Guidance for the revision of the FY 2020-2021 for the Mental Health 

Block Grant Application for the new Crisis Services 5% set-aside 

Substance Abuse and Mental Health Services Administration (SAMHSA) is directed by 

Congress through the Consolidated Appropriations Act, 2021 and the Coronavirus Response and 

Relief Supplement Appropriations Act, 2021 [P.L. 116-260], to set aside 5 percent of the Mental 

Health Block Grant (MHBG) allocation for each state to support evidence-based crisis systems. 

Congress specifically provided an increase to federal fiscal year (FY) 2021 MHBG appropriation 

over the FY 2020 level to help states meet this new requirement without losing funds for existing 

services. The appropriation bill has the following requirement for the new 5 percent set-aside. 

Furthermore, the Committee directs a new five percent set- aside of the total for 

evidence-based crisis care programs addressing the needs of individuals with serious 

mental illnesses and children with serious mental and emotional disturbances. The 

Committee directs SAMHSA to use the set-aside to fund, at the discretion of eligible 

States and Territories, some or all of a set of core crisis care elements including: 

centrally deployed 24/7 mobile crisis units, short-term residential crisis stabilization 

beds, evidence-based protocols for delivering services to individuals with suicide risk, 

and regional or State-wide crisis call centers coordinating in real time.

 A fully developed crisis response system is responsive any time and any place. What does a 

person in crisis need? Someone to talk to, or someone to respond, or a safe place to go for 

evaluation, stabilization and follow up. SAMHSA expects that states will build on the emerging 

and growing body of evidence for effective community-based crisis-intervention and response 

systems. SAMHSA recognizes that the development of fully accessible and responsive crises 

services involves complex problem solving with multiple entities and systems. We also 

recognize that strategic crisis services implementation can result in better care and cost savings 

through the reduction in avoidable emergency department visits, psychiatric admissions, police 

engagement, arrests, incarcerations and 911 calls. 

SAMHSA recently developed Crisis Services: Meeting Needs, Saving Lives, which includes 

“National Guidelines for Behavioral Health Crisis Care: Best Practice Toolkit” as well as other 

related National Association of State Mental Health Programs Directors (NASMHPD) papers on 

crisis services. Please note that this set aside funding is dedicated for the core set of crisis 

services as directed by Congress. Nothing precludes states from utilizing more than 5 percent of 

its MHBG funds for crisis services for individuals with serious mental illness or children with 

serious emotional disturbances. If states have other investments for crisis services, they are 

encouraged to coordinate those programs with programs supported by this new 5 percent set 

aside. This coordination will help ensure services for individuals are swiftly identified and are 

engaged in the core crisis care elements. 

SAMHSA is requesting states to implement this 5 percent set-aside through a “request for 

revision of the 2020-21 MHBG plan” within the Environmental Factors, Section 15. Crisis 
Services. States are encouraged to fund programs to meet the needs of persons with crisis 

services, specifically utilizing the SAMHSA’s National Guidelines for Behavioral Health Crisis 

Care, tool kit. States may address the three core services either through enhancing existing 

program activities or through developing a set of new activities based on the tool kit. 

It is expected that the states’ capacity to implement crisis services will vary based on the actual 

funding from the 5% allocation. It is also recognized that with the timing of the allocation 

distribution, states may need to dedicate the rest of the current fiscal year to planning, training, 

and/or infrastructure development while targeting program implementation to the following year. 

Additionally, many states have begun implementing such models or similar approaches and can 

build on these existing efforts through their proposed MHBG plan revision. States must submit 

their plan revision request proposal into the FY 2020-2021 MHBG Behavioral Health 

Assessment and Plan in Section C. Environmental Factors and Plan, 15. Crisis Services. This 

section initially requested to report how states and local communities identify and effectively 

respond to, prevent, manage and help individuals, families, and communities recover from crises. 

States should also complete line 10, Crisis Services (5%) in Table 2 State Agency Planned 

Expenditures [MH] under Section B: MHBG. 

SAMHSA requests states to submit the following with the proposal. 

• Update the checkboxes and add any comments in the comment boxes in Section C. 

Environmental Factors and Plan, 15. Crisis Services 

• Update Table 2 to reflect the 5% set-aside funds

Include a description of the current status of your states crisis program as well as proposed plan 

for expenditure of the 5% set aside. We recommend the following information when submitting 

the proposals. 

• Description of the status of the state’s current crisis system. Please describe in terms of 

the following three elements: current access to local crisis call centers, the availability of 

mobile crisis behavioral health first responder services and the availability and or 

utilization of short-term crisis receiving and stabilization centers. The suggested 

framework for describing your states current system capacity is below. Receipt of this 

data will enable us to track national development and utilization of each of the crisis 

components over time. 

• Stages of Implementation terms: 

a) The Exploration-Planning stage: is the stage when states identify their communities’ 

needs, assess organizational capacity, identify how crisis services meet community 

needs, and understand program requirements and adaptation. 

b) The Installation stage: occurs once the state has proposed a plan and begins making 

the changes necessary to implement the service based on the SAMHSA guidance. 

This includes coordination, training and community outreach and education activities. 

c) Early Implementation: occurs when the state has the core crisis service implemented

in some parts of the state, about 25% or less persons have access to that service. 
d) Middle Implementation stage: occurs when the state has the core crisis service 

implemented such that about half of the people in your state have access to that 

service. 

e) Majority Implementation: occurs when the state has the core crisis service 

implemented in most parts of the state so that most people have access. 

f) Program Sustainment stage: occurs when implementation is statewide and has a clear 

funding plan. 

We request that you indicate what stage each of the three elements is in your state and submit this 

back to us in your application. 

Exploration

Planning 

Installation Early 

implementation 

Less than 25% 

of people in 

state 

Middle 

Implementation

About 50% of 

people in state 

Majority 

Implementation 

At least 75% of 

people in state 

Program 

Sustainment 

Someone 

to talk to

Someone 

to 

respond

Place to 

go 

Other program implementation data that might be useful to characterize crisis services 

system development. These are included for your consideration only and we recognize that 

some of these are not readily available. These are based on data components that some states 

and localities have found useful in measuring impact and outcome of crisis services. 

1. Someone to talk to: Call Center Capacity 

a. Number of locally based crisis call Centers in state

i. In the Suicide lifeline network 

ii. Not in the suicide lifeline network

b. Number of Crisis Call Centers with follow up Protocols in place 

c. Total number of calls statewide and by local crisis call center

d. Percent of 911 calls that are identified as MH related 

2. Someone to respond: mobile behavioral health crisis capacity 

a. Number of mobile responders that are independent of first responder structures 

(police, paramedic, fire)

b. Number of mobile responders that are integrated with first responder structures 

(police, paramedic, fire)
c. Number of mobile responders that employ peers 

d. Number of police responses to mental health crises

3. Place to Go: Available resources in the state 

a. Number of Emergency Departments 

b. Number of Emergency Departments that operate a specialized behavior health 

component. 

c. Number of Crisis Receiving and Stabilization Centers (short term, 23 hr units that 

can diagnose and stabilize individuals in crisis) 

d. Number of hours of overtime by law enforcement related to accompaniment of 

persons with MH conditions in ED or other settings. 

e. Number of persons boarded in ED (In ED longer than 24 hours and waiting for 

psychiatric admission.) 

• Clearly describe the proposed/planned activities utilizing the 5% set aside for FY 21, 

including an estimated budget. States may be at different stages for different geographic 

locations. States will be required to report on what activities have been completed 

throughout the grant with this set-aside funding. 

• Via the revision request, upload the document (word or pdf) using the upload tab into 

Section C. Environmental Factors and Plan, 15. Crisis Services. Please title this document 

“Crisis Services in FY 21”. Upon submission, SAMHSA will review the revision 

proposals to ensure they are complete and responsive. Once the revision proposal is 

approved by SAMHSA, the allotment for the 5 percent set aside will be awarded to the 

state.