LEADING CHANGE -- SAMHSA’S FY 2012 BUDGET – 2/15/11 Page 1 of 4

LEADING CHANGE – PRESIDENT OBAMA’S FY 2012 BUDGET FOR SAMHSA

1. THE SAMHSA BUDGET REFLECTS COMMITMENT TO BEHAVIORAL HEALTH. 

In a time of fiscal austerity, the total budget requested for SAMHSA in FY 2012 is over $3.6 billion, 

a net increase of almost $67 million. These dollars include an increase of $38 million in PHS 

Evaluation Funds, almost $73 million in Affordable Care Act (ACA) Prevention Funds, and a 

decrease of $44 million in Budget Authority (BA).

Along with this commitment comes the recognition that a new approach is needed. Critical 

unmet need at a time of significant changes in the health care environment calls for a new and 

fiscally responsible approach for behavioral health in America. 

Behavioral health conditions are among the leading causes of disability in America and the unmet 

need is great. Over 60 percent of people who experience mental health problems and 90 percent 

of people who need substance abuse treatment do not receive care, often because they did not 

have insurance or could not afford the cost of care. Most individuals with a mental illness or an 

addictive disorder also experience elements of both. Persons with a mental or substance use 

disorder are more likely to have a co-existing physical health condition, and the cost of treating the 

physical health condition is higher if the mental or substance use disorder is not also addressed. 

The American people deserve better. Like many physical health conditions, mental and 

substance use disorders can be prevented and treated effectively, and people do recover and 

lead productive lives. While gains have been made, more remains to be done. To do more with 

available resources requires a new approach.

Additionally, the environment in which behavioral health policy and funding decisions are made is 

changing. Changes are occurring in health care financing with States playing an increasing role in 

policy and funding decisions affecting behavioral health prevention, treatment and recovery 

support services. At the same time, America’s health care system is experiencing rapid adoption 

of health information technology, scientific advances in prevention and treatment services, and a 

growing understanding of recovery along with the importance of personal responsibility and selfdirection in the prevention and treatment of health and behavioral health conditions. These 

advances, along with implementation of the Mental Health Parity and Addiction Equity Act 

(MHPAEA) and tight budgets at federal, state and local levels, provide both opportunities and 

significant challenges. These forces call for a new and fiscally responsible approach to behavioral 

health in America. 

2. THE SAMHSA BUDGET REFLECTS A FOCUS ON SAMHSA’S STRATEGIC INITIATIVES.

The SAMHSA FY 2012 Budget request includes a changed budget structure and policy focus that 

emphasize meeting the behavioral health needs of people rather than focusing on the conditions 

that afflict them. The FY 2012 Budget, along with actions taken to manage FY 2011 funding 

differently, focuses resources on SAMHSA’s eight (8) Strategic Initiatives – 1) Prevention of 

Substance Abuse and Mental Illness, 2) Trauma and Justice, 3) Military Families, 4) Health 

Reform, 5) Recovery Support, 6) Health Information Technology, 7) Data, Outcomes, and Quality, 

and 8) Public Awareness and Support. Two of these initiatives are highlighted here.
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Prevention: SAMHSA’s Budget represents a commitment to prevention of substance abuse and 

mental illness as priority # 1. The Budget includes $535 million, an increase of $55 million over 

FY 2010, for new and expanded substance abuse prevention and mental health promotion grants 

to States and Tribes to bring evidence-based prevention strategies to scale nationwide. The

Nation’s behavioral health system must reach America’s young people before they become 

involved with alcohol, illegal drugs, tobacco and abuse of prescription drugs. Using 

comprehensive approaches across multiple systems and at every stage of development, the rates 

of substance abuse, mental illness, and suicide among America’s youth can be reduced.

Substance Abuse – State Prevention Grants (SA-SPG): The Budget includes a new Substance 

Abuse – State Prevention Grant (SA-SPG) program, using $395 million in funds from the SA Block 

Grant 20 percent set aside and additional PRNS funds currently going to States and Territories, 

combined to avoid duplication, improve coordination, make it easier to apply for and receive funds, 

and better leverage resources. State and Territorial Substance Abuse Authorities (SSAs) will be 

eligible for these grants, and will be required to provide at least 80 percent of these resources to 

high need communities. The Budget creates a predictable and sustained source of prevention 

funding for all States and Territories to bring evidence-based practices to scale with a focus on 

comprehensive multi-strategy substance abuse prevention in high-risk communities. 

Mental Health - State Prevention Grants: The Budget includes $90 million for a new Mental Health 

– State Prevention Grant program through an expansion of the Project LAUNCH concept (Linking 

Actions for Unmet Needs in Children’s Health) for children and youth up to age 25. State and 

Territorial Mental Health Authorities (MHAs) will be eligible for these grants, and will be required to 

provide at least 80 percent of these resources to high need communities. These grants will 

enable States and Territories to work across systems to implement evidence-based prevention 

and promotion strategies to build emotional health in children by targeting common risk and 

protective factors related to mental, emotional, and behavioral disorders.

Behavioral Health - Tribal Prevention Grants: The Budget includes $50 million for a new 

Behavioral Health - Tribal Prevention Grant (BH-TPG) program, from the Prevention Fund 

authorized and appropriated by the Affordable Care Act (ACA). Funds will be provided to 

Federally-recognized Tribes that apply to implement strategies to prevent alcohol and substance 

abuse and prevent suicide in Tribal communities. SAMHSA will coordinate with the Indian Health 

Service (IHS) to implement community-based prevention strategies that complement the clinical 

services provided by IHS-funded providers. SAMHSA will also coordinate with IHS, BIA/BIE and 

DOJ to implement the Tribal Law and Order Act (TLOA) that allows Tribes to develop Tribal Action 

Plans (TAPs) addressing substance abuse and related suicides.

Prevention Prepared Communities: The Budget also includes $23 million for a new program in 

collaboration with the Office of National Drug Control Policy (ONDCP), the Department of 

Education (ED), and the Department of Justice (DOJ) to implement comprehensive, evidencebased community prevention programs that serve young people during their at-risk years. The 

Budget will support approximately 30 communities to identify and address their predominant 

substance abuse issues and related concerns such as violence and mental health using 

appropriate evidence-based strategies. 

Preventing Suicide: The Budget includes $48 million, the same as FY 2010, to prevent suicide by 

continuing the investment in activities authorized by the Garrett Lee Smith Memorial Act that 

support intervention and prevention strategies in schools, institutions of higher education, juvenile 

justice systems, and other youth support organizations. The Budget also sustains the capacity of 

the national hotline (Suicide Lifeline) that routes calls across the country to a network of certified 
LEADING CHANGE -- SAMHSA’S FY 2012 BUDGET – 2/15/11 Page 3 of 4

local crisis centers that can link callers to local emergency, mental health, and social service 

resources. These funds, along with ACA Prevention Funds for FY 2011, support and complement 

the work of the National Action Alliance for Suicide Prevention that began in late 2010.

Health Reform’s Implications for Block Grants: The Budget includes $1.9 billion, an increase 

of $54 million over FY 2010, for two Substance Abuse and Mental Health Block Grants (SABG and 

MHBG respectively) to implement evidence-based treatment strategies nationwide and maintain 

the Nation’s behavioral health treatment infrastructure. As access to health services – including 

mental health and substance abuse services – expands through health reform, SAMHSA will work 

with States to use these Block Grant funds more strategically and with greater efficiency through 

the dissemination and implementation of evidence-based treatment strategies and interventions.

3. SAMHSA’S BUDGET REFLECTS THE IMPLEMENTATION OF A THEORY OF CHANGE.

SAMHSA’s Budget supports innovation by identifying solutions to emerging issues through the 

use of limited, short-term discretionary grants. Those evidence-based practice and policy 

solutions are then moved into the Nation’s behavioral health system through Block Grants to 

States, formula grants to States and Tribes, on-going discretionary grants, Medicaid/Medicare, or 

private insurance. 

In FY 2012, SAMHSA’s Budget includes a new budget line – Innovation and Emerging Issues (IEI) 

– that combines three previous Programs of Regional and National Significance (PRNS) budget 

lines. This new program will address emerging issues identified within SAMHSA’s Strategic 

Initiatives such as primary/behavioral health care integration, health information technology, the 

needs of military families and implementation of new laws such as MHPAEA, ACA and the Health 

Information Technology for Economic and Clinical Health Act (HITECH). 

In lieu of making new awards in a number of fully tested programs, SAMHSA’s FY 2012 Budget 

proposes to invest those resources in the validation of promising practices and in bolstering 

nationwide efforts to implement and sustain already evidence-based strategies. Behavioral health 

in America can be transformed through innovation in policy, financing, technology, training and 

education. This new budget line includes $790 million (a combination of budget authority, ACA, 

and PHS evaluation fund dollars), a decrease of $42 million below FY 2010, and will provide 

SAMHSA a systematic and sustained approach for bringing the best prevention and treatment 

services for people in communities nationwide. Examples of IEI areas of focus are:

Military Families: In keeping with President Obama’s recently released report Strengthening Our 

Military Families: Meeting America’s Commitment, the Budget includes $10 million for a new 

effort to address the behavioral health needs of military service personnel and their families. 

Many military families experience stress and behavioral health consequences as a result of life 

disruptions, prolonged deployments, and exposure to trauma. The Budget will support States and 

Territories in a two-phased planning and implementation process to enhance access to prevention, 

treatment, and recovery support services for military personnel and their families.

Health Information Technology: The adoption of health information technology (HIT) holds 

promise for improving behavioral health outcomes by improving care coordination and quality of 

care. The Budget includes $4 million for a new pilot effort for States, working with SAMHSA 

and the Office of the National Coordinator (ONC) to incentivize development and adoption of 

interoperable electronic health records (EHRs) by behavioral health providers. 
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Housing – Services Assisting in the Transition from Homelessness: The Budget dedicates a 

total of $154 million, an increase of $12 million, for services to support individuals with mental 

and substance use disorders who are or are at risk of homelessness. Included within this funding 

is a new collaborative approach with the Department of Housing and Urban Development (HUD) 

that will combine health, behavioral health, and other support services to move and maintain 

permanent housing that supports recovery for individuals with mental and substance use disorders 

who are experiencing chronic homelessness. 

Screening, Brief Intervention and Referral to Treatment (SBIRT): Early identification and 

interventions can decrease total health care costs by impeding progression to addiction. The 

Budget provides $29 million, the same level as FY 2010, for substance abuse screening and 

interventions within general medical primary care settings. Some of these funds will be used to 

develop pilots to test the addition of trauma screening and brief intervention to the SBIRT process.

4. SAMHSA’S BUDGET REFLECTS EFFICIENT AND EFFECTIVE USE OF DOLLARS.

Tight times require tough choices. They also offer opportunities for needed change. The FY 2012 

SAMHSA Budget represents a bold plan of action to increase effectiveness and efficiency, 

embrace opportunities presented by changes in the Nation’s healthcare system, and better meet 

the behavioral health needs of the Nation. This Budget request will help SAMHSA support 

programs providing critical services for those individuals in need of behavioral health care that are

not covered by public or private insurance. SAMHSA has spent years supporting a robust 

discretionary portfolio to test and refine proven practices. Now is the time to bring those practices 

to scale in every State, Territory and Tribe as SAMHSA continues to look for innovative 

approaches to test in the field and to collaborate with federal and other partners to chart a course 

for the future.

SAMHSA’s Budget restructuring includes the new prevention grants budget line, the new IEI 

budget line, as well as three consolidations described below that align investments in data 

systems that monitor the performance of SAMHSA programs; public education efforts; and 

regulatory oversight functions. All of these changes will allow SAMHSA to continue or even 

improve current activities with less dollars than in FY 2010.

Consolidation of Performance and Quality Information Systems (PQIS): The Budget includes 

a new budget line consolidating three different performance data systems that will improve 

coordination, efficiencies, and the usefulness of performance management and quality 

improvement activities. Center contributions for the evidence-based practice registry are also 

consolidated into this budget line.

Improving Public Awareness and Support: Many Americans are not getting the help they need 

for behavioral health problems, and many opportunities for prevention and early intervention are 

being missed. The Budget includes $14 million to consolidate public awareness activities to better 

deploy marketing approaches that combine sound public health practices with evidence-based 

communication strategies.

Regulatory and Oversight Functions (ROF): The ROF budget line consolidates several other 

activities currently funded from multiple lines within SAMHSA, slightly less than FY 2010, for more 

effective management of these critical functions.