health Fund (non-add).......... 35,000 N/A 26,004 -8,996

Suicide Prevention........................................................... 58,045 48,339 50,045 -8,000

National Strategy for Suicide Prevention (non-add)... --- --- 2,000 +2,000

Suicide Lifeline (non-add)........................................... 6,373 5,545 5,512 -862

Prevention & Public Health Fund (non-add).......... 862 N/A --- -862

GLS- Youth Suicide Prevention - States (non-add)...... 34,002 29,863 29,682 -4,320

Prevention & Public Health Fund (non-add).......... 4,320 N/A --- -4,320

GLS- Youth Suicide Prevention - Campus (non-add)... 9,134 4,996 4,966 -4,168

Prevention & Public Health Fund (non-add).......... 4,168 N/A --- -4,168

GLS - Suicide Prevention Resource Center (non-add). 5,598 4,978 4,948 -650

Prevention & Public Health Fund (non-add).......... 650 N/A --- -650

AI/AN Suicide Prevention Initiative (non-add)............. 2,938 2,956 2,938 ---

Homelessness Prevention Programs.................................. 30,772 30,960 30,772 ---

Minority AIDS................................................................. 9,265 9,322 22,770 +13,505

Grants for Adult Trauma Screening & Brief Intervention.... --- --- 2,896 +2,896

Criminal and Juvenile Justice Programs............................. 6,671 6,712 4,281 -2,390

Subtotal, Capacity 299,758 256,317 343,470 +43,712
52

FY 2012 FY 2013 FY 2014 FY 2014 

FY 2013

Programs of Regional & National Significance

Actual Annualized 

CR

President's 

Budget

+/- 

FY 2012

SCIENCE AND SERVICE

Practice Improvement Training......................................... 7,863 7,911 7,863 ---

Consumer and Consumer Supporter Technical Assistance 

Centers........................................................................... 1,923 1,935 1,923 ---

Primary and Behavioral Health Care Integration TTA........ 1,996 2,008 1,996 ---

Prevention & Public Health Fund (non-add).............. --- N/A 1,996 +1,996

Disaster Response........................................................... 1,052 1,058 2,950 +1,898

Homelessness.................................................................. 2,302 2,316 2,302 ---

HIV/AIDS Education....................................................... 773 777 773 ---

Subtotal, Science and Service 15,909 16,006 17,807 +1,898

TOTAL, PRNS1/ 2/ $315,666 $272,323 $361,277 +$45,611

1/ The PRNS FY 2012 total includes $35.0 million for the PBHCI program and $10 million for the Garrett Lee 

Smith (GLS) Suicide Prevention and the Suicide Lifeline programs funded by the Prevention and Public Health 

Fund. The FY 2013 Prevention Fund resources are reflected in the Office of the Secretary. The FY 2014 total 

includes $28.0 million for PBHCI funded by the Prevention and Public Health Fund. 

2/ The Minority Fellowship Program budget is now reflected in the Health Surveillance and Program Support 

Authorizing Legislation........................... Sections 501, 506, 520A, 520C, 520E, 520E (2), 520G, 

520K, 516, 581, and 582 of the Public Health Service Act

FY 2014 Authorization:

520K of the Public Health Service Act ................................................... Such Sums as Necessary

All others......................................................................................................................... Expired

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

Program Description and Accomplishments

Seclusion & Restraint

People die as a result of seclusion and restraint practices, countless others are injured, and many 

are secondarily traumatized by coercive practices. Children with emotional and behavioral 

problems are more frequently subjected to restraints in schools than students with other 

disabilities, often leading to serious physical injuries and emotional trauma for the students and 

the staff. Coercive practices such as seclusion and restraint impede recovery and well-being. 

Trauma-informed approaches to care have been developed and implemented to reduce the 

traumatizing impact of service settings and to reduce or eliminate the use of coercive practices. 

This program area supports states/tribes and communities in their efforts to implement best 

practices to reduce and ultimately eliminate the use of restraints and seclusion in institutional-
53

and community-based settings that provide services for individuals with mental and co-occurring 

substance use disorders. While this initiative includes a focus on the mental health delivery 

system, it also includes other service sectors such as criminal justice, schools, and child welfare

that are likely to use coercive practices with people with mental and co-occurring substance use 

disorders. SAMHSA‟s vision for this initiative is to facilitate the implementation of evidencebased strategies for preventing and reducing the use of seclusion and restraint and implementing 

trauma-informed care, an approach that mitigates the use and harmful effects of coercive 

practices. 

Population surveys and clinical studies have documented the association between experiences of 

trauma and mental health and substance use disorders. Accordingly, investments have been made 

in the development and dissemination of effective trauma-specific treatments. Studies of trauma 

survivors, behavioral health consumers, and practitioners in behavioral health settings have 

similarly documented the manner in which many service settings can be secondarily traumatizing 

for the people seeking services and interfere with positive treatment outcomes.

In FY 2010, SAMHSA awarded a three-year contract to establish the National Technical 

Assistance Center: Promoting Alternatives to Seclusion and Restraint Through Trauma-Informed 

Practices. The purpose of this center is to disseminate, train, and implement programs supported 

by available evidence to provide trauma-informed care with the goal of reducing and, ultimately, 

preventing the use of seclusion, restraint, and other traumatizing practices in service systems and 

treatment agencies that serve children, youth, and adults with mental disorders and/or cooccurring substance use disorders. Recipients of the training are publicly funded systems, 

organizations and service delivery personnel who intersect with people who have mental 

illnesses. This contract also supports SAMHSA‟s efforts in developing a standard definition and 

measures of individual and community trauma and develop criteria and measures for traumainformed care that can be used with a range of health and human service programs.

Recent evidence of the effectiveness of this training includes reduced use of seclusion and 

restraint in facilities where the training has taken place as well as reduced incidents of violence 

where these trauma-informed strategies have been employed. In FY 2012, SAMHSA awarded 

the final year of this contract. 

In FY 2013, SAMHSA plans to award a new contract to support the continuation of these 

activities and a training institute, and further refine the criteria for implementing and evaluating a 

trauma-informed approach in multiple service sectors towards the prevention, reduction, and 

elimination of coercive practices. 

Youth Violence Prevention

Youth violence remains a public health problem in the United States. In a 2009 nationwide 

survey, approximately 32 percent of high school students reported being in a physical fight in the 

12 months before the survey. Close to six percent of high school students in 2009 reported 

taking a gun, knife, or club to school in the 30 days before the survey. An estimated 20 percent

of high school students reported being bullied on school property in 2009. 
54

The Safe Schools/Healthy Students (SS/HS) Initiative is a discretionary grant program that seeks 

to create healthy learning environments which help students thrive, succeed in school, and build 

healthy relationships. Since 1999, this program has been jointly administered by SAMHSA, the 

Department of Education (ED), and the Department of Justice (DOJ). The SS/HS initiative 

implements an enhanced, coordinated, and comprehensive plan of activities, programs, and 

services that promote healthy childhood development, prevent violence, and prevent alcohol and 

drug abuse. Grantees are required to develop local strategic plans that address five required 

elements across the three sectors: (1) safe school environments and violence prevention 

activities; (2) alcohol, tobacco, and other drug prevention activities; (3) student behavioral, 

social, and emotional supports; (4) mental health services; and, (5) early childhood social and 

emotional learning programs. Grantees have developed organizational, informational, and 

programmatic systems that bring together many diverse sectors of the community, creating the 

capacity for comprehensive system reform so all agencies concerned with the welfare of children 

and families could collaborate on an ongoing basis. As a result of the SS/HS initiative 

implemented in local educational authorities (LEAs), more than 90 percent of school staff saw 

reduced violence on school grounds and almost 80 percent reported that SS/HS had reduced 

violence in their communities. Children and adolescents participating in the SS/HS grant 

program experienced a 47.1 percent increase in access to school-based mental health service, 

29.7 percent increase in access to community-based mental health services, and a 29.8 percent

increase in receipt of community-based mental health services. Nearly 90 percent of school staff 

stated that they were better able to detect mental health problems in their students and more than 

80 percent of school staff reported that they saw reductions in alcohol and other drug use among 

their students. 

In FY 2012, SAMHSA supported existing SS/HS grants in collaboration with ED. SAMHSA 

utilized the funding in FY 2012 to realign technical assistance activities to meet the needs of 

grantees and the field, and to evaluate the performance of the existing program. SAMHSA 

transferred $2.2 million to ED to help finance technical assistance to improve the school climate 

for learning; including, but not limited to, bullying prevention. In addition, SAMHSA awarded 

3

rd, 4th, and final year funding for 21 Implementing Evidence-Based Prevention Practices in 

Schools grants which will come to an end in FY 2014.

In FY 2013, SAMHSA will award eight new 4-year grants, which build on the investments in the 

SS/HS Initiative through state and community level partnerships among educational, behavioral 

health, and criminal justice systems that promote systems integration and policy change and 

sustainable policies, infrastructure, services, and supports. The SS/HS State Planning and 

Community Pilot Program is intended to create safe and supportive schools and communities. 

National Child Traumatic Stress Initiative

Established in 2000, the purpose of the National Child Traumatic Stress Initiative (NCTSI) is to 

improve behavioral health treatment, services, and interventions for children and adolescents 

exposed to traumatic events. The NCTSI has provided funding for a national network of 

grantees known as the National Child Traumatic Stress Network (NCTSN) to develop and 

promote effective community practices for children and adolescents exposed to a wide array of 
55

traumatic events. The NCTSN has grown from a collaborative Network of 17 to over 165 funded 

and affiliate centers located nationwide in university, hospital, and diverse community-based 

organizations, with thousands of national and local partners. The NCTSN mission is to raise the 

standard of care and improve access to services for traumatized children, their families, and 

communities. Coordinated by the National Center for Child Traumatic Stress (NCCTS), Network 

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

of governmental and non-governmental organizations. The Network offers training, support, and 

resources to providers who work with children and families exposed to a wide range of traumatic 

experiences, including physical and sexual abuse; domestic, school, and community violence; 

natural disasters, terrorism, or military family challenges; and life-threatening injury and illness.

The NCTSN provides training and technical support on intervention approaches to reduce the 

mental, emotional, and behavioral effects of traumatic events on children/adolescents and their 

families. By working with established systems of care including public health, mental health, 

education, law enforcement, child welfare, juvenile justice, and military family service systems, 

the NCTSN ensures that there is a comprehensive trauma-informed continuum of accessible 

care. It also raises public awareness of the scope and serious impact of child traumatic stress on 

the safety and healthy development of America's children and youth as well as advances a broad 

range of effective services and interventions by creating trauma-informed developmentally and 

culturally appropriate programs that improve the standard of care. Finally, the NCTSN fosters a 

community dedicated to collaboration within and beyond the network to ensure that widely 

shared knowledge and skills become a sustainable national resource.

The NCTSN is composed of three types of centers: 

The National Center for Child Traumatic Stress (Category I) develops and maintains the 

collaborative network structure, supports resource development and dissemination, and 

coordinates the Network‟s national child trauma education and training efforts. It 

promotes further product development, learning collaborations, and system change 

efforts in systems across the country.

The Treatment and Service Adaptation (TSA) Centers - (Category II) provide national 

expertise and assume responsibility in the Network for specific areas of trauma, such as 

specific types of traumatic events, population groups, and service systems; and support 

the development and adaptation of effective trauma treatments and services for children, 

adolescents and their families that can be implemented throughout the nation. The TSAs 

are comprised of nationally-recognized experts in child and adolescent trauma who have 

developed evidence-based interventions to treat children who have experienced a range 

of traumas including neglect, physical abuse, sexual abuse, medical trauma, school 

violence, war, refugee status, and disasters

The Community Treatment and Services (CTS) Centers - (Category III) are primarily 

community service providers across multiple child-serving systems service programs that 

implement and evaluate effective treatment and services in community settings and youth 

serving service systems and collaborate with other NCTSN centers on clinical issues, 

service approaches, policy, financing, and training issues. 
56

The program has provided over 25,000 trainings and/or education in assessment and treatment of 

traumatic stress to over 1.1 million people including mental health professionals, primary care 

providers, and other professionals in child-serving systems, consumers, and members of the 

public. The Network has developed resources for child/adolescent trauma on the NCTSN 

website, which receives more than 2,000 visits a day and houses over 150 Network-developed 

resources downloaded more than 50,000 times a year. More than 121,310 people were trained in 

2012 in annual training/education events. In FY 2012, 76.1 percent of children receiving 

trauma-informed services reported positive functioning at six-month follow-up. The 

unduplicated count of the number of children and adolescents receiving trauma-informed 

services at 2,367 was improved in FY 2012. 

In FY 2012, SAMHSA awarded a new cohort of NCTSI 78 grants, (1 Category I, 21 Category II 

and 56 Category III) with an increased focus on effective implementation and dissemination 

strategies for maximizing the uptake of trauma interventions, enhanced learning networks, and 

strong linking of child trauma in the child welfare and juvenile justice systems. In FY 2013, the 

NCTSI will build on the robust work of the NCTSN and improve and enhance the capacity of the 

NCTSI to deliver effective interventions and core practices developed by the NCTSN to children 

and youth in need. 

Children and Family Programs

The Children and Family Programs provide support for the State/Community Partnerships to 

Integrate Services and Supports for Youth and Young Adults 16-25 with Serious Mental Health 

Conditions and their Families and Circles of Care grant programs. These two programs provide

services and support to children and youth with and at risk for mental health conditions and their 

families. The State/Community Partnerships to Integrate Services and Supports for Youth and 

Young Adults 16-25 with Serious Mental Health Conditions And Their Families program was 

funded in 2009 as a five-year pilot program that promotes a system of care approach which 

facilitates seamless transitions to independence and the successful adaptation of adult roles and 

responsibilities for youth and young adults with serious mental health conditions and their 

families. Young people with serious mental health conditions (often with co-occurring substance 

use disorders) face a difficult transition to adulthood compared to their peers. Moreover, youth 

who age out of child-serving systems may have difficulty obtaining developmentally appropriate, 

culturally-competent, and appealing support services as they move into adulthood. By creating 

supportive state-level policies and making available evidence-based, age-appropriate services 

and supports, these at-risk youth are better able to navigate the transition to adulthood.

Initially funded in 1998, the Circles of Care Program is a three year program that promotes the 

elimination of mental health disparities by providing tribal and Alaskan Native communities with 

tools and resources to build their own culturally competent systems of care model for children‟s 

mental health. The program also increases capacity and community readiness to address the 

mental health issues of children and families. 
57

In FY 2012, SAMHSA provided continuation support for seven Circles of Care grants and seven 

State/Community Partnerships to Integrate Services and Supports for Youth and Young Adults 

16-25 with Serious Mental Health Conditions and their Families grants. 

In FY 2013, SAMHSA plans to award final year funding for the seven Circles of Care and seven

State/Community Partnerships to Integrate Services and Supports for Youth and Young Adults 

16-25 with Serious Mental Health Conditions and their Families grants.

Consumer & Family Network Programs

The Consumer and Family Network Programs supports SAMHSA‟s Recovery Support Strategic 

Initiative by promoting consumer, family, and youth participation in the development of policies, 

programs, and quality assurance activities related to mental health systems reform across 

America. 

The Statewide Consumer Network Program focuses on the needs of adult mental health 

consumers 18-years and older by strengthening the capacities of state-wide consumer-run 

organizations to be catalysts for transforming the mental health and related systems in their 

states. It establishes sustainable mechanisms for integrating the consumer voice in state mental 

health and allied systems to (1) expand service system capacity, (2) support policy and program 

development, and (3) enhance peer support. This program promotes skill development with an 

emphasis on leadership and business management as well as coalition/partnership-building and 

economic empowerment as part of the recovery process for consumers. In FY 2011, SAMHSA 

funded 31 Statewide Consumer Network continuation grants for four years. 

In FY 2012, SAMHSA awarded 11 new Statewide Consumer Network grants and the final year 

of 19 grants. In addition, SAMHSA awarded the 4

th year of a 5-year technical assistance 

contract. 

In FY 2013, SAMHSA anticipates awarding 15 new grants to support emphasis on integrated 

care and assist in planning for implementation of health reform and provide continuation funding 

to 11 grants and a technical assistance contract.

The Statewide Family Network Program is a three year program that provides education and 

training to increase family organizations‟ capacity for policy and service development by 1) 

strengthening organizational relationships and business management skills, 2) fostering 

leadership skills among families of children and adolescents with serious emotional disturbances,

and 3) identifying and addressing the technical assistance needs of children and adolescents with 

serious emotional disturbances and their families. The Statewide Family Network Program 

focuses on families: parents; the primary caregivers of children; youth; and young adults. In this 

case, 'young adults' refers to individuals generally up to age 18, up to age 21 if they have an 

Individual Education Plan, or up to age 26 if they are transitioning to the adult mental health 

system.
58

In FY 2012, SAMHSA awarded six new Statewide Family Network grants and continuation 

funding of 37 grants. In addition, SAMHSA continued funding of a technical assistance contract. 

In FY 2013, SAMHSA anticipates awarding 29 new grants to support emphasis on integrated 

care and assist in planning for implementation of health reform and provide continuation funding 

for six grants and a technical assistance contract.

Project LAUNCH

In FY 2008, Congress provided initial funding to implement the Project LAUNCH Wellness 

Initiative. Project LAUNCH implements evidence-based practices that promote and enhance the 

wellness of young children by increasing grantees‟ capacities to develop infrastructure and 

implement prevention/promotion strategies necessary to promote wellness for young children. 

Project LAUNCH focuses on children from birth through age eight. The goal of Project 

LAUNCH is to create a shared vision for the wellness of young children that drives the 

development of federal, state, territorial, tribal and local networks for the coordination of key 

child-serving systems and the integration of behavioral and physical health services.

In FY 2011, the most recent data available, 78,944 children and parents have been screened and 

assessed in diverse settings and over 14,021 families have been served in Project LAUNCHsupported home visiting and family strengthening programs. Over 24,500 community providers 

have been trained on social-emotional and behavioral health for young children. Mental health 

consultation has been provided to 3,876 child care and education staff, as well as 2,337 primary 

care providers. Project LAUNCH data also indicates that nearly 5,778 organizations are 

collaborating, coordinating, and sharing resources to implement prevention/promotion strategies 

for young children.

In FY 2012, SAMHSA continued to support continuation grants and contracts and awarded

grants to a new cohort of Project LAUNCH grantees. In FY 2013, SAMHSA plans to support 

Project LAUNCH continuations and contracts.

Mental Health System Transformation and Health Reform

SAMHSA assists in the implementation of the Affordable Care Act by supporting activities that 

facilitate the transformation of the mental health delivery system. These efforts include the 

Mental Health Transformation (MHT) and the Behavioral Health Treatment Court Collaborative

(BHTCC) grant programs. In FY 2010, SAMHSA awarded 20 MHT grants for five years to 

promote the adoption and implementation of permanent transformative changes in how 

communities manage and deliver mental health services. Grantees are currently implementing 

evidence-based or best practices that will create or expand capacity to address prevention of 

mental illness, trauma-informed care, screening, treatment, and support services for military 

personnel, and housing and employment support. Necessary changes to policies and 

organizational structures to support improved mental health services will also be supported along 

with workforce training, implementation of evidence-based practices, and improving access to 
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quality mental health services. In FY 2011, SAMHSA awarded 11 BHTCC grants for three 

years.

The purpose of the BHTCC program is to help state and local courts offer treatment and recovery 

support instead of incarceration for individuals who are in a court system due to mental or 

substance use disorders and to provide more flexibility within the criminal justice system to work 

with other authorities and service providers to better address behavioral health needs of 

detainees, inmates and parolees. SAMHSA's vision of a BHTCC in the justice system is one that 

encourages treatment and recovery support for individuals involved in the criminal justice 

system with mental and substance abuse disorders and also improves public health and public 

safety by facilitating the transformation of the behavioral health/criminal justice system at the 

community level. The court system can direct an individual into the appropriate forum, whether 

it is - Drug Court, Veterans Court, Mental Health Court, Family Court, or another combined 

specialty court approach. This will be done as is appropriate for the individual and the services 

with which the court(s) coordinate to provide treatment and services for individuals engaged in 

the criminal justice system.

In FY 2012 SAMHSA funded continuations for the MHT and the BHTCC grants and an 

evaluation contract.

In FY 2013, SAMHSA plans to fund continuations for the MHT and BHTCC grants and the 

evaluation contract for the BHTTC program.

Primary & Behavioral Health Care Integration (PBHCI)

SAMHSA provided funding for the Primary & Behavioral Health Care Integration (PBHCI) 

program beginning in FY 2009 to address the increased rates of morbidity and mortality among 

adults with serious mental illness (SMI). These rates are due, in large part, to elevated incidence 

and prevalence of cardiovascular disease, obesity, diabetes, hypertension, and dyslipidemia. 

Increased morbidity and mortality can be attributed to a number of other issues, too, including 

inadequate physical activity and poor nutrition, smoking, side effects from atypical antipsychotic 

medications, and lack of access to primary health care services. Many of these health conditions 

are preventable through routine health promotion activities, primary care screening, monitoring, 

treatment, and care management/coordination strategies and/or other outreach programs at home 

or community sites. Physical health problems among people with SMI impact quality of life and 

contribute to premature death. While several factors contribute to this disparity, empirical 

findings indicate that early mortality among people with SMI is clearly linked to the lack of 

access to primary care services.

The PBHCI program is comprised of competitive cooperative agreements and the PBHCI 

Training and Technical Assistance (TTA) Center which is co-funded with HRSA. The program 

supports the coordination and integration of primary care services into publicly-funded 

community behavioral health settings. This program is also a part of SAMHSA‟s Health Reform 

Strategic Initiative. The expected outcome of improved health status for people with SMI will be 

achieved by encouraging grantees to engage in necessary partnerships, expand infrastructure, and 
60

increase the availability of primary health care and wellness services to individuals with mental 

illness. Partnerships between primary care and behavioral health organizations, as well as 

information technology entities, are deemed crucial to the success of this program. The 

population of focus for this grant program is individuals with SMI and/or people with cooccurring disorders served by the public mental health system. Recipients are non-profit mental 

health provider agencies that will use these grant funds to develop and offer primary care as well 

as behavioral health services in an integrated manner.

In FY 2011, $35.0 million was allocated from the Prevention Fund (PPHF) for PBHCI to 

promote more integrated services between primary care services and mental health services. 

These funds were used to facilitate screening and referral for necessary primary care prevention 

and treatment needs. SAMHSA funded eight new multi-year funded PBHCI grants and 34 

continuation grants with PPHF and 22 grant and 1 contract continuations with Budget Authority.

In FY 2012, SAMHSA supported 56 existing grants and multi-year funded 20 new grants and 10 

annually funded grants awarded from both SAMHSA Budget Authority and Prevention Fund

($30.5M - BA and $35M - PPHF) as well as $1.9 million for the PBHCI Training and Technical 

Assistance (TTA) Center. SAMHSA plans to continue the program in FY 2013. SAMHSA has 

awarded 94 PBHCI grants to date.

Because the program is new, evaluation results are not yet complete. Over 23,000 consumers 

were served in FY 2012, an increase of 94.4 percent over FY 2011. Improvements in all four 

National Outcome Measures were consistently positive as a result of this intervention, with 

individual measure ratings improving an average of 13 percent. Of particular importance were 

the increases in measures of functioning and education/employment, demonstrating that the 

program supports health and productivity. 

Suicide Prevention Programs

National Suicide Prevention Lifeline

The National Suicide Prevention Lifeline, 1-800-273-TALK, launched in FY 2005, coordinates a 

network of 160 crisis centers across the United States by providing suicide prevention and crisis 

intervention services to individuals seeking help at any time, day or night. The Lifeline routes 

calls from anywhere in the country to a network of certified local crisis centers that can then link 

callers to local emergency, mental health, and social services resources, averaging nearly 73,000 

answered calls per month during FY 2012. National Suicide Prevention Lifeline crisis centers 

across the nation are responding to people in suicidal crises. At the same time, these centers are 

threatened with significant cutbacks in funding from state and local governments and other 

sources of support. 

Since FY 2007, SAMHSA has partnered with the Department of Veterans Affairs (VA) to 

provide and ensure 24/7 access to the Veterans‟ suicide prevention hotline. In FY 2012, more 

than 17,500 callers per month have accessed the Veterans crisis line. The National Suicide 
61

Prevention Lifeline is also responding to calls from active duty military and their families. 

SAMHSA is in the process of developing a suicide hotline outcome measure to determine the 

number of people who contacted the Lifeline who believe the call prevented them from taking 

their lives. This new data collection will help inform SAMHSA and HHS on the vital impact the 

Lifeline is having across the nation.

In addition, in FY 2012, SAMHSA awarded a new Suicide Lifeline grant and provided 

continuation support for 12 National Suicide Prevention Lifeline Crisis Center grants to provide 

follow up to suicidal callers. Evaluation and research findings indicated that in the immediate 

aftermath of suicidal crises, there is a period of heightened risk for suicide, but in this time there 

is a great potential for suicide prevention. Preliminary data from this program indicated that 

when asked by an independent evaluator, “To what extent did the counselor‟s calling you stop 

you from killing yourself?” more than 50 percent of those receiving follow-up phone contact 

indicated the call played a significant role in keeping them alive. 

The National Suicide Prevention Lifeline uses evaluation results to document and improve 

program effectiveness. Evaluation results have been used to develop standards for suicide risk 

assessment, guidelines for callers at imminent risk for suicide, and follow up protocols for 

suicidal callers. In turn, these quality and performance improvement efforts have been evaluated 

and found to have positive impacts. Some of these outcomes have included decreases in suicidal 

ideation and hopelessness among callers, increased frequency of performing suicide risk 

assessments by crisis counselors, increased follow up of suicidal callers by crisis centers, and 

suicidal callers reporting such calls played a significant role in keeping them alive. 

In FY 2013, SAMHSA will support the continuation of the Suicide Lifeline grant and grants to 

crisis centers. In addition, six new crisis center grants will be awarded, which will include a 

focus on providing follow up to suicidal people discharged from emergency rooms and inpatient 

units. This focus is based on current evaluation and research findings. 

The National Suicide Prevention Lifeline uses evaluation results to document and improve 

program effectiveness. Evaluation results have been used to develop standards for suicide risk 

assessment, guidelines for callers at imminent risk for suicide, and follow up protocols for 

suicidal callers. In turn, these quality and performance improvement efforts have been evaluated 

and found to have positive impacts. Some of these outcomes have included decreases in suicidal 

ideation and hopelessness among callers, increased frequency of performing suicide risk 

assessments by crisis counselors, increased follow up of suicidal callers by crisis centers, and 

suicidal callers reporting such calls played a significant role in keeping them alive. To see one 

aspect of this outreach effort in action, visit https://www.facebook.com/800273TALK.

GLS Youth Suicide Prevention

The Garrett Lee Smith (GLS) Memorial Act authorizes SAMHSA to manage two significant 

youth suicide prevention programs and one resource center. The GLS State/Tribal Youth 

Suicide Prevention and Early Intervention Grant Program currently supports a total of 61 

grantees which includes four multi-year funded grants in FY 2011, three multi-year funded 

grants in FY 2012, and 54 annually funded grants, 26 states, 28 tribes or tribal organizations, and 

the District of Columbia in developing and implementing youth suicide prevention and early 
62

intervention strategies involving public-private collaborations among youth serving institutions. 

The GLS Campus Suicide Prevention program currently provides funding to 60 institutions of 

higher education, inclusive of tribal colleges and universities, which includes 5 multi-year 

funded grants in FY 2011, 15 multi-year funded grants and 40 annually funded grants in FY

2012, to prevent suicide and suicide attempts. 

In FY 2012, through Budget Authority, SAMHSA provided support for 34 GLS state/tribal 

continuation grants and awarded 20 new grants. In addition, SAMHSA supported 16 GLS 

campus continuation grants and awarded 24 new grants. 

In FY 2012, SAMHSA also received $10.0 million in Prevention Funds, which supported the 

GLS grants, the National Suicide Prevention Lifeline, and the Suicide Prevention Resource 

Center. Three grants were multi-year funded for the GLS state/tribal grantees and 15 grants were 

multi-year funded for the campus grantees.

According to the evaluation of the GLS suicide prevention programs, more than 500,000 

individuals have been trained in suicide prevention since FY 2005, with most of this training 

focused on recognizing the warning signs of suicide and actions to take in response. In addition 

367,950 trained in the state/Tribal program and 194,904 trained in the Campus Suicide 

Prevention program. Significant numbers of those trained used what they had learned to 

intervene with people at risk. 

In FY 2013, SAMHSA anticipates funding the continuation of existing state/tribal and campus 

grantees. 

Suicide Prevention Resource Center

In addition to programs that build suicide prevention capacity, SAMHSA also supports the 

Suicide Prevention Resource Center (SPRC). This program promotes the implementation of the 

National Strategy for Suicide Prevention and enhances the nation‟s mental health infrastructure 

by providing states, tribes, government agencies, private organizations, colleges and universities, 

and suicide survivor and mental health consumer groups with access to the science and 

experience that can support their efforts to develop programs, implement interventions, and 

promote policies to prevent suicide. The SPRC also advances youth suicide prevention efforts in 

states, territories, tribes, and campuses as authorized through the Garrett Lee Smith (GLS) 

Memorial Act. 

Through the SPRC, SAMHSA continues to provide support for the National Action Alliance for 

Suicide Prevention (NAASP), a public-private partnership to implement the National Strategy 

for Suicide Prevention and reduce suicide in America. The NAASP was launched on September 

10, 2010, by HHS Secretary Kathleen Sebelius and the former Secretary of Defense, Robert 

Gates.

In FY 2011, SAMHSA received $10.0 million in Prevention Funds, from which SAMHSA 

funded one supplement to the SPRC of $0.7 million to expand and enhance the level of support 

provided to the NAASP. This supplement expanded future organizational development, 
63

partnerships, and collaborations to support the implementation of the Surgeon General‟s National 

Strategy for Suicide Prevention.

In FY 2012, SAMHSA utilized Prevention Funds for the SPRC to help support implementation 

of high impact objectives identified by the National Strategy for Suicide Prevention and the 

NAASP and to develop, based on the experience of GLS grantees, a strategic framework to 

embed sustainable, comprehensive, coordinated youth suicide prevention activities in states, 

tribes, and colleges across the nation. 

In FY 2013, SAMHSA anticipates funding the continuation of the SPRC grant with a reduced 

level of support for the NAASP as it transitions to alternate sources of funding.

AI/AN Suicide Prevention

SAMHSA supports an innovative training and technical assistance project that helps tribal 

communities mobilize existing social and educational resources by facilitating the development 

and implementation of comprehensive and collaborative community based prevention plans to 

reduce violence, bullying, and suicide among American Indian/Alaska Native (AI/AN) youth. 

To date, 65 tribal communities have been provided specialized technical assistance and support 

in suicide prevention and related topic areas. In addition, over 9,200 community members were 

trained in prevention and mental health promotion in these communities. 

In FY 2012, SAMHSA continued to support the existing AI/AN Suicide Prevention training and 

technical assistance efforts including evaluation efforts.

In FY 2013, SAMHSA‟s CMHS AI/AN Suicide Prevention and CSAP‟s NACE programs will 

collaborate through braided funding to provide comprehensive, broad, focused, and/or intensive 

training and technical assistance to federally-recognized tribes and other American Indian/Alaska 

Native communities, seeking to address and prevent mental and substance use disorders, suicide, 

and promote mental health. Any braided amounts spent or awarded will be tracked as distinct 

funding streams and will only be used for purposes consistent with legislative direction and 

intent.

Homelessness Prevention and Housing Program

One of the goals of SAMHSA‟s Strategic Initiative on Recovery Support is to ensure that 

permanent housing and supportive services are available for individuals with mental and 

substance use disorders. Two programs are helping to support the goal of this Strategic 

Initiative. They include Services in Supportive Housing (SSH) and Grants for the Benefit of

Homeless Individuals (GBHI) which are supported by both CSAT and CMHS. 

Studies indicate that Permanent Supportive Housing (PSH) is effective in helping single adults

(target population) maintain stability in housing. Performance data for the CMHS Services in 

Supportive Housing (SSH) program demonstrate increases in individual‟s perception of their 

overall functioning. Program participants report a decrease in serious psychological distress, use 
64

of tobacco products, binge drinking and criminal justice system involvement as well as an 

increased retention in stable housing.

The first program, SSH, was implemented in 2007 and is in its sixth year of funding grants to 

help end chronic homelessness. The SSH program provides comprehensive services that focus 

on outreach, engagement, intensive case management, mental health services, substance abuse 

treatment, benefits support, and linkage to permanent housing. The population of focus is 

individuals with serious mental illness and/or a co-occurring mental and substance use disorder 

and their families who have been continuously homeless for at least one year or have had at least 

four episodes of homelessness in the past three years. At the start of FY 2013, the SSH 

program‟s outreach efforts resulted in 9,611 total contacts made. In FY 2012, SAMHSA

provided support for 51 SSH grants. In FY 2013, SAMHSA plans to provide support for 48 

grants.

The second program, GBHI, awarded the Cooperative Agreements to Benefit Homeless 

Individuals (CABHI) in FY 2011 by CSAT in collaboration with CMHS. The major goal of the 

program is to ensure that the most vulnerable individuals who experience chronic homelessness 

receive access to sustainable permanent housing, treatment, and recovery supports through grant 

funds and mainstream funding sources. This program builds on the success of the previous 

SAMHSA SSH and CSAT‟s Treatment for Homeless programs. As of FY 2012, there are 31 

funded grants that have served 1,630 people with notable evidence of reduced experiences of 

depression and anxiety (60.7 percent and 64.3 percent respectively). 

In FY 2013, CMHS will continue to jointly fund 31 CABHI grants with CSAT. In addition, 

SAMHSA plans to fund another cohort of the CABHI program, which will provide grants to 

states with the highest prevalence of individuals who are chronically homeless. The program will 

help states and communities enhance their infrastructure for providing treatment and services for 

individuals with mental and substance use disorders who need supportive services to sustain 

housing and support recovery. 

Minority AIDS

The purpose of the Minority AIDS program is to enhance and expand the provision of effective, 

culturally-competent HIV/AIDS-related mental health services in minority communities for 

people living with HIV/AIDS and who have a need for mental health services. The Centers for 

Disease Control and Prevention (CDC) reports significantly higher rates of HIV/AIDS among 

people of color. African Americans accounted for 44 percent and Hispanics accounted for 20 

percent of all HIV/AIDS cases diagnosed in 2009, per the most recent data available (CDC, 

2011). The 2009 data also shows a significant increase of 48 percent in HIV incidence among 

African American Men who have Sex with Men (MSM) aged 13-29, even as overall rates 

remained stable. Reasons for this increase are not fully known, although the high HIV 

prevalence rate in African American MSM and factors such as prejudice and discrimination; in 

addition, CMHS uses social inclusion (in the promotion of) and social exclusion (in trying to 

end) of HIV and homosexuality, limited healthcare access, and poverty may create an enabling 

environment for HIV (CDC 2011). Psychiatric and psychosocial complications are frequently
65

not diagnosed or addressed either at the time of diagnosis or through the course of the HIV/AIDS 

disease process. When untreated, these complications are associated with increased morbidity 

and mortality, impaired quality of life, and numerous medical and/or behavioral challenges, such 

as non-adherence with the treatment regimen. Over 2,200 individuals received services in FY 

2011 and almost 1,000 received services in FY 2012. The Mental Health Care Provider 

Education in HIV/AID Education program disseminates knowledge and training on the treatment 

of the neuropsychiatric and psychological sequelae of HIV/AIDS. The program provides 

training to front line providers, including psychiatrists, psychologists, social workers, primary 

care practitioners and medical students.

In FY 2012, SAMHSA collaborated with CDC to provide support for 11 continuation grants for 

the Minority AIDS Initiative Targeted Capacity Expansion: Integrated Behavioral 

Health/Primary Care Network Cooperative Agreements with funding provided by CMHS, 

CSAT, and CSAP. This grant program facilitates the development and expansion of culturally 

competent and effective integrated behavioral health and primary care networks, which include 

HIV services, medical treatment, and the expansion of behavioral health services within racial 

and ethnic minority communities in 11 Metropolitan Statistical Areas and Metropolitan 

Divisions most impacted by HIV/AIDS. Recipients are state and city health departments from 

the 12 cities most impacted by HIV/AIDS. The grant fosters development of a network of care 

for those with behavioral health conditions who are at risk for or who have HIV/AIDS. 

In FY 2013, SAMHSA plans to provide funding for the continuation of 11 grants as well as 

evaluation and technical assistance contracts.

Criminal and Juvenile Justice Programs

Studies of people involved in the criminal justice system have found higher rates of co-occurring 

psychiatric and substance use disorders than the general population.1The number of individuals

involved in the criminal justice system with mental or substance use disorders whose treatment 

needs are not being met by community treatment and supportive services is significant. As a 

result, they are at greater risk for parole or probation failure leading to re-incarceration at 

substantial additional governmental and societal cost. There is an ongoing need for broader 

implementation of effective treatment and reentry services for this high-risk, mostly nonviolent 

population. 

Over the past 30 years, the criminal justice system has become a repository for a large number of 

individuals with SMI who are arrested for a wide range of crimes.2Since 2002, SAMHSA has 

administered the Jail Diversion Program for adults involved in the criminal justice system and 

has awarded grants to 48 states and communities. The purpose of this initiative is to divert 

individuals with mental illness from the criminal justice system to more appropriate, communitybased treatment and recovery support services including primary health care, housing, and job 

counseling/placement. 

 

1

Serious Mental Illness and Arrest, Swartz and Lurigio, 2007

2

Id.
66

In FY 2012, SAMHSA provided continuation support for three cohorts of 13 grants and related 

contracts. 

In FY 2013 SAMHSA will fund the continuation of seven grants and the evaluation and 

technical assistance contracts. In FY 2013, SAMHSA will fund another cohort of the Jail 

Diversion Program. This three-year grant program will emphasize on early diversion of 

individuals with behavioral health conditions at risk of being arrested. Early diversion will focus 

on the role of law enforcement working collaboratively with community behavioral health 

providers to prevent arrest and adjudication. Police will divert these individuals to behavioral 

health providers in the community who will assess their needs and coordinate a comprehensive 

plan of treatment and supports. 

Performance data demonstrate that the program has had a positive impact on the welfare of 

participants with significant increases in housing stability and employment and with major 

reductions in arrests and incarcerations. 

Practice Improvement/Training

SAMHSA addresses the need for disseminating key information, such as evidence-based mental 

health practices, to the mental health delivery system and facilitates health reform by engaging in 

activities that support mental health system transformation and reform. These activities include 

Historically Black Colleges and Universities (HBCU) – Center of Excellence and Peer Review 

activities, Research and Training Centers, Recovery into Practice, and Education for Social 

Inclusion.

The purpose of the HBCU-Center of Excellence is to network the 103 HBCUs in the United 

States and promote workforce development through expanding knowledge of best practices, 

developing leadership, and encouraging community partnerships that enhance the participation 

of African Americans in the substance abuse treatment and mental health professions. The 

comprehensive focus of the HBCU–Center for Excellence will simultaneously expand service 

capacity on campuses and in other treatment venues. 

There is one grant awarded for the HBCU-Center for Excellence. In FY 2012 SAMHSA 

provided continuation support to the grantee for the coordination and monitoring of 34 substance 

abuse treatment workforce development and mental health sub-award projects. Funding will be 

continued in FY 2013. 

The Rehabilitation Research and Training Centers (RRTCs) are funded in partnership with the 

U.S. Department of Education‟s National Institute of Disability, Rehabilitation and Research. 

The RTCs develop, test, and disseminate a broad range of care models and practices that 

promote and support recovery for adults with mental illnesses and support resilience and 

recovery among youth and young adults with serious mental health challenges. This program 

was first established in 1979. Currently there are four RRTCs funded for up to five years. 
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Program outcomes include the development of new treatments and interventions, trainings, 

workforce development, and new products.

Recovery into Practice is a five-year contract, funded in FY 2009, which supports the expansion 

and integration of recovery-oriented care delivered by mental health providers which will be 

accomplished through training and education, policy and analysis, and materials development. 

The effort collaborates amongst professional mental health disciplines to provide education and 

training on what recovery-oriented care is and how to implement it into practice, meet with 

stakeholders, establish collaborative relations with provider and consumer leaders, and conduct 

research and literature reviews on the current state of recovery-oriented care, knowledge, and 

attitudes. In FY 2013, CMHS will fund the continuation of this contract.

Education for Social Inclusion is a five-year contract, funded in FY 2009, which promotes social 

inclusion, opportunities for full community participation and integration, broad public 

acceptance, and recovery and wellness through evidence-based tools for education, awareness, 

technical assistance, engagement, and support. In FY 2013, CMHS will fund the continuation of 

this contract.

In FY 2012, as part of its wellness activities, SAMHSA collaborated with the CDC on its Million 

Hearts Initiative by focusing on the increased risk for cardiovascular disease, hypertension, and 

diabetes for individuals with and at risk for mental and substance use disorders. 

Consumer and Consumer-Supporter TA Centers

The Consumer and Consumer-Supporter TA Centers is a grant program that was first funded in 

1992. The purpose of Consumer and Consumer-Supported TA Centers is to provide technical 

assistance to facilitate the restructuring of the mental health system by promoting consumer 

directed approaches for adults with serious mental illnesses. Such programs maximize consumer 

self-determination and recovery and assist individuals with serious mental illness by decreasing 

their dependence on expensive social services and avoiding psychiatric hospitalization. This 

program also improves collaboration among consumers, families, advocates, providers, and 

administrators and facilitates community mental health services to be more consumer-driven and 

family-focused. 

This program also supports the annual Alternatives Conference, which provides a forum for 

consumers nationwide to meet, exchange information and lessons learned, and receive technical 

assistance on a variety of topics, such as peer support, consumer-operated services, self-help, 

protection and advocacy issues, empowerment, and recovery. The information and knowledge 

gained through attending this conference enables consumers to advocate for effective individual 

treatments and services, as well as for broader managed care and service system improvements.

Performance data indicate that the program has been effective. In the past fiscal year, over 

50,000 persons were trained and more than 11,500 consumers and family members have become 

involved in mental health-related planning and advocacy. 
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In FY 2010, SAMHSA awarded grants to five organizations for a five-year period. In FY 2011 

and FY 2012 SAMHSA provided support to the five continuation grants and plans to continue 

this support in FY 2013. 

Disaster Response

Over the last 39 years, SAMHSA, in partnership with the Federal Emergency Management 

Agency FEMA has been providing Disaster Behavioral Health Response and Recovery efforts 

through the FEMA Crisis Counseling Assistance and Training Program (CCP). 

The mission of CCP is to assist individuals and communities in recovering from challenging 

effects of natural and human-caused disasters through the provision of community-based 

outreach and psycho-educational services. The CCP supports short-term interventions that 

involve the counseling goals of assisting disaster survivors in understanding their current 

situation and reactions, mitigating stress, assisting survivors in reviewing their disaster recovery 

options, promoting the use or development of coping strategies, providing emotional support, 

and encouraging linkages with other individuals and agencies who may help survivors in their 

recovery process. 

The CCP is administered through an interagency agreement with FEMA. On behalf of FEMA, 

CMHS provides technical assistance, program guidance and monitoring, as well as oversight of 

the CCP. States, U.S. territories and federally recognized tribes are eligible to apply for CCP 

grants under the Stafford Act, with a designation for Individual Assistance in the affected areas, 

following a Presidential disaster declaration.

SAMHSA and FEMA jointly fund a Disaster Technical Assistance Center (DTAC) that provides 

technical assistance, strategic planning, consultation, and logistical support. Through these 

services, it helps states establish state-of-the-art behavioral health readiness and response 

capacity through “all hazards” disaster planning to respond readily to catastrophic events and 

emergencies such as those resulting from bioterrorism, mass violence, natural disaster, and other 

traumatic incidents. SAMHSA DTAC provides consultation to review disaster plans and 

compiles research on new threats and how best to plan for them. Services include a wide range of 

technical assistance activities and products to advance state and local capacity to deliver 

effective behavioral health services that are well integrated with traditional public health and 

disaster recovery efforts. 

The SAMHSA‟s Disaster Distress Helpline (DDH) is the first national hotline dedicated to 

providing year-round disaster crisis counseling. This toll-free, multilingual crisis support service 

is available 24/7 via telephone (1-800-985-5990) and SMS (text „TalkWithUs‟ to 66746) to 

residents in the United States and its territories who are experiencing emotional distress related 

to natural or man-made disasters. In FY 2012, DDH received 1,483 calls and 1,528 text 

messages. Four Core Region Centers implemented trainings for 200 paid staff, interns and 

volunteers. The helpline established relationships with over 300 local, state and national disaster 

relief stakeholders. A website was created (disasterdistress.samhsa.gov) with social media pages 

that continue to grow, offering information and resources on healthy coping. The website has 
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received 2000+ visits post-Hurricane Isaac (August 2012) while the Helpline itself received over 

2,600 calls.

SAMHSA and the nation are aware that when disasters strike, the role of behavioral health in 

recovery is immense. In 2013, SAMHSA received 10 million in supplemental funds to assist the 

survivors of Hurricane Sandy recover. Efforts focused on providing for behavioral health 

treatment that could be funded no other way, restoring the capability of medication assisted 

substance abuse treatment services in the impacted areas, ensuring the operation of the DDH, 

conducting resiliency training with educators, and ensuring crisis counseling services wherever 

Sandy survivors relocated. No additional funding is requested for 2014. 

Funding History1\

Fiscal Year Amount

FY 2010 $356,038,000

FY 2011 $83,998,000

FY 2012 $315,666,472

FY 2013 $272,322,951

FY 2014 $361,277,493

1\

The funding history is presented on a comparable basis to previous funding levels to represent the 

revised budget structure and includes the PHS Evaluation Funds and Prevention Funds other than in FY 

2013. The FY 2013 Prevention Fund resources are reflected in the Office of the Secretary.

Budget Request 

The FY 2014 Budget Request is comprised of $361.3 million at the program level with $333.3

million from Budget Authority (BA) and $28.0 million provided by Prevention Fund. This is an

increase of $45.6 million from the FY 2012 funding level. This level of funding enables the 

continuation of most programmatic activities. The request will support 279 grant and 18 contract 

continuations, as well as 206 new grants and 27 new contracts.

Project AWARE

In an effort to support the Administration‟s response to the tragedy at Sandy Hook Elementary 

School, $55 million is requested to support Project AWARE, (Advancing Wellness and 

Resilience in Education) to increase awareness of mental health issues and connect young people 

with behavioral health issues and their families with needed services. SAMHSA will partner 

with the Departments of Education and Justice in the development, implementation and 

management of this initiative to maximize coordination and avoid duplication of efforts. 

Project AWARE proposes two components: Project AWARE State Grants ($40.0 million) build

on the Safe Schools/Healthy Students State Planning and Community Pilot Program which is 
70

intended to create safe and supportive schools and communities. For more than a decade, the 

Safe Schools/Healthy Students Initiative has successfully decreased violence and increased the 

number of students receiving mental health services. Project AWARE grants will be braided 

with funds from Education and Justice to support 20 grants to State Education Authorities 

(SEAs) that will promote a comprehensive, coordinated and integrated program with the goal of 

making schools safer and increasing access to mental health services. The SEAs will be required 

to partner with the State Mental Health and Law Enforcement agencies to establish Interagency 

State Management Teams, conduct environmental needs assessments, develop a state plan with 

an evaluation mechanism, and develop the mechanisms to coordinate funding, service delivery, 

systems improvement, and data collection. In addition, each SEA will be required to identify 

three high-need Local Education Authorities (LEAs) as pilot communities that will receive subawards to implement comprehensive and coordinated school safety and mental health programs. 

SAMHSA expects that these 20 State grants will promote data driven models in 60 LEAs 

(reaching 1000-1500 schools).

The second component, Mental Health First Aid (MHFA) ($15.0 million) proposes widespread 

dissemination of the Mental Health First Aid curriculum and supports training to reach 750,000 

students to identify mental illness early and refer them to treatment. MHFA prepares teachers 

and other individuals who work with youth to help schools and communities to understand, 

recognize, and respond to signs of mental illness or substance abuse in children and youth, 

including how to talk to adolescents and families experiencing these problems so they are more 

willing to seek treatment. The Budget proposes that $10.0 million of the Project AWARE –

MHFA funds will be braided with Education and Justice funds to support competitive grants to 

LEAs with the goal of making schools safer and providing mental health literacy training. An 

Interagency Supervisory Team (IST) will work together to provide oversight and guidance to 

both the state and local initiatives. The additional $5.0 million proposed for MHFA will be 

braided with the 20 SEA grants to support MHFA training in the 20 SEAs and 60 LEAs subgrantees implementing Project AWARE. 

Healthy Transitions

The FY 2014 Budget includes $25.0 million for a new Healthy Transitions Program, to assist 16 

to 25 year-olds with mental illnesses and their families to access and navigate behavioral health 

treatment systems. Compared with their peers, young adults, aged 18-25 with mental health 

conditions are more likely to experience homelessness, be arrested, drop out of school and be 

underemployed. Compared to all other chronic health conditions, mental disorders produce the 

greatest disability burden within this age group. Furthermore, 18-25 year-olds with mental 

health conditions are significantly less likely to receive mental health services than other adults. 

This new demonstration grant program for states proposes innovative approaches to provide

support for transition-age youth with mental health and/or co-occurring substance abuse 

disorders and their families. States will take steps to expand services for these young 

individuals, develop family and youth networks for information sharing and peer support, and

disseminate best practices for services to youth ages 16-25. The $25.0 million would support 5-

year grants to 19 states.
71

Statewide Network Development Program for Recovery and Resiliency

In FY 2014, SAMHSA requests a total of approximately $1.8 million in Budget Authority ($0.4 

million in CMHS and $1.4 million in CSAT) in support of SAMHSA‟s Recovery Support 

Strategic Initiative. These funds will be used to build capacity for statewide consumer-run, 

family member-run, or addiction recovery community organizations to promote cross-service 

system and infrastructure development that is recovery-focused and resiliency oriented. $1.0 

million in budget authority will be used to award new addiction recovery community statewide 

networks. The remaining $0.8 million will be braided to allow for supplemental awards for 

collaborative partnerships across the mental and substance use disorder fields. Any braided 

amounts spent or awarded will be tracked as distinct funding streams and will only be used for 

purposes consistent with legislative direction and intent. Eligible applicants for supplements will 

be those organizations who have an existing mental health or addiction statewide network 

award. Up to 10 grant awards at $100,000 will be made for addiction recovery statewide 

networks. Eight supplemental awards will be given at $100,000 each.

Grantees will be expected to facilitate effective participation in state and local behavioral health 

services planning and health reform activities related to improving community-based services 

and supports for people in recovery from substance use disorders, children and youth with 

serious mental health conditions and their families or adult mental health consumers. The 

program will also address gaps in behavioral health policy as well as inform health reform 

planning. In order to ensure a stronger policy voice across the behavioral health field and 

facilitate readiness for the implementation of health reform, a supplemental incentive award will 

be offered to applicants proposing to build a collaborative partnership between mental health and 

addictions peer-run state-wide networks and those that are mental health family-run.

Additionally, partnerships with affiliate health networks will be encouraged.

Behavioral Health Treatment Court Collaboratives

In support of SAMHSA‟s Recovery Support Strategic Initiative, SAMHSA proposes to use a 

total of $4.5 million in Budget Authority ($2.3 million in CMHS and $2.2 million in CSAT) to 

fund an additional cohort of Behavioral Health Treatment Court Collaboratives Grants. The 

purpose of this grant program is to allow local courts more flexibility to collaborate with 

multiple criminal justice system components and local community treatment and recovery 

providers to address the behavioral health needs of adults who are involved with the criminal 

justice system. The court collaborative will focus on diversion of adults with behavioral health 

problems from the criminal justice system, including alternatives to incarceration. The 

collaborative will allow eligible individuals to receive treatment and recovery support services as 

part of a court collaborative. This program will focus on connecting with individuals early in 

their involvement with the criminal justice system and prioritize the participation of municipal 

and misdemeanor courts in the collaborative. The program will support community behavioral 

health services for individuals with mental and/or substance disorders and will include a focus on 

veterans involved with the criminal justice system. 
72

Transforming Lives through Supported Employment Grant Program

In support of SAMHSA‟s Recovery Support Strategic Initiative, SAMHSA proposes to use a 

total of approximately $5.0 million in Budget Authority to establish the Transforming Lives 

through Supported Employment Grant Program. Based on learning from previous Mental Health 

Transformation grant cohorts, SAMHSA will use a total of $5 million of Mental Health Systems 

Transformation and Health Reform funds and Practice Improvement and Training funds to focus 

the program on an existing activity: enhancing state and community capacity to provide 

evidence-based supported employment programs for adults and youth with serious mental 

illnesses/emotional disturbances. This strengthening of an existing program activity is consistent 

with SAMHSA‟s four pillars of Recovery (Health, Home, Purpose, and Community). In 

addition, Supported Employment was one of five allowable activities in earlier Transformation 

grants and has demonstrated excellent outcomes in helping individuals achieve and sustain 

recovery.

By having gainful employment as the target outcome and helping mental health consumers, their 

treatment providers, and their employers develop mutual understanding and successful 

relationships, Transforming Lives through Supported Employment Grants will help people with 

mental illnesses discover paths of self-sufficiency and recovery rather than disability and 

dependence. A total of up to 13 grant awards of approximately $375,000 dollars each will be 

awarded for five years.

Housing and Homelessness

SAMHSA works in partnership with the U.S. Interagency Council on Homelessness (USICH) to 

support and implement Opening Doors: The Federal Plan to Prevent and End Homelessness.

Through both the Recovery Support and Criminal Justice and Trauma Strategic Initiatives, 

SAMHSA promotes collaborative leadership with other federal agencies with collaborative calls, 

trainings, workgroups, and expert panels to address various goals and objectives outlined in the 

Plan. SAMHSA accomplishes the goals and objectives outlined in the Plan by providing 

technical assistance to grantees and other stakeholders regarding behavioral health, 

homelessness, and successful interventions to prevent and end homelessness. SAMHSA takes a 

leadership role in convening expert panels and developing a Policy Academy to address 

homelessness. SAMHSA encourages grantees to provide consumers with meaningful and 

sustainable employment opportunities and permanent housing that supports recovery to prevent 

and end homelessness. The SAMHSA Cooperative Agreements to Benefit Homeless Individuals 

(CABHI) grant program aligns with the USICH goal to improve access to mainstream programs 

and services to reduce people‟s financial vulnerability to homelessness and to provide integrated 

primary and behavioral health care services. SAMHSA along with HUD, other HHS agencies, 

and VA, will explore the possibility of developing criteria to incentivize demonstrated 

collaboration between primary and behavioral healthcare providers and homeless assistance 

providers.
73

In support of the Federal Strategic Plan to Prevent and End Homelessness and SAMHSA‟s 

Recovery Support Strategic Initiative, SAMHSA proposes to use approximately $28.6 million in 

Budget Authority in working with state and local Public Housing Authorities and state Medicaid 

agencies to develop systematic, cost-effective, and integrated approaches to housing that 

includes treatment and services for mental and substance use disorders. This program will build 

upon lessons learned from the CABHI and the Department of Housing and Urban 

Development‟s (HUD) new Section 811 demonstration program, and will be developed by 

SAMHSA in collaboration with its federal partners, including HUD, Health Resources and 

Services Administration, Centers for Medicare and Medicaid Services, and the Interagency 

Council on Homelessness. The program will specifically focus on providing support services and 

housing to individuals who are chronically homeless.

The program will support innovative strategies to transform and increase the availability of 

affordable housing and to provide needed services and supports that will help integrate 

individuals who are homeless with substance abuse and mental health disorders into the 

community, assist providers in strengthening their infrastructure for delivering and sustaining 

housing to support recovery with integrated behavioral health, and other critical services. The 

program also will assist providers in preparing for implementation of the Affordable Care Act by 

encouraging third-party billing and requiring that clients are enrolled in eligible benefit 

programs. Efforts will include the design and implementation of strategies that require the use of 

SAMHSA funds for providing supportive services to individuals who are not Medicaid-eligible 

(or who in the process of being enrolled), Medicaid funds for covered services, and HUD 

vouchers or other funding sources for housing. SAMHSA‟s FY 2014 request for housing and 

homelessness includes a total of $28.6 million ($18.8 million in CMHS and $9.9 million in 

CSAT). A total of up to 38 grant awards of approximately $750,000 dollars each will be awarded 

for five years. 

National Strategy for Suicide Prevention

SAMHSA supports the goals and objectives of the National Strategy for Suicide Prevention 

(NSSP) though several programmatic activities. The SAMHSA Suicide Prevention Resource 

Center provides support to the joint effort between the Office of the Surgeon General and the 

National Action Alliance for Suicide Prevention which has revised the NSSP to serve as the 

nation's blueprint for reducing suicide over the next decade. The SAMHSA supported Suicide 

Prevention Lifeline facilitates key NSSP objectives related to crisis intervention, follow up of 

high risk suicidal individuals, post discharge continuity of care, and the use of social networking 

to reach those at risk. Through the SAMHSA Garrett Lee Smith Suicide Prevention grant 

programs, states, tribes, and colleges are supported in implementing NSSP goals related to 

suicide prevention education and training as well as comprehensive, community-based 

approaches to youth suicide prevention.

In 2008, suicide became the tenth leading cause of death in the U.S. and remained so in 2009, the 

most recent year for which there is available mortality data. Previously, suicide had been the 

eleventh leading cause of death. In 2010, SAMHSA‟s National Survey on Drug Use and Health 

reported that over 1.1 million Americans over the age of 18 attempt suicide annually and over 8 

million seriously consider it. Research, however, has shown that implementing comprehensive 
74

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. These 

comprehensive approaches also need to focus on reducing suicide since in 2009 more than 70 

percent of the suicides in the U.S. took place among adults between ages 25-64.

While youths have the highest rates of suicide attempts, middle aged adults have the highest 

number of deaths by suicide nationwide, and older adults have the highest rates of death by 

suicide. The nation‟s suicide prevention efforts must go beyond youth and address the issues of 

suicide thoughts, plans, attempts, and deaths among adults. The NSSP addresses all age groups 

and specific populations with specific needs (e.g. military families, LGBT youth, Native 

American youth). The various aspects of the NSSP must be implemented to accomplish the goal 

of turning around the annual growth in deaths by suicide, and actually reducing that number 

significantly over the next few years. SAMHSA‟s role as both a payer and a director of 

standards of care throughout much of the nation‟s health care delivery system is key to this 

effort. 

Consequently, and consistent with SAMHSA‟s Prevention of Substance Abuse and Mental 

Illness Strategic Initiative, $2.0 million is requested to assist states in further establishing 

evidence based suicide prevention efforts that support the goals and objectives of the NSSP. The 

requested $2.0 million will directly support the recommendations of the NSSP and allow for the 

implementation of elements of the NSSP that are not currently being addressed in any other 

national initiative. This year is critical in continuing the momentum achieved during the release 

of the National Strategy. Some states will require assistance in developing these plans required 

under the block grants as well as in collaborating with Medicaid, dual eligible, and health home 

efforts. The $2.0 million will be utilized to develop and test nationwide efforts such as suicide 

awareness, provider credentialing changes, emergency room referral processes, clinical care 

practice standards, practitioner training regarding depression and suicide screening techniques, 

and technical assistance for those community human services and health workers most likely to 

encounter those who may be thinking about suicide.

Grants for Adult Trauma Screening and Brief Intervention

Consistent with the Trauma and Justice Strategic Initiative, $2.9 million is requested for a new 

program line, Grants for Adult Trauma Screening and Brief Intervention. Trauma is a 

widespread, harmful, and costly public health problem. It occurs as a result of violence, abuse, 

neglect, loss, disaster, war, and other emotionally harmful experiences. Trauma has no 

boundaries with regard to age, gender, socioeconomic status, race, ethnicity, geography, or 

sexual orientation. It is an almost universal experience of individuals receiving treatment for 

mental and substance use disorders. The need to address trauma is increasingly viewed as an 

important component of effective behavioral health service delivery. 

The effects of trauma place a heavy burden on individuals, families, and communities and create 

challenges for public institutions and service systems. Although many individuals who 

experience a traumatic event will go on with their lives without lasting negative effects, others 

will have more difficulty and experience traumatic stress reactions. Emerging research has 

documented the relationship among traumatic events, impaired neurodevelopment and immune 
75

system responses, and subsequent health risk behaviors resulting in chronic physical and 

behavioral disorders. In fact, the chronic stress that often accompanies repeated or unresolved 

trauma has even been linked to physically observable negative changes in brain development, 

including a reduction in the size of the hippocampus, the portion of the brain associated with 

long-term memory and spatial reasoning. With appropriate supports and intervention, individuals

can overcome traumatic experiences. However, most individuals go without these services and 

supports. Unaddressed trauma significantly increases the risk of mental and substance use 

disorders, chronic physical diseases, and early death.

Individuals with experiences of trauma are found in multiple service sectors, not just in 

behavioral health. Studies of individuals in the juvenile and criminal justice systems reveal high 

rates of mental and substance use disorders and personal histories of trauma. Children and 

families in the child welfare system similarly experience high rates of trauma and associated 

behavioral health problems. Preventing exposure to traumatic events and responding with early 

interventions and treatment for those experiencing traumatic stress may improve outcomes for 

these individuals and prevent prolonged involvement with the justice and child welfare systems. 

Previous research has shown that there is a strong need for a public health approach to 

addressing trauma and adverse childhood events. According to the Adverse Childhood 

Experiences Study (2008), more than one in four individuals have experienced multiple adverse 

childhood experiences (such as sexual and emotional abuse, divorce or having a parent with a 

substance use disorder), which makes them more likely to have higher rates of substance abuse, 

depression, and suicide than others. Thus, the GATSBI program will draw upon existing and 

effective screening frameworks in order to identify and intervene with adults that have 

experienced past trauma and/or adverse events.

The Grants for Adult Trauma Screening and Brief Intervention (GATSBI) program will advance 

the knowledge base to address trauma in common health care settings, such as emergency 

departments, primary care, and OB/GYN. The concept and design for these grants will be 

developed by SAMSHA in consultation with its federal partners: CDC, NIAAA, NIDA, NIMH, 

and VA. An estimated four grants will be awarded with up to $0.6 million per year for five years.

The FY 2014 Budget Request includes increases for the following (+$95.4 million):

Project AWARE: $55 million, a new request for the FY 2014 Budget. This funding will 

support Project AWARE State Grants and Mental Health First Aid. The funding will 

support 15 grants and five contracts. 

Healthy Transitions: $25 million, a new request for the FY 2014 Budget. The funding 

will support 19 new grants, and 2 new contracts.

Minority AIDS: $22.8 million, which is an increase of $13.5 million from the FY 2012 

funding level in the Mental Health appropriation, but when combined with the additional 

resources from Substance Abuse Prevention and Substance Abuse Treatment

appropriations reflects level funding SAMHSA-wide from the FY 2012 SAMHSA-wide 

funding level. The Mental Health funding will support 1 contract continuation, 20 new 

grants, and 1 new contract.
76

Disaster Response: $3.0 million, which is an increase of $1.9 million above the FY 2012 

funding level to support a nationally available disaster distress crisis counseling 

telephone line through a connection to local crisis lines throughout the country. The need 

for this initiative has been documented through the Assistant Secretary for Preparedness 

and Response after various emergency conditions throughout the world and after U.S. 

disasters that did not rise to the level of presidentially declared emergencies and therefore 

did not qualify for Stafford Act Funding. 

The FY 2014 Budget Request includes level funding, the same as FY 2012, for the following:

Children and Family Programs: $6.5 million

Youth Violence Prevention: $23.2 million

NCTSI: $45.7 million

MH State Transformation and Health Reform: $10.6 million

Project LAUNCH: $34.6 million

PBHCI Technical Assistance: $1.9 million is level funded from the FY 2012 level but is 

now requested in Prevention Funds.

AI/AN Suicide Prevention Initiative: $2.9 million

Homelessness Prevention Programs: $30.8 million

Practice Improvement and Training: $7.8 million 

Consumer and Consumer Supporter TA Centers: $1.9 million

Homelessness: $2.3 million

HIV/AIDS Education: $0.8 million

The FY 2014 Budget Request includes decreases for the following (-$54.8 million):

Seclusion and Restraint: $1.2 million, which is $1.3 million below the FY 2012 funding 

level. SAMHSA intends to integrate much of the Seclusion and Restraint strategies into 

current programs. 

Consumer and Family Network Grants: $5.0 million, which is $1.3 million below the FY 

2012 funding level. Funding will support 55 grant continuations and 5 new supplements.

Primary and Behavioral Health Care Integration: $26.0 million, which is $39.7 million 

below the FY 2012 funding level and is now requested in Prevention Funds. This level of 

funding will support 10 grant continuations and 13 new grants. 

Suicide Lifeline: $5.5 million, which is $0.9 million below the FY 2012 funding level. 

Reduction was a result of one-time activities supported the Prevention Fund in FY 2012. 

GLS-Youth Suicide Prevention-States: $29.7 million, which is $4.3 million below the FY 

2012 funding level. Reduction was a result of multi-year funding grants in FY 2012 by 

the Prevention Fund. The funding will support 20 grant continuations and 34 new grants 

and 1 new contract.

GLS-Youth Suicide Prevention-Campus: $4.9 million, which is $4.2 million below the 

FY 2012 funding level. Reduction was a result of fully funding grants in FY 2012 with 

the Prevention Fund. Funding will support 23 grants and 18 new grants.
77

GLS-Suicide Prevention Resource Center: $4.9 million, which is $0.7 million below the 

FY 2012 funding level. Reduction was a result of not renewing supplemental funds that 

were received as part of the Prevention Fund in FY 2012.

Criminal and Juvenile Justice Programs: $4.3 million, which is $2.4 million below the FY 

2012 funding level. This funding will support 1 grant and 1 contract continuation and 5

new grants.

A detailed table for all grant and contract continuations and new activities can be found in

supplementary tables.
78

SAMHSA/Mental Health

PRNS Mechanism Table by APT

(Dollars in thousands)

No. Amount No. Amount No. Amount

Programs of Regional & National Significance

Grants/Cooperative Agreements

Continuations........................................................................... 375 $140,941 428 $179,649 279 $117,690

New/Competing...................................................................... 207 116,863 84 32,472 172 107,818

Subtotal................................................................................ 582 257,803 512 212,122 451 225,508

Contracts

Continuations........................................................................... 32 49,964 30 41,156 18 40,552

New/Competing...................................................................... 10 7,899 9 19,046 20 15,217

Subtotal................................................................................ 42 57,863 39 60,201 38 55,769

Children's Mental Health Services

Grants/Cooperative Agreements

Continuations........................................................................... 47 76,720 62 75,954 56 57,695

New/Competing...................................................................... 22 19,292 26 23,583 42 42,004

Subtotal................................................................................ 69 96,012 88 99,537 98 99,700

Contracts

Continuations........................................................................... 2 9,264 1 8,296 2 10,539

New/Competing...................................................................... --- --- 1 1,500 --- ---

Subtotal................................................................................ 2 9,264 2 9,796 2 10,539

Technical Assistance.................................................................. 4 11,619 4 8,966 3 7,076

Report to Congress.................................................................... --- 420 --- --- --- ---

Projects for Assistance in Transition from Homelessness 56 64,794 56 65,191 56 64,794

Protection and Advocacy for Individuals with Mental Illness 57 36,238 57 36,460 57 36,238

Mental Health Block Grant 59 459,756 59 462,570 59 459,756

Total, Mental Health 1 / 871 $993,770 817 $954,844 764 $959,380

1/ The Prevention and Public Health Funds amount to $45.0 million in FY 2012 and $73.1 million in FY 2014. The FY 2013 

Prevention Fund resources are reflected in the Office of the Secretary. 

FY 2012 FY 2013 FY 2014

Actual Annualized CR President's 

Budget
79

Outcomes and Outputs

Program: Youth Violence Prevention

NOTE: SAMHSA grant awards are made late in the year. FY 2012 funding is reflected in FY 2013 performance targets, FY 

2014 funding is associated with FY 2015 targets.

Measure

Year and Most 

Recent Result /

Target for 

Recent Result /

(Summary of 

Result)

FY 2013 

Target

FY 2015 

Target

FY 2015

Target 

+/-

FY 2013

Target 

3.2.04 Number of children served through the 

Youth Violence Prevention program (Outcome)

FY 2012: 973,694

Target:

2,328,500

(Target Not Met)

2,328,500 979,724 -1,348,776

3.2.10 Percentage of students who receive mental

health services (Outcome)

FY 2012: 66.8%

Target:

66.0%

(Target Exceeded)

66.0% 66.0% Maintain

3.2.29 Percentage of middle and high school 

students who have been in a physical fight on 

school property (Outcome)

FY 2012: 15.9%

Target:

27.0%

(Target Exceeded)

27.0% 27.0% Maintain

3.2.30 Decrease the percentage of middle and high 

school students who report current substance abuse 

(Outcome)

FY 2012: 19.1%

Target:

20.0%

(Target Exceeded)

20.0% 20.0% Maintain

3.2.31 Number of children (ages 0-5) screened for 

mental health or related interventions (Outcome)

N/A N/A TBD

N/A

3.2.32 Number of organizations collaborating and 

sharing resources with other organizations as a 

result of the grant (Outcome)

N/A N/A TBD

N/A
80

Program: National Child Traumatic Stress Initiative (NCTSI)

NOTE: SAMHSA grant awards are made late in the year. FY 2012 funding is reflected in FY 2013 performance targets, FY 

2014 funding is associated with FY 2015 targets.

Measure

Year and Most 

Recent Result /

Target for 

Recent Result /

(Summary of 

Result)

FY 2013 

Target

FY 2015 

Target

FY 2015

Target

+/-

FY 2013

Target

3.2.02a Increase the percentage of children receiving 

trauma informed services who report positive 

functioning at 6 month follow-up (Outcome)

FY 2012: 76.1%

(Historical 

Actual)

76.1% 76.1% Maintain

3.2.23 Unduplicated count of the number of children 

and adolescents receiving trauma-informed services 

(Outcome)

FY 2012: 2,367

Target:

1,922

(Target 

Exceeded)

3,052 2,658 -394

3.2.24 Number of child-serving professionals trained 

in providing trauma-informed services (Outcome)

FY 2012: 

121,310

Target:

95,186

(Target 

Exceeded)

73,992 136,204 +62,212

3.2.33 Percentage of children receiving trauma 

informed services who demonstrated significant 

improvement in functioning (Outcome)

N/A Set 

Baseline

TBD N/A
81

Program: Project LAUNCH

NOTE: SAMHSA grant awards are made late in the year. FY 2012 funding is reflected in FY 2013 performance targets, FY 

2014 funding is associated with FY 2015 targets.

Measure

Year and Most 

Recent Result /

Target for Recent 

Result /

(Summary of 

Result)

FY 2013

Target

FY 2015 

Target

FY 2015

Target 

+/-

FY 2013

Target 

2.3.94 Number of people served (Output)

N/A Set 

Baseline

TBD

N/A

2.3.95 Number of people trained in mental illness 

prevention or mental health promotion (Outcome)

N/A Set 

Baseline

TBD

N/A

2.3.99 Percentage of youth age 12-25 who 

experiences a Major Depressive Episode in the past 

12 months (Outcome)

N/A Set 

Baseline

TBD

N/A

Program: Mental Health System Transformation Grants3

NOTE: SAMHSA grant awards are made late in the year. FY 2012 funding is reflected in FY 2013 performance targets, FY 

2014 funding is associated with FY 2015 targets.

Measure

Year and Most 

Recent Result /

Target for 

Recent Result /

(Summary of 

Result)

FY 

2013Target

FY 2015 

Target

FY 2015 

Target

+/-

FY 2013 

Target

1.2.11 Number of people in the mental health and 

related workforce trained in specific mental-health 

related practices/activities as a result of the grant 

(Outcome)

FY 2012: 

34,127

Target:

4,095

(Target 

Exceeded)

1,4884 13,647 +12,159

 

3

This program is still under development and performance measures will be added once the program is finalized. In the interim, targets for FY 

2013, FY 2014, and FY 2015 have been included and are subject to change.

4

Target has been reduced to reflect the reduced program funding.
82

Program: Suicide Prevention

NOTE: SAMHSA grant awards are made late in the year. FY 2012 funding is reflected in FY 2013 performance targets, FY 

2014 funding is associated with FY 2015 targets.

Measure

Year and Most 

Recent Result /

Target for Recent 

Result /

(Summary of 

Result)

FY 2013

Target

FY 2015 

Target

FY 2015

Target

+/-

FY 2013 

Target

2.3.59 Total number of individuals trained in 

youth suicide prevention (Outcome)

FY 2012: 103,529

Target:

35,371

(Target Exceeded)

35,371 90,270 +54,899

2.3.60 Total number of youth screened 

(Output)

FY 2012: 33,904

Target:

3,360

(Target Exceeded)

3,360 29,562 +26,202

2.3.61 Increase the number of calls answered 

by the suicide hotline (Output)

FY 2012: 884,536

Target:

555,132

(Target Exceeded)

555,132 765,638 +210,506
83

Program: Mental Health Homelessness Prevention Programs

NOTE: SAMHSA grant awards are made late in the year. FY 2012 funding is reflected in FY 2013 performance targets, FY 

2014 funding is associated with FY 2015 targets.

Measure

Year and Most 

Recent Result /

Target for 

Recent Result /

(Summary of 

Result)

FY 2013

Target

FY 2015 

Target

FY 2015 

Target 

+/-

FY 2013 

Target

3.4.01 Number of clients served (Output) FY 2012: 5,423

Target:

2,223

(Target Exceeded)

5,034 5,413 +379

3.4.02 Increase the percentage of adults receiving 

homeless support services who report positive 

functioning at 6 month follow-up (Outcome)

FY 2012: 66.7%

Target:

68.4%

(Target Not Met)

63.1% 63.1% Maintain

3.4.03 Percentage of adults receiving services who 

were currently employed at 6 month follow-up

(Outcome)

FY 2012: 23.0%

Target:

15.6%

(Target Exceeded)

15.6% 15.6% Maintain

3.4.05 Percentage of adults receiving services who had 

a permanent place to live in the community at 6 month 

follow-up (Outcome)

FY 2012: 84.3%

Target:

60.6%

(Target Exceeded)

74.2% 60.6% -13.6%

3.4.06 Percentage of adults receiving services who had

positive social support at 6 month follow-up

(Outcome)

FY 2012: 74.0%

Target:

78.0%

(Target Not Met

but Improved)

71.0% 71.0% Maintain
84

Program: Mental Health - Other Capacity Activities5

NOTE: SAMHSA grant awards are made late in the year. FY 2012 funding is reflected in FY 2013 performance targets, FY 

2014 funding is associated with FY 2015 targets.

Measure

Year and Most 

Recent Result /

Target for 

Recent Result /

(Summary of 

Result)

FY 2013

Target

FY 2015

Target

FY 2015

Target

+/-

FY 2013 

Target

1.2.05 Percentage of clients receiving services who 

report positive functioning at 6 month follow-up

(Outcome)

FY 2012: 53.4%

Target:

54.0%

(Target Not Met

but Improved)

54.0% 54.0% Maintain

1.2.82 Percentage of clients receiving services who 

had a permanent place to live in the community at 6 

month follow-up (Outcome)

FY 2012: 67.5%

Target:

67.7%

(Target Not Met)

67.7% 67.7% Maintain

1.2.83 Percentage of clients receiving services who 

are currently employed at 6 month follow-up 

(Outcome)

FY 2012: 24.3%

Target:

14.0%

(Target Exceeded)

14.0% 14.0% Maintain

1.2.88 Number of individuals screened for mental 

health or related interventions (Outcome)

FY 2012: 58,782

Target:

32,763

(Target Exceeded)

32,763 61,574 +28,811

 

5

Includes the following programs: Jail Diversion, Older Adults, HIV/AIDS, Primary and Behavioral Health Care Integration, and Healthy 

Transitions.
85

Program: Mental Health - Science and Service Activities6

NOTE: SAMHSA grant awards are made late in the year. FY 2012 funding is reflected in FY 2013 performance targets, FY 

2014 funding is associated with FY 2015 targets.

Measure

Year and Most 

Recent Result /

Target for Recent 

Result /

(Summary of 

Result)

FY 2013 

Target

FY 2015 

Target

FY 2015

Target 

+/-

FY 2013

Target

1.4.06 Number of people trained by CMHS 

Science and Service Programs (Output)

FY 2012: 70,227

Target:

4,237

(Target Exceeded)

3,390 30,4817 +27,091

1.4.09 Increase the number of individuals trained 

by SAMHSA's Science and Services Program 

(Output)

FY 2012: 108,494

Target:

37,896

(Target Exceeded)

110,0008110,0009 Maintain

Size of Awards

(Whole Dollars)

FY 2012 

Actual

FY 2013 

Annualized CR

FY 2014 

President's Budget

Number of Awards 582 512 451

Average Awards $442,961 $414,300 $500,019

Range of Awards $15,000 - $6,000,000 $15,000 - $6,000,000 $15,000 - $6,000,000

 

6

Includes the following programs: Consumer and Consumer Supported TA Center, HBCU, HIV Training, , Suicide Prevention Resource Center, 

TTA-Primary Behavioral Health Care Integration.

7

Target increase due to the addition of several programs to the calculation of this outcome.

8

Target has been increased from previously reported.

9

Target has been increased from previously reported.
86

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87

Children’s Mental Health Services Program

(Dollars in thousands)

FY 2012 FY 2013 FY 2014 FY 2014 

Actual Annualized FY 2013

CR

President's 

Budget

+/- 

FY 2012

Budget Authority................................................ $117,315 $118,300 $117,315 ---

Authorizing Legislation............................... Sections 561 to 565 of the Public Health Service Act

FY 2014 Authorization..................................................................................................... Expired

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

Program Description and Accomplishments

Authorized in 1992, the Children’s Mental Health Initiative (CMHI) supports the development of 

comprehensive, community-based systems of care for the estimated nine to13 percent of children 

and youth with serious emotional disorders (SED) and their families. A system of care (SOC) is 

a strategic approach to the delivery of services and supports that incorporate family-driven, 

youth-guided, strength-based, and culturally and linguistically competent care in order to meet 

the physical, intellectual, emotional, cultural, and social needs of children and youth. The SOC 

helps prepare children and youth for successful transition to adulthood and successful 

assumption of adult roles and responsibilities. These guiding principles also call for a broad 

array of effective services, individualized care, and coordination across child and youth-serving 

systems (e.g. Juvenile Justice, Child Welfare, Education, Primary Care, and Substance Abuse) 

and have become standards for care throughout much of the nation. A hallmark of this program 

is that youth and families partner with state and local providers and policy makers in service 

delivery, system reform planning, and decision-making. In addition to the substantial role 

children, youth, and families play in the care they receive, 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 both appropriately and 

effectively. 

Since 1993, the CMHI program has funded 173 cooperative agreements across the country,

serving more than 110,000 children, youth, and their families. Through FY 2010, cooperative 

agreements were funded for a total of six years, with an increasing non-federal matching 

requirement. The matching requirement is intended to promote sustainability of the local system 

of care beyond the grant period. Over 64 percent of programs funded under the CMHI have been 

sustained at least five-years post-federal funding. In FY 2011, SAMHSA funded 24 one-year 

System of Care Expansion Planning grants. The purpose of these grants was to bring systems of 

care to scale from a community to a statewide focus where the grantee develops a comprehensive 

strategic plan for improving and expanding services and supports broadly throughout a state or 

political subdivision of a state, tribe, or territory. In FY 2012, SAMHSA funded six additional 

one-year planning grants along with 16 four-year System of Care Expansion Implementation 

grants. The goal of these new grants was to assist states, tribes and larger geographic areas in 

implementing their strategic plans to expand the system of care approach to improve outcomes 
88

for children and youth with serious mental health conditions and their families. In addition, 

SAMHSA also supported 47 CMHI continuation grants as well as five contract continuations.

National program evaluation data reported annually to Congress indicates that CMHI systems of 

care are successful, resulting in many favorable outcomes for children, youth, and their families, 

including:

Sustained mental health disorder improvements for participating children and youth in 

behavioral health outcomes after as little as six months of program participation;

Improvements in school attendance and achievement;

Reductions in suicide-related behaviors;

Decreases in the use of inpatient care and reduced costs due to fewer days in residential 

settings; and

Significant reductions in contacts with law enforcement.

Due to the success of this approach, SAMHSA funding ensures that grantees will continue to 

expand and sustain CMHI system of care values and principles, infrastructure and services 

throughout their states, tribes, and territories. A central focus of these efforts is linking CMHI 

systems of care with other child and youth-serving systems (e.g. Child Welfare, Juvenile Justice, 

and Education), block grant activities, and coordinating funding streams to support the SOC 

approach. 

In FY 2013, SAMHSA intends to award a new cohort of one-year System of Care Expansion 

Planning and support the continuation of 46 CMHI and 16 System of Care Expansion 

Implementation grants and contracts.

Funding History

Fiscal Year Amount

FY 2010 $121,316,000

FY 2011 $117,803,000

FY 2012 $117,314,524

FY 2013 $118,299,944

FY 2014 $117,314,524

Budget Request

The FY 2014 Budget Request is comprised of $117.3 million, the same as the FY 2012 funding 

level. At this funding level, SAMHSA expects to maintain current programmatic activities and 

support a robust technical assistance effort, a vitally important component of CMHI. In addition, 

SAMHSA is considering opportunities within the CMHI program for in-sourcing technical 

expertise in the evolving children’s mental health services arena. In FY 2014, an estimated 

6,331 children with a serious emotional disorder will be served by this program and 

approximately 10,430 mental health professionals will be trained in children’s mental health 

practices. The request will support 56 service grants, one technical assistance cooperative 

agreement, and two technical assistance and two evaluation contract continuations, as well as the 

implementation of 42 new grants. 
89

SAMHSA/Mental Health

Mechanism Table 

(Dollars in thousands)

No. Amount No. Amount No. Amount

Children's Mental Health Services

Grants/Cooperative Agreements

Continuations........................................................................... 47 $76,720 62 $75,954 56 $57,695

New/Competing...................................................................... 22 19,292 26 23,583 42 42,004

Subtotal................................................................................ 69 96,012 88 99,537 98 99,700

Contracts

Continuations........................................................................... 2 9,264 1 8,296 2 10,539

New/Competing...................................................................... --- --- 1 1,500 --- ---

Subtotal................................................................................ 2 9,264 2 9,796 2 10,539

Technical Assistance.................................................................. 4 11,619 4 8,966 3 7,076

Report to Congress.................................................................... --- 420 --- --- --- ---

Total, Children's Mental Health Services 75 $117,315 94 $118,300 103 $117,315

FY 2012 FY 2013 FY 2014

Actual Annualized CR President's 

Budget
90

Outcomes and Outputs

Program: Children's Mental Health Services

NOTE: SAMHSA grant awards are made late in the year. FY 2012 funding is reflected in FY 2013 performance targets, FY 

2014 funding is associated with FY 2015 targets.

Measure

Year and Most 

Recent Result 

/

Target for 

Recent Result 

/

(Summary of 

Result)

FY 2013 

Target

FY 2015

Target

FY 2015

Target

+/-

FY 2013

Target 

3.2.16 Number of children receiving services (Output) FY 2012: 6,357

Target:

4,930

(Target 

Exceeded)

6,457 6,331 -126

3.2.25 Percentage of children receiving services who report

positive social support at 6 month follow-up (Outcome)

FY 2012: 

88.3%

Target:

87.6%

(Target 

Exceeded)

87.6% 87.6% Maintain

3.2.26 Increase the percentage of children receiving 

Systems of Care mental health services who report positive 

functioning at 6 month follow-up (Outcome)

FY 2012: 

64.2%

Target:

63.1%11

(Target 

Exceeded)

64.2%12 64.2% Maintain

 

11 Target has been revised from previously reported.

12 Target has been revised from previously reported.
91

Measure

Year and Most 

Recent Result 

/

Target for 

Recent Result 

/

(Summary of 

Result)

FY 2013 

Target

FY 2015

Target

FY 2015

Target

+/-

FY 2013

Target 

3.2.27 Number of people in the mental health and related 

workforce trained in specific mental health-related 

practices/activities as a result of the program (Output)

FY 2012: 

10,473

Target:

4,571

(Target 

Exceeded)

4,571 3,385 -1,186

3.2.28 Number of organizations that entered into formal 

written inter/intra-organizational agreements (e.g. 

MOUs/MOAs) to improve mental health-related 

practices/activities as a result of the grant (Output)

FY 2012: 668

Target:

928

(Target Not 

Met)

928 691 -237

Size of Awards

(Whole Dollars)

FY 2012 

Actual

FY 2013 

Annualized CR

FY 2014 

President's Budget

Number of Awards 69 88 98

Average Awards $1,391,472 $1,131,104 $1,017,343

Range of Awards $330,000 - $2,000,000 $330,000 - $2,000,000 $330,000 - $2,000,000
92

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93

Projects for Assistance in Transition from Homelessness

(Dollars in thousands)

FY 2012 FY 2013 FY 2014 FY 2014 

Actual Annualized FY 2013

CR

President's 

Budget

+/- 

FY 2012

Budget Authority................................................ $64,794 $65,191 $64,794 ---

Authorizing Legislation............................................Section 521 of the Public Health Service Act

FY 2014 Authorization..................................................................................................... Expired

Allocation Method .................................................................................................Formula Grant

Program Description and Accomplishments

In 1990, the Stewart B. McKinney Homeless Assistance Amendments Act authorized the 

Projects for Assistance in Transition from Homelessness (PATH) program. The PATH budget 

supports 56 grants to all 50 states, the District of Columbia, Puerto Rico, Guam, American 

Samoa, the United States Virgin Islands, and the Northern Mariana Islands as well as centralized 

activities such as technical assistance and evaluation. PATH funds community-based outreach, 

mental health, substance abuse, case management, other supportive services, and a limited set of 

housing services in more than 500 communities. All recipients of PATH allocations (except the 

territories) are required by the authorizing legislation to provide a matching contribution of $1 

for every $3 of federal money received. The PATH formula calculates state allotments based on 

the population living in urbanized areas. This population data is updated after each census.

PATH is unique in that is specifically authorized to address the needs of individuals with serious 

mental illness (SMI) and/or SMI with a co-occurring substance use disorder who are 

experiencing homelessness or are at risk of homelessness. On a single night in January 2012, it is 

estimated that 633,782 people were homeless in the United States. Behavioral health issues are 

common among this population, as are chronic physical illnesses and other disabling conditions. 

Almost half of people experiencing homelessness have mental health problems and/or substance 

use disorders. In addition many individuals who have SMI are at risk of becoming homelessness 

due to their disabling conditions. The PATH program has been highly successful in targeting 

assistance to individuals with SMI who are homeless or are at-risk for homelessness or 

experiencing a co-occurring mental and substance use disorder. PATH connects members of this 

largely under-served population with critical services and resources to assist them on their 

recovery.

Performance has improved over the years as evidenced by increased numbers relating to PATH 

program Government Performance and Results Act (GPRA) measures. Over the past five years, 

national PATH program data indicate increases in the number of individuals experiencing 

homelessness who are outreached, contacted, number of eligible individuals who are enrolled in 

the PATH program, and an increase in the percentage of enrolled PATH clients who receive 

community mental health services. The GPRA measures for the PATH program show 

improvements in the PATH program’s effectiveness. PATH program results related to these 
94

measures show the number of homeless individuals contacted by the PATH program has 

increased from 135,007 individuals contacted in 2008 to 192,290 individuals contacted in 2012. 

Of these 103,259 individuals were enrolled in the PATH program, and 68,652 of the enrolled 

received community mental health services. 

Factors that affect performance include changes in counting methodology for certain PATH data 

elements and clarification of definitions of PATH data elements. The primary external factor is 

the transient nature of the population that PATH seeks to serve. PATH providers encounter 

several challenges. This include staff retention, difficulty serving all clients due to funding 

availability, the need for increased funding, defining PATH services and programs, and lack of 

standardized data tracking procedures. 

The need for standardized definitions are addressed through the PATH’s Administrative 

Workgroup and is in the process of defining PATH data elements. Issues relating to retention, 

staff shortages, and funding are managed at the local level. PATH has implemented several 

activities to improve data collection and reporting. The PATH program continues its efforts 

towards program-wide use of Homeless Management Information System (HMIS) for PATH 

data collection and GPRA reporting and the goal is 100 percent PATH provider participation of 

HMIS by 2016. This will enable SAMHSA to report reliable and consistent client-andaggregate-level data on the performance of the PATH program. 

Performance for the number of PATH providers trained on Supplemental Security Income/Social 

Security Disability Insurance (SSI/SSDI), Outreach, Access, and Recovery (SOAR) was not met 

in FY 2011. It is important to note, however, that nearly 24,000 PATH funded providers have 

been trained since the initiative began. This output is important in that once trained, PATH 

providers are better able to assist PATH clients in applying for and getting the income benefits 

for which they are eligible.13

The PATH program is improving program performance through alignment with HMIS, which 

will ensure that more reliable and standardized data is collected and reported by all PATH 

providers. Training and technical assistance (TA) are ongoing and long-term TA engagements 

(i.e., virtual classrooms, follow-up consultation) are being implemented to ensure that PATH 

providers are able to use the information obtained in the training to make changes in their 

programs.

The ability of PATH providers to build trusting and supportive relationships that lead to 

consumers making meaningful contributions to agency administration and service provision is a 

major accomplishment. Nearly all PATH provider agencies had consumer involvement, and 

consumers had a range of responsibilities as peer specialists, as members of committees, 

assessing services received etc. It also presents opportunities for providers working with 

individuals who are homeless to connect with each other.

 

13 Supplemental Security Income (SSI) and Social Security Disability Insurance (SSDI) are disability income benefits administered by the Social 

Security Administration (SSA) that generally also provide either Medicaid and/or Medicare health insurance to individuals who are eligible. 

Accessing these benefits is often a critical first step in recovery. For people, who are homeless with mental health problems that impair cognition 

or who are returning to the community from institutions (jails, prisons or hospitals), access to these programs can be extremely challenging. The 

application process for SSI/SSDI is complicated, detailed, and often difficult to navigate. Typically, about 10-15 percent of individuals who are 

homeless have these benefits. 
95

In FY 2012 SAMHSA continued to fund 56 grants to states and territories, as well as centralized 

activities such as technical assistance and evaluation. This funding and the population of focus 

will continue in FY 2013. 

Funding History

Fiscal Year Amount

FY 2010 $65,047,000

FY 2011 $64,917,000

FY 2012 $64,794,307

FY 2013 $65,190,848

FY 2014 $64,794,000

Budget Request

The FY 2014 Budget Request is comprised of $64.8 million, the same as the FY 2012 funding 

level. These funds will support outreach to an estimated 192,000 individuals with a serious 

mental illness and/or co-occurring mental and substance use disorder who are experiencing 

homelessness or at risk of homelessness and training for 4,591 providers. Although not all people 

enroll in services when first contacted, on average the program provides mental health and cooccurring substance use disorders services to over half of those contacted. The request will 

support 56 grants to states and territories, as well as centralized activities such as technical 

assistance and evaluation. In FY 2014, the PATH grant allotment calculations will use the newly 

available 2010 Decennial Census’s total population of urbanized areas count. 
96

Outcomes and Outputs

Program: Projects to Assist in the Transition from Homelessness

NOTE: SAMHSA grant awards are made late in the year. FY 2012 funding is reflected in FY 2013 performance targets, FY 

2014 funding is associated with FY 2015 targets.

Measure

Year and Most 

Recent Result /

Target for 

Recent Result /

(Summary of 

Result)

FY 2013 

Target

FY 2015

Target

FY 2015

Target

+/-

FY 2013 

Target

3.4.15 Percentage of enrolled homeless people who 

receive community mental health services (Outcome)

FY 2012: 66.0%

Target:

47.0%

(Target 

Exceeded)

50.0% 47.0% -3.0%

3.4.16 Number of homeless persons contacted 

(Outcome)

FY 2012: 

192,290

Target:

182,000

(Target 

Exceeded)

182,000 191,926 +9,926

3.4.17 Percentage of contacted homeless people with 

serious mental illness who become enrolled in services 

(Outcome)

FY 2012: 58.0%

Target:

55.0%

(Target 

Exceeded)

55.0% 55.0% Maintain

3.4.20 Increase the number of PATH providers trained 

on SSI/SSDI Outreach, Access, Recovery (SOAR) to 

ensure eligible homeless clients are receiving benefits. 

(Output)

FY 2012: 4,781

Target:

5,420

(Target Not Met

but Improved)

5,420 4,591 -829
97

Department of Health and Human Services

Substance Abuse and Mental Health Services Administration

FY 2014 Discretionary State/Formula Grants

CFDA # 93.150

STATE/TERRITORY

FY 2012 

Enacted

FY 2013 

Estimate

FY 2014 

Estimate

FY 2014 

+/- FY 2012

Alabama $586,000 $588,000 $611,000 +$25,000

Alaska 300,000 300,000 300,000 ---

Arizona 1,179,000 1,184,000 1,346,000 +167,000

Arkansas 300,000 300,000 303,000 +3,000

California 9,034,000 9,077,000 8,789,000 -245,000

Colorado 969,000 974,000 1,016,000 +47,000

Connecticut 859,000 863,000 797,000 -62,000

Delaware 300,000 300,000 300,000 ---

District Of Columbia 300,000 300,000 300,000 ---

Florida 4,063,000 4,082,000 4,323,000 +260,000

Georgia 1,511,000 1,518,000 1,665,000 +154,000

Hawaii 300,000 300,000 300,000 ---

Idaho 300,000 300,000 300,000 ---

Illinois 2,937,000 2,951,000 2,698,000 -239,000

Indiana 1,029,000 1,034,000 1,009,000 -20,000

---

Iowa 336,000 338,000 334,000 -2,000

Kansas 364,000 366,000 376,000 +12,000

Kentucky 473,000 475,000 468,000 -5,000

Louisiana 765,000 768,000 731,000 -34,000

Maine 300,000 300,000 300,000 ---

Maryland 1,281,000 1,287,000 1,268,000 -13,000

Massachusetts 1,700,000 1,708,000 1,555,000 -145,000

Michigan 1,984,000 1,994,000 1,725,000 -259,000

Minnesota 818,000 822,000 809,000 -9,000

Mississippi 300,000 300,000 300,000 ---

Missouri 932,000 937,000 891,000 -41,000

Montana 300,000 300,000 300,000 ---

Nebraska 300,000 300,000 300,000 ---

Nevada 506,000 508,000 614,000 +108,000

New Hampshire 300,000 300,000 300,000 ---
98

Department of Health and Human Services

Substance Abuse and Mental Health Services Administration

FY 2014 Discretionary State/Formula Grants

CFDA # 93.150

STATE/TERRITORY

FY 2012 

Enacted

FY 2013 

Estimate

FY 2014 

Estimate

FY 2014 

+/- FY 2012

New Jersey 2,339,000 2,350,000 2,132,000 -207,000

New Mexico 300,000 300,000 300,000 ---

New York 4,677,000 4,699,000 4,212,000 -465,000

North Carolina 1,134,000 1,140,000 1,376,000 +242,000

North Dakota 300,000 300,000 300,000 ---

Ohio $2,205,000 $2,216,000 $1,981,000 -$224,000

Oklahoma 448,000 450,000 452,000 +4,000

Oregon 596,000 599,000 629,000 +33,000

Pennsylvania 2,477,000 2,488,000 2,360,000 -117,000

Rhode Island 300,000 300,000 300,000 ---

South Carolina 565,000 568,000 678,000 +113,000

South Dakota 300,000 300,000 300,000 ---

Tennessee 894,000 898,000 907,000 +13,000

Texas 4,463,000 4,484,000 4,982,000 +519,000

Utah 527,000 530,000 590,000 +63,000

Vermont 300,000 300,000 300,000 ---

Virginia 1,422,000 1,428,000 1,468,000 +46,000

Washington 1,298,000 1,304,000 1,326,000 +28,000

West Virginia 300,000 300,000 300,000 ---

Wisconsin 857,000 861,000 834,000 -23,000

Wyoming 300,000 300,000 300,000 ---

American Samoa 50,000 50,000 50,000 ---

Guam 50,000 50,000 50,000 ---

Northern Marianas 50,000 50,000 50,000 ---

Puerto Rico 1,049,000 1,054,000 889,000 -160,000

Virgin Islands 50,000 50,000 50,000 ---
99

Protection and Advocacy for Individuals with Mental Illness

(Dollars in thousands)

FY 2012 FY 2013 FY 2014 FY 2014 

Actual Annualized FY 2013

CR

President's 

Budget

+/- 

FY 2012

Budget Authority................................................................ $36,238 $36,460 $36,238 ---

Authorizing Legislation.................................................................. Section 102 of the PAIMI Act

FY 2014 Authorization..................................................................................................... Expired

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

Program Description and Accomplishments

The Protection and Advocacy for Individuals with Mental Illness Program (PAIMI) began in 

1986 and is authorized by Section 102 of the PAIMI Act. The PAIMI Program provides formula 

grant awards to support protection and advocacy systems designated by the Governor of each 

state and the territories, and the Mayor of the District of Columbia. State protection and 

advocacy systems monitor compliance with respect to the rights of individuals through activities 

that ensure the enforcement of the constitution and federal and state laws. State protection and 

advocacy systems monitor public and private residential care and treatment facilities and nonmedical community-based facilities for children and youth. An independent evaluation of the 

program was completed in FY 2009 which confirmed that PAIMI programs provide those with 

psychiatric disability a voice in the exercise of their rights and are highly successful in achieving 

client and system goals and objectives. 

In 2011, the PAIMI program:

Provided casework to 3,900 children and adolescents and 12,592 adults and elderly 

individuals with mental illness;

Closed 13,133 cases, of which 3,389 were related to abuse, 2,658 to neglect, and 7,086 to 

a violation of individual rights; and

Resolved 91 percent of alleged abuse cases, 91 percent of alleged neglect cases, and 93

percent of alleged rights violations cases that resulted in positive change for the client in 

her/his environment, community, or facility. 

The FY 2011 funding resolved over an estimated 11,000 complaints, based on a marginal cost 

analysis conducted for this program (which estimated an average cost per complaint resolved 

successfully in FY 2009 of $3,164). Complaints of alleged abuse that were resolved resulting in 

positive change for the client in her or his environment, community, or facility as a result of 

PAIMI involvement was at a rate of 83 percent in FY 2007, improving to 91 percent in FY 2011.

 

PAIMI programs within each state Protection and Advocacy agency are monitored via on-site 

reviews on a regular schedule. These on-site monitoring reviews are conducted by trained federal 

staff to provide SAMHSA an assessment of key areas: governance, legal, fiscal, and 

consumer/constituent services/activities of the state’s PAIMI Program. Following these site 
100

visits, a report is completed that summarizes program findings and when appropriate, may 

include recommendations for technical assistance and/or corrective action. 

The first external evaluation in the 24-year history of the PAIMI Program was completed in 

2010. The evaluation found that individual PAIMI programs provide those with psychiatric 

disabilities a voice in the exercise of their rights and are highly successful in achieving client and 

system goals and objectives. The PAIMI Program contributes to the transformation of this 

nation’s mental health system into a more open, adaptive system that promotes recovery. 

In FY 2012 SAMHSA continued to fund 57 grants to states and territories as well as centralized 

activities such as technical assistance. This will remain the same in FY 2013.

Funding History

Fiscal Year Amount

FY 2010 $36,380,000

FY 2011 $36,307,000

FY 2012 $36,238,380

FY 2013 $36,460,159

FY 2014 $36,238,000

Budget Request

The FY 2014 Budget Request is $36.2 million, the same as the FY 2012 funding level. These 

funds support state and territorial protection and advocacy systems for individuals with serious 

mental illness in public and private residential care and treatment facilities and community-based 

services. In FY 2014, an estimated 16,428 people will be served by the program and over 74,092

people will receive public education and trainings on consumer rights and services. In FY 2014 

SAMHSA continued to fund 57 grants to states and territories as well as centralized activities 

such as technical assistance. 
101

Outcomes and Outputs

Program: Protection & Advocacy

NOTE: SAMHSA grant awards are made late in the year. FY 2012 funding is reflected in FY 2013 performance targets, FY 

2014 funding is associated with FY 2015 targets.

Measure

Year and 

Most Recent 

Result /

Target for 

Recent 

Result /

(Summary 

of Result)

FY 2013

Target

FY 

2015 

Target

FY 2015

Target 

+/-

FY 2013 

Target

3.4.12 Number of people served by the PAIMI program 

(Outcome)

FY 2011: 

16,492

Target:

22,325

(Target Not 

Met)

16,49914 16,428 -71

3.4.19 Number attending public education/constituency training 

and public awareness activities (Output)

FY 2011: 

74,382

Target:

120,000

(Target Not 

Met)

92,953 74,092 -18,861

3.4.21 Increase percentage of complaints of alleged abuse, 

neglect, and rights violations substantiated and not withdrawn 

by the client that resulted in positive change through the 

restoration of client rights, expansion or maintenance of 

personal decision-making,elimination of other barriers to 

personal decision-making,as a result of PAIMI involvement 

(Outcome)

FY 2011: 

92.0%

Target:

87.0%

(Target 

Exceeded)

87.0% 87.0% Maintain

 

14 Target was reduced to reflect most recent actual given previous two years of performance results were off nearly 30 percent and is not related 

to 2012 budget levels.
102

Department of Health and Human Services

Substance Abuse and Mental Health Services Administration

FY 2014 Discretionary State/Formula Grants

CFDA # 93.138

STATE/TERRITORY

FY 2012 

Enacted

FY 2013 

Estimate

FY 2014 

Estimate

FY 2014 

+/- FY 2012

Alabama $451,372 $458,563 $453,879 +$2,507

Alaska 429,100 431,700 429,100 ---

Arizona 633,443 604,746 610,923 -22,520

Arkansas 429,100 431,700 429,100 ---

California 3,134,571 3,171,629 3,179,373 +44,802

Colorado 429,546 431,700 429,705 +159

Connecticut 429,100 431,700 429,100 ---

Delaware 429,100 431,700 429,100 ---

District Of Columbia 429,100 431,700 429,100 ---

Florida 1,642,108 1,686,787 1,685,433 +43,325

Georgia 933,039 912,364 912,424 -20,615

Hawaii 429,100 431,700 429,100 ---

Idaho 429,100 431,700 429,100 ---

Illinois 1,102,843 1,097,035 1,084,662 -18,181

Indiana 610,362 616,840 608,409 -1,953

Iowa 429,100 431,700 429,100 ---

Kansas 429,100 431,700 429,100 ---

Kentucky 429,100 431,700 429,100 ---

Louisiana 429,100 431,700 429,100 ---

Maine 429,100 431,700 429,100 ---

Maryland 456,215 460,446 459,052 +2,837

Massachusetts 521,358 511,836 506,782 -14,576

Michigan 941,212 929,395 914,289 -26,923

Minnesota 450,085 449,619 446,424 -3,661

Mississippi 429,100 431,700 429,100 ---

Missouri 551,979 545,926 543,318 -8,661

Montana 429,100 431,700 429,100 ---

Nebraska 429,100 431,700 429,100 ---

Nevada 429,100 431,700 429,100 ---

New Hampshire 429,100 431,700 429,100 ---
103

Department of Health and Human Services

Substance Abuse and Mental Health Services Administration

FY 2014 Discretionary State/Formula Grants

CFDA # 93.138

STATE/TERRITORY

FY 2012 

Enacted

FY 2013 

Estimate

FY 2014 

Estimate

FY 2014 

+/- FY 2012

New Jersey 686,332 687,801 684,390 -1,942

New Mexico 429,100 431,700 429,100 ---

New York 1,591,215 1,551,920 1,526,904 -64,311

North Carolina 880,448 895,788 897,017 +16,569

North Dakota 429,100 431,700 429,100 ---

Ohio $1,069,448 $1,061,943 $1,045,456 -23,992

Oklahoma 429,100 431,700 429,100 ---

Oregon 429,100 431,700 429,100 ---

Pennsylvania 1,099,025 1,104,273 1,091,386 -7,639

Rhode Island 429,100 431,700 429,100 ---

South Carolina 444,614 452,018 452,775 +8,161

South Dakota 429,100 431,700 429,100 ---

Tennessee 595,224 595,752 590,212 -5,012

Texas 2,204,946 2,276,461 2,256,111 +51,165

Utah 429,100 431,700 429,100 ---

Vermont 429,100 431,700 429,100 ---

Virginia 657,158 669,228 665,512 +8,354

Washington 562,766 572,780 574,672 +11,906

West Virginia 429,100 431,700 429,100 ---

Wisconsin 510,809 509,744 505,535 -5,274

Wyoming 429,100 431,700 429,100 ---

American Samoa 229,900 231,300 229,900 ---

Guam 229,900 231,300 229,900 ---

Northern Marianas 229,900 231,300 229,900 ---

Puerto Rico 618,294 579,460 568,084 -50,210

Virgin Islands 229,900 231,300 229,900 ---

American Indian Consortium 229,900 231,300 229,900 ---
104

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105

Community Mental Health Services Block Grant

(Dollars in thousands)

FY 2012 FY 2013 FY 2014 FY 2014

Actual Annualized 

CR

President's 

Budget

+/- 

FY 2012

Community Mental Health Services Block Grant.................. $459,756 $462,570 $459,756 ---

PHS Evaluation Funds (non-add)............................ $21,039 $21,168 $21,039 ---

Authorizing Legislation..........................................Section 1911 of the Public Health Service Act

FY 2014 Authorization..................................................................................................... Expired

Allocation Method .................................................................................................Formula Grant

Program Description and Accomplishments

Since 1992, the Community Mental Health Services Block Grant (MHBG) distributes funds to 

59 eligible states and territories through a formula based upon specified economic and 

demographic factors. The MHBG distributes funds to eligible states and territories for a variety 

of services and for planning, administration, and educational activities under the state plan for 

comprehensive community-based mental health services for children with serious emotional 

disturbance and adults with serious mental illness. Services funded by the MHBG include 

supported employment and supported housing, rehabilitation services, crisis stabilization and 

case management, peer specialist and consumer-directed services, wrap around services for 

children and families, jail diversion programs, and services for special populations (people who 

are homeless, live in rural and frontier areas, and increasingly for military families). The 

majority of these services are not currently covered under Medicaid, Medicare, or commercial 

insurance. The MHBG also supports and encourages states to implement proven practices 

demonstrated in the discretionary portfolio at SAMHSA. The MHBG continues to represent a 

significant “safety net” source of funding for mental health services for some of the most 

vulnerable populations across the country. 

Ninety-five percent of the funds allocated to the MHBG program are distributed to states through 

a formula prescribed by the authorizing legislation. Factors used to calculate the allotments 

include total personal income, state population data by age groups (total population data for 

territories), total taxable resources, and a cost of services index factor. States and territories may 

expend Block Grant funds only to carry out the annual plan, to evaluate programs and services 

carried out under the plan, and for planning, administration, and educational activities related to 

providing services under the plan. 

States rely on the MHBG for delivery of critical services and for an array of non-clinical 

coordination and support services to strengthen their respective systems of services, for example,

planning, coordination, needs assessment, quality assurance, program development, training, and 

evaluation. 
106

The MHBG statute provides a five percent set-aside to allow 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. 

In FY 2011, SAMHSA redesigned the FY 2012/2013 MHBG and SABG applications to better 

align with the current federal/state environments and related policy initiatives, including the

Affordable Care Act, the Mental Health Parity and Addiction Equity Act (MHPAEA), and the 

Tribal Law and Order Act (TLOA). The new design offered states the opportunity to complete a 

combined application for mental health and substance abuse services, submit a bi-annual versus 

an annual plan,15,16 and provide information regarding their efforts to respond to various federal 

and state initiatives. Almost one-half of the states took advantage of this streamlined application 

and submitted combined plans for mental health and substance abuse services. Over 95 percent 

of the states provided specific information requested by SAMHSA regarding strategies to 

respond to a variety of areas including primary care and behavioral health integration, recovery 

support services, prevention of substance use, and promotion of emotional health. States 

continued to provide information regarding the spending of their Block Grant funds to support 

services identified in SAMHSA’s Good and Modern Service System brief.

The FY 2014/2015 Block Grant application builds upon the FY 2012/2013 application and 

furthers SAMHSA’s efforts to have states use and report the opportunities offered under various 

federal initiatives and to build upon FY 2012/2013 efforts. In addition, the FY 2014/2015 Block 

Grant continues to allow states to submit a combined application for mental health and substance 

abuse services as well as a bi-annual versus an annual plan. 

Most states are currently reporting on National Outcome Measures (NOMS) for public mental 

health services within their state. The first compilation of state NOMS data was submitted to 

Congress in the spring of 2005. State level outcome data for mental health are currently reported 

by State Mental Health Authorities through the Uniform Reporting System. The following 

outcomes for all people served by the publicly funded mental health system17 during 2011 show 

that:

For the 54 states and territories that reported data in the Employment Domain, 18 percent of 

the mental health consumers were in competitive employment;

For the 55 states and territories that reported data in the Housing Domain, 82 percent of the 

mental health consumers were living in private residences; 

For the 56 states and territories that reported data in the Access/Capacity Domain, state 

mental health agencies provided mental health services for 21.93 people per 1,000 

population;

For the 50 states and territories that reported data in the Retention Domain, only 9 percent of 

the patients returned to a state psychiatric hospital within 30 days of state hospital discharge; 

and

 

15 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))

16 State Plan (Sec. 1932(b) of Title XIX, Part B, Subpart II of the Public Health Service (PHS) Act (42 USC § 300x-32(b))

17 May reflect multiple sources of funding including, MHBG, State General Fund, Medicaid, Private Insurance, etc.
107

For the 51 states and territories that reported data in the Perception of Care Domain, 70

percent of adult mental health consumers improved functioning as a direct result of the 

mental health services they received. 

The independent evaluation of the MHBG demonstrates that funds allow states to explore new 

innovations and strategies, target emerging needs with special programs; pay for recoveryfocuses and consumer-centered services not covered by commercial insurance, Medicaid, or 

Medicare; and create the administrative, organizational, or service delivery linkages that foster a 

community-based, transformed system of mental health services. The study of the program has 

been completed and the final report is available on the SAMHSA website 

(http://store.samhsa.gov/shin/content//SMA10-4610/SMA10-4610.pdf).

Funding History1/

Fiscal Year Amount

FY 2010 $420,774,000

FY 2011 $419,933,000

FY 2012 $459,756,254

FY 2013 $462,569,962

FY 2014 $459,756,000

1\The funding history includes PHS Evaluation Funds.

Budget Request

The FY 2014 Budget Request is $459.8 million, the same as the FY 2012 funding level. These 

funds will support the public mental health system which provides services for over 7.4 million 

individuals. The request will support 59 grants to states and territories.

Enrollment and Provider Business Practices (3 Percent Block Grant Set Aisde)

Through the Affordable Care Act, up to 62 million people will benefit from Federal parity 

protections under the ACA. This includes 32 million who will gain coverage for behavioral 

health conditions, including 27 million who are currently uninsured, and 30.4 million who have 

some behavioral health benefits and will benefit from federal parity protections18. Persons with 

mental and substance use disorders are uninsured at higher rates than the general population. Of 

the 27 million who are uninsured, up to 11 million of these individuals are estimated to have 

substance abuse and/or mental health conditions. The Qualified Health Plans (QHPs) to be 

offered by the new insurance marketplaces are required to have sufficient mental health and 

 

18 US Department of Health and Human Services. Office of the Assistance Secretary of Performance and 

Evaluation, Office of Health Policy. "Affordable Care Act Will Expand Mental Health and Substance Use Disorder 

Benefits and Parity Protections for 62 Million Americans." By Sherry Glied, Laura Skopec, Rosa Po, and Kirsten 

Beronio. 20 Feb. 2013. <http://aspe.hhs.gov/health/reports/2013/mental/rb_mental.pdf>.
108

substance abuse providers to assure timely access to mental health and substance services. 

However, many providers supported by MHBG funds are not sufficiently prepared to be part of 

the network of providers under contract with QHPs, Medicaid and Medicare plans, and 

commercial insurance plans. It is critical for specialty behavioral health providers to be able to 

participate in integrated care models, utilize interoperable electronic health records (EHRs), and 

bill for and collect insurance resources for which persons they serve are eligible in order to 

maximize limited MHBG and SABG funds for those services and those persons not covered by 

public and commercial insurance plans.

After the full implementation of the Affordable Care Act, SAMHSA strongly recommends that

MHBG and SABG funds be directed toward four purposes: (1) to fund priority treatment and 

support services for individuals without insurance or for whom coverage is terminated for short 

periods of time; (2) to fund priority treatment and support services not covered by Medicaid, 

Medicare, or private insurance for low income individuals and that demonstrate success in

improving outcomes and/or supporting recovery; (3) to fund primary prevention (universal, 

selective, and indicated) prevention activities and services for individuals not identified as 

needing treatment; and (4) to collect performance and outcome data to determine the ongoing 

effectiveness of behavioral health promotion, treatment, and recovery support services and to 

plan the implementation of new services on a nationwide basis. State authorities should make 

every effort to ensure that the right recipient is receiving the right payment for the right reason at 

the right time.

In FY 2014, the President’s Budget includes a requirement that states set aside at least three 

percent of their MHBG allocation to support providers of mental health services in improving 

their enrollment, billing, and business practices and to support enrollment into health insurance 

for eligible individuals served in the public mental health system. States that receive two percent 

or more of the total FY 2014 state allotment will be required to implement a competitive subaward process for their funds. Major needs identified by both mental health and substance abuse 

providers are education and technical support to improve business management, integrate with 

primary care and develop the capability needed to effectively deploy electronic health records to 

meaningful use standards, billing and scheduling systems that are aligned with those in the 

commercial insurance and primary care environment. Particular concern was raised related to 

the lack of provider experience, especially peer, recovery, and opioid treatment organizations, in 

negotiating contracts with and billing third party payers, ensuring compliance, revenue 

management, and accountability reporting. 

Business operations practices needed include: 

Outreach and enrollment support for individuals in need of behavioral health services 

who may be eligible for Medicare, Medicaid, private insurance offered through the State 

and Federally Facilitated Marketplaces;

Business plan redesign responsive to the changing market under the Affordable Care Act

and MHPAEA, (e.g., development of a strategic plan that is responsive to the changing 

marketplace, identification of new markets, revision of data management systems,

integration of recovery support and treatment service payment systems, negotiating 

agreements/partnerships with primary care organizations, [e.g., Federally Qualified 

Health Centers (FQHCs)] and other provider networks to develop business operations 
109

systems that ensure appropriate care management across the continuum of services, (e.g. 

preventive clinical services, treatment, referral and recovery support services); 

Development, redesign and/or implementation of practice management and accounts 

receivable systems that address billings, collections, risk management and compliance;

Third-party contract negotiation; e.g., negotiating contracts for participation in a qualified 

health plan, or Medicaid managed care plan; 

Coordination of benefits among multiple funding sources, including insurance and 

MHBG funding; and

Adoption of health information technology that meets meaningful use standards.

The Affordable Care Act has already enhanced opportunities for individuals with behavioral 

health conditions to have continuous access to insurance and a benefit package that includes 

mental health and substance abuse services, as well as preventive, medical, and other health 

services. A series of immediate private insurance market reforms help to give individuals the 

stability and flexibility they need to make informed choices about their health care. Under these 

market reforms, individuals have a right to appeal health insurance plan decisions, including 

appeals to health plans when payment for a service or treatment is denied; helps children with 

pre-existing conditions gain and keep coverage, and will extend this protection to adults starting 

in 2014; allows individuals to continue to choose their primary care provider; keeps certain 

young adults covered up to age 26 on their parents’ health plans; ends lifetime limits on 

coverage; provides for review of unreasonable increases in insurance premiums; and requires 

insurance companies to spend at least 80% or 85% of premium dollars on medical care, helping 

to ensure that premium dollars be primarily spent on health care (including behavioral health 

care). 

Use of MHBG dollars for these purposes will help states assist their specialty provider 

infrastructure to be prepared for the shifting funding environment and maximize limited MHBG 

dollars for those individuals, services and activities not otherwise funded through other sources.

Evidence-Based Prevention and Treatment Approaches (5 Percent Block Grant Set Aside)

While the federal statute requires states to spend a portion of the SABG on primary substance 

abuse prevention services, no such set aside requirement currently exists in the MHBG statute. 

Likewise, the MHBG statute currently directs funding only to those children and adults with the 

most severe disorders without recognizing the growing science about preventing mental 

disorders or preventing the disability caused by early onset of such disorders through earlier 

intervention.

The scientific understanding of mental health promotion and mental illness prevention was not 

well-known or developed when the MHBG was first authorized in the 1980s. Since that time, the 

knowledge base of effective mental health promotion and mental illness prevention and 

mitigation approaches has rapidly expanded via research findings, the identification of best 

practices in community coordination, and proven planning processes such as the Strategic 

Prevention Framework. SAMHSA efforts such as Project LAUNCH, Safe Schools/Healthy 

Students, Implementing Evidence-Based Prevention Practices in Schools, along with suicide 
110

prevention activities have demonstrated that such approaches can achieve successful outcomes. 

The landmark 2009 Institute of Medicine report, Preventing, Mental, Emotional, and Behavioral 

Disorders Among Young People, and the Clinical Manual of Prevention in Mental Health

(Michael Compton, MD, ed.) clearly defined and delineated the efficacy of such models. These 

models can ultimately assist states and the nation as a whole reduce the future prevalence along 

with the human and financial costs of mental and behavioral disorders. 

The knowledge base on evidence-based treatment and recovery support services has also grown 

dramatically. SAMHSA has developed a series of evidence-based practice toolkits 

(http://store.samhsa.gov/list/series?name=Evidence-Based-Practices-KITs) to assist states and 

communities to adopt such approaches. SAMHSA’s National Registry of Evidence-Based 

Programs and Practices (http://www.nrepp.samhsa.gov/) has collected more than 280 

interventions that support mental health promotion, treatment, and recovery.

Thus, in FY 2014, states should take such scientific developments of the last 25 years into 

account and prioritize proven mental illness prevention, emotional health promotion, and 

treatment/recovery support approaches as they develop comprehensive and coordinated plans to 

address mental disorders. 

Additionally, states have worked to utilize their MHBG funds for evidence-based treatment 

strategies for populations served with MHBG and other public dollars. Evidence is growing 

about treatment approaches and system designs that can help to prevent and/or mitigate the 

disabilities caused by serious and persistent mental illness and severe emotional disturbances. 

Taking into consideration the findings of the National Institute of Mental Health’s (NIMH) 

emerging work on early intervention with first break psychosis and the findings from 

SAMHSA’s mental health discretionary portfolio serving children and youth with the most 

serious mental disorders, SAMHSA will work with states to utilize at least five percent of their 

MHBG funds to award grants to implement the most effective evidence-based prevention and 

treatment approaches, focusing on promotion, prevention and early intervention. This new setaside and focus will be used by states to demonstrate how both MHBG and other funding 

streams can be utilized in the changing funding and service delivery environment to have the 

most positive impact on the health and well-being of the persons and communities served 

through these set-aside awards. States that receive two percent or more of the total FY 2014 state 

allotment will be required to implement a competitive sub award process for their funds.

Health Reform

As a result of the analysis and examination of the various components of the Affordable Care 

Act beginning in 2010, SAMHSA has undertaken a major redesign of the planning section of the 

application process for both the MHBG and SABG. SAMHSA is aligning the block grants to be 

critical components of the 2014 Affordable Care Act implementation in which state and federal 

responsibility is supporting behavioral health services and supports for those otherwise unable to 

receive services through Medicaid, Medicare, and/or private insurance plans offered through 

employers or through the new insurance marketplaces. Together, SAMHSA’s block grants 

support the provision of services and related supports to approximately eight million individuals 

with mental and substance use conditions. With an estimated 11.4 million adults having a severe 
111

mental illness19, 44.7 million adults having any mental illness20, and another 22.1 million adults

with substance use disorder21, demand clearly outpaces the public behavioral health system’s 

established capacity. Many of these individuals and some of the services they need will continue 

to be without coverage through public or private insurance mechanisms. Aligning and 

coordinating the SAMHSA block grants with the 2014 Affordable Care Act implementation 

process begins assembling a cohesive national service system that is responsive to potential gaps

in service delivery and effectively provides needed behavioral health serves across sectors and 

across payment sources.

States should determine if established systems and procedures are sufficient to ensure that Block 

Grant funds are expended in accordance with program requirements and directed to support and 

not supplant health reform activities. In the Uniform Block Grant Application for FY 

2014/2015, SAMHSA has strongly recommended that states use these resources to support and 

not supplant services that will be covered through commercial and public insurer plans. States 

will be asked to develop metrics or targets for their systems to measure increases in the number 

of individuals who become enrolled or providers that join commercial or publicly funded

provider networks. The primary goals of SAMHSA’s program integrity efforts are to continue to 

(1) promote the proper expenditure of block grant funds, (2) improve block grant program 

compliance nationally, and (3) demonstrate the effective use of block grant funds. 

SAMHSA will provide additional guidance to the states to assist them in complying with this 

continuing emphasis on program integrity, will develop new and better tools for reviewing block 

grant application and reports, and will train SAMHSA staff in these program integrity 

approaches and tools. SAMHSA will be working with states to develop changes to information

systems and compliance review processes to assure increasing program integrity. This may 

include working closely with Medicaid and Health Insurance Exchanges to obtain information to 

determine if individuals and providers in their systems are enrolled. This may also include 

strategies to assist their providers to develop the necessary infrastructures to operate in 

commercial and public insurer networks (Medicaid and Medicare). The Uniform Application 

along with the new set asides along with evolution of SAMHSA’s block grant reporting system 

are all tools to assist in this process.

 

19 http://www.samhsa.gov/data/NSDUH/2k10MH_Findings/2k10MHResults.htm

20http://www.samhsa.gov/data/2k12/NSDUH110/sr110-adult-mental-illness.htm

21 http://www.samhsa.gov/data/NSDUH/2k10ResultsRev/NSDUHresultsRev2010.htm#Ch7
112

Outcomes and Outputs

Program: Mental Health Block Grant

NOTE: SAMHSA grant awards are made late in the year. FY 2012 funding is reflected in FY 2013 performance targets, FY 

2014 funding is associated with FY 2015 targets.

Measure

Year and Most 

Recent Result /

Target for 

Recent Result /

(Summary of 

Result)

FY 2013

Target

FY 2015 

Target

FY 2015

Target 

+/-

FY 2013

Target 

2.3.14 Number of people served by the public 

mental health system (Output)

FY 2011: 

6,879,637

Target:

6,300,000

(Target Exceeded)

6,340,320 7,418,653 +1,078,333

2.3.11 Number of evidence based practices 

(EBPs) implemented (Output)

FY 2011: 4.3 per 

State

Target:

4.2 per State

(Target Exceeded)

4.2 per 

State

4.2 per 

State

Maintain

2.3.15 Rate of consumers (adults) reporting 

positively about outcomes (Outcome)

FY 2011: 70.5%

Target:

72.0%

(Target Not Met)

72.0% 72.0% Maintain

2.3.16 Rate of family members 

(children/adolescents) reporting positively about 

outcomes (Outcome)

FY 2011: 64.6%

Target:

73.0%

(Target Not Met

but Improved)

67.0% 67.0% Maintain
113

Measure

Year and Most 

Recent Result /

Target for 

Recent Result /

(Summary of 

Result)

FY 2013

Target

FY 2015 

Target

FY 2015

Target 

+/-

FY 2013

Target 

2.3.81 Percentage of service population receiving 

any evidence based practice (Outcome)

FY 2011: 6.4%

Target:

7.2%

(Target Not Met)

7.2% 7.2% Maintain
114

Department of Health and Human Services

Substance Abuse and Mental Health Services Administration

FY 2014 Discretionary State/Formula Grants

Community Mental Health Services Block Grant Program

CFDA #93.958

FY 2012 FY 2013 FY 2014 FY 2014

State/Territory Enacted Estimate Estimate +/- FY 2012

Alabama $6,551,928 $6,419,986 $6,206,418 -$345,510

Alaska 765,128 745,652 716,710 -48,418

Arizona 10,381,931 9,837,513 9,766,415 -615,516

Arkansas 3,996,615 4,089,681 3,949,834 -46,781

California 57,438,409 58,317,193 57,487,129 +48,720

Colorado 7,176,225 6,377,861 6,313,606 -862,619

Connecticut 4,464,764 4,464,350 4,448,783 -15,981

Delaware 812,652 1,009,327 972,793 +160,141

District Of Columbia 813,506 848,427 826,377 +12,871

Florida 28,619,330 28,948,326 28,760,329 +140,999

Georgia 14,426,622 13,436,228 13,187,135 -1,239,487

Hawaii 2,112,561 2,220,618 2,174,299 +61,738

Idaho 1,968,874 2,413,318 2,361,788 +392,914

Illinois 16,726,381 16,505,505 16,013,432 -712,949

Indiana 8,545,466 8,107,978 7,901,301 -644,165

Iowa 3,588,593 3,573,876 3,453,075 -135,518

Kansas 3,343,934 3,338,959 3,228,673 -115,261

Kentucky 5,847,060 6,172,172 5,980,327 +133,267

Louisiana 5,980,444 5,455,568 5,169,957 -810,487

Maine 1,758,811 1,757,226 1,692,699 -66,112

Maryland 7,936,269 8,674,816 8,390,403 +454,134

Massachusetts 8,810,187 9,555,824 9,242,248 +432,061

Michigan 13,557,223 13,779,285 13,532,906 -24,317

Minnesota 7,380,034 6,823,431 6,588,812 -791,222

Mississippi 4,265,884 4,023,164 3,896,910 -368,974

Missouri 7,592,862 7,536,595 7,259,445 -333,417

Montana 1,279,671 1,292,445 1,260,990 -18,681

Nebraska 2,079,360 2,080,565 1,989,680 -89,680

Nevada 4,007,238 4,256,500 4,203,668 +196,430

New Hampshire 1,613,013 1,791,212 1,722,505 +109,492
115

Department of Health and Human Services

Substance Abuse and Mental Health Services Administration

FY 2014 Discretionary State/Formula Grants

Community Mental Health Services Block Grant Program

CFDA #93.958

FY 2012 FY 2013 FY 2014 FY 2014

State/Territory Enacted Estimate Estimate +/- FY 2012

New Jersey 12,251,010 12,371,221 11,983,048 -267,962

New Mexico 2,565,434 2,658,520 2,597,688 +32,254

New York 25,017,742 26,980,283 26,406,631 +1,388,889

North Carolina 12,312,708 12,319,025 11,897,432 -415,276

North Dakota 794,932 810,657 764,117 -30,815

Ohio 14,858,394 14,518,749 14,120,367 -738,027

Oklahoma 4,715,738 4,749,501 4,598,474 -117,264

Oregon 5,380,731 5,757,744 5,536,269 +155,538

Pennsylvania 15,696,685 15,747,128 15,216,936 -479,749

Rhode Island 1,478,709 1,701,196 1,635,470 +156,761

South Carolina 6,363,877 6,307,585 6,167,611 -196,266

South Dakota 936,853 903,449 881,742 -55,111

Tennessee 8,415,280 8,457,731 8,166,062 -249,218

Texas 35,096,299 34,582,003 33,831,667 -1,264,632

Utah 3,380,306 3,313,813 3,215,736 -164,570

Vermont 788,942 800,470 776,168 -12,774

Virginia 10,863,652 10,867,463 10,544,719 -318,933

Washington 9,258,112 9,776,840 9,641,077 +382,965

West Virginia 2,562,028 2,619,228 2,510,561 -51,467

Wisconsin 8,015,911 7,034,083 6,822,203 -1,193,708

Wyoming 490,976 473,792 472,878 -18,098

American Samoa 93,638 83,740 81,658 -11,980

Guam 254,936 240,363 236,107 -18,829

Northern Marianas 68,105 81,273 77,174 +9,069

Puerto Rico 5,608,135 5,619,682 5,483,550 -124,585

Palau 50,000 50,000 50,000 ---

Marshall Islands 92,831 99,336 99,387 +6,556

Micronesia 151,038 161,622 158,050 +7,012

Virgin Islands 154,697 160,493 156,493 +1,796
116

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117

SAMHSA 

Substance Abuse Prevention

Table of Contents

SAMHSA/Substance Abuse Prevention Page

1. SAMHSA/ Programs of Regional & National Significance................................................119

a) Strategic Prevention Framework....................................................................................119

 b) Mandatory Drug Testing ...............................................................................................120

 c) Minority AIDS Initiative (MAI) ....................................................................................121

 d) Sober Truth on Preventing Underage Drinking Act (STOP Act)....................................122

 e) Fetal Alcohol Spectrum Disorders (FASD)....................................................................123

 f) Center for the Application of Prevention Technologies (CAPT).....................................124

 g) Science and Service Program Coordination ...................................................................124

2. Mechanism Table by APT..................................................................................................129

3. Mechanism Table by Summary Listing of Activity Tables .................................................283
118

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119

SAMHSA/ Programs of Regional & National Significance 

Substance Abuse Prevention

(Dollars in thousands)

FY 2012 FY 2013 FY 2014 FY 2014

Programs of Regional & National Significance

Actual Annualized 

CR

President's 

Budget

+/- 

FY 2012

CAPACITY

 Strategic Prevention Framework....................... $109,754 $110,479 $109,754 $---

Mandatory Drug Testing.................................. 5,196 5,228 4,906 -290

Minority AIDS Initiative................................... 41,307 41,560 41,307 ---

Sober Truth on Preventing Underage Drinking 

(STOP Act)................................................... 6,987 7,030 7,000 +13

Subtotal, Capacity 163,244 164,296 162,967 -277

SCIENCE AND SERVICE 

Fetal Alcohol Spectrum Disorder...................... 9,802 9,862 1,000 -8,802

Center for the Application of Prevention 

Technologies (CAPT)...................................... 8,059 8,108 7,511 -548

Science and Service Program Coordination....... 4,780 4,809 4,082 -698

Subtotal, Science and Service 22,641 22,780 12,593 -10,048

TOTAL, PRNS 1/ $185,885 $187,076 $175,560 -$10,325

1/In the FY 2014 Request, the CSAP Minority Fellowship Program budget is reflected in the Health Surveillance and 

Program Support Appropriation under the Agency-Wide Initiatives Workforce program. 

Authorizing Legislation................................................Sections 516, 519B, 519D of the PHS Act

FY 2014 Authorization..................................................................................................... Expired

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

Program Description and Accomplishments

Strategic Prevention Framework

Partnerships for Success

The Partnerships for Success (PFS) program was initiated in FY 2009 with the goals of reducing 

substance abuse-related problems; preventing the onset and reducing the progression of substance 

abuse; strengthening prevention capacity and infrastructure at the state- and community-levels in 

support of prevention; and leveraging, redirecting and realigning state-wide funding streams for 

substance abuse prevention. Eligible applicants are states and Territories that have completed a 

SPF State Incentive Grant (SPF-SIG). In FY 2009, four grants were awarded, and in FY 2010, one 
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additional award was made. The first two cohorts incorporated an incentive award to grantees that 

have reached or exceeded their prevention performance targets (subject to availability of funds).

In FY 2012, SAMHSA supported these efforts by awarding five continuation grants. The FY

2011 data from the first cohort reporting show that 50 communities increased the number of 

activities supported through collaboration and leveraging. Grantees reported implementing almost 

two thousand evidence based programs during FY 2011. Thirty-two communities reported 

improvements on targeted National Outcome Measures indicators. The vast majority of 

communities (88 percent) targeted alcohol use.

A new cohort of PFS grants was implemented in FY 2012 to address two of the nation’s top 

substance abuse prevention priorities: underage drinking among youth aged 12 to 20 and 

prescription drug misuse and abuse among individuals aged 12 to 25. The program is based on the 

premise that changes at the community level will, over time, lead to measurable changes at the 

state and national level. In FY 2012, SAMHSA awarded 15 new grants for three years.

In FY 2013, SAMHSA will support continuation awards for the initial cohort established in FY 

2009 and FY 2010. SAMHSA will make a new SPF SIG award to Iowa, the last SPF SIG state 

remaining to receive one and will award up to 17 new PFS grants. In addition, SAMHSA will 

make funds available for grantees in the first cohort who meet their performance targets and are 

eligible to apply for the incentive supplement.

Mandatory Drug Testing

SAMHSA’s Mandatory Drug Testing is a critical nationwide prevention program consisting of 

two principal activities mandated by Executive Order and Public Law: (1) oversight of the Federal 

Drug-Free Workplace Program, aimed at elimination of illicit drug use in the federal workforce,

with impact in the private sector workforce as well; and (2) oversight of the National Laboratory 

Certification Program, which certifies laboratories to conduct forensic drug testing for the federal

agencies and for some federally-regulated industries.

Executive Order 12564, first signed on September 15, 1986, requires the head of each executive 

agency to establish a program to test for the use of illegal drugs by federal employees in sensitive 

positions and requires the Secretary to promulgate scientific and technical guidelines for drug 

testing programs. The Executive Order also requires HHS to assist the Office of Personnel 

Management to develop and improve training programs for federal supervisors and managers on 

illegal drug use and to mount an intensive drug awareness campaign throughout the federal 

workforce.

The Supplemental Appropriations Act, 1987 (Public Law 100-71) requires HHS to: (1) certify that 

each federal agency has developed a plan for achieving a drug-free workplace; and (2) publish 

Mandatory Guidelines that establish comprehensive standards for laboratory drug testing 

procedures, specify the drugs for which federal employees may be tested, and establish standards 

and procedures for periodic review and certification of laboratories to perform drug testing for 

federal agencies.
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The program is further supported by the CSAP Workplace Helpline, a toll-free telephone service 

for business and industry that answers questions about drug abuse in the workplace. 

SAMHSA will continue these activities in FY 2013. In addition, the Drug Testing program is 

examining the scientific basis for oral fluid testing as an alternative specimen to urine, and also to 

include additional Schedule II prescription medications (e.g., oxycodone, oxymorphone, 

hydrocodone and hydromorphone) in the drug testing protocol. Any changes will be based on 

scientific supportability. SAMHSA continues to partner with NIH/NIDA, FDA, and other federal 

agencies to ascertain the scientific evidence needed to set standards for the Mandatory Guidelines. 

Minority AIDS Initiative (MAI)

Implemented in FY 1999, SAMHSA/CSAP’s Minority AIDS Initiative (MAI) supports efforts to 

increase access to substance abuse and HIV prevention services for the highest risk and hardest-toserve racial and ethnic minority populations. Grantees must implement integrated, evidence-based 

substance abuse and HIV prevention interventions, including HIV testing, that target one or more 

high-risk populations such as African-American women, adolescents, individuals who have been 

released from prisons and jails within the past two years, or men having sex with men (MSM). In 

addition, the MAI supports partnerships between public and private nonprofit organizations to 

prevent and reduce the onset of substance abuse and transmission of HIV among high-risk 

populations. 

Since its inception, CSAP has funded a total of ten cohorts. In FY 2011, SAMHSA/CSAP funded 

the Ready-To-Respond Initiative and the Capacity Building Initiative programs, and a total of 62

grants in these cohorts will continue to be funded in FY 2013. The Ready-To-Respond Initiative, 

targeted toward experienced MAI grantees, provides substance abuse and HIV prevention services 

to at-risk minority populations in communities disproportionately affected by HIV/AIDS. The 

Capacity Building Initiative focuses on using evidence-based prevention strategies and media 

technology to reach college students, who comprise one-third of the 18-24 year old population in 

the United States and are particularly at risk for substance use and HIV infection. Performance 

data for FY 2011, the most recent available showed that over 4,000 people received substance 

abuse prevention education services. Over 355,000 were reached through environmental 

approaches. Additionally, 95.5 percent of participants rated the risk of harm from substance abuse 

as great. Of those participants who were non-users, 92.5 percent remained non-users of drugs and 

88.1 percent remained alcohol free. During FY 2011, over 11,000 participants were tested for 

HIV, of whom almost 4,000 were tested for the first time. SAMHSA has supported these grants 

in FY 2012 and will continue to do so in FY 2013.

In FY 2011, SAMHSA also awarded grants for the Minority AIDS Initiative Targeted Capacity 

Expansion Integrated Behavioral Health/Primary Care Network Cooperative Agreements, jointly 

funded with CMHS and CSAT. This grant program facilitates the development and expansion of 

culturally-competent and effective integrated behavioral health and primary care networks, which 

include HIV services and medical treatment, within racial and ethnic minority communities in the 

11 Metropolitan Statistical Areas and Metropolitan Divisions most impacted by HIV/AIDS. 

Expected outcomes include: reducing the impact of behavioral health problems, HIV risk and 
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incidence, and HIV-related health disparities in these areas. SAMHSA continued to support these 

grants in FY 2012 and is continuing to do so in FY 2013.

In FY 2013, SAMHSA is awarding a new cohort of grants for the MAI and HIV Prevention in 

High Risk Minority Serving Institutions (MSI) and Communities (MAI/MSI) program. The purpose 

of the MAI/MSI program is to equip and empower high risk MSIs located in communities with the 

highest risk of substance abuse and HIV infections with evidence-based methodologies to increase 

access to comprehensive, integrated substance abuse and HIV prevention services on their 

campuses/institutions and in the surrounding community. High risk population are communities 

with higher prevalence rate of substance abuse, HIV/AIDS, underage drinking and/or prescription 

drug misuse and has limited resources or has had fewer opportunities or less success in identifying 

and bringing to bear resources to address the identified priorities. The MAI/MSI recipients also 

will be required to partner with local community organizations serving at-risk racial/ethnic 

minority young adults, MSMs, as well as (if applicable), other demonstrated high risk groups in 

communities disproportionately affected by SA and HIV/AIDS, i.e. Black/African American men 

and women, Latino(a), Hispanic and sexual minorities. The goal is to reduce the rate of new 

substance abuse and HIV infections on minority serving college/institution campuses and the 

surrounding at risk communities. SAMHSA will award up to 60 grants for three years.

SAMHSA supports the National HIV/AIDS Strategy through its grant programs, including the 

cross-Center Targeted Capacity Expansion Integrated Behavioral Health/Primary Care Network 

Cooperative Agreements, the CSAT Targeted Capacity Expansion/HIV program, and the CSAP 

Ready-to-Respond and Capacity Building Initiative programs, all described in their respective 

sections of this document. SAMHSA also provides technical assistance to its grantees to assure 

they are focusing on the goals of the Strategy and collaborates with other HHS Operating 

Divisions involved with the Strategy to assure a coordinated, Departmental approach.

Sober Truth on Preventing Underage Drinking Act (STOP Act)

The Sober Truth on Preventing Underage Drinking Act (STOP Act) of 2006 is the nation’s first 

comprehensive legislation on underage drinking. One of the primary components of the Act is the 

STOP Act grant program, which provides additional funds to current or former grantees under the 

Drug Free Communities Act of 1997 to prevent and reduce alcohol use among youth age 12-20. 

The STOP Act grant program enables organizations to strengthen collaboration and coordination 

among stakeholders in order to achieve a reduction in underage drinking in their communities. 

Grants are limited by statute to $50,000 per year for four years. In FY 2012, 81 new grants were 

awarded. In FY 2011, performance data show that the STOP Act grant program has exceeded 

targets in all GPRA performance measures. Eighty-four percent of coalitions reported a reduction 

in the past 30 day use of alcohol, 75 percent of coalitions reported an increase in perceived risk, 

and 75 percent of coalitions reported an increase in perception of parental disapproval of alcohol 

use (69.6 percent). In FY 2013, SAMHSA will award up to 16 new grants.

Another component of the STOP Act is the National Adult-Oriented Media Public Service 

Campaign, which educates parents regarding how to speak with their 11- through 15-year-old 

children about underage drinking in order to delay the onset of, and ultimately reduce, underage 
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drinking. Nationwide, 38.9 percent of the estimated 10 million underage drinkers were provided 

free alcohol by adults 21 or older (2010 NSDUH). Further research continues to show that parents 

of teens generally underestimate the extent of alcohol used by youth and its negative 

consequences, with the vast majority viewing underage drinking as “inevitable.” 

The third component of the STOP Act is the federal Interagency Coordinating Committee on the 

Prevention of Underage Drinking (ICCPUD), which provides high-level leadership from 15 

federal agencies for coordinating federal efforts to prevent and reduce underage drinking. In FY 

2012, the ICCPUD was reinvigorated with principals meeting from all federal agencies working to 

prevent underage drinking, and the launch of a webinar series featuring common messages with 

individualized information for the field from each involved federal agency. In 2012, the ICCPUD 

updated the 2007 Surgeon General’s Call to Action to Prevent Underage Drinking to reflect 

progress over the past six years, the impact of the Affordable Care Act, and new research 

supporting effective prevention approaches. SAMHSA will continue to support ICCPUD’s

activities in FY 2013.

 

Fetal Alcohol Spectrum Disorders (FASD)

SAMHSA’s Fetal Alcohol Spectrum Disorders (FASD) Center for Excellence (CFE) program 

focuses on preventing Fetal Alcohol Spectrum Disorders among women of childbearing age and 

improving the quality of life for individuals and families impacted by these disorders. 

SAMHSA’s FASD CFE uses a comprehensive approach across the lifespan to work toward 

reducing the number of infants exposed to alcohol prenatally, increasing the functioning of

individuals who have an FASD, and addressing the challenges of individuals and families 

impacted by FASD.

As part of these efforts, SAMHSA’s FASD CFE has successfully established a website that 

provides the public with information and resources on the prevention of FASD, chartered an 

expert panel that provides guidance and recommendations about best practices for healthcare

providers and social services, organized a Self Advocates with FASD (SAFA) Network

comprising young adults with an FASD and Birth Mothers Network (BMN); partnered with the 

National Institute on Alcohol Abuse and Alcoholism’s (NIAAA) Interagency Coordinating 

Committee on FASD (ICCFASD) to advance new research and best practices on FASD; 

coordinated and collaborated with organizations such as the National Organization on Fetal 

Alcohol Syndrome (NOFAS) to develop curricula for juvenile justice systems and certified 

addictions counselors; provided ongoing support to the National Association of FASD State 

Coordinators (NAFSC) to integrate FASD services into existing health care systems; and 

convened 10 "Building FASD State Systems" (BFSS) annual conferences to facilitate the 

development of comprehensive systems of care for people affected by FASD. In addition, 

SAMHSA’s FASD CFE established a Native Communities Initiative to address FASD in 

American Indian /Alaska Native /Native Hawaiian (AI/AN/NH) populations

In FY 2011, the most recent year for which data is available, SAMHSA’s FASD CFE screened 

10,829 at-risk individuals and provided direct services to a total of 1,651 individuals. Over 90 

percent of participants who used alcohol reported decreased current and binge drinking after 
124

program participation. In addition, SAMHSA’s FASD provided 26 trainings to over 1,483

providers nationwide. 

In FY 2012, SAMHSA continued to support the FASD CFE to work toward the prevention of 

FASD in communities throughout the nation. In FY 2013, SAMHSA will continue to support

FASD CFE to focus on identifying new methods for screening and providing preventive services 

and resources to women of childbearing age, as well as increasing collaboration and coordination 

of prevention efforts with other federal and national partners.

Center for the Application of Prevention Technologies (CAPT) 

SAMHSA’s Center for the Application of Prevention Technologies (CAPT) program provides 

state-of-the-art training and technical assistance designed to build the capacity of SAMHSA 

grantees and develop the skills, knowledge, and expertise of the prevention workforce. 

SAMHSA’s CAPT builds capacity and promotes the development of substance abuse prevention 

professionals in the behavioral health field through three core strategies: (1) establishing technical

assistance networks using local experts; (2) developing and delivering targeted training and 

technical assistance activities; and (3) using innovative communication media such as 

teleconference and video conferencing, online events, and Web-based support. These activities 

help ensure the delivery of effective prevention programs and practices and the development of 

accountability systems for performance measurement and management. 

During FY 2012 and FY 2013, SAMHSA’s CAPT completed a comprehensive revision and 

updating of its flagship Substance Abuse Prevention Skills Training, which offers participants 31 

training hours toward certification as a Substance Abuse Prevention Specialist. CAPT also 

developed a Pacific Islander and Native American adaptation of the training for an additional six 

training hour credits. In FY 2012 and 2013, CAPT has continued to develop behavioral health 

indicators and related training and technical assistance products focused on shared risk and 

protective factors to promote collaboration across substance abuse and mental health disciplines

within the behavioral health field. 

During FY 2011, SAMHSA’s CAPT delivered over 415 training events nationwide and trained 

over 10,060 substance abuse prevention professionals. During FY 2012, there was a slight decline 

to 9,041 in numbers. In addition, SAMHSA’s CAPT provided technical assistance services to 

7,655 people. Over 96 percent of service recipients reported that their organization’s capacity was 

increased as a result of the service. Almost half of the recipients reported fully implementing the 

training recommendations. Additional performance data for the CAPT is captured using common 

measures with other technical assistance activities in the Science and Service Program 

Coordination category.

Science and Service Program Coordination

The Science and Service Program Coordination category primarily encompasses contracts that 

provide technical assistance and training to states, tribes, communities, and grantees around 
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substance abuse prevention. Included in the performance measurement section for this category 

are the Native American Center for Excellence (NACE) and the Underage Drinking Prevention 

Education Initiative (UADPEI). 

The purpose of SAMHSA’s NACE is to promote effective substance abuse prevention programs 

in tribal and urban American Indian and Alaska Native (AI/AN) communities throughout the 

United States. The NACE mission is to promote best practices in substance abuse prevention by 

disseminating information on cultural- and evidence-based programs, practices, and policies and 

providing training and technical assistance (TTA) to prevention programs and organizations 

serving urban and tribal Native American communities. The target audiences include the Native 

American SPF-SIG grantees, tribal nations and organizations, health and social service providers, 

federal and state level organizations, and community and faith-based providers serving Native 

Americans. It has provided TTA to 482 recipients and training to 213 people during FY 2011. 

Additionally 88 percent of recipients report that the NACE services increased their individual 

capacity to provide prevention services. 

NACE expanded its outreach in FY 2012 and FY 2013 through presentations at national 

conferences and regional events, and increased collaborative efforts with other SAMHSA 

initiatives and national organizations. The NACE website greatly expanded its collection of 

resources and dissemination of current news worthy events through daily “headlines” entries while 

tripling its number of visitors each month. FY 2012 and FY 2013 also brought the development of 

four new NACE learning communities (National Prevention Network, SPF Tribal Incentive Grant, 

Gathering of Native Americans, and 2-Spirit) to bring stakeholders together on conference calls or 

webinars to further disseminate information and support cross-fertilization of information and 

idea. Lastly, NACE expanded the frequency and reach of its national webinars.

In FY 2013, SAMHSA’s CSAP’s NACE and CMHS’s AI/AN Suicide Prevention programs will 

collaborate through braided funding to provide comprehensive, broad, focused, and/or intensive 

training and technical assistance to federally-recognized tribes and other American Indian/Alaska 

Native communities, seeking to address and prevent mental and substance use disorders, suicide, 

and promote mental health. Any braided amounts spent or awarded will be tracked as distinct 

funding streams and will only be used for purposes consistent with legislative direction and intent. 

The UADPEI engages parents and other caregivers, schools, communities, all levels of 

government, all social systems that interface with youth, and youth themselves in a coordinated 

national effort to prevent and reduce underage drinking and its consequences. Through this 

initiative, families, their children, and other youth-serving organizations have been reached 

through Town Hall Meetings (held in even-numbered years), technical assistance, trainings, and a 

variety of tools and materials. In FY 2011, more than 2,800 people were trained.

Performance data show that, collectively, the CAPT and Science and Service Program 

Coordination programs have exceeded their targets for customer satisfaction, and for the 

proportion of participants who report implementing recommendations. Efficiencies have been 

achieved from the growing focus on train-the-trainer models rather than training of individuals. In 

addition, since the Town Hall Meetings under the UADPEI contract occur biannually, numbers 

served expand in the years the meetings occur and contract in alternate years. 
126

Funding History1\

Fiscal Year Amount

FY 2010 $192,439,000

FY 2011 $186,302,000

FY 2012 $185,884,920

FY 2013 $187,076,000 

FY 2014 $175,560,080 

1\The funding history is presented on a comparable basis to previous funding levels to represent the revised 

budget structure and includes the PHS Evaluation Funds and Prevention Funds other than in FY 2013. The 

FY 2013 Prevention Fund resources are reflected in the Office of the Secretary.

Budget Request

The FY 2014 Budget Request is comprised of $175.6 million, $10.3 million less than FY 2012. 

This level of funding enables the continuation of programmatic activities. The request will 

support 260 grant and 26 contract continuations, as well as 56 new grants and two new contracts. 

Partnerships for Success

In FY 2014, SAMHSA requests $36.7 million to implement a new cohort of Partnerships for 

Success (PFS) grants, which will be consistent with the Prevention of Substance Abuse and 

Mental Illness Strategic Initiative. Similar to the previous cohorts, this PFS program will focus on 

implementing the Strategic Prevention Framework to strengthen prevention capacity and 

infrastructure at the state, territorial, and community levels; preventing the onset and reducing the 

progression of substance abuse; and leveraging, redirecting, and aligning statewide funding 

streams and resources to focus on promoting evidence-based substance abuse prevention. The 

new PFS grantees will also have the option of focusing on addressing trauma as one of the risk 

factors for substance abuse. Up to 32 grants will be awarded to eligible states, territories and 

tribes who have completed SPF-SIG grants. Grant award amounts will be divided into tiers with a 

maximum grant of approximately $2.0 million per year for the top tier. 

SAMHSA will also consider how best to help tribes committed to substance abuse prevention to 

strengthen their existing service delivery systems and/or to begin building the necessary capacity 

and/or infrastructure to successfully prevent substance abuse in their communities.

The FY 2014 Budget Request includes increases for the following (+$0.013 million):

The STOP Act program request is $7.0 million. This reflects a $0.013 million increase 

from the FY 2012 funding level. This level of funding will support 97 continuation grants 

and two continuation contracts. 
127

The FY 2014 Budget Request includes same level of funding for the following: 

Minority AIDS Initiative request is $41.3 million, which is the same as the FY 2012 

funding level which will support 133 continuation grants, 22 new grants, and one 

continuation contract

Strategic Prevention Framework request is $109.8 million, which is the same as FY 2012 

funding. These funds will support 30 grant and nine contract continuations and 34 new 

grants.

The FY 2014 Budget Request includes decreases for the following (-$10.3 million):

Mandatory Drug Testing request is $4.9 million, reduced by $0.3 million. These funds 

will support three continuation contracts and one new contract.

The FASD Center of Excellence program request is $1.0 million, reduced by $8.8 million, 

for technical support activities. These funds will continue to support prevention strategies, 

in partnership with other activities, to prevent alcohol use among women of childbearing 

age. In order to maximize dissemination of knowledge developed previously under this 

contract through direct services, the new phase of this contract will focus on technical 

assistance and training and will no longer provide funds to support direct services to 

communities. These activities can be supported by states through the Substance Abuse 

Prevention and Treatment Block Grant at their discretion.

The CAPT program request is $7.5 million, reduced by $0.6 million. These funds will 

enable provisional continuation of technical assistance to the field in support of delivery of 

effective prevention programs and practices.

Science and Services Program Coordination request is $4.1 million, reduced by $0.7 

million. These funds will support six continuation contracts and one new contract.

A detailed table for all grant and contract continuations and new activities can be found in

supplementary tables.
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129

Substance Abuse Prevention Programs of Regional and National Significance 

Mechanism Table by APT

(Dollars in thousands)

Programs of Regional & National Significance No. Amount No. Amount No. Amount

Grants

Continuations........................................................ 195 $95,867 199 $84,997 260 $82,389

New/Competing.................................................... 96 45,762 99 48,800 56 49,149

Subtotal................................................................ 291 141,629 298 133,797 316 131,538

Contracts

Continuations........................................................ 22 33,445 15 38,916 21 41,943

New.................................................................... 6 10,811 10 14,364 2 2,079

Subtotal................................................................ 28 44,256 25 53,279 23 44,022

Total, CSAP PRNS 1/ 319 $185,885 323 $187,076 339 $175,560

1/In the FY 2014 Request, the CSAP Minority Fellowship Program budget is reflected in the Health 

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

FY 2012 FY 2013 FY 2014

Actual Annualized 

CR

President's 

Budget
130

Key Outputs and Outcomes Table

(SAMHSA)

Program: Minority AIDS Initiative22

NOTE: SAMHSA grant awards are made late in the year. FY 2012 funding is reflected in FY 2013 performance targets, FY 2014 

funding is associated with FY 2015 targets.

Measure

Year and Most 

Recent Result /

Target for 

Recent Result /

(Summary of 

Result)

FY 2013 

Target

FY 2015 

Target

FY 2015 

Target

+/-

FY 2013 

Target 

2.3.56 Number of program participants exposed to 

substance abuse prevention education services 

(Output)

FY 2011: 4,283

Target:

1,53523

(Target Exceeded)

5,73424 3,00025-2,734

2.3.82 Percent of program participants that rate the 

risk of harm from substance abuse as great (all ages) 

(Outcome)

FY 2011: 95.5%

Target:

88.0%

(Target Exceeded)

88.0% 88.0% Maintain

2.3.83 Percent of program participants who report no 

use of alcohol at pre-test who remain non-users at 

post-test (all ages) (Outcome)

FY 2011: 88.1%

Target:

91.2%

(Target Not Met)

91.2% 91.2% Maintain

2.3.84 Percent of participants who report no illicit 

drug use at pre-test who remain non-users at post-test 

(all ages) (Outcome)

FY 2011: 92.5%

Target:

92.6%

(Target Not Met)

92.6% 92.6% Maintain

2.3.85a Number of individuals tested for HIV through 

the Minority AIDS Initiative prevention activities 

(Output)

FY 2011: 11,066

(Historical Actual)

Set 

Baseline

TBD N/A

 

22 The Minority AIDS Initiative in CSAP is a cohort-based program. As a result, there are observable decreases in targets in various years. For 

example, FY 2011 reflects the close-out of Cohort VI and start-up of Cohorts VII and VIII. Targets increase during FY 2012 and FY 2013 to reflect 

the newly funded Cohorts IX and X. However, in FY 2014, targets begin to decrease to reflect the close-out of Cohort VII.

23 Target reflects close-out of Cohort VI and start-up of Cohort VII and Cohort VIII.

24 Target has been revised from previously reported. Target has been changed to include Cohorts VII, VIII, IX, and X.

25

Decrease in target is due to cohort effects and includes Cohorts IX and X.
131

Program: Sober Truth on Preventing Underage Drinking (STOP Act)26

Measure

Year and Most 

Recent Result /

Target for 

Recent Result /

(Summary of 

Result)

FY 2013 

Target

FY 2015 

Target

FY 2015 

Target

+/-

FY 2013 

Target

3.3.01 Increase the percentage of coalitions that report at 

least 5.0% improvement in the past 30-day use of 

alcohol in at least two grades (Outcome)

FY 2011: 84.4%

Target:

41.0%

(Target 

Exceeded)

40.0%

27 40.0% Maintain

3.3.02 Percentage of coalitions that report improvement 

in youth perception of risk from alcohol in at least two 

grades (Outcome)

FY 2011: 75.0%

Target:

63.4%

(Target 

Exceeded)

60.9%28 60.9% Maintain

3.3.03 Percentage of coalitions that report improvement 

in youth perception of parental disapproval on the use of 

alcohol in at least two grades (Outcome)

FY 2011: 75.0%

Target:

56.7%

(Target 

Exceeded)

54.5%29 54.5% Maintain

 

26 The STOP Act program provides additional funds to current or prior Drug Free Community Program (DFC) grantees to support activities 

targeting underage alcohol. As is the case with the DFC grantees, STOP Act grantees collect performance data using a variety of school and 

community surveys and report them online through the COMET (Coalition Online Management and Evaluation Tool) system every two years –

thereby affecting the ability to make accurate comparisons of performance from year to year. Lastly, Cohort I of STOP Act will close-out at the end

of FY 2012 and Cohort II will close-out at the end of FY 2013. As a result, targets for performance measures have been decreased to reflect the 

decrease in the number of grantees.

27 Target has been changed from previously reported. The target has been decreased due to cohort effects. Now, the target reflects close-out of 

Cohort I and start of Cohort III.

28 Target has been changed from previously reported. The target has been decreased due to cohort effects. This target now reflects close-out of 

Cohort I and start of Cohort III.

29 Target has been changed from previously reported. The target has been decreased due to cohort effects. Now, the target reflects close-out of 

Cohort I and start of Cohort III.
132

Program: Prevention - Science and Service Activities30

NOTE: SAMHSA grant awards are made late in the year. FY 2012 funding is reflected in FY 2013 performance targets, FY 2014 

funding is associated with FY 2015 targets.

Measure

Year and Most 

Recent Result /

Target for 

Recent Result /

(Summary of 

Result)

FY 2013 

Target

FY 2015 

Target

FY 2015 

Target 

+/-

FY 2013 

Target 

2.3.71 Number of people provided technical assistance 

(TA) services (Output)

FY 2011: 7,868

Target:

21,420

(Target Not 

Met)

13,143 N/A N/A

2.3.74 Percentage of TA recipients who reported that the 

TA recommendations have been fully implemented 

(Outcome)

FY 2011: 53.1%

Target:

54.0%

(Target Not 

Met)

60.2% N/A N/A

2.3.75 Number of individuals receiving prevention 

information directly (Output)

FY 2011: 1,254

Target:

55031

(Target 

Exceeded)

36832 N/A N/A

1.4.09 Increase the number of individuals trained by 

SAMHSA's Science and Services Program (Output)

FY 2012: 

108,494

Target:

37,896

(Target 

Exceeded)

110,00033 110,00034 Maintain

 

30 Measures in the Science and Service category include the Center for Application of Prevention Technology (CAPT), Native American Center of 

Excellence (NACE), Prevention Fellowships, and Town Hall Meetings.

31 The Town Hall Meetings (THM) are conducted only in even-numbered years, so the targets in odd-numbered years reflect only the direct TA 

activities of FASD.

32 The Town Hall Meetings (THM) are conducted only in even-numbered years, so the targets in odd-numbered years reflect only the direct TA 

activities of FASD.

33 Target has been increased from previously reported.

34 Target has been increased from previously reported.
133

Measure

Year and Most 

Recent Result /

Target for 

Recent Result /

(Summary of 

Result)

FY 2013 

Target

FY 2015 

Target

FY 2015 

Target 

+/-

FY 2013 

Target 

1.4.10 For CSAP, the number of individuals trained by 

SAMHSA’s Science and Services Programs

FY 2012: 9,211

Target:

37,896

(Target Not 

Met)

37,049 30,000 -7,049

2.3.36 Percent of participants that agree or strongly agree 

that the training or TA provided increased their capacity 

to do substance abuse prevention work (Outcome)

FY 2011: 83.8%

(Historical 

Actual)

Set 

Baseline

TBD N/A

2.3.37 Percent of participants that agree or strongly agree 

that the training or TA provided increased their 

organization's capacity to do substance abuse prevention 

work (Outcome)

N/A Set 

Baseline

TBD N/A
134

Program: Partnerships for Success

NOTE: SAMHSA grant awards are made late in the year. FY 2012 funding is reflected in FY 2013 performance targets, FY 2014 

funding is associated with FY 2015 targets.

Measure

Year and Most 

Recent Result /

Target for 

Recent Result /

(Summary of 

Result)

FY 2013 

Target

FY 2015 

Target

FY 2015 

Target

+/-

FY 2013 

Target 

2.3.78 Number of communities who report an increase in 

prevention activities that are supported by collaboration 

and leveraging of funding streams (Output)

FY 2011: 50

Target:

24

(Target 

Exceeded)

50 50 Maintain

2.3.79 Number of EBPs implemented by sub-recipient 

communities (Output)

FY 2011: 1,976

Target:

96

( Target 

Exceeded)

950 950 Maintain

2.3.80 Number of sub-recipient communities that 

improved on one or more targeted NOMs indicators 

(Outcome)

FY 2011: 32

Target:

24

(Target 

Exceeded)

50 50 Maintain
135

Program: Strategic Prevention Framework State Incentive Grants35

NOTE: SAMHSA grant awards are made late in the year. FY 2012 funding is reflected in FY 2013 performance targets, FY 2014 

funding is associated with FY 2015 targets.

Measure

Year and Most 

Recent Result /

Target for 

Recent Result /

(Summary of 

Result)

FY 2013 

Target

FY 2015 

Target

FY 2015 

Target

+/-

FY 2013 

Target

2.3.21 Decrease underage drinking as measured by an 

increase in the percent of SPF SIG states that show a 

decrease in 30-day use of alcohol for individuals 12 - 20 

years old (Outcome)

FY 2011: 85.0%

Target:

50.4%36

(Target 

Exceeded)

50.0% 50.0% Maintain

2.3.23 Percent of SPF SIG states showing a decrease in 

state level estimates of survey respondents (age 12-17) who 

report 30-day use of other illicit drugs (Outcome)

FY 2011: 50.0%

Target:

59.0%

37

(Target Not Met 

but Improved)

52.0% 52.0% Maintain

2.3.25 Percent of SPF SIG states showing an increase in 

state level estimates of survey respondents (age 12-17) who 

rate the risk of substance abuse as moderate or great 

(Outcome)

FY 2011: 27.0%

Target:

47.1%38

(Target Not Met 

but Improved)

50.0% 50.0% Maintain

2.3.28 Number of evidence-based policies, practices, and 

strategies implemented (Output)

FY 2011: 834

Target:

39739

(Target 

Exceeded)

25040 250 Maintain

 

35 The SPF SIG program is cohort-based and, as a result, there are observable decreases in targets to reflect the close-out of Cohort III in FY 2011, 

Cohort IV in FY 2012, and Cohort V in FY 2013. Data reported for output measures are collected through the PMRTS. However, outcome data are 

based on calculations from NSDUH state-level, pooled sample estimates that are available at the time of the budget submission. For example, FY 

2011 results were calculated using pooled NSDUH samples from 2009/2010 and 2010/2011.

36 Includes Cohorts III and IV. Cohort IV began the SPF process July 2009.

37 Includes Cohorts III and IV. Cohort IV began the SPF process July 2009.

38 Includes Cohorts III and IV. Cohort IV began the SPF process July 2009.

39 Includes Cohorts III and IV. Cohort IV began the SPF process July 2009.

40 Target decreased due to close-out of Cohort III and IV.
136

Grant Award Table

(Whole Dollars)

FY 2012 

Actual

FY 2013 

Annualized CR

FY 2014 

President's Budget

Number of Awards 291 298 316

Average Awards $486,698 $448,982 $416,260

Range of Awards $50,000 - $2,300,000 $50,000 - $2,300,000 $50,000 - $2,300,000
137

SAMHSA

Substance Abuse Treatment

Table of Contents

SAMHSA/Substance Abuse Treatment

1. SAMHSA/Programs of Regional and National Significance.............................................. 139

a) Opioid Drug Treatment/Regulatory Activities.............................................................. 140

b) Screening, Brief Intervention and Referral to Treatment (SBIRT)............................... 142

c) Targeted Capacity Expansion-General (TCE-General) ................................................ 143

d) Pregnant & Postpartum Women (PPW)........................................................................ 144

e) Strengthening Treatment Access & Retention (STAR) ................................................ 145

f) Recovery Community Services Program (RCSP)......................................................... 146

g) Access to Recovery ....................................................................................................... 147

h) Children & Family Programs........................................................................................ 147

i) Treatment Systems for Homelessness........................................................................... 149

j) Minority AIDS .............................................................................................................. 150

k) Criminal Justice Activities ............................................................................................ 151

l) Addition Technology Transfer Centers (ATTCs) ......................................................... 154

m) Special Initiatives/Outreach .......................................................................................... 155

2. PRNS Mechanism Table by APT........................................................................................ 163

3. Substance Abuse Prevention and Treatment Block Grant .................................................. 175

4. PRNS Mechanism Table by SLOA..................................................................................... 285
138

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139

SAMHSA/Programs of Regional and National Significance

Substance Abuse Treatment

(Dollars in thousands)

FY 2012 FY 2013 FY 2014 FY 2014

Programs of Regional & National Significance

Actual Annualized 

CR

President's 

Budget

+/- 

FY 2012

CAPACITY:

Opioid Treatment Programs/Regulatory Activities........... $12,886 $8,941 $8,746 -$4,140 

Prevention and Public Health Fund....................... 4,000 N/A --- -4,000 

Screening, Brief Intervention and Referral to Treatment.. 53,187 28,360 30,000 -23,187 

PHS Evaluation Funds (non-add).......................... 2,000 2,012 --- -2,000 

Prevention and Public Health Fund....................... 25,000 N/A 30,000 +5,000 

TCE-General................................................................ 27,980 28,151 13,256 -14,724 

Pregnant & Postpartum Women.................................... 15,970 16,067 15,970 ---

Strengthening Treatment Access and Retention.............. 1,672 1,682 1,000 -672 

Recovery Community Services Program......................... 2,445 2,460 2,562 +116.63 

Access to Recovery...................................................... 98,268 98,869 65,000 -33,268 

Children and Families.................................................... 30,620 30,807 29,678 -942 

Treatment Systems for Homeless................................... 41,571 41,826 41,571 ---

Minority AIDS.............................................................. 65,863 66,266 52,359 -13,504 

Criminal Justice Activities.............................................. 66,903 67,920 65,135 -1,768 

Subtotal, Capacity 417,366 391,351 325,277 -92,089 

SCIENCE AND SERVICE:

Addiction Technology Transfer Centers.......................... 9,064 9,119 8,081 -983 

Special Initiatives/Outreach............................................ 2,267 2,281 1,436 -831 

Subtotal, Science and Service 11,331 11,400 9,517 -1,814 

TOTAL, PRNS $428,697 $402,751 $334,794 -$93,903 

1/The FY 2012 total includes Prevention and Public Health Fund (PPHF) dollars in the amount of $25.0 million for SBIRT and $3.8 million 

for Opioid. The FY 2013 Prevention Fund resources are reflected in the Office of the Secretary, the FY 2014 total includes PPHF dollars in 

the amount of $30.0 million for SBIRT. In FY 2012- FY 2014, the CSAT Minority Fellowship Program budget is reflected in the Health 

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

Authorizing Legislation...................Sections 506, 508, 509, 514 of the Public Health Service Act

FY 2014 Authorization..................................................................................................... Expired

Allocation Method .................................. Competitive Grants/Contracts/Cooperative Agreements
140

Program Description and Accomplishments

Opioid Drug Treatment/Regulatory Activities

SAMHSA/CSAT funds a number of contracts that support its regulatory efforts and monitoring 

activities of opioid treatment programs. In FY 2012, SAMHSA funded the continuation of 

two grants, supported eight contracts, as well as nine new multi-year grants.

SAMHSA will continue to support the Physician Clinical Support System-Opioids (PCSS-O), a 

national mentoring network offering support (clinical updates, evidence-based outcomes, and 

training) to physicians and other medical professionals in the appropriate use of methadone and 

other opioids for the treatment of chronic pain and opioid addiction. This program also 

addresses the nation’s rise in opioid-associated morbidity and mortality that has been spurred by 

misuse/abuse, and fatal drug interactions involving methadone and other prescription 

medications, over the counter medications, and illicit drugs. The PCSS-O program works to 

develop a variety of evidence-based, authoritative, and educational programs that will be offered 

in multiple media formats and are cost effective, easy to use, and sensitive to the varied needs of 

different healthcare providers. This will increase the likelihood that these materials will be used 

by prescribers to develop an extensive system of dissemination activities through the efforts of 

consortium members aimed at increasing the knowledge base and training of prescribers (or 

those in training who will become prescribers) from diverse multi-disciplinary healthcare 

backgrounds, and also to develop a novel system of peer support and mentoring for providers 

from diverse clinical backgrounds or those who practice in diverse geographic and demographic 

areas, both urban and rural, in order to provide the necessary support to increase confidence in 

the ability to safely and effectively utilize opioids in patients with chronic pain or opioid use 

disorders. 

In FY 2012, SAMHSA continued funding for the last year of the Physician Clinical Support 

System-Buprenorphine (PCSS-B), a program designed to assist practicing physicians that want

to incorporate into their practices the treatment of prescription opioid-and-heroin dependent 

patients using the medication buprenorphine. The goal of this program is to expand access to 

office-based buprenorphine treatment by first providing expert education and training to 

physicians on the appropriate use of buprenorphine, and to certify their eligibility to treat opioid 

dependent patients. The PCSS-B works collaboratively with medical organizations to educate 

physicians about opioid use disorders and the use of buprenorphine in treating opioid addiction. 

Mentoring is also made available to physicians-in-training and those engaged in clinical practice. 

Educational presentations on advanced topics in the treatment of opioid use disorders are offered 

monthly by telemedicine modalities, including telephone conferencing and webinars.

In FY 2012, SAMHSA supported a new program, the Prescription Drug Monitoring Program 

(PDMP) Electronic Health Record (EHR) Integration and Interoperability Expansion, with 

$4 million in funding from the Prevention Fund. Working collaboratively with the Harold 

Rogers Prescription Drug Monitoring National Training and Technical Assistance Program at the 

Department of Justice, this program is intended to complement existing federal efforts by 

improving real-time access to PDMP data by integrating PDMPs into existing technologies, like 

EHRs, in order to improve the ability of state PDMPs to reduce the nature, scope, and extent of 
141

misuse, use and also to strengthen state PDMPs that are currently operational by providing 

resources to make the changes necessary to increase interoperability of state PDMPs. 

Nine states received funding to integrate their PDMPs into EHR and other health information 

technology systems to expand utilization of PDMP data by increasing the production and 

distribution of unsolicited reports and alerts to prescribers and dispensers of prescription data. 

Grant funds will also be used by states to allow for modification of their systems to expand 

interoperability; enhancement of current EHR and pharmacy systems; adoption of specification 

for exchanging PDMP reports; and modification of EHR and pharmacy systems to permit new 

linkages.

This grant program is complemented by an evaluation program conducted by the Centers for 

Disease Control and Prevention (CDC).

SAMHSA also collaborated with the Office of the National Coordinator (ONC), the CDC, and 

the Office of the National Drug Control Policy (ONDCP) on a jointly funded Enhancing Access 

to PDMPs Project. This project stems from joint efforts of public sector and private industry 

experts that participated in the White House Roundtable on Health IT and Prescription Drug 

Abuse in June 2011. In turn, the HHS Prescription Drug Abuse and Health IT Work Group of 

the Behavioral Health Coordinating Committee created the Action Plan for Improving Access to 

Prescription Drug Monitoring Programs through Health Information Technology. 

The project’s purpose is to use Health IT to increase timely access to PMDP data in an effort to 

reduce prescription drug misuse and overdose. The project’s focus is to enhance access for three 

types of medical professionals within a variety of care settings: 

Ambulatory clinic healthcare providers (e.g., physicians, nurses, nurse practitioners) 

Emergency department (ED) physicians 

Dispensing pharmacists

The project sets out to investigate and develop the standards necessary to utilize existing 

technologies, the health information exchanges, and the PDMPs to improve the tracking of 

opioid use by convening work groups and implementing pilot studies. The first part of the 

project involving the work groups was completed and a report summarizing the findings, 

recommendations, and artifacts of the work groups was finalized and published in June 2012. To 

date, six pilot projects have been launched and an additional pilot candidate is actively being 

engaged to cover seven different pilot types. 

SAMHSA also certifies opioid treatment programs (OTPs) that use methadone, buprenorphine, 

or buprenorphine/naloxone to treat patients with opioid dependence. SAMHSA carries out this 

responsibility by enforcing regulations that established an accreditation-based system, and it is 

accomplished in coordination with the Drug Enforcement Administration (DEA), states, 

territories, and the District of Columbia. An OTP must comply with applicable state licensing 

requirements to operate as an OTP and must meet regulatory requirements set forth in Title 42 

Code of Federal Regulations Part 8 (42 CFR Part 8). The regulations also require each OTP to 

achieve and sustain accreditation by a SAMHSA/CSAT approved accreditation organization as a 
142

condition for SAMHSA certification. SAMHSA funds the Medical Education and Supporting 

Services for Opioid Treatment Program to educate and prepare OTPs to achieve accreditation by 

SAMHSA’s approved accreditation organizations. Accreditation has been shown to improve 

treatment and access to treatment for patients and provides the opportunity for OTPs to 

incorporate best practices in their treatment programs. Other goals include improving OTP 

administration and management, increasing staff retention, providing more OTP staff training, 

increasing availability of comprehensive services and emergency services, and improving patient 

outcomes. Even though most OTPs have been able to achieve initial accreditation 

(approximately 97 percent of over 1,260 active OTPs are accredited), continuing technical 

assistance is considered necessary to assist OTPs in maintaining accreditation, as they are subject 

to re-survey, occurring at least triennially. 

In FY 2013 SAMHSA anticipates funding one grant continuation, 46 new grants and supporting 

seven contracts. New grants include: 20 Enhancing Opioid Treatment Program Patient 

Continuity of Care through Data Interoperability (OTP-CoC) one-year grants. The purpose of 

this program is to provide resources to opioid treatment programs (OTPs) that will enable them 

to develop electronic health record systems that fulfill regulatory requirements, achieve certified 

status, and become interoperable with other patient health record systems. By enhancing OTP 

EHR systems in this manner and achieving levels of integration, it is expected that OTPs will 

improve behavioral health outcomes. Additionally, SAMHSA also anticipates funding 25 oneyear grants to support the Rapid Hepatitis C Virus Screening and Referral grants. The purpose of 

this program is to address the high prevalence of viral hepatitis C infection among IV drug users 

in selected opioid treatment programs (OTPs). In addition to providing rapid hepatitis C virus 

(HCV) testing, applicants must develop a plan for providing referrals for care and treatment that 

include, but are not limited to primary health care, public health, mental health, and medical 

services for those who are HCV positive or are at high-risk of HCV infection. Also planned is a

one, three-year Cooperative Agreement for the Physician Clinical Support System – Medication 

Assisted Treatment grant. The purpose of this program is to build upon the current SAMHSAfunded PCSS-B, a national mentoring network offering support (clinical updates, evidence-based 

outcomes and training) by expanding the focus on buprenorphine to include the other two FDA 

approved medications for the treatment of opioid addiction, methadone and extended release 

naltrexone and increasing the amount of training for office based physicians and opioid treatment 

program medical professionals. The program will provide up to date and evidence-based 

information to support training of health professionals and to address complex issues of 

addiction.

Screening, Brief Intervention and Referral to Treatment (SBIRT)

Screening, Brief Intervention, and Referral to Treatment (SBIRT) was initiated by 

SAMHSA/CSAT in FY 2003, using cooperative agreements to expand and enhance a state or 

tribal organization’s continuum of care. The purpose of the program is to integrate screening, 

brief intervention, referral, and treatment services within general medical and primary care 

settings. 

The SBIRT program requires grant recipients to effect practice change throughout the spectrum 

of medical practice. This is achieved through implementation in all levels of primary care, 

including hospitals, trauma centers, health clinics, nursing homes, employee assistance 
143

programs, and school systems. Practice change also alters the educational structure of medical 

schools by developing and implementing SBIRT curricula as standard and permanent practice. 

Research and clinical experience supports the use of the SBIRT approach to provide effective 

early identification and interventions in primary care and general medical settings. Early 

identification can decrease total healthcare costs by arresting progression toward addiction. 

SBIRT also can identify people, individuals with more serious problems and encourage them to 

obtain appropriate specialty treatment services. Funds may be used for the following services: 

pre/screening for substance use and co-occurring disorders; brief Interventions designed with 

client centered, non-judgmental, motivational interviewing techniques; brief treatment including 

the monitoring of individuals who misuse alcohol and other drugs but are not yet dependent; 

referral to treatment (when indicated) for those who have a substance use disorder; and when 

appropriate, referral to and expansion of specialty treatment services. Since the beginning of this 

program, more than 1.7 million individuals have been screened. Of those, 19 percent required a 

brief intervention, brief treatment, or referral to specialty treatment programs. 

In 2011, over 213,000 clients were served by the SBIRT Program. The percentage of clients 

reporting abstinence at follow-up tripled compared to the percentage reporting abstinence at 

baseline. 

SBIRT has great future potential for promoting changes to the entire primary care medical 

service delivery system. Efforts are underway to identify other funding streams to help take this 

practice to scale. For example, new diagnostic codes have been adopted by 16 states, making it 

easier for doctors to get reimbursed for screening Medicaid patients. Likewise, alcohol 

screening is now available to Medicare beneficiaries as a preventive service without cost. In 

FY 2012, SAMHSA funded the continuation of 27 SBIRT grants, supported five contracts as 

well as three new multi-year grants funded out of the Prevention Fund, and continued to monitor 

the progress of the three FY 2011 multi-year Prevention Fund grants. In FY 2013 SAMHSA 

anticipates funding up to 19 new grants as well as 12 grant continuations and supporting five

contracts.

Targeted Capacity Expansion-General (TCE-General)

The Targeted Capacity Expansion (TCE-General) program was initiated in FY 1998 to help 

communities to bridge gaps in treatment services. TCE funding supports grants to expand or 

enhance a community’s ability to provide rapid, strategic, comprehensive, integrated, 

community-based responses to a specific, well-documented substance abuse capacity problem. 

Since inception, TCE grants have been awarded to address the following targeted populations or 

urgent, unmet, and emerging treatment needs: American Indian and Alaska Natives, Asian 

Americans, Pacific Islanders, rural areas, methamphetamine abuse, e-therapy, grassroots 

partnerships, and other populations and issues. 

In FY 2011, SAMHSA funded Grants to Expand Care Coordination Through the Use of Health 

Information Technology (HIT) in Targeted Areas of Need. The purpose of this program is to 

leverage technology to enhance and/or expand the capacity of substance abuse treatment and 

service providers to serve people, individuals in treatment who have been underserved because 
144

of lack of access to treatment in their immediate community due to transportation concerns, an 

inadequate number of substance abuse treatment and service providers in their community, 

and/or financial constraints. The use of HIT, including web-based services, smart phones, 

behavioral health electronic applications (e-apps), and telehealth will expand and enhance the 

ability of providers to effectively communicate with people, individuals in treatment and to track 

and manage their health to ensure treatment and services are available where and when needed. 

Grantees will use technology that will support recovery and resiliency efforts and promote 

wellness. 

In FY 2012, SAMHSA funded 46 grant continuations and supported 12 contracts as well as six 

new multi-year funded HIT grants. In FY 2013, SAMHSA anticipates funding 14 TCETechnology Assisted Care (TAC) grants, 20 TCE-Peer to Peer (TCE-PTP) services, 30 grant 

continuations, and supporting 10 contracts. The purpose of TCE-TAC is to expand and/or 

enhance the capacity of substance abuse treatment and service providers to serve people, 

individuals in treatment who have been underserved because of lack of access to treatment in

rural areas, or in their immediate community due to transportation concerns, an inadequate 

number of substance abuse treatment and service providers in their community, and/or financial 

constraints. The use of technology, including web-based services, smart phones, and behavioral 

health electronic applications (e-apps), will expand and/or enhance the ability of providers to 

effectively communicate with individuals in treatment and to track and manage their health to 

ensure treatment and services are available where and when needed. 

The TCE-PTP program’s purpose is to expand and enhance service capacity through the 

provision of addiction peer recovery support services for those individuals with substance use 

disorders. It is the expectation that those with lived experience will play an integral role in the 

design, development, and implementation of this program. A primary program objective is to 

help achieve and maintain recovery and to improve the overall quality of life for those being 

served. This will be assessed through increased employment, housing stability, abstinence from 

substance use, social connectedness, and decreased criminal justice involvement.

Pregnant & Postpartum Women (PPW)

Women with substance use disorders and their children, particularly those living at or near the 

poverty line, are among the most vulnerable of populations, and they often have histories of 

physical violence, sexual abuse, co-occurring mental health problems, mental illness, and 

HIV/AIDS. Their children often have multiple health, developmental, and social problems, and 

are at risk for neglect, abuse, and removal from their families and communities. The risk of 

infant mortality and premature births is highly correlated with a pregnant mother’s substance 

abuse, lack of prenatal care, and demographic factors, such as poverty and a lower level of 

education.

As part of SAMHSA’s Strategic Initiative on Trauma and Justice, SAMHSA/CSAT’s Pregnant 

and Postpartum Women (PPW) program has supported gender-and culturally-specific treatment 

service grants for pregnant, postpartum, and other parenting women. Using a family-centered 
145

trauma-informed treatment approach in residential and community settings, with women and 

their minor children at the center, the program has focused on the strengths and resources of the 

entire family. It supports sustained recovery for individual family members, coordinates with 

services in the community, and improves overall family functioning. The PPW program is 

designed to support comprehensive substance abuse prevention, treatment, and recovery support 

services for women, their minor children, age 17 and under children, and family members. 

Services for women include: outreach, engagement, pre-treatment, screening, and assessment; 

detoxification; substance abuse education, treatment, and relapse prevention; health care 

services; specialized assessment, monitoring, and referrals for education, peer support, 

therapeutic interventions and physical safety; mental health care including a trauma-informed 

system of assessments and interventions; parenting education and interventions; home 

management and life skills training; education, testing, counseling, and treatment of hepatitis, 

HIV/AIDS, other STDs, and related issues; and wraparound services including employment 

readiness, and job training and placement, education and tutoring assistance, peer-to-peer 

recovery support activities; and transportation.

Services for children include: screenings and developmental diagnostic assessments; prevention 

assessments and interventions related to mental, emotional, and behavioral wellness; traumainformed system of assessments, interventions, and social-emotional skill building services; 

developmental services and therapeutic interventions; health care services; social services; and 

education and recreational services.

Services for families include: family-focused programs to support family strengthening including 

fathers where appropriate; reunification; alcohol and drug education and referral services; mental 

health promotion and assessment, prevention and treatment services, in a trauma-informed 

context; and social services.

Case management services include: coordination and integration of services; assessment and 

monitoring of services; assistance with community reintegration; and assistance in accessing 

resources from federal, state, and local programs that provide a range of services. 

In FY 2011, the PPW program funded a new cohort of grantees. FY 2011 data show that the 

percentage of women reporting abstinence at six month follow-up doubled compared to those 

reporting abstinence at intake. Employment also showed large increases with the percentage 

tripling from intake to follow-up. In FY 2012, SAMHSA funded the continuation of 20 grants, 

seven new grants, and support for five contracts. In FY 2013, SAMHSA anticipates funding 27 

grant continuations and supporting five contracts

Strengthening Treatment Access & Retention (STAR)

During the initial phase of the STAR program, CSAT joined with the Robert Wood Johnson 

Foundation (RWJF) in an initiative to substantially increase client access and retention using 

process improvement methods. Under a program titled Network for the Improvement of 
146

Addiction Treatment (or NIATx), CSAT awarded 13 Strengthening Treatment Access and 

Retention (STAR) grants and RWJF awarded 27 Paths to Recovery grants to support 

implementation of organizational improvements that included streamlining client intake, 

assessment and appointment scheduling procedures, eliminating paperwork duplication, 

extending clinic hours, contacting client no shows, eliciting customer feedback, and using 

clinical protocols (e.g., motivational interviewing and motivational incentives to engage clients 

during the initial phase of treatment). The NIATx initiative demonstrated that process 

improvement skills can be successfully transferred to treatment organizations. Grantees also 

participated in a learning network that included semi-annual learning sessions, process 

improvement coaching, web resources, information sharing, and peer-to-peer learning 

opportunities.

Based on the NIATx program success, CSAT funded a follow-up effort in 2006, the STAR-State 

Implementation (STAR-SI) program, an infrastructure initiative that promotes state-level 

implementation of process improvement methods to improve access to and retention in 

outpatient treatment. 

 

In FY 2010 and FY 2011, the STAR initiative provided technical assistance and support to six 

SAMHSA/CSAT discretionary grant programs and over 50 treatment organizations to improve 

client access, retention and handoffs to other levels of care. The program also conducted a 

learning collaborative with over 300 treatment and service providers on how to improve thirdparty billing practices in anticipation of the expansion in addiction treatment services coverage 

and health insurance affordability program eligibility under the Affordable Care Act. In FY 

2012, SAMHSA supported four contracts to continue to provide technical assistance in 

promoting service efficiency. In FY 2013 SAMHSA is supporting four contracts.

Recovery Community Services Program (RCSP)

SAMHSA’s Strategic Initiative on Recovery Support focuses on health, home, purpose, and 

community. As part of the community component of this initiative, the Recovery Community 

Services Program (RCSP) responds to the need for community-based recovery support services 

that help prevent relapse and promote long-term recovery. Such services can reduce the strain 

relapse places upon the already overburdened treatment system and minimize the negative 

effects of relapse when it does occur, as well as contribute to a better quality of life for people in 

recovery and their families and communities. The purpose of the RCSP is to advance peer-topeer recovery support services that help to prevent relapse and promote sustained recovery from 

alcohol and drug use disorders.

The RCSP program has targeted a variety of underserved groups including women, AfricanAmericans, Latinos, rural populations, people, individuals recently released from incarceration, 

the homeless, adolescents, and gay, lesbian, and transgender populations. In addition, the RCSP 

program serves family members and allies of individuals in recovery. The primary targets for 

the RCSP initiative are people with a history of alcohol and/or drug problems who are in or 

seeking recovery. RCSP grants provide a wide range of services such as peer coaching; peer 

support groups; life skills workshops; peer-led resource connector programs for housing, 
147

employment, educational assistance, vocational rehabilitation and training; leadership 

development; alcohol and drug free events; and recovery drop-in centers. In FY 2011, the RCSP 

program provided supplemental funding to the existing 13 grantees. FY 2011 data demonstrates 

positive outcomes, with 80 percent of clients served reporting being abstinent at follow-up; 

35 percent reported being employed; 57 percent reported being housed; and 99 percent reported 

not being involved in the criminal justice system. 

In FY 2012, SAMHSA funded the continuation of five grants and support for two contracts. In 

FY 2013, SAMHSA anticipates funding five grant continuations and supporting two contracts.

Access to Recovery

The Access to Recovery (ATR) program represents one component of SAMHSA’s Recovery 

Support Strategic Initiative. This effort provides grants to states, tribes, and tribal organizations 

to carry out voucher programs that expand substance abuse treatment capacity and promote 

choice among clinical treatment and recovery support providers in order to facilitate client 

recovery from substance abuse. The objectives of the program are to expand substance abuse 

treatment capacity by increasing the number and types of providers (including faith-based and 

grass-roots providers) to allow clients to play a more significant role in the development of their 

treatment plans through the use of electronic vouchers, and to link clinical treatment with critical 

recovery support services such as childcare, transportation, and mentoring. The populations 

served through ATR include the following: youth, users of methamphetamine, individuals 

involved with the criminal justice system, military families, and women with dependent children. 

ATR enhances accountability by measuring outcomes and monitoring data to deter fraud and 

abuse.

Since 2004, ATR has funded a total of 69 grants in a total of three cohorts: 15 three-year grants 

were awarded in FY 2004, 24 three-year grants were awarded in FY 2007, and 30 four-year 

grants were awarded in FY 2010. ATR is designed to: (1) allow recovery to be pursued through 

personal choice and many pathways; (2) require grantees to manage performance based on 

outcomes that demonstrate client successes; and (3) expand capacity by increasing the number 

and types of providers who deliver clinical treatment and/or recovery support services. The 

target is 225,000 clients for the third cohort, which began in FY 2010, with approximately 

33,500 to be served in the first year; 70,750 clients to be served in each of the two subsequent 

years; and 50,000 to be served in the final year. In its first year of operation this cohort of ATR 

has exceeded its target of 33,500, having served over 47,000 clients. SAMHSA funded the 

continuation of 30 grants and supported six contracts in FY 2012. SAMHSA will fund 30 grant 

continuations in the final year of the third cohort in FY 2013 as well as one contract. 

Children & Family Programs

As part of SAMHSA’s Trauma and Justice Strategic Initiative, SAMHSA/CSAT’s Adolescent

Treatment grants are designed to address the gaps in substance abuse services by providing 

services to adolescents and their families/primary caregivers using previously proven effective 
148

practices that are family-centered. Forty-eight grantee sites across the nation are implementing 

the Assertive Community Reinforcement Approach and the Assertive Continuing Care 

(ACRA/ACC) treatment interventions. ACRA and ACC were developed with funding from 

SAMHSA/CSAT and the National Institute on Alcohol Abuse and Alcoholism (NIAAA), and 

have proven effective in building community capacity for family-centered treatment. These 

approaches, which are in the public domain, allow for cost-effective training of multiple staff, 

and are amenable to a “train-the-trainers” approach, ensuring sustainability over time. 

Each site has received training and certification to conduct a standardized bio-psychosocial 

clinical assessment that identifies substance use disorders, co-occurring mental health problems, 

mental illness, and family support and functioning. Utilizing this intensive process ensures that a 

standardized implementation of the intervention is completed. Important lessons to be learned 

from these grantee sites include how to effectively implement and sustain best and proven 

practices in community-based agencies. 

The Assertive Adolescent and Family Treatment (AAFT) grants provide adolescents 12 through 

17 and their families/care givers with: a full bio-psycho-social clinical assessment, the Global 

Appraisal of Individual Needs, which identifies substance use disorders, co-occurring mental 

health problems, mental illness, and family support and functioning; six months of substance 

abuse treatment and follow-up monitoring using the ACRA and ACC; urine testing; case 

management; and referrals to other needed community service providers. 

In FY 2012 SAMHSA funded 13 new state-based adolescent treatment grants to further the use 

of effective family-centered treatment approaches through state-wide training and uptake while 

supporting connections between locally based treatment systems and their state, tribal, or 

territorial infrastructure. The services provided under this program include: evidence-based 

assessment and treatment intervention, outreach and other engagement strategies; recovery 

services and supports (e.g., peer-to-peer support, parent/family/caregiver support, youth and 

caregiver respite care, technology support services, therapeutic mentors, behavioral health 

consultation, vocational, educational and transportation services and case management and 

coordination services.

In addition to the adolescent treatment grant programs, SAMHSA/CSAT has been collaborating 

with the Administration for Children and Families (ACF) through an inter-agency agreement to 

fund a National Center on Substance Abuse and Child Welfare (National Center). The vast 

majority of children, particularly infants, who are placed in protective custody have a parent with 

a substance use disorder. Thus, it is imperative that child welfare, substance abuse treatment and 

service providers, and the courts work efficiently together. Activities of this National Center 

include in-depth technical assistance to states, forging more extensive partnerships with family 

drug courts, and planning greater emphasis on work with tribes. ACF grantees will be able to 

draw upon SAMHSA technical assistance provided to the child welfare and substance abuse 

treatment fields, including grants awarded under an ACF grant program entitled “Targeted 

Grants to Increase the Well Being of and to Improve the Permanency Outcomes for Children 

Affected by Methamphetamine and Other Substance Abuse,” referred to as Regional Partnership 

grants. 
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In FY 2012, the adolescent portfolio supported 32 grant continuations, six contracts and 13 new 

state grants. In FY 2013, SAMHSA anticipates funding 13 grant continuations and supporting 

five contracts. Additionally, SAMHSA anticipates funding 11 new grants.

Treatment Systems for Homelessness

SAMHSA’s Center for Substance Abuse Treatment (CSAT) manages two grant portfolios under 

its Grants for the Benefit of Homeless Individuals (GBHI) authority (Treatment for Homeless 

and Cooperative Agreements to Benefit Homeless Individuals (CABHI), that provide focused 

services to individuals with a substance use disorder or who have co-occurring substance use and 

mental disorders. These programs tie directly to the SAMHSA Recovery Support Strategic 

Initiative which focuses specifically on “home” as an integral component of one’s well-being.

The Treatment for Homeless-General grants, funded solely by CSAT, enable communities to 

expand and strengthen their substance abuse treatment services for individuals who are at risk for 

homelessness or have experienced homelessness (including chronic homelessness) who have 

substance use disorders or with co-occurring substance use and mental disorders, and move them 

to permanent supportive housing. In addition, CSAT provides funds for expanding and 

strengthening substance abuse treatment services for homeless, alcohol-dependent people, 

individuals who have histories of public inebriation, frequent emergency room visits, arrests, 

mental illness, or co-occurring substance use and mental disorders. 

In FY 2008, CSAT also funded grants that address services in supportive housing (SSH). The 

Treatment for Homeless-SSH grants seek to expand and strengthen treatment services for people, 

individuals who experience chronic homelessness by providing linkages to appropriate treatment 

for substance use or other support services. This approach combines long-term, communitybased housing assistance and intensive individualized treatment and recovery support services to 

those experiencing chronic homelessness who have substance use disorders or co-occurring 

substance use and mental disorders. This is a cost-effective combination of affordable housing 

with substance abuse treatment services which helps people live more stable, productive lives 

and leads to reductions in substance use.

In FY 2011, CSAT in collaboration with CMHS awarded CABHI under the GBHI authority. 

The major goal of the program is to ensure that the most vulnerable individuals who experience 

chronic homelessness receive access to sustainable permanent housing, treatment, and recovery 

supports through grants funds and mainstream funding sources. This program builds on the 

success of the previous SAMHSA SSH and Treatment for Homeless programs. 

All programs funded under the GBHI authority (Treatment for Homeless (general and SSH) and 

CABHI) may purchase a number of services: outreach and direct treatment (including screening, 

assessment, and active treatment) for both mental and substance use disorders. Treatment must 

be provided in outpatient (including outreach-based services), day treatment or intensive 

outpatient, or short-term residential programs (90 days or less in duration and at a cost not to 

exceed 6.5 percent of total grant funds). Case management or other strategies to link with and 

retain clients in housing and other necessary services, including but not limited to primary care 
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services, and to coordinate these services with other services provided to the client; engage and 

enroll individuals in Medicaid and other mainstream benefit programs (e.g., SSI/SSDI, TANF, 

SNAP, etc.); recovery support services designed to improve access to and retention in services 

and to continue treatment gains, which may include (as appropriate for each client) vocational, 

child care, educational and transportation services; independent living skills (e.g., budgeting and 

financial education); employment readiness, training, and placement; crisis care; medications 

management; self-help programs; discharge planning; psychosocial rehabilitation; and peer 

recovery support(s). 

Grantees may also provide the following allowable services: education, screening, and 

counseling for hepatitis and other sexually transmitted infections; active steps to reduce 

HIV/AIDS risk behaviors by their clients. Active steps include client screening and assessment, 

and either direct provision of appropriate services or referral to and close coordination with other 

providers of appropriate services; trauma-informed services, including assessment and 

interventions for emotional, sexual, and physical abuse; and use of an integrated 

primary/substance abuse/mental health care approach in developing the service delivery plan. 

This approach involves screening for health issues and delivery of client-centered substance 

abuse and mental health services in collaboration and consultation with medical care providers. 

In FY 2012, SAMHSA funded the continuation of 95 grants and supported four contracts. 

In FY 2013, SAMHSA anticipates funding 71 grant continuations and support five contracts. In 

addition, CSAT in collaboration with CMHS, also anticipates funding 12 new Cooperative 

Agreements to Benefit Homeless Individuals for States (CABHI-States). CABHI-States builds 

on the current CABHI program by adding a state infrastructure improvement approach 

addressing chronic homelessness to the community-based behavioral health service component 

for newly housed individuals who experience chronic homelessness with substance use disorders 

or co-occurring substance use and mental disorders. 

Minority AIDS

SAMHSA/CSAT’s Minority AIDS (MAI) grants are awarded to community-based organizations 

with two or more years of experience in the delivery of substance abuse treatment and related 

HIV/AIDS services. Funded programs target one or more of the following high-risk substance 

abusing populations: African American, Hispanic/Latino, and/or other racial/ethnic minority 

communities; women, including women with children; adolescents; men who inject drugs; 

minority men who have sex with men (MSM); and individuals who have been released from 

prisons and jails within the past two years. 

In addition to providing substance abuse treatment services, pre-treatment services are provided, 

including the provision of literature and other materials to support behavior change, facilitation 

of access to drug treatment, HIV/AIDS testing and counseling services, and other medical and 

social services in the local community. 

In FY 2011, SAMHSA/CSAT’s TCE/HIV program served approximately 6,200 individuals. Of 

these individuals, approximately 70 percent were between the ages of 25 and 54 years old.
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Approximately 31 percent identified themselves as Hispanic/Latino in ethnicity; 46 percent as 

African-American; 22 percent White; one percent Asian, Native Hawaiian, or Pacific Islander; 

and 4 percent as American Indian/Alaska Native.

In FY 2011, SAMHSA awarded 11 Minority AIDS Initiative Targeted Capacity Expansion 

(MAI-TCE) Integrated Behavioral Health/Primary Care Network Cooperative Agreements. This 

program is jointly funded with CMHS and CSAP and facilitates the development and expansion 

of culturally-competent and effective integrated behavioral health and primary care networks--

which includes HIV services and medical treatment-- within racial and ethnic minority 

communities in the 11 Metropolitan Statistical Areas and Metropolitan Divisions most impacted 

by HIV/AIDS. Expected outcomes include reducing the impact of behavioral health problems, 

HIV risk and incidence, and HIV-related health disparities in these areas. SAMHSA continued 

to support these grants in 2012.

In FY 2012, SAMHSA funded the continuation of 75 grants and supported five contracts as well 

as a new cohort of 52 grants to target areas of highest need based on the most recently available 

HIV epidemiological data. 

In FY 2013, SAMHSA anticipates funding 79 grant continuations and supporting four contracts 

and 38 new grants. The 38 grants will support Targeted Capacity Expansion: Substance Abuse 

Treatment for Racial/Ethnic Minority Women at High Risk for HIV/AIDS (TCE-HIV: Minority 

Women). The purpose of this program is to expand substance abuse treatment and HIV services 

for African American, Hispanic/Latina, and other racial/ethnic minority women (ages 18 years 

and older), including heterosexual, lesbian, bisexual, previously incarcerated women, and these 

women’s significant others, who have substance use or co-occurring substance use and mental 

disorders, and are living with or at risk for HIV/AIDS.

Criminal Justice Activities

Criminal Justice (CJ) activities include grant programs which focus on diversion, alternatives to 

incarceration, and re-entry from incarceration for adolescents and adults with substance use 

disorders, and/or co-occurring substance use and mental disorders. These activities comport 

directly with SAMHSA’s Trauma and Justice Strategic Initiative efforts. Data shows positive 

improvements in outcomes of clients served by the CJ portfolio. For example, in 2011, 

abstinence increased by over 62 percent from intake to follow-up, CJ involvement decreased by 

11.7 percent, and employment and housing increased by 37 percent and 30 percent, respectively.

The proposed number of clients to be served with 2014 funding is 3,552. Outcomes including 

abstinence from substance use will also be tracked. By 2015, 80 percent of clients are expected 

to report being abstinent from substance use and 94.9 percent of clients are expected to report 

having no involvement with the criminal justice system.

Drug Courts

Drug courts are designed to combine the sanctioning power of courts with effective treatment 

services for a range of populations and problems such as alcohol and/or drug use, child 
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abuse/neglect or criminal behavior, mental illness, and veterans’ issues. In 2010, the criminal 

justice system was the largest single source of referrals to substance abuse treatment. As 

treatment drug courts and other problem solving courts addressing drug and other behavioral 

health-related issues are being established at a high rate, communities are challenged to find 

sufficient substance abuse treatment and recovery support resources for people referred by the 

courts.

In FY 2010, SAMHSA/CSAT funded 10 new adult treatment drug court grants for three years at 

a cost of up to $325,000 per year. Also in FY 2010, SAMHSA and the Department of Justice 

(DOJ)/Office of Justice Programs (OJP)/Bureau of Justice Affairs (BJA) developed a joint 

program to enhance court services, coordination, and the substance abuse treatment capacity of 

adult drug courts. The purpose of this joint initiative is for applicants to submit one application 

that outlines a comprehensive strategy for enhancing drug court capacity. SAMHSA and BJA 

jointly funded 20 new adult treatment drug court grants. Each grantee was awarded one separate 

grant from each agency, representing an innovative braided funding opportunity. Any braided 

amounts spent or awarded will be tracked as distinct funding streams and will only be used for 

purposes consistent with legislative direction and intent. This collaboration was modeled after 

the successful SAMHSA and DOJ/Office of Juvenile Justice and Delinquency Prevention 

(OJJDP) collaborative juvenile treatment drug court grant program.

Funding for both the SAMHSA/CSAT and the SAMHSA/OJP/BJA adult treatment drug court 

programs must be used primarily for the following: direct treatment or prevention services for 

diverse populations at risk; “wrap-around”/recovery support services designed to improve access 

and retention; to provide drug testing for illicit substances required for supervision, treatment 

compliance, and therapeutic intervention; education support; relapse prevention and long-term 

management; Medication-Assisted Treatment (MAT); and HIV testing conducted in accordance 

with state and local requirements. 

In 2010 SAMHSA started the Children Affected by Methamphetamine/Family Treatment Drug 

Court program. These grants provide a child care coordinator to link available community-based 

social services resources that will focus on the trauma to the youngest victims caused by 

substance abuse/methamphetamine use in the family and concurrent criminal justice system 

involvement. In FY 2010, SAMHSA/CSAT funded 12 grants at up to $370,000 per year for up 

to four years. 

The Children Affected by Methamphetamine (CAM) program delivers services to the children of 

parents participating in Family Drug Treatment Court (FDTC). This grant program has been 

instrumental in developing a FDTC model that includes services for children, as well as, 

parenting/family programs for the family. Examples of services and supports for children, 

parents and families include: identification of substance exposed newborns so that interventions 

can be initiated/enhanced with these infants at birth; coordination with child welfare agencies 

around services provided to the family and child; home visiting services or referrals and linkages 

for medical and/or developmental follow-up with pediatric specialists knowledgeable about 

exposure to methamphetamine; primary care coordination; developmental assessments and 

services, and intervention with children identified as needing services; mental health services to 

children; and case management services. Services and linkages for parents include: evidence-
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based strategies to promote parenting abilities and address trauma; ancillary services for families 

to provide assistance in securing needed services such as safe and drug-free housing, 

transportation, vocational training and education, government benefits, legal services and child 

care; family planning services to avoid future in-utero exposure to methamphetamine and other 

drugs; domestic violence prevention/intervention services; and training for foster parents, 

relatives, and other substitute caregivers about the special needs of children and youth who have 

suffered from abuse or neglect and whose parents have a substance use disorder. Services for 

families include: evidence-based family and parenting interventions designed for children of 

parents with substance use disorders and their parents; and family counseling to strengthen 

family functioning and assist with reunification of families when children have been in out-ofhome placements. 

In FY 2012, SAMHSA funded the continuation of 81 Drug Court grants and supported eight

contracts, as well as 54 new grants. In FY 2013, SAMHSA will fund the continuation of 76 

grants, support for five contracts, and 51 new grants.

Offender Re-entry Program

The Offender Reentry Program (ORP) grants provide screening, assessment and comprehensive 

treatment and recovery support services to offenders reentering the community, as well as 

offenders who are currently on or being released from probation or parole. SAMHSA and the 

DOJ/BJA share a mutual interest in supporting and shaping offender re-entry-treatment services, 

as both agencies fund “offender reentry” programs. Formal agreements have been developed to 

further encourage and engage in mutual interests and activities related to criminal justicetreatment issues. ORP grantees are expected to seek out and coordinate with local federallyfunded offender reentry initiatives, including the DOJ/BJA’s Prisoner Reentry Initiative or 

“Second Chance Act” offender re-entry programs, as appropriate. 

Funding for the ORP may be used for the following services/activities: screening, comprehensive 

individual assessment for substance use and/or co-occurring mental disorders, case management, 

program management and referrals related to substance abuse treatment for clients; alcohol and 

drug treatment; wraparound services supporting the access to and retention in substance abuse 

treatment or to address the treatment-specific needs of clients during or following a substance 

abuse treatment episode; individualized services planning; drug testing as required for 

supervision, treatment compliance, and therapeutic intervention; support in obtaining a GED 

and/or other necessary education; and relapse prevention and long-term management support.

Other Criminal Justice Activity

In FY 2011, SAMHSA awarded grants to Develop and Expand Behavioral Health Treatment 

Court Collaboratives (BHTCC) in collaboration with CMHS. SAMHSA's vision of a BHTCC in 

the criminal justice system is one that supports treatment and recovery for people with behavioral 

health conditions and that improves public health and public safety by transforming the 

behavioral health system at the community level. The purpose of the BHTCC grant program is 

to provide state and local criminal and dependency courts serving adults with more flexibility to 

collaborate with the other judicial components and local community treatment and recovery 
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providers to better address the behavioral health needs of adults who are involved with the 

criminal justice system. Funds may be used for the following services/activities: purchase and/or 

administration of brief diagnostic and screening tools and instruments for identification of 

behavioral health needs for the identified individuals in need; treatment services in outpatient, 

day treatment, intensive out patient, and residential treatment; services to improve family 

functioning; employment support services; addressing criminogenic factors leading to 

recidivism; case management models such as wraparound services, team approaches that include 

adult criminal court supervising authorities, and existing treatment alternatives organizations; 

drug testing for illicit substances required for supervision, treatment compliance, and therapeutic 

intervention; education support; relapse prevention and long-term management; forensic peer 

support; medication-assisted treatment (MAT); and HIV testing conducted in accordance with 

state and local requirements. 

In FY 2012, SAMHSA funded the continuation of 27 grants and supported five contracts and 

funded 28 new grants. This includes funding for the Teen Courts program (TCP), of which the 

primary focus is on preventing crimes by diverting youth with substance abuse treatment needs 

from deeper penetration into the traditional juvenile justice system. Funds will be used to 

provide screening, assessment, substance abuse treatment, and recovery support services for 

youth involved in a TCP.

Funding for the TCP may be used for the following services/activities: screening, comprehensive 

individual assessment for substance use and/or co-occurring mental disorders, case management, 

program management and referrals related to substance abuse treatment for youth; alcohol and

drug treatment; wrap-around services supporting the access to and retention in substance abuse 

treatment or to address the treatment-specific needs of clients during or following a substance 

abuse treatment episode; individualized services planning; drug testing as required for treatment 

compliance and therapeutic intervention; support in obtaining a GED and/or other necessary 

education; and relapse prevention and long-term management support. 

In FY 2013, SAMHSA/CSAT’s Other Criminal Justice Program anticipates funding 39 grant 

continuations, supporting four contracts and also anticipates funding 15 new grants.

Addiction Technology Transfer Centers (ATTCs)

The Addiction Technology Transfer Center (ATTC) Network supports national activities and 

implements programs and initiatives in response to regional needs, decreasing the gap in time 

between the release of new scientific findings and evidence-based practices and the 

implementation of these interventions by front-line clinicians. ATTCs disseminate evidencebased, promising practices to addiction treatment/recovery professionals, public health/mental 

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

disciplines. The ATTC program dissemination models include technical assistance, training 

events, a growing catalog of educational and training materials, and an extensive array of Webbased resources created to translate the latest science for adoption into practice by the substance 

use disorders treatment workforce. The ATTCs are highly responsive to emerging challenges in 

the field. Data show that over 25,000 people were trained in 2011, exceeding the target of 

20,516. In FY 2012, SAMHSA funded a new cohort of 15 grants. Ten of the new grants are 
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geographically consistent with HHS’s 10 regional offices in order to coordinate SAMHSA 

services, technical assistance and workforce training and development with other HHS Operating 

Divisions such as HRSA, CMS, ACF, and the SAMHSA Regional Administrators. The 

remaining five awards support one national and four focus area ATTCs. In FY 2013, SAMHSA 

will fund the continuation of all 15 grants and support two contracts.

Special Initiatives/Outreach

Special Initiatives/Outreach activities include a grant program for Historically Black Colleges 

and Universities (HBCU)-Center for Excellence, which is an innovative national resource center 

dedicated to continuing the effort to network the 105 HBCUs throughout the United States. The 

HBCU-Center for Excellence promotes workforce development through expanding knowledge 

of best practices and leadership development that enhance the participation of AfricanAmericans in the substance abuse and mental health professions. The Center also supports a 

policy academy which focuses on workforce development, leadership development, crosssystems collaboration, cultural competency, and eliminating disparities. The Center collaborates 

with other HHS agencies including the HHS/Office of Minority Health (OMH) to achieve the 

objectives of various Executive Orders on educational excellence for minority populations. 

Through this program, approximately 31 Substance Abuse Treatment Workforce Development 

pilots were funded to provide opportunities for more students to obtain practical experience in 

the addictions field. This program has increased the number of students interning in behavioral 

health and has established or increased HBCU partnerships with local, regional and state 

behavioral health partners, primarily substance abuse, committed to increasing diversity in the 

addictions field.

In FY 2010 SAMHSA/CSAT entered into an inter-agency agreement with the Agency for 

Healthcare Research and Quality (AHRQ) to examine and graphically display selected trends in 

hospital-based stays for mental health and substance abuse treatment. This work was used to 

write a chapter in the annual AHRQ publication, Healthcare Cost and Utilization Project 

(HCUP) Facts and Figures: Statistics on Hospital Based Care in the US 2008. This report drew 

attention to the extensive hospital resources devoted to people with mental and substance use 

disorders, some of which may be more effectively and efficiently served in community-based 

settings with a recovery-based system of care approach. In FY 2012, SAMHSA funded the 

continuation of one grant and supported one contract. In FY 2013, SAMHSA will fund the 

continuation of one grant and support two contracts.
156 Fiscal Year Amount

FY 2010 $451,912,000

FY 2011 $430,842,000

FY 2012 $428,696,822

FY 2013 $402,750,627

FY 2014 $334,794,000

Funding History1\

1\The funding history is presented on a comparable basis to previous funding levels to represent the 

revised budget structure and includes the PHS Evaluation Funds and Prevention Funds other than in FY 

2013. The FY 2013 Prevention Fund resources are reflected in the Office of the Secretary.

Budget Request

The FY 2014 Budget Request is comprised of $334.8 million at the program level with $304.8

million from Budget Authority and $30.0 million provided by Prevention Funds. This reflects a 

decrease of $92.9 million in Budget Authority. This level of funding enables the continuation of 

most programmatic activities. The request will support 367 grant and 20 contracts, as well as 

183 new grants and two new contracts. The Request includes: 

Screening, Brief Intervention and Referral to Treatment

In FY 2014, SAMHSA requests $30.0 million from the Prevention Fund for the SBIRT program

(an increase of $5 million from the Prevention Fund, but an overall decrease of $23.2 million 

from FY 2012). This level of funding will further support the integration and use of the SBIRT 

model into states and tribal primary care settings. In FY 2014, an estimated 141,435 individuals 

will be served by the program. The request will support 41 grants (25 continuations and 16 new) 

and one contract. Grant funds will further integrate SBIRT within medical treatment settings to 

provide early identification and intervention to at-risk individuals within the context of their 

primary care provider.

Based on the CSAT funded cross-site evaluation of SBIRT’s cohort one grantees (conducted 

between 2004 and 2009)), alcohol was the most widely used substance (74.4 percent) among 

those who screened positive. Among those who reported using illicit drugs, 70.2 percent also 

reported consuming alcohol. Marijuana use was second in prevalence (27.3 percent), and cocaine 

was third (14.5 percent). Rates of use reported for other drugs, although generally low (less than 

5 percent for most specific substances), were consistently higher among patients assigned to 

Brief Treatment (BT) and Referral to Treatment (RT) than those for whom Brief Intervention 

(BI) was recommended. Overall, patients receiving Brief Intervention, Brief Treatment or 

Referral to Treatment BI, BT, or RT reduced their alcohol and substance use at follow-up as 

compared to baseline. Reductions as measured by the Alcohol, Smoking and Substance 

Involvement Screening Test (ASSIST) included significant decreases in:
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Total Substance Involvement Score (TSIS) among higher-risk BI, BT, and RT patients. 

For patients in the high-risk BI, BT, and RT groups, reductions in total substance use 

risk, as measured by the TSIS, were observed and were statistically significant at the 0.05 

level. 

Specific Substance Score for Alcohol (SSA) among BT and RT patients (44 percent and 

49 percent decreases, respectively).

Total Illicit Substance Involvement Score (TISIS) among RT patients (45 percent 

decrease).

Percentages of higher-risk BI, BT, and RT patients using alcohol.

Percentages of BT and RT patients using marijuana and also cocaine.

The SBIRT program generated net social cost savings that far exceeded the costs of the 

program. Correcting for covariates such as gender, race, age, income, education, and marital 

status, the evaluation team found a reduction in social cost from baseline to follow-up when 

considering the cost areas of healthcare utilization, criminal justice (e.g., arrests), automobile 

incidents (e.g., DUIs), and work absences. When all costs were considered, estimated cost 

savings were $1,206 per patient over a 6-month period. When healthcare costs alone were 

considered, estimated cost savings were $644 per patient. Compared to the average total cost of 

$70 per patient, the magnitude of social cost reduction suggests that SBIRT provides significant 

value for a limited investment. 

Access to Recovery

The FY 2014 budget request includes $65.0 million for the ATR program. Although reduced in 

scale from past years, it will serve 21,000 individuals. In FY 2014, the program will preserve the 

core concepts embodied in the three previous ATR cohorts, while also striving to better support 

provisions of the Affordable Care Act. 

State and tribal ATR grants will support the provision of treatment and recovery support services 

to those with substance use disorders. Services payable under Medicaid and covered through 

essential health benefit plans, such as outpatient clinical treatment services and residential 

services, would, for the most part, not be allowable under this program. In order to ensure nonduplication of billing sources, providers will work with clients to link them to other usable 

funding sources where appropriate. For those services not covered, providers will be responsible 

for the provision of direct services. As was the case in the first three cohorts of ATR, 

states/tribes will be required to establish provider networks and develop a voucher-based 

mechanism to ensure client choice can be easily and feely exercised. 

SAMHSA plans to award 19 three-year grants of $3.2 million annually. The majority of services 

provided are expected to be recovery support not otherwise fundable through insurance 

mechanisms. These include services such as transportation, housing, and jobs support. 

ATR grant funds will also support creating linkages with state health information exchanges 

(HIEs) to ensure coordination and non-duplication; working with non-traditional providers, such 

as faith-based and peer providers; working with traditional providers to ensure that proper 

sources of billing are being utilized for recovery support and clinical treatment services not being 
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covered under Medicaid and other sources; and increasing availability and access to training and 

certification programs for non-traditional providers, such as faith-based and peer providers. 

The ATR program will be better integrated into the fabric of health reform as it is implemented 

during 2014. At the same time, service gaps will be filled, especially in the area of recovery 

support, to help achieve comprehensive coverage for those with substance abuse disorders. 

The proposed number of clients to be served with 2014 funding is 21,242. Outcomes including 

abstinence from substance use will also be tracked. By 2015, 80 percent of clients are expected 

to report being abstinent from substance use, 93 percent of clients are expected to report having 

no involvement with the criminal justice system, and 88 percent of clients are expected to report 

having improved social support.

Statewide Network Development Program for Recovery and Resiliency

In FY 2014, SAMHSA requests a total of approximately $1.8 million in Budget Authority ($1.4 

million in CSAT and $0.4 million in CMHS) in support of SAMHSA’s Recovery Support 

Strategic Initiative. These funds will be used to build capacity for statewide consumer-run, 

family member-run, or addiction recovery community organizations to promote cross-service 

system and infrastructure development that is recovery-focused and resiliency oriented. $1.0 

million in budget authority will be used to award new addiction recovery community statewide 

networks. The remaining $0.8M will be braided to allow for supplemental awards for 

collaborative partnerships across the mental and substance use disorder fields. Any braided 

amounts spent or awarded will be tracked as distinct funding streams and will only be used for 

purposes consistent with legislative direction and intent. Eligible applicants for supplements will 

be those organizations who have an existing mental health or addiction statewide network 

award. Up to 10 grant awards at $100,000 will be made for addiction recovery statewide 

networks. Eight supplemental awards will be given at $100,000 each.

Grantees will be expected to facilitate effective participation in state and local behavioral health 

services planning and health reform activities related to improving community-based services 

and supports for people in recovery from substance use disorders, children and youth with 

serious mental health conditions and their families or adult mental health consumers. The 

program will also address gaps in behavioral health policy as well as inform health reform 

planning. In order to ensure a stronger policy voice across the behavioral health field and 

facilitate readiness for the implementation of health reform, a supplemental incentive award will 

be offered to applicants proposing to build a collaborative partnership between mental health and 

addictions peer-run state-wide networks and those that are mental health family-run.

Additionally, partnerships with affiliate health networks will be encouraged.

Housing and Homelessness

SAMHSA works in partnership with the U.S. Interagency Council on Homelessness (USICH) to 

support and implement Opening Doors: The Federal Plan to Prevent and End Homelessness.
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Through both the Recovery Support and Criminal Justice and Trauma Strategic Initiatives, 

SAMHSA promotes collaborative leadership with other federal agencies with collaborative calls, 

trainings, workgroups, and expert panels to address various goals and objectives outlined in the 

Plan. SAMHSA accomplishes the goals and objectives outlined in the Plan by providing 

technical assistance to grantees and other stakeholders regarding behavioral health, 

homelessness, and successful interventions to prevent and end homelessness. SAMHSA takes a 

leadership role in convening expert panels and developing a Policy Academy to address 

homelessness. SAMHSA encourages grantees to provide consumers with meaningful and 

sustainable employment opportunities and permanent housing that supports recovery to prevent 

and end homelessness. The SAMHSA Cooperative Agreements to Benefit Homeless Individuals 

(CABHI) grant program aligns with the USICH goal to improve access to mainstream programs 

and services to reduce people’s financial vulnerability to homelessness and to provide integrated 

primary and behavioral health care services. SAMHSA along with HUD, other HHS agencies, 

and VA, will explore the possibility of developing criteria to incentivize demonstrated 

collaboration between primary and behavioral healthcare providers and homeless assistance 

providers.

In support of the Federal Strategic Plan to Prevent and End Homelessness and SAMHSA’s 

Recovery Support Strategic Initiative, SAMHSA proposes to use approximately $28.6 million in 

Budget Authority in working with state and local Public Housing Authorities and state Medicaid 

agencies to develop systematic, cost-effective, and integrated approaches to housing that 

includes treatment and services for mental and substance use disorders. This program will build 

upon lessons learned from the CABHI and the Department of Housing and Urban 

Development’s (HUD) new Section 811 demonstration program, and will be developed by 

SAMHSA in collaboration with its federal partners, including HUD, Health Resources and 

Services Administration, Centers for Medicare and Medicaid Services, and the Interagency 

Council on Homelessness. The program will specifically focus on providing support services and 

housing to individuals who are chronically homeless.

The program will support innovative strategies to transform and increase the availability of 

affordable housing and to provide needed services and supports that will help integrate 

individuals who are homeless with substance abuse and mental health disorders into the 

community, assist providers in strengthening their infrastructure for delivering and sustaining 

housing to support recovery with integrated behavioral health, and other critical services. The 

program also will assist providers in preparing for implementation of the Affordable Care Act by 

encouraging third-party billing and requiring that clients are enrolled in eligible benefit 

programs. Efforts will include the design and implementation of strategies that require the use of 

SAMHSA funds for providing supportive services to individuals who are not Medicaid-eligible 

(or who in the process of being enrolled), Medicaid funds for covered services, and HUD 

vouchers or other funding sources for housing. SAMHSA’s FY 2014 request for housing and 

homelessness includes a total of $28.6 million ($9.9 million in CSAT and $18.8 million in 

CMHS). A total of up to 38 grant awards of approximately $750,000 dollars each will be 

awarded for five years. 
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Criminal Justice 

Behavioral Health Treatment Court Collaboratives

In support of SAMHSA’s Recovery Support Strategic Initiative, SAMHSA proposes to use a 

total of $4.5 million in Budget Authority ($2.2 million in CSAT and $2.3 million in CMHS) to 

fund an additional cohort of Behavioral Health Treatment Court Collaboratives Grants. The

purpose of this grant program is to allow local courts more flexibility to collaborate with 

multiple criminal justice system components and local community treatment and recovery 

providers to address the behavioral health needs of adults who are involved with the criminal 

justice system. The court collaborative will focus on diversion of adults with behavioral health 

problems from the criminal justice system, including alternatives to incarceration. The 

collaborative will allow eligible individuals to receive treatment and recovery support services as 

part of a court collaborative. This program will focus on connecting with individuals early in 

their involvement with the criminal justice system and prioritize the participation of municipal 

and misdemeanor courts in the collaborative. The program will support community behavioral 

health services for individuals with mental and/or substance disorders and will include a focus on 

veterans involved with the criminal justice system.

The FY 2014 Budget Request includes increases in the following ($0.1 million):

The Recovery Community Services Program request is $2.6 million, an increase of $0.1 

million from FY 2012. This level of funding will support 18 new grants, one contract 

continuation, and one new contract.

The FY 2014 Budget Request includes level funding in the following:

The Pregnant and Postpartum Women request is $16.0 million, the same as FY 2012.

This level of funding will support the continuation of seven grants and two contracts as 

well as 14 new grants. The proposed number of clients to be served with 2014 funds is 

700. Outcomes including abstinence from substance use will also be tracked. By 2015, 

82 percent of clients are expected to report being abstinent from substance use, 26 

percent of clients are expected to report being employed or engaged in productive 

activities, 22 percent of clients are expected to report a permanent place to live in the 

community.

The Treatment Systems for Homeless program request is $41.6 million. This level of 

funding will support the continuation of 35 grants and four contracts as well as 49 new 

grants. The proposed number of clients to be served with 2014 funding is 5,800. 

Outcomes including abstinence from substance use will also be tracked. By 2015, 66.4 

percent of clients are expected to report being abstinent from substance use, 31.7 percent 

of clients are expected to report being employed or engaged in productive activities, and 

24.6 percent of clients are expected to report a permanent place to live in the community.
161

The FY 2014 Budget Request includes decreases in the following ($89.9 million):

The Opioid Treatment Programs request is $8.8 million. This reflects a decrease of $0.1

million below FY 2012. This level of funding will support the continuation of two grants 

and eight contracts as well as 40 new grants.

The SBIRT program request is $30.0 million from the Prevention Fund. This reflects a 

program level decrease of $23.2 million below FY 2012. This level of funding will 

support the continuation of 25 grants, support two contract continuations as well as 16

new grants.

The Targeted Capacity Expansion program request is $13.3 million. This reflects a 

decrease of $14.7 million below FY 2012. This level of funding will support the 

continuation of 30 grants and support four contracts, and will continue to monitor the 

progress of the four FY 2012 multi-year funded HIT Grants. The proposed number of 

clients to be served with 2014 funds is 3,300. Outcomes including abstinence from 

substance use will also be tracked. By 2015, 69 percent of clients are expected to report 

being abstinent from substance use, 44 percent of clients are expected to report being 

employed or engaged in productive activities, 57 percent of clients are expected to report 

a permanent place to live in the community, and 96 percent of clients are expected to 

report having no involvement with the criminal justice system.

The Strengthening Treatment Access and Retention program request is $1.0 million. This 

reflects a decrease of $0.7 million below FY 2012. 

The Access to Recovery program request is $65.0 million. This reflects a decrease of 

$33.3 million below FY 2012. This level of funding will support 19 new grants and one 

contract continuation and two new contracts.

The Children and Families program request is $29.7 million. This reflects a decrease of 

$0.9 million below FY 2012. This level of funding will support the continuation of 24

grants and support three contracts. SAMHSA expects to serve approximately 2,500 

clients with FY 2014 funds. All outcomes, including abstinence from substance use, will 

also be tracked. By 2015, 56 percent of clients are expected to report being abstinent 

from substance use, 80 percent of clients are expected to report being employed or 

engaged in productive activities. This reduction is to technical assistance and contracts 

and will not impact the number of individuals served. 

The Criminal Justice Activities program request is $65.1 million. This reflects a decrease 

of $1.8 million below FY 2012. This level of funding will support 142 grant 

continuations and eight contract continuations and 26 new grants. 

The Minority HIV/AIDS program request is $52.4 million. This reflects a decrease of 

$13.5 million below FY 2012 in the Substance Abuse Treatment appropriation, but when 

combined with the additional resources from Substance Abuse Prevention and Mental 

Health appropriation reflects level funding SAMHSA-wide from the FY 2012 SAMHSAwide funding level. The Substance Abuse Treatment funding will support the 

continuation of 87 grants and support five contracts, and will continue to monitor the 

progress of the 3 FY 2012 multi-year funded grants. The proposed number of clients to

be served with 2014 funds is 13,558. Outcomes including abstinence from substance use 

will also be tracked. By 2015, 62 percent of clients are expected to report being abstinent 

from substance use, 38 percent of clients are expected to report being employed or 

engaged in productive activities, 48 percent of clients are expected to report a permanent 
162

place to live in the community, and 96 percent of clients are expected to report having no 

involvement with the criminal justice system.

The Addiction Technology Transfer Centers program request is $8.1 million. This 

reflects a decrease of $1 million below FY 2012. This level of funding will support the 

continuation of 15 grants. The proposed number of individuals to be trained with 2014 

funding is 20,516. Outcomes including participants who report implementing

improvements will also be tracked. By 2015, 90 percent of participants are expected to 

report implementing improvements in treatment methods on the basis of information and 

training provided by the program.

The Special Initiatives/Outreach program request is $1.4 million. This reflects a decrease 

of $0.8 million below FY 2012. This level of funding will support one contract as well as 

one new grant.

A detailed table for all grant and contract continuations and new activities can be found in

supplementary tables.
163

SAMHSA/Substance Abuse Treatment

PRNS Mechanism Table by APT

(Dollars in thousands)

PRNS-Treatment No. Amount No. Amount No. Amount

Grants/Cooperative Agreements:

 Continuations............................................... 441 $246,494 399 $243,981 367 $172,138

 New/Competing........................................... 187 106,096 226 90,634 173 97,548

 Subtotal.................................................... 628 352,590 625 334,615 540 269,686

Contracts:

 Continuations............................................... 28 73,406 18 61,568 20 60,378

 New/Competing........................................... 2 2,700 5 6,568 2 4,731

 Subtotal.................................................... 3 0 76,106 2 3 68,136 2 2 65,108

Subtotal, PRNS-Treatment 1/..................... 658 $428,697 648 $402,751 562 $334,794

1/ This total includes PRNS items funded with both Budget Authority, Prevention and Public Health Funds and PHS 

Evaluation Funds in FY 2012 and FY 2014. The FY 2013 Prevention Fund resources are reflected in the Office of the 

Secretary. The CSAT Minority Fellowship Program budget is reflected in the Health Surveillance and Program Support 

Appropriation under the Agency-Wide Initiatives Workforce program.

FY 2012 FY 2013 FY 2014

Actual Annualized 

CR

President's 

Budget
164

Outcomes and Outputs

Program: Screening, Brief Intervention and Referral to Treatment

NOTE: SAMHSA grant awards are made late in the year. FY 2012 funding is reflected in FY 2013 performance 

targets, FY 2014 funding is associated with FY 2015 targets.

Measure

Year and Most 

Recent Result /

Target for Recent 

Result /

(Summary of

Result)

FY 2013 

Target

FY 2015

Target

FY 2015 

Target 

+/-

FY 2013 

Target 

1.2.40 Number of clients served (Output) FY 2012: 142,016

Target:

139,650

(Target Exceeded)

139,650 75,015 -64,635

1.2.41 Percentage of clients receiving services 

who had no past month substance use (Outcome)

FY 2012: 42.1%

Target:

36%

(Target Exceeded)

36% 36% Maintain
165

Program: Access to Recovery

NOTE: SAMHSA grant awards are made late in the year. FY 2012 funding is reflected in FY 2013 performance 

targets, FY 2014 funding is associated with FY 2015 targets.

Measure

Year and Most 

Recent Result /

Target for Recent 

Result /

(Summary of 

Result)

FY 2013 

Target

FY 2015

Target

FY 2015

Target 

+/-

FY 2013 

Target 

1.2.32 Number of clients gaining access to treatment 

(Output)

FY 2012: 76,592

Target:

70,750

(Target Exceeded)

70,750 22,142 -48,608

1.2.33 Increase the percentage of adults receiving 

services who had no past month substance use 

(Outcome)

FY 2012: 84.1%

Target:

83.0%

(Target Exceeded)

83.0% 80.0% -3.0%

1.2.35 Percentage of adults receiving services who 

had no/reduced involvement with the criminal justice 

system (Outcome)

FY 2012: 96.6%

Target:

96.0%

(Target Exceeded)

96.0% 93.0% -3.0%

1.2.36 Percentage of adults receiving services who 

had improved social support (Outcome)

FY 2012: 91.9%

Target:

91.0%

(Target Exceeded)

91.0% 88.0% -3.0%
166

Program: Treatment System for Homelessness (GBHI)

NOTE: SAMHSA grant awards are made late in the year. FY 2012 funding is reflected in FY 2013 performance 

targets, FY 2014 funding is associated with FY 2015 targets.

Measure

Year and Most 

Recent Result /

Target for Recent 

Result /

(Summary of 

Result)

FY 2013

Target

FY 2015

Target

FY 2015 

Target 

+/-

FY 2013 

Target 

3.4.22 Percentage of clients receiving services who 

had no past month substance use (Outcome)

FY 2012: 67.1%

Target:

67.4%

(Target Not Met 

but Improved )

67.4% 66.4% -1.0%

3.4.23 Number of clients served (Output) FY 2012: 5,882

Target:

5,800

(Target Exceeded)

5,800 5,800 Maintain

3.4.24 Percentage of clients receiving services who 

were currently employed or engaged in productive 

activities (Outcome)

FY 2012: 32.7%

Target:

32.7%

(Target Met)

32.7% 31.7% -1.0%

3.4.25 Increase the percentage of clients receiving 

services who had a permanent place to live in the 

community (Outcome)

FY 2012: 35.7%

Target:

25.6%

(Target Exceeded)

25.6% 24.6% -1.0%
167

Program: Criminal Justice - Drug Courts

NOTE: SAMHSA grant awards are made late in the year. FY 2012 funding is reflected in FY 2013 performance 

targets, FY 2014 funding is associated with FY 2015 targets.

Measure

Year and Most 

Recent Result /

Target for 

Recent Result /

(Summary of 

Result)

FY 2013 

Target

FY 2015 

Target

FY 2015

Target

+/-

FY 2013 

Target

1.2.63 Percentage of juvenile clients receiving 

services who were currently employed or engaged 

in productive activities (Outcome)

FY 2012: 88%

Target:

88%

(Target Met)

88%

Discontinued

N/A

1.2.64 Percentage of juvenile clients receiving 

services who had a permanent place to live in the 

community (Outcome)

FY 2012: 79.3%

Target:

82%

(Target Not Met

but Improved)

82%

Discontinued

N/A

1.2.65 Percentage of juvenile clients receiving 

services who had no involvement with the criminal 

justice system (Outcome)

FY 2012: 94%

Target:

95%

(Target Not Met

but Improved)

95%

Discontinued

N/A

1.2.67 Percentage of juvenile clients receiving 

services who had no past month substance use 

(Outcome)

FY 2012: 61.6%

Target:

73%

(Target Not Met)

73%

Discontinued

N/A

1.2.70 Number of juvenile clients served (Output) FY 2012: 475

Target:

1,463

(Target Not Met)

1,463

Discontinued

N/A
168

Measure

Year and Most 

Recent Result /

Target for 

Recent Result /

(Summary of 

Result)

FY 2013 

Target

FY 2015 

Target

FY 2015

Target

+/-

FY 2013 

Target

1.2.72 Percentage of adult clients receiving services 

who were currently employed or engaged in 

productive activities (Outcome)

FY 2012: 60.8%

Target:

57.0%

(Target 

Exceeded)

57.0%

55.0%

-2.0%

1.2.73 Percentage of adult clients receiving services 

who had a permanent place to live in the 

community (Outcome)

FY 2012: 44.2%

Target:

43.0%

(Target 

Exceeded)

43.0%

41.0% 

-2.0%

1.2.74 Percentage of adult clients receiving services 

who had no involvement with the criminal justice 

system (Outcome)

FY 2012: 93.1%

Target:

93.0%

(Target 

Exceeded)

93.0%

91.0%

-2.0%

1.2.76 Percentage of adult clients receiving services 

who had no past month substance use (Outcome)

FY 2012: 86.1%

Target:

73.0%

(Target 

Exceeded)

73.0%

71.0%

-2.0%

1.2.79 Number of adult clients served (Output) FY 2012: 5,845

Target:

5,265

(Target 

Exceeded)

5,265

4,413

-852
169

Program: Criminal Justice – Teen Courts

NOTE: SAMHSA grant awards are made late in the year. FY 2012 funding is reflected in FY 2013 performance 

targets, FY 2014 funding is associated with FY 2015 targets.

Measure

Year and Most 

Recent Result /

Target for Recent 

Result /

(Summary of 

Result)

FY 2013

Target

FY 2015

Target

FY 2015 

Target

+/-

FY 2013 

Target

1.2.89 Number of teen court clients served (Output) N/A Set 

Baseline

TBD

N/A

1.2.90 Percentage of teen court clients receiving 

services who had no involvement with the criminal 

justice system (Outcome)

N/A Set 

Baseline

TBD

N/A

1.2.91 Percentage of teen court clients receiving 

services who had no past month substance use 

(Outcome)

N/A Set 

Baseline

TBD

N/A
170

Program: Criminal Justice - Ex-Offender Re-Entry Program

NOTE: SAMHSA grant awards are made late in the year. FY 2012 funding is reflected in FY 2013 performance 

targets, FY 2014 funding is associated with FY 2015 targets.

Measure

Year and Most 

Recent Result /

Target for Recent 

Result /

(Summary of 

Result)

FY 2013 

Target

FY 2015 

Target

FY 2015 

Target

+/-

FY 2013 

Target 

1.2.80 Number of clients served (Outcome) FY 2012: 3,532

Target:

2,912

(Target Exceeded)

2,912 3,552 +640

1.2.81 Percentage of clients who had no past month 

substance use (Outcome)

FY 2012: 77.4%

Target:

80.0%

(Target Not Met)

80.0% 80.0% Maintain

1.2.84 Percentage of clients receiving services who 

had no involvement with the criminal justice system 

(Outcome)

FY 2012: 96.1%

Target:

95.0%

(Target Exceeded)

96.0% 94.9% -1.1%
171

Program: Treatment - Other Capacity41

NOTE: SAMHSA grant awards are made late in the year. FY 2012 funding is reflected in FY 2013 performance 

targets, FY 2014 funding is associated with FY 2015 targets.

Measure

Year and Most 

Recent Result /

Target for Recent 

Result /

(Summary of 

Result)

FY 

2013Target

FY 2015

Target

FY 2015

Target 

+/-

FY 2013 

Target

1.2.25 Percentage of adults receiving services who 

had no past month substance use (Outcome)

FY 2012: 70.0%

Target:

62.0%

(Target Exceeded)

66.0% 60.0% -6.0%

1.2.26 Number of clients served (Output) FY 2012: 40,026

Target:

34,784

(Target Exceeded)

34,784 30,849 -3,935

1.2.27 Percentage of adults receiving services who 

were currently employed or engaged in productive 

activities (Outcome)

FY 2012: 43.3%

Target:

47.0%

(Target Not Met)

47.0% 45.0% -2.0%

1.2.28 Percentage of adults receiving services who 

had a permanent place to live in the community 

(Outcome)

FY 2012: 51.4%

Target:

49.0%

(Target Exceeded)

49.0% 47.0% -2.0%

 

41 Includes TCE General, HIV/AIDS Outreach, Addiction Treatment for Homeless People, individuals, Assertive Adolescent and Family 

Treatment, Family and Juvenile Drug Courts, Young Offender Re-Entry Program, Pregnant and Post-Partum Women, Recovery Community 

Service-Recovery, Recovery Community Service-Facilitating, and Child and Adolescent State Incentive Grants.
172

Measure

Year and Most 

Recent Result /

Target for Recent 

Result /

(Summary of 

Result)

FY 

2013Target

FY 2015

Target

FY 2015

Target 

+/-

FY 2013 

Target

1.2.29 Percentage of adults receiving services who 

had no involvement with the criminal justice 

system (Outcome)

FY 2012: 95.9%

Target:

95.0%

(Target Exceeded)

96.0% 93.0% -3.0%

Program: Treatment - Science and Service Activities42

NOTE: SAMHSA grant awards are made late in the year. FY 2012 funding is reflected in FY 2013 performance 

targets, FY 2014 funding is associated with FY 2015 targets.

Measure

Year and Most 

Recent Result /

Target for 

Recent Result /

(Summary of 

Result)

FY 2013

Target

FY 2015

Target

FY 2015 

Target 

+/-

FY 2013 

Target

1.4.01 Percentage of participants who report 

implementing improvements in treatment methods on 

the basis of information and training provided by the 

program (Outcome)

FY 2012: 90.0%

Target:

90.0%

(Target Met)

90.0% 90.0% Maintain

1.4.02 Number of individuals trained per year 

(Output)

FY 2012: 

29,056

Target:

20,516

(Target 

Exceeded)

20,516 20,516 Maintain

 

42 Includes Addiction Technology Transfer Centers.
173

Measure

Year and Most 

Recent Result /

Target for 

Recent Result /

(Summary of 

Result)

FY 2013

Target

FY 2015

Target

FY 2015 

Target 

+/-

FY 2013 

Target

1.4.09 Increase the number of individuals trained by 

SAMHSA's Science and Services Program (Output)

FY 2012: 

108,494

Target:

37,896

(Target 

Exceeded)

110,00043 110,00044 Maintain

Size of Awards 

(Whole Dollars) FY 2012 Actual

FY 2013 

Annualized CR

FY 2014 

President's Budget

Number of Awards 628 624 550

Average Award $561,450 $536,242 $490,338

Range of Awards $300,000-$7,575,000 $300,000-$600,000 $300,000-$600,000

 

43 Target has been increased from previously reported.

44 Target has been increased from previously reported.
174

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175

Substance Abuse Prevention and Treatment Block Grant

(Dollars in thousands)

FY 2012 FY 2013 FY 2014

Actual Annualized 

CR

President's 

Budget

Substance Abuse Prevention and Treatment Block Grant.............................. $1,800,332 $1,811,350 $1,819,856 +$19,524

PHS Evaluation Funds (non-add)....................................................... $79,200 $79,685 $71,724 -$7,476

FY 2014 

+/- 

FY 2012

Authorizing Legislation........................................ Sections 1921 of the Public Health Service Act

FY 2014 Authorization..................................................................................................... Expired

Allocation Method ............................................................................................... Formula Grants

Program Description and Accomplishments

The Substance Abuse Prevention and Treatment Block Grant Program (SABG) distributes funds 

to 60 eligible states, territories, the District of Columbia, and the Red Lake Indian Tribe of 

Minnesota to plan, carry out, and evaluate substance abuse treatment and recovery support 

services provided for individuals, families, and communities impacted by substance abuse and 

substance use disorders (SUD). 

This formula grant program provides funding based upon specified economic and demographic 

factors and is administered by SAMHSA’s Center for Substance Abuse Treatment and Center for 

Substance Abuse Prevention. All Block Grant applications must include an annual plan that 

contains detailed provisions for complying with each funding agreement specified in the 

legislation, and describe how the applicant intends to expend the SABG. The law includes 

specific provisions and funding set-asides, such as a 20 percent prevention set-aside; an 

HIV/AIDS early intervention set-aside; requirements and potential penalty reduction of the 

Block Grant allotment with respect to sale of tobacco products to those under the age of 18; a 

maintenance of effort requirement; and “hold harmless” provisions that limit fluctuations in 

allotments as the total appropriation changes from year to year. 

The program’s overall goal is to support and expand substance abuse prevention and treatment 

services while providing maximum flexibility. States and territories may expend Block Grant 

funds only for the purpose of planning, carrying out, and evaluating activities related to these 

services. Targeted technical assistance is available for the states and territories through CSAT’s 

State Systems Technical Assistance Project. The SABG requires states to maintain expenditures 

for authorized activities at a level that is not less than the average level of such expenditures

maintained by the state for the two year period preceding the year for which the state is applying 

for a grant. Given the current economic situation, a number of states experienced challenges 

meeting the maintenance of effort requirement in the federal FY 2012 grant cycle, and SAMHSA 

continues to monitor the situation closely. 

Of the amounts appropriated for the SABG program, 95 percent are distributed to states and 

other eligible applicants through a formula prescribed by the authorizing legislation. Factors 
176

used to calculate the allotments include total personal income, state population data by age 

groups (total population data for territories), total taxable resources, and a cost of services index 

factor. 

The SABG is critically important to the states because it provides them the flexibility to respond 

to local and/or regional emergent issues impacting health, public health, and public safety 

through a consistent federal funding stream. For example, this program provides approximately 

32 percent of total State Substance Abuse Agency funding, and 23 percent of total substance 

abuse prevention funding. Because SAMHSA encourages states to focus on these populations, 

individuals who are currently in need of such services may fall into several categories, such as 

having no insurance or limited health insurance coverage for substance use disorder treatment 

and recovery support services, or having been mandated to enter SUD treatment through public 

safety and/or public welfare systems. Individuals and families without health coverage or whose 

health insurance benefit will not cover certain services (e.g., recovery supports) rely on services 

funded by the SABG. States also rely on the SABG funding for an array of non-clinical 

activities and services which support critical needs of their respective service systems, such as

planning, coordination, needs assessment, quality assurance, program development, and 

evaluation. 

In FY 2011, SAMHSA redesigned the FY 2012/2013 MHBG and SABG applications to better 

align with the current federal/state environments and related policy initiatives, including the 

Affordable Care Act, the Mental Health Parity and Addiction Equity Act (MHPAEA), and the 

Tribal Law and Order Act (TLOA). The new design offered states the opportunity to complete a 

combined application for mental health and substance abuse services, submit a bi-annual versus 

an annual plan, and provide information regarding their efforts to respond to various federal and 

state initiatives. Almost one-half of the states took advantage of this streamlined application and 

submitted combined plans for mental health and substance abuse services. Over 95 percent of 

the states provided specific information requested by SAMHSA regarding strategies to respond 

to a variety of areas including primary care and behavioral health integration, recovery support 

services, prevention of substance use, and promotion of emotional health. States continued to 

provide information regarding the spending of their Block Grant funds to support services 

identified in SAMHSA’s Good and Modern Service System brief.

45

The FY 2014/2015 Block Grant application builds upon the FY 2012/2013 application and 

furthers SAMHSA’s efforts to have states use and report the opportunities offered under various 

federal initiatives. In addition, the FY 2014/2015 Block Gant continues to allow states to submit 

a combined application for mental health and substance abuse services as well as a bi-annual 

versus an annual plan. 

The independent evaluation of the SABG program46 demonstrated how states have leveraged the 

statutory requirements of this Block Grant to expand existing or establish new treatment capacity 

 

5

http://www.samhsa.gov/healthReform/docs/good_and_modern_4_18_2011_508.pdf

46 http://tie.samhsa.gov/SAPT2010.html#Evaluation
177

in underserved areas of states and territories and to improve coordination of services with other 

state systems. 

As noted below, the SABG Program has been successful in expanding treatment capacity in the 

latest year for which actual data are available in FY 201147 by supporting approximately two

million48 admissions to treatment programs receiving public funding. Outcome data for the 

Block Grant program show positive results. In FY 2011, at discharge, clients have demonstrated 

high abstinence rates from both illegal drug (73.5 percent) and alcohol (81.7 percent) use. 

State Substance Abuse Authorities reported the following outcomes for services provided during 

FY 2011, the most recent year data is available:

 For the 50 states

49 and D.C that reported data in the Abstinence from Drug/Alcohol Use 

Domain for alcohol use, 51 of 51 identified improvements in client abstinence.

 Similarly, for the 50 states and D.C. that reported data in the Abstinence from Drug/Alcohol 

Use Domain for drug use, 50 of 51 identified improvements in client abstinence. 

 For the 50 states and D.C. that reported data in the Employment Domain, 47 of 51 identified 

improvements in client employment. 

 For the 50 states and D.C. that reported in the Criminal Justice Domain, 46 of 51 reported an 

increase in clients with no arrests based on data reported to TEDS.

For the 49 states and D.C. that reported data in the Housing Domain, 42 of 49 identified 

improvements in stable housing for clients based on data reported to TEDS.

20 Percent Prevention Set-Aside

SAMHSA/CSAP is responsible for managing the 20 percent prevention set-aside of the 

Substance Abuse Prevention and Treatment Block Grant (SABG). This is one of SAMHSA’s 

main vehicles for supporting Strategic Initiative #1: Prevention of Substance Abuse and Mental 

Illness. States use these funds to develop infrastructure and capacity specific to substance abuse 

prevention. Some states rely solely on the 20 percent set-aside to fund their prevention systems

while others use the funds to target gaps and enhance existing program efforts.

In an effort to streamline the application and reporting procedures for both the SABG and the 

Mental Health Block Grant programs, SAMHSA has developed a uniform application and 

reporting process to promote consistent planning, application, assurance, and reporting dates 

across both block grants. States are encouraged to make prevention a top priority, taking 

advantage of recent science, best practices in community coordination, proven planning 

processes, and the science articulated by the IOM report on Preventing Mental, Emotional, and 

 

47 Source: 2013 SABG Report – Tables 16-21. While this is referenced as FY 2011, the actual time period varies by 

State, e.g; CY 2011 (imported TEDS data); SFY 2011 (manually entered by States); SFY 2012 (manually entered by 

States.

48Source: 2013 SABG Report – Table II

49Source: West Virginia numbers have been included in the text, but that appear lower than expected.
178

Behavioral Disorders Among Young People50. SAMHSA will work with states to increase their 

accountability systems for prevention and to develop necessary reporting capacities. 

Synar

The Synar program is the set of actions put in place by states, with the support of the federal 

government, to implement the requirements of the Synar Amendment. The Amendment was 

developed in the context of a growing body of evidence about the health problems related to 

tobacco use by youth, as well as evidence about the ease with which youth could purchase 

tobacco products through retail sources. The Synar program is a critical component of the 

success of youth tobacco use prevention efforts. SAMHSA/CSAP is charged with overseeing 

states’ implementation of the Synar requirements and provides technical assistance to states on 

both the Synar requirements and youth tobacco access issues in general.

Since the inception of the Synar program in 1996, SAMHSA/CSAP has worked with states to 

assist them in complying with and attaining the goals of the Synar Amendment and has issued 

programmatic requirements and guidance documents to assist states in their efforts.

By regulation, states must achieve a retailer noncompliance rate of 20 percent or less. Since

FY 2006, all 50 states, Puerto Rico, and the District of Columbia have been in compliance with 

the Synar requirements. In FY 2011, the most recent year available, the national weighted 

average retailer violation rate was 8.5 percent.

Funding History

Fiscal Year Amount/1

FY 2004 $1,779,146,000

FY 2005 $1,755,555,000

FY 2006 $1,757,425,000

FY 2007 $1,758,591,000

FY 2008 $1,758,728,000

FY 2009 $1,778,591,000

FY 2010 $1,798,472,000

FY 2011 $1,782,528,000

FY 2012 $1,800,331,901

FY 2013 $1,811,349,932

FY 2014 $1,819,856,000

1/The funding history includes PHS Evaluation Funds.

 

50 http://www.iom.edu/Reports/2009/Preventing-Mental-Emotional-and-Behavioral-Disorders-Among-YoungPeople-Progress-and-Possibilities.aspx
179

Budget Request

The Substance Abuse Block Grant (SABG) request is $1.820 billion. This reflects a $27 million 

increase in Budget Authority from FY 2012 funding level and a $7.5 million decrease in PHS 

Evaluation funds from FY 2012 funding level for a net increase of $19.5 million

Enrollment and Provider Business Practices (3 Percent Block Grant Set-Aside)

Through the Affordable Care Act, up to 62 million people will benefit from Federal parity 

protections under the ACA. Up to 11 million of these individuals are estimated to have 

substance abuse and/or mental health conditions. Persons with mental and substance use 

disorders are uninsured at higher rates than the general population. The Qualified Health Plans 

(QHPs) to be offered by the new insurance marketplaces are required to have sufficient mental 

health and substance providers to assure timely access to mental health and substance services.

However, many providers supported by SABG funds are not sufficiently prepared to be part of 

the network of providers under contract with QHPs, Medicaid and Medicare plans, and 

commercial insurance plans. It is critical for specialty behavioral health providers to be able to 

participate in integrated care models, utilize interoperable electronic health records (EHRs), and 

bill for and collect insurance resources for which persons they serve are eligible in order to 

maximize limited MHBG and SABG funds for those services and those persons not covered by 

public and commercial insurance plans.

After the full implementation of the Affordable Care Act, SAMHSA strongly recommends that 

MHBG and SABG funds be directed toward four purposes: (1) to fund priority treatment and 

support services for individuals without insurance or for whom coverage is terminated for short 

periods for time; (2) to fund priority treatment and support services not covered by Medicaid, 

Medicare, or private insurance for low income individuals and that demonstrate success in 

improving outcomes and/or supporting recovery; (3) to fund primary prevention: universal, 

selective, and indicated prevention activities and services for people, individuals not identified as 

needing treatment; and (4) to collect performance and outcome data to determine the ongoing 

effectiveness of behavioral health promotion, treatment, and recovery support services and to 

plan the implementation of new services on a nationwide basis. State authorities should make 

every effort to ensure that the right recipient is receiving the right payment for the right reason at 

the right time.

Therefore, in FY 2014, the President’s Budget includes a requirement that states set aside at least 

three percent of their SABG allocation to support providers of mental health services in 

improving their enrollment, billing, and business practices, and to support enrollment into health 

insurance for eligible individuals served in the public mental health system. States that receive

one percent or more of the total FY 2014 state allotment will be required to implement a 

competitive sub award process for their funds. Major needs identified by both mental health and 

substance abuse providers are education and technical support to improve business management, 

integrate with primary care and develop the capability needed to effectively deploy electronic 

health records to meaningful use standards, billing and scheduling systems that are aligned with 
180

those in the commercial insurance and primary care environment. Particular concern was raised 

related to the lack of provider experience, especially peer, recovery, and opioid treatment 

organizations, in negotiating contracts with and billing third party payers, ensuring compliance, 

revenue management, and accountability reporting. 

Business operations practices needed include: 

Outreach and enrollment support for individuals in need of behavioral health services 

who may be eligible for Medicare, Medicaid, private insurance offered through the State 

and Federally Facilitated Marketplaces;

Business plan redesign responsive to the changing market under the Affordable Care Act 

and MHPAEA, (e.g., development of a strategic plan that is responsive to the changing 

marketplace, identification of new markets, revision of data management systems, 

integration of recovery support and treatment service payment systems, negotiating 

agreements/partnerships with primary care organizations, [e.g., Federally Qualified 

Health Centers (FQHCs)] and other provider networks to develop business operations 

systems that ensure appropriate care management across the continuum of services, (e.g. 

preventive clinical services, treatment, referral and recovery support services);

Development, redesign and/or implementation of practice management and accounts 

receivable systems that address billings, collections, risk management and compliance;

Third-party contract negotiation; e.g., negotiating contracts for participation in a qualified 

health plan, or Medicaid managed care plan; 

Coordination of benefits among multiple funding sources, including insurance and SABG 

funding; and

Adoption of health information technology that meets meaningful use standards.

The Affordable Care Act has already enhanced opportunities for individuals with behavioral 

health conditions to have continuous access to insurance and a benefit package that includes 

mental health and substance abuse services, as well as preventive, medical, and other health 

services. A series of immediate private insurance market reforms help to give individuals the 

stability and flexibility they need to make informed choices about their health care. Under these

market reforms, individuals have a right to appeal health insurance plan decisions, including 

appeals to health plans when payment for a service or treatment is denied; helps children with 

pre-existing conditions gain and keep coverage, and will extend this protection to adults starting 

in 2014; allows individuals to continue to choose their primary care provider; keeps certain 

young adults covered up to age 26 on their parents’ health plans; ends lifetime limits on 

coverage; provides for review of unreasonable increases in insurance premiums; and requires 

insurance companies to spend at least 80% or 85% of premium dollars on medical care, helping 

to ensure that premium dollars be primarily spent on health care (including behavioral health 

care).

Use of SABG dollars for these purposes will help states assist their specialty provider 

infrastructure to be prepared for the shifting funding environment and maximize limited SABG 

dollars for those individuals, services and activities not otherwise funded through other sources.
181

Health Reform

As a result of the analysis and examination of the various components of the Affordable Care 

Act beginning in 2010, SAMHSA has undertaken a major redesign of the planning section of the 

application process for both the MHBG and SABG. SAMHSA is aligning the block grants to be 

critical components of the 2014 Affordable Care Act implementation in which state and federal 

responsibility is supporting behavioral health services and supports for those otherwise unable to 

receive services through Medicaid, Medicare, and/or private insurance plans offered through 

employers or through the new insurance marketplaces. Together, SAMHSA’s block grants 

support the provision of services and related supports to approximately eight million individuals 

with mental and substance use conditions. With an estimated 11.4 million adults having a severe 

mental illness51, 44.7 million adults having any mental illness52, and another 22.1 million adults

with substance abuse disorder53, demand clearly outpaces the public behavioral health system’s 

established capacity. Many of these individuals and some of the services they need will continue 

to be without coverage through public or private insurance mechanisms. Aligning and 

coordinating the SAMHSA block grants with the 2014 Affordable Care Act implementation 

process begins assembling a cohesive national service system that is responsive to potential gaps

in service delivery and effectively provides needed behavioral health serves across sectors and 

across payment sources.

States should determine if established systems and procedures are sufficient to ensure that Block 

Grant funds are expended in accordance with program requirements and directed to support and 

not supplant health reform activities. In the Uniform Block Grant Application for FY 

2014/2015, SAMHSA has strongly recommended that states use these resources to support and

not supplant services that will be covered through commercial and public insurer plans. States 

will be asked to develop metrics or targets for their systems to measure increases in the number 

of individuals who become enrolled or providers that join commercial or publicly funded

provider networks. The primary goals of SAMHSA’s program integrity efforts are to continue to 

(1) promote the proper expenditure of block grant funds, (2) improve block grant program 

compliance nationally, and (3) demonstrate the effective use of block grant funds. 

SAMHSA will provide additional guidance to the states to assist them in complying with this 

continuing emphasis on program integrity, will develop new and better tools for reviewing block 

grant application and reports, and will train SAMHSA staff in these program integrity 

approaches and tools. SAMHSA will be working with states to develop changes to information 

systems and compliance review processes to assure increasing program integrity. This may 

include working closely with Medicaid and Health Insurance Exchanges to obtain information to 

determine if individuals and providers in their systems are enrolled. This may also include 

strategies to assist their providers to develop the necessary infrastructures to operate in 

commercial and public insurer networks (Medicaid and Medicare). The Uniform Application 

along with the new set asides along with evolution of SAMHSA’s block grant reporting system 

are all tools to assist in this process.

 

51 http://www.samhsa.gov/data/NSDUH/2k10MH_Findings/2k10MHResults.htm

52http://www.samhsa.gov/data/2k12/NSDUH110/sr110-adult-mental-illness.htm

53 http://www.samhsa.gov/data/NSDUH/2k10ResultsRev/NSDUHresultsRev2010.htm#Ch7
182

Key Outputs and Outcomes Table

Program: Treatment Activities

NOTE: SAMHSA grant awards are made late in the year. FY 2012 funding is reflected in FY 2013 performance 

targets, FY 2014 funding is associated with FY 2015 targets.

Measure

Year and Most 

Recent Result /

Target for Recent 

Result /

(Summary of 

Result)

FY 2013

Target

FY 2015

Target

FY 2015

Target

+/-

FY 2013 

Target 

1.2.43 Number of admissions to substance abuse 

treatment programs receiving public funding 

(Output)

FY 2010: 

2,073,708

Target:

1,881,515

(Target Exceeded)

1,937,960 1,937,960 Maintain

1.2.48 Percentage of clients reporting no drug 

use in the past month at discharge (Outcome)

FY 2011: 76.2%

Target:

70.3%

(Target Exceeded)

74.0% 74.0% Maintain

1.2.49 Percentage of clients reporting no alcohol 

use in the past month at discharge (Outcome)

FY 2011: 84.2%

Target:

74.7%

(Target Exceeded)

78.0% 78.0% Maintain

1.2.50 Percentage of clients reporting being 

employed/in school at discharge (Outcome)

FY 2011: 36.5%

Target:

43.9%

(Target Not Met)

43.0% 43.0% Maintain

1.2.51 Percentage of clients reporting no 

involvement with the Criminal Justice System 

(Outcome)

FY 2011: 94.6%

Target:

88.9%

(Target Exceeded)

92.0% 92.0% Maintain
183

Measure

Year and Most 

Recent Result /

Target for Recent 

Result /

(Summary of 

Result)

FY 2013

Target

FY 2015

Target

FY 2015

Target

+/-

FY 2013 

Target 

1.2.85 Percentage of clients receiving services 

who had a permanent place to live in the 

community (Outcome)

FY 2011: 93.6%

Target:

92.0%

(Target Exceeded)

92.0% 92.0% Maintain
184

Program: Synar Amendment

NOTE: SAMHSA grant awards are made late in the year. FY 2012 funding is reflected in FY 2013 performance 

targets, FY 2014 funding is associated with FY 2015 targets.

Measure

Year and Most 

Recent Result /

Target for Recent 

Result /

(Summary of 

Result)

FY 

2013Target

FY 2015 

Target

FY 2015 

Target

+/-

FY 2013 

Target 

2.3.49 Number of States (including Puerto Rico) 

whose retail sales violations is at or below 20% 

(Outcome)

FY 2011: 52

Target:

52

(Target Met)

52 52 Maintain

2.3.62 Number of States (excluding Puerto Rico) 

reporting retail tobacco sales violation rates 

below 10% (Outcome)

FY 2011: 34

Target:

26

(Target Exceeded)

34 34 Maintain
185

Program: Prevention Set-Aside

NOTE: SAMHSA grant awards are made late in the year. FY 2012 funding is reflected in FY 2013 performance 

targets, FY 2014 funding is associated with FY 2015 targets.

Measure

Year and Most 

Recent Result /

Target for 

Recent Result /

(Summary of 

Result)

FY 2013

Target

FY 2015

Target

FY 2015 

Target 

+/-

FY 2013 

Target`

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 12-20) (Outcome)

FY 2011: 78.0%

Target:

52.9%

(Target 

Exceeded)

52.9% 60.0% +7.1%

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 2011: 49.0%

Target:

64.7%

(Target Not Met)

64.7% 61.0% -3.7%

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 2011: 49.0%

Target:

37.3%

(Target 

Exceeded)

37.3% 37.3% Maintain
186

Department of Health and Human Services

Substance Abuse and Mental Health Services Administration

FY 2014 Discretionary State/Formula Grants

Substance Abuse Prevention and Treatment Block Grant Program

CFDA #93.959

FY 2012 FY 2013 FY 2014 FY 2014

State/Territory Enacted Estimate Estimate +/- FY 2012

Alabama $23,669,104 $23,691,410 $23,379,947 -$289,157

Alaska 4,903,771 4,993,804 4,928,152 +24,381

Arizona 37,009,944 37,044,822 36,557,806 -452,138

Arkansas 13,234,062 13,246,534 13,072,386 -161,676

California 248,892,428 249,126,983 245,851,797 -3,040,631

Colorado 26,103,262 26,127,862 25,784,368 -318,894

Connecticut 16,883,413 16,899,324 16,677,154 -206,259

Delaware 6,670,567 6,792,562 6,703,262 +32,695

District Of Columbia 6,670,567 6,792,562 6,703,262 +32,695

Florida 99,581,639 99,675,484 98,365,084 -1,216,555

Georgia 50,140,789 50,188,041 49,528,236 -612,553

Hawaii 7,576,229 7,583,369 7,483,673 -92,556

Idaho 6,855,073 7,451,403 7,353,442 +498,369

Illinois 69,343,892 69,409,241 68,496,741 -847,151

Indiana 33,055,561 33,086,712 32,651,732 -403,829

Iowa 13,422,031 13,434,680 13,258,059 -163,972

Kansas 12,198,382 12,209,878 12,049,359 -149,023

Kentucky 20,508,321 20,527,648 20,257,778 -250,543

Louisiana 25,654,671 25,678,848 25,341,257 -313,414

Maine 6,670,567 6,792,562 6,703,262 +32,695

Maryland 31,737,430 31,767,339 31,349,704 -387,726

Massachusetts 34,073,216 35,206,135 34,743,292 +670,076

Michigan 57,459,952 57,514,102 56,757,983 -701,969

Minnesota 24,707,075 24,730,359 24,405,237 -301,838

Red Lake Indians 608,939 609,513 601,500 -7,439

Mississippi 14,150,075 14,163,410 13,977,208 -172,867

Missouri 25,960,043 25,984,508 25,642,898 -317,145

Montana 6,670,567 6,792,562 6,703,262 +32,695

Nebraska 7,833,059 7,840,441 7,737,365 -95,694

Nevada 13,745,028 14,452,647 14,262,643 +517,615

New Hampshire $6,670,567 6,792,562 6,703,262 +32,695

New Jersey 46,585,408 46,629,310 46,016,290 -569,118

New Mexico 8,909,981 8,918,378 8,801,131 -108,850

New York 114,637,337 114,745,371 113,236,852 -1,400,485

North Carolina 39,601,511 39,638,831 39,117,713 -483,798
187

Department of Health and Human Services

Substance Abuse and Mental Health Services Administration

FY 2014 Discretionary State/Formula Grants

Substance Abuse Prevention and Treatment Block Grant Program

CFDA #93.959

FY 2012 FY 2013 FY 2014 FY 2014

State/Territory Enacted Estimate Estimate +/- FY 2012

North Dakota 5,440,418 5,540,304 5,467,467 +27,049

Ohio 66,155,781 66,218,126 65,347,578 -808,203

Oklahoma 17,579,842 17,596,409 17,365,075 -214,767

Oregon 17,801,059 17,865,150 17,630,283 -170,776

Pennsylvania 58,639,671 58,694,933 57,923,290 -716,381

Rhode Island 6,670,567 6,792,562 6,703,262 +32,695

South Carolina 20,457,841 20,477,120 20,207,914 -249,927

South Dakota 5,030,871 5,123,238 5,055,884 +25,013

Tennessee 29,522,772 29,550,594 29,162,102 -360,670

Texas 134,956,016 135,083,198 133,307,304 -1,648,712

Utah 17,005,006 17,021,031 16,797,261 -207,745

Vermont 5,379,071 5,477,831 5,405,816 +26,745

Virginia 42,761,980 42,802,279 42,239,572 -522,408

Washington 34,712,990 34,745,703 34,288,913 -424,077

West Virginia 8,644,366 8,652,512 8,538,760 -105,606

Wisconsin 27,880,736 27,907,011 27,540,127 -340,609

Wyoming 3,495,265 3,559,438 3,512,643 +17,378

American Samoa 367,834 328,680 324,025 -43,809

Guam 1,001,449 943,422 936,890 -64,559

Northern Marianas 267,531 318,995 306,233 +38,702

Puerto Rico 22,030,073 22,057,192 21,759,154 -270,919

Palau 115,607 123,607 123,017 +7,410

Marshall Islands 364,661 389,895 394,374 +29,713

Micronesia 593,312 634,367 627,153 +33,841

Virgin Islands 607,686 629,933 620,977 +13,291
188

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SAMHSA Health Surveillance and Program Support

Table of Contents

Health Surveillance and Program Support Page

1. Health Surveillance and Program Support .........................................................................191

2. Public Awareness and Support ..........................................................................................195

3. Performance & Quality Information Systems ....................................................................201

4. Agency-Wide Initiatives....................................................................................................205
190

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191

Health Surveillance and Program Support

(Dollars in thousands)

 FY 2012 

Actual

FY 2013 

Annualized 

CR 1/

FY 2014 

President's 

Budget

FY 2014 

+/- 

FY 2012

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

Health Surveillance and Program Support......................... $124,318 $106,968 $120,157 -$4,161

 Health Surveillance (non-add)................................. 47,428 29,608 47,428 ---

 Budget Authority (non-add)................................. 2,000 2,012 2,000 ---

 Prevention and Public Health Fund (non-add).... 18,000 N/A --- -18,000

 PHS Evaluation Funds (non-add)........................ 27,428 27,596 45,428 +18,000

Program Support (non-add)...................................... 76,890 77,360 72,729 -4,161

Total, Health Surveillance and Program Support....... $124,318 $106,968 $120,157 -$4,161

Data Request and Publication User Fees.......................... --- --- 1,500 +1,500

1/ The FY 2013 Prevention Fund resources are reflected in the Office of the Secretary.

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

FY 2014 Authorization..................................................................................................... Expired

Allocation Method .....................................................Direct Federal/Intramural, Contracts, Other

Program Description and Accomplishments

Health Surveillance and Program Support

Health Surveillance

The Health Surveillance budget supports many of the critical behavioral health data systems, 

national surveys, and surveillance activities for DHHS undertaken by SAMHSA/CBHSQ to 

support SAMHSA grantees, the field, and the public. The National Survey on Drug Use and 

Health (NSDUH) serves as the nation’s primary source for information on the incidence and

prevalence of substance use and mental disorders and related health conditions. A new NSDUH 

contract will be awarded in FY 2013 to finance surveys for 2014, 2015, 2016 and 2017 pending 

the availability of funds. 

The Drug Abuse Warning Network (DAWN) is a national public health surveillance system that 

monitors emergency room visits for drug and mental illness-related problems. This activity 

represents a partnership with the National Center for Health Statistics (NCHS)/CDC which is 

expected both to increase response rates and improve the quality of behavioral health data 

available to help inform public policy and prevention and treatment initiatives. NCHS and 

CBHSQ are working under an Interagency Agreement (IAA) on the development and integration 

of DAWN into the emergency department component of the National Hospital Care Survey 

(NHCS). These changes are consistent with proposals presented in previous budgets. The IAA 

will allow SAMHSA to incorporate DAWN within the NCHS ED data collection system which 

will include data elements now collected by NCHS for the nation. SAMHSA has phased in 

support for the IAA with CDC in FY 2012 and will continue to do so FY 2013 and FY 2014.
192

In FY 2013, SAMHSA is working to modify the current Drug Abuse Services Information 

System (DASIS) contract to become the new Behavioral Health Services Information System 

(BHSIS). DASIS was the primary source of data on substance abuse treatment facilities and 

treatment admissions. One aspect of this program is the treatment locator, which is accessed 

more than two million times a year by individuals, families, community groups, and 

organizations to identify appropriate treatment services. The DASIS/BHSIS project is currently 

piloting a new program with the intention of integrating a mental health treatment admissions 

data set with its counterpart in substance abuse. This was a contract modification in 2013 and 

the 2014 contract will be funded by both CBHSQ and CMHS. SAMHSA will be working 

closely with stakeholders including the National Association of State Alcohol and Drug Abuse 

Directors (NASADAD), the National Association of State Mental Health Program Directors 

(NASMHPD), and our state partners in the development and implementation of this integration 

effort which includes identifying metrics for reporting. In addition, SAMHSA will field 

integrated substance abuse and mental health facility surveys in FY 2013. FY 2013 and FY 2014 

provides for $16.1 million, and $23.1 million respectively for DASIS/BHSIS. In addition, 

CMHS will provide $7.5 million in FY 2013 and FY 2014 for DASIS/BHSIS.

With the implementation of health reform, new models for integrating behavioral health and 

primary health care are being developed. It is expected that these changes will have a profound 

impact on the currently separate systems of substance abuse and mental health treatment. 

SAMHSA will explore additional strategies to capture changes in the behavioral health systems 

resulting from reform efforts during 2013 with the expectation of expanding its current facilities 

efforts during 2014. This expanded effort will provide decision makers and researchers 

enhanced information about how systems of care are organized and financed as well as the 

outcomes of care on treatment engagement and recovery. This expansion of systems level data 

will provide information in the following areas:

the structure and management of care across multiple modalities of care within selected 

markets;

the availability, quality, and accessibility to behavioral health services delivered by providers 

who treat individuals who have substance use and/or mental disorders and related 

conditions;

the costs, financing, and effectiveness of service delivery in terms of treatment access, entry, 

retention, and outcomes (i.e., reductions in substance use and/or symptoms of mental illness, 

criminal behavior, and other high risk behaviors, as well as improvements in social 

functioning); 

the nature and function of collaborative relationships among behavioral health, primary care, 

and other service as they relate to meeting patient care needs; and

the way individuals progress over time through the recovery process. 

Any new effort would work in concert with the National Survey of Drug Use and Health, the 

Community Early Warning and Monitoring System, the Financing Center of Excellence, and 

ongoing analytic projects within the Center for Behavioral Health Statistics and Quality to 

respond to critical questions related to parity, program effectiveness, financing, and access. 

Additional information can be found in the CBHSQ chapter on page 209.
193

Program Support

The Program Support budget supports the majority of SAMHSA staff who plans, directs, and 

administers SAMHSA programs and individuals who provide technical assistance and program 

guidance to states, mental health and substance abuse professionals, stakeholders, federal

partners, and the general public. SAMHSA staffing represents a critical component of the 

budget. Staff not financed directly through the Health Surveillance and Program Support 

account provide direct state technical assistance and are funded through the Block Grant setasides or are financed from other budget lines to perform services previously contracted out. In 

addition, this budget supports the Unified Financial Management System, which covers 

administrative activities such as human resources, information technology and the centralized 

services provided by HHS’s Program Support Center and the Department.

In FY 2012, SAMHSA continued to insource positions for activities that are central to 

SAMHSA’s mission, represent critical skills for the agency, and result in overall savings. The 

additional positions are fiscally neutral. The amount of FTEs for FY 2012 was 590. 

In FY 2013, SAMHSA projects a total of 631 FTEs, which reflects, the impact of insourcerelated hiring not finalized in FY 2012. SAMHSA’s historical attrition factors have been applied 

to determine the overall anticipated FY FTE forecast. 

SAMHSA applies an estimated internal administrative charge for overhead expenses to all 

programs, projects and activities including its Programs of Regional and National Significance, 

both Block Grants, CMHI, PATH, PAIMI and the Health Surveillance and Program Support 

appropriation. These estimates will be adjusted to reflect final operating plans during the year of 

execution.
194

Funding History1\

Fiscal Year Amount

FY 2010 $101,947,000

FY 2011 $119,789,000

FY 2012 $124,317,616

FY 2013 $106,968,280

FY 2014 $120,157,000

1\The funding history is presented on a comparable basis to previous funding levels to represent the 

revised budget structure and includes the PHS Evaluation Funds and Prevention Funds other than in FY 

2013. The FY 2013 Prevention Fund resources are reflected in the Office of the Secretary.

Budget Request

A total of $120.2 million is requested for Health Surveillance and Program Support, reflecting a 

decrease of $4.2 million. This includes a decrease of $4.2 million in BA and a shift of funding 

source in the amount of $18.0 million from Health Surveillance Prevention Fund to the Public 

Health Service (PHS) evaluation fund. SAMHSA will use $1.7 million for DAWN, $1.2 million 

for CDP (DCAR), $0.707 million for NSDUH, $4.3 million for DAISIS, $1.9 million for 

National Analytic Center, $0.500 million for C-EMS, $1.8 million for CDP SAIS and TRAC, 

$5.0 million for Grantee Data Development TA, and $0.888 million for Operations. 

A total of $47.4 million is requested for Health Surveillance activities, reflecting level funding. 

The source of part of the funding for CBHSQ within HSPS has shifted from the Prevention Fund 

to the Public Health Service Evaluation Fund (PHS). Funding from HSPS reflects the phasing 

out of Legacy data collection and analysis programs and the full implementation of the Common 

Data Platform and the expansion of the new BHSIS contract. Addition detail on the CBHSQ 

budget can be found starting on page 209.

A total of $72.7 million is requested for Program Support, reflecting a decrease of $4.2 million. 

Savings will be generated through administrative efficiencies. Sufficient funds are available to 

staff up to 655 FTE, an increase of 3.8 percent over the FY 2013 forecast, reflecting full 

annualization of SAMHSA's in sourcing initiative. 
195

Public Awareness and Support

(Dollars in thousands)

 FY 2012 

Actual

FY 2013 

Annualized 

CR

FY 2014 

President's 

Budget

FY 2014 

+/- 

FY 2012

Program Level............................................................. $13,545 $13,628 $13,571 $26

PHS Evaluation Funds (non-add)............................. --- --- 13,571 +13,571

Authorizing Legislation..................................... Sections 501, 509, 516 and 520A of the PHS Act

FY 2014 Authorization..................................................................................................... Expired

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

Program Description and Accomplishments

The rapidly changing healthcare environment, the critical role behavioral health plays in 

achieving national health status objectives, and advances in communications technology provide 

new opportunities to change the way behavioral health is viewed and services are delivered in 

the U.S.

The unmet need for prevention, treatment, and recovery support services provides a vast 

untapped market for SAMHSA products and services. Today in the U.S., opportunities to 

prevent or intervene early to reduce disability and death associated with mental and substance 

use disorders are often missed. The tragedy at Sandy Hook Elementary School in December, 

2012 affords us an unprecedented opportunity to educate the American people about the 

importance of mental health and substance abuse. The Departments of Health and Human 

Services and Education are working to facilitate a national dialogue on the mental and emotional 

health of young people. About 60 percent of adults experiencing a mental disorder did not 

receive treatment and nearly 90 percent of people who needed substance abuse treatment did not 

receive care (2010 National Survey on Drug Use and Health). For children and adolescents, only 

about 1 in 5 receives the treatment they need for diagnosable mental health and substance use

disorders.

By learning to recognize the signs and symptoms of mental illness and substance abuse, friends 

and family members can help their loved ones take action and seek care. Trained health 

professionals can also work with patients and families to identify problems early. 

By confronting fear and misunderstanding with facts, raising awareness about the effectiveness 

of prevention and treatment, and improving knowledge about when and where to seek help, 

SAMHSA can bring mental illness, and addictions out of the shadows and help the nation 

achieve the full potential of prevention and treatment for mental illnesses and substance abuse.

The SAMHSA Office of Communications, through the Communications Governance Council 

(CGC), is charged with setting the strategic direction and policy for SAMHSA’s public 

communication activities. The CGC is working to assure research based approaches are used to 
196

influence behavior change for the sake of improving health, preventing injuries, protecting the 

environment, and/or contributing to the community. Individual behavior change involves five

basic steps: knowledge, approval, intention, practice, and advocacy.

To employ the best communication practices and technologies that focus on creating and 

sustaining behavior change, SAMHSA is putting into place a new science-based life cycle 

approach for public education communication efforts. The lifecycle provides a five step process 

for planning, creating, disseminating, promoting, and evaluating educational information 

produced and distributed by SAMHSA. 

SAMHSA’s Public Engagement Platform (PEP) and Project Evolve, SAMHSA’s web 

consolidation and modernization project, are funded through the Public Awareness and Support 

budget line. These two initiatives provide the SAMHSA the wide infrastructure required to 

advance SAMHSA’s Strategic Initiatives by engaging audiences in a meaningful way. 

The internet is the primary way people engage with the government. SAMHSA has prioritized 

the internet as a strategic business and communications asset and launched Project Evolve to 

consolidate and modernize SAMHSA’s web presence. Elimination of redundant web 

development efforts is a key objective for this project and the installation of a Web Content 

Management System will result in lower overall costs, greater efficiency, increased 

effectiveness, and improved service for visitors to SAMHSA’s website. Related project 

activities include audience analysis, usability testing, and planning for the prioritized migration 

of information from other sites to a consolidated SAMHSA.gov site.

Consistent with the draft Federal Digital Strategy, the project is working to support the 

development of quality content and effective communications governance, and the use of 

modern communications platforms all to increase efficiencies in SAMHSA’s web based 

communication efforts with the long term goals of improving customer satisfaction and 

achieving cost savings to the agency.

SAMHSA’s PEP provides the agency’s programs a customer-oriented fulfillment system. 

SAMHSA’s online store (http://store.samhsa.gov) is its most highly visible customer interface 

and works in concert with a call-in contact center, warehouse, email updates, exhibit program,

and strategic partnerships to fulfill the publication needs of public and health services providers. 

The various channels of communication managed by the Office of Communications generated 

more than 24 million customer interactions last year and enabled SAMHSA to gather data that 

illuminate the “voice” of SAMHSA customers and how well they are being served by the 

agency. 

Through its Knowledge Management System, SAMHSA integrates content, operations, and data 

collection and analytics on all PEP customer interactions. These touch points annually include 

about 500,000 inquiries to the contact center; 143,400 publication orders; 

21,290,000 publication copies shipped; 1,734,000 SAMHSA Store visitors; 530,000 PDF 

documents downloaded; 11,941,000 email updates delivered; and 12,000 exhibit booth visitors. 

SAMHSA’s email update service has grown to nearly 193,000 subscribers. PEP also distributes 

a bi-weekly electronic resource entitled SAMHSA Headlines that provides the behavioral health 
197

field with the latest news, upcoming events, resources, and a quarterly newsletter, SAMHSA 

News, that provides in-depth information on key SAMHSA developments and findings.

Just as Americans are aware of the connection between hypertension, stroke, and heart disease 

and accordingly take action to monitor their blood pressure they can become aware of the 

connection between mental and substance use disorders and physical health and take action to 

prevent and treat these conditions. SAMHSA’s PEP and new Web Program provides prevention, 

treatment, and recovery support programs the communication channels needed to reach public 

and professional audiences with critical behavioral health information.

 

The Public Awareness and Support Initiative (http://www.samhsa.gov/publicAwareness/)

continues to be driven by research with SAMHSA stakeholders-- including web-based public 

engagement strategies/platforms-- and applies the communications and marketing principles of 

customer research and audience segmentation, message development and evaluation. Because it 

is based on customer needs and input, the Public Awareness and Support Initiative is dynamic 

and continues to evolve based on the shifting landscape of communications technologies and 

government involvement with the public. 

The Public Awareness and Support Initiative specifically supports the agency’s role in 

“Supporting the field with Information/Communications by conducting and sharing information 

from national surveys and surveillance (e.g., NSDUH, DAWN, DASIS); vetting and sharing 

information about evidence-based practices (e.g., National Registry of Evidence-based Programs 

and Practices [NREPP]); using the Web, print, social media, public appearances, and the press to 

reach the public, providers (e.g., primary, specialty, guilds, peers), and other stakeholders; and 

listening to and reflecting the voices of people in recovery and their families.” (See “SAMHSA’s 

Roles” in the agency’s strategic planning document “Leading Change: A Plan for SAMHSA’s 

Roles and Actions 2011-2014”, p. 6)

Budget Request

$13.6 million is requested for PAS, reflecting level funding. The increase of $13.6 million in 

PHS evaluation offsets the decrease of $13.6 million of BA to reflect the transfer to a different 

source of funding. 

These funds will be used to continue to support the Public Engagement Platform (PEP) and 

Project Evolve, the Federal Digital Strategy, the Knowledge Management System, and the Public 

Awareness and Support Initiative. Collectively, these programs will help to consolidate and 

streamline digital engagement efforts, and implement SAMHSA’s five-step life cycle approach 

to public education communication. Part of this lifecycle seeks to provide customers with 

increased access to SAMHSA’s services, website, publications, and data, ensuring more 

effective communication and meaningful customer service. These funds will also aid 

SAMHSA’s efforts to research the best methods of collaboration with its stakeholders, which 

will improve its messaging and marketing; and, as a result, more accurately reflect the voices of 

people and families in recovery.
198

This request also includes $1.5 million in Data Request and Publication User Fees (please see the 

HSPS table on page 191). Fees will be collected for extraordinary data and publications user 

requests are not otherwise able to be fulfilled within existing resources.
199

Outcomes and Outputs

Program: Public Awareness Activities

NOTE: SAMHSA grant awards are made late in the year. FY 2012 funding is reflected in FY 2013 performance targets, FY 

2014 funding is associated with FY 2015 targets.

Measure

Year and Most 

Recent Result /

Target for 

Recent Result /

(Summary of 

Result)

FY 2013 

Target

FY 2015

Target

FY 2015

Target

+/-

FY 2013 

Target

2.3.76 Number of persons receiving prevention 

information indirectly from advertising, 

broadcast, or website (Output)

FY 2011: 

9,408,930

Target:

906,707

(Target 

Exceeded)

1,250,000 250,000 -1,000,000

4.4.06 Percentage of persons reporting 

knowledge of how to find treatment services 

for mental and substance use disorders 

(Outcome)

N/A Discontinued N/A

N/A

4.4.07 Percentage of persons indicating they 

were screened by a health care provider for 

mental and substance use disorder (Outcome)

N/A Discontinued N/A

N/A

4.4.12 Number of individuals referred for 

behavioral health treatment resources (Output)

FY 2012: 

319,290

Target:

310,000

(Target 

Exceeded)

310,000 310,000

Maintain

4.4.09 Percentage of children reporting their 

parents have talked to them about alcohol and 

drugs (Outcome)

FY 2011: 57.7%

Target:

58.2%

(Target Not Met)

58.2%

Discontinued

N/A
200

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201

Performance and Quality Information Systems

(Dollars in thousands)

 FY 2012 

Actual

FY 2013 

Annualized 

CR

FY 2014 

President's 

Budget

FY 2014 

+/- 

FY 2012

Program Level............................................................. $12,940 $13,051 $12,996 $56

PHS Evaluation Funds (non-add)............................. --- --- 12,996 +12,996

Authorizing Legislation.................................... Sections 501, 509, 516, and 520A of the PHS Act

FY 2014 Authorization..................................................................................................... Expired

Allocation Method .......................................................................................................... Contract

Program Description and Accomplishments

Funding is requested for performance and quality information systems includes funding to phase 

in the implementation of SAMHSA’s Common Data Platform (CDP) which will provide a 

uniform collection and reporting system providing SAMHSA management and staff with the 

ability to analyze programs at various levels (state, program, community, etc.), provide each 

Center with tailored information in real-time about the progress and activities of their grantees, 

and provide data to grantees to support them in the efficient and effective implementation of 

projects. Funding from PQIS along with funding from HSPS activities will support the 

continuation of all three Center legacy programs (SAIS, TRAC, and DCAR) during FY 2013 

while the CDP is being phased in. 

During 2013 and 2014, SAMHSA will be working closely with the National Association of State 

Alcohol and Drug Abuse Directors (NASADAD), the National Association of State Mental 

Health Directors (NASMHD), and state partners to identify, refine, and test measures that, where 

possible, build upon current efforts within states. Moving forward, SAMHSA is committed to 

harmonizing measures across data collection programs in a way that reduces burden, increases 

the quality of data collected, and provides necessary information to measure performance and 

manage grants. 

Funding is also requested for the continuation of the National Registry of Evidence-based 

Programs and Practices (NREPP), a searchable online system that supports states, communities, 

and tribes in identifying and implementing evidence-based mental health promotion, substance 

abuse prevention, and substance abuse and mental health treatment interventions. 

Other SAMHSA activities related to the Strategic Initiative on Data, Quality and Outcomes 

include the development of the National Behavioral Health Quality Framework, stemming from 

the National Quality Strategy recently released by AHRQ in cooperation with CMS and ONC; 

and coordination with Health Information Technology efforts and Meaningful Use Measures for 

application in electronic health records, lead by ONC and CMS.
202

Budget Request

$13.0 million is requested for PQIS, reflecting level funding. An increase of $13.0 in PHS 

evaluation is offset by a decrease of $13.0 million of BA to reflect the transfer to a different 

source of funding. These funds will be used to fully fund the new Common Data Platform which 

will be awarded in FY 2013 and fully implemented in FY 2014. 
203

Outcomes and Outputs

Program: Performance and Quality Improvement Systems54

Measure Year and Most 

Recent Result /

Target for 

Recent Result /

(Summary of 

Result)

FY 2012 

Target

FY 2014

Target

FY 2014

Target

+/-

FY 2012

Target

4.4.10 Combined count of webpage hits, hits to the 

locator, and hits to SAMHDA for SAMHSAsupported data sets (Output)

FY 2012: 

1,707,165

Target:

6,000,300

(Target Not Met)

6,000,300 1,882,149 -4,118,15155

4.4.11 Number of evidence-based programs or 

practices in review (Output)

FY 2012: 46

Target:

44

(Target Exceeded)

44 48 +4

 

54 There is no delay between fiscal year funding and the performance year.

55 Decrease in target due to change in data collection methodology.
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Agency-Wide Initiatives

(Dollars in thousands)

 FY 2012 

Actual

FY 2013 

Annualized 

CR

FY 2014 

President's 

Budget

FY 2014 

+/- 

FY 2012

Agency-Wide Initiatives.............................................. $9,200 $9,256 $54,395 +$45,195

Military Families(non-add)........................................ 3,493 3,515 --- -3,493

Behavioral Health Workforce (non-add)................... 5,706 5,741 54,395 +48,689

Minority Fellowship Program (non-add) 1/............ 5,706 5,741 9,395 +3,689

Minority Fellowship Program - Youth (nonadd).................................................................. --- --- 5,000 +5,000

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

SAMHSA-HRSA MBHET Grant Program (non-add) $--- $--- $35,000 +$35,000

1/ The Minority Fellowship Program budgets from the MH, SAP, and SAT appropriations are reflected under the 

Workforce initiative.

Authorizing Legislation..................................... Sections 501, 509, 516 and 520A of the PHS Act 

FY 2014 Authorization..................................................................................................... Expired

Allocation Method ....................................................................................... Discretionary Grants

Program Descriptions and Accomplishments

Military Families

In FY 2013, SAMHSA will conduct at least two Service Members, Veterans, and their Families 

(SMVF) Policy Academies for the remaining 17 states that have not yet participated, as well as 

for the Virgin Islands and Guam. SAMHSA’s Policy Academies help states and territories 

strengthen their behavioral health care systems and services for SMVF through the development 

of interagency strategic plans and the provision of technical assistance to facilitate 

implementation of those plans. The strategic plans developed by the Policy Academies will be 

available immediately; thereby assuring the maximum impact will be felt in a short time. 

SAMHSA will also provide intensive technical assistance to those states and territories to ensure 

implementation of evidence-based behavioral health prevention, treatment, and recovery support 

services that advance and sustain the interagency approach to their strategic plan, and that meet 

the behavioral health needs of service members (especially National Guard and Reserves), 

veterans, and their families. The intensive technical assistance provided will greatly assist in the 

building of linkages between evidence-based services and recovery support services. 
206

Minority Fellowship Program

Through a partnership among SAMHSA’s CMHS, CSAP and CSAT centers, this program 

increases behavioral health practitioners’ knowledge of issues related to ethnic minority mental 

health and substance use disorders. Additionally, it aims to improve the quality of mental health 

and substance abuse prevention and treatment delivered to ethnic minorities by providing 

stipends to post-graduate students. This will increase the number of culturally competent 

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

direct mental health/substance abuse services to underserved minority populations. Since its 

start in 1973, the Minority Fellowship Program (MFP) has helped to enhance services to 

minority communities through specialized training of mental health professionals in psychiatry, 

nursing, social work, and psychology, and since 2006, marriage and family therapists. These 

individuals often serve in key leadership positions in mental health and substance abuse direct 

services, services supervision, services research, training, and administration. In FY 2011, 125 

individuals were trained across the five disciplines represented. In FY 2012, SAMHSA received 

additional funding to increase the pool of culturally competent mental health professions eligible 

to receive funds through this program to include professional counselors. In FY 2013, SAMHSA 

anticipates funding all MFP continuation grants. 

Budget Request

The FY 2014 Budget request for Agency Wide initiatives is $54.4 million, a net increase of 

$45.2 million from the FY 2012 funding level. The request includes plans to phase out Military 

Families in 2014. The Minority Fellowship Program (MFP) has been comparably adjusted as 

MFP was realigned from the three centers to the Health Surveillance and Program Support 

(HSPS) appropriation. SAMHSA plans on braiding these funds, tracking them as distinct funding 

streams and for use consistent with legislative direction and intent, to continue to support the 

same core activities supported in the centers. The FY 2014 budget request for MFP core 

activities is $9.4 million, which is a $4.4 million increase from FY 2012. In addition, FY 2014 

includes new funding for MFP-Youth (expansion) at $5.0 million, $35 million for a jointly 

administered activity with HRSA to expand the Mental and Behavioral Health Education and 

Training (MBHET), and $10.0 million for Peer Professionals Workforce Development. 

Minority Fellowship Program – Youth (MFP-Y)

For FY 2014, SAMHSA requests $5.0 million for the Minority Fellowship Program (MFP-Y) to 

provide stipends to graduate students to increase the number of culturally competent behavioral 

health professionals who provide direct mental health and/or co-occurring substance abuse 

services to underserved minority populations. MFP-Y would utilize the existing infrastructure of 

the MFP to expand the focus of the program to support master’s level trained behavioral health 

providers in the fields of psychology, social work, professional counseling, marriage and family 

therapy, and nursing. This support would increase the number of providers who are available to 

provide clinical services to underserved, at-risk children, adolescents, and populations 
207

transitioning to adulthood (ages 16 – 25) in an effort to increase access to, and quality of,

behavioral health services for this age group. 

SAMHSA-HRSA Mental and Behavioral Health

Education and Training (MBHET) Grant Program

In FY 2014, SAMHSA will collaborate with HRSA in expanding the Mental and Behavioral 

Education and Training (MBHET) Grant Program. This expansion will increase the clinical 

service capacity of the behavioral health workforce by supporting training for Master’s level 

social workers, psychologists and marriage and family therapists as well as behavioral health 

paraprofessionals. This effort is critical to ensure that the behavioral health workforce is able to 

meet the needs of high need and high demand populations, including rural, vulnerable, and 

underserved populations. In FY 2014, the program will include an emphasis on training to 

address the needs of children, adolescents, and transition-age youth (ages 16-25) and their 

families. SAMHSA requests $35.0 million in FY 2014 for the SAMHSA-HRSA expansion of 

the MBHET grant program and will help increase the behavioral health workforce by 3,950.

Peer Professionals Workforce Development

For FY 2014, SAMHSA requests $10.0 million to strengthen the behavioral health workforce by 

increasing the number of trained peers, recovery coaches, mental health/addiction specialists, 

prevention specialists, and pre-Master’s level addiction counselors working with an emphasis on 

youth ages 16-25. Because of their lived experience with behavioral health conditions, and being 

able to build trust and foster connections with individuals accessing care, these entry entry-level 

providers play a significant role in the delivery of prevention and recovery support services. 

SAMHSA plans to award up to 19 grant awards to community colleges or community college 

networks, states and national organizations. These funds will provide tuition support and further 

establish the capacity of community colleges to develop and sustain behavioral health 

paraprofessional training and education 
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209

SAMHSA 

Center for Behavioral Health Statistics and Quality (CBHSQ)

Table of Contents

SAMHSA/Behavioral Health Statistics and Quality Page

1. SAMHSA/Center for Behavioral Health Statistics and Quality (CBHSQ) ........211

2. Surveillance and Data Collection .....................................................................213

3. Evaluation........................................................................................................215

4. Analysis...........................................................................................................216

5. Services Systems Research...............................................................................217

6. Performance and Quality Information Systems.................................................217

7. Statistical and Analytic Support .......................................................................218
210

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211

SAMHSA/Center for Behavioral Health Statistics and Quality (CBHSQ)

(Dollars in thousands)

FY 2012 

Actual

FY 2013 

Annualized 

C R

FY 2014 

President's 

Budget

FY 2014 

+/- 

FY 2012

Substance Abuse Treatment Appropriation

Substance Abuse Block Grant (SABG) Set Aside

PHS Evaluation Funds

NSDUH $34,614 $33,532 $29,776 -$4,838

National Analytic Center 2,462 2,930 2,500 +38

DASIS/BHSIS 12,847 14,190 15,596 +2,749

C-EMS 418 500 500 +82

SAMHDA/Data Archive 1,295 1,294 1,291 -4

NREPP --- 3,000 --- ---

DAWN --- 2,000 --- ---

FTE/Operations/1 6,907 1,097 1,293 -5,614

Subtotal, PHS Evaluation Funds 58,543 58,543 50,956 -7,587

Budget Authority

DAWN 148 --- 3,300 +3,152

NREPP 1,163 1,342 1,716 +553

FTE/Operations 3,679 3,650 3,793 +114

Subtotal, Budget Authority 4,989 4,992 8,809 -3,767

Subtotal, SABG Set Aside 63,532 63,535 59,765 -3,767

Health Surveillance and Program Support Appropriation

Health Surveillance

 Budget Authority 

CDC NHIS IAA 2,000 2,012 2,000 ---

Subtotal, Budget Authority 2,000 2,012 2,000 ---

PHS Evaluation Funds

DAWN 5,000 --- 6,700 +1,700

CDP Legacy Program (DCAR) 6 --- 1,180 +1,174

NSDUH 14,137 10,833 14,844 +707

DASIS/BHSIS --- 2,002 7,488 +7,488

National Analytic Center --- --- 1,943 +1,943

 C-EMS --- 500 500 +500

CDP Legacy Programs - SAIS and TRAC --- 8,300 1,800 +1,800

Grantee Data Development TA --- --- 5,000 +5,000

 DASIS Modification 3,200 --- --- -3,200

 BRFSS --- --- --- ---

FTE/Operations 5,085 5,960 5,973 +888

Subtotal, PHS Evaluation Funds 27,428 27,595 45,428 +18,000

Prevention and Public Health Fund

 National Analytic Center 460 N/A --- -460

 C-EMS 500 N/A --- -500

DCAR 4,490 N/A --- -4,490

 NSDUH 10,650 N/A --- -10,650

 Behavioral Health U.S. 657 N/A --- -657

 BRFSS 600 N/A --- -600

 Operations 643 N/A --- -643

Subtotal, Prevention and Public Health Fund 1 /

18,000 --- --- -18,000

Subtotal, Health Surveillance 47,428 29,607 47,428 ---

Performance and Q uality Information Systems (PQ IS)

Budget Authority

NREPP 1,040 1,379 --- -1,040

CDP Legacy Programs (SAIS and TRAC) 10,900 --- --- -10,900

Common Data Platform (CDP) --- 10,900 --- ---

Operations 1,000 772 --- -1,000

Subtotal, Budget Authority 12,940 13,051 --- -12,940

PHS Evaluation Funds

NREPP --- --- 1,784 +1,784

Common Data Platform (CDP) --- --- 10,900 +10,900

Operations --- --- 312 +312

Subtotal, PHS Evaluation Funds --- --- 12,996 +12,996

Subtotal, PQ IS 12,940 13,051 12,996 +56

Subtotal, Health Surveillance and Program Support 60,368 42,658 60,424 +56

Total, CBHSQ $123,901 $106,193 $120,189 -$3,711

1/The FY 2013 Prevention and Public Health Funds are reflected in the Office of the Secretary.
212

Resources by Activity

(Dollars in thousands)

FY 2012 

Actual

FY 2013 

Annualized 

CR 1/

FY 2014 

President's 

Budget

FY 2014 

+/- 

FY 2012

CBHSQ Activities

NSDUH $59,401 $44,365 $44,620 -$14,780

DAWN 5,148 2,000 10,000 +4,852

CDC NHIS IAA 2,000 2,012 2,000 ---

DASIS/BHSIS 16,047 16,192 23,084 +7,037

C-EMS 918 1,000 1,000 +82

National Analytic Center 2,922 2,930 4,443 +1,521

SAMHDA/Data Archive 1,295 1,294 1,291 -4

Common Data Platform (CDP) --- 10,900 10,900 +10,900

Grantee Data Development TA --- --- 5,000 +5,000

CDP Legacy Program (DCAR) 4,496 --- 1,180 -3,316

CDP Legacy Programs (SAIS and TRAC) 10,900 8,300 1,800 -9,100

NREPP 2,203 5,721 3,500 +1,297

BRFSS 600 --- --- -600

Behavioral Health U.S. 657 N/A --- -657

FTE/Operations 17,313 11,479 11,371 -5,942

Total, CBHSQ $123,901 $106,193 $120,189 -$3,711

1 /The FY 2013 Prevention and Public Health Funds are reflected in the Office of the Secretary.

Authorizing Legislation..........................................Sections 501, 505, 1911, 1921 of the PHS Act

FY 2014 Authorization..................................................................................................... Expired

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

Program Description and Accomplishments

Beginning in FY 2011 and FY 2012, and moving forward in FY 2013, SAMHSA undertook a 

new initiative focused on data, outcomes, and quality. The purpose of this initiative was to 

realize an integrated data strategy and a national framework for quality improvement in 

behavioral healthcare to help inform policy, measure program impacts, and lead to improved 

quality of services and outcomes for individuals, families, communities, and tribal communities. 

A major accomplishment that began in FY 2011 and was completed in FY 2012 was the 

realignment of a number of data and analytic activities within CBHSQ to improve accountability 

and transparency in the development and dissemination of information to support this behavioral 

health care transformation. 
213

There are six functions coordinated through CBHSQ that provide significant support to 

SAMHSA’s integrated data strategy: surveillance and data collection, evaluation, analysis, 

service systems research, performance and quality information systems, and statistical and 

analytic support. CBHSQ also supports SAMHSA’s efforts to increase public access to data.

In FY 2013, CBHSQ ended or combined contracts to achieve better efficiency. This was the 

culmination of a comprehensive review of SAMHSA’s contracts conducted in FY 2011 

determining whether contracted activities were mission critical or would be less expensive to 

accomplish the Federal staff rather than contractors. For CBHSQ, this resulted in hiring for 36 

positions where savings were possible. 

Surveillance and Data Collection

SAMHSA manages a number of critical behavioral health data systems for HHS that provide 

high quality data on the incidence and prevalence of mental and substance use disorders, the use 

of emergency and specialty care, and more recently local indicators of behavioral health status of 

communities. The NSDUH serves as the nation’s primary source for information on the 

incidence and prevalence of substance use and mental illness and related health conditions. A 

new NSDUH contract was awarded in FY 2013 that will finance the 2014, 2015, 2016, and 2017 

annual surveys, pending the availability of funds. The Drug Abuse Warning Network (DAWN) 

is a national public health surveillance system that monitors drug-related emergency room visits 

for drug and mental illness related problems. SAMHSA partnered with the National Center for 

Health Statistics/CDC to better inform public policy and prevention and treatment initiatives. 

NCHS and CBHSQ are working under an Interagency Agreement (IAA) on the development and 

integration of DAWN into the emergency department (ED) component of the National Hospital 

Care Survey (NHCS). These changes are consistent with proposals presented in previous 

budgets. The IAA will allow SAMHSA to incorporate DAWN within the NCHS ED data 

collection system which will include data elements now collected by NCHS for the nation. 

CBHSQ provided $5.0 million to the IAA in FY 2012. Due to the slow start-up of the 

contract/IAA in FY 2012, CBHSQ plans to add only $2 million to the activity in FY 2013. 

NSDUH’s anticipated funding for FY 2012 and FY 2014 is $59.4 million and $44.6 million 

respectively. In addition, CMHS will provide $1.0 million in both FY 2013 and FY 2014 for 

NSDUH to cover mental health related data collection.

In FY 2013, SAMHSA will modify the current Drug Abuse Services Information System 

(DASIS) contract to become the new Behavioral Health Services Information System (BHSIS). 

DASIS was the primary source of data on substance abuse treatment facilities and treatment 

admissions. One aspect of this program is the treatment locator, which is accessed more than 

two million times a year by individuals, families, community groups, and organizations to 

identify appropriate treatment services. By mid-2013, SAMHSA will post a new up-to-date 

mental health treatment locator that will provide accurate, timely, and regularly updated 

information on mental health treatment facilities across the country. The DASIS/BHSIS project 

is currently piloting the new program with the intention of integrating a mental health treatment 

admissions data set with its counterpart in substance abuse. This contract modification in 2013 
214

and the new contract to be awarded in 2014 will be funded by both CBHSQ and CMHS. 

SAMHSA will be working closely with stakeholders including NASADAD, NASMHPD, and 

our state partners in the development and implementation of this integration effort which 

includes identifying metrics for reporting. In addition, SAMHSA will field integrated substance 

abuse and mental health facility surveys in FY 2013. Funding from CBHSQ in FY 2012 and FY 

2014 provides for $16.2 million and $23.1 million respectively for DASIS/BHSIS. In addition, 

CMHS will provide $7.5 million in both FY 2013 and FY 2014 for DASIS/BHSIS.

With the implementation of health reform, new models for integrating behavioral health and 

primary health care are being developed. It is expected that these changes will have a profound 

impact on the currently separate systems of substance abuse and mental health treatment. 

SAMHSA will explore additional strategies to capture changes in the behavioral health systems 

resulting from reform efforts during 2013 with the expectation of expanding DAISIS/BHSIS’

current facilities efforts during 2014. This expanded effort will provide decision makers and 

researchers enhanced information about how systems of care are organized and financed as well 

as the outcomes of care on treatment engagement, treatment outcomes, and recovery. This 

expansion of systems level data will provide information in the following areas:

the structure and management of care across multiple modalities of care within selected 

markets;

the availability, quality, and accessibility to behavioral health services delivered by providers 

who treat individuals who have substance use and/or mental disorders and related 

conditions;

the costs, financing, and effectiveness of service delivery in terms of treatment access, entry, 

retention, and outcomes (i.e., reductions in substance use and/or symptoms of mental illness, 

criminal behavior, and other high risk behaviors, as well as improvements in social 

functioning);,

the nature and function of collaborative relationships among behavioral health, primary care, 

and other service as they relate to meeting patient care needs; and

how individuals progress over time through the recovery process. 

It is expected that this data will allow work to be done to examine both treatment and recovery 

process and will work in concert with the National Survey of Drug Use and Health, the 

Community Early Warning and Monitoring System, the Financing Center of Excellence, and 

ongoing analytic projects within the Center for Behavioral Health Statistics and Quality to 

respond to critical questions related to parity, program effectiveness, financing, and access. 

During FY 2012, in collaboration with NIH, CDC, the National Institute of Justice (NIJ), and the 

Office of National Drug Control Policy (ONDCP), SAMHSA developed the framework and 

baseline measures for the Community Early Warning and Monitoring System (C-EMS). The 

purpose of this system is to provide quality community-level behavioral health indicators to 

understand problems at a local level. This evidence is critical to develop effective prevention 

and wellness approaches to address specific community challenges. Such a system is necessary 

as national indicators may bear little resemblance to what is actually happening in any individual 

community. Meanwhile, many measures available at the local level (e.g., drug-related arrests 

and incarcerations, suicide, admissions to the hospital for behavioral health conditions, or 
215

domestic violence) are not fully captured in national data sets, which impede the ability to detect 

emerging problems in particular states or regions. 

In FY 2012, CBHSQ began working with the Agency for Healthcare and Quality (AHRQ) in the 

development and implementation of specific informational and data needs that will support both 

the C-EMS project and AHRQ’s data collection in community emergency departments. CBHSQ 

will supplement a task order within AHRQ to develop a working definition of “community”, as 

well as to identify and develop community indicators that CBHSQ could then pilot in the 

development of the C-EMS program. This is an opportunity to continue to enhance the 

integration of behavioral health measures in AHRQ’s hospital, community, and insurance data 

collection efforts. Information from this system will help capture regional and local problems 

and provide a near real-time data network that warns of emerging threats from changes in the 

behavioral health status of communities.

Also, in FY 2012, CBHSQ funded a contract to support three expert panel meetings of fifty or 

fewer local government officials, community providers, and local evaluators to assist SAMHSA 

in identifying potential community-level indicators and data sources to understand emerging 

trends that can impact on community behavioral health. These meetings were planned to serve 

and highlight gaps in data collection efforts that impact on the understanding of behavioral health 

in the community. The resultant information will be developed into reports that will be provided 

to AHRQ in a joint effort to develop and implement a data warehouse for analytic efforts.

Evaluation

Consistent with the Administration’s increased emphasis on the use of rigorous and independent 

program evaluation to determine if programs achieve the intended outcomes at a reasonable cost, 

SAMHSA will continue to support the systematic collection of data to assess its investments in 

discretionary and block grant programs. The evaluation policy was finalized in early 2012. In 

late 2012, CBHSQ conducted a review of all evaluation activity in the Agency. This process 

helped CBHSQ identify current evaluations which could be enhanced or improved with the 

support from evaluation experts. For all new program activity in which an evaluation is 

proposed, CBHSQ meets with program staff and the SAMHSA Evaluation Team (SET) to gather 

information about planned evaluation activities, program objectives, and budget estimates for 

evaluation. During this period, CBHSQ reviews the planned grant language to ensure there is 

sufficient description of evaluation and data collection plans for award. During this period and 

the time leading up to grant award, CBHSQ staff continues to meet and design the evaluation 

that will actually inform the stated objectives of the program. CBHSQ’s role in the actual 

evaluation is to: 1) conduct an evaluation or 2) co-direct an evaluation using a contractor to 

gather data and assist with report writing or 3) serve as a consultant as needed on evaluations that 

are directed by an originating Center with in SAMHSA. 

Through its evaluation guidance, SAMHSA proposes to expand its efforts to improve the quality 

of information on behavioral health investments by:

providing uniform standards for evaluations;
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supporting rigorous evaluation designs;

building a cadre of trained evaluators to oversee evaluations; 

providing a structure to assess environmental contexts that promote or impede program 

effectiveness;

allowing for designs that enable adaptation and adjustments in the implementation 

process; 

producing timely results for decision makers; and 

creating an accessible, central repository for information related to SAMHSA 

evaluations.

Analysis

Funding is requested for a number of activities to support a broad range of analytic work to be 

carried out in the Center for Behavioral Health Statistics and Quality. These activities include 

support for the National Analytic Center (NAC) which undertakes a number of scientific and 

writing tasks on policy and practice related topics in response to requests from SAMHSA 

Centers, HHS agencies (CDC, AHRQ, FDA, and the Surgeon General’s Office), the Office of 

National Drug Control Policy, and the Department of Justice. Work within CBHSQ will be 

coordinated with OPPI and the Financing Center of Excellence contract to ensure that critical 

health econometric work and systems analysis is prioritized in line with health reform goals. 

Funding will also support the outgoing Substance Abuse and Mental Health Data Archive 

(SAMHDA) which serves as SAMHSA’s primary repository for public access data files. 

SAMHDA provides free access and on-line analytic tools to the public. Resources will also be 

used to develop a program for providing limited public access to files restricted for privacy or 

other reasons, serving to expand the use and application of data collected under the survey 

contracts. 

Finally, funding will be utilized to support positions focused on analyzing and reporting on data 

collected within CBHSQ, SAMHSA and HHS, as well as identifying and analyzing information 

from other data sets that may help inform the work of SAMHSA. Staff will also respond to 

requests for data and explanations of existing data points, preparing internal reports, supporting 

SAMHSA staff in the development of materials that require statistical information, preparation 

of short reports and data spotlights, as well as preparing manuscripts for publication. These staff 

also support data needs by serving on workgroups that require data analysis as part of their 

function and will prepare data requests for departmental activities. Particularly important is the 

inclusion of a new Health Economics and Financing Team that will focus on studies related to

cost and financing trends as health care delivery models change over the next several years. 

Some of these positions have been created by insourcing tasks that are most appropriately done

by federal staff, are less expensive than contract staff, or are mission critical and thus improve 

SAMHSA’s capacity to respond to data and information needs relevant to SAMHSA’s mission.

The appropriations language proposed for the FY 2014 for SAMHSA includes a proposal to 

collect a small amount in fees to offset some cost of analyses of these data that would otherwise 

not be done within existing SAMHSA resources and that are requested by proprietary or other 
217

private or public entities that are interested in additional data analyses that SAMHSA’s NBHAC 

could provide if funds were available. 

FY 2012 and FY 2014 provide for $2.9 million and $4.4 million respectively for the National 

Analytic Center.

Services Systems Research

Building on efforts begun in FY 2011 and FY 2012, SAMHSA proposes to continue to build its 

practice-based service systems research program which complements efforts in its sister

agencies of NIH, AHRQ, and CDC. This will provide pilot data for full-scale research proposals 

to NIH or other practice settings in which to test models being developed through these agencies’ 

research efforts. The program will focus on critical gaps in knowledge about prevention, 

wellness, treatment, and recovery services for individuals, families, and communities at risk for 

or suffering from mental illnesses, addictions, and related chronic conditions. Of particular 

interest to SAMHSA are issues of quality, cost, access to, and outcomes of behavioral health 

services both in the primary and specialty care service sectors as provisions for the Prevention 

Fund are implemented. Significant attention will be given to developing analyses that enhance 

understanding of the economic and cost implications of changes in health insurance access for 

behavioral health care within the larger SAMHSA analytic agenda coordinated through CBHSQ. 

Performance and Quality Information Systems

Continued funding is requested for performance and quality information systems to phase in the 

implementation of SAMHSA’s Common Data Platform (CDP) which will provide a uniform 

collection and reporting system providing SAMHSA management and staff with the ability to 

analyze programs at various levels (state, program, community, etc.), provide each Center with 

tailored information in real-time about the progress and activities of their grantees, and provide 

data to grantees to support them in the efficient and effective implementation of projects. 

During 2013 and 2014, SAMHSA will be working closely with the National Association of State 

Alcohol and Drug Abuse Directors (NASADAD), the National Association of State Mental 

Health Directors (NASMHD), and state partners to identify, refine, and test measures that, where 

possible, build upon current efforts within states. Moving forward, SAMHSA is committed to 

harmonizing measures across data collection programs in a way that reduces burden, increases 

the quality of data collected, and provides necessary information to measure performance and 

manage grants

Funding is also requested for the continuation of the National Registry of Evidence-based 

Programs and Practices (NREPP), a searchable online system that supports states, communities, 

and tribes in identifying and implementing evidence-based mental health promotion, substance 

abuse prevention, and substance abuse and mental health treatment interventions. This registry 

is made up of interventions, mental health and substance abuse, that have been reviewed and 

rated by independent reviewers and is ready to assist the public in identifying scientifically based 

approaches to preventing and treating mental and/or substance use disorders that can be readily 
218

disseminated to the field. This program is one way that SAMHSA is working to improve access 

to information on tested interventions and thereby reduce the lag time between the creation of 

scientific knowledge and its practical application in the field. FY 2012 and FY 2014 provide for 

$2.2 million and $3.5 million respectively for NREPP.

Other SAMHSA activities related to the Strategic Initiative on Data, Outcomes and Quality 

include the development of the National Behavioral Health Quality Framework, stemming from 

the National Quality Strategy and coordination with Health Information Technology efforts and 

Meaningful Use Measures for application in electronic health records, led by ONC and CMS.

Statistical and Analytic Support

Funding is requested to continue support for statistical and analytic FTE’s and operational needs 

consistent with the realignment of data collection, analytic, and measurement development tasks 

within the CBHSQ. As SAMHSA moves to implement its Strategic Initiative on Data, 

Outcomes, and Quality, 14 additional staff will be hired in 2013 to carry out the management of 

data collection activities as well as analysis and report development related to health and 

behavioral health reform.

Resource Summary

A total of $120.2 million is provided for CBHSQ, including $59.8 million from the Substance 

Abuse Treatment appropriation and $60.4 million from the Health Surveillance and Program 

Support appropriation. This reflects a net decrease of $3.7 million, including a decrease of $3.8

million from the Substance Abuse Treatment (SAT) appropriation and practically level funding 

from the Health Surveillance and Program Support (HSPS) appropriation. The source of funding 

for CBHSQ within HSPS has shifted from the Prevention Fund to the Public Health Service 

Evaluation Fund (PHS), reflecting a decrease of $18 million in Prevention Funds and an increase 

of $18 million in PHS Evaluation fund. Major increases include funding for DAWN to fully 

fund the IAA with CDC to incorporate DAWN within the NCHS ED data collection system, 

funding for grantee data collection technical assistance to transition to help grantees transition to 

the new Common Data Platform, and funding for the BHSIS contract. Decreases include 

funding for NSDUH, NAC, and funding for the Legacy data collection which will be phased out 

as the Common Data Platform becomes fully operational, and funding for FTE/operations.

The FY 2014 resources include increases from the FY 2012 funding level for the following 

activities (+29.1 million): 

DAWN: $10.0 million, an increase of $4.9 million from the FY 2012 funding level. This 

increase includes funding for an IAA with CDC to incorporate DAWN within the NCHS 

ED data collection system. In addition, other data sources will supplement ED reporting 

from the NHCS.

DAISIS/BHSIS: $23.1 million, an increase of $7.0 million from the FY 2012 funding 

level. An additional $7.5 million will be provided from the mental health appropriation.

C-EMS: $1.0 million, an increase of $0.082 million from the FY 2012 funding level. 

Funding will support ongoing analytic projects.
219

National Analytic Center: $4.4 million, an increase of $1.5 million from the FY 2012

funding level. Increased funding will allow for the expanded use and application of data 

collected under the survey contracts. 

CDP: $10.9 million, an increase of $10.9 million from the FY 2012 funding level. This 

increase includes funding for implementation of the Common Data Platform.

Grantee Data Development TA: $5.0 million, an increase of $5.0 million from the FY 

2012 funding level.

NREPP: $3.5 million, an increase of $1.3 million from the FY 2012 funding level. This 

increase will support and enhance the online public registry of ready to use approaches 

for treating and preventing mental and substance abuse disorders. 

The FY 2014 resources also include same level funding as in FY 2012 for the following activity:

CDC NHIS IAA: $2.0 million

The FY 2014 resources also include decreases from FY 2012 funding level for the following 

activities (-$32.8 million): 

NSDUH: $44.6 million, a decrease of $14.8 million from the FY 2012 funding level. 

Funding will support annual surveys. An additional $1.0 million dollars will be provided 

from the mental health appropriation.

SAMHDA/Data Archive: $1.3 million, a decrease of $0.004 million from the FY 2012

funding level.

DCAR- Legacy: $1.2 million, a decrease of $3.3 million from the FY 2012 funding level. 

Funding decrease attributed to the phasing out of legacy contracts and moving towards 

implementing CDP. 

SAIS/TRAC: $1.8 million, a decrease of $9.1 million from the FY 2012 funding level. 

Funding decrease attributed to phasing out of legacy contracts and moving towards 

implementing CDP.

BRFSS: $0, a decrease of $0.600 million from the FY 2012 funding level. In FY 2014, 

funding for BRFSS will be provided by the mental health appropriation.

Behavioral Health U.S.: $0, a decrease of $0.657 million from the FY 2012 funding level.

FTE/Operations: $11.4 million, a decrease of $5.9 million from the FY 2012 funding 

level due to reduction in overhead costs. 
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RESOURCE SUMMARY

FY 2012 FY 2013 FY 2014

Actual Annualized CR 2 / President's 

Budget

Drug Resources by Function

Prevention $574,214 $573,976 $571,204

Treatment 1,982,013 1,950,351 1,917,369

Total, Drug Resources by Function 2,556,227 2,524,327 2,488,572

Drug Resources by Decision Unit 

Programs of Regional and National Significance 1Substance Abuse Prevention 

Programs of Regional and National Significance 1 / 185,885 187,076 175,560

Substance Abuse Prevention and Treatment Block Grant 360,066 362,270 363,971

545,951 549,346 539,531

Programs of Regional and National Significance 1Substance Abuse Treatment 

Programs of Regional and National Significance 1 / 428,697 402,751 334,794

Substance Abuse Prevention and Treatment Block Grant 1,440,266 1,449,080 1,455,885

1,868,962 1,851,831 1,790,679

Program Management Health Surveillance and Program Support

Prevention 28,263 24,630 31,672

Treatment 113,050 98,520 126,690

Total, Health Surveillance and Program Support 141,313 123,150 158,362

Total, Drug Resources by Decision Unit 2,556,227 2,524,327 2,488,572

Total FTEs (direct only) 590 631 655

Total Agency Budget $3,568,687 $3,498,924 $3,572,209

Drug Resources Percentage 71.6% 72.1% 69.7%

Footnotes

2

 The FY 2013 Prevention Fund Resources are reflected in the Office of the Secretary.

DEPARTMENT OF HEALTH AND HUMAN SERVICES

Substance Abuse and Mental Health Services Administration

Drug Resources Personnel Summary

Total, Substance Abuse Prevention

Drug Resources as a Percent of Budget

1 A detailed breakout of programs within the Programs of Regional and National Significances can be found on the following page; 

does not include Mental Health Programs. 

Total, Substance Abuse Treatment
222

Substance Abuse Prevention FY 2012 Actual

FY 2013

Annualized CR 1 /

FY 2014 

President's 

Budget

Substance Abuse Prevention PRNS

Strategic Prevention Framework $109,754 $110,479 $109,754

Manadatory Drug Testing 5,196 5,228 4,906

Minority AIDS Initiative 41,307 41,560 41,307

STOP Act 6,987 7,030 7,000

Fetal Acohol Syndrome 9,802 9,862 1,000

Center for the Application of Prevention Technologies 8,059 8,108 7,511

Science and Service Program Coordination 4,780 4,809 4,082

Total, Substance Abuse Prevention PRNS $185,885 $187,076 $175,560

Substance Abuse Prevention and Treatment Block Grant $360,066 $362,270 $363,971

PHS Evaluation Funds (non-add) 15,840 15,937 14,345

Total, Substance Abuse Block Grant $360,066 $362,270 $363,971

Health Surveillance and Program Support

Health Surveillance and Program Support $24,176 $20,515 $23,056

Prevention and Public Health Fund (non-add) 3,218 N/A ---

Budget Authority (non-add) 15,778 15,874 14,946

Data Request/Publication User Fees (non-add) --- --- 300

PHS Evaluation Funds (non-add) 5,181 4,640 7,811

Public Awareness and Support 1,355 1,363 1,357

PHS Evaluation Funds (non-add) --- --- 1,357

Performance and Quality Information Systems 1,812 1,827 1,819

PHS Evaluation Funds (non-add) --- --- 1,819

Agency Wide Initiatives 920 926 5,440

Workforce (non-add) 571 574 5,440

Military Families Initiative (non-add) 349 351 ---

Total, Substance Abuse Prevention HSPS $28,263 $24,630 $31,672

Total, Substance Abuse Prevention $574,214 $573,976 $571,204

1 The FY 2013 Prevention Fund Resources are reflected in the Office of the Secretary.

Drug Budget Split between Prevention and Treatment FY 2012-FY 2014

(Dollars in Thousands)
223

Substance Abuse Treatment FY 2012 Actual

FY 2013

Annualized CR 1 /

FY 2014 

President's 

Budget

Substance Abuse Treatment PRNS

Opioid Treatment Programs/Regulatory Activities $12,886 $8,941 $8,746

Prevention and Public Health Fund (non-add) 4,000 N/A ---

Screening, Brief Intervention and Referral to Treatment 53,187 28,360 30,000

Budget Authority (non-add) 26,187 26,348 ---

Prevention and Public Health Fund (non-add) 25,000 N/A 30,000

PHS Evaluation Funds (non-add) 2,000 2,012 ---

TCE - General 27,980 28,151 13,256

Pregnant & Postpartum Women 15,970 16,067 15,970

Strengthening Treatment Access and Retention 1,672 1,682 1,000

Recovery Community Services Program 2,445 2,460 2,562

Access to Recovery 98,268 98,869 65,000

Children and Family Programs 30,620 30,807 29,678

Treatment Systems for Homeless 41,571 41,826 41,571

Minority AIDS 65,863 66,266 52,359

Criminal Justice Activities 66,903 67,920 65,135

Addiction Technology Transfer Centers 9,064 9,119 8,081

Special Initiatives/Outreach 2,267 2,281 1,436

Total, Substance Abuse Treatment PRNS $428,697 $402,751 $334,794

Substance Abuse Prevention and Treatment Block Grant $1,440,266 $1,449,080 $1,455,885

PHS Evaluation Funds (non-add) 63,360 63,748 57,379

Total, Substance Abuse Block Grant $1,440,266 $1,449,080 $1,455,885

Health Surveillance and Program Support

Health Surveillance and Program Support $96,706 $82,058 $92,226

Prevention and Public Health Fund (non-add) 12,872 N/A ---

Budget Authority (non-add) 63,112 63,498 59,783

Data Request/Publication User Fees (non-add) --- --- 1,200

PHS Evaluation Funds (non-add) 20,722 18,560 31,242

Public Awareness and Support 5,418 5,451 5,428

PHS Evaluation Funds (non-add) --- --- +5,428

Performance and Quality Information Systems 7,247 7,308 7,278

PHS Evaluation Funds (non-add) --- --- +7,278

Agency Wide Initiatives 3,680 3,702 21,758

Workforce (non-add) 2,282 2,296 21,758

Military Families Initiative (non-add) 1,397 1,406 ---

Total, Substance Abuse Treatment HSPS $113,050 $98,520 $126,690

Total, Substance Abuse Treatment $1,982,013 $1,950,351 $1,917,369

1 The FY 2013 Prevention Fund Resources are reflected in the Office of the Secretary.

Drug Budget Split between Prevention and Treatment FY 2012-FY 2014

(Dollars in Thousands)
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MISSION

The Substance Abuse and Mental Health Services Administration’s (SAMHSA) mission is to 

reduce the impact of substance abuse and mental illness on America’s communities. SAMHSA 

supports the President’s National Drug Control Strategy through a broad range of programs 

focusing on prevention, treatment and recovery from substance abuse. Major programs for 

FY 2014 will include the Substance Abuse Block Grant, competitive grant programs reflecting 

Programs of Regional and National Significance (PRNS) and Health Surveillance and Program 

Support. These programs are administered through SAMHSA’s Centers for Substance Abuse 

Prevention (CSAP) and Substance Abuse Treatment (CSAT) as well as through SAMHSA’s 

Center for Behavioral Health Statistics and Quality (CBHSQ) and the Office of 

Communications.

METHODOLOGY 

SAMHSA distributes drug control funding into two functions: prevention and treatment. Both 

functions include a portion from the Health Surveillance and Program Support appropriation. 

Since the PAS and PQIS programs represent the consolidation of funding from existing CSAT, 

CSAP and Center for Mental Health Services (CMHS) programs, 50 and 70 percents, 

respectively, of funding for these activities would be included in the drug budget which 

represents the substance abuse portion of split between substance abuse and mental health for the 

entire agency. The 50 and 70 percents are then divided 20 percent/80 percent into the two 

functions, prevention and treatment, respectively. The Health Surveillance and Program Support 

activities are split first between mental health and substance abuse (as determined by each 

activity) and then the substance abuse portion is split 80 percent and 20 percent between 

prevention and treatment. Agency-wide programs would be evenly split between mental health 

and substance abuse and then the substance abuse portion will be split the same 20 percent and 

80 percent for prevention and treatment.

Included in the prevention functions are the funds in the Substance Abuse Prevention 

appropriation, including the Substance Abuse Prevention Programs of Regional and National 

Significance and 20 percent of the Substance Abuse Block Grant funds from the Substance 

Abuse Treatment appropriation. Also included in prevention are 20 percent of the substance 

abuse portions of Performance and Quality Information Systems (PQIS) and Public Awareness 

and Support (PAS) programs, a portion of the Agency-wide Initiatives, and 20 percent of the 

remaining funding in Health Surveillance and Program Support. Included in treatment are the 

funds in the Substance Abuse Treatment appropriation, including the Substance Abuse 

Treatment Programs of Regional and National Significance and 80 percent of the Substance 

Abuse Block Grant funds. Also included in treatment are 80 percent of the substance abuse 

portions of PQIS and PAS programs, a portion of the Agency-wide Initiatives, and 80 percent of 

the remaining funding in Health Surveillance and Program Support.
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BUDGET SUMMARY

In FY 2014, SAMHSA requests a total of $2.489 billion for drug control activities, which is a 

decrease of $67.7 million from the FY 2012 level. The Budget directs resources to activities that 

have demonstrated improved health outcomes and that increase service capacity. SAMHSA has 

three major drug-related decision units: Substance Abuse Prevention, Substance Abuse 

Treatment, and Health Surveillance and Program Support. Each decision unit is discussed 

below:

Substance Abuse Prevention 

Substance Abuse Prevention Programs of Regional and National Significance

Total FY 2014 Request: $175.6 million

(Reflects $10.3 million decrease from FY 2012)

The Substance Abuse Prevention Programs of Regional and National Significance (PRNS) 

support states and communities in carrying out an array of activities to improve the quality and 

availability of services in priority areas.

The FY 2014 President’s Budget request for SAMHSA Substance Abuse Prevention PRNS 

includes $175.6 million which covers seven programmatic activities, a decrease of $10.3 million 

from the FY 2012 level. The request includes: $109.8 million for Strategic Prevention 

Framework; $41.3 million for Minority AIDS; $1.0 million for the Fetal Alcohol Spectrum 

Disorders (FASD) contract; $7.5 million to continue provision of technical assistance to 

maximize effectiveness through the Centers for the Application of Prevention Technologies; $4.9 

million for Mandatory Drug Testing; $7.0 million for other Sober Truth on Preventing Underage 

Drinking; and $4.1 million for Science and Service Program Coordination.

Strategic Prevention Framework 

Total FY 2014 Request: $109.8 million

(Reflects level funding from FY 2012) 

Partnerships for Success 

The Partnerships for Success (PFS) program was initiated in FY 2009 with the goals of reducing 

substance abuse-related problems; preventing the onset and reducing the progression of 

substance abuse; strengthening prevention capacity and infrastructure at the state- and 

community-levels in support of prevention; and leveraging, redirecting and realigning state-wide 

funding streams for substance abuse prevention. Eligible applicants are states and Territories that 

have completed a SPF State Incentive Grant (SPF-SIG). In FY 2009, four grants were awarded, 

and in FY 2010, one additional award was made. The first two cohorts incorporated an incentive 

award to grantees that have reached or exceeded their prevention performance targets (subject to 

availability of funds). In FY 2012, SAMHSA supported these efforts by awarding five 
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continuation grants. The FY 2011 data from the first cohort reporting show that 50 communities 

increased the number of activities supported through collaboration and leveraging. Grantees 

reported implementing almost two thousand evidence based programs during FY 2011. Thirtytwo communities reported improvements on targeted National Outcome Measures indicators. 

The vast majority of communities (88 percent) targeted alcohol use.

A new cohort of PFS grants was implemented in FY 2012 to address two of the nation’s top 

substance abuse prevention priorities: underage drinking among youth aged 12 to 20 and 

prescription drug misuse and abuse among individuals aged 12 to 25. The program is based on 

the premise that changes at the community level will, over time, lead to measurable changes at 

the state and national level. In FY 2012, SAMHSA awarded 15 new grants for three years. 

In FY 2013, SAMHSA will support continuation awards for the initial cohort established in FY 

2009 and FY 2010. SAMHSA will make a new SPF SIG award to Iowa, the last SPF SIG state 

remaining to receive one and will award up to 17 new PFS grants. In addition, SAMHSA will 

make funds available for grantees in the first cohort who meet their performance targets and are 

eligible to apply for the incentive supplement.

In FY 2014, SAMHSA requests $36.7 million to implement a new cohort of Partnerships for 

Success (PFS) grants, which will be consistent with the Prevention of Substance Abuse and 

Mental Illness Strategic Initiative. Similar to the previous cohorts, this PFS program will focus 

on implementing the Strategic Prevention Framework to strengthen prevention capacity and 

infrastructure at the state, territorial, and community levels; preventing the onset and reducing 

the progression of substance abuse; and leveraging, redirecting, and aligning statewide funding 

streams and resources to focus on promoting evidence-based substance abuse prevention. The 

new PFS grantees will also have the option of focusing on addressing trauma as one of the risk 

factors for substance abuse.. Up to 32 grants will be awarded to eligible states, territories and 

tribes who have completed SPF-SIG grants. Grant award amounts will be divided into tiers with 

a maximum grant of approximately $2.0 million per year for the top tier. 

SAMHSA will also consider how best to help tribes committed to substance abuse prevention to 

strengthen their existing service delivery systems and/or to begin building the necessary capacity 

and/or infrastructure to successfully prevent substance abuse in their communities.

Minority AIDS Initiative

Total FY 2014 Request: $41.3 million

(Reflects level funding from FY 2012)

Implemented in FY 1999, SAMHSA/CSAP’s Minority AIDS Initiative (MAI) supports efforts to 

increase access to substance abuse and HIV prevention services for the highest risk and hardestto-serve racial and ethnic minority populations. Grantees must implement integrated, evidencebased substance abuse and HIV prevention interventions, including HIV testing, that target one 

or more high-risk populations such as African-American women, adolescents, individuals who 

have been released from prisons and jails within the past two years, or men having sex with men 

(MSM). In addition, the MAI supports partnerships between public and private nonprofit 

organizations to prevent and reduce the onset of substance abuse and transmission of HIV among 

high-risk populations. 
227

Since its inception, CSAP has funded a total of ten cohorts. In FY 2011, SAMHSA/CSAP 

funded the Ready-To-Respond Initiative and the Capacity Building Initiative programs, and a 

total of 62 grants in these cohorts will continue to be funded in FY 2013. The Ready-ToRespond Initiative, targeted toward experienced MAI grantees, provides substance abuse and 

HIV prevention services to at-risk minority populations in communities disproportionately 

affected by HIV/AIDS. The Capacity Building Initiative focuses on using evidence-based 

prevention strategies and media technology to reach college students, who comprise one-third of 

the 18-24 year old population in the United States and are particularly at risk for substance use 

and HIV infection. Performance data for FY 2011, the most recent available showed that over 

4,000 people received substance abuse prevention education services. Over 355,000 were 

reached through environmental approaches. Additionally, 95.5 percent of participants rated the 

risk of harm from substance abuse as great. Of those participants who were non-users, 92.5 

percent remained non-users of drugs and 88.1 percent remained alcohol free. During FY 2011, 

over 11,000 participants were tested for HIV, of whom almost 4,000 were tested for the first 

time. SAMHSA has supported these grants in FY 2012 and will continue to do so in FY 2013.

In FY 2011, SAMHSA also awarded grants for the Minority AIDS Initiative Targeted Capacity 

Expansion Integrated Behavioral Health/Primary Care Network Cooperative Agreements, jointly 

funded with CMHS and CSAT. This grant program facilitates the development and expansion of 

culturally-competent and effective integrated behavioral health and primary care networks, 

which include HIV services and medical treatment, within racial and ethnic minority 

communities in the 11 Metropolitan Statistical Areas and Metropolitan Divisions most impacted 

by HIV/AIDS. Expected outcomes include: reducing the impact of behavioral health problems, 

HIV risk and incidence, and HIV-related health disparities in these areas. SAMHSA continued 

to support these grants in FY 2012 and is continuing to do so in FY 2013.

In FY 2013, SAMHSA is awarding a new cohort of grants for the MAI and HIV Prevention in 

High Risk Minority Serving Institutions (MSI) and Communities (MAI/MSI) program. The 

purpose of the MAI/MSI program is to equip and empower high risk MSIs located in 

communities with the highest risk of substance abuse and HIV infections with evidence-based 

methodologies to increase access to comprehensive, integrated substance abuse and HIV 

prevention services on their campuses/institutions and in the surrounding community. High risk 

population are communities with higher prevalence rate of substance abuse, HIV/AIDS, 

underage drinking and/or prescription drug misuse and has limited resources or has had fewer 

opportunities or less success in identifying and bringing to bear resources to address the 

identified priorities. The MAI/MSI recipients also will be required to partner with local 

community organizations serving at-risk racial/ethnic minority young adults, MSMs, as well as 

(if applicable), other demonstrated high risk groups in communities disproportionately affected 

by SA and HIV/AIDS, i.e. Black/African American men and women, Latino(a), Hispanic and 

sexual minorities. The goal is to reduce the rate of new substance abuse and HIV infections on 

minority serving college/institution campuses and the surrounding at risk communities. 

SAMHSA will award up to 60 grants for three years.

SAMHSA supports the National HIV/AIDS Strategy through its grant programs, including the 

cross-Center Targeted Capacity Expansion Integrated Behavioral Health/Primary Care Network 

Cooperative Agreements, the CSAT Targeted Capacity Expansion/HIV program, and the CSAP 
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Ready-to-Respond and Capacity Building Initiative programs, all described in their respective 

sections of this document. SAMHSA also provides technical assistance to its grantees to assure 

they are focusing on the goals of the Strategy and collaborates with other HHS Operating 

Divisions involved with the Strategy to assure a coordinated, Departmental approach.

Fetal Alcohol Spectrum Disorder

Total FY 2014 Request: $1.0 million

(Reflects $8.8 million decrease from FY 2012)

SAMHSA’s Fetal Alcohol Spectrum Disorders (FASD) Center for Excellence (CFE) program 

focuses on preventing Fetal Alcohol Spectrum Disorders among women of childbearing age and 

improving the quality of life for individuals and families impacted by these disorders. 

SAMHSA’s FASD CFE uses a comprehensive approach across the lifespan to work toward 

reducing the number of infants exposed to alcohol prenatally, increasing the functioning of 

individuals who have an FASD, and addressing the challenges of individuals and families 

impacted by FASD.

As part of these efforts, SAMHSA’s FASD CFE has successfully established a website that 

provides the public with information and resources on the prevention of FASD, chartered an 

expert panel that provides guidance and recommendations about best practices for healthcare 

providers and social services, organized a Self Advocates with FASD (SAFA) Network 

comprising young adults with an FASD and Birth Mothers Network (BMN); partnered with the 

National Institute on Alcohol Abuse and Alcoholism’s (NIAAA) Interagency Coordinating 

Committee on FASD (ICCFASD) to advance new research and best practices on FASD; 

coordinated and collaborated with organizations such as the National Organization on Fetal 

Alcohol Syndrome (NOFAS) to develop curricula for juvenile justice systems and certified 

addictions counselors; provided ongoing support to the National Association of FASD State 

Coordinators (NAFSC) to integrate FASD services into existing health care systems; and 

convened 10 "Building FASD State Systems" (BFSS) annual conferences to facilitate the 

development of comprehensive systems of care for people affected by FASD. In addition, 

SAMHSA’s FASD CFE established a Native Communities Initiative to address FASD in 

American Indian /Alaska Native /Native Hawaiian (AI/AN/NH) populations

In FY 2011, the most recent year for which data is available, SAMHSA’s FASD CFE screened 

10,829 at-risk individuals and provided direct services to a total of 1,651 individuals. Over 90 

percent of participants who used alcohol reported decreased current and binge drinking after 

program participation. In addition, SAMHSA’s FASD provided 26 trainings to over 1,483 

providers nationwide. 

In FY 2012, SAMHSA continued to support the FASD CFE to work toward the prevention of 

FASD in communities throughout the nation. In FY 2013, SAMHSA will award a new FASD 

CFE to focus on identifying new methods for screening and providing preventive services and 

resources to women of childbearing age, as well as increasing collaboration and coordination of 

prevention efforts with other federal and national partners.
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Center for the Application of Prevention Technologies

Total FY 2014 Request: $7.5 million

(Reflects a $0.6 million decrease from FY 2012)

SAMHSA’s Center for the Application of Prevention Technologies (CAPT) program provides 

state-of-the-art training and technical assistance designed to build the capacity of SAMHSA 

grantees and develop the skills, knowledge, and expertise of the prevention workforce. 

SAMHSA’s CAPT builds capacity and promotes the development of substance abuse prevention 

professionals in the behavioral health field through three core strategies: (1) establishing 

technical assistance networks using local experts; (2) developing and delivering targeted training 

and technical assistance activities; and (3) using innovative communication media such as 

teleconference and video conferencing, online events, and Web-based support. These activities 

help ensure the delivery of effective prevention programs and practices and the development of 

accountability systems for performance measurement and management. 

During FY 2012 and FY 2013, SAMHSA’s CAPT completed a comprehensive revision and 

updating of its flagship Substance Abuse Prevention Skills Training, which offers participants 31 

training hours toward certification as a Substance Abuse Prevention Specialist. CAPT also 

developed a Pacific Islander and Native American adaptation of the training for an additional six 

training hour credits. In FY 2012 and 2013, CAPT has continued to develop behavioral health 

indicators and related training and technical assistance products focused on shared risk and 

protective factors to promote collaboration across substance abuse and mental health disciplines 

within the behavioral health field. 

During FY 2011, SAMHSA’s CAPT delivered over 415 training events nationwide and trained 

over 10,060 substance abuse prevention professionals. During FY 2012, there was a slight 

decline to 9,041 in numbers. In addition, in FY 2012, SAMHSA’s CAPT provided technical 

assistance services to 7,655 people. Over 96 percent of service recipients reported that their 

organization’s capacity was increased as a result of the service. Almost half of the recipients 

reported fully implementing the training recommendations. Additional performance data for the 

CAPT is captured using common measures with other technical assistance activities in the 

Science and Service Program Coordination category.

Mandatory Drug Testing

Total FY 2014 Request: $4.9 million

(Reflects $0.3 million decrease from FY 2012) 

SAMHSA’s Mandatory Drug Testing is a critical nationwide prevention program consisting of 

two principal activities mandated by Executive Order and law: (1) oversight of the Federal DrugFree Workplace Program, aimed at elimination of illicit drug use in the federal workforce, with 

impact in the private sector workforce as well; and (2) oversight of the National Laboratory 

Certification Program, which certifies laboratories to conduct forensic drug testing for the federal 

agencies and for some federally-regulated industries.

Executive Order 12564, first signed on September 15, 1986, requires the head of each executive 

agency to establish a program to test for the use of illegal drugs by federal employees in sensitive 
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positions and requires the Secretary to promulgate scientific and technical guidelines for drug 

testing programs. The Executive Order also requires HHS to assist the Office of Personnel 

Management to develop and improve training programs for federal supervisors and managers on 

illegal drug use and to mount an intensive drug awareness campaign throughout the federal 

workforce.

The Supplemental Appropriations Act, 1987 (Public Law 100-71) requires HHS to: (1) certify 

that each federal agency has developed a plan for achieving a drug-free workplace; and (2) 

publish Mandatory Guidelines that establish comprehensive standards for laboratory drug testing 

procedures, specify the drugs for which federal employees may be tested, and establish standards 

and procedures for periodic review and certification of laboratories to perform drug testing for 

federal agencies.

The program is further supported by the CSAP Workplace Helpline, a toll-free telephone service 

for business and industry that answers questions about drug abuse in the workplace. 

SAMHSA will continue these activities in FY 2013. In addition, the Drug Testing program is 

examining the scientific basis for oral fluid testing as an alternative specimen to urine, and also 

to include additional Schedule II prescription medications (e.g., oxycodone, oxymorphone, 

hydrocodone and hydromorphone) in the drug testing protocol. Any changes will be based on 

scientific supportability. SAMHSA continues to partner with NIH/NIDA, FDA, and other federal 

agencies to ascertain the scientific evidence needed to set standards for the Mandatory 

Guidelines. 

Sober Truth on Preventing Underage Drinking (STOP Act)

Total FY 2014 Request: $7.0 million

(Reflects $0.013 million increase from FY 2012) 

The Sober Truth on Preventing Underage Drinking Act (STOP Act) of 2006 is the nation’s first 

comprehensive legislation on underage drinking. One of the primary components of the Act is 

the STOP Act grant program, which provides additional funds to current or former grantees 

under the Drug Free Communities Act of 1997 to prevent and reduce alcohol use among youth 

age 12-20. The STOP Act grant program enables organizations to strengthen collaboration and 

coordination among stakeholders in order to achieve a reduction in underage drinking in their 

communities. Grants are limited by statute to $50,000 per year for four years. In FY 2012, 81 

new grants were awarded. In FY 2011, performance data show that the STOP Act grant program 

has exceeded targets in all GPRA performance measures. Eighty-four percent of coalitions 

reported a reduction in the past 30 day use of alcohol, 75 percent of coalitions reported an 

increase in perceived risk, and 75 percent of coalitions reported an increase in perception of 

parental disapproval of alcohol use (69.6 percent). In FY 2013, SAMHSA will award up to 16 

new grants.

Another component of the STOP Act is the National Adult-Oriented Media Public Service 

Campaign, which educates parents regarding how to speak with their 11- through 15-year-old 

children about underage drinking in order to delay the onset of, and ultimately reduce, underage 

drinking. Nationwide, 38.9 percent of the estimated 10 million underage drinkers were provided 
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free alcohol by adults 21 or older (2010 NSDUH). Further research continues to show that 

parents of teens generally underestimate the extent of alcohol used by youth and its negative 

consequences, with the vast majority viewing underage drinking as “inevitable.” 

The third component of the STOP Act is the federal Interagency Coordinating Committee on the 

Prevention of Underage Drinking (ICCPUD), which provides high-level leadership from 15 

federal agencies for coordinating federal efforts to prevent and reduce underage drinking. In FY 

2012, the ICCPUD was reinvigorated with principals meeting from all federal agencies working 

to prevent underage drinking, and the launch of a webinar series featuring common messages 

with individualized information for the field from each involved federal agency. In 2012, the 

ICCPUD updated the 2007 Surgeon General’s Call to Action to Prevent Underage Drinking to 

reflect progress over the past six years, the impact of the Affordable Care Act, and new research 

supporting effective prevention approaches. SAMHSA will continue to support ICCPUD’s 

activities in FY 2013.

Science and Service Program Coordination

Total FY 2014 Request: $4.1 million

(Reflects $0.7 million decrease from FY 2012)

The Science and Service Program Coordination category primarily encompasses contracts that 

provide technical assistance and training to states, tribes, communities, and grantees around 

substance abuse prevention. Included in the performance measurement section for this category 

are the Native American Center for Excellence (NACE) and the Underage Drinking Prevention 

Education Initiative (UADPEI). 

The purpose of SAMHSA’s NACE is to promote effective substance abuse prevention programs 

in tribal and urban American Indian and Alaska Native (AI/AN) communities throughout the 

United States. The NACE mission is to promote best practices in substance abuse prevention by 

disseminating information on cultural- and evidence-based programs, practices, and policies and 

providing training and technical assistance (TTA) to prevention programs and organizations 

serving urban and tribal Native American communities. The target audiences include the Native 

American SPF-SIG grantees, tribal nations and organizations, health and social service 

providers, federal and state level organizations, and community and faith-based providers 

serving Native Americans. It has provided TTA to 482 recipients and training to 213 people 

during FY 2011. Additionally 88 percent of recipients report that the NACE services increased 

their individual capacity to provide prevention services. 

NACE expanded its outreach in FY 2012 and FY 2013 through presentations at national 

conferences and regional events, and increased collaborative efforts with other SAMHSA 

initiatives and national organizations. The NACE website greatly expanded its collection of 

resources and dissemination of current news worthy events through daily “headlines” entries 

while tripling its number of visitors each month. FY 2012 and FY 2013 also brought the 

development of four new NACE learning communities (National Prevention Network, SPF 

Tribal Incentive Grant, Gathering of Native Americans, and 2-Spirit) to bring stakeholders 

together on conference calls or webinars to further disseminate information and support cross-
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fertilization of information and idea. Lastly, NACE expanded the frequency and reach of its 

national webinars.

In FY 2013, SAMHSA’s CSAP’s NACE and CMHS’s AI/AN Suicide Prevention programs will 

collaborate through braided funding to provide comprehensive, broad, focused, and/or intensive 

training and technical assistance to federally-recognized tribes and other American Indian/Alaska 

Native communities, seeking to address and prevent mental and substance use disorders, suicide, 

and promote mental health. Any braided amounts spent or awarded will be tracked as distinct 

funding streams and will only be used for purposes consistent with legislative direction and 

intent. 

The UADPEI engages parents and other caregivers, schools, communities, all levels of 

government, all social systems that interface with youth, and youth themselves in a coordinated 

national effort to prevent and reduce underage drinking and its consequences. Through this 

initiative, families, their children, and other youth-serving organizations have been reached 

through Town Hall Meetings (held in even-numbered years), technical assistance, trainings, and 

a variety of tools and materials. In FY 2011, more than 2,800 people were trained.

Performance data show that, collectively, the CAPT and Science and Service Program 

Coordination programs have exceeded their targets for customer satisfaction, and for the 

proportion of participants who report implementing recommendations. Efficiencies have been 

achieved from the growing focus on train-the-trainer models rather than training of individuals. 

In addition, since the Town Hall Meetings under the UADPEI contract occur biannually, 

numbers served expand in the years the meetings occur and contract in alternate years. 

Substance Abuse Treatment 

Substance Abuse Treatment Programs of Regional and National Significance

Total FY 2014 Request: $334.8 million

(Reflects $93.9 million decrease from FY 2012)

The Substance Abuse Treatment Programs of Regional and National Significance (PRNS) 

support states and communities in carrying out an array of activities to improve the quality and 

availability of services in priority areas.

The FY 2014 President’s Budget request for SAMHSA Substance Abuse Treatment PRNS 

includes $334.8 million which covers thirteen programmatic activities, a decrease of $93.9 

million from the FY 2012 level. The request includes: $65.0 million for Access to Recovery; 

$30.0 million for Screening, Brief Intervention and Referral to Treatment; $41.6 million for 

Treatment Systems for Homeless; $52.4 million for Minority AIDS Initiative; $65.1 million for 

Criminal Justice Activities of which $41.3 million will fund Drug Courts and $11.9 million for 

Ex-Offender Reentry; and $80.7 million for Other PRNS Treatment Programs.
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Access to Recovery

FY 2014 Request: $65.0 million

(Reflects $33.3 million decrease from FY 2012)

The Access to Recovery (ATR) program represents one component of SAMHSA’s Recovery 

Support Strategic Initiative. This effort provides grants to states, tribes, and tribal organizations 

to carry out voucher programs that expand substance abuse treatment capacity and promote 

choice among clinical treatment and recovery support providers in order to facilitate client 

recovery from substance abuse. The objectives of the program are to expand substance abuse 

treatment capacity by increasing the number and types of providers (including faith-based and 

grass-roots providers) to allow clients to play a more significant role in the development of their 

treatment plans through the use of electronic vouchers, and to link clinical treatment with critical 

recovery support services such as childcare, transportation, and mentoring. The populations 

served through ATR include the following: youth, users of methamphetamine, individuals 

involved with the criminal justice system, military families, and women with dependent children. 

ATR enhances accountability by measuring outcomes and monitoring data to deter fraud and 

abuse.

Since 2004, ATR has funded a total of 69 grants in a total of three cohorts: 15 three-year grants 

were awarded in FY 2004, 24 three-year grants were awarded in FY 2007, and 30 four-year 

grants were awarded in FY 2010. ATR is designed to: (1) allow recovery to be pursued through 

personal choice and many pathways; (2) require grantees to manage performance based on 

outcomes that demonstrate client successes; and (3) expand capacity by increasing the number 

and types of providers who deliver clinical treatment and/or recovery support services. The 

target is 225,000 clients for the third cohort, which began in FY 2010, with approximately 

33,500 to be served in the first year; 70,750 clients to be served in each of the two subsequent 

years; and 50,000 to be served in the final year. In its first year of operation this cohort of ATR 

has exceeded its target of 33,500, having served over 47,000 clients. SAMHSA funded the 

continuation of 30 grants and supported six contracts in FY 2012. SAMHSA will fund 30 grant 

continuations in the final year of the third cohort in FY 2013 as well as one contract. 

The FY 2014 budget request includes $65.0 million for the ATR program. Although reduced in 

scale from past years, it will serve 21,000 individuals. In FY 2014, the program will preserve the 

core concepts embodied in the three previous ATR cohorts, while also striving to better support 

provisions of the Affordable Care Act. 

State and tribal ATR grants will support the provision of treatment and recovery support services 

to those with substance use disorders. Services payable under Medicaid and covered through 

essential health benefit plans, such as outpatient clinical treatment services and residential 

services, would, for the most part, not be allowable under this program. In order to ensure nonduplication of billing sources, providers will work with clients to link them to other usable 

funding sources where appropriate. For those services not covered, providers will be responsible 

for the provision of direct services. As was the case in the first three cohorts of ATR, 

states/tribes will be required to establish provider networks and develop a voucher-based 

mechanism to ensure client choice can be easily and feely exercised. 
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SAMHSA plans to award 19 three-year grants of $3.2 million annually. The majority of services 

provided are expected to be recovery support not otherwise fundable through insurance 

mechanisms. These include services such as transportation, housing, and jobs support. 

ATR grant funds will also support creating linkages with state health information exchanges 

(HIEs) to ensure coordination and non-duplication; working with non-traditional providers, such 

as faith-based and peer providers; working with traditional providers to ensure that proper 

sources of billing are being utilized for recovery support and clinical treatment services not being 

covered under Medicaid and other sources; and increasing availability and access to training and 

certification programs for non-traditional providers, such as faith-based and peer providers. 

The ATR program will be better integrated into the fabric of health reform as it is implemented 

during 2014. At the same time, service gaps will be filled, especially in the area of recovery 

support, to help achieve comprehensive coverage for those with substance abuse disorders. 

The proposed number of clients to be served with 2014 funding is 21,242. Outcomes including 

abstinence from substance use will also be tracked. By 2015, 80 percent of clients are expected 

to report being abstinent from substance use, 93 percent of clients are expected to report having 

no involvement with the criminal justice system, and 88 percent of clients are expected to report 

having improved social support.

Screening, Brief Intervention and Referral to Treatment

FY 2014 Request: $30.0 million

(Reflects $23.2 million decrease from FY 2012)

Screening, Brief Intervention, and Referral to Treatment (SBIRT) was initiated by 

SAMHSA/CSAT in FY 2003, using cooperative agreements to expand and enhance a state or 

tribal organization’s continuum of care. The purpose of the program is to integrate screening, 

brief intervention, referral, and treatment services within general medical and primary care 

settings. 

The SBIRT program requires grant recipients to effect practice change throughout the spectrum 

of medical practice. This is achieved through implementation in all levels of primary care, 

including hospitals, trauma centers, health clinics, nursing homes, employee assistance 

programs, and school systems. Practice change also alters the educational structure of medical 

schools by developing and implementing SBIRT curricula as standard and permanent practice. 

Research and clinical experience supports the use of the SBIRT approach to provide effective 

early identification and interventions in primary care and general medical settings. Early 

identification can decrease total healthcare costs by arresting progression toward addiction. 

SBIRT also can identify people, individuals with more serious problems and encourage them to 

obtain appropriate specialty treatment services. Funds may be used for the following services: 

pre/screening for substance use and co-occurring disorders; brief Interventions designed with 

client centered, non-judgmental, motivational interviewing techniques; brief treatment including 

the monitoring of individuals who misuse alcohol and other drugs but are not yet dependent; 

referral to treatment (when indicated) for those who have a substance use disorder; and when 

appropriate, referral to and expansion of specialty treatment services. Since the beginning of this 
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program, more than 1.7 million individuals have been screened. Of those, 19 percent required a 

brief intervention, brief treatment, or referral to specialty treatment programs. 

In 2011, over 213,000 clients were served by the SBIRT Program. The percentage of clients 

reporting abstinence at follow-up tripled compared to the percentage reporting abstinence at 

baseline. 

SBIRT has great future potential for promoting changes to the entire primary care medical 

service delivery system. Efforts are underway to identify other funding streams to help take this 

practice to scale. For example, new diagnostic codes have been adopted by 16 states, making it 

easier for doctors to get reimbursed for screening Medicaid patients. Likewise, alcohol 

screening is now available to Medicare beneficiaries as a preventive service without cost. In 

FY 2012, SAMHSA funded the continuation of 27 SBIRT grants, supported five contracts as 

well as three new multi-year grants funded out of the Prevention Fund, and continued to monitor 

the progress of the three FY 2011 multi-year Prevention Fund grants. In FY 2013 SAMHSA 

anticipates funding up to 19 new grants as well as 12 grant continuations and supporting three 

contracts.

In FY 2014, SAMHSA requests $30.0 million from the Prevention Fund for the SBIRT program

(an increase of $5 million from the Prevention Fund, but an overall decrease of $23.2 million 

from FY 2012). This level of funding will further support the integration and use of the SBIRT 

model into states and tribal primary care settings. In FY 2014, an estimated 141,435 individuals 

will be served by the program. The request will support 41 grants (25 continuations and 16 new) 

and one contract. Grant funds will further integrate SBIRT within medical treatment settings to 

provide early identification and intervention to at-risk individuals within the context of their 

primary care provider.

Treatment Drug Courts

FY 2014 Request: $41.3 million

(Reflects $3.7 million decrease from FY 2012)

Drug Courts

Drug courts are designed to combine the sanctioning power of courts with effective treatment 

services for a range of populations and problems such as alcohol and/or drug use, child 

abuse/neglect or criminal behavior, mental illness, and veterans’ issues. In 2010, the criminal 

justice system was the largest single source of referrals to substance abuse treatment. As 

treatment drug courts and other problem solving courts addressing drug and other behavioral 

health-related issues are being established at a high rate, communities are challenged to find 

sufficient substance abuse treatment and recovery support resources for people referred by the 

courts.

In FY 2010, SAMHSA/CSAT funded 10 new adult treatment drug court grants for three years at 

a cost of up to $325,000 per year. Also in FY 2010, SAMHSA and the Department of Justice 

(DOJ)/Office of Justice Programs (OJP)/Bureau of Justice Affairs (BJA) developed a joint 

program to enhance court services, coordination, and the substance abuse treatment capacity of 
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adult drug courts. The purpose of this joint initiative is for applicants to submit one application

that outlines a comprehensive strategy for enhancing drug court capacity. SAMHSA and BJA 

jointly funded 20 new adult treatment drug court grants. Each grantee was awarded one separate 

grant from each agency, representing an innovative braided funding opportunity. Any braided 

amounts spent or awarded will be tracked as distinct funding streams and will only be used for 

purposes consistent with legislative direction and intent. This collaboration was modeled after 

the successful SAMHSA and DOJ/Office of Juvenile Justice and Delinquency Prevention 

(OJJDP) collaborative juvenile treatment drug court grant program.

Funding for both the SAMHSA/CSAT and the SAMHSA/OJP/BJA adult treatment drug court 

programs must be used primarily for the following: direct treatment or prevention services for 

diverse populations at risk; “wrap-around”/recovery support services designed to improve access 

and retention; to provide drug testing for illicit substances required for supervision, treatment 

compliance, and therapeutic intervention; education support; relapse prevention and long-term 

management; Medication-Assisted Treatment (MAT); and HIV testing conducted in accordance 

with state and local requirements. 

In 2010 SAMHSA started the Children Affected by Methamphetamine/Family Treatment Drug 

Court program. These grants provide a child care coordinator to link available community-based 

social services resources that will focus on the trauma to the youngest victims caused by 

substance abuse/methamphetamine use in the family and concurrent criminal justice system 

involvement. In FY 2010, SAMHSA/CSAT funded 12 grants at up to $370,000 per year for up 

to four years. 

The Children Affected by Methamphetamine (CAM) program delivers services to the children of 

parents participating in Family Drug Treatment Court (FDTC). This grant program has been 

instrumental in developing a FDTC model that includes services for children, as well as, 

parenting/family programs for the family. Examples of services and supports for children, 

parents and families include: identification of substance exposed newborns so that interventions 

can be initiated/enhanced with these infants at birth; coordination with child welfare agencies 

around services provided to the family and child; home visiting services or referrals and linkages 

for medical and/or developmental follow-up with pediatric specialists knowledgeable about 

exposure to methamphetamine; primary care coordination; developmental assessments and 

services, and intervention with children identified as needing services; mental health services to 

children; and case management services. Services and linkages for parents include: evidencebased strategies to promote parenting abilities and address trauma; ancillary services for families 

to provide assistance in securing needed services such as safe and drug-free housing, 

transportation, vocational training and education, government benefits, legal services and child 

care; family planning services to avoid future in-utero exposure to methamphetamine and other 

drugs; domestic violence prevention/intervention services; and training for foster parents, 

relatives, and other substitute caregivers about the special needs of children and youth who have 

suffered from abuse or neglect and whose parents have a substance use disorder. Services for 

families include: evidence-based family and parenting interventions designed for children of 

parents with substance use disorders and their parents; and family counseling to strengthen 

family functioning and assist with reunification of families when children have been in out-ofhome placements. 
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In FY 2012, SAMHSA funded the continuation of 81 Drug Court grants and supported eight 

contracts, as well as 54 new grants. In FY 2013, SAMHSA will fund the continuation of 76 

grants, support for five contracts, and 51 new grants.

Offender Re-Entry Program

FY 2014 Request: $11.9 million

(Reflects $1.5 million decrease from FY 2012)

The Offender Reentry Program (ORP) grants provide screening, assessment and comprehensive 

treatment and recovery support services to offenders reentering the community, as well as 

offenders who are currently on or being released from probation or parole. SAMHSA and the 

DOJ/BJA share a mutual interest in supporting and shaping offender re-entry-treatment services, 

as both agencies fund “offender reentry” programs. Formal agreements have been developed to 

further encourage and engage in mutual interests and activities related to criminal justicetreatment issues. ORP grantees are expected to seek out and coordinate with local federallyfunded offender reentry initiatives, including the DOJ/BJA’s Prisoner Reentry Initiative or 

“Second Chance Act” offender re-entry programs, as appropriate. 

Funding for the ORP may be used for the following services/activities: screening, comprehensive 

individual assessment for substance use and/or co-occurring mental disorders, case management, 

program management and referrals related to substance abuse treatment for clients; alcohol and 

drug treatment; wraparound services supporting the access to and retention in substance abuse 

treatment or to address the treatment-specific needs of clients during or following a substance 

abuse treatment episode; individualized services planning; drug testing as required for 

supervision, treatment compliance, and therapeutic intervention; support in obtaining a GED 

and/or other necessary education; and relapse prevention and long-term management support.

Treatment Systems for Homeless Programs

FY 2014 Request: $41.6 million

(Reflects level funding from FY 2012)

SAMHSA’s Center for Substance Abuse Treatment (CSAT) manages two grant portfolios under 

its Grants for the Benefit of Homeless Individuals (GBHI) authority (Treatment for Homeless 

and Cooperative Agreements to Benefit Homeless Individuals (CABHI), that provide focused 

services to individuals with a substance use disorder or who have co-occurring substance use and 

mental disorders. These programs tie directly to the SAMHSA Recovery Support Strategic 

Initiative which focuses specifically on “home” as an integral component of one’s well-being.

The Treatment for Homeless-General grants, funded solely by CSAT, enable communities to 

expand and strengthen their substance abuse treatment services for individuals who are at risk for 

homelessness or have experienced homelessness (including chronic homelessness) who have 

substance use disorders or with co-occurring substance use and mental disorders, and move them 

to permanent supportive housing. In addition, CSAT provides funds for expanding and 
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strengthening substance abuse treatment services for homeless, alcohol-dependent people, 

individuals who have histories of public inebriation, frequent emergency room visits, arrests, 

mental illness, or co-occurring substance use and mental disorders. 

In FY 2008, CSAT also funded grants that address services in supportive housing (SSH). The 

Treatment for Homeless-SSH grants seek to expand and strengthen treatment services for people, 

individuals who experience chronic homelessness by providing linkages to appropriate treatment 

for substance use or other support services. This approach combines long-term, communitybased housing assistance and intensive individualized treatment and recovery support services to 

those experiencing chronic homelessness who have substance use disorders or co-occurring 

substance use and mental disorders. This is a cost-effective combination of affordable housing 

with substance abuse treatment services which helps people live more stable, productive lives 

and leads to reductions in substance use.

In FY 2011, CSAT in collaboration with CMHS awarded CABHI under the GBHI authority. 

The major goal of the program is to ensure that the most vulnerable individuals who experience 

chronic homelessness receive access to sustainable permanent housing, treatment, and recovery 

supports through grants funds and mainstream funding sources. This program builds on the 

success of the previous SAMHSA SSH and Treatment for Homeless programs. 

All programs funded under the GBHI authority (Treatment for Homeless (general and SSH) and 

CABHI) may purchase a number of services: outreach and direct treatment (including screening, 

assessment, and active treatment) for both mental and substance use disorders. Treatment must 

be provided in outpatient (including outreach-based services), day treatment or intensive 

outpatient, or short-term residential programs (90 days or less in duration and at a cost not to 

exceed 6.5 percent of total grant funds). Case management or other strategies to link with and 

retain clients in housing and other necessary services, including but not limited to primary care 

services, and to coordinate these services with other services provided to the client; engage and 

enroll individuals in Medicaid and other mainstream benefit programs (e.g., SSI/SSDI, TANF, 

SNAP, etc.); recovery support services designed to improve access to and retention in services 

and to continue treatment gains, which may include (as appropriate for each client) vocational, 

child care, educational and transportation services; independent living skills (e.g., budgeting and 

financial education); employment readiness, training, and placement; crisis care; medications 

management; self-help programs; discharge planning; psychosocial rehabilitation; and peer 

recovery support(s). 

Grantees may also provide the following allowable services: education, screening, and 

counseling for hepatitis and other sexually transmitted infections; active steps to reduce 

HIV/AIDS risk behaviors by their clients. Active steps include client screening and assessment, 

and either direct provision of appropriate services or referral to and close coordination with other 

providers of appropriate services; trauma-informed services, including assessment and 

interventions for emotional, sexual, and physical abuse; and use of an integrated 

primary/substance abuse/mental health care approach in developing the service delivery plan. 

This approach involves screening for health issues and delivery of client-centered substance 

abuse and mental health services in collaboration and consultation with medical care providers. 

In FY 2012, SAMHSA funded the continuation of 95 grants and supported four contracts. 
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In FY 2013, SAMHSA anticipates funding 71 grant continuations and support five contracts. In 

addition, CSAT in collaboration with CMHS, also anticipates funding 12 new Cooperative 

Agreements to Benefit Homeless Individuals for States (CABHI-States). CABHI-States builds 

on the CABHI program by adding a state infrastructure improvement approach addressing 

chronic homelessness to the community-based behavioral health service component for newly 

housed individuals who experience chronic homelessness with substance use disorders or cooccurring substance use and mental disorders. 

Minority AIDS Initiative

FY 2014 Request: $52.4 million

(Reflects $13.5 million decrease from FY 2012)

SAMHSA/CSAT’s Minority AIDS (MAI) grants are awarded to community-based organizations 

with two or more years of experience in the delivery of substance abuse treatment and related 

HIV/AIDS services. Funded programs target one or more of the following high-risk substance 

abusing populations: African American, Hispanic/Latino, and/or other racial/ethnic minority 

communities; women, including women with children; adolescents; men who inject drugs; 

minority men who have sex with men (MSM); and individuals who have been released from 

prisons and jails within the past two years. 

In addition to providing substance abuse treatment services, pre-treatment services are provided, 

including the provision of literature and other materials to support behavior change, facilitation 

of access to drug treatment, HIV/AIDS testing and counseling services, and other medical and 

social services in the local community. 

In FY 2011, SAMHSA/CSAT’s TCE/HIV program served approximately 6,200 individuals. Of 

these individuals, approximately 70 percent were between the ages of 25 and 54 years old.

Approximately 31 percent identified themselves as Hispanic/Latino in ethnicity; 46 percent as 

African-American; 22 percent White; one percent Asian, Native Hawaiian, or Pacific Islander; 

and 4 percent as American Indian/Alaska Native.

In FY 2011, SAMHSA awarded 11 Minority AIDS Initiative Targeted Capacity Expansion 

(MAI-TCE) Integrated Behavioral Health/Primary Care Network Cooperative Agreements. This 

program is jointly funded with CMHS and CSAP and facilitates the development and expansion 

of culturally-competent and effective integrated behavioral health and primary care networks--

which includes HIV services and medical treatment-- within racial and ethnic minority 

communities in the 11 Metropolitan Statistical Areas and Metropolitan Divisions most impacted 

by HIV/AIDS. Expected outcomes include reducing the impact of behavioral health problems, 

HIV risk and incidence, and HIV-related health disparities in these areas. SAMHSA continued 

to support these grants in 2012.

In FY 2012, SAMHSA funded the continuation of 75 grants and supported five contracts as well 

as a new cohort of 52 grants to target areas of highest need based on the most recently available 

HIV epidemiological data. 
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In FY 2013, SAMHSA anticipates funding 79 grant continuations and supporting four contracts 

and 38 new grants. The 38 grants will support Targeted Capacity Expansion: Substance Abuse 

Treatment for Racial/Ethnic Minority Women at High Risk for HIV/AIDS (TCE-HIV: Minority 

Women). The purpose of this program is to expand substance abuse treatment and HIV services 

for African American, Hispanic/Latina, and other racial/ethnic minority women (ages 18 years 

and older), including heterosexual, lesbian, bisexual, previously incarcerated women, and these 

women’s significant others, who have substance use or co-occurring substance use and mental 

disorders, and are living with or at risk for HIV/AIDS.

In FY 2014 SAMHSA will support the continuation of 87 grants and support 3 contracts. The 

proposed number of clients to be served with 2014 funds is 13,558. Outcomes including 

abstinence from substance use will also be tracked. By 2015, 62 percent of clients are expected 

to report being abstinent from substance use, 38 percent of clients are expected to report being 

employed or engaged in productive activities, 48 percent of clients are expected to report a 

permanent place to live in the community, and 96 percent of clients are expected to report having 

no involvement with the criminal justice system.

Other PRNS Treatment Programs

FY 2014 Request: $80.7 million

(Reflects $18.4 million decrease from 2012)

The FY 2013 Budget includes resources of $80.7 million for several other Treatment Capacity 

programs including: Strengthening Treatment Access and Retention; Children and Family 

Programs; Pregnant and Post-Partum Women (PPW); Recovery Community Services Program 

(RCSP); Special Initiatives/Outreach; Addiction Technology Transfer Centers; Opioid treatment 

Programs; and Targeted Capacity Expansion (TCE) General. The FY 2014 Budget includes 

funds for continuing grants and contracts in the various programs, and reflects discontinuation of 

one-time Congressional projects. Grant funding will be used to enhance overall drug treatment 

quality by incentivizing treatment and service providers to achieve specific performance targets. 

Examples of grant awards could include supplements for treatment and service providers who 

are able to connect higher proportions of detoxified patients with continuing recovery-oriented 

treatment; or for outpatient providers who are able to successfully retain greater proportions of 

patients in active treatment participation for longer time periods. 

In FY 2014, SAMHSA anticipates funding the continuation of 165 grants and 15 contracts as 

well as 60 new grants. 

Substance Abuse Block Grant

FY 2014 Request: $1.820 billion

(Reflects $19.5 million increase from 2012)

The Substance Abuse Prevention and Treatment Block Grant Program (SABG) distributes funds 

to 60 eligible states, territories, the District of Columbia, and the Red Lake Indian Tribe of 
241

Minnesota to plan, carry out, and evaluate substance abuse treatment and recovery support 

services provided for individuals, families, and communities impacted by substance abuse and 

substance use disorders (SUD). 

This formula grant program provides funding based upon specified economic and demographic 

factors and is administered by SAMHSA’s Center for Substance Abuse Treatment and Center for 

Substance Abuse Prevention. All Block Grant applications must include an annual plan that 

contains detailed provisions for complying with each funding agreement specified in the 

legislation, and describe how the applicant intends to expend the SABG. The law includes 

specific provisions and funding set-asides, such as a 20 percent prevention set-aside; an 

HIV/AIDS early intervention set-aside; requirements and potential penalty reduction of the 

Block Grant allotment with respect to sale of tobacco products to those under the age of 18; a 

maintenance of effort requirement; and “hold harmless” provisions that limit fluctuations in 

allotments as the total appropriation changes from year to year. 

The program’s overall goal is to support and expand substance abuse prevention and treatment 

services while providing maximum flexibility. States and territories may expend Block Grant 

funds only for the purpose of planning, carrying out, and evaluating activities related to these 

services. Targeted technical assistance is available for the states and territories through CSAT’s 

State Systems Technical Assistance Project. The SABG requires states to maintain expenditures 

for authorized activities at a level that is not less than the average level of such expenditures 

maintained by the state for the two year period preceding the year for which the state is applying 

for a grant. Given the current economic situation, a number of states experienced challenges 

meeting the maintenance of effort requirement in the federal FY 2012 grant cycle, and SAMHSA 

continues to monitor the situation closely. 

Of the amounts appropriated for the SABG program, 95 percent are distributed to states and 

other eligible applicants through a formula prescribed by the authorizing legislation. Factors 

used to calculate the allotments include total personal income, state population data by age 

groups (total population data for territories), total taxable resources, and a cost of services index 

factor. 

The SABG is critically important to the states because it provides them the flexibility to respond 

to local and/or regional emergent issues impacting health, public health, and public safety 

through a consistent federal funding stream. For example, this program provides approximately 

32 percent of total State Substance Abuse Agency funding, and 23 percent of total substance 

abuse prevention funding. Because SAMHSA encourages states to focus on these populations, 

individuals who are currently in need of such services may fall into several categories, such as 

having no insurance or limited health insurance coverage for substance use disorder treatment 

and recovery support services, or having been mandated to enter SUD treatment through public 

safety and/or public welfare systems. Individuals and families without health coverage or whose 

health insurance benefit will not cover certain services (e.g., recovery supports) rely on services 

funded by the SABG. States also rely on the SABG funding for an array of non-clinical 

activities and services which support critical needs of their respective service systems, such as 

planning, coordination, needs assessment, quality assurance, program development, and 

evaluation. 
242

In FY 2011, SAMHSA redesigned the FY 2012/2013 MHBG and SABG applications to better 

align with the current federal/state environments and related policy initiatives, including the 

Affordable Care Act, the Mental Health Parity and Addiction Equity Act (MHPAEA), and the 

Tribal Law and Order Act (TLOA). The new design offered states the opportunity to complete a 

combined application for mental health and substance abuse services, submit a bi-annual versus 

an annual plan, and provide information regarding their efforts to respond to various federal and 

state initiatives. Almost one-half of the states took advantage of this streamlined application and 

submitted combined plans for mental health and substance abuse services. Over 95 percent of 

the states provided specific information requested by SAMHSA regarding strategies to respond 

to a variety of areas including primary care and behavioral health integration, recovery support 

services, prevention of substance use, and promotion of emotional health. States continued to 

provide information regarding the spending of their Block Grant funds to support services 

identified in SAMHSA’s Good and Modern Service System brief.56

The FY 2014/2015 Block Grant application builds upon the FY 2012/2013 application and 

furthers SAMHSA’s efforts to have states use and report the opportunities offered under various 

federal initiatives. In addition, the FY 2014/2015 Block Gant continues to allow states to submit 

a combined application for mental health and substance abuse services as well as a bi-annual 

versus an annual plan. 

The independent evaluation of the SABG program57 demonstrated how states have leveraged the 

statutory requirements of this Block Grant to expand existing or establish new treatment capacity 

in underserved areas of states and territories and to improve coordination of services with other 

state systems. 

As noted below, the SABG Program has been successful in expanding treatment capacity in the 

latest year for which actual data are available in FY 201158 by supporting approximately two 

million59 admissions to treatment programs receiving public funding. Outcome data for the 

Block Grant program show positive results. In FY 2011, at discharge, clients have demonstrated 

high abstinence rates from both illegal drug (73.5 percent) and alcohol (81.7 percent) use. 

State Substance Abuse Authorities reported the following outcomes for services provided during 

FY 2010, the most recent year data is available:

For the 50 states60 and D.C that reported data in the Abstinence from Drug/Alcohol Use 

Domain for alcohol use, 51 of 51 identified improvements in client abstinence.

 

56

http://www.samhsa.gov/healthReform/docs/good_and_modern_4_18_2011_508.pdf

57 http://tie.samhsa.gov/SAPT2010.html#Evaluation

58 Source: 2013 SABG Report – Tables 16-21. While this is referenced as FY 2011, the actual time period varies by 

State, e.g; CY 2011 (imported TEDS data); SFY 2011 (manually entered by States); SFY 2012 (manually entered by 

States.

59Source: 2013 SABG Report – Table II

60Source: West Virginia numbers have been included in the text, but appear lower than expected.
243

Similarly, for the 50 states and D.C. that reported data in the Abstinence from 

Drug/Alcohol Use Domain for drug use, 50 of 51 identified improvements in client 

abstinence. 

For the 50 states and D.C. that reported data in the Employment Domain, 47 of 51 

identified improvements in client employment. 

For the 50 states and D.C. that reported in the Criminal Justice Domain, 46 of 51 reported 

an increase in clients with no arrests based on data reported to TEDS.

For the 49 states and D.C. that reported data in the Housing Domain, 42 of 49 identified 

improvements in stable housing for clients based on data reported to TEDS.

20 Percent Prevention Set-Aside

SAMHSA/CSAP is responsible for managing the 20 percent prevention set-aside of the 

Substance Abuse Prevention and Treatment Block Grant (SABG). This is one of SAMHSA’s 

main vehicles for supporting Strategic Initiative #1: Prevention of Substance Abuse and Mental 

Illness. States use these funds to develop infrastructure and capacity specific to substance abuse 

prevention. Some states rely solely on the 20 percent set-aside to fund their prevention systems 

while others use the funds to target gaps and enhance existing program efforts.

In an effort to streamline the application and reporting procedures for both the SABG and the 

Mental Health Block Grant programs, SAMHSA has developed a uniform application and 

reporting process to promote consistent planning, application, assurance, and reporting dates 

across both block grants. States are encouraged to make prevention a top priority, taking 

advantage of recent science, best practices in community coordination, proven planning 

processes, and the science articulated by the IOM report on Preventing Mental, Emotional, and 

Behavioral Disorders Among Young People61. SAMHSA will work with states to increase their 

accountability systems for prevention and to develop necessary reporting capacities. 

Synar

The Synar program is the set of actions put in place by states, with the support of the federal 

government, to implement the requirements of the Synar Amendment. The Amendment was 

developed in the context of a growing body of evidence about the health problems related to 

tobacco use by youth, as well as evidence about the ease with which youth could purchase 

tobacco products through retail sources. The Synar program is a critical component of the 

success of youth tobacco use prevention efforts. SAMHSA/CSAP is charged with overseeing 

states’ implementation of the Synar requirements and provides technical assistance to states on 

both the Synar requirements and youth tobacco access issues in general.

Since the inception of the Synar program in 1996, SAMHSA/CSAP has worked with states to 

assist them in complying with and attaining the goals of the Synar Amendment and has issued 

programmatic requirements and guidance documents to assist states in their efforts.

 

61 http://www.iom.edu/Reports/2009/Preventing-Mental-Emotional-and-Behavioral-Disorders-Among-YoungPeople-Progress-and-Possibilities.aspx
244

By regulation, states must achieve a retailer noncompliance rate of 20 percent or less. Since

FY 2006, all 50 states, Puerto Rico, and the District of Columbia have been in compliance with 

the Synar requirements. In FY 2011, the most recent year available, the national weighted 

average retailer violation rate was 8.5 percent.

Enrollment and Provider Business Practices (3 Percent Block Grant Set-Aside)

Through the Affordable Care Act, up to 62 million people will benefit from Federal parity 

protections under the ACA. Up to 11 million of these individuals are estimated to have 

substance abuse and/or mental health conditions. Persons with mental and substance use 

disorders are uninsured at higher rates than the general population. The Qualified Health Plans 

(QHPs) to be offered by the new insurance marketplaces are required to have sufficient mental 

health and substance providers to assure timely access to mental health and substance services.

However, many providers supported by SABG funds are not sufficiently prepared to be part of 

the network of providers under contract with QHPs, Medicaid and Medicare plans, and 

commercial insurance plans. It is critical for specialty behavioral health providers to be able to 

participate in integrated care models, utilize interoperable electronic health records (EHRs), and 

bill for and collect insurance resources for which persons they serve are eligible in order to 

maximize limited MHBG and SABG funds for those services and those persons not covered by 

public and commercial insurance plans.

After the full implementation of the Affordable Care Act, SAMHSA strongly recommends that 

MHBG and SABG funds be directed toward four purposes: (1) to fund priority treatment and 

support services for individuals without insurance or for whom coverage is terminated for short 

periods for time; (2) to fund priority treatment and support services not covered by Medicaid, 

Medicare, or private insurance for low income individuals and that demonstrate success in 

improving outcomes and/or supporting recovery; (3) to fund primary prevention: universal, 

selective, and indicated prevention activities and services for people, individuals not identified as 

needing treatment; and (4) to collect performance and outcome data to determine the ongoing 

effectiveness of behavioral health promotion, treatment, and recovery support services and to 

plan the implementation of new services on a nationwide basis. State authorities should make 

every effort to ensure that the right recipient is receiving the right payment for the right reason at 

the right time.

Therefore, in FY 2014, the President’s Budget includes a requirement that states set aside at least

three percent of their SABG allocation to support providers of mental health services in 

improving their enrollment, billing, and business practices, and to support enrollment into health 

insurance for eligible individuals served in the public mental health system. States that receive 

two percent or more of the total FY 2014 state allotment will be required to implement a 

competitive sub award process for their funds. Major needs identified by both mental health and 

substance abuse providers are education and technical support to improve business management, 

integrate with primary care and develop the capability needed to effectively deploy electronic 

health records to meaningful use standards, billing and scheduling systems that are aligned with 

those in the commercial insurance and primary care environment. Particular concern was raised 

related to the lack of provider experience, especially peer, recovery, and opioid treatment 
245

organizations, in negotiating contracts with and billing third party payers, ensuring compliance, 

revenue management, and accountability reporting. 

Business operations practices needed include: 

Outreach and enrollment support for individuals in need of behavioral health services 

who may be eligible for Medicare, Medicaid, private insurance offered through the State 

and Federally Facilitated Marketplaces;

Business plan redesign responsive to the changing market under the Affordable Care Act 

and MHPAEA, (e.g., development of a strategic plan that is responsive to the changing 

marketplace, identification of new markets, revision of data management systems, 

integration of recovery support and treatment service payment systems, negotiating 

agreements/partnerships with primary care organizations, [e.g., Federally Qualified 

Health Centers (FQHCs)] and other provider networks to develop business operations 

systems that ensure appropriate care management across the continuum of services, (e.g. 

preventive clinical services, treatment, referral and recovery support services);

Development, redesign and/or implementation of practice management and accounts 

receivable systems that address billings, collections, risk management and compliance;

Third-party contract negotiation; e.g., negotiating contracts for participation in a qualified 

health plan, or Medicaid managed care plan; 

Coordination of benefits among multiple funding sources, including insurance and SABG 

funding; and

Adoption of health information technology that meets meaningful use standards.

The Affordable Care Act has already enhanced opportunities for individuals with behavioral 

health conditions to have continuous access to insurance and a benefit package that includes 

mental health and substance abuse services, as well as preventive, medical, and other health 

services. A series of immediate private insurance market reforms help to give individuals the 

stability and flexibility they need to make informed choices about their health care. Under these

market reforms, individuals have a right to appeal health insurance plan decisions, including 

appeals to health plans when payment for a service or treatment is denied; helps children with 

pre-existing conditions gain and keep coverage, and will extend this protection to adults starting 

in 2014; allows individuals to continue to choose their primary care provider; keeps certain 

young adults covered up to age 26 on their parents’ health plans; ends lifetime limits on 

coverage; provides for review of unreasonable increases in insurance premiums; and requires 

insurance companies to spend at least 80% or 85% of premium dollars on medical car, helping to 

ensure that premium dollars be primarily spent on health care (including behavioral health care).

Use of SABG dollars for these purposes will help states assist their specialty provider 

infrastructure to be prepared for the shifting funding environment and maximize limited SABG 

dollars for those individuals, services and activities not otherwise funded through other sources.

Health Reform

As a result of the analysis and examination of the various components of the Affordable Care 

Act beginning in 2010, SAMHSA has undertaken a major redesign of the planning section of the 
246

application process for both the MHBG and SABG. SAMHSA is aligning the block grants to be 

critical components of the 2014 Affordable Care Act implementation in which state and federal 

responsibility is supporting behavioral health services and supports for those otherwise unable to 

receive services through Medicaid, Medicare, and/or private insurance plans offered through 

employers or through the new insurance marketplaces. Together, SAMHSA’s block grants 

support the provision of services and related supports to approximately eight million individuals 

with mental and substance use conditions. With an estimated 11.4 million adults having a severe 

mental illness62, 44.7 million adults having any mental illness63, and another 22.1 million adults 

with substance abuse disorder64, demand clearly outpaces the public behavioral health system’s 

established capacity. Many of these individuals and some of the services they need will continue 

to be without coverage through public or private insurance mechanisms. Aligning and 

coordinating the SAMHSA block grants with the 2014 Affordable Care Act implementation 

process begins assembling a cohesive national service system that is responsive to potential gaps 

in service delivery and effectively provides needed behavioral health serves across sectors and 

across payment sources.

States should determine if established systems and procedures are sufficient to ensure that Block 

Grant funds are expended in accordance with program requirements and directed to support and 

not supplant health reform activities. In the Uniform Block Grant Application for FY 

2014/2015, SAMHSA has strongly recommended that states use these resources to support and 

not supplant services that will be covered through commercial and public insurer plans. States 

will be asked to develop metrics or targets for their systems to measure increases in the number 

of individuals who become enrolled or providers that join commercial or publicly funded 

provider networks. The primary goals of SAMHSA’s program integrity efforts are to continue to 

(1) promote the proper expenditure of block grant funds, (2) improve block grant program 

compliance nationally, and (3) demonstrate the effective use of block grant funds. 

SAMHSA will provide additional guidance to the states to assist them in complying with this 

continuing emphasis on program integrity, will develop new and better tools for reviewing block 

grant application and reports, and will train SAMHSA staff in these program integrity 

approaches and tools. SAMHSA will be working with states to develop changes to information 

systems and compliance review processes to assure increasing program integrity. This may 

include working closely with Medicaid and Health Insurance Exchanges to obtain information to 

determine if individuals and providers in their systems are enrolled. This may also include 

strategies to assist their providers to develop the necessary infrastructures to operate in 

commercial and public insurer networks (Medicaid and Medicare). The Uniform Application 

along with the new set asides along with evolution of SAMHSA’s block grant reporting system 

are all tools to assist in this process.

 

62 http://www.samhsa.gov/data/NSDUH/2k10MH_Findings/2k10MHResults.htm

63http://www.samhsa.gov/data/2k12/NSDUH110/sr110-adult-mental-illness.htm

64 http://www.samhsa.gov/data/NSDUH/2k10ResultsRev/NSDUHresultsRev2010.htm#Ch7
247

Health Surveillance and Program Support

The FY 2014 Request is $158.4 million, which represents the Substance Abuse portion of the 

HSPS appropriation and supports staffing and activities to administer SAMHSA programs. This 

includes:

Health Surveillance and Program Support

FY 2014 Request: $115.3 million

(Reflects $1.4 million decrease from 2012)

Health Surveillance and Program Support provides funding for personnel costs, building and 

facilities, equipment, supplies, administrative costs and associated overhead to support 

SAMHSA programmatic activities as well as providing funding for SAMHSA national data 

collection and survey systems, funding to support the CDC NHIS Survey, and the data archive. 

This represents the total funding available for these activities first split between mental health 

and substance abuse (as determined by each activity), then, of the amount for substance abuse is 

split 80/20 between Treatment and Prevention.

Public Awareness and Support 

FY 2014 Request: $6.8 million

(Reflects $0.01 million increase from 2012)

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 split 50/50 between mental health 

and substance abuse, then, of the amount for substance abuse is split 80/20 between Treatment 

and Prevention.

Performance and Quality Information Systems

FY 2014 Request: $9.1 million

(Reflects $0.04 million increase from 2012)

Performance and Quality Information Systems provides funding to support the Consolidated 

Data Platform as well as the transition from legacy systems. This represents the total funding 

available for these activities first split 30/70 between mental health and substance abuse, then, of 

the amount for substance abuse is split 80/20 between Treatment and Prevention.

Agency-Wide Initiatives

FY 2014 Request: $27.2 million

(Reflects $22.6 million increase from 2012)

Agency-Wide Initiatives provides funding for across Agency initiatives such as Minority 

Fellowship Program which improves the quality of mental health and substance abuse prevention 

and treatment delivered to ethnic minorities by providing stipends to post-graduate students and 

other Behavioral Health Workforce programs. This represents the total funding available for 
248

these activities first split 50/50 between mental health and substance abuse, then, of the amount 

for substance abuse is split 80/20 between Treatment and Prevention.
249

SAMHSA

Prevention and Public Health Fund

Table of Contents

SAMHSA/Prevention and Public Health Fund Page

1. Summary of Programs .....................................................................................................251

2. Screening, Brief Intervention, and Referral to Treatment..................................................253

3. Primary & Behavioral Health Care Integration.................................................................257
250

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251

SAMHSA

Prevention and Public Health Fund

Summary of Programs

(Dollars in Thousands)

FY 2012 FY 2013 FY 2014 FY 2014

Prevention and Public Health Fund Actual

Annualized 

CR1/ 

President's 

Budget

 +/- 

FY 2012 

Screening, Brief Intervention, & Referral to 

Treatment.......................................................... $25,000 N/A $30,000 +$5,000

Garrett Lee Smith Youth Suicide Prevention....... 10,000 N/A --- -10,000

Primary and Behavioral Health Care Integration.. 35,000 N/A 28,000 -7,000

Health Surveillance............................................. 18,000 N/A --- -18,000

Prescription Drug Monitoring Program .............. 4,000 N/A --- -4,000

Total, Prevention and Public Health Fund $92,000 N/A $58,000 -$34,000

1 / The FY 2013 Prevention Fund resources are reflected in the Office of the Secretary.

The FY 2014 Budget Request for the Prevention Fund is $58.0 million, a decrease of $34.0

million from the FY 2012 funding level. The FY 2014 request includes the following: $30.0 

million for Screening, Brief Intervention, and Referral to Treatment and $28.0 million for 

Primary and Behavioral Health Care Integration. The funding for these programs is requested 

entirely from the Prevention Fund.
252

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253

Screening, Brief Intervention, and Referral to Treatment

(Dollars in thousands)

FY 2012 FY 2013 FY 2014 FY 2014

Actual

Annualized 

CR1/ 

President's 

Budget

 +/- 

FY 2012 

Program Level................................................... $53,187 $28,360 $30,000 -$23,187

PHS Evaluation Funds (non-add).................. 2,000 2,012 --- -2,000

Prevention & Public Health Fund (non-add). $25,000 N/A $30,000 +$5,000

1 / The FY 2013 Prevention Fund resources are reflected in the Office of the Secretary.

Authorizing Legislation................................................................... Section 520A of the PHS Act 

and Section 4002 of the Patient and Protection and Affordable Care Act

FY 2014 Authorization..................................................................................................... Expired

Allocation Method ................................................................... Competitive Grants and Contracts

Program Description and Accomplishments

Screening, Brief Intervention, and Referral to Treatment (SBIRT) was initiated by 

SAMHSA/CSAT in FY 2003, using cooperative agreements to expand and enhance a state or 

tribal organization’s continuum of care. The purpose of the program is to integrate screening, 

brief intervention, referral, and treatment services within general medical and primary care 

settings. 

The SBIRT program requires grant recipients to effect practice change throughout the spectrum 

of medical practice. This is achieved through implementation in all levels of primary care, 

including hospitals, trauma centers, health clinics, nursing homes, employee assistance 

programs, and school systems. Practice change also alters the educational structure of medical 

schools by developing and implementing SBIRT curricula as standard and permanent practice. 

Research and clinical experience supports the use of the SBIRT approach to provide effective 

early identification and interventions in primary care and general medical settings. Early 

identification can decrease total healthcare costs by arresting progression toward addiction. 

SBIRT also can identify persons with more serious problems and encourage them to obtain 

appropriate specialty treatment services. Funds may be used for the following services: 

pre/screening for substance use and co-occurring disorders; brief Interventions designed with 

client centered, non-judgmental, motivational interviewing techniques; brief treatment including 

the monitoring of individuals who misuse alcohol and other drugs but are not yet dependent; 

referral to treatment (when indicated) for those who have a substance use disorder; and when 

appropriate, referral to and expansion of specialty treatment services. Since the beginning of this 

program, more than 1.7 million individuals have been screened. Of those, 19 percent required a 

brief intervention, brief treatment, or referral to specialty treatment programs. 
254

In FY 2010, SAMHSA/CSAT supported continuation of eight SBIRT state grants and 17 

medical residency SBIRT training grants. In 2011, over 213,000 clients were served by the 

SBIRT Program. The percentage of clients reporting abstinence at follow-up tripled compared to 

the percentage reporting abstinence at baseline. 

SBIRT has great future potential for promoting changes to the entire primary care medical 

service delivery system. Efforts are underway to identify other funding streams to help take this 

practice to scale. For example, new diagnostic codes have been adopted by 16 states, making it 

easier for doctors to get reimbursed for screening Medicaid patients. Likewise, alcohol 

screening is now available to Medicare beneficiaries as a preventive service without cost. In 

FY 2012, SAMHSA funded the continuation of 27 SBIRT grants supported five contracts and as 

well as three new multi-year grants funded out of the Prevention Fund, and continued to monitor 

the progress of the three FY 2011 multi-year Prevention Fund grants. In FY 2013, SAMHSA 

anticipates funding up to 19 new grants as well as 12 grant continuations and supporting three 

contracts.

Budget Request

In FY 2014, SAMHSA requests $30.0 million from the Prevention Fund for the SBIRT program 

(an increase of $5 million from FY 2012). This level funding will further support the integration 

and use of the SBIRT model into states and tribal primary care settings. In FY 2014, an 

estimated 141,435 individuals will be served by the program. The request will support 41 grants 

(25 continuations and 16 new) and one contract. Grant funds will further integrate SBIRT within 

medical treatment settings to provide early identification and intervention to at-risk individuals 

within the context of their primary care provider. 
255

Outcomes and Outputs

Program: Screening, Brief Intervention and Referral to Treatment

NOTE: SAMHSA grant awards are made late in the year. FY 2012 funding is reflected in FY 2013 performance 

targets, FY 2014 funding is associated with FY 2015 targets.

Measure

Year and Most 

Recent Result /

Target for Recent 

Result /

(Summary of 

Result)

FY 2013 

Target

FY 2015

Target

FY 2015 

Target 

+/-

FY 2013 

Target 

1.2.40 Number of clients served (Output) FY 2012: 142,016

Target:

139,650

(Target Exceeded)

139,650 75,015 -64,635

1.2.41 Percentage of clients receiving services 

who had no past month substance use (Outcome)

FY 2012: 42.1%

Target:

36%

(Target Exceeded)

36% 36% Maintain
256

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257

Primary & Behavioral Health Care Integration

(Dollars in thousands)

Authorizing Legislation..................................................Sections 520A and 520K of the PHS Act 

and Section 4002 of the Patient and Protection and Affordable Care Act

FY 2014 Authorization.......................................................................... Such Sums As Necessary

Allocation Method ......................................................................................... Competitive Grants

Program Description and Accomplishments 

SAMHSA provided funding for the Primary & Behavioral Health Care Integration (PBHCI) 

program beginning in FY 2009 to address the increased rates of morbidity and mortality among 

adults with serious mental illness (SMI). These rates are due, in large part, to elevated incidence 

and prevalence of cardiovascular disease, obesity, diabetes, hypertension, and dyslipidemia. 

Increased morbidity and mortality can be attributed to a number of other issues, too, including 

inadequate physical activity and poor nutrition, smoking, side effects from atypical antipsychotic 

medications, and lack of access to primary health care services. Many of these health conditions 

are preventable through routine health promotion activities, primary care screening, monitoring, 

treatment, and care management/coordination strategies and/or other outreach programs at home 

or community sites. Physical health problems among people with SMI impact quality of life and 

contribute to premature death. While several factors contribute to this disparity, empirical 

findings indicate that early mortality among people with SMI is clearly linked to the lack of 

access to primary care services.

The PBHCI program is comprised of competitive cooperative agreements and the PBHCI 

Training and Technical Assistance (TTA) Center which is co-funded with HRSA. The program 

supports the coordination and integration of primary care services into publicly-funded 

community behavioral health settings. This program is also a part of SAMHSA’s Health Reform 

Strategic Initiative. The expected outcome of improved health status for people with SMI will be 

achieved by encouraging grantees to engage in necessary partnerships, expand infrastructure, and 

increase the availability of primary health care and wellness services to individuals with mental

illness. Partnerships between primary care and behavioral health organizations, as well as 

information technology entities, are deemed crucial to the success of this program. The 

population of focus for this grant program is individuals with SMI and/or persons with coFY 2012 FY 2013 FY 2014 FY 2014

Actual

Annualized 

CR1/ 

President's 

Budget

 +/- 

FY 2012 

Program Level................................................... $67,745 $32,945 $28,000 -$39,745

Prevention & Public Health Fund (non-add). $35,000 N/A $28,000 -$7,000

1 / The FY 2013 Prevention Fund resources are reflected in the Office of the Secretary.
258

occurring disorders served by the public mental health system. Recipients are non-profit mental 

health provider agencies that will use these grant funds to develop and offer primary care as well 

as behavioral health services in an integrated manner.

In FY 2011, $35.0 million was allocated from the Prevention Fund for PBHCI to promote more 

integrated services between primary care services and mental health services. These funds were 

used to facilitate screening and referral for necessary primary care prevention and treatment 

needs. SAMHSA funded eight new PBHCI grants and 34 continuation grants with Prevention 

Funds and 22 grant and 1 contract continuations with Budget Authority. 

In FY 2012, SAMHSA supported 56 existing grants and multi-year funded 20 new grants and 10 

annually funded grants awarded from both SAMHSA Budget Authority and Prevention Funds 

($30.5M - BA and $35M - PPHF) as well as $1.9 million for the PBHCI Training and Technical 

Assistance (TTA) Center. SAMHSA plans to continue the program in FY 2013. SAMHSA has 

awarded 94 PBHCI grants to date.

Since the program is new evaluation results are not yet complete. Over 23,000 consumers were 

served in FY 2012, an increase of 94.4 percent over FY 2011. Improvements in all four National 

Outcome Measures were consistently positive as a result of this intervention, with individual 

measure ratings improving an average of 13 percent. Of particular importance were the 

increases in measures of functioning and education/employment, demonstrating that the program 

supports health and productivity. 

 

Budget Request

The Primary and Behavoiral Health Care Integration program request is $28.0 million from the 

Prevention Fund, which is a decrease of $7.0 million from the FY 2012 Prevention Fund level.

This level of funding will support 22 continuation grants, 10 new grants as well as continue 

support for the Training and Technical Assistance Center and will support the coordination and 

integration of primary care services into publically funded behavioral health settings for adults 

with serious mental illnesses.
259

Outcomes and Outputs

Program: Mental Health - Other Capacity Activities65

NOTE: SAMHSA grant awards are made late in the year. FY 2012 funding is reflected in FY 2013 performance targets, FY 2014 

funding is associated with FY 2015 targets.

Measure

Year and Most 

Recent Result /

Target for 

Recent Result /

(Summary of 

Result)

FY 2013

Target

FY 2015

Target

FY 2015

Target

+/-

FY 2013 

Target

1.2.05 Percentage of clients receiving services who 

report positive functioning at 6 month follow-up

(Outcome)

FY 2012: 53.4%

Target:

54%

(Target Not Met

but Improved)

54% 54% Maintain

1.2.82 Percentage of clients receiving services who 

had a permanent place to live in the community at 6 

month follow-up (Outcome)

FY 2012: 67.5%

Target:

67.7%

(Target Not Met)

67.7% 67.7% Maintain

1.2.83 Percentage of clients receiving services who 

are currently employed at 6 month follow-up 

(Outcome)

FY 2012: 24.3%

Target:

14%

(Target Exceeded)

14% 14% Maintain

1.2.88 Number of individuals screened for mental 

health or related interventions (Outcome)

FY 2012: 58,782

Target:

32,763

(Target Exceeded)

32,763 61,574 +28,811

 

65 Includes the following programs: Jail Diversion, Older Adults, HIV/AIDS, Primary and Behavioral Health Care Integration, and Healthy 

Transitions.
260

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261

SAMHSA

Supplementary Tables

Table of Contents

SAMHSA/Supplementary Tables

1. Budget Authority by Object Class................................................................................263

2. Salaries and Expenses..................................................................................................267

3. Detail of Full Time Equilvalent Employee (FTE).........................................................268

4. Detail of Positions .......................................................................................................268

5. Programs Proposed For Elimination ............................................................................270

6. Federal Employment Funded by the Patient Protection and Affordable Care Act .........271

7. FY 2014 Budget by Strategic Goal ..............................................................................272

8. Physicians’ Comparability Allowance (PCA) Worksheet.............................................273

9. PRNS Mechanism Tables by SLOA ............................................................................274
262

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263

Object Classification Table – Mental Health

(Dollars in Thousands)

Object Class-Budget Authority 

FY 2012 

Actual *

FY 2013 

Annualized 

CR

FY 2014 

President's 

Budget *

FY 2014 +/- 

FY 2012

Direct Obligations:

Personnel Compensation:

 Full Time Permanent (11.1)............................................... $439 $819 $832 +$393

 Other than Full-Time Permanent (11.3).............................. 108 158 161 +53

 Other Personnel Compensation (11.5)................................ 152 3 3 -149

 Military Personnel Compensation (11.7)............................. 43 --- --- -43

 Special personal services payments (11.8).......................... 2 --- --- -2

Subtotal Personnel Compensation: 744 981 995 +251

 Civilian Personnel Benefits (12.1)...................................... 150 454 461 +311

 Military Personnel Benefits (12.2) ................................... 12 --- --- -12

 Benefits for Former Personnel (13.1)................................. --- --- --- ---

Subtotal Pay Costs: ......................................................... 906 1,435 1,456 +550

Travel (21.0)....................................................................... 49 44 45 -4

Transportation of Things (22.0)............................................ 43 --- 33 -10

Rental Payments to GSA (23.1)........................................... --- --- --- ---

Rental Payments to Others (23.2)......................................... --- --- --- ---

Communications, Utilities and Misc. Charges (23.3)................................................. 6 5 6 -

Printing and Reproduction (24.0).......................................................................................... 190 171 174 -16

Other Contractual Services:

 Advisory and Assistance Services (25.1)..................................................................... 7,077 16,291 16,500 +9,423

 Other Services (25.2)..................................................................................................... 44,681 51,650 52,975 +8,294

 Other Purchases of Goods & Svc from Govt Accts (25.3).................................. 33,491 17,898 17,047 -16,444

 Operation & Maintenance of Facilities (25.4).............................................................. 647 850 868 +221

 Medical Care (25.6) --- --- --- ---

 Operation and Maintenance of Equipment (25.7) --- 29 30 ---

 Transfers (25.9)........................................................ --- 200 200 +200

 Subtotal Other Contractual Services:...................................................................... 85,896 86,918 87,620 +1,694

Supplies and Materials (26.0)................................................................................................................ 81 73 74 -7

Equipment (31.0) --- --- --- ---

Grants, Subsidies, and Contributions (41.0).......................................................................... 885,529 845,000 928,900 +43,371

Insurance Claims & Indemnities (42.0)...................................................................................... 31 30 33 +2

Interest & Dividends (43.0) --- --- --- ---

Subtotal Non-Pay Costs.................................................................. 971,825 932,241 1,016,884 +45,059

Total Budget Authority............................................................................................................... $972,731 $933,676 $1,018,341 +$45,610

* Includes $45 million in Prevention and Public Health Funding for FY 2012 Enacted and $28 million in FY 2014 President's Budget. The FY 2013 Prevention 

Fund resources are reflected in the Office of the Secretary.
264

Object Classification Table – Substance Abuse Prevention

(Dollars in Thousands)

Object Class-Budget Authority 

FY 2012 

Actual

FY 2013 

Annualized 

CR

FY 2014 

President's 

Budget *

FY 2014 +/- 

FY 2012

Direct Obligations:

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 personal services payments (11.8)........................................................................................ --- --- --- ---

Subtotal Personnel Compensation: ................................................................................. --- --- --- ---

 Civilian Personnel Benefits (12.1)........................................................................................................ --- --- --- ---

 Military Personnel Benefits (12.2) ................................................................................................... --- --- --- ---

 Benefits for Former Personnel (13.1)............................................................................................... --- --- --- ---

Subtotal Pay Costs: ............................................................................................................................ --- --- --- ---

Travel (21.0)....................................................................... --- --- --- ---

Transportation of Things (22.0)................................................................................................................ --- --- --- ---

Rental Payments to GSA (23.1)............................................................................................................. --- --- --- ---

Rental Payments to Others (23.2).......................................................................................................... --- --- --- ---

Communications, Utilities and Misc. Charges (23.3)................................................................... --- --- --- ---

Printing and Reproduction (24.0).......................................................................................................... 264 223 227 -37

Other Contractual Services:

 Advisory and Assistance Services (25.1)................................................................................................ 3,794 3,501 2,980 -814

 Other Services (25.2)................................................................................................................................ 39,703 38,118 34,119 -5,584

 Other Purchases of Goods & Svc from Govt Accts (25.3)......................................................................... 3,747 3,000 3,000 -747

 Operation & Maintenance of Facilities (25.4) .................................................................................... --- 64 64 ---

 Medical Care (25.6)........................................................................................................................................... --- --- --- ---

 Operation and Maintenance of Equipment (25.7) ........................................................................... --- 170 170 ---

 Transfers (25.9).............................................

 Subtotal Other Contractual Services:....................................................................................... 47,244 44,853 40,333 -7,145

Supplies and Materials (26.0) --- --- --- ---

Equipment (31.0)................................................................. --- --- --- ---

Grants, Subsidies, and Contributions (41.0)..................................................................................... 138,377 142,000 135,000 -3,377

Insurance Claims & Indemnities (42.0)................................................................................................ --- --- --- ---

Interest & Dividends (43.0).............................................................................................................................. --- --- --- ---

Subtotal Non-Pay Costs.......................................................................................................... 185,885 187,076 175,561 -10,558

Total Budget Authority............................................................................................................... $185,885 $187,076 $175,561 -$10,324
265

Object Classification Table – Substance Abuse Treatment

(Dollars in Thousands)

Object Class-Budget Authority 

FY 2012 

Actual *

FY 2013 

Annualized 

CR

FY 2014 

President's 

Budget *

FY 2014 +/- 

FY 2012

Direct Obligations:

Personnel Compensation:

 Full Time Permanent (11.1)................................................................................... $4,720 $4,064 $4,125 - 595

 Other than Full-Time Permanent (11.3)................................................................... 290 194 196 - 94

 Other Personnel Compensation (11.5)...................................................................... 366 34 34 - 332

 Military Personnel Compensation (11.7)...................................................................... 341 52 52 - 289

 Special personal services payments (11.8)........................................................... 5 --- --- - 5

Subtotal Personnel Compensation: ................................................................. 5,722 4,343 4,408 - 1,314

 Civilian Personnel Benefits (12.1)............................................................................... 1,364 1,210 1,228 - 136

 Military Personnel Benefits (12.2) ..................................................................... 182 30 30 - 152

 Benefits for Former Personnel (13.1)......................................................................... --- --- --- ---

Subtotal Pay Costs: ........................................................................................................... 7,268 5,583 5,666 - 1,602

Travel (21.0)............................................................................................................................... 46 41 42 - 4

Transportation of Things (22.0)...................................................................................... --- --- --- ---

Rental Payments to GSA (23.1)............................................................................................ --- --- --- ---

Rental Payments to Others (23.2).................................................................................... --- --- --- ---

Communications, Utilities and Misc. Charges (23.3)....................................... 145 131 133 - 12

Printing and Reproduction (24.0)................................................................................ 511 460 469 - 42

Other Contractual Services:

 Advisory and Assistance Services (25.1)............................................................ 18,668 35,341 30,000 + 11,332

 Other Services (25.2) .................................................................................................... 65,862 57,500 55,266 - 10,596

 Purchases from Government Accounts (25.3)............................................................ 7,093 15,453 7,346 + 253

 Operation & Maintenance of Facilities (25.4)...................................................... 331 298 304 - 27

 Medical Care (25.6)........................................................................................................ --- --- --- ---

 Operation and Maintenance of Equipment (25.7)............................................................... 340 --- --- - 340

 Transfers (25.9)........................................................ --- --- --- ---

 Subtotal Other Contractual Services:.......................................................................... 92,294 108,592 92,916 + 622

Supplies and Materials (26.0)........................................................................................... 95 86 87 - 8

Equipment (31.0).................................................................................................................................... 13 12 12 - 1

Grants, Subsidies, and Contributions (41.0)...................................................................................... 2,047,457 2,017,500 1,983,600 - 63,857

Insurance Claims & Indemnities (42.0)....................................................................................... --- --- --- ---

Interest & Dividends (43.0)............................................................................................................ --- --- --- ---

Subtotal Non-Pay Costs.............................................................................................. 2,140,561 2,126,821 2,077,259 - 63,302

Total Budget Authority............................................................................................................... $2,147,829 $2,132,404 $2,082,926 - 64,903

* Includes $29 million in Prevention and Public Health Funding for FY 2012 Enacted and $30 million for FY14 President's Budget. The FY 2013 Prevention Fund 

resources are reflected in the Office of the Secretary.
266

Object Classification Table – Health Surveillance and Program Support

(Dollars in Thousands)

Object Class-Budget Authority 

FY 2012 

Actual *

FY 2013 

Annualized 

CR

FY 2014 

President's 

Budget

FY 2014 +/- 

FY 2012

Direct Obligations:

Personnel Compensation: 

 Full Time Permanent (11.1)....................................................................................... $42,694 $46,014 $48,047 + $5,353

 Other than Full-Time Permanent (11.3).................................................................. 2,645 2,843 2,969 + 324

 Other Personnel Compensation (11.5)................................................................ 3,360 923 964 - 2,396

 Military Personnel Compensation (11.7)............................................................... 2,985 3,373 3,522 + 537

 Special personal services payments (11.8)..................................................... 42 76 79 + 37

Subtotal Personnel Compensation: ................................................................. 51,726 53,229 55,581 + 3,855

 Civilian Personnel Benefits (12.1) ............................................................................. 12,325 13,243 13,828 + 1,503

 Military Personnel Benefits (12.2) .................................................................... 1,577 1,740 1,817 + 240

 Benefits for Former Personnel (13.1) --- --- --- ---

Subtotal Pay Costs: .................................................................................................... 65,628 68,212 71,226 + 5,598

Travel (21.0)......................................................................................................................... 1,050 945 964 - 86

Transportation of Things (22.0)..................................................................................... 44 5 7 - 37

Rental Payments to GSA (23.1)..................................................................................... 5,687 6,918 6,964 + 1,277

Rental Payments to Others (23.2)..................................................................................... --- --- --- ---

Communications, Utilities and Misc. Charges (23.3).................................... 2 --- --- - 2

Printing and Reproduction (24.0)................................................................................. 328 295 301 - 27

Other Contractual Services:

 Advisory and Assistance Services (25.1).......................................................... 225 --- --- - 225

 Other Services (25.2, 25.9)............................................................................................... 11,338 25,412 24,094 + 12,756

 Other Purchases of Goods & Svc from Govt Accts (25.3)................... 40,018 5,100 4,255 - 35,763

 Operation & Maintenance of Facilities (25.4)........................................................ 1,587 1,619 1,651 + 64

 Medical Care (25.6)......................................................................................................... --- --- --- ---

 Operation and Maintenance of Equipment (25.7)................................................... 63 64 66 + 3

 Transfers (25.9)........................................................ --- --- --- ---

 Subtotal Other Contractual Services:........................................................................... 53,231 32,195 30,066 - 23,165

Supplies and Materials (26.0)..................................................................................... 330 337 343 + 13

Equipment (31.0)....................................................................................................................... 35 36 36 + 1

Grants, Subsidies, and Contributions (41.0)................................................................... 4,590 4,682 17,500 + 12,910

Insurance Claims & Indemnities (42.0).................................................................... 1,650 1,683 1,717 ---

Interest & Dividends (43.0).................................................................................................... --- --- --- ---

Subtotal Non-Pay Costs.............................................................................................. 66,947 47,095 57,898 - 9,049

Total Budget Authority............................................................................................................... $132,575 $115,307 $129,124 - $3,451

* Includes $18 million in Prevention and Public Health Funding for FY 2012. The FY 2013 Prevention Fund resources are reflected in the Office of the Secretary.
267

Salaries and Expenses Tables

(Dollars in thousands)

Direct BA Salaries and Expenses

FY 2012 

Actual *

FY 2013 

Annualized 

CR

FY 2014 

President's 

Budget

FY 2014 +/- 

FY 2012

Personnel Compensation:

Full Time Permanent (11.1)................................................... $47,853 $50,898 $53,004 +$5,151

Other than Full-Time Permanent (11.3).................................. 3,043 3,195 3,326 +283

Other Personnel Compensation (11.5).................................... 3,878 960 1,001 -2,877

Military Personnel Comprensation (11.7)................................ 3,369 3,424 3,574 +205

Special personal services payments (11.8).............................. 49 76 79 +30

Subtotal Personnel Compensation: 58,192 58,553 60,985 +2,793

Civilian Personnel Benefits (12.1).......................................... 13,839 14,907 15,517 +1,678

Military Personnel Benefits (12.2)......................................... 1,771 1,770 1,847 +76

Subtotal Pay Costs: 73,802 75,230 78,349 +4,547

Travel (21.0)........................................................................... 1,145 1,031 1,051 -94

Transportation of Things (22.0)................................................ 87 5 40 -47

Rental Payments to Others (23.2)............................................. --- --- --- ---

Communications, Utilities and Misc. Charges (23.3)................... 153 136 139 -14

Printing and Reproduction (24.0).............................................. 1,293 1,149 1,172 -121

Other Contractual Services:

Advisory and Assistance Services (25.1)............................... 29,764 55,133 49,480 +19,716

Other Services (25.2)........................................................... 161,584 172,680 166,454 +4,870

Other Purchases of Goods & Svc from Govt Accts (25.3)...... 84,349 41,451 31,648 -52,701

Operation & Maintenance of Facilities (25.4)......................... 2,565 2,831 2,887 +322

Operation and Maintenance of Equipment (25.7).................... 403 263 266 -137

 Transfers (25.9)........................................................ --- 200 200 +200

 Subtotal Other Contractual Services:............................... 278,665 272,358 250,735 -27,931

Supplies and Materials (26.0)................................................... 506 495 505 -1

Subtotal Non-Pay Costs........................................................ 355,651 350,403 331,990 -23,661

Total, Salaries and Expenses............................................... $429,453 $425,633 $410,338 -19,114

Rental Payments to GSA (23.1)............................................ 5,687 6,918 6,964 +1,277

Grand Total, Salaries, Expenses, and Rent......................... $435,140 $432,551 $417,302 -17,837

Total FTE............................................................................. 590 631 655 +65

1) FTE Forecast inclusive of Direct BA & Reimbursable Requirements
268

Substance Abuse and Mental Health Services Administration 

Detail of Full Time Equivalent (FTE)

Appropriation

2012 Act. 

Civilian

2012 Act. 

Military

2012 Act. 

Total

2013 Est. 

Civilian

2013 Est. 

Military

2013 Est. 

Total

2014 Est. 

Civilian

2014 Est. 

Military

2014 Est. 

Total

Health Surveillance & Program Support

Direct:........................... 456 32 488 471 29 500 472 29 501

Reimbursable:................ 21 8 29 21 2 23 40 2 42

Total: ......................... 477 40 517 492 31 523 512 31 543

Mental Health

Direct:........................... 6 3 9 6 3 9 10 3 13

Reimbursable:................ 17 3 20 20 3 23 20 3 23

Total: ......................... 23 6 29 26 6 32 30 6 36

Substance Abuse Prevention

Direct:........................... --- --- --- --- --- --- --- --- ---

Reimbursable:................ 8 4 12 16 4 20 16 4 20

Total: ......................... 8 4 12 16 4 20 16 4 20

Substance Abuse Treatment

Direct:........................... 28 3 31 38 9 47 38 9 47

Reimbursable:................ 1 --- 1 9 --- 9 9 --- 9

Total: ......................... 29 3 32 47 9 56 47 9 56

Total Direct.................... 490 38 528 515 41 556 520 41 561

Total Reimbursable....... 47 15 62 66 9 75 85 9 94

SAMHSA FTE Total..... 537 53 590 581 50 631 605 50 655
269

Substance Abuse and Mental Health Services Administration

Detail of Positions

 FY 2012 FY 2013 FY 2014

Actual Annualized CR President's Budget

Executive Level IV 1 1 1

Subtotal 1 1 1

Total - Exec Level Salaries $146,091 $146,091 $146,091

SES 13 13 13

Subtotal 13 13 13

Total, SES salaries $1,978,517 $1,998,302 $2,028,277

GM/GS-15/EE 80 80 80

GM/GS-14 138 145 145

GM/GS-13 149 159 163

GS-12 51 55 61

GS-11 31 32 35

GS-10 7 10 10

GS-09 14 16 25

GS-08 19 20 22

GS-07 19 23 23

GS-06 15 15 15

GS-05 3 9 9

GS-04 1 2 2

GS-03 0 1 1

GS-02 0 1 1

Subtotal 527 568 592

Total, GS salaries $65,166,811 $69,731,395 $70,899,551

CC-08/09 0 1 1

CC-07 1 0 0

CC-06 9 11 11

CC-05 14 16 16

CC-04 14 13 13

CC-03 11 9 9

CC-02 1 0 0

Subtotal 50 50 50

Total, CC salaries $5,032,339 $5,193,899 $5,420,999

Total Positions 590 631 655

Average ES level ES ES ES

Average ES salary $146,091 $146,091 $146,091

Average SES level SES SES SES

Average SES salary $152,194 $153,716 $156,021

Average GS grade 13.3 13.7 13.7

Average GS salary $123,656 $122,767 $119,763

Average CC level 4.5 4.6 4.6

Average CC salaries $100,647 $103,878 $108,420
270

Programs Proposed For Elimination

There are no programs proposed for elimination or consolidation.
271

Federal Employment Funded by the Patient Protection and Affordable Care Act

P.L. 111-148

Substance Abuse Mental Health Services Administration

(Dollars in thousands)

Program Section(s) $ FTEs CEs $ FTEs CEs $ FTEs CEs $ FTEs CEs

New programs authorized and 

funded by PPACA 0 0 0 0 0 0 0 0 0 0 0 0 0

Pre-existing programs funded by 

PPACA 0 0 0 0 0 0 0 0 0 0 0 0 0

Programs authorized by PPACA 

but funded by other sources 0 0 0 0 0 0 0 0 0 0 0 0 0

Oversight and administration 

activities 0 0 0 0 0 0 0 0 0 0 0 0 0

FY 2011 FY 2012 FY 2013 FY 2014
272

FY 2014 Budget by Strategic Goal

(Dollars in thousands)

HHS Strategic Goals

1.Strengthen Health Care $764,599 $705,762 $683,775

1.A Make coverage more secure for those who have insurance and extend 

affordable coverage to the uninsured

--- --- ---

1.B Improve health care quality and patient safety 51,569 47,860 46,133

1.C Emphasize primary & preventative care linked with community 120,932 61,305 58,000

1.D Reduce growth of healthcare costs while promoting high-value, effective care 100,713 101,330 67,562

1.E Ensure access to quality, culturally competent care for vulnerable populations 491,385 495,267 512,079

1.F Promote the adoption and meaningful use of health information technology --- --- ---

2. Advance Scientific Knowledge and Innovation 21,616 21,748 18,528

2.A Accelerate the process of scientific discovery to improve patient care --- --- ---

2.B Foster innovation at HHS to create shared solutions --- --- ---

2.C Invest in the regulatory sciences to improve food & medical product safety --- --- ---

2.D Increase our understanding of what works in public health and human service 

services

21,616 21,748 18,528

3. Advance the Health, Safety and Well-Being of the American People 2,751,637 2,740,358 2,829,045

3.A Promote the safety, well-being, resilience, and healthy development of children 

and youth 

205,636 196,833 276,707

3.B Promote economic & social well-being for individuals, families and communities 13,344 13,425 11,795

3.C Improve the accessibility and quality of supportive services for people with 

disabilities and older adults

--- --- ---

3.D Promote prevention and wellness 2,531,606 2,529,041 2,537,593

3.E Reduce the occurrence of infectious diseases --- --- ---

3.F Protect Americans’ health and safety during emergencies, and foster resilience in 

response to emergencies

1,052 1,058 2,950

4. Increase Efficiency, Transparency and Accountability of HHS Programs 12,940 13,051 14,496

4.A Ensure program integrity and responsible stewardship of resources --- --- ---

4.B Fight fraud and work to eliminate improper payments --- --- ---

4.C Use HHS data to improve American health and well-being of the American 

people

12,940 13,051 14,496

4.D Improve HHS environmental, energy, and economic performance to promote 

sustainability

--- --- ---

5. Strengthen the Nation’s Health and Human Service Infrastructure and 

Workforce

17,895 18,005 26,365

5.A Invest in HHS workforce to meet America's health and human service needs 

today & tomorrow

--- --- ---

5. B Ensure that the Nation's health care workforce meets increased demands 17,895 18,005 26,365

5.C Enhance the ability of the public health workforce to improve health at home and 

abroad

--- --- ---

5.D Strengthen the Nation’s human service workforce --- --- ---

5.E Improve national, state & local surveillance and epidemiology capacity --- --- ---

TOTAL $3,568,687 $3,498,924 $3,572,209

FY 2012 

Actual

FY 2013 

Annualized 

CR

FY 2014 

President's 

Budget
273

Physicians’ Comparability Allowance (PCA) Worksheet

SAMHSA

CY 2012 

(Estimates)

BY 2013 

(Estimates)

PB 2014 

(Estimates)

3 4 4

--- --- ---

3 4 4

$143,236 $143,236 $147,179

$19,333 $18,000 $18,000

Category I Clinical Position --- --- ---

Category II Research Position --- --- ---

Category III Occupational Health --- --- ---

Category IV-A Disability Evaluation --- --- ---

Category IV-B Health and Medical Admin. 3 4 4

1) Number of Physicians Receiving PCAs

SAMHSA is in the process of filing the Chief Medical Officer Position, and is currently negotiating a PCA for this Critical Position

5) Average Annual PCA Payment

4) Average Annual PCA Physician Pay (without PCA payment)

3) Number of Physicians with Multi-Year PCA Agreements

2) Number of Physicians with One-Year PCA Agreements

6) Number of Physicians 

Receiving PCAs by Category 

(non-add)

10) Explain the degree to which recruitment and retention problems were alleviated in your agency through the use of PCAs in the 

prior fiscal year.

We have to offer PCAs in order to be competitive with private sector. Salaries being offered by the Government are usually lower than 

the candidates are making on the outside and a PCA is the only way to raise the income and make the offer attractive.

11) Provide any additional information that may be useful in planning PCA staffing levels and amounts in your agency.

N/A

7) If applicable, list and explain the necessity of any additional physician categories designated by your agency (for categories other 

than I through IV-B). Provide the number of PCA agreements per additional category for the PY, CY and BY.

N/A

8) Provide the maximum annual PCA amount paid to each category of physician in your agency and explain the reasoning for these 

amounts by category.

$30.000.00 - based on years of education, experience and the position held by the incumbent. Amount is required to retain the 

employee.

9) Explain the recruitment and retention problem(s) for each category of physician in your agency (this should demonstrate that a 

current need continues to persist).
274

SAMHSA/Mental Health

PRNS Mechanism Table by SLOA

(Dollars in thousands)

Programs of Regional & National Significance No. Amount No. Amount No. Amount

CAPACITY:

Seclusion and Restraint

Grants

Continuations.......................................................... --- $--- --- $--- --- $---

New/Competing..................................................... --- --- --- --- --- ---

Subtotal................................................................ --- --- --- --- --- ---

Contracts

Continuations.......................................................... 1 2,444 --- --- 1 1,149

New/Competing..................................................... --- --- 1 2,459 --- ---

Subtotal................................................................ 1 2,444 1 2,459 1 1,149

Total, S & R 1 2,444 1 2,459 1 1,149

Youth Violence Prevention

Grants

Continuations.......................................................... 22 12,119 --- --- 8 12,000

New/Competing..................................................... --- 486 8 12,000 1 1,500

Subtotal................................................................ 22 12,605 8 12,000 9 13,500

Contracts

Continuations.......................................................... 3 6,217 1 1,781 2 8,195

New/Competing..................................................... 3 4,335 4 9,516 3 1,461

Subtotal................................................................ 6 10,551 5 11,298 5 9,656

Total, YVP 28 23,156 13 23,298 14 23,156

Project AWARE

Grants

Continuations.......................................................... --- --- --- --- --- ---

New/Competing..................................................... --- --- --- --- 15 30,000

Subtotal................................................................ --- --- --- --- 15 30,000

Contracts

Continuations.......................................................... --- --- --- --- --- ---

New/Competing..................................................... --- --- --- --- 5 25,000

Subtotal................................................................ --- --- --- --- 5 25,000

Total, Project AWARE --- --- --- --- 20 55,000

Actual Base President's 

Budget

FY 2012 FY 2013 FY 2014
275

Programs of Regional & National Significance No. Amount No. Amount No. Amount

National Traumatic Stress Network

Grants

Continuations.......................................................... 3 1,792 78 41,538 78 42,358

New/Competing..................................................... 78 41,397 --- 800 --- ---

Subtotal................................................................ 81 43,188 78 42,338 78 42,358

Contracts

Continuations.......................................................... --- 2,442 --- 2,813 1 3,356

New/Competing..................................................... --- 83 1 842 --- ---

Subtotal................................................................ --- 2,525 1 3,655 1 3,356

Total, NTSCI 81 45,713 79 45,993 79 45,714

Children and Family Programs

Grants

Continuations.......................................................... 14 5,336 14 4,982 --- 212

New/Competing..................................................... --- --- --- --- 12 4,300

Subtotal................................................................ 14 5,336 14 4,982 12 4,512

Contracts

Continuations.......................................................... 2 1,137 2 1,531 --- 397

New/Competing..................................................... --- --- --- --- 4 1,565

Subtotal................................................................ 2 1,137 2 1,531 4 1,962

Total, CFP 16 6,474 16 6,513 16 6,474

Healthy Transitions

Grants

Continuations.......................................................... --- --- --- --- --- ---

New/Competing..................................................... --- --- --- --- 19 19,467

Subtotal................................................................ --- --- --- --- 19 19,467

Contracts

Continuations.......................................................... --- --- --- --- --- ---

New/Competing..................................................... --- --- --- --- 2 5,533

Subtotal................................................................ --- --- --- --- 2 5,533

Total, Healthy Transitions --- --- --- --- 21 25,000

Consumer and Family Network Grants

Grants

Continuations.......................................................... 56 3,858 17 1,148 55 3,808

New/Competing..................................................... 17 1,147 44 3,800 5 400

Subtotal................................................................ 73 5,005 61 4,948 60 4,208

Contracts

Continuations.......................................................... 1 1,220 1 1,314 --- 655

New/Competing..................................................... --- --- --- 1 --- 103

Subtotal................................................................ 1 1,220 1 1,315 --- 758

Total, CFN 74 6,224 62 6,262 60 4,966

FY 2012 FY 2013 FY 2014

Actual Base President's 

Budget
276

Programs of Regional & National Significance No. Amount No. Amount No. Amount

Project LAUNCH

Grants/Cooperative Agreements

Continuations.......................................................... 25 21,300 29 23,312 25 20,157

New/Competing..................................................... 11 9,158 7 7,100 13 10,123

Subtotal................................................................ 36 30,457 36 30,412 38 30,280

Contracts

Continuations.......................................................... 1 4,141 --- 2,092 1 4,360

New/Competing..................................................... --- 42 1 2,348 --- ---

Subtotal................................................................ 1 4,183 1 4,440 1 4,360

Total, LAUNCH 37 34,640 37 34,852 39 34,640

MH System Transformation and Health Reform

Grants

Continuations.......................................................... 31 8,610 31 8,703 20 6,458

New/Competing..................................................... --- --- --- --- 5 1,987

Subtotal................................................................ 31 8,610 31 8,703 25 8,445

Contracts

Continuations.......................................................... 2 1,993 2 1,965 2 2,158

New/Competing..................................................... --- --- --- --- --- ---

Subtotal................................................................ 2 1,993 2 1,965 2 2,158

Total, MH-STHR 33 10,603 33 10,668 27 10,603

Primary and Behavioral Health Care Integration

Grants

Continuations.......................................................... 56 27,250 53 24,579 10 3,788

New/Competing..................................................... 30 35,577 3 4,722 13 20,622

Subtotal................................................................ 86 62,827 56 29,302 23 24,410

Contracts

Continuations.......................................................... --- 2,921 --- 1,635 --- 1,595

New/Competing..................................................... --- --- --- --- --- ---

Subtotal................................................................ --- 2,921 --- 1,635 --- 1,595

Total, PBHCI 1 / 86 65,749 56 30,937 23 26,004

National Strategy for Suicide Prevention

Grants

Continuations.......................................................... --- --- --- --- --- ---

New/Competing..................................................... --- --- --- --- --- ---

Subtotal................................................................ --- --- --- --- --- ---

Contracts

Continuations.......................................................... --- --- --- --- --- ---

New/Competing..................................................... --- --- --- --- 1 2,000

Subtotal................................................................ --- --- --- --- 1 2,000

Total, NSSP --- --- --- --- 1 2,000

1/ The FY 2013 Prevention Fund resources are reflected in the Office of the Secretary

FY 2012 FY 2013 FY 2014

Actual Base President's 

Budget
277

Programs of Regional & National Significance No. Amount No. Amount No. Amount

Suicide Lifeline

Grants

Continuations...................................................... 12 726 7 4,059 7 4,060

New/Competing................................................. 1 4,200 6 360 7 420

Subtotal........................................................... 13 4,926 13 4,419 14 4,480

Contracts

Continuations...................................................... --- 1,448 --- 982 --- 492

New/Competing................................................. --- --- --- 145 --- 540

Subtotal........................................................... --- 1,448 --- 1,127 --- 1,032

Total, Suicide Lifeline 1 / 13 6,373 13 5,545 14 5,512

GLS- Youth Suicide Prevention - States

Grants

Continuations...................................................... 34 15,905 54 25,182 20 9,180

New/Competing................................................. 23 13,724 --- --- 34 16,320

Subtotal........................................................... 57 29,629 54 25,182 54 25,500

Contracts

Continuations...................................................... 1 4,016 1 4,295 --- 2,247

New/Competing................................................. --- 357 --- 386 1 1,935

Subtotal........................................................... 1 4,372 1 4,681 1 4,182

Total, GLS-States 1 / 58 34,002 55 29,863 55 29,682

GLS- Youth Suicide Prevention - Campus

Grants

Continuations...................................................... 16 1,549 40 3,776 23 2,138

New/Competing................................................. 39 6,383 --- --- 18 1,800

Subtotal........................................................... 55 7,932 40 3,776 41 3,938

Contracts

Continuations...................................................... --- 785 --- 1,156 --- 446

New/Competing................................................. --- 417 --- 64 --- 582

Subtotal........................................................... --- 1,202 --- 1,220 --- 1,028

Total, GLS-Campus 1 / 55 9,134 40 4,996 41 4,966

1/ The FY 2013 Prevention Fund resources are reflected in the Office of the Secretary

FY 2012 FY 2013 FY 2014

Actual Base President's 

Budget
278

Programs of Regional & National Significance No. Amount No. Amount No. Amount

GLS - Suicide Prevention Resource Center

Grants

Continuations...................................................... 1 4,471 1 4,471 1 4,471

New/Competing................................................. --- 800 --- 244 --- 172

Subtotal........................................................... 1 5,271 1 4,715 1 4,643

Contracts

Continuations...................................................... --- 327 --- 263 --- 305

New/Competing................................................. --- --- --- --- --- ---

Subtotal........................................................... --- 327 --- 263 --- 305

Total, SPRC 1 / 1 5,598 1 4,978 1 4,948

AI/AN Suicide Prevention Initiative

Grants

Continuations...................................................... --- --- --- --- --- ---

New/Competing................................................. --- --- --- --- --- ---

Subtotal........................................................... --- --- --- --- --- ---

Contracts

Continuations...................................................... 1 2,304 1 529 1 2,938

New/Competing................................................. --- 634 1 2,427 --- ---

Subtotal........................................................... 1 2,938 2 2,956 1 2,938

Total, AI/AN 1 2,938 2 2,956 1 2,938

Homelessness Prevention Programs

Grants

Continuations...................................................... 74 20,311 79 23,387 25 6,674

New/Competing................................................. 8 3,991 12 686 25 18,759

Subtotal........................................................... 82 24,302 91 24,074 50 25,433

Contracts

Continuations...................................................... 3 5,767 3 6,098 3 4,538

New/Competing................................................. --- 702 1 788 1 801

Subtotal........................................................... 3 6,469 4 6,886 4 5,339

Total, HPP 85 30,772 95 30,960 54 30,772

1/ The FY 2013 Prevention Fund resources are reflected in the Office of the Secretary

FY 2012 FY 2013 FY 2014

Actual Base President's 

Budget
279

Programs of Regional & National Significance No. Amount No. Amount No. Amount

Minority AIDS

Grants

Continuations...................................................... 11 8,497 11 7,866 --- ---

New/Competing................................................. --- --- --- --- 20 19,561

Subtotal........................................................... 11 8,497 11 7,866 20 19,561

Contracts

Continuations...................................................... 1 768 2 1,456 1 2,021

New/Competing................................................. --- --- --- --- 1 1,188

Subtotal........................................................... 1 768 2 1,456 2 3,209

Total, MAI 12 9,265 13 9,322 22 22,770

Grants for Adult Trauma Screening & Brief 

Intervention

Grants

Continuations...................................................... --- --- --- --- --- ---

New/Competing................................................. --- --- --- --- 4 2,718

Subtotal........................................................... --- --- --- --- 4 2,718

Contracts

Continuations...................................................... --- --- --- --- --- ---

New/Competing................................................. --- --- --- --- --- 178

Subtotal........................................................... --- --- --- --- --- 178

Total, GATSBI --- --- --- --- 4 2,896

Criminal and Juvenile Justice Programs

Grants

Continuations...................................................... 13 5,231 7 2,754 1 394

New/Competing................................................. --- --- 4 2,760 --- ---

Subtotal........................................................... 13 5,231 11 5,514 1 394

Contracts

Continuations...................................................... 2 1,426 2 1,132 1 706

New/Competing................................................. --- 14 --- 67 6 3,181

Subtotal........................................................... 2 1,440 2 1,199 7 3,887

Total, CJJP 15 6,671 13 6,712 8 4,281

Subtotal, CAPACITY 559 265,117 492 221,464 462 308,830

FY 2012 FY 2013 FY 2014

Actual Base President's 

Budget
280

Programs of Regional & National Significance No. Amount No. Amount No. Amount

SCIENCE AND SERVICE:

Practice Improvement Training

Grants

Continuations...................................................... 1 215 1 215 1 215

New/Competing................................................. --- --- --- --- 8 3,013

Subtotal........................................................... 1 215 1 215 9 3,228

Contracts

Continuations...................................................... 9 6,538 10 7,696 4 3,169

New/Competing................................................. 6 1,110 --- --- 4 1,466

Subtotal........................................................... 15 7,648 10 7,696 8 4,635

Total, PIT 16 7,863 11 7,911 17 7,863

Consumer and Consumer Supporter Technical 

Assistance Centers

Grants

Continuations...................................................... 5 1,775 5 1,775 5 1,777

New/Competing................................................. --- --- --- --- --- ---

Subtotal........................................................... 5 1,775 5 1,775 5 1,777

Contracts

Continuations...................................................... --- 148 --- 160 --- 146

New/Competing................................................. --- --- --- --- --- ---

Subtotal........................................................... --- 148 --- 160 --- 146

Total, CCSTAC 5 1,923 5 1,935 5 1,923

Primary and Behavioral Health Care 

Integration TA

Grants

Continuations...................................................... 1 1,996 1 1,902 --- ---

New/Competing................................................. --- --- --- --- 1 1,874

Subtotal........................................................... 1 1,996 1 1,902 1 1,874

Contracts

Continuations...................................................... --- --- 106 --- ---

New/Competing................................................. --- --- --- --- --- 122

Subtotal........................................................... --- --- 106 --- 122

Total, PBHCI TA 1 / 1 1,996 1 2,008 1 1,996

1/ The FY 2013 Prevention Fund resources are reflected in the Office of the Secretary

FY 2012 FY 2013 FY 2014

Actual Base President's 

Budget
281

Programs of Regional & National Significance No. Amount No. Amount No. Amount

Disaster Response

Grants

Continuations...................................................... --- --- --- --- --- ---

New/Competing................................................. --- --- --- --- 1 2,000

Subtotal........................................................... --- --- --- --- 1 2,000

Contracts

Continuations...................................................... 1 846 1 1,058 --- 401

New/Competing................................................. 1 206 --- --- --- 549

Subtotal........................................................... 2 1,052 1 1,058 --- 950

Total, Disaster Response 2 1,052 1 1,058 1 2,950

Homelessness

Grants

Continuations...................................................... --- --- --- --- --- ---

New/Competing................................................. --- --- --- --- --- ---

Subtotal........................................................... --- --- --- --- --- ---

Contracts

Continuations...................................................... 1 2,302 1 2,316 1 1,231

New/Competing................................................. --- --- --- --- 1 1,071

Subtotal........................................................... 1 2,302 1 2,316 2 2,302

Total, Homelessness 1 2,302 1 2,316 2 2,302

HIV/AIDS Education

Grants

Continuations...................................................... --- --- --- --- --- ---

New/Competing................................................. --- --- --- --- --- ---

Subtotal........................................................... --- --- --- --- --- ---

Contracts

Continuations...................................................... 3 773 3 777 --- 47

New/Competing................................................. --- --- --- --- 3 726

Subtotal........................................................... 3 773 3 777 3 773

Total, HIV/AIDS 3 773 3 777 3 773

Subtotal, SCIENCE AND SERVICE 28 15,909 22 16,006 29 17,807

TOTAL, MH PRNS 587 $281,026 514 $237,471 491 $326,637

FY 2012 FY 2013 FY 2014

Actual Base President's 

Budget
282

SAMHSA/Mental Health

CMHI Mechanism Table by SLOA

(Dollars in thousands)

No. Amount No. Amount No. Amount

Children's Mental Health Services

Grants/Cooperative Agreements

Continuations...................................................... 47 $76,720 62 $75,954 56 $57,695

New/Competing................................................. 22 19,292 26 23,583 42 42,004

Subtotal........................................................... 69 96,012 88 99,537 98 99,700

Contracts

Continuations...................................................... 2 9,264 1 8,296 2 10,539

New/Competing................................................. --- --- 1 1,500 --- ---

Subtotal........................................................... 2 9,264 2 9,796 2 10,539

Technical Assistance............................................. 4 11,619 4 8,966 3 7,076

Report to Congress............................................... --- 420 --- --- --- ---

Total, Children's Mental Health Services 75 $117,315 94 $118,300 103 $117,315

FY 2012 FY 2013 FY 2014

Actual Annualized CR President's 

Budget
283

SAMHSA/Substance Abuse Prevention

PRNS Mechanism Table by SLOA

(Dollars in thousands)

Programs of Regional & National Significance No. Amount No. Amount No. Amount

CAPACITY:

Strategic Prevention Framework

Grants

Continuations........................................................ 40 $55,211 40 $60,068 30 $43,430

New/Competing.................................................... 15 41,875 23 33,034 34 48,056

Subtotal................................................................ 55 97,085 63 93,102 64 91,486

Contracts

Continuations........................................................ 9 12,074 5 8,977 9 18,269

New.................................................................... 1 594 4 8,400 --- ---

Subtotal................................................................ 10 12,669 9 17,377 9 18,269

Total, Strategic Prevention Framework 6 5 109,754 7 2 110,479 7 3 109,754

Mandatory Drug Testing

Contracts

Continuations........................................................ 4 4,496 2 1,459 3 4,480

New.................................................................... 2 700 2 3,769 1 426

Subtotal................................................................ 6 5,196 4 5,228 4 4,906

Total, Mandatory Drug Testing 6 5,196 4 5,228 4 4,906

Minority AIDS

Grants

Continuations........................................................ 133 39,557 78 21,042 133 34,378

New/Competing.................................................... --- --- 60 14,984 22 1,093

Subtotal................................................................ 133 39,557 138 36,026 155 35,471

Contracts

Continuations........................................................ --- 1,750 1 5,533 1 5,836

New.................................................................... --- --- --- --- --- ---

Subtotal................................................................ --- 1,750 1 5,533 1 5,836

Total, Minority AIDS 133 41,307 139 41,560 156 41,307

Sober Truth on Preventing Underage Drinking 

Grants

Continuations........................................................ 22 1,100 81 3,886 97 4,581

New/Competing.................................................... 81 3,887 16 782 --- ---

Subtotal................................................................ 103 4,987 97 4,669 97 4,581

Contracts

Continuations........................................................ 1 1,000 1 1,372 2 2,419

New.................................................................... 1 1,000 1 989 --- ---

Subtotal................................................................ 2 2,000 2 2,361 2 2,419

 Total, STOP 105 6,987 9 9 7,030 9 9 7,000

 Subtotal, CAPACITY 309 $163,244 314 $164,296 332 $162,967

FY 2012 FY 2013 FY 2014

Actual Annualized 

CR

President's 

Budget
284

Programs of Regional & National Significance No. Amount No. Amount No. Amount

SCIENCE AND SERVICE:

Fetal Alcohol Center of Exellence

Contracts

Continuations........................................................ 1 $1,485 1 $9,862 1 $1,000

New.................................................................... 1 8,317 --- --- --- ---

Subtotal................................................................ 2 9,802 1 9,862 1 1,000

Total, Fetal Alcohol Center of Exellence 2 9,802 1 9,862 1 1,000

Center for the Application of Prevention 

Technologies

Contracts

Continuations........................................................ 1 8,059 1 8,108 1 7,511

New.................................................................... --- --- --- --- --- ---

Subtotal................................................................ 1 8,059 1 8,108 1 7,511

Total, Center for the Application of 

Prevention Technologies 1 8,059 1 8,108 1 7,511

 Science & Service Program Coordination

Contracts

Continuations........................................................ 6 4,580 4 3,604 4 2,429

New.................................................................... 1 200 3 1,205 1 1,653

Subtotal................................................................ 7 4,780 7 4,809 5 4,082

 Total, Science & Service Program 

Coordination 7 4,780 7 4,809 5 4,082

 Subtotal, SCIENCE AND SERVICE 1 0 22,641 9 22,780 7 12,593

Total, CSAP 1/ 319 $185,885 323 $187,076 339 $175,560

1/In the FY 2014 Request, the CSAP Minority Fellowship Program budget is reflected in the Health 

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

Actual

Annualized 

CR

President's 

Budget

FY 2012 FY 2013 FY 2014
285

SAMHSA/Substance Abuse Treatment

PRNS Mechanism Table by SLOA

(Dollars in thousands)

Programs of Regional & National Significance No. Amount No. Amount No. Amount

CAPACITY:

Opioid Treatment Programs/Regulatory 

Activities

 Grants

Continuations ........................................................ 2 $999 1 $500 2 $1,494

New/Competing ................................................... 9 3,439 46 3,000 40 1,947 

Subtotal.............................................................. 11 4,438 47 3,500 42 3,441 

 Contracts

Continuations ........................................................ 6 5,749 4 4,233 6 5,305 

New/Competing ................................................... 2 2,700 2 1,207 --- ---

Subtotal.............................................................. 8 8,449 6 5,441 6 5,305 

Total, Opioid Treatment Programs/Regulatory 

Activities 1/ 19 12,886 53 8,941 48 8,746 

Screening, Brief Intervention and Referral to 

Treatment 

 Grants

Continuations ........................................................ 27 25,585 12 12,193 25 21,585 

New/Competing ................................................... 3 22,725 19 11,788 16 4,795 

Subtotal.............................................................. 30 48,310 31 23,981 41 26,380 

 Contracts

Continuations ........................................................ 1 4,877 --- 4,179 1 3,620 

New/Competing ................................................... --- --- 1 200 --- ---

Subtotal.............................................................. 1 4,877 1 4,379 1 3,620 

Total, Screening, Brief Intervention and 

Referral to Treatment 1/ 31 53,187 32 28,360 42 30,000 

TCE - General 

 Grants

Continuations ........................................................ 46 14,295 30 8,033 30 7,820 

New/Competing ................................................... 6 4,867 34 10,920 --- ---

Subtotal.............................................................. 52 19,162 64 18,953 30 7,820 

 Contracts

Continuations ........................................................ 7 8,818 4 7,103 3 5,436 

New/Competing ................................................... --- --- 1 2,096 --- ---

Subtotal.............................................................. 7 8,818 5 9,199 3 5,436 

Total, TCE - General 59 27,980 69 28,151 33 13,256 

1/ The FY 2013 Prevention Fund resources are reflected in the Office of the Secretary.

Actual Annualized CR President's 

Budget

FY 2012 FY 2013 FY 2014
286

Programs of Regional & National Significance No. Amount No. Amount No. Amount

Pregnant & Postpartum Women 

 Grants

Continuations ........................................................ 20 9,687 27 13,362 7 3,597 

New/Competing ................................................... 7 3,664 --- --- 14 7,106 

Subtotal.............................................................. 27 13,351 27 13,362 21 10,703 

 Contracts

Continuations ........................................................ --- 2,619 --- 2,540 --- 5,261 

New/Competing ................................................... --- --- --- 166 --- 6 

Subtotal.............................................................. --- 2,619 --- 2,706 --- 5,267 

Total, Pregnant & Postpartum Women 27 $15,970 27 $16,067 21 $15,970

Strengthening Treatment Access and Retention

 Contracts

Continuations ........................................................ --- $1,672 --- $1,682 --- $1,000

New/Competing ................................................... --- --- --- --- --- ---

Subtotal.............................................................. --- 1,672 --- 1,682 --- 1,000 

Total, Strengthening Treatment Access and 

Retention --- 1,672 --- 1,682 --- 1,000 

Recovery Community Services Program

 Grants

Continuations ........................................................ 5 1,749 5 1,629 --- ---

New/Competing ................................................... --- --- --- --- 18 1,400 

Subtotal.............................................................. 5 1,749 5 1,629 18 1,400 

 Contracts

Continuations ........................................................ --- 696 --- 831 --- 856 

New/Competing ................................................... --- --- --- --- 1 306 

Subtotal.............................................................. --- 696 --- 831 1 1,162 

Total, Recovery Community Services Program 5 2,445 5 2,460 19 2,562 

Access to Recovery

 Grants

Continuations ........................................................ 30 85,990 30 89,958 --- ---

New/Competing ................................................... --- --- --- --- 19 55,795 

Subtotal.............................................................. 30 85,990 30 89,958 19 55,795 

 Contracts

Continuations ........................................................ 2 12,278 1 8,911 --- 4,986 

New/Competing ................................................... --- --- --- --- 1 4,219 

Subtotal.............................................................. 2 12,278 1 8,911 1 9,205 

Total, Access to Recovery 32 98,268 31 98,869 20 65,000 

FY 2012 FY 2013 FY 2014

Actual Annualized CR President's 

Budget
287

Programs of Regional & National Significance No. Amount No. Amount No. Amount

Children and Family Programs

 Grants

Continuations ........................................................ 32 9,446 13 12,837 24 23,847 

New/Competing ................................................... 13 12,744 11 11,000 --- ---

Subtotal.............................................................. 45 22,190 24 23,837 24 23,847 

 Contracts

Continuations ........................................................ 3 8,430 2 6,545 2 5,831 

New/Competing ................................................... --- --- --- 425 --- ---

Subtotal.............................................................. 3 8,430 2 6,970 2 5,831 

Total, Children and Family Programs 48 30,620 26 30,807 26 29,678 

Treatment Systems for Homeless 

 Grants

Continuations ........................................................ 95 35,832 71 26,562 35 16,975 

New/Competing ................................................... --- --- 12 8,873 39 18,604 

Subtotal.............................................................. 95 35,832 83 35,434 74 35,579 

 Contracts

Continuations ........................................................ 2 5,739 2 6,391 2 5,992 

New/Competing ................................................... --- --- --- --- --- ---

Subtotal.............................................................. 2 5,739 2 6,391 2 5,992 

Total, Treatment Systems for Homeless 97 $41,571 85 $41,826 76 $41,571

Minority AIDS 

 Grants

Continuations ........................................................ 75 $31,466 79 $35,954 87 $44,173

New/Competing ................................................... 52 25,570 38 22,348 --- ---

Subtotal.............................................................. 127 57,035 117 58,302 87 44,173 

 Contracts

Continuations ........................................................ 3 8,828 2 6,715 3 8,186 

New/Competing ................................................... --- --- --- 1,249 --- ---

Subtotal.............................................................. 3 8,828 2 7,964 3 8,186 

Total, Minority AIDS 130 65,863 119 66,266 90 52,359 

Criminal Justice Activities

 Grants

Continuations ........................................................ 108 31,146 115 34,079 142 45,061 

New/Competing ................................................... 82 24,518 66 22,705 26 7,602 

Subtotal.............................................................. 190 55,664 181 56,785 168 52,662 

 Contracts

Continuations ........................................................ 3 11,239 3 10,936 2 12,273 

New/Competing ................................................... --- --- --- 200 --- 200 

Subtotal.............................................................. 3 11,239 3 11,136 2 12,473 

Total, Criminal Justice Activities 193 66,903 184 67,920 170 65,135 

Subtotal, CAPACITY 641 $417,366 631 $391,351 545 $325,277

FY 2012 FY 2013 FY 2014

Actual Annualized CR President's 

Budget
288

Programs of Regional & National Significance No. Amount No. Amount No. Amount

SCIENCE AND SERVICE:

Addiction Technology Transfer Centers

 Grants

Continuations ........................................................ --- --- 15 $8,573 15 $7,585

New/Competing ................................................... 15 8,570 --- --- --- ---

Subtotal.............................................................. 15 8,570 15 8,573 15 7,585 

 Contracts

Continuations ........................................................ --- 494 --- 546 --- 496 

New/Competing ................................................... --- --- --- --- --- ---

Subtotal.............................................................. --- 494 --- 546 --- 496 

 Total, Addiction Technology Transfer Centers 15 9,064 15 9,119 15 8,081 

Special Initiatives/Outreach 

 Grants

Continuations ........................................................ 1 300 1 300 --- ---

New/Competing ................................................... --- --- --- --- 1 300 

Subtotal.............................................................. 1 300 1 300 1 300 

 Contracts

Continuations ........................................................ 1 1,967 --- 956 1 1,136 

New/Competing ................................................... --- --- 1 1,025 --- ---

Subtotal.............................................................. 1 1,967 1 1,981 1 1,136 

Total, Special Initiatives/Outreach 2 2,267 2 2,281 2 1,436 

Subtotal, SCIENCE AND SERVICE 17 11,331 17 11,400 17 9,517 

Total,CSAT 658 $428,697 648 $402,751 572 $334,794

FY 2012 FY 2013 FY 2014

Actual Annualized CR President's 

Budget
289

Substance Abuse and Mental Health Services Administration

SIGNIFICANT ITEMS IN SENATE REPORT

FY 2013 Consolidated Senate Report Language

(Senate Report 112-76)

General Items

Item

Child Trauma – The Committee reiterates its strong support for the National Child Traumatic 

Stress Initiative [NCTSI] and its work on behalf of children, families, and communities affected 

by a wide range of trauma, including physical and sexual abuse, natural disasters, sudden death 

of a loved one, and the impact of war on military families. The Committee provides $48,713,000 

under section 582 of the PHS Act to support the continuance of the current model and mission of 

the NCTSI by providing grants to the National Center for Child Traumatic Stress [NCCTS] and 

academic, clinical, and community-based centers for the purposes of developing knowledge of 

best practices, offering trauma training to child-serving providers, and providing mental health 

services to children and families suffering from PTSD and other trauma-related disorders. The 

Committee is aware that SAMHSA is developing a new definition of trauma-informed services 

to be used by NCTSI grantees and expects to be informed of any major changes before they are 

implemented.

The Committee also recognizes the extraordinary value of the core data set developed by the 

NCCTS. Within the total provided, the Committee provides $1,500,000 to the NCCTS for the 

targeted collection of new outcome data from selected NCTSI centers and related analyses and 

reports.

Action taken or to be taken

SAMHSA will continue to build on the strong work of the Network and will improve and 

enhance the capacity of the NCTSI to deliver core practices developed by the NCTSN to 

children and youth in need. The additional appropriation for data collection will provide the 

resources for the National Center to institute a Network capacity to collect, aggregate, and 

analyze data on the characteristics of traumatized children and adolescents and the overall 

success of Network outcomes in intervention development and implementation, screening and 

assessment, trauma resources for service systems, training and dissemination. 

SAMHSA acknowledges the Committee’s request to be informed in advance of any major 

changes with the newly developed definition and framework for trauma informed services and 

how this will be implemented with NCTSI.

Item

Minority Fellowship Program – The Committee continues to be concerned that while 

minorities represent 30 percent of the population and are projected to increase to 40 percent by 

2025, only 23 percent of recent doctorates in psychology, social work, and nursing were awarded 
290

to minorities. The Committee has, therefore, continued funding at last year's level for the 

Minority Fellowship Program.

Action taken or to be taken

Since its start in 1973, the MFP has helped to enhance services to minority communities through 

specialized training of mental health professionals in psychiatry, nursing, social work, and 

psychology. In 2006, marriage and family therapists were added and in 2012, counselors were 

included in the program. Since its inception, the MFP has supported about 1,700 MFP fellows. 

In 2012, the MPF supported 123 individuals across these disciplines. Working closely with the 

MFP grantee organizations, SAMHSA will continue to strengthen the MFP, diversify its fellows, 

foster collaboration among the grantee organizations and ensure that the MFP continues to make 

a significant impact in the development of the behavioral health workforce.

Item

Primary and Behavioral Healthcare Integration – The Committee continues to direct 

SAMHSA to ensure that new Integration grants awarded for fiscal year 2013, from both 

discretionary and PPH funds, are funded under the authorities in section 520K of the PHS Act.

Action taken or to be taken

Any Primary and Behavioral Healthcare Integration grants awarded in fiscal year 2013 will be 

awarded under the section 520K of the PHS Act authorities. 

Item

Project LAUNCH – The Committee intends that funds provided to Project LAUNCH not 

duplicate activities eligible for funding elsewhere in the Department. The Committee reiterates 

its intention that funds provided to this program focus on mental health promotion and promotion 

strategies for children aged 0 to 8.

Action taken or to be taken

Project LAUNCH makes ongoing efforts at the national, state and local levels to ensure that 

grant activities expand and enhance other efforts and are not duplicative of them. Grantees are 

required to: (1) bring together a wide range of child- and family-serving agencies as part of the 

LAUNCH Councils at the state and local levels so that they are integrating programs, funding, 

and policies rather than acting in duplicative silos; (2) conduct environmental scans of existing 

state and community resources so that they are aware of what programs exist and design their 

strategic plans and implementation approaches to address gaps in service; and (3) at the local 

level, focus on enhancing existing services and systems by training the workforce, increasing 

access to care, increasing the quality of care, and raising awareness and knowledge of healthy 

child development. 

Project LAUNCH leaders at the state level are integrally involved in work on other early 

childhood national initiatives such as the Maternal, Infant, and Early Childhood Home Visiting 

Initiative (MIECHV) and the Race to the Top Early Learning Challenge grants. Important goals 
291

of this collaboration are to ensure that the programs are well coordinated and integrated, that 

there is no duplication, and that lessons learned can be shared. 

Project LAUNCH remains committed to focusing on children birth through eight years old.

Item

Seclusion and Restraint – The Committee recommends $2,444,000 for seclusion and restraint 

activities at CMHS. The Committee is deeply concerned that a recent Department of Education 

report showed that tens of thousands of students with disabilities are physically restrained in 

school systems across the country. There are also widespread media reports of people with 

mental illnesses and developmental disabilities living in congregate care facilities who are 

subject to excessive use of seclusion and restraint causing psychological trauma, serious physical 

injury, and even death. The Committee urges SAMHSA to partner with other federal agencies to 

reduce and ultimately eliminate the use of seclusion and restraints in institutional, community, 

and educational settings, and to promote evidence-based alternatives to restraint and seclusion, 

including the use of positive behavioral interventions and supports.

Action taken or to be taken

SAMHSA continues to provide training and technical assistance to promote the dissemination, 

implementation and uptake of best practices to reduce and ultimately eliminate the use of 

restraints and seclusion in a broad range of institutional and community settings. SAMHSA’s 

work continues in settings that provide services for individuals with mental health and cooccurring substance abuse disorders. However, this initiative has expanded beyond the 

behavioral health system, most notably in educational and criminal and juvenile justice settings. 

SAMHSA fosters a systematic, trauma-informed approach to the reduction of these coercive –

seclusion and restraint – practices which have been identified as non-therapeutic and most often 

retraumatizing. SAMHSA worked with the U.S. Department of Education in the development of 

their “Restraint and Seclusion: Resource Document” issued by the Secretary of Education in 

2012, which promotes 15 principles regarding the use of seclusion and restraint, much of which 

draws upon SAMHSA’s work in this area in conjunction with the use of positive behavioral 

interventions and supports as alternatives to coercive practices. 

In 2010, SAMHSA awarded a contract to establish the National Technical Assistance Center: 

Promoting Alternatives to Seclusion and Restraint Through Trauma-Informed Practices. The 

Center provides in-depth training and TA on preventing seclusion and restraint, and promoting 

trauma- informed approaches in a wide range of settings that provide services to children, youth 

and adults with mental and co-occurring disorders or conditions. Since October 2010, the Center 

has provided 116 technical assistance events in 32 states; more than 50 of these events included 

representatives of state education departments, public and private schools and residential 

programs for children and youth; 80 events focused on congregate living environments including 

residential programs for people with mental health and addictions, groups homes and congregate 

living environments for people with developmental disabilities, long-term care hospitals, prisons, 

jails and juvenile detention centers. The Center worked with the National Association of State 

Directors of Developmental Disabilities Services on reducing the use of seclusion and restraint in 

state run institutions and group homes. Most of these technical assistance events included 

multiple service systems in cross-training and collaborative systems planning. The goals of these 
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training and technical assistance efforts are to change policy and practice and promote traumainformed care as an alternative and more effective approach to care than coercive practices and 

policies. 

In FY 2013, SAMHSA will develop a core curriculum for a trauma-informed approach that 

includes strategies for eliminating seclusion and restraint and that can be adapted for multiple 

service sectors and settings. As SAMHSA continues to get requests for these trainings from a 

range of service sectors, a core evidence-supported curriculum readily adaptable to different 

settings will multiply the reach of this initiative.

Item

Suicide Prevention in Indian Populations – The Committee remains concerned about the high 

incidence of drug and alcohol abuse and suicide in American Indian populations. SAMHSA is 

encouraged to continue its efforts in providing culturally competent suicide prevention training 

courses to selected gatekeepers in Indian country. These courses should teach community 

leaders, school personnel, and families how to identify and talk with at-risk individuals to 

motivate them to seek help. Courses should also include mental health support services 

information tailored to the specific geographical location of the participants in each program. 

The Committee further urges SAMHSA to collaborate with the Indian Health Service to identify 

priority communities and help ensure sustainability within American Indian/Alaska Native 

communities.

Action taken or to be taken

SAMHSA has provided significant support for the provision of suicide prevention training in 

Indian Country to a broad array of gatekeepers. As of November 2012, Tribal Garrett Lee Smith 

grantees have conducted 980 trainings that have trained 21,372 people. Additionally, State and 

Campus Garrett Lee Smith grantees have trained an additional 18,378 people who are American 

Indian/Alaska Native. In addition, SAMHSA has funded the adaptation of an evidenced based 

intervention in Emergency Departments for youth suicide attempters for tribal use in the White 

Mountain Apache community; has funded the development of a dissemination manual for a 

comprehensive youth suicide prevention program developed in Indian Country and shown to 

reduce youth suicide attempts; and has created the resource “To Live To See The Great Day That 

Dawns” to assist tribes in adapting culturally competent suicide prevention practices in their 

communities.

In addition to SAMHSA’s work through the Garrett Lee Smith Act programs, SAMHSA’s 

Native Aspirations program identifies American Indian and Alaska Native communities hardest 

hit by suicide, bullying and violence through community-wide behavioral health infrastructure 

development, demonstrably increasing the collective readiness for effective prevention 

interventions and healing. Finally, SAMHSA participates in the HHS Annual Tribal Budget 

Consultation during March of each year, in HHS Regional Consultations between January and 

May of each year and in SAMHSA specific Tribal Consultations throughout the year as needed.
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Item

Addiction Technology Transfer Centers [ATTCs] – The Committee continues to direct 

SAMHSA to ensure that ATTCs maintain a primary focus on addiction treatment and recovery 

services in order to strengthen the addiction workforce. As more individuals become eligible for 

substance abuse services through Medicaid and private insurance, the ATTC network is critical 

to ensure there are enough skilled workers to meet the demand in substance use disorder 

services.

Action taken or to be taken

SAMHSA continues to direct attention to strengthening the addiction workforce. The ATTC 

program is expected to directly support and enhance SAMHSA's new regional presence. 

Through the funding of this effort, SAMHSA expects to provide training and technical assistance 

(TA) which will ultimately lead to a more educated and capable addictions workforce equipped 

to meet the upcoming challenges and requirements of health reform. SAMHSA recognizes the 

critical role the ATTC Network plays in preparing the workforce for the changes health reform 

will bring. The ATTCs develop and conduct training and technology transfer activities for the 

substance use disorders workforce to meet identified needs by raising awareness of and 

improving skills in using evidence-based and promising treatment and recovery practices in 

recovery-oriented systems of care. The program was restructured in 2012 to better align with the 

HHS Regions and 15 grants were awarded including 10 Regional Centers, four Focus Area 

Centers and one National Office. 

Item

Addiction Workforce – As the provision of quality substance use disorder services is dependent 

on an adequate, qualified workforce and SAMHSA is the lead federal agency charged with 

improving these services, the Committee directs SAMHSA to continue to focus on developing 

the addiction workforce and identifying ways to address the current and future workforce needs 

of the addiction prevention, treatment, and recovery fields.

Action taken or to be taken

SAMHSA’s primary vehicle for addressing addiction workforce issues is the Addiction 

Technology Transfer Centers program. ATTCs develop and conduct training and technology 

transfer activities for the substance use disorders workforce to meet identified needs by raising 

awareness of and improving skills in using evidence-based and promising treatment and recovery 

practices in recovery-oriented systems of care. The program was restructured in 2012 to better 

align with the HHS Regions and 15 grants were awarded including 10 Regional Centers, four 

Focus Area Centers and one National Office. Recent activities and projects include an ATTC 

curriculum was created for workforce development for “Medication-Assisted Treatment with 

Special Populations” (MAT Project), which involves developing outreach materials, piloting 

prototypes and designing and implementing online courses. The Clinical Supervision 

Foundation’s Suite of Training has been developed. The target audience is professionals 

interested in the fundamentals of supervision, and a variety of training modules have been 

developed to address their training needs. 
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In addition to this expansive effort, other examples of SAMHSA’s continued addiction 

workforce development activities include programs such as Partners for Recovery, Minority 

Fellowship Program, and its work with Historically Black Colleges and Universities.

Item

Drug Treatment Courts – The Committee continues to direct SAMHSA to ensure that all 

funding appropriated for drug treatment courts is allocated to serve people diagnosed with a 

substance use disorder as their primary condition. In addition, the Committee urges CSAT to 

ensure that state substance abuse agencies are eligible to apply for all drug treatment court grant 

programs in its portfolio. The Committee expects CSAT to ensure that non-state substance abuse 

agency applicants for any drug treatment court grant in its portfolio continue to demonstrate 

evidence of working directly and extensively with the corresponding state substance abuse 

agency in the planning, implementation, and evaluation of the grant.

Action taken or to be taken

In FY 2013 SAMHSA funding appropriated to CSAT for drug treatment courts will continue to 

support and provide technical assistance to state and community programs where substance 

abuse is the primary focus. State substance abuse agencies will continue to be eligible to apply 

for all drug treatment court grant programs and non-state substance abuse agency applicants for 

drug treatment court grants continues to demonstrate evidence of working directly and 

extensively with the corresponding state substance abuse agency in the planning, 

implementation, and evaluation of the grant. In 2013 SAMHSA plans to fund additional cohorts 

of SAMHSA/BJA Drug Courts and SAMHSA Adult and Family Drug Courts. The purpose of 

the Adult and Family Drug Courts program is to expand and/or enhance substance abuse 

treatment services in existing adult and family “problem solving” courts which use the treatment 

drug court model in order to provide alcohol and drug treatment to defendants/offenders.

Services include recovery support services for substance abuse treatment, screening, assessment, 

case management, and program coordination. The purpose of the SAMHSA/BJA program is the 

provision of services to populations for which primary issues are substance abuse related. This 

joint initiative allows applicants to submit a comprehensive strategy for enhancing drug court 

services and capacity by permitting applicants to compete for both criminal justice and substance 

abuse treatment funds with one application. This jointly managed program provides resources to 

state, local and tribal governments, and drug courts to enhance drug court programs and systems 

for nonviolent substance-abusing offenders. 

Item

Hepatitis Testing – The Committee notes the high incidence of hepatitis among injection drug 

users and urges SAMHSA to implement viral hepatitis testing as a standard of care in drugtreatment programs, consistent with the HHS Action Plan for the Prevention, Care and Treatment 

of Viral Hepatitis. The Committee encourages SAMHSA to use established best practices for 

infectious disease testing, including rapid tests.
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Action taken or to be taken

SAMHSA recognizes the importance of addressing the high incidence of hepatitis among 

injection drug users and has taken steps to incorporate or encourage rapid testing in many of the 

agency’s programs. SAMHSA continues to support testing of opioid treatment program (OTP)

patients for hepatitis C virus (HCV) and the vaccination of HIV/HCV co-infected individuals 

through the bulk purchase and distribution of HCV test kits and a hepatits B vaccine for 

maintenance and detoxification programs. In addition, the current hepatitis curriculum is being 

updated. The curriculum, titled Enhancing Substance Abuse Treatment Services to Promote 

Healthy Lifestyles through Addressing Hepatitis Infection among Injection Drug Users, will be 

implemented in designated OTPs. The focus of the course will be on screening, patient 

education, and treatment of hepatitis infection. 

SAMHSA is a lead or partnering agency in at least 23 strategies specified in the HHS Viral 

Hepatitis Plan. To promote the awareness of viral hepatitis, CSAT, in collaboration with the 

Centers for Disease Control and Prevention (CDC), issued a dear colleague letter to OTPs 

encouraging their participation in the first National Hepatitis Testing Day on May 19. The Viral 

Hepatitis Education Work Group is continuing to develop educational materials to support 

testing activities, including a new online risk assessment tool.

In 2012, SAMHSA required the 10 new regional ATTC programs to work with federally 

qualified health centers to provide training/TA specific to the development of the workforce 

regarding issues related to serving clients with hepatitis. In 2012, the grant announcement for 

Targeted Capacity Expansion Program: Substance Abuse Treatment for Racial/Ethnic Minority 

Populations at High-Risk for HIV/AIDS contains the following statement: All clients who are 

considered to be at risk for viral hepatitis (B and C) as specified by CDC recommendations for 

hepatitis B (CDC, 2008) and hepatitis C (CDC, 1998) must be tested for viral hepatitis (B and C) 

in accordance with state and local requirements, either onsite or through referral. No more than 

5 percent of grant funds may be used for viral hepatitis (B and C) testing, including purchase of 

test kits and other required supplies (e.g., gloves, biohazardous waste containers, etc.) and 

training for staff related to viral hepatitis (B and C) testing. Grantees must report all positive

viral hepatitis test results to the local and state health department, as appropriate.

Item

HIV Testing – The Committee urges SAMHSA to expand voluntary routine HIV-testing 

services at substance abuse and mental health treatment clinics, consistent with the National 

HIV/AIDS Strategy Implementation Plan. The Committee requests an update on the 

implementation of these activities in SAMHSA's fiscal year 2014 congressional budget 

justification.

Action taken or to be taken

SAMHSA recognizes the need and continues to support the expansion of voluntary routine HIVtesting services at substance abuse and mental health treatment clinics, consistent with the 

National HIV/AIDS Strategy Implementation Plan. From March through June 2012, 6,853 

Rapid HIV Testing (RHT) forms were collected and submitted for preliminary analyses. The 
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forms included all demographic, substance abuse and sexual risk variables for those clients who 

a) are newly diagnosed as preliminarily HIV-positive and b) were previously diagnosed as HIVpositive. All 6,853 were offered a rapid HIV test. The number of individuals who accepted the 

test was 6,085 (88.8 percent) and the number who refused testing was 768 (11.2 percent). A total 

of 274 (4 percent) RHT forms were from clients diagnosed as HIV-positive. Of HIV-positive 

clients, 255 (3.7 percent of all clients tested) were previously diagnosed as positive and 19 (0.3 

percent of clients tested) were newly diagnosed as HIV-positive.

Additionally, SAMHSA received $1.6 million from the Secretary’s Minority AIDS Initiative 

Fund in FY 2012 to expand the capacity of Minority AIDS Initiative grantees in CSAT and 

CSAP, and for criminal justice grantees in CSAT and CMHS. These funds will provide rapid 

HIV testing, counseling, and referral to care. SAMHSA funded 21 one-year supplements. 

Item

Minority AIDS – The Committee is concerned by SAMHSA's proposal to transfer funds to 

CMHS from the Minority Aids Initiative [MAI] administered by CSAT. According to NIDA, 1 

in 4 of those living with HIV in 2009 reported use of alcohol or drugs at a level that warranted 

treatment. In addition, research shows alcohol and drug use are major risk factors for HIV/AIDS. 

The Committee directs SAMHSA to maintain funding for CSAT's MAI and to focus on building 

capacity and outreach efforts to individuals with, or at risk of developing, a primary substance 

use disorder and to improve efforts to identify such individuals to prevent the spread of the 

disease.

Action taken or to be taken

In accordance with the Committee, in FY 2013 SAMHSA plans to maintain funding for CSAT's 

MAI and to focus on building capacity and outreach efforts to individuals with, or at risk of 

developing, a primary substance use disorder and to improve efforts to identify such individuals 

to prevent the spread of the disease. To support already ongoing efforts, SAMHSA plans to issue 

a new TCE-HIV program of which the primary focus will be substance abuse treatment for 

racial/ethnic minority women at high Risk for HIV/AIDS. The proposed purpose of this 

program is to expand substance abuse treatment and HIV services for African American, 

Hispanic/Latina and other racial/ethnic minority women (ages 18 years and older), including 

heterosexual, lesbian, bisexual, and previously incarcerated women and their significant others, 

who have substance use or co-occurring substance use and mental disorders, and are living with 

or at risk for HIV/AIDS, tuberculosis, and other sexually transmitted diseases.

Item

Oral Fluid Testing – The Committee commends SAMHSA for updating its substance abuse 

testing guidelines to include oral fluid and encourages the agency to continue to advance oral 

fluid testing guidelines.

Action taken or to be taken

The CSAP Drug Testing Advisory Board (DTAB) is responsible for evaluating the scientific 

sufficiency of oral fluid and providing advice to the SAMHSA Administrator on the federal 

workplace drug testing programs. In July 2011, the DTAB deliberated in open session on the 
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scientific sufficiency of oral fluid as an alternative specimen in the federal drug testing program 

and unanimously voted that SAMHSA include oral fluid as an alternative specimen in the 

Mandatory Guidelines for Federal Workplace Drug Testing Programs.

In April 2012, CSAP completed the draft proposed revisions to the Mandatory Guidelines for 

Federal Workplace Drug Testing Programs to include oral fluid as an alternative specimen. 

These proposed revisions were written in a question/answer format to harmonize with the 2008 

urine Mandatory Guidelines. For the first time, this preamble to the proposed oral fluid 

Mandatory Guidelines has its discussion points supported by scientific peer-reviewed literature 

references. This proposed draft was reviewed by the DTAB on September 24, 2012 in closed 

session. 

Item

Screening, Brief Intervention, and Referral to Treatment [SBIRT] – The Committee 

continues to direct SAMHSA to ensure that funds provided for SBIRT are used for existing 

evidence-based models of providing early intervention and treatment services to those at risk of 

developing substance abuse disorders.

Action taken or to be taken

All SBIRT funds utilize the existing evidence base and provide funds to applicants who 

demonstrate the ability to provide early intervention and substance abuse treatment referral 

services to those in need. 

Item

Underage Drinking – The Committee provides a total of $5,000,000 for Sober Truth on 

Preventing Underage Drinking [STOP] Act Community Based Coalition Enhancement Grants. 

The Committee understands that building on the infrastructure of current and past Drug Free 

Communities grantees is the most effective way to invest limited federal dollars to deal with 

underage drinking issues at the community level.

Action taken or to be taken

In fiscal year 2012, SAMHSA awarded 81 new STOP Act grants to current and former Drug 

Free Communities coalitions that had not received STOP Act funding in prior years. CSAP will 

continue to focus these community grants on using coalitions to implement effective strategies 

for preventing and reducing underage drinking as well as other substance use and abuse issues.

In fiscal year 2013 SAMHSA will award up to 16 new STOP Act grants to prevent and reduce 

alcohol use among youth ages 12-20 in communities throughout the United States.

Item

Overdose Prevention — Accidental deaths from overdose, particularly from prescription drugs 

such as opioids, are on the rise and have become the leading cause of preventable death for 

individuals under the age of 65 in the United States. The Committee strongly encourages the 

Secretary to launch a public awareness campaign to educate the public and health professionals 

about the signs, symptoms, and risk factors for overdose, as well as how individuals can make 
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linkages to recovery and treatment services. The Committee urges the Secretary to develop the 

campaign with the participation of federal agencies including SAMHSA, NIDA, HRSA, FDA, 

and the Office of National Drug Control Policy.

Action taken or to be taken

SAMHSA/CSAT has developed an overdose prevention and reversal toolkit which is currently 

undergoing internal clearance. Should the toolkit be approved, the recommendation is to 

distribute it through the SAMHSA website and to provide limited technical assistance to users.

However, at this time SAMHSA/CSAT does not possess the resources or expertise to conduct a 

public awareness campaign as envisioned in the congressional provision.

Item

SPFSIG/PFS - The Committee reiterates its strong support for SPFSIG/PFS programs, which 

are promising approaches to preventing the onset and reducing the progression of substance 

abuse, including childhood and underage drinking. The Committee intends that continuation 

awards for SPFSIG/PFS grantees should be made at amounts no less than what grantees received 

in fiscal year 2012. Furthermore, SAMHSA shall use any additional funding to provide new 

grants under SPFSIG/PFS. The Committee intends that these new grants shall be awarded as the 

program was originally designed prior to fiscal year 2011, with similar eligible applicants, a 

multiyear project period, reliance on epidemiological workgroups, and financial incentives for 

grantees that meet performance targets. The Committee expects SAMHSA to awards these 

multiyear grants on an annual, incremental basis rather than fully funding them in fiscal year 

2013.

Action taken or to be taken

The SPF SIG and PFS programs are flagship SAMHSA prevention programs that help to prevent 

substance abuse, including underage drinking and misuse, use in states, jurisdictions, and tribes 

across America. SAMHSA intends to provide full continuation funding for SPF SIG and PFS 

grants in fiscal year 2013. SAMHSA also plans to fund additional PFS grants in 2013 for states 

and jurisdictions that have completed SPF SIG. These grants will be for a multiyear project 

period and rely on epidemiological workgroups. The FY 2013 PFS grants will be funded on an 

annual, incremental basis.

Item

PRNS – The Committee continues to provide funding for Programs of Regional and National 

Significance [PRNS] under each of SAMHSA's statutorily created centers and directs that 

SAMHSA shall account for all of its PRNS funding in this manner, which shall include future 

budget requests. SAMHSA's authorization states that the agency's work to improve the provision 

of mental health and substance abuse services shall be established and carried out by the agency's 

three centers. Therefore, SAMHSA shall account for the funding for all of its programs, 

contracts and activities through the accounts, budget line items, and categories identified in this 

act and the accompanying Senate report. The Committee requests that the fiscal year 2014 

congressional justification include budgetary and programmatic information on programs as they 
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existed in fiscal year 2013, even if the budget request proposes a new structure or consolidation 

in fiscal year 2014.

Action taken or to be taken

SAMHSA will continue to account for the funding of all its programs, contracts, and activities 

supported through the three centers. 

Item

Block Grants – The Committee is extremely concerned that the increases provided to the 

Community Mental Health Services Block Grant [MHBG] and SAPT Block Grant in last year's 

conference report were eroded by the administration's decision to tap 1.25 percent of both block 

grants for program evaluation transfers pursuant to section 241 of the PHS Act. In prior years the 

administration has exempted these block grants from being used as a source for these evaluation 

transfers. The Committee directs SAMHSA and the Department to exempt these two programs 

from being used as a source for PHS evaluation transfers in fiscal year 2013, as was done prior to 

fiscal year 2012.

Action taken or to be taken

The PHS Evaluation Set Aside, authorized by Congress in 1970, funds critical evaluation 

activities through a set aside of up to 1 percent of PHS Act authorized activities. As you know, 

both the set-aside rate and the uses of the funds generated by the set-aside are currently specified 

by Congress in the annual appropriations bill. The FY 2012 set-aside rate specified by Congress 

required assessing this activity, and in total was 2.5%. This funding is used to support critical 

public health and evaluation activities across HHS in a centralized and coordinated manner. 

However, Congress specifies these uses, including to assess performance and assist grantees with 

activities such as the technical assistance provided to states in implementing the Mental Health 

and Substance Abuse Block Grants, and other activities that presented HHS with new challenges 

in financing these activities, which required the Department to include the Mental Health block 

grant in the assessment along with other Public Health Service Act authorized programs. The 

PHS Evaluation set aside is increased from 1.25 percent in the FY 2013 to 3 percent for FY 

2014. 

Item

CMHI – The Committee rejects the administration's proposed cut to this important program. The 

Committee notes that in the United States every year 5,000 young people between the ages of 14 

and 24 commit suicide, and 600,000 make an attempt that is serious enough to require an 

emergency room visit. Furthermore, the Committee understands that 75 percent of psychiatric 

illness occurs before the age of 24. This public health crisis is exacerbated by the fact that there 

are only 7,500 child and adolescent psychiatrists and 3,500 child psychologists nationwide to 

treat this vulnerable population. The Committee encourages SAMHSA to seek innovative means 

to increase the number of children's mental health professionals, including efforts to develop 

bachelor's degree and master's level training curricula focusing on evidence-based interventions.
300

Action taken or to be taken

The Children’s Mental Health Initiative continues to develop and implement innovative 

strategies to improve services and systems to help children and youth who have serious mental 

health challenges and their families. In response to the Committee’s inquiry, SAMHSA will 

issue a request for application as part of the Comprehensive Community Mental Health Services 

for Children’s and their Families Program to develop and test a specialized curricula that will 

focus on ensuring that bachelor’s and master’s prepared children’s mental health professionals 

have access to training on the delivery of appropriate evidence based practices. In addition, in 

support of the Administration’s plan to address the needs of transition age youth, SAMHSA 

proposes to invest new resources in workforce activities to train more than 5,000 additional 

professionals to work with students and young adults with mental illnesses and other behavioral 

health problems.