DEPARTMENT of 

HEALTH

and HUMAN

SERVICES 

Fiscal Year 

2018

Substance Abuse and Mental Health 

Services Administration

Justification of Estimates for 

Appropriations Committees 
ii

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iii

I am pleased to present the Substance Abuse and Mental Health Services Administration 

(SAMHSA) fiscal year (FY) 2018 Budget Request. SAMHSA is requesting a total of $3.9 billion. 

As a primary federal agency responsible for addressing substance abuse and mental health 

services, SAMHSA proudly leads public health efforts to advance the behavioral health of the 

nation. Now, more than ever, we must ensure individuals living with substance use and mental 

disorders gain access to high quality prevention, treatment, and recovery services.

SAMHSA is committed to optimizing the impact of every dollar entrusted to our agency. This 

budget aligns with the Administration’s priorities to address behavioral health for children, adults, 

families, and communities. Through a sustained focus on enhancing and developing critical 

partnerships, SAMHSA’s budget aims to improve the lives of people and patients across the 

nation.

SAMHSA’s FY 2018 budget request includes investments to:

 Expand access to care for opioid use disorders through the State Targeted Response 

program financed with a continued investment of $500 million to combat the nation’s 

opioid crisis. In addition, the budget invests in Medication Assisted Treatment (MAT) 

and continued strategies to prevent opioid abuse through evidence-based prevention 

strategies, including the use of the live-saving drug, naloxone.

 Help engage individuals with serious mental illness into care, especially those who are 

hardest to reach and the most vulnerable.

 Address the alarming rate of suicide across the nation.

 Make critical data from national surveys and surveillance available to support innovation 

and improve patient outcomes.

SAMHSA provides strategic investments that foster flexibility and leverage change across the 

nation. Program performance and continuous quality improvement are critical aspects of our work. 

We carefully monitor and measure our programs to ensure the needs of the public are being met. 

In FY 2018, SAMHSA initiative to support its highly trained workforce and robust business 

practices will ensure responsible stewardship of the American taxpayer’s dollar.

What SAMHSA does every day helps save lives. Reversing opioid overdose, preventing suicide, 

or building the foundation for a socially and emotionally healthy childhood, a strong community, 

a drug-free workplace, or an individual pathway to recovery – the work SAMHSA does is vital to 

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

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

Kana Enomoto

Acting Deputy Assistant Secretary for

Mental Health and Substance Use
iv

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v

DEPARTMENT OF HEALTH AND HUMAN SERVICES

SUBSTANCE ABUSE AND MENTAL HEALTH SERVICES ADMINISTRATION

Table of Contents 

Fiscal Year 2018 Budget Page

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

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

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

A. Executive Summary

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

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

3. Overview of Performance ..................................................................................................5

4. Discretionary All-Purpose Table ........................................................................................6

B. Budget Exhibits

1. Appropriations Language ...................................................................................................9

2. Language Analysis ...........................................................................................................13

3. Amounts Available for Obligation ...................................................................................17

4. Summary of Changes .......................................................................................................18

5. Budget Authority by Activity ...........................................................................................20

6. Authorizing Legislation ....................................................................................................21

7. Appropriations History .....................................................................................................23

C. Mental Health Services

1. Mental Health Programs of Regional and National Significance ....................................28

2. Children’s Mental Health Services ...................................................................................97

3. Projects for Assistance in Transition from Homelessness .............................................103

4. Protection and Advocacy for Individuals with Mental Illness .......................................109 

5. Community Mental Health Services Block Grant ..........................................................115

D. Substance Abuse Prevention

1. Substance Abuse Prevention Programs of Regional and National Significance............127

E. Substance Abuse Treatment

1. Substance Abuse Treatment Programs of Regional and National Significance ............163

2. State Targeted Response to the Opioid Crisis Grants ....................................................207

3. Substance Abuse Prevention and Treatment Block Grant .............................................209

F. Health Surveillance and Program Support 

1. Health Surveillance .......................................................................................................229

2. Performance and Quality Information Systems .............................................................237

3. Program Support .............................................................................................................245

4. Public Awareness and Support .......................................................................................247
vi

G. Drug Control Budget ...........................................................................................................253

H. Supplementary Tables

1. Budget Authority by Object Class ...................................................................................273

2. Salaries and Expenses ......................................................................................................282

3. Detail of Full-Time Equivalent Employee (FTE) ............................................................284

4. Detail of Positions ............................................................................................................285

5. Programs Proposed for Elimination ................................................................................ 286

6. Physician’s Comparability Allowance Worksheet ..........................................................288

I. Significant Items...................................................................................................................289
vii
viii

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1

Performance Budget Overview 

Introduction

Now, more than ever, the need to face mental health and substance abuse is critical to the nation’s 

future. Prevention, treatment, and support to help people recover from mental illness and

drug/alcohol addiction are essential strategies for the health and prosperity of individuals, families,

communities, and the country. Half of all Americans will meet criteria for a mental or substance

use disorder during their lives. Unfortunately, the majority of those who need treatment do not

receive it. Only 41 percent of the 43 million adults with diagnosable mental health problems

received treatment. The unmet treatment need for those with substance abuse problems (21 million

adults) is even greater with only one in 10 individuals receiving specialty treatment.1

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

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

Administration, 2014.

The nation

can do better. SAMHSA has a unique responsibility to focus on these preventable and treatable 

problems, which, if unaddressed, lead to significant individual, societal, and economic 

consequences. 

Mission

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

communities. SAMHSA accomplishes this mission through providing leadership and devoting its 

resources, including programs, policies, information and data, contracts and grants to help 

demonstrate that:

 Behavioral Health is essential to health

 Prevention works

 Treatment is effective

 People recover 

 
2

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3

Overview of Budget Request

The FY 2018 President’s Budget Request is $3.9 billion, a decrease of $399.1 million from the 

FY 2017 Annualized CR. This budget request seeks to advance SAMHSA’s mission to reduce 

the impact of substance abuse and mental illness on America’s communities. The need to 

advance the nation’s behavioral health is more apparent than ever. Along with other behavioral 

health priorities, the proposed budget aims to combat the nation’s opioid crisis, address serious 

mental illness, and continue to develop and implement strategies to prevent suicide.

Key Budget Highlights:

Substance Abuse Prevention and Treatment Block Grant 

The FY 2018 Budget Request is $1.9 billion. This funding serves as a critical safety net for 

substance abuse prevention and treatment services. The states and jurisdictions have the 

flexibility to plan, carry out, and evaluate substance abuse prevention, treatment, and recovery 

services that address the needs of individuals, families, and communities. Recognizing that 

prevention works, the statute requires that twenty percent of the SABG state allocation must be 

spent on primary prevention services.

State Targeted Response (STR) to the Opioid Crisis

The FY 2018 Budget Request is $500.0 million. In 2015, the United States lost 33,000 

Americans due to opioid overdose-related deaths. The tragic rates of opioid abuse across the 

nation are unacceptable. The STR Program addresses this crisis directly and comprehensively. 

The program combats 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 abuse (including prescription opioids as well as 

illicit drugs such as heroin). In FY 2017, grants were awarded via formula to all 50 states, the 

District of Columbia, Puerto Rico, the Virgin Islands, Northern Marianas, Micronesia, Palau, and 

American Samoa. The FY 2018 Budget Request supports the continuation of these grants.

Knowledge gained through the first year of the program as well as through the newly created 

President’s Commission on Combating Drug Addiction and the Opioid Crisis will be used to 

determine the resource allocations and priorities for the program’s second year (FY 2018). 

Suicide Prevention Activities

The FY 2018 Budget Request is $59.9 million. Suicide is a critical public health issue involving 

multiple psychological and social factors. It is one of the ten leading causes of death in the United 

States. Suicide rates have increased steadily for individuals of all ages from 1999 to 2014 with the 

rate increasing by 24 percent during this time period. SAMHSA supports a full complement of 

programs which address the nation’s alarming rates of suicide. These include: the National 

Strategy for Suicide Prevention, which focuses on adult suicide prevention, the Garrett Lee Smith 

State and Campus Suicide Programs, which address youth and young adult suicide, and the Tribal 

Training and Technical Assistance Center, which aims to provide needed training and TA to tribal 

communities to develop comprehensive suicide prevention strategies.
4

Children’s Mental Health Initiative

The FY 2018 Budget Request is $118.8 million. It is estimated that over 7.4 million children and 

youth in the United States have a serious mental disorder. Unfortunately, only 41 percent of those 

in need of mental health services actually receive treatment.2

2 Substance Abuse and Mental Health Services Administration, U.S. Department of Health and Human Services. 

(2014). Results from the 2013 National Survey on Drug Use and Health: Summary of National Findings, NSDUH 

Series H-48, HHS Publication No. (SMA) 144863. Rockville, MD: Substance Abuse and Mental Health Services 

Administration.

 The request supports the continuation 

of the Children’s Mental Health Services grants to enable states and communities to design

comprehensive systems of care to develop strategies that address the needs of children and youth 

with serious emotional disturbances. As part of this budget request, SAMHSA seeks to develop 

and implement a services research demonstration effort based on the North American Prodrome 

Longitudinal Study funded by the National Institute of Mental Health. During the prodrome phase, 

a disease process has begun but is not yet diagnosable or inevitable. The demonstration will 

address whether community-based intervention during this phase can prevent the further 

development of serious emotional disturbances and ultimately serious mental illness. The project 

will examine the extent to which evidence-based early intervention for young people at clinical 

high risk for psychosis can be scaled up to mitigate or delay the progression of mental illness, 

reduce disability, and/or maximize recovery. The new effort will be funded from a 10 percent setaside of the base program, and will focus on youth and young adults who are identified to be at 

clinical high risk for developing a first episode of psychosis. Funding of this new effort will not 

affect continuation funding of any CMHI-base funded program. 

Community Mental Health Services Block Grant

The FY 2018 Budget Request is $415.5 million. This funding continues to serve as a safety net 

for mental health services for some of the nation’s most vulnerable populations. By statute,

MHBG funds must be used to address the needs of adults with serious mental illness (SMI) and 

children with serious emotional disturbances (SED). SAMHSA will maintain the ten percent setaside for evidence-based programs that address the needs of individuals with early serious 

mental illness, including psychotic disorders. The set-aside funds help reduce costs to society, as 

intervening early helps prevent deterioration of functioning in individuals experiencing a first 

episode of serious mental illness. 

 
5

Overview of Performance

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

Substance Abuse and Mental Health Services Administration (SAMHSA) continues to refine its 

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

performance reviews help SAMHSA leadership analyze outcome data and learn 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 reports performance information for 18 of the 21 HHS 2014-2018 Strategic Plan goals 

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

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

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

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

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

services programs include: 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 numbers of people served, the numbers 

trained, and the number of training events held. 

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

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

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

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

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

assistance on use of the data to enhance grantee performance monitoring and improve quality of 

service delivery.
6

All-Purpose Table 

Substance Abuse and Mental Health Services Administration 

(Dollars in thousands) 

1/ Reflects Annualized CR ending April 28, 2017 including the ATB rescission, Cures, and Prevention Funding at FY 2016 minus rescissions.

2/ This program's funding is required by the 21st Century Cures Act to be subtracted from the estimate of discretionary budget authority under the Congressional 

Budget and Impoundment Control Act of 1974 or the Balanced Budget and Emergency Deficit Control Act of 1985.

Program FY 2016 Final

FY 2017 

Annualized CR /1 

12/10/16 

FY 2018 

President's 

Budget 

FY 2018 

President's 

Budget +/−

FY 2017 

Annualized CR 

Mental Health 0.1901%

Programs of Regional and National Significance 414,609 413,843 277,419 −136,424 

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

Children's Mental Health Services 119,026 118,800 118,800 --

Set-Aside for Youth in Prodrome Phase of Psychosis (non-add) 11,903 11,880 11,880 --

Projects for Assistance in Transition from Homelessness 64,635 64,512 64,512 −0.129 

Protection and Advocacy for Individuals with Mental Illness 36,146 36,077 36,077 −0.286 

Community Mental Health Services Block Grant 532,571 531,599 415,539 −116,060 

Budget Authority (non-add) 511,532 510,560 400,000 −110,560 

PHS Evaluation Funds (non-add) 21,039 21,039 15,539 −5,500 

Total, Mental Health 1,166,987 1,164,831 912,347 −252,484 

Budget Authority (non-add) 1,133,948 1,131,792 896,808 −234,984 

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

PHS Evaluation Funds (non-add) 21,039 21,039 15,539 −5,500 

Substance Abuse Prevention

Programs of Regional and National Significance 211,219 222,817 149,703 −73,114 

Total, Substance Abuse Prevention 211,219 222,817 149,703 −73,114 

Substance Abuse Treatment

Programs of Regional and National Significance 337,345 341,708 341,738 +30 

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

State Targeted Response to the Opioid Crisis Grants /2 -- 500,000 500,000 --

Substance Abuse Prevention and Treatment Block Grant 1,858,079 1,854,697 1,854,697 --

Budget Authority (non-add) 1,778,879 1,775,497 1,775,497 --

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

Total, Substance Abuse Treatment 2,195,424 2,696,405 2,696,435 +30 

SAT Budget Authority (non-add) 2,114,224 2,615,205 2,615,235 +30 

SAT PHS Evaluation Funds (non-add) 81,200 81,200 81,200 --

Health Surveillance and Program Support

Health Surveillance and Program Support 126,817 126,635 106,885 −19,750 

PHS Evaluation Funds (non-add) 30,428 30,428 22,428 −8,000 

Public Awareness and Support 15,571 15,541 11,572 −3,969 

Performance and Quality Information Systems 12,918 12,893 12,893 --

Agency-Wide Initiatives 51,000 50,905 998 −49,907 

PHS Evaluation Funds (non-add) 1,000 1,000 998 −1.901 

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

Total, Health Surveillance and Program Support 207,806 207,474 133,848 −73,626 

HSPS Budget Authority (non-add) 174,878 174,546 108,922 −65,624 

HSPS PHS Evaluation Funds (non-add) 31,428 31,428 23,426 −8,002 

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

TOTAL, SAMHSA Program Level 3,781,436 4,291,527 3,892,333 −399,194 

Less Funds from Other Sources:

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

PHS Evaluation Funds −133,667 −133,667 -120,165 +13,502 

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

TOTAL, SAMHSA Budget Authority 3,634,269 4,144,360 3,770,668 −373,692 

FTEs 620 615 610 −5 
7

Budget Exhibits

Table of Contents

1. Appropriations Language.................................................................................................... 9

2. Language Analysis............................................................................................................ 13

3. Amounts Available for Obligation.................................................................................... 17

4. Summary of Changes........................................................................................................ 18

5. Budget Authority by Activity ........................................................................................... 20

6. Authorizing Legislation .................................................................................................... 21

7. Appropriations History ..................................................................................................... 23
8

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9

Appropriations Language

SUBSTANCE ABUSE AND MENTAL HEALTH SERVICES ADMINISTRATION 

MENTAL HEALTH 

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

Protection and Advocacy for Individuals with Mental Illness Act, [$1,133,948,000]$896,808,000: 

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

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

further, That in addition to amounts provided herein, [$21,039,000]$15,539,000 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 up to 10 percent 

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

be used to carry out demonstration grants or contracts for early interventions with persons not 

more than 25 years of age at clinical high risk of developing a first episode of psychosis: [Provided 

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

for fiscal year 2016: Provided further, That of the amount appropriated under this heading, 

$46,887,000 shall be for the National Child Traumatic Stress Initiative as described in section 582 

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

technical assistance may be provided to a public entity to establish or operate a system of 

comprehensive community mental health services to children with a serious emotional 

disturbance, without regard to whether the public entity receives a grant under section 561(a) of 
10

such Act: Provided further, That States shall expend at least 10 percent of the amount each receives 

for carrying out section 1911 of the PHS Act to support evidence-based programs that address the 

needs of individuals with early serious mental illness, including psychotic disorders, regardless of 

the age of the individual at onset]: Provided further, That none of the funds provided for section 

1911 of the PHS Act shall be subject to section 241 of such Act: Provided further, That of the 

funds made available under this heading, [$15,000,000]$14,971,000 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).

SUBSTANCE ABUSE TREATMENT

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

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

abuse treatment and prevention, [$2,114,224,000]$2,115,235,000: Provided, That in addition to 

amounts provided herein, [the following amounts]$81,200,000 shall be available under section 

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

abuse treatment activities and to carry out subpart II of part B of title XIX of the PHS Act to fund 

section 1935(b) technical assistance, national data, data collection and evaluation activities, and 

further that the total available under this Act for section 1935(b) activities shall not exceed 5 

percent of the amounts appropriated for subpart II of part B of title XIX[; and (2) $2,000,000 to 

evaluate substance abuse treatment programs]: Provided further, That none of the funds provided 

for section 1921 of the PHS Act shall be subject to section 241 of such Act.
11

SUBSTANCE ABUSE PREVENTION

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

[$211,219,000]$149,703,000. 

HEALTH SURVEILLANCE AND PROGRAM SUPPORT

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

headings "Mental Health", "Substance Abuse Treatment", and "Substance Abuse Prevention" in 

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

with Mental Illness Act in the Substance Abuse and Mental Health Services Administration 

("SAMHSA"), [$174,878,000]$108,922,000: Provided, That in addition to amounts provided 

herein, [$31,428,000]$23,426,000 shall be available under section 241 of the PHS Act to 

supplement funds available to carry out national surveys on drug abuse and mental health, to 

collect and analyze program data, and to conduct public awareness and technical assistance 

activities: Provided further, That, in addition, fees may be collected for the costs of publications, 

data, data tabulations, and data analysis completed under title V of the PHS Act and provided to a 

public or private entity upon request, which shall be credited to this appropriation and shall remain 

available until expended for such purposes: Provided further, That amounts made available in this 

Act for carrying out section 501[(m)](o) of the PHS Act shall remain available through September 

30, [2017]2019: Provided further, That funds made available under this heading may be used to 

supplement program support funding provided under the headings "Mental Health", "Substance 

Abuse Treatment", and "Substance Abuse Prevention"[.]: Provided further, That the Assistant 

Secretary for Mental Health and Substance Use may transfer discretionary funds (pursuant to the 

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

current fiscal year for SAMHSA in this Act between any of the accounts of SAMHSA with 
12

notification to the Committees on Appropriations of both Houses of Congress at least 15 days in 

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

such transfer. 

Note.—A full-year 2017 appropriation for this account was not enacted at the time the budget was 

prepared; therefore, the budget assumes this account is operating under the Further Continuing 

Appropriations Act, 2017 (P.L. 114-254). The amounts included for 2017 reflect the annualized 

level provided by the continuing resolution. 
13

Language Analysis

Language Provision Explanation

Provided further, That in addition to amounts 

provided herein, [$21,039,000]$15,539,000

shall be available under section 241 of the PHS 

Act to supplement funds otherwise available 

for mental health activities and to carry out 

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

to fund section 1920(b) technical assistance, 

national data, data collection and evaluation 

activities,

Sets the amount of Public Health Service 

Evaluation Fund dollars allocated to 

supplement the budget authority for programs 

and activities authorized under title XIX as 

well as under titles III and V. 

Provided further, That up to 10 percent of the 

amounts made available to carry out the 

Children's Mental Health Services program 

may be used to carry out demonstration grants 

or contracts for early interventions with 

persons not more than 25 years of age at 

clinical high risk of developing a first episode 

of psychosis:

This provision permits SAMHSA to set aside 

up to 10 percent of CMHS for a demonstration 

with flexibility which would help address 

youth (which addresses 75 percent of first time 

psychotic episodes) instead of only children 

(which represent less than 50 percent of first 

time psychotic episodes) in the prodrome 

phase, which evidence indicates may prevent 

the further development of serious emotional 

disturbances and ultimately serious mental 

illness.
14

Language Analysis (continued)

Language Provision Explanation

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

the PHS Act shall not apply to funds 

appropriated in this Act for fiscal year 2016: 

This language is no longer necessary due to 

changes made in the authorization by the 21st

Century Cures Act.

Provided further, That of the amount 

appropriated under this heading, $46,887,000 

shall be for the National Child Traumatic 

Stress Initiative as described in section 582 of 

the PHS Act:

The FY 2018 Budget pursues this policy using 

administrative authority. A statutory earmark 

is not required. 

Provided further, That notwithstanding 

section 565(b)(1) of the PHS Act, technical 

assistance may be provided to a public entity 

to establish or operate a system of 

comprehensive community mental health 

services to children with a serious emotional 

disturbance, without regard to whether the 

public entity receives a grant under section 

561(a) of such Act:

Authorization for these activities is provided 

by the 21st Century Cures Act. 

Provided further, That States shall expend at 

least 10 percent of the amount each receives 

for carrying out section 1911 of the PHS Act 

to support evidence-based programs that 

address the needs of individuals with early 

serious mental illness, including psychotic 

disorders, regardless of the age of the 

individual at onset:

This language is no longer necessary because 

this requirement on State expenditures was 

21st added to the authorization by the Century 

Cures Act. 
15

Language Analysis (continued)

Language Provision Explanation

For carrying out titles III and V of the PHS Act 

with respect to substance abuse treatment and 

title XIX of such Act with respect to substance 

abuse treatment and prevention,

Sets out the budget authority for the Substance 

Abuse Treatment appropriation. 

Provided, That in addition to amounts 

provided herein, [the following amounts 

]$81,200,000 shall be available under section 

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

supplement funds otherwise available for 

substance abuse treatment activities and to 

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

PHS Act to fund section 1935(b) technical 

assistance, national data, data collection and 

evaluation activities, and further that the total 

available under this Act for section 1935(b) 

activities shall not exceed 5 percent of the 

amounts appropriated for subpart II of part B 

of title XIX[; and (2) $2,000,000 to evaluate 

substance abuse treatment programs]:

Sets the amount of Public Health Service 

Evaluation Fund dollars allocated to 

supplement the budget authority available for 

programs and activities authorized under title 

XIX as well as under titles III and V. These 

evaluation efforts will enable the gathering and 

dissemination of best practices. 
16

Language Analysis (continued)

Language Provision Explanation

Provided further, That the Assistant Secretary 

for Mental Health and Substance Use may 

transfer discretionary funds (pursuant to the 

Balanced Budget and Emergency Deficit 

Control Act of 1985) which are appropriated 

for the current fiscal year for SAMHSA in this 

Act between any of the accounts of SAMHSA 

with notification to the Committees on 

Appropriations of both Houses of Congress at 

least 15 days in advance of any transfer, but 

no such account shall be decreased by more 

than 3 percent by any such transfer. 

Establishes a permissive authority to transfer a 

small portion of funds between any of the 

SAMHSA accounts in order to ensure that 

multiple accounts are not a barrier to the 

efficient administration of the agency, or 

appropriate responsiveness to emerging issues 

with congressional notification.
17

Amounts Available for Obligation

(Whole dollars)

FY 2016

Final

FY 2017 

Annualized CR 

FY 2018

President's 

Budget

General Fund Discretionary Appropriation:

Appropriation (L/HHS, Ag, or, Interior) $3,634,269,000 $4,144,360,000 $3,770,668,000 

Across-the-board reductions (L/HHS, Ag, or Interior) --- --- ---

Subtotal, Appropriation (L/HHS, Ag, or Interior) 3,634,269,000 4,144,360,000 3,770,668,000 

Rescission (other appropriation bills, provide PL ##-###) --- --- ---

Subtotal, adjusted appropriation 3,634,269,000 4,144,360,000 3,770,668,000 

Total, Discretionary Appropriation 3,634,269,000 4,144,360,000 3,770,668,000 

Mandatory Appropriation:

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

Subtotal, adjusted mandatory appropriation 12,000,000 12,000,000 ---

Offsetting collections from:

Federal Source 133,667,000 133,667,000 120,165,000 

Data Request and Publications User Fees 1,500,000 1,500,000 1,500,000 

Unobligated balance, start of year 289,482 973,128 ---

Unobligated balance, end of year 1,020,913 968,063 880,774 

Unobligated balance, lapsing --- --- ---

Total obligations $3,781,436,000 $4,291,527,000 $3,892,333,000 
18

Summary of Changes

(Whole dollars)

2017

Total estimated budget authority $4,144,360,000 

(Obligations) 4,144,360,000 

2018

Total estimated budget authority 3,770,668,000 

(Obligations) 3,770,668,000 

Net Change −$373,692,000

 

 

FY 2018 

PB FTE 

FY 2018 

PB BA 

FY 2018 

+/- 

FY 2017 

FTE

FY 2018 

+/− 

FY 2017 

BA

Increases:

A. Built-in:

1. Annualization of 2017 commissioned corps pay increase $8,282,276 +$856,584

2. Annualization of 2017 civilian pay increase 83,591,849 −661,171

Subtotal, Built-in Increases 91,874,125 +195,413

A. Program:

1. Pregnant and Postpartum Women 30,000 +30,000

Subtotal, Program Increases 30,000 +30,000

Total Increases --- --- --- +225,413

Decreases:

A. Built-in:

1. Absorption of built-in increases −195,413

Subtotal, Built-in Decreases −195,413

A. Program:

1. Mental Health 896,808,000 −234,984,000

2. Substance Abuse Prevention PRNS 149,703,000 −73,114,000

3. Health Surveillance 33,842,000 −5,384,000

4. Program Support 73,043,000 −6,366,000

5. Public Awareness and Support 11,572,000 −3,969,000

6. Agency-Wide Initiatives 998 −49,905,000

Subtotal, Program Decreases 1,164,968,998 −373,722,000

Total Decreases --- --- --- −373,917,413

Net Change --- $--- --- −$373,692,000
19

Summary of Changes (Continued)

(Whole dollars)

2017

Total estimated mandatory $12,000,000 

(Obligations) 12,000,000 

2018

Total estimated mandatory - 

(Obligations) - 

Net Change −$12,000,000

FY 

2018 

PB 

FTE 

FY 2018 

PB Mandatory 

FY 2018 

+/- 

FY 2017 

FTE 

FY 2018 

+/− 

FY 2017 

Mandatory 

Increases:

A. Program:

1. Mental Health $0 $0

Subtotal, Program Increases 0 ---

Decreases:

A. Program:

1. Mental Health PRNS --- −12,000,000

Subtotal, Program Decreases --- --- --- −12,000,000

Net Change --- $--- --- −$12,000,000
20

Budget Authority by Activity

(Dollars in thousands)

1/ Reflects Annualized CR ending April 28, 2017 including the ATB rescission, Cures, and Prevention Funding at FY 2016 minus 

rescissions.

2/ This program's funding is required by the 21st Century Cures Act to be subtracted from the estimate of discretionary budget 

authority under the Congressional Budget and Impoundment Control Act of 1974 or the Balanced Budget and Emergency Deficit 

Control Act of 1985.

Program FY 2016 

Final

FY 2017 

Annualized 

CR /1 

12/10/16 

FY 2018 

President's 

Budget 

FY 2018 

President's 

Budget '+/−

FY 2017 

Annualized CR 

Mental Health 0.1901%

Programs of Regional and National Significance 414,609 413,843 277,419 −136,424 

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

Children's Mental Health Services 119,026 118,800 118,800 --

Projects for Assistance in Transition from Homelessness 64,635 64,512 64,512 --

Protection and Advocacy for Individuals with Mental Illness 36,146 36,077 36,077 --

Community Mental Health Services Block Grant 532,571 531,599 415,539 −116,060 

Budget Authority (non-add) 511,532 510,560 400,000 −110,560 

PHS Evaluation Funds (non-add) 21,039 21,039 15,539 −5,500 

Total, Mental Health 1,166,987 1,164,831 912,347 −252,484 

Substance Abuse Prevention

Programs of Regional and National Significance 211,219 222,817 149,703 −73,114 

Total, Substance Abuse Prevention 211,219 222,817 149,703 −73,114 

Substance Abuse Treatment

Programs of Regional and National Significance 337,345 341,708 341,738 +30

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

State Targeted Response to the Opioid Crisis Grants /2 -- 500,000 500,000 --

Substance Abuse Prevention and Treatment Block Grant 1,858,079 1,854,697 1,854,697 -0

Budget Authority (non-add). 1,778,879 1,775,497 1,775,497 -0

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

Total, Substance Abuse Treatment 2,195,424 2,696,405 2,696,435 +30

Health Surveillance and Program Support

Health Surveillance and Program Support 126,817 126,635 106,885 −19,750 

PHS Evaluation Funds (non-add) 30,428 30,428 22,428 −8,000 

Public Awareness and Support 15,571 15,541 11,572 −3,969 

Performance and Quality Information Systems 12,918 12,893 12,893 --

Agency-Wide Initiatives 51,000 50,905 998 −49,907 

PHS Evaluation Funds (non-add) 1,000 1,000 998 −2.000 

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

Total, Health Surveillance and Program Support 207,806 207,474 133,848 −73,626 

TOTAL, SAMHSA Program Level 3,781,436 4,291,527 3,892,333 −399,194 

Less Funds from Other Sources:

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

PHS Evaluation Funds −133,667 −133,667 −120,165 +13,502

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

TOTAL, SAMHSA Budget Authority 3,634,269 4,144,360 3,770,668 −373,692 

FTEs 620 615 610 −5 
21

Authorizing Legislation

(Whole dollars)

 

Program Description/PHS Act:

FY 2017 

Amount 

Authorized

FY 2017

Appropriations 

Act

FY 2018

Amount 

Authorized

FY 2018 

President's 

Budget

Grants for the Benefit of Homeless 

 Individuals 

 Sec. 506 

 

Expired 

 

$41,225,000 

 

$41,304,000 

 

$41,225,000 

Residential Treatment Programs for 

 Pregnant and Postpartum Women 

 Sec. 508 

 

 

Expired 

 

 

$15,900,715 

 

 

$16,900,000 

 

 

$15,930,715 

Priority Substance Abuse Treatment Needs 

 of Regional and National Significance 

Sec. 509* 

 

 

Expired 

 

 

$753,033,073 

 

 

$751,954,788 

 

 

$753,033,213 

Substance Abuse Treatment Services 

 for Children and Adolescents 

Sec. 514* 

 

 

Expired 

 

 

$29,548,721 

 

 

$29,548,721 

 

 

$29,548,721 

Priority Substance Abuse Prevention 

 Needs of Regional and National 

 Significance 

Sec. 516* 

 

 

 

Expired 

 

 

 

$215,830,780 

 

 

 

$143,703,077 

 

 

 

$142,715,925 

Programs to Reduce Underage Drinking 

Sec. 519B* 

 

Expired 

 

$ 6,986,693 

 

$6,000,000 

 

$ 6,987,000 

Priority Mental Health Needs of Regional and 

 National Significance 

Sec. 520A* 

 

 

Expired 

 

 

$227,141,381 

 

 

$277,419,000 

 

 

$135,471,340 

Youth Interagency Research, Training, 

 and Technical Assistance Centers 

Sec. 520C* 

 

 

Expired 

 

 

$5,976,617 

 

 

$5,976,617 

 

 

$5,976,617 

Suicide Prevention for Children and Youth 

Sec. 520E* 

 

Expired 

 

$23,382,465 

 

$35,382,465 

 

$35,382,465 

Sec. 520E2* Expired $6,475,666 $6,475,666 $6,475,666

Grants for Jail Diversion Programs 

Sec. 520G* 

 

Expired 

 

$4,260,885 

 

$4,269,000 

 

$4,260,885 

Awards for Co-locating Primary and Specialty Care 

in Community-based Mental Health Settings 

Sec. 520K* 

 

 

$49,782,184 

 

 

$51,878,000 

 

 

Expired ---

PATH Grants to States 

Sec. 535(a) 

 

Expired 

 

$64,512,129 

 

$64,512,129 

 

$64,512,052 

Community Mental Health Services for 

 Children with Serious Emotional Disturbances 

Sec. 565 (f) 

 

Expired 

 

 

$118,799,732 

 

 

$118,799,732 

 

 

$118,799,732 

Children and Violence Program 

Sec. 581* 

 

Expired 

 

$23,055,089 

 

$23,055,089 

 

$ 23,055,089 

Grants for Persons who Experience Violence 

 Related Stress 

Sec. 582 

 

 

Expired 

 

 

$46,797,868 

 

 

$46,797,868 

 

 

$46,797,868 

Community Mental Health Services 

 Block Grants 

Sec. 1920(a) 

 

 

Expired 

 

 

$510,559,578 

 

 

$400,000,000 

 

 

$400,000,000 

Substance Abuse Prevention and Treatment 

 Block Grants 

Sec. 1935(a) 

 

 

Expired 

 

 

$1,775,497,351 

 

$1,858,079,000 

 

 

$1,775,497,351 
22

Authorizing Legislation (Continued)

(Whole dollars)

 *Denotes programs that were authorized in the Children's Health Act of 2000. We have the authority to carryout these 

 programs in our general authorities in Section 507, 516, and 520A 

 FY 2017 

Amount 

Authorized

FY 2017

Appropriations 

Act

FY 2018

Amount 

Authorized

FY 2018 

President's 

Budget

Other Legislation/Program Description 

Protecting Access to Medicare Act of 2014 

 P.L. 113-93, Sec. 224 $15,000,000 $14,971,485 $15,000,000 $20,000,000 

Protection and Advocacy for Individuals 

with Mental Illness Act 

 P.L. 99-319, Sec. 117 Expired $36,077,286 Expired $36,077,286 

Health Surveillance and Program Support

 Program Management, Sec. 501 Indefinite $79,407,758 Indefinite $73,043,000

 Total, Program Management Indefinite $79,407,758 Indefinite $73,043,000

Heath Surveillance, Sec. 501, 505 Indefinite $16,798,066 Indefinite $ 11,414,000

Public Awareness and Support (FY12) Indefinite $15,541,400 Indefinite $ 11,572,000

PQIS(FY12) Indefinite $12,893,443 Indefinite $ 12,893,000

Agency-Wide Initiatives Indefinite $49,905,049 Indefinite ---

TOTAL, SAMHSA Budget Authority $15,000,000 $4,144,360,414 $3,897,055,152 $3,770,668,925

Mandatory Legislation/Program Description 

Prevention and Public Health Fund 

 P.L. 111-148, Sec. 4002 N/A --- N/A ---

Mental Health Initiative N/A --- N/A ---

Expanding Access to Treatment to 

Reduce Prescription Drug Abuse

and Heroin Use

N/A --- N/A ---

TOTAL, SAMHSA Mandatory --- --- --- ---

 

 
23

Appropriations History

(Whole dollars)

1/ Reflects a $508 thousand transfer to HHS.

2/ Reflects a 0.189 percent across-the-board Rescission from the P.L. 112-74, and $953,809 Ryan White transfer. 

3/ Reflects the annualized level provided by the continuing resolution.

4/ Reflects the whole year appropriation.

 

Budget 

Estimate to 

Congress

House 

Allowance Senate Allowance Appropriation 

FY 2009

General Fund Appropriation:

Base $3,024,967,000 $3,303,265,000 $3,257,647,000 $3,334,906,000

P.L. 111-8

Subtotal $3,024,967,000 $3,303,265,000 $3,257,647,000 $3,334,906,000

FY 2010

General Fund Appropriation:

Base $3,393,882,000 $3,429,782,000 $3,419,438,000 $3,431,116,000 1/

P.L. 111-117 

Subtotal $3,393,882,000 $3,429,782,000 $3,419,438,000 $3,431,116,000

 

FY 2011 

General Fund Appropriation: 

Base $3,541,362,000 $3,565,360,000 $3,576,184,000 $3,386,311,000

P.L. 112-10

Subtotal $3,541,362,000 $3,565,360,000 $3,576,184,000 $3,386,311,000

FY 2012 

General Fund Appropriation: 

Base $3,386,903,000 $3,096,914,000 $3,354,637,000 $3,347,020,000 2/

P.L. 112-74

Subtotal $3,386,903,000 $3,096,914,000 $3,354,637,000 $3,347,020,000

 

FY 2013 

General Fund Appropriation: 

 

 

 

 

 

 

 

 

Base $3,151,508,000 --- $3,472,213,000 $3,172,154,778 3/

S.R. 112-176

Subtotal $3,151,508,000 --- $3,472,213,000 $3,172,154,778

 

FY 2014 

General Fund Appropriation: 

Base $3,347,951,097 --- $3,529,944,000 $3,434,935,000 4/

S.R. 113-071 

Subtotal $3,347,951,097 --- $3,529,944,000 $3,434,935,000 
24

Appropriations History (continued)

(Whole dollars)

5/ Reflects the whole year appropriation.

6/ Reflects the whole year appropriation.

7/ Reflects the Annualized Continuing Resolution through April 28, 2017.

8/ Reflects the additional amount provided to the Secretary of Health and Human Services to carry out the authorizations in the Comprehensive 

Addiction and Recovery Act of 2016 (Public Law 114–198), at a rate for operations of $17,000,000.

9/ Reflects the Annualized Continuing Resolution..

 

Budget Estimate 

to Congress 

House 

Allowance 

Senate 

Allowance Appropriation 

FY 2015

General Fund Appropriation:

Base $3,297,669,000 --- $3,431,878,000 $3,474,045,000 5/

P.L. 113-235

Subtotal $3,297,669,000 --- $3,431,878,000 $3,474,045,000

 

FY 2016 

General Fund Appropriation: 

Base $3,395,663,000 $3,642,710,000 $3,314,817,000 $3,634,269,000 6/

P.L. 114-113 

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

 

FY 2017 

General Fund Appropriation: 

Comprehensive Addiction and Recovery Act $17,000,000 7/

21st Century Cures Act $500,000,000 8/

Base $3,488,783,000 $4,211,603,000 $3,739,577,000 $4,144,360,000 9/

Subtotal $3,488,783,000 $4,211,603,000 $3,739,577,000 $4,144,360,000

 

FY 2018 

General Fund Appropriation: 

 

 

 

 

 

 

 

 

Comprehensive Addiction and Recovery Act $17,000,000 7/

21st Century Cures Act $500,000,000 8/

Base $3,779,668,000

Subtotal $3,779,668,000
25

SAMHSA

Mental Health

Table of Contents

1. Mental Health Appropriation ............................................................................................ 27

2. Programs of Regional and National Significance (PRNS) ............................................... 28

a) National Child Traumatic Stress Network ............................................................ 29

b) Youth Violence Prevention ................................................................................... 32

c) Project AWARE.................................................................................................... 35

d) Healthy Transitions ............................................................................................... 38

e) Children and Family Programs ............................................................................. 41

f) Consumer and Family Network Grants ................................................................ 43

g) Project LAUNCH.................................................................................................. 45

h) Mental Health System Transformation and Health Reform ................................. 48

i) Primary and Behavioral Health Care Integration .................................................. 51

j) Suicide Prevention Programs ................................................................................ 54

i. National Strategy for Suicide Prevention ....................................................... 55

ii. Garrett Lee Smith Youth Suicide Prevention – State/Tribal and Campus...... 56

iii. Garrett Lee Smith Suicide Prevention Resource Center ................................. 58

iv. Suicide Lifeline ............................................................................................... 59

v. American Indian/Alaska Native Suicide Prevention Initiative ....................... 61

a. Homelessness Prevention Programs ..................................................................... 63

b. Minority AIDS and HIV/AIDS Education ........................................................... 66

c. Criminal and Juvenile Justice Programs ............................................................... 68

d. Practice Improvement and Training ...................................................................... 70

e. Consumer and Consumer-Supporter TA Centers ................................................. 72

f. Disaster Response ................................................................................................. 74

g. Seclusion and Restraint ......................................................................................... 76

h. Assisted Outpatient Treatment for Individuals with Serious Mental Illness ........ 78

i. Tribal Behavioral Health Grants ........................................................................... 82

j. Minority Fellowship Program ............................................................................... 85

k. Assertive Communitive Treatment for Individuals with Serious Mental Illness . 87

3. PRNS Mechanism Table Summary .................................................................................. 89

4. PRNS Mechanism Table by Program, Project, and Activity............................................ 90

5. Grant Awards Table .......................................................................................................... 96

6. Children's Mental Health Services .................................................................................... 97

7. Projects for Assistance in Transition from Homelessness (PATH)................................ 103

8. Protection and Advocacy for Individuals with Mental Illness (PAIMI)......................... 109

9. Community Mental Health Services Block Grant (MHBG) ........................................... 115
26

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27

Mental Health Appropriation

(Dollars in thousands)

Program Activities

FY 2016

Final

FY 2017

Annualized 

CR

FY 2018 

President's 

Budget

FY 2018

+/−

FY 2017

Programs of Regional and National Significance $414,609 $413,844 $277,419 −136,424

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

Children's Mental Health Services 119,026 118,800 118,800 ---

Projects for Assistance in Transition From Homelessness. 64,635 64,512 64,512 ---

Protection and Advocacy For Individuals with Mental Illness 36,146 36,077 36,077 ---

Community Mental Health Services Block Grant 532,571 531,599 415,539 −116,060

PHS Evaluation Funds (non-add) 21,039 21,039 15,539 −5,500

Total, Mental Health $1,166,987 $1,164,831 $912,347 -252,484

The Mental Health FY 2018 Budget Request is $912.3 million, a decrease of $252.5 million from 

the FY 2017 Annualized CR. The request includes $896.8 million in Budget Authority and $15.5

million in PHS Evaluation Funds. 
28

Programs of Regional and National Significance (PRNS) 

Mental Health Appropriation 

(Dollars in thousands) 

Programs of Regional & National Significance

Capacity:

FY 

2016

Final 

FY 2017

Annualized

CR 

FY 2018 

President's 

Budget 

FY 2018

+/−

FY 2017 

 

National Child Traumatic Stress Network 46,887 46,798 46,798 ---

Youth Violence Prevention 23,099 23,055 23,055 ---

Project AWARE 64,865 64,742 --- −64,742

Project AWARE State Grants (non-add 49,902 49,807 --- −49,807

Mental Health First Aid (non-add) 14,963 14,935 --- −14,935

Healthy Transitions 19,951 19,913 --- −19,913

Children and Family Programs 6,458 6,446 6,446 ---

Consumer and Family Network Grants 4,954 4,945 4,945 ---

Project LAUNCH 34,555 34,489 34,489 ---

Mental Health System Transformation and Health Reform 3,779 3,772 3,772 ---

Primary and Behavioral Health Care Integration 49,877 49,782 --- −49,782

Suicide Prevention 60,032 59,940 59,940 ---

National Strategy for Suicide Prevention (non-add) 2,000 1,996 1,996 ---

Suicide Lifeline (non-add) 7,198 7,184 7,184 ---

GLS - Youth Suicide Prevention - States (non-add). 35,427 35,382 35,382 ---

Prevention & Public Health Fund (non-add 12,000 12,000 --- −12,000

GLS - Youth Suicide Prevention - Campus (non-add) 6,488 6,476 6,476 ---

GLS - Suicide Prevention Resource Center (non-add) 5,988 5,977 5,977 ---

AI/AN Suicide Prevention Initiative (non-add 2,931 2,925 2,925 ---

Homelessness Prevention Programs 30,696 30,638 30,638 ---

Minority AIDS 9,224 9,206 4,206 −5,000

Criminal and Juvenile Justice Programs 4,269 4,261 4,261 ---

Seclusion and Restraint 1,147 1,145 1,145 ---

Assisted Outpatient Treatment for Individuals with SMI 15,000 14,971 14,971 ---

Assertive Community Treatment for Individuals with SMI --- --- 5,000 5,000

Tribal Behavioral Health Grants 15,000 14,971 14,971 ---

Subtotal, Capacity 389,793 389,074 254,637 −134,437

Science and Service:

Primary and Behavioral Health Care Integration TTA 1,991 1,987 --- −1,987

Practice Improvement and Training 7,828 7,813 7,813 ---

Consumer and Consumer-Supporter TA Centers 1,918 1,914 1,914 ---

Disaster Response 1,953 1,949 1,949 ---

Homelessness 2,296 2,292 2,292 ---

Minority Fellowship Program. 8,059 8,044 8,044

HIV/AIDS Education 771 770 770 ---

Subtotal, Science and Service 24,816 24,769 22,782 −1,987

Total, PRNS $414,609 $413,843 $277,419 −$136,424

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

FY 2018 Authorization .......................................................................................................$394,550

Allocation Method ....................................Competitive Grants/Contracts/Cooperative Agreements

Eligible Entities..............................................................States, Federally Recognized,

American Indian/Alaska Native tribe or tribal organizations, 

Indian Health Service-operated and contracted health facilities 

and programs, other public and private nonprofit entities
29

National Child Traumatic Stress Network 

(Dollars in thousands)

Programs of Regional & National Significance

FY 2016

Final 

FY 2017

Annualized 

CR 

FY 2018 

President's 

Budget 

FY 2018

+/−

FY 2017 

National Child Traumatic Stress Network $46,887 $46,798 $46,798 $---

Authorizing Legislation .............................................Section 582 of the Public Health Service Act

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

Eligible Entities......................................................................... States, Local Governments, Tribes, 

Institutions of Higher Education, and Community Organizations

Program Description and Accomplishments 

Child traumatic stress is a pervasive and potentially life changing experience that affects tens of 

thousands of children each year. Child traumatic stress occurs when children and adolescents are 

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

they have experienced. Child traumatic stress can interfere with a wide range of childhood 

developmental capabilities, including social and educational functioning. There is strong evidence 

that the negative impact of child trauma progresses into adulthood and increases the likelihood of 

later adverse physical and behavioral health outcomes if not recognized and addressed early in 

life.3,4 Studies show that 25 percent to 80 percent or more of children and adolescents are exposed 

to traumatic events, with many exposed to multiple traumatic events.5 While the effects of trauma 

and exposure to violence are found in all 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. Studies show that youth in foster care can have rates of Post-Traumatic Stress Disorder 

that are nearly double those of combat veterans.6 

Established in 2000, the National Child Traumatic Stress Initiative (NCTSI) aims to improve 

behavioral health services and interventions for children and adolescents exposed to traumatic 

events. SAMHSA has provided funding for a national network of grantees known as the National 

Child Traumatic Stress Network (NCTSN) to develop and promote effective community practices 

for children and adolescents exposed to a wide array of traumatic events. The NCTSN has grown 

from a collaborative network of 17 sites to more than 225 funded and affiliate centers located 

nationwide in universities, hospitals, and other diverse community-based organizations with 

thousands of national and local partners. The NCTSN’s mission is to raise the standard of care 

and improve access to evidence-based services for children experiencing trauma, their families, 

and communities. A rapidly expanding component of this work has been the development of 

 

3 Putnam, K.T., Harris, W.W., Putnam, F.W. (2013). Synergistic childhood adversities and complex adult 

psychopathology. Journal of Traumatic Stress, 26(4), 435-442.

4 Kerker, B.D., Zhang, J., Nadeem, E., Stein, R.E., Hurlburt, M.S., Heneghan, A., Landsverk, J., McCue Horwitz 

S.(2015). Adverse Childhood Experiences and mental health, chronic medical conditions, and development in young 

children. Academy of Pediatrics, 13(15), 00173-00174.

5 Fairbank, J.A. (2008). The epidemiology of trauma, and trauma related disorders in children and youth. PTSD 

Research Quarterly, (19), 1050-1835.

6 Pecora, P.J., Kessler, R.C., Williams, J., O’Brien, K., Downs, A.C., English, E., Holmes, K. (2005). Improving 

family foster care: Findings from the northwest foster care alumni study. Casey Family Programs. Retrieved from 

http://www.casey.org/resources/publications/ImprovingFamilyFosterCare.htm
30

resources and delivery of training and consultation to support the development of trauma-informed 

child-serving systems. Network members work together within and across diverse settings, 

including a wide variety of governmental and non-governmental organizations.

Data collected in FY 2016 demonstrate that the current NCTSN grantees have provided evidencebased treatment to over 47,000 children, adolescents, and family members. Seventy-seven percent 

reported positive functioning at six months, far exceeding the target of 65 percent. In addition, 

thousands more youth and families have benefited indirectly from the training and consultation 

provided by NCTSN grantees to organizations not receiving direct NCTSN funding enabling these 

organizations to deliver evidence-based trauma interventions. 

The NCTSN continues to be a principal source of child-trauma information and training for the 

nation. In FY 2016, NCTSN grantee sites provided trauma-informed training to over 200,000 

individuals. Since its inception, the NCTSN has provided training on best practices and other 

aspects of child trauma to over one million participants throughout the country. The NCTSI’s 

newly created Helping Kids Recover and Thrive Campaign generated 100 online social media 

touches (e.g., Facebook, Twitter, etc.). This campaign informed the public about the efforts and 

resources available through the NCTSI. 

In FY 2016, SAMHSA awarded 82 new five-year NCTSI grants for the program. SAMHSA will 

continue to encourage grantees to disseminate information regarding evidence-based interventions 

for the prevention and treatment of childhood trauma so more children can benefit from proven 

practices. In FY 2017, SAMHSA will support 82 grant continuations of the program.

 

Funding History 

Fiscal Year Amount

FY 2014 $45,887,000 

FY 2015 $45,887,000 

FY 2016 $46,887,000 

FY 2017 $46,798,000

FY 2018 $46,798,000

Budget Request 

The FY 2018 Budget Request is $46.8 million, level with the FY 2017 Annualized CR. SAMHSA 

requests funding to continue support for 82 continuation grants for the improvement of mental 

disorder treatment, services, and interventions for children and adolescents exposed to traumatic 

events and plans to provide trauma-informed services for children and adolescents as well as 

provide training.
31

Outputs and Outcomes Table 

Program: National Child Traumatic Stress Network

NOTE: SAMHSA makes grant awards toward the end of the year and therefore, basesthe FY 2018 targets on the

FY 2017 Annualized CR and the FY 2019 targets are based on the FY 2018 President’s Budget.

Measure

Year and Most Recent Result

Target for Recent Result

(Summary of Result)

FY 2018

Target

FY 2019

Target

FY 2019

Target

+/−

FY 2018

Target

3.2.02a Increase the percentage of children 

receiving trauma informed services who 

report positive functioning at 6 month 

follow-up. (Outcome)

FY 2016: 77 %

Target: 65.9 %

(Target Exceeded)

77 % 77 % Maintain

3.2.23 Increase the unduplicated count of 

the number of children and adolescents 

receiving trauma-informed services.

(Outcome)

FY 2016: 52,603

Target: 48,8721

1Target has been revised to include an additional data source. Previously, the measure greatly underreported the number of children benefitting 

from NCTSI evidence–based practices as it only included those children who received services provided by the NCTSI Category III grantees. By 

including the additional data source, the total now includes the number of children receiving services from providers trained by NCTSI Category 

II and Category III grantees.

(Target Exceeded)

48,872 48,872 Maintain

3.2.24 Increase the number of child-serving 

professionals trained in providing traumainformed services. (Outcome)

FY 2016: 204,122

Target: 225,710

(Target Not Met but Improved)

225,710 225,710 Maintain
32

Youth Violence Prevention 

(Dollars in thousands)

Programs of Regional & National Significance

 FY 2016 

Final 

 FY 2017 

Annualized 

CR 

 FY 2018 

President's 

Budget 

FY 2018

+/−

FY 2017 

Youth Violence Prevention $23,099 $23,055 $23,055 $---

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

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

Eligible Entities.................................. State Education Agencies, State Mental Health Authorities,

Tribes and Territories

Program Description and Accomplishments 

Although dimensions of youth violence have decreased in parts of the country, youth violence 

remains a public health problem in the United States. Studies show that fewer students are 

engaging in fights.7 The percent of high school students who have been in a physical fight 

decreased from 32.8 percent in 2011 to 22.6 percent in 2015.8 Fights on school property also 

decreased during the past five years, with 11 percent of high school students having been in a fight 

on school property in 2011, compared to 7.8 percent in 2015. However, other indicators of 

violence have not significantly improved in recent years. Nationwide, in 2015, 16.2 percent of 

students had carried a weapon (e.g., gun, knife, or club) on at least one day during the 30 days 

before the survey. In 2015, an estimated 20 percent of high school students reported being bullied 

on school property and 15.5 percent reported being bullied electronically. 

The Safe Schools/Healthy Students (SS/HS) Initiative is a discretionary grant program that seeks 

to create healthy learning environments that help students thrive, succeed in school, and build 

healthy relationships. For more than a decade, the SS/HS Initiative has successfully decreased 

violence and increased the number of students receiving mental health services, supporting 

programs in more than 300 local school districts.9 The initiative implements an enhanced, 

coordinated, and comprehensive plan of activities, programs, and services that promote healthy 

childhood development, prevent violence, and prevent alcohol and drug use. Grantees are required 

to develop local strategic plans that address five required elements: 1) safe school environments 

and violence prevention activities; 2) alcohol, tobacco, and other drug prevention activities; 3) 

student behavioral, social, and emotional supports; 4) mental health services; and 5) early 

childhood social and emotional learning programs. 

In addition to the SS/HS grants, SAMHSA has supported an ongoing SS/HS State Program 

evaluation. The final SS/HS evaluation report will be completed in September 2017. This 

evaluation will focus on four areas: 

 

7 The 2013 Youth Risk Behavior Surveillance System – United States complete reference

8 The 2013 Youth Risk Behavior Surveillance System – United States complete reference

9 http://www.sshs.samhsa.gov/initiative/currentinit.aspx
33

1) Assessing the extent to which comprehensive school violence prevention 

initiatives, guided by the SS/HS framework, are implemented at the state 

and community level; 

2) Determining the breadth and volume of activities necessary to achieve 

coordination across multiple service systems; 

3) Identifying and describing the elements or activities associated with 

improved child wellness; and 

4) Estimating the extent to which states and communities improve access to 

mental health services for target populations and reduce subpopulation 

disparities in access, services, and outcomes. 

In FY 2016, SAMHSA provided continuation funds for eight four-year grants through the SS/HS 

State Planning, Local Education Agency and Local Community program grants (SS/HS State 

program). In FY 2016, SAMHSA awarded continuation funds for the fourth year for these same 

grants and contracts. This includes adjusting the applicant to the State Education Agency, with 

required partnership between the State Children’s Behavioral/Mental Health Agency.

Funding History 

Fiscal Year Amount

FY 2014 $23,099,000 

FY 2015 $23,099,000 

FY 2016 $23,099,000 

FY 2017 $23,055,000

FY 2018 $23,055,000

Budget Request 

The FY 2018 Budget Request is $23.1 million, level with the FY 2017 Annualized CR. The budget 

request supports the continuation of 7 grants to implement an enhanced, coordinated, and 

comprehensive plan of activities, programs, and services that promote healthy childhood 

development, prevent violence, and prevent alcohol and drug use. Grantees are required to develop 

local strategic plans that address four required elements: 1) promoting early childhood social and 

emotional learning and development; 2) promoting emotional, physical and behavioral health 

(mental health promotion and substance use prevention); 3) connecting families, schools, and 

communities; and 4) creating safe and violence-free schools. 
34

Outputs and Outcomes Table 

Program: Youth Violence Prevention -Safe Schools Healthy Students State and Tribal

NOTE: SAMHSA makes grant awards toward the end of the year and therefore, basesthe FY 2018 targets on the

FY 2017 Annualized CR and the FY 2019 targets are based on the FY 2018 President’s Budget.

Measure

Year and Most Recent Result

Target for Recent Result

(Summary of Result)

FY 2018

Target

FY 2019

Target

FY 2019

Target

+/−

FY 2018

Target

3.2.46 Increase the number of 

individuals who receive training in 

prevention or mental health 

promotion (Intermediate Outcome)

FY 2016: 9,840

Target: 680

(Target Exceeded)

4,787 4,787 Maintain

3.2.47 Increase the number of 

people in mental health and related 

workforce trained in mental healthrelated practices/activities that are 

consistent with the goals of the 

grant (Output)

FY 2016: 23,569

Target: 737

(Target Exceeded)

2,070 2,070 Maintain

3.2.48 Increase the number of state 

and local policy changes 

completed as a result of the grant 

(Output)

FY 2016: 23

Target: 2

(Target Exceeded)

12 12 Maintain

3.2.49 Increase the number of 

organizations that entered into a 

formal written inter/intra 

organizational agreements (such as 

an MOU) to improve mental health 

related practices/activities that are 

consistent with the goals of the 

grant (Output)

FY 2016: 274

Target: 52

(Target Exceeded)

52 52 Maintain

3.2.50 Decrease the percentage of 

middle and high school students 

who report current alcohol use 

(Intermediate Outcome)

FY 2016: 22.2 %

Target: 18.1 %

(Target Not Met but Improved)

25 % 25 % Maintain
35

Project AWARE 

(Dollars in thousands)

Programs of Regional & National Significance

FY 2016

Final 

FY 2017

Annualized 

CR 

FY 2018 

President's 

Budget 

FY 2018

+/−

FY 2017 

Project AWARE $64,865 $64,742 $--- −$64,742

Project AWARE State Grants (non-add) 49,902 49,807 --- −49,807

Mental Health First Aid (non-add) 14,963 14,935 --- −14,935

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

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

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

Local Governmental Entities, Community Organizations and Provider Organizations,

Community Colleges, Networks, National Non-Profit Organizations, 

States, and Tribes

Program Description and Accomplishments

Project AWARE is made up of three components: Project AWARE State Educational Agency 

(SEA) grants, Mental Health First Aid Grants, and Resilience in Communities After Stress and 

Trauma Grants. Project AWARE State Educational Agency grants are awarded to State Education 

Authorities (SEAs) to promote comprehensive, coordinated, and integrated state efforts to make 

schools safer and increase access to mental health services. Mental Health First Aid grants provide 

supports to teachers and other individuals who work with youth to help schools and communities 

understand, recognize, and response to signs of mental health issues and/or substance abuse in 

children and youth. Resiliency in Communities After Stress and Trauma (ReCAST) program 

assists high-risk youth and families and promotes resilience in communities that have recently 

faced civil unrest through implementation of evidence-based, violence prevention and community 

youth engagement programs as well as linkages to trauma-informed behavioral health services.

In FY 2016, SAMHSA supported the continuation of 89 grants (20 AWARE SEA grants and 69 

MHFA Community grants) and related contracts. In addition, SAMHSA awarded eight new grants 

under the Resiliency in Communities After Stress and Trauma (ReCAST) program. The program 

assists high-risk youth and families and promotes resilience in communities that have recently 

faced civil unrest through implementation of evidence-based, violence prevention and community 

youth engagement programs as well as linkages to trauma-informed behavioral health services. 

In FY 2017, SAMHSA will support the continuation of 97 grants (20 AWARE SEA grants, 69 

MHFA Community grants, and 8 ReCAST grants), a new cohort of ReCAST grants, technical 

assistance, and evaluation activities.
36

Funding History

Fiscal Year Amount

FY 2014 $54,865,000 

FY 2015 $54,865,000 

FY 2016 $64,865,000 

FY 2017 $64,742,000

FY 2018 $0

Budget Request

The FY 2018 Budget Request is $0.0, a decrease of $64.7 million from the FY 2017 Annualized 

CR. SAMHSA is eliminating this program to reduce duplication of efforts. Additionally, 

SAMHSA has developed significant knowledge and evidence for states to begin implementing 

and bringing to scale these efforts; SAMHSA will continue to ensure this knowledge is 

disseminated. 
37

Outputs and Outcomes Table

Program: Project AWARE

NOTE: SAMHSA makes grant awards toward the end of the year and therefore, basesthe FY 2018 targets on the

FY 2017 Annualized CR and the FY 2019 targets are based on the FY 2018 President’s Budget.

Measure

Year and Most Recent Result

Target for Recent Result

(Summary of Result)

FY 2018

Target

FY 2019

Target

FY 2019

Target

+/−

FY 2018

Target

3.2.18 Increase the number of 

children served. (Output)

FY 2016: 7,313,144

Target: 750,000

(Target Exceeded)

4,696,119 Elimination

3.2.19 Increase the number of 

children referred to mental health 

or related services. (Output)

FY 2016: 145,830

Target: 16,508

(Target Exceeded)

16,508 Elimination

3.2.39 Increase the number of 

individuals who have received 

training in prevention or mental 

health promotion (Outcome)

FY 2016: 63,581

Target: 145,356

(Target Not Met)

145,356 Elimination
38

Healthy Transitions 

(Dollars in thousands)

Programs of Regional & National Significance

FY 2016

Final 

FY 2017

Annualized 

CR 

FY 2018 

President's 

Budget 

FY 2018

+/−

FY 2017 

Healthy Transitions $19,951 $19,913 $--- −$19,913

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

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

Eligible Entities......................................................................................................States and Tribes

Program Description and Accomplishments 

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

illness and drug/alcohol addiction, face a more difficult transition to adulthood than do their peers. 

Nearly 20 percent of young adults aged 18 to 25 living in U.S. households had a diagnosable 

mental health condition in the past year. Of these, more than 1.3 million had a disorder so serious, 

such as schizophrenia, bipolar disorder, and major depression, that it compromised their ability to 

function. Compared to their peers, these young people were significantly more likely to experience 

homelessness,10 be arrested,11 drop out of school,12 and be unemployed.13

10 Embry, L. E., Vander Stoep, A., Evens, C., Ryan, K. D., & Pollock, A. (2009). Risk factors for homelessness in 

adolescents released from psychiatric residential treatment. Journal of the American Academy of Child and 

Adolescent Psychiatry, 39(10), 1293-1299.

11 Davis, M., Banks, S. M., Fisher, W. H., Gershenson, B.,& Grudzinskas, A. J. (2007). Arrests of adolescents 

clients of a public mental health system during adolescence and young adulthood. Psychiatric Services, 58(11), 

1454-1460.

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

education 2008 (NCES 2008-031).

13 Newman, L., Wagner, M., Cameto, R., & Knokey, A. M. (2009). The post-high school outcomes of youth with 

disability up to 4 years after high school: A report from the national longitudinal transition study-2 (NLTSC) 

(NCSER 2009-3017). Menlo Park, CA: SRI International.

 It is important to identify 

these young people, develop appropriate outreach and engagement processes, and facilitate access 

to effective clinical and supportive interventions. Outreach and engagement are essential to these 

youth and young adults, and their families, as many are disconnected from social and other 

community supports.

In FY 2014, SAMHSA provided $20.0 million for the Healthy Transitions initiative. The Healthy 

Transitions program awarded five-year grants to 17 states to improve access to mental disorder 

treatment and related support services for young people aged 16 to 25 who either have, or are at 

risk of developing, a serious mental health condition. Individuals who are 16 to 25 years old are 

at high risk of developing a mental illness or drug/alcohol addiction and are at high risk for suicide. 

Unfortunately, these youth are among the least likely to seek help.14

14 IOM (Institute of Medicine) and NRC (National Research Council). (2015), p. 56. Investing in the health and 

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

 Through this program, states 

are expanding services, developing family and youth networks for information sharing and peer 

support, and disseminating best practices for services for these young individuals. 

In FY 2016, SAMHSA supported 17 Healthy Transitions continuation grants and technical 

assistance and evaluation contracts. In FY 2017, SAMHSA will continue to support the 

continuation grants and the technical assistance and evaluation contracts. 

 
39

Funding History

Fiscal Year Amount

FY 2014 $19,951,000 

FY 2015 $19,951,000 

FY 2016 $19,951,000 

FY 2017 $19,913,000

FY 2018 $0

Budget Request

The FY 2018 Budget Request is $0.0, a decrease of $19.9 million from the FY 2017 Annualized 

CR. SAMHSA has developed significant knowledge and evidence for states to begin 

implementing and bringing to scale these efforts. SAMHSA will continue to ensure this knowledge 

is disseminated.
40

Outputs and Outcomes Table

Program: Healthy Transitions

NOTE: SAMHSA makes grant awards toward the end of the year and therefore, bases the FY 2018 targets on the 

FY 2017 Annualized CR and the FY 2019 targets are based on the FY 2018 President’s Budget.

Measure

Year and Most Recent Result

Target for Recent Result

(Summary of Result)

FY 2018

Target

FY 2019

Target

FY 2019

Target

+/−

FY 2018

Target

3.2.34 Increase the percentage of 

clients receiving services who 

report positive functioning at 6-

month follow-up. (Outcome)

FY 2016: 58.5%

Target: 64%

Target Not Met

64% Elimination

3.2.35 Increase the percentage of 

clients receiving services who 

had a permanent place to live in 

the community at 6-month 

follow-up. (Outcome)

FY 2016: 38 %

Target: 36 %

(Target Exceeded)

36 % Elimination

3.2.36 Increase the percentage of 

clients receiving services who are 

currently employed at 6-month 

follow-up. (Outcome)

FY 2016: 65.9%

Target: 56%

Target Exceeded

56% Elimination 
41

Children and Family Programs 

(Dollars in thousands)

Programs of Regional & National Significance

FY 2016

Final 

FY 2017

Annualized 

CR 

FY 2018 

President's 

Budget 

FY 2018

+/−

FY 2017 

Children and Family Programs $6,458 $6,446 $6,446 $---

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

Allocation Method ................................... Competitive Grants/Contracts/ Interagency Agreements

Eligible Entities....................................................................................................................... Tribes

Program Description and Accomplishments 

Without early identification, intervention, treatment, and support, children with serious emotional 

disturbances (SED) are likely to face challenges at home, in school, and in their psychosocial 

development. It is a public health priority that these children and their families have access to 

effective, evidence-based services, and support. 

SAMHSA’s Children and Family Programs provide funding for the Circles of Care grant program. 

Initially funded in 1998, the Circles of Care Program is a three-year infrastructure/planning grant 

which seeks to promote mental disorder treatment equity by providing American Indian/Alaska 

Native (AI/AN) communities with tools and resources to design and sustain their own culturally 

competent system of care approach for children. Circles of Care reflects the unique history and 

needs of individual AI/AN communities and promotes the idea of building on cultural 

strengths. The program increases capacity and community readiness to address the mental health 

issues of children and their families through the provision of evidence based treatment services 

and supports. This grant program is of critical importance as there are significant mental health 

needs in AI/AN communities. For example, suicide is the second leading cause of death for Indian 

youth ages 15 to 24. Through Circles of Care, SAMHSA has improved the availability, 

accessibility, and acceptability of behavioral health services for native youth. For example, data 

from the previous cohort of grantees show that over 3,000 consumer/family members were 

involved in ongoing mental health related planning activities and there were 4,300 peer-to-peer 

collaborations. 

Rehabilitation Research and Training Centers (RRTCs) seek to advance the current knowledge 

base by supporting research, training, technical assistance, and knowledge translation activities 

that help youth and young adults with serious mental health conditions, including youth and young 

adults from high-risk, disadvantaged backgrounds, achieve their life goals. SAMHSA’s Children 

and Family Program supports two RRTC programs that are co-funded with the National Institute 

on Disability, Independent Living, and Rehabilitation Research (NIDILRR). The first, RRTC on 

Transition to Employment for Youth and Young Adults with Serious Mental Health Conditions 

will conduct research and evaluative studies that contribute to improved employment outcomes 

for youth and young adults with serious mental health conditions, including those from high-risk, 

disadvantaged backgrounds. The second program, RRTC on Community Living and Participation 

for Youth and Young Adults with Serious Mental Health Conditions, will conduct research and 

evaluative studies that contribute to improved community participation for youth and young adults 

with SMHC. Unemployment rates for youth with mental disorders are significantly higher than 

those for youth with no disabilities. Unemployed young adults are three times more likely to suffer 
42

from depression, and youth without jobs are at higher risk to use alcohol, drugs, and engage in 

risky behaviors that have negative health outcomes.15

15 McGee RE, Thompson NJ. Unemployment and Depression Among Emerging Adults in 12 States, Behavioral 

Risk Factor Surveillance System, 2010. Prev Chronic Dis 2015; 12:140451.

 

In FY 2016, SAMHSA provided continuation support for 11 three-year Circles of Care grants to 

AI/AN communities and two RRTCs. 

In FY 2017, SAMHSA is awarding a new cohort of Circles of Care grants and the continuation of 

RRTCs. 

Funding History 

Fiscal Year Amount

FY 2014 $6,458,000 

FY 2015 $6,458,000 

FY 2016 $6,458,000 

FY 2017 $6,446,000 

FY 2018 $6,446,000 

Budget Request 

The FY 2018 Budget Request is $6.4 million, level with the FY 2017 Annualized CR. SAMHSA 

requests funding to enhance and improve the quality of existing services and promote the use of

culturally competent services and support for children and youth with, or at risk for, serious mental 

health conditions and their families. This funding will be used to support existing Circles of Care 

grants RRTCs.

The output and outcome measures for Children and Family Programs are part of the Mental Health 

- Other Capacity Activities outputs and outcomes table shown on page 80. 

 
43

Consumer and Family Network Grants 

(Dollars in thousands)

Programs of Regional & National Significance

FY 2016

Final 

FY 2017

Annualized 

CR 

FY 2018 

President's 

Budget 

FY 2018

+/−

FY 2017 

Consumer and Family Network Grants $4,954 $4,945 $4,945 $---

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

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

Eligible Entities.......................................................................................Community Organizations

Program Description and Accomplishments 

Across the healthcare arena, there is growing recognition and evidence that patient-centered care 

positively influences an individual’s health outcomes, improves quality and efficacy of care 

received, and provides feedback to drive service and systems improvements. As with other health 

disciplines, people with serious mental illness 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 support SAMHSA’s Recovery Support Strategic 

Initiative by providing consumers, families, and youth with opportunities to participate 

meaningfully in the development of policies, programs, and quality assurance activities related to 

mental health systems across the United States. The Consumer and Family Network Programs 

support two primary grant activities: the Statewide Consumer Network Program and the Statewide 

Family Network Program.

The Statewide Consumer Network Grant Program focuses on the needs of adults (18 years and 

older) with serious mental illness by strengthening the capabilities of statewide consumer-run 

organizations. These entities serve an important role in engaging consumers of mental health 

services, caregivers, and providers in improving and transforming the mental health and related 

systems in their states. This network is a sustainable mechanism for integrating the consumer 

voice in state mental health and allied systems to: 1) expand service system capacity; 2) support 

policy and program development; and 3) enhance peer support. This program promotes skill 

development with an emphasis on leadership and business management as well as 

coalition/partnership-building and economic empowerment as part of the recovery process for 

consumers. 

The Statewide Family Network Grant Program provides education and training to increase family 

organizations’ capacity for policy and service development. This is accomplished by: 

1) strengthening organizational relationships and business management skills; 2) fostering 

leadership skills among families of children and adolescents with serious emotional disturbances; 

and 3) identifying and addressing the technical assistance needs of children and adolescents with 

serious emotional disturbances and their families. The Statewide Family Network Program 

focuses on families, parents, and the primary caregivers of children, youth, and young adults.
44

In FY 2016, SAMHSA awarded nine Statewide Consumer Network continuation and nine new 

Statewide Consumer Network grants, five Statewide Family Network continuations and 21 new 

Statewide Family Network grants, and a technical assistance contract. 

In FY 2016, the Statewide Consumer Networks trained over 3,000 people, including 1,635 people 

in the mental health and related workforce, as well as 1,373 members of the public. They reached 

over 70,000 people through mental health awareness and promotion activities. Grantees 

collaborated with 225 organizations, and more than 300 consumers and family members 

participated in mental health-related planning, systems improvement, and evaluation-related 

activities. 

In FY 2017, SAMHSA will support 18 Statewide Consumer Network continuations, 26 Statewide 

Family Network continuations, a technical assistance contract, and a Statewide Peer Network 

Development activity demonstrating collaboration between the addiction recovery network and 

the consumer and family networks.

Funding History

Fiscal Year Amount

FY 2014 $4,954,000 

FY 2015 $4,954,000 

FY 2016 $4,954,000 

FY 2017 $4,945,000

FY 2018 $4,945,000

Budget Request 

The FY 2018 Budget Request is $4.9 million, level with the FY 2017 Annualized CR. SAMHSA 

requests funding to continue support for 30 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 America. SAMHSA will also fund new cohorts of Family 

and Consumer Network programs. 

The output and outcome measures for Consumer and Family Network Programs are part of the 

Mental Health - Other Capacity Activities outputs and outcomes table shown on page 80.
45

Project LAUNCH 

(Dollars in thousands)

Programs of Regional & National Significance

FY 2016

Final 

FY 2017

Annualized 

CR 

FY 2018 

President's 

Budget 

FY 2018

+/−

FY 2017 

Project LAUNCH $34,555 $34,489 $34,489 $---

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

Allocation Method ....................................Competitive Grants/Contracts/Cooperative Agreements

Eligible Entities......................................................................................................States and Tribes

Program Description and Accomplishments 

Researchers estimate that between 9.5 percent and 14.2 percent of children aged five or under 

experience an emotional or behavioral disturbance. Studies also show that half of all lifetime cases 

of mental illness begin before age 14.16

16 Brauner, Cheryl, and Cheryll Stephens. "Estimating the Prevalence of Early Childhood Serious 

Emotional/Behavioral Disorders: Challenges and Recommendations." Public Health Reports 121.3 (2006): 303-10.

 The preschool expulsion rate is more than three times the 

expulsion rate of students in kindergarten through 12th grade. Boys are more than four times as 

likely to be expelled than girls. African American preschoolers are almost twice as likely to be 

expelled than Caucasian preschoolers.17

17 Gilliam, W. (2005). Pre-kindergarteners left behind: Expulsion rates in state prekindergarten systems. Foundation 

for Child Development.

 School suspensions and expulsions have shown to 

increase the likeliness of later life negative outcomes. Research has shown that prevention and 

early treatment of mental disorders is more beneficial and cost-effective than waiting to address 

these issues later in life. Integrating behavioral health into primary care and early childcare 

settings, increasing screening for developmental and social/emotional issues, and training people 

who interact with young children to help them feel safe and secure are all critical elements to 

ensure children start life with the tools and skills needed to succeed. 

Established in 2008, Project Linking Actions for Unmet Needs in Children’s Health (LAUNCH) 

is a national initiative that has funded 55 sites, including states, tribes, territories, communities, 

and the District of Columbia. The purpose of the Project LAUNCH initiative is to promote the 

wellness of young children from birth to eight years of age by addressing the physical, social, 

emotional, cognitive, and behavioral aspects of their development. Project LAUNCH pays 

particular attention to the social and emotional development of young children and works to ensure 

that the systems that serve them (including early child care and education, home visiting, and 

primary care) are equipped to promote and monitor healthy social and emotional development. 

The program also ensures that the systems intervene to prevent mental, emotional, and behavioral 

disorders in early childhood and into the early elementary grades.

 
46

As of 2016, performance data for the program found that:

 Approximately 175,000 children and parents have been screened or assessed for behavioral 

health concerns across a range of diverse settings (e.g., primary care, child care, and home 

visiting); 

 Approximately 122,235 families have been served through home visiting programs with 

an added focus on the social/emotional and behavioral health needs of children and parents; 

 Approximately 65,000 community providers have been trained on social/emotional 

development and behavioral health for young children; 

 Over 136,000 individuals received evidence-based mental health-related services, this 

includes:

 Nearly 7,200 new organizations are collaborating, coordinating, and sharing resources to 

implement prevention/promotion strategies for young children and their families.

The multi-site evaluation of Project LAUNCH is ongoing. Phase one of the evaluation used a 

meta-analytical approach to assess the implementation of the program. The findings indicate that 

grantees successfully achieved three goals: 1) improvements to the local child services system in 

the LAUNCH communities; 2) improvements to the state child services system; and 3) 

enhancements to the child and family services in the communities. In addition, Project LAUNCH 

grantees have reported improved social and academic functioning among the targeted population, 

and 78 percent have reported decreases in problem behaviors among the targeted population. As 

the program expands to new states and territories, the current phase of the multi-site evaluation 

has evolved to a quasi-experimental design to assess the impact of Project LAUNCH more 

effectively.

In FY 2016, SAMHSA supported 36 five-year continuation grants, a new cohort of grants, and a 

technical assistance and evaluation contract. The new grant cohort provides support to states and 

tribes that have successfully implemented Project LAUNCH with the goal of expanding the work 

beyond the pilot communities to additional communities across the states and tribes. In FY 2017, 

SAMHSA will award 25 continuation grants, a new cohort of Project LAUNCH grants focusing 

on tribes and territories, and a technical assistance and evaluation contract.

Funding History

Fiscal Year Amount

FY 2014 $34,555,000 

FY 2015 $34,555,000 

FY 2016 $34,555,000 

FY 2017 $34,489,000

FY 2018 $34,489,000
47

Budget Request 

The FY 2018 Budget Request is $34.5 million, level with the FY 2017 Annualized CR. This 

funding will support 33 five-year continuation grants, a new grant cohort, and contract activities 

that will improve health outcomes for young children. Funding will support children at high risk 

for mental illness and their families in order to prevent future disability. This funding request will 

provide services for over 38,000 individuals, training to 13,102 people, and screening for mental 

health or related intervention to 44,775 children up to eight years old.

Outputs and Outcomes Table

Program: Mental Health-Project LAUNCH

Note: SAMHSA makes grant awards toward the end of the year and therefore, bases the FY 2018 targets on the 

FY 2017 Annualized CR and the FY 2019 targets are based on the FY 2018 President’s Budget.

Measure

Year and Most Recent Result

Target for Recent Result

(Summary of Result)

FY 2018

Target

FY 2019

Target

FY 2019

Target

+/−

FY 2018

Target

2.3.94 Increase the number of 

persons served (Output)

FY 2016: 25,128

Target: 38,588

(Target Not Met but Improved)

38,594 38,594 Maintain

2.3.95 Increase the number of 

persons trained in mental illness 

prevention or mental health 

promotion (Outcome)

FY 2016: 10,182

Target: 13,102

(Target Not Met)

13,102 13,102 Maintain

2.4.00 Increase the number of 0-8 

year old children screened for 

mental health or related 

interventions (Outcome)

FY 2016: 22,472

Target: 44,775

(Target Not Met but Improved)

44,775 44,775 Maintain

2.4.01 Increase the number of 0-8 

year old children referred to mental 

health or related interventions 

(Outcome)

FY 2016: 7337

Target: 9,114

(Target Not Met but Improved)

9,114 9,114 Maintain
48

Mental Health System Transformation and Health Reform 

(Dollars in thousands)

Programs of Regional & National Significance

FY 2016

Final 

FY 2017

Annualized 

CR 

FY 2018 

President's 

Budget 

FY 2018

+/−

FY 2017 

Mental Health System Transformation and Health 

Reform $3,779 $3,772 $3,772 $---

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

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

Eligible Entities......................................................................................................States and Tribes

Program Description and Accomplishments 

There is a significant gap between the number of people with serious mental illness, such as 

schizophrenia, bipolar disorder, and major depression, who want to work (66 percent) and the 

number of people who are actually employed (less than 20 percent). The benefits of steady 

competitive employment are substantial and include increased income, improved adherence with 

mental disorder treatment, enhanced self-esteem, reduced use of substances, and improved quality 

of life.18

18 IPS Supported Employment: The Evidence-Based Practice for Employment. (n.d.). Retrieved August 4, 2015.

 The Transforming Lives through Supported Employment Grant program is the remaining 

component of the Mental Health System Transformation program. This program was implemented 

to help states foster the adoption and implementation of permanent transformative changes in how 

public health services are organized, managed, and delivered throughout the United States. 

The program began in FY 2014 as a focused effort to enhance state and community capacity to 

provide evidence-based supported employment programs for adults and youth with serious mental 

illnesses/serious emotional disturbances (SMI/SED). These grants help people with serious mental 

illnesses build paths to self-sufficiency and recovery rather than disability and dependence. They 

also support mental health consumers, treatment and service providers, and employers to develop 

and maintain sustained competitive employment circumstances for people with serious mental 

illness. The grant program helps states to identify and implement the structural and financing 

changes that are essential to make supported employment programs sustainable and statewide. FY 

2016 data show that sixty percent of individuals were employed at six month follow-up. 

In FY 2016, SAMHSA provided continuation funds for seven grants and related technical 

assistance activities. In FY 2017, SAMHSA is supporting the continuation of these grants and 

related technical assistance activities.

 
49

Funding History

Fiscal Year Amount

FY 2014 $10,556,000 

FY 2015 $3,779,000 

FY 2016 $3,779,000 

FY 2017 $3,772,000

FY 2018 $3,772,000

Budget Request

The FY 2018 Budget Request is $3.7 million, level with the FY 2017 Annualized CR. SAMHSA 

requests funding to support the continuation of seven five-year Transforming Lives Through 

Supported Employment grants to enhance state and community capacity to provide evidence-based 

supported employment programs for adults and youth with serious mental illnesses/emotional 

disturbances and technical assistance to the grantees.
50

Outputs and Outcomes Table

Program: Mental Health System Transformation and Health Reform

Note: SAMHSA makes grant awards toward the end of the year and therefore, bases the FY 2018 targets on the 

FY 2017 Annualized CR and the FY 2019 targets are based on the FY 2018 President’s Budget.

Measure

Year and Most Recent Result

Target for Recent Result

(Summary of Result)

FY 2018

Target

FY 2019

Target

FY 2019

Target

+/−

FY 2018

Target

1.2.11 Increase the number of 

persons in the mental health and 

related workforce trained in 

specific mental-health related 

practices/activities as a result of 

the grant (Outcome)

FY 2016: 5,702

Target: 1,540

(Target Exceeded)

4,303 4,303 Maintain

1.2.21 Increase the percentage of 

clients receiving services who 

report positive functioning at 6 

month follow-up. (Outcome)

FY 2016: 69 %

Target: 52 %

(Target Exceeded)

57 % 57 % Maintain

1.2.22 Increase the percentage of 

clients receiving services who had 

a permanent place to live in the 

community at 6 month follow-up. 

(Outcome)

FY 2016: 60 %

Target: 74 %

(Target Not Met but Improved)

77 % 77 % Maintain

1.2.23 Increase the percentage of 

clients receiving services who are 

currently employed at 6 month 

follow-up. (Outcome)

FY 2016: 56 %

Target: 31 %

(Target Exceeded)

32 % 32 % Maintain
51

Primary and Behavioral Health Care Integration 

(Dollars in thousands)

Programs of Regional & National Significance

FY 2016

Final 

FY 2017

Annualized 

CR 

FY 2018 

President's 

Budget 

FY 2018

+/−

FY 2017 

Primary and Behavioral Health Care Integration $49,877 $49,782 $--- −$49,782

Primary and Behavioral Health Care Integration TTA $1,991 $1,987 $--- −$1,987

Total PBHCI $51,868 $51,769 $--- −$51,769

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

FY 2018 Authorization...............................................................................$51,878

Allocation Method ....................................................Competitive Grants/Cooperative Agreements

Eligible Entities.................Qualified Community Mental Health Programs (FY 2017 Authorization), 

States or State Agency

Program Description and Accomplishments

The high rates of morbidity and mortality among adults with serious mental illnesses (SMI) such 

as schizophrenia, bipolar disorder, and major depression are alarming. These rates are due, in 

large part, to elevated incidence and prevalence of cardiovascular disease, obesity, diabetes, 

hypertension, and dyslipidemia in people with SMI.19

19 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.

 Physical health problems among people 

with SMI affect an individual’s quality of life and contribute to premature death. Empirical 

findings indicate the clear link between early mortality among people with SMI and the lack of 

access to primary care services.20

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

2014: 13:1153-160.

The Primary and Behavioral Health Care Integration (PBHCI) program began in FY 2009 to 

address specifically this intersection between primary care and mental disorder treatment. The 

program supports two activities: grants to community mental health centers and States and the 

PBHCI Training and Technical Assistance (TTA) Center, which is co-funded through a 

competitive cooperative agreement with the Health Resources and Services Administration 

(HRSA). These two activities collectively support the coordination and integration of primary 

care services and publicly funded community behavioral health settings for individuals with SMI 

and/or people with co-occurring disorders served by the public mental health system. PBHCI 

seeks to improve health outcomes for people with SMI by encouraging grantees to engage in 

necessary collaboration, expand infrastructure, and increase the availability of primary healthcare 

and wellness services for individuals with mental illness. Collaboration between primary care and 

behavioral health organizations, as well as information technology entities, is crucial to the success 

of this program. As of September 2016, SAMHSA has awarded 214 PBHCI grants. 

PBHCI activities also include the braided Minority AIDS Initiative HIV Continuum of Care pilot 

program, which supports behavioral health screening, primary prevention, and treatment for

racial/ethnic minority populations with or at high risk for mental illness and drug/alcohol addiction

 
52

and HIV/AIDS. This includes HIV/AIDS integrated programs that either can co-locate or have 

fully integrated HIV/AIDS prevention and medical care services with behavioral health services.

In FY 2016, SAMHSA supported 58 continuation grants, awarded 28 new grants to support the 

coordination and integration of primary care services into publicly funded community behavioral 

health settings, and one technical assistance contract that is co-funded with HRSA. In FY 2017, 

SAMHSA will support 62 continuation grants, award a new cohort of grants to states (a new 

eligibility requirement of the 21st Century Cures Act) with awards up to $2 million per grant, and 

support the continuation of the technical assistance contract. 

Funding History

Fiscal Year Amount

FY 2014 $51,868,000 

FY 2015 $51,868,000 

FY 2016 $51,868,000 

FY 2017 $51,769,000

FY 2018 $0

Budget Request 

The FY 2018 Budget Request is $0.0, a decrease of $51.8 million from the FY 2017 Annualized 

CR. SAMHSA has eliminated this program due to other funding source availability for integrated 

care. SAMHSA will continue to disseminate the lessons learned from this program. 
53

Outputs and Outcomes Table

Program: Primary & Behavioral Health Care Integration (PBHCI)

Note: SAMHSA makes grant awards toward the end of the year and therefore, bases the FY 2018 targets on the 

FY 2017 Annualized CR and the FY 2019 targets are based on the FY 2018 President’s Budget.

Measure

Year and Most Recent Result

Target for Recent Result

(Summary of Result)

FY 2018

Target

FY 2019

Target

FY 2019 

Target 

+/−

FY 2018 

Target 

3.2.40 Increase the number of 

clients served (Output)

FY 2016: 29,705

Target: 56,552

(Target Not Met but Improved)

56,552 Elimination

3.2.41 Increase the percentage of 

clients receiving services who 

report positive functioning at 6 

month follow-up. (Outcome)

FY 2016: 55.9 %

Target: 49.9 %

(Target Exceeded)

57 % Elimination

3.2.42 Increase the percentage of 

clients receiving services who are 

currently employed at 6 month 

follow-up. (Outcome)

FY 2016: 23.8 %

Target: 22.1 %

(Target Exceeded)

22.1 % Elimination

3.2.43 Increase the percentage of 

clients receiving services who had 

a permanent place to live in the 

community at 6 month follow-up. 

(Outcome)

FY 2016: 69.7 %

Target: 65.7 %

(Target Exceeded)

75 % Elimination
54

Suicide Prevention Programs 

(Dollars in thousands)

 

Programs of Regional & National Significance

FY 2016

Final 

FY 2017

Annualized 

CR 

FY 2018 

President's 

Budget 

FY 2018

+/−

FY 2017 

Suicide Prevention $60,032 $59,940 $59,940 $---

National Strategy for Suicide Prevention (non-add). 2,000 1,996 1,996 ---

Suicide Lifeline (non-add) 7,198 7,184 7,184 ---

GLS - Youth Suicide Prevention - States (non-add) 35,427 35,382 35,382 ---

Budget Authority (non-add) 23,427 23,382 35,382 12,000

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

GLS - Youth Suicide Prevention - Campus (non-add) 6,488 6,476 6,476 ---

GLS - Suicide Prevention Resource Center (non-add) 5,988 5,977 5,977 ---

AI/AN Suicide Prevention Initiative (non-add) 2,931 2,925 2,925 ---

Program Description and Accomplishments 

SAMHSA supports the goals and objectives of the National Strategy for Suicide Prevention 

(NSSP) through the Suicide Prevention Programs highlighted below. Research has shown that 

implementing comprehensive public health approaches that make suicide prevention a priority 

within health and community systems can reduce the rates of death by suicide as well as suicide 

attempts. The NSSP supports this type of comprehensive approach and is an important step toward 

reducing suicide. 

Approximately 44,193 Americans died by suicide in 2015. One American dies by suicide every 

11.9 minutes. In 2008, suicide became the 10th leading cause of death in the United States and has 

remained so through 2015, the most recent year for which there are available mortality data. The 

2015 National Survey on Drug Use and Health reported that approximately 1.4 million Americans 

age 18 and over attempted suicide, 9.7 million seriously considered suicide, and 2.7 million made 

a plan. While youth have the highest rate of suicide attempts, middle-aged adults have the highest 

number of deaths by suicide nationwide, and middle aged and older Americans have the highest 

rates of death by suicide. The nation’s suicide prevention efforts must go beyond youth and address 

the issues of suicidal thoughts, plans, attempts, and deaths among adults.
55

National Strategy for Suicide Prevention 

(Dollars in thousands)

Programs of Regional & National Significance

FY 2016

Final 

FY 2017

Annualized 

CR 

FY 2018 

President's 

Budget 

FY 2018

+/−

FY 2017 

National Strategy for Suicide Prevention $2,000 $1,996 $1,996 $---

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

FY 2018 Authorization .........................................................................................................$30,000

Allocation Method .............................................................................................Competitive Grants

Eligible Entities.......................................................Community –based primary care or behavioral 

health entity, Federally Recognized, American Indian/Alaska 

Native tribe or tribal organizations, State mental health or public health agency

Program Description and Accomplishments 

Suicide has been increasing in the United States, particularly in adults and older adults. Suicide is 

the fifth leading cause of death among middle-aged adults (ages 35 to 64 years).21

21 Centers for Disease Control and Prevention (CDC) Vital Signs: Suicide among adults aged 35–64 years – United 

States, 1999–2010. MMWR Morbidity Mortality Weekly Report. 2013; 62 (17):321–325.

 In 2013, suicide 

among working-aged adults (25 to 64) accounted for almost 70 percent of all suicides, and from 

1999 to 2010, the suicide rate among individuals age 35 to 64 increased by nearly 30 percent.22

22 Centers for Disease Control and Prevention (CDC) Vital Signs: Suicide among adults aged 35–64 years – United 

States, 1999–2010. MMWR Morbidity Mortality Weekly Report. 2013; 62 (17):321–325.

 

Additionally, the highest rates of suicide are seen among men who are 80 or older. With the rising 

rates of suicide among adults, particularly middle-aged and older adults, focusing on preventing 

suicide among adults is urgently required in order to reduce suicide nationally. The baby boomer 

generation is the group that has had high rates of suicide throughout its lifecycle and is entering 

the stage of life that has historically had the highest rate of suicide. There is a risk that without 

significant targeted intervention toward this population, the number of suicides in the United States 

could dramatically increase. The nation’s suicide prevention efforts must go beyond youth and 

address the issues of suicidal thoughts, plans, attempts, and deaths among adults. 

The 2012 National Strategy for Suicide Prevention (NSSP) seeks to reduce the overall suicide rate 

and number of suicides in the U.S. nationally. The NSSP grant program supports states’ efforts to 

implement the NSSP. While the NSSP addresses all age groups and populations with specific 

needs, the goals and objectives of the NSSP grants are focused on preventing suicide and suicide 

attempts among working-aged adults, 25 to 64 years old, the age group whose deaths by suicide 

outnumber all others. In FY 2014, SAMHSA awarded four new grants to support states in 

implementing the NSSP goals and objectives. States use NSSP funding to support efforts such as 

raising suicide awareness, establishing emergency room referral processes, and improving clinical 

care practice standards. These grants focus on preventing suicide and suicide attempts among 

working-aged adults 25 to 64 years old. In FY 2015 and FY 2016, SAMHSA 

 
56

provided continuation funds for these four grants. In FY 2017, SAMHSA will award a new cohort 

of grants.

Funding History 

Fiscal Year Amount

FY 2014 $2,000,000 

FY 2015 $2,000,000 

FY 2016 $2,000,000 

FY 2017 $1,996,000

FY 2018 $1,996,000

Budget Request 

The FY 2018 Budget Request is $2.0 million, level with the FY 2017 Annualized CR. Funding 

will support the continuation of four grants. The grants support states in implementing the NSSP 

goals and objectives. States use NSSP funding to support efforts such as raising suicide awareness, 

establishing emergency room referral processes, and improving clinical care practice standards.

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

(Dollars in thousands)

Programs of Regional & National Significance 

 FY 2016 

Final 

 FY 2017 

Annualized 

CR 

FY 2018 

President's 

Budget 

FY 2018

+/−

FY 2017 

GLS - Youth Suicide Prevention - States. $35,427 $35,382 $35,382 $---

Budget Authority (non-add) 23,427 23,382 35,382 12,000

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

GLS - Youth Suicide Prevention - Campus 6,488 6,476 6,476 ---

Subtotal 41,915 41,858 41,858 ---

Authorizing Legislation .........................................Sections 520E of the Public Health Service Act

FY 2018 Authorization...............................................................................$30,000

Allocation Method ....................................Competitive Grants/Contracts/Cooperative Agreements

Eligible Entities......................................................................................................States and Tribes

Program Description and Accomplishments 

In the fall of 2003, Garrett Lee Smith, son of Sen. Gordon and Sharon Smith, died by suicide in 

his apartment in Utah where he attended college. He was one day shy of 22 years old. Like most 

suicides, Garrett's came unexpectedly. As many families have tragically experienced,
57

depression is not rare or peculiar, but can be deadly. It affects one in six Americans at some point. 

Hardly a family goes untouched.23

23 http://www.jaredstory.com/garrett_smith.html

The Garrett Lee Smith (GLS) Memorial Act (Public Law 108-355) authorizes SAMHSA to 

manage two significant youth suicide prevention programs and one resource center. The GLS 

State/Tribal Youth Suicide Prevention and Early Intervention Grant Program has awarded 

180 grants to 50 states and the District of Columbia, 47 tribes or tribal organizations, and 

one territory. These grants develop and implement youth suicide prevention and early intervention 

strategies involving public-private collaboration among youth-serving institutions. The GLS 

Campus Suicide Prevention program has awarded 190 grants to 175 institutions of higher 

education, including tribal colleges and universities, to prevent suicide and suicide attempts. 

Grantees often use their funds to provide suicide prevention training in their communities. As of 

April 2017, 1,280,249 individuals participated in 34,562 training events or educational seminars 

provided by grantees. The most common approach was gatekeeper training, designed to help 

trainees recognize suicide risk in young people, address the immediate needs of these individuals, 

and refer young people to appropriate services. Over 25 percent of trainees received training 

through campus-sponsored courses and educational seminars. Seventy percent of trainees 

participated in state-sponsored training activities and 4.3 percent in tribal-sponsored training 

activities. 

Results from the congressionally mandated cross-site evaluation have shown that counties who 

implemented GLS supported activities had lower suicide rates than matched counties that did not 

in the first year following suicide prevention activities. 

In FY 2016, SAMHSA provided continuation funds for 38 GLS State/Tribal grants, 37 GLS 

Campus grants, 4 new GLS State/Tribal grants and 18 new GLS Campus grants as well as the 

National Suicide Prevention Evaluation. In FY 2017, SAMHSA will support the continuation of 

43 GLS State/Tribal grants, 40 GLS Campus grants, a new cohort of GLS State/Tribal grants and 

GLS Campus grants, and the National Suicide Prevention evaluation. 

Funding History 

Fiscal Year Amount

FY 2014 $41,915,000 

FY 2015 $41,915,000 

FY 2016 $41,915,000 

FY 2017 $41,858,000

FY 2018 $41,858,000

 
58

Budget Request 

The FY 2018 Budget Request is $41.8 million, level with the FY 2017 Annualized CR. SAMHSA 

requests funding for 42 State grant continuations, 32 campus continuations, and a new campus 

cohort to continue developing and implementing youth suicide prevention and early intervention 

strategies involving public-private collaboration among youth serving institutions. In addition, the 

funding will support prevention of suicide and suicide attempts at institutions of higher education 

and the National Suicide Prevention Evaluation.

Garrett Lee Smith Suicide Prevention Resource Center 

(Dollars in thousands)

Programs of Regional & National Significance

FY 2016 

Final 

 FY 2017 

Annualized 

CR 

FY 2018 

President's 

Budget 

FY 2018

+/−

FY 2017 

GLS - Suicide Prevention Resource Center $5,988 $5,977 $5,977 $---

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

FY 2018 Authorization ...........................................................................................................$5,988

Allocation Method ........................................................................ Competitive Grants or Contracts

Eligible Entities.....................................................Domestic Public and Private Nonprofit Entities,

Tribal and Urban Indian Organizations, Community and Faith-Based Organizations

Program Description and Accomplishments 

In addition to the above programs that build suicide prevention capacity, SAMHSA also supports

the Suicide Prevention Resource Center (SPRC). The purpose of this program is to build national 

capacity for preventing suicide by providing technical assistance, training, and resources to assist 

states, tribes, organizations, and SAMHSA grantees to develop suicide prevention strategies 

(including programs, interventions, and policies that advance the National Strategy for Suicide 

Prevention (NSSP), with the overall goal of reducing suicides and suicidal behaviors in the nation. 

This work includes support of the public-private National Action Alliance for Suicide Prevention, 

and working to advance high-impact objectives of the NSSP. 

In FY 2015, SAMHSA awarded a new five-year SPRC grant. In FY 2016, SAMHSA supported 

the continuation of this grant. In FY 2017, SAMHSA is supporting the continuation of this grant.

Funding History 

Fiscal Year Amount

FY 2014 $5,988,000 

FY 2015 $5,988,000 

FY 2016 $5,988,000 

FY 2017 $5,977,000

FY 2018 $5,977,000
59

Budget Request 

The FY 2018 Budget Request is $6.0 million, level with the FY 2017 Annualized CR. Funding 

will support one grant continuation to continue to promote the implementation of the NSSP and 

enhance the nation’s mental health infrastructure. The Suicide Prevention Resource Center will 

provide states, tribes, government agencies, private organizations, colleges and universities, and 

suicide survivor and mental health consumer groups with access to information and resources that 

support program development, intervention implementation, and adoption of policies that prevent 

suicide. 

Suicide Lifeline 

(Dollars in thousands)

Programs of Regional & National Significance

 FY 2016 

Final 

 FY 2017 

Annualized 

CR 

FY 2018 

President's 

Budget 

FY 2018

+/−

FY 2017 

Suicide Lifeline $7,198 $7,184 $7,184 $---

Authorizing Legislation .......................................Section 520E-3 of the Public Health Service Act

FY 2018 Authorization ..........................................................................................................$7,198

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

Eligible Entities............................................................... States, Tribes, Community Organizations

Program Description and Accomplishments 

To prevent death and injury as the result of suicide attempts, individuals need rapid access to 

suicide prevention and crisis intervention services. In FY2015, the National Suicide Prevention 

Lifeline answered calls from over 1.5 million Americans. This helped provide rapid access at any 

time of the day or night to crisis intervention, and when needed, emergency response.

Launched in FY 2005, the National Suicide Prevention Lifeline (Lifeline), 1-800-273-TALK, 

coordinates a network of 164 crisis centers across the United States by providing suicide 

prevention and crisis intervention services for individuals seeking help at any time, day or 

night. The Lifeline routes calls from anywhere in the country to a network of certified local crisis 

centers that can then link callers to local emergency, mental health, and social services 

resources. The Lifeline averaged 123,839 calls per month in FY 2016, including a peak of 

129,628 calls in May 2016. SAMHSA evaluation studies have found that when a sample of 

suicidal callers to the Lifeline are asked, “...to what extent did calling the crisis hotline stop you 

from killing yourself?” 69 percent respond “a lot” and 21.6 percent respond “a little.” 

Since FY 2007, SAMHSA has collaborated with the Department of Veterans Affairs (VA) to 

ensure that veterans, service members, and their families who call the Lifeline and “press 1” have 

24/7 access to the VA’s Veterans Crisis Line. In FY 2015, more than 40,000 callers per month 

pressed “1” and were seamlessly connected to the Veterans Crisis Line.

The Lifeline Evaluation is a part of the National Suicide Prevention Evaluation (NSPE), which 

includes many of the programs in SAMHSA’s suicide prevention portfolio. The NSPE is an
60

evaluation that will assess the impact of SAMHSA’s suicide prevention initiatives on reducing 

suicidal behavior, attempts, and mortality. The NSPE also provides training and technical 

assistance to grantees related to evaluation, data collection, and surveillance.

Prior Lifeline evaluations have been the primary vehicle for collaborating with the crisis centers 

to adopt standards and guidelines based on evaluation results. These evaluation-driven standards 

and guidelines have, to date, focused on suicide risk assessment, imminent risk protocols, 

emergency intervention, and follow-up procedures and have advanced improvements in practice 

that are lifesaving. 

In FY 2015, SAMHSA awarded 12 crisis center follow-up continuation grants, continued support

for the evaluation contract, and awarded a new three-year Lifeline grant. In FY 2016, SAMHSA 

awarded six new crisis center follow-up grants and the continuation of the Lifeline grant. In FY 

2017, SAMHSA is supporting the continuation of six crisis center follow-up grants and the Lifeline 

grant.

Funding History 

Fiscal Year Amount

FY 2014 $7,198,000 

FY 2015 $7,198,000 

FY 2016 $7,198,000 

FY 2017 $7,184,000

FY 2018 $7,184,000

Budget Request 

The FY 2018 Budget Request is $7.2 million, level with the FY 2017 Annualized CR. SAMHSA 

is requesting funding to award a new grant to continue to support the National Suicide Prevention 

Lifeline, which routes calls from anywhere in the country to a network of certified local crisis 

centers that can then link callers to local emergency, mental health, and social services resources. 

In addition, the funding will support the continuation of six National Suicide Prevention Lifeline 

Crisis Center grants to focus on providing follow up to suicidal people discharged from emergency 

rooms and inpatient units, and will support a crisis chat system. 
61

American Indian/Alaska Native Suicide Prevention Initiative 

(Dollars in thousands)

Programs of Regional & National Significance

FY 2016

Final 

FY 2017

Annualized 

CR 

FY 2018 

President's 

Budget 

FY 2018

+/−

FY 2017 

American Indian/Alaska Native Suicide Prevention

Initiative $2,931 $2,925 $2,925 $---

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

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

Eligible Entities..........................................................................................................Not applicable

Program Description and Accomplishments 

The Tribal Training and Technical Assistance Center (Tribal TTA Center) is an innovative training 

and technical assistance project that helps tribal communities facilitate the development and 

implementation of comprehensive and collaborative community-based prevention plans to reduce 

violence, bullying, substance abuse, and suicide among American Indian/Alaska Native (AI/AN) 

youth. These plans mobilize tribal communities’ existing social and educational resources to meet 

their goals. From 2015 to 2017, 126 tribal communities have received specialized technical 

assistance and support in suicide prevention and related areas. In addition, more than 10,860 

members of these communities received training in prevention and mental health promotion. 

In FY 2016, SAMHSA supported the continuation of this five-year contract. In FY 2017, 

SAMHSA will continue support for this activity through the existing contract.

Funding History

Fiscal Year Amount

FY 2014 $2,931,000 

FY 2015 $2,931,000 

FY 2016 $2,931,000 

FY 2017 $2,925,000

FY 2018 $2,925,000

Budget Request 

The FY 2018 Budget Request is $2.9 million, level with the FY 2017 Annualized CR. SAMHSA 

requests funding to support comprehensive, broad, focused, and intensive training and technical 

assistance to federally recognized tribes and other AI/AN communities in order to address and 

prevent mental illness and drug/alcohol addiction, prevent suicide, and promote mental health 

through the contract continuation.
62

Outputs and Outcomes Table 

Program: Suicide Prevention

Note: SAMHSA makes grant awards toward the end of the year and therefore, bases the FY 2018 targets on the 

FY 2017 Annualized CR and the FY 2019 targets are based on the FY 2018 President’s Budget.

Measure

Year and Most Recent Result 

Target for Recent Result 

(Summary of Result) 

FY 2018 

Target 

FY 2019 

Target 

FY 2019 

Target 

+/−

FY 2018 

Target 

2.3.59 Increase the total number of 

individuals trained in youth suicide 

prevention (Outcome)

FY 2016: 173,564

Target: 154,369

(Target Exceeded)

160,082 160,082 Maintain

2.3.60 Increase the total number of youth 

screened (Output)

FY 2016: 3,337

Target: 61,626

(Target Not Met)

3,337 3,337 Maintain

2.3.61 Increase the number of calls 

answered by the suicide hotline (Output)

FY 2016: 1,486,072

Target: 1,308,825

(Target Exceeded)

1,308,825 1,308,825 Maintain

3.1.01 Increase the number of

individuals screened for mental health or 

related interventions (Intermediate 

Outcome)

FY 2017: Result Expected 

December 31, 2017

Target: Set Baseline

(Pending)

N/A N/A Maintain

3.1.02 Increase the number of 

individuals referred to mental health or 

related services (Intermediate Outcome)

FY 2017: Result Expected 

December 31, 2017

Target: Set Baseline

(Pending)

N/A N/A Maintain

3.1.03 Increase the number of 

organizations that establish management 

information/information technology 

system links across multiple agencies 

(Intermediate Outcome)

FY 2017: Result Expected 

December 31, 2017

Target: Set Baseline

(Pending)

N/A N/A Maintain

3.1.04 Increase the number of 

organizations or communities that 

demonstrate improved readiness to 

change their systems (Intermediate 

Outcome)

FY 2017: Result Expected 

December 31, 2017

Target: Set Baseline

(Pending)

N/A N/A Maintain

3.2.37 Increase the number of youth

referred to mental health or related 

services (Output)

FY 2016: 6,164

Target: 8,850

(Target Not Met but Improved)

9,177 9,177 Maintain
63

Homelessness Prevention Programs 

(Dollars in thousands) 

 FY 2017 

Annualized 

CR 

 FY 2018 

President's 

Budget 

 FY 2018 

+/−

FY 2017 

 FY 2016 

Programs of Regional & National Significance Final 

Homelessness Prevention Programs $30,696 $30,638 $30,638 $---

Homelessness 2,296 $2,292 2,292 ---

Authorizing Legislation .......................... Sections 520A and 506 of the Public Health Service Act 

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

Eligible Entities ........................................ States, Domestic Public and Community Organizations, 

Private Nonprofit Entities, and Community-based Public or Nonprofit Entities 

Program Description and Accomplishments 

While significant progress has been made over the last decade to reduce homelessness in specific 

communities and with specific populations, the number of people experiencing homelessness has 

remained at unacceptably high levels. Many factors contribute to homelessness including lack of 

affordable housing, foreclosures, rising housing costs, job loss, underemployment, mental illness, 

and addiction. Services are needed to link individuals to permanent housing, mainstream benefits, 

treatment, and supportive services. According to the National Alliance to End Homelessness, over 

570,000 individuals experienced homelessness on any given night in the United States, about 15 

percent (84,291) of the homeless population is considered “chronically homeless,” and about nine 

percent (49,933) of individuals who are homeless are veterans.24

24 Snapshot of Homelessness. (n.d.). Retrieved August 21, 2015, from 

http://www.endhomelessness.org/pages/snapshot of homelessness

 Approximately 26 percent of 

individuals experiencing homelessness have a serious mental illness, 50 percent struggle with 

substance abuse, and 66 percent of the chronically homeless population has a substance use 

disorder or other chronic health condition.25,26

25 United State Interagency Council on Homelessness. Substance Abuse. Available at 

http://usich.gov/issue/substance_abuse

26 Office of National Drug Control Policy. Integrate Treatment for Substance Use Disorders into Mainstream Health 

Care and Expand Support for Recovery. Available at: https://www.whitehouse.gov/ondcp/chapter-integratetreatment-for-substance-use-disorders

In FY 2011, SAMHSA initiated the CABHI program, jointly funded by the Center for Mental 

Health Services (CMHS) and Center for Substance Abuse Treatment (CSAT) to support treatment 

and the development and expansion of local systems that provide permanent housing and 

supportive services. This includes integration of treatment and other critical services for 

individuals with serious mental illness and drug/alcohol addiction. Target populations for this 

program include veterans and individuals with serious mental illness and/or drug/alcohol 

addiction. CABHI also supports coordination and planning at the local level with state or local 

Public Housing Authorities; local mental health, substance misuse, and primary care provider 

organizations; the local Department of Housing and Urban Development-supported Continuum of 

Care (CoC) program (designed to promote community-wide commitment to the goal of ending 

homelessness; provide funding for efforts by nonprofit providers, and state and local 
64

governments); the state Medicaid Office; and the state Mental Health and Substance Abuse 

Authorities. This program expanded to include states as the eligible entity in 2013. 

In FY 2015, SAMHSA also supported a national evaluation contract to compare the effectiveness 

of programs and various models of service delivery that are used across homeless service 

programs. SAMHSA also supported a technical assistance contract to provide training and support 

to its homeless services grantees. In FY 2016, SAMHSA supported 17 continuation grants, and 

awarded 30 new grants to states, local governments, and community-based organizations, and a 

technical assistance and evaluation contract. 

Most recent data show that at six-month follow-up, 71 percent of individuals reported positive 

functioning, 26 percent were employed, and 84.5 percent had a permanent place to live.

In FY 2017, SAMHSA will support 39 continuation grants, a new cohort of CABHI grants, 

technical assistance, and evaluation. 

Funding History

Fiscal Year Amount

FY 2014 $32,992,000 

FY 2015 $32,992,000 

FY 2016 $32,992,000 

FY 2017 $32,930,000

FY 2018 $32,930,000

Budget Request 

The FY 2018 Budget Request is $32.9 million, level with the FY 2017 Annualized CR. This 

funding will support 34 continuation grants and a new grant cohort to continue to develop and 

enhance the infrastructure of states and their treatment service systems to increase capacity to 

provide accessible, effective, comprehensive, and evidence-based treatment services for 

individuals with serious mental illness and/or co-occurring disorders, experiencing homelessness. 

It will also increase access to permanent housing and provide other critical services for those who 

experience homelessness. In addition, funding is requested to continue to assist providers in 

delivering housing and recovery support services for individuals who are experiencing 

homelessness as well as mental illness and drug/alcohol addiction. The budget request will provide 

services and support for approximately 5,000 individuals.
65

Outputs and Outcomes Table

Program: Mental Health Homelessness Prevention Programs

Note: SAMHSA makes grant awards toward the end of the year and therefore, bases the FY 2018 targets on the 

FY 2017 Annualized CR and the FY 2019 targets are based on the FY 2018 President’s Budget.

Measure

Year and Most Recent Result 

Target for Recent Result 

(Summary of Result) 

FY 2018 

Target 

FY 2019 

Target 

FY 2019 

Target 

+/−

FY 2018 

Target 

3.4.01 Increase the number of clients 

served (Output)

FY 2015: 2,432

Target: 4,959

(Target Not Met)

4,959 4,959 Maintain

3.4.02 Increase the percentage of 

adults with severe mental illness 

receiving homeless support services 

who report positive functioning at 6 

month follow-up (Outcome)

FY 2015: 70.8 %

Target: 66.1 %

(Target Exceeded)

66.1 % 66.1 % Maintain

3.4.03 Increase the percentage of 

adults receiving services who were 

currently employed at 6 month 

follow-up (Outcome)

FY 2015: 26.5 %

Target: 26.0 %

(Target Exceeded)

26.0 % 26.0 % Maintain

3.4.05 Increase the percentage of 

adults receiving services who had a 

permanent place to live in the 

community at 6 month follow-up 

(Outcome)

FY 2015: 84.5 %

Target: 81.2 %

(Target Exceeded)

81.2 % 81.2 % Maintain
66

Minority AIDS and HIV/AIDS Education 

(Dollars in thousands)

Programs of Regional & National Significance 

 FY 2016 

Final 

 FY 2017 

Annualized 

CR 

FY 2018 

President's 

Budget 

FY 2018

+/−

FY 2017 

Minority AIDS $9,224 $9,206 $4,206 −$5,000

HIV/AIDS Education 771 770 770 ---

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

Allocation Method ....................................Competitive Grants/Contracts/Cooperative Agreements

Eligible Entities.....................................Community and faith-based organizations, Tribes, Urban, 

Indian organizations, Hospitals, Public and private universities and colleges

Program Description and Accomplishments 

Minority AIDS 

The Centers for Disease Control and Prevention (CDC) reports significantly higher rates of 

HIV/AIDS among racial/ethnic minorities compared with the general population.27

27 Centers for Disease Control and Prevention. HIV Surveillance Report. (2013); vol. 25. Published February 2015. 

Accessed May 8, 2015 from http://www.cdc.gov/hiv/library/reports/surveillance.

 African 

Americans accounted for 45 percent and Hispanics accounted for 23 percent of all HIV/AIDS 

cases diagnosed in 2013.28

28 Centers for Disease Control and Prevention. HIV Surveillance Report. (2013); vol. 25. Published February 2015. 

Accessed May 8, 2015 from http://www.cdc.gov/hiv/library/reports/surveillance.

 Psychiatric and psychosocial complications are frequently not 

diagnosed nor addressed at the time of HIV diagnosis or through the course of the disease process. 

When untreated, these complications are associated with increased morbidity and mortality, 

impaired quality of life, and numerous medical issues such as non-adherence with the treatment 

regimen. 

The Minority AIDS program enhances and expands the provision of effective, culturally 

competent, HIV/AIDS-related mental health services in racial and ethnic minority communities 

for people living with or at high risk for HIV/AIDS. More than 4,600 individuals received services 

in FY 2015. 

In FY 2014, SAMHSA’s Centers for Mental Health Services, Substance Abuse Prevention, and 

Substance Abuse Treatment supported the Minority AIDS Initiative Continuum of Care Pilot 

(MAI CoC). The MAI CoC supports behavioral health screening, primary prevention, and 

treatment for racial/ethnic minority populations with or at high risk for mental illness and 

drug/alcohol addiction and HIV/AIDS. MAI CoC supports substance abuse treatment, primary 

prevention/treatment service programs, community mental health programs, and HIV/AIDS 

integrated programs that either can co-locate or have fully integrated HIV/AIDS prevention and 

medical care services. This program also provides primary prevention services for SUD and 

HIV/AIDS in local communities served by behavioral health programs. Of those with SMI such 

as schizophrenia, bipolar disorder, and major depression, approximately 20 percent are infected 

with the hepatitis C virus and 23 percent are infected with the hepatitis B virus. In addition, 

 
67

between 14 percent and 36 percent of those who misuse alcohol are infected with the hepatitis C 

virus.29,30

29 Bhattacharya R, Shuhart MC. Hepatitis C and alcohol: interactions, outcomes, and implications. J Clin 

Gastroenterol. 2003;36(3):242-52.

30 Rosenberg et al. Prevalence of HIV, Hepatitis B, and Hepatitis C in People With Severe Mental Illness. Am J 

Public Health. 2001;91:(31–37).

 

SAMHSA supports a consolidated evaluation of its HIV/AIDS programs. This comprehensive 

process and outcome evaluation will assess the degree to which SAMHSA is providing effective 

and efficient mental and substance abuse treatment services and prevention programs to those with 

and at risk of HIV/AIDS. The evaluation results will help inform program development and refine 

the approach used in SAMHSA’s HIV portfolio.

In FY 2015, SAMHSA funded the continuation of 34 HIV Continuum of Care grants, a technical 

assistance contract, and awarded a new evaluation contract. In FY 2016 and FY 2017, SAMHSA 

is supporting the continuation of 34 HIV Continuum of Care grants, and evaluation and technical 

assistance contracts.

The Mental Health Care Provider Education in HIV/AIDS Education 

The Mental Health Care Provider Education in HIV/AIDS Education program disseminates 

knowledge and training on the treatment of the neuropsychiatric and psychological complications 

of HIV/AIDS. Front-line providers, including psychiatrists, psychologists, social workers, 

primary care practitioners, and medical students receive this training.

Funding History

Fiscal Year Amount

FY 2014 $9,995,000 

FY 2015 $9,995,000 

FY 2016 $9,995,000 

FY 2017 $9,976,000

FY 2018 $4,976,000

Budget Request 

The FY 2018 Budget Request is $5.0 million, level with the FY 2017 Annualized CR. The

requested funding will support a new cohort of grants to continue to enhance and expand the 

provision of effective, culturally competent, HIV/AIDS-related mental health services in minority 

communities for people living with HIV/AIDS. In addition, the funding will support continuation 

of the HIV Continuum of Care grants, evaluation, and technical assistance contracts. The output 

and outcome measures for the Minority AIDS Initiative are part of the Mental Health - Other 

Capacity Activities outputs and outcomes table shown on page 80. 

 
68

Criminal and Juvenile Justice Programs 

(Dollars in thousands)

Programs of Regional & National Significance

 FY 2016 

Final 

 FY 2017 

Annualized 

CR 

 FY 2018 

President's 

Budget 

FY 2018

+/−

FY 2017 

Criminal and Juvenile Justice Programs $4,269 $4,261 $4,261 $---

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

FY 2018 Authorization ...........................................................................................................$4,269

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

Eligible Entities.................... Tribal Court Administrator, the Administrative Office of the Courts, 

the Single State Agency for Alcohol and Drug Abuse, the State Mental 

Health Agency, the Designated State Drug Court Coordinator, and 

Local Governmental Unit

Program Description and Accomplishments 

Studies of people involved in the criminal justice system have documented higher rates of cooccurring diagnoses of psychiatric and substance use disorders than those of the general 

population.31

31 Steadman, HJ, Osher, FC, Robbins, PC, Case, BF, & Samuels, S. (2009). Prevalence of serious mental illness 

among jail inmates. Psychiatric Services, 60(6), 761-765.

 Approximately 15 percent of people in the justice system with a diagnosis of 

substance use disorder and 30 percent with a diagnosed mental illness receive treatment.32

32 Cloud, D., (2014). On life support: Public health in the age of mass incarceration. New York: Vera Institute of 

Justice. 

 

Inadequate resources to address behavioral health conditions place millions of individuals at 

greater risk for parole or probation failure and re-incarceration at substantial human, social, and 

economic cost to society. Of inmates released from prison, 43 percent commit a new crime or a 

technical violation within three years of release. The costs associated with incarceration are high: 

state corrections budgets alone account for $39.0 billion in taxpayer costs.33,34

33 Pew Center on the States. (2011). State of recidivism: The revolving door of America’s prisons. Washington, DC: 

The Pew Charitable Trusts. http://www.pewtrusts.org/en/research-and-analysis/reports/0001/01/01/state-ofrecidivism 

34 Henrichson, C., & Delaney, R. (2012). The price of prisons: What incarceration costs taxpayers. New York: Vera 

Institute of Justice.

 There is a clear and 

largely unmet need for effective behavioral health services and supports that are accessible before, 

during, and after incarceration and continue in the community as needed for this high-risk, 

population. 

In FY 2014, SAMHSA supported a second cohort of four-year Behavioral Health Treatment Court 

Collaborative grants (BHTCC) in the Mental Health and Substance Abuse Treatment 

appropriations. BHTCC supports judges and staff of specialty (e.g., drug court) and other courts 

within a jurisdiction to work together to divert adults with mental illness and/or drug/alcohol 

addiction from the criminal justice system. The purpose of this grant program is to allow municipal 

courts more flexibility to collaborate with multiple criminal justice system 

 

http://www.vera.org/sites/default/files/resources/downloads/on-life-support-public-health-massincarceration-report.pdf
69

components and local community treatment and recovery providers to address the behavioral 

health needs of adults who are involved with the criminal justice system. The Court Collaborative 

focuses on the diversion of adults with behavioral health problems, including serious mental 

illness, from the criminal justice system, including alternatives to incarceration. The program 

supports community behavioral health services for individuals with mental and/or substance 

disorders and includes a focus on veterans involved with the criminal justice system. 

SAMHSA completed an evaluation of the first cohort of BHTCC grantees in September 2014. 

Findings of the evaluation demonstrate that grantees built multi-agency workgroups or 

collaboratives to oversee programs. Because of the grant funding, all grant recipients expanded 

access to specialty courts. Most grant recipients anticipated continuing new screening and 

assessment processes addressing a broader array of behavioral health needs after grant funding 

ended. Program innovations were divided into four main groups, including court and treatment 

provider collaboration, court and community case management, unified cross-court screening and 

referral, and meaningful peer involvement. BHTCC served over 1,400 individuals, with two-thirds 

of them identified as having co-occurring mental illness and drug/alcohol addiction and with 54 

percent reporting significant trauma exposure in their lives. Based on performance data reporting, 

program participants experienced improvements in mental health and reductions in substance use. 

Mental health problems declined by 20 percent in the first six months while alcohol and drug use 

declined by 60 percent over the same period. Nearly 74 percent of participants reported physical 

health improvements at six months. In addition, employment rates increased from 36 percent to 

45 percent over the first six months, with monthly median income increasing by $298.35

35 Advocates for Human Potential. (2014). Evaluation of the Adult Treatment Court Collaborative Program: Final 

evaluation report. Albany, NY: Author.

In FY 2015, SAMHSA provided continuation support for the second year of 17 four-year grants, 

continued technical assistance, and awarded a new evaluation contract. The new BHTCC 

evaluation focuses on examining the clinical and functional outcomes of program participants with 

behavioral health issues. The new BHTCC evaluation is building on the findings from the first 

cohort and more deeply examine both the features of successful collaborations between the courts 

and community services as well as the clinical and functional outcomes of program participants. 

In FY 2016 and FY 2017, SAMHSA is continuing support for 17 grants, and the technical 

assistance and evaluation contracts. 

Funding History

Fiscal Year Amount

FY 2014 $4,296,000 

FY 2015 $4,296,000 

FY 2016 $4,269,000 

FY 2017 $4,261,000

FY 2018 $4,261,000

 
70

Budget Request 

The FY 2018 Budget Request is $4.3 million, level with the FY 2017 Annualized CR. SAMHSA’s

request, through a new grant cohort, will continue to provide comprehensive treatment and 

recovery support services for adolescents and adults with co-occurring mental illness and 

drug/alcohol addiction who come into contact with the criminal justice system, as well as offenders 

re-entering the community. 

The output and outcome measures for Criminal and Juvenile Justice Programs are part of the 

Mental Health - Other Capacity Activities outputs and outcomes table shown on page 80.

Practice Improvement and Training

(Dollars in thousands)

Programs of Regional & National Significance 

 FY 2016 

Final 

 FY 2017 

Annualized 

CR 

FY 2018 

President's 

Budget 

FY 2018

+/−

FY 2017 

Practice Improvement and Training $7,828 $7,813 $7,813 $---

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

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

Eligible Entities............. 105 Nationally Recognized Historically Black Colleges and Universities

Program Description and Accomplishments 

SAMHSA facilitates health integration by engaging in activities that support mental health system 

transformation. The Practice Improvement and Training programs address the need for 

disseminating key information, such as evidence-based mental health practices, to the mental 

health delivery system through these activities: the Historically Black Colleges and Universities 

Center for Excellence in Behavioral Health (HBCU-CFE) program, the Rehabilitation Research 

and Training Centers (RRTCs), the Transforming Lives through Supported Employment Grant 

Program, the Recovery into Practice, and Programs to Achieve Wellness.

The purpose of the HBCU-CFE program is to network the 105 HBCUs throughout the United 

States and promote behavioral health workforce development through expanding knowledge of 

best practices, developing leadership, and encouraging community partnerships that enhance the 

participation of African Americans in substance abuse treatment and mental health professions. 

The comprehensive focus of the HBCU-CFE program simultaneously expands service capacity on 

campuses and in other treatment venues. 

In FY 2014, SAMHSA awarded a three-year new HBCU-Center for Excellence grant to a 

consortium of HBCUs with a lead university. SAMHSA continued this effort in FY 2015 and FY 

2016. In FY 2017, SAMHSA is awarding a new one year HBCU-Center for Excellence.

RRTCs seek to advance the current knowledge base by supporting research, training, technical 

assistance, and knowledge translation activities that help adults with serious mental health illness

achieve their life goals. The RRTCs are funded in partnership with the Administration for 
71

Community Living’s National Institute on Disability, Independent Living, and Rehabilitation 

Research. Currently, there are two RRTCs funded for up to five years. The first program, RRTC 

on Improving Employment Outcomes for Persons with Mental Illness will conduct research 

activities and evaluation studies on improving employment outcomes of individuals with serious 

mental illness. The second program, RRTC on Self-Directed Care to Promote Recovery, Health 

and Wellness for Individuals with Serious Mental Illness, will conduct research and evaluation 

studies to develop, adapt, and enhance self-directed models of medical, mental health, and 

nonmedical services designed to improve health, recovery and employment outcomes for 

individuals with serious mental illness. 

In FY 2015, SAMHSA continued funding for the two RRTCs and will continue this funding in 

FY 2016 and FY 2017.

The Recovery into Practice contract supports the expansion and integration of recovery-oriented 

care delivered by mental health providers through training and education, policy and analysis, and 

materials development. The effort crosses professional mental health disciplines (e.g., psychiatry, 

psychology, nursing, social work, peer specialists, primary care, and substance use and addiction) 

to provide training on the principles and practices of evidenced-based recovery-oriented care and 

its implementation, to hold meetings with stakeholders, to establish collaborative relations with 

provider, consumer, and family leaders, and to conduct research and literature reviews on the 

current state of recovery-oriented care, knowledge and attitudes. 

In FY 2015, SAMHSA supported the continuation of the Recovery into Practice contract. In 

FY 2016 and FY 2017, SAMHSA will continue support of this contract. 

In addition, in FY 2015, SAMHSA awarded a new contract for Programs to Achieve Wellness that 

promotes and facilitates wellness initiatives for people with mental disorders, including those with 

the most serious mental illnesses and with co-occurring diagnoses of substance use disorders. 

Research indicates alarming health disparities between people with serious mental and/or 

drug/alcohol addiction and the general population. These individuals are likely to die decades 

earlier, mostly due to preventable, chronic medical conditions. The median reduction in life 

expectancy among those with mental illness was 10.1 years.36

36 Walker ER, McGee RE, Druss BG. Mortality in Mental Disorders and Global Disease Burden Implications: A 

Systematic Review and Meta-analysis. JAMA Psychiatry. 2015 Feb 11. doi: 10.1001/jamapsychiatry.2014.2502.

 The project engages people with 

mental disorders, national organizations, communities, states, and tribes in the promotion of 

evidence-based tools for wellness. In FY 2016 and FY 2017, SAMHSA will continue to fund this 

contract.

 
72

Funding History

Fiscal Year Amount

FY 2014 $7,828,000 

FY 2015 $7,828,000 

FY 2016 $7,828,000 

FY 2017 $7,813,000

FY 2018 $7,813,000

Budget Request 

The FY 2018 Budget Request is $7.8 million, level with the FY 2017 Annualized CR. In FY 2018, 

SAMHSA proposes to expand the HBCU program to include other minority serving institutions, 

including tribal universities. This request supports the continuation of eight grants. In addition, 

SAMHSA’s funding request will continue to address the need for disseminating key information 

to the mental health delivery system and engage in activities that support mental health system 

transformation. 

The output and outcome measures for Practice Improvement and Training are part of the Mental 

Health - Science and Service Activities outputs and outcomes table shown on page 81.

Consumer and Consumer-Supporter TA Centers 

(Dollars in thousands)

......................................

 FY 2017 

Annualized 

CR 

 FY 2018 

President's 

Budget 

 FY 2018 

+/−

FY 2017 

 FY 2016 

Programs of Regional & National Significance Final 

Consumer and Consumer-Supporter Technical 

Assistance Centers $1,918 $1,914 $1,914 $---

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

Allocation Method .............................................................................................Competitive Grants

Eligible Entities.......................................................................................Community Organizations

Program Description and Accomplishments 

Consumer-centered services and supports such as peer specialists are vital to improving the quality 

and outcomes of health and behavioral healthcare services for people with mental disorders 

including serious mental illnesses.

First funded in 1992, the purpose of Consumer and Consumer-Supporter Technical Assistance 

(TA) Centers is to provide technical assistance to facilitate quality improvement of the mental 

health system by specific promotion of consumer-directed approaches for adults with serious 

mental illnesses (SMI). Such approaches maximize consumer self-determination, promote longterm recovery, and assist individuals with serious mental illness to increase their community 
73

involvement through work, school, and social connectedness. This decreases their dependence on 

a variety of social service programs and reduces unnecessary or inappropriate psychiatric 

hospitalization. This program also improves collaboration among consumers, families, providers, 

and administrators. It helps to transform community mental health services into a more consumer 

and family driven model. 

In FY 2014, the Consumer and Consumer-Supporter Technical Assistance Centers provided 

training to more than 9,500 individuals. Because of this funding, more than 1,700 consumers and 

family members participated in mental health-related planning and systems improvement. 

In the first six months of FY 2015, Consumer and Consumer-Supporter TA Centers facilitated 

peer-led technical assistance and presentations for over 2,500 participants throughout the U.S. The 

Centers also facilitated 77 webinars and trainings for over 9,000 participants on a range of topics 

that included Employment Strategy; Exemplary Peer Groups; Olmstead Implementation and the 

Americans with Disabilities Act; Engagement Skills; and Strategic Planning. 

In FY 2015, SAMHSA awarded a new cohort of five regionally focused Consumer and ConsumerSupporter TA Centers for five years. Through the first two quarters of FY 2017, the Consumer 

and Consumer-Supporter Technical Assistance Centers provided training to over 2,200 people and 

helped other consumer-run organizations develop organizational infrastructure and businesses 

practices. 

In FY 2016 and FY 2017, SAMHSA will support the continuation of these grants.

Funding History

Fiscal Year Amount

FY 2014 $1,918,000 

FY 2015 $1,918,000 

FY 2016 $1,918,000 

FY 2017 $1,914,000

FY 2018 $1,914,000

Budget Request 

The FY 2018 Budget Request is $1.9 million, level with the FY 2017 Annualized CR. SAMHSA’s

funding request will continue support of five grants to provide technical assistance to facilitate the 

quality improvement of the mental health system by promoting consumer-directed approaches for 

adults with serious mental illness.

The output and outcome measures for Consumer and Consumer-Supporter TA Centers are part of 

the Mental Health - Science and Service Activities outputs and outcomes table shown on page 81.
74

Disaster Response 

(Dollars in thousands)

Programs of Regional & National Significance 

 FY 2016 

Final 

 FY 2017 

Annualized 

CR 

FY 2018 

President's 

Budget 

FY 2018

+/−

FY 2017 

Disaster Response $1,953 $1,949 $1,949 $---

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

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

Eligible Entities.......................................................Domestic Public or Private Non-Profit Entities

Program Description and Accomplishments 

Disasters like Hurricane Sandy, the Oregon and Washington mudslides, the Iowa and Oklahoma 

tornados, and the Boston Marathon bombing strike without warning. These unexpected disasters 

leave individuals, families, and whole communities struggling to rebuild. 

SAMHSA helps ensure that the nation is prepared to address the behavioral health needs that 

follow a natural or man-made disaster. SAMHSA focuses on three major programs: the Crisis 

Counseling Assistance and Training Program (CCP), the Disaster Distress Helpline (DDH), and 

Disaster Behavioral Health. These programs use allocated supplemental funds to support survivors 

of natural and man-made disasters. 

SAMHSA, through an interagency agreement with the Federal Emergency Management Agency 

(FEMA), operates the CCP. This program assists individuals and communities in recovering from 

presidentially declared disasters through the provision of community-based behavioral health 

outreach and psycho-educational services. SAMHSA provides technical assistance, program 

guidance and monitoring, and oversight of the CCP. SAMHSA and FEMA jointly fund a Disaster 

Technical Assistance Center (DTAC) designed to provide additional technical assistance, strategic 

planning, consultation, and logistical support. SAMHSA provides Disaster Behavioral Health 

expertise around emerging public health initiatives to develop and disseminate innovative 

consultation and to technologies to communities, federal partners, and other stakeholders.

SAMHSA’s Disaster Distress Helpline is a toll-free, multilingual crisis systems service available 

24/7 via telephone (1-800-985-5990) and Short Message Service (SMS) (text ‘TalkWithUs’ to 

66746) to residents in the United States and its territories who are experiencing emotional distress 

resulting from disasters. In FY 2014, SAMHSA’s first Disaster app was created and launched on 

Apple and Android platforms. The Disaster App provided evidence-informed/based resources in 

the Disaster Kit, along with additional partner resources, local mental health and substance abuse 

facilities, the ability to share content anonymously, and functioned with limited Internet 

connectivity.

Periodically, SAMHSA receives additional funding to help survivors of a particular emergency or 

disaster.
75

between 14 percent and 36 percent of those who misuse alcohol are infected with the hepatitis C 

virus.37,38

37 Bhattacharya R, Shuhart MC. Hepatitis C and alcohol: interactions, outcomes, and implications. J Clin 

Gastroenterol. 2003;36(3):242-52.

38 Rosenberg et al. Prevalence of HIV, Hepatitis B, and Hepatitis C in People With Severe Mental Illness. Am J 

Public Health. 2001;91:(31–37).

 

SAMHSA supports a consolidated evaluation of its HIV/AIDS programs. This comprehensive 

process and outcome evaluation will assess the degree to which SAMHSA is providing effective 

and efficient mental and substance abuse treatment services and prevention programs to those with 

and at risk of HIV/AIDS. The evaluation results will help inform program development and refine 

the approach used in SAMHSA’s HIV portfolio.

In FY 2015, SAMHSA funded the continuation of 34 HIV Continuum of Care grants, a technical 

assistance contract, and awarded a new evaluation contract. In FY 2016 and FY 2017, SAMHSA 

is supporting the continuation of 34 HIV Continuum of Care grants, and evaluation and technical 

assistance contracts.

The Mental Health Care Provider Education in HIV/AIDS Education 

The Mental Health Care Provider Education in HIV/AIDS Education program disseminates 

knowledge and training on the treatment of the neuropsychiatric and psychological complications 

of HIV/AIDS. Front-line providers, including psychiatrists, psychologists, social workers, 

primary care practitioners, and medical students receive this training.

Funding History

Fiscal Year Amount

FY 2014 $9,995,000 

FY 2015 $9,995,000 

FY 2016 $9,995,000 

FY 2017 $9,976,000

FY 2018 $4,976,000

Budget Request 

The FY 2018 Budget Request is $5.0 million, level with the FY 2017 Annualized CR. The

requested funding will support a new cohort of grants to continue to enhance and expand the 

provision of effective, culturally competent, HIV/AIDS-related mental health services in minority 

communities for people living with HIV/AIDS. In addition, the funding will support continuation 

of the HIV Continuum of Care grants, evaluation, and technical assistance contracts. The output 

and outcome measures for the Minority AIDS Initiative are part of the Mental Health - Other 

Capacity Activities outputs and outcomes table shown on page 80. 

 
76

Seclusion and Restraint 

(Dollars in thousands)

Programs of Regional & National Significance

FY 2016 

Final 

 FY 2017 

Annualized 

CR 

FY 2018 

President's 

Budget 

FY 2018

+/−

FY 2017 

Seclusion and Restraint - $1,147 $1,145 $1,145 $---

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

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

Eligible Entities.........................................................................................................Not Applicable

Program Description and Accomplishments 

People die because of the inappropriate use of seclusion and restraint practices; countless others 

are injured; and many are traumatized by coercive practices. Children with emotional and 

behavioral problems are more frequently subjected to restraints in schools than students with other 

disabilities, often leading to serious physical injuries and emotional trauma for both students and 

staff. Coercive practices such as seclusion and restraint impede recovery and well-being. 

Through SAMHSA’s National Technical Assistance Center: Promoting Alternatives to Seclusion 

and Restraint Through Trauma-Informed Practices, evidence-based approaches to care have been 

developed, proven effective, and implemented to reduce or eliminate the use of traumatizing 

practices. This program provides technical assistance to states/tribes and communities in their 

efforts to implement best practices to reduce and ultimately eliminate the use of restraints and 

seclusion in institutional and community-based settings that provide services to individuals with 

mental illness and/or drug/alcohol addiction. This initiative focuses on the mental health delivery 

system and other service sectors, including criminal justice systems, schools, and child welfare 

organizations, that may use coercive practices with people who have mental illness and/or 

drug/alcohol addiction. 

SAMHSA awarded a five-year contract in FY 2013 to design, assess, and implement a technical 

assistance strategy to assist publicly funded systems, agencies, and organizations across the nation 

in addressing two high priority and interrelated objectives. The first objective is to promote 

alternatives to and the elimination of restraint, seclusion, and other coercive practices. The second 

objective is to develop and implement training and technical assistance on SAMHSA’s concept of 

trauma,39 key principles, and practice guidance for a trauma-informed approach,40 and enhance 

recognition that both organizational and cultural changes are necessary to sustain efforts to 

eliminate the use of seclusion and restraints. 

39 Individual trauma results from an event, series of events, or set of circumstances that is experienced by an 

individual as physically or emotionally harmful or threatening and that has lasting adverse effects on the individual's 

functioning and physical, social, emotional, or spiritual well-being. 

40 Substance Abuse and Mental Health Services Administration. SAMHSA’s Concept of Trauma and Guidance for a 

Trauma-Informed Approach. HHS Publication No. (SMA) 14-4884. Rockville, MD: Substance Abuse and Mental 

Health Services Administration, 2014. 

 In addition, the contract facilitates dissemination of 

trauma-informed practices across multiple service settings. In FY 2015, SAMHSA supported the 

continuation of this contract. In FY 2016 and FY 2017, SAMHSA continues to support this 

contract.

 
77

Funding History

Fiscal Year Amount

FY 2014 $1,147,000 

FY 2015 $1,147,000 

FY 2016 $1,147,000 

FY 2017 $1,145,000

FY 2018 $1,145,000

Budget Request 

The FY 2018 Budget Request is $1.1 million, level with the FY 2017 Annualized CR. SAMHSA’s 

funding request will allow continued support of a contract to disseminate trauma-informed 

practices across multiple service settings. These efforts will help advance the goal of reducing and 

eliminating the use of seclusion, restraint, and other traumatizing practices in service systems and 

treatment agencies. 
78 

Assisted Outpatient Treatment for Individuals with Serious Mental Illness

(Dollars in thousands)

Programs of Regional & National Significance

 FY 2016 

Final 

FY 2017

Annualized 

CR 

FY 2018 

President's 

Budget 

FY 2018

+/−

FY 2017 

Assisted Outpatient Treatment for Individuals 

with Serious Mental Illness $15,000 $14,971 $14,971 $---

Authorizing Legislation ....................... ................................................Section 224 of the 

Protecting Access to Medicare Act of 2014, as amended

FY 2018 Authorization .........................................................................................................$20,000 

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

Eligible Entities ........................................................................................... States and Communities

Program Description and Accomplishments

Recent data show that one in 25 Americans live with a serious mental illness (SMI), such as 

schizophrenia, bipolar disorder and/or major depression. Less than half of adults with diagnosable 

mental health problems receive the treatment they need. Without access to and receipt of evidencebased mental health services, mental health related challenges can negatively affect all areas of a 

person’s life. 

In an effort to increase access to evidence-based mental health services for individuals with SMI, 

in April 2014, Congress passed the Protecting Access to Medicare Act of 2014 (PAMA), which 

authorized a four year pilot program to award grants for Assisted Outpatient Treatment (AOT) 

programs for individuals with SMI. AOT is the practice of delivering outpatient treatment under 

court order to adults with serious mental illness who meet specific criteria such as a prior history 

of repeated hospitalizations or arrest. AOT involves petitioning local courts through a civil process 

to order individuals to enter and remain in treatment within the community for a specified period 

of time. This program will help to identify evidence-based AOT practices that support improved 

outcomes including outreach and engagement, clinical treatment and supportive services, and due 

process protections. 

In FY 2016, SAMHSA implemented an AOT grant program and awarded 17 grants to eligible 

entities such as a county, city, mental health system, mental health court, or any other entity with 

authority under the law of the state in which the grantee is located. This four-year pilot program 

is intended to implement and evaluate new AOT programs and identify evidence-based practices 

in order to reduce the incidence and duration of psychiatric hospitalization, homelessness, 

incarcerations, and interactions with the criminal justice system while improving the health and 

social outcomes of individuals with an SMI. This program is designed to work with families and 

courts to allow these individuals to obtain treatment while continuing to live in the community and 

their homes. Grants were awarded to applicants that have not previously implemented an AOT 

program. 

SAMHSA has partnered with the Assistant Secretary for Planning and Evaluation to implement a 

cross-site evaluation which will assess the effectiveness and impact of the AOT grant program. 

Additional program outcomes that will be evaluated will include, but are not be limited to, the 
79

rates of incarceration, employment, healthcare utilization, mortality, suicide, substance use, 

hospitalization, homelessness, and use of services. 

SAMHSA will continue to consult with the National Institute of Mental Health, the Attorney 

General, and the Administration for Community Living on this pilot program. In addition, 

SAMHSA will work with families and courts in the implementation of this program. 

In FY 2017, SAMHSA will provide funding for the continuation of 17 grants, technical assistance, 

and the evaluation of this program. 

Funding History

Fiscal Year Amount

FY 2014 ---

FY 2015 ---

FY 2016 $15,000,000

FY 2017 $14,971,000

FY 2018 $14,971,000

Budget Request

The FY 2018 Budget Request includes $15.0 million, level with the FY 2017 Annualized CR. 

This funding will support 17 grant continuations to improve the health and social outcomes for 

individuals with serious mental illness by providing continuation funding for the AOT grants, 

evaluation, and technical assistance.
80

Outputs and Outcomes Table

Program: Mental Health – Other Capacity Activities 1

NOTE: SAMHSA makes grant awards toward the end of the year and therefore, bases the FY 2018

targets on the FY 2017 Annualized CR and the FY 2019 targets are based on the FY 2018 

President’s Budget. 

Measure

Year and Most Recent Result

Target for Recent Result

(Summary of Result)

FY 2018

Target

FY 2019

Target

FY 2019

Target

+/−

FY 2018

Target

1.2.05 Increase the percentage 

of clients receiving services 

who report positive functioning 

at 6 month follow-up 

(Outcome)

FY 2016: 72.6 %

Target: 55.7 %

(Target Exceeded)

55.7 % 55.7 % Maintain

1.2.82 Increase the percentage 

of clients receiving services 

who had a permanent place to 

live in the community at 6 

month follow-up (Outcome)

FY 2016: 47.3 %

Target: 70.5 %

(Target Not Met)

70.5 % 70.5 % Maintain

1.2.83 Increase the percentage 

of clients receiving services 

who are currently employed at 

6 month follow-up (Outcome)

FY 2016: 35.1 %

Target: 22.2 %

(Target Exceeded)

25.3 % 25.3 % Maintain

1.2.88 Increase the number of 

individuals screened for mental 

health or related interventions 

(Outcome)

FY 2016: 8,742

Target: 13,775

(Target Not Met)

29,813 29,813 Maintain

1 includes the following: Law Enforcement and Behavioral health partnership for Early Diversion, Jail Diversion and 

Trauma Recovery-Priority to Veterans, Minority AIDS Initiative, Targeted Capacity Expansion, and Primary and 

Behavioral Health Care Integration. 
81

Outputs and Outcomes Table

Program: Mental Health - Science and Service Activities

Note: SAMHSA makes grant awards toward the end of the year and therefore, bases the FY 2018 targets on the 

FY 2017 Annualized CR and the FY 2019 targets are based on the FY 2018 President’s Budget.

Measure

Year and Most Recent Result

Target for Recent Result

(Summary of Result)

FY 2018

Target

FY 2019

Target

FY 2019

Target

+/−

FY 2018

Target

1.4.06 Increase the number of 

people trained by CMHS Science 

and Service Programs (Output)

FY 2016: 34,468

Target: 16,271

(Target Exceeded)

20,000 20,000 Maintain

1.4.14 Increase the number of calls 

answered by the Disaster Distress 

Hotline (Output)

FY 2016: 8,422

Target: 3,228

(Target Exceeded)

6,000 6,000 Maintain

1.4.15 Increase the number of text 

messages answered by the Disaster 

Distress Hotline (Output)

FY 2016: 8,210

Target: 4,131

(Target Exceeded)

10,000 10,000 Maintain
82

Tribal Behavioral Health Grants 

(Dollars in thousands)

Programs of Regional & National Significance

 FY 2016 

Final 

FY 2017

Annualized 

CR 

FY 2018 

President's 

Budget 

FY 2018

+/−

FY 2017 

Tribal Behavioral Health Grants $15,000 $14,971 $14,971 $---

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

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

Eligible Entities ....................................................................................................................... Tribes

Program Description and Accomplishments

Suicide is the second leading cause of death among American Indian/Alaska Native (AI/AN) youth 

ages 8 to 24 years.6 Further, AI/AN high school students report higher rates of suicidal behaviors 

than the general population of U.S. high school students.7

 These behaviors include serious 

thoughts of suicide, suicide plans, suicide attempts, and medical attention for a suicide attempt. 

However, the risk of suicide is not the same in all AI/AN youth demographic groups. For instance, 

AI/AN youth raised in urban settings have a smaller risk of suicide than AI/AN youth raised on 

tribal reservations (21 percent and 33 percent, respectively).8

Consistent with the goals of the Tribal Behavioral Health Agenda, the Tribal Behavioral Health 

Grant (TBHG) program addresses the high incidence of substance use and suicide among AI/AN 

populations. Starting in FY 2014, this program supports tribal entities with the highest rates of 

suicide by providing effective and promising strategies that address substance abuse, trauma, and 

suicide and by promoting the mental health of AI/AN young people. 

In FY 2014, SAMHSA’s Center for Mental Health Services awarded five-year TBHG grants of 

up to $0.2 million annually to 20 tribes or tribal organizations with high rates of suicide. These 

five-year grants help grantees develop and implement a plan that addresses suicide and substance 

abuse, thereby promoting mental health among tribal youth. In addition, SAMHSA’s Tribal 

Training and Technical Assistance Center (http://www.samhsa.gov/tribal-ttac) provides training 

and education to AI/AN grantees and organizations serving AI/AN populations to support their 

ability to achieve their goals. An evaluation component allows grantees and SAMHSA to work 

collaboratively to monitor progress and learn from each other. 

In FY 2016, SAMHSA expanded the TBHG program to include a Native youth initiative focused 

on removing possible barriers to success for Native youth. This initiative takes a comprehensive, 

culturally appropriate approach to help improve the lives of and opportunities for AI/AN youth. 

In addition to the Department of Health and Human Services, multiple agencies, including the 

Departments of Interior, Education, Housing and Urban Development, Agriculture, Labor, and 

Justice, are working collaboratively with tribes to address issues facing AI/AN youth. This 

6 Centers for Disease Control and Prevention. Fatal injury data, 2010. Web-based Injury Statistics Query and 

Reporting System. Available at www.cdc.gov/injury/wisqars/fatal.html. Accessed May 27, 2014.

7 Centers for Disease Control and Prevention. Youth Risk Behavior Surveillance System (YRBSS). Available at 

http://www.cdc.gov/healthyyouth/yrbs/index.htm. Accessed May 27, 2014. 

8 http://www.suicidology.org/Portals/14/docs/Resources/FactSheets/2011/AI-AN2011.pdf
83

funding allows SAMHSA to expand activities through the braided TBHG ($15.0 million in the 

Substance Abuse Prevention appropriation and $15.0 million in Mental Health appropriation) to 

allow tribes the flexibility to implement community-based strategies to address trauma, prevent 

substance abuse, and promote mental health and resiliency among youth in tribal communities. 

The additional FY 2016 funding expands these activities to approximately 90 tribes and tribal 

entities. With the expansion of the TBHG program, SAMHSA’s goal is to reduce substance use 

and the incidence of suicide attempts among AI/AN youth and to address behavioral health 

conditions that affect learning in the Bureau of Indian Education-funded schools. The TBHG 

program will support mental health promotion, including trauma-informed strategies, and 

substance use prevention activities for high-risk AI/AN youth and their families, enhance early 

detection of mental illness and drug/alcohol addiction among AI/AN youth, and increase referral 

to treatment. In FY 2017, SAMHSA will provide funding to support 81 grant continuations, a new 

cohort of grants, and the evaluation and technical assistance activities. 

Funding History

Fiscal Year Amount

FY 2014 $4,988,000 

FY 2015 $4,988,000 

FY 2016 $15,000,000 

FY 2017 $14,971,000

FY 2018 $14,971,000

Budget Request

The FY 2018 Budget Request is $15.0 million level with the FY 2017 Annualized CR. This 

request, combined with $15.0 million $15.0 million in the Substance Abuse Prevention will 

continue support for 113 grants that promote mental health and prevent substance use activities for 

high-risk AI/AN youth and their families.

As a braided activity, SAMHSA will track separately any amounts spent or awarded under Tribal 

Behavioral Health Grants through the distinct appropriations and ensure that funds are used for 

purposes consistent with legislative direction and intent of these appropriations. 
84

Outputs and Outcomes Table

Program: Tribal Behavioral Health

Note: SAMHSA makes grant awards toward the end of the year and therefore, bases the FY 2018 targets on the 

FY 2017 Annualized CR and the FY 2019 targets are based on the FY 2018 President’s Budget.

Measure

Year and Most Recent Result

Target for Recent Result

(Summary of Result)

FY 2018

Target

FY 2019

Target

FY 2019

Target

+/−

FY 2018

Target

2.4.12 Increase the number of 

youth age 10 - 24 who received 

mental health or related services 

after screening, referral or attempt 

(Output)

FY 2016: 20

Target: 20

(Baseline)

20 20 Maintain

2.4.13 Increase the number of 

programs/organizations that 

implemented specific mentalhealth related practices/activities as 

a result of the grant (Outcome)

FY 2016: 296

Target: 296

(Baseline)

296 296 Maintain
85

Minority Fellowship Program

(Dollars in thousands)

Programs of Regional & National Significance

 FY 2016 

Final 

FY 2017

Annualized 

CR 

FY 2018 

President's 

Budget 

FY 2018

+/−

FY 2017 

Minority Fellowship Program $8,059 $8,044 $8,044 $---

Authorizing Legislation ........................................................................ Section 516 of the PHS Act 

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

Eligible Entities ...... American Nurses Association (ANA), American Psychiatric Association (ApA), 

American Psychological Association (APA), Council on Social Work Education (CSWE), 

American Association for Marriage and Family Therapy (AAMFT)

Program Description and Accomplishments

The mental health-related and substance use-related service needs of racial and ethnic minority 

communities within the United States have been historically under–addressed due to a variety of 

factors. These include a limited number of trained practitioners who are equipped with the 

language skills or cultural competency training needed to deliver effective services for this 

population. SAMHSA’s Minority Fellowship Program (MFP) increases behavioral health 

practitioners’ knowledge of issues related to prevention, treatment, and recovery support for 

mental illness and drug/alcohol addiction among racial and ethnic minority populations. The 

program provides stipends to funding increases the number of culturally competent behavioral 

health professionals who teach, administer, conduct services research, and provide direct mental 

illness or substance abuse treatment services for minority populations that are underserved. This 

will result in improved quality of mental and substance abuse prevention and increased treatment 

delivered to ethnic minorities. Since its start in 1973, the program has helped to enhance services 

for racial and ethnic minority communities through specialized training of mental health 

professionals in psychiatry, nursing, social work, and psychology. In 2006, the program expanded 

to include marriage and family therapists and later added professional counselors. These 

individuals often serve in key leadership positions in mental illness and substance abuse treatment

services, services supervision, services research, training, and administration. Professional guilds 

receive competitively awarded grants, and then competitively award the stipends to post-graduate 

students pursuing a degree in that professional field. In FY 2015 and FY 2016, SAMHSA funded 

six continuation grants. 

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

Begun in FY 2014, MFP-Y is a component of MFP that support master’s level trained behavioral 

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

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

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

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

outcomes for racially and ethnically diverse youth and young adults. 

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

behavioral health professionals serving children, adolescents, and populations in transition to 
86

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

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

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

competitively awarded to professional guilds, which then competitively award the stipends to postgraduate students pursuing a degree in that professional field. 

MFP-AC is a component of MPP to support master’s level addiction counselors (MFP-AC) for 

youth and young adults. The purpose of the four-year grant program is to reduce health disparities 

and improve behavioral healthcare outcomes for racially and ethnically diverse populations by 

increasing the number of culturally competent master’s level addiction counselors available to 

underserved minority populations with a specific focus on transition age youth (ages 16 to 25) in 

public and private non-profit sectors. MFP-AC grants are supporting students pursuing master’s 

level degrees in addiction/substance abuse counseling, with the goal of increasing the number of 

masters-level addiction counselors across the nation by approximately 300 counselors. As is the 

case with MFP and MFP-Y, grants are competitively awarded to professional guilds, who then 

competitively award the stipends to post-graduate students pursuing a degree in that professional 

field. 

Funding History

Fiscal Year Amount

FY 2014 $7,977,134

FY 2015 $8,058,998 

FY 2016 $8,059,000 

FY 2017 $8,044,000 

FY 2018 $8,044,000

Budget Request

The FY 2018 Budget Request is $8.0 million, level with the FY 2017 Annualized CR. The funds 

will support six MFPs, five MFP-Y, and one technical assistance and evaluation support contract. 

Funding will support the training of approximately 300 fellows. 
87

Assertive Community Treatment for Adults with SMI

(Dollars in thousands)

Programs of Regional & National Significance

 FY 2016 

Final 

FY 2017

Annualized 

CR 

FY 2018 

President's 

Budget 

FY 2018

+/−

FY 2017 

Assertive Community Treatment for Individuals 

with Serious Mental Illness $--- $--- $5,000 $5,000

Authorizing Legislation .......................... Sections 520A and 506 of the Public Health Service Act

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

Eligible Entities ........................................ States, Domestic Public and Community Organizations, 

Private Nonprofit Entities, and Community-based Public or Nonprofit Entities 

Program Description and Accomplishments

The Assertive Community Treatment (ACT) for Adults with Serious Mental Illness (SMI) 

program is authorized under the 21st Century Cures Act of 2016. ACT is an evidence-based 

practice considered one of the most effective approaches to deliver services to people with serious 

mental illness9 and has been disseminated by SAMHSA for widespread use through its Evidence 

Based Toolkit series10 beginning in 2008. ACT was developed to reduce re-hospitalization and 

improve outcomes soon after discharge. ACT is designed as a coordinated care approach to

provide a comprehensive array of services - including medication management along with other 

supportive services - directly rather than through referrals. The ACT team is composed of 10-12 

transdisciplinary behavioral health staff – including psychiatrists, nurses, peer specialists and 

others - working together to deliver a mix of individualized, recovery oriented services to 

approximately 100 people with serious mental illness to help them to integrate into the community. 

Caseloads are approximately one staff to every 10 individuals. The services are provided 24 hours, 

7 days a week and as long as needed, wherever they are needed. Teams often find they can 

anticipate and avoid crises. 

In FY 2018 SAMHSA will award grants, to states, counties, cities, tribes and tribal organizations, 

mental health systems, health care facilities and entities to establish, maintain or expand ACT 

programs. Special consideration will be given to applicants that serve those adults with serious 

mental illness who are high utilizers of health and social services including homeless and justice 

involved populations. In addition, technical assistance and a program evaluation will be supported. 

A program evaluation will be conducted to report public health outcomes to include mortality, 

suicide, substance use, hospitalization; rates of homelessness and involvement with the criminal 

justice system; patient and family satisfaction with program participation; service utilizations and 

cost.

9 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3589962/ 10 http://store.samhsa.gov/product/Assertive-Community-Treatment-ACT-Evidence-Based-Practices-EBPKIT/SMA08-4345
88

Funding History

Fiscal Year Amount

FY 2014 ---

FY 2015 ---

FY 2016 ---

FY 2017 ---

FY 2018 $5,000,000 

Budget Request 

The FY 2018 Budget Request is $5.0 million, an increase of $5.0 million from the FY 2017 

Annualized CR. Funding will support approximately seven grants and technical assistance and 

evaluation activities.
89

SAMHSA/Mental Health

PRNS Mechanism Table Summary

(Dollars in thousands)

FY 2016 

Final

FY 2017

Annualized 

CR

FY 2018 

President's 

Budget

No. Amount No. Amount No. Amount

Programs of Regional & National Significance

Grants/Cooperative Agreements

Continuations 420 $226,675 629 $246,210 434 $177,460

New/Competing 302 119,042 107 65,882 114 41,017

Subtotal 722 345,717 736 312,092 548 218,477

Contracts

Continuations 19 56,100 24 85,302 18 47,423

New/Competing 9 12,792 4 16,449 6 11,520

Subtotal 28 68,892 28 101,751 24 58,943

Total, Mental Health PRNS 750 $414,609 764 $413,843 572 $277,419
90

SAMHSA/Mental Health

PRNS Mechanism Table by Program, Project, and Activity

(Dollars in thousands)

FY 2016

Final

FY 2017

Annualized CR

FY 2018 

President's 

Budget

Programs of Regional & National Significance No. Amount No. Amount No. Amount

Capacity:

National Child Traumatic Stress Network

Grants

Continuations --- $ --- 82 $43,283 82 $43,299

New/Competing 82 43,284 --- --- --- --- 

Subtotal 82 43,284 82 43,283 82 43,299

Contracts

Continuations --- 3,603 --- 2,489 --- 3,499

New/Competing --- --- --- 1,025 --- --- 

Subtotal --- 3,603 --- 3,514 --- 3,499

Total ,National Child Traumatic Stress Network 82 46,887 82 46,798 82 46,798

Youth Violence Prevention

Grants

Continuations 8 19,587 --- --- 7 15,160

New/Competing --- --- 7 15,153 --- --- 

Subtotal 8 19,587 7 15,153 7 15,160

Contracts

Continuations 1 3,512 --- 2,202 1 4,889

New/Competing --- --- 1 5,700 --- 3,006

Subtotal 1 3,512 1 7,902 1 7,895

Total, Youth Violence Prevention 9 23,099 8 23,055 8 23,055

Project AWARE

Grants

Continuations 89 46,547 96 35,137 --- --- 

New/Competing 10 10,239 --- 4,534 --- --- 

Subtotal 99 56,786 96 39,671 --- --- 

Contracts

Continuations 1 6,009 3 22,160 --- --- 

New/Competing 1 2,070 --- 2,911 --- --- 

Subtotal 2 8,078 3 25,071 --- --- 

Total, Project AWARE 101 64,865 99 64,742 --- --- 

Healthy Transitions

Grants

Continuations 17 16,853 16 15,323 --- --- 

New/Competing --- --- --- --- --- --- 

Subtotal 17 16,853 16 15,323 --- --- 

Contracts

Continuations --- 2,286 --- 4,590 --- --- 

New/Competing --- 812 --- --- --- --- 

Subtotal --- 3,098 --- 4,590 --- --- 

Total, Healthy Transitions 17 19,951 16 19,913 --- --- 
91

SAMHSA/Mental Health

PRNS Mechanism Table by Program, Project, and Activity

(Dollars in thousands)

FY 2016

Final

FY 2017

Annualized 

CR

FY 2018 

President's 

Budget

Programs of Regional & National Significance No. Amount No. Amount No. Amount

Children and Family Programs

Grants

Continuations 11 4,383 --- --- 11 4,560

New/Competing --- --- 11 4,586 --- --- 

Subtotal 11 4,383 11 4,586 11 4,560

Contracts

Continuations --- 2,075 --- 1,860 --- 1,090

New/Competing --- --- --- --- --- 796

Subtotal --- 2,075 --- 1,860 --- 1,886

Total, Children and Family Programs 11 6,458 11 6,446 11 6,446

Consumer and Family Network Grants

Grants

Continuations 14 1,322 44 4,123 30 2,836

New/Competing 37 3,195 --- --- 14 1,310

Subtotal 51 4,517 44 4,123 44 4,146

Contracts

Continuations --- 183 --- 821 --- 798

New/Competing --- 253 --- --- --- --- 

Subtotal --- 437 --- 821 --- 798

Total, Consumer and Family Network Grants 51 4,954 44 4,945 44 4,945

Project LAUNCH

Grants/Cooperative Agreements

Continuations 36 28,956 25 17,733 33 22,051

New/Competing --- --- 13 7,600 5 3,536

Subtotal 36 28,956 38 25,333 38 25,588

Contracts

Continuations 2 5,513 2 5,582 2 6,902

New/Competing --- 86 2 3,574 1 2,000

Subtotal 2 5,599 4 9,156 3 8,902

Total, Project LAUNCH 38 34,555 42 34,489 41 34,489

Mental Health System Transformation and Health Reform

Grants

Continuations 7 2,633 7 1,688 7 2,678

New/Competing --- --- --- --- --- --- 

Subtotal 7 2,633 7 1,688 7 2,678

Contracts

Continuations --- 222 --- 2,084 --- 1,094

New/Competing --- 924 --- --- --- --- 

Subtotal --- 1,146 --- 2,084 --- 1,094

Total, Mental Health System Transformation and Health 

Reform 7 3,779 7 3,772 7 3,772

Primary and Behavioral Health Care Integration

Grants

Continuations 53 20,628 62 22,650 --- --- 

New/Competing 28 25,899 11 23,009 --- --- 

Subtotal 81 46,527 73 45,659 --- --- 

Contracts

Continuations --- 3,350 --- 4,123 --- --- 

New/Competing --- --- --- --- --- --- 

Subtotal --- 3,350 --- 4,123 --- --- 

Total, PBHCI 81 49,877 73 49,782 --- --- 
92

SAMHSA/Mental Health

PRNS Mechanism Table by Program, Project, and Activity

(Dollars in thousands)

FY 2016

Final

FY 2017

Annualized CR

FY 2018 

President's 

Budget

Programs of Regional & National Significance No. Amount No. Amount No. Amount

National Strategy for Suicide Prevention

Grants

Continuations 4 1,880 --- --- 4 1,886

New/Competing --- --- 4 1,886 --- ---

Subtotal 4 1,880 4 1,886 4 1,886

Contracts

Continuations --- 120 --- 111 --- 111

New/Competing --- --- --- --- --- ---

Subtotal --- 120 --- 111 --- 111

Total, National Strategy for Suicide Prevention 4 2,000 4 1,996 4 1,996

GLS - Youth Suicide Prevention - States

Grants

Continuations 38 27,590 43 29,728 42 30,802

New/Competing 4 2,942 --- --- --- ---

Subtotal 42 30,533 43 29,728 42 30,802

Contracts

Continuations 1 4,894 1 5,655 1 4,580

New/Competing --- --- --- --- --- ---

Subtotal 1 4,894 1 5,655 1 4,580

Total, GLS - States 43 35,427 44 35,382 43 35,382

GLS - Youth Suicide Prevention - Campus

Grants

Continuations 37 3,505 40 3,665 31 3,238

New/Competing 18 1,756 15 1,656 22 2,062

Subtotal 55 5,261 55 5,321 53 5,300

Contracts

Continuations --- 1,227 --- 1,155 --- 1,176

New/Competing --- --- --- --- --- ---

Subtotal --- 1,227 --- 1,155 --- 1,176

Total, GLS - Campus 55 6,488 55 6,476 53 6,476

GLS - Suicide Prevention Resource Center

Grants

Continuations 1 5,634 1 5,634 1 5,634

New/Competing --- --- --- --- --- ---

Subtotal 1 5,634 1 5,634 1 5,634

Contracts

Continuations --- 354 --- 343 --- 343

New/Competing --- --- --- --- --- ---

Subtotal --- 354 --- 343 --- 343

Total, GLS - Suicide Prevention Resource Center 1 5,988 1 5,977 1 5,977

Suicide Lifeline

Grants

Continuations 1 5,288 7 5,975 6 687

New/Competing 6 690 --- --- 1 5,288

Subtotal 7 5,978 7 5,975 7 5,975

Contracts

Continuations --- 1,220 --- 1,210 --- 1,210

New/Competing --- --- --- --- --- ---

Subtotal --- 1,220 --- 1,210 --- 1,210

Total, Suicide Lifeline 7 7,198 7 7,184 7 7,184
93

SAMHSA/Mental Health

PRNS Mechanism Table by Program, Project, and Activity

(Dollars in thousands) 

FY 2016

Final

FY 2017

Annualized 

CR

FY 2018 

President's 

Budget

Programs of Regional & National Significance No. Amount No. Amount No. Amount

AI/AN Suicide Prevention Initiative

Grants

Continuations --- --- --- --- --- --- 

New/Competing --- --- --- --- --- --- 

Subtotal --- --- --- --- --- --- 

Contracts

Continuations 1 2,781 1 2,925 --- 153

New/Competing 1 150 --- --- 1 2,772

Subtotal 2 2,931 1 2,925 1 2,925

Total, AI/AN 2 2,931 1 2,925 1 2,925

Homelessness Prevention Programs

Grants

Continuations 17 14,758 39 18,682 37 14,831

New/Competing 30 9,738 14 4,899 10 10,403

Subtotal 47 24,496 53 23,581 47 25,234

Contracts

Continuations 2 5,114 2 5,014 2 5,404

New/Competing 1 1,086 --- 2,043 --- --- 

Subtotal 3 6,200 2 7,057 2 5,404

Total, Homelessness Prevention Programs 50 30,696 55 30,638 49 30,638

Minority AIDS

Grants

Continuations 34 7,675 34 7,753 --- --- 

New/Competing --- --- --- --- 34 2,936

Subtotal 34 7,675 34 7,753 34 2,936

Contracts

Continuations --- 1,549 --- 1,453 --- 868

New/Competing --- --- --- --- --- 402

Subtotal --- 1,549 --- 1,453 --- 1,271

Total, Minority AIDS 34 9,224 34 9,206 34 4,206

Criminal and Juvenile Justice Programs

Grants

Continuations 17 2,903 17 2,249 --- --- 

New/Competing --- --- --- --- 17 2,905

Subtotal 17 2,903 17 2,249 17 2,905

Contracts

Continuations 1 681 2 2,012 2 1,356

New/Competing 1 684 --- --- --- --- 

Subtotal 2 1,366 2 2,012 2 1,356

Total, Criminal and Juvenile Justice Programs 19 4,269 19 4,261 19 4,261

Seclusion and Restraint

Grants

Continuations --- $--- --- $--- --- $--- 

New/Competing --- --- --- --- --- --- 

Subtotal --- --- --- --- --- --- 

Contracts

Continuations 1 1,147 1 1,145 --- 60

New/Competing --- --- --- --- 1 1,085

Subtotal 1 1,147 1 1,145 1 1,145

Total, Seclusion and Restraint 1 1,147 1 1,145 1 1,145
94

SAMHSA/Mental Health

PRNS Mechanism Table by Program, Project, and Activity

(Dollars in thousands) 

FY 2016 

Final

FY 2017

Annualized CR

FY 2018 

President's 

Budget

Programs of Regional & National Significance No. Amount No. Amount No. Amount

Assertive Community Treatment for Individuals with Serious Mental 

Illness

Grants

Continuations --- --- --- --- --- 5,000

New/Competing --- --- --- --- --- ---

Subtotal --- --- --- --- --- 5,000

Contracts

Continuations --- --- --- --- --- ---

New/Competing --- --- --- --- --- ---

Subtotal --- --- --- --- --- ---

Total, Assertive Community Treatment for Individuals with Serious 

Mental Illness --- --- --- --- --- $5,000

Assisted Outpatient Treatment for Individuals with Serious Mental Illness

Grants

Continuations --- --- 17 13,318 17 13,305

New/Competing 17 13,430 --- --- --- ---

Subtotal 17 13,430 17 13,318 17 13,305

Contracts

Continuations --- --- --- 1,653 1 1,667

New/Competing 1 1,570 --- --- --- ---

Subtotal 1 1,570 --- 1,653 1 1,667

Total, Assisted Outpatient Treatment for Individuals with Serious 

Mental Illness 18 15,000 17 14,971 18 14,971

Tribal Behavioral Health Grants

Grants

Continuations 20 3,804 81 7,812 113 11,532

New/Competing 70 7,869 32 2,560 --- ---

Subtotal 90 11,672 113 10,372 113 11,532

Contracts

Continuations --- 265 1 3,904 1 3,440

New/Competing 1 3,063 --- 696 --- ---

Subtotal 1 3,328 1 4,599 1 3,440

Total, Tribal Behavioral Health Grants 91 15,000 114 14,971 114 14,971

Subtotal, Capacity 722 $389,793 734 $389,075 537 $254,638

Science and Service:

Primary and Behavioral Health Care Integration TA

Grants

Continuations --- --- --- --- --- ---

New/Competing --- --- --- --- --- ---

Subtotal --- --- --- --- --- ---

Contracts

Continuations 1 1,938 1 1,987 --- ---

New/Competing --- 53 --- --- --- ---

Subtotal 1 1,991 1 1,987 --- ---

Total, PBHCI TA 1 1,991 1 1,987 --- ---

Practice Improvement & Training

Grants

Continuations --- 3,156 2 2,137 8 3,158

New/Competing --- --- --- --- --- ---

Subtotal --- 3,156 2 2,137 8 3,158

Contracts

Continuations 5 3,775 6 5,176 6 3,815

New/Competing 2 897 1 500 2 840

Subtotal 7 4,672 7 5,676 8 4,655

Total, Practice Improvement & Training 7 7,828 9 7,813 16 7,813
95

SAMHSA/Mental Health

PRNS Mechanism Table by Program, Project, and Activity

(Dollars in thousands)

Programs of Regional & National Significance

FY 2016

Final

FY 2017

Annualized CR

FY 2018 

President's 

Budget

No. Amount No. Amount No. Amount

Consumer and Consumer-Supporter TA Centers

Grants

Continuations 5 1,799 5 1,547 5 1,804

New/Competing --- --- --- --- --- ---

Subtotal 5 1,799 5 1,547 5 1,804

Contracts

Continuations --- 119 --- 368 --- 111

New/Competing --- --- --- --- --- ---

Subtotal --- 119 --- 368 --- 111

Total, CCSTAC 5 1,918 5 1,914 5 1,914

Disaster Response

Grants

Continuations --- 923 --- 923 --- ---

New/Competing --- --- --- --- --- 828

Subtotal --- 923 --- 923 --- 828

Contracts

Continuations 1 1,030 1 1,026 1 1,121

New/Competing --- --- --- --- --- ---

Subtotal 1 1,030 1 1,026 1 1,121

Total, Disaster Response 1 1,953 1 1,949 1 1,949

Homelessness

Grants

Continuations --- --- --- --- --- ---

New/Competing --- --- --- --- --- ---

Subtotal --- --- --- --- --- ---

Contracts

Continuations --- 1,153 1 2,292 1 2,292

New/Competing 1 1,143 --- --- --- ---

Subtotal 1 2,296 1 2,292 1 2,292

Total, Homelessness 1 2,296 1 2,292 1 2,292

Minority Fellowship Program

Grants

Continuations 11 6,851 11 6,851 --- ---

New/Competing --- --- --- --- 11 6,749

Subtotal 11 6,851 11 6,851 11 6,749

Contracts

Continuations 1 1,208 1 1,193 --- 676

New/Competing --- --- --- --- 1 619

Subtotal 1 1,208 1 1,193 1 1,295

Total, Homelessness 12 8,059 12 8,044 12 8,044

HIV/AIDS Education

Grants

Continuations --- --- --- --- --- ---

New/Competing --- --- --- --- --- ---

Subtotal --- --- --- --- --- ---

Contracts

Continuations 1 771 1 770 --- 770

New/Competing --- --- --- --- --- ---

Subtotal 1 771 1 770 --- 770

Total, HIV/AIDS Education 1 771 1 770 --- 770

Subtotal, Science and Service 28 24,816 30 24,769 35 22,782

Total, Mental Health PRNS 750 $414,609 764 $413,843 572 $277,419
96

Grant Awards Table

(Whole dollars) 

FY 2016

Final

FY 2017

Annualized CR

FY 2018 

President's 

Budget

Number of Awards 722 736 548

Average Awards $478,832 $424,039 $389,680

Range of Awards $15,000 - $6,000,000 $15,000 - $6,000,000 $15,000 - $6,000,000
97

Children’s Mental Health Services

(Dollars in thousands)

FY 2016

Final 

FY 2017

Annualized 

CR 

FY 2018 

President's 

Budget 

FY 2018

+/−

FY 2017 

Programs of Regional & National Significance

Budget Authority $119,026 $118,800 $118,800 ---

 10% set-aside for youth in prodrome phase of

 psychosis (non-add) --- --- 11880 11880

Authorizing Legislation ........................................... Sections 561 of the Public Health Service Act 

FY 2018 Authorization .......................................................................................................$119,026 

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

Eligible Entities.................................................States, Tribes, Communities, Territories

Program Description and Accomplishments

It is estimated that over 7.4 million children and youth in the United States have a serious mental 

disorder. Unfortunately, only 41 percent of those in need of mental health services actually receive 

treatment.11 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 and their families to increase their access to evidence-based treatment and supports. 

The 21st Century Cures Act reauthorized the CMHI through FY 2022. Approximately 9-13 percent 

of America’s youth are estimated to have a serious emotional disturbance (SED). CMHI provides 

grants to assist states, local governments, tribes, and territories in their efforts to deliver services 

and supports to meet the needs of children and youth with SED. 

CMHI supports the development, implementation, expansion, and sustainability of 

comprehensive, community-based services that use the SOC approach. SOC is a strategic 

approach to the delivery of services and supports that incorporates family-driven, youth-guided, 

strength-based, and culturally and linguistically competent care in order to meet the physical, 

intellectual, emotional, cultural, and social needs of children and youth throughout the U.S. The 

SOC approach helps prepare children and youth for successful transition to adulthood and 

assumption of adult roles and responsibilities. Services are delivered in the least restrictive 

environment with evidence-supported treatments and interventions. Individualized care 

management ensures that planned services and supports are delivered with an appropriate, 

effective, and youth-guided approach. This approach has demonstrated improved outcomes for 

children at home, at school, and in their communities. For example, CMHI grantee data show that 

suicide attempt rates fell over 38 percent within 12 months after children and youth accessed 

CMHI-related SOC services. In addition, school suspensions/expulsions fell over 42 percent and 

unlawful behavior fell over 40 percent within 18 months of children and youth beginning SOCrelated services and supports. 

11 Substance Abuse and Mental Health Services Administration, U.S. Department of Health and Human Services. 

(2014). Results from the 2013 National Survey on Drug Use and Health: Summary of National Findings, NSDUH 

Series H-48, HHS Publication No. (SMA) 144863. Rockville, MD: Substance Abuse and Mental Health Services 

Administration.
98

In addition, the CMHI program seeks to address behavioral health disparities for children and 

youth with SED/Serious Mental Illness (SMI) from racial and ethnic minorities by promoting clear 

and culturally competent strategies to improve their access, use of services, and outcomes.

SAMHSA funding ensures that grantees will continue to expand and sustain CMHI SOC values, 

principles, infrastructure, and services throughout their states, tribes, and territories. A central 

focus of these efforts is ensuring collaboration between the CMHI SOC and other child-and youthserving systems (e.g., Child Welfare, Juvenile Justice, and Education). SAMHSA also strongly 

encourages efforts by CMHI SOC to coordinate with other SAMHSA programs, such as those 

supported by the Community Mental Health Services Block Grant (MHBG) and Substance Abuse 

Prevention and Treatment Block Grant (SABG). 

CMHI has an ongoing national evaluation, which is designed to provide information on: 1) the 

mental health outcomes of children and youth, and their families; 2) the implementation, process, 

and sustainability of SOC; and 3) critical and emerging issues in children’s and youth’s mental 

health. The evaluation includes an SOC assessment that describes the infrastructure and an 

assessment of outcomes derived from direct SOC services. A service experience study evaluates: 

1) change in service use patterns of children and their families; 2) differences in client satisfaction

between groups of children (and their families) in the SOC communities who receive an evidencebased treatment and those who do not; and 3) retention in services.

National program evaluation data reported annually to Congress indicate that CMHI SOCs are 

successful, resulting in many favorable outcomes for children, youth, and their families, including: 

• sustained mental disorder improvements for participating children and youth in

behavioral health outcomes after as little as six months of program participation;

• improvements in school attendance and achievement;

• reductions in suicide-related behaviors;

• decreases in the use of inpatient care and reduced costs due to fewer days in residential

settings; and

• significant reductions in contacts with law enforcement.

In FY 2015, SAMHSA supported 54 continuation grants. SAMHSA also awarded 24 four-year 

new SOC Expansion and Sustainability Cooperative Agreements that focused on sustainable 

financing, cross-agency collaboration, the creation of policy and infrastructure, and the 

development and implementation of services and supports. In addition, SAMHSA supported one 

new technical assistance contract and one new evaluation contract. 

In FY 2016, SAMHSA supported 47 continuation grants, 53 new grants, and five contracts. In FY 

2017, SAMHSA will support 64 continuation grants, 8 new grants, and four contracts.
99

Funding History

Fiscal Year Amount

FY 2014 $117,026,000 

FY 2015 $117,026,000 

FY 2016 $119,026,000 

FY 2017 $118,800,000

FY 2018 $118,800,000

Budget Request

The FY 2018 Budget Request is $118.8 million, level with the FY 2017 Annualized CR. As part 

of this budget request, SAMHSA seeks to develop and implement a services research 

demonstration effort based on the North American Prodrome Longitudinal Study funded by the 

National Institute of Mental Health. During the prodrome phase, a disease process has begun but 

is not yet diagnosable or inevitable. The demonstration will address whether community-based 

intervention during this phase can prevent the further development of serious emotional 

disturbances and ultimately serious mental illness. The project will examine the extent to which 

evidence-based early intervention for young people at clinical high risk for psychosis can be scaled 

up to mitigate or delay the progression of mental illness, reduce disability, and/or maximize 

recovery. The new effort will be funded from a 10 percent set-aside of the base program, and will 

focus on youth and young adults who are identified to be at clinical high risk for developing a first 

episode of psychosis. Funding of this new effort will not affect continuation funding of any CMHIbase funded program. The grantees will focus on this population in order to support the 

development and implementation of evidence-based programs providing community outreach and 

psychosocial interventions for youth and young adults in the prodrome phase of psychotic illness. 

The Budget includes new appropriations language for the 10 percent set-aside.

The budget request will also support funding for 72 continuation grants and four continuation 

contracts. This funding will provide training to 5,100 people in the mental health and related 

workforce and serve 13,595 children with serious emotional disturbances.
100

SAMHSA/Mental Health

Mechanism Table 

(Dollars in thousands)

Program Activity

FY 2016

Final

FY 2017

Annualized 

CR

FY 2018 

President's 

Budget

No. Amount No. Amount No. Amount

Children's Mental Health Services

Grants/Cooperative Agreements

Continuations 47 $42,132 64 $77,873 65 $86,878

New/Competing 32 54,379 8 18,348 12 11,326

Subtotal. 79 96,511 72 96,221 77 98,204

Contracts

Continuations 2 12,561 --- 13,380 1 9,278

New/Competing --- 500 --- --- 1 2,000

Subtotal 2 13,061 --- 13,380 2 11,278

Technical Assistance 2 9,454 --- 9,199 2 9,318

Total, Children's Mental Health Services 83 $119,026 72 $118,800 81 $118,800

* Totals may not add due to rounding.
101

Outputs and Outcomes Table

Program: Children's Mental Health Services

NOTE: SAMHSA makes grant awards toward the end of the year and therefore, bases the FY 2018

targets on the FY 2017 Annualized CR and the FY 2019 targets are based on the FY 2018 

President’s Budget. 

Measure

Year and Most Recent Result

Target for Recent Result

(Summary of Result)

FY 2018

Target

FY 2019

Target

FY 2019

Target

+/−

FY 2018

Target

3.2.16 Increase the number of children 

with severe emotional disturbance that 

are receiving services from the 

Children's Mental Health Initiative 

(Output)

FY 2016: 7,830

Target: 6,610

(Target Exceeded)

7,830 7,830 Maintain

3.2.25 Increase the percentage of 

children receiving services who report 

positive social support at 6 month 

follow-up (Outcome)

FY 2016: 86.1 %

Target: 87.6 %

(Target Not Met)

87.6 % 87.6 % Maintain

3.2.26 Increase the percentage of 

children receiving Systems of Care 

mental health services who report 

positive functioning at 6 month followup (Outcome)

FY 2016: 59.6 %

Target: 62.7 %

(Target Not Met)

62.7 % 62.7 % Maintain

3.2.27 Increase the number of people in 

the mental health and related workforce 

trained in specific mental health-related 

practices/activities as a result of the 

program (Output)

FY 2016: 48,818

Target: 5,101

(Target Exceeded)

48,818 48,818 Maintain
102

Grant Awards Table 

(Whole dollars)

FY 2016 

Final

FY 2017 

Annualized CR

FY 2018 

President's

Budget

Number of Awards 79 72 77

Average Awards $1,221,658 $1,336,403 $1,275,373

Range of Awards $330,000 - $2,000,000 $330,000 - $2,000,000 $330,000 - $2,000,000
103

Projects for Assistance in Transition from Homelessness

(Dollars in thousands)

Program Activity

 FY 2016 

Final 

FY 2017

Annualized 

CR 

FY 2018 

President's 

Budget 

FY 2018

+/−

FY 2017 

Budget Authority $64,635 $64,512 $64,512 $---

Authorizing Legislation ........................................ Section 535(a) of the Public Health Service Act

FY 2018 Authorization .........................................................................................................$64,635 

Allocation Method ................................................................................................... Formula Grants 

Eligible Entities ............................................................................................... States and Territories

Program Description and Accomplishments

On an average night, an estimate of 578,424 individuals experience homelessness.12 Data suggest 

that approximately 26 percent of individuals experiencing homelessness have a serious mental 

illness (SMI), and that 30 percent of the chronically homeless population (individuals or families 

with a disabling condition who have been experiencing homelessness for longer than one year or 

more than four times in the past three years) have a serious mental illness.13,14,15 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.16 

Data show that the PATH program’s efforts to identify primary care, behavioral disorder treatment, 

and housing for individuals who are chronically homeless is two to three times more cost effective 

than having them in the criminal justice system or treating them via other costly healthcare settings 

(e.g., emergency rooms, critical care units).

In 1990, the Stewart B. McKinney Homeless Assistance Amendments Act authorized the PATH 

program to provide services to individuals who are experiencing homelessness and SMI. The 

12 The U.S. Department of Housing and Urban Development, Office of Community Planning and Development. 

(2014). The 2014 Annual Homeless Assessment Report (AHAR) to Congress, Part 1. Available 

at: https://www.hudexchange.info/resources/documents/2014-AHAR-Part1.pdf 13 The U.S. Department of Housing and Urban Development, Office of Community Planning and Development. 

(2010). The 2010 Annual Homeless Assessment Report (AHAR) to Congress. Available 

at: https://www.hudexchange.info/resources/documents/2010HomelessAssessmentReport.pdf 14 National Alliance on Mental Illness. Mental Health by the Numbers. Available at: https://www.nami.org/LearnMore/Mental-Health-By-the-Numbers 15 Office of National Drug Control Policy. Integrate Treatment for Substance Use Disorders into Mainstream Health 

Care and Expand Support for Recovery. Available at: https://www.whitehouse.gov/ondcp/chapter-integratetreatment-for-substance-use-disorders 16 National Alliance on Mental Illness (2004). Homelessness. Available at: 

http://www2.nami.org/Content/ContentGroups/Policy/Fact_Sheets/homelessnessPFS.pdf
104

PATH program supports 56 grants to the 50 states, the District of Columbia, Puerto Rico, Guam, 

American Samoa, the United States Virgin Islands, and the Northern Mariana Islands, as well as 

centralized activities such as technical assistance and evaluation. PATH funds community-based 

outreach, mental illness and substance abuse treatment services, case management, assistance with 

accessing housing, and other supportive services. PATH helps to engage people with SMI into 

mental disorder treatment. PATH outreach workers specialize in engaging those who are most 

vulnerable in their communities and who are least likely to seek out services on their own. PATH’s 

primary goal is to bring the most vulnerable into the service system and to connect them with the 

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

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

In FY 2015, the PATH program outreached to 181,336 individuals experiencing homelessness and 

enrolled 60 percent of individuals with an SMI into the PATH program (90,054 individuals). 

Additionally, 53 percent of enrolled individuals were experiencing a co-occurring drug/alcohol 

addiction. Of those enrolled in PATH, 56,405 individuals received community mental health 

services. In addition, 10,372 individuals received substance abuse treatment through PATH, while 

17,318 individuals were referred by PATH to substance abuse treatment services in the 

community. In addition, PATH assisted 17,232 individuals with addressing complex housing 

needs and referred 25,911 individuals to housing assistance agencies in their communities. The 

services provided by the PATH program fill gaps in existing community resources and play a 

crucial role in communities’ strategic plans to end homelessness. In FY 2016 and FY 2017, 

SAMHSA continued support for this program. 

Funding History

Fiscal Year Amount

FY 2014 $64,635,000 

FY 2015 $64,635,000 

FY 2016 $64,635,000 

FY 2017 $64,512,000

FY 2018 $64,512,000

Budget Request

The FY 2018 Budget Request is $64.5 million, level with the FY 2017 Annualized CR. This 

formula-based funding to all states will continue PATH services in over 500 communities that the 

states provide funding to in order to support outreach workers and mental health specialists that 

engage with individuals who are living with SMI or those living with both SMI and drug/alcohol 

addiction and are homeless or at imminent risk of becoming homeless. The services provided by 

the program help ensure that these individuals have an opportunity to access stable housing, 

improve their health and wellness, lead self-directed lives, and achieve their full potential. 
105

Outputs and Outcomes Table

Program: Projects for Assistance in Transition from Homelessness

Note: SAMHSA makes grant awards toward the end of the year and therefore, bases the FY 2018 targets on the 

FY 2017 Annualized CR and the FY 2019 targets are based on the FY 2018 President’s Budget.

Measure

Year and Most Recent 

Result

Target for Recent Result

(Summary of Result)

FY 2018

Target

FY 2019

Target

FY 2019

Target

+/−

FY 2018

Target

3.4.15 Increase the percentage of enrolled 

homeless persons in the Projects for 

Assistance in Transition from 

Homelessness (PATH) program who 

receive community mental health services 

(Intermediate Outcome)

FY 2015: 63 %

Target: 66 %

(Target Not Met)

66 % 66 % Maintain

3.4.16 Increase the number of homeless 

persons contacted (Outcome)

FY 2015: 181,336

Target: 191,926

(Target Not Met)

185,524 185,524 Maintain

3.4.17 Increase the percentage of contacted 

homeless persons with serious mental 

illness who become enrolled in services 

(Outcome)

FY 2015: 60 %

Target: 58 %

(Target Exceeded)

58 % 58 % Maintain

3.4.20 Increase the number of Projects for 

Assistance in Transition from 

Homelessness (PATH) providers trained on 

SSI/SSDI Outreach, Access, Recovery 

(SOAR) to ensure eligible homeless clients 

are receiving benefits (Output)

FY 2015: 1,676

Target: 4,360

(Target Not Met)

2,296 2,296 Maintain
106

Department of Health and Human Services

Substance Abuse and Mental Health Services Administration

FY 2017 DISCRETIONARY STATE/FORMULA GRANTS

Projects for Assistance in Transition from Homelessness (PATH)

CFDA # 93.150 

State/Territory

FY 2016 

Final

FY 2017 

Annualized 

CR

FY 2018 

President's 

Budget

FY 2018

+/−

FY 2017

Alabama $613,371 $611,547 $611,434 −113

Alaska 300,000 300,000 300,000 ---

Arizona 1,349,975 1,345,960 1,345,711 −249

Arkansas 304,097 303,192 303,136 −56

California 8,817,598 8,791,370 8,789,750 −1,620

Colorado 1,019,638 1,016,606 1,016,418 −188

Connecticut 799,779 797,401 797,253 −148

Delaware 300,000 300,000 300,000 ---

District of Columbia 300,000 300,000 300,000 ---

Florida 4,336,545 4,323,649 4,322,850 −799

Georgia 1,670,861 1,665,892 1,665,585 −307

Hawaii 300,000 300,000 300,000 ---

Idaho 300,000 300,000 300,000 ---

Illinois 2,706,572 2,698,522 2,698,024 −498

Indiana 1,012,019 1,009,009 1,008,822 −187

Iowa 334,729 333,733 333,672 −61

Kansas 377,583 376,460 376,390 −70

Kentucky 469,142 467,747 467,661 −86

Louisiana 733,419 731,238 731,102 −136

Maine 300,000 300,000 300,000 ---

Maryland 1,272,182 1,268,399 1,268,164 −235

Massachusetts 1,559,659 1,555,021 1,554,733 −288

Michigan 1,730,447 1,725,301 1,724,982 −319

Minnesota 811,399 808,986 808,837 −149

Mississippi 300,000 300,000 300,000 ---

Missouri 894,234 891,575 891,410 −165

Montana 300,000 300,000 300,000 ---

Nebraska 300,000 300,000 300,000 ---

Nevada 616,251 614,419 614,305 −114

New Hampshire 300,000 300,000 300,000 ---
107

Department of Health and Human Services

Substance Abuse and Mental Health Services Administration

FY 2017 DISCRETIONARY STATE/FORMULA GRANTS

Projects for Assistance in Transition from Homelessness (PATH)

CFDA # 93.150 

State/Territory

FY 2016 

Final

FY 2017 

Annualized 

CR

FY 2018 

President's 

Budget

FY 2018

+/−

FY 2017

New Jersey 2,139,241 2,132,879 2,132,485 −394

New Mexico 300,000 300,000 300,000 ---

New York 4,225,285 4,212,719 4,211,941 −778

North Carolina 1,380,314 1,376,209 1,375,955 −254

North Dakota 300,000 300,000 300,000 ---

Ohio 1,987,508 1,981,597 1,981,231 −366

Oklahoma 453,063 451,716 451,632 −84

Oregon 631,332 629,454 629,338 −116

Pennsylvania 2,368,105 2,361,062 2,360,626 −436

Rhode Island 300,000 300,000 300,000 ---

South Carolina 680,567 678,543 678,418 −125

South Dakota 300,000 300,000 300,000 ---

Tennessee 910,234 907,527 907,359 −168

Texas 4,998,114 4,983,250 4,982,329 −921

Utah 591,777 590,018 589,909 −109

Vermont 300,000 300,000 300,000 ---

Virginia 1,472,964 1,468,584 1,468,312 −272

Washington 1,329,846 1,325,891 1,325,646 −245

West Virginia 300,000 300,000 300,000 ---

Wisconsin 837,078 834,589 834,435 −154

Wyoming 300,000 300,000 300,000 ---

Puerto Rico 891,574 888,923 888,759 −164

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 ---
108

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109

Protection and Advocacy for Individuals with Mental Illness (PAIMI) 

(Dollars in thousands)

Program Activity

FY 2016

Final 

FY 2017

Annualized 

CR 

FY 2018 

President's 

Budget 

FY 2018

+/−

FY 2017 

Budget Authority $36,146 $36,077 $36,077 $---

Authorizing Legislation ................................................... The PAIMI Act, 42 U.S.C. 10801 et seq. 

FY 2018 Authorization ......................................................................................................... Expired

Allocation Method ................................................................................................... Formula Grants 

Eligible Entities ............................................................................................... States and Territories

Program Description and Accomplishments

The Protection and Advocacy for Individuals with Mental Illness (PAIMI) program is highly 

effective ensuring that the most vulnerable individuals with serious mental illness, especially those 

residing in public and private residential care and treatment facilities, are free from abuse, 

including inappropriate restraint and seclusion, neglect, and rights violations. The program 

ensures individuals receive the appropriate mental disorder treatment and discharge planning 

services they will need to facilitate their recovery and subsequent placement into the least 

restrictive, appropriate, community-based setting. 

The Protection and Advocacy for Individuals with Mental Illness Act of 1986, as amended by the 

Children’s Health Act of 2000, extended the protections of the Developmental Disabilities (DD) 

Assistance Act of 1975 to individuals with significant mental illness (adults) and significant 

emotional impairments (children/youth) at risk for abuse, neglect, and rights violations while 

residing in public and private care and treatment facilities. The PAIMI Act authorized the same 

governor-designated state protection and advocacy (P&A) systems established under the DD Act 

of 1975 to receive PAIMI Program formula grant awards from SAMHSA. The PAIMI Program 

supports legal-based advocacy services that are provided by the 57 governor-designated P&A 

systems located in each state, territory, and the District of Columbia (Mayor). Each system is 

mandated to: 1) ensure that the rights of individuals with mental illness who are at risk for abuse, 

neglect, and rights violations while residing in public or private care or treatment facilities are 

protected; 2) protect and advocate for the rights of these individuals through activities that ensure 

the enforcement of the Constitution and federal and state statutes; and 3) investigate incidents of 

abuse and/or neglect of individuals with mental illness. 

In FY 2016, the 57 state PAIMI Programs: 

• Served 11,197 PAIMI-eligible individuals/clients: 2,520 children and youth (ages 0 to 18),

7,987 adults (ages 19 to 64), and 690 older adults (age 65 and older). These individuals

filed 9,344 complaints alleging abuse, neglect, and/or rights violations.
110

• Resolved 91 percent of abuse allegations, 89 percent of neglect allegations, and 92 percent

of rights violations allegations, and attained outcomes that resulted in positive change for

the clients served. These positive outcomes included receipt of appropriate medical and

mental disorder treatment; safer, cleaner facility environment; discharge into an

appropriate community-based setting; and discharge from a nursing facility.

In FY 2016, SAMHSA continued to fund 57 annual grants to states and territories as well as 

continued technical assistance activities and support for grantees. In FY 2017, SAMHSA is 

continuing support for this program. 

Funding History

Fiscal Year Amount

FY 2014 $36,146,000 

FY 2015 $36,146,000 

FY 2016 $36,146,000 

FY 2017 $36,077,000

FY 2018 $36,077,000

Budget Request

The FY 2018 Budget Request is $36.1 million, level with the FY 2017 Annualized CR. Funding 

will support the continuation of the PAIMI grants in order to serve the same number of individuals, 

approximately 15,000, as in past years. This program will continue to assist individuals with 

serious mental illness increase access to treatment. These grantees protect and advocate for the 

rights of individuals with mental illness and investigate incidents of abuse and neglect of 

individuals with mental illness if the incidents are reported to the system or if there is probable 

cause to believe that the incidents occurred. 
111

Outputs and Outcomes Table

Program: Protection and Advocacy for Individuals with Mental Illness

Note: SAMHSA makes grant awards toward the end of the year and therefore, bases the FY 2018 targets on the 

FY 2017 Annualized CR and the FY 2019 targets are based on the FY 2018 President’s Budget.

Measure

Year and Most Recent Result

Target for Recent Result

(Summary of Result)

FY 2018

Target

FY 2019

Target

FY 2019

Target

+/−

FY 2018

Target

3.4.12 Increase the number of people 

served by the PAIMI program 

(Outcome)

FY 2016: 11,197

Target: 15,925

(Target Not Met)

15,192 15,192 Maintain

3.4.19 Increase the number attending 

public education/constituency training 

and public awareness activities (Output)

FY 2016:98,441

Target: 139,427

(Target Not Met but Improved)

139,427 139,427 Maintain

3.4.21 Increase percentage of complaints 

of alleged abuse, neglect, and rights 

violations substantiated and not 

withdrawn by the client that resulted in 

positive change through the restoration 

of client rights, expansion or 

maintenance of personal decisionmaking, elimination of other barriers to 

personal decision-making, as a result of 

Protection and Advocacy for Individuals

with Mental Illness (PAIMI) 

involvement (Outcome)

FY 2016: 91 %

Target: 87 %

(Target Exceeded)

88 % 88 % Maintain
112

Department of Health and Human Services

Substance Abuse and Mental Health Services Administration

FY 2017 DISCRETIONARY STATE/FORMULA GRANTS

Protection and Advocacy for Individuals with Mental Illness (PAIMI)

CFDA # 93.138

State/Territory

FY 2016 

Final

FY 2017 

Annualized 

CR

FY 2018 

President's 

Budget

FY 2018

+/−

FY 2017

Alabama $456,202 $453,049 $457,317 4,268

Alaska 428,000 427,200 427,200 ---

Arizona 620,810 625,436 632,493 7,057

Arkansas 428,000 427,200 427,200 ---

California 3,133,536 3,134,386 3,092,688 −41,698

Colorado 437,326 437,288 442,249 4,961

Connecticut 428,000 427,200 427,200 ---

Delaware 428,000 427,200 427,200 ---

District of Columbia 428,000 427,200 427,200 ---

Florida 1,724,396 1,735,256 1,756,972 21,716

Georgia 924,616 924,065 931,585 7,520

Hawaii 428,000 427,200 427,200 ---

Idaho 428,000 427,200 427,200 ---

Illinois 1,068,437 1,064,548 1,048,251 −16,297

Indiana 601,509 598,854 591,130 −7,724

Iowa 428,000 427,200 427,200 ---

Kansas 428,000 427,200 427,200 ---

Kentucky 428,000 427,200 427,200 ---

Louisiana 428,000 427,200 427,200 ---

Maine 428,000 427,200 427,200 ---

Maryland 461,758 465,178 465,787 609

Massachusetts 507,383 506,654 501,621 −5,033

Michigan 900,554 886,029 876,602 −9,427

Minnesota 447,204 445,000 445,042 42

Mississippi 428,000 427,200 427,200 ---

Missouri 538,623 536,028 540,838 4,810

Montana 428,000 427,200 427,200 ---

Nebraska 428,000 427,200 427,200 ---

Nevada 428,000 427,200 427,200 ---

New Hampshire 428,000 427,200 427,200 ---
113

Department of Health and Human Services

Substance Abuse and Mental Health Services Administration

FY 2017 DISCRETIONARY STATE/FORMULA GRANTS

Protection and Advocacy for Individuals with Mental Illness (PAIMI)

CFDA # 93.138

State/Territory

FY 2016 

Final

FY 2017 

Annualized 

CR

FY 2018 

President's 

Budget

FY 2018

+/−

FY 2017

New Jersey 684,418 676,962 673,808 −3,154

New Mexico 428,000 427,200 427,200 ---

New York 1,522,543 1,519,082 1,503,160 −15,922

North Carolina 900,754 907,663 910,450 2,787

North Dakota 428,000 427,200 427,200 ---

Ohio 1,026,130 1,017,456 1,016,749 −707

Oklahoma 428,000 427,200 427,200 ---

Oregon 428,000 427,200 427,200 ---

Pennsylvania 1,068,002 1,056,446 1,049,098 −7,348

Rhode Island 428,000 427,200 427,200 ---

South Carolina 455,079 457,046 459,017 1,971

South Dakota 428,000 427,200 427,200 ---

Tennessee 587,219 587,707 588,267 560

Texas 2,268,331 2,274,421 2,315,644 41,223

Utah 428,000 427,200 427,200 ---

Vermont 428,000 427,200 427,200 ---

Virginia 672,622 670,316 672,260 1,944

Washington 573,924 572,446 575,818 3,372

West Virginia 428,000 427,200 427,200 ---

Wisconsin 496,018 493,823 491,960 −1,863

Wyoming 428,000 427,200 427,200 ---

Puerto Rico 538,623 527,152 527,535 383

American Samoa 229,300 228,900 228,900 ---

Guam 229,300 228,900 228,900 ---

American Indian Consortium 229,300 228,900 228,900 ---

Northern Mariana Islands 229,300 228,900 228,900 ---

Virgin Islands 229,300 228,900 228,900 ---
114

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115

Community Mental Health Services Block Grant (MHBG)

(Dollars in thousands)

FY 2016

Final 

FY 2017

Annualized

CR 

FY 2018 

President's 

Budget 

FY 2018

+/−

FY 2017

Programs of Regional & National Significance

Community Mental Health Services Block Grant $532,571 $531,599 $415,539 −$116,060

PHS Evaluation Funds (non-add) 21,039 21,039 15,539 −$5,500

Authorizing Legislation...............................Sections 1920 of the Public Health Service Act

FY 2018 Authorization......................................................................................................$532,571 

Allocation Method ..................................................................................................... Formula Grant 

Eligible Entities .................. States, Territories, Freely Associated States, and District of Columbia

Program Description and Accomplishments

Serious mental illnesses are more common in the United States than is generally realized. 

According to the 2015 Behavioral Health Barometer: United States, approximately 4.1 percent of 

U.S. adults (an estimated 9.8 million individuals) reported having a serious mental illness (SMI) 

within the year prior to being surveyed.17,18 Nearly a third of these individuals did not receive any 

services in the year before being surveyed.19 

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.20 The MHBG distributes funds for a variety of 

services and for planning, administration, and educational activities. By statute, these services and 

activities must support community-based mental health services for children with serious 

emotional disturbances and adults with serious mental illness. MHBG services include: outpatient 

treatment for serious mental illnesses, such as schizophrenia and bipolar disorders; supported 

employment and supported housing; rehabilitation services; crisis stabilization and case 

management; peer specialist and consumer-directed services; wraparound services for children and 

families; jail diversion programs; and services for vulnerable populations (e.g., individuals, who 

are homeless, those in rural and frontier areas, military families, and veterans). Through the 

administration of the MHBG, SAMHSA supports implementation of practices demonstrated and 

17 Center for Behavioral Health Statistics and Quality. (2016). Key substance use and mental health indicators in the 

United States: Results from the 2015 National Survey on Drug Use and Health (HHS Publication No. SMA 16-

4984, NSDUH Series H-51) 18 Substance Abuse and Mental Health Services Administration. Behavioral Health Barometer: United States, 2015. 

HHS Publication No. SMA–16–Baro–2015. Rockville, MD: Substance Abuse and Mental Health Services 

Administration, 

19 Substance Abuse and Mental Health Services Administration. Behavioral Health Barometer: United States, 2015. 

HHS Publication No. SMA–16–Baro–2015. Rockville, MD: Substance Abuse and Mental Health Services 

Administration, 2015.

20 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
116

proven effective in the Mental Health Programs of Regional and National Significance (PRNS) 

portfolio. 

The MHBG continues to represent a significant “safety net” source of funding for mental health 

services for some of the most vulnerable populations across the country. Together, SAMHSA’s 

block grants support the provision of services and related support activities to approximately 

seven million individuals with mental and substance use conditions in any given year. The Block 

Grant’s “flexibility and stability” have made it a vital support for public mental health systems.

States rely on the MHBG for delivery of services and for an array of non-clinical coordination and 

support services that are not supported by Medicaid or other third party insurance to strengthen 

their service systems. The MHBG statute provides for a five percent administrative set-aside that 

allows SAMHSA to assist the states and territories in the development of their mental health 

systems through the support of technical assistance, data collection, and evaluation activities. 

States also use block grant funds, with other funding sources, to support training for staff and 

implementation of evidence-based practices and other promising practices for the treatment of 

mental disorders, improved business practices, use of health information technology, and 

integration of physical and behavioral health services. 

SAMHSA’s MHBG and Substance Abuse Prevention and Treatment Block Grant (SABG) 

applications align with changes in federal/state environments and statutes. SAMHSA offers states 

the opportunity to complete a combined application for mental health and substance abuse 

services, submit a biennial versus an annual plan, and provide information regarding their efforts 

to respond to various changes in federal and state law.21,22 Permitting MHBG recipients to submit 

the application/plan biennially reduces the burden on states. 

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 Substance Abuse Prevention and Treatment 

Block Grant (SABG) as well as other SAMHSA-funded efforts such as the systems of care for 

children and adolescents supported through the Children’s Mental Health Initiative. 

Most block grant recipients are currently reporting on National Outcome Measures (NOMS) for 

public mental health services within their state. State-level outcome data for mental health are 

currently reported by State Mental Health Authorities. The following outcomes for all people 

served by the publicly funded mental health system during 2015 show that: 

• For the 57 states and territories that reported data in the Employment Domain, 21.7 percent

of the mental health consumers were in competitive employment;

• For the 58 states and territories that reported data in the Housing Domain, 76.2 percent of

the mental health consumers were living in private residences;

21 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). 22 State Plan (Sec. 1932 (b) of Title XIX, Part B, Subpart II of the Public Health Service (PHS) Act (42 USC § 300x32(b)).
117

• For the 58 states and territories that reported data in the Access/Capacity Domain, state

mental health agencies provided mental health services for approximately 23.07 people per

1,000 population;

• For the 50 states and territories that reported data in the Retention Domain, only 8.2 percent

of the patients returned to a state psychiatric hospital within 30 days of state hospital

discharge; and

• For the 45 states and territories that reported data in the Perception of Care Domain,

70 percent of adult mental health consumers improved functioning as a direct result of the

mental health services they received.

Set-aside for Evidence-based Programs That Address Needs of Individuals with Early Serious 

Mental Illness

Starting in FY 2014, states were required to set aside five percent of their MHBG funds to support 

“evidence-based programs that address the needs of individuals with early serious mental illness, 

including psychotic disorders.”23 SAMHSA is collaborating with the National Institute of Mental 

Health and states to implement this provision.

The majority of individuals with serious mental illness experience their first symptoms during 

adolescence or early adulthood, and there are often long delays between the initial onset of 

symptoms and receiving treatment. The consequences of delayed treatment can include loss of 

family and social supports, reduced educational achievement, incarceration, disruption of 

employment, substance abuse, increased hospitalizations, and reduced prospects for long-term 

recovery.

The five percent set-aside allocated to states totaling approximately $24.2 million per year in 

FY 2014 and FY 2015 supported implementation of evidenced-based models that seek to address 

treatment of serious mental illness at an early stage through reducing symptoms and relapse rates, 

and preventing deterioration of cognitive function in individuals living with psychotic illness. In 

FY 2016, Congress increased the set-aside to 10 percent; through this funding, the number of states 

with fully implemented operating first-episode treatment programs is 39 and SAMHSA continues 

to monitor and ensure that the set-aside program is solely used to address first-episode psychosis. 

Beginning in September 2016, SAMHSA, in partnership with NIMH, initiated a 3-year evaluation 

study of such programs funded through the MHBG set-aside to ensure that funds are only used for 

programs showing strong evidence of effectiveness and target first episode of psychosis. In FY 

2017, SAMHSA is continuing support for the MHBG and maintaining the ten percent set-aside.

The table below identifies activities which have been implemented with the 10% set-aside

23 http://www.samhsa.gov/sites/default/files/mhbg-5-percent-set-aside-guidance.pdf
118

State 10% Set Aside Allotment Program Description

Alabama $735,122 Statewide EASA (Early Assessment and Support Alliance) 

program model is being developed and implemented.

Alaska $97,223 A CSC (Coordinated Speciality Care) Program model is in the 

process of being developed and implemented.

American Samoa $9,815 Training 2-4 peer support specialists to begin FEP outreach.

Arizona $1,163,988 An EPICENTER FEP program is operational in Phoenix and in 

Tuscon.

Arkansas $448,397 Developing portions of CSC model in thirteen locations.

California $6,918,048 Forty-one CSC programs, from several different models, are in 

various states of development throughout CA. Thiry-seven are fully 

operational.

Colorado $848,285 Implementing three CSC (OnTRACKUSA) programs.

Connecticut $523,715 State is implementing two programs based on two distinct CSC 

models (Potential and STEP).

District of Columbia $105,711 CSC program is being developed and implemented. Training staff 

on Cognitive Behavioral Therapy for individuals experiencing 

psychosis.

Delaware $141,740 A statewide program, PIER, has been implemented

Florida $126,787 State has implemented two CSC programs; three more are being 

developed and implemented. All of these programs are based on the 

Navigate model.

Georgia $1,717,993 State has implemented three CSC programs; three more are being 

developed and implemented. All programs are based on the 

LIGHT-ETP model.

Guam $28,767 Ongoing training of staff on the OnTRACKNY model.

Hawaii $263,692 State has implemented a program in Honolulu based on the 

OnTRACK model.

Idaho $237,867 Three CSC programs have been implemented.

Illinois $1,983,932 State is in the process of setting up CSC services in eleven 

locations.

Indiana $911,070 State is establishing four programs based on the PARC model and 

making use of a "hub and spoke" design.

Iowa $406,786 State has two functioning CSC programs and is in the process of 

contracting for four additional locations/programs.

Kansas $377,195 State has one fully functional CSC program in Kansas City and is 

operationalizing a second program in Topeka.

Kentucky $662,889 Two EASA CSC program sites are operational and two more are 

being developed. State is also developing data infrastructure to 

track outcomes.

Louisana $618,316 Three sites are in the process of being implemented. These 

programs are using the Navigate CSC model.

Maine $200,943 State has implemented one program based on the PIER Model and 

is developing a second location.

Marshall Islands $5,501 Marshall Islands is using the set-aside block grant funding to 

develop first episode outreach practices and protocols for 

individuals experiencing FEP.

Maryland $853,207 The state has implemented two CSC programs, one in Baltimore 

and a second in Gaithersburg. They are continuing to develop staff 

expertise in the FEP approaches.

Massachusetts $1,049,346 Massachusetts has developed two CSC programs, one in Boston 

and a second in western Mass. They are using the PREP model of 

CSC.

Michigan $1,601,844 The State has implemented three CSC programs and are in the 

process of developing three additional locations. They are using the 

NAVIGATE CSC model.

Federated States of 

Micronesia

$19,032 Funds are being used to train staff on the OnTrack CSC model in 

four locations.

Minnesota $786,276 State is implementing two CSC programs in the Twin Cities area 

and plan to expand these services throughout MN.
119

State 10% Set Aside Allotment Program Description

Mississippi 467,436 State is fully implementing the NAVIGATE CSC programs to 

provide training and technical assistance to two CSC teams.

Missouri 856,200 State plans is continuing to implement CSC programs that include 

the empirically-supported interventions of cognitive-behavioral 

psychotherapy, family education, and supports and has established 

two CSC sites.

Montana $149,765 The state is implementing the NAVIGATE model in one site for 

the state.

Nebraska $232,531 Nebraska is implementing OnTrackUSA in two of the six 

behavioral health service regions of the state.

Nevada $507,552 Nevada will implement an FEP program in northern Nevada using 

the RAISE TEAM approach. The state will incorporate 

telemedicine into the service delivery model to reach rural areas, 

and will support efforts to expand RAISE into the southern part of 

the state.

New Hampshire $180,828 The state is using a NAVIGATE training team to train Community 

Mental Health Centers to establish CSC teams that will continue to 

expand beyond the training period, using a staged approach.

New Jersey $1,433,147 New Jersey is funding three CSC teams implementing the RAISE 

CSC model.

New Mexico $299,365 New Mexico is expanding access to the NAVIGATE model for 

specialty coordinated care for individuals with FEP through the 

University of New Mexico EARLY program.

New York $3,242,519 New York is spending set-aside funds to expand its existing 

OnTrackNY program to six new sites with a goal of having eleven 

sites by the end of 2015. These sites will include rural and lesspopulated areas.

North Carolina $1,430,851 North Carolina will continue to support two CSC sites currently 

operated in the state, and will work to expand services. The state 

will also look to implement one to two additional CSC sites, and 

fully implement a Quality Assurance Database developed by the 

UNC OASIS (Outreach and Support Intervention Services) 

technical assistance program, which will be utilized by all FEP sites 

funded through the MHBG (Mental Health Block Grant).

North Dakota $87,958 The state is using the set-aside funds to identify and contract with a 

vendor for the implementation of CSC services.

Northern Mariana Islands $9,178 The Community Guidance Center is implementing a 

psychoeducation group in FY 2016 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.

Ohio $1,629,288 OhioMHAS is continuing to support existing programs that were 

funded under the 5% set-aside.

Oklahoma $543,405 Oklahoma is using MHBG set-aside funds to implement 

NAVIGATE and Transition to Independence (TIP) in five to six 

CMHCs in Oklahoma, Okmulgee, and Washington Counties by 

funding training, outreach activities and an employment/education 

coach. Will also be expanding to Tulsa area.

Oregon $672,682 Oregon is using the additional funds to initiate FEP services in the 

remaining ten counties that do not currently offer such services, 

provide additional support programs for psychosocial and 

community education.

Palau $5,000 One CSC team will be supported in a population area of roughly 

20,000 with 1% need annually.

Pennsylvania $1,799,735 Pennsylvania selected eight program sites for fiscal year 2016-

2017, including four new sites, increasing geographical coverage to 

each region of the state.
120

State 10% Set Aside Allotment Program Description

Puerto Rico $653,909 Puerto Rico is using the 10% set-aside of its MHBG for 

intervention in situations of First Episode Psychosis (FEP). Block 

grant funds will continue to support the development of the PORTI 

program in San Juan and replicated in Mayagüez for the fiscal year 

2016-2017 beginning in October 2016.

Rhode Island $186,254 Rhode Island is usingthe entire set-aside amount to serve 

individuals ages 16-25 experiencing a first episode of psychosis by 

enhancing the two existing treatment teams so that they will be able 

to serve an additional ten clients.

South Carolina $743,578 South Carolina is funding two programs, The existing, or 

Traditional Program, will be evaluated against the CSC Program in 

terms of clinical and social outcomes.

South Dakota $105,107 Southeastern Behavioral Health care (SEBHC) is receiving 

additional training and/or technical assistance to ensure proficiency 

in delivering FEP specialty services as well as fidelity to the 

OnTrackNY model. They will also research the possibility of 

adding another FEP program, including researching the need and 

financial viability of an additional program.

Tennessee $1,032,585 Tennessee is using the additional funds to expand OnTrackTN to 

two additional sites, create a statewide FEP learning collaborative 

consisting of all three sites, improve outcomes, provide rapid 

access to services including services that are linguistically and 

culturally competent, increase awareness and early detection, 

provide statewide training for providers and the community, and 

increase statewide capacity to provide FEP services.

Texas $4,092,545 Texas is in the process of expanding to eight additional locations in 

rural and urban areas across the state. These new sites will be able 

to serve both indigent and Medicaid eligible populations.

Utah $385,888 The additional funds is supporting two counties, Davis and Weber, 

to operate their FEP teams to fidelity.

Vermont $89,609 Vermont is continuing to partner with the Vermont Cooperative for 

Practice Improvement and Innovation to facilitate the initiative 

including targeted research, implementation, workforce 

development, outreach and education.

Virgin Islands $18,786 Virgin Islands is planning and designing an intervention program 

and securing the resources necessary to train staff and implement 

the program.

Virginia $1,157,845 Developing CSC sites through the state’s community service 

boards (CSBs). The existing programs will continue to receive 

training and technical assistance to strengthen their clinical service 

delivery skills and to ensure fidelity to the model.

Washington $1,160,642 The additional funds are supporting the startup of two Coordinated 

Specialty Care (CSC) teams and continuing the funding of the 

current, New Journeys Demonstration Project.. Washington is now 

implementing the NAVIGATE CSC Model.

West Virginia $290,608 West Virginia is continuing capacity development for CSC using 

the OnTrackNY model.

Wisconsin $844,055 Wisconsin is continuing to fund the CSC model PROPS program 

operated by JMHC and expand CSC programs by funding two to 

seven additional programs.

Wyoming $54,319 There are two programs being piloted in Wyoming to implement 

and provide FEP services.
121

Funding History

Fiscal Year Amount

FY 2009 420,774,000 

FY 2010 420,774,000 

FY 2011 419,933,000 

FY 2012 459,756,000 

FY 2013 436,809,376 

FY 2014 482,571,000 

FY 2015 482,571,000 

FY 2016 532,571,000 

FY 2017 531,599,000 

FY 2018 415,539,000 

Budget Request

The FY 2018 Budget Request is $415.5 million, a decrease of $116.1 million from the FY 2017 

Annualized CR. With this funding, SAMHSA will continue to address the needs of individuals 

with SMI and SED through the MHBG. SAMHSA will maintain the ten percent set-aside for 

evidence-based programs that address the needs of individuals with early serious mental illness, 

including psychotic disorders. The set-aside funds help reduce costs to society, as intervening 

early helps prevent deterioration of functioning in individuals experiencing a first episode of 

serious mental illness. With the decreased level of funding, state set-aside activities will be 

reduced along with a reduction in infrastructure activities for activities such as outpatient 

treatment, supported employment, housing services, and crisis counseling. 
122

Outputs and Outcomes Table

Program: Mental Health Block Grant

Note: SAMHSA makes grant awards toward the end of the year and therefore, bases the FY 2018 targets on the 

FY 2017 Annualized CR and the FY 2019 targets are based on the FY 2018 President’s Budget.

Measure

Year and Most Recent Result

Target for Recent Result

(Summary of Result)

FY 2018

Target

FY 2019

Target

FY 2019

Target

+/−

FY 2018

Target

2.3.11 Increase the number of 

evidence based practices (EBPs) 

implemented (Output)

FY 2015: 4.8 per State

Target: 4.8 per State

(Target Not Met but Improved)

4.5 per 

State

4.5 per 

State

Maintain

2.3.14 Increase the number of 

people served by the public mental 

health system (Output)

FY 2015: 7,448,380

Target: 8,249,930

(Target Not Met but Improved)

7,448,380 7,396,241 -52,139

2.3.15 Increase the rate of 

consumers (adults) reporting 

positively about outcomes 

(Outcome)

FY 2015: 72.3 %

Target: 71.8 %

(Target Exceeded)

71.8 % 71.8 % Maintain

2.3.16 Increase the rate of family 

members (children/adolescents) 

reporting positively about outcomes 

(Outcome)

FY 2015: 69.7 %

Target: 66.3 %

(Target Exceeded)

66.1 % 66.1 % Maintain

2.3.81 Increase the percentage of 

service population receiving any 

evidence based practice (Outcome)

FY 2015: 11.4 %

Target: 6.2 %

(Target Exceeded)

10.8 % 10.8 % Maintain
123

Department of Health and Human Services

Substance Abuse and Mental Health Services Administration

FY 2017 DISCRETIONARY STATE/FORMULA GRANTS

Community Mental Health Services Block Grant Program

CFDA #93.958 

State/Territory

FY 2016 

Final

FY 2017 

Annualized 

CR

FY 2018 

President's 

Budget

FY 2018

+/−

FY 2017

Alabama $7,351,221 $7,338,061 $5,788,356 −1,549,705

Alaska 972,230 1,068,158 834,064 −234,094

Arizona 11,639,880 12,202,879 9,778,695 −2,424,184

Arkansas 4,483,965 4,549,014 3,602,265 −946,749

California 69,180,482 70,093,153 55,322,680 −14,770,473

Colorado 8,482,852 8,357,605 6,696,058 −1,661,547

Connecticut 5,237,154 5,289,593 4,169,782 −1,119,811

Delaware 1,417,398 1,521,362 1,205,530 −315,832

District Of Columbia 1,057,109 1,155,933 934,922 −221,011

Florida 33,793,628 34,686,212 27,798,833 −6,887,379

Georgia 17,179,928 16,651,002 13,262,496 −3,388,506

Hawaii 2,636,917 2,818,497 2,236,821 −581,676

Idaho 2,378,674 2,431,683 1,934,130 −497,553

Illinois 19,839,321 19,397,263 15,176,612 -4,220,651

Indiana 9,110,702 9,007,052 7,077,625 −1,929,427

Iowa 4,067,863 4,043,482 3,180,786 −862,696

Kansas 3,771,945 3,804,500 2,999,642 −804,858

Kentucky 6,628,893 6,576,470 5,174,065 −1,402,405

Louisiana 6,183,159 6,170,251 4,977,695 −1,192,556

Maine 2,009,425 2,024,283 1,599,475 −424,808

Maryland 8,532,072 8,626,658 6,849,038 −1,777,620

Massachusetts 10,493,458 10,051,034 7,929,569 −2,121,465

Michigan 16,018,438 15,597,185 12,214,458 −3,382,727

Minnesota 7,862,764 7,537,088 5,919,589 −1,617,499

Mississippi 4,674,359 4,615,012 3,630,976 −984,036

Missouri 8,562,000 8,457,358 6,658,176 −1,799,182

Montana 1,497,654 1,542,944 1,220,302 −322,642

Nebraska 2,325,306 2,333,088 1,844,851 −488,237

Nevada 5,075,524 5,385,069 4,324,301 −1,060,768

New Hampshire 1,808,281 1,810,249 1,430,470 −379,779
124

Department of Health and Human Services

Substance Abuse and Mental Health Services Administration

FY 2017 DISCRETIONARY STATE/FORMULA GRANTS

Community Mental Health Services Block Grant Program

CFDA #93.958 

State/Territory

FY 2016 

Final

FY 2017 

Annualized 

CR

FY 2018 

President's 

Budget

FY 2018

+/−

FY 2017

New Jersey 14,331,474 13,966,123 11,036,215 −2,929,908

New Mexico 2,995,653 3,074,426 2,401,898 -672,528

New York 32,425,192 31,313,707 24,496,970 −6,816,737

North Carolina 14,308,507 14,319,694 11,430,055 −2,889,639

North Dakota 879,581 887,838 651,646 −236,192

Ohio 16,292,879 15,867,498 12,772,348 −3,095,150

Oklahoma 5,434,052 5,473,044 4,257,666 −1,215,378

Oregon 6,726,815 6,872,776 5,611,552 −1,261,224

Pennsylvania 17,997,348 17,728,079 13,833,367 −3,894,712

Rhode Island 1,862,535 1,853,017 1,457,937 −395,080

South Carolina 7,435,778 7,481,490 5,966,267 −1,515,223

South Dakota 1,051,067 1,081,348 856,388 −224,960

Tennessee 10,325,846 10,291,957 8,117,196 −2,174,761

Texas 40,925,451 41,075,077 32,818,255 −8,256,822

Utah 3,858,877 3,965,020 3,179,640 −785,380

Vermont 896,094 903,361 710,303 −193,058

Virginia 11,578,454 11,223,456 8,937,722 −2,285,734

Washington 11,606,420 11,885,963 9,495,810 −2,390,153

West Virginia 2,906,084 2,883,716 2,235,643 −648,073

Wisconsin 8,440,552 8,251,416 6,473,906 −1,777,510

Wyoming 543,194 606,798 477,800 −128,998

American Samoa 98,148 98,155 77,753 −20,402

Guam 287,665 289,873 231,480 −58,393

Northern Marianas 91,782 92,692 74,893 −17,799

Puerto Rico 6,539,088 6,519,207 5,148,482 −1,370,725

Palau 50,000 50,000 50,000 ---

Marshall Islands 125,103 127,801 103,290 −24,511

Micronesia 190,316 190,272 150,542 −39,730

Virgin Islands 187,864 187,552 148,192 −39,360

Territory Subtotal 7,569,966 7,555,552 5,984,632 −1,570,920
125

SAMHSA

Substance Abuse Prevention

Table of Contents 

1. Substance Abuse Prevention Appropriation ......................................................................... 127

2. Programs of Regional and National Significance (PRNS)................................................... 128

a) Strategic Prevention Framework..................................................................................... 129 

b) Federal Drug-Free Workplace ........................................................................................ 134 

c) Minority AIDS ................................................................................................................ 136 

d) Sober Truth on Preventing Underage Drinking Act (Stop Act) ..................................... 140 

e) Center for the Application of Prevention Technologies ................................................. 143 

f) Science and Service Program Coordination ................................................................... 146

g) Tribal Behavioral Health Grants..................................................................................... 147 

h) Grants to Prevent Prescription Drug/Opioid Overdose Related Deaths ......................... 150 

i) First Responder Training (Comprehensive Addition and Recovery Act (CARA))........ 152 

j) Minority Fellowship Program......................................................................................... 153 

3. PRNS Mechanism Table Summary ...................................................................................... 156 

4. PRNS Mechanism Table by Program, Project, and Activity................................................ 157 

5. Grant Awards Table.............................................................................................................. 160 
126

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127

Substance Abuse Prevention Appropriation

(Dollars in thousands)

Program Activities

FY 2016 

Final

FY 2017 

Annualized 

CR

FY 2018 

President's 

Budget

FY 2018 

+/− 

FY 2017

Programs of Regional and National Significance $211,219 $222,817 $149,703 −$73,114

Total, Substance Abuse Prevention $211,219 $222,817 $149,703 −$73,114

The FY 2018 Budget Request is $149.7 million, a decrease of $73.1 million from the FY 2017

Annualized CR. 
128

Programs of Regional and National Significance (PRNS) 

Substance Abuse Prevention Appropriation 

(Dollars in thousands)

Programs of Regional & National Significance

FY 2016 

Final 

FY 2017 

Annualized 

CR

FY 2018 

President's 

Budget

FY 2018 

+/−

FY 2017

Capacity:

Strategic Prevention Framework $119,484 $119,257 $58,427 −$60,830

Strategic Prevention Framework Rx (non-add) 10,000 9,981 10,000

Federal Drug-Free Workplace 4,894 4,885 4,885 ---

First Responder Training --- 12,000 12,000 ---

Minority AIDS 41,205 41,127 28,843 −$12,284

Sober Truth on Preventing Underage Drinking Act (Stop Act) 7,000 6,986 6,986 ---

Grants to Prevent Prescription Drug/Opioid Overdose 

Related Deaths 12,000 11,977 11,977 ---

Tribal Behavioral Health Grants 15,000 14,971 14,971 ---

Subtotal, Capacity 199,583 211,203 138,089 −$73,114

Science and Service:

Center for the Application of Prevention Technologies 7,493 7,479 7,479 ---

SAP Minority Fellowship Program 71 71 71 ---

Science and Service Program Coordination 4,072 4,064 4,064 ---

Subtotal, Science and Service 11,636 11,614 11,614 ---

Total, PRNS $211,219 $222,817 $149,703 −$73,114

Authorizing Legislation ....................................................................... Sections 516 of the PHS Act

FY 2018 Authorization .......................................................................................................$211,148 

Allocation Method .................................... Competitive Grants/Cooperative Agreements/Contracts

Eligible Entities............................................................States, political subdivisions of 

States, Federally Recognized 

 American Indian/Alaska Native tribe or tribal organizations, 

 Indian Health Service-operated and contracted health facilities 

and programs, public or private nonprofit entities 
129

Strategic Prevention Framework 

(Dollars in thousands)

Programs of Regional & National Significance

FY 2016 

Final 

FY 2017 

Annualized 

CR

FY 2018 

President's 

Budget

 FY 

2018 

+/− 

FY 2017

Strategic Prevention Framework $119,484 $119,257 $58,427 −$60,830

Strategic Prevention Framework Rx (non-add) 10,000 9,981 10,000 ---

Authorizing Legislation ........................................................................ Section 516 of the PHS Act 

Allocation Method .................................... Competitive Grants/Cooperative Agreements/Contracts

Eligible Entities .................................................................................. States, Tribes, and Territories 

Program Description and Accomplishments

Strategic Prevention Framework (SPF)

Drug and alcohol use are significant public health problems. Youth and adolescents who use 

alcohol and drugs face an increased risk of poor school performance, criminal justice involvement, 

the development of a drug/alcohol addiction, risky sexual behavior, illnesses such as HIV and 

hepatitis, depression and anxiety, and injury and death. The immediate and long-term risks and 

negative outcomes associated with adolescent drug and alcohol use underscore the need for 

effective prevention and treatment programs. 

Youth and adolescents use a variety of substances. In 2015, 27.1 million people aged 12 or older 

used an illicit drug in the past 30 days, which corresponds to about 1 in 10 Americans (10.1 

percent). The illicit drug use estimate for 2015 continues to be driven primarily by marijuana use 

and the misuse of prescription pain relievers, with 22.2 million individuals who currently use 

marijuana aged 12 or older (i.e., past 30 day use) and 3.8 million people aged 12 or older who 

reported current misuse of prescription pain relievers. The 2015 estimate of current marijuana use

was similar to the estimate in 2014; but it was higher than the estimates from 2002 to 2013. This 

increase in marijuana use among people aged 12 or older reflects the increase in marijuana use by 

adults aged 26 or older and, to a lesser extent, the increase in marijuana use among young adults 

aged 18 to 25. 

The Strategic Prevention Framework – Partnerships for Success program addresses underage 

drinking among youth and young adults age 12 to 20 and allows states to prioritize their top data 

driven substance abuse target areas such as marijuana and cocaine. 

Data show that states and communities receiving Partnerships for Success funding have made 

improvements in reducing the impact of substance abuse. The 2015 National Survey on Drug Use 

and Health (NSDUH) report shows that underage alcohol use (i.e., people aged 12 to 20) and binge 

and heavy drinking use among young adults aged 18 to 25, have declined over time but remain a 

concern. In 2015, 20.3 percent of underage people reported current use of alcohol, 13.4 percent 

reported binge drinking, and 3.3 percent reported heavy alcohol use. The binge-drinking rate 

declined from 14.2 percent to 13.4 percent, and the rate of heavy drinking declined from 3.7 
130

percent to 3.3 percent.24 In 2015, 7.0 percent of adolescents aged 12 to 17 were currently using 

marijuana. This means that approximately 1.8 million adolescents used marijuana in the past

month. The percentage of adolescents in 2015 who currently used marijuana was similar to the

percentages in most years between 2004 and 2014. 25

The correlation between perceived risk and substance use informed the design and implementation 

of SAMHSA’s FY 2016 Partnerships For Success program. In 2016, the program addressed

underage drinking and prescription drug misuse among youth and young adults and encouraged 

grantees to address issues related to marijuana and heroin use. 

The cross-site evaluation for the Partnerships For Success program will address the following 

questions: 

1) Was the implementation of Partnerships for Success program associated with a reduction

in underage drinking and/or prescription drug misuse?

2) Did variability in the total level of funding from all sources relate to outcomes? Did

variability in the total level of Partnerships for Success funding relate to outcomes, above

and beyond other funding available to communities?

3) What intervention type, combinations of interventions, and dosages of interventions were

related to outcomes at the grantee level? What intervention type, combinations of

interventions, and dosages of interventions were related to outcomes at the community

level?

4) Were some types and combinations of interventions within communities more costeffective than other interventions?

5) How does variability in factors (strategy selection and implementation, infrastructure,

geography, demography, sub-recipient selection, Training/Technical Assistance, barriers

to implementation) relate to outcomes across funded communities?

In FY 2016, SAMHSA funded one new Strategic Prevention Framework grant cohort and 65 grant 

continuations. In FY 2017, SAMHSA plans to support 66 Strategic Prevention Framework grant 

continuations. 

Strategic Prevention Framework for Prescription Drugs (SPF Rx) 

Drug overdose death rates have increased five-fold since 1980.26 Since 2000, the drug overdose 

death rates have continued to increase and have more than doubled.27 In 2009, drug overdose 

deaths outnumbered deaths due to motor vehicle crashes for the first time. In the U.S., misuse of 

prescription drugs, including opioid-analgesic pain relievers, is responsible for much of the 

24 Substance Abuse and Mental Health Services Administration, Results from the 2013 National

Survey on Drug Use and Health: Summary of National Findings, NSDUH Series H-48, HHS Publication No. (SMA) 

14-4863. Rockville, MD: Substance Abuse and Mental Health Services Administration, 2014. 25https://www.samhsa.gov/data/sites/default/files/NSDUH-FFR1-2015/NSDUH-FFR1-2015/NSDUH-FFR1-

2015.pdf

26 Warner M, Chen LH, Makuc DM, Anderson RN, Miniño AM. Drug poisoning deaths in the United States, 1980–

2008. NCHS data brief, no 81. Hyattsville, MD: National Center for Health Statistics. 2011.

27 Centers for Disease Control and Prevention. NCHS Data on Drug Poisoning Deaths. NCHS Fact Sheet. June

2015. Hyattsville, MD: National Center for Health Statistics. 2015. Available at

http://www.cdc.gov/nchs/data/factsheets/factsheet_drug_poisoning.pdf.
131

recent increase in drug-poisoning deaths.1 Opioid painkillers

Opioids(https://www.cdc.gov/drugoverdose/opioids/index.html) (including prescription 

opioids(https://www.cdc.gov/drugoverdose/opioids/prescribed.html) and 

heroin(https://www.cdc.gov/drugoverdose/opioids/heroin.html)) killed more than 33,000 people 

in 2015, more than any year on record. Nearly half of all opioid overdose deaths involve a 

prescription opioid.2

Funding for SAMHSA and the Centers for Disease Control and Prevention (CDC) in FY 2016 was 

part of a strategic effort to address non-medical use of prescription drugs as well as opioid 

overdoses. Leveraging the strengths and capabilities of each agency, SAMHSA and CDC 

partnered to ensure alignment with HHS’s policy and plan for prevention of opioid-related 

overdoses and deaths involving multiple operating divisions and offices. CDC provided funding 

to states to address opioid prescribing on multiple fronts, and SAMHSA provided funding to states 

for the prevention of prescription drug misuse in high priority age groups (including young and 

middle-aged adults) and the public through the Strategic Prevention Framework – Partnerships for 

Success program. 

In FY 2016, SAMHSA implemented the Strategic Prevention Framework for Prescription Drugs 

to raise awareness about the dangers of sharing medications and to work with pharmaceutical and 

medical communities on the risks of overprescribing to young adults. SAMHSA’s program 

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 Program 

(PDMP) data into needs assessments and strategic plans as indicators of program success. 

SAMHSA awarded 25 grants in FY 2016. In FY 2017 and FY 2018, SAMHSA will support 

25 grant continuations. 

Funding History

Fiscal Year Amount

FY 2014 $109,484,000 

FY 2015 $109,484,000

FY 2016 $119,484,000

FY 2017 $119,257,000

FY 2018 $58,427,000

Budget Request 

The FY 2018 Budget Request is $58.4 million, a decrease of $60.8 million from the FY 2017 

Annualized CR. Funding for the SPF Rx program will be maintained in its entirety ($10.0M). 

Funding will support 25 Strategic Prevention Framework for Prescription Drugs continuation 

1 Paulozzi LJ. Prescription drug overdoses: A review. J. Safety Res 43(4):283–9. 2012. 2 Centers for Disease Control and Prevention. Hyattsville, MD: National Center for Health Statistics. 2015. 

Available at https://www.cdc.gov/drugoverdose/
132

and overdose prevention efforts, in conjunction with other state and local partners. In FY 2018, in 

order to ensure that every state receives SPF funding, a new cohort of PFS grants will be awarded 

to focus on underage drinking and two other substances including but not limited to marijuana and 

cocaine. Additionally, SAMHSA will also support the continuation at a significantly reduced rate 

of 49 Strategic Prevention Framework - Partnerships For Success grants to decrease the impact of 

underage drinking and prescription drug misuse while lessening the progression of emergent issues 

such as heroin and marijuana use. 

Outputs and Outcomes Table

Program: Partnerships for Success

NOTE: SAMHSA makes grant awards toward the end of the year and therefore, bases the 

FY 2018 targets on the FY 2017 Annualized CR and the FY 2019 targets are based on the 

FY 2018 President’s Budget.

Measure

Year and Most Recent Result 

Target for Recent Result 

(Summary of Result)

FY 2018 

Target

FY 2019 

Target

FY 2018

Target

+/−

FY 2017

Target

2.3.79 Increase the number of 

EBPs implemented by subrecipient communities (Output)

FY 2015: 300

Target: 950

(Target Not Met but Improved)

300 300 Maintain

2.3.80 Increase the number of subrecipient communities that 

improved on one or more targeted 

NOMs indicators (Outcome)

FY 2015: 301

Target: 50

(Target Exceeded)

200 200 Maintain
133

Outputs and Outcomes Table

Program: Strategic Prevention Framework Rx

NOTE: SAMHSA makes grant awards toward the end of the year and therefore, bases the FY 2018 

targets on the FY 2017 Annualized CR and the FY 2019 targets are based on the FY 2018 President’s 

Budget. 

Measure

Year and Most Recent 

Result

Target for Recent Result

(Summary of Result)

FY 2018

Target

FY 2019

Target

FY 2019

Target

+/−

FY 2018

Target

3.3.11 Increase the percent of funded 

states that incorporate PDMP data into 

their needs assessments in developing 

their strategic plans (Outcome)

FY 2016: Result Expected 

August 31, 2017

Target: 100 %

(Pending)

100 % 100 % Maintain

3.3.12 Increase the percent of funded 

states reporting reductions in opioid 

overdoses (Outcome)

FY 2016: Result Expected 

August 31, 2017

Target: 55 %

(Pending)

55 % 55 % Maintain
134 

Federal Drug-Free Workplace

(Dollars in thousands)

Programs of Regional & National Significance

FY 

2016 

Final 

FY 2017 

Annualized 

CR

FY 2018 

President's 

Budget

 FY 

2018 

+/− 

FY 2017

Federal Drug-Free Workplace $4,894 $4,885 $4,885 $---

Authorizing Legislation ........................................................................ Section 516 of the PHS Act 

Allocation Method .................................................................. Inter-Agency Agreements/Contracts

Eligible Entities ...................................................................... Federal Agencies, Regulated Entities 

(e.g., Department of Transportation, Nuclear Regulatory Commission), 

HHS- Certified Laboratories

Program Descriptions and Accomplishments

Alcohol and other drug use are widespread and have a variety of negative consequences, 

particularly in the workplace. Employers with successful drug-free workplace programs report 

decreases in absenteeism, accidents, downtime, turnover, and theft; increases in productivity; and 

overall improved morale. They also report better health status among many employees and family 

members and decreased use of medical benefits. Some organizations with drug-free workplace 

programs qualify for incentives, for example, decreased premium costs for certain kinds of 

insurance, such as Workers’ Compensation. 

In 1986, the President signed an Executive Order mandating that all Federal agencies be drug-free. 

In 1988, Congress passed the Drug-Free Workplace Act.

The Federal Drug-Free Workplace Programs (DFWP) ensure employees in national security, 

public health, and public safety positions are tested for the use of illegal drugs and the misuse of 

prescription drugs and ensure the laboratories that perform this drug testing are inspected and 

certified by HHS. Through this program, the federal government is able to avoid lost productivity 

and reduce absenteeism, injuries, and fatalities. 

SAMHSA implements the Federal Drug-Free Workplace Programs, which consist of two principal 

activities mandated by Executive Order (E.O.) 12564 and Public Law (P.L.) 100-71. These 

include: 1) oversight of the Federal Drug-Free Workplace Programs, aimed at the elimination of 

the use of illegal drugs and the misuse of prescription drugs within Executive Branch agencies and 

the federally-regulated industries, and 2) oversight of the National Laboratory Certification 

Program (NLCP), which certifies laboratories to conduct forensic drug testing for federal agencies 

and federally-regulated industries; the private sector also uses the HHS-Certified Laboratories. 

First signed on September 15, 1986, E.O. 12564 requires the head of each executive agency to 

establish a comprehensive Drug-Free Workplace Plan that includes supervisor/employee 

education, an employee assistance program, and a random testing component to test the use of 

illegal substances and the misuse of prescription drugs by federal employees in safety-sensitive 

positions. 
135

The Supplemental Appropriations Act, 1987 (Public Law 100-71) included language which 

requires HHS to: 1) certify that each Executive Branch agency has developed a plan for achieving

a drug-free workplace, and 2) publish mandatory guidelines that establish comprehensive 

standards for laboratory drug testing procedures, specify the drugs for which federal employees 

may be tested, and establish standards and procedures for periodic review and certification of 

laboratories to perform drug testing for federal agencies. 

Since FY 2014, SAMHSA has funded the Drug-Free Workplace drug testing activities. These 

activities will continue in FY 2018 under the NLCP contract. The NLCP oversees the certification 

of the labs that perform drug testing under the Drug-Free Workplace Programs. The Drug Testing 

Advisory Board (DTAB) provides recommendations to the Assistant Secretary for Mental Health 

and Substance Use based on an ongoing review of the direction, scope, balance, and emphasis of 

SAMHSA’s drug testing activities and the NLCP. On January 10, 2012, SAMHSA approved the 

DTAB’s recommendations to revise the mandatory guidelines to include oral fluid as an alternative 

specimen to urine as well as include additional Schedule II prescription drug medications 

(e.g., oxycodone, oxymorphone, hydrocodone and hydromorphone). On August 7, 2015, 

SAMHSA approved the DTAB’s recommendations to pursue hair as an alternative specimen in 

the Mandatory Guidelines for Federal Workplace Drug Testing Programs. CSAP’s Workplace 

Helpline supports the drug-free workplace program. The helpline is a toll-free telephone service 

(800-WORKPLACE) that answers questions from the public and private sectors about drug testing 

in the workplace. 

Continued funding for the Federal Drug-Free Workplace Programs has ensured the testing of 

federal employees in national security, public health, and public safety positions for the use of 

illegal drugs, the misuse of prescription drugs, and the inspection certification of HHS-certified 

laboratories for the past four years. 

Funding History

Fiscal Year Amount

FY 2014 $4,894,000 

FY 2015 $4,894,000 

FY 2016 $4,894,000 

FY 2017 $4,885,000

FY 2018 $4,885,000

Budget Request

The FY 2018 Budget Request is $4.9 million, level with the FY 2017 Annualized CR. In FY 2018, 

SAMHSA will continue oversight of the Executive Branch Agencies’ Federal Drug-Free 

Workplace Programs. This includes review of Federal Drug-Free Workplace plans from those 

federal agencies that perform federal employee testing, random testing of those designed testing 

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

the misuse of prescription drugs. SAMHSA will continue its oversight role for the inspection and 

certification of the HHS-certified laboratories. 
136

SAMHSA will continue/add the below items to its drug testing portfolio: 

• DTAB continued evaluation of the scientific supportability of hair as an alternative

specimen to urine and oral fluids in the Mandatory Guidelines for Federal Workplace Drug

Testing Programs;

• Continued use of subject matter experts and partnering with other federal agencies to

establish the scientific standards set out in the mandatory guidelines;

• Implementation of the final Urine Specimen Mandatory Guidelines;

• Continued development of the final Oral Fluid Specimen Mandatory Guidelines and

provide technical assistance on implementation;

• Research of alternative specimens for scientific supportability and inclusion in the

Mandatory Guidelines;

• Technical and scientific leadership for federal agencies on marijuana testing; and

• Updates to the DFWP website.

Minority AIDS

(Dollars in thousands)

Programs of Regional & National Significance

FY 

2016 

Final 

FY 2017 

Annualized 

CR

FY 2018 

President's 

Budget

FY 2018 

+/− 

FY 2017

Minority AIDS $41,205 $41,127 $28,843 −$12,284

Authorizing Legislation ........................................................................ Section 516 of the PHS Act 

Allocation Method .................................... Competitive Grants/Cooperative Agreements/Contracts

Eligible Entities ................................ Local Government Entities, Community-based Organization, 

Minority Serving Institutions,

and Institutions of Higher Education 

Program Description and Accomplishments

The update to the 2010 National HIV/AIDS Strategy for the United States reports that there is still 

an HIV epidemic, which remains a major health issue for the United States. It also notes that 

people across the nation deserve access to tools and education to prevent HIV transmission.30 In 

1995, 44 percent of the public indicated that HIV/AIDS was the most urgent health problem facing 

the U.S., compared to only six percent in 2009. Approximately 50,000 people become infected 

each year. In addition, because HIV and viral hepatitis share common modes of transmission, one 

third of HIV infected individuals are also infected with hepatitis C.31

The Minority AIDS program supports activities that assist grantees in building a solid foundation 

for delivering and sustaining quality and accessible state-of-the-science substance misuse and HIV 

prevention services. The program aims to engage community-level domestic public and private 

non-profit entities, tribes, and tribal organizations in order to prevent and reduce the onset of 

substance misuse and transmission of HIV/AIDS among at-risk populations, including 

30 National HIV/AIDS Strategy for the United States: Update to 2020

31 Action Plan for the Prevention, Care and Treatment of Viral Hepatitis, 

http://www.hhs.gov/ash/initiatives/hepatitis/
137

racial/ethnic minority youth and young adults, ages 13 to 24. SAMHSA works with college and 

university clinics/wellness centers and community-based providers that can provide 

comprehensive substance abuse and HIV prevention strategies. These strategies combine 

education and awareness programs, social marketing campaigns, and HIV and viral hepatitis 

testing services in non-traditional settings with substance misuse and HIV prevention 

programming for the population of focus. Because of the high rate of HIV/AIDS and hepatitis comorbidity, this program includes viral hepatitis prevention and education training. 

SAMHSA helps to prevent HIV and hepatitis infection acquired through substance abuse and other 

means. SAMHSA’s Minority AIDS programs address incidence, care, disparities and 

coordination, and provide counseling to reduce risk. The program emphasizes that all grantees 

must be prepared to serve the community in which they are located. The Capacity-Building 

Initiative (CBI) supports grantees in building a solid foundation for delivering evidence-based 

substance misuse and HIV prevention services. The program aims to engage community 

organizations, tribes, and tribal organizations to prevent and reduce the onset of substance use and 

the transmission of HIV/AIDS among at-risk individuals, including, racial/ethnic minority youth 

and young adults, ages 13 to 24. SAMHSA’s Minority Serving Institutions (MSI) in Partnerships 

with Community-Based Organizations (MSI CBO) program supports grants to MSIs. The MSI 

CBO program focuses on preventing and reducing substance use and the transmission of 

HIV/AIDS and hepatitis C virus infections among minority young adults ages 18 to 24 on campus 

and in the surrounding communities. 

In the FY2015 MAI report, significant improvements were observed between participants’ 

baseline and exit knowledge and attitudes associated with SA and HIV transmission: 

25 percent increase in perceived risk of harm from binge drinking; 

43 percent increase in perceived risk of harm from weekly marijuana use; 

4 percent increase in perceived risk of harm from sharing unsanitized needles; 

15 percent increase in perceived risk of harm from unprotected anal sex (adult participants); 

23 percent increase in perceived risk of harm from unprotected oral sex (adult participants); 

18 percent increase in perceived risk of harm from unprotected vaginal sex (adult participants 

In FY 2014, SAMHSA’s Centers for Mental Health Services, Substance Abuse Prevention, and 

Substance Abuse Treatment supported the Minority AIDS Continuum of Care pilot. The Minority 

AIDS Continuum of Care program supports mental illness and drug/alcohol addiction screening, 

primary prevention, and treatment for racial/ethnic minority populations with or at high risk for 

mental illness and drug/alcohol addiction and HIV/AIDS. Minority AIDS Continuum of Care 

grants support substance abuse treatment, primary prevention/treatment service programs, 

community mental health programs, and HIV/AIDS integrated programs that either can co-locate 

or have fully integrated HIV/AIDS prevention and medical care services. This program also 

provides primary prevention services for substance abuse and HIV/AIDS in local communities 

served by behavioral health programs. In addition, approximately 20 percent and 23 percent of 

those with Serious Mental Illness such as schizophrenia, bipolar disorder, and major depression 

are infected with hepatitis C virus and hepatitis B virus, respectively, while 
138

between 14 percent and 36 percent of those who misuse alcohol are infected with the hepatitis C 

virus.32,33 

SAMHSA supports a consolidated evaluation of its HIV/AIDS programs. This comprehensive 

process and outcome evaluation will assess the degree to which SAMHSA is providing effective 

and efficient mental illness and substance abuse treatment services and prevention programs to 

those with and at risk of HIV/AIDS. The evaluation results will help inform program development 

and refine the approach used in SAMHSA’s HIV portfolio. 

Under the FY 2017 Annualized CR, SAMHSA will fund an additional 14 new grants under the 

Prevention Navigator program. These funds support an array of activities to assist grantees in 

building a solid foundation for delivering and sustaining quality and accessible state of the science 

substance use and HIV prevention services. In addition to new grant awards, SAMHSA will also 

support 145 grant continuations as well as grant technical assistance and evaluation efforts. 

Funding History

Fiscal Year Amount

FY 2014 $41,205,000 

FY 2015 $41,205,000 

FY 2016 $41,205,000 

FY 2017 $41,127,000 

FY 2018 $28,843,000 

Budget Request 

The FY 2018 Budget Request of $28.8 million, a decrease of $12.3 million from the FY 2017 

Annualized CR. New MAI CoC grants will not be awarded and CBI will be phased out in order 

to reduce duplication and target funding most effectively in SAMHSA’s Prevention Navigator and 

MSI/CBO programs. SAMHSA will support up to 73 grant continuations to assist grantees in 

building a solid foundation for delivering integrated evidence-based substance use, HIV and viral 

hepatitis prevention services that are in alignment with the National HIV/AIDS Strategy. These 

funds continue to address a critical public health problem and provide lifesaving prevention 

services, including testing for HIV. 

32 Bhattacharya R, Shuhart MC. Hepatitis C and alcohol: interactions, outcomes, and implications. J Clin 

Gastroenterol. 2003;36(3):242-52. 33 Rosenberg et al. Prevalence of HIV, Hepatitis B, and Hepatitis C in People With Severe Mental Illness. Am J Public 

Health. 2001;91:(31–37).
139

Outputs and Outcomes Table

Program: Minority AIDS 

NOTE: SAMHSA makes grant awards toward the end of the year and therefore, bases the FY 2018

targets on the FY 2017 Annualized CR and the FY 2019 targets are based on the FY 2018 

President’s Budget.

Measure

Year and Most Recent Result

Target for Recent Result

(Summary of Result)

FY 2018

Target

FY 2019

Target

FY 2019

Target

+/−

FY 2018

Target

2.3.56 Increase the number of program 

participants exposed to substance abuse 

prevention education services (Output)

FY 2015: 3,944

Target: 3,000

(Target Exceeded)

2,580 2,580 Maintain

2.3.83 Increase the percent of program 

participants who report no use of 

alcohol at pre-test who remain nonusers at post-test (all ages) (Outcome)

FY 2015: 89.4 %

Target: 91.2 %

(Target Not Met but Improved)

85.7 % 85.7 % Maintain

2.3.85a Increase the number of persons 

tested for HIV through the Minority 

AIDS Initiative prevention activities 

(Outcome)

FY 2015: 27,731

Target: 11,066

(Target Exceeded)

21,137 21,137 Maintain
140

Sober Truth on Preventing Underage Drinking Act (STOP Act)

(Dollars in thousands)

Programs of Regional & National Significance

FY 2016 

Final 

FY 2017 

Annualized 

CR

FY 2018 

President's 

Budget

FY 2018 

+/− 

FY 2017

Sober Truth on Preventing Underage Drinking Act

(STOP Act) $7,000 $6,986 $6,986 $---

Authorizing Legislation ......................................................................Section 519B of the PHS Act 

FY 2018 Authorization ...........................................................................................................$6,000 

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

Eligible EntitiesCurrent and former Drug-Free Communities

grantees .............................................................................................................................................. 

Program Description and Accomplishments

Underage drinking continues to be a national concern. It disrupts the lives of individuals and 

families and imposes great costs on communities. Alcohol-related consequences include 

impairments in cognitive abilities (e.g., decision-making and impulse control) and motor skills 

(e.g., balance and hand-eye coordination), death, injury, physical and sexual assault, unsafe sex, 

health problems, suicide attempts, memory loss, and more.34 Those who report being intoxicated 

at least once a week have a higher likelihood of becoming injured and needing medical treatment, 

causing injury in traffic crashes, and being taken advantage of sexually.35 Twenty-five percent of 

college students report academic consequences of their drinking, including missing class, falling 

behind in class, doing poorly on exams, and receiving lower grades overall.36 

The Sober Truth on Preventing Underage Drinking Act (STOP Act) of 2006 (Public Law 

109 - 422) was the nation’s first comprehensive legislation on underage drinking. One of the 

primary components of the STOP Act is the community-based coalition enhancement grant 

program, which provides up to $50,000 per year over four years to current or former grantees under 

the Drug Free Communities Act of 1997 to prevent and reduce alcohol use among youth under the 

age of 21. The STOP Act grant program enables organizations to strengthen collaboration and 

coordination among stakeholders to achieve a reduction in underage drinking in their communities. 

Strong prevention efforts are necessary to continue to address underage drinking. These efforts 

have proven effective. Over the past decade, a large number of evaluation studies have 

demonstrated the far-reaching effects of prevention interventions in reducing alcohol, tobacco, and 

other drug abuse as well as delinquent behaviors; violence; and other mental, emotional, and 

behavioral health problems.37 

34 Chaloupka, Grossman, & Saffer, 2002; O'Brien et al., 2013; A. White & Hingson, 2013. 35 A. White & Hingson, 2013. 36 A. White & Hingson, 2013. 37 e.g., Calear & Christensen, 2010; Lemstra et al., 2010; Ttofi & Farrington, 2011.
141

In 2015, there were 138.3 million Americans aged 12 or older who reported current use of alcohol, 

including 66.7 million who reported binge alcohol use in the past month and 17.3 million who 

reported heavy alcohol use in the past month. Individuals with past month binge drinking and 

heavy alcohol use represented 24.9 and 6.5 percent of people aged 12 or older, respectively. 

In both FY 2011 and FY 2012, SAMHSA conducted program evaluations of the STOP Act grant 

program. The findings indicated that the program is accomplishing its intended goal of enhancing 

underage drinking prevention efforts in coalition communities around the country. In mid-2014, 

SAMHSA began conducting a retrospective national cross-site evaluation of the STOP Act grant 

program. SAMHSA awarded 97 grant continuations in FY 2015 and awarded 81 new STOP Act 

grants and 17 continuations in FY 2016. In FY 2017, SAMHSA will continue these grants. 

Funding History 

Fiscal Year Amount

FY 2014 $6,983,000 

FY 2015 $7,000,000

FY 2016 $7,000,000

FY 2017 $6,986,000

FY 2018 $6,986,000

Budget Request 

The FY 2018 Budget Request of $7.0 million, level with the FY 2017 Annualized CR. In 

FY 2018, SAMHSA will support 95 STOP Act grant continuations. This funding will continue to 

strengthen SAMHSA’s commitment to reduce and prevent underage drinking. 
142

Outputs and Outcomes Table

Program: Sober Truth on Preventing Underage Drinking (STOP Act)

NOTE: SAMHSA makes grant awards toward the end of the year and therefore, bases the 

FY 2018 targets on the FY 2017 Annualized CR and the FY 2019 targets are based on the FY 

2018 President’s Budget.

Measure

3.3.01 Increase the percent of 

coalitions that report at least 5% 

improvement in the past 30-day use 

of alcohol in at least two grades 

(Outcome)

Year and Most Recent Result

Target for Recent Result

(Summary of Result)

FY 2015: 81.8 %

Target: 62 % 

(Target Exceeded)

FY 2018

Target

FY 2019

Target

FY 2019

Target

+/- 

FY 2018

Target

45 % 45 % Maintain

3.3.02 Increase the percent of 

coalitions that report improvement in 

youth perception of risk from alcohol 

in at least two grades (Outcome)

FY 2015: 50 %

Target: 68% 

(Target Not Met)

45 % 45 % Maintain
143

Center for the Application of Prevention Technologies

(Dollars in thousands) 

Programs of Regional & National Significance

FY 2016 

Final 

FY 2017 

Annualized 

CR

FY 2018 

President's 

Budget

FY 

2018 

+/− 

FY 2017

Center for the Application of Prevention Technologies $7,493 $7,479 $7,479 $---

Authorizing Legislation ........................................................................ Section 516 of the PHS Act 

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

Eligible Entities ................................................................................... Domestic and Public Entities

Program Description and Accomplishments

SAMHSA’s Center for the Application of Prevention Technologies (CAPT) program provides 

state-of-the-art training and technical assistance to build the capacity of SAMHSA grantees and 

develop the skills, knowledge, and expertise of the prevention workforce. The program builds 

capacity and promotes the development of substance abuse prevention professionals in the 

behavioral health field through three core strategies: 1) establishing technical assistance networks 

using local experts; 2) developing and delivering targeted training and technical assistance 

activities; and 3) using communication media such as teleconference and video conferencing, 

online events, and web-based support. These activities help ensure the delivery of effective 

prevention programs and practices and the development of accountability systems for performance 

measurement and management. 

During FY 2013, the program completed a comprehensive revision and update of its flagship 

Substance Abuse Prevention Skills Training (SAPST), which offers participants 31 training hours 

toward certification as a Substance Abuse Prevention Specialist. The CAPT also developed a 

Pacific Islander and Native American adaptation of the training for six additional training hour 

credits. Through FY 2016, the CAPT continued to develop comprehensive training products and 

technical assistance products. These products focus on shared risk and protective factors to 

promote collaboration across substance abuse and mental health disciplines within the behavioral 

health field. 

The program is increasing emphasis on virtual or distance forms of service delivery and relying 

more heavily on webinars and online training. The CAPT program developed a series of selfpaced courses to increase the capacity of community-level grantees to use epidemiological data to 

guide their prevention planning efforts, as well as webinars and coaching consultations to help 

grantees identify risk and protective factors and appropriate strategies to address emerging 

prevention needs such as prescription drug misuse and youth marijuana use. In FY 2015, the 

CAPT supported the organizational capacity of high-need communities to address health 

disparities and achieve benchmarks identified in SAMHSA’s Partnerships for Success program. 

CAPT continues to strengthen the prevention workforce, overall, by increasing the availability of 

interactive virtual trainings on using epidemiological data and risk and protective factors to guide 

implementation of effective prevention strategies.
144

In FY 2016, CAPT expanded its scope of work by providing technical assistance to new SAMHSA 

grantees in the SPF Rx program as well as Grants to Prevent Prescription Drug/Opioid Overdose 

Related Deaths program. 

In FY 2017, funding will continue to support the delivery of technical assistance and workforce 

development to the prevention field. 

Funding History

Fiscal Year Amount

FY 2014 $7,493,000 

FY 2015 $7,493,000 

FY 2016 $7,493,000 

FY 2017 $7,479,000 

FY 2018 $7,479,000

Budget Request

The FY 2018 Budget Request is $7.5 million, level with the FY 2017 Annualized CR. The 

program will continue to provide technical assistance and training to over 9,000 individuals in the 

prevention field. 
145 

Outputs and Outcomes Table

Program: Center for the Application of Prevention Technologies (CAPT)

NOTE: SAMHSA makes grant awards toward the end of the year and therefore, bases the FY 2018

targets on the FY 2017 Annualized CR and the FY 2019 targets are based on the FY 2018 

President’s Budget.

Measure

Year and Most Recent 

Result

Target for Recent Result

(Summary of Result)

FY 2018

Target

FY 2019

Target

FY 2019

Target

+/−

FY 2018

Target

1.4.11 Prevention: increase the number 

of individuals trained by the CAPT 

(Output)

FY 2015: 8,874

Target: 5,216

(Target Exceeded)

9,000 9,000 Maintain

1.4.12 Increase the percent of 

participants that agree or strongly agree 

that the training or TA provided 

increased their capacity to do substance 

abuse prevention work (Outcome)

FY 2015: 94 %

Target: 90 %

(Target Exceeded)

90 % 90 % Maintain
146

Science and Service Program Coordination

(Dollars in thousands)

Programs of Regional & National Significance

FY 2016 

Final 

FY 2017 

Annualized 

CR

FY 2018 

President's 

Budget

FY 

2018 

+/− 

FY 

2017

Science and Service Program Coordination $4,072 $4,064 $4,064 $---

Authorizing Legislation ........................................................................ Section 516 of the PHS Act 

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

Eligible Entities ................................................................................... Domestic and Public Entities

Program Description and Accomplishments

SAMHSA has made prevention of underage drinking a priority because of its potential impact on 

the health and well-being of young people and their communities. Over the past decade, there has 

been a steady decline in past-month, or current drinking by adolescents and young adults. Trend 

data report similar declines in underage binge and heavy drinking. In fact, among 8th to 12th grade 

students, rates of current, binge, and heavy drinking have declined to record lows. Yet, alcohol 

remains the drug of choice for individuals between the ages of 12 to 20 years. Risky and heavy 

drinking among college students remains unacceptably high. 

The Science and Service Program Coordination program funds the provision of technical 

assistance and training to states, tribes, communities, and grantees around substance abuse 

prevention. Specifically, the program supports the Tribal Training and Technical Assistance 

Center and the Underage Drinking Prevention Education Initiatives (UADPEI). 

The Tribal Training and Technical Assistance Center is an innovative training and technical 

assistance project that helps tribal communities facilitate the development and implementation of 

comprehensive and collaborative community-based prevention plans to reduce violence, bullying,

substance abuse, and suicide among American Indian/Alaska Native (AI/AN) youth, in support of 

the HHS Tribal Health and Well-Being Coordination. These plans mobilize tribal communities’ 

existing social and educational resources to meet their goals. As of FY 2015, 65 tribal 

communities have received specialized technical assistance and support in suicide prevention and 

related areas. In addition, more than 9,200 members of these communities received training in 

prevention and mental health promotion. 

The Underage Drinking Prevention Education Initiatives engage parents and other caregivers, 

schools, communities, all levels of government, all social systems that interface with youth, and 

youth themselves in a coordinated national effort to prevent and reduce underage drinking and its 

consequences. Through this initiative, families, their children, and other youth-serving 

organizations have been reached through Town Hall Meetings, technical assistance, trainings, and 

a variety of tools and materials. Efficiencies have been achieved from the growing focus on trainthe-trainer models rather than training of individuals. 

In FY 2016, community-based organizations registered to host 1,500 events. These events were 

held in all 50 states, the District of Columbia, and three territories. Approximately 870 individuals 
147

attended live online training webinars and SAMHSA responded to 3,000 requests for technical 

assistance in planning, promoting, hosting, and evaluating events. In FY 2017, SAMHSA will 

continue to fund two contracts to support these activities.

Funding History

Fiscal Year Amount

FY 2014 $4,072,000 

FY 2015 $4,072,000 

FY 2016 $4,072,000 

FY 2017 $4,064,000 

FY 2018 $4,064,000

Budget Request

The FY 2018 Budget Request is $4.1 million, level with the FY 2017 Annualized CR. These funds 

will support SAMHSA’s substance abuse prevention efforts and include a focus on preventing 

underage drinking and providing technical assistance and training to American Indians/Alaska 

Native communities. 

Tribal Behavioral Health Grants

(Dollars in thousands)

Programs of Regional & National Significance

FY 2016 

Final 

FY 2017 

Annualized 

CR

FY 2018 

President's 

Budget

FY 

2018 

+/− 

FY 2017

Tribal Behavioral Health Grants $15,000 $14,971 $14,971 $---

Authorizing Legislation ........................................................................ Section 516 of the PHS Act 

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

Eligible Entities ....................................................................................................................... Tribes

Program Description and Accomplishments

Suicide is the second leading cause of death among American Indian/Alaska Native (AI/AN) youth 

ages eight to 24 years.38 Further, AI/AN high school students report higher rates of suicidal 

behaviors than the general population of U.S. high school students.39 These behaviors include 

having serious thoughts of suicide, making suicide plans, attempting suicide, and getting medical 

attention for a suicide attempt. However, the risk of suicide is not the same in all AI/AN youth 

38 Centers for Disease Control and Prevention. Fatal injury data, 2010. Web-based Injury Statistics Query and 

Reporting System. Available at http://www.cdc.gov/injury/wisqars/fatal.html.

39 Centers for Disease Control and Prevention. Youth Risk Behavior Surveillance System (YRBSS). Available at 

http://www.cdc.gov/healthyyouth/yrbs/index.htm. 
148

The Tribal Behavioral Health Grants (TBHG) program addresses the high incidence of substance 

abuse and suicide among AI/AN populations. Starting in FY 2014, this program supports tribal 

entities with the highest rates of suicide by providing effective and promising strategies that 

address substance abuse, trauma, and suicide and by promoting the mental health of AI/AN young 

people. 

In FY 2014, SAMHSA’s Center for Mental Health Services awarded Tribal Behavioral Health 

grants up to $0.2 million annually for a total of five years to 20 tribes or tribal organizations with 

high rates of suicide. These five-year grants help grantees develop and implement a plan that 

addresses suicide and substance abuse, thereby promoting mental health among tribal youth. In 

addition, SAMHSA’s Tribal Training and Technical Assistance Center 

(http://www.samhsa.gov/tribal-ttac) provides technical assistance to AI/AN grantees, 

organizations, and providers serving AI/AN populations to support their ability to achieve their 

goals. An evaluation component allows grantees and SAMHSA to work collaboratively to monitor 

progress and learn from each other. SAMHSA has incorporated lessons learned to enhance this 

program and other national efforts to reduce suicide and substance abuse and support positive 

mental health among AI/AN youth. SAMHSA continued the support of this program in FY 2015. 

Grantees completed their needs assessments in FY 2015 and are working with SAMHSA to 

implement action plans based on these assessments. These action plans will report baseline data 

by the end of FY 2017. 

In FY 2016, SAMHSA proposed an expansion of its TBHG program. This initiative takes a 

comprehensive, culturally appropriate approach to help improve the lives of and opportunities for 

AI/AN youth. In addition to HHS, multiple agencies, including the Departments of Interior, 

Education, Housing and Urban Development, Agriculture, Labor, and Justice, are working 

collaboratively with tribes to address issues facing AI/AN youth. This funding allows SAMHSA 

to expand activities through the braided TBHG ($15.0 million in Prevention; $15.0 million in 

Mental Health) to allow tribes the flexibility to implement community-based strategies to address 

trauma, prevent substance abuse, and promote mental health and resiliency among youth in tribal 

communities. The additional FY 2016 funding expanded these activities to approximately 75 

tribes and tribal entities. With the expansion of the TBHG program, SAMHSA’s goal is to reduce 

substance use and the incidence of suicide attempts among AI/AN youth and to address behavioral 

health conditions that affect learning in the Bureau of Indian Education-funded schools. The 

TBHG program will support mental health promotion, including trauma informed care, and 

substance use prevention activities for high-risk AI/AN youth and their families, enhance early 

detection of mental illness and drug/alcohol addiction among AI/AN youth, and increase referral 

to treatment. In FY 2017, this activity will continue at the same level with grant continuations and 

a new cohort of TBHG grantees. 
149

Funding History

Fiscal Year Amount

FY 2014 ---

FY 2015 ---

FY 2016 $15,000,000 

FY 2017 $14,971,000 

FY 2018 $14,971,000 

Budget Request

The FY 2018 Budget Request for the Tribal Behavioral Health Grant program is $15.0 million is 

level with the FY 2017 Annualized CR. This will be combined with the $15.0 million in the 

Mental Health appropriation for a total of $30.0 million. This request will continue support for 

programs that promote mental health and prevent substance use activities for high-risk AI/AN 

youth and their families. In FY 2018, SAMHSA will fund TBHG continuation grants. 

Outputs and Outcomes Table 

Program: Tribal Behavioral Health

NOTE: SAMHSA makes grant awards toward the end of the year and therefore, bases the 

FY 2018 targets on the FY 2017 Annualized CR and the FY 2019 targets are based on the 

FY 2018 President’s Budget.

Measure

Year and Most Recent 

Result

Target for Recent Result

(Summary of Result)

FY 2018

Target

FY 2019

Target

FY 2019

Target

+/- 

FY 2018

Target

2.4.12 Increase the number of youth age 

10 - 24 who received mental health or 

related services after screening, referral 

or attempt (Output)

FY 2016: 20

Target: 20

(Baseline)

20 20 Maintain

2.4.13 Increase the number of 

programs/organizations that implemented 

specific mental-health related 

practices/activities as a result of the grant 

(Outcome)

FY 2016: 296

Target: 296

(Baseline)

296 296 Maintain
150

Grants to Prevent Prescription Drug/Opioid Overdose Related Deaths

(Dollars in thousands)

Authorizing Legislation ............................................. Section 516 and Section 546 of the PHS Act

FY 2018 Authorization ........................................................................................................$12,000 

Allocation Method ............................................................................ Competitive Grants, Contracts

Eligible Entities .........................................States, local government entities, Federally Recognized 

American Indian/Alaska Native tribe or tribal organizations

Program Description and Accomplishments

Opioid overdose is a significant contributor to accidental deaths among those who use, misuse, or 

abuse illicit and prescription opioids (including synthetics), such as fentanyl).

1

 Opioids include 

illegal drugs such as heroin, as well as prescription medications used to treat pain. These 

prescription medications include morphine, codeine, methadone, oxycodone (Oxycontin, 

Percodan, Percocet), hydrocodone (Vicodin, Lortab, Norco), fentanyl (Duragesic, Fentora), 

hydromorphone (Dilaudid, Exalgo), and buprenorphine (Subutex, Suboxone). Opioids bind to 

specific receptors in the brain, spinal cord, and gastrointestinal tract and reduce the body’s 

perception of pain. As opioids reduce pain, they induce a slight sense of euphoria, which can lead 

to overuse. 

In 2013, SAMHSA released the Opioid Overdose Prevention Toolkit to help reduce the number 

of opioid-related overdose deaths and adverse events. Developed by SAMHSA, the Association 

of State and Territorial Health Officials, the National Association of State Alcohol and Drug Abuse 

Directors, and the American Association for the Treatment of Opioid Dependence, the Toolkit was 

the first federal resource that includes safety and prevention information for individuals at risk for 

overdose. The toolkit provides information on how to recognize and respond appropriately to 

overdose, identifies specific drug-use behaviors to avoid, and describes the role of overdose 

reversing drugs in preventing death from an overdose. Naloxone is an opioid antagonist that 

reverses the effects of opioids, including respiratory depression. A growing evidence base 

suggests that naloxone is a cost-effective method to reduce opioid overdose deaths. 

As the rates of prescription drug abuse, heroin abuse, illicit synthetic opioid abuse, overdoses, and 

opioid-related overdose deaths increase, communities are searching for ways to reduce the death 

rate from opioid-related overdoses. 

The Grants to Prevent Prescription Drug and Opioid Overdose-related Deaths program helps states 

identify communities of high need and provide education, training, and resources necessary to 

1 National Institute on Drug Use (NIDA). America’s Addiction to Opioids: Heroin and Prescription Drug Abuse. 

(2014) Available from URL: http://www.drugabuse.gov/about-nida/legislative-activities/testimony-tocongress/2015/americas-addiction-to-opioids-heroin-prescription-drug-abuse#_ftnref4

Programs of Regional & National Significance

FY 2016 

Final 

FY 2017 

Annualized 

CR

FY 2018 

President's

Budget

 FY 2018 

+/- 

FY 2017

Grants to Prevent Prescription Drug/ Opioid Overdose 

Related Deaths.................................................................... $12,000 $11,977 $11,977 $---
151

tailor the overdose kits to meet their specific needs. The grant funds can be used for purchasing 

overdose reversing drugs, equipping first responders with them, providing training on it and other 

overdose-related death prevention strategies, and providing materials to assemble and disseminate 

overdose kits. 

These grantees are required to develop a dissemination plan and a training course tailored to meet 

the needs of first responders in the communities within their state. The course uses SAMHSA’s 

Opioid Overdose Prevention Toolkit as a guide and includes a comprehensive prevention program 

that will focus on prevention, treatment, and recovery services in order to decrease the likelihood 

of drug overdose recurrence. 

Funding History

Fiscal Year Amount

FY 2014 ---

FY 2015 ---

FY 2016 $12,000,000 

FY 2017 $11,977,000 

FY 2018 $11,977,000 

Budget Request

The FY 2018 Budget Request is $12.0 million, level with the FY 2017 Annualized CR. This 

funding will provide continuation grants to 12 states to reduce the number of opioid overdoserelated deaths. Funding will help states purchase overdose reversing drugs, equip first responders 

in high-risk communities, support education on the use of naloxone and other overdose-related 

death prevention strategies, provide the necessary materials to assemble overdose kits, and cover 

expenses incurred from dissemination efforts. 
152

First Responder Training

(Dollars in thousands)

Authorizing Legislation.........................................Section 546 of the Public Health Service Act 

FY 2018 Authorization...............................................................................$12,000 

Allocation Method............................................................................................Competitive Grants

Eligible entities...............................States, local government entities, Federally Recognized 

American Indian/Alaska Native tribe or tribal organizations

Program Description and Accomplishments

Under Section 202 of the Comprehensive Addiction and Recovery Act (CARA), SAMHSA is 

authorized to support additional efforts to prevent opioid overdose-related deaths by providing 

grants to train first responders. In FY 2017, SAMHSA will fund up to 11 grants for the First 

Responder Training program. The purpose of this program is to reduce the number of prescription 

drug/opioid overdose-related deaths and adverse events among individuals at risk for opioid abuse. 

Applicants will train first responders and members of other key community sectors at the local 

government and tribal levels to implement secondary prevention strategies, such as the 

administration of naloxone through FDA-approved delivery devices to reverse the effects of opioid 

overdose. 

In 2013, SAMHSA released the Opioid Overdose Prevention Toolkit to help reduce the number 

of opioid-related overdose deaths and adverse events. The grant program will utilize this toolkit 

and other resources to help grantees develop a comprehensive prevention program that educates 

the public about the dangers of sharing medications, raises awareness among pharmaceutical and 

medical communities on the risks of overprescribing, and implements overdose death prevention 

strategies, such as naloxone distribution and the purchase of overdose reversing drugs for first 

responders, in communities of high need. Grantees will develop a naloxone distribution plan and 

a training course for first responders and others on the use of overdose reversing drugs tailored to 

meet the needs of their communities. The grant program also will work to strengthen communities 

in developing policies and practices that prevent and respond appropriately to prescription 

drug/opioid-related overdoses. 

Training, technical assistance, and evaluation activities are also being supported to assist grantees, 

determine best practices, and assess program outcomes. 

Programs of Regional & National Significance

FY 2016 

Final 

FY 2017 

Annualized CR

FY 2018 

President's

Budget

 FY 2018 

+/- 

 FY 2017

First Responder Training (CARA) .......................................... $--- $12,000 $12,000 $---
153

Funding History

Fiscal Year Amount

FY 2014 ---

FY 2015 ---

FY 2016 --- 

FY 2017 $12,000,000 

FY 2018 $12,000,000 

Budget Request

The FY 2018 Budget Request is $12.0 million, level with the FY 2017 Annualized CR. This 

funding will provide continuation grants to 11 grantees to address the opioid crisis in this country. 

Minority Fellowship Program

(Dollars in thousands)

Authorizing Legislation ........................................................................ Section 516 of the PHS Act 

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

Eligible Entities ...... American Nurses Association (ANA), American Psychiatric Association (ApA), 

American Psychological Association (APA), Council on Social Work Education (CSWE), 

American Association for Marriage and Family Therapy (AAMFT), 

and professional organization representing addictions counselors

Program Description and Accomplishments

The mental health-related and substance use-related service needs of racial and ethnic minority 

communities within the United States have been historically under–addressed due to a variety of 

factors. These include a limited number of trained practitioners who are equipped with the 

language skills or cultural competency training needed to deliver effective services for this 

population. SAMHSA’s Minority Fellowship Program (MFP) increases behavioral health 

practitioners’ knowledge of issues related to prevention, treatment, and recovery support for 

mental illness and drug/alcohol addiction among racial and ethnic minority populations. The 

program provides stipends to funding increases the number of culturally competent behavioral 

health professionals who teach, administer, conduct services research, and provide direct mental 

illness or substance abuse treatment services for minority populations that are underserved. This 

will result in improved quality of mental and substance abuse prevention and increased treatment 

delivered to ethnic minorities. Since its start in 1973, the program has helped to enhance services 

for racial and ethnic minority communities through specialized training of mental health 

professionals in psychiatry, nursing, social work, and psychology. In 2006, the program expanded 

to include marriage and family therapists and later added professional counselors. These 

Programs of Regional & National Significance

FY 2016 

Final 

FY 2017 

Annualized 

CR

FY 2018 

President's

Budget

 FY 2018 

+/- 

 FY 2017

Minority Fellowship Program................................................... $71 $71 $71 $---
154

individuals often serve in key leadership positions in mental illness and substance abuse treatment

services, services supervision, services research, training, and administration. Professional guilds 

receive competitively awarded grants, and then competitively award the stipends to post-graduate 

students pursuing a degree in that professional field. In FY 2015 and in FY 2016, SAMHSA 

funded six continuation grants. 

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

Begun in FY 2014, MFP-Y is a component of MFP that support master’s level trained behavioral 

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

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

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

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

outcomes for racially and ethnically diverse youth and young adults. 

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

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

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

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

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

competitively awarded to professional guilds, which then competitively award the stipends to postgraduate students pursuing a degree in that professional field. 

MFP-AC is a component of MPP to support master’s level addiction counselors (MFP-AC) for 

youth and young adults. The purpose of the four-year grant program is to reduce health disparities 

and improve behavioral healthcare outcomes for racially and ethnically diverse populations by 

increasing the number of culturally competent master’s level addiction counselors available to 

underserved minority populations with a specific focus on transition age youth (ages 16 to 25) in 

public and private non-profit sectors. MFP-AC grants are supporting students pursuing master’s 

level degrees in addiction/substance abuse counseling, with the goal of increasing the number of 

masters-level addiction counselors across the nation by approximately 300 counselors. As is the 

case with MFP and MFP-Y, grants are competitively awarded to professional guilds, who then 

competitively award the stipends to post-graduate students pursuing a degree in that professional 

field. 

Funding History

Fiscal Year Amount

FY 2014 $71,000 

FY 2015 $71,000 

FY 2016 $71,000 

FY 2017 $71,000 

FY 2018 $71,000 
155

Budget Request

The FY 2018 Budget Request is $71 thousand, level with the FY 2017 Annualized CR. The 

funding will provide continued support for both base and expansion activities. The funds will 

support one MFP and one technical assistance and evaluation support contracts. 
156

SAMHSA/Center for Substance Abuse Prevention

PRNS Mechanism Table Summary

(Dollars in thousands)

FY 2016 Final

FY 2017 

Annualized CR

FY 2018

President's 

Budget

Programs of Regional & National Significance No. Amount No. Amount No. Amount

Grants

Continuations 215 $125,302 386 $158,842 343 $107,674

New/Competing 198 41,857 37 21,990 15 5,114

Subtotal 413 167,159 423 180,832 358 112,788

Contracts

Continuations 22 37,707 3 28,248 23 31,720

New 14 6,353 33 13,738 6 5,195

Subtotal 36 44,060 36 41,986 29 36,915

Total, Substance Abuse Prevention PRNS 449 $211,219 459 $222,817 387 $149,703
157

SAMHSA/Center for Substance Abuse Prevention

PRNS Mechanism Table by Program, Project, and Activity

(Dollars in thousands)

FY 2016 Final

FY 2017 

Annualized 

CR

FY 2018

President's 

Budget

Programs of Regional & National Significance No. Amount No. Amount No. Amount

Capacity:

Strategic Prevention Framework

Grants

Continuations 66 $92,927 89 $106,308 73 $43,884

New/Competing 21 11,815 --- --- 15 5,048

Supplements --- --- --- --- --- ---

Subtotal 87 104,742 89 106,308 88 48,932

Contracts

Continuations 8 13,582 13 12,849 8 9,494

New 6 1,160 --- 100 --- ---

Subtotal 14 14,742 13 12,949 8 9,494

Total, Strategic Prevention Framework 101 119,484 102 119,257 96 58,426

Federal Drug-Free Workplace 

Contracts

Continuations 3 4,880 4 4,735 3 746

New 1 14 --- 150 1 4,138

Subtotal 4 4,894 4 4,885 4 4,885

Total, Federal Drug-Free Workplace 4 4,894 4 4,885 4 4,885

Minority AIDS

Grants

Continuations 132 31,504 137 31,136 73 25,714

New/Competing 19 3,957 --- 5,597 --- ---

Subtotal 151 35,461 137 36,733 73 25,714

Contracts

Continuations 4 5,221 4 3,594 1 2,076

New 1 522 --- 800 3 1,052

Subtotal 5 5,744 4 4,394 4 3,128

Total, Minority AIDS 156 41,205 141 41,127 77 28,843

Sober Truth on Preventing Underage Drinking Act

Grants

Continuations 17 804 78 3,898 95 4,634

New/Competing 78 3,780 17 766 --- ---

Subtotal 95 4,584 95 4,664 95 4,634

Contracts

Continuations 2 2,416 2 1,336 2 2,353

New --- --- --- 987 --- ---

Subtotal 2 2,416 2 2,323 2 2,353

Total, Sober Truth on Preventing Underage Drinking 

Act 97 7,000 97 6,987 97 6,987
158

SAMHSA/Center for Substance Abuse Prevention

PRNS Mechanism Table by Program, Project, and Activity

(Dollars in thousands)

FY 2016 Final

FY 2017 

Annualized 

CR

FY 2018

President's 

Budget

Programs of Regional & National Significance No. Amount No. Amount No. Amount

Grants to Prevent Prescription Drug/Opioid Overdose 

Related Deaths

Grants

Continuations --- --- 12 10,529 12 10,477

New 10 10,546 --- --- --- ---

Subtotal 10 10,546 12 10,529 12 10,477

Contracts

Continuations --- --- 2 1,448 2 1,500

New 3 1,454 --- --- --- ---

Subtotal 3 1,454 2 1,448 2 1,500

Total, Grants to Prevent Prescription Drug/ Opioid 

Overdose Related Deaths 13 12,000 14 11,977 14 11,977

Tribal Behavioral Health Grants

Grants

Continuations --- --- 70 6,904 70 12,593

New/Competing 70 11,759 --- 5,204 --- ---

Subtotal 70 11,759 70 12,108 70 12,593

Contracts

Continuations --- --- 4 2,313 3 2,378

New/Competing 2 3,241 --- 550 --- ---

Subtotal 2 3,241 4 2,863 3 2,378

 Total, Tribal Behavioral Health Grants 72 15,000 74 14,971 73 14,971

Comprehensive Addiction and Recovery Act

Grants

Continuations --- --- --- --- 20 10,371

New/Competing --- --- 20 $10,423 --- ---

Subtotal 20 $10,423 20 10,371

Contracts

Continuations --- --- --- --- 2 1,629

New/Competing --- --- 2 1,577 --- ---

Subtotal --- --- 2 1,577 2 1,629

Total, Comprehensive Addiction and Recovery Act --- --- 22 12,000 22 12,000

Subtotal, Capacity 443 $199,583 432 $199,203 361 $126,089
159

SAMHSA/Center for Substance Abuse Prevention

PRNS Mechanism Table by Program, Project, and Activity

(Dollars in thousands)

FY 2016 Final

FY 2017 

Annualized 

CR

FY 2018

President's 

Budget

Programs of Regional & National Significance No. Amount No. Amount No. Amount

Science and Service:

Center for the Application of Prevention Technologies

Contracts

Continuations 1 $7,705 1 $359 1 $7,479

New/Competing 1 -212 --- 7,119 --- ---

Subtotal 2 7,493 1 7,479 1 7,479

Technologies 2 7,493 1 7,479 1 7,479

SAP Minority Fellowship Program

Grants

Continuations 1 66,582 1 66 --- ---

New/Competing --- --- --- --- 1 66

Subtotal 1 66,582 1 66,301 1 66,301

Contracts

Continuations 1 4 --- 5 --- ---

New/Competing --- --- --- --- 1 5

Subtotal 1 4,418 --- 4,699 1 4,699

Total, SAP Minority Fellowship Program 2 71,000 1 71,000 2 71,000

Science & Service Program Coordination

Contracts

Continuations 4 3,899 3 1,610 3 4,064

New --- 173 --- 2,454 --- ---

Subtotal 4 4,072 3 4,064 3 4,064

Total, Science & Service Program Coordination 4 4,072 3 4,064 3 4,064

Subtotal, Science and Service 6 11,636 4 11,614 4 11,614

Total, Substance Abuse Prevention 449 $211,219 458 $222,817 387 $149,703
160

Grant Awards Table

(Whole dollars)

FY 2016

Final

FY 2017

Annualized CR

FY 2018 

President's Budget

Number of Awards 413 423 358

Average Award $470,421 $486,500 $386,828

Range of Awards $50,000 – $2,300,000 $50,000 – $2,300,000 $50,000 – $2,300,000
161

SAMHSA 

Substance Abuse Treatment 

Table of Contents 

1. Substance Abuse Treatment Appropriation ......................................................................... 163

2. Programs of Regional and National Significance (PRNS) ................................................... 164

a) Opioid Treatment Programs/Regulatory Activities ....................................................... 165

b) Screening, Brief Intervention and Referral to Treatment .............................................. 169

c) Targeted Capacity Expansion-General .......................................................................... 173

d) Pregnant and Postpartum Women ................................................................................. 178

e) Recovery Community Services Program ...................................................................... 181

f) Children and Families ................................................................................................... 183

g) Treatment Systems for Homeless .................................................................................. 186

h) Minority AIDS .............................................................................................................. 191

i) Criminal Justice Activities ............................................................................................ 194

j) Building Communities of Recovery .............................................................................. 201

k) Minority Fellowship Program............................................................................................... 202

l) Addiction Technology Transfer Centers ....................................................................... 204

3. State Targeted Response to the Opioid Crisis Grants ........................................................... 207

4. Substance Abuse Prevention and Treatment Block Grant .................................................... 209

5. PRNS Mechanism Table Summary ...................................................................................... 221

6. PRNS Mechanism Table by Program, Project, and Activity ................................................ 222

7. Grant Award Table ............................................................................................................... 225
162

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163

Substance Abuse Treatment Appropriation 

 (Dollars in thousands)

Programs of Regional & National Significance 

FY 2016 

Final 

FY 2017 

Annualized 

CR

FY 2018 

President's 

Budget 

FY 2018 

+/− 

FY 2017 

Programs of Regional and National Significance $337,345 $341,708 $341,738 30 

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

Substance Abuse Prevention and Treatment Block Grant 1,858,079 1,854,697 1,854,697 --- 

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

State Targeted Response to the Opioid Crisis Grants --- 500,000 500,000 --- 

Total, Substance Abuse Treatment $2,195,424 $2,696,405 $2,696,435 30 

The Substance Abuse Treatment FY 2018 Budget Request is $2.7 billion, an increase of $0.03 

million from the FY 2017 Annualized CR. The request includes $2.6 billion in Budget Authority 

and $81.2 million in Public Health Service (PHS) Evaluation funds. 
164

Substance Abuse Treatment Appropriation 

(Dollars in thousands) 

Programs of Regional & National Significance 

FY 2016 

Final 

FY 2017 

Annualized 

CR

FY 2018 

President's 

Budget 

FY 2018 

+/− 

FY 2017 

Capacity: 

Opioid Treatment Programs/Regulatory Activities $8,724 $8,708 $8,708 --- 

Screening, Brief Intervention and Referral to Treatment 46,889 46,804 46,804 --- 

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

Targeted Capacity Expansion-General 36,303 36,234 36,234 --- 

Medication-Assisted Treatment for Prescription 

Drug and Opioid Addiction (non-add) 25,000 24,952 24,952 --- 

Pregnant and Postpartum Women 15,931 19,901 19,931 30

Recovery Community Services Program 2,434 2,429 2,429 --- 

Children and Families 29,605 29,549 29,549 --- 

Treatment Systems for Homeless 41,304 41,225 41,225 --- 

Minority AIDS 65,570 65,445 65,445 --- 

Criminal Justice Activities 78,000 77,852 77,852 --- 

SAT Minority Fellowship Programs 3,539 3,532 3,532 --- 

Building Communities of Recovery 1,000 1,000 --- 

Subtotal, Capacity 328,299 332,679 332,709 30

Science and Service: --- 

Addiction Technology Transfer Centers 9,046 9,029 9,029 --- 

Subtotal, Science and Service 9,046 9,029 9,029 --- 

Total, PRNS $337,345 $341,708 $341,738 $30 

Authorizing Legislation ............................................. Section 509 of the Public Health Service Act

FY 2018 Authorization .......................................................................................................$333,806 

Allocation Method .................................... Competitive Grants/Cooperative Agreements/Contracts 

Eligible Entities.......................................... ...... .................States, local governments, 

 Communities, Federally Recognized

 American Indian/Alaska Native tribe or tribal organizations,

 Indian Health Service-operated and contracted health facilities

 and programs, public or private nonprofit entities
165

Opioid Treatment Programs/Regulatory Activities 

(Dollars in thousands)

Programs of Regional & National Significance 

FY 2016 

Final 

FY 2017 

Annualized 

CR

FY 2018 

President's 

Budget 

FY 2018 

+/− 

FY 2017 

Opioid Treatment Programs/Regulatory Activities $8,724 $8,708 $8,708 --- 

Authorizing Legislation ............................................. Section 509 of the Public Health Service Act 

Allocation Method .................................... Competitive Grants/Contracts/Cooperative Agreements 

Eligible Entities .............................................................. American Society of Addiction Medicine, 

American Academy of Addiction Psychiatry, American Medical Association, 

American Osteopathic Association, American Psychiatric Association, 

American Dental Association 

Program Description and Accomplishments 

The misuse of prescription opioid pain relievers and illicit opioids such as heroin is causing 

suffering, sickness, overdose, and death in the United States at epidemic levels.77 Communities 

across the nation also face the risk that individuals who inject opioids will contract and spread HIV 

and hepatitis C.78 The underlying cause of these problems is increasing rates of opioid abuse.79,80 

With increasing incidence of opioid abuse, there is a corresponding increase in admissions for 

treatment of opioid use disorder diagnoses.81 Medication-assisted treatment (MAT), which is the 

use of FDA-approved medications (i.e., buprenorphine, methadone, extended-release injectable 

naltrexone), in combination with counseling and behavioral therapies to provide a whole-patient 

approach to the treatment of substance abuse, including opioid abuse. MAT is a safe and effective 

strategy for decreasing the frequency and quantity of opioid use and reducing the risk of overdose 

and death. 

Approximately one million Americans need, but do not access treatment for an opioid addiction.

82

 

A search of SAMHSA’s behavioral health treatment locator reveals only 20 percent of surveyed 

facilities offer MAT for individuals with opioid addiction. The majority of the approximately 

1,500 opioid treatment programs (OTPs) which provide supervised dosing of methadone - and 

 

77 U.S. Department of Health and Human Services. Addressing prescription drug abuse in the United States: current 

activities and future opportunities. 2013. Retrieved from 

http://www.cdc.gov/homeandrecreationalsafety/overdose/hhs_rx_abuse.html

78 Substance Abuse and Mental Health Services Administration. Associations of nonmedical pain reliever use and 

initiation of heroin use in the United States. 2013. Retrieved from 

http://samhsa.gov/data/2k13/DataReview/DR006/nonmedical-pain-reliever-use-2013.html

79 Johnson EM, Lanier WA, Merrill RM, et al. Unintentional prescription opioid-related overdose deaths: 

description of decedents by next of kin or best contact, Utah, 2008-2009. J Gen Intern Med. 2013;28(4): 522-9.

80 Bohnert AS, Valenstein M, Bair MJ, et al. Association between opioid prescribing patterns and opioid overdoserelated deaths. JAMA. 2011;305(13):1315-1321. doi:10.1001/jama.2011.370. 

81 Paulozzi LJ, Jones CM, Mack KA, Rudd RA. Vital signs: overdoses of prescription opioid pain relievers – United 

States, 1999-2008. MMWR Morb Mortal Wkly Rep. 2011;60(43): 1487-92. 

82 Jones, C. M. (2013). Heroin use and heroin use risk behaviors among nonmedical users of prescription opioid 

pain relievers, United States, 2002-2004 and 2008-2010. Drug and Alcohol Dependence, 132(1-2):95-100. 
166

sometimes buprenorphine - are at or near capacity. OTPs are the only means of providing 

medication assisted treatment (MAT) with methadone. Buprenorphine can be prescribed in an 

office setting by physicians who have received a waiver under the Drug Addiction Treatment Act 

of 2000 (DATA 2000) provision of the Controlled Substances Act. Most physicians with a waiver 

to prescribe buprenorphine do not treat the maximum allowable number of patients. Some 

physicians willing to attempt to fill the unmet need for treatment by serving more individuals are 

prevented from doing so due to the patient limit on prescribing buprenorphine. 

On July 8, 2016, HHS/SAMHSA published a final rule, “Medication Assisted Treatment for 

Opioid Use Disorders,” which allows practitioners who have had a waiver to prescribe 

buprenorphine for up to 100 patients for a year or more, to now obtain a waiver to treat up to 275 

patients.

SAMHSA is responsible for regulating and certifying approximately 1,500 OTPs to use opioid 

agonist treatment medications and processing waivers for physicians and mid-level practitioners 

who wish to treat opioid abuse with buprenorphine. SAMHSA reviews new and renewal 

applications for OTPs and oversees their accreditation. OTPs are required to be accredited as a 

condition of certification. SAMHSA’s regulation of OTPs plays a critical role in expanding access 

and maintaining quality. Accrediting organizations must be approved by SAMHSA to fulfill this 

function and this approval must be renewed every five years. SAMHSA monitors the accrediting 

bodies for quality assurance and improvement by making 10 to 20 site visits to recently-accredited 

programs each year, and conducts unannounced OTP site visits to investigate complaints from 

members of the public, state and local jurisdictions, and others. In addition to regulating OTPs, 

SAMHSA provides training and technical support through a contract entitled Opioid Treatment 

Program Quality (OTP-Q) which was re-competed and awarded in 2016. The goal is to provide 

trainings for OTP staff, on-site consultations for programs with deficiencies or unique challenges, 

and annual training for State Opioid Treatment Authorities. The Federal Guidelines for Opioid 

Treatment Programs are available to the field and describe SAMHSA’s expectation of how the 

federal opioid treatment standards found in Title 42 of the Code of Federal Regulations Part 8 are 

to be satisfied by OTPs. 

SAMHSA also implements DATA 2000 in coordination with the Drug Enforcement Agency. This 

includes approving waivers for qualified practitioners to provide medication-assisted treatment in 

office-based settings. More than 37,000 practitioners have been granted waivers since 2001. 

Waiver processing is conducted under a contract entitled DATA Waiver Processing and Support 

Project. This contract was modified in FY 2016 to update and upgrade the database of information 

about waivered practitioners and to modernize the system to handle the expected increase in 

volume. From August 2016 through March 2017, SAMHSA has processed over 7,365 waiver 

applications of which 3,211 physicians were certified to treat 30 patients, 1,107 were certified to 

treat 100 patients, and 3,047 were certified to treat 275 patients. 

On November 17, 2016, the Department of Health and Human Services (HHS) announced that 

nurse practitioners (NPs) and physician assistants (PAs) can immediately begin taking the 24 hours 

of required training to prescribe buprenorphine for the treatment of opioid addiction. This was 

based on Section 303 of the Comprehensive Addiction and Recovery Act (CARA), which made 

several changes to the law regarding office-based opioid addiction treatment with buprenorphine. 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

One of these changes was that prescribing privileges have been expanded to NPs and PAs for five 

years (until October 1, 2021). NPs and PAs who complete the required training and seek to 

prescribe buprenorphine for up to 30 patients were able to begin applying for a waiver in February 

2017. SAMHSA supports a cooperative agreement with the American Academy of Addiction 

Psychiatry which provides education, training, and mentors to behavioral healthcare providers. 

The Providers Clinical Support Services for Medication Assisted Treatment (PCSS-MAT) focuses 

on medication-assisted treatment for opioid abuse. 

Through the Behavioral Health Information Technology and Standards (BHITS) contract, 

SAMHSA funded a competition that resulted in three new mobile applications for overdose 

prevention in FY 2015. In FY 2016, SAMHSA conducted another challenge to promote the 

development of recovery support applications for patients receiving medication-assisted treatment. 

Also through BHITS, in FY 2015, an Opioid Treatment Program Service continuity Project was 

conducted, and successfully demonstrated the ability to assure continuity of care for OTP patients 

via a health information exchange while fully respecting patient privacy. In FY 2016, a second 

such pilot began using a different software vendor and programs in a different geographic area in 

order to increase the number of health information exchange organizations incorporating substance 

use and mental disorder treatment data using Health Level 7 (HL7) standards. 

SAMHSA’s Preventing Prescription Drug Abuse and Overdose technical assistance contract has 

provided live, free, continuing medical education (CME) across the country on safe and 

appropriate opioid prescribing making a special effort to reach isolated areas. CME courses are 

offered in conjunction with annual meetings of various national organizations. Since 2011, 

PPDAO recorded 64,063 online CME completions and 72 live CME trainings, attracting almost 

10,812 participants. This contract supported the publication of two brief guides for clinicians: 

“Clinical Use of Extended-Released Injectable Naltrexone in the Treatment of Opioid Use 

Disorder” and “Alcohol Brief Guide – Medication for the Treatment of Alcohol Use Disorder” 

which SAMHSA developed in coordination with the National Institutes of Health. Both of these 

were released as “pocket” versions in FY 2016. This contract was also used to develop 

SAMHSA’s guidance document on the management of pregnant and parenting opioid dependent 

women and their infants. In 2015, the Rand-UCLA Appropriateness Method was used to review 

the evidence and formulate recommendations. In 2016, a report of this activity was released for 

public comment. The findings are being converted into a patient-centered, multi-disciplinary 

clinical guide. Additional activities for FY 2016, under this contract included CME training in 

Indiana, Virginia, Minnesota, Vermont, California, and Alabama and at two large meetings. The 

first was a Telebehavioral health for Medication-Assisted Treatment Providers and the second was 

a Non-Agonist Pharmacotherapies Scientific Review. The contract was competed and awarded 

for FY 2016 as Addressing Opioid Misuse and Overdose (AOMO). Subsequent to the passage of 

the Comprehensive Addiction and Recovery Act, AOMO organized a public meeting where 

stakeholders discussed the training requirements for midlevel practitioners to prescribe 

buprenorphine for an opioid addiction. Under AOMO, SAMHSA plans to implement training in 

addiction medicine to providers, including NP and PA, with the ECHO model, and to evaluate 

whether the ECHO training model results in clinician practice change for addiction providers. 

SAMHSA developed the MATx, a public domain app for healthcare practitioners to support 

medication-assisted treatment of opioid abuse. This is a significant step forward in efforts to 

167
 
 

 

Funding History 

Fiscal Year Amount 

FY 2014 $8,724,000 

FY 2015 $8,724,000 

FY 2016 $8,724,000 

FY 2017 $8,708,000 

FY 2018 $8,708,000 

 

improve access to MAT, making it easier for patients living with addiction to access effective, 

evidence-based treatment. This public domain app puts the most critical information to support 

the delivery of MAT in one place—the latest on treatment approaches, medications, and clinical 

support tools, plus helplines and access to SAMHSA’s Treatment Locators. Since, the launch date 

of October 2016, there has been 9,247 downloads of the app. 

In FY 2017, SAMHSA plans to fund one continuation grant, one new supplement and three new 

contracts and four continuing contracts. 

Budget Request 

The FY 2018 Budget Request is $8.7 million, level with the FY 2017 Annualized CR. In FY 2018, 

SAMHSA intends to continue funding two continuation grants and three contracts and plans to 

support two new contracts. 

168
 
 

Screening, Brief Intervention and Referral to Treatment 

(Dollars in thousands) 

Programs of Regional & National Significance 

FY 2016 

Final 

FY 2017 

Annualized 

CR 

FY 2018 

President's 

Budget 

FY 2018 

+/−

FY 2017 

Screening, Brief Intervention and Referral to Treatment 

PHS Evaluation Funds (non-add) 

$46,889 

2,000 

$46,804 

2,000 

$46,804 

2,000 

--­

--­

Authorizing Legislation .............................................Section 509 of the Public Health Service Act 

Allocation Method ....................................Competitive Grants/Contracts/Cooperative Agreements 

Eligible Entities...................................... Single State Authority and Health Departments in States, 

Territories, the District of Columbia, 

Federally Recognized American Indian/Alaska Native Tribe or Tribal Organizations, 

Domestic Public and Private Non-Profit Entities, and 

Public and Private Universities Colleges 

Program Description and Accomplishments 

A high number of individuals misuse illicit drugs and alcohol. Of all individuals age 12 or older, 

27.1 million (10.1 percent) use illicit drugs, 66.7 million (24.9 percent) binge drink, and 

17.3 million (6.5 percent) drink heavily.83 This increases the cost to society by compromising 

individual health and potentially causing injury to others. Misuse of illicit drugs and alcohol costs 

society $488.0 billion each year.84 Of the individuals who need treatment for drug/alcohol 

addiction, only 10.8 percent receive treatment in a specialty treatment facility.85 The vast majority 

of those meeting criteria for having a diagnosable substance use disorder (SUD) have not been 

diagnosed with an SUD. 

In 2003, SAMHSA started the Screening, Brief Intervention and Referral to Treatment (SBIRT) 

program, which is intended to help primary care physicians identify individuals who misuse 

substances and help them intervene early with education, brief treatment, or referral to specialty 

treatment. The program’s goal is to increase the number of individuals who receive treatment and 

81 Center for Behavioral Health Statistics and Quality. (2016). Key substance use and mental health indicators in the 

United States: Results from the 2015 National Survey on Drug Use and Health (HHS Publication No. SMA 16­

4984, NSDUH Series H-51). Retrieved from http://www.samhsa.gov/data/ 82 National Institute on Drug Abuse (2016), Trends and Statistics, http://www.drugabuse.gov/related-topics/trendsstatistics. 83 Center for Behavioral Health Statistics and Quality. (2016). Key substance use and mental health indicators in the 

United States: Results from the 2015 National Survey on Drug Use and Health (HHS Publication No. SMA 16­

4984, NSDUH Series H-51). Retrieved from http://www.samhsa.gov/data/ 

169
 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

reduce the rate of substance misuse. Studies have shown that this approach is effective in helping 

reduce harmful alcohol consumption.86,87,88 

The SBIRT program seeks to increase the use of SBIRT in medical settings by promoting wide 

dissemination and adoption of the practice across the spectrum of primary care services. To 

achieve this, SAMHSA awards state implementation grants to encourage adoption of SBIRT by 

healthcare providers in each state. SAMHSA also supports the SBIRT Student Training grant 

programs. 

The SBIRT program requires state grant recipients to implement the model in all primary care 

settings, as well as hospitals, trauma centers, federally qualified health centers, and other relevant 

health care settings. Recipients may use funds to screen for substance abuse and co-occurring 

mental illness and drug/alcohol addiction. They can support evidence-based client-centered 

interventions such as motivational interviewing, brief treatment, and referral to specialty care for 

individuals exhibiting SUD symptoms. 

The SBIRT training program helps train a wide range of medical providers to incorporate SBIRT 

as part of their ongoing practice. This includes physicians, nurses, counselors, social workers, 

health promotion advocates, health educators, and others. A SAMHSA-funded cross-site 

evaluation found that allied health professionals, rather than the physicians themselves, were more 

likely to implement SBIRT with their patients.89 The SBIRT Student Training and Health 

Professionals Training grant programs support SBIRT training efforts for medical students, 

medical residents, nurses, social workers, psychologists, pharmacists, dentists, and physician 

assistants. These efforts aim to develop further the primary healthcare workforce in substance 

abuse treatment and services. 

SAMHSA has demonstrated the effectiveness of SBIRT and continues to disseminate SBIRT 

practices. As of 2016, SAMHSA data show roughly 2.7 million individuals have received 

screening and/or intervention through this initiative.[1] Of those screened, roughly, 11.5 percent 

were determined to be at risk, another 1.9 percent were referred for brief treatment, and an 

additional 2.2 percent are referred to specialty treatment.[2] 

In FY 2017, SAMHSA continued funding for 11 state cooperative agreements and 80 training 

grant continuations. SAMHSA also supported funding of three contracts, which support training 

86 Bertholet, N., Daeppen, J.-B., Wietlisbach, V., Fleming, M., & Burnand, B. (2005). Reduction of alcohol 

consumption by brief alcohol intervention in primary care: systematic review and meta-analysis. Archives of 

Internal Medicine 165, 986–995. 87 Kahan, M., Wilson, L., & Becker, L. (1995). Effectiveness of physician-based interventions with problem 

drinkers: A review. Canadian Medical Association Journal, 152, 851–859. 88 Wilk, A.I., Jensen, N.M., and Havighurst, T.C. (1997). Meta-analysis of randomized control trails addressing 

brief interventions in heavy alcohol drinkers. Journal of General Medicine, 12 (5), 274-283. 89 RTI International (2009). RTI International to Evaluate Comprehensive Substance Abuse Intervention Programs 

for SAMHSA. Retrieved from http://www.rti.org/newsroom/news.cfm?obj=070E322D-5056-B172­

B8E8D0FB9C898DB7 

[1] Services Accountability Improvement System, (2016) 

[2] Services Accountability Improvement System, (2016) 

170
 
Funding History 

Fiscal Year Amount 

FY 2014 $46,889,000 

FY 2015 $46,889,000 

FY 2016 $46,889,000 

FY 2017 $46,804,000 

FY 2018 $46,804,000 

 

 

 

 

 

 

and technical assistance and the evaluation of the SBIRT program. SAMHSA projects to fund one 

new training grant in FY 2017. 

Budget Request 

The FY 2018 Budget Request is $46.8 million, the same level as the FY 2017 Annualized CR. 

SAMHSA intends to fund a new SBIRT program utilizing a tiered evidence design. The new 

effort will utilize a two-tiered approach, in which a portion of the funds will be utilized to fund 

innovative approaches and the evaluation of such to broaden the program’s reach and scalability 

in a variety of settings. The remaining funds will support more traditional approaches to program 

implementation. Using this approach, along with robust cross-site evaluation, will enable 

innovation and assessment of targeted screening for drug use for specific populations in specific 

setting, i.e., young adults outside of healthcare settings. This design will allow for new approaches 

to brief intervention for drug abuse to develop and refine knowledge of what works and what does 

not; the tiered approach allows for the continued promotion and scaling up of SBIRT in primary 

care, school-based health programs, and emergency departments. SAMHSA also intends to fund 

20 continuations grants (12 SBIRT Student Training and eight SBIRT State) and support two 

contracts that include technical assistance and evaluation. 

171
 
 

 

Outputs and Outcomes Table 

Program: Screening, Brief Intervention and Referral to Treatment 

NOTE: SAMHSA makes grant awards toward the end of the year and therefore, bases the FY 2018 

targets on the FY 2017 Annualized CR and the FY 2019 targets are based on the FY 2018 

President’s Budget. 

Measure 

Year and Most Recent Result 

Target for Recent Result 

(Summary of Result) 

FY 2018 

Target 

FY 2019 

Target 

FY 2019 

Target 

+/−

FY 2018 

Target 

1.2.40 Increase the number of clients served 

(Output) 

FY 2016: 291,025 

Target: 143,7831 

(Target Exceeded) 

300,000 300,000 Maintain 

1.2.41 Increase the percentage of clients 

receiving services who had no past month 

substance use (Outcome) 

FY 2016: 29.5 % 

Target: 36 % 

(Target Not Met) 

36 % 36 % Maintain 

1Increase in target from previously reported. 

172
 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Targeted Capacity Expansion-General 

(Dollars in thousands) 

Programs of Regional & National Significance 

FY 2016 

Final 

FY 2017 

Annualized 

CR 

FY 2018 

President's 

Budget 

FY 2018 

+/−

FY 2017 

Targeted Capacity Expansion-General 

Medication-Assisted Treatment for Prescription 

Drug and Opioid Addiction (non-add) 

$36,303 

25,000 

$36,234 

24,952 

$36,234 

24,952 

--­

--­

Authorizing Legislation ........................................... Sections 509 of the Public Health Service Act 

Allocation Method ....................................Competitive Grants/Contracts/Cooperative Agreements 

Eligible Entities........................................Domestic Public and Private Non-Profit Entities, States, 

Opioid Medication-Assisted Treatment Service Providers, Outpatient Substance Abuse 

Providers, Community Mental Health Centers, Federally Qualified Health Centers, 

SAMHSA Certified Opioid Treatment Programs, and 

Licensed Outpatient Substance Abuse Treatment Programs 

Program Description and Accomplishments 

Urgent, unmet, and emerging substance abuse treatment and recovery support service capacity 

needs remain a critical issue for the nation. When these needs are not being addressed, there are a 

host of individual, societal, and community consequences. In an effort to assist communities in 

overcoming these barriers, SAMHSA initiated the Targeted Capacity Expansion (TCE) program. 

The 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 addiction; lack of 

resources needed to adopt and implement health information technologies (HIT) in treatment 

settings; and short supply of trained and qualified peer recovery coaches to assist individuals in 

the recovery process. 

Medication-Assisted Treatment for Prescription Drug and Opioid Addiction (MAT PDOA) 

MAT refers to the use of the Food and Drug Administration-approved pharmacotherapies 

(i.e., buprenorphine products, methadone, and naltrexone products) in combination with evidencebased psychosocial interventions for treatment of opioid addiction. MAT is a safe and effective 

strategy for decreasing the frequency and quantity of opioid use and reducing the risk of overdose 

and death. 

Drug overdose is the leading cause of accidental death in the U.S., with 52,404 lethal drug 

overdoses in 2015, an increase from 47,055 in 2014; among these deaths, 33,091 (63.1 percent) 

involved an opioid, an increase from 28,647 in 2014. Opioid addiction is driving this alarming 

trend, with 20,101 overdose deaths related to prescription pain relievers, and 12,990 overdose 

deaths related to heroin in 2015.90 Overdose deaths involving opioid pain relievers quadrupled 

from 1999 to 2014. Heroin overdose death rates increased by 20.6 percent from 2014 to 2015 and 

90 Rudd RA, Seth P, David F, Scholl L. Increases in Drug and Opioid-Involved Overdose Deaths — United States, 

2010–2015. MMWR Morb Mortal Wkly Rep 2016;65:1445–1452. DOI: 

http://dx.doi.org/10.15585/mmwr.mm655051e1 

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have more than tripled since 2010, from 1.0 per 100,000 in 2010 to 3.4 per 100,000 in 2014. 

Despite these troubling statistics, significant gaps persist between treatment needs and capacity. 

In 2012, 48 states and the District of Columbia reported levels of opioid addiction that were higher 

than their rates of MAT capacity. Furthermore, 38 states reported that at least 75 percent of their 

opioid treatment programs (OTPs) were operating at 80 percent or greater capacity.91 

MAT PDOA addresses treatment needs of individuals who have an opioid addiction by 

expanding/enhancing treatment system capacity to provide accessible, effective, comprehensive, 

coordinated/integrated, and evidence-based MAT and recovery support services. Recovery 

support services include linking patients and families to social, legal, housing, and other supports 

to improve the probability of positive outcomes. 

In FY 2016, SAMHSA funded 11 continuation state grants, 11 new state grants, as well as one 

contract. In FY 2017, SAMHSA plans to fund 22 continuation state grants, and one technical 

assistance contract. The 22 grantees in FY 2016 represent all 10 HHS regions in the U.S. To date, 

approximately 2,470 individuals with opioid addiction are being served through the grant program. 

In FY 2017, SAMHSA plans to fund 22 continuation MAT PDOA grants and one continuing 

technical assistance contract. 

Targeted Capacity Expansion-Technology Assisted Care (TCE-TAC) 

Access to treatment still remains inadequate for underserved populations living with drug/alcohol 

addiction and/or co-occurring mental illness and drug/alcohol addiction, such as those living in 

rural and extremely rural areas. A key component of this access challenge relates to a lack of 

dependable transportation and many organizations experience significant financial constraints in 

serving these rural populations. SAMHSA believes that behavioral healthcare providers who use 

health information technology (HIT) can help patients improve their access to necessary care and 

prevention services. For example, tele-health and tele-psychiatry can bring addiction medicine 

providers to clients in areas without local specialists. Web-based tools can improve 

communication and help deliver much-needed support and education. Health information 

technology approaches can also enable providers to document and coordinate better mental and 

substance abuse treatment services directly or via tele-psychiatry or telemedicine with families and 

other providers and specialists. 

SAMHSA established the TCE-TAC grant program to address the lack of resources in the field 

necessary to adopt and implement health information technologies including electronic health 

records (EHRs), smart phones, tablets, web-based technologies and applications to support tele

psychiatry and telemedicine. The program also addresses the behavioral healthcare providers’ 

need to expand and/or enhance their ability to communicate effectively with individuals in 

treatment, as well as monitor their health to ensure treatment and prevention services are available 

when and where needed. 

­

TCE-TAC and the predecessor program, Targeted Capacity Expansion-Health Information 

Technology (TCE-HIT), have improved care delivery in 48 behavioral healthcare organizations 

91Jones, C. M., Campopiano, M., Baldwin, G., McCance-Katz, E. (2015). National and state treatment need and 

capacity for opioid agonist medication-assisted treatment. American Journal of Public Health, 105(8), e55-c63. 

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across 23 states. In FY 2017, the TCE-TAC program will include 12 additional grantees; bringing 

to total since 2011 to 60 behavioral healthcare organizations. Grantees have deployed all of the 

above mentioned technologies to provide substance abuse treatment services directly or via remote 

service delivery (i.e., tele-psychiatry and telemedicine). In FY 2015, the TCE-TAC and TCE- HIT 

programs served roughly 1,195 individuals. Health information technology clearly holds great 

potential for increasing access to treatment services and providing reliable exposure to meaningful 

health information for underserved individuals with mental illness and drug/alcohol addiction. 

Providing the means to sustain this technology is likely to be an ongoing challenge for these and 

similarly-situated organizations. For example, River Edge Behavioral Health Center, Macon, GA, 

used funds from SAMHSA’s TCE-TAC grant to establish an “I-Care Network” and promoted its 

successes at the 2014 American Telemedicine National Conference. The I-Care Network uses 

innovative technology including a HIPAA compliant product called “Veamea” to expand access 

to tele-health and advance service delivery for individuals with substance drug/alcohol 

addiction. In addition, a web portal and computer lab called “Smoke Signal” is used to enhance 

access to counseling and treatment for any client with s disorders within River Edge Behavioral 

Health Center areas of responsibility. The combined use of both technologies helped to improve 

overall access for clients in rural and remote areas across more than 10 counties in central and 

northeast Georgia with transportation challenges.

92 

In FY 2016, SAMHSA funded 13 new TCE-TAC grants to enhance or expand the capacity of 

treatment providers to serve individuals who are traditionally underserved and to help achieve and 

maintain recovery and to improve the overall quality of life for those being served. 

In FY 2017, SAMHSA plans to support continued funding for the 12 TCE-TAC grant awards. 

These awards support the continuous development and deployment of unique advanced technology 

solutions to serve more clients with fewer resources. These adaptable and scalable HIT solutions 

use common technical requirements and components, making interoperability possible across 

various health domains of mental health services, substance abuse prevention, and substance abuse 

treatment services. In addition, these state-of-the-art innovative solutions supports integrated 

behavioral healthcare delivery across rural and extremely rural communities. 

Targeted Capacity Expansion-Peer to Peer (TCE-PTP) 

Peer support is built on the premise that individuals in recovery from substance drug/alcohol 

addiction can be of great value through the sharing of their recovery experiences with those 

attempting to achieve and sustain recovery. Peer recovery support services, as an adjunct to 

clinical treatment, extends the reach of treatment beyond the clinical setting into the everyday 

environment of those seeking to achieve or sustain recovery from substance drug/alcohol 

addiction. Peer support and peer recovery support services have been shown to reduce healthcare 

costs. Additionally, the overall message from limited research studies conducted to date is that 

recovery support service adjuncts appear to be helpful over and above treatment alone 

92 Monroe County Reporter (2014). River Edge to present successes in telemedicine at national conference. 

Retrieved from http://www.mymcr.net/news/river-edge-to-present-successes-in-telemedicine-at-nationalconference/article_f448ca2c-26c1-5c96-adf4-d1c37f7195f1.html 

175
 
 

 

 

 

 

Funding History 

Fiscal Year Amount 

FY 2014 $13,223,000 

FY 2015 $23,223,000 

FY 2016 $36,303,000 

FY 2017 $36,234,000 

FY 2018 $36,234,000 

 

There is currently a short supply of adequately trained peer support providers to work both in 

treatment and community-based settings. There is also a growing need to train and certify existing 

peer providers to address the increasing demand and diverse settings in which peer providers are 

employed. Since 2002, SAMHSA has awarded over 105 grants to community-based organizations 

to provide peer recovery support services to individuals in or seeking recovery from substance 

drug/alcohol addiction and their families. The primary objective of these services is to help 

individuals and families in search of recovery to obtain much needed support, sustain clinical 

treatment gains, engage in healthy community living, and improve overall quality of life. This 

grant program incorporates a peer-to-peer model, which capitalizes on the expertise of those 

individuals with similar lived experience. 

The TCE-PTP program has reached over 5,800 individuals and their families. Significant strides 

have been made in increasing abstinence, work and educational opportunities, social 

connectedness, housing stability, housing support, and decreasing criminal justice involvement. 

In FY 2016, the percentage of people who were employed or currently attending school increased 

from 27.5 percent at intake to 47.1 percent at six-month follow-up and abstinence in the past 

30 days from alcohol and drug use improved from 63.6 percent at intake to 82.1 percent at sixmonth month follow-up. In addition, the percentage of individuals reporting stability in housing 

improved from 45.2 percent at intake to 55.6 percent at six-month follow-up. In FY 2017, 

SAMHSA plans to fund 17 continuation TCE peer-to-peer grants and two contracts. 

Budget Request 

The FY 2018 Budget Request is $36.2 million, level with the FY 2017 Annualized CR. SAMHSA 

intends to fund 11 new MAT PDOA grants, 11 continuation MAT PDOA grants, 12 TCE-TAC 

continuation grants, and 17 TCE-PTP continuation grants, as well as support two contracts. 

176
 
 

 

Outputs and Outcomes Tables 

Program: Treatment Prescription Drug and Opioid Addiction 

NOTE: SAMHSA makes grant awards toward the end of the year and therefore, bases the 

FY 2018 targets on the FY 2017 Annualized CR and the FY 2019 targets are based on the 

FY 2018 President’s Budget. 

Measure 

Year and Most Recent Result 

Target for Recent Result 

(Summary of Result) 

FY 2018 

Target 

FY 2019 

Target 

FY 2019 

Target 

+/−

FY 2018 

Target 

1.3.01 Increase the number of 

admissions for Medication 

Assisted Treatment (Output) 

FY 2016: 1,616 

Target: 1,400 

(Target Exceeded) 

1,400 1,400 Maintain 

1.3.02 Increase number of clients 

receiving integrated care (Output) 

FY 2016: 1,280 

Target: 1,100 

(Target Exceeded) 

1,100 1,100 Maintain 

1.3.03 Decrease illicit drug use at 

6-month follow-up (Outcome) 

FY 2016: 61% 

Target: 61% 

(Baseline) 

60% 60% Maintain 

177
 
178

Pregnant and Postpartum Women 

(Dollars in thousands) 

Programs of Regional & National Significance 

FY 2016 

Final 

FY 2017 

Annualized 

CR

FY 2018 

President's 

Budget 

FY 2018 

+/− 

FY 2017 

Pregnant and Postpartum Women $15,931 $19,901 $19,931 $30 

Authorizing Legislation..................................Section 508 of the Public Health Service Act 

FY 2018 Authorization.............................................................................. $16,900

Allocation Method .................................... Competitive Grants/Contracts/Cooperative Agreements 

Eligible Entities .................................................... Domestic Public and Private Non-Profit Entities 

Program Description and Accomplishments 

From 1992 to 2012, a steady four percent of women admitted to treatment were pregnant. From 

FY 2003 through FY 2015, 28.4 percent of pregnant and postpartum women who had custody of 

their children at intake reported any illegal drug use in the past 30 days.93 Since many traditional 

substance abuse treatment programs do not allow for the inclusion of children, a woman may be 

torn between the need to care for her dependent children and the need for treatment.94 The nation’s 

opioid crisis has also added to this challenge for many pregnant and parenting women. The 

proportion of pregnant women entering treatment who reported any prescription opioid misuse 

increased substantially from two percent in 1992 to 28 percent in 2012, an increase of 173 percent, 

from 351 to 6,087 women.95 The proportion of pregnant women who entered treatment and 

reported prescription opioids as their primary substance use increased from one percent in 1992 to 

19 percent in 2012, an increase of 344 percent, from 124 to 4,268 women.96

Since 2003, SAMHSA has supported comprehensive residential substance abuse treatment, 

prevention, and recovery support services for pregnant and postpartum women, their minor 

children, and services for other family members (e.g., fathers of the children) through the Pregnant 

and Postpartum Women program (PPW). SAMHSA has successfully implemented a familycentered approach in the PPW program, which has evolved over time. This approach includes 

partnering with others to leverage diverse funding streams, encouraging the use of evidence-based 

practices, supporting innovation, and developing workforce capacity to meet the needs of these 

families. 

The PPW family-centered approach includes a variety of services and case management for 

women, children, and families. Services provided to women include: outreach; engagement; pretreatment; screening and assessment; detoxification; substance misuse education; treatment; 

relapse-prevention; healthcare services, including mental health services; postpartum health care, 

including attention to depression, anxiety, and medication needs; parenting education and 

 

93 Services Accountability Improvement System. 

94 Women and Treatment, Office of National Drug Control Policy. Retrieved from 

http://www.whitehouse.gov/ondcp/women-treatment

95 Journal of Substance Abuse Treatment, 48(1), 37–42. 

96 Martin, Longinaker, & Terplan, 2014. 
179

interventions; home management and life skills training, education, testing, and counseling; and 

treatment of hepatitis, HIV/AIDS, and other sexually transmitted diseases. Services available to 

children include screening and developmental diagnostic assessments regarding social, 

emotional, cognitive, and physical well-being prevention assessments; and interventions related to 

mental, emotional, and behavioral wellness. Services for families include family-focused 

programs to support family strengthening, including, involvement with the child’s other parent. 

The PPW program also supports tobacco use counseling and interventions, screening and 

assessment for Fetal Alcohol Syndrome Disorders, and a trauma-informed approach.

The PPW program provides essential services not covered under most public and private 

insurance. Based on an in-depth review of cross-site evaluation and performance data in FY 2014, 

SAMHSA built the current PPW program model on an evidence-based approach for serving 

pregnant and post-partum women in need of residential substance abuse treatment. 

In FY 2015, SAMHSA developed and began implementing a two-year action plan to inform and 

guide the development of the PPW program in FY 2017 to ensure a wider uptake of a familycentered approach. Since FY 2015, SAMHSA has placed an increased focus on studying sustained 

models of care and developing training curricula. 

In FY 2016, SAMHSA funded two new residential treatment grants, 25 residential treatment grant 

continuations, and one Addiction Technology Transfer Center (ATTC) supplement grant 

continuation. 

In FY 2016, SAMHSA convened a PPW Family-Centered Summit. The Summit’s purpose was 

to elicit recommendations from experts in the area of women’s substance abuse treatment services 

and family-centered care to inform the expansion of CSAT’s PPW program to incorporate a wider 

range of family-centered services for pregnant and postpartum women and their minor 

children. This includes the expansion of treatment modalities to go beyond residential treatment 

and include intensive outpatient and outpatient treatment with or without housing components. 

SAMHSA has reviewed the recommendations from the Summit and is taking them into 

consideration in determining the future direction of the PPW Program, including the development 

of service requirements for the PPW program expansion effort to support wide-scale adoption of 

the family-centered approach. 

In FY 2017, SAMHSA plans to fund 19 new residential treatment grants, seven residential 

treatment grant continuations, and three contracts. In 2017, SAMHSA will fund additional PPW 

grants consistent with the new Comprehensive Addiction and Recovery Act (CARA) authority. 

Pregnant and Postpartum Women Pilot

A major aim of the Comprehensive Addiction and Recovery Act (CARA) is to address substance 

use and addiction across the country through the implementation of prevention, treatment, and 

recovery programs. In FY 2017, SAMHSA received funding to support two of these programs 

through its Substance Abuse Treatment Appropriation.

Historically, the PPW program has only supported the provision of residential treatment services. 

In order to ensure increased accessibility and availability of services for pregnant women, CARA 
180

authorizes the provision of outpatient and intensive outpatient services for pregnant women 

through the PPW Pilot program.

In FY 2017, SAMHSA plans on funding three new state PPW pilot grants to: 1) support familybased services for pregnant and postpartum women with a primary diagnosis of a substance use 

disorder, including opioid disorders; 2) help state substance abuse agencies address the continuum 

of care, including services provided to women in nonresidential-based settings; and 3) promote a 

coordinated, effective and efficient state system managed by state substance abuse agencies by 

encouraging new approaches and models of service delivery. An evaluation of this program will 

be conducted to determine the effectiveness of the pilot.

In addition to this Pilot, the Substance Abuse Treatment appropriation supports one other program 

with the additional funding to implement CARA programs.

Funding History

Fiscal Year Amount

FY 2014 $15,931,000

FY 2015 $15,931,000

FY 2016 $15,931,000

FY 2017 $19,901,000

FY 2018 $19,931,000

Budget Request

The FY 2018 Budget Request is $19.9 million, level with the FY 2017 Annualized CR. SAMHSA 

intends to fund five new residential treatment grants and 21 continuation residential treatment 

grants. These funds also support the continuation of the PPW Pilot ($4.0 million) to provide an 

array of services and supports to pregnant women and their children.
181

Recovery Community Services Program

(Dollars in thousands) 

Programs of Regional & National Significance 

FY 2016 

Final 

FY 2017 

Annualized 

CR

FY 2018 

President's 

Budget 

FY 2018 

+/− 

FY 2017 

Recovery Community Services Program $2,434 $2,429 $2,429 --- 

Authorizing Legislation ............................................. Section 509 of the Public Health Service Act

Allocation Method .................................... Competitive Grants/Contracts/Cooperative Agreements 

Eligible Entities .......................................................... Family/Consumer Controlled Organizations, 

Domestic Public and Private Non-Profit Organizations in States, Territories, and Tribes, 

Recovery Community Organizations of Domestic Private Non-Profit Entities in States, 

Territories, and Tribes 

Program Description and Accomplishments 

An estimated 23 million people in the United States are in recovery from addiction to alcohol and 

other drugs.97 As public education increases, we have witnessed a broader acknowledgement of 

addiction as a treatable condition that needs to be managed over the course of a lifetime. More 

people in recovery are now willing to be open about their own recovery and to share their 

experience to help others attempting to achieve recovery. Through the use of their lived 

experience, individuals in recovery can provide support and hope to those newly seeking recovery. 

Since 1998, SAMHSA has recognized the value of supporting recovery through peers and other 

recovery supports, and has provided funding through the Recovery Community Services Program 

(RCSP). RCSP was designed to assist recovery communities strengthen their infrastructure and 

provide peer recovery support services to those in or seeking recovery from drug/alcohol addiction 

across the nation. The delivery of recovery support services by people in recovery is known as 

peer recovery support services (PRSS). PRSS are a strong component in helping individuals and 

families address substance abuse in the context of chronic disease management, especially when 

delivered by a Peer (often known as a Recovery Coach, Peer Specialist, or Peer Mentor). 

SAMHSA initiated RCSP to help build an infrastructure for PRSS programs to support the 

development and expansion of peer recovery services. These peer services are most frequently 

offered by Recovery Community Organizations (RCOs), that now number over one hundred in the 

US alone. 

Though the RCSP was a services program from 2002-2010, it was evident that this approach 

needed to be taken system-wide to have a larger effect. Many states recognize the value of 

addiction peer recovery services; however, further efforts are required to realize the potential of 

these services and supports at a system-wide level. The infusion of these services into state 

systems is critical in ensuring the wide scale adoption of peer recovery support. By developing a 

workforce of trained and certified peers and engaging recovery community organizations in the 

full continuum of treatment and recovery services, states have the ability to enhance their systems 

to ensure holistic approaches to care. SAMHSA supports this state system development effort 

 

97 Partnership for Drug Free Kids, March, 2015. Retrieved from http://www.drugfree.org/newsroom/survey-tenpercent-of-american-adults-report-being-in-recovery-from-substance-abuse-or-addiction 
182

through the RCSP Statewide Network grant program. Since the inception of the RCSP, over 120 

grants have been awarded to RCOs to expand PRSS locally and lay the groundwork for a national 

network of PRSS programs. 

Recovery Community Services Program Statewide Network (RCSP-SN) 

The RCSP-SN grant program supports a statewide approach to enhance the presence of people 

with lived experience in recovery from drug/alcohol addiction as key partners in state systems, as 

well as building a peer workforce. Key activities include collaborating on local and state 

workforce-development, developing linkages with other organizations that promote recovery 

throughout the state, and participating in policy, planning, and program development discussions 

at the state, community, and local level. Involving recovery community leaders and key 

stakeholders in decision making helps states to design peer services and PRSS programs that are 

authentic to the recovery experience, complementary to clinical practice, demonstrate strong 

recovery outcomes, and are sustainable over time. Additionally, the statewide networks help to 

ensure the development of a trained, qualified, and aptly supervised peer workforce. 

Key workforce outcomes for the program include the amount of training provided, the number of 

people trained, trainee satisfaction, and the usefulness of information presented. Other key 

outcomes include: the number of RCOs that have been linked across the state; the number of statesponsored events where participation of the statewide network occurred; the effects of linkages 

with behavioral health and other health systems; the outcomes of program activities on raising 

awareness about addiction peer recovery support; and the number of policy/program discussions 

which included addiction peer recovery support as a result of project efforts. 

In FY 2017, SAMHSA plans to fund a new cohort of up to 10 RCSP-SN grants, three contracts, 

as well as a statewide peer network development activity to foster collaboration between the 

addiction recovery and mental health consumer and family network communities. This effort is 

also supported by a contract designed to strengthen the development and expansion of the recovery 

support work of the RCSP-SN grantees and other related SAMHSA recovery support efforts. 

Funding History 

Fiscal Year Amount 

FY 2014 $2,434,000 

FY 2015 $2,434,000 

FY 2016 $2,434,000 

FY 2017 $2,429,000

FY 2018 $2,429,000

Budget Request 

The FY 2018 Budget Request is $2.4 million, level with the FY 2017 Annualized CR. SAMHSA 

intends to fund the continuation of 10 RCSP Statewide Network grants and two technical 

assistance contacts to continue the efforts of building addiction recovery networks throughout the 
183

nation and the collaboration among peer-run organizations working toward mental illness and 

substance abuse treatment service integration. 

Children and Families 

(Dollars in thousands) 

Programs of Regional & National Significance 

FY 2016 

Final 

FY 2017 

Annualized 

CR

FY 2018 

President's 

Budget 

FY 2018 

+/− 

FY 2017 

Children and Families $29,605 $29,549 $29,549 --- 

Authorizing Legislation ............................................. Section 509 of the Public Health Service Act 

Allocation Method .................................... Competitive Grants/Contracts/Cooperative Agreements 

Eligible Entities ......................... Single State Agencies in States, Territories, District of Columbia, 

Federally Recognized American Indian/Alaska Native Tribes, and Tribal Organizations 

Program Description and Accomplishments 

Substance abuse plays a significant role in the lives of many children and youth (ages 12 to 25) 

throughout the nation. In 2014, approximately nine percent of adolescents between the ages of 12 

and 17 and 22 percent of youth between the ages of 18 and 25 reported current illicit drug use. 

Five percent of adolescents and 16 percent of youth between the ages of 18 and 25 reported alcohol 

and/or illicit drug abuse or dependence. Many of these youth have co-occurring mental illness and 

drug/alcohol addiction. In 2014, among those adolescents who had a diagnosable substance use 

disorder in the past year, approximately 28 percent had a co-occurring major depressive episode. 

Approximately seven percent of admissions to substance abuse treatment facilities were 

adolescents in 2012. Most substance abuse begins during adolescence, making this developmental 

period a critical time for intervention.98 Sixty-one percent of infants and 41 percent of older 

children involved in the child welfare system have at least one parent who is using drugs or alcohol. 

On average, 31 percent of children are removed from home care resulting from parental alcohol or 

drug use; this rate increases to 41 percent for children under the age of one. SAMHSA’s Children 

and Families programs make appropriate treatment available to youth and their families/caregivers 

to reduce the impact of substance abuse and/or co-occurring substance abuse and mental disorders 

on America’s communities.99

Substance Abuse Treatment for Youth 

In 2013, less than 10 percent of youth (ages 12 to 25) with an illicit drug or alcohol use problem 

received the needed treatment at a specialty facility. Although data show that the number of youth 

with illicit drug or alcohol use problems has declined since 2002, there is still a significant percent 

that need but are not receiving treatment.100 Adolescents constitute 7.4 percent of total admissions 

to the public substance abuse treatment system.101 Youth have psychological, developmental, and 

 

98 2014 National Survey on Drug Use and Health (NSDUH)

99 Wulczyn, F., Ernst, M., & Fisher, P. (2011). Who are the children in out-of-home care? An epidemiological and 

developmental snapshot. 

100 2013 National Survey on Drug Use and Health (NSDUH) 

101 2012 TEDS Report, CBHSQ 
184

emotional needs that are distinct from adults. The neurological and developmental differences 

between youth and adults require tailored treatment and recovery approaches for youth with 

drug/alcohol addiction. 

SAMHSA’s programs to treat youth with addiction and/or co-occurring substance abuse and 

mental disorders address gaps in service delivery by providing services for youth and their families 

and primary caregivers using effective evidence-based, family-centered practices. SAMHSA 

supports a youth treatment grant initiative at the state, territorial, and tribal levels. The populations 

of focus for the initiatives are adolescents (ages 12 to 17), transitional-aged youth (ages 18 to 25), 

and their families and caregivers. 

The initiative helps to further the use of, and access to, effective evidence-based family-centered 

treatment approaches for youth with drug/alcohol addiction. The initiative includes statewide 

training and collaboration between local community-based providers and their state, tribal, or 

territorial infrastructure. The services provided include evidence-based assessment and treatment 

interventions appropriate for adolescents and transitional age youths. 

From FY 2013 to FY 2015, these programs served approximately 3,870 individuals. Of those 

served from intake to six-month follow-up from intake, there was a: 50 percent increase in 

abstinence from substance use, 11 percent increase in no alcohol-related or illegal drug-related 

health, behavioral, or social consequences, and 5 percent increase in no arrests in the past 30 

days102. Since FY 2012, the initiative has assisted in developing or strengthening the 

infrastructures in 37 states, territories, and tribes, which resulted in the development of policies to 

increase access to treatment for youth with drug/alcohol addiction, an expanded trained workforce, 

the dissemination of evidence-based family centered practices, and the implementation of financial 

mechanisms to fund treatment for youth with drug/alcohol addiction. 

In FY 2015, SAMHSA began a new five-year evaluation to assess the effectiveness of the 

initiative, document best practices, disseminate lessons learned, and guide programmatic and 

policy changes. SAMHSA also restructured the initiative into two separate approaches in order to 

distinguish planning and implementation efforts. With this change, SAMHSA is supporting a twoyear youth treatment planning grant and a three-year youth treatment implementation grant. The 

planning grant is designed to support infrastructure development only; it does not have a direct 

service component. It supports states, territories, and tribes in strengthening the existing 

infrastructure to ensure that youth have access to evidence-based assessments, treatment, and 

recovery support services. The implementation grant includes infrastructure and direct services. 

It further strengthens the existing state, territorial, and tribal infrastructure and provides direct 

treatment services for adolescents and/or transitional aged youth and their families/care givers with 

SUDs. 

Addressing Child Abuse and Neglect

SAMHSA and the Administration for Children and Families collaborate to address child abuse 

and neglect by supporting a National Center on Substance Abuse and Child Welfare (NCSACW). 

NCSACW works across agencies to provide technical assistance and training to professionals in 

order to meet the needs of families affected by parental substance abuse. From September 2016 

 

102 Services Accountability Improvement System. 
185

through March 2017, NCSACW disseminated nearly 8000 informational materials, which include 

reports, guidance documents, presentations from conferences and webinars, research articles, 

toolkits, and grantee site-specific tools. NCSACW facilitated 30 events, attended by an estimated 

4,000 participants, with an average of 130 attendees per event. NCSACW monitored and provided 

support to trainees on web-based tutorials. Since 2007, 71,141 users have completed the 

NCSACW’s tutorials and the current completion rate is 97 percent. The content of the tutorials 

was updated in 2015 to infuse the latest research and evidence-based practices and to offer a more 

interactive and engaging user experience. NCSACW’s activities have assisted professionals 

throughout the nation in improving cross-system collaboration and being better prepared to meet 

child welfare mandates requirements for timely child permanency decisions. 

NCSACW continues to provide support and technical assistance and training to tribes, state 

agencies, and communities to developing collaborative approaches to the treatment of pregnant 

women with opioid addiction. Since its publication in August 2016, NCSACW has disseminated 

the SAMHSA publication A Collaborative Approach to the Treatment of Pregnant Women with 

Opioid Use Disorders: Practice and Policy Considerations for Child Welfare, Collaborating 

Medical, and Service Providers to child welfare, substance abuse treatment, dependency court, and 

medical professionals. The publication has been downloaded 13,000 times from the NCSACW 

website. Since the passage of the Comprehensive Addiction and Recovery Act of 2016 (CARA), 

Section 503, Infant Plan of Safe Care Act, NCSACW has responded to 440 TA requests on Plans 

of Safe Care and the provisions on prenatal substance exposure in the Child Abuse and Prevention 

Treatment Act (CAPTA). Launched in September 2014, NCSACW provides the Substance 

Exposed Infant In-Depth Technical Assistance Program (SEI-IDTA) to strengthen collaboration 

linkages across child welfare, substance abuse treatment, and the courts, as well as medical 

communities, early care and education systems, home visiting, and other key partners to improve 

outcomes for infants and their families. 

In FY 2016, SAMHSA funded 32 grant continuations (11 for youth treatment grants, 10 for youth 

treatment planning grants, and 11 for youth treatment implementation grants), and five contracts. 

SAMHSA also funded two new youth treatment implementation grants to support treatment for 

youth with SUD. 

In FY 2017, SAMHSA plans to fund 10 new youth treatment implementation grants and one new 

contract. SAMHSA also plans to fund 14 grant continuations and two continuing contracts. 
186

Funding History 

Fiscal Year Amount 

FY 2014 $29,605,000 

FY 2015 $29,605,000 

FY 2016 $29,605,000 

FY 2017 $29,549,000

FY 2018 $29,549,000

Budget Request 

The FY 2018 Budget Request is $29.5 million, level with the FY 2017 Annualized CR. In 

FY 2018, SAMHSA intends to fund 12 new youth treatment implementation grants. SAMHSA 

also intends to fund 15 grant continuations. These funds will continue to address the gaps in 

substance abuse treatment by providing services for youth, their families, and caregivers. 

Treatment Systems for Homeless 

(Dollars in thousands) 

Programs of Regional & National Significance 

FY 2016 

Final 

FY 2017 

Annualized 

CR

FY 2018 

President's 

Budget 

FY 2018 

+/− 

FY 2017 

Treatment Systems for Homeless $41,304 $41,225 $41,225 --- 

Authorizing Legislation ............................................. Section 506 of the Public Health Service Act 

FY 2018 Authorization .........................................................................................................$41,304 

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

Eligible Entities ........................................ States, Domestic Public and Community Organizations, 

Private Nonprofit Entities, and Community-based Public or Nonprofit Entities 

Program Description and Accomplishments 

SAMHSA’s Treatment Systems for Homeless portfolio supports services for those with 

drug/alcohol addiction and who are experiencing homelessness, including veterans, and those 

experiencing chronic homelessness. 

Between 2007 and 2014, homelessness in the United States declined by 11 percent, while chronic 

homelessness declined by 31 percent.103 Chronic homelessness is defined as individuals or 

families with a disabling condition who have been without housing for longer than one year or 

more than four times in the past three years. Despite this progress, the number of people 

experiencing homelessness remains at unacceptably high levels. On a given night in January 2015, 

 

103 The U.S. Department of Housing and Urban Development, Office of Community Planning and Development. 

(2014). The 2014 Annual Homeless Assessment Report (AHAR) to Congress, Part 1. Retrieved 

from https://www.hudexchange.info/resources/documents/2015-AHAR-Part-1.pdf
187

564,708 individuals were experiencing homelessness. Of these individuals, 96,275 were 

experiencing chronic homelessness, 104,083 had severe mental illness, 103,888 were affected by 

chronic substance abuse, and 47,725 were veterans.104

Many factors contribute to the problem of homelessness, including lack of affordable housing, 

foreclosures, rising housing costs, job loss, underemployment, mental illness, and drug/alcohol 

addiction. The progress made to date in reducing homelessness points to improvement in services, 

as well as the effectiveness of collaboration across all levels, from the federal government to state 

governments and community systems. The U.S. Interagency Council on Homelessness, in which 

HHS participates, has set aggressive goals to prevent and end homelessness. These goals include: 

preventing and ending homelessness among veterans; preventing and ending chronic 

homelessness; preventing and ending homelessness for families, youth, and children; and setting 

a path to ending homelessness for all individuals. The services and support offered through 

SAMHSA’s Treatment Systems for Homeless programs are crucial to achieving these goals. 

SAMHSA’s homelessness programs are a component of its Recovery Support Strategic Initiative. 

One of the goals of this Strategic Initiative is to increase access to permanent housing for 

individuals with mental illness and/or substance drug/alcohol addiction and their families. 

SAMHSA manages the following Treatment Systems for Homelessness grant programs: 

Cooperative Agreements to Benefit Homeless Individuals (CABHI) 

In FY 2011, SAMHSA initiated the Cooperative Agreements to Benefit Homeless Individuals 

(CABHI) program, jointly funded by Center for Substance Abuse Treatment (CSAT) and Center 

for Mental Health Services (CMHS) to support treatment and the development and/or expansion 

of local systems that provide permanent housing and supportive services. This includes integration 

of treatment and other critical services for individuals with serious mental illness and drug/alcohol 

addiction. Target populations for this program include veterans and individuals with serious 

mental illness and/or drug/alcohol addiction. CABHI also supports coordination and planning at 

the local level with state or local Public Housing Authorities, local mental health, substance 

misuse, and primary care provider organizations, the local Department of Housing and Urban 

Development-supported Continuum of Care (CoC) program, the state Medicaid Office, and the 

state Mental Health and Substance Abuse Authorities. 

Cooperative Agreements to Benefit Homeless Individuals for States (CABHI-States) 

In FY 2013, SAMHSA initiated the CABHI-States program, funded jointly by CSAT and CMHS, 

which builds on the CABHI program by working with states to provide accessible, effective, 

comprehensive, coordinated/integrated, and evidence-based treatment services. CABHI-States 

supports services for individuals with serious mental illness and/or drug/alcohol addiction who 

experience chronic homelessness and/or veterans who experience homelessness. It also provides 

peer supports and enhancement or development of a statewide plan to ensure sustained 

collaboration across public health and housing systems that will result in short-term and long-term 

strategies to support behavioral health services for individuals who experience chronic 

homelessness. The grantees work with state and local Public Housing Authorities and state 

Medicaid agencies to develop systematic, cost-effective, and integrated approaches to housing and 

 

104 U.S. Department of Housing and Urban Development (HUD) 2014 Continuum of Care (CoC) Homeless 

Assistance Programs-Homeless Populations and Subpopulations Report. Retrieved from 

https://www.hudexchange.info/resource/reportmanagement/published/CoC_PopSub_NatlTerrDC_2015.pdf
188

behavioral disorder treatment and services for individuals with mental illness and/or drug/alcohol 

addiction experiencing homelessness. This program was further enhanced in FY 2015 with the 

implementation of CABHI State Enhancement grants, which enabled CABHI-States grantees to 

build upon their programs. 

Grants for the Benefit of Homeless Individuals (GBHI) 

In FY 2017, CSAT plans to fund the GBHI program (last funded in FY 2010). The purpose of this 

program is to support the development and/or expansion of local implementation of a community 

infrastructure that integrates behavioral health treatment and services for drug/alcohol addiction 

and co-occurring mental illness and drug/alcohol addiction, permanent housing, and other critical 

services for individuals (including youth) and families experiencing homelessness. 

Based on FY 2016 data for CSAT funded programs, 58 percent of clients in Treatment Systems 

for Homeless-supported programs report abstinence from substance use at a six-month follow up, 

while approximately 25.3 percent of clients report being employed or engaged in productive 

activities and 54.4 percent of clients report having a permanent place to live in the community.105

In FY 2016, SAMHSA funded 30 new CABHI grants to states, local governments, and community 

based organizations and 50 continuation grants (33 GBHI-SSH, seven CABHI-States 

Enhancements, and 10 CABHI-States). Additional funds support up to two contracts including 

cross-center contracts for national evaluation and technical assistance. 

In FY 2017, SAMHSA plans to fund 14 new CABHI grants, 24 new GBHI grants, and 46 

continuation grants (30 CABHI, seven GBHI-SSH, and nine CABHI-States) as well as supporting 

two contracts for national evaluation and technical assistance. 

Funding History 

Fiscal Year Amount 

FY 2014 $41,386,000 

FY 2015 $41,386,000 

FY 2016 $41,304,000 

FY 2017 $41,225,000 

FY 2018 $41,225,000

Budget Request 

The FY 2018 Budget Request is $41.2 million, level with the FY 2017 Annualized CR. SAMHSA 

plans to support annual Cooperative Agreements to Benefit Homeless Individuals for StatesEnhancement (CABHI-States Enhancement) and Grants for the Benefit of Homeless Individuals 

(GBHI) grant continuations and continue to expand programs and support homeless programs 

through the support of new grants. SAMHSA intends to fund 68 continuation grants; 44 for 

CABHI and 24 GBHI. SAMHSA also plans to award nine new CABHI grants, and 10 new GBHI 

 

105 Services Accountability Improvement System. (2014). Retrieved from www.samhsa-gpra.samhsa.gov.
189

grants. Additional funds will support two contracts including the continuation of cross-center 

contracts for national evaluation and technical assistance. 
190

Outputs and Outcomes Table

Program: Treatment System for Homelessness (GBHI)

NOTE: SAMHSA makes grant awards toward the end of the year and therefore, bases the

FY 2018 targets on the FY 2017 Annualized CR and the FY 2019 targets are based on the 

FY 2018 President’s Budget.

Measure

Year and Most Recent Result

Target for Recent Result

(Summary of Result)

FY 2018

Target

FY 2019

Target

FY 2019

Target

+/−

FY 2018

Target

3.4.22 Increase the percentage of 

clients receiving services who had 

no past month substance use 

(Outcome)

FY 2016: 58.0 %

Target: 65.0 %

(Target Not Met)

65.0 % 65.0 % Maintain

3.4.23 Increase the number of 

clients served (Output)

FY 2016: 4,694

Target: 5,800

(Target Not Met but Improved)

5,100 5,100 Maintain

3.4.24 Increase the percentage of 

homeless clients receiving services 

who were currently employed or 

engaged in productive activities 

(Outcome)

FY 2016: 25.3 %

Target: 31.7 %

(Target Not Met)

30 % 30 % Maintain

3.4.25 Increase the percentage of 

clients receiving services who had a 

permanent place to live in the 

community (Outcome)

FY 2016: 54.4 %

Target: 33 %

(Target Exceeded)

33 % 33 % Maintain
191

Minority AIDS 

(Dollars in thousands) 

Programs of Regional & National Significance 

FY 2016 

Final 

FY 2017 

Annualized 

CR

FY 2018 

President's 

Budget 

FY 2018 

+/− 

FY 2017 

Minority AIDS $65,570 $65,445 $65,445 --- 

Authorizing Legislation ............................................. Section 509 of the Public Health Service Act 

Allocation Method .................................... Competitive Grants/Contracts/Cooperative Agreements 

Eligible Entities .................................................... Domestic Public and Private Non-Profit Entities 

Program Description and Accomplishments 

An estimated 287,400 women were living with HIV at the end of 2013, representing 23 percent of 

all Americans living with the virus; a disproportionate percent of the women living with HIV are

Black/African American and Hispanic/Latina women.106 In 2014, gay and bisexual men 

accounted for 83 percent (29,418) of the estimated new HIV diagnoses among all males aged 13 

and older and 67 percent of the total estimated new diagnoses in the United States.107 In addition, 

the Department of Health and Human Services’ National Viral Hepatitis Action Plan cites people 

living with HIV and viral hepatitis co-infection as a priority population. Among the 1.2 million 

people in the United States living with HIV, approximately one in 10 is co-infected with HBV and 

one in five is co-infected with HCV. 

Three of SAMHSA’s Minority AIDS Initiative (MAI) programs address HIV and hepatitis 

infection by facilitating the development and expansion of culturally competent and effective 

community-based treatment systems for substance drug/alcohol addiction and co-occurring mental 

illness and substance abuse treatment within racial and ethnic minority communities. The goals 

of the MAI program are to reduce the impact of behavioral health issues, reduce the risk for and 

incidence of HIV and hepatitis, and increase access to HIV and hepatitis testing and treatment for 

these individuals in states with the highest HIV prevalence rates (at or above 299.5 per 100,000). 

By region, the prevalence rates were highest in the Northeast at 419.5 per 100,000 

and the South at 352.5 per 100,000. 108

 

106 Center for Disease Control and Prevention. (2017). HIV Among Women. 

Retrieved from https://www.cdc.gov/hiv/group/gender/women/index.html 

107Center for Disease Control and Prevention. (2016). HIV Among Gay and Bisexual Men 

Retrieved from https://www.cdc.gov/hiv/group/msm/index.html

108Centers for Disease Control and Prevention. (2016). HIV in the United States by Geographic Distribution Retrieved from 

https://www.cdc.gov/hiv/pdf/statistics/cdc-hiv-geographic-distribution.pdf
192

Targeted Capacity Expansion Program (TCE): Substance Use Disorder Treatment for 

Racial/Ethnic Minority Populations at High-Risk for HIV/AIDS (TCE-HIV): High Risk 

Populations) 

Under SAMHSA’s TCE-HIV program, grantees are required to provide substance use and/or cooccurring substance use and mental disorder treatment, recovery support services, and HIV/AIDS 

testing and case management services. In addition, grantees must enhance infrastructure and 

capacity to improve their community’s response to HIV/AIDS by increasing access to care and 

services for racial and ethnic minorities at high risk for or living with HIV/AIDS. Target 

populations include young men who have sex with men, ages 18 to 29, adult heterosexual women 

and men, and men who have sex with men, ages 30 and older. 

In FY 2016, SAMHSA funded 78 TCE-HIV High Risk continuation grants and supported three 

contracts. In FY 2017, SAMHSA plans to fund 52 new grants, 26 grant continuations and three 

contracts. These grants are expected to reduce the negative impact of behavioral health problems; 

increase access to and retention in treatment for behavioral health conditions; reduce the risk of 

HIV; reduce new HIV and viral hepatitis infections by increasing HIV and viral hepatitis testing 

and diagnosis; and increase provisions of or linkage to HIV care including antiretroviral therapy. 

In FY 2017, SAMHSA plans to support 58 new and 25 continuation grants. 

Targeted Capacity Expansion: Substance Abuse Treatment for Racial/Ethnic Minority Women 

at High Risk for HIV/AIDS (TCE-HIV: Minority Women) 

The populations of focus for this program are African American, Hispanic/Latina, and other 

racial/ethnic minority women ages 18 years and older who have substance use or co-occurring 

substance use and mental disorders and are living with or at risk for HIV/AIDS and 

hepatitis. Grantees are expected to address the impact of violence and trauma on women’s 

increased risk of SUD and HIV infection, and provide comprehensive evidence-based traumainformed care services that consider the individuals adverse life experiences within the context of 

their culture, history, and experience of traumatic events. 

In FY 2016, SAMHSA supported 22 new TCE-HIV: Minority Women grants, and five grant 

continuations. In FY 2017, SAMHSA intends to support 23 continuations. 

Minority AIDS Initiative Continuum of Care Pilot- Integration of HIV Prevention and Medical 

Care into Mental Health and Substance Abuse Treatment Programs for Racial/Ethnic Minority 

Populations at High Risk for Mental and Substance Use Disorders and HIV (MAICoC Pilot: 

Integration of HIV Medical Care into BH Programs or “MAI-CoC”)

SAMHSA’s Centers for Mental Health Services, Substance Abuse Prevention, and Substance 

Abuse Treatment supported the MAI Continuum of Care Pilot (MAI CoC). This grant supports 

substance use and mental disorder treatment and substance abuse and HIV primary prevention 

programs that either can co-locate or have fully integrated HIV/AIDS and hepatitis prevention and 

medical care services for racial/ethnic minority populations. 
193

This program also provides primary prevention services for drug/alcohol addiction and HIV/AIDS 

in local communities served by behavioral health programs. People with drug/alcohol addiction

and mental disorders are at high risk for hepatitis, as over 60 percent of the estimated 3.9 million 

individuals in the U.S. currently chronically infected with HCV became infected through substance 

use (70-90 percent HCV prevalence for people who inject drugs). 109

By the third year, 2017, over 5,700 consumers were engaged in services for mental and substance 

abuse treatment. Across the program, 13 percent reported improved housing status and 47 percent 

with improvement in social connectedness; 24 percent reported improvements with ‘no illicit drug 

use’ and 20 percent with reduced psychological distress. Overall, there was a 66 percent reduction 

in emergency room use, with a decline from 4.5 to 2.0 percent. Over 13,000 individuals were 

tested for HIV, and over 10,000 were tested for hepatitis. For those testing positive, 61 percent

were linked to HIV medical care, and 76 percent for hepatitis treatment. In addition, thirteen 

grantees were supplemented to engage or strengthen a partnership in their community with a 

syringe services program for supportive linkages to behavioral health care and HIV and hepatitis 

testing and care. 

In FY 2017, SAMHSA plans to support up to 34 HIV CoC continuation grants. 

Funding History

Fiscal Year Amount

FY 2014 $65,570,000

FY 2015 $65,570,000

FY 2016 $65,570,000

FY 2017 $65,445,000

FY 2018 $65,445,000

Budget Request

The FY 2018 Budget Request is $65.5 million, level with the FY 2017 Annualized CR. SAMHSA 

intends to fund two new TCE-HIV/AIDS grants, and up to 34 HIV MAI CoC grants. SAMHSA 

also plans to fund 59 continuation TCE-HIV/AIDS grants, 23 HIV Women’s continuation grants, 

one Addiction Technology Transfer Center Network supplemental grant, and three new contracts. 

 

109 Services Accountability Improvement System. (2016)
194

Criminal Justice Activities 

(Dollars in thousands) 

Programs of Regional & National Significance 

FY 2016 

Final 

FY 2017 

Annualized 

CR

FY 2018 

President's 

Budget 

FY 2018 

+/− 

FY 2017 

Criminal Justice Activities $78,000 $77,852 $77,852 --- 

Authorizing Legislation ............................................. Section 509 of the Public Health Service Act 

Allocation Method .................................... Competitive Grants/Contracts/Cooperative Agreements 

Eligible Entities ............................... Domestic Public and Private Non-Profit Entities, Operational 

Individual Misdemeanor and Felony Adult Criminal Courts, 

Municipal Courts, Tribal, State, Local Government Proxies, 

Government with Direct Involvement with Adult Criminal Courts, 

Tribal Organizations and Individual Adult Tribal Healing to Wellness Courts, and 

Individual Juvenile Treatment Drug Courts 

Program Description and Accomplishments 

SAMHSA’s Criminal Justice portfolio includes several grant programs that focus on diversion, 

alternatives to incarceration, drug courts, and re-entry from incarceration for adolescents and 

adults with drug/alcohol addiction and/or co-occurring drug/alcohol addiction and mental illness. 

Drug Courts 

According to a 2006 Bureau of Justice Statistics report, approximately 74 percent of state 

prisoners, 63 percent of federal prisoners, and 76 percent of jail inmates met the criteria for a 

mental disorder. An estimated 42 percent of state prisoners and 49 percent of jail inmates met the 

criteria for both a mental illness and drug/alcohol addiction. Studies have found that for youth in 

the juvenile justice system, 50 to 70 percent met criteria for a mental disorder and 60 percent met 

criteria for a substance use disorder. Of those youth with co-occurring mental and substance use 

disorders, almost 30 percent experienced severe disorders that impaired their ability to function.110 

The criminal justice system was the major source of referrals to substance abuse treatment, with 

probation or parole referrals representing the largest proportion of criminal justice system referrals 

to treatment.111 Most probation or parole referrals to treatment were males between the ages of 18 

and 44.112

 The most common substances reported by these referrals were alcohol, marijuana, and 

methamphetamine. Similarly, in SAMHSA’s adolescent substance abuse treatment grant 

programs, juvenile justice is the most frequent referring agency. Although the prevalence of 

substance use disorders is high, only about 10 percent of those involved in the justice system 

received treatment and recovery services. 

Drug courts are designed to combine the sanctioning power of courts with effective treatment 

services for a range of populations with circumstances such as alcohol and/or drug use, child 

 

110 Teplin, Linda et al, (2005) Major mental disorders, substance use disorders, comorbidity and HIV-AIDS risk 

behaviors in juvenile detainees. Psychiatric Services, 56,: 7, pp 823-28. 

111 Client Level Data/TEDS CBHSQ (2012). Retrieved from http://www.samhsa.gov/data/client-level-data-teds 

112 SAMHSA. (2015). Criminal and Juvenile Justice. Retrieved from http://www.samhsa.gov/criminal-juvenilejustice
195

abuse/neglect or criminal behavior, veterans or people with mental illness. Drug courts represent 

the coordinated efforts of the judiciary, prosecution, defense bar, probation, law enforcement, 

mental health, social service, and treatment communities to intervene and break the cycle of 

substance misuse, addiction, and crime. Stakeholders work together to give individual clients the 

opportunity to improve their lives, including recovery from substance drug/alcohol addiction, and 

develop the capacity and skills to become fully-functioning parents, employees, and citizens. 

Many drug courts lack sufficient funding or the ability to implement evidence based practices for 

substance abuse treatment and recovery services.113 Through its Treatment Drug Court grant 

programs, SAMHSA seeks to reduce this gap in treatment services while also improving treatment 

services by requiring that evidence-based practices be used. SAMHSA’s interest is to support and 

shape treatment drug courts that serve clients with drug/alcohol addiction in the respective 

problem-solving court models as long as the court meets all the elements required for drug courts. 

The intent is to meet the treatment needs of clients using evidence-based practices consistent with 

the disease model and the problem-solving model, rather than with the traditional court caseprocessing model. A long-term goal of this program is to build sustainable systems of care for 

individuals needing treatment drug court services. 

SAMHSA’s Adult Drug Court programs support a variety of services including direct treatment 

services for diverse populations, wraparound/recovery support services designed to improve 

access and retention, drug testing for illicit substances, education support, relapse prevention and 

long-term management, pharmacotherapy, and HIV testing conducted in accordance with state and 

local requirements. The program seeks to address behavioral health disparities among racial and 

ethnic minorities by encouraging the implementation of strategies to decrease the differences in 

access, service use, and outcomes among the racial and ethnic minority populations served.

These grant programs use existing evidence from numerous studies to support current programs 

and new proposals. There have been more than 125 evaluation and research studies of the 

effectiveness of drug courts in addition to Government Accountability Office reports. SAMHSA’s 

funding opportunity announcements require evidence-based practices to be used from federal 

inventories, including SAMHSA’s National Registry of Evidence-Based Programs and Practices. 

SAMHSA also has regular communications with the National Association of Drug Court 

Professionals to obtain and incorporate the latest findings and field expertise.

Performance data show that these grant programs are effective in improving the lives of drug court 

participants. In FY 2015, 5,497 clients received services through the Drug Court Programs. Of 

these, 85.1 percent had no past month substance use, 91.8 percent had no involvement with the 

criminal justice system thirty days prior to intake, 58.9 percent of adult clients were either 

employed or engaged in productive activities, and 43.8 percent had a permanent place to live in 

the community. 

In FY 2015, SAMHSA supported the continuation of 103 drug court grants, 110 new family drug 

court grants, and 48 new Treatment Drug Courts; including 10 new Bureau of Justice Assistance 

jointly funded drug court grants. Additionally, SAMHSA conducted a performance evaluation of 

 

113 SAMHSA's GAINS Center for Behavioral Health and Justice Transformation. (n.d.). Adult Mental Health 

Treatment Courts Database. Retrieved from http://gainscenter.samhsa.gov/judgescourts/courtsjudges.asp
196

the FY 2015 Family Treatment Drug Court (FTDC) grant program. The purpose of this evaluation 

is to measure the performance of each FY 2015 FTDC grantee, including assessing the progress 

of children, parents, and family functioning after receiving SAMHSA funding. 

In FY 2015, FY 2016 and FY 2017, SAMHSA’s Adult Drug Court grant programs were required 

to ensure that drug courts funded by SAMHSA could not deny the use of FDA-approved 

medications for opioid addiction to drug court clients. Drug court judges, however, retained 

judicial discretion in cases where specified conditions for pharmacotherapy provisions were not 

met. 

In FY 2016, SAMHSA funded 122 drug court grant continuations, 60 new drug court grants 

including new BJA jointly funded drug court grants, and four contracts. In FY 2017, SAMHSA 

plans to fund 103 drug court grant continuations, 71 new drug court grants and two contracts. 

Criminal Justice Other/Offender Reentry Program 

In addition to the drug court portfolio, SAMHSA supports Offender Reentry Program (ORP) 

grants, as well as other criminal justice activities such as evaluation and behavioral health 

contracts. 

Studies show that only about 10 percent of individuals involved with the criminal justice system 

who are in need of substance abuse treatment receive it as part of their justice system supervision. 

Approximately one-half of the institutional treatment provided is educational programming.114 

Over the past decade, awareness of the need for a continuum of care of services for adult offenders 

has grown as states and local communities have struggled with the increasing number of these 

individuals returning to the community after release from correctional confinement. ORP grants 

provide screening, assessment, comprehensive treatment, and recovery support services for 

individuals reentering the community from incarceration. ORP services include screening, 

comprehensive individual assessment for substance use and/or co-occurring mental disorders, case 

management, program management, alcohol and drug treatment, wraparound services, drug 

testing, relapse prevention and long-term support. 

In FY 2016, SAMHSA funded 10 ORP grant continuations, one contract, and 20 new ORP grants 

that will implement the Risk-Needs- Responsivity Simulation Tool to implement best practices 

and opioid overdose prevention programs.115 In FY 2017, SAMHSA plans to fund 13 new ORP 

grants 27 ORP grant continuations. 

 

Behavioral Health Treatment Court Collaborative Program 

In FY 2014, SAMHSA supported a second cohort of four-year Behavioral Health Treatment Court 

Collaborative grants (BHTCC) in the Mental Health and Substance Abuse Treatment 

appropriations. BHTCC supports judges and staff of specialty (e.g., drug court) and other courts 

within a jurisdiction to work together to divert adults with mental illness and/or drug/alcohol 

addiction from the criminal justice system. The purpose of this grant program is to allow municipal 

 

114 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. 

115 George Mason University (2011). Risk-Needs-Responsivity (RNR) Simulation Tools. Retrieved from: Center for 

Advancing Correctional Excellence!: http://www.gmuace.org/research_rnr.html
197

courts more flexibility to collaborate with multiple criminal justice system components and local 

community treatment and recovery providers to address the behavioral health needs of adults who 

are involved with the criminal justice system. The court collaborative focuses on adults with 

behavioral health problems, including serious mental illness, from the criminal justice system, 

including alternatives to incarceration. The program supports community behavioral health 

services for individuals with mental and/or substance disorders and includes a focus on veterans 

involved with the criminal justice system. 

SAMHSA completed an evaluation of the first cohort of BHTCC grantees in September 2014. 

Findings of the evaluation demonstrate that grantees built multi-agency workgroups or 

collaboratives to oversee programs. Because of the grant funding, all grant recipients expanded 

access to specialty courts. Most grant recipients anticipated continuing new screening and 

assessment processes addressing a broader array of behavioral health needs after grant funding 

ended. Program innovations were divided into four main groups, including court and treatment 

provider collaboration, court and community case management, unified cross-court screening and 

referral, and meaningful peer involvement. Over 1,400 individuals were served through the 

BHTCC, with two-thirds of them identified as having co-occurring mental illness and substance 

abuse treatment services, trauma-specific treatment, peer support, and more. Based on 

performance data reporting, program participants experienced improvements in mental health and 

reductions in substance use. Alcohol and drug use declined by 60 percent in the first six months 

while mental health symptoms declined by 20 percent over the same period and 74 percent of 

participants reported physical health improvements at six months. In addition, employment rates 

increased from 36 percent to 45 percent over the first six months, with monthly median income 

increasing by $298.116

In FY 2016, SAMHSA provided continuation support for the third year of 17 four-year grants, 

continued technical assistance, and support one evaluation contract. The new BHTCC evaluation 

focuses on examining the clinical and functional outcomes of program participants with behavioral 

health issues. The new BHTCC evaluation is building on the findings from the first cohort and 

more deeply examines both the features of successful collaborations between the courts and 

community services as well as the clinical and functional outcomes of program participants. In 

FY 2017, SAMHSA intends to fund 17 continuation grants and the evaluation contract. 

 

116 Advocates for Human Potential. (2014). Evaluation of the Adult Treatment Court Collaborative Program: Final 

evaluation report. Albany, NY: Author. 
198

Funding History

Fiscal Year Amount

FY 2014 $74,816,000

FY 2015 $78,000,000

FY 2016 $78,000,000

FY 2017 $77,852,000

FY 2018 $77,852,000

Budget Request

The FY 2018 Budget Request is $77.9 million ($60.0 million for Drug Courts and $17.9 million 

for Other Criminal Justice Activities), level with the FY 2017 Annualized CR.

SAMHSA intends to support 115 Drug Court continuations grants, 70 new drug court grants, and 

three contracts. SAMHSA intends to fund 17 new Offender Reentry Program (ORP) new grants, 

and 13 continuation ORP grants. 
199

Outputs and Outcomes Table

Program: Criminal Justice - Drug Courts

NOTE: SAMHSA makes grant awards toward the end of the year and therefore, bases the

FY 2018 targets on the FY 2017 Annualized CR and the FY 2019 targets are based on the 

FY 2018 President’s Budget.

Measure

Year and Most Recent Result

Target for Recent Result

(Summary of Result)

FY 2018

Target

FY 2019

Target

FY 2019

Target

+/−

FY 2018

Target

1.2.72 Increase the percentage of 

adult clients receiving services who 

were currently employed or engaged 

in productive activities (Outcome)

FY 2016: 64.3 %

Target: 55 %

(Target Exceeded)

60 % 60 % Maintain

1.2.73 Increase the percentage of 

adult clients receiving services who 

had a permanent place to live in the 

community (Outcome)

FY 2016: 50.6 %

Target: 41 %

(Target Exceeded)

45 % 45 %

Maintain

1.2.74 Increase the percentage of 

adult clients receiving services who 

had no involvement with the 

criminal justice system (Outcome)

FY 2016: 94.3 %

Target: 91 %

(Target Exceeded)

92 % 92 %

Maintain

1.2.76 Increase the percentage of 

adult clients receiving services who 

had no past month substance use 

(Outcome)

FY 2016: 87.5 %

Target: 71 %

(Target Exceeded)

85 % 85 %

Maintain

1.2.79 Increase the number of adult 

clients served (Output)

FY 2016: 8,539

Target: 4,369

(Target Exceeded)

5,500 5,500

Maintain
200

Outputs and Outcomes Table 

Program: Criminal Justice - Ex-Offender Re-Entry Program 

NOTE: SAMHSA makes grant awards toward the end of the year and therefore, bases the 

FY 2018 targets on the FY 2017 Annualized CR and the FY 2019 targets are based on the 

FY 2018 President’s Budget.

Measure 

Year and Most Recent Result 

Target for Recent Result 

(Summary of Result) 

FY 2018 

Target 

FY 2019 

Target 

FY 2019 

Target 

+/−

FY 2018 

Target 

1.2.80 Increase the number of 

clients served. (Outcome) 

FY 2016: 1,366 

Target: 2,000 

(Target Not Met) 

2,5001 2,500 Maintain 

1.2.81 Increase the percentage of 

clients who had no past month 

substance use. (Outcome) 

FY 2016: 73.2 % 

Target: 74 % 

(Target Not Met) 

80 %2 80 % 

Maintain

1.2.84 Increase the percentage of 

clients receiving services who had 

no involvement with the criminal 

justice system. (Outcome) 

FY 2016: 92.2 % 

Target: 94 % 

(Target Not Met) 

95 % 95 % 

Maintain

 

1

 Decrease in target from prior year level reflects a decrease in funding and changes in data trends. 

 

2 Decrease in target from prior year level reflects a decrease in funding and changes in data trends.
201

Building Communities of Recovery 

(Dollars in thousands) 

Programs of Regional & National Significance 

FY 2016 

Final 

FY 2017 

Annualized 

CR

FY 2018 

President's 

Budget 

FY 2018 

+/− 

FY 2017 

Building Communities of Recovery $--- $1,000 $1,000 --- 

Program Description and Accomplishments 

In FY 2017, SAMHSA is planning to support a new cohort of grants through the Building 

Communities of Recovery program. The purpose of this program is to mobilize resources within 

and outside of the recovery community to increase the prevalence and quality of long-term 

recovery support from drug/alcohol addiction. 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 will be principally governed by people in 

recovery from SUDs 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. Grantees will also work to reduce 

negative attitude, discrimination, and prejudice around addiction and addiction recovery. 

Funding History 

Fiscal Year Amount 

FY 2014 ---

FY 2015 ---

FY 2016 --- 

FY 2017 $1,000,000 

FY 2018 $1,000,000 

Budget Request 

The FY 2018 budget request is $1.0 million, level with the FY 2017 Annualized CR. These funds 

will be used to support the Building Communities of Recovery Program to develop, expand, and 

enhance recovery support services. 
202

Minority Fellowship Program

(Dollars in thousands)

Programs of Regional & National Significance

FY 2016 

Final

FY 2017 

Annualized 

CR

FY 2018 

President's 

Budget

FY 2018

+/−

FY 2017

Minority Fellowship Program (MFP) $3,539 $3,532 $3,532 ---

Authorizing Legislation .............................................Section 509 of the Public Health Service Act

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

Eligible Entities......American Nurses Association (ANA), American Psychiatric Association (ApA), 

American Psychological Association (APA), Council on Social Work Education (CSWE),

American Association for Marriage and Family Therapy (AAMFT)

Program Description and Accomplishments

The mental health-related and substance abuse-related service needs of racial and ethnic minority 

communities within the United States have been historically under–addressed due to a variety of 

factors. These include a limited number of trained practitioners who are equipped with the 

language skills or cultural competency training needed to deliver effective services for this 

population. SAMHSA’s Minority Fellowship Program (MFP) increases behavioral health 

practitioners’ knowledge of issues related to prevention, treatment, and recovery support for 

mental illness and drug/alcohol addiction among racial and ethnic minority populations. The 

program provides stipends to funding increases the number of culturally competent behavioral 

health professionals who teach, administer, conduct services research, and provide direct mental 

illness or substance abuse treatment services for minority populations that are underserved. This 

will result in improved quality of mental illness and substance abuse prevention and increased 

treatment delivered to ethnic minorities. Since its start in 1973, the program has helped to enhance 

services for racial and ethnic minority communities through specialized training of mental health 

professionals in psychiatry, nursing, social work, and psychology. In 2006, the program expanded 

to include marriage and family therapists and later added professional counselors. These 

individuals often serve in key leadership positions to deliver mental illness and substance abuse 

treatment services, services supervision, services research, training, and administration. 

Professional guilds receive competitively awarded grants, and then competitively award the 

stipends to post-graduate students pursuing a degree in that professional field. In FY 2015 and FY 

2016, SAMHSA funded six continuation grants.

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

Begun in FY 2014, MFP-Y is a component of MFP that support master’s level trained behavioral 

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

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

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

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

outcomes for racially and ethnically diverse youth and young adults. 

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

behavioral health professionals serving children, adolescents, and populations in transition to 
203

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

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

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

competitively awarded to professional guilds, which then competitively award the stipends to postgraduate students pursuing a degree in that professional field. 

MFP-AC is a component of MPP to support master’s level addiction counselors (MFP-AC) for 

youth and young adults. The purpose of the four-year grant program is to reduce health disparities 

and improve behavioral healthcare outcomes for racially and ethnically diverse populations by 

increasing the number of culturally competent master’s level addiction counselors available to 

underserved minority populations with a specific focus on transition age youth (ages 16 to 25) in 

public and private non-profit sectors. MFP-AC grants are supporting students pursuing master’s 

level degrees in addiction/substance abuse counseling, with the goal of increasing the number of 

masters-level addiction counselors across the nation by approximately 300 counselors. As is the 

case with MFP and MFP-Y, grants are competitively awarded to professional guilds, who then 

competitively award the stipends to post-graduate students pursuing a degree in that professional 

field. 

Funding History

Fiscal Year Amount

FY 2014 $2,107,265

FY 2015 $2,920,045 

FY 2016 $3,539,000 

FY 2017 $3,532,000 

FY 2018 $3,532,000

Budget Request

The FY 2018 Budget Request is $3.5 million, level with the FY 2017 Annualized CR. The funding 

will provide continued support for both base and expansion activities. The funds will support six 

MFPs, four MFP Addiction Counselors, and two technical assistance and evaluation support 

contracts. 
204

Addiction Technology Transfer Centers 

(Dollars in thousands) 

Programs of Regional & National Significance 

FY 2016 

Final 

FY 2017 

Annualized 

CR

FY 2018 

President's 

Budget 

FY 2018 

+/−

FY 2017 

Addiction Technology Transfer Centers $9,046 $9,029 $9,029 --- 

Authorizing Legislation ............................................. Section 509 of the Public Health Service Act 

Allocation Method .................................... Competitive Grants/Contracts/Cooperative Agreements 

Eligible Entities .................................................... Domestic Public and Private Non-Profit Entities 

Program Description and Accomplishments 

Misuse of, and addiction to alcohol, tobacco, and illicit drugs cost Americans more than 

$700 billion a year in increased healthcare costs, crime, and lost productivity.117, 118 Recently the 

nation’s attention has been on the increase misuse of opioids. The majority of drug overdose 

deaths (more than six out of ten) involved an opioid.119 Drug/alcohol addiction is treatable and 

research has led to development of medications and evidence-based psychosocial interventions 

that help people achieve recovery and resume productive lives. One critical need is to help recruit, 

train, and support treatment providers in the use of evidence-based practices. 

The Addiction Technology Transfer Center Network (ATTC Network) is one of SAMHSA’s 

proven models for building behavioral health capacity in health systems and communities through 

the sharing and transfer of expertise. SAMHSA supports the ATTC Network to develop and 

provide low or no cost training opportunities using evidence-based teaching, technologies, 

implementation, coaching, and information dissemination to behavioral health professionals. 

During the last cycle of the ATTC program (FY 2011 - 2016), the ATTC network supported the 

completion of over 430 events (technical assistance, webinars, onsite training, presentations etc.) 

benefiting over 128,000 health professionals. Overall, over 94 percent of the participants reported 

satisfaction with the quality of the training or technical assistance they received from the ATTC 

Network. 

There is a critical and rising need for practitioners to reflect the diversity of their client population 

in terms of characteristics such as age, race/ethnicity, and sexual orientation. Existing diversity 

requires recruitment of new professionals from a variety of backgrounds.120 

117 National Institute for Drugs and Alcohol. (2015). Trends and Statistics. Retrieved from NIH/NIDA: 

http://www.drugabuse.gov/related-topics/trends-statistics 

118 National Institute for Drugs and Alcohol. (2015). Trends and Statistics. Retrieved from NIH/NIDA: 

http://www.drugabuse.gov/related-topics/trends-statistics 

119 Rudd RA, Seth P, David F, Scholl L. Increases in Drug and Opioid-Involved Overdose Deaths — United States, 

2010–2015. MMWR Morb Mortal Wkly Rep. ePub: 16 December 2016 

120 Ryan, O., Murphy, D., Krom, L. (2012). Vital Signs: Taking the Pulse of the Addiction Treatment Workforce, A 

National Report, Version 1. Kansas City, MO: Addiction Technology Transfer Center National Office in residence 

at the University of Missouri-Kansas City. Retrieved from 

http://www.attcnetwork.org/documents/VitalSignsReport.pdf 
205

Treating persons with drug/alcohol addiction is difficult and challenging. Pay and benefits often 

do not fully reflect the difficulty of this work. Burnout and turnover are significant challenges for 

providers and their employing organizations and may impede patient recovery. 

Faced with an average annual staff turnover rate of 18.5 percent, substance abuse treatment 

programs deal with significant challenges to fill open positions.121

 Common hurdles for many 

substance abuse treatment facilities include difficulty retaining and recruiting qualified 

individuals, the need for a diverse racial/ethnic workforce capable of working in integrated 

settings, and the perception that substance abuse is not a valid health issue (i.e., that addiction is 

a ‘choice’).122 

To address the gaps in workforce, the ATTC Network supports national and regional activities 

focused on improving the skills of substance abuse treatment and other healthcare professionals. 

The ATTC Network decreases the gap in time between the release of new scientific findings and 

the adoption of these interventions by front-line substance abuse treatment clinicians. This 

program disseminates evidence-based and promising practices to addiction treatment/recovery 

professionals, public health/mental health personnel, institutional and community corrections 

professionals, nurses, and other health professions. The ATTC Network dissemination models 

include technical assistance, training and an extensive array of web-based resources created to 

translate the latest science for adoption into practice by the substance abuse treatment workforce. 

Using a systems change approach, the goal is to improve organizations and systems of care, 

enhancing access, engagement, and outcomes based in a continuous quality improvement 

framework; not limited to training and knowledge enhancement alone. 

The ATTC Network currently includes 10 Regional Centers, four National Focus Area Centers, 

and a Network Coordinating Office. In FY 2017, a new ATTC Network will be awarded and will 

consist of 10 Regional Centers and one Coordinating Center. The National Center will take on an 

enhanced coordination function. Together, the members of the ATTC Network will continue to 

provide technical assistance, workforce training, support meetings, and the collaboration with 

other HHS agencies, the SAMHSA Regional Administrators, and other partners. 

121 Ryan, O., Murphy, D., Krom, L. (2012). Vital Signs: Taking the Pulse of the Addiction Treatment Workforce, A 

National Report, Version 1. Kansas City, MO: Addiction Technology Transfer Center National Office in residence 

at the University of Missouri-Kansas City. Retrieved from 

http://www.attcnetwork.org/documents/VitalSignsReport.pdf

122 Ryan, O., Murphy, D., Krom, L. (2012). Vital Signs: Taking the Pulse of the Addiction Treatment Workforce, A 

National Report, Version 1. Kansas City, MO: Addiction Technology Transfer Center National Office in residence 

at the University of Missouri-Kansas City. Retrieved from 

http://www.attcnetwork.org/documents/VitalSignsReport.pdf
206

Funding History

Fiscal Year Amount

FY 2014 $9,024,000

FY 2015 $9,046,000

FY 2016 $9,046,000

FY 2017 $9,029,000

FY 2018 $9,029,000

Budget Request

The FY 2018 Budget Request is $9.0 million, level with the FY 2017 Annualized CR. In FY 2018, 

SAMHSA plans to fund up to 11 continuation grants. SAMHSA expects the ATTC grantees to 

sponsor over 1,000 events involving more than 30,000 unique participants in FY 2018. In addition 

to the number of participants, event topics and contact hours, other metrics to be collected include 

participant satisfaction measures and self-assessed improvement skill levels. Funding will allow 

the ATTC grantees to disseminate evidence-based, promising practices to addiction treatment and 

recovery professionals, public health and mental health personnel, institutional and community 

corrections professionals, and other related disciplines. 
207

State Targeted Response to the Opioid Crisis 

(Dollars in thousands)

Programs of Regional & National Significance 

FY 2016 

Final 

FY 2017 

Annualized 

CR

FY 2018 

President's 

Budget 

FY 2018 

+/− 

FY 2017 

State Response to the Opioid Abuse Crisis $--- $500,000 $500,000 --- 

Authorizing Legislation ................................................ Section 1003 of the 21st Century Cures Act

FY 2018 Authorization .......................................................................................................$500,000 

Allocation Method .................................................................................................................. Grants 

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

Program Description and Accomplishments 

Opioid abuse continues to causa significant crisis across the nation. Opioid-overdose related 

deaths numbered 33,000 in 2015. As abuse continues to rise, Americans are dealing with the 

devastating consequences that accompany this use including: loss of employment, social 

connectedness, increased criminal justice involvement, injury, and death. 

The State Targeted Response to the Opioid Crisis Grant Program (Opioid STR) was authorized 

under Section 1003 of the 21st Century Cures Act. The program aims to address 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 

addiction (including prescription opioids as well as illicit drugs such as heroin). 

Grantees will be required to do the following: use epidemiological data to demonstrate the 

critical gaps in availability of treatment for opioid addiction in geographic, demographic, and 

service level terms; utilize evidence-based implementation strategies to identify which system 

design models will most rapidly address the gaps in their systems of care; implement prevention 

strategies; deliver evidence based treatment interventions including medication and psychosocial 

interventions; deliver recovery support services; and report progress toward increasing 

availability of treatment for opioid addiction and reducing opioid-related overdose deaths. 

In FY 2017, grants were awarded via formula to all 50 states, the District of Columbia, Puerto 

Rico, the Virgin Islands, Northern Marianas, Micronesia, Palau, and American Samoa. Funds 

will also be used to support a cross-site evaluation to demonstrate program effectiveness and 

technical assistance activities. 

Funding History 

Fiscal Year Amount

FY 2014 --- 

FY 2015 ---

FY 2016 ---

FY 2017 $500,000,000 

FY 2018 $500,000,000 
208

Budget Request

In FY 2018, SAMHSA requests $500.0 million, level with the FY 2017 Annualized CR. These 

funds will support the Opioid STR Program. During the first year of the program, lessons 

learned will be utilized to determine if resource allocations and priorities need to be adjusted in 

the second year of the program. 
209

Substance Abuse Prevention and Treatment Block Grant

(Dollars in thousands)

Programs of Regional & National Significance

FY 2016 

Final

FY 2017 

Annualized 

CR

FY 2018 

President'

s Budget

FY 2018

+/−

FY 2017

Substance Abuse Prevention and Treatment Block 

Grant $1,858,079 $1,854,697 $1,854,697 $---

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

Authorizing Legislation . .........................................Section 1935 of the Public Health Service Act

FY 2018 Authorization ....................................................................................................$1,858,079

Allocation Method ................................................................................................... Formula Grants

Eligible Entities........................States, Territories, Freely Associated States, District of Columbia, 

and the Red Lake Band of Chippewa Indians of Minnesota

Program Description and Accomplishments

The authorizing legislation and implementing regulation governing the Substance Abuse 

Prevention and Treatment Block Grant (http://www.samhsa.gov/grants/block-grants) includes a 

number of prescriptive performance and expenditure requirements as well as explicit expenditure 

prohibitions. The states and jurisdictions have the flexibility to plan, carry out, and evaluate 

substance abuse treatment and recovery services that reflect comments received from individuals, 

families and communities during the development of their respective biennial plans and the results 

of such plans are reflected in their respective annual reports. The legislation and regulation 

prioritizes two populations to be served with SABG funds: (1) substance using pregnant women 

and women with dependent children; and (2) persons who inject drugs. Although the legislation 

and regulation prioritizes such individuals, the states and jurisdictions have the flexibility to 

prioritize other underserved populations as determined by anecdotal and empirical data. For 

example, most states and jurisdictions prioritize substance abuse treatment and recovery services 

for adolescents and transitional age youth. Some states and jurisdictions are also developing peerto-peer recovery services to facilitate individuals’ entry to substance abuse treatment services and 

to promote and support individuals in early recovery. States and jurisdictions frequently partner 

with other executive branch departments, e.g., education, human services, justice and public 

health, to coordinate services for individuals and families impacted by substance abuse.

The Massachusetts Bureau of Substance Abuse Services uses Substance Abuse Prevention and 

Treatment funds to collaborate with the state’s Medicaid agency, Mass Health, in developing a 

Centralized Navigation System. The substance abuse treatment availability information is 

collected multiple times a day and reflected to the public. The website provides information, 

facilitated support, and referral to the public to access the treatment system and other recovery 

resources. The website is expanding its capacity by adding more treatment modalities over time 

and will soon release an improved user interface.

The Georgia Department of Behavioral Health and Developmental Disabilities, Office of 

Addictive Diseases in collaboration with the Office of Behavioral Health Prevention utilizes 

SABG funds to support three innovative and unique prevention clubhouses designed to provide 

prevention services to at-risk adolescents residing in Norcross, LaGrange, and Dawson, Georgia. 
210

Participation is limited to adolescents at risk for or involved in underage drinking and illicit drug 

use, engaged in ongoing detention and/or alternative school, residing with a parent(s) with a 

drug/alcohol addiction or in recovery or a sibling(s) receiving substance abuse treatment, or 

experiencing education or social issues. The clubhouses use peer mentors, evidence based 

prevention curricula, and interactive youth activities to build coping, decision making, and life 

skills. Each clubhouse includes family activities/participation, community service, education 

and employment services, nutrition, and physical activities.

Texas is committed to focusing efforts on improving recovery services, principles and best 

practices. Texas currently funds 22 Recovery Support Service providers responsible for integrating 

recovery support services throughout their system of care, strengthening the alignment of treatment 

services with a recovery oriented approach, and expanding the community supports available to 

assist individuals in successfully integrating into their communities. Evaluation results for 

participants include increases in stable housing, employment, and wages earned. In addition, 

healthcare utilization decreased with an estimated cost savings of $3.4 million.

The Utah Department of Human Services, Division of Substance Abuse and Mental Health 

provides the Southwest Regional Behavioral Health Center with SABG funds to support a 

residential facility for women, Desert Haven, in the five county area that is serviced by the 

Southwest Regional Behavioral Health Center local treatment authority. The facility is licensed 

for up to 7-10 adult women and up to 6-9 children (ages eight and under) belonging to the women. 

The women in the program attend substance abuse treatment in the daytime, while day care 

services are provided to their children. The treatment offered combines group and individual 

therapy, education classes, anger management, communication skill building, parenting skills, life 

skills education, and relapse prevention.

In addition to the states’ and jurisdictions’ plans and reports, the authorizing legislation provides 

SAMHSA with significant resources to support targeted technical assistance to the SABG grantees 

and their respective sub-recipients, i.e., community- and faith-based organizations approved by the 

states and jurisdictions to provide substance abuse treatment and recovery services. SAMHSA’s 

Knowledge Application Program (KAP) (http://www.samhsa.gov/kap) produces the Technical 

Assistance Public Series that provide practical guidance and information related to the delivery of 

substance abuse 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.

The Substance Abuse Prevention and Treatment Block Grant (SABG) program distributes funds 

to 60 eligible states, territories and freely associated states123, the District of Columbia, and the 

Red Lake Band of Chippewa Indians of Minnesota (referred to collectively as states) to plan, carry 

out, and evaluate substance abuse prevention, treatment, and recovery support services for 

individuals, families, and communities impacted by substance abuse. The SABG’s overall goal is 

 

123 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. Retrieved from 

http://www.doi.gov//oia/islands/index.cfm
211

to support and expand substance abuse prevention and treatment services while providing 

maximum flexibility to grantees. 

The SABG is critically important because it provides the states and their respective SABG subrecipients, including, but not limited to, administrative service organizations, county and municipal 

governments, and prevention and treatment providers, the flexibility to respond to local and/or 

regional emergent issues impacting health, public health, and public safety through a consistent 

federal funding stream. SABG accounts for approximately 32 percent of total state substance 

abuse agency funding and 23 percent of total state substance abuse prevention and public health 

funding.124 Individuals and families without health coverage or whose health insurance benefit 

will not cover certain services (e.g., recovery support) rely on services funded by the SABG. Block 

grant funds are being leveraged by states, along with other funding sources, to support training for 

staff and implementation of evidence-based practices for the prevention of substance misuse and 

the treatment of drug/alcohol addiction, improved business practices such as facilitating 

enrollment in appropriate health coverage and use of health information technology and integration 

of physical and behavioral health.125 SAMHSA encourages states to use block grant resources to 

support and not supplant services that are covered through commercial and public insurer plans. 

SAMHSA Block Grant funds are directed toward four purposes: to fund priority treatment and 

support services for individuals without insurance or for whom coverage is terminated for short 

periods of time; to fund those priority treatment and support services not covered by Medicaid, 

Medicare, or private insurance for low-income individuals and that demonstrate success in 

improving outcomes and/or supporting recovery; to fund primary prevention for individuals not 

identified as needing treatment (universal programs that reach everyone in a group being served 

regardless of risk, selective interventions that serve people at elevated risk of substance misuse or 

a drug/alcohol addiction, and indicated prevention interventions that serve people who exhibit 

some symptoms of a clinical substance use disorder, but do not yet meet criteria for a diagnosis); 

and to collect performance and outcome data to determine the ongoing effectiveness of behavioral 

disorder treatment, and recovery support services and to plan the implementation of new services 

on a nationwide basis. 

SAMHSA also encourages the states to use their Block Grants to: allow recovery to be pursued 

through personal choice and many pathways; encourage providers to assess performance based on 

outcomes that demonstrate client successes; and expand capacity by increasing the number and 

types of providers who deliver clinical treatment and/or recovery support services. 

Funding Allocations and Requirements 

SABG funds are distributed126 through a formula grant that provides funding based on specified 

economic and demographic factors and is administered by SAMHSA’s Centers for Substance 

Abuse Treatment (CSAT) and Substance Abuse Prevention (CSAP). Of the amounts appropriated 

 

124 SABG State Agency Reported Expenditures by Target Activity Within Source of Funds, State/Jurisdiction 

Selection: All States/Jurisdictions (2015) 

125 Case Studies of Three Policy Areas and Early State Innovators: 2014 State Profiles of Mental Health and 

Substance Use Disorder Agencies. HHS Publication In Press. Rockville, MD: Substance Abuse and Mental Health 

Services Administration. (2015). 

126 Block Grants and Formula Grants: A Guide for Allocation Calculations; 2007 Department of Health and Human 

Services, SAMHSA. 
212

for the SABG program, 95 percent are distributed to states through a formula included in the 

authorizing legislation. Factors used to calculate the allotments include total personal income, 

state population data by age groups (total population data for territories), total taxable resources, 

and a cost of services index factor. The SABG also includes “hold harmless” provisions that limit 

fluctuations in allotments as the total block grant appropriation changes from year to year. 

Maintenance of Effort: The SABG requires states to maintain its expenditures for certain substance 

abuse prevention and treatment activities at a level that is no less than the state’s average 

expenditures for the previous two-years. While maintenance of effort (MOE) requirements can be 

important tools for maximizing the effectiveness of Federal funds, the way the SABG requirement 

is currently structured makes it a challenge for SAMHSA to administer. For example, timing 

requirements on when penalties must be assessed precede when SAMHSA receives final State 

data that demonstrates compliance. In addition, States are currently unable to claim credit for 

substance abuse prevention and treatment efforts that occur outside of the Single State Agency 

(defined as the agency within the State that has primary responsibility for administering SABG 

funds). For example, substance abuse prevention and treatment activities conducted by State 

Education Agencies and State Departments of Justice do not count toward the MOE. Finally, the 

State penalties for non-compliance with the MOE can exceed the size of the State SABG allotment. 

Funding Set-Asides and Other Requirements: The authorizing legislation and implementation 

regulation for the SABG includes specific funding set-asides, including 20 percent for primary 

prevention (see below), and five percent for early intervention service for HIV for designated 

states.127 The statute also includes performance requirements for the treatment of substance-using 

pregnant women and women with dependent children, and provides states with the flexibility to 

expend a combination of federal and non-federal funds. There are also requirements and potential 

penalty reduction of the Block Grant allotment if the recipient fails to prohibit and enforce sale of 

tobacco products to individuals under the age of 18. 

Coordination of Efforts: SAMHSA emphasizes that Block Grant recipients should coordinate and 

partner with government agencies, nonprofit organizations, consumers and families and providers 

to support integrated and coordinated services and programs. SAMHSA provides targeted 

technical assistance for SABG grantees through a technical assistance contract. 

Recent Updates: Guidance to states regarding the use of SABG funds for naloxone was sent out 

on April 2, 2014. Additionally, in July 2014, the Centers for Medicare & Medicaid Services, in 

collaboration with SAMHSA, the Centers for Disease Control and Prevention and the National 

Institutes of Health disseminated an Informational Bulletin, “Medication Assisted Treatment for 

Substance Use Disorders.”128

Performance and Evaluation 

SAMHSA is undertaking a series of agency-wide efforts designed to develop a set of common 

performance, quality, and cost measures to demonstrate the impact of SAMHSA’s programs. 

 

127 Substance Abuse and Mental Health Services Administration. (2015). Block Grant Laws and Regulations.

Retrieved from http://www.samhsa.gov/grants/block-grants/laws-regulations. 

128 Centers for Medicare & Medicaid. (n.d.). Federal Policy Guidance. Retrieved from 

http://www.medicaid.gov/federal-policy-guidance/federal-policy-guidance.html
213

Ultimately, SAMHSA and its state partners will collaborate to develop a streamlined behavioral 

health data system that complements other existing systems (e.g., Medicaid administrative and 

billing data systems, and state mental health and substance abuse treatment data systems), ensures 

consistency in the use of measures, and provides a more complete perspective of the delivery of 

mental illness and substance abuse treatment services. 

An independent evaluation of the SABG demonstrated how states have leveraged the statutory 

requirements of this Block Grant program to expand existing or establish new treatment capacity 

in underserved areas of states and territories and to improve coordination of services with other 

state systems.129 SAMHSA data show that the SABG has been successful in expanding treatment 

capacity by supporting approximately two million130 admissions to treatment programs receiving 

public funding. Outcome data for the Block Grant program show positive results as reported 

through Behavioral Health Services Information System/Treatment Episode Data Set (TEDS) 

administered by SAMHSA’s Center for Behavioral Health Statistics and Quality. In FY 2015, at 

discharge, clients demonstrated high abstinence rates from both illegal drug (70 percent) and 

alcohol (83 percent) use. State substance abuse authorities reported the following outcomes for 

services provided during FY 2015, the most recent year for which data is available: 

 For the 50 states[3] and the District of Columbia that reported data concerning abstinence 

from alcohol use, all 51 identified improvements in client abstinence; 

 Similarly, for the 50 states and D.C. that reported data concerning the abstinence from drug 

use, 50 of 51 identified improvements in client abstinence; 

 For the 50 states and D.C. that reported employments data, 47 of 50 identified 

improvements in client employment; 

 For the 50 states and D.C. that reported criminal justice data, 47 of 51 reported an increase 

in clients with no arrests based on data reported to TEDS; and 

 For the 49 states and D.C. that reported housing data, 48 of 50 identified improvements in 

stable housing for clients based on data reported to TEDS. 

 For the 51 states that reported recovery support data, 49 states out of 51 identified 

improvements in client engagement in recovery support programs. At intake clients who 

were engaged in recovery support programs increased from 28 percent to 43.9 percent at 

discharge. 

20 Percent Prevention Set-Aside 

SAMHSA is responsible for managing the 20 percent prevention set-aside of the SABG. The 

20 percent set-aside requires SABG grantees to spend at least 20 percent of their SABG award to 

develop and implement a comprehensive prevention program, which includes a broad array of 

prevention strategies directed at individuals not identified to be in need of treatment.131 The 

prevention set-aside is one of SAMHSA’s main vehicles for supporting SAMHSA’s Strategic 

Initiative for the Prevention of Substance Abuse and Mental Illness. The 20 percent set-aside is 

 

129 Substance Abuse and Mental health Administration. Retrieved from 

http://tie.samhsa.gov/SAPT2010.html#Evaluation. 

130 Substance Abuse and Mental Health Services Administration (2015). Clients Level Data / TEDS. Retrieved from 

http://www.samhsa.gov/data/client-level-data-teds

[3] Source: West Virginia numbers have been included in the text, but they appear lower than expected. 

131 Substance Abuse and Mental Health Services Administration (2015). Substance Abuse Prevention and Treatment 

Block Grant. Retrieved from http://www.samhsa.gov/grants/block-grants/sabg 
214

focused only on substance use prevention. States use these funds to develop infrastructure and 

capacity and to fund programs specific to primary substance abuse prevention. Some states rely 

solely on the 20 percent set-aside to fund their prevention systems while others use the funds to 

target gaps and enhance existing program efforts. 

States are encouraged to make prevention a top priority, taking advantage of recent science, best 

practices in community coordination, proven planning processes, and the findings articulated by 

the Institute of Medicine report, Preventing Mental, Emotional, and Behavioral Disorders Among 

Young People.132 SAMHSA regularly works with states to improve their accountability systems 

for prevention and to establish necessary reporting capacities. 

Synar 

The Synar program is the set of actions put in place by states, with the support of the federal 

government, to implement the requirements of the Synar Amendment. The Synar Amendment 

requires states to ensure tobacco is not sold to individuals under age 18.133 The Amendment was 

developed in the context of a growing body of evidence about the health problems related to 

tobacco use by youth, as well as evidence about the ease with which youth could purchase tobacco 

products through retail sources. The Synar program is a critical component of the success of youth 

tobacco use prevention efforts. SAMHSA is charged with overseeing states’ implementation of 

the Synar requirements and provides technical assistance to states on both the Synar requirements 

and youth tobacco access issues in general. 

While the national weighted retailer violation rate declined steadily from the program’s baseline 

year in FY 1997 through FY 2011, the rate has increased slightly since FY 2012. One of the 

greatest predictors of a state's retailer violation rate is the amount and reach of their enforcement 

efforts. As states have faced budget shortfalls, some have scaled back on their enforcement 

programs and this may be contributing to the increase in the rate of tobacco sales to youth. Also, 

under the Synar program, SAMHSA encourages states to include in their inspections the types of 

tobacco products most often used by youth in their states. As states have expanded the types of 

tobacco products included in their Synar inspections, some states are reporting that retailers are 

sometimes more likely to sell non-cigarette tobacco products, including smokeless tobacco, to 

youth. These factors are likely contributing to the overall increase in the national weighted retailer 

violation rate. SAMHSA is addressing this increase by providing technical assistance to states, as 

well as examining Synar data in order to provide states with guidance on best practices including 

enforcement, merchant education, and community mobilization. 

 

132 "Front Matter." Preventing Mental, Emotional, and Behavioral Disorders Among Young People: Progress and 

Possibilities. Washington, DC: The National Academies Press, 2009. Retrieved from 

http://www.iom.edu/Reports/2009/Preventing-Mental-Emotional-and-Behavioral-Disorders-Among-Young-PeopleProgress-and-Possibilities.aspx.

133 Substance Abuse and Mental Health Services Administration (2015). Synar Program. Retrieved from 

http://www.samhsa.gov/synar 
215

Funding History

Fiscal Year Amount

FY 2009 1,778,591,000 

FY 2010 1,454,713,000 

FY 2011 1,782,528,000 

FY 2012 1,800,332,000 

FY 2013 1,710,306,376 

FY 2014 1,815,443,000 

FY 2015 1,819,856,000 

FY 2016 1,858,079,000 

FY 2017 1,854,697,000 

FY 2018 1,854,697,000 

Budget Request

The FY 2018 Budget Request is $1.9 billion, the same level from the FY 2017 Annualized CR. 

SABG funds will continue to serve as a source of safety net funding and will continue to support 

certain services (e.g., recovery support services) not covered by commercial insurance and nonclinical activities and services that address the critical needs of state substance abuse prevention 

and treatment service systems.
216

Department of Health and Human Services 

Substance Abuse and Mental Health Services Administration 

FY 2018 DISCRETIONARY STATE/FORMULA GRANTS

Substance Abuse Prevention and Treatment Block Grant (SABG)

CFDA #93.959

State/Territory

FY 2016 

Final

FY 2017 

Annualized 

CR

FY 2018 

President's 

Budget

FY 2018

+/−

FY 2017

Alabama $23,089,486 $23,045,458 $22,751,632 −$293,826

Alaska 5,889,074 5,877,844 5,802,903 −$74,941

Arizona 40,187,732 40,111,100 39,599,681 −$511,409

Arkansas 13,524,497 13,498,708 13,326,602 −$172,106

California 254,414,759 253,929,625 250,692,065 −$3,237,560

 

Colorado 28,777,345 28,722,471 28,356,265 −$366,206

Connecticut 18,212,225 18,177,497 17,945,737 −$231,760

Delaware 6,967,796 6,954,509 6,865,840 −$88,669

District Of Columbia 6,967,796 6,954,509 6,865,840 −$88,669

Florida 111,379,297 111,166,912 109,749,553 −$1,417,359

 

Georgia 57,152,217 57,043,236 56,315,945 −$727,291

Hawaii 8,469,866 8,453,715 8,345,932 −$107,783

Idaho 8,535,838 8,519,561 8,410,938 −$108,623

Illinois 67,645,777 67,516,786 66,655,959 −$860,827

Indiana 32,246,086 32,184,597 31,774,249 −$410,348

 

Iowa 13,093,348 13,068,381 12,901,761 −$166,620

Kansas 11,899,663 11,876,972 11,725,543 −$151,429

Kentucky 20,378,373 20,339,514 20,080,189 −$259,325

Louisiana 25,026,431 24,978,709 24,660,235 −$318,474

Maine 6,967,796 6,954,509 6,865,840 −$88,669

 

Maryland 34,079,985 34,014,999 33,581,314 −$433,685

Massachusetts 39,845,084 39,769,105 39,262,056 −$507,049

Michigan 56,052,853 55,945,968 55,232,667 −$713,301

Minnesota 24,102,039 24,056,080 23,749,369 −$306,711

Red Lake Indians 594,027 592,894 585,335 −$7,559

 

Mississippi 13,803,562 13,777,241 13,601,584 −$175,657

Missouri 26,548,475 26,497,851 26,160,008 −$337,843

Montana 6,967,796 6,954,509 6,865,840 −$88,669

Nebraska 7,641,241 7,626,670 7,529,431 −$97,239

Nevada 16,890,047 16,857,840 16,642,906 −$214,934
217

Department of Health and Human Services 

Substance Abuse and Mental Health Services Administration 

FY 2018 DISCRETIONARY STATE/FORMULA GRANTS 

Substance Abuse Prevention and Treatment Block Grant (SABG) 

CFDA #93.959 

State/Territory

FY 2016 

Final

FY 2017 

Annualized 

CR

FY 2018 

President's 

Budget

FY 2018

+/−

FY 2017

New Hampshire 6,967,796 6,954,509 6,865,840 −$88,669

New Jersey 48,064,193 47,972,541 47,360,900 −$611,641

New Mexico 9,565,114 9,546,875 9,425,154 −$121,721

New York 111,830,061 111,616,817 110,193,722 −$1,423,095

North Carolina 44,991,909 44,906,116 44,333,571 −$572,545

North Dakota 6,533,547 6,521,088 6,437,945 −$83,143

Ohio 64,535,736 64,412,675 63,591,425 −$821,250

Oklahoma 17,149,341 17,116,640 16,898,406 −$218,234

Oregon 20,578,346 20,539,106 20,277,236 −$261,870

Pennsylvania 59,100,201 58,987,505 58,235,425 −$752,080

Rhode Island 7,598,476 7,583,987 7,487,293 −$96,694

South Carolina 23,717,773 23,672,546 23,370,725 −$301,821

South Dakota 6,041,710 6,030,189 5,953,305 −$76,884

Tennessee 31,978,247 31,917,269 31,510,329 −$406,940

Texas 144,708,674 144,432,735 142,591,243 −$1,841,492

Utah 16,588,581 16,556,949 16,345,851 −$211,098

Vermont 6,459,874 6,447,556 6,365,351 −$82,205

Virginia 41,979,903 41,899,853 41,365,637 −$534,216

Washington 37,784,663 37,712,613 37,231,784 −$480,829

West Virginia 8,432,680 8,416,600 8,309,290 −$107,310

Wisconsin 27,197,983 27,146,120 26,800,012 −$346,108

Wyoming 4,197,559 4,189,555 4,136,139 −$53,416

American Samoa 342,788 342,799 339,035 −$3,764

Guam 1,004,691 1,012,363 1,009,343 −$3,020

Northern Marianas 320,555 323,721 326,563 $2,842

Puerto Rico 22,838,224 22,767,940 22,449,405 −$318,535

Palau 132,231 133,216 132,668 −$548

Marshall Islands 436,931 446,336 450,385 $4,049

Micronesia 664,690 664,515 656,421 −$8,094

Virgin Islands 656,127 655,013 646,177 −$8,836
218

Outputs and Outcomes Tables

Program: Treatment Activities

NOTE: SAMHSA makes grant awards toward the end of the year and therefore, bases the FY 2018

targets on the FY 2017 Annualized CR and the FY 2019 targets are based on the FY 2018 

President’s Budget.

Measure

Year and Most Recent Result

Target for Recent Result

(Summary of Result)

FY 2018

Target

FY 2019

Target

FY 2019

Target

+/−

FY 2018

Target

1.2.43 Increase the number of 

admissions to substance abuse treatment 

programs receiving public funding 

(Output)

FY 2015: 1,806,941

Target: 1,937,960

(Target Not Met)

1,880,000 1,880,000 Maintain

1.2.48 Percentage of clients reporting no 

drug use in the past month at discharge 

(Outcome)

FY 2016: 69.6 %

Target: 74 %

(Target Not Met)

74 % 74 % Maintain

1.2.49 Increase the percentage of clients 

reporting no alcohol use in the past 

month at discharge (Outcome)

FY 2016: 83.1 %

Target: 78 %

(Target Exceeded)

78 % 78 % Maintain

1.2.50 Increase the percentage of clients 

reporting being employed/in school at 

discharge (Outcome)

FY 2015: 35.7 %

Target: 43 %

(Target Not Met)

40 % 40 % Maintain

1.2.51 Increase the percentage of clients 

reporting no involvement with the 

Criminal Justice System (Outcome)

FY 2015: 93.2 %

Target: 92 %

(Target Exceeded)

92 % 92 % Maintain

1.2.85 Increase the percentage of clients 

receiving services who had a permanent 

place to live in the community 

(Outcome)

FY 2015: 88.9 %

Target: 92 %

(Target Not Met)

92 % 92 % Maintain
219

Outputs and Outcomes Tables

Program: Synar Amendment

NOTE: SAMHSA makes grant awards toward the end of the year and therefore, bases the FY 2018

targets on the FY 2017 Annualized CR and the FY 2019 targets are based on the FY 2018 

President’s Budget.

Measure

Year and Most Recent Result

Target for Recent Result

(Summary of Result)

FY 2018

Target

FY 2019

Target

FY 2019

Target

+/−

FY 2018

Target

2.3.49 Increase the number of 

States (including Puerto Rico) 

whose retail sales violations is at 

or below 20% (Outcome)

FY 2015: 52

Target: 52

(Target Met)

52 52 Maintain

2.3.62 Increase the number of 

States (excluding Puerto Rico) 

reporting retail tobacco sales 

violation rates below 10% 

(Outcome)

FY 2015: 27

Target: 34

(Target Not Met)

33 33 Maintain
220

Outputs and Outcomes Tables 

Program: Prevention Set-Aside 

NOTE: SAMHSA makes grant awards toward the end of the year and therefore, bases the 

FY 2018 targets on the FY 2017 Annualized CR and the FY 2019 targets are based on the 

FY 2018 President’s Budget.

Measure 

Year and Most Recent Result 

Target for Recent Result 

(Summary of Result) 

FY 2018 

Target 

FY 2019 

Target 

FY 2019 

Target 

+/−

FY 2018 

Target 

2.3.63 Increase the percent of states 

showing an increase in state level 

estimates of survey respondents who 

rate the risk of substance abuse as 

moderate or great (age 12-

17). (Outcome) 

FY 2014: 35 % 

(Historical Actual) 

22 % 22 % Maintain 

2.3.65 Increase the percent of states 

showing a decrease in state level 

estimates of percent of survey 

respondents who report 30 day use of 

alcohol (age 12-20). (Outcome) 

FY 2015: 73 % 

Target: 67.5 %1

(Target Exceeded) 

67.5 % 67.5 % 

Maintain

2.3.67 Increase the percent of states 

showing a decrease in state level 

estimates of percent of survey 

respondents who report 30 day use of 

other illicit drugs (age 12-

17). (Outcome) 

FY 2014: 49 % 

Target: 59 % 

(Target Not Met) 

63 % 63 % 

Maintain

2.3.68 Increase the percent of states 

showing a decrease in state level 

estimates of percent of survey 

respondents who report 30 day use of 

other illicit drugs (age 18+). (Outcome) 

FY 2014: 24 % 

Target: 37 % 

(Target Not Met) 

43 % 43 % 

Maintain

 

1

 Change from previously reported to reflect average of FY 2011 result and FY 2014 target. 
221

SAMHSA/Substance Abuse Treatment 

PRNS Mechanism Table Summary

(Dollars in thousands)

Programs of Regional & National 

Significance 

FY 2016 

Final

FY 2017 

Annualized CR

FY 2018

President's 

Budget

FY 2018

+/−

FY 2017

No. Amount No. Amount No. Amount No. Amount

Grants/Cooperative Agreements:

 Continuations 493 194,371 421 176,076 395 181,772 −26 5,696 

 New/Competing 200 85,342 234 111,755 253 108,459 19 −3,296 

 Subtotal 693 279,713 655 287,831 648 290,230 −7 2,399 

Contracts:

 Continuations 15 37,985,980 23 34,415,973 27 40,040,207 4 5,624 

 New/Competing 21 19,646,497 15 19,460,908 4 11,467,095 −11 −7,994 

 Subtotal 36 57,632 38 53,877 31 51,507 −7 −2,370 

Total, Substance Abuse Treatment 729 $337,345 693 $341,708 679 $341,738 −14 −30 
222

SAMHSA/Substance Abuse Treatment 

PRNS Mechanism Table by Program, Project, and Activity

(Dollars in thousands)

FY 2016 

Final

FY 2017 

Annualized 

CR

FY 2018

President's 

Budget

FY 2018

+/−

FY 2017

Programs of Regional & National Significance No. Amount No. Amount No. Amount No. Amount

Capacity:

Opioid Treatment Programs/Regulatory 

Activities

 Grants

Continuations 11 $1,391 1 $1,000 1 $1,393 393 

New/Competing 1 999 1 1,400 1 1,000 −400 

Subtotal 12 2,391 2 2,400 2 2,393 −7 

 Contracts ---

Continuations 2 1,685 4 4,589 3 4,004 −585 

New/Competing 5 4,649 3 1,718 2 2,311 592 

Subtotal 7 6,333 7 6,308 5 6,315 7 

Total, Opioid Treatment 

Programs/Regulatory Activities 19 8,724 9 8,708 7 8,708 ---

Screening, Brief Intervention and Referral to 

Treatment ---

 Grants ---

Continuations 63 22,246 81 39,316 20 16,607 −22,709 

New/Competing 21 17,459 1 870 59 22,324 21,454 

Subtotal 84 39,705 82 40,186 79 38,931 −1,255 

 Contracts ---

Continuations 1 6,051 3 5,306 4 7,554 2,248 

New/Competing 3 1,132 --- 1,312 --- 318 -994 

Subtotal 4 7,184 3 6,618 4 7,872 1,255 

Total, Screening, Brief Intervention and 

Referral to Treatment 88 46,889 85 46,804 83 46,804 -

Targeted Capacity Expansion ---

 Grants ---

Continuations 13 11,013 52 29,046 43 19,223 −9,823 

New/Competing 39 18,673 2 800 11 11,392 10,592 

Subtotal 52 29,686 54 29,846 54 30,615 769 

 Contracts ---

Continuations 2 5,272 2 3,180 1 3,171 -9 

New/Competing 3 1,344 2 3,208 1 2,448 −761 

Subtotal 5 6,617 4 6,388 2 5,619 −769 

Total, Targeted Capacity Expansion 57 36,303 58 36,234 56 36,234 ---

Pregnant and Postpartum Women ---

 Grants ---

Continuations 26 11,504 7 3,559 21 11,170 7,610 

New/Competing 2 1,035 19 10,134 5 2,366 −7,769 

Subtotal 28 12,540 26 13,694 26 13,535 -159 

 Contracts ---

Continuations --- 2,481 2 2,055 1 2,395 341 

New/Competing --- 911 --- 152 --- --- −152 

Subtotal --- 3,391 2 2,207 1 2,395 189 

Total, Pregnant and Postpartum Women 28 $15,931 28 $15,901 27 $15,931 30 
223

SAMHSA/Substance Abuse Treatment 

PRNS Mechanism Table by Program, Project, and Activity

(Dollars in thousands)

FY 2016 

Final

FY 2017 

Annualized 

CR

FY 2018

President's 

Budget

FY 2018

+/−

FY 2017

Programs of Regional & National Significance No. Amount No. Amount No. Amount No. Amount

Recovery Community Services Program

 Grants

Continuations 10 900 --- --- 10 1,500 1,500 

New/Competing 8 350 10 1,500 --- --- −1,500 

Subtotal 18 1,250 10 1,500 10 1,500 ---

 Contracts ---

Continuations 1 1,006 --- 117 2 774 657 

New/Competing 1 178 3 813 --- 156 −657 

Subtotal 2 1,184 3 929 2 929 ---

Total, Recovery Community Services Program 20 2,434 13 2,429 12 2,429 ---

Children and Families ---

 Grants ---

Continuations 32 $20,668 14 $10,921 12 $11,954 1,033 

New/Competing 2 1,264 10 10,600 15 11,708 1,108 

Subtotal 34 21,933 24 21,521 27 23,663 2,141 

 Contracts ---

Continuations 3 5,009 2 3,702 3 4,922 1,220 

New/Competing 2 2,664 1 4,325 --- 964 −3,361 

Subtotal 5 7,672 3 8,027 3 5,886 −2,141 

Total, Children and Families 39 29,605 27 29,549 30 29,549 ---

Treatment Systems for Homeless ---

 Grants ---

Continuations 50 26,222 46 22,207 68 24,022 1,816 

New/Competing 31 10,538 38 14,345 16 12,533 −1,812 

Subtotal 81 36,760 84 36,552 84 36,556 3 

 Contracts ---

Continuations --- 2,734 2 3,703 2 3,741 38 

New/Competing 2 1,811 --- 971 --- 929 −41 

Subtotal 2 4,544 2 4,673 2 4,670 −3 

Total, Treatment Systems for Homeless 83 41,304 86 41,225 86 41,225 ---

Minority AIDS ---

 Grants ---

Continuations 116 46,776 82 30,315 81 40,332 10,017 

New/Competing 23 12,489 58 28,916 59 18,901 −10,015 

Subtotal 139 59,265 140 59,231 140 59,233 2 

 Contracts ---

Continuations 3 5,969 2 4,638 3 4,769 131 

New/Competing --- 336 1 1,576 --- 1,444 −133 

Subtotal 3 6,305 3 6,214 3 6,212 -2 

Total, Minority AIDS 142 65,570 143 65,445 143 65,445 ---
224

SAMHSA/Substance Abuse Treatment 

PRNS Mechanism Table by Program, Project, and Activity

(Dollars in thousands)

FY 2016

Final

FY 2017 

Annualized 

CR

FY 2018

President's 

Budget

FY 2018

+/−

FY 2017

Programs of Regional & National Significance No. Amount No. Amount No. Amount No. Amount

Criminal Justice Activities

 Grants

Continuations 149 42,964 130 37,604 128 43,043 5,438 

New/Competing 71 21,721 84 29,805 87 25,156 −4,649 

Subtotal 220 64,685 214 67,409 215 68,198 789 

 Contracts ---

Continuations 1 6,695 4 6,267 4 6,861 594 

New/Competing 5 6,621 3 4,176 1 2,792 −1,384 

Subtotal 6 13,315 7 10,442 5 9,653 −789 

Total, Criminal Justice Activities 226 78,000 221 77,852 220 77,852 ---

Subtotal, Capacity 702 324,760 670 324,147 664 324,177 30 

Science and Service: ---

Addiction Technology Transfer Centers ---

 Grants ---

Continuations 15 8,579 --- --- 11 8,468 8,468 

New/Competing --- --- 11 8,528 --- --- −8,528 

Subtotal 15 8,579 11 8,528 11 8,468 -60 

 Contracts ---

Continuations --- 599 --- 434 --- 473 39 

New/Competing --- -131 --- 67 --- 88 21 

Subtotal --- 467 --- 501 --- 561 60 

Total, Addiction Technology Transfer Centers 15 9,046 11 9,029 11 9,029 ---

Subtotal, Science and Service 15 9,046 11 9,029 11 9,029 ---

Minority Fellowship Program (MFP)

 Grants

Continuations 8 2,107 8 2,107 --- --- −2,107 

New/Competing 2 813 2 796 11 3,078 2,283 

Subtotal 10 2,920 10 2,903 11 3,078 175 

 Contracts ---

Continuations 2 486 2 427 2 436 9 

New/Competing --- 133 --- 202 --- 18 −184 

Subtotal 2 619 2 629 2 454 −175 

Total, Minority Fellowship Program (MF) 12 3,539 12 3,532 13 3,532 ---

Subtotal, Capacity 729 38,658 693 61,512 688 54,374 −7,138 

Science and Service: ---

Comprehensive Addiction and Recovery Act (CARA) ---

 Grants ---

Continuations --- --- --- --- 8 4,060 4,060 

New/Competing --- --- 8 4,060 --- --- −4,060 

Subtotal --- --- 8 4,060 8 4,060 ---

 Contracts ---

Continuations --- --- --- --- 2 940 940 

New/Competing --- --- 2 940 --- --- −940 

Subtotal --- --- 2 940 2 940 ---

Total, Comprehensive Addiction and Recovery Act 

(CARA) --- --- 10 5,000 10 5,000 ---

Subtotal, Science and Service --- --- 10 5,000 10 5,000 ---

Total, Substance Abuse Treatment PRNS 1 729 $337,345 703 $341,708 698 $341,738 30 
225

Grant Awards Table 

FY 2016 

Final

FY 2017 

Annualized CR

FY 2018

President's Budget

FY 2018

+/− 

FY 2017

Number of Awards 691 654 647 −7

Average Award $403,618 $438,573 $447,033 8 

Range of Awards $300,000–$600,000 $300,000–$600,000 $300,000–$600,000 $300,000–$600,000
226

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227

SAMHSA 

Health Surveillance and Program Support 

Table of Contents 

1. Health Surveillance ........................................................................................................ 229

2. Performance and Quality Information Systems .............................................................. 237

3. Program Support ............................................................................................................. 245

4. Public Awareness Support .............................................................................................. 247
228

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229

Health Surveillance

(Dollars in thousands)

FY 

2016 

Final

FY 2017 

Annualized 

CR

FY 2018 

President's 

Budget

FY 2018

+/−

FY 2017

Health Surveillance $47,258 $47,226 $33,842 -$13,384

Budget Authority (non-add) 16,830 16,798 11,414 -5,384

PHS Evaluation Funds (non-add) 30,428 30,428 22,428 -8,000

Data Request and Publication User Fees $1,500 $1,500 $1,500 ---

Authorizing Legislation ............................. Sections 501 and 505 of the Public Health Service Act

FY 2018 Authorization .........................................................................................................Expired

Allocation Method .................................................................. Federal/Intramural, Contracts, Other

Eligible Entities.........................................................................................................Not Applicable

Program Description and Accomplishments

The Health Surveillance funding primarily supports the activities of the Center for Behavioral 

Health Statistics and Quality (CBHSQ). The detailed funding for each activity along with a 

detailed narrative description of each project follows.

Health Surveillance 

Resources by Activity/Program

(Dollars in thousands)

FY 2016

Final

FY 2017 

Annualized 

CR

FY 2018 

President's 

Budget

FY 2018 

+/- FY 

2017

Health Surveillance and Program Support Appropriation

Health Surveillance

Population Data Collection, Analysis, and Dissemination $10,987 $17,886 $10,284 -$7,602

National Survey on Drug Use and Health (NSDUH) 10,987 17,886 10,284 -7,602

Community Behavioral Health Surveillance 2,525 3,000 --- -3,000

Community Early Warning and Monitoring System (CEM-S) 2,525 3,000 --- -3,000

Evidence-Based Programs/Practices 2,348 2,044 --- -2,044

National Registry for Evidence Based Programs and Practices (NREPP) 2,348 2,044 --- -2,044

Emergency Department Data Collection, Analysis, and Dissemination --- 125 --- -125

SAMHSA’s Emergency Department Surveillance System (SEDSS) --- 125 --- -125

Treatment Services Data Collection, Analysis, and Dissemination 16,073 11,125 13,696 2,572

Behavioral Health Services Information System (BHSIS) 16,073 11,125 13,696 2,572

Behavioral Health Research and Dissemination 3,084 3,810 1,880 -1,930

Substance Abuse and Mental Health Data Archive (SAMHDA) --- 425 372 -52

Analytic Support Center (ASC) 1,741 2,698 1,507 -1,190

Center for Financing Reform & Innovations (CFRI) 1,344 688 --- -688

Performance Measurement/Systems 912 --- --- ---

WebBGAS 912 --- --- ---

Program Evaluations --- 696 --- -696

Primary and Behavioral Health Care Integration (PBHCI) --- 696 --- -696

Content Management 26 --- --- ---

Innovation and Logistical Services Support 1,953 --- ---

Support 9,351 8,540 7,982 -558

Operations 3,460 2,560 1,912 -648

Payroll 5,892 5,980 6,070 90

Total Health Surveillance $47,258 $47,226 $33,842 -$13,384
230

Overview

SAMHSA’s Center for Behavioral Health Statistics and Quality (CBHSQ) is the government’s 

lead agency for behavioral health statistics. As detailed in the 21st Century Cures Act, CBHSQ 

performs activities that: (1) coordinate SAMHSA’s integrated data strategy, including by 

collecting data each year; (2) provide statistical and analytical support for SAMHSA’s activities; 

(3) recommend a core set of performance metrics to evaluate activities supported by SAMHSA; 

(4) coordinate with the Assistant Secretary, the Assistant Secretary for Planning and Evaluation, 

and the Chief Medical Officer, as appropriate, to improve the quality of services and evaluations. 

CBHSQ activities are integrated and cross over multiple funding lines. 

CBHSQ receives budget for Health Surveillance (HS) and Performance and Quality Information 

Systems (PQIS) within the Health Surveillance and Program Support appropriation (HSPS) 

funding sources and the Substance Abuse Treatment appropriation from Block Grant Set Aside 

(SABG) funding sources. Programs are often funded from several sources. (A table detailing All 

Funding Sources follows the PQIS section). Under Health Surveillance, CBHSQ work includes 

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

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

Behavioral Health Surveillance; and Behavioral Health Research and Dissemination. Under PQIS, 

CBHSQ activities include Performance Measurement/Systems, Program Evaluations, and 

Evidence-Based Programs/Practices.

The total funding amount requested for CBHSQ (from all sources) in FY 2018 is $102.3 million, 

including $46.7 million from Health Surveillance and Program Support (HSPS) Appropriation and 

$55.6 million from the Substance Abuse Treatment (SAT) Appropriation. The CBHSQ overall 

FY 2018 budget reflects a decrease of $16.0 million from the FY 2017 Annualized CR. Funding 

has been prioritized to continue the NSDUH survey at its current sample size and to maintain 

NREPP activities at the current funding level. 

Population Data Collection, Analysis, and Dissemination

Section 505 of the Public Health Service Act (42 USC 290aa-4) requires SAMHSA, on an annual 

basis, to collect data on the prevalence of substance use and mental illness. To accomplish this, 

SAMHSA administers the National Survey on Drug Use and Health (NSDUH). NSDUH is an 

annual collection of behavioral health data on approximately 67,500 persons aged 12 or older of 

the U.S. civilian, non-institutionalized population. NSDUH is the nation’s primary source of 

statistical information on the use of illegal drugs, alcohol, and tobacco, certain mental disorders, 

co-occurring substance use and mental disorders, and treatment for substance use and mental 

health problems. NSDUH data provide estimates at the national, state, and sub-state level. 

NSDUH can be used to determine the prevalence of substance use and mental illness among 

demographic or geographic subgroups and provides trend estimates over time. NSDUH data 

provide states the opportunity to focus on their leading public health challenges through the release 

of state-specific data. Each year, three simultaneous NSDUH activities are ongoing: planning for 

future surveys, collecting data on over 67,500 persons in the current year survey, and analysis and 

dissemination of data from previous collections.
231

The prevalence of substance use from the FY 2015 NSDUH estimates that 27.1 million Americans 

aged 12 or older, or 10.1 percent were current (past month) illicit drug users.134 From the FY 2015 

NSDUH, 17.9 percent of adults ages 18 and older had any mental illness in the past year (43.4 

million) and 4 percent (9.8 million) of adults had serious mental illness.135 

The FY 2015 NSDUH included changes to the data collection equipment, respondent contact 

materials, and survey questions. The changes made to the survey questions were intended to 

improve the quality of the data collected and address changing substance use (e.g., misuse of 

prescription drugs) and mental health policy and research needs. All of the FY 2015 NSDUH 

changes were evaluated in field tests during FY 2012 and FY 2013, with appropriate adjustments 

made to the FY 2015 NSDUH based on field test findings.136 The current NSDUH contract 

supports annual surveys through FY 2017; the contract was re-competed in FY 2016 and was 

awarded in early FY 2017 for survey years FY 2018 through FY 2021. 

CBHSQ has partnered with the Office of the Assistant Secretary for Planning and Evaluation 

(ASPE) and the National Research Council (NRC) for guidance on how to collect data on other 

behavioral health issues (including trauma, recovery, and serious emotional disturbance among 

children) through extramural data collection initiatives. SAMHSA also continues to explore 

opportunities for a future NSDUH redesign to ensure the survey is clinically up-to-date through 

alignment of questions to the DSM-5. Other potential areas for the next possible redesign include, 

but are not limited to, electronic cigarettes, synthetic marijuana, and alignment of treatment 

questions for substance use and mental health. In FY 2018, a total of $54.9 million is available 

for NSDUH ($10.2 million from HSPS and $44.7 million from SAT) to continue survey activities 

without reducing sample size, representing a decrease of $2.6 million from FY 2017. SAMHSA 

will plan to roll out the results of the 2017 survey, field the 2018 survey, plan for the 2019 survey, 

and will continue to explore options for a future NSDUH redesign. 

 

134 Substance Abuse and Mental Health Services Administration, Behavioral Health Trends in the United States: 

Results from the 2014 National Survey on Drug Use and Health, NSDUH Series H-50, HHS 

Publication No. (SMA) 15-4927. Rockville, MD: Substance Abuse and Mental Health Services 

Administration, 2015. See: 

http://www.samhsa.gov/data/sites/default/files/NSDUH-FRR1-2014/NSDUH-FRR1- 2014.pdf.

135 Substance Abuse and Mental Health Services Administration, Behavioral Health Trends in the United States: 

Results from the 2015 National Survey on Drug Use and Health, NSDUH Series H-50, HHS 

Publication No. (SMA) 15-4927. Rockville, MD: Substance Abuse and Mental Health Services 

Administration, 2016. See: 

http://www.samhsa.gov/data/sites/default/files/NSDUH-FRR1-2014/NSDUH-FRR1- 2014.pdf.

136 The following report provides a summary of the changes made to the 2014 NSDUH sample design and 2015 

NSDUH redesign, including data collection equipment, respondent contact materials, and the survey questionnaire. 

http://www.samhsa.gov/data/sites/default/files/NSDUH-RedesignChanges-2015.pdf
232

NSDUH data are disseminated through public-use files made available on the Substance Abuse 

and Mental Health Data Archive (SAMHDA). Data are also disseminated through annual 

reports.137,138,139 Collectively, in FY 2015 and FY 2016, approximately 200 reports and articles 

were written by external researchers using NSDUH, TEDS, N-SSATS, and DAWN data. In 

FY 2017, 30,000 NSDUH downloaded events are anticipated. CBHSQ staff also responded to 

over 600 requests for NSDUH data in FY 2016. 

Treatment Services Data Collection, Analysis, and Dissemination 

Section 505 of the Public Health Service Act (42.U.S.C. 290aa-4) requires SAMHSA to collect 

data on substance use and mental disorder treatment services. For this purpose, SAMHSA’s 

Center for Behavioral Health Statistics and Quality (CBHSQ) developed the Behavioral Health 

Services Information System (BHSIS). Data collected through the BHSIS provide information to 

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

portion of the National Treatment Referral Service. The Locator provides accurate, timely, and 

regularly updated information on mental and substance abuse treatment facilities across the 

country. 

BHSIS includes multiple data collection programs and information resources to support the 

Locator. BHSIS data collections comprise: (1) the National Mental Health Services Survey (NMHSS) which provides information on all specialty mental disorder treatment facilities in the 

United States; in FY 2016, the overall response rate was 92.1 percent; (2) the National Survey of 

Substance Abuse Treatment Services (N-SSATS) which provides information on all public and 

private substance abuse treatment facilities in the United States; in FY 2016, the overall response 

rate was 92.4 percent; (3) the Treatment Episode Data Set (TEDS) which provides demographic 

and services information on publicly funded admissions and discharges from substance abuse 

treatment; (4) the Mental Health Treatment Episode Data Set (MH-TEDS) and the Mental Health 

Client Level Data (MH-CLD) which provide demographic and services information on publicly 

funded admissions and discharges of clients in mental disorder treatment; and (5) 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 (MHBG) annual implementation 

reports. 

137 Substance Abuse and Mental Health Services Administration, Behavioral Health Trends in the United States: 

Results from the 2014 National Survey on Drug Use and Health, NSDUH Series H-50, HHS 

Publication No. (SMA) 15-4927. Rockville, MD: Substance Abuse and Mental Health Services 

Administration, 2015. See: 

http://www.samhsa.gov/data/sites/default/files/NSDUH-FRR1-2014/NSDUH-FRR1- 2014.pdf.

138 Substance Abuse and Mental Health Services Administration. Suicidal Thoughts and Behavior among Adults: 

Results from the 2014 National Survey on Drug Use and Health

Rockville, MD: Substance Abuse and Mental Health Services Administration, 2015. See 

http://www.samhsa.gov/data/sites/default/files/NSDUH-FRR2-2014/NSDUH-FRR2-2014.pdf

139 Substance Abuse and Mental Health Services Administration. Risk and Protective Factors and Initiation of 

Substance Use: Results from the 2014 National Survey on Drug Use and Health. Rockville, MD: Substance Abuse 

and Mental Health Services Administration, 2015. See: 

http://www.samhsa.gov/data/sites/default/files/NSDUH-DR-FRR4-2014v1/NSDUH-DR-FRR4-2014.pdf
233

One important element of the BHSIS is the Inventory of Behavioral Health Services (I-BHS) 

which provides a listing of all known mental disorder and substance abuse treatment facilities. As 

of March 2017, I-BHS had identified 19,529 active substance abuse treatment facilities and 14,263 

active mental disorder treatment facilities in the United States and its territories. 

In FY 2015, the Behavioral Health Treatment Services Locator was accessed more than 2.8 million 

times by individuals, families, community groups, and organizations to identify appropriate 

treatment services. Also in FY 2016, for the months of May through October that SAMHDA was 

operational, researchers downloaded over 2,000 BHSIS public-use datasets, and it is projected, 

based on increasing downloads and an expanding repository of datasets available, that in FY 2017, 

researchers will download over 10,000 BHSIS public use datasets. CBHSQ staff responded to 

over 100 requests for BHSIS data. In February 2017, data users accessed over 380 web pages for 

URS tables. 

In FY 2016, SAMHSA awarded a new BHSIS contract for four cycles of the annual N-SSATS 

and N-MHSS. The Behavioral Health Treatment Services Locator is part of the National 

Treatment Referral Routing Service, which is required through Section 9006 of the 21st Century 

Cures Act. In FY 2017, SAMHSA continued each of the BHSIS data programs and is coordinating 

with states to develop Mental Health-Treatment Episode Data Set/Mental Heath-Client Level Data 

(MH-TEDS/MH-CLD) further. In FY 2018, a total of $18.9 million is requested for BHSIS ($13.7 

million in HSPS and $5.2 million from SAT). Additional funds totaling $8.5 million are provided 

by CMHS and CSAT from the MH and SAT Appropriations to support state payment for data 

collection. 

Emergency Department Data Collection, Analysis, and Dissemination 

Section 505 of the Public Health Service Act (42.U.S.C. 290aa-4) requires SAMHSA to collect 

and publish data on Emergency departments (ED) visits related to the use of alcohol and drugs. 

Emergency departments (EDs) are a robust source of information about substance use and mental 

disorder-related morbidity; an ongoing collection of data allows monitoring of patterns, trends, 

and the identification of emergent drugs of use. 

In late FY 2011, SAMHSA began collaborating with the National Center for Health Statistics 

(NCHS) to obtain data from the National Hospital Care Survey (NHCS) on ED visits related to 

substance use and mental illness for the SAMHSA Emergency Department Surveillance System 

(SEDSS). The NHCS is a survey that describes national patterns of healthcare delivery in hospitalbased settings, including inpatient, emergency, and outpatient departments. With SEDSS data, 

national level estimates of drug-related ED visits and mental illness can be published. 

In FY 2017, efforts focus on challenges that include recruiting hospitals to participate in the survey, 

developing an infrastructure to collect electronic health record (EHR) data for surveillance 

purposes, and developing methods to identify information about drug-related ED visits in EHR 

data. SAMHSA also worked with NCHS to fund a NCHS research data center to help prepare for 

analysis of the EHR data. 
234 

In FY 2018, no funding is requested for SEDSS, representing a decrease of $4.0 million from 

FY 2017. SAMHSA plans to continue the partnership with NCHS to explore the viability of this 

approach to collect emergency department data in future years. 

Community Behavioral Health Surveillance 

SAMHSA coordinates public health response data efforts to create opportunities for cross-agency 

and public-private partnerships to address critical public health questions and use existing or 

decreasing resources more effectively. Surveillance of health conditions is critical to track 

aberrations, changes over time, impact of public health interventions, and national and regional 

differences. Currently, no such surveillance system exists for behavioral health data; national 

surveillance systems do exist, though, for 52 infectious diseases. 

In FY 2016, SAMHSA funded support for the Community Early Warning and Monitoring System 

(C-EMS), a cooperative initiative in which national level behavioral health indicators are being 

developed. In FY 2017, SAMHSA provided funding for a pilot program, establishing 

infrastructure and reporting mechanisms for data collection using this national behavioral health 

surveillance system. The pilot will be completed in FY 2017 and the results will be available for 

review. 

In FY 2016 and FY 2017, SAMHSA supported and reported on field investigations by deploying 

staff to New Mexico, Baltimore, and Flint, Michigan to assess the capacity of the local community 

to respond to behavioral health public health concerns. Additionally, SAMHSA supported and 

reported on field investigations related to suicide, opioid-overdose deaths, and an opioid-related 

HIV outbreak in Indiana. 

SAMHSA has also developed a community assessment tool (CAST)1 that provides a modeled 

“gold standard” for local-level community behavioral health infrastructure compared to an on-theground asset mapping. CAST allows for a local-level evaluation of gaps and overages in 

programmatic coverage, and facilitates community level discussions about resource management. 

The CAST tool, within the context of public health, can be used as a preparation, mitigation, 

response, or recovery tool. 

In FY 2018, no funding is requested for C-EMS, representing a decrease of $3.0 million from 

FY 2017. SAMHSA plans to continue a partnership with state and territorial epidemiologists to 

explore the viability of this approach to collect local behavioral health indicators in future years.

Behavioral Health Research and Dissemination 

OMB’s Open Data Policy Memorandum (M-13-13) requires the Federal Government to make data 

it collects accessible and usable through dissemination activities. CBHSQ conducts 

epidemiological and health services research in the area of behavioral health. Results of these 

research studies inform policymakers, service providers, program developers, and the public about 

important behavioral health findings. 

1 Green B, Lyerla R, Stroup DF, Azofeifa A, High PM. A Tool for Assessing a Community’s Capacity for 

Substance Abuse Care. Prev Chronic Dis 2016;13:160190. DOI: http://dx.doi.org/10.5888/pcd13.160190
235 

CBHSQ is completing a research framework to feed into a broader SAMHSA learning agenda for 

research, statistical studies, and program evaluation. CBHSQ categorizes its research activities 

into four major portfolio areas: substance use, mental health, community behavioral health 

surveillance, and methodological studies. Additionally, several portfolio topic areas, subsets of 

the portfolio areas, have been identified to represent a snapshot of current and past CBHSQ 

research endeavors. The portfolio topic areas allow CBHSQ to optimize resources and balance 

priorities. This approach is moving CBHSQ, and SAMHSA, toward finalizing a research 

framework to reflect the principles of the learning agenda as envisioned by OMB and the 

Department. 

From FY 2012 – FY 2016, CBHSQ produced 64 articles; these articles were across the four 

Portfolio areas in the CBHSQ Research Framework. CBHSQ is projected to produce 64 articles 

in FY 2017 and 16 articles in FY 2018. Additionally, CBHSQ disseminates information through 

short reports and data spotlights using CBHSQ and other data sources that focus on topics 

impacting the behavioral health of the nation. Short reports describe trends in substance use, 

treatment, and mental health topics with in-depth analysis by age, gender, substance use initiation, 

socioeconomic status, and national and state estimates. Spotlights focus on a single topic with one 

chart or graph and a descriptive paragraph delineating public health significance. These are 

published on the SAMHSA website and at the National Library of Medicine. During the period 

FY 2012 – FY 2016, CBHSQ staff authored over 200 such reports. CBHSQ staff are projected to 

produce approximately 50 short reports and spotlights in FY 2017. Due to reductions in resources 

over the past two years, CBHSQ projects a reduction of at least 50 percent in the number of short 

reports and spotlights in FY 2018. 

The Analytical Support Contract will continue to provide support for these activities as well as 

support for ad hoc requests, short- and long-term analyses, special requests, and evaluation 

activities, a total of $3.4 million is requested for this contract, which is provided from a variety of 

sources (HSPS [HS and PQIS] and SAT). 

The Substance Abuse and Mental Health Data Archive (SAMHDA) serves as SAMHSA’s primary 

means for dissemination of data through Public-Use Files (PUF). From May 23, 2016 to October 

2016, users downloaded over 17,000 PUFs from SAMHDA and generated over 8,000 tables 

utilizing a web-based analytic tool launched September 15, 2016. Through SAMHDA, CBHSQ 

provides limited, no-cost, public access to confidential data for researcher analysis. A restricted 

version of the current web-based analytic tool is anticipated to launch in April, 2017, and will 

allow researchers to generate tables based on confidential data. After SAMHDA reopened in May 

2016, an increase in visitors to the website reflected 30 percent returning visitors and 70 percent 

new visitors, with a total of 1,081 download events processed. 

In FY 2017, web-based analytic tool improvements were implemented; and, projected FY 2017 

SAMHDA usage is over 50,000 public-use datasets downloaded by researchers and over 100,000 

tables generated using online analytic tools. Estimates include supporting over 100 research groups 

(with up to 10 researchers per group) in the Data Portal, which allows researchers to apply for 

access to micro-level confidential data for statistical research purposes. CBHSQ will continue to 

incorporate SAMDHA improvements in FY 2018. SAMHSA anticipates increased SAMHDA 
236 

usage in FY 2018 as the website becomes fully operational. In FY 2018, a total of $0.74 million 

is requested for SAMHDA ($0.37 from HSPS and $0.37 from SAT), representing a decrease of 

$0.1 million from FY 2017 reflecting savings realized in the fourth option year of its contract. 

Funding History

Fiscal Year Amount

FY 2014 $47,258,000 

FY 2015 $47,258,000 

FY 2016 

FY 2017

$47,258,000 

$47,226,000

FY 2018 $33,842,000 

Budget Request

The FY 2018 Budget Request is $33.8 million, a decrease of $13.3 million from the FY 2017 

Annualized CR. This funding will support the continuation of the NSDUH, NREPP, BHSIS, and 

the Analytic Support Center contracts. The funding will also support $1.0 million to continue a 

collaboration between HRSA and SAMHSA to collect and analyze data to examine the Behavioral 

Health Workforce. 

Mechanism Table for Health Surveillance

(Dollars in thousands) 

 

FY 2016 Final

FY 2017 

Annualized 

CR

FY 2018 

President's 

Budget

FY 2018

+/

FY 2017

No. Amount No. Amount No. Amount No. Amount

Health Surveillance 

Contracts 

Continuations 3 $40,669 5 $40,027 3 $33,842 --- -$6,185 

New/Competing --- 6,589 1 7,199 --- --- --- -$7,199 

Subtotal 3 47,258 6 47,226 3 33,842 --- -13,384 

Total, Health Surveillance 3 $47,258 6 $47,226 3 $33,842 --- -$13,384
237 

Performance and Quality Information Systems 

(Dollars in thousands)

Program Activity

FY 

2016 

Final

FY 2017 

Annualized 

CR

FY 2018 

President's 

Budget

FY 2018 

+/

FY 2017 

Performance and Quality Information Systems $12,918 $12,893 $12,893 $ 

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

FY 2018 Authorization ......................................................................................................... Expired

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

Eligible Entities ......................................................................................................... Not Applicable 

Program Description and Accomplishments 

The Performance and Quality Improvement Systems (PQIS) funding primarily supports the 

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

funding for each activity along with a detailed narrative description of each project follows. 

Performance and Quality Information Systems 

Resources by Activity/Program

(Dollars in thousands)

 

FY 2016

Final

FY 2017 

Annualized 

CR

FY 2018 

President's 

Budget

FY 2018

+/- 

FY 2017

Performance and Quality Information Systems 

Performance Measurement/Systems $11,167 $9,872 $7,375 -$2,497

SAMHSA Performance Accountability Reports System 10,988 9,872 7,375 -2,497

WebBGAS 179 --- --- ---

Program Evaluations --- 696 --- -696

Primary and Behavioral Health Care Integration --- 696 --- -696

Evidence-Based Programs/Practices 794 770 2,814 2,044

National Registry for Evidence Based Programs and Practices 794 770 2,814 2,044

Behavioral Health Research and Dissemination --- --- 1,360 1,360

Analytic Support Center (ASC) --- --- 1,360 1,360

Content Management 51 --- --- ---

Innovation and Logistical Services Support 16 --- --- ---

Support 890 1,554 1,344 -210

Operations 890 1,554 1,344 -210

Total Performance and Quality Information Systems $12,918 $12,893 $12,893 $---

Performance Measurement and Performance Systems

SAMHSA collects data on key output and outcome measures to monitor and manage grantee 

performance, improve the quality of services provided, and inform program evaluations. 

These data previously were collected by legacy systems, including Data Collection, Analyses, and 

Reporting (DCAR); Prevention Management Reporting and Training System (PMRTS); Services 

Accountability Improvement System (SAIS); and the Transformation Accountability System 

(TRAC). These legacy systems were migrated to a single system, the SAMHSA Performance 
238 

Accountability Reports System (SPARS), in FY 2017, to meet SAMHSA’s vision of a more 

efficient, holistic approach to its performance data collection. 

In FY 2016, the SPARS contract was awarded. In FY 2017, SPARS was deployed as a real-time 

data entry and reporting system for all of SAMHSA’s discretionary grant programs. In FY 2018, 

a total of $7.4 million is requested for SPARS, representing a decrease of $2.5 million from 

FY 2017 reflecting savings realized in the second option year of its contract. In FY 2018, SPARS 

will continue to provide data entry, data validation and verification, data management, data 

analysis support, automated reporting, and additional ad-hoc data analysis to SAMHSA, 

SAMHSA grantees, and others. 

Program Evaluations 

In FY 2012, SAMHSA established a policy for the development and management of evaluation 

and performance monitoring, with a specific focus on implementing a rigorous and consistent 

process of program evaluation within SAMHSA. During the fall of 2016, CBHSQ developed an 

updated Evaluation Policy and Procedure (P&P) document to guide SAMHSA in developing a 

long-term evaluation plan based on the selection and use of the best methods for answering specific 

evaluation questions. The objectives of the Evaluation P&P are: to put into place a policy and a 

consistent business practice to: match the type of evaluation activity to the maturity of the 

program and to the nature of the research questions, determine the degree of independence of 

evaluation activities for different types of programs, incorporate these practices and considerations 

into the contract planning process, collect and disseminate meaningful and critical findings to 

colleagues and to the behavioral health and scientific fields, and develop a learning agenda to 

identify priorities for future evaluation activities. The updated Evaluation P&P will be finalized 

and fully implemented for the FY 2018 planning cycle. 

SAMHSA program evaluations are primarily funded by SAMHSA’s other three programmatic 

appropriations. In FY 2017, the program Centers are funding over a dozen evaluations covering a 

variety of programs (e.g., Strategic Prevention Framework for Prescription Drugs; Screening, Brief 

Intervention, and Referral to Treatment; Pregnant and Postpartum Women; Children’s Mental 

Health Initiative; etc.). CBHSQ has directly funded the Primary and Behavioral Health Care 

Integration (PBHCI) evaluation since FY 2015. In FY 2018, no funding is requested to continue 

the evaluation of the PBHCI as the program is being eliminated. 

 

In FY 2017, CBHSQ entered into several Center Collaboration Agreements (CCAs) with CSAT 

and CMHS to conduct small-scale, time-limited assessments and evaluations. These include three 

CCAs with CSAT to conduct a community assessment for the Medication-Assisted Therapy 

Prescription Drug Overdose Program (MAT-PDOA), to develop and execute the CARA-required 

evaluation of the Pregnant and Post-Partum Women and Pilot (PPWP), and to evaluate the State 

Targeted Response to Opioid Crisis (Opioid STR) program authorized by the 21st Cures Act. 

Activities also include three CCAs with CMHS to conduct an assessment of barriers and 

facilitators to implementing the Resiliency in Communities After Stress and Trauma (ReCAST) 

grants, an analysis of the facilitators to successful implementation of Assisted Outpatient 

Treatment (AOT) programs, and a study of state’s adoption of quality measures for behavioral 

health clinics. CBHSQ plans to continue these activities in FY 2018. 
239 

Evidence-based Programs and Practices 

The National Registry of Evidence-based Programs and Practices (NREPP) was established over 

the past decade to provide decision support to behavioral health service providers as they seek to 

adopt evidence-based programs for improving the quality of their prevention efforts and behavioral 

health services. The Learning Center provides its users with tools and information to select 

programs that will best improve the quality of their behavioral health services. The NREPP serves 

to meet the requirements of Section 7002 of the 21st Century Cures Act in that SAMHSA shall, as 

appropriate, improve access to reliable and valid information on evidence-based programs and 

practices, including information on the strength of evidence associated with such programs and 

practices related to mental illness and drug/alcohol addiction for states, local communities, nonprofit entities, and other stakeholders, by posting on the Internet website of the Administration 

information on evidence-based programs and practices that have been reviewed. 

During the early years of the Registry, efforts were made to attract programs via an open 

submission process which allowed the developer to identify studies and outcomes to be reviewed 

and to decline posting of the results. Beginning in FY 2014, the NREPP process was significantly 

revamped to move toward more rigorous review criteria, an effort to address comments from 

stakeholders regarding the rigor of NREPP reviews. 

With the new process, developers may participate in open submission; but, an external, objective 

review of the literature is conducted, a range of behavioral health outcomes are reviewed, and an 

effect size is calculated. Reviewed programs come from three sources: voluntary submissions, 

programs identified through literature searches, and re-reviews of the 356 legacy programs listed 

on NREPP prior to incorporation of the new review criteria. Due to the increased rigor and 

streamlining of the review process, NREPP increased the number of new programs reviewed 

annually. 

In FY 2016 (contract period June 2016 – June 2017), approximately 230 program reviews will be 

conducted, including a mixture of re-reviews and new program reviews; approximately 30 

literature reviews will also be completed. This work included programs that addressed pregnant 

and post-partum women, co-occurring disorders, medication-assisted treatment, assertive 

community treatment, prescription drug misuse and overdose prevention, drug courts, and mental 

health courts, among others. Additionally, a substantial revision of the Learning Center is 

underway to provide information on developing, implementing, and sustaining programs while 

bolstering support for emerging practices, particularly with underserved populations. 

In FY 2017, it is anticipated CBHSQ will complete approximately 230 program reviews, along 

with an additional 10 literature reviews, and will continue to build out the Learning Center. 

In FY 2018, $2.8 million is requested for NREPP, including the Learning Center, reflecting level 

funding for these activities). CBHSQ will continue to work to improve access to reliable and valid 

information on evidence-based programs and practices related to mental illness and drug/alcohol 

addiction for states, local communities, non-profit entities, and other stakeholders. 
240 

Behavioral Health Quality Measures 

Behavioral health quality activities are housed within CBHSQ; the Center provides oversight of 

the agency’s quality improvement efforts, including the identification of gaps in behavioral health 

quality measurement and the adoption and implementation of behavioral health quality measures. 

Oversight of the agency’s measure development efforts includes current 

re-specification work funded by CSAT, re-specification of measures for HEDIS adoption, 

measures-conceptualization development work in suicide prevention in CMHS, and ongoing 

partnerships with CMS and ASPE, among other Federal partners, in quality measure work. 

CBHSQ serves as the SAMHSA lead to the National Quality Forum as well as participates as a 

Federal advisor for other agencies conducting measure development work, including CMS and 

ASPE. CBHSQ also represents SAMHSA on the HHS Measurement Policy Council, leading 

discussions related to behavioral health metrics and contributing to discussions focused on broader 

healthcare metrics. CBHSQ also participates on the Measures Application Partnership, a group 

convened to guide CMS on measure adoption. 

In response to the National Quality Strategy, SAMHSA developed its own specific quality 

strategy, the National Behavioral Health Quality Framework, a stand-alone document that 

recommends core and supplemental measures to be utilized at the payer, provider, and population 

level to track meaningful service delivery process and outcome measures in behavioral health. 

This document is often referenced by the National Quality Forum (NQF) as a foundational 

document used to guide its behavioral health quality measures work. 

To date, a significant amount of behavioral health quality measure development has occurred; but 

gaps remain. A critical issue is field implementation; therefore, SAMHSA is focused on 

implementation issues since NQF measures have three years to demonstrate use by the field, after 

which they are retired. Challenges in implementation are frequently encountered due to the lack 

of infrastructure or personnel for collection and reporting in behavioral health programs. 

SAMHSA is jointly advancing behavioral health quality measure implementation by co-leading 

an HHS Behavioral Health Coordinating Council (BHCC) subcommittee on quality measures with 

ASPE and CMS which will resulted in recommendations about the uptake of consistent behavioral 

health quality measures capturing alcohol misuse, tobacco cessation, depression measurement and 

management, and medication reconciliation, across HHS programs, including CMS, HRSA, 

SAMHSA, and others. CBHSQ will continue to engage in these types of activities going forward.

CBHSQ staff provides internal collaborations across SAMHSA, advising on quality measure 

issues and identifying key next steps. Additionally, CBHSQ staff continues to serve as advisors 

for NQF projects jointly funded by ASPE and CMS and focused on a broad range of quality 

activities. CBHSQ staff regularly consults with other Federal agencies, the NQF, and other key 

stakeholders regarding behavioral health quality indicators, including barriers to and facilitators of 

data collection, tracking, and reporting. SAMHSA must continue its key leadership role around 

behavioral health quality measure activities through ongoing identification of behavioral health 

measurement gaps and the capacity to address such gaps. 
241 

Funding History

Fiscal Year Amount

FY 2014 $12,918,000 

FY 2015 $12,918,000 

FY 2016 

FY 2017 

$12,918,000 

$12,893,000 

FY 2018 $12,893,000 

Budget Request

The FY 2018 Budget Request is $12.9 million, level with the FY 2017 Annualized CR. SAMHSA 

will use these funds to continue support for NREPP, SPARS, and other program evaluation and 

quality improvement efforts. This funding will ensure that SAMHSA continues a strong focus on 

developing and implementing evidence-based practices and programs and continues its emphasis 

on performance management for quality improvement and program monitoring. 

Mechanism Table for Performance and Quality Information Systems

(Dollars in thousands)

Program Activity

FY 2016 Final

FY 2017 

Annualized 

CR

FY 2018 

President's 

Budget

FY 2018

+/

FY 2017

No. Amount No. Amount No. Amount No. Amount

Performance and Quality Information Systems 

Contracts 

Continuations 1 $2,313 2 $12,893 3 $12,893 --- $ 

New/Competing 1 10,605 --- --- --- --- --- ---

Subtotal 2 12,918 2 12,893 3 12,893 --- 

Total, Performance and Quality Information Systems 2 $12,918 2 $12,893 3 $12,893 --- $
242 

The following table provides a detailed description of all funding sources supporting CBHSQ 

activities.

SAMHSA

Center for Behavioral Health Statistics and Quality

Breakout by Activity/Program (all sources) 

(Dollars in thousands)

 

FY 2016

Final

FY 2017 

Annualized 

CR

FY 2018 

President's 

Budget

FY 2018 

+/- 

FY 2017

Substance Abuse Treatment Appropriation 

Substance Abuse Block Grant Set Aside 

Population Data Collection, Analysis, and Dissemination $40,627 $39,701 $44,655 $4,955 

PHS Evaluation (non add) 39,929 39,003 44,655 5,652 

Treatment Services Data Collection, Analysis, and Dissemination 6,782 7,193 5,162 -2,032 

PHS Evaluation (non add) 6,628 7,193 5,162 -2,032 

Emergency Department Data Collection, Analysis, and Dissemination 1,375 3,875 --- -3,875 

PHS Evaluation (non add) 1,375 3,875 --- -3,875 

Behavioral Health Research and Dissemination 1,992 1,802 892 -909 

PHS Evaluation (non add) 1,992 1,802 892 -909 

Program Evaluations 1,699 --- --- ---

PHS Evaluation (non add) 1,699 --- --- ---

Innovation and Logistical Services Support 233 --- --- ---

PHS Evaluation (non add) 233 --- --- ---

Support 5,604 5,690 4,849 -841 

PHS Evaluation (non add) 5,604 5,690 4,849 -841 

Total Substance Abuse Block Grant Set Aside 58,313 58,261 55,558 -2,703 

Total Substance Abuse Treatment PHS Evaluation 57,460 57,564 55,558 -2,006 

Health Surveillance and Program Support Appropriation 

Health Surveillance 

Population Data Collection, Analysis, and Dissemination 10,987 17,886 10,284 -7,602 

PHS Evaluation (non add) 1,040 6,443 1,333 -5,110 

Treatment Services Data Collection, Analysis, and Dissemination 16,073 11,125 13,696 2,572 

PHS Evaluation (non add) 16,073 11,125 13,696 2,572 

Emergency Department Data Collection, Analysis, and Dissemination --- 125 --- -125 

PHS Evaluation (non add) --- 125 --- -125 

Community Behavioral Health Surveillance 2,525 3,000 --- -3,000 

PHS Evaluation (non add) 2,525 3,000 --- -3,000 

Behavioral Health Research and Dissemination 3,084 3,810 1,880 -1,930 

PHS Evaluation (non add) --- 425 372 -52 

Program Evaluations 912 696 --- -696 

PHS Evaluation (non add) --- 696 --- -696 

Evidence-Based Programs/Practices 2,348 2,044 --- -2,044 

PHS Evaluation (non add) 1,695 1,412 --- -1,412 

Innovation and Logistical Services Support 1,953 --- --- ---

PHS Evaluation (non add) 1,327 --- --- ---

Content Management 26 --- --- ---

PHS Evaluation (non add) --- --- --- ---

Support 9,351 8,482 7,982 -500 

PHS Evaluation (non add) 7,617 7,144 7,026 -118 

Total Health Surveillance 47,258 47,168 33,842 -13,326 

Performance and Quality Information Systems 

Performance Measurement/Systems 11,167 9,872 7,375 -2,497 

Program Evaluations --- 696 --- -696 

Evidence-Based Programs/Practices 794 770 2,814 2,044 

Behavioral Health Research and Dissemination --- --- 1,360 1,360 

Innovation and Logistical Services Support 16 --- --- ---

Content Management 51 --- --- ---

Support 890 1,554 1,344 -210 

Total Performance and Quality Information Systems 12,918 12,893 12,893 ---

Agency Wide 

Behavioral Health Workforce Data Development 1,000 998 998 ---

PHS Evaluation (non add) 1,000 998 998 ---

Total Agency-Wide 1,000 998 998 ---

Total Health Surveillance and Program Support 61,176 61,059 47,733 -13,326 

Total Health Surveillance and Program Support PHS Evaluation 31,276 31,368 23,426 -7,942 

Total Substance Abuse Block Grant Set Aside and

Health Surveillance and Program Support $119,489 $119,320 $103,291 -$16,029
243 

Outputs and Outcomes Table

Program: Performance and Quality Information Systems

NOTE: SAMHSA makes grant awards toward the end of the year and therefore, bases the FY 2018 targets on the 

FY 2017 Annualized CR and the FY 2019 targets are based on the FY 2018 President’s Budget.

Measure

Year and Most Recent Result

Target for Recent Result

(Summary of Result)

FY 2018

Target

FY 2019

Target

FY 2019

Target

+/- 

FY 2018

Target

4.4.10 Increase the combined 

count of webpage hits, hits to the 

locator, and hits to Substance 

Abuse and Mental Health Data 

Archive (SAMHDA) for 

SAMHSA-supported data sets 

(Output)

FY 2016: 95,3781

Target: 1,700,000

(Target Not Met)

1,700,000 1,700,000 Maintain

4.4.11 Increase the number of 

evidence-based programs or 

practices in review (Output)

FY 2016: 119

Target: 55

(Target Exceeded)

55 55 Maintain

1 Website relaunched end of 2016. Site still under development and will not be fully launched until FY 2017.
244 

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245 

Program Support

(Dollars in thousands)

Program Activity 

FY 

2016 

Final

FY 2017 

Annualized 

CR

FY 2018 

President's 

Budget

FY 2018 

+/

FY 2017 

Program Support $79,559 $79,409 $73,043 -$6,366 

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

FY 2018 Authorization ......................................................................................................... Expired

Allocation Method ....................................................... Direct Federal/Intramural, Contracts, Other

Eligible Entities ......................................................................................................... Not Applicable 

Program Description and Accomplishments

The Program Support budget supports the majority of SAMHSA staff who plan, direct, and 

administer SAMHSA’s programs, as well as business operations and processes, information 

technology, and overhead expenses, such as rent, utilities, and miscellaneous charges. In addition, 

this budget supports the Unified Financial Management System, which covers administrative 

activities such as human resources, information technology, and the centralized services provided 

by HHS and the Program Support Center. 

SAMHSA supported 620 Full Time Equivalents (FTEs) in FY 2016; in FY 2017, in order to 

support staffing for areas such as the Office of the Chief Medical Officer and Cures 

implementation, SAMHSA projects support of 615 FTEs. Staff positions that are not covered

through the Health Surveillance and Program Support appropriation are funded with Substance 

Abuse Prevention and Treatment and Mental Health Block Grant set-asides for activities 

associated with technical assistance, data collection, and evaluation. 

SAMHSA applies an estimated internal administrative charge for overhead expenses to all 

programs, projects, and activities. 

Funding History

Fiscal Year Amount

FY 2014 $72,002,000 

FY 2015 $72,002,000 

FY 2016 

FY 2017 

$79,559,000 

$79,409,000 

FY 2018 $73,043,000 

Budget Request 

The FY 2018 Budget Request is $73.0 million, a decrease of $6.3 million from the FY 2017 

Annualized CR. This level of funding will continue to cover personnel, overhead costs associated 

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

and security charges. Funding in FY 2016 and FY 2017 reflected an increase due to the agency’s 
246 

relocation; given that these expenses will not be incurred in FY 2018, the funding request has been 

decreased. 

In FY 2018, SAMHSA plans to support 610 FTEs with funding from the Mental Health, Substance 

Abuse Treatment, and Health Surveillance and Program Support appropriations. Funding types 

include Budget Authority, PHS Evaluation, and other reimbursables. 

Mechanism Table for Program Support

(Dollars in thousands)

Program Activity

FY 2016 Final

FY 2017 

Annualized 

CR

FY 2018 

President's 

Budget

FY 2018

+/

FY 2017

No. Amount No. Amount No. Amount No. Amount

Program Support 

Contracts 

Continuations --- $79,559 --- $79,409 --- $73,043 --- -$6,366 

New/Competing --- --- --- --- --- --- --- ---

Subtotal --- 79,559 --- 79,409 --- 73,043 --- -6,366 

Total, Program Support --- $79,559 --- $79,409 --- $73,043 --- -$6,366
247 

Public Awareness and Support

(Dollars in thousands)

Program Activity

FY 

2016 

Final

FY 2017 

Annualized 

CR

FY 2018 

President's 

Budget

FY 2018 

+/

FY 2017 

Public Awareness and Support $15,571 $15,541 $11,572 -$3,969 

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

FY 2018 Authorization ......................................................................................................... Expired

Allocation Method ........................................................................................... Grants and Contracts 

Eligible Entities ......................................................................................................... Not Applicable 

Program Description and Accomplishments

The behavioral healthcare system is critical to the overall health of the nation. A study funded by 

the National Institutes of Health and SAMHSA2 estimated that at some point in their lives, almost 

half of all Americans will experience symptoms of a clinical mental and/or substance use disorder. 

In addition, half of all lifetime cases of mental illness and/or drug addiction begin by age 14 and 

three-fourths by age 24.3

 For these reasons, it is important to identify issues early and help 

individuals get the treatment they need as soon as possible. Communities are increasingly 

engaging in prevention, treatment, and recovery that are effective in supporting the behavioral 

health and wellness of their residents, particularly children and young adults. An important part 

of SAMHSA’s mission is to raise the public’s understanding of mental illness and drug/alcohol 

addiction, serve as an expert on behavioral health issues, and lead public health efforts to advance 

the behavioral health of the nation. 

Collaborating Across Agencies 

In FY 2017, SAMHSA worked with the Office of the Surgeon General and other HHS agencies to 

release the Facing Addiction in America: Surgeon General’s Report on Alcohol, Drugs, and 

Health, the first ever Surgeon General’s report on this topic, to bring national attention to substance 

misuse and addiction. The report called on people throughout the U.S. to take action to end the 

public health crisis of addiction and discuss the importance of taking a comprehensive approach 

to the problem of substance abuse. In FY2018, through the Materials Development and Marketing 

Support (MDMS) contract, SAMHSA will continue to promote the Surgeon General’s Report 

through communication products such as fact sheets and infographics. SAMHSA also will 

promote the Report through conferences, grantee meetings, webinars, and social media.

SAMHSA’s Public Awareness and Support effort utilizes the Behavioral Health Coordinating 

Council (BHCC) Communications Subcommittee to improve communications and collaboration. 

Co-led by SAMHSA and the Office of the Assistant Secretary for Public Affairs (ASPA), the 

BHCC comprises representatives from HHS agencies and meets monthly. Through the BHCC 

 

2 Kessler, R. C., Berglund, P., Demler, O., Jin, R., Merikangas, K. R., & Walters, E. E. (2005). Lifetime prevalence 

and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. Archives of 

general psychiatry, 62(6), 593-602. 3 Ibid.
248 

Communications Subcommittee, SAMHSA will be able to collaborate and cross-promote 

campaigns, initiatives, events, and products. 

Providing Critical Resources to the Behavioral Health Community

SAMHSA’s strategic communications plan ensures that the vital information and training 

materials produced through SAMHSA’s Centers and Offices are available to the behavioral and 

healthcare community through the Public Engagement Platform (PEP) contract, which manages 

SAMHSA’s print and online information resources. The PEP contract is a resource for the public 

as well as the behavioral health workforce; it provides a warehouse of publications and access to 

the National Helpline. The PEP contract provides a customer-oriented order fulfillment system, 

including an online store, call-in contact center (the National Helpline), warehouse, and e-blasts 

to thousands of subscribers. The current opioid crisis has increased a demand for treatment 

services. The National Helpline provides free confidential treatment referral and information 

services in English and Spanish for individuals and families facing mental illness and/or 

drug/alcohol addiction. It is operational every day, 24/7. The PEP contract is experiencing 

unprecedented levels of call volume. In FY 2016, SAMHSA’s Helpline responded to over 2.5 

million calls. Although SAMHSA has instituted new technologies such as text messaging (SMS) 

and an interactive voice response system as cost-effective solutions, SAMHSA needs to continue 

to explore innovative solutions to avoid any service disruption and to ensure callers get referred to 

treatment services.

SAMHSA is also responsible for managing the Disaster Distress Helpline to provide information 

and counseling referral to the public after tragic events. SAMHSA quickly mobilizes in the 

aftermath of a disaster to deliver behavioral health information and support services for responders 

and survivors. SAMHSA has adopted a rapid response practice which it will continue to do in FY 

2018. When a disaster occurs, SAMHSA quickly disseminates an e-blast featuring the 

SAMHSA’s Disaster Distress Helpline, links to many of SAMHSA’s resources, and a link to 

SAMHSA’s behavioral health treatment locator.

Over the last several years, SAMHSA has leveraged mobile technology to increase the reach of its 

resources by launching multiple mobile apps. Each app has had a greater reach than the ones that 

preceded it. In FY 2015, SAMHSA launched the “Suicide Safe” app for primary care and 

behavioral health providers. The Suicide Safe app is designed to help primary care and behavioral 

health providers address suicide risk and integrate suicide prevention strategies in patient care. 

Suicide Safe has been downloaded 46,811 times since its March 2015 launch. In FY 2017, 

SAMHSA launched MATx, an app that provides healthcare practitioners with immediate access 

to vital information about medication assisted treatment (MAT) for opioid addiction. The MATx 

app includes information on medications approved by FDA for use in treatment of opioid use 

disorders and treatment approaches for practitioners, a buprenorphine prescribing guide, clinical 

support tools, and access to critical helplines and SAMHSA treatment locators. MATx is available 

free for Apple and Android mobile devices. MATx has been downloaded 9,432 since October 

2016. 

In FY 2017, SAMHSA also published the Decisions in Recovery: Treatment for Opioid Use 

Disorder, an online interactive tool and handbook to help people who want information about the 

role of medication in treating opioid addiction. The tool is primarily designed for individuals in, 
249 

or seeking recovery from, opioid addiction and their service providers. It can also be used by 

health officials, policy makers, and other members of the communities involved in addressing the 

problem of opioid addiction. 

 

In FY 2018, SAMHSA will examine its current suite of opioid related products to identify gaps, 

to cross-promote, and to maximize promotional opportunities. 

Leveraging SAMHSA’s Online Presence

Available 24/7, SAMHSA.gov is the public’s primary access point for behavioral health 

information from the federal government. SAMHSA’s website and social media presence on 

channels such as Facebook, Twitter, and YouTube are critical to efforts to engage with citizens 

about behavioral health. In addition to print and traditional media, social media is now 

incorporated in communications plans and is employed daily to communicate behavioral health 

messages and resources. The increasingly effective reach of these online channels is demonstrated 

by the fact that the number of people following SAMHSA on Twitter is 71,179 (an increase from 

7,000 in 2013); the “likes” of SAMHSA’s Facebook page is 72,976 (an increase from 20,000 in 

2013); and the subscribers on SAMHSA’s YouTube is 5,758 (an increase from 800 in 2013). 

In the course of prioritizing the internet as a strategic business initiative and communications asset, 

SAMHSA consolidated and modernized its web presence. In FY 2016, SAMHSA managed a 

significant increase in web visits from the previous year: a 16% growth in annual web visits (over 

33 million visits) and a 50% increase in unique visits (almost 9 million new visitors).

Leading in Dissemination of Behavioral Health Data and Surveillance

A key goal of SAMHSA’s Public Awareness and Support effort is to make certain that valuable 

behavioral health data reach the widest number of Americans, enabling them to make informed 

decisions about the health and wellbeing of their loved ones and themselves. SAMHSA shares 

this vital information through the aforementioned vehicles (e.g., MDMS, PEP, the Web, and social 

media) and other program operations. These include press releases issued by SAMHSA to 

highlight recent findings from the National Survey on Drug Use and Health and SAMHSA’s 

Behavioral Health Barometer. These surveys provide data on behavioral health trends at the 

national level, by geographic region, and for each of the 50 states and the District of Columbia. 

As part of an effort undertaken to change social norms related to behavioral health, SAMHSA 

charged the National Academy of Sciences, Engineering and Medicine (NASEM) Board on 

Behavioral, Cognitive, and Sensory Sciences to research the current state of social norms regarding 

behavioral health and to create a consensus report including recommendations on positively 

impacting those norms. This effort, “Science of Changing Social Norms: Building the Evidence 

Base” laid fundamental groundwork in FY 2015. In FY 2016, SAMHSA awarded a one-year 

contract with NASEM to undertake Phase 2 of the Science of Changing Social Norms project, 

which will produce a communications toolkit and a pilot public awareness campaign. A committee 

of experts in the field of behavioral health and health communications has been formed and 

engaged to discuss campaign themes. 
250 

Funding History

Fiscal Year Amount

FY 2015 $13,482,000 

FY 2015 $13,482,000 

FY 2016 

FY 2017 

$15,571,000 

$15,541,000 

FY 2018 $11,572,000 

Budget Request

The FY 2018 Budget Request is $11.6 million, a decrease of $4.0 million from the FY 2017 

Annualized CR. Funds for Public Awareness and Support will allow SAMHSA to maintain and 

update its web presence, manage critical helplines, deliver publications and resources, expand its 

presence on social media, and provide other resources to support behavioral health and other 

health. SAMHSA will continue to collaborate with other agencies. These efforts will allow 

SAMHSA to broaden the reach of its four key messages: behavioral health is essential to health, 

prevention works, treatment is effective, and people recover. SAMHSA will discontinue support 

for the Science of Changing Social Norms effort but will continue to disseminate lessons learned 

from the project. 

Mechanism Table for Public Awareness and Support

(Dollars in thousands)

 

FY 2016 Final

FY 2017 

Annualized 

CR

FY 2018 

President's 

Budget

FY 2018

+/

FY 2017

No. Amount No. Amount No. Amount No. Amount

Public Awareness and Support 

Contracts 

Continuations 5 $13,107 6 $15,515 3 $4,063 --- -$11,452 

New/Competing 2 2,464 --- 26 1 7,509 --- 7,483 

Subtotal 7 15,571 6 15,541 4 11,572 --- -3,969 

Total, Public Awareness and Support 7 $15,571 6 $15,541 4 $11,572 --- -$3,969
251 

Outputs and Outcomes Table

Program: Public Awareness and Support

NOTE: SAMHSA makes grant awards toward the end of the year and therefore, bases the FY 2018 targets on the 

FY 2017 Annualized CR and the FY 2019 targets are based on the FY 2018 President’s Budget.

Measure

Year and Most Recent Result

Target for Recent Result

(Summary of Result)

FY 2018

Target

FY 2019

Target

FY 2019

Target

+/- 

FY 2018 

Target

4.4.12 Increase the number of 

individuals referred for 

behavioral health treatment 

resources. (Output)

FY 2015: 565,925

Target: 310,000

(Target Exceeded)

600,000 600,000 Maintain

4.4.13 Increase the total number 

of interactions through phone 

inquiries, e-blasts, dissemination 

of SAMHSA publications, and 

total website hits (Output)

FY 2015: 34,151,612

Target: 30,325,334

(Target Exceeded)

33,430,000 33,430,000 Maintain
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253 

Department of Health and Human Services

Substance Abuse and Mental Health Services Administration

(Dollars in millions) 

Resource Summary

FY 2016 

Final

FY 2017 

Annualized 

CR

FY 2018 

President’s 

Budget

Drug Resources by Decision Unit and Function

Programs of Regional and National Significance

Substance Abuse Prevention $211.219 $222.817 $149.703

Substance Abuse Treatment 337.345 341.708 341.738

Total Programs of Regional and National Significance 548.564 564.525 491.441

State Targeted Response to the Opioid Crisis Grants --- 500,000 500,000

Substance Abuse Prevention and Treatment Block Grant1

Prevention 371.616 370.939 370.939

Treatment 1,486.463 1,483.758 1,483.758

Total, Substance Abuse Prevention and Treatment Block Grant 1,858.079 1,854.697 1,854.697

Health Surveillance and Program Support2

Prevention 25.416 26.58 19.419

Treatment 101.663 106.319 77.677

Total, Health Surveillance and Program Support 127.078 132.898 97.096

Total Funding $2,533.721 $3,052.12 $2,943.234

Drug Resources Personnel Summary

Total FTEs 416 437 461

Drug Resources as a Percent of Budget

Total Agency Budget $3,781.436 $4,291.527 $3,892.333

Drug Resources Percentage 67.0% 71.12% 75.6%

1 The Substance Abuse Prevention and Treatment Block Grant is split 20% to the Prevention function and 80% to the Treatment 

function.

2 The Health Surveillance and Program Support Appropriation funded activities are split between Mental Health and Substance 

Abuse as follows: Program Support, Health Surveillance and PQIS are split the same percentage split as between MH/SA 

appropriations. PAS, Agency-wide, and Data Request and Publication User Fees are split 50/50 between MH/SA. The resulting 

Substance Abuse total is then divided between Prevention (20%) and Treatment (80%).
254 

Drug Budget Split between Prevention and Treatment

(Dollars in thousands) 

Substance Abuse Prevention

FY 2016

Final

FY 2017

Annualized 

CR

FY 2018

President's 

Budget

Programs of Regional and National Significance (PRNS) 

Strategic Prevention Framework $119,484 $119,257 $58,427

Strategic Prevention Framework Rx (non-add) 10,000 9,981 10,000

Budget Authority (non-add) 109,484 109,276 48,427

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

Federal Drug-Free Workplace 4,894 4,885 4,885

Minority AIDS 41,205 41,127 28,843

Sober Truth on Preventing Underage Drinking 7,000 6,986 6,986

Center for the Application of Prevention Technologies 7,493 7,479 7,479

Budget Authority (non-add) 7,493 7,479 7,479

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

Science and Service Program Coordination 4,072 4,064 4,064

Grants to Prevent Prescription Drug/Opioid Overdose Related Deaths 12,000 11,977 11,977

Tribal Behavioral Health Grants 15,000 14,971 14,971

First Responder Training (Comprehensive Addiction and Recovery Act- CARA) --- 12,000 12,000

SAP Minority Fellowship Program 71 71 71

Total, Substance Abuse Prevention PRNS 211,219 222,817 149,703

Substance Abuse Prevention and Treatment Block Grant1 371,616 370,939 370,939

PHS Evaluation Funds (non-add) 15,840 15,840 15,840

Total, Substance Abuse Prevention and Treatment Block Grant 371,616 370,939 370,939

Health Surveillance and Program Support2

Health Surveillance 6,293 6,697 5,089

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

Budget Authority (non-add) 2,241 2,382 1,716

PHS Evaluation Funds (non-add) 4,052 4,315 3,373

Program Support 10,595 11,260 10,984

Public Awareness and Support 1,557 1,554 1,157

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

Performance and Quality Information Systems 1,720 1,828 1,939

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

Agency-wide Initiatives 5,100 5,091 100

PHS Evaluation Funds (non-add) 100 100 100

Data Request/Publication User Fees 150 150 150

Total, Health Surveillance and Program Support 25,416 26,580 19,419

Total, Substance Abuse Prevention $608,250 $620,336 $540,062 1 The Substance Abuse Prevention and Treatment Block Grant is split 20% to the Prevention function and 80% to the Treatment function. 2 The Health Surveillance and Program Support Appropriation funded activities are split between Mental Health and Substance Abuse as follows: 

Program Support, Health Surveillance and PQIS are split the same percentage split as between MH/SA appropriations. PAS, Agency-wide, and Data 

Request and Publication User Fees are split 50/50 between MH/SA. The resulting Substance Abuse amount is then divided between Prevention (20%) 

and Treatment (80%).

 

 

 
255 

Drug Budget Split between Prevention and Treatment (Continued)

(Dollars in thousands)

 

Substance Abuse Treatment

FY 2016

Final

FY 2017

Annualized 

CR

FY 2018

President's 

Budget

Programs of Regional and National Significance (PRNS) 

Opioid Treatment Programs/Regulatory Activities $8,724 $8,708 $8,708

Prescription Drug and Opioid Medication-Assisted Treatment --- --- ---

Screening, Brief Intervention and Referral to Treatment 46,889 46,804 46,804

Budget Authority (non-add) 44,889 44,804 44,804

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

Targeted Capacity Expansion 36,303 36,234 36,234

Medication-Assisted Treatment for Prescription Drug and Opioid Addiction 

(non-add) 25,000 24,952 24,952

Pregnant and Postpartum Women 15,931 19,901 19,931

Comprehensive Addiction and Recovery Act ( non-add) --- 4,000 4,000

Recovery Community Services Program 2,434 2,429 2,429

Children and Family Programs 29,605 29,549 29,549

Treatment Systems for Homeless 41,304 41,225 41,225

Minority AIDS 65,570 65,445 65,445

SAP Minority Fellowship Program 3,539 3,532 3,532

Criminal Justice Activities 78,000 77,852 77,852

Addiction Technology Transfer Centers 9,046 9,029 9,029

Building Communities of Recovery --- 1,000 1,000

Total, Substance Abuse Treatment PRNS 337,345 341,708 341,738

State Targeted Response to the Opioid Crisis Grants --- 500,000 500,000

Substance Abuse Prevention and Treatment Block Grant1 1,486,463 1,483,758 1,483,758

PHS Evaluation Funds (non-add) 63,360 63,360 63,360

Total, Substance Abuse Prevention and Treatment Block Grant 1,486,463 1,483,758 1,483,758

Health Surveillance and Program Support2 

Health Surveillance 25,173 26,787 20,357

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

Budget Authority (non-add) 13,464 13,438 9,131

PHS Evaluation Funds (non-add) 16,208 17,259 13,491

Program Support 42,380 45,041 43,937

Public Awareness and Support 6,228 6,216 4,629

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

Performance and Quality Information Systems 6,881 7,313 7,755

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

Agency-wide Initiatives 20,400 20,362 399

PHS Evaluation Funds (non-add) 400 400 399

Data Request/Publication User Fees 600 600 600

Total, Health Surveillance and Program Support 101,663 106,319 77,677

Total, Substance Abuse Treatment $1,925,471 $2,431,784 $2,403,172 1 The Substance Abuse Prevention and Treatment Block Grant is split 20% to the Prevention function and 80% to the Treatment function. 2 The Health Surveillance and Program Support Appropriation funded activities are split between Mental Health and Substance Abuse as follows: 

Program Support, Health Surveillance and PQIS are split the same percentage split as between MH/SA appropriations. PAS, Agency-wide, and Data 

Request and Publication User Fees are split 50/50 between MH/SA. The resulting Substance Abuse amount is then divided between Prevention (20%) 

and Treatment (80%).
256 

Mission

The Substance Abuse and Mental Health Services Administration’s (SAMHSA) mission is to 

reduce the impact of substance abuse and mental illness on America’s communities. SAMHSA 

supports the President’s National Drug Control Strategy through a broad range of programs 

focusing on prevention, treatment and recovery from substance abuse. Major programs for 

FY 2018 will include the Substance Abuse Prevention and Treatment Block Grant, the new 

mandatory State Targeted Response Cooperative Agreements, competitive grant programs 

reflecting Programs of Regional and National Significance (PRNS) and Health Surveillance and 

Program Support. SAMHSA’s Centers for Substance Abuse Prevention (CSAP) and Substance 

Abuse Treatment (CSAT) as well as through SAMHSA’s Center for Behavioral Health Statistics 

and Quality (CBHSQ) and the Office of Communications administer these programs. 

Methodology 

SAMHSA distributes drug control funding into two functions: prevention and treatment. Both 

functions include a portion of funding from the Health Surveillance and Program Support (HSPS) 

appropriation. 

The portion of the Health Surveillance and Program Support account attributed to the Drug Budget 

uses the following calculations: 

• The Health Surveillance, Program Support, and PQIS portions of the HSPS appropriation 

are divided between Mental Health and Substance Abuse using the same percentages splits 

as between the Mental Health and Substance Abuse (Prevention and Treatment) 

appropriation amounts. 

o The Substance Abuse portion is then split 20 percent/80 percent into the two 

functions, prevention and treatment, respectively. 

• The PAS and Agency-wide portions of the HSPS appropriation are divided evenly between 

Mental Health and Substance Abuse. 

o The Substance Abuse portion is then split 20 percent/80 percent into the two 

functions, prevention and treatment, respectively. 

The prevention function also includes all of the Substance Abuse Prevention appropriation, 

including the Substance Abuse Prevention Programs of Regional and National Significance, and 

20 percent of the Substance Abuse Prevention and Treatment Block Grant funds specifically 

appropriated for prevention activities from the Substance Abuse Treatment appropriation. 

The treatment function also includes the Substance Abuse Treatment appropriation, including the 

Substance Abuse Treatment Programs of Regional and National Significance, 80 percent of the 

Substance Abuse Prevention and Treatment Block Grant funds, and the State Targeted Response 

to the Opioid Crisis funding. 

Budget Summary

In FY 2018, SAMHSA requests a total of $2.9 billion for drug control activities, a decrease of 

$108.9 million from the FY 2017 Annualized CR. The budget directs resources to activities that 

have demonstrated improved health outcomes and that increase service capacity. SAMHSA has 
257 

three major drug-related decision units: Substance Abuse Prevention, Substance Abuse Treatment, 

and Health Surveillance and Program Support. Each decision unit is discussed below: 

Substance Abuse Prevention

Substance Abuse Prevention Programs of Regional and National Significance

FY 2018 Request: $149.7 million

(Reflects -$73 million below level funding from the FY 2017 Annualized CR) 

The Substance Abuse Prevention Programs of Regional and National Significance support states 

and communities in carrying out an array of activities to improve the quality and availability of 

services in priority areas. The FY 2018 President’s Budget request for SAMHSA’s Substance 

Abuse Prevention Programs of Regional and National Significance includes $149.7 million for 

eight programmatic activities, which is $73 million below the FY 2017 Annualized CR. The 

request includes: $58.4 million for Strategic Prevention Framework, $4.9 million for the Federal 

Drug-Free Workplace Program, $28.8 million for Minority AIDS, $7 million for Sober Truth on 

Preventing Underage Drinking, $7.5 million to continue provision of technical assistance to 

maximize effectiveness through the Centers for the Application of Prevention Technologies, $4.1 

million for Science and Service Program Coordination, $12.0 million for Grants to Prevent 

Prescription Drug/Opioid Overdose Related Deaths, $14.9 million for Tribal Behavioral Health 

Grants, $0.1 million for SAP Minority Fellowship Program, and $12.0 million for First Responder 

Training (Comprehensive Addiction and Recovery Act). 

Strategic Prevention Framework (PRNS non-add)

FY 2018 Request: $58.4 million

(Reflects $60.8 million below level funding from the FY 2017 Annualized CR) 

SAMHSA’s Strategic Prevention Framework (SPF) grant programs support activities to help 

grantees build a solid foundation for delivering and sustaining effective substance abuse 

prevention services and reducing substance abuse problems. The Strategic Prevention Framework 

– Partnerships for Success program addresses one of the nation’s top substance use prevention 

priorities: underage drinking among youth and young adults age 12 to 20 and allows states to 

prioritize their top data driven substance use target areas such as marijuana and cocaine. 

See page 129 in the CSAP chapter for the start of the full description of this program. 

Strategic Prevention Framework for Prescription Drugs (PRNS non-add)

Due to alarming trends related to prescription drug misuse and overdoses involving opioids, 

SAMHSA is prioritizing efforts to address prescription drug misuse. SAMHSA implemented the 

Strategic Prevention Framework for Prescription Drugs to raise awareness about the dangers of 

sharing medications and to work with pharmaceutical and medical communities on the risks of 

overprescribing to young adults. SAMHSA’s program 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 Program (PDMP) data into needs assessments and 

strategic plans as indicators of program success. SAMHSA awarded 25 grants in FY 2016. In FY 

2017 and FY 2018, SAMHSA will support 25 grant continuations. 
258 

See page 130 in the CSAP chapter for the start of the full description of these efforts. 

Budget Request 

The FY 2018 Budget Request is $58.4 million, a decrease of $60.8 million from the FY 2017 

Annualized CR. Funding for the SPF Rx program will be maintained in its entirety ($10.0M). 

Funding will support 25 Strategic Prevention Framework for Prescription Drugs continuation 

grants, technical assistance, and evaluation to build capacity to address prescription drug misuse 

and overdose prevention efforts, in conjunction with other state and local partners. In FY 2018, in 

order to ensure that every state receives SPF funding, a new cohort of PFS grants will be awarded 

to focus on underage drinking and two other substances including but not limited to marijuana and 

cocaine. Additionally, SAMHSA will also support the continuation at a significantly reduced rate 

of 49 Strategic Prevention Framework - Partnerships For Success grants to decrease the impact of 

underage drinking and prescription drug misuse while lessening the progression of emergent issues 

such as heroin and marijuana use. 

Federal Drug-Free Workplace (PRNS non-add)

FY 2018 Request: $4.9 million

(Reflects level funding from the FY 2017 Annualized CR) 

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 include: 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. 

See page 134 in the CSAP chapter for the start of the full description of this program. 

Budget Request

The FY 2018 Budget Request is $4.9 million, level with the FY 2017 Annualized CR. In FY 2018, 

SAMHSA will continue oversight of the Executive Branch Agencies’ Federal Drug-Free 

Workplace Programs. This includes review of Federal Drug-Free Workplace plans from those 

federal agencies that perform federal employee testing, random testing of those designed testing 

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

the misuse of prescription drugs. SAMHSA will continue its oversight role for the inspection and 

certification of the HHS-certified laboratories. 

Minority AIDS (PRNS non-add)

FY 2018 Request: $28.8 million 

(Reflects -$12.3 million below level funding from FY 2017 Annualized CR) 

The Minority AIDS program supports activities that assist grantees in building a solid foundation 

for delivering and sustaining quality and accessible state-of-the-science substance misuse and HIV 

prevention services. The program aims to engage community-level domestic public and private 

non-profit entities, tribes, and tribal organizations in order to prevent and reduce the onset of 

substance misuse and transmission of HIV/AIDS among at-risk populations, including 

racial/ethnic minority youth and young adults, ages 13 to 24. SAMHSA works with college and 
259 

university clinics/wellness centers and community-based providers that can provide 

comprehensive substance misuse and HIV prevention strategies. These strategies combine 

education and awareness programs, social marketing campaigns, and HIV and viral hepatitis 

testing services in non-traditional settings with substance misuse and HIV prevention 

programming for the population of focus. Because of the high rate of HIV/AIDS and hepatitis comorbidity, this program includes viral hepatitis prevention and education training. 

See page 136 in the CSAP chapter for the start of the full description of this program. 

Budget Request 

The FY 2018 Budget Request of $28.8 million, a decrease of $12.3 million from the FY 2017 

Annualized CR. New MAI CoC grants will not be awarded and CBI will be phased out in order 

to reduce duplication and target funding most effectively in SAMHSA’s Prevention Navigator and 

MSI/CBO programs. SAMHSA will support up to 73 grant continuations to assist grantees in 

building a solid foundation for delivering integrated evidence-based substance use, HIV and viral 

hepatitis prevention services that are in alignment with the National HIV/AIDS Strategy. These 

funds continue to address a critical public health problem and provide lifesaving prevention 

services, including testing for HIV. 

SAP Minority Fellowship Program

FY 2018 Request: $0.1 million 

(Reflects level funding from the FY 2017 Annualized CR)

SAMHSA’s Minority Fellowship Program (MFP) increases behavioral health practitioners’ 

knowledge of issues related to prevention, treatment, and recovery support for mental illness and 

drug/alcohol addiction among racial and ethnic minority populations. The program provides 

stipends to funding increases the number of culturally competent behavioral health professionals 

who teach, administer, conduct services research, and provide direct mental illness or substance 

abuse treatment services for minority populations that are underserved. 

See page 153 in the CSAP chapter for the start of the full description of this program. 

Budget Request 

The FY 2018 Budget Request is $71 thousand, level with the FY 2017 Annualized CR The funding 

will provide continued support for both base and expansion activities. The funds will support one 

MFP and one technical assistance and evaluation support contracts. 

First Responder Training (Comprehensive Addiction and Recovery Act)

FY 2018 Request: $12.0 million

(Reflects level funding from the FY 2017 Annualized CR)

Comprehensive Addiction and Recovery Act (CARA), SAMHSA is authorized to support 

additional efforts to prevent opioid overdose-related deaths by providing grants to train first 

responders. In FY 2017, SAMHSA will fund up to 11 grants for the new First Responder Training 

program. The purpose of this program is to reduce the number of prescription drug/opioid 

overdose-related deaths and adverse events among individuals at risk for opioid addiction. 

Applicants will train first responders and members of other key community sectors at the state, 

local government, and tribal levels to implement secondary prevention strategies, such as the 
260 

administration of Naloxone through FDA approved delivery devices to reverse the effects of opioid 

overdose. 

 

See page 152 in the CSAP chapter for the start of the full description of this program. 

Budget Request 

The FY 2018 Budget Request is $12 million, level with the FY 2017 Annualized CR. This funding 

will provide continuation grants to 11 grantees to further address the opioid crisis in this country. 

Sober Truth on Preventing Underage Drinking (PRNS non-add)

FY 2018 Request: $7.0 million

(Reflects level funding from the FY 2017 Annualized CR) 

The Sober Truth on Preventing Underage Drinking Act (STOP Act) of 2006 (Public Law 109-422) 

was the nation’s first comprehensive legislation on underage drinking. One of the primary 

components of the STOP Act is the community-based coalition enhancement grant program aimed 

at preventing and reducing alcohol use among youth under age 21. 

See page 140 in the CSAP chapter for the start of the full description of this program. 

Budget Request 

The FY 2018 Budget Request of $7.0 million, level with the FY 2017 Annualized CR. In FY 2018, 

SAMHSA will support 95 STOP Act grant continuations. This funding will continue to strengthen 

SAMHSA’s commitment to reduce and prevent underage drinking. 

Centers for the Application of Prevention Technologies (PRNS non-add)

FY 2018 Request: $7.5 million

(Reflects level funding from the FY 2017 Annualized CR)

The Center for the Application of Prevention Technologies (CAPT) program provides state-ofthe-art training and technical assistance to build the capacity of SAMHSA grantees and develop 

the skills, knowledge, and expertise of the prevention workforce. The program builds capacity 

and promotes the development of substance abuse prevention professionals in the behavioral 

health field through three core strategies: 1) establishing technical assistance networks using local 

experts; 2) developing and delivering targeted training and technical assistance activities; and 3) 

using communication media such as teleconference and video conferencing, online events, and 

web-based support. These activities help ensure the delivery of effective prevention programs and 

practices and the development of accountability systems for performance measurement and 

management.

See page 143 in the CSAP chapter for the start of the full description of this program. 
261 

Budget Request 

The FY 2018 Budget Request is $7.5 million, level with the FY 2017 Annualized CR. The 

program will continue to provide technical assistance and training to over 7,500 individuals in the 

prevention field. 

Science and Service Program Coordination (PRNS non-add)

FY 2018 Request: $4.1 million

(Reflects level funding from the FY 2017 Annualized CR) 

The Science and Service Program Coordination program funds the provision of technical 

assistance and training to states, tribes, communities, and grantees around substance abuse 

prevention. Specifically, the program supports the Tribal Training and Technical Assistance 

Center and the Underage Drinking Prevention Education Initiatives (UADPEI). 

See pages 146 in the CSAP chapter for the start of the full description of this program. 

Budget Request

The FY 2018 Budget Request is $4.1 million, level with the FY 2017 Annualized CR. These funds 

will support SAMHSA’s substance abuse prevention efforts and include a focus on preventing 

underage drinking and providing technical assistance and training to American Indians/Alaska 

Native communities.

Tribal Behavioral Health Grants (PRNS non-add)

FY 2018 Request: $15.0 million

(Reflects level funding from the FY 2017 Annualized CR)

SAMHSA’s Tribal Behavioral Health Grants (TBHG) program addresses the high incidence of 

substance abuse and suicide among AI/AN populations. 

See page 147 in the CSAP chapter for the start of the full description of this program. 

Budget Request

The FY 2018 Budget Request for the Tribal Behavioral Health Grant program is $30.0 million, 

including $15.0 million in the Mental Health appropriation and $15.0 million in the Substance 

Abuse Prevention appropriation. This is level with the FY 2017 Annualized CR. This request will 

continue support for programs that promote mental health and prevent substance use activities for 

high-risk AI/AN youth and their families. In FY 2018, SAMHSA will fund TBHG continuation 

grants.

Grants to Prevent Prescription Drug/Opioid Overdose Related Deaths (PRNS non-add)

FY 2018 Request: $12.0 million

(Reflects level funding from the FY 2017 Annualized CR)

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 

overdose reversing drugs, equip first responders with naloxone and other overdose death 
262 

prevention strategies, support education on these strategies, provide materials to assemble and 

disseminate overdose kits. 

See page 150 in the CSAP chapter for the start of the full description of this program. 

Budget Request

The FY 2018 Budget Request is $12.0 million, level with the FY 2017 Annualized CR. This 

funding will provide continuation grants to 12 states to reduce the number of opioid overdoserelated deaths. 

Substance Abuse Treatment

Substance Abuse Treatment Programs of Regional and National Significance 

FY 2018 Request: $341.7 million

(Reflects level funding from the FY 2017 Annualized CR)

The Substance Abuse Treatment Programs of Regional and National Significance (PRNS) support 

states and communities in carrying out an array of activities to improve the quality and availability 

of services in priority areas. The FY 2018 Budget Request for SAMHSA’s Substance Abuse 

Treatment PRNS includes $341.7 million, level with the FY 2017 Annualized CR. Specific PRNS

activities are described below.

Opioid Treatment Programs/Regulatory Activities (PRNS non-add)

FY 2018 Request: $8.7 million

(Reflects level funding from the FY 2017 Annualized CR)

As part of its regulatory responsibility, SAMHSA certifies Opioid Treatment Programs that use 

methadone, buprenorphine, or buprenorphine/naloxone to treat patients with opioid dependence. 

SAMHSA carries out this responsibility by enforcing regulations established by an accreditationbased system. This is accomplished in coordination with the Drug Enforcement Administration, 

states, territories, and the District of Columbia. SAMHSA also funds the Opioid Treatment 

Programs Medical Education and Supporting Services project aimed at preparing Opioid 

Treatment Programs to achieve accreditation and providing technical assistance and clinical 

training to enhance program clinical activities. Additionally, SAMHSA funds grants and contracts 

that support the regulatory oversight and monitoring activities of Opioid Treatment Programs. 

See page 165 in the CSAT chapter for the start of the full description of this program. 

Budget Request

The FY 2018 Budget Request is $8.7 million, level with the FY 2017 Annualized CR. In FY 2018, 

SAMHSA intends to continue funding two continuation grants and three contracts and plans to 

support two new contracts. 

Screening, Brief Intervention and Referral to Treatment (PRNS non-add)

FY 2018 Request: $46.8 million

(Reflects level funding from the FY 2017 Annualized CR)
263 

The Screening, Brief Intervention and Referral to Treatment (SBIRT) program requires state grant 

recipients to implement the model in all primary care settings, as well as hospitals, trauma centers, 

federally qualified health centers, and other relevant health care settings. The program’s goal is to 

increase the number of individuals who receive treatment and reduce the rate of substance misuse. 

Studies have shown that this approach is effective in helping reduce harmful alcohol consumption. 

The SBIRT training program helps train a wide range of medical providers to incorporate SBIRT 

as part of their ongoing practice. This includes physicians, nurses, counselors, social workers, 

health promotion advocates, health educators, and others. 

See page 169 in the CSAT chapter for the start of the full description of this program. 

Budget Request

The FY 2018 Budget Request is $46.8 million, level with the FY 2017 Annualized CR. 

Targeted Capacity Expansion (PRNS non-add)

FY 2018 Request: $36.2 million

(Reflects level funding from the FY 2017 Annualized CR)

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 addiction; lack of resources needed to adopt and implement health 

information technologies (HIT) in substance abuse treatment settings; and short supply of trained 

and qualified peer recovery coaches to assist individuals in the recovery process. 

See page 173 in the CSAT chapter for the start of the full description of this program.

Budget Request

The FY 2018 Budget Request is $36.2 million, level with the FY 2017 Annualized CR. SAMHSA 

intends to fund 11 new MAT PDOA grants, 11 continuation MAT PDOA grants, 12 TCE-TAC 

continuation grants, and 17 TCE-PTP continuation grants, as well as support two contracts. 

Treatment Systems for Homeless (PRNS non-add)

FY 2018 Request: $41.2 million

(Reflects level funding from the FY 2017 Annualized CR)

SAMHSA’s Treatment Systems for Homeless portfolio supports services for those with 

drug/alcohol addiction and who are experiencing homelessness, including veterans, and those 

experiencing chronic homelessness. 

See page 186 in the CSAT chapter for the start of the full description of this program. 
264 

Budget Request

The FY 2018 Budget Request is $41.2 million, level with the FY 2017 Annualized CR. SAMHSA 

plans to support annual Cooperative Agreements to Benefit Homeless Individuals for StatesEnhancement (CABHI-States Enhancement) and Grants for the Benefit of Homeless Individuals 

(GBHI) grant continuations and continue to expand programs and support homeless programs 

through the support of new grants. 

Minority AIDS – Treatment (PRNS non-add)

FY 2018 Request: $65.4 million

(Reflects level funding from the FY 2017 Annualized CR)

The purpose of the Minority AIDS grant program is to facilitate the development and expansion 

of culturally competent and effective community-based treatment systems for substance use and 

co-occurring substance use and mental disorders within racial and ethnic minority communities. 

The goals of the program are to reduce the impact of behavioral health problems, reduce HIV risk 

and incidence, and increase access to treatment for individuals with co-existing behavioral health, 

HIV, and Hepatitis conditions. 

See page 191 in the CSAT chapter for the start of the full description of this program. 

Budget Request

The FY 2018 Budget Request is $65.4 million, level with the FY 2017 Annualized CR. SAMHSA 

intends to fund two new TCE-HIV/AIDS grants, and up to 34 HIV MAI CoC grants. SAMHSA 

also plans to fund 59 continuation TCE-HIV/AIDS grants, 23 HIV Women’s continuation grants, 

one Addiction Technology Transfer Center Network supplemental grant, and three new contracts.

SAT Minority Fellowship Program

Total FY 2018 Request: $3.5 million 

(Reflects level funding from the FY 2017 Annualized Continuing Resolution)

SAMHSA’s Minority Fellowship Program (MFP) increases behavioral health practitioners’ 

knowledge of issues related to prevention, treatment, and recovery support for mental illness and 

drug/alcohol addiction among racial and ethnic minority populations. The program provides 

stipends to funding increases the number of culturally competent behavioral health professionals 

who teach, administer, conduct services research, and provide direct mental illness or substance 

abuse treatment services for minority populations that are underserved. 

See page 202 in the CSAT chapter for the start of the full description of this program. 

Budget Request 

The FY 2018 Budget Request is $3.5 million, level with the FY 2017 Annualized CR. The funding 

will provide continued support for both base and expansion activities. The funds will support six 

MFPs, five MFP-Y, two MFP-AC grants, and three technical assistance and evaluation support 

contracts. 
265 

Pregnant and Postpartum Women and Comprehensive Addiction and Recovery Act

Total FY 2018 Request: $19.9 million

(Reflects level funding from the FY 2017 Annualized CR)

The Pregnant and Postpartum Women and Comprehensive Addiction and Recovery Act (CARA) 

address the substance use and addiction across the country through the implementation of 

prevention, treatment, and recovery programs. In FY 2017, SAMHSA received funding to support 

two of these programs through its Substance Abuse Treatment Appropriation. 

In FY 2017, SAMHSA plans on funding three new state PPW pilot grants to: 1) support familybased services for pregnant and postpartum women with a primary diagnosis of a substance use 

disorder, including opioid disorders; 2) help state substance abuse agencies address the continuum 

of care, including services provided to women in nonresidential-based settings; and 3) promote a 

coordinated, effective and efficient state system managed by state substance abuse agencies by 

encouraging new approaches and models of service delivery. An evaluation of this program will 

be conducted to determine the effectiveness of the pilot.

See page 178 in the CSAT chapter for the start of the full description of this program. 

Budget Request 

The FY 2018 budget request is $19.9 million, level with the FY 2017 Annualized CR. These funds 

will be used to fund five new residential treatment grants and 21 continuation residential treatment

grants and support the continuation of the PPW Pilot ($4.0 million) to provide an array of services 

and supports to pregnant women and their children. 

Building Communities of Recovery 

Total FY 2018 Request: $1.0 million 

(Reflects level funding from the FY 2017 Annualized CR)

In FY 2017, SAMHSA is planning to support a new cohort of grants through the Building 

Communities of Recovery program. The purpose of this program is to mobilize resources within 

and outside of the recovery community to increase the prevalence and quality of long-term 

recovery support from drug/alcohol addiction. 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. 

See page 201 in the CSAT chapter for the start of the full description of this program. 

Budget Request 

The FY 2018 budget request is $1.0 million, level with the FY 2017 Annualized CR. These funds 

will be used to the Building Communities of Recovery Program to develop, expand, and enhance 

recovery support services. 
266 

Criminal Justice Activities (PRNS non-add)

FY 2018 Request: $77.9 million

(Reflects level funding from the FY 2017 Annualized CR)

SAMHSA’s Criminal Justice portfolio includes several grant programs that focus on diversion, 

alternatives to incarceration, drug courts, and re-entry from incarceration for adolescents and 

adults with drug/alcohol addiction and/or co-occurring drug/alcohol addiction and mental illness. 

This includes Treatment Drug Courts and the Offender Re-Entry Programs.

See page 194 in the CSAT chapter for the start of the full description of this program. 

Drug Court Activities

FY 2018 Request: $60.0 million

(Reflects level funding from the FY 2017 Annualized Continuing Resolution) 

SAMHSA’s Adult Drug Court programs support a variety of services including direct treatment 

services for diverse populations, wraparound/recovery support services designed to improve 

access and retention, drug testing for illicit substances, education support, relapse prevention and 

long-term management, pharmacotherapy), and HIV testing conducted in accordance with state 

and local requirements. The program seeks to address behavioral health disparities among racial 

and ethnic minorities by encouraging the implementation of strategies to decrease the differences 

in access, service use, and outcomes among the racial and ethnic minority populations served. 

See page 194 in the CSAT chapter for the start of the full description of this program. 

Ex-Offender Re-Entry Program 

FY 2018 Request: $17.9 million

(Reflects level funding from the FY 2017 Annualized Continuing Resolution) 

SAMHSA plans to support 27 Offender Reentry Program continuation grants and one contract. 

See page 196 in the CSAT chapter for the start of the full description of this program. 

Budget Request

The FY 2018 Budget Request is $77.9 million ($60.0 million for Drug Courts and $17.9 million 

for Other Criminal Justice Activities), level with the FY 2017 Annualized CR. SAMHSA intends 

to support 115 Drug Court continuations grants, 70 new drug court grants, and three contracts. 

SAMHSA intends to fund 17 new Offender Reentry Program (ORP) new grants, and 13 

continuation ORP grants. 

Other PRNS Treatment Programs (PRNS non-add)

FY 2018 Request: $40.9 million 

(Reflects level funding from the FY 2017 Annualized CR)

The FY 2018 budget includes resources of $40.9 million for several other Treatment Capacity 

programs including: Recovery Community Services Program; Children and Families; and 

Addiction Technology Transfer Centers. The FY 2018 Budget includes funds for continuing 

grants and contracts in these programs. Grant funding will enhance overall drug treatment quality 

by incentivizing treatment and service providers to achieve specific performance targets. 

Examples of grant awards could include supplements for treatment and service providers who are 
267 

able to connect higher proportions of detoxified patients with continuing recovery-oriented 

treatment; or for outpatient providers who are able to successfully retain greater proportions of 

patients in active treatment participation for longer periods. 

State Targeted Response to the Opioid Crisis Grants 

FY 2018 Request: 500.0 million

(Reflects level funding from the FY 2017 Annualized CR)

The State Targeted Response to the Opioid Crisis Grant Program (STR) was authorized under 

Section 1003 of the 21st Century Cures Act. The program aims to address 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 

addiction (including prescription opioids as well as illicit drugs such as heroin). 

Grantees will be required to do the following: use epidemiological data to demonstrate the critical 

gaps in availability of treatment for opioid addiction in geographic, demographic, and service level 

terms; utilize evidence-based implementation strategies to identify which system design models 

will most rapidly address the gaps in their systems of care; implement prevention strategies; deliver 

evidence based treatment interventions including medication and psychosocial interventions; 

deliver recovery support services; and report progress toward increasing availability of treatment 

for opioid addiction and reducing opioid-related overdose deaths.

See page 207 in the CSAT chapter for the start of the full description of this program. 

Budget Request

In FY 2018, SAMHSA requests $500.0 million, level with the FY 2017 Annualized CR. These 

funds will support the Opioid STR Program. During the first year of the program, lessons learned 

will be utilized to determine if resource allocations and priorities need to be adjusted in the second 

year of the program.

Substance Abuse Prevention and Treatment Block Grant

FY 2018 Request: $1.9 billion

(Reflects level funding from the FY 2017 Annualized CR) 

The Substance Abuse Prevention and Treatment Block Grant (SABG) program distributes funds 

to 60 eligible states, territories and freely associated states, the District of Columbia, and the Red 

Lake Band of Chippewa Indians of Minnesota (referred to collectively as states) to plan, carry out, 

and evaluate substance abuse prevention, treatment, and recovery support services for individuals, 

families, and communities impacted by substance abuse. The SABG’s overall goal is to support 

and expand substance abuse prevention and treatment services while providing maximum 

flexibility to grantees. 

See page 209 in the CSAT chapter for the start of the full description of this program. 

Budget Request

The FY 2018 Budget Request is $1.9 billion, level with the FY 2017 Annualized CR. SABG funds 

will continue to serve as a source of safety net funding and will continue to support certain services 

(e.g., recovery support services) not covered by commercial insurance and non-clinical activities 
268 

and services that address the critical needs of state substance abuse prevention and treatment 

service systems.

Health Surveillance and Program Support Appropriation

The FY 2018 Budget Request is $97.0 million, which represents the Substance Abuse portion of 

the Health Surveillance and Program Support appropriation and supports staffing and activities to 

administer SAMHSA programs as described below. 

Health Surveillance and Program Support (PRNS non-add)

FY 2018 Request: $80.3 million

(Reflects a $6.1 million decrease from the FY 2017 Annualized CR) 

Health Surveillance and Program Support (HSPS) provides funding for personnel costs, building 

and facilities, equipment, supplies, administrative costs, and associated overhead to support 

SAMHSA programmatic activities, as well as provide funding for SAMHSA national data 

collection and survey systems, funding to support the Center for Disease Control and Prevention’s 

National Health Information Survey, and the data archive. This request represents the total funding 

available for these activities first divided between Mental Health and Substance Abuse using the 

same percentages splits that exist between the Mental Health and Substance Abuse (Prevention 

and Treatment) appropriation amounts. The Substance Abuse portion is then split 20 percent/80 

percent into the two functions, prevention and treatment, respectively. 

See page 229 and page 245 in the HSPS chapter for the start of the full description of this program.

Budget Request

The FY 2018 Budget Request is $80.2 million, a decrease of $6.2 million from the FY 2017 

Annualized CR. Health Surveillance funding will support the continuation of the NSDUH, 

NREPP, BHSIS, C-EMS, and the Analytic Support Center contracts as well as operations and 

payroll Program Support funding will continue to cover overhead costs associated with 

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

security charges. 

Public Awareness and Support 

FY 2018 Request: $5.8 million

(Reflects $0.9 million decrease from the FY 2017 Annualized CR)

Public Awareness and Support provides funding to support the unified communications approach 

to increase awareness of behavioral health, mental disorders and substance abuse issues. This 

represents the total funding available for these activities first divided evenly between Mental 

Health and Substance Abuse. The Substance Abuse portion is then split 20 percent/80 percent into 

the two functions, prevention and treatment, respectively. 

See page 247 in the HSPS chapter for the start of the full description of this program. 
269 

Budget Request

The FY 2018 request of $5.8 million will support the President’s initiative and will allow 

SAMHSA to continue to streamline its web presence, develop innovative mobile apps, expand its 

presence on social media, and provide other critical resources to support behavioral health and 

other health. 

Performance and Quality Information Systems 

FY 2018 Request: $9.7 million

(Reflects a $0.8 million increase from the FY 2017 Annualized CR)

Performance and Quality Information Systems provides funding to support SAMHSA’s 

Performance Accountability and Reporting System (SPARs) related activities, as well as provide 

support for the National Registry of Evidence-based Programs and Practices that will reduce the 

backlog of interventions accepted but not reviewed under the previous contract. SPARS will 

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

programmatic technical assistance (TA) on use of the data to enhance grantee performance 

monitoring and improve quality of service delivery. This request represents the total funding 

available for these activities first split into Mental Health and Substance Abuse using the same 

percentages splits as between the Mental Health and Substance Abuse (Prevention and Treatment) 

appropriation amounts. The Substance Abuse portion is then split 20 percent/80 percent into the 

two functions, prevention and treatment, respectively. 

See page 237 in the HSPS chapter for the start of the full description of this program. 

Budget Request

The FY 2018 Budget Request is $9.7 million, an increase of $0.8 million from the FY 2017 

Annualized CR. SAMHSA will use these funds for system development, training and TA to 

support operations, National Registry of Evidence-Based Programs (NREPP) and SPARS. 

Data Request and Publication User Fees

FY 2018 Request: $0.8 million

(Reflects level funding from the FY 2017 Annualized CR)

The FY 2018 Budget Request is $0.8 million and is equal to the FY 2017 Annualized CR. 

SAMHSA will collect and retain fees for extraordinary data and publications requests. This 

represents the total funding estimated for these activities first divided evenly between Mental 

Health and Substance Abuse. The Substance Abuse portion is then split 20 percent/80 percent into 

the two functions, prevention and treatment, respectively. 
270 

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271 

SAMHSA

Supplementary Tables

Table of Contents 

1. Budget Authority by Object Classification Tables..........................................................273

2. Salaries and Expenses Tables ...........................................................................................282

3. Detail of Full Time Equivalent Employee (FTE) .............. ..............................................284

4. Detail of Positions............................................................................................................285

5. Programs Proposed for Elimination ................................................................................ 286 

6. Physicians’ Comparability Allowance (PCA) Worksheet................................................288
272 

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273 

Budget Authority by Object Classification Tables 

Substance Abuse and Mental Health Services Administration

Total Budget Authority – Object Class

(Dollars in thousands)

 

Object Class - Direct Budget Authority1,2,3

FY 2016

Final

FY 2017 

Annualized 

CR

FY 2018 

President's 

Budget

FY 2018

+/-

FY 2017

Personnel compensation:

Full-time permanent (11.1)............................................... $46,503 $47,248 $47,721 +$473 

Other than full-time permanent (11.3)............................ 2,643 2,685 2,713 +28 

Other personnel compensation (11.5)............................ 532 541 546 +5 

Military personnel (11.7).................................................. 3,935 +73 

Special personnel services payments (11.8) ................ 24 

3,889 

24 

3,863 

25 + 

Subtotal personnel compensation: 54,361 54,940 +579 

Civilian benefits (12.1)...................................................... 15,490 15,738 15,908 +170 

Military benefits (12.2)..................................................... 2,019 

53,592 

2,005 2,043 +38 

Subtotal Pay Costs: 71,100 72,103 72,891 +788 

Travel and transportation of persons (21.0)................. 1,297 1,233 1,253 +20 

Transportation of things (22.0)....................................... 26 36 35 -1 

Rental payments to GSA (23.1)....................................... 9,583 6,116 6,147 +31 

Rental payments to Others (23.2)................................... 1 --- --- --- 

Communication, utilities, and misc. charges (23.3)...... 374 392 412 +20 

Printing and reproduction (24.0)..................................... 792 1,063 1,089 +27 

Advisory and assistance services (25.1).

Other Contractual Services:

..................... 29,661 32,430 32,949 +519 

Other services (25.2)......................................................... 184,243 171,667 174,414 +2,747 

 Purchase of Goods & Svcs. from Govt. Accts (25.3).. 92,460 65,072 8,023 -57,050 

Operation and maintenance of facilities (25.4)............. 983 999 +16 

Research and Development Contracts (25.5)............... --- 

865 

 --- --- --- 

Operation and maintenance of equipment (25.7)......... 108 257 261 +4

Subtotal Other Contractual Services: 307,337 270,409 216,645 -53,764 

Supplies and materials (26.0)........................................... 125 704 716 +11 

Equipment (31.0)............................................................... 670 393 399 +6 

Grants, subsidies, and contributions (41.0).................. 3,254,849 3,803,910 3,471,082 -332,828 

Interest and dividends (43.0).......................................... 113 --- --- --- 

Subtotal Non-Pay Costs 3,575,168 4,084,257 3,697,778 -386,479 

Total Direct Obligations $3,646,269 $4,156,360 $3,770,668 -$385,692 

1

 Does not include PHS EVAL Funds.

2

 Includes Prevention and Public Health Funds in FY 2016 and FY 2017.

3

 Reflects the transfer of funding associated with the Behavioral Health Workforce Expansion and Training 

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

program.
274 

Substance Abuse and Mental Health Services Administration

Mental Health Services

Budget Authority – Object Class

(Dollars in thousands)

Object Class - Direct Budget Authority1,2,3

FY 2016

Final

FY 2017 

Annualized 

CR

FY 2018 

President's 

Budget

FY 2018

+/- 

FY 2017

Personnel compensation: 

Full-time permanent (11.1) $865 $879 $894 +$16 

Other than full-time permanent (11.3) 38 38 39 +1 

Other personnel compensation (11.5) 7 7 7 --- 

Military personnel (11.7) --- --- --- --- 

Special personnel services payments (11.8). --- --- --- --- 

Subtotal personnel compensation: 910 924 941 +16 

Civilian benefits (12.1) 292 297 302 +5 

Military benefits (12.2) --- --- --- --- 

Subtotal Pay Costs: 1,202 1,221 1,243 +22 

Travel and transportation of persons (21.0) 163 176 179 +3 

Transportation of things (22.0) 2 --- --- --- 

Rental payments to GSA (23.1) 1,215 1,715 1,507 -208 

Rental payments to Others (23.2) --- --- --- --- 

Communication, utilities, and misc. charges (23.3) 320 110 101 -9 

Printing and reproduction (24.0) 526 300 303 +3 

Other Contractual Services: 

Advisory and assistance services (25.1) 14,121 18,051 18,340 +289 

Other services (25.2) 67,494 60,190 61,153 +963 

 Purchase of Goods & Svcs. from Govt. Accts (25.3) 16,335 3,509 1,967 -1,542 

Operation and maintenance of facilities (25.4) 794 770 782 +12 

Research and Development Contracts (25.5) --- --- --- --- 

Operation and maintenance of equipment (25.7) 57 47 48 +1 

Subtotal Other Contractual Services: 98,801 82,567 82,290 -277 

Supplies and materials (26.0) 32 25 25 + 

Equipment (31.0) 216 106 108 +2 

Grants, subsidies, and contributions (41.0) 1,036,620 1,057,571 811,052 -246,519 

Interest and dividends (43.0) --- --- --- --- 

Subtotal Non-Pay Costs 1,137,894 1,142,570 895,565 -247,005 

Total Direct Obligations $1,139,097 $1,143,792 $896,808 -$246,983 

1 Does not include PHS EVAL Funds.

2 Includes Prevention and Public Health Funds.

3 The Minority Fellowship Program budget appears in the Health Surveillance and Program Support appropriation, 

Agency-wide Initiatives Workforce program. This is consistent with the FY 2017 Budget Request.
275 

Substance Abuse and Mental Health Services Administration

Substance Abuse Prevention

Budget Authority – Object Class

(Dollars in thousands)

Object Class - Direct Budget Authority1,2,3

FY 2016

Final

FY 2017 

Annualized 

CR

FY 2018 

President's 

Budget

FY 2018

+/- 

FY 2017

Personnel compensation: 

Full-time permanent (11.1) $--- $--- $--- $--- 

Other than full-time permanent (11.3) --- --- --- --- 

Other personnel compensation (11.5) --- --- --- --- 

Military personnel (11.7) --- --- --- --- 

Special personnel services payments (11.8) --- --- --- --- 

Subtotal personnel compensation: --- --- --- ---

Civilian benefits (12.1) --- --- --- --- 

Military benefits (12.2) --- --- --- --- 

Subtotal Pay Costs: --- --- --- ---

Travel and transportation of persons (21.0) --- --- --- --- 

Transportation of things (22.0) --- 5 5 --- 

Rental payments to GSA (23.1) 63 641 514 -127

Rental payments to Others (23.2) --- --- --- --- 

Communication, utilities, and misc. charges (23.3) 49 41 34 -7 

Printing and reproduction (24.0) --- 457 465 +7 

Other Contractual Services: 

Advisory and assistance services (25.1) 5,114 4,366 4,436 +70 

Other services (25.2) 29,824 33,535 34,072 +537 

 Purchase of Goods & Svcs. from Govt. Accts (25.3) 8,440 826 671 -155

Operation and maintenance of facilities (25.4) --- 69 70 +1 

Research and Development Contracts (25.5) --- --- --- --- 

Operation and maintenance of equipment (25.7) --- 146 148 +2 

Subtotal Other Contractual Services: 43,377 38,942 39,397 +455

Supplies and materials (26.0) --- 4 4 --- 

Equipment (31.0) 99 140 143 +2 

Grants, subsidies, and contributions (41.0) 167,565 182,587 109,141 -73,446 

Interest and dividends (43.0) --- --- --- --- 

Subtotal Non-Pay Costs 211,152 222,817 149,703 -73,114

Total Direct Obligations $211,152 $222,817 $149,703 -$73,114

1 Does not include PHS EVAL Funds.

2 Includes Prevention and Public Health Funds.

3 The Minority Fellowship Program budget appears in the Health Surveillance and Program Support appropriation, 

Agency-wide Initiatives Workforce program. This is consistent with the FY 2017 Budget Request.
276 

Substance Abuse and Mental Health Services Administration

Substance Abuse Treatment

Budget Authority – Object Class

(Dollars in thousands)

Object Class - Direct Budget Authority1,2,3

FY 2016

Final

FY 2017 

Annualized 

CR

FY 2018 

President's 

Budget

FY 2018

+/−

FY 2017

Personnel compensation: 

Full-time permanent (11.1) $2,140 $2,174 $2,209 +$35 

Other than full-time permanent (11.3) 239 243 247 +4 

Other personnel compensation (11.5) 16 17 17 --- 

Military personnel (11.7) 130 132 135 +2 

Special personnel services payments (11.8) --- --- --- --- 

Subtotal personnel compensation: 2,525 2,566 2,607 +41 

Civilian benefits (12.1) 822 835 860 +25 

Military benefits (12.2) 53 54 56 +2 

Subtotal Pay Costs: 3,400 3,454 3,522 +68 

Travel and transportation of persons (21.0) 234 237 241 +4 

Transportation of things (22.0) 1 --- −1 

Rental payments to GSA (23.1) 994 3,126 3,622 +497 

Rental payments to Others (23.2) --- --- --- --- 

Communication, utilities, and misc. charges (23.3) 5 200 243 +42 

Printing and reproduction (24.0) 258 262 266 +4 

Other Contractual Services: 

Advisory and assistance services (25.1) 8,119 8,249 8,381 +132 

Other services (25.2) 41,773 42,645 43,327 +682 

 Purchase of Goods & Svcs. from Govt. Accts (25.3) 16,376 4,025 4,728 +703 

Operation and maintenance of facilities (25.4) 69 70 71 +1 

Research and Development Contracts (25.5) --- --- --- --- 

Operation and maintenance of equipment (25.7) 32 37 38 +1 

Subtotal Other Contractual Services: 66,369 55,026 56,545 +1,519 

Supplies and materials (26.0) 49 50 +1 

Equipment (31.0) 325 2 2 + 

Grants, subsidies, and contributions (41.0) 2,039,719 2,552,847 2,550,743 −2,105 

Interest and dividends (43.0) --- --- --- --- 

Subtotal Non-Pay Costs 2,107,904 2,611,751 2,611,713 −38 

Total Direct Obligations $2,111,304 $2,615,205 $2,615,235 +$30 

1 Does not include PHS EVAL Funds.

2 Includes Prevention and Public Health Funds.

3 The Minority Fellowship Program budget appears in the Health Surveillance and Program Support appropriation, Agencywide Initiatives Workforce program. This is consistent with the FY 2017 Budget Request.

 
277 

Substance Abuse and Mental Health Services Administration

Health Surveillance and Program Support

Budget Authority – Object Class

(Dollars in thousands)

Object Class - Direct Budget Authority1,2,3

FY 2016

Final

FY 2017 

Annualized 

CR

FY 2018 

President's 

Budget

FY 2018

+/−

FY 2017

Personnel compensation: 

Full-time permanent (11.1) $43,499 $44,195 $44,618 +$423 

Other than full-time permanent (11.3) 2,367 2,404 2,427 --- 

Other personnel compensation (11.5) 509 517 522 --- 

Military personnel (11.7) 3,759 3,730 3,801 +70 

Special personnel services payments (11.8) 24 24 25 --- 

Subtotal personnel compensation: 50,157 50,871 51,392 +521 

Civilian benefits (12.1) 14,376 14,606 14,746 +140 

Military benefits (12.2) 1,966 1,951 1,987 +37 

Subtotal Pay Costs: 66,498 67,427 68,125 +698 

Travel and transportation of persons (21.0) 900 820 833 +13 

Transportation of things (22.0) 24 30 30 + 

Rental payments to GSA (23.1) 7,311 634 503 −131 

Rental payments to Others (23.2) 1 --- --- --- 

Communication, utilities, and misc. charges (23.3) --- 41 34 −7 

Printing and reproduction (24.0) 8 43 55 +12 

Other Contractual Services: 

Advisory and assistance services (25.1) 2,308 1,764 1,792 +28 

Other services (25.2) 45,153 35,297 35,861 +565 

 Purchase of Goods & Svcs. from Govt. Accts (25.3) 51,310 56,713 657 −56,056 

Operation and maintenance of facilities (25.4) 2 75 76 +1 

Research and Development Contracts (25.5) --- --- --- --- 

Operation and maintenance of equipment (25.7) 18 26 27 + 

Subtotal Other Contractual Services: 98,790 93,874 38,413 −55,462 

Supplies and materials (26.0) 93 627 637 +10 

Equipment (31.0) 30 145 147 +2 

Grants, subsidies, and contributions (41.0) 10,946 10,904 145 −10,760 

Interest and dividends (43.0) 113 --- --- --- 

Subtotal Non-Pay Costs 118,218 107,118 40,797 −66,321 

Total Direct Obligations $184,716 $174,546 $108,922 −$65,623 

1 Does not include PHS EVAL Funds.

2 Includes Prevention and Public Health Funds and Mandatory Funds.

3 Reflects the transfer of funding associated with the Behavioral Health Workforce Expansion and Training program from 

SAMHSA to HRSA in FY 2016 and FY 2017.

 
278 

Substance Abuse and Mental Health Services Administration

Total PHS Evaluation Funds – Object Class

 

 

(Dollars in thousands)

Object Class - PHS Evaluation Funds

FY 2016

Final

FY 2017 

Annualized 

CR

FY 2018 

Current 

Services

FY 2018

+/−

FY 2017

Personnel Compensation: 

 Full Time Permanent (11.1) $9,535 $9,204 $9,238 +$33 

 Other than Full-Time Permanent (11.3) 679 634 631 −3 

 Other Personnel Compensation (11.5) 99 95 95 + 

 Military Personnel Compensation (11.7) 1,113 1,219 1,242 +23 

Special personnel services payments (11.8) 28 --- --- --- 

Subtotal Personnel Compensation: 11,454 11,152 11,205 +53 

 Civilian Personnel Benefits (12.1) 3,012 2,902 2,928 +25 

 Military Personnel Benefits (12.2) 581 638 652 +13 

Subtotal Pay Costs: 15,048 14,693 14,785 +92 

Travel (21.0) 105 124 121 −3 

Transportation of things (22.0) --- --- --- 

Rental payments to GSA (23.1) --- --- --- --- 

Communications, Utilities and Misc. Charges (23.3) --- --- --- --- 

Printing and Reproduction (24.0) 288 391 394 +3 

Other Contractual Services: --- --- --- 

Advisory and assistance services (25.1) --- --- --- --- 

Other services (25.2) 113,649 113,806 100,139 −13,667 

 Purchase of Goods & Svcs. from Govt. Accts (25.3) 1,069 1,086 1,104 +17 

Operation and maintenance of equipment (25.7) 2 5 5 --- 

Subtotal Other Contractual Services: 114,720 114,898 101,248 −13,650 

Supplies and Materials (26.0) 11 8 7 −1 

Equipment (31.0) 16 20 20 + 

Grants, Subsidies, and Contributions (41.0) 3,479 3,534 3,591 +57 

Subtotal Non-Pay Costs 118,619 118,974 105,380 −13,594 

Total Reimbursable Obligations $133,667 $133,667 $120,165 −$13,502
279 

Substance Abuse and Mental Health Services Administration

Mental Health Services

PHS Evaluation Funds – Object Class

(Dollars in thousands)

Object Class - PHS Evaluation 

FY 2016

Final

FY 2017 

Annualized 

CR

FY 2018 

President's 

Budget

FY 2018

+/- 

FY 2017

Personnel compensation: 

Full-time permanent (11.1) $1,936 $1,967 $2,002 +$35 

Other than full-time permanent (11.3) 71 72 74 +1 

Other personnel compensation (11.5) 15 16 16 + 

Military personnel (11.7) 262 354 361 +7 

Special personnel services payments (11.8) --- --- --- --- 

Subtotal personnel compensation: 2,284 2,409 2,452 +43 

Civilian benefits (12.1) 638 649 660 +11 

Military benefits (12.2) 141 190 194 +4 

Subtotal Pay Costs: 3,063 3,248 3,307 +58 

Travel and transportation of persons (21.0) 16 38 38 +1 

Transportation of things (22.0) --- --- --- 

Rental payments to GSA (23.1) --- --- --- --- 

Communication, utilities, and misc. charges (23.3) --- --- --- --- 

Printing and reproduction (24.0) 22 28 25 -3 

Other Contractual Services: 

Advisory and assistance services (25.1) --- --- --- --- 

Other services (25.2) 17,936 17,718 12,163 -5,555 

 Purchase of Goods & Svcs. from Govt. Accts (25.3) --- --- --- --- 

Operation and maintenance of equipment (25.7) --- --- --- --- 

Subtotal Other Contractual Services: 17,936 17,718 12,163 -5,555 

Supplies and materials (26.0) 2 8 7 -1 

Equipment (31.0) --- --- --- 

Grants, subsidies, and contributions (41.0) --- --- --- --- 

Subtotal Non-Pay Costs 17,976 17,791 12,233 -5,558 

Total Reimbursable Obligations $21,039 $21,039 $15,539 -$5,500 
280 

Substance Abuse and Mental Health Services Administration

Substance Abuse Treatment

PHS Evaluation Funds – Object Class

(Dollars in thousands)

Object Class - PHS Evaluation 

FY 2016

Final

FY 2017 

Annualized 

CR

FY 2018 

President's 

Budget

FY 2018

+/- 

FY 2017

Personnel compensation: 

Full-time permanent (11.1) $3,792 $3,853 $3,915 +$62 

Other than full-time permanent (11.3) 171 174 $177 +3 

Other personnel compensation (11.5) 37 37 $38 +1 

Military personnel (11.7) 235 238 $243 +4 

Special personnel services payments (11.8) 28 --- --- --- 

Subtotal personnel compensation: 4,263 4,303 4,372 +69 

Civilian benefits (12.1) 1,130 1,148 1,182 +34 

Military benefits (12.2) 125 127 130 +4 

Subtotal Pay Costs: 5,518 5,577 5,684 +107 

Travel and transportation of persons (21.0) 9 5 --- -5 

Transportation of things (22.0) --- --- --- --- 

Rental payments to GSA (23.1) --- --- --- --- 

Communication, utilities, and misc. charges (23.3) --- --- --- --- 

Printing and reproduction (24.0) 266 363 369 +6 

Other Contractual Services: 

Advisory and assistance services (25.1) --- --- --- --- 

Other services (25.2) 74,229 74,071 73,944 -127 

 Purchase of Goods & Svcs. from Govt. Accts (25.3) --- --- --- --- 

Operation and maintenance of equipment (25.7 2 2 2 --- 

Subtotal Other Contractual Services: 74,231 74,073 73,946 -127 

Supplies and materials (26.0) 3 --- --- --- 

Equipment (31.0) 12 2 2 - 

Grants, subsidies, and contributions (41.0) 1,162 1,181 1,199 +19 

Subtotal Non-Pay Costs 75,683 75,623 75,515 -107 

Total Reimbursable Obligations $81,200 $81,200 $81,200 +$

 
281 

Substance Abuse and Mental Health Services Administration

Health Surveillance and Program Support

PHS Evaluation Funds – Object Class

(Dollars in thousands)

Object Class - PHS Evaluation 

FY 2016

Final

FY 2017 

Annualized 

CR

FY 2018 

President's 

Budget

FY 2018

+/- 

FY 2017

Personnel compensation: 

Full-time permanent (11.1) $3,807 $3,384 $3,321 -$63 

Other than full-time permanent (11.3) 436 388 $380 -7 

Other personnel compensation (11.5) 47 42 $41 -1 

Military personnel (11.7) 616 626 $638 +12 

Special personnel services payments (11.8) --- --- $--- --- 

Subtotal personnel compensation: 4,907 4,440 4,381 -59 

Civilian benefits (12.1) 1,244 1,106 1,085 -21 

Military benefits (12.2) 316 321 327 +6 

Subtotal Pay Costs: 6,467 5,868 5,794 -74 

Travel and transportation of persons (21.0) 80 82 83 +1 

Transportation of things (22.0) --- --- --- 

Rental payments to GSA (23.1) --- --- --- --- 

Communication, utilities, and misc. charges (23.3) --- --- --- --- 

Printing and reproduction (24.0) --- --- --- --- 

Other Contractual Services: 

Advisory and assistance services (25.1) --- --- --- --- 

Other services (25.2) 21,484 22,017 14,032 -7,985 

 Purchase of Goods & Svcs. from Govt. Accts (25.3) 1,069 1,086 1,104 +17 

Operation and maintenance of equipment (25.7) --- 4 4 --- 

Subtotal Other Contractual Services: 22,553 23,107 15,140 -7,968 

Supplies and materials (26.0) 7 --- --- --- 

Equipment (31.0) 3 18 18 + 

Grants, subsidies, and contributions (41.0) 2,317 2,354 2,391 +38 

Subtotal Non-Pay Costs 24,961 25,560 17,632 -7,928 

Total Reimbursable Obligations $31,428 $31,428 $23,426 -$8,002
282 

Substance Abuse and Mental Health Services Administration

Salaries and Expenses Tables

Direct Budget Authority – Object Class

(Dollars in thousands)

Object Class - Direct Budget Authority1,2,3

FY 2016

Final

FY 2017 

Annualized 

CR

FY 2018 

President's 

Budget

FY 2018

+/- 

FY 2017

Personnel compensation:

Full-time permanent (11.1) $46,503 $47,248 $47,721 +$473 

Other than full-time permanent (11.3) 2,643 2,685 2,713 +28

Other personnel compensation (11.5) 532 541 546 +5

Military personnel (11.7) 3,889 3,863 3,935 +73

Special personnel services payments (11.8) 24 24 25 +

Subtotal personnel compensation 53,592 54,361 54,940 +579

Civilian benefits (12.1) 15,490 15,738 15,908 +170

Military benefits (12.2) 2,019 2,005 2,043 +38

Subtotal Pay Costs: 71,100 72,103 72,891 +788

Travel (21.0) 1,297 1,233 1,253 +20

Transportation of things (22.0) 26 36 35 -1

Rental payments to Others (23.2) 1 --- --- ---

Communication, utilities, and misc. charges (23.3) 374 392 412 +20

Printing and reproduction (24.0) 792 1,063 1,089 +27

Other Contractual Services:

Advisory and assistance services (25.1) 29,661 32,430 32,949 +519

Other services (25.2) 184,243 171,667 174,414 +2,747

 Purchase of Goods & Svcs. from Govt. Accts (25.3) 92,460 65,072 8,023 -57,050

Operation and maintenance of facilities (25.4) 865 983 999 +16

Research and Development Contracts (25.5) --- --- --- ---

Operation and maintenance of equipment (25.7) 108 257 261 +4

Subtotal Other Contractual Services: 307,337 270,409 216,645 -53,764

Supplies and materials (26.0) 125 704 716 +11

Subtotal Non-Pay Costs 309,953 273,838 220,150 -53,688

Total Salary and Expenses 381,053 345,941 293,041 -52,900

Rental Payments to GSA (23.1) 9,583 6,116 6,147 +31

Grand Total, Salaries & Expenses and Rent $390,636 $352,057 $299,188 -$52,869 

Direct FTE 504 503 499 - 

1 Does not include PHS EVAL Funds.

2 Includes Prevention and Public Health Funds in FY 2016 and FY 2017.

3 Reflects the transfer of funding associated with the Behavioral Health Workforce Expansion and Training 

program from SAMHSA to HRSA in FY 2016 and FY 2017. 
283 

Substance Abuse and Mental Health Services Administration

Salaries and Expenses Tables

PHS Evaluation Funds – Object Class

(Dollars in thousands)

Object Class1

FY 2016

Final

FY 2017 

Annualized 

CR

FY 2018 

President's 

Budget

FY 2018

+/- 

FY 2017

Personnel compensation: 

Full-time permanent (11.1) $9,535 $9,204 $9,238 +$33 

Other than full-time permanent (11.3) 679 634 631 -3 

Other personnel compensation (11.5) 99 95 95 + 

Military personnel (11.7) 1,113 1,219 1,242 +23 

Special personnel services payments (11.8) 28 --- --- ---

Subtotal personnel compensation 11,454 11,152 11,205 +53 

Civilian benefits (12.1) 3,012 2,902 2,928 +25 

Military benefits (12.2) 581 638 652 +13 

Subtotal Pay Costs: 15,048 14,693 14,785 +92 

Travel (21.0) 105 124 121 -3 

Transportation of things (22.0) --- --- ---

Rental payments to Others (23.2) --- --- --- ---

Communication, utilities, and misc. charges 

(23.3). --- --- --- ---

Printing and reproduction (24.0) 288 391 394 +3 

Other Contractual Services: 

Advisory and assistance services (25.1) --- --- --- ---

Other services (25.2) 113,649 113,806 100,139 -13,667 

Purch. Goods & Svcs. Govt. Accts (25.3) 1,069 1,086 1,104 +17 

Operation and maintenance of facilities (25.4) --- --- --- ---

Research and Development Contracts (25.5) --- --- --- ---

Operation and maintenance of equipment (25.7) 2 5 5 ---

Subtotal Other Contractual Services: 114,720 114,898 101,248 -13,650 

Supplies and materials (26.0) 11 8 7 -1 

Subtotal Non-Pay Costs 115,125 115,420 101,769 -13,651 

Total Salary and Expenses 130,173 130,113 116,554 -13,559 

Rental Payments to GSA (23.1) --- --- --- --- 

Grand Total, Salaries & Expenses and Rent $130,173 $130,113 $116,554 -13,559 

Reimbursable FTE1

 

116 

 

112 

 

111 - 

1 Does not include Other reimbursable FTEs (30) and associated Object Class cost.
284 

Detail of Full Time Equivalent Employee (FTE) 

FY 2016 

Final 

Civilian

FY 2016 

Final 

Military

FY 

2016 

Final 

Total

FY 2017 

Est. 

Civilian

FY 

2017 

Est. 

Military

FY 2017 

Est. 

Total

FY 2018 

Est. 

Civilian

FY 2018 

Est. 

Military

FY 

2018 

Est. 

Total

Health Surveillance and Program Support 

 Direct: 431 39 470 431 38 469 428 38 466

 Reimbursable: 32 7 39 28 7 35 27 7 34

 Total: 463 46 509 459 45 504 455 45 500

Mental Health Services 

 Direct: 9 0 9 9 0 9 9 0 9

 Reimbursable: 18 4 22 18 4 22 18 4 22

 Total: 27 4 31 27 4 31 27 4 31

Substance Abuse Prevention 

 Direct: 0 0 0 0 0 0 0 0 0

 Reimbursable: 21 0 21 18 2 20 18 2 20

 Total: 21 0 21 18 2 20 18 2 20

Substance Abuse Treatment 

 Direct: 23 1 24 23 1 24 23 1 24

 Reimbursable: 32 3 35 32 3 35 32 3 35

 Total: 55 4 59 55 4 59 55 4 59

SAMHSA FTE Total 567 53 620 560 55 615 555 55 610
285 

Detail of Positions 

 

FY 2016 

Final

FY 2017 

Annualized CR

FY 2018 

President's 

Budget

Executive Level IV 1 1 1 

Subtotal 1 1 1 

Total - Exec Level 

Salaries $155,500 $155,500 $155,500

SES 13 13 13

Subtotal 13 13 13

Total, SES salaries $3,939,509 $3,979,416 $4,019,847

GM/GS-15/EE 72 73 73

GM/GS-14 128 125 125

GM/GS-13 209 209 208

GS-12 54 55 55

GS-11 19 19 19

GS-10 1 2 2 

GS-09 15 13 12

GS-08 20 18 17

GS-07 19 18 17

GS-06 10 10 9 

GS-05 4 4 4 

GS-04 0 0 0 

GS-03 0 0 0 

GS-02 0 0 0 

GS-01 0 0 0 

Subtotal 551 546 541

Total, GS salaries $77,314,646 $77,309,014 $78,042,708

CC-08/09 1 1 1 

CC-07 0 0 0 

CC-06 15 15 15

CC-05 18 18 18

CC-04 16 16 16

CC-03 5 5 5 

CC-02 0 0 0 

CC-01 0 0 0 

Subtotal 55 55 55

Total, CC salaries $7,601,413 $8,129,435 $8,283,973

Total Positions 620 615 610

Average ES level ES ES ES

Average ES salary $155,500 $155,500 $155,500

Average SES level SES SES SES

Average SES salary $303,039 $306,109 $309,218.99

Average GS grade 13.5 13.6 13.6

Average GS salary $140,317.0 $141,591.6 $144,256.4

Average CC level 5.2 5.2 5.2

Average CC salaries $138,208 $147,808 $150,618
286 

Programs Proposed for Elimination 

The following table shows the programs proposed for elimination in the FY 2018 Budget Request. 

Terminations of these programs total $186.3 million across the three appropriations: Mental 

Health, Substance Abuse Prevention, and Health Surveillance and Program Support. 

The following is a brief summary of the program and rational for the elimination proposal. 

(Dollars in thousands)

Program

FY 2017 

Annualized 

CR 

Project AWARE $64,742 

Healthy Transitions 19,913 

Primary and Behavioral Health Care Integration 51,769 

Behavioral Health Workforce Education and Traning 49,905 

Total 186,329 

Project AWARE

SAMHSA awarded these grants to 20 State Education Authorities (SEAs) to promote 

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

to mental health services. Mental Health First Aid (MHFA), supports widespread dissemination 

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

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

mental illness and/or drug/alcohol addiction in children and youth, including how to talk to 

adolescents and families experiencing these problems so that they are more willing to seek 

treatment.

SAMHSA is proposing an elimination of Project Advancing Wellness and Resiliency in Education 

(AWARE) ($64.0M). This program is being proposed for elimination to reduce duplication of 

school-based programs. This program is very similar in nature to the programs funded under the 

Youth Violence Prevention line. Additionally, SAMHSA has developed significant knowledge 

and evidence for states to begin implementing and bringing to scale these efforts; SAMHSA will 

continue to ensure this knowledge is disseminated. 

Healthy Transitions

The Healthy Transitions program awarded five-year grants to 17 states to improve access to mental 

disorder treatment and related support services for young people aged 16 to 25 who either have, 

or are at risk of developing, a serious mental health condition. Individuals who are 16 to 25 years 

old are at high risk of developing a mental illness or drug/alcohol addiction and are at high risk for 
287 

suicide. Unfortunately, these youth are among the least likely to seek help. Through this program, 

states are expanding services, developing family and youth networks for information sharing and 

peer support, and disseminating best practices for services for these young individuals. 

SAMHSA is proposing an elimination of the Healthy Transitions initiative ($20.0M) to avoid 

duplication with other programs such as the Children’s Mental Health Services program. 

SAMHSA has developed significant knowledge and evidence for states to begin implementing 

and bringing to scale these efforts; SAMHSA will continue to ensure this knowledge is 

disseminated.

Primary and Behavioral Health Care Integration

The Primary and Behavioral Health Care Integration (PBHCI) program began in FY 2009 to 

address specifically this intersection between primary care and mental disorder treatment. The 

program supports two activities: grants to community mental health centers and the PBHCI 

Training and Technical Assistance (TTA) Center, which is co-funded through a competitive 

cooperative agreement with the Health Resources and Services Administration (HRSA). These 

two activities collectively support the coordination and integration of primary care services into 

publicly funded community behavioral health settings for individuals with SMI and/or people with 

co-occurring disorders served by the public mental health system. PBHCI seeks to improve health 

outcomes for people with SMI by encouraging grantees to engage in necessary collaboration, 

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

individuals with mental illness

The Primary and Behavioral Healthcare Integration ($52M) program is being proposed for 

elimination, as this program is potentially fundable through other sources of funds including the 

Substance Abuse Block Grant and Certified Community Behavioral health Center funding. 

SAMHSA will continue to disseminate the lessons learned from this program. 

Behavioral Health Workforce Education and Training 

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

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

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

clinical service capacity of the behavioral health workforce by supporting training for masterslevel social workers, professional counselors, psychologists, marriage and family therapists, 

psychology doctoral interns, as well as behavioral health paraprofessionals.

SAMHSA is proposing an elimination of the BHWET ($50M) from SAMHSA’s budget to 

prioritize targeted efforts to provide direct health care services. For example, the National Health 

Service Corps administered by the Health Resources and Services Administration directly hires 

behavioral health professionals serving in communities with shortages, directly responding to 

public health needs. 
288 

Physicians’ Comparability Allowance (PCA) Worksheet 

Substance Abuse and Mental Health Services Administration

(Whole dollars) 

CY 2016

(Estimates) 

BY 2017

(Estimates) 

BY 2018

(Estimates) 

1) Number of Physicians Receiving PCAs 3 3 5 

2) Number of Physicians with One-Year PCA Agreements --- --- --- 

3) Number of Physicians with Multi-Year PCA Agreements 3 3 5 

4) Average Annual PCA Physician Pay (without PCA payment) $141,000 $141,000 $142,851

5) Average Annual PCA Payment $14,667 $14,667 $14,000

6) Number of Physicians

Receiving PCAs by Category

(non-add)

Category I Clinical Position --- --- --- 

Category II Research Position --- --- --- 

Category III Occupational Health --- --- --- 

Category IV - A Disability Evaluation --- --- --- 

Category IV - B Health and Medical Admin. 3 3 3 

7) If applicable, list and explain the necessity of any additional physician categories designated by your agency (for categories 

other than I through IV-B). Provide the number of PCA agreements per additional category for the PY, CY and BY.

N/A

8) Provide the maximum annual PCA amount paid to each category of physician in your agency and explain the reasoning for 

these amounts by category.

$30,000.00 - based on years of education, experience, and the position held by the incumbent. Amount is required to retain the 

employee.

9) Explain the recruitment and retention problem(s) for each category of physician in your agency (this should demonstrate that 

a current need continues to persist.

SAMHSA is projecting two medical officer vacancies for FY 2018 and we have to offer PCAs because our salaries are not 

competitive with the private sector.

10) Explain the degree to which recruitment and retention problems were alleviated in your agency through the use of PCAs in 

the prior fiscal year.

We have to offer PCAs because our salaries are not competitive with the private sector (e.g., we might offer 75% of a physician’s 

salary on the outside). In addition, physicians of interest to SAMHSA often have income from consulting as well. The PCA is 

the only way to raise the government income so as to make the offer acceptable.

11) Provide any additional information that may be useful in planning PCA staffing levels and amounts in your agency.

N/A
289 

Substance Abuse and Mental Health Services Administration

SIGNIFICANT ITEMS IN OMNIBUS, HOUSE, AND SENATE REPORTS 

FY 2017 Senate Appropriations Committee, Labor/HHS/Education Subcommittee 

(Senate Report 114-274) 

MENTAL HEALTH

Project Aware.—The Committee strongly supports Project AWARE which increases awareness 

of mental health issues and connects young people that have behavioral health issues and their 

families with needed services. The Committee recommendation reflects the administration’s 

proposal to reallocate funding from Youth Violence Prevention to Project AWARE. This shift will 

allow SAMHSA to avoid program duplication. The increase provided will support a new cohort 

of Project AWARE State Education Agency awards. Of the amount provided for Project AWARE, 

the Committee directs SAMHSA to use $10,000,000 for discretionary grants to support efforts in 

high-crime, high-poverty areas and, in particular, communities that are seeking to address relevant 

impacts and root causes of civil unrest. These grants should maintain the same focus as fiscal year 

2016 grants and continue to be coordinated with the Department of Education grants. The 

Committee requests a report on progress of fiscal year 2016 grantees 180 days after the enactment 

of this act. [Senate Report, pg 117]

Action taken or to be taken

In FY 2016, SAMHSA issued a Funding Opportunity Announcement (FOA), Resiliency in 

Communities After Stress and Trauma (ReCAST), and awarded eight grants for communities and 

surrounding areas that have recently faced civil unrest. The grantees are focusing on high risk 

youth and family populations that have experienced significant exposure to trauma, and requires 

grantees to provide evidence-based violence prevention and community youth engagement 

programs as well as linkages to trauma-informed behavioral health services. In FY 2017, 

SAMHSA will support the continuation of eight grants and award a new cohort of grants. 

SAMHSA coordinated with ED on the administration of the funding announcements, activities, 

oversight of the grant program and will continue this collaboration in FY 2017. 

Primary and Behavioral Healthcare Integration.—The Committee directs SAMHSA to require 

grantees of the Primary and Behavioral Health Care Integration program to include in their 

biannual National Outcome Measures report a summary of the policies that serve as barriers to the 

provision of integrated care and the specific steps the grantee has taken or will take to address such 

barriers. [Senate Report, page 117] 

Action taken or to be taken

SAMHSA has and continues to require Primary and Behavioral Healthcare Integration (PBHCI) 

grantees to report their National Outcome Measures (NOMS) client level services data into 
290 

SAMHSA’s data collection system each quarter of the year. In the quarterly narrative reports, 

grantees describe new policy developments and changes to improve integration activities and 

discuss barriers and solutions for the successful provision of integrated care. In the final reports, 

grantees describe the challenges encountered when providing integrated care and the steps taken 

to address them. SAMHSA will continue to monitor the reporting requirements to ensure that 

grantees address barriers to the provision of integrated care and the specific steps taken to 

overcome them. SAMHSA will also continue to provide technical assistance to grantees on 

barriers to improve the provision of integrated care. 

Community Mental Health Services Block Grant.—The Committee recommendation continues 

bill language requiring that at least 10 percent of the funds for the MHBG program be set-aside 

for evidence-based programs that address the needs of individuals with early serious mental illness, 

including psychotic disorders. The Committee commends SAMHSA for its collaboration with 

NIMH on the implementation of this set-aside. The Committee notes that it usually takes 17 years 

to translate research findings into practice and hopes that this joint effort between NIMH and 

SAMHSA may be a model for how to reduce this timeframe. The Committee directs SAMHSA to 

continue its collaboration with NIMH to ensure that funds from this set-aside are only used for 

programs showing strong evidence of effectiveness and that target the first episode of psychosis. 

SAMHSA shall not expand the use of the set-aside to programs outside of the first episode 

psychosis. The Committee directs SAMHSA to include in the fiscal year 2018 CJ a detailed table 

showing at a minimum each State’s allotment, name of the program being implemented, and a 

short description of the program. [Senate Report, page 118]

Action taken or to be taken

SAMHSA in collaboration with NIMH has and continues to provide technical assistance to states 

for implementation of evidence-based Coordinated Specialty Care (CSC) programs that 

specifically address treatment, services, and supports to individuals who are diagnosed with firstepisode psychosis. Since the set-aside was enacted in FY 2014, the number of states with fully 

implemented operating CSC treatment programs has steadily increased and SAMHSA continues 

to monitor and ensure that the set-aside program is solely used to address first-episode psychosis. 

Beginning in September 2016, SAMHSA, in partnership with NIMH, initiated a three year 

evaluation study of CSC programs funded through the MHBG set-aside to ensure that funds are 

only used for programs showing strong evidence of effectiveness and target first episode of 

psychosis. SAMHSA developed a “snapshot” of all the First Episode Psychosis programs, 

detailing each State’s allotment, name of the program being implemented, and a short description 

of the program. The requested table is part of SAMHSA’s FY 2018 CJ. 

SUBSTANCE ABUSE TREATMENT

Addiction Technology Transfer Centers [ATTCs].—The Committee again rejects the 

administration’s proposal to reduce funding for the ATTCs and instead provides the same funding 

level as fiscal year 2016. The Committee directs SAMHSA to ensure that ATTCs maintain a 

primary focus on addiction treatment and recovery services. [Senate Report, page 120]
291 

Action taken or to be taken 

On December 7, 2016, SAMHSA, through the Center for Substance Abuse Treatment released a 

Funding Opportunity Announcement seeking applications for fiscal year (FY) 2017 Addiction 

Technology Transfer Centers (ATTC) Cooperative Agreements. The FOA specifically states that 

the purpose of the ATTC program is to develop and strengthen the specialized behavioral 

healthcare and primary healthcare workforce that provides substance abuse treatment and recovery 

support services. 

Combating Opioid Abuse.—Of the amount provided for Targeted Capacity Expansion, the 

Committee includes $60,000,000 for discretionary grants to States for the purpose of expanding 

treatment services to those with heroin or opioid dependence. The Committee directs CSAT to 

ensure that these grants include as an allowable use the support of medication assisted treatment 

and other clinically appropriate services. These grants should target States with the highest age 

adjusted rates of admissions and that have demonstrated a dramatic age adjusted increase in 

admissions for the treatment of opioid addiction. [Senate Report, page 120] 

Action taken or to be taken 

SAMHSA, through the Center for Substance Abuse Treatment, is working with the Targeted 

Capacity Expansion Medication-Assisted Treatment Prescription Drug and Opioid Addiction 

grantees to ensure use of medication assisted treatment and other clinically appropriate services 

and have informed the grantees that they should prioritize treatment regimens that are less 

susceptible to diversion for illicit purposes. 

Drug Courts.—SAMHSA is directed to ensure that all Drug Treatment Court funding is allocated 

to serve people diagnosed with a drug/alcohol addiction as their primary condition. SAMHSA is 

further directed to ensure that all drug treatment court grant recipients work directly with the 

corresponding State substance abuse agency in the planning, implementation, and evaluation of 

the grant. SAMHSA should expand training and technical assistance to drug treatment court grant 

recipients to ensure evidence-based practices are fully implemented. [Senate Report, page 120] 

Action taken or to be taken 

SAMHSA, through the Center for Substance Abuse Treatment, ensures that all funding 

appropriated for Drug Treatment Courts is allocated to serve people diagnosed with a substance 

use disorder as their primary condition. In addition, grantees in the program are expected to work 

with the state substance abuse agency in planning, implementation and evaluation of the grants. 

SAMHSA also continues to provide training and technical assistance to Drug Treatment Court 

grantees. 
292 

Screening, Brief Intervention, and Referral to Treatment [SBIRT].—The Committee is pleased 

that SAMHSA recently included language in the SBIRT Request for Proposal to allow grantees to 

focus 20 percent of the funding on individuals between the ages of 12 and 18 who are seeking 

medical services. This will expand opportunities for health care and youth service practitioners to 

engage young people in preventative conversations about substance use, as well as identify and 

address risky use before it progresses to addiction. The Committee expects SAMHSA to continue

to encourage applicants to take advantage of this allowable use of funds for 12- to 18-year-olds. 

[Senate Report, page 121] 

Action taken or to be taken

In Fiscal Year 2016, SAMHSA, through the Center for Substance Abuse Treatment, provided 

funding to eight states for SBIRT program and these grantees are allowed to allocate 20 percent of 

their population of focus on youth and young adults aged 12 to 18 years old. One of the states, 

Massachusetts, is implementing an initiative as part of the SBIRT grant which requires school 

guidance counselors to use the SBIRT model in counseling their students about substance misuse.

Viral Hepatitis Screening.—The Committee applauds SAMHSA for encouraging grantees to 

screen for viral hepatitis, including the use of innovative strategies like rapid testing and urges 

SAMHSA to continue these efforts. The Committee notes the disproportionate impact of viral 

hepatitis among minority populations and the co-infection rate among individuals with HIV/AIDS. 

The Committee urges SAMHSA to work with minority AIDS grantees to incorporate hepatitis 

screening into programmatic activities. [Senate Report, page 121] 

Action taken or to be taken

SAMHSA, through the Center for Substance Abuse Treatment, implements the Department of 

Health and Human Services’ Hepatitis Action Plan which notes that people with HIV are 

disproportionally affected by viral hepatitis and related adverse conditions. Through the Center 

for Substance Abuse Treatment’s Minority AIDS program, grantees are required to implement 

hepatitis screening as a condition of the award. 

SUBSTANCE ABUSE PREVENTION

Oral Fluid Guidelines.—The Committee is pleased with SAMHSA’s recommendation of oral 

fluid as an alternative specimen for drug testing and commends SAMSHA for the progress made 

on issuing oral fluid guidelines for the Federal Workplace Drug Testing Programs. The Committee 

urges SAMSHA to publish the guidelines expeditiously and to implement the guidelines in 

partnership with stakeholders and other agencies. [Senate Report, page 121] 

Action taken or to be taken 

The Proposed Oral Fluid Mandatory Guidelines for the Federal Workplace Drug Testing 

Programs (OFMG) were published in the Federal Register in May 2015. 
293 

The Committee notes that youth drug use continues to be a major issue and that perceptions of 

harm are significantly waning. Therefore, the Committee directs that all of the money appropriated 

explicitly for Substance Abuse Prevention purposes both in CSAP’s PRNS lines as well as the 

funding from the 20 percent prevention set-aside in the SAPT Block Grant be used only for bona 

fide substance abuse prevention activities and not for any other purpose. [Senate Report, page 

122] 

Action taken or to be taken

SAMHSA ensures that all of the money appropriated explicitly for Substance Abuse Prevention 

purposes both in CSAP’s PRNS lines as well as the funding from the 20 percent prevention setaside in the SAPT Block Grant be used only for bona fide substance abuse prevention activities 

and not for any other purpose

Combating Opioid Abuse.—The Committee provides $26,000,000 for grants to prevent opioid 

overdose related deaths. Part of the initiative to Combat Opioid Abuse, this program will help 

States equip and train first responders and other community partners with the use of devices that 

rapidly reverse the effects of opioids. Of this amount, the Committee provides $8,000,000 to 

prevent opioid overdose-related deaths in rural areas. People in rural communities are especially 

vulnerable and more likely to overdose on prescription pain killers than people in urban areas, 

according to the CDC. The Committee encourages SAMHSA to work with HRSA in the 

administration of these resources to rural areas. The Committee directs SAMHSA to ensure 

applicants outline how proposed activities in the grant would work with treatment and recovery 

communities in addition to first responders. Furthermore, the Committee provides $10,000,000 for 

the Strategic Prevention Framework Rx program to increase awareness of opioid abuse and misuse 

in communities. [Senate Report, page 122] 

Action taken or to be taken

SAMHSA ensures that the Grants to Prevent Prescription Drug/Opioid Overdose Related Deaths

grantees develop a dissemination plan and a training course tailored to meet the needs of their 

community. The course uses SAMHSA’s Opioid Overdose Prevention Toolkit as a guide, and 

includes a comprehensive prevention program, which focuses on prevention, treatment and 

recovery services to decrease the likelihood of drug overdose recurrence. Grantees are also 

equipping and training first responders with the use of devices that rapidly reverse the effects of 

opioids. 

In addition, SAMHSA’s Strategic Prevention Framework for Prescription Drugs (SPF-Rx)

program assists grantees in developing capacity and expertise in the use of data from state run 

prescription drug monitoring programs (PDMP). Grantees are strategically planning and 

strengthening their current prescription drug misuse efforts through the use of PDMP data. The 

SPF Rx grant program is also intended to identify communities by geography and high-risk 

population (e.g., age group), as well as target those communities that are in need of primary and 

secondary prevention. 
294 

SAMHSA is continuing its collaboration with CDC to implement the most effective outreach 

strategies and reduce any duplication of activities. The two agencies are coordinating to ensure 

that the efforts are aligned with HHS’s recently established policy and plan for prevention of 

Opioid-Related Overdoses and Deaths involving multiple Operating Divisions and offices.

Strategic Prevention Framework State Incentive Grant and Partnerships for Success.—The 

Committee intends that these two programs continue to focus exclusively on: addressing Stateand community-level indicators of alcohol, tobacco, and drug use; targeting and implementing 

appropriate universal prevention strategies; building infrastructure and capacity; and preventing 

substance use and abuse. [Senate Report, page 123] 

Action taken or to be taken

SAMHSA’s Strategic Prevention Framework State Incentive Grants (SPF-SIG) and Strategic 

Prevention Framework Partnerships for Success (SPF-PFS) programs continue to address the 

nation’s top emerging substance abuse priorities including underage drinking and prescription 

drug misuse. SAMHSA continues to focus exclusively on: addressing State- and communitylevel indicators of alcohol, tobacco, and drug use; targeting and implementing appropriate 

universal prevention strategies; building infrastructure and capacity; and preventing substance use

and abuse. SAMHSA provides support for grantees to strengthen substance abuse prevention

infrastructure and capacity using the strategic prevention framework. 

STOP Act.—The Committee directs that all funds appropriated for STOP Act community-based 

coalition enhancement grants shall be used for making grants to eligible communities and not for 

any other purposes or activities. [Senate Report, page 123]

Action taken or to be taken

The STOP Act program continues to address alcohol use among youth and young adults ages 12-

20 in communities throughout the United States. STOP Act recipients are expected to: 1) Enhance 

the ability of established community organizations to create community-level change regarding 

underage drinking; 2) Strengthen collaboration among communities, the federal government, state, 

local, and tribal governments to reduce alcohol use among youth and young adults in current and 

former DFC recipient communities; 3) Enhance intergovernmental cooperation and coordination 

on the issue of alcohol use among youth and young adults; 4) Address the barriers to collaboration 

with institutions of higher education, local education agencies, and state counterparts of the 

members of the federal Interagency Coordinating Committee on the Prevention of Underage 

Drinking (ICCPUD) and their Single State Authority (SSA) or tribal equivalent; 5) Host sites for 

local Town Hall Meetings to address underage drinking issues; and 6) Develop an action plan to 

address underage drinking. SAMHSA project officers routinely (e.g. reporting requirements and 

site visits) review grantees work to ensure it remains in compliance with only those allowable grant 

activities as articulated in the funding announcement and terms of the award. 
295 

FY 2017 House Appropriations Committee, Labor/HHS/Education Subcommittee 

(House Report 114-699) 

MENTAL HEALTH

Mental Health Block Grant—The Committee recommends a total of $532,571,000 for the Mental 

Health Block Grant, which is the same as the fiscal year 2016 enacted program level and the fiscal 

year 2017 budget request program level. The block grant provides funds to States to support mental 

illness prevention, treatment, and rehabilitation services. Funds are allocated according to a 

statutory formula among the States that have submitted approved annual plans. The Committee 

continues the ten percent set-aside within the Mental Health Block Grant for evidence-based 

programs that address the needs of individuals with early serious mental illness, including 

psychotic disorders. The Committee expects SAMHSA to continue its collaboration with the 

National Institute of Mental Health to encourage States to use this block grant funding to support 

programs that demonstrate strong evidence of effectiveness. [House Report, page 82] 

Action taken or to be taken

Through collaborations and an Interagency Agreement (IAA), NIMH and SAMHSA have worked 

together since 2014 to develop guidance, training, and technical assistance to states and territories 

to implement evidence-based programs for early serious mental illness focusing on first-episode 

psychosis through a set-aside in the Community Mental Health Services Block Grant (MHBG). 

SAMHSA, in partnership with NIMH, has supported, guided, and monitored the development of 

evidence-based programs throughout the nation. SAMHSA provides oversight and ongoing 

technical support through its training and technical assistance functions. Every state and territory 

has a program underway and the majority has fully implemented programs while a few are in 

earlier stages of development. SAMHSA has developed a “snapshot” of all the First Episode 

Psychosis (FEP) programs, detailing each State’s allotment, name of the program being 

implemented, and a short description of the program. 

SUBSTANCE ABUSE TREATMENT

Targeted Capacity Expansion.—The Committee recommends $61,303,000 for Targeted Capacity 

Expansion activities. Of this amount, $50,080,000 is for services that address prescription drug 

abuse and heroin use in high-risk communities. This funding level will provide funding for 45 

States. SAMHSA should target States with the highest rates of admissions and that have 

demonstrated a dramatic increase in admissions for the treatment of opioid addiction. The United 

States has seen a 500 percent increase in admissions for treatment for prescription drug abuse since 

2000. Moreover, according to a recent study, in the past two years, 28 States saw an increase in 

admissions for treatment for heroin dependence. The Center for Substance Abuse Treatment is 

directed to include as an allowable use medication-assisted treatment and other clinically 
296 

appropriate services to achieve and maintain abstinence from all opioids and heroin and prioritize 

treatment regimens that are less susceptible to diversion for illicit purposes. [House Report, page 

83]

Action taken or to be taken 

SAMHSA, through the Center for Substance Abuse Treatment, is working with the Targeted 

Capacity Expansion Medication-Assisted Treatment Prescription Drug and Opioid Addiction 

grantees to ensure use of medication assisted treatment and other clinically appropriate services 

and have informed the grantees that they should prioritize treatment regimens that are less 

susceptible to diversion for illicit purposes. 

Drug Treatment Courts.—The Committee continues to direct SAMHSA to ensure that all funding 

appropriated for Drug Treatment Courts is allocated to serve people diagnosed with a substance 

use disorder as their primary condition. SAMHSA is directed to ensure that all drug treatment 

court grant recipients work directly with the corresponding State substance abuse agency in the 

planning, implementation, and evaluation of the grant. The Committee further directs SAMHSA 

to expand training and technical assistance to drug treatment court grant recipients to ensure 

evidence-based practices are fully implemented. [House Report, page 83] 

Action taken or to be taken 

SAMHSA, through the Center for Substance Abuse Treatment, ensures that all funding 

appropriated for Drug Treatment Courts is allocated to serve people diagnosed with a substance 

use disorder as their primary condition. In addition, grantees in the program are expected to work 

with the state substance abuse agency in planning, implementation and evaluation of the grants. 

SAMHSA also continues to provide training and technical assistance to Drug Treatment Court 

grantees. 

Drug Testing for Opioid Treatment Programs.—Drug testing plays a key role in the delivery of 

safe and effective substance abuse treatment programs. Providers utilize these tests to identify the 

type of substance abuse, to determine a proper treatment plan, to continue on-going evaluations,

and to prevent drug diversion. The Committee requests SAMHSA ensure that all opioid treatment 

programs are implementing drug tests at a frequency necessary to implement a safe and an 

effective program. [House Report, page 84]

Action taken or to be taken 

SAMHSA, through the Center for Substance Abuse Treatment’s Division of Pharmacologic 

Therapies, works with all certified opioid treatment programs (OTPs) to ensure that requisite drug 

testing is implemented across the treatment episode for all clients of opioid abuse treatment at 

OTPs in an evidence-based fashion. 

Overdose Fatality Prevention.—The agreement reflects strong concerns about the increasing 

number of unintentional overdose deaths attributable to prescription and nonprescription opioids. 
297 

SAMHSA is urged to take steps to encourage and support the use of Substance Abuse and 

Prevention Block Grant funds for opioid safety education and training, including initiatives that 

improve access for licensed healthcare professionals, including paramedics, to emergency devices 

used to rapidly reverse the effects of opioid overdoses. Such initiatives should incorporate robust 

evidence based intervention training, and facilitate linkage to treatment and recovery services.

[House Report, page 84] 

Action taken or to be taken 

SAMHSA, through the Center for Substance Abuse Treatment, is working with Substance Abuse 

Prevention and Treatment Block Grant recipients to ensure the provision of evidence-based 

training and technical assistance in the area of opioid safety, including training supporting access 

to life saving devices used to rapidly reverse the effects of opioid overdose. 

Viral Hepatitis Screening.—The Committee applauds SAMHSA for encouraging grantees to 

screen for viral hepatitis including the use of innovative strategies like rapid testing. The 

Committee notes the disproportionate impact of viral hepatitis among minority populations and 

the co-infection rate among individuals with HIV/AIDS. The committee urges SAMHSA to work 

with Minority AIDS grantees to incorporate hepatitis screening into programmatic activities.

[House Report, page 84] 

Action taken or to be taken 

SAMHSA, through the Center for Substance Abuse Treatment, implements the Department of 

Health and Human Services’ Hepatitis Action Plan which notes that people with HIV are 

disproportionally affected by viral hepatitis and related adverse conditions. Through the Center 

for Substance Abuse Treatment’s Minority AIDS program, grantees are required to implement 

hepatitis screening as a condition of the award.

Comprehensive Opioid Response.—The Committee recommends $500,000,000 for 

Comprehensive Opioid Response grants. SAMHSA, in coordination with CDC, may award funds 

to eligible states, units of local government, territories or Indian Tribes, which may, in turn, subgrant to non-governmental organizations as appropriate. Funds may be used to plan for and 

implement an integrated opioid abuse response initiative that incorporates prevention and 

education, treatment, and recovery services. Eligible activities are as follows: (1) Prevention and 

education efforts concerning heroin and opioid use, treatment, and recovery; (2) Education of 

physicians, residents, medical students, and other medical providers who prescribe controlled 

substances on the prescription drug monitoring program of the State, on the CDC Guideline for 

Prescribing Opioids for Chronic Pain, and on the treatment of addiction; (3) Expanding 

prescription drug and opioid addiction treatment programs of the State. This includes the 

expansion of abstinence-based and medication assistance treatment programs that incorporate 

training for treatment and recovery support providers; behavioral health therapy for individuals 

who are in treatment for prescription drug and opioid addiction; screening for and clinically 

appropriate treatment of hepatitis C and HIV; and screening, early intervention, and referral to 

treatment for teenagers and young adults in primary care, middle schools, high schools, 

universities, school-based health centers, and other community-based health care settings; and (4) 
298 

Developing, implementing, and expanding programs to prevent overdose death from prescription 

medications and opioids that incorporate a referral to treatment services. Priority shall be given to 

States with the highest burden of opioid-related overdoses. SAMHSA is directed to brief the 

Committee no less than 30 days before issuing a funding announcement regarding the criteria for 

grant awards. In addition, SAMHSA is directed to brief the Committee no less than 30 days before 

awarding a grant. [House Report, pg 85] 

Action taken or to be taken

On December 14, 2016, SAMHSA released a Funding Opportunity Announcement in line with 

the State Response to the Opioid Abuse Crisis program authorized in Section 1003 of the 21st

Century Cures Act and Section 195 of the Further Continuing and Security Assistance 

Appropriations Act, 2017 which appropriated the $500,000,000 for the State Response to the 

Opioid Abuse Crisis program. The program aims to address 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 (including prescription opioids as 

well as illicit drugs such as heroin). These grants will be awarded to states and territories via 

formula based on unmet need for opioid abuse treatment and drug poisoning deaths. SAMHSA 

would be pleased to brief the Committee at its convenience regarding this important program. 

SUBSTANCE ABUSE PREVENTION

Strategic Prevention Framework State Incentive Grant and Partnerships for Success.—The 

Committee intends that the Strategic Prevention Framework State Incentive Grant and Partnerships 

for Success programs continue to focus exclusively on: addressing State- and community-level 

indicators of alcohol, tobacco, and drug use; targeting and implementing appropriate universal 

prevention strategies, building infrastructure and capacity, and preventing substance use and 

abuse. [House Report, page 85] 

Action taken or to be taken 

The Strategic Prevention Framework State Incentive Grant and Strategic Prevention Framework 

Partnerships for Success (SPF-PFS) programs continue to address the nation’s top emerging 

substance abuse priorities including underage drinking and prescription drug misuse. SAMHSA 

continues to focus exclusively on: addressing State- and community-level indicators of alcohol, 

tobacco, and drug use; targeting and implementing appropriate universal prevention strategies;

building infrastructure and capacity; and preventing substance use and abuse. SAMHSA provides 

support for grantees to strengthen substance abuse prevention infrastructure and capacity using 

the strategic prevention framework. 

Grants to Prevent Prescription Drug and Opioid Overdose Related Deaths.—The Committee 

recommends $12,000,000 for discretionary grants to States to prevent prescription drug and opioid 

overdose related deaths. This program will help States equip and train first responders with the use 

of devices that rapidly reverse the effects of opioids. SAMHSA is directed to ensure applicants 

outline how proposed activities in the grant would work with treatment and recovery communities 

in addition to first responders. Furthermore, the agreement provides $10,000,000 for the Strategic 
299 

Prevention Framework Rx program to increase awareness of opioid abuse and misuse in 

communities. SAMHSA shall collaborate with CDC to implement the most effective outreach 

strategy and to reduce duplication of activities. [House Report, page 85] 

Action taken or to be taken 

SAMHSA ensures that the Grants to Prevent Prescription Drug/Opioid Overdose Related Deaths

grantees develop a dissemination plan and a training course tailored to meet the needs of their 

community. The course uses SAMHSA’s Opioid Overdose Prevention Toolkit as a guide, and 

includes a comprehensive prevention program, which focuses on prevention, treatment and 

recovery services to decrease the likelihood of drug overdose recurrence. Grantees are also 

equipping and training first responders with the use of devices that rapidly reverse the effects of 

opioids. 

In addition, SAMHSA’s Strategic Prevention Framework for Prescription Drugs (SPF-Rx)

program assists grantees in developing capacity and expertise in the use of data from state run 

prescription drug monitoring programs (PDMP). Grantees are strategically planning and 

strengthening their current prescription drug misuse efforts through the use of PDMP data. The 

SPF Rx grant program is also intended to identify communities by geography and high-risk 

population (e.g., age group), as well as target those communities that are in need of primary and 

secondary prevention. 

SAMHSA is continuing its collaboration with CDC to implement the most effective outreach 

strategies and reduce any duplication of activities. The two agencies are coordinating to ensure 

that the efforts are aligned with HHS’s recently established policy and plan for prevention of 

Opioid-Related Overdoses and Deaths involving multiple Operating Divisions and offices.

Oral Fluid Drug Screening Guidelines.—The Committee is pleased with SAMHSA’s 

recommendation of oral fluid as an alternative specimen for drug testing, and commends the 

agency for progress made to issue oral fluid guidelines for the Federal Drug-Free Workplace 

testing program. The Committee urges SAMHSA to implement the guidelines expeditiously in 

partnership with key stakeholders and other agencies. [House Report, page 85]

Action taken or to be taken 

The Proposed Oral Fluid Mandatory Guidelines for the Federal Workplace Drug Testing 

Programs (OFMG) were published in the Federal Register in May 2015. SAMHSA has reviewed 

comments and is in the process of revising the OFMG in order to publish final OFMG in the 

near future. 

Minority Fellowship Program.—The Committee understands there is a workforce shortage 

among children’s mental health providers. The Committee is concerned that the National Minority 

Fellowship Program unnecessarily excludes related psychiatric subspecialists from programmatic 

eligibility. The Committee requests SAMHSA review internal eligibility criterion and provide an

update in the fiscal year 2018 budget request. [House Report, page 86] 
300 

Action taken or to be taken 

SAMHSA’s Minority Fellowship Program (MFP) aims to reduce health disparities and improve 

health care outcomes for racially and ethnically diverse populations by increasing the number of 

culturally competent behavioral health providers available to underserved minority populations 

(e.g., Asian American, African American, American Indian/Alaska Native, Hispanic/Latino, and 

Native Hawaiian and other Pacific Islanders). SAMHSA supports efforts to include psychiatric 

subspecialties in the MFP, including efforts to alleviate the workforce shortage among children’s 

mental health providers. SAMHSA regularly meets with the seven associated grantees for the 

Minority Fellowship Program and discusses and plans for the recruitment of fellows. The MFP 

was not previously authorized, but was recently codified in the 21st Century Cures Act. SAMHSA 

will continue to ensure the program meets the language specified in statute.