i 

DEPARTMENT of 

HEALTH

and HUMAN

SERVICES

Fiscal Year

2025

 

Substance use And Mental Health

Services Administration

 

Justification of Estimates for

Appropriations Committees
ii

Letter from the Assistant Secretary

I am pleased to present the FY 2025 President’s Budget Request for the Substance use And Mental 

Health Services Administration (SAMHSA). The FY 2025 President’s Budget includes a total of 

$8.1 billion. The budget reflects the Administration’s commitment to addressing the spectrum of 

behavioral health conditions affecting millions of Americans and aims to improve the lives of 

people across the country. SAMHSA is committed to fulfilling our responsibility to support the 

numerous initiatives and goals of the Administration, Congress, and HHS that include the critical 

priorities of the Biden-Harris Administration’s Unity Agenda, National Drug Control Strategy, the

Bipartisan Safer Communities Act, and the American Rescue Plan Act. This budget also reflects 

SAMHSA’s four guiding principles of equity, trauma-informed approaches, recovery, and a 

commitment to data and evidence-based practices as we address our five key priorities:

1. Preventing Substance Use and Overdose 

2. Enhancing Access to Suicide Prevention and Mental Health Services 

3. Promoting Resilience and Emotional Health for Children, Youth, and Families 

4. Integrating Behavioral and Physical Health Care 

5. Strengthening the Behavioral Health Workforce. 

The FY 2025 budget request includes investments to: 

• Prevent substance use and overdose by expanding programs providing resources to prevention 

professionals and prevention strategies in communities, supporting dedicated harm reduction 

grants and initiatives, and increasing access to opioid overdose reversal medications. This includes 

medications for the treatment of opioid use disorder (MOUD) through the State Opioid Response 

(SOR) program, other grant programs, and further implementation of the substantially revised 

regulations for Opioid Treatment Programs (OTPs) that occurred in 2024. In particular, detect and 

respond to emerging drug threats such as fentanyl adulterated or associated with xylazine. 

• Increase access to suicide prevention and mental health services by serving anyone, any time, 

from anywhere across the nation through continued expansion of the 988 and Behavioral Health 

Crisis Services Programs. The budget supports strengthening the reach and response of 988 for all 

Americans and continues to invest in 988 dedicated services to LGBTQ Youth and Spanish 

Speakers. 

•Expand investments in children’s behavioral health services and support robust investments 

across the developmental continuum for children, youth, families, and communities in line with 

the three pillars of the National Mental Health Strategy. 

• Maintain critical investments in programs that promote resilience and emotional health across 

the country such as Mental Health Awareness Training (MHAT), Project Linking Actions for 

Unmet Needs in Children’s Health (Project LAUNCH), and Healthy Transitions. In addition, this 

budget supports historically underserved tribal communities through several programs including 

the Tribal Behavioral Health program. 
iii

• Advance the integration of behavioral health and physical care services through programs that 

support HIV and viral hepatitis testing for people with behavioral health conditions, and Primary 

and Behavioral Health Care Integration grants. 

• Support expansion of the Certified Community Behavioral Health Centers and the Community 

Mental Health Centers to transform community behavioral health system; provide comprehensive, 

coordinated behavioral health care; and to improve the quality of behavioral health care service 

available across the nation. 

In FY 2025, SAMHSA maintains a strong commitment to enhancing the accessibility of evidencebased behavioral health care services. SAMHSA continues to streamline its business operations 

while expanding access to mental health and substance use disorder services, including the 

provision of technical assistance and training to optimize service delivery and strengthen the

workforce that engages and serves people, families, and communities affected by behavioral health 

conditions. I am confident this budget request supports our shared vision that people with, affected 

by, or at risk for mental health and substance use conditions receive timely and appropriate care, 

achieve wellbeing, and thrive. I thank you for supporting SAMHSA as it serves communities 

across the country. 

Miriam E. Delphin-Rittmon, Ph.D. 

Assistant Secretary for Mental Health and Substance Use
iv

DEPARTMENT OF HEALTH AND HUMAN SERVICES

SUBSTANCE USE AND MENTAL HEALTH SERVICES ADMINISTRATION

Table of Contents

LETTER FROM THE ASSISTANT SECRETARY ......................................................................... II

TABLE OF CONTENTS .......................................................................................................... IV

ORGANIZATION CHART ...................................................................................................... VII

I. PERFORMANCE BUDGET OVERVIEW ........................................................................1 

INTRODUCTION .....................................................................................................................2 

MISSION ................................................................................................................................2 

VISION ..................................................................................................................................2 

OVERVIEW OF THE BUDGET REQUEST ..................................................................................3 

OVERVIEW OF PERFORMANCE ...............................................................................................9 

ALL-PURPOSE TABLE ..........................................................................................................10 

II. BUDGET EXHIBITS ......................................................................................................11 

APPROPRIATIONS LANGUAGE GUIDELINES .........................................................................12 

LANGUAGE ANALYSIS ........................................................................................................17 

AMOUNTS AVAILABLE FOR OBLIGATION ............................................................................24 

SUMMARY OF CHANGES ......................................................................................................25 

BUDGET AUTHORITY BY ACTIVITY .....................................................................................26 

AUTHORIZING LEGISLATION ...............................................................................................27 

APPROPRIATIONS HISTORY .................................................................................................30 

APPROPRIATIONS NOT AUTHORIZED BY LAW .....................................................................31 

III. MENTAL HEALTH ..........................................................................................................32 

SUMMARY OF THE REQUEST ...............................................................................................33 

PROGRAMS OF REGIONAL AND NATIONAL SIGNIFICANCE (PRNS) .....................................35 

Project AWARE......................................................................................................................................36

Mental Health Awareness Training .......................................................................................................41

Healthy Transitions................................................................................................................................44

Children and Family Programs .............................................................................................................47

Consumer and Family Network Grants..................................................................................................49

Project LAUNCH ...................................................................................................................................51

Mental Health System Transformation and Health Reform ...................................................................55

Primary and Behavioral Health Care Integration .................................................................................58

Suicide Prevention Programs.................................................................................................................62

Mental Health Crisis Response Partnership Program...........................................................................76

Homelessness Prevention Programs......................................................................................................78

Minority AIDS ........................................................................................................................................80

Criminal and Juvenile Justice Programs...............................................................................................83

Practice Improvement and Training ......................................................................................................87

Consumer and Consumer-Supporter TA Centers...................................................................................89

Disaster Response ..................................................................................................................................91

Seclusion and Restraint..........................................................................................................................95
v 

Assertive Community Treatment for Individuals with Serious Mental Illness........................................97

Tribal Behavioral Health Grants.........................................................................................................100

MH Minority Fellowship Program.......................................................................................................103

Infant and Early Childhood Mental Health..........................................................................................107

Interagency Task Force on Trauma-Informed Care ............................................................................110

Women Behavioral Health Technical Assistance Center.....................................................................112

NATIONAL CHILD TRAUMATIC STRESS NETWORK ............................................................114 

ASSISTED OUTPATIENT TREATMENT FOR INDIVIDUALS WITH SERIOUS MENTAL ILLNESS 118 

CHILDREN’S MENTAL HEALTH SERVICES .........................................................................121 

PROJECTS FOR ASSISTANCE IN TRANSITION FROM HOMELESSNESS ..................................125 

PROTECTION AND ADVOCACY FOR INDIVIDUALS WITH MENTAL ILLNESS (PAIMI) .........130 

CERTIFIED COMMUNITY BEHAVIORAL HEALTH CLINICS (CCBHC) .................................135 

PRNS MECHANISM TABLE ...............................................................................................139 

GRANT AWARDS TABLE ...................................................................................................142 

COMMUNITY MENTAL HEALTH SERVICES BLOCK GRANT (MHBG) ................................143 

COMMUNITY MENTAL HEALTH CENTERS (CMHC) ..........................................................159 

IV. SUBSTANCE USE PREVENTION SERVICES ............................................................164 

SUMMARY OF THE REQUEST .............................................................................................165 

PROGRAMS OF REGIONAL AND NATIONAL SIGNIFICANCE (PRNS) ...................................166 

Strategic Prevention Framework .........................................................................................................167

Federal Drug-Free Workplace.............................................................................................................172

Sober Truth on Preventing Underage Drinking Act (STOP Act) .........................................................175

Tribal Behavioral Health Grants.........................................................................................................180

Minority AIDS Initiative.......................................................................................................................183

Minority Fellowship Program..............................................................................................................186

Center for the Application of Prevention Technologies.......................................................................188

Science and Service Program Coordination ........................................................................................191

PRNS MECHANISM TABLE ...............................................................................................194 

GRANT AWARDS TABLE ...................................................................................................198 

V. SUBSTANCE USE SERVICES ......................................................................................199 

SUMMARY OF THE REQUEST .............................................................................................200 

Programs of Regional and National Significance (PRNS)...................................................................202

Opioid Treatment Programs/Regulatory Activities..............................................................................203

Screening, Brief Intervention, and Referral to Treatment ....................................................................207

Targeted Capacity Expansion-General................................................................................................211

Pregnant and Postpartum Women .......................................................................................................217

Improving Access to Overdose Treatment............................................................................................222

Building Communities of Recovery (BCOR)........................................................................................225

Recovery Community Services Program..............................................................................................229

Children and Families..........................................................................................................................233

Treatment Systems for Homeless..........................................................................................................237

Criminal Justice Activities ...................................................................................................................240

Minority AIDS Initiative.......................................................................................................................248

Minority Fellowship Program..............................................................................................................251

Addiction Technology Transfer Centers...............................................................................................253

Grants to Prevent Prescription Drug/Opioid Overdose Related Deaths.............................................256

Peer Support Technical Assistant Center.............................................................................................259

Treatment, Recovery, and Workforce Support .....................................................................................262

Emergency Department Alternatives to Opioids..................................................................................265

Comprehensive Opioid Recovery Centers............................................................................................268
vi 

First Responder Training – Comprehensive Addiction and Recovery Act...........................................271

Youth Prevention and Recovery Initiative............................................................................................274

Community Harm Reduction and Engagement Initiative.....................................................................276

Women’s Behavioral Health Technical Assistance Center..................................................................280

PRNS MECHANISM TABLE ...............................................................................................282 

GRANT AWARDS TABLE ...................................................................................................290 

STATE OPIOID RESPONSE GRANTS ....................................................................................291 

SUBSTANCE USE PREVENTION, TREATMENT, AND RECOVERY SERVICES BLOCK GRANT .299 

VI. HEALTH SURVEILLANCE AND PROGRAM SUPPORT .........................................312 

SUMMARY OF THE REQUEST .............................................................................................313 

HEALTH SURVEILLANCE ...................................................................................................314 

PERFORMANCE AND QUALITY INFORMATION SYSTEMS (PQIS) ........................................319 

DRUG ABUSE WARNING NETWORK (DAWN) ..................................................................323 

PUBLIC AWARENESS AND SUPPORT ..................................................................................325 

PROGRAM SUPPORT ..........................................................................................................329 

PRNS MECHANISM TABLE ...............................................................................................330 

VII. NONRECURRING EXPENSES FUND .........................................................................331 

VIII. SUPPLEMENTARY TABLES .......................................................................................333 

BUDGET AUTHORITY BY OBJECT CLASS ........................................................................334 

SALARIES AND EXPENSES ................................................................................................343 

DETAILS OF FULL-TIME EQUIVALENT EMPLOYMENT ..................................................345 

DETAIL OF POSITIONS .....................................................................................................346 

PHYSICIANS’ COMPARABILITY ALLOWANCE WORKSHEET ..........................................347 

RESOURCES FOR CYBER ACTIVITIES ..............................................................................348 

IX. DRUG CONTROL BUDGET .......................................................................................349 

X. PROPOSED LAW ...........................................................................................................375 
vii 

Organization Chart
1 

Performance Budget Overview

Table of Contents` 

Introduction ..........................................................................................................................2

Mission.................................................................................................................................2

Vision...................................................................................................................................2

Overview of the Budget Request .........................................................................................3

Overview of Performance ....................................................................................................9

All-Purpose Table ..............................................................................................................10
2 

Introduction

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

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

communities, and the country. In these unprecedented times, individuals and families across the 

nation are experiencing the challenges of living with mental and substance use disorders. In 2022, 

SAMHSA’s National Survey on Drug Use and Health (NSDUH) data estimated 16.5 percent (or 

46.6 million people) used illicit drugs in the past year. In addition, nearly 20 percent, adolescents

experience a major depressive episode. Further, among adults aged 18 and older 23.1 percent (or 

59.3 million people) had any mental illness (AMI) and 6.0 percent (or 15.4 million people) had 

serious mental illness (SMI). 

In his 2023 State of the Union Address, President Biden provided an update on the progress made 

in advancing efforts to tackle the mental health crisis and beat the opioid and overdose epidemic - 

two of the four pillars of his Unity Agenda. This Budget builds on the progress made and outlines 

ways to sustain and grow SAMHSA’s efforts to strengthen system capacity, connect more

Americans to care, and create a continuum of support that aims to transform our health and social

services infrastructure to address mental health and substance use holistically and equitably. 

Mission

SAMHSA’s mission is to lead public health and service delivery efforts that promote mental 

health, prevent substance misuse, and provide treatments and supports to foster recovery while 

ensuring equitable access and better outcomes. 

Vision

SAMHSA envisions that people with, affected by, or at risk for mental health and substance use 

conditions receive care, achieve well-being, and thrive. 
3 

Overview of the Budget Request

The FY 2025 President’s Budget is $8.1 billion, an increase of $612 million above the FY 2023 

Final level. The Budget provides resources to advance mental health and substance use disorder 

prevention, treatment, and recovery support services to improve individual, community, and public 

health. The Budget also supports the HHS 2022-2026 Strategic Plan, the SAMHSA 2023-2026 

Strategic Plan, the Biden-Harris Administration’s inaugural National Drug Control Strategy, and 

President Biden’s Unity Agenda to address the overdose and mental health crisis in the nation. 

Overall, the FY 2025 President’s Budget Request reflects SAMHSA’s guiding principles of 

prioritizing equity, trauma-informed approaches, recovery and a commitment to data and 

evidence as well as supports SAMHSA’s five key priorities:

1. Preventing Substance Use and Overdose 

2. Enhancing Access to Suicide Prevention and Mental Health Services

3. Promoting Resilience and Emotional Health for Children, Youth, and Families 

4. Integrating Behavioral and Physical Health Care 

5. Strengthening the Behavioral Health Workforce

Preventing Substance Use and Overdose

SAMHSA prioritizes preventing substance use and overdoses and its budget supports the HHS 

Overdose Prevention Strategy (OPS), which outlines four pillars: Primary Prevention, Harm 

Reduction, Evidence-Based Treatment, and Recovery Support. The Strategy is built on the 

principles of maximizing health equity by using best available data and evidence to inform policy 

and actions, integrating substance use disorder (SUD) services into other types of health care and 

social services, and reducing stigma. It recognizes the full continuum of integrated care and 

services needed to help prevent substance use, expand quality treatment, and sustain recovery from 

SUD, all while emphasizing HHS’ commitment to helping historically underserved populations. 

To advance the four pillars of the OPS, SAMHSA’s budget addresses primary prevention by 

maintaining funding for the Strategic Prevention Framework program (SPF) at the FY 2023 Final 

level. The funding continues support for supporting vital primary prevention work, including 

community prevention messaging and outreach, individual and small group prevention services, 

and collaboration with community-based entities to identify underserved communities. 

The FY 2025 President’s Budget includes expanded resources to support SAMHSA’s effort to 

prevent substance use and overdose. It includes $10 million for a new Community Harm 

Reduction and Engagement Initiative program. The American Rescue Plan (ARP) Act provided 

SAMHSA the opportunity to launch a dedicated harm reduction grant program. Harm reduction 

approaches, such as distribution of naloxone and other opioid overdose reversal medications and 

fentanyl test strips (where permitted by State law) to those at high risk for overdose and their 

family members and first responders, are a key component in addressing the overdose crises. The 

FY 2025 President’s Budget also includes $1.6 billion for the State Opioid Response (SOR) 

program, which is a $20 million increase from the FY 2023 Final level, including $5 million 

increase to the Tribal Opioid Response grants. The budget request addresses the overdose crisis 
4 

that is increasingly being driven by illicitly manufactured fentanyl by providing resources to states 

and territories for increasing access to FDA-approved medications for the treatment of OUD, and 

for supporting prevention, harm reduction, treatment, and recovery support services for OUD and 

other concurrent SUDs. This continuum is critical during an era of fentanyl and other toxic 

substances, such as xylazine, are complicating the public health and services landscape for 

OUD. The SOR program also supports care for stimulant misuse and use disorders, such as cocaine 

and methamphetamine, an important component given the increasing contamination of stimulants 

with fentanyl causing overdose and death to those who do not know their drug supply is 

adulterated. 

The FY 2025 President’s Budget maintains support for other opioid/overdose-related programs at 

the FY 2023 Final level, including MAT for Prescription Drug and Opioid Addiction, Grants to 

Prevent Prescription Drug/Opioid Overdose-Related Death, First Responder Training for Opioid 

Overdose Reversal Drugs, and Improving Access to Overdose Treatment. It also provides ongoing 

support for activities related to continued implementation of SAMHSA’s substantially updated 

regulations for Opioid Treatment Programs (OTPs). The FY 2025 President’s Budget also

maintains funding for various programs, including the Building Communities of Recovery 

program, Recovery Community Services Program, and the Treatment, Recovery, and Workforce 

Support program. These funds will continue to provide career services and supports for individuals 

in recovery from substance use disorder through partnerships with local organizations. The budget 

will also support programs to enhance the nation's capacity for recovery support services, including 

funding for Emergency Department Alternatives to Opioids and Comprehensive Opioid Recovery 

Centers. 

The FY 2025 President’s Budget proposes level funding for criminal justice activities such as Drug 

Courts, Adult and Youth Diversion, and Reflection programs.

Enhancing Access to Suicide Prevention and Mental Health Services

Enhancing access to suicide prevention and mental health services is a key priority for SAMHSA. 

The most recent NSDUH data indicate that 59 million US adults report the presence of any mental 

illness and of those, 15 million are living with a serious mental illness. In 2022, the CDC estimates 

that more than 49,400 people in the United States died from suicide.1 Minority groups were 

particularly impacted, with non-Hispanic American Indian or Alaska Native having the highest 

rate.2 Data from the CDC National Violent Death Reporting System indicates that the proportion 

of suicide decedents who were LGBTQ+ increased from 2014 to 2019.3 By improving access to 

life-saving services, individuals experiencing suicidal ideation and other behavioral health crises 

can achieve wellbeing and thrive. 

The FY 2025 President’s Budget requests $602 million for 988 and Behavioral Health Crisis 

1 Stone DM, Mack KA, Qualters J. Notes from the Field: Recent Changes in Suicide Rates, by Race and Ethnicity 

and Age Group — United States, 2021. MMWR Morb Mortal Wkly Rep 2023;72:160–162. 

DOI: http://dx.doi.org/10.15585/mmwr.mm7206a4 2 ibid

3 Ream GL. Trends in Deaths by Suicide 2014-2019 Among Lesbian, Gay, Bisexual, Transgender, Queer, 

Questioning, and Other Gender/Sexual Minority (LGBTQ+) Youth. J Adolesc Health. 2022 Nov;71(5):609-615. 

doi: 10.1016/j.jadohealth.2022.06.017. Epub 2022 Aug 11. PMID: 35963758.
5 

Services, an increase of $100 million from the FY 2023 Final level. In FY 2025 SAMHSA 

anticipates that contact volume – including calls, texts, and chats – will continue to increase, with 

capacity needed to respond to an estimated 7.5 million annual contacts. The FY 2025 Budget 

provides additional support for the SAMHSA Behavioral Health Crisis Coordinating Center, local 

and national subnetwork and backup capacity, the communications/media campaign, and capacity, 

specialized services for LGBTQ+ youth. The FY 2025 Presidents Budget also includes of a total 

of $736 million in additional funding for mental health services, including the Certified 

Community Behavioral Health Clinic (CCBHC), Community Mental Health Centers, the 

Community Mental Health Services Block Grant, which maintains a 5 percent set aside for crisis 

services supports, and the Mental Health Crisis Response Partnership that supports the startup of 

mobile crisis teams.

With regards to suicide, the FY 2025 President’s Budget for the National Strategy for Suicide 

Prevention (NSSP) is $29.9 million, an increase of $1.75 million from the FY 2023 Final level. 

The increase supports a new Older Adult Suicide Prevention grant program, which will be 

implemented with support from the Administration for Community Living. This new program is 

expected to decrease the number of suicides and suicide attempts by older adults served by this 

grant. This funding will also support continuations and new Zero Suicide grants and NSSP 

continuation grants. It is expected that 98,000 individuals will be referred for services. 

The Budget also maintains support at the FY 2023 Final Level for the Garett Lee Smith (GLS) 

Youth Suicide, GLS Suicide Prevention Resource Center, and GLS AI/AN Suicide Prevention 

Initiative. The FY 2025 funding also supports treatment and recovery, including Assertive 

Community Treatment for Individuals with SMI and Assisted Outpatient Treatment for Individuals 

with SMI. Recognizing the role trauma contributes to plays in impacting poor mental health and 

substance use, the FY 2025 President’s Budget Request includes funding for the Interagency Task 

Force on Trauma-Informed Care and Disaster Response efforts.

Promoting Resilience and Emotional Health for Children, Youth, and Families

Even before the pandemic, the nation’s youth were experiencing significant mental health and 

substance use challenges. Nearly 1 in 5 young people had a diagnosable mental health condition, 

and 1 in 10 had a serious emotional disturbance that negatively impacted their ability to function 

at home, in school, or in the community.4,5,6,7 In 2021, there were 2.2 million adolescents aged 12 

to 17 with a SUD8, and death by suicide was the second leading cause of death for individuals ages 

4 velliBitsko RH, Claussen AH, Lichstein J, et al. Mental Health Surveillance Among Children - United States, 

2013-2019. MMWR Suppl. Feb 25 2022;71(2):1-42. 5 Williams NJ, Scott L, Aarons GA. Prevalence of Serious Emotional Disturbance Among U.S. Children: A MetaAnalysis. Psychiatr Serv. Jan 1 2018;69(1):32-40. 6 Bitsko RH, Claussen AH, Lichstein J, et al. Mental Health Surveillance Among Children - United States, 2013-

2019. MMWR Suppl. Feb 25 2022;71(2):1-42. 7 Williams NJ, Scott L, Aarons GA. Prevalence of Serious Emotional Disturbance Among U.S. Children: A MetaAnalysis. Psychiatr Serv. Jan 1 2018;69(1):32-40. 8 Center for Behavioral Health Statistics and Quality. https://www.samhsa.gov/data/sites/default/files/2022-

12/2021NSDUHFFRHighlights092722.pdf Accessed February 13, 2023. 
6 

10-34 in the United States.9 Unfortunately, many young people do not receive the treatment

supports they need.

SAMHSA’s FY 2025 Budget continues to provide robust investments to address children, youth, 

and families, behavioral health in line with all three pillars of the National Mental Health Strategy. 

Significant investments are proposed to connect children, youth and families to care through 

various SAMHSA programs. 

The FY 2025 President’s Budget for Children’s Mental Health Services is $180 million, an 

increase of $50 million from the FY 2023 Final level. This funding will support the continuations 

of Community Programs for Outreach and Intervention with Youth and Young Adults at Clinical 

High Risk for Psychosis grants (CHR-P) under the 10 percent set-aside for this program. In 

addition, funding will support new and continuing Children’s Mental Health Initiative (CMHI) 

and a technical assistance center. SAMHSA expects to serve 14,000 children and the train 80,000 

in mental health activities and practices. The budget request includes $190 million funding for 

Project AWARE an increase of $50 million from the FY 2023 Final level. This funding will help 

to identify and refer approximately 150,000 school-aged youth to mental health and related 

services; and to train approximately 750,000 mental health and mental health-related professionals 

on evidence-based mental health practices.

The Budget includes funding to maintain programs that provide behavioral health support for

children, youth and families across the full developmental and severity continuum including: the 

Infant and Early Childhood Mental Health program, the National Child Traumatic Stress Initiative, 

Mental Health Awareness Training grants, Project LAUNCH, Healthy Transitions, Tribal 

Behavioral Health Grants, and The Sober Truth on Preventing Underage Drinking Act (STOP 

Act), Grant Program Children and Families (YTREE Residential). 

To expand support for maternal health, the FY 2025 President’s Budget proposes $44 million for 

the Pregnant and Postpartum Women program, an increase of $5 million from FY 2023 Final level. 

The funds will increase access to comprehensive high-quality behavioral and maternal health 

services for pregnant and postpartum women, their minor children, and other family members 

(e.g., fathers of the children). The proposed increase for this program will support the 

Administration’s priority to address the maternal health crisis. This funding will support both new 

grants and continuations.

The FY 2025 President’s Budget also includes funding for a new Women’s Behavioral Health 

Technical Assistance Center is $3.5 million, with CSUS and CMHS each contributing $1.75 

million per year. This cooperative agreement focuses on assisting providers with topics that are 

not traditionally covered in behavioral health training programs such as suicide and crisis 

prevention, how to address gender-based violence, and importantly how to address the needs of 

women facing special challenges due to social determinants of health, such as socioeconomic 

status, racial/ethnic minority status, and/or sexual orientation, and disabilities in a culturally 

competent manner. 

9

National Institute of Mental Health. Suicide. National Institute of Mental Health. Available at: 

https://www.nimh.nih.gov/health/statistics/suicide#part_2585. Accessed August 15, 2022. 
7 

Integrating Behavioral and Physical Health Care 

A key to achieving SAMHSA’s mission is advancing the integration of behavioral health and 

physical health care services. In the FY 2025 President’s Budget, SAMHSA maintains the

investment in its Primary and Behavioral Health Integration (PBHCI) program and the PBHCI 

Training and Technical Assistance. The Budget also includes $34 million for Screening, Brief 

Intervention and Referral to Treatment programming to expand, enhance, and integrate behavioral 

health in primary care settings, as well as hospitals, trauma centers, federally qualified health 

centers, and other relevant health care and community settings. SAMHSA also is maintaining 

investments in programs that support identification of and linkages to HIV and viral hepatitis 

treatment, aligning with the Administration’s efforts to end the HIV epidemic and eliminate 

Hepatitis C. 

Strengthening the Behavioral Health Workforce 

The nation’s workforce of mental health and SUD providers is critical to providing Americans 

with access to essential health care services. Prior to the pandemic, there was already a projected 

shortage of behavioral health care providers, with acute shortages predicted for psychiatrists and 

addiction counselors through 2030. 

The FY 2025 President’s Budget maintains resources for several SAMHSA behavioral health 

workforce programs. This includes SAMHSA’s Minority Fellowship Program (MFP), which aims

to reduce health disparities and improve behavioral health care outcomes for minority populations. 

Additionally, the Budget request maintains funding for: Federal Workplace Drug Testing 

Programs; the Practice Improvement and Training program, which builds upon the existing 

Historically Black Colleges and Universities Center of Excellence; Addiction Technology 

Transfer Centers; the Center for the Application of Prevention Technologies; the Peer Support 

Technical Assistance Center; and Science and Service Program Coordination. 

Highlights

SAMHSA’s FY 2025 Budget is central to President Biden’s Unity Agenda. SAMHSA’s proposed 

budget for FY 2025 is $8.1 billion, which is $612 million more than the FY 2023 Final. The 

increase in the budget will be used to expand behavioral health care services, youth-oriented 

services, community harm reduction initiatives, and substance use disorder treatment. Specifically 

increases in Project Aware ($50 million), Children’s Mental Health Services ($50 million), and 

the Pregnant and Postpartum Women program ($5 million) will provide additional behavioral 

health support for children, women, and families. In addition, a proposed Women’s Behavioral 

Health Technical Assistance Center ($3.5 million) will create a national system of clinical 

consultation and technical assistance for health providers spanning topics across the lifespan 

within the field of women’s mental health and substance use. In addition, the budget provides 

increases to support suicide prevention and crisis care, including additional increases to support 

the 988 lifeline ($100 million) and the Mental Health Crisis Response Partnership Pilot project 

($20 million), as well as a new program to prevent suicide in older adults ($1.75 million). The 

budget also includes increases for the Community Mental Health Services Block Grant ($35 

million), the Certified Community Behavioral Health Clinics ($65 million), and State Opioid 
8 

Response program ($20 million). It also proposes a new Community Harm Reduction Initiative 

($10 million), which is based on the FY 2022 pilot harm reduction project. Finally, the President’s 

budget reproposes an investment in a new mandatory Community Mental Health Centers program 

($413 million). 

Through new programs and increased investments to: prevent substance use and overdose; 

enhance access to suicide prevention and mental health services; promote resilience and emotional 

health for children, youth, and families; integrate behavioral and physical health care; and 

strengthening the behavioral health workforce, SAMHSA will ensure people with, affected by, or 

at risk for mental health and substance use conditions receive care, achieve wellbeing, and thrive.
9 

Overview of Performance

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

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

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

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

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

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

overall efficiency. 

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

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

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

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

trained, and the number of training events held. 

SAMHSA collects data on key measures to monitor and manage discretionary grant performance, 

improve the quality of treatment, prevention, and mental health services. Data collected are in line 

with the Government Performance and Results Act (GPRA). SAMHSA grantees submit these data 

into the SAMHSA Performance Accountability and Reporting System (SPARS). Data collected 

and analyzed through SPARS allows SAMHSA to monitor the progress of discretionary grants, 

support data-informed decision-making for funding, and provide an understanding of the services 

delivered through the programs. 

SAMHSA implements the requirements of 21st Century Cures Act through continuously 

monitoring key performance. Monitoring staff work with SAMHSA Centers and Program Officers 

to enhance the system to be more user friendly with greater data visualization strategies. 

The SAMHSA’s Center for Behavioral Health Statistics and Quality (CBHSQ) Office of 

Evaluation (OE) is responsible for providing centralized planning and management of program 

evaluation and performance management activity across SAMHSA. In this role, OE provides 

support to SAMHSA’s programmatic centers by supporting evaluation proposals, performance 

management, and monitoring and quality improvement activities. OE provides oversight and 

management of agency quality improvement and performance management activities and 

advances agency goals and objectives relating to performance measurements and quality 

improvement. 

Additionally, SAMHSA established an Evidence and Evaluation Board (SEEB) comprised of 

representative from all Centers and Offices. The purpose of the SEEB is to serve as the agency’s 

principal evaluation and evidence forum for managing SAMHSA’s evaluation portfolio, 

evaluation and evidence data, and as a strategic asset to support the agency in meeting its mission 

and agency priorities, including implementation of the Evidence Act. 
10 

Substance use And Mental Health Services Administration

All-Purpose Table 

(Dollars in millions)

Activity FY 2023 

Final FY 2024 CR FY 2025 President's Budget

FY 2025 +/- FY 

2023

$ FTE $ FTE $ FTE $ FTE

CMHS 141 190 190 +49

Programs of Regional and National Significance 1,044.033 1,044.033 1,217.533 +173.500 

National Child Traumatic Stress Network ............................................................ 93.887 93.887 93.887 -- 

Assisted Outpatient Treatment for Individuals with SMI ..................................... 21.420 21.420 21.420 -- 

Children's Mental Health Services ........................................................................ 130.000 130.000 180.000 +50.000 

Set-Aside for Youth in Prodrome Phase of Psychosis (non-add)...................... 13.000 13.000 13.000 -- 

Projects for Assistance in Transition from Homelessness .................................... 66.635 66.635 66.635 -- 

Protection and Advocacy for Individuals with Mental Illness................. 40.000 40.000 40.000 -- 

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

Community Mental Health Services Block Grant............................ 1,007.571 1,007.571 1,042.571 +35.000 

Budget Authority (non-add) ............................................. 986.532 986.532 1,021.532 +35.000 

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

Certified Community Behavioral Health Clinics............................. 385.000 385.000 450.000 +65.000 

Total, Mental Health 2,788.546 2,788.546 3,524.546 +736.000 

Budget Authority (non-add) ............................................... 2,755.507 2,755.507 3,079.007 +323.500 

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

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

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

CSUPS 93 93 93 -- 

Programs of Regional and National Significance................................................. 236.879 236.879 236.879 -- 

Total, Substance Use Prevention Services............................................................. 236.879 236.879 236.879 -- 

Budget Authority (non-add)................................................................................... 236.879 236.879 236.879 -- 

CSUS 109 175 175 -- +66

Programs of Regional and National Significance 574.219 574.219 590.969 +16.750 

State Opioid Response Grants ............................................. 1,575.000 1,575.000 1,595.000 +20.000 

Set-Aside for Tribes (non-add) ........................................ 55.000 55.000 60.000 +5.000 

Substance Use Prevention, Treatment, and Recovery Services Block Grant.... 2,008.079 2,008.079 2,008.079 -- 

Budget Authority (non-add) ............................................. 1,928.879 1,928.879 1,928.879 -- 

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

Total, Substance Use Services .............................................. 4,157.298 4,157.298 4,194.048 +36.750 

SAT Budget Authority (non-add) ........................................... 4,076.098 4,076.098 4,112.848 +36.750 

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

Health Surveillance and Program Support 379 407 407 -- +28

Health Surveillance and Program Support..................................... 135.123 135.123 135.123 -- 

Program Support (non-add)................................................ 84.500 84.500 84.500 -- 

Health Surveillance (non-add) ............................................. 50.623 50.623 50.623 -- 

Budget Authority (non-add) ............................................. 20.195 20.195 20.195 -- 

PHS Evaluation Funds (non-add)........................................ 30.428 30.428 30.428 -- 

Subtotal, Health Surveillance and Program Support ................... 135.123 135.123 135.123 -- 

Congressional Earmarks.................................................. 160.777 160.777 -- +160.777 

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

Public Awareness and Support............................................. 13.260 13.260 13.260 -- 

Budget Authority (non-add) ............................................. 13.260 13.260 13.260 -- 

Performance and Quality Information Systems.............................. 10.200 10.200 10.200 -- 

Budget Authority (non-add) ............................................. 10.200 10.200 10.200

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

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

Drug Abuse Warning Network............................................. 13.000 13.000 13.000 -- 

Total, Health Surveillance and Program Support ........................... 334.860 334.860 174.083 +160.777 

HSPS Budget Authority (non-add) ......................................... 301.932 301.932 141.155 +160.777 

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

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

TOTAL, SAMHSA Program Level 7,517.583 722 7,517.583 865 8,129.556 865 +611.973 +143

Nonrecurring Expenses Fund (NEF) -- -- 21.95 +21.95-- 

Less Funds from Other Sources:

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

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

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

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

TOTAL, SAMHSA Budget Authority 7,370.416 7,370.416 7,569.889 +199.473 +143
11 

Budget Exhibits

Table of Contents

BUDGET EXHIBITS .........................................................................................................................11 

APPROPRIATIONS LANGUAGE GUIDELINES .........................................................................12 

LANGUAGE ANALYSIS ........................................................................................................17 

AMOUNTS AVAILABLE FOR OBLIGATION ............................................................................24 

SUMMARY OF CHANGES ......................................................................................................25 

BUDGET AUTHORITY BY ACTIVITY .....................................................................................26 

AUTHORIZING LEGISLATION ...............................................................................................27 

APPROPRIATIONS HISTORY .................................................................................................30 

APPROPRIATIONS NOT AUTHORIZED BY LAW .....................................................................31 

 
12 

Appropriations Language Guidelines

MENTAL HEALTH

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

Protection and Advocacy for Individuals with Mental Illness Act, and the SUPPORT for Patients 

and Communities Act, $3,079,007,000: Provided, That of the funds made available under this 

heading, $93,887,000 shall be for the National Child Traumatic Stress Initiative: Provided 

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

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

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

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

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

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

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

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

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

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

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

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

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

psychosis: Provided further, That $450,000,000 shall be available until September 30, 2027 for 

grants to communities and community organizations who meet criteria for Certified Community 

Behavioral Health Clinics pursuant to section 223(a) of Public Law 113–93: Provided further, 

That none of the funds provided for section 1911 of the PHS Act shall be subject to section 241 of 

such Act: Provided further, That of the funds made available under this heading, $21,420,000 

shall be to carry out section 224 of the Protecting Access to Medicare Act of 2014 (Public Law 

113–93; 42 U.S.C. 290aa 22 note). Provided further, That notwithstanding sections 1911(b) and 

1912 of the PHS Act, amounts made available under this heading for subpart I of part B of title 

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

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

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

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

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

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

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

proviso pursuant to plan criteria established by the Secretary. 
13 

SUBSTANCE USE SERVICES

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

XIX of such Act with respect to substance use treatment and prevention, section 1003 of the 21st 

Century Cures Act, and the SUPPORT for Patients and Communities Act, $4,112,848,000: 

Provided, That $1,595,000,000 shall be for carrying out section 1003 of the 21st Century Cures 

Act: Provided further, That of such amount $60,000,000 shall be made available to Indian Tribes 

or tribal organizations: Provided further, That of the amount not reserved by the previous proviso, 

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

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

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

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

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

referral to treatment services, recovery support, and medical screening associated with such 

treatment: Provided further, That in addition to amounts provided herein, the following amounts 

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

otherwise available for substance use treatment activities to carry out subpart II of part B of title 

XIX of the PHS Act to fund section 1935(b) technical assistance, national data, data collection 

and evaluation activities, and further that the total available under this Act for section 1935(b) 

activities shall not exceed 5 percent of the amounts appropriated for subpart II of part B of title 

XIX; and (2) $2,000,000 to evaluate substance use treatment programs: Provided further, That for 

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

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

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

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

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

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

SUBSTANCE USE PREVENTION SERVICES

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

$236,879,000. 

HEALTH SURVEILLANCE AND PROGRAM SUPPORT

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

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

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

Individuals with Mental Illness Act in the Substance Use and Mental Health Services 

Administration, $141,155,000: Provided, That in addition to amounts provided herein, 

$31,428,000 shall be available under section 241 of the PHS Act to supplement funds available to 

carry out national surveys on drug abuse and mental health, to collect and analyze program data, 

and to conduct public awareness and technical assistance activities: Provided further, That, in 

addition, fees may be collected for the costs of publications, data, data tabulations, and data 

analysis completed under title V of the PHS Act and provided to a public or private entity upon 
14 

request, which shall be credited to this appropriation and shall remain available until expended 

for such purposes: Provided further, That amounts made available in this Act for carrying out 

section 501(o) of the PHS Act shall remain available through September 30, 2026: Provided 

further, That funds made available under this heading (other than amounts specified in the first 

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

the headings ‘‘Mental Health’’, ‘‘Substance Abuse Treatment’’, and ‘‘Substance Abuse 

Prevention’’.
15 

General Provisions 

SEC. 238. (a) The Public Health Service Act (42 U.S.C. 201 et seq.) is amended – 

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

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

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

"Center for Substance Use Services"; and 

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

"Center for Substance Use Prevention Services". 

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

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

ADMINISTRATION" and inserting "SUBSTANCE USE AND MENTAL HEALTH SERVICES 

ADMINISTRATION";

(2) in section 501 – 

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

ADMINISTRATION" and inserting "SUBSTANCE USE AND MENTAL HEALTH SERVICES 

ADMINISTRATION"; and 

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

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

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

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

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

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

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

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

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

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

inserting "CENTER FOR SUBSTANCE USE PREVENTION SERVICES". 

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

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

inserting "CENTER FOR SUBSTANCE USE PREVENTION SERVICES".
16 

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

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

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

Administration". 

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

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

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

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

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

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

(h) 

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

paper, or other record of the United States to the Substance Abuse and Mental Health Services 

Administration, the Center for Substance Abuse Treatment of Such Administration, or the Center 

for Substance Abuse Prevention of such Administration shall be considered to be a reference to 

the Substance use And Mental Health Services Administration, the Center for Substance Use 

Services of such Administration, or the Center for Substance Use Prevention Services of such 

Administration, respectively.

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

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

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

Assistant Secretary for Mental Health and Substance Use.
17 

Language Analysis 

Language Provision Explanation

Provided further, That in addition to amounts 

provided herein,

$21,039,000 shall be available under section 241 of 

the PHS Act to supplement funds otherwise 

available for mental health activities and to carry 

out subpart I of part B of title XIX of the PHS Act to 

fund section 1920(b) technical assistance, national 

data, data collection and evaluation activities, and 

further that the total available under this Act for 

section 1920(b) activities shall not exceed 5 percent 

of the amounts appropriated for subpart I of part B 

of title XIX:

Sets the amount of Public Health Service 

Evaluation Fund dollars allocated to 

supplement the budget authority for 

programs for mental health activities and 

programs authorized under titles XIX as 

well as under titles III and V.

Provided further, That of the funds made available 

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

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

available to support evidence-based crisis systems: 

Increases the set-aside in the Community 

Mental Health Services Block Grant for 

crisis services to 10 percent.
18 

Language Provision Explanation

Provided further, That notwithstanding sections 

1911(b) and 1912 of the PHS Act, amounts made 

available under this heading for subpart I of part B 

of title XIX of such Act shall also be available to 

support evidence-based programs that address early 

intervention and prevention of mental disorders 

among at-risk children and adults: Provided further, 

That States shall expend at least 10 percent of the 

amount each receives for carrying out section 1911 

of the PHS Act to support evidence-based programs 

that address early intervention and prevention of 

mental disorders for at-risk youth and adults: 

Provided further, That notwithstanding section 1912 

of the PHS Act, the plan described in such section 

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

include the evidence-based programs described in 

the previous proviso pursuant to plan criteria 

established by the Secretary.

Includes a 10-percent set-aside for 

evidence-based programs that address 

early intervention and prevention of 

mental disorders for at-risk youth and 

adults.

For carrying out titles III and V of the PHS Act with 

respect to substance use treatment and title XIX of 

such Act with respect to substance use treatment and 

prevention, section 1003 of the 21st Century Cures 

Act, and the SUPPORT for Patients and 

Communities Act,

Adds authorization of the State Opioid 

Response program. 

Provided, That $1,595,000,000 shall be for 

carrying out section 1003 of the 21st Century Cures 

Act: Provided further, That of such amount 

$60,000,000 shall be made available to Indian 

Tribes or tribal organizations:

Adds authorization of the State Opioid 

Response program as amended by 

Section 1273 of the Consolidated 

Appropriations Act, 2023 and removes 

duplicative language. Set-aside $60 

million for the Tribal Opioid Response 

program. 
19 

Language Provision Explanation

Provided further, That of the amount not reserved

by the previous provisos, the Secretary shall make 

allocations to States, territories, and the District of 

Columbia according to a formula using data that

the Secretary determines to be the most objective 

and reliable measure of drug use and drug-related 

deaths Provided further, That prevention and 

treatment activities funded through such grants 

may include education, treatment (including the 

provision of medication), behavioral health

services for individuals in treatment programs, 

referral to treatment services, recovery support, 

and medical screening associated with such 

treatment

Provides increased flexibility to use the 

most accurate data.

Provided further, That in addition to amounts

provided herein, the following amounts shall be

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

$79,200,000 to supplement funds otherwise 

available for substance use treatment activities and

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

PHS Act to fund section 1935(b) technical

assistance, national data, data collection and

evaluation activities, and further that the

total available under this Act for section 1935(b) 

activities shall not exceed 5 percent of the amounts 

appropriated for subpart II of part B of title XIX;

and (2) 2 ,000,000 to evaluate substance use

treatment programs:

Sets the amount of Public Health Service

Evaluation Fund dollars allocated to

supplement the budget authority

available for programs and activities

authorized under title XIX, titles III and

V, and substance abuse treatment

activities.
20 

Language Provision Explanation

Provided further, That for purposes of calculating 

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

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

the rate of cases of AIDS:

Uses HIV cases as opposed to AIDS cases 

to calculate the HIV set-aside in the 

Substance Use Prevention, Treatment, and 

Recovery Services Block Grant.

Provided further, That each State that receives funds 

appropriated under this heading in this Act for 

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

PHS Act shall expend not less than 10 percent of 

such funds for recovery support services:

Sets-aside 10 percent of the Substance Use 

Prevention, Treatment, and Recovery 

Services Block Grant for recovery support 

services.

For program support and cross-cutting activities 

that supplement activities funded under the headings 

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

"Substance Use 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 Use and Mental Health 

Services Administration, 

$150,827,000:

Updates names of SAMHSA accounts.
21 

Language Provision Explanation

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

U.S.C. 201 et seq.) is amended – 

(1) by striking "Substance Abuse and Mental 

Health Services Administration" each place it 

appears and inserting "Substance use And Mental 

Health Services Administration"; 

(2) by striking "Center for Substance Abuse 

Treatment" each place it appears and inserting 

"Center for Substance Use Services"; and

(3) by striking "Center for Substance Abuse 

Prevention" each place it appears and inserting 

"Center for Substance Use Prevention Services".

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

U.S.C. 290aa et seq.) is amended – 

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

ABUSE AND MENTAL HEALTH SERVICES

ADMINISTRATION" and inserting "SUBSTANCE 

USE AND MENTAL HEALTH SERVICES 

ADMINISTRATION";

(2) in section 501 – 

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

ABUSE AND MENTAL HEALTH SERVICES

ADMINISTRATION" and inserting "SUBSTANCE 

USE AND MENTAL HEALTH SERVICES 

ADMINISTRATION"; and

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

to in this title as the Administration)" and inserting 

"(hereafterreferred to in this title as SAMHSA or the 

Administration)";

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

"CENTER FOR SUBSTANCE ABUSE

TREATMENT" and inserting "CENTER FOR 

SUBSTANCE USE SERVICES";

Changes the name of the Substance 

Abuse and Mental Health Services 

Administration to the Substance use And 

Mental Health Services Administration.

Changes the name of the Center for 

Substance Abuse Treatment to the 

Center for Substance Use Services.

Changes the name of the Center for 

Substance Abuse Prevention to the 

Center for Substance Use Prevention 

Services.
22 

Language Provision Explanation

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

striking "CENTER FOR SUBSTANCE ABUSE

TREATMENT" and inserting "CENTER FOR 

SUBSTANCE USE SERVICES"; and

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

"CENTER FOR SUBSTANCE ABUSE

PREVENTION" and inserting "CENTER FOR 

SUBSTANCE USE PREVENTION SERVICES".

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

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

paragraph heading by striking "CENTER FOR 

SUBSTANCE ABUSE PREVENTION" and inserting 

"CENTER FOR SUBSTANCE USE PREVENTION 

SERVICES".

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

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

paragraph heading by striking "CENTER FOR 

SUBSTANCE ABUSE PREVENTION" and inserting 

"CENTER FOR SUBSTANCE USE PREVENTION 

SERVICES".

(e) The Indian Alcohol and Substance Abuse 

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

2401 et seq.) is amended by striking "Substance 

Abuse and Mental Health Services Administration" 

each place it appears and inserting "Substance use 

And Mental Health Services Administration". 

(f) The Social Security Act is amended in sections 

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

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

Mental Health Services Administration" each place 

it appears and inserting "Substance use And Mental 

Health Services Administration". 

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

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

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

"Substance Abuse and Mental Health Services 

Administration" and inserting "Substance use And 

Mental Health Services Administration". 
23 

Language Provision Explanation

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

reference in any law, regulation, map, document, 

paper, or other record of the United States – 

(1) to the Substance Abuse and Mental Health 

Services Administration shall be considered to be a 

reference to the Substance use And Mental Health 

Services Administration;

(2) to the Center for Substance Abuse Treatment of 

such Administration shall be treated as a reference 

to the Center for Substance Use Services of such 

Administration; and 

(3) to the Center for Substance Abuse Prevention of 

such Administration shall be treated as a reference 

to the Center for Substance Use Prevention Services 

of such Administration. 

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

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

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

to the Administrator of the Substance Abuse and 

Mental Health Services Administration shall be 

construed to be a reference to the Assistant 

Secretary for Mental Health and Substance Use.
24 

Amounts Available for Obligation

(Whole dollars)

FY 2023

Final

FY 2024

CR

FY 2025

President's 

Budget

General Fund Discretionary Appropriation:

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

 

$7,370,416,000 

 

$7,370,416,000 

 

$7,569,889,000 

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

 

---

 

---

 

---

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

 

7,370,416,000 

 

7,370,416,000 

 

7,569,889,000 

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

 

---

 

---

 

---

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

 

7,370,416,000 

 

7,370,416,000 

 

7,569,889,000 

Bipartisan Safer Communities Act

Advanced Appropriation 162,500,000 162,500,000 162,500,000

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

 

7,532,916,000

 

7,532,916,000

 

7,732,389,000

Mandatory Appropriation:

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

 

12,000,000 

 

12,000,000 

 

12,000,000 

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

 

---

 

---

 

412,500,000 

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

 

12,000,000 

 

12,000,000 

 

424,500,000 

Offsetting collections from:

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

 

133,667,000 

 

133,667,000 

 

133,667,000 

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

 

1,500,000 

 

1,500,000 

 

1,500,000 

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

 

---

 

---

 

---

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

 

---

 

---

 

---

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

 

---

 

---

 

---

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

 

$7,680,083,000 $7,680,083,000

 

$8,292,056,000
25 

Summary of Changes

(Dollars in millions) 

Dollars FTEs

FY 2023 CR

Total estimated budget authority 7,370.416 722

7,370.416 722

FY 2025 President's Budget

Total estimated budget authority 7,569.889 865 

7,569.889 865 

Net Change 199.473 143 

FY 2023 Final

FY 2025 President's 

Budget FY 2025 +/- FY 2023

BA FTE BA FTE BA FTE

Increases:

A. Built-in:

1. Annualization of 2023 commissioned corps pay increase 6.861 -- 7.543 -- 0.682 ---

2. Annualization of 2023 civilian pay increase 117.502 -- 145.255 -- 27.753 ---

Subtotal, Built-in Increases 124.363 -- 152.797 -- 28.434 ---

B. Program:

1. Mental Health 2,755.507 141 3,079.007 184 323.500 +43

2. Substance Use Prevention --- 93 --- 83 --- -10

3.Substance Use Services 4,076.098 109 4,112.848 175 36.750 +66

4. Health Surveillance and Program Support --- 379 --- 423 --- +44

Congressional Earmarks

Subtotal, Program Increases 6,831.605 865 7,191.855 865 360.250 +143

Total Increases 6,960.662 865 7,344.652 865 383.990 +143

Decreases:

A. Built-in:

1. Absorption of built-in increases --- -28.434 ---

Subtotal, Built-in Decreases --- -28.434 ---

B. Program:

4. Health Surveillance and Program Support

Congressional Earmarks 160.777 --- --- --- -160.777 ---

Subtotal, Program Decreases 160.777 --- --- --- -160.777 ---

Total Decreases 160.777 --- --- --- -189.211 ---

Net Change 199.473 +143
26 

Budget Authority by Activity

(Dollars in millions) 

 FY 2023 Final FY 2024 CR

FY 2025 

President's 

Budget

Mental Health

Programs of Regional and National Significance.............................................................. $1,044,033 $1,044,033 $1,217,533 

National Child Traumatic Stress Network................................................................... 93,887 93,887 93,887 

Assisted Outpatient Treatment for Individuals with SMI............................................... 21,420 21,420 21,420 

Children's Mental Health Services............................................................................... 130,000 130,000 180,000 

Set-Aside for Youth in Prodrome Phase of Psychosis (non-add) ......................... 13,000 13,000 18,000 

Projects for Assistance in Transition from Homelessness.............................................. 66,635 66,635 66,635 

Protection and Advocacy for Individuals with Mental Illness........................................ 40,000 40,000 40,000 

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

Community Mental Health Services Block Grant......................................................... 1,007,571 1,007,571 1,042,571 

Budget Authority (non-add) ................................................................................. 986,532 986,532 1,021,532 

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

Certified Community Behavioral Health Clinics............................................................ 385,000 385,000 450,000 

Total, Mental Health .................................................................................................. 2,788,546 2,788,546 3,524,546 

Substance Use Prevention Services

Programs of Regional and National Significance.............................................................. 236,879 236,879 236,879 

Total, Substance Use Prevention Services................................................................ 236,879 236,879 236,879 

Substance Use Services

Programs of Regional and National Significance.............................................................. 574,219 574,219 590,969 

State Opioid Response Grants.................................................................................... 1,575,000 1,575,000 1,595,000 

Set-Aside for Tribes (non-add) ......................................................................... 55,000 55,000 55,000 

Substance Use Prevention, Treatment, and Recovery Services Block Grant................. 2,008,079 2,008,079 2,008,079 

Budget Authority (non-add) ................................................................................. 1,928,879 1,928,879 1,928,879 

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

Total, Substance Use Services................................................................................... 4,157,298 4,157,298 4,194,048 

Health Surveillance and Program Support

Health Surveillance and Program Support 135,123 135,123 135,123 

Program Support (non-add) ........................................................................................ 84,500 84,500 84,500 

Health Surveillance (non-add) ..................................................................................... 50,623 50,623 50,623 

Budget Authority (non-add) ................................................................................. 20,195 20,195 20,195 

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

Subtotal, Health Surveillance and Program Support 135,123 135,123 135,123 

Congressional Earmarks......................................................................................... 160,777 160,777 --

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

Public Awareness and Support................................................................................... 13,260 13,260 13,260 

Budget Authority (non-add) ................................................................................. 13,260 13,260 13,260 

Performance and Quality Information Systems............................................................. 10,200 10,200 10,200 

Budget Authority (non-add) ................................................................................. 10,200 10,200 10,200 

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

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

Drug Abuse Warning Network................................................................................... 13,000 13,000 13,000 

Total, Health Surveillance and Program Support...................................................... 334,860 334,860 174,083 

HSPS Budget Authority (non-add) ........................................................................... 301,932 301,932 141,155 

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

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

TOTAL, SAMHSA Program Level............................................................................ 7,517,583 7,517,583 8,129,556 

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

Less Funds from Other Sources:

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

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

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

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

TOTAL, SAMHSA Budget Authority........................................................................ $7,370,416 $7,370,416 $7,569,889 

FTEs 722 865 865 
27 

Substance use And Mental Health Services Administration

Authorizing Legislation

(Whole dollars) 

Activity

FY 2024 

Amount 

Authorized

FY 2024 

Amount 

Appropriated

FY 2025 

Amount 

Authorized

FY 2025 

President's 

Budget

1. Grants for the Benefit of Homeless Individuals $ 41,304,000 $ 37,114,000 $ 41,304,000 $ 37,114,000 

PHS Act, Section 506..............................................................................

2. Residential Treatment Programs for Pregnant and Postpartum Women $ - $ 38,931,000 $ - $ 43,931,000 

PHS Act, Section 508..............................................................................

3. Priority Substance Use Disorder Treatment Needs of Regional and 

National Significance

$ 521,517,000 $ 574,219,000 $ 521,517,000 $ 590,969,000 

PHS Act, Section 509.............................................................................

4. Substance Use Disorder Treatment and Early Intervention Services for 

Children, Adolescents, and Young Adults

$ 29,600,000 $ 30,197,000 $ 29,600,000 $ 30,197,000 

PHS Act, Section 514...............................................................................

5. Priority Substance Use Disorder Prevention Needs of Regional and 

National Significance

$ 218,219,000 $ 245,738,000 $ 218,219,000 $ 245,738,000 

PHS Act, Section 516...................................................................................

6. Sober Truth on Preventing Underage Drinking $ 15,000,000 $ 14,500,000 $ 14,500,000 $ 14,500,000 

PHS Act, Section 519B................................................................................

7. Priority Mental Health Needs of Regional and National Significance $ 599,036,000 $ 1,044,033,000 $ 599,036,000 $ 1,217,533,000 

PHS Act, Section 520A................................................................................

8. Suicide Prevention Technical Assistance Center $ 9,000,000 $ 11,000,000 $ 9,000,000 $ 11,000,000 

PHS Act, Section 520C................................................................................

9. Youth Suicide Early Intervention and Prevention Strategies $ 40,000,000 $ 43,806,000 $ 40,000,000 $ 43,806,000 

PHS Act, Section 520E................................................................................

10. Mental Health and Substance Use Disorder Services for Students in 

Higher Education

$ 7,000,000 $ 8,488,000 $ 7,000,000 $ 8,488,000 

PHS Act, Section 520E-2............................................................................

11. 988 and Behavioral Health Crisis Services $ 101,621,000 $ 501,618,000 $ 101,621,000 $ 601,618,000 

PHS Act, Section 520A...............................................................................
28 

Authorizing Legislation (continued)

(Whole dollars) 

Activity

FY 2024 

Amount 

Authorized

FY 2024 

Amount 

Appropriated

FY 2025 

Amount 

Authorized

FY 2025 

President's 

Budget

12. Grants for Jail Diversion Programs $ 14,000,000 $ 11,269,000 $ 14,000,000 $ 11,269,000 

PHS Act, Section 520G.........................................................................

13. Mental Health Awareness Training Grants $ 24,963,000 $ 27,963,000 $ 24,963,000 $ 27,963,000 

PHS Act, Section 520J..........................................................................

14. Improving uptake and patient access to integrated care services $ 60,000,000 $ 57,868,000 $ 60,000,000 $ 57,868,000 

PHS Act, Section 520K.........................................................................

15. Adult Suicide Prevention $ 30,000,000 $ 28,200,000 $ 30,000,000 $ 29,950,000 

PHS Act, Section 520L.........................................................................

16. Assertive Community Treatment Grant Program $ 9,000,000 $ 9,000,000 $ 9,000,000 $ 9,000,000 

PHS Act, Section 520M........................................................................

17. Projects for Assistance in Transition From Homelessness $ 64,635,000 $ 66,635,000 $ 64,635,000 $ 66,635,000 

PHS Act, Sections 521-535(a)...............................................................

18. First Responder Training $ - $ 56,000,000 $ - $ 56,000,000 

PHS Act, Section 546............................................................................

19. Building Communities of Recovery $ - $ 16,000,000 $ - $ 16,000,000 

PHS Act, Section 547............................................................................

20. Comprehensive Community Mental Health Services for Children 

with Serious Emotional Disturbances

$ 125,000,000 $ 130,000,000 $ 125,000,000 $ 180,000,000 

PHS Act, Sections 561-565(ff)..............................................................

21. Grants to Address the Problems of Persons Who Experience 

Violence Related Stress

$ - $ 93,887,000 $ - $ 93,887,000 

PHS Act, Section 582............................................................................
29 

Authorizing Legislation (continued)

(Whole dollars) 

Activity

FY 2024 

Amount 

Authorized

FY 2024 

Amount 

Appropriated

FY 2025 

Amount 

Authorized

FY 2025 

President's 

Budget

22. Community Mental Health Services Block Grants $ 857,571,000 $ 1,007,571,000 $ 857,571,000 $ 1,042,571,000 

PHS Act, Section 1911-1920...........................................................

23. Substance Abuse Prevention and Treatment Block Grants $ 1,908,079,000 $ 2,008,079,000 $ 1,908,079,000 $ 2,008,079,000 

PHS Act, Section 1921-1935..............................................................

24. Assisted Outpatient Treatment Grant Program for Individuals 

With SMI

$ 22,000,000 $ 21,420,000 $ 22,000,000 $ 21,420,000 

Section 224 of the Protecting Access to Medicare Act of 2014...

25. Protection and Advocacy for Individuals with Mental Illness* $ - $ 40,000,000 $ - $ 40,000,000 

Section 117 of the Protection and Advocacy of Mentally Ill 

Individuals Act of 1986.....................

26. Heath Surveillance and Program Support $ 135,123,000 $ 135,123,000 $ 137,795,000 $ 135,123,000 

PHS Act, Section 501, 505.................................................................

27. Public Awareness and Support $ 13,260,000 $ 13,260,000 $ 13,260,000 $ 13,260,000 

PHS Act, Section 501, 509, 516, 520A..............................................

28. Performance and Quality Information Systems $ 10,200,000 $ 10,200,000 $ 10,200,000 $ 10,200,000 

PHS Act, Section 501, 509, 516, 520A..............................................

29. Drug Abuse Warning Network $ 13,000,000 $ 13,000,000 $ 20,000,000 $ 13,000,000 

PHS Act, Section 505.........................................................................

30. Minority Fellowship Program $ 25,000,000 $ 19,516,000 $ 25,000,000 $ 19,516,000 

PHS Act, Section 597 ...................................................................

31. Trauma-Informed Services in Schools $ - $ 12,000,000 $ - $ 12,000,000 

Section 7134 of P.L. 115-271 .......................................................

32. Infant and Early Childhood Mental Health Program $ 50,000,000 $ 15,000,000 $ 50,000,000 $ 15,000,000 

PHS Act, Section 399Z–2 ............................................................

33. Mental health crisis response partnership pilot program $ 10,000,000 $ 20,000,000 $ 10,000,000 $ 40,000,000 

PHS Act, 520F ............................................................................

34. Center of Excellence for Eating Disorders for education and 

training on eating disorders

$ 1,000,000 $ - $ 1,000,000 $ - 

PHS Act, 520N .........................................................................
30 

Appropriations History

(Whole dollars) 

Budget Estimate to 

Congress

House 

Allowance

Senate 

Allowance Appropriation

FY 2016

General Fund Appropriation:

Annual (P.L. 114-113) $3,395,663,000 $3,642,710,000 $3,314,817,000 $3,634,269,000

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

FY 2017

General Fund Appropriation:

Supplemental (21st Century Cures Act) $500,000,000

Annual (P.L. 115-31) $3,488,783,000 $4,211,603,000 $3,739,577,000 $3,611,003,000

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

FY 2018

General Fund Appropriation:

Supplemental (21st Century Cures Act) $500,000,000

Annual (P.L. 115-141) $3,770,668,000 $4,193,936,000 $4,279,092,000 $4,513,327,000

Subtotal $3,770,668,000 $4,193,936,000 $4,279,092,000 $5,013,327,000

FY 2019

General Fund Appropriation:

Annual (P.L. 115-245) $3,425,887,000 $5,319,561,000 $5,592,827,000 $5,596,829,000

Subtotal $3,425,887,000 $5,319,561,000 $5,592,827,000 $5,596,829,000

FY 2020

General Fund Appropriation:

Supplemental (CARES Act P.L. 116-136) --- --- --- $425,000,000

Annual (P.L. 116-94) $5,534,908,000 $5,870,996,000 $5,856,496,000 $5,736,829,000

Subtotal $5,534,908,000 $5,870,996,000 $5,856,496,000 $5,736,829,000

FY 2021

General Fund Appropriation:

Supplemental (American Rescue Plan Act of 2021 P.L. 117-2) --- --- --- $3,560,000,000

Supplemental:

(Coronavirus Emergency Response and Relief Act P.L. 116-260) --- --- --- $4,250,000,000

Annual (P.L. 116-260) $5,597,651,000 $5,830,829,000 $5,853,840,000 $5,869,841,000

Subtotal $5,597,651,000 $5,830,829,000 $5,853,840,000 $13,679,841,000

FY 2022

General Fund Appropriation:

Supplemental (Bipartisan Safer Communities Act P.L. 117-159) --- --- --- $312,500,000

Annual (P.L. 117-103) $9,586,844,000 $9,014,610,000 $8,957,412,000 $6,399,935,000

Subtotal $9,586,844,000 $9,014,610,000 $8,957,412,000 $6,712,435,000

FY 2023

General Fund Appropriation:

Annual (P.L. 117-328) $10,137,487,000 $9,024,713,000 $9,002,834,000 $7,370,416,000

Subtotal $10,137,487,000 $9,024,713,000 $9,002,834,000 $7,370,416,000

FY 2024

General Fund Appropriation:

Annual (P.L. 118-15) $10,274,808,000 $6,975,882,000 $7,333,639,000 $7,370,416,000

Subtotal $10,274,808,000 $6,975,882,000 $7,333,639,000 $7,370,416,000

FY 2025

General Fund Appropriation:

Base $7,569,889,000 --- --- ---

Subtotal $7,569,889,000 --- --- ---
31 

Appropriations Not Authorized by Law

(Whole dollars) 

Program

Last Year of 

Authorization

Authorization 

Level

Appropriations in 

Last Year of 

Authorization

Appropriations 

in FY 2024

Protection and Advocacy for Individuals with Mental Illness Act

P.L. 99-319, Sec. 117 2003 $ 19,500,000 $ 40,000,000 $ 40,000,000

TOTAL, SAMHSA Budget Authority $ 19,500,000 $ 40,000,000 $ 40,000,000
32 

Mental Health

 

Table of Contents 

Mental Health.....................................................................................................................32 

Summary of the Request ....................................................................................................33 

Programs of Regional and National Significance (PRNS) ................................................35 

Project AWARE ............................................................................................................36 

Mental Health Awareness Training .............................................................................41

Healthy Transitions ......................................................................................................44

Children and Family Programs ...................................................................................47

Consumer and Family Network Grants .......................................................................49

Project LAUNCH .........................................................................................................51

Mental Health System Transformation and Health Reform ........................................55

Primary and Behavioral Health Care Integration.......................................................58

Suicide Prevention Programs ......................................................................................62 

988 and Behavioral Health Crisis Services ...........................................................63 

National Strategy for Suicide Prevention ..............................................................66 

Garrett Lee Smith Youth Suicide Prevention – State/Tribal and Campus .............69 

Suicide Prevention Resource Center .....................................................................71 

American Indian/Alaska Native Suicide Prevention Initiative ..............................73 

Mental Health Crisis Response Partnership Program ................................................76 

Homelessness Prevention Programs ............................................................................78 

Minority AIDS ..............................................................................................................80

Criminal and Juvenile Justice Programs .....................................................................83

Practice Improvement and Training ............................................................................87

Consumer and Consumer-Supporter TA Centers ........................................................89

Disaster Response ........................................................................................................91

Seclusion and Restraint ................................................................................................95

Assertive Community Treatment for Individuals with Serious Mental Illness .............97

Tribal Behavioral Health Grants ...............................................................................100

Minority Fellowship Program ...................................................................................103

Infant and Early Childhood Mental Health ...............................................................107

Interagency Task Force on Trauma-Informed Care ..................................................110 

Women Behavioral Health Technical Assistance Center ..........................................112

National Child Traumatic Stress Network .......................................................................114 

Assisted Outpatient Treatment for Individuals with Serious Mental Illness ...................118 

Children’s Mental Health Services ..................................................................................121 

Projects for Assistance in Transition from Homelessness ...............................................125 

Protection and Advocacy for Individuals with Mental Illness (PAIMI)..........................130 

Certified Community Behavioral Health Clinics (CCBHC) ...........................................135 

PRNS Mechanism Table ............................................................................................139

Grant Awards Table ...................................................................................................142

Community Mental Health Services Block Grant (MHBG) ............................................143 

Community Mental Health Centers (CMHC) ..................................................................159 
33 

Mental Health

Summary of the Request

(Dollars in millions) 

Programs of Regional and National Significance

FY 2023 

Final FY 2024 CR

FY 2025 

President's 

Budget 

FY 2025 +/- 

FY 2023 

CMHS

Programs of Regional and National Significance................................... 1,044.033 1,044.033 1,217.533 +173.500 

National Child Traumatic Stress Network.......................................... 93.887 93.887 93.887 -- 

Assisted Outpatient Treatment for Individuals with SMI.................... 21.420 21.420 21.420 -- 

Children's Mental Health Services...................................................... 130.000 130.000 180.000 +50.000 

Set-Aside for Youth in Prodrome Phase of Psychosis (non-add)..... 13.000 13.000 13.000 -- 

Projects for Assistance in Transition from Homelessness.................. 66.635 66.635 66.635 -- 

Protection and Advocacy for Individuals with Mental Illness............. 40.000 40.000 40.000 -- 

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

Community Mental Health Services Block Grant............................... 1,007.571 1,007.571 1,042.571 +35.000 

Budget Authority (non-add)........................................................... 986.532 986.532 1,021.532 +35.000 

 Evidence-Based Crisis Systems (Non add)....................................... -- -- -- -- 

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

Certified Community Behavioral Health Clinics................................. 385.000 

 

385.000 450.000 +65.000 

Total, Mental Health ........................................................................ 2,788.546 

 

2,788.546 3,524.546 +736.000 

Budget Authority (non-add).............................................................. 2,755.507 2,755.507 3,079.007 +323.500 

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

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

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

FTE 141 190 190 +49 

The Mental Health FY 2025 President’s Budget Request is $3.5 billion, an increase of $736 million 

from the FY 2023 Final level. 

 

SAMHSA’s Center for Mental Health Services (CMHS) manages over 40 formula and 

discretionary grant programs, with approximately 2,500 grant and technical assistance programs 

throughout the US. The programming, which covers individuals’ lifespan, funds interventions 

across the full range of the public health model, from mental health promotion, case 

identification/screening, early intervention, treatment, and recovery support services. A portion of 

CMHS’ programming, particularly the programming focused on mental health promotion and case 

identification, apply to children and adults experiencing Any Mental Illness (AMI). However, 

much of CMHS’ programming is targeted towards supporting and treating adults with Serious 

Mental Illness (SMI) and children with Serious Emotional Disturbance (SED).

 

CMHS’ grant and technical assistance programs are a critical response to our nation’s mental 

health crisis. The programs increase access to quality services that include mental health 

promotion, early intervention, treatment, and recovery supports for individuals across the lifespan. 

CMHS grants support direct services, infrastructure development, capacity building, and technical 

assistance to enhance the behavioral health system for all Americans. SAMHSA programs meet 

people where they are through supporting services beyond office based behavioral health systems, 

such as in primary healthcare clinics, schools, child welfare, criminal and juvenile justice, and 

supported housing services. 

 
34 

In designing and maintaining these programs, CMHS collaborates with federal partners and often 

requires grantees to engage with related state or community providers to ensure alignment and 

impact. This cross-agency collaboration also contributes to SAMHSA’s overall efforts to address

the need for an integrated, comprehensive crisis response and intervention system, as charged by 

Congress. CMHS programs also advance the HHS Strategic Plan FY 2022-2026 objectives to 

bolster the health workforce, strengthen early childhood development, expand access to highquality services and resources, support those who have experienced trauma or violence, and 

prioritize evidence-based practices.

In FY 2025, the President’s budget provides increases for several programs to support key 

behavioral health priorities. This includes a $50 million increase for Project AWARE ($190) 

million), a $100 million increase for 988 Suicide and Crisis Lifeline ($602 million), a $1.75 million 

increase for a new program addressing suicide and older adults, an increase of $20 million for 

Crisis Response grants ($40 million), and $1.75 million for a new Women’s Behavioral Health 

Technical Assistance Center (with additional funding from CSUS). It also includes a $50 million 

increase in the Children’s Mental Health Services program ($180 million), a $35 million increase 

for the Community Mental Health Services Block Grant ($1.0 billion), a $65 million increase for 

the Certified Community Behavioral Health Clinics ($450 million) and $413 million for a new 

mandatory Community Mental Health Centers program. 
35 

Mental Health

Programs of Regional and National Significance (PRNS)

(Dollars in millions)

FY 2023 

Final 

FY 2024 

CR 

FY 2025 

President's 

Budget

FY 2025 

+/- FY 

2023

Capacity

Programs of Regional and National Significance..................................... 1,044.033 1,044.033 1,217.533 173.500 

Project AWARE................................................................................. 140.001 140.001 190.001 50.000 

Project AWARE: State Grants(non-add).......................................... 110.501 110.501 160.501 50.000 

Project AWARE: Civil Unrest(non-add)........................................... 17.500 17.500 17.500 -- 

Project AWARE -School-based Trauma-Informed Care (non-add).. 12.000 12.000 12.000 -- 

Mental Health Awareness Training..................................................... 27.963 27.963 27.963 -- 

Healthy Transitions............................................................................ 30.451 30.451 30.451 -- 

Children and Family Programs............................................................ 7.229 7.229 7.229 -- 

Consumer and Family Network Grants................................................ 4.954 4.954 4.954 -- 

MH System Transformation and Health Reform................................. 3.779 3.779 3.779 -- 

Project LAUNCH............................................................................... 25.605 25.605 25.605 -- 

Primary and Behavioral Health Care Integration................................. 55.877 55.877 55.877 -- 

Suicide Prevention Programs........................................................ 

988 and Behavioral Health Crisis Services.................................... 501.618 501.618 601.618 100.000 

National Strategy for Suicide Prevention.......................................... 28.200 28.200 29.950 1.750 

Suicide Prevention and Older Adults (non-add)..................... -- -- 1.750 1.750 

Zero Suicide (non-add)................................................................ 26.200 26.200 26.200 -- 

Zero Suicide American Indian and Alaska Native (non-add).. 3.400 3.400 3.400 -- 

All Other National Strategy for Suicide Prevention (non-add)...... 2.000 2.000 2.000 -- 

GLS - Youth Suicide Prevention - States........................................... 43.806 43.806 43.806 -- 

Budget Authority (non-add)......................................................... 31.806 31.806 31.806 -- 

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

GLS - Youth Suicide Prevention - Campus........................................ 8.488 8.488 8.488 -- 

GLS - Suicide Prevention Resource Center........................................ 11.000 11.000 11.000 -- 

AI/AN Suicide Prevention Initiative................................................. 3.931 3.931 3.931 -- 

MH Crisis Response Partnership Pilot Program Grants.. 20.000 20.000 40.000 20.000 

Homelessness Prevention Programs.................................................... 33.696 33.696 33.696 -- 

Criminal and Juvenile Justice Programs............................................... 11.269 11.269 11.269 -- 

Assertive Community Treatment for Individuals with SMI.................. 9.000 9.000 9.000 -- 

Minority AIDS.................................................................................... 9.224 9.224 9.224 -- 

Seclusion & Restraint.......................................................................... 1.147 1.147 1.147 -- 

Tribal Behavioral Health Grants 22.750 22.750 22.750 -- 

Infant and Early Childhood Mental Health.......................................... 15.000 15.000 15.000 -- 

Women's Behavioral Health Technical Assistance Center................... -- -- 1.750 1.750 

Interagency Task Force on Trauma-Informed Care........ 2.000 2.000 2.000 -- 

Subtotal, Capacity 1,016.988 1,016.988 1,190.488 173.500

Science and Service

Primary and Behavioral Health Care Integration TTA........................ 1.991 1.991 1.991 -- 

Practice Improvement and Training................................................... 7.828 7.828 7.828 -- 

Consumer and Consumer Support TA Centers..................................... 1.918 1.918 1.918 -- 

Disaster Response............................................................................... 1.953 1.953 1.953 -- 

Homelessness...................................................................................... 2.296 2.296 2.296 -- 

MH Minority Fellowship Program...................................................... 11.059 11.059 11.059 -- 

Subtotal, Science and Services 27.045 27.045 27.045 -- 

Subtotal, Programs of Regional and National Significance 1,044.033 1,044.033 1,217.533 173.500 
36 

Project AWARE

(Dollars in millions)

Programs of Regional and National Significance

FY 2023 

Final 

FY 2024 

CR 

FY 2025 

President's 

Budget 

FY 2025 +/- 

FY 2023 

Project AWARE................................................................................ 140.001 140.001 190.001 50.000 

Project AWARE: State Grants(non-add) ......................................... 110.501 110.501 160.501 50.000 

Project AWARE: Civil Unrest(non-add) ......................................... 17.500 17.500 17.500 -- 

Project AWARE -School-based Trauma-Informed Care (non-add) 12.000 12.000 12.000 -- 

Authorizing Legislation .... Sections 520A and 520J of the Public Health Service Act; Section 

7134 (42 USC 280h-7) of the SUPPORT Act for Patients and Communities Act (P.L. 115-271) 

FY 2025 Authorization............................................................................................... $190,001,000 

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

Eligible Entities ............................................................................... ....State and Local Education 

Agencies, Local Governmental Entities, Community Organizations and Provider Organizations,

Community Colleges, Networks, National Non-Profit Organizations, States and Tribes

Program Description

According to the CDC Web-based Injury Statistic Query and Reporting Systems Leading Causes 

of Death Reports,10 suicide was the second leading cause of death among individuals between the 

ages of 10-14, and the third leading cause of death among individuals between the ages of 15-24 

in 2021.11 In 2021, 42% of high school students felt so sad or hopeless almost every day for at 

least two weeks in a row that they stopped doing their usual activities. Female students were more 

likely than male students to experience persistent feelings of sadness or hopelessness.12 In 2021, 

22% of high school students seriously considered attempting suicide during the past year. Female 

students were more likely than male students to seriously consider attempting suicide. LGBTQI+ 

students and students who had any same-sex partners were more likely than their peers to seriously 

consider attempting suicide. Multiracial students were more likely than Asian, Black, and White 

students to experience persistent feelings of sadness or hopelessness. LGBTQI+ students and 

students who had any same-sex partners were more likely than their peers to experience persistent 

feelings of sadness or hopelessness.13

 

Project AWARE (Advancing Wellness and Resiliency in Education) is made up of three 

components: Project AWARE; ReCAST (Resilience in Communities after Stress and Trauma); 

and Cooperative Agreements for School-Based Trauma-Informed Support Services and Mental 

10 Centers for Disease Control and Prevention. (2021). Web-based Injury Statistics Query and Reporting System. Retrieved from: 

https://wisqars.cdc.gov/lcd/?o=LCD&y1=2021&y2=2021&ct=10&cc=ALL&g=00&s=0&r=0&ry=0&e=0&ar=lcd1age&at=groups&ag=lcd1age

&a1=0&a2=199. 11 ibid

12 Center for Disease Control and Prevention. (2023). Youth Risk Behavior Survey: Data Summary and Trends Report. Retrieved 

from: https://www.cdc.gov/healthyyouth/data/yrbs/pdf/YRBS_Data-Summary-Trends_Report2023_508.pdf. 13 Center for Disease Control and Prevention. (2023). Youth Risk Behavior Survey: Data Summary and Trends Report. Retrieved 

from: https://www.cdc.gov/healthyyouth/data/yrbs/pdf/YRBS_Data-Summary-Trends_Report2023_508.pdf. 
37 

Health Care for Children and Youth (Trauma-Informed Services in Schools). All three programs 

are a part of a comprehensive mental health project that focuses on building infrastructure within 

schools and communities to provide trauma-informed, developmentally appropriate, and culturally 

competent services to children and youth, their families, and their communities. 

Established in 2014, Project AWARE grantees develop collaborative partnerships that include the 

State Education Agency (SEA), Local Education Agency (LEA), Tribal Education Agency (TEA), 

the State Mental Health Agency (SMHA), community-based providers of behavioral health care 

services, school personnel, community organizations, families, and school-aged youth. In FY 

2022, eligibility for funding expanded beyond State Education Agencies and Tribal Education 

Agencies to include political subdivisions of States; health facilities, or programs operated by or 

in accordance with a contract or award with the Indian Health Service; or other public or private 

non-profit entities. Award recipients will leverage their partnerships to implement mental health 

related promotion, awareness, prevention, intervention, and resilience activities to ensure that 

school-aged youth have access and are connected to appropriate and effective behavioral health 

services. SAMHSA expects that this program will promote the healthy social and emotional 

development of school-aged youth and prevent youth violence in school settings. 

 

ReCAST

Established in 2016, ReCAST grantees support efforts in high-crime, high-poverty communities 

that have experienced civil unrest, community violence, and collective trauma within the previous 

24 months. In FY 2022, eligibility was expanded beyond local municipalities to include public or 

private non-profit community organizations. ReCAST grantees are guided by a community-based 

coalition of residents and community-based, non-profit organizations, in partnership with other 

entities (e.g., health and human service providers, schools, institutions of higher education, faithbased organizations, businesses, state and local government, law enforcement, and employment, 

housing, and transportation services agencies). ReCAST grantees work to create more equitable 

access to trauma-informed community behavioral health resources and strengthen the integration 

of behavioral health services and other community systems to address the social determinants of 

health. Through these community-based coalitions, ReCAST grantees build a foundation to 

promote well-being, resiliency, and change that promote community and youth engagement using 

community-based participatory approaches.

 

School-Based Trauma-Informed Support Services and Mental Health Care for Children 

and Youth (Trauma-Informed Services in Schools)

Established in FY 2022, Trauma-Informed Services in Schools grantees increase students’ access 

to evidence-based, culturally relevant, and trauma-informed mental health care by developing 

innovative initiatives, activities, and programs to link local school systems with mental health 

systems and support, including those under the Indian Health Service. The COVID-19 pandemic 

increased the need for school and community-based trauma-informed services for children and 

youth, and their families. The collaborative efforts of this program will create and/or improve 

identification, referral, early intervention, and treatment, and support services for students that 

need specialized support. With this program, SAMHSA aims to further enhance and improve 

trauma-informed support and mental health services for children and youth. 

 
38 

Budget Request

The FY 2025 President’s Budget Request is $190.0 million, an increase of $50.0 million from the 

FY 2023 Final level. Funding for this program will support 48 continuations as well as a new 

cohort of 33 grants for Project AWARE grants, 13 continuations for School-based Trauma grants, 

four continuations for LBGTQI family support grants, and 17 continuations for ReCAST grants.

The funding will support the programs’ focus and expand the programs’ training settings to include 

non-educational and non-health care sites. It is expected that the additional funding for Project 

AWARE will help to identify and refer approximately 35,000 additional school-aged youth to 

mental health and related services, for a total of 135,000; and to train an additional 105,000 mental 

health and mental health-related professionals on evidence-based mental health practices, for a 

total of 405,000 professionals. 

Funding History Table

Fiscal Year Amount

FY 2021 $105,117,728

FY 2022 $119,984,000

FY 2023 Final $140,001,000

FY 2024 CR $140,001,000

FY 2025 President’s Budget $190,001,000

.

Program Accomplishments

Project AWARE

In FY 2023, SAMHSA funded 62 Project AWARE grant continuations (35 continuation grants 

with base budget authority, four grants with American Rescue Plan Act funds, and 25 grants with 

Bipartisan Safer Community Act) and awarded a new cohort of 26 grants (with base budget 

authority). In FY 2023, Project AWARE grantees trained 309,953 individuals in mental health and 

related practices; screened 299,815 children and youth for mental health related concerns; and 

referred 92,205 children and youth for mental health services and treatment. 

In FY 2024, SAMHSA anticipates funding 63 continuation grants. In FY 2024, it is estimated that 

the number of individuals trained in mental health-related practices will increase to 440,000; that 

the number of children and youth screened for mental health-related concerns will increase to 

450,000; and that the number of children and youth referred to mental health and related services 

will increase to 120,000. 

 
39 

ReCAST

In FY 2023, SAMHSA funded 20 grant continuations (10 continuation grants with base budget 

authority and 10 with Bipartisan Safer Community Act) and awarded seven new grants. In FY 

2023, the ReCAST grantees trained 14,441 individuals; reached 198,445 community members 

with mental health messaging addressing trauma-informed practices; and provided evidence-based 

mental health-related services to 15,922 individuals. In addition, because of ReCAST, 1,421 

organizations have collaborated on shared resources and coordinated mental health services with 

ReCAST grantees to provide resilience and equity in communities that have recently faced civil 

unrest. 

In FY 2024, SAMHSA anticipates funding 27 continuation grants (17 continuation grants with 

base budget authority and 10 grants with Bipartisan Safer Community Act). SAMHSA anticipates 

that ReCAST grantees will train 8,200 individuals; will reach 190,000 community members with 

mental health messaging addressing trauma-informed practices; and provide evidence-based 

mental health-related services to 9,900 individuals.

 

Trauma-Informed Services in Schools

In FY 2023, SAMHSA funded 15 continuation grants (seven grants with base budget authority 

and eight with Bipartisan Safer Community Act) and a new cohort of six grants with base budget 

authority. In FY 2023, Trauma Informed Services in Schools trained 4,752 individuals in 

prevention or mental health related practices; screened 34,678 students for mental health services; 

and referred 2,965 students for mental health or related services. For students who received

services in FY 2023, 18 percent were 10 to 12 years old, 38 percent were 13 to 15 years old, and 

21 percent were 16 to 17 years old. 

In FY 2024, SAMHSA anticipates funding 21 (13 grants with base budget authority and eight 

with Bipartisan Safer Community Act advanced appropriations). SAMHSA anticipates that 

grantees will screen approximately 62,400 children and youth for services and will serve nearly 

57,500 children and youth. 

 
40 

Outputs and Outcomes Table

Program: Project AWARE 

Measure Year and Most Recent 

Result /

Target for Recent Result 

/

(Summary of Result)

FY 2024

Target

FY 2025

Target

FY 2025

Target

+/-FY 2024

Target

3.2.21 Percentage of 

individuals receiving 

mental health services 

after referral. (Invalid 

measure type)

FY 2023: 71.0

Target:

74.5

(Target Not Met, but 

improved)

74.5 74.5 Maintain

3.2.39 Number of 

individuals who have 

received training in 

prevention or mental 

health promotion 

(Outcome)

FY 2023: 329,146

Target:

300,000

(Target Exceeded)

300,000 405,000 +105,000

3.2.51 Number of 

individuals referred to 

mental health or related 

interventions (Output)

FY 2023: 92,795.0

Target:

64,000

(Target Exceeded)

100,000 135,000 +35,000
41 

Mental Health Awareness Training

(Dollars in millions) 

Programs of Regional and National Significance

FY 2023 

Final 

FY 2024 

CR 

FY 2025 

President's 

Budget

FY 2025 +/- 

FY 2023 

Mental Health Awareness Training................................................... 27.963 27.963 27.963 -- 

Authorizing Legislation..........................Sections 520J of the Public Health Service Act

FY 2025 Authorization..........................................................................................$27,963,000 

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

Eligible Entities.................................................States and Territories, Political Subdivisions of States; Tribes or Tribal Organizations; and Non-Profit Entities

Program Description

Established in 2018, the purpose of the Mental Health Awareness Training (MHAT) program is to 

(1) train individuals (e.g., school, higher education, and post-secondary education personnel and 

emergency services personnel including fire department and law enforcement personnel, 

healthcare providers, faith leaders, veterans, armed services members and their families) to 

recognize the signs and symptoms of mental disorders and how to safely de-escalate crisis 

situations involving youth and/or adults with a mental illness and (2) provide education on 

resources available in the community for individuals with a mental illness and other relevant 

resources, including how to establish linkages with school and/or community-based mental health 

agencies.

The MHAT program uses several evidence-based activities and programs to ultimately increase 

the number of individuals prepared and trained on how to respond to individuals appropriately and 

safely with mental disorders, particularly youth and/or adults with serious mental illness (SMI) 

and/or serious emotional disturbance (SED). The MHAT program looks to support projects that 

present data-driven, quality improvement approaches to advance equity for all, and to identify 

racial, ethnic, sexual and gender minority populations at highest risk for experiencing behavioral 

health disparities as a part of the grant. These programs include but are not limited to: Mental 

Health First Aid and its associated specialty curriculums, Question, Persuade, Refer (QPR); 

Applied Suicide Intervention Skills Training (ASIST); Signs of Suicide (SOS); and Crisis 

Intervention Training (CIT). With the MHAT program, SAMHSA aims to increase the number of 

individuals prepared and trained on how to respond to individuals with mental disorders 

appropriately and safely. The MHAT program also aims to help build secure, safe, and healthy 

communities; reinforce partnership between law enforcement and communities; and increase 

public trust and enhance public safety. 

 

Budget Request

The FY 2025 President’s Budget Request is $27.9 million, equal to the FY 2023 Final level. Funding 

level for this program will support 195 continuation grants. The budget will enable populations to be 

trained, including college students, veterans and armed services personnel and their family members, 

and to broaden applicable settings for trainings to include noneducational, non-health care settings. 
42 

With this funding, it is estimated the number of individuals referred to mental health and related 

services will near 325,000and the number of individuals trained to recognize the signs and symptoms 

of mental illness will be approximately 600,000. 

Funding History Table

Fiscal Year Amount

FY 2021 $23,963,000

FY 2022 $24,946,200

FY 2023 Final $27,963,000

FY 2024 CR $27,963,000

FY 2025 President’s Budget $27,963,000

Program Accomplishments

In FY 2023, SAMHSA funded 409 grant continuations (173 grants with base budget authority and 

236 with Bipartisan Safer Community Act) and awarded a new cohort of 22 grants. Grantees 

trained 217,690ndividuals in mental health awareness, including 85,014 individuals in the mental 

health and related workforce, out of which 85 percent demonstrated an improvement in their 

knowledge and beliefs related to prevention and mental health treatment; and referred 181,813 

youth and adults to mental health and related services and activities.

 

In FY 2024, SAMHSA anticipates funding 432 continuation grants (195 grants with base budget 

authority and 237 with Bipartisan Safer Community Act). In FY 2024, the MHAT grantees are 

expected to train 270,000 individuals in mental health awareness, 85 percent of which will 

demonstrate an improvement in their knowledge and beliefs related to prevention and mental 

health treatment; and refer 200,000,000 individuals to mental health and related services and 

activities.
43 

Outputs and Outcomes Table

Measure Year and Most Recent 

Result /

 

Target for Recent Result 

/ 

 

(Summary of Result)

FY 2024

Target

FY 2025

Target

FY 2025

Target

 

+/-FY 2024

Target

3.6.1 Number of 

individuals trained in 

prevention or mental 

health promotion 

(Output)

FY 2023: 217,690

Target:

270,000

(Target Not Met)

270,000 270,000 Maintain

3.6.2 Number of 

individuals referred to 

mental health or related 

interventions 

(Intermediate 

Outcome)

FY 2023: 181,813

Target:

179,000

(Target Exceeded)

200,000 200,000 Maintain
44 

Healthy Transitions

(Dollars in millions) 

Programs of Regional and National Significance

FY 2023 

Final 

FY 2024 

CR 

FY 2025 

President's 

Budget

FY 2025 +/- 

FY 2023 

Healthy Transitions......................................................................... 30.451 30.451 30.451 -- 

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

FY 2025 Authorization............................................................................................... $30,451,000 

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

Eligible Entities.............................................................................................States and Territories; 

Political Sub-divisions of States; Indian Tribes or Tribal Organizations; Health Facilities 

Operated in accordance with the Indian Health Service.

Program Description

The Healthy Transitions Program has evolved since its creation in 2002. The program began with 

the Partnership for Youth Transitions in 2002-2004, followed by the Healthy Transitions Initiative 

(2009-2014), and the Healthy Transitions: Now is the Time (NITT) from 2014-2019. The current 

program’s iteration is called the Healthy Transitions Initiative (HTI) which began in 2018. 

 

The purpose of this program is to improve and expand access to developmentally, culturally, and 

linguistically appropriate services and supports for transition-aged youth and young adults (ages 

16-25) who either have, or are at risk for developing, serious mental health conditions. One of the 

risks affecting transition-aged youth is that it coincides with the age of onset for most mental and 

behavioral health challenges. Most mental health challenges emerge in the late teens to early 20’s, 

with roughly 50 percent of mental health challenges beginning by the early 20s.14 According to 

the 2022 National Survey on Drug Use and Health (NSDUH), 6.0% of adults aged 18 or older (or 

15.4 million people) had serious mental illness (SMI) in the past year. The percentage of adults 

aged 18 or older with SMI was highest among young adults aged 18 to 25 (11.6% or 4 million 

people), followed by adults aged 26 to 49 (7.6% or 7.8 million people), then by adults aged 50 or 

older (3.0% or 3.5 million people). Furthermore, among the 15.4 million adults aged 18 or older 

in 2022 with SMI in the past year who did not receive treatment, 49.7% (or 2.5 million people) 

perceived an unmet need for mental health services in the past year.15 Serious mental illness or 

diagnosable mental health challenges that substantially interfere with or limit major life activities, 

are more prevalent during the transition age to adulthood than at any other period.16 

 

Since 2018, the Healthy Transitions program has provided states, territories, and tribes with 

resources to improve access to mental health treatment and related support services for youth and 

14 Kessler RC, Amminger GP, Aguilar-Gaxiola S, Alonso J, Lee S, Ustün TB. Age of onset of mental disorders: a review of 

recent literature. Curr Opin Psychiatry. 2007 Jul;20(4):359-64. doi: 10.1097/YCO.0b013e32816ebc8c. PMID: 17551351; 

PMCID: PMC1925038.

15 Substance Abuse and Mental Health Services Administration. (2023). 2022 National Survey on Drug Use and Health (NSDUH) Annual 

National Report. Retrieved from: https://www.samhsa.gov/data/sites/default/files/reports/rpt42731/2022-nsduh-nnr.pdf 16Zajac, K., Sheidow, A. J., & Davis, M. (2013). Transitional Youth with Mental Health Challenges in the Juvenile Justice 

System. Juvenile Justice Resource Series. Retrieved from: https://nicic.gov/resources/nic-library/all-library-items/transition-ageyouth-mental-health-challenges-juvenile. 

 
45 

young adults ages 16-25 with serious mental health conditions. Grantees use these funds to provide 

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

and risks for developing SMI among young people ages 16-25. This is accomplished by improving 

awareness, outreach and engagement strategies, screening and assessment, referrals to treatment, 

coordination of care, and evidence-based/informed treatment for youth and young adults. Grantees 

also develop formal partnerships with child and adult serving organizations to promote seamless 

and coordinated care, develop sustainable policies, and provide needed training both at the state 

and community levels to effectively engage and serve this unique population. Appropriate outreach 

and engagement processes are imperative to create access to effective behavioral health 

interventions and supports. With the Healthy Transitions program, SAMHSA aims to improve 

emotional and behavioral health functioning so that this population of youth and young adults can 

maximize their potential to assume adult roles and responsibilities and lead full and productive 

lives.

 

Budget Request

The FY 2025 President’s Budget Request is $30.5 million, equal to the FY 2023 Final level. This 

budget will support 31 continuation grants. Funding will improve access to mental disorder 

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

risk of developing a serious mental health condition. It is expected that this program will serve 

approximately 3,200 young people and provide quality supports and services needed to engage 

this population. 

 

Funding History Table

Fiscal Year Amount

FY 2021 $29,451,000

FY 2022 $29,433,536

FY 2023 Final $30,451,000

FY 2024 CR $30,451,000

FY 2025 President’s Budget $30,451,000

Program Accomplishments

In FY 2023, SAMHSA awarded 16 grant continuations and a new cohort of 23 new grants. Thus 

far in FY 2023, Healthy Transitions grantees screened 2,997 young people for serious mental 

illness and referred 1,301 to needed mental health or related services and supports. Grantees also 

developed 46 formal partnerships or collaborations to create a coordinated network of support for 

youth and young adults and changed 37 policies to improve service delivery and reduce system 

access barriers.

 

In FY 2024, SAMHSA anticipates funding 26 grant continuations and a new cohort of eight grants. 

It is expected that 3,200 youth and young adults will be served by this program. 
46 

Outputs and Outcomes Table

Program: Healthy Transitions

 

Measure Year and Most Recent 

Result /

Target for Recent Result 

/

(Summary of Result)

FY 2024

Target

FY 2025

Target

FY 2025

Target

+/-FY 2024

Target

3.2.34 Percentage of 

clients receiving 

services who report 

positive functioning at 

6 month follow-up. 

(Outcome)

FY 2023: 45 %

Target:

58 %

(Target Not Met)

58 % 58 % Maintain

3.2.57 Number of 

clients served (Output)

FY 2023: 2,997

Target:

3,200

(Target Not Met)

3,200 3,200 Maintain
47 

Children and Family Programs

(Dollars in millions) 

Programs of Regional and National Significance

FY 2023 

Final 

FY 2024 

CR 

FY 2025 

President's 

Budget

FY 2025 +/- 

FY 2023 

Children and Family Programs.......................................................... 7.229 7.229 7.229 -- 

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

FY 2025 Authorization.............................................................................................. $7,229,000 

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

Eligible Entities............................................................... Federally recognized 

American Indian/Alaska Native tribes and tribal organizations.

Program Description

Initially funded in 1998, the Circles of Care program is a three-year infrastructure/planning grant 

that provides tribes and tribal organizations with the tools and resources to plan and design a 

family-driven, community-based, and culturally and linguistically competent system of care. A 

system of care is “a spectrum of effective community-based services and supports for children and 

youth, with or at risk for mental health or other challenges, and their families, that is organized 

into a coordinated network, builds meaningful partnerships with families and youth, and addresses 

their cultural and linguistic needs, in order for them to function better at home, in school, and 

throughout life.”17

 

AI/AN children face major difficulties from birth that stem from historical trauma, health 

inequities, socioeconomic barriers, and racism.18 When compared with the general U.S. child 

population, AI/AN children have higher levels of obesity, obesity-related cardiovascular issues, 

mental health concerns, suicide, toxic stress, substance use disorder, injury and violence, and 

exposure to environmental hazards.19 More specifically, AI/AN children and adolescents have the 

highest rates of lifetime major depressive episodes and the highest self-reported depression rates

when compared to all children and adolescents.

20 They begin to use and abuse alcohol and other 

drugs at younger ages and at higher rates than other ethnic/racial groups.21 With the Circles of 

Care program, SAMHSA aims to increase resilience and improve emotional health for American 

Indian/Alaska Native (AI/AN) children, youth, and families. 

 

17 Stroul, B., Blau, G., & Friedman, R. (2010). Updating the system of care concept and philosophy. Washington, DC: 

Georgetown University Center for Child and Human Development, National Technical Assistance Center for Children’s Mental Health. 

Retrieved from: https://gucchd.georgetown.edu/products/Toolkit_SOC_Resource1.pdf. 18 American Academy of Pediatrics. (2022). Native American Child Health. Retrieved from: https://www.aap.org/en/patientcare/native-american-child-health/. 19 American Academy of Pediatrics. (2022). Native American Child Health. Retrieved from: https://www.aap.org/en/patient-care/nativeamerican-child-health/. 20 American Psychiatric Association. (2017). Mental Health Disparities: American Indians and Alaska Natives. Retrieved from: 

https://www.psychiatry.org/File%20Library/Psychiatrists/Cultural-Competency/Mental-Health-Disparities/Mental-HealthFacts-for-American-Indian-Alaska-Natives.pdf. 21 Mental Health America. (2023). Native and Indigenous Communities and Mental Health. Retrieved from: 

https://www.mhanational.org/issues/native-and-indigenous-communities-and-mental-health.
48 

Budget Request

The FY 2025 President’s Budget Request is $7.2 million, equal to the FY 2023 Final level. This 

funding will support 12 Circles of Care continuation grants and award a new cohort of eight grants. 

Funding will enhance and improve the quality of existing services and promote the use of culturally 

competent services and support for children and youth with, or at risk for, serious mental health 

conditions, and their families. SAMHSA will maintain the FY 2024 targets: 1,500 mental health 

professionals trained in mental health-related practices; develop collaborative partnerships and 

shared resources with nearly 2,500 organizations; and contact 40,075 individuals through program 

outreach efforts. 

 

Funding History Table

Fiscal Year Amount

FY 2021 $7,229,000

FY 2022 $7,212,200

FY 2023 Final $7,229,000

FY 2024 CR $7,229,000

FY 2025 President’s Budget $7,229,000

Program Accomplishments

In FY 2023, SAMHSA awarded three continuation grants and a new cohort of nine grants for the 

Circles of Care program. In FY 2023 these grants have surpassed their target number of 

individuals contacted in through program outreach efforts reaching 44,8231 individuals and have 

developed 579 collaborative partnerships that share resources among organizations, trained 3,553 

people in the mental health and related workforce, and cultivated 284 organizational changes made 

to support improvement of mental health-related practices/activities for AI/AN youth and families.

 

In FY 2024, SAMHSA anticipates supporting the same number of grants as FY 2023. It is 

estimated that in FY 2024, Circles of Care grantees will provide training to 2,500 mental health 

professionals, developed collaborative partnerships and shared resources with nearly 1,000 

organizations, and contact 40,075 individuals through program outreach efforts.
49 

Consumer and Family Network Grants

(Dollars in millions) 

Programs of Regional and National Significance

FY 2023 

Final 

FY 2024 

CR 

FY 2025 

President's 

Budget 

FY 2025 +/- 

FY 2023 

Consumer and Family Network Grants.............................................. 4.954 4.954 4.954 -- 

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

FY 2025 Authorization........................................................................ $4,954,000 

Allocation Method........................................................................................... Competitive Grants

Eligible Entities......................................................................................Domestic public or private 

non-profit organizations; States and Territories; Political Sub-divisions of States; AI/AN tribes and 

tribal organizations

 

Program Description

Across the health care arena, there is growing recognition and evidence that client-centered care 

positively influences an individual’s health outcomes, improves quality and efficacy of care 

received, and provides feedback to drive service and systems improvements.22 As with other health 

concerns, people with serious mental illness (SMI) and their family members should have 

meaningful involvement in all aspects of their health care and treatment, including behavioral 

health care.

 

The Consumer and Family Network Programs provide consumers, families, and youth with 

opportunities to participate meaningfully in the development of policies, programs, and quality 

assurance activities related to mental health systems across the United States. The Consumer and 

Family Network Programs support two primary grant programs: the Statewide Consumer Network 

(SCN) Program and the Statewide Family Network (SFN) Program.

 

The SCN program was first funded in 1997. SCN grants focus on the needs of adults (18 years and 

older) with SMI or serious emotional disturbance (SED) by strengthening the capabilities of 

statewide consumer-run organizations. These entities serve an important role in engaging 

consumers of mental health services, caregivers, policy makers, and providers in improving and 

transforming the mental health and related systems in their states. This network is a sustainable 

mechanism for integrating the consumer voice in state mental health and allied systems to: (1) 

expand service system capacity; (2) support policy and program development; and (3) enhance 

peer support. This program promotes skill development with an emphasis on leadership and 

business management, as well as on coalition/partnership-building and economic empowerment, 

as part of the recovery process for consumers.

 

Initiated in 1993, the SFN grant program provides education and training to increase family 

organizations’ capacity for policy and service development. This is accomplished by: (1) 

22 Edgman-Levitan, S., Schoenbaum, S.C. Patient-centered care: achieving higher quality by designing care through the patient’s 

eyes. Israel Journal of Health Policy Research 10, 21 (2021). https://doi.org/10.1186/s13584-021-00459-9. 
50 

strengthening organizational relationships and business management skills; (2) fostering 

leadership skills among families of children and adolescents with SED; and (3) identifying and 

addressing the technical assistance needs of children and adolescents with SED and their families. 

The SFN program focuses on families, parents, and the primary caregivers of children, youth, and 

young adults. 

 

Budget Request

The FY 2025 President’s Budget Request is $5.0 million, equal to the FY 2023 Final level. Funds 

will be used for 21 continuation grants (10 SFN and 11 SCN) and 17 new grants that promote 

consumer, family, and youth participation in the development of policies, programs and quality 

assurance activities related to mental health systems reform across the United States. It is expected 

that in FY 2025, SCN will train 16,000 individuals in the mental health and related workforce and 

SFN will train 25,500 individuals in prevention, mental health promotion, and mental healthrelated practices/activities.

 

Funding History Table

Fiscal Year Amount

FY 2021 $4,970,508

FY 2022 $4,937,200

FY 2023 Final $4,954,000

FY 2024 CR $4,954,000

FY 2025 President’s Budget $4,954,000

Program Accomplishments

In FY 2023, SAMHSA awarded 43 continuations (26 SFN and 17 SCN) and one new SCN grantee. 

In FY 2023, SCN grantees trained 5,175 individuals in the mental health and related workforce 

and SFN grantees trained 22,882 individuals on mental health prevention and promotion. SFN and 

SCN grantees also together involved 4,603 consumers and family members in ongoing mental 

health- related planning and advocacy activities. SCN grantees have also had 53% consumer and 

family member representation on the work group/advisory group/and councils that they support. 

 

 In FY 2024, SAMHSA anticipates funding 20 continuations (13 SFN and seven SCN) and 

awarding 10 new SFN grants and 10 new SCN grants. In FY 2024, SAMHSA will maintain the 

target outputs for both SCN and SFN programs. It is expected that in FY 2024, SCN will train 

5,000 individuals in the mental health and related workforce and SFN will train 25,000 

individuals in prevention, mental health promotion, and mental health-related practices/activities.
51 

Project LAUNCH

(Dollars in millions) 

Programs of Regional and National Significance

FY 2023 

Final 

FY 2024 

CR 

FY 2025 

President's 

Budget

FY 2025 +/- 

FY 2023 

Project LAUNCH............................................................................. 25.605 25.605 25.605 -- 

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

FY 2025 Authorization.............................................................................................. $25,605,000 

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

Agreements

Eligible Entities..........................States and Territories; Political Sub-divisions of States;

Indian Tribes or Tribal Organizations; Health Facilities or program operated in accordance with 

the Indian Health Service

Program Description

Established in 2008, Project LAUNCH (Linking Actions to Unmet Needs in Children’s Health) 

promotes the wellness of young children, from birth to 8 years of age, by addressing the social, 

emotional, cognitive, physical, and behavioral aspects of their development. High quality early 

care and education benefits all children, especially those from disadvantaged backgrounds. 

Children of color experience unequal behavioral health treatment beginning at an early age, which 

contributes to inequalities in learning and development. However, based on state eligibility 

parameters, roughly 79 percent of eligible Black children, 92 percent of eligible Hispanic/Latino 

children, and 95 percent of eligible Asian children under 13 years old lack access to childcare 

subsidies.23 This lack of access to early childcare and quality early education contributes 

inequalities in services that promote wellness, including inequities in access to behavioral health 

services that would support learning and development. 

 

Project LAUNCH is designed to build the capacities of adult caregivers of young children to 

promote healthy social and emotional development; to prevent mental, emotional, and behavioral 

disorders; and to identify and address behavioral concerns before they develop into serious 

emotional disturbances (SED). This program also serves to address these inequities among 

children and families of color and to create programs and services to broaden access to high quality 

education and care. The grant awards provide local communities or tribes resources to disseminate 

effective and innovative early childhood mental health practices and services.

 

Symptoms of historical trauma, including poverty, substance abuse, and disproportionate 

representation in the child welfare system, are evident in many Native American communities. 

And while many of the traumatic events happened decades ago, the impact can be passed from one 

generation to another as American Indian/Alaska Native (AI/AN) children grow up in challenging 

circumstances in their homes and communities. In addition, parenting practices, which are shaped 

by parents’ own upbringing, play an important role in child development. AI/AN children who 

face excessive stress without the buffer of supportive caregivers are at risk for having learning 

23 New America. (April 14, 2020). Equity in Early Childhood Education. New America. Retrieved from: https://www.newamerica.org/educationpolicy/collections/equity-ece/.
52 

difficulties and long-term health problems.24 The current approach to early education also 

segregates children by family income and race, enrolls only one percent of Hispanic/Latino and 

four percent of Black three- and four-year-old children in high-quality state pre-K settings, and 

disproportionately disenfranchises students of color, especially Black boys, through punitive 

discipline practices.25, 26

 

Established in FY 2017, Indigenous Project LAUNCH (I-LAUNCH) promotes the wellness of 

young children from birth to eight years within Tribes, territories, and Pacific Island jurisdictions. 

This program provides local communities or Tribes the opportunity to disseminate effective and 

innovative early childhood mental health practices and services, ultimately leading to better 

outcomes for young children and their families. Through Indigenous LAUNCH, children can 

thrive in safe, supportive environments and enter school ready to learn and succeed. With these 

Project LAUNCH programs, SAMHSA aims to promote resilience and emotional health for 

children, youth, and their families. 

 

Budget Request

The FY 2025 President’s Budget Request is $25.6 million, equal to the FY 2023 Final level. This 

funding will support 27 continuation grants and the Center of Excellence for Infant and Early 

Childhood TTA center (CoE-IECMHC) to improve health outcomes for young children and 

support children at high risk for mental illness and their families to prevent future disability. This 

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

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

the U.S. through the CoE-IECMHC. It is expected that approximately 29,000 young children will 

be screened for mental health disorders, and about 8,500 children will be referred for mental health 

and related services.

 

Funding History Table

Fiscal Year Amount

FY 2021 $23,508,709

FY 2022 $23,588,200

FY 2023 Final $25,605,000

FY 2024 CR $25,605,000

FY 2025 President’s Budget $25,605,000

Program Accomplishments

24 Grunewald, R. (2017). The promise of early childhood development in Indian Country. Federal Reserve Bank of Minneapolis.

Retrieved from: https://www.minneapolisfed.org/article/2017/the-promise-of-early-childhood-development-in-indian-country. 25New America. (April 14, 2020). Equity in Early Childhood Education. New America. Retrieved from: 

https://www.newamerica.org/education-policy/collections/equity-ece/. 26 Malik, R. (2017). New Data Reveal 250 Preschoolers Are Suspended or Expelled Every Day. Center for American Programs. 

Retrieved from: https://www.americanprogress.org/article/new-data-reveal-250-preschoolers-suspended-expelled-every-day/. 
53 

In FY 2023, SAMHSA awarded 16 grant continuations, a new cohort of 16 new grants, and the 

CoE-IECMHC. In FY 2023, LAUNCH grantees trained 4,904 families and providers in mental 

health- or related practices; 20,616 children and caregivers were screened for mental health or 

related interventions; 7,332 children and caregivers were referred to mental health or related 

services; 7,848 children and caregivers received evidence-based mental health services; and 84 

organizations collaborated, coordinated, and shared resources with other organizations. 

 

 I-LAUNCH grantees achieved the following outcomes in FY 2023: trained 5,448 families and 

providers in mental health-related practices/activities; screened 10,127 children and caregivers for 

mental health or related interventions; referred 1,431 children and caregivers to mental health or 

related services; and provided evidence-based or informed mental health services to 5,003 children 

and caregivers; and collaborated, coordinated or shared resources with 186 other organizations.

 

The CoE-IECMHC advances the implementation of high-quality infant and early childhood mental 

health consultation across the nation through the development of tools, resources, and mentorship 

to the infant and early childhood mental health field. In FY 2023, the CoE-IECMHC work resulted 

in 2,209 people in mental health and related workforce receiving training in mental health-related 

practices/activities and 40 programs/organizations/communities implementing evidence-based 

mental health-related practices/activities.

 

In FY 2024, SAMHSA anticipates funding 16 continuation grants and awarding a new cohort of 

11 grants. In FY 2023, SAMHSA estimates that the number of individuals in the mental health 

and related workforce who are trained in mental health-related practices/activities will near 14,500; 

that the number of children screened for mental health or related interventions will near 22,000; 

that the number of children referred to mental health or related services will near 8,500; that the 

number of children receiving evidence-based mental health services will near 9,600, and that the 

number of organizations collaborating, coordinating, and/or sharing resources with other 

organizations will near 540.
54 

Outputs and Outcomes Table

Program: Mental Health – Project LAUNCH

Measure Year and Most Recent 

Result /

Target for Recent Result 

/

(Summary of Result)

FY 2024

Target

FY 2025

Target

FY 2025

Target

+/-FY 2024

Target

2.3.94 Number of 

persons served (Output)

FY 2023: 12,851

Target:

9,600

(Target Exceeded)

12,600 12,600 Maintain

2.3.95 Number of 

persons trained in 

mental illness 

prevention or mental 

health promotion 

(Outcome)

FY 2023: 12,561

Target:

10,500

(Target Not Met)

14,500 14,500 Maintain

2.4.00 Number of 0-8 

year old children 

screened for mental 

health or related 

interventions 

(Outcome)

FY 2023: 30,743

Target:

22,000

(Target Exceeded)

29,000 29,000 Maintain

2.4.01 Number of 0-8 

year old children 

referred to mental 

health or related 

interventions 

(Outcome)

FY 2023: 8,763

Target:

6,500

(Target Exceeded)

8,500 8,500 Maintain
55 

Mental Health System Transformation and Health Reform

(Dollars in millions) 

Programs of Regional and National Significance

FY 2023 

Final 

FY 2024 

CR 

FY 2025 

President's 

Budget 

FY 2025+/- 

FY 2024

Mental Health System Transformation and Health Reform.............. 3.779 3.779 3.779 -- 

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

FY 2025 Authorization.............................................................................................. $3,779,000 

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

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

Program Description

Mental Health System Transformation and Health Reform funding supports the Transforming 

Lives through Supported Employment Program (SEP). There is a significant gap between the 

number of people with serious mental illness (SMI), such as schizophrenia, bipolar disorder, and 

major depression, who want to work (66 percent) and the number of these individuals who are 

employed (less than 20 percent). The benefits of steady competitive employment for individuals 

with SMI are substantial and include increased income, improved adherence with treatment for 

mental illness, enhanced self-esteem, reduced use of substances, and improved quality of life.27

 

In FY 2014, the Transforming Lives through Supported Employment (SEP) Grant program was 

initiated to help states foster the adoption and implementation of permanent transformative 

changes in how public mental health services are organized, managed, and delivered throughout 

the United States. This program aims to enhance state and community capacity to provide 

evidence-based supported employment programs for adults and youth with SMI or serious 

emotional disturbance (SED). In FY 2023, the program continued to support state and community 

efforts to refine, implement, and sustain evidence-based practices but altered its population of 

focus to include both adults with SMI or co-occurring disorders (COD). 

 

A new funding announcement released in FY 2023 emphasized greater alignment with evidencebased practice and implementation science principles. The end goal of the program is to support 

individuals with serious mental illness to achieve competitive employment and build paths to selfsufficiency and recovery. With this program, SAMHSA aims to increase state and community 

capacity to implement and sustain SEP models and integrated supports to improve competitive 

employment outcomes. SEP grants are also supported through the Practice Improvement and 

Training budget line. 

27 IPS Supported Employment: The Evidence-based Practice for Employment. (n.d.). Retrieved August 4, 2015
56 

Budget Request

The FY 2025 President’s Budget Request is $3.8 million, equal to the FY 2023 Final level. Funding 

will support four continuation grants to enhance state and community capacity to provide 

evidence-based supported employment programs and mutually compatible and supportive 

evidence-based practices for adults and youth with SMI/SED and co-occurring mental and 

substance use disorders. It is expected that in FY 2025, the supported employment program will 

serve 800 individuals. 

 

Funding History Table

Fiscal Year Amount

FY 2021 $3,779,000

FY 2022 $3,762,200

FY 2023 Final $3,779,000

FY 2024 CR $3,779,000

FY 2025 President’s Budget $3,779,000

Program Accomplishments

In FY 2023, SAMHSA awarded three SEP grant continuations and one new grant. In FY 2023, 

49.2 percent of participants were competitively employed at six-month follow-up, compared to 

19.4 percent at intake (baseline), representing a 154 percent positive change. Additionally, 75.9 

percent reported having a stable place to live at follow-up compared to 48.1 percent at intake, and 

80.6 percent were retained in the community compared to 66.9 percent at intake. 

 

In FY 2024, SAMHSA anticipates funding one continuation grant and award three new grants to 

support state and community efforts to enhance evidence-based supported employment programs 

and mutually compatible and supportive evidence-based practices (e.g., supported education) for 

adults with SMI or co-occurring mental and substance use disorders. In FY 2024, SAMHSA will 

maintain the performance measures targets.
57 

Outputs and Outcomes Table

 Program: Mental Health System Transformation Grants and Health Reform

Measure Year and Most Recent 

Result /

Target for Recent Result 

/

(Summary of Result)

FY 2024

Target

FY 2025

Target

FY 2025

Target

+/-FY 2024

Target

1.2.21 Percentage of 

clients receiving 

services who report 

positive functioning at 

6 month follow-up. 

(Outcome)

FY 2023: 60%

Target:

70%

(Target Not Met)

70% 70% Maintain

1.2.22 Percentage of 

clients receiving 

services who had a 

permanent place to live 

in the community at 6 

month follow-up. 

(Outcome)

FY 2023: 75.9%

Target:

56%

(Target Exceeded)

56% 56% Maintain

1.2.23 Percentage of 

clients receiving 

services who are 

currently employed at 6 

month follow-up. 

(Outcome)

FY 2023: 49.2%

Target:

55%

(Target Not Met)

55% 55% Maintain

1.2.991 Number of 

clients served (Output)

FY 2023: 1,035

Target:

800

(Target Exceeded)

800 800 Maintain
58 

Primary and Behavioral Health Care Integration

(Dollars in millions) 

Programs of Regional and National Significance

FY 2023 

Final 

FY 2024 

CR 

FY 2025 

President’s 

Budget

FY 2025 +/- 

FY 2023 

Primary and Behavioral Health Care Integration...................... 57.868 57.868 57.868 -- 

Primary and Behavioral Health Care Integration.............................. 55.877 55.877 55.877 -- 

Primary and Behavioral Health Care Integration TTA..................... 1.991 1.991 1.991 -- 

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

FY 2025 Authorization................................................................................................ $57,868,000 

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

Eligible Entities...................................................................States or State Agency

Program Description

The Primary and Behavioral Health Care Integration (PBHCI) grant program was established in 

FY 2009 to address the intersection between primary care and treatment for mental illness and cooccurring disorders. This program was replaced by the Promoting Integration of Primary and 

Behavioral Health Care (PIPBHC) grant program in FY 2017. Adults with serious mental illness 

(SMI) experience high rates of morbidity and mortality.28 These rates are due, in large part, to 

elevated incidence and prevalence of cardiovascular disease, obesity, diabetes, hypertension, and 

dyslipidemia.29 People with SMI and physical health problems have decreased quality of life and 

are at higher risk for premature death. In fact, mortality among people with SMI and substance use 

disorders are higher and are often exacerbated by fragmented and poor-quality physical health 

care.30, 31 People with SUDs also are at an increased risk of a range of physical health problems. 

Beyond tragic and prevalent overdose risk, SUDs are associated with increased rates of smoking 

and related physical health problems; cardiovascular disease; infectious disease, including HIV 

and viral hepatitis; organ damage; and cancer.32 As a result, there is need to improve whole-person 

health by increasing capacity and access to treatments for mental and substance use disorders and 

co-occurring physical health conditions in bi-directional primary and behavioral health care 

28 de Mooij LD, Kikkert M, Theunissen J, Beekman ATF, de Haan L, Duurkoop PWRA, Van HL, Dekker JJM. 

Dying Too Soon: Excess Mortality in Severe Mental Illness. Front Psychiatry. 2019 Dec 6;10:855. doi: 

10.3389/fpsyt.2019.00855. PMID: 31920734; PMCID: PMC6918821.

29 Forman-Hoffman, Muhuri, Novak, Pemberton, Ault, and Mannix (August 2014) CBHSQ Data Review: 

Psychological Distress and Mortality among Adults in the U.S. Household Population.

30 Liu, N. H., Daumit, G. L., Dua, T., Aquila, R., Charlson, F., Cuijpers, P., Druss, B., Dudek, K.,

Freeman, M., Fujii, C., Gaebel, W., Hegerl, U., Levav, I., Munk Laursen, T., Ma, H., Maj, M., Elena

Medina-Mora, M., Nordentoft, M., Prabhakaran, D., Pratt, K., ... Saxena, S. (2017). Excess mortality in

persons with severe mental disorders: a multilevel intervention framework and priorities for clinical 

practice, policy and research agendas. World psychiatry: official journal of the World Psychiatric 

Association (WPA), 16(1), 30–40. https://doi.org/10.1002/wps.20384.

31 Druss, B.G., & Goldman, H.H. (2018). Integrating health and mental health services: A past

and future history. American Journal of Psychiatry, 175:1199-1204; 

doi:10.1176/appi.ajp.2018.18020169.

32 Schulte, M. T., & Hser, Y. I. (2014). Substance Use and Associated Health Conditions throughout the Lifespan. 

Public health reviews, 35(2).
59 

settings.

The purpose of PIPBHC is to (1) promote full integration and collaboration in clinical practice 

between behavioral healthcare and primary physical healthcare for identified special populations; 

(2) support the improvement of integrated care models for behavioral healthcare and 

primary/physical healthcare to improve the overall wellness and physical health status of: adults 

with a SMI; adults who have co-occurring mental illness and physical health conditions or chronic 

disease; children and adolescents with a serious emotional disturbance (SED) who have a cooccurring physical health conditions or chronic disease; individuals with a substance use disorder 

(SUD); or people with co-occurring mental health and substance use conditions (COD); and (3) 

promote the implementation and improvement of bidirectional integrated care services, including 

evidence-based or evidence-informed screening, assessment, diagnosis, prevention, treatment, and 

recovery services for mental and substance use disorders, and co-occurring physical health 

conditions and chronic diseases. In FY 2023, Congress directed 10 percent of PIPBHC grants to 

be awarded to states that proposed to partner with primary care practices and providers 

implementing the Collaborative Care Model (CoCM). In FY 2023, SAMHSA released a new 

funding announcement to incorporate this and other changes in the statute as well as improvements 

to the program. In FY 2024, SAMHSA is separating the PIPBHC program into two tracks, each 

with its own Notice of Funding Opportunity (NOFO). The first NOFO will support the traditional 

PIPBHC model and the second will specifically support the implementation of the CoCM in 

primary care settings.

 

In FY 2019, SAMHSA established The National Center of Excellence for Integrated Health 

Solutions (CoE-IHS). This 5-year grant program aims to advance the implementation of high 

quality, evidence-based treatment for individuals with co-occurring physical and mental health 

conditions, including substance use disorders. The program complements the PIPBHC program

by offering technical assistance and training for communities, individual practitioners, providers, 

and states on evidence-based strategies that address the integration of primary and behavioral 

health care for individuals with mental and substance use disorders and co-occurring physical 

health conditions and chronic diseases.

 

Budget Request

The FY 2025 President’s Budget Request is $57.9 million, equal to the FY 2023 Final level. 

Funding will support the continuation of 21 PIPBHC grants, award a new cohort of four grants

and the continuation of the CoE-IHS. SAMHSA anticipates that this funding will enable the 

PIPBHC program to greatly expand its reach across the U.S. and enable the program to advance 

the integration of physical and behavioral health care, through evidence-based models, including 

the CoCM. Funding for the CoE-IHS in FY 2025 is proposed to be level with the FY 2023 Final

level. This funding will enable the PIPBHC to reach approximately 40,000 people with treatment 

and services and COE-IHS to train approximately 17,000 individuals in primary and behavioral 

health integration practices.
60 

Funding History Table

Fiscal Year Amount

FY 2021 $54,368,001

FY 2022 $54,834,400

FY 2023 Final $57,868,000

FY 2024 CR $57,868,000

FY 2025 President’s Budget $57,868,000

Program Accomplishments

All active PIPBHC grants collect data on program recipients to demonstrate favorable outcomes 

on critical domains. These outcomes included: improvement in mental health functioning; 

reduction in substance use; reduction in homelessness, and reduction in criminal justice system 

involvement. In FY 2023, data indicates that 82.6 percent of assessed individuals reported no 

serious psychological distress at the six-month reassessment in comparison to 55.6 percent at 

baseline. Moreover, 60.8 percent reported functioning in everyday life and 65.6 percent reported 

being mentally healthy overall at their six-month reassessment. Together, these outcomes comprise 

measurement for an improvement in overall quality of life. The CoE-IHS trained 49,037 people 

across the country, further advancing an integration framework that defines and measures the 

uptake of integrated care in future years.

 

In FY 2023, SAMHSA awarded 12 PIPBHC grant continuations and 15 new PIPBHC grants as 

well as continuation of the CoE-IHS.

 

In FY 2024, SAMHSA will fund 21 PIPBHC grant continuations, award a new cohort of four 

PIPBHC grants, as well as a new grant to support the CoE-IHS. 

 
61 

Outputs and Outcomes Table

Program: Primary & Behavioral Health Care Integration (PBHCI)

Measure Year and Most Recent 

Result /

Target for Recent 

Result /

(Summary of Result)

FY 2024

Target

FY 2025

Target

FY 2025

Target

+/-FY 2024

Target

3.2.41 Increase the

percentage of clients

receiving services

who report positive

functioning at 6- 

month follow-up.

(Outcome)

FY 2023: 60.8 %

 

Target:

63 %

 

(Target Not Met)

 

63 %

 

 

 

 

 

 

63 %

 

 

 

 

 

 

Maintain

 

 

 

 

 

 

3.2.54 Number of 

clients 

served(Output)

FY 2023: 25,059.0

Target:

24,000.0

(Target Exceeded)

40,000.0 40,000.0 Maintain
62 

Suicide Prevention Programs 

Summary of the Request

(Dollars in millions) 

FY 2023 

Final 

FY 2024 

CR 

FY 2025 

President's 

Budget 

FY 2025 

+/- FY 

2023 

Suicide Prevention Programs........................................................ 

988 and Behavioral Health Crisis Services..................................... 501.618 501.618 601.618 100.000 

National Strategy for Suicide Prevention.................................... 28.200 28.200 29.950 1.750 

Suicide Prevention and Older Adults (non-add)..................... -- -- 1.750 1.750 

Zero Suicide (non-add)................................................................ 26.200 26.200 26.200 -- 

Zero Suicide American Indian and Alaska Native (non-add).. 3.400 3.400 3.400 -- 

All Other National Strategy for Suicide Prevention (non-add)...... 2.000 2.000 2.000 -- 

GLS - Youth Suicide Prevention - States........................................... 43.806 43.806 43.806 -- 

Budget Authority (non-add)......................................................... 31.806 31.806 31.806 -- 

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

GLS - Youth Suicide Prevention - Campus........................................ 8.488 8.488 8.488 -- 

GLS - Suicide Prevention Resource Center........................................ 11.000 11.000 11.000 -- 

AI/AN Suicide Prevention Initiative................................................. 3.931 3.931 3.931 -- 

MH Crisis Response Partnership Pilot Program Grants (New FY 22).. 20.000 20.000 40.000 20.000 

Behavioral Health Crisis Coordinating Office (New FY 22)................. -- -- -- -- 

Subtotal, Suicide Prevention Programs 617.043 617.043 738.793 121.750 

Program Description

 

Suicide is one of the leading causes of death in the United States with CDC provisional data 

reporting that the number of deaths by suicide increased 2.6% from 2021 to 2022 but decreased 

among American Indians/Alaska Natives people and youth.33 Approximately 47,646 Americans 

died by suicide in 2021.34 The 2022 National Survey on Drug Use and Health reported that 

approximately 1.6 million Americans ages 18 and older attempted suicide over the previous 12 

months, 13.2 million seriously considered suicide, and 3.8 million made a plan.35 Among youth 

ages 12-17 in 2021, 892,000 attempted suicide, 3.3 million seriously considered suicide, and 1.5 

million made a suicide plan.36

 

Research has shown that implementing comprehensive public health approaches that make suicide 

prevention a priority within health and community systems can reduce the rates of death by suicide 

as well as suicide attempts. Accordingly, SAMHSA supports a comprehensive portfolio of suicide 

prevention programs including the 988 and Behavioral Health Crisis Services (which subsumed 

the Suicide Lifeline); the National Strategy for Suicide Prevention and Zero Suicide grant 

programs; and interventions that focus on youth suicide prevention such as the Garrett Lee Smith 

and the AI/AN programs. 

33 Suicide Data and Statistics | Suicide | CDC

34 Curtin, S.C., Garnett, M.F., and Ahmad, F.B. Provisional numbers and rates of suicide by month and

demographic characteristics: United States, 2021. Vital Statistics Rapid Release; no 24. September 

2022. DOI: https://dx.doi. org/10.15620/cdc:120830. 35 Substance Abuse and Mental Health Services Administration. (2023). Key substance use and mental health 

indicators in the United States: Results from the 2022 National Survey on Drug Use and Health (HHS Publication No. 

PEP23-07-01-006, NSDUH Series H-58). Center for Behavioral Health Statistics and Quality, Substance Abuse and 

Mental Health.

36 ibid
63 

988 and Behavioral Health Crisis Services 

(Dollars in millions) 

Programs of Regional and National Significance

FY 2023 

Final 

FY 2024 

CR 

FY 2025 

President's 

Budget 

FY 2025 +/- 

FY 2023 

988 and Behavioral Health Crisis Services.......................... 501.618 501.618 601.618 100.000 

Authorizing Legislation....................Section 520A and 520E-3 of the Public Health Service Act

FY 2025 Authorization.........................................................................................$0 

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

Eligible Entities...............................................States, Tribes, Community Organizations 

Program Description

Individuals need rapid access to suicide prevention and crisis intervention services to prevent death 

and injury as the result of suicide attempts. Implementation of the 988 Suicide & Crisis Lifeline 

has been and continues to be a once-in-a-lifetime opportunity to strengthen and transform 

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

time, from anywhere across the nation. Planning for the 988 program was accelerated on July 16, 

2020, when the Federal Communications Commission issued a final order designating 988 as the 

new, three-digit number for suicide prevention and mental health crises. On October 17, 2020, the 

National Suicide Hotline Designation Act of 2020 (Public Law 116-172) was signed into law, 

incorporating 988 into statute as the new number for individuals in crisis. On July 16, 2022, the 

U.S. transitioned from the previous 10-digit hotline to the 988 Suicide & Crisis Lifeline. 

In FY 2022, SAMHSA established and began implementation of a national 988 strategy, with 

critical performance targets to ensure 988 meets national demands. The key performance indicators 

and target outcomes include, but are not limited to, monthly and as-needed reports on the total 

number of call, chats, and texts contacts received; monthly and as-needed reports on the total 

number of call, chats, and texts contacts answered—with a 90% or greater target for local centers 

and a 95% or greater target for the full network; and monthly and as-needed reports on the speed 

to answer call, chats, and texts—with a 95% answered in 20 seconds full target for the full network. 

In addition, SAMHSA monitors abandonment rate and rollover contacts from the local to backup 

centers and provide action plans for improvement of responses as required. 

The new 988 hotline builds directly on the original Lifeline that was established in 2005. The 988 

system operates 24 hours per day, 7 days per week and contains four primary elements: 

• A network of independently operated crisis centers offering local response through call, 

chat, and/or text. 

• A subset of centers supporting the national subnetworks, including national backup, 

Spanish language services, services for LGBTQI+ youth and young adults, and videophone 

services for people who are deaf or hard of hearing. 

• A single Lifeline administrator; and 

• The Federal 988 & Behavioral Health Crisis Coordinating Office. 

SAMHSA anticipates continued growth in the contact volume and in needed system capacity. In 
64 

FY 2025, contacts —including calls, texts, and chats—are expected to increase to approximately 

7.5 million a year. This will be driven by historic growth, increased awareness, and diversion from 

911. Volume will also depend greatly on the degree to which national marketing campaigns 

amplify the availability of this vital resource and promote help seeking behaviors. The budget 

increases investment in the 988 program to ensure there is sufficient funding to support 988 crisis 

center response and necessary service linkages to minimize repeated crisis events and/or law 

enforcement response to crisis encounters. 

 

Funding History Table 

Fiscal Year Amount

FY 2021 $0

FY 2022 $0

FY 2023 Final $501,618,000

FY 2024 CR $501,618,000

FY 2025 President’s Budget $601.618,000

Budget Request

At the FY 2025 President’s Budget, the budget request is $601.6 million, an increase of $100.0 

million from the FY 2023 Final level. In FY 2025 SAMHSA anticipates that annual contact 

volume – including calls, texts, and chats – will continue to increase, with capacity needed to 

respond to an estimated 7.5 million contacts. 

The FY 2025 request is based on the following estimated breakdown of funding needs: 

Network administration Funding of the Network Administrator includes data and 

telephony infrastructure; standards, training, and quality improvement; evaluation and 

oversight. 

Local, national subnetwork & backup capacity:

 Local capacity will be funded through the existing 988 state/territory grant 

program, the 988 Tribal response program and the Lifeline crisis center 

follow up program. Local center capacity is critical to ensuring that 

individuals in crisis receive responses that are tailored to the service system 

where they are located and that services across the continuum are linked 

and coordinated. As SAMHSA continues to evaluate state support of local 

services, funding for states may include opportunities for better linkage of 

crisis centers to a full continuum of care. The local grant program funding 

continuation will ensure ongoing leadership engagement, enhanced 

nationwide technical assistance, and the achievement of standardized key 

performance indicator outcomes.

 Backup and national subnetwork capacity, including Spanish language 
65 

services and specialized service access for LGBTQI+ youth and young 

adults, will be funded through subcontracts executed by the 988 Lifeline 

Administrator.

Communications Resources will be required to continue to conduct and expand 988 

awareness and engagement work activities, including:

 Developing, testing, and marketing research-based messaging and 

advertising that is proven to resonate with at-risk audiences and 

continuously measuring for success

 Increasing and aligning communications partnerships with 988 grantees, 

states, territories, tribes, associations, federal partners, and other trusted 

messengers to increase cohesive awareness of 988, with a particular focus 

on building awareness and credibility in high-risk communities

 Continuing to evaluate and update messaging content and paid advertising 

strategies that answer questions about how 988 works and what happens 

when people use the service.

988 & Behavioral Health Crisis Coordinating Office Coordination activities include 

technical assistance to states, and crisis centers; strategic planning, performance 

management, evaluation, and oversight; and formal partnerships, convenings, and crossentity coordination.

Program Accomplishments

In September 2022, the Lifeline piloted a “Press 3” option to link LGBTQI+ youth and young 

adults to specialized care through an organization focused on their needs. That pilot was expanded 

into a subnetwork of seven crisis call centers providing response to LGBTQI+ youth and young 

adults. In July 2023, the Lifeline network activated services in Spanish through text and chat. In 

September 2023, the Lifeline activated videophone services for people who are Deaf or hard of 

hearing. 

 

SAMHSA has a bold vision for the future of crisis care in our nation. It is built on a belief that 

everyone experiencing crisis should have: Someone to talk to. Someone to respond. A safe place 

for help. The U.S. transition to 988 on July 16, 2022, was a key first step in realizing this vision. 

Data for the months following the transition to 988 continue to show an increase in overall calls, 

texts, and chats from the year prior – all while answer rates are significantly improving. 

Specifically, 

 

• Since launching in July 2022, the 988 Suicide & Crisis Lifeline has answered 

approximately 8 million contacts through calls, chats, and texts. 

• In November 2023 vs. June 2022, the 988 Lifeline answered about 164,000 more contacts 

and improved how quickly contacts were answered. 

• Since moving to the three-digit number and increased investment, the lifeline answered 43 

percent more calls and the average speed to answer decreased from 2 minutes and 46 

seconds to 49 seconds. 

This means more people are getting connected to care (and connected sooner) than ever before.
66 

National Strategy for Suicide Prevention

(Dollars in millions)

Programs of Regional and National Significance

FY 2023 

Final 

FY 2024 

CR 

FY 2025 

President's 

Budget

FY 2025 +/- 

FY 2023 

National Strategy for Suicide Prevention..................................... 28.200 28.200 29.950 1.750 

Suicide Prevention and Older Adults (non-add)...................... -- -- 1.750 1.750 

Zero Suicide (non-add)................................................................. 26.200 26.200 26.200 -- 

Zero Suicide American Indian and Alaska Native (non-add).. 3.400 3.400 3.400 -- 

All Other National Strategy for Suicide Prevention (non-add)....... 2.000 2.000 2.000 -- 

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

FY 2025 Authorization................................................................................................ $29,950,000 

Allocation Method.......................................................................Competitive 

Grants, Community–based primary care or behavioral health entity, Federally Recognized, 

American Indian/Alaska Native tribe or tribal organizations, State mental health or public health 

agency

 

Program Description

In January 2021, the Office of the Surgeon General issued a Call to Action to implement the 

National Strategy for Suicide Prevention (National Strategy). Established in FY 2014, the National 

Strategy for Suicide Prevention (NSSP) grant program supports the Call to Action’s broad-based 

public health approach to suicide prevention by enhancing collaboration with key community 

stakeholders (e.g., county health departments, workplace settings, senior-serving organizations, 

community firearm stakeholders),37 raising awareness of the available resources for suicide 

prevention and implementing lethal means safety. While the NSSP addresses all age groups and 

populations with specific needs, the goals, and objectives of the NSSP grants focus on preventing 

suicide and suicide attempts among adults who comprised more than 40,000 of the more than 

47,000 suicides in the United States in 2021.38

Established in FY 2017, the Zero Suicide program funds a comprehensive, multi-setting approach 

to suicide prevention in health systems, including tribal health systems. The purpose of this 

program is to implement suicide prevention and intervention programs by systematically applying

evidence-based approaches to screening and risk assessment, developing care protocols, 

collaborating for safety planning, providing evidence-based treatments, maintaining continuity of 

care during high-risk periods, and improving care and outcomes for individuals who are at risk for 

suicide being seen in health care systems.

The proposed Suicide Prevention and Older Adults program intends to address the rising rates of 

suicide among older adults. The baby boomer generation has had high rates of suicide throughout 

37 Community firearm stakeholders include firearm safety instructors, members of law enforcement,

firearm retailers, and gun owners.

38 Curtin SC, Garnett MF, Ahmad FB. Provisional numbers and rates of suicide by month and 

demographic characteristics: United States, 2021. Vital Statistics Rapid Release; no 24. September 

2022. DOI: https://dx.doi. org/10.15620/cdc:120830.
67 

the generational lifecycle39 and is entering the stage of life that has historically had the highest rate 

of suicide.40 Older adults are especially vulnerable to suicide: while older adults comprise just 12 

percent of the population, they account for nearly 18 percent of all suicides. They are also more 

likely to use more lethal methods of suicide. Very limited suicide prevention work has been 

directed toward older adults who have the highest rates of suicide. 

 

Budget Request

 

The FY 2025 President’s Budget Request is $29.9 million, an increase of 1.75 million from the 

FY 2023 Final level. The increase supports a new Older Adult Suicide Prevention program, which 

will be implemented in conjunction with the Administration for Community Living. This new 

Older Adult program would provide funding to up to five grantees for three years at up to $350,000 

. This program is expected to decrease the number of suicides and suicide attempts by older adults 

in communities served by this program. Expected outcomes includes increased screening, 

intervention, and/or referrals for older adults at risk for suicide and increased respite for family 

caregivers of older adults; reduced access to lethal means and increased safety planning for older 

adults receiving care; provide evidence-based trainings and learning opportunities to a minimum 

of 35 gerontologists and primary care providers annually; and provide evidence-based training to 

70 mental health professionals and 35 caregivers annually. The FY 2025 funding will also support 

35 Zero Suicide continuation grants, support five NSSP continuation grants, and award a new 

cohort of 11 Zero Suicide grants. It is expected that 98,000 individuals will be referred for services.

Funding History Table

 

Fiscal Year Amount

FY 2021 $23,200,000

FY 2022 $23,183,200

FY 2023 Final $28,200,000

FY 2024 CR $28,200,000

FY 2025 President’s Budget $29,950,000

 

Program Accomplishments

 

In FY 2023, SAMHSA awarded 25 Zero Suicide grant continuations and awarded a new cohort of 

five NSSP grants and 25 Zero Suicide grants. In 2023, the NSSP program has contacted 194,787 

people through program outreach efforts and screened 18,355 people for mental health 

interventions with a focus on suicide risk. The Zero Suicide grant program screened 1,898,526 

people for mental health interventions with a focus on suicide risk and referred 144,582 individuals 

for mental health services with 71 percent receiving services after referral in FY 2023. There will 

39 Phillips. J.A. A changing epidemiology of suicide? The influence of birth cohorts on suicide rates in the United 

States Social Science Medicine 2014 August

40 Ismael Conjero, Emilie Olie, Philippe Courtet &Raffella Calati (2018) Suicide in older adults : current perspectives,

Clinical Interventions in Aging ,13,691-699
68 

also be a national, cross-site program evaluation funded for the Zero Suicide grant program in FY 

2023. 

 

In FY 2024, SAMHSA anticipates funding 50 Zero Suicide and five NSSP grant continuations and 

anticipates slight increases in contact and outreach targets from FY 2023 for both programs. The 

Zero Suicide program evaluation will continue in FY 2024. 
69 

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

(Dollars in millions) 

Programs of Regional and National Significance

FY 2023 

Final 

FY 2024 

CR 

FY 2025 

President's 

Budget 

FY 2025 +/- 

FY 2023 

GLS - Youth Suicide Prevention - States........................................... 43.806 43.806 43.806 -- 

Budget Authority (non-add).......................................................... 31.806 31.806 31.806 -- 

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

GLS - Youth Suicide Prevention - Campus........................................ 8.488 8.488 8.488 -- 

Authorizing Legislation...............Sections 520E and 520E-2 of the Public Health Service Act

FY 2025 Authorization......................................................................$52,294,000 

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

Eligible Entities...........................................................Private\ and public non-profit 

institution of higher education, including Tribal colleges and universities; States and territories; 

public organizations of private non-profit organization designated by a State; or a federal 

recognized Indian tribe, tribal organization, or an Urban Indian organization. 

Program Description

In the fall of 2003, Garrett Lee Smith, son of Sen. Gordon and Sharon Smith, died by suicide in 

his apartment in Utah where he attended college. He was one day shy of 22 years old. In his 

memory, the Garrett Lee Smith Memorial Act was signed into law.

 

The Garrett Lee Smith (GLS) Memorial Act authorizes SAMHSA to manage two significant youth 

suicide prevention grant programs and one resource center. Since its inception in 2005, the GLS 

State/Tribal Youth Suicide Prevention and Early Intervention Grant Program has awarded 256 

grants to 50 states and the District of Columbia, 67 unique tribes/tribal organizations, and two 

territories. These grants develop and implement comprehensive youth suicide prevention and early 

intervention strategies including public-private collaboration among youth-serving institutions. 

Since 2005, the GLS Campus Suicide Prevention grant program has implemented a comprehensive 

public health approach to suicide prevention across an array of institutions of higher education 

include state university systems, private colleges, community colleges, and historically black 

colleges and universities. The goals of this grant are to engage the entire college community to 

enhance protective factors, identify risks, and promote an array of suicide prevention initiatives. 

This comprehensive approach identifies students at risk, increases help-seeking behaviors, 

provides substance use disorder and mental health services, and promotes social connectedness. 

 

In FY 2022, SAMHSA awarded a task order contract to support the design, implementation, and 

dissemination of the findings of a national impact evaluation of the GLS State/Tribal Youth 

Prevention and Early Intervention program. The evaluation aims to assess the impact of GLS 

State/Tribal Youth program at reducing suicide attempts and mortality due to suicide and to 

provide training and technical assistance to grantees related to evaluation, data collection and 

surveillance. 
70 

Budget Request

The FY 2025 President’s Budget Request is $52.9 million, equal to the FY 2023 Final level. Funds 

will support the continuation of 46 GLS State/Tribal grants and award a new cohort of eight grants. 

Funding will also support 55 GLS Campus continuation grants and award a new cohort of 18 

grants. SAMHSA will also continue support for evaluation activities. The program will continue 

developing and implementing youth suicide prevention and early intervention strategies involving 

public-private collaboration among youth serving institutions as well as to support suicide 

prevention among institutions of higher learning. It is anticipated that 118,200 individuals will be 

served.

 

Funding History Table

Fiscal Year Amount

FY 2021 $42,915,000

FY 2022 $45,260,200

FY 2023 Final $52,294,000

FY 2024 CR $52,294,000

FY 2025 President’s Budget $52,294,000

Program Accomplishments

In FY 2023, SAMHSA awarded 56 GLS State/Tribal grants continuations (51 continuation grants 

with base budget authority, five grants with American Rescue Plan Act funds) and awarded 12 

new state/tribal grants as well as 55 GLS Campus grant continuations (46 continuation grants with 

base budget authority, nine grans American Rescue Plan Act funds) and awarded 34 new GLS 

campus grants. The GLS state/tribal evaluation will also receive continued support in FY 2023. In 

FY 2023, GLS State/Tribal grants screened 78,444 youth for suicide risk and referred 28,440 youth 

for suicide prevention or related services.

In FY 2024, SAMHSA anticipates funding 33 GLS State/Tribal grant continuations, 56 GLS 

Campus grant continuations and awarding a new cohort of 23 GLS State and Tribal grants and 21 

GLS Campus grants. It is expected that in FY 2024, the GLS State/Tribal program will screen 

53,300 youth for suicide risk and refer 13,000 to services, of which 72 percent will receive services 

after referral. SAMHSA will continue support for evaluation activities in FY 2024. 
71 

Suicide Prevention Resource Center

(Dollars in millions) 

Programs of Regional and National Significance

FY 2023 

Final 

FY 2024 

CR 

FY 2025 

President's 

Budget

FY 2025 +/- 

FY 2023 

GLS - Suicide Prevention Resource Center....................................... 11.000 11.000 11.000 -- 

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

FY 2025 Authorization.............................................................................................. $11,000,000 

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

Eligible Entities ........................................................... Domestic Public and Private Nonprofit 

Entities

 

Program Description

SAMHSA supports the Suicide Prevention Resource Center (SPRC), first funded in 2002. The 

SPRC’s purpose is to build national capacity for preventing suicide by providing technical 

assistance, training, and resources to assist states, tribes, organizations, and SAMHSA grantees to 

develop suicide prevention strategies (including programs, interventions, and policies that advance 

the NSSP), with the overall goal of reducing suicides and suicidal behaviors in the nation. This 

work includes support for the National Action Alliance for Suicide Prevention which is a publicprivate partnership and working to advance high-impact objectives of the NSSP.

 

The SPRC has played an important role in transforming suicide prevention and treatment across 

the lifespan, particularly for those at high risk for suicide. Efforts to advance suicide prevention 

include: 

• Developing and promoting the adoption of evidence-based resources, tools, and online 

trainings to support strategic, comprehensive, best practice suicide prevention programs 

around the country.

• Building the capacity of suicide prevention programs nationwide by providing 

consultation, training, and resources to states, AI/AN communities, colleges and 

universities, health systems, and organizations serving groups at higher risk for suicide.

• Improving care for those at risk for suicide, including promoting the Zero Suicide model 

for safer suicide care in health and behavioral health care systems; and

• Providing leadership and operational support, which brings together more than 250 

national partners from the public and private sectors to advance implementation of the 

goals and objectives of the National Strategy.

 

In addition, the SPRC collaborates closely with national and regional technical assistance (TA) 

centers that focus on issues related to suicide prevention, such as mental health, injury prevention, 

substance use prevention and treatment, and violence prevention. SPRC’s collaborations include 

contacts with the coordinating offices of SAMHSA’s Mental Health Technology Transfer Centers 

(TTCs), Prevention TTCs, and Addiction TTCs; Service Member, Veterans, and their Families TA 

Center; Center for Integrated Health Solutions; and Health Resources and Services Administration 

(HRSA)’s National Center for Fatality Review and Prevention.
72 

Budget Request

The FY 2025 President’s Budget Request is $11.0 million, equal to the FY 2023 Final level. The 

funding will award one new grant and provide states, tribes, government agencies, private 

organizations, colleges and universities, and suicide survivors and mental health consumer groups 

with access to information and resources that support program development, intervention 

implementation, and adoption of policies that prevent suicide. The funding will expand youth 

suicide prevention and early intervention strategies involving public-private collaboration. 

SAMHSA anticipates that SPRC will provide training to approximately 14,000 people. 

 

Funding History Table

Fiscal Year Amount

FY 2021 $9,000,000

FY 2022 $8,983,200

FY 2023 Final $11,000,000

FY 2024 CR $11,000,000

FY 2025 President’s Budget $11,000,000

Program Accomplishments

In FY 2023, SAMHSA awarded one SPRC grant continuation, which provided free online courses 

to prepare the clinical workforce to address suicide risk in effective ways. In FY 2023, 6,970 

individuals had received training through the SPRC and an additional 13,337 participated in an 

education or awareness activity. SPRC is currently developing courses on safety planning for 

youth and lethal means intervention for crisis workers. 

In FY 2024, SAMHSA anticipates supporting this grant continuation and maintaining the 

performance targets. 
73 

American Indian/Alaska Native Suicide Prevention Initiative

(Dollars in millions)

Programs of Regional and National Significance

FY 2023 

Final 

FY 2024 

CR 

FY 2025 

President's 

Budget 

FY 2025 +/- 

FY 2023 

AI/AN Suicide Prevention Initiative................................................ 3.931 3.931 3.931 -- 

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

FY 2025 Authorization................................................................................................$3,931,000 

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

Eligible Entities ............................................................. Domestic Public and Private Non-Profit 

Entities

Program Description

Established in FY 2013, the Tribal Training and Technical Assistance Center (Tribal TTA Center) 

is an innovative training and technical assistance project that helps tribal communities facilitate 

the development and implementation of comprehensive and collaborative community-based 

prevention plans to reduce violence, bullying, substance misuse, and suicide among American 

Indian/Alaska Native (AI/AN) youth. These plans mobilize tribal communities’ existing social and 

educational resources to meet their goals. 

 

Additionally, in FY 2018, SAMHSA awarded a Mental Health Transfer Technology Center 

(MHTTC) grant for Tribal Affairs to develop a collaborative network to support resource 

development and dissemination, training and technical assistance, and workforce development to 

the field and SAMHSA grant recipients; at this same time, SAMHSA’s Centers for Substance Use 

Prevention and Substance Use Treatment also funded their own TTCs for Tribal Affairs. In FY 

2023, SAMHSA merged the three Tribal Affairs TTCs into one Center to coordinate and manage 

SAMHSA’s national efforts to ensure that high-quality, effective mental health disorder treatment 

and recovery support services, and evidence-based practices are available for all individuals with 

mental disorders including those with serious mental illness.

 

Budget Request

The FY 2025 President’s Budget Request is $3.9 million, equal to the FY 2023 Final level. This 

funding will provide funding for the Tribal Affairs Center and continuation of the contract to 

provide comprehensive, broad, focused, and intensive training and technical assistance to federally 

recognized tribes and other AI/AN communities to address and prevent mental illness and 

alcohol/other drug addiction, prevent suicide, and promote mental health through the contract 

continuation. 
74 

Funding History Table

Fiscal Year Amount

FY 2021 $2,931,000

FY 2022 $2,931,000

FY 2023 Final $3,931,000

FY 2024 CR $3,931,000

FY 2025 President’s Budget $3,931,000

Program Accomplishments

In FY 2023, SAMHSA funded the Tribal TTA Center contract and the continuation of the MHTTC 

Tribal Affairs Center. A total of 7,614 participants received specialized TTA and support in suicide 

prevention, substance abuse prevention, and mental health promotion. 

 

In FY 2023 and FY 2024, SAMHSA anticipates providing training or technical assistance to 

35,000 people and providing Continuation funding for the Tribal TTA Center and MHTTC Tribal 

Affairs Center.
75 

Output and Outcomes Table

Program: Suicide Prevention

Measure Year and Most Recent 

Result /

Target for Recent Result 

/

(Summary of Result)

FY 2024

Target

FY 2025

Target

FY 2025

Target

+/-FY 2024

Target

2.3.59 Number of 

individuals trained in 

youth suicide 

prevention (Outcome)

FY 2023: 126,113

Target:

210,000

(Target Not Met)

220,000 220,000 Maintain

2.3.60 Number of 

youth screened 

(Output)

FY 2023: 87,343

Target:

105,000

(Target Not Met)

110,000 110,000 Maintain

2.3.61 Number of 

contacts answered by 

the Suicide & Crisis

Lifeline (Output)

FY 2021: 2,396,885

Target:

2,186,000

(Target Exceeded)

6,000,000 7,500,000 +1,500,000

2.3.62 Number of 

individuals trained in 

suicide prevention 

(Invalid measure type)

FY 2023: 57,184

Target:

75,000.0

(Target Not Met)

75,000 75,140 +140

3.1.01 Number of 

individuals screened for 

mental health or related 

interventions 

(Intermediate 

Outcome)

FY 2023: 1,966,880

Target:

1,500,000.0

(Target Exceeded)

1,500,000 1,500,000 Maintain

3.1.02 Number of 

individuals referred to 

mental health or related 

services (Intermediate 

Outcome)

FY 2023: 156,984

Target:

136,000

(Target Exceeded)

136,000 136,000 Maintain

3.2.37 Number of 

youth referred to 

mental health or related 

services (Output)

FY 2023: 29,302

Target:

96,000

(Target Not Met)

96,000 96,000 Maintain
76 

Mental Health Crisis Response Partnership Program

(Dollars in millions)

Programs of Regional and National Significance

FY 2023 

Final 

FY 2024 

CR 

FY 2025 

President's 

Budget

FY 2025 +/- 

FY 2023 

MH Crisis Response Partnership Pilot Program Grants (New FY 22) 20.000 20.000 40.000 20.000 

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

FY 2025 Authorization........................................................................................... $40,000,000 

Allocation Method................................................................ Competitive Cooperative Agreements

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

CBOs

Program Description

In FY 2022, SAMHSA established the Cooperative Agreements for Innovative Community Crisis 

Response Partnerships (ICCRP) program. In the FY 2023 Omnibus, Congress authorized this 

program under Section 520F “Mental Health Crisis Response Partnership Program.” The purpose 

of this program is to create or enhance existing mobile crisis response teams to divert adults, 

children, and youth experiencing mental health crises from law enforcement in high-need 

communities. The program uses SAMHSA’s National Guidelines for Behavioral Health Crisis 

Care: Best Practice Toolkit as a guide for best practices in the delivery of mobile crisis services. 

Mobile crisis team services (including co-responder teams) will offer community-based 

intervention to individuals in need wherever they are, including at home, work, or anywhere else 

in the community where the person is experiencing a crisis. These grants will enable communities 

across the country to leverage the implementation of the 988 system and improve mobile crisis 

response systems through partnerships with law enforcement, emergency medical services, 911 

Public Safety Answering Points and 988 call centers.

Historically, mental health crisis services in the United States have been inconsistent and 

inadequate, resulting in the overuse of law enforcement, jails, hospital emergency rooms, and 

psychiatric hospital beds. In some communities, law enforcement agencies are the mental health 

crisis responders by default and over the past years, law enforcement agencies have reported 

increases in police contacts with individuals experiencing mental health challenges.41 This can 

result in drawing valuable police resources away from public safety priorities, increasing stigma 

and trauma for those experiencing a crisis, and may even result in tragic outcomes if law 

enforcement does not have the specialized training required to successfully de-escalate behavioral 

health crises. However, strong partnerships between crisis care systems and law enforcement (and 

other first responders) are essential for public safety, including suicide prevention. 

Mental Health Crisis Response Partnership Program recipients employ a wide array of required 

activities to help achieve 24/7 coverage of mobile crisis response services, dispatch times 

standards, increased professional response capacity, incorporation of telehealth when appropriate, 

improved service access in rural and remote areas, community-based stabilization with 

coordinated referrals to mental health services and supports, and minimization of law enforcement 

41 https://www.samhsa.gov/sites/default/files/national-guidelines-for-behavioral-health-crisis-care-02242020.pdf
77 

involvement and involuntary transport whenever possible. Additionally, recipients ensure that 

crisis response and follow-up services are delivered in a culturally responsive and developmentally 

appropriate manner, and that partnerships and training opportunities are established with first 

responders, law enforcement, 988 call centers, public safety answering points (911 call centers), 

and other relevant stakeholders. 

 

Budget Request

The FY 2025 President’s Budget Request is $40.0 million, an increase of $20.0 million from the 

FY 2023 Final level. Funding will support 25 grant continuations and award a new cohort of 23 

grants. These projects will support communities across the country to improve crisis response 

capacity and integrate community 988 and crisis systems. It is estimated that in FY 2025, 14,000 

individuals will be screened and 8,000 will be referred for services.

Funding History Table

Fiscal Year Amount

FY 2021 $---

FY 2022 $10,000,000

FY 2023 Final $20,000,000

FY 2024 CR $20,000,000

FY 2025 President’s Budget $40,000,000

Program Accomplishments

In FY 2023, SAMHSA awarded 12 grant continuations and 13 new grants. In FY 2023, grantees 

had screened 11,274 individuals and referred 6,651 individuals for mental health or related 

services. Additionally, 1,458 individuals were trained in evidence-based suicide risk assessment.

 

In FY 2024, SAMHSA anticipates funding 25 grant continuations. In FY 2024, it is estimated that 

approximately 7,000 individuals will be screened and over 4,000 individuals will be referred for 

mental health and related services. Also, there will be over 1,900 individuals trained in evidencebased suicide risk assessment in FY 2024.
78 

Homelessness Prevention Programs

(Dollars in millions) 

Programs of Regional and National Significance

FY 2023 

Final 

FY 2024 

CR 

FY 2025 

President's 

Budget

FY 2025 +/- 

FY 2023 

Homelessness............................................................................... 35.992 35.992 35.992 -- 

Homelessness Prevention Programs............................................. 33.696 33.696 33.696 -- 

Homelessness............................................................................... 2.296 2.296 2.296 -- 

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

FY 2025 Authorization.............................................................................................. $35,992,000 

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

Eligible Entities..............................States, Domestic Public and Community Organizations, 

Private Nonprofit Entities, and Community-based Public or Nonprofit Entities 

Program Description

In FY 2018, SAMHSA initiated the Treatment for Individuals Experiencing Homelessness (TIEH) 

program to support the development and/or expansion of local implementation of an infrastructure 

that integrates behavioral health treatment and recovery support services for individuals, youth, 

and families with a serious mental illness (SMI), serious emotional disturbance (SED), or cooccurring disorder who are experiencing homelessness. The goal of the TIEH program is the 

development and/or expansion of an infrastructure that integrates behavioral health treatment, peer 

support, recovery support services, and linkages to sustainable permanent housing. 

Homelessness continues to be a significant challenge for communities across the nation. Between 

2020 and 2022, the overall number of people experiencing homelessness increased by less than 

one percent (1,996 people). This increase reflects a three percent increase in people experiencing 

unsheltered homelessness, which was offset by a two percent decline in people staying in sheltered 

locations. However, between 2021 and 2022, sheltered homelessness increased by seven percent, 

or 22,504 people.42 Many factors contribute to homelessness, such as lack of affordable housing, 

foreclosures, rising housing costs, job loss, underemployment, domestic violence, mental illness, 

and addiction. According to HUD, 582,462 individuals experienced homelessness on any given 

night in 2022 in the United States.43 In addition, the number of individuals experiencing chronic 

homelessness was 138,361.44 The number of veterans experiencing homelessness was 33,129. 

Over 122,000 individuals experiencing homelessness have a SMI and over 95,000 struggle with 

chronic substance use.

In FY 2023, SAMHSA released a new funding announcement which expands the population of 

focus to include individuals at imminent risk of homelessness, allows for greater flexibility in the 

definition of homelessness, and strengthens collaboration with homeless services organizations 

42 Exchange, H. U. D. (2022). The 2022 Annual Homeless Assessment Report (AHAR) to Congress. Available at 

https://www.huduser.gov/portal/sites/default/files/pdf/2022-AHAR-Part-1.pdf Exchange, H. U. D. (2021). The 2020 Annual 

Homeless Assessment Report (AHAR) to Congress. 

43 The U.S. Department of Housing and Urban Development, 2022 CoC Homeless Populations and Reports. Available at 

https://files.hudexchange.info/reports/published/CoC_PopSub_NatlTerrDC_2022.pdf Subpopulations 

44 ibid 
79 

and HUD Continuum of Care Program.45 

Budget Request

The FY 2025 President’s Budget Request is $35.9 million, equal to the FY 2023 Final level. With 

this funding, SAMHSA will support 47 TIEH continuation grants, award a new cohort of five 

TIEH grants, one Housing and Homeless Resource Center (HHRC) contract, and one SSI Outreach 

Access and Recovery (SOAR) contract. These resources will increase capacity and provide 

accessible, effective, comprehensive, coordinated, integrated, and evidence-based treatment 

services, peer support and other recovery support services, and linkages to sustainable and 

permanent housing. Grantees will expand access to treatment and connect homeless individuals 

experiencing SMI with safe, secure housing. The number of individuals served is estimated to 

increase to approximately 7,000 individuals 

Funding History Table

Fiscal Year Amount

FY 2021 $32,992,000

FY 2022 $32,958,400

FY 2023 Final $35,992,000

FY 2024 CR $35,992,000

FY 2025 President’s Budget $35,992,000

Program Accomplishments

In FY 2023, SAMHSA awarded 24 TIEH grant continuations, awarded 31 new TIEH grants, one 

HHRC grant, and one SOAR contract. In FY 2023, SAMHSA released a new funding 

announcement which expands the population of focus to include individuals at imminent risk of 

homelessness, allows for greater flexibility in the definition of homelessness, and strengthens 

collaboration with homeless services organizations and HUD Continuum of Care Program. 

In FY 2024, SAMHSA anticipates funding 36 TIEH grant continuations, award a new cohort of 

16 TIEH grants, one HHRC grant, one SOAR contract, and technical assistance activities. This 

will expand access to 7,000 individuals with SMI, SED, SUD, or co-occurring disorders, who are 

experiencing homelessness or at imminent risk of homelessness.

45 https://www.hudexchange.info/programs/coc/
80 

Minority AIDS

(Dollars in millions) 

Programs of Regional and National Significance

FY 2023 

Final 

FY 2024 

CR 

FY 2025 

President's 

Budget 

FY 2025 +/- 

FY 2023 

Minority AIDS................................................................................ 9.224 9.224 9.224 -- 

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

FY 2025 Authorization......................................................................................... $ 9,224,000 

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

Eligible Entities ............................................ Community and faith-based organizations, Tribes, 

Urban organizations, Hospitals, Public and private universities, and colleges 

Program Description

Initiated in FY 2017, the Minority AIDS Initiative – Service Integration (MAI-SI) grant program 

provides resources to help reduce the co-occurring epidemics of HIV, hepatitis, and mental health 

disorders through accessible, evidence-based, culturally appropriate mental and co-occurring 

disorder treatment that is integrated with HIV primary care and prevention services. SAMHSA 

expects that this program will help reduce the incidence of HIV and improve overall health 

outcomes for those at-risk individuals with a mental health disorder or co-occurring disorder 

(COD). The population of focus is individuals, ages 18 and over, of racial and ethnic minorities 

(e.g., black/African American, Hispanic/Latino, American Indian, Alaska Native, Native 

Hawaiian, and Asian and Pacific Islander populations) with a mental health disorder or COD with 

or at risk for HIV and/or hepatitis. These at-risk populations are disproportionately impacted by 

HIV and hepatitis.46 Grantees provide evidence-based mental, and substance use disorder (SUD) 

treatment and practices that are trauma-informed and recovery-oriented. 

Budget Request

The FY 2025 President’s Budget Request is $9.2 million, equal to the FY 2023 Final level. 

SAMHSA will support 19 continuation grants focused on individuals with mental disorders and/or 

co-occurring disorders with or at risk for HIV. SAMHSA will also maintain its performance 

measure targets for FY 2025. 

46 https://www.hiv.gov/hiv-basics/overview/data-and-trends/impact-on-racial-and-ethnic- minorities
81 

Funding History Table

Fiscal Year Amount

FY 2021 $9,224,000

FY 2022 $9,207,200

FY 2023 Final $9,224,000

FY 2024 CR $9,224,000

FY 2025 President’s Budget $9,224,000

Program Accomplishments

In FY 2023, SAMHSA awarded 19 grant continuations focused on individuals with mental 

disorders and/or co-occurring disorders with or at risk for HIV. Additionally, SAMHSA began 

collecting data on the number of organizations collaborating, coordinating, and sharing resources 

with other organizations as a result of the grant and the number of individuals screened for mental 

health or related interventions. In FY 2023, 78.7 percent of individuals receiving services were not 

experiencing serious psychological distress at six-month follow-up, compared to 62.0 percent at 

intake (baseline), and 79.5 percent of individuals were retained in the community at six-month 

follow-up, compared to 67.0 percent at intake.

 

In FY 2024, SAMHSA anticipates funding 19 grant continuations and maintaining the FY 2023 

targets.
82 

Outputs and Outcomes Table

Program: Minority AIDS Initiative Service Integration

Measure Year and Most Recent 

Result /

Target for Recent Result 

/

(Summary of Result)

FY 2024

Target

FY 2025

Target

FY 2025

Target

+/-FY 2024

Target

3.5.02 Percentage of 

clients receiving 

services who report 

positive functioning at 

6 month follow-up. 

(Outcome)

FY 2023: 54.9%

Target:

66%

(Target Not Met)

66% 66% Maintain

3.5.45 Number of 

clients served (Output)

FY 2023: 1,470

Target:

2,000

(Target Not Met)

2,000 2,000 Maintain
83

Criminal and Juvenile Justice Programs

(Dollars in millions)

Programs of Regional and National Significance

FY 2023 

Final FY 2024 CR

FY 2025 

President's 

Budget

FY 2025 +/- 

FY 2023 

Criminal and Juvenile Justice Programs............................... 11.269 11.269 11.269 -- 

Authorizing Legislation ........ ................................................Sections 520G of the Public 

Health Service Act. 

FY 2025 Authorization ..................................................................................................$11,269,000 

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

Eligible Entities...........................................................................States and Territories; Political 

Sub-Divisions of States; Indian Tribes or Tribal Organizations; Health Facilities or Programs 

Operated in Accordance with a contract or award with the Indian Health Service.

 

Program Description

SAMHSA’s Behavioral Health Partnerships for Early Diversion grants began in FY 2013. The 

purpose of this program is to establish or expand programs that divert adults and/or youth with a 

mental illness or a co-occurring disorder (COD) from the criminal or juvenile justice system to 

community-based mental health and substance use disorder (SUD) services and other supports 

prior to arrest and booking. 

 

Data indicate that a significant number of individuals who come in contact with law enforcement 

and the criminal justice system have a mental or substance use disorder. The U.S. Department of 

Justice, Office of Justice Programs, reported that 1 in 7 state and federal prisoners (14 percent) and

1 in 4 jail inmates (26 percent) reported experiences that met the threshold for serious 

psychological distress.47 Approximately 383,000 individuals with serious mental illness (SMI) are 

incarcerated at any given time48 and more than 90 percent of arrests for people with SMI are for 

non-violent offenses49 such as trespassing or disorderly conduct. 

 

Additionally, high rates of incarceration disproportionately impact communities of color, 

especially among African American, Hispanic/Latino and LGBTQI+ populations. Black 

Americans are incarcerated in state prisons nationally at nearly five times the rate of whites and 

Latino people are 1.3 times as likely to be incarcerated than non-Latino whites.50 According to 

data from the National Survey on Drug Use and Health, in 2019, gay, lesbian, and bisexual 

individuals were 2.25 times as likely as straight individuals to be arrested within the last 12 months. 

This, like the imprisonment rates of LGBTQI+ people, is largely the result of disparate arrests of 

lesbian and bisexual women who were arrested at 4 times the rate of straight women. Gay and

47 Bronson, J. and Berzofsky, M. (2017). Indicators of Mental Health Problems Reported by Prisoners and Jail 

Inmates, 2011-12. Indicators of Mental Health Problems Reported by Prisoners and Jail Inmates, 2011-12 (ojp.gov) 48 Center, T. A. (2016). Serious mental illness (SMI) prevalence in jails and prisons. Arlington, VA: Treatment 

Advocacy Center. https://www.treatmentadvocacycenter.org/evidence-and-research/learn-more-about/3695 49 Compton, M. T., Zern, A., Pope, L. G., Gesser, N., Stagoff-Belfort, A., Tan de Bibiana, J., ... & Smith, T. E. (2022). 

Misdemeanor Charges Among Individuals With Serious Mental Illnesses: A Statewide Analysis of More Than Two 

Million Arrests. Psychiatric Services, appi-ps. 50 https://www.sentencingproject.org/reports/the-color-of-justice-racial-and-ethnic-disparity-in-state-prisonsthesentencing-project
84

bisexual men were arrested at 1.35 times the rate of straight men, according to the survey.51 

Sixty-five to seventy percent of children in the juvenile justice system have a diagnosable mental 

health condition, and children in the juvenile justice system have substantially higher rates of 

behavioral health conditions than children in the general population. At least seventy-five percent 

of youth in the juvenile justice system experienced traumatic victimization, and ninety-three 

percent reported exposure to adverse childhood experiences including child abuse, family and 

community violence, and serious illness. Unfortunately, children are often involved in the juvenile 

justice system because of a lack of community-based treatment options and are detained or placed 

in juvenile facilities for minor, nonviolent offenses.52 Moreover, “when a student is suspended or 

expelled his or her likelihood of being involved in the juvenile justice system the subsequent year 

increases significantly.” African American students are disproportionately affected by what has 

been referred to as a “school to prison pipeline.”53 There is a clear and largely unmet need for 

effective behavioral health services and supports that are accessible before, during, and after 

incarceration as needed for this high-risk population. 

Budget Request

The FY 2025 President’s Budget Request is $11.3 million, equal to FY 2023 Final level. In FY 

2025 SAMHSA anticipates awarding 22 grant continuations and award a new cohort of nine grants

to establish or expand programs that divert adults and youth with a mental illness or a COD from 

the criminal or juvenile justice system to community-based mental health and substance use 

disorder services and other supports prior to arrest and booking. SAMHSA estimates the total 

number of individuals served by both programs will remain the same as in FY 2023. 

Funding History Table

Fiscal Year Amount

FY 2021 $6,269,000

FY 2022 $6,252,200

FY 2023 Final $11,269,000

FY 2024 CR $11,269,000

FY 2025 President’s Budget $11,269,000

Program Accomplishments

In FY 2023, SAMHSA awarded 6 grant continuations, 22 new grants, and conducted technical 

assistance activities that will expand access to people with mental illness across local criminal 

justice and court systems. In FY 2023, 6.3 percent of individuals served by this program reported 

51 https://www.samhsa.gov/data/data-we-collect/nsduh-national-survey-drug-use-and-health 52 Mental Health America (2022). Position Statement 51: Children With Emotional Disorders In The Juvenile 

Justice System, 2015. https://www.mhanational.org/issues/position-statement-51-children-emotional-disordersjuvenilejustice-system 53 Justice Center: The Council of State Governments, Public Policy Research Institute (2020). Breaking Schools’ 

Rules: A Statewide Study of How School Discipline Relates to Students’ Success and Juvenile Justice Involvement, 

2011.
85

that they were hospitalized for mental health care in the past 30 days, compared with 27.8 percent 

at baseline. Similar improvements were seen in clients reporting one or more nights homeless in 

the previous 30 days, from 12.7 percent at 6 months compared to 22.8 percent at baseline. 

Additionally, after 6 months of receiving grant services, 1.3 percent of individuals served by this 

program reported spending time in a correctional facility compared with 5.1 percent at baseline, 

79.5 percent reported being retained in the community compared with 55.1 percent at baseline, 

and 39.7 percent reported improved functioning in everyday life compared with 34.6 percent at 

baseline. 

 

In 2024, SAMHSA anticipates funding 27 grant continuations to establish or expand programs that 

divert adults and/or youth with mental illness or a co-occurring disorder from the criminal or 

juvenile justice systems and conduct technical assistance activities to expand access to people with 

mental illness across local and criminal justice systems. 

 
86

Outputs and Outcomes Table

Program: Law Enforcement and Behavioral Health Partnerships for Early Diversion

Measure Year and Most Recent 

Result /

Target for Recent Result 

/

(Summary of Result)

FY 2024

Target

FY 2025

Target

FY 2025

Target

+/-FY 2024

Target

3.5.06 Percentage of 

clients receiving 

services who report 

positive functioning at 

6 month follow-up 

(Outcome)

FY 2023: 39.7

 

Target:

40.0

 

(Target Not Met but 

Improved)

40.0 40.0 Maintain

3.5.09 Number of 

individuals screened 

for mental health or 

related interventions. 

(Output)

FY 2023: 4,056

 

Target:

3,500.0

 

(Target Exceeded)

3,500.0 3,500 Maintain

3.5.40 Number of 

clients served (Output)

FY 2023: 2,290.0

Target:

1,800.0

(Target Exceeded)

1,800.0 1,800.0 Maintain
87

Practice Improvement and Training

(Dollars in millions) 

Programs of Regional and National Significance

FY 2023 

Final FY 2024 CR

FY 2025 

President's 

Budget 

FY 2025 +/- 

FY 2023 

Practice Improvement and Training................................................... 7.828 7.828 7.828 -- 

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

FY 2025 Authorization ...................................................................................................$ 7,828,000 

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

Eligible Entities....................................States and Territories; Political sub-divisions of 

States, Indian Tribes or Tribal Organizations; health facilities or programs operated in accordance 

with the Indian Health Services; 105 Nationally Recognized Historically Black Colleges and 

Universities; public or private non-profit organizations. 

 

Program Description

The Practice Improvement and Training (PIT) programs address the need for disseminating key 

information, such as evidence-based mental health practices, to the mental health delivery system. 

Four programs are funded with PIT: Historically Black Colleges and Universities Center of 

Excellence (HBCU-COE); Transforming Lives through Supported Employment Program (SEP); 

the Clinical Support Services Technical Assistance Center and the Center of Excellence for Eating 

Disorders.

The purpose of the HBCU-COE program is to network the 105 HBCUs throughout the United 

States and promote behavioral health workforce development by expanding knowledge of best 

practices, developing leadership, and encouraging community partnerships that enhance the 

participation of African Americans in substance use disorder treatment and mental health 

professions. The comprehensive focus of the HBCU-COE program simultaneously expands 

service capacity on campuses and in other treatment venues.

Established in FY 2014, the purpose of SEP is to support state and community efforts to refine, 

implement, and sustain evidence-based practices but altered its population of focus to include both 

adults with serious mental illness (SMI) or co-occurring disorders (COD). Please refer to Mental 

Health System Transformation and Mental Health Reform for more information on this program.

 

The purpose of the Center of Excellence for Eating Disorders (NCEED) is to establish one National 

Center of Excellence to develop and disseminate training and technical assistance for healthcare 

practitioners on issues related to addressing eating disorders. It is expected that this program will 

facilitate the identification of model programs, develop and update materials related to eating 

disorders, and ensure that high-quality training is provided to health professionals.

 
88

Budget Request

The FY 2025 President’s Budget Request is $7.8 million, is equal to the FY 2023 Final level. 

Funding will support continuation of the Clinical Support Services TA Center for SMI, HBCU 

grant program to support workforce development, the NCEED in contract and a continuation of 

eight Transforming Lives through Supported Employment Programs (SEP) grants. 

Funding History Table

Fiscal Year Amount

FY 2021 $7,828,000

FY 2022 $7,811,200

FY 2023 Final $7,828,000

FY 2024 CR $7,828,000

FY 2025 President’s Budget $7,828,000

Program Accomplishments

In FY 2023, SAMHSA funded the HBCU grant program, four SEP grant continuations, five new 

SEP grants, and one NCEED grant. In FY 2023, 49.2 percent of participants were competitively 

employed at six-month follow-up, compared to 19.4 percent at intake (baseline), representing a 

154 percent positive change. Additionally, 75.9 percent reported having a stable place to live at 

follow-up compared to 48.1 percent at intake, and 80.6 percent were retained in the community 

compared to 66.9 percent at intake. 

 

In FY 2024, SAMHSA anticipates providing continuation funding for five SEP grants, a new SEP 

cohort of three grants, continue funding the HBCU grant program to support workforce 

development, and fund one NCEED contract. 
89

Consumer and Consumer-Supporter TA Centers

(Dollars in millions) 

Programs of Regional and National Significance

FY 2023 

Final 

FY 2024 

CR 

FY 2025 

President’s 

Budget

FY 2025 

+/- FY 

2023

Consumer and Consumer-Supporter TA Centers............................. 1.918 1.918 1.918 -- 

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

FY 2025 Authorization................................................................................................ $1,918,000 

Allocation Method ............................................................................................Competitive Grants

Eligible Entities .......................................................................................................States, political

subdivisions of states, health facilities or programs operated in accordance with the Indian Health 

Service, or other domestic public or private non-profit entities

Program Description

First funded in 1992, the Consumer and Consumer-Supporter Technical Assistance (TA) Centers 

provide technical assistance to facilitate quality improvement of the mental health system by the 

specific promotion of consumer-directed approaches for adults with serious mental illness (SMI). 

This program also improves collaboration among consumers, families, providers, and 

administrators and helps to transform community mental health services into a more consumer and 

family driven model. 

 

Consumer-centered services and supports, such as peer specialists, are key to improving the quality 

and outcomes of health and behavioral healthcare services for people with mental disorders 

including SMI. Such approaches maximize consumer self-determination, promote long-term 

recovery, and assist individuals with SMI to increase their community involvement through work, 

school, and social connectedness. 

 

Budget Request

The FY 2025 President’s Budget is $1.9 million, is equal to the FY 2023 Final level. This funding 

request will support new grants to provide technical assistance to facilitate the quality 

improvement of the mental health system by promoting consumer-directed approaches for adults 

with SMI and focus on coordination with the state-wide consumer network program and engaging 

people with lived experience of mental illness to improve mental health systems and supports and 

advance community inclusion, recovery, and resilience. In FY 2025, SAMHSA will continue to 

maintain the performance measure targets for this program.
90

Funding History Table

Fiscal Year Amount

FY 2021 $1,901,492

FY 2022 $1,901,200

FY 2023 Final $1,918,000

FY 2024 CR $1,918,000

FY 2025 President’s Budget $1,918,000

Program Accomplishments

In FY 2023, SAMHSA funded five grant continuations. In FY 2023 these grants provided training 

to 31,051 individuals and reached 315,051 people with mental health awareness activities. These 

trainings covered a range of topics, including peer support, peer-run crisis services, employment 

and education supports, mental health first aid, and improving care for people with mental illness 

and intellectual or developmental disabilities. SAMHSA expects to serve a similar number of 

people in FY 2023. 

 

In FY 2024, SAMHSA anticipates funding five grant continuations and provide technical 

assistance to facilitate the quality improvement of the mental health system by promoting 

consumer-directed approaches for adults with SMI. SAMHSA will continue to maintain its 

performance measure targets.
91

Disaster Response

(Dollars in millions) 

Programs of Regional and National Significance

FY 2023 

Final 

FY 2024 

CR 

FY 2025 

President's 

Budget 

FY 2025 +/- 

FY 2023 

Disaster Response................................................ 1.953 1.953 1.953 -- 

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

FY 2025 Authorization................................................................................................ $1,953,000 

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

Eligible Entities .......................................................States, political sub-divisions of states, health 

facilities or programs operated in accordance with the Indian Health Service, or other domestic 

public or private non-profit entities

 

Program Description

Natural and human-caused disasters and emergent events such as the COVID-19 pandemic, 

wildfires, mass shootings, hurricanes and tropical storms, floods, and tornadoes strike without 

warning and leave individuals, families, and whole communities struggling to rebuild. SAMHSA’s 

Disaster Behavioral Health Program aims to ensure that the nation is prepared to address the 

behavioral health needs that follow these events by funding three major programs: the Disaster 

Distress Helpline (DDH), the Crisis Counseling Assistance and Training Program (CCP), and the 

Disaster Technical Assistance Center (DTAC). These programs provide disaster behavioral health 

expertise and emerging public health initiatives to develop and disseminate innovative consultation 

and technologies to communities, federal partners, and other stakeholders.

 

SAMHSA’s DDH is the nation’s first permanent hotline dedicated to providing immediate disaster 

crisis counseling. SAMHSA launched the Oil Spill Distress Helpline in 2010 following the 

Deepwater Horizon Explosion/BP Oil Spill. The number then transitioned to the national Disaster 

Distress Helpline in February 2012. The DDH is a toll-free, multilingual crisis systems service 

available 24/7 via telephone (1-800-985-5990) and Short Message Service (SMS) (text 

‘TalkWithUs’ to 66746) to residents in the United States and its territories who are experiencing 

emotional distress resulting from disasters.

SAMHSA operates the CCP through an interagency agreement with the Federal Emergency 

Management Agency (FEMA). The CCP was established in 1974 under the Stafford Act. Section 

416 of the Robert T. Stafford Disaster Relief and Emergency Assistance Act, 42 U.S.C. § 5183 

authorizes FEMA to fund mental health assistance and training activities in areas that have been 

declared a major disaster by the President. This program assists individuals and communities to 

recover from presidentially declared disasters through the provision of community-based 

behavioral health outreach and psycho-educational services.

 

The DTAC is funded by SAMHSA and FEMA and was founded in 2002. This program is designed 

to provide additional technical assistance, strategic planning, consultation, and logistical support 

to communities and response personnel in advance of, during, and in response to disasters. In 

addition, SAMHSA’s Disaster App (available on Apple and Android platforms) provides 

evidence-informed and evidence-based resources in the Disaster Kit, along with additional partner 
92

resources and information on local mental health and substance use treatment facilities.

 

Budget Request

The FY 2025 President’s Budget is $1.9 million, is equal to the FY 2023 Final level. Funding will 

continue the support of a nationally available disaster distress crisis counseling telephone line and 

the DTAC. In FY 2025, SAMHSA will continue to maintain the same performance measure targets 

as FY 2023. 

 

Funding History Table

Fiscal Year Amount

FY 2021 $1,953,000

FY 2022 $1,936,200

FY 2023 Final $1,953,000

FY 2024 CR $1,953,000

FY 2025 President’s Budget $1,953,000

Program Accomplishments

In FY 2023, the SAMHSA DDH responded to 37,622 calls and answered 2,996 text sessions. 

Overall DDH volume increased by 25% in FY 2023 compared to FY 2022, and increased by 200% 

compared to FY 2019, prior to the onset of the COVID pandemic. The DDH also received 1,403 

calls to its Videophone option for Deaf/Hard of Hearing American Sign Language users in FY

2023, a 9% increase in volume compared to FY 2022. The majority of DDH callers and texters are 

experiencing acute, temporary stress related to a disaster. DDH crisis counselors utilize 

stabilization, psychological first aid, and other brief supportive counseling techniques regardless 

of presenting concern. Disasters that resulted in an increase in call volume in FY 2023 include the 

following: Hurricane Ian and Fiona recovery which continued into October 2022 (50% higher 

volume compared to weeks prior); the Monterey Park shooting and severe storms and flooding, 

both in California in late January 2023 (18% and 35% increases, respectively); tornadoes in 

Mississippi and surrounding states at the end of March and early April 2023 (40% increase); 

Typhoon Mawar in Guam (landfall 5/30/23, 300% increase in calls from Guam); June 2023 

tornado outbreaks in Texas and Florida (20% increase in volume); July 2023 major flooding in 

Vermont and New York (23% increase in volume); August 8th, 2023, outbreak of wildfires in 

Maui, Hawaii (almost 2000% increase in calls from Hawaii compared to week prior); and 

Hurricane Idalia in Florida at the end of August 2023 (40% increase in volume). In addition, 

membership to the DDH Online Peer Support Communities program grew by 55% in FY 2023 

(2,985 total members across its 1) Survivors of Mass Violence, and 2) Survivors and Responders 

of COVID peer support communities, compared to 1,930 total members in FY 2022), all of whom 

received 12,704 supportive interactions from 25 trained DDH Peer Supporters and via 200 Crisis 

Support Over Messenger chats with DDH crisis counselors from the DDH Online Peer Support 

crisis center.
93

During FY 2023, the FEMA funded Crisis Counseling Assistance and Training Program 

(commonly referred to as CCP, supported by FEMA Interagency Agreement with SAMHSA 

CMHS) Online Data Collection and Evaluation System (ODCES) showed the following contacts 

and encounters funded by 38 CCP grants: 

• 825,966 in-person brief educational supportive contacts 

• 23,461 telephone, 17,162 hotline, and 42,437 e-mail contacts 

• 171,007 individual and family crisis counseling encounters (lasting 15 to 60 minutes or 

more) serving 195,971 individuals

• 153,884 group encounters (public education and group counseling) serving 228,338 

individuals 

• 8,851 public education sessions serving 202,141 individuals

Individual and family crisis counseling encounters were most often conducted with adults ages 40 

to 64 (86,874), followed by older adults (65+) (71,687), adults ages 18-39 (30,674), children 

(2,670), adolescents (1,936) and pre-school (2,130). Individual and family encounters occurred 

most often with female (109,765) disaster survivors, compared to males (85,413) and transgender 

(793). Excluding the Puerto Rico programs, 2,217 individual crisis counseling encounters occurred 

in Spanish. The three most common risk factors reported by counseling participants were past 

trauma (142,464), other financial loss (140,178), and preexisting physical disability (114,001). The 

three most common disaster reactions reported by individual crisis counseling recipients and their 

numbers are: anxious/fearful (131,370); preoccupied with death/destruction (131,209); and 

extreme change in activity level (125,048).

In FY 2024, SAMHSA anticipates continued funding for DDH and DTAC to support a nationally 

available disaster distress crisis counseling telephone line and the Disaster Technical Assistance 

Center and will continue to maintain its performance measures targets.

 
94

Output and Outcomes Table

Program: Mental Health - Science and Service Activities

Measure Year and Most Recent 

Result /

Target for Recent 

Result /

(Summary of Result)

FY 2024

 Target

FY 2025

 Target

FY 2025

 Target

+/-FY 2024

 Target

1.4.14 Number of 

calls answered by the 

Disaster Distress 

Hotline (Output)

FY 2023: 37,622

 

Target:

 38,000 

 

(Target Not Met but 

Improved)

38,000 38,000 Maintain

1.4.15 Number of 

text messages 

answered by the 

Disaster Distress 

Hotline (Output)

FY 2023: 2,996

 

Target:

 17,000 

 

(Target Not Met)

17,000 17,000 Maintain
95

Seclusion and Restraint

(Dollars in millions) 

Programs of Regional and National Significance

FY 2023 

Final 

FY 2024 

CR 

FY 2025 

President's 

Budget 

FY 2025 +/- 

FY 2023 

Seclusion and Restraint...................................................................... 1.147 1.147 1.147 -- 

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

FY 2025Authorization................................................................................................ $1,147,000 

Allocation Method ........................................................................ Grants/Cooperative Agreements

Eligible Entities ....................................................Domestic Public and Private Non-Profit Entities

Program Description

Because of the inappropriate use of seclusion and restraint practices, people die, countless others 

are injured, and many people are traumatized by coercive practices. Schoolchildren, with and 

without disabilities, have been restrained and secluded in the United States since at least the 

1950s.54 Children with emotional and behavioral issues are more frequently subjected to restraints 

in schools than students with other disabilities, often leading to serious physical injuries and 

emotional trauma for both students and staff. Even if children suffer no physical harm as the result 

of the use of seclusion and restraints, studies have shown they remain severely traumatized and 

may even experience post-traumatic stress disorder.55 As a result of their experiences, children 

who have been restrained have reported nightmares, anxiety, and mistrust of adults in authority.56

 

In 2018, SAMHSA funded a regionally based technical assistance effort focused on providing 

supports and services for individuals living with mental disorders and/or serious mental illness 

(SMI), including the dissemination of trauma-informed practices across multiple service settings 

and promoting alternatives to restraint, seclusion, and other coercive practices. The purpose of the 

Mental Health Technology Transfer Center (MHTTC) Network is to disseminate and implement 

evidence-based practices for treating mental disorders into the field. In FY 2023, the MHTTC 

Network included 10 Regional Centers, and a Network Coordinating Office. 

 

54 Joseph B. Ryan & Reece L. Peterson, Physical Restraint in School, 29 J. COUNS. FOR CHILD. BEHAV. 

DISORDERS 154, 158 (2004).

55 CCBD, supra note 14; see also NDRN, supra note 3 (compiling research on harmful effects of

seclusion and restraint). 56 David M. Day, Review of the Literature on Restraints and Seclusion with Children and Youth: Toward the 

Development of a Perspective in Practice (2000).
96

Budget Request

The FY 2025 President’s Budget is $1.1 million, is equal to the FY 2023 Final level. With these 

funds, SAMHSA will support the MHTTC. 

 

Funding History Table

Fiscal Year Amount

FY 2021 $1,147,000

FY 2022 $1,130,198

FY 2023 Final $1,147,000

FY 2024 CR $1,147,000

FY 2025 President’s Budget $1,147,000

Program Accomplishments

In FY 2023, SAMHSA funded 11 MHTTC continuation grants and will maintain the FY 2023 

performance measure targets.

In FY 2024, one National Center for Mental Health Dissemination, Implementation and 

Sustainment Cooperative Agreement (MHDIS) recipient will be tasked with developing 

opportunities for communication and collaboration across CMHS training and technical assistance 

centers. The MHDIS will also develop resources that aid CMHS grantees in dissemination, 

implementation and evaluation of training and TA, and will oversee five bi-regional sub-grantees. 

These Mental Health Technical Assistance Centers (MTACs) will provide localized targeted and 

intensive TA to grantees and the field that builds upon the work of CMHS’ national TA centers 

and COEs.
97

Assertive Community Treatment for Individuals with Serious Mental Illness

(Dollars in millions) 

Programs of Regional and National Significance

FY 2023 

Final 

FY 2024 

CR 

FY 2025 

President's 

Budget

FY 2025 +/- 

FY 2023 

Assertive Community Treatment for Individuals with SMI................... 9.000 9.000 9.000 -- 

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

FY 2025 Authorization $9,000,000 

Allocation Method Competitive Grants/Contracts

Eligible Entities..................States, Political Sub-divisions of states; community-based 

behavioral health non-profit organizations; Indian tribes or tribal organizations, mental health 

systems; health care facilities

Program Description

Initiated in FY 2018, the Assertive Community Treatment (ACT) for Individuals with serious 

mental illness (SMI) program establishes or expands and maintains ACT programs for transitionaged youth and adults with a SMI or serious emotional disturbance (SED). Grantees are expected 

to implement an ACT program to fidelity and provide ACT services to the population of focus. 

With this program, SAMHSA aims to improve behavioral health outcomes for individuals by 

reducing rates of hospitalization, mortality, substance use, homelessness, and involvement with 

the criminal justice system.

ACT is an evidence-based practice considered to be one of the most effective approaches to 

delivering services to individuals with the most severe impairments associated with SMI.57

Individuals with severe functional impairments tend to need services from multiple providers (e.g., 

physicians, socials workers) and multiple systems (e.g., social services, housing services, health 

care). ACT was developed to deliver comprehensive effective services to those who live with the 

most serious psychiatric symptoms, the most significant social functioning challenges, and whose 

needs have not been well met by traditional approaches. In FY 2023, SAMHSA released a new 

funding opportunity to further implement ACT programs to fidelity and provide ACT services to 

the population of focus. 

ACT is a services-delivery model, not a case management program. The ACT team model is 

composed of 10-12 multi-disciplinary behavioral health care staff who work together to deliver a 

mix of individualized, recovery-oriented services to individuals living with SMI to help them 

successfully reintegrate into the community. Team members themselves provide the 

comprehensive array of services directly rather than through referrals. Caseloads are 

approximately one staff for every 10 individuals served. Services are provided 24 hours a day, 7 

days a week, as long as needed and wherever they are needed. Based on the ACT model, a multidisciplinary team is available around the clock to deliver a wide range of services in a person’s 

home or other community settings. 

ACT is considered one of the most effective evidence-based programs designed to support 

57 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3589962/
98

community living for individuals with the most severe functional impairments associated with 

SMI. As a result, the ACT model is implemented widely across the United States. The ACT 

program is focused on innovation and pairs grantees with a technical assistance center. This 

strategy supports grantees, captures lessons learned from grantee innovations, gives support to 

ACT providers outside the grant program, and supports state planning related to ACT and the 

continuum of care for people with serious mental illness. The ACT Evidence-Based Practices 

toolkit is available in SAMHSA’s Evidenced-Based Resource Center.

Budget Request

The FY 2025 President’s Budget Request is $9.0 million, equal to the FY 2023 Final level. This 

funding will support the continuation of nine grants to advance the ACT approach to address the 

needs of those living with SMI and award a new cohort of three grants. In FY 2025, SAMHSA 

will continue to maintain the same performance measure targets as FY 2023. 

 

Funding History Table

Fiscal Year Amount

FY 2021 $9,000,000

FY 2022 $8,983,200

FY 2023 Final $9,000,000

FY 2024 CR $9,000,000

FY 2025 President Budget $9,000,000

Program Accomplishments

In FY 2023 SAMHSA awarded five grant continuations and a new cohort of seven grants. In FY 

2023, the percentage of individuals who experienced homelessness in the last 30 days decreased 

from 22.2 percent at baseline to 11.1 percent at the 6- month reassessment; further, 25.0 percent 

of individuals served by the program reported that they had a stable place to live at baseline, 

compared to 35.7 percent at the 6-month reassessment. At baseline, 7.0 percent of the individuals 

served reported time spent in a correctional facility in the past 30 days, compared to 2.3 percent at 

6-month reassessment. Additionally, there was an increase in retention in the community from 

37.8 percent to 71.1 percent of clients at reassessment. 

In FY 2024 SAMHSA anticipates funding 12 continuation grants. SAMHSA will continue to 

maintain its performance measure targets from FY 2023.

 
99

 

Outputs and Outcomes Table

Program: Assertive Community Treatment Grants

Measure Year and Most Recent 

Result /

Target for Recent Result 

/

(Summary of Result)

FY 2024

Target

FY 2025

Target

FY 2025

Target

+/-FY 2024

Target

3.4.13 Percentage of 

clients receiving 

services who report 

positive functioning at 

6 month follow-up. 

(Outcome)

FY 2023: 42.9

 

Target:

50.0

 

(Target Not Met)

50.0 50.0 Maintain

3.4.36 Number of 

clients served (Output)

FY 2023: 647.0

Target:

500.0

(Target Exceeded)

500.0 500.0 Maintain
100

Tribal Behavioral Health Grants

(Dollars in millions) 

Programs of Regional and National Significance

FY 2023 

Final 

FY 2024 

CR 

FY 2025 

President's 

Budget

FY 2025 +/- 

FY 2023 

Tribal Behavioral Health Grants........................................................ 22.750 22.750 22.750 -- 

Authorizing Legislation...................... Section 520A (290bb-22) and 516 (290bb-22) of the 

Public Health Service Act, as amended. 

FY 2025 Authorization................................................................................................ $22,750,000 

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

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

Program Description

Starting in FY 2014, the Tribal Behavioral Health grant program supports tribal entities with the 

highest rates of suicide by providing effective and promising strategies that address substance use, 

trauma, and suicide and by promoting the mental health of American Indian/Alaska Native 

(AI/AN) young people. The purpose of this program is to prevent and reduce suicidal behavior 

and substance use, reduce the impact of trauma, and promote mental health among AI/AN youth, 

through age 24, by building a healthy network of systems, services, and partnerships that impact 

youth. 

In 2021, AI/AN high school students reported higher rates of suicidal behaviors than the general 

population of U.S. high school students. 27% of AI/AN high school student seriously considered 

attempting suicide (5% greater than all high school students). 22% of these students made a suicide 

plan (4% greater than al high school students). 16% of AI/AN high school students actually 

attempted suicide (6% higher than all high school students).

58 American Indian or Alaska Native 

(27.6%) are also more likely to have a substance use disorder (SUD) in the past year compared 

with Black or African American (17.2%), White (17.0%), Hispanic or Latino (15.7%), or Asian 

people (8.0%).59 Finally, in 2021, the percentage of people who needed substance use treatment 

in the past year was higher among American Indian or Alaska Native or Multiracial people. 

In addition, SAMHSA’s Tribal Training and Technical Assistance Center60 provides training and 

education to AI/AN grantees and organizations serving AI/AN populations to support their 

ability to achieve their goals.

Budget Request

The FY 2025 President’s Budget is $22.8 million, is equal to the FY 2023 Final level. Combined 

with $23.6 million in the Substance Use Prevention Services appropriation, these funds will 

support technical assistance activities, 133 continuation grants that promote mental health and 

prevent substance misuse activities for high-risk AI/AN youth and their families and award a new 

58

. https://www.cdc.gov/healthyyouth/data/yrbs/pdf/YRBS_Data-Summary-Trends_Report2023_508.pdf 

59Center for Behavioral Health Statistics and Quality. (2022). 2021 National Survey on Drug Use and Health: Methodological

summary and definitions. https://www.samhsa.gov/data/report/2021-methodological-summary-and- definitions 

60

 (http://www.samhsa.gov/tribal-ttac)
101

cohort of 25 grants. 

As a braided activity, SAMHSA is tracking separately any amounts spent or awarded under Tribal 

Behavioral Health Grants through the distinct appropriations and ensures that funds are used for 

purposes consistent with legislative direction and intent of these appropriations. 

 

Funding History Table

Fiscal Year Amount

FY 2021 $20,881,047

FY 2022 $20,733,200

FY 2023 Final $22,750,000

FY 2024 CR $22,750,000

FY 2025 President’s Budget $22,750,000

Program Accomplishments

In FY 2023, SAMHSA funded 105 grant continuations and 48 new grants out of the Center for 

Mental Health Services and continuing support for technical assistance activities to expand youth 

suicide prevention and early intervention strategies for the tribal nations. In FY 2023, SAMHSA 

reached 861,476 youth through the TBH program. 

 

In FY 2024, SAMHSA anticipates supporting 127 grant continuations and awarding a new cohort 

of 44 grants and continued support for tribal technical assistance. In FY 2024, SAMHSA will 

continue the same performance measures and it is expected that 500,000 youth with mental health 

or substance use disorders will be contacted through program outreach efforts targets. 
102

Outcomes and Outputs Table

Program: Tribal Behavioral Health

Measure Year and Most Recent 

Result /

Target for Recent Result 

/

(Summary of Result)

FY 2024

Target

FY 2025

Target

FY 2025

Target

+/-FY 2024

Target

2.4.12 Percentage of 

youth age 10 - 24 who 

received mental health 

or related services after 

screening, referral or 

attempt (Output)

FY 2023: 34%

 

Target:

33% 

 

(Target Exceeded)

33% 33% Maintain

2.4.17 Number of 

youth with mental 

health or substance use 

disorders who are 

contacted through 

program outreach 

efforts (Output)

FY 2023: 861,476

 

Target:

470,790

 

(Target Exceeded) 

470,790 470,790 Maintain

2.4.18 Number of 

individuals who 

received mental health 

or related services after 

screening, referral or 

suicide attempt 

(Outcome)

FY 2023: 5,883

 

Target:

5,883

 

(Baseline)

5,883 5,883 Maintain
103

MH Minority Fellowship Program 

(Dollars in millions) 

Programs of Regional and National Significance

FY 2023 

Final 

FY 2024 

CR 

FY 2025 

President's 

Budget

FY 2025 +/- 

FY 2023 

MH Minority Fellowship Program................................................... 11.059 11.059 11.059 -- 

Authorizing Legislation .....................................................................Section 597 of the PHS Act 

FY 2025 Authorization ..............................................................................................$11,059,000 

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

Eligible Entities ............................................... Organizations that represent individuals obtaining 

post-baccalaureate training (including for master’s and doctoral degrees) for mental and 

substance use disorder treatment professionals, including in the fields of psychiatry, nursing, 

... social work, psychology, marriage and family therapy, mental health counseling, and 

substance

use disorder and addiction counseling 

 

Program Description

SAMHSA’s Minority Fellowship Program (MFP) is intended to increase behavioral health 

practitioners’ knowledge of issues related to prevention, treatment, and recovery support for 

mental illness and addiction among racial and ethnic minority populations. The program provides 

stipends to increase the number of culturally competent behavioral health professionals who teach, 

administer, conduct services research, and provide direct mental illness or substance use disorder 

treatment services for minority populations that are underserved. Since its start in 1973, the 

program has helped to enhance services for racial and ethnic minority communities through 

specialized training of mental health professionals in psychiatry, nursing, social work, marriage 

and family therapy, mental health counseling, psychology; substance use/addiction counseling, 

marriage and family therapists and professional counselors. This program is jointly administered 

by the Center for Substance Use Services (CSUS), the Center for Substance Use Prevention 

(CSUP), and the Center for Mental Health Services (CMHS) at SAMHSA. Combined, this 

program will support fellowships for hundreds of students as well as support additional training 

through webinars on culturally appropriate services to thousands of students. 

 

Budget Request

The FY 2025 President’s Budget is $11.1 million, equal to the FY 2023 Final level. This funding 

is combined with $7.1 million in the Substance Use Services appropriation and $1.3 million in the 

Substance Use Prevention appropriation. Funding will support seven continuation grants and a 

technical assistance contract and will continue to support 428 fellows. As a braided activity, this 

funding will directly address the significant treatment gap across the care continuum and the 

workforce shortage in disenfranchised and minority populations. In addition, SAMHSA will 

conduct a robust evaluation of the program for culturally appropriate approaches to further 

improve retention and increase recruitment of more diverse fellows into the workforce.

Please note, SAMHSA is tracking separately any amounts spent, or awarded, under the Minority 

Fellowship Program through the distinct appropriations to ensure that funds are used for purposes 

consistent with legislative direction and intent of these appropriations.
104

The Budget also proposes to add a service requirement to ensure participants are supporting 

communities in need, as well as to add addiction medicine, and sexual and gender minority 

populations as participants in the Minority Fellowship Program.

Funding History Table

Fiscal Year Amount

FY 2021 $10,059,000

FY 2022 $10,042,200

FY 2023 Final $11,059,000

FY 2024 CR $11,059,000

FY 2025 President’s Budget $11,059,000

Program Accomplishments

In FY 2022, SAMHSA supported eight grant continuations, and the MFP technical assistance 

contract. In FY 2022, the MFP grant supported 428 fellows (see the table below for details). In 

addition, the MFP program provided over 135 trainings and workshops for the fellows and other 

interested participants.

In FY 2023, SAMHSA awarded one grant continuation and supplement seven based year cohort 

and technical assistance contract. In FY 2022, the MFP grantees reported the following program 

accomplishments:

 

• The American Association for Marriage and Family Therapy had 57 master’s fellows 

representing their largest cohort since expanding to include master’s education in 2014, 

which is a 40% increase.

• The American Nurses Association used the Infusionsoft software to send weekly email 

blasts to prospective applicants, Historically Black Colleges, and Universities (HBCUs), 

tribal colleges, Hispanic Serving Institutions, and other major universities with a

psychiatric nursing program.

• The American Psychiatric Association fellows participated in the Presidential Taskforce 

on Social Determinants of Mental Health. Fellows joined a group discussion and provided 

their input and feedback based on their understanding of the social determinants of mental 

health based on their pre-clinical and clinical curriculum and training.

• The American Psychological Association launched a leadership development program 

containing 10-modules with content, discussion, and implementation sections. Topics 

included mapping out your career, cultural competencies, professionalism, ethics, and 

others.

• The Council on Social Work Education launched several new initiatives: 1) Monthly 

Monday group mentoring sessions where MFP alum were invited to come and share their 

experiences, 2) Lunch and Learns on the last Wednesday of each month to discuss specific 

topics, and 3) Office hours twice a month on Fridays for fellows to ask questions.

• The National Board of Certified Counselors hosted a virtual career fair, The Counseling 
105

Foundations: Your Path to Career Success virtual career fair, which aimed to connect 

employers, recent graduates from master’s and doctoral counseling programs, and 

seasoned counseling professionals nationwide in a virtual setting to explore current and 

future staffing opportunities.

 

In FY 2024, SAMHSA anticipates awarding a new cohort of seven grants and continued support 

technical assistance contract
106

Outcomes and Outputs Table

Total Doctoral and Master’s Fellows FY 2023

Total (428)

FY 2024

Total (406)

Grantee Organization Masters 

Fellows

Doctoral

Fellows

Masters

Fellows

Doctoral 

Fellows

National Board of Certified Counselors 70 20 83 24

Council on Social Work Education 45 28 40 25

Interdisciplinary Minority Fellowship 

Program

18 37 14 33

Amer. Psychological Association 13 24 4 27

Amer. Psychiatric Association 0 51 0 31

American Nurses Association 16 24 32 20

Amer. Association for Marriage and 

Family Therapy

57 25 48 25

TOTAL: 219 209 221 185
107

Infant and Early Childhood Mental Health

(Dollars in millions) 

Programs of Regional and National Significance

FY 2023 

Final 

FY 2024 

CR 

FY 2025 

President's 

Budget

FY 2025 +/- 

FY 2023 

Infant and Early Childhood Mental Health..................................... 15.000 15.000 15.000 -- 

Authorization Legislation .................................. Section 399Z-2 of the Public Health Service Act

FY 2025 Authorization................................................................................................ $15,000,000 

Eligible Entities ..............................................Human Services Agencies or Non-profit Institutions

 

Program Description

Infant and Early Childhood Mental Health Funding supports two programs: The Infant and Early 

Childhood Mental Health (IECMH) grant program and the Center of Excellence for Infant and 

Early Childhood Mental Health Consultation (CoE-IECMHC)

 

Established in FY 2018, the IECMH programs are focused on improving the outcomes for 

children, from birth to 12 years of age, who are at risk for, show early signs of, or have been 

diagnosed with a mental illness, including a serious emotional disturbance. The purpose is to 

improve outcomes using a prevention-based approach that pairs a mental health consultant with 

adults who work with infants and young children in the different settings where they learn and 

grow, such as childcare, preschool, home visiting, early intervention, and their home. 

 

In FY 2019, the CoE-IECMCH was established to provide technical assistance to communities, 

states, territories, tribal communities, and IECMH grantees, as well as professional development 

to individual mental health consultants to increase access to high quality mental health consultation 

throughout the country.

 

The IECMH program and the CoE-IECMHC have: (1) helped to increase access to a range of 

evidence-based and culturally appropriate infant and early childhood mental health services; (2) 

equipped caregivers to facilitate children’s mental health and social and emotional development, 

and (3) strengthened positive caregiving relationships, via multigenerational therapy approach and 

services. These IECMHC programs aid in addressing the national shortage of mental health 

professionals with infant and early childhood expertise.

 

Budget Request

The FY 2025 President’s Budget is $15.0 million, equal to the FY 2023 Final level. The proposed 

funding will support the continuation of 23 grants and support TTA contract in Center of 

Excellence for Infant and Early childhood. 
108

Funding History Table

Fiscal Year Amount

FY 2021 $8,096,291

FY 2022 $9,983,200

FY 2023 Final $15,000,000

FY 2024 CR $15,000,000

FY 2025 President’s Budget $15,000,000

Program Accomplishments

In FY 2023, SAMHSA awarded nine grant continuations, 18 new grants, and provided supplement 

to support COE-IECMHC technical assistance. To date in, FY 2023, grantees trained 7,546 people 

in the mental health and related workforce in mental health-related practices/activities; screened 

11,977 children for mental health or related interventions; and referred 4,129 children for mental 

health services.

 

In FY 2024, SAMHSA anticipates funding 27 grant continuations and award TTA contract in 

Center of Excellence for Infant and Early Childhood. 

 
109

Outputs and Outcomes Table

Program: Infant and Early Childhood Mental Health Grant Program 

Measure Year and Most Recent 

Result /

Target for Recent 

Result /

(Summary of Result)

FY 2024

 Target

FY 2025

 Target

FY 2025

 Target

+/-FY 2024

 Target

3.4.16 Number of 

children screened for 

mental health or 

related interventions 

(Output) 

FY 2023: 11,977.0

 

Target:

 14,000.0 

 

(Target Not Met, but 

Improved)

14,000 14,000 Maintain

3.4.17 Number of 

children referred to 

mental health or 

related interventions 

(Output) 

FY 2023: 4,129.0

 

Target:

5,000.0 

 

(Target Not Met, but 

Improved)

5,000 5,000 Maintain

3.4.18 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 2023: 5,337

 

Target:

 7,000.0 

 

(Target Not Met) 

7,000 7,000 Maintain
110

Interagency Task Force on Trauma-Informed Care

(Dollars in millions) 

Programs of Regional and National Significance

FY 2023 

Final 

FY 2024 

CR 

FY 2025 

President's 

Budget

FY 2025 +/- 

FY 2023 

Interagency Task Force on Trauma-Informed Care (New FY 22)........ 2.000 2.000 2.000 -- 

Authorizing Legislation ................................................................ Section 7132 of the Support Act 

FY 2025 Authorization .................................................................................................$2,000,000 

Allocation Method ...........................................................................................................Contract 

Eligible Entities ....................................................... Domestic Public or Private Non-Profit Entities

 

Program Description

Trauma-informed approaches are essential to ensure that children, youth, and their families receive 

the necessary behavioral health treatment and support services for substance use/misuse and 

mental health challenges to enhance their resilience, facilitate their recovery, and improve their 

well-being. Trauma-informed approaches are more critical than ever now as we recognize the 

impact that COVID-19 and the resulting effects, i.e., social isolation, increased rates of anxiety 

and depression, have had on children, youth, and their families, the youth behavioral health crisis, 

and the recognition that trauma-informed care can provide settings that recognize and respond to 

the possible sequelae of trauma, prevent traumatization, and promote the healing process. 

Providing trauma-informed care is not limited to behavioral health interventions and can help 

increase the effectiveness of other kinds of interventions such as disaster recovery services, 

housing, and primary health care. 

The creation of an Interagency Task Force on Trauma-Informed Care (Task Force) was mandated 

in the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for 

Patients and Communities Act (SUPPORT Act).61

 

The SUPPORT Act mandated SAMHSA lead an interagency task force comprised of twenty 

agencies in the development of a National Strategy for Trauma-informed Care and submit an 

operating plan outlining its implementation. In FY 2022, SAMHSA developed a four pillared 

National Strategy for Trauma-informed Care and submitted an operating plan to Congress 

detailing a phased approach to implementation centered on for children/families who have 

experienced trauma and federal agencies’ coordinated response, as well as publishing best 

practices of trauma-informed care.

 

The National Strategy is grounded in equity with four main pillars: best practices, research, data, 

and federal coordination. Supported by robust stakeholder engagement, the Task Force is 

concluding the implementation of Phase One, which has focused on planning and laying the 

ground. In completing Phase One, the Task Force has focused on building a core component and 

outcomes taxonomy of trauma-informed care, and environmental scans under the research, data, 

and federal coordination pillars. Phase Two is focused on delivering value to stakeholders (in years 

2 and 3), such as developing a federal portal to house best practices and deliver value to 

stakeholders; and Phase Three is focused on sustainability (Years 4 and 5). 

61 (P.L. 115-271)
111

Through consultation with stakeholders and robust environmental scans, SAMHSA anticipates the 

Task Force’s efforts will result in building a user-centered website that will curate and catalogue 

over 1,200 different resources that will provide needed information to equip community providers 

and members with trauma-informed evidenced based approaches and help to mitigate risks of 

responding to and further traumatization of the most vulnerable children and families. The website 

will also be a mechanism to connect and share resources between state and community providers 

who are implementing trauma-informed care policy across service delivery systems. Based on 

SAMHSA’s experience with the National Child Traumatic Stress Network (NCTSN) website and 

prior stakeholder engagement, it is estimated that the website will have over 1 million visitors and 

that the resources provided will influence the care of over 2 million children and their families 

receive within the first three years. The Task Force will continue their work on building a core 

component and outcome taxonomy that will create a shared understanding of the measurement 

tools to aid in the evaluation of trauma-informed care, develop a research agenda based on the 

completed research review, create shared understanding of how to measure trauma-informed care, 

and enhance federal coordination through common definitions and language. 

 

Budget Request

The FY 2025 President’s Budget is $2.0 million, equal to the FY 2023 Final level. In FY 2025, 

SAMHSA expects to continue the implementation of the operating plan through a series of expert 

panel meetings, and youth, family, and community stakeholder engagement meetings. These 

engagements will inform the development of a user-centered website. In addition, SAMHSA will 

continue to develop a robust framework for community providers, using research and evidencebased interventions. This budget request will continue to carry out Phase One of the National 

Strategy. 

 

Based on SAMHSA’s experience with the NCTSN website and prior stakeholder engagement, it 

is estimated that the website will have over 1 million visitors and that the resources provided will 

influence the care received of over 2 million children and their families.

 

Funding History Table

Fiscal Year Amount

FY 2021 $---

FY 2022 $1,000,000

FY 2023 Final $2,000,000

FY 2024 CR $2,000,000

FY 2025 President’s Budget $2,000,000

 
112

Women Behavioral Health Technical Assistance Center

(Dollars in millions)

Programs of Regional and National Significance

FY 2023 

Final FY 2024 CR

FY 2025 

President's 

Budget

FY 2025 +/- 

FY 2023 

Women's Behavioral Health Technical Assistance Center.............. -- -- 1.750 1.750 

Authorizing Legislation .............................................. Section 2707 of the American Rescue Plan 

FY 2025 Authorizing .......................................................................................................$1,700,000 

Allocation Method ................................................................................................................... Grant

Eligible Entities..............................................State, Local, Tribal, and Territorial government, 

Tribal organizations, nonprofit community-based entities, and primary care and behavioral health 

organizations 

 

Program Description

 

The Women’s Behavioral Health Technical Assistance (TA) Center program is a joint effort 

between the Center for Mental Health Services (CMHS) and the Center for Substance Use Services 

(CSUS). It is a five-year program to create a national system of clinical consultation and technical 

assistance (TA) for health providers of various disciplines spanning topics across the lifespan 

within the field of women’s (including female adolescents) mental health and substance use (e.g., 

equity, intimate partner violence, medical co-morbidities, maternal and perinatal, suicide and 

crisis, and trauma). The TA center aims to improve the use of data and evidence by focusing on 

its applications to patient care and implementation in various health settings. This TA Center 

would be outcome- and measurement-focused building on SAMHSA’s experience with similar 

clinical consultation type models, including the Provider Clinical Support System (PCSS), and the 

SMI Advisor TA center. The center improves the customer experience compared to other TA 

initiatives because it provides interdisciplinary, on-demand, flexible, and individually tailored 

technical assistance on topics often not covered in their traditional educational courses. 

 

This program is expected to positively impact the mental and substance use-related health of 

thousands of women across the nation by better equipping multidisciplinary providers to 

individually address and treat women’s behavioral health disorders with the most up-to-date 

evidence-based interventions, rather than refer them out to limited specialists. The program will 

have a national reach and will assist providers in rural areas and other areas with traditionally low 

access. This is a resource that could potentially change the national landscape of women’s 

behavioral health treatment. 

Budget Request

 

The FY 2025 President’s Budget is $3.5 million, with CSUS increasing $1.75 million and CMHS 

increasing $1.75 million from the FY 2023 Final level. The program, over its lifetime, is expected 

to have over 2,660,000 website visits, 99,200 unique clinicians trained, 3,200 vetted resources 

offered, and 6,300 clinical consultations. Additionally, this cooperative agreement focuses on 

assisting providers with topics that are not traditionally covered in behavioral health training 

programs such as suicide and crisis prevention, how to address gender-based violence, and 

importantly how to address the needs of women facing special challenges due to social 

determinants of health, including socioeconomic status, racial/ethnic minority status, and/or sexual 
113

orientation, and disabilities, in a culturally competent manner. 

 

Funding History Table

Fiscal Year Amount

FY 2021 $---

FY 2022 $---

FY 2023 Final $---

FY 2024 CR $---

FY 2025 President’s Budget $1,750,000
114

National Child Traumatic Stress Network

(Dollars in millions) 

Program Name

FY 2023 

Final 

FY 2024 

CR 

FY 2025 

President's 

Budget

FY 2025 +/- 

FY 2023 

National Child Traumatic Stress Network....................................... 93.887 93.887 93.887 -- 

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

FY 2025 Authorization.................................................................................................................. 

$93,887,000 Allocation Method ............... Competitive Grants/Contracts/Cooperative Agreements

Eligible Entities States, Local Governments, Tribes, Institutions of Higher Education, and 

Community Organizations

Program Description

Experiences of chronic and/or severe stress during early childhood, often also conceptualized as 

early life stress, childhood adversity, child maltreatment, or childhood trauma, have persistent and 

pervasive consequences for development.62 Children affected by the COVID-19 pandemic have 

suffered traumatic stress from serious illness, hospitalization, or the loss of a family member or 

loved one during the pandemic, as well as fear and isolation resulting from the pandemic and the 

measures taken to combat it.63 According to the Adolescent Behaviors and Experiences Survey 

(ABES) 2021 data, approximately 37% high school students experienced poor mental health (most 

of the time or always) during the COVID-19 pandemic and 31.1% experienced poor mental health 

during the preceding 30 days.64 Without a focused strategy to change the altered life trajectory that 

the COVID-19 pandemic has created for many children, a generation of young people will enter 

adulthood with worse mental health and a greater burden of chronic disease and impaired physical 

health as they age through adulthood.65 “Evidence-based treatments are available to address 

trauma- related symptoms, but their impact is hindered because access is limited and unequal.66 In 

the U.S., adverse experiences and mental disorders disproportionately affect socioeconomically 

disadvantaged groups that face treatment access barriers.”67 While the effects of trauma and 

exposure to violence are found in all child and adolescent populations and service sectors, it is 

particularly prominent among youth with mental illness and/or drug/alcohol addiction involved in 

the child welfare, and juvenile justice systems. 68

 

Since its establishment in 2000, SAMHSA funded the National Child Traumatic Stress Initiative 

62Smith KE, Pollak SD. (2020) Early life stress and development: potential mechanisms for adverse outcomes. Journal of 

Neurodevelopmental Disorders. 2020 Dec 16;12(1):34. doi: 10.1186/s11689-020-09337-y. PMID: 33327939; PMCID: 

PMC7745388. 63 National Academies of Sciences, Engineering, and Medicine. (2023). Addressing the Long-Term Effects of the COVID-19 Pandemic on 

Children and Families. The National Academies Press. Retrieved from: https://nap.nationalacademies.org/catalog/26809/addressing-the-longterm-effects-of-the-covid-19-pandemic-on-children-and-families 64 Jones SE, Ethier KA, Hertz M, et al. (2022). Mental Health, Suicidality, and Connectedness Among High School Students During the COVID19 Pandemic – Adolescent Behaviors and Experiences Survey. Centers for Disease Controland Prevention. Retrieved from: 

https://www.cdc.gov/mmwr/volumes/71/su/su7103a3.htm#suggestedcitation

65 National Academies of Sciences, Engineering, and Medicine. (2023). Addressing the Long-Term Effects of the COVID-19 Pandemic on 

Children and Families. The National Academies Press. Retrieved from: https://nap.nationalacademies.org/catalog/26809/addressing-the-longterm-effects-of-the-covid-19-pandemic-on-children-and-families 66 Mersky, J. P., Topitzes, J., Langlieb, J., & Dodge, K. A. (2021). Increasing mental health treatment access and equity through traumaresponsive care. American Journal of Orthopsychiatry, 91(6), 703–713. https://doi.org/10.1037/ort0000572. 67 ibid 68 ibid
115

(NCTSI) to increase access to effective trauma- and grief-focused treatment and services systems 

for children, adolescents, and their families, who experience traumatic events. The NCTSI grew 

into a national collaborative network of grantees and affiliates (formerly funded grantees) known 

as the National Child Traumatic Stress Network (NCTSN). The NCTSN has expanded from 17 to 

184 centers and over 200 affiliate centers and individuals located nationwide in universities, 

hospitals, and a range of diverse community-based organizations with thousands of national and 

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

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

The NCTSI grantees work together within and across diverse settings, including a wide variety of 

governmental and non-governmental organizations, and continue to be a principal source of child 

trauma information and training for the nation. 

Budget Request

The FY 2025 President’s Budget is $93.9 million, equal to the FY 2023 Final level. SAMHSA 

will support 182 grant continuations (158 with base budget authority, three grants with American 

Rescue Plan Act and 21 grants with Bipartisan Safer Community Act) and award a new cohort of 

10 grants with base budget authority for the improvement of mental disorder treatment, services, 

and interventions for children and adolescents exposed to traumatic events and to provide traumainformed services for children and adolescents as well as training for the child-serving workforce. 

SAMHSA estimates approximately 13,000 children and adolescents will be served and the 

approximately 500,000 people in the mental health and related workforce will be trained.

 

Funding History Table

Fiscal Year Amount

FY 2021 $71,671,000

FY 2022 $81,887,000

FY 2023 Final $93,887,000

FY 2024 CR $93,887,000

FY 2025 President’s Budget $93,887,000

Program Accomplishments

In FY 2023, SAMHSA awarded 163 grant continuations (141 grants with base budget authority, 

two grants with American Rescue Plan Act, and 21 with Bipartisan Safer Community Act) and 

awarded a new cohort of 30 grants. In FY 2023 NCTSN grantee sites have provided traumainformed training to over 317,638 people. Since its inception, the NCTSN has provided training 

on best practices and other aspects of child trauma to over 2 million participants throughout the 

country. The NCTSN Learning Center currently has over 496,000 registered users accessing this 

evidence-based child trauma resource. Data collected in FY 2023 demonstrates that current 

NCTSN grantees have provided screening to 123,953 individuals and evidence-based treatment to 

40,393 children, adolescents, and family members. In addition, thousands more youth and families 

have benefited indirectly from the training and consultation provided by NCTSN grantees to 
116

organizations that deliver evidence-based trauma interventions to various communities throughout 

the country. 

In FY 2024, SAMHSA anticipates funding 198 grant continuations (171 grants continuation with 

base budget authority, six grants with American Rescue Plan Act, and 21 with Bipartisan Safer 

Community Act). 
117

Outputs and Outcomes Table

Program: National Child Traumatic Stress Initiative (NCTSI)

Measure Year and Most Recent 

Result /

Target for Recent 

Result /

(Summary of Result)

FY 2024

 Target

FY 2025

 Target

FY 2025

 Target

+/-FY 2024

 Target

3.2.02a Percentage of 

children receiving 

trauma informed 

services who report 

positive functioning 

at 6 month follow-up 

(Outcome)

FY 2023: 44.9 %

 

Target:

 70 % 

 

(Target Not Met)

70 % 70 % Maintain

3.2.23 Unduplicated 

count of the number 

of children and 

adolescents receiving 

trauma-informed 

services (Outcome)

FY 2023: 11,824.0

 

Target:

 12,000.0 

 

(Target Not Met, but 

Improved)

13,000 13,000 Maintain

3.2.39 Number of 

child-serving 

professionals trained 

in providing traumainformed services 

(Outcome)

FY 2023: 317,638.0

 

Target:

 500,000 

 

(Target Not Met)

500,000 500,000 Maintain
118

Assisted Outpatient Treatment for Individuals with Serious Mental Illness

(Dollars in millions)

Program Name

FY 2023 

Final 

FY 2024 

CR 

FY 2025 

President's 

Budget 

FY 2025 +/- 

FY 2023 

Assisted Outpatient Treatment for Individuals with SMI........................... 21.420 21.420 21.420 -- 

Authorizing Legislation ................ Section 224 of the Protecting Access to Medicare Act of 2014 

FY 2025 Authorization ..................................................................................................$21,420,000 

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

Eligible Entities ............................................................................................ States and communities

 

Program Description

SAMHSA initiated the Assisted Outpatient Treatment (AOT) program in FY 2016. AOT is the 

practice of delivering outpatient treatment under a civil court order to adults with serious mental 

illness (SMI) who meet specific state civil commitment AOT criteria, such as a prior history of 

non-adherence to treatment, repeated hospitalizations, or arrest. AOT involves petitioning local 

courts through a civil process to order individuals to enter and remain in treatment within the 

community for a specified period of time. This program is intended reduce the incidence and 

duration of psychiatric hospitalization, homelessness, individual incarcerations, and interactions 

with the criminal justice system while improving the health and social outcomes of individuals 

with a SMI. The AOT program is designed to work with families and courts to allow individuals 

with SMI to obtain treatment while continuing to live in the community and their homes. 

In 2020, there were an estimated 14.2 million adults aged 18 or older in the United States with 

SMI, such as schizophrenia, bipolar disorder and major depression.69 Approximately 4.2 million 

individuals remain untreated for serious mental illness, costing $28 billion in hospitalization costs 

per year.70

To increase access to evidence-based mental health services for individuals with SMI, Congress 

passed the Protecting Access to Medicare Act of 2014 (PAMA), which authorized a four-year 

Assisted Outpatient Treatment (AOT) program for individuals with SMI. This authorization was 

extended in the 21st Century Cures Act. 

Budget Request

The FY 2025 President’s Budget is $21.4 million, equal to the FY 2023 Final level. This funding 

will support 18 grant continuations and award a new cohort of three grants to improve the health 

and social outcomes for individuals with SMI and continuation of the technical assistance center. 

In FY 2025, SAMHSA will maintain the same performance targets as FY 2024. 

69 https://www.nimh.nih.gov/health/statistics/mentalillness#:~:text=Mental%20illnesses%20are%20common%20in,mild%20to%20moderate%20to%20severe./Updated January 2022. 70 Treatment Advocacy Center. (2017, May). Serious Mental Illness and Treatment Prevalence. Retrieved from Treatment Advocacy Center: 

https://www.treatmentadvocacycenter.org/
119

Funding History Table

Fiscal Year Amount

FY 2021 $20,937,000

FY 2022 $21,420,000

FY 2023 Final $21,420,000

FY 2024 CR $21,420,000

FY 2025 President’s Budget $21,420,000

Program Accomplishments

In FY 2023, SAMHSA awarded 22 grant continuations. In FY 2023 AOT grantees had the 

following services outcomes: 

 

1. Cost savings and public health outcomes including hospitalization, and use of services 

a. 11.2 percent of AOT program participants reported spending at least one day in the 

hospital for mental health care in the past 30 days at their 6-month reassessment 

compared to 65.0 percent at intake.

b. 7.0 percent of AOT program participants reported spending at least one day in the 

emergency department for a psychiatric or emotional problem in the past 30 days at 

their most 6-month reassessment compared to 21.7 percent at intake.

 

2. Rates of Incarceration

a. 4.9 percent of AOT program participants reported spending one or more nights in a 

correctional facility in the past 30 days at their 6-month reassessment compared to 9.0 

percent at intake.

 

3. Patient and family satisfaction with program participation

a. 95.1 percent of AOT program participants responded Yes to the statement “I liked the 

services I received here” at their 6-month reassessment.

 

In FY 2024, SAMHSA will support six grant continuations and award a new cohort of 15 grants 

to improve the health and social outcomes for individuals with SMI and continuation of the 

technical assistance center. SAMHSA will continue to maintain the performance measures targets 

as in FY 2023. 
120

Outputs and Outcomes Table

Program: Assisted Outpatient Treatment for Individuals with SMI

Measure Year and Most Recent 

Result /

Target for Recent 

Result /

(Summary of Result)

FY 2024

 Target

FY 2025

 Target

FY 2025

 Target

+/-FY 2024

 Target

3.4.06 Percentage of 

clients receiving 

services who report 

positive functioning 

at 6 month follow-up. 

(Outcome)

FY 2023: 65.7

 

Target:

 70.0 

 

(Target Not Met)

70.0 70.0 Maintain

3.4.31 Number of 

clients served 

(Output) 

FY 2023: 1,386.0

Target:

1,100.0

(Target Exceeded)

1,100.0 1,100.0 Maintain
121

Children’s Mental Health Services

(Dollars in millions)

Program Name

FY 2023 

Final

FY 2024 

CR

FY 2025 

President’s Budget

FY 2025 +/-

FY 2023

Children’s Mental Health Services............................................ 130.000 130.000 180.000 +50.000 

Authorizing Legislation .........................................Sections 561 of the Public Health Service Act 

FY 2025 Authorization ........................................................................$180,000,000 

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

Eligible Entities...............................................................States and territories, 

governmental units within political sub-divisions of states, and federally recognized American 

Indian/Alaska Native tribes and tribal organizations

 

Program Description

It is estimated that 49.5 percent of adolescents in the United States have any mental illness, of 

which 22.2 percent had a severe impairment. Unfortunately, only 41 percent of those in need of 

mental health services receive treatment.71 Created in 1992, SAMHSA's Children's Mental Health 

Initiative (CMHI) addresses this gap by supporting "systems of care" (SOC) for children and youth 

with serious emotional disturbances (SED) and their families to increase their access to evidencebased treatment and supports. This program was originally authorized in 1992 by the Alcohol, 

Drug Abuse, and Mental Health Administration (ADAMHA) Reorganization Act (Pub. L. 102-

321)1, and most recently reauthorized in December 2022 as part of the 2023 Consolidated 

Appropriations Act (P.L., 117-328); CMHI is currently authorized through FY 2026. CMHI 

provides grants to assist states, local governments, tribes, and territories in their efforts to deliver 

services and supports to meet the needs of children and youth with SED.

 

CMHI funding supports two grant programs: Grants for Expansion and Sustainability of the 

Comprehensive Community Mental Health Services for Children with SED (CMHI); and Clinical 

High Risk for Psychosis (CHR-P) grants. CMHI supports the implementation, expansion, and 

integration of the SOC approach by creating sustainable infrastructure and services that are 

required as part of the Comprehensive Community Mental Health Services for Children and their 

Families Program (also known as the Children’s Mental Health Initiative or CMHI). With this 

program, SAMHSA aims to provide mental health services to children and youth, from birth 

through age 21, at risk for or with SED and their families. SAMHSA intends to prepare children 

and youth at risk for or with SED for successful transition to adulthood and assumption of adult 

roles and responsibilities.

 

In FY 2018, SAMHSA implemented the CHR-P to address what is often referred to as the 

prodrome phase, in which a disease process has begun but is not yet diagnosable or inevitable. The 

population of focus for CHR-P are youth and young adults (not more than 25 years of age) who 

are identified to be at clinical high risk for developing a first episode of psychosis. Award 

recipients are expected to use evidence-based intervention to: (1) improve symptomatic and 

behavioral functioning; (2) enable youth and young adults to resume age-appropriate social, 

71 National Institute of Mental Health. (2023). Mental Illness. National Institute of Mental Health. Retrieved from: 

https://www.nimh.nih.gov/health/statistics/mental-illness
122

academic, and/or vocational activities; (3) delay or prevent the onset of psychosis; and (4) 

minimize the duration of untreated psychosis for those who develop psychotic symptoms. 

 

SAMHSA also funds the National Training & Technical Assistance Center for Children, Youth, 

& Family Mental Health (NTTAC) to provide resources that increase access to, effectiveness of, 

and dissemination of evidence-based mental health services for young people (birth to age 21) and 

their families, including young people experiencing serious mental illness (SMI) or SED. NTTAC 

supports CMHI grantees and provides an array of trainings, technical assistance, and resources to 

providers, organizations, and agencies from across the system of care. With these programs, 

SAMHSA aims to prevent the onset of psychosis or lessen the severity of psychotic disorders 

among youth and youth adults. 

 

Budget Request

The FY 2025 President’s Budget is $180.0 million, an increase of $50.0 million from the FY 2023 

Final level. This funding will support the continuations of 34 CHR-P under the 10 percent setaside for CHR-P. In addition, funding will support 62 CMHI continuation grants, award a new 

cohort of 40 CMHI grants and a technical assistance center. SAMHSA expects to increase the 

number of children served to over 12,500 and to train an additional 3,458 people in mental health 

activities and practices, for a total of 71,760 people trained. These funds will increase access to 

services and supports children and youth with SED and improve the system of care for these 

children and their families.

Funding History Table

Fiscal Year Amount

FY 2021 $125,000,000

FY 2022 $125,000,000

FY 2023 Final $130,000,000

FY 2024 CR $130,000,000

FY 2025 President’s Budget $180,000,000

Program Accomplishments

In FY 2023, SAMHSA awarded 44 CMHI continuation grants and awarded a new cohort of 33 

grants, and a technical assistance center. In FY 2023, grantees have trained 25,609 individuals in 

the mental health and related workforce in specific mental health- related practices/activities, 

completed 242 policy changes to improve service delivery and reduce system access barriers 

pertaining for youth, contacted 127,011 youth through program outreach and 9,102 youth received 

evidence based mental health services as a result of the grant. In FY 2023, SAMHSA also awarded 

19 CHR-P grants funded from a 10 percent set-aside of the base CMHI program and awarded a 

new cohort of two grants. In FY 2023, CHR-P screened 7,086 individuals for early psychosis 

symptoms, provided outreach to 11,341 individuals, and made 4,594 referrals to other mental 

health or related services. In FY 2023, NTTAC provided trainings to 10,563 individuals in the 

mental health and related work force in specific mental-health related practices/ activities. In 

addition, NTTAC exposed 280,788 individuals to mental-health awareness messages.

 
123

In FY 2024, SAMHSA anticipates funding 50 CMHI continuation grants, funding one 

continuation award for the NTTAC, and awarding a new cohort of 23 grants. In FY 2024, 

SAMHSA also anticipates supporting 21 CHR-P continuation grants and awarding a new cohort 

of 13 grants. 
124

Output and Outcomes Table

Program: Children's Mental Health Services

Measure Year and Most Recent 

Result /

Target for Recent 

Result /

(Summary of Result)

FY 2024

 Target

FY 2025

 Target

FY 2025

 Target

+/-FY 2024

 Target

3.2.16 Number of 

children with or at 

risk of SMI/SED that 

are receiving services 

from the Children's 

Mental Health 

Initiative (Output)

FY 2023: 9,102

 

Target:

 9,000 

 

(Target Exceeded) 

9,100 12,558 +2,658

3.2.25 Percentage of 

children receiving 

services who report 

positive social 

support at 6 month 

follow-up (Outcome)

FY 2023: 75.3 %

 

Target:

 85.0 % 

 

(Target Not Met)

85.0 % 85.0 % Maintain

3.2.26 Percentage of 

children receiving 

Systems of Care 

mental health 

services who report 

positive functioning 

at 6 month follow-up 

(Outcome)

FY 2023: 42.6%

 

Target:

 60 % 

 

(Target Not Met)

60.0 % 60.0 % Maintain

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 2023: 40,429

 

Target:

 52,000 

 

(Target Not Met, but 

Improved) 

52,000 71,760 +19,760
125

Projects for Assistance in Transition from Homelessness

(Dollars in millions)

Program Name

FY 2023 

Final 

FY 2024 

CR 

FY 2025 

President's 

Budget 

FY 2025 +/- 

FY 2023 

Projects for Assistance in Transition from Homelessness....... 66.635 66.635 66.635 -- 

Authorizing Legislation .................................Section 535(a) of the Public Health Service Act

FY 2025 Authorization .............................................. Reauthorized at current level of $66,635,000 

Allocation Method ................................................................................................... Formula Grants

Eligible Entities .............................................................................................. .States and Territories

Program Description

The Projects for Assistance in Transition from Homelessness (PATH) program was originally 

authorized by the Stewart B. McKinney Homeless Assistance Amendments Act of 1990 and has 

been reauthorized most recently by the Consolidated Appropriations Act, 2023. The PATH 

program supports 56 grants to the 50 states, the District of Columbia, Puerto Rico, Guam, 

American Samoa, the United States Virgin Islands, and the Northern Mariana Islands, as well as 

centralized activities such as technical assistance and evaluation.

 

On a single night in 2022, roughly 582,500 people were experiencing homelessness in the United 

States. Six in ten (60%) were staying in sheltered locations—emergency shelters, safe havens, or 

transitional housing programs—and four in ten (40%) were in unsheltered locations such as on the 

street, in abandoned buildings, or in other places not suitable for human habitation. Nearly onethird (30%) of all individuals experiencing homelessness in 2022 had chronic patterns of 

homelessness.72 Data also suggest that at least 20 percent of individuals experiencing 

homelessness have a serious mental illness (SMI).73 Mental illness affects individuals’ abilities to 

maintain stable relationships, perform daily living activities, and maintain stable employment.

Symptoms of mental disorders also often cause individuals to become estranged from family 

members and caregivers, leaving them without a support system. As a result, individuals with a 

mental illness are more likely to experience homelessness than those without mental illness and 

experience homelessness longer than the rest of the homeless population. 

 

PATH funds community-based outreach, mental illness and substance use disorder treatment 

services, case management, assistance with accessing housing, and other supportive services for 

individuals with SMI or a co-occurring disorder (COD) who are experiencing homelessness in all 

fifty states, the District of Columbia, the Commonwealth of Puerto Rico, the U.S. Virgin Islands, 

Guam, American Samoa, and the Commonwealth of the Northern Mariana Islands. PATH 

outreach workers are specialized in engaging those who are most vulnerable in their communities

72 The U.S. Department of Housing and Urban Development, Office of Community Planning and

Development. The 2022 Annual Homeless Assessment Report (AHAR) to Congress, Part 1. Available 

at: https://www.huduser.gov/portal/sites/default/files/pdf/2022-AHAR-Part-1.pdf 73 The U.S. Department of Housing and Urban Development, 2020 CoC Homeless Populations and Subpopulations 

Reports Available at 

https://www.hudexchange.info/resource/reportmanagement/published/CoC_PopSub_NatlTerrDC_2020.pdf
126

and who are least likely to seek out services on their own. The primary goal of the PATH program 

is to link and connect homeless individuals into the mainstream treatment and service systems and 

supportive services that they need to access and stable housing, build social connections, and 

access treatment and services to support their recovery.

 

Budget Request

The FY 2025 President’s Budget is $66.6 million, equal to the FY 2023 Final level. The PATH 

program was flat funded from FY 2010 to FY 2022 and had a slight increase of $2 million in FY 

2023. The PATH program pays for the street outreach and engagement not covered by most 

funding sources and helping to bring one of the most vulnerable groups, individuals with serious 

mental illness lacking housing, off the street. SAMHSA expects that the FY 2025 budget request 

will maintain the current level of local PATH providers and current level of service. 

 

Funding History Table

Fiscal Year Amount

FY 2021 $64,635,000

FY 2022 $64,635,000

FY 2023 Final $66,635,000

FY 2024 CR $66,635,000

FY 2025 President’s Budget $66,635,000

Program Accomplishments

In FY 2023, SAMHSA funded all fifty states, the District of Columbia, the Commonwealth of 

Puerto Rico, the U.S. Virgin Islands, Guam, American Samoa, and the Commonwealth of the 

Northern Mariana Islands. PATH providers offered essential services in over 400 communities 

to support outreach workers and mental health specialists who engaged with over 100,000 

individuals living with SMI or living with both SMI and drug/alcohol addiction and were 

homeless or at imminent risk of becoming homeless.

 
127

Outputs and Outcomes Table

Program: Projects for Assistance in Transition from Homelessness

Measure Year and Most Recent 

Result /

Target for Recent 

Result /

(Summary of Result)

FY 2024

 Target

FY 2025

 Target

FY 2025

 Target

+/-FY 2024

 Target

3.4.15a Percentage of 

enrolled homeless 

persons in the 

Projects for 

Assistance in 

Transition from 

Homelessness 

(PATH) program 

who receive 

community mental 

health services 

(Intermediate 

Outcome)

FY 2022: 35 %

 

Target:

 64 % 

 

(Target Not Met)

64 % 64 % Maintain

3.4.16 Number of 

homeless persons 

contacted (Outcome) 

FY 2021: 103,933

 

Target:

 125,000 

 

(Target Not Met)

105,000 105,000 Maintain

3.4.17 Percentage of 

contacted homeless 

persons with serious 

mental illness who 

become enrolled in 

services (Outcome)

FY 2020: 57 %

 

Target:

 57 % 

 

(Target Met)

57 % 57 % Maintain

3.4.20 Number of 

Projects for 

Assistance in 

Transition from 

Homelessness 

(PATH) providers 

trained on SSI/SSDI 

Outreach, Access, 

Recovery (SOAR) to 

ensure eligible 

homeless clients are 

receiving benefits 

(Output)

FY 2021: 2,122

 

Target:

 2,214 

 

(Target Not Met)

2,122 2,122 Maintain
128

State Table

DEPARTMENT OF HEALTH AND HUMAN SERVICES

SAMHSA 

FY 2025 MANDATORY STATE/FORMULA GRANTS

CFDA NUMBER/PROGRAM NAME: 93.150/PATH

FY 2023 FY 2024 FY 2025 FY 2025 +/-

State or Territory Final CR President's Budget FY 2023

Alabama $629,605 $629,605 $659,492 $29,887

Alaska $300,000 $300,000 $300,000 ---

Arizona $1,385,704 $1,385,704 $1,451,632 $65,928

Arkansas $312,145 $312,145 $379,815 $67,670

California $9,050,968 $9,050,968 $8,470,651 -$580,317

Colorado $1,046,625 $1,046,625 $1,129,194 $82,569

Connecticut $820,947 $820,947 $707,069 -$113,878

Delaware $300,000 $300,000 $300,000 ---

District of Columbia $300,000 $300,000 $300,000 ---

Florida $4,451,319 $4,451,319 $4,482,006 $30,687

Georgia $1,715,084 $1,715,084 $1,803,729 $88,645

Hawaii $300,000 $300,000 $300,000 ---

Idaho $300,000 $300,000 $300,000 ---

Illinois $2,778,206 $2,778,206 $2,532,043 -$246,163

Indiana $1,038,803 $1,038,803 $1,097,991 $59,188

Iowa $343,588 $343,588 $458,056 $114,468

Kansas $387,576 $387,576 $482,888 $95,312

Kentucky $481,559 $481,559 $601,287 $119,728

Louisiana $752,830 $752,830 $757,558 $4,728

Maine $300,000 $300,000 $300,000 ---

Maryland $1,305,852 $1,305,852 $1,202,358 -$103,494

Massachusetts $1,600,938 $1,600,938 $1,458,831 -$142,107

Michigan $1,776,247 $1,776,247 $1,683,300 -$92,947

Minnesota $832,874 $832,874 $932,502 $99,628

Mississippi $300,000 $300,000 $311,638 $11,638

Missouri $917,902 $917,902 $972,038 $54,136

Montana $300,000 $300,000 $300,000 ---

Nebraska $300,000 $300,000 $325,555 $25,555

Nevada $632,561 $632,561 $664,113 $31,552

New Hampshire $300,000 $300,000 $300,000 ---
129

FY 2023 FY 2024 FY 2025 FY 2025 +/-

State or Territory Final CR President's Budget FY 2023

New Jersey $2,195,860 $2,195,860 $1,979,872 -$215,988

New Mexico $300,000 $300,000 $358,871 $58,871

New York $4,337,114 $4,337,114 $4,016,037 -$321,077

North Carolina $1,416,846 $1,416,846 $1,583,376 $166,530

North Dakota $300,000 $300,000 $300,000 ---

Ohio $2,040,111 $2,040,111 $2,046,329 $6,218

Oklahoma $465,054 $465,054 $581,680 $116,626

Oregon $648,041 $648,041 $775,460 $127,419

Pennsylvania $2,430,781 $2,430,781 $2,260,024 -$170,757

Rhode Island $300,000 $300,000 $300,000 ---

South Carolina $698,580 $698,580 $790,666 $92,086

South Dakota $300,000 $300,000 $300,000 ---

Tennessee $934,324 $934,324 $1,040,609 $106,285

Texas $5,130,398 $5,130,398 $5,547,307 $416,909

Utah $607,440 $607,440 $667,773 $60,333

Vermont $300,000 $300,000 $300,000 ---

Virginia $1,511,949 $1,511,949 $1,484,161 -$27,788

Washington $1,365,043 $1,365,043 $1,460,454 $95,411

West Virginia $300,000 $300,000 $300,000 $0

Wisconsin $859,233 $859,233 $898,841 $39,608

Wyoming $300,000 $300,000 $300,000 ---

Puerto Rico $915,171 $915,171 $686,325 -$228,846

Guam $50,000 $50,000 $50,000 ---

Virgin Islands $50,000 $50,000 $50,000 ---

American Samoa $50,000 $50,000 $50,000 ---

Northern Mariana Islands $50,000 $50,000 $50,000 ---

Total Allotments $63,117,278 $63,117,278 $63,141,531 $24,253

Total Administrative Costs $3,517,722 $3,517,722 $3,493,469 -$24,253

Total Appropriation Amount $66,635,000 $66,635,000 $66,635,000 ---
130

Protection and Advocacy for Individuals with Mental Illness (PAIMI)

(Dollars in millions)

Program Name

FY 2023 

Final 

FY 2024 

CR 

FY 2025 

President’s 

Budget

FY 2025 +/- 

FY 2023 

Protection and Advocacy for Individuals with Mental Illness (PAIMI)... 40.000 40.000 40.000 -- 

Authorizing Legislation ...................................................The PAIMI Act, 42 U.S.C. 10801 et seq. 

FY 2025 Authorization ..................................................................................................$40,000,000 

Allocation Method ................................................................................................... Formula Grants

Eligible Entities ............................................................................................... States and Territories

 

Program Description

The Protection and Advocacy for Individuals with Mental Illness (PAIMI) Program ensures that 

the most vulnerable individuals with serious mental illness (SMI) and significant emotional 

impairment, especially those residing in public and private residential care and treatment facilities, 

are free from abuse, including inappropriate restraint and seclusion, neglect, and rights violations 

while receiving appropriate mental disorder treatment and discharge planning services.

The Protection and Advocacy for Individuals with Mental Illness Act of 1986, as amended by the 

Children’s Health Act of 2000, extended the protections of the Developmental Disabilities (DD) 

Assistance Act of 1975 to individuals with significant mental illness (adults) and significant 

emotional impairments (children/youth) at risk for abuse, neglect, and rights violations while 

residing in public or private care treatment facilities; or living in a community setting, including 

their own homes. The PAIMI Act authorized the same governor-designated state protection and 

advocacy (P&A) systems established under the DD Assistance Act of 1975 to receive PAIMI 

Program formula grant awards from SAMHSA.

PAIMI supports legal-based advocacy services that are provided by the 57 governor-designated 

P&A systems, which include states, territories, and the District of Columbia. Each system is 

mandated to: (1) ensure that the rights of individuals with mental illness who are at risk of abuse, 

neglect, and rights violations while residing in public or private care or treatment facilities or living 

in a community setting are protected; (2) protect and advocate for the rights of these individuals 

through activities that ensure the enforcement of the Constitution and federal and state statutes; 

and (3) investigate incidents of abuse and/or neglect of individuals with mental illness. The priority 

for services is individuals who are an in-patient or residents of public or private care and treatment 

facilities for individuals with mental illness.

 

Budget Request

The FY 2025 President’s Budget is $40.0 million, equal to the FY 2023 Final level. PAIMI 

programs will continue to focus on addressing abuse and neglect issues for vulnerable populations 

and advocate for the rights of individuals with mental illness as well as continue to assist 

individuals with SMI increase access to treatment.
131

Funding History Table

Fiscal Year Amount

FY 2021 $36,146,000

FY 2022 $38,000,000

FY 2023 Final $40,000,000

FY 2024 CR $40,000,000

FY 2025 President’s Budget $40,000,000

Program Accomplishments

 

 In FY 2023, SAMHSA anticipates supporting 57 annual grants to states, District of Columbia, 

and territories. It is expected that, when available in July 2024, PAIMI grantees will serve 8,600 

individuals. .In FY 2024, SAMHSA and maintaining the same performance targets as FY 2023. 
132

Outputs and Outcomes Table

Program: Protection & Advocacy

Measure Year and Most Recent 

Result /

Target for Recent 

Result /

(Summary of Result)

FY 2024

 Target

FY 2025

 Target

FY 2025

 Target

+/-FY 2024

 Target

3.4.12 Number of 

people served by the 

PAIMI program 

(Outcome)

FY 2022: 8,636

 

Target:

 9,821 

 

(Target Not Met)

8,600 8,600 Maintain

3.4.19 Number 

attending public 

education/constituenc

y training and public 

awareness activities 

(Output)

FY 2022: 299,536

 

Target:

 120,000 

 

(Target Exceeded)

150,000 150,000 Maintain

3.4.21 Percentage of 

complaints of alleged 

abuse, neglect, and 

rights violations 

substantiated and not 

withdrawn by the 

client that resulted in 

positive change 

through the 

restoration of client 

rights, expansion or 

maintenance of 

personal decisionmaking, elimination

of other barriers to 

personal decisionmaking, as a result of 

Protection and 

Advocacy for 

Individuals with 

Mental Illness 

(PAIMI) 

involvement 

(Outcome)

FY 2022: 95 %

 

Target:

 92 % 

 

(Target Exceeded) 

92 % 92 % Maintain
133

State Table

DEPARTMENT OF HEALTH AND HUMAN SERVICES

SAMHSA 

FY 2025 MANDATORY STATE/FORMULA GRANTS

CFDA NUMBER: 93.138/PROGRAM NAME: PAIMI

FY 2023 FY 2024 FY 2025 FY 2025 +/-

State or Territory Final CR President's Budget FY 2023

Alabama $500,629 $500,629 $512,887 $12,258

Alaska $473,700 $473,700 $473,700 - 

Arizona $728,342 $728,342 $690,777 -$37,565

Arkansas $473,700 $473,700 $473,700 - 

California $3,258,367 $3,258,367 $3,204,036 -$54,331

Colorado $502,394 $502,394 $483,167 -$19,227

Connecticut $473,700 $473,700 $473,700 - 

Delaware $473,700 $473,700 $473,700 - 

District of Columbia $473,700 $473,700 $473,700 - 

Florida $2,009,341 $2,009,341 $1,981,481 -$27,860

Georgia $1,027,926 $1,027,926 $1,041,776 $13,850

Hawaii $473,700 $473,700 $473,700 - 

Idaho $473,700 $473,700 $473,700 - 

Illinois $1,095,797 $1,095,797 $1,097,453 $1,656

Indiana $647,370 $647,370 $642,069 -$5,301

Iowa $473,700 $473,700 $473,700 - 

Kansas $473,700 $473,700 $473,700 - 

Kentucky $473,700 $473,700 $473,700 - 

Louisiana $473,700 $473,700 $473,700 - 

Maine $473,700 $473,700 $473,700 - 

Maryland $512,647 $512,647 $528,189 $15,542

Massachusetts $543,574 $543,574 $550,181 $6,607

Michigan $942,630 $942,630 $953,908 $11,278

Minnesota $495,993 $495,993 $494,528 -$1,465

Mississippi $473,700 $473,700 $473,700 - 

Missouri $590,911 $590,911 $583,152 -$7,759

Montana $473,700 $473,700 $473,700 - 

Nebraska $473,700 $473,700 $473,700 - 

Nevada $473,700 $473,700 $473,700 - 

New Hampshire $473,700 $473,700 $473,700 - 

New Jersey $720,483 $720,483 $759,597 $39,114

New Mexico $473,700 $473,700 $473,700 - 

New York $1,559,151 $1,559,151 $1,631,086 $71,935

North Carolina $1,033,101 $1,033,101 $1,007,259 -$25,842

North Dakota $473,700 $473,700 $473,700 - 
134

FY 2023 FY 2024 FY 2025 FY 2025 +/-

State or Territory Final CR President's Budget FY 2023

Ohio $1,101,859 $1,101,859 $1,110,093 $8,234

Oklahoma $473,700 $473,700 $473,700 - 

Oregon $473,700 $473,700 $473,700 - 

Pennsylvania $1,123,397 $1,123,397 $1,158,149 $34,752

Rhode Island $473,700 $473,700 $473,700 - 

South Carolina $521,389 $521,389 $519,041 -$2,348

South Dakota $473,700 $473,700 $473,700 - 

Tennessee $665,972 $665,972 $662,765 -$3,207

Texas $2,728,154 $2,728,154 $2,721,769 -$6,385

Utah $473,700 $473,700 $473,700 - 

Vermont $473,700 $473,700 $473,700 - 

Virginia $753,430 $753,430 $750,364 -$3,066

Washington $649,831 $649,831 $645,675 -$4,156

West Virginia $473,700 $473,700 $473,700 - 

Wisconsin $539,658 $539,658 $538,928 -$730

Wyoming $473,700 $473,700 $473,700 - 

Puerto Rico $552,218 $552,218 $547,563 -$4,655

American Samoa $253,800 $253,800 $253,800 - 

Guam $253,800 $253,800 $253,800 - 

American Indian Consortium $253,800 $253,800 $253,800 - 

Northern Mariana Islands $253,800 $253,800 $253,800 - 

Virgin Islands $253,800 $253,800 $253,800 - 

Total Allotments $38,863,464 $38,863,464 $38,874,793 $11,329

Total Administrative Costs $1,136,536 $1,136,536 $1,125,207 -$11,329

Total Appropriation $40,000,000 $40,000,000 $40,000,000 - 
135

Certified Community Behavioral Health Clinics (CCBHC)

(Dollars in millions)

Program Name

FY 2023 

Final 

FY 2024 

CR 

FY 2025 

President's 

Budget 

FY 2025 +/- 

FY 2023 

Certified Community Behavioral Health Clinics............................... 385.000 385.000 450.000 65.000 

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

FY 2025 Authorization ................................................................................................$450,000,000 

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

Eligible Entities .................................................... Certified Community Behavioral Health Clinics,

Community-Based Behavioral Health Clinics

Program Description

In 2022, among adults aged 18 or older, 23.1 percent (or 5.3 million people) had a mental illness 

and 6.0 percent (or 15.4 million people) had a serious mental illness (SMI) in the past year. 48.7 

million people aged 12 or older (or 17.3 percent) had an SUD in 2022.74 While effective treatment 

and supportive services exist, many individuals with behavioral health conditions do not receive 

the help they need.75 When they do try to access services, they often face significant delays and/or 

have limited access to services.76 Too often, services are incomplete and uncoordinated. People 

who receive services, such as medication or psychotherapy, often do not get other supports they 

need, such as crisis management, supported employment, supportive housing, and care for cooccurring physical health problems. 77, 78, 79

Congress created a new approach to addressing these issues by creating the Certified Community 

Behavioral Health Clinics (CCBHC) model as a part of the Protecting Access to Medicare Act of 

2014 (PAMA). The purpose of this program is to transform community behavioral health systems 

and provide comprehensive, coordinated behavioral health care by (a) enhancing and improving 

CCBHCs that meet the CCBHC Certification Criteria80; (b) providing a comprehensive range of 

outreach, screening, assessment, treatment, care coordination, and recovery supports based on a 

74 Substance Abuse and Mental Health Services Administration. (2023). Key substance use and mental health 

indicators in the United States: Results from the 2022 National Survey on Drug Use and Health (HHS Publication No. 

PEP2307-01-006, NSDUH Series H-58). Center for Behavioral Health Statistics and Quality, Substance Abuse and 

Mental Health Services Administration. https://www.samhsa.gov/data/sites/default/files/reports/rpt42731/2022-

nsduh-nnr.pdf 

75 Ibid 

76 https://www.gao.gov/assets/gao-22-104597.pdf

77 https://www.samhsa.gov/data/sites/default/files/reports/rpt39371/Alabama.pdf 

78 Substance Abuse and Mental Health Services Administration. (2022). Key substance use and mental

health indicators in the United States: Results from the 2021 National Survey on Drug Use and Health

(HHS Publication No. PEP22-07-01-005, NSDUH Series H-57). Center for Behavioral Health

Statistics and Quality, Substance Abuse and Mental Health Services Administration. 

https://www.samhsa.gov/data/report/2021-nsduh-annual-national-report 

79 https://www.samhsa.gov/sites/default/files/national-guidelines-for-behavioral-health-crisiscare-02242020.pdf 80 https://www.samhsa.gov/sites/default/files/programs_campaigns/ccbhc-criteria-2022.pdf
136

needs assessment with fidelity to the CCBHC Certification Criteria; and (c) supporting recovery 

from mental illness and/or substance use disorders by providing access to high-quality mental 

health and substance use services, regardless of an individual’s ability to pay.

CCBHC’s ensure access to coordinated care so that individuals receive timely diagnosis, 

treatment, and recovery support services. As required in PAMA, HHS established criteria for 

clinics to be certified as CCBHCs in 2015. These criteria cover six areas that CCBHCs must 

address to be certified: (1) staffing; (2) availability and accessibility of services; (3) care 

coordination; (4) scope of services; (5) quality and other reporting; and (6) organizational 

authority. Crisis services are also required with the CCBHC model.

 

CCBHCs serve all individuals across the lifespan in need of behavioral health services in the 

geographic catchment area served by the CCBHC. This includes individuals with SMI; SUD, 

including opioid use disorders; children and youth with SED; individuals with COD; and people 

experiencing a mental health or substance use related crisis. SAMHSA expects that applicants will 

include a focus on groups facing health disparities, as identified in the community needs 

assessment in the population of focus. 

 

In FY 2016, SAMHSA assisted 24 states through planning grants to be eligible for a CCBHC 

demonstration, and in FY 2017, CMS selected eight states to participate in a two-year CCBHC 

demonstration program. This demonstration program has been extended by Congress until 2026 

and was expanded to include two additional states under the CARES Act in 2020. CCBHC 

demonstration clinics are reimbursed for the care and services provided to Medicaid beneficiaries 

through a cost-based prospective payment system.

 

In 2018, SAMHSA established the (CCBHC-E) grant program. The CCBHC-E program assists 

clinics to implement the CCBHC model and enhance their programs using grant funding in 

addition to the existing funding sources at these clinics. These include community-based mental, 

and substance use disorder services; treatment of co-occurring disorders; primary care screening 

and monitoring; and use of evidence-based practices chosen to meet community need. SAMHSA’s 

CCBHC-E program is separate from the Medicaid Demonstration program, though some clinics 

participate in both programs. Grant funding for the CCBHC-E program is provided directly to the 

certified clinics. 

 

In FY 2022, SAMHSA also revamped the CCBHC-E funding announcement requirements and 

built two tracks into the CCBHC-E grant program. One track is for clinics that are interested in 

newly becoming CCBHCs [the CCBHC Planning, Development, and Implementation (CCBHCPDI) Grants], and the other track is for clinics that are already established CCBHCs seeking to 

expand, improve, and advance their services [the CCBHC Improvement and Advancement 

(CCBHC-IA) Grants].

 

SAMHSA updated the CCBHC Criteria in FY 2023. To develop the updated CCBHC Criteria, 

SAMHSA gathered input from the public, key stakeholders, and federal partners. The updated 

criteria modernize and strengthen the criteria without significantly adding to state or clinic burden. 

SAMHSA updated and revised the criteria to 1) respond to developments in the field, 2) update 

criteria that are no longer current, and 3) address areas of improvement suggested by CCBHCs, 

states, and other stakeholders.
137

 

SAMHSA expects that CCBHC-E grants will improve behavioral health care for individuals 

across the lifespan by supporting providers to operate in accordance with the Federal CCBHC 

criteria and:

 

1. Increase access to and availability of high-quality services that are responsive to the 

needs of the community;

 

2. Support recovery from mental health and substance use disorder challenges via 

comprehensive community-based mental and substance use disorder treatment and 

supports;

 

3. Use evidence-based practices that address the needs of the individuals the CCBHC 

serves;

 

4. Continually work to measure and improve the quality of services; and

 

5. Meaningfully involve consumers and family members in their own care and the broader 

governance of the CCBHC.

 

Budget Request

 

The FY 2025 President’s Budget is $450.0 million, an increase of $65.0 million from the FY 2023 

Final level. The funding will support 363 continuation grants and award a new cohort of 63 grants. 

SAMHSA expects to serve approximately 819,000 individuals directly with grant-funded services, 

expanding CCBHC’s services across the nation. The FY 2025 president’s budget includes a 

technical assistance center contract. The contract will support CCBHC expansion grant recipients, 

state CCBHCs outside of the expansion program, states in the CCBHC Demonstration program, 

states planning to be part of the Demonstration, states with CCBHC programs independent of the 

Demonstration, and states considering adopting the CCBHC model. This contract will also 

incorporate funding appropriated from the Bipartisan Safer Communities Act. The FY 2025 budget 

request will also support an evaluation contract that will assess the extent to which grant recipients 

develop, improve, implement, and sustain the CCBHC model and will assess the delivered services 

consistent with the CCBHC certification requirements to measure client outcomes and experiences 

with care.

 

The Budget also proposes an accreditation process similar to the process for which many health 

facilities are accredited. This new process would support consistent implementation of the CCBHC 

model and adherence to the CCBHC certification criteria. A CCBHC accreditation process will 

allow for improved accountability for CCBHCs across the country s and will ensure that CCBHCs 

are consistently providing access to quality behavioral health care. 
138

Funding History Table

Fiscal Year Amount

FY 2021 $249,249,440

FY 2022 $315,000,000

FY 2023 Final $385,000,000

FY 2024 CR $385,000,000

FY 2025 President’s Budget $450,000,000

Program Accomplishments

 

In FY 2023, SAMHSA awarded 298 grant continuations (234 continuation grants with base budget 

authority, 64 grans American Rescue Plan Act funds) and awarded 128 new grants in addition to 

a training and technical assistance center, and a CCBHC expansion grant evaluation contract. In 

FY 2023, the CCBHC-E grant program served 963,938 people. In FY 2023, 79.5 percent of 

assessed individuals served by CCBHC-E grantees reported no psychological distress at the sixmonth reassessment in comparison to 68.4 percent at baseline. Over the same period, CCBHC-E 

clients had a 53.6 percent reduction in hospitalizations and a 54.8 percent reduction in Emergency 

Department visits in the previous 30 days. CCBHC- E grantees have increased the availability of 

critical services, improved staffing and training, reduced wait times, enhanced the integration of 

physical and behavioral health care, expanded addiction treatment capacity including Medication 

Assisted Treatment (MAT) for opioid use disorder. 

 

In FY 2024, SAMHSA anticipates funding 362 continuation grants. 

Outputs and Outcomes Table

Program: Certified Behavioral Health Clinic Expansion Grants

Measure Year and Most Recent 

Result /

Target for Recent Result /

(Summary of Result)

FY 2024

Target

FY 2025

Target

FY 2025

Target

+/-FY 2024

Target

3.4.10 Percentage of 

clients receiving services 

who report positive 

functioning at 6 months 

follow-up. (Outcome)

FY 2023: 49.6

Target:

56.0

(Target Not Met)

56.0 56.0 Maintain

3.5.10 Number of 

individuals served by the 

program (Output)

FY 2023: 963,938.0

Target:

311,000.0

(Target Exceeded)

700,000.0 819,000.0 +119,000

3.5.31 Percentage of 

clients who report no 

serious psychological 

distress at 6 months 

(Output)

FY 2023: 79.5

Target:

79.5

(Baseline)

79.5 79.5 Maintain
139

PRNS Mechanism Table 

Mental Health

Summary

(Dollars in millions) 

Mental Health PRNS

Program Activity

FY 2023 

Final FY 2024 CR

FY 2025 

President's Budget

Programs of Regional & National Significance

Grants/Cooperative Agreements

Continuations....................................................................... 645 311.731 817 807.713 841 873.112

New/Competing.................................................................... 435 628.082 178 126.981 170 225.183

Supplements*...................................................................... 12 20.440 --- 2.276 --- 0.000

Subtotal............................................................................ 1,080 960.253 995 936.970 1,011

1,098.29

5

Contracts

Continuations....................................................................... 3 59.457 3 98.321 5 118.452

New/Competing.................................................................... 1 24.323 1 8.742 1 0.786

Subtotal............................................................................. 4 83.780 4 107.063 6 119.238

Total, Mental Health PRNS 1,084 1,044.033 999 1,044.033 1,017

1,217.53

3

* Bipartisan Safer Communities Act Funding. Excluding Supplements number count to avoid duplication.

 
140

PRNS Mechanism Table

Mental Health

Program, Project, and Activity 

(Dollars in millions)

Children's Mental Health Services

Program Activity

FY 2023 

Final FY 2024 CR

FY 2025 

President's Budget

Children's Mental Health Services

Grants/Cooperative Agreements

Continuations...................................................................... 65 69.752 74 $79.887 97 104.172

New/Competing.............................................................. 35 50.606 36 $39.565 40 66.023

Supplements*.................................................................. --- 0.450 --- $0.000 --- 0.000

Subtotal....................................................................... 100 120.808 110 $119.452 137 170.195

Contracts

Continuations................................................................ --- 7.339 0.00 $7.548 0.00 9.805

New/Competing............................................................... --- 1.853 --- $3.000 --- 0.000

Subtotal..................................................................... --- 9.192 0.00 $10.548 0.00 9.805

Total, Children's Mental Health Services 100 130.000 110 $130.000 137 180.000

* Excluding Supplements number count to avoid duplication. Funding was for for additional resources to Hawaii in response to Maui wildfires.. 
141

PRNS Mechanism Table

Mental Health

Program, Project, and Activity 

(Dollars in millions)

Certified Community Behavioral Health Clinics

Program Activity

FY 2023 

Final FY 2024 CR

FY 2025 

President's Budget

Certified Community Behavioral Health Clinics

Grants/Cooperative Agreements

Continuations........................................................................... 235 233.396 363 362.059 363 362.413

New/Competing........................................................................ 128 127.713 --- 0.000 63 62.324

Subtotal................................................................................. 363 361.109 363 362.059 426 424.736

Contracts

Continuations........................................................................... --- 20.961 1 22.941 1 25.264

New/Competing........................................................................ 1 2.130 --- 0.000 --- 0.000

Supplements*........................................................................... --- 0.800 --- 0.000 --- 0.000

Subtotal................................................................................. 1 23.891 1 22.941 1 25.264

Total, Certified Community Behavioral Health Clinics 364 385.000 364 385.000 427 450.000

* Funding was for additional resources to Hawaii in response to Maui wildfires.
142

Grant Awards Table

Mental Health

(Whole dollars) 

Mental Health PRNS 

FY 2023

Final 

FY 2024

CR 

FY 2025

President's Budget 

Number of Awards 1080 995 1011

Average Awards $889,123 $942,090 $1,086,848

Range of Awards $20,000 - $10,000,000 $20,000 - $10,000,000 $20,000 - $10,000,000

Children's Mental Health Services

FY 2023

Final 

FY 2024

CR 

FY 2025

President's Budget 

Number of Awards 100 110 137 

Average Awards $1,208,079 $1,085,498 $1,242,302

Range of Awards $330,000 - $2,000,000 $330,000 - $2,000,000 $330,000 - $2,000,001

Certified Community Behavioral Health Clinics

FY 2023

Final 

FY 2024

CR 

FY 2025

President's Budget 

Number of Awards 363 363 426

Average Awards $994,792 $997,407 $997,033

Range of Awards $1,000,000-$2,000,000 $1,000,000-$2,000,000 $1,000,000-$2,000,001
143

Community Mental Health Services Block Grant (MHBG)

(Dollars in millions)

Program Name

FY 2023 

Final 

FY 2024 

CR 

FY 2025 

President's 

Budget 

FY 2025 +/- 

FY 2023 

Community Mental Health Services Block Grant...................... 1,007.571 1,007.571 1,042.571 35.000 

Budget Authority (non-add)......................................................... 986.532 986.532 1,021.532 35.000 

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

Authorizing Legislation .......................................................................... Section 1911 of the PHS Act

FY 2025 Authorization .............................................................................................$1,042,571,000 

Allocation Method ..................................................................................................... Formula Grant 

Eligible Entities .................. States, Territories, Freely Associated States, and District of Columbia

Program Description

According to the 2022 National Survey on Drug Use and Health (NSDUH),816.0 percent of adults 

aged 18 and older had a serious mental illness (SMI) in 2022 (an estimated 15.4 million adults) 

and only 66.7 percent adults with SMI received services in 2021 (an estimated 10.2 million adults). 

Since 1992, the Community Mental Health Services Block Grant (MHBG) has distributed funds 

to 59 eligible states and territories and freely associated states through a formula based upon 

specified economic and demographic factors.82The MHBG distributes funds that can be used for 

a variety of behavioral health services and for planning, administration, and educational activities. 

By statute, these services and activities must support community-based mental health services for 

children with SED and adults with SMI. MHBG services include: outpatient treatment for persons

with SMI, such as schizophrenia and bipolar disorders; supported employment and supported 

housing; rehabilitation services; crisis stabilization and case management; peer specialist and 

consumer-directed services; wraparound services for children and families; jail diversion 

programs; and services for at-risk populations (e.g., individuals, who experience homelessness, 

those in rural and frontier areas, military families, and veterans).

The MHBG continues to represent a significant “safety net” source of funding for mental health 

services for some of the most at-risk populations across the country. Together, SAMHSA’s block 

grants support the provision of services and related support activities to more than eight million 

individuals with mental and substance use conditions in any given year. The MHBG’s flexibility 

81 Substance Abuse and Mental Health Services Administration. (2023). Key substance use and mental health 

indicators in the United States: Results from the 2022 National Survey on Drug Use and Health (HHS Publication 

No. PEP23-07-01-006, NSDUH Series H-58). Rockville, MD: Center for Behavioral Health Statistics and Quality, 

Substance use And Mental Health Services Administration. Retrieved from 

https://www.samhsa.gov/data/sites/default/files/reports/rpt42731/2022-nsduh-nnr.pdf. 

82 Territories include Guam, Puerto Rico, the Northern Mariana Islands, U.S. Virgin Islands and 

American Samoa. Freely Associated States, which have signed Compacts of Free Association

with the United States, include the Republic of Palau, Federated States of Micronesia and 

Republic of the Marshall Islands.See http://www.doi.gov//oia/islands/index.cfm. Further 

information about the Block Grant program can be found on SAMHSA’s Web site at 

http://www.samhsa.gov/grants/block-grants
144

and stability have made it a vital support for public mental health systems. States rely on the 

MHBG for delivery of services and for an array of non-clinical coordination and support services 

that are not supported by Medicaid or other third-party insurance to strengthen their service.

 

The MHBG statute provides for a five percent administrative set-aside that allows SAMHSA to 

assist the states and territories in the development of their mental health systems through the 

support of technical assistance, data collection, and evaluation activities. States also use block 

grant funds, with other funding sources, to support training for staff and implementation of 

evidence-based practices and other promising practices for the treatment of mental disorders, 

improved business practices, use of health information technology, and integration of physical and 

behavioral health services.

SAMHSA’s MHBG and Substance Use Prevention, Treatment, and Recovery Services Block 

Grant (SUPTRS BG) applications align with changes in federal/state environments and statutes. 

SAMHSA offers states the opportunity to complete a combined application for mental health and 

substance abuse services, submit a biennial plan, and provide information regarding their efforts 

to respond to various changes in federal and state law.83,84

There are many individuals, both adolescent and adult, with co-occurring mental illness and 

drug/alcohol addiction. In recognition of this, SAMHSA strongly encourages coordination 

between MHBG programs and those supported by the SUPTRS BG as well as other SAMHSAfunded efforts such as the systems of care for children and adolescents supported through the 

Children’s Mental Health Initiative.

 

Crisis Services Set-Aside

States are required to set aside 5 percent of their total allocation for evidence-based crisis care 

programs that address the needs of individuals with SMIs and children with serious mental and 

emotional disturbances. The set-aside funds some or all the core crisis care elements including 

centrally deployed 24/7 mobile crisis units, short-term residential crisis stabilization beds, 

evidence-based protocols for delivering services to individuals with suicide risk, and regional or 

State-wide crisis call centers coordinating in real time.

A fully developed crisis response system is responsive any time and any place. SAMHSA expects 

that states build on the emerging and growing body of evidence for effective community-based 

crisis-intervention and response systems. SAMHSA recognizes that the development of fully 

accessible and responsive crises services involves complex problem solving with multiple entities 

and systems including a partnership between mental health and law enforcement. The 988 Suicide 

& Crisis Lifeline plays a critical role in such fully developed crisis systems. SAMHSA also 

recognizes that strategic crisis services implementation can result in better care and cost savings 

through the reduction in avoidable emergency department visits, psychiatric admissions, police 

engagement, arrests, incarcerations, and 911 calls. SAMHSA views the 988 Suicide & Crisis 

83 State Plan for Comprehensive Community Mental Health Services for Certain Individuals (Sec. 1912 of Title XIX, 

Part B, Subpart I of the Public Health Service (PHS) Act (42 USC § 300x-2).

84 State Plan (Sec. 1932 (b) of Title XIX, Part B, Subpart II of the Public Health Service (PHS) Act

(42 USC § 300x- 32(b)).
145

Lifeline as a catalyst for this crisis service development and transformation.

Now that the National Suicide Prevention Lifeline has transitioned to the 988 Suicide and Crisis 

Lifeline, SAMHSA has emphasized to states the importance of 988 implementation, and that the 

MHBG crisis set aside can be used to support local Lifeline call centers who provide regional or 

statewide coverage and coordinate in real time. SAMHSA continues to partner with states on the 

crisis set-aside through the provision of technical assistance on the use of funds, requests for 

information on specific allocations of funding across the crisis continuum of care, and 

recommended changes to the data reporting system. The Budget increases the crisis set-aside to 

10 percent. 

Set-aside for Evidence-based Programs that Address the Needs of Individuals with Early Serious 

Mental Illness

States are required to set aside ten percent of their MHBG funds to support “evidence-based 

programs that address the needs of individuals with early SMI, including psychotic disorders”.85

This totaled $81.5 million in FY 2022. SAMHSA is collaborating with the NIMH and states to 

implement this provision.

The majority of individuals with SMI experience their first symptoms during adolescence or early 

adulthood, and there are often long delays between the initial onset of symptoms and receiving 

treatment. The consequences of delayed treatment can include loss of family and social supports, 

reduced educational achievement, incarceration, disruption of employment, substance use, 

increased hospitalizations, and reduced prospects for long-term recovery.

Through this funding, 50 states, DC and Puerto Rico implemented fully operating first-episode 

treatment programs and SAMHSA continues to monitor and ensure that the set-aside program is 

solely used to address first-episode psychosis.

Set-aside for Early Intervention and Prevention of Mental Disorders Among At-Risk Children 

and Adults 

The FY 2024 Budget includes a new set-aside that would require states to expend at least 10 

percent of their MHBG funding for evidence-based prevention and early intervention programs to

improve outcomes for at-risk youth and adults who are at risk to develop SMI or SED through

prevention, education, screening, and early identification. This investment expands funding to 

support earlier identification and prevention of mental health disorders and further support targeted 

services for youth and prevent more serious symptoms further on in a person’s life.

85 http://www.samhsa.gov/sites/default/files/mhbg-5-percent-set-aside-guidance.pdf
146

Budget Request

The FY 2025 President’s Budget is $1.0 billion, an increase of $35.0 million from the FY 2023 

Final level. With this funding, SAMHSA will continue to address the needs of individuals with 

SMI and SED and will continue to maintain the 10 percent set-aside for evidence- based programs 

that address the needs of individuals with early SMI, including psychotic disorders. The 10 percent 

crisis care set set-aside funds help reduce costs to society, as intervening early helps prevent 

deterioration of functioning in individuals experiencing a first episode of SMI. The Budget also 

includes a 10 percent set-aside for evidence-based programs for early intervention and prevention 

of mental disorders among at-risk children and adults. States will continue to use the Coronavirus 

Response and Relief Supplement and American Rescue Plan funding through FY 2024 with No 

Cost Extension request approvals and FY 2025, respectively, as states expand their MHBG 

infrastructure to address unmet service needs.

Funding History Table

Fiscal Year Amount

FY 2021 $755,571,000

FY 2022 $857,571,000

FY 2023 Final $1,007,571,000

FY 2024 CR $1,007,571,000

FY 2025 President’s Budget $1,042,571,000

 
147

Program Accomplishments

Most block grant recipients are currently reporting on National Outcome Measures (NOMS) for 

public mental health services within their state. State-level outcome data for mental health are 

currently reported by State Mental Health Authorities. According to the 2022 NOMS Report, the 

MHBG served 8,180,236 clients through the State Mental Health Systems. The table below 

provides FY 2022 demographics on the clients served. 
148

Mental Health Block Grant Demographics

Adults 5,983,234

Children 2,197,002

Female 53.7%

Male 45.6%

Age

0-12 14.2%

13-17 12.7%

18-20 5.0%

20-24 6.0%

25-44 33.1%

45-64 22.8%

65-74 4.3%

75+ 1.7%

The following outcomes for all people served by the publicly funded mental health system during 

2022 show that: 

For the 59 states and territories that reported data in the Employment Domain, 27.2 percent of the 

mental health consumers were in competitive employment;

 

For the 58 states and territories that reported data in the Housing Domain, 85.8 percent of the 

mental health consumers were living in private residences;

For the 59 states and territories that reported data in the Access/Capacity Domain, state mental 

health agencies provided mental health services for approximately 24.37 people per 1,000 

population; 

For the 43 states and territories that reported data in the Retention Domain, only 7.8 percent of the 

patients returned to a state psychiatric hospital within 30 days of state hospital discharge and 

For the 51 states and territories that reported data in the Perception of Care Domain, 77.7 percent 

of adult mental health consumers improved functioning as a direct result of the mental health 

services they received.

The table below identifies activities that states have implemented with the 10 percent set-aside 

for First Episode Psychosis (FEP)/Early Serious Mental Illness (ESMI).

 
149

State FY 2023 10%

Set Aside 

Allotment

Program Description

Alabama $1,405,119 

State uses the EASA and OnTrack USA. Services are 

delivered through a Coordinated Specialty Care Team that is 

reflective of the demographic mix of the community.

Alaska $236,083 

Use the OnTrAK model. The staffing structure highlights the 

realities of the Mat-Su Borough in size, scope, and incidence 

rate leading to the development of a task-based team approach 

focused on outcome.

American 

Samoa $18,003

AS has adopted the Assertive Community Treatment (ACT) 

model for community mental health services for use with 

individuals with FEP.

Arizona $2,420,760 State has CSC model at 3 sites with planned expansion.

Arkansas $853,221 

State ESMI/FEP program is contractually assigned to the 

Community Mental Health Centers. Evidenced-based 

treatment models are utilized for each client newly diagnosed 

with psychosis.

California $12,370,027

State allocates MHBG funds to 57 local county subrecipients 

who administer their own Mental Health Plans that are unique 

to their geographic and population circumstances each year 

and utilize models, such as Portland Identification and Early 

Referral (PIER).

Colorado $1,894,011 Providers have implemented CSC models with high fidelity.

Connecticut $978,610

State implemented four programs based on two distinct CSC 

models (Potential and STEP).

Delaware $207,525

A statewide program, Community Outreach, Referral and 

Early Intervention (CORE)) has been implemented.

District of 

Columbia $237,982 

The District’s early intervention program (EIP), the Youth 

Blossom program at Community Connections, is utilizing 

CSC model offers early treatment to young adults (age 16-25) 

experiencing their first psychotic break.

Florida $6,548,174

The State of Florida currently has 7 Coordinated Specialty 

Care teams. Six of the seven utilize the NAVIGATE model 

and one utilizes the OnTrack model.

Georgia $2,944,305

State has now implemented ten (10) Coordinated Specialty 

Care teams around the state. All programs are based on the 

LIGHT- ETP model.

Guam $64,005 

State has begun providing services in the I Fine'na program, 

which is based on OnTrackNY, and offers Early Serious 

Mental Illness (ESMI) services through the OASIS 

Empowerment Center.
150

Hawaii $477,660

State has implemented a program with three sites in Honolulu 

based on the OnTRACK model.

Idaho $531,105 

Four CSC programs have been implemented Idaho is 

implementing the STAR (Strength Through Active Recovery) 

program to provide FEP treatment based on the On-Track CSC 

treatment model.

Indiana $2,997,067

State offers three programs based on the Prevention and 

Recovery Care (PARC) model and makes use of a "hub and 

spoke" design.

Iowa $1,917,394

State has three functioning CSC programs based on the 

NAVIGATE model.

Kansas $773,941

There are three teams in Kansas. The eligibility age was raised 

from 15 to 25-years-old to 15 to 36-years-old to increase 

access to women.

Kentucky

 

$700,572

Eight EASA CSC program sites are available throughout the 

state, with one in the installation phase. State is also using the 

MHBG to support data infrastructure to track outcomes.

Louisiana $1,258,208

Six sites have been implemented. These programs are using 

the Navigate CSC model.

Maine $382,538 

State has implemented one program, Maine Medical 

Center/Portland Identification and Early Referral Program, 

based on the PIER Model in Portland. The state has also 

contracted with the PIER program to train staff at one other 

provider to provide FEP services.

Marshall 

Islands $29,532

Use the set aside funding to develop first episode outreach 

practices and protocols for individuals experiencing FEP. 

Maryland $1,255,878 

The state has implemented four CSC programs, two in 

Baltimore, one in Gaithersburg and one in Catonsville. 

Massachusetts $2,041,956

Seven Community Clinics with comprehensive specialized 

FEP services are in operation, and 3 outpatient hospital sites. 

Michigan $2,796,893 

The State has implemented six CSC programs using the 

NAVIGATE CSC model.

Federated 

States of

Micronesia

$38,869 

Funds are being used to train staff on the OnTrack CSC model 

in four locations. The state also has developed outreach and 

screening processes in schools and in the community in 

Majuro, Ebeye and Outer Islands.

Minnesota $1,555,152 

State has implemented three CSC programs using the 

Navigate model.

Mississippi $878,993 

State is fully implementing the NAVIGATE CSC programs 

to provide training and technical assistance to five CSC 

teams.
151

Missouri $1,642,217 

State has established ten sites spread throughout the state that 

provide Assertive Community Treatment for Transitional Age 

Youth (ACT-TAY) for individuals experiencing an early 

SMI.

Montana $350,987 

The state has implemented the NAVIGATE model in one 

site.

Northern 

Mariana 

Islands $19,697 

The Community Guidance Center implemented a 

psychoeducation group geared toward family education, which 

will help families and the community better identify FEP 

symptoms in their family or community leading to earlier 

treatment of the client.

Nebraska $448,906 

The state has implemented OnTrackUSA in two of the six 

behavioral health service regions of the state.

Nevada $1,113,378 

The state has implemented three CSC programs: in the Reno 

area and Las Vegas area using the Recovery After Initial 

Schizophrenic Episode (RAISE) TEAM approach and a third 

CSC program in Carson City that follows the NAVIGATE 

model.

New 

Hampshire

$324,777 

State currently has one FEP program at the Greater Nashua 

Mental Health Center (GNMHC), utilizing the NAVIGATE 

model. 

New Jersey $2,659,541 

State has implemented three CSC teams that provide CSC 

service in all 21 NJ counties. 

New Mexico $591,415 

State is expanding access to the NAVIGATE model for 

specialty coordinated care for individuals with FEP through the 

already implemented University of New Mexico EARLY 

program.

New York $5,453,918 

State is spending set-aside funds to expand its existing 

OnTrackNY program to two new sites, for 22 CSC sites 

statewide.

North 

Carolina

$2,872,609 

North Carolina supports four CSC for FEP programs.

North Dakota $171,655

State implemented CSC services in Fargo, which serves six 

counties in the state. 

Ohio $3,019,256

State has expanded to 17 teams serving 37 counties.

Oklahoma $1,085,193 

State indicates they have expanded to 14 CSC and ESMI 

programs. 

Oregon $1,527,760 

Oregon is integrating Coordinated Specialty Care teams in all 

counties using a standard model of care supported by the 

EASA Center for Excellence at Oregon Health & Science 

University and Portland State University.
152

Palau $8,179

Supports one CSC team.

Pennsylvania $3,238,835 

State has 14 Coordinated Specialty Care Programs for First 

Episode Psychosis, serving 20 counties. 

Puerto Rico $1,211,954 

Puerto Rico has implemented two Coordinated Specialty Care 

Programs using the OnTrack model. 

Rhode Island $338,106 

Rhode Island will continue to use the entire set-aside amount 

to serve individual ages 16-25 experience a first episode of 

psychosis in the two CSC community health care centers. 

South 

Carolina

$1,482,932 

State is funding four programs for individuals with an early 

SMI, one of which uses the NAVIGATE model. 

South Dakota $211,838 

State has implemented two CSC programs in Sioux Falls and 

Rapid City. They have been trained by OnTrackNY. 

Tennessee $2,034,401 

State uses the MHBG funds to provide OnTrackTN in five 

sites across the state.

Texas $7,919,259

State offers 24 CSC programs in rural and urban. These sites 

serve both indigent and Medicaid-eligible populations.

Utah $1,084,863

State has 5 programs in total, all funded by MHBG. Four are 

FEP programs that follow the RAISE model, and one is an 

ESMI program for Hispanic/Latino youth (14-25).

Vermont $167,236 

State continues to partner with Vermont Corporative for 

Practice Improvement and Innovation to facilitate the initiative 

including targeted, research, implementation, workforce 

development, outreach, and education.

Virgin Islands $40,377

State reports site using the CSC model

Virginia $2,453,857 

Eight (8) Virginia community services boards (CSBs) operate 

CSC programs. 

Washington $2,342,351 

State operates nine sites using the New Journeys model based 

on the NAVIGATE model. 

West Virginia $515,627

State has seven provider sites utilizing the FIRST CSC model 

ESMI services to fidelity.

Wisconsin $1,481,149 

State is continuing to fund the CSC model PROPS program 

operated by JMHC in Madison, which serves three rural 

counties north of Madison. In addition, the state is funding a 

CSC program in Milwaukee.

Wyoming $126,941

The state has two providers providing CSC FEP programs: 

Southwest Counseling Service

Yellowstone Behavioral Health Center.
153 

Outputs and Outcomes Table

Program: Mental Health Block Grant

Measure Year and Most 

Recent Result /

Target for Recent 

Result /

(Summary of Result)

FY 2024

 Target

FY 2025

 Target

FY 2025

 Target

+/-FY 2024

 Target

2.3.11 Number of 

evidence based 

practices (EBPs) 

implemented 

(Output) 

FY 2022: 5.3 per State

 

Target:

 5.0 per State 

 

(Target Exceeded)

5.0 per State 5.0 per State Maintain

2.3.14 Number of 

people served by 

the public mental 

health system 

(Output) 

FY 2022: 8,180,236

 

Target:

 8,013,396 

 

(Target Exceeded)

8,200,000 8,500,000 +300,000

2.3.15 Rate of 

consumers (adults) 

reporting positively 

about outcomes 

(Outcome)

FY 2022: 77.7 %

 

Target:

 77.1 % 

 

(Target Exceeded)

75 % 75 % Maintain

2.3.16 Rate of 

family members 

(children/adolescen

ts) reporting 

positively about 

outcomes 

(Outcome)

FY 2022: 70.7 %

 

Target:

 72.2 % 

 

(Target Not Met) 

72.2 % 72.2 % Maintain

2.3.19A: Supported 

Housing Supported 

Housing: 

Percentage of the 

population 

accessing selected 

evidence-based 

programs among 

people served by 

state mental health 

authorities 

(Outcome)

FY 2022: 3.1 %

 

Target:

 3.1 % 

 

(Target Met )

3.1 % 3.1 % Maintain
154 

Measure Year and Most 

Recent Result /

Target for Recent 

Result /

(Summary of Result)

FY 2024

 Target

FY 2025

 Target

FY 2025

 Target

+/-FY 2024

 Target

2.3.19B Supported 

Employment: 

Percentage of the 

population 

accessing selected 

evidence-based 

programs among 

people served by 

state mental health 

authorities 

(Outcome)

FY 2022: 1.7 %

 

Target:

 1.9 % 

 

(Target Not Met)

1.9 % 1.9 % Maintain

2.3.19C Assertive 

Community 

Treatment: 

Percentage of the 

population 

accessing selected 

evidence-based 

programs among 

people served by 

state mental health 

authorities (Output)

FY 2022: 1.9 %

 

Target:

 1.9 % 

 

(Target Met) 

1.9 % 1.9 % Maintain

2.3.19D Family 

Psychoeducation: 

Percent of the 

population 

accessing selected 

evidence-based 

programs among 

people served by 

state mental health 

authorities 

(Outcome)

FY 2022: 2.4 %

 

Target:

 2.6 % 

 

(Target Not Met) 

2.6 % 2.6 % Maintain
155 

Measure Year and Most 

Recent Result /

Target for Recent 

Result /

(Summary of Result)

FY 2024

 Target

FY 2025

 Target

FY 2025

 Target

+/-FY 2024

 Target

2.3.19E Dual 

Diagnosis 

Treatment: Percent 

of the population 

accessing selected 

evidence-based 

programs among 

people served by 

state mental health 

authorities. 

(Outcome) 

FY 2022: 8.7 %

 

Target:

 10.1 % 

 

(Target Not Met)

10.1 % 10.1 % Maintain

2.3.19F Illness 

Self-Management: 

Percent of the 

population 

accessing selected 

evidence-based 

programs among 

people served by 

state mental health 

authorities. 

(Outcome)

FY 2022: 17.9 %

 

Target:

 18.7 % 

 

(Target Not Met) 

18.7 % 18.7 % Maintain

2.3.19G 

Medication 

Management: 

Percent of the 

population 

accessing selected 

evidence-based 

programs among 

people served by 

state mental health 

authorities. 

(Outcome)

FY 2022: 28.6

 

Target:

 30.5% 

 

(Target Not Met)

30.5% 30.5% Maintain
156 

Measure Year and Most 

Recent Result /

Target for Recent 

Result /

(Summary of Result)

FY 2024

 Target

FY 2025

 Target

FY 2025

 Target

+/-FY 2024

 Target

2.3.19H Treatment 

Foster Care: 

Percent of the 

population 

accessing selected 

evidence-based 

programs among 

people served by 

state mental health 

authorities. 

(Outcome)

FY 2022: 1.6 %

 

Target:

 1.7 % 

 

(Target Not Met) 

1.7 % 1.7 % Maintain

2.3.19I MultiSystemic Therapy: 

Percent of the 

population 

accessing selected 

evidence-based 

programs among 

people served by 

state mental health 

authorities. 

(Outcome)

FY 2022: 3.2 %

 

Target:

 4.14 % 

 

(Target Not Met)

4.1 % 4.1 % Maintain

2.3.19J Functional 

Family Therapy: 

Percent of the 

population 

accessing selected 

evidence-based 

programs among 

people served by 

state mental health 

authorities. 

(Outcome)

FY 2022: 9.0 %

 

Target:

 5.8 % 

 

(Target Exceed) 

5.8 % 5.8 % Maintain

2.3.81 Percentage 

of service 

population 

receiving any 

evidence based 

practice (Outcome)

FY 2022: 11.8 %

 

Target:

 10.1 % 

(Target Exceed) 

10.1 % 10.1 % Maintain
157 

State Table

DEPARTMENT OF HEALTH AND HUMAN SERVICES

SAMHSA 

FY 2025 MANDATORY STATE/FORMULA GRANTS

CFDA NUMBER/PROGRAM NAME: 93.958/MENTAL HEALTH BLOCK 

GRANT

` FY 2023 FY 2024 FY 2025 FY 2025 +/-

State or Territory Final CR President's Budget FY 2023

Alabama $14,051,192 $14,051,192 $14,761,168 $709,976

Alaska $2,360,826 $2,360,826 $2,304,969 -$55,857

Arizona $24,207,604 $24,207,604 $23,861,392 -$346,212

Arkansas $8,532,210 $8,532,210 $9,529,139 $996,929

California $123,700,265 $123,700,265 $124,294,339 $594,074

Colorado $18,940,105 $18,940,105 $17,590,792 -$1,349,313

Connecticut $9,786,104 $9,786,104 $10,532,544 $746,440

Delaware $2,075,248 $2,075,248 $2,628,109 $552,861

District Of Columbia $2,379,819 $2,379,819 $1,812,259 -$567,560

Florida $65,481,738 $65,481,738 $74,116,065 $8,634,327

Georgia $29,443,052 $29,443,052 $31,139,684 $1,696,632

Hawaii $4,776,600 $4,776,600 $5,185,653 $409,053

Idaho $5,311,053 $5,311,053 $5,862,568 $551,515

Illinois $29,970,671 $29,970,671 $31,331,497 $1,360,826

Indiana $19,173,943 $19,173,943 $19,048,512 -$125,431

Iowa $7,739,414 $7,739,414 $8,002,295 $262,881

Kansas $7,005,715 $7,005,715 $7,269,588 $263,873

Kentucky $12,582,078 $12,582,078 $12,910,319 $328,241

Louisiana $12,558,779 $12,558,779 $12,772,564 $213,785

Maine $3,825,384 $3,825,384 $4,313,126 $487,742

Maryland $16,215,620 $16,215,620 $18,335,132 $2,119,512

Massachusetts $20,419,558 $20,419,558 $20,023,585 -$395,973

Michigan $27,968,934 $27,968,934 $28,010,222 $41,288

Minnesota $15,551,519 $15,551,519 $15,347,064 -$204,455

Mississippi $8,789,930 $8,789,930 $8,864,854 $74,924

Missouri $16,422,171 $16,422,171 $16,705,963 $283,792

Montana $3,509,870 $3,509,870 $3,448,544 -$61,326

Nebraska $4,489,055 $4,489,055 $4,560,616 $71,561

Nevada $11,133,777 $11,133,777 $10,320,643 -$813,134

New Hampshire $3,247,773 $3,247,773 $4,017,297 $769,524

New Jersey $26,595,406 $26,595,406 $28,942,299 $2,346,893

New Mexico $5,914,148 $5,914,148 $6,124,588 $210,440

New York $54,539,184 $54,539,184 $57,070,176 $2,530,992

North Carolina $28,726,086 $28,726,086 $29,424,104 $698,018

North Dakota $1,716,550 $1,716,550 $1,783,834 $67,284
158 

FY 2023 FY 2024 FY 2025 FY 2025 +/-

State or Territory Final CR President's Budget FY 2023

Ohio $30,192,557 $30,192,557 $31,094,794 $902,237

Oklahoma $10,851,934 $10,851,934 $11,343,924 $491,990

Oregon $15,277,597 $15,277,597 $15,700,977 $423,380

Pennsylvania $32,388,348 $32,388,348 $34,695,701 $2,307,353

Rhode Island $3,381,064 $3,381,064 $3,277,721 -$103,343

South Carolina $14,829,315 $14,829,315 $15,200,180 $370,865

South Dakota $2,118,382 $2,118,382 $2,190,109 $71,727

Tennessee $20,344,012 $20,344,012 $19,408,450 -$935,562

Texas $79,192,589 $79,192,589 $84,696,098 $5,503,509

Utah $10,848,626 $10,848,626 $9,711,040 -$1,137,586

Vermont $1,672,361 $1,672,361 $1,803,550 $131,189

Virginia $24,538,570 $24,538,570 $24,367,494 -$171,076

Washington $23,423,510 $23,423,510 $24,647,440 $1,223,930

West Virginia $5,156,267 $5,156,267 $5,230,496 $74,229

Wisconsin $14,811,489 $14,811,489 $15,463,057 $651,568

Wyoming $1,269,406 $1,269,406 $1,277,486 $8,080

State Subtotal $939,437,408 $939,437,408 $972,354,020 $32,916,612

American Samoa $180,030 $180,030 $183,227 $3,197

Guam $640,046 $640,046 $681,760 $41,714

Northern Marianas $196,969 $196,969 $207,549 $10,580

Puerto Rico $12,119,541 $12,119,541 $12,492,929 $373,388

Palau $81,794 $81,794 $87,475 $5,681

Marshall Islands $295,318 $295,318 $322,183 $26,865

Micronesia $388,687 $388,687 $407,271 $18,584

Virgin Islands $403,768 $403,768 $425,028 $21,260

Territory Subtotal $14,306,153 $14,306,153 $14,807,422 $501,269

Total State-Territory $953,743,561 $953,743,561 $987,161,442 $33,417,881

Total Administrative $53,827,439 $53,827,439 $55,409,558 $1,582,119

Total Appropriation $1,007,571,000 $1,007,571,000 $1,042,571,000 $35,000,000
159 

Community Mental Health Centers (CMHC) 

(Dollars in millions)

Program Name

FY 2023

Final 

FY 2024

CR 

FY 2025

President’s 

Budget

FY 2025 

+/- FY 

2023

Community Mental Health Centers $--- $--- $412.500 $412.500

Authorizing Legislation ..................................Section 330 of the Public Health Service Act 

FY 2025 Authorization ...............................................................................................$412,500,000 

Allocation Method.................................................................................................................. Grants 

Eligible Entities......Community Mental Health Centers, State and Local Government-Operated 

........................................................................Community Mental Health Centers 

Program Description

SAMHSA proposes new mandatory funding for Community Mental Health Centers (CMHCs) to 

expand and improve the quality of services available to people with mental illness. The funding is 

provided through 50 states and 6 territories by utilizing the Mental Health Block Grant formula. 

CMHCs have informally existed in communities across America for decades but lack standards or 

consistency in the services available. This program is intended to offer an opportunity to increase 

the quality of mental health services in communities across the United States. The purpose of this 

program is to enable CMHCs to support the delivery of clinical services and effectively address 

the needs of individuals with serious emotional disturbance (SED), serious mental illness (SMI), 

and individuals with SMI or SED and substance use disorders, referred to as co-occurring disorder 

(COD). SAMHSA recognizes the needs of individuals with behavioral health conditions, including 

those in minority populations and living in economically disadvantaged communities, have not 

been met during the pandemic, and that CMHC staff and other caregivers have been impacted. 
160 

Budget Request

The FY 2025 President’s Budget Request is $412.5 million, an increase of $412.5 million from 

the FY 2023 Final level. The funding increase will be used to further develop the quality and 

continuum of behavioral health services, expanding access to crisis care, integrated care, and other 

recovery support services. CMHC funding to states would require the providers to develop a 

continuum of behavioral health services plan, which incorporates a crisis care continuum (i.e., 

crisis residential, crisis stabilization, adverse event crisis coordination, and mobile crisis teams); 

screening (i.e., mental health, substance use disorder, and common medical conditions), treatment, 

and/or referral for substance use disorders and medical conditions; outpatient mental health 

services regardless of ability to pay; and recovery support services (i.e., case management; peer 

support, and family support approaches), including screening, treatment and recovery supports for 

children’s mental and co-occurring disorders. Funding would also support the development and 

implementation of the behavioral health services plan, including overhead costs (subject to all 

existing limitations on use of SAMHSA funds). Establishment of long-term support for CMHCs 

will directly increase the scope and quality of behavioral health services in CMHCs funded by the 

program, establish a higher standard as a target for all CMHCs and address the incomplete and 

inconsistent service array in much of America. 

SAMHSA is requesting that this be funded as a mandatory grant program. It is estimated that these 

services will directly benefit at least 20,000 individuals per year, providing an improved level of 

treatment, and support to meet the increase behavioral health services needs in local communities. 

SAMHSA is requesting that this be funded as a mandatory grant program. 
161 

Funding History Table

Fiscal Year Amount

FY 2021 $---

FY 2022 $---

FY 2023 Final $---

FY 2024 CR $---

FY 2025 President’s Budget $412,500,000

Program Accomplishments

In FY 2021, SAMHSA awarded 230 CMHC grants for two years with COVID 19 Relief 

supplemental funding. 

In FY 2023, CMHC grantees trained 81,579 individuals in mental health and mental health-related 

practices and 181,966 clients were served. Half (50.0 percent) of clients reported positive 

functioning (for example, able to handle daily life) at 6-month reassessment compared to only 39.3 

percent at baseline.
162 

State Table

DEPARTMENT OF HEALTH AND HUMAN SERVICES

SAMHSA 

FY 2025 MANDATORY STATE/FORMULA GRANTS

CFDA NUMBER/PROGRAM NAME: 93.958/COMMUNITY MENTAL HEALTH BLOCK GRANT

FY 2023 FY 2024 FY 2025 FY 2025 +/-

State or Territory Final CR President's Budget FY 2023

Alabama $5,994,660 $5,994,660

Alaska $936,072 $936,072

Arizona $9,690,354 $9,690,354

Arkansas $3,869,880 $3,869,880

California $50,477,195 $50,477,195

Colorado $7,143,800 $7,143,800

Connecticut $4,277,373 $4,277,373

Delaware $1,067,302 $1,067,302

District Of Columbia $735,977 $735,977

Florida $30,099,287 $30,099,287

Georgia $12,646,142 $12,646,142

Hawaii $2,105,946 $2,105,946

Idaho $2,380,848 $2,380,848

Illinois $12,724,039 $12,724,039

Indiana $7,735,795 $7,735,795

Iowa $3,249,813 $3,249,813

Kansas $2,952,254 $2,952,254

Kentucky $5,243,012 $5,243,012

Louisiana $5,187,068 $5,187,068

Maine $1,751,604 $1,751,604

Maryland $7,446,084 $7,446,084

Massachusetts $8,131,781 $8,131,781

Michigan $11,375,236 $11,375,236

Minnesota $6,232,599 $6,232,599

Mississippi $3,600,107 $3,600,107

Missouri $6,784,462 $6,784,462

Montana $1,400,489 $1,400,489

Nebraska $1,852,113 $1,852,113

Nevada $4,191,318 $4,191,318

New Hampshire $1,631,465 $1,631,465

New Jersey $11,753,762 $11,753,762

New Mexico $2,487,257 $2,487,257

New York $23,176,779 $23,176,779

North Carolina $11,949,428 $11,949,428

North Dakota $724,433 $724,433
163 

FY 2023 FY 2024 FY 2025 FY 2025 +/-

State or Territory Final CR President's Budget FY 2023

Ohio $12,627,912 $12,627,912

Oklahoma $4,606,883 $4,606,883

Oregon $6,376,327 $6,376,327

Pennsylvania $14,090,277 $14,090,277

Rhode Island - - $1,331,116 $1,331,116

South Carolina - - $6,172,948 $6,172,948

South Dakota - - $889,425 $889,425

Tennessee - - $7,881,969 $7,881,969

Texas - - $34,395,947 $34,395,947

Utah - - $3,943,752 $3,943,752

Vermont - - $732,440 $732,440

Virginia - - $9,895,887 $9,895,887

Washington - - $10,009,576 $10,009,576

West Virginia - - $2,124,158 $2,124,158

Wisconsin - - $6,279,705 $6,279,705

Wyoming - - $518,800 $518,800

State Subtotal - - $394,882,855 $394,882,855

American Samoa - - $74,230 $74,230

Guam - - $276,199 $276,199

Northern Marianas - - $84,084 $84,084

Puerto Rico - - $5,061,219 $5,061,219

Palau - - $50,000 $50,000

Marshall Islands - - $130,525 $130,525

Micronesia - - $164,996 $164,996

Virgin Islands - - $172,190 $172,190

Territory Subtotal - - $6,013,444 $6,013,444

Total State-Territory - - $400,896,299 $400,896,299

Total Administrative - - $11,603,701 $11,603,701

Total Appropriation - - $412,500,000 $412,500,000
164 

Substance Use Prevention Services

Table of Contents

Substance Use Prevention Services .................................................................................164 

Summary of the Request ..................................................................................................165 

Programs of Regional and National Significance (PRNS) ..............................................166 

Strategic Prevention Framework ...............................................................................167

Federal Drug-Free Workplace ..................................................................................172

Sober Truth on Preventing Underage Drinking Act (STOP Act) ..............................175

Tribal Behavioral Health Grants ...............................................................................180

Minority AIDS Initiative ............................................................................................183

Minority Fellowship Program ...................................................................................186

Center for the Application of Prevention Technologies ............................................188

Science and Service Program Coordination ..............................................................191

PRNS Mechanism Table ..................................................................................................194 

Grant Awards Table .........................................................................................................198 
165 

Substance Use Prevention Services

Summary of the Request

(Dollars in millions) 

Programs of Regional and National Significance

FY 2023 

Final FY 2024 CR

FY 2025 

President's 

Budget

FY 2025 +/- 

FY 2023 

Total, Substance Use Prevention Services................................ 236.879 236.879 236.879 -- 

FTE 93 93 93 --

SAMHSA’s substance use prevention programs reach across the lifespan and across the 

substance use continuum, with the goal of reaching people wherever they are to prevent 

substance use in the first place and to reduce the harmful impacts of substance use and misuse on 

their lives, on their families, and in their communities. The Center for Substance Use Prevention 

Services (CSUPS) leads SAMHSA’s substance use prevention programs and practices, providing 

resources, data-driven leadership, and technical assistance to States, Tribes, and communities to 

deliver a range of evidence-based, community public health programming, especially focusing 

on high-risk, underserved populations. 

Overall, the CSUPS programs: (1) protect and strengthen equitable access to high quality and 

affordable healthcare; (2) expand equitable access to comprehensive, community-based, 

innovative, and culturally competent prevention programs and healthcare services while 

addressing social determinants of health and key risk and protective factors for substance use; (3) 

enhance youth-focused promotion of healthy behaviors to reduce occurrence and disparities in 

preventable injury, illness, and death; (4) strengthen social well-being, equity and economic 

resilience; and (5) increase safeguards to empower individuals, families and communities to 

prevent and respond to neglect, abuse, and violence, while supporting those who have experienced 

trauma or violence.

The CSUPS programs largely reach young people early in life with primary prevention programs, 

practices, and services. Primary prevention has the greatest return on investment in reducing the 

lifelong negative impacts of alcohol and substance misuse on individuals, families, and 

communities. Over 85 percent of the resources are dedicated to youth-focused primary prevention 

services, which aim to lay the foundation for lifelong healthy decisions for the approximately 75 

million young people under 18 in the U.S.86 In addition, these prevention programs make an 

important contribution to responding to the evolving opioid and overdose crises. The spike in 

overdose deaths the country is experiencing, driven by highly potent and toxic substances like 

illicitly made fentanyl and resurgent methamphetamine, demonstrates the critical need to focus on 

reaching vulnerable populations with intensive prevention programs that prevent substance use in 

the first place, help people reduce harmful substance use, and serve as a gateway to other 

behavioral health services.

86 U.S. Census Bureau quickfacts: United States. (n.d.). Retrieved February 15, 2023, from

https://www.census.gov/quickfacts/fact/table/US/PST045222
166 

Substance Use Prevention Services

Programs of Regional and National Significance (PRNS)

(Dollars in millions)

Programs of Regional & National Significance

FY 2023 

Final

FY 2024 

CR

FY 2025 

President's 

Budget

FY 2025 +/- 

FY 2023

Capacity:

Strategic Prevention Framework 135.484 135.484 135.484 --

Non-SPF Rx (non-add) 125.484 125.484 125.484 --

Budget Authority (non-add) 125.484 125.484 125.484 --

Prevention Capacity Expansion Grant (PCEG) (New) (non-Add) --- --- --- -- 

Strategic Prevention Framework Rx (non-add) 10.000 10.000 10.000 --

Budget Authority (non-add) 10.000 10.000 10.000 --

Federal Drug-Free Workplace 5.139 5.139 5.139 -- 

Sober Truth on Preventing Underage Drinking Act (STOP Act) 14.500 14.500 14.500 -- 

Community-based Coalition Enhancement Grants (non-add) 11.000 11.000 11.000 --

National Adult-Oriented Media Public Service Campaign (non-add) 2.500 2.500 2.500 --

ICC on the Prevention of Underaged Drinking (non-add) 1.000 1.000 1.000 -- 

Tribal Behavioral Health Grants 23.665 23.665 23.665 -- 

Minority AIDS 43.205 43.205 43.205 -- 

Subtotal, Capacity 221,993 221,993 221,993 --

Science and Service:

Minority Fellowship Program 1.321 1.321 1.321 --

Center for the Application of Prevention Technologies 9.493 9.493 9.493 --

Science and Service Program Coordination 4.072 4.072 4.072 -- 

Subtotal, Science and Service 14.886 14.886 14.886 --

Total, PRNS 236.879 236.879 236.879 --
167 

Strategic Prevention Framework

(Dollars in millions) 

Programs of Regional and National Significance

FY 2023 

Final 

FY 2024 

CR 

FY 2025 

President's 

Budget

FY 2025 +/- 

FY 2023 

Strategic Prevention Framework.............................................. 135.484 135.484 135.484 -- 

Non-SPF Rx (non-add).................................................... 125.484 125.484 125.484 -- 

Budget Authority (non-add).......................................... 125.484 125.484 125.484 -- 

Prevention Capacity Expansion Grant (PCEG) (New) (non-Add) -- -- -- -- 

Strategic Prevention Framework Rx (non-add)............... 10.000 10.000 10.000 -- 

Budget Authority (non-add).......................................... 10.000 10.000 10.000 -- 

Authorizing Legislation..............................................................................Section 516 of the PHS Act

FY 2025 Authorization ...................................................................................................... $218,219,000 

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

Eligible Entities............................................................................................States, Tribes, and Communities

Program Description

The Strategic Prevention Framework (SPF) is a five-step data-driven community engagement 

model grounded in public health principles and focused on providing evidence-based prevention 

services to high-risk underserved communities. Under the SPF, SAMHSA funds the Strategic 

Prevention Framework Partnership for Success Program (SPF-PFS) and the Strategic Prevention 

Framework for Prescription Drugs (SPF Rx) grants. The SPF-PFS was developed to prevent the 

onset and reduce the progression of substance misuse and related problems while strengthening 

prevention capacity and infrastructure at the community and state level. The SPF Rx is intended 

to provide resources to help prevent and address prescription drug misuse within a state or locality.

Strategic Prevention Framework- Partnerships for Success Program (SPF-PFS) 

SPF-PFS is designed to help state, community, and tribal organizations reduce the onset and 

progression of substance misuse and its related problems by supporting the development and 

delivery of substance misuse prevention and mental health promotion services. The program 

extends established cross-agency and community-level partnerships by connecting substance 

misuse prevention programming to departments of social services and their community service 

providers. This includes working with populations disproportionately impacted by the 

consequences of substance misuse (e.g., children entering the foster care system and transition age 

youth) and individuals who support persons with substance misuse issues (e.g., women, families, 

parents, caregivers, and young adults). Beginning in 2019, both states and communities were 

eligible for SPF-PFS funds. SPF-PFS helps states, tribes, and communities address locally 

identified prevention priorities through a data-driven process. Common priorities include underage 

drinking, as well as marijuana and other drug misuse among youth and young adults aged 12 to 

20. For 2023, separate notice of funding opportunities (NOFOs) were published for SPF-PFS 

Communities, Local Governments, Universities, Colleges, and Tribes/Tribal Organizations and 

another NOFO specific to States.

Strategic Prevention Framework for Prescription Drugs (SPF Rx)
168 

While illicit opioids, contributed to the spike in the opioid overdose crisis, prescription drugs 

continue to play a significant role, with prescription opioids contributing to over 16,000 overdose 

deaths in 2021.87 In addition to amplifying opioid overdose rates, opioid prescriptions can lead to 

dependence and opioid use disorder (OUD). An estimated 14.2 million individuals aged 12 or 

older in 2022 misused one or more prescription psychotherapeutic drugs in the past year including 

prescription pain relievers (8.5 million), tranquilizers or sedatives (4.8 million), and stimulants 

(4.3 million).88 In addition, 48.7 million people aged 12 or older in 2022 had a substance use 

disorder (SUD) in the past year.89 Among those aged 12 and older, 0.6 percent (or 1.8 million 

people) had a prescription stimulant use disorder, and 0.8 percent (or 2.4 million people) had a 

prescription tranquilizer use disorder or sedative use disorder in the past year.90

 

The purpose of the SPF Rx grant program is to provide resources to help prevent and address 

prescription drug misuse within a state or locality. The program was established in 2016 to raise 

awareness about the dangers of sharing medications as well as the risks of fake or counterfeit pills 

purchased over social media or other unknown sources, and to work with pharmaceutical and 

medical communities on the risks of overprescribing. Grant recipients are required to track 

reductions in opioid related overdoses and incorporate relevant prescription and overdose data into 

strategic planning and future programming. Recipients are expected to leverage knowledge gained 

through participation in the SPF process to address targeted community needs more effectively.

Budget Request

The FY 2025 President’s Budget request is $135.5 million, equal to the FY 2023 Final level. This 

funding level will support 51 new and 144 continuing SPF-PFS grant awardsand 27 continuing 

SPF-Rx grants. 

Funding History

87 National Institute on Drug Abuse (2023,June 30). Overdose death rates. https://nida.nih.gov/drug-topics/trendsstatistics/overdose-death-rates 88 Substance Abuse and Mental Health Services Administration. (2023). Key substance use and mental health 

indicators in the United States: Results from the 2022 National Survey on Drug Use and Health (HHS Publication 

No. PEP23-07-01-006, NSDUH Series H-58). Center for Behavioral Health Statistics and Quality, Substance Abuse 

and Mental Health Services Administration. https://www.samhsa.gov/data/ 89 Substance Abuse and Mental Health Services Administration. (2023). Key substance use and mental health 

indicators in the United States: Results from the 2022 National Survey on Drug Use and Health (HHS Publication 

No. PEP23-07-01-006, NSDUH Series H-58). Center for Behavioral Health Statistics and Quality, Substance Abuse 

and Mental Health Services Administration. https://www.samhsa.gov/data/ 90 Substance Abuse and Mental Health Services Administration. (2023). Key substance use and mental health 

indicators in the United States: Results from the 2022 National Survey on Drug Use and Health (HHS Publication 

No. PEP23-07-01-006, NSDUH Series H-58). Center for Behavioral Health Statistics and Quality, Substance Abuse 

and Mental Health Services Administration. https://www.samhsa.gov/data/
169 

Fiscal Year Amount

FY 2021 $119,484,000

FY 2022 $127,484,000

FY 2023 Final $135,484,000

FY 2024 CR $135,484,000

FY 2025 President’s Budget $135,484,000

 

Program Accomplishments

SPF-PFS 

 

In FY 2023, 75 new and 218 continuing PFS grants were awarded. SAMHSA is committed to 

addressing substance use and misuse prevention with its state prevention partners through 

population health strategies and with its community and tribal organization partners through 

community health and evidenced-based prevention strategies. For FY 2023, PFS implemented two 

separate notices of funding opportunity (NOFOs), one focused on states, and one specific to 

communities to better address the specific needs and strengths of states and communities.

In FY 2024, SAMHSA plans to award 48 new grants and 181 continuing grant awards. These 

grants will continue to support the development and delivery of (1) state and (2) community 

substance use and misuse prevention and mental health promotion services to address the key risk 

and protective factors for substance use and misuse. CSUPS intends to maintain FY 2023 outcome 

targets for the SPF-PFS program in FY 2024. 

PFS grantees had 193,017,363 contacts through community-based, universal strategies such as 

media and social norming campaigns, prescription drug boxes / drug take back events, and through 

evidence-based programs such as Communities that Care. Individuals may have been reached by 

more than one intervention and therefore may be counted multiple times. Grantees served 

7,328,345 individuals through programs such as Life skills Training, Guiding Good Choices, and 

Too Good for Drugs. These figures are based on grantee reported data from activities generated in 

accordance with funding requirements for PFS. SAMHSA has begun an evaluation of this program 

and anticipates preliminary findings in FY 2025. 

SPF-Rx

In FY 2023, the SPF Rx program awarded 27 continuing grants. In FY 2024, , the number of 

continuing SPF Rx continuing grants will remain at 27. An ongoing evaluation of the FY 2021 

cohort found that use of prescription drug monitoring programs (PDMP) by prescribers appears to 

be increasing over time. The number of prescribers (or their delegates) using PDMPs increased by 

12 percent from 2019 through 2021. This increase was associated with an almost 30 percent 
170 

increase in the number of PDMP queries by prescribers or their delegates over this time period. 

Both 2021 SPF Rx cohort grantee states and other states demonstrated significant decreases in 

opioid prescribing rates from 2015 through 2022. These decreases likely stem from support, in 

part, offered by SAMHSA and other agencies to address prescription drug misuse throughout the 

past decade. 

In FY 2023, SAMHSA established new measures to better align with grant activities. The FY 

2023 results will be used as baseline and SAMHSA will continue to monitor trends in FY 2024 

and FY 2025. Starting in FY 2023, SAMHSA is collecting two new outcomes measures for SPFRx: the number of individuals reached through population-based prevention efforts; and the 

number of individuals served through direct prevention efforts. SAMHSA anticipates in FY 2024 

and FY 2025, the number of individuals reached through population-based prevention efforts will 

be 13,129,915 and the number of individuals served through direct prevention efforts will be 

503,903. 
171 

Outputs and Outcomes Table

Program: Partnerships for Success

Measure Year and Most Recent 

Result /

Target for Recent Result 

/

(Summary of Result)

FY 2024

Target

FY 2025

Target

FY 2025

Target

+/-FY 2024

Target

2.3.83 Number of 

individuals (nonunique) reached 

through populationbased prevention 

efforts (Outcome)

FY 2023: 193,017,363

Target:

193,017,363

(Baseline)

193,017,363 193,017,363 Maintain

2.3.84 Number of 

individuals (nonunique) served through 

direct prevention 

efforts 

(Outcome)measure

FY 2023: 7,328,345

Target:

7,328,345

(Baseline)

7,328,345 7,328,345 Maintain

Program: SPF Rx

Measure Year and Most Recent 

Result /

Target for Recent Result 

/ 

(Summary of Result)

FY 2024

Target

FY 2025

Target

FY 2025

Target

+/-FY 2024

Target

3.3.13 Number of 

individuals reached 

through populationbased prevention efforts 

(Outcome)

FY 2023: 13,129,915 

Target:

13,129,915

(Baseline)

13,129,915 13,129,915 Maintain

3.3.14 Number of 

individuals served 

through direct 

prevention efforts 

(Outcome)

FY 2023: 503,903

Target:

503,903

(Baseline)

503,903 503,903 Maintain
172 

Federal Drug-Free Workplace

(Dollars in millions)

Programs of Regional and National Significance

FY 2023 

Final 

FY 2024 

CR 

FY 2025 

President's 

Budget

FY 2025 +/- 

FY 2023 

Federal Drug-Free Workplace 5.139 5.139 5.139 -- 

Authorizing Legislation ........................................................................ Section 516 of the PHS Act 

FY 2025 Authorization ................................................................................................$218,219,000 

Allocation Method..............................................................................Inter-Agency Agreements/Contracts

Eligible Entities...................................................................................Federal Agencies, Regulated Entities 

........................... (e.g., Department of Transportation, Nuclear Regulatory Commission), 

.................................................................................HHS- Certified Laboratories

Program Descriptions 

The Federal Drug-Free Workplace Programs (DFWP) ensure employees in national security, 

public health, and public safety positions are tested for the use of illegal drugs and the misuse of 

prescription drugs and ensure the laboratories that perform this regulated drug testing are inspected 

and certified by HHS. The DFWP helps prevent individuals from using illegal drugs and 

demonstrates that illegal drug use will not be tolerated in the federal workplace through policies 

and procedures including drug testing, which allows for the drug testing of all executive branch 

agency employees. Additionally, the DFWP helps reduce health insurance costs, improves 

attendance and employee productivity, provides a safer workplace with reduced accidents, and 

provides employee assistance programs (EAP) services to employees with substance use disorders.

In October 2023, the Final Mandatory Guidelines for both urine and oral fluid were issued as a 

Federal Register Notice with implementation dates of February 1, 2024 and October 10, 2023 

respectively. 

The Workplace Helpline supports the DFWP. The Helpline is a toll-free telephone service that 

answers questions from federal agencies, the public and private sectors about drug testing in the 

workplace. 

Budget Request

The FY 2025 President’s Budget request is $5.1 million, equal to the FY 2023 Final level. The 

funding continues to support the DFWP with implementing and maintaining Mandatory 

Guidelines for oral fluid in the federally regulated drug testing program. This includes costs 

associated with laboratory proficiency testing specimens, application fees, inspector training, HHS 

pre-inspections for applicant laboratories, and HHS laboratory certification for new oral fluid 

testing laboratories. Along with the implementation of the oral fluid testing program, SAMHSA 

will continue to pursue the implementation of hair testing and oversight of the Executive Branch 

Agencies’ DFWP as well as continue its oversight role for the inspection and certification of the 

HHS-certified laboratories.
173 

Funding History

Fiscal Year Amount

FY 2021 $4,894,000

FY 2022 $4,894,000

FY 2023 Final $5,139,000

FY 2024 CR $5,139,000

FY 2025 President’s Budget $5,139,000

 

Program Accomplishments

In FY 2023, plans for DFWP included (1) certification of new laboratories across the nation to 

conduct federal and federally regulated drug tests; (2) analysis of and guidance on new emerging 

issues (e.g., opioids/synthetic opiates; polysubstance use; young adults; high-risk workplaces); (3) 

analysis of and guidance on Employee Assistance Programs (EAPs); and (4) support the public 

and private drug testing industry through Helpline inquiry responses providing research and 

consultation on approaches to prevent the use and misuse of those substances in a workplace 

setting and include a revised and updated Workplace Toolkit. 

In FY 2024, DFWP plans to continue to support the implementation and maintenance of 

Mandatory Guidelines for oral fluid in the federally regulated drug testing program. This includes 

costs associated with laboratory proficiency testing specimens, application fees, inspector training, 

HHS pre-inspections for applicant laboratories, and HHS laboratory certification for new oral fluid 

testing laboratories. Along with the implementation of the oral fluid testing program, SAMHSA 

will continue to pursue the implementation of hair testing and oversight of the Executive Branch 

Agencies’ DFWP as well as continue its oversight role for the inspection and certification of the 

21 HHS-certified laboratories. 
174 

Outputs and Outcomes Table

Program: Federal Drug-Free Workplace

Measure Year and Most 

Recent Result /

Target for Recent 

Result /

(Summary of Result)

FY 2024

 Target

FY 2025

 Target

FY 2025

 Target

+/-FY 2024

 Target

6.0 Number of 

HHS Certified Labs 

(Output) 

FY 2023: 21.0 

certified labs

 

Target:

 20.0 certified labs 

 

(Target Exceeded)

23.0 

certified labs

23.0 

certified labs

Maintain
175 

Sober Truth on Preventing Underage Drinking Act (STOP Act)

(Dollars in millions)

Programs of Regional and National Significance

FY 2023 

Final 

FY 2024 

CR 

FY 2025 

President’s 

Budget

FY 2025 +/- 

FY 2023 

Sober Truth on Preventing Underage Drinking (STOP Act)...... 14.500 14.500 14.500 -- 

Community-based Coalition Enhancement Grants (non-add) 11.000 11.000 11.000 -- 

National Adult-Oriented Media Public Service Campaign (non-add) 2.500 2.500 2.500 -- 

ICC on the Prevention of Underaged Drinking (non-add) 1.000 1.000 1.000 -- 

Authorizing Legislation..................................................................................Section 519B of the PHS Act 

FY 2025 Authorization ..................................................................................................$14,500,000 

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

Eligible Entities....................................................Current and former Drug Free Communities grantees

Program Description

The Sober Truth on Preventing Underage Drinking Act (STOP Act) of 2006 was the nation’s first 

comprehensive legislation on underage drinking and was reauthorized in 2022 as part of 

Consolidated Appropriations Act, 2023 (Public Law No. 117-328). The Act states, “a coordinated 

approach to prevention, intervention, treatment, enforcement, and research is key to making 

progress. This Act recognizes the need for a focused national effort and addresses particulars of 

the federal portion of that effort, as well as federal support for state activities.” 

In keeping with the STOP Act’s language calling for a multi-faceted, coordinated approach, the 

Interagency Coordinating Committee for the Prevention of Underage Drinking (ICCPUD) 

developed a Comprehensive Plan in 2022, with updates in 2023. The plan included consensus 

recommendations from the federal agency members, as well as for all interested parties identified 

in the STOP Act, and established the following overarching goals and objectives: 

1. Strengthen a national commitment to address the problem of underage drinking;

2. Reduce demand for, the availability of, and access to alcohol by persons under the age of 

21; and

3. Use research, evaluation, and scientific surveillance to improve the effectiveness of 

policies, programs, and practices designed to prevent and reduce underage drinking.

The STOP Act requires the HHS Secretary, in collaboration with other federal officials enumerated 

in the Act, to “formally establish and enhance the efforts of the Interagency Coordinating 

Committee for the Prevention of Underage Drinking (ICCPUD) that began operating in 2004.” In 

2006, SAMHSA assumed leadership as the HHS Secretary’s designee.

The STOP Act calls for data and information on individual state performance and the enforcement 

of drinking laws, steps to reduce alcohol’s availability to youth under the age of 21, research on 

underage drinking, and resources for local community efforts. The STOP Act also calls for four 

annual reports to Congress, which are developed under contract ($1 million/year): a report on the 

prevention and reduction of underage drinking, a report on state performance and best practices 

for the prevention and reduction of underage drinking, and a report series on state underage 

drinking prevention and enforcement activities. A report on the evaluation of the adult oriented 
176 

national media campaign to prevent underage drinking that includes the production, broadcasting, 

and effectiveness of the campaign – also known as “Talk They Hear You.” 

 

The national media campaign to prevent underage drinking, “Talk They Hear You.” (TTHY) 

responds to directives set forth in Section 2(d) of the STOP Act ($2.5 million/year), to produce 

and oversee an adult-oriented national media campaign to provide parents and caregivers of youth 

under the age of 21 with information and resources to discuss the issue of alcohol with their 

children. The ICCPUD will continue to guide the development process of the national media 

campaign, and subsequent evaluation, which is included as Chapter 5 of the Report to Congress 

annually. 

 

The community-based coalition enhancement grant program provides up to $60,000 per year over 

four years to current or former grantees under the Drug-Free Communities Act of 1997 to prevent 

and reduce alcohol use among youth under the age of 21. The STOP Act grant program enables 

organizations to strengthen collaboration and coordination among stakeholders to achieve a 

reduction in underage drinking in their communities.

Budget Request

The FY 2025 President’s Budget Request is $14.5 million, equal to the FY 2023 Final level. In FY 

2025 the program will support 6 new and 177 continuing grants. This program will continue to 

support efforts to prevent and reduce alcohol use among youth and young adults ages 12-20 in 

communities throughout the United States. The STOP Act Program aims to (1) address norms 

regarding alcohol use by youth, (2) reduce opportunities for underage drinking, (3) create changes 

in underage drinking enforcement efforts, (4) address penalties for underage use, and (5) reduce 

negative consequences associated with underage drinking.
177 

Funding History

Fiscal Year Amount

FY 2021 $10,000,000

FY 2022 $12,000,000

FY 2023 Final $14,500,000

FY 2024 CR $14,500,000

FY 2025 President’s Budget $14,500,000

Program Accomplishments

In FY 2023, SAMHSA awarded 50 new and 148 continuation grants for continued support to 

communities to implement interventions that identify, address, and reduce underage drinking 

among the underage population within their jurisdictions. In FY 2023, STOP Act grantees reached 

12,352,947 people through community-based, universal strategies such as media and social 

norming campaigns, Communities Mobilizing for Change on Alcohol, and Parents Who Host Lose 

the Most. They served an additional 1,151,9177 through individual-based prevention strategies 

such as Life Skills Training. These figures are based on grantee reported data from activities 

reported by STOP Act recipients. SAMHSA has begun an evaluation of this program and 

anticipates preliminary findings in FY 2025. 

Through the leadership of the Interagency Coordinating Committee for the Prevention of Underage 

Drinking (ICCPUD) the adult national media campaign (Talk. They Hear You.” reached 

102,761,100 households delivering 2,319,924,778 impressions, with an additional 42,165 

individuals reached through public awareness engagements and 150 Alcohol Policy Academy 

participants.

In meeting the requirements of the STOP Act, SAMHSA, under the leadership of ICCPUD, will 

continue to garner support for program efficacy over the next year and will implement evaluation 

plans for the upcoming 2023–2024 campaign evaluation cycle. These plans include (1) an 

evaluation of the usability, reach, and effectiveness of the TTHY mobile app and Screen4Success 

self-screening, a referral management system; (2) the initial development of a complementary 

youth campaign that includes message testing and audience segmentation analysis; and (3) 

beginning of a multi-year evaluation of the student assistance and school health and wellnessfocused training with formative, outcome, and long-term impact evaluation methodologies that 

can be adopted by schools and districts. The formative measures will assess how well the campaign 

is being implemented, and the outcome and impact measures will look to examine impact on the 

target audiences, the students. Armed with data from this and future efforts, SAMHSA will persist 

in its work to estimate overall campaign impact as well as to ensure that the TTHY campaign 

evolves in ways that resonate with its primary target audiences and meets the needs of the U.S. 

population at large. 

The FY 2023 and FY 2024 targets were updated due to better reflect grantees abilities given 

identified challenges with data collection, access to target populations, and the ongoing impact of 
178 

COVID. These targets will align with SAMHSA’s efforts to address identified challenges and the 

ongoing impact of COVID on program activities. 

In FY 2024, given level funding, the program plans to award 70 new and 104 continuing grants. 
179 

Outputs and Outcomes Table

Program: Sober Truth on Preventing Underage Drinking (STOP Act)

Measure Year and Most Recent 

Result /

Target for Recent Result 

/

(Summary of Result)

FY 2024

Target

FY 2025

Target

FY 2025

Target

+/-FY 2024

Target

3.3.03 Percentage of 

individuals reporting 

past 30-day alcohol use 

(Outcome)

FY 2023: 19.1%

Target:

19.1%

(Baseline)

19.1% 19.1% Maintain

3.3.04 Percentage of 

individuals reporting 

perception of risk from 

alcohol use (Outcome)

FY 2023: 62.4%

Target:

 62.4%

(Baseline)

62.4% 62.4% Maintain

3.3.05 Number of 

individuals reached 

through populationbased prevention 

efforts (Outcome)

FY 2023: 12,352,947

Target:

12,352,947

(Baseline)

12,352,947 12,352,947 Maintain

3.3.06 Number of 

individuals served 

through direct 

prevention efforts 

(Outcome)

FY 2023: 1,151,948

Target:

1,151,948

(Baseline)

1,151,948 1,151,948 Maintain
180 

Tribal Behavioral Health Grants

(Dollars in millions)

Programs of Regional and National Significance

FY 2023 

Final

FY 2024 

CR

FY 2025 

President's Budget

FY 2025 +/-

FY 2023

Tribal Behavioral Health Grants ............................................. 23.665 23.665 23.665 -- 

Authorizing Legislation......................................................................................Section 516 of the PHS Act 

FY 2025 Authorization ................................................................................................$218,219,000 

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

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

Program Description 

Suicide is a leading cause of death among American Indian/Alaska Native (AI/AN) youth and 

young adults ages ten to 14 years.91 For American Indian/Alaska Native Youth aged 10-19, the 

unadjusted suicide rate is more than twice the rate for the nation as a whole.92 Further, AI/AN 

high school student report higher rates of suicidal behaviors than the general population of U.S. 

high school students.93 These behaviors include serious thoughts of suicide, suicide plans, suicide 

attempts, and medical attention for a suicide attempt. 

Consistent with the goals of the Tribal Behavioral Health Agenda, the Tribal Behavioral Health 

Grant (TBHG)/Native Connections (NC) program prioritizes a syndemic approach to address the 

overlapping psychosocial issues that place underserved populations at higher risk for substance 

use, mental health disorders, and suicide. These programs embody “culture is prevention” to 

address the unique needs that exist within AI/AN communities. Starting in FY 2014, this program 

supports tribal entities with the highest rates of suicide by providing effective and promising 

strategies that address substance use, trauma, and suicide and by promoting the mental health of 

AI/AN young people. 

These five-year grants help tribes or tribal organizations develop and implement a plan that 

addresses suicide and substance misuse, thereby promoting mental health among Tribal youth. 

Grant recipients implement a variety of prevention strategies focused on suicide and substance 

use, reducing the impact of trauma and promoting mental health. Grant recipients also focus on 

improving responses to young people who are identified as being at risk for suicide, including 

following attempted suicide. 

In addition, SAMHSA’s Tribal Training and Technical Assistance Center, funded through Science 

to Service (below), provides training and education to AI/AN grantees and organizations serving 

AI/AN populations to support their ability to achieve their goals. 

91 Centers for Disease Control and Prevention. Fatal injury data, 2018-2021. Web-based Injury Statistics Query and 

Reporting System. Available at www.cdc.gov/injury/wisqars/fatal.html. Accessed December 4, 2023.

92 ibid 93 Centers for Disease Control and Prevention. Youth Risk Behavior Surveillance System (YRBSS). Available at 

http://www.cdc.gov/healthyyouth/yrbs/index.htm. Accessed December 4, 2023. 
181 

Budget Request

The FY 2025 President’s Budget Request is $23.6 million, equal to the FY 2023 Final level. 

Combined with $22.7 million in the Mental Health appropriation these funds will support technical 

assistance activities. SAMHSA anticipates funding 133 continuation grants and a new cohort of 

25 grants. In FY 2025, SAMHSA expects Tribal Behavioral Health grantees to contact 470,790 

youth through the program. Additionally, SAMHSA estimates that 26,000 individuals will be 

screened for mental health or related interventions and 5,883 will receive services after screening.

As a braided activity, SAMHSA is tracking separately any amounts spent or awarded under Tribal 

Behavioral Health Grants through the distinct appropriations and ensuring that funds are used for 

purposes consistent with legislative direction and intent of these appropriations.

Funding History

 

Fiscal Year Amount

FY 2021 $20,000,000

FY 2022 $20,750,000

FY 2023 Final $23,665,000

FY 2024 CR $23,665,000

FY 2025 President’s Budget $23,665,000

 

Program Accomplishments

In FY 2023, SAMHSA funded 106 continuation grants and a new cohort of 48 grants and technical 

assistance activities to expand youth suicide prevention and early intervention strategies for the 

Tribal nations. In FY 2023, Tribal Behavioral Health grantees contacted 861,476 youth with 

mental health or substance use disorders, exceeding the FY 2023 target. Additionally, 26,121 

individuals were screened for mental health or related interventions and 5,883 received services 

after screening. Over 13,500 people received evidence-based services as a result of the grant and 

151 policy changes were made in that fiscal year. FY 2025 targets will be maintained. 

In FY 2024, SAMHSA given level funding, the program plans to award 44 new and 127 continuing 

grants. In FY 2024, SAMHSA expects Tribal Behavioral Health grantees to contact 470,790 

youth through the program. Additionally, SAMHSA estimates that 26,000 individuals will be 

screened for mental health or related interventions and 5,883 will receive services after screening.
182 

Outputs and Outcomes Table

Program: Tribal Behavioral Health 

Measure Year and Most 

Recent Result /

Target for Recent 

Result /

(Summary of Result)

FY 2024

 Target

FY 2025

 Target

FY 2025

 Target

+/-FY 2024

 Target

2.4.12 Percentage 

of youth age 10 - 

24 who received 

mental health or 

related services 

after screening, 

referral or attempt 

(Output)

FY 2023: 34%

 

Target:

 33% 

 

(Target Exceeded) 

33% 33% Maintain

2.4.17 Number of 

youth with mental 

health or substance 

use disorders who 

are contacted 

through program 

outreach efforts 

(Output)

FY 2023: 861,476

 

Target:

470,790

 

(Target Exceeded) 

470,790 470,790 Maintain

2.4.18 Number of 

individuals who 

received mental 

health or related 

services after 

screening, referral 

or suicide attempt 

(Outcome)

FY 2023: 5,883

 

Target:

 5,883 

 

(Baseline) 

5,883 5,883 Maintain
183 

Minority AIDS Initiative

(Dollars in millions) 

Programs of Regional and National Significance

FY 2023 

Final

FY 2024 

CR

FY 2025 

President's Budget

FY 2025 +/-

FY 2023

Minority AIDS........................................................................ 43.205 43.205 43.205 -- 

Authorizing Legislation ........................................................................ Section 516 of the PHS Act 

FY 2025 Authorization ................................................................................................$218,219,000 

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

Eligible EntitiesLocal Government Entities, Community-based Organization, Minority Serving 

Institutions, and Institutions of Higher Education 

Program Description

The Minority AIDS Initiative (MAI), established in 1998, provides funding designed to strengthen 

organizational capacity to expand HIV-related services within minority communities. The purpose 

of the MAI is to provide services to those at highest risk for HIV and substance use disorders. 

CSUPS oversees two MAI programs: Prevention Navigator and HIV Capacity Building Initiative 

(HIV CBI). The programs use a navigation approach (community health workers, neighborhood 

navigators, and peer support specialists) to expedite services for these populations. The programs 

provide training and education around the risks of substance misuse, education on HIV/AIDS, and 

needed linkages to service provision for individuals at high risk for HIV. The HIV CBI program 

was established in 2017 to support an array of activities to assist grant recipients in building a solid 

foundation for delivering and sustaining quality and accessible state-of-the-science substance 

misuse and HIV prevention services. 

The MAI serves racial and ethnic minorities ages 13-24 at highest risk for HIV and substance use 

disorders. HIV CBI aims to engage community-level domestic public and private non-profit 

entities, Tribes and Tribal organizations to prevent and reduce the onset of substance use disorders

and transmission of HIV/AIDS among at-risk populations ages 13-24, including racial/ethnic 

minority youth and young adults, hereafter referred to as the “population of focus”. Applicants 

may elect to serve youth aged 13-17, young adults aged 18-24, or elect to serve both youth and 

young adults. SAMHSA is particularly interested in eliciting the interest of college and university 

clinics/wellness centers and community-based providers who can provide comprehensive 

substance use and HIV prevention strategies to reduce the impact of substance use, HIV, and viral 

hepatitis in high-risk communities. 

Budget Request

The FY 2025 President’s Budget Request is $43.2 million, equal to the FY 2023 Final level. Given 

level-funding, the program will award approximately 66 new and 94 continuing grants. In FY 

2025, the grant recipients will serve approximately 11,000 individuals and provide over 18,000 

referrals to support services. 
184 

Funding History

Fiscal Year Amount

FY 2021 $41,205,000

FY 2022 $41,205,000

FY 2023 Final $43,205,000

FY 2024 CR $43,205,000

FY 2025 President’s Budget $43,205,000

 

Program Accomplishments

In FY 2023, the MAI/Prevention Navigator program awarded 147 continuing and 42 new grants. 

In FY 2023, 20,218 individuals received HIV tests and 7,062 individuals received viral hepatitis 

tests through this grant program. Grantees provided 11,783 individual services, including risk 

reduction counseling, HIV education, and substance use education. Grantees provided 7,428 group 

services. 10,328 individuals were exposed to substance use prevention services and 18,392 

referrals to support services were made. Although grantees did not meet targets for numbers tested 

or HIV or in reducing the number of participants reporting binge drinking, grantees were able to 

provide more services than in FY 2022: 5,291 more individual services, 2,776 more group services, 

and 7,902 more referrals to treatment. Additionally, 4,373 more individuals were exposed to 

prevention messaging in FY 2023 than in FY 2022. SAMHSA has begun an evaluation of this 

program and anticipates preliminary findings in FY 2025.

In FY 2024, given level-funding, the program will award 176 continuing grants. Beginning in FY 

2024, all new grants will be awarded as part of an agency-wide braided program. In FY 2025, the 

grant recipients will serve approximately 11,000 individuals and provide over 18,000 referrals to 

support services. 
185 

Outputs and Outcomes Table

Program: Minority AIDS Initiative 

Measure Year and Most 

Recent Result /

Target for Recent 

Result /

(Summary of Result)

FY 2024

 Target

FY 2025

 Target

FY 2025

 Target

+/-FY 2024

 Target

2.3.56 Number of 

program 

participants 

exposed to 

substance abuse 

prevention 

education services 

(Output)

FY 2023: 10,328

 

Target:

 8,345 

 

(Target Exceeded) 

8,345 8,345 Maintain

2.3.85a Number of 

persons tested for 

HIV through the 

Minority AIDS 

Initiative 

prevention 

activities (Output)

FY 2023: 20,218

 

Target:

 31,514 

 

 (Target Exceeded) 

31,514 31,514 Maintain

2.3.90 Percentage 

of program 

participants who 

reported reduced 

binge drinking at 

follow-up. 

(Outcome)

FY 2023: 59.84%

 

Target:

 64% 

 

(Target Not Met)

64% 64% Maintain
186 

Minority Fellowship Program 

(Dollars in millions)

Programs of Regional and National Significance

FY 2023 

Final 

FY 2024 

CR 

FY 2025 

President's 

Budget

FY 2025 +/- 

FY 2023 

Minority Fellowship Program................................................... 1.321 1.321 1.321 -- 

Authorizing Legislation......................................................................................Section 597 of the PHS Act 

FY 2025 Authorization ..................................................................................................$25,000,000 

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

Eligible Entities......Organizations that represent individuals obtaining post baccalaureate training

(including for master’s and doctoral degrees) for mental and substance use disorder treatment 

professionals in the fields of psychiatry, nursing, social work, psychology, marriage and family 

therapy, mental health counseling, and substance use disorder and addiction counseling. 

Program Description 

 

SAMHSA’s Minority Fellowship Program (MFP) is intended to increase behavioral health 

practitioners’ knowledge of issues related to prevention, treatment, and recovery support for 

mental illness and addiction among racial and ethnic minority populations. The program provides 

stipends to increase the number of culturally competent behavioral health professionals who teach, 

administer, conduct services research, and provide direct mental illness or substance use disorder 

treatment services for minority populations that are underserved. Since its start in 1973, the 

program has helped to enhance services for racial and ethnic minority communities through 

specialized training of mental health professionals in psychiatry, nursing, social work, marriage 

and family therapy, mental health counseling, psychology; substance use/addiction counseling, 

marriage and family therapists and professional counselors. This program is jointly administered 

by the Center for Substance Use Services (CSUS), the Center for Substance Use Prevention 

(CSUPS), and the Center for Mental Health Services (CMHS) at SAMHSA. Combined, this 

program will support fellowships for hundreds of students as well as support additional training 

through webinars on culturally appropriate services to thousands of students.

Budget Request

The FY 2025 President’s Budget Request is $1.3 million, equal to the FY 2023 Final level. 

SAMHSA will support 7 continuation grants. The budget request will continue to support 428 

fellows. 

The Budget also proposes to add a service requirement to ensure participants are supporting 

communities in need, as well as to add addiction medicine, and sexual and gender minority 

populations as participants in the Minority Fellowship Program.

Note, SAMHSA is tracking separately any amounts spent, or awarded, under the Minority 

Fellowship Program through the distinct appropriations and to ensure that funds are used for 

purposes consistent with legislative direction and intent of these appropriations.
187 

Funding History

Fiscal Year Amount

FY 2021 $321,000

FY 2022 $321,000

FY 2023 Final $1,321,000

FY 2024 CR $1,321,000

FY 2025 President’s Budget $1,321,000

 

Program Accomplishments

In FY 2023, SAMHSA funded 9 grant continuations. These grants will continue to fund 

approximately 428 fellows. 

In FY 2024, SAMHSA plans to support approximately 7 new grants. The number of fellows 

supported will remain unchanged at 428. 
188 

Center for the Application of Prevention Technologies

(Dollars in millions)

Programs of Regional and National Significance

FY 2023 

Final 

FY 2024 

CR 

FY 2025 

President's 

Budget

FY 2025 +/- 

FY 2023 

Center for the Application of Prevention Technologies ............ 9.493 9.493 9.493 --

Authorizing Legislation......................................................................................Section 516 of the PHS Act 

FY 2025 Authorization ................................................................................................$218,219,000 

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

Eligible Entities...................................................................................................Domestic and Public Entities

Program Description 

The Prevention Technology Transfer Centers (PTTCs) Network is comprised of 10 Domestic 

Regional Centers, and Network Coordinating Office. Together the Network serves the 50 U.S. 

states, District of Columbia, Puerto Rico, U.S. Virgin Islands, the Pacific Islands of Guam, 

American Samoa, Republic of Palau, Republic of the Marshall Islands, Federated States of 

Micronesia, and the Commonwealth of Northern Mariana Islands. 

The purpose of the PTTC Network is to improve implementation and delivery of effective 

substance use prevention interventions and provide training and technical assistance services to 

the substance misuse prevention field. This is accomplished by developing and disseminating 

tools and strategies needed to improve the quality of substance misuse prevention efforts; 

providing intensive technical assistance and learning resources to prevention professionals to 

improve their understanding of prevention science, epidemiological data, and implementation of 

evidence-based and promising practices; and developing tools and resources to engage the next 

generation of prevention professionals. 

 

Budget Request

The FY 2025 President’s Budget Request is $9.5 million, equal to the FY 2023 Final level. 

SAMHSA plans to support 13 continuing grants with no new grant awards. This program is a key 

component to expanding and enhancing the prevention workforce. The program funding includes 

support for continuation funding to continue the PTTC Network to ensure consistent high quality, 

easily accessible technical assistance resources are available to the prevention field. In FY 2025, 

CSUPS intends to continue to advance key prevention knowledge transfer and workforce 

development through the PTTCs, including continued support of the prevention fellowship 

program and continued training of the prevention workforce. SAMHSA anticipates grantees will

provide trainings to approximately 39,774 participants. 
189 

Funding History Table

Fiscal Year Amount

FY 2021 $7,493,000

FY 2022 $7,493,000

FY 2023 Final $9,493,000

FY 2024 CR $9,493,000

FY 2025 President’s Budget $9,493,000

Program Accomplishments

In FY 2024, SAMHSA anticipates issuing a new Notice of Funding Opportunity to fund the 

iteration of the PTTCs including one National Coordinating Organization (NCO) grant, ten 

regional centers, 11 PTTCs as well as continue funding for two Centers of Excellence (COEs). In 

FY 2025, SAMHA intends to continue funding the PTTC Network through one NCO grant and 

ten regional centers, in addition to continued funding of two COEs. SAMHSA anticipates grantees 

will provide trainings to approximately 39,774 participants. 

During FY 2023, the PTTC Network completed 978 training and technical events, in which 43,408 

prevention participants attended – exceeding FY 2023 targets. The PTTC Network has six stateof-the-art working groups which are as follows: Cannabis Risk, Data Informed Decisions, 

Community Coalitions & Collaborators, Building Health Equity & Social Justice, Workforce 

Development, and Implementation Science. The Network also implemented the Prevention 

Fellowship Program, comprising 16 individuals across the regional centers and the national special 

populations centers. In collaboration with the Opioid Response Network (ORN), they created a 

strategic plan to support the professionalization and workforce of prevention. SAMHSA will 

maintain targets in FY 2024 and FY 2025 as new grants will be awarded. Targets may be adjusted 

reflecting FY 2024 actuals. 
190 

Outputs and Outcomes Table

Program: Center for the Application of Prevention Technologies

Measure Year and Most Recent 

Result /

Target for Recent Result 

/

(Summary of Result)

FY 2024

Target

FY 2025

Target

FY 2025

Target

+/-FY 2024

Target

1.4.14 Number of 

people trained (Output)

FY 2023: 43,408

Target:

39,774

(Target exceeded)

39,774 39,774 Maintain
191 

Science and Service Program Coordination 

(Dollars in millions)

Programs of Regional and National Significance

FY 2023 

Final

FY 2024 

CR

FY2025 

President’s Budget

FY 2025 +/-

FY 2023

Science and Service Program Coordination............................. 4.072 4.072 4.072 -- 

Authorizing Legislation......................................................................................Section 516 of the PHS Act 

FY 2025 Authorization ................................................................................................$218,219,000 

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

Eligible Entities...................................................................................................Domestic and Public Entities

Program Description 

 

The Substance Use Disorder Prevention Engagement Initiatives (SUDPEI) contributes to 

SAMHSA’s efforts to collaborate across the agency to promote wider adoption and application of 

effective SUD prevention strategies across the continuum of care, with an emphasis on integrating 

prevention services into other systems through efforts such as partner engagement. The SUDPEI 

promotes the adoption of evidence-based policies, programs, and practices by developing 

materials, resources, and other engagement tools to strengthen community-based prevention 

efforts to address substance use and misuse. The initiative supports the Interagency Coordinating 

Committee on the Prevention on Underage Drinking (ICCPUD) through operation and 

maintenance of the ICCPUD web portal, StopAlcoholAbuse.gov. As part of its work to support 

SAMHSA and the ICCPUD, the SUDPEI develops communications resources for prevention 

professionals and community coalitions that call out important trends from the National Survey on 

Drug Use and Health and promote evidence-based strategies to prevent substance use and misuse 

and related issues. Another key SUDPEI activity, Communities Talk to Prevent Substance Use 

Disorders, is designed to raise awareness of SUD prevention issues as well as mobilize and support 

community action. 

 

Communities Talk to Prevent Substance Use Disorders 

Historically, every two years, the SUDPEI has distributed Communities Talk planning stipends to 

community-based organizations (CBOs), institutions of higher education (IHEs), and statewide or 

state-based organizations to plan activities that raise awareness and educate youth, families, and 

communities about the potentially harmful consequences of underage and problem drinking and 

other substance misuse among individuals 12 to 25 years old. Community events and activities 

have been conducted in every state and territory.

 

Budget Request

The FY 2025 President’s Budget Request is $4.1 million, equal to the FY 2023 Final level. Funding 

will continue to maintain improvements in community readiness in identified tribal communities 

through tribally focused, and tribally specific technical assistance delivery. In FY 2025, CSUPS 

anticipates serving 2,583 individuals through tribally-focused technical assistance. 
192 

Funding History Table

Fiscal Year Amount

FY 2021 $4,153,000

FY 2022 $4,072,000

FY 2023 Final $4,072,000

FY 2024 CR $4,072,000

FY 2025 President’s Budget $4,072,000

 

Program Accomplishments

Beginning in FY 2023, 500 Communities Talk planning stipends will be distributed every year to 

CBOs and IHEs to conduct community-based prevention activities, with the focus broadening to 

address the potentially harmful consequences of underage and problem drinking and substance use 

and misuse. To support community-based planning, a new web-based planning app is now 

available. Using an OMB-approved survey, data regarding community activities will be captured 

in FY 2023. In addition, success stories are also developed and shared via 

https://www.stopalcoholabuse.gov/communitiestalk/.

In FY 2024, CSUPS will continue to elevate community success stories via its podcast series, 

webinars, and prominent placement of stories on the Communities Talk website. Additionally, 

CSUPS will expand its use of mini campaigns, which promote and amplify substance use data, 

research, and prevention resources related to alcohol and substance misuse by youth and youth 

adults. Other focus areas for communications activities will include technical assistance in 

bridging prevention service delivery between substance misuse and mental health promotion as 

well as operationalizing diversity, equity, and inclusion in prevention service delivery. 

In FY 2023, The Tribal Technical Assistance Center (TTAC) conducted 94 training and technical 

assistance (TTA) events in FY 2023, training 2,583 individuals. This number will be used as 

baseline for this measure and will be monitored for trends in FY 2024 and FY 2025. These TTA 

events included 19 broad and 21 focused trainings, including 8 Gathering of Native Americans 

(GONA) events. They conducted an additional six opioid focused GONAs, and 11 TTA events on 

988. 
193 

Outputs and Outcomes Table

Program: Prevention - Science and Service Activities

Measure Year and Most 

Recent Result /

Target for Recent 

Result /

(Summary of Result)

FY 2024

 Target

FY 2025

 Target

FY 2025

 Target

+/-FY 2024

 Target

2.3.101 Number of 

individuals trained 

(Outcome)

FY 2023: 2,583

 

Target:

 2,583 

 

(Baseline)

2,583 2,583 Maintain
194 

PRNS Mechanism Table 

Center for Substance Abuse Prevention

Summary

(Dollars in millions) 

Programs of Regional & National Significance

FY 2023 

Final FY 2024 CR

FY 2025

President's Budget

No. Amount No. Amount No. Amount

Grants

Continuations 658 140.937 617 154.543 565 145.964

New/Competing 217 66.160 169 46.632 163 55.918

Subtotal 875 207.096 785 201.176 729 201.882

Contracts

Continuations 11 26.527 13 35.055 14 29.677

New 13 3.256 --- 0.648 --- 5.320

Subtotal 24 29.783 13 35.703 14 34.997

Total, Substance Use Prevention PRNS 899 236.879 798 236.879 743 236.879
195 

PRNS Mechanism Table

Center for Substance Abuse Prevention

Program, Project, and Activity 

(Dollars in millions) 

FY 2023 

Final FY 2024 CR

FY 2025

President's Budget

Programs of Regional & National Significance No. Amount No. Amount No. Amount

Capacity:

Strategic Prevention Framework

Grants

Continuations 245 83.369 208 93.350 171 92.812 

New/Competing 75 42.579 48 28.137 51 29.224 

Subtotal 320 125.947 256 121.488 222 122.036 

Contracts

Continuations 2 8.317 2 13.996 3 13.448 

New 1 1.220 --- -- --- -- 

Subtotal 3 9.537 2 13.996 3 13.448 

Total, Strategic Prevention Framework 323 135.484 258 135.484 225 135.484 

Federal Drug-Free Workplace 

Contracts

Continuations 2 5.043 4 4.838 4 0.314 

New 1 0.096 --- 0.301 --- 4.825 

Subtotal 3 5.139 4 5.139 4 5.139 

Total, Federal Drug-Free Workplace 3 5.139 4 5.139 4 5.139 

Minority AIDS

Grants

Continuations 147 30.499 176 39.593 94 23.212 

New/Competing 42 10.457 --- -- 66 16.389 

Subtotal 189 40.956 176 39.593 160 39.601 

Contracts

Continuations --- 2.339 --- 3.720 --- 3.604 

New --- -0.090 --- -0.108 --- -- 

Subtotal --- 2.249 --- 3.612 --- 3.604 

Total, Minority AIDS 189 43.205 176 43.205 160 43.205 

Sober Truth on Preventing Underage Drinking Act

Grants

Continuations 148 7.385 104 5.718 177 9.587 

New/Competing 50 3.004 70 4.202 6 0.377 

Subtotal 198 10.390 174 9.920 183 9.965 

Contracts

Continuations 2 4.110 2 4.580 2 4.535 

New --- -- --- -- --- -- 

Subtotal 2 4.110 2 4.580 2 4.535 

Total, Sober Truth on Preventing Underage Drinking Act 200 14.500 176 14.500 185 14.500 
PRNS Mechanism Table

Center for Substance Abuse Prevention

Program, Project, and Activity 

(Dollars in millions) 

FY 2023 

Final FY 2024 CR

FY 2025

President's Budget

Programs of Regional & National Significance No. Amount No. Amount No. Amount

Tribal Behavioral Health Grants

Grants

Continuations 106 11.942 127 15.036 117 19.146 

New/Competing 48 9.127 28 5.257 23 1.251 

Subtotal 154 21.070 155 20.292 140 20.397 

Contracts

Continuations 1 2.595 1 3.373 1 3.268 

New/Competing --- -- --- -- --- -- 

Subtotal 1 2.595 1 3.373 1 3.268 

Total, Tribal Behavioral Health Grants 155 23.665 156 23.665 141 23.665 

Subtotal, Capacity 869 221.993 770 221.993 714 221.993 
197

PRNS Mechanism Table

Center for Substance Abuse Prevention

Program, Project, and Activity 

(Dollars in millions) 

Science and Service

FY 2023 

Final FY 2024 CR

FY 2025

President's Budget

No. Amount No. Amount No. Amount

Center for the Application of Prevention Technologies

Grants

Continuations 11 6.492 2 0.847 --- -- 

New/Competing 2 0.842 16 7.829 18 8.6757 

Subtotal 13 7.334 18 8.676 18 8.676 

Contracts

Continuations --- 0.514 --- 0.817 --- 0.792 

New/Competing 9 1.645 --- -- --- 0.026 

Subtotal 9 2.159 --- 0.817 --- 0.817 

Total, Center for the Application of Prevention Technol 22 9.493 18 9.493 18 9.4930 

SAP Minority Fellowship Program

Grants

Continuations 1 1.249 --- -- 7 1.207 

New/Competing --- -- 7 1.207 --- -- 

Supplements* --- -- --- -- --- -- 

Subtotal 1 1.249 7 1.207 7 1.207 

Contracts

Continuations --- 0.072 --- 0.114 --- 0.110 

New/Competing --- -- --- -- --- 0.004 

Subtotal --- 0.072 --- 0.114 --- 0.114 

Total, SAP Minority Fellowship Program 1 1.321 7 1.321 7 1.321 

Science & Service Program Coordination

Grants

Continuations --- -- --- -- --- -- 

New/Competing 1 0.150 --- -- --- -- 

Subtotal 1 0.150 --- -- --- -- 

Contracts

Continuations 4 3.537 4 3.6166 4 3.6057 

New 2 0.385 --- 0.4554 --- 0.4663 

Subtotal 6 3.922 4 4.0720 4 4.0720 

Total, Science & Service Program Coordination 7 4.072 4 4.0720 4 4.0720 

Subtotal, Science and Service 30 14.886 29 14.8860 29 14.8860 

Total, Substance Use Prevention 899 $236.879 798 $236.879 743 $236.879
198

Grant Awards Table

Center for Substance Abuse Prevention

(Whole dollars) 

FY 2023 Final FY 2024 CR FY 2025 President's Budget

Number of Awards 875 785 729

Average Award $236,560 $256,183 $277,059

Range of Awards $50,000 - $2,300,000 $50,000 - $2,300,000 $50,000 - $2,300,000
199

Substance Use Services

Table of Contents 

Substance Use Services ....................................................................................................199

Summary of the Request ..................................................................................................200

Programs of Regional and National Significance (PRNS) ..............................................202

Opioid Treatment Programs/Regulatory Activities ...................................................203

Screening, Brief Intervention, and Referral to Treatment .........................................207

Targeted Capacity Expansion-General .....................................................................211

Pregnant and Postpartum Women .............................................................................217 

Improving Access to Overdose Treatment .................................................................222

Building Communities of Recovery (BCOR) ..............................................................225

Recovery Community Services Program ...................................................................229

Children and Families ...............................................................................................233

Treatment Systems for Homeless ...............................................................................237

Criminal Justice Activities .........................................................................................240

Minority AIDS Initiative ............................................................................................248

Minority Fellowship Program ...................................................................................251

Addiction Technology Transfer Centers ....................................................................253 

Grants to Prevent Prescription Drug/Opioid Overdose Related Deaths ..................256 

Peer Support Techincal Assistant Center ..................................................................259 

Treatment, Recovery, and Workforce Support ...........................................................262

Emergency Department Alternatives to Opioids .......................................................265

Comprehensive Opioid Recovery Centers .................................................................268

First Responder Training – Comprehensive Addiction and Recovery Act ................271 

Youth Prevention and Recovery Initiative .................................................................274 

Community Harm Reduction and Engagement Initiative ..........................................276 

Women's Behavioral Health Technical Assistance Center ........................................280 

PRNS Mechanism Table ..................................................................................................282 

Grant Awards Table .........................................................................................................290 

State Opioid Response Grants .........................................................................................291

Substance Abuse Prevention and Treatment Block Grant ...............................................299
200

Substance Use Services

Summary of the Request

 (Dollars in millions) 

FY 2023 

Final 

FY 2024 

CR 

FY 2025 

President's 

Budget

FY 2025 

+/- FY 

2023

Programs of Regional and National Significance ..................... 574.219 574.219 590.969 16.750 

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

State Opioid Response Grants......................................... 1,575.000 1,575.000 1,595.000 20.000 

Set-Aside for Tribes (non-add)...................................... 55.000 55.000 60.000 5.000 

Substance Use Prevention, Treatment, and Recovery Services Block Grant 2,008.079 2,008.079 2,008.079 -- 

Budget Authority (non-add)......................................... 1,928.879 1,928.879 1,928.879 -- 

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

Total, Substance Use Services 4,157.298 4,157.298 4,194.048 36.750 

FTE 109 175 175 +66

The FY 2025 President’s Budget level is $4.2 billion, $37 million above the FY 2023 Final. 

SAMHSA’s Center for Substance Use Services (CSUS) manages over 35 formula and 

discretionary grant programs with over 1,200 grantee entities throughout the nation. The Center’s 

programs fund interventions across the continuum of substance use care from prevention to public 

health harm reduction, treatment, and recovery services, with the broad goals of saving and 

improving lives and recognizing the often-long-term nature of substance use disorders 

(SUD). The Budget proposes providing funds for access to quality evidence-based care and 

treatment services for SUD and addressing the overdose crisis for individuals, families, and 

communities — especially as it relates to opioid, stimulant, and polysubstance use disorders. 

CSUS’s focus areas, as outlined in this Budget, align with Office of National Drug Control Policy’s 

(ONDCP) National Drug Control Strategy and the Biden-Harris Administration drug policy 

priorities through support for the continued access to evidence-based and public health focused 

harm reduction, prevention, treatment, inclusive of medications for opioid and other SUDs, 

recovery support services, and the addiction treatment workforce. 

The Budget for CSUS focuses on continuing investments not only in individuals and families 

impacted by substance use across the lifespan but also across diverse communities that are at 

especially high risk for overdose. This includes pregnant and postpartum women and their families, 

individuals with SUD who encounter the criminal justice system or experience housing instability, 

and individuals specifically seeking treatment and recovery support services for addiction to 

opioids, stimulants, alcohol, and, increasingly, polysubstances. SAMHSA’s SUD budget requests 

funds for direct services, infrastructure development, system capacity building, and training and 

technical assistance efforts for service integration, quality improvement, and workforce 

development. Multiple touchpoints exist for people with SUD and their families. CSUS’s 

programs involve multiple systems beyond the specialty behavioral health system, such as primary 

health care, school, child welfare, criminal and juvenile justice, and housing systems. 

Programs central to CSUS’s direct services and system capacity building, and, the State Opioid 

Response (SOR), Tribal Opioid Response (TOR) grants, and the Substance Use Prevention, 

Treatment, and Recovery Services Block Grants (SUPTRS BG) encompass the majority of the 

Center’s current FY 2025 Budget Request. The $3.6 billion in proposed funds between these grant 

programs provide a foundation for states, tribes, tribal nations, and territories to create a safety net 

of SUD care across public health, treatment, trauma informed care, and recovery support services. 
201

In addition, in FY 2025, the President’s budget provides increased support for several programs to 

support key behavioral health priorities. This includes a $5 million increase for the Pregnant and 

Postpartum Women’s program ($43.9 million), $10 million for a new Community Harm Reduction 

and Engagement Initiative, and $1.75 million for a new Women’s Behavioral Health Technical 

Assistance Center (co-funded with CMHS). 

CSUS programs support direct funding to behavioral health workforce and community 

organizations to expand and enhance treatment and recovery support services in different settings 

and for a range of priority populations. Of particular focus are pregnant and postpartum women. 

The wide breadth of CSUS programs allows grant recipients to focus on meeting their 

community’s unique needs. Workforce shortages are one of the greater challenges facing many 

behavioral health providers today. CSUS grants provide significant training and technical 

assistance opportunities to connect health professional students and practitioners with the 

behavioral health and addiction medicine/addiction psychiatry field and to strengthen the 

knowledge base and skills of the existing, broader healthcare professional field in the care of 

people with SUDs. Funding also supports innovative delivery of pharmacologic therapies for 

opioid use disorder under CSUS’s regulatory framework. 

CSUS’s programs prevent overdose and support recovery; promote children and youth behavioral 

health; integrate primary and SUD health care; support the behavioral health workforce; and 

use performance measures, data, and evaluation to guide decision-making. CSUS’s strategies aim 

to improve access and reduce barriers to quality care and reduce the stigma of SUD, which often 

prevents individuals from receiving needed services to promote recovery. 

CSUS’s programs support the framework of a coordinated, integrated continuous care model of 

SUD services. To achieve this, the programs work to: 1) drive the integration of behavioral health 

into the healthcare system to strengthen and expand access to mental and SUD treatment and 

recovery services for individuals and families; 2) bolster the health workforce to ensure delivery 

of quality services and care; 3) enhance the promotion of healthy behaviors to reduce occurrence 

and disparities in preventable injury, illness, and death; and 4) improve the design, delivery, and 

outcomes of HHS programs by prioritizing science, evidence, and inclusion. Overall, the CSUS 

Budget Request supports the HHS Overdose Prevention and the National Drug Control Strategy. 
202

Substance Use Services

Programs of Regional and National Significance (PRNS)

(Dollars in millions)

Programs of Regional and National Significance

FY 2023 

Final 

FY 2024 

CR 

FY 2025 

President's 

Budget 

FY 2025 +/- 

FY 2023

Capacity

Opioid Treatment Programs/Regulatory Activities................................................. 10.724 10.724 10.724 -- 

Screening, Brief Intervention and Referral to Treatment........................................ 33.840 33.840 33.840 -- 

Budget Authority (non-add)................................................................................. 31.840 31.840 31.840 -- 

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

Targeted Capacity Expansion-General.................................................................... 122.416 122.416 122.416 -- 

Other Targeted Capacity Expansion ................................................................... 11.416 11.416 11.416 -- 

MAT for Prescription Drug and Opioid Addiction (non-add)............................ 111.000 111.000 111.000 -- 

MAT for Prescription Drug and Opioid Addiction (Tribes)(non-add)....... 14.500 14.500 14.500 -- 

Low-Threshold Housing First Pilot Project (non-add, new).............................. -- -- -- -- 

 First Generation Students (via HBCU, non-add).................................................. -- -- -- -- 

 Advancing Recovery-Centric Systems (ARCS): Capacity Building Pilot 1, non-add) -- -- -- -- 

Pregnant & Postpartum Women .............................................................................. 38.931 38.931 43.931 5.000 

Improving Access to Overdose Treatment .............................................................. 1.500 1.500 1.500 -- 

Building Communities of Recovery ........................................................................ 16.000 16.000 16.000 -- 

 Program to Expand Recovery Supports on College Campuses .......................... -- -- -- -- 

Recovery Community Services Program................................................................. 4.434 4.434 4.434 -- 

Children and Families.............................................................................................. 30.197 30.197 30.197 -- 

Treatment Systems for Homeless............................................................................ 37.114 37.114 37.114 -- 

Criminal Justice Activities....................................................................................... 94.000 94.000 94.000 -- 

Other Criminal Justice Activities (non-add) ....................................................... 20.000 20.000 20.000 -- 

Drug Court Activities (non-add).......................................................................... 74.000 74.000 74.000 -- 

Adult and Youth Diversion and Deflection – Criminal Justice........................... -- -- -- -- 

Minority AIDS ........................................................................................................ 66.881 66.881 66.881 -- 

Grants to Prevent Prescription Drug/Opioid Overdose-Related Deaths ................ 16.000 16.000 16.000 -- 

Peer Support TA Center........................................................................................... 2.000 2.000 2.000 -- 

Treatment, Recovery, and Workforce Support........................................................ 12.000 12.000 12.000 -- 

Emergency Department Alternatives to Opioids..................................................... 8.000 8.000 8.000 -- 

Grants to Develop Curricula for DATA Act Waivers............................................. -- -- -- -- 

Opioid Response Grants .......................................................................................... -- -- -- -- 

Comprehensive Opioid Recovery Centers............................................................... 6.000 6.000 6.000 -- 

First Responder Training (CARA) .......................................................................... 56.000 56.000 56.000 -- 

First Responder Training (non-add) .................................................................. 25.000 25.000 25.000 -- 

Rural Set-Aside (non-add) ................................................................................... 31.000 31.000 31.000 -- 

Community Harm Reduction and Engagement Initiative (new)............................. -- -- 10.000 10.000 

Youth Prevention and Recovery Initiative .............................................................. 2.000 2.000 2.000 -- 

Women's Behavioral Health Technical Assistance Center ..................................... -- -- 1.750 1.750 

Subtotal, Capacity 558.037 558.037 574.787 16.750

Science and Service

SAT Minority Fellowship Program............................................................................ 7.136 7.136 7.136 -- 

Addiction Technology Transfer Centers ................................................................... 9.046 9.046 9.046 -- 

Subtotal, Science and Services 16.182 16.182 16.182 -- 

Subtotal, Programs of Regional and National Significance 574.219 574.219 590.969 16.750 
203

Opioid Treatment Programs/Regulatory Activities

(Dollars in millions) 

Programs of Regional and National Significance

FY 2023 

Final 

FY 2024 

CR 

FY 2025 

President's 

Budget 

FY 2025 +/- 

FY 2023

Opioid Treatment Programs/Regulatory Activities 10.724 10.724 10.724 -- 

Authorizing Legislation ............................................. Section 509 of the Public Health Service Act 

FY 2025 Authorization ................................................................................................$521,517,000 

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

Eligible Entities States, political subdivisions of States, Indian Tribes and Tribal organizations (as 

such terms are defined in section 4 of the Indian Self-Determination and Education Assistance 

Act), health facilities, programs operated by or in accordance with a contract or grant with the 

Indian Health Service, and other public and nonprofit private entities 

Program Description 

SAMHSA seeks to close the gap between the number of people needing treatment for Opioid Use 

Disorder (OUD) and the capacity to treat them with Food and Drug Administration (FDA)-

approved Medications for Opioid Use Disorder (MOUD) (buprenorphine, methadone, and 

naltrexone products). These medications are often used in combination with additional evidencebased treatment and recovery support services. SAMHSA expands access to MOUD through 

regulating and supporting Opioid Treatment Programs (OTPs); provider support for those who 

provide MOUD with buprenorphine and naltrexone in office-based settings; and education and 

training of healthcare students and practitioners on the treatment of OUD, including with MOUD, 

through universities and professional organizations. These activities apply to multiple other CSUS 

programs and form a cornerstone of efforts related to the HHS Overdose Prevention Strategy. 

MOUD and Opioid Treatment Program Expansion 

SAMHSA is responsible for regulating and certifying the country's OTPs; providing direct support 

to OTPs, healthcare systems, states, and other federal agencies regarding certification, 

accreditation, and evidence-based OUD treatment; and overseeing accreditation of these programs. 

SAMHSA approves all organizations that accredit OTPs (accreditation bodies), reviews the 

standards they apply in their accreditation of OTPs, and monitors them for quality assurance and 

improvement. SAMHSA meets regularly with the State Opioid Treatment Authorities (SOTAs). 

SOTAs provide oversight of OTPs in their respective state; provide state-level technical assistance, 

guidance, and support for issues related to OUD care, such as assisting state officials in evaluating 

state requirements and adherence to the federal regulations for OTPs; and promote evidence-based 

substance use disorder (SUD) treatment and related care. These responsibilities and interactions 

enable SAMHSA to address barriers to treatment and promote means of expanding access to 

services. 

A key population of focus are individuals with OUD who are involved in the criminal justice 

system. To ensure access to MOUD for this high-risk population, CSUS has partnered with the 
204

federal Bureau of Prisons (BOP), state Departments of Corrections (DOC), the Department of 

Justice (DOJ), the Drug Enforcement Administration (DEA), and other stakeholders to establish 

OTP services throughout federal and state correctional systems. For example, SAMHSA has been 

meeting regularly with all of the State Opioid Treatment Authorities to assist them in integrating 

MOUD into their state prisons, provided technical assistance directly to states, and supporting 

efforts of the DOJ’s Bureau of Justice Assistance (BJA) to integrate MOUD in county jails across 

the country. 

CSUS’ certification and accreditation oversight activities of OTPs will continue in FY 2025. 

During FY 2025, it will be increasing its onsite visits to OTPs, to accommodate the increased 

number of OTPs in the nation and to enhance its oversight of the work of the accreditation bodies. 

It will continue to work with SOTAs and the OTP community on implementation of substantially 

revised OTP regulations, helping the BOP with service implementation, arranging training and 

providing technical support as the sites continue implementation of MOUD, and working with at 

least five states to improve the capacity of their criminal justice systems to provide the full 

complement of MOUD and training resources to support this expansion. 

Substance Use Disorder, including Opioid Use Disorder, Education and Training of Providers 

The Consolidated Appropriations Act, 2023 (PL 117-238) removed the requirement that 

practitioners hold a waiver that certifies their qualification to prescribe buprenorphine in an officebased setting, as established in the Drug Addiction Treatment Act of 2000 (DATA 2000). It also 

expanded the requirement for SUD training for all providers qualified to prescribe any controlled 

medications designated by the DEA as schedule II-V substances. Together, these expand the 

universe of providers available to treat OUD and other SUDs and the number of practitioners 

requiring training and other practice support. 

Healthcare providers play a pivotal role in educating their patients and colleagues about substance 

use and SUD; screening, diagnosing, and treating patients; and modeling positive attitudes to 

reduce the stigma attached to SUD and its treatment. Early career physicians have identified lack 

of preparedness to treat SUD as a barrier to prescribing MOUD,94 and further research shows that 

lack of appropriate education fosters an unwillingness to prescribe MOUD.95 Comprehensive and 

uniform training on SUDs and treatment and recovery modalities can overcome these deficits. 

SAMHSA promotes provider education through its grants and contracted programs, including the 

Provider’s Clinical Support System-University (PCSS-U) and Provider’s Clinical Support SystemMedications for Opioid Use Disorder (PCSS-MOUD) programs. PCSS-U promotes SUD 

education in professional healthcare schools and aims to engage students in treating SUD upon 

graduation. PCSS-MOUD expands the number of licensed providers completing training for 

prescribing MOUD and provides mentoring and other supports for practitioners treating OUD and 

94 DeFlavio JR, Rolin SA, Nordstrom BR, Kazal LA, Jr. Analysis of barriers to adoption of buprenorphine 

maintenance therapy by family physicians. Rural & Remote Health. 201515:3019.

95 Mackey K, Veazie S, Anderson J, Bourne D, and Peterson K. Evidence Brief: Barriers and Facilitators to Use of 

Medications for Opioid Use Disorder. Washington, DC: Evidence Synthesis Program, Health Services Research 

and Development Service, Office of Research and Development, Department of Veterans Affairs. 2019
205

other SUDs. 

There remains a significant need to increase the number of healthcare providers prepared to 

provide treatment for OUD and other SUDs. SAMHSA will continue to provide up-to-date and 

evidence-based information to support the training of health professionals and to address the 

complex issues of SUD. 

Budget Request

The FY 2025 President’s Budget request is $10.7 million, equal to the FY 2023 Final. SAMHSA 

plans to award 19 continuation PCSS-U grants, plus two continuation cooperative agreements for 

PCSS-MOUD and PCSS-MAUD and two contracts. One of these contracts supports the 

technology used to process certification applications and requests for exemptions to the federal 

regulations that govern OTP services (42 CFR Part 8). The other, starting in FY 2024, will be 

critical to assisting the accreditation bodies, states, and OTPs’ implementation of the substantially 

revised 42 CFR Part 8 regulations. In FY 2025, CSUS expects to continue to support practitioners, 

particularly in adjusting to the removal of the DATA-waiver process, the introduction of new 

training requirements for all providers prescribing controlled medications that went into effect in 

June 2023, and the revised OTP regulations for those practitioners caring for patients in this setting. 

It will also continue its support activities to assure providers of MOUD and other systems of care 

have access to CSUS-funded technical assistance and training resources. 

Funding History Table

Fiscal Year Amount

FY 2021 $8,724,000

FY 2022 $8,724,000

FY 2023 Final $10,724,000

FY 2024 CR $10,724,000

FY 2025 President’s Budget $10,724,000

Program Accomplishments

In FY 2023, SAMHSA funded a Provider’s Clinical Support System – Medications for Alcohol 

Use Disorder (PCSS-MAUD) program. This program provides training, guidance, and mentoring 

on the use of Medications for Alcohol Use Disorder (MAUD). With this program, SAMHSA aims 

to expand access to treatment of Alcohol Use Disorder (AUD) by increasing the number of 

healthcare professionals that provide MAUD in their setting, provide training, coaching, 

consultation, and other support services for a wide range of treatment providers, improve 

healthcare and AUD treatment outcomes, and decrease alcohol-related morbidity and mortality 

through use of MAUD. 

MOUD in Opioid Treatment Programs
206

In 2023, SAMHSA certified 178 new OTPs. As of December 2023, there are 2,116 active OTPs 

across 49 states and two territories; collectively, these OTPs also operate 128 affiliated medication 

units and 39 mobile units. In FY 2024, SAMHSA continued to build off work started in FY 2023 

to assist states and local jails in implementing MOUD in their criminal justice settings, including 

a Policy Academy in FY 2024 to assist additional states beyond the five that participated in a 

similar event in FY 2023. SAMHSA also worked extensively with the OTP community, SOTAs, 

and others on the initial implementation of the substantially revised regulations establishing 

standards of care provided in OTPs released in January 2024. 

MOUD in Other Health Care Settings

In FY 2023, following passage of Sections 1262 and 1263 of the Consolidated Appropriations Act, 

2023 (also commonly known as the Mainstreaming Addiction Treatment Act, or MAT Act, and 

Medication Access and Training Expansion Act, or MATE Act, respectively), SAMHSA 

developed educational materials and other resources that explained these Acts to providers, 

patients and pharmacies, and assisted these stakeholdersin navigating the elimination of the waiver

previously required to prescribe buprenorphine. It also developed recommendations for SUD 

training and gathered experts in healthcare education to expand these recommendations into 

curriculum that could be utilized by healthcare training programs. SAMHSA continues supporting 

healthcare practitioners in accessing SUD training in FY 2024 and FY 2025. 

• MOUD Education and Training of Providers

In FY 2023, drawing from the lessons learned from its 86 PCSS-U grantees and the professional 

organizations named in Section 1263 of the Consolidated Appropriations Act, 2023, SAMHSA 

developed recommendations for core SUD curricula to facilitate the integration of the content into 

graduate healthcare programs. SAMHSA will continue to promote use of this content in FY 2024 

and FY 2025, disseminating it through professional organizations and education accreditation 

bodies. SAMHSA will continue to gather publicly available training content and resources to make 

these more accessible to providers. 

In FY 2023, SAMHSA funded three new and 18 continuation PCSS-U grants, one new PCSSMAUD cooperative agreement, one new PCSS-MOUD cooperative agreement and one contract. 

The PCSS systems offer live webinars, roundtable discussions, self-paced webinars, and in-person 

trainings. During FY 2023, it provided training for over 55,000 participants and provided support 

for more than 20 other universities to incorporate SUD content into their education programs. The 

PCSS-MOUD program provides mentoring services, enlisting the assistance of over 210 mentors

to provide support to over 1250 practitioners. It maintains a curriculum library that can be utilized 

by providers and education programs and develops toolkits and guidelines to support providers in 

their practices. 

In FY 2024, SAMHSA anticipates funding 17 new and one continuation PCSS-U grants, two

PCSS continuation cooperative agreements (MOUD and MAUD), one contract to support 

certification and accreditation processes, and a new contract to support OTP and states’ continued 

implementation of the substantially revised 42 CFR Part 8. 
207

Screening, Brief Intervention, and Referral to Treatment 

(Dollars in millions) 

Programs of Regional and National Significance

FY 2023 

Final 

FY 2024 

CR 

FY 2025 

President’s 

Budget

FY 2025 +/- 

FY 2023

Screening, Brief Intervention, and Referral to Treatment .................... 33.840 33.840 33.840 -- 

Budget Authority (non-add) .............................................................. 31.840 31.840 31.840 -- 

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

Authorizing Legislation ............................................. Section 509 of the Public Health Service Act 

FY 2025 Authorization ................................................................................................$521,517,000 

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

Eligible Entities....States, political subdivisions of States, Indian Tribes and Tribal organizations 

(as such terms are defined in section 4 of the Indian Self-Determination and Education Assistance 

Act), health facilities, programs operated by or in accordance with a contract or grant with the 

Indian Health Service, and other public and nonprofit private entities 

Program Description 

In 2022, according to the National Survey on Drug Use and Health (NSDUH), 48.7 million people 

aged 12 or older (17.3 percent) had a substance use disorder (SUD) in the past year, including 29.5 

million who had an alcohol use disorder, 27.2 million who had a drug use disorder, and 6.1 million 

people who had an opioid use disorder. Among the 137.4 million current alcohol users aged 12 or 

older in 2022, 61.2 million people (44.5 percent) were past month binge drinkers. Among past 

month binge drinkers, 16.1 million people were past month heavy drinkers.

96 The National 

Institute on Drug Abuse estimates that the misuse of illicit drugs, tobacco, and alcohol costs society 

$740 billion each year.97 Unfortunately, among the 39.7 million adults (ages 18 or older) who had 

an SUD in the past year, 36.8 million people did not seek treatment.98

The Screening, Brief Intervention and Referral to Treatment (SBIRT) program is intended to help 

primary care and community settings integrate a public health approach to identifying and 

intervening early with individuals engaged in risky substance use. The SBIRT Program identifies 

individuals who misuse substances or are at high risk for a SUD and intervenes with education, 

brief interventions, or referral to SUD treatment if clinically indicated. The program’s goals are to 

reduce the rate of substance misuse, intervene early to prevent progression to more severe illness, 

and increase the number of individuals who receive treatment for their SUD. Studies have long 

shown that this approach is effective in helping reduce harmful alcohol consumption.

The SBIRT program is designed to expand or enhance the continuum of care for people who use 

substances, reduce alcohol and other drug (AOD) consumption and its negative health impact, 

increase abstinence, reduce costly health care utilization, and promote sustainability and the 

96 https://www.samhsa.gov/data/release/2022-national-survey-drug-use-and-health-nsduh-releases#annual-nationalreport

97 https://nida.nih.gov/research-topics/trends-statistics 98 Substance Abuse and Mental Health Services Administration. (2022). Key substance use and mental health 

indicators in the United States: Results from the 2022National Survey on Drug Use and Health 

https://www.samhsa.gov/data/release/2022-national-survey-drug-use-and-health-nsduh-releases#annual-nationalreport
208

integration of behavioral health and primary care services through policy changes that increase 

treatment access. These grants support clinically appropriate services for persons at risk for SUD, 

as well as those diagnosed with SUD across different settings, including primary care, as well as 

hospitals, trauma centers, federally qualified health centers, and other relevant health care and 

community settings.

All SBIRT grant recipients may use funds to screen not only for substance use and SUD, but also 

co-occurring mental illness. Funds can support evidence-based, person-centered interventions, 

such as reinforcement of less risky alcohol use; motivational interviewing; brief interventions; and 

referral to treatment for individuals exhibiting symptoms of substance use disorder. The population 

of focus is adults and adolescents seeking medical attention and intervention in primary care and 

other health care and community settings. 

The SBIRT program, like the majority of CSUS’s discretionary grant programs, gathers grantee 

data on key elements that help SAMHSA create a national picture of substance misuse and identify

reach and impact associated with SAMHSA grants.

Budget Request

The FY 2025 President’s Budget request is $33.8 million, equal to the FY 2023 Final level. 

SAMHSA plans to fund 30 continuation grants and anticipates grant recipients will serve 

146,366 clients. 

Funding History Table

Fiscal Year Amount

FY 2021 $30,000,000

FY 2022 $31,840,000

FY 2023 Final $33,840,000

FY 2024 CR $33,840,000

FY 2025 President’s Budget $33,840,000

Program Accomplishments

In FY 2023 the SBIRT program served 148,018 clients. Significant steps have been taken to 

increase clients’ abstinence, no criminal justice involvement, and housing stability. In FY 2023, 

the percentage of clients who reported that they did not use alcohol or illegal drugs within the past 

30 days increased by 140.7 percent between intake to 6-month follow-up. Between intake and sixmonth follow-up, the percentage of clients who reported no arrests within the past 30 days 

increased by 2.2 percent. In addition, the percentage of clients who reported housing stability 

increased by 11.7 percent. 99

99 Source: SAMHSA’s Performance Accountability and Reporting System (SPARS). Retrieved January 16, 2024, 
209

In FY 2023, SAMHSA funded seven new and 26 continuation SBIRT grants. 

In FY 2024, SAMHSA anticipates funding 10 new and 20 continuation SBIRT grants. 

from http://spars.samhsa.gov. Based on 148,018 client intakes assessments, and 750 client six-month follow-up 

reassessments. Limitations: There are several limitations to the program evaluation including (but not limited to) 

incomplete data, self-report, selection bias, and the launch of a new client-level instrument in January 2023.
210

Outputs and Outcomes Table

Program: Screening, Brief Intervention and Referral to Treatment

Measure Year and Most 

Recent Result /

Target for Recent 

Result /

(Summary of Result)

FY 2024

 Target 

FY 2025

 Target 

FY 2025

 Target

+/-FY 2024

 Target 

1.2.40 The number 

of clients served 

(Output) 

FY 2023: 148,018

 

Target:

 144,917 

 

(Target Exceeded)

146,366 146,366 Maintain

1.2.41 Percentage 

of clients receiving 

services who had 

no past month 

substance use 

(Outcome)

FY 2023: 52 %

 

Target:

 46.7 % 

 

(Target Exceeded)

47.7 % 47.7 % Maintain
211

Targeted Capacity Expansion-General 

(Dollars in millions) 

Programs of Regional and National Significance

FY 2023 

Final 

FY 2024 

CR 

FY 2025 

President's 

Budget 

FY 2025 +/- 

FY 2023

Targeted Capacity Expansion-General ........................................................... 122.416 122.416 122.416 -- 

Other Targeted Capacity Expansion ........................................................... 11.416 11.416 11.416 -- 

MAT for Prescription Drug and Opioid Addiction (non-add) .................... 111.000 111.000 111.000 -- 

MAT for Prescription Drug and Opioid Addiction (Tribes)(non-add) 14.500 14.500 14.500 -- 

Authorizing Legislation ............................................. Section 509 of the Public Health Service Act 

FY 2025 Authorization ................................................................................................$521,517,000 

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

Eligible Entities........ States, political subdivisions of States, Indian Tribes and Tribal 

organizations (as such terms are defined in section 4 of the Indian Self-Determination and 

Education Assistance Act), health facilities, programs operated by or in accordance with a contract 

or grant with the Indian Health Service, and other public and nonprofit private entities 

Program Description 

 

Urgent, unmet, and emerging substance use disorder (SUD) treatment and recovery support service 

capacity needs remain a critical issue for the nation. To assist communities in addressing these 

needs, SAMHSA initiated the Targeted Capacity Expansion (TCE) program. Projects within this 

program provide rapid, strategic, comprehensive, and integrated community-based responses to 

gaps and capacity for substance use disorder treatment and recovery support services. Examples 

of the gaps addressed by these projects include limited or no access to medications for opioid use 

disorders (MOUD), lack of resources needed to adopt and implement health information 

technology (HIT) in SUD treatment settings, and short supply of trained and qualified peer 

recovery coaches to assist individuals in the recovery process. This program supports the 

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

TCE-Special Projects (TCE-SP) grants.

 

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

Among people aged 12 or older in 2022, 3.2 percent (8.9 million people) misused opioids in the 

past year.100 According to the Centers for Disease Control and Prevention (CDC), provisional data 

indicate there were 106,363 drug overdose deaths in the United States during the 12-month period 

ending in August 2023. Of the drug overdose deaths, 80,609 involved opioids.101 This underscores 

the risks of potent illicit synthetic opioids and need to continue to engage people in a continuum of

public health-focused harm reduction, treatment, and recovery services.102 

The MAT-PDOA program addresses individuals with opioid use disorder (OUD) and their unique 

treatment needs by expanding/enhancing the local treatment system capacity to provide accessible, 

effective, comprehensive, coordinated, integrated, and evidence-based MOUD and recovery 

100 Highlights for the 2022 National Survey on Drug Use and Health (samhsa.gov) 101 https://www.cdc.gov/nchs/nvss/vsrr/drug-overdose-data.htm 102 ibid
212

support services. MOUD refers to the three classes of Food and Drug Administration-approved 

pharmacotherapies (buprenorphine products, methadone, and naltrexone products) for treating 

OUD. Medications are often combined with evidence-based psychosocial interventions tailored to 

an individual's needs. This approach is a safe and effective strategy for decreasing the frequency 

and quantity of opioid use, reducing the risk of overdose and death, and supporting remission and 

recovery from OUD and other substance use disorders (SUD). Recovery support services include 

linking patients and families to social, legal, housing, and other supports to improve retention in 

care and increase the probability of positive outcomes.

Targeted Capacity Expansion – Special Projects 

The 2022 National Survey on Drug Use and Health (NSDUH) results indicate that over 48.7 

million people 12 or older used illicit drugs in the past year; 8.9 million people misused opioids 

(heroin or prescription pain relivers). Marijuana was the most used illicit drug with 22 percent of 

people using it in the past year.

103,104 Of the 21. 5 million adults aged 18 or older with co-occurring 

any mental illness (AMI) and SUD in the past year, 8.8 million people did not receive any type of 

treatment; of the 12.7 million with co-occurring AMI and an SUD, most received only mental 

health treatment.

105 

The TCE-SP program develops and implements focused strategies for the provision of SUD 

treatment services to underserved populations and addresses unmet needs identified by the 

community. The purpose of the program is to implement focused strategies for the provision of 

public health-focused harm reduction, treatment, and recovery support services to support underresourced populations or community-identified unmet needs regarding SUD and co-occurring 

disorders (COD). Diversity, equity, access, and inclusion are integrated in the provision of services 

and activities throughout the project for example, when conducting eligibility assessments, 

outreach, and engagement or developing policies. 

TCE-SP funding also supports the Historically Black Colleges and Universities Center for 

Excellence in Behavioral Health (HBCU-CFE) through an approved limited justification. This 

five-year discretionary grant program, established in 2017, is jointly administered by the Center 

for Mental Health Services (CMHS) and the Center for Substance Use Services (CSUS). The 

purpose of this program is to recruit college-level students for careers in the behavioral health field 

addressing mental health conditions and SUDs, provide training that can lead to careers in 

behavioral health, and/or prepare students to obtain advanced degrees in behavioral health. This 

program is aligned with Executive Order 14041,

106 which is the White House Initiative on 

Addressing Educational Equity, Excellence, and Economic Opportunity Through Historically 

Black Colleges and Universities. 

103 https://www.samhsa.gov/data/sites/default/files/reports/rpt42731/2022-nsduh-main-highlights.pdf 104 ibid 105 ibid 106 https://www.federalregister.gov/documents/2021/09/09/2021-19579/white-house-initiative-on-advancingeducational-equity-excellence-and-economic-opportunity-through
213

Budget Request

The FY 2025 President’s Budget request is $122.4 million, equal to the FY 2023 Final level. With 

this proposed funding, SAMHSA plans to fund 177 continuation MAT-PDOA grants. SAMHSA 

will award 22 new and five continuation TCE-SP grants and the continuation of a HBCU-CFE 

grant, using 50 percent braided funding from CMHS. SAMHSA anticipates grant recipients will 

serve approximately 13,844 clients. 

Funding Table 

Fiscal Year Amount

FY 2021 $100,192,000

FY 2022 $112,192,000

FY 2023 Final $122,416,000

FY 2024 CR $122,416,000

FY 2025 President’s Budget $122,416,000

Program Accomplishments 

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

In FY 2023, the MAT-PDOA program served 14,733 clients. Significant steps have been taken to 

increase clients’ abstinence, social connectedness, and housing stability. In FY 2023, the 

percentage of clients who reported that they did not use alcohol or illegal drugs within the past 30 

days increased by 63.1 percent between intake to 6-month follow-up. Between intake and sixmonth follow-up, the percentage of clients who reported no arrests within the past 30 days 

increased by 4.1 percent. Those clients who reported being socially connected increased by 4.8 

percent from intake to 6-month follow-up. Similarly, the percentage of clients who reported 

housing stability increased by 18.7 percent.107 

In FY 2023, SAMHSA awarded 21 new grants and funded 154 continuation MAT-PDOA grants. 

SAMHSA set a target of 12,586 clients served for FY 2023. 

In FY 2024, SAMHSA anticipates funding 176 continuation MAT-PDOA grants and SAMHSA 

plans to serve approximately 13,844 clients. 

107 Source: SAMHSA’s Performance Accountability and Reporting System (SPARS). Retrieved January 16, 2024, 

from http://spars.samhsa.gov. Based on 14,733 client intakes assessments, and 3,642 client six-month follow-up 

reassessments. Limitations: There are several limitations to the program evaluation including (but not limited to) 

incomplete data, self-report, selection bias, and the launch of a new client-level instrument in January 2023.
214

Targeted Capacity Expansion – Special Projects

In FY 2023 the TCE-Special Projects program served 1,557 clients. Significant steps have been 

taken to increase clients’ abstinence, employment and educational opportunities, social 

connectedness, and housing stability. In FY 2023, the percentage of clients who reported that they 

did not use alcohol or illegal drugs within the past 30 days increased by 72.0 percent between 

intake to 6-month follow-up. Between intake and six-month follow-up, the percentage of clients 

who reported no arrests within the past 30 days increased by 2.9 percent. In addition, the 

percentage of clients who were employed or attending school increased by 28.6 percent. Those 

clients who reported being socially connected increased by 2.6 percent from intake to 6-month 

follow-up. Similarly, the percentage of clients who reported housing stability increased by 8.6 

percent.108

In FY 2023, SAMHSA funded three new and 25 continuation TCE-SP grants along with the new 

HBCU-CFE grant, using 50 percent braided funding with CMHS. In FY 2023, the program 

achieved positive client outcomes, improved mental health outcomes, reduced drug use, and 

reduced risky behavior outcomes. Strategies utilized by the program included the following: 1) 

screening and assessing clients for the presence of SUD and/or COD and using the information 

obtained to develop appropriate harm reduction, treatment and/or recovery approaches; 2) 

providing evidence-based and population-appropriate harm reduction, treatment, and/or recovery 

approaches to meet the unique needs of diverse populations; 3) providing recovery support services 

designed to improve access and retention in services; 4) developing and implementing strategies 

that are inclusive and used to recruit and engage diverse people in care, ensuring those with the 

greatest need are being served by the program; and 5) collaborating with trained community 

partners that can serve diverse populations to provide comprehensive services. SAMHSA served 

100 graduate-level students across the entire program.

In FY 2024, SAMHSA anticipates funding two new and 25 continuation TCE-SP grants along 

with the continuation of a HBCU-CFE grant, using 50 percent braided funding from CMHS. 

SAMHSA plans to continue serving 100 graduate-level students. 

108 Source: SAMHSA’s Performance Accountability and Reporting System (SPARS). Retrieved January 16, 2024, 

from http://spars.samhsa.gov. Based on 1,557 client intakes assessments, and 591 client six-month follow-up 

reassessments. Limitations: There are several limitations to the program evaluation including (but not limited to) 

incomplete data, self-report, selection bias, and the launch of a new client-level instrument in January 2023
215

Outcomes and Outputs Table

Program: Medication-Assisted Treatment for Prescription Drug and Opioid Addiction

Measure Year and Most 

Recent Result /

Target for Recent 

Result /

(Summary of Result)

FY 2024

 Target 

FY 2025

 Target 

FY 2025

 Target

+/-FY 2024

 Target 

1.3.01 Number of 

admissions for 

Medication 

Assisted Treatment 

(Output) 

FY 2023: 14,733

Target:

 12,586 

(Target Exceeded)

13,844 13,844 Maintain

1.3.03 Percentage 

of clients who had 

no past month 

substance use at 6-

month follow-up 

(Outcome)

FY 2023: 68.4 %

Target:

 62% 

(Target Exceeded)

67% 67% Maintain
216

Program: Treatment-Targeted Capacity Expansion: Other

Measure Year and Most Recent 

Result /

Target for Recent Result /

(Summary of Result)

FY 2024

Target

FY 2025

Target

FY 2025

Target

+/-FY 2024

Target

1.2.25 Percentage of 

adults receiving services 

who had no past month 

substance use (Outcome)

FY 2023: 74.1 %

Target:

63 %

(Target Exceeded)

64 % 64 % Maintain

1.2.26 Number of clients 

served (Output)

FY 2023: 1,557

Target:

2,844

(Target Not Met)

2,872 2,872 Maintain

1.2.27 Percentage of 

adults receiving services 

who were currently 

employed or engaged in 

productive activities 

(Outcome)

FY 2023: 55.7 %

Target:

60.1 %

(Target Not Met)

61.1 % 61.1 % Maintain

1.2.28 Percentage of 

adults receiving services 

who had a permanent 

place to live in the 

community (Outcome)

FY 2023: 43.5 %

Target:

54.3 %

(Target Not Met)

55.3 % 55.3 % Maintain
217

Pregnant and Postpartum Women

(Dollars in millions)

Programs of Regional and National Significance

FY 2023 

Final 

FY 2024 

CR 

FY 2025 

President's 

Budget

FY 2025 +/- 

FY 2023

Pregnant and Postpartum Women......................................................... 38.931 38.931 43.931 5.000 

Authorizing Legislation..................................Section 508 of the Public Health Service Act 

FY 2025 Authorization ..................................................................................................$29,931,000 

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

Eligible Entities ................. Domestic Public and Private Non-Profit Entities that satisfy minimum 

qualifications as enumerated in 42 U.S.C. 290bb–1(e) 

Program Description

The Pregnant and Postpartum Women (PPW) program uses a family-centered approach to provide

comprehensive residential SUD treatment, prevention, and recovery support services for pregnant 

and postpartum women, their minor children, and other family members (e.g., fathers of the 

children). Section 501 of the Comprehensive Addiction and Recovery Act (CARA) increased 

accessibility and availability of services for pregnant women by expanding the authorized purposes 

of the PPW program to include the provision of outpatient and intensive outpatient services for 

pregnant women. CARA requires that 25 percent of all PPW funds support these ambulatory 

services. The PPW program provides services not covered under most public and private insurance 

and includes the Pregnant and Postpartum Women – Residential Treatment (PPW-R) program and 

Pregnant and Postpartum Women – Pilot (PPW-PLT) programs. 

Pregnant and Postpartum Women – Residential Treatment (PPW-R)

The PPW-R program provides services for pregnant and postpartum women for treatment of SUD 

through programs in which: 1) the women reside in funded facilities; 2) the minor children of the 

women reside with the women in such facilities, at the request of the women; 3) the family 

members as designated by the women receive services; and 4) facilities providing these services 

are in locations accessible to low-income women. The PPW-R family-centered approach includes 

a variety of services and case management for women, children, and families. Interventions 

include outreach, SUD assessment, public health harm reduction services, tobacco cessation 

therapies, FDA-approved medication for OUD, and recovery support services. Services available 

to children through the PPW-R program include screening and developmental diagnostic 

assessments addressing social, emotional, cognitive, and physical well-being and interventions 

related to mental, emotional, and behavioral wellness. The PPW-R program also includes 

assessment for Fetal Alcohol Syndrome Disorders. 

Pregnant and Postpartum Women – Pilot (PPW-PLT)

PPW-PLT program enhances the flexibility for states in the use of funds to support family-based 

services for pregnant and postpartum women with primary SUD, emphasizing the treatment of 

opioid use disorders; helping state substance use agencies address the continuum of care, including 

services provided to pregnant and postpartum women in outpatient--based settings; and promoting 
218

a coordinated, effective and efficient state system managed by state substance use agencies by 

encouraging new approaches and models of service delivery. 

 

Budget Request

The FY 2025 President’s Budget request is $43.9 million, an increase of $5.0 million from the FY 

2023 Final level. SAMHSA plans to award two new and 10 continuation PPW-pilot grants, as well 

as 10 new and 48 continuation PPW-residential treatment grants to provide an array of services 

and supports to pregnant women and their families. In FY 2025, SAMHSA anticipates serving an 

additional 43 women in the PPW-residential treatment program, for a total of 2,165 and 6 

additional women in the PPW-pilot program, for a total of 640 people. The proposed increase for 

this program will support the Administration’s priority to address the maternal health crisis.

Funding History Table

Fiscal Year Amount

FY 2021 $32,766,850

FY 2022 $34,931,000

FY 2023 Final $38,931,000

FY 2024 CR $38,931,000

FY 2025 President’s Budget $43,931,000

Program Accomplishments

Pregnant and Postpartum Women – Residential Treatment (PPW-R)

The PPW-R has demonstrated benefits in the following areas: increasing access to medications for 

SUD, mental disorders, and primary health conditions; integrating peer recovery approaches to 

engage and retain women in care; incorporating home visiting as part of the continuum of care and 

as a key strategy to extending services to support recovery; and providing opportunities to increase 

access to care for diverse populations of women, particularly for those living in rural and remote 

locations. 

In FY 2023, the PPW-R program served 1,396 clients. Significant steps have been taken to 

increase clients’ abstinence, employment and educational opportunities, social connectedness, and 

housing stability. In FY 2023, the percentage of clients who reported that they did not use alcohol 

or illegal drugs within the past 30 days increased by 114.7 percent between intake to 6-month 

follow-up. Between intake and six-month follow-up, the percentage of clients who reported no 

arrests within the past 30 days increased by 7.0 percent. Those clients who reported being socially 

connected increased by 5.0 percent from intake to 6-month follow-up. Similarly, the percentage 

of clients who reported housing stability increased by 15.7 percent.109

109 Source: SAMHSA’s Performance Accountability and Reporting System (SPARS). Retrieved January 16, 2024, 

from http://spars.samhsa.gov. Based on 1,396 client intakes assessments, and 345 client six-month follow-up 
219

In FY 2023, SAMHSA funded 24 new and 30 continuation PPW residential treatment grants to 

provide an array of services and supports to pregnant women and their families. During FY 2023, 

the PPW Residential program had a target of serving 1,929 women, and 1,396 women have been 

served, with over 50% of grantees new in FY 2022. 

Of the women served in 2023: 

• 31.0 percent used marijuana

• 34.3 percent used methamphetamine 

• 18.3 percent used any alcohol

• 17.4 percent used opioids

• 5.8 percent used benzodiazepines

In FY 2024, SAMHSA plans to fund one new and 51 continuation PPW residential treatment 

grants to provide an array of services and supports to pregnant women and their families. During 

FY 2024, the PPW Residential program has a target of serving 2,122 women. 

Pregnant and Postpartum Women – Pilot (PPW-PLT)

In FY 2023 the PPW-PLT program served 897 clients. Significant steps have been taken to 

increase clients’ abstinence, employment and educational opportunities, social connectedness, and 

housing stability. In FY 2023, the percentage of clients who reported that they did not use alcohol 

or illegal drugs within the past 30 days increased by 50.3 percent between intake to 6-month 

follow-up. Those clients who reported being socially connected increased by 1.6 percent from 

intake to 6-month follow-up. Similarly, the percentage of clients who reported housing stability 

increased by 6.7 percent.110

In FY 2023, SAMHSA funded six new and four PPW-PLT continuation grants that, as established 

and fully functional grantees were able to exceed the target number of individuals served. 

SAMHSA’s CSUS Children and Families Team hosted quarterly learning communities where 

staff, grantees, and guest subject matter experts shared learning from successful and less effective 

project implementation and data collection experiences to deepen the collective knowledge and 

share best practices to overcome barriers. 

In FY 2024, SAMHSA anticipates funding four new PPW-PLT grants and six PPW-PLT 

continuation grants. 

reassessments. Limitations: There are several limitations to the program evaluation including (but not limited to) 

incomplete data, self-report, selection bias, and the launch of a new client-level instrument in January 2023.

110 Source: SAMHSA’s Performance Accountability and Reporting System (SPARS). Retrieved January 16, 2024, 

from http://spars.samhsa.gov. Based on 897 client intakes assessments, and 274 client six-month follow-up 

reassessments. Limitations: There are several limitations to the program evaluation including (but not limited to) 

incomplete data, self-report, selection bias, and the launch of a new client-level instrument in January 2023 
220 

Outputs and Outcomes Table

Program: Pregnant and Postpartum Women Program 

Measure Year and Most Recent 

Result /

Target for Recent 

Result /

(Summary of Result)

FY 2024 

Target 

FY 2025 

Target 

FY 2025 

Target 

+/-FY 2024 

Target 

1.2.84 Number of 

admissions of 

women who are 

currently pregnant or 

have a child to 

substance use 

disorder treatment 

programs (Output) 

FY 2023: 1,396 

Target:

1,929 

(Target Not Met but 

Improved) 

2,122 2,165 +43 

1.2.85 Percentage of 

PPW clients 

reporting no drug use 

in the past month at 

six month follow-up 

(Outcome)

FY 2023: 87.1 % 

Target:

87 % 

(Target Exceeded) 

92 % 94 % +2 percentage 

point(s) 

1.2.86 Percentage of 

PPW-PLT clients 

who reported 

substance misuse at 

intake, percent who 

report reduction in 

substance misuse at 

six month follow-up 

(Outcome)

FY 2023: 88.5 % 

Target:

79.6 % 

(Target Exceeded) 

84.6 % 86.6 % +2 percentage 

point(s) 

1.2.87 Percentage of 

PPW clients who 

reported 

child/children not 

living with client at 

intake, percent who 

report child/children 

is living with client 

at six month followFY 2022: 56.4 % 

Target:

50 % 

(Target Exceeded) 

Discontinued Discontinued N/A
221 

Measure Year and Most Recent 

Result /

Target for Recent 

Result /

(Summary of Result)

FY 2024 

Target 

FY 2025 

Target 

FY 2025 

Target 

+/-FY 2024 

Target 

up (Outcome)1

1.2.88 Number of 

PPW-PLT women 

who are currently 

pregnant or have a 

child who receive 

SUD and related 

treatment services 

(Outcome) 

FY 2023: 897.0 

Target:

576.0 

(Target Exceeded) 

634.0 640.0 +6 

1Due to the launch of a new client-level instrument in FY2023, measure 1.2.87 is no longer available for reporting. 
222 

Improving Access to Overdose Treatment

(Dollars in millions) 

Programs of Regional and National Significance

FY 2023 

Final 

FY 2024 

CR 

FY 2025 

President’s 

Budget

FY 2025 +/- 

FY 2023

Improving Access to Overdose Treatment ........................................... 1.500 1.500 1.500 -- 

Authorizing Legislation ............................................. Section 544 of the Public Health Service Act 

FY 2025 Authorization ....................................................................................................$5,000,000 

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

Eligible Entities .... States, Territories, localities, Indian Tribes, and Tribal organizations (as those 

terms are defined in section 4 of the Indian Self-Determination and Education 

Assistance Act) 

Program Description

The Improving Access to Overdose Treatment (ODTA) program supports awards to States, 

localities, Indian Tribes, Tribal organizations, and Urban Indian organizations (as those terms are 

defined in section 4 of the Indian Self-Determination and Education Assistance Act). The 

recipients collaborate with other prescribers at the community level to implement trainings on 

policies, procedures, and models of care for prescribing, co-prescribing, and expanding access to 

naloxone and other opioid overdose reversal medications to the specified population of focus (i.e., 

rural or urban). The ODTA program is a key component of the public health response to the 

overdose epidemic that rapidly accelerates workforce capacity and strengthens prevention systems. 

A combination of community-based public health prevention and harm reduction strategies are 

utilized across the prevention continuum to mitigate the impact of the overdose epidemic within 

communities. These community-based public health prevention efforts serve the high-risk 

population outside of substance use treatment facilities and can serve as an important engagement 

point to treatment for people with substance use disorders. 

According to the Centers for Disease Control and Prevention (CDC), provisional data indicate 

there were 106,363 drug overdose deaths in the United States during the 12-month period ending 

in August 2023. Of the drug overdose deaths, 80,609 involved opioids.111

Eligibility is limited to FQHCs (as defined in section 1861(aa) of the Social Security Act); OTPs 

as defined under part 8 of title 42, Code of Federal Regulations; and practitioners dispensing opioid 

medications pursuant to section 303(g) of the Controlled Substances Act (including secondary and 

higher education settings).

Budget Request

The FY 2025 President’s Budget request is $1.5 million, equal to the FY 2023 Final level. 

SAMHSA will support seven continuation grants to continue reducing opioid overdose related 

deaths through the provision of prevention, harm reduction, and linkages to treatment for opioid 

use disorder (OUD). SAMHSA anticipates that approximately 3,000 people will be trained in 

111 https://www.cdc.gov/nchs/nvss/vsrr/drug-overdose-data.htm
223 

policies, procedures, and models of care for prescribing co-prescribing, and expanding access to 

naloxone and other opioid overdose reversal medications.

Funding History Table

Fiscal Year Amount

FY 2021 $1,000,000

FY 2022 $1,000,000

FY 2023 Final $1,500,000

FY 2024 CR $1,500,000

FY 2025 President’s Budget $1,500,000

Program Accomplishments

In FY 2023, SAMHSA funded seven new grants under the ODTA program. This program is 

focusing its efforts on Train of Trainer Models (ToT) to expand its scope to secondary and higher 

educational settings to reach future prescribers and train them in policies, procedures, and models 

of care for prescribing co-prescribing, and expanding access to naloxone and other opioid overdose 

reversal medications. This approach focuses on demographic populations in rural and urban areas 

with the highest incidence of opioid overdose rates and SUD to address the increasing overdose 

deaths in the U.S. The training curriculums focus on reducing stigma using a culturally informed 

approach and scale up ToT models in person, virtually or hybrid settings to reach health care 

providers and pharmacists who will also train future providers in their regions. 

In FY 2023, 4,194 medical professionals, including pharmacists, physicians, physician assistants, 

and nurse practitioners were trained on prescribing drugs or devices approved or cleared under the 

Federal Food Drug, and Cosmetic Act for emergency treatment of known or suspected opioid 

overdose, exceeding the FY 2023 target. An additional 1,013 individuals were trained on 

administering naloxone or other opioid overdose reversal medications. This number will be used 

as the baseline for this measure. Grantees also purchased 1,341 naloxone kits and prescribed drugs 

for emergency treatment of known or suspected opioid overdose 1,588 times and prescribed 

buprenorphine 7,906 times. 

In FY 2024, SAMHSA anticipates funding seven grant continuations providing training to 3,000 

individuals on prescribing opioid overdose reversal medications or devices for emergency 

treatment of known or suspected opioid overdose and intends to increase targets for professionals 

trained in prescribing opioid overdose reversal drugs in FY 2024 and 2025 to better reflect FY 

2023 actuals and will maintain baseline for numbers trained in administering naloxone or other 

opioid overdose reversal medications to assess trends. Targets may be adjusted with FY 2024 

actuals.
224 

Outputs and Outcomes Table

Program: Improving Access to Overdose Treatment (ODTA)

Measure Year and Most 

Recent Result / 

Target for Recent

Result /

(Summary of Result)

FY 2024

Target

FY 2025

Target

FY 2025

Target

+/-FY 2024

Target

5.2.1 Number of 

individuals trained 

on prescribing 

FDA-approved 

opioid overdosereversing 

medication 

(Output)

FY 2023: 4,194

Target: 

2,141.0

(Target Exceeded) 

3,000 3,000 +29%

5.2.2 Number of 

individuals trained 

in how to 

administer FDAapproved opioid 

overdose-reversing 

medication 

(Outcome)

FY 2023: 1,013

Target:

Set Baseline

(Baseline Established) 

1,013 1,013 Maintain
225 

Building Communities of Recovery (BCOR)

(Dollars in millions)

Programs of Regional and National Significance

FY 2023 

Final 

FY 2024 

CR 

FY 2025 

President's 

Budget 

FY 2025 +/- 

FY 2023

Building Communities of Recovery ............................................................ 16.000 16.000 16.000 -- 

Authorizing Legislation ............................................. Section 547 of the Public Health Service Act 

FY 2025 Authorization ..................................................................................................$50,000,000 

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

Eligible Entities ....... ..................... Independent nonprofit recovery community organizations, 

wholly or principally governed by people in recovery from substance use disorders who reflect 

the community served, that mobilize resources within and outside of the recovery community. 

Program Description 

Through shared understanding, respect, and mutual empowerment, peer services play a vital role 

in assisting individuals in achieving recovery from SUDs and co-occurring disorders (COD).

Recovery Community Organizations (RCOs) and Recovery Community Centers (RCCs) are 

central to the delivery of those services. In FY 2017, SAMHSA launched the Building 

Communities of Recovery (BCOR) grant program. The purpose of this program is to mobilize and 

connect a broad base of community-based resources to increase the prevalence and quality of longterm recovery supports for persons with SUD and/or COD. These grants are intended to support 

the development, enhancement, expansion, and delivery of recovery support services (RSS) as 

well as the promotion of and education about recovery. It is expected that these grant activities 

will be administered and implemented by individuals with lived experience who are in recovery 

from SUD and COD and reflect the needs and population of the community being served. 

Budget Request

The FY 2025 President’s Budget request is $16.0 million, flat from the FY 2023 Final level. 

SAMHSA plans to support 13 new grants and 37 continuation grants for the BCOR program. The 

funding will support ongoing coverage and integration of recovery support and social services

(including peer support) to promote access to and strengthen behavioral and physical healthcare. 

The BCOR program relies heavily on the peer support of others in recovery. Investing in peer 

recovery services bolsters a strong community of shared life experiences and a wealth of practical 

knowledge among program participants.

112 Peer support services can effectively extend the reach 

of treatment beyond the clinical setting into the everyday environment of those seeking a 

successful, sustained recovery process. With continued investment, SAMHSA is responding 

directly to concerns from the recovery community that funding is needed to provide the full range 

of recovery services. 

112 https://www.whitehouse.gov/wp-content/uploads/2022/04/2022Performance-Reporting-System.pdf
226 

Funding History Table

Fiscal Year Amount

FY 2021 $12,000,000

FY 2022 $13,000,000

FY 2023 Final $16,000,000

FY 2024 CR $16,000,000

FY 2025 President’s Budget $16,000,000

Program Accomplishments

In FY 2023, SAMHSA funded 19 new and 41 continuation BCOR grants to develop, expand, and 

enhance recovery support services. The BCOR program served 3,746 clients. Significant steps 

have been taken to increase clients’ abstinence, employment and educational opportunities, social 

connectedness, and housing stability. In FY 2023, the percentage of clients who reported that they 

did not use alcohol or illegal drugs within the past 30 days increased by 27.6 percent between 

intake to 6-month follow-up. Between intake and six-month follow-up, the percentage of clients 

who reported no arrests within the past 30 days increased by 1.6 percent. In addition, the 

percentage of clients who were employed or attending school increased by 32.3 percent. Those 

clients who reported being socially connected increased by 0.6 percent from intake to 6-month 

follow-up. Similarly, the percentage of clients who reported housing stability increased by 16.9 

percent.113

In FY 2023, BCOR grantees conducted ongoing outreach to build relationships and expand their 

Recovery Oriented Systems of Care (ROSC) to offer increased number of referrals and 

engagement for clients. Grantees prioritized many sectors and populations including underresourced communities and groups that experience high rates of overdose including but not limited 

to Black, Latino, LGBTQIA+, Rural and Veteran populations. 

 

A requirement of the BCOR grant was for grantees to prioritize lived experience, first and 

foremost, allowing recovery coaches to draw upon their insights, challenges, and lessons learned 

when working with members. In addition, most BCOR grant recipients have established a goal to 

further the development the peer recovery support workforce. As a result, hundreds of peers have 

been trained and certified to strengthen the workforce and meet the needs of this growing 

population. 

BCOR grantees also assist families and loved ones of individuals with SUD and COD by providing 

113 Source: SAMHSA’s Performance Accountability and Reporting System (SPARS). Retrieved January 16, 2024, 

from http://spars.samhsa.gov. Based on 3,746 client intakes assessments, and 984 client six-month follow-up 

reassessments. Limitations: There are several limitations to the program evaluation including (but not limited to) 

incomplete data, self-report, selection bias, and the launch of a new client-level instrument in January 2023.
227 

family coaching and connections to social services including, but not limited to, clothing 

assistance, nutritional awareness, as well as job placement. They hold family recovery meetings 

and groups to give families and loved ones dedicated time and space to discuss challenges in 

supporting loved ones with SUD and COD. BCOR grantees have established long-term 

relationships within the community and disseminate resources not only to individuals with SUD 

but to their support systems and communities as well.

In FY 2024, SAMHSA anticipates funding 19 new grants and 31 continuation BCOR grants and 

anticipates grant recipients will serve about 3,566 clients. 
228 

Outputs and Outcomes Table

Program: Building Communities for Recovery

Measure Year and Most Recent 

Result /

Target for Recent 

Result /

(Summary of Result)

FY 2024 

Target 

FY 2025 

Target 

FY 2025 

Target 

+/-FY 2024 

Target 

1.2.80 Number of 

clients receiving 

recovery services 

(Output) 

FY 2023: 3,746 

Target:

2,972 

(Target Exceeded) 

3,566 3,566 Maintain

1.2.81 Percentage of 

clients who achieved 

stable housing as a 

result of this program 

(Outcome)

FY 2023: 43.9 % 

Target:

36.4 % 

(Target Exceeded) 

41.4 % 41.4 % Maintain

1.2.82 Percentage of 

clients who enrolled 

in school or achieved 

employment as a 

result of this program 

(Outcome)

FY 2023: 62.6 % 

Target:

66.6 % 

(Target Not Met)

71.6 % 71.6 % Maintain
229 

Recovery Community Services Program

(Dollars in millions) 

Programs of Regional and National Significance

FY 2023 

Final 

FY 2024 

CR 

FY 2025 

President's 

Budget

FY 2025 +/- 

FY 2023

Recovery Community Services Program..................................................... 4.434 4.434 4.434 -- 

Authorizing Legislation ............................................. Section 509 of the Public Health Service Act 

FY 2025 Authorization ................................................................................................$521,517,000 

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

Eligible Entities .... States, political subdivisions of States, Indian Tribes and Tribal organizations 

(as such terms are defined in section 4 of the Indian Self-Determination and Education 

Assistance Act), health facilities, programs operated by or in accordance with a contract or grant 

with the Indian Health Service, and other public and nonprofit private entities 

Program Description

In 2022, 48.7 million people aged 12 or older (or 17.3 percent) had a substance use disorder (SUD) 

in the past year, including 29.5 million who had an alcohol use disorder, 27.2 million who had a 

drug use disorder, and 8.0 million people who had both an alcohol and a drug disorder.114 As public 

education increases, there is broader acknowledgement of SUDs as treatable conditions that can 

be successfully managed over the course of a lifetime with the appropriate resources. More people 

in recovery are now willing to be open about their own recovery and to share their experience to 

help others attempting to achieve recovery. Using their lived experience, individuals in recovery 

can provide support and hope to those newly seeking recovery. The Recovery Community Services 

Program (RCSP) has two components: a core RCPS program and a separate RCSP-Statewide 

Network Program. 

Recovery Community Services Program (RCSP)

The core Recovery Community Services Program (RCSP) is designed to assist recovery 

communities with strengthening their infrastructure and providing direct peer recovery support 

services (PRSS) to individuals with a SUD or co-occurring substance use and mental disorder 

(COD), including those in recovery from these disorders. The program’s foundation is the value 

of lived experience of peers to assist others in achieving and maintaining recovery. These services, 

in conjunction with clinical treatment services, are an integral component of the recovery process 

for many people. SAMHSA initiated the RCSP to help strengthen recovery communities by 

providing equitable service delivery and access to PRSS training to individuals seeking long-term 

recovery support services. 

RCSP – Statewide Network (RCSP-SN) program 

The RCSP – Statewide Network (RCSP-SN) program was established to strengthen recovery 

organizations, their statewide network of recovery stakeholders, and specialty and general 

114 https://www.samhsa.gov/data/release/2022-national-survey-drug-use-and-health-nsduh-releases#annual-nationalreport
230 

healthcare systems as key partners in the delivery of state and local recovery support services 

(RSS) through collaboration, systems improvement, public health messaging, and training 

conducted for (or with) key recovery groups. RCSP-SN grant recipients collaborate with health 

care providers who deliver SUD and/or COD treatment to emphasize the relevance and 

appropriateness of PRSS as fundamental features of the Recovery Oriented Systems of Care 

(ROSC) environment. This is achieved through enhanced participation in state and local 

government health and recovery-related activities and in other, multilevel planning, policy, and 

program development councils. 

Budget Request

The FY 2025 President’s Budget request is $4.4 million, flat from the FY 2023 Final level. 

SAMHSA plans to award five new and nine continuation RCSP grants, as well as three 

continuation RCSP-SN grants. SAMHSA anticipates that RCSP will serve 794 clients and the 

RCSP-SN program will serve 339 clients.

Funding History Table

Fiscal Year Amount

FY 2021 $2,512,107

FY 2022 $2,434,000

FY 2023 Final $4,434,000

FY 2024 CR $4,434,000

FY 2025 President’s Budget $4,434,000

Program Accomplishments

In FY 2023, SAMHSA funded four new grants and eight RCSP continuation grants and three new 

RCSP-SN grants. The RCSP program served 794 clients. Significant steps have been taken to 

increase clients’ abstinence, employment and educational opportunities, social connectedness, and 

housing stability. In FY 2023, the percentage of clients who reported that they did not use alcohol 

or illegal drugs within the past 30 days increased by 42.4 percent between intake to 6-month 

follow-up. Those clients who reported being socially connected increased by 6.5 percent from 

intake to 6-month follow-up. Similarly, the percentage of clients who reported housing stability 

increased by 42.3 percent.115

In FY 2023, grant recipients continued to expand recovery support service delivery to include 

recovery support groups, resource referrals and linkages to care, supportive employment and 

115 Source: SAMHSA’s Performance Accountability and Reporting System (SPARS). Retrieved January 16, 2024, 

from http://spars.samhsa.gov. Based on 794 client intakes assessments, and 209 client six-month follow-up 

reassessments. Limitations: There are several limitations to the program evaluation including (but not limited to) 

incomplete data, self-report, selection bias, and the launch of a new client-level instrument in January 2023
231 

housing, transportation assistance and sponsoring community wide recovery events. Grantees are 

also enhancing service delivery by hiring recovery coaches from diverse backgrounds such as 

coaches who identify as gender nonconforming, Native American, bilingual, and/or reflect the 

populations of focus. RCSP grant funds have also supported overdose and naloxone trainings to 

staff, peers, and community members. In efforts to bolster the recovery workforce, several RCSP 

recipients have offered training, such as peer recovery coaching, certified peer counselor, and 

certified peer recovery specialist classes. 

RCSP-SN recipients have created networks and partnerships with recovery organizations, 

community-based organizations, and payers to provide trainings to improve access in communities 

of greatest need. Approaches and activities include conducting needs assessments, partnering with 

technical assistance providers, and providing recovery-oriented Training and Technical Assistance 

(TTA) to infectious disease and harm reduction organizations. Grantees report ongoing challenges 

that have impacted their RCSP programs which include rising opioid-related overdose deaths, and 

shortages of residential treatment services. Despite these barriers, grantees continue to increase 

their network of partners and successfully enroll individuals into their recovery support services.

In FY 2024, SAMHSA plans to fund 11 continuation RCSP grants and three continuation RCSPSN grants. SAMHSA started supporting the RCSP-SN program again in FY 2023. SAMHSA 

anticipates that RCSP will serve 794 clients and the RCSP-SN program will serve 339 clients. 
232 

Outputs and Outcomes Table

Program: Recovery Community Services Program

Measure Year and Most Recent 

Result /

Target for Recent 

Result /

(Summary of Result)

FY 2024 

Target 

FY 2025 

Target 

FY 2025 

Target 

+/-FY 2024 

Target 

3.4.26 Number of 

clients served 

(Output) 

FY 2023: 794 

Target:

794 

(Baseline)

794 794 Maintain

3.4.27 Number of 

clients receiving 

recovery services 

(Output) 

FY 2023: 339 

Target:

339 

(Baseline)

339 339 Maintain

 
233 

Children and Families

(Dollars in millions) 

Programs of Regional and National Significance

FY 2023 

Final 

FY 2024 

CR 

FY 2025 

President's 

Budget 

FY 2025 +/- 

FY 2023

Children and Families.................................................................................. 30.197 30.197 30.197 -- 

Authorizing Legislation ............................................. Section 514 of the Public Health Service Act 

FY 2025 Authorization ..................................................................................................$29,605,000 

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

Eligible Entities ....................................................................... Public and private nonprofit entities, 

Indian Tribes and Tribal organizations (as such terms are defined in section 4 of the Indian SelfDetermination and Education Assistance Act), and health facilities or programs operated by or in 

accordance with a contract or grant with the Indian Health Service

Program Description

 

SAMHSA’s Children and Families programs in the substance use disorder (SUD) treatment area 

support youth-friendly treatment initiatives to further the use of and access to evidence-based 

family-focused models for youth with alcohol use disorder and other SUDs. In addition, programs 

support training across participating states and collaboration between local community-based 

providers and their state, tribal, or territorial infrastructure. The services provided include 

evidence-based assessment, treatment, prevention, recovery supports, public health-focused harm 

reduction interventions, and medication for opioid use disorder appropriate for adolescents and 

young adults. This Children and Families program area supports the Enhancement and Expansion 

of Treatment and Recovery Services for Adolescents, Transitional Aged Youth, and their Families 

(YFTREE) grant and the National Center on Substance Abuse and Child Welfare (NCSACW) 

contract. 

Enhancement and Expansion of Treatment and Recovery Services for Adolescents, Transitional 

Aged Youth, and their Families (YFTREE) 

The YFTREE program enhances and expands comprehensive outpatient-based treatment, early 

intervention, and recovery support services for adolescents (ages 12-18) and transitional-aged 

youth (ages 16-25) with SUD and those with COD and their families/primary caregivers. The 

services include screening, assessment, treatment, and wraparound services in ambulatory settings. 

YFTREE programs have strengthened their partnership, collaboration, and presence at local 

middle and high schools, hospital emergency rooms, community events, and the Sheriff's 

Department, hosting educational workshops on the dangers of fentanyl and promoting the use of 

naloxone. YFTREE staff are distributing naloxone and informing students, families, and the 

community of the risks of drug use, the signs and physical effects, as well as the mental and 

emotional impact. State legalization of cannabis use continues to present challenges among the 

YFTREE population. Results of the 2022 National Survey on Drug Use and Health show the 

percentage of marijuana vaping in the past month among current marijuana users was highest 

among adolescents aged 12 to 17 (54.9 percent). Additionally, the results noted 1.8 million 

adolescents aged 12 to 17 in 2022 had an SUD in the past year. 
234 

SAMHSA continues to elevate outreach activities in settings where youth seek services coupled 

with the implementation of evidence-based practices, integration of MOUD for youth, appropriate 

intervention with COD, contingency management, and public health-focused harm reduction 

intervention to counter barriers to engagement and retention of adolescents, youth adults, and 

families in treatment. This has included adolescent substance use disorder treatment convenings 

with grantees, young people with lived experience, and national subject matter experts to further 

focus on strategies for improving and strengthening youth and young adult SUD treatment 

systems.

 

National Center on Substance Abuse and Child Welfare (NCSACW) 

SAMHSA and the Administration for Children and Families (ACF) collaborate to support the 

NCSACW contract. NCSACW provides training and technical assistance to improve collaborative 

practices among agencies and organizations that serve families affected by SUD and are involved 

with child welfare services.

Budget Request

The FY 2025 President’s Budget request is $30.2 million, level with the FY 2023 Final level. 

SAMHSA plans to fund 53 continuation YFTREE grants, estimated to serve 1,740 people. 

Funding History Table

Fiscal Year Amount

FY 2021 $29,605,000

FY 2022 $29,605,000

FY 2023 Final $30,197,000

FY 2024 CR $30,197,000

FY 2025 President’s Budget $30,197,000

Program Accomplishments

In FY 2023, SAMHSA funded 35 new and 19 continuation YFTREE grants. In FY 2023, the 

Children and Families program had a target to serve 1,740 youth. The YTREE program served 

2,731 clients. Significant steps have been taken to increase clients’ abstinence, employment and 

educational opportunities, social connectedness, and housing stability. In FY 2023, the percentage 

of clients who reported that they did not use alcohol or illegal drugs within the past 30 days 

increased by 64.9 percent between intake to 6-month follow-up. Between intake and six-month 

follow-up, the percentage of clients who reported no arrests within the past 30 days increased by 

4.7 percent. In addition, the percentage of clients who were employed or attending school 

increased by 2.6 percent. Those clients who reported being socially connected increased by 8.5 

percent from intake to 6-month follow-up. Similarly, the percentage of clients who reported 
235 

housing stability increased by 0.7 percent.116

In FY 2024, SAMHSA will fund 53 continuation YFTREE grants and will serve approximately 

1,740 clients 

 

116 Source: SAMHSA’s Performance Accountability and Reporting System (SPARS). Retrieved January 16, 2024, 

from http://spars.samhsa.gov. Based on 2,731 client intakes assessments, and 829 client six-month follow-up 

reassessments. Limitations: There are several limitations to the program evaluation including (but not limited to) 

incomplete data, self-report, selection bias, and the launch of a new client-level instrument in January 2023 
236 

Outputs and Outcomes Table

Program: Enhancement and Expansion of Treatment and Recovery for Adolescents, 

Transitional Aged Youth, and their Families

Measure Year and Most Recent 

Result /

Target for Recent 

Result /

(Summary of Result)

FY 2024 

Target 

FY 2025 

Target 

FY 2025 

Target 

+/-FY 2024 

Target 

2.00.2 Percentage of 

clients receiving 

services who had no 

past substance use 

(Outcome)

FY 2023: 79.6 % 

Target:

63 % 

(Target Exceeded) 

64 % 64 % Maintain

2.00.3 Number of 

clients served 

(Output) 

FY 2023: 2,731 

Target:

1,723 

(Target Exceeded) 

1,740 1,740 Maintain

2.00.4 Percentage of 

clients receiving 

services who were 

currently employed 

or engaged in 

productive activities 

(Outcome)

FY 2023: 85.6 % 

Target:

80 % 

(Target Exceeded) 

81 % 81 % Maintain

2.00.5 Percentage of 

clients receiving 

services who had a 

permanent place to 

live in the 

community 

(Outcome)

FY 2023: 74.9 % 

Target:

65 % 

(Target Exceeded) 

66 % 66 % Maintain
237 

Treatment Systems for Homeless

(Dollars in millions) 

Programs of Regional and National Significance

FY 2023 

Final 

FY2 024 

CR 

FY 2025 

President's 

Budget

FY 2025 +/- 

FY 2023 

Treatment Systems for Homeless................................... 37.114 37.114 37.114 -- 

Authorizing Legislation ............................................. Section 506 of the Public Health Service Act 

FY 2025 Authorization ..................................................................................................$41,304,000 

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

Eligible Entities ...................................................................... Community-based public and private 

nonprofit entities

Program Description

On a single night in January 2023, 653,104 people were experiencing homelessness in the United 

States. Of these, 154,313 were experiencing chronic homelessness, 137,076 had severe mental 

illness, 108,035 were affected by chronic substance use, and 35,574 were veterans.117 Many 

factors contribute to the problem of homelessness, including lack of affordable housing, 

foreclosures, rising housing costs, job loss, underemployment, mental illness, and alcohol and 

other drug misuse and use disorders. The U.S. Interagency Council on Homelessness, in which 

HHS participates, has set aggressive goals to prevent and end homelessness, including reducing 

homelessness by 25 percent by January 2025. The strategic plan is built around three foundational 

pillars—equity, data, and collaboration—and three solution pillars—housing and supports, 

homelessness response, and prevention. 

SAMHSA’s Treatment Systems for Homeless portfolio, that includes programs from across the 

agency, supports services for those with substance use disorders, mental illness, or co-occurring 

mental and substance use disorders who are experiencing homelessness, including youth, veterans, 

and families. The services and support offered through SAMHSA’s Treatment Systems for 

Homeless programs are crucial to achieving U.S. Interagency Council on Homelessness’s goals. 

The Grants for the Benefit of Homeless Individuals (GBHI) program managed in CSUS supports 

the development and/or expansion of local implementation of a community infrastructure that 

integrates treatment and recovery support services for SUDs or CODs, permanent housing, and 

other critical services for individuals (including youth) and families experiencing homelessness. 

Budget Request

The FY 2025 President’s Budget request is $37.1 million, equal to the FY 2023 Final level. 

SAMHSA intends to fund 11 new and 62 continuation GBHI grants with a target to serve 4,600

people. 

117 U.S. Department of Housing and Urban Development (HUD) 2023 Continuum of Care (CoC) Homeless 

Assistance Programs Homeless Populations and Subpopulations Report – Retrieve from 

https://files.hudexchange.info/reports/published/CoC_PopSub_NatlTerrDC_2023.pdf
238 

Funding History Table

Fiscal Year Amount

FY 2021 $36,386,000

FY 2022 $36,386,000

FY 2023 Final $37,114,000

FY 2024 CR $37,114,000

FY 2025 President’s Budget $37,114,000

Program Accomplishments

In FY 2023, the GBHI program served 3,748 clients. Significant steps have been taken to increase 

clients’ abstinence, employment and educational opportunities, social connectedness, and housing 

stability. In FY 2023, the percentage of clients who reported that they did not use alcohol or illegal 

drugs within the past 30 days increased by 23.6 percent between intake to 6-month follow-up. 

Between intake and six-month follow-up, the percentage of clients who reported no arrests within 

the past 30 days increased by 1.8 percent. In addition, the percentage of clients who were employed 

or attending school increased by 52.1 percent. Those clients who reported being socially connected 

increased by 4.6 percent from intake to 6-month follow-up. Similarly, the percentage of clients 

who reported housing stability increased by 219.8 percent.118

In FY 2023, SAMHSA funded 31 new grants and 51 continuation GBHI grants. During this year, 

the program achieved positive client outcomes, improved mental health outcomes, and reduced 

drug use outcomes. Strategies utilized by the program included the following: (1) Engaging and 

connecting the population of focus to behavioral health treatment, public health-focused harm 

reduction services, case management, and recovery support services; (2) Assisting with identifying 

sustainable permanent housing by collaborating with homeless services organizations and housing 

providers, including public housing agencies; and (3) Providing case management that includes 

care coordination/service delivery planning and other strategies that support stability across 

services and housing transitions. Challenges, though, continue as service providers are 

experiencing difficulty with hiring qualified staff and the lack of stable housing options in 

communities. For enrolled clients, the program utilizes a combination of in-person and virtual 

service provision to maintain contact with clients and provide services.

In FY 2024, SAMHSA anticipates funding 14 new grants and 61 continuation GBHI grants. The 

program anticipates serving 4,083 clients during this period. 

118 Source: SAMHSA’s Performance Accountability and Reporting System (SPARS). Retrieved January 16, 2024, 

from http://spars.samhsa.gov. Based on 3,748 client intakes assessments, and 1,233 client six-month follow-up 

reassessments. Limitations: There are several limitations to the program evaluation including (but not limited to) 

incomplete data, self-report, selection bias, and the launch of a new client-level instrument in January 2023. 
239 

Outputs and Outcomes Table

Program: Treatment System for Homelessness (GBHI)

Measure Year and Most Recent 

Result /

Target for Recent 

Result /

(Summary of Result)

FY 2024 

Target 

FY 2025 

Target 

FY 2025 

Target 

+/-FY 2024 

Target 

3.4.23 The number of 

clients served 

(Output) 

FY 2023: 3,748 

Target:

4,043 

(Target Not Met)

4,083 4,083 Maintain

3.4.24 Percentage of 

homeless clients 

receiving services 

who were currently 

employed or engaged 

in productive 

activities (Outcome)

FY 2023: 40.8 % 

Target:

36.9 % 

(Target Exceeded) 

37.9 % 37.9 % Maintain

3.4.25 Percentage of 

clients receiving 

services who had a 

permanent place to 

live in the 

community 

(Outcome)

FY 2023: 29.1% 

Target:

41.9 % 

(Target Not Met)

42.9 % 42.9 % Maintain
240 

Criminal Justice Activities

(Dollars in millions) 

Programs of Regional and National Significance

FY 2023 

Final 

FY 2024 

CR 

FY 2025 

President's 

Budget 

FY 2025 +/- 

FY 2023

Criminal Justice Activities........................................................................... 94.000 94.000 94.000 -- 

Other Criminal Justice Activities (non-add)............................................ 20.000 20.000 20.000 -- 

Drug Court Activities (non-add).............................................................. 74.000 74.000 74.000 -- 

Authorizing Legislation ................................................... Section 509 of the Public Health Service 

FY 2025 Authorization ................................................................................................$521,517,000 

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

Eligible Entities . ...States, political subdivisions of States, Indian Tribes and Tribal organizations 

(as such terms are defined in section 4 of the Indian Self-Determination and Education 

Assistance Act), health facilities, programs operated by or in accordance with a contract or grant 

with the Indian Health Service, and other public and nonprofit private entities

Program Description

The criminal justice system is a major source of referrals to substance use disorder treatment, with 

probation or parole referrals representing the largest proportion of criminal justice system referrals 

to treatment.119 Most probation or parole referrals to treatment are men between the ages of 18 and 

44. The most commonly used substances reported by these individuals are alcohol, marijuana, and 

methamphetamine.120 

SAMHSA’s Criminal Justice Activities portfolio includes several grant programs that focus on 

diversion, alternatives to incarceration, drug courts, and re-entry from incarceration for adolescents 

and adults with alcohol and other drug use disorders and/or COD. This program supports the Adult 

Treatment Drug Court (ATDC), Family Treatment Drug Court (FTDC), Tribal Wellness Court 

and the Adult Reentry (AR Program). 

Drug Court Programs 

Estimates of substance use disorders among prison and jail populations range from 53 to 68 

percent, in stark contrast to approximately 14.5 percent among people 12 years and older in the 

general public121. Similar trends exist among those with co-occurring mental and substance use 

disorders – 33 to 60percent of those in prison and jail have co-occurring disorders compared to 14 

119 Substance use And Mental Health Services Administration, Center for Behavioral Health Statistics and Quality. 

Treatment Episode Data Set (TEDS): 2005-2015. National Admissions to Substance Abuse Treatment Services. 

BHSIS Series S-91, HHS Publication No. (SMA) 17-5037. Rockville, MD: Substance Abuse and Mental Health 

Services Administration, 2017.

120 SAMHSA. (2022). Criminal and Juvenile Justice. Retrieved from https://www.samhsa.gov/criminal-juvenilejustice

121https://store.samhsa.gov/product/guidelines-successful-transition-people-mental-or-substance-use-disorders-jailand-prison
241 

to 25 percent of those not incarcerated.122 Individuals with an opioid use disorder are at 

significantly increased risk for recurrence, overdose, and death upon leaving incarceration 

compared with their community-dwelling peers and the general population.123

Drug courts are designed to combine the sanctioning power of courts with effective treatment 

services for a range of populations with circumstances that have put them in contact with the 

criminal justice system. This could be circumstances related to alcohol and/or other drug use and/or 

mental illness. Drug courts represent the coordinated efforts of the judiciary, prosecution, defense 

bar, probation, law enforcement, mental health, social service, and substance use disorder 

treatment communities to intervene and break the cycle of substance use disorder and crime. 

SAMHSA’s Adult Treatment Drug Court (ATDC) programs support a variety of services 

including direct treatment services for diverse populations, wraparound, and recovery support 

services such as recovery housing and peer recovery support services designed to improve access 

to and retention in care, drug test monitoring for illicit substances, educational support, relapse 

prevention , and HIV and viral hepatitis B and C testing and/or referral, conducted in accordance 

with state and local requirements. 

The Family Treatment Drug Court (FTDC) program expands SUD treatment services in existing 

family treatment drug courts, which use the family treatment drug court model in order to provide 

alcohol and drug treatment as well as recovery support services, case management, and service 

coordination, to parents with a SUD and/or COD, who have had a dependency petition filed against 

them or are at risk of such filing. 

SAMHSA’s drug court grant recipients are encouraged to use part of their annual award to support 

the provision of MOUD and are required to ensure that drug courts funded by SAMHSA not deny 

the use of FDA-approved medications for OUD by drug court clients. SAMHSA requires the use 

of evidence-based practices from federal resource access points. SAMHSA also has regular 

communications with All RISE (formerly the National Association of Drug Court Professionals) 

to obtain and incorporate the latest findings and field expertise. 

Adult Reentry Program

Over 10,000 individuals are released from America’s state and federal prisons every week and 

arrive on the doorsteps of our nation's communities. More than 650,000 individuals are released 

from prison every year, and studies show that approximately two-thirds will likely be rearrested 

within three years of release.124 People returning to their communities from incarceration often 

face a variety of challenges. Often, when individuals are released, they face several critical barriers 

to successful reentry that they will need to overcome. Some have substance use issues, others have 

122 https://store.samhsa.gov/product/guidelines-successful-transition-people-mental-or-substance-use-disorders-jailand-prison 123 James, D. J., & Glaze, L. E. (2006). Highlights mental health problems of prison and jail inmates. Retrieved from 

https://bjs.ojp.gov/library/publications/mental-health-problems-prison-and-jail-inmates 124 Prisons and Prisoners Re-Entry (n.d.). Retrieved September 6, 2022, from USDOJ: E Interact website: USDOJ: 

FBCI: Prisoners and Prisoner Re-Entry (justice.gov)
242 

no place to live, and a criminal record makes it difficult for many to find a job.125 The 

communities to which they are returning are often impoverished and disenfranchised 

neighborhoods with few social supports and persistently high crime rates with limited resources to 

adequately support their returning residents. For many individuals, it is only a matter of time before 

they return to prison. According to the Bureau of Justice Statistics, 68 percent of state prisoners 

are rearrested within three years of their release.126 Studies show that only about 10 percent of 

individuals involved with the criminal justice system who are in need of substance use disorder 

treatment receive it as part of their justice system supervision. Approximately one-half of the 

institutional treatment provided is educational programming.127 SAMHSA’s Adult Reentry 

Program (AR Program) grants provide screening, assessment, comprehensive treatment, and 

recovery support services for diverse populations reentering the community from incarceration. 

Other supported services include wraparound and recovery support services, such as recovery 

housing and peer recovery support, designed to improve access to and retention in care, drug test 

monitoring for illicit substances, educational support, relapse prevention, and HIV and viral 

hepatitis B and C testing and/or referral, conducted in accordance with state and local 

requirements. SAMHSA’s AR Program grant recipients are encouraged to use part of their annual 

award to provide MOUD treatment with FDA-approved medications. 

Budget Request

The FY 2025 President’s Budget request is $94.0 million, flat from the FY 2023 Final level. 

SAMHSA plans to support 170 drug court continuation grants, 38 AR continuation and six new 

AR grants, and one contract. At least one award will be made to tribes/tribal organizations, and at 

least eight will be made to FTDCs, pending sufficient application volume from these groups. 

SAMHSA expects these programs will serve approximately 7,787 people in FY 2025. 

Funding History Table

Fiscal Year Amount

FY 2021 $65,570,000

FY 2022 $89,000,000

FY 2023 Final $94,000,000

FY 2024 CR $94,000,000

FY 2025 President’s Budget $94,000,000

125 Blair Ames, “NIJ-Funded Research Examines What Works for Successful Reentry,” NIJ Journal 281, November 

2019, https://nij.ojp.gov/topics/articles/nij-funded-research-examines-what-works-successful-reentry 126 Mariel Alper, Matthew R. Durose, and Joshua Markman, 2018 Update on Prisoner Recidivism: A 9-Year 

Follow-up Period (2005-2014), Special Report, Washington, DC: U.S. Department of Justice, Bureau of Justice 

Statistics, May 2018, NCJ 250975, https://bjs.ojp.gov/content/pub/pdf/18upr9yfup0514.pdf 127 Taxman FS, Perdoni ML, Harrison LD. (2007). Drug treatment services for adult offenders: The state of the 

state. Journal of Substance Abuse Treatment 32(3), 239-254. 
243 

Program Accomplishments

The Criminal Justice Activities portfolio has seen significant improvements across a variety of 

outcome measures, including alcohol/drug use, criminal justice involvement, employment/school 

attendance, and housing stability. 

Drug Court Program 

In FY 2023, SAMHSA funded 93 new and 97 continuation Drug Court grants. The ATDC and 

FTDC programs collectively served 7,059 clients. 

In FY 2023, the ATDC program served 6,222 clients. Significant steps have been taken to increase 

clients’ abstinence, employment and educational opportunities, social connectedness, and housing 

stability. In FY 2023, the percentage of clients who reported that they did not use alcohol or illegal 

drugs within the past 30 days increased by 30.7 percent between intake to 6-month followup. Between intake and six-month follow-up, the percentage of clients who reported no arrests 

within the past 30 days increased by 7.4 percent. In addition, the percentage of clients who were 

employed or attending school increased by 52.7 percent. Those clients who reported being socially 

connected increased by 8.1 percent from intake to 6-month follow-up. Similarly, the percentage 

of clients who reported housing stability increased by 30.8 percent.128

In FY 2023 the FTDC program served 837 clients. Significant steps have been taken to increase 

clients’ abstinence, employment and educational opportunities, social connectedness, and housing 

stability. In FY 2023, the percentage of clients who reported that they did not use alcohol or illegal 

drugs within the past 30 days increased by 49.4 percent between intake to 6-month followup. Between intake and six-month follow-up, the percentage of clients who reported no arrests 

within the past 30 days increased by 7.2 percent. In addition, the percentage of clients who were 

employed or attending school increased by 35.6 percent. Those clients who reported being socially 

connected increased by 5.1 percent from intake to 6-month follow-up. Similarly, the percentage 

of clients who reported housing stability increased by 27.7 percent.129

Adult Reentry Program

In FY 2023, SAMHSA funded 34 new and 12 continuation AR Program grants. The AR program 

served 2,270 clients. Significant steps have been taken to increase clients’ abstinence, 

employment and educational opportunities, social connectedness, and housing stability. In FY 

2023, the percentage of clients who reported that they did not use alcohol or illegal drugs within 

the past 30 days increased by 113.4 percent between intake to 6-month follow-up. Between intake 

128 Source: SAMHSA’s Performance Accountability and Reporting System (SPARS). Retrieved January 16, 2024, 

from http://spars.samhsa.gov. Based on 6,222 client intakes assessments, and 1,936 client six-month follow-up 

reassessments. Limitations: There are several limitations to the program evaluation including (but not limited to) 

incomplete data, self-report, selection bias, and the launch of a new client-level instrument in January 2023. 129Source: SAMHSA’s Performance Accountability and Reporting System (SPARS). Retrieved January 16, 2024, 

from http://spars.samhsa.gov. Based on 837 client intakes assessments, and 302 client six-month follow-up 

reassessments. Limitations: There are several limitations to the program evaluation including (but not limited to) 

incomplete data, self-report, selection bias, and the launch of a new client-level instrument in January 2023.

 
244 

and six-month follow-up, the percentage of clients who reported no arrests within the past 30 days 

increased by 13.5 percent. In addition, the percentage of clients who were employed or attending 

school increased by 223.5 percent. Those clients who reported being socially connected increased 

by 5.1 percent from intake to 6-month follow-up. Similarly, the percentage of clients who reported 

housing stability increased by 113.7 percent.130

In FY 2024, SAMHSA anticipates funding 57 new and 117 continuation Drug Court grants and 

one contract, and four new and 44 continuation AR Program grants. The programs are expected 

to serve about 7,787 clients. 

130 Source: SAMHSA’s Performance Accountability and Reporting System (SPARS). Retrieved January 16, 2024, 

from http://spars.samhsa.gov. Based on 2,270 client intakes assessments, and 746 client six-month follow-up 

reassessments. Limitations: There are several limitations to the program evaluation including (but not limited to) 

incomplete data, self-report, selection bias, and the launch of a new client-level instrument in January 2023.
245 

Outputs and Outcomes Table

Program: Criminal Justice – Drug Courts

Measure Year and Most Recent 

Result /

Target for Recent 

Result /

(Summary of Result)

FY 2024 

Target 

FY 2025 

Target 

FY 2025 

Target 

+/-FY 2024 

Target 

1.2.72 Percentage of 

adult clients 

receiving services 

who were currently 

employed or engaged 

in productive 

activities (Outcome)

FY 2023: 64.5 % 

Target:

62.4 % 

(Target Exceeded) 

67.4 % 67.4 % Maintain

1.2.73 Percentage of 

adult clients 

receiving services 

who had a permanent 

place to live in the 

community 

(Outcome)

FY 2023: 45.9 % 

Target:

49 % 

(Target Not Met)

54 % 54 % Maintain

1.2.76 Percentage of 

adult clients 

receiving services 

who had no past 

month substance use 

(Outcome)

FY 2023: 89.1 % 

Target:

84.9 % 

(Target Exceeded) 

86.9 % 86.9 % Maintain

1.2.79 Number of 

adult clients served 

(Output) 

FY 2023: 7,056 

Target:

6,489 

(Target Exceeded) 

7,787 7,787 Maintain

1.2.80 Percent of 

clients who report 

criminal justice 

FY 2023: 86.6 

Target:

86.6 86.6 Maintain
246 

Measure Year and Most Recent 

Result /

Target for Recent 

Result /

(Summary of Result)

FY 2024 

Target 

FY 2025 

Target 

FY 2025 

Target 

+/-FY 2024 

Target 

involvement at 

baseline who report 

no criminal justice 

involvement at sixmonth follow-up. 

(Output) 

86.6

(Baseline)
247 

Program: Criminal Justice – Adult Reentry Program

Measure Year and Most Recent 

Result /

Target for Recent 

Result /

(Summary of Result)

FY 2024 

Target 

FY 2025 

Target 

FY 2025 

Target 

+/-FY 2024 

Target 

1.2.80 Number of 

clients served 

(Outcome)

FY 2023: 2,270 

Target:

2,130 

(Target Exceeded) 

2,151 2,151 Maintain

1.2.81 Percentage of 

clients who had no 

past month substance 

use (Outcome)

FY 2023: 84.9 % 

Target:

80.2 % 

(Target Exceeded) 

81.2 % 81.2 % Maintain

1.2.84 Percentage of 

clients receiving 

services who had no 

involvement with the 

criminal justice 

system (Outcome)

FY 2023: 94.2 % 

Target:

97.1 % 

(Target Not Met)

98.1 % 98.1 % Maintain
248 

Minority AIDS Initiative

(Dollars in millions) 

Programs of Regional and National Significance

FY 2023 

Final 

FY 2024 

CR 

FY 2025 

President’s 

Budget

FY 2025 +/- 

FY 2023

Minority AIDS .......................................................................................... 66.881 66.881 66.881 -- 

Authorizing Legislation.................................Section 509 of the Public Health Service Act 

FY 2024 Authorization ................................................................................................$521,517,000 

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

Eligible Entities .... States, political subdivisions of States, Indian Tribes and Tribal organizations 

(as such terms are defined in section 4 of the Indian Self-Determination and Education 

Assistance Act), health facilities, programs operated by or in accordance with a contract or grant 

with the Indian Health Service, and other public and nonprofit private entities 

Program Description

The purpose of the Minority AIDS Initiative – High Risk Populations Program (MAI-HRP) is to 

increase engagement in care for racial and ethnic medically underserved individuals with SUDs 

and/or COD who are at risk for or living with HIV. There is a strong link between SUD, HIV and 

viral hepatitis, particularly Hepatitis C (HCV). About one in ten new HIV infections in the United 

States are related to injection drug use,131 but drinking alcohol and ingesting, smoking, or inhaling 

drugs are also associated with increased risk for HIV.132 Injection drug use is the most common 

method of transmission for HCV in the United States,133 and there have been increases in new 

cases of HCV in the United States since 2013.134 For that reason, the MAI-HRP grant program 

takes a syndemic approach to SUD, HIV, and viral hepatitis by providing SUD treatment to 

medically underserved racial and ethnic individuals at risk for or living with HIV and viral 

hepatitis. To do so, the program incorporates the goals, objectives, and strategies highlighted in 

the National HIV/AIDS Strategy (NHAS) for the United States (2022 - 2025),135 and is in 

alignment with SAMHSA’s commitments in the NHAS Federal Implementation Plan (FIP).136 It 

also incorporates goals and objectives laid out in the Viral Hepatitis National Strategic Plan137 and 

incorporates the pillars of the Ending the HIV Epidemic in the U.S. (EHE) Initiative.138 

Budget Request

The FY 2025 President’s Budget request is $66.9 million, equal to the FY 2023 Final level. 

SAMHSA plans to fund 124 MAI-HRP continuation grants and will serve approximately 10,185 

people. 

131 https://www.cdc.gov/hiv/basics/hiv-transmission/injection-drug-use.html 132 https://www.cdc.gov/hiv/basics/hiv-transmission/substance-use.html 133 https://www.cdc.gov/mmwr/volumes/69/rr/rr6902a1.htm 134 https://www.cdc.gov/hepatitis/policy/npr/2023/nationalprogressreport-hepc-reduceinfections.htm 135 https://www.hiv.gov/federal-response/national-hiv-aids-strategy/national-hiv-aids-strategy-2022-2025/ 136 https://files.hiv.gov/s3fs-public/2022-09/NHAS_Federal_Implementation_Plan.pdf 137 https://www.hhs.gov/sites/default/files/Viral-Hepatitis-National-Strategic-Plan-2021-2025.pdf 138 https://www.cdc.gov/endhiv/index.html
249 

Funding History Table

Fiscal Year Amount

FY 2021 $65,570,000

FY 2022 $65,570,000

FY 2023 Final $66,881,000

FY 2024 CR $66,881,000

FY 2025 President’s Budget $66,881,000

Program Accomplishments

Emerging from the COVID-19 pandemic, grant recipients have continued to serve the public by 

implementing evidence-based practices (EBP) while offering increased flexibilities, including the 

use of telehealth and the ability to receive home-based HIV and hepatitis C self-test kits. Grant 

recipients provide comprehensive whole-person care through creative social media marketing, 

strong partnerships, continuous community outreach and updated internal processes to engage 

clients. 

In FY 2023, SAMHSA funded 44 new and 85 continuation MAI-HRP grants. The MAI -HR 

program served 10,354 clients. Significant steps have been taken to increase clients’ abstinence, 

employment and educational opportunities, social connectedness, and housing stability. In FY 

2023, the percentage of clients who reported that they did not use alcohol or illegal drugs within 

the past 30 days increased by 80.2 percent between intake to 6-month follow-up. Between intake 

and six-month follow-up, the percentage of clients who reported no arrests within the past 30 days 

increased by 1.7 percent. In addition, the percentage of clients who were employed or attending 

school increased by 30.8 percent. Those clients who reported being socially connected increased 

by 8.8 percent from intake to 6-month follow-up. Similarly, the percentage of clients who reported 

housing stability increased by 4.4 percent.139

In FY 2024, SAMHSA anticipates funding 19 new and 105 continuation MAI-HRP grants.

SAMHSA anticipates that the MAI-HRP grants will serve 10,185 clients in FY 2024. 

139 Source: SAMHSA’s Performance Accountability and Reporting System (SPARS). Retrieved January 16, 2024, 

from http://spars.samhsa.gov. Based on 10,354 client intakes assessments, and 3,166 client six-month follow-up 

reassessments. Limitations: There are several limitations to the program evaluation including (but not limited to) 

incomplete data, self-report, selection bias, and the launch of a new client-level instrument in January 2023
250 

Outputs and Outcomes Table

Program: Treatment: Minority AIDS Initiative- Targeted Capacity Expansion-HIV

Measure Year and Most Recent 

Result /

Target for Recent Result /

(Summary of Result)

FY 2024

Target

FY 2025

Target

FY 2025

Target

+/-FY 2024

Target

2.1.11 Percentage of 

adults receiving services 

who had no past month 

substance use at 6-month 

follow-up (Outcome)

FY 2023: 64.3 %

Target:

51.1 %

(Target Exceeded)

52.1 % 52.1 % Maintain

2.1.12 Number of clients 

served (Output)

FY 2023: 10,354

Target:

10,084

(Target Exceeded)

10,185 10,185 Maintain

2.1.13 Percentage of 

adults receiving services 

who were currently 

employed or engaged in 

productive activities at 6-

month follow-up 

(Outcome)

FY 2023: 59.8 %

Target:

56.4 %

(Target Exceeded) 

57.4 % 57.4 % Maintain

2.1.14 Percentage of 

adults receiving services 

who had a permanent 

place to live in the 

community at 6-month 

follow-up (Outcome)

FY 2023: 52.2 %

Target:

56.6 %

(Target Not Met)

57.6 % 57.6 % Maintain
251 

Minority Fellowship Program 

(Dollars in millions) 

Programs of Regional and National Significance

FY 2023 

Final 

FY 2024 

CR 

FY 2025 

President's 

Budget

FY 2025 +/- 

FY 2023

SAT Minority Fellowship Program ............................................................. 7.136 7.136 7.136 -- 

Authorizing Legislation ............................................. Section 597 of the Public Health Service Act 

FY 2025 Authorization ..................................................................................................$25,000,000 

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

Eligible Entities ..... Organizations that represent individuals obtaining post-baccalaureate training 

(including for master’s and doctoral degrees) for mental and SUD treatment 

professionals, including in the fields of psychiatry, addiction medicine, nursing, social work, 

psychology, marriage and family therapy, mental health counseling, and SUD and addiction 

counseling 

Program Description

The MFP program aims to increase the knowledge of mental and/or substance use disorder 

behavioral health professionals on issues related to prevention, treatment, and recovery support 

and harm reduction for individuals from racial and ethnic minority populations who have a mental 

or substance use disorder. Additionally, the program aims to increase the number of culturally 

competent mental and substance use disorders professionals who teach, administer services, 

conduct research, and provide direct mental and/or substance use disorder services to racial and 

ethnic minority populations. Lastly, the program aims to improve the quality of mental and 

substance use disorder prevention and treatment services delivered to racial and ethnic minority 

populations. 

The program provides stipends to increase the number of culturally competent behavioral health 

professionals who teach, administer, conduct services research, and provide direct mental illness 

or substance use disorder treatment services for minority populations that are underserved. Since 

its start in 1973, the program has helped to enhance services for racial and ethnic minority 

communities through specialized training of mental health professionals in psychiatry, nursing, 

social work, marriage and family therapy, mental health counseling, psychology, substance 

use/addiction counseling, marriage and family therapists and professional counselors. This 

program is jointly administered by the CSUS, CSUP, and CMHS. 

The jointly funded MFP program supports fellowships for hundreds of students as well as supports 

additional training through webinars on culturally appropriate services to thousands of students. 

Budget Request

The FY 2025 President’s Budget request is $7.1 million, equal to the FY 2023 Final level. These 

funds, in combination with $11.0 million in the Mental Health appropriation and $1.3 million in 

the Substance Use Prevention appropriation, will support eight continuation grants and one 
252 

contract. The budget request will continue to support 428 fellows. As a braided activity, this 

funding in fellows will directly address the significant treatment gap across the care continuum 

and the workforce shortage in disenfranchised and minority populations. In addition, SAMHSA 

will conduct a robust evaluation of the program for culturally appropriate approaches to further 

improve retention and increase recruitment of more diverse fellows into the workforce. 

The Budget also proposes to add a service requirement to ensure participants are supporting 

communities in need, as well as to continue inclusion of addiction medicine, and sexual and gender 

minority populations as participants in the Minority Fellowship Program.

SAMHSA separately tracks any amounts spent, or awarded, under the Minority Fellowship 

Program through the distinct appropriations and to ensure that funds are used for purposes 

consistent with legislative direction and intent of these appropriations.

Funding History Table

Fiscal Year Amount

FY 2021 $5,789,000

FY 2022 $5,789,000

FY 2023 Final $7,136,000

FY 2024 CR $7,136,000

FY 2025 President’s Budget $7,136,000

Program Accomplishments

In FY 2023, SAMHSA supported eight braided MFP grant continuations, one CSAT grant 

continuation and one contract. In addition, 1,200 health professionals in the field of mental health 

and/or SUD and related workforce were trained in specific mental health and/or substance userelated practices/activities. SAMHSA completed 130 events, and 2,620 participants were targeted. 

In FY 2024, SAMHSA will award eight new MFP grants and fund one contract. The program will 

continue to train behavioral health professionals on issues related to prevention, treatment, and 

recovery support for individuals who are from racial and ethnic minority populations and have a 

mental or co-occurring mental and substance use disorder (COD), and to improve the quality of 

care provided to individuals. 
253 

Addiction Technology Transfer Centers

(Dollars in millions) 

Programs of Regional and National Significance

FY 2023 

Final 

FY 2024 

CR 

FY 2025 

President’s 

Budget

FY 2025 +/- 

FY 2023

Addiction Technology Transfer Centers...................................................... 9.046 9.046 9.046 -- 

Authorizing Legislation ............................................. Section 509 of the Public Health Service Act 

FY 2025 Authorization ................................................................................................$521,517,000 

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

Eligible Entities ..... States, political subdivisions of States, political subdivisions of states, Indian 

Tribes or Tribal organizations (as such terms are defined in section 4 of the Indian SelfDetermination and Education Assistance Act), health facilities, programs operated by or in 

accordance with a contract or grant with the Indian Health Service, and other public or nonprofit 

private entities

Program Description

The estimated cost of substance use in the United States – including illegal drugs, alcohol, and 

tobacco – is more than $740 billion a year and growing.140 Substance misuse in the U.S. costs 

society in increased healthcare expenses, crime, and lost productivity. In recent years, the nation’s 

attention has been on the increased misuse and lethal consequences of opioids. According to the 

Centers for Disease Control and Prevention (CDC), provisional data indicate there were 106,363 

drug overdose deaths in the United States during the 12-month period ending in August 2023. Of 

the drug overdose deaths, 80,609 involved opioids.

141 Illicitly manufactured fentanyl continues to 

drive the majority of deaths, with an emerging threat of fentanyl mixed with xylazine142. Mortality 

rates due to cocaine and psychostimulants such as methamphetamine are also on the rise. The 

misuse of opioids and opioid use disorder, including prescription pain relievers, heroin, and 

synthetic opioids such as fentanyl, is a serious national crisis that affects public health as well as 

social and economic welfare, and that was exacerbated by the COVID-19 pandemic. The country 

continues to deal with the repercussions of the pandemic’s effect on substance use disorders (SUD) 

and will do so for years to come. 

 

SUDs are among the leading causes of disability in the United States. In 2022, among people aged 

12 or older, about 17 percent had a SUD.

143 Despite high prevalence rates, many people who 

require behavioral health services do not receive quality care, due in part to behavioral health 

workforce shortages as well as deficiencies in knowledge, skills, and capacity across the behavioral 

health workforce to meet the unmet needs of diverse and underserved populations. 

 

In response to the aforementioned national crises, the purpose of the Technology Transfer Centers 

(TTCs) is to develop and strengthen the specialized behavioral healthcare and broad primary 

healthcare workforce who provides the continuum of prevention, public health harm reduction, 

treatment, and recovery support services for SUD and mental illness. The program’s mission is to 

140 https://nida.nih.gov/research-topics/trends-statistics 141 https://www.cdc.gov/nchs/nvss/vsrr/drug-overdose-data.htm 142 https://www.cdc.gov/drugoverdose/deaths/other-drugs/xylazine/faq.html 143 https://www.samhsa.gov/data/sites/default/files/reports/rpt42730/2022-nsduh-infographic-report.pdf
254 

help practitioners and organizations incorporate effective evidence-based practices across the 

continuum of behavioral health. The TTCs are comprised of multiple networks, which include 

the Addiction Technology Transfer Centers (ATTC) network. 

 

In 1993, SAMHSA established the ATTC network, which has undergone several maturations to 

evolve over time. The current iteration of the ATTC network includes ten regional ATTCs and 

a ATTC National Coordinating Office. Together, the ATTC network serves the 50 United States, 

the District of Columbia, Puerto Rico, the U.S. Virgin Islands, and the Pacific Islands of Guam, 

American Samoa, Palau, the Marshall Islands, Micronesia, and the Mariana Islands. The target 

audience of the ATTC network includes medical and behavioral health professionals, recovery 

specialists, addiction counselors, criminal justice professionals, administrators, and educators. 

 

Specific activities that the ATTC network carries out include: providing custom technical 

assistance, building capacity to address regional, local and/or population-specific needs on a 

variety of topics; promoting and facilitating relationship building among stakeholders in 

behavioral health policy, research, and practice; serving as a continuous feedback loop for 

innovation and practice; focusing on consultation and implementation to achieve systems change; 

and continually adapting and growing to improve, advance, and expand treatment and recovery 

services.

Budget Request

The FY 2025 President’s Budget request is $9 million, equal to the FY 2023 Final level. At this 

level, SAMHSA will fund 11 cooperative agreement continuations and maintain the same 

performance target as in the FY 2024. In FY 2025, ATTCs will conduct an estimated 1,200 events, 

with an estimated 40,000 total participants. 

Funding History Table

Fiscal Year Amount

FY 2021 $9,046,000

FY 2022 $9,046,000

FY 2023 Final $9,046,000

FY 2024 CR $9,046,000

FY 2025 President’s Budget $9,046,000

Program Accomplishments

The ATTCs have been improving and updating their programs to offer novel training and technical 

assistance options that include multiple learning components in new delivery formats focused on 

changing practices. With lessons from the COVID-19 pandemic, the network has developed a 

robust virtual platform that has proven successful in supporting healthcare professionals with 
255 

telehealth strategies and many adaptations of evidence-based interventions for virtual settings. 

Using this platform and other training modalities, the ATTC network will continue to respond to 

the differential impact of the evolving overdose crisis by addressing the needs of providers and 

continuing to develop resources to help to address the needs of all communities. 

 

In FY 2023, ATTCs conducted 1,266 total events, which were attended by 41,826 total 

participants. Participant satisfaction rates were consistently high, with over 87.6 percent of 

participants reporting that they were satisfied with the overall quality of training or technical 

assistance events; over 88 percent of participants reporting that they expected benefits to 

themselves, clients, professional development, practice, or community from the events they 

attended; and 77.5 percent of participants reporting that they expect the events will improve their 

ability to work effectively.

In FY 2023, SAMHSA funded a nine-month extension for the National American Indian and 

Alaska Native ATTC and 12-month continuation for the National Hispanic and Latino ATTC, as 

a part of the ATTC network evolution that reconfigured the population-focused ATTCs into 

Centers of Excellence. Additionally, in FY 2023, SAMHSA funded a 12-month extension for 11 

ATTC cooperative agreements (ten regional ATTCs and one ATTC National Coordinating Office) 

to continue to disseminate evidence-based promising practices that are effective in combating 

substance misuse, including the opioid crisis. 

In FY 2024, SAMHSA anticipates awarding 11 new ATTC cooperative agreements for 10 regional 

ATTCs and one ATTC National Coordinating Office. In FY 2024, ATTCs will conduct an 

estimated 1,200 events, with an estimated 40,000 total participants. 
256 

Grants to Prevent Prescription Drug/Opioid Overdose Related Deaths

(Dollars in millions)

Programs of Regional and National Significance

FY 2023 

Final 

FY 2024 

CR 

FY 2025 

President's 

Budget

FY 2025 +/- 

FY 2023 

Grants to Prevent Prescription Drug/Opioid Overdose Related Deaths 16.000 16.000 16.000 -- 

Authorizing Legislation ........................................................................ Section 516 of the PHS Act 

FY 2025 Authorization...............................................................................................$218,219,000 

Allocation Method ............................................................................ Competitive Grants, Contracts

Eligible Entities .. States, political subdivisions of States, Indian Tribes or Tribal organizations (as 

such terms are defined in section 4 of the Indian Self-Determination and Education Assistance 

Act), health facilities, programs operated by or in accordance with a contract or grant with the 

Indian Health Service, and other public and nonprofit private entities 

Program Description

The purpose of the Prevent Prescription Drug/Opioid Overdose-Related Deaths (PDO) grant 

program is to reduce the number of prescription drug/opioid overdose-related deaths and adverse 

events among individuals by training first responders and other key community sectors on the 

prevention of prescription drug/opioid overdose-related deaths and implementing secondary 

prevention and harm reduction strategies, including the purchase and distribution of naloxone to 

first responders. Examples of the long-term and short-term outcomes for education and distribution 

of naloxone include: (1) the rate of intentional, unintentional, and undetermined intentional opioid 

overdose (using hospitalization, emergency department, police, or other accessible data); (2) the 

number of opioid overdose-related deaths; (3) the number of opioid overdose reversals; (4) the 

number of referrals to substance use disorder treatment services; and (5) the number of naloxone 

kits that reached communities of high need.

The Grants to Prevent Prescription Drug and Opioid Overdose-Related Deaths program is a key 

component of the public health response to the overdose epidemic. It uses a combination of 

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

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

community-based public health prevention efforts serve the high-risk population outside of 

substance use treatment facilities and offer an engagement opportunity and linkage to care for 

people with a SUD. This program promotes integration of substance use disorder prevention 

information, activities into primary health care systems, and emerging drug issues.

Budget Request

The FY 2025 President’s Budget request is $16.0 million, equal to the FY 2023 Final level. 

SAMHSA will fund 18 continuation grants. This funding will help states purchase overdose 

reversing agents, equip first responders in high-risk communities, support education on the use of 

naloxone and other opioid overdose reversal medications, provide the necessary materials to 

assemble overdose kits, and cover expenses incurred from dissemination efforts. SAMHSA 

anticipates distributing 50,000 naloxone kits and training 15,000 people with this funding. 

PDO places focused emphasis upon getting lifesaving opioid reversal kits into the hands of 
257 

community organizations and individuals that are in close proximity to those vulnerable to opioid 

overdose. This program builds upon existing assets and resources within communities that allows 

programs to serve as a bridge to close gaps and mitigate with prevention efforts for those at higher 

risks of substance misuse, substance use disorders, and overdose.

Funding History Table

Fiscal Year Amount

FY 2021 $14,000,000

FY 2022 $14,000,000

FY 2023 Final $16,000,000

FY 2024 CR $16,000,000

FY 2025 President’s Budget $16,000,000

Program Accomplishments

In FY 2023, SAMHSA funded three new and 15 continuation grants. Grantees exceeded targets 

by distributing 90,072 opioid overdose reversal medication kits and by training 32,555 

professional first responders, lay persons and other community organization staff, medical 

professionals, and other individuals through 4,933 trainings. 93.3 percent of trainees reported 

feeling confident administering naloxone or other opioid overdose reversing medications and 89.6 

percent perceived they had learned new information. 

In FY 2024, SAMHSA anticipates funding 18 continuation grants. The program has set a FY 2024 

target to distribute 50,000 naloxone or other opioid overdose reversal medication kits and to train 

15,000 people. 

SAMHSA adjusted its targets for FY 2023 and FY 2024 as a “correction to former targets” to 

better reflect real life circumstances within the communities in which grantees conduct business. 

These targets align with SAMHSA’s efforts to reduce opioid overdose by saturating communities 

with high rates of opioid overdose with opioid overdose reversal medications, trained first 

responders and concerned public citizens, who have been trained to administer naloxone to those 

experiencing an overdose, and support the increased emphasis to refer these individuals into 

buprenorphine and other and modalities of treatment and recovery supports, wherever appropriate. 
258 

Outputs and Outcomes Table 

Program: PDO/Naloxone

 

Measure Year and Most 

Recent Result / 

Target for Recent

Result /

(Summary of Result)

FY 2024

Target

FY 2025

Target

FY 2025

Target

+/-FY 2024

Target

5.0 Number of 

FDA-approved 

opioid overdosereversing 

medication kits 

distributed. 

(Output)

FY 2023: 90,072

Target: 

36,719

(Target Exceeded) 

50,000.0 50,000.0 Maintain

5.1 Number of 

individuals trained 

in how to 

administer FDAapproved opioid 

overdose-reversing 

medication 

(Output)

FY 2023: 27,266

Target: 

8,207

(Target Exceeded) 

15,000.0 15,000.0 Maintain

 
259 

Peer Support Technical Assistant Center

(Dollars in millions) 

Programs of Regional and National Significance

FY 2023 

Final 

FY 2024 

CR 

FY 2025 

President’s 

Budget

FY 2025 +/- 

FY 2023

Peer Support TA Center............................................................................ 2.000 2.000 2.000 -- 

 

Authorizing Legislation ......... Sec. 7152 of the Substance Use-Disorder Prevention that Promotes 

Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act

FY 2025 Authorization ..................................................................................................................$0 

Allocation Method ............................................................................................. Competitive Grants

Eligible Entities ..... Recovery Community Organizations (RCOs) (as defined in section 547 of the 

Public Health Service Act) and peer support networks 

Program Description

The Peer Recovery Center of Excellence (PRCOE) provides peer recovery support services 

through training and technical assistance for recovery community organizations (RCO) as well as 

peer support networks and other settings in which people with substance use disorders seek 

services. The Center reinforces recovery as a guiding principle in SAMHSA’s policies, programs, 

and services. In FY 2024, the PRCOE program evolved to support efforts to strengthen the peer 

workforce while expanding its scope to include peer and other recovery support services across 

focused, professional, and educational settings. Focus areas include 1) expanding and 

strengthening the peer workforce, 2) advancing peer and recovery support in focused settings, and 

3) advancing recovery in professional and educational settings. Each focus area includes a set of 

objectives that guide training and technical assistance efforts. Examples of these include peer 

financing and certification, recovery housing, strengthening the peer workforce in clinical 

treatment settings, expanding the role of recovery support in criminal justice and educational 

settings, and advancing recovery-ready workplace efforts.

RSS – CoE aligns with one of the ONDCP drug policy priorities, “Expanding access to recovery 

support services,” as well as the four dimensions of 2022 National Drug Control Strategy of 

building a “recovery-ready nation” of “home, health, purpose, and community,” which aims to 

expand RSS and PRSS capacity and foster the adoption of more consistent standards for the peer 

workforce, Recovery Counseling Centers (RCC), RCOs, and similar peer-led organizations. 

Budget Request

The FY 2025 President’s Budget request is $2 million, equal to the FY 2023 Final level. SAMHSA 

will award one continuation cooperative agreement at $2 million, providing training to 

approximately 2,500 individuals on peer support services. 
260 

Funding History Table

Fiscal Year Amount

FY 2021 $1,000,000

FY 2022 $1,000,000

FY 2023 Final $2,000,000

FY 2024 CR $2,000,000

FY 2025 President’s Budget $2,000,000

Program Accomplishments

In FY 2023, SAMHSA funded one grant. Over the course of FY 2023, the PRCOE conducted 

trainings, provided 1-on-1 technical assistance, and developed products that align with each of the 

outlined focus areas (Diversity, Equity, and Inclusion (DEI), Evidence-Based Practices, RCO

Capacity Building, Peer Workforce Development, and Peer Services Integration). This included 

78 total trainings/webinars that trained a total of 4,511 participants. Specific examples include a 

training on harm reduction and peer support (92 peers/non-clinical professionals trained), 

Supervisors of PRSS—Supporting Staff Navigating Work-Related Loss (mix of 48 non-clinical 

and clinical professionals trained), and PRSS—Exploring and Defining Lived Experience (68 nonclinical professionals trained). The PRCOE also added a new focus area (DEI) and added an 

additional advisory group member to lead related efforts. The PRCOE exceeded targets for 

numbers trained. In FY 2024, the target was increased based on FY 2023 actuals and will be 

maintained in FY 2025. 

In FY 2024, the program anticipates funding one new grant and training 2,500 people. 
261 

Outputs and Outcomes Table

Program: Peer Support Technical Assistance Center

Measure Year and Most 

Recent Result /

Target for Recent 

Result /

(Summary of Result)

FY 2024

 Target

FY 2025

 Target

FY 2025

 Target

+/-FY 2024

 Target

1.1.0 Number of 

people train for the 

support of the 

recovery 

community 

organizations and 

peer support 

networks (Output)

FY 2023: 4,511

 

Target:

 2,100 

 

(Target Exceeded)) 

2,500 2,500 Maintain
262 

Treatment, Recovery, and Workforce Support 

(Dollars in millions) 

Programs of Regional and National Significance

FY 2023 

Final 

FY 2024 

CR 

FY 2025 

President's 

Budget

FY 2025 +/- 

FY 2023

Treatment, Recovery, and Workforce Support......................................... 12.000 12.000 12.000 -- 

Authorizing Legislation ............................................................ Section 7183 of the SUPPORT Act

FY 2025 Authorization ................................................................................................$521,517,000 

Allocation Method ............................................................................................. Competitive Grants

Eligible Entities .... Entities that offer treatment or recovery services for individuals with SUD and 

partners with one or more local or State stakeholders

Program Description 

The purpose of the Treatment, Recovery, Workforce Support (TRWS) program is to support 

individuals in SUD and/or COD treatment and recovery to live independently and participate in 

the workforce. In 2022, 21.2 million or 71 percent of adults who perceived ever having a substance 

use problem considered themselves to be in recovery or to have recovered. Additionally, 40.8 

million or 65.8 percent of adults who perceived ever having a mental health issue considered 

themselves to be in recovery or to have recovered. Among people aged 12 or older, 48.7 million 

or about 17 percent had an SUD in the past year.144

One of the pillars of recovery is gainful employment. The TRWS program aims to help participants 

gain viable employment while supporting their recovery journey. This program requires grant 

recipients to coordinate among state workforce development boards, local workforce development 

boards, state agencies responsible for a workforce investment activity, Indian Tribes, Tribal 

organizations, and state agencies responsible for carrying out SUD or COD prevention and 

treatment programs.

145 Grantees in the TRWS program ascertain the economic and workforce 

impacts associated with high rates of SUD and COD and coordinate with and align statewide 

employment and training activities to assist in matching individuals with SUD and COD with 

employers. 

Budget Request

The FY 2025 President’s Budget request is $12 million, equal to the FY 2023 Final level. This 

level will continue to provide access to career services for people in recovery from substance use 

disorder through partnerships with local organizations. SAMHSA plans to fund seven new and 16 

continuation grants. The investment will further strengthen and develop America’s workforce and 

allow for greater support to those in recovery. SAMHSA will maintain the same performance 

targets as FY 2024. 

144 https://www.samhsa.gov/data/sites/default/files/reports/rpt42730/2022-nsduh-infographicreport.pdf
263 

Funding History Table

Fiscal Year Amount

FY 2021 $10,000,000

FY 2022 $10,000,000

FY 2023 Final $12,000,000

FY 2024 CR $12,000,000

FY 2025 President’s Budget $12,000,000

Program Accomplishments

In FY 2023, SAMHSA funded four new and 20 continuation TRWS grants. The TRWS program 

served 2,012 clients. Significant steps have been taken to increase clients’ abstinence, employment 

and educational opportunities, social connectedness, and housing stability. In FY 2023, the 

percentage of clients who reported that they did not use alcohol or illegal drugs within the past 30 

days increased by 13.8 percent between intake and 6-month follow-up. Between intake and sixmonth follow-up, the percentage of clients who reported no arrests within the past 30 days 

increased by 1.7 percent. In addition, the percentage of clients who were employed or attending

school increased by 244.8 percent. Those clients who reported being socially connected decreased 

by 0.7 percent from intake to 6-month follow-up. However, the percentage of clients who reported 

housing stability increased by 59.0 percent.146

Successes in the TRWS program include pre-employment sessions that entail resume building, 

mock-interviewing, review of employment options, risks and benefits of employment 

opportunities, and guidelines for follow-up interviews. Moreover, the TRWS program has resulted 

in increased collaborations with recovery-friendly organizations. Grant recipients have continued 

to utilize telemedicine and virtual mediums to engage clients, provide entrepreneurial training and 

support programs, and work to improve linkages between one-stop delivery systems and 

employers in their state. One grant recipient offers in demand occupational training credentials 

with a focus in the sectors of customer service, hospitality, and culinary. Workforce staff have also 

met with local stakeholders and other local training institutions that can offer access to other 

employment resources and opportunities. 

In FY 2024, SAMHSA anticipates funding 24 continuation TRWS grants. In FY 2024, TRWS 

program expects to serve 836 clients, with 233 clients having stable housing outcomes at the sixmonth follow-up. 

Outputs and Outcomes Table

146 Source: SAMHSA’s Performance Accountability and Reporting System (SPARS). Retrieved January 16, 2024, 

from http://spars.samhsa.gov. Based on 2,012 client intakes assessments, and 444 client six-month follow-up 

reassessments. Limitations: There are several limitations to the program evaluation including (but not limited to) 

incomplete data, self-report, selection bias, and the launch of a new client-level instrument in January 2023. 
264 

Program: Treatment, Recovery, and Workforce Support

Measure Year and Most Recent 

Result /

Target for Recent Result /

(Summary of Result)

FY 2024

Target

FY 2025

Target

FY 2025

Target

+/-FY 2024

Target

1.21.1 Number of people 

participating in the 

workforce (Output)

FY 2023: 2,012

Target:

828

(Target Exceeded)

836 836 Maintain

1.21.2 Number of clients 

who report having stable 

housing at six-month 

follow-up (Outcome)

FY 2023: 132

Target:

231

(Target Not Met)

233 233 Maintain

 
265 

Emergency Department Alternatives to Opioids

(Dollars in millions) 

Programs of Regional and National Significance

FY 2023 

Final 

FY 2024 

CR 

FY 2025 

President's 

Budget

FY 2025 +/- 

FY 2023

Emergency Department Alternatives to Opioids...................................... 8.000 8.000 8.000 -- 

Authorizing Legislation ... Section 7091 of the SUPPORT Act, as amended by section 1221 of the 

Consolidated Appropriations Act, 2023 

FY 2025 Authorization ..................................................................................................$10,000,000 

Allocation Method ............................................................................................. Competitive Grants

Eligible Entities ................................................................... Hospitals and Emergency Departments 

Program Description

The Emergency Department-Alternatives to Opioids (EDAO) grant program, authorized under 

Section 7091 of the SUPPORT Act for Patients and Communities, began as a demonstration 

project in FY 2021, and was revised to an ongoing grant program in 2023. This program supports 

training, development and implementation of alternatives to opioids for pain management in 

hospitals and ED settings to reduce the likelihood of future opioid misuse. The EDAO program 

provides funding to hospitals and emergency departments, including freestanding emergency 

departments, to develop, implement, enhance, or study alternative pain management protocols and 

treatments that limit the use and prescribing of opioids in emergency departments. These funds 

are used to target common painful conditions, train providers and other hospital personnel to 

recognize the presence of an opioid use disorder, initiate treatment as appropriate, and provide 

alternatives to opioids for patients with painful conditions.

Budget Request

The FY 2025 President’s Budget request is $8.0 million, equal to the FY 2023 Final level. 

SAMHSA plans to award 16 continuation grants. In FY 2025, SAMHSA anticipates funding one 

new and 15 continuation grants with a target of training 2,520 providers on using non-opioid 

therapies and providing non-opioid therapies to 115,850 patients.

Funding History Table

Fiscal Year Amount

FY 2021 $6,000,000

FY 2022 $6,000,000

FY 2023 Final $8,000,000

FY 2024 CR $8,000,000

FY 2025 President’s Budget $8,000,000
266 

Program Accomplishments

In FY 2023, SAMHSA funded 15 new and two continuation grants. The 12 grantees that were 

funded from 2021-2024 were demonstration grants, as noted above. They all implemented 

alternatives to opioids in the EDs, trained providers in identifying and managing OUD. Several 

built relationships with local OTP providers to link patients to ongoing treatment 

In FY 2024, SAMHSA anticipates funding 15 continuation grants and one new grant. 

ED practitioners supported by this program are employing a growing range of non-opioid analgesic 

pain relievers and non-pharmacological interventions since program inception, such as use of 

virtual reality, physical therapy and Transcutaneous Electrical Nerve Stimulation (TENS units). 

As demonstration projects with varying activities, data collected by these grantees varied. 

However, as an example of the reach of the program, one grantee provided training to 160 

providers practitioners and treated 35,226 during FY 2023. Similarly, another grantee trained 119 

practitioners and treated 38,225 patients with non-opioid therapies. The EDAO program was 

revised from a demonstration grant to an ongoing, funded program with the Consolidated 

Appropriations Act of 2023. With that change, data collection will be standardized among 

grantees. 
267 

Outputs and Outcomes Table

Program: Emergency Department Alternative to Opioids

Measure Year and Most Recent 

Result /

Target for Recent 

Result /

(Summary of Result)

FY 2024

 Target

FY 2025

 Target

FY 2025

 Target

+/-FY 2024

 Target

1.60.1 Number of 

providers trained on 

non-opioids 

therapies.1 (Output) 

FY 2023: TBD

 

Target:

 2,493 

 

(Target Status: TBD)

2,520 2,520 Maintain 

1.60.2 Number of 

patients who 

received non-opioid 

therapies. 2 (Output) 

FY 2023: TBD

 

Target: 114,698 

 

 

(Target Status: TBD)

115,850 115,850 Maintain 

1 FY 2023 data for this measure is delayed due to tool change. 

2

 ibid 
268 

Comprehensive Opioid Recovery Centers

(Dollars in millions) 

Programs of Regional and National Significance

FY 2023 

Final 

FY 2024 

CR 

FY 2025 

President's 

Budget

FY 2025 +/- 

FY 2023

Comprehensive Opioid Recovery Centers................................................ 6.000 6.000 6.000 -- 

Authorizing Legislation ......................................... ...Section 552 of the Public Health Service Act 

FY 2025 Authorization ..................................................................................................................$0 

Allocation Method ............................................................................................. Competitive Grants

Eligible Entities ......... Single Entities and Integrated Delivery Networks that Offer Treatment and 

Other Services to Individuals with SUD

Program Description

Comprehensive Opioid Recovery Centers (CORC) provide grants to nonprofit SUD treatment 

organizations to operate comprehensive centers which provide a full spectrum of treatment and 

recovery support services for OUD. Grantees are required to provide outreach and the full 

continuum of treatment services, including medication for opioid use disorder (MOUD); 

counseling; screening and treatment for mental disorders; testing and referral for treatment of 

infectious diseases; residential treatment, and intensive outpatient services; recovery housing; peer 

recovery support services; job training, job placement assistance, and continuing education; and 

family support services such as childcare, family counseling, and parenting interventions. 

Grantees must utilize third party and other revenue to the extent possible. Grantees are required to 

report client-level data, including demographic characteristics, substance use, assessment, services 

received, types of MOUD received, length of stay in treatment, employment status, criminal justice 

involvement, and housing. 

CORC grantees have been utilizing funding to expand access to comprehensive services in a 

variety of ways, including improving the system of comprehensive MOUD care at the county level; 

improving access to overdose reversal medications and providing follow-up with clients who have 

experienced overdose reversals; removing barriers to accessing MOUD in residential treatment; 

engaging special populations, such as homeless persons, tribal members, LGBTQI+, people in 

correctional settings and those on probation; and increasing access to services for those in 

underserved areas. Grantees have also ensured access to recovery-based services, including 

recovery housing and support. 

Budget Request

The FY 2025 President’s Budget request is $6.0 million, equal to the FY 2023 Final level. 

SAMHSA plans to fund two new and five continuation grants. These funds will provide critical 

comprehensive care services, including long-term care and support services utilizing the full range 

of FDA-approved medications and evidence-based services and will cover the costs of critical 

linkage and system development not currently covered by other sources of funding. These funds 

will extend the reach of MOUD treatment and recovery support services to address the overdose 
269 

epidemic across systems and regional locations, reducing scattered, uncoordinated treatment 

efforts, and expanding access to care for people with special needs and/or in rural areas. SAMHSA 

will maintain the same performance targets for FY 2025 as in FY 2023. 

Funding History Table

Fiscal Year Amount

FY 2021 $5,000,000

FY 2022 $5,000,000

FY 2023 Final $6,000,000

FY 2024 CR $6,000,000

FY 2025 President’s Budget $6,000,000

Program Accomplishments

In FY 2023 the CORC program funded two new and five continuation grants and served 353 

clients. Significant steps have been taken to increase clients’ abstinence, employment and 

educational opportunities, social connectedness, and housing stability. In FY 2023, the percentage 

of clients who reported that they did not use alcohol or illegal drugs within the past 30 days 

increased by 66.7 percent between intake to 6-month follow-up. Between intake and six-month 

follow-up, the percentage of clients who reported no arrests within the past 30 days increased by 

2.2 percent. In addition, the percentage of clients who were employed or attending school increased 

by 70.6 percent. Those clients who reported being socially connected increased by 7.0 percent 

from intake to 6-month follow-up. Similarly, the percentage of clients who reported housing 

stability increased by 71.4 percent.147

In addition to directly providing services and supports grantees are also required to conduct 

outreach activities. Grantees have provided outreach on the effectiveness of MOUD and strategies 

for overdose reversals to a variety of stakeholders, including criminal justice staff, college 

campuses, state health department representatives, Tribes, first responders, public transportation 

employees, and veterans' services organizations. 

In FY 2024, SAMHSA anticipates funding one new and five continuation grants, and is targeting 

to serve a baseline of 264 clients. Grantees will continue to raise awareness of MOUD services 

and overdose reversal medications in FY 2024 and FY 2025. 

147 Source: SAMHSA’s Performance Accountability and Reporting System (SPARS). Retrieved January 16, 2024, 

from http://spars.samhsa.gov. Based on 353 client intakes assessments, and 96 client six-month follow-up 

reassessments. Limitations: There are several limitations to the program evaluation including (but not limited to) 

incomplete data, self-report, selection bias, and the launch of a new client-level instrument in January 2023.
270 

Outputs and Outcomes Table

Program: Comprehensive Opioid Recovery Centers

Measure Year and Most Recent 

Result /

Target for Recent 

Result /

(Summary of Result)

FY 2024 

Target 

FY 2025 

Target 

FY 2025 

Target 

+/-FY 2024 

Target 

1.2.1 Percentage of 

adults receiving 

services who had no 

past month substance 

use at 6-month 

follow-up (Output)

FY 2023: 89.5 % 

Target:

90.2 % 

(Target Not Met)

91.2 % 91.2 % Maintain

1.3.1 Percentage of 

clients who enrolled 

in school or achieved 

employment as a 

result of this program 

(Outcome)

FY 2023: 61.5% 

Target:

65.9 % 

(Target Not Met but 

Improved) 

66.9 % 66.9 % Maintain

1.4.1 Number of 

adults receiving 

recovery housing and 

community based 

and peer recovery 

support services at 6-

month follow-up 

(Output) 

FY 2023: 296 

Target:

25 

(Target Exceeded) 

26 26 Maintain

1.6.1 Percentage of 

clients diagnosed 

with an OUD and 

received MOUD 

(Output) 

FY 2023: 58.5 

Target:

58.5 

(Baseline)

58.5 58.5 Maintain
271 

First Responder Training – Comprehensive Addiction and Recovery Act

(Dollars in millions) 

Programs of Regional and National Significance

FY 2023 

Final 

FY 2024 

CR 

FY 2025 

President's 

Budget

FY 2025 +/- 

FY 2023

First Responder Training (CARA)............................................................ 56.000 56.000 56.000 -- 

First Responder Training (non-add) .................................................... 25.000 25.000 25.000 -- 

Rural Set-Aside (non-add) .................................................................... 31.000 31.000 31.000 -- 

Authorizing Legislation ........................................................................ Section 546 of the PHS Act 

FY 2025 Authorization ..................................................................................................................$0 

Allocation Method............................................................................................Competitive Grants 

Eligible Entities .. States, local government entities, and Indian Tribes and Tribal organizations (as 

defined in section 4 of the Indian Self-Determination and Education Assistance Act) 

Program Description

SAMHSA’s First Responder Training – Comprehensive Addiction and Recovery Act (FR-CARA) 

program is an important part of the US government’s response to the opioid crisis. The program 

provides resources to first responders and members of other key community sectors at the state, 

tribal, and other government levels to train, carry, and administer Federal Food, Drug, and 

Cosmetic Act approved drugs and devices for emergency reversal of known or suspected opioid 

overdose. It uses a combination of community-based public health prevention and harm reduction 

strategies across the continuum to mitigate the impact of the overdose epidemic within 

communities. These community-based public health prevention efforts serve the high-risk 

population outside of substance use treatment facilities, and provide a linkage and engagement 

point to treatment for individuals with a substance use disorder. The program serves populations 

disproportionately impacted (relative to national averages) by opioid use as evidenced by high 

rates of opioid and other drug-related overdose. 

Rural Emergency Medical Services Training Grant 

The Rural Emergency Medical Services Training Grant (EMS Training) program is a program to 

recruit and train EMS personnel in rural areas with a particular focus on addressing mental and 

substance use disorders. This program also provides activities to develop new ways to educate 

emergency health care providers using technology-enhanced educational methods. SAMHSA 

recognizes the great need for emergency services in rural areas and the critical role EMS personnel 

serve across the country. 
272 

Budget Request

The FY 2025 President’s Budget request is $56.0 million, equal to the FY 2023 Final level. 

SAMHSA anticipates funding 60 new and 65 continuation grants. SAMHSA will utilize multiple 

sources of data (including, but not limited to, previous program, morbidity, and mortality data) to 

identify priority communities and populations in greatest need of funding. 

FR-CARA will continue to prevent overdoses with increasing access to overdose prevention that 

includes purchasing, training, and equipping first responders and community members with 

naloxone and other opioid overdose reversal medications. Additionally, an important goal will be 

facilitating referral and linkage where the first responder is directly connecting the person in need 

of services with a provider of substance use services. This program will continue providing access 

for individuals treated with naloxone for overdose to obtain services such as low threshold 

buprenorphine with psychosocial support services to address the multifaceted challenges a person 

experiences after an overdose.

Funding History Table

Fiscal Year Amount

FY 2021 $46,000,000

FY 2022 $46,000,000

FY 2023 Final $56,000,000

FY 2024 CR $56,000,000

FY 2025 President’s Budget $56,000,000

Program Accomplishments 

In FY 2023, the program funded 64 new and 47 continuation grants that expand organizational 

and workforce capacity to enhance linkage to care for people at risk for opioid overdose and 

implement innovative prevention activities. Grantees exceeded FY 2023 targets by distributing 

101,210 opioid overdose reversal medication kits. They also exceeded FY 2023 targets by training 

76,641 professional first responders, lay persons and other community organization staff, medical 

professionals, and other individuals through 16,644 trainings. 89 percent of trainees reported 

feeling confident administering naloxone or other opioid overdose reversing medications and 94.4 

percent perceived they had learned new information. These increases are likely due to significant 

efforts by CSAP/SAMHSA to improve grantee data reporting as well as focused efforts by 

SAMHSA to work with states and communities to expand access to naloxone and other opioid 

overdose reversal medications. 

In FY 2024, the program anticipates funding 61 new and 66 continuation grants with a target of 

130,000 opioid overdose reversal medication kits distributed and 25,000 first responders trained. 

SAMHSA will adjust the FY 2025 targets for number of medication kits distributed to 100,000 

based on FY 2023 actuals and will maintain the number of first responders trained. SAMHSA has 

begun an evaluation of this program and anticipates preliminary findings in FY 2025. 
273 

Output and Outcome Table

Program: First Responder Training-CARA

Measure Year and Most 

Recent Result / 

Target for Recent 

Result /

(Summary of Result)

FY 2024

Target

FY 2025

Target

FY 2025

Target

+/-FY 2024

Target

5.0.1 Number of FY 2023: 101,210 130,000 100,000 30,000

FDA-approved

opioid overdose- Target:

Reversing 58,025

medication kits

(Target Exceeded)

distributed (Output)

5.1.1 Number of FY 2023: 76,641 25,000 25,000 Maintain

individuals trained

in how to administer Target:

FDA-approved 10,690

opioid overdoseReversing (Target Exceeded)

medication.

(Output)
274 

Youth Prevention and Recovery Initiative

(Dollars in millions) 

Programs of Regional and National Significance

FY 2023 

Final 

FY 2024 

CR 

FY 2025 

President's 

Budget

FY 2025 +/- 

FY 2023

Youth Prevention and Recovery Initiative................................................ 2.000 2.000 2.000 -- 

Authorizing Legislation ............................................. Section 514 of the Public Health Service Act

FY 2025 Authorization ..................................................................................................$29,605,000 

Allocation Method ............................................................................................. Competitive Grants

Eligible Entities ................. Public and private nonprofit entities, including Indian Tribes or Tribal 

organizations (as such terms are defined in section 4 of the Indian Self-Determination and Edu 

cation Assistance Act), and health facilities or programs operated by or in accordance with a 

contract or grant with the Indian Health Service

Program Description

The ongoing opioid overdose crisis continues to affect adolescents and young adults adversely. 

Medications for Opioid Use Disorder (MOUD) are a safe and effective treatment that has the 

potential to reduce opioid use and associated harms. However, access to MOUD for adolescents 

and young adults remains low. To provide MOUD to adolescents and young adults who may need 

it, healthcare providers must be able to prescribe these medications. They must also have access 

to the latest resources and training to prescribe MOUD safely and effectively.

In FY 2023, a new initiative, Preventing Youth Overdose: Treatment, Recovery, Education 

Awareness and Training (PYO-TREAT), was launched for healthcare providers and other entities. 

The purpose of PYO-TREAT is to increase access to MOUD for adolescents and young adults, 

train healthcare providers on the safe prescribing of MOUD, educate parents, families, and school 

personnel on OUD and MOUD, and raise awareness about the increasing exposure of young 

people to illicitly manufactured fentanyl. Results released from the 2022 National Survey on Drug 

Use and Health shows the prevalence of opioid use increases with age from adolescents, 12 to 17 

years of age (1.6 percent or 406,000 people) to young adults, 18 to 25 years of age (3.2 percent or 

1.1 million people).148 The program aims for healthcare providers and other entities to create SUD 

treatment and prevention programs that include the appropriate use of MOUD for adolescents and 

young adults 

 

SAMHSA intends to continue advancing the goal of increasing integrated behavioral health access 

to children, youth, and families by allocating funding for fiscal year (FY) 2025 to support the 

Youth Prevention and Recovery Initiative for Adolescents and Young Adults Program. 

 

148 https://www.samhsa.gov/data/sites/default/files/reports/rpt42731/2022-nsduh-nnr.pdf
275 

Budget Request

The FY 2025 President’s Budget request is $2.0 million, equal to the FY 2023 Final level. 

SAMHSA anticipates funding four continuation grants. Data from the initial cohort of grantees 

funded in FY 2023, that will serve as a baseline for future years, will be available in the spring of 

2024. 

Funding History Table

Fiscal Year Amount

FY 2021 ---

FY 2022 ---

FY 2023 Final $2,000,000

FY 2024 CR $2,000,000

FY 2025 President’s Budget $2,000,000

Program Accomplishment

In FY 2023, SAMHSA funded four new PYO-TREAT grants. Data from this initial cohort of 

grantees, that will serve as a baseline for future years, will be available in the spring of 2024. 

In FY 2024, SAMHSA anticipates funding four continuations of the PYO-TREAT grants.
276 

Community Harm Reduction and Engagement Initiative

(Dollars in millions) 

Programs of Regional and National Significance

FY 2023 

Final 

FY 2024 

CR 

FY 2025 

President's 

Budget

FY 2025 +/- 

FY 2023

Community Harm Reduction and Engagement Initiative(new)............... -- -- 10.000 10.000 

Authorizing Legislation...............................Section 509 of the Public Health Service Act 

FY 2025 Authorization ................................................................................................$521,517,000 

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

Eligible Entity ...............................States, political subdivisions of States, Indian Tribes 

and Tribal organizations (as such terms are defined in section 4 of the Indian Self-Determination 

and Education Assistance Act), health facilities, programs operated by or in accordance with a 

contract or grant with the Indian Health Service, and other public and nonprofit private entities 

Program Description 

Harm reduction is a proactive and evidence-based public health approach to reduce the negative 

individual and public health impacts of alcohol and other substance use and substance use 

disorders (SUD). With millions of Americans meeting diagnostic criteria for a SUD and not 

receiving treatment, harm reduction approaches engage individuals in lifesaving care that meets 

people where they are. The Community Harm Reduction and Engagement Initiative will address 

gaps in care by supporting broad-based community harm reduction activities and linkages to 

services.

Specifically, harm reduction services can:

• Connect individuals to overdose education, counseling, and referral to treatment for 

infectious diseases and substance use disorders.

• Distribute opioid overdose reversal medications (e.g., naloxone) to individuals at risk of 

overdose, or to those who might respond to an overdose.

• Lessen harms associated with drug use and related behaviors that increase the risk of 

infectious diseases, including HIV, viral hepatitis, and bacterial and fungal infections.

• Reduce infectious disease transmission among people who use drugs, including those who 

inject drugs by equipping them with accurate information and facilitating referral to 

resources.

• Reduce overdose deaths, promote linkages to care, facilitate co-location of services as part 

of a comprehensive, integrated approach.

• Reduce stigma associated with substance use and co-occurring disorders.

• Promote a philosophy of hope and healing by utilizing those with lived experience of 

recovery in the management of harm reduction services, and connecting those who have 

expressed interest to treatment, peer support workers and other recovery support services.

• Support any positive change. 

This program is based on the pilot Harm Reduction grant program launched by SAMHSA in FY 

2022. In FY 2023, through SAMHSA’s pilot Harm Reduction grant program, 177,789 service 

encounters were made, with 8,505 linkages to services, including to treatment, recovery, and peer 

services. Grantees distributed 1,056 medication lock boxes and 16,622 sharp/medication disposal 
277 

boxes as well as distributing 105,056 safer sex kits. Grantees conducted 30,378 trainings on 

naloxone and other opioid overdose reversal medications with 66,333 individuals receiving 

training. They provided other overdose prevention services to 16,062 individuals. 

SAMHSA’s Community Harm Reduction and Engagement Initiative program builds upon the 

following three components: 

1) Support for smaller community-based harm reduction service organizations focused on 

high-risk populations such as those experiencing homelessness;

2) Expansion grants to existing programs such as SAMHSA’s dedicated harm reduction 

program, Targeted Capacity Expansion-Special Projects program, and Medication Assisted 

Treatment-Prescription Drug and Opioid Addiction (MAT-PDOA) program, with the 

inclusion of low-threshold buprenorphine initiation for opioid use disorder and linkages to 

harm-reduction oriented SUD treatment services; and

3) Technical assistance to support communities and organizations seeking to establish or 

improve existing harm reduction services. 

In addition to the above, this new harm reduction program will facilitate the distribution of 

naloxone and other opioid overdose reversal medications to help prevent overdose deaths, increase 

testing for HIV and viral hepatitis and improve access to infectious disease care, and provide peer 

support services. Data for FY 2023 measures of numbers of linkages to support, numbers of 

substance test kits distributed, and number of syringes distributed, as allowable under the 

American Rescue Plan authorizing language for the pilot Harm Reduction Program, are used to 

establish baseline for this program. 

Budget Request

The FY 2025 President’s Budget request is $10.0 million to establish the new harm reduction 

program. SAMHSA’s community harm reduction and engagement initiative aims to reach 

181,000 individuals with harm reduction and low threshold treatment services through three 

approaches: 

1. Harm Reduction Resources for Community-Based Organizations ($3 million): Provide 

awards reaching at least 41 small community-based organizations that are already serving 

populations needing these services but without other federal resources to support harm 

reduction services. These organizations will receive technical assistance and capacitybuilding support, as well as resources to expand their services. These efforts will enable 

organizations to expand their reach to an additional 21,000 individuals. 

2. Community Harm Reduction and Engagement Expansion Grants ($5 million): Grants will 

be provided to approximately 41 harm reduction service organizations serving who have 

the capacity to expand their services to an additional 60,000 individuals. 

3. Harm Reduction TA Center ($2 million): Technical assistance will be made available to 

States, Tribes and communities interested in establishing or strengthening their harm 

reduction services. It is estimated this TA will reach a minimum of 75 organizations, who 

will in turn be able to reach 100,000 individuals. 
278 

Funding History Table

Fiscal Year Amount

FY 2021 ---

FY 2022 ---

FY 2023 Final ---

FY 2024 CR ---

FY 2025 President’s Budget $10,000,000
279 

Outputs and Outcomes Table

Program: Community Harm Reduction and Engagement Initiative 

Measure Year and Most Recent 

Result / 

Target for Recent 

Result / 

(Summary of Result)

FY 2023

Target 

FY 2025

Target 

FY 2025

Target 

+/-FY 2023 

Target 

6.1.1 Number of 

Linkages to support 

services (Output) 

FY 2023: 8,505 

Target: 

8,505 

(Baseline)

8,505 8,505 Maintain

6.1.2 Number of 

Substance Test Kits 

Distributed (Output) 

FY 2023: 116,521

Target: 

116,521 

(Baseline)

116,521 116,521 Maintain

6.1.3 Number of 

Syringes Distributed 

(Output) 

FY 2023: 4,798,960

Target: 

4,798,960 

(Baseline)

4,798,960 4,798,960 Maintain
280 

Women’s Behavioral Health Technical Assistance Center

(Dollars in millions) 

Programs of Regional and National Significance

FY 2023 

Final 

FY 2024 

CR 

FY 2025 

President's 

Budget 

FY 2025 +/- 

FY 2023

Women’s Behavioral Health Technical Assistance Center...................... -- -- 1.750 1.750 

Authorizing Legislation........................................Section 2707 of the American Rescue Plan

FY 2025 Authorization ....................................................................................................$1,750,000 

Allocation Method ................................................................................................................... Grant

Eligible Entity ...............................State, Local, Tribal, and Territorial government, Tribal 

organizations, nonprofit community-based entities, and primary care and behavioral health 

organizations

Program Description

The Women’s Behavioral Health Technical Assistance (TA) Center program is a joint effort 

between the Center for Mental Health Services (CMHS) and the Center for Substance Use Services 

(CSUS). It is a five-year program to create a national system of clinical consultation and technical 

assistance (TA) for health providers of various disciplines spanning topics across the lifespan 

within the field of women’s (including female adolescents) mental health and substance use (e.g., 

equity, intimate partner violence, medical co-morbidities, maternal and perinatal, suicide and 

crisis, and trauma). The TA center aims to improve the use of data and evidence by focusing on 

its applications to patient care and implementation in various health settings. This TA Center 

would be outcome- and measurement-focused building on SAMHSA’s experience with similar 

clinical consultation type models, including the Provider Clinical Support System (PCSS), and the 

SMI Advisor TA center. The center improves the customer experience compared to other TA 

initiatives because it provides interdisciplinary, on-demand, flexible and individually tailored 

technical assistance on topics often not covered in their traditional educational courses. 

This program is expected to positively impact the mental and substance use-related health of 

thousands of women across the nation by better equipping multidisciplinary providers to 

individually address and treat women’s behavioral health disorders with the most up to date 

evidence-based interventions, rather than refer them out to limited specialists. The program will 

have a national reach and will assist providers in rural areas and other areas with traditionally low 

access. This is a resource that could potentially change the national landscape of women’s 

behavioral health treatment.

Budget Request

The FY 2025 President’s Budget request is $3.5 million, with CSUS contributing $1.75 million 

and CMHS contributing $1.75 million per year. The program, over its lifetime, is expected to have 

over 2,660,000 website visits, 99,200 unique clinicians trained, 3,200 vetted resources offered, and 

6,300 clinical consultations. Additionally, this cooperative agreement focuses on assisting 

providers with topics that are not traditionally covered in behavioral health training programs such 
281 

as suicide and crisis prevention, how to address gender-based violence, and importantly how to 

address the needs of women facing special challenges due to lower socioeconomic status, 

racial/ethnic minority status, and/or sexual orientation and disabilities in a culturally competent 

manner. 

Funding History Table

Fiscal Year Amount

FY 2021 ---

FY 2022 ---

FY 2023 Final ---

FY 2024 CR ---

FY 2025 President’s Budget $1,750,000
282 

PRNS Mechanism Table 

Center for Substance Use Services

Summary

 

(Dollars in millions)

FY 2023

Final FY 2024 CR

FY 2025 

President's 

Budget

Programs of Regional & National Significance No. Amount No. Amount No. Amount

 Grants

Continuations....................................................................................... 661 310.566 845 430.171 953 497.325 

New/Competing................................................................................... 429 208.596 230 102.285 150 51.184 

Supplements......................................................................................... 19 18.423 --- 0.042 --- -- 

Subtotal............................................................................................ 1,109 537.586 1,075 532.498 1,103 548.509 

Contracts

Continuations....................................................................................... 3 33.54 4 41.938 4 41.416 

New.................................................................................................... 3 3.09 ---

 

0.217 --- 1.044 

Supplements......................................................................................... --- --- --- --- --- ---

Subtotal............................................................................................ 6 36,633 4 41,721 4 42,460

Total, Substance Use Services PRNS 1,115 574.219 1,079 574.219 1,107 590.969 

Supplements encompass additional resources and interventions provided by state agencies to enhance existing programs.
283 

PRNS Mechanism Table

Center for Substance Use Services

Program, Project, and Activity 

(Dollars in millions)

FY 2023

Final FY 2024 CR

FY 2025 

President’s Budget

Programs of Regional & National Significance No. Amount No. Amount No. Amount

Capacity:

Opioid Treatment Programs/Regulatory Activities

 Grants

Continuations....................................................................................... 18 4.662 3 3.244 21 8.534 

New/Competing................................................................................... 5 4.209 17 5.400 --- -- 

Supplements*....................................................................................... --- -- --- -- --- -- 

Subtotal............................................................................................ 23 8.871 20 8.644 21 8.534 

 Contracts

Continuations....................................................................................... 1 0.959 2 1.933 2 1.918 

New/Competing................................................................................... 1 0.894 --- 0.147 --- 0.272 

Subtotal............................................................................................ 2 1.853 2 2.080 2 2.190 

Total, Opioid Treatment Programs/Regulatory Activities 25 10.724 22 10.724 23 10.724 

Screening, Brief Intervention and Referral to Treatment 

 Grants

Continuations....................................................................................... 26 24.777 20 21.591 30 31.585 

New/Competing................................................................................... 7 6.898 10 9.950 --- -- 

Supplements*....................................................................................... --- -- --- -- --- -- 

Subtotal............................................................................................ 33 31.675 30 31.541 30 31.585 

 Contracts

Continuations....................................................................................... -- 2.064 -- 2.274 -- 2.146 

New/Competing................................................................................... -- 0.101 --- 0.026 --- 0.110 

Subtotal............................................................................................ --- 2.165 --- 2.299 --- 2.255 

Total, Screening, Brief Intervention and Referral to Treatment 33 33.840 30 33.840 30 33.840 

Targeted Capacity Expansion

 Grants

Continuations....................................................................................... 179 96.115 202 113.011 183 105.746 

New/Competing................................................................................... 25 19.612 2 0.750 22 8.250 

Supplements*....................................................................................... --- -- --- 0.042 --- -- 

Subtotal............................................................................................ 204 115.726 204 113.803 205 113.996 

 Contracts

Continuations....................................................................................... --- 6.626 --- 8.551 --- 8.189 

New/Competing................................................................................... 0.063 --- 0.062 --- 0.232 

Supplements*....................................................................................... --- -- --- -- --- -- 

Subtotal............................................................................................ 6.690 --- 8.613 --- 8.420 

Total, Targeted Capacity Expansion 205 122.416 204 122.416 205 122.416 
284 

PRNS Mechanism Table

Center for Substance Use Services

Program, Project, and Activity 

(Dollars in millions)

FY 2023

Final FY 2024 CR

FY 2025 President’s 

Budget

Programs of Regional & National Significance No. Amount No. Amount No. Amount

Pregnant and Postpartum Women 

 Grants

Continuations....................................................................................... 34 18.981 57 32.233 58 34.143 

New/Competing................................................................................... 30 17.789 5 4.125 12 7.050 

Supplements*....................................................................................... --- -- --- -- --- -- 

Subtotal............................................................................................ 64 36.770 62 36.358 70 41.193 

 Contracts

Continuations....................................................................................... --- 2.107 --- 2.672 --- 2.885 

New/Competing................................................................................... --- 0.054 --- 0.099 --- 0.147 

Supplements*....................................................................................... --- -- --- -- --- -- 

Subtotal............................................................................................ --- 2.161 --- 2.573 --- 2.738 

Total, Pregnant and Postpartum Women 64 38.931 62 38.931 70 43.931 

Recovery Community Services Program

 Grants

Continuations....................................................................................... 8 2.399 14 4.033 9 2.534 

New/Competing................................................................................... 7 1.795 --- -- 5 1.500 

Supplements **.................................................................................... --- -- --- -- --- -- 

Subtotal............................................................................................ 15 4.194 14 4.033 14 4.034 

 Contracts

Continuations....................................................................................... -- 0.240 -- 0.304 --- 0.291 

New/Competing................................................................................... --- -- --- 0.097 --- 0.109 

Subtotal............................................................................................ --- 0.240 --- 0.401 --- 0.400 

Total, Recovery Community Services Program 15 4.434 14 4.434 14 4.434 

Children and Families

 Grants

Continuations....................................................................................... 19 9.794 53 28.470 53 28.473 

New/Competing................................................................................... 35 18.873 --- -- --- -- 

Supplements *...................................................................................... --- -- --- -- --- -- 

Subtotal............................................................................................ 54 28.667 53 28.470 53 28.473 

 Contracts

Continuations....................................................................................... -- 1.635 -- 2.072 --- 1.983 

New/Competing................................................................................... -- 0.104 --- 0.345 --- 0.259 

Subtotal............................................................................................ --- 1.530 --- 1.727 --- 1.724 

Total, Children and Families 54 30.197 53 30.197 53 30.197 
285 

PRNS Mechanism Table

Center for Substance Use Services

Program, Project, and Activity 

(Dollars in millions)

FY 2023

Final FY 2024 CR

FY 2025 President’s 

Budget

Programs of Regional & National Significance No. Amount No. Amount No. Amount

Treatment Systems for Homeless 

 Grants

Continuations....................................................................................... 51 19.166 61 27.279 62 28.892 

New/Competing................................................................................... 31 15.305 14 7.000 11 5.500 

Supplements *...................................................................................... --- 0.499 --- -- --- -- 

Subtotal............................................................................................ 82 34.969 75 34.279 73 34.392 

 Contracts

Continuations....................................................................................... -- 2.009 -- 2.547 --- 2.437 

New/Competing................................................................................... -- 0.136 --- 0.288 --- 0.285 

Subtotal............................................................................................ --- 2.145 --- 2.835 --- 2.722 

Total, Treatment Systems for Homeless 82 37.114 75 37.114 73 37.114 

Minority AIDS 

 Grants

Continuations....................................................................................... 85 41.208 105 52.310 124 62.293 

New/Competing................................................................................... 44 21.953 19 10.000 --- -- 

Supplements *...................................................................................... --- -- --- -- --- -- 

Subtotal............................................................................................ 129 63.161 124 62.310 124 62.293 

 Contracts

Continuations....................................................................................... -- 3.620 -- 4.590 --- 4.392 

New/Competing................................................................................... -- 0.100 --- 0.019 --- 0.196 

Subtotal............................................................................................ --- 3.720 --- 4.571 --- 4.588 

Total, Minority AIDS 129 66.881 124 66.881 124 66.881 

Criminal Justice Activities

 Grants

Continuations....................................................................................... 109 30.301 161 60.654 208 83.506 

New/Competing................................................................................... 127 55.656 61 25.300 6 2.550 

Supplements *...................................................................................... --- -- --- -- --- -- 

Subtotal............................................................................................ 236 85.957 222 85.954 214 86.056 

 Contracts

Continuations....................................................................................... 2 7.423 1 8.024 1 7.792 

New/Competing................................................................................... -- 0.620 --- 0.022 --- 0.152 

Subtotal............................................................................................ 2 8.043 1 8.046 1 7.944 

Total, Criminal Justice Activities 238 94.000 223 94.000 215 94.000 

Improving Access to Overdose Treatment

 Grants

Continuations....................................................................................... --- -- 7 1.400 7 1.400 

New/Competing................................................................................... 7 1.400 --- -- --- -- 

Supplements *...................................................................................... --- -- --- -- --- -- 

Subtotal............................................................................................ 7 1.400 7 1.400 7 1.400 

 Contracts

Continuations....................................................................................... -- 0.081 -- 0.103 --- 0.099 

New/Competing................................................................................... -- 0.019 --- 0.003 --- 0.001 

Subtotal............................................................................................ --- 0.100 --- 0.100 --- 0.100 

Total, Improving Access to Overdose Treatment 7 1.500 7 1.500 7 1.500 
286 

PRNS Mechanism Table

Center for Substance Use Services

Program, Project, and Activity 

(Dollars in millions)

FY 2023

Final FY 2024 CR

FY 2025 President’s 

Budget

Programs of Regional & National Significance No. Amount No. Amount No. Amount

Building Communities of Recovery

 Grants

Continuations....................................................................................... 41 9.399 31 9.143 37 10.888 

New/Competing................................................................................... 19 5.454 19 5.759 13 4.061 

Supplements *.................................................................................... --- -- --- -- --- -- 

Subtotal............................................................................................ 60 14.853 50 14.902 50 14.949 

 Contracts

Continuations....................................................................................... -- 0.866 -- 1.098 --- 1.051 

New/Competing................................................................................... -- 0.281 --- -- --- -- 

Subtotal............................................................................................ --- 1.147 --- 1.098 --- 1.051 

Total, Building Communities of Recovery 60 16.000 50 16.000 50 16.000 

Grants to Prevent Prescription Drug/Opioid Overdoes-Related 

Deaths

 Grants

Continuations....................................................................................... 15 12.742 18 15.292 18 15.292 

New/Competing................................................................................... 3 2.550 --- -- --- -- 

Supplements 

*...................................................................................... --- -- --- -- --- -- 

Subtotal............................................................................................ 18 15.292 18 15.292 18 15.292 

 Contracts

Continuations....................................................................................... --- 0.866 --- 1.098 --- 1.051 

New/Competing................................................................................... --- 0.158 --- 0.390 --- 0.343 

Subtotal............................................................................................ --- 0.708 --- 0.708 --- 0.708 

Total, Grants to Prevent Prescription Drug/Opioid OverdoesRelated Deaths 18 16.000 18 16.000 18 16.000 

First Responder Training (CARA)

 Grants

Continuations....................................................................................... 47 25.212 66 36.305 65 36.750 

New/Competing................................................................................... 64 23.870 61 15.852 60 15.573 

Supplements *.................................................................................... --- 2.977 --- -- --- -- 

Subtotal............................................................................................ 111 52.059 127 52.157 125 52.323 

 Contracts

Continuations....................................................................................... --- 3.031 --- 3.843 --- 3.677 

New/Competing................................................................................... --- 0.910 --- -- --- -- 

Subtotal............................................................................................ --- 3.941 --- 3.843 --- 3.677 

Total, First Responder Training (CARA) 111 56.000 127 56.000 125 56.000 
287 

PRNS Mechanism Table

Center for Substance Use Services

Program, Project, and Activity 

(Dollars in millions)

FY 2023

Final FY 2024 CR

FY 2025 

President’s Budget

Programs of Regional & National Significance No. Amount No. Amount No. Amount

Peer Support TA Center

 Grants

Continuations....................................................................................... 1 0.950 --- -- 1 1.900 

New/Competing................................................................................... --- -- 1 1.900 --- -- 

Supplements 

*...................................................................................... --- 0.942 --- -- 

Subtotal............................................................................................ 1 1.892 1 1.900 1 1.900 

 Contracts

Continuations....................................................................................... --- 0.108 --- 0.137 --- 0.131 

New/Competing................................................................................... --- -- --- 0.037 --- 0.031 

Subtotal............................................................................................ --- 0.108 --- 0.100 --- 0.100 

Total, Peer Support TA Centers 1 2.000 1 2.000 1 2.000 

Treatment, Recovery, and Workforce Support

 Grants

Continuations....................................................................................... 20 9.797 24 11.860 16 7.887 

New/Competing................................................................................... 4 1.981 -- -- 7 3.500 

Subtotal............................................................................................ 24 11.778 24 11.860 23 11.387 

 Contracts

Continuations....................................................................................... --- 0.359 --- 0.533 --- 0.496 

New/Competing................................................................................... --- -0.137 --- 0.393 --- 0.117 

Subtotal............................................................................................ --- 0.222 --- 0.140 --- 0.613 

Total, Treatment, Recovery, and Workforce Support 24 12.000 24 12.000 23 12.000 

Emergency Department Alternatives to Opioids

 Grants

Continuations....................................................................................... 2 0.219 15 7.297 16 7.802 

New/Competing................................................................................... 15 7.376 1 0.500 --- -- 

Subtotal............................................................................................ 17 7.595 16 7.797 16 7.802 

 Contracts

Continuations....................................................................................... --- 0.239 --- 0.355 --- 0.331 

New/Competing................................................................................... --- 0.166 --- 0.152 --- 0.133 

Subtotal............................................................................................ --- 0.405 --- 0.203 --- 0.198 

Total, Emergency Department Alternatives to Opioids 17 8.000 16 8.000 16 8.000 
288 

PRNS Mechanism Table

Center for Substance Use Services

Program, Project, and Activity 

(Dollars in millions)

FY 2023

Final FY 2024 CR FY 2025 President’s Budget

Programs of Regional & National Significance No. Amount No. Amount No. Amount

Comprehensive Opioid Recovery Centers

 Grants

Continuations....................................................................................... 5 4.249 5 4.250 4 3.400 

New/Competing................................................................................... 2 1.700 1 0.850 2 1.700 

Subtotal............................................................................................ 7 5.949 6 5.100 6 5.100 

 Contracts

Continuations....................................................................................... --- 0.325 --- 0.412 --- 0.394 

New/Competing................................................................................... --- 0.274 --- 0.488 --- 0.506 

Subtotal............................................................................................ --- 0.051 --- 0.900 --- 0.900 

Total, Comprehensive Opioid Recovery Centers 7 6.000 6 6.000 6 6.000 

Women's Behavioral Health Technical Assistance Center

 Grants

Continuations....................................................................................... --- -- --- -- --- -- 

New/Competing................................................................................... --- -- --- -- 3 1.750 

Subtotal............................................................................................ --- -- --- -- 3 1.750 

 Contracts

Continuations....................................................................................... --- -- --- -- --- ---

New/Competing................................................................................... --- -- --- -- --- ---

Subtotal............................................................................................ --- -- --- -- --- ---

Total, Women's Behavioral Health Technical Assistance Center --- -- --- -- 3 1.750 

Community Harm Reduction and Engagement Initiative

 Grants

Continuations....................................................................................... --- -- --- -- 19 9.500 

New/Competing................................................................................... --- -- --- -- 19 9.500 

Subtotal............................................................................................ --- -- --- -- 19 9.500 

 Contracts

Continuations....................................................................................... --- -- --- -- --- 0.657 

New/Competing................................................................................... --- -- --- -- --- -0.157 

Subtotal............................................................................................ --- -- --- -- --- 0.500 

Total, Community Harm Reduction and Engagement Initiative --- -- --- -- 19 10.000 

Youth Prevention and Recovery Initiative

 Grants

Continuations....................................................................................... --- -- 4 1.800 4 1.800 

New/Competing................................................................................... 4 1.800 --- -- 9 -- 

Subtotal............................................................................................ 4 1.800 4 1.800 13 1.800 

 Contracts

Continuations....................................................................................... --- 0.108 --- 0.108 --- 0.131 

New/Competing................................................................................... --- 0.092 --- 0.092 --- 0.069 

Subtotal............................................................................................ --- 0.200 --- 0.200 --- 0.200 

Total, Youth Prevention and Recovery Initiative 4 2.000 4 2.000 13 2.000 

Total, Capacity 1,093 558.037 1,059 558.037 1,087 574.787 
289 

PRNS Mechanism Table

Center for Substance Use Services

Program, Project, and Activity 

(Dollars in millions)

FY 2023

Final FY 2024 CR

FY 2025 President’s

Budget

Science and Service No. Amount No. Amount No. Amount

Addiction Technology Transfer Centers

 Grants

Continuations....................................................................................... --- -- 0 -- 11 8.425 

New/Competing................................................................................... 1 0.375 11 8.425 --- -- 

Supplements *..................................................................................... 11 8.181 --- -- --- -- 

Subtotal............................................................................................ 12 8.556 11 8.425 11 8.425 

 Contracts

Continuations....................................................................................... --- 0.490 --- 0.621 --- 0.594 

New/Competing................................................................................... --- 0.000 --- -- --- 0.027 

Subtotal............................................................................................ --- 0.490 --- 0.621 --- 0.621 

Total, Addiction Technology Transfer Centers 12 9.046 11 9.046 11 9.046 

SAT Minority Fellowship Program

 Grants

Continuations....................................................................................... 0.596 - -- 8 6.577 

New/Competing................................................................................... --- -- 8 6.473 --- -- 

Supplements *..................................................................................... 8 5.825 --- -- --- -- 

Subtotal............................................................................................ 9 6.421 8 6.473 8 6.577 

 Contracts

Continuations....................................................................................... --- 0.386 1 0.663 1 0.657 

New/Competing................................................................................... 1 0.329 --- -- --- 0.098 

Subtotal............................................................................................ 1 0.715 1 0.663 1 0.559 

Total, Minority Fellowship Program (MF) 10 7.136 9 7.136 9 7.136 

Subtotal, Science and Service: 22 16.182 20 16.182 20 16.182 

Total, Substance Use Services PRNS 1,115 $574.219 1,079 $574.219 1,107 $590.969
290 

Grant Awards Table

Center for Substance Use Services

(Whole dollars) 

FY 2023

Final FY 2024 CR

FY 2025 

President's Budget

Number of Awards 1,109 1,075 1,103

Average Award $484,698 $495,298 $497,246 

Range of Awards $300,000-$995,000 $300,000-$995,000 $300,000-$995,000
291 

State Opioid Response Grants

(Dollars in millions) 

Programs of Regional and National Significance

FY 2023 

Final 

FY 2024 

CR 

FY 2025 

President's 

Budget

FY 2025 +/- 

FY 2023

State Opioid Response Grants .................................................................. 1,575.000 1,575.000 1,595.000 20.000 

Set-Aside for Tribes (non-add).............................................................. 55.000 55.000 60.000 5.000 

Authorizing Legislation................... Consolidated Appropriations Act, 2023, Division H, Title II 

FY 2025 Authorization .............................................................................................$1,750,000,000 

Allocation Method ................................................................................................... Formula Grants

Eligible Entities ....... Limited to Single State Agencies (SSAs), the District of Columbia, and U.S. 

Territories, Tribes and Tribal organizations are eligible to apply to set-aside funds described 

below 

Program Description

The State Opioid Response Grants (SOR) program was established by Congress in 2018 to address 

the public health crisis caused by escalating opioid misuse, opioid use disorder, and opioid-related 

overdose across the nation. Since that time, the country has experienced an evolution of this crisis, 

one that is increasingly involving illicitly manufactured fentanyl rather than heroin or prescription 

opioids, and exposure to multiple substances. According to the Centers for Disease Control and 

Prevention (CDC), provisional data indicate there were 106,363 drug overdose deaths in the United 

States during the 12-month period ending in August 2023. Of the drug overdose deaths, 80,609 

involved opioids.149 Illicitly manufactured fentanyl continues to drive the majority of deaths, but 

mortality rates due to cocaine and psychostimulants such as methamphetamine have also 

increased. Overdose deaths involving stimulants increased by 6 percent from 2022 to 2023. These 

deaths are likely linked to co-use or mixing, by illicit producers, of cocaine or methamphetamine 

with fentanyl or heroin.150 As in other areas, the COVID-19 years saw an exacerbation of health 

disparities in overdoses. 

Xylazine has been detected in nearly every state in the country and the Biden-Harris 

Administration has designated it an emerging threat to the United States. This is due to xylazine’s 

growing role in overdose deaths nationwide, and since the designation, data from the CDC have 

continued to show an increase in xylazine-related overdose deaths. In a new report released in June 

2023, the monthly percentage of illegally manufactured fentanyl-involved deaths with xylazine 

detected increased 276 percent (from 2.9 percent to 10.9 percent) between January 2019 and June 

2022.151

149 Ahmad FB, Cisewski JA, Rossen LM, Sutton P. Provisional drug overdose death counts. National Center for 

Health Statistics. 2023. Accessed December 15, 2023. Available at https://www.cdc.gov/nchs/nvss/vsrr/drugoverdose-data.htm 150 Ahmad, F.B., Rossen, L.M., Sutton, P. (2021). Provisional drug overdose death counts. National Center for 

Health Statistics.

151 Kariisa M, O’Donnell J, Kumar S, Mattson CL, Goldberger BA. Illicitly Manufactured Fentanyl–Involved 

Overdose Deaths with Detected Xylazine — United States, January 2019–June 2022. MMWR Morbidity Mortality

Weekly Rep 2023; 72:721–727. Available at: 

https://www.cdc.gov/mmwr/volumes/72/wr/mm7226a4.htm?s_cid=mm7226a4_w
292 

Congressional appropriations and authorizing language have led to the development of three 

components to the grant program; the core State Opioid Response (SOR) grant program; the Tribal 

Opioid Response (TOR) grant program; and the Rural Opioid Technical Assistance-Regional 

Centers (ROTA-R) Cooperative Agreement program. 

State Opioid Response (SOR) Grant Program

The SOR program provides resources to states, the District of Columbia, and territories to continue 

to enhance the development of comprehensive strategies focused upon preventing, intervening, 

and promoting recovery from issues related to opioid use/misuse, opioid use disorder, overdose, 

and stimulant use and use disorder. The program aims to address the overdose crisis by increasing 

access to the three FDA-approved medications for the treatment of opioid use disorder (MOUD), 

reducing unmet treatment need, and reducing overdose deaths through the provision of prevention, 

public health harm reduction interventions, treatment, and recovery activities for opioid use 

disorder (OUD) and other concurrent substance use disorders. The SOR program also supports the 

continuum of care for stimulant misuse and use disorders, including those involving cocaine and 

methamphetamine. SAMHSA has also approved fentanyl and xylazine test strips as an allowable 

expense in this program. 

The SOR program requires grantees to use evidence-based treatments, practices, and interventions 

for OUD and stimulant use disorders. The program requires that MOUD is available to those 

diagnosed with OUD. MOUD includes methadone, buprenorphine products, including singleentity buprenorphine products such as long-acting injectable buprenorphine formulations, 

buprenorphine/naloxone tablets or films, and injectable extended-release naltrexone. The program 

supplements activities pertaining to opioids currently undertaken by the state agency that also 

manages the Substance Use Prevention, Treatment, and Recovery Services Block Grant, and 

supports a comprehensive response to the overdose epidemic. The program identifies gaps and 

resources while building upon existing substance use primary prevention, public health harm 

reduction interventions including opioid overdose reversal medications and fentanyl test strip 

purchase and distribution, treatment activities, as well as community-based recovery support 

services. A primary strategy to reduce overdose deaths in the SOR program, which will continue 

in FY 2025, is education on, and purchase and distribution of, naloxone and other opioid overdose 

reversal medications, proven medications that reverse opioid-related overdoses to save lives. 

In addition to the service grant program, SAMHSA supports a robust technical assistance and 

training effort to enhance education across the country to address the overdose crisis. This effort 

is available not only to SOR and Tribal Opioid Response grantees but to all their sub-recipients 

and affiliated entities, as well as the general public. A key component of this technical assistance 

is local teams of multi-disciplinary experts, including clinicians, preventionists, and recovery 

specialists, in every state. These teams, and the associated technical expertise and educational 

resources they bring, provide training and educational support not only to individual practitioners 

but also to individuals and families, healthcare practices, and law enforcement, criminal justice 

groups, and other community-based organizations. Providing these resources ensures that local 

response to the opioid and overdose crisis is tailored to local needs. 
293 

Tribal Opioid Response (TOR) Grants Program

The Tribal Opioid Response Grants (TOR) program is funded through the same appropriation as 

the SOR program and seeks to address the public health crisis of escalating opioid misuse, opioid 

use disorder, and overdose specifically in Tribal communities. The purpose of the TOR program 

is to assist in addressing the overdose crisis in Tribal communities by increasing access to MOUD, 

and supporting the continuum of prevention, public health harm reduction interventions, treatment, 

and recovery support services for OUD and co-occurring substance use disorders. The TOR 

program also supports the full continuum of prevention, public health harm reduction, treatment 

and recovery support services for stimulant misuse and use disorders, including for cocaine and 

methamphetamine. According to the Centers for Disease Control and Prevention (CDC), American 

Indians and Alaska Natives (AI/AN) had the highest drug overdose death rates in both 2020 and 

2021.152

AI/AN communities experience high rates of physical, emotional, and historical trauma and 

significant socioeconomic disparities, all of which may contribute to higher rates of drug misuse 

in Tribal communities.153 The TOR program addresses the gaps in prevention, public health harm 

reduction, treatment, and recovery identified by Tribes and supports strategies to purchase and 

disseminate naloxone and other opioid overdose reversal medications and provide training on their 

use to first responders and other Tribal members. 

Rural Opioid Technical Assistance- Regional Centers (ROTA-R) Cooperative Agreements 

The purpose of the Rural Opioid Technical Assistance- Regional Centers (ROTA-R) program is 

to develop and disseminate training and technical assistance on addressing opioid and other 

stimulant issues affecting rural communities specifically. Grant recipients are expected to 

facilitate the identification of model programs, develop and update materials related to the 

prevention, public health harm reduction, treatment, and recovery activities for OUD and/or 

stimulant use disorder; and ensure that high-quality training is provided. 

 

In 2022, according to a CDC National Center for Health Statistics Data Brief, the rate of deaths 

involving psychostimulants was 31 percent higher in rural counties (9.4 percent) than in urban 

counties (7.2 percent), and the rate of deaths involving natural and semisynthetic opioids was 

nearly 13 percent higher in rural counties (4.5 percent) than in urban counties (4.0 percent).154

The literature recognizes the need to develop creative and nuanced solutions that work with 

impacted communities.155 The need for an innovative overdose response is particularly clear in 

rural areas, which face unique social, economic, and infrastructural challenges.156 Some solutions 

152 https://www.cdc.gov/nchs/data/databriefs/db457.pdf 153https://www.cdc.gov/injury/tribal/index.html?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Finjury%2F

fundedprograms%2Ftribal.html

154 https://www.cdc.gov/nchs/products/databriefs/db403.htm 155Nabila El-Bassel, Rebecca D Jackson, Jeffrey Samet, and Sharon L Walsh, “Introduction to the Special Issue on 

the HEALing Communities Study.” Drug and Alcohol Dependence, (December 1, 2020): 1, 

https://doi.org/10.1016/j.drugalcdep.2020.108327

156 Shannon Monnat and Khary Rigg, “The Opioid Crisis in Rural and Small Town America,” University of New 

Hampshire Carsey School of Public Policy, (2018): 3, doi:10.34051/p/2020.332
294 

offered by the evidence base include providing public overdose education, improving access to 

naloxone157 and reducing OUD-related stigma.158

 

Budget Request

The FY 2025 President’s Budget request is $1.6 billion, an increase of $20.0 million over the 

FY 2023 Final level. The funding includes a $60.0 million set-aside for the TOR program, an 

increase of $5 million over the FY 2023 Final level. SAMHSA plans to fund 59 new SOR grants 

to continue to support states and territories. SAMHSA aims to admit 127,500 people for OUD 

treatment through SOR in FY 2025. The allowable uses of this program will continue to include 

state efforts to address stimulants, including methamphetamine, and cocaine. Stimulants are an 

increasing source of concern and are involved in a significant proportion of deaths in a number of 

states.159 

Based on an assessment of a state’s naloxone purchasing and distribution conducted in FY 2022 

and further refined through technical assistance in FY 2023 and FY 2024, many states will utilize 

SOR grant dollars as a key source of funds to provide naloxone and other opioid overdose reversal 

medications to underserved areas and organizations in FY 2025. SAMHSA will assist states in the 

identification of underserved communities and agencies and continue to work with states on 

implementation and iterative refinement of overdose reversal medication distribution and 

saturation. 

Funding History Table

Fiscal Year Amount 

FY 2021 $1,525,000,000

FY 2022 $1,525,000,000

FY 2023 Final $1,575,000,000

FY 2024 CR $1,575,000,000

FY 2025 President’s Budget $1,595,000,000

Program Accomplishments

State Opioid Response (SOR) Grant Program 

157 Joan Stephenson, “Commission Outlines New Strategies to Combat Opioid Crisis,” JAMA Health Forum 3, no. 2 

(2022): e220382, doi:10.1001/jamahealthforum.2022.0382

158 Bernard Showers, Danielle Dicken, Jennifer S. Smith, and Aaron Hemlepp, “Medication for Opioid Use Disorder 

in Rural America: A Review of the Literature,” Journal of Rural Mental Health 45, no. 3 (2021): 184, 

doi:10.1037/rmh0000187

159 https://www.cdc.gov/nchs/data/databriefs/db457.pdf
295 

In FY 2023 the State Opioid Response program served 110,650 clients. Significant steps have 

been taken to increase clients’ abstinence, employment and educational opportunities, social 

connectedness, and housing stability. In FY 2023, the percentage of clients who reported that they 

did not use alcohol or illegal drugs within the past 30 days increased by 29.7. percent between 

intake to 6-month follow-up. Between intake and six-month follow-up, the percentage of clients 

who reported no arrests within the past 30 days increased by 1.8. percent. In addition, the 

percentage of clients who were employed or attending school increased by 39.5 percent. Those 

clients who reported being socially connected increased by 1.6 percent from intake to 6-month 

follow-up. Similarly, the percentage of clients who reported housing stability increased by 13.7 

percent.160

In FY 2023, SAMHSA provided continuation grant awards to 58 states and territories including 

the District of Columbia via a formula. This included a 15 percent set-aside for states with the 

highest mortality rate related to drug overdose deaths. Since the SOR program began, states report 

that approximately 1,270,250 patients have received treatment services, including 650,820 who 

have received MOUD. Of that number, 251,321 received methadone, 364,686 received 

buprenorphine, and 34,813 received naltrexone.161 Through the SOR program, 121,937 patients 

received treatment services for stimulant use disorder 162 and 1,465,433 patients received recovery 

support services.163 As of December 15, 2023, grantees reported in the SAMHSA Performance 

Accountability and Reporting System (SPARs), that they distributed 10,032,987 naloxone kits.164

Grantees also reported using naloxone to reverse approximately 551,062 overdoses.165

Tribal Opioid Response (TOR) Grant Program

In FY 2023, the TOR program served 3,408 clients through 89 continuation grants. Significant 

steps have been taken to increase client outcomes, including employment and educational 

160 Source: SAMHSA’s Performance Accountability and Reporting System (SPARS). Retrieved January 16, 2024, 

from http://spars.samhsa.gov. Based on 110,650 client intakes assessments, and 18,598 client six-month follow-up 

reassessments. Limitations: There are several limitations to the program evaluation including (but not limited to) 

incomplete data, self-report, selection bias, and the launch of a new client-level instrument in January 2023. 161 Data is from the FY 2018 SOR cohort, including no-cost extensions, Performance Progress Reports (September 

30, 2018 to September 29, 2021); the FY 2020 SOR cohort, including no-cost extension mid-year Performance 

Progress Reports (September 30, 2020, to March 30, 2023); and the FY 2022 SOR cohort mid-year Performance 

Progress Reports (September 30, 2022 to March 30, 2023); This is the most current data available. 162 Data is from the FY 2020 SOR cohort, including no-cost extension mid-year Performance Progress Reports 

(September 30, 2020, to March 30, 2023); and the FY 2022 SOR cohort mid-year Performance Progress Reports 

(September 30, 2022, to March 30, 2023);This is the most current data available. 163 Data is from the FY 2018 SOR cohort, including no-cost extensions, Performance Progress Reports (September 

30, 2018 to September 29, 2021); the FY 2020 SOR cohort, including no-cost extension mid-year Performance 

Progress Reports (September 30, 2020, to March 30, 2023); and the FY 2022 SOR cohort mid-year Performance 

Progress Reports (September 30, 2022 to March 30, 2023); This is the most current data available. 164 Data reported is based on GPRA data generated in SPARs on January 18, 2024, for the number of naloxone kits 

distributed.

165 Data is from the FY 2018 SOR cohort, including no-cost extensions, Performance Progress Reports (September 

30, 2018-September 29, 2021); the FY 2020 SOR cohort Performance Progress Reports (September 30, 2020, to 

September 29, 2022); and includes GPRA data generated in SPARS on December 15, 2023, for FY 2023 Q1, Q2, 

Q3, and Q4; This is the most current data available.
296 

opportunities, social connectedness, and housing stability. In FY 2023, the percentage of clients 

who were employed or attending school increased by 26.1 percent. In addition, the percentage of 

clients who reported housing stability increased by 5.5 percent. Those clients who reported being 

socially connected increased by 5 percent from intake to 6-month follow-up. Similarly, the 

percentage of clients who reported no arrests within the past 30 days increased by 3.8 percent.166

Since the TOR program began in September 2018, Tribes and Tribal organizations have provided 

TOR-funded treatment and recovery support services to 11,426 clients. Tribes also purchased and 

distributed 49,676 naloxone kits and 37,159 fentanyl testing strips and trained 26,764 community 

members on the use of lifesaving naloxone during this time. Tribes and Tribal organizations funded 

through TOR have also educated over 78,000 individuals on the consequences of opioid misuse 

and overdose through prevention activities during this time.

Rural Opioid Technical Assistance Regional Centers (ROTA-R) Cooperative Agreements 

In FY 2023, SAMHSA funded continuation awards for 10 ROTA Regional Centers. Throughout 

FY 2023, the ROTA Regional grantees implemented 228 events serving close to 11,000 providers 

and community members, disseminating training and technical assistance for rural communities 

addressing opioid and stimulant issues affecting their communities. They also engaged with 

communities and stakeholders in the States within their regions to discuss the most appropriate 

approaches to reach their rural communities.

166 Source: SAMHSA’ Performance Accountability and Reporting System (SPARS). Retrieved January 30, 2023, 

from http://spars.samhsa.gov. Based on 2,468 client intakes assessments, and 420 client six-month followup reassessments. Based on 2,468client intakes assessments, and 421 client six-month follow-up reassessments.

Limitations: There are several limitations to the program evaluation including (but not limited to) incomplete data, 

self-report, and selection bias.
297 

Outputs and Outcomes Table

Program: State Opioid Response Grants 

Measure Year and Most Recent 

Result /

Target for Recent 

Result /

(Summary of Result)

FY 2024 

Target 

FY 2025 

Target 

FY 2025 

Target 

+/-FY 2024 

Target 

1.2.70 Number of 

admissions for OUD 

treatment (Output)

FY 2023: 110,650 

Target:

133,875 

(Target Not Met)

140,569 141,975 +1,406 

1.2.71 number of 

clients receiving 

recovery services 

(Output) 

FY 2023: 41,119 

Target:

51,639.0 

(Target Not Met)

54,221 54,763 +542 

1.2.73 Illicit drug use 

at 6 months followup (Output) 

FY 2023: 78.2 % 

Target:

73.3 % 

(Target Exceeded) 

75.3 % 76.3 % +1 percentage 

point(s) 

1.2.74 Number of 

people educated on 

the consequences of 

opioid and/or 

stimulant misuse 

through prevention 

activities (Output)

FY 2023: 26,323,104 

Frequency/Count 

Target:

26,323,104 

Frequency/Count 

(Baseline)

26,323,104 

Frequency/Co

unt 

26,586,335 

Frequency/Co

unt 

+263,231 

Frequency/Count 
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SOR Mechanism Table

Center for Substance Use Services

Program, Project, and Activity 

(Dollars in millions)

FY 2023

Final FY 2024 CR

FY 2025 

President’s 

Budget

No. Amount No. Amount No. Amount

State Opioid Response Grant

 Grants

Continuations....................................................................................... 166 1,558.701 --- -- 70 1,570.600 

New/Competing................................................................................... --- -- 70 1,551.000 --- -- 

Supplements*....................................................................................... 102 7.853 --- -- --- -- 

Subtotal............................................................................................ 268 1,566.554 70 1,551.000 70 1,570.600 

 Contracts

Continuations....................................................................................... --- 4.200 --- 6.030 --- 6.030 

New/Competing................................................................................... --- 4.246 --- 17.970 --- 18.370 

Supplements*....................................................................................... --- -- --- -- --- -- 

Subtotal............................................................................................ --- 8.446 --- 24.000 --- 24.400 

Total, State Opioid Response Grant 268 1,575.000 70 1,575.000 70 1,595.000 

*Excluding Supplements number count to avoid duplication. FY 2023 Consolidated Appropriations Act provides additional resources and 

interventions provided by state agencies to enhance existing programs.
299 

Substance Use Prevention, Treatment, and Recovery Services Block Grant

(Dollars in millions) 

Programs of Regional and National Significance

FY 2023 

Final 

FY 2024 

CR 

FY 2025 

President's 

Budget 

FY 2025 +/- 

FY 2023

Substance Use Prevention, Treatment, and Recovery Services Block Grant 2,008.079 2,008.079 2,008.079 -- 

Budget Authority (non-add).............................................. 1,928.879 1,928.879 1,928.879 -- 

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

Authorizing Legislation Sections 1921-1935 of Title XIX, Part B, Subpart II of the Public Health 

Service Act, as amended

FY 2025 Authorization .............................................................................................$1,908,079,000 

Allocation Method ................................................................................................... Formula Grants

Eligible Entities .... States, Territories, Freely Associated States, District of Columbia, and the Red 

Lake Band of Chippewa Indians 

Program Description

The Substance Use Prevention, Treatment, and Recovery Services Block Grant (SUPTRS BG) 

program is a formula grant which funds 60 eligible states, territories, and freely associated states, 

the District of Columbia, and the Red Lake Band of Chippewa Indians (referred to collectively as 

states). SUPTRS BG grantees plan, implement, and evaluate substance use disorder (SUD) 

prevention, treatment, harm reduction, and recovery support services based on the specific needs 

of their state systems and populations. Ninety-five percent of SUPTRS BG funding is distributed 

to states through a formula that allocates funds based on specified economic and demographic 

factors and provisions that limit fluctuations in allotments as the total SUPTRS BG appropriation 

changes from year to year.

As reauthorized in the Consolidated Appropriations Act, 2023 (P.L. 117-328), the goal of the 

SUPTRS BG program is to ensure that individuals, their families, and communities have access to 

the range of substance use-related prevention, treatment, public health, and recovery support 

services necessary to improve individual outcomes and reduce the impact of substance use on 

America’s communities.

Priority Services and Populations 

The SUPTRS BG program’s authorizing statute and regulations afford states flexibility to identify 

and deliver substance use-related services to meet their state-specific needs while also ensuring 

attention to critical prevention-focused public health issues. However, certain service areas and 

populations are statutorily required to be addressed with SUPTRS BG funds. The following 

services and populations of focus must be addressed using program funds: 

1. Primary prevention program services; 

2. SUD treatment services for substance using pregnant women and women with dependent 

children; 

3. SUD treatment services for persons who inject drugs; 
300 

4. Early intervention services for HIV/AIDS for individuals in SUD treatment services in 

designated states; and

5. Tuberculosis (TB) services involving TB screening, counseling, and referral for medical 

evaluation and treatment for individuals in SUD treatment services. 

States must also comply with the Synar Amendment to receive their full SUPTRS BG 

funding. The Synar Amendment requires states to enact and enforce laws prohibiting the sale or 

distribution of tobacco products to individuals under the federal legal age of sale. 

Maintenance of Effort (MOE) 

The SUPTRS BG statute includes two maintenance of effort (MOE) requirements for states. First, 

a state must maintain its state expenditures for certain SUD prevention, treatment, and recovery 

support activities at a level that is no less than the state’s average expenditures for the previous 

two state fiscal years. Additionally, the statute requires states to maintain no less than an amount 

equal to the FY 1994 level of expenditures for SUD treatment services for pregnant women and 

women with dependent children. The statute and regulation provide states with the flexibility to 

expend a combination of SUPTRS BG and state SUD treatment funds focused on women to satisfy 

the MOE for women’s SUD treatment services.

Funding Set-Asides

In addition to the two maintenance of effort requirements, the authorizing legislation and 

implementing regulations for the SUPTRS BG includes two specific funding set-asides, a 20 

percent set-aside for primary prevention program services and a five percent set-aside for early 

intervention services for HIV/AIDS for designated states with specific case rates of AIDS. The FY 

2025 Budget Request includes a proposed 10 percent set-aside within the SUPTRS BG for 

substance use recovery support services to significantly expand the upstream and downstream 

continuum of care. 

Primary Prevention Set-Aside

The 20 percent primary prevention program set-aside requires SUPTRS BG grantees to spend at 

least 20 percent of their SUPTRS BG funds to develop and implement a comprehensive substance 

use/ misuse primary prevention program, which includes a broad array of prevention strategies 

directed at individuals not identified to need SUD treatment. The primary prevention program setaside is one of SAMHSA’s main vehicles aimed at preventing substance use/misuse and allows 

states to develop prevention infrastructure and capacity. A thriving prevention infrastructure will 

achieve and maintain long-term outcomes by ensuring that states have the necessary infrastructure 

in place to conduct needs assessments, develop strategic plans, provide culturally appropriate 

services, capture data to make data driven decisions on how prevention resources should be 

allocated throughout communities in their state, and evaluate process and outcome data. Some 

states rely solely on the 20 percent set-aside to fund their primary prevention systems while others 

use the funds to target gaps and enhance existing program efforts. SAMHSA regularly works with 

states to improve their accountability systems for prevention and to establish necessary reporting 

capabilities. FY 2023 data will be available on December 31, 2024. FY 2025 targets may be 
301 

adjusted based on FY 2023 actuals.

HIV/AIDS Set-Aside

In accordance with Public Health statute and SUPTRS BG regulations, states and jurisdictions 

with an AIDS case rate of 10 or more such cases per 100,000 individuals (“designated States”) are 

required to obligate and expend 5 percent of their respective SUPTRS BG annual award for early 

intervention services for HIV. For the purpose of determining which states and jurisdictions are 

considered “designated States” SAMHSA relies on the most current reporting from the AtlasPlus 

HIV·Hepatitis·STD·TB·Social Determinants of Health Data. This reporting of HIV/AIDS data is 

available through the Centers for Disease Control and Prevention (CDC), National Center for HIV, 

Viral Hepatitis, STD and TB Prevention (NCHHSTP). The most current HIV data reporting that 

is accessible on the AtlasPlus website, on or before October 1 of the federal fiscal year for which 

a state is applying for a grant, is used to determine the states or jurisdictions that will be required 

to meet this set-aside. These states use the HIV/AIDS set-aside funds to establish one or more 

projects to provide HIV early intervention services (EIS/HIV) at the sites at which individuals are 

receiving SUD treatment services. This set-aside is required to support specific EIS/HIV services 

including (1) appropriate pretest counseling for HIV/AIDS; (2) testing individuals with respect to 

such disease, including tests to confirm the presence of the disease, tests to diagnose the extent of 

the deficiency of the immune system, and tests to provide information on appropriate therapeutic 

measures for preventing and treating the deterioration of the immune system and for preventing 

and treating conditions arising from the disease; 3) appropriate post-test counseling; and 4) 

providing the therapeutic measures described above. The FY 2025 budget request includes a 

proposed update to the HIV set-aside language to better reflect the current HIV epidemic. Under 

this proposal, SAMHSA would use HIV cases as opposed to AIDS cases to calculate the HIV setaside in the SUPTRS BG. 

Recovery Support Services Set-Aside 

 

The Budget Request includes a 10 percent set-aside within the SUPTRS BG for recovery support 

services. 

Section 1242 of the Consolidated Appropriations Act, 2023 (P.L. 117-328) included language that 

requires states to describe the State’s comprehensive statewide recovery support services activities, 

including the number of individuals being served, target populations, workforce capacity, and 

priority needs; and the amount of funds received that are expended on recovery support services, 

disaggregated by the amount expended for type of service activity. Further, the Joint Explanatory 

Statement accompanying the Consolidated Appropriations Act, 2023 noted that the agreement 

does not include a new set-aside within the SUPTRS BG for recovery services but urges SAMHSA 

to strongly encourage States to use a portion of their SUPTRS BG funding for recovery support 

services. SAMHSA included such language as well as recovery-specific reporting elements in the 

SUPTRS BG FY 2024/FY 2025 state application and reporting requirements. 

However, SAMHSA recognizes that states often have competing priorities for SUPTRS BG funds. 

Given how fundamental recovery support services are to the health and well-being of people with 

SUD and their families, the FY 2025 budget request includes a proposed 10 percent set-aside for 
302 

non-clinical, substance use disorder recovery support services. This will help ensure the more than 

20 million Americans recovering from substance use disorder receive the services and supports to 

help them thrive. These services may include substance use disorder recovery housing that meets 

national certification standards, recovery community centers, peer recovery support services, 

recovery schools, and a variety of other allowable recovery support services. These programs 

utilize individual, community, and system-level approaches to increase the four dimensions of 

recovery as defined by SAMHSA: 

1. Health (access to quality health and SUD treatment); 

 2. Home (housing with needed supports); 

 3. Purpose (education, employment, and other pursuits); and 

 4. Community (peer, family, and other social supports) 

 

States can use these funds to develop local recovery community support institutions, provide 

system navigation resources and supports, and collaborate and coordinate with local private, 

public, non-profit, and faith community response efforts. SAMHSA anticipates that this set-aside 

will help increase access to recovery support services across the country and complement the 

existing efforts to respond to the ongoing overdose crisis that accelerated during the COVID-19 

pandemic. 

 

Budget Request

The FY 2025 President’s Budget request is $2.0 billion, equal to the FY 2023 Final level. Coming 

out of the COVID-19 pandemic, and with an evolving overdose crisis, the need and demand for 

prevention, treatment, harm reduction, and recovery support services for SUDs continues to grow. 

The SUPTRS BG will continue to serve as a source of safety-net funding for vulnerable 

populations that rely on public funding to pay for substance use disorder prevention, treatment, 

public health interventions, and recovery support services. SAMHSA will continue to provide 

assistance to states in addressing and evaluating activities to prevent, reduce harm from, treat, and 

provide recovery support services for individuals, families, and communities that are adversely 

impacted by substance use disorders (SUDs) and related conditions. SAMHSA will also assist 

states and jurisdictions in planning for, expanding, enhancing, and building capacity in their 

service systems to address these evolving needs. States continue to use the Coronavirus Response 

and Relief Supplemental Funding and the American Rescue Plan Supplemental funding through 

March 14, 2024 (with No Cost Extension request approvals) and September 30, 2025, respectively, 

as states expand their SUD infrastructure to address unmet service needs.

Funding History Table 

Fiscal Year Amount

FY 2021 $1,858,079,000

FY 2022 $1,908,079,000

FY 2023 Final $2,008,079,000
303 

FY 2024 CR $2,008,079,000

 FY 2025 President’s Budget $2,008,079,000

Program Accomplishments 

States and their sub-recipients learned a tremendous amount from the COVID-19 experience and 

continue to address the evolution of the overdose crisis. This includes the need for, and ability to 

provide support for recovery housing and funding of other recovery support services. Both service 

areas have been integral to strengthening the substance use disorder treatment services that have 

been provided to clients at all levels of care at a time when the need for the full continuum is at an 

all-time high. There has been extensive adoption of telehealth modalities to provide continuous 

accessibility of services to clients and communities. Grantees have also been encouraged to use 

SUPTRS BG funds to strengthen the crisis continuum of care, and to expand mobile substance use 

disorder services, including mobile medication services to reach persons with opioid use disorders. 

Plans for FY 2025 are to continue strengthening service accessibility and quality, while expanding 

services to under-served populations, including the expansion of recovery support services. 

Importantly, SUPTRS BG funds are also directed towards the collection of performance and 

outcome data to determine the ongoing effectiveness of supported activities and provide states and 

the federal government the grounding to plan the implementation of new evidence-based services. 

At this critical moment in the country’s substance use crisis, it is imperative that our response truly 

evolve from an acute, short-term one to a broader and longer-term community recovery response. 

Substance use disorder is a chronic illness, and recovery often is a life-long process where the 

healthcare system, external community, and social determinants of health play vital roles in 

helping people, their families, and communities find and sustain well-being. Modernizing the data 

component for the SUPTRS BG will be a significant focus for FY 2025. 

Performance and Evaluation 

The SUPTRS BG enables the development of comprehensive statewide systems of care that 

provide a broad continuum of SUD services and recovery supports encompassing prevention, 

treatment, harm reduction, and recovery support services for individuals in need. By statute, 

SAMHSA collects performance metric data from the states to monitor performance outcomes 

across the program. The data is used to measure and monitor state program goals and client 

outcomes. The data is used by the states for future strategic planning to enhance the state’s SUD 

systems of care. In addition, the data is used by SAMHSA in policymaking and recommendations 

for innovative programs to address gaps in the SUD systems of care. 

In FY 2024-2025, as part of SAMHSA’s ongoing data modernization strategy, SAMHSA is 

developing a common performance, evaluation, and quality dataset, and clarifying reporting 

instructions for states. This new dataset and clearer instructions will increase SAMHSA’s ability 

to assess and monitor SAMHSA’s BG programs. 
304 

SUPTRS BG SUD Treatment Outcomes

States reported 1,678,575 SUD treatment admissions for state fiscal year (SFY) 2022, the last year 

for which complete data are available, suggesting ongoing critical support of SUD treatment by 

public funding, including BG funds.167 The outcome data from the Behavioral Health Services 

Information System/Treatment Episode Data Set (TEDS), administered by SAMHSA’s Center for 

Behavioral Health Statistics and Quality (CBHSQ) provides more detailed information for SFY 

2022. 

 

In SFY 2022, states expended Block Grant funds as follows168: 

• $141,205,758 for SUD Treatment for Pregnant Women and Women with 

Dependent Children

• $1,220,442,272 for All Other SUD Treatment and Prevention Services 

• $364,068,458 for SUD Primary Prevention Program Services 

• $299,148 for Tuberculosis Services 

• $12,127,486 for HIV/AIDS Early Intervention Services 

• $80,197,533 for SSA Administration 

 

In total, all states and jurisdiction admitted 2,520,918 clients in SFY 2022, specifically169: 

• 215,042 persons admitted to withdrawal management services; 

• 362,193 persons admitted to residential treatment levels of care; 

• 1,575,108 persons admitted to ambulatory/outpatient services; and 

• 368,575 persons received outpatient treatment that included medication for opioid 

use disorder

Note: the 2,520,918 number does not represent unduplicated individuals as persons may 

have been admitted more than once, or received more than one particular service. 

167 Web Block Grant Application System (WebBGAS) 2023 SABG Report, Table 10 -Treatment Utilization Matrix, 

WebBGAS Report #78 SUPTRS BG Treatment Utilization Matrix - Admissions & Persons Served, , 2023 Report 

Year for the SFY 22 period of 7/1/21 through 6/30/22. 168 Source: WebBGAS 2023 Report, Table 2a - State Agency Expenditure Report, WebBGAS Report #48 - SABG 

State Agency Reported Expenditures by Target Activity within Source of Funds, 2023 Report Year for the SFY 

2022 period of 7/1/21 through 6/30/22.

169 Source: WebBGAS 2023 SABG Report, Table 10 - Treatment Utilization Matrix, WebBGAS Report #20 – 

SUPTRS BG Treatment Utilization Matrix - Summary of Admissions by Level of Care, 2023 Report Year for the 

SFY 2022 period of 7/1/21 through 6/30/22.
305 

SFY 2022 SUPTRS BG Demographics170,171

Total Unduplicated Persons Served (Adults 

and Children) 1,523,265

Female 40.5%

Male 59.5%

Race

White 62.12%

Blacks or African Americans 16.48%

American Indian/Alaska Natives 4.08%

Asians .70%

Native Hawaiian/Other Pacific Islanders .44%

Unknown 13.43%

Multi-Racial 2.69%

Ethnicity

Not Hispanic or Latino 85.8%

Hispanic or Latino 14.2%

A

17 and Under 3.89%

18 – 24 9.15%

25 – 44 56.65%

45 – 64 27.43%

65 and Over 2.89%

Synar Program Outcomes 

The Synar Program was established to monitor and enforce the federal prohibition on the sale or 

distribution of tobacco products to individuals under the age of 18, recently updated to 21, by 

conducting unannounced and random inspections of retailers selling such products. While the 

national weighted retailer violation rate declined steadily from 40.1 percent in the program’s 

baseline year in FY 1997 through FY 2011, the rate increased from an all-time low of 8.5 percent 

in FY 2011 to 9.6 percent in FY 2018. In FY 2019 and FY 2020, the national weighted retailer 

isolation rate was 7.6 and 8.4, respectively.172 These figures represent the latest data as there are 

currently no withhold amounts under subsection (b) for the three-year period immediately 

following the date of enactment of the Consolidated Appropriations Act, 2020. For FY 2021, FY 

2022, and FY 2023, no penalties were assessed per legislation (PL 116-94) for retail violations. 

170 Source: WebBGAS 2023 Report, Tables 11A, 11B, and 11C - Unduplicated Count of Persons Served for Alcohol 

and Other Drug Use, WebBGAS Report #69 SUPTRS BG Unduplicated Count of Persons Served by Age Group 

with Gender & Race Breakout, and WebBGAS Report #72, SUPTRS BG Unduplicated Count of Persons Served by 

Age Group with Gender and Ethnicity Breakout, 2023 Report Year, for the SFY 2022 period of 7/1/21 through 

6/30/22.

171 Source: 2023 SABG Report - Tables 11A, 11B, and 11C – Unduplicated Count of Persons Served for Alcohol 

and Other Drug Use, WebBGAS Report #72 SUPTRS BG Unduplicated Count of Persons Served by Age Group 

with Gender and Ethnicity Breakout, 2023 Report Year for the SFY 22 period of 7/1/21 through 6/30/22. 172 https://www.samhsa.gov/sites/default/files/synar_program_rvr_table_1997-2018_dec_11_2018.pdf. 
306 

The national average for retail violation data during this period cannot be readily ascertained due 

to variations in reporting and states having to make the needed protocol adjustments for 

compliance. We anticipate most up to date data projections and national trends in June 2025. 

Tobacco 21 legislation was included in a larger fiscal year 2020 appropriations package (P.L. 116-

94) that was enacted in December 2019. Tobacco 21 legislation, signed into law in 2019, does not 

require that states pass laws to raise their sales age to 21, but, in line with Synar requirements, 

requires states to demonstrate that their retailers are complying with the federal law not to sell 

tobacco products to individuals under the age of 21. Synar inspections are conducted on a federal 

fiscal year timeline. The next federal fiscal year that would subject states to penalty would be 

October 1, 2023-September 30, 2024. FY 2022 is the latest data that are available. FY 2023 data 

will become available December 31, 2024. 

There are a few known factors impacting Synar retailer violation rates (RVR). Public Law (PL) 

116-94 which increased the legal age for the purchase of tobacco products from age 18 to age 21. 

State restrictions resulting from the COVID-19 Pandemic played a significant role in current retail 

violation rates (RVR). As a result of the new legislation states were granted a three (3) year grace 

period where no penalties would be enforced. During this period states were directed to develop 

implementation strategies and plans to address any noted challenges). The initial grace period 

covered the period between December 2019 and December 2022. In 2023, the grace period was 

extended through December 2024. During the grace period, no Synar Amendments penalties to 

the Substance Use Treatment and Recovery Services Block Grant are enforced. 

Technical Assistance

In addition to the states and jurisdictions’ plans and reports, authorizing legislation provides 

SAMHSA with resources to support technical assistance to the SUPTRS BG grantees and their 

sub-recipients to ensure that they can effectively provide prevention, substance use disorder 

treatment, harm reduction, and recovery support services. SAMHSA’s Knowledge Application 

Program (KAP) (https://www.samhsa.gov/kap) produces the Technical Assistance Publication 

Series that provide practical guidance and information on the delivery of SUD treatment services 

and related public health services to individuals and families. The KAP also produces the 

Treatment Improvement Protocol Series, a growing library of best practice guidelines, which are 

produced by a consensus-development process based on the experience and knowledge of clinical, 

research, and administrative experts. SAMHSA has also re-developed a two-pronged quality 

assurance and individualized, state-specific technical assistance program to provide additional 

support to states in their implementation of the SUPTRS BG program. 
307 

Output and Outcomes Table

Program: Treatment Activities

Measure Year and Most Recent 

Result /

Target for Recent Result /

(Summary of Result)

FY 2024

Target

FY 2025

Target

FY 2025

Target

+/-FY 2024

Target

1.2.43 Number of 

admissions to substance 

use treatment programs 

receiving public funding 

(Output)

FY 2023: 1,678,575

Target:

1,448,024

(Target Exceeded)

1,476,984 1,476,984 Maintain

1.2.48 Percentage of 

clients reporting no drug 

use in the past month at 

discharge (Outcome)

FY 2023: 54.3 %

Target:

52.4 %

(Target Exceeded)

54.4 % 54.4 % Maintain

1.2.49 Percentage of 

clients reporting no 

alcohol use in the past 

month at discharge 

(Outcome)

FY 2023: 78.5 %

Target:

78.6 %

(Target Not Met but 

Improved)

80.6 % 80.6 % Maintain

1.2.50 Percentage of 

clients reporting being 

employed/in school at 

discharge (Outcome)

FY 2023: 34.7 %

Target:

36.4 %

(Target Not Met but 

Improved)

38.4 % 38.4 % Maintain

1.2.85 Percentage of 

clients receiving services 

who had a permanent 

place to live in the 

community (Outcome)

FY 2023: 89.3 %

Target:

92.9 %

(Target Not Met but 

Improved)

94.9 % 94.9 % Maintain
308 

Program: Prevention Set-Aside

Measure Year and Most 

Recent Result /

Target for Recent 

Result /

(Summary of Result)

FY 2024

 Target

FY 2025

 Target

FY 2025

 Target

+/-FY 2024

 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 12-17) 

(Outcome)

FY 2022: 62.5 %

 

Target:

 73.9 % 

 

(Target Not Met)

73.9 % 73.9 % Maintain

2.3.67 Percent of 

states showing a 

decrease in state 

level estimates of 

percent of survey 

respondents who 

report 30 day use of 

any illicit drugs 

other than 

marijuana (age 12-

17) (Outcome)

FY 2022: 69.6 %

 

Target:

 63 % 

 

(Target Exceeded) 

63 % 63 % Maintain

2.3.68 Percent of 

states showing a 

decrease in state 

level estimates of 

percent of survey 

respondents who 

report 30 day use of 

any illicit drugs 

other than 

marijuana (age 

18+) (Outcome)

FY 2022: 39.3 %

 

Target:

 48 % 

 

(Target Not Met)

48 % 48 % Maintain
309 

SUBG Mechanism Table

Center for Substance Use Services

Program, Project, and Activity 

(Dollars in millions)

FY 2023

Final FY 2024 CR

FY 2025 President’s 

Budget

No. Amount No. Amount No. Amount

Substance Use Prevention, Treatment, and Recovery Block Grant

Continuations.............................................................................................................. --- --- --- --- --- ---

New/Competing........................................................................................................... 60 1,928.879 60

 

1,928.879 --- 1,928.879

Supplements*.............................................................................................................. --- --- --- -- --- ---

Subtotal.................................................................................................................... 60 1,928.879 60

 

1,928.879 --- 1,928.879

 Contracts

Continuations.............................................................................................................. --- --- --- -- --- ---

New/Competing........................................................................................................... --- 79.200 --- 79.200 --- 79.200

Supplements*.............................................................................................................. --- --- --- -- --- ---

Subtotal.................................................................................................................... --- 79.200 --- 79.200 --- 79.200

Total, SUBG 60 2,008.079 60

 

2,008.079 --- 2,008.079
310 

State Table

DEPARTMENT OF HEALTH AND HUMAN SERVICES

SAMHSA

FY 2025 MANDATORY STATE/FORMULA GRANTS 

CFDA NUMBER/PROGRAM NAME: 93.959/SUBG 

FY2023 FY2024 FY2025 FY 2025 +/-

State Final CR President's Budget FY 2024

Alabama $24,686,455 $24,686,455 $24,688,661 $2,206

Alaska $7,365,856 $7,365,856 $7,366,514 $658

Arizona $47,835,777 $47,835,777 $47,840,051 $4,274

Arkansas $14,433,529 $14,433,529 $14,434,819 $1,290

California $260,569,705 $260,569,705 $260,592,984 $23,279

Colorado $36,229,697 $36,229,697 $36,232,934 $3,237

Connecticut $20,463,616 $20,463,616 $20,465,444 $1,828

Delaware $7,530,296 $7,530,296 $7,530,969 $673

District Of Columbia $7,530,296 $7,530,296 $7,530,969 $673

Florida $116,814,207 $116,814,207 $116,824,644 $10,437

Georgia $58,534,875 $58,534,875 $58,540,105 $5,230

Hawaii $8,789,845 $8,789,845 $8,790,630 $785

Idaho $9,195,796 $9,195,796 $9,575,126 $379,330

Illinois $69,282,302 $69,282,302 $69,288,492 $6,190

Indiana $36,957,352 $36,957,352 $36,960,654 $3,302

Iowa $14,119,045 $14,119,045 $14,120,307 $1,262

Kansas $12,976,950 $12,976,950 $12,978,109 $1,159

Kentucky $21,294,912 $21,294,912 $21,296,815 $1,903

Louisiana $25,631,884 $25,631,884 $25,634,174 $2,290

Maine $7,530,296 $7,530,296 $7,530,969 $673

Maryland $34,904,467 $34,904,467 $34,907,586 $3,119

Massachusetts $44,048,382 $44,048,382 $44,052,318 $3,936

Michigan $57,408,915 $57,408,915 $57,414,044 $5,129

Minnesota $26,746,812 $26,746,812 $26,749,202 $2,390

Red Lake Indians $659,211 $659,211 $659,270 $59

Mississippi $14,137,505 $14,137,505 $14,138,768 $1,263

Missouri $29,032,034 $29,032,034 $29,034,628 $2,594

Montana $7,530,296 $7,530,296 $7,530,969 $673

Nebraska $8,476,196 $8,476,196 $8,476,953 $757

Nevada $20,537,145 $20,537,145 $20,538,980 $1,835

New Hampshire $7,530,296 $7,530,296 $7,530,969 $673

New Jersey $52,033,413 $52,033,413 $52,038,062 $4,649

New Mexico $10,381,561 $10,381,561 $10,382,489 $928

New York $114,535,516 $114,535,516 $114,545,750 $10,234

North Carolina $52,356,446 $52,356,446 $52,361,124 $4,678

North Dakota $7,530,296 $7,530,296 $7,530,969 $673
311 

FY2023 FY2024 FY2025 FY 2025 +/-

State Final CR President's Budget FY 2024

Ohio $66,097,021 $66,097,021 $66,102,927 $5,906

Oklahoma $19,133,801 $19,133,801 $19,135,511 $1,710

Oregon $26,191,379 $26,191,379 $26,193,719 $2,340

Pennsylvania $60,529,987 $60,529,987 $60,535,395 $5,408

Rhode Island $7,782,301 $7,782,301 $7,782,996 $695

South Carolina $26,137,986 $26,137,986 $26,140,321 $2,335

South Dakota $7,530,296 $7,530,296 $7,530,969 $673

Tennessee $35,879,258 $35,879,258 $35,882,464 $3,206

Texas $163,031,546 $163,031,546 $163,046,113 $14,567

Utah $25,514,492 $25,514,492 $25,516,772 $2,280

Vermont $7,530,296 $7,530,296 $7,530,969 $673

Virginia $47,578,842 $47,578,842 $47,583,093 $4,251

Washington $41,988,215 $41,988,215 $41,991,967 $3,752

West Virginia $8,636,687 $8,636,687 $8,637,459 $772

Wisconsin $27,855,973 $27,855,973 $27,858,462 $2,489

Wyoming $5,250,164 $5,250,164 $5,250,633 $469

State Subtotal $1,872,289,426 $1,872,289,426 $1,872,835,221 $545,795

American Samoa $358,798 $358,798 $352,911 -$5,887

Guam $1,275,605 $1,275,605 $1,313,126 $37,521

Northern Marianas $392,556 $392,556 $399,756 $7,200

Puerto Rico $24,154,125 $24,154,125 $24,062,425 -$91,700

Palau $163,016 $163,016 $168,484 $5,468

Marshall Islands $588,566 $588,566 $620,552 $31,986

Micronesia $774,650 $774,650 $784,438 $9,788

Virgin Islands $804,706 $804,706 $818,640 $13,934

Territory Subtotal $28,512,022 $28,512,022 $28,520,332 $8,310

State-Territory Total $1,900,801,448 $1,900,801,448 $1,901,355,553 $554,105

Administrative $107,277,552 $107,277,552 $106,723,447 -$554,105

Appropriation $2,008,079,000 $2,008,079,000 $2,008,079,000 ---
312 

Health Surveillance and Program Support

Table of Contents

Summary of the Request ..................................................................................................313

Health Surveillance ..........................................................................................................314

Performance and Quality Information Systems (PQIS)...................................................319 

Drug Abuse Warning Network (DAWN) ........................................................................323

Public Awareness and Support ........................................................................................325

Program Support ..............................................................................................................329
313 

Health Surveillance and Program Support

Summary of the Request

(Dollars in millions)

Program Name

FY 2023 

Final 

FY 2024 

CR 

FY 2025 

President's 

Budget

FY 2025 +/- 

FY 2023 

Health Surveillance and Program Support 135.123 135.123 135.123 -- 

Program Support ................................................................................... 84.500 84.500 84.500 -- 

Health Surveillance (non-add) ................................................................. 50.623 50.623 50.623 -- 

Budget Authority (non-add) ............................................................. 20.195 20.195 20.195 -- 

PHS Evaluation Funds (non-add) .................................................... 30.428 30.428 30.428 -- 

Subtotal, Health Surveillance and Program Support 135.123 135.123 135.123 -- 

Congressional Earmarks..................................................................... 160.777 160.777 -- -160.777 

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

Public Awareness and Support............................................................... 13.260 13.260 13.260 -- 

Budget Authority (non-add) ............................................................. 13.260 13.260 13.260 -- 

Performance and Quality Information Systems......................................... 10.200 10.200 10.200 -- 

Budget Authority (non-add) ............................................................. 10.200 10.200 10.200 -- 

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

Communities of Strength – Building the Community Workforce (New) -- -- -- -- 

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

Drug Abuse Warning Network............................................................... 13.000 13.000 13.000 -- 

Total, Health Surveillance and Program Support.................................. 334.860 334.860 174.083 -160.777 

HSPS Budget Authority (non-add) ....................................................... 301.932 301.932 141.155 -160.777 

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

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

FTE 379 407 407 -- 

Overview

The Health Surveillance and Program Support (HSPS) FY 2025 Budget Request is $174.1 million, 

equal to FY 2023 Final level. 

SAMHSA maintains multiple U.S. behavioral health data collection systems and surveys, supports 

public awareness, and funds a range of business operations and processes within HSPS. 
314 

Health Surveillance

(Dollars in millions)

 

Programs Name

FY 2023 

Final FY 2024 CR

FY 2025 

President's 

Budget

FY 2025 +/- 

FY 2023 

Health Surveillance................................................................................. 50.623 50.623 50.623 -- 

Budget Authority (non-add) ............................................................. 20.195 20.195 20.195 -- 

PHS Evaluation Funds (non-add) .................................................... 30.428 30.428 30.428 -- 

Authorizing Legislation......................Sections 501 and 505 of the Public Health Service Act 

FY 2025 Authorization .................................................................................................... Permanent

Allocation Method ..................................................... Federal/Intramural, Contracts, Grants, Other

Eligible Entities ......................................................................................................... Not Applicable 

The Health Surveillance provided resources for SAMHSA’s Center for Behavioral Health 

Statistics and Quality (CBHSQ). CBHSQ is the lead Federal government agency for behavioral 

health data collection, evaluation, and research. CBHSQ promotes basic and applied research in 

behavioral health data systems and statistical methodology, designs and carries out special data 

collection and analytic projects to examine issues for SAMHSA and other federal agencies, and 

participates with other federal agencies in developing national health statistics policy. CBHSQ’s 

focus is to leverage data and evidence to strengthen SAMHSA data collection activities to inform 

policies, programs, and funding to prevent overdose; enhance access to suicide prevention and 

crisis care; promote resilience and emotional health for children, youth, and families; integrate 

behavioral and physical healthcare; and strengthen the behavioral health workforce. 

Health Surveillance supports the following activities: (1) Population Data Collection, Analysis, 

and Dissemination; (2) Treatment Services Data Collection, Analysis, and Dissemination; (3) 

Behavioral Health Data Dissemination; (4) Performance Measurement/Systems and; (5) Drug 

Abuse Warning Network (DAWN). Collectively, all Health Surveillance programs serve to 

advance SAMHSA’s vision to ensure that people with, affected by, or at risk for, mental health 

and substance use conditions received care, thrive, and achieve well-being. 
315 

Center for Behavioral Health Statistics and Quality

Health Surveillance Resources by Activity/Program

(Dollars in millions)

Program Name

FY 2023 

Final

FY 2024

CR

FY 2025 

President's 

Budget

FY 2025 +/- 

FY 2023

Health Surveillance

Population Data Collection, Analysis, and Dissemination 8.469 8.469 8.469 --

National Survey on Drug Use and Health (NSDUH)................................ 8.469 8.469 8.469 --

Treatment Services Data Collection, Analysis, and Dissemination 13.283 13.283 13.283 --

Behavioral Health Services Information System (BHSIS)........................ 13.283 13.283 13.283 --

Behavioral Health Data Dissemination 4.331 4.331 4.331 --

SAMHDA/Data Webpage.......................................................................... 3.049 3.049 3.049 --

Quality Logistics Support........................................................................... 1.281 1.281 1.281 --

Performance Measurement/Systems 1.067 1.067 1.067 --

WebBGAS................................................................................................. 1.067 1.067 1.067 --

Drug Abuse Warning Network --- --- --- --

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

Support 23.473 23.473 23.473 --

Operations............................................................................................... 23.473 23.473 23.473 --

Total Health Surveillance 50.623 50.623 50.623 --

Program Description and Accomplishments

CBHSQ performs activities that: (1) coordinate and implement SAMHSA’s integrated data 

strategy, including annual data collection; (2) provide statistical and analytical support for 

SAMHSA’s activities; (3) develop and manage a core set of performance metrics to evaluate high 

priority activities supported by SAMHSA; and (4) coordinate with the Assistant Secretary, the 

Assistant Secretary for Planning and Evaluation, SAMHSA’s National Mental Health and 

Substance Use Policy Lab, SAMHSA’s Chief Medical Officer, the Office of Behavioral Health 

Equity, the Office of Recovery, as well as the program Centers as appropriate, to improve the 

quality of data collection services and evaluations of SAMHSA activities. 

CBHSQ activities cross over multiple programs throughout SAMHSA.

Population Data Collection, Analysis, and Dissemination 

CBHSQ leads SAMHSA’s annual requirement to collect prevalence data on substance use and 

mental health via the National Survey of Drug Use and Health (NSDUH). NSDUH is an annual 

collection of behavioral health data on persons aged 12 or older of the U.S. civilian, noninstitutionalized population. It is used as the nation’s primary source of statistical information on 

the use of illicit drugs, alcohol, tobacco, certain mental health issues, co-occurring disorders, 

treatment for mental and substance use disorders, and recovery. NSDUH data provide estimates 

at the national, state, and sub-state level and among demographic, socioeconomic, or geographic 

subgroups, as well as trend estimates over time. The public can readily access state-level NSDUH 
316 

data via SAMHSA’s interactive online tools173, specifically designed for customized analyses of 

substance use and mental health indicators, without needing to download any data. In addition, 

SAMHSA disseminates data-based products in the form of annual reports, data visualizations, 

slide decks, data tables and other types of reports. 

To ensure NSDUH is collecting the highest quality data to address emerging and critical data needs 

related to mental health and substance use behaviors, SAMHSA has made critical improvements 

to the questionnaire: 

• In 2022, a number of changes were made including updating and renaming the Nicotine 

module (formerly Tobacco module) and the Alcohol and Drug Treatment module (formerly 

the Drug Treatment module). The Marijuana module was also updated through an 

extensive literature review, subject matter expert (SME) input, and three rounds of 

cognitive testing. This revised module includes updated terminology, updated modes of 

administration for marijuana, and items on Cannabidiol (CBD) use. 

• In 2023, the most notable being the addition/revision of sexual orientation and gender 

identity (SOGI) questions for both youth and adults. The 2023 NSDUH includes a question 

assessing sex assigned at birth and a question assessing gender identity. All respondents, 

not just adults as in previous years, were asked about their sexual attraction and sexual 

identity. Response options for sexual identity were revised to be more inclusive. 

Terminology was updated throughout the survey to use gender-neutral language. 

• In 2024, selected module introductions were revised to update and simplify language, a 

question asking about past year use of overdose reversal medicine was added, and the 

general anxiety disorder scale (GAD-7) was added to the mental health module for adults.

In a united effort to support broader use of restricted-use NSDUH data, researchers apply for, and 

obtain access to, restricted-use NSDUH data using a process that has been streamlined and 

expanded to facilitate easier and broader access to the data. SAMHSA promotes data use by 

aiding researchers in navigating resources, accessing relevant substance use and mental health 

indicators, and completing important public health investigations, while also protecting privacy 

and minimizing disclosure risk. Findings from the research analytic activities have been helpful in 

influencing program implementation of evidence-based interventions and strategies.

In FY 2023, the SAMHSA Data webpage (Data webpage) and Substance Abuse and Mental Health 

Data Archive (SAMHDA) received over 2.03 million page views overall, with about 69% of the 

traffic comprised of new visitors to the website. There were almost 340,000 total files downloaded 

from SAMHSA and SAMHDA in FY 2023. NSDUH webpages within SAMHSA and SAMHDA 

received around 890,000 page views and close to 170,000 downloads in FY 2023. In FY 2024, 

CBHSQ plans to continue to modernize and streamline the Data webpage by merging the Data 

webpage and SAMHDA into one seamless site. These updates will allow easier access to a wider 

audience and promote increased use and access to behavioral health data. 

173 https://pdas.samhsa.gov/saes/state
317 

Treatment Services Data Collection, Analysis, and Dissemination

SAMHSA collects data on mental health and substance use disorder treatment services through 

the Behavioral Health Services Informational System (BHSIS). Data collected through BHSIS 

provides information to the public on treatment services through the Behavioral Health Treatment 

Services Locator, which is part of the National Treatment Referral Service. 

BHSIS includes multiple data collection programs and information resources. The data collections 

comprise: 

1) The National Substance Use and Mental Health Services Survey (N-SUMHSS), which 

provides information on all public and private specialty mental health and substance use 

disorder treatment facilities in the United States; 

2) The Treatment Episode Data Set (TEDS), which provides demographic, clinical, and substance 

use characteristics on publicly funded admissions and discharges from substance use disorder 

treatment facilities; 

3) The Mental Health Treatment Episode Data Set (MH-TEDS) and the Mental Health Client 

Level Data (MH-CLD), which provide demographic characteristics and outcomes of 

individuals served by state mental health agencies (SMHAs) for mental health treatment; and 

4) The Uniform Reporting System (URS), which provides a set of standardized data tables 

submitted annually by states and territories as part of their Mental Health Block Grant annual 

implementation reports. 

In FY 2023, the Behavioral Health Treatment Locator, renamed as FindTreatment.gov, was 

redesigned to improve access and usability. As a result, in Feb 2023, traffic to the site increased 

by 700%. In FY 2024, a Spanish version of FindTreatment.gov will be scheduled for release. 

Behavioral Health Data Dissemination

The SAMHDA, a data archive, makes public-use data files available in a variety of formats that 

anyone can download and analyze and explore. Through SAMHDA, CBHSQ provides access to 

a data visualization tool and to public- and restricted-use state and substate data through a webbased analytic tool. This site currently resides at https://datafiles.samhsa.gov/. The Data webpage, 

which currently resides at https://www.samhsa.gov/data/, makes reports, survey information, and 

supporting documentation available for multiple public audiences. 

Budget Request

The FY 2025 Budget Request for SAMHSA’s Health Surveillance programs is $50.6 million, 

equal to FY 2023 Final level. With the funding for FY 2025, CBHSQ will explore the feasibility 

of modernizing FindTreatment.gov, SAMHSA’s treatment locator, to feature appointment 

capability to reduce barriers for individuals and families to access treatment. CBHSQ will 

implement a Spanish version of the Locator. Within BHSIS, CBHSQ is planning to disseminate 

and analyze an N-SUMHSS supplement to provide information regarding use of Electronic Health 

Records among facilities. Additional funding would also allow the TEDS to provide increased 

technical support to the States to overcome the challenges and difficulties of data reporting. For 

FY 2025, CBHSQ is planning to implement an N-SUMHSS supplement for facilities offering 
318 

crisis intervention services for 988.

Funding History Table

Fiscal Year Amount

FY 2021 $47,154,285

FY 2022 $48,623,000

FY 2023 Final $50,623,000

FY 2024 CR $50,623,000

FY 2025 President's Budget $50,623,000
319 

Performance and Quality Information Systems (PQIS)

(Dollars in millions) 

Programs Name

FY 2023 

Final 

FY 2024 

CR 

FY 2025 

President's 

Budget

FY 2025 +/- 

FY 2023 

Performance and Quality Information Systems......................................... 10.200 10.200 10.200 -- 

Authorizing Legislation ...................................... Sections 501, 509, 516, and 520Aof the PHS Act 

FY 2025 Authorization ...................................................................................................... Indefinite

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

Eligible Entities ......................................................................................................... Not Applicable 

Overview

SAMHSA’s maintains Performance Measurement and Performance Systems, Evidenced-Based 

Programs and Practices and CBHSQ’s Operations with PQIS funds. 
320 

Resources by Activity/Program

(Dollars in millions) 

Program Name FY 2023

Final

FY 2024

CR

FY 2025

President's 

Budget

FY 2025

+/- FY 2023

Performance and Quality Information Systems

Performance Measurement and Performance 

Systems........................ 7.021 6.011 7.635 .614

 SAMHSA Performance Accountability Reports System 

(SPARS)... 7.021 6.011 7.635 .614

Evidence-Based 

Programs/Practices.................................................... 1.783 1.839 1.882 .099

 Evidence Based Resource 

Center.................................................... 1.783 1.839 1.882 .099

Behavioral Health Data 

Dissemination............................................... --- --- --- ---

Support.......................................................................................

........ 1.396 2.350 .683 -.713

 

Operations...................................................................................... 1.396 2.350 .683 -.713

Total Performance and Quality Information Systems 10.200 10.200 10.200 ---

Performance Measurement and Performance Systems

SAMHSA Performance Accountability and Reporting System (SPARS) 

Through SPARS, SAMHSA collects data on key output and outcome measures to monitor and 

manage discretionary grant performance and improve the quality of behavioral health services 

across the continuum. Data collected and analyzed through SPARS allow SAMHSA to monitor 

the progress of discretionary grants, support data-informed decision-making for funding, and 

provide an understanding of the services delivered through the programs. The Office of Evaluation 

Center Evaluation Advisors (CEAs) work with SAMHSA’s Centers and Offices to routinely 

enhance SPARS to be more user friendly with greater data visualization capacity. These 

enhancements improve data visualization options for examination of demographic data on both 

adult and youth participants for a single year or for multiple years of funding. 

In FY 2022, SPARS was updated to include new versions of more than 40 of SAMHSA’s 

Government Performance Results Act (GPRA) tools for discretionary grant programs and 

implemented in FY 2023. These updated tools required CBHSQ to make significant changes to 

the SPARS system and required updates to GPRA documentation and resources including 

recorded videos and live, interactive training sessions. SPARS infrastructure and security were 

upgraded to ensure operational stability and protection. 

Evidenced-Based Programs and Practices

Evidence-Based Practice Resource Center (EBPRC) 

Section 7002 of the 21st Century Cures Act directs SAMHSA to promote access to reliable and 

valid information on evidence-based programs and practices and share information on the strength 

of evidence associated with such programs and practices related to mental illness and drug/alcohol 

addiction. To fulfill this charge, SAMHSA has developed the Evidence-Based Practices Resource 
321 

Center (EBPRC). The EBPRC, which is managed by the National Mental Health and Substance 

Use Policy Laboratory (NMHSUPL), provides states, local communities, clinicians, policymakers, 

and others in the field with the information and tools that they need to incorporate evidence-based 

practices in their communities or clinical settings. As part of this effort, SAMHSA develops and 

disseminates resources, such as new or updated guidebooks, advisories, Treatment Improvement 

Protocols, guidance documents, clinical practice policies, toolkits, systematic reviews, data 

reports, and other actionable materials that incorporate the latest evidence on mental health and 

substance use. The EBPRC enables SAMHSA to collaborate with experts in the field and to rapidly 

translate science into action. In particular, SAMHSA disseminates the EBPs listed in the EBPRC 

through various avenues including through regional and locally based training and technical 

assistance efforts to ensure that communities and practitioners are equipped to bring about the 

improvements in mental health, substance use prevention and treatment, and recovery that our 

Nation requires.

Support

Operations 

The CBHSQ’s OE is responsible for providing centralized planning and management of program 

evaluation and performance management activity across SAMHSA. In this role, OE provides 

support to CMHS, CSUS, CSUPS, the Office of Tribal Affairs and Policy (OTAP), the Office of 

Behavioral Health Equity, the Office of Recovery, the 988 and Behavioral Health Crisis 

Coordinating Office, and the Office of Intergovernmental and Public Affairs grantees and project 

officers. This support includes evaluation proposals, performance management and monitoring 

and quality improvement activities. OE’s Evaluation Policy and Procedures (P & P) document 

formalizes the systematic approach to planning, managing, and overseeing programmatic and 

policy evaluation activities within SAMHSA. 

In FY 2022, the OE led the effort to create the SAMHSA Evidence and Evaluation Board (SEEB). 

The SEEB is a strategic asset that supports SAMHSA in meeting its mission and agency priorities, 

especially implementation of the Evidence Act (Foundations for Evidence-Based Policy Making 

Act of 2018). It is the agency’s principal forum for managing SAMHSA’s evaluation portfolio and 

evaluation and evidence data. Within this consensus-driven setting, SAMHSA’s Centers and 

Offices share data-driven insights and best practices and learn from each other and experts across 

HHS to support evidence-based decision making. The SEEB has served as the forum for SAMHSA 

to administer and share results of an agency Capacity Assessment, create an evaluation repository, 

and begin to develop an agency wide Evaluation Plan and Learning Agenda, all in FY 2023. 

In FY 2023, the OE was responsible for the management for several multiyear program evaluations 

funded by each of the three SAMHSA Centers. Additionally, in partnership with CMHS, the 

Interdepartmental Serious Mental Illness Coordinating Committee (ISMICC), other agencies in 

DHHS, and the Veterans Administration, OE staff has expanded efforts to enhance the use of 

measurement-based care (MBC) in community settings providing behavioral health services. This 

work has included publication of an issue brief and a convening of subject matter experts in the 

field of MBC.
322 

Budget Request

The FY 2025 Budget Request is $10.2 million, equal to FY 2023 Final level. In FY 2025, 

SAMHSA plans to use funding to continue to operate and maintain the SPARS system. The Office 

of Evaluation within CBHSQ will continue to develop minor enhancements to collect GPRA data 

from the more than 7,500 discretionary grants in FY 2023 funded by SAMHSA. This funding 

would also support SAMHSA’s ability to enhance the current SPARS system to continuously 

support SAMHSA’s evolving data and reporting needs and better align with SAMHSA Evidence 

Act. 

Funding History Table

Fiscal Year Amount

FY 2021 $9,969,596

FY 2022 $10,000,000

FY 2023 Final $10,200,000

FY 2024 CR $10,200,000

FY 2025 President's Budget $10,200,000
323 

Drug Abuse Warning Network (DAWN)

(Dollars in millions) 

Programs Name

FY 2023 

Final FY 2024 CR

FY 2025 

President's 

Budget

FY 2025 +/- 

FY 2023 

Drug Abuse Warning Network................................................................ 13.000 13.000 13.000 -- 

Authorizing Legislation.................................... Section 505 of the Public Health Service Act

FY 2025 Authorization ..................................................................................................................$0 

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

Eligible Entities ......................................................................................................... Not Applicable 

Program Description and Accomplishments 

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

to respond effectively to the overdose and addiction crises in the United States. DAWN data is 

used to better inform public health, clinicians, policymakers, and other stakeholders when 

responding to emerging substance use trends. By using data abstracted directly from emergency 

department (ED) records, DAWN captures detailed information about the substances involved in 

ED visits and serves as an early warning system for the emergence of new and novel psychoactive 

substances. It monitors the geographic, temporal, and demographic characteristics of drug-related 

ED visits. DAWN captures both ED visits that are directly caused by drugs, such as overdoses, 

and those in which drugs are a contributing factor but not the direct cause of the ED visit, such as 

a motor vehicle crash involving a driver who had combined medications with alcohol. These 

criteria encompass all types of drug-related events, from substance use and misuse to substancerelated suicide attempts. 

 

As of January 9, 2024, the DAWN surveillance system has reviewed more than 7,143,062 ED 

records from 54 participating hospitals (27 urban, 11 suburban, and 16 rural) and abstracted over 

562,736 DAWN cases (7.9 percent of total ED records reviewed). Preliminary analysis 

demonstrates that the most common substances associated with DAWN cases are alcohol (257,724 

cases, 45.8 percent), illicit substances (191,316 cases, 34.0 percent) and Central Nervous System 

(CNS) agents (104,281 cases, 18.5 percent); among illicit drugs, stimulants were the most 

associated with DAWN cases, with the majority involving methamphetamine.

Budget Request

The FY 2025 Budget Request is $13.0 million, equal to the FY 2023 Final level. In FY 2025, 

SAMHSA plans to continue to operate and maintain DAWN. 
324 

Funding History Table

Fiscal Year Amount

FY 2021 $10,000,000

FY 2022 $10,000,000

FY 2023 Final $13,000,000

FY 2024 CR $13,000,000

FY 2025 President's Budget $13,000,000
325 

Public Awareness and Support 

(Dollars in millions) 

Programs Name

FY 2023 

Final 

FY 2024 

CR 

FY 2025 

President's 

Budget

FY 2025 +/- 

FY 2023 

Public Awareness and Support ............................................................... 13.260 13.260 13.260 -- 

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

FY 2025 Authorization...................................................................... Indefinite 

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

Eligible Entities ......................................................................................................... Not Applicable 

 

Program Description and Accomplishments 

 

An essential part of SAMHSA’s mission is to increase public awareness of available services, 

education, and resources that promote mental health, prevent substance misuse, and provide 

treatments and supports to foster recovery while ensuring equitable access and better outcomes.

SAMHSA’s Office of Communications (OC) staff ensure that the vital information, publications, 

and training materials produced through SAMHSA’s centers and offices are available to the 

healthcare workforce, people in treatment and recovery, people in crisis or in areas affected by 

disasters, SAMHSA grantees, and the public. Several channels are used to communicate this 

information, including online, print, radio, and television media; social media platforms; the 

SAMHSA.gov website; the SAMHSA Store, the subscription-based e-blast system; and inquiries 

received through the National Helpline. In addition, the OC staff manage interactions with media 

organizations and the public and assist in the development and execution of materials, products, 

and campaigns. 

The OC media team evaluate and act upon media inquiries; develop rollout plans; issue press 

releases, news bulletins, and media advisories; and provide in-house media support to SAMHSA 

centers and offices. The team build relationships with representatives of the media; identify and 

seek corrections to inaccuracies about SAMHSA in media products, when necessary; work to add 

SAMHSA’s life-saving resources to journalistic and entertainment products; support broad HHS 

and administration communications priorities; and collaborate with departmental operating 

divisions. The media team also collaborate with SAMHSA staff when a disaster occurs to quickly 

disseminate press releases and social media featuring SAMHSA’s Disaster Distress Helpline and 

links to relevant SAMHSA resources.

The OC digital team manage SAMHSA’s social media presence on Facebook, Twitter, LinkedIn, 

Instagram, and YouTube. Social media messaging is incorporated in all communications plans 

and is employed daily to communicate messages about SAMHSA news and resources. The staff 

monitor social media conversations, create content, participate in Twitter chats and Facebook Live 

sessions, and post blogs on SAMHSA.gov. The digital team also manage the SAMHSA.gov 

website, which provides enterprise-wide content and related public-facing websites, and support 

Section 508 activities. 

 

The following contract services are managed within the OC and provide various levels of support 

to enable the sharing of vital information to the public:
326 

Health Education and Campaign Communications: Enables OC to develop and disseminate a 

variety of national informational campaigns, public service announcements (PSAs), and other 

materials for a broad range of platforms. Topics, audiences, and formats range but includes all 

phases of campaign management from research to development and delivery and to monitoring 

and measuring outcomes. Provides messages and materials to support targeted public education 

efforts such as social media, advertising, digital media, and collateral materials. Provides writing, 

editing, design, and layout support for communication products. Also develops partner 

relationships to deliver the campaign messages thus extending the reach.

Materials Development and Editorial Services: Provides communication support services for 

media outreach, publications, digital products, speechwriting, graphics, copyediting, and 

meeting/event logistics.

Web Management and Support: Supports SAMHSA’s website, listserv and subscriber database 

system, and mobile applications. For its online publication library (i.e., SAMHSA Store), the OC 

has entered into an interagency agreement with the U.S. Government Publishing Office (GPO) to 

manage a customer-oriented fulfillment and distribution center, including a warehouse to store 

SAMHSA publications. 

Contact Center: Supports the National Helpline (1-800-662-HELP) and the 1-877-SAMHSA-7 

information line. The National Helpline provides free, confidential treatment referral and 

information services in English and Spanish for individuals and families facing mental illness 

and/or substance use disorders via phone or text (HELP4U). It is operational 365 days-a-year, 

24/7. The 1-877-SAMHSA-7 line is the single point of entry for SAMHSA’s information services 

and is operated Monday through Friday, 8:00 am to 8:00 pm (except for federal holidays). 

Budget Request 

 

The FY 2025 Budget Request is $13.3 million, equal to the FY 2023 Final level. The Budget will 

be used to manage media relationships, maintain its web and social media presence, manage 

critical helplines, deliver publications and resources, produce, and deliver PSAs, and conduct 

national campaigns. 
327 

Funding History Table 

Fiscal Year Amount

FY 2021 $12,961,000

FY 2022 $13,000,000

FY 2023 Final $13,260,000

FY 2024 CR $13,260,000

FY 2025 President's Budget $13,260,000

 
328 

Outputs and Outcomes Table

Program: Public Awareness and Support

Measure Year and Most 

Recent Result /

Target for Recent 

Result /

(Summary of Result)

FY 2024

 Target

FY 2025

 Target

FY 2025

 Target

+/-FY 2024

 Target

4.4.12 The number 

of individuals 

referred for 

behavioral health 

treatment 

resources. (Output)

FY 2023: 794,488

Target:

1,054,200 

(Target Not Met)

802,430 810,450 +8,020 

4.4.13 The total 

number of 

interactions 

through phone 

inquiries, e-blasts, 

dissemination of 

SAMHSA 

publications, and 

total website hits 

(Output)

FY 2023: 64,937,499

Target:

61,224,900 

(Target Exceeded) 

65,586,870 66,242,740 +655,870 
329 

Program Support

(Dollars in millions) 

Programs Name

FY 2023 

Final 

FY 2024 

CR 

FY 2025 

President's 

Budget 

FY 2025 +/- 

FY 2023 

Program Support................................................................................... 84.500 84.500 84.500 -- 

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

FY 2025 Authorization ..................................................................................................................$0 

Allocation Method .......................................... Direct Federal/Intramural, Contracts, Grants, Other

Eligible Entities ......................................................................................................... Not Applicable 

Program Description and Accomplishments

The Program Support budget supports SAMHSA staff who plan, direct, and administer 

SAMHSA’s programs, as well as business operations and processes, information technology, and 

overhead expenses, such as rent and utilities. In addition, this budget supports the Unified 

Financial Management System (UFMS), which covers administrative activities such as human 

resources, information technology, financial integrity, and the centralized services provided by 

HHS and the Program Support Center. SAMHSA’s FTE increase in FY 2023 and FY 2024 

supports programmatic growth described throughout the budget and supplemental appropriations. 

SAMHSA also applies an estimated internal administrative charge for overhead expenses to all 

programs, projects, and activities. 

Budget Request 

The FY 2025 Budget Request is $84.5 million, equal to the FY 2023 Final level. SAMHSA will 

continue to support staff to administer and manage SAMHSA’s diverse array of programs. At this 

funding level, SAMHSA will also ensure the agency can efficiently and effectively respond to the 

evolving behavioral health crisis, as well as provide the significant resources, technical assistance, 

and leadership within the mental health and behavioral health public health sphere. This level of 

funding will also continue to cover overhead costs associated with 5600 Fishers Lane, including 

rent, the Federal Acquisition Service loan repayment program, and security charges. 

Funding History Table

Fiscal Year Amount

FY 2021 $78,762,000

FY 2022 $81,500,000

FY 2023 Final $84,500,000

FY 2024 CR $84,500,000

FY 2025 President's Budget $84,500,000
330 

PRNS Mechanism Table

Program, Project, and Activity 

(Dollars in millions)

FY 2023 

Final FY 2024 CR

FY 2025

President's Budget

Program Activity No. Amount No. Amount No. Amount

Health Surveillance

Contracts

Continuations.......................................................................................... --- 49.342 --- 47.951 --- 50.623 

New/Competing....................................................................................... 1 1.281 --- 2.672 --- --

Subtotal 1 50.623 --- 50.623 --- 50.623 

Total, Health Surveillance 1 50.623 --- 50.623 --- 50.623 

Program Support

Grants

Continuations.......................................................................................... --- -- --- -- --- --

New/Competing...................................................................................... --- -- --- -- --- --

Subtotal............................................................................................... --- -- --- -- --- --

Contracts

Continuations.......................................................................................... --- 84.50 --- 84.50 --- 84.50 

New..................................................................................................... --- -- --- -- --- 0.00 

Subtotal.............................................................................................. --- 84.50 --- 84.50 --- 84.50 

Total, Program Support --- 84.50 --- 84.50 --- 84.50 

Performance and Quality Information Systems

Contracts

Continuations......................................................................................... 2 10.200 2 10.200 2 10.200 

New/Competing..................................................................................... --- -- --- -- --- --

Subtotal........................................................................................... 2 10.200 2 10.200 2 10.200 

Total, Performance and Quality Information Systems 2 10.200 2 10.200 2 10.200 

Drug Abuse Warning Network

Contracts

Continuations........................................................................................ 1 13.000 1 13.000 1 13.000 

New/Competing................................................................................... --- -- --- -- --- --

Subtotal............................................................................................ 1 13.000 1 13.000 1 13.000 

Total, Drug Abuse Warning Network 1 13.000 1 13.000 1 13.000 

Behavioral Health Workforce Data and Development

Grants

Continuations......................................................................................... 1 0.982 1 0.970 1 0.972 

New/Competing..................................................................................... --- -- --- -- --- --

Subtotal.............................................................................................. 1 0.982 1 0.970 1 0.972 

Contracts

Continuations......................................................................................... --- 0.018 --- 0.030 --- 0.028 

New/Competing..................................................................................... --- -- --- -- --- --

Subtotal.............................................................................................. --- 0.018 -- 0.030 --- 0.028 

Total, Behavioral Health Workforce Data and Development 1 1.000 0.00 1.000 1 1.000 

Total, HSPS 5 159.323 4 159.323 4 159.323 
331 

Nonrecurring Expenses Fund

Budget Summary

(Dollars in millions)

 

FY 20232 FY 20243 FY 20254

Notification1 -- -- $21.95

 

Authorizing Legislation:

Authorization.............Section 223 of Division G of the Consolidated Appropriations Act, 2008 

Allocation Method..................................................Direct Federal, Competitive Contract 

Program Description and Accomplishments

The Nonrecurring Expenses Fund (NEF) permits HHS to transfer unobligated balances of expired 

discretionary funds from FY 2008 and subsequent years into the NEF account. Congress 

authorized use of the funds for capital acquisitions necessary for the operation of the Department, 

specifically information technology (IT) and facilities infrastructure acquisitions. NEF resources 

will allow SAMHSA to make critical capital investments in information technology that 

modernize SAMHSA’s systems and improve the effectiveness of agency operations and the 

utilization of data across the agency. 

 

Budget Allocation FY 2025 

 

In FY 2025 SAMHSA will utilize NEF funding for two projects: 

 

• WebBGAS: This project will develop a new data dashboard system which provides critical 

data about SAMHSA’s block grant programs to the public in a transparent way. This new 

system will:

o Enhance users’ data analysis and visualization capabilities of block grant program 

data through the creation of new tools such as measurement dashboards on 

SAMHSA’s samhsa.gov website which will allow for improved external data 

sharing on program performance. 

o Integrate with other SAMHSA data sources such as SAMHSA’s Performance 

Accountability and Reporting System (SPARS), WebBGAS, Treatment Episode 

Data Set (TEDS), Uniform Reporting System (URS), and data from external 

sources such as Centers for Medicare and Medicaid Services (CMS) and the 

Centers for Disease Control and Prevention (CDC) to help further knowledge 

sharing and understanding of the cross-cutting impact of SAMHSA’s block grant 

programs. 

o Increase use of block grant data for policymaking and research by providing public 

use files and other research resources. 

o Support a customer solution for SAMHSA and comply with Federal Integrated 

Business Framework (FIBF).

 
332 

• Disparity Impact Statement (DIS) Equity-Centered Integrated Data Enterprise (DECIDE): 

This project will build an integrated data management system to support the analysis of 

SAMHSA’s DIS data and ultimately the performance of the grant investments in advancing 

equity for racial and ethnic populations. The DECIDE system would have a user-friendly 

interface and customizable data visualizations, such as charts, graphs, tables, and 

dashboards, making it easier for users to assess performance and glean insights from the 

data. The integrated system will facilitate cross-functional collaboration, enabling teams 

to share data, findings, and insights which will help drive better QI decisions and outcomes. 

Budget Allocation FY 2022 and Prior 

• FY 2019 

o CBHSQ Data Web Site: This project will update and improve timely access to the 

behavioral health data maintained on this web site.

o NSDUH Contract: The project associated with this NEF request is for the purchase 

of new field interviewer (FI) data collection equipment to be deployed on the 2020 

NSDUH. Given the size and scope of NSDUH the fleet of FI data collection 

equipment typically needs refreshed every 5 years. The most recent refresh was 

deployed on the 2015 NSDUH. 

• FY 2017 

o Project Evolve: This project is an ongoing effort to improve and consolidate stand 

alone web sites to SAMHSA.gov. 

o NSDUH IT Upgrade: Migrate system from FIPS low environment to FIPS high 

environment. 

• FY 2016 

o Grants and Information Management Tool: This project funded the creation of 

the SAMHSA Performance Accountability and Reporting System (SPARS) which 

replaced Services Accountability Improvement System (SAIS), the 

Transformation Accountability System (TRAC), and the Prevention Management 

Reporting and Training System (PMRTS). 

o BASCIC: This project customized and configured SAMHSA’s Behavioral 

Health Analytic, Scientific and Clinical Information Component. This system 

was an advanced information explorer and web service that allowed individuals, 

providers and organizations to seek and receive contextual behavioral health 

information. 

o Extranet Portal: This project provided web support, IT security, and data web 

page support. 

 

1 Pursuant to Section 223 of Division G of the Consolidated Appropriation Act, 2008, 

notification is required of planned use. 

2 Notification submitted to the Committees on Appropriations in the House of Representatives 

and the Senate on September 23, 2022. 

3 Notification submitted to the Committees on Appropriations in the House of Representatives 

and the Senate on October 19, 2023. 

4

 HHS has not yet notified for FY 2025. 
333 

Supplementary Tables

Table of Contents

Budget Authority by Object Class ...............................................................................................334 

Salaries and Expenses ..................................................................................................................343 

Details of Full-Time Equivalent Employment .............................................................................345 

Detail of Positions........................................................................................................................346

Physicians’ Comparability Allowance Worksheet ......................................................................347 

Resources for Cyber Activities ....................................................................................................348 

 
334 

Budget Authority by Object Class

Summary Direct Budget Authority

(Dollars in millions)

Object Class - Direct Budget Authority1,2,3

FY 2023

Final

FY 2024

CR

FY 2025

President's 

budget

FY 2025 +/- 

FY 2023

Personnel compensation:

Full-time permanent (11.1)................................................... $61.653 $86.836 $107.352 +$45.315 

Other than full-time permanent (11.3)................................... 1.509 2.150 2.658 +1.130 

Other personnel compensation (11.5)................................... 2.819 3.942 4.873 +2.044 

Military personnel (11.7)...................................................... 5.636 8.055 8.431 +3.188

Special personnel services payments (11.8) ......................... 0.017 0.024 0.030 +0.013 

Subtotal personnel compensation: 71.634 101.007 123.345 +51.689

Civilian benefits (12.1)........................................................ 23.086 32.478 40.152 +16.963 

Military benefits (12.2).......................................................... 0.411 0.844 2.282 +2.285

Subtotal Pay Costs: 95.131 134.329 165.779 +70.938

Travel and transportation of persons (21.0)........................... 0.995 0.986 1.006 +0.011 

Transportation of things (22.0).............................................. 0.001 0.000 0.000 -0.001 

Rental payments to GSA (23.1)............................................. 5.380 7.078 7.220 +1.839 

Rental payments to Others (23.2).......................................... -- -- -- --

Communication, utilities, and misc. charges (23.3).............. 0.025 0.131 0.134 +0.109 

Printing and reproduction (24.0)........................................... 0.675 0.343 0.350 -0.325 

Other Contractual Services:

Advisory and assistance services (25.1)............................ 53.793 53.360 52.535 -1.258 

Other services (25.2)........................................................ 91.727 73.843 70.815 -23.498 

Purchase of Goods & Svcs. from Govt. Accts (25.3)........ 24.712 25.123 21.797 -0.616 

Operation and maintenance of facilities (25.4).................. 0.216 0.298 0.304 +0.088 

Research and Development Contracts (25.5).................... -- -- -- --

Operation and maintenance of equipment (25.7).............. 0.974 1.197 1.220 +0.246 

Subtotal Other Contractual Services: 171.422 153.821 146.672 -25.038

Supplies and materials (26.0)............................................... 0.070 0.118 0.121 +0.051 

Equipment (31.0)................................................................ 0.138 0.133 0.136 0.002 

Grants, subsidies, and contributions (41.0).......................... 7,096.509 7,073.402 7,248.780 +152.272 

Insurance claims and indemnities (42.0)............................... 0.071 0.074 0.075 +0.004 

Interest and dividends (43.0)................................................ -- -- -- --

Refunds (44.0)...................................................................... -- -- -- --

Subtotal Non-Pay Costs 7,275.286 7,236.087 7,404.493 +126.979 

Total Direct Obligations $7,370.416 $7,370.416 $7,569.889 +$199.473 

1 Does not include PHS Evaluation Funds.

2 Does not include Prevention and Public Health 

Funds.

3 Does not include Mandatory funds
335 

Budget Authority by Object Class

Mental Health

(Dollars in millions)

Object Class - Direct Budget Authority1,2,3

FY 2023

Final

FY 2024

CR

FY 2025 

President's Budget

FY 2025 +/- 

FY 2023

Personnel compensation:

Full-time permanent (11.1)............................................ $15.329 $17.574 $21.726 +$6.397 

Other than full-time permanent (11.3)......................... 0.353 0.405 0.500 +0.147 

Other personnel compensation (11.5)............................. 0.806 0.924 1.142 +0.336 

Military personnel (11.7).............................................. 1.444 1.721 1.801 +0.357 

Special personnel services payments (11.8) ................ 0.004 0.004 0.005 +0.002 

Subtotal personnel compensation: 17.936 20.628 25.175 +7.239 

Civilian benefits (12.1)................................................. 5.861 6.719 8.306 +2.446 

Military benefits (12.2)................................................. 0.157 0.187 1.801 +1.644 

Subtotal Pay Costs: 23.953 27.534 35.283 +11.329 

Travel and transportation of persons (21.0)................... 0.148 0.154 0.158 +0.009 

Transportation of things (22.0)..................................... -- -- -- --

Rental payments to GSA (23.1)..................................... 0.056 1.921 1.960 +1.903 

Rental payments to Others (23.2).................................. -- -- -- --

Communication, utilities, and misc. charges (23.3)..... 0.022 0.023 0.023 +0.001 

Printing and reproduction (24.0).................................. 0.001 0.002 0.002 +0.001 

Other Contractual Services: --

Advisory and assistance services (25.1)....................... 33.064 31.053 33.281 +0.217 

Other services (25.2).................................................... 61.023 49.689 49.369 -11.654 

Purchase of Goods & Svcs. from Govt. Accts (25.3).. 12.893 11.004 11.224 -1.668 

Operation and maintenance of facilities (25.4)............. 0.005 0.011 0.011 +0.007 

Research and Development Contracts (25.5)............... -- -- -- --

Operation and maintenance of equipment (25.7)......... 0.483 0.612 0.624 +0.140 

Subtotal Other Contractual Services: 107.467 92.368 94.509 -12.958 

Supplies and materials (26.0)....................................... 0.009 0.005 0.006 -0.003 

Equipment (31.0)......................................................... 0.063 0.078 0.079 +0.016 

Grants, subsidies, and contributions (41.0)................... 2,623.787 2,633.421 2,946.987 +323.200 

Interest and dividends (43.0)......................................... -- -- -- --

Subtotal Non-Pay Costs 2,731.554 2,727.973 3,043.724 +312.170 

Total Direct Obligations $2,755.507 $2,755.507 $3,079.007 +$323.500 

1 Does not include PHS Evaluation Funds.

2 Does not include ACA or PPHF

3 Does not include Mandatory funds of 

$412.5M
336 

Budget Authority by Object Class

Substance Use Prevention Services

(Dollars in millions)

Object Class - Direct Budget Authority1

FY 2023

Final

FY 2024

CR

FY 2025 

President's 

Budget

FY 2025 +/- 

FY 2023

Personnel compensation:

Full-time permanent (11.1)............................................... $6.705 $8.850 $10.941 +$4.237 

Other than full-time permanent (11.3).............................. 0.059 0.078 0.096 +0.037 

Other personnel compensation (11.5)............................... 0.268 0.354 0.438 +0.169 

Military personnel (11.7).................................................. 1.426 1.957 2.049 +0.622 

Special personnel services payments (11.8) ...................... -- -- -- --

Subtotal personnel compensation: 8.458 11.239 13.523 +5.065 

Civilian benefits (12.1)...................................................... 2.475 3.267 4.039 +1.564 

Military benefits (12.2)...................................................... -- 0.256 -- --

Subtotal Pay Costs: 10.933 14.761 17.562 +6.629 

Travel and transportation of persons (21.0)....................... -- -- -- --

Transportation of things (22.0).......................................... -- -- -- --

Rental payments to GSA (23.1)........................................ 0.000 1.140 1.163 +1.163 

Rental payments to Others (23.2)....................................... -- -- -- --

Communication, utilities, and misc. charges (23.3)........... -- -- -- --

Printing and reproduction (24.0)....................................... 0.002 0.001 0.001 -0.001 

Other Contractual Services: --

Advisory and assistance services (25.1)............................ 5.922 6.146 4.269 -1.653 

Other services (25.2)......................................................... 11.807 10.021 9.143 -2.664 

Purchase of Goods & Svcs. from Govt. Accts (25.3)........ 1.373 1.097 0.291 -1.082 

Operation and maintenance of facilities (25.4).................. 0.018 0.085 0.087 +0.069 

Research and Development Contracts (25.5).................... -- -- -- --

Operation and maintenance of equipment (25.7)............... -- -- -- --

Subtotal Other Contractual Services: 19.120 17.350 13.790 -5.330 

Supplies and materials (26.0)........................................... -- 0.000 0.000 +0.000 

Equipment (31.0).............................................................. 0.001 0.001 0.001 +0.000 

Grants, subsidies, and contributions (41.0)....................... 206.823 203.626 204.362 -2.461 

Interest and dividends (43.0)............................................ -- -- -- --

Subtotal Non-Pay Costs 225.946 222.118 219.317 -6.629 

Total Direct Obligations $236.879 $236.879 $236.879 --

1 Does not include PHS Evaluation Funds.
337 

Budget Authority by Object Class

Substance Use Services

(Dollars in millions)

Object Class - Direct Budget Authority1

FY 2023

Final

FY 2024

CR

FY 2025 

President's 

Budget

FY 2025 +/- 

FY 2023

Personnel compensation:

Full-time permanent (11.1).......................................................... $11.904 $18.421 $22.773 +$10.869 

Other than full-time permanent (11.3)......................................... 0.152 0.235 0.290 +0.139 

Other personnel compensation (11.5).......................................... 0.627 0.970 1.199 +0.572 

Military personnel (11.7)............................................................. 0.662 1.065 1.115 +0.453 

Special personnel services payments (11.8) ................................ -- -- -- --

Subtotal personnel compensation: 13.345 20.691 25.377 +12.032 

Civilian benefits (12.1)................................................................ 4.458 6.899 8.529 +4.071 

Military benefits (12.2)................................................................ 0.045 0.073 0.091 +0.045 

Subtotal Pay Costs: 17.848 27.662 33.997 +16.148 

Travel and transportation of persons (21.0)................................. 0.175 0.182 0.186 +0.011 

Transportation of things (22.0)................................................... -- -- -- --

Rental payments to GSA (23.1)................................................... -- 2.877 2.934 +2.934 

Rental payments to Others (23.2)................................................. -- -- -- --

Communication, utilities, and misc. charges (23.3)..................... -- 0.108 0.111 +0.111 

Printing and reproduction (24.0)................................................. 0.102 0.340 0.346 +0.244 

Other Contractual Services: --

Advisory and assistance services (25.1)...................................... 13.805 12.798 13.054 -0.752 

Other services (25.2).................................................................. 15.057 11.303 10.337 -4.720 

Purchase of Goods & Svcs. from Govt. Accts (25.3).................. 5.142 9.495 9.685 +4.543 

Operation and maintenance of facilities (25.4)............................ -- -- -- --

Research and Development Contracts (25.5).............................. -- -- -- --

Operation and maintenance of equipment (25.7)......................... 0.064 0.422 0.430 +0.367 

Subtotal Other Contractual Services: 34.069 34.018 33.507 -0.562 

Supplies and materials (26.0)...................................................... 0.000 0.010 0.010 +0.010 

Equipment (31.0)......................................................................... 0.001 -0.005 -0.005 -0.006 

Grants, subsidies, and contributions (41.0).................................. 4,023.903 4,010.907 4,041.763 +17.860 

Interest and dividends (43.0)........................................................ -- -- -- --

Subtotal Non-Pay Costs 4,058.250 4,048.436 4,078.851 +20.602 

Total Direct Obligations $4,076.098 $4,076.098 $4,112.848 +$36.750 

1 Does not include PHS Evaluation Funds.
338 

Budget Authority by Object Class

Health Surveillance and Program Support

(Dollars in millions)

Object Class - Direct Budget Authority1

FY 2023

Final

FY 2024

CR

FY 2025 

President's 

Budget

FY 2025 

+/- FY 

2023

Personnel compensation:

Full-time permanent (11.1)............................................... $27.715 $41.990 $51.911 +$24.196 

Other than full-time permanent (11.3)............................ 0.946 1.433 1.771 +0.826 

Other personnel compensation (11.5)............................. 1.119 1.695 2.095 +0.977 

Military personnel (11.7)................................................ 2.103 3.312 3.467 +1.364 

Special personnel services payments (11.8) ..................... 0.013 0.020 0.025 +0.012 

Subtotal personnel compensation: 31.895 48.450 59.269 +27.374 

Civilian benefits (12.1)................................................ 10.292 15.594 19.278 +8.986 

Military benefits (12.2).................................................. 0.208 0.328 0.390 +0.182 

Subtotal Pay Costs: 42.396 64.372 78.938 +36.542 

Travel and transportation of persons (21.0)..................... 0.672 0.650 0.663 -0.009 

Transportation of things (22.0)...................................... 0.001 0.000 0.000 -0.001 

Rental payments to GSA (23.1)...................................... 5.324 1.140 1.163 -4.161 

Rental payments to Others (23.2)..................................... -- -- -- --

Communication, utilities, and misc. charges (23.3).......... 0.003 -- -- -0.003 

Printing and reproduction (24.0)...................................... 0.570 0.001 0.001 -0.569 

Other Contractual Services: --

Advisory and assistance services (25.1)............................ 1.001 3.364 1.931 +0.930 

Other services (25.2).................................................... 3.840 2.830 1.582 -2.257 

Purchase of Goods & Svcs. from Govt. Accts (25.3)....... 5.303 3.526 0.597 -4.707 

Operation and maintenance of facilities (25.4)................. 0.193 0.202 0.206 +0.012 

Research and Development Contracts (25.5).................... -- -- -- --

Operation and maintenance of equipment (25.7).............. 0.427 0.163 0.166 -0.261 

Subtotal Other Contractual Services: 10.765 10.085 4.482 -6.283 

Supplies and materials (26.0)....................................... 0.061 0.103 0.105 +0.044 

Equipment (31.0)........................................................ 0.073 0.060 0.061 -0.012 

Grants, subsidies, and contributions (41.0)....................... 241.996 225.448 55.667 -186.328 

Insurance claims and indemnities (42.0)........................... 0.071 0.074 0.075 +0.004 

Interest and dividends (43.0)........................................... -- -- -- ---

Subtotal Non-Pay Costs 259.536 237.560 62.217 -197,319 

Total Direct Obligations $301.932 $301.932 $141.155 -$160.777 

1 Does not include PHS Evaluation Funds.
339 

Budget Authority by Object Class

Summary PHS Evaluation Funds

(Dollars in millions)

Object Class - PHS Evaluation Funds

FY 2023

Final

FY 2024

CR

FY 2025 

President's 

Budget

FY 2025 +/- 

FY 2023

Personnel Compensation:

 Full Time Permanent (11.1)....................................................... $6.915 $1.434 $1.773 -$5.142 

Other than Full-Time Permanent (11.3)...................................... 0.030 -- -- -0.030 

Other Personnel Compensation (11.5)....................................... 0.217 0.052 0.065 -0.153 

Military Personnel Compensation (11.7).................................... 0.516 0.509 0.533 +0.017 

Special personnel services payments (11.8) ............................. -- -- -- --

Subtotal Personnel Compensation: 7.678 1.996 2.371 -5.307 

Civilian Personnel Benefits (12.1)............................................... 2.508 0.496 0.613 -1.895 

Military Personnel Benefits (12.2)............................................ 0.052 0.055 0.068 +0.017 

Subtotal Pay Costs: 10.238 2.547 3.052 -7.186 

Travel (21.0)........................................................................... 0.000 0.000 0.000 +0.000 

Transportation of things (22.0)................................................. -- -- -- --

Rental payments to GSA (23.1)............................................... -- -- -- --

Communications, Utilities and Misc. Charges (23.3)................. 0.098 0.098 0.100 +0.002 

Printing and Reproduction (24.0).............................................. 0.000 0.201 0.205 +0.205 

Other Contractual Services: --

Advisory and assistance services (25.1).................................... -- -- -- --

Other services (25.2)............................................................... 120.717 129.048 128.501 +7.784 

Purchase of Goods & Svcs. from Govt. Accts (25.3)................ 1.265 0.853 0.870 -0.395 

Operation and maintenance of equipment (25.7)....................... 0.099 0.101 0.103 +0.004 

Subtotal Other Contractual Services:..................................... 122.081 130.003 129.474 +7.393 

Supplies and Materials (26.0)................................................... 0.000 0.000 0.000 +0.000 

Equipment (31.0)..................................................................... -- -- -- --

Grants, Subsidies, and Contributions (41.0)............................................ 1.250 0.820 0.835 -0.415 

Subtotal Non-Pay Costs 123,429 131,121 130,615 +7.186 

Total PHS Evaluation Funds $133.667 $133.667 $133.667 -
340 

Budget Authority by Object Class

Mental Health

(Dollars in millions)

Object Class - PHS Evaluation 

FY 2023

Final

FY 2024

CR

FY 2025 

President's 

Budget

FY 2025 +/- 

FY 2023

Personnel compensation:

Full-time permanent (11.1)............................................. +$1.302 +$1.434 +$1.773 +0.471 

Other than full-time permanent (11.3)............................ -- -- -- --

Other personnel compensation (11.5)............................. 0.047 0.052 0.065 +0.017 

Military personnel (11.7)................................................ 0.445 0.509 0.533 +0.088 

Special personnel services payments (11.8) ................... -- -- -- --

Subtotal personnel compensation: 1.794 1.996 2.371 +0.576 

Civilian benefits (12.1)................................................... 0.450 0.496 0.613 +0.163 

Military benefits (12.2).................................................. 0.048 0.055 0.068 +0.020 

Subtotal Pay Costs: 2.293 2.547 3.052 +0.760 

Travel and transportation of persons (21.0)..................... 0.000 0.000 0.000 +0.000 

Transportation of things (22.0)....................................... -- -- -- --

Rental payments to GSA (23.1)....................................... -- -- -- --

Communication, utilities, and misc. charges (23.3)........ -- -- -- --

Printing and reproduction (24.0)..................................... 0.000 0.000 0.000 +0.000 

Other Contractual Services: -- --

Advisory and assistance services (25.1)......................... -- -- -- --

Other services (25.2)...................................................... 17.670 17.851 17.333 -0.338 

Purchase of Goods & Svcs. from Govt. Accts (25.3)...... 0.076 0.047 0.048 -0.028 

Operation and maintenance of equipment (25.7)............ -- -- -- --

Subtotal Other Contractual Services: 17.746 17.898 17.380 -0.366 

Supplies and materials (26.0)......................................... 0.000 0.000 0.000 +0.000 

Equipment (31.0)................................................... -- -- -- --

Grants, subsidies, and contributions (41.0).................... 1.000 0.594 0.606 -0.394 

Subtotal Non-Pay Costs 18.746 18.492 17.987 -0.760 

Total PHS Evaluation Funds $21.039 $21.039 $21.039 --
341 

Budget Authority by Object Class

Substance Use Services

(Dollars in millions)

Object Class - PHS Evaluation 

FY 2023

Final

FY 2024

CR

FY 2025 

President's 

Budget

FY 2025 

+/- FY 

2023

Personnel compensation:

Full-time permanent (11.1)................................................. $1.398 -- -- -$1.398 

Other than full-time permanent (11.3).............................. -- -- -- --

Other personnel compensation (11.5)............................... 0.053 -- -- -0.053 

Military personnel (11.7)................................................... -- -- -- --

Special personnel services payments (11.8) ..................... -- -- -- --

Subtotal personnel compensation: 1.450 -- -- -1.450 

Civilian benefits (12.1)................................................. 0.506 -- -- -0.506 

Military benefits (12.2)................................................... -- -- -- --

Subtotal Pay Costs: 1.956 -- -- -1.956 

Travel and transportation of persons (21.0)........................ -- -- -- --

Transportation of things (22.0)......................................... -- -- -- --

Rental payments to GSA (23.1)...................................... -- -- -- --

Communication, utilities, and misc. charges (23.3)............ -- -- -- --

Printing and reproduction (24.0).................................... -- 0.201 0.205 +0.205 

Other Contractual Services: -- -- -- --

Advisory and assistance services (25.1).............................. -- -- -- --

Other services (25.2)..................................................... 78.811 80.587 80.575 +1.764 

Purchase of Goods & Svcs. from Govt. Accts (25.3)......... 0.085 0.086 0.088 +0.003 

Operation and maintenance of equipment (25.7)................ 0.099 0.101 0.103 +0.004 

Subtotal Other Contractual Services: 78.994 80.774 80.766 +1.771 

Supplies and materials (26.0).......................................... -- -- -- --

Equipment (31.0).......................................................... -- -- -- --

Grants, subsidies, and contributions (41.0)........................ 0.250 0.225 0.229 -0.021 

Subtotal Non-Pay Costs 79.244 81.200 81.200 +1.956 

Total PHS Evaluation Funds $81.200 $81.200 $81.200 -
342 

Budget Authority by Object Class

Health Surveillance and Program Support

(Dollars in millions)

Object Class - PHS Evaluation 

FY 2023

Final

FY 2024

CR

FY 2025 

President's 

Budget

FY 2025 +/- 

FY 2023

Personnel compensation:

Full-time permanent (11.1)................................................ $4.216 -- -- -$4.216 

Other than full-time permanent (11.3)................................ 0.030 -- -- -0.030 

Other personnel compensation (11.5)................................ 0.117 -- -- -0.117 

Military personnel (11.7).................................................... 0.071 -- -- -0.071 

Special personnel services payments (11.8) ...................... -- -- -- -- 

Subtotal personnel compensation: 4.434 -- -- -4.434 

Civilian benefits (12.1)...................................................... 1.552 -- -- -1.552 

Military benefits (12.2)...................................................... 0.004 -- -- -0.004 

Subtotal Pay Costs: 5.990 -- -- -5.990 

Travel and transportation of persons (21.0)........................ -- -- -- -- 

Transportation of things (22.0)........................................... -- -- -- -- 

Rental payments to GSA (23.1)......................................... -- -- -- -- 

Communication, utilities, and misc. charges (23.3)........... 0.098 0.098 0.100 +0.002 

Printing and reproduction (24.0)........................................ -- -- -- -- 

Other Contractual Services: -- 

Advisory and assistance services (25.1)............................. -- -- -- -- 

Other services (25.2).......................................................... 24.236 30.610 30.594 +6.358 

 Purchase of Goods & Svcs. from Govt. Accts (25.3)......... 1.104 0.720 0.734 -0.370 

Operation and maintenance of equipment (25.7)............... -- -- -- -- 

Subtotal Other Contractual Services: 25.341 31.330 31.328 +5.988 

Supplies and materials (26.0)............................................ -- -- -- -- 

Equipment (31.0)............................................................... -- -- -- -- 

Grants, subsidies, and contributions (41.0)........................ -- -- -- -- 

Subtotal Non-Pay Costs 25.438 31.428 31.428 +5.990 

Total Reimbursable Obligations $31.428 $31.428 $31.428 -
343 

Salaries and Expenses

(Dollars in millions)

Object Class - Direct Budget Authority1,2,3

FY 2023

Final

FY 2024

CR

FY 2025 

President's 

Budget

FY 2025 +/- 

FY 2023

Personnel compensation:

Full-time permanent (11.1)........................................................ +$61.653 +$86.836 +$107.352 +$45.699 

Other than full-time permanent (11.3)........................................ 1.509 2.150 2.658 +1.149 

Other personnel compensation (11.5)........................................ 2.819 3.942 4.873 +2.054 

Military personnel (11.7)............................................................ 5.636 8.055 8.431 +2.796 

Special personnel services payments (11.8) ............................. 0.017 0.024 0.030 +0.013 

Subtotal personnel compensation 71.634 101.007 123.345 +51.711 

Civilian benefits (12.1)............................................................... 23.086 32.478 40.152 +17.066 

Military benefits (12.2).............................................................. 0.411 0.844 2.282 +1.872 

Subtotal Pay Costs: 95.131 134.329 165.779 +70.649 

Travel (21.0).............................................................................. 0.995 0.986 1.006 +0.011 

Transportation of things (22.0).................................................. 0.001 0.000 0.000 -0.001 

Rental payments to Others (23.2)........................................... -- -- -- --

Communication, utilities, and misc. charges (23.3)................... 0.025 0.131 0.134 +0.109 

Printing and reproduction (24.0)............................................... 0.675 0.343 0.350 -0.325 

Other Contractual Services: --

Advisory and assistance services (25.1)................................. 53.793 53.360 52.535 -1.258 

Other services (25.2)............................................................ 91.727 73.843 70.815 -20.912 

Purchase of Goods & Svcs. from Govt. Accts (25.3)............. 24.712 25.123 21.797 -2.914 

Operation and maintenance of facilities (25.4)....................... 0.216 0.298 0.304 +0.088 

Research and Development Contracts (25.5)........................ -- -- -- --

Operation and maintenance of equipment (25.7)................... 0.974 1.197 1.220 +0.246 

Subtotal Other Contractual Services: 171.422 153.821 146.672 -24.750 

Supplies and materials (26.0)..................................................... 0.070 0.118 0.121 +0.051 

Subtotal Non-Pay Costs 173.188 155.400 148.282 -24.906 

Total Salary and Expenses 268.319 289.729 314.062 +45.743 

Rental Payments to GSA (23.1)................................................. 5.380 7.078 7.220 +1.839 

Grand Total, Salaries & Expenses and Rent $273.699 $296.807 $321.281 +$47.582 

Direct FTE....................................... 706 849 849 143

1 Does not include PHS Evaluation Funds.

2 Does not include Prevention and Public Health Funds.

3 Does not include Mandatory Funds.
344 

Salaries and Expenses

PHS Salaries and Expenses Table

(Dollars in millions)

Object Class - PHS Evaluation 

FY 2023

Final

FY 2024

CR

FY 2025 

President's 

Budget

FY 2025 +/- 

FY 2023

Personnel compensation:

Full-time permanent (11.1).......................................................... $6.915 $1.434 $1.773 -$5.142 

Other than full-time permanent (11.3)......................................... 30 --- --- -0.030 

Other personnel compensation (11.5).......................................... 217 52 65 -0.153 

Military personnel (11.7)............................................................ 516 509 533 +0.017 

Special personnel services payments (11.8) ............................... --- --- --- -- 

Subtotal personnel compensation 7,678 1,996 2,371 -5.307 

Civilian benefits (12.1)................................................................. 2,508 496 613 -1.895 

Military benefits (12.2)................................................................ 52 55 68 +0.017 

Subtotal Pay Costs: 10,238 2,547 3,052 -7.186 

Travel (21.0)............................................................................. +0.000 

Transportation of things (22.0).................................................. --- --- --- -- 

Rental payments to Others (23.2)............................................ --- --- --- -- 

Communication, utilities, and misc. charges (23.3)..................... 98 98 100 +0.002 

Printing and reproduction (24.0)............................................... 201 205 +0.205 

Other Contractual Services: -- 

Advisory and assistance services (25.1).................................... --- --- --- -- 

Other services (25.2)................................................................. 120,717 129,048 128,501 +7.784 

Purch. Goods & Svcs. Govt. Accts (25.3).................................... 1,265 853 870 -0.395 

Operation and maintenance of facilities (25.4)............................. 99 101 103 +0.004 

Research and Development Contracts (25.5).............................. --- --- --- -- 

Operation and maintenance of equipment (25.7)......................... 101 103 +0.103 

Subtotal Other Contractual Services: 122,081 130,103 129,577 +7.496 

Supplies and materials (26.0).................................................... +0.000 

Subtotal Non-Pay Costs 122,179 130,403 129,882 +7.704 

Total Salary and Expenses 132,417 132,949 132,935 +0.518 

Rental Payments to GSA (23.1)................................................ --- --- --- ---

Grand Total, Salaries & Expenses and Rent $132.417 $132.949 $132.935 +$0.518 

Reimbursable FTE...................................... 16 16 16 ---
345 

Substance use And Mental Health Services Administration

Details of Full-Time Equivalent Employment

FY 2023 

Actual 

Civilian

FY 2023 

Actual 

Military

FY 2023 

Actual 

Total

FY 2024

Est. 

Civilian

FY

2024 

Est. 

Military

FY 2024 

Est. 

Total

FY

2025 

Est. 

Civilian

FY 2025 

Est. 

Military

FY 2025 

Est. 

Total

Mental Health Services

Direct: 116 8 124 166 8 174 166 8 174

Reimbursable: 13 3 16 13 3 16 13 3 16

Total: 129 11 140 179 11 190 179 11 190

Substance Use Prevention

Direct: 84 9 93 84 9 93 84 9 93

Reimbursable: -- -- -- -- -- -- -- -- -- 

Total: 83 9 93 84 9 93 84 9 93

Substance Use Services

Direct: 103 6 109 170 5 175 170 5 175

Reimbursable: -- -- -- -- -- -- -- -- --

Total: 104 6 109 170 5 175 170 5 175

Health Surveillance and Program Support

Direct: 368 12 380 388 19 407 388 19 407

Reimbursable: -- -- -- -- -- -- -- -- --

Total: 368 12 380 388 19 407 388 19 407

SAMHSA FTE Total................................ 684 38 722 821 44 865 821 44 865
346 

Substance use And Mental Health Services Administration

Detail of Positions 

FY 2023 

Final

FY 2024 

CR

FY 2025 

President's Budget

Executive Level IV 1 1 1

Subtotal 1 1 1

Total – Exec. Level Salaries $208,054 $218,873 $223,250

SES 6 7 7

Subtotal 6 7 7

Total, SES salaries $1,548,497 $1,900,523 $1,938,533

GM/GS-15/EE 84 100 100

GM/GS-14 165 175 175

GM/GS-13 240 265 265

GS-12 83 75 75

GS-11 61 60 60

GS-10 2 5 5

GS-09 16 35 35

GS-08 13 20 20

GS-07 9 25 25

GS-06 0 10 10

GS-05 2 2 2

GS-04 1 -- --

GS-03 -- -- --

GS-02 -- -- --

GS-01 -- -- --

Subtotal 676 772 772

Total, GS salaries $117,501,752 $121,839,206 $145,254,523

CC-08/09 -- -- --

CC-07 -- -- --

CC-06 16 18 18

CC-05 11 13 13

CC-04 8 7 7

CC-03 5 6 6

CC-02 -- -- --

CC-01 -- -- --

Subtotal 40 44 44

Total, CC salaries $6,861,086 $7,217,863 $7,542,666

Total Positions 723 824 824

Average EX level ES ES ES

Average EX salary $208,054 $208,054 $208,054

Average SES level SES SES SES

Average SES salary $258,083 $271,503 $276,933

Average GS grade 13.5 13.4 13.4

Average GS salary $173,819 $157,823 $188,154

Average CC level 5 5 5

Average CC salaries $171,527 $164,042 $171,424
347 

Physicians’ Comparability Allowance Worksheet 

1) Department and component: 

HHS/Substance Abuse and Mental Health Services Administration

2) Explain the recruitment and retention problem(s) justifying the need for the PCA pay 

authority. 

(Please include any staffing data to support your explanation, such as number and duration of 

unfilled positions and number of accessions and separations per fiscal year.)

We have to offer PCAs because our salaries are not competitive with the private sector.

3-4) Please complete the table below with details of the PCA agreement for the following years:

 

PY 2023 

(Final) 

CY* 2024 

(CR) 

BY 2025 

(President’s 

Budget)

3a) Number of Physicians Receiving PCAs 1 1 1

3b) Number of Physicians with One-Year PCA Agreements 0 0 0

3c) Number of Physicians with Multi-Year PCA Agreements 1 1 1

4a) Average Annual PCA Physician Pay (without PCA payment) 172,075 181,216 181,216

4b) Average Annual PCA Payment 16,000 16,000 16,000

*FY2024 data will be approved during the FY 2025 Budget cycle. 

5) Explain the degree to which recruitment and retention problems were alleviated in your 

agency through the use of PCAs in the prior fiscal year. 

(Please include any staffing data to support your explanation, such as number and duration of 

unfilled positions and number of accessions and separations per fiscal year.) 

We have to offer PCAs because our salaries are not competitive with the private sector (e.g., we 

might offer 75% of a physician's salary on the outside). In addition, physicians of interest to 

SAMHSA often have income from consulting as well. The PCA is the only way to raise the 

government income to make the offer acceptable.

6) Provide any additional information that may be useful in planning PCA staffing levels and 

amounts in your agency. 
348 

Resources for Cyber Activities

(Dollars in millions) 

Cyber Category FY 2023 Final FY 2024 CR 

FY 2025 

President's 

Budget 

FY 2025 +/- 

FY 2023

Cyber Human Capital.......................................................... 0.047 0.297 0.547 +0.500 

Planning Roles and Responsibilities.................................... 0.829 1.029 1.229 +0.400 

Sector Risk Assessment, Management, and Operations...... -- 0.010 0.011 +0.011 

Sector Coordination ............................................................ -- 0.010 0.011 +0.011 

Other NIST CSF Capabilities:

Detect.............................................................................. 0.996 1.026 1.056 +0.060 

Identity............................................................................. 0.047 0.077 0.107 +0.060 

Protect............................................................................. 0.851 0.881 0.911 +0.060 

Recover............................................................................ 0.039 0.069 0.099 +0.060 

Respond........................................................................... 0.073 0.103 0.123 +0.050 

Total Cyber Request.......................................................... 2.881 3.501 4.093 1.212 

Technology Ecosystems (non-add)......................... -- -- -- -- 

Zero Trust Implementation (non-add)..................... -- 0.500 0.500 0.500 
349 

Drug Control Budget

DEPARTMENT OF HEALTH AND HUMAN SERVICES

Substance use And Mental Health Services Administration

(Dollars in millions)

Drug Resources by Decision Unit and Function

FY2023 

Final

FY 2024 

CR

FY2025 

President’s 

Budget

FY 2025 +/- 

FY 2024 CR

Programs of Regional and National Significance (PRNS)1

Prevention2............................................................. 236.88 236.88 236.88 -- 

Harm Reduction....................................... 72.00 72.00 82.00 10.00 

Treatment3............................................................ 465.79 465.79 472.54 6.75 

Recovery........................................................................ 34.43 34.43 34.43 -- 

Total, PRNS................................................................. 809.10 809.10 825.85 16.75 

State Opioid Response Grants

State Opioid Response Grants .................................... 1,559.25 1,559.25 1,579.05 19.80 

Harm 

Reduction.............................................................................. 15.75 15.95 0.20 

Total, SOR................................................................... 1,575.00 1,575.00 1,595.00 20.00 

Substance Abuse Prevention and Treatment Block Grant (SABG)4

Prevention.................................................................... 381.54 381.54 381.54 -- 

Harm Reduction............................................................ 20.08 20.08 20.08 -- 

Treatment..................................................................... 1,405.66 1,405.66 1,405.66 -- 

Recovery........................................................................ 200.81 200.81 200.81 -- 

Total, SABG ............................................................... 2,008.08 2,008.08 2,008.08 -- 

Health Surveillance and Program Support (HSPS)5

Prevention............................................................ 21.73 21.73 20.12 -1.62 

Harm Reduction............................................................ 3.26 3.26 3.02 -0.24 

Treatment..................................................................... 78.24 78.24 72.42 -5.82 

Recovery........................................................................ 5.43 5.43 5.03 -0.40 

Total, HSPS ............................................................... 108.66 108.66 100.58 -8.08 

Total Funding ............................................................ 4,500.84 4,500.84 4,529.51 28.67 

Drug Resources Personnel Summary

Total Full Time Equivalents (FTEs)6 ................................... 402 404 376 -26

Drug Resources as a Percent of Budget 

Total Agency Budget (in billions) ................................. 7,517.58 7,517.58 8,129.56 611.97 

Drug Resources Percentage ....................................... 59.9% 59.9% 55.7% -4.2%

1/The State Opioid Response Grant is split 99% to the Treatment function and 1% to the Harm Reduction function. 

2/The Substance Use Prevention, Treatment, and Recovery Services Block Grant is split 19% to the Prevention function, 70% to the Treatment function, 1% to the 

Harm Reduction function, and 10% to the Recovery function. 

"3/ The Health Surveillance and Program Support Appropriation funded activities are split between Mental Health and Drug Control as follows:

- The Drug Abuse Warning Network is allocated fully to Drug Control. Program Support, Health Surveillance and PQIS are proportionally assessed under drug 

control by determining the proportion of SAMHSA's total budget that covers Mental Health services (the Center for Mental Health Services) and the proportion 

covering Drug Control-related services (the Center for Substance Use Services and the Center for Substance Use Prevention).

- Public Awareness and Support, Behavioral Health Workforce Data and Development and Data Request and Publication User Fees are assessed at 50% of total 

appropriated funds are directed toward drug control activities. 

- The drug control total for HSPS after these calculations is allocated between Prevention (20%) and Treatment (80%). Within the total for Treatment, HSPS is 

assessed at 3% toward Harm Reduction and 5% toward Recovery, consistent with the drug control methodology" 

4/Only Direct FTEs included in total.
350 

Drug Budget Split between Prevention, Treatment, Harm Reduction, and Recovery

FY 2023-2025 

(Dollars in millions)

Prevention: 

Substance Use Prevention Services

FY2023 

Final 

FY2024 

CR 

FY2025 

President’s 

Budget

FY 2025 +/- 

FY 2024 CR

Programs of Regional and National Significance (PRNS)

Strategic Prevention Framework........................................................................ 135.484 135.484 135.484 -- 

Strategic Prevention Framework Rx (non-add).............................................. 10.000 10.000 10.000 -- 

Budget Authority (non-add)......................................................................... 10.000 10.000 10.000 -- 

Federal Drug-Free Workplace.............................................................................. 5.139 5.139 5.139 -- 

Sober Truth on Preventing Underage Drinking .................................................. 14.500 14.500 14.500 -- 

Tribal Behavioral Health Grants........................................................................... 23.665 23.665 23.665 -- 

Minority AIDS....................................................................................................... 43.205 43.205 43.205 -- 

SAP Minority Fellowship Program........................................................................ 1.321 1.321 1.321 -- 

Center for the Application of Prevention Technologies......................................... 9.493 9.493 9.493 -- 

Science and Service Program Coordination............................................................. 4.072 4.072 4.072 -- 

Improving Access to Overdose Treatment -- -- -- -- 

Total, Substance Use Prevention Services PRNS 236.879 236.879 236.879 -- 

Substance Use Prevention, Treatment, and Recovery Services Block Grant1 381.535 381.535 381.535 -- 

PHS Evaluation Funds (non-add)....................................................................... 15.048 15.048 15.048 -- 

Total, Substance Use Prevention, Treatment, and Recovery Services Block Grant 381.535 381.535 381.535 -- 

Health Surveillance and Program Support2

Health Surveillance and Program Support 16.324 16.324 14.821 -1.503 

Health Surveillance................................................................................................. 6.116 6.116 5.553 -0.563 

Budget Authority (non-add).................................................................................. 2.440 2.440 2.215 -0.225 

PHS Evaluation Funds (non-add)........................................................................ 3.676 3.676 3.338 -0.338 

Program Support............................................................................................................ 10.208 10.208 9.269 -0.940 

Public Awareness and Support....................................................................................... 1.326 1.326 1.326 -- 

Performance and Quality Information Systems.............................................................. 1.232 1.232 1.119 -0.113 

Behavioral Health Workforce Data and Development..................................................... 0.100 0.100 0.100 -- 

PHS Evaluation Funds (non-add)............................................................................. 0.100 0.100 0.100 -- 

Drug Abuse Warning Network......................................................................................... 2.600 2.600 2.600 -- 

Data Request/Publication User Fees................................................................................. 0.150 0.150 0.150 -- 

Total, Health Surveillance and Program Support 21.732 21.732 20.116 -1.616 

Total, Substance Use Prevention Services 640.146 640.146 638.53 -1.616

1/ The Substance Use Prevention, Treatment, and Recovery Services Block Grant is split 19% to the Prevention function, 70% to the Treatment function, 1% to the 

Harm Reduction function, and 10% to the Recovery function.

2/ The Health Surveillance and Program Support Appropriation funded activities are split between Mental Health and Drug Control as follows:

- The Drug Abuse Warning Network is allocated fully to Drug Control. Program Support, Health Surveillance and PQIS are proportionally assessed under drug 

control by determining the proportion of SAMHSA's total budget that covers Mental Health services (the Center for Mental Health Services) and the proportion 

covering Drug Control-related services (the Center for Substance Use Services and the Center for Substance Use Prevention).

- Public Awareness and Support, Behavioral Health Workforce Data and Development and Data Request and Publication User Fees are assessed at 50% of total 

appropriated funds are directed toward drug control activities. 

- The drug control total for HSPS after these calculations is allocated between Prevention (20%) and Treatment (80%). Within the total for Treatment, HSPS is 

assessed at 3% toward harm reduction and 5% toward recovery, consistent with the drug control methodology
351 

Drug Budget Split between Prevention, Treatment, Harm Reduction, and Recovery

FY 2023-2025 

(Dollars in millions) 

Harm Reduction FY2023 

Final 

FY2024 

CR 

FY2025 

President’s 

Budget 

FY 2025 +/- 

FY 2024 

CR 

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

Community Harm Reduction and Engagement Initiative1.......................... -- -- 10.000 10.000 

Screening, Brief Intervention and Referral to Treatment ............................ 33.840 33.840 33.840 -- 

Budget Authority (non-add)................................................................. 31.840 31.840 31.840 -- 

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

First Responder Training (CARA)...... 56.000 56.000 56.000 -- 

First Responder Training (CARA) -- -- -- -- 

Grants to Prevent Prescription Drug/Opioid Overdose Related Deaths .... 16.000 16.000 16.000 -- 

Grants to Prevent Prescription Drug/Opioid Overdose Related Deaths -- -- -- -- 

Total, Harm Reduction PRNS 72.000 72.000 82.000 10.000 

State Opioid Response Grants2 ...................................................................... 15.750 15.750 15.950 0.200 

Substance Use Prevention, Treatment, and Recovery Services Block Grant3 20.081 20.081 20.081 -- 

PHS Evaluation Funds (non-add)........................................................ 0.792 0.792 0.792 -- 

Total, Substance Use Prevention, Treatment, and Recovery Services Block 

Grant

20.081 20.081 20.081 -- 

Health Surveillance and Program Support4

Health Surveillance and Program Support 2.449 2.449 2.223 -0.225 

Health Surveillance............................................................................. 0.917 0.917 0.833 -0.084 

Budget Authority (non-add)................................................................ 0.366 0.366 0.332 -0.034 

PHS Evaluation Funds (non-add)..................................................... 0.551 0.551 0.501 -0.051 

Program Support........................................................................................... 1.531 1.531 1.390 -0.141 

Public Awareness and Support..................................................................... 0.199 0.199 0.199 -- 

Performance and Quality Information Systems........................................... 0.185 0.185 0.168 -0.017 

Behavioral Health Workforce Data and Development................................. 0.015 0.015 0.015 -- 

Communities of Strength – Building the Community Workforce (New) -- -- -- -- 

PHS Evaluation Funds (non-add).......................................................... 0.015 0.015 0.015 -- 

Drug Abuse Warning Network...................................................................... 0.390 0.390 0.390 -- 

Data Request/Publication User Fees.............................................................. 0.023 0.023 0.023 -- 

Total, Health Surveillance and Program Support 3.260 3.260 3.017 -0.242 

Total, Harm Reduction 111.091 111.091 121.048 9.958 

1/New program proposed in SAMHSA's FY 2025 Performance Budget. 

2/ The State Opioid Response Grant is split 99% to the Treatment function and 1% to the Harm Reduction function.

3/ The Substance Use Prevention, Treatment, and Recovery Services Block Grant is split 19% to the Prevention function, 70% to the Treatment function, 1% to the 

Harm Reduction function, and 10% to the Recovery function.

4/ The Health Surveillance and Program Support Appropriation funded activities are split between Mental Health and Drug Control as follows:

- The Drug Abuse Warning Network is allocated fully to Drug Control. Program Support, Health Surveillance and PQIS are proportionally assessed under drug 

control by determining the proportion of SAMHSA's total budget that covers Mental Health services (the Center for Mental Health Services) and the proportion 

covering Drug Control-related services (the Center for Substance Use Services and the Center for Substance Use Prevention).

- Public Awareness and Support, Behavioral Health Workforce Data and Development and Data Request and Publication User Fees are assessed at 50% of total 

appropriated funds are directed toward drug control activities. 

- The drug control total for HSPS after these calculations is allocated between Prevention (20%) and Treatment (80%). Within the total for Treatment, HSPS is 

assessed at 3% toward harm reduction and 5% toward recovery, consistent with the drug control methodology.
352 

Drug Budget Split between Prevention, Treatment, Harm Reduction, and Recovery

FY 2023-2025 

(Dollars in millions)

Treatment: 

Substance Use Services

FY2023 

Final 

FY2024 

CR 

FY2025 

President’s 

Budget

FY 2025 +/- 

FY 2024 CR

Programs of Regional and National Significance (PRNS)

Opioid Treatment Programs/Regulatory Activities........................................ 10.724 10.724 10.724 -- 

Target Capacity Expansion............................................................................. 122.416 122.416 122.416 -- 

Other Targeted Capacity Expansion.......................................................... 11.416 11.416 11.416 -- 

MAT for Prescription Drug and Opioid Addiction (non-add) 111.000 111.000 111.000 -- 

MAT for Prescription Drug and Opioid Addiction (Tribes)(non-add) 14.500 14.500 14.500 -- 

Pregnant & Postpartum Women............................................................................ 38.931 38.931 43.931 5.000 

Improving Access to Overdose Treatment 1.500 1.500 1.500 -- 

Children and Family 

Programs....................................................................................................

30.197 30.197 30.197 

-- 

Treatment Systems for Homeless ........................................................................ 37.114 37.114 37.114 -- 

Minority AIDS ...................................................................................................... 66.881 66.881 66.881 -- 

Minority Fellowship Program............................................................................... 7.136 7.136 7.136 -- 

Criminal Justice Activities..................................................................................... 94.000 94.000 94.000 -- 

Addiction Technology Transfer Centers.............................................................. 9.046 9.046 9.046 -- 

Emergency Department Alternatives to Opioids.......................................... 8.000 8.000 8.000 -- 

Comprehensive Opioid Recovery Centers........................................................... 6.000 6.000 6.000 -- 

Women's Behavioral Health Technical Assistance Center.................................. -- -- 1.750 1.750

Total, Substance Use Services PRNS 465.785 465.785 472.535 6.750 

State Opioid Response Grants1 ............................................................................. 1,559.250 1,559.250 1,579.050 19.800 

Substance Use Prevention, Treatment, and Recovery Services Block Grant2

1,405.655 1,405.655 1,405.655 -- 

PHS Evaluation Funds (non-add)................................................................. 55.440 55.440 55.440 -- 

Total, Substance Use Prevention, Treatment, and Recovery Services Block 

Grant 1,405.655 1,405.655 1,405.655 -- 

Health Surveillance and Program Support3 -- 

Health Surveillance and Program Support 58.766 58.766 53.357 -5.409 

Health Surveillance 22.016 22.016 19.990 -2.027 

Budget Authority (non-add)...................................................................... 8.783 8.783 7.974 -0.808 

PHS Evaluation Funds (non-add)............................................................. 13.233 13.233 12.015 -1.218 

Program Support......................................................................................... 36.750 36.750 33.367 -3.383 

Public Awareness and Support...................................................................... 4.774 4.774 4.774 -- 

Performance and Quality Information Systems................................................ 4.436 4.436 4.028 -0.408 

Behavioral Health Workforce Data and Development...................................... 0.360 0.360 0.360 -- 

Communities of Strength – Building the Community Workforce (New)........ -- -- -- -- 

PHS Evaluation Funds (non-add)............................................................... 0.360 0.360 0.360 -- 

Drug Abuse Warning Network..................................................................... 9.360 9.360 9.360 -- 

Data Request/Publication User Fees.............................................................. 0.540 0.540 0.540 -- 

Total, Health Surveillance and Program Support 78.236 78.236 72.418 -5.818 

Total, Substance Use Services 3,508.926 3,508.926 3,529.658 20.732 

1/ The State Opioid Response Grant is split 99% to the Treatment function and 1% to the Harm Reduction function.

2/ The Substance Use Prevention, Treatment, and Recovery Services Block Grant is split 19% to the Prevention function, 70% to the Treatment function, 1% to the 

Harm Reduction function, and 10% to the Recovery function.

3/ The Health Surveillance and Program Support Appropriation funded activities are split between Mental Health and Drug Control as follows:

- The Drug Abuse Warning Network is allocated fully to Drug Control. Program Support, Health Surveillance and PQIS are proportionally assessed under drug 

control by determining the proportion of SAMHSA's total budget that covers Mental Health services (the Center for Mental Health Services) and the proportion 

covering Drug Control-related services (the Center for Substance Use Services and the Center for Substance Use Prevention).

- Public Awareness and Support, Behavioral Health Workforce Data and Development and Data Request and Publication User Fees are assessed at 50% of total 

appropriated funds are directed toward drug control activities. 

- The drug control total for HSPS after these calculations is allocated between Prevention (20%) and Treatment (80%). Within the total for Treatment, HSPS is 

assessed at 3% toward harm reduction and 5% toward recovery, consistent with the drug control methodology
353 

Drug Budget Split between Prevention, Harm Reduction, Treatment, and Recovery

FY 2023-2025

(Dollars in millions)

Recovery FY2023 

Final 

FY2024 

CR 

FY2025 

President’s 

Budget 

FY 2025 +/- 

FY 2024 CR

Programs of Regional and National Significance (PRNS)

Recovery Community Services Program......................................................... $4.434 $4.434 $4.434 -- 

Building Communities of Recovery................................................................ 16.000 16.000 16.000 -- 

Peer Support TA Center.................................................................................. 2.000 2.000 2.000 -- 

Treatment, Recovery, and Workforce Support............................................... 12.000 12.000 12.000 -- 

Recovery Support Services- Center of Excellence (COE) -- .000 -- -- 

Total, Recovery PRNS 34.434 34.434 34.434 -- 

Substance Use Prevention, Treatment, and Recovery Services Block 

Grant1 200.808 200.808 200.808 -- 

PHS Evaluation Funds (nonadd)............................................................. 7.920 7.920 7.920 -- 

Total, Substance Use Prevention, Treatment, and Recovery Services 

Block Grant 200.808 200.808 200.808 -- 

Health Surveillance and Program Support2 -- 

Health Surveillance and Program Support $4.081 $4.081 $3.705 -0.376 

Health Surveillance 1.529 1.529 1.388 -0.141 

Budget Authority (non-add).................................................................... .610 .610 .554 -0.056 

PHS Evaluation Funds (non-add).................................................. .919 .919 .834 -0.085 

Program Support.................................................................. 2.552 2.552 2.317 -0.235 

Public Awareness and Support................................................................ .332 .332 .332 -- 

Performance and Quality Information Systems...................................... .308 .308 .280 -0.028 

Behavioral Health Workforce Data and Development.............................. .025 .025 .025 -- 

Communities of Strength – Building the Community Workforce (New).. -- -- .000 -- 

PHS Evaluation Funds (non-add)................................................. .025 .025 .025 -- 

Drug Abuse Warning Network.............................................................. .650 .650 .650 -- 

Data Request/Publication User Fees...................................................... .038 .038 .038 -- 

Total, Health Surveillance and Program Support 5.433 5.433 5.029 -0.404 

Total, Recovery 240.675 240.675 240.271 -0.404 

1/ The Substance Use Prevention, Treatment, and Recovery Services Block Grant is split 19% to the Prevention function, 70% to the Treatment function, 1% to the 

Harm Reduction function, and 10% to the Recovery function.

2/ The Health Surveillance and Program Support Appropriation funded activities are split between Mental Health and Drug Control as follows:

- The Drug Abuse Warning Network is allocated fully to Drug Control. Program Support, Health Surveillance and PQIS are proportionally assessed under drug 

control by determining the proportion of SAMHSA's total budget that covers Mental Health services (the Center for Mental Health Services) and the proportion 

covering Drug Control-related services (the Center for Substance Use Services and the Center for Substance Use Prevention).

- Public Awareness and Support, Behavioral Health Workforce Data and Development and Data Request and Publication User Fees are assessed at 50% of total 

appropriated funds are directed toward drug control activities. 

- The drug control total for HSPS after these calculations is allocated between Prevention (20%) and Treatment (80%). Within the total for Treatment, HSPS is 

assessed at 3% toward harm reduction and 5% toward recovery, consistent with the drug control methodology.
354 

METHODOLOGY

SAMHSA distributes drug control funding into four functions: Prevention, Harm Reduction, 

Treatment, and Recovery. 

Prevention includes all the Substance Use Prevention Services appropriation (i.e., 100 percent of 

PRNS programs), 19 percent of the Substance Use Prevention, Treatment, and Recovery Services 

Block Grant (SUPTRS BG) funds which is specifically appropriated for prevention activities from 

the Substance Use Prevention Services appropriation, and 20 percent is of the Health Surveillance 

and Program Support (HSPS) funding. 

Harm Reduction includes 100 percent of the Community 

Harm Reduction and Engagement Initiative; 100 percent of First Responders- Comprehensive 

Addiction and Recovery Act (FR-CARA) Training; 100 percent of Grants to Prevent Prescription 

Drug/Opioid Overdose Related Deaths; 100 percent of Screening, Brief Intervention, and Referral 

to Treatment; 1 percent of SOR grants; 1 percent of the SUPTRS BG funds; and a proportionate 

share of HSPS funding. 

Treatment includes 100 percent of the Substance Use Services PRNS, 99 percent of SOR grants, 

70 percent of the SUPTRS BG funds, and a proportionate share of HSPS funding. 

Recovery includes 100 percent of the Recovery Community Services Program; 100 percent 

Building Communities of Recovery; 100 percent of Treatment, Recovery and Workforce Support; 

100 percent of Recovery Support Services- Center of Excellence (COE); 10 percent of the 

SUPTRS BG funds (i.e., 10 percent is a proposed set-aside for recovery support services in 

SUPTRS BG for FY 2023); and a proportionate share of HSPS funding. HSPS is proportionately 

attributed to the Prevention, Harm Reduction, Treatment, and Recovery. 

First, the HSPS base for the Drug Control budget is calculated using the following three rules: (1) 

100% of the Drug Abuse Warning Network funding; (2) 50 percent of the Public Awareness and

Support, Behavioral Health Workforce Data and Development and Data Request and Publication 

user fees funding; and (3) The combined Program Support, Health Surveillance, and PQIS funding 

multiplied by SAMHSA’s total Substance Use budgets divided by SAMHSA’s total Substance 

Use budgets plus SAMHSA’s Mental Health budget. Second, the calculated HSPS base is 

allocated to the four drug control areas base on the proportionately: 20 percent Prevention, 

3percent Harm Reduction, 72 percent Treatment and 5 percent Recovery. 

EQUITY

The Office of Behavioral Health Equity (OBHE) coordinates SAMHSA’s efforts to reduce mental 

and/or substance use disorders across a spectrum of under resourced populations by advancing 

equity. The SAMHSA Office of Behavioral Health Equity (OBHE) was established in accordance 

with Section 10334(b) of the Patient Protection and Affordable Care Act of 2010. OBHE advances 

behavioral health equity by reducing disparities in racial, ethnic, LGBTQIA+, and other underresourced communities across the country by improving access to quality services and supports 
355 

that enables all to thrive, participate, and contribute to healthier communities. OBHE is organized 

around five key public-facing strategic domains on policy, data, quality practice and workforce 

development, communication, and technical assistance. 

OBHE also has one internal facing strategy area focused on infrastructure. For the next three 

years, OBHE’s efforts are focused on the promotion of behavioral health equity for a targeted 

population: under resourced racial and ethnic minority, LGBTQIA+, Mixed race, and poor rural 

white residents.

OBHE currently funds a new contract that includes funding for The National Network to 

Eliminate Disparities in Behavioral Health (NNED) and NNEDLearn. OBHE Flagship 

Initiatives include the Disparity Impact Statement (DIS), Elevate Community Based 

Organizations (CBOs), The NNED, and multiple population-specific Centers of Excellence: the 

LGBT, Asian American Native Hawaiian and Pacific Islander, the Hispanic/Latino, the African 

American Centers of Excellence. Additionally, OBHE conducts a monthly SAMHSA-wide 

Equity Cross-Cutting workgroup that addresses topics embedding equity in SAMHSA grants and 

operations, identifying funding streams to support equity efforts in States and communities, 

addressing equity in the development of the behavioral health workforce and relevant career 

pathways, Diversity Equity and Inclusion (DEI) that also includes SAMHSA’s key Offices and 

Centers. OBHE also works closely with the Agency for Healthcare Research and Quality's 

(AHRQ) to co-produce racial/ethnic/LGBTQ data snapshots. OBHE also serves on President 

Biden’s Equity driven Executive Order (EO) workgroups (EO 13985, 13995, 14021, and others) 

and other trans-HHS workgroups such as NIH’s Social Determinates of Health as well as serve 

on National Academies of Science, Engineering, and Medicine Forum on Mental Health and 

Substance Use Disorders, the Disparities Council and the Equitable Data Work Group. 

Disparity Impact Statement 2.0 Initiative

SAMHSA’s Disparity Impact Statement 2.0 Initiative ensure the agency’s grants address health 

disparities among populations underserved by the behavioral health system using a data-informed 

quality improvement approach to reach all Americans in need of behavioral health services- no 

matter their race, ethnicity, social-economic status, or sexual orientation. This Initiative will 

involve analyzing how the current DIS is implemented across the agency, the capacity of 

SAMHSA to expand the DIS across a greater segment of its investments and programs, and the 

necessary changes needed to update the current DIS components and framework. This Initiative 

will also provide guidance to SAMHSA to facilitate the development of clear guidance for grantees 

on the purpose and expectations for targeting and addressing behavioral health disparities in their 

communities, provide clear instruction on how to submit an appropriate DIS to SAMHSA, and 

determine the most effective method to report, monitor and evaluate DIS impact to ensure 

effectiveness. The DIS will also identify racial, ethnic, LGBTQIA+, mixed-race, and poor rural 

white residents’ behavioral health gaps that could be filled by SAMHSA’s future Notice of 

Funding Opportunities (NOFO). 

Elevate CBOs Initiative    

Elevate CBOs is an overarching policy-driven initiative at SAMHSA's Office of Behavioral Health 
356 

Equity to build capacity, increase the visibility, and highlight the unique role of CBOs serving 

under-resourced communities in behavioral health. Community-based organizations (CBOs) play 

an important role when serving their respective communities. CBOs work at the local level as 

trusted, familiar entities to provide behavioral health services in their respective communities. 

OBHE provides capacity -building trainings and technical assistance on such topics as funding, 

workforce development, partnerships with State leadership, using and managing data, and

providing culturally-driven, quality critical services to the community. 

The National Network to Eliminate Disparities in Behavioral Health (NNED) 

NNED is a virtual network of community-based organizations across the U.S. focused on the 

mental health and substance use issues of diverse racial, ethnic, cultural, and sexual minority 

communities. Using data informed approaches, the NNED supports information sharing, training, 

and technical assistance towards the goal of promoting behavioral health equity. It is currently 

funded by SAMHSA and managed by SAMHSA’s Office of Behavioral Health Equity (OBHE). 

NNED opportunities include NNEDLearn, Partner Central, NNEDshare, and a CBO Locator. This 

is an annual intensive training for NNED members from community-based organizations to 

develop their skills in evidence-supported and culturally appropriate practices for mental illness 

and substance use. Partner Central is a private space for NNED members to search for communitybased organizations in the network to build partnerships to achieve a shared goal. NNED share is 

a collaborative online space for NNED members and the public to share resources and intervention 

efforts to improve the delivery of behavioral health care interventions in diverse populations. Asian 

American, Native Hawaiian, and Pacific Islander Behavioral Health Center of Excellence The 

Center of Excellence on Asian American, Native Hawaiian, and Pacific Islander (AANHPICoE) 

Behavioral Health Center of Excellence will promote culturally and linguistically appropriate 

behavioral health information and practices; establish a steering committee to identify emerging 

issues; and provide training, technical assistance, and consultation to practitioners, educators, and 

community organizations. Training topics include addressing mental health impacts caused by 

unconscious bias and hate against AANHPI communities. The AANHPI-CoE will also develop 

accessible, public-facing infographics and other materials that address behavioral health, including 

those that provide data disaggregated by race and ethnicity, as well as best practices for improving 

engagement and retention of AANHPI behavioral health professionals. 

African American Behavioral Health Center of Excellence 

Responding to the urgent need for greater equity and effectiveness in behavioral health services 

for African Americans, the U.S. Department of Health and Human Services, Substance Abuse and 

Mental Health Services Administration (SAMHSA) has established a new National Center, the 

African American Behavioral Health Center of Excellence (AABH-COE). From its administrative 

and academic home in the National Center for Primary Care at Morehouse School of Medicine 

(MSM) in Atlanta, the new Center of Excellence will develop and disseminate training, technical 

assistance (TA), and resources to help healthcare practitioners eliminate behavioral health 

disparities within this large and diverse population. The new Center of Excellence will take a 

highly collaborative public health approach toward cultural and practical transformation of: 

behavioral health systems; intervention, treatment, and recovery support practices; the professional 

and non-professional workforce; and the systems of education, training, and TA that prepare the 
357 

field for its work. 

The Center of Excellence on LGBTQI+ Behavioral Health Equity 

The Center of Excellence on LGBTQI+ Behavioral Health Equity provides behavioral health 

practitioners with vital information on supporting the population of people identifying as lesbian, 

gay, bisexual, transgender, queer, questioning, intersex, two-spirit, and other diverse sexual 

orientations, gender identities, and expressions. Through training, coaching, and technical 

assistance we are implementing change strategies within mental health and substance use disorder 

treatment systems to address disparities affecting LGBTQI+ people across all stages of life. This 

Center for Excellence is led by SAMHSA’s OBHE, the National SOGIE Center at Innovations 

Institute, University of Connecticut School of Social Work and is a partnership with Affirmative 

Research, Judge Baker Children’s Center, Harvard Medical School, and The Institute for 

Innovation and Implementation, University of Maryland School of Social Work. The work of this 

Center relies on:  • an expert pool that includes individuals with lived experience • leaders from 

provider organizations that are implementing best practices to address behavioral health disparities 

among the LBGTQ+ community • and researchers and clinical experts skilled in translating 

research into practice in mental health and substance use practice settings.
358 

BUDGET REQUEST

The FY 2025 President’s Budget Request is $4.5 billion, an increase of $28.6 million from the 

FY 2024 CR level. 

The budget directs resources to activities that have demonstrated improved health outcomes and 

that increase service capacity. SAMHSA has five major drug-related portfolios, and attendant 

decision units: Substance Use Prevention Services, Substance Use Services, Health Surveillance 

and Program Support, Harm Reduction, and Recovery. 

Each decision unit is discussed below:
359 

Prevention

Substance Use Prevention Services

Programs of Regional and National Significance 

Strategic Prevention Framework

FY 2025 President’s Budget Request: $135.5 million, equal to the FY 2024 CR level. 

SAMHSA’s Strategic Prevention Framework (SPF) grant programs support activities to help 

grantees build a solid foundation for delivering and sustaining effective Substance Use Prevention 

Services and reducing substance abuse problems. The Strategic Prevention Framework – 

Partnerships for Success (SPF-PFS) program addresses underage drinking among youth and young 

age 12 to 20 and allows states to prioritize state-identified top data driven substance abuse target 

areas. 

 

Strategic Prevention Framework for Prescription Drugs

SAMHSA implemented the Strategic Prevention Framework for Prescription Drugs (SPF-Rx) to 

raise awareness about the dangers of sharing medications and to work with pharmaceutical and 

medical communities on the risks of overprescribing to young adults. SAMHSA’s program 

focuses on raising community awareness and bringing prescription drug use prevention activities 

and education to schools, communities, parents, prescribers, and their patients. SAMHSA tracks 

reductions in opioid overdoses and the incorporation of prescription drug monitoring data into 

needs assessments and strategic plans as indicators of program success. 

Federal Drug-Free Workplace 

FY 2025 President’s Budget Request: $5.1 million, equal to the FY 2024 CR level. 

SAMHSA’s activities related to the Federal Drug-Free Workplace support two principal activities 

mandated by Executive Order (E.O.) 12564 and Public Law (P.L.) 100-71. This includes: 1) 

oversight of the Federal Drug-Free Workplace, aimed at the elimination of illicit drug use within 

Executive Branch agencies and the federally regulated industries; and 2) oversight of the National 

Laboratory Certification Program (NLCP), which certifies laboratories to conduct forensic drug 

testing for federal agencies, federally regulated industries; the private sector also uses the HHSCertified Laboratories. SAMHSA will continue to implement the new mandatory guidelines for 

oral fluid and hair in the federally regulated drug testing program and continue oversight of the

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

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

The budget request will allow SAMHSA to continue oversight of the Executive Branch Agencies’ 

Federal Drug-Free Workplace Programs and all legislative requirements remain in place at the FY 

2025 target level. This includes review of Federal Drug-Free Workplace plans from those federal 

agencies that perform federal employee testing, random testing of those designated testing 

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

the misuse of prescription drugs. SAMHSA will continue its oversight role for the inspection and 
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certification of the HHS-certified laboratories. 

Sober Truth on Preventing Underage Drinking 

FY 2025 President’s Budget Request: $14.5 million, equal to the FY 2024 CR level. 

The Sober Truth on Preventing Underage Drinking Act (STOP Act) of 2006 (Public Law 109 - 

422) was the nation’s first comprehensive legislation on underage drinking. One of the primary 

components of the STOP Act is the community-based coalition enhancement grant program, which 

provides up to $50,000 per year over four years to current or former grantees under the Drug Free 

Communities Act of 1997 to prevent and reduce alcohol use among youth under the age of 21. 

The STOP Act grant program enables organizations to strengthen collaboration and coordination 

among stakeholders to achieve a reduction in underage drinking in their communities. The STOP 

Act was reauthorized in the 21st Century Cures Act. In FY 2025, SAMHSA will continue to 

support the 2022–2023 campaign evaluation cycle, which includes an evaluation of the usability, 

reach, and effectiveness of the TTHY mobile app and Screen4Success self-screening, a referral 

management system; the initial development of a complementary youth campaign that includes 

message testing and audience segmentation analysis; and the beginning of a multi-year evaluation 

of the student assistance- and school health and wellness-focused training with formative, 

outcome, and long-term impact evaluation methodologies that can be adopted by schools and 

districts. At the FY 2025 Target level, all legislative requirements remain in place.

Tribal Behavioral Health Grants

FY 2025 President’s Budget Request: $23.7 million, equal to the FY 2024 CR level. 

SAMHSA’s Tribal Behavioral Health Grants (TBHG) program addresses the high incidence of 

substance abuse and suicide among AI/AN populations. Starting in FY 2014, this program 

supports tribal entities with the highest rates of suicide by providing effective and promising 

strategies that address substance abuse, trauma, and suicide and by promoting the mental health of 

AI/AN young people. In FY 2016, SAMHSA expanded activities through the braided 

TBHG/Native Connections program across SAMHSA’s Center for Substance Use and Prevention 

Services (CSUPS) and the Center of Mental Health Services (CMHS) to allow tribes the flexibility 

to implement community-based strategies to address trauma, prevent substance misuse, and 

promote mental health and resiliency among youth in tribal communities. At the FY 2025 Target 

level, SAMHSA’s CSUPS and CMHS will continue to support this braided program to promote 

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

Centers for the Application of Prevention Technologies 

FY 2025 President’s Budget Request: $9.5 million, equal to the FY 2024 CR level. 

In 2019, Center for the Application of Prevention Technologies (CAPT) changed how it delivered 

services and began providing science-based training and technical assistance through Prevention 

Technology Transfer Centers (PTTC) cooperative agreements. SAMHSA leadership established 

the PTTC the previous year to expand and improve implementation and delivery of effective 

Substance Use Prevention Services interventions and provide training and technical assistance 

services to the Substance Use Prevention Services field. The PTTC does this by developing 

and disseminating tools and strategies needed to improve the quality of Substance Use 
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Prevention Services efforts; providing intensive technical assistance and learning resources 

to prevention professionals to improve their understanding of prevention science, 

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

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

The FY 2025 budget request will allow SAMHSA to continue to provide direct technical 

assistance to states, communities, Tribe, or territories, to strengthen grantee programs. This 

funding will support the HHS priority of advancing the goal of ending the opioid crisis and the 

ONDCP Drug Policy Priority of supporting evidence-based prevention efforts to reduce youth 

substance use. 

Science and Service Program Coordination 

FY 2025 President’s Budget Request: $4.1 million, equal to the FY 2024 CR level. 

The Science and Service Program Coordination program funds the provision of technical 

assistance and training to states, tribes, communities, and grantees around Substance Use 

Prevention Services. Specifically, the program supports the Tribal Training and Technical 

Assistance Center and the Underage Drinking Prevention Education Initiatives (UADPEI). The 

FY 2025 budget request will continue to support SAMHSA’s Substance Use Prevention Services 

efforts and include a focus on preventing underage drinking and providing technical assistance and 

training to American Indians/Alaska Native communities. 

Other PRNS Prevention Programs $44.5 million, equal to the FY 2024 CR level. 

The FY 2025 budget request includes resources for Minority AIDS and Minority Fellowship 

Programs. The funding will support activities that build a strong foundation for delivering and 

sustaining high-quality and accessible substance misuse and HIV prevention service among at-risk 

populations, including racial/ethnic minority youth and young adults, ages 13 to 24. The funding 

will also help to enhance services for racial and ethnic minority communities through specialized 

training of mental health professionals in psychiatry, nursing, social work, marriage and family 

therapy, mental health counseling, psychology; and substance use/addiction counseling. 
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Treatment

Substance Use Services

Substance Use Prevention and Treatment Block Grant:

FY 2025 President’s Budget Request: $2.0 billion, equal to the FY 2024 CR level.

The goal of the SUBG program is to ensure that individuals, their families, and communities have 

access to the range of substance use-related prevention, treatment, harm reduction, and recovery 

support services necessary to improve individual outcomes and reduce the impact of substance 

misuse on America’s communities. SUBG grantees plan, implement, and evaluate substance use 

disorder (SUD) prevention, treatment, and recovery support services based on the specific needs 

of their state systems and populations.

The SUBG program enables the development of comprehensive statewide systems of care that 

provide a broad continuum of SUD services and supports encompassing prevention, treatment, 

and recovery support services for all individuals who need them. Funding will aid in having a 

positive effect on the health and quality of life of individuals with SUD as demonstrated by positive 

client outcomes in the treatment domains of the National Outcomes Measures (NOMs); improve 

state prevention and treatment systems’ infrastructure and capacity resulting in an increase in 

services, development and implementation of evidence-based practices, development and 

collection of specific outcome measures, and development and maintenance of state data 

management systems; aid states in leveraging requirements, resources, and federal guidance to 

sustain and improve state systems further emphasizing the importance of the SUBG in the 

development of the same; and contribute to the development and maintenance of successful state 

collaborations with other agencies and stakeholders concerned with preventing and treating SUD. 

It is imperative that our addiction crisis response evolves from an acute short-term individualfocused treatment response to a broader community recovery response. Addiction is a chronic 

illness, and recovery often is a life-long process where external community and social determinants 

of health play a vital role in its sustainability. 

In FY 2025, SAMHSA plans to continue serving as a source of safety-net funding, including 

providing assistance to states in addressing and evaluating activities to prevent, reduce harm, treat, 

and provide recovery support services for individuals, families, and communities that are adversely 

impacted by substance use disorders (SUDs) and related conditions.

State Opioid Response

FY 2025 President’s Budget Request: $1.6 billion, an increase of $20 million with the FY 

2024 CR l level. 

The Substance use And Mental Health Services Administration established the State Opioid 

Response Grants (SOR) program in FY 2018. This program aims to address the opioid crisis by 

increasing access to treatment that includes the three FDA-approved medications for the treatment 

of opioid use disorder, reducing unmet treatment needs, and reducing opioid overdose related 
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deaths through the provision of prevention, treatment, and recovery activities for opioid use 

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

analogs). Funding is awarded through grants to states and territories via formula. The program 

includes a $60 million set-aside for tribes. Given the varying nature of substance misuse across 

the United States, the budget continues to allow the use of State Opioid Response grants to include 

methamphetamine and other stimulants, giving states and tribes flexibility to address their unique 

community needs. The budget request will continue to enhance states’ ability to address stimulants, 

as well as other issues related to the overdose epidemic that was compounded by COVID-19. A 

primary strategy to reduce overdose deaths in the SOR program, that will also continue in FY 

2025, is education on, and purchase and distribution of naloxone and other opioid overdose 

reversal medications, proven medications that reverse opioid-related overdoses to save lives. 

SAMHSA will assist states in the identification of underserved communities and agencies and 

continue in FY 2025 to work with states on implementation and further refinement of naloxone 

and other opioid overdose reversal medication distribution and saturation. 

Programs of Regional and National Significance 

Opioid Treatment Programs/Regulatory Activities

FY 2025 President’s Budget Request: $10.7 million, equal to the FY 2024 CR level. 

As part of its regulatory responsibility, SAMHSA certifies Opioid Treatment Programs that use 

methadone, buprenorphine, or buprenorphine/naloxone to treat patients with opioid use disorder. 

SAMHSA carries out this responsibility by enforcing regulations established by an accreditationbased system. This is accomplished in coordination with the Drug Enforcement Administration, 

states, territories, and the District of Columbia. SAMHSA also funds the Opioid Treatment 

Programs Medical Education and Supporting Services project aimed at preparing Opioid 

Treatment Programs to achieve accreditation and providing technical assistance and clinical 

training to enhance program clinical activities. Additionally, SAMHSA funds grants and contracts 

that support the regulatory oversight and monitoring activities of Opioid Treatment Programs. 

SAMHSA will continue in FY 2025 to work with the OTP community, states, and other 

stakeholders on the implementation of the substantially updated regulations released in January 

2024 that establish standards of care provided by OTPs. 

Targeted Capacity Expansion 

FY 2025 President’s Budget Request: $122.4 million, equal to the FY 2024 CR level. 

The Targeted Capacity Expansion (TCE) program provides rapid, strategic, comprehensive, and 

integrated community-based responses to gaps in and capacity for SUD treatment and recovery 

support services. Examples of such needs include limited or no access to medication-assisted 

treatment (MAT) for opioid use disorders; lack of resources needed to adopt and implement health 

information technologies (HIT) in SUD treatment settings; and short supply of trained and 

qualified peer recovery coaches to assist individuals in the recovery process. 

Treatment Systems for Homeless

FY 2025 President’s Budget Request: $ 37.1 million, equal to the FY 2024 CR level. 
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In FY 2023, SAMHSA funded 31 new grants and 51 continuation GBHI grants. During this year, 

the program achieved positive client outcomes for National Outcome Measures (NOMs), 

improved mental health outcomes, and reduced drug use outcomes. Strategies utilized by the 

program included the following: (1) Engaging and connecting the population of focus to behavioral 

health treatment, public health-focused harm reduction services, case management, and recovery 

support services; (2) Assisting with identifying sustainable permanent housing by collaborating 

with homeless services organizations and housing providers, including public housing agencies; 

and (3) Providing case management that includes care coordination/service delivery planning and 

other strategies that support stability across services and housing transitions. Challenges, though, 

continue as potential clients live in congregate settings (e.g., shelters) that periodically may be 

closed to external organizations. For enrolled clients, the program utilizes a combination of inperson and virtual service provision to maintain contact with clients and provide services. 

Pregnant and Postpartum Women

FY 2025 President’s Budget Request: $43.9 million, $5 million increase from the FY 2024 

CR level. 

The Pregnant and Postpartum Women supports grants for residential treatment and the Pregnant 

and Postpartum Women Pilot, authorized in the Comprehensive Addiction and Recovery Act 

(CARA), helps state substance use agencies address the continuum of care, including services 

provided to women in nonresidential-based settings and promote a coordinated, effective, and 

efficient state system managed by state substance use agencies by encouraging new approaches 

and models of service delivery. The PPW program provides services not covered under most public 

and private insurance. SAMHSA plans to award two new and ten continuation PPW-pilot grants, 

as well as ten new and 48 continuation PPW-residential treatment grants to provide an array of 

services and supports to pregnant women and their families.

Criminal Justice Activities

FY 2025 President’s Budget Request: $94 million, equal to the FY 2024 CR level. 

SAMHSA’s Criminal Justice portfolio includes several grant programs that focus on diversion, 

alternatives to incarceration, drug courts, and re-entry from incarceration for adolescents and 

adults with substance use disorders and/or co-occurring substance use and mental disorders. This 

includes Treatment Drug Courts and the Offender Re-Entry Programs. 

The criminal justice system is a major source of referrals to substance use disorder treatment, with 

probation or parole referrals representing the largest proportion of criminal justice system referrals 

to treatment.101 Most probation or parole referrals to treatment are men between the ages of 18 

and 44. The most commonly used substances reported by these individuals are alcohol, marijuana, 

and methamphetamine. 

Drug Court Activities
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SAMHSA’s Adult Drug Court programs support a variety of services including direct treatment 

services for diverse populations, wraparound, and recovery support services such as recovery 

housing and peer recovery support services designed to improve access and retention, drug testing 

for illicit substances, educational support, relapse prevention and long-term management, and HIV 

and viral hepatitis B and C testing conducted in accordance with state and local requirements. The 

program seeks to address behavioral health disparities among racial and ethnic minorities by 

encouraging the implementation of strategies to decrease the differences in access, service use, 

and outcomes among the racial and ethnic minority populations served. 

Ex-Offender Re-Entry Program

In addition to the drug court portfolio, SAMHSA supports Offender Reentry Program (ORP) 

grants, as well as other criminal justice activities, such as evaluation and behavioral health 

contracts. These grants will provide screening, assessment, comprehensive treatment, and 

recovery support services for diverse populations reentering the community from incarceration. 

Other supported services include wraparound and recovery support services such as recovery 

housing and peer recovery support designed to improve access and retention, drug testing for illicit 

substances, educational support, relapse prevention and long-term management, and HIV and viral 

hepatitis B and C testing conducted in accordance with state and local requirements. SAMHSA’s

ORP grants are encouraged to use part of their annual award to provide medication-assisted 

treatment with FDA-approved medications. 

Emergency Department Alternatives to Opioids

FY 2025 President’s Budget Request: $8.0 million, equal to the FY 2024 CR level. 

The program is authorized by section 7091 of the SUPPORT for Patients and Communities Act 

(P.L. 115-271) to provide funding to hospitals and emergency departments, including freestanding 

emergency departments, to develop, implement, enhance, or study alternative pain management 

protocols and treatments that limit the use and prescribing of opioids in emergency departments. 

In addition, the program seeks to target common painful conditions, train providers and other 

hospital personnel, and provide alternatives to opioids for patients with painful conditions. 

Improving Access to Overdose Treatment

FY 2025 President’s Budget Request: $1.5 million, equal to the FY 2024 CR level. 

As part of SAMHSA’s response to the increase in the number of opioid-related overdose deaths, 

the Opioid Overdose Prevention Toolkit was developed to help reduce the number of opioidrelated overdose deaths and adverse events. SAMHSA’s Improving Access to Overdose 

Treatment (ODTx) grant program utilizes this toolkit and other resources to help grantees train 

and support health care providers and pharmacists on the prescribing of FDA approved drugs or 

devices for the emergency treatment of known or suspected opioid overdose. In addition, the 

ODTx program addresses the opioid crisis by increasing access to treatment, reducing unmet 

treatment need, and reducing opioid overdose related deaths through the provision of prevention, 

treatment, and recovery activities for opioid use disorder (including prescription opioids as well as 

illicit drugs such as heroin). The FY 2025 funding request will continue increasing access to 

treatment, reducing unmet treatment need, and reducing opioid overdose related deaths through 
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the provision of prevention, treatment, and recovery activities for opioid use disorder. 

Other PRNS Treatment Programs

FY 2025 President’s Budget Request: $153.1 million, equal to the FY 2024 CR level. 

The budget request includes resources for several Treatment Capacity programs including: 

Screening, Brief Intervention and Referral to Treatment; Children and Families; Addiction 

Technology Transfer Centers; Comprehensive Opioid Recovery Centers; Minority AIDS; and 

Minority Fellowship Program. The budget request in FY 2025 will continue enhance overall drug 

treatment quality by incentivizing treatment and service providers to achieve specific performance 

targets. Examples of grant awards could include supplements for treatment and service providers 

who are able to connect higher proportions of detoxified patients with continuing recoveryoriented treatment; or for outpatient providers who are able to successfully retain greater 

proportions of patients in active treatment participation for longer periods. 
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Harm Reduction

Community Harm Reduction and Engagement Initiative 

FY 2025 President’s Budget Request: $10 million

Harm reduction is a proactive and evidence-based public health approach to reduce the negative 

individual and public health impacts of alcohol and other substance use/use disorder. With millions 

of Americans meeting diagnostic criteria for a substance use disorder and not receiving treatment, 

harm reduction approaches engage individuals in lifesaving care that meets people where they 

are. SAMHSA is proposing the Community Harm Reduction and Engagement Initiative ($10 

million) to establish this new harm reduction program, which also supports overdose prevention. 

SAMHSA’s Center for Substance Use Services Community Harm Reduction and Engagement 

Initiative aims to reach 181,000 individuals with harm reduction and low-threshold treatment 

services through three approaches: 1) Harm Reduction Resources for Community-Based 

Organizations, 2) Community Harm Reduction and Engagement Expansion Grants, 3) Harm 

Reduction Technical Assistance (TA) Center. SAMHSA will support a TA center to provide TA 

to States, Tribes, and communities interested in establishing or strengthening their harm reduction 

services.

1. Harm Reduction Resources for Community-Based Organizations ($3 million): Provide 

awards reaching at least 41 small community-based organizations that are already serving 

populations needing these services but without other federal resources to support harm 

reduction services. These organizations will receive technical assistance and capacity-building 

support, as well as resources to expand their services. These efforts will enable organizations 

to expand their reach to an additional 21,000 individuals. 

2. Community Harm Reduction and Engagement Expansion Grants ($5 million): Grants will 

be provided to approximately 41 harm reduction service organizations serving who have the 

capacity to expand their services to an additional 60,000 individuals. 

3. Harm Reduction TA Center ($2 million): Technical assistance will be made available to 

States, Tribes and communities interested in establishing or strengthening their harm reduction 

services. It is estimated this TA will reach a minimum of 75 organizations, who will in turn 

be able to reach 100,000 individuals. 

 

Grants to Prevent Prescription Drug/Opioid Overdose Related Deaths

FY 2025 President’s Budget Request: $16 million, equal to the FY 2024 CR level. 

Opioid overdose is a significant contributor to accidental deaths among those who use, misuse, or 

abuse illicit and prescription opioids (including synthetics), such as fentanyl. SAMHSA’s Grants 

to Prevent Prescription Drug/Opioid Overdose Related Deaths program seeks to help states 

identify communities of high need, and provide education, training, and resources necessary to 

tailor the overdose kits to meet their specific needs. Grantees can use the funds to purchase 

naloxone, equip first responders with naloxone and other opioid overdose reversal medications , 

support education on these strategies, provide materials to assemble and disseminate overdose kits. 
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The FY 2025 funding request will continue to help states purchase overdose reversing drugs, equip 

first responders in high-risk communities, support education on the use of naloxone and other 

opioid overdose reversal medication, provide the necessary materials to assemble overdose kits, 

and cover expenses incurred from dissemination efforts. 

First Responder Training 

FY 2025 President’s Budget Request: $56 million, equal to the FY 2024 CR level. 

First Responder Training supports efforts to help first responders and members of other key 

community sectors to administer a drug or device approved or cleared under the Federal Food, 

Drug, and Cosmetic Act for emergency treatment of known or suspected opioid overdose. 

Grantees train and provide resources to first responders and members of other key community 

sectors at the state, tribal, and local governmental levels on carrying and administering a drug or 

device approved or cleared under the Federal Food, Drug, and Cosmetic Act for emergency 

treatment of known or suspected opioid overdose. Grantees also establish processes, protocols, 

and mechanisms for referral to appropriate treatment and recovery communities. Training, 

technical assistance, and evaluation activities are also being supported to assist grantees, determine 

best practices, and assess program outcomes. The FR-CARA program provides funding to state, 

Tribal and local governments to train and equip first responders to administer naloxone. The FY 

2025 budget request will continue to fund new and continuation grants. 
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Recovery

Programs of Regional and National Significance 

Recovery Community Services Program

FY 2025 President’s Budget Request: $4.4 million, equal to the FY 2024 CR level. 

As public education increases, there is broader acknowledgement of substance use disorder as a 

treatable condition that can be successfully managed over the course of a lifetime with the 

appropriate resources. The Recovery Community Services Program (RCSP) was designed to assist 

recovery communities to strengthen their infrastructure and provide peer recovery support services 

to those in or seeking recovery from substance use disorders across the nation. The FY 2025 

budget request at $4.4 million will allow SAMHSA to continue the efforts of building substance 

use disorder recovery networks throughout the nation and the collaboration among peer-run 

organizations. This investment will allow all 50 states, DC, and Puerto Rico to have an opportunity 

to build on their recovery infrastructure through Recovery Community Organizations (RCOs). 

RCOs, local non-profit organizations governed by people with lived experience, are the bedrock 

of local recovery communities. Additionally, this investment will further ONDCP’s priority of 

increasing the number of peer-led recovery community organizations by 25 percent by 2025. 

Building Communities of Recovery

FY 2025 President’s Budget Request: $16 million, equal to the FY 2024 CR level. 

The purpose of this program is to mobilize resources within and outside of the recovery community 

to increase the prevalence and quality of long-term recovery support from drug/alcohol misuse. 

Programs are designed to be overseen by individuals in recovery from SUDs who reflect the 

community served. These grants are intended to support the development, enhancement, 

expansion, and delivery of Recovery Support Services (RSS) as well as promotion of, and 

education about recovery. Programs are designed to be overseen by people in recovery from 

substance use disorders who reflect the community served. Grants support linkages between 

recovery networks and a variety of other organizations, systems, and communities, including 

primary care, other recovery networks, child welfare system, criminal justice system, housing 

services and employment systems. The FY 2025 Budget request supports ONDCP’s priority to 

expand recovery service by increasing the number of peer-led recovery community organizations 

and certified recovery residences by 25% in 2025. 

Peer Support Technical Assistance Center

FY 2025 President’s Budget Request: $2 million, equal to the FY 2024 CR level. 

The program is authorized by section 7152 of the SUPPORT for Patients and Communities Act 

(P.L. 115-271), is to provide funding for the creation of a National Peer-Run Training and 

Technical Assistance Center for Addiction Recovery Support, or the Center. The Center provides 

training and technical assistance and support to recovery community organizations (RCOs), and 

peer support networks. The technical assistance is related to training, translation and interpretation 

services, data collection, capacity building, and evaluation and improvement of the effectiveness 
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of such services provided by recovery community organizations and peer support networks. The 

FY 2025 budget request will provide resources for the existing grantee to maintain this program. 

Treatment, Recovery, and Workforce Support

FY 2025 President’s Budget Request: $12 million, equal to the FY 2024 CR level. 

The program is authorized by section 7081 of the SUPPORT for Patients and Communities Act, 

is to support the implementation of evidence-based programs for care and treatment of individuals 

after a drug overdose, as appropriate, which may include utilizing recovery coaches, establishing 

policies and procedures that address the provision overdose reversal medication and FDAapproved medications to treat substance use disorders, and establishing integrated models of care 

for individuals who have experienced a non-fatal drug overdose. SAMHSA is directed, in 

consultation with the Secretary of Labor, to award competitive grants to entities to carry out 

evidence- based programs to support individuals in substance use disorder treatment and recovery 

to live independently and participate in the workforce. The FY 2025 budget request at $12 million 

will fund up to 51 new grants and will serve an additional 3,485 clients and support the 

administration’s recovery-ready workplace efforts and ONDCP’s drug policy priority of 

advancing recovery-ready workplaces and expanding the addiction workforce. This program’s 

continuation will provide necessary career services for those in recovery from SUD through 

partnerships with local employers, community stakeholders local and state workforce development 

boards, local and state governments, and Indian Tribes or tribal organizations. 
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Health Surveillance and Program Support

The FY2025 budget request represents the Substance Abuse portion of the Health Surveillance 

and Program Support appropriation and supports staffing and activities to administer SAMHSA

programs as described below.

Health Surveillance and Program Support 

FY 2025 President’s Budget Request: $75.94 million, equal to the FY 2024 CR level. 

The Health Surveillance and Program Support (HSPS), SAMHSA is maintaining multiple U.S. 

behavioral health data collection systems and surveys, supports public awareness, and funds a 

range of business operations and processes within HSPS. 

Program Support

The FY 2025 Budget Request is $47.49 million, level with FY 2024 CR level. SAMHSA will 

continue to support staff to administer and manage SAMHSA’s diverse array of programs. At this 

funding level, SAMHSA will also ensure the agency can efficiently and effectively respond to the 

evolving and growing opioid crisis, as well as provide the significant resources, technical 

assistance, and leadership within the mental health and behavioral health public health sphere. This 

level of funding will also continue to cover overhead costs associated with 5600 Fishers Lane, 

including rent, the Federal Acquisition Service loan repayment program, and security charges 

activities.

Health Surveillance

The budget request at $28.5 million will fund the modernization of the Behavioral Health 

Treatment Locator to feature appointment capability to reduce barriers for individuals and families 

to access treatment. CBHSQ is also planning to implement a Spanish version of the Locator, which 

has been selected by the HHS Secretary’s Health Disparities Council Policy Lab as a special 

project. Also, within BHSIS, CBHSQ is planning to implement a National Substance Use and 

Mental Health Services Survey (N-SUMHSS) supplement to gather additional information on 

racial and ethnic minority-based treatment facilities. Additional funding would also allow the 

Treatment Episode Data Set (TEDS) to provide increased technical support to the States to 

overcome the challenges and difficulties of data reporting.

Public Awareness and Support 

FY 2025 President’s Budget Request: $6.6 million, equal to the FY 2024 CR level. 

SAMHSA’s mission is to lead public health and service delivery efforts that promote mental 

health, prevent substance misuse, and provide treatments and supports to foster recovery while 

ensuring equitable access and better outcomes. To support the mission, SAMHSA’s Office of 

Communications (OC) staff ensure that the vital information, publications, and training materials 

produced through SAMHSA’s centers and offices are available to the healthcare workforce, people 

in treatment and recovery, people in crisis or in areas affected by disasters, SAMHSA grantees, 

and the public. Several channels are used to communicate this information, including online, print, 
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radio, and television media; social media platforms; the SAMHSA.gov website; the SAMHSA 

Store, the subscription-based e-blast system; and inquiries received through the National 

Helpline. In addition, the OC staff manage SAMHSA events to interact with stakeholders, media 

organizations, and the public and assist in the development and execution of materials, products, 

and campaigns. 

The OC media team evaluate and act upon media inquiries; develop rollout plans; issue press 

releases, news bulletins, and media advisories; and provide in-house media support to SAMHSA 

centers and offices. The team build relationships with representatives of the media; identify and 

seek corrections to inaccuracies about SAMHSA in media products, when necessary; work to add 

SAMHSA’s life-saving resources to journalistic and entertainment products; support broad HHS 

and administration communications priorities; and collaborate with departmental operating 

divisions. The media team also collaborate with SAMHSA staff when a disaster occurs to quickly 

disseminate press releases and social media featuring SAMHSA’s Disaster Distress Helpline and 

links to relevant SAMHSA resources. 

The OC digital team manage SAMHSA’s social media presence on Facebook, Twitter, LinkedIn, 

Instagram, and YouTube. Social media messaging is incorporated in all communications plans 

and is employed daily to communicate messages about SAMHSA news and resources. The staff 

monitor social media conversations, create content, participate in Twitter chats and Facebook Live 

sessions, and post blogs on SAMHSA.gov. The digital team also manage the SAMHSA.gov 

website, which provides enterprise-wide content and related public-facing websites, and support 

Section 508 activities. 

 

The following contract services are managed within the OC and provide various levels of support 

to enable the sharing of vital information to the public. Examples of this work include content 

development and amplification of critical resources like the 988 Suicide and Crisis Lifeline, 

Disaster Distress Helpline, and findtreatment.gov; materials development and dissemination for 

national observances like Mental Health Awareness and Recovery Month, Prevention Week, and 

others; support for messaging around the Administration’s behavioral health strategies and 

program funding; building and maintaining the new findsupport.gov resource and continuous 

revitalizing SAMHSA.gov webpages; and developing educational campaigns and resources to 

support people in recovery from mental health conditions and substance use disorder. 

Public Awareness and Support Activities: Enables the agency to develop and disseminate a 

variety of national informational campaigns, public service announcements (PSAs), and other 

materials for a broad range of platforms. Topics, audiences, and formats range but all phases from 

creative concepts to storyboards as well as focus group testing are included. As an example, the 

OC has issued, with the assistance of this contract, information, graphics and resources for 

National Mental Health Awareness and National Recovery Month as well as the continued 

promotion of the 988 Suicide and Crisis Lifeline. 

Materials Development and Editorial Services: Provides communication support services for 

media outreach, publications, digital products, speechwriting, graphics, copyediting, and 

meeting/event logistics. As an example, through this contract OC is supporting the Office of 

Recovery in developing reports and outreach materials for their programs and events. 
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Web Management and Support: Supports SAMHSA’s website, list serve and subscriber 

database system, and mobile applications. For its online publication library (aka SAMHSA Store), 

the OC has entered into an interagency agreement with the U.S. Government Publishing Office 

(GPO) to manage a customer-oriented fulfillment and distribution center, including a warehouse 

to store SAMHSA publications. This contract also keeps the website current in terms of U.S. web 

standards, improved search engines, new dashboards, and a modernized homepage. 

Contact Center: Supports the National Helpline (1-800-662-HELP) and the 1-877-SAMHSA-7 

information line. The National Helpline provides free, confidential treatment referral and 

information services in English and Spanish for individuals and families facing mental illness 

and/or substance use disorders via phone or text (HELP4U). It is operational 365 days-a-year, 

24/7. The 1-877-SAMHSA-7 line is the single point of entry for SAMHSA’s information services 

and is operated Monday through Friday, 8:00 am to 8:00 pm (except for federal holidays).

Performance and Quality Information Systems

FY 2025 President’s Budget Request: $5.7 million, equal to the FY 2024 CR level. 

Performance and Quality Information Systems provides funding to support SAMHSA’s

Performance Accountability and Reporting System (SPARs) related activities, as well as provide 

support for the National Registry of Evidence-based Programs and Practices. SPARS provides a 

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

programmatic technical assistance (TA) on use of the data to enhance grantee performance 

monitoring and improve quality of service delivery. This request represents the total funding 

available for these activities first split into Mental Health and Substance Abuse using the same 

percentages splits as between the Mental Health and Substance Abuse (Prevention and Treatment) 

appropriation amounts. The Drug Control portion is then split 20 percent/80 percent into the two 

functions, prevention, and treatment, respectively.

Drug Abuse Warning Network (DAWN)

FY 2025 President’s Budget Request: $10.4 million, equal to the FY 2024 CR level. 

Authorized by the 21st Century Cures Act, DAWN provides necessary information such as patient 

demographic details and substances used to respond effectively to the opioid and addiction crises 

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

stakeholders to respond to emerging substance use trends. DAWN is allocated fully to substance 

abuse. The FY 2025 budget request at $10.4 million will maintain all activities associated with 

DAWN. SAMHSA would also begin expanding the natural language processing and machine 

learning for data abstraction. CBHSQ is also planning to begin gender data abstraction. 

Data Request and Publication User Fees

FY 2025 President’s Budget Request: $1.9 million, equal to the FY 2024 CR level. 

SAMHSA will collect and retain fees for extraordinary data and publications requests. This 

represents the total funding estimated for these activities first divided evenly between Mental 

Health and Substance Abuse. The Drug Control portion is then split 20 percent/80 percent into 
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the two functions, prevention, and treatment, respectively. 
375 

Proposed Law 

Renames Substance Abuse and Mental Health Services Administration, Center for 

Substance Abuse Treatment, and Center for Substance Abuse Prevention. 

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

(1) by striking “Substance Abuse and Mental Health Services Administration” each place 

it appears and inserting “Substance use And Mental Health Services Administration”; 

(2) by striking “Center for Substance Abuse Treatment” each place it appears and 

inserting “Center for Substance Use Services”; and 

(3) by striking “Center for Substance Abuse Prevention” each place it appears and 

inserting 

“Center for Substance Use Prevention Services”. 

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

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

SERVICES ADMINISTRATION” and inserting “SUBSTANCE USE AND MENTAL 

HEALTH 

SERVICES ADMINISTRATION”; 

(2) in section 501— 

 

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

HEALTH SERVICES ADMINISTRATION” and inserting “SUBSTANCE USE AND 

MENTAL HEALTH SERVICES ADMINISTRATION”; and 

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

‘Administration’)” and inserting “(hereafter referred to in this title as ‘SAMHSA’ or the 

‘Administration’)”; 

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

ABUSE TREATMENT” and inserting “CENTER FOR SUBSTANCE USE SERVICES”; 

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

SUBSTANCE ABUSE TREATMENT” and inserting “CENTER FOR SUBSTANCE USE 

SERVICES”; and 

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

ABUSE PREVENTION” and inserting “CENTER FOR SUBSTANCE USE PREVENTION 

SERVICES”. 
376 

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

amended in the paragraph heading by striking “CENTER FOR SUBSTANCE ABUSE 

PREVENTION” and inserting “CENTER FOR SUBSTANCE USE PREVENTION 

SERVICES”. 

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

amended in the paragraph heading by striking “CENTER FOR SUBSTANCE ABUSE 

PREVENTION” and inserting “CENTER FOR SUBSTANCE USE PREVENTION 

SERVICES”. 

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

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

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

Administration”. 

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

1395x, 1395cc-6, 1396w-4) by striking “Substance Abuse and Mental Health Services 

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

Administration”. 

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

U.S.C. 5106(a)(7)(C)(i)(III)) is amended by striking “Substance Abuse and Mental Health 

Services Administration” and inserting “Substance use And Mental Health Services 

Administration”. 

(h)(1) Except as provided in paragraph (2), any reference in any law, regulation, map, 

document, paper, or other record of the United States— 

(A) to the Substance Abuse and Mental Health Services Administration shall be 

considered to be a reference to the Substance use And Mental Health Services Administration; 

(B) to the Center for Substance Abuse Treatment of such Administration shall be treated 

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

(C) to the Center for Substance Abuse Prevention of such Administration shall be treated 

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

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

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

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

to the Assistant Secretary for Mental Health and Substance Use.
377 

Minority Fellowship Program Proposal 

The Minority Fellowship Program (MFP) currently aims to reduce health disparities and improve 

behavioral health care outcomes for racial and ethnic populations. SAMHSA is seeking to improve 

the MFP in three ways. SAMHSA is proposing to require that graduating professionals who have 

received a fellowship from one of the MFP grantees serve in low-income, underserved 

communities including racial, ethnic, sexual and gender minority populations for a minimum of 2 

years. Additionally, SAMHSA proposes that professionals in the addiction medicine field be an 

eligible profession under the Minority Fellowship Program. Lastly, the agency proposes inclusion 

of sexual and gender minority populations as populations served by this program. All of the 

proposed changes have a positive impact on equity for individuals from racial, ethnic, sexual and 

gender minority populations and socioeconomically diverse backgrounds. 

 

Certified Community Behavioral Health Clinic Proposal 

Certified Community Behavioral Health Clinics (CCBHCs) provide comprehensive, coordinated 

treatment and recovery support services to anyone who requests care for mental health or substance 

use, regardless of their ability to pay. This includes crisis services that are available 24 hours a 

day, 7 days a week. This proposal supports CCBHCs by proposing an accreditation process similar 

to the process for which many health facilities are accredited. This new process would support 

consistent implementation of the CCBHC model and adherence to the CCBHC certification 

criteria. A CCBHC accreditation process will allow for improved accountability for CCBHCs 

across the country s and will ensure that CCBHCs are consistently providing access to quality 

behavioral health care. 

Office of Recovery Authorization

SAMHSA established the Office of Recovery in response to requests from the mental health and 

substance use stakeholder community to enhance existing programs and improve recovery 

outcomes. Since its launch in September 2021, the Office has initiated programmatic, policy, 

public awareness campaigns, and data-related activities to strengthen recovery support across the 

nation. The Office of Recovery was established under the broad authorities described in 

subsections (c)(2) and (d)(5) of section 501 of the Public Health Services Act (42 U.S.C. 290aa)

and is not specifically authorized in statute. SAMHSA is proposing specific statutory 

authorization for the Office of Recovery. Specific statutory authorization at this time would bring 

additional focus and attention of the Office and its activities. It would also expand opportunities 

to provide guidance and direction to improve the Office of Recovery consistent with existing 

Centers, Offices, and programs that are authorized by statute. Specific statutory authorization 

would establish the Office to coordinate recovery-focused efforts across SAMHSA and the Federal 

government to improve efficiencies and avoid duplication of effort.