DEPARTMENT

of HEALTH

and HUMAN

SERVICES

Fiscal Year

2015

Justification of 

Estimates for 

Appropriations Committees

Substance Abuse and Mental Health 

Services Administration
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DEPARTMENT OF HEALTH AND HUMAN SERVICES

SUBSTANCE ABUSE AND MENTAL HEALTH SERVICES ADMINISTRATION

Table of Contents

Fiscal Year 2015 Budget Page

Letter from Administrator.............................................................................................................. iii

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

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

A. Executive Summary

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

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

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

4. All Purpose Table ............................................................................................................. 15

5. Summary of the Request................................................................................................... 17

B. NOW IS THE TIME..............................................................................................................27

C. Budget Exhibits

1. Appropriations Language...................................................................................................35

2. Language Analysis............................................................................................................ 39

3. Amounts Available for Obligation.....................................................................................43

4. Summary of Changes.........................................................................................................44

5. Budget Authority by Activity ............................................................................................45

6. Authorizing Legislation .....................................................................................................46

7. Appropriations History ......................................................................................................48

8. Appropriations Not Authorized by Law ........................................................................... 50

D. Mental Health Services 

1. Mental Health Programs of Regional and National Significance..................................... 53

2. Children’s Mental Health Services................................................................................... 99

3. PATH Homeless Grants.................................................................................................. 105

4. PAIMI ............................................................................................................................. 111

5. Community Mental Health Services Block Grant .......................................................... 117

E. Substance Abuse Prevention

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

F. Substance Abuse Treatment

1. Substance Abuse Treatment Programs of Regional and National Significance ............. 151

2. Substance Abuse Prevention and Treatment Block Grant.............................................. 187

G. Health Surveillance and Program Support 

1. Health Surveillance and Program Support.......................................................................201

2. Public Awareness and Support ....................................................................................... 205

3. Performance and Quality Information Systems.............................................................. 211

4. Agency-Wide Initiatives................................................................................................. 215
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H. Center for Behavioral Health Statistics and Quality....................................................... 219

I. Drug Control Budget.......................................................................................................... 235

J. Prevention and Public Health Fund.................................................................................. 273

K. Supplementary Tables

1. Budget Authority by Object Class.................................................................................. 293

2. Salaries and Expenses......................................................................................................303

3. Detail of Full-Time Equivalent Employee (FTE)............................................................305

4. Detail of Positions............................................................................................................306

5. Programs Proposed for Elimination................................................................................ 307

6. Federal Employment Funded by the Patient Protection and Affordable Care Act......... 308

7. Physician’s Comparability Allowance Worksheet ..........................................................309

8. Mechanism by Summary Level of Activity Tables........................................................ 310

L. Significant Items.................................................................................................................. 325

M. SAMHSA Specific Items......................................................................................................337
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1

Performance Budget Overview

Introduction and Mission

Introduction

The wholeness of individuals and their families rests not on the absence of disease but on their 

mental and physical well-being—which includes both mental health and freedom from addiction. 

Prevention, treatment, and recovery support services for mental health and substance use 

disorders are essential components of health service systems and community-wide strategies. In 

addition to improving the health status of our citizens, these support services lower costs for 

individuals, families, businesses and governments. In fact, the presence of substance abuse and 

mental illness increases the cost of treating co-morbid physical diseases and results in the highest 

disability burden in the world. However, substance abuse, addiction, poor emotional health and 

mental illnesses do not just cost money, they cost lives—particularly when we do not prevent or 

manage them effectively. For these reasons, SAMHSA has a unique responsibility to focus the 

nation's health and human services agendas on these preventable and treatable problems 

stemming from disease, trauma, lack of access to appropriate care, and insufficient community 

and family supports.

Vision

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

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

 Behavioral health is essential for health.

 Prevention works.

 Treatment is effective.

 People recover from mental and substance use disorders.

Mission

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

communities. SAMHSA serves as a national voice on mental health and mental illness, 

substance abuse, and behavioral health systems of care. It coordinates behavioral health 

surveillance to understand better the impact of substance abuse and mental illness on children, 

individuals, families and the costs associated with treatment. And, SAMHSA helps to ensure 

dollars are invested in evidence-based and data-driven programs and initiatives that result in 

improved health and resilience. 
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Leading Change 2.0 – SAMHSA’s Proposed Six Strategic Initiatives

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

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

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

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

promote the nation’s health. As the driving force for its direction, SAMHSA’s Strategic Plan for 

the last four years – Leading Change: A Plan for SAMHSA’s Roles and Actions 2011 – 2014 –

outlined eight Strategic Initiatives within the concept of a public health approach and a changing 

health care delivery system. Since issuing the plan in 2011, SAMHSA has achieved significant 

successes in these strategic areas and is on track to meet its goals. Moreover, SAMHSA 

completed the key objectives within three of the Strategic Initiatives – Military Families; Data, 

Outcomes and Quality; and Public Awareness and Support – and has embedded the ongoing 

scope and priorities of these issue areas into programmatic and business operations across

SAMHSA. 

Going forward, for FY 2015 through FY 2018, SAMHSA is in the process of updating its 

strategic plan to align with the evolving needs of the behavioral health field, the people 

SAMHSA serves, and the parameters of the fiscal environment. Leading Change 2.0: A Plan 

for SAMHSA’s Roles and Actions 2015 – 2018, to be issued in late FY 2014, will reflect 

SAMHSA’s programmatic priorities and policy drivers including the new HHS strategic plan 

and the transition to full implementation of the Affordable Care Act.

SAMHSA intends to present its draft strategic plan including six Strategic Initiatives to the 

public for input in Spring of 2014 and issue a final plan in the Fall.

1 Prevention of Substance Abuse and Mental Illness 

This Strategic Initiative focuses on the prevention of substance abuse and mental illness 

by maximizing opportunities to create environments where individuals, families, 

communities, and systems are motivated and empowered to manage their overall 

emotional, behavioral, and physical health. This SI will include a focus on several 

populations of high risk, including college students and transition age youth, especially 

those at risk of first episodes of mental illness or substance abuse; American 

Indian/Alaska Natives; ethnic minorities experiencing health and behavioral health 

disparities; military families; and lesbian, gay, bisexual, and transgender individuals.

2 Health Care and Health Systems Integration

This Strategic Initiative focuses on health care and integration across systems including 

systems of particular importance for persons with behavioral health needs such as 

community health promotion, health care delivery, specialty behavioral health care, and 

community living needs. Integration efforts will seek to increase access to appropriate 

high quality prevention, treatment, recovery and wellness services and supports; reduce

disparities between the availability of services for mental illness (including serious 
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mental illness) and substance use disorders compared with the availability of services for 

other medical conditions; and support coordinated care and services across systems. 

3 Trauma and Justice

This Strategic Initiative focuses on trauma and justice by integrating a trauma-informed 

approach throughout health, behavioral health, human services, and related systems in 

order to reduce the harmful effects of trauma and violence on individuals, families and 

communities. This SI also will support the utilization of innovative strategies to reduce 

the involvement of individuals with trauma and behavioral health issues in the criminal 

and juvenile justice systems.

4 Recovery Support

This Strategic Initiative will promote partnering with people in recovery from mental and 

substance use disorders and their family members to guide the behavioral health system 

and promote individual, program, and system-level approaches that foster health and 

resilience (including helping individuals with behavioral health needs be well, manage 

symptoms, and achieve and maintain abstinence); increase housing to support recovery;

reduce barriers to employment, education, and other life goals; and secure necessary 

social supports in their chosen community.

5 Health Information Technology

This Strategic Initiative will ensure that the behavioral health system – including states, 

community providers, patients, peers, and prevention specialists – fully participate with 

the general healthcare delivery system in the adoption of health information technology 

(Health IT), including interoperable electronic health records (EHRs) and the use of other 

electronic training, assessment, treatment, monitoring, and recovery support tools, to 

ensure high-quality integrated health care, appropriate specialty care, improved 

patient/consumer engagement, and effective prevention and wellness strategies.

6 Workforce Development

This Strategic Initiative will support active strategies to strengthen the behavioral health 

workforce. Through technical assistance, training and focused programs, the initiative 

will promote an integrated, aligned, competent workforce that enhances the availability 

of prevention and treatment for substance abuse and mental illness, strengthens the 

capabilities of behavioral health professionals, and promotes the infrastructure of health 

systems to deliver competent, organized behavioral health services. This initiative will 

continually monitor and assess the needs of peers, communities, and health professionals 

in meeting behavioral health needs in America’s transformed health promotion and health 

care delivery systems. 
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Overview of the Budget Request

The SAMHSA FY 2015 Budget Request for its Total Program Level is $3.6 billion, a decrease 

of $63.2 million below the FY 2014 Enacted Level. The FY 2015 Total Program Level of $3.6 

billion includes $3.3 billion in Budget Authority (a decrease of $137.3 million below the FY 

2014 Enacted Level), $210.7 million in PHS Evaluation Funds (an increase of $78.0 million

above the FY 2014 Enacted Level), and $58.0 million in Prevention and Public Health Fund 

resources (a decrease of $4.0 million below the FY 2014 Enacted Level. The budget continues a

$1.5 million for user fees for extraordinary data and publication requests. The FY 2015 Budget 

Request presents four appropriations consistent with the Consolidated Appropriations Act, 2012, 

and the FY 2014 Enacted Level: Mental Health, Substance Abuse Prevention, Substance Abuse 

Treatment, and Health Surveillance and Program Support. 

The FY 2015 Budget Request reflects key goals for advancing the nation’s behavioral health 

promotion, prevention, treatment, and recovery support systems while accommodating 

continuing constraints on public funding at all levels. At the same time, SAMHSA’s Budget 

Request reflects the need to support an emerging and dynamic healthcare environment. The 

request reflects ongoing internal and external changes which have resulted in integrated data and 

operating structures, uniform guidance, and braided funding strategies in key discretionary 

programs. SAMHSA has achieved both programmatic and fiscal efficiencies through assessing 

its internal workforce and increasing collaboration with other federal agencies, while reducing 

redundancy to deliver improved program outcomes.

The FY 2015 budget continues investments to increase access to mental health services to protect 

children and communities, and to reduce suicide rates, with a special focus on American Indian 

and Alaska Native communities. The Budget Request supports the President’s Now is the Time

initiative, and lays out changes to achieve a healthier and safer nation. The Budget includes 

funding to improve the states’ capacity to provide behavioral health services through the block 

grants, with a mental health set-aside dedicated to early intervention for the most serious mental 

illnesses, and leverages funding for competitive grant activities that will now be brought to scale 

through other mechanisms such as the block grants or state-level funding streams. The Budget 

also invests new resources to integrate primary care and addiction services and address 

prescription drug abuse. 

As part of SAMHSA’s role in the nation’s mental health and substance abuse prevention and 

treatment systems, SAMHSA will work to target investments more strategically by:

 Targeting resources to evidence-based prevention and treatment interventions;

 Integrating Minority AIDS and related programs into the HIV Continuum of Care; and

 Decreasing negative attitudes toward seeking help for mental health and substance abuse 

problems, and increasing the willingness to seek help for those problems. 
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The FY 2015 Budget Request prioritizes essential investments which require the programmatic 

expertise and leadership of SAMHSA’s highly trained and dedicated staff. As SAMHSA 

continues its commitment to be an efficient, effective steward of taxpayer dollars, it will manage 

resources from the Prevention and Public Health Fund, the PHS Evaluation fund, and directly 

appropriated Budget Authority with utmost care and integrity. Maintaining critical agency 

investments in FY 2015 will allow SAMHSA to build capacity in states, territories, tribes and 

communities to protect and promote behavioral health in America. 

Programmatic Priorities to Support Strategic Initiatives

SAMHSA’s Strategic Plan, Leading Change, has been the driving force in SAMHSA’s strategic 

direction since 2011. Using a public health approach, and guided by the Affordable Care Act, 

SAMHSA has achieved significant success and is on track with the metrics established for the 

six strategic initiatives (SIs). As SAMHSA prepares for FY 2015 and beyond, the agency is 

retooling the strategic initiatives in light of current external drivers to better meet the needs of 

our stakeholders and to align with SAMHSA’s vision and mission. As SAMHSA prepares for 

the future, the agency must continue to ensure that staff has the necessary resources and 

knowledge, and that SAMHSA as an organization has the infrastructure and capacity, to lead 

public health efforts to advance the nation’s behavioral health.

In FY 2015, SAMHSA is requesting funding for the Science of Changing Social Norms

initiative. Building on the President’s effort to reduce negative attitudes and increase 

understanding about mental health through the Now is the Time initiative, this public awareness 

and education initiative will identify and employ science-based, data-driven methodologies to 

change societal and cultural norms in this important domain.

Prevention of Substance Abuse and Mental Illness

In FY 2015, SAMHSA proposes a new program, Prescription Drug Abuse and Overdose 

Prevention (SPF Rx), will provide funding for the prevention of prescription drug misuse and 

abuse in high priority age groups (including young and middle-aged adults) and populations 

through education and other prevention strategies. Grantees will be required to collaborate with 

the state’s public health authority, education authority, and Medicaid authority, as well as the 

state’s Prescription Drug Monitoring Program (PDMP) and health information exchanges 

(HIEs), to raise awareness of the dangers of sharing medications. It will also work with 

pharmaceutical and medical communities on the risks of overprescribing and on the use of 

PDMPs and educational materials at points of prescribing, sale, and dispensing. SAMHSA will 

also partner with the National Institute on Drug Abuse (NIDA) to further develop the evidence 

base to support these efforts. 

Up to 20 other states would receive planning grants to build capacity to address prescription drug 

abuse and overdose prevention efforts. Funding also will be used to provide technical assistance 

and evaluation, and to expand work with the Office of the National Coordinator of Health 

Information Technology (ONC) on standards alignment for interoperability among state PDMPs 

and electronic health records (EHRs)/health information exchanges (HIEs) and/or any other 

technology efforts determined necessary for the exchange of data.
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Within existing resources, SAMHSA proposes to establish the Building Behavioral Health 

Coalitions program to support cross-fertilization among mental health and substance abuse 

prevention community coalitions and/or organizations to expand their focus and activities to 

include a behavioral health approach. Funded activities may include, but are not limited to, bidirectional education on substance abuse prevention and mental health promotion; assessing 

shared community risk and protective factors, especially among youth; developing the capacity 

to jointly implement evidence-based programming that addresses these factors; and working with 

stakeholders such as health insurance companies, Marketplaces, and state Medicaid officials to 

promote health insurance coverage for substance abuse prevention and mental health promotion.

Mental health and substance abuse funding streams will be kept separate and used for activities 

consistent with their funding authorities.

SAMHSA also proposes to support further implementation of the newly updated National 

Strategy for Suicide Prevention for a nationally coordinated, locally driven effort to bring down 

the tenth leading cause of death in the U.S.

In the FY 2015 Budget Request, the 20 percent Substance Abuse Prevention set aside funds are 

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

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

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

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

abuse. 

Health Care and Systems Integration

In anticipation of ongoing changes and improvements brought about by the Affordable Care Act, 

SAMHSA continues to prepare and guide the behavioral health community through the 

implementation of health reform. Vulnerable populations, such as individuals who are homeless 

and those with co-occurring mental and substance use disorders and those with serious mental 

illness, continue to shape SAMHSA’s educational activities as well as its outreach, eligibility, 

and enrollment efforts. Simultaneously, efforts to increase primary and behavioral health care 

integration will expand, including specific technical assistance for tribes. 

As highlighted by Congress in FY 2012, the behavioral health workforce faces significant 

shortages with tens of thousands of new providers needed in order to maintain current service 

levels. 

Business practices and enrollment: SAMHSA has invested significant time and resources in the 

behavioral health provider system to update business practices while leveraging resources to 

provide technical assistance and innovative collaborations. SAMHSA also has embedded health 

reform readiness activities regarding enrollment and billing into existing grants and initiatives. 

The FY 2014/2015 block grant applications have been revised, a new grants management tool 

has been launched, and SAMHSA project officer training continues. In addition, the FY 2015 

Leading Change 2.0 Strategy will enable states to further build capacity of their workforce to 

manage in an insurance marketplace environment.
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Primary care/substance abuse treatment integration: Building on past behavioral health 

integration efforts, SAMHSA is making a major investment in the bi-directional integration of 

substance abuse treatment services and primary care. The Primary Care and Addiction Services 

Integration (PCASI) grant program will address service coordination and infrastructure needs at 

the provider level.

Block grants: The block grant programs remain the cornerstones of SAMHSA’s portfolio for 

implementation of health reform in FY 2015. The budget fully funds the Community Mental 

Health Services Block Grant (MHBG) and the Substance Abuse Prevention and Treatment Block 

Grant (SABG) to support states in an effective transition to full implementation of the Affordable 

Care Act, which includes expanded coverage for mental health and substance abuse treatment 

services.

The FY 2015 Budget Request prioritizes essential health reform activities to ensure individuals 

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

coverage. Additionally, SAMHSA stands ready to assist with critical issues related to health 

care insurance and behavioral health coverage. The MHBG includes a set-aside dedicated to 

early intervention for the most serious mental illnesses.

Trauma and Justice 

Grants for Adult Trauma Screening and Brief Intervention remain a high priority in FY 2015. 

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

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

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

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

violence and abuse. The National Child Traumatic Stress Initiative and Drug Court grant 

programs are close to level-funded with the FY 2014 enacted level and SAMHSA maintains its 

strong partnership with the Administration for Children and Families and CMS to address the

HHS High-Priority Goal on improving trauma services for children and youth in child welfare.

Recovery Support 

Building on lessons learned from the early iterations of the Cooperative Agreements to Benefit 

Homeless Individuals (CABHI) program, SAMHSA will continue this program designed to work 

with state and local Public Housing Authorities and state Medicaid agencies to develop 

systematic, cost-effective, and integrated approaches to housing that includes treatment and 

services for mental and substance use disorders. The program will support innovative strategies 

to provide needed services and supports that will help integrate individuals who experience 

homelessness with mental and substance use disorders into the community, assist providers in 

strengthening their infrastructure for delivering and sustaining housing to support recovery with 

integrated behavioral health and other critical services. 

SAMHSA is also proposing to award a new cohort of Mental Health Transformation Grants 

(MHTG). The purpose of the MHTG grant program is to foster adoption and implementation of 
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permanent transformative changes in how public mental health services are organized, managed 

and delivered so that they are consumer-driven, recovery-oriented and supported through 

evidence-based and best practices. The new grants will expand service capacity to address the 

need for crisis support and response services for adults with serious mental illness (SMI) or 

children/youth with serious emotional disturbance (SED).

Health Information Technology 

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

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

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

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

Documents that fully and appropriately integrate behavioral health data.

 

Promoting widespread implementation of Health Information Technology (HIT) systems that 

support quality, integrated behavioral health care is currently one of SAMHSA’s strategic 

initiatives. HIT has the potential to transform the healthcare system by improving the quality of 

care delivery, supporting patient engagement and self-management, improving the efficiency of 

the workforce, and expanding access to care. In FY 2011-12 SAMHSA provided supplemental 

funding to the Primary Behavioral Health Care Integration (PBHCI) program to help 47 grantees 

become meaningful users of electronic health record (EHR) technology. Ninety-three percent of 

these grantees successfully implemented a certified EHR system in 2012 and this technology 

continues to support the integration of primary and behavioral healthcare in these programs. Due 

to the success of the PBHCI HIT supplemental program we are requesting additional funding for 

the TCE program in FY 2015 to fund a similar HIT initiative among the Primary Care and 

Addiction Services Integration (PCASI) Program grantees. This supplemental funding will 

support the adoption and meaningful use of certified EHR technology which will facilitate the 

integration of care for patients in substance abuse treatment.

Program Increases:

Primary Care and Addiction Services Integration (PCASI) (+$20.0 million)

SAMHSA is requesting $20.0 million to support the development of a new initiative related to 

the bi-directional integration of substance abuse treatment services and primary care. The 

PCASI program will enable providers to offer a full array of both physical health and substance 

abuse services to clients. Through this program, integrated teams of professionals will be able to 

provide needed primary care services to individuals seeking care for their substance use disorder. 

In addition, healthcare providers will enhance their capacity to address substance abuse problems 

in the primary care setting beyond screening and referral. Grantees will establish strong 

partnerships between specialty substance abuse treatment providers and local community health 

centers. Some portion of the PCASI funds will be braided with MAI HIV funds to advance the 

integration of primary care, substance abuse treatment, and HIV services for critical populations 

in the HIV Continuum of Care grant program.
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TCE-General (+$2.0 million)

The FY 2015 request for TCE-General is $15.3 million. This is an increase of $2.0 million

above the FY 2014 Enacted Level. With the success of the PBHCI HIT supplemental program, 

SAMHSA requests an additional $2.0 million in funding for the TCE program in FY 2015 to 

fund the Behavioral Health Information Privacy Center of Excellence. The Center of Excellence 

will provide coordinated technical assistance to provider organizations, HIEs, states, consumers, 

and vendors to support integration of behavioral health and general healthcare through health 

information exchange. 

Now is the Time Initiative (+$14.7 million)

The FY 2015 request for Agency-Wide Initiatives is $130.0 million. This is an increase of $14.7

million above the FY 2014 Enacted Level. The increase will support three new activities: the 

Science of Changing Social Norms: Building the Evidence Base and Social Media ($4.0 million) 

to improve the attitudes, understanding and behavior of Americans about mental and substance 

use disorders; Peer Professionals ($10.0 million) to strengthen the behavioral health workforce 

by increasing the number of trained peers, recovery coaches, mental health/addiction specialists, 

prevention specialists, and pre-Master’s level addiction counselors working with an emphasis on 

youth ages 16-25; and Behavioral Health Workforce Data and Development ($1.0 million) to 

develop a consistent data set to define and track the behavioral health workforce, a capacity 

which does not currently exist. This increase is offset by a $0.3 million decrease in the Minority 

Fellowship Program expansion activities. 

Strategic Prevention Framework (+$10.0 million)

SAMHSA is requesting $10.0 million for a new program, Prescription Drug Abuse and 

Overdose Prevention (SPF Rx) that will provide funding for the prevention of prescription drug 

misuse and abuse in high priority age groups (including young and middle-aged adults) and 

populations through education and other prevention strategies. SAMHSA will be partnering 

with NIDA to further develop the evidence base to support these efforts. Funding will also be 

used to provide technical assistance and evaluation, and to expand work with the Office of the 

National Coordinator of Health Information Technology (ONC) on standards alignment on 

interoperability among state PDMPs and electronic health records (EHRs)/health information 

exchanges (HIEs) and/or any other technology efforts determined necessary for the exchange of 

data.

Grants for Adult Treatment, Screening, and Brief Intervention (GATSBI) (+$2.9 million)

SAMHSA requests to implement a new program line, Grants for Adult Trauma Screening and 

Brief Intervention in FY 2015. This request is $2.9 million to advance the knowledge base to 

address trauma in common health care settings, such as emergency departments, primary care, 

and OB/GYN. The concept and design for these grants will be developed by SAMHSA in 

consultation with its federal partners: ACF, CDC, NIAAA, NIDA, NIMH, and VA. An 

estimated four grants will be awarded with up to $600,000 per year for five years.

Suicide Prevention – National Strategy on Suicide Prevention (NSSP) (+$2.0 million)

The FY 2015 request for Suicide Prevention – National Strategy on Suicide Prevention (NSSP) 

is $4.0 million, an increase of $2.0 million above the FY 2014 Enacted Level. The funding 

assists states in further establishing evidence-based suicide prevention efforts that support the 
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goals and objectives of the NSSP. The requested $4.0 million will directly support the 

recommendations of the National Strategy released in September of 2012 and allow for a more 

complete implementation of the NSSP, including elements not addressed in any other national 

initiatives. The funding will develop and test nationwide efforts such as suicide awareness 

messaging, provider credentialing changes, emergency room referral processes, clinical care 

practice standards, practitioner training regarding depression and suicide screening techniques, 

and technical assistance for those community human services and health workers most likely to 

encounter individuals thinking about suicide. The request will support the continuation of this 

program.

Disaster Response (+$1.0 million)

The FY 2015 request for Disaster Response is $2.95 million. This is an increase of $1.0 million 

above the FY 2014 Enacted Level to continue the support of a nationally available disaster 

distress crisis counseling telephone line through a connection to local crisis lines throughout the 

country.

Minority AIDS Initiative (MAI) for Mental Health (+$7 million offset by a decrease)

The FY 2015 request for Minority AIDS is $16.3 million. This is an increase of $7.0 million 

above the FY 2014 Enacted Level which is offset by a shift between MAI AIDS programs with 

an decrease in Minority AIDS Substance Abuse Treatment. SAMHSA plans to pilot in 2014

HIV Continuum of Care grants. In FY 2015, HIV Continuum of Care will also include braided 

funding from MAI, PBHCI and PCASI.

Program Decreases:

Access to Recovery (-$50.0 million)

SAMHSA is proposing eliminating the Access to Recovery (ATR) program in FY 2015. Many 

of the clinical services provided under ATR will now be covered by public and private insurance. 

In addition, states have been encouraged to support recovery support services and client choice 

with SABG funding. States that would like to continue this activity will have support from 

SAMHSA in FY 2014 in incorporating lessons learned from the successful test.

Primary and Behavioral Health Care Integration (PBHCI) (-$24.0 million)

The FY 2015 request for PBHCI is $28.0 million, a decrease of $24.0 million below the FY 2014 

Enacted Level. The request will continue to support integrated services between primary care 

services and mental health services and facilitate screening and referral for necessary primary 

care prevention and treatment needs. Some portion of the remaining PBHCI funds will be 

braided with MAI HIV funds to advance the integration of primary care, mental health services, 

and HIV services for critical populations in the HIV Continuum of Care grant program.

Screening, Brief Intervention and Referral to Treatment (SBIRT) (-$17.0 million)

The FY 2015 request for SBIRT is $30.0 million; all funded from PHS Evaluation Funds. This 

is a decrease of $17.0 million below the FY 2014 Enacted Level. SAMHSA strategically multiyear funded its 10 grants for $18.4 million in FY 2014.
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Criminal Justice Activities (-$10.6 million)

The FY 2015 request for Criminal Justice Activities is $64.4 million. This is a decrease of $10.6 

million below the FY 2014 Enacted Level. While funding for this program is reduced in FY 

2015, this level will allow the continuations for 121 grants and fund 57 new grants.

Suicide Prevention Programs (-$10.1 million)

The FY 2015 request for Suicide Prevention Programs is $50.0 million. This is a total decrease 

of $10.1 million below the FY 2014 Enacted Level. These reductions include: $7.8 million 

from GLS – Youth Suicide Prevention – States, $1.5 million from GLS – Youth Suicide 

Prevention – Campus, $1.1 million from GLS-Suicide Prevention Resource Center, and $1.7 

million from Suicide Lifeline. With an offsetting increase of $2.0 million for National Strategy 

on Suicide Prevention, this results in a net reduction of $10.1 million in Suicide Programs. 

This request will continue to support selected state planning evidence-based suicide prevention 

efforts to support the goals and objectives of the National Strategy for Suicide Prevention. 

Minority AIDS Initiative (MAI) for Substance Abuse Treatment (-$6.9 million)

The FY 2015 request for Minority AIDS is $58.9 million. This is a decrease of $6.9 million 

below the FY 2014 Enacted Level in CSAT which is offset by a shift between MAI AIDS 

programs with an increase in Mental Health. This shift will support HIV Continuum of Care 

grants and enable the full participation of each center. In 2015, HIV Continuum of Care will 

also include braided funding from MAI, PBHCI, and PCASI.
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Overview of Performance

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

related legislation, SAMHSA uses performance and evaluation data to demonstrate impact. 

SAMHSA reduces the impact of substance abuse and mental illness in United States’ 

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

SAMHSA promotes the health of the U.S. population by helping those with mental and 

substance use disorders while also supporting their families, building strong and supportive 

communities, and preventing costly behavioral health problems.

SAMHSA promotes efficient and effective government by defining clear roles and

responsibilities, setting ambitious goals and targets, using data to review progress, coordinating 

across groups, and emphasizing the use of evidence to support decisions. This aids in the 

analysis and feedback of data in ways that contribute to improved outcomes, such as Center 

Performance Review Boards and similar initiatives based on the grantee continuation process. 

Despite the challenges posed during times of fiscal restraint, SAMHSA demonstrated progress in 

each of its Strategic Initiatives (SIs) during FY 2013, including prevention of substance abuse 

and mental health (http://beta.samhsa.gov/about-us/strategic-initiatives). Each SI has specific 

action steps that link SAMHSA’s programs to the current Department of Health and Human 

Services (HHS) budget (http://www.hhs.gov/budget/) as well as linking to HHS performance 

priorities (http://goals.performance.gov/agency/hhs). Examples of progress include an ongoing 

decrease in the percentage of middle and high school students who report current substance 

abuse as well as over a million suicide and crisis prevention calls answered through a network of 

hotlines operating nationally, day and night. 

Within the FY 2014 HHS Annual Performance Report and Performance Plan, 

(http://www.hhs.gov/budget/fy2014/opa_040513.pdf), the services SAMHSA provides to diverse 

populations were highlighted, including increasing the percentage of homeless clients in 

substance abuse treatment who secured a permanent place to live in the community. During FY 

2013, SAMHSA also continued to participate in an HHS Priority Goal to reduce cigarette 

smoking, a department-wide effort to increase the percentage of children receiving trauma 

informed services, and responded to urgent situations across the Country, such as hurricane 

relief. During FY 2013, SAMHSA also participated in HHS’ response to 62 federally declared 

major disasters, including severe thunderstorm outbreaks, tornados, two hurricanes, a drought,

and wildfires.

Data-Driven Performance Management

SAMHSA uses a data-driven performance management approach to foster ongoing 

improvements that achieve measurable impact within a reasonable time period. SAMHSA is 

developing a common data platform designed to streamline performance reporting and 

management, validate data quality, and promote evidence-based decision-making. Performance 

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

Health Quality Framework (NBHQF), which helps to integrate performance and evaluation 
14

results with the best available evidence. The NBHQF facilitates communication with federal 

partners, states, networks, and non-governmental groups. 

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

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

funding directed to drug control efforts, as reflected in the National Drug Control Budget, FY 

2014 Funding Highlights, released April, 2013 (http://www.whitehouse.gov/

sites/default/files/ondcp/policy-and-research/fy_2014_drug_control_budget_highlights_3.pdf). 

Since a wide array of SAMHSA’s funding supports drug control efforts (including awards 

directly to providers), several programs focus on advancement of treatment methods and services 

to targeted groups, including those served by SAMHSA’s Substance Abuse Prevention and 

Treatment Block Grant (SABG). This formula‐based funding is especially important during 

times of fiscal restraint for states since it fosters expansion of substance abuse treatment services, 

while providing maximum flexibility. For example, SAMHSA grants support the delivery of 

treatment while also allowing states to access funding for prevention services. 

As areas of key importance, such as child trauma, continue to be emphasized, SAMHSA assures 

that the knowledge, infrastructure, and capacity are available to contribute to the health care 

reform activities associated with the Affordable Care Act. These efforts facilitate health care 

reform while also advancing the nation’s behavioral health. 
15

Discretionary All-Purpose Table

Substance Abuse and Mental Health Services Administration

(Dollars in Thousands)

FY 2013 FY 2014 FY 2015 FY 2015

Final Enacted President's 

Budget

+/-

FY 2014

Now is the Time Presidential Initiatives

Mental Health: 

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

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

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

Healthy Transitions.......................................................................................................... --- 20,000 20,000 ---

Health Surveillance and Program Support:

Health Surveillance.......................................................................................................... --- --- 2,000 +2,000

Science of Changing Social Norms : Building the Evidence Base (non-add). --- --- 2,000 +2,000

Public Awareness and Support....................................................................................... --- --- 2,000 +2,000

Science of Changing Social Norms: Social Media (non-add)............................ --- --- 2,000 +2,000

Behavioral Health Workforce........................................................................................ --- 40,259 51,000 +10,741

Minority Fellowship Program Expansion (non-add)........................................... --- 5,259 5,000 -259

SAMHSA-HRSA BHWET Grant Program (non-add)............................................. --- 35,000 35,000 ---

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

Behavioral Health Workforce Data and Development (non-add)..................... --- --- 1,000 +1,000

TOTAL 1/ (information only -- amounts included below) --- 115,259 130,000 +14,741

Mental Health: 

Programs of Regional and National Significance........................................................... 266,509 378,216 354,740 -23,476

Prevention and Public Health Fund (non-add)....................................................... --- 12,000 38,000 +26,000

PHS Evaluation Funds (non-add)............................................................................... --- --- 5,000 +5,000

Children's Mental Health Services.................................................................................... 111,430 117,315 117,315 ---

Projects for Assistance in Transition from Homelessness........................................... 61,405 64,794 64,794 ---

Protection and Advocacy for Individuals with Mental Illness.................................... 34,343 36,238 36,238 ---

Community Mental Health Services Block Grant........................................................... 436,809 483,744 483,744 ---

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

Total, Mental Health .......................................................................................................... 910,496 1,080,307 1,056,831 -23,476

Substance Abuse Prevention: 

Programs of Regional and National Significance........................................................... 175,513 175,560 185,560 +10,000

Strategic Prevention Framework Rx (non-add)....................................................... --- --- 10,000 +10,000

PHS Evaluation Funds (non-add)............................................................................... --- --- 16,468 +16,468

Total, Substance Abuse Prevention................................................................................. 175,513 175,560 185,560 +10,000

Substance Abuse Treatment: 

Programs of Regional and National Significance........................................................... 404,085 361,460 297,400 -64,060

Prevention and Public Health Fund (non-add)....................................................... --- 50,000 --- -50,000

PHS Evaluation Funds (non-add)............................................................................... 2,000 2,000 30,000 +28,000

Substance Abuse Prevention and Treatment Block Grant........................................... 1,710,306 1,819,856 1,819,856 ---

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

Total, Substance Abuse Treatment................................................................................. 2,114,392 2,181,316 2,117,256 -64,060

Health Surveillance and Program Support:

Health Surveillance and Program Support:...................................................................... 123,419 120,157 122,157 +2,000

Prevention and Public Health Fund (non-add)....................................................... 14,733 --- 20,000 +20,000

PHS Evaluation Funds (non-add)............................................................................... 27,428 30,428 29,428 -1,000

Public Awareness and Support......................................................................................... 13,545 13,571 15,571 +2,000

PHS Evaluation Funds (non-add)............................................................................... --- --- 15,571 +15,571

Performance and Quality Information Systems.............................................................. 8,803 12,996 12,996 ---

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

Agency-Wide Initiatives 2/ .............................................................................................. 8,293 45,695 56,000 +10,305

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

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

Total, Health Surveillance/Program Support............................................................... 154,061 193,919 208,224 +14,305

TOTAL, SAMHSA Discretionary PL............................................................................. 3,354,461 3,631,102 3,567,871 -63,231

Less PHS Evaluation Funds............................................................................................. 129,667 132,667 210,702 +78,035

Less Prevention and Public Health Funds.................................................................... 14,733 62,000 58,000 -4,000

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

TOTAL, SAMHSA Budget Authority............................................................................. $3,210,061 $3,434,935 $3,297,669 -$137,266

FTEs 608 655 655 ---

*Totals may not add due to rounding.

2/ The Minority Fellowship Program budgets from the Mental Health, Substance Abuse Prevention and Treatment appropriations have been comparable 

adjusted in this table to be in line with the FY 2015 Request and are reflected in the Health Surveillance and Program Support Appropriation under the 

Agency-Wide Initiatives Workforce program.

1/ A total of $115 million has been enacted in FY 2014 and $130 million is requested in FY 2015 to address the behavioral health needs of transition age youth 

and their families in the wake of the Newtown, Connecticut tragedy at Sandy Hook Elementary School.

Program Activities
16

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17

Summary of Change

SAMHSA

The SAMHSA FY 2015 Budget Request for its Total Program Level is $3.6 billion, a decrease 

of $63.2 million from the FY 2014 Enacted Level. The FY 2015 Total Program Level of $3.6 

billion includes $3.3 billion in Budget Authority (a decrease of $137.3 million below the FY 

2014 Enacted Level), $210.7 million in PHS Evaluation Funds (an increase of $78.0 million 

above the FY 2014 Enacted Level), and $58.0 million in Prevention and Public Health Fund 

resources (a decrease of $4.0 million below the FY 2014 Enacted Level). The budget continues 

to reflect $1.5 million for user fees for extraordinary data and publication requests. The FY 2015 

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

Appropriations Act and the FY 2014 Enacted Level: (1) Mental Health, (2) Substance Abuse 

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

FY 2015

Request

HIV Continuum of Care $24,000

Mental Health: Primary and Behavioral Health Care Integration (non-add)...................... 3,000

Mental Health: Minority AIDS Initiative (non-add)............................................................. 6,500

Substance Abuse Prevention: Minority AIDS Initiative (non-add)....................................... 3,000

Substance Abuse Treatment: Minority AIDS Initiative (non-add)......................................... 6,500

Substance Abuse Treatment: Primary Care and Addiction Services Integration (non-add).. 5,000

Building Behavioral Health Coalitions $3,000

Mental Health: MH System Transformation and Health Reform (non-add)......................... 1,500

Substance Abuse Prevention: Strategic Prevention Framework (non-add).......................... 1,500

Housing and Homelessness $14,763

Mental Health: Homelessness Prevention Program (non-add)............................................. 5,992

Substance Abuse Treatment: Treatment Systems for Homeless (non-add)............................ 8,771

Braided Programs 

The FY 2015 Budget Request includes three new braided programs that draws on funds across 

the Mental Health, Substance Abuse Prevention and Substance Abuse Treatment appropriations. 

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

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

 $24 million, including $9.5 million from the Mental Health Appropriation (Primary and 

Behavioral Health Care Integration and Minority Aids Initiative), $3 million from the 

Substance Abuse Prevention Appropriation (Minority Aids Initiative), and $11.5 million 

from the Substance Abuse Treatment Appropriation (Minority Aids Initiative and Primary 

Care and Addiction Services Integration) to establishing integrated behavioral health and 

HIV care in addition to primary care needed by those living with or at high risk for HIV 

infection in minority communities heavily impacted by HIV. This program will be based on a 

pilot effort in 2014, which also includes a substance abuse prevention component. Please 

refer to HIV Continuum of Care in the Additional Item chapter.
18

 $3 million, including $1.5 million from the Mental Health appropriation (MH System 

Transformation and Health Reform) and $1.5 million from the Substance Abuse Prevention 

appropriation (Strategic Prevention Framework) to establish the Building Behavioral Health 

Coalitions program. Coalitions are ready to expand their focus and activities to include a 

mental health promotion, mental illness prevention, and substance abuse prevention. 

Funding streams will be kept separate and used for activities consistent with separate funding 

authorities.

 $14.7 million, including $6 million from the Mental Health appropriation (Homelessness 

Prevention Program) and $8.7 million from the Substance Abuse Treatment appropriation 

(Treatment Systems for Homeless) to support approximately 15 grants at $750,000 per year 

to build on lessons learned from the CABHI program and the proposed FY 2015 program.
19

Mental Health Appropriation

The Mental Health appropriation request is $1.057 billion, a decrease of $23.5 million from the 

FY 2014 Enacted Level. The request includes $992.8 million in Budget Authority (a decrease of 

$54.5 million from the FY 2014 Enacted Level), $26 million in PHS Evaluation Funds (an 

increase of $5 million from the FY 2014 Enacted Level), and $38 million in Prevention and 

Public Health Fund resources (an increase of $26 million from the FY 2014 Enacted Level). The 

following mental health priorities are requested: 

 $354.7 million for Programs of Regional and National Significance (PRNS) which 

represents a $23.5 million decrease below the FY 2014 Enacted Level and will support 

the following key PRNS programs: 

o $75 million for Now is the Time initiative which includes $55 million for Project 

AWARE and $20 million for Healthy Transitions.

o $50 million for Suicide Prevention programs, which is $10.1 million below the 

FY 2014 Enacted Level. These reductions include: $7.8 million from GLS –

Youth Suicide Prevention – States, $1.5 million from GLS – Youth Suicide 

Prevention – Campus, $1.1 million from GLS-Suicide Prevention Resource 

Center, and $1.7 million from Suicide Lifeline. With an offsetting increase of $2 

million for National Strategy on Suicide Prevention, this results in a net reduction 

of $10.1 million in Suicide Programs.

o $45.7 million for the National Child Traumatic Stress Initiative, which is $0.3 

million below the FY 2014 Enacted Level, to develop and promote effective 

community practices for children and families exposed to traumatic events.

o $28 million for Primary and Behavioral Health Care Integration (PBHCI) and 

PBHCI Training and Technical Assistance, which is $24 million below the FY 

2014 Enacted Level.

o $16.3 million for Minority AIDS, which is $7 million above the FY 2014 Enacted 

Level, which is offset by a shift between MAI AIDS program in Treatment. 

SAMHSA plans to jointly award a new cohort of HIV Continuum of Care grants.

o $3 million for Disaster Response, which is $1 million above the FY 2014 Enacted 

Level to continue the support of a nationally available disaster distress crisis 

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

country.

o $2.9 million for Grants for Adult Treatment, Screening and Brief Intervention to 

implement a new program line to advance the knowledge base to address trauma 

in common health care settings, such as emergency departments, primary care, 

and OB/GYN.
20

o $133.8 million for all other PRNS programs, including Youth Violence 

Prevention $23.2 million, Children and Family Programs $6.5 million, Consumer 

and Family Network Grants $5 million, Project LAUNCH $34.6 million, MH 

System Transformation and Health Reform $10.6 million (of which, $1.5 million 

is braided with CSAP), Homelessness Prevention Programs $30.8 million (of 

which, $6.3 million is braided with CSAT), Criminal and Juvenile Justice 

Programs $4.3 million, Practice Improvement and Training $7.8 million, 

Consumer and Consumer Support TA Centers $1.9 million, Homelessness $2.3 

million, HIV/AIDS Education $0.773 million, Seclusion and Restraint and 

Trauma $1.1 million, and Tribal Behavioral Health Grants $5 million.

 $117.3 million for Children’s Mental Health Services, which is the same as the FY 2014 

Enacted Level, to support the development of comprehensive, community-based systems 

of care. 

 $64.8 million for Programs for Assistance in Transition from Homelessness (PATH) 

Homeless Formula Grants, which is the same as the FY 2014 Enacted Level, to continue 

to address critical behavioral health needs of individuals with serious mental illness 

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

risk for homelessness.

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

which is the same as the FY 2014 Enacted Level, to support state and territorial 

protection and advocacy systems for individuals with serious mental illness. 

 $483.7 million for the Community Mental Health Services Block Grant (MHBG), which 

is the same as the FY 2014 Enacted Level. The request includes a five percent set aside 

to focus on evidence-based practices to address the needs of individuals with early 

serious mental illness.
21

Substance Abuse Prevention Appropriation

The Substance Abuse Prevention appropriation request is $185.6 million, an increase of $10 

million above the FY 2014 Enacted Level. The request includes $169.1 million in Budget 

Authority (a decrease of $6.5 million below the FY 2014 Enacted Level), and $16.5 million in 

PHS Evaluation Funds (an increase of $16.5 million from the FY 2014 Enacted Level). The 

following substance abuse prevention priorities are requested: 

 

 $185.6 million, for Programs of Regional and National Significance (PRNS) which 

represents a $10 million increase above the FY 2014 Enacted Level and will support the 

following programs: 

o $119.8 million for Strategic Prevention Framework (SPF), which is an increase of 

$10 million above the FY 2014 Enacted Level. A new program, SPF Rx will 

support the Secretary’s comprehensive plan to prevent prescription drug abuse 

and opioid-related overdose deaths.

o $65.8 million for all other PRNS programs, maintaining the FY 2014 Enacted 

Level including, Mandatory Drug testing $4.9 million, Minority AIDS $41.3 

million, Sober Truth on Preventing Underage Drinking (STOP) $7 million, Fetal 

Alcohol Spectrum Disorder $1 million, Center for the Application of Prevention 

Technologies (CAPT) $7.5 million, and Science and Service Program 

Coordination $4.1 million. 
22

Substance Abuse Treatment Appropriation

The Substance Abuse Treatment appropriation request is $2.117 billion, a decrease of $64.1

million below the FY 2014 Enacted Level. The request includes $2.008 billion in Budget 

Authority (a decrease of $42 million below the FY 2014 Enacted Level), and $109.2 million in 

PHS Evaluation Funds (an increase of $28 million above the FY 2014 Enacted Level) and a 

decrease of $50 million from Prevention and Public Health Funds. The following substance 

abuse treatment priorities are requested: 

 $297.4 million for Programs of Regional and National Significance (PRNS) which 

represents a $64 million decrease below the FY 2014 Enacted Level and will support the 

following key PRNS programs: 

o $64.4 million for Criminal Justice Activities, which is a decrease of $10.6 million 

from the FY 2014 Enacted Level, to continue activities that focus on diversion, 

alternatives to incarceration, and re-entry from incarceration for adolescents and 

adults with substance use disorders, and/or co-occurring substance use and mental 

disorders. 

o $58.9 million for Minority AIDS, which is a decrease of $6.9 million from the FY 

2014 Enacted Level, which is offset by a shift between MAI AIDS program in 

Mental Health.

o $30 million for Screening, Brief Intervention and Referral to Treatment (SBIRT), 

which is a decrease of $17 million below the FY 2014 Enacted Level and is 

funded with PHS Evaluation Funds instead of Budget Authority.

o $20 million for Primary Care and Addiction Services Integration (PCASI), a new 

request in 2015. PCASI will enable community providers to implement primary 

care and substance abuse treatment integration. 

o $15.3 million for TCE-General, which is an increase of $2 million above the FY 

2014 Enacted Level. Funding will go toward the implementation of Health 

Information Technology to support PCASI. 

o $8.1 million for Addiction Technology Transfer Centers, which is a decrease of 

$1 million from the FY 2014 Enacted Level to support national activities in 

response to regional needs by implementing evidence-based practices and 

supporting interventions by front-line clinicians.

o $1 million for Strengthening Treatment Access and Retention (STAR), which is a 

decrease of $0.7 million from the FY 2014 Enacted Level. Funding will improve 

treatment access and retention of clients in treatment though the use of process 

improvement to ensure effective business operation practices.
23

o The elimination of Access to Recovery, which is a decrease of $50.0 million from 

the FY 2014 Enacted Level. Grants will be multi-year funded in FY 2014 for this 

program to support FY 2015 continuation activity. This program will be

eliminated in FY 2015 as many of the clinical services provided under ATR will 

now be covered by public and private insurance. In addition, states have been 

encouraged to support recovery support services and client choice with SABG 

funding. States that would like to continue this activity will have support from 

SAMHSA in FY 2014 in incorporating lessons learned from the successful test.

o $99.7 million in all other PRNS programs remain the same as the FY 2014 

Enacted Level including, Opioid Treatment $8.7 million, Pregnant and 

Postpartum Women $16 million, Recovery Community Services Program $2.4 

million, Children and Families $29.7 million, Treatment Systems for Homeless 

$41.5 million, and Special Initiatives/Outreach $1.4 million. 

 $1.8 billion for SABG, which is level funded from the FY 2014 Enacted Level. With

many of the clinical services provided under ATR now covered by public and private 

insurance, SAMHSA is proposing eliminating the ATR program in the FY 2015 budget.
24

Health Surveillance and Program Support

The Health Surveillance and Program Support appropriation request is $208.2 million, an 

increase of $14.3 million above the FY 2014 Enacted Level. The request includes $127.7 million 

in Budget Authority (a decrease of $34.3 million below the FY 2014 Enacted Level), $59 million 

in PHS Evaluation Funds (an increase of $28.6 million above the FY 2014 Enacted Level), and 

$20 million in Prevention and Public Health Fund resources (an increase of $20 million above 

the FY 2014 Enacted Level). In addition, the request includes $1.5 million for Data Request and 

Publications User Fees. The following are key priorities: 

The Health Surveillance and Program Support budget supports four activities consistent with the 

2014 Enacted Level: Health Surveillance, Program Support, Performance and Quality 

Information Systems, Public Awareness and Support, and Agency-Wide Initiatives. 

 $122.1 million for Health Surveillance and Program Support, which is $2 million above 

the FY 2014 Enacted Level. This includes:

o $49.4 million for Health Surveillance, which is an increase of $2 million above 

the FY 2014 Enacted Level and builds on the President’s effort to increase 

understanding about mental health through Now is the Time initiative. Funds 

will support work begun by the White House Conference on Mental Health 

through the collection and use of data to demonstrate evidence for effecting 

behavioral change at the individual, community and population levels. 

o $72.7 million for Program Support, which is the same as the FY 2014 Enacted 

Level. Funding supports administrative and operational costs related to the 

relocation of the Agency to a new building. 

 $15.6 million for Public Awareness and Support, which is an increase of $2.0 million 

above the FY 2014 Enacted Level, builds on the effort to increase understanding about 

mental health through Now is the Time initiative. This increase will be used to support 

the work begun by the White House Conference on Mental Health, supporting the 

collection and use of data to learn if what and how we are communicating is making a 

positive difference.

 

 $13 million for Performance and Quality Information Systems, which is level funded 

from FY 2014 Enacted Level, to continue to support for National Registry of EvidenceBased Programs and Practices (NREPP) and Common Data Platform (CDP). 

 $56 million for Agency-Wide Initiatives, which is an increase of $10.3 million above the 

FY 2014 Enacted Level. This includes:

o $56 million for Behavioral Health Workforce, a net increase of $10.3 million 

above the FY 2014 Enacted Level to fund the Behavioral Health Workforce. 
25

 $5 million for MFP core activities which is a decrease of $0.7 million 

below the FY 2014 Enacted Level. Funding provides services to support 

minority communities through specialized training of mental health 

professionals in psychiatry, nursing, social work, and psychology. 

 $51 million for Now is the Time initiative, which is $10.7 million above 

FY 2014 Enacted Level, and includes: $5 million for MFP- Youth, $10.0 

million for Peer Professionals, $35 million for Behavioral Health 

Workforce Education and Training (BHWET), and $1.0 million 

Behavioral Health Workforce Data and Development. 

 $1.5 million for Data Request and Publication User Fees, which is level funded from FY 

2014 Enacted Level. Fees will be collected and retained for extraordinary data and 

publications requests.
26

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27

NOW IS THE TIME

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

and increasing access to mental health services.

(Dollars in thousands)

FY 2013 FY 2014 FY 2015 FY 2015

Final Enacted President's 

Budget

+/-

FY 2014

Now is the Time Presidential Initiatives

Mental Health: 

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

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

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

Healthy Transitions............................................................................................................. --- 20,000 20,000 ---

Health Surveillance and Program Support:

Health Surveillance............................................................................................................. --- --- 2,000 +2,000

Science of Changing Social Norms : Building the Evidence Base (non-add)... --- --- 2,000 +2,000

Public Awareness and Support......................................................................................... --- --- 2,000 +2,000

Science of Changing Social Norms: Social Media (non-add).............................. --- --- 2,000 +2,000

Behavioral Health Workforce.......................................................................................... --- 40,259 51,000 +10,741

Minority Fellowship Program Expansion (non-add)............................................. --- 5,259 5,000 -259

SAMHSA-HRSA BHWET Grant Program (non-add)............................................... --- 35,000 35,000 ---

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

Behavioral Health Workforce Data and Development (non-add)........................ --- --- 1,000 +1,000

TOTAL $--- $115,259 $130,000 +$14,741

Program Activities

The FY 2015 Budget Request reflects a continued commitment to the President’s, Now is the 

Time initiative1to increase access to mental health services. The FY 2015 Budget includes a 

total of $130 million including $115 million of funding for activities begun in FY 2014 to help 

teachers recognize signs of mental illness in students, improve referrals and access to mental 

health services for young people ages 16-25, and help train approximately 5,000 more mental 

health professionals with a focus on serving students and young adults. The Budget Request

includes increases of $15 million in funding for:

 $10 million in funding is requested for Peer Professionals which will provide support to 

strengthen the behavioral health workforce by increasing the number of trained peers,

recovery coaches, mental health/addiction specialists, prevention specialists, and preMaster’s level addiction counselors working with an emphasis on youth ages 16-25. 

 $4 million in funding is requested in the HSPS appropriation to develop and test an array 

of messages and media to change the attitudes, understanding and behavior of Americans 

about mental and substance use disorders and willingness to seek help for them. 

 $1 million for the Behavioral Health Workforce Data and Development component of 

Now is the Time initiative that will focus on supporting clinical internships and field 

placements, and certificate program completion across a range of professional and 

paraprofessional disciplines (some of whom may be peers) to produce a ready cohort of 

new behavioral health providers. This component will be managed by the Center for 

Behavioral Health Statistics and Quality in cooperation with HRSA, based on preliminary 

 

1

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

http://www.whitehouse.gov/issues/preventing-gun-violence
28

work to develop a minimum data set to track the behavioral health workforce across the

country. 

Project AWARE

In response to the tragedy at Sandy Hook Elementary School, in FY 2015, $55 million is 

requested to support Project AWARE, (Advancing Wellness and Resilience in Education) to 

increase awareness of mental health issues and connect young people with behavioral health 

issues and their families with needed services. SAMHSA will partner with the Departments of 

Education and Justice in the development, implementation and management of this initiative to 

maximize coordination and avoid duplication of efforts. This initiative is expected to reach 

750,000 children and youth.

Project AWARE proposes two components: Project AWARE State Grants ($40 million) build 

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

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

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

number of students receiving mental health services. Project AWARE grants will go to 20 State 

Education Authorities (SEAs) and in collaboration with Education and Justice, will promote 

comprehensive, coordinated, and integrated State efforts to make schools safer and increase

access to mental health services. The SEAs will be required to partner with the State Mental 

Health and Law Enforcement agencies to establish Interagency State Management Teams, 

conduct needs assessments, develop a state plan with an evaluation mechanism, and develop the 

mechanisms to coordinate funding, service delivery, systems improvement, and data collection. 

In addition, each SEA will be required to identify three high-need Local Education Authorities 

(LEAs) as pilot communities that will receive sub-awards to implement comprehensive and 

coordinated school safety and mental health programs.

The second component, Mental Health First Aid (MHFA) ($15 million) proposes widespread 

dissemination of the Mental Health First Aid curriculum. MHFA-Youth prepares teachers and 

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

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

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

willing to seek treatment. The Budget proposes that $10 million of the Project AWARE – MHFA

funds support training of teachers and a broad array of actors at the community level, including 

parents, law enforcement, youth and faith-based leaders. The additional $5 million proposed for 

MHFA will continue to support dissemination of MHFA through the 20 Project AWARE SEA 

grants.

Healthy Transitions

The FY 2015 Budget includes $20 million to continue the Healthy Transitions Program, which 

assists 16 to 25 year-olds with mental illnesses and their families in accessing and navigating 

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

mental health conditions are more likely to experience homelessness, be arrested, drop out of 

school and be underemployed. Compared to all other chronic health conditions, mental disorders 

produce the greatest disability impact within this age group. Furthermore, 18-25 year-olds with 
29

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

adults. This new demonstration grant program for states proposes new and creative approaches 

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

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

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

disseminate best practices for services to youth ages 16-25. The $20 million will support fiveyear grants to 16 states as well as new evaluation and technical assistance contracts. An 

estimated 5,900 individuals will be referred to mental health or related services.

Behavioral Health Workforce

The FY 2015 Budget includes the continuation of $40 million for workforce activities to help 

train approximately 5,000 additional professionals to work with students and young adults with 

mental illnesses and other behavioral health problems. The proposal continues $35 million for a 

jointly administered activity with HRSA to expand the Behavioral Health Workforce Education 

and Training (BHWET) Grant Program, and $5 million for the expansion of SAMHSA’s 

Minority Fellowship Program as described below. 

SAMHSA-HRSA Behavioral Health Workforce Education and Training

(BHWET) Grant Program

In FY 2015, SAMHSA will collaborate with HRSA in expanding the Behavioral Health 

Workforce Education and Training (BHWET) Grant Program. This expansion will increase the 

clinical service capacity of the behavioral health workforce by supporting training for Master’s 

level social workers, psychologists, marriage and family therapists, psychology doctoral interns,

as well as behavioral health paraprofessionals. This effort is critical to ensure that the behavioral 

health workforce is able to meet the needs of high need and high demand populations, including 

rural, vulnerable, and underserved populations. In FY 2015, the program will continue to 

include an emphasis on training to address the needs of children, adolescents, and transition-age 

youth (ages 16-25) and their families. SAMHSA requests $35 million in FY 2015 for the 

SAMHSA-HRSA expansion of the BHWET grant program and will help increase the behavioral 

health workforce by 3,500 individuals, in addition to those below.

Minority Fellowship Program Expansion – Youth (MFP-Y) and Addiction Counselors

For FY 2015, the Minority Fellowship Program - Youth (MFP-Y) of $5 million in part provides 

stipends to graduate students to increase the number of culturally competent behavioral health 

professionals who provide direct mental health and/or co-occurring substance abuse services to 

underserved minority populations. MFP-Y would utilize the existing infrastructure of the MFP 

to expand the focus of the program to support master’s level trained behavioral health providers 

in the fields of psychology, social work, professional counseling, marriage and family therapy, 

and nursing. This support would increase the number of providers who are available to provide 

clinical services to underserved, at-risk children, adolescents, and populations transitioning to 

adulthood (ages 16 – 25) in an effort to increase access to and quality of behavioral health 

services for this age group. 
30

In addition, SAMHSA also will continue grants to entities providing training to Master’s level 

addictions counselors. Because these funds are part of the President’s Now is the Time initiative, 

there will be an emphasis on providing clinical services to underserved, at-risk children, 

adolescents, and populations transitioning to adulthood (ages 16 – 25). These grants will 

support graduate student stipends to increase the number of Masters level addiction counselors 

across the nation by approximately 300 counselors. Some portion of the funds will support 

evaluation and technical assistance for these new MFP grantees.

Budget Request

A total of $130 million is requested for Now is the Time initiative, including a $4 million

increase for Science of Changing Social Norms, $10 million increase for Peer Professionals, and 

a $1 million increase for Behavioral Health Workforce Data and Development. These funds will 

be used to continue the work with HRSA to develop, for the first time, a consistent and common 

data set tracking the behavioral health workforce. 

Science of Changing Social Norms

This Budget Request includes $4 million to support a new initiative, the Science of Changing 

Social Norms, to develop and test an array of messages and media designed to improve attitudes, 

understanding and behavior of Americans about mental and substance use disorders and the 

willingness to seek help for them. Building on the effort to increase understanding about mental 

health through the Now is the Time initiative launched on January 16, 2013, this public 

awareness and education initiative will seek to target the message resulting from the national 

conversation about behavioral health most effectively. A total of $2 million in Public Awareness 

and Support funds will employ social media strategies to support the work begun by the White 

House National Conference on Mental Health. The goal is to use communications science and 

market research to identify the most effective and evidence-based methods for decreasing 

negative attitudes, increasing knowledge and improving willingness to seek help for mental 

health and substance abuse problems to ensure outreach funds are spent where they will make 

the most impact. An additional $2 million in Health Surveillance funds will be used in 

conjunction with the Science of Changing Social Norms: Building the Evidence Base in the 

Center for Behavioral Health Statistics and Quality’s which is essential to understand the impact 

of social messaging and demonstrate evidence for effecting change in social norms and behavior 

to reduce negative attitudes and improve people’s willingness to seek help. CBHSQ’s data 

collection component will be funded separately under Health Surveillance and Program Support.

Peer Professionals Workforce Development

In FY 2015, SAMHSA requests $10 million for the Peer Professional Workforce Development 

program which will provide support to strengthen the behavioral health workforce by increasing 

the number of trained peers, recovery coaches, mental health/addiction specialists, prevention 

specialists, and pre-Master’s level addiction counselors working with an emphasis on youth ages 

16-25. Because of their lived experience with behavioral health conditions, and being able to 

build trust and foster connections with individuals accessing care, the entry-level providers 

supported by this program will play a significant role in the delivery of prevention and recovery 
31

support services. SAMHSA plans to award up to 19 grant awards to community colleges or 

community college networks, states, and national organizations. These funds will provide tuition 

support and further establish the capacity of community colleges to develop and sustain 

behavioral health paraprofessional training and education. Funding will increase the behavioral 

health workforce by 1,200 peer professionals.

The Behavioral Health Workforce Education and Training (BHWET) will focus on supporting 

clinical internships and field placements, and certificate program completion across a range of 

professional and paraprofessional disciplines (some of whom may be peers) to produce a ready 

cohort of new behavioral health providers. The Peer Professional Workforce Development 

program focuses exclusively on peers, or people with personal experiences with mental illness 

and/or substance use conditions. Peers may play roles across the spectrum of prevention, 

treatment and recovery/family support. The Peer Professional program will award grants to 

community colleges, community college networks, states, and national organizations in order to 

develop the training infrastructure for peer professionals nationwide. 

Behavioral Health Workforce Data and Development

This Budget Request includes an additional $1 million to support Behavioral Health Workforce 

Data and Development. Beginning in 2014, over 62 million Americans will have expanded or 

first time access to coverage for services for mental and substance use disorders as a result of a 

combination of the Affordable Care Act and the Mental Health Parity and Addictions Equity 

Act. Almost 11 million of these individuals are expected to have mild to severe mental health 

and/or substance abuse conditions with related treatment needs. Current data indicate that almost 

90 percent of persons with substance abuse issues do not receive the services they need and over 

half of those with mental disorders do not receive needed treatment. 

SAMHSA received $40 million in new behavioral health workforce activities in the FY 2014 

Appropriation. This budget assumes continuation of those programs to develop approximately 

5,000 new behavioral health clinical professionals. To ensure the existing workforce 

investments are responsible and well-targeted, SAMHSA’s FY 2015 budget proposes $1 million

to partner with HRSA on the Behavioral Health Minimum Data Set to develop consistent data 

collection methods to identify and track behavioral health workforce needs as well as to partner 

with the Department of Defense, and the Department of Veterans Affairs to inventory existing 

and emerging workforce issues, efforts and impacts, and develop coordinated plans.
32

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33

SAMHSA

Budget Exhibits

Table of Contents

SAMHSA/Budget Exhibits

1. Appropriations Language........................................................................................................ 35

2. Language Analysis.................................................................................................................. 39

3. Amounts Available for Obligation.......................................................................................... 43

4. Summary of Changes.............................................................................................................. 44

5. Budget Authority by Activity ................................................................................................. 45

6. Authorizing Legislation .......................................................................................................... 46

7. Appropriations History ........................................................................................................... 48

8. Appropriations Not Authorized by Law ................................................................................. 50
34

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35

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, [$1,055,347,000]

$992,792,000: 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] $26,039,000 shall be available under section 241 of the PHS Act to

supplement funds otherwise available for mental health activities and to carry out

subpart I of part B of title XIX of the PHS Act to fund section 1920(b) technical assistance,

national data, data collection and evaluation activities, and further that the total available

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

appropriated forsubpart I of part B of title XIX: Provided further, Thatsection 520E(b)(2)

of the PHS Act shall not apply to funds appropriated under this Act for fiscal year [2014]

2015: Provided further, That [of the amount appropriated under this

heading,$46,000,000 shall be for the National Child Traumatic Stress Initiative as described

in section 582 of the PHS Act] 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: Provided further, That States shall expend at least 5 percent of the

amount each receives for carrying out section 1911 of the PHS Act to support evidence-
36

based [programs that] mental health prevention and treatment practices to 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.

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 ofsuch Act with

respect to substance abuse treatment and prevention, [$2,052,661,000] $2,008,056,000:

Provided, That in addition to amounts provided herein, [the following amounts]

$109,200,000 shall be available under section 241 of the PHS Act[: (1) $79,200,000] to

supplement funds otherwise available forsubstance 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.

SUBSTANCE ABUSE PREVENTION

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

[$175,631,000] $169,092,000: Provided, That in addition to amounts provided herein,
37

$16,468,000 shall be available under section 241 of the PHS Act to supplement funds

otherwise available forsubstance abuse prevention activities.

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, [$151,296,000] $127,729,000: Provided, That in addition to

amounts provided herein, [$30,428,000] $58,995,000 shall be available under section 241 of

the PHS Act to supplement funds available to carry out national surveys on drug abuse and

mental health, to collect and analyze program data, and to conduct public aware ness 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) of the PHS

Act shall remain available through September 30, 2016: Provided further, That funds made

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

under the headings "Mental Health'', "Substance Abuse Treatment'', and "Substance Abuse

Prevention'': Provided further, That the Administrator may transfer funds between any of

the accounts of SAMHSA with 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
38

decreased by more than 3 percent by any such transfer. (Department of Health and Human

Services Appropriations Act, 2014.)
39

Language Analysis

Language Provision Explanation

Provided further, That in addition to

amounts provided herein, $26,039,000 shall

be available undersection241ofthePHSAct

to supplement funds otherwise available for

mental health activities and to carry out

subpartI of partB 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 Act 

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. This change 

would allow PHS Evaluation funds to be used 

to fund the Tribal Behavioral Health Grants in 

addition to those in the past.

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

of the PHS Act shall not apply to funds

appropriated under this Act for fiscal year

2015:

Because all states will have received a grant

under the Garrett Lee Smith Youth Suicide 

Prevention statewide program and the original 

purpose of the restriction in 520E(b)(2) has 

been served, this language would allow the 

program to continue by allowing states to 

receive a second grant.

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) ofsuch Act:

The system of care model is evidence-based 

and effective, but currently SAMHSA may 

only give TA to communities with a current 

grant. This would allow SAMHSA to provide 

TA to communities whether they have a 

current grant or not; which would significantly 

leverage SAMHSA funds to establish more

Systems of Care programs.
40

Provided further, That States shall expend at

least 5 percent of the amount each receives

for carrying out section 1911 of the PHS Act

to support evidence-based mental health

prevention and treatment practices to

address the needs of individuals with early

serious mental illness, including psychotic

disorders, regardless of the age of the

individual at onset:

States must use at least five percent of their 

Community Mental Health Services Block 

Grant award to support evidence-based mental 

health promotion and treatment practices with 

respect to individuals with early serious mental 

illness.

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, $2,008,056,000:

Sets out the budget authority for the Substance 

Abuse Treatment appropriation.

Provided, That in addition to amounts

provided herein, $109,200,000 shall be

available under section 241 of the PHS Act

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

Sets the amount of Public Health Service Act 

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. This 

change would allow PHS Evaluation funds to be 

used to fund the Screening, Brief Intervention, 

and Referral to Treatment program.
41

Provided, That in addition to amounts

provided herein, $16,468,000 shall be

available under section 241 of the PHS Act

to supplement funds otherwise available for

substance abuse prevention activities.

Sets the amount of Public Health Service Act 

Evaluation Fund dollars allocated to 

supplement the budget authority available for 

programs and activities authorized under titles 

III and V. This change would allow PHS 

Evaluation funds to be used to fund the Center 

for the Application on Prevention Technologies 

and Strategic Prevention Framework Rx 

programs.

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 forsuch purposes:

This section allows for fees to be collected for 

data and publications which would otherwise 

not be fulfilled because they incur especially 

onerous costs upon SAMHSA, and for those 

fees to be available for the same appropriation 

until expended.

Provided further, That amounts made

available in this Act for carrying out section

501(m) of the PHS Act shall remain

available through September 30, 2016:

Currently, SAMHSA’s emergency authority 

allows it to tap certain programs up to one 

percent for emergency response SERG grants. 

SAMHSA’s ability to respond to disasters 

which occur at the end of the year, which is 

hurricane season, is hampered by low available 

balances. To ensure programs are only tapped 

to the extent necessary and to ensure that 

SAMHSA’s emergency response is agile, this 

proviso would allow funds tapped to be carried 

over one additional year, and only for the same 

purpose.
42

Provided further, That the Administrator

may transfer funds 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.
43

Amounts Available for Obligation

General Fund Discretionary Appropriation:

Appropriation (L/HHS, Ag, or, Interior)......................................................... 3,347,973,348 3,434,935,000 3,297,669,000

Across-the-board reductions (L/HHS, Ag, or Interior)................................ (6,695,950) - -

Subtotal, Appropriation (L/HHS, Ag, or Interior)..................................... 3,341,277,398 3,434,935,000 3,297,669,000

Sequestration...................................................................................................... (168,423,147) -

Subtotal, adjusted appropriation................................................................. (168,423,147) - -

Transfer to the Department............................................................................... (699,673) - -

Transfer from the Department.......................................................................... 37,906,000 - -

Transfer from the Prevention and Public Health Funds............................... 14,733,000 62,000,000 58,000,000

Subtotal, adjusted general fund discr. appropriation............................... 51,939,327 62,000,000 58,000,000

Total, Discretionary Appropriation........................................................ 3,224,793,578 3,496,935,000 3,355,669,000

Offsetting collections from:

Federal Source 129,667,000 132,667,000 210,702,000

Data Request and publications User Fees - 1,500,000 1,500,000

Unobligated balance, start of year....................................................................... 175,390 175,390 175,890

Unobligated balance, end of year........................................................................ 175,390 175,890 173,890

Total obligations................................................................................................ 3,354,460,578 3,631,102,000 3,567,871,000

FY 2013 

Actual

FY 2014 

Enacted

FY 2015 

President's Budget
44

Summary of Changes

2014

Total estimated budget authority..................................................................... 3,434,935,000

(Obligations).................................................................................................. 3,434,935,000

2015

Total estimated budget authority..................................................................... 3,297,669,000

(Obligations).................................................................................................. 3,297,669,000

Net Change................................................................................................. -$137,266,000

 FY 2015 

PB FTE 

 FY 2015 

PB BA 

 FY 2015 +/- 

FY 2014 FTE 

 FY 2015 +/- 

FY 2014 BA 

Increases: 655

 A. Built-in:

1. Annualization of 2015 Commissioned Corps pay costs.................................. --- $ 44,225 --- +$44,225

2. Increase for January 2015 pay raise............................................................ --- 635,295 --- +635,295

3. Increase in rental payments to GSA............................................................ --- 3,709,158 --- +3,709,158

Subtotal, Built-in Increases......................................................... --- 4,388,678 --- +4,388,678

 B. Program:

1. Agency Wide Initiatives............................................................................. --- 55,000,000 --- +9,305,000

Subtotal, Program Increases....................................................... --- 55,000,000 --- +9,305,000

Total Increases............................................................................ --- 59,388,678 --- +13,693,678

Decreases:

 A. Built-in:

1. Absorption of built increases ...................................................................... --- --- --- -4,388,678

Subtotal, Built-in Decreases........................................................ --- --- --- -4,388,678

 B. Program:

1. Mental Health PRNS................................................................................. --- 311,740,000 --- -54,476,000

2. Substance Abuse Prevention PRNS............................................................ --- 169,092,000 --- -6,468,000

3. Substance Abuse Treatment PRNS............................................................ --- 267,400,000 --- -42,060,000

4. Program Support........................................................................................ --- 72,729,000 --- -17,000,000

5. PAS.......................................................................................................... --- --- --- -13,571,000

6. PQIS........................................................................................................ --- --- --- -12,996,000

Subtotal, Program Increases....................................................... --- 820,961,000 --- -146,571,000

Total Decreases........................................................................... --- --- --- -150,959,678

Net Change, Discretionary Budget Authority............................ 655 --- --- -$137,266,000
45

Budget Authority by Activity

FY 2013 FY 2014 FY 2015 FY 2015

Final Enacted President's 

Budget

+/-

FY 2014

1. Mental Health: 

Programs of Regional and National Significance........................................................... 266,509 378,216 354,740 -23,476

Prevention and Public Health Fund (non-add)....................................................... --- 12,000 38,000 +26,000

PHS Evaluation Funds (non-add)............................................................................... --- --- 5,000 +5,000

Children's Mental Health Services.................................................................................... 111,430 117,315 117,315 ---

Projects for Assistance in Transition from Homelessness........................................... 61,405 64,794 64,794 ---

Protection and Advocacy for Individuals with Mental Illness.................................... 34,343 36,238 36,238 ---

Community Mental Health Services Block Grant........................................................... 436,809 483,744 483,744 ---

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

Total, Mental Health .......................................................................................................... 910,496 1,080,307 1,056,831 -23,476

2. Substance Abuse Prevention: 

Programs of Regional and National Significance........................................................... 175,513 175,560 185,560 +10,000

Strategic Prevention Framework Rx (non-add)....................................................... --- --- 10,000 +10,000

PHS Evaluation Funds (non-add)............................................................................... --- --- 16,468 +16,468

Total, Substance Abuse Prevention................................................................................. 175,513 175,560 185,560 +10,000

3. Substance Abuse Treatment: 

Programs of Regional and National Significance........................................................... 404,085 361,460 297,400 -64,060

Prevention and Public Health Fund (non-add)....................................................... --- 50,000 --- -50,000

PHS Evaluation Funds (non-add)............................................................................... 2,000 2,000 30,000 +28,000

Substance Abuse Prevention and Treatment Block Grant........................................... 1,710,306 1,819,856 1,819,856 ---

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

Total, Substance Abuse Treatment................................................................................. 2,114,392 2,181,316 2,117,256 -64,060

4. Health Surveillance and Program Support:

Health Surveillance and Program Support:...................................................................... 123,419 120,157 122,157 +2,000

Prevention and Public Health Fund (non-add)....................................................... 14,733 --- 20,000 +20,000

PHS Evaluation Funds (non-add)............................................................................... 27,428 30,428 29,428 -1,000

Public Awareness and Support......................................................................................... 13,545 13,571 15,571 +2,000

PHS Evaluation Funds (non-add)............................................................................... --- --- 15,571 +15,571

Performance and Quality Information Systems.............................................................. 8,803 12,996 12,996 ---

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

Agency-Wide Initiatives 1/............................................................................................... 8,293 45,695 56,000 +10,305

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

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

Total, Health Surveillance/Program Support............................................................... 154,061 193,919 208,224 +14,305

TOTAL, SAMHSA Discretionary PL............................................................................. 3,354,461 3,631,102 3,567,871 -63,231

Less PHS Evaluation Funds............................................................................................. 129,667 132,667 210,702 +78,035

Less Prevention and Public Health Funds.................................................................... 14,733 62,000 58,000 -4,000

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

TOTAL, SAMHSA Budget Authority............................................................................. $3,210,061 $3,434,935 $3,297,669 -$137,266

FTEs 608 655 655 ---

*Totals may not add due to rounding.

Program Activities

1/ The Minority Fellowship Program budgets from the Mental Health, Substance Abuse Prevention and Treatment appropriations have been comparable 

adjusted in this table to be in line with the FY 2015 Request and are reflected in the Health Surveillance and Program Support Appropriation under the 

Agency-Wide Initiatives Workforce program.
46

Authorizing Legislation

FY 2014 Amount 

Authorized

FY 2014

Enacted

FY 2015 

Amount 

Authorized

FY 2015 

President's 

Budget

Grants for the Benefit of Homeless

 Individuals

Sec. 506................................................ Expired $41,488,000 Expired $41,488,000

Residential Treatment Programs for

 Pregnant and Postpartum Women

Sec. 508................................................ Expired $15,970,000 Expired $15,970,000

Priority Substance Abuse Treatment Needs

 of Regional and National Significance

Sec. 509*.............................................. Expired $222,324,000 Expired $173,764,000

Substance Abuse Treatment Services 

 for Children and Adolescents

Sec. 514*...................................................Expired $29,678,000 Expired $29,678,000

Priority Substance Abuse Prevention

 Needs of Regional and National

 Significance

Sec. 516*.............................................................. Expired $167,560,000 Expired $161,092,000

Programs to Reduce Underage Drinking

Sec. 519B*............................................... Expired $ 7,000,000 Expired $ 7,000,000

Centers of Excellence on Services for

 Individuals with FAS and Alcohol-related

 Birth Defects and Treatment for

 Individuals with Such Conditions and

 Their Families

Sec. 519D*..................................................... Expired $1,000,000 Expired $1,000,000

Priority Mental Health Needs of Regional and

 National Significance

Sec. 520A*...................................................Expired $203,080,000 Expired $216,632,000

Youth Interagency Research, Training,

 and Technical Assistance Centers

Sec. 520C*.................................................Expired $5,000,000 Expired $4,298,000

Suicide Prevention for Children and Youth

Sec. 520E*.................................................... Expired $29,700,000 Expired $23,363,000

Sec. 520E2*............................................. Expired $5,000,000 Expired $797,000

Grants for Jail Diversion Programs

Sec. 520G*.......................................... Expired $4,280,000 Expired $4,280,000

Awards for Co-locating Primary and Specialty Care

 in Community-based Mental Health Settings

Sec. 520K*............................................. SSAN $50,000,000 Expired 0

PATH Grants to States

Sec. 535(a)............................................. Expired $64,794,000 Expired $64,794,000

SSAN = Such Sums as Necessary

Program Description/PHS Act:
47

Authorizing Legislation

FY 2014 Amount 

Authorized

FY 2014 

Enacted

FY 2015 

Amount 

Authorized

FY 2015 

President's 

Budget

Community Mental Health Services for

 Children with Serious Emotional Disturbances

Sec. 565 (f).......................................... Expired $117,315,000 Expired $117,315,000

Children and Violence Program

Sec. 581*..................................................Expired $23,156,000 Expired $23,156,000

Grants for Persons who Experience Violence

 Related Stress

Sec. 582 **........................................... Expired $46,000,000 Expired $45,714,000

Community Mental Health Services

 Block Grants

Sec. 1920(a)......................................... Expired $462,705,000 Expired $462,705,000

Substance Abuse Prevention and Treatment

 Block Grants

Sec. 1935(a)...................................................... Expired $1,740,656,000 Expired $1,740,656,000

Other Legislation/Program Description

Protection and Advocacy for Individuals

 with Mental Illness Act

P.L. 99-319, Sec. 117......................................Expired $36,238,000 Expired $36,238,000

Health Surveillance and Program Support

 Program Management, Sec. 501..........................Indefinite $71,569,000 Indefinite $71,569,000

P.L. 98-621............................................ Indefinite $1,160,000 Indefinite $1,160,000

Total, Program Management...................... Indefinite $72,729,000 Indefinite $72,729,000

Heath Surveillance...................... Indefinite $17,000,000 Indefinite 0

Public Awareness and Support (FY12)...................... Indefinite $13,571,000 Indefinite 0

PQIS(FY12)...................... Indefinite $12,996,000 Indefinite 0

Agency-Wide Initiatives...................... Indefinite $45,695,000 Indefinite $55,000,000

Indian Health Care Improvement Reauthorization 

and Extension Act of 2009

Substance Abuse and Mental Health 

Services Administration Grants

Sec. 724 ...................................... SSAN 0 SSAN 0

Indian Youth Life Skills Development

Demonstration Program

Sec. 726...................................... $1,000,000 0 $1,000,000 0

TOTAL, SAMHSA Budget Authority.......................................... $1,000,000 $3,434,935,000 0 $3,297,669,000

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

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

Program Description/PHS Act:
48

Appropriations History

Budget Estimate 

to Congress House Allowance Senate Allowance Appropriation

FY 2006

General Fund Appropriation:

Base................................................. $3,336,023,000 $3,352,047,000 $3,398,086,000 $3,237,813,000

P.L. 109-149

Rescission (P.L. 109-359) .............. 0 0 0 -$1,681,000 1/

Transfers (Section 202)................... 0 0 0 -$2,201,000

Subtotal............................................ $3,336,023,000 $3,352,047,000 $3,398,086,000 $3,233,931,000

FY 2007

General Fund Appropriation:

Base................................................. $3,260,001,000 $3,326,341,772 $3,326,341,772 $1,211,654,381 2/

P.L. 109-383

Continuing Resolution .................... 0 0 0 $3,326,341,772 3/

Subtotal............................................ $3,260,001,000 $3,326,341,772 $3,326,341,772 $4,537,996,153

FY 2008

General Fund Appropriation:

Base................................................. $3,167,589,000 $3,393,841,000 $3,404,798,000 $3,291,543,000

P.L. 110-161

Rescission (P.L. 110-161)............... 0 0 0 -$57,503,000 4/

Subtotal............................................ $3,167,589,000 $3,393,841,000 $3,404,798,000 $3,234,040,000

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 5/

P.L. 111-117

Subtotal............................................ $ 3,393,882,000 $ 3,429,782,000 $ 3,419,438,000 $ 3,431,116,000
49

Budget Estimate 

to Congress House Allowance Senate Allowance Appropriation

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 6/

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 7/

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 8/

S.R. 113-071

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

FY 2015

General Fund Appropriation:

Base................................................. $ 3,297,669,000 

Subtotal............................................ $ 3,297,669,000 

1/ Reflects Section 202 transfer to CMS. 

2/ Reflects Continuing Resolution through February 15, 2007.

3/ Reflects the whole year appropriation

4/ Reflects a 1.7 percent across-the-board Rescission from the P.L. 110-161. 

5/ Reflects a $508 thousand transfer to HHS

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

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

8/ Reflects the whole year appropriation
50

Appropriations Not Authorized by Law

Program

Last Year of 

Authorization

Authorization 

Level

Appropriations 

in Last Year of 

Authorization

Appropriations 

in FY 2014

Grants for the Benefit of Homeless Individuals 

Sec. 506.................................................................. 2003 $ 50,000,000 $ 16,700,000 $41,488,000

Residential Treatment Programs for

 Pregnant and Postpartum Women

Sec. 508.................................................................. 2003 SSAN $0 $15,970,000

Priority Substance Abuse Treatment Needs

 of Regional and National Significance

Sec. 509*................................................................ 2003 $ 300,000,000 $ 322,994,000 $222,324,000

Substance Abuse Treatment Services 

 for Children and Adolescents

Sec. 514*................................................................ 2003 $ 40,000,000 $ 20,000,000 $29,678,000

Priority Substance Abuse Prevention

 Needs of Regional and National Significance

Sec. 516*................................................................ 2003 $ 300,000,000 $ 138,399,000 $174,560,000

Centers of Excellence on Services for Individuals with FAS

 and Alcohol-related Birth Defects and Treatment for

 Individuals with Such Conditions and Their Families

Sec. 519D*.............................................................. 2003 $ 5,000,000 $ 2,416,000 $1,000,000

Priority Mental Health Needs of Regional and

 National Significance

Sec. 520A*.............................................................. 2003 $ 300,000,000 $ 94,289,000 $253,080,000

Youth Interagency Research, Training,

 and Technical Assistance Centers

Sec. 520C*.............................................................. 2007 $ 5,000,000 $ 3,960,000 $5,000,000

Suicide Prevention for Children and Youth

Sec. 520E (GLS - State Grants)................................ 2007 $ 30,000,000 $ 17,829,000 $ 29,700,000

Sec. 520E2 (GLS-Campus Grants)............................ 2007 $ 5,000,000 $ 4,950,000 $5,000,000

Grants for Jail Diversion Programs

Sec. 520G*.............................................................. 2003 $ 10,000,000 $ 6,043,000 $4,280,000

PATH Grants to States

Sec. 535(a).............................................................. 2003 $ 75,000,000 $ 46,855,000 $ 64,794,000

Community Mental Health Services for

 Children with Serious Emotional Disturbances

Sec. 565 (f)............................................................. 2003 $ 100,000,000 $ 96,694,000 $117,315,000

Children and Violence Program

Sec. 581*................................................................ 2003 $ 100,000,000 $ 83,035,000 $ 23,156,000

Grants for Persons who Experience Violence Related Stress

Sec. 582 *.............................................................. 2003 $ 50,000,000 $ 20,000,000 $ 46,000,000

Community Mental Health Services Block Grants

Sec. 1920(a)............................................................ 2003 $ 450,000,000 $ 433,000,000 $462,705,000

Substance Abuse Prevention and Treatment Block Grants

Sec. 1935(a)............................................................ 2003 $ 2,000,000,000 $ 1,785,000,000 $1,740,656,000

Other Legislation/Program Description

Protection and Advocacy for Individuals with Mental Illness Act

P.L. 99-319, Sec. 117............................................... 2003 $ 19,500,000 $ 32,500,000 $ 36,238,000

TOTAL, SAMHSA Budget Authority.................. $ 4,222,500,000 $ 3,142,664,000 $ 3,272,944,000

**Congress authorized two provisions as section 514.

*Denotes programs that were authorized in the Children's Health Act of 2000. SAMHSA has the authority to carryout 

these programs in our general authorities in Section 507, 516 and 520A. 
51

SAMHSA

Mental Health Services

Table of Contents

SAMHSA/Mental Health........................................................................................................ Page

1) Mental Health/Programs of Regional and National Significance........................................... 53

a) Seclusion and Restraint and Trauma........................................................................... 54

b) Youth Violence Prevention......................................................................................... 55

c) Project AWARE.......................................................................................................... 57

d) Healthy Transitions..................................................................................................... 58

e) National Child Traumatic Stress Initiative ................................................................. 58

f) Children and Family Programs................................................................................... 60

g) Consumer and Family Network Programs.................................................................. 60

h) Project LAUNCH........................................................................................................ 61

i) Mental Health System Transformation and Health Reform ....................................... 62

j) Primary & Behavioral Health Care Integration (PBHCI)........................................... 64

k) Suicide Prevention Programs...................................................................................... 65

i. National Strategy for Suicide Prevention ............................................................. 65

ii. National Suicide Prevention Lifeline.................................................................... 66

iii. GLS Youth Suicide Prevention............................................................................. 67

iv. Suicide Prevention Resource Center..................................................................... 68

v. AI/AN Suicide Prevention .................................................................................... 69

l) Homelessness Prevention and Housing Program ....................................................... 69

m) Minority AIDS............................................................................................................ 71

n) Criminal and Juvenile Justice Programs..................................................................... 72

o) Practice Improvement and Training............................................................................ 73

p) Consumer and Consumer-Supporter TA Centers....................................................... 74

q) Disaster Response ....................................................................................................... 75

r) Tribal Behavioral Health Grants................................................................................. 76

s) PRNS Mechanism Table by APT ............................................................................... 85

2. Children’s Mental Health Services............................................................................................99

3. Projects for Assistance in Transition from Homelessness.......................................................105

4. Protection and Advocacy for Individuals with Mental Illness.................................................111

5. Community Mental Health Services Block Grant ...................................................................117

6. PRNS Mechanism Table by SLOA .........................................................................................310
52

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53

SAMHSA/Programs of Regional and National Significance

Mental Health Services

(Dollars in thousands)

 FY 2013 FY 2014 FY 2015 FY 2015 

Programs of Regional & National Significance

 Final Enacted President's 

Budget

 +/-

FY 2014 

CAPACITY

Seclusion and Restraint and Trauma.................................... $2,121 $1,150 $1,149 -$1

Youth Violence Prevention..................................................... 21,945 23,156 23,156 ---

Project AWARE....................................................................... --- 55,000 55,000 ---

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

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

Healthy Transitions................................................................. --- 20,000 20,000 ---

National Child Traumatic Stress Initiative............................ 43,322 46,000 45,714 -286

Children and Family Programs............................................... 6,461 6,474 6,474 ---

Consumer and Family Network Grants................................. 6,140 4,966 4,966 ---

Project LAUNCH ..................................................................... 32,829 34,640 34,640 ---

MH System Transformation and Health Reform................. 10,448 10,582 10,582 ---

Primary and Behavioral Health Care Integration................. 28,641 50,000 26,004 -23,996

Prevention & Public Health Fund (non-add)......... --- --- 7,909 +7,909

Suicide Prevention................................................................... 55,532 60,150 50,046 -10,104

National Strategy for Suicide Prevention (non-add)... --- 2,000 4,000 +2,000

Prevention & Public Health Fund (non-add)......... --- 2,000 --- -2,000

Suicide Lifeline (non-add)................................................. 6,085 7,212 5,512 -1,700

Prevention & Public Health Fund (non-add)......... --- 1,700 862 -838

GLS- Youth Suicide Prevention - States (non-add)...... 32,448 35,500 27,682 -7,818

Prevention & Public Health Fund (non-add)......... --- 5,800 4,319 -1,481

GLS- Youth Suicide Prevention - Campus (non-add)... 8,875 6,500 4,966 -1,534

Prevention & Public Health Fund (non-add)......... --- 1,500 4,169 +2,669

GLS - Suicide Prevention Resource Center (non-add) 5,339 6,000 4,948 -1,052

Prevention & Public Health Fund (non-add)......... --- 1,000 650 -350

AI/AN Suicide Prevention Initiative (non-add)............. 2,785 2,938 2,938 ---

Tribal Behavioral Health Grants............................................. --- 5,000 5,000 ---

PHS Evaluation Funds (non-add)............................. --- --- 5,000 +5,000

Homelessness Prevention Programs..................................... 29,162 30,772 30,772 ---

Minority AIDS.......................................................................... 8,781 9,247 16,270 +7,023

Grants for Adult Trauma Screening & Brief Intervention.. --- --- 2,896 +2,896

Criminal and Juvenile Justice Programs................................ 5,877 4,280 4,280 ---

Subtotal, Capacity $251,259 $361,417 $336,949 -$24,468
54

FY 2013 FY 2014 FY 2015 FY 2015

Programs of Regional & National Significance

Final Enacted President's 

Budget

+/-

FY 2014

SCIENCE AND SERVICE

Practice Improvement and Training...................................... 7,413 7,847 7,847 ---

Consumer and Consumer Supporter Technical 

Assistance Centers................................................................. 1,875 1,923 1,923 ---

Primary and Behavioral Health Care Integration TTA....... 1,992 1,996 1,996 ---

Prevention & Public Health Fund (non-add)............... --- --- 1,996 +1,996

Disaster Response................................................................... 997 1,958 2,950 +992

Homelessness........................................................................... 2,181 2,302 2,302 ---

HIV/AIDS Education............................................................... 791 773 773 ---

Subtotal, Science and Service $15,249 $16,799 $17,791 +$992

TOTAL, PRNS1/ 2 $266,509 $378,216 $354,740 -$23,476

* Totals may not add due to rounding.

2/ In the FY 2015 Request, the CMHS Minority Fellowship Program budget is reflected in the Health 

Surveillance and Program Support Appropriation under the Agency-Wide Initiatives Workforce program. 

1/ The PRNS FY 2014 total includes $12,000,000 and 2015 Request total includes $38,000,000 funded by the 

Prevention and Public Health Fund. 

Authorizing Legislation ............................Sections 501, 506, 520A, 520C, 520E, 520E (2), 520G, 

520K, 516, 581, and 582 of the Public Health Service Act

FY 2015 Authorization .........................................................................................................Expired

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

Program Description and Accomplishments

Seclusion and Restraint and Trauma

People die as a result of seclusion and restraint practices, countless others are injured, and many 

are secondarily traumatized by coercive practices. Children with emotional and behavioral 

problems are more frequently subjected to restraints in schools than students with other 

disabilities, often leading to serious physical injuries and emotional trauma for the students and 

the staff. Coercive practices such as seclusion and restraint impede recovery and well-being. 

Trauma-informed approaches to care have been developed and implemented to reduce or 

eliminate the use of coercive practices across identified service settings. 

This program area supports states/tribes and communities in their efforts to implement best 

practices to reduce and ultimately eliminate the use of restraints and seclusion in institutionaland community-based settings that provide services for individuals with mental and co-occurring 

substance use disorders. While this initiative includes a focus on the mental health delivery 

system, it also includes other service sectors such as criminal justice, schools, and child welfare

that may use coercive practices with people who have mental and/or co-occurring substance use 

disorders. SAMHSA’s vision for this initiative is to facilitate the implementation of evidence-
55

based strategies for preventing and reducing the use of seclusion and restraint and implementing 

trauma-informed care, an approach that reduces the use and harmful effects of coercive practices. 

Population surveys and clinical studies have documented the association between experiences of 

trauma and mental and substance use disorders. Accordingly, investments have been made in the 

development and dissemination of effective trauma-specific treatments. Studies of trauma 

survivors, behavioral health consumers, and practitioners in behavioral health settings have 

similarly documented the manner in which many service settings can be secondarily traumatizing 

for the people seeking services and interfere with positive treatment outcomes.

In FY 2010, SAMHSA awarded a three-year contract to establish the National Technical

Assistance Center: Promoting Alternatives to Seclusion and Restraint Through Trauma-Informed 

Practices. The purpose of this center is to disseminate, train, and implement programs supported 

by available evidence to provide trauma-informed care with the goal of reducing and, ultimately, 

preventing the use of seclusion, restraint, and other coercive practices in service systems and 

treatment agencies that serve children, youth, and adults with mental and/or co-occurring 

substance use disorders. Recipients of the training are publicly funded systems, organizations 

and service delivery personnel who intersect with people who have mental illnesses. This 

contract also supports SAMHSA’s efforts in developing a standard definition and measures of 

individual and community trauma and develops criteria and measures for trauma-informed care 

that can be used with a range of health and human service programs.

Recent evidence of the effectiveness of this training includes reduced use of seclusion and 

restraint in facilities where the training has taken place as well as reduced incidents of violence 

where these trauma-informed strategies have been employed. 

In FY 2013, SAMHSA awarded a new contract to support the continuation of these activities, a 

training institute, and to further refine the criteria for implementing and evaluating a traumainformed approach in multiple service sectors towards the prevention, reduction, and elimination 

of coercive practices.

In FY 2014, SAMHSA plans to continue support of this contract. 

Youth Violence Prevention

Youth violence remains a public health problem in the United States. The 2011 Youth Risk 

Behavior Surveillance-US reports that in 2011, approximately 12 percent of high school students 

reported being in a physical fight in the 12 months before the survey. Almost six percent of high 

school students in 2011 reported taking a gun, knife, or club to school in the 30 days before the 

survey. An estimated 20.1 percent of high school students reported being bullied on school 

property in 2011.

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

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

healthy relationships. From 1999 through 2012, this program was jointly administered by 

SAMHSA, the Department of Education (ED), and the Department of Justice (DOJ). In addition 
56

to the cross-federal partnership with Justice through the SS/HS Initiative, SAMHSA has also 

supported the Justice-led National Forum on Youth Violence Prevention. The Forum aims to 

build a national conversation about youth and gang violence to increase awareness, drive action, 

and build local capacity to more effectively address youth violence. It models a new kind of 

federal and local collaboration, encouraging its members to change the way they do business by 

sharing common challenges and promising strategies, through comprehensive planning and 

coordinated action. Since inception in 2010, ten cities have been supported through this 

Initiative. SAMHSA has provided federal staff support as well as providing technical assistance

support through the National Center for Mental Health Promotion and Youth Violence 

Prevention. 

The SS/HS initiative implements an enhanced, coordinated, and comprehensive plan of 

activities, programs, and services that promote healthy childhood development, prevent violence,

and prevent alcohol and drug abuse. Grantees are required to develop local strategic plans that 

address five required elements across the three sectors: (1) safe school environments and 

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

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

childhood social and emotional learning programs. Grantees have developed organizational, 

informational, and programmatic systems that bring together many diverse sectors of the 

community, creating the capacity for comprehensive system reform so all agencies concerned 

with the welfare of children and families could collaborate on an ongoing basis.

As a result of the SS/HS initiative implemented in local educational authorities (LEAs), more 

than 90 percent of school staff saw reduced violence on school grounds and almost 80 percent 

reported that SS/HS had reduced violence in their communities. Children and adolescents 

participating in the SS/HS grant program experienced a 47.1 percent increase in access to schoolbased mental health service and a 29.8 percent increase in receipt of community-based mental 

health services. Nearly 90 percent of school staff stated that they were better able to detect

mental health problems in their students and more than 80 percent of school staff reported that 

they saw reductions in alcohol and other drug use among their students.

In FY 2012, SAMHSA supported the final cohort of SS/HS grants in collaboration with ED.

SAMHSA also utilized funding in FY 2012 to realign technical assistance activities to meet the 

needs of grantees and the field, and to evaluate the performance of the existing program. 

SAMHSA transferred $2.2 million to ED to help finance technical assistance to improve the 

school climate for learning; including, but not limited to, bullying prevention. In addition, 

SAMHSA awarded 3rd, 4th, and final year funding for 21 Implementing Evidence-Based 

Prevention Practices in Schools grants which will come to an end in FY 2014.

In FY 2013, SAMHSA provided funds for the Safe Schools/Healthy Students State Planning, 

Local Education Agency and Local Community grant program (SS/HS State program). This 

grant program builds on the investments in the SS/HS Initiative through state and community 

level partnerships among education, behavioral health, and criminal justice systems that promote

systems integration and policy change and sustainable policies, infrastructure, services, and 

supports. The SS/HS State Program is supported with SAMHSA funds only and is intended to 
57

create safe and supportive schools and communities. In addition, SAMHSA awarded the new 

Resource Center for Mental Health Promotion and Youth Violence Prevention.

In FY 2014, SAMHSA plans to continue support of these efforts.

Project AWARE

In response to the tragedy at Sandy Hook Elementary School, in FY 2014, SAMHSA plans to 

utilize $55 million to support Project AWARE, (Advancing Wellness and Resilience in 

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

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

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

this initiative to maximize coordination and avoid duplication of efforts.

Project AWARE proposes two components: Project AWARE State Grants ($40 million) build 

on the Safe Schools/Healthy Students State Program which is intended to create safe and 

supportive schools and communities. For more than a decade, the Safe Schools/Healthy 

Students Initiative has successfully decreased violence and increased the number of students 

receiving mental health services. Project AWARE grants will go to 20 State Education 

Authorities (SEAs), and in collaboration with Education and Justice will promote

comprehensive, coordinated, and integrated State efforts to make schools safer and increase

access to mental health services. The SEAs will be required to partner with the State Mental 

Health and Law Enforcement agencies to establish Interagency State Management Teams, 

conduct needs assessments, develop a state plan with an evaluation mechanism, and develop the 

mechanisms to coordinate funding, service delivery, systems improvement, and data collection. 

In addition, each SEA will be required to identify three high-need Local Education Agencies 

(LEAs) as communities that will receive sub-awards to implement comprehensive and 

coordinated school safety and mental health programs. 

The second component, Mental Health First Aid (MHFA) ($15 million) proposes widespread 

dissemination of the Mental Health First Aid curriculum. MHFA-Youth prepares teachers and 

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

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

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

willing to seek treatment. The Budget proposes that $10 million of the Project AWARE – MHFA

funds support training of teachers and a broad array of actors at the community level, including 

parents, law enforcement, youth and faith-based leaders. The additional $5 million proposed for 

MHFA will continue to support dissemination of MHFA through the 20 Project AWARE SEA 

grants. 

A target of 750,000 students served is an achievable goal for first year of program 

implementation from these two components.
58

Healthy Transitions

The FY 2014 Budget includes $20 million for a new Healthy Transitions Program, which assists

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

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

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

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

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

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

This new demonstration grant program for states proposes new and creative approaches to 

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

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

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

disseminate best practices for services to youth ages 16-25. The $20 million will support fiveyear grants to 16 states as well as new evaluation and technical assistance contracts. An 

estimated 5,900 individuals will be referred to mental health or related services.

National Child Traumatic Stress Initiative

Established in 2000, the purpose of the National Child Traumatic Stress Initiative (NCTSI) is to 

improve behavioral health treatment, services, and interventions for children and adolescents 

exposed to traumatic events. The NCTSI has provided funding for a national network of 

grantees known as the National Child Traumatic Stress Network (NCTSN) to develop and 

promote effective community practices for children and adolescents exposed to a wide array of 

traumatic events. The NCTSN has grown from a collaborative Network of 17 to over 165 funded 

and affiliate centers located nationwide in university, hospital, and diverse community-based 

organizations, with thousands of national and local partners. The NCTSN mission is to raise the 

standard of care and improve access to services for traumatized children, their families, and 

communities. Coordinated by the SAMHSA funded National Center for Child Traumatic Stress 

(NCCTS), Network members and partners work together within and across diverse settings, 

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

offers training, support, and resources to providers who work with children and families exposed 

to a wide range of traumatic experiences, including physical and sexual abuse; domestic, school, 

and community violence; natural disasters, terrorism, or military family challenges; and lifethreatening injury and illness.

The NCTSN provides training and technical support on intervention approaches to reduce the 

mental, emotional, and behavioral effects of traumatic events on children/adolescents and their 

families. By working with established systems of care including public health, mental health, 

education, law enforcement, child welfare, juvenile justice, and military family service systems, 

the NCTSN ensures that there is a comprehensive trauma-informed continuum of accessible 

care. It also raises public awareness of the scope and serious impact of child traumatic stress on 

the safety and healthy development of America's children and youth as well as advances a broad 

range of effective services and interventions by creating trauma-informed developmentally and 

culturally appropriate programs that improve the standard of care. Finally, the NCTSN fosters a 
59

community dedicated to collaboration within and beyond the network to ensure that widely 

shared knowledge and skills become a sustainable national resource.

The NCTSN is composed of three types of centers: 

The National Center for Child Traumatic Stress - (Category I) develops and maintains the 

collaborative network structure, supports resource development and dissemination, and 

coordinates the Network’s national child trauma education and training efforts. It 

promotes further product development, learning collaborations, and system change 

efforts in systems across the country.

The Treatment and Service Adaptation (TSA) Centers - (Category II) provide national 

expertise and assume responsibility in the Network for specific areas of trauma, such as 

specific types of traumatic events, population groups, and service systems; and support 

the development and adaptation of effective trauma treatments and services for children, 

adolescents and their families that can be implemented throughout the nation. The TSAs 

are comprised of nationally-recognized experts in child and adolescent trauma who have 

developed evidence-based interventions to treat children who have experienced a range 

of traumas including neglect, physical abuse, sexual abuse, medical trauma, school 

violence, war, refugee status, and disasters.

The Community Treatment and Services (CTS) Centers - (Category III) are primarily 

community service providers across multiple child-serving systems service programs that 

implement and evaluate effective treatment and services in community settings and youth 

serving service systems and collaborate with other NCTSN centers on clinical issues, 

service approaches, policy, financing, and training issues.

Data collected during FY 2013 shows that the current grantees in the NCTSN have provided 

trauma treatment to more than 24,478 children, adolescents and family members. The previously 

collected NCTSN Core Data Set includes outcome data from more than 7,000 clinical cases in 

which 43 percent of cases demonstrated significant improvements. This database of clinical 

characteristics, trauma exposure, and treatment outcomes includes more than 18,000 cases and 

follow-up data on approximately 50 percent of these cases.

The NCTSN continues to be a principal source of child trauma training for our nation. In FY 

2013 the NCTSN grantee sites provided training to over 170,000 individuals. The Network has 

developed resources for child/adolescent trauma on the NCTSN website, which receives an 

average of 2,500 visits a day. During this same time period 45 new resources were developed. In 

addition, site products such as fact sheets and toolkits were downloaded more than 70,000 times. 

A Learning Center website has also been developed that provides access to 195 expert webinars 

on trauma topics. In addition, the Network has developed 26 intensive learning collaboratives, 

and various online certification programs that offer continuing education credits free of charge.

In FY 2013, SAMHSA provided continuation support for a cohort of 78 NCTSI grants, (one 

Category I, 21 Category II and 56 Category III) with an increased focus on effective 

implementation and dissemination strategies for maximizing the uptake of trauma interventions, 
60

enhanced learning networks, and strong linking of child trauma in the child welfare and juvenile 

justice systems. 

In FY 2014, the NCTSI will build on the robust work of the NCTSN and improve and enhance 

the capacity of the NCTSI to deliver effective interventions and core practices developed by the 

NCTSN to children and youth in need.

Children and Family Programs

The Children and Family Programs provide support for the Circles of Care grant program. This 

program provides services and support to children and youth with and at risk for mental health

conditions and their families. Initially funded in 1998, the Circles of Care Program is a three 

year program that promotes the elimination of mental health disparities by providing tribal and 

Alaskan Native communities with tools and resources to build their own culturally competent 

systems of care model for children’s mental health. The program also increases capacity and 

community readiness to address the mental health issues of children and families. 

In FY 2013, SAMHSA awarded the final year of funding for the six Circles of Care and seven 

State/Community Partnerships to Integrate Services and Supports for Youth and Young Adults 

16-25 with Serious Mental Health Conditions and their Families grants. In FY 2014, SAMHSA 

plans to award a new cohort of Circles of Care grants. 

Consumer and Family Network Programs

The Consumer and Family Network Programs supports SAMHSA’s Recovery Support Strategic 

Initiative by promoting consumer, family, and youth meaningful participation in the 

development of policies, programs, and quality assurance activities related to mental health 

systems reform across America. 

The Statewide Consumer Network Program focuses on the needs of adult mental health 

consumers 18-years and older by strengthening the capacities of state-wide consumer-run 

organizations to be catalysts for transforming the mental health and related systems in their 

states. It establishes sustainable mechanisms for integrating the consumer voice in state mental 

health and allied systems to (1) expand service system capacity, (2) support policy and program 

development, and (3) enhance peer support. This program promotes skill development with an 

emphasis on leadership and business management as well as coalition/partnership-building and 

economic empowerment as part of the recovery process for consumers. In FY 2011, SAMHSA 

funded 31 Statewide Consumer Network continuation grants for four years. 

In FY 2013, SAMHSA awarded 15 new grants to support emphasis on integrated care and assist 

in planning for implementation of health reform and provide continuation funding to 11 grants 

and a technical assistance contract. In FY 2014, SAMHSA plans to support continuation grants 

and contracts for this program.

The Statewide Family Network Program is a three year program that provides education and 

training to increase family organizations’ capacity for policy and service development by 1) 
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strengthening organizational relationships and business management skills, 2) fostering 

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

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

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

focuses on families: parents; the primary caregivers of children; youth; and young adults. In this 

case, 'young adults' refers to individuals generally up to age 18, up to age 21 if they have an 

Individual Education Plan, or up to age 26 if they are transitioning to the adult mental health 

system.

In FY 2013, SAMHSA awarded 29 new grants to support emphasis on integrated care and assist 

in planning for implementation of health reform and provide continuation funding for six grants 

and a technical assistance contract. In FY 2014, SAMHSA plans to support continuation grants 

and contract of the program.

In addition, in FY 2014, SAMHSA expects to provide support for the Statewide Peer Network 

Development Program for Recovery and Resiliency. In support of SAMHSA’s Recovery 

Support Strategic Initiative, this program builds capacity for statewide consumer-run, family 

member-run, or addiction recovery community organizations to promote cross-service system 

and infrastructure development that is recovery-focused and resiliency oriented. $1 million in 

Substance Abuse Treatment (SAT) budget authority will be used to award new addiction 

recovery community statewide networks. The remaining $0.8 million will be braided between 

Mental Health budget authority and SAT budget authority to allow for supplemental awards for 

collaborative partnerships across the mental and substance use disorder fields. Any braided 

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

purposes consistent with legislative direction and intent. Eligible applicants for this program will 

be those organizations who have an existing mental health or addiction statewide network award

from SAMHSA. Up to 10 grant awards at $0.1 million will be made for addiction recovery 

statewide networks. Eight supplemental awards will be given at $0.1 million each.

Grantees will be expected to facilitate effective participation in state and local behavioral health 

services planning and health reform activities related to improving community-based services 

and supports for people in recovery from substance use disorders, children and youth with 

serious mental health conditions and their families or adult mental health consumers. The 

program will also address gaps in behavioral health policy as well as inform health reform 

implementation. In order to ensure a stronger policy voice across the behavioral health field and 

facilitate readiness for the implementation of health reform, a supplemental incentive award will 

be offered to applicants proposing to build a collaborative partnership between mental health and 

addictions peer-run state-wide networks and those that are mental health family-run.

Additionally, partnerships with affiliate health networks will be encouraged.

Project LAUNCH

In FY 2008, Congress provided initial funding to implement the Project LAUNCH (Linking 

Actions for Unmet Needs in Children’s Health) Wellness Initiative. Project LAUNCH 

implements evidence-based practices that promote and enhance the wellness of young children 

by increasing grantees’ capacities to develop infrastructure and implement prevention/promotion 
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strategies necessary to promote wellness for young children. Project LAUNCH focuses on 

children from birth through age eight. The goal of Project LAUNCH is to create a shared vision 

for the wellness of young children that drives the development of federal, state, territorial, tribal 

and local networks for the coordination of key child-serving systems and the integration of 

behavioral and physical health services.

Cumulative performance data for the program (October 2008 through September 2013) show 

that approximately 106,000 children and parents have been screened and assessed in diverse 

settings and over 22,892 families have been served in Project LAUNCH-supported home visiting 

and family strengthening programs. Over 38,571 community providers have been trained on 

social-emotional and behavioral health for young children. Nearly 67,000 individuals received 

evidence-based mental health services. Project LAUNCH data also indicate that nearly 2,599 

new organizations are collaborating, coordinating, and sharing resources to implement 

prevention/promotion strategies for young children. All Project LAUNCH grantees reported 

improved social and academic functioning, and 78% reported decreases in problem behaviors 

among the targeted population.

In FY 2013, SAMHSA supported 29 continuation grants and contracts and awarded five new 

Project LAUNCH grants and one new contract. In FY 2014, SAMHSA plans to support Project 

LAUNCH continuations and contracts and award 14 new grants.

Mental Health System Transformation and Health Reform

SAMHSA supports activities that facilitate the transformation of the mental health delivery 

system. These efforts include the Mental Health Transformation (MHT) and the Behavioral 

Health Treatment Court Collaborative (BHTCC) grant programs. In FY 2010, SAMHSA 

awarded 20 MHT grants for five years to promote the adoption and implementation of permanent 

transformative changes in how communities manage and deliver mental health services. Grantees 

are currently implementing evidence-based or best practices that will create or expand capacity 

to address mental illness prevention, trauma-informed care, screening, treatment, and support 

services for military personnel, supported housing and supported employment. In FY 2013, 

grantees trained more than 7,700 mental health and related workforce personnel in specific 

mental-health related practices/activities as a result of the grant. Necessary changes to policies 

and organizational structures to support improved mental health services also will be supported 

along with workforce training, implementation of evidence-based practices, and improving 

access to quality mental health services. 

In FY 2011, SAMHSA awarded 11 BHTCC grants for three years. The purpose of the BHTCC

program is to help state and local courts offer treatment and recovery support instead of 

incarceration for individuals who are in a court system due to mental or substance use disorders 

and to provide more flexibility within the criminal justice system to work with other authorities 

and service providers to better address behavioral health needs of detainees, inmates and 

parolees. SAMHSA's vision of a BHTCC in the justice system is one that encourages treatment 

and recovery support for individuals involved in the criminal justice system with mental and 

substance abuse disorders and also improves public health and public safety by facilitating the 

transformation of the behavioral health/criminal justice system at the community level. The court 
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system can direct an individual into the appropriate forum, whether it is Drug Court, Veterans 

Court, Mental Health Court, Family Court, or another combined specialty court approach. This 

will be done as is appropriate for the individual and the services with which the court(s) 

coordinate to provide treatment and services for individuals engaged in the criminal justice 

system. 

The BHTCC grantees have demonstrated significant accomplishment over the past year and a 

half. Having been built from drug courts, they have increased or expanded access for 

participants with mental health and/or co-occurring disorders (COD) to specialty courts and 

diversion opportunities. This has resulted in improved access to behavioral health services 

including trauma specific treatment. To accomplish this, the programs have developed new 

standardized assessment procedures that include court and clinical team reviews for eligibility 

and appropriate services to multiple courts. They have conducted cross system and discipline 

training, particularly Trauma Informed Care (TIC) reaching over 300 court and behavioral health 

staff. These accomplishments were accompanied with infrastructure changes including new 

cross collaboration and significant increases in the involvement of peers (persons with lived 

experience), and the implementation of Trauma Informed Care approaches to working with 

clients. Program participants are typically male, younger than 35 years old, parents, with a high 

school education. More than two thirds of program participants report experiencing violence and 

trauma. As a result of the program participants report reduced anxiety and depression and 

increased use of prescribed medication. They also report improved abstinence from substances, 

increased employment, and housing stability.

In FY 2013, SAMHSA awarded continuations for the MHT and BHTCC grants and the 

evaluation contract for the BHTTC program. In FY 2014, SAMHSA plans to fund continuations 

for the MHT grants. 

In addition, in support of SAMHSA’s Recovery Support Strategic Initiative, SAMHSA proposes 

to use a total of approximately $4.9 million in Budget Authority to establish the Transforming 

Lives through Supported Employment Grant Program. Based on learning from previous Mental 

Health Transformation grant cohorts, SAMHSA will use a total of $4.9 million (Mental Health 

Systems Transformation and Health Reform funds of $2.2 million and Practice Improvement and 

Training funds of $2.7 million) to focus the program on an existing activity: enhancing state and 

community capacity to provide evidence-based supported employment programs for adults and 

youth with serious mental illnesses/emotional disturbances. This strengthening of an existing 

program activity is consistent with SAMHSA’s four pillars of Recovery (Health, Home, Purpose, 

and Community). In addition, Supported Employment was one of five allowable activities in 

earlier Transformation grants and has demonstrated excellent outcomes in helping individuals 

achieve and sustain recovery.

By having gainful employment as the target outcome and helping mental health consumers, their 

treatment providers, and their employers develop mutual understanding and successful 

relationships, Transforming Lives through Supported Employment Grants will help people with 

mental illnesses discover paths of self-sufficiency and recovery rather than disability and 

dependence. A total of up to 6 grant awards of approximately $0.85 million dollars each will be 

awarded for five years.
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Primary & Behavioral Health Care Integration (PBHCI)

SAMHSA provided funding for the Primary & Behavioral Health Care Integration (PBHCI) 

program beginning in FY 2009 to address the increased rates of morbidity and mortality among 

adults with serious mental illness (SMI). These rates are due, in large part, to elevated incidence 

and prevalence of cardiovascular disease, obesity, diabetes, hypertension, and dyslipidemia in 

people with SMI. Increased morbidity and mortality can be attributed to a number of other 

issues, including inadequate physical activity and poor nutrition, smoking, side effects from 

atypical antipsychotic medications, and lack of access to primary health care services. Many of 

these health conditions are preventable through routine health promotion activities, primary care 

screening, monitoring, treatment, and care management/coordination strategies and/or other 

outreach programs at home or community sites. Physical health problems among people with 

SMI impact quality of life and contribute to premature death. While several factors contribute to 

this disparity, empirical findings indicate that early mortality among people with SMI is clearly 

linked to the lack of access to primary care services.

The PBHCI program supports SAMHSA’s Health Reform Strategic Initiative and is comprised 

of competitive cooperative agreements and the PBHCI Training and Technical Assistance (TTA) 

Center which is co-funded with HRSA. The program supports the coordination and integration 

of primary care services into publicly-funded community behavioral health settings. This 

program is also a part of SAMHSA’s Health Reform Strategic Initiative. The expected outcome 

of improved health status for people with SMI will be achieved by encouraging grantees to 

engage in necessary partnerships, expand infrastructure, and increase the availability of primary 

health care and wellness services to individuals with mental illness. Partnerships between 

primary care and behavioral health organizations, as well as information technology entities, are 

deemed crucial to the success of this program. The population of focus for this grant program is 

individuals with SMI and/or people with co-occurring disorders served by the public mental 

health system. Recipients are non-profit mental health provider agencies that will use these grant 

funds to develop and offer primary care as well as behavioral health services in an integrated 

manner.

In FY 2011, $35 million was allocated from the Prevention and Public Health Fund for PBHCI 

to promote more integrated services between primary care services and mental health services. 

These funds were used to facilitate screening and referral for necessary primary care prevention 

and treatment needs. SAMHSA funded eight new multi-year funded PBHCI grants and 34 

continuation grants with Prevention and Public Health Funds and 22 grants and one contract 

continuation with Budget Authority. 

In FY 2012, SAMHSA supported 56 existing grants; 20 new multi-year funded grants and 10 

new annually funded grants from SAMHSA Budget Authority and Prevention and Public Health 

Fund ($30.8 million in Budget Authority and $35 million in Prevention and Public Health Funds) 

as well as $1.9 million for the continuation of PBHCI Training and Technical Assistance (TTA) 

Center.

In FY 2013, SAMHSA awarded continuation of the program and awarded seven new grants. 

SAMHSA has awarded 100 PBHCI grants to date including the FY 2013 cohort.
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Over 33,000 consumers were served in FY 2013, an increase of 43.5 percent over FY 2012. 

Improvements in all four National Outcome Measures were consistently positive as a result of 

this intervention. Of particular importance were the increases in measures of functioning and 

education/employment, demonstrating that the program supports health and productivity. 

The following health indicators, as of April 2013, show improvements in program participants’ 

physical health: 

 Blood pressure: 17.4 percent of program participants showed some improvement in this 

biomarker. For 16.2 percent of program participants, their blood pressure improved 

enough that it was no longer a risk factor for hypertension.

 Blood glucose: 36.8 percent of program participants showed some improvement in this 

biomarker. For 10.4 percent of program participants, their blood glucose improved 

enough that it was no longer a risk factor for diabetes.

 HgBA1c: 40.4 percent of program participants showed some improvement in this 

biomarker. For 9.3 percent of program participants, their HgBA1c improved enough that 

it was no longer a risk factor for diabetes.

 HDL: 38 percent of program participants showed some improvement in this biomarker. 

For 8.9 of program participants, their HDL improved enough that it was no longer a risk 

factor for high cholesterol.

 LDL: 41.9 percent of program participants showed some improvement in this biomarker.

For 10.7 percent of program participants, their LDL improved enough that it was no 

longer a risk factor for high cholesterol.

 Triglycerides: 41.1 percent of program participants showed some improvement in this 

biomarker. For 11.3 percent of program participants, their triglycerides improved enough 

it was no longer a risk factor for hyperlipidemia.

In FY 2014, SAMHSA plans to support continuation grants as well as award a new cohort of 

PBHCI grants and one technical assistance contract.

Suicide Prevention Programs

National Strategy for Suicide Prevention

SAMHSA supports the goals and objectives of the National Strategy for Suicide Prevention 

(NSSP) though several programmatic activities. The SAMHSA Suicide Prevention Resource 

Center provides support to the joint effort between the Office of the Surgeon General and the 

National Action Alliance for Suicide Prevention which has revised the NSSP to serve as the 

nation's blueprint for reducing suicide over the next decade. The SAMHSA supported Suicide 

Prevention Lifeline facilitates key NSSP objectives related to crisis intervention, follow up of 

high risk suicidal individuals, post discharge continuity of care, and the use of social networking 

to reach those at risk. Through the SAMHSA Garrett Lee Smith Suicide Prevention grant 

programs, states, tribes, and colleges are supported in implementing NSSP goals related to 

suicide prevention education and training as well as comprehensive, community-based 

approaches to youth suicide prevention.
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In 2008, suicide became the tenth leading cause of death in the U.S. and has remained so through 

2010, the most recent year for which there is available mortality data. Previously, suicide had 

been the eleventh leading cause of death. In 2012, SAMHSA’s National Survey on Drug Use 

and Health reported that over 1.3 million Americans over the age of 18 attempted suicide and 

nine million had seriously considered it. Research, however, 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. 

While youths have the highest rates of suicide attempts, middle aged adults have the highest 

number of deaths by suicide nationwide, and older adults have the highest rates of death by

suicide. In 2010 more than 70 percent of the suicides in the U.S. took place among adults 

between ages 25-64. The nation’s suicide prevention efforts must go beyond youth and address 

the issues of suicidal thoughts, plans, attempts, and deaths among adults. The NSSP addresses 

all age groups and specific populations with specific needs (e.g. military families, LGBT youth, 

Native American youth). The various aspects of the NSSP must be implemented to accomplish 

the goal of turning around the annual growth in deaths by suicide, and actually reducing that 

number significantly over the next few years. SAMHSA’s role as both a payer and a director of 

standards of care throughout much of the nation’s health care delivery system is key to this 

effort. 

National Suicide Prevention Lifeline

Launched in FY 2005, the National Suicide Prevention Lifeline, 1-800-273-TALK, coordinates a 

network of 160 crisis centers across the United States by providing suicide prevention and crisis 

intervention services to individuals seeking help at any time, day or night. The Lifeline routes 

calls from anywhere in the country to a network of certified local crisis centers that can then link 

callers to local emergency, mental health, and social services resources, The Lifeline averaged 

94,183 calls per month in 2013, including a peak of 104,754 calls in December. National 

Suicide Prevention Lifeline crisis centers across the nation are responding to people in suicidal 

crises. 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”. At the same time, these centers are 

threatened with significant cutbacks in funding from state and local governments and other 

sources of support. 

Since FY 2007, SAMHSA has partnered with the Department of Veterans Affairs (VA) to 

provide and ensure that Veterans calling the Lifeline have 24/7 access to a specialized Veterans’ 

suicide prevention hotline. In FY 2013, more than 26,943 callers per month were seamlessly 

connected to the Veterans crisis line. The National Suicide Prevention Lifeline is also 

responding to calls from active duty military and their families. SAMHSA is in the process of 

developing a suicide hotline outcome measure to determine the number of people who contacted 

the Lifeline who believe the call prevented them from taking their lives. 

In addition, in FY 2012, SAMHSA awarded a new Suicide Lifeline grant and provided 

continuation support for 12 National Suicide Prevention Lifeline Crisis Center grants to provide 

follow up to suicidal callers. Evaluation and research findings indicated that in the immediate 
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aftermath of suicidal crises, there is a period of heightened risk for suicide, but in this time there 

is a great potential for suicide prevention. Preliminary data from this program indicated that 

when asked by an independent evaluator, “To what extent did the counselor’s calling you stop 

you from killing yourself?” more than 50 percent of those receiving follow-up phone contact 

indicated the call played a significant role in keeping them alive. 

The National Suicide Prevention Lifeline uses evaluation results to document and improve 

program effectiveness. Evaluation results have been used to develop standards for suicide risk 

assessment, guidelines for callers at imminent risk for suicide, and follow up protocols for 

suicidal callers. In turn, these quality and performance improvement efforts have been evaluated 

and found to have positive impacts. Some of these outcomes have included decreases in suicidal 

ideation and hopelessness among callers, increased frequency of performing suicide risk 

assessments by crisis counselors, increased follow up of suicidal callers by crisis centers, and 

suicidal callers reporting such calls played a significant role in keeping them alive.

In FY 2013, SAMHSA awarded the continuation of the Suicide Lifeline grant and grants to crisis 

centers. In addition, 12 new crisis center grants were awarded, which will include a focus on 

providing follow up to suicidal people discharged from emergency rooms and inpatient units. 

This focus is based on current evaluation and research findings. In FY 2014, SAMHSA plans to 

award continuation grants and contracts as well as award a supplement to Suicide Lifeline from 

Prevention and Public Health Fund.

The National Suicide Prevention Lifeline uses evaluation results to document and improve 

program effectiveness. Evaluation results have been used to develop standards for suicide risk 

assessment, guidelines for callers at imminent risk for suicide, and follow up protocols for 

suicidal callers. In turn, these quality and performance improvement efforts have been evaluated 

and found to have positive impacts. Some of these outcomes have included decreases in suicidal 

ideation and hopelessness among callers, increased frequency of performing suicide risk 

assessments by crisis counselors, increased follow up of suicidal callers by crisis centers, and 

suicidal callers reporting such calls played a significant role in keeping them alive. To see one

aspect of this outreach effort in action, visit https://www.facebook.com/800273TALK.

GLS Youth Suicide Prevention

The Garrett Lee Smith (GLS) Memorial Act authorizes SAMHSA to manage two significant 

youth suicide prevention programs and one resource center. The GLS State/Tribal Youth 

Suicide Prevention and Early Intervention Grant Program currently supports a total of 68

grantees which includes four multi-year funded grants in FY 2011, three multi-year funded 

grants in FY 2012, and 61 annually funded grants, 31 states, 29 tribes or tribal organizations, and 

the District of Columbia in developing and implementing youth suicide prevention and early 

intervention strategies involving public-private collaborations among youth serving institutions. 

The GLS Campus Suicide Prevention program currently provides funding to 82 institutions of 

higher education, inclusive of tribal colleges and universities, which includes five multi-year 

funded grants in FY 2011, 15 multi-year funded grants in FY 2012, four multi-year funded 

grants in FY 2013 and 58 annually funded grants, to prevent suicide and suicide attempts. 
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In FY 2012, through Budget Authority, SAMHSA provided support for 34 GLS state/tribal 

continuation grants and awarded 20 new grants. In addition, SAMHSA supported 16 GLS 

campus continuation grants and awarded 24 new grants. 

In FY 2012, SAMHSA also received $10 million in Prevention and Public Health Fund, which 

supported the GLS grants, the National Suicide Prevention Lifeline, and the Suicide Prevention 

Resource Center. Three grants were multi-year funded for the GLS state/tribal grantees and 15 

grants were multi-year funded for the campus grantees. 

As of July 2013, 592,580 individuals had participated in 21,433 training events or educational 

seminars provided by grantees. Grantees often used their funds to provide suicide prevention

trainings in their communities. The most common approach was gatekeeper training, designed 

to help trainees recognize suicide risk in young people, address the immediate needs of the 

youths, and refer youths to appropriate services. Over one third of 34.5 percent (n = 204,351) of 

trainees were trained through campus-sponsored trainings and educational seminars. Over half of 

trainees 61.0 percent (n = 361,765) participated in State-sponsored and 4.5 percent (n = 26,464) 

in tribal-sponsored training activities.

In FY 2013, SAMHSA provided support for the continuation of existing state/tribal and campus 

grantees and awarded seven new GLS State/Tribal grants and 22 GLS Campus grants. 

In FY 2014, SAMHSA plans to continue support both GLS State/Tribal and GLS Campus 

programs and anticipates awarding 24 new GLS State/Tribal grants, 15 new GLS Campus, and 

one new evaluation contract.

Suicide Prevention Resource Center

In addition to programs that build suicide prevention capacity, SAMHSA also supports the 

Suicide Prevention Resource Center (SPRC). This program promotes the implementation of the 

National Strategy for Suicide Prevention and enhances the nation’s mental health infrastructure 

by providing states, tribes, government agencies, private organizations, colleges and universities, 

and suicide survivor and mental health consumer groups with access to the science and 

experience that can support their efforts to develop programs, implement interventions, and 

promote policies to prevent suicide. The SPRC also advances youth suicide prevention efforts in 

states, territories, tribes, and campuses as authorized through the Garrett Lee Smith (GLS) 

Memorial Act. 

Through the SPRC, SAMHSA continues to provide support for the National Action Alliance for 

Suicide Prevention (NAASP), a public-private partnership to implement the National Strategy 

for Suicide Prevention and reduce suicide in America. The NAASP was launched on September 

10, 2010, by HHS Secretary Kathleen Sebelius and the former Secretary of Defense, Robert 

Gates.

In FY 2011, SAMHSA received $10 million in Prevention and Public Health Fund, from 

which SAMHSA funded one supplement to the SPRC of $0.7 million to expand and enhance the 

level of support provided to the NAASP. This supplement expanded future organizational 
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development, partnerships, and collaborations to support the implementation of the Surgeon 

General’s National Strategy for Suicide Prevention.

In FY 2012, SAMHSA utilized Prevention and Public Health Fund for the SPRC to help support 

implementation of high impact objectives identified by the National Strategy for Suicide 

Prevention and the NAASP and to develop, based on the experience of GLS grantees, a strategic 

framework to embed sustainable, comprehensive, coordinated youth suicide prevention activities 

in states, tribes, and colleges across the nation. 

In FY 2013, SAMHSA provided support for the continuation of the SPRC grant with a reduced 

level of support for the NAASP as it transitions to alternate sources of funding. In FY 2014, 

SAMHSA plans to fund the continuation of the SPRC grant and a supplement from Prevention 

and Public Health Fund.

AI/AN Suicide Prevention

SAMHSA supports an innovative training and technical assistance project that helps tribal 

communities mobilize existing social and educational resources by facilitating the development 

and implementation of comprehensive and collaborative community based prevention plans to 

reduce violence, bullying, and suicide among American Indian/Alaska Native (AI/AN) youth. 

To date, 65 tribal communities have been provided specialized technical assistance and support 

in suicide prevention and related topic areas. In addition, over 9,200 community members were 

trained in prevention and mental health promotion in these communities. 

In FY 2013, SAMHSA’s CMHS AI/AN Suicide Prevention and CSAP’s Native American 

Center for Excellence programs collaborated through braided funding to provide comprehensive, 

broad, focused, and/or intensive training and technical assistance to federally-recognized tribes 

and other American Indian/Alaska Native communities, seeking to address and prevent mental 

and substance use disorders, suicide, and promote mental health. Any braided amounts spent or 

awarded are being tracked as distinct funding streams and used for purposes consistent with 

legislative direction and intent. In FY 2014, SAMHSA plans to support the continuation of the 

jointly funded contract.

Homelessness Prevention and Housing Program

One of the goals of SAMHSA’s Strategic Initiative on Recovery Support is to ensure that 

permanent housing and supportive services are available for individuals with mental and 

substance use disorders. Two programs are helping to support the goal of this Strategic 

Initiative. They include Services in Supportive Housing (SSH) and Grants for the Benefit of 

Homeless Individuals (GBHI) which are supported by both CSAT and CMHS. 

Studies indicate that Permanent Supportive Housing (PSH) is effective in helping single adults

(target population) maintain stability in housing. Performance data for the CMHS Services in 

Supportive Housing (SSH) program demonstrate increases in individual’s perception of their 

overall functioning as well as decreases in serious psychological distress, use of tobacco 
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products, binge drinking and criminal justice system involvement and an increased retention in 

stable housing.

The first program, SSH, implemented in 2007, provides comprehensive services that focus on 

outreach, engagement, intensive case management, mental health services, substance abuse 

treatment, benefits support, and linkage to permanent housing. Individuals with serious mental 

illness and/or a co-occurring mental and substance use disorder and their families who have been 

continuously homeless for at least one year or have had at least four episodes of homelessness in 

the past three years are the population of focus. In FY 2013, the SSH program’s outreach efforts 

resulted in 49,821 total contacts made. In FY 2012, SAMHSA provided support for 51 SSH 

grants. In FY 2013, SAMHSA provided support for 48 grants.

The second program, GBHI, awarded the Cooperative Agreements to Benefit Homeless 

Individuals (CABHI) in FY 2011 by CSAT in collaboration with CMHS. The purpose of this 

jointly funded program is to enhance or develop the infrastructure of states and their treatment 

service systems to increase capacity to provide accessible, effective, comprehensive, 

coordinated/integrated, and evidence-based treatment services; permanent supportive housing; 

peer supports; CMHS-funded peer navigator(s); and other critical services to persons who 

experience chronic homelessness with substance use disorders or co-occurring substance use and 

mental disorders. This program builds on the success of the previous SAMHSA SSH and 

CSAT’s Treatment for Homeless programs. As of FY 2013, there are 42 funded grants that have 

served 1,939 people with notable evidence of reduced experiences of depression and anxiety 

(62.5 percent and 66.2 percent respectively). 

In FY 2013, CMHS awarded 31 jointly funded CABHI grants with CSAT. In addition, 

SAMHSA awarded another 11 CABHI grants, which provided grants to states with the highest 

prevalence of individuals who are chronically homeless. 

In FY 2014, SAMHSA will work in partnership with the U.S. Interagency Council on 

Homelessness (USICH) to support and implement Opening Doors: The Federal Plan to Prevent 

and End Homelessness. Through both the Recovery Support and Criminal Justice and Trauma 

Strategic Initiatives, SAMHSA promotes collaborative leadership with other federal agencies 

with collaborative calls, trainings, workgroups, and expert panels to address various goals and 

objectives outlined in the Plan. SAMHSA accomplishes the goals and objectives outlined in the 

Plan by providing technical assistance to grantees and other stakeholders regarding behavioral 

health, homelessness, and successful interventions to prevent and end homelessness. The 

SAMHSA CABHI grant program aligns with the USICH goal to improve access to mainstream 

programs and services to reduce people’s financial vulnerability to homelessness and to provide 

integrated primary and behavioral health care services. SAMHSA along with other HHS 

agencies, HUD, and VA will explore the possibility of developing criteria to incentivize 

demonstrated collaboration between primary and behavioral healthcare providers and homeless 

assistance providers.

SAMHSA proposes to use approximately $21 million in Budget Authority in working with state 

and local Public Housing Authorities and state Medicaid agencies to develop systematic, costeffective, and integrated approaches to housing and behavioral health treatment and services for 
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mental and substance use disorders. This program will build upon lessons learned from the 

CABHI and the Department of Housing and Urban Development’s (HUD) new Section 811 

demonstration program, and will be developed by SAMHSA in collaboration with its federal 

partners, including HUD, Health Resources and Services Administration, Centers for Medicare 

and Medicaid Services, and the Interagency Council on Homelessness. 

The program will support innovative strategies to increase the availability of affordable housing 

combined with access to and behavioral health treatment services and supports that will help 

integrate individuals who are homeless with substance abuse and mental health disorders into the 

community, and assist providers in strengthening their infrastructure for delivering and 

sustaining housing integrated behavioral health and other critical services to support recovery. 

The program also will assist providers in preparing for implementation of the Affordable Care 

Act by encouraging third-party billing and requiring that clients are enrolled in eligible benefit 

programs. Efforts will include the design and implementation of strategies that require the use of 

SAMHSA funds for providing supportive services to the most needy individuals who are not 

Medicaid-eligible (or who in the process of being enrolled), Medicaid funds for covered services, 

and HUD vouchers or other funding sources for housing. The FY 2014 funding will support up 

to 19 grant awards of approximately $1.2 million dollars each. They will be awarded for three

years.

Minority AIDS

The purpose of the Minority AIDS program is to enhance and expand the provision of effective, 

culturally-competent HIV/AIDS-related mental health services in minority communities for 

people living with HIV/AIDS and who have a need for mental health services. The Centers for 

Disease Control and Prevention (CDC) reports significantly higher rates of HIV/AIDS among 

people of color. African Americans accounted for 44 percent and Hispanics accounted for 20 

percent of all HIV/AIDS cases diagnosed in 2009, per the most recent data available (CDC, 

2011). The 2009 data also shows a significant increase of 48 percent in HIV incidence among 

African American Men who have Sex with Men (MSM) aged 13-29, even as overall rates 

remained stable. Reasons for this increase are not fully known, although the high HIV 

prevalence rate in African American MSM and factors such as prejudice and discrimination, 

limited healthcare access, and poverty may create an enabling environment for HIV (CDC 2011). 

Psychiatric and psychosocial complications are frequently not diagnosed or addressed at the time 

of diagnosis or through the course of the HIV/AIDS disease process. When untreated, these 

complications are associated with increased morbidity and mortality, impaired quality of life, and 

numerous medical and/or behavioral challenges, such as non-adherence with the treatment 

regimen. Over 3,900 individuals received services in FY 2012 and over 3,800 received services 

in FY 2013. The Mental Health Care Provider Education in HIV/AID Education program 

disseminates knowledge and training on the treatment of the neuropsychiatric and psychological 

sequelae of HIV/AIDS. The program provides training to front line providers, including 

psychiatrists, psychologists, social workers, primary care practitioners and medical students.

In FY 2012, SAMHSA collaborated with CDC to provide support for 11 continuation grants for 

the Minority AIDS Initiative Targeted Capacity Expansion: Integrated Behavioral 

Health/Primary Care Network Cooperative Agreements with funding provided by CMHS, 
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CSAT, and CSAP. This grant program facilitates the development and expansion of culturally 

competent and effective integrated behavioral health and primary care networks, which include 

HIV services, medical treatment, and the expansion of behavioral health services within racial 

and ethnic minority communities in 11 Metropolitan Statistical Areas and Metropolitan 

Divisions most impacted by HIV/AIDS. Recipients are state and city health departments from 

the 12 cities most impacted by HIV/AIDS. The grant fosters development of a network of care 

for those with behavioral health conditions who are at risk for or who have HIV/AIDS. 

In FY 2013, SAMHSA provided funding for the continuation of 11 grants as well as evaluation 

and technical assistance contracts.

In FY 2014, SAMHSA’s CMHS, CSAP, and CSAT plan to pilot HIV Continuum of Care grants

which supports behavioral health screening, primary prevention, and treatment for racial/ethnic 

minority populations with or at high risk for mental and substance use disorders and HIV. This 

will include Substance Abuse (SA) primary prevention/treatment service programs, community 

mental health programs, and HIV integrated programs that can either co-locate or fully integrate 

HIV prevention and medical care services within them. Also, this program will provide SA and 

HIV primary prevention services in local communities served by the behavioral health program.

Criminal and Juvenile Justice Programs

Studies of people involved in the criminal justice system have found higher rates of co-occurring 

psychiatric and substance use disorders than the general population.2The number of individuals 

involved in the criminal justice system with mental or substance use disorders whose treatment 

needs are not being met by community treatment and supportive services is significant. As a 

result, they are at greater risk for parole or probation failure leading to re-incarceration at 

substantial additional governmental and societal cost. There is an ongoing need for broader 

implementation of effective treatment and reentry services for this high-risk, mostly nonviolent 

population. 

Over the past 30 years, the criminal justice system has become a repository for a large number of 

individuals with SMI who are arrested for a wide range of crimes.3 Since 2002, SAMHSA has 

administered the Jail Diversion Program for adults involved in the criminal justice system and 

has awarded grants to 51 states and communities. The purpose of this initiative is to divert 

individuals with mental illness from the criminal justice system to more appropriate, communitybased treatment and recovery support services including primary health care, housing, and job 

counseling/placement. 

In FY 2013, SAMHSA funded the continuation of seven grants and the evaluation and technical 

assistance contracts. In FY 2013, SAMHSA awarded three new grants of the Jail Diversion 

Program. This three-year grant program will emphasize on early diversion of individuals with 

behavioral health conditions at risk of being arrested. Early diversion will focus on the role of 

law enforcement working collaboratively with community behavioral health providers to prevent 

arrest and adjudication. Police will divert these individuals to behavioral health providers in the 

 

2

Serious Mental Illness and Arrest, Swartz and Lurigio, 2007

3

Id.
73

community who will assess their needs and coordinate a comprehensive plan of treatment and 

supports. Performance data demonstrate that the program has had a positive impact on the 

welfare of participants with significant increases in housing stability and employment and with 

major reductions in arrests and incarcerations.

In FY 2014, and in support of SAMHSA’s Recovery Support Strategic Initiative, a total of $5.4 

million in Budget Authority ($2.5 million in CMHS and $2.9 million in CSAT) will fund an 

additional cohort of Behavioral Health Treatment Court Collaborative Grants. The purpose of 

this grant program is to allow local courts more flexibility to collaborate with multiple criminal 

justice system components and local community treatment and recovery providers to address the 

behavioral health needs of adults who are involved with the criminal justice system. The court 

collaborative will focus on diversion of adults with behavioral health problems from the criminal 

justice system, including alternatives to incarceration. The collaborative will allow eligible 

individuals to receive treatment and recovery support services as part of a court collaborative.

This program will focus on connecting with individuals early in their involvement with the 

criminal justice system and prioritize the participation of municipal and misdemeanor courts in 

the collaborative. The program will support community behavioral health services for 

individuals with mental and/or substance disorders and will include a focus on veterans involved 

with the criminal justice system. 

Practice Improvement and Training

SAMHSA addresses the need for disseminating key information, such as evidence-based mental 

health practices, to the mental health delivery system and facilitates health reform by engaging in 

activities that support mental health system transformation and reform. These activities include 

Historically Black Colleges and Universities (HBCU) – Center of Excellence and Peer Review 

activities, Research and Training Centers, and Recovery into Practice.

The purpose of the HBCU-Center of Excellence is to network the 103 HBCUs in the United 

States and promote workforce development through expanding knowledge of best practices, 

developing leadership, and encouraging community partnerships that enhance the participation 

of African Americans in the substance abuse treatment and mental health professions. The 

comprehensive focus of the HBCU–Center for Excellence will simultaneously expand service 

capacity on campuses and in other treatment venues. There is one grant awarded for the HBCUCenter for Excellence. In FY 2013, SAMHSA provided continuation support to the grantee for 

the coordination and monitoring of 34 substance abuse treatment workforce development and 

mental health sub-award projects. In FY14, a new grant will be awarded. 

In FY 2012, as part of its wellness activities, SAMHSA collaborated with the CDC on its Million 

Hearts Initiative by focusing on the increased risk for cardiovascular disease, hypertension, and 

diabetes for individuals with and at risk for mental and substance use disorders. In FY 13, 

SAMHSA continued its collaboration with CDC and will do so in FY 2014.

The Rehabilitation Research and Training Centers (RRTCs) are funded in partnership with the 

U.S. Department of Education’s National Institute of Disability, Rehabilitation and Research. 

The RTCs develop, test, and disseminate a broad range of care models and practices that 
74

promote and support recovery for adults with mental illnesses and support resilience and 

recovery among youth and young adults with serious mental health challenges. This program 

was first established in 1979. Currently there are two RRTCs funded for up to five years. 

Program outcomes include the development of new treatments and interventions, trainings, 

workforce development, and new products. SAMHSA plans to continue these Centers in FY 

2013 and FY 2014.

Recovery into Practice is a five-year contract, funded in FY 2009, which supports the expansion 

and integration of recovery-oriented care delivered by mental health providers which will be 

accomplished through training and education, policy and analysis, and materials development. 

The effort collaborates amongst professional mental health disciplines to provide education and 

training on what recovery-oriented care is and how to implement it into practice, meet with 

stakeholders, establish collaborative relations with provider and consumer leaders, and conduct 

research and literature reviews on the current state of recovery-oriented care, knowledge, and 

attitudes. In FY 2013, SAMHSA funded the continuation of this contract and plans to recompete

the contract in FY 2014.

Consumer and Consumer-Supporter TA Centers

The Consumer and Consumer-Supporter TA Centers is a grant program that was first funded in 

1992. The purpose of Consumer and Consumer-Supported TA Centers is to provide technical 

assistance to facilitate the restructuring of the mental health system by promoting consumer 

directed approaches for adults with serious mental illnesses. Such programs maximize consumer 

self-determination and recovery and assist individuals with serious mental illness by decreasing 

their dependence on expensive social services and avoiding unnecessary or inappropriate

psychiatric hospitalization. This program also improves collaboration among consumers, 

families, advocates, providers, and administrators and facilitates community mental health 

services to be more consumer-driven and family-focused. 

This program also supports the annual Alternatives Conference, which provides a forum for 

consumers nationwide to meet, exchange information and lessons learned, and receive technical 

assistance on a variety of topics, such as peer support, consumer-operated services, self-help, 

protection and advocacy issues, empowerment, and recovery. The information and knowledge 

gained through attending this conference enables consumers to support effective individual 

treatments and services, as well as for broader managed care and service system improvements.

Performance data indicate that the program has been effective. In FY 2013, over 7,736 persons 

were trained and more than 1,034 consumers and family members have become involved in 

mental health-related planning and advocacy. 

In FY 2013, SAMHSA provided support to the five continuation grants and plans to continue 

this support in FY 2014.
75

Disaster Response

Over the last 39 years, SAMHSA, in partnership with the FEMA (Federal Emergency 

Management Agency) has been providing Disaster Behavioral Health Response and Recovery 

efforts through the FEMA Crisis Counseling Assistance and Training Program (CCP). 

The mission of CCP is to assist individuals and communities in recovering from challenging 

effects of natural and human-caused disasters through the provision of community-based 

outreach and psycho-educational services. The CCP supports short-term interventions that 

involve the counseling goals of assisting disaster survivors in understanding their current 

situation and reactions, mitigating stress, assisting survivors in reviewing their disaster recovery 

options, promoting the use or development of coping strategies, providing emotional support, 

and encouraging linkages with other individuals and agencies who may help survivors in their 

recovery process. 

The CCP is administered through an interagency agreement with FEMA. On behalf of FEMA, 

CMHS provides technical assistance, program guidance and monitoring, as well as oversight of 

the CCP. States, U.S. territories and federally recognized tribes are eligible to apply for CCP 

grants under the Stafford Act, with a designation for Individual Assistance in the affected areas, 

following a Presidential disaster declaration.

SAMHSA and FEMA jointly fund a Disaster Technical Assistance Center (DTAC) that provides 

technical assistance, strategic planning, consultation, and logistical support. Through these 

services, it helps states establish state-of-the-art behavioral health readiness and response 

capacity through “all hazards” disaster planning to respond readily to catastrophic events and 

emergencies such as those resulting from bioterrorism, mass violence, natural disaster, and other 

traumatic incidents. SAMHSA DTAC provides consultation to review disaster plans and 

compiles research on new threats and how best to plan for them. Services include a wide range of 

technical assistance activities and products to advance state and local capacity to deliver 

effective behavioral health services that are well integrated with traditional public health and 

disaster recovery efforts. 

The SAMHSA’s Disaster Distress Helpline (DDH) is the first national hotline dedicated to 

providing year-round disaster crisis counseling. This toll-free, multilingual crisis support service 

is available 24/7 via telephone (1-800-985-5990) and SMS (text ‘TalkWithUs’ to 66746) to 

residents in the United States and its territories who are experiencing emotional distress related 

to natural or man-made disasters. In FY 2013, the Disaster Distress Helpline (DDH) received 

6,436 calls and 7,848 text messages from 720 users. Four Core Regional Centers implemented 

trainings for 281 paid staff, interns and volunteers. The helpline established relationships with 

275 local, state and national disaster relief stakeholders. The Disaster Distress Helpline website 

(http://disasterdistress.samhsa.gov) had 31,962 unique visits and the DDH Facebook and Twitter 

pages grew by 1,612 (to 3,429) and 1,521 (to 2,061) followers and likes, respectively.

When disasters strike, the role of behavioral health in recovery is immense. In 2013, SAMHSA 

received a total of $7.5 million in supplemental funds to assist the survivors of Hurricane Sandy 

recovery. Efforts focused on providing behavioral health treatment that could be funded no other 
76

way, restoring the capability of medication assisted substance abuse treatment services in the 

impacted areas, ensuring the operation of the DDH, conducting resiliency training with 

educators, and ensuring crisis counseling services wherever Sandy survivors relocated. 

Tribal Behavioral Health Grants

In FY 2014, Congress appropriated $5 million to address the high incidence of substance abuse 

and suicide in American Indian/Alaska Native (AI/AN) populations. The Appropriations 

Committee recommended that HHS use the funding for competitively awarded grants targeting 

tribal entities with the highest rates of suicide per capita over the past 10 years for effective and 

promising strategies that address the problems of substance abuse and suicide and promote 

mental health among AI/AN young people.

In 2010, the suicide rate among AI/AN age 8 to 24 was 14.98 per 100,000, more than twice the 

suicide rate for all races of the same age (7.29). Suicide is the second leading cause of death 

among AI/AN youth of that age group. Furthermore, AI/AN high school students report higher 

rates of suicidal behaviors (serious thoughts of suicide, making suicide plans, attempting suicide, 

and getting medical attention for a suicide attempt) than the general population of U.S. high 

school students. Lifetime rates of having attempted suicide are higher for AI/AN youth raised on 

reservations than for those raised in urban areas (17.6 percent vs. 14.3 percent), and lifetime rates 

of suicidal ideation were significantly higher among youth raised on reservations (32.6 percent) 

compared to youth raised in urban areas (21 percent).

In 2012, past month illicit drug abuse was highest among AI/AN youth ages 12-17 (12.1 

percent), as is past month tobacco use (18.3 percent), compared to others in this age group. 

Consultation sessions with AI/AN tribal leaders in 2010, 2011, and 2012 indicated the issues of 

suicide and substance abuse to be the two biggest issues affected the mental health of tribal 

young people, and that these two issues are often experienced together among youth in tribal 

communities. Prescription drug abuse was also a growing concern for tribal leaders, with 4.7 

percent of AI/AN youth ages 12-17 acknowledging nonmedical use of prescription drugs - and 

3.0 percent acknowledging nonmedical use of pain relievers - in the past month, the highest of 

any group

SAMHSA will competitively award Tribal Behavioral Health Grants of up to $0.2 million to 

approximately 20 tribes or tribal organizations with high rates of suicide to develop and 

implement a plan that addresses suicide and substance abuse (including alcohol), designed to 

promote mental health among tribal youth. Grantees will indicate how they will incorporate 

evidence-based, culture-based, and practice-based strategies for tribal youth in age ranges they 

choose to address, up to age 24. Grantees will indicate how the strategies they choose are 

designed to prevent suicidal thoughts, plans and attempts among the selected tribal youth, and 

how they will connect promotion of positive mental health to prevention of suicide and substance 

abuse and how they will identify, refer, and provide assistance for tribal youth with or at risk of 

substance abuse and suicidal ideation, and their families. Grantees will be expected to provide or 

arrange for intervention and follow up with those youth who have made suicide attempts. The 

plan must include the development of a sustainable infrastructure.
77

Grantees will be required to work across tribal suicide prevention, mental health, substance 

abuse prevention, and substance abuse treatment programs to build positive behavioral health 

among youth. Using real-time surveillance data of suicide deaths and attempts, grantees will 

create or enhance effective systems of follow up for those identified at risk of suicide and/or 

substance abuse or mental health issues that could lead to suicide. With a focus on tribal 

traditions, interagency collaboration, early identification, community healing, and preventing 

future deaths by suicide, grantees will connect appropriate cultural practices, intervention 

services, care, and information with families, friends, schools, educational institutions, 

correctional systems, substance abuse programs, mental health programs, foster care systems, 

and other support organizations for tribal youth. Attention to the families and friends of tribal 

community members who recently died by suicide will be encouraged. 

In addition, technical assistance will be provided to grantees through SAMHSA’s Tribal 

Technical Assistance Center to support their ability to achieve their goals. An evaluation 

component will allow grantees and SAMHSA to work collaboratively to monitor progress, learn 

from each other, and incorporate lessons learned into enhancing the program and into national 

efforts to reduce suicide and substance abuse and build positive mental health among AI/AN 

Americans.

Funding History1\

Fiscal Year Amount

FY 2011 $340,847,774

FY 2012 $315,666,472

FY 2013 $266,508,991

FY 2014

FY 2015

$378,216,000

$354,740,000

1\

The funding history is presented on a comparable basis to previous funding levels to represent the 

revised budget structure and includes the PHS Evaluation Fund and Prevention and Public Health Funds.

Budget Request 

The FY 2015 Budget Request is $354.7 million at the program level with $311.7 million from 

Budget Authority, $38 million from Prevention and Public Health Fund, and $5 million from 

PHS Evaluation Funds. This is an overall decrease of $23.5 million from the FY 2014 Enacted 

Level which includes a decrease of $54.5 million in Budget Authority, an increase of $26 million 

in Prevention and Public Health Funds, and an increase of $5 million in PHS Evaluation Fund. 

This level of funding will support the continuation of all programmatic activities and four new 

activities: HIV Continuum of Care, Building Behavioral Health Coalitions, CABHI and Health 

Information Technology, as well as a new program, Grants for Adult Trauma Screening and 

Brief Intervention. The request includes:
78

Minority AIDS Initiative and 

Primary and Behavioral Health Care Integration

HIV Continuum of Care Pilot

(Braided program with Substance Abuse Treatment: Minority AIDS Initiative and Primary Care 

and Addiction Services Integration and with Substance Abuse Prevention: Minority AIDS 

Initiative)

SAMHSA expects that data generated from the 2014 HIV Continuum of Care pilot grant will 

help to inform an expanded program proposed for 2015 to continue the co-location and 

integrated HIV/primary care within either substance abuse or community mental health treatment 

programs. Braided funds in 2015 in the amount of $24 million would be dedicated to establishing 

integrated behavioral health and HIV care in addition to primary care needed by those living 

with or at high risk for HIV infection in minority communities heavily impacted by HIV. In 

addition, because of the significant comorbidity of viral hepatitis with HIV infection and because 

viral hepatitis occurs in up to 20% of those with either substance use disorders or serious mental 

illness, 5% of the allocated funds will be used to provide services to prevent, screen, test and 

refer to treatment as clinically appropriate those at risk for or living with viral hepatitis.

SAMHSA will work closely with CDC and HRSA to ensure these efforts are complimentary and 

not duplicative. In integrating HIV care into behavioral health settings, people living with 

HIV/AIDS and M/SUDs will have greater access to treatment for these conditions. Integrated 

care programs developed as a result of this grant program will make it possible for behavioral 

health and HIV care needs to be addressed in one setting. This will result in effective, personcentered, treatment that will reduce the risk of HIV transmission, improve outcomes for those 

living with HIV, and ultimately reduce new infections. SAMHSA’s Common Data platform 

(CDP), now under development, will integrate substance abuse and mental health elements with

HIV and Hepatitis elements to ensure a more rigorous evaluation and data analysis to inform 

future public health intervention decision-making that addresses the intersection of behavioral 

health and HIV. 

Mental Health System Transformation and Health Reform

SAMHSA will continue to engage in activities that support the transformation of the mental 

health system in alignment with the implementation of coverage expansions for mental health 

and substance abuse services contained in the Affordable Care Act and Mental Health Parity and 

Addiction Equity Act. In FY 2015, these activities include the Mental Health Transformation 

Grant Program and Building Behavioral Health Coalitions; Working to Address Shared Risk and 

Protective Factors.

Mental Health System Transformation Grants

In support of SAMHSA’s Recovery Support Strategic Initiative, SAMHSA proposes to use 

approximately $5.2 million to award a new cohort of Mental Health Transformation Grants 

(MHTG). The purpose of the MHTG grant program is to foster adoption and implementation of 

permanent transformative changes in how public mental health services are organized, managed 

and delivered so that they are consumer-driven, recovery-oriented and supported through 
79

evidence-based and best practices. The new grants will allow applicants to expand their service 

capacity to address emerging needs, including the need for crisis support and response services. 

Specifically, the new MHTG will demonstrate the continuum of services most helpful in 

improving community capacity to respond to psychiatric crises and reduce the need for use of inpatient services by adults with serious mental illness (SMI) or children/youth with serious 

emotional disturbance (SED).

Building Behavioral Health Coalitions: 

Working to Address Shared Risk and Protective Factors

(Braided program with Substance Abuse Prevention: Strategic Prevention Framework)

In support of SAMHSA’s Prevention of Substance Abuse and Mental Illness Strategic Initiative, 

SAMHSA proposes to use $3 million in Budget Authority to establish the Building Behavioral 

Health Coalitions program. SAMHSA will use $1.5 million from Mental Health 

Appropriation’s Mental Health Transformation and Health Reform funds and $1.5 million from 

Substance Abuse Prevention Appropriation’s Strategic Prevention Framework funds to support 

this new initiative. The purpose of this program is to support active community coalitions and/or 

organizations to expand their focus and activities to include mental health promotion, mental 

illness prevention and substance abuse prevention. Consistent with the Institute of Medicine’s 

2009 report on Preventing Mental, Emotional, and Behavioral Disorders Among Young People, 

this program seeks to build on the emerging evidence that a significant number of mental, 

emotional and substance abuse problems in young people are largely preventable, and 

community-based prevention can play a significant role in facilitating key prevention efforts. 

Evidence shows that to create emotionally healthy communities, it is important to address the 

shared risk factors that contribute to an array of adverse outcomes, and the protective factors that 

reduce the risk of these negative consequences. Risk factors include poverty, early trauma, 

drug/alcohol misuse, family dysfunction, poor academic performance, and peer rejection.

Protective factors include good communication skills, stress mitigation, reliable support and 

guidance from parents and caregivers, support for high quality early learning, quality health care, 

healthy peer groups, social connectedness, and successful learning environments.

Mental Health Transformation and Health Reform funds will be provided to substance abuse 

prevention community coalitions (including, but not limited to, current and former Drug Free 

Communities grantees) and organizations to expand their activities to include mental health 

promotion and mental illness prevention, and Strategic Prevention Framework funds will be 

provided to coalitions and organizations with a mental health focus to expand their activities to 

include substance abuse prevention. Funding streams will be kept separate and used for 

activities consistent with separate funding authorities. 

Funded activities may include but are not limited to, bi-directional education on substance abuse 

prevention and mental health promotion; assessing shared community risk and protective 

factors, especially among youth, connecting across community service systems including 

primary care, and developing the capacity to jointly implement evidence-based programming 

that addresses these factors; and working with stakeholders such as health insurance companies, 

Marketplaces, and state Medicaid officials to promote health insurance coverage for substance 

abuse prevention and mental health promotion. Grantees will be encouraged to consider best 
80

practices and models developed through other community-level programs such as Drug Free 

Communities, Safe Schools/Healthy Students, and Project LAUNCH.

Homelessness Prevention Programs

Housing and Homelessness 

(Braided program with Substance Abuse Treatment: Treatment Systems for Homelessness)

In FY 2015, SAMHSA proposes to use approximately $13.2 million, for new programming 

related to homelessness (CSAT-$8 million; CMHS-$5.2 million). This includes funding 

approximately 15 grants at $0.8 million per year to build on lessons learned from the CABHI and 

CABHI-States programs which are designed to work with state and local partners including 

public housing authorities, Medicaid, Veteran’s Affairs, behavioral health providers and other 

agencies to develop systematic, cost-effective, and integrated approaches to housing that 

includes treatment and services for mental and substance use disorders. The program will support 

innovative strategies to provide needed services and supports that will help integrate individuals 

who are experiencing homelessness with substance abuse and mental health disorders into the 

community, assist providers in strengthening their infrastructure for delivering and sustaining 

housing to support recovery with integrated behavioral health, and other critical services. The 

program also will support providers in the implementation of coverage expansions for mental 

health and substance abuse services. The program will also support recovery residences. 

Funds will also be used to support a Homelessness Health Information Sharing pilot project. This 

program will pilot-test automated sharing of client information within and among health care 

providers and social service agencies by means of electronic health records (EHRs), homeless 

management information systems (HMIS), and other social service information systems. The 

pilots will address a number of policy and technology issues including: privacy policies for 

protecting sensitive information, interoperability across systems, development of data collection 

and reporting standards for information sharing, workflow integration, etc. This initiative builds 

on SAMHSA’s current homelessness activities in both CSAT and CMHS and will be used to 

explore how technology can improve systems for addressing homelessness in community-based 

health systems for individuals with behavioral health conditions. 

Grants for Adult Trauma Screening and Brief Intervention

Consistent with the Trauma and Justice Strategic Initiative, and the Women’s Preventive 

Services recommended by the Institute of Medicine’s (IOM), in FY 2015, SAMHSA requests to 

implement a new $2.9 million program line, Grants for Adult Trauma Screening and Brief 

Intervention (GATSBI). Trauma is a widespread, harmful, and costly public health problem. It 

occurs as a result of violence, abuse, neglect, loss, disaster, war, and other adverse experiences. 

Trauma has no boundaries with regard to age, gender, socioeconomic status, race, ethnicity, 

geography, or sexual orientation. The need to address trauma is increasingly viewed as an 

important component of effective behavioral health service delivery. 

The effects of trauma significantly impact individuals, families, and communities and create 

challenges for public institutions and service systems. Although many individuals who 
81

experience a potentially traumatic event will go on with their lives without lasting negative 

effects, others will have more difficulty and experience traumatic stress reactions. Emerging 

research has documented the relationship among traumatic events, impaired neurodevelopment 

and immune system responses, and subsequent health risk behaviors resulting in chronic physical 

and behavioral disorders. In fact, the chronic stress that often accompanies repeated or 

unresolved trauma has even been linked to physically observable negative changes in brain 

development, including a reduction in the size of the hippocampus, the portion of the brain 

associated with long-term memory and spatial reasoning. With appropriate supports and 

intervention, individuals can overcome traumatic experiences. However, most individuals go 

without these services and supports. Unaddressed trauma significantly increases the risk of 

mental and substance use disorders, chronic physical diseases, and early death.

Individuals with experiences of trauma are found in multiple service sectors, not just in 

behavioral health. Studies of individuals in the juvenile and criminal justice systems reveal high 

rates of mental and substance use disorders and personal histories of trauma. Children and 

families in the child welfare system similarly experience high rates of trauma and associated 

behavioral health problems. Preventing exposure to potentially traumatic events and responding 

with early interventions and treatment for those experiencing traumatic stress may improve 

outcomes for these individuals and prevent prolonged involvement with the justice and child 

welfare systems. 

Previous research has shown that there is a strong need for a public health approach to 

addressing trauma and adverse childhood events. According to the Adverse Childhood 

Experiences Study (2008), more than one in four individuals have experienced multiple adverse 

childhood experiences (such as sexual and emotional abuse, divorce or having a parent with a 

substance use disorder), which makes them more likely to have higher rates of substance abuse, 

depression, and suicide than others. Thus, the GATSBI program will draw upon existing and 

effective screening frameworks in order to identify and intervene with adults that have 

experienced past trauma and/or adverse events.

The GATSBI program will advance the knowledge base to address trauma in common health 

care settings, such as emergency departments, primary care, and OB/GYN. The concept and 

design for these grants will be developed by SAMHSA in consultation with its federal partners: 

ACF, CDC, NIAAA, NIDA, NIMH, and VA. An estimated four grants will be awarded with up 

to $600,000 per year for five years.
82

The FY 2015 Budget Request also includes an increase in the following:

 The National Strategy for Suicide Prevention request is $4 million, an increase of $2

million from the FY 2014 Enacted Level. Consistent with SAMHSA’s Prevention of 

Substance Abuse and Mental Illness Strategic Initiative, $2 million is requested to assist 

states in further establishing evidence-based suicide prevention efforts that support the 

goals and objectives of the NSSP. The requested $2 million will directly support the 

recommendations of the NSSP and allow for the implementation of elements of the NSSP 

that are not currently being addressed in any other national initiative. This year is critical 

in continuing the momentum achieved during the release of the National Strategy. Some 

states will require assistance in developing these plans required under the block grants as 

well as in collaborating with Medicaid, dual eligible, and health home efforts. The $2

million will be utilized to develop and test nationwide efforts such as suicide awareness, 

provider credentialing changes, emergency room referral processes, clinical care practice 

standards, practitioner training regarding depression and suicide screening techniques, 

and technical assistance for those community human services and health workers most 

likely to encounter those who may be thinking about suicide. 

 Minority AIDS Budget Request is $16.3 million, an increase of $7 million from FY 2014 

Enacted Level, which is offset by a decrease to the Substance Abuse Treatment MAI to 

continue the support of MAI as well as HIV Continuum of Care grants.

 Disaster Response Budget Request is $2.9 million, an increase of $1 million from the FY 

2014 Enacted Level to continue the support of a nationally available disaster distress 

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

country. The need for this initiative has been documented through the Assistant 

Secretary for Preparedness and Response after various emergency conditions throughout 

the world and after U.S. disasters that did not rise to the level of presidentially declared 

emergencies and, therefore, did not qualify for Stafford Act Funding. In addition, funding 

will continue to support DTAC contract which provides consultation to review disaster 

plans and compiles research on new threats and how best to plan for them. Services 

include a wide range of technical assistance activities and products to advance state and 

local capacity to deliver effective behavioral health services that are well integrated with 

traditional public health and disaster recovery efforts.

The FY 2015 Budget Request includes level funding from the FY 2014 Enacted Level for the 

programs below

 Seclusion and Restraint and Trauma: Funding is requested to continue support for 

dissemination of trauma informed practices across multiple services settings advancing 

the goal of reducing and eliminating the use of seclusion, restraint, and other traumatizing 

practices in service systems and treatment agencies.

 Youth Violence Prevention: Funding is requested to provide continued assistance to help 

students thrive, succeed in school, and build healthy relationships. Funds will provide 

continued support for state and community level partnerships among educational, 

behavioral health and juvenile justice systems and promote systems integration and 

collaboration.
83

 Project AWARE: Funding is requested to support increased awareness of mental health 

issues and connect young people with behavioral health issues and their families with 

needed services. Funds will provide support for the continuation of the partnerships with 

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

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

 Healthy Transitions: Funding is requested to continue support for the newly developed 

demonstration grant program for states. This program proposes innovative approaches to 

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

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

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

support, and disseminate best practices for services to youth, ages 16-25, informing state 

systems and other programs serving transitional-aged youth.

 Children and Family Programs: Funding is requested to continue to support Children and 

Family programs which provide much needed services and support to children and youth 

with and at risk for mental health conditions and their families.

 Consumer and Family Network Grants: Funding is requested to support SAMHSA’s 

Recovery Support Strategic Initiative by promoting consumer, family, and youth 

participation in the development of policies, programs, and quality assurance activities 

related to mental health systems reform across America.

 Project LAUNCH: Funding is requested to continue to support, creating a shared vision 

for the wellness of young children that drives the development of federal, state, territorial, 

tribal and local networks for the coordination of key child-serving systems and the 

integration of behavioral and physical health services. In addition, the funding will allow 

Project LAUNCH to improve health outcomes for young children and coordinate with 

other HHS partners on early learning and other relevant services for those living in 

communities with highly concentrated poverty.

 MH System Transformation and Health Reform: Funding is requested to continue to 

support Transforming Lives through Supported Employment Grant Program to focus the 

program on an existing activity: enhancing state and community capacity to provide 

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

illnesses/emotional disturbances.

 AI/AN Suicide Prevention Initiative: Funding is requested to continue support that 

provides comprehensive, broad, focused, and/or intensive training and technical 

assistance to federally-recognized tribes and other American Indian/Alaska Native 

communities, seeking to address and prevent mental and substance use disorders, suicide, 

and promote mental health.

 Homelessness Prevention Programs: Funding is requested to continue working in 

partnership with the U.S. Interagency Council on Homelessness (USICH) to support and 

implement Opening Doors: The Federal Plan to Prevent and End Homelessness.

Through both the Recovery Support and Criminal Justice and Trauma Strategic 

Initiatives, SAMHSA promotes collaborative leadership with other federal agencies with 

collaborative calls, trainings, workgroups, and expert panels to address various goals and 

objectives outlined in the Plan.

 Criminal and Juvenile Justice Programs: Funding is requested to continue the support for 

allowing local courts more flexibility to collaborate with multiple criminal justice system 

components and local community treatment and recovery providers to address the 
84

behavioral health needs of adults who are involved with the criminal justice system. The 

court collaborative will focus on diversion of adults with behavioral health problems 

from the criminal justice system, including alternatives to incarceration.

 Practice Improvement & Training: Funding is requested to address the need for 

disseminating key information, such as evidence-based mental health practices, to the 

mental health delivery system and facilitates health reform by engaging in activities that 

support mental health system transformation and reform.

 Consumer and Consumer Support TA Centers: Funding is requested to continue to 

provide technical assistance to facilitate the restructuring of the mental health system by 

promoting consumer directed approaches for adults with serious mental illnesses.

 Homelessness: Funding is requested to continue to provide technical assistance on 

permanent supportive housing and related recovery supports to grantees. This program 

advances SAMHSA’s Strategic Initiatives, specifically Recovery Support, as it pertains 

to housing and homelessness, as well as the Strategic Initiative on Trauma and Justice.

 HIV/AIDS Education: Funding is requested to continue to provide training and education 

activities specific to psychiatry and HIV/AIDS, prioritizing areas of highest HIV 

prevalence in the U.S.

The FY 2015 Budget Request includes decreases in the following:

 National Child Traumatic Stress Initiative: request is $45.7 million, a decrease of $0.3

million from the FY 2014 Enacted Level.

 Primary and Behavioral Health Care Integration request is $28 million a decrease of $24

million from the FY 2014 Enacted Level. The funding will also support Braided 

Program: HIV Continuum of Care to provide bi-directional integration between primary 

care services and substance abuse treatment/mental health services (for CSAT/CMHS) 

and address service coordination and infrastructure needs to providers.

 Suicide Lifeline: request is $5.5 million, a decrease of $1.7 million from FY 2014 

Enacted Level.

 GLS - Youth Suicide Prevention – Campus request is $5 million, a decrease of $1.5

million from FY 2014 Enacted Level.

 The GLS - Youth Suicide Prevention – States program request is $27.7 million, a 

decrease of $7.8 million from the FY 2014 Enacted Level. 

 GLS - Suicide Prevention Resource Center request is $4.9 million, a decrease of $1

million from FY 2014 Enacted Level.
85

SAMHSA/Mental Health

PRNS Mechanism Table by APT

(Dollars in thousands)

No. Amount No. Amount No. Amount

Programs of Regional & National Significance

Grants/Cooperative Agreements

Continuations......................................................................... 425 $176,608 311 $126,218 450 $237,222

New/Competing..................................................................... 118 36,438 280 187,049 101 50,618

Subtotal............................................................................... 543 213,046 591 313,267 551 287,840

Contracts

Continuations......................................................................... 26 38,847 13 37,158 35 63,172

New/Competing..................................................................... 6 14,617 23 27,791 --- 3,728

Subtotal............................................................................... 32 53,463 36 64,949 35 66,900

Subtotal, PRNS 1/ 575 $266,509 627 $378,216 586 $354,740

FY 2015

President's 

Budget

FY 2014

Enacted

FY 2013

Final

*Totals may not add due to rounding.

1/ The Prevention and Public Health Funds amount to $12,000,000 in FY 2014 and $38,000,000 in the FY 2015 Request.

A detailed table for all grant and contract continuations and new activities can be found in the 

Supplementary Tables Chapter.
86

Key Outputs and Outcomes 

Program: Youth Violence Prevention

NOTE: SAMHSA grant awards are made late in the year. FY 2014 Enacted is reflected in FY 2015 targets. FY 

2015 President’s Budget is reflected in FY 2016 targets.

Measure Year and Most 

Recent Result /

Target for Recent 

Result /

(Summary of Result)

FY 

2015

Target

FY 

2016

Target

FY 2016

Target

+/-

FY 2015

Target

3.2.04 Number of children served through the Youth 

Violence Prevention program (Outcome)

FY 2013: 952,142

Target:

2,328,500

(Target Not Met)

952,1424952,1425 Maintain

3.2.10 Percentage of students who receive mental health 

services (Outcome)

FY 2013: 70.7%

Target:

66%

(Target Exceeded)

70.7% 70.7% Maintain

3.2.29 Percentage of middle and high school students 

who have been in a physical fight on school property 

(Outcome)

FY 2013: 13.8 %

Target:

27.0 %

(Target Exceeded)

13.8 % 13.8 % Maintain

3.2.30 Decrease the percentage of middle and high 

school students who report current substance abuse 

(Outcome)

FY 2013: 18.1 %

Target:

20.0 %

(Target Exceeded)

18.1 % 18.1 % Maintain

3.2.31 Number of children (ages 0-5) screened for 

mental health or related interventions (Outcome)

FY 2014: Result 

Expected Dec 31, 

2014

Target:

Set Baseline

(Pending)

TBD TBD Maintain

3.2.32 Number of organizations collaborating and 

sharing resources with other organizations as a result of 

the grant (Outcome)

FY 2014: Result 

Expected Dec 31, 

2014

Target:

Set Baseline

(Pending)

TBD TBD Maintain

 

4

Target includes children served through the Project AWARE program.

5

Target includes children served through the Project AWARE program.
87

Program: National Child Traumatic Stress Initiative (NCTSI)

NOTE: SAMHSA grant awards are made late in the year. FY 2014 Enacted is reflected in FY 2015 targets. FY 

2015 President’s Budget is reflected in FY 2016 targets.

Measure Year and Most 

Recent Result /

Target for Recent 

Result /

(Summary of 

Result)

FY 

2015

Target

FY 

2016

Target

FY 2016

Target

+/-

FY 2015

Target

3.2.02a Increase the percentage of children receiving trauma 

informed services who report positive functioning at 6 

month follow-up (Outcome)

FY 2013: 65.9%

Target:

76.1%

(Target Not Met)

65.9% 65.9% Maintain

3.2.23 Unduplicated count of the number of children and 

adolescents receiving trauma-informed services (Outcome)

FY 2013: 2,295

Target:

3,052

(Target Not Met)

2,309 2,295 -14

3.2.24 Number of child-serving professionals trained in 

providing trauma-informed services (Outcome)

FY 2013: 170,201

Target:

73,992

(Target Exceeded)

171,270 170,205 -1,065
88

Program: Project AWARE

NOTE: SAMHSA grant awards are made late in the year. FY 2014 Enacted is reflected in FY 2015 targets. FY 

2015 President’s Budget is reflected in FY 2016 targets.

Measure Year and Most Recent 

Result /

Target for Recent 

Result /

(Summary of Result)

FY 

2015

Target

FY 

2016

Target

FY 2016

Target

+/-

FY 2015

Target

3.2.18 Number of children served. (Output) FY 2015: Result 

Expected Dec 31, 2015

Target:

750,000

(Pending)

750,000 750,000 Maintain

3.2.19 Number of children referred to mental health or 

related services. (Output)

FY 2015: Result 

Expected Dec 31, 2015

Target:

Set Baseline

(Pending)

Maintain

3.2.20 Number of organizations collaborating and 

sharing resources as a result of the grant. (Outcome)

FY 2015: Result 

Expected Dec 31, 2015

Target:

Set Baseline

(Pending)

Maintain
89

Program: Healthy Transitions

NOTE: SAMHSA grant awards are made late in the year. FY 2014 Enacted is reflected in FY 2015 targets. FY 

2015 President’s Budget is reflected in FY 2016 targets.

Measure Year and Most 

Recent Result /

Target for Recent 

Result /

(Summary of 

Result)

FY 

2015

Target

FY 

2016

Target

FY 2016

Target

+/-

FY 2015

Target

3.2.34 Percentage of clients receiving services who report 

positive functioning at 6 month follow-up. (Outcome)

FY 2013: 64.0 %

Target:

64.0 %

(Baseline)

64.0 % 64.0 % Maintain

3.2.35 Percentage of clients receiving services who had a

permanent place to live in the community at 6 month followup. (Outcome)

FY 2013: 36.0 %

Target:

36.0 %

(Baseline)

36.0 % 36.0 % Maintain

3.2.36 Percentage of clients receiving services who are 

currently employed at 6 month follow-up. (Outcome)

FY 2013: 56.0 %

Target:

56.0 %

(Baseline)

56.0 % 56.0 % Maintain

3.2.37 Increase the number of individuals referred to mental 

health or related services (Output)

FY 2013: 7,389

Target:

7,389

(Baseline)

5,911 5,911 Maintain
90

Program: Mental Health-Project LAUNCH

NOTE: SAMHSA grant awards are made late in the year. FY 2014 Enacted is reflected in FY 2015 targets. FY 

2015 President’s Budget is reflected in FY 2016 targets.

Measure Year and Most 

Recent Result /

Target for Recent 

Result /

(Summary of 

Result)

FY 

2015

Target

FY 

2016

Target

FY 2016

Target

+/-

FY 2015

Target

2.3.94 Number of persons served (Output) FY 2013: 32,232

Target:

32,232

(Baseline)

32,232 32,232 Maintain

2.3.95 Number of persons trained in mental illness 

prevention or mental health promotion (Outcome)

FY 2013: 13,102

Target:

13,102

(Baseline)

13,102 13,102 Maintain

2.4.00 Number of 0-8 year old children screened for 

mental health or related interventions (Outcome)

FY 2013: 44,775

Target:

44,775

(Baseline)

44,775 44,775 Maintain

2.4.01 Number of 0-8 year old children referred to mental 

health or related interventions (Outcome)

FY 2013: 9,114

Target:

9,114

(Baseline)

9,114 9,114 Maintain
91

Program: Mental Health System Transformation Grants

NOTE: SAMHSA grant awards are made late in the year. FY 2014 Enacted is reflected in FY 2015 targets. FY 

2015 President’s Budget is reflected in FY 2016 targets.

Measure Year and Most 

Recent Result /

Target for Recent 

Result /

(Summary of 

Result)

FY 

2015

Target

FY 

2016

Target

FY 2016

Target

+/-

FY 2015

Target

1.2.11 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 2013: 7,751

Target:

1,4886

(Target Exceeded)

7,736 7,736 Maintain

1.2.21 Percentage of clients receiving services who report 

positive functioning at 6 month follow-up. (Outcome)

FY 2013: 52.1

Target:

52.1

(Baseline)

TBD TBD Maintain

1.2.22 Percentage of clients receiving services who had a 

permanent place to live in the community at 6 month followup. (Outcome)

FY 2013: 73.7

Target:

73.7

(Baseline)

TBD TBD Maintain

1.2.23 Percentage of clients receiving services who are 

currently employed at 6 month follow-up. (Outcome)

FY 2013: 30.7

Target:

30.7

(Baseline)

TBD TBD Maintain

1.2.24 Number of individuals referred to mental health or 

related services. (Outcome)

FY 2014: Result 

Expected Dec 31, 

2014

Target:

Set Baseline

(Pending)

TBD TBD Maintain

 

6

Target has been reduced to reflect the reduced program funding in FY 2012. 
92

Program: Primary & Behavioral Health Care Integration (PBHCI)

NOTE: SAMHSA grant awards are made late in the year. FY 2014 Enacted is reflected in FY 2015 targets. FY 

2015 President’s Budget is reflected in FY 2016 targets.

Measure Year and Most 

Recent Result /

Target for Recent 

Result /

(Summary of 

Result)

FY 

2015

Target

FY 

2016

Target

FY 2016

Target

+/-

FY 2015

Target

3.2.40 Number of clients served (Output) FY 2013: 33,023

Target:

33,023

(Baseline)

21,100 21,100 Maintain

3.2.41 Percentage of clients receiving services who report 

positive functioning at 6 month follow-up. (Outcome)

FY 2013: 55.3%

Target:

55.3%

(Baseline)

49.9% 49.9% Maintain

3.2.42 Percentage of clients receiving services who are 

currently employed at 6 month follow-up. (Outcome)

FY 2013: 21.1%

Target:

21.1%

(Baseline)

22.1% 22.1% Maintain

3.2.43 Percentage of clients receiving services who had a 

permanent place to live in the community at 6 month followup. (Outcome)

FY 2013: 71.6%

Target:

71.6%

(Baseline)

65.7% 65.7% Maintain

3.2.44 Percentage of adults receiving services who had 

positive social support at 6 month follow-up. (Outcome)

FY 2013: 68.3%

Target:

68.3%

(Baseline)

64.3% 64.3% Maintain
93

Program: Suicide Prevention

NOTE: SAMHSA grant awards are made late in the year. FY 2014 Enacted is reflected in FY 2015 targets. FY 

2015 President’s Budget is reflected in FY 2016 targets.

Measure Year and Most 

Recent Result /

Target for Recent 

Result /

(Summary of Result)

FY 

2015

Target

FY 

2016

Target

FY 2016

Target

+/-

FY 2015

Target

2.3.59 Total number of individuals trained in youth 

suicide prevention (Outcome)

FY 2013: 172,8767

Target:

35,371

(Target Exceeded)

161,000 134,000 -27,000

2.3.60 Total number of youth screened (Output) FY 2013: 79,318

Target:

3,360

(Target Exceeded)

73,996 61,626 -12,370

2.3.61 Increase the number of calls answered by the 

suicide hotline (Output)

FY 2013: 1,061,204

Target:

765,638

(Target Exceeded)

989,994 824,501 -165,493

3.2.37 Increase the number of individuals referred to 

mental health or related services (Output)

FY 2013: 7,389

Target:

7,389

(Baseline)

5,911 5,911 Maintain

 

7

Programs included are the Garrett Lee Smith Campus Suicide Prevention Program and the Garrett Lee Smith State/Tribal Suicide Prevention 

Program.
94

Program: Mental Health Homelessness Prevention Programs

NOTE: SAMHSA grant awards are made late in the year. FY 2014 Enacted is reflected in FY 2015 targets. FY 

2015 President’s Budget is reflected in FY 2016 targets.

Measure Year and Most 

Recent Result /

Target for 

Recent Result /

(Summary of 

Result)

FY 

2015

Target

FY 

2016

Target

FY 2016

Target

+/-

FY 2015

Target

3.4.01 Number of clients served (Output) FY 2013: 4,959

Target:

5,034

(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 2013: 66.1 %

Target:

63.1 %

(Target 

Exceeded)

66.1 % 66.1 % Maintain

3.4.03 Percentage of adults receiving services who were 

currently employed at 6 month follow-up (Outcome)

FY 2013: 26.0 %

Target:

15.6 %

(Target 

Exceeded)

26.0 % 26.0 % Maintain

3.4.05 Percentage of adults receiving services who had a 

permanent place to live in the community at 6 month followup (Outcome)

FY 2013: 81.2 %

Target:

74.2 %

(Target 

Exceeded)

81.2 % 81.2 % Maintain

3.4.06 Percentage of adults receiving services who had 

positive social support at 6 month follow-up (Outcome)

FY 2013: 72 %

Target:

71 %

(Target 

Exceeded)

72 % 72 % Maintain
95

Program: Mental Health - Other Capacity Activities

NOTE: SAMHSA grant awards are made late in the year. FY 2014 Enacted is reflected in FY 2015 targets. FY 

2015 President’s Budget is reflected in FY 2016 targets.

Measure Year and Most 

Recent Result /

Target for Recent 

Result /

(Summary of 

Result)

FY 

2015

Target

FY 

2016

Target

FY 2016

Target

+/-

FY 2015

Target

1.2.05 Percentage of clients receiving services who report 

positive functioning at 6 month follow-up (Outcome)

FY 2013: 55.7 %

Target:

54.0 %

(Target Exceeded)

55.7 % 55.7 % Maintain

1.2.82 Percentage of clients receiving services who had a 

permanent place to live in the community at 6 month followup (Outcome)

FY 2013: 70.5 %

Target:

67.7 %

(Target Exceeded)

70.5 % 70.5 % Maintain

1.2.83 Percentage of clients receiving services who are 

currently employed at 6 month follow-up (Outcome)

FY 2013: 22.2 %

Target:

14.0 %

(Target Exceeded)

22.2 % 22.2 % Maintain

1.2.88 Number of individuals screened for mental health or 

related interventions (Outcome)

FY 2013: 90,684

Target:

32,763

(Target Exceeded)

20,341 28,0488+7,707

 

8

Primary and Behavioral Health Care Integration, and Healthy Transitions will be reported separately for FY 2016 target.
96

Program: Mental Health - Science and Service Activities

NOTE: SAMHSA grant awards are made late in the year. FY 2014 Enacted is reflected in FY 2015 targets. FY 

2015 President’s Budget is reflected in FY 2016 targets.

Measure Year and Most 

Recent Result /

Target for Recent 

Result /

(Summary of 

Result)

FY 

2015

Target

FY 

2016

Target

FY 2016

Target

+/-

FY 2015

Target

1.4.06 Number of people trained by CMHS Science and 

Service Programs (Output)

FY 2013: 26,736

Target:

3,390

(Target Exceeded)

18,827 16,271 -2,556

1.4.09 Increase the number of individuals trained by 

SAMHSA's Science and Services Program (Output)

FY 2013: 67,9449

Target:

110,000

(Target Not Met)

110,000 110,000 Maintain

 

9

Results are preliminary and will be updated in 2014. 
97

Size of Awards

(Whole Dollars)

FY 2013

Final

FY 2014

Enacted

FY 2015

President's Budget

Number of Awards 543 591 553

Average Awards $392,349 $530,062 $520,980

Range of Awards $15,000 - $6,000,000 $15,000 - $6,000,000 $15,000 - $6,000,000
98

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99

Children’s Mental Health Services Program

(Dollars in thousands)

FY 2013 FY 2014 FY 2015 FY 2015

Final Enacted President's 

Budget

 +/-

FY 2014 

Budget Authority........................................................................... $111,430 $117,315 $117,315 $---

Authorizing Legislation ................................Sections 561 to 565 of the Public Health Service Act

FY 2015 Authorization .........................................................................................................Expired

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

Program Description and Accomplishments

Authorized in 1992, the Children’s Mental Health Initiative (CMHI) supports the development of 

comprehensive, community-based systems of care for the estimated nine to thirteen percent of 

children and youth with serious emotional disorders (SED) and their families. A system of care 

(SOC) is a strategic approach to the delivery of services and supports that incorporate familydriven, youth-guided, strength-based, and culturally and linguistically competent care in order to 

meet the physical, intellectual, emotional, cultural, and social needs of children and youth. The 

SOC helps prepare children and youth for successful transition to adulthood and successful 

assumption of adult roles and responsibilities. These guiding principles also call for a broad 

array of effective services, individualized care, and coordination across child and youth-serving 

systems (e.g. Juvenile Justice, Child Welfare, Education, Primary Care, and Substance Abuse) 

and have become standards for care throughout much of the nation. A hallmark of this program 

is that youth and families partner with state and local providers and policy makers in service 

delivery, system reform planning, and decision-making. In addition to the substantial role 

children, youth, and families play in the care they receive, services are delivered in the least 

restrictive environment with evidence-supported treatments and interventions. Individualized 

care management ensures that planned services and supports are delivered both appropriately and 

effectively. 

Since 1993, the CMHI program has funded 173 cooperative agreements across the country, 

serving more than 110,000 children, youth, and their families. Through FY 2010, cooperative 

agreements were funded for a total of six years, with an increasing non-federal matching 

requirement. The matching requirement is intended to promote sustainability of the local system 

of care beyond the grant period. Over 64 percent of programs funded under the CMHI have been 

sustained at least five-years post-federal funding. In FY 2011, SAMHSA funded 24 one-year 

System of Care Expansion Planning grants. The purpose of these grants was to bring systems of 

care to scale from a community to a statewide focus where the grantee develops a comprehensive 

strategic plan for improving and expanding services and supports broadly throughout a state or 

political subdivision of a state, tribe, or territory. In FY 2012, SAMHSA funded six additional 

one-year planning grants along with 16 four-year System of Care Expansion Implementation 

grants. The goal of these new grants was to assist states, tribes and larger geographic areas in 

implementing their strategic plans to expand the system of care approach to improve outcomes 

for children and youth with serious mental health conditions and their families. In addition, 

SAMHSA also supported 47 CMHI continuation grants as well as five contract continuations.
100

National program evaluation data reported annually to Congress indicates that CMHI systems of 

care are successful, resulting in many favorable outcomes for children, youth, and their families, 

including:

 Sustained mental health disorder improvements for participating children and youth in 

behavioral health outcomes after as little as six months of program participation;

 Improvements in school attendance and achievement;

 Reductions in suicide-related behaviors;

 Decreases in the use of inpatient care and reduced costs due to fewer days in residential 

settings; and

 Significant reductions in contacts with law enforcement.

Due to the success of this approach, SAMHSA funding ensures that grantees will continue to 

expand and sustain CMHI system of care values and principles, infrastructure and services 

throughout their states, tribes, and territories. A central focus of these efforts is linking CMHI 

systems of care with other child and youth-serving systems (e.g. Child Welfare, Juvenile Justice, 

and Education), block grant activities, and coordinating funding streams to support the SOC 

approach. 

In FY 2013, SAMHSA awarded 11 one-year System of Care Expansion Planning grants, 15 

System of Care Expansion Implementation Grants, and supported the continuation of 46 CMHI

and 16 System of Care Expansion Implementation grants and five contracts.

In FY 2014, SAMHSA plans to support continuation grants and contracts as well as award a new 

cohort of System of Care Expansion Planning grants and System of Care Expansion 

Implementation Grants as well as a new contract.

Funding History

Fiscal Year Amount

FY 2011 $117,803,000

FY 2012 $117,314,524

FY 2013 $111,430,194

FY 2014

FY 2015

$117,315,000

$117,315,000

Budget Request

The FY 2015 Budget Request is $117.3 million, which is the same level as of the FY 2014 

Enacted Level. The Budget Request will support the continuation of Children’s Mental Health 

Initiative. The request will support 66 grant and three contract continuations, as well as 37 new 

grants and one new contract. In addition, System of Care grantees will be encouraged to use 

technology-based solutions that meet their program needs, including, but not limited to: telemental health, technology assisted applications, technologies to support health information 

exchange for integration of care, electronic health records (EHRs), digital dashboards for care 

coordination, clinical decision support for delivery of evidence-based practices for children’s 
101

behavioral health care, and mobile technologies to improve communication with patients and 

caregivers and for more effective monitoring of patient status outside of the clinical setting. In 

addition, SAMHSA is considering opportunities within the CMHI program for in-sourcing 

technical expertise in the evolving children’s mental health services arena.
102

SAMHSA/Mental Health

Mechanism Table 

(Dollars in thousands)

No. Amount No. Amount No. Amount

Children's Mental Health Services

Grants/Cooperative Agreements

Continuations......................................................................... 62 $74,163 59 $60,956 66 $65,520

New/Competing..................................................................... 26 17,922 43 36,284 36 35,356

Subtotal............................................................................... 88 92,085 102 97,240 102 100,876

Contracts

Continuations......................................................................... 1 8,405 2 10,737 2 10,606

New/Competing..................................................................... 1 1,517 --- 500 --- 500

Subtotal............................................................................... 2 9,922 2 11,237 2 11,106

Technical Assistance................................................................ 4 9,424 5 8,838 3 5,333

Report to Congress.................................................................. --- --- --- --- --- ---

Total, Children's Mental Health Services 9 4 $111,430 109 $117,315 107 $117,315

* Totals may not add due to rounding.

President's 

Budget

Final Enacted

FY 2013 FY 2014 FY 2015
103

Key Outputs and Outcomes

Program: Children's Mental Health Services

NOTE: SAMHSA grant awards are made late in the year. FY 2014 Enacted Level is reflected in FY 2015 targets. 

FY 2015 President’s Budget is reflected in FY 2016 targets.

Measure Year and Most 

Recent Result /

Target for 

Recent Result /

(Summary of

Result)

FY 

2015

Target

FY 

2016

Target

FY 2016

Target

+/-

FY 2015

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 2013: 6,610

Target:

6,457

(Target 

Exceeded)

6,610 6,610 Maintain

3.2.25 Percentage of children receiving services who report 

positive social support at 6 month follow-up (Outcome)

FY 2013: 87.6 

%

Target:

87.6 %

(Target 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 follow-up (Outcome)

FY 2013: 62.7 

%

Target:

64.2 %

(Target Not 

Met)

62.7 % 62.7 % Maintain

3.2.27 Number of people in the mental health and related 

workforce trained in specific mental health-related 

practices/activities as a result of the program (Output)

FY 2013: 5,101

Target:

4,571

(Target 

Exceeded)

5,101 5,101 Maintain

3.2.28 Number of organizations that entered into formal written 

inter/intra-organizational agreements (e.g. MOUs/MOAs) to 

improve mental health-related practices/activities as a result of 

the grant (Output)

FY 2013: 782

Target:

928

(Target Not Met 

but Improved)

691 691 Maintain
104

Size of Awards

(Whole Dollars)

FY 2013

Final

FY 2014

Enacted

FY 2015

President's Budget

Number of Awards 88 102 102

Average Awards $1,046,418 $953,330 $988,982

Range of Awards $330,000 - $2,000,000 $330,000 - $2,000,000 $330,000 - $2,000,000
105

Projects for Assistance in Transition from Homelessness

(Dollars in thousands)

FY 2013 FY 2014 FY 2015 FY 2015

Final Enacted President's 

Budget

+/-

FY 2014

Budget Authority........................................................................... $61,405 $64,794 $64,794 ---

Authorizing Legislation .............................................Section 521 of the Public Health Service Act

FY 2015 Authorization .........................................................................................................Expired

Allocation Method .....................................................................................................Formula Grant

Program Description and Accomplishments

In 1990, the Stewart B. McKinney Homeless Assistance Amendments Act authorized the 

Projects for Assistance in Transition from Homelessness (PATH) program. The PATH budget 

supports 56 grants to all 50 states, the District of Columbia, Puerto Rico, Guam, American 

Samoa, the United States Virgin Islands, and the Northern Mariana Islands as well as centralized 

activities such as technical assistance and evaluation. PATH funds community-based outreach, 

mental health, substance abuse, case management, other supportive services, and a limited set of 

housing services in more than 500 communities. All recipients of PATH allocations (except the 

territories) are required by the authorizing legislation to provide a matching contribution of $1 

for every $3 of federal money received. The PATH formula calculates state allotments based on 

the population living in urbanized areas. This population data is updated after each census.

PATH is unique in that is specifically authorized to address the needs of individuals with serious 

mental illness (SMI) and/or SMI with a co-occurring substance use disorder who are 

experiencing homelessness or are at risk of homelessness. On a single night in January 2012, it 

is estimated that 633,782 people were homeless in the United States. Behavioral health issues are 

common among this population, as are chronic physical illnesses and other disabling conditions. 

Almost half of people experiencing homelessness have mental health problems and/or substance 

use disorders. In addition, many individuals who have SMI are at risk of becoming 

homelessness due to their disabling conditions. The PATH program has been highly successful 

in targeting assistance to individuals with SMI who are homeless or are at-risk for homelessness 

or experiencing a co-occurring mental and substance use disorder. PATH connects members of 

this largely under-served population with critical services and resources to assist them in their 

recovery.

Grantee performance has improved over the years as evidenced by increased numbers relating to 

PATH program Government Performance and Results Act (GPRA) measures. Over the past five 

years, national PATH program data indicate increases in the number of individuals experiencing 

homelessness who are contacted through outreach, the number of eligible individuals who are 

enrolled in the PATH program, and in the percentage of enrolled PATH clients who receive 

community mental health services. The GPRA measures for the PATH program show 

improvements in the PATH program’s effectiveness. PATH program results related to these 

measures show the number of homeless individuals contacted by the PATH program has 

increased from 135,007 individuals contacted in 2008 to 192,290 individuals contacted in 2012. 
106

Of these 103,259 individuals were enrolled in the PATH program, and 68,652 of the enrolled 

received community mental health services. 

Factors that affect performance data include changes in counting methodology for certain PATH 

data elements and clarification of definitions of PATH data elements. The primary external 

factor is the transient nature of the population that PATH seeks to serve. PATH providers 

encounter several challenges including staff retention, difficulty serving all clients due to funding 

availability, the need for increased funding, defining PATH services and programs, and lack of 

standardized data tracking procedures. 

The need for standardized definitions is addressed through the PATH’s Administrative 

Workgroup which is in the process of defining PATH data elements. Issues relating to retention, 

staff shortages, and funding are managed at the local level. PATH has implemented several 

activities to improve data collection and reporting. 

Performance for the number of PATH providers trained on Supplemental Security Income/Social 

Security Disability Insurance (SSI/SSDI), Outreach, Access, and Recovery (SOAR) was not met 

in FY 2011, FY 2012, and FY 2013. It is important to note, however, that nearly 24,000 PATH 

funded providers have been trained since the initiative began. This output is important in that 

once trained, PATH providers are better able to assist PATH clients in applying for and getting 

the income benefits for which they are eligible.10

Training and technical assistance (TA) are ongoing and long-term TA engagements (i.e., virtual 

classrooms, follow-up consultation) are being implemented to ensure that PATH providers are 

able to use the information obtained in the training to make changes in their programs.

The ability of PATH providers to build trusting and supportive relationships that lead to 

consumers making meaningful contributions to agency administration and service provision is a 

major accomplishment. Nearly all PATH provider agencies had consumer involvement, and 

consumers had a range of responsibilities as peer specialists, as members of committees, 

assessing services received etc. PATH also presents opportunities for providers working with 

individuals who are homeless to connect with each other.

In FY 2012 and FY 2013 SAMHSA funded 56 grants to states and territories, as well as 

centralized activities such as technical assistance and evaluation. This funding and the population 

of focus will continue in FY 2014. 

 

10 Supplemental Security Income (SSI) and Social Security Disability Insurance (SSDI) are disability income benefits administered by the Social 

Security Administration (SSA) that generally also provide either Medicaid and/or Medicare health insurance to individuals who are eligible. 

Accessing these benefits is often a critical first step in recovery. For people, who are homeless with mental health problems that impair cognition 

or who are returning to the community from institutions (jails, prisons or hospitals), access to these programs can be extremely challenging. The 

application process for SSI/SSDI is complicated, detailed, and often difficult to navigate. Typically, about 10-15 percent of individuals who are 

homeless have these benefits.
107

Funding History

Fiscal Year Amount

FY 2011 $64,917,000

FY 2012 $64,794,307

FY 2013 $61,405,176

FY 2014

FY 2015

$64,794,000

$64,794,000

Budget Request

The FY 2015 Budget Request is $64.8 million, which is same as the FY 2014 Enacted Level. 

The Budget Request will support the continuation of Projects for Assistance in Transition from 

Homelessness to remain the same level of the number of homeless individuals contacted which is 

approximately 192,000 through the PATH program.
108

Key Outputs and Outcomes

Program: Projects to Assist in the Transition from Homelessness

NOTE: SAMHSA grant awards are made late in the year. FY 2014 Enacted is reflected in FY 2015 targets. FY 

2015 President’s Budget is reflected in FY 2016 targets.

Measure Year and Most 

Recent Result /

Target for 

Recent Result /

(Summary of 

Result)

FY 

2015

Target

FY 

2016

Target

FY 2016

Target

+/-

FY 2015

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 (Outcome)

FY 2012: 66

Target:

47

(Target 

Exceeded)

66 66 Maintain

3.4.16 Number of homeless persons contacted (Outcome) FY 2012: 

192,290

Target:

182,000

(Target 

Exceeded)

191,926 191,926 Maintain

3.4.17 Percentage of contacted homeless persons with serious 

mental illness who become enrolled in services (Outcome)

FY 2012: 58%

Target:

55%

(Target 

Exceeded)

58% 58% Maintain

3.4.20 Increase the number of PATH (Projects for Assistance in 

Transition from Homelessness) providers trained on SSI/SSDI 

Outreach, Access, Recovery (SOAR) to ensure eligible 

homeless clients are receiving benefits (Output)

FY 2013: 4,360

Target:

5,420

(Target Not 

Met)

4,360 4,360 Maintain
109

FY 2013 FY 2014 FY 2015 FY 2015

STATE/TERRITORY

Final Enacted President's 

Budget 

+/- 

FY 2014

Alabama $550,000 $609,000 $611,000 +2,000

Alaska 300,000 300,000 300,000 ---

Arizona 1,107,000 1,341,000 1,345,000 +4,000

Arkansas 300,000 302,000 303,000 +1,000

California 8,483,000 8,761,000 8,782,000 +21,000

Colorado 910,000 1,013,000 1,016,000 +3,000

Connecticut 807,000 795,000 797,000 +2,000

Delaware 300,000 300,000 300,000 ---

District Of Columbia 300,000 300,000 300,000 ---

Florida 3,815,000 4,309,000 4,319,000 +10,000

Georgia 1,419,000 1,660,000 1,664,000 +4,000

Hawaii 300,000 300,000 300,000 ---

Idaho 300,000 300,000 300,000 ---

Illinois 2,758,000 2,689,000 2,696,000 +7,000

Indiana 966,000 1,005,000 1,008,000 +3,000

Iowa 316,000 333,000 333,000 ---

Kansas 342,000 375,000 376,000 +1,000

Kentucky 444,000 466,000 467,000 +1,000

Louisiana 718,000 729,000 730,000 +1,000

Maine 300,000 300,000 300,000 ---

Maryland 1,203,000 1,264,000 1,267,000 +3,000

Massachusetts 1,596,000 1,550,000 1,553,000 +3,000

Michigan 1,863,000 1,719,000 1,723,000 +4,000

Minnesota 768,000 806,000 808,000 +2,000

Mississippi 300,000 300,000 300,000 ---

Missouri 875,000 888,000 891,000 +3,000

Montana 300,000 300,000 300,000 ---

Nebraska 300,000 300,000 300,000 ---

Nevada 475,000 612,000 614,000 +2,000

New Hampshire 300,000 300,000 300,000 ---

DEPARTMENT OF HEALTH AND HUMAN SERVICES

Substance Abuse and Mental Health Services Administration

FY 2015 DISCRETIONARY STATE/FORMULA GRANTS

Projects for Assistance in Transition from Homelessness (PATH)

CFDA # 93.150
110

FY 2013 FY 2014 FY 2015 FY 2015

STATE/TERRITORY

Final Enacted President's 

Budget 

+/- 

FY 2014

New Jersey 2,196,000 2,125,000 2,131,000 +6,000

New Mexico 300,000 300,000 300,000 ---

New York 4,392,000 4,198,000 4,208,000 +10,000

North Carolina 1,065,000 1,371,000 1,375,000 +4,000

North Dakota 300,000 300,000 300,000 ---

Ohio $2,071,000 $1,975,000 $1,979,000 +4,000

Oklahoma 420,000 450,000 451,000 +1,000

Oregon 560,000 627,000 629,000 +2,000

Pennsylvania 2,326,000 2,353,000 2,359,000 +6,000

Rhode Island 300,000 300,000 300,000 ---

South Carolina 531,000 676,000 678,000 +2,000

South Dakota 300,000 300,000 300,000 ---

Tennessee 840,000 904,000 907,000 +3,000

Texas 4,191,000 4,966,000 4,978,000 +12,000

Utah 495,000 588,000 589,000 +1,000

Vermont 300,000 300,000 300,000 ---

Virginia 1,335,000 1,463,000 1,467,000 +4,000

Washington 1,219,000 1,321,000 1,324,000 +3,000

West Virginia 300,000 300,000 300,000 ---

Wisconsin 805,000 832,000 834,000 +2,000

Wyoming 300,000 300,000 300,000 ---

American Samoa 50,000 50,000 50,000 ---

Guam 50,000 50,000 50,000 ---

Northern Marianas 50,000 50,000 50,000 ---

Puerto Rico 985,000 886,000 888,000 +2,000

Virgin Islands $50,000 $50,000 $50,000 ---

Substance Abuse and Mental Health Services Administration

FY 2015 DISCRETIONARY STATE/FORMULA GRANTS

Projects for Assistance in Transition from Homelessness (PATH)

CFDA # 93.150

DEPARTMENT OF HEALTH AND HUMAN SERVICES
111

Protection and Advocacy for Individuals with Mental Illness

(Dollars in thousands)

FY 2013 FY 2014 FY 2015 FY 2015

Final Enacted President's 

Budget

+/-

FY 2014

Budget Authority........................................................................... $34,343 $36,238 $36,238 ---

Authorizing Legislation ....................................................... The PAIMI Act 42 USC 10801 et seq.

FY 2015 Authorization .........................................................................................................Expired

Allocation Method ................................................................................................... Formula Grants

Program Description and Accomplishments

The Protection and Advocacy for Individuals with Mental Illness (PAIMI) Act of 1986 [42 USC 

10801 et seq., as amended in 2000 by the Children’s Health Act of 2000 [42 USC 290 ii- ii-2] 

extended the protections of the Developmental Disabilities Assistance Act of 1975 [as amended 

in 2000, 42 USC 15001 et seq.] 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 awards support legal-based advocacy services that are provided by the 57 governordesignated P&A systems located in each state, and territories, 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; 2) protect and advocate 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, neglect of individuals with mental illness. 

In 2010, the results of an independent PAIMI Program evaluation concluded that individuals 

with significant mental health disabilities and their family members were well served by this 

program by providing them a voice in the exercise of their rights. The PAIMI program is highly 

successful in achieving client and system goals and objectives. The PAIMI Programs are highly 

effective in assuring that the most vulnerable individuals with 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, and receive the 

appropriate mental health treatment and discharge planning services they will need to facilitate 

their recovery and subsequent placement into an appropriate, least restrictive, community-based 

setting. 

In 2012, the 57 state Protection and Advocacy system PAIMI Programs:

 Served 16,307 PAIMI-eligible individuals/clients: 3805 children and youth (ages 0 – 18) 

and 11,289 adults (ages 19 - 64), 920 adults (age 65 and older), and 23 individuals whose 

ages were not known. These individuals filed 18,021 complaints alleging abuse, neglect, 

or and/or rights violations. 
112

 Of the closed 12,906 of these complaints, 2481 the allegation not substantiated, lacked 

legal merit, or was withdrawn by the client 10,525 substantiated and investigated, 

including 2127 abuse, 2134 neglect, and 6164 rights violation allegations. 

 Resolved 85 percent of abuse, 90 percent of neglect allegations, and 87 percent of rights 

violations allegations and attained outcomes that resulted in positive change for the 

clients served, e.g: discharge into an appropriate community-based setting; discharge 

from a nursing facility; safer, cleaner facility environment; and reciept of appropraite 

medical and mental heath treatment. 

The FY 2012 program funding supported various legal-based advocacy activities mandated by 

the PAIMI Act [42 USC at 10805]. The PAIMI Program marginal cost analysis conducted for 

this program estimated the average cost in FY 2012 was $2,018 per individual client served). In 

FY 2012 SAMHSA conducted a range of activities to ensure that the 57 PAIMI Programs 

within each state P&A system are monitored and fully compliant with the authorizing legislation 

and rules, respectively 42 USC 10801 et seq. and 42 CFR Part 51. These activities included 

close collaboration with the SAMHSA Division of Grants Management on annual application 

and program performance report criteria and reviews. Regular monthly meetings and weekly 

collaborations with other federal P&A program representatives are held to share information on 

federal monitoring activities, including site visit reports, and to coordinate P&A system technical 

assistance and training.

In FY 2012, SAMHSA program and grants management staff conducted on-site visits to monitor 

selected P&A systems. Each P&A system was assessed in the following key areas that are 

consistent with PAIMI Rules: governance, PAIMI Advisory Council, the administration of legal 

activities, and financial/fiscal management. After each site visit a report summarizing the 

findings and recommendations is issued. A corrective action plan is required and technical 

assistance is provided to all P&A systems with major compliance findings. 

In FY 2013, SAMHSA continued to fund 57 grants to states and territories as well as centralized 

technical assistance activities and support for grantees. 

In FY 2014, SAMHSA plans to continue supporting this program. 

Funding History

Fiscal Year Amount

FY 2011 $36,307,000

FY 2012 $36,238,380

FY 2013 $34,342,895

FY 2014

FY 2015

$36,238,000

$36,238,000
113

Budget Request

The FY 2015 Budget Request is $36.2 million, level funded from the FY 2014 Enacted Level. 

The Budget Request will support the continuation of Protection and Advocacy for Individuals 

with Mental Illness to maintain the same level of individuals served, approximately 16,000 

clients and 140,000 individuals trained, educated, or reached through the program.
114

Key Outputs and Outcomes

Program: Protection & Advocacy

NOTE: SAMHSA grant awards are made late in the year. FY 2014 Enacted is reflected in FY 2015 targets. FY 2015 President’s 

Budget is reflected in FY 2016 targets.

Measure Year and 

Most Recent 

Result /

Target for 

Recent 

Result /

(Summary of 

Result)

FY 

2015

Target

FY 

2016

Target

FY 2016

Target

+/-

FY 2015

Target

3.4.12 Number of people served by the PAIMI program 

(Outcome)

FY 2012: 

15,955

Target:

22,325

(Target Not 

Met)

15,925 15,925 Maintain

3.4.19 Number attending public education/constituency training 

and public awareness activities (Output)

FY 2012: 

139,692

Target:

92,95311

(Target 

Exceeded)

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 decisionmaking,as a result of PAIMI involvement (Outcome)

FY 2012: 

87.0 %

Target:

87.0 %

(Target Met)

87.0 % 87.0 % Maintain

 

11

Target was reduced to reflect most recent actual given previous two years of performance results were off nearly 30 percent and is not related 

to 2012 budget levels. 
115

FY 2013 FY 2014 FY 2015 FY 2015

STATE/TERRITORY

Final Enacted President's 

Budget 

+/- 

FY 2014

Alabama $431,790 $452,480 $457,246 +4,766

Alaska 406,700 428,000 429,100 +1,100

Arizona 569,438 609,040 618,472 +9,432

Arkansas 406,700 428,000 429,100 +1,100

California 2,986,452 3,169,574 3,164,791 -4,783

Colorado 406,700 428,381 434,723 +6,342

Connecticut 406,700 428,000 429,100 +1,100

Delaware 406,700 428,000 429,100 +1,100

District Of Columbia 406,700 428,000 429,100 +1,100

Florida 1,588,303 1,680,238 1,709,038 +28,800

Georgia 859,095 909,612 919,984 +10,372

Hawaii 406,700 428,000 429,100 +1,100

Idaho 406,700 428,000 429,100 +1,100

Illinois 1,032,984 1,081,319 1,078,311 -3,008

Indiana 580,825 606,534 600,630 -5,904

Iowa 406,700 428,000 429,100 +1,100

Kansas 406,700 428,000 429,100 +1,100

Kentucky 406,700 428,000 429,100 +1,100

Louisiana 406,700 428,000 429,100 +1,100

Maine 406,700 428,000 429,100 +1,100

Maryland 433,563 457,637 457,774 +137

Massachusetts 481,952 505,220 508,248 +3,028

Michigan 875,131 911,471 905,909 -5,562

Minnesota 423,367 445,048 445,474 +426

Mississippi 406,700 428,000 429,100 +1,100

Missouri 514,052 541,644 545,747 +4,103

Montana 406,700 428,000 429,100 +1,100

Nebraska 406,700 428,000 429,100 +1,100

Nevada 406,700 428,000 429,100 +1,100

New Hampshire 406,700 428,000 429,100 +1,100

DEPARTMENT OF HEALTH AND HUMAN SERVICES

Substance Abuse and Mental Health Services Administration

FY 2015 DISCRETIONARY STATE/FORMULA GRANTS

Protection and Advocacy for Individuals with Mental Illness (PAIMI)

CFDA # 93.138
116 FY 2013 FY 2014 FY 2015 FY 2015

STATE/TERRITORY

Final Enacted President's 

Budget 

+/- 

FY 2014

New Jersey 647,643 682,281 683,141 +860

New Mexico 406,700 428,000 429,100 +1,100

New York 1,461,310 1,522,198 1,529,647 +7,449

North Carolina 843,487 894,253 898,586 +4,333

North Dakota 406,700 428,000 429,100 +1,100

Ohio $999,941 $1,042,233 $1,033,678 -8,555

Oklahoma 406,700 428,000 429,100 +1,100

Oregon 406,700 428,000 429,100 +1,100

Pennsylvania 1,039,800 1,088,023 1,077,471 -10,552

Rhode Island 406,700 428,000 429,100 +1,100

South Carolina 425,627 451,380 453,931 +2,551

South Dakota 406,700 428,000 429,100 +1,100

Tennessee 560,968 588,392 588,087 -305

Texas 2,143,549 2,249,157 2,260,873 +11,716

Utah 406,700 428,000 429,100 +1,100

Vermont 406,700 428,000 429,100 +1,100

Virginia 630,154 663,461 668,277 +4,816

Washington 539,338 572,901 576,348 +3,447

West Virginia 406,700 428,000 429,100 +1,100

Wisconsin 479,982 503,977 499,851 -4,126

Wyoming 406,700 428,000 429,100 +1,100

American Samoa 217,900 229,300 229,900 +600

Guam 217,900 229,300 229,900 +600

Northern Marianas 217,900 229,300 229,900 +600

Puerto Rico 545,628 566,333 553,288 -13,045

Virgin Islands 217,900 229,300 229,900 +$600

American Indian Consortium $217,900 $229,300 $229,900 +600

Substance Abuse and Mental Health Services Administration

FY 2015 DISCRETIONARY STATE/FORMULA GRANTS

Protection and Advocacy for Individuals with Mental Illness (PAIMI)

CFDA # 93.138

DEPARTMENT OF HEALTH AND HUMAN SERVICES
117

Community Mental Health Services Block Grant

(Dollars in thousands)

FY 2013 FY 2014 FY 2015 FY 2015

Final Enacted President's 

Budget

+/-

FY 2014

Community Mental Health Services Block Grant $436,809 $483,744 $483,744 ---

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

Authorizing Legislation ...........................................Section 1911 of the Public Health Service Act

FY 2015 Authorization .........................................................................................................Expired

Allocation Method .....................................................................................................Formula Grant

Program Description and Accomplishments

Since 1992, the Community Mental Health Services Block Grant (MHBG) distributes funds to 

59 eligible states and territories through a formula based upon specified economic and 

demographic factors. The MHBG distributes funds to eligible states and territories for a variety 

of services and for planning, administration, and educational activities under the state plan for 

comprehensive community-based mental health services for children with serious emotional 

disturbance and adults with serious mental illness. Services funded by the MHBG include 

services identified in SAMHSA’s Good and Modern Service System12 brief, including supported 

employment and supported housing, rehabilitation services, crisis stabilization and case 

management, peer specialist and consumer-directed services, wrap around services for children 

and families, jail diversion programs, and services for special populations (people who are 

homeless, live in rural and frontier areas, and increasingly for military families). The majority of 

these services are currently not broadly covered under private and public insurance. The MHBG 

also supports and encourages states to implement proven practices demonstrated in the 

discretionary portfolio at SAMHSA. The MHBG continues to represent a significant “safety 

net” source of funding for mental health services for some of the most vulnerable populations 

across the country. 

Ninety-five percent of the funds allocated to the MHBG program are distributed to states through 

a formula prescribed by the authorizing legislation. Factors used to calculate the allotments 

include total personal income, state population data by age groups (total population data for 

territories), total taxable resources, and a cost of services index factor. States and territories may 

expend block grant funds only to carry out the annual plan, to evaluate programs and services 

carried out under the plan, and for planning, administration, and educational activities related to 

providing services under the plan. 

States rely on the MHBG for delivery of critical services and for an array of non-clinical 

coordination and support services to strengthen their respective systems of services, for example,

planning, coordination, needs assessment, quality assurance, program development, training, and 

evaluation. 

 

12 http://www.samhsa.gov/healthReform/docs/good_and_modern_4_18_2011_508.pdf
118

The MHBG statute provides a five percent set-aside to allow SAMHSA to assist the states and 

territories in the development of their mental health systems through the support of technical 

assistance, data collection and evaluation activities. 

In FY 2011, SAMHSA redesigned the FY 2012/2013 MHBG and SABG applications to better 

align with the current federal/state environments and related policy initiatives, including the 

Affordable Care Act, the Mental Health Parity and Addiction Equity Act (MHPAEA), and the 

Tribal Law and Order Act (TLOA). The new design offered states the opportunity to complete a 

combined application for mental health and substance abuse services, submit a bi-annual versus 

an annual plan,13,14 and provide information regarding their efforts to respond to various federal 

and state initiatives. Almost one-half of the states took advantage of this streamlined application 

and submitted combined plans for mental health and substance abuse services. Over 95 percent 

of the states provided specific information requested by SAMHSA regarding state strategies to 

respond to a variety of areas including primary care and behavioral health integration, recovery 

support services, prevention of substance use, and the promotion of emotional health. In 

addition, states continued to provide information on how their Block Grant funds are used to 

support the categories of services identified in SAMHSA’s Good and Modern Service System15

brief as described in the block grant application.

The FY 2014/2015 Block Grant application builds upon the FY 2012/2013 application and 

furthers SAMHSA’s efforts to have states use and report the opportunities offered under various 

federal initiatives. In addition, the FY 2014/2015 Block Grant continues to allow states to 

submit a combined application for mental health and substance abuse services as well as a biannual versus an annual plan. 

After the full implementation of the ACA, SAMHSA has strongly recommended that MHBG 

funds be directed toward four purposes: (1) to fund priority treatment and support services for 

individuals without insurance or for whom coverage is terminated for short periods of time; (2) 

to fund priority treatment (Essential Health Benefits – EHB) and support services not covered by 

private and public insurance for low and moderate income individuals and that demonstrate 

success in improving outcomes and/or supporting recovery (non-EHB covered treatments); (3) to 

fund primary prevention (universal, selective, and indicated) activities and services for 

individuals with serious mental illness and serious emotional disturbance; and (4) to collect 

performance and outcome data to determine the ongoing effectiveness of behavioral health 

promotion, treatment, and recovery support services and to plan the implementation of new 

services on a nationwide basis. In addition, consistent with SAMHSA's Theory of Change, 

which draws a path from innovation, translation, dissemination, to implementation and finally 

wide scale adoption, SAMHSA will be taking advantage of the successful strategies 

implemented through the Access to Recovery program, by encouraging the states to utilize their 

Block Grants to: (1) allow recovery to be pursued through personal choice and many pathways; 

(2) encourage providers to manage performance and quality based on outcomes that demonstrate 

 

13 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))

14 State Plan (Sec. 1932(b) of Title XIX, Part B, Subpart II of the Public Health Service (PHS) Act (42 USC § 300x-32(b))

15 http://www.samhsa.gov/healthReform/docs/good_and_modern_4_18_2011_508.pdf
119

client successes; and (3) expand capacity by increasing the number and types of providers who 

deliver clinical treatment and/or recovery support services.

Most states 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 system16 during 2012 show that:

 For the 58 states and territories that reported data in the Employment Domain, 17 percent of 

the mental health consumers were in competitive employment;

 For the 57 states and territories that reported data in the Housing Domain, 81 percent of the 

mental health consumers were living in private residences; 

 For the 59 states and territories that reported data in the Access/Capacity Domain, state 

mental health agencies provided mental health services for 22.67 people per 1,000 

population;

 For the 51 states and territories that reported data in the Retention Domain, only 9 percent of 

the patients returned to a state psychiatric hospital within 30 days of state hospital discharge; 

and

 For the 52 states and territories that reported data in the Perception of Care Domain, 71 

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, SAMHSA will work with states required to use 5 percent set-aside of their 

MHBG funds to support evidence-based programs that address the needs of individuals with 

early serious mental illness, including psychotic disorders.

The majority of individuals with severe mental illness experience their first symptoms during 

adolescence or early adulthood, and there are often long delays between the first onset of 

symptoms and receiving treatment. The consequences of delayed treatment can include loss of 

family and social supports, disruption of employment, substance abuse, increased 

hospitalizations, and reduced prospects for long-term recovery.

The 5 percent set-aside of $24.2 million, allocated to states consistent with the block grant 

formula, will support creation of promising 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 suffering from psychotic illness. The increase 

to the block grant in FY 2014 over the FY 2013 level will help States meet this new requirement 

in addition to maintaining existing services. SAMHSA is collaborating with NIMH in 

developing guidelines to States regarding effective programs funded by this set-aside.

 

16 May reflect multiple sources of funding including, MHBG, State General Fund, Medicaid, Private Insurance, etc.
120

Funding History1/

Fiscal Year Amount

FY 2006 $427,974,000

FY 2007 $428,256,000

FY 2008 $420,774,000

FY 2009 $420,774,000

FY 2010 $420,774,000

FY 2011 $419,933,000

FY 2012 $459,756,254

FY 2013 $436,808,709

FY 2014

FY 2015

$483,744,000

$483,744,000

1\The funding history includes PHS Evaluation Funds.

Budget Request

The FY 2015 Budget Request is $483.7 million, with $462.7 million from Budget Authority and 

$21 million from PHS Evaluation Funds. This request is the same as the FY 2014 Enacted 

Level. The Budget Request will support the continuation of Community Mental Health Services 

Block Grant.

Health Reform Implementation

As a result of the analysis and examination of the various components of the Affordable Care 

Act beginning in 2010, SAMHSA has undertaken a major redesign of the planning section of the 

application process for both the MHBG and SABG. SAMHSA is aligning the block grants to 

complement mental health and substance abuse coverage expansions in the Affordable Care Act, 

for example, implementation in which state and federal responsibility is supporting behavioral 

health services and supports for those otherwise unable to receive services through private and 

public insurance. Together, SAMHSA’s block grants support the provision of services and 

related supports to approximately eight million individuals with mental and substance use 

conditions. With an estimated 11.4 million adults having a severe mental illness17, 44.7 million 

adults having any mental illness18, and another 22.1 million adults with substance use disorder19, 

demand clearly outpaces the public behavioral health system’s established capacity. Many of 

these individuals and some of the services they need will continue to be without coverage 

through public or private insurance mechanisms. Aligning and coordinating the SAMHSA block 

grants with the Affordable Care Act helps create a cohesive national service system that is 

responsive to potential gaps in service delivery and effectively provides needed behavioral health 

services across sectors and across payment sources.

 

17 http://www.samhsa.gov/data/NSDUH/2k10MH_Findings/2k10MHResults.htm

18http://www.samhsa.gov/data/2k12/NSDUH110/sr110-adult-mental-illness.htm

19 http://www.samhsa.gov/data/NSDUH/2k10ResultsRev/NSDUHresultsRev2010.htm#Ch7
121

States should determine if established systems and procedures are sufficient to ensure that Block 

Grant funds are expended in accordance with program requirements and directed to support and 

not supplant health reform activities. In the Uniform Block Grant Application for FY 

2014/2015, SAMHSA has strongly recommended that states use these resources to support and 

not supplant services that will be covered through commercial and public insurer plans. States 

will be asked to develop metrics or targets for their systems to measure increases in the number 

of individuals who become enrolled or providers that join commercial or publicly funded 

provider networks. The primary goals of SAMHSA’s program integrity efforts are to continue to 

(1) promote the proper expenditure of block grant funds, (2) improve block grant program 

compliance nationally, and (3) demonstrate the effective use of block grant funds. 

SAMHSA will provide additional guidance to the states to assist them in complying with this 

continuing emphasis on program integrity, will develop new and better tools for reviewing block 

grant application and reports, and will train SAMHSA staff in these program integrity 

approaches and tools. SAMHSA will be working with states to develop changes to information 

systems and compliance review processes to ensure increasing program integrity. This may 

include working closely with Medicaid and Health Insurance Exchanges to obtain information to 

determine if individuals and providers in their systems are enrolled. This may also include 

strategies to assist their providers to develop the necessary infrastructures to operate in 

commercial and public insurer networks. The Uniform Application along with the new set 

asides along with evolution of SAMHSA’s block grant reporting system are all tools to assist in 

this process.
122

Key Outputs and Outcomes

Program: Mental Health Block Grant

NOTE: SAMHSA grant awards are made late in the year. FY 2014 Enacted is reflected in FY 2015 targets. FY 

2015 President’s Budget is reflected in FY 2016 targets.

Measure Year and Most 

Recent Result /

Target for Recent 

Result /

(Summary of 

Result)

FY 2015

Target

FY 2016

Target

FY 2016

Target

+/-

FY 2015

Target

2.3.11 Number of evidence-based practices (EBPs) 

implemented (Output)

FY 2012: 4.9 per 

State

Target:

4.2 per State

(Target Exceeded)

4.8 per 

State

4.5 per 

State

-0.36

2.3.14 Number of people served by the public mental 

health system (Output)

FY 2012: 7,161,659

Target:

6,300,000

(Target Exceeded)

8,249,930 8,249,930 Maintain

2.3.15 Rate of consumers (adults) reporting positively 

about outcomes (Outcome)

FY 2012: 71.8%

Target:

72%

(Target Not Met 

but Improved)

71.8% 71.8% Maintain

2.3.16 Rate of family members (children/adolescents) 

reporting positively about outcomes (Outcome)

FY 2012: 66.3%

Target:

73%

(Target Not Met 

but Improved)

66.3% 66.1% -0.17

2.3.81 Percentage of service population receiving any 

evidence-based practice (Outcome)

FY 2012: 6.2 %

Target:

7.2 %

(Target Not Met)

6.2 % 6.2 % Maintain
123

FY 2013 FY 2014 FY 2015 FY 2015

State/Territory

Final Enacted President's 

Budget 

+/- 

FY 2014

Alabama $6,061,587 $6,713,670 $6,663,129 -$50,541

Alaska 704,026 775,287 795,224 +19,937

Arizona 9,288,329 10,564,627 10,764,162 +199,535

Arkansas 3,861,373 4,272,655 4,237,982 -34,673

California 55,061,609 62,185,567 63,247,936 +1,062,369

Colorado 6,021,813 6,829,619 6,917,175 +87,556

Connecticut 4,215,125 4,812,384 4,797,390 -14,994

Delaware 952,980 1,052,300 1,045,382 -6,918

District Of Columbia 801,063 893,917 930,079 +36,162

Florida 27,332,270 31,110,919 31,779,312 +668,393

Georgia 12,686,143 14,264,923 14,360,619 +95,696

Hawaii 2,096,651 2,352,005 2,374,475 +22,470

Idaho 2,278,593 2,554,817 2,567,359 +12,542

Illinois 15,584,077 17,322,214 17,199,945 -122,269

Indiana 7,655,345 8,547,076 8,402,340 -144,736

Iowa 3,374,363 3,735,295 3,695,279 -40,016

Kansas 3,152,560 3,492,553 3,463,095 -29,458

Kentucky 5,827,608 6,469,100 6,373,450 -95,650

Louisiana 5,151,008 5,592,499 5,526,824 -65,675

Maine 1,659,128 1,831,044 1,806,718 -24,326

Maryland 8,190,540 9,076,153 9,054,545 -21,608

Massachusetts 9,022,365 9,997,620 9,995,556 -2,064

Michigan 13,010,049 14,638,954 14,551,366 -87,588

Minnesota 6,442,510 7,127,318 7,107,025 -20,293

Mississippi 3,798,569 4,215,406 4,197,808 -17,598

Missouri 7,115,861 7,852,761 7,812,754 -40,007

Montana 1,220,293 1,364,051 1,363,037 -1,014

Nebraska 1,964,416 2,152,297 2,108,156 -44,141

Nevada 4,018,879 4,547,235 4,662,378 +115,143

New Hampshire 1,691,217 1,863,286 1,845,724 -17,562

Department of Health and Human Services

Substance Abuse and Mental Health Services Administration

FY 2015 Discretionary State/Formula Grants

Community Mental Health Services Block Grant Program

CFDA #93.958
124 FY 2013 FY 2014 FY 2015 FY 2015

State/Territory

Final Enacted President's 

Budget 

+/- 

FY 2014

New Jersey 11,680,591 12,962,425 13,007,089 +44,664

New Mexico 2,510,107 2,809,998 2,797,905 -12,093

New York 25,474,094 28,564,852 28,305,335 -259,517

North Carolina 11,631,309 12,869,812 12,865,573 -4,239

North Dakota 765,401 826,569 818,991 -7,578

Ohio 13,708,232 15,274,428 15,112,980 -161,448

Oklahoma 4,484,357 4,974,309 4,990,212 +15,903

Oregon 5,436,315 5,988,749 5,998,120 +9,371

Pennsylvania 14,868,037 16,460,620 16,291,707 -168,913

Rhode Island 1,606,225 1,769,137 1,753,497 -15,640

South Carolina 5,955,461 6,671,692 6,672,308 +616

South Dakota 853,013 953,807 949,334 -4,473

Tennessee 7,985,574 8,833,476 8,823,748 -9,728

Texas 32,651,444 36,596,738 36,802,122 +205,384

Utah 3,128,818 3,478,559 3,498,766 +20,207

Vermont 755,783 839,604 823,049 -16,555

Virginia 10,260,781 11,406,542 11,399,971 -6,571

Washington 9,231,043 10,429,045 10,469,467 +40,422

West Virginia 2,473,008 2,715,750 2,652,970 -62,780

Wisconsin 6,641,402 7,379,783 7,292,050 -87,733

Wyoming 447,342 511,527 537,073 +25,546

American Samoa 79,029 88,385 88,510 +125

Guam 226,840 255,557 257,594 +2,037

Northern Marianas 76,701 83,532 82,789 -743

Puerto Rico 5,303,526 5,935,283 5,945,449 +10,166

Palau 50,000 50,000 50,000 ---

Marshall Islands 93,748 107,574 110,310 +2,736

Micronesia 152,530 171,070 171,532 +462

Virgin Islands $151,464 $169,385 $169,580 +195

Department of Health and Human Services

Substance Abuse and Mental Health Services Administration

FY 2015 Discretionary State/Formula Grants

Community Mental Health Services Block Grant Program

CFDA #93.958
125

SAMHSA 

Substance Abuse Prevention

Table of Contents

1. SAMHSA/ Programs of Regional & National Significance................................................. 127

a) Strategic Prevention Framework (SPF) .....................................................................127

b) Mandatory Drug Testing............................................................................................128

c) Minority AIDS Initiative (MAI)................................................................................129

d) Sober Truth on Preventing Underage Drinking Act (STOP Act)..............................131

e) Fetal Alcohol Spectrum Disorders (FASD)...............................................................132

f) Center for the Application of Prevention Technologies (CAPT) ..............................132

g) Science and Service Program Coordination ..............................................................133

2. PRNS Mechanism Table by APT ......................................................................................... 140

3. PRNS Mechanism Table by SLOA ...................................................................................... 318
126

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127

SAMHSA/ Programs of Regional & National Significance

Substance Abuse Prevention

(Dollars in thousands)

Authorizing Legislation .................................................Sections 516, 519B, 519D of the PHS Act

FY 2015 Authorization .........................................................................................................Expired

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

Program Description and Accomplishments

Strategic Prevention Framework (SPF)

Partnerships for Success

The Partnerships for Success (PFS) program was initiated in FY 2009 with the goals of reducing 

substance abuse-related problems; preventing the onset and reducing the progression of 

substance abuse; strengthening prevention capacity and infrastructure at the state and community

levels in support of prevention; and leveraging, redirecting and realigning state-wide funding 

streams for substance abuse prevention. Eligible applicants are states and territories that have 

completed a SPF State Incentive Grant (SPF-SIG). In FY 2009, four grants were awarded, and 

in FY 2010, one additional award was made. The first two cohorts incorporated an incentive 

award to grantees that reached or exceeded their prevention performance targets (subject to 

availability of funds). In FY 2012, SAMHSA supported these efforts by awarding five

continuation grants. The FY 2012 data from the first cohort reporting show that 50 communities 

FY 2013 FY 2014 FY 2015 FY 2015

Programs of Regional & National Significance

Final Enacted President's 

Budget

+/-

FY 2014

CAPACITY

 Strategic Prevention Framework............................................. $107,902 $109,754 $119,754 $+10,000

Strategic Prevention Framework Rx (non-add)................... --- --- 10,000 +10,000

PHS Evaluations Funds (non-add)..................................... --- --- 10,000 +10,000

Mandatory Drug Testing....................................................... 5,252 4,906 4,906 ---

Minority AIDS Initiative........................................................ 40,996 41,307 41,307 ---

Sober Truth on Preventing Underage Drinking (STOP Act)..... 6,994 7,000 7,000 ---

Subtotal, Capacity 161,143 162,967 172,967 +10,000

SCIENCE AND SERVICE 

Fetal Alcohol Spectrum Disorder........................................... 1,104 1,000 1,000 ---

Center for the Application of Prevention Technologies 

(CAPT)............................................................................... 8,098 7,511 7,511 ---

PHS Evaluations Funds (non-add)..................................... --- --- 6,468 +6,468

Science and Service Program Coordination............................. 5,168 4,082 4,082 ---

Subtotal, Science and Service 14,369 12,593 12,593 ---

TOTAL, PRNS 1/ $175,513 $175,560 $185,560 +$10,000

1/In FY 2013- FY 2015, the CSAP Minority Fellowship Program budget is reflected in the Health Surveillance and Program 

Support Appropriation under the Agency-Wide Initiatives Workforce program.
128

increased the number of activities supported through collaboration and leveraging. Grantees 

reported implementing 888 evidence-based programs and thirty-two communities reported 

improvements on targeted National Outcome Measures indicators. Two of the three 

performance measures exceeded their targets. The vast majority of communities (88 percent) 

targeted alcohol use.

A new cohort of PFS grants began in FY 2012 to address two of the nation’s top substance abuse 

prevention priorities: underage drinking among youth aged 12 to 20 and prescription drug misuse 

and abuse among individuals aged 12 to 25. The program is based on the premise that changes 

at the community level will, over time, lead to measurable changes at the state and national level.

In FY 2012, SAMHSA awarded 15 new grants for three years.

In FY 2013, SAMHSA supported continuation awards for the initial cohorts established in FY 

2009 and FY 2010. SAMHSA also made a new SPF SIG award to Idaho, the last state 

remaining to receive a SPF SIG and awarded 16 new PFS grants. In addition, SAMHSA made 

funds available for grantees in the first cohort who met their performance targets and were 

eligible for the incentive supplement.

 

In FY 2014, SAMHSA will award a new cohort of PFS grants. Similar to the previous cohorts, 

these grants will address two of the nation’s top substance abuse prevention priorities: underage 

drinking among youth age 12-20 and prescription drug misuse and abuse among individuals age 

12 to 25. The PFS program will focus on implementing the Strategic Prevention Framework to 

strengthen prevention capacity and infrastructure at the state, territorial, and community levels; 

preventing the onset and reducing the progression of substance abuse; and leveraging, 

redirecting, and aligning statewide funding streams and resources to focus on promoting 

evidence-based substance abuse prevention. Up to 34 grants will be awarded to eligible states, 

territories and tribes who have completed SPF-SIG. SAMHSA will also consider how best to 

help tribes committed to substance abuse prevention strengthen their existing service delivery 

systems and/or begin building the necessary infrastructure to successfully prevent substance 

abuse in their communities. 

Of the remaining SPFSIG grantees, 88 percent reported decreases in underage drinking, 82

percent of grantees reported decreases in drug use, 29 percent reported increased perceived risk 

of substance use and 901 evidence-based policies, practices, and strategies were implemented. 

Three of these four measures exceeded their targets.

Mandatory Drug Testing

The Mandatory Drug Testing program is a critical nationwide prevention program consisting of 

two principal activities mandated by Executive Order and Public Law: (1) oversight of the 

Federal Drug-Free Workplace Program, aimed at elimination of illicit drug use in the federal 

workforce, with impact in the private sector workforce as well; and (2) oversight of the National 

Laboratory Certification Program, which certifies laboratories to conduct forensic drug testing 

for the federal agencies and for some federally-regulated industries.
129

Executive Order 12564, first signed on September 15, 1986, requires the head of each executive 

agency to establish a program to test for the use of illegal drugs by federal employees in sensitive 

positions and requires the Secretary to promulgate scientific and technical guidelines for drug 

testing programs. The Executive Order also requires HHS to assist the Office of Personnel 

Management to develop and improve training programs for federal supervisors and managers on 

illegal drug use.

The Supplemental Appropriations Act, 1987 (Public Law 100-71) requires HHS to: (1) certify 

that each federal agency has developed a plan for achieving a drug-free workplace; and (2) 

publish Mandatory Guidelines that establish comprehensive standards for laboratory drug testing 

procedures, specify the drugs for which federal employees may be tested, and establish standards 

and procedures for periodic review and certification of laboratories to perform drug testing for 

federal agencies.

The program is further supported by the CSAP Workplace Helpline, a toll-free telephone service 

for business and industry that answers questions about drug abuse in the workplace. 

SAMHSA continued these activities in FY 2013 and will continue do so in FY 2014. In 

addition, the Drug Testing Advisory Board is examining the scientific basis for utilization of oral 

fluid and other alternative specimens to urine, and the inclusion of additional Schedule II 

prescription medications (e.g., oxycodone, oxymorphone, hydrocodone and hydromorphone) in 

the Mandatory Guidelines. Any changes in the guidelines will be based on scientific 

supportability. SAMHSA continues to partner with other federal agencies to ascertain the 

scientific evidence needed to set standards for the Mandatory Guidelines. 

Minority AIDS Initiative (MAI)

Minority AIDS Initiative (MAI) supports efforts to increase access to substance abuse and HIV 

prevention services for the highest risk and hardest-to-serve racial and ethnic minority 

populations. Grantees must implement integrated, evidence-based substance abuse and HIV 

prevention interventions, including HIV testing, that target one or more high-risk populations 

such as young adults (18 to 24), African-American women, adolescents, individuals who have 

been released from prisons and jails within the past two years, or men having sex with men 

(MSM). In addition, the MAI supports partnerships between public and private nonprofit 

organizations to prevent and reduce the onset of substance abuse and transmission of HIV among 

high-risk populations. 

In FY 2010, SAMHSA funded the Ready-To-Respond Initiative and the Capacity Building 

Initiative programs. A total of 62 grants in these cohorts will continue to be funded in FY 2014. 

The Ready-To-Respond Initiative, was awarded to experienced MAI grantees, and provides 

substance abuse and HIV prevention services to at-risk minority populations in communities 

disproportionately affected by HIV/AIDS. The Capacity Building Initiative focuses on using 

evidence-based prevention strategies and media technology to reach college students, who

comprise one-third of the 18-24 year old population in the United States and are particularly at 

risk for substance use and HIV infection. Performance data for FY 2012 showed that almost 

6,600 people received substance abuse prevention education services. Additionally, 96.8 percent 
130

of participants rated the risk of harm from substance abuse as great. Of those participants who 

were non-users, 93.2 percent remained non-users of drugs and 88.4 percent remained alcohol 

free. During FY 2012, over 32, 975 participants were tested for HIV. SAMHSA continued to 

support these grants in FY 2012 and FY 2013. 

In FY 2011, SAMHSA also awarded 11 grants for the MAI Targeted Capacity Expansion 

Integrated Behavioral Health/Primary Care Network Cooperative Agreements, jointly funded 

with CMHS and CSAT. This grant program facilitates the development and expansion of 

culturally-competent and effective integrated behavioral health and primary care networks, 

which include HIV services and medical treatment, within racial and ethnic minority 

communities in the 11 Metropolitan Statistical Areas and Metropolitan Divisions most impacted 

by HIV/AIDS. Expected outcomes include: reducing the impact of behavioral health problems, 

HIV risk and incidence, and HIV-related health disparities in these areas. SAMHSA continued

to support these grants in FY 2014.

In FY 2013, SAMHSA awarded a new cohort of grants for the MAI funding for Minority 

Serving Institutions (MSIs) Partnerships with Community-Based Organizations (CBOs). The 

purpose of this program is to prevent and reduce substance abuse (SA) and transmission of 

HIV/AIDS among African-American, Hispanic/Latino, and American Indian/Alaska Natives 

(AI/AN) young adults (ages 18- 24) populations on campus. MSIs will partner with one or more 

community-based organizations (CBOs) to provide integrated SA and HIV prevention programs

to African-American, Hispanic/Latino, American Indian/Alaska Native (AI/AN), and Asian 

American/Pacific Islander young adults (ages 18-24) in the surrounding communities. 

SAMHSA awarded 29 grants for three years. 

In FY 2013, SAMHSA also implemented a new program, Substance Abuse and HIV/AIDS 

Prevention and New Media. The purpose of this program is to enhance the infrastructure 

capacity of community-based organizations to more effectively reach the most at-risk 

racial/ethnic minority populations and subpopulations using new media and emerging 

technologies. This program builds capacity for substance use disorders and HIV/AIDS 

prevention services consistent with the goals and objectives of the National HIV/AIDS Strategy 

and SAMHSA’s Strategic Initiative #1 – Prevention of Substance Abuse and Mental Illness. 

SAMHSA awarded 20 grants.

SAMHSA supports the National HIV/AIDS Strategy through its grant programs, including the 

cross-Center Targeted Capacity Expansion Integrated Behavioral Health/Primary Care Network 

Cooperative Agreements, the CSAT Targeted Capacity Expansion/HIV program, and the CSAP 

Ready-to-Respond, Capacity Building Initiative, Minority Serving Institutions in Partnership 

with Community Based Organizations, and Substance Abuse & HIV/AIDS Prevention & New 

Media programs, all described in their respective sections of this document. SAMHSA also 

provides training and technical assistance to its grantees to ensure they are focusing on the goals 

of the Strategy and collaborates with other HHS Operating Divisions involved with the Strategy 

to ensure a coordinated, departmental approach.

In FY 2014, SAMHSA’s CMHS, CSAP, and CSAT plan to pilot HIV Continuum of Care grants

which supports behavioral health screening, primary prevention, and treatment for racial/ethnic 
131

minority populations with or at high risk for mental and substance use disorders and HIV. This 

will include (SA) primary prevention/treatment service programs, community mental health 

programs, and HIV integrated programs that can either co-locate or fully integrate HIV 

prevention and medical care services within them. Also, this program will provide SA and HIV 

primary prevention services in local communities served by the behavioral health program.

Sober Truth on Preventing Underage Drinking Act (STOP Act)

The Sober Truth on Preventing Underage Drinking Act (STOP Act) of 2006 is the nation’s first 

comprehensive legislation on underage drinking. One of the primary components of the Act is 

the STOP Act grant program, which provides additional funds to current or former grantees 

under the Drug Free Communities Act of 1997 to prevent and reduce alcohol use among youth 

age 12-20. The STOP Act grant program enables organizations to strengthen collaboration and 

coordination among stakeholders in order to achieve a reduction in underage drinking in their 

communities. Grants are limited by statute to $0.1 million per year for four years. In FY 2012, 

81 new grants were awarded. In FY 2012, performance data showed that the STOP Act grant 

program has exceeded targets in two of the three GPRA performance measures. Almost 72

percent of coalitions reported a reduction in the past 30-day use of alcohol, 55 percent of 

coalitions reported an increase in perceived risk, and 58.2 percent of coalitions reported an 

increase in perception of parental disapproval of alcohol use (69.6 percent). In FY 2013, 

SAMHSA awarded 17 new grants

Another component of the STOP Act is the National Adult-Oriented Media Public Service 

Campaign, which educates parents regarding how to speak with their 11- through 15-year-old 

children about underage drinking in order to delay the onset of, and ultimately reduce, underage 

drinking. Nationwide, 36.6 percent of the estimated 10 million underage drinkers were provided 

free alcohol by adults 21 or older (2012 NSDUH). Further research continues to show that 

parents of teens generally underestimate the extent of alcohol used by youth and its negative 

consequences, with the vast majority viewing underage drinking as “inevitable.” 

The third component of the STOP Act is the federal Interagency Coordinating Committee on the 

Prevention of Underage Drinking (ICCPUD), which provides high-level leadership from 15 

federal agencies for coordinating federal efforts to prevent and reduce underage drinking. In FY 

2012, the ICCPUD was reinvigorated with principals meeting from all federal agencies working 

to prevent underage drinking, and the launch of a webinar series featuring common messages 

with individualized information for the field from each involved federal agency. In 2012, the 

ICCPUD updated the 2007 Surgeon General’s Call to Action to Prevent Underage Drinking to 

reflect progress over the past six years, the impact of the Affordable Care Act, and new research 

supporting effective prevention approaches. SAMHSA continued to support ICCPUD’s 

activities in FY 2013. In FY 2014, SAMHSA will support 97 grant continuations and will 

continue to support the National-Adult-Oriented Media Campaign and ICCPUD. 

 
132

Fetal Alcohol Spectrum Disorders (FASD)

The Fetal Alcohol Spectrum Disorders (FASD) Center for Excellence (CFE) program focuses on 

preventing Fetal Alcohol Spectrum Disorders among women of childbearing age and improving 

the quality of life for individuals and families impacted by these disorders. FASD CFE uses a 

comprehensive approach across the lifespan to work toward reducing the number of infants 

exposed to alcohol prenatally, increasing the functioning of individuals who have an FASD, and 

addressing the challenges of individuals and families impacted by FASD.

As part of these efforts, FASD CFE has successfully established a website that provides the 

public with information and resources on the prevention of FASD, chartered an expert panel that 

provides guidance and recommendations about best practices for healthcare providers and social 

services, organized a Self-Advocates with FASD Network comprising young adults with a 

FASD and Birth Mothers Network. In addition FASD CFE partnered with the National Institute 

on Alcohol Abuse and Alcoholism’s Interagency Coordinating Committee on FASD to advance 

new research and best practices on FASD, coordinated and collaborated with organizations such 

as the National Organization on Fetal Alcohol Syndrome to develop curricula for juvenile justice 

systems and certified addictions counselors, provided ongoing support to the National 

Association of FASD State Coordinators to integrate FASD services into existing health care 

systems and convened 10 "Building FASD State Systems" annual conferences to facilitate the 

development of comprehensive systems of care for people affected by FASD. FASD CFE also 

established a Native Communities Initiative to address FASD in American Indian /Alaska Native 

/Native Hawaiian populations.

In FY 2012, SAMHSA continued to support the FASD CFE to work toward the prevention of 

FASD in communities throughout the nation. In FY 2013, the CFE provided technical assistance 

and training to other federal and national partners to assist them in developing evidence-based 

prevention, intervention, and treatment approaches. Primary audiences for the FASD CFE are 

women of child-bearing age, persons and families affected by FASD, states, local communities, 

AI/AN communities, military families, other special populations, as well as health, social 

service, and faith-based providers who study and/or provide services for persons affected by an 

FASD. In 2014, the FASD CFE will continue this technical assistance.

Center for the Application of Prevention Technologies (CAPT)

The Center for the Application of Prevention Technologies (CAPT) program provides state-ofthe-art training and technical assistance designed to build the capacity of SAMHSA grantees and 

develop the skills, knowledge, and expertise of the prevention workforce. CAPT builds capacity 

and promotes the development of substance abuse prevention professionals in the behavioral 

health field through three core strategies: (1) establishing technical assistance networks using 

local experts; (2) developing and delivering targeted training and technical assistance activities; 

and (3) using 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. 
133

During FY 2012 and FY 2013, CAPT completed a comprehensive revision and updating of its 

flagship Substance Abuse Prevention Skills Training, which offers participants 31 training hours 

toward certification as a Substance Abuse Prevention Specialist. CAPT also developed a Pacific 

Islander and Native American adaptation of the training for an additional six training hour 

credits. In FY 2012 and 2013, CAPT has continued to develop behavioral health indicators and 

related training and technical assistance products focused on shared risk and protective factors to 

promote collaboration across substance abuse and mental health disciplines within the behavioral 

health field. 

During FY 2012, CAPT provided training to 9,041 substance abuse professionals. In addition, 

CAPT provided technical assistance services to 7,655 people. Over 96 percent of service 

recipients reported that their organization’s capacity was increased as a result of the service. 

Almost half of the recipients reported fully implementing the training recommendations. 

Additional performance data for the CAPT is captured using common measures with other 

technical assistance activities in the Science and Service Program Coordination category. 

Although the CAPT funding line was reduced in FY 2014, it is co-funded with Block Grant setaside funds. Therefore the CAPT will be fully funded in FY 2014.

Science and Service Program Coordination

The Science and Service Program Coordination category primarily encompasses contracts that 

provide technical assistance and training to states, tribes, communities, and grantees around 

substance abuse prevention. Included in the performance measurement section for this category 

is the former Native American Center for Excellence (NACE) and the Underage Drinking 

Prevention Education Initiative (UADPEI). 

The purpose of NACE was to promote effective substance abuse prevention programs in tribal 

and urban American Indian and Alaska Native (AI/AN) communities throughout the United 

States. The NACE mission was to promote best practices in substance abuse prevention by 

disseminating information on cultural and evidence-based programs, practices, and policies and 

providing training and technical assistance to prevention programs and organizations serving 

urban and tribal Native American communities. The target audiences included the Native 

American SPF-Tribal Incentive Grant grantees, tribal nations and organizations, health and 

social service providers, federal and state level organizations, and community and faith-based 

providers serving Native Americans. Eighty-eight percent of recipients reported that the NACE 

services increased their individual capacity to provide prevention services.

NACE expanded its outreach in FY 2012 and FY 2013 through presentations at national 

conferences and regional events, and increased collaborative efforts with other SAMHSA 

initiatives and national organizations. The NACE website greatly expanded its collection of 

resources and dissemination of current news worthy events through daily “headlines” entries 

while tripling its number of visitors each month. FY 2012 and FY 2013 also brought the 

development of four new NACE learning communities (National Prevention Network, SPF 

Tribal Incentive Grant, Gathering of Native Americans, and 2-Spirit) to bring stakeholders 

together on conference calls or webinars to further disseminate information and support cross-
134

fertilization of information and ideas. Lastly, NACE expanded the frequency and reach of its 

national webinars.

In FY 2013, NACE was consolidated into the braided Tribal Training and Technical Assistance 

Center (Tribal TTA Center). The Tribal TTA Center provides comprehensive, broad, focused, 

and/or intensive training and technical assistance to federally-recognized tribes and other 

American Indian/Alaska Native communities, seeking to address and prevent mental and 

substance use disorders, suicide, and promote mental health. The braided amounts spent and 

awarded are tracked as distinct funding streams and are only to be used for purposes consistent 

with Congressional intent. In FY 2014, the training and technical assistance will continue. 

The Underage Drinking Prevention Education Initiative (UADPEI) engages parents and other 

caregivers, schools, communities, all levels of government, all social systems that interface with 

youth, and youth themselves in a coordinated national effort to prevent and reduce underage 

drinking and its consequences. Through this initiative, families, their children, and other youthserving organizations have been reached through Town Hall Meetings (held in even-numbered 

years), technical assistance, trainings, and with a variety of tools and materials performance data 

shows that, collectively, the CAPT and Science and Service Program Coordination programs 

have exceeded their targets for customer satisfaction, and for the proportion of participants who 

report implementing recommendations. Efficiencies have been achieved from the growing focus 

on train-the-trainer models rather than training of individuals. In addition, since the Town Hall 

Meetings under the UADPEI contract occur biannually, numbers served expand in the years the 

meetings occur and contract in alternate years. Science and Service performance data for FY 

2012, 15,269 people were trained and almost 9,000 received technical assistance. In FY 2014, 

UADPEI funding will be reduced because the town hall meetings occur every other year. 

Funding History1\

Fiscal Year Amount

FY 2011 $186,302,000

FY 2012 $185,884,920

FY 2013 $175,512,571

FY 2014 $175,560,000 

FY 2015 $185,560,000

1\The funding history is presented on a comparable basis to previous funding levels to represent the 

revised budget structure and includes the PHS Evaluation Fund.

Budget Request 

The FY 2015 Budget Request is $185.6 million at the program level with $169.1 million in

Budget Authority, and $16.5 million in PHS Evaluation Fund. This is an increase of $10 million

from the FY 2014 Enacted Level. The FY 2015 Budget Request continues the activities as 

described in the FY 2014 Enacted Level and includes an increase of $10 million for the new 

Strategic Prevention Framework Prescription Drug Abuse and Overdose Prevention (SPF Rx).

The request includes:
135

Strategic Prevention Framework Prescription Drug Abuse 

and Overdose Prevention (SPF Rx)

According to the 2012 National Survey on Drug Use and Health (NSDUH), 2.6 percent of the 

U.S. population uses prescription drugs non-medically, including 4.9 million users of pain 

relievers, 2.1 million users of tranquilizers, 1.2 million users of stimulants, and 270,000 users of 

sedatives. Drug overdose death rates have increased five-fold since 1980.20 By 2009, drug 

overdose deaths outnumbered deaths due to motor vehicle crashes for the first time in the U.S. 

Prescription drugs, especially opioid analgesics, have been increasingly involved in drug 

overdose deaths.21 Opioid analgesics were involved in 30 percent of drug overdose deaths where 

a drug was specified in 1999, compared to nearly 60 percent in 2010. Opioid-related overdose 

deaths now outnumber overdose deaths involving all illicit drugs such as heroin and cocaine 

combined.22 In addition to overdose deaths, emergency department visits, substance treatment 

admissions and economic costs associated with opioid abuse have all increased in recent years. 

Rates of chronic nonmedical use of opioids are highest among 18-25 year olds, followed by 26-

34 year olds, and 35-49 year olds.23 Rates of emergency department visits due to misuse or 

abuse of opioids or benzodiazepines are highest among 21-29 year olds followed by 30-44 and 

45-54 year olds.24 Substance abuse treatment admissions for opioid analgesics are highest for 25-

34 year olds, followed by 18-24 year olds, and 35-44 year olds.25 Drug overdose death rates for 

opioids are highest among people aged 45-54 years old, followed by 35-44, 25-34, and 55-64 

year olds.26 

 

In FY 2015, funding is being requested for SAMHSA and CDC as 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. The two agencies are coordinating to ensure that the 

efforts are aligned with HHS’ recently established policy and plan for prevention of OpioidRelated Overdoses and Deaths involving multiple Operating Divisions and offices. 

CDC will expand its Core Violence and Injury Prevention Program to provide basic injury and 

violence prevention infrastructure to additional states with a high burden of prescription drug 

overdose. This expansion will provide additional funding and technical assistance to some 

current and new Core states to focus on the main drivers of the epidemic – high-risk prescribing 

and high-risk patients. 

 

20 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.

21 Paulozzi L, Jones C, Mack K, Rudd R; Centers for Disease Control and Prevention (CDC). Vital signs: overdoses of prescription opioid 

analgesics—United States, 1999-2008. MMWR Morb Mortal Wkly Rep. 2011;60(43):1487- 1492.

22 Centers for Disease Control and Prevention. WONDER [database]. Atlanta, GA: US Department of Health and Human Services, Centers for 

Disease Control and Prevention; 2013. Available at http://wonder.cdc.gov. 

23 Jones CM. Frequency of prescription pain reliever nonmedical use: 2002-2003 and 2009-2010. Arch Intern Med. 2012;172(16):1265-1267.

24 Substance Abuse and Mental Health Services Administration, Center for Behavioral Health Statistics and Quality. (July 2, 2012). 

The DAWN Report: Highlights of the 2010 Drug Abuse Warning Network (DAWN) Findings on Drug-Related Emergency Department Visits. 

Rockville, MD.

25 Substance Abuse and Mental Health Services Administration, Center for Behavioral Health Statistics and Quality. Treatment Episode Data Set 

(TEDS): 2000-2010. National Admissions to Substance Abuse Treatment Services. DASIS Series S-61, HHS Publication No. (SMA) 12-4701. 

Rockville, MD: Substance Abuse and Mental Health Services Administration, 2012.

26 CDC analysis of the 2010 Multiple Cause of Death Mortality File. 2012. 
136

SAMHSA proposes to dedicate $10 million to a new program, the Strategic Prevention 

Framework Prescription Drug Abuse and Overdose Prevention (SPF Rx), that will provide 

funding for the prevention of prescription drug misuse and abuse in high priority age groups 

(including young and middle-aged adults) and the general public. SAMHSA’s program will 

complement the CDC program by awarding grants to a state’s substance abuse authority to 

develop a comprehensive prevention approach in collaboration with the state’s public health 

authority, education authority, and Medicaid authority, as well as the state’s Prescription Drug 

Monitoring Program (PDMP) and Health Information Exchange (HIE). The goal will be to raise 

awareness of the dangers of sharing medications and work with pharmaceutical and medical 

communities on the risks of overprescribing and on the use of data from PDMPs and to provide 

educational materials at points of prescribing, sale and dispensing. SAMHSA’s program will 

also focus on raising community awareness and bringing prescription drug abuse prevention 

activities and education to schools, communities, parents, prescribers and their patients. 

SAMHSA proposes to utilize $4 million to fund SAMHSA SPF Rx grantees to:

 Use the state’s strategic plan to target prescription drug abuse and misuse within the state;

 Use PDMP data for prevention planning; and

 Implement evidence-based practices and/or environmental strategies aimed at reducing 

prescription drug abuse and misuse. 

Grantees will be required to track and monitor outcomes in non-medical use of prescription 

medications, emergency room admissions, and deaths due to prescription drug misuse or 

overdoses, as well as potential shifts in use of heroin or other illicit drugs in grantee states.

SAMHSA’s SPF Rx grantees will be required to use needs assessment data to determine the risk 

factors leading to prescription drug abuse in the state, including lack of public knowledge of the 

dangers of misuse of prescription drugs and easy access to prescription drugs through friends, 

family members, and health care professionals. Because these risk factors will likely differ 

across grantees, the educational activities and community awareness activities implemented by 

SPF Rx grantees may also differ. Activities might include media campaigns targeted at parents 

and focused on the safe storage of prescription drugs,27 the publication and distribution of opioid 

prescribing guidelines for health care professionals,28 and evidence-based educational programs 

delivered in the school setting, such as Strengthening Families.29 SAMHSA will also partner 

with NIDA to further develop the evidence base to support these efforts. 

SAMHSA will utilize approximately $4 million for planning grants for up to 20 other states to 

build capacity to address prescription drug abuse and overdose prevention efforts, in conjunction 

 

27 Johnson EM, Porucznik CA, Anderson JW, Rolfs RT. State level strategies for reducing prescription drug 

overdose deaths: Utah’s prescription safety program. Pain Medicine: June 2011, Vol.12, Supp 2:S66-72.

28 Ibid.

29 Richard Spoth, Linda Trudeau, Chungyeol Shin, Ekaterina Ralston, Cleve Redmond, Mark Greenberg, and Mark 

Feinberg. Longitudinal Effects of Universal Preventive Intervention on Prescription Drug Misuse: Three 

Randomized Controlled Trials With Late Adolescents and Young Adults. American Journal of Public Health: April

2013, Vol. 103, No. 4, pp. 665-672. 
137

with other state and local partners. They will utilize these funds to create partnerships with the 

existing prevention workforce, especially existing coalitions, to utilize PDMP, SAMHSA 

NSDUH, and/or commercial prescribing data to identify communities at risk and develop plans 

for appropriate prevention and intervention strategies. These states will be expected to produce a 

strategic plan focused on bringing prescription drug abuse prevention activities and education to 

schools, communities, and parents, and include a new focus on prescribers and their patients. 

These 20 states would be positioning themselves to eventually become implementation states. 

Of the remaining $2 million, $1.4 million will be utilized, working in conjunction with CDC, to 

evaluate and provide technical assistance for funded states, and $0.6 million will be utilized to 

continue and expand work begun in FY 2011 with the Office of the National Coordinator of 

Health Information Technology (ONC) to focus on standards alignment on interoperability 

among state Prescription Drug Monitoring Programs (PDMPs) and electronic health records 

(EHRs) and HIEs and/or any other technology efforts determined necessary for the exchange of 

data. Additionally, grantees may identify and implement new opportunities (e.g., pilots, 

innovation challenges, etc.) focused on the use of EHRs and HIEs to improve clinical decisionmaking within and across states and to support PDMP communication and outreach activities.

SAMHSA’s SPF Rx will provide funds to develop capacity and expertise in the utilization of 

data from the state’s PDMP to identify communities by geography and population (e.g., age 

group) of high risk, particularly those communities that are in need of primary and secondary 

prevention. This will be coordinated with CDC’s expansion of the Core Violence and Injury 

Prevention Program to include additional states with a high burden of prescription drug 

overdose, States will also provide technical assistance and training to the identified communities 

on the selection and implementation of appropriate evidence-based prevention programming 

using the Strategic Prevention Framework as their guide. In addition, SAMHSA’s resources can 

be used to provide technical assistance and training on the use of SAMHSA’s Opiate Overdose 

Prevention Tool Kit to prevent overdose deaths. 

SAMHSA and CDC will coordinate to implement interventions that address the key drivers of 

overdose and high-risk prescribers and patients, while also implementing the foundational 

prevention programs required to sustain a state-wide response to this significant public health 

issue.

Minority AIDS Initiative

HIV Continuum of Care

(Braided program with Mental Health: Minority AIDS Initiative and Primary and Behavioral 

Health Care Integration and Substance Abuse Treatment: Minority AIDS Initiative and Primary 

Care and Addiction Services Integration)

SAMHSA expects that data generated from the 2014 HIV Continuum of Care pilot will help to 

inform an expanded program proposed for 2015 to continue the co-location and integrated 

HIV/primary care within either substance abuse or community mental health treatment programs. 

Braided funds in 2015 in the amount of $24 million would be dedicated to establishing integrated 

behavioral health and HIV care in addition to primary care needed by those living with or at high 
138

risk for HIV infection in minority communities heavily impacted by HIV. In addition, because of 

the significant comorbidity of viral hepatitis with HIV infection and because viral hepatitis 

occurs in up to 20 percent of those with either substance use disorders or serious mental illness, 5

percent of the allocated funds will be used to provide services to prevent, screen, test and refer to 

treatment as clinically appropriate those at risk for or living with viral hepatitis. In integrating 

HIV care into behavioral health settings, people living with HIV/AIDS and M/SUDs will have 

greater access to treatment for these conditions. Integrated care programs developed as a result of 

this grant program will make it possible for behavioral health and HIV care needs to be 

addressed in one setting. This will result in effective, person-centered, treatment that will reduce 

the risk of HIV transmission, improve outcomes for those living with HIV, and ultimately reduce 

new infections. SAMHSA’s Common Data platform (CDP), now under development, will 

integrate substance abuse and mental health elements with HIV and Hepatitis elements to ensure 

a more rigorous evaluation and data analysis to inform future public health intervention decisionmaking that addresses the intersection of behavioral health and HIV. 

Strategic Prevention Framework

Building Behavioral Health Coalitions: 

Working to Address Shared Risk and Protective Factors

(Braided program with Mental Health: MH System Transformation and Health Reform)

In support of SAMHSA’s Prevention of Substance Abuse and Mental Illness Strategic Initiative, 

SAMHSA proposes to use $3 million in Budget Authority to establish the Building Behavioral 

Health Coalitions program. SAMHSA will use $1.5 million from Mental Health Appropriation’s 

Mental Health Transformation and Health Reform funds and $1.5 million from Substance Abuse 

Prevention Appropriation’s Strategic Prevention Framework funds to support this new 

initiative. The purpose of this program is to support active community coalitions and/or 

organizations to expand their focus and activities to include mental health promotion, mental 

illness prevention and substance abuse prevention. Consistent with the Institute of Medicine’s 

2009 report on Preventing Mental, Emotional, and Behavioral Disorders Among Young People, 

this program seeks to build on the emerging evidence that a significant number of mental, 

emotional and substance abuse problems in young people are largely preventable and 

community-based prevention can play a significant role in facilitating key prevention efforts. 

Evidence shows that to create emotionally healthy communities, it is important to address the 

shared risk factors that contribute to an array of adverse outcomes, and the protective factors that 

reduce the risk of these negative consequences. Risk factors include poverty, early trauma, 

drug/alcohol misuse, family dysfunction, poor academic performance, and peer 

rejection. Protective factors include good communication skills, stress mitigation, reliable 

support and guidance from parents and caregivers, support for high quality early learning, quality 

health care, healthy peer groups, social connectedness, and successful learning environments.

Mental Health Transformation and Health Reform Funds will be provided to substance abuse 

prevention community coalitions (including, but not limited to, current and former Drug Free 

Communities grantees) and organizations to expand their activities to include mental health 

promotion and mental illness prevention, and Strategic Prevention Framework funds will be 

provided to coalitions and organizations with a mental health focus to expand their activities to 
139

include substance abuse prevention. Funding streams will be kept separate and used for 

activities consistent with separate funding authorities. 

Funded activities may include but are not limited to, bi-directional education on substance abuse 

prevention and mental health promotion; assessing shared community risk and protective 

factors, especially among youth, connecting across community service systems including 

primary care, and developing the capacity to jointly implement evidence-based programming 

that addresses these factors; and working with stakeholders such as health insurance companies, 

Marketplaces, and state Medicaid officials to promote health insurance coverage for substance 

abuse prevention and mental health promotion. Grantees will be encouraged to consider best 

practices and models developed through other community-level programs such as Drug Free 

Communities, Safe Schools/Healthy Students, and Project LAUNCH.

The FY 2015 Budget Request includes level funding from the FY 2014 Enacted Level in the 

following:

 Mandatory Drug Testing: Funding maintains the Federal Drug-Free Workplace Program 

and National Laboratory Certification Program as required by law. Both of these are 

critical public health and safety programs ensuring that individuals in sensitive and 

safety-related federal positions are not using illicit drugs, and that drug testing 

laboratories produce accurate results. 

 Minority Aids Initiative: Funding addresses a critical public health problem and health 

disparity. Research has shown that there is a direct correlation between substance use 

(including alcohol) and HIV infection. The aim is to achieve normative and 

environmental changes to prevent and/or reduce substance abuse problems as risk factors 

for the transmission of HIV/AIDS among African-American, Hispanic/Latino, Asian 

American/Pacific Islander (AA/PI) and American Indian/Alaska Native (AI/AN) young 

adult populations (ages 18- 24) on campus. In addition, about 60 percent of youth with 

HIV do not know they are infected. The Minority AIDS Initiative provides life-saving 

prevention services, including testing. 

 Sober Truth on Preventing Underage Drinking (STOP Act): Funding allows for one new 

grant in FY 2015. 

 Fetal Alcohol Spectrum Disorder: Funding will maintain the Center for Excellence.

 Center for the Application of Prevention Technologies: Funding to provide technical 

assistance and workforce development to the prevention field. This is a critical function 

as the nation moves toward health reform and a behavioral health model.

 Science and Service Program Coordination: Funding is necessary to support SAMHSA’s 

top strategic initiative, prevention of substance abuse and mental illness, which includes a 

focus on preventing underage drinking and on American Indians/Alaska Natives. 
140

SAMHSA/ Substance Abuse Prevention

PRNS Mechanism Table by APT

(Dollars in thousands)

Programs of Regional & National No. Amount No. Amount No. Amount

Grants

Continuations.................................................. 184 $83,444 205 $72,373 196 $100,915

New/Competing............................................. 63 46,119 57 56,640 125 39,139

Supplements................................................... 17 3,900 15 2,175 --- ---

Subtotal.......................................................... 264 133,463 277 131,188 321 140,054

Contracts

Continuations.................................................. 25 30,774 22 39,535 20 33,515

New............................................................... 17 11,276 7 4,837 6 11,991

Subtotal.......................................................... 42 42,049 29 44,372 26 45,506

Total, CSAP PRNS 1 / 306 $175,513 306 $175,560 347 $185,560

Final Enacted President's Budget

1/In the FY 2015 Request, the CSAP Minority Fellowship Program budget is reflected in the Health Surveillance and 

Program Support Appropriation under the Agency-Wide Initiatives Workforce program. 

FY 2013 FY 2014 FY 2015

A detailed table for all grant and contract continuations and new activities can be found in the 

SAMHSA Supplementary Tables Chapter.
141

Key Outputs and Outcomes Table

(SAMHSA)

Program: Minority AIDS Initiative

NOTE: SAMHSA grant awards are made late in the year. FY 2014 Enacted is reflected in FY 2015 targets. FY 2015 President’s 

Budget is reflected in FY 2016 targets.

Measure Year and Most 

Recent Result /

Target for Recent 

Result /

(Summary of 

Result)

FY 

2015

Target

FY 

2016

Target

FY 2016

Target

+/-

FY 2015

Target

2.3.56 Increase the number of program participants exposed 

to substance abuse prevention education services (Output)

FY 2012: 6,593

Target:

1,535

(Target Exceeded)

3,00030 3,000 Maintain

2.3.82 Percent of program participants that rate the risk of 

harm from substance abuse as great (all ages) (Outcome)

FY 2012: 96.8%

Target:

88%

(Target Exceeded)

88% 90% +2

2.3.83 Percent of program participants who report no use of 

alcohol at pre-test who remain non-users at post-test (all 

ages) (Outcome)

FY 2012: 88.4%

Target:

91.2%

(Target Not Met 

but Improved)

91.2% 91.2% Maintain

2.3.84 Percent of participants who report no illicit drug use 

at pre-test who remain non-users at post-test (all ages) 

(Outcome)

FY 2012: 93.2%

Target:

92.6%

(Target Exceeded)

92.6% 92.6% Maintain

2.3.85a Number of persons tested for HIV through the 

Minority AIDS Initiative prevention activities (Outcome)

FY 2012: 32,975

Target:

32,975

(Baseline)

11,066 11,066 Maintain

 

30

Decrease in target from previous year is due to cohort effects and includes Cohorts IX and X.
142

Program: Sober Truth on Preventing Underage Drinking (STOP Act)

NOTE: SAMHSA grant awards are made late in the year. FY 2014 Enacted is reflected in FY 2015 targets. FY 

2015 President’s Budget is reflected in FY 2016 targets.

Measure Year and Most 

Recent Result /

Target for 

Recent Result /

(Summary of 

Result)

FY 

2015

Target

FY 

2016

Target

FY 2016

Target

+/-

FY 2015

Target

3.3.01 the percentage of coalitions that report at least 5% 

improvement in the past 30-day use of alcohol in at least two 

grades (Outcome)

FY 2012: 71.7%

Target:

46.7%

(Target Exceeded)

62%31 62% Maintain

3.3.02 Percentage of coalitions that report improvement in 

youth perception of risk from alcohol in at least two grades 

(Outcome)

FY 2012: 55%

Target:

63.4%

(Target Not Met)

68%32 68% Maintain

3.3.03 Percentage of coalitions that report improvement in 

youth perception of parental disapproval on the use of alcohol 

in at least two grades (Outcome)

FY 2012: 58.2%

Target:

56.7%

(Target Exceeded)

65%33 65% Maintain

 

31

Change from previously reported to reflect average of FY 2011 result and FY 2014 target.

32

Change from previously reported to reflect average of FY 2011 result and FY 2014 target.

33

Change from previously reported to reflect average of FY 2011 result and FY 2014 target.
143

Program: Prevention - Science and Service Activities

NOTE: SAMHSA grant awards are made late in the year. FY 2014 Enacted is reflected in FY 2015 targets. FY 2015 President’s 

Budget is reflected in FY 2016 targets.

Measure Year and Most 

Recent Result /

Target for Recent 

Result /

(Summary of 

Result)

FY 

2015

Target

FY 

2016

Target

FY 2016

Target

+/-

FY 2015

Target

1.4.09 Increase the number of individuals trained by 

SAMHSA's Science and Services Program (Output)

FY 2013: 67,94434

Target:

110,000

(Target Not Met)

110,000 110,000 Maintain

1.4.10 Prevention: Increase the number of individuals 

trained by SAMHSA' Science and Services Program 

(Output)

FY 2013: 12,08635

Target:

37,049

(Target Not Met)

14,94336 17,719 +2,776

2.3.36 Percent of participants that agree or strongly agree 

that the training or TA provided increased their capacity to 

do substance abuse prevention work (Outcome)

FY 2012: 88.3%

(Historical Actual)

83.8% 83.8% Maintain

2.3.37 Percent of participants that agree or strongly agree 

that the training or TA provided increased their 

organization's capacity to do substance abuse prevention 

work (Outcome)

FY 2013: Result 

Expected Dec 31, 

2014

Target:

Set Baseline

(Pending)

83.8% 83.8% Maintain

 

34

Results are preliminary and will be updated in 2014. 

35

FY 2013 results are preliminary and will be updated in 2014. 

36

Revised to reflect actual trends and year without Town Hall Meetings.
144

Program: Partnerships for Success

NOTE: SAMHSA grant awards are made late in the year. FY 2014 Enacted is reflected in FY 2015 targets. FY 2015 President’s 

Budget is reflected in FY 2016 targets.

Measure Year and Most 

Recent Result /

Target for Recent 

Result /

(Summary of 

Result)

FY 

2015

Target

FY 

2016

Target

FY 2016

Target

+/-

FY 2015

Target

2.3.78 Number of communities who report an increase in 

prevention activities that are supported by collaboration and 

leveraging of funding streams (Output)

FY 2012: 5037

Target:

75

(Target Not Met)

50 14238 +92

2.3.79 Number of EBPs implemented by sub-recipient 

communities (Output)

FY 2012: 88839

Target:

300

(Target Exceeded)

950 1,85040 +900

2.3.80 Number of sub-recipient communities that improved 

on one or more targeted NOMs indicators (Outcome)

FY 2012: 3241

Target:

30

(Target Exceeded)

50 14242 +92

 

37

Data submitted by PFS cohort I grantees.

38

Target increased from previous year due to substantial increase in grants and sub recipients reporting.

39

Data submitted by PFS cohort I grantees.

40

Target increased from previous year due to substantial increase in grants and sub recipients reporting.

41

Data submitted by PFS cohort I grantees.

42

Target increased from previous year due to substantial increase in grants and sub recipients reporting.
145

Program: Strategic Prevention Framework State Incentive Grants

NOTE: SAMHSA grant awards are made late in the year. FY 2014 Enacted is reflected in FY 2015 targets. FY 2015 President’s 

Budget is reflected in FY 2016 targets.

Measure Year and 

Most Recent 

Result /

Target for 

Recent Result 

/

(Summary of 

Result)

FY 

2015

Target

FY 2016

Target

FY 2016

Target

+/-

FY 2015

Target

2.3.21 Decrease underage drinking as measured by an 

increase in the percent of SPF SIG (Strategic Prevention 

Framework State Incentive Grant) states that show a 

decrease in 30-day use of alcohol for individuals 12 - 20 

years old (Outcome)

FY 2012: 88%

Target:

55.9%

(Target 

Exceeded)

50% 50% Maintain

2.3.23 Percent of SPF SIG states showing a decrease in 

state level estimates of survey respondents (age 12-17) who 

report 30-day use of other illicit drugs (Outcome)

FY 2012: 

82%43

Target:

67.6%

(Target 

Exceeded)

52% 52% Maintain

2.3.25 Percent of SPF SIG states showing an increase in 

state level estimates of survey respondents (age 12-17) who 

rate the risk of substance abuse as moderate or great 

(Outcome)

FY 2012: 

29%44

Target:

50%

(Target Not 

Met but 

Improved)

50% 50% Maintain

2.3.28 Number of evidence-based policies, practices, and 

strategies implemented (Output)

FY 2012: 901

Target:

274

(Target 

Exceeded)

12745 Discontinued N/A

 

43

NSDUH state estimates are provided for 17 of the 35 grantees, many of whom are Pacific Jurisdictions and Tribal entities.

44

NSDUH state estimates are provided for 17 of the 35 grantees, many of whom are Pacific Jurisdictions and Tribal entities.

45

Change from previously reported. Number of grantees reduced. Last year of funding for Cohort 5 is 2014.
146

Program: SPF Rx

NOTE: SAMHSA grant awards are made late in the year. FY 2014 Enacted is reflected in FY 2015 targets. FY 2015 President’s 

Budget is reflected in FY 2016 targets.

Measure Year and Most 

Recent Result /

Target for Recent 

Result /

(Summary of Result)

FY 

2015

Target

FY 

2016

Target

FY 2016

Target

+/-

FY 2015

Target

3.3.11 Number of funded states that incorporate PDMP 

data into their needs assessments in developing their 

strategic plans (Outcome)

FY 2015: Result 

Expected Dec 31, 

2015

Target:

Set Baseline

(Pending)

Maintain

3.3.12 Number of funded states reporting reductions in 

opioid overdoses (Outcome)

FY 2015: Result 

Expected Dec 31, 

2015

Target:

Set Baseline

(Pending)

Maintain
147

Size of Awards

Number of Awards 306 306 347

Average Awards $573,570 $573,725 $534,074

Range of Awards $50,000 - $2,300,000 $50,000 - $2,300,000 $50,000 - $2,300,000

FY 2013 

Final (whole dollars) FY 2014 Enacted

FY 2015 

President's Budget
148

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149

SAMHSA

Substance Abuse Treatment

Table of Contents

1. Substance Abuse Treatment ................................................................................................ 149

a) Opioid Drug Treatment/Regulatory Activities ......................................................... 151

b) Screening, Brief Intervention and Referral to Treatment (SBIRT) .......................... 153

c) Targeted Capacity Expansion-General (TCE-General)............................................ 154

d) Pregnant & Postpartum Women (PPW) ................................................................... 156

e) Strengthening Treatment Access & Retention (STAR)............................................ 157

f) Recovery Community Services Program (RCSP) .................................................... 158

g) Access to Recovery................................................................................................... 160

h) Children & Family Programs.................................................................................... 161

i) Treatment Systems for Homelessness ...................................................................... 162

j) Minority AIDS.......................................................................................................... 163

k) Criminal Justice Activities........................................................................................ 165

l) Addiction Technology Transfer Centers (ATTCs)................................................... 167

m) Special Initiatives/Outreach ...................................................................................... 168

n) Treatment Systems for Homelessness ...................................................................... 173

2. PRNS Mechanism Table by APT........................................................................................ 176

3. Substance Abuse Prevention and Treatment Block Grant .................................................. 187

4. PRNS Mechanism Table by SLOA..................................................................................... 320
150

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151

SAMHSA/Programs of Regional and National Significance

Substance Abuse Treatment

(Dollars in thousands)

FY 2013 FY 2014 FY 2015 FY 2015 

Programs of Regional & National Significance

Final Enacted President's 

Budget

+/-

FY 2014

CAPACITY:

Opioid Treatment Programs/Regulatory Activities........... $12,421 $8,746 $8,746 ---

Screening, Brief Intervention and Referral to Treatment.. 47,464 47,000 30,000 -17,000 

PHS Evaluation Funds (non-add).......................... 2,000 2,000 30,000 +28,000 

TCE-General................................................................ 26,516 13,256 15,256 +2,000 

Pregnant & Postpartum Women.................................... 15,634 15,970 15,970 ---

Strengthening Treatment Access and Retention.............. 1,584 1,668 1,000 -668 

Recovery Community Services Program......................... 2,445 2,440 2,440 ---

Access to Recovery...................................................... 93,128 50,000 --- -50,000 

Prevention and Public Health Fund (non-add)...... --- 50,000 --- -50,000 

Primary Care and Addiction Services Integration............ --- --- 20,000 +20,000 

Children and Families.................................................... 29,018 29,678 29,678 ---

Treatment Systems for Homeless................................... 39,397 41,488 41,488 ---

Minority AIDS.............................................................. 61,918 65,732 58,859 -6,873 

Criminal Justice Activities.............................................. 63,558 75,000 64,446 -10,554 

Subtotal, Capacity $393,085 $350,978 $287,883 -$63,095

SCIENCE AND SERVICE:

Addiction Technology Transfer Centers.......................... 9,008 9,046 8,081 -965 

Special Initiatives/Outreach............................................ 1,992 1,436 1,436 ---

Subtotal, Science and Service $11,000 $10,482 $9,517 -965 

TOTAL, PRNS1/ $404,085 $361,460 $297,400 -$64,060

* Totals may not add due to rounding.

1/In FY 2013- FY 2015, the CSAT Minority Fellowship Program budget is reflected in the Health Surveillance 

and Program Support Appropriation under the Agency-Wide Initiatives Workforce program.

Authorizing Legislation ................... Sections 506, 508, 509, 514 of the Public Health Service Act

FY 2015 Authorization .........................................................................................................Expired

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

Program Description and Accomplishments

Opioid Drug Treatment/Regulatory Activities

SAMHSA funds a number of grants and contracts that support the regulatory efforts and 

monitoring activities of opioid treatment programs. 
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In FY 2013, SAMHSA awarded seven Cooperative Agreements for Electronic Health Record 

(EHR) and Prescription Drug Monitoring Program (PDMP) Data Integration grants for 

approximately $2.9 million. The purpose of this program is to reduce prescription drug misuse 

and abuse by providing healthcare providers with access to PDMP data to make sound clinical 

decisions without disturbing their regular clinical workflow. Providing resources to states to 

enable hospital emergency department EHRs, primary care facility EHRs, and retail store 

pharmacy dispensing systems to link electronically to PDMPs will facilitate increased utilization. 

Grant funds will assist states in addressing prescription drug misuse and abuse strategies by 

integrating their PDMP data into EHRs and other health information technology (HIT) systems. 

These grant funds can only be used for the purposes of integrating PDMP data into health 

information systems – they cannot be used to enhance or expand existing PDMPs. 

In FY 2013, SAMHSA funded 15 Enhancing Opioid Treatment Program Patient Continuity of 

Care through Data Interoperability one-year grants. The purpose of this program is to provide 

resources to opioid treatment programs (OTPs) that will enable them to develop electronic health 

record systems that fulfill regulatory requirements, achieve certified status, and become 

interoperable with other patient health record systems. Additionally, SAMHSA funded nine oneyear grants to support the Rapid Hepatitis C Virus Screening and Referral grants. The purpose of 

this program is to address the high prevalence of viral hepatitis C infection among IV drug users 

in selected OTPs.

As part of its regulatory responsibility, SAMHSA certifies OTPs that use methadone, 

buprenorphine, or buprenorphine/naloxone to treat patients with opioid dependence. SAMHSA 

carries out this responsibility by enforcing regulations that established an accreditation-based 

system, and it is accomplished in coordination with the Drug Enforcement Administration and 

states, territories, and the District of Columbia. SAMHSA funds the OTP Medical Education and 

Supporting Services project aimed at preparing OTPs to achieve accreditation, providing 

technical assistance and clinical training to enhance program clinical activities.

In FY 2014 SAMHSA will support the Physician Clinical Support System-Opioids (PCSS-O)

through one new grant.

PCSS-O is a national mentoring network offering clinical updates, evidence-based outcomes, 

and training to physicians and other medical professionals in the appropriate use of opioids for 

the treatment of chronic pain and opioid addiction. A three-year Cooperative Agreement for the 

Physician Clinical Support System–Medication Assisted Treatment (PCSS-MAT) was awarded 

in FY 2013. The purpose of this program is to provide a national mentoring network offering 

clinical updates, evidence-based outcomes and training by expanding the previous focus on 

buprenorphine to include the other two FDA approved medications for the treatment of opioid 

addiction, methadone and extended release naltrexone. 

All discretionary grantees are required to collect and report data on a regular and real-time 

basis. Data are monitored to provide information which can be used to improve service, monitor 

grantee performance and quality and provide recommendations for future directions. Grantee 

performance and outcomes data are monitored using the Services Accountability Improvement 

System. During the next fiscal year, data will still play an integral role in the monitoring of 
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grantee performance; however, the data system used for this monitoring will be switched to the 

Common Data Platform which will house data from all SAMHSA discretionary grantees.

SAMHSA also ensures that the accreditation bodies are using sound and evidence-based 

approaches in accrediting OTPs through SAMHSA staff monitoring of the accrediting process 

and procedures. 

In FY 2014, SAMHSA plans to support the continuation of two grants and six contracts as well 

as one new grant.

Screening, Brief Intervention and Referral to Treatment (SBIRT)

Screening, Brief Intervention, and Referral to Treatment (SBIRT) was initiated by SAMHSA in 

FY 2003, using cooperative agreements to expand and enhance a state or tribal organization’s 

continuum of care. The purpose of the program is to integrate screening, brief intervention, 

referral, and treatment services within general medical and primary care settings. 

The SBIRT program requires grant recipients to affect practice change throughout the spectrum 

of medical practice. This is achieved through implementation in all levels of primary care, 

including hospitals, trauma centers, health clinics, nursing homes, employee assistance 

programs, and school systems. Practice change also alters the educational structure of medical 

schools by developing and implementing SBIRT curricula as standard and permanent practice. 

Research and clinical experience supports the use of the SBIRT approach to provide effective 

early identification and interventions in primary care and general medical settings. Early 

identification can decrease total healthcare costs by arresting progression toward addiction. 

SBIRT also can identify individuals with more serious problems and encourage them to obtain 

appropriate specialty treatment services. Funds may be used for the following services: 

pre/screening for substance use and co-occurring disorders; brief interventions designed with 

client centered, non-judgmental, motivational interviewing techniques; brief treatment including 

the monitoring of individuals who misuse alcohol and other drugs but are not yet dependent; 

referral to treatment (when indicated) for those who have a substance use disorder; and when 

appropriate, referral to and expansion of specialty treatment services. Since the beginning of this 

program, more than two million individuals have been screened. Of those, 19 percent required a 

brief intervention, brief treatment, or referral to specialty treatment programs. 

In FY 2012, over 142,000 individuals were served by the SBIRT program. The percentage of 

individuals reporting abstinence at follow up tripled compared to the percentage reporting 

abstinence at baseline. In FY 2013, 274,873 individuals were served by the SBIRT program.

SBIRT has great future potential for promoting changes to the entire primary care medical 

service delivery system. Efforts are underway to identify other funding streams to help take this 

practice to scale. For example, new diagnostic codes have been adopted by 16 states, making it 

easier for doctors to get reimbursed for screening Medicaid patients. Likewise, alcohol 

screening is now available to Medicare beneficiaries as a preventive service without cost. In FY 

2012, SAMHSA funded the continuation of 27 SBIRT grants, supported six contracts as well as 

three new multi-year grants funded out of the Prevention and Public Health Fund, and continued 
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to monitor the progress of the three FY 2011 multi-year Prevention and Public Health Fund 

grants. 

In FY 2013, SAMHSA funded five state SBIRT grants, 14 SBIRT Medical Professional Training 

Program grants as well as 12 grant continuations and supported five contracts.

In FY 2014, SAMHSA plans to support nine additional (SBIRT) Medical Professional Training 

grants and one State SBIRT grant. The purpose of SBIRT Training is to develop and implement 

training programs to teach health professionals (medical residents and students of nursing, social 

work and counseling) the skills necessary to provide evidence-based screening, brief intervention 

and brief treatment and to refer patients who are at risk for a substance use disorder (SUD) to 

appropriate treatment. As shown by data collected from SBIRT cross-site evaluations (SBIRT 

Cohort I Cross-Site Evaluation Final Report, 2010), the vast majority of SBIRT service providers 

are nurses, social workers and counselors with the role of the physician as leading the effort 

through clinical work, advocacy and supervising SBIRT in medical settings. Grantees are 

required to use training curricula developed by the initial cohort of SAMHSA SBIRT Medical 

Residency grantees. The intended outcome of this program is to increase the adoption and 

practice of SBIRT throughout the health care delivery system. The SBIRT Training program 

supports the SAMHSA Health Reform Strategic Initiative to expand access to individuals 

vulnerable to health disparities.

The utilization of the previous cross site evaluations inform current and future SBIRT cohorts 

and highlights the roles of non-physicians in the actual provision of SBIRT services. The 

intention is to continue with a new cross site evaluation intended to show outcome measure 

achievement rather than process data. This will help prove the efficacy and efficiency of the 

SBIRT process and inform future grant design. Many grantees are also publishing information 

related to the outcomes achieved through the grant activities and this will help to further the 

acceptance of SBIRT and inform future grant proposals. 

All discretionary grantees are required to collect and report data on a regular and real-time basis. 

Data are monitored to provide information which can be used to improve service, monitor 

grantee performance and quality, and provide recommendations for future directions. Grantee 

performance and outcomes data are monitored using the Services Accountability Improvement 

System

In FY 2014, SAMHSA plans to support the continuation of 22 grants, four contracts and 

approximately 10 new grants.

Targeted Capacity Expansion-General (TCE-General)

The Targeted Capacity Expansion (TCE-General) program was initiated in FY 1998 to help 

communities bridge gaps in treatment services. TCE funding supports grants to expand or 

enhance a community’s ability to provide rapid, strategic, comprehensive, integrated, 

community-based responses to a specific, well-documented substance abuse capacity problem. 

Since inception, TCE grants have been awarded to address the following targeted populations or 

urgent, unmet, and emerging treatment needs: American Indian and Alaska Natives, Asian 
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Americans, Pacific Islanders, rural areas, methamphetamine abuse, e-therapy, grassroots 

partnerships, and other populations and issues. 

In FY 2011, SAMHSA funded Grants to Expand Care Coordination Through the Use of Health 

Information Technology (HIT) in Targeted Areas of Need. The purpose of this program is to 

leverage technology to enhance and/or expand the capacity of substance abuse treatment 

providers to serve persons in treatment who have been underserved because of lack of access to 

treatment in their immediate community due to transportation concerns, an inadequate number of 

substance abuse treatment providers in their community, and/or financial constraints. The use of 

HIT, including web-based services, smart phones, behavioral health electronic applications (eapps), and telehealth will expand and enhance the ability of providers to effectively communicate 

with persons in treatment and to track and manage their health to ensure treatment and services 

are available where and when needed. Grantees will use technology to support recovery and 

resiliency efforts and promote wellness. 

In FY 2012, SAMHSA funded 46 grant continuations and supported 13 contracts as well as six 

new multi-year funded HIT grants. In FY 2013, SAMHSA funded 13 TCE-Technology Assisted 

Care (TAC) grants, 20 TCE-Peer to Peer (TCE-PTP) grants, 30 grant continuations, and 

supported eight contracts. The purpose of the TCE-TAC program is to expand and/or enhance 

the capacity of substance abuse treatment providers to serve persons in treatment who have been 

underserved because of lack of access to treatment in rural areas, or in their immediate 

community due to transportation concerns, an inadequate number of substance abuse treatment 

and service providers in their community, and/or financial constraints. The use of technology, 

including web-based services, smart phones, and behavioral health electronic applications (eapps), will expand and/or enhance the ability of providers to effectively communicate with 

persons in treatment and to track and manage their health to ensure treatment and services are 

available where and when needed. SAMHSA is in the process of implementing an evaluation 

program to analyze the impact of these technologies on the delivery of substance abuse treatment 

services. This will include patient and provider feedback that will be used to inform future 

decision making related to the program. 

The TCE-PTP program’s purpose is to expand and enhance service capacity through the 

provision of addiction peer recovery support services for those individuals with substance use 

disorders. It is the expectation that those with lived experience will play an integral role in the 

design, development, and implementation of this program. A primary program objective is to 

help achieve and maintain recovery and to improve the overall quality of life for those being 

served. This will be assessed through increased employment, housing stability, abstinence from 

substance use, social connectedness, and decreased criminal justice involvement.

In FY 2014, SAMHSA plans to support the continuation of 29 grants, one new TCE-PTP multiyear funded grant, and support six contracts. SAMHSA will continue to monitor the progress of 

the four FY 2012 multi-year funded HIT Grants and four FY 2013 TCE-PTP multi-year funded 

grants. It is anticipated that 3,300 clients will be served with FY 2014 funds. Outcomes 

including abstinence from substance use will also be tracked.
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All discretionary grantees are required to collect and report data on a regular and real-time 

basis. Data are monitored to provide information which can be used to improve service, monitor 

grantee performance and quality and provide recommendations for future directions. Grantee 

performance and outcomes data are monitored using the Services Accountability Improvement 

System. During the next fiscal year, the data system used for this monitoring will be switched to 

the Common Data Platform which will house data from all SAMHSA discretionary grantees.

Pregnant & Postpartum Women (PPW)

As part of SAMHSA’s Strategic Initiative on Trauma and Justice, the Pregnant and Postpartum 

Women (PPW) program has supported gender-and culturally-specific treatment service grants 

for pregnant, postpartum, and other parenting women. Using a family-centered trauma-informed 

treatment approach in residential and community settings, with women and their minor children 

at the center, the program has focused on the strengths and resources of the entire family. It 

supports sustained recovery for individual family members, coordinates with services in the 

community, and improves overall family functioning. The PPW program is designed to support 

comprehensive substance abuse prevention, treatment, and recovery support services for women, 

their minor children, age 17 and under children, and family members. 

The PPW program provides a variety of services for women, children, and families and case 

management. Services for women include: outreach, engagement, pre-treatment, screening, and 

assessment; detoxification; substance abuse education, treatment, and relapse prevention; health 

care services; specialized assessment, monitoring, and referrals for education, peer support, 

therapeutic interventions and physical safety; mental health care including a trauma-informed 

system of assessments and interventions; parenting education and interventions; home 

management and life skills training; education, testing, counseling, and treatment of hepatitis, 

HIV/AIDS, other STDs, and related issues; and wraparound services. Services for children 

include: screenings and developmental diagnostic assessments; prevention assessments and 

interventions related to mental, emotional, and behavioral wellness; trauma-informed system of 

assessments, interventions, and social-emotional skill building services; and developmental 

services and therapeutic interventions. Services for families include: family-focused programs to 

support family strengthening including fathers; reunification; alcohol and drug education and 

referral services; mental health promotion and assessment, and prevention and treatment 

services.

In FY 2011, the PPW program funded a new cohort of grantees. In FY 2012, SAMHSA funded 

the continuation of 20 grants, six new grants, and support for five contracts. In FY 2013, 

SAMHSA funded 26 grant continuations and supported four contracts. In FY 2014, SAMHSA 

plans to fund 17 new grants that will build on the current PPW program. Funding will also 

support the continuation of six grants and five contracts. 

The proposed number of clients to be served with FY 2014 funds is 966 women, 1,900 children 

and 1,000 other family members. Based on prior cohorts funded under the PPW program and 

relevant literature, the PPW program approaches service delivery from a family-centered 

perspective and meets the multiple individual needs of family members), including strategies to 

stabilize, strengthen, preserve, and reunite families. The PPW program supports comprehensive 
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substance abuse prevention, treatment, and recovery support services system for women, their 

children, and family members. 

The collection of data continues to improve understanding regarding the substantial lack of 

access to and services for the needs of these populations of focus, particularly transitional-aged 

youth. Our data collection efforts will assist in the identification of gaps and needs by assessing 

the system of care provided by the PPW and adolescent treatment programs. As such, we intend 

to determine best practices and lessons learned, disseminate findings where they can be applied 

in other treatment modalities, guide real-time and future programmatic and policy development, 

and support technical assistance for this sub-population. Outcomes data are currently monitored 

using the Services Accountability Improvement System. During the next fiscal year, the data 

system used for this monitoring will be switched to the Common Data Platform which will house 

data from all SAMHSA discretionary grantees.

Given the availability of Medicaid and Children’s Health Insurance Program (CHIP), many of 

the children and women served by the PPW program are eligible for these insurance options 

across the country. SAMHSA will consider building upon the program to advance the successful 

PPW model as an evidence-based approach for serving pregnant and post-partum women in need 

of residential substance abuse treatment.

The Affordable Care Act will further expand health insurance coverage eligibility through the 

expansion of Medicaid in some states and the establishment of Affordable Insurance 

Marketplaces in all states. The PPW program provides crucial services that are not covered 

under most public and private insurance. In particular the PPW program includes non-covered 

services and activities such as outreach, engagement, pre-treatment, substance abuse education, 

relapse prevention, monitoring, and referrals for education, peer support, physical safety;

parenting education and interventions; home management and life skills training; education on 

hepatitis, HIV/AIDS, other STDs, and related issues; and wraparound services. 

Strengthening Treatment Access & Retention (STAR)

During the initial phase of the STAR program, CSAT joined with the Robert Wood Johnson 

Foundation (RWJF) in an initiative to substantially increase client access and retention using 

process improvement methods. Under a program titled Network for the Improvement of 

Addiction Treatment (NIATx), CSAT awarded 13 Strengthening Treatment Access and 

Retention (STAR) grants and RWJF awarded 27 Paths to Recovery grants to support 

implementation of organizational improvements that included streamlining client intake, 

assessment and appointment scheduling procedures, eliminating paperwork duplication, 

extending clinic hours, contacting client no shows, eliciting customer feedback, and using 

clinical protocols (e.g., motivational interviewing and motivational incentives to engage clients 

during the initial phase of treatment). The NIATx initiative demonstrated that process 

improvement skills can be successfully transferred to treatment organizations. Grantees also 

participated in a learning network that included semi-annual learning sessions, process 

improvement coaching, web resources, information sharing, and peer-to-peer learning 

opportunities.
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Based on the NIATx program success, CSAT funded a follow-up effort in 2006, the STAR-State 

Implementation (STAR-SI) program, an infrastructure initiative that promotes state-level 

implementation of process improvement methods to improve access to and retention in 

outpatient treatment. 

 

In FY 2010 and FY 2011, the STAR initiative provided technical assistance and support to six 

SAMHSA/CSAT discretionary grant programs and over 50 treatment organizations to improve 

client access, retention and handoffs to other levels of care. The program also conducted a 

learning collaborative with over 300 treatment and service providers on how to improve thirdparty billing practices in anticipation of the expansion in addiction treatment services coverage 

and health insurance affordability program eligibility under the Affordable Care Act. In FY 2012

and 2013, SAMHSA supported four contracts to continue to provide technical assistance in 

promoting service efficiency. In FY 2014, SAMHSA plans to support five contracts, which 

includes the operation of 15 provider business operations learning networks, involving an 

estimated 300 provider organizations. These networks will expand training to include strategic 

business planning, third party contracting and ensuring client eligibility and engagement in 

treatment.

STAR utilizes the National Institute on Drug Abuse (NIDA) research based process 

improvement practice to inform all business operations learning networks and organizational 

implementation. Treatment organizations that implement business operations practices utilize 

evidence-based PDSA Cycles (plan, do, study, act) as part of their improvement process. This 

includes collecting data before, during and following the changed that is implemented.

Recovery Community Services Program (RCSP)

SAMHSA’s Strategic Initiative on Recovery Support focuses on health, home, purpose, and 

community. As part of the community component of this initiative, the Recovery Community 

Services Program (RCSP) responds to the need for community-based recovery support services 

that help prevent relapse and promote long-term recovery. Such services can reduce the strain 

relapse places upon the already overburdened treatment system and minimize the negative 

effects of relapse when it does occur, as well as contribute to a better quality of life for people in 

recovery and their families and communities. The purpose of the RCSP is to advance peer-topeer recovery support services that help to prevent relapse and promote sustained recovery from 

alcohol and drug use disorders.

The RCSP program has targeted a variety of underserved groups including women, AfricanAmericans, Latinos, rural populations, persons recently released from incarceration, the 

homeless, adolescents, and gay, lesbian, and transgender populations. In addition, the RCSP 

program serves family members and allies of individuals in recovery. The primary targets for 

the RCSP initiative are people with a history of alcohol and/or drug problems who are in or 

seeking recovery. RCSP grants provide a wide range of services such as peer coaching; peer 

support groups; life skills workshops; peer-led resource connector programs for housing, 

employment, educational assistance, vocational rehabilitation and training; leadership 

development; alcohol and drug free events; and recovery drop-in centers. FY 2013 data 

demonstrate positive outcomes, with 84 percent of clients served reporting being abstinent at 
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follow-up; 32 percent reported being unemployed; 63 percent reported being housed; and 99 

percent reported not being involved in the criminal justice system.

In FY 2012, SAMHSA funded the continuation of five grants and support for two contracts. In 

FY 2013, SAMHSA funded five grant continuations and supported two contracts.

The RCSP and TCE-PTP grant programs design and deliver peer recovery support 

services. Both programs use CSAT GPRA outcome data to evaluate relapse, social 

connectedness, housing, employment/education, and criminal justice involvement. Additionally, 

these grant programs are utilizing practice-based models of recovery coaching, and evidencebased practices of Wellness Recovery Action Planning ( WRAP) and other wellness models of 

Whole Health Action Management (WHAM) as well as other EBP’s that support peer recovery 

supports.

The RCSP and TCE-PTP are identifying peer recovery supports that promote sustained recovery 

and improved quality of life. These programs will support the proposed GPRA recovery measure 

for SAMHSA. Data is being used to evaluate the usefulness of specific recovery supports with 

culturally-specific populations, and to identify program models that best address the needs of 

individuals in recovery from addiction. The new RCSP Statewide Network Grant Program 

builds on evaluations of previous cohorts to move forward on strengthening the capacity of 

community organizations that support addiction recovery through the building of statewide 

networks.

In FY 2014, SAMHSA plans to support three contracts and 18 new grants ($1.4 million in CSAT 

and $0.4 million in CMHS) in support of the Recovery Support Strategic Initiative. These funds 

will be used to build capacity for statewide consumer-run, family member run, or addiction 

recovery community organizations to promote cross-service system and infrastructure 

development that is recovery-focused and resiliency oriented. Of that total, $1 million in budget 

authority will be used to award new addiction recovery community statewide networks.

In order to ensure a stronger policy voice across the behavioral health field and facilitate 

readiness for the implementation of health reform, a supplemental incentive award will be 

offered to applicants proposing to build a collaborative partnership among SAMHSA-funded 

mental health and addictions peer-run state-wide networks and those that are mental health 

family-run. Up to $0.8 million will be braided to allow for supplemental awards for 

collaborative partnerships across the mental and substance use disorder fields. Additionally, 

partnerships with affiliate health networks will be encouraged. Any braided amounts spent or 

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

with legislative direction and intent. Eligible applicants for supplements will be those 

organizations who have an existing mental health (Statewide Family and Statewide Consumer 

Networks) or addiction statewide network award.

Up to 10 grant awards at $1 million will be made for addiction recovery statewide networks. Up 

to eight supplemental awards will be given at $0.1 million each. Grantees will be expected to 

facilitate effective participation in state and local behavioral health services planning and health 

reform activities related to improving community-based services and supports for people in 
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recovery from substance use disorders, children and youth with serious mental health conditions 

and their families or adult mental health consumers. The program will also address gaps in 

behavioral health policy as well as inform health reform planning.

All discretionary grantees are required to collect and report data on a regular and real-time 

basis. Data are monitored to provide information which can be used to improve service, monitor 

grantee performance and quality and provide recommendations for future directions. Grantee 

performance and outcomes data are monitored using the Services Accountability Improvement 

System. During the next fiscal year, the data system used for this monitoring will be switched to 

the Common Data Platform which will house data from all SAMHSA discretionary grantees.

Access to Recovery

Since 2004 the ATR program has served 221,607 clients through 69 grantees. In FY 2014, 

SAMHSA plans to award approximately five Prevention and Public Health Fund grants of up to 

$3 million per year for three years – these grants will be multi-year funded. The majority of 

services provided are expected to be recovery support not otherwise fundable through insurance 

mechanisms. These include services such as transportation, housing, and jobs support. Reduced 

in scale from past years, ATR will serve approximately 8,000 individuals per year. In FY 2014, 

the program will preserve the core concepts embodied in the three previous ATR cohorts, while 

also striving to better support provisions of the Affordable Care Act.

State and tribal ATR grants will support the provision of treatment and recovery support services 

to those with substance use disorders. Services payable under Medicaid and covered through 

essential health benefit plans, such as outpatient clinical treatment services and residential 

services, would, for the most part, not be allowable under this program. In order to ensure nonduplication of billing sources, providers will work with clients to link them to other usable 

funding sources where appropriate. For those services not covered, providers will be responsible 

for the provision of direct services. As was the case in the first three cohorts of ATR, 

states/tribes will be required to establish provider networks and develop a voucher-based 

mechanism to ensure client choice can be easily and freely exercised. 

ATR grant funds will also support creating linkages with state health information exchanges 

(HIEs) to ensure coordination and non-duplication; working with non-traditional providers, such 

as faith-based and peer providers; working with traditional providers to ensure that proper 

sources of billing are being utilized for recovery support and clinical treatment services not being 

covered under Medicaid and other sources; and increasing availability and access to training and 

certification programs for non-traditional providers, such as faith-based and peer providers. 

In FY 2014, the ATR program will better support the integration of third party payers, the 

provision of services unlikely to be covered by insurance such as supportive services like 

housing, and services to those who are ineligible for insurance or are unable to acquire it. ATR 

utilizes data from GPRA in the Services Accountability Improvement System (SAIS) system to 

monitor grantee performance and to support effective program operation. Data are compared 

across time and between programs to identify high performing programs. Grantees report at the 

grantee meeting their approaches to data analytics to inform future program design and 
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implementation opportunities. Successful ATR innovations will be communicated and new 

evidence shared to strengthen capacity nationwide and to inform future decision making 

regarding ATR models of service delivery. 

Children & Family Programs

As part of SAMHSA’s Trauma and Justice Strategic Initiative, adolescent treatment programs 

are designed to address the gaps in substance abuse services by providing services to adolescents 

and their families/primary caregivers using previously proven effective practices that are familycentered. 

The Assertive Adolescent and Family Treatment (AAFT) grants provide adolescents 12 through 

17 and their families/care givers with: a full bio-psycho-social clinical assessment, the Global 

Appraisal of Individual Needs (GAIN), which identifies substance use disorders, co-occurring 

mental health problems, mental illness, and family support and functioning; six months of 

substance abuse treatment and follow-up monitoring using the Assertive Community 

Reinforcement Approach and the Assertive Continuing Care (A-CRA/ACC) treatment 

interventions; urine testing; case management; and referrals to other needed community service 

providers. A-CRA and ACC were developed with funding from SAMHSA and the National 

Institute on Alcohol Abuse and Alcoholism and have proven effective in building community 

capacity for family-centered treatment and ensuring sustainability over time. 

In FY 2012, SAMHSA funded 13 new state-based adolescent treatment grants called 

Cooperative Agreements for State Adolescent Treatment Enhancement and Dissemination (SATED), to further the use of, and access to, effective family-centered treatment approaches through 

state-wide training while supporting connections between locally based treatment systems and 

their state, tribal, or territorial infrastructure. The services provided under this program include: 

evidence-based assessment and treatment interventions, outreach and other engagement 

strategies; recovery services and supports (e.g., peer-to-peer support, parent/family/caregiver 

support), youth and caregiver respite care, technology support services, therapeutic mentors, 

behavioral health consultation, vocational, educational and transportation services and case 

management and coordination services.

In addition to the adolescent treatment grant programs, SAMHSA has been collaborating with 

the Administration for Children and Families (ACF) through an inter-agency agreement to fund a 

National Center on Substance Abuse and Child Welfare (National Center). The vast majority of 

children, particularly infants, who are placed in protective custody, have a parent with a 

substance use disorder. Thus, it is imperative that child welfare, substance abuse treatment and 

service providers, and the courts work efficiently together. Activities of this National Center 

include: in-depth technical assistance to states, forging more extensive partnerships with family 

drug courts, and planning greater emphasis on work with tribes. ACF grantees are able to draw 

upon SAMHSA technical assistance provided to the child welfare and substance abuse treatment 

fields, including grants awarded under an ACF grant program referred to as Regional Partnership 

grants. 
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All discretionary grantees are required to collect and report data on a regular and real-time basis. 

Data are monitored to provide information which can be used to improve service, monitor 

grantee performance and quality and provide recommendations for future directions. Grantee 

performance and outcomes data are monitored using the Services Accountability Improvement 

System. During the next fiscal year, data will still play an integral role in the monitoring of 

grantee performance; however, the data system used for this monitoring will be switched to the 

Common Data Platform which will house data from all SAMHSA discretionary grantees.

In FY 2012, the adolescent portfolio supported 32 AAFT grant continuations, six contracts and 

13 new SAT-ED grants. In FY 2013, SAMHSA funded 13 SAT-ED grant continuations, 

supported five contracts, and funded 10 new State Youth Treatment (SYT) grants. In FY 2014, 

SAMHSA plans to support the continuation of 23 grants and seven contracts. SAMHSA expects 

to serve approximately 2,500 clients with FY 2014 funds. All outcomes, including abstinence 

from substance use, will also be tracked. 

Treatment Systems for Homelessness

The Center for Substance Abuse Treatment (CSAT) manages two grant portfolios under its 

Grants for the Benefit of Homeless Individuals (GBHI) authority - Treatment for Homeless and 

Cooperative Agreements to Benefit Homeless Individuals (CABHI), that provide focused 

services to individuals with a substance use disorder or who have co-occurring substance use and 

mental disorders. These programs tie directly to the SAMHSA Recovery Support Strategic 

Initiative which focuses specifically on “home” as an integral component of one’s well-being.

The Treatment for Homeless-General grants enable communities to expand and strengthen their 

substance abuse treatment services for individuals who are at risk for experiencing homelessness 

or are experiencing homelessness. The Treatment for Homeless-Services in Supportive Housing 

(SSH) grants seek to expand and strengthen treatment services for individuals who experience 

chronic homelessness using a supportive housing approach. 

In FY 2011, CSAT in collaboration with CMHS, began awarding CABHI under the GBHI 

authority. The major goal of the program is to ensure that the most vulnerable individuals who 

experience chronic homelessness receive access to sustainable permanent housing, treatment, 

and recovery supports through mainstream funding sources. This program builds on the success 

of the previous Treatment for Homeless program. 

In FY 2013, SAMHSA funded 71 grant continuations and supported five contracts. In addition, 

CSAT in collaboration with CMHS funded 11 new Cooperative Agreements to Benefit 

Homeless Individuals for States (CABHI-States). CABHI-States builds on the current CABHI 

program by adding a state infrastructure improvement approach addressing chronic homelessness 

to the community-based behavioral health service component for newly housed individuals who 

experience chronic homelessness with substance use disorders or co-occurring substance use and 

mental disorders. 

In FY 2014, SAMHSA plans to support 34 grant continuation, five contracts and approximately 

39 grant awards within a new cohort of jointly funded CSAT and CMHS CABHI-State grants 

and Grants for the Benefit of Homeless Individuals-Services in Supportive Housing (GBHI-
163

SSH). The proposed number of clients to be served with FY 2014 funding is 5,800. Outcomes 

including abstinence from substance use will also be tracked. 

SAMHSA’s homeless grant programs are designed to provide supports and services for people 

with mental illness and/or substance use disorders who experience homelessness or are at risk of 

homelessness. SAMHSA encourages grantees to work collaboratively with HUD grant programs 

in providing supportive services for individuals experiencing homelessness. SAMHSA homeless 

programs do not fund housing; therefore linkage with HUD programs is essential. SAMHSA 

grantees frequently work side-by-side with HUD’s Permanent Supportive Housing, Section 8, 

Shelter plus Care, Vouchers and other programs. SAMHSA funds an array of integrated 

behavioral health, treatment, housing support and recovery-oriented services and supports 

including outreach, engagement, intensive case management, treatment for mental and/or 

substance abuse disorders, enrollment in mainstream benefits, employment readiness, and 

linkage to permanent housing.

All discretionary grantees are required to collect and report data on a regular and real-time basis. 

These data are used to monitor grantee performance to ensure that progress is being made toward 

meeting program goals and objectives. Data provided evidence of the effectiveness of the 

services being provided. Several key domains have been identified in order to assess the extent 

to which service provision is effective. These domains include abstinence from substance use, 

employment, housing stability, criminal justice status and social connectedness. Outcomes data 

are monitored using the Services Accountability Improvement System. Data are monitored to 

provide information which can be used to improve service quality, monitor grantee performance 

and provide recommendations for future direction. During the next fiscal year, data will still 

play an integral role in the monitoring of grantee performance; however, the data system used for 

this monitoring will be switched to the Common Data Platform which will house data from all 

SAMHSA discretionary grantees. 

Minority AIDS

Minority AIDS (MAI) grants are awarded to community-based organizations with two or more 

years of experience in the delivery of substance abuse treatment and related HIV/AIDS services. 

Funded programs target one or more of the following high-risk substance abusing populations: 

African American, Hispanic/Latino, and/or other racial/ethnic minority communities; women, 

including women with children; adolescents; men who inject drugs; minority men who have sex 

with men (MSM); and individuals who have been released from prisons and jails within the past 

two years. 

In addition to providing substance abuse treatment services, pre-treatment services are provided, 

including the provision of literature and other materials to support behavior change, facilitation 

of access to drug treatment, HIV/AIDS testing and counseling services, and other medical and 

social services in the local community. 

In FY 2012, SAMHSA’s TCE/HIV program served approximately 8,000 individuals. Of these 

individuals, approximately 69 percent were between the ages of 25 and 54 years 

old. Approximately 32 percent identified themselves as Hispanic/Latino in ethnicity; 42 percent 
164

as African-American; 27 percent White; one percent Asian, Native Hawaiian, or Pacific Islander; 

and seven percent as American Indian/Alaska Native.

In FY 2011, SAMHSA awarded 11 Minority AIDS Initiative Targeted Capacity Expansion 

(MAI-TCE) Integrated Behavioral Health/Primary Care Network Cooperative Agreements. This 

program is jointly funded with CMHS and CSAP and facilitates the development and expansion 

of culturally-competent and effective integrated behavioral health and primary care networks 

which includes HIV services and medical treatment within racial and ethnic minority 

communities in the 11 Metropolitan Statistical Areas and Metropolitan Divisions most impacted 

by HIV/AIDS. Expected outcomes include reducing the impact of behavioral health problems, 

HIV risk and incidence, and HIV-related health disparities in these areas. SAMHSA continued 

to support these grants in 2012 and 2013.

In FY 2012, SAMHSA funded the continuation of 76 grants and supported five contracts as well 

as a new cohort of 52 grants to target areas of highest need based on the most recently available 

HIV epidemiological data. 

In FY 2013, SAMHSA funded 79 grant continuations and supported seven contracts and 35 new 

grants. The 35 grants support Targeted Capacity Expansion: Substance Abuse Treatment for 

Racial/Ethnic Minority Women at High Risk for HIV/AIDS (TCE-HIV: Minority Women). The 

purpose of this program is to expand substance abuse treatment and HIV services for African 

American, Hispanic/Latina, and other racial/ethnic minority women (ages 18 years and older), 

including heterosexual, lesbian, bisexual, previously incarcerated women, and their significant 

others, who have substance use or co-occurring substance use and mental disorders, and are 

living with or at risk for HIV/AIDS.

Scientific literature supports that as the incidence and prevalence of HIV/AIDS increases among 

racial and ethnic minority populations, the need for substance abuse and mental health treatment 

increases as well. Limited or a complete absence of appropriate behavioral treatment 

intervention services is very likely to lead to unmet behavioral health needs, adverse medical 

conditions, impaired quality of life, increased morbidity and mortality for this vulnerable 

population. To address this public health challenge, the MAI-TCE program facilitates the 

development and expansion of culturally competent and effective integrated behavioral health 

and primary care networks, which includes HIV services and medical treatment, within racial 

and ethnic minority communities in 11 Metropolitan Statistical Areas (MSAs) highly impacted 

by HIV/AIDS.

SAMHSA Services Accountability Improvement System (SAIS) data and CDC HIV prevalence 

data was used to identify specific minority high-risk populations that resulted in SAMHSA 

publishing population focused RFAs for YMSM and minority women.

By focusing on specific vulnerable populations and requiring grantees to utilize specific 

evidence-based interventions SAMHSA/CSAT programs can build new evidence that supports 

the value of simultaneous treatment of co-occurring substance abuse and HIV and the value of 

using evidence-based interventions for recruitment and retention of high-risk, minority 

populations in substance abuse treatment and antiretroviral therapy. Improved treatment 
165

outcomes would lend itself to more rigorous evaluation and data analysis by the SAMHSA 

Common Data platform (CDP) to inform future public health intervention decision-making. 

In FY 2014, SAMHSA plans to support the continuation of 87 grants and six contracts, and will 

continue to monitor the progress of the three FY 2012 multi-year funded grants. The proposed 

number of clients to be served with 2014 funds is 13,558. Outcomes including abstinence from 

substance use will also be tracked. 

In FY 2014, SAMHSA’s CMHS, CSAP, and CSAT plan to pilot HIV Continuum of Care grants 

which supports behavioral health screening, primary prevention, and treatment for racial/ethnic

minority populations with or at high risk for mental and substance use disorders and HIV. This 

will include Substance Abuse (SA) primary prevention/treatment service programs, community 

mental health programs, and HIV integrated programs that can either co-locate or fully integrate 

HIV prevention and medical care services within them. Also, this program will provide SA and 

HIV primary prevention services in local communities served by the behavioral health program.

Criminal Justice Activities

Criminal Justice activities include grant programs, which focus on diversion, alternatives to 

incarceration, and re-entry from incarceration for adolescents and adults with substance use 

disorders, and/or co-occurring substance use and mental disorders. These activities comport 

directly with SAMHSA’s Trauma and Justice Strategic Initiative efforts. 

Drug courts are designed to combine the sanctioning power of courts with effective treatment 

services for a range of populations and problems such as alcohol and/or drug use, child 

abuse/neglect or criminal behavior, mental illness, and veterans’ issues. Funding for adult 

treatment drug court programs provide a variety of services, including: direct treatment or 

prevention services for diverse populations at risk; “wrap-around”/recovery support services 

designed to improve access and retention; drug testing for illicit substances required for 

supervision, treatment compliance, and therapeutic intervention; education support; relapse 

prevention and long-term management; Medication-Assisted Treatment (MAT); and HIV testing 

conducted in accordance with state and local requirements. 

In FY 2012, SAMHSA funded the continuation of 81 drug court grants and supported eight 

contracts, and 54 new drug court grants. In FY 2013, SAMHSA funded the continuation of 78 

drug court grants, supported three contracts, and funded 39 new drug court grants. In FY 2014, 

SAMHSA plans to support 92 grant continuations, two contracts, and 55 new drug court grants.

The SAMHSA Drug Court grant programs are utilizing existing evidence to support current 

programs and new proposals by incorporating findings from numerous studies of drug courts. 

There have been over 125 evaluation and research studies of the effectiveness of drug courts and 

several micro-analyses in addition to GAO reports on the effectiveness of treatment drug courts. 

SAMHSA’s RFA require evidence-based practices to be used from federal inventories of such 

practices (NIDA, SAMHSA’s NREPP). SAMHSA also has regular communications with the 

national drug court constituency group, the National Association of Drug Court Professionals in 

order to obtain and incorporate the latest findings and field expertise. Examples of SAMHSA’s 
166

drug court programs incorporating the latest “standards” for drug courts as promulgated by 

NADCP with the support of the Bureau of Justice Assistance, U.S. Department of Justice. 

Language pertaining to screening for co-occurring disorders, use of medically assisted treatments 

for opioid or alcohol dependent persons, and identification of behavioral health disparities have 

been included in the grant solicitations. 

In addition to SAMHSA’s drug court portfolio, the agency also supports other robust criminal 

justice programs. For example, the Offender Reentry Program (ORP) grants provide screening, 

assessment and comprehensive treatment and recovery support services to offenders reentering 

the community, as well as offenders who are currently on or being released from probation or 

parole. SAMHSA and the DOJ/BJA share a mutual interest in supporting and shaping offender 

re-entry-treatment services, as both agencies fund “offender reentry” programs. Formal 

agreements have been developed to further encourage and engage in mutual interests and 

activities related to criminal justice-treatment issues. ORP grantees are expected to seek out and 

coordinate with local federally-funded offender reentry initiatives, including the DOJ/BJA’s 

Prisoner Reentry Initiative or “Second Chance Act” offender re-entry programs, as appropriate. 

Funding for ORP may be used for a variety of services, including: screening, comprehensive 

individual assessment for substance use and/or co-occurring mental disorders, case management, 

program management and referrals related to substance abuse treatment for clients; alcohol and 

drug treatment; wraparound services supporting the access to and retention in substance abuse 

treatment or to address the treatment-specific needs of clients during or following a substance 

abuse treatment episode; individualized services planning; drug testing; and relapse prevention 

and long-term management support.

The (ORP) grant program utilizes existing evidence to support current programs and new 

proposals by incorporating findings from numerous studies of drug courts. SAMHSA’s ORP 

RFA requires evidence-based practices to be used from federal inventories of such practices 

(NIDA, SAMHSA’s NREPP). SAMHSA is represented at the Attorney General’s Reentry 

Council and in numerous inter- and intra-agency workgroups in order to obtain and incorporate 

the latest findings and field expertise. A federal reentry resource center has been established on 

the MAX electronic information forum to constantly update the ‘state of the state’ of offender 

reentry programming, research, and grant initiatives. The ORP grant solicitation contains 

language pertaining to Risks, Needs, and Responsivity models as part of the latest cutting edge 

approach to screening and assessing ex-offenders, the grant program, and the community 

response. Language pertaining to screening for co-occurring disorders, use of medically assisted 

treatments for opioid or alcohol dependent persons, and identification of behavioral health 

disparities has been included in the ORP grant solicitation. 

In FY 2011, SAMHSA awarded grants to Develop and Expand Behavioral Health Treatment 

Court Collaborative (BHTCC) in collaboration with CMHS. The purpose of the BHTCC is to 

provide state and local criminal and dependency courts serving adults with more flexibility to 

collaborate with the other judicial components and local community treatment and recovery 

providers to better address the behavioral health needs of adults who are involved with the 

criminal justice system. In FY 2014 SAMHSA plans to support an additional cohort (up to 14 

new grants) of BHTCC grants ($2,429,534 in CSAT and $2,969,430 in CMHS).
167

In FY 2012, SAMHSA created the Teen Courts grant program (TCP), of which the primary 

focus is preventing crimes by diverting youth with substance abuse treatment needs from deeper 

penetration into the traditional juvenile justice system. Funds are used to provide screening, 

assessment, substance abuse treatment, and recovery support services for youth involved in a 

TCP.

In FY 2012, in addition to drug courts, SAMHSA funded the continuation of 27 grants, 

supported five contracts, and funded 28 new grants.

In FY 2013, SAMHSA funded three new Early Diversion grants with CMHS, 13 Offender 

Reentry grants and supported five contracts. In FY 2014, and in support of SAMHSA’s Trauma 

and Justice, a total of 5.4 million in Budget Authority ($2.5 million in CMHS and $2.9 million in 

CSAT) will fund an additional cohort of Behavioral Health Treatment Court Collaboratives 

Grants along with plans to support 41 grant continuations, nine contracts, and 15 new grants.

Addiction Technology Transfer Centers (ATTCs)

The Addiction Technology Transfer Center (ATTC) Network supports national activities and 

implements programs and initiatives in response to regional needs, decreasing the gap in time 

between the release of new scientific findings and evidence-based practices and the 

implementation of these interventions by front-line clinicians. ATTCs disseminate evidencebased, promising practices to addiction treatment/recovery professionals, public health/mental 

health personnel, institutional and community corrections professionals, and other related 

disciplines. The ATTC program dissemination models include technical assistance, training 

events, a growing catalog of educational and training materials, and an extensive array of Webbased resources created to translate the latest science for adoption into practice by the substance 

use disorders treatment workforce. The ATTCs are highly responsive to emerging challenges in 

the field. Data show that over 29,000 people were trained in FY 2012, exceeding the target of 

20,516. In FY 2012, SAMHSA funded a new cohort of 15 grants. Ten of the new grants are 

geographically consistent with HHS’s 10 regional offices in order to coordinate SAMHSA 

services, technical assistance and workforce training and development with other HHS Operating 

Divisions such as HRSA, CMS, ACF, and the SAMHSA Regional Administrators. The 

remaining five awards support one national and four focus area ATTCs. In FY 2013, SAMHSA 

funded the continuation of all 15 ATTC grants. Data show 36,391 people were trained in FY 

2013, exceeding the target of 21,000.

All discretionary grantees are required to collect and report data on a regular and real-time 

basis. Data are monitored to provide information which can be used to improve service, monitor 

grantee performance and quality, and provide recommendations for future directions. Grantee 

performance and outcomes data are monitored using the Services Accountability Improvement 

System. During the next fiscal year, data will still play an integral role in the monitoring of 

grantee performance; however, the data system used for this monitoring will be switched to the 

Common Data Platform which will house data from all SAMHSA discretionary grantees.

In FY 2014, SAMHSA plans to support the continuation of 15 grants. The proposed number of 

individuals to be trained with FY 2014 funding is 20,516. Outcomes including participants who 
168

report implementing improvements will also be tracked. By 2015, 90 percent of participants are 

expected to report implementing improvements in treatment methods on the basis of information 

and training provided by the program. 

Special Initiatives/Outreach

Special Initiatives/Outreach activities include a grant program for Historically Black Colleges 

and Universities (HBCU)-Center for Excellence, which is an innovative national resource center 

dedicated to continuing the effort to network the 105 HBCUs throughout the United States. The 

HBCU-Center for Excellence promotes workforce development through expanding knowledge 

of best practices and leadership development that enhance the participation of AfricanAmericans in the substance abuse and mental health professions. The Center also supports a 

policy academy which focuses on workforce development, leadership development, crosssystems collaboration, cultural competency, and eliminating disparities. The Center collaborates 

with other HHS agencies including the HHS/Office of Minority Health (OMH) to achieve the 

objectives of various Executive Orders on educational excellence for minority populations. 

Through this program, approximately 31 Substance Abuse Treatment Workforce Development 

pilots were funded to provide opportunities for more students to obtain practical experience in 

the addictions field. This program has increased the number of students interning in behavioral 

health and has established or increased HBCU partnerships with local, regional and state 

behavioral health partners, primarily substance abuse, committed to increasing diversity in the 

addictions field.

In FY 2010 SAMHSA entered into an inter-agency agreement with the Agency for Healthcare 

Research and Quality (AHRQ) to examine and graphically display selected trends in hospitalbased stays for mental health and substance abuse treatment. This work was used to write a 

chapter in the annual AHRQ publication, Healthcare Cost and Utilization Project (HCUP) Facts 

and Figures: Statistics on Hospital Based Care in the US 2008. This report drew attention to 

the extensive hospital resources devoted to people with mental and substance use disorders, some 

of which may be more effectively and efficiently served in community-based settings with a 

recovery-based system of care approach. In FY 2012, SAMHSA funded the continuation of one 

grant and supported four contracts. In FY 2013, SAMHSA funded the continuation of one grant 

and supported five contracts. SAMHSA plans to support three contracts and one continuation

grant in FY 2014.
169 Fiscal Year Amount

FY 2011 $430,842,000

FY 2012 $428,696,822

FY 2013 $404,085,188

FY 2014 $361,460,000

FY 2015 $297,400,000

Funding History1\

1\

The funding history is presented on a comparable basis to previous funding levels to 

represent the revised budget structure and includes the PHS Evaluation Funds and 

Prevention and Public Health Fund.

Budget Request

The FY 2015 Budget Request is $297.4 million at the program level with $267.4 million from 

Budget Authority and $30 million provided by PHS Evaluation Funds. This is a decrease of $64

million in Budget Authority from the FY 2014 Enacted Level. The request includes:

The Primary Care and Addiction Services Integration (PCASI) Program 

SAMHSA is requesting $20 million to support the development of a new initiative related to the 

integration of substance abuse treatment services and primary care. The PCASI Program would 

enable providers to offer a full array of both physical health and substance abuse services to 

clients. In conjunction with the Affordable Care Act (ACA), SAMHSA recognizes the need to 

emphasize the importance of integrated service delivery. Through this program, integrated teams 

of professionals will be able to provide needed primary care services to individuals seeking care 

for their substance use disorder. The purpose of this program is to establish projects for the 

provision of coordinated and integrated services through the co-location of primary and specialty 

care services in community-based substance abuse treatment settings. The goal is to improve the 

physical health status of adults with substance use disorders who have or are at risk for cooccurring primary care conditions and chronic diseases, with the objective of supporting the 

triple aim of improving the health of those with SUD; enhancing the client’s experience of care 

(including quality, access, and reliability); and reducing/controlling the per capita cost of care.

The expected outcome of improved health status for people with SUD will be achieved by 

encouraging grantees to engage in necessary partnerships, expand infrastructure, and increase the 

availability of primary health care and wellness services to individuals with SUD. Partnerships 

between primary care and behavioral health organizations, as well as information technology 

entities, are deemed crucial to the success of this program.

Currently, a significant component of the overall higher cost of care for those with SUD is 

untreated chronic disease.46 The likelihood that a patient seeking care for a substance use 

disorder will successfully complete a referral to a primary care facility is low in general but 

 

46 Druss, B. g., & Rosenheck. R. A. (1999). Patterns of health care costs associated with depression and substance 

abuse in a national sample. Psychiatric Services, 50, 214-218
170

greatly improved within a single visit or facility.47 This program will not only improve the data 

about the success and impact of these improved referrals, but will also illuminate other benefits 

of integration such as improved provider knowledge and effectiveness at identifying and 

referring individuals in need of primary care and substance abuse treatment. 

The demand for substance use disorder prevention, intervention, treatment, and recovery services 

after the implementation of the ACA will far exceed the current capacity and a focused effort 

through the states to address this shortage will be critical. As described above, the PCASI 

program provides the structure and infrastructure necessary to support the integrated service 

delivery. Together, these two programs will perform synergistically, with the process and 

performance outcomes building on each other.

Substance use disorders can cause physical health problems and/or exacerbate existing physical 

health problems. For example, several cardiovascular complications are closely related to 

cocaine use. They include chest pain syndromes, heart attacks, heart failure, strokes, aortic 

dissection, and fatal and nonfatal arrhythmias.

48 According to the CDC, alcohol use causes 

80,000 deaths a year.

49

 Alcohol use contributes to a variety of chronic health conditions 

including; cirrhosis, hypertension, obesity, diabetes, hepatitis, pancreatitis, cardiomyopathy, 

gastritis, etc...which increases morbidity and mortality. Additionally, excessive alcohol use 

increases the risk of cancers such as mouth, throat, and esophagus. As the result of other chronic 

health issues, many individuals develop substance abuse problems due to self-medication. The 

National Institute on Drug Abuse defines self-medication as the use of a substance to lessen the 

negative effects of stress, anxiety, or other mental disorders (or side effects of their 

pharmacotherapy). Self-medication may lead to addiction and other drug or alcohol-related 

problems.50

A continuum of preventive and health promotion services will be offered to and/or coordinated 

for clients within the PCASI program, where different services are offered to different categories 

of clients according to the severity of the condition/risk factors. Wellness programs (e.g., 

tobacco cessation, nutrition consultation, health education and literacy, self-help/management 

programs) will be offered, including interventions that involve preventive screening and 

assessment tools for all clients. In addition, this grant program can support the infrastructure 

necessary to ensure an effective coordination of services, including such tasks as necessary to 

expand partnerships, increase the use of an integrated electronic health record, and other such 

activities. Grantees will be required to bill third party insurance or utilize other funds and to only 

use SAMHSA grant funds for services to individuals who are ineligible for public health 

insurance programs, individuals for whom coverage has been formally determined to be 

unaffordable, or for services that are not sufficiently covered by an individual’s health insurance 

plan (co-pay or other cost sharing requirements are an acceptable use of SAMHSA grant funds).

 

47 Kathol, R. G., McAlpine, D., Kishi, Y., Speies, R., Meller, W., Bernhardt, T., et al. (2005). General medical and 

pharmacy claims expenditures in users of behavioral health services. Journal of General Internal Medicine, 20, 160-

167.

48 http://www.heart.org/HEARTORG/Conditions/Cocaine-Marijuana-and-Other-Drugs_UCM_428537_Article.jsp

49 Jeffrey J. Sacks, MD, MPH, Jim Roeber, MSPH, Ellen E. Bouchery, MS, Katherine Gonzales, MPH, Frank J. 

Chaloupka, PhD, Robert D. Brewer, MD, MSPH; State Costs of Excessive Alcohol Consumption, 2006: Accessed 

at http://www.ajpmonline.org/webfiles/images/journals/amepre/AMEPRE_3854-stamped-081313.pdf

50 http://www.drugabuse.gov/publications/research-reports/comorbidity-addiction-other-mental-illnesses/glossary
171

SAMHSA will fund a total of 34 grants at approximately $0.5 million annually for up to three 

years. Eligible applicants will be publicly funded community substance abuse treatment 

centers. To address the bi-directional nature of the integration approach emphasized by this 

grant program, the applicant must demonstrate they are able to offer the following core 

requirements; provided by qualified professionals, both substance abuse treatment and primary 

care services. Additional eligibility criteria include the ability to show demonstrable progress or 

commitment to the implementation of interoperable electronic health records.

The remaining $3 million will be used to fund technical assistance and evaluation activities to 

assess the clinical and cost effectiveness of these programs and other programs in the field, to 

ensure fidelity to implementation, and to assist with documentation and dissemination of lessons 

learned from the program. The success of the PBHCI program has taught SAMHSA that 

technical assistance must include strategies around integrated models, workforce, financing, 

clinical practice, and operations and administration of the PCASI grant. SAMHSA has been able 

to realize improved health outcomes for PBHCI clients across myriad domains, including blood 

pressure, tobacco use, and diabetes measures, in addition to improvement in client selfperception of overall health. The PBHCI program has created bridges between community 

behavioral health and primary care providers, yielding a cadre of providers able to serve the 

holistic health care needs of their patients.

Promoting widespread implementation of Health Information Technology (HIT) systems that 

support quality, integrated behavioral health care is currently one of SAMHSA’s eight strategic 

initiatives. HIT has the potential to transform the health care system by improving the quality of 

care delivery, supporting patient engagement and self-management, improving the efficiency of 

the workforce, and expanding access to care. In FY 2011-2012, SAMHSA provided 

supplemental funding to our Primary & Behavioral Health Care Integration (PBHCI) program to 

help 4 grantees become meaningful users of electronic health record (EHR) technology. Of 

these, 93 percent successfully implemented a certified EHR system in 2012 and this technology 

is continuing to support the integration of primary and behavioral healthcare in these programs. 

Due to the success of the PBHCI HIT supplemental program, SAMHSA is requesting an 

additional $2 million in funding for the Targeted Capacity Expansion-General program in FY 

2015 to fund the Behavioral Health Information Privacy Center of Excellence, a similar HIT 

initiative, among the Primary Care and Addiction Services Integration (PCASI) program 

grantees. This supplemental funding will support the enhancement and adoption and meaningful

use of certified EHR technology which will facilitate the integration of care for patients in 

substance abuse treatment to improve compliance with Federal privacy law.

In addition, the funding will support Braided Program: HIV Continuum of Care grants as

provided below to provide bi-directional integration between primary care services and 

substance abuse treatment/mental health services (for CSAT/CMHS) and address service 

coordination and infrastructure needs of providers serving this vulnerable population.
172

TCE General

Behavioral Health Information Privacy Center of Excellence

A primary objective of SAMHSA’s Health Information Technology Strategic Initiative is to 

promote interoperability of behavioral health priorities with primary health care. Federal privacy 

law (42 CFR Part 2) restricts the disclosure and re-disclosure of records pertaining to substance 

abuse treatment. Many state laws also limit the sharing of information related to behavioral 

health and other sensitive health conditions such as HIV. These regulations set detailed 

requirements for obtaining consent and sharing health information. Currently, within the health 

information technology field, specifically, most electronic health record (EHR) and health 

information exchange (HIE) systems do not have the capacity to manage consents, to 

communicate privacy related obligations, or to control the re-disclosure of select types of 

information. In addition, most general health care providers and technology vendors are 

unaware of these regulations and the legal obligations associated with receiving substance abuse 

treatment data. This constitutes a significant barrier to the integration of primary and behavioral 

health care. SAMHSA therefore requests an additional $2 million within Targeted Capacity 

Expansion–General to create the Behavioral Health Information Privacy Center of Excellence 

(COE). The COE will work to address these issues by providing coordinated technical 

assistance to provider organizations, HIEs, states, consumers, and vendors to support integration 

of behavioral health and general healthcare through health information exchange. The Center of 

Excellence will develop resources to support information exchange between behavioral health 

and general health care including tools to facilitate implementation of technologies that support 

compliance with 42 CFR Part 2 and similar state privacy laws and regulations. This will include 

the development of privacy policies, best practices and toolkits for sharing sensitive health 

information. In addition, the Center will work to support broad dissemination of educational 

resources to general medical systems on compliance with federal and state regulations when 

receiving protected behavioral health information.

Minority AIDS and 

Primary Care and Addiction Services Integration

HIV Continuum of Care

(Braided program with Mental Health: Minority Aids Initiative and Primary and Behavioral 

Health Care Integration and with Substance Abuse Prevention: Minority Aids Initiative)

SAMHSA expects that data generated from the 2014 HIV Continuum of Care pilot will help to 

inform an expanded program proposed for 2015 to continue the co-location and integrated 

HIV/primary care within either substance abuse or community mental health treatment programs. 

Braided funds in 2015 in the amount of $24 million would be dedicated to establishing integrated 

behavioral health and HIV care in addition to primary care needed by those living with or at high 

risk for HIV infection in minority communities heavily impacted by HIV. In addition, because of 

the significant comorbidity of viral hepatitis with HIV infection and because viral hepatitis 

occurs in up to 20 percent of those with either substance use disorders or serious mental illness, 5

percent of the allocated funds will be used to provide services to prevent, screen, test and refer to 

treatment as clinically appropriate those at risk for or living with viral hepatitis. In integrating 

HIV care into behavioral health settings, people living with HIV/AIDS and M/SUDs will have 
173

greater access to treatment for these conditions. Integrated care programs developed as a result of 

this grant program will make it possible for behavioral health and HIV care needs to be 

addressed in one setting. This will result in effective, person-centered, treatment that will reduce 

the risk of HIV transmission, improve outcomes for those living with HIV, and ultimately reduce 

new infections. SAMHSA’s Common Data platform (CDP), will integrate substance abuse and 

mental health elements with HIV and Hepatitis elements to ensure a more rigorous evaluation 

and data analysis to inform future public health intervention decision-making that addresses the 

intersection of behavioral health and HIV.

Treatment Systems for Homelessness

Housing and Homelessness 

(Braided program with Mental Health: Homelessness Prevention Programs)

In FY 2015, SAMHSA proposes to use approximately $13.2 million, for new programming 

related to homelessness (CSAT- $8 million; CMHS- $5.2 million). This includes funding 

approximately 15 grants at $0.8 million per year to build on lessons learned from the CABHI and 

CABHI-States programs which are designed to work with state and local partners including 

public housing authorities, Medicaid, Veteran’s Affairs, behavioral health providers and other 

agencies to develop systematic, cost-effective, and integrated approaches to housing that 

includes treatment and services for mental and substance use disorders. The program will 

support innovative strategies to provide needed services and supports that will help integrate 

individuals who are experiencing homelessness with substance abuse and mental health disorders 

into the community, assist providers in strengthening their infrastructure for delivering and 

sustaining housing to support recovery with integrated behavioral health, and other critical 

services, including the support of recovery residences. The program also will support providers 

in the implementation of coverage expansions for mental health and substance abuse services. 

Funds will be used to support a Homelessness Health Information Sharing activity. This program 

will pilot-test automated sharing of client information within and among health care providers 

and social service agencies by means of electronic health records (EHRs), homeless management 

information systems (HMIS), and other social service information systems. The pilots will 

address a number of policy and technology issues including: privacy policies for protecting 

sensitive information, interoperability across systems, development of data collection and 

reporting standards for information sharing, workflow integration, etc. This initiative builds on 

SAMHSA’s current homelessness activities in both CSAT and CMHS and will be used to 

explore how technology can improve systems for addressing homelessness in community-based 

health systems for individuals with behavioral health disorders.

By 2015, 66.4 percent of clients are expected to report being abstinent from substance use at a

six-month follow up, while, 31.7 percent of clients are expected to report being employed or 

engaged in productive activities, and 24.6 percent of clients are expected to report a permanent 

place to live in the community.
174

The FY 2015 Budget Request includes increases in the following:

 Primary Care and Addiction Services Integration (PCASI): request is $20.0 million to 

support the development of a new initiative related to the integration of substance abuse 

treatment services and primary care. The PCASI Program would enable providers to 

offer a full array of both physical health and substance abuse services to clients.

 TCE General: request is $15.2 million, an increase of $2.0 million from the FY 2014 

Enacted Level. Due to the success of the PBHCI Health Information Technology (HIT) 

supplemental program we are requesting an additional $2.0 million in funding for the 

TCE program in FY 2015 to fund a similar HIT initiative among the Primary Care and 

Addiction Services Integration (PCASI) program grantees. This supplemental funding 

will support the adoption and meaningful use of certified EHR technology which will 

facilitate the integration of care for patients in substance abuse treatment.

The FY 2015 Budget Request includes level funding from the FY 2014 Enacted Level in the 

following:

 Opioid Treatment Programs: Funding will support two grant continuations as well as 10

contracts. In FY 2015 SAMHSA also plans to fund a demonstration project testing the 

feasibility of using existing health information exchange (HIE) infrastructure to support 

care coordination for patients in opioid treatment programs during disasters.

 Pregnant and Postpartum Women: Funding will support 17 grant continuations five

contracts, and seven new grants. Approximately 82 percent of clients are expected to 

achieve abstinence from substance abuse, 26 percent expected to be employed or engaged 

in productive activity; and 22 percent are expected to report permanent housing. Based 

on an in-depth review of cross-site evaluation and performance data conducted in 

FY2014, SAMHSA plans to build upon the program to advance the successful PPW 

model as an evidence-based approach for serving pregnant and post-partum women in 

need of residential substance abuse treatment.

 The Recovery Community Services Program: Funding will allow for the continuation of 

existing RCSP Statewide Networks and related contracts.

 Children and Families: Funding will support 10 grant continuations, two contracts and 

support a new cohort of grantees. 56 percent of clients are expected to report being 

abstinent from substance abuse, 80 percent are expected to be employed or engaged in 

productive activities; and approximately 2500 individuals would be expected to be 

served.

 Treatment Systems for Homeless: Funding will support all continuations as well as 

approximately 12 new grants.

 Special Initiatives/Outreach: Funding will support three contracts. 
175

The FY 2015 Budget Request includes decreases in the following:

 Screening, Brief Intervention and Referral to Treatment: request is for $30.0 million a 

decrease of $17.0 million from FY 2014 Enacted Level. This level of funding will enable 

SAMHSA to support continuations.

 Strengthening Treatment Access & Retention: request is for $1 million, a decrease of 

$0.67 million from FY 2014 Enacted Level.

 Access to Recovery (ATR): SAMHSA is proposing eliminating the Access to Recovery 

program in the FY 2015 budget, a decrease of $50 million from the FY 2014 Enacted 

Level. Many of the clinical services provided under ATR will now be covered by public 

and private insurance. In addition, states have been encouraged to support recovery 

support services and client choice with SABG funding. States that would like to continue 

this activity will have support from SAMHSA in FY 2014 in incorporating lessons 

learned from the successful test.

 Minority AIDS Initiatives: request is for $58.9 million a decrease of $6.9 million from 

the FY 2014 Enacted Level which is offset by the increase in Mental Health MAI. This 

level will support funding of grant continuations and some new programming.

 Criminal Justice Activities: request is for $64.4 million, a decrease of $10.6 million from 

the FY 2014 Enacted Level. This level will support some new grants in FY 2015.

 Addiction Technology Transfer Centers: request is for $8.1 million, a decrease of $1 

million. Proposed number of clients to be served in 2015 is approximately 20,516. By 

2015, participants are also expected to report implementing improvements in treatment 

methods on the basis of information and training provided by the program.
176

SAMHSA/Substance Abuse Treatment

PRNS Mechanism Table by APT

(Dollars in thousands)

Programs of Regional National 

Significance No. Amount No. Amount No. Amount

Grants/Cooperative Agreements:

 Continuations................................... 399 $240,818 352 $164,077 381 $173,387

 New/Competing............................... 198 98,658 175 130,008 171 64,705 

 Subtotal......................................... 597 339,476 527 294,086 552 238,092 

Contracts:

 Continuations................................... 23 56,970 15 52,626 18 53,517 

 New/Competing............................... 6 7,639 5 14,749 5 5,791 

 Subtotal......................................... 29 64,609 20 67,374 23 59,308 

Total,Substance Abuse Treatment 626 $404,085 547 $361,460 575 $297,400

*Totals may not add due to rounding.

1/ The CSAT Minority Fellowship Program budget is reflected in the Health Surveillance and Program Support 

Appropriation under the Agency-Wide Initiatives Workforce program.

FY 2013 FY 2014 FY 2015

Final President's 

Budget

Enacted

A detailed table for all grant and contract continuations and new activities can be found in the 

SAMHSA Supplementary Table Chapter.
177

Key Outputs and Outcomes Tables

Program: Screening, Brief Intervention and Referral to Treatment

NOTE: SAMHSA grant awards are made late in the year. FY 2014 Enacted is reflected in FY 2015 targets. FY 

2015 President’s Budget is reflected in FY 2016 targets.

Measure Year and Most Recent 

Result /

Target for Recent Result /

(Summary of Result)

FY 2015

Target

FY 2016

Target

FY 2016

Target

+/-

FY 2015

Target

1.2.40 Number of clients 

served (Output)

FY 2013: 254,017

Target:

139,650

(Target Exceeded)

52,510 52,510 Maintain

1.2.41 Percentage of 

clients receiving services 

who had no past month 

substance use (Outcome)

FY 2013: 36.1%

Target:

36%

(Target Exceeded)

36% 36% Maintain
178

Program: Access to Recovery

NOTE: SAMHSA grant awards are made late in the year. FY 2014 Enacted is reflected in FY 2015 targets. FY 

2015 President’s Budget is reflected in FY 2016 targets.

Measure Year and Most Recent 

Result /

Target for Recent Result /

(Summary of Result)

FY 2015

Target

FY 2016

Target

FY 2016

Target

+/-

FY 2015

Target

1.2.32 Number of clients 

gaining access to 

treatment (Output)

FY 2013: 74,309

Target:

70,750

(Target Exceeded)

11,15051 8,00052-3,150

1.2.33 Increase the 

percentage of adults 

receiving services who 

had no past month 

substance use (Outcome)

FY 2013: 83.5%

Target:

83%

(Target Exceeded)

80% 80% Maintain

1.2.35 Percentage of 

adults receiving services 

who had no/reduced 

involvement with the 

criminal justice system 

(Outcome)

FY 2013: 96.9%

Target:

96%

(Target Exceeded)

93% 93% Maintain

1.2.36 Percentage of 

adults receiving services 

who had improved social 

support (Outcome)

FY 2013: 91.5%

Target:

91%

(Target Exceeded)

88% 88% Maintain

 

51

Decrease in target from prior years due to decrease in funding levels.

52

Decrease in target from prior years due to decrease in funding levels. Clients are still being served due to multi-year funding grants in FY 2014. 
179

Program: Treatment System for Homelessness (GBHI)

NOTE: SAMHSA grant awards are made late in the year. FY 2014 Enacted is reflected in FY 2015 targets. FY 

2015 President’s Budget is reflected in FY 2016 targets.

Measure Year and Most 

Recent Result /

Target for Recent 

Result /

(Summary of 

Result)

FY 

2015

Target

FY 

2016

Target

FY 2016

Target

+/-FY 

2015

Target

3.4.22 Percentage of clients receiving services who had no 

past month substance use (Outcome)

FY 2013: 63.5 %

Target:

67.4 %

(Target Not Met)

66.4 % 66.4 % Maintain

3.4.23 Number of clients served (Output) FY 2013: 5,375

Target:

5,800

(Target Not Met)

5,800 5,800 Maintain

3.4.24 Increase the percentage of homeless clients receiving 

services who were currently employed or engaged in 

productive activities (Outcome)

FY 2013: 29 %

Target:

32.7 %

(Target Not Met)

31.7 % 31.7 % Maintain

3.4.25 Increase the percentage of homeless clients receiving 

services who had a permanent place to live in the 

community (Outcome)

FY 2013: 44.9 %

Target:

25.6 %

(Target Exceeded)

33 % 33 % Maintain
180

Program: Treatment - Science and Service Activities

NOTE: SAMHSA grant awards are made late in the year. FY 2014 Enacted is reflected in FY 2015 targets. FY 

2015 President’s Budget is reflected in FY 2016 targets.

Measure Year and Most 

Recent Result /

Target for 

Recent Result /

(Summary of 

Result)

FY 

2015

Target

FY 

2016

Target

FY 2016

Target

+/-

FY 2015

Target

1.4.01 Percentage of participants who report implementing 

improvements in treatment methods on the basis of 

information and training provided by the program (Outcome)

FY 2013: 79.5%

Target:

90%

(Target Not Met)

90% 90% Maintain

1.4.02 Number of individuals trained per year (Output) FY 2013: 29,122

Target:

20,516

(Target 

Exceeded)

20,516 20,516 Maintain

1.4.09 Increase the number of individuals trained by 

SAMHSA's Science and Services Program (Output)

FY 2013: 

67,94453

Target:

110,000

(Target Not Met)

110,000 110,000 Maintain

 

53

Results are preliminary and will be updated in 2014. 
181

Program: Criminal Justice - Drug Courts

NOTE: SAMHSA grant awards are made late in the year. FY 2014 Enacted is reflected in FY 2015 targets. FY 

2015 President’s Budget is reflected in FY 2016 targets.

Measure Year and Most 

Recent Result /

Target for Recent 

Result /

(Summary of 

Result)

FY 

2015

Target

FY 

2016

Target

FY 2016

Target

+/-

FY 2015

Target

1.2.72 Percentage of adult clients receiving services who 

were currently employed or engaged in productive activities 

(Outcome)

FY 2013: 59%

Target:

57%

(Target Exceeded)

55% 55% Maintain

1.2.73 Percentage of adult clients receiving services who 

had a permanent place to live in the community (Outcome)

FY 2013: 42.4%

Target:

43%

(Target Not Met)

41% 41% Maintain

1.2.74 Percentage of adult clients receiving services who 

had no involvement with the criminal justice system 

(Outcome)

FY 2013: 92.8%

Target:

93%

(Target Not Met)

91% 91% Maintain

1.2.76 Percentage of adult clients receiving services who 

had no past month substance use (Outcome)

FY 2013: 86%

Target:

73%

(Target Exceeded)

71% 71% Maintain

1.2.79 Number of adult clients served (Output) FY 2013: 7,576

Target:

5,265

(Target Exceeded)

4,413 4,369 -44
182

Program: Criminal Justice – Teen Courts

NOTE: SAMHSA grant awards are made late in the year. FY 2014 Enacted is reflected in FY 2015 targets. FY 

2015 President’s Budget is reflected in FY 2016 targets.

Measure Year and Most 

Recent Result /

Target for Recent 

Result /

(Summary of 

Result)

FY 

2015

Target

FY 

2016

Target

FY 2016

Target

+/-

FY 2015

Target

1.2.89 Number of teen court clients served (Output) FY 2013: 584

Target:

584

(Baseline)

600 600 Maintain

1.2.90 Percentage of teen court clients receiving services 

who had no involvement with the criminal justice system 

(Outcome)

FY 2013: 95.3%

Target:

95.3%

(Baseline)

88% 90% +2

1.2.91 Percentage of teen court clients receiving services 

who had no past month substance use (Outcome)

FY 2013: 62.3%

Target:

62.3%

(Baseline)

86% 88% +2
183

Program: Criminal Justice - Ex-Offender Re-Entry Program

NOTE: SAMHSA grant awards are made late in the year. FY 2014 Enacted is reflected in FY 2015 targets. FY 

2015 President’s Budget is reflected in FY 2016 targets.

Measure Year and Most 

Recent Result /

Target for Recent 

Result /

(Summary of 

Result)

FY 

2015

Target

FY 

2016

Target

FY 2016

Target

+/-

FY 2015

Target

1.2.80 Number of clients served (Outcome) FY 2013: 2,149

Target:

2,912

(Target Not Met)

2,500 2,500 Maintain

1.2.81 Percentage of clients who had no past month 

substance use (Outcome)

FY 2013: 73%

Target:

80%

(Target Not Met)

80% 74% -6

1.2.84 Percentage of clients receiving services who had no 

involvement with the criminal justice system (Outcome)

FY 2013: 94.7 %

Target:

96 %

(Target Not Met)

94.9 % 94 % -0.9
184

Program: Treatment - Primary Care and Addiction Services Integration (PCASI)

NOTE: SAMHSA grant awards are made late in the year. FY 2014 Enacted is reflected in FY 2015 targets. FY 

2015 President’s Budget is reflected in FY 2016 targets.

Measure Year and Most 

Recent Result /

Target for Recent 

Result /

(Summary of Result)

FY 

2015

Target

FY 

2016

Target

FY 2016

Target

+/-

FY 2015

Target

1.2.52 Number of persons served (Output) FY 2015: Result 

Expected Dec 31, 2015

Target:

Set Baseline

(Pending)

Maintain

1.2.53 Percentage of clients receiving services who had 

no past month substance use (Outcome)

FY 2015: Result 

Expected Dec 31, 2015

Target:

Set Baseline

(Pending)

Maintain

1.2.54 Percentage of clients receiving services who were 

currently employed or engaged in productive activities 

(Outcome)

FY 2015: Result 

Expected Dec 31, 2015

Target:

Set Baseline

(Pending)

Maintain
185

Program: Treatment - Other Capacity

NOTE: SAMHSA grant awards are made late in the year. FY 2014 Enacted is reflected in FY 2015 targets. FY 

2015 President’s Budget is reflected in FY 2016 targets.

Measure Year and Most 

Recent Result /

Target for Recent 

Result /

(Summary of 

Result)

FY 

2015

Target

FY 

2016

Target

FY 2016

Target

+/-

FY 2015

Target

1.2.25 Percentage of adults receiving services who had no 

past month substance use (Outcome)

FY 2013: 70.2%

Target:

66%

(Target Exceeded)

60% 58% -2

1.2.26 Number of clients served (Output) FY 2013: 28,692

Target:

34,784

(Target Not Met)

30,849 28,998 -1,851

1.2.27 Percentage of adults receiving services who were 

currently employed or engaged in productive activities 

(Outcome)

FY 2013: 44.6%

Target:

47%

(Target Not Met but 

Improved)

45% 43% -2

1.2.28 Percentage of adults receiving services who had a 

permanent place to live in the community (Outcome)

FY 2013: 49.5%

Target:

49%

(Target Exceeded)

47% 45% -2

1.2.29 Percentage of adults receiving services who had no 

involvement with the criminal justice system (Outcome)

FY 2013: 96.5%

Target:

96%

(Target Exceeded)

93% 91% -2
186

Size of Awards 

(Whole Dollars)

FY 2013

Final

FY 2014

Enacted

FY 2015

President's 

Budget

Number of Awards 597 527 552

Average Award $568,637 $558,037 $431,327

Range of Awards $300,000-$7,575,000 $300,000-$600,000 $300,000-$600,000
187

Substance Abuse Prevention and Treatment Block Grant

(Dollars in thousands)

FY 2013 FY 2014 FY 2015 FY 2015 

Request +/-

FY 2014

Substance Abuse Prevention and Treatment Block Grant........... $1,710,306 $1,819,856 $1,819,856 ---

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

Final Enacted President's 

Budget

Authorizing Legislation ......................................... Sections 1921 of the Public Health Service Act 

FY 2015 Authorization .........................................................................................................Expired

Allocation Method ................................................................................................... Formula Grants

Program Description and Accomplishments

The Substance Abuse Prevention and Treatment Block Grant Program (SABG) distributes funds 

to 60 eligible states, territories, the District of Columbia, and the Red Lake Band of Chippewa 

Indians of Minnesota to plan, carry out, and evaluate substance abuse prevention, treatment and 

recovery support services provided for individuals, families, and communities impacted by 

substance abuse and substance use disorders (SUD). 

This formula grant program provides funding based upon specified economic and demographic 

factors and is administered by SAMHSA’s Center for Substance Abuse Treatment and Center for 

Substance Abuse Prevention. 

All Block Grant applications must include an annual plan that contains detailed provisions for 

complying with each funding agreement specified in the legislation, and describe how the 

grantees and their respective SABG sub-recipients intend to expend the SABG. The legislation 

includes specific provisions and funding set-asides, such as 20 percent for primary prevention; a 

5 percent HIV early intervention services set-aside; performance requirements for substance 

using pregnant women and women with dependent children; requirements and potential penalty 

reduction of the Block Grant allotment with respect to sale of tobacco products to individuals 

under the age of 18; a maintenance of effort requirement; and “hold harmless” provisions that 

limit fluctuations in allotments as the total appropriation changes from year to year. 

The program’s overall goal is to support and expand substance abuse prevention and treatment 

services while providing maximum flexibility. Services funded by the SABG include services 

identified in SAMHSA’s Good and Modern Service System54 brief as described in the block 

application. States and territories may expend Block Grant funds only for the purpose of 

planning, carrying out, and evaluating activities related to these services. Targeted technical 

assistance is available for the states and territories through SAMHSA’s technical assistance 

contract. The SABG requires states to maintain expenditures for authorized activities at a level 

that is not less than the average level of such expenditures maintained by the state for the two 

year period preceding the year for which the state is applying for a grant. 

 

54 http://www.samhsa.gov/healthReform/docs/good_and_modern_4_18_2011_508.pdf
188

Of the amounts appropriated for the SABG program, 95 percent are distributed to, territories and 

Red Lake Band of the Chippewa Indians through a formula prescribed by the authorizing 

legislation. Factors used to calculate the allotments include total personal income, state 

population data by age groups (total population data for territories), total taxable resources, and a 

cost of services index factor. 

The SABG is critically important because it provides the grantees and their respective SABG 

sub-recipients the flexibility to respond to local and/or regional emergent issues impacting 

health, public health, and public safety through a consistent federal funding stream. For 

example, this program provides approximately 32 percent of total State Substance Abuse Agency 

funding, and 23 percent of total substance abuse Prevention and Public Health Funding. Because 

SAMHSA encourages states to focus on these populations, individuals who are currently in need 

of such services may fall into several categories, such as having no insurance or limited health 

insurance coverage for substance use disorder treatment and recovery support services, or having 

been mandated to enter SUD treatment through public safety and/or public welfare systems. 

Individuals and families without health coverage or whose health insurance benefit will not 

cover certain services (e.g., recovery supports) rely on services funded by the SABG. States also 

rely on the SABG funding for an array of non-clinical activities and services which support 

critical needs of their respective service systems, such as planning, coordination, needs 

assessment, quality assurance, program development, and evaluation. 

In FY 2011, SAMHSA redesigned the FY 2012/2013 MHBG and SABG applications to better 

align with the current federal/state environments and related policy initiatives, including the 

Affordable Care Act, the Mental Health Parity and Addiction Equity Act (MHPAEA), and the 

Tribal Law and Order Act (TLOA). The new design offered states the opportunity to complete a 

combined application for mental health and substance abuse services, submit a bi-annual versus 

an annual plan, and provide information regarding their efforts to respond to various federal and 

state initiatives. Almost one-half of the states took advantage of this streamlined application and 

submitted combined plans for mental health and substance abuse services. Over 95 percent of 

the states provided specific information requested by SAMHSA regarding strategies to respond 

to a variety of areas including primary care and behavioral health integration, recovery support 

services, prevention of substance use, and promotion of emotional health. States continued to 

provide information regarding the spending of their Block Grant funds to support services 

identified in SAMHSA’s Good and Modern Service System55 brief as described in the block 

grant application.

The FY 2014/2015 Block Grant application builds upon the FY 2012/2013 application and 

furthers SAMHSA’s efforts to have states use and report the opportunities offered under various 

federal initiatives. In addition, the FY 2014/2015 Block Gant continues to allow states to submit 

a combined application for mental health and substance abuse services as well as a bi-annual 

versus an annual plan. 

After the full implementation of the ACA, SAMHSA has strongly recommended that SABG 

funds be directed toward four purposes: (1) to fund priority treatment and support services for 

 

55 http://www.samhsa.gov/healthReform/docs/good_and_modern_4_18_2011_508.pdf
189

individuals without insurance or for whom coverage is terminated for short periods of time; (2) 

to fund priority treatment (Essential Health Benefits – EHB) and support services not covered by 

private and public insurance for low and moderate income individuals and that demonstrate 

success in improving outcomes and/or supporting recovery (non-EHB covered treatments); (3) to 

fund primary prevention (universal, selective, and indicated) activities and services for 

individuals not identified as needing treatment; and (4) to collect performance and outcome data 

to determine the ongoing effectiveness of behavioral health promotion, treatment, and recovery 

support services and to plan the implementation of new services on a nationwide basis. In 

addition, consistent with SAMHSA's Theory of Change, which draws a path from innovation, 

translation, dissemination, to implementation and, finally, widescale adoption, the agency will 

take advantage of the successful strategies implemented through the Access to Recovery 

program. SAMHSA will encourage the states to utilize their Block Grants to: (1) allow 

recovery to be pursued through personal choice and many pathways; (2) encourage providers to 

manage performance based on outcomes that demonstrate client successes; and (3) expand 

capacity by increasing the number and types of providers who deliver clinical treatment and/or 

recovery support services.

The independent evaluation of the SABG program56 demonstrated how states have leveraged the 

statutory requirements of this Block Grant to expand existing or establish new treatment capacity 

in underserved areas of states and territories and to improve coordination of services with other 

state systems. 

As noted below, the SABG Program has been successful in expanding treatment capacity in the 

latest year for which actual data are available in FY 201157 by supporting approximately two 

million58 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 2011, at discharge, 

clients demonstrated high abstinence rates from both illegal drug (73.4 percent) and alcohol 

(81.6 percent) use. 

State Substance Abuse Authorities reported the following outcomes for services provided during 

FY 2011, the most recent year data is available:

 For the 50 states59 and D.C that reported data in the Abstinence from Drug/Alcohol Use 

Domain for alcohol use, 51 of 51 identified improvements in client abstinence.

 Similarly, for the 50 states and D.C. that reported data in the Abstinence from Drug/Alcohol 

Use Domain for drug use, 50 of 51 identified improvements in client abstinence. 

 For the 50 states and D.C. that reported data in the Employment Domain, 47 of 51 identified 

improvements in client employment. 

 

56 http://tie.samhsa.gov/SAPT2010.html#Evaluation

57 Source: 2013 SABG Report – Tables 16-21. While this is referenced as FY 2011, the actual time period varies by State, e.g; 

CY 2011 (imported TEDS data); SFY 2011 (manually entered by States); SFY 2012 (manually entered by States.

58Source: 2013 SABG Report – Table II

59Source: West Virginia numbers have been included in the text, but that appear lower than expected.
190

 For the 50 states and D.C. that reported in the Criminal Justice Domain, 46 of 51 reported an 

increase in clients with no arrests based on data reported to TEDS.

 For the 49 states and D.C. that reported data in the Housing Domain, 42 of 49 identified 

improvements in stable housing for clients based on data reported to TEDS.

20 Percent Prevention Set-Aside

SAMHSA is responsible for managing the 20 percent prevention set-aside of the Substance 

Abuse Prevention and Treatment Block Grant (SABG). This is one of SAMHSA’s main 

vehicles for supporting Strategic Initiative #1: Prevention of Substance Abuse and Mental 

Illness. States use these funds to develop infrastructure and capacity specific to substance abuse 

prevention. Some states rely solely on the 20 percent set-aside to fund their prevention systems 

while others use the funds to target gaps and enhance existing program efforts. Performance 

results will be available in December, 2013.

In an effort to streamline the application and reporting procedures for both the SABG and the 

Mental Health Block Grant programs, SAMHSA has developed a uniform application and 

reporting process to promote consistent planning, application, assurance, and reporting dates 

across both block grants. States are encouraged to make prevention a top priority, taking 

advantage of recent science, best practices in community coordination, proven planning 

processes, and the science articulated by the IOM report on Preventing Mental, Emotional, and 

Behavioral Disorders Among Young People60. SAMHSA will work with states to increase their 

accountability systems for prevention and to develop necessary reporting capacities. 

Synar

The Synar program is the set of actions put in place by states, with the support of the federal 

government, to implement the requirements of the Synar Amendment. The Amendment was 

developed in the context of a growing body of evidence about the health problems related to 

tobacco use by youth, as well as evidence about the ease with which youth could purchase 

tobacco products through retail sources. The Synar program is a critical component of the 

success of youth tobacco use prevention efforts. SAMHSA is charged with overseeing states’ 

implementation of the Synar requirements and provides technical assistance to states on both the 

Synar requirements and youth tobacco access issues in general.

Since the inception of the Synar program in 1996, SAMHSA has worked with states to assist 

them in complying with and attaining the goals of the Synar Amendment and has issued 

programmatic requirements and guidance documents to assist states in their efforts.

By regulation, states must achieve a retailer noncompliance rate of 20 percent or less. Since FY 

2006, all 50 states, Puerto Rico, and the District of Columbia have been in compliance with the 

Synar requirements. In FY 2012, the most recent year available, the national weighted average 

retailer violation rate was 9.1 percent. FY 2013 data will be available by August 31, 2014.

 

60 http://www.iom.edu/Reports/2009/Preventing-Mental-Emotional-and-Behavioral-Disorders-Among-Young-People-Progressand-Possibilities.aspx
191

Funding History

Fiscal Year Amount/1

FY 2006 $1,757,425,000 

FY 2007 $1,758,591,000 

FY 2008 $1,758,728,000 

FY 2009 $1,778,591,000 

FY 2010 $1,798,472,000 

FY 2011 $1,782,528,000 

FY 2012 $1,800,331,901 

FY 2013 $1,710,306,376 

FY 2014 $1,819,856,000 

FY 2015 $1,819,856,000 

1/The funding history includes PHS Evaluation Funds.

Budget Request

A total of $1.8 billion is requested, reflecting the same level funding from the FY 2014 Enacted 

Level. The FY 2015 request for the SABG includes recognition of new coverage for some 

limited services for SUDs in some states, mostly after an addiction is already 

diagnosed. SAMHSA’s FY 2015 budget also recognizes the increased demand for services 

likely to be created by additional coverage options.

In addition, the most recent versions of the uniform SABG and Mental Health Block Grant 

(MHBG) application, and related investments in technical assistance, have called upon states to 

make particular efforts. These include ensuring that the providers they work with are 

administratively prepared to bill third-party sources of coverage, and are doing so for enrolled 

clients. In particular, a five-year multi-million dollar training and technical assistance effort was 

launched in FY 2012 for training community behavioral health providers on third-party 

contracting and billing practices in partnership with state-level mental health and substance 

abuse officials.

As public and private health insurance expand coverage of substance abuse treatment, SABG 

funding will focus upon the provision of effective non-covered prevention and intervention 

services that support health outcomes. 

Health Reform Implementation

As a result of the analysis and examination of the various components of the Affordable Care 

Act beginning in 2010, SAMHSA has undertaken a major redesign of the planning section of the 

application process for both the MHBG and SABG. SAMHSA is aligning the block grants to 

complement mental health and substance abuse coverage expansions in the Affordable Care Act

and the Mental Health Parity and Addiction Equity Act support individuals otherwise unable to 

receive services through public and private insurance. Together, SAMHSA’s block grants 
192

support the provision of services and related supports to approximately eight million individuals 

with mental and substance use conditions. With an estimated 11.4 million adults having a severe 

mental illness,61 44.7 million adults having any mental illness,62 and another 22.1 million adults 

with substance abuse disorder,63 demand clearly outpaces the public behavioral health system’s 

established capacity. Many of these individuals and some of the services they need will continue 

to be without coverage through public or private insurance mechanisms. Aligning and 

coordinating the SAMHSA block grants with the Affordable Care Act helps create a cohesive 

national service system that is responsive to potential gaps in service delivery and effectively 

provides needed behavioral health services across sectors and across payment sources.

States should determine if established systems and procedures are sufficient to ensure that Block 

Grant funds are expended in accordance with program requirements and directed to support and 

not supplant health reform activities. The Block Grant Application for FY 2014/2015, 

SAMHSA has strongly recommended that states use these resources to support and not supplant 

services that will be covered through commercial and public insurer plans. States will be asked 

to develop metrics or targets for their systems to measure increases in the number of individuals 

who become enrolled or providers that join commercial or publicly funded provider networks. 

The primary goals of SAMHSA’s program integrity efforts are to continue to (1) promote the 

proper expenditure of block grant funds, (2) improve block grant program compliance nationally, 

and (3) demonstrate the effective use of block grant funds. 

SAMHSA will provide additional guidance to the states to assist them in complying with this 

continuing emphasis on program integrity, will develop new and better tools for reviewing block 

grant application and reports, and will train SAMHSA staff in these program integrity 

approaches and tools. SAMHSA will be working with states to develop changes to information 

systems and compliance review processes to ensure increasing program integrity. This may 

include working closely with Medicaid and Health Insurance Exchanges to obtain information to 

determine if individuals and providers in their systems are enrolled. This may also include 

strategies to assist their providers to develop the necessary infrastructures to operate in 

commercial and public insurer networks. The Uniform Application, along with evolution of 

SAMHSA’s block grant reporting system are tools to assist in this process. 

 

61 http://www.samhsa.gov/data/NSDUH/2k10MH_Findings/2k10MHResults.htm

62http://www.samhsa.gov/data/2k12/NSDUH110/sr110-adult-mental-illness.htm

63 http://www.samhsa.gov/data/NSDUH/2k10ResultsRev/NSDUHresultsRev2010.htm#Ch7
193

Key Outputs and Outcomes Table

Program: Treatment Activities

NOTE: SAMHSA grant awards are made late in the year. FY 2014 Enacted is reflected in FY 2015 targets. FY 

2015 President’s Budget is reflected in FY 2016 targets.

Measure Year and Most 

Recent Result /

Target for Recent 

Result /

(Summary of 

Result)

FY 2015

Target

FY 2016

Target

FY 2016

Target

+/-

FY 2015

Target

1.2.43 Number of admissions to substance abuse 

treatment programs receiving public funding (Output)

FY 2011: 1,909,124

Target:

1,881,515

(Target Exceeded)

1,937,960 1,880,000 -57,960

1.2.48 Percentage of clients reporting no drug use in the 

past month at discharge (Outcome)

FY 2012: 73.4%

Target:

70%

(Target Exceeded)

74% 74% Maintain

1.2.49 Percentage of clients reporting no alcohol use in 

the past month at discharge (Outcome)

FY 2012: 81.6%

Target:

75%

(Target Exceeded)

78% 78% Maintain

1.2.50 Percentage of clients reporting being 

employed/in school at discharge (Outcome)

FY 2012: 37.1%

Target:

43%

(Target Not Met but 

Improved)

43% 43% Maintain

1.2.51 Percentage of clients reporting no involvement 

with the Criminal Justice System (Outcome)

FY 2012: 91.1%

Target:

89%

(Target Exceeded)

92% 92% Maintain

1.2.85 Percentage of clients receiving services who had 

a permanent place to live in the community (Outcome)

FY 2012: 92.1%

Target:

92%

(Target Exceeded)

92% 92% Maintain
194

Program: Synar Amendment

NOTE: SAMHSA grant awards are made late in the year. FY 2014 Enacted is reflected in FY 2015 targets. FY 

2015 President’s Budget is reflected in FY 2016 targets.

Measure Year and Most 

Recent Result /

Target for Recent 

Result /

(Summary of 

Result)

FY 

2015

Target

FY 

2016

Target

FY 2016

Target

+/-

FY 2015

Target

2.3.49 Number of States (including Puerto Rico) whose 

retail sales violations is at or below 20% (Outcome)

FY 2012: 51

Target:

52

(Target Not Met)

52 52 Maintain

2.3.62 Number of States (excluding Puerto Rico) reporting 

retail tobacco sales violation rates below 10% (Outcome)

FY 2012: 30

Target:

34

(Target Not Met)

34 33 -1
195

Program: Prevention Set-Aside

NOTE: SAMHSA grant awards are made late in the year. FY 2014 Enacted is reflected in FY 2015 targets. FY 

2015 President’s Budget is reflected in FY 2016 targets.

Measure Year and Most 

Recent Result /

Target for 

Recent Result /

(Summary of 

Result)

FY 

2015

Target

FY 

2016

Target

FY 2016

Target

+/-

FY 2015

Target

2.3.63 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 2012: 27%

(Historical 

Actual)

19% 22% +3

2.3.65 Percent of states showing a decrease in state level 

estimates of percent of survey respondents who report 30 day 

use of alcohol (age 12-20) (Outcome)

FY 2012: 76%

Target:

52.9%

(Target 

Exceeded)

67.5%64 67.5% Maintain

2.3.67 Percent of states showing a decrease in state level 

estimates of percent of survey respondents who report 30 day 

use of other illicit drugs (age 12-17) (Outcome)

FY 2012: 63%

Target:

64.7%

(Target Not Met 

but Improved)

61% 63% +2

2.3.68 Percent of states showing a decrease in state level 

estimates of percent of survey respondents who report 30 day 

use of other illicit drugs (age 18+) (Outcome)

FY 2012: 41%

Target:

37.3%

(Target 

Exceeded)

43%65 43% Maintain

 

64

Change from previously reported to reflect average of FY 2011 result and FY 2014 target. 

65

Change from previously reported to reflect average of FY 2011 result and FY 2014 target. 
196

Department of Health and Human Services

Substance Abuse and Mental Health Services Administration

FY 2015 Discretionary State/Formula Grants

Substance Abuse Prevention and Treatment Block Grant Program

CFDA #93.959

FY 2013 FY 2014 FY 2015 FY 2015

State/Territory

Final Enacted President's 

Budget 

+/- 

FY 2014

Alabama $22,413,051 $22,926,066 $22,940,970 +14,904

Alaska 4,643,542 5,499,891 5,539,999 +40,108

Arizona 35,045,931 39,323,249 39,546,356 +223,107

Arkansas 12,531,768 13,428,775 13,437,505 +8,730

California 235,684,407 249,086,920 250,324,755 +1,237,835

Colorado 24,718,036 25,283,810 25,300,247 +16,437

Connecticut 15,987,458 17,584,936 17,596,368 +11,432

Delaware 6,316,579 6,807,911 6,824,460 +16,549

District Of Columbia 6,316,579 6,807,911 6,824,460 +16,549

Florida 94,297,122 109,951,627 110,663,333 +711,706

Georgia 47,479,959 51,074,888 51,162,247 +87,359

Hawaii 7,174,180 8,150,210 8,212,632 +62,422

Idaho 6,491,294 8,475,423 8,480,933 +5,510

Illinois 65,664,007 67,166,999 67,210,663 +43,664

Indiana 31,301,396 32,017,858 32,038,672 +20,814

Iowa 12,709,762 13,000,677 13,009,129 +8,452

Kansas 11,551,048 11,815,441 11,823,122 +7,681

Kentucky 19,420,002 20,234,141 20,247,295 +13,154

Louisiana 24,293,250 24,849,301 24,865,455 +16,154

Maine 6,316,579 6,807,911 6,824,460 +16,549

Maryland 30,053,214 33,838,777 33,860,775 +21,998

Massachusetts 32,265,047 39,563,072 39,588,791 +25,719

Michigan 54,410,714 55,656,128 55,692,309 +36,181

Minnesota 23,395,940 23,931,452 23,947,009 +15,557

Red Lake Indians 576,624 589,822 590,206 +384

Mississippi 13,399,170 13,705,865 13,714,775 +8,910

Missouri 24,582,417 26,346,394 26,363,521 +17,127

Montana 6,316,579 6,807,911 6,824,460 +16,549

Nebraska 7,417,381 7,587,158 7,592,090 +4,932

Nevada 13,015,618 16,462,188 16,698,247 +236,059

New Hampshire 6,316,579 6,807,911 6,824,460 +16,549

New Jersey 44,113,252 46,349,018 46,379,149 +30,131

New Mexico 8,437,153 9,497,415 9,503,589 +6,174

New York 108,553,857 111,038,560 111,110,745 +72,185

North Carolina 37,499,971 43,346,419 43,374,598 +28,179
197

Department of Health and Human Services

Substance Abuse and Mental Health Services Administration

FY 2015 Discretionary State/Formula Grants

Substance Abuse Prevention and Treatment Block Grant Program

CFDA #93.959

FY 2013 FY 2014 FY 2015 FY 2015

State/Territory

Final Enacted President's 

Budget 

+/- 

FY 2014

North Dakota 5,151,710 6,101,774 6,146,271 +44,497

Ohio 62,645,080 64,078,971 64,120,628 +41,657

Oklahoma 16,646,929 17,027,963 17,039,033 +11,070

Oregon 16,856,407 20,011,555 20,024,564 +13,009

Pennsylvania 55,527,829 58,681,907 58,720,055 +38,148

Rhode Island 6,316,579 7,544,696 7,549,601 +4,905

South Carolina 19,372,201 23,149,144 23,164,193 +15,049

South Dakota 4,763,897 5,642,441 5,683,588 +41,147

Tennessee 27,956,082 29,340,645 29,359,719 +19,074

Texas 127,794,281 139,747,042 139,837,890 +90,848

Utah 16,102,598 16,471,172 16,481,880 +10,708

Vermont 5,093,619 6,032,970 6,076,965 +43,995

Virginia 40,492,722 41,682,781 41,709,878 +27,097

Washington 32,870,870 37,271,989 37,296,219 +24,230

West Virginia 8,185,634 8,372,996 8,378,439 +5,443

Wisconsin 26,401,184 27,005,484 27,023,040 +17,556

Wyoming 3,309,781 3,920,161 3,948,749 +28,588

American Samoa 310,284 333,113 333,547 +434

Guam 890,619 963,165 970,731 +7,566

Northern Marianas 301,141 314,821 311,985 -2,836

Puerto Rico 20,822,658 22,369,385 22,405,135 +35,750

Palau 116,688 126,467 127,671 +1,204

Marshall Islands 368,072 405,435 415,696 +10,261

Micronesia 598,861 644,741 646,412 +1,671

Virgin Islands $594,675 $638,392 $639,054 +662
198

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199

SAMHSA Health Surveillance and Program Support

Table of Contents

SAMHSA/HSPS

1. Health Surveillance and Program Support............................................................................ 201

2. Public Awareness and Support ............................................................................................. 205

3. Performance and Quality Information Systems.................................................................... 211

4. Agency-Wide Initiatives....................................................................................................... 215
200

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201

Health Surveillance and Program Support

(Dollars in thousands)

FY 2013

Final

FY 2014

Enacted

FY 2015

President's

Budget

FY 2015

+/- 

FY 2014

Health Surveillance and Program Support........................

Health Surveillance............................................................. $45,421 $47,428 $49,428 +$2,000

Budget Authority (non-add)......................................... 3,260 17,000 --- -17,000

Prevention and Public Health Fund (non-add)............ 14,733 --- 20,000 +20,000

PHS Evaluation Funds (non-add)................................ 27,428 30,428 29,428 -1,000

Program Support................................................................ 77,998 72,729 72,729 ---

Total, Health Surveillance and Program Support............. $123,419 $120,157 $122,157 +$2,000

Data Request and Publication User Fees................................ $--- $1,500 $1,500 $---

*Totals may not add due to rounding.

Authorizing Legislation .............................................Section 501 of the Public Health Service Act

FY 2015 Authorization .........................................................................................................Expired

Allocation Method .......................................................Direct Federal/Intramural, Contracts, Other

Program Description and Accomplishments

Health Surveillance

The Health Surveillance budget supports many of the critical behavioral health data systems, 

national surveys, and surveillance activities for HHS undertaken by SAMHSA to support 

SAMHSA grantees, the field, and the public.

The National Survey on Drug Use and Health (NSDUH) serves as the nation’s primary source 

for information on the incidence and prevalence of substance use and mental disorders and 

related health conditions. A new NSDUH contract was awarded in FY 2013 to finance surveys 

for 2014, 2015, 2016 and 2017.

In FY 2013, funding was provided for other public surveillance systems, including data 

collection efforts within the Community Behavioral Health Data Initiative (CDI). The goal of the 

CDI is to create new opportunities for cross-agency and public-private partnerships to address 

critical public health questions and more effectively utilize existing or declining resources. Data 

from this coordinated initiative is intended to be utilized in concert with data collected by other 

agencies such as Centers for Medicare and Medicaid Services (CMS) and Agency for Healthcare 

Research and Quality (AHRQ) to more fully develop an understanding of the status of behavioral 

health at the regional and community level. Use of these data will allow communities to identify 

service and program needs specific to the local community. Moreover, the longitudinal nature of 

these data will allow those evaluating the effectiveness of services and policies in a community 

to measure the impact and outcomes of those interventions. 
202

Specifically in FY 2013, the SAMHSA Emergency Department Surveillance Systems (SEDSS) 

(formerly the Drug Abuse Warning Network – DAWN was funded at $3.75 million ($2 million 

in Health Surveillance PHS Evaluation Funds and $1.75 million in PQIS BA). Funding was 

reduced in FY 2013 for SEDSS due to delays in incorporating it into the CDC/National Center 

for Health Statistics’ (NCHS) National Hospital Care Survey (NHCS). Funding was eliminated 

to the National Health Interview Survey (NHIS) to accommodate sequester reductions.

In FY 2013, funding was also provided to partially support the Behavioral Health Services 

Information System (BHSIS) to reflect the transition of the Drug and Alcohol Services 

Information System (DASIS) to the BHSIS by: 1) collecting mental health treatment admissions 

data along with the ongoing substance abuse treatment admissions data, and 2) augmenting the 

treatment locator to include mental health facility level information. SAMHSA will be working 

closely with the National Association of State Alcohol and Drug Abuse Directors (NASADAD)

and the National Association of State Mental Health Program Directors (NASMHPD) and our 

state and federal partners in the development and implementation of this integration effort which 

includes identifying metrics for reporting. BHSIS funding was increased to $16.6 million in FY 

2013 with SAMHSA’s CMHS providing $7.1 million (these funds were used for the former Data 

Infrastructure Grant Program).

Funding was also provided in 2013 for CMHS Transformation Accountability System (TRAC), 

and CSAT Services Accountability Improvement System (SAIS). These data systems will be 

replaced with the new SAMHSA Common Data Platform (CDP). 

In FY 2014, funding was appropriated for a number of activities to support a broad range of 

analytic work to be carried out in the CBHSQ. These activities include support for an Analytic 

Support Center (ASC) which undertakes a number of scientific and writing tasks on policy and 

practice-related topics in response to requests from SAMHSA Centers and related components, 

HHS agencies (CDC, AHRQ, and FDA), the Surgeon General’s Office, the Office of National 

Drug Control Policy, and the Department of Justice. FY 2013 and FY 2014 funds $3 million for 

the Analytic Support and CBHSQ’s Logistics contracts (formerly the National Analytic 

contracts).

In FY 2014, funding reflects the transition of the Drug and Alcohol Services Information System 

(DASIS) to the BHSIS by: 1) collecting mental health treatment admissions data along with the 

ongoing substance abuse treatment admissions data, and 2) augmenting the treatment locator to 

include mental health facility level information. In addition, through BHSIS SAMHSA will 

conduct coordinated substance abuse and mental health facility surveys in FY 2014. FY 2014 

funding will increase to $21 million and CMHS will provide $7.5 million for BHSIS.

Funding for Grantee Data Development Technical Assistance (TA) will be provided in 2014. 

The funding will be used to support the development of a support contract and TA Team for an

integrated approach to performance and quality data collection and reporting, including a pilot to 

fund regional data coordinators. 

To meet the growing evaluation and data request and needs of SAMHSA, CBHSQ has proposed 

to phase-in taking over support for its full complement of current 78 FTEs over FY 2014, FY 
203

2015, and FY 2016. While SAMHSA as a whole remains flat, CBHSQ proposes to hire 

additional FTEs to better manage its resources and plan for long-term evaluation and data 

projects. These FTEs include staff that will be assigned to support the Grantee Data Technical 

Assistance (TA) project, State data TA support, additional data collection activities across the 

public behavioral health surveys supported within CBHSQ, and one additional support staff.

Program Support

The Program Support budget supports the majority of SAMHSA staff who plan, direct, and 

administer SAMHSA programs and individuals who provide technical assistance, data collection 

and evaluation, and program guidance to states, mental health and substance abuse professionals, 

stakeholders, federal partners, and the general public. SAMHSA staffing represents a critical 

component of the budget. Staff positions that are not financed directly through the Health 

Surveillance and Program Support account provide direct state technical assistance and are 

funded through the Block Grant set-asides or are financed from other budget lines to perform 

services previously contracted out. In addition, this budget supports the Unified Financial 

Management System, which covers administrative activities such as human resources, 

information technology and the centralized services provided by HHS’s Program Support Center 

and the department.

In FY 2015, SAMHSA projects a total of 655 FTEs across all appropriations and funding sources

which reflect the impact of in source-related hiring which is fully annualized in FY 2014. 

SAMHSA’s historical attrition factors have been applied to determine the overall anticipated FY

FTE forecast. 

SAMHSA applies an estimated internal administrative charge for overhead expenses to all 

programs, projects and activities including its Programs of Regional and National Significance, 

both Block Grants, Children’s Mental Health Initiatives (CMHI), Projects for Assistance in 

Transition from Homelessness (PATH), Protection and Advocacy for Individuals with Mental 

Illness (PAIMI) and the Health Surveillance and Program Support appropriation. These 

estimates will be adjusted to reflect final operating plans during the year of execution.

SAMHSA is pursuing an agency-wide program integrity initiative to mitigate the risk of 

improper payments throughout our grant portfolio. Building on the SAMHSA-specific risk 

assessments to date, along with the department’s findings across operating and staff divisions, 

SAMHSA is pursuing a coordinated effort to better monitor grants and respond to grant 

allegations. The department has identified human resources, in particular, the competencies of 

federal and grantee staff as putting the department’s programs at risk. SAMHSA established an 

Office of Financial Advisory Services to address these risks.
204

Funding History1\

Fiscal Year Amount

FY 2011 $119,789,000

FY 2012 $124,317,616

FY 2013 $123,418,779

FY 2014 $120,157,000

FY 2015 $122,157,000

1\The funding history is presented on a comparable basis to previous funding levels to represent the 

revised budget structure and includes the PHS Evaluation Funds and Prevention and Public Health Funds.

Budget Request

A total of $122.2 million is requested for Health Surveillance and Program Support, reflecting an 

increase of $2 million from the FY 2014 Enacted Level. 

A total of $49.4 million is requested for Health Surveillance activities, reflecting a $2 million

increase from the FY 2014 Enacted Level. These funds will be used to support the President’s 

Now is the Time initiative. This increase will be used to support the work begun by the White 

House National Conference on Mental Health, supporting the collection and use of data to learn 

if, what, and how we are communicating is making a positive difference. Specifically, this 

funding will be used for a new initiative, Science of Changing Social Norms: Building the 

Evidence Base, to support efforts to measure and track behavioral, attitudinal, and related 

community data to understand the impact of social messaging and demonstrate evidence for 

effecting change in social norms and behavior to reduce negative attitudes and improve people’s 

willingness to seek help for themselves and others when they experience a mental health 

problem. The Science of Changing Social Norms will have a second component, Social Media, 

funded from Public Awareness and Support.

A total of $72.7 million is requested for Program Support, level funding relative to the FY 2014 

Enacted Level. The additional costs associated with fully annualizing in-sourced staffing and 

with extending the current building lease will be absorbed. The funding request includes costs 

associated with the consolidation of several Operating Divisions at 5600 Fishers Lane, including 

rent and associated costs. SAMHSA’s move is currently scheduled for early FY 2016.

SAMHSA will be supporting 493 Direct BA FTEs funded from Program Support. 
205

Public Awareness and Support

(Dollars in thousands)

FY 2013

Final

FY 2014

Enacted

FY 2015

President's

Budget

FY 2015

+/- 

FY 2014

Program Level................................................................... $13,545 $13,571 $15,571 +$2,000

PHS Evaluation Funds (non-add).................................... --- --- 15,571 +15,571

Authorizing Legislation ...........Section 501, 509, 516, and 520A of the Public Health Service Act

FY 2015 Authorization .........................................................................................................Expired

Allocation Method ............................................................................................................. Contracts

Program Description and Accomplishments

In recent years, the news coverage has been filled with increasing reports of tragic events and, as 

each report has unfolded, attention has focused increasingly on behavioral health and the

country’s behavioral health care system. Americans want to know what their government is 

already doing, and what more can be done to prevent similar tragedies in the future. It is 

estimated that almost half of all Americans will experience symptoms of a behavioral health 

disorder – mental illness or addiction – at some point in their lives. Half of all lifetime cases of 

mental illness begin by age 14 and three-fourths by age 24. It is important to identify issues early 

and help individuals get the treatment they need before crisis situations develop. Also, 

communities need to engage in prevention approaches that are effective in stopping problems

from developing in the first place. 

In light of the public’s sustained interest and concerns about behavioral health issues, this is a 

critical time to raise the public’s understanding of mental and substance use disorders and 

increase the recognition of SAMHSA’s behavioral health expertise. SAMHSA’s Office of 

Communications is charged with setting the strategic direction and policy for the agency’s public 

awareness and communications activities. SAMHSA’s communications strategy will continue to 

focus on four vital efforts:

 Collaborating across agencies to communicate the importance of behavioral health to our 

nation; 

 Providing critical resources to the behavioral health workforce; 

 Leveraging SAMHSA’s online and social media presence to reach our existing audience 

efficiently and expand our reach nationally; and 

 Raising awareness of SAMHSA as a leader in behavioral health data and surveillance.

In FY 2014 and FY 2015, the SAMHSA will complete a number of vital programs and activities, 

both internally and externally, to solidify its role as a leader of public health efforts to advance

the behavioral health of the nation. 
206

Collaborating Across Agencies

In FY 2014 and FY 2015, SAMHSA plans to continue to collaborate with other agencies to 

promote awareness of behavioral health. For example, SAMHSA will coordinate with the 

Centers for Disease Control and Prevention (CDC) to promote the Million Hearts Campaign 

through social marketing activities specific to blood pressure screening and control, smoking 

cessation, and weight loss in communities with the highest prevalence of reported cardiovascular 

disease among persons with behavioral health conditions. SAMHSA also will work to support

MentalHealth.gov. Internally, SAMHSA’s National Outreach, Public Education and 

Engagement Initiative (NOPEEI), provides consistent communications support for national 

outreach and public education initiatives across a variety of behavioral health topics. 

Funding support in FY 2015 will enable SAMHSA to broaden its reach by collaborating across 

agencies to help people recognize mental and/or substance use disorders and seek assistance with 

the same urgency as any other health condition and with the expectation of recovery. 

Providing Critical Resources to the Behavioral Health Workforce

SAMHSA’s communications strategy ensures that the vital information and training materials 

produced through SAMHSA’s centers and offices are available to the behavioral health 

workforce through the Public Engagement Platform (PEP), which manages the agency’s print 

and online information resources. PEP provides a customer-oriented fulfillment system, 

including an online store, call-in contact center, warehouse, email updates, exhibit program, and 

strategic partnerships to fulfill the educational and training needs of the public and health 

services providers. SAMHSA’s various channels of communication generated more than 25 

million customer interactions in FY 2013. 

SAMHSA also manages the Disaster Distress Helpline (DDH), with its vast network of 

behavioral health experts nationwide, to provide information and counseling referral to the 

public after tragic events. For example, the Helpline was deployed just 30 minutes after the 

Boston Marathon bombing, which injured hundreds of runners and spectators. Due to increased 

public awareness, the HHS mental health team deployed to support the city and state was able to 

touch the lives of over 1,000 people. SAMHSA, in support of the DDH, also disseminated more 

than 8,500 disaster kits in the wake of the bombing. 

To further support behavioral health first responders, SAMHSA has also developed and launched 

a behavioral health disaster response mobile application, available on iTunes, Google Play, and 

the Blackberry World. Using this app, behavioral health first responders can easily access and 

share behavioral health resources, updated in real-time, with those most in need at the site of a 

disaster. The SAMHSA disaster app has the potential to reach thousands of people with vital 

behavioral health resources right at the time of greatest need.

SAMHSA will also collaborate with WebMD, which reaches over 3 million US healthcare 

providers every month, to provide critical information to both the behavioral health workforce 

and primary care providers. With WebMD, SAMHSA will develop a continuing medical 

education (CME) resource to train providers in the Screening, Brief Intervention, and Referral to 

Treatment (SBIRT) approach to the delivery of early intervention and treatment services for 
207

persons with substance use disorders, as well as those who are at risk of developing these 

disorders.

In FY 2013, SAMHSA released the Opioid Overdose Prevention Toolkit, which equips 

communities and local governments with material to develop policies and practices to help 

prevent opioid-related overdoses and deaths. The toolkit addresses issues for first responders, 

treatment providers, and those recovering from opioid overdose.

Funding support in FY 2015 is important for SAMHSA to continue providing quality and timely 

information resources, and access to emergency response networks, for the public and the 

behavioral health workforce. 

Leveraging SAMHSA’s Online Presence

The internet is the primary way the public engages with the government. SAMHSA’s website 

and social media channels—such as Facebook, Twitter and YouTube—are critical to our efforts 

to engage with citizens about behavioral health. The wide reach of these online channels was 

demonstrated during a “Tweet up” event SAMHSA coordinated to launch National Children’s 

Mental Health Awareness Day 2013, which reached over 20 million Twitter users in less than 12 

hours, setting a record for SAMHSA and HHS. Also, in accordance with the Americans with 

Disabilities Act (ADA), SAMHSA has met the federal government’s deadline for ensuring the 

Section 508 compliance of its websites. SAMHSA.gov continues to be among the highest rated

of any HHS Operating or Staff Division. 

In the course of prioritizing the internet as a strategic business initiative and communications 

asset, SAMHSA launched Project Evolve to consolidate and modernize SAMHSA’s web 

presence. Through Project Evolve, almost 90 disparate websites created for various SAMHSAsponsored campaigns and programs are being consolidated into one site. This consolidation will 

help ensure that SAMHSA speaks to the nation with a unified voice. It also helps eliminate 

redundant web development and maintenance efforts, resulting in lower overall costs, greater 

efficiency, increased effectiveness, and improved service for visitors to SAMHSA’s website. 

Related Project Evolve activities include audience analysis, usability testing, and planning for the 

prioritized migration of information from other sites to a consolidated SAMHSA.gov site. In FY

2013, the agency launched a beta version of SAMHSA.gov and anticipates the completion of the 

website consolidation phase in FY 2016.

Raising Awareness of SAMHSA’s Role as a Leader in

Behavioral Health Data and Surveillance

SAMHSA’s Center for Behavioral Health Statistics and Quality (CBHSQ) is the government’s 

lead agency for behavioral health statistics, as designated by the Office of Management and 

Budget. A key goal of the agency’s Public Awareness and Support efforts is to make certain that 

these valuable 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 vehicles described above—MDMS, PEP, the Web, and social 

media—as well as through other program operations such as the press releases issued by the 

Office of Communications to announce CBHSQ’s latest findings, including the National Survey 
208

on Drug Use and Health (NSDUH), and SAMHSA’s first-ever Behavioral Health Barometer, 

which provides data about key indicators of behavioral health problems. The Barometer shows 

this data at the national level, and for each of the 50 states and the District of Columbia.

Budget Request

A total of $15.6 million is requested for Public Awareness and Support, an increase of $2 million

from the FY 2014 Enacted Level, and shifts from Budget Authority to PHS Evaluation funds. 

The increase of $2 million will be used to support the President’s Now is the Time initiative by 

ensuring sufficient communications infrastructure to change social norms around mental health. 

The goals of this data and evidence-driven communications effort are to reduce negative public 

attitudes and to encourage people to seek help for themselves or others when they experience a 

mental health problem. Funds will be placed within Public Awareness and Support so SAMHSA 

can continue to release timely and accurate behavioral health information to the public, the 

demand for which is demonstrated by the fact that, since they were released to the public, 

SAMHSA’s publications to support Community Conversations about Mental Health have been 

shipped or downloaded over 23,000 times.

Specifically, this additional request of $2 million will support a new initiative, the Science of 

Changing Social Norms: Social Media, to develop and test an array of messages and media

designed to improve attitudes, understanding and behavior of Americans about mental and 

substance use disorders and the willingness to seek help for them. Building on the effort to 

increase understanding about mental health through the Now is the Time initiative launched on 

January 16, 2013, this public awareness and education initiative will seek to target the message 

resulting from the national conversation about behavioral health most effectively. The $2 

million will fund social media strategies to support the work begun by the White House National 

Conference on Mental Health. The goal is to use communications science and market research 

to identify the most effective and evidence-based methods for decreasing negative attitudes, 

increasing knowledge and improving willingness to seek help for mental health and substance 

abuse problems to ensure outreach funds are spent where they will make the most impact. This 

initiative is in conjunction with the Science of Changing Social Norms: Building the Evidence 

Base in the Center for Behavioral Health Statistics and Quality’s which is essential to understand 

the impact of social messaging and demonstrate evidence for effecting change in social norms

and behavior to reduce negative attitudes and improve people’s willingness to seek help.

CBHSQ’s data collection component will be funded separately under Health Surveillance and 

Program Support.
209

Key Outputs and Outcomes Table

Program: Public Awareness and Support

NOTE: SAMHSA grant awards are made late in the year. FY 2014 Enacted is reflected in FY 2015 targets. FY 

2015 President’s Budget is reflected in FY 2016 targets.

Measure Year and Most 

Recent Result /

Target for Recent 

Result /

(Summary of 

Result)

FY 

2015

Target

FY 

2016

Target

FY 2016

Target

+/-

FY 2015

Target

2.3.76 Number of persons receiving prevention 

information indirectly from advertising, broadcast, or 

website (Output)

FY 2012: 1,511,158

Target:

1,250,000

(Target Exceeded)

250,000 250,000 Maintain

4.4.12 Number of individuals referred for behavioral 

health treatment resources. (Output)

FY 2013: 365,919

Target:

310,000

(Target Exceeded)

310,000 310,000 Maintain
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211

Performance and Quality Information Systems

(Dollars in thousands)

FY 2013

Final

FY 2014

Enacted

FY 2015

President's

Budget

FY 2015

+/- 

FY 2014

Program Level................................................................... $8,803 $12,996 $12,996 $---

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

Authorizing Legislation ...........Section 501, 509, 516, and 520A of the Public Health Service Act

FY 2015 Authorization .........................................................................................................Expired

Allocation Method ............................................................................................................. Contracts

Program Description and Accomplishments 

In FY 2013, PQIS funding was used to partially fund SEDSS and the C-EMS activities. 

In FY 2014, funding is also requested to provide support for a new contract 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. NREPP, a searchable online system that 

provides states, communities, and tribes tools for identifying and implementing evidence-based 

mental health promotion, substance abuse prevention, and substance abuse and mental health 

treatment interventions. 

Due to unanticipated delays, PQIS funding will be used for the continued implementation of 

SAMHSA’s Common Data Platform (CDP) which will provide a uniform collection and 

reporting system for SAMHSA management and staff with the ability to analyze programs at 

various levels (state, program, community, etc.), provide each Center with tailored information 

in real-time about the progress and activities of their grantees, and provide data to grantees to 

support them in the efficient and effective implementation of projects. Funding from PQIS also 

will fund the continuation of all three Center legacy programs (SAIS), (TRAC), and (DCAR) 

while the CDP is phased in.

Other SAMHSA activities related to the implementation of the Strategic Initiative on Data, 

Quality and Outcomes included the development of the National Behavioral Health Quality 

Framework, stemming from the National Quality Strategy recently released by the Agency for 

Healthcare Research & Quality (AHRQ) in cooperation with the Centers for Medicare & 

Medicaid Services (CMS) and the Office of the National Coordinator (ONC); and coordination 

with Health Information Technology efforts and Meaningful Use Measures for application in 

electronic health records, led by ONC and CMS. These activities will be substantially completed 

in FY 2014 and will move to regular operations beginning in FY 2015.
212

Budget Request 

In FY 2015, a total of $13.0 million is requested for Performance and Quality Information 

Systems, reflecting level funding relative to the FY 2014 Enacted Level. The increase of $13 

million in PHS Evaluation funds offsets the decrease of $13 million in Budget Authority to 

reflect the transfer to a different source of funding. These funds will be used to continue support 

for the Common Data Platform, which was awarded in late FY 2013 and implemented in FY 

2014, as well as provide support for the continuation of NREPP.
213

Key Outputs and Outcomes Table

Program: Performance and Quality Improvement Systems

Measure Year and Most 

Recent Result /

Target for 

Recent Result /

(Summary of 

Result)

FY 2014

Target

FY 2015

Target

FY 2015

Target

+/-

FY 2014

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 SAMHSAsupported data sets (Output)

FY 2013: 

2,298,46466

Target:

1,792,52367

(Target 

Exceeded)

1,882,14968 2,390,402 +508,253

4.4.11 Number of evidence-based programs or practices 

in review (Output)

FY 2013: 6169

Target:

46

(Target 

Exceeded)

48 55 +7

 

66There is no delay between fiscal year funding and the performance year.

67Reduction in target reflects a change in the data collection methodology.

68Reduction in target reflects a change in the data collection methodology.

69There is no delay between fiscal year funding and the performance year.
214

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215

Agency-Wide Initiatives

(Dollars in thousands)

FY 2013

Final

FY 2014

Enacted

FY 2015

President's

Budget

FY 2015

+/- 

FY 2014

Agency-Wide Initiatives.................................................... $8,293 $45,695 $56,000 +$10,305

Military Families................................................................. 2,857 --- --- ---

Behavioral Health Workforce.............................................. 5,436 45,695 56,000 +10,305

Minority Fellowship Program (non-add) ...................... 5,436 10,695 10,000 -695

Minority Fellowship Program - Base (non-add) 1/.... 5,436 5,436 5,000 -436

Minority Fellowship Program - Youth (non-add)....... --- 5,259 5,000 -259

Peer Professional Workforce Development (non-add)... --- --- 10,000 +10,000

SAMHSA-HRSA BHWET Grant Program (non-add)...... --- 35,000 35,000 ---

Behavioral Health Workforce Data and Development 

(non-add)....................................................................... --- --- 1,000 +1,000

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

*Totals may not add due to rounding.

1 /The Minority Fellowship Program budgets from the MH, SAP, and SAT appropriations are reflected under the Workforce 

initiative.

Authorizing Legislation ...........Section 501, 509, 516, and 520A of the Public Health Service Act

FY 2015 Authorization .........................................................................................................Expired

Allocation Method ..........................................................................Discretionary Grants, Contracts

Program Description and Accomplishments

Behavioral Health Workforce

Minority Fellowship Program

As SAMHSA implements the Leading Change 2.0 Strategic Initiatives for 2015 - 2019, the new 

Strategic Initiative on Workforce provides the opportunity for a concerted focus on developing 

the behavioral health workforce. In order to increase the visibility of this issue and to manage 

and administer our workforce programs more efficiently, SAMHSA is moving the Minority 

Fellowship Programs (MFP) to an Agency-Wide Initiative. The focus on building the 

components of the mental health, substance use prevention and substance use treatment 

workforce will be maintained through a strengthened collaboration. 

Through a partnership among SAMHSA’s CMHS, CSAP and CSAT, the MFP program 

increases behavioral health practitioners’ knowledge of issues related to prevention, treatment 

and recovery support for mental and substance use disorders among racial and ethnic minority 

populations. Additionally, it aims to improve the quality of mental and substance use disorder 

prevention and treatment delivered to ethnic minorities by providing stipends to post-graduate 

students. This funding will increase the number of culturally competent behavioral health 

professionals who teach, administer, conduct services research, and provide direct mental 
216

health/substance abuse services to underserved minority populations. Since its start in 1973, the 

Minority Fellowship Program has helped to enhance services to minority communities through 

specialized training of mental health professionals in psychiatry, nursing, social work, and 

psychology, and since 2006, marriage and family therapists. These individuals often serve in 

key leadership positions in mental and substance use disorder services, services supervision, 

services research, training, and administration. In FY 2012, SAMHSA received additional 

funding to increase the pool of culturally competent mental health professions eligible to receive 

funds through this program to include professional counselors. In FY 2013 and in FY 2014, 

SAMHSA anticipates funding all MFP continuation grants. 

Minority Fellowship Program Expansion – Youth (MFP-Y) and Addiction Counselors

The Minority Fellowship Program Expansion - Youth (MFP-Y) provides stipends to graduate 

students to increase the number of culturally competent behavioral health professionals who 

provide direct mental and/or co-occurring substance use disorder services to underserved 

minority populations. MFP-Y would utilize the existing infrastructure of the MFP to expand the 

focus of the program to support master’s level trained behavioral health providers in the fields of 

psychology, social work, professional counseling, marriage and family therapy, and nursing. 

This support would increase the number of providers who are available to provide clinical 

services to underserved, at-risk children, adolescents, and populations transitioning to adulthood 

(ages 16 – 25) in an effort to increase access to, and quality of, behavioral health services for this 

age group. 

In FY 2014, SAMHSA also will award grants to entities providing training to Master’s level 

addictions counselors. Because these funds are part of the President’s Now is the Time initiative, 

there will be an emphasis on providing clinical services to underserved, at-risk children, 

adolescents, and populations transitioning to adulthood (ages 16 – 25). These grants will support 

graduate student stipends to increase the number of Masters level addiction counselors across the 

nation by approximately 300 counselors. Some portion of the funds will support evaluation and 

technical assistance for these new MFP grantees.

SAMHSA-HRSA Behavioral Health Workforce Education and Training Grant Program

SAMHSA in collaboration with HRSA will continue the Behavioral Health Workforce 

Education and Training (BHWET) Grant Program, which will increase the clinical service 

capacity of the behavioral health workforce by supporting training for Master’s level social 

workers, psychologists, marriage and family therapists, psychology doctoral interns, as well as 

behavioral health paraprofessionals. This effort is critical to ensure that the behavioral health 

workforce is able to meet the needs of high need and high demand populations, including rural, 

vulnerable, and underserved populations. In FY 2014, the program will include an emphasis on 

training to address the needs of children, adolescents, and transition-age youth (ages 16-25) and 

their families. The SAMHSA-HRSA BHWET grant program will help increase the behavioral 

health workforce by 3,500 individuals.
217

Budget Request

SAMHSA requests $56 million for Agency-Wide Initiatives reflecting an increase of $10.3 

million from the FY 2014 Enacted Level.

This increase will fund:

 $56 million for Behavioral Health Workforce, which is an increase of $10.3 million 

above the FY 2014 Enacted Level. As described in detail below, funding increases of $1 

million will fund the Behavioral Health Workforce Data and Development to develop 

consistent data set to define and track the behavioral workforce and $10 million will fund 

Peer Professional Workforce Development with an offset of a $0.7 million reduction in 

Minority Fellowship Program.

Peer Professional Workforce Development

In FY 2015, SAMHSA proposes to implement a program to strengthen the behavioral health 

workforce by increasing the number of trained peers, recovery coaches, mental health/addiction 

specialists, prevention specialists, and pre-Master’s level addiction counselors working with an 

emphasis on youth ages 16-25. Because of their lived experience with behavioral health 

conditions, and being able to build trust and foster connections with individuals accessing care, 

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

support services. SAMHSA plans to award up to 19 grant awards to community colleges or 

community college networks, states, and national organizations. These funds will provide tuition 

support and further establish the capacity of community colleges to develop and sustain 

behavioral health paraprofessional training and education. Funding will increase the behavioral 

health workforce by 1,200 peer professionals.

The Behavioral Health Workforce Education and Training (BHWET) will focus on supporting 

clinical internships and field placements, and certificate program completion across a range of 

professional and paraprofessional disciplines (some of whom may be peers) to produce a ready 

cohort of new behavioral health providers. The Peer Professional Workforce Development 

program focuses exclusively on peers, or people with personal experiences with mental illness 

and/or substance use conditions. Peers may play roles across the spectrum of prevention, 

treatment and recovery/family support. The Peer Professional program will award grants to 

community colleges, community college networks, states, and national organizations in order to 

develop the training infrastructure for peer professionals nationwide. 

Behavioral Health Workforce Data and Development

Beginning in 2014, over 62 million Americans will have expanded or first time access to 

coverage for services for mental and substance use disorders as a result of a combination of the 

Affordable Care Act and the Mental Health Parity and Addictions Equity Act. Almost 11 

million of these individuals are expected to have mild to severe mental health and/or substance 

abuse conditions with related treatment needs. Current data indicate that almost 90 percent of 
218

persons with substance abuse issues do not receive the services they need and over half of those 

with mental disorders do not receive needed treatment. 

SAMHSA received $40 million in new behavioral health workforce activities in the FY 2014 

Appropriation. This budget assumes continuation of those programs to develop approximately 

5,000 new behavioral health clinical professionals. To ensure the existing workforce 

investments are responsible and well-targeted, SAMHSA’s FY 2015 budget proposes $1 million

to partner with HRSA on the Behavioral Health Minimum Data Set to develop consistent data 

collection methods to identify and track behavioral health workforce needs as well as to partner 

with the Department of Defense, and the Department of Veterans Affairs to inventory existing 

and emerging workforce issues, efforts and impacts, and develop coordinated plans.
219

SAMHSA

Center for Behavioral Health Statistics and Quality (CBHSQ)

Table of Contents

1. SAMHSA/Center for Behavioral Health Statistics and Quality (CBHSQ).......................... 221

2. Surveillance and Data Collection.......................................................................................... 224

3. Evaluation ............................................................................................................................. 228

4. Statistical and Analytic Support............................................................................................ 229

5. Services Systems Research ................................................................................................... 229

6. Performance and Quality Information Systems.................................................................... 230
220

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221

SAMHSA/Center for Behavioral Health Statistics and Quality (CBHSQ)

(Dollars in thousands)

FY 2013 

Final

FY 2014 

Enacted

FY 2015

President's 

Budget

FY 2015

+/- 

FY 2014

Substance Abuse Treatment Appropriation

Substance Abuse Block Grant (SABG) Set Aside

PHS Evaluation Funds

NSDUH $40,087 $42,709 $41,012 -$1,697

Analytic Support Center (ASC) (formerly NAC) 2,563 --- 1,000 +1,000

BHSIS (formerly DASIS) 13,182 --- 1,291 +1,291

SAMHDA/Data Archive 1,294 1,291 1,291 ---

Community Behavioral Health Data Initiative 136 7,342 7,500 +158

C-EMS (non-add) 136 3,000 --- -3,000

SEDSS (formerly DAWN) (non-add) --- 4,000 4,500 +500

PSTAR (non-add) --- 342 3,000 +2,658

Data Collection and Evaluation Activities --- 1,020 --- -1,020

Operations --- 270 202 -68

 FTE Payroll 2,183 6,591 5,371 -1,220

Subtotal, PHS Evaluation Funds 59,445 59,223 57,667 -1,556

Budget Authority

NSDUH --- --- 601 +601

Community Behavioral Health Data Initiative --- 458 --- -458

PSTAR (non-add) --- 458 --- -458

FTE/Operations 432 --- --- ---

Subtotal, Budget Authority 432 458 601 +143

Subtotal, SABG Set Aside $59,877 $59,681 $58,268 -$1,413

Health Surveillance and Program Support Appropriation

Health Surveillance

 Budget Authority 

NSDUH 2,066 5,417 --- -5,417

Common Data Platform (CDP) 583 --- --- ---

Grantee Data Development TA --- 5,000 --- -5,000

Analytic Support Center (ASC) (formerly NAC) 483 2,000 --- -2,000

Data Collection and Evaluation Activities --- 2,078 --- -2,078

Operations 128 2,505 --- -2,505

Subtotal, Budget Authority 3,260 17,000 --- -17,000

PHS Evaluation Funds

NSDUH 2,536 --- --- ---

 NREPP 2,382 --- --- ---

 BHSIS (former DASIS) 3,813 21,000 17,028 -3,972

Common Data Platform (CDP) 3,854 --- --- ---

CDP Legacy Program (SAIS and TRAC) 8,299 --- --- ---

CBHSQ Logistics (formerly NAC) --- 1,000 1,000 ---

Science of Changing Social Norms: Building the Evidence Base --- --- 2,000 +2,000

Community Behavioral Health Data Initiative 2,000 --- --- ---

SEDSS (formerly DAWN) (non-add) 2,000 --- --- ---

Data Collection and Evaluation Activities --- 3,277 1,442 -1,835

Operations --- 988 960 -28

FTE Payroll 4,544 4,163 6,998 +2,835

Subtotal, PHS Evaluation Funds 27,428 30,428 29,428 -1,000
222

FY 2013 

Final

FY 2014 

Enacted

FY 2015

President's 

Budget

FY 2015

+/- 

FY 2014

Prevention and Public Health Fund

Analytic Support Center (ASC) (formerly NAC) --- --- 1,000 +1,000

 CDP Legacy Program (DCAR) 3,505 --- --- ---

 NSDUH 10,121 --- 11,113 +11,113

 BHSIS (former DASIS) --- --- 2,681 +2,681

 NREPP --- --- 1,600 +1,600

Community Behavioral Health Data Initiative 500 --- 3,000 +3,000

C-EMS (non-add) 500 --- 3,000 +3,000

 Operations 606 --- 606 +606

Subtotal, Prevention and Public Health Fund 14,733 --- 20,000 +20,000

Subtotal, Health Surveillance 45,421 47,428 49,428 +2,000

Performance and Q uality Information Systems (PQ IS)

Budget Authority

NREPP --- 3,500 --- -3,500

Common Data Platform (CDP) --- 1,400 --- -1,400

CDP Legacy Program (SAIS and TRAC) --- 4,000 --- -4,000

 CDP Legacy Program (DCAR) --- 3,000 --- -3,000

Community Behavioral Health Data Initiative 4,250 --- --- ---

C-EMS (non-add) 2,500 --- --- ---

SEDSS (formerly DAWN) (non-add) 1,750 --- --- ---

Materials Development 476 --- --- ---

Content Migration 2,399 --- --- ---

Innovation and Logistical Services Support 1,075 --- --- ---

Operations 603 1,096 --- -1,096

Subtotal, Budget Authority 8,803 12,996 --- -12,996

PHS Evaluation Funds

NREPP --- --- 400 +400

Common Data Platform (CDP) --- --- 5,000 +5,000

Grantee Data Development TA --- --- 4,000 +4,000

Data Collection and Evaluation Activities --- --- 1,213 +1,213

Operations --- --- 2,383 +2,383

Subtotal, PHS Evaluation Funds --- --- 12,996 +12,996

Subtotal, PQ IS 8,803 12,996 12,996 ---

Agency-Wide Inititatives

PHS Evaluation Funds

Behavioral Health Workforce Data and Development --- --- 1,000 +1,000

Subtotal, Agency-Wide Initiatives --- --- 1,000 +1,000

Subtotal, Health Surveillance and Program Support 54,225 60,424 63,424 +3,000

Total, CBHSQ $114,102 $120,105 $121,692 +$1,587
223

Resources by Activity

(Dollars in thousands)

FY 2013 

Final

FY 2014 

Enacted

FY 2015 

President's 

Budget

FY 2015

+/-

FY 2014

CBHSQ Activities

NSDUH ................................................................................

$54,811 $48,126 $52,726 +$4,600

DASIS/BHSIS........................................................................ 16,995 21,000 21,000 ---

CBHSQ Logistics and Analytic Support Center (formerly 

NAC)..................................................................................... 3,046 3,000 3,000 ---

SAMHDA/Data Archive ........................................................ 1,294 1,291 1,291 ---

Common Data Platform (CDP)................................................ 4,437 1,400 5,000 +3,600

Grantee Data Development TA................................................ --- 5,000 4,000 -1,000

CDP Legacy Programs (DCAR).............................................. 3,505 3,000 --- -3,000

CDP Legacy Programs (SAIS and TRAC)............................... 8,299 4,000 --- -4,000

NREPP.................................................................................. 2,382 3,500 2,000 -1,500

Science of Changing Social Norms: Building the Evidence Base. --- --- 2,000 +2,000

Community Behavioral Health Data Initiative............................ 6,886 7,800 10,500 +2,700

C-EMS (non-add)............................................................. 3,136 3,000 3,000 ---

SEDSS (formerly DAWN) (non-add)................................. 3,750 4,000 4,500 +500

PSTAR (non-add).............................................................. --- 800 3,000 +2,200

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

Materials Development............................................................ 476 --- --- ---

Content Migration.................................................................... 2,399 --- --- ---

Innovation and Logistical Services Support................................ 1,075 --- --- ---

Data Collection and Evaluation Activities.................................. --- 6,375 2,655 -3,720

Operations.............................................................................. --- 4,859 4,151 -708

FTE Payroll............................................................................. 3,824 10,754 12,369 +1,615

Total, CBHSQ $109,430 $120,105 $121,692 +$1,587

 Center for Behavioral Health Statistics and Quality

FY 2015 CJ Breakout by Activity

 (Dollars in thousands)

Authorizing Legislation ...........................................Sections 501, 505, 1911, 1921 of the PHS Act

FY 2015 Authorization .........................................................................................................Expired

Allocation Method ............................................................................................................. Contracts
224

Program Description and Accomplishments

In FY 2015, SAMHSA will focus on strengthening and streamlining efforts begun in FY 2011 to 

improve data, outcomes, and quality by realigning of a number of data and analytic activities 

within the Center for Behavioral Health Statistics and Quality (CBHSQ). By creating an 

integrated data strategy and a national framework for quality improvement in behavioral 

healthcare, CBHSQ helps inform policy, measure program impacts, and has led to improved 

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

This realignment improves accountability and transparency in the development and 

dissemination of information to support this behavioral health care transformation. 

There continue to be five major functions coordinated through CBHSQ that provide significant 

support to SAMHSA’s integrated data strategy; surveillance and data collection; evaluation; 

statistical and analytic support; service systems research; and performance and quality 

information systems. CBHSQ also supports SAMHSA’s efforts to increase public access to 

data.

In FY 2013, CBHSQ ended or modified several contracts to achieve greater efficiency. This was 

the culmination of a comprehensive review of SAMHSA’s contracts conducted in FY 2011 

which determined that many mission-critical contracted activities would be less expensive to 

accomplish by-insourcing. For CBHSQ, this resulted in hiring approximately 36 positions. 

To meet the growing evaluation and data request and needs of SAMHSA, CBHSQ has proposed 

to phase-in taking over support for its full complement of 78 FTEs over FY 2014, FY 2015, and 

FY 2016. This will allow CBHSQ to better manage its resources and plan for long-term 

evaluation and data projects. While SAMHSA as a whole remains flat, CBHSQ proposes to hire 

additional FTEs in response to growing responsibility for providing data support needs within 

the agency. These FTEs include staff that will be assigned to support the Grantee Data 

Technical Assistance (TA) project, State data TA support, additional data collection activities 

across the public behavioral health surveys supported within CBHSQ, and one additional support 

staff.

Surveillance and Data Collection

SAMHSA manages a number of critical behavioral health data systems for HHS that provide 

high quality data on the incidence and prevalence of mental and substance use disorders, the use 

of emergency and specialty care, and more recently local indicators of behavioral health status of

communities.

National Surveillance and Data Collection

The National Survey on Drug Use and Health (NSDUH) serves as the nation’s primary source 

for information on the incidence and prevalence of substance use and mental illness and related 

health conditions. A new NSDUH contract was awarded in FY 2013 that will support the 2014, 

2015, 2016, and 2017 annual surveys, pending the availability of funds. NSDUH’s anticipated 

funding in FY 2013 was $54.8 million. In FY 2014, funding for NSDUH and NSDUH-related 
225

activities is expected to be $48.1 million. In addition to those amounts, CMHS provides 

approximately $1 million a year for NSDUH to support mental health related data collection. 

Building on the findings from a study commissioned by SAMHSA from the National Center for 

Health Statistic/Centers for Disease Control (NCHS/CDC), CBHSQ will begin to develop and 

test methods to produce credible estimates of Serious Emotional Disturbance (SED) within the 

NSDUH survey framework. In addition, CBHSQ will partner with ASPE and the Institute of 

Medicine (IOM) to provide a comprehensive review and to make recommendations for 

integrating the full-range of behavioral health conditions (mental health and substance abuse) 

into the NSDUH. Also, in response to Congressional recommendation, SAMHSA will explore 

options for incorporating Puerto Rico, the U.S. Virgin Islands and U.S. Pacific jurisdictions into 

the NSDUH data collection efforts.

Behavioral Health Services Information System (BHSIS) 

(formerly Drug Abuse Services Information System/ Behavioral Health Services Information System)

In FY 2013, SAMHSA modified the current Drug Abuse Services Information System (DASIS) 

contract to become the new Behavioral Health Services Information System (BHSIS). DASIS 

was the primary source of data on substance abuse treatment facilities and treatment admissions. 

One aspect of this program is the treatment locator, which is accessed more than two million 

times a year by individuals, families, community groups, and organizations to identify 

appropriate treatment services. SAMHSA will post a new up-to-date Behavioral Health 

Treatment Services Locator that will provide integrated, accurate, timely, and regularly updated 

information on mental health and substance abuse treatment facilities across the country. 

CBHSQ will also explore during the coming year the potential for integrating both 

buprenorphine providers and health center locator information into the current treatment locator 

efforts. The BHSIS project completed a pilot study of a new approach to integrating a mental 

health treatment admissions data set with its counterpart in substance abuse. The feasibility of 

expanding this approach to a broader group of states and the incorporation of new datasets to be 

made available through advances in Health Information Technology (HIT) will be studied as part 

of the 2013 contract modification funded by both CBHSQ and the Center for Mental Health 

Services (CMHS). SAMHSA will be working closely with stakeholders including NASADAD,

NASMHPD, and our state partners in the development and implementation of this integration 

effort which includes identifying metrics for reporting. In addition, SAMHSA will conduct 

coordinated substance abuse and mental health facility surveys in FY 2014. Funding from 

CBHSQ in FY 2013 and FY 2014 provides for $17.0 million and $21.0 million respectively for 

BHSIS. In addition, CMHS will provide $7.1 million in FY 2013 and $7.5 million in FY 2014 

for BHSIS. 

Community Behavioral Health Data Initiative (CDI)

Data collected from local communities are used to deliver programs and services are an 

important component of a strong public health infrastructure. Much of SAMHSA’s current data 

effort is captured and reported at the national or state level. Information on the health and 

behavioral health at the community level serves to identify current and emerging problems and 

highlight opportunities for progress that may vary from larger geographical areas. Importantly, 

when communities have access to surveillance data over time, prevention can happen. 
226

Communities using data can identify what the issues may be and then direct targeted prevention 

efforts at the vulnerable populations in their communities. Under the new Community 

Behavioral Health Data Initiative (CDI) structure, SAMHSA will more closely coordinate three 

separate existing data efforts, the Community Early Warning and Monitoring Systems (C-EMS), 

SAMHSA’s Emergency Department Surveillance System (SEDSS) (formerly the Drug Abuse 

Warning Network (DAWN)), and the Program Studies on Treatment and Recovery (PSTAR), to 

create new opportunities for cross-agency and public-private partnerships to address critical 

public health questions and more effectively utilize existing or declining resources. Data from 

this coordinated initiative can be combined with data from other Agencies such as CMS and 

AHRQ, and then be reported by regional and community type. Use of these data will allow 

communities to identify service and program needs specific to the local community. Moreover, 

the longitudinal nature of these data will allow those evaluating the effectiveness of services and 

policies in a community to measure the impact and outcomes of those interventions. SAMHSA 

will continue to examine where in-sourcing additional staff and collaborations with other 

agencies can support this effort while maximizing limited resources and cost-efficiencies.

The nature and approach to the collection and reporting of these community level data may 

change as efforts in FY 2013 and FY 2014 suggest the best methods and as the amount of 

available resources is known.

Community Early Warning and Monitoring System (C-EMS)

The foundation of SAMHSA’s community-based work begun in the Community Early Warning 

and Monitoring System (C-EMS) provides the basis for community data development in FY 

2014 and beyond. With federal partners, CBHSQ will further develop the data system begun in 

FY 2012 in collaboration with the Agency for Healthcare Research and Quality (AHRQ) of 

community level data collection related to emergency departments. This expanded collaboration 

will engage additional federal partners (United States Department of Agriculture and National 

Institute of Environmental Health Sciences) to apply data from resources at the local, state and 

national level to populate a database available to communities to develop data tables and reports 

for use in surveillance of the behavioral health status of local communities. Moreover, CBHSQ 

will consider developing data toolkits with survey measures and instructions in the use of these 

measures, as well as technical assistance in sampling and survey deployment, to assist 

communities interested in conducting local behavioral/public health surveillance. These data 

may be uploaded to a community behavioral health database that SAMHSA and contributing 

communities may use to understand community behavioral health needs and changes over time.

In FY 2013, CBHSQ provided $2.5 million and plans to provide $3.0 million in FY 2014 to 

expand their current IAA with United States Department of Agriculture (USDA)/National 

Institute of Food and Agriculture (NIFA) to develop and collect community-level data through 

their cooperative extension programs.

SAMHSA’s Emergency Department Surveillance System (SEDSS)

Emergency Department (ED) data remains an important component of public health data because 

it provides a picture of the most urgent health, and more specifically behavioral health issues in 

the community. ED data is an excellent tool for monitoring trends in mental and substance use 
227

disorders and related conditions, and when examined across the nation, provides important 

surveillance for targeting emerging behavioral health issues. As the SAMHSA Emergency 

Department Surveillance System (SEDSS) transitions to a more community specific face, ED 

data can provide a summary of visits by patients with mental health conditions, domestic 

violence, substance use problems, and trauma. In FY 2012, SAMHSA partnered with the 

National Center for Health Statistics (NCHS)/CDC through an Interagency Agreement (IAA) to 

integrate components of the Drug Abuse Warning Network (DAWN) data collection into the 

emergency department (ED) component of the National Hospital Care Survey (NHCS). DAWN 

served as the nation’s public health surveillance system that monitored drug abuse related ED 

visits. By collaborating with NCHS, SAMHSA has an opportunity to understand more 

comprehensively the nature and course of behavioral health presentations to EDs. Thus, 

SAMHSA’s Emergency Department Surveillance System (SEDSS), which will replace the Drug 

Abuse Warning Network (DAWN), will collect ED visit information on both mental and 

substance use disorders. The development of the SEDSS started when CBHSQ provided $5 

million to NCHS in FY 2012 for planning and development. CBHSQ added $3.8 million to the 

activity in FY 2013 for continued development and to expand the implementation in FY 2014 

will add another $4.0 million to the IAA to fully implement data collection efforts. As SEDSS 

continues, SAMHSA will also consider collaboration with CMS hospital data efforts to increase 

participation or maximize resources. 

Program Studies on Treatment and Recovery (PSTAR)

With the implementation of health reform, behavioral health and primary care service networks 

can expect significant changes in terms of how the mix of services are financed, changes in the 

locus of behavioral health and primary care services, and an increase in certain populations with 

mental and substance use disorders that had not previously been treated in primary care and 

behavioral health specialty programs (e.g., veterans, youth involved in the criminal justice 

system, and individuals with co-occurring mental health, substance use, and physical health 

conditions). 

It is likely that in changing the health care financing landscape, the care delivery network will 

expand into new settings including proprietary, private, and quasi-public partnerships. As well, 

lines between for profit and not-for-profit may blur. Because of these and other changes that will 

occur, there is an expectation of greater diversity among those seeking care. In FY 2014, 

SAMHSA expects to award a new contract that will monitor the impact of organizational, 

financing, and management strategies as they change or impact the population of individuals 

requiring behavioral health care. Of special interest is furthering an understanding of how these 

local variations impact special populations of interest (e.g., veterans, minorities, individuals with 

co-occurring conditions). 

It is expected that PSTAR will become a public health resource that works in concert with the 

other data initiatives under the Community Behavioral Health Data Initiative as well as the 

National Survey of Drug Use and Health, other facility data systems, and ongoing analytic 

projects within the Center for Behavioral Health Statistics and Quality to respond to critical 

questions related to health reform implementation, parity, program effectiveness, financing, and 

access. In FY 2014, CBHSQ will provide $0.8 million for planning and development activities. 
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Data Collection and Evaluation Activities

In FY 2014, CBHSQ will provide $6.4 million in funding for data collection and evaluation 

activities, including an evaluation of the Primary Behavioral Health Care Integration (PBHCI) 

program, pilot implementation of a data room for use by agency research staff to access 

confidential data in a secure environment, and a pilot study to collect behavioral health data from 

electronic health records. 

Evaluation

Consistent with the Administration’s increased emphasis on the use of rigorous and independent 

program evaluation to determine if programs achieve intended outcomes at a reasonable cost, 

SAMHSA will continue to support the systematic collection of data to assess its investments in 

discretionary and block grant programs. The evaluation policy was finalized in early 2012. In 

late 2012, CBHSQ conducted a review of all evaluation activities. This process helped 

SAMHSA identify current evaluations which could be enhanced or improved with support from 

in-house evaluation expertise. For all new program activity in which an evaluation is proposed, 

CBHSQ meets with program staff and the SAMHSA Evaluation Team (SET) to gather 

information about planned evaluation activities, program objectives, and budget estimates for 

evaluation. During this period, CBHSQ reviews the planned grant or contract language to ensure 

there is sufficient description of evaluation and data collection plans. CBHSQ’s roles vary, and 

may include: 1) conducting an evaluation; 2) co-directing an evaluation using a contractor to 

gather data and assist with report writing; or 3) serving as a consultant as needed on evaluations 

that are directed by an originating Center within SAMHSA. CBHSQ has been actively engaged 

in evaluation design and implementation in FY 2013. In FY 2014, CBHSQ will continue 

implementation of the evaluation guidance and begin providing training in evaluation design to 

relevant SAMHSA staff.

Through its evaluation guidance, SAMHSA proposes to expand its efforts to improve the quality 

of information on behavioral health investments by:

 providing uniform standards for evaluations;

 supporting rigorous evaluation designs;

 building a cadre of trained evaluators to oversee evaluations; 

 providing a structure to assess environmental contexts that promote or impede program 

effectiveness;

 allowing for designs that enable adaptation and adjustments in the implementation 

process; 

 producing timely results for decision makers; and 

 creating an accessible, central repository for information related to SAMHSA 

evaluations.
229

Statistical and Analytic Support

Funding is requested for a number of activities to support a broad range of analytic work to be 

carried out in the CBHSQ. These activities include support for an Analytic Support Center 

(ASC) which undertakes a number of scientific and writing tasks on policy and practice-related 

topics in response to requests from SAMHSA Centers and related components, HHS agencies 

(CDC, AHRQ, and FDA), the Surgeon General’s Office, the Office of National Drug Control 

Policy, and the Department of Justice. FY 2013 and FY 2014 funds $3.0 million for the Analytic 

Support and CBHSQ’s Logistics contracts (formerly the National Analytic contracts).

Funding will also support the ongoing Substance Abuse and Mental Health Data Archive 

(SAMHDA) which serves as SAMHSA’s primary repository for public access data files. 

Funding for SAMHDA in both FY 2013 and FY 2014 was $1.3 million. SAMHDA provides 

free access and on-line analytic tools to the public. Resources will also be used to sustain a 

program for providing limited public access to files restricted for privacy or other reasons, 

serving to expand the use and application of data collected under the survey contracts. 

Finally, funding will be utilized to continue the support of positions focused on analyzing and 

reporting on data collected within CBHSQ, SAMHSA and HHS, as well as identifying and 

analyzing information from other data sets that may help inform the work of SAMHSA. Staff 

will also respond to requests for data and explanations of existing data points, prepare internal 

reports, support SAMHSA staff in the development of materials that require statistical 

information, and prepare short reports, data spotlights, and manuscripts for publication. These 

staff support data needs by serving on workgroups that require data analysis as part of their 

function and will prepare data requests for departmental activities. Particularly important is the 

inclusion of a new Health Economics and Financing Team that will focus on studies related to 

cost and financing trends as health care delivery models change over the next several years. 

Some of these positions have been created by in-sourcing tasks that are most appropriately done 

by federal staff, are less expensive than contract staff and/or are mission critical and thus 

improve SAMHSA’s capacity to respond to data and information needs relevant to SAMHSA’s 

mission.

The SAMHSA appropriations language in FY 2014 included authority to collect fees to offset 

the cost of publications or analyses of these data that would otherwise not be done within 

existing SAMHSA resources and which are requested by proprietary or other private or public 

entities that are interested in additional data analyses that SAMHSA’s Data Request and 

Publication User Fees could provide if funds were available. 

Services Systems Research

Building on efforts begun in FY 2011, and continued through FY 2014, SAMHSA proposes to 

continue to build its practice-based service systems research program which complements efforts 

in its sister agencies of National Institutes of Health (NIH), AHRQ, and CDC in FY 2014 and 

FY 2015. This will provide pilot data for full-scale research proposals to NIH or other practice 

settings in which to test models being developed through these agencies’ research efforts. The 

program will focus on critical gaps in knowledge about prevention, wellness, treatment, and 
230

recovery services for individuals, families, and communities at risk for or suffering from mental 

illnesses, addictions, and related chronic conditions. Of particular interest to SAMHSA are 

issues of quality, cost, access to, and outcomes of behavioral health services both in the primary 

and specialty care service sectors. Significant attention will be given to developing analyses that 

enhance understanding of the economic and cost implications of changes in health insurance 

access for behavioral health care within the larger SAMHSA analytic agenda coordinated 

through CBHSQ. A team of health economists and health services researchers are specifically 

focused on cost and finance studies related to behavioral health.

Performance and Quality Information Systems

Continued funding is requested for performance and quality information systems to phase in the 

implementation of SAMHSA’s Common Data Platform (CDP), which was awarded in late FY 

2013. The CDP will provide a uniform collection and reporting system providing SAMHSA 

management and staff with the ability to analyze programs at various levels (state, program, 

community, etc.); provide each Center with tailored information about the progress and activities 

of grantees; and provide data to grantees to support them in the efficient and effective 

implementation of projects. 

During 2013 and 2014, SAMHSA will be working closely with NASADAD, NASMHD, and 

state partners to identify, refine, and test measures that, where possible, build upon current 

efforts within states. Moving forward, SAMHSA is committed to harmonizing measures across 

data collection programs in a way that reduces burden, increases the quality of data collected, 

and provides necessary information to measure performance and manage grants. CBHSQ staff 

has worked closely with the HHS Measures Policy Council and the National Quality Forum to 

ensure that SAMHSA expertise informs the field of behavioral health quality measure alignment, 

development, and implementation. These efforts will continue in the rapidly changing measures 

environment.

Funding is also requested for the continuation of the National Registry of Evidence-based 

Programs and Practices (NREPP), a searchable online system that supports states, communities, 

and tribes in identifying and implementing evidence-based mental health promotion, substance 

abuse prevention, and substance abuse and mental health treatment interventions. This registry 

is comprised of mental health and substance abuse interventions that have been reviewed and 

rated by independent reviewers. Moreover, the registry assists the public in identifying 

scientifically based approaches to preventing and treating mental and/or substance use disorders 

that can be readily disseminated to the field. This program is one way that SAMHSA is working 

to improve access to information on tested interventions and thereby reduce the lag time between 

the creation of scientific knowledge and its practical application in the field. FY 2013 and FY 

2014 provided for $2.4 million and $3.5 million respectively for NREPP.
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Resource Summary

A total of $121.7 million is provided for CBHSQ, reflecting a $1.6 million increase above the 

FY 2014 Enacted Level. The FY 2015 resources of $121.7 million includes $57.7 million in 

Substance Abuse Prevention and Treatment Block Grant Set Aside (SABG-SA) PHS Evaluation 

Funds (a decrease of $1.5 million below FY 2014 Enacted Level), $0.6 million in SABG-SA 

Budget Authority (an increase of $0.1 million above FY 2014 Enacted Level), $0 in Health 

Surveillance and Program Support (HSPS) Budget Authority (a decrease of $17.0 million below

FY 2014 Enacted Level), $29.4 million in HSPS PHS Evaluation Funds (a decrease of $1.0 

million below FY 2014 Enacted Level), $20.0 million in Prevention and Public Health Fund (an 

increase of $20 million above the FY 2014 Enacted Level), $13.0 million in Performance and 

Quality Information Systems (PQIS) PHS Evaluation Funds (which includes a decrease of $13.0 

million in PQIS BA funds, but a $13.0 million increase in PQIS PHS Evaluation Funds for a net 

level funding from the FY 2014 Enacted Level), and $1.0 million in Agency-wide PHS 

Evaluation Funds (an increase of $1.0 million above the FY 2014 Enacted Level).

Modules in NSDUH

CBHSQ will explore optimal strategies to obtain data on recovery, trauma, and serious emotional 

disturbance among children which may include the use of topical modules, as part of the 

NSDUH. These data are important as they fill critical data gaps in these major areas of concern 

associated with behavioral health. CBHSQ will support part of this effort with $2 million in FY 

2015.

Trauma and Recovery Modules

CBHSQ will identify the best way to use NSDUH to address gaps in this important behavioral 

health national surveillance system. Once the conceptual, definitional, and operational aspects of 

trauma and recovery are determined, substantive areas of interest will be defined. These 

substantive areas will be translated into brief questionnaire modules that will be refined through 

a process of testing to include cognitive interviews and field tests. A plan for collecting the data, 

including a potential inclusion of questions in the NSDUH, should be ready for fielding by FY 

2017 or FY 2018. While these modules are defined, CBHSQ will identify additional 

opportunities to provide empirical data related to trauma and recovery.

Serious Emotional Disturbance

SAMHSA's authorization stipulates that the agency provide estimates of Serious Emotional 

Disturbance (SED) among children. A pilot study done jointly by SAMHSA, National Institute 

of Mental Health (NIMH), and the Centers for Disease Control (CDC), using CDC's National 

Health Interview Survey (NHIS) yielded important preliminary results that will guide future 

development. Using lessons learned from the NHIS SED pilot study, SAMHSA will extend the 

initial development of definitions and procedures, taking into account new mental disorder 

criteria specified in the Diagnostic and Statistical Manual – Fifth Edition (DSM-5). This will 

entail the development of a valid diagnostic clinical interview tool for children, determination of 
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an operational definition of serious emotional disturbance, and development of new sampling 

and interview techniques for NSDUH. 

Behavioral Health Workforce Data and Development 

The President’s Now is the Time Initiative, released in January 2013, proposed $50 million in 

new behavioral health workforce activities in SAMHSA’s FY 2014. The FY 2014 Enacted level 

was $40 million. The FY 2015 Budget includes all of the investments in the FY 2014 Enacted 

budget, and $11 million in new investments. In total, the $51 million for workforce investments 

will result in approximately 5,000 new behavioral health clinical professionals. To ensure the 

existing workforce investments are responsible and well-targeted, the overall increase of 

$11 million within SAMHSA for workforce activities includes $1 million within CBHSQ to 

partner with HRSA on the Behavioral Health Minimum Data Set to develop consistent data 

collection methods to identify and track behavioral health workforce needs as well as to partner 

with the Department of Defense, and the Department of Veterans Affairs to inventory existing 

and emerging workforce issues, efforts and impacts, and develop coordinated plans.

Because of the current lack of consistent and complete data, HRSA and SAMHSA began a 

minimum data set project in 2012 and 2013 to define and track the behavioral health service 

needs and workforce in the country. However, this effort needs additional support to continue 

and complete its goals. In FY 2015, SAMHSA proposes to work with HRSA to develop a 

consistent and common data set and to develop clear goals and objectives to meet the national 

behavioral health workforce needs in America.

Ensuring coordinated workforce strategies will benefit the specialty behavioral health sector as 

well as VA and DOD’s total workforce availability in the future. In FY 2015, SAMHSA 

requests $1.0 million to work with HRSA, DOD, and VA to track existing and emerging 

workforce trends, to inventory activities in public and private sectors, produce analysis of 

potential efforts and impacts, and proposals regarding creative actions for FY 2016 and beyond 

to address the critical behavioral health workforce needs of America.

Science of Changing Social Norms - Building the Evidence Base: $2 million, an increase of $2 

million in support of the President’s Now is the Time initiative to develop and test an array of 

messages and media designed to improve attitudes, understanding and behavior of Americans 

about mental and substance use disorders and willingness to seek help for them. This increase 

will be used to support the work begun by the White House National Conference on Mental 

Health, supporting the collection and use of data to learn if what and how we are communicating 

is making a positive difference. The increase funding represents the addition of this program that 

will support efforts to measure and track behavioral, attitudinal, and related community data to 

inform how we understand the impact of exposure to social messaging and demonstrate evidence 

for effecting behavioral change at the individual, community, and population levels. The data 

collection component of this effort will be led through SAMHSA’s Center for Behavioral Health 

Statistics and Quality and will be included in the CDI.
233

Major increases from the FY 2014 Enacted Level include the following activities:

 NSDUH: $52.7 million, an increase of $4.6 million. The increase funding represents 

survey technology purchases and the addition of the trauma, recovery, and serious and 

emotional disturbance among children modules that will be added to the NSDUH. 

 CDI: $10.5 million, an increase of $2.7 million. This increase supports the development 

and integration of the C-EMS, SEDSS, and PSTAR data collection programs (total does 

not include the Science of Changing Social Norms costs mentioned above).

 CDP: $5 million, an increase of $3.6 million from FY 2014 Enacted Level. The decrease 

to CDP in FY 2013 was due to the contract total cost coming in lower than expected. In 

FY 2014, due to a protest to the contract, the award of this contract was delayed until 

early 2014 and used FY 2013 funds. In FY 2014, this savings will be used to continue to 

fund the CDP-related Legacy programs. In FY 2015, the overall savings on the cost of 

the project, mentioned above, will be used to fund additional activities under the CDI and 

Grantee Data TA activities and to fund additional FTE’s for a data technical assistance 

team.

Major decreases in funding from the FY 2014 Enacted Level include the following activities:

 NREPP: $2 million, a $1.5 million decrease. The NREPP backlog will be handled in 

FY 2014 and a normal schedule resumes in FY 2015. 

 Grantee Data Development Technical Assistance: $4 million, a $1.0 million decrease. 

The initial ramping up of TA activities around development and implementation of 

measures, will taper off in year two, as states and grantees become familiar with the 

system and efficiencies are gained through lessons-learned.

 CDP Legacy - DCAR: $0, a decrease of $3.0 million from FY 2014 Enacted Level. Due 

to the later than expected start date of the CDP (due to protest) the phasing out of legacy 

system and implementation of the CDP are happening in FY 2014. CDP Legacy systems 

will still be funded in FY 2014 at prorated amounts and will be phased out fully in FY 

2015.

 CDP Legacy – SAIS and TRAC: $0, a decrease of $4.0 million from FY 2014 Enacted

Level. Due to the later than expected start date of the CDP (due to protest) the phasing 

out of legacy system and implementation of the CDP are happening in FY 2014. CDP 

Legacy systems will continue to be funded in FY 2014 at prorated amounts and will be 

phased out fully in FY 2015.
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235

DEPARTMENT OF HEALTH AND HUMAN SERVICES

Substance Abuse and Mental Health Services

(Dollars in thousands)

Drug Control Budget

RESOURCE SUMMARY

FY 2013 FY 2014 FY 2015

Final Enacted President's 

Budget

Drug Resources by Decision Unit and Function

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

Prevention1/ 175,513 175,560 185,560

Total, SAP PRNS $175,513 $175,560 $185,560

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

Treatment2/ 404,085 361,460 297,400

Total, SAT PRNS $404,085 $361,460 $297,400

Programs of Regional and National Significance 1 Substance Abuse Prevention and Treatment Block Grant

Prevention3/ 342,061 363,971 363,971

Treatment3/ 1,368,245 1,455,885 1,455,885

Total, SABG $1,710,306 $1,819,856 $1,819,856

Program Management Health Surveillance and Program Support

Prevention 4 21,105 24,337 21,265

Treatment 4 84,420 97,349 103,339

Total, HSPS $105,525 $121,686 $124,604

Total Funding $2,395,429 $2,478,562 $2,427,420

Total FTEs (direct only) 526 555 546

Total Agency Budget $3,354,461 $3,631,102 $3,567,871

Drug Resources Percentage 71.4% 68.3% 68.0%

Footnotes

3 The Substance Abuse Prevention and Treatment Block Grant is split 20% to the prevention function and 80% to the treatment function.

2 Includes funding from the Substance Abuse Treatment PRNS.

4 The Health Surveillance and Program Support Appropriation funded activities are split between Mental Health /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 subsequent Substance Abuse amounts are then divided into 20% 

for Prevention and 80% for Treatment.

Drug Resources Personnel Summary

Drug Resources as a Percent of Budget

1 Includes funding from the Substance Abuse Prevention PRNS.
236

Drug Budget Split between Prevention and Treatment FY 2013 - FY 2015

(Dollars in thousands)

Substance Abuse Prevention

FY 2013 

Final

FY 2014

Enacted

FY 2015 

President's 

Budget

Substance Abuse Prevention PRNS

Strategic Prevention Framework 107,902 109,754 119,754

 SPF Rx(PHS Evaluation Funds)(non-add) 10,000

Mandatory Drug Testing 5,252 4,906 4,906

Minority AIDS Initiative 40,996 41,307 41,307

Minority Fellowship Program --- --- ---

STOP Act 6,994 7,000 7,000

Fetal Alcohol Syndrome 1,104 1,000 1,000

Center for the Application of Prevention Technologies 8,098 7,511 7,511

 PHS Evaluation Funds (non-add) --- --- 6,468

Science and Service Program Coordination 5,168 4,082 4,082

Total, Substance Abuse Prevention PRNS $175,513 $175,560 $185,560

Substance Abuse Prevention and Treatment Block Grant 342,061 363,971 363,971

PHS Evaluation Funds (non-add) 15,840 15,840 15,840

Total, Substance Abuse Block Grant $342,061 $363,971 $363,971

Health Surveillance and Program Support

Health Surveillance 6,500 6,504 6,776

Prevention and Public Health Fund (non-add) 2,108 --- 2,742

PHS Evaluation Funds (non-add) 3,925 4,173 4,034

Program Support 11,162 9,974 9,970

Public Awareness and Support 1,355 1,357 1,557

PHS Evaluation Funds (non-add) --- --- 1,557

Performance and Quality Information Systems 1,260 1,782 1,782

PHS Evaluation Funds (non-add) --- --- 1,782

Agency Wide Initiatives 829 4,570 1,031

Data Request/Publication User Fees --- 150 150

Total, Substance Abuse Prevention HSPS $21,105 $24,337 $21,265

Total, Substance Abuse Prevention $538,679 $563,868 $570,796
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Substance Abuse Treatment

FY 2013 

Enacted

FY 2014

Enacted

FY 2015 

President's 

Budget

Substance Abuse Treatment PRNS

Opioid Treatment Programs/Regulatory Activities 8,421 8,746 8,746

PDMP HER Integration and Interoperability Expansion 4,000

Screening, Brief Intervention and Referral to Treatment 47,464 47,000 30,000

PHS Evaluation Funds (non-add) 2,000 2,000 30,000

TCE - General 26,516 13,256 15,256

Pregnant & Postpartum Women 15,634 15,970 15,970

Strengthening Treatment Access and Retention 1,584 1,668 1,000

Recovery Community Services Program 2,445 2,440 2,440

Access to Recovery 93,128 50,000 ---

Prevention and Public Health Fund (non-add) --- 50,000 ---

Primary Care and Addiction Services Integration (PCASI) --- --- 20,000

Children and Family Programs 29,018 29,678 29,678

Treatment Systems for Homeless 39,397 41,488 41,488

Minority AIDS 61,918 65,732 58,859

Criminal Justice Activities 63,558 75,000 64,446

Addiction Technology Transfer Centers 9,008 9,046 8,081

Special Initiatives/Outreach 1,992 1,436 1,436

Total, Substance Abuse Treatment PRNS $404,085 $361,460 $297,400

Substance Abuse Prevention and Treatment Block Grant 1,368,245 1,455,885 1,455,885

PHS Evaluation Funds (non-add) 63,360 63,360 63,360

Total, Substance Abuse Block Grant $1,368,245 $1,455,885 $1,455,885

Health Surveillance and Program Support

Health Surveillance 25,999 26,017 27,104

Prevention and Public Health Fund (non-add) 8,433 --- 10,967

PHS Evaluation Funds (non-add) 15,700 16,692 16,137

Program Support 44,646 39,896 39,881

Public Awareness and Support 5,418 5,428 6,228

PHS Evaluation Funds (non-add) --- --- 6,228

Performance and Quality Information Systems 5,039 7,129 7,126

PHS Evaluation Funds (non-add) --- --- 7,126

Agency Wide Initiatives 3,317 18,278 22,400

Data Request/Publication User Fees --- 600 600

Total, Substance Abuse Treatment HSPS $84,420 $97,349 $103,339

Total, Substance Abuse Treatment $1,856,750 $1,914,694 $1,856,624
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MISSION

The Substance Abuse and Mental Health Services Administration’s (SAMHSA) mission is to 

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

supports the President’s National Drug Control Strategy through a broad range of programs 

focusing on prevention, treatment and recovery from substance abuse. Major programs for 

FY 2015 will include the Substance Abuse Prevention and Treatment Block Grant, competitive 

grant programs reflecting Programs of Regional and National Significance (PRNS) and Health 

Surveillance and Program Support. These programs are administered through SAMHSA’s 

Centers for Substance Abuse Prevention (CSAP) and Substance Abuse Treatment (CSAT) as 

well as through SAMHSA’s Center for Behavioral Health Statistics and Quality (CBHSQ) and 

the Office of Communications.

METHODOLOGY 

SAMHSA distributes drug control funding into two functions: prevention and treatment. Both 

functions include a portion from the Health Surveillance and Program Support (HSPS) 

appropriation. 

In FY 2014, the HSPS portion of the drug budget was split as follows. Since the Performance 

Awareness and Support (PAS) and Performance and Quality Information Systems (PQIS) 

programs represented the consolidation of funding from existing CSAT, CSAP and Center for 

Mental Health Services (CMHS) programs, 50 and 70 percents, respectively, of funding for these 

activities were included in the drug budget representing the substance abuse portion between 

substance abuse and mental health for the entire agency. The 50 and 70 percents were then 

divided 20 percent/80 percent into the two functions, prevention and treatment, respectively. The 

Health Surveillance and Program Support activities within the HSPS appropriation were split 

first between mental health and substance abuse (as determined by each activity) and then the 

substance abuse portion was split 20 percent/80 percent between prevention and treatment. 

Agency-wide programs were evenly split between mental health and substance abuse and then 

the substance abuse portion was split the same 20 percent and 80 percent for prevention and 

treatment.

In FY 2015, the proportion of the Health Surveillance and Program Support account attributed to 

the Drug Budget has used updated calculations as follows: 

 The Health Surveillance, Program Support, and PQIS portions of the HSPS appropriation 

are 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. 

o The Substance Abuse portion is then split 20 percent/80 percent into the two 

functions, prevention and treatment, respectively. 
239

 The PAS and Agency-wide portions of the HSPS appropriation are first 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.

Also included in the prevention function are the funds in the Substance Abuse Prevention 

appropriation, including the Substance Abuse Prevention Programs of Regional and National 

Significance and 20 percent of the Substance Abuse Prevention and Treatment Block Grant 

funds from the Substance Abuse Treatment appropriation. 

Also included in the treatment function are the funds in the Substance Abuse Treatment 

appropriation, including the Substance Abuse Treatment Programs of Regional and National 

Significance and 80 percent of the Substance Abuse Prevention and Treatment Block Grant 

funds.

BUDGET SUMMARY

In FY 2015, SAMHSA requests a total of $2.427 billion for drug control activities, which is a 

decrease of $51.1 million from the FY 2014 Enacted Level. The Budget directs resources to 

activities that have demonstrated improved health outcomes and that increase service capacity. 

SAMHSA has three major drug-related decision units: Substance Abuse Prevention, Substance 

Abuse Treatment, and Health Surveillance and Program Support. Each decision unit is discussed 

below:

Substance Abuse Prevention 

Substance Abuse Prevention Programs of Regional and National Significance

Total FY 2015 Request: $185.6 million

(Reflects $10 million increase from FY 2014 Enacted Level)

The Substance Abuse Prevention Programs of Regional and National Significance (PRNS) 

support states and communities in carrying out an array of activities to improve the quality and 

availability of services in priority areas.

The FY 2015 President’s Budget request for SAMHSA Substance Abuse Prevention PRNS 

includes $185.6 million which covers seven programmatic activities, a decrease of $10 million 

from the FY 2014 Enacted Level. The request includes: $119.8 million for Strategic Prevention 

Framework; $41.3 million for Minority AIDS; $1.0 million for the Fetal Alcohol Spectrum 

Disorders (FASD) contract; $7.5 million to continue provision of technical assistance to 

maximize effectiveness through the Centers for the Application of Prevention Technologies; $4.9 

million for Mandatory Drug Testing; $7.0 million for other Sober Truth on Preventing Underage 

Drinking; and $4.1 million for Science and Service Program Coordination.
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Strategic Prevention Framework 

Total FY 2015 Request: $119.8 million

(Reflects $10 million increase from FY 2014 Enacted Level)

Partnerships for Success 

The Partnerships for Success (PFS) program was initiated in FY 2009 with the goals of reducing 

substance abuse-related problems; preventing the onset and reducing the progression of 

substance abuse; strengthening prevention capacity and infrastructure at the state and community 

levels in support of prevention; and leveraging, redirecting and realigning state-wide funding 

streams for substance abuse prevention. Eligible applicants are states and territories that have 

completed a SPF State Incentive Grant (SPF-SIG). In FY 2009, four grants were awarded, and 

in FY 2010, one additional award was made. The first two cohorts incorporated an incentive 

award to grantees that reached or exceeded their prevention performance targets (subject to 

availability of funds). In FY 2012, SAMHSA supported these efforts by awarding five 

continuation grants. The FY 2012 data from the first cohort reporting show that 50 communities 

increased the number of activities supported through collaboration and leveraging. Grantees 

reported implementing 888 evidence-based programs and thirty-two communities reported 

improvements on targeted National Outcome Measures indicators. Two of the three 

performance measures exceeded their targets. The vast majority of communities (88 percent) 

targeted alcohol use.

A new cohort of PFS grants began in FY 2012 to address two of the nation’s top substance abuse 

prevention priorities: underage drinking among youth aged 12 to 20 and prescription drug misuse 

and abuse among individuals aged 12 to 25. The program is based on the premise that changes 

at the community level will, over time, lead to measurable changes at the state and national level.

In FY 2012, SAMHSA awarded 15 new grants for three years. 

In FY 2013, SAMHSA supported continuation awards for the initial cohorts established in FY 

2009 and FY 2010. SAMHSA also made a new SPF SIG award to Idaho, the last state 

remaining to receive a SPF SIG and awarded 16 new PFS grants. In addition, SAMHSA made 

funds available for grantees in the first cohort who met their performance targets and were 

eligible for the incentive supplement.

 

In FY 2014, SAMHSA will award a new cohort of PFS grants. Similar to the previous cohorts, 

these grants will address two of the nation’s top substance abuse prevention priorities: underage 

drinking among youth age 12-20 and prescription drug misuse and abuse among individuals age 

12 to 25. The PFS program will focus on implementing the Strategic Prevention Framework to 

strengthen prevention capacity and infrastructure at the state, territorial, and community levels; 

preventing the onset and reducing the progression of substance abuse; and leveraging, 

redirecting, and aligning statewide funding streams and resources to focus on promoting 

evidence-based substance abuse prevention. Up to 34 grants will be awarded to eligible states, 

territories and tribes who have completed SPF-SIG. SAMHSA will also consider how best to 

help tribes committed to substance abuse prevention strengthen their existing service delivery 

systems and/or begin building the necessary infrastructure to successfully prevent substance 

abuse in their communities. 
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Of the remaining SPFSIG grantees, 88 percent reported decreases in underage drinking, 82 

percent of grantees reported decreases in drug use, 29 percent reported increased perceived risk 

of substance use and 901 evidence-based policies, practices, and strategies were implemented. 

Three of these four measures exceeded their targets.

In FY 2015, funding will support the continuation of grants and contracts as well as award a new 

cohort of PFS grants. Funding will also support the new activities mentioned below.

Building Behavioral Health Coalitions: 

Working to Address Shared Risk and Protective Factors

(Braided program with Mental Health: MH System Transformation and Health Reform)

In FY 2015, in support of SAMHSA’s Prevention of Substance Abuse and Mental Illness 

Strategic Initiative, SAMHSA proposes to use $3 million in Budget Authority to establish the 

Building Behavioral Health Coalitions program. SAMHSA will use $1.5 million from Mental 

Health Appropriation’s Mental Health Transformation and Health Reform funds and $1.5 million 

from Substance Abuse Prevention Appropriation’s Strategic Prevention Framework funds to 

support this new initiative. The purpose of this program is to support active community 

coalitions and/or organizations to expand their focus and activities to include mental health 

promotion, mental illness prevention and substance abuse prevention. Consistent with the 

Institute of Medicine’s 2009 report on Preventing Mental, Emotional, and Behavioral Disorders 

Among Young People, this program seeks to build on the emerging evidence that a significant 

number of mental, emotional and substance abuse problems in young people are largely 

preventable and community-based prevention can play a significant role in facilitating key 

prevention efforts. Evidence shows that to create emotionally healthy communities, it is 

important to address the shared risk factors that contribute to an array of adverse outcomes, and 

the protective factors that reduce the risk of these negative consequences. Risk factors include 

poverty, early trauma, drug/alcohol misuse, family dysfunction, poor academic performance, and 

peer rejection. Protective factors include good communication skills, stress mitigation, reliable 

support and guidance from parents and caregivers, support for high quality early learning, quality 

health care, healthy peer groups, social connectedness, and successful learning environments.

Mental Health Transformation and Health Reform Funds will be provided to substance abuse 

prevention community coalitions (including, but not limited to, current and former Drug Free 

Communities grantees) and organizations to expand their activities to include mental health 

promotion and mental illness prevention, and Strategic Prevention Framework funds will be 

provided to coalitions and organizations with a mental health focus to expand their activities to 

include substance abuse prevention. Funding streams will be kept separate and used for 

activities consistent with separate funding authorities. 

Funded activities may include but are not limited to, bi-directional education on substance abuse 

prevention and mental health promotion; assessing shared community risk and protective 

factors, especially among youth, connecting across community service systems including 

primary care, and developing the capacity to jointly implement evidence-based programming 

that addresses these factors; and working with stakeholders such as health insurance companies, 

Marketplaces, and state Medicaid officials to promote health insurance coverage for substance 
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abuse prevention and mental health . Grantees will be encouraged to consider best practices and 

models developed through other community-level programs such as Drug Free Communities, 

Safe Schools/Healthy Students, and Project LAUNCH.

Strategic Prevention Framework Prescription Drug Abuse 

and Overdose Prevention (SPF Rx)

According to the 2012 National Survey on Drug Use and Health (NSDUH), 2.6 percent of the 

U.S. population uses prescription drugs non-medically, including 4.9 million users of pain 

relievers, 2.1 million users of tranquilizers, 1.2 million users of stimulants, and 270,000 users of 

sedatives. Drug overdose death rates have increased five-fold since 1980.70 By 2009, drug 

overdose deaths outnumbered deaths due to motor vehicle crashes for the first time in the U.S. 

Prescription drugs, especially opioid analgesics, have been increasingly involved in drug 

overdose deaths.71 Opioid analgesics were involved in 30 percent of drug overdose deaths where 

a drug was specified in 1999, compared to nearly 60 percent in 2010. Opioid-related overdose 

deaths now outnumber overdose deaths involving all illicit drugs such as heroin and cocaine 

combined.72 In addition to overdose deaths, emergency department visits, substance treatment 

admissions and economic costs associated with opioid abuse have all increased in recent years. 

Rates of chronic nonmedical use of opioids are highest among 18-25 year olds, followed by 26-

34 year olds, and 35-49 year olds.73 Rates of emergency department visits due to misuse or 

abuse of opioids or benzodiazepines are highest among 21-29 year olds followed by 30-44 and 

45-54 year olds.74 Substance abuse treatment admissions for opioid analgesics are highest for 25-

34 year olds, followed by 18-24 year olds, and 35-44 year olds.75 Drug overdose death rates for 

opioids are highest among people aged 45-54 years old, followed by 35-44, 25-34, and 55-64 

year olds.76 

In FY 2015, funding is being requested for SAMHSA and CDC as 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. The two agencies are coordinating to ensure that the 

efforts are aligned with HHS’ recently established policy and plan for prevention of OpioidRelated Overdoses and Deaths involving multiple Operating Divisions and offices. 

CDC will expand its Core Violence and Injury Prevention Program to provide basic injury and 

violence prevention infrastructure to additional states with a high burden of prescription drug 

 

70 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.

71 Paulozzi L, Jones C, Mack K, Rudd R; Centers for Disease Control and Prevention (CDC). Vital signs: overdoses of prescription opioid 

analgesics—United States, 1999-2008. MMWR Morb Mortal Wkly Rep. 2011;60(43):1487- 1492.

72 Centers for Disease Control and Prevention. WONDER [database]. Atlanta, GA: US Department of Health and Human Services, Centers for 

Disease Control and Prevention; 2013. Available at http://wonder.cdc.gov. 

73 Jones CM. Frequency of prescription pain reliever nonmedical use: 2002-2003 and 2009-2010. Arch Intern Med. 2012;172(16):1265-1267.

74 Substance Abuse and Mental Health Services Administration, Center for Behavioral Health Statistics and Quality. (July 2, 2012). 

The DAWN Report: Highlights of the 2010 Drug Abuse Warning Network (DAWN) Findings on Drug-Related Emergency Department 

Visits. Rockville, MD.

75 Substance Abuse and Mental Health Services Administration, Center for Behavioral Health Statistics and Quality. Treatment Episode Data 

Set (TEDS): 2000-2010. National Admissions to Substance Abuse Treatment Services. DASIS Series S-61, HHS Publication No. (SMA) 12-

4701. Rockville, MD: Substance Abuse and Mental Health Services Administration, 2012.

76 CDC analysis of the 2010 Multiple Cause of Death Mortality File. 2012. 
243

overdose. This expansion will provide additional funding and technical assistance to some 

current and new Core states to focus on the main drivers of the epidemic – high-risk prescribing 

and high-risk patients. 

SAMHSA proposes to dedicate $10 million to a new program, the Strategic Prevention 

Framework Prescription Drug Abuse and Overdose Prevention (SPF Rx), that will provide 

funding for the prevention of prescription drug misuse and abuse in high priority age groups 

(including young and middle-aged adults) and the general public. SAMHSA’s program will 

complement the CDC program by awarding grants to a state’s substance abuse authority to 

develop a comprehensive prevention approach in collaboration with the state’s public health 

authority, education authority, and Medicaid authority, as well as the state’s Prescription Drug 

Monitoring Program (PDMP) and Health Information Exchange (HIE). The goal will be to raise 

awareness of the dangers of sharing medications and work with pharmaceutical and medical 

communities on the risks of overprescribing and on the use of data from PDMPs and to provide 

educational materials at points of prescribing, sale and dispensing. SAMHSA’s program will 

also focus on raising community awareness and bringing prescription drug abuse prevention 

activities and education to schools, communities, parents, prescribers and their patients. 

SAMHSA proposes to utilize $4 million to fund SAMHSA SPF Rx grantees to:

 Use the state’s strategic plan to target prescription drug abuse and misuse within the state;

 Use PDMP data for prevention planning; and

 Implement evidence-based practices and/or environmental strategies aimed at reducing 

prescription drug abuse and misuse. 

Grantees will be required to track and monitor outcomes in non-medical use of prescription 

medications, emergency room admissions, and deaths due to prescription drug misuse or 

overdoses, as well as potential shifts in use of heroin or other illicit drugs in grantee states. 

SAMHSA’s SPF Rx grantees will be required to use needs assessment data to determine the risk 

factors leading to prescription drug abuse in the state, including lack of public knowledge of the 

dangers of misuse of prescription drugs and easy access to prescription drugs through friends, 

family members, and health care professionals. Because these risk factors will likely differ 

across grantees, the educational activities and community awareness activities implemented by 

SPF Rx grantees may also differ. Activities might include media campaigns targeted at parents 

and focused on the safe storage of prescription drugs,77 the publication and distribution of opioid 

prescribing guidelines for health care professionals,78 and evidence-based educational programs 

delivered in the school setting, such as Strengthening Families.iSAMHSA will also partner with 

NIDA to further develop the evidence base to support these efforts. 

SAMHSA will utilize approximately $4 million for planning grants for up to 20 other states to 

build capacity to address prescription drug abuse and overdose prevention efforts, in conjunction 

with other state and local partners. They will utilize these funds to create partnerships with the 

existing prevention workforce, especially existing coalitions, to utilize PDMP, SAMHSA 

 

77 Johnson EM, Porucznik CA, Anderson JW, Rolfs RT. State level strategies for reducing prescription drug 

overdose deaths: Utah’s prescription safety program. Pain Medicine: June 2011, Vol.12, Supp 2:S66-72.

78 Ibid.
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NSDUH, and/or commercial prescribing data to identify communities at risk and develop plans 

for appropriate prevention and intervention strategies. These states will be expected to produce a 

strategic plan focused on bringing prescription drug abuse prevention activities and education to 

schools, communities, and parents, and include a new focus on prescribers and their patients. 

These 20 states would be positioning themselves to eventually become implementation states. 

Of the remaining $2 million, $1.4 million will be utilized, working in conjunction with CDC, to 

evaluate and provide technical assistance for funded states, and $0.6 million will be utilized to 

continue and expand work begun in FY 2011 with the Office of the National Coordinator of 

Health Information Technology (ONC) to focus on standards alignment on interoperability 

among state Prescription Drug Monitoring Programs (PDMPs) and electronic health records 

(EHRs) and HIEs and/or any other technology efforts determined necessary for the exchange of 

data. Additionally, grantees may identify and implement new opportunities (e.g., pilots, 

innovation challenges, etc.) focused on the use of EHRs and HIEs to improve clinical decisionmaking within and across states and to support PDMP communication and outreach activities.

SAMHSA’s SPF Rx will provide funds to develop capacity and expertise in the utilization of 

data from the state’s PDMP to identify communities by geography and population (e.g., age 

group) of high risk, particularly those communities that are in need of primary and secondary 

prevention. This will be coordinated with CDC’s expansion of the Core Violence and Injury 

Prevention Program to include additional states with a high burden of prescription drug 

overdose, States will also provide technical assistance and training to the identified communities 

on the selection and implementation of appropriate evidence-based prevention programming 

using the Strategic Prevention Framework as their guide. In addition, SAMHSA’s resources can 

be used to provide technical assistance and training on the use of SAMHSA’s Opiate Overdose 

Prevention Tool Kit to prevent overdose deaths. 

SAMHSA and CDC will coordinate to implement interventions that address the key drivers of 

overdose and high-risk prescribers and patients, while also implementing the foundational 

prevention programs required to sustain a state-wide response to this significant public health 

issue.

Minority AIDS Initiative

Total FY 2015 Request: $41.3 million

(Reflects level funding from FY 2014 Enacted Level)

Minority AIDS Initiative (MAI) supports efforts to increase access to substance abuse and HIV 

prevention services for the highest risk and hardest-to-serve racial and ethnic minority 

populations. Grantees must implement integrated, evidence-based substance abuse and HIV 

prevention interventions, including HIV testing, that target one or more high-risk populations 

such as young adults (18 to 24), African-American women, adolescents, individuals who have 

been released from prisons and jails within the past two years, or men having sex with men 

(MSM). In addition, the MAI supports partnerships between public and private nonprofit 

organizations to prevent and reduce the onset of substance abuse and transmission of HIV among 

high-risk populations. 
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In FY 2010, SAMHSA funded the Ready-To-Respond Initiative and the Capacity Building 

Initiative programs. A total of 62 grants in these cohorts will continue to be funded in FY 2014. 

The Ready-To-Respond Initiative, was awarded to experienced MAI grantees, and provides 

substance abuse and HIV prevention services to at-risk minority populations in communities 

disproportionately affected by HIV/AIDS. The Capacity Building Initiative focuses on using 

evidence-based prevention strategies and media technology to reach college students, who 

comprise one-third of the 18-24 year old population in the United States and are particularly at 

risk for substance use and HIV infection. Performance data for FY 2012 showed that almost 

6,600 people received substance abuse prevention education services. Additionally, 96.8 percent 

of participants rated the risk of harm from substance abuse as great. Of those participants who 

were non-users, 93.2 percent remained non-users of drugs and 88.4 percent remained alcohol 

free. During FY 2012, over 32, 975 participants were tested for HIV. SAMHSA continued to 

support these grants in FY 2012 and FY 2013. 

In FY 2011, SAMHSA also awarded 11 grants for the MAI Targeted Capacity Expansion 

Integrated Behavioral Health/Primary Care Network Cooperative Agreements, jointly funded 

with CMHS and CSAT. This grant program facilitates the development and expansion of 

culturally-competent and effective integrated behavioral health and primary care networks, 

which include HIV services and medical treatment, within racial and ethnic minority 

communities in the 11 Metropolitan Statistical Areas and Metropolitan Divisions most impacted 

by HIV/AIDS. Expected outcomes include: reducing the impact of behavioral health problems, 

HIV risk and incidence, and HIV-related health disparities in these areas. SAMHSA continued 

to support these grants in FY 2014.

In FY 2013, SAMHSA awarded a new cohort of grants for the MAI funding for Minority 

Serving Institutions (MSIs) Partnerships with Community-Based Organizations (CBOs). The 

purpose of this program is to prevent and reduce substance abuse (SA) and transmission of 

HIV/AIDS among African-American, Hispanic/Latino, and American Indian/Alaska Natives 

(AI/AN) young adults (ages 18- 24) populations on campus. MSIs will partner with one or more 

community-based organizations (CBOs) to provide integrated SA and HIV prevention programs 

to African-American, Hispanic/Latino, American Indian/Alaska Native (AI/AN), and Asian 

American/Pacific Islander young adults (ages 18-24) in the surrounding communities. 

SAMHSA awarded 29 grants for three years. 

In FY 2013, SAMHSA also implemented a new program, Substance Abuse and HIV/AIDS 

Prevention and New Media. The purpose of this program is to enhance the infrastructure 

capacity of community-based organizations to more effectively reach the most at-risk 

racial/ethnic populations and subpopulations using new media and emerging technologies. This 

program builds capacity for substance use disorders and HIV/AIDS prevention services 

consistent with the goals and objectives of the National HIV/AIDS Strategy and SAMHSA’s 

Strategic Initiative #1 – Prevention of Substance Abuse and Mental Illness. SAMHSA awarded 

20 grants.

SAMHSA supports the National HIV/AIDS Strategy through its grant programs, including the 

cross-Center Targeted Capacity Expansion Integrated Behavioral Health/Primary Care Network 

Cooperative Agreements, the CSAT Targeted Capacity Expansion/HIV program, and the CSAP 
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Ready-to-Respond, Capacity Building Initiative, Minority Serving Institutions in Partnership 

with Community Based Organizations, and Substance Abuse & HIV/AIDS Prevention & New 

Media programs, all described in their respective sections of this document. SAMHSA also 

provides training and technical assistance to its grantees to ensure they are focusing on the goals 

of the Strategy and collaborates with other HHS Operating Divisions involved with the Strategy 

to ensure a coordinated, departmental approach.

In FY 2014, SAMHSA’s CMHS, CSAP, and CSAT plan to pilot HIV Continuum of Care grants 

which supports behavioral health screening, primary prevention, and treatment for racial/ethnic 

minority populations with or at high risk for mental and substance use disorders and HIV. This 

will include (SA) primary prevention/treatment service programs, community mental health 

programs, and HIV integrated programs that can either co-locate or fully integrate HIV 

prevention and medical care services within them. Also, this program will provide SA and HIV 

primary prevention services in local communities served by the behavioral health program.

In FY 2015, funding addresses a critical public health problem and health disparity. Research 

has shown that there is a direct correlation between substance use (including alcohol) and HIV 

infection. The aim is to achieve normative and environmental changes to prevent and/or reduce 

substance abuse problems as risk factors for the transmission of HIV/AIDS among AfricanAmerican, Hispanic/Latino, Asian American/Pacific Islander (AA/PI) and American 

Indian/Alaska Native (AI/AN) young adult populations (ages 18- 24) on campus. In addition, 

about 60 percent of youth with HIV do not know they are infected. The Minority AIDS 

Initiative provides life-saving prevention services, including testing. 

HIV Continuum of Care

(Braided program with Mental Health: Minority AIDS Initiative and Primary and Behavioral 

Health Care Integration and Substance Abuse Treatment: Minority AIDS Initiative and Primary 

Care and Addiction Services Integration)

SAMHSA expects that data generated from the 2014 HIV Continuum of Care pilot will help to 

inform an expanded program proposed for 2015 to continue the co-location and integrated 

HIV/primary care within either substance abuse or community mental health treatment programs. 

Braided funds would be dedicated to establishing integrated behavioral health and HIV care in 

addition to primary care needed by those living with or at high risk for HIV infection in minority 

communities heavily impacted by HIV. In addition, because of the significant comorbidity of 

viral hepatitis with HIV infection and because viral hepatitis occurs in up to 20 percent of those 

with either substance use disorders or serious mental illness, 5 percent of the allocated funds will 

be used to provide services to prevent, screen, test and refer to treatment as clinically appropriate 

those at risk for or living with viral hepatitis. In integrating HIV care into behavioral health 

settings, people living with HIV/AIDS and M/SUDs will have greater access to treatment for 

these conditions. Integrated care programs developed as a result of this grant program will make 

it possible for behavioral health and HIV care needs to be addressed in one setting. This will 

result in effective, person-centered, treatment that will reduce the risk of HIV transmission, 

improve outcomes for those living with HIV, and ultimately reduce new infections. SAMHSA’s 

Common Data platform (CDP), now under development, will integrate substance abuse and 

mental health elements with HIV and Hepatitis elements to ensure a more rigorous evaluation 
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and data analysis to inform future public health intervention decision-making that addresses the 

intersection of behavioral health and HIV. 

Fetal Alcohol Spectrum Disorder

Total FY 2015 Request: $1.0 million

(Reflects level funding from FY 2014 Enacted Level)

The Fetal Alcohol Spectrum Disorders (FASD) Center for Excellence (CFE) program focuses on 

preventing Fetal Alcohol Spectrum Disorders among women of childbearing age and improving 

the quality of life for individuals and families impacted by these disorders. FASD CFE uses a 

comprehensive approach across the lifespan to work toward reducing the number of infants 

exposed to alcohol prenatally, increasing the functioning of individuals who have an FASD, and 

addressing the challenges of individuals and families impacted by FASD.

As part of these efforts, FASD CFE has successfully established a website that provides the 

public with information and resources on the prevention of FASD, chartered an expert panel that 

provides guidance and recommendations about best practices for healthcare providers and social 

services, organized a Self-Advocates with FASD Network comprising young adults with a 

FASD and Birth Mothers Network. In addition FASD CFE partnered with the National Institute 

on Alcohol Abuse and Alcoholism’s Interagency Coordinating Committee on FASD to advance 

new research and best practices on FASD, coordinated and collaborated with organizations such 

as the National Organization on Fetal Alcohol Syndrome to develop curricula for juvenile justice 

systems and certified addictions counselors, provided ongoing support to the National 

Association of FASD State Coordinators to integrate FASD services into existing health care 

systems and convened 10 "Building FASD State Systems" annual conferences to facilitate the 

development of comprehensive systems of care for people affected by FASD. FASD CFE also 

established a Native Communities Initiative to address FASD in American Indian /Alaska Native 

/Native Hawaiian populations.

In FY 2012, SAMHSA continued to support the FASD CFE to work toward the prevention of 

FASD in communities throughout the nation. In FY 2013, the CFE provided technical assistance 

and training to other federal and national partners to assist them in developing evidence-based 

prevention, intervention, and treatment approaches. Primary audiences for the FASD CFE are 

women of child-bearing age, persons and families affected by FASD, states, local communities, 

AI/AN communities, military families, other special populations, as well as health, social 

service, and faith-based providers who study and/or provide services for persons affected by an 

FASD. In 2014, the FASD CFE will continue this technical assistance.

In FY 2015, Fetal Alcohol Spectrum Disorder will maintain funding for the Center for 

Excellence.

Center for the Application of Prevention Technologies

Total FY 2015 Request: $7.5 million

(Reflects level funding from FY 2014 Enacted Level)
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The Center for the Application of Prevention Technologies (CAPT) program provides state-ofthe-art training and technical assistance designed to build the capacity of SAMHSA grantees and 

develop the skills, knowledge, and expertise of the prevention workforce. CAPT builds capacity 

and promotes the development of substance abuse prevention professionals in the behavioral 

health field through three core strategies: (1) establishing technical assistance networks using 

local experts; (2) developing and delivering targeted training and technical assistance activities; 

and (3) using communication media such as teleconference and video conferencing, online 

events, and Web-based support. These activities help ensure the delivery of effective prevention 

programs and practices and the development of accountability systems for performance 

measurement and management. 

During FY 2012 and FY 2013, CAPT completed a comprehensive revision and updating of its 

flagship Substance Abuse Prevention Skills Training, which offers participants 31 training hours 

toward certification as a Substance Abuse Prevention Specialist. CAPT also developed a Pacific 

Islander and Native American adaptation of the training for an additional six training hour 

credits. In FY 2012 and 2013, CAPT has continued to develop behavioral health indicators and 

related training and technical assistance products focused on shared risk and protective factors to 

promote collaboration across substance abuse and mental health disciplines within the behavioral 

health field. 

During FY 2012, CAPT provided training to 9,041 substance abuse professionals. In addition, 

CAPT provided technical assistance services to 7,655 people. Over 96 percent of service 

recipients reported that their organization’s capacity was increased as a result of the service. 

Almost half of the recipients reported fully implementing the training recommendations. 

Additional performance data for the CAPT is captured using common measures with other 

technical assistance activities in the Science and Service Program Coordination category. 

Although the CAPT funding line was reduced in FY 2014, it is co-funded with Block Grant setaside funds. Therefore the CAPT will be fully funded in FY 2014.

In FY 2015, funding will provide technical assistance and workforce development to the 

prevention field. This is a critical function as the nation moves toward health reform and a 

behavioral health model.

Mandatory Drug Testing

Total FY 2015 Request: $4.9 million

(Reflects level funding from FY 2014 Enacted Level)

The Mandatory Drug Testing program is a critical nationwide prevention program consisting of

two principal activities mandated by Executive Order and Public Law: (1) oversight of the 

Federal Drug-Free Workplace Program, aimed at elimination of illicit drug use in the federal 

workforce, with impact in the private sector workforce as well; and (2) oversight of the National 

Laboratory Certification Program, which certifies laboratories to conduct forensic drug testing 

for the federal agencies and for some federally-regulated industries.

Executive Order 12564, first signed on September 15, 1986, requires the head of each executive 

agency to establish a program to test for the use of illegal drugs by federal employees in sensitive 
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positions and requires the Secretary to promulgate scientific and technical guidelines for drug 

testing programs. The Executive Order also requires HHS to assist the Office of Personnel 

Management to develop and improve training programs for federal supervisors and managers on 

illegal drug use. 

The Supplemental Appropriations Act, 1987 (Public Law 100-71) requires HHS to: (1) certify 

that each federal agency has developed a plan for achieving a drug-free workplace; and (2) 

publish Mandatory Guidelines that establish comprehensive standards for laboratory drug testing 

procedures, specify the drugs for which federal employees may be tested, and establish standards 

and procedures for periodic review and certification of laboratories to perform drug testing for 

federal agencies.

The program is further supported by the CSAP Workplace Helpline, a toll-free telephone service 

for business and industry that answers questions about drug abuse in the workplace. 

SAMHSA continued these activities in FY 2013 and will continue do so in FY 2014. In 

addition, the Drug Testing Advisory Board is examining the scientific basis for utilization of oral 

fluid and other alternative specimens to urine, and the inclusion of additional Schedule II 

prescription medications (e.g., oxycodone, oxymorphone, hydrocodone and hydromorphone) in 

the Mandatory Guidelines. Any changes in the guidelines will be based on scientific 

supportability. SAMHSA continues to partner with other federal agencies to ascertain the 

scientific evidence needed to set standards for the Mandatory Guidelines. 

In FY 2015, funding will maintain the Federal Drug-Free Workplace Program and National 

Laboratory Certification Program as required by law. Both of these are critical public health and 

safety programs ensuring that individuals in sensitive and safety-related federal positions are not 

using illicit drugs, and that drug testing laboratories produce accurate results. 

Sober Truth on Preventing Underage Drinking (STOP Act)

Total FY 2015 Request: $7.0 million

(Reflects level funding from FY 2014 Enacted Level)

The Sober Truth on Preventing Underage Drinking Act (STOP Act) of 2006 is the nation’s first 

comprehensive legislation on underage drinking. One of the primary components of the Act is 

the STOP Act grant program, which provides additional funds to current or former grantees 

under the Drug Free Communities Act of 1997 to prevent and reduce alcohol use among youth 

age 12-20. The STOP Act grant program enables organizations to strengthen collaboration and 

coordination among stakeholders in order to achieve a reduction in underage drinking in their 

communities. Grants are limited by statute to $0.1 million per year for four years. In FY 2012, 

81 new grants were awarded. In FY 2012, performance data showed that the STOP Act grant 

program has exceeded targets in two of the three GPRA performance measures. Almost 72 

percent of coalitions reported a reduction in the past 30-day use of alcohol, 55 percent of 

coalitions reported an increase in perceived risk, and 58.2 percent of coalitions reported an 

increase in perception of parental disapproval of alcohol use (69.6 percent). In FY 2013, 

SAMHSA awarded 17 new grants
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Another component of the STOP Act is the National Adult-Oriented Media Public Service 

Campaign, which educates parents regarding how to speak with their 11- through 15-year-old 

children about underage drinking in order to delay the onset of, and ultimately reduce, underage 

drinking. Nationwide, 36.6 percent of the estimated 10 million underage drinkers were provided 

free alcohol by adults 21 or older (2012 NSDUH). Further research continues to show that 

parents of teens generally underestimate the extent of alcohol used by youth and its negative 

consequences, with the vast majority viewing underage drinking as “inevitable.” 

The third component of the STOP Act is the federal Interagency Coordinating Committee on the 

Prevention of Underage Drinking (ICCPUD), which provides high-level leadership from 15 

federal agencies for coordinating federal efforts to prevent and reduce underage drinking. In FY 

2012, the ICCPUD was reinvigorated with principals meeting from all federal agencies working 

to prevent underage drinking, and the launch of a webinar series featuring common messages 

with individualized information for the field from each involved federal agency. In 2012, the 

ICCPUD updated the 2007 Surgeon General’s Call to Action to Prevent Underage Drinking to 

reflect progress over the past six years, the impact of the Affordable Care Act, and new research 

supporting effective prevention approaches. SAMHSA continued to support ICCPUD’s 

activities in FY 2013. In FY 2014, SAMHSA will support 97 grant continuations and will 

continue to support the National-Adult-Oriented Media Campaign and ICCPUD. 

In FY 2015, funding will allow for one new grant.

Science and Service Program Coordination

Total FY 2015 Request: $4.1 million

(Reflects level funding from FY 2014 Enacted Level)

The Science and Service Program Coordination category primarily encompasses contracts that 

provide technical assistance and training to states, tribes, communities, and grantees around 

substance abuse prevention. Included in the performance measurement section for this category 

is the former Native American Center for Excellence (NACE) and the Underage Drinking 

Prevention Education Initiative (UADPEI). 

The purpose of NACE was to promote effective substance abuse prevention programs in tribal 

and urban American Indian and Alaska Native (AI/AN) communities throughout the United 

States. The NACE mission was to promote best practices in substance abuse prevention by 

disseminating information on cultural and evidence-based programs, practices, and policies and 

providing training and technical assistance to prevention programs and organizations serving 

urban and tribal Native American communities. The target audiences included the Native 

American SPF-Tribal Incentive Grant grantees, tribal nations and organizations, health and 

social service providers, federal and state level organizations, and community and faith-based 

providers serving Native Americans. Eighty-eight percent of recipients reported that the NACE 

services increased their individual capacity to provide prevention services. 

NACE expanded its outreach in FY 2012 and FY 2013 through presentations at national 

conferences and regional events, and increased collaborative efforts with other SAMHSA 

initiatives and national organizations. The NACE website greatly expanded its collection of 
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resources and dissemination of current news worthy events through daily “headlines” entries 

while tripling its number of visitors each month. FY 2012 and FY 2013 also brought the 

development of four new NACE learning communities (National Prevention Network, SPF 

Tribal Incentive Grant, Gathering of Native Americans, and 2-Spirit) to bring stakeholders 

together on conference calls or webinars to further disseminate information and support crossfertilization of information and ideas. Lastly, NACE expanded the frequency and reach of its 

national webinars.

In FY 2013, NACE was consolidated into the braided Tribal Training and Technical Assistance 

Center (Tribal TTA Center). The Tribal TTA Center provides comprehensive, broad, focused, 

and/or intensive training and technical assistance to federally-recognized tribes and other 

American Indian/Alaska Native communities, seeking to address and prevent mental and 

substance use disorders, suicide, and promote mental health. The braided amounts spent and 

awarded are tracked as distinct funding streams and are only to be used for purposes consistent 

with Congressional intent. In FY 2014, the training and technical assistance will continue. 

The Underage Drinking Prevention Education Initiative (UADPEI) engages parents and other 

caregivers, schools, communities, all levels of government, all social systems that interface with 

youth, and youth themselves in a coordinated national effort to prevent and reduce underage 

drinking and its consequences. Through this initiative, families, their children, and other youthserving organizations have been reached through Town Hall Meetings (held in even-numbered 

years), technical assistance, trainings, and with a variety of tools and materials performance data 

shows that, collectively, the CAPT and Science and Service Program Coordination programs 

have exceeded their targets for customer satisfaction, and for the proportion of participants who 

report implementing recommendations. Efficiencies have been achieved from the growing focus 

on train-the-trainer models rather than training of individuals. In addition, since the Town Hall 

Meetings under the UADPEI contract occur biannually, numbers served expand in the years the 

meetings occur and contract in alternate years. Science and Service performance data for FY 

2012, 15,269 people were trained and almost 9,000 received technical assistance. In FY 2014, 

UADPEI funding will be reduced because the town hall meetings occur every other year. 

In FY 2015, funding is necessary to support SAMHSA’s top strategic initiative, prevention of 

substance abuse and mental illness, which includes a focus on preventing underage drinking and 

on American Indians/Alaska Natives.
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Substance Abuse Treatment 

Substance Abuse Treatment Programs of Regional and National Significance

Total FY 2015 Request: $297.4 million

(Reflects $64.1 million decrease from FY 2014 Enacted Level)

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 2015 President’s Budget request for SAMHSA’s Substance Abuse Treatment PRNS 

includes $297.4 million which covers thirteen programmatic activities, a decrease of $64.1

million from the FY 2014 Enacted Level. The request includes: $30.0 million for Screening, 

Brief Intervention and Referral to Treatment; $41.5 million for Treatment Systems for Homeless; 

$58.9 million for Minority AIDS Initiative; $64.5 million for Criminal Justice Activities of 

which $45.9 million will fund Drug Courts and $5.5 million for Ex-Offender Reentry; $0 for 

Access to Recovery, $20 million for the Primary Care and Addiction Services Integration 

Program; and $102.6 million for other PRNS Treatment Programs.

Screening, Brief Intervention and Referral to Treatment

FY 2015 Request: $30.0 million

(Reflects $17 million decrease from FY 2014 Enacted Level)

Screening, Brief Intervention, and Referral to Treatment (SBIRT) was initiated by SAMHSA in 

FY 2003, using cooperative agreements to expand and enhance a state or tribal organization’s 

continuum of care. The purpose of the program is to integrate screening, brief intervention, 

referral, and treatment services within general medical and primary care settings. 

The SBIRT program requires grant recipients to affect practice change throughout the spectrum 

of medical practice. This is achieved through implementation in all levels of primary care, 

including hospitals, trauma centers, health clinics, nursing homes, employee assistance 

programs, and school systems. Practice change also alters the educational structure of medical 

schools by developing and implementing SBIRT curricula as standard and permanent practice. 

Research and clinical experience supports the use of the SBIRT approach to provide effective 

early identification and interventions in primary care and general medical settings. Early 

identification can decrease total healthcare costs by arresting progression toward addiction. 

SBIRT also can identify individuals with more serious problems and encourage them to obtain 

appropriate specialty treatment services. Funds may be used for the following services: 

pre/screening for substance use and co-occurring disorders; brief interventions designed with 

client centered, non-judgmental, motivational interviewing techniques; brief treatment including 

the monitoring of individuals who misuse alcohol and other drugs but are not yet dependent; 

referral to treatment (when indicated) for those who have a substance use disorder; and when 

appropriate, referral to and expansion of specialty treatment services. Since the beginning of this 

program, more than two million individuals have been screened. Of those, 19 percent required a 

brief intervention, brief treatment, or referral to specialty treatment programs. 
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In FY 2012, over 142,000 individuals were served by the SBIRT program. The percentage of 

individuals reporting abstinence at follow up tripled compared to the percentage reporting 

abstinence at baseline. In FY 2013, 274,873 individuals were served by the SBIRT program.

SBIRT has great future potential for promoting changes to the entire primary care medical 

service delivery system. Efforts are underway to identify other funding streams to help take this 

practice to scale. For example, new diagnostic codes have been adopted by 16 states, making it 

easier for doctors to get reimbursed for screening Medicaid patients. Likewise, alcohol 

screening is now available to Medicare beneficiaries as a preventive service without cost. In FY 

2012, SAMHSA funded the continuation of 27 SBIRT grants, supported six contracts as well as 

three new multi-year grants funded out of the Prevention and Public Health Fund, and continued 

to monitor the progress of the three FY 2011 multi-year Prevention and Public Health Fund 

grants. 

In FY 2013, SAMHSA funded five state SBIRT grants, 14 SBIRT Medical Professional Training 

Program grants as well as 12 grant continuations and supported five contracts.

In FY 2014, SAMHSA plans to support nine additional (SBIRT) Medical Professional Training 

grants and one State SBIRT grant. The purpose of SBIRT Training is to develop and implement 

training programs to teach health professionals (medical residents and students of nursing, social 

work and counseling) the skills necessary to provide evidence-based screening, brief intervention 

and brief treatment and to refer patients who are at risk for a substance use disorder (SUD) to 

appropriate treatment. As shown by data collected from SBIRT cross-site evaluations (SBIRT 

Cohort I Cross-Site Evaluation Final Report, 2010), the vast majority of SBIRT service providers 

are nurses, social workers and counselors with the role of the physician as leading the effort 

through clinical work, advocacy and supervising SBIRT in medical settings. Grantees are 

required to use training curricula developed by the initial cohort of SAMHSA SBIRT Medical 

Residency grantees. The intended outcome of this program is to increase the adoption and 

practice of SBIRT throughout the health care delivery system. The SBIRT Training program 

supports the SAMHSA Health Reform Strategic Initiative to expand access to individuals 

vulnerable to health disparities.

The utilization of the previous cross site evaluations inform current and future SBIRT cohorts 

and highlights the roles of non-physicians in the actual provision of SBIRT services. The 

intention is to continue with a new cross site evaluation intended to show outcome measure 

achievement rather than process data. This will help prove the efficacy and efficiency of the 

SBIRT process and inform future grant design. Many grantees are also publishing information 

related to the outcomes achieved through the grant activities and this will help to further the 

acceptance of SBIRT and inform future grant proposals. 

All discretionary grantees are required to collect and report data on a regular and real-time basis. 

Data are monitored to provide information which can be used to improve service, monitor 

grantee performance and quality, and provide recommendations for future directions. Grantee 

performance and outcomes data are monitored using the Services Accountability Improvement 

System
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In FY 2014, SAMHSA plans to support the continuation of 22 grants, four contracts and 

approximately 10 new grants.

In FY 2015, funding will enable SAMHSA to support continuations.

Treatment Drug Courts

FY 2015 Request: $45.9 million

(Reflects $6.4 million decrease from FY 2014 Enacted Level)

Drug Courts

Criminal Justice activities include grant programs, which focus on diversion, alternatives to 

incarceration, and re-entry from incarceration for adolescents and adults with substance use 

disorders, and/or co-occurring substance use and mental disorders. These activities comport 

directly with SAMHSA’s Trauma and Justice Strategic Initiative efforts. 

Drug courts are designed to combine the sanctioning power of courts with effective treatment 

services for a range of populations and problems such as alcohol and/or drug use, child 

abuse/neglect or criminal behavior, mental illness, and veterans’ issues. Funding for adult 

treatment drug court programs provide a variety of services, including: direct treatment or 

prevention services for diverse populations at risk; “wrap-around”/recovery support services 

designed to improve access and retention; drug testing for illicit substances required for 

supervision, treatment compliance, and therapeutic intervention; education support; relapse 

prevention and long-term management; Medication-Assisted Treatment (MAT); and HIV testing 

conducted in accordance with state and local requirements. 

In FY 2012, SAMHSA funded the continuation of 81 drug court grants and supported eight 

contracts, and 54 new drug court grants. In FY 2013, SAMHSA funded the continuation of 78 

drug court grants, supported three contracts, and funded 39 new drug court grants. In FY 2014, 

SAMHSA plans to support 92 grant continuations, two contracts, and 55 new drug court grants.

The SAMHSA Drug Court grant programs are utilizing existing evidence to support current 

programs and new proposals by incorporating findings from numerous studies of drug courts. 

There have been over 125 evaluation and research studies of the effectiveness of drug courts and 

several micro-analyses in addition to GAO reports on the effectiveness of treatment drug courts. 

SAMHSA’s RFA require evidence-based practices to be used from federal inventories of such 

practices (NIDA, SAMHSA’s NREPP). SAMHSA also has regular communications with the 

national drug court constituency group, the National Association of Drug Court Professionals in 

order to obtain and incorporate the latest findings and field expertise. Examples of SAMHSA’s 

drug court programs incorporating the latest “standards” for drug courts as promulgated by 

NADCP with the support of the Bureau of Justice Assistance, U.S. Department of Justice. 

Language pertaining to screening for co-occurring disorders, use of medically assisted treatments 

for opioid or alcohol dependent persons, and identification of behavioral health disparities have 

been included in the grant solicitations. 
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In FY 2015, funding will support some new grants as well as the continuation on existing 

cohorts.

Offender Re-Entry Program

FY 2015 Request: $5.5 million

(Reflects $9.6 million decrease from FY 2014 Enacted Level)

In addition to SAMHSA’s drug court portfolio, the agency also supports other robust criminal 

justice programs. For example, the Offender Reentry Program (ORP) grants provide screening, 

assessment and comprehensive treatment and recovery support services to offenders reentering 

the community, as well as offenders who are currently on or being released from probation or 

parole. SAMHSA and the DOJ/BJA share a mutual interest in supporting and shaping offender 

re-entry-treatment services, as both agencies fund “offender reentry” programs. Formal 

agreements have been developed to further encourage and engage in mutual interests and 

activities related to criminal justice-treatment issues. ORP grantees are expected to seek out and 

coordinate with local federally-funded offender reentry initiatives, including the DOJ/BJA’s 

Prisoner Reentry Initiative or “Second Chance Act” offender re-entry programs, as appropriate. 

Funding for ORP may be used for a variety of services, including: screening, comprehensive 

individual assessment for substance use and/or co-occurring mental disorders, case management, 

program management and referrals related to substance abuse treatment for clients; alcohol and 

drug treatment; wraparound services supporting the access to and retention in substance abuse 

treatment or to address the treatment-specific needs of clients during or following a substance 

abuse treatment episode; individualized services planning; drug testing; and relapse prevention 

and long-term management support.

The (ORP) grant program utilizes existing evidence to support current programs and new 

proposals by incorporating findings from numerous studies of drug courts. SAMHSA’s ORP 

RFA requires evidence-based practices to be used from federal inventories of such practices 

(NIDA, SAMHSA’s NREPP). SAMHSA is represented at the Attorney General’s Reentry 

Council and in numerous inter- and intra-agency workgroups in order to obtain and incorporate 

the latest findings and field expertise. A federal reentry resource center has been established on 

the MAX electronic information forum to constantly update the ‘state of the state’ of offender 

reentry programming, research, and grant initiatives. The ORP grant solicitation contains 

language pertaining to Risks, Needs, and Responsivity models as part of the latest cutting edge 

approach to screening and assessing ex-offenders, the grant program, and the community 

response. Language pertaining to screening for co-occurring disorders, use of medically assisted 

treatments for opioid or alcohol dependent persons, and identification of behavioral health 

disparities has been included in the ORP grant solicitation. 

In FY 2011, SAMHSA awarded grants to Develop and Expand Behavioral Health Treatment 

Court Collaborative (BHTCC) in collaboration with CMHS. The purpose of the BHTCC is to 

provide state and local criminal and dependency courts serving adults with more flexibility to 

collaborate with the other judicial components and local community treatment and recovery 

providers to better address the behavioral health needs of adults who are involved with the 

criminal justice system. In FY 2014 SAMHSA plans to support an additional cohort (up to 14 

new grants) of BHTCC grants ($2,429,534 in CSAT and $2,969,430 in CMHS).
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In FY 2012, SAMHSA created the Teen Courts grant program (TCP), of which the primary 

focus is preventing crimes by diverting youth with substance abuse treatment needs from deeper 

penetration into the traditional juvenile justice system. Funds are used to provide screening, 

assessment, substance abuse treatment, and recovery support services for youth involved in a 

TCP.

In FY 2015, funding will support new grants as well as the continuation of existing cohorts.

Treatment Systems for Homeless Programs

FY 2015 Request: $41.5 million

(Reflects level funding from FY 2014 Enacted Level)

The Center for Substance Abuse Treatment (CSAT) manages two grant portfolios under its 

Grants for the Benefit of Homeless Individuals (GBHI) authority - Treatment for Homeless and 

Cooperative Agreements to Benefit Homeless Individuals (CABHI), that provide focused 

services to individuals with a substance use disorder or who have co-occurring substance use and 

mental disorders. These programs tie directly to the SAMHSA Recovery Support Strategic 

Initiative which focuses specifically on “home” as an integral component of one’s well-being.

The Treatment for Homeless-General grants enable communities to expand and strengthen their 

substance abuse treatment services for individuals who are at risk for experiencing homelessness 

or are experiencing homelessness. The Treatment for Homeless-Services in Supportive Housing 

(SSH) grants seek to expand and strengthen treatment services for individuals who experience 

chronic homelessness using a supportive housing approach. 

In FY 2011, CSAT in collaboration with CMHS, began awarding CABHI under the GBHI 

authority. The major goal of the program is to ensure that the most vulnerable individuals who 

experience chronic homelessness receive access to sustainable permanent housing, treatment, 

and recovery supports through mainstream funding sources. This program builds on the success 

of the previous Treatment for Homeless program. 

In FY 2013, SAMHSA funded 71 grant continuations and supported five contracts. In addition, 

CSAT in collaboration with CMHS funded 11 new Cooperative Agreements to Benefit 

Homeless Individuals for States (CABHI-States). CABHI-States builds on the current CABHI 

program by adding a state infrastructure improvement approach addressing chronic homelessness 

to the community-based behavioral health service component for newly housed individuals who 

experience chronic homelessness with substance use disorders or co-occurring substance use and 

mental disorders. 

In FY 2014, SAMHSA plans to support 34 grant continuation, five contracts and approximately 

39 grant awards within a new cohort of jointly funded CSAT and CMHS CABHI-State grants 

and Grants for the Benefit of Homeless Individuals-Services in Supportive Housing (GBHISSH). The proposed number of clients to be served with FY 2014 funding is 5,800. Outcomes 

including abstinence from substance use will also be tracked. 
257

SAMHSA’s homeless grant programs are designed to provide supports and services for people 

with mental illness and/or substance use disorders who experience homelessness or are at risk of 

homelessness. SAMHSA encourages grantees to work collaboratively with HUD grant programs 

in providing supportive services for individuals experiencing homelessness. SAMHSA homeless 

programs do not fund housing; therefore linkage with HUD programs is essential. SAMHSA 

grantees frequently work side-by-side with HUD’s Permanent Supportive Housing, Section 8, 

Shelter plus Care, Vouchers and other programs. SAMHSA funds an array of integrated 

behavioral health, treatment, housing support and recovery-oriented services and supports 

including outreach, engagement, intensive case management, treatment for mental and/or 

substance abuse disorders, enrollment in mainstream benefits, employment readiness, and 

linkage to permanent housing.

All discretionary grantees are required to collect and report data on a regular and real-time basis. 

These data are used to monitor grantee performance to ensure that progress is being made toward 

meeting program goals and objectives. Data provided evidence of the effectiveness of the 

services being provided. Several key domains have been identified in order to assess the extent 

to which service provision is effective. These domains include abstinence from substance use, 

employment, housing stability, criminal justice status and social connectedness. Outcomes data 

are monitored using the Services Accountability Improvement System. Data are monitored to 

provide information which can be used to improve service quality, monitor grantee performance 

and provide recommendations for future direction. During the next fiscal year, data will still 

play an integral role in the monitoring of grantee performance; however, the data system used for 

this monitoring will be switched to the Common Data Platform which will house data from all 

SAMHSA discretionary grantees. 

In FY 2015, funding will support all continuations as well as approximately 12 new grants.

Minority AIDS Initiative

FY 2015 Request: $58.9 million

(Reflects $6.9 million decrease from FY 2014 Enacted Level)

Minority AIDS (MAI) grants are awarded to community-based organizations with two or more 

years of experience in the delivery of substance abuse treatment and related HIV/AIDS services. 

Funded programs target one or more of the following high-risk substance abusing populations: 

African American, Hispanic/Latino, and/or other racial/ethnic minority communities; women, 

including women with children; adolescents; men who inject drugs; minority men who have sex 

with men (MSM); and individuals who have been released from prisons and jails within the past 

two years. 

In addition to providing substance abuse treatment services, pre-treatment services are provided, 

including the provision of literature and other materials to support behavior change, facilitation 

of access to drug treatment, HIV/AIDS testing and counseling services, and other medical and 

social services in the local community. 

In FY 2012, SAMHSA’s TCE/HIV program served approximately 8,000 individuals. Of these 

individuals, approximately 69 percent were between the ages of 25 and 54 years old.

Approximately 32 percent identified themselves as Hispanic/Latino in ethnicity; 42 percent as 
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African-American; 27 percent White; one percent Asian, Native Hawaiian, or Pacific Islander; 

and seven percent as American Indian/Alaska Native.

In FY 2011, SAMHSA awarded 11 Minority AIDS Initiative Targeted Capacity Expansion 

(MAI-TCE) Integrated Behavioral Health/Primary Care Network Cooperative Agreements. This 

program is jointly funded with CMHS and CSAP and facilitates the development and expansion 

of culturally-competent and effective integrated behavioral health and primary care networks 

which includes HIV services and medical treatment within racial and ethnic minority 

communities in the 11 Metropolitan Statistical Areas and Metropolitan Divisions most impacted 

by HIV/AIDS. Expected outcomes include reducing the impact of behavioral health problems, 

HIV risk and incidence, and HIV-related health disparities in these areas. SAMHSA continued 

to support these grants in 2012 and 2013.

In FY 2012, SAMHSA funded the continuation of 76 grants and supported five contracts as well 

as a new cohort of 52 grants to target areas of highest need based on the most recently available 

HIV epidemiological data. 

In FY 2013, SAMHSA funded 79 grant continuations and supported seven contracts and 35 new 

grants. The 35 grants support Targeted Capacity Expansion: Substance Abuse Treatment for 

Racial/Ethnic Minority Women at High Risk for HIV/AIDS (TCE-HIV: Minority Women). The 

purpose of this program is to expand substance abuse treatment and HIV services for African 

American, Hispanic/Latina, and other racial/ethnic minority women (ages 18 years and older), 

including heterosexual, lesbian, bisexual, previously incarcerated women, and their significant 

others, who have substance use or co-occurring substance use and mental disorders, and are 

living with or at risk for HIV/AIDS.

Scientific literature supports that as the incidence and prevalence of HIV/AIDS increases among 

racial and ethnic minority populations, the need for substance abuse and mental health treatment 

increases as well. Limited or a complete absence of appropriate behavioral treatment 

intervention services is very likely to lead to unmet behavioral health needs, adverse medical 

conditions, impaired quality of life, increased morbidity and mortality for this vulnerable 

population. To address this public health challenge, the MAI-TCE program facilitates the 

development and expansion of culturally competent and effective integrated behavioral health 

and primary care networks, which includes HIV services and medical treatment, within racial 

and ethnic minority communities in 11 Metropolitan Statistical Areas (MSAs) highly impacted 

by HIV/AIDS.

SAMHSA Services Accountability Improvement System (SAIS) data and CDC HIV prevalence 

data was used to identify specific minority high-risk populations that resulted in SAMHSA 

publishing population focused RFAs for YMSM and minority women.

By focusing on specific vulnerable populations and requiring grantees to utilize specific 

evidence-based interventions SAMHSA/CSAT programs can build new evidence that supports 

the value of simultaneous treatment of co-occurring substance abuse and HIV and the value of 

using evidence-based interventions for recruitment and retention of high-risk, minority 

populations in substance abuse treatment and antiretroviral therapy. Improved treatment 
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outcomes would lend itself to more rigorous evaluation and data analysis by the SAMHSA 

Common Data platform (CDP) to inform future public health intervention decision-making. 

In FY 2014, SAMHSA plans to support the continuation of 87 grants and six contracts, and will 

continue to monitor the progress of the three FY 2012 multi-year funded grants. The proposed 

number of clients to be served with 2014 funds is 13,558. Outcomes including abstinence from 

substance use will also be tracked. 

In FY 2015, funding will support grant continuations.

HIV Continuum of Care

(Braided program with Mental Health: Minority Aids Initiative and Primary and Behavioral 

Health Care Integration and with Substance Abuse Prevention: Minority Aids Initiative)

In FY 2014, SAMHSA’s CMHS, CSAP, and CSAT plan to pilot HIV Continuum of Care grants 

which supports behavioral health screening, primary prevention, and treatment for racial/ethnic 

minority populations with or at high risk for mental and substance use disorders and HIV. This 

will include Substance Abuse (SA) primary prevention/treatment service programs, community 

mental health programs, and HIV integrated programs that can either co-locate or fully integrate 

HIV prevention and medical care services within them. Also, this program will provide SA and 

HIV primary prevention services in local communities served by the behavioral health program.

SAMHSA expects that data generated from the 2014 HIV Continuum of Care pilot will help to 

inform an expanded program proposed for 2015 to continue the co-location and integrated 

HIV/primary care within either substance abuse or community mental health treatment programs. 

Braided funds would be dedicated to establishing integrated behavioral health and HIV care in 

addition to primary care needed by those living with or at high risk for HIV infection in minority 

communities heavily impacted by HIV. In addition, because of the significant comorbidity of 

viral hepatitis with HIV infection and because viral hepatitis occurs in up to 20 percent of those 

with either substance use disorders or serious mental illness, 5 percent of the allocated funds will 

be used to provide services to prevent, screen, test and refer to treatment as clinically appropriate 

those at risk for or living with viral hepatitis. In integrating HIV care into behavioral health 

settings, people living with HIV/AIDS and M/SUDs will have greater access to treatment for 

these conditions. Integrated care programs developed as a result of this grant program will make 

it possible for behavioral health and HIV care needs to be addressed in one setting. This will 

result in effective, person-centered, treatment that will reduce the risk of HIV transmission, 

improve outcomes for those living with HIV, and ultimately reduce new infections. SAMHSA’s 

Common Data platform (CDP), will integrate substance abuse and mental health elements with 

HIV and Hepatitis elements to ensure a more rigorous evaluation and data analysis to inform 

future public health intervention decision-making that addresses the intersection of behavioral 

health and HIV.
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Access to Recovery

FY 2015 Request: $0

(Reflects $50 million decrease from FY 2014 Enacted Level)

Since 2004 the ATR program has served 221,607 clients through 69 grantees. In FY 2014, 

SAMHSA plans to award approximately five Prevention and Public Health Fund grants of up to 

$3 million per year for three years – these grants will be multi-year funded. The majority of 

services provided are expected to be recovery support not otherwise fundable through insurance 

mechanisms. These include services such as transportation, housing, and jobs support. Reduced 

in scale from past years, ATR will serve approximately 8,000 individuals per year. In FY 2014, 

the program will preserve the core concepts embodied in the three previous ATR cohorts, while 

also striving to better support provisions of the Affordable Care Act.

State and tribal ATR grants will support the provision of treatment and recovery support services 

to those with substance use disorders. Services payable under Medicaid and covered through 

essential health benefit plans, such as outpatient clinical treatment services and residential 

services, would, for the most part, not be allowable under this program. In order to ensure nonduplication of billing sources, providers will work with clients to link them to other usable 

funding sources where appropriate. For those services not covered, providers will be responsible 

for the provision of direct services. As was the case in the first three cohorts of ATR, 

states/tribes will be required to establish provider networks and develop a voucher-based 

mechanism to ensure client choice can be easily and freely exercised. 

ATR grant funds will also support creating linkages with state health information exchanges 

(HIEs) to ensure coordination and non-duplication; working with non-traditional providers, such 

as faith-based and peer providers; working with traditional providers to ensure that proper 

sources of billing are being utilized for recovery support and clinical treatment services not being 

covered under Medicaid and other sources; and increasing availability and access to training and 

certification programs for non-traditional providers, such as faith-based and peer providers. 

In FY 2014, the ATR program will better support the integration of third party payers, the 

provision of services unlikely to be covered by insurance such as supportive services like 

housing, and services to those who are ineligible for insurance or are unable to acquire it. 

Successful ATR innovations will be communicated and new evidence shared to strengthen 

capacity nationwide and to inform future decision making regarding ATR models of service 

delivery. 

SAMHSA is proposing eliminating the ATR program in FY 2015 budget, a decrease of $50 

million from the FY 2014 Enacted Level. Many of the clinical services provided under ATR 

will now be covered by public and private insurance. In addition, states have been encouraged to 

support recovery support services and client choice with SABG funding. States that would like 

to continue this activity will have support from SAMHSA in FY 2014 in incorporating lessons 

learned from the successful test.
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Primary Care and Addiction Services Integration

FY 2015 Request: $20 million

(Reflects $20 million increase from FY 2014 Enacted Level)

In FY 2015, SAMHSA is requesting $20 million to support the development of a new initiative 

related to the integration of substance abuse treatment services and primary care. The PCASI 

Program would enable providers to offer a full array of both physical health and substance abuse 

services to clients. In conjunction with the Affordable Care Act (ACA), SAMHSA recognizes 

the need to emphasize the importance of integrated service delivery. Through this program, 

integrated teams of professionals will be able to provide needed primary care services to 

individuals seeking care for their substance use disorder. The purpose of this program is to 

establish projects for the provision of coordinated and integrated services through the co-location 

of primary and specialty care services in community-based substance abuse treatment settings.

The goal is to improve the physical health status of adults with substance use disorders who have 

or are at risk for co-occurring primary care conditions and chronic diseases, with the objective of 

supporting the triple aim of improving the health of those with SUD; enhancing the client’s 

experience of care (including quality, access, and reliability); and reducing/controlling the per 

capita cost of care. The expected outcome of improved health status for people with SUD will be 

achieved by encouraging grantees to engage in necessary partnerships, expand infrastructure, and 

increase the availability of primary health care and wellness services to individuals with SUD. 

Partnerships between primary care and behavioral health organizations, as well as information 

technology entities, are deemed crucial to the success of this program.

Currently, a significant component of the overall higher cost of care for those with SUD is 

untreated chronic disease.79 The likelihood that a patient seeking care for a substance use 

disorder will successfully complete a referral to a primary care facility is low in general but 

greatly improved within a single visit or facility.80 This program will not only improve the data 

about the success and impact of these improved referrals, but will also illuminate other benefits 

of integration such as improved provider knowledge and effectiveness at identifying and 

referring individuals in need of primary care and substance abuse treatment. 

The demand for substance use disorder prevention, intervention, treatment, and recovery services 

after the implementation of the ACA will far exceed the current capacity and a focused effort

through the states to address this shortage will be critical. As described above, the PCASI 

program provides the structure and infrastructure necessary to support the integrated service 

delivery. Together, these two programs will perform synergistically, with the process and 

performance outcomes building on each other.

Substance use disorders can cause physical health problems and/or exacerbate existing physical 

health problems. For example, several cardiovascular complications are closely related to 

cocaine use. They include chest pain syndromes, heart attacks, heart failure, strokes, aortic 

 

79 Druss, B. g., & Rosenheck. R. A. (1999). Patterns of health care costs associated with depression and substance 

abuse in a national sample. Psychiatric Services, 50, 214-218

80 Kathol, R. G., McAlpine, D., Kishi, Y., Speies, R., Meller, W., Bernhardt, T., et al. (2005). General medical and 

pharmacy claims expenditures in users of behavioral health services. Journal of General Internal Medicine, 20, 160-

167.
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dissection, and fatal and nonfatal arrhythmias.

81 According to the CDC, alcohol use causes 

80,000 deaths a year.82 Alcohol use contributes to a variety of chronic health conditions 

including; cirrhosis, hypertension, obesity, diabetes, hepatitis, pancreatitis, cardiomyopathy, 

gastritis, etc...which increases morbidity and mortality. Additionally, excessive alcohol use 

increases the risk of cancers such as mouth, throat, and esophagus. As the result of other chronic 

health issues, many individuals develop substance abuse problems due to self-medication. The 

National Institute on Drug Abuse defines self-medication as the use of a substance to lessen the 

negative effects of stress, anxiety, or other mental disorders (or side effects of their 

pharmacotherapy). Self-medication may lead to addiction and other drug or alcohol-related 

problems.83

A continuum of preventive and health promotion services will be offered to and/or coordinated 

for clients within the PCASI program, where different services are offered to different categories 

of clients according to the severity of the condition/risk factors. Wellness programs (e.g., 

tobacco cessation, nutrition consultation, health education and literacy, self-help/management 

programs) will be offered, including interventions that involve preventive screening and 

assessment tools for all clients. In addition, this grant program can support the infrastructure 

necessary to ensure an effective coordination of services, including such tasks as necessary to 

expand partnerships, increase the use of an integrated electronic health record, and other such 

activities. Grantees will be required to bill third party insurance or utilize other funds and to only 

use SAMHSA grant funds for services to individuals who are ineligible for public health 

insurance programs, individuals for whom coverage has been formally determined to be 

unaffordable, or for services that are not sufficiently covered by an individual’s health insurance 

plan (co-pay or other cost sharing requirements are an acceptable use of SAMHSA grant funds).

SAMHSA will fund a total of 34 grants at approximately $0.5 million annually for up to three 

years. Eligible applicants will be publicly funded community substance abuse treatment centers.

To address the bi-directional nature of the integration approach emphasized by this grant 

program, the applicant must demonstrate they are able to offer the following core requirements; 

provided by qualified professionals, both substance abuse treatment and primary care services. 

Additional eligibility criteria include the ability to show demonstrable progress or commitment 

to the implementation of interoperable electronic health records.

The remaining $3 million will be used to fund technical assistance and evaluation activities to 

assess the clinical and cost effectiveness of these programs and other programs in the field, to 

ensure fidelity to implementation, and to assist with documentation and dissemination of lessons 

learned from the program. The success of the PBHCI program has taught SAMHSA that 

technical assistance must include strategies around integrated models, workforce, financing, 

clinical practice, and operations and administration of the PCASI grant. SAMHSA has been able 

to realize improved health outcomes for PBHCI clients across myriad domains, including blood 

pressure, tobacco use, and diabetes measures, in addition to improvement in client self-

 

81 http://www.heart.org/HEARTORG/Conditions/Cocaine-Marijuana-and-Other-Drugs_UCM_428537_Article.jsp

82 Jeffrey J. Sacks, MD, MPH, Jim Roeber, MSPH, Ellen E. Bouchery, MS, Katherine Gonzales, MPH, Frank J. 

Chaloupka, PhD, Robert D. Brewer, MD, MSPH; State Costs of Excessive Alcohol Consumption, 2006: Accessed 

at http://www.ajpmonline.org/webfiles/images/journals/amepre/AMEPRE_3854-stamped-081313.pdf

83 http://www.drugabuse.gov/publications/research-reports/comorbidity-addiction-other-mental-illnesses/glossary
263

perception of overall health. The PBHCI program has created bridges between community 

behavioral health and primary care providers, yielding a cadre of providers able to serve the 

holistic health care needs of their patients.

Promoting widespread implementation of Health Information Technology (HIT) systems that 

support quality, integrated behavioral health care is currently one of SAMHSA’s eight strategic 

initiatives. HIT has the potential to transform the health care system by improving the quality of 

care delivery, supporting patient engagement and self-management, improving the efficiency of 

the workforce, and expanding access to care. In FY 2011-2012, SAMHSA provided 

supplemental funding to our Primary & Behavioral Health Care Integration (PBHCI) program to 

help 4 grantees become meaningful users of electronic health record (EHR) technology. Of 

these, 93 percent successfully implemented a certified EHR system in 2012 and this technology 

is continuing to support the integration of primary and behavioral healthcare in these programs. 

Due to the success of the PBHCI HIT supplemental program, SAMHSA is requesting an 

additional $2 million in funding for the Targeted Capacity Expansion-General program in FY 

2015 to fund the Behavioral Health Information Privacy Center of Excellence, a similar HIT 

initiative, among the Primary Care and Addiction Services Integration (PCASI) program 

grantees. This supplemental funding will support the enhancement and adoption and meaningful 

use of certified EHR technology which will facilitate the integration of care for patients in 

substance abuse treatment to improve compliance with Federal privacy law.

In addition, the funding will support Braided Program: HIV Continuum of Care as provided 

below to provide bi-directional integration between primary care services and substance abuse 

treatment/mental health services (for CSAT/CMHS) and address service coordination and

infrastructure needs of providers serving this vulnerable population.

Other PRNS Treatment Programs

FY 2015 Request: $102.6 million

(Reflects $29.6 million decrease from FY 2014 Enacted Level)

The FY 2015 Budget includes resources of $102.6 million for several other Treatment Capacity 

programs including: Strengthening Treatment Access and Retention; Children and Family 

Programs; Pregnant and Post-Partum Women (PPW); Recovery Community Services Program 

(RCSP); Special Initiatives/Outreach; Addiction Technology Transfer Centers; Opioid treatment 

Programs; and Targeted Capacity Expansion (TCE) General. The FY 2015 Budget includes 

funds for continuing grants and contracts in the various programs, and reflects discontinuation of 

one-time Congressional projects. Grant funding will be used to enhance overall drug treatment 

quality by incentivizing treatment and service providers to achieve specific performance targets. 

Examples of grant awards could include supplements for treatment and service providers who 

are able to connect higher proportions of detoxified patients with continuing recovery-oriented 

treatment; or for outpatient providers who are able to successfully retain greater proportions of 

patients in active treatment participation for longer time periods. 
264

Substance Abuse Prevention and Treatment Block Grant

FY 2015 Request: $1.820 billion

(Reflects level funding from FY 2014 Enacted Level)

The Substance Abuse Prevention and Treatment Block Grant Program (SABG) distributes funds 

to 60 eligible states, territories, the District of Columbia, and the Red Lake Band of Chippewa 

Indians of Minnesota to plan, carry out, and evaluate substance abuse prevention, treatment and 

recovery support services provided for individuals, families, and communities impacted by 

substance abuse and substance use disorders (SUD). 

This formula grant program provides funding based upon specified economic and demographic 

factors and is administered by SAMHSA’s Center for Substance Abuse Treatment and Center for 

Substance Abuse Prevention. 

All Block Grant applications must include an annual plan that contains detailed provisions for 

complying with each funding agreement specified in the legislation, and describe how the 

grantees and their respective SABG sub-recipients intend to expend the SABG. The legislation 

includes specific provisions and funding set-asides, such as 20 percent for primary prevention; a 

5 percent HIV early intervention services set-aside; performance requirements for substance 

using pregnant women and women with dependent children; requirements and potential penalty 

reduction of the Block Grant allotment with respect to sale of tobacco products to individuals 

under the age of 18; a maintenance of effort requirement; and “hold harmless” provisions that 

limit fluctuations in allotments as the total appropriation changes from year to year. 

The program’s overall goal is to support and expand substance abuse prevention and treatment 

services while providing maximum flexibility. Services funded by the SABG include services 

identified in SAMHSA’s Good and Modern Service System84 brief as described in the block 

application. States and territories may expend Block Grant funds only for the purpose of 

planning, carrying out, and evaluating activities related to these services. Targeted technical 

assistance is available for the states and territories through SAMHSA’s technical assistance 

contract. The SABG requires states to maintain expenditures for authorized activities at a level 

that is not less than the average level of such expenditures maintained by the state for the two 

year period preceding the year for which the state is applying for a grant. 

Of the amounts appropriated for the SABG program, 95 percent are distributed to, territories and 

Red Lake Band of the Chippewa Indians through a formula prescribed by the authorizing 

legislation. Factors used to calculate the allotments include total personal income, state 

population data by age groups (total population data for territories), total taxable resources, and a 

cost of services index factor. 

The SABG is critically important because it provides the grantees and their respective SABG 

sub-recipients the flexibility to respond to local and/or regional emergent issues impacting 

health, public health, and public safety through a consistent federal funding stream. For 

example, this program provides approximately 32 percent of total State Substance Abuse Agency 

 

84 http://www.samhsa.gov/healthReform/docs/good_and_modern_4_18_2011_508.pdf
265

funding, and 23 percent of total substance abuse Prevention and Public Health Funding. Because 

SAMHSA encourages states to focus on these populations, individuals who are currently in need 

of such services may fall into several categories, such as having no insurance or limited health 

insurance coverage for substance use disorder treatment and recovery support services, or having 

been mandated to enter SUD treatment through public safety and/or public welfare systems. 

Individuals and families without health coverage or whose health insurance benefit will not 

cover certain services (e.g., recovery supports) rely on services funded by the SABG. States also 

rely on the SABG funding for an array of non-clinical activities and services which support 

critical needs of their respective service systems, such as planning, coordination, needs 

assessment, quality assurance, program development, and evaluation. 

In FY 2011, SAMHSA redesigned the FY 2012/2013 MHBG and SABG applications to better 

align with the current federal/state environments and related policy initiatives, including the 

Affordable Care Act, the Mental Health Parity and Addiction Equity Act (MHPAEA), and the 

Tribal Law and Order Act (TLOA). The new design offered states the opportunity to complete a 

combined application for mental health and substance abuse services, submit a bi-annual versus 

an annual plan, and provide information regarding their efforts to respond to various federal and 

state initiatives. Almost one-half of the states took advantage of this streamlined application and 

submitted combined plans for mental health and substance abuse services. Over 95 percent of 

the states provided specific information requested by SAMHSA regarding strategies to respond 

to a variety of areas including primary care and behavioral health integration, recovery support 

services, prevention of substance use, and promotion of emotional health. States continued to 

provide information regarding the spending of their Block Grant funds to support services 

identified in SAMHSA’s Good and Modern Service System85 brief as described in the block 

grant application.

The FY 2014/2015 Block Grant application builds upon the FY 2012/2013 application and 

furthers SAMHSA’s efforts to have states use and report the opportunities offered under various 

federal initiatives. In addition, the FY 2014/2015 Block Gant continues to allow states to submit 

a combined application for mental health and substance abuse services as well as a bi-annual 

versus an annual plan. 

After the full implementation of the ACA, SAMHSA has strongly recommended that SABG 

funds be directed toward four purposes: (1) to fund priority treatment and support services for 

individuals without insurance or for whom coverage is terminated for short periods of time; (2) 

to fund priority treatment (Essential Health Benefits – EHB) and support services not covered by 

private and public insurance for low and moderate income individuals and that demonstrate 

success in improving outcomes and/or supporting recovery (non-EHB covered treatments); (3) to 

fund primary prevention (universal, selective, and indicated) activities and services for 

individuals not identified as needing treatment; and (4) to collect performance and outcome data 

to determine the ongoing effectiveness of behavioral health promotion, treatment, and recovery 

support services and to plan the implementation of new services on a nationwide basis. In 

addition, consistent with SAMHSA's Theory of Change, which draws a path from innovation, 

translation, dissemination, to implementation and, finally, wide scale adoption, the agency will 

take advantage of the successful strategies implemented through the Access to Recovery 

 

85 http://www.samhsa.gov/healthReform/docs/good_and_modern_4_18_2011_508.pdf
266

program. SAMHSA will encourage the states to utilize their Block Grants to: (1) allow 

recovery to be pursued through personal choice and many pathways; (2) encourage providers to 

manage performance based on outcomes that demonstrate client successes; and (3) expand 

capacity by increasing the number and types of providers who deliver clinical treatment and/or 

recovery support services.

The independent evaluation of the SABG program86 demonstrated how states have leveraged the 

statutory requirements of this Block Grant to expand existing or establish new treatment capacity 

in underserved areas of states and territories and to improve coordination of services with other 

state systems. 

As noted below, the SABG Program has been successful in expanding treatment capacity in the 

latest year for which actual data are available in FY 201187 by supporting approximately two 

million88 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 2011, at discharge, 

clients demonstrated high abstinence rates from both illegal drug (73.4 percent) and alcohol 

(81.6 percent) use. 

State Substance Abuse Authorities reported the following outcomes for services provided during 

FY 2011, the most recent year data is available:

 For the 50 states89 and D.C that reported data in the Abstinence from Drug/Alcohol Use 

Domain for alcohol use, 51 of 51 identified improvements in client abstinence.

 Similarly, for the 50 states and D.C. that reported data in the Abstinence from Drug/Alcohol 

Use Domain for drug use, 50 of 51 identified improvements in client abstinence. 

 For the 50 states and D.C. that reported data in the Employment Domain, 47 of 51 identified 

improvements in client employment. 

 For the 50 states and D.C. that reported in the Criminal Justice Domain, 46 of 51 reported an 

increase in clients with no arrests based on data reported to TEDS.

 For the 49 states and D.C. that reported data in the Housing Domain, 42 of 49 identified 

improvements in stable housing for clients based on data reported to TEDS.

20 Percent Prevention Set-Aside

SAMHSA is responsible for managing the 20 percent prevention set-aside of the Substance 

Abuse Prevention and Treatment Block Grant (SABG). This is one of SAMHSA’s main 

vehicles for supporting Strategic Initiative #1: Prevention of Substance Abuse and Mental 

Illness. States use these funds to develop infrastructure and capacity specific to substance abuse 

 

86 http://tie.samhsa.gov/SAPT2010.html#Evaluation

87 Source: 2013 SABG Report – Tables 16-21. While this is referenced as FY 2011, the actual time period varies by State, e.g; 

CY 2011 (imported TEDS data); SFY 2011 (manually entered by States); SFY 2012 (manually entered by States.

88Source: 2013 SABG Report – Table II

89Source: West Virginia numbers have been included in the text, but that appear lower than expected.
267

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. Performance 

results will be available in December, 2013.

In an effort to streamline the application and reporting procedures for both the SABG and the 

Mental Health Block Grant programs, SAMHSA has developed a uniform application and 

reporting process to promote consistent planning, application, assurance, and reporting dates 

across both block grants. States are encouraged to make prevention a top priority, taking 

advantage of recent science, best practices in community coordination, proven planning 

processes, and the science articulated by the IOM report on Preventing Mental, Emotional, and 

Behavioral Disorders Among Young People90. SAMHSA will work with states to increase their 

accountability systems for prevention and to develop necessary reporting capacities. 

Synar

The Synar program is the set of actions put in place by states, with the support of the federal 

government, to implement the requirements of the Synar Amendment. The Amendment was 

developed in the context of a growing body of evidence about the health problems related to 

tobacco use by youth, as well as evidence about the ease with which youth could purchase 

tobacco products through retail sources. The Synar program is a critical component of the 

success of youth tobacco use prevention efforts. SAMHSA is charged with overseeing states’ 

implementation of the Synar requirements and provides technical assistance to states on both the 

Synar requirements and youth tobacco access issues in general.

Since the inception of the Synar program in 1996, SAMHSA has worked with states to assist 

them in complying with and attaining the goals of the Synar Amendment and has issued 

programmatic requirements and guidance documents to assist states in their efforts.

By regulation, states must achieve a retailer noncompliance rate of 20 percent or less. Since FY 

2006, all 50 states, Puerto Rico, and the District of Columbia have been in compliance with the 

Synar requirements. In FY 2012, the most recent year available, the national weighted average 

retailer violation rate was 9.1 percent. FY 2013 data will be available by August 31, 2014.

A total of $1.8 billion is requested in FY 2015, reflecting the same level funding from the FY 

2014 Enacted Level. The FY 2015 request for the SABG includes recognition of new coverage 

for some limited services for SUDs in some states, mostly after an addiction is already 

diagnosed. SAMHSA’s FY 2015 budget also recognizes the increased demand for services 

likely to be created by additional coverage options.

In addition, the most recent versions of the uniform SABG and Mental Health Block Grant 

(MHBG) application, and related investments in technical assistance, have called upon states to 

make particular efforts. These include ensuring that the providers they work with are 

administratively prepared to bill third-party sources of coverage, and are doing so for enrolled 

clients. In particular, a five-year multi-million dollar training and technical assistance effort was 

 

90 http://www.iom.edu/Reports/2009/Preventing-Mental-Emotional-and-Behavioral-Disorders-Among-Young-People-Progressand-Possibilities.aspx
268

launched in FY 2012 for training community behavioral health providers on third-party 

contracting and billing practices in partnership with state-level mental health and substance 

abuse officials.

As public and private health insurance expand coverage of substance abuse treatment, SABG 

funding will focus upon the provision of effective non-covered prevention and intervention 

services that support health outcomes. 

Health Reform Implementation

As a result of the analysis and examination of the various components of the Affordable Care 

Act beginning in 2010, SAMHSA has undertaken a major redesign of the planning section of the 

application process for both the MHBG and SABG. SAMHSA is aligning the block grants to 

complement mental health and substance abuse coverage expansions in the Affordable Care, and 

the Mental Health Parity and Addiction Equity Acts support individuals otherwise unable to 

receive services through public and private insurance. Together, SAMHSA’s block grants 

support the provision of services and related supports to approximately eight million individuals 

with mental and substance use conditions. With an estimated 11.4 million adults having a severe 

mental illness,91 44.7 million adults having any mental illness,92 and another 22.1 million adults 

with substance abuse disorder,93 demand clearly outpaces the public behavioral health system’s 

established capacity. Many of these individuals and some of the services they need will continue 

to be without coverage through public or private insurance mechanisms. Aligning and 

coordinating the SAMHSA block grants with the Affordable Care Act helps create a cohesive 

national service system that is responsive to potential gaps in service delivery and effectively 

provides needed behavioral health services across sectors and across payment sources.

States should determine if established systems and procedures are sufficient to ensure that Block 

Grant funds are expended in accordance with program requirements and directed to support and 

not supplant health reform activities. The Block Grant Application for FY 2014/2015, 

SAMHSA has strongly recommended that states use these resources to support and not supplant 

services that will be covered through commercial and public insurer plans. States will be asked 

to develop metrics or targets for their systems to measure increases in the number of individuals 

who become enrolled or providers that join commercial or publicly funded provider networks. 

The primary goals of SAMHSA’s program integrity efforts are to continue to (1) promote the 

proper expenditure of block grant funds, (2) improve block grant program compliance nationally, 

and (3) demonstrate the effective use of block grant funds. 

SAMHSA will provide additional guidance to the states to assist them in complying with this 

continuing emphasis on program integrity, will develop new and better tools for reviewing block 

grant application and reports, and will train SAMHSA staff in these program integrity 

approaches and tools. SAMHSA will be working with states to develop changes to information 

systems and compliance review processes to ensure increasing program integrity. This may 

include working closely with Medicaid and Health Insurance Exchanges to obtain information to 

 

91 http://www.samhsa.gov/data/NSDUH/2k10MH_Findings/2k10MHResults.htm

92http://www.samhsa.gov/data/2k12/NSDUH110/sr110-adult-mental-illness.htm

93 http://www.samhsa.gov/data/NSDUH/2k10ResultsRev/NSDUHresultsRev2010.htm#Ch7
269

determine if individuals and providers in their systems are enrolled. This may also include 

strategies to assist their providers to develop the necessary infrastructures to operate in 

commercial and public insurer networks. The Uniform Application, along with evolution of 

SAMHSA’s block grant reporting system are tools to assist in this process. 

Health Surveillance and Program Support

The FY 2015 Request is $124.6 million, which represents the Substance Abuse portion of the 

HSPS appropriation and supports staffing and activities to administer SAMHSA programs. This 

includes:

Health Surveillance and Program Support

FY 2015 Request: $83.7 million

(Reflects $1.3 million increase from FY 2014 Enacted Level)

Health Surveillance and Program Support provides funding for personnel costs, building and 

facilities, equipment, supplies, administrative costs and associated overhead to support 

SAMHSA programmatic activities as well as providing funding for SAMHSA national data 

collection and survey systems, funding to support the CDC NHIS Survey, and the data archive. 

This 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.

A total of $83.7 million is requested in FY 2015 for Health Surveillance activities. The increase 

in funds will be used to support the President’s Now is the Time initiative. This increase will be 

used to support the work begun by the White House National Conference on Mental Health, 

supporting the collection and use of data to learn if, what, and how we are communicating is 

making a positive difference. Specifically, this funding will be used for a new initiative, Science 

of Changing Social Norms: Building the Evidence Base, to support efforts to measure and track 

behavioral, attitudinal, and related community data to understand the impact of social messaging 

and demonstrate evidence for effecting change in social norms and behavior to reduce negative 

attitudes and improve people’s willingness to seek help for themselves and others when they 

experience a mental health problem. The Science of Changing Social Norms will have a second 

component, Social Media, funded from Public Awareness and Support.

Public Awareness and Support 

FY 2015 Request: $7.8 million

(Reflects $1 million increase from FY 2014 Enacted Level)

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.
270

The additional request in FY 2015 will support a new initiative, the Science of Changing Social 

Norms: Social Media, to develop and test an array of messages and media designed to improve

attitudes, understanding and behavior of Americans about mental and substance use disorders 

and the willingness to seek help for them. Building on the effort to increase understanding about 

mental health through the Now is the Time initiative launched on January 16, 2013, this public 

awareness and education initiative will seek to target the message resulting from the national 

conversation about behavioral health most effectively. The increase will fund social media 

strategies to support the work begun by the White House National Conference on Mental Health. 

The goal is to use communications science and market research to identify the most effective and 

evidence-based methods for decreasing negative attitudes, increasing knowledge and improving 

willingness to seek help for mental health and substance abuse problems to ensure outreach 

funds are spent where they will make the most impact. This initiative is in conjunction with the 

Science of Changing Social Norms: Building the Evidence Base in the Center for Behavioral 

Health Statistics and Quality’s which is essential to understand the impact of social messaging 

and demonstrate evidence for effecting change in social norms and behavior to reduce negative 

attitudes and improve people’s willingness to seek help. CBHSQ’s data collection component 

will be funded separately under Health Surveillance and Program Support.

Performance and Quality Information Systems

FY 2015 Request: $8.9 million

(Reflects level funding from FY 2014 Enacted Level)

Performance and Quality Information Systems provides funding to support the Consolidated 

Data Platform and CDP related activities, as well as provide support for a new contract 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. 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.

In FY 2015, these funds will be used to continue support for the Common Data Platform, which 

was awarded in late FY 2013 and implemented in FY 2014, as well as provide support for the 

continuation of NREPP.

Agency-Wide Initiatives

FY 2015 Request: $23.4 million

(Reflects $0.6 million increase from FY 2014 Enacted Level)

Agency-Wide Initiatives provides funding for across Agency initiatives such as Minority 

Fellowship Program which improves the quality of mental health and substance abuse prevention 

and treatment delivered to ethnic minorities by providing stipends to post-graduate students and 

other Behavioral Health Workforce programs. This represents the total funding available for 

these activities first divided evenly between Mental Health and Substance Abuse. The Substance 
271

Abuse portion is then split 20 percent/80 percent into the two functions, prevention and 

treatment, respectively.

In FY 2015, SAMHSA will collaborate with HRSA in expanding the Behavioral Health 

Workforce Education and Training (BHWET) Grant Program. This expansion will increase the 

clinical service capacity of the behavioral health workforce by supporting training for Master’s 

level social workers, psychologists, marriage and family therapists, psychology doctoral interns, 

as well as behavioral health paraprofessionals. This effort is critical to ensure that the behavioral 

health workforce is able to meet the needs of high need and high demand populations, including 

rural, vulnerable, and underserved populations. In FY 2015, the program will continue to 

include an emphasis on training to address the needs of children, adolescents, and transition-age 

youth (ages 16-25) and their families. SAMHSA requests $35 million in FY 2015 for the 

SAMHSA-HRSA expansion of the BHWET grant program and will help increase the behavioral 

health workforce by 3,500 individuals, in addition to those below.

Peer Professional Workforce Development

In FY 2015, SAMHSA proposes to implement a program to strengthen the behavioral health 

workforce by increasing the number of trained peers, recovery coaches, mental health/addiction 

specialists, prevention specialists, and pre-Master’s level addiction counselors working with an 

emphasis on youth ages 16-25. Because of their lived experience with behavioral health 

conditions, and being able to build trust and foster connections with individuals accessing care, 

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

support services. SAMHSA plans to award up to 19 grant awards to community colleges or 

community college networks, states, and national organizations. These funds will provide tuition 

support and further establish the capacity of community colleges to develop and sustain 

behavioral health paraprofessional training and education. Funding will increase the behavioral 

health workforce by 1,200 peer professionals.

The Behavioral Health Workforce Education and Training (BHWET) will focus on supporting 

clinical internships and field placements, and certificate program completion across a range of 

professional and paraprofessional disciplines (some of whom may be peers) to produce a ready 

cohort of new behavioral health providers. The Peer Professional Workforce Development 

program focuses exclusively on peers, or people with personal experiences with mental illness 

and/or substance use conditions. Peers may play roles across the spectrum of prevention, 

treatment and recovery/family support. The Peer Professional program will award grants to 

community colleges, community college networks, states, and national organizations in order to 

develop the training infrastructure for peer professionals nationwide. 

Behavioral Health Workforce Data and Development

Beginning in 2014, over 62 million Americans will have expanded or first time access to 

coverage for services for mental and substance use disorders as a result of a combination of the 

Affordable Care Act and the Mental Health Parity and Addictions Equity Act. Almost 11 

million of these individuals are expected to have mild to severe mental health and/or substance 

abuse conditions with related treatment needs. Current data indicate that almost 90 percent of 
272

persons with substance abuse issues do not receive the services they need and over half of those 

with mental disorders do not receive needed treatment. 

SAMHSA received $40 million in new behavioral health workforce activities in the FY 2014 

Appropriation. This budget assumes continuation of those programs to develop approximately 

5,000 new behavioral health clinical professionals. To ensure the existing workforce 

investments are responsible and well-targeted, SAMHSA’s FY 2015 budget proposes to partner 

with HRSA on the Behavioral Health Minimum Data Set to develop consistent data collection 

methods to identify and track behavioral health workforce needs as well as to partner with the 

Department of Defense, and the Department of Veterans Affairs to inventory existing and 

emerging workforce issues, efforts and impacts, and develop coordinated plans.

Data Request and Publication User Fees

FY 2015 Request: $0.8 million

(Reflects level funding from FY 2014 Enacted Level)

In 2015, SAMHSA estimates $0.8 million in Data Request and Publication User Fees. These fees 

will be collected and retained 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.

 

i

Richard Spoth, Linda Trudeau, Chungyeol Shin, Ekaterina Ralston, Cleve Redmond, Mark Greenberg, and Mark 

Feinberg. Longitudinal Effects of Universal Preventive Intervention on Prescription Drug Misuse: Three 

Randomized Controlled Trials With Late Adolescents and Young Adults. American Journal of Public Health: April 

2013, Vol. 103, No. 4, pp. 665-672. 
273

SAMHSA

Prevention and Public Health Fund

Table of Contents

SAMHSA/Prevention and Public Health Fund

1. Summary of the Request ..................................................................................................... 275

2. Primary and Behavioral Health Care Integration ................................................................ 277

3. GLS Youth Suicide Prevention ........................................................................................... 281

4. Health Surveillance ............................................................................................................. 287
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SAMHSA

Prevention and Public Health Fund

Summary of the Request

(Dollars in thousands)

FY 2013 FY 2014 FY 2015 

Prevention and Public Health Fund

Final Enacted President's 

Budget

Primary and Behavioral Health Care Integration...... $--- $--- $28,000 +$28,000

Suicide Prevention.................................................. --- 10,000 10,000 ---

Health Surveillance................................................. 14,733 --- 20,000 +20,000

National Strategy on Suicide Prevention.................. --- 2,000 --- -2,000

Access to Recovery............................................... --- 50,000 --- -50,000

Total, Prevention and Public Health Fund $14,733 $62,000 $58,000 -$4,000

FY 2015

+/- 

FY 2014 

The FY 2015 Budget Request for the Prevention and Public Health Fund is $58 million, a

decrease of $4 million from the FY 2014 Enacted Level. The FY 2015 Prevention and Public 

Health Fund request includes the following: $28 million for Primary and Behavioral Health Care 

Integration, $10 million for GLS Suicide Prevention, and $20 million for Health Surveillance.
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277

Primary and Behavioral Health Care Integration

(Dollars in thousands)

FY 2013 FY 2014 FY 2015 

Final Enacted President's 

Budget

Program Level........................................................ $30,634 $51,996 $28,000 -$23,996

Prevention & Public Health Fund (non-add)...... $--- $--- $28,000 +$28,000

FY 2015

+/- 

FY 2014 

Authorizing Legislation ................................................... Sections 520A and 520K of the PHS Act 

and Section 4002 of the Patient and Protection and Affordable Care Act

FY 2015 Authorization .........................................................................................................Expired

Allocation Method .............................................................................................Competitive Grants

Program Description and Accomplishments

SAMHSA provided funding for the Primary & Behavioral Health Care Integration (PBHCI) 

program beginning in FY 2009 to address the increased rates of morbidity and mortality among 

adults with serious mental illness (SMI). These rates are due, in large part, to elevated incidence 

and prevalence of cardiovascular disease, obesity, diabetes, hypertension, and dyslipidemia in 

people with SMI. Increased morbidity and mortality can be attributed to a number of other 

issues, including inadequate physical activity and poor nutrition, smoking, side effects from 

atypical antipsychotic medications, and lack of access to primary health care services. Many of 

these health conditions are preventable through routine health promotion activities, primary care 

screening, monitoring, treatment, and care management/coordination strategies and/or other 

outreach programs at home or community sites. Physical health problems among people with 

SMI impact quality of life and contribute to premature death. While several factors contribute to 

this disparity, empirical findings indicate that early mortality among people with SMI is clearly 

linked to the lack of access to primary care services.

The PBHCI program supports SAMHSA’s Health Reform Strategic Initiative and is comprised 

of competitive cooperative agreements and the PBHCI Training and Technical Assistance (TTA) 

Center which is co-funded with HRSA. The program supports the coordination and integration 

of primary care services into publicly-funded community behavioral health settings. This 

program is also a part of SAMHSA’s Health Reform Strategic Initiative. The expected outcome 

of improved health status for people with SMI will be achieved by encouraging grantees to 

engage in necessary partnerships, expand infrastructure, and increase the availability of primary 

health care and wellness services to individuals with mental illness. Partnerships between 

primary care and behavioral health organizations, as well as information technology entities, are 

deemed crucial to the success of this program. The population of focus for this grant program is 

individuals with SMI and/or people with co-occurring disorders served by the public mental 

health system. Recipients are non-profit mental health provider agencies that will use these grant 

funds to develop and offer primary care as well as behavioral health services in an integrated 

manner.
278

In FY 2011, $35 million was allocated from the Prevention and Public Health Fund for PBHCI 

to promote more integrated services between primary care services and mental health services. 

These funds were used to facilitate screening and referral for necessary primary care prevention 

and treatment needs. SAMHSA funded eight new multi-year funded PBHCI grants and 34 

continuation grants with Prevention and Public Health Funds and 22 grants and one contract 

continuation with Budget Authority. 

In FY 2012, SAMHSA supported 56 existing grants; 20 new multi-year funded grants and 10 

new annually funded grants from SAMHSA Budget Authority and Prevention and Public Health 

Fund ($30.8 million in Budget Authority and $35 million in Prevention and Public Health Funds) 

as well as $1.9 million for the continuation of PBHCI Training and Technical Assistance (TTA) 

Center.

In FY 2013, SAMHSA awarded continuation of the program and awarded seven new grants. 

SAMHSA has awarded 100 PBHCI grants to date including the FY 2013 cohort.

Over 33,000 consumers were served in FY 2013, an increase of 43.5 percent over FY 2012. 

Improvements in all four National Outcome Measures were consistently positive as a result of 

this intervention. Of particular importance were the increases in measures of functioning and 

education/employment, demonstrating that the program supports health and productivity. 

The following health indicators, as of April 2013, show improvements in program participants’ 

physical health: 

 Blood pressure: 17.4 percent of program participants showed some improvement in this 

biomarker. For 16.2 percent of program participants, their blood pressure improved 

enough that it was no longer a risk factor for hypertension.

 Blood glucose: 36.8 percent of program participants showed some improvement in this 

biomarker. For 10.4 percent of program participants, their blood glucose improved 

enough that it was no longer a risk factor for diabetes.

 HgBA1c: 40.4 percent of program participants showed some improvement in this 

biomarker. For 9.3 percent of program participants, their HgBA1c improved enough that 

it was no longer a risk factor for diabetes.

 HDL: 38 percent of program participants showed some improvement in this biomarker. 

For 8.9 of program participants, their HDL improved enough that it was no longer a risk 

factor for high cholesterol.

 LDL: 41.9 percent of program participants showed some improvement in this biomarker.

For 10.7 percent of program participants, their LDL improved enough that it was no 

longer a risk factor for high cholesterol.

 Triglycerides: 41.1 percent of program participants showed some improvement in this 

biomarker. For 11.3 percent of program participants, their triglycerides improved enough 

it was no longer a risk factor for hyperlipidemia.

In FY 2014, SAMHSA plans to support continuation grants as well as award a new cohort of 

PBHCI grants and one technical assistance contract.
279

Budget Request

The FY 2015 Request for PBHCI Prevention and Public Health Fund is for $28 million, an

increase of $28 million from the FY 2014 Enacted Level. This level of funding provides support 

to 34 grants and 1 contract continuation. The funding will also support Braided Program: HIV 

Continuum of Care to provide bi-directional integration between primary care services and 

substance abuse treatment/mental health services (for CSAT/CMHS) and address service 

coordination and infrastructure needs to providers.
280

Key Outputs and Outcomes

Program: Primary & Behavioral Health Care Integration (PBHCI)

NOTE: SAMHSA grant awards are made late in the year. FY 2014 Enacted is reflected in FY 2015 targets. FY 

2015 President’s Budget is reflected in FY 2016 targets.

Measure Year and Most 

Recent Result /

Target for Recent 

Result /

(Summary of 

Result)

FY 

2015

Target

FY 

2016

Target

FY 2016

Target

+/-

FY 2015

Target

3.2.40 Number of clients served (Output) FY 2013: 33,023

Target:

33,023

(Baseline)

11,156 11,156 Maintain

3.2.41 Percentage of clients receiving services who report 

positive functioning at 6 month follow-up. (Outcome)

FY 2013: 55.3%

Target:

55.3%

(Baseline)

49.9% 49.9% Maintain

3.2.42 Percentage of clients receiving services who are 

currently employed at 6 month follow-up. (Outcome)

FY 2013: 21.1%

Target:

21.1%

(Baseline)

22.1% 22.1% Maintain

3.2.43 Percentage of clients receiving services who had a 

permanent place to live in the community at 6 month followup. (Outcome)

FY 2013: 71.6%

Target:

71.6%

(Baseline)

65.7% 65.7% Maintain

3.2.44 Percentage of adults receiving services who had 

positive social support at 6 month follow-up. (Outcome)

FY 2013: 68.3%

Target:

68.3%

(Baseline)

64.3% 64.3% Maintain
281

Suicide Prevention

(Dollars in thousands)

FY 2013 FY 2014 FY 2015 FY 2015

Final Enacted President's 

Budget

+/-

FY 2014

Program Level........................................................ $52,747 $55,212 $43,108 -$12,104

Prevention & Public Health Fund (non-add)...... $--- $10,000 $10,000 $---

Authorizing Legislation ................................Sections 520, 520A, 520C, and 520E of the PHS Act 

and Section 4002 of the Patient and Protection and Affordable Care Act

FY 2015 Authorization .........................................................................................................Expired

Allocation Method ......................................................................Competitive Grants and Contracts

Program Description and Accomplishments

GLS Youth Suicide Prevention

The Garrett Lee Smith (GLS) Memorial Act authorizes SAMHSA to manage two significant 

youth suicide prevention programs and one resource center. The GLS State/Tribal Youth 

Suicide Prevention and Early Intervention Grant Program currently supports a total of 68 

grantees which includes four multi-year funded grants in FY 2011, three multi-year funded 

grants in FY 2012, and 61 annually funded grants, 31 states, 29 tribes or tribal organizations, and 

the District of Columbia in developing and implementing youth suicide prevention and early 

intervention strategies involving public-private collaborations among youth serving institutions. 

The GLS Campus Suicide Prevention program currently provides funding to 82 institutions of 

higher education, inclusive of tribal colleges and universities, which includes five multi-year 

funded grants in FY 2011, 15 multi-year funded grants in FY 2012, four multi-year funded 

grants in FY 2013 and 58 annually funded grants, to prevent suicide and suicide attempts. 

In FY 2012, through Budget Authority, SAMHSA provided support for 34 GLS state/tribal 

continuation grants and awarded 20 new grants. In addition, SAMHSA supported 16 GLS 

campus continuation grants and awarded 24 new grants. 

In FY 2012, SAMHSA also received $10 million in Prevention and Public Health Fund, which 

supported the GLS grants, the National Suicide Prevention Lifeline, and the Suicide Prevention 

Resource Center. Three grants were multi-year funded for the GLS state/tribal grantees and 15 

grants were multi-year funded for the campus grantees. 

As of July 2013, 592,580 individuals had participated in 21,433 training events or educational 

seminars provided by grantees. Grantees often used their funds to provide suicide prevention 

trainings in their communities. The most common approach was gatekeeper training, designed 

to help trainees recognize suicide risk in young people, address the immediate needs of the 

youths, and refer youths to appropriate services. Over one third of 34.5 percent (n = 204,351) of 

trainees were trained through campus-sponsored trainings and educational seminars. Over half of 
282

trainees 61.0 percent (n = 361,765) participated in State-sponsored and 4.5 percent (n = 26,464) 

in tribal-sponsored training activities. 

In FY 2013, SAMHSA provided support for the continuation of existing state/tribal and campus 

grantees and awarded seven new GLS State/Tribal grants and 22 GLS Campus grants. 

In FY 2014, SAMHSA plans to continue support both GLS State/Tribal and GLS Campus 

programs and anticipates awarding 24 new GLS State/Tribal grants, 15 new GLS Campus, and 

one new evaluation contract.

Suicide Prevention Resource Center

In addition to programs that build suicide prevention capacity, SAMHSA also supports the 

Suicide Prevention Resource Center (SPRC). This program promotes the implementation of the 

National Strategy for Suicide Prevention and enhances the nation’s mental health infrastructure 

by providing states, tribes, government agencies, private organizations, colleges and universities, 

and suicide survivor and mental health consumer groups with access to the science and 

experience that can support their efforts to develop programs, implement interventions, and 

promote policies to prevent suicide. The SPRC also advances youth suicide prevention efforts in 

states, territories, tribes, and campuses as authorized through the Garrett Lee Smith (GLS) 

Memorial Act. 

Through the SPRC, SAMHSA continues to provide support for the National Action Alliance for 

Suicide Prevention (NAASP), a public-private partnership to implement the National Strategy 

for Suicide Prevention and reduce suicide in America. The NAASP was launched on September 

10, 2010, by HHS Secretary Kathleen Sebelius and the former Secretary of Defense, Robert 

Gates.

In FY 2011, SAMHSA received $10 million in Prevention and Public Health Fund, from 

which SAMHSA funded one supplement to the SPRC of $0.7 million to expand and enhance the 

level of support provided to the NAASP. This supplement expanded future organizational 

development, partnerships, and collaborations to support the implementation of the Surgeon 

General’s National Strategy for Suicide Prevention.

In FY 2012, SAMHSA utilized Prevention and Public Health Fund for the SPRC to help support 

implementation of high impact objectives identified by the National Strategy for Suicide 

Prevention and the NAASP and to develop, based on the experience of GLS grantees, a strategic 

framework to embed sustainable, comprehensive, coordinated youth suicide prevention activities 

in states, tribes, and colleges across the nation. 

In FY 2013, SAMHSA provided support for the continuation of the SPRC grant with a reduced 

level of support for the NAASP as it transitions to alternate sources of funding. In FY 2014, 

SAMHSA plans to fund the continuation of the SPRC grant and a supplement from Prevention 

and Public Health Fund.
283

National Suicide Prevention Lifeline

Launched in FY 2005, the National Suicide Prevention Lifeline, 1-800-273-TALK, coordinates a 

network of 160 crisis centers across the United States by providing suicide prevention and crisis 

intervention services to individuals seeking help at any time, day or night. The Lifeline routes 

calls from anywhere in the country to a network of certified local crisis centers that can then link 

callers to local emergency, mental health, and social services resources, The Lifeline averaged 

94,183 calls per month in 2013, including a peak of 104,754 calls in December. National 

Suicide Prevention Lifeline crisis centers across the nation are responding to people in suicidal 

crises. 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”. At the same time, these centers are 

threatened with significant cutbacks in funding from state and local governments and other 

sources of support. 

Since FY 2007, SAMHSA has partnered with the Department of Veterans Affairs (VA) to 

provide and ensure that Veterans calling the Lifeline have 24/7 access to a specialized Veterans’ 

suicide prevention hotline. In FY 2013, more than 26,943 callers per month were seamlessly 

connected to the Veterans crisis line. The National Suicide Prevention Lifeline is also 

responding to calls from active duty military and their families. SAMHSA is in the process of 

developing a suicide hotline outcome measure to determine the number of people who contacted 

the Lifeline who believe the call prevented them from taking their lives. 

In addition, in FY 2012, SAMHSA awarded a new Suicide Lifeline grant and provided 

continuation support for 12 National Suicide Prevention Lifeline Crisis Center grants to provide 

follow up to suicidal callers. Evaluation and research findings indicated that in the immediate 

aftermath of suicidal crises, there is a period of heightened risk for suicide, but in this time there 

is a great potential for suicide prevention. Preliminary data from this program indicated that 

when asked by an independent evaluator, “To what extent did the counselor’s calling you stop 

you from killing yourself?” more than 50 percent of those receiving follow-up phone contact 

indicated the call played a significant role in keeping them alive. 

The National Suicide Prevention Lifeline uses evaluation results to document and improve 

program effectiveness. Evaluation results have been used to develop standards for suicide risk 

assessment, guidelines for callers at imminent risk for suicide, and follow up protocols for 

suicidal callers. In turn, these quality and performance improvement efforts have been evaluated 

and found to have positive impacts. Some of these outcomes have included decreases in suicidal 

ideation and hopelessness among callers, increased frequency of performing suicide risk 

assessments by crisis counselors, increased follow up of suicidal callers by crisis centers, and 

suicidal callers reporting such calls played a significant role in keeping them alive.

In FY 2013, SAMHSA awarded the continuation of the Suicide Lifeline grant and grants to crisis 

centers. In addition, 12 new crisis center grants were awarded, which will include a focus on 

providing follow up to suicidal people discharged from emergency rooms and inpatient units. 

This focus is based on current evaluation and research findings. In FY 2014, SAMHSA plans to 
284

award continuation grants and contracts as well as award a supplement to Suicide Lifeline from 

Prevention and Public Health Fund.

The National Suicide Prevention Lifeline uses evaluation results to document and improve 

program effectiveness. Evaluation results have been used to develop standards for suicide risk 

assessment, guidelines for callers at imminent risk for suicide, and follow up protocols for 

suicidal callers. In turn, these quality and performance improvement efforts have been evaluated 

and found to have positive impacts. Some of these outcomes have included decreases in suicidal 

ideation and hopelessness among callers, increased frequency of performing suicide risk 

assessments by crisis counselors, increased follow up of suicidal callers by crisis centers, and 

suicidal callers reporting such calls played a significant role in keeping them alive. To see one

aspect of this outreach effort in action, visit https://www.facebook.com/800273TALK.

Budget Request

The FY 2015 Budget Request for GLS Suicide Prevention is $10 million in Prevention and 

Public Health Funds, the same level as FY 2014 Enacted Level. The total program level request, 

which includes both Budget Authority and Prevention and Public Health Funds, is $43.1 million, 

a decrease of $12.1 million from the FY 2014 Enacted Level.
285

Key Outputs and Outcomes

Program: Suicide Prevention

NOTE: SAMHSA grant awards are made late in the year. FY 2014 Enacted is reflected in FY 2015 targets. FY 

2015 President’s Budget is reflected in FY 2016 targets.

Measure Year and Most 

Recent Result /

Target for Recent 

Result /

(Summary of Result)

FY 

2015

Target

FY 

2016

Target

FY 2016

Target

+/-

FY 2015

Target

2.3.59 Total number of individuals trained in youth 

suicide prevention (Outcome)

FY 2013: 172,87695

Target:

35,371

(Target Exceeded)

161,000 134,000 -27,000

2.3.60 Total number of youth screened (Output) FY 2013: 79,318

Target:

3,360

(Target Exceeded)

73,996 61,626 -12,370

2.3.61 Increase the number of calls answered by the 

suicide hotline (Output)

FY 2013: 1,061,204

Target:

765,638

(Target Exceeded)

989,994 824,501 -165,493

3.2.37 Increase the number of individuals referred to 

mental health or related services (Output)

FY 2013: 7,389

Target:

7,389

(Baseline)

5,911 5,911 Maintain

 

95

Programs included are the Garrett Lee Smith Campus Suicide Prevention Program and the Garrett Lee Smith State/Tribal Suicide Prevention 

Program.
286

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287

Health Surveillance

(Dollars in thousands)

FY 2013 FY 2014 FY 2015 

Final Enacted President's 

Budget

Program Level........................................................ $45,421 $47,428 $49,428 +$2,000

PHS Evaluation Funds (non-add)....................... 27,428 30,428 29,428 -1,000

Prevention & Public Health Fund (non-add)...... $14,733 $--- $20,000 +$20,000

FY 2015

+/- 

FY 2014 

Authorizing Legislation .............................................Section 501 of the Public Health Service Act

and Section 4002 of the Patient and Protection and Affordable Care Act

FY 2015 Authorization .........................................................................................................Expired

Allocation Method .......................................................Direct Federal/Intramural, Contracts, Other

Program Description and Accomplishments

The Health Surveillance budget supports many of the critical behavioral health data systems, 

national surveys, and surveillance activities for HHS undertaken by SAMHSA to support 

SAMHSA grantees, the field, and the public.

The National Survey on Drug Use and Health (NSDUH) serves as the nation’s primary source 

for information on the incidence and prevalence of substance use and mental disorders and 

related health conditions. A new NSDUH contract was awarded in FY 2013 to finance surveys 

for 2014, 2015, 2016 and 2017. 

In FY 2013, funding was provided for other public surveillance systems, including data 

collection efforts within the Community Behavioral Health Data Initiative (CDI). The goal of the 

CDI is to create new opportunities for cross-agency and public-private partnerships to address 

critical public health questions and more effectively utilize existing or declining resources. Data 

from this coordinated initiative is intended to be utilized in concert with data collected by other 

agencies such as Centers for Medicare and Medicaid Services (CMS) and Agency for Healthcare 

Research and Quality (AHRQ) to more fully develop an understanding of the status of behavioral 

health at the regional and community level. Use of these data will allow communities to identify 

service and program needs specific to the local community. Moreover, the longitudinal nature of 

these data will allow those evaluating the effectiveness of services and policies in a community 

to measure the impact and outcomes of those interventions. Funding was also provided in 2013 

for DCAR. This data system will be replaced with the new SAMHSA Common Data Platform 

In FY 2014, no PPHF funds were provided for Health Surveillance.

Budget Request

The FY 2015 Budget Request is for $20 million in Prevention and Public Health Funds, an 

increase of $20.0 million from the FY 2014 Enacted Budget. The total program level request, 

which includes PHS Evaluation Funds and Prevention and Public Health Funds, is $49.4 million, 
288

an increase of $2 million above the FY 2014 Enacted Budget. The Prevention and Public Health 

funding will support the work of NSDUH, BHSIS, Analytic Support Center, CDI, as well as, the 

C-EMS project.

Funding is requested for a number of activities to support a broad range of analytic work to be 

carried out in the CBHSQ. These activities include support for an Analytic Support Center 

(ASC) which undertakes a number of scientific and writing tasks on policy and practice-related 

topics in response to requests from SAMHSA Centers and related components, HHS agencies 

(CDC, AHRQ, and FDA), the Surgeon General’s Office, the Office of National Drug Control 

Policy, and the Department of Justice. FY 2015 funds $1.0 million for the Analytic Support with 

PPHF funds.

A new NSDUH contract was awarded in FY 2013 that will support the 2014, 2015, 2016, and 

2017 annual surveys, pending the availability of funds. In FY 2015, funding for NSDUH and 

NSDUH-related activities is expected to be $52.7 million, of which, $11.1 million will be funded

with PPHF funds. 

In FY 2013, funding was also provided to partially support the Behavioral Health Services 

Information System (BHSIS) to reflect the transition of the Drug and Alcohol Services 

Information System (DASIS) to the BHSIS by: 1) collecting mental health treatment admissions 

data along with the ongoing substance abuse treatment admissions data, and 2) augmenting the 

treatment locator to include mental health facility level information. SAMHSA will continue 

the transition from DASIS to BHSIS in FY 2014 by working closely with the National 

Association of State Alcohol and Drug Abuse Directors (NASADAD) and the National 

Association of State Mental Health Program Directors (NASMHPD) and our state and federal 

partners in the development and implementation of this integration effort which includes 

identifying metrics for reporting outcomes. In FY 2015, funding for BHSIS funding is $21.0 

million, $2.7 million funded with PPHF funds.

Funding is also requested for the continuation of the National Registry of Evidence-based 

Programs and Practices (NREPP), a searchable online system that supports states, communities, 

and tribes in identifying and implementing evidence-based mental health promotion, substance 

abuse prevention, and substance abuse and mental health treatment interventions. This registry 

is comprised of mental health and substance abuse interventions that have been reviewed and 

rated by independent reviewers. Moreover, the registry assists the public in identifying 

scientifically based approaches to preventing and treating mental and/or substance use disorders 

that can be readily disseminated to the field. This program is one way that SAMHSA is working 

to improve access to information on tested interventions and thereby reduce the lag time between 

the creation of scientific knowledge and its practical application in the field. In FY 2015, PPHF 

funds NREPP at $1.6 million.

Under the new Community Behavioral Health Data Initiative (CDI) structure, $3.0 million is 

funded in 2015 with PPHF funds. Data collected from local communities are used to deliver 

programs and services are an important component of a strong public health infrastructure. 

Much of SAMHSA’s current data effort is captured and reported at the national or state level. 

Information on the health and behavioral health at the community level serves to identify current 
289

and emerging problems and highlight opportunities for progress that may vary from larger 

geographical areas. Importantly, when communities have access to surveillance data over time, 

prevention can happen. Communities using data can identify what the issues may be and then 

direct targeted prevention efforts at the vulnerable populations in their communities. SAMHSA 

will more closely coordinate three separate existing data efforts, the Community Early Warning 

and Monitoring Systems (C-EMS), SAMHSA’s Emergency Department Surveillance System 

(SEDSS) (formerly the Drug Abuse Warning Network (DAWN)), and the Program Studies on 

Treatment and Recovery (PSTAR), to create new opportunities for cross-agency and publicprivate partnerships to address critical public health questions and more effectively utilize 

existing or declining resources. Data from this coordinated initiative can be combined with data 

from other Agencies such as CMS and AHRQ, and then be reported by regional and community 

type. Use of these data will allow communities to identify service and program needs specific to 

the local community. Moreover, the longitudinal nature of these data will allow those evaluating 

the effectiveness of services and policies in a community to measure the impact and outcomes of 

those interventions. SAMHSA will continue to examine where in-sourcing additional staff and 

collaborations with other agencies can support this effort while maximizing limited resources 

and cost-efficiencies
290

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291

SAMHSA

Supplementary Tables

Table of Contents

SAMHSA/Supplementary Tables

1. Budget Authority by Object Classification Tables............................................................... 293

2. Salaries and Expenses Table................................................................................................. 303

3. Detail of Full Time Equivalent Employee (FTE) ................................................................. 305

4. Detail of Positions................................................................................................................. 306

5. Programs Proposed for Elimination...................................................................................... 307

6. Federal Employment Funded by the Patient Protection and Affordable Care Act............... 308

7. Physician’s Comparability Allowance Worksheet ............................................................... 309

8. PRNS Mechanism Tables by SLOA..................................................................................... 310
292

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293

Budget Authority by Object Classification Tables

Object Class - Direct Budget Authority

FY 2014 

Enacted

FY 2015 

President's 

Budget

Difference 

+/- FY 2014

Personnel compensation:

Full-time permanent (11.1).......................................... 46,600.458 45,670.129 (930.329)

Other than full-time permanent (11.3).......................... 3,755.777 3,680.820 (74.956)

Other personnel compensation (11.5)........................... 749.171 734.220 (14.952)

Military personnel (11.7)............................................. 2,993.606 3,206.787 213.181

Special personnel services payments (11.8) ................. 40.208 41.615 1.407

Subtotal personnel compensation: 54,139.220 53,333.571 (805.648)

Civilian benefits (12.1)................................................ 14,084.662 14,713.191 628.530

Military benefits (12.2)............................................... 1,486.610 1,792.581 305.971

Subtotal Pay Costs: 69,710.491 69,839.344 128.852

Travel and transportation of persons (21.0).................. 853.099 853.000 (0.099)

Transportation of things (22.0).................................... 7.000 7.000 -

Rental payments to GSA (23.1)................................... 727.704 1,156.440 428.736

Printing and reproduction (24.0).................................. 253.000 253.000 -

Other Contractual Services:

Other services (25.2).................................................. 41,692.544 40,052.845 (1,639.699)

 Purchase of Goods & Svcs. from Govt. Accts (25.3).. 8,200.000 8,300.000 100.000

Operation and maintenance of facilities (25.4).............. 342.000 345.000 3.000

Research and Development Contracts (25.5)............... 3,043.162 3,310.372 267.210

Operation and maintenance of equipment (25.7)........... 86.000 86.000 -

Subtotal Other Contractual Services: 53,363.706 52,094.217 (1,269.489)

Supplies and materials (26.0)....................................... 203.000 203.000 -

Equipment (31.0)........................................................ 365.000 365.000 -

Grants, subsidies, and contributions (41.0).................... 36,500.000 22,950.000 (13,550.000)

Interest and dividends (43.0)....................................... 8.000 8.000 -

Subtotal Non-Pay Costs 92,280.508 77,889.656 (14,390.852)

Total Direct Obligations 161,991.000 147,729.000 (14,262.000)

Health Surveillance and Program Support

(Dollars in Thousands)
294 Object Class - Direct Budget Authority

FY 2014 

Enacted

FY 2015 

President's 

Budget

Difference 

+/- FY 2014

Personnel compensation:

Full-time permanent (11.1)........................................ 987.291 1,096.881 109.589

Other than full-time permanent (11.3)........................ 79.572 88.404 8.832

Other personnel compensation (11.5)......................... 15.872 17.634 1.762

Military personnel (11.7)........................................... 90.715 91.622 0.907

Subtotal personnel compensation: 1,173.451 1,294.541 121.091

Civilian benefits (12.1).............................................. 298.404 353.374 54.970

Military benefits (12.2).............................................. 45.049 51.217 6.168

Subtotal Pay Costs: 1,516.903 1,699.132 182.228 

Travel and transportation of persons (21.0)................ 230.000 232.000 2.000

Rental payments to GSA (23.1)................................. 2,029.513 3,225.226 1,195.713

Communication, utilities, and misc. charges (23.3)....... 221.000 223.000 2.000

Printing and reproduction (24.0)................................. 35.000 37.000 2.000

Other Contractual Services: -

Other services (25.2)(25.9)....................................... 44,955.701 42,000.000 (2,955.701)

 Purchase of Goods & Svcs. from Govt. Accts (25.3).. 35,000.000 35,443.700 443.700

Operation and maintenance of facilities (25.4)............ 230.000 235.000 5.000

Research and Development Contracts (25.5)............. 868.000 870.000 2.000

Operation and maintenance of equipment (25.7)......... 30.000 32.000 2.000

Subtotal Other Contractual Services: 81,083.701 78,580.700 (2,503.001)

Supplies and materials (26.0)..................................... 4.500 4.750 0.250

Equipment (31.0)...................................................... 3.100 3.250 0.150

Grants, subsidies, and contributions (41.0).................. 974,089.387 946,726.942 (27,362.445)

Interest and dividends (43.0)..................................... 54.896 60.000 5.104

Subtotal Non-Pay Costs 1,057,751.097 1,029,092.868 (28,658.229)

Total Direct Obligations 1,059,268.000 1,030,792.000 (28,476.000)

Mental Health Services

(Dollars in Thousands)
295 Object Class - Direct Budget Authority

FY 2014 

Enacted

FY 2015 

President's 

Budget

Difference 

+/- FY 2014

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: --- --- ---

Rental payments to GSA (23.1)................................. 842.273 1,338.509 496.236

Communication, utilities, and misc. charges (23.3)....... 33.418 35.000 1.582

Printing and reproduction (24.0)................................. 227.460 230.000 2.540

Other Contractual Services:

Advisory and assistance services (25.1)..................... 3,509.774 2,939.507 (570.267)

Other services (25.2)(25.9)....................................... 35,951.773 29,382.793 (6,568.980)

 Purchase of Goods & Svcs. from Govt. Accts (25.3).. 3,071.053 2,572.069 (498.984)

Operation and maintenance of facilities (25.4)............ 64.000 66.000 2.000

Operation and maintenance of equipment (25.7)......... 170.000 175.000 5.000

Subtotal Other Contractual Services: 42,766.600 35,135.369 (7,631.231)

Supplies and materials (26.0)..................................... 2.431 5.000 2.569

Grants, subsidies, and contributions (41.0)................... 131,687.817 132,348.122 660.305

Subtotal Non-Pay Costs 175,560.000 169,092.000 (6,468.000)

Total Direct Obligations 175,560.000 169,092.000 (6,468.000)

 Substance Abuse Prevention

(Dollars in Thousands)
296 Object Class - Direct Budget Authority

FY 2014 

Enacted

FY 2015 

President's 

Budget

Difference 

+/- FY 2014

Personnel compensation:

Full-time permanent (11.1)........................................ 3,751.708 3,988.658 236.950

Other than full-time permanent (11.3)........................ 302.372 321.469 19.097

Other personnel compensation (11.5)......................... 60.315 64.124 3.809

Military personnel (11.7)........................................... 90.715 91.622 0.907

Subtotal personnel compensation: 4,205.109 4,465.873 260.764 

Civilian benefits (12.1).............................................. 1,133.935 1,284.995 151.060

Military benefits (12.2)............................................. 45.049 51.217 6.168

Subtotal Pay Costs: 5,384.093 5,802.085 417.992 

Travel and transportation of persons (21.0)................ 147.286 150.000 2.714

Rental payments to GSA (23.1)................................. 2,696.155 4,284.629 1,588.473

Communication, utilities, and misc. charges (23.3)...... 459.000 465.000 6.000

Printing and reproduction (24.0)................................ 830.468 835.000 4.532

Other Contractual Services: -

Advisory and assistance services (25.1)..................... 45,000.000 40,445.436 (4,554.564)

Other services (25.2)(25.9)....................................... 75,000.000 66,183.441 (8,816.559)

 Purchase of Goods & Svcs. from Govt. Accts (25.3). 17,000.000 15,933.051 (1,066.949)

Operation and maintenance of facilities (25.4)............ 225.000 225.000 -

Subtotal Other Contractual Services: 137,225.000 122,786.927 (14,438.073)

Supplies and materials (26.0)..................................... 18.436 25.000 6.564

Equipment (31.0)...................................................... 77.900 85.000 7.100

Grants, subsidies, and contributions (41.0).................. 1,953,277.662 1,873,622.360 (79,655.302)

Subtotal Non-Pay Costs 2,094,731.908 2,002,253.916 (92,477.992)

Total Direct Obligations 2,100,116.000 2,008,056.000 (92,060.000)

Substance Abuse Treatment

(Dollars in Thousands)
297 Object Class - Direct Budget Authority 

FY 2014 

Enacted

FY 2015 

President's 

Budget

Difference 

+/- FY 2014

Personnel compensation:

Full-time permanent (11.1).................................... 51,339.457 50,755.667 (583.789)

Other than full-time permanent (11.3).................... 4,137.720 4,090.693 (47.027)

Other personnel compensation (11.5)..................... 825.358 815.978 (9.381)

Military personnel (11.7)....................................... 3,175.037 3,390.032 214.995

Special personnel services payments (11.8) ........... 40.208 41.615 1.407

Subtotal personnel compensation: 59,517.780 59,093.986 (423.794)

Civilian benefits (12.1).......................................... 15,517.000 16,351.560 834.559

Military benefits (12.2).......................................... 1,576.707 1,895.014 318.307

Subtotal Pay Costs: 76,611.487 77,340.560 729.072

Travel and transportation of persons (21.0)............ 1,230.385 1,235.000 4.615

Transportation of things (22.0)............................... 7.000 7.000 -

Rental payments to GSA (23.1)............................. 6,295.646 10,004.803 3,709.158

Communication, utilities, and misc. charges (23.3)... 713.418 723.000 9.582

Printing and reproduction (24.0)............................. 1,345.928 1,355.000 9.072

Other Contractual Services:

Advisory and assistance services (25.1)................. 48,509.774 43,384.943 (5,124.831)

Other services (25.2)(25.9)................................... 197,600.018 177,619.079 (19,980.939)

 Purch. Goods & Svcs. Govt. Accts (25.3).............. 63,271.053 62,248.819 (1,022.233)

Operation and maintenance of facilities (25.4)........ 861.000 871.000 10.000

Research and Development Contracts (25.5)......... 3,911.162 4,180.372 269.210

Operation and maintenance of equipment (25.7)..... 286.000 293.000 7.000

Subtotal Other Contractual Services: 314,439.007 288,597.213 (25,841.794)

Supplies and materials (26.0)................................. 228.368 237.750 9.382

Equipment (31.0).................................................. 446.000 453.250 7.250

Grants, subsidies, and contributions (41.0).............. 3,095,554.866 2,975,647.424 (119,907.442)

Interest and dividends (43.0)................................. 62.896 68.000 5.104

Subtotal Non-Pay Costs 3,420,323.512 3,278,328.440 (141,995.072)

Total Direct Obligations 3,496,935.000 3,355,669.000 (141,266.000)

Summary Direct Budget Authority

(Dollars in Thousands)
298 Object Class - PHS EVAL Funds

FY 2014 

Enacted

FY 2015 

President's 

Budget

Difference 

+/- FY 2014

Personnel compensation:

Full-time permanent (11.1).......................................... 2,953.530 4,320.301 1,366.771

Other than full-time permanent (11.3).......................... 319.874 467.899 148.025

Other personnel compensation (11.5)........................... 6.122 8.955 2.833

Military personnel (11.7)............................................. 578.737 730.655 151.918

Subtotal personnel compensation: 3,858.263 5,527.810 1,669.547

Civilian benefits (12.1)................................................ 911.708 1,409.229 497.521

Military benefits (12.2)............................................... 306.152 408.433 102.281

Subtotal Pay Costs: 5,076.123 7,345.472 2,269.349

Travel and transportation of persons (21.0).................. 60.000 61.333 1.333

Communication, utilities, and misc. charges (23.3)........ 56.667 57.667 1.000

Printing and reproduction (24.0).................................. 40.917 40.375 (0.542)

Other Contractual Services:

Advisory and assistance services (25.1)....................... 1,799.887 1,799.887 -

Other services (25.2)(25.9)......................................... 21,547.853 47,842.879 26,295.026

 Purchase of Goods & Svcs. from Govt. Accts (25.3).. 1,799.887 1,799.887 -

Subtotal Other Contractual Services: 25,147.627 51,442.652 26,295.026

Supplies and materials (26.0)....................................... 41.667 42.500 0.833

Equipment (31.0)........................................................ 5.000 5.000 -

Grants, subsidies, and contributions (41.0).................... --- - - 

Subtotal Non-Pay Costs 25,351.877 51,649.528 26,297.651

Total Reimbursable Obligations 30,428.000 58,995.000 28,567.000

Health Surveillance and Program Support

(Dollars in Thousands)
299 Object Class - PHS EVAL Funds

FY 2014 

Enacted

FY 2015 

President's 

Budget

Difference 

+/- FY 2014

Personnel compensation:

Full-time permanent (11.1)........................................ 2,036.917 1,830.767 (206.150)

Other than full-time permanent (11.3)........................ 220.603 66.784 (153.819)

Other personnel compensation (11.5)......................... 4.222 18.818 14.596 

Military personnel (11.7)........................................... 144.684 76.539 (68.145)

Subtotal personnel compensation: 2,406.426 1,992.907 (413.519)

Civilian benefits (12.1).............................................. 628.764 548.084 (80.680)

Military benefits (12.2).............................................. 76.538 39.554 (36.984)

Subtotal Pay Costs: 3,111.729 2,580.546 (531.182)

Travel and transportation of persons (21.0)................ 60.000 61.333 1.333

Communication, utilities, and misc. charges (23.3)....... 56.667 57.667 1.000

Printing and reproduction (24.0)................................. 127.117 143.812 16.695

Other Contractual Services:

Other services (25.2)(25.9)....................................... 17,636.821 19,132.020 1,495.199 

Subtotal Other Contractual Services: 17,636.821 19,132.020 1,495.199

Supplies and materials (26.0)..................................... 41.667 42.500 0.833

Equipment (31.0)...................................................... 5.000 5.000 -

Grants, subsidies, and contributions (41.0).................. - 4,016.122 4,016.122

Subtotal Non-Pay Costs 17,927.271 23,458.454 5,531.183

Total Reimbursable Obligations 21,039.000 26,039.000 5,000.000

Mental Health Services

(Dollars in Thousands)
300 Object Class - PHS EVAL Funds

FY 2014 

Enacted

FY 2015 

President's 

Budget

Difference 

+/- FY 2014

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)............................................. --- --- ---

Benefits to former personnel (13.0)........................... --- --- ---

Subtotal Pay Costs: --- --- -

Other Contractual Services:

Advisory and assistance services (25.1)..................... --- --- ---

Other services (25.2)(25.9)....................................... --- 8,762.204 8,762.204 

 Purchase of Goods & Svcs. from Govt. Accts (25.3). --- --- ---

Operation and maintenance of facilities (25.4)............ --- --- ---

Research and Development Contracts (25.5)............. --- --- ---

Medical care (25.6).................................................. --- --- ---

Operation and maintenance of equipment (25.7)......... --- --- ---

Subsistence and support of persons (25.8).................. --- --- ---

Subtotal Other Contractual Services: --- 8,762.204 8,762.204

 Grants, subsidies, and contributions (41.0) 7,705.796 7,705.796 

Subtotal Non-Pay Costs - 7,705.796 7,705.796

Total Reimbursable Obligations - 16,468.000 16,468.000

Substance Abuse Prevention

(Dollars in Thousands)
301 Object Class - PHS EVAL Funds

FY 2014 

Enacted

FY 2015 

President's 

Budget

Difference 

+/- FY 2014

Personnel compensation:

Full-time permanent (11.1)........................................ 916.613 720.050 (196.563)

Other than full-time permanent (11.3)........................ 99.271 77.983 (21.288)

Other personnel compensation (11.5)......................... 1.900 1.492 (0.407)

Military personnel (11.7)........................................... 85.359 73.066 (12.294)

Subtotal personnel compensation: 1,103.143 872.591 (230.552)

Civilian benefits (12.1).............................................. 282.944 234.871 (48.072)

Military benefits (12.2)............................................. 41.368 40.843 (0.525)

Subtotal Pay Costs: 1,427.456 1,148.306 (279.149)

Travel and transportation of persons (21.0)................ 60.000 61.333 1.333

Communication, utilities, and misc. charges (23.3)...... 56.667 57.667 1.000

Printing and reproduction (24.0)................................ 158.966 143.812 (15.154)

Other Contractual Services:

Advisory and assistance services (25.1)..................... 1,691.649 1,691.649 -

Other services (25.2)(25.9)....................................... 75,004.947 79,532.657 4,527.711

 Purchase of Goods & Svcs. from Govt. Accts (25.3). 1,691.649 1,691.649 -

Subtotal Other Contractual Services: 78,388.245 82,915.955 4,527.711

Supplies and materials (26.0)..................................... 41.667 42.500 0.833

Equipment (31.0)...................................................... 5.000 5.000 -

Grants, subsidies, and contributions (41.0).................. 1,062.000 24,825.430 23,763.430

Subtotal Non-Pay Costs 79,772.544 108,051.698 28,279.154

Total Reimbursable Obligations 81,200.000 109,200.004 28,000.004

Substance Abuse Treatment

(Dollars in Thousands)
302 Object Class - PHS EVAL Funds

FY 2014 

Enacted

FY 2015 

President's 

Budget

Difference 

+/- FY 2014

Direct Obligations:

Personnel Compensation:

 Full Time Permanent (11.1)................................................. 5,907.060 6,871.119 964.059

 Other than Full-Time Permanent (11.3)................................ 639.749 612.666 (27.083)

 Other Personnel Compensation (11.5).................................. 12.244 29.265 17.021

 Military Personnel Compensation (11.7)............................... 808.780 880.259 71.479

Subtotal Personnel Compensation: 7,367.833 8,393.309 1,025.476

 Civilian Personnel Benefits (12.1)........................................ 1,823.417 2,192.185 368.768

 Military Personnel Benefits (12.2) ...................................... 424.058 488.831 64.773

Subtotal Pay Costs: ............................................................ 9,615.307 11,074.325 1,459.017

Travel (21.0)......................................................................... 180.000 184.000 4.000

Communications, Utilities and Misc. Charges (23.3)................. 170.000 173.000 3.000

Printing and Reproduction (24.0)............................................. 327.000 328.000 1.000

Other Contractual Services:

Advisory and assistance services (25.1)............................... 3,491.536 3,491.536 -

Other services (25.2)(25.9).................................................. 114,189.621 152,975.555 38,785.935

 Purchase of Goods & Svcs. from Govt. Accts (25.3)............ 3,491.536 3,491.536 -

 Subtotal Other Contractual Services:............................. 121,172.693 159,958.627 38,785.935

Supplies and Materials (26.0).................................................. 125.000 127.500 2.500

Equipment (31.0)................................................................... 15.000 15.000 -

Grants, Subsidies, and Contributions (41.0).......................................................................... 1,062.000 38,841.552 37,779.552

Subtotal Non-Pay Costs............................................................................................. 123,051.692 199,627.679 76,575.987

Total Reimbursable: ........................................................................................................................... 132,667.000 210,702.004 78,035.005

Summary PHS Evaluation Funds

(Dollars in Thousands)
303

Salaries and Expenses Table

Object Class

FY 2014 

Enacted

FY 2015 

President's 

Budget

Difference 

+/- FY 2014

Personnel compensation:

Full-time permanent (11.1)..................................... 51,339.457 50,755.667 (583.789)

Other than full-time permanent (11.3)..................... 4,137.720 4,090.693 (47.027)

Other personnel compensation (11.5)...................... 825.358 815.978 (9.381)

Military personnel (11.7)........................................ 3,175.037 3,390.032 214.995

Special personnel services payments (11.8) ............ 40.208 41.615 1.407

Subtotal personnel compensation 59,517.780 59,093.986 (423.794)

Civilian benefits (12.1)........................................... 15,517.000 16,351.560 834.559

Military benefits (12.2)........................................... 1,576.707 1,895.014 318.307

Subtotal Pay Costs: 76,611.487 77,340.560 729.072

Travel (21.0)......................................................... 1,230.385 1,235.000 4.615

Transportation of things (22.0)................................ 7.000 7.000 -

Communication, utilities, and misc. charges (23.3).... 713.418 723.000 9.582

Printing and reproduction (24.0).............................. 1,345.928 1,355.000 9.072

Other Contractual Services: -

Advisory and assistance services (25.1).................. 48,509.774 43,384.943 (5,124.831)

Other services (25.2)............................................. 197,600.018 177,619.079 (19,980.939)

 Purch. Goods & Svcs. Govt. Accts (25.3)............... 63,271.053 62,248.819 (1,022.233)

Operation and maintenance of facilities (25.4)......... 861.000 871.000 10.000

Research and Development Contracts (25.5).......... 3,911.162 4,180.372 269.210

Operation and maintenance of equipment (25.7)...... 286.000 293.000 7.000

Subtotal Other Contractual Services: 314,439.007 288,597.213 (25,841.794)

Supplies and materials (26.0).................................. 228.368 237.750 9.382

Subtotal Non-Pay Costs 317,964.105 292,154.963 (25,809.142)

Total Salary and Expenses 394,575.592 369,495.522 (25,080.070)

Rental Payments to GSA (23.1)............................. 6,295.646 10,004.803 3,709.158

Grand Total, Salaries & Expenses and Rent 400,871.238 379,500.326 (21,370.912)

Direct FTE........................................................... 555 546 (9)

Direct Budget Authority 

(Dollars in Thousands)
304

Salaries and Expenses Table

Object Class - PHS EVAL Funds

FY 2013 

Final

FY 2014 

Enacted

FY 2015 

President's 

Budget

Difference 

+/- FY 2014

Personnel compensation:

Full-time permanent (11.1)................................... 4,529.620 5,907.060 6,871.119 964.059

Other than full-time permanent (11.3)................... 490.569 639.749 612.666 (27.083)

Other personnel compensation (11.5).................... 9.389 12.244 29.265 17.021

Military personnel (11.7)...................................... 535.847 808.780 880.259 71.479

Special personnel services payments (11.8) .......... - - - -

Subtotal personnel compensation 5,565.424 7,367.833 8,393.309 1,025.476

Civilian benefits (12.1)......................................... 1,412.797 1,823.417 2,192.185 368.768

Military benefits (12.2)......................................... 312.703 424.058 488.831 64.773

Subtotal Pay Costs: 7,290.924 9,615.307 11,074.325 1,459.017

Travel (21.0)....................................................... 33.699 180.000 184.000 4.000

Communication, utilities, and misc. charges (23.3).. - 170.000 173.000 3.000

Printing and reproduction (24.0)............................ 187.865 327.000 328.000 1.000

Other Contractual Services:

Advisory and assistance services (25.1)................ - 3,491.536 3,491.536 -

Other services (25.2)........................................... 117,560.432 114,189.621 152,975.555 38,785.935

 Purch. Goods & Svcs. Govt. Accts (25.3)............. 2,679.625 3,491.536 3,491.536 -

Subtotal Other Contractual Services: 120,240.057 121,172.693 159,958.627 38,785.935

Supplies and materials (26.0)................................ - 125.000 127.500 2.500

Subtotal Non-Pay Costs 120,461.622 121,974.692 160,771.127 38,796.435

Total Salary and Expenses 127,752.546 131,590.000 171,845.452 40,255.452

Rental Payments to GSA (23.1)............................ 539.562 - - -

Grand Total, Salaries & Expenses and Rent 128,292.108 131,590.000 171,845.452 40,255.452

Reimbursable FTE(1)........................................... 52 71 79 8

(1) Does not include Other reimbursable FTE's (30) and associated Object Class Cost.

PHS Evaluation Funds 

(Dollars in Thousands)
305

Detail of Full Time Equivalent Employee (FTE)

2013 

Actual 

Civilian

2013 

Actual. 

Military

2013 

Actual 

Total

2014 

Est. 

Civilian

2014 

Est. 

Military

2014 

Est. 

Total

2015 

Est. 

Civilian

2015 

Est. 

Military

2015 

Est. 

Total

CMHS

Direct:................. 99 9 108 103 9 112 105 9 114

Reimbursable:...... 18 2 20 21 2 23 21 2 23

Total: ............... 118 11 128 124 11 135 126 11 137

CSAP

Direct:................. 88 9 96 92 9 101 90 9 99

Reimbursable:...... 8 3 12 12 3 15 12 3 15

Total: ............... 96 12 108 104 12 116 102 12 114

CSAT

Direct:................. 102 10 112 105 10 115 104 10 114

Reimbursable:...... 4 --- 4 5 --- 5 5 --- 5

Total: ............... 106 10 116 110 10 120 109 10 119

O C

Direct:................. 8 --- 8 11 --- 11 11 --- 11

Reimbursable:...... --- --- --- --- --- --- --- --- ---

Total: ............... 8 --- 8 11 --- 11 11 --- 11

O A

Direct:................. 7 --- 7 8 --- 8 8 --- 8

Reimbursable:...... --- --- --- --- --- --- --- --- ---

Total: ............... 7 --- 7 8 --- 8 8 --- 8

OFR

Direct:................. 67 2 68 73 2 75 73 1 74

Reimbursable:...... 8 8 9 --- 9 9 --- 9

Total: ............... 75 2 77 82 2 84 82 1 83

CBHSQ

Direct:................. 24 2 26 25 2 27 19 5 24

Reimbursable:...... 22 5 27 33 5 38 41 6 47

Total: ............... 46 7 53 58 7 65 60 11 71

OPPI

Direct:................. 39 1 40 43 1 44 40 1 41

Reimbursable:...... 5 1 6 5 1 6 5 1 6

Total: ............... 44 2 46 48 2 50 45 2 47

OMTO

Direct:................. 58 2 60 60 2 62 59 2 61

Reimbursable:...... --- --- --- --- --- --- --- --- ---

Total: ............... 58 2 60 60 2 62 59 2 61

St. Elizabeths

Direct:................. --- --- --- --- --- --- --- --- ---

Reimbursable:...... --- 4 4 --- 4 4 --- 4 4

Total: ............... --- 4 4 --- 4 4 --- 4 4

SAMHSA Totals

Direct:............... 492 34 526 520 35 555 509 37 546

Reimbursable:... 66 16 82 85 15 100 93 16 109

Total: ............. 558 50 608 605 50 655 602 53 655

FY 2014

FY 2015

Average GS Grade

FY 2011............... 13/8

FY 2012............... 13/7

FY 2013............... 13/6

FY 2014............... 13/7

FY 2015............... 13/8

SAMHSA staffing increases reflect annualization of resources identified to contracts that were insourced in FY 2011. 

Additionally SAMHSA ability to backfill vacated positions due to attrition has been impacted by higher average of 

retirements than normal historical attrition would indicate for future planning.

SAMHSA staffing levels reflect optimal staffing levels necessary to achieve budget authority management and execution. 

Historical attrition rates and Human Resources hiring practices are utilized in overall forecast. 
306

Detail of Positions

FY 2013 FY 2014 FY 2015

Actual Base Budget

Executive Level IV 1 1 1

Subtotal 1 1 1

Total - Exec Level Salaries $155,500 $155,500 $155,500

SES 10 13 13

Subtotal 10 13 13

Total, SES salaries $1,651,944 $2,169,002 $2,190,692

GM/GS-15/EE 74 79 79

GM/GS-14 141 145 145

GM/GS-13 185 190 187

GS-12 62 64 64

GS-11 21 25 25

GS-10 1 1 1

GS-09 15 16 16

GS-08 23 25 25

GS-07 18 23 23

GS-06 14 18 18

GS-05 2 5 5

GS-04 0 0 0

GS-03 0 0 0

GS-02 0 0 0

Subtotal 556 591 588

Total, GS salaries $57,882,322 $63,529,560 $63,851,596

CC-08/09 1 1 1

CC-07 0 0 0

CC-06 13 13 13

CC-05 16 16 16

CC-04 16 16 16

CC-03 4 4 7

CC-02 0 0 0

Subtotal 50 50 53

Total, CC salaries $4,421,830 $4,402,266 $4,606,711

Total Positions 1/ 617 655 655

Average ES level ES ES ES

Average ES salary $155,500 $155,500 $155,500

Average SES level SES SES SES

Average SES salary $165,194 $166,846 $168,515

Average GS grade 13.6 13.7 13.8

Average GS salary $104,105 $107,495 $108,591

Average CC level 4.5 4.4 4.2

Average CC salaries $88,437 $88,045 $86,919

1/ This figure represents on-board staff.
307

Programs Proposed for Elimination

The following table shows the programs proposed for elimination in the President’s FY 2015 

Budget Request. Termination of this program allows the agency to redirect approximately $50 

million from the FY 2014 Enacted Level for health programs that have a demonstrated record of 

success or that hold significant promise for increasing accountability and improving health 

outcomes. Following the table is a brief summary of the program and rationale for its 

elimination. 

Program FY 2014 Enacted (in Millions)

Access to Recovery $50.0

Access to Recovery (-$50.0 million)

SAMHSA is proposing eliminating the Access to Recovery (ATR) program in FY 2015. Many 

of the clinical services provided under ATR will now be covered by public and private insurance. 

In addition, states have been encouraged to support recovery support services and client choice 

with SABG funding. States that would like to continue this activity will have support from 

SAMHSA in FY 2014 in incorporating lessons learned from the successful test.
308

Federal Employment Funded by the Patient Protection and Affordable Care Act

Program Section Total FTEs CEs Total FTEs CEs Total FTEs CEs Total FTEs CEs Total FTEs CEs

Primary and Behavioral Health Care 

Integration

 Discretionary

 Mandatory 4002 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

Sucide Prevention

 Discretionary

 Mandatory 4002 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

Health Surveillance

 Discretionary

 Mandatory 4002 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

FY 2011 FY 2012 FY 2013 FY 2014 FY 2015

Substance Abuse Mental Health Services Administration

(Dollars in Thousands)
309

Physician’s Comparability Allowance Worksheet

PY 2013

(Estimates)

CY 2014 

(Estimates)

BY 2015 

(Estimates)

1) Number of Physicians Receiving PCAs 4 4 4

2) Number of Physicians with One-Year PCA Agreements --- --- ---

3) Number of Physicians with Multi-Year PCA Agreements 4 4 4

4) Average Annual PCA Physician Pay (without PCA payment) $143,236 $143,236 $147,179

5) Average Annual PCA Payment $18,000 $18,000 $18,000

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. 4 4 4

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.

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.

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).

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.

11) Provide any additional information that may be useful in 

planning PCA staffing levels and amounts in your agency.

N/A

$30.000.00 - based on years of education, 

experience and the position held by the 

incumbent. Amount is required to retain the 

employee.

 SAMHSA does not have any medical 

officer vacancies at this time. 

We have to offer PCAs in order to be 

competitive with the private sector. Salaries 

being offered by the Government are usually 

lower than the candidates are making on the 

outside and a PCA is the only way to raise 

the income and make the offer attractive.
310

PRNS Mechanism Tables by SLOA

SAMHSA/Mental Health

PRNS Mechanism Table by SLOA

(Dollars in thousands)

Programs of Regional & National Significance No. Amount No. Amount No. Amount

CAPACITY:

Seclusion and Restraint and Trauma

Grants

Continuations......................................................................... --- $--- --- $--- --- $---

New/Competing..................................................................... --- --- --- --- --- ---

Subtotal............................................................................... --- --- --- --- --- ---

Contracts

Continuations......................................................................... --- --- 1 1,150 1 1,001

New/Competing..................................................................... 1 2,121 --- --- --- 148

Subtotal............................................................................... 1 2,121 1 1,150 1 1,149

Total, S & R & T 1 2,121 1 1,150 1 1,149

Youth Violence Prevention

Grants

Continuations......................................................................... --- --- 7 15,479 7 15,621

New/Competing..................................................................... 7 14,237 --- --- --- ---

Subtotal............................................................................... 7 14,237 7 15,479 7 15,621

Contracts

Continuations......................................................................... --- 1,947 2 7,302 5 7,535

New/Competing..................................................................... 3 5,761 3 375 --- ---

Subtotal............................................................................... 3 7,708 5 7,677 5 7,535

Total, YVP 1 0 21,945 1 2 23,156 1 2 23,156

Project AWARE

Grants

Continuations......................................................................... --- --- --- --- 40 51,388

New/Competing..................................................................... --- --- 40 51,535 --- ---

Subtotal............................................................................... --- --- 40 51,535 40 51,388

Contracts

Continuations......................................................................... --- --- --- --- --- 3,612

New/Competing..................................................................... --- --- --- 3,465 --- ---

Subtotal............................................................................... --- --- --- 3,465 --- 3,612

Total, Project AWARE --- --- 4 0 55,000 4 0 55,000

Final

FY 2013 FY 2014

Enacted

FY 2015

President's 

Budget
311

Programs of Regional & National Significance No. Amount No. Amount No. Amount

National Child Traumatic Stress Network

Grants

Continuations......................................................................... 78 40,594 78 41,681 79 42,437

New/Competing..................................................................... --- --- 3 1,200 --- ---

Subtotal............................................................................... 78 40,594 81 42,881 79 42,437

Contracts

Continuations......................................................................... --- 2,728 --- 2,934 --- 3,277

New/Competing..................................................................... --- --- --- 184 --- ---

Subtotal............................................................................... --- 2,728 --- 3,119 --- 3,277

Total, NCTSI 7 8 43,322 8 1 46,000 7 9 45,714

Children and Family Programs

Grants

Continuations......................................................................... 13 4,982 --- 212 11 4,830

New/Competing..................................................................... --- --- 11 4,563 --- ---

Subtotal............................................................................... 13 4,982 11 4,775 11 4,830

Contracts

Continuations......................................................................... 2 1,479 --- 572 2 1,644

New/Competing..................................................................... --- --- 2 1,127 --- ---

Subtotal............................................................................... 2 1,479 2 1,699 2 1,644

Total, CFP 1 5 6,461 1 3 6,474 1 3 6,474

Healthy Transitions

Grants

Continuations......................................................................... --- --- --- --- 16 15,687

New/Competing..................................................................... --- --- 16 15,740 --- ---

Subtotal............................................................................... --- --- 16 15,740 16 15,687

Contracts

Continuations......................................................................... --- --- --- --- 2 4,313

New/Competing..................................................................... --- --- 2 4,260 --- ---

Subtotal............................................................................... --- --- 2 4,260 2 4,313

Total, Healthy Transitions --- --- 1 8 20,000 1 8 20,000

Consumer and Family Network Grants

Grants

Continuations......................................................................... 17 1,148 56 3,856 43 3,108

New/Competing..................................................................... 44 3,756 4 400 12 1,176

Subtotal............................................................................... 61 4,904 60 4,256 55 4,283

Contracts

Continuations......................................................................... 1 1,237 --- 710 --- 683

New/Competing..................................................................... --- --- --- --- --- ---

Subtotal............................................................................... 1 1,237 --- 710 --- 683

Total, CFN 6 2 6,140 6 0 4,966 5 5 4,966

FY 2015

President's 

Budget

FY 2014

Enacted

FY 2013

Final
312

Programs of Regional & National Significance No. Amount No. Amount No. Amount

Project LAUNCH

Grants/Cooperative Agreements

Continuations......................................................................... 29 23,312 22 18,688 30 26,364

New/Competing..................................................................... 5 5,572 14 11,571 4 3,806

Subtotal............................................................................... 34 28,884 36 30,259 34 30,170

Contracts

Continuations......................................................................... --- 1,999 1 4,151 1 4,470

New/Competing..................................................................... 1 1,945 --- 230 --- ---

Subtotal............................................................................... 1 3,944 1 4,381 1 4,470

Total, LAUNCH 3 5 32,829 3 7 34,640 3 5 34,640

MH System Transformation and Health Reform

Grants

Continuations......................................................................... 31 8,551 20 6,429 5 1,997

New/Competing..................................................................... --- --- 5 2,197 38 6,777

Subtotal............................................................................... 31 8,551 25 8,626 43 8,774

Contracts

Continuations......................................................................... 2 1,897 1 1,956 1 1,808

New/Competing..................................................................... --- --- --- --- --- ---

Subtotal............................................................................... 2 1,897 1 1,956 1 1,808

Total, MH-STHR 3 3 10,448 2 6 10,582 4 4 10,582

Primary and Behavioral Health Care Integration

Grants

Continuations......................................................................... 52 24,179 16 6,185 34 13,266

New/Competing..................................................................... 7 2,793 39 40,665 --- 11,030

Subtotal............................................................................... 59 26,972 55 46,850 34 24,296

Contracts

Continuations......................................................................... --- 93 --- 3,150 --- 1,708

New/Competing..................................................................... --- 1,576 --- --- --- ---

Subtotal............................................................................... --- 1,669 --- 3,150 --- 1,708

Total, PBHCI 5 9 28,641 5 5 50,000 3 4 26,004

National Strategy for Suicide Prevention

Grants

Continuations......................................................................... --- --- --- --- --- ---

New/Competing..................................................................... --- --- --- --- --- ---

Subtotal............................................................................... --- --- --- --- --- ---

Contracts

Continuations......................................................................... --- --- --- --- --- 2,142

New/Competing..................................................................... --- --- 1 2,000 --- 1,858

Subtotal............................................................................... --- --- 1 2,000 --- 4,000

Total, NSSP --- --- 1 2,000 --- 4,000

FY 2013 FY 2014 FY 2015

Final President's 

Budget

Enacted
313

Programs of Regional & National Significance No. Amount No. Amount No. Amount

Suicide Lifeline

Grants

Continuations......................................................................... 7 4,059 13 4,389 12 690

New/Competing..................................................................... 12 890 --- 1,440 1 3,700

Subtotal............................................................................... 19 4,948 13 5,829 13 4,390

Contracts

Continuations......................................................................... --- 963 --- 348 --- 1,122

New/Competing..................................................................... --- 174 --- 1,035 --- ---

Subtotal............................................................................... --- 1,137 --- 1,383 --- 1,122

Total, Suicide Lifeline 1/ 1 9 6,085 1 3 7,212 1 3 5,512

GLS- Youth Suicide Prevention - States

Grants

Continuations......................................................................... 54 25,182 27 12,251 31 20,452

New/Competing..................................................................... 7 3,015 24 17,678 3 2,136

Subtotal............................................................................... 61 28,196 51 29,929 34 22,588

Contracts

Continuations......................................................................... 1 4,127 --- 2,124 1 5,094

New/Competing..................................................................... --- 125 1 3,447 --- ---

Subtotal............................................................................... 1 4,252 1 5,571 1 5,094

Total, GLS-States 1/ 6 2 32,448 5 2 35,500 3 5 27,682

GLS- Youth Suicide Prevention - Campus

Grants

Continuations......................................................................... 40 3,776 41 3,864 33 3,208

New/Competing..................................................................... 22 2,959 15 1,409 6 614

Subtotal............................................................................... 62 6,735 56 5,273 39 3,822

Contracts

Continuations......................................................................... --- 1,648 --- 416 --- 1,144

New/Competing..................................................................... --- 492 --- 811 --- ---

Subtotal............................................................................... --- 2,139 --- 1,227 --- 1,144

Total, GLS-Campus 6 2 8,875 5 6 6,500 3 9 4,966

FY 2013 FY 2014 FY 2015

President's 

Budget

Final Enacted
314

Programs of Regional & National Significance No. Amount No. Amount No. Amount

GLS - Suicide Prevention Resource Center

Grants

Continuations......................................................................... 1 4,471 1 4,471 --- ---

New/Competing..................................................................... --- 583 --- 1,154 1 4,623

Subtotal............................................................................... 1 5,054 1 5,625 1 4,623

Contracts

Continuations......................................................................... --- 285 --- 315 --- ---

New/Competing..................................................................... --- --- --- 61 --- 325

Subtotal............................................................................... --- 285 --- 375 --- 325

Total, SPRC 1 5,339 1 6,000 1 4,948

AI/AN Suicide Prevention Initiative

Grants

Continuations......................................................................... --- --- --- --- --- ---

New/Competing..................................................................... --- --- --- --- --- ---

Subtotal............................................................................... --- --- --- --- --- ---

Contracts

Continuations......................................................................... --- 521 1 2,571 1 2,677

New/Competing..................................................................... 1 2,264 --- 367 --- 261

Subtotal............................................................................... 1 2,785 1 2,938 1 2,938

Total, AI/AN 1 2,785 1 2,938 1 2,938

Homelessness Prevention Programs

Grants

Continuations......................................................................... 79 22,468 24 6,542 31 18,266

New/Competing..................................................................... 11 550 31 17,716 15 5,242

Subtotal............................................................................... 90 23,018 55 24,258 46 23,508

Contracts

Continuations......................................................................... 2 6,145 2 4,214 3 6,514

New/Competing..................................................................... --- --- 1 2,300 --- 750

Subtotal............................................................................... 2 6,145 3 6,514 3 7,264

Total, HPP 9 2 29,162 5 8 30,772 4 9 30,772

FY 2013

Final Enacted

FY 2015

President's 

Budget

FY 2014
315

Programs of Regional & National Significance No. Amount No. Amount No. Amount

Minority AIDS

Grants

Continuations......................................................................... 11 7,257 --- --- 36 7,689

New/Competing..................................................................... --- 83 36 7,689 12 6,111

Subtotal............................................................................... 11 7,340 36 7,689 48 13,800

Contracts

Continuations......................................................................... 2 1,441 --- 583 2 2,470

New/Competing..................................................................... --- --- 2 975 --- ---

Subtotal............................................................................... 2 1,441 2 1,558 2 2,470

Total, MAI 1 3 8,781 3 8 9,247 5 0 16,270

Grants for Adult Trauma Screening & Brief Intervention

Grants

Continuations......................................................................... --- --- --- --- --- ---

New/Competing..................................................................... --- --- --- --- 4 2,706

Subtotal............................................................................... --- --- --- --- 4 2,706

Contracts

Continuations......................................................................... --- --- --- --- --- ---

New/Competing..................................................................... --- --- --- --- --- 190

Subtotal............................................................................... --- --- --- --- --- 190

Total, GATSBI --- --- --- --- 4 2,896

Criminal and Juvenile Justice Programs

Grants

Continuations......................................................................... 7 2,754 1 394 14 2,497

New/Competing..................................................................... 3 2,000 14 2,497 --- ---

Subtotal............................................................................... 10 4,754 15 2,891 14 2,497

Contracts

Continuations......................................................................... 2 1,123 1 989 2 1,713

New/Competing..................................................................... --- --- --- 400 --- 70

Subtotal............................................................................... 2 1,123 1 1,389 2 1,783

Total, CJJP 1 2 5,877 1 6 4,280 1 6 4,280

Tribal Behavoiral Health Grants

Grants

Continuations......................................................................... --- --- --- --- 20 4,016

New/Competing..................................................................... --- --- 20 3,885 --- ---

Subtotal............................................................................... --- --- 20 3,885 20 4,016

Contracts

Continuations......................................................................... --- --- --- --- --- 984

New/Competing..................................................................... --- --- --- 1,115 --- ---

Subtotal............................................................................... --- --- --- 1,115 --- 984

Total, TBHG --- --- 2 0 5,000 2 0 5,000

Subtotal, CAPACITY 555 251,259 599 361,417 559 336,949

FY 2013

President's 

Budget

FY 2014

Final Enacted

FY 2015
316

Programs of Regional & National Significance No. Amount No. Amount No. Amount

SCIENCE AND SERVICE:

Practice Improvement Training

Grants

Continuations......................................................................... --- 215 --- --- 6 2,906

New/Competing..................................................................... --- --- 6 2,902 --- ---

Subtotal............................................................................... --- 215 6 2,902 6 2,906

Contracts

Continuations......................................................................... 8 7,039 3 2,153 9 4,941

New/Competing..................................................................... --- 159 7 2,792 --- ---

Subtotal............................................................................... 8 7,198 10 4,945 9 4,941

Total, PIT 8 7,413 1 6 7,847 1 5 7,847

Consumer and Consumer Supporter Technical Assistance 

Centers

Grants

Continuations......................................................................... 5 1,775 5 1,777 --- ---

New/Competing..................................................................... --- --- --- --- 5 1,797

Subtotal............................................................................... 5 1,775 5 1,777 5 1,797

Contracts

Continuations......................................................................... --- 100 --- 146 --- ---

New/Competing..................................................................... --- --- --- --- --- 126

Subtotal............................................................................... --- 100 --- 146 --- 126

Total, CCSTAC 5 1,875 5 1,923 5 1,923

Primary and Behavioral Health Care Integration TA

Grants

Continuations......................................................................... 1 1,886 --- --- 1 1,865

New/Competing..................................................................... --- --- 1 1,870 --- ---

Subtotal............................................................................... 1 1,886 1 1,870 1 1,865

Contracts

Continuations......................................................................... --- 106 --- --- --- 131

New/Competing..................................................................... --- --- --- 126 --- ---

Subtotal............................................................................... --- 106 --- 126 --- 131

Total, PBHCI TA 1 1,992 1 1,996 1 1,996

FY 2013 FY 2014 FY 2015

President's 

Budget

Final Enacted
317

Programs of Regional & National Significance No. Amount No. Amount No. Amount

Disaster Response

Grants

Continuations......................................................................... --- --- --- --- 1 936

New/Competing..................................................................... --- --- 1 936 --- 900

Subtotal............................................................................... --- --- 1 936 1 1,836

Contracts

Continuations......................................................................... 1 997 --- 273 1 1,114

New/Competing..................................................................... --- --- 1 749 --- ---

Subtotal............................................................................... 1 997 1 1,022 1 1,114

Total, Disaster Response 1 997 2 1,958 2 2,950

Homelessness

Grants

Continuations......................................................................... --- --- --- --- --- ---

New/Competing..................................................................... --- --- --- --- --- ---

Subtotal............................................................................... --- --- --- --- --- ---

Contracts

Continuations......................................................................... 2 2,181 1 1,102 1 2,302

New/Competing..................................................................... --- --- --- 1,200 --- ---

Subtotal............................................................................... 2 2,181 1 2,302 1 2,302

Total, Homelessness 2 2,181 1 2,302 1 2,302

HIV/AIDS Education

Grants

Continuations......................................................................... --- --- --- --- --- ---

New/Competing..................................................................... --- --- --- --- --- ---

Subtotal............................................................................... --- --- --- --- --- ---

Contracts

Continuations......................................................................... 3 791 --- --- 3 773

New/Competing..................................................................... --- --- 3 773 --- ---

Subtotal............................................................................... 3 791 3 773 3 773

Total, HIV/AIDS 3 791 3 773 3 773

Subtotal, SCIENCE AND SERVICE 2 0 15,249 2 8 16,799 2 7 17,791

TOTAL, MH PRNS 575 $266,509 627 $378,216 586 $354,740

1/In the FY 2015 Request, the Mental Health Minority Fellowship Program budget is reflected in the Health Surveillance and 

Program Support Appropriation under the Agency-Wide Initiatives Workforce program. 

Enacted President's 

Budget

FY 2013 FY 2015

Final

FY 2014
318

SAMHSA/Substance Abuse Prevention

PRNS Mechanism Table by SLOA

(Dollars in thousands)

Programs of Regional & National 

Significance No. Amount No. Amount No. Amount

CAPACITY:

Strategic Prevention Framework

Grants

Continuations................................................... 39 $60,068 28 $43,960 51 $78,272

New/Competing.............................................. 17 30,981 34 47,292 85 22,007

Supplements.................................................... 17 3,900 15 2,175 --- ---

Subtotal........................................................... 73 94,949 77 93,427 136 100,279

Contracts

Continuations................................................... 5 7,812 10 16,077 7 16,059

New............................................................... 5 5,142 1 250 3 3,415

Subtotal........................................................... 10 12,953 11 16,327 10 19,475

Total, Strategic Prevention Framework 8 3 $107,902 8 8 $109,754 146 $119,754

Mandatory Drug Testing

Contracts

Continuations................................................... 2 2,179 2 4,065 3 4,443

New............................................................... 2 3,072 2 841 1 463

Subtotal........................................................... 4 5,252 4 4,906 4 4,906

Total, Mandatory Drug Testing 4 $5,252 4 $4,906 4 $4,906

Minority AIDS

Grants

Continuations................................................... 65 19,538 80 23,766 48 17,999

New/Competing.............................................. 29 14,334 23 9,348 40 17,133

Subtotal........................................................... 94 33,872 103 33,115 88 35,131

Contracts

Continuations................................................... 12 6,716 3 7,692 3 6,176

New............................................................... 3 407 2 500 --- ---

Subtotal........................................................... 15 7,123 5 8,192 3 6,176

Total, Minority AIDS 109 $40,996 108 $41,307 9 1 $41,307

Sober Truth on Preventing Underage 

Drinking Act

Grants

Continuations................................................... 80 3,838 97 4,646 97 4,643

New/Competing.............................................. 17 804 --- --- --- ---

Subtotal........................................................... 97 4,642 97 4,646 97 4,643

Contracts

Continuations................................................... 1 1,362 1 1,367 1 1,449

New............................................................... 1 989 1 987 1 907

Subtotal........................................................... 2 2,352 2 2,354 2 2,357

 Total, STOP 9 9 6,994 9 9 7,000 9 9 7,000

 Subtotal, CAPACITY 295 $161,143 299 $162,967 340 $172,967

Final Enacted President's Budget

FY 2013 FY 2014 FY 2015
319

Programs of Regional & National 

Significance No. Amount No. Amount No. Amount

SCIENCE AND SERVICE:

Fetal Alcohol Center of Exellence

Contracts

Continuations................................................... --- $508 1 $1,000 1 $1,000

New............................................................... 1 595 --- --- --- ---

Subtotal........................................................... 1 1,104 1 1,000 1 1,000

Total, Fetal Alcohol Center of Exellence 1 1,104 1 1,000 1 1,000

Center for the Application of Prevention 

Technologies

Contracts

Continuations................................................... 1 8,098 1 7,511 --- 306

New............................................................... --- --- --- --- 1 7,205

Subtotal........................................................... 1 8,098 1 7,511 1 7,511

Total, Center for the Application of 

Prevention Technologies 1 8,098 1 7,511 1 7,511

 Science & Service Program Coordination

Contracts

Continuations................................................... 4 4,099 4 1,823 5 4,082

New............................................................... 5 1,070 1 2,259 --- ---

Subtotal........................................................... 9 5,168 5 4,082 5 4,082

 Total, Science & Service Program 

Coordination 9 5,168 5 4,082 5 4,082

 Subtotal, SCIENCE AND SERVICE 1 1 14,369 7 12,593 7 12,593

Total, CSAP 1/ 306 $175,513 306 $175,560 347 $185,560

FY 2013 FY 2014 FY 2015

1/In the FY 2015 Request, the CSAP Minority Fellowship Program budget is reflected in the Health Surveillance and 

Program Support Appropriation under the Agency-Wide Initiatives Workforce program. 

Final Enacted President's Budget
320

SAMHSA/Substance Abuse Treatment

PRNS Mechanism Table by SLOA

(Dollars in thousands)

Programs of Regional & National Significance No. Amount No. Amount No. Amount

CAPACITY:

Opioid Treatment Programs/Regulatory Activities

 Grants

Continuations .............................................................................. 1 $500 2 $1,398 2 $2,400

New/Competing .......................................................................... 33 5,315 1 1,000 --- ---

Subtotal..................................................................................... 34 5,815 3 2,398 2 2,400 

 Contracts

Continuations .............................................................................. 5 4,562 6 4,997 4 5,510 

New/Competing .......................................................................... 3 2,045 --- 1,352 3 836 

Subtotal..................................................................................... 8 6,607 6 6,348 7 6,346 

Total, Opioid Treatment Programs/Regulatory Activities 4 2 12,421 9 8,746 9 8,746 

Screening, Brief Intervention and Referral to Treatment 

 Grants

Continuations .............................................................................. 12 12,194 22 19,923 22 19,919 

New/Competing .......................................................................... 19 29,575 10 18,407 12 3,844 

Subtotal..................................................................................... 31 41,769 32 38,330 34 23,763 

 Contracts

Continuations .............................................................................. 1 5,238 --- 4,036 1 6,237 

New/Competing .......................................................................... --- 457 1 4,634 --- ---

Subtotal..................................................................................... 1 5,695 1 8,670 1 6,237 

Total, Screening, Brief Intervention and Referral to 

Treatment 3 2 47,464 3 3 47,000 3 5 30,000 

TCE - General 

 Grants

Continuations .............................................................................. 30 8,033 29 7,611 30 7,672 

New/Competing .......................................................................... 33 10,595 2 800 --- ---

Subtotal..................................................................................... 63 18,628 31 8,411 30 7,672 

 Contracts

Continuations .............................................................................. 5 6,932 1 3,338 2 4,816 

New/Competing .......................................................................... 1 956 --- 1,508 2 2,769 

Subtotal..................................................................................... 6 7,889 1 4,845 4 7,584 

Total, TCE - General 6 9 26,516 3 2 13,256 3 4 15,256 

Final Enacted President's Budget

FY 2013 FY 2014 FY 2015
321

Programs of Regional & National Significance No. Amount No. Amount No. Amount

Pregnant & Postpartum Women 

 Grants

Continuations .............................................................................. 26 12,579 6 3,073 17 8,884 

New/Competing .......................................................................... --- --- 17 8,884 9 4,452 

Subtotal..................................................................................... 26 12,579 23 11,957 26 13,336 

 Contracts

Continuations .............................................................................. --- 2,382 --- 3,256 1 2,455 

New/Competing .......................................................................... --- 674 1 757 --- 178 

Subtotal..................................................................................... --- 3,056 1 4,013 1 2,634 

Total, Pregnant & Postpartum Women 2 6 15,634 2 4 15,970 2 7 15,970 

Strengthening Treatment Access and Retention

 Contracts

Continuations .............................................................................. 1 1,584 --- 1,585 --- 1,000 

New/Competing .......................................................................... --- --- --- 83 --- ---

Subtotal..................................................................................... 1 1,584 --- 1,668 --- 1,000 

Total, Strengthening Treatment Access and Retention.......... 1 1,584 --- 1,668 --- 1,000 

Recovery Community Services Program

 Grants

Continuations .............................................................................. 5 1,749 --- --- 10 1,000 

New/Competing .......................................................................... --- --- 18 1,400 --- ---

Subtotal..................................................................................... 5 1,749 18 1,400 10 1,000 

 Contracts

Continuations .............................................................................. --- 696 --- 530 1 921 

New/Competing .......................................................................... --- --- 1 510 --- 519 

Subtotal..................................................................................... --- 696 1 1,040 1 1,440 

Total, Recovery Community Services Program 5 2,445 1 9 2,440 1 1 2,440 

Access to Recovery

 Grants

Continuations .............................................................................. 29 87,486 --- --- --- ---

New/Competing .......................................................................... 2 328 --- 46,969 --- ---

Subtotal..................................................................................... 31 87,814 --- 46,969 --- ---

 Contracts

Continuations .............................................................................. --- 5,314 --- 3,031 --- ---

New/Competing .......................................................................... --- --- --- --- --- ---

Subtotal..................................................................................... --- 5,314 --- 3,031 --- ---

Total, Access to Recovery 3 1 93,128 --- 50,000 --- ---

Primary Care and Addiction Services Integration 

 Grants

Continuations .............................................................................. --- --- --- --- --- ---

New/Competing .......................................................................... --- --- --- --- 68 18,687 

Subtotal..................................................................................... --- --- --- --- 68 18,687 

 Contracts

Continuations .............................................................................. --- --- --- --- --- ---

New/Competing .......................................................................... --- --- --- --- --- 1,313 

Subtotal..................................................................................... --- --- --- --- --- 1,313 

Total, Primary Care and Addiction Services Integration......... --- --- --- --- 6 8 20,000 

Final Enacted President's Budget

FY 2013 FY 2014 FY 2015
322

Programs of Regional & National Significance No. Amount No. Amount No. Amount

Children and Family Programs

 Grants

Continuations .............................................................................. 13 12,818 23 21,954 10 9,112 

New/Competing .......................................................................... 10 9,103 --- --- 13 13,893 

Subtotal..................................................................................... 23 21,920 23 21,954 23 23,005 

 Contracts

Continuations .............................................................................. 2 6,629 2 5,513 2 6,673 

New/Competing .......................................................................... --- 469 --- 2,211 --- ---

Subtotal..................................................................................... 2 7,098 2 7,724 2 6,673 

Total, Children and Family Programs 2 5 29,018 2 5 29,678 2 5 29,678 

Treatment Systems for Homeless 

 Grants

Continuations .............................................................................. 71 26,560 34 15,732 50 26,995 

New/Competing .......................................................................... 11 7,157 39 20,029 12 8,771 

Subtotal..................................................................................... 82 33,717 73 35,760 62 35,765 

 Contracts

Continuations .............................................................................. 2 5,680 3 5,430 2 5,723 

New/Competing .......................................................................... --- --- 1 298 --- ---

Subtotal..................................................................................... 2 5,680 4 5,728 2 5,723 

Total, Treatment Systems for Homeless 8 4 39,397 7 7 41,488 6 4 41,488 

Minority AIDS 

 Grants

Continuations .............................................................................. 79 35,936 87 43,480 102 50,892 

New/Competing .......................................................................... 35 17,870 18 11,584 --- ---

Subtotal..................................................................................... 114 53,807 105 55,064 102 50,892 

 Contracts

Continuations .............................................................................. 2 6,608 2 10,468 2 7,967 

New/Competing .......................................................................... 1 1,503 --- 200 --- ---

Subtotal..................................................................................... 3 8,112 2 10,668 2 7,967 

Total, Minority AIDS 117 61,918 107 65,732 104 58,859 

Criminal Justice Activities

 Grants

Continuations .............................................................................. 117 34,137 133 42,130 122 38,663 

New/Competing .......................................................................... 55 18,715 70 20,935 57 15,058 

Subtotal..................................................................................... 172 52,852 203 63,065 179 53,721 

 Contracts

Continuations .............................................................................. 3 10,182 1 9,648 1 10,550 

New/Competing .......................................................................... --- 524 --- 2,287 --- 175 

Subtotal..................................................................................... 3 10,706 1 11,935 1 10,725 

Total, Criminal Justice Activities 175 63,558 204 75,000 180 64,446 

Subtotal, CAPACITY 607 393,085 530 350,978 557 287,883 

FY 2013 FY 2014 FY 2015

Final Enacted President's Budget
323

Programs of Regional & National Significance No. Amount No. Amount No. Amount

SCIENCE AND SERVICE:

Addiction Technology Transfer Centers

 Grants

Continuations .............................................................................. 15 8,527 15 8,476 15 7,550 

New/Competing .......................................................................... --- --- --- --- --- ---

Subtotal..................................................................................... 15 8,527 15 8,476 15 7,550 

 Contracts

Continuations .............................................................................. --- 481 --- 570 --- 531 

New/Competing .......................................................................... --- --- --- --- --- ---

Subtotal..................................................................................... --- 481 --- 570 --- 531 

 Total, Addiction Technology Transfer Centers 1 5 9,008 1 5 9,046 1 5 8,081 

Special Initiatives/Outreach 

 Grants

Continuations .............................................................................. 1 300 1 300 1 300 

New/Competing .......................................................................... --- --- --- --- --- ---

Subtotal..................................................................................... 1 300 1 300 1 300 

 Contracts

Continuations .............................................................................. 2 681 --- 225 2 1,136 

New/Competing .......................................................................... 1 1,010 1 911 --- ---

Subtotal..................................................................................... 3 1,692 1 1,136 2 1,136 

Total, Special Initiatives/Outreach 4 1,992 2 1,436 3 1,436 

Subtotal, SCIENCE AND SERVICE 1 9 11,000 1 7 10,482 1 8 9,517 

Total, CSAT PRNS 1/ 626 $404,085 547 $361,460 575 $297,400

FY 2013 FY 2014 FY 2015

Final Enacted President's Budget

1/In the FY 2015 Request, the CSAT Minority Fellowship Program budget is reflected in the Health Surveillance and Program Support 

Appropriation under the Agency-Wide Initiatives Workforce program. 
324

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325

Substance Abuse and Mental Health Services Administration

SIGNIFICANT ITEMS IN SENATE REPORT

FY 2015 Consolidated Senate Report Language

(Senate Report 113-71)

General Items

Item

The Committee is disappointed that the administration has continued to use the Substance 

Abuse Prevention and Treatment [SAPT] Block Grant and the MHBG as sources for 

program evaluation transfers pursuant to section 241 of the PHS Act. The Committee directs 

SAMHSA and the Department to exempt these two programs from being used as a source for 

PHS evaluation transfers in fiscal year 2014, as was done prior to fiscal year 2012. (Page 111)

Action taken or to be taken

Consistent with Congressional direction, the Substance Abuse Prevention and Treatment Block 

Grant and Mental Health Block Grant are exempt from being used as a source for PHS 

evaluation transfers in fiscal year 2014. The 2015 President’s Budget continues this exemption in 

2015.

Item

The Committee is concerned that the combined block grant application for fiscal years 2014-

2015 does not make clear that, in the absence of congressional action, using funds to improve 

provider enrollment and billing practices is an allowable use of funds but is not a requirement. 

The Committee directs SAMHSA to clarify with State mental health and substance abuse 

authorities which block grant activities are required and which are optional. (Page 111-112)

Action taken or to be taken

The FY14-15 block grant application asked states to set-aside five percent of the MHBG for 

implementation of evidence-based practices and three percent of their SABG and MHBG 

allocations to improve provider business practices, including billings systems, and to support 

enrollment into health insurance for eligible individuals served in the public service system. The 

block grant application does not require that the states conduct this activity. 

This clarification has been provided to the State mental health and substance abuse authorities in 

several different ways and through several mechanisms. SAMHSA had included this 

clarification in several conference calls and informational webinars with the state authorities, 

mental health block grant planners and the two national organizations, NASADAD and 

NASMHPD; through ongoing communication between the SAMHSA state project officers and 

state block grant coordinators; and in the online instructions in the web based application itself.
326

Item

Primary and Behavioral Healthcare Integration - The Committee provides funding for this 

program through budget authority rather than through transfers from the PPH Fund as requested 

by the administration. The Committee continues to direct SAMHSA to ensure that new 

Integration grants awarded for fiscal year 2014 are funded under the authorities in section 520K 

of the PHS Act. (Page 113)

Action taken or to be taken

In FY 2014, SAMHSA plans to fund approximately 40 new grants under section 520K of the 

PHS Act.

Item

Psychotropic Medications and Children - The Committee has become increasingly concerned 

about the safe, appropriate, and effective use of psychotropic medications and children, 

particularly children in foster care settings. According to a December 2012 GAO report, an 

alarming 18 percent of foster children are prescribed psychotropic medications, compared with 

4.8 percent of privately insured children. The Committee strongly encourages SAMHSA to 

establish meaningful partnerships with Medicaid, the foster care program, medical specialty 

societies, and treatment centers to develop new strategies for treating this vulnerable population. 

The Committee would like an update in next year's congressional justification on the steps 

SAMHSA has taken to promote the most effective and appropriate treatment approaches, 

including the use of evidence-based psychosocial therapies instead of, or in combination with, 

psychotropic medications. (Page 113)

Action taken or to be taken

SAMHSA has taken a significant leadership role to address the safe, effective and appropriate 

use of psychotropic medication in children and youth. The agency has collaborated extensively 

with the Administration on Children and Families (ACF) and the Centers for Medicare & 

Medicaid Services (CMS) to address this issue for children in foster care; has partnered with 

professional groups to create more stringent guidelines related to prescribing and medication 

oversight practices; and has worked closely with parents and youth to improve consumer 

decision-making with regards to the use of medications. Below reflect a number of activities and 

developments that SAMHSA has been engaged in to address the issue. 

SAMHSA supported the American Academy of Child and Adolescent Psychiatry’s (AACAP) 

development of guidelines on issues that community agencies should address when prescribers 

are considering the use of psychotropic medications. Titled, “A Guide for Community Child 

Serving Agencies on Psychotropic Medications for Children and Adolescents,” this document 

provides information to community agencies about safely and effectively prescribing 

psychotropic medications, describes the phases in treatment when medication could be 

considered part of an overall treatment plan, and provides information about the use of 

community based alternatives that child serving systems and agencies should consider in 

addition to psychotropic medications. SAMHSA has also collaborated with AACAP to support a 
327

Child and Adolescent Psychiatry Fellow at SAMHSA one day a week (20% FTE). For the past 

four years each Fellow has undertaken a project to improve psychiatric service delivery, connect 

with community agencies and organizations, and identify evidence-based treatment strategies. 

Perhaps one of the most significant advances SAMHSA has helped to support has been the 

development of a Youth Advisory Group at AACAP that provides advice, guidance and 

information about medication use and empowers youth to make their own informed decisions 

regarding using medications. One accomplishment supported through this youth group was the 

development and expansion of the AACAP website as a resource to youth and families. Via a 

simple click on the “families and youth” toolbar on the AACAP homepage, youth and families 

can obtain a wealth of resources that include a section on how to choose a child and adolescent 

psychiatrist; “Facts for Families” on a wide range of topics; a patient education section that 

provides information about mental health conditions; and an entire section dedicated to youth 

resources. Going forward, SAMHSA will be continuing its efforts to address the importance of 

using psychotropic medications safely and effectively in collaboration with AACAP.

In addition to the work with AACAP, SAMHSA has also supported efforts by the Center for 

Health Care Strategies of the Robert Wood Johnson Foundation to provide technical assistance 

on strategies to improve oversight of psychotropic medication use in foster children. The 

technical assistance has included a webinar series, “Psychotropic Medication Use among 

Children in Foster Care: Technical Assistance Webinar Series.” As part of this series, in 

September of 2013, a webinar was held titled, “The Use and Financing of Non-Pharmacologic 

Evidence-Based Practices: Alternatives to Psychotropic Medications.” Evidence-based 

psychosocial interventions were identified that may offer a more comprehensive and costeffective means of addressing behavioral health and social challenges experienced by children 

and youth in foster care, as well as other child populations with significant behavioral health 

challenges. SAMHSA also supported the Center for Health Care Strategies recently released 

“Faces of Medicaid Analysis,” which identified areas to improve behavioral health treatment, 

including the use of psychotropic medications and alternative approaches.

SAMHSA was also one of the sponsors of an Administration on Children Youth and Families 

conference and dialogue about the appropriate use of psychotropic medication for foster 

children. SAMHSA provided training to nearly 100 early career child and adolescent 

psychiatrists on community and public sector psychiatry, systems of care and youth and family 

engagement. 

As part of SAMHSA’s ongoing commitment, SAMHSA will maintain its meaningful 

partnerships with other federal agencies, guilds and organizations to further the important agenda 

to address psychotropic medication use in America’s children and youth. 

Item

One promising model that seeks to address serious mental illness at an early stage is called First 

Episode Psychosis [FEP], currently being used in Canada, the United Kingdom, and Australia. 

This early treatment model may help reduce symptoms, reduce relapse rates, and prevent 

deterioration of cognitive function in individuals suffering from psychotic illness. The 5 percent 

set-aside will provide $24,817,000 to programs such as FEP. The Committee provides an 

increase to the block grant over the fiscal year 2013 level to help States meet this new 
328

requirement without losing funding for existing services. The Committee directs SAMHSA to 

collaborate with NIMH in developing guidelines to States regarding effective programs funded 

by this set-aside. (Page 114)

Action taken or to be taken

SAMHSA supports States’ efforts to address the identification and referral of individuals 

experiencing first episode psychosis (FEP) in order to substantially reduce the duration of 

untreated psychosis. SAMHSA has been involved for some time in an ongoing collaboration 

with NIMH directed toward the goals of the FEP model. SAMHSA staff has received training 

and consultation on the Recovery After an Initial Schizophrenia Episode (RAISE) project that is 

designed to change the identification and treatment of this illness to reduce the likelihood of long 

term disability and promote productive and independent lives. SAMHSA has already engaged 

with State Mental Health Authorities to discuss the upcoming guidance and necessary updates to 

each state’s Block Grant Plan for FY 2014. SAMHSA will continue to work with NIMH to 

assure that states have access to information relating to the RAISE project and other researchbased early intervention programs to address serious mental illness.

Item

Addiction Technology Transfer Centers [ATTCs] - The Committee continues to direct 

SAMHSA to ensure ATTCs continue to maintain a primary focus on addiction treatment and 

recovery services in order to strengthen the addiction workforce. (Page 116)

Action taken or to be taken

SAMHSA ensures ATTCs continue to maintain a primary focus on addiction treatment and 

recovery services in order to strengthen the addiction workforce. The target audience of the 

ATTCs includes both those members of the workforce who work in traditional substance abuse 

treatment settings and those members who provide services to individuals with substance use 

disorders in other behavioral health and primary health care locations.

Through ongoing discussions with state authorities, treatment provider associations, addiction 

counselors, multidisciplinary behavioral health and primary health care professionals, and faithbased and recovery community leaders, the ATTCs assess the training and development needs 

of those providing substance abuse treatment services in their regions. The focus of the training 

and technical assistance provided by the ATTCs is on increasing knowledge and improving skills 

in the use of evidence-based and promising treatment/recovery practices in recovery-oriented 

systems of care. 

The ATTCs are the primary mechanisms through which SAMHSA focuses on building the 

addiction workforce’s capacity in terms of both the number of members in the workforce and the 

competencies and qualifications of those members. ATTCs are located in each of the ten 

Department of Health and Human Services’ regions. In addition to the ten regional centers, 

SAMHSA funds four national focus area ATTCs: the National American Indian and Alaskan 
329

Native ATTC, the National Frontier and Rural ATTC, the National Hispanic and Latino ATTC, 

and the National Screening, Brief Intervention and Referral to Treatment ATTC. 

Item

Addiction Workforce - The Committee notes that several studies conducted over the past decade 

suggest that lack of information about the addiction field and the perception that addiction 

counselors are not viewed as a valued profession appear to be recruitment barriers for the

addiction workforce. This is particularly concerning given that the demand for substance abuse 

services is anticipated to increase in the coming years as a result of the ACA and the Mental 

Health Parity and Addictions Equity Act. The Committee strongly urges SAMHSA to work with 

community colleges, universities, and State substance abuse agencies to develop ways to 

encourage individuals to enter the addiction prevention, treatment, and recovery workforce. 

(Page 116) 

Action taken or to be taken

SAMHSA’s primary vehicle for addressing substance abuse treatment practice improvement 

issues is the Addiction Technology Transfer Centers (ATTC) program. The ATTCs seek to 

increase the numbers of individuals in the workforce and to promote the adoption of researchbased treatment interventions. By increasing the science-base of the methodologies employed by 

the addictions treatment workforce, individuals in the substance abuse treatment workforce 

increase their competencies and the likelihood of preferred client outcomes. These efforts help to 

elevate the profession in the eyes of stakeholders to retain those in the workforce and to attract 

new members. The ATTCs seek to increase the number of individuals entering the addiction 

workforce through adoption and implementation of pre-service strategies. Thirteen of the fifteen 

ATTCs are situated in Universities, including one historically African American university and 

one Hispanic university. The ATTC staffs, located on these campuses, are faculty members who 

teach relevant classes in behavioral health theory and practice, and support the development of 

curricula that will prepare students for service in the behavioral/addiction treatment 

workforce. The ATTC network also has a standing committee on Pre-Service Education. This 

committee seeks to reach out to universities and colleges in the ten Department of Health and 

Human Service regions, and advocate for curriculum/course tracks in behavioral health 

care. The National American Indian and Alaska Native ATTC works with Tribal Universities 

and Colleges to ensure access to courses that will help American Indians and Alaska Natives 

meet certification requirements in their states and enable them to pass the necessary tests. A 

combination of this effort along with the efforts of the National Hispanic and Latino ATTC, the 

presence of the ATTC at Historically Black Colleges and Universities, and other SAMHSA 

initiatives reflect its focus on increasing the diversity of the behavioral health workforce.

In addition, in September 2013, SAMHSA convened two workforce meetings including: a 

stakeholder listening session with national organizations and guilds with the goal of developing 

an initial roadmap for strengthening the behavioral health workforce, and a second meeting 

which addressed strategies for integrating peers, paraprofessionals and community health 

workers in the behavioral health and broader healthcare workforce. Summary reports from each 

of these meetings are in final stages of development. 
330

SAMHSA is using 2014 Minority Fellowship Program funds to support the training of addiction 

counselors with a focus on those planning to work with youth ages 16-25. SAMHSA is also 

partnering with HRSA to expand its Behavioral Health Workforce Education and Training 

Program to include paraprofessional workers such as recovery coaches and mental health/ 

addition specialists. 

Further, working collaboratively with HRSA, SAMHSA will use FY 2014 funds to provide 

internship support for Master’s level psychologists, professional counselors, social workers, 

marriage and family therapists, psychology doctoral interns and behavioral health 

paraprofessionals. 

Item

Drug Treatment Courts - The Committee continues to direct SAMHSA to ensure that all 

funding appropriated for Drug Treatment Courts is allocated to serve people diagnosed with a 

substance use disorder as their primary condition. The Committee expects CSAT to ensure that 

non-State substance abuse agency applicants for any drug treatment court grant in its portfolio 

continue to demonstrate extensive evidence of working directly and extensively with the 

corresponding State substance abuse agency in the planning, implementation, and evaluation of 

the grant. (Page 116)

Action taken or to be taken

SAMHSA will ensure their FY 2014 drug court grant solicitations contain language requiring

funds to be used to serve people diagnosed with a substance use disorder as their primary 

condition. In addition, language will be included to assure all non-State substance abuse agency 

applicants have demonstrated evidence of working directly and extensively with the 

corresponding state alcohol and drug abuse agency in the planning, implementation and

evaluation of the grant. 

Item

Infectious Disease Testing - The Committee remains concerned by the high incidence of viral 

hepatitis and HIV among the populations that SAMHSA serves. The Committee encourages 

SAMHSA to continue to support hepatitis and HIV testing within its activities and to utilize 

rapid tests to encourage patient receipt of results. In addition, SAMHSA is encouraged to 

continue surveillance of these activities in order to monitor the progress of infectious diseases 

screening. (Page 116) 

Action taken or to be taken

SAMHSA will maintain the requirement that substance abuse treatment programs which receive 

funding from CSAT perform HIV testing with all clients, and HIV case management of HIV 

positive clients who participate in SAMHSA’s Minority AIDS Initiative-funded programs. 

SAMHSA allows grantees in certain substance abuse treatment programs to utilize up to 5 
331

percent of their funds to provide viral hepatitis testing. For those grantees that provide hepatitis 

testing, SAMHSA offers technical assistance to build their capacity to provide hepatitis case 

management services including confirmatory testing and referral to treatment. All new CSAT 

Request for Applications (RFAs) will require that substance abuse treatment clients be tested for 

HIV and hepatitis. All new HIV Continuum of Care grants will also require hepatitis testing. 

Item

Minority AIDS Initiative - The Committee rejects the administration request to move funds to 

CMHS from the Minority AIDS Initiative administered by CSAT. The Committee urges 

SAMHSA to focus its efforts on building capacity and outreach to individuals at risk for or with 

a primary substance use disorder and to improve efforts to identify such individuals to prevent 

the spread of HIV. (Page 116) 

Action taken or to be taken

Consistent with Congressional direction, SAMHSA will maintain 2014 funding for CSAT's 

substance abuse treatment Minority AIDS Initiative (MAI) grant programs and focus on 

building capacity and outreach efforts to individuals with, or at risk of developing, a primary 

substance use disorder and to improve efforts to identify such individuals to prevent the spread 

of HIV. To support ongoing efforts, SAMHSA intends to issue a collaborative MAI program 

funded by CMHS, CSAT and CSAP. The primary focus will be the co-location and integration 

of HIV services within substance abuse primary prevention, substance abuse treatment and 

mental health treatment for racial/ethnic minority individuals with or at risk for mental illness, 

substance abuse, and HIV/AIDS. Grantees will submit separate budgets for each funding source 

to ensure that all funding is used in a manner consistent with the purpose for which it was 

appropriated. 

Item

Screening, Brief Intervention, and Referral to Treatment [SBIRT] - The Committee provides 

funding for SBIRT through budget authority rather than through transfers from the PPH Fund as 

requested by the administration. The Committee continues to direct SAMHSA to ensure that 

funds provided for SBIRT are used for existing evidence-based models of providing early 

intervention and treatment services to those at risk of developing substance abuse disorders. 

(Page 116-117) 

Action taken or to be taken

Screening, Brief Intervention, and Referral to Treatment (SBIRT) appropriated funds are used 

for programs that utilize the evidence-based SBIRT models that provide early intervention and 

substance abuse treatment referral to those in need. Models include use of validated substance 

abuse screening tools, motivational interviewing techniques that inform counseling interventions, 

and promotion of established referral to treatment methodologies. In addition, SBIRT funds are

used to train primary care practitioners in existing SBIRT evidence-based models.
332

Item

Workforce Development - The Committee is concerned that only 50 to 55 percent of addiction 

counselors hold a master's degree. While 75 percent hold at least a bachelor's degree, the 

remainder have only a high school diploma or equivalent. The Committee urges SAMHSA to 

work with HRSA to ensure that programs aimed at mental health and substance use disorder 

professionals are available to addiction professionals seeking to move from a bachelor's level to 

a master's level. (Page 117)

Action taken or to be taken

SAMHSA agrees with the committee and is making significant investments in behavioral health 

workforce development. Efforts in 2014 include a $1.6 million investment to create the Minority 

Fellowship Program for Addiction Counselors (MFP-AC), which will provide additional support 

for the broader objective of the MFP grant. Specifically, the purpose of the MFP-AC, part of the 

President’s Now is the Time Initiative, is for “increasing the number of addiction counselors with 

Master’s level training.” The MFP-AC will provide stipends to students pursuing master’s 

degrees in addiction/substance abuse counseling. Part of the student’s program must include 

training on addiction issues associated with transitional age youth (16-21 years old). 

Additionally, SAMHSA will work with HRSA using FY 2014 funds to administer an expansion 

of the Mental and Behavioral Health Workforce Education and Training Program to strengthen 

the clinical field competencies of graduate students. 

Item

Programs of Regional and National Significance - Given that youth drug use is on the rise and 

perceptions of harm are waning, 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 programs and strategies and not for any other purposes. (Page 

118)

Action taken or to be taken

SAMHSA agrees with the Committee and can confirm that substance abuse prevention funds in 

both CSAP’s PRNS line and funding from the 20 percent prevention set-aside in the Substance 

Abuse Prevention and Treatment Block Grant (SABG) are used solely to fund substance abuse 

prevention programs and strategies.

Specifically, the FY 2014-2015 SABG Block Grant application states, as per statute, that “the 

20% set aside funds of the SABG Block Grant must be used only for substance abuse primary 

prevention activities by the state.” CSAP State Project Officers monitor state expenditures to 

confirm that states are spending at least 20% of the total SABG award on primary substance 

abuse prevention programs, practices and strategies. Similarly, grantees funded through CSAP’s 

PRNS line are also required to expend grant funds on substance abuse prevention strategies and 

infrastructure development. CSAP Project Officers also monitor these grant expenditures to 

ensure that grant funds are spent appropriately and on allowable items.
333

While all SAMHSA prevention funds must be used by grantees to funds strategies that have a 

positive impact on the prevention of substance use, it is important to acknowledge that many 

evidence-based substance abuse prevention strategies also have a positive impact on other health 

and social outcomes such as education, juvenile justice involvement, violence prevention, and 

mental health.

Item

Overdose Fatality Prevention - The Committee is deeply concerned about the increasing number 

of unintentional overdose deaths attributable to prescription and nonprescription opioids. The 

Committee urges SAMHSA to take steps to encourage and support the use of SAPT Block Grant 

funds for opioid safety education and training, with a focus on initiatives that improve access of 

naloxone to public health and law enforcement professionals. (Page 117) 

Action taken or to be taken

SAMHSA’s Opioid Overdose Prevention Toolkit (Toolkit) can serve as a foundation for such 

education and training. CSAT, through the SABG Technical Assistance Tracker process, will 

continue to stress the importance of SAMHSA’s Toolkit to Single State Authorities (SSAs). The

Toolkit information link was distributed on the TA Tracker list serve on August 29, 2013 to help 

raise awareness of overdose prevention and reversal strategies available to them through 

SAMHSA (http://store.samhsa.gov/product/Opioid-Overdose-Prevention-Toolkit/SMA13-

4742). CSAT also intends to send a letter to all SSAs reminding them of this valuable 

information and urge them to include it in their strategic planning as they furnish communities 

and local governments with materials on how to develop policies and practices to help prevent 

opioid-related overdoses and deaths. SAMHSA agrees that increasing access to naloxone or 

naloxone administration is an important component to addressing unintentional overdose. 

Since CSAP/DWP can provide linkages with workplace employees and treatment, CSAP/DWP 

intends to promote SAMHSA’s Opioid Overdose Prevention Toolkit through the Prevention of 

Prescription Drug Abuse in the Workplace (PAW) Technical Assistance contract as well as 

through the education of federal Medical Review Officers who interpret drug test results of 

donors. In addition, SAMHSA will provide a link to its Opioid Overdose Prevention Toolkit on 

DWP’s website.

Item

Minority Fellowships - The Committee recommendation includes $10,695,000 for the Minority 

Fellowship program, a $5,000,000 increase above the fiscal year 2013 level. The Committee 

provides funding for this program within the three Centers as it has done in previous years, rather

than in the Health Surveillance and Program Support account as requested by the administration. 

The Committee intends that the increase provided in CSAT for Minority Fellowship be used to 

increase the number of addiction counselors receiving Master's level training. (Page 119) 
334

Action taken or to be taken

Consistent with Congressional direction, funding for Minority Fellowship Program will be 

expanded and is provided in all appropriations. Please refer to the Agency-Wide Initiatives in the 

Health Surveillance and Program Support Chapter. 

Item

National Survey on Drug Use and Health [NSDUH] - The Committee is concerned about the 

exclusion of American Samoa, Guam, the Northern Mariana Islands, Puerto Rico and the U.S. 

Virgin Islands from NSDUH. The exclusion is especially troubling with respect to Puerto Rico 

and the U.S. Virgin Islands, which are designated as a high intensity drug trafficking area, 

because NSDUH is a leading evidence-based resource used to measure the effectiveness of 

Federal drug control policies and programs. The Committee encourages SAMHSA to consider 

fully incorporating each territory into the redesign of NSDUH. (Page 119)

Action taken or to be taken

SAMHSA understands the concerns over exclusion of American Samoa, Guam, the Northern 

Mariana Islands, Puerto Rico and the U.S. Virgin Islands from the NSDUH, especially with 

respect to the inclusion of Puerto Rico and the U.S Virgin Islands as designated High Intensity 

Drug Trafficking areas.

The redesign of the NSDUH sample was implemented in 2013, and data collection based on this 

new design will begin in January 2014. Thus, it will not be possible to incorporate additional 

data collection in these outlying areas in the current NSDUH redesign. Also, given the 

differences between the States and the District of Columbia and American Samoa, Guam, the 

Northern Mariana Islands, Puerto Rico and the U.S. Virgin Islands, there may be substantial 

cultural, scientific and methodological reasons for considering a separately designed and 

delivered study so as not to compromise or undermine the quality and validity of current 

NSDUH data.

In FY 2014, SAMHSA will conduct a feasibility study that will provide options for addressing 

the concerns noted above. The results of the study could be ready by summer 2015 and include 

estimated costs and potential timelines for the implementation of various options.

Item

Overdose Prevention - The Committee notes that accidental deaths from overdose, particularly 

from prescription drugs such as opioids, are on the rise and have become the leading cause of 

preventable death for individuals under the age of 65 in the United States. The Committee is 

concerned that many healthcare professionals, treatment providers and at-risk populations are 

unaware of overdose prevention and reversal strategies. The Committee urges the Secretary, in 

collaboration with other agencies such as SAMHSA and CDC, to raise awareness of the 

symptoms and risk factors of overdose, how to deploy naloxone, rescue breathing and 

emergency services for someone experiencing an overdose, and how to help individuals make 

the linkage to treatment and recovery services. (Page 147)
335

Action taken or to be taken

SAMHSA continues to promote its Opioid Overdose Prevention Toolkit (Toolkit) to its Block 

Grant and discretionary grantees to raise awareness of overdose prevention and reversal 

strategies. SAMHSA released the Toolkit in August 2013 which has been widely disseminated 

via SAMHSA’s Regional Administrators, HRSA, CDC’s Morbidity and Mortality Weekly 

Report (MMWR), and non-federal partners. SAMHSA also intends to inform discretionary 

grantees about the increasing number of unintentional overdose deaths attributable to 

prescription and nonprescription opioids and to urge them to include this issue in their strategic 

planning, screening, and referral to treatment protocols. In addition, SAMHSA will include 

opioid overdose prevention messages and strategies derived from the Toolkit in various 

continuing medical education (CME) efforts. These efforts include live CME courses offered 

around the country 7 times per year; a listing of an online learning module devoted to the subject 

with free CME on opioidprescribing.com, a SAMHSA funded site; and, webinars on the 

Prescriber Clinical Support Systems for both Opioids and Medication Assisted Treatment aimed 

at SAMHSA grantees. These activities will be jointly coordinated with CDC. SAMHSA is also 

holding stakeholder calls on the subject of opioid overdose, the first of which was held on 

February 20, 2014. Additionally, SAMHSA plans to expand its overdose prevention education to 

opioid treatment providers, disseminate information in the Revised Federal Opioid Treatment 

Program Guidelines (to be published in 2014); and, continue to host the Emerging Opioid 

Overdose Strategic Group, a biweekly teleconference for stakeholders nationwide. 

Since CSAP/DWP can provide linkages with workplace employees and treatment, CSAP/DWP 

intends to promote SAMHSA’s Opioid Overdose Prevention Toolkit through the Prevention of 

Prescription Drug Abuse in the Workplace (PAW) Technical Assistance contract as well as 

through the education of federal Medical Review Officers who interpret drug test results of 

donors. In addition, SAMHSA will provide a link to its Opioid Overdose Prevention Toolkit on 

DWP’s website.

SIGNIFICANT ITEMS FROM OMNIBUS CONFERENCE REPORT

Item

Mental Health First Aid - The Administrator is directed to focus on a broad public safety 

approach when implementing the Mental Health First Aid program that offers training for both 

school officials and the range of actors in the public sphere that interact with youth.

Action taken or to be taken

Under Project AWARE, Mental Health First Aid funding will promote widespread dissemination 

of the Mental Health First Aid curriculum. MHFA-Y prepares teachers and other individuals 

who work with youth to help schools and communities to understand, recognize, and respond to 

signs of mental illness or substance abuse in children and youth. In 2014, SAMHSA will award 

MHFA funds through competitive grants to State Education Agencies and Local Education 

Agencies. Grant recipients will be required to work with their respective mental health and 
336

juvenile justice counterparts as well as other community based organizations to ensure that 

teachers and a broad array of community actors receive training in the MHFA-Y model. 

Item 

Screening, Brief Intervention, and Referral to Treatment (SBIRT) - The Administrator is 

directed to ensure the funds provided for the Screening, Brief Intervention and Referral to

Treatment program are used for existing evidence-based models of providing early intervention 

and treatment services to those at risk of developing substance abuse disorders.

Action taken or to be taken

All SBIRT funds utilize the existing evidence-based SBIRT model and provide funds to 

applicants who demonstrate the ability to provide early intervention and substance abuse 

treatment referral services to those in need. In FY 2014, SAMHSA plans to support additional 

Screening, Brief Intervention, and Referral to Treatment (SBIRT) Medical Professional Training 

Program grants (SBIRT Training) and one State SBIRT grant. The purpose of SBIRT Training is 

to develop and implement training programs to teach health professionals (medical residents and 

students of nursing, social work and counseling) the skills necessary to provide evidence-based 

screening, brief intervention and brief treatment and to refer patients who are at risk for a 

substance use disorder (SUD) to appropriate treatment. The intended outcomes of this program 

are to increase the adoption and practice of SBIRT throughout the health care delivery system.

Item 

STOP Act - The Administrator is commended for providing funding for the STOP Act within the 

budget request this year; however, the Administrator is strongly encouraged to eliminate the 

requirement for Community Enhancement Grant program applicants to provide evidence of State 

collaboration in the grant application. This program was intended by law to be a community 

program.

Action taken or to be taken

SAMHSA appreciates the support for the STOP ACT program which is an important component 

of a broader strategy for preventing and reducing alcohol use among America’s youth. STOP 

ACT grantees will continue to be encouraged to collaborate with state, local and tribal 

governments to enhance and further their community initiatives.
337

SAMHSA

SAMHSA Additional Item

Table of Contents

SAMHSA/SAMHSA Additional Item

1. HIV Continuum of Care ...................................................................................................... 339
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HIV Continuum of Care

SAMHSA Strengthening HIV Continuum of Care through Behavioral Health/Substance Abuse 

& Primary Care Integration Grants - Should show how SAMHSA intends to build new evidence 

and strengthen capacity for rigorous evaluation and data analytics. 

The National HIV/AIDS Strategy and Implementation Plan 

SAMHSA currently funds projects under the Minority AIDS Initiative (MAI) that implement the 

goals of the National HIV/AIDS Strategy which are sponsored through the Center for Substance 

Abuse Prevention (CSAP), the Center for Substance Abuse Treatment (CSAT), and the Center 

for Mental Health Services (CMHS). CSAP-funded projects provide funding for substance abuse 

prevention services and HIV testing while CSAT and CMHS-funded projects support substance 

abuse/mental health treatment services, HIV testing and referral to quality HIV care. 

In 2011, SAMHSA joined with the Office of HIV/ AIDS and Infectious Diseases and other HHS 

agencies nationally to better coordinate HIV responses under the ‘HHS 12 Cities Project’. 

Consistent with this effort, through its three centers SAMHSA funded 11 cooperative agreements 

under the Minority AIDS Initiative-Targeted Capacity Expansion Integrated Behavioral 

Health/Primary Care Network Cooperative Agreements (MAI-TCE Program) under the MAI. In 

this program, the 11 cities with the highest HIV/AIDS rates in the racial and ethnic minority 

communities who are most impacted by HIV/AIDS, are targeted through city/state health 

departments to develop/expand culturally competent and effective community-based treatment 

services. Integrated behavioral health and primary care networks were also expanded across 

behavioral health, HIV services and medical treatment. The program ensures that individuals 

who are at high risk for, or have a mental and/or substance use disorder, and who are most at risk 

for, or are living with HIV/AIDS, receive appropriate behavioral health services, including 

prevention and treatment (HIV testing), HIV/AIDS care and medical treatment in integrated 

behavioral health and primary care settings, such as infectious disease or other HIV specialty 

providers. The priority populations for this program included those identified in the National 

HIV/AIDS Strategy including Black and Latino women and men, gay and bisexual men, 

transgendered persons, and substance users, as appropriate to the grantee. SAMHSA provided 

supplemental funding to three grantees under the MAI-TCE to expand screening for substance 

use and mental disorders within HIV specialty treatment programs with a goal of increasing 

retention in treatment and successful establishment of antiretroviral treatment. 

SAMHSA’s programs to deliver and sustain high quality, accessible substance abuse and HIV 

prevention services focus on preventing and reducing onset of substance abuse and transmission 

of HIV/AIDS among at-risk racial/ethnic minority subpopulations. Nationally, approximately 

50% of HIV-infected persons who are aware of their HIV status are not receiving regular HIV 

care or antiretroviral therapy. Large numbers of these individuals have behavioral health 

conditions. Mental and Substance Use Disorders (M/SUDs) have a disproportionate impact on 

those at risk for or living with HIV/AIDS. It is estimated that fifty percent of those in HIV care 

have a co-occurring behavioral health condition. While these illnesses can arise either 

independently of infection, predispose to (through risk-related behaviors), or be a psychological 

consequence of having HIV, co-occurrence of mental and/or substance use disorders in the 
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presence of HIV poses particular challenges for care of this population. It is known that untreated 

M/SUDs are among the top 5 predictors of poor adherence to HIV/AIDS treatment. Furthermore, 

alcohol and drug abuse are linked to poor treatment response and more rapid progression of HIV. 

Addressing the complexities of co-occurring disorders in which HIV/AIDS and behavioral health 

conditions can be treated effectively requires new approaches that simplify care. 

In 2014, SAMHSA is implementing a program that will explore a pilot of integrated care that

bring HIV and primary care to those receiving treatment in either substance abuse or mental 

health treatment programs. In addition, the program will integrate substance abuse primary 

prevention education and messaging into the broader service spectrum. This 2014 braided 

funding RFA, which utilizes recycle funds in the amount of $24 million, will support behavioral 

health programs that both integrate and co-locate HIV/primary care. In integrating HIV care into 

behavioral health settings, people living with HIV/AIDS and M/SUDs will have greater access to 

treatment for these conditions. Integrated care programs developed as a result of this grant will 

make it possible for behavioral health and HIV care needs to be addressed in one setting. This 

will result in effective, person-centered, treatment that will reduce the risk of HIV transmission, 

improve outcomes for those living with HIV, and ultimately reduce new infections.

Budget Request

SAMHSA expects that data generated from the 2014 pilot will help to inform an expanded 

program proposed for 2015 to continue the co-location and integrated HIV/primary care within 

either substance abuse or community mental health treatment programs. Braided funds in 2015 in 

the amount of $24 million would be dedicated to establishing integrated behavioral health and 

HIV care in addition to primary care needed by those living with or at high risk for HIV infection 

in minority communities heavily impacted by HIV. In addition, because of the significant 

comorbidity of viral hepatitis with HIV infection and because viral hepatitis occurs in up to 20% 

of those with either substance use disorders or serious mental illness, 5% of the allocated funds 

will be used to provide services to prevent, screen, test and refer to treatment as clinically 

appropriate those at risk for or living with viral hepatitis. In integrating HIV care into behavioral 

health settings, people living with HIV/AIDS and M/SUDs will have greater access to treatment 

for these conditions. Integrated care programs developed as a result of this grant program will 

make it possible for behavioral health and HIV care needs to be addressed in one setting. This 

will result in effective, person-centered, treatment that will reduce the risk of HIV transmission, 

improve outcomes for those living with HIV, and ultimately reduce new infections. SAMHSA’s 

Common Data platform (CDP), now under development, will integrate substance abuse and 

mental health elements with HIV and Hepatitis elements to ensure a more rigorous evaluation 

and data analysis to inform future public health intervention decision-making that addresses the 

intersection of behavioral health and HIV.