DEPART MENT 

of HEALTH 

and HUMAN 

SERVICES 

Fiscal Year 

2012 

Substance Abuse and Mental Health 

Services Administration 

Justification of 

Estimates for 

Appropriations Committees 
Page intentionally left blank 
l 

.... s~~~M!:l~f1 A Life in 'he Community for Everyone 

1 Choke Cherry Road· Rockville, MO 20657 

www.samhs8.gov.'-871-SAMHSA-7(1-871-726-4727) 

~~ ~ ........................................................ . 

LETTER FROM ADMINISTRATOR 

I am pleased to present the SAMHSA FY 2012 Performance Budget. SAMHSA's 

FY 2012 budget request reflects a restructuring of SAMHSA's programs to focus resources on 

making progress on HHS' and SAMHSA's strategic initiatives and improving the Nation's 

behavioral health service system. A total of$3.6 billion is requested for FY 2012, representing a 

net increase of $67 million over FY 2010. It restructures SAMHSA's programs to increase 

effectiveness and efficiency and to provide increased focus on prevention of substance abuse and 

mental illness and promotion of emotional health, and to assist Tribes in addressing substance 

abuse and suicide issues within their communities. It also addresses emerging issues such as 

primary/behavioral health care integration, health information technology in the behavioral 

health field, and the special behavioral health prevention and treatment needs of military 

families. In addition, SAMHSA's restructuring invests funding to improve the data systems that 

monitor the performance of SAMHSA programs and to increase public awareness that 

behavioral health is essential to health, prevention works, treatment is effective, and people 

recover. 

The Nation's economic situation has put a strain on public funding at both State and Federal 

levels. For example, almost every State in the Nation has had to reduce its health and social 

services spending and many anticipate further reductions in the near future. Therefore, 

SAMHSA's resources are all the more important for States, Tribes, Territories and communities. 

SAMHSA needs the ability to implement a flexible, thoughtful and deliberate theory of change 

to improve the Nation's behavioral health service system. SAMHSA seeks to identify emerging 

issues, foster innovative solutions to real world problems, demonstrate and disseminate new 

research or promising practices, and use limited, short-term discretionary grant investments to 

move evidence-based practices and policies into the Nation's core behavioral health system 

funded either through Block Grants to States, formula grants to States and Tribes, on-going 

discretionary grants, State and County funding, MedicaidlMedicare, or private insurance. 

Therefore, SAMHSA is requesting a new budget line in FY 2012 for Innovation and Emerging 

Issues which will include new funding to address high priority issues and opportunities emerging 

as a result of new science, new collaborations, or recent new laws such as the Mental Health 

Parity and Addiction Equity Act, the Affordable Care Act and the Health Information 

Technology for Economic and Clinical Health. 

To accomplish these goals, SAMHSA's FY 2012 budget: 1) creates the Substance Abuse - State 

Prevention Grant (SA-SPG), the Mental Health - State Prevention Grant (MH-SPG), and the 

Behavioral Health - Tribal Prevention Grant (BH-TPG); 2) combines the budget lines for the 

three Programs of Regional and National Significance (PRNS) into a single account for 

Innova~ion and Emerging Issues (IEI); 3) consolidates funding for three different data collection 

V· •. ~ - . 

BehaVioral Health IS Essential To Health • Prevention Works • Treatment IS Effective • People Recover 

r; 
an~ the evidence-based practice registry into one Performance and Quality Infonnation 

Systems (PQIS) budget line; 4) consolidates a number of communications contracts funded from 

across SAMHSA and SAMHSA's previous health infonnation network into a new budget line 

for Public Awareness and Support (PAS); and 5) consolidates several other activities currently 

funded from multiple lines within SAMHSA into a single budget line for Regulatory and 

Oversight Functions (ROF). 

The FY 2012 SAMHSA budget represents a bold plan of action to increase effectiveness and 

efficiency, build on new opportunities including preparing for changes in the Nation's healthcare 

system, and better meet the behavioral health needs of the Nation. This budget will help 

SAMHSA support programs providing critical services for those individuals in need of 

behavioral health care that is not covered by public or private insurance. SAMHSA has. spent 

years supporting a robust discretionary portfolio to test and refine proven practices. Now is the 

time to begin bringing those practices to scale in every State and Tribe as SAMHSA continues to 

look for innovative approaches to test in the field and to collaborate with Federal and other 

partners to chart a course for the future. 
 

 

 


 


 

DEPARTMENT OF HEALTH AND HUMAN SERVICES
 

SUBSTANCE ABUSE AND MENTAL HEALTH SERVICES ADMINISTRATION
 

Table of Contents 

Fiscal Year 2012 Budget Page 

Letter from Administrator 

Table of Contents 

Organization Chart 

A. Executive Summary 

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

2. Eight Strategic Initiatives.....................................................................................................3 

3. FY 2012 Budget Overview ..................................................................................................5 

4. FY 2012 Performance Overview .........................................................................................9 

5. Summary of Targets and Results Table .............................................................................11 

6. All Purpose Table ..............................................................................................................13 

B. Budget Exhibits 

1. Appropriations Language...................................................................................................17 

2. Language Analysis.............................................................................................................18 

3. Amounts Available for Obligation.....................................................................................19 

4. Summary of Changes.........................................................................................................20 

5. Budget Authority by Activity ............................................................................................21 

6. Authorizing Legislation .....................................................................................................22 

7. Appropriations History Table ............................................................................................25 

8. Appropriations Not Authorized by Law ............................................................................27 

C. SAMHSA Block Grants 

1. Mental Health Block Grant................................................................................................35 

2. Substance Abuse Block Grant ..........................................................................................45 

D. State, Tribal, and Community Prevention Grants 

1. Substance Abuse - State Prevention Grants.......................................................................59 

2. Behavioral Health - Tribal Prevention Grants ...................................................................63 

3. Mental Health - State Prevention Grants ...........................................................................67 

E. Innovation & Emerging Issues 

1. Agency-wide Initiatives.....................................................................................................75 

2. Center for Mental Health Services.....................................................................................81 

3. Center for Substance Abuse Prevention ..........................................................................107 

4. Center for Substance Abuse Treatment ...........................................................................123 

F. Children’s Mental Health Services.....................................................................................149 

G. PATH Homeless Grants ......................................................................................................153 
 

 


 


 


 

H. Regulatory & Oversight Functions 

1. Opioid Drug Treatment Regulatory Activities ................................................................161 

2. Mandatory Drug Testing .................................................................................................162 

3. Prescription Drug Monitoring ..........................................................................................166 

4. Seclusion and Restrain.....................................................................................................166 

5. Protection and Advocacy .................................................................................................167
 

I. Public Awareness and Support...........................................................................................171 

J. Performance & Quality Information Systems ..................................................................175
 

K. Center for Behavioral Health Statistics and Quality........................................................177
 

L. Health Surveillance and Program Support & St. Elizabeths Hospital...........................179 

M. Drug Control Budget ...........................................................................................................185 

N. Supplementary Tables 

1. Budget Authority by Object Class ...................................................................................207 

2. Salaries and Expenses......................................................................................................208 

3. Detail of Full-Time Equivalent Employment (FTE) .......................................................209 

4. Detail of Positions............................................................................................................210 

5. Programs Proposed for Elimination.................................................................................211 

6. SAMHSA FY 2012 Budget Structure Crosswalk............................................................215 

O. Prevention and Public Health Fund...................................................................................235 

Page intentionally left blank 
 

 

 

 

 

 

SAMHSA Overview 

The Substance Abuse and Mental Health Services Administration (SAMHSA), part of the U.S. 

Department of Health and Human Services, is the principal Federal Agency charged with 

increasing access to substance abuse and mental health services. SAMHSA was established in 

1992 and reauthorized in 2000. SAMHSA provides leadership on behavioral health issues 

nationwide; administers a combination of competitive, formula, and block grant programs and 

data collection activities; promotes practice improvements and provides information about 

behavioral health and available services to the public and to behavioral health providers and 

practitioners. Programs are carried out through the Center for Mental Health Services (CMHS); 

the Center for Substance Abuse Prevention (CSAP); the Center for Substance Abuse Treatment 

(CSAT); and the Center for Behavioral Health Statistics and Quality (CBHSQ). Finally, the 

Office of Policy, Planning and Innovation (OPPI) is guiding SAMHSA’s innovation and 

emerging issues agenda. 

Behavioral health plays a crucial role in the health and well-being of individuals and their 

communities. SAMHSA is committed to making sure that those who need these services get 

them through its programs as well as through the health care delivery system and other social, 

economic and support systems that are run and financed by the Federal, State, and local 

governments and the private sector. SAMHSA’s resources enable service capacity expansion 

and the implementation of evidence-based practices. SAMHSA seeks to engage and prepare 

communities to provide effective services by facilitating access to the latest information on 

prevention, evidence-based practices and accountability standards. 

Vision 

SAMHSA gears all of its resources—programs, policies, information and data, contracts and 

grants—toward helping the Nation realize SAMHSA’s vision: 

• Behavioral Health is essential for health 

• Prevention works 

• Treatment is effective 

• People recover from mental and substance use disorders 

SAMHSA leads the Nation in building resilience and facilitating recovery for people with or at 

risk for mental or substance use disorders and supporting the communities where they live. 

Mission 

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

communities and accomplishes this mission by building resilience and facilitating recovery for 

people with or at risk for mental or substance use disorders and supporting the communities 

where they live. By providing leadership, voice, funding, and standards, SAMHSA provides the 

expertise and collaboration necessary to make the most meaningful impact toward achieving this 

vision. SAMHSA-funded services help individuals achieve or maintain a stable home, a purpose 

in life, a community, and a healthy lifestyle including being free of abuse of substances or 

alcohol and free of disabling mental disorders or symptoms. Maintaining funding streams will 

ensure adequate service capacity for States, Tribes, local governments, and communities while 

helping to improve practices. Increasing understanding of mental and substance use disorder 

prevention and treatment services will achieve the full potential of prevention and help people 

recognize and seek assistance for these health conditions with the same urgency as any other 

health condition. 

1 
Page intentionally left blank 
 

 

 

4 Health Reform Implementation 

 

Eight Strategic Initiatives 

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

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

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

recovery support services, SAMHSA with its partners can advance and protect the Nation’s 

health. In order to achieve this goal, SAMHSA has identified eight Strategic Initiatives to focus 

SAMHSA’s work on improving lives and capitalizing on emerging opportunities. The eight 

Initiatives are described below. 

1 Prevention of Substance Abuse and Mental Illness 

(Fran Harding, Director, Center for Substance Abuse Prevention) 

Creating communities where individuals, families, schools, faith-based organizations, and 

workplaces take action to promote emotional health and reduce the likelihood of mental 

illness, substance abuse including tobacco, and suicide. This initiative will focus 

especially on the Nation’s high risk youth, youth in Tribal communities, and among 

military families. 

2 Trauma and Justice 

(Larke Huang, Director, Office of Behavioral Health Equity) 

Reducing the pervasive, harmful, and costly health impact of violence and trauma by 

integrating trauma-informed approaches throughout health, behavioral health, and related 

systems; and addressing the behavioral health needs of people involved or at risk of 

involvement in the criminal and juvenile justice systems. 

3 Military Families 

(Kathryn Power, Director, Center for Mental Health Services) 

Supporting America’s service men and women – Active Duty, National Guard, Reserve, 

Coast Guard, and Veterans – together with their families and communities by leading 

efforts to ensure needed behavioral health services are accessible and outcomes are 

positive. 

(John O’Brien, Senior Advisor for Health Finance) 

Broadening health coverage to increase access to appropriate high quality care and to 

reduce disparities that currently exist between the availability of services for substance 

abuse, mental disorders, and other medical conditions. 

3 
 

 

 

 

5 Recovery Support 

(Kathryn Power, Director, Center for Mental Health Services) 

Partnering with people in recovery from mental and substance use disorders to guide the 

behavioral health system and promote individual-, program-, and system-level 

approaches that foster health and resilience; increase permanent housing, employment, 

education, and other necessary supports; and reduce barriers to social inclusion. 

6 Health Information Technology 

(Westley Clark, Director, Center for Substance Abuse Treatment) 

Ensuring the behavioral health system, including States, community providers, and peer 

and prevention specialists, fully participates with the general healthcare delivery system 

in the adoption of Health Information Technology (HIT) and interoperable Electronic 

Health Records (EHR). 

7 Data, Outcomes, and Quality 

(Pete Delany, Director, Center for Behavioral Health Statistics and Quality) 

Realizing an integrated data strategy that informs policy and measures program impact, 

leading to improved quality of services and outcomes for individuals, families, and 

communities. 

8 Public Education and Support 

(Mark Weber, Director, Office of Communications) 

Increasing understanding of mental and substance use disorders to: achieve the full 

potential of prevention; help people recognize mental and substance use disorders and 

seek assistance with the same urgency as any other health condition; and make recovery 

the expectation. 

4 
 

Overview of the Budget Request 

SAMHSA’s FY 2012 Budget advances the President’s initiative under health care reform and is 

oriented towards transitioning to a new future of physical and behavioral health care in this 

country. This future creates both opportunities and imperatives for SAMHSA and other federal 

partners that have historically focused primarily on the provision of health care services for 

individuals with or at risk of substance use and mental disorders, especially those who cannot 

afford access to quality care. SAMHSA’s mission is to reduce the impact of substance abuse and 

mental illness on America’s communities. SAMHSA-funded services help persons achieve a 

stable home, a purpose in life, a community, and a healthy lifestyle including being free of abuse 

of substances or alcohol and being free of mental disorders and related problems or uncontrolled 

symptoms. Additionally, as a leader and voice for behavioral health issues and as a practice 

improvement agent, SAMHSA also has regulatory, surveillance, and public education 

responsibilities. SAMHSA works with its partners within HHS and throughout the Federal 

government, many of whom also provide funding, information or leadership in aspects of the 

prevention and treatment of or recovery from mental and substance use disorders. SAMHSA also 

focuses on several key opportunities and challenges rather than spread its limited funding and 

attention broadly across issues that other partners also address. 

The costs of untreated and under-treated substance use and mental illness are staggering. The 

latest estimate for the societal cost of substance abuse in the United States is more than $510 

billion1 annually. The National Institute of Mental Health estimates the annual total direct and 

indirect costs of Serious Mental Illness in 2002 to be over $310 billion. Additionally, the 

Nation’s economic situation has put a strain on public funding at both State and Federal levels. 

Almost every State in the Nation has had to reduce its health and social services spending in the 

last couple of years. For FY 2010, SAMHSA granted waivers to 19 States and 3 territories that 

did not meet the Maintenance of Effort (MOE) requirement for the MHBG, the SABG, or both. 

During that period, the net loss of funding for behavioral health was in excess of $500 million. In 

FY 2011, SAMHSA expects to grant waivers to 28 States, the District of Columbia, and one 

territory for the MHBG, the SABG, or both. In addition, Federal support for the Mental Health 

Block grant is less than in FY 2002 and support for the Substance Abuse Block Grant has not 

grown by any significant amount over the same period. 

The FY 2012 President’s Budget request prioritizes funding for new programs to address 

SAMHSA’s top three strategic initiatives: (1) prevention of substance abuse and mental illness; 

(2) trauma and justice; and (3) military families. SAMHSA is committed to measuring what 

matters to people currently and what makes a difference in their lives. Overall, the Budget 

request restructures SAMHSA’s programs in preparation for changes in health financing and 

reinvests funding to improve the data systems that monitor the performance of SAMHSA 

programs and to increase public awareness that behavioral health is essential for health, 

prevention works, treatment is effective, and people recover. SAMHSA is undertaking a 

reconfiguration of Government Performance and Results Act (GPRA) measures to focus on 

services delivered or people served as the output measure, with specific measures for each 

individual program area. It focuses on recovery-oriented outcomes. 

1 Miller, T. and Hendrie, D. Substance Abuse Prevention Dollars and Cents: A Cost Benefit Analysis. DHHS Pub. No. (SMA) 

07-4298. Rockville, MD: Center for Substance Abuse Prevention, Substance Abuse and Mental Health Services Administration, 

2009. 

5 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

In addition to the creation of the State, Tribal, and Community Prevention Grants, which 

includes the Substance Abuse – State Prevention Grants (SA-SPG), the Behavioral Health – 

Tribal Prevention Grants (BH-TPG), and the Mental Health – State Prevention Grants (MHSPG), the budget also combines the budget lines for the three Programs of Regional and National 

Significance (PRNS) into a single account for Innovation and Emerging Issues (IEI). A new 

budget line is created for Performance and Quality Information Systems (PQIS), which 

consolidates funding for three different data collection systems (SAIS, TRAC and PMRT) and 

the National Registry of Evidence-based Programs and Practices (NREPP). The Public 

Awareness and Support (PAS) budget line is also created, which consolidates funding for a 

number of communications contracts funded across all three Centers and the SAMHSA Health 

Information Network (SHIN). Several other activities funded within the Centers have been 

consolidated into a single budget line for Regulatory and Oversight Functions (ROF). 

SAMHSA’s FY 2012 Budget is $3.387 billion in budget authority, a decrease of 

$44 million from the FY 2010 Level. SAMHSA’s request prioritizes the reallocation of funding 

to create the new State, Tribal, and Community Prevention Grants, as well as the Performance 

and Quality Information Systems, and the Public Awareness and Support budget lines. It also 

includes funding for two SAMHSA-wide initiatives totaling $14 million for Military Families 

($10 million) and Health Information Technology ($4 million). The SAMHSA request includes 

$395 million to support the Substance Abuse State Prevention Grants; $50 million to support the 

Behavioral Health Tribal Prevention Grants (allocated from ACA Prevention Funds); $90 

million to support the Mental Health State Prevention Grants; $12.9 million to support the 

Performance and Quality Information Systems; and $13.6 million to support Public Awareness 

and Support. In addition, the Mental Health Block Grant is increased by $14 million, or three 

percent, the largest increase since 2005. The Substance Abuse Block Grant for Treatment is 

increased by $40 million, or three percent, to support the States’ behavioral health infrastructure 

as the States prepare to implement health reform and structure a good and modern system of 

care. Additionally, key programs that have been shown to be effective are maintained at their FY 

2010 levels, including Safe Schools/Healthy Students, Garrett Lee Smith Suicide Prevention 

activities, Minority AIDS, Minority Fellowship Programs, STOP Under-Age Drinking Act, 

SBIRT, Pregnant and Post Partum Women program, Access to Recovery, and Criminal Justice 

Activities. In support of the Administration’s Homelessness Prevention initiative, SAMHSA 

requests $154 million, an increase of $12 million, for housing support services for individuals 

with mental illness and substance abuse who are or at risk of being homeless. 

In 2014, many individuals previously ineligible for Medicaid or unable to obtain commercial 

insurance for or because of mental and substance use disorders will be covered by Medicaid, 

commercial insurance through employers or on the private market through health insurance 

exchanges. This will necessitate recasting the SABG and the MHBG in terms of who they serve 

and what services they fund. Generally, these Block Grants need to provide funding for those 

individuals and those services not otherwise funded by other sources such as Medicaid and 

commercial insurance. The Block Grants will need to be redesigned to operate as a 

“coordination of benefits” or wrap around services for those priority individuals who are 

receiving core behavioral health services elsewhere. Block Grants will also need to fund priority 

services for those priority individuals who remain uninsured and whose untreated behavioral 

health needs will be a burden on the individual, his/her family and his/her community. 

6 
 

 

 

 

 

 

 

 

 

 

SAMHSA will begin to request different information in State/Territory BG applications 

regarding specific service approaches and planning activities, capacities and needs for 

implementing the Affordable Care Act, and proposed responses to priorities outlined by 

SAMHSA. This request for different information will introduce a message to States that 

SAMHSA is preparing for a major paradigm shift in the healthcare system, and will signal the 

direction of future changes. In addition, this State information will tell SAMHSA what kind of 

technical assistance and resources States may need as they improve their service delivery 

systems in the midst of fiscal austerity at the State and Federal levels. For some information, 

SAMHSA plans to encourage a single submission from each State, necessitating coordination 

across Mental Health and Substance Abuse Authorities and other State departments including 

State Medicaid and public health authorities. In preparation for the next round of full BG 

applications, SAMHSA is making necessary adjustments to internal operations to facilitate 

consistent timing and content of the SABG and the MHBG applications for 2012. To make these 

transitions, SAMHSA needs to utilize its current authority more fully and be authorized more 

fully to provide direction and technical assistance to States as the BG priorities change and as 

serving individuals through multiple funding sources complicates coordination of care. 

SAMHSA also needs to direct reporting requirements so that successes or failures or areas 

needing improvement are clearer more quickly so that limited resources are utilized in the 

context of the much larger and more complex health care delivery and financing systems in each 

State, and Nationwide. 

The first comprehensive National HIV/AIDS Strategy (NHAS) was released in July 2010. 

SAMHSA was involved in a Federal interagency working group and worked with the Office of 

National AIDS Policy to develop the NHAS. The Strategy focuses on three overarching goals: 

reducing the number of new HIV infections, increasing access to care for people living with 

HIV, and reducing HIV-related health disparities. SAMHSA is committed to supporting the 

NHAS through the promotion of evidence-based prevention interventions and behavioral health 

services and treatment for people at risk for or living with HIV/AIDS who have co-occurring 

mental and/or substance use disorders. SAMHSA is working with Federal partners to ensure that 

behavioral health services are an integral part of a comprehensive approach to HIV/AIDS 

prevention, care and treatment. 

Finally, SAMHSA is undergoing a major policy review of all grants and contracts for FY 2011, 

resulting in revisions to its regular contract planning process. The review, which includes those 

grants and contracts financed by the block grant set-asides, will determine where efficiencies and 

consolidations may be warranted. The goal of the policy review is to have policy-driven grants 

and contracts planning and to bring these activities in closer alignment with the mission and 

vision for SAMHSA. 

7 
Page intentionally left blank 
 

 

 

 

 

Support for the HHS Strategic Plan and Other Federal Priorities 

 

 

	 

	 

	 

	 

Overview of Performance 

FY 2012 Performance Overview 

SAMHSA’s performance measures include outcomes and outputs which allow SAMHSA to 

effectively manage grants, contracts and data collection activities, and to report performance 

results to the President, Congress, and other stakeholders. 

The FY 2012 Budget includes substantial revisions to SAMHSA’s performance measures 

reported in the Annual GPRA Plan and Annual GPRA Report. The resulting set of measures 

seeks to capture the following key items for each program: the number of services delivered or 

people served, a specific measure or two for each individual program area, and a measure that 

captures client recovery. Further, SAMHSA spent a good deal of time reviewing existing 

measures to ensure that they were meaningful and met the needs of both program management 

and policy-makers. This effort resulted in a reduction of measures from almost 200 (as published 

in the 2011 President’s Budget) to around 100 measures in the FY 2012 President’s Budget. 

Although this reduction changes the display of measures in the Annual GPRA Report/Plan, the 

majority of the measures that have been removed (including NOMS) will continue to be 

collected and used for program management purposes. 

Work on SAMHSA’s GPRA measures and other data collection activities are ongoing. 

SAMHSA is working with internal and external stakeholders on developing appropriate 

measures of recovery for those with mental or substance use disorders. As these efforts become 

more defined, the GPRA measures reported in the budget as well as those used for program 

management may be altered to bring them in line with other cross-cutting efforts. 

SAMHSA data efforts, including GPRA, support many of the priorities of the Secretary and the 

President. SAMHSA has ongoing activities that relate to each of the Secretarial priorities: 

•	 Transforming Health Care - Through its National Survey on Drug Use and Health, 

SAMHSA is monitoring the percentage of persons with a mental health or substance use 

disorder service needs and who have health insurance. 

•	 Advance Scientific Knowledge and Innovation – SAMHSA has established a new Office 

of Policy, Planning and Innovation to lead cutting edge efforts across SAMHSA and 

across government. 

•	 Advance the Health, Safety, and Well-Being of the American People - SAMHSA is 

monitoring trends in mental health and substance abuse disorders. One example is the 

percentage of youth age 12-20 who report drinking in the past month and taking steps to 

reduce that percentage to 23.8 percent by 2015 from 27.2 percent in 2009. 

•	 Increase Efficiency, Transparency, and Accountability of HHS programs – SAMHSA is 

working directly with the HHS Chief Technology Officer to make more SAMHSA data 

publicly available. 

9 
 

 

 

	 

	 

	 

	 

	 

	 

•	 Strengthen the Nation’s Health and Human Services Infrastructure and Workforce – 

SAMHSA is working with HRSA to examine ongoing technical assistance and training 

activities and incentives to see if there are more effective and efficient ways of 

expanding, supporting and reaching the behavioral health workforce. 

•	 SAMHSA is also preparing for implementation of the GPRA Modernization Act of 2010 

which endorses improved accountability through quarterly performance data reporting, 

priority setting and regular senior leadership meetings. SAMHSA is awaiting guidance 

from OMB and HHS on how this law will be operationalized and has already begun 

thinking about how to take these new mandates and utilize them internally to improve 

transparency, accountability and leadership involvement. 

SAMHSA is also preparing for implementation of the GPRA Modernization Act of 2010 which 

endorses improved accountability through quarterly performance data reporting, priority setting 

and regular senior leadership meetings. 

Significant Accomplishments 

Over the last several years, SAMHSA has maintained between 58-70 percent target achievement 

among its GPRA measures published in the budget. The most significant challenge to success 

was among the FY 2009 and 2010 data. Considering that many of these measures are outcomes 

(e.g., substance use, housing, and employment) which have been greatly impacted by the 

economic downturn, SAMHSA has been remarkably successful. 

SAMHSA’s Strategic Initiatives and a New Vision for Data, Outcomes, and Quality 

SAMHSA spent much of CY 2010 developing and refining a Strategic Plan focusing on eight 

priorities, which will take SAMHSA and its programs into the future. (See earlier section 

describing the eight initiatives.) The intent of the Data, Outcomes, and Quality initiative is to 

realize an integrated data strategy that informs policy, measures program impact, and results in 

improved quality of services and outcomes for individuals, families, and communities. 

SAMHSA is: 

•	 Implementing an integrated approach for SAMHSA’s collection, analysis, and use of 

data; 

•	 Creating common standards for measurement and data collection to better meet 

stakeholder needs; 

•	 Improving the quality of SAMHSA’s program evaluations and services research; and 

•	 Improving quality and accessibility of surveillance, outcome/performance, and evaluation 

information for staff, stakeholders, funders, and policymakers. 

This revised approach to data, outcomes, and quality is clearly a work in progress and will 

require continued discussions into CY 2011 and beyond as SAMHSA’s work on this initiative 

unfolds and as SAMHSA engages in discussions with other HHS agencies and stakeholder 

groups interested in quality and outcome measurement. 

10 
 

 

 

 

 

 

 

 

 

 

 

Summary of Performance Targets and Results 

The FY 2012 Budget includes substantial revisions to SAMHSA’s performance measures 

reported in the Annual GPRA Plan and Annual GPRA Report. The resulting set of measures 

seeks to capture the following key items for each program: the number of services delivered or 

people served, a specific measure or two for each individual program area, and a measure that 

captures client recovery. Further, SAMHSA spent a good deal of time reviewing existing 

measures to ensure that they were meaningful and met the needs of both program management 

and policy-makers. This effort resulted in a reduction of measures from almost 200 (as published 

in the 2011 President’s Budget) to around 100 measures in the FY 2012 President’s Budget. 

Although this reduction changes the display of measures in the Annual GPRA Report/Plan, the 

majority of the measures that have been removed (including NOMS) will continue to be 

collected and used for program management purposes. 

Work on SAMHSA’s GPRA measures and other data collection activities are ongoing. 

SAMHSA is working with internal and external stakeholders on developing appropriate 

measures of recovery for those with mental or substance use disorders. As these efforts become 

more defined, the GPRA measures reported in the budget as well as those used for program 

management may be altered to bring them in line with other cross-cutting efforts. 

Table 1: Summary of Performance Targets and Results2 

Fiscal 

Year 

Total 

Targets 

Targets with 

Results Reported 

Percent of Targets 

with Results 

Reported 

Total 

Targets 

Met 

Percent of 

Targets Met 

2007 144 142 99% 99 70% 

2008 162 160 99% 110 69% 

2009 184 180 98% 106 59% 

2010 179 82 46% 50 61% 

2011 93 0 N/A 0 N/A 

2012 106 0 N/A 0 N/A 

2013 833 0 N/A 0 N/A 

2 Table completed using HHS Program Performance Tracking System, 1/19/2011 

3 Total does not include targets for measures that have yet to be established. In most circumstances this includes new 

programs where baseline data has not yet been collected. 

11 
SAMHSA Linkages to HHS Strategic Plan 

SAMHSA spent much of CY 2010 developing and refining a Strategic Plan focusing on eight 

priorities, to guide our programmatic, policy, and management decisions and take SAMHSA 

and its programs into the future. The eight priorities are: (1) Prevention of Substance Abuse and 

Mental Illness; (2) Trauma and Justice; (3) Military Families; (4) Health Reform; 

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

(8) Public Awareness and Support. SAMHSA programmatic activities are guided by these eight 

priorities and the HHS Strategic Plan. SAMHSA activities support at least one HHS strategic 

objective; many support more than one. 

Many of SAMHSA’s activities are focused on the first of its eight priorities: the Prevention of 

Substance Abuse and Mental Illness. Prevention ties closely to the HHS Strategic Plan Objective 

3.D, Promote Prevention and Wellness as well as several other objectives including 1.E, 3.A, 

3.B, 3.C. The SAPT and CMHS Block Grants and the majority of the CSAP Innovation and 

Emerging Issues, including Prevention Prepared Communities focus on these objectives. 

SAMHSA’s programs (Safe Schools/Healthy Students, National Traumatic Stress network, 

Project LAUNCH now included in the Mental Health State Prevention Grant, and our Children 

and Families Programs) focus on Objective 3.A Ensuring the safety, well-being and healthy 

development of children and youth and are simultaneously being guided by SAMHSA’s Trauma 

and Violence and Prevention initiatives. 

SAMHSA recognizes the challenge of serving homeless individuals and understands the 

incredible need among this population for substance abuse and mental health services. As such, 

SAMHSA’s Recovery Support initiative and the ongoing Homelessness programs (including 

Services in Supportive Housing, Grants for the Benefit of Homeless Individuals, an ongoing 

collaboration with HUD, and the PATH formula grant) support Objectives 1.E, 3.B, and 3.C. 

SAMHSA further recognizes the changing face of health care service provision and increasing 

need to modify established programs to meet Health Reform and the development of Health 

Information Technology. As such, SAMHSA has established initiatives around both of these 

areas. Programs linked to the Health Reform Initiative are the CMHS and SAPT Block Grants. 

Programs impacted by Health IT include an ongoing demonstration project as well as the Block 

Grants. 

Lastly, SAMHSA is working to both improve the outcomes of our clients through increasing 

quality of care and more effectively get our prevention message out through refined Public 

awareness efforts. The ongoing activities around these two initiatives include health surveillance, 

other data collection efforts, information dissemination, and expanding the use of evidence-based 

practices through our technical assistance and training. These programs are closely linked with 

the HHS objective 2.D, 3.D, 4.C, 5.C. 

As the nation moves toward mental health parity and health reform, SAMHSA will continue to 

examine its eight strategic initiatives to assure that they are consistent with national needs and 

priorities. 

12 

 


 

Discretionary All-Purpose Table
 

FY 2012 Budget Submission
 

(Dollars in Thousands) 

Program Activities 

FY 2010 

Actual 

FY 2011 

Continuing 

Resolution 

FY 2012 

President's 

Budget 

Mental Health Block Grant............................................................................... $399,735 $399,735 $413,645 

PHS Evaluation Funds.......................................................................................... 21,039 21,039 21,039 

Subtotal, Mental Health Block Grant............................................................... 420,774 420,774 434,684 

Substance Abuse Block Grant........................................................................... 1,375,513 1,375,513 1,419,603 

PHS Evaluation Funds.......................................................................................... 79,200 79,200 74,711 

Subtotal, Substance Abuse Block Grant........................................................... 1,454,713 1,454,713 1,494,314 

State, Tribal and Community Prevention Grants........................................... 480,576 480,655 485,000 

Substance Abuse - State Prevention Grant (non-add)..................................... --­ --­ 395,000

Behavioral Health - Tribal Prevention Grant (non-add) 1/............................ --­ --­ --­

Mental Health - State Prevention Grant (non-add)......................................... 24,993 25,000 90,000 

Innovation and Emerging Issues....................................................................... 809,714 809,211 745,188 

Agency-Wide Initiatives (non-add)................................................................... --­ --­ 14,000 

CMHS (non-add)............................................................................................... 327,842 327,689 270,893 

CSAP (non-add)................................................................................................ 75,438 75,527 69,376 

CSAT (non-add)................................................................................................ 406,434 405,995 390,919 

PHS Evaluation Funds.......................................................................................... 2,000 2,000 2,000 

Subtotal, Innovation and Emerging Issues....................................................... 811,714 811,211 747,188 

Children's Mental Health Services................................................................... 121,316 121,316 121,316 

PATH Homeless Formula Grant....................................................................... 65,047 65,047 65,047 

Regulatory & Oversight Functions................................................................... 55,052 54,938 54,938

Public Awareness and Support.......................................................................... 14,006 14,230 --­

PHS Evaluation Funds.......................................................................................... --­ --­ 13,571 

Subtotal, Public Awareness and Support......................................................... 14,006 14,230 13,571

Performance and Quality Information Systems.............................................. 30,165 30,987 --­

PHS Evaluation Funds.......................................................................................... 6,596 6,596 12,996 

Subtotal, Performance and Quality Information Systems............................. 36,761 37,583 12,996 

Health Surveillance and Program Support...................................................... 79,197 79,197 82,166 

PHS Evaluation Funds.......................................................................................... 22,750 22,750 45,428 

Subtotal, Health Surveillance and Program Support..................................... 101,947 101,947 127,594

St. Elizabeths Hospital B&F.............................................................................. 795 795 --­

ACA Prevention Fund 

Primary and Behavioral Health Care Integration................................................. 20,000 35,000 20,000

Garrett Lee Smith Youth Suicide Prevention....................................................... --­ 10,000 --­

Prevention Prepared Communities....................................................................... --­ --­ 22,600

Health Surveillance............................................................................................... --­ 18,000 --­

Screening, Brief Intervention, & Referral to Treatment....................................... --­ 25,000 --­

Behavioral Health - Tribal Prevention Grants...................................................... --­ --­ 50,000 

Subtotal, ACA Prevention Fund 20,000 88,000 92,600 

TOTAL, SAMHSA Discretionary PL............................................................... 3,582,701 3,651,209 3,649,248 

Less PHS Evaluation Funds................................................................................. 131,585 131,585 169,745 

Less ACA Prevention Funds................................................................................ 20,000 88,000 92,600 

TOTAL, SAMHSA Budget Authority.............................................................. $3,431,116 $3,431,624 $3,386,903 

FTEs 537 537 544 

1/ Behavioral Health - Tribal Prevention Grant includes $50 million from the ACA Prevention Funds 

13 
 

 

 


 


 

Summary of Changes
 

SAMHSA
 

(Dollars in Thousands) 

FY 2010 

Actual 

FY 2011 

Continuing 

Resolution 

FY 2012 

President's 

Budget 

FY 2012 +/­

FY 2010 

Mental Health Block Grant............................................ $420,774 $420,774 $434,684 +$13,910 

Substance Abuse Block Grant........................................ 1,454,713 1,454,713 1,494,314 +39,601 

State, Tribal and Community Prevention Grants........ 480,576 480,655 485,000 +4,424 

Innovation and Emerging Issues.................................... 811,714 811,211 747,188 -64,526 

Regulatory & Oversight Functions................................ 55,052 54,938 54,938 -114 

Public Awareness and Support...................................... 14,006 14,230 13,571 -435 

Performance and Quality Information Systems.......... 36,761 37,583 12,996 -23,765 

Health Surveillance and Program Support.................. 101,947 101,947 127,594 +25,647 

St. Elizabeths Hospital B&F........................................... 795 795 --­ -795 

Summary of the Budget Request: 

The SAMHSA President’s Budget request is $3.387 billion in budget authority, a $44.2 million 

decrease from the FY 2010 Enacted Budget. Major strategic realignments include: $395 million 

for the Substance Abuse - State Prevention Grant; $90 million for the Mental Health - State 

Prevention Grant; the Behavioral Health - Tribal Prevention Grant ($50 million allocated from 

ACA Prevention Funds); and $747.2 million from the three Programs of Regional and National 

Significance budget lines to create the new Innovations and Emerging Issues budget line. Also, 

$13 million is requested for Performance and Quality Information Systems (PHS Evaluation 

Funds); and $13.6 million for Public Awareness and Support (PHS Evaluation Funds). Within 

the Innovation and Emerging Issues budget line, there are new SAMHSA-Wide initiatives 

totaling $14 million for Military Families ($10 million) and Health Information Technology ($4 

million). 

14 

 


 


 


 


 


 

Program Increases: 

Mental Health Block Grant: (+$13.910 million)
 

The budget increase provides $13.910 million to the Mental Health Block Grant to maintain
 

State services.
 

Substance Abuse Block Grant: (+$39.601 million)
 

The budget increase provides $39.601 million to the Substance Abuse Block Grant to maintain
 

State services.
 

State, Tribal and Community Prevention Grants: (+$4.424 million)
 

The budget increase provides $4.424 million for the State, Tribal and Community Prevention 

Grants over the comparable FY 2010 Level. The increase will support a new Substance Abuse – 

State Prevention Grant and a new Mental Health – State Prevention Grant. Additionally, the
 

Behavioral Health – Tribal Prevention Grant ($50 million) will be supported by the ACA
 

Prevention Fund. 

Health Surveillance and Program Support: (+$25.647 million) 

The budget increase provides $25.647 million for Center for Behavioral Health Statistics and 

Quality data collection activities and other technical assistance, evaluation and data collection 

activities. The funding will support the national data systems and surveillance activities, 

including the Drug Abuse Warning Network (DAWN), National Survey on Drug Use and Health 

(NSDUH), and Drug Abuse Services Information System (DASIS), and $1 million will support 

the development of the Community Early Warning and Monitoring System (C-EMS) to develop 

a community-level, early warning system to detect the emergence of new drug threats and to 

assist in the identification of public health and safety consequences of drug abuse. The funding 

will also support analytic and evaluation activities responsive to SAMHSA and HHS priorities. 

15 
 

 


 


 


 


 


 


 

Program Decreases: 

Innovation and Emerging Issues: (-$64.526 million) 

The net budget decrease reflects savings from grant programs coming to a natural end. The 

budget includes funding for all ongoing grants Youth Violence Prevention, National Traumatic 

Stress Network, Primary and Behavioral Health Care Integration, Garrett Lee Smith Suicide 

Prevention Programs, Suicide Lifeline, Minority Fellowship, Minority AIDS, STOP Under-Age 

Drinking Act, Fetal Alcohol Center of Excellence, the Center for the Application of Prevention 

Technologies, Screening, Brief Intervention and Referral to Treatment, Pregnant & Postpartum 

Women, Targeted Capacity Expansion, Recovery Community Services Program, Access to 

Recovery, and Problem-Solving Courts. In addition, new funds are available for Homelessness 

Prevention Programs, Behavioral Health Information Technology, and a Military Families 

Initiative. 

Regulatory and Oversight Functions: (-$0.114 million) 
 

The net budget decrease reflects projected contract savings in Opioid Treatment/Regulatory
 

Activities and Seclusion & Restraint.
 

Public Awareness and Support: (-$0.435 million) 
 

By consolidating multiple programs and contracts that conduct public awareness and technical
 

assistance activities, SAMHSA is able to realize efficiencies.
 

Performance and Quality Information Systems: (-$23.765 million)
 

By consolidating multiple programs and contracts that collect performance data, streamlining
 

operations, and realigning NREPP, SAMHSA is able to realize efficiencies.
 

St. Elizabeths Hospital Building and Facilities: (-$0.795 million)
 

The General Services Administration has indicated that additional funding will not be needed 

from SAMHSA in FY 2012 for environmental remediation at the former St. Elizabeths hospital 

site. 

16 
17 

Appropriation Language

SUBSTANCE ABUSE AND MENTAL HEALTH SERVICES

ADMINISTRATION

For carrying out titles III, V, and XIX of the Public Health Service Act (‘‘PHS Act’’) with respect 

to substance abuse and mental health services and the Protection and Advocacy for Individuals 

with Mental Illness Act, $3,386,903,000 Provided, That notwithstanding section 520A(f)(2) of the 

PHS Act, no funds appropriated for carrying out section 520A are available for carrying out 

section 1971 of the PHS Act: Provided further, That in addition to amounts provided herein, the 

following amounts shall be available under section 241 of the PHS Act: (1) $74,711,000 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; (2) $21,039,000 to carry out subpart I of part B of title XIX of 

the PHS Act to fund section 1920(b) technical assistance, national data, data collection and 

evaluation activities, and further that the total available under this Act for section 1920(b) 

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

XIX; (3) $45,428,000 to carry out national surveys on drug abuse and mental health; (4) 

$28,567,000 to collect and analyze data , conduct public awareness and technical assistance 

activities, and evaluate substance abuse treatment programs, and (5) $1,000,000 to collect and 

analyze data and evaluate mental health programs: Provided further, That section 520E(b)(2) of 

the PHS Act shall not apply to funds appropriated under this Act for fiscal year 2012: Provided 

further, That section 1922(a)(1) of the PHS Act shall not apply to amounts provided herein. 
18 

Language Analysis 

Language Provision Explanation 

Provided, That notwithstanding section 520A(f)(2) 

of the PHS Act, no funds appropriated for carrying 

out section 520A are available for carrying out 

section 1971 of the PHS Act: Provided further) 

No funds from the CMHS PRNS can be used to 

fund data infrastructure support. 

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

PHS Act shall not apply to funds appropriated

under this Act for fiscal year 2012. 

Allows States to receive more than one grant under 

the Garrett Lee Smith Youth Suicide Statesponsored statewide program.

conduct public awareness and technical 

assistance activities

Provides PHS evaluation funds to finance public 

awareness and support which constitutes technical 

assistance in the new SAMHSA budget structure.

Provided further, That section 1922(a)(1) of the 

PHS Act shall not apply to amounts provided 

herein. 

Waives the 20% of the Substance Abuse 

Prevention and Treatment Block Grant minimum 

expenditure requirement for prevention services; 

prevention activities will be funded under the new 

Substance Abuse State Prevention Grants under the 

new SAMHSA budget structure 
19 

Amounts Available for Obligation

FY 2010 

Appropriation

FY 2012 

President's Budget

Appropriation:

FY 2011 CR

Labor/HHS/Ed-Annual Appropriation..................... $3,431,624,000 3,431,624,000 3,386,903,000

Subtotal, adjusted appropriation.............................. 3,431,116,000 3,431,624,000 3,386,903,000

Subtotal, adjusted budget authority.......................... 3,431,116,000 3,431,624,000 3,386,903,000

Offsetting Collections from:

 Federal Sources..................................................... 131,585,000 131,585,000 169,745,000

 ARRA................................................................... 0 0 0

Unobligated balance start of year............................. 239,346 311,781 311,827

Unobligated balance end of year.............................. -311,781 -311,827 -307,763

Unobligated balance expiring..................................

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

 0 0 0

$3,562,628,565 $3,563,208,954 $3,556,652,064
20 

Summary of Changes 

(Dollars in Thousands)

2010

Total estimated budget authority $ 3,431,116,000 

(Obligation) 3,431,116,000

2012

Total estimated budget authority 3,386,903,000

(Obligation) 3,386,903,000

Net Change -$44,213,000

Increases:

FY 2010 Enacted Change from base

 A. Built-in:

FTE Budget Authority FTE Budget Authority

1. Annualization of 2011 Commissioned Corps pay costs ................ --- $ 66,277,000 --- +$22,000

2. Increase for January 2012 pay raise .............................................. --- 66,277,000 --- +108,000

3. Increase in rental payments to GSA.......................................... --- 7,023,000 --- +119,000

 Subtotal, Built-in Increases....................................... --- --- --- +249,000

 B. Program:

1. Mental Health Block Grant........................................................... --- 399,735,000 --- +13,910,000 

2. Substance Abuse Block Grant....................................................... --- 1,375,513,000 --- +44,090,000 

3. State, Tribal and Community Prevention Grants.......................... --- 480,576,000 --- +4,424,000 

4. Health Surveillance and Program Support:

 a. Overseas Rightsizing................................................................. --- 79,197,000 --- +5,000 

 b. Technical Assistance, Evaluation and Data Activities.............. --- 79,197,000 --- +2,735,000 

 Subtotal, Program Increases....................................... --- --- --- +65,164,000 

 Total Increases...................................................... --- --- --- +65,413,000 

Decreases:

 A. Built-in:

 Subtotal, Built-in Decreases....................................... --- --- --- ---

 B. Program:

1. Innovation and Emerging Issues.................................................... --- 809,714,000 --- -64,526,000

2. Regulatory & Oversight Functions................................................ --- 55,052,000 --- -114,000

3. Public Awareness and Support...................................................... --- 14,006,000 --- -14,006,000

4. Performance and Quality Information Systems............................ --- 30,165,000 --- -30,165,000

5. Health Surveillance and Program Support:

 a. HHS Joint Funding Arrangement --- 82,166,000 --- -20,000

6. St. Elizabeths Hospital: --- 795,000 --- -795,000

 Subtotal, Program Decreases.................................... --- --- --- -109,626,000

 Total Decreases...................................................... --- --- --- -109,626,000

 Net Change, Discretionary Budget Authority............... --- --- --- -$44,213,000
21 

Budget Authority by Activity

(Dollars in Thousands)

Program Activities

FY 2010 

Actual 

FY 2011 

Continuing 

Resolution

FY 2012 

President's 

Budget

Mental Health Block Grant............................................................................... $420,774 $420,774 $434,684

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

Subtotal, Mental Health Block Grant............................................................... 420,774 420,774 434,684

Substance Abuse Block Grant........................................................................... 1,454,713 1,454,713 1,494,314

PHS Evaluation Funds (non-add)......................................................................... ( 79,200) ( 79,200) ( 74,711)

Subtotal, Substance Abuse Block Grant........................................................... 1,454,713 1,454,713 1,494,314

Prevention Grants .............................................................................................. 480,576 480,655 485,000

Innovation and Emerging Issues....................................................................... 811,714 811,211 747,188

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

Subtotal, Innovation and Emerging Issues....................................................... 811,714 811,211 747,188

Children's Mental Health Services................................................................... 121,316 121,316 121,316

PATH Homeless Formula Grant....................................................................... 65,047 65,047 65,047

Regulatory & Oversight Functions................................................................... 55,052 54,938 54,938

Public Awareness and Support.......................................................................... 14,006 14,230 ---

PHS Evaluation Funds (non-add)......................................................................... --- --- ( 13,571)

Subtotal, Public Awareness and Support......................................................... 14,006 14,230 13,571

Performance and Quality Information Systems.............................................. 36,761 37,583 ---

PHS Evaluation Funds (non-add)......................................................................... ( 6,596) ( 6,596) ( 12,996)

Subtotal, Performance and Quality Information Systems............................. 36,761 37,583 12,996

Health Surveillance and Program Support...................................................... 101,947 101,947 127,594

PHS Evaluation Funds (non-add)......................................................................... ( 22,750) ( 22,750) ( 45,428)

Subtotal, Health Surveillance and Program Support..................................... 101,947 101,947 127,594

St. Elizabeths Hospital B&F.............................................................................. 795 795 ---

ACA Prevention Fund 20,000 73,750 92,600

TOTAL, SAMHSA Discretionary PL............................................................... 3,582,701 3,636,959 3,649,248

Less PHS Evaluation Funds................................................................................. 131,585 131,585 169,745

Less ACA Prevention Funds................................................................................ 20,000 73,750 92,600

TOTAL, SAMHSA Budget Authority.............................................................. $3,431,116 $3,431,624 $3,386,903

FTEs 537 537 544
22 

Authorizing Legislation

FY 2011 

Amount 

Authorized

FY 2011 

Continuing 

Resolution

FY 2012 

Amount 

Authorized

FY 2012 

President's 

Program Description/PHS Act: Budget

NASPER

Sec. 399O.......................................... Expired $2,000,000 Expired $2,000,000

Emergency Response

Sec. 501........................................... 0 0 0 0

Grants for the Benefit of Homeless

 Individuals

Sec. 506........................................... Expired $42,750,000 Expired $47,360,000

Alcohol and Drug Prevention or 

 Treatment Services for Indians and 

 Native Alaskans

Sec. 506A*......................................... 0 0 0 0

Grants for Ecstasy and Other Club

 Drugs Abuse Prevention

Sec. 506B*....................................... 0 0 0 0

Residential Treatment Programs for

 Pregnant and Postpartum Women

Sec. 508............................................ Expired $16,000,000 Expired $16,000,000

Priority Substance Abuse Treatment Needs

 of Regional and National Significance

Sec. 509*.......................................... Expired $354,605,000 Expired $314,784,000

Substance Abuse Treatment Services 

 for Children and Adolescents

Sec. 514*.......................................... Expired $30,678,000 Expired $30,678,000

Early Intervention Services for Children

 and Adolescents

Sec. 514A*....................................... 0 0 0 0

Methamphetamine and Amphetamine

 Treatment Initiative 

Sec. 514(d)*....................................... 0 0 0 0

Priority Substance Abuse Prevention

 Needs of Regional and National

 Significance

Sec. 516*.......................................... Expired $529,266,000 Expired $454,582,000

Prevention, Treatment and Rehabilitation

 Model Projects for High Risk Youth

Sec. 517..........................................

. .

 0 0 0 0

Services for Children of Substance Abusers

Sec. 519*......................................... 0 0 0 0

Grants for Strengthening Families

Sec. 519A*........................................ 0 0 0 0

Programs to Reduce Underage Drinking

Sec. 519B*....................................... Expired $ 7,000,000 Expired $ 7,000,000

SSAN = Such Sums as Necessary
23 

Authorizing Legislation

FY 2011 

Amount 

Authorized

FY 2011 

Continuing 

Resolution

FY 2011 

Amount 

Authorized

FY 2012 

President's 

Program Description/PHS Act: Budget

Services for Individuals with Fetal Alcohol

 Syndrome (FAS)

Sec. 519C*....................................... 0 0 0 0

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 $9,821,000 Expired $8,000,000

Prevention of Methamphetamine and

 Inhalant Abuse and Addiction

Sec. 519E*....................................... Expired 0 Expired 0

Priority Mental Health Needs of Regional and

 National Significance

Sec. 520A*....................................... Expired $179,865,000 Expired $216,355,000

Youth Interagency Research, Training,

 and Technical Assistance Centers

Sec. 520C*....................................... Expired $4,957,000 Expired $4,957,000

Services for Youth Offenders

Sec. 520D*....................................... 0 0 0 0

Suicide Prevention for Children and Youth

Sec. 520E1*....................................... Expired $29,738,000 Expired $29,738,000

Sec. 520E2*....................................... Expired $4,975,000 Expired $4,975,000

Grants for Emergency Mental Health Centers

Sec. 520F*....................................... 0 0 0 0

Grants for Jail Diversion Programs

Sec. 520G*....................................... Expired $6,684,000 Expired $6,684,000

Improving Outcomes for Children and

 Adolescents through Services Integration

 between Child Welfare and MH Services

Sec. 520H*....................................... 0 0 0 0

Grants for Integrated Treatment of Serious Mental

 Illness and Co-occurring Substance Abuse

Sec. 520I*....................................... 0 0 0 0

Mental Health Training Grants

Sec. 520J*....................................... 0 0 0 0

PATH Grants to States

Sec. 535(a)....................................... Expired $65,047,000 Expired $65,047,000

SSAN = Such Sums as Necessary
24 

Authorizing Legislation 

 

FY 2011 

Amount 

Authorized

FY 2011 

Continuing 

Resolution

FY 2011 

Amount 

Authorized

FY 2012 

President's 

Program Description/PHS Act: Budget

Community Mental Health Services for

 Children with Serious Emotional Disturbances

Sec. 565 (f)....................................... Expired $121,316,000 Expired $121,316,000

Children and Violence Program

Sec. 581*.......................................... Expired $94,502,000 Expired $94,333,000

Grants for Persons who Experience Violence

 Related Stress

Sec. 582 **....................................... Expired $40,800,000 Expired $11,300,000

Community Mental Health Services

 Block Grants

Sec. 1920(a)....................................... Expired $399,735,000 Expired $413,735,000

Substance Abuse Prevention and Treatment

 Block Grants

Sec. 1935(a)....................................... Expired $1,375,513,000 Expired $1,419,513,000

Data Infrastructure Development

Sec. 1971*....................................... Expired 0 Expired 0

Other Legislation/Program Description

Protection and Advocacy for Individuals

 with Mental Illness Act

P.L. 99-319, Sec. 117........................... Expired $36,380,000 Expired $36,380,000

Program Management:

 Program Management, Sec. 501.................. Indefinite $77,842,000 Indefinite $80,811,000

 SEH Workers' Compensation Fund

P.L. 98-621....................................... Indefinite $1,355,000 Indefinite $1,355,000

Total, Program Management.................. 0 $79,197,000 0 $82,166,000

St. Elizabeths Hospital Building & Facilities

Sec. 501...................................... 0 $795,000 0 0

Data Evaluation

Sec. 505...................................... 0 0 0 0

TOTAL, SAMHSA Budget Authority............. 0 $3,431,624,000 0 $3,386,903,000

* 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.

 
25 

Appropriation History Table 

Budget Estimate to 

Congress House Allowance Senate Allowance Appropriation

2002

2002 Res. H.R. 3061

2002 Res. P.L. 107-216

$3,058,456,000

0

0

$3,131,558,000

0

0

$3,073,456,000

0

0

$3,138,279,000

-$589,000

-$1,681,000

1/

2/

3/

2003 P.L. 108-5

2003 P.L. 108-7

$3,193,086,000

0

$3,167,897,000

0

$3,129,717,000

0

$3,158,068,000

-$20,521,235 4/

2004 P.L. 108-84

2004 P.L. 108-199

$3,393,315,000

0

$3,329,000,000

0

$3,157,540,000

0

$3,253,763,000

-$19,856,290 5/

2005 P.L. 108-447 & P.L.

108-309 as mended

2005 H.R. 4818

$3,428,939,000

0

$3,270,360,000

0

$3,361,426,000

0

$3,295,361,000

-$26,895,592

6/

2006 P.L. 109-149

2006 Res. P.L. 109-359

2006 Section 202

$3,336,023,000

0

0

$3,352,047,000

0

0

$3,398,086,000

0

0

$3,237,813,000

-$1,681,000

-$2,201,000

7/

2007 P.L. 109-383

2007 Continuing Resolution

$3,260,001,000

0

$3,326,341,772

0

$3,326,341,772

0

$1,211,654,381

$3,326,341,772

8/

9/

2008 H.R. 2764/P.L. 110-161

2008 Res. P.L. 110-161

$3,167,589,000

0

$3,393,841,000

0

$3,404,798,000

0

$3,291,543,000

-$57,503,000 10/

2009 H.R. 1105/P.L. 111-8 $3,024,967,000 $3,303,265,000 $3,257,647,000 $3,334,906,000

2010 H.R. 3288/P.L. 111-117 $ 3,393,882,000 $ 3,429,782,000 $3,419,438,000 $3,431,116,000 11/

2011 $ 3,541,362,000 $ 3,565,360,000 $ 3,576,184,000 

2012 $ 3,386,903,000 
26 

1/ Reflects Administrative reduction in Section 516 of the Appropriations Bill (H.R. 3061).

2/ Reflects Administrative reduction in P.L. 107-216.

3/ Reflects a Rescission mandated by P.L.108-7.

4/ Reflects SAMHSA's share of the Division E, section 515 reduction on administrative and related expenses and the Division H, section 

168(b) rescission of P.L. 108-199.

5/ Reflects SAMHSA's share of the Division F, section 519(a) reduction on administrative and related expenses and the Division J, 

section 122(a) rescission of H.R. 4818.

6/ Reflects SAMHSA's share of the rescission mandated by P.L. 109-359.

7/ Reflects Section 202 transfer to CMS.

8/ Reflects Continuing Resolution through February 15, 2007.

9/ Reflects the whole year appropriation

10/ Reflects a 1.7 percent across-the-board Rescission from the H.R. 2764/P.L. 110-161. 

11/ Reflects a $508 thousand transfer to HHS
27 

Appropriations Not Authorized by Law

Program

Last Year of 

Authorization

Authorization 

Level

Appropriations in 

Last Year of 

Authorization

Appropriations 

in FY 2010

Emergency Response

Sec. 501O................................................ 2003 $ 25,000,000 2.5% all disc grants $0

Grants for the Benefit of Homeless

 Individuals

Sec. 506................................................ 2003 $ 50,000,000 $ 16,700,000 $ 42,750,000

Alcohol and Drug Prevention or 

 Treatment Services for Indians and 

 Native Alaskans

Sec. 506A*........................................... 2003 $ 15,000,000 $0 $0

Grants for Ecstasy and Other Club

 Drugs Abuse Prevention

Sec. 506B*............................................ 2001 $ 10,000,000 $0 $0

Residential Treatment Programs for

 Pregnant and Postpartum Women

Sec. 508................................................ 2003 SSAN $0 $ 16,000,000

Priority Substance Abuse Treatment Needs

 of Regional and National Significance

Sec. 509*.............................................. 2003 $ 300,000,000 $ 322,994,000 $ 354,436,000

Substance Abuse Treatment Services 

 for Children and Adolescents

Sec. 514*................................................... 2003 $ 40,000,000 $ 20,000,000 $ 30,678,000

Early Intervention Services for Children

 and Adolescents

Sec. 514A*.................................................... 2003 $ 20,000,000 $0 $0

Methamphetamine and Amphetamine

 Treatment Initiative 

Sec. 514**.............................................. 2003 $ 10,000,000 $0 $0

Priority Substance Abuse Prevention

 Needs of Regional and National

 Significance

Sec. 516*...................................................... 2003 $ 300,000,000 $ 138,399,000 $ 192,218,000

Prevention, Treatment and Rehabilitation

 Model Projects for High Risk Youth

Sec. 517.................................................... 2003 SSAN $ 7,000,000 $0

Services for Children of Substance Abusers

Sec. 519*................................................... 2003 $ 50,000,000 $0 $0

Grants for Strengthening Families

Sec. 519A*............................................... 2003 $ 3,000,000 $0 $0

Services for Individuals with Fetal Alcohol

 Syndrome (FAS)

Sec. 519C*................................................... 2003 $ 25,000,000 $0 $0

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 $ 9,821,000
28 

Appropriations Not Authorized by Law

Program

Last Year of 

Authorization

Authorization 

Level

Appropriations in 

Last Year of 

Authorization

Appropriations 

in FY 2010

Prevention of Methamphetamine and

 Inhalant Abuse and Addiction

Sec. 519E*.............................................. 2003 $ 10,000,000 $ 5,000,000 $0

Priority Mental Health Needs of Regional and

 National Significance

Sec. 520A*................................................... 2003 $ 300,000,000 $ 94,289,000 $ 184,822,000

Youth Interagency Research, Training,

 and Technical Assistance Centers

Sec. 520C*................................................. 2007 $ 5,000,000 $ 3,960,000 $0

Services for Youth Offenders

Sec. 520D*............................................. 2003 $ 40,000,000 $0 $0

Suicide Prevention for Children and Youth

Sec. 520E (GLS - State Grants).............................. 2007 $ 30,000,000 $ 17,829,000 $ 29,738,000

Sec. 520E1 (Suicide Prevention for Youth)............... 2003 $ 75,000,000 $0 $0

Sec. 520E2 (GLS-Campus Grants)........................ 2007 $ 5,000,000 $ 4,950,000 $ 4,975,000

Grants for Emergency Mental Health Centers

Sec. 520F*.......................................... 2003 $ 25,000,000 $0 $0

Grants for Jail Diversion Programs

Sec. 520G*.......................................... 2003 $ 10,000,000 $ 6,043,000 $ 6,684,000

Improving Outcomes for Children and Adolescents through Services

Integration between Child Welfare and MH Services

Sec. 520H*................................................. 2003 $ 10,000,000 $0 $0

Grants for Integrated Treatment of Serious Mental

 Illness and Co-occurring Substance Abuse

Sec. 520I*............................................... 2003 $ 40,000,000 $0 $0

Mental Health Training Grants

Sec. 520J*............................................. 2003 $ 25,000,000 $0 $0

PATH Grants to States

Sec. 535(a)............................................. 2003 $ 75,000,000 $ 46,855,000 $ 65,047,000

Community Mental Health Services for

 Children with Serious Emotional Disturbances

Sec. 565 (f).......................................... 2003 $ 100,000,000 $ 96,694,000 $ 121,316,000

Children and Violence Program

Sec. 581*.................................................. 2003 $ 100,000,000 $ 83,035,000 $ 94,333,000

Grants for Persons who Experience Violence

 Related Stress

Sec. 582 *........................................... 2003 $ 50,000,000 $ 20,000,000 $ 40,800,000

Community Mental Health Services

 Block Grants

Sec. 1920(a)......................................... 2003 $ 450,000,000 $ 433,000,000 $ 399,735,000

Substance Abuse Prevention and Treatment

 Block Grants

Sec. 1935(a)................................................... 2003 $ 2,000,000,000 $ 1,785,000,000 $ 1,719,391,000

Data Infrastructure Development

Sec. 1971*................................................. 2003 SSAN $ 6,000,000 $0

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 $ 36,380,000

TOTAL, SAMHSA Budget Authority........................................ $ 4,222,500,000 $ 3,142,664,000 $ 3,349,124,000

*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. 

**Congress authorized two provisions as section 514.
SAMHSA Block Grants 

Table of Contents 

SAMHSA Block Grants Page

1 SAMHSA Block Grants - Overview....................................................................................... 31 

2 Community Mental Health Services Block Grant .................................................................. 35 

3 Substance Abuse Prevention and Treatment Block Grant...................................................... 45 

29 
Page intentionally left blank 

30 
SAMHSA Block Grants - Overview 

 (Dollars in Thousands) 

FY 2011 

Continuing 

Resolution 

FY 2012 

President’s 

Budget 

FY 2010 

Actual 

Mental Health Block Grant.................................. $420,774 $420,774 $434,684

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

Substance Abuse Prevention and Treatment Block 

Grant1

............................................................................ $1,454,713 $1,454,713 $1,494,314

PHS Evaluation Fund (non-add).................................. 79,200 79,200 74,711

Total, SAMHSA Block Grants............................... $1,875,487 $1,875,487 $1,928,998

PHS Evaluation Fund (non-add).................................. $100,239 $100,239 $95,750 1

/ Reflects reallocation of the 20% Prevention Set-Aside in FY 2012 and comparable adjustments in FY 2010 and 

FY 2011 

Authorizing Legislation ...........................Section 1911 and 1921 of the Public Health Service Act 

FY 2012 Authorization .........................................................................................................Expired 

Allocation Method ......................................................................................................Formula grant 

Public funding, including SAMHSA’s Block Grants, supports behavioral health promotion and 

services for the prevention and treatment of mental and substance use disorders. These services 

and programs are geared toward highly vulnerable and at-risk populations who tend to be poor, 

uninsured, and underserved. In particular, public treatment services are prioritized for youth 

with serious emotional disturbances and adults with serious mental illnesses and addictions. 

These services provide critical care and infrastructure that support the recovery of persons with 

significant behavioral health issues and that, if left untreated, would cost businesses, 

communities, governments and families far more. 

The MHBG has not received any significant budget increases in recent years, and yet serves as 

the backbone of public mental health services for vulnerable populations nationwide. The SABG 

has received small increases over time, and represents a critical mass of the available dollars for 

persons with substance use disorders, 61 percent of whom are currently uninsured, who would 

otherwise continue in their addictions without help and without hope. In both cases, the needs 

are dire and far outstrip the available dollars. 

Due to the way these Block Grants evolved in the 1980s, some assumptions about their nature 

and use have evolved as well. The common practice of allowing States to use these dollars in an 

unrestricted, flexible manner without strong accountability measures has become equated with 

the Block Grant concept across the behavioral health systems and State governments, in general. 

In the meantime, newer, innovative, and evidence-based services have gone unfunded or without 

widespread adoption. This “science to service” lag and lack of person-level data have been 

particularly true with the MHBG. While SAMHSA receives individual client level data from 

SABG grantees, MHBG grantees only reports aggregate consumer outcomes or lists of programs 

and services funded by MHBG dollars. The two SAMHSA Block Grants differ on a number of 

their statutory authorities (e.g., method of calculating Maintenance of Effort requirements, 

stakeholder input requirements for planning, set-asides for specific populations or programs, 

31 
etc.). The Centers within SAMHSA that administer these Block Grants also have different 

approaches to application requirements and reporting. To compound this variation, States have 

different structures for accepting, planning, and accounting for the Block Grants and the 

Prevention Set Aside within the SABG. As a result, how these dollars are spent and what is 

known about the services and clients that receive these funds vary by Block Grant and by State. 

Additionally, because these Block Grants historically have been viewed as flexible State funding, 

SAMHSA has placed less emphasis on guiding States toward purchasing high-quality and 

evidence-based services with their Block Grant dollars. Only about 15 percent of SAMHSA’s 

program staff provide oversight to the States on their Block Grant programs (constituting 

approximately 64 percent of SAMHSA’s budget) while about 85 percent of SAMHSA’s program 

staff work with the SAMHSA’s discretionary grantees (which include organizations, 

communities, and States), representing only about 40 percent of SAMHSA’s available dollars. 

These SAMHSA discretionary dollars are awarded on a competitive basis as short-term (three to 

five years) grants to States, communities, and organizations for specific activities such as direct 

services, capacity building, technical assistance, and evaluation. Although these grants have 

become a significant source of funds for some State or local grantees, they do not provide 

enough funding for SAMHSA to take these tested approaches to scale nationwide. The 

limitations of these discretionary grants – they are few in number and fixed in duration and scope 

– are impediments to sustainability and scalability. In all too many cases, SAMHSA 

discretionary grants support the local implementation of an evidence-based program or 

innovative set of services that go away once Federal grant funding ends, even if they show great 

promise. In other cases, SAMHSA grants fund the same evidence-based practice over and over 

again, having proved its efficacy and effectiveness in a variety of communities over many years 

but with no way to move these practices to scale into the Nation’s overall behavioral health 

system. All said, however, SAMHSA’s experience is that the Block Grant mechanism, with the 

changes proposed, offer a viable mechanism to dramatically decrease the time it takes to put 

evidence based practices in the hands of providers more broadly. 

Nevertheless, discretionary grants can and do provide the funding and impetus for major system 

or practice changes in the community or State where they are funded. When this happens, it is 

usually because other funds exist (State or local dollars) and State or local leadership is in place 

and stable over time to sustain and replicate the innovation. However, the current economy and 

significant turnover in State leadership impede the ability of States and communities to sustain or 

expand these localized programs, even with significant efforts to build in sustainability plans 

from the beginning of each grant program. This challenge is especially true in Indian country 

and other underserved communities or States.

SAMHSA will need to spend more time assisting States and Communities build and maintain 

more effective behavioral health systems for prevention, treatment, services and recovery 

supports; and to make its block grant requirements more consistent and effective in terms of 

State planning, reporting and expenditure obligations. SAMHSA also needs the ability to 

implement a flexible, thoughtful and deliberate theory of change to improve the Nation’s 

behavioral health systems. That is, SAMHSA needs the ability to identify emerging issues, 

foster innovative solutions to real world problems, demonstrate and disseminate new research or 

promising practices, and use limited, short-term discretionary grant investments to move 

32 
evidence-based practices and policies into the nation’s core behavioral health systems funded 

either through the BGs to States, Medicaid/Medicare, or private insurance. In order to move 

innovative, evidence-based solutions rapidly into standard practice in the public behavioral 

health system, SAMHSA must have the ability to provide – through its Block Grants -- direction 

to the States on the implementation of a good and modern behavioral health system. The goals 

of such a system are to help people with or at risk for mental and substance use disorders be 

resilient, recover, and lead fulfilling lives in America’s communities. 

SAMHSA needs to spend more time assisting States to build and maintain more effective 

behavioral health systems for prevention, treatment, services and recovery supports, and to make 

its Block Grant requirements more consistent and effective in terms of State planning, reporting 

and expenditure obligations. SAMHSA’s FY 2012 Budget focuses on Block Grants while 

expanding SAMHSA’s authority or using existing authority to direct the use of Block Grant 

dollars by States. SAMHSA is proposing to move proven practices from key discretionary grant 

programs which are proposed for reduction to scale through the Block Grants. SAMHSA also 

proposes to create separate prevention programs for the States and for the Tribes to address 

behavioral health care needs. These programs can be funded under current law as discretionary 

grants. 

In addition to the national economic conditions and the growing prevention science, the passage 

of the Affordable Care Act (ACA) creates a dynamic that is critical for SAMHSA to address. As 

indicated above, the SABG and the MHBG have provided significant proportions of the Nation’s 

core behavioral health systems for vulnerable populations for decades. Under the ACA, many 

individuals previously ineligible for Medicaid or unable to obtain commercial insurance for or 

because of mental and substance use disorders will be covered by Medicaid, commercial 

insurance through employers or on the private market or through the State health insurance 

exchanges. Estimates are that up to 32 million more people will become eligible for health 

insurance, of which six to ten million will have significant untreated mental health and/or 

addictions. Of the 32 million newly insured, about half of those individuals, 16 million people, 

will be eligible for Medicaid including four to six million people with significant untreated 

mental illness and/or addictions. Many of these individuals will have been treated through the 

Block Grants and related State MOE1

 dollars or would have been eligible for such services, had 

there been enough dollars. Many others of the 32 million persons expected to be newly insured 

will have unidentified or untreated substance abuse and/or depression, anxiety, post traumatic 

stress, and other mental disorders. Many of these will be treated through primary care settings, 

utilizing brief interventions and referrals to treatment that will help to prevent more significant 

disorders later, IF these individuals can be served. 

These changes require recasting the SABG and the MHBG in terms of who they serve and what 

services they fund. Generally, these Block Grants need to provide funding for those individuals 

and those services not otherwise funded by other sources such as Medicaid and commercial 

insurance. The services that the Block Grants cover will need to be redesigned to operate as a 

“coordination of benefits” or wrap around services for those priority individuals who are 

 

1

 Maintenance of Effort-States have to maintain expenditures of non-Federal funds for services no less than the 

preceding two-year average of expenditures 

33 
receiving core behavioral health services elsewhere. BGs will also need to fund priority services 

for those priority individuals who remain uninsured and whose untreated behavioral health needs 

will be a burden on the individual, his/her family and his/her community. 

SAMHSA will begin to request different information in State BG applications regarding specific 

service approaches and planning activities, capacities and needs for implementing the Affordable 

Care Act, and proposed responses to priorities outlined by SAMHSA. This request for different 

information will introduce a message to States that SAMHSA is preparing for a major paradigm 

shift in the healthcare system, and will signal the direction of future changes. In addition, this 

State information will tell SAMHSA what kind of technical assistance and resources they may 

need as 2014 approaches in the midst of fiscal austerity at the State and Federal levels. For 

some information SAMHSA plans to require a single submission from each State, necessitating 

coordination across Mental Health and Substance Abuse Authorities and other State departments 

including State Medicaid and public health authorities. In preparation for the next round of full 

BG applications, SAMHSA is making necessary adjustments to internal operations to facilitate 

consistent timing and content of the SABG and the MHBG applications for 2012. 

34 
Community Mental Health Services Block Grant

(Dollars in Thousands) 

FY 2011 FY 2012 

FY 2010 Continuing President’s 

 Actual Resolution Budget 

Mental Health Block Grant..................................... $420,774 $420,774 $434,684

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

Authorizing Legislation ...........................................Section 1911 of the Public Health Service Act 

FY 2012 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 Community Mental Health Block Grant 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 Block Grant include 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 not currently covered under Medicaid, 

Medicare, or commercial insurance. The MHBG also supports and encourages States to 

implement proven practices demonstrated in the discretionary portfolio at SAMHSA. 

A major provision of the MHBG authorization includes a Maintenance of Effort (MOE) 

requirement wherein States are required 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 

2-year period proceeding the year for which the State is applying for a grant. In FY 2010, due to 

significant fiscal reductions among many State budgets, approximately one-third of States and 

Territories had MHBG MOE expenditure shortfalls. 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 county. Funding for the MHBG has been flat for the past three 

years following a reduction from FY 2007 funding. During this time, the number of people 

served by the State mental health authorities across the country has increased from 

approximately six million in FY 2006 to 6.3 million in FY 2008. Additionally, in part due to the 

current economic downturn, State mental health authorities are expecting increasing demand for 

mental health services. 

35 
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 also rely on the MHBG for an array 

of non-clinical activities and services in support of their respective systems of care, e.g., 

planning, coordination, needs assessment, quality assurance, program development, and 

evaluation. 

The legislation provides a five percent set-aside, which is retained by 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. A breakout of the MHBG set-aside 

funding is provided in a table following the ten-year funding table display. 

The Mental Health State Data Infrastructure Grants are funded under the Block Grant Set-aside. 

This grant program meets the goal of developing State capacity to collect and report data on 21 

Uniform Reporting System measures, which include the National Outcome Measures (NOMS). 

With support of the Data Infrastructure Grants and through the Uniform Reporting System, State 

Mental Health Authorities provide annual State mental health system data reports to the MHBG 

program to assure efficiency and effectiveness and to report on program performance. Over the 

past six years, 59 States and Territories have consistently increased in their ability to provide 

data, focusing on use of common measures across States. The Data Infrastructure Grant also 

supports mental health data system development and use of data for policy and program decision 

making. States must match grant awards at a 100 percent level. SAMHSA is working to initiate 

client-level data collection through the Uniform Reporting System. 

Most States are currently reporting on NOMS for public mental health services within their State 

through the Uniform Reporting System (URS). The first compilation of State National Outcome 

Measures data was submitted to Congress in the spring of 2005. For the fifth consecutive year, 

significantly increased numbers of States have reported on National Outcome Measures domains 

for both mental health and substance use programs. 

State level outcome data for mental health are currently reported by State Mental Health 

Authorities through the Uniform Reporting System. The following outcomes for services 

provided during 2009 show that: 

 For the 58 States that reported data in the Employment Domain, 21 percent of the mental 

health consumers were in competitive employment; 

 For the 596 States that reported data in the Housing Domain, 83 percent of the mental 

health consumers were living in private residences; 

 For the 58 States and Territories that reported data in the Access/Capacity Domain, State 

mental health agencies provided mental health services for 21 people per 1,000 

population. 

36 
 For the 52 States that reported data in the Retention Domain, only nine percent of the 

mental health patients returned to a State hospital within 30 days of State hospital 

discharge; 

 For the 54 States that reported data in the Perception of Care Domain, 72 percent of adult 

mental health consumers improved functioning as a direct result of the mental health 

services they received; 

The independent evaluation of the MHBG demonstrates that funds allow States to explore new 

innovations and strategies, target emerging needs with special programs; pay for non-covered 

services (e.g., peer support programs) that are recovery-focused and consumer-centered; and 

create the administrative, organizational, or service delivery linkages that foster communitybased, transformed system of mental health services. The study of the program has been 

completed and the final will be placed on the SAMHSA website in early February 2011. Efforts 

toward the collection of client-level data across all States for five of the National Outcome 

Measures are also underway. Additionally, the pilot was designed to collect estimates of the 

costs of modifying the State IT systems to report all the requested data files and a final project 

report that summarizes the steps in the process of implementing the pilot and challenges faced. 

All of this information will be useful as SAMHSA extends Client Level Data reporting to all 

States. A draft report will be completed in February. A final report on the pilot will be completed 

by the end of the year which will summarize the extent to which client level outcome data could 

be reported as well as what resources would be needed to roll out client level data collection and 

reporting to all States. 

Funding History 

FY Amount

2002 $433,000,000

2003 $437,140,000

2004 a/ $434,690,000 

2005 a/ $432,756,000 

2006 a/ $427,974,000 

2007 a/ $428,256,000 

2008 a/ $420,774,000 

2009 a/ $420,774,000 

2010 a/ $420,774,000 

2011 a/ $420,774,000 

a/ Includes PHS Evaluation funds of $21.8 million in FY 2004 and FY 2005, $21.4 million in FY 2006 and FY 

2007, $21.0 million from FY 2008 to FY 2012. 

Data Elements Used to Calculate FY 2012 Allotments

Population: States and the District of Columbia July 1, 2009 Population Estimates from U.S. 

Census Bureau; Territory population estimates as of July 1, 2010 from U.S. Census Bureau. 

Total Taxable Resources: 2005, 2006 and 2007 data from U.S. Department of Treasury. 

37 
Income: 2007, 2008, and 2009 Total Personal Income for States and District of Columbia from 

Department of Commerce/Bureau of Economic Analysis. 

Cost of Services Index: This index is determined triennially (i.e., it is revised every third fiscal 

year rather than annually). The most current index is being used for the determination of 

allotments for FY 2010, FY 2011, and FY 2012. The base wage rate was calculated using wages 

paid and hours worked from the 2000 Decennial Census for specific occupation-industry 

categories. The update factor was determined using wages paid and hours worked for base year 

(FY 1999 for FY 2003 Final Rule), and recent year (FY 2005 for FY 2009 Final Rule), as 

reported to the Centers for Medicare and Medicaid Services by hospitals participating in the 

Medicare program. FY 2009 Median Fair Market Rent Estimates from Department of Housing 

and Urban Development; July 1, 2007 Population Estimates by County/Subcounty from U.S. 

Census Bureau. 

Budget Request 

The MHBG always has and will continue to fund those individuals who do not have other 

sources of funding for care and those services not otherwise covered. The Affordable Care Act 

(ACA) significantly enhances access to health care, including prevention and treatment services 

for mental illness for millions of Americans. Many individuals that are supported in whole or in 

part by current block grant funds will be insured in FY 2014. These individuals will have 

various outpatient and other services covered under ACA. However, ACA will not enhance 

access to other support services that are necessary to support an individual’s recovery. As 

individuals become insured through Medicaid or private insurance, many of those individuals 

remaining uninsured and some of those services not covered for those who are insured will be 

funded through MHBG dollars. 

Under ACA, the block grant funds will be used for four purposes: 1) to fund priority treatment 

and support services for individuals that will not be insured or for whom coverage is terminated 

for short periods of time; 2) to fund priority treatment and support services that are not covered 

by Medicaid, Medicare or private insurance offered through the exchanges and that show proven 

success in improving outcomes and/or supporting recovery; 3) to collect performance and 

outcome data to determine the ongoing effectiveness of behavioral health services and to plan the 

implementation of new services on a nationwide basis; and 4) to bring effective programs to 

scale. 

The FY 2012 President’s Budget request is $434.7 million, a $13.9 million increase from the FY 

2010 Level. Starting in FY 2012 the Mental Health Block Grant funds will be used to provide 

additional supports for children with serious emotional disturbance and persons at risk of 

acquiring these conditions. This budget will support 59 grants to States and Territories. In FY 

2012, 3.2 percent of the Budget Authority appropriated for the MHBG will be set aside pursuant 

to section 241 of the Public Health Service Act. These resources will be used to support 

activities such as evaluation, data collection, and technical assistance of the MHBG. 

Over the next year, policy and operational decisions will need to be made that affect SAMHSA, 

other Federal agencies, State authorities, providers, and individuals and families that benefit 

38 
from services and supports underwritten by SAMHSA block grants. SAMHSA will work with

States and Territories to increase accountability for those funds, as well as bringing best practices 

and evidence-based practices to scale. 

To start preparing for the realignment and restructuring of SAMHSA Block Grants, SAMHSA 

developed and States completed a FY 2011 Application Addendum for both the MHBG and 

SABG, to compare and gain more insights on these two major funding programs. In FY 2012, 

SAMHSA will begin to request different information in State BG applications regarding specific 

service approaches and planning activities, capacities and needs for implementing the Affordable 

Care Act, and proposed responses to priorities outlined by SAMHSA. This request for different 

information will introduce a message to States that SAMHSA is preparing for a major paradigm 

shift in the healthcare system, and will signal the direction of future changes. States have the 

option to submit a joint application for their MHBG and SABG to ensure better program 

coordination, collaboration, and efficiency of using funds for behavioral health services. 

39 
SAMHSA/Center for Mental Health Services 

Set-Aside Activities 

(Dollars in Thousands) 

FY 2011 

Continuing 

Resolution

FY 2012 

President's 

Budget

FY 2010 

Actual

Funding Sources

Budget Authority

Program Management $2,000 $2,000 $2,000

National Health Interview Survey (non-add) 2,000 2,000 2,000

PHS Evaluation Funds

Mental Health Block Grant Set-Aside 21,039 21,039 21,039

Program Management 1,000 1,000 1,000

NSDUH Mental Health Surveillance (non-add) 1,000 1,000 1,000

Total Program Level $24,039 $24,039 $24,039

Mental Health Block Grant Set-Aside Activities

FY 2011 

Continuing 

Resolution

FY 2012 

President's 

Budget

FY 2010 

State Data Systems Actual

State Data Infrastructure Grants

State Data Infrastructure Contracts

$6,851

435

$6,850

 ---

$6,850

 ---

Subtotal, State Data Systems

National Data Collection

National MH Data Contracts

7,286

2,030

6,850

2,348

6,850

1,790

Subtotal - National Data Collection 2,030 2,348 1,790

Technical Assistance (TA)

TA to States 11,294 11,411 11,970

FTE Support (non-add)

Subtotal, Technical Assistance

2,210 2,551 2,750

11,294 11,411 11,970

Program Evaluation

Development of Spending Estimates for MH/SAT 429 430 429

Subtotal, Program Evaluation 429 430 429

TOTAL, MH Block Grant Set-Aside $21,039 $21,039 $21,039

40 
Outcomes and Outputs 

Community Mental Health Services Block Grant 

Table 1: Key Performance Indicators for Mental Health Block Grant 

FY 2011 

Performance 

Target 

Associated 

with FY 2010 

PB 

FY 2013 

Performance 

Target 

Associated 

with FY 2012 

Request 

FY 2013 

Performance 

Target +/- FY 

2011 

Performance 

Target 

Most Recent 

Result Measure 

FY 2009: 

6,430,635 

(Target 

Exceeded) 

2.3.14: Number of people served by 

the public mental health system2

(Output) 

6,300,000 6,340,320 +40,320 

FY 2009: 4.3 

per State 

(Target 

Exceeded) 

2.3.11: Number of evidence based 

practices (EBPs) implemented3

(Output) 

4.2 per State 4.2 per State Maintain 

FY 2009: 

71.6% 

(Target Not 

Met) 

2.3.15: Rate of consumers (adults) 

reporting positively about outcomes 

(Outcome) 

72% 72% Maintain 

FY 2009: 

65.2% 

(Target Not 

Met but 

Improved) 

2.3.16: Rate of family members 

(children/adolescents) reporting 

positively about outcomes (Outcome) 

73% 67% -6% 

FY 2009: 7.2 

% 

(Target 

Exceeded) 

2.3.81: Percentage of service 

population receiving any evidence 

based practice (Outcome) 

7.2 % 7.2 % Maintain 

 

2

The FY 2010, FY 2011 and FY 2012 targets have been set at 6.3 million persons served (slightly lower than the most recent actual) based on the 

expectation that the current recession will impact the service delivery systems of the State Mental Health Authorities and may result in fewer 

persons receiving mental health care nationally.

3

National average of evidence-based practices per state, based on 35 States reporting. Excludes Medication Management and Illness SelfManagement, which continue to undergo definitional clarification

41 
DEPARTMENT OF HEALTH AND HUMAN SERVICES 

Substance Abuse and Mental Health Services Administration 

FY 2012 DISCRETIONARY STATE/FORMULA GRANTS 

Community Mental Health Services Block Grant Program 

CFDA # 93.958 

FY 2010 FY 2011 FY 2012 

STATE/TERRITORY Appropriation Estimate Estimate +/- FY 2010

Alabama $6,030,049 $6,043,224 $6,068,781 +$38,732

Alaska 710,941 699,955 708,706 -2,235

Arizona 9,383,677 9,524,857 9,616,355 +232,678

Arkansas 3,687,284 3,684,620 3,701,900 +14,616

California 53,676,045 53,470,793 53,202,825 -473,220

Colorado 6,560,592 6,618,166 6,647,041 +86,449

Connecticut 4,233,212 4,172,385 4,135,527 -97,685

Delaware 730,894 736,297 752,726 +21,832

District Of Columbia 772,964 763,690 753,517 -19,447

Florida 26,711,963 26,381,061 26,508,905 -203,058

Georgia 13,141,697 13,303,932 13,362,785 +221,088

Hawaii 1,991,184 1,967,992 1,956,778 -34,406

Idaho 1,806,946 1,815,091 1,823,687 +16,741

Illinois 15,774,494 15,721,669 15,492,957 -281,537

Indiana 7,887,788 7,944,223 7,915,313 +27,525

Iowa 3,370,840 3,374,230 3,323,966 -46,874

Kansas 3,116,308 3,122,152 3,097,349 -18,959

Kentucky 5,420,187 5,412,148 5,415,890 -4,297

Louisiana 5,293,123 5,424,261 5,539,438 +246,315

Maine 1,649,042 1,643,710 1,629,114 -19,928

Maryland 7,281,807 7,308,278 7,351,039 +69,232

Massachusetts 8,050,963 8,073,592 8,160,512 +109,549

Michigan 12,810,013 12,798,172 12,557,496 -252,517

Minnesota 6,831,525 6,850,165 6,835,821 +4,296

Mississippi 3,942,229 3,961,974 3,951,312 +9,083

Missouri 6,959,268 7,007,039 7,032,955 +73,687

Montana 1,191,479 1,187,436 1,185,306 -6,173

Nebraska 1,943,546 1,937,291 1,926,025 -17,521

Nevada 3,678,154 3,668,825 3,711,740 +33,586

New Hampshire 1,510,763 1,503,859 1,494,068 -16,695

New Jersey 11,561,060 11,481,491 11,347,605 -213,455

New Mexico 2,365,487 2,360,459 2,376,256 +10,769

New York 23,725,265 23,484,085 23,172,903 -552,362

North Carolina 11,162,694 11,316,517 11,404,753 +242,059

North Dakota $746,161 $737,998 $736,313 -$9,848

42 
DEPARTMENT OF HEALTH AND HUMAN SERVICES 

Substance Abuse and Mental Health Services Administration 

FY 2012 DISCRETIONARY STATE/FORMULA GRANTS 

Community Mental Health Services Block Grant Program 

CFDA # 93.958 

FY 2010 FY 2011 FY 2012 

STATE/TERRITORY Appropriation Estimate Estimate +/- FY 2010

Ohio $13,695,234 $13,792,762 $13,762,718 +$67,484

Oklahoma 4,390,515 4,348,099 4,367,994 -22,521

Oregon 4,963,996 4,979,213 4,983,949 +19,953

Pennsylvania 14,485,712 14,409,512 14,539,192 +53,480

Rhode Island 1,387,146 1,375,754 1,369,668 -17,478

South Carolina 5,726,309 5,808,930 5,894,597 +168,288

South Dakota 863,186 865,047 867,768 +4,582

Tennessee 7,723,117 7,759,542 7,794,726 +71,609

Texas 32,209,069 32,256,069 32,508,255 +299,186

Utah 3,048,064 3,109,620 3,131,038 +82,974

Vermont 743,593 739,208 730,765 -12,828

Virginia 9,999,072 10,009,499 10,062,553 +63,481

Washington 8,463,723 8,485,053 8,575,408 +111,685

West Virginia 2,411,707 2,399,115 2,373,101 -38,606

Wisconsin 7,463,832 7,462,992 7,424,808 -39,024

Wyoming 455,056 436,923 454,771 -285

State Sub-total 393,738,975 393,738,975 393,738,975 0

American Samoa 84,418 85,886 86,680 +2,262

Guam 229,028 233,507 235,991 +6,963

Marshall Islands 82,265 84,439 85,932 +3,667

Micronesia 140,202 140,596 139,813 -389

Northern Marianas 112,792 67,376 63,043 -49,749

Puerto Rico 5,154,286 5,190,495 5,191,365 +37,079

Palau 50,000 50,000 50,000 0

Virgin Islands 143,034 143,726 143,201 +167

Territory Sub-Total 5,996,025 5,996,025 5,996,025 0

Total States/Territories 399,735,000 399,735,000 399,735,000 0

SAMHSA Set-Aside 21,039,000 21,039,000 21,039,000 0

Transfer 0 0 13,910,000 +13,910,000

TOTAL, MHBG $420,774,000 $420,774,000 $434,684,000 +$13,910,000

43 
Page intentionally left blank

44 
Substance Abuse Prevention and Treatment Block Grant 

(Dollars in Thousands) 

FY 2010 

Actual 

FY 2011 

Continuing 

Resolution 

FY 2012 

President’s 

Budget 

Substance Abuse Prevention and Treatment Block 

Grant 1/........................................................... $1,454,713 $1,454,713 $1,494,314 

PHS Evaluation Fund (non-add).................................. 79,200 79,200 74,711 

1/ Reflects reallocation of the 20% Prevention Set-Aside in FY 2012 and comparable adjustments in FY 2010 and 

FY 2011 

Authorizing Legislation ........................................Section 1921 of the Public Health Services Act4

FY 2012 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 Indian Tribe of 

Minnesota to plan, carry out, and evaluate substance abuse 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. All Block 

Grant applications must include an annual plan that contains detailed provisions for complying 

with each funding agreement specified in the legislation, and describes how the applicant intends 

to expend the grant. The current law includes specific provisions and funding set-asides, such as 

a 20 percent prevention set-aside; an HIV/AIDS early intervention set-aside; requirements and 

potential reduction of the Block Grant allotment with respect to sale of tobacco products to those 

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 treatment services while 

providing maximum flexibility to the States. 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 CSAT’s 

State Systems Technical Assistance Project. The Block Grant 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 2-year period proceeding the year for which the 

State is applying for a grant. Given the current economic situation, SAMHSA is aware that a 

number of States may experience challenges meeting the maintenance of effort requirement in 

the Federal FY 2011 grant cycle, and is monitoring the situation closely. 

 

4

 Appropriation language will notwithstand the 20% prevention set-aside and allow for the movement of these funds into a separate State 

Prevention Grants for behavioral health; State will still be able to spend SAPTBG funds for prevention services 

45 
Of the amounts appropriated for the Block Grant program, 95 percent 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. 

The Block Grant is critically important to the States because it provides them the flexibility to 

respond to local and/or regional emergent issues impacting health, public health, and public 

safety through a consistent Federal funding stream. Individuals who are currently in need of such 

services may fall into several categories, such as no insurance or limited health insurance 

coverage for substance use disorder treatment and recovery support services, or may have been 

mandated to enter SUD treatment through public safety and/or public welfare systems. As 

previously indicated, there will continue to be individuals and families without health insurance 

or whose health insurance benefit will not cover certain services, e.g. recovery supports. Such 

individuals rely on services funded by the Block Grant. States also rely on the Block Grant for an 

array of non-clinical activities and services in support of their respective systems of care, e.g. 

planning, coordination, needs assessment, quality assurance, program development, and 

evaluation. The independent evaluation of the original Substance Abuse Prevention and 

Treatment Block Grant program (http://tie.samhsa.gov/SAPT2010.html#Evaluation ) 

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 to 

improve coordination of services with other State systems. 

As seen in the following table, the Block Grant Program has been successful in expanding 

treatment capacity in the latest year for which actual data are available (FY 2008) by supporting 

almost 2.3 million admissions to treatment programs receiving public funding. Outcomes data 

for the Block Grant Program also show positive results. At discharge, clients have demonstrated 

high abstinence rates from both illegal drug (73.7 percent) and alcohol (78.2 percent) use. 

State Substance Abuse Authorities reported the following outcomes for services provided during 

2007, the most recent year data is available: 

 For the 51 States that reported data in the Abstinence from Drug/Alcohol Use 

Domain for alcohol, 50 of 51 identified improvements in client abstinence. Fortythree of these States reported improvements based on information submitted to the 

Treatment Episode Data Set (TEDS) and seven reported improvements based on their 

own data collection systems. 

 Similarly, for the 51 States that reported data in the Abstinence from Drug/Alcohol 

Use Domain for drug use, 50 of 51 identified improvements in client abstinence. 

Forty-three of these States reported improvements based on information submitted to 

TEDS and seven reported improvements based on their own data collection systems. 

 For the 51 States that reported data in the Employment Domain, 46 of 51 identified 

improvements in client employment. Forty of these States reported improvements 

based on information submitted to TEDS and six reported improvements based on 

their own data collection systems. 

46 
 For the 51 States that reported in the Criminal Justice Domain, 35 of 40 reported an 

increase in clients with no arrests based on data reported to TEDS. 

 For the 51 States that reported data in the Housing Domain, 35 of 47 identified 

improvements in stable housing for clients based on data reported to TEDS. 

Funding History 

FY Funding FTEs 

2002 $1,725,000,000 

2003 $1,753,932,000 

2004 a/ $1,779,146,000 

2005 a/ $1,775,555,000 

2006 a/ $1,757,425,000 40 

2007 a/ $1,758,591,000 40 

2008 a/ $1,758,728,000 40 

2009 a/ $1,778,591,000 40 

2010 a/ $1,454,713,000 40 

2011 a/ $1,454,713,000 40 

a/ Includes $79.2 million from the PHS evaluation funds. 

Data Elements Used to Calculate State Allotments

Population Data: States and the District of Columbia July 1, 2008 Population Estimates) from 

U.S. Census Bureau; Territory population estimates as of July 1, 2009 from U.S. Department of 

Commerce. 

Total Taxable Resources: 2005, 2006 and 2007 data from U.S. Department of Treasury. 

Income: 2006, 2007, and 2008 Total Personal Income for States and District of Columbia from 

Department of Commerce/Bureau of Economic Analysis. 

Cost of Services Index: This index is determined triennially (i.e., it is revised every third fiscal 

year rather than annually). The most current index is being used for the determination of 

allotments for FY 2010, FY 2011, and FY 2012. The base wage rate was calculated using wages 

paid and hours worked from the 2000 Decennial Census for specific occupation-industry 

categories. The update factor was determined using wages paid and hours worked for base year 

(FY 1999 for FY 2003 Final Rule), and recent year (FY 2005 for FY 2009 Final Rule), as 

reported to the Centers for Medicare and Medicaid Services by hospitals participating in the 

Medicare program. FY 2009 Median Fair Market Rent Estimates from Department of Housing 

and Urban Development; July 1, 2007 Population Estimates by County/Sub-county from U.S. 

Census Bureau. 

47 
Budget Request 

The Affordable Care Act (ACA) significantly enhances access to health care, including 

prevention and treatment services for mental illness for millions of Americans. Many 

individuals that are supported in whole or in part by current block grant funds will be insured in 

FY 2014. These individuals will have various outpatient and other services covered under 

ACA. However, ACA will not enhance access to other support services that are necessary to 

support an individual’s recovery. 

Under ACA, the block grant funds will be used for four purposes: 1) to fund priority treatment 

and support services for individuals that will not be insured or for whom coverage is terminated 

for short periods of time); 2) to fund priority treatment and support services that are not covered 

by Medicaid, Medicare or private insurance offered through the exchanges and that show proven 

success in improving outcomes and/or supporting recovery; and 3) to collect performance and 

outcome data to determine the ongoing effectiveness of behavioral health services and to plan the 

implementation of new services on a nationwide basis; and 4) to bring effective programs to 

scale. 

SAMHSA needs to begin planning now for the FY 2014 effective dates of critical aspects of the 

ACA. This will require that SAMHSA use FY 2011, 2012 and 2013 to transition the block grant 

to these three purposes. This transition includes strengthening SAMHSA’s authority regarding 

the States’ use of Block Grant funds, and a shift in SAMHSA staff functions to support and 

provide technical assistance for States as they move through these changes. 

The FY 2012 Budget Request is for $1.494 billion, an increase of approximately $39.6 million 

over the FY 2010 Level. This reflects a comparability adjustment of $343 million down to 

$1.454 billion to transfer funding for the 20 percent SABG prevention set-aside to the new 

Substance Abuse - State Prevention Grants. It also includes an increase in funding of 

approximately $39.6 million to bring the total for the program over the adjusted FY 2010 level. 

In FY 2012, 3.2 percent of the Budget Authority appropriated for the SABG will be set aside 

pursuant to section 241 of the Public Health Service Act. These resources will be used to 

support activities such as evaluation, data collection, and technical assistance of the SABG. 

Over the next year, policy and operational decisions will need to be made that affect SAMHSA, 

other Federal agencies, State authorities, providers, and individuals and families that benefit 

from services and supports underwritten by SAMHSA block grants. SAMHSA intends to work 

with States and Territories to increase accountability for these funds, as well as bringing best 

practices and evidence-based practices to scale. States and Territories will also be allowed to 

utilize a portion of the SABG funds to augment the Substance Abuse State Prevention Grant 

funding for additional prevention services if the submitted application indicates a desire to do so 

in the plan for expenditure of these dollars. 

To start preparing for the realignment and restructuring of SAMHSA Block Grants, SAMHSA 

developed and States completed a FY 2011 Application Addendum for both the SABG, and 

MHBG to compare and gain more insights on these two major funding programs. In FY 2012, 

SAMHSA will begin to request different information in State BG applications regarding specific 

48 
service approaches and planning activities, capacities and needs for implementing the Affordable 

Care Act, and proposed responses to priorities outlined by SAMHSA. This request for different 

information will introduce a message to States that SAMHSA is preparing for a major paradigm 

shift in the healthcare system, and will signal the direction of future changes. States have the 

option to submit a joint application for their SABG and MHBG to ensure better program 

coordination, collaboration, and efficiency of using funds for behavioral health services. 

49 
Outcomes and Outputs 

Substance Abuse Block Grant Treatment Activities 

Table 2: Key Performance Indicators for Substance Abuse Block Grant – Treatment Activities 

FY 2011 

Performance 

Target 

Associated 

with FY 2010 

PB 

FY 2013 

Performance 

Target 

Associated 

with FY 2012 

Request 

FY 2013 

Performance 

Target +/- FY 

2011 

Performance 

Target 

Measure Most Recent 

Result 

1.2.43: Number of admissions to 

substance abuse treatment programs 

receiving public funding5 (Output) 

FY 2008: 

2,272,250 

(Target 

Exceeded) 

1,881,515 1,937,960 +56,445 

1.2.48: Percentage of clients 

reporting no drug use in the past 

month at discharge (Outcome) 

FY 2009: 

75.7% 

(Target 

Exceeded) 

70.3% 74% +3.7% 

1.2.49: Percentage of clients 

reporting no alcohol use in the past 

month at discharge (Outcome) 

FY 2009: 

81.5% 

(Target 

Exceeded) 

74.7% 78% +3.3% 

1.2.50: Percentage of clients 

reporting being employed/in school 

at discharge (Outcome) 

FY 2009: 

42.9% 

(Target Met) 

43.9% 43% -0.9% 

1.2.51: Percentage of clients 

reporting no involvement with the 

Criminal Justice System (Outcome) 

FY 2009: 92% 

(Target 

Exceeded) 

88.9% 92% +3.1% 

1.2.85: Percentage of clients 

receiving services who had a 

permanent place to live in the 

community (Outcome) 

FY 2009: 92.0 

% 

(Target Met) 

92.0 % 92.0 % Maintain 

 

5

Formerly Number of Clients Served. Wording change approved by OMB 12/4/07.

50 
51 

Synar

Table 3: Key Performance Indicators for Substance Abuse Block Grant – Synar Amendment 

Measure Most Recent 

Result 

FY 2011 

Performance 

Target 

Associated 

with FY 2010 

PB 

FY 2013 

Performance 

Target 

Associated 

with FY 2012 

Request 

FY 2013 

Performance 

Target +/- FY 

2011 

Performance 

Target 

2.3.49: Number of States (including 

Puerto Rico) whose retail sales 

violations is at or below 20%6

(Outcome) 

FY 2009: 52 

(Target Met) 52 52 Maintain 

2.3.62: Number of States (excluding 

Puerto Rico) reporting retail tobacco 

sales violation rates below 10% 

(Outcome) 

FY 2009: 34 

(Target 

Exceeded) 

26 347

 +8 

 

6

The 20% retail sales violation data apply to the 50 states, D.C., and Puerto Rico. 7

The target rate for 2012 and 2013 have been increased. Although States continue to face funding cuts to their youth tobacco access enforcement 

programs due to weak economic conditions, SAMHSA anticipates that new funding available to States from the FDA as a result of the Tobacco 

Control Act will help to offset State budget cuts and greatly increase the amount and reach of enforcement of youth access laws taking place in 

States, which SAMHSA expects to result in lower RVRs.
DEPARTMENT OF HEALTH AND HUMAN SERVICES 

Substance Abuse and Mental Health Services Administration 

FY 2012 DISCRETIONARY STATE/FORMULA GRANTS 

Substance Abuse Prevention and Treatment Block Grant (SABG) 

CFDA #93.959 

FY 2010 

Appropriation

FY 2011 

Estimate

FY 2012 

STATE/TERRITORY Estimate +/- FY 2010

Alabama $23,932,208 $23,932,208 $19,265,992 -$4,666,216

Alaska 4,958,281 4,958,281 3,991,533 -966,748

Arizona 37,421,345 37,421,345 30,125,066 -7,296,279

Arkansas 13,381,171 13,381,171 10,772,159 -2,609,012

California 251,659,105 251,659,105 202,591,519 -49,067,586

Colorado 26,393,425 26,393,425 21,247,330 -5,146,095

Connecticut 17,071,088 17,071,088 13,742,629 -3,328,459

Delaware 6,744,716 6,744,716 5,429,656 -1,315,060

District Of Columbia 6,744,716 6,744,716 5,429,656 -1,315,060

Florida 100,688,583 100,688,583 81,056,686 -19,631,897

Georgia 50,698,151 50,698,151 40,813,208 -9,884,943

Hawaii 7,660,446 7,660,446 6,166,840 -1,493,606

Idaho 6,931,273 6,931,273 5,579,838 -1,351,435

Illinois 70,114,715 70,114,715 56,444,001 -13,670,714

Indiana 33,423,005 33,423,005 26,906,308 -6,516,697

Iowa 13,571,229 13,571,229 10,925,160 -2,646,069

Kansas 12,333,978 12,333,978 9,929,143 -2,404,835

Kentucky 20,736,291 20,736,291 16,693,204 -4,043,087

Louisiana 25,939,847 25,939,847 20,882,189 -5,057,658

Maine 6,744,716 6,744,716 5,429,656 -1,315,060

Maryland 32,090,222 32,090,222 25,833,386 -6,256,836

Massachusetts 34,451,972 34,451,972 27,734,651 -6,717,321

Michigan 58,098,674 58,098,674 46,770,804 -11,327,870

Minnesota 24,981,718 24,981,718 20,110,873 -4,870,845

Red Lake Indians 615,708 615,708 495,659 -120,049

Mississippi 14,307,367 14,307,367 11,517,768 -2,789,599

Missouri 26,248,614 26,248,614 21,130,754 -5,117,860

Montana 6,744,716 6,744,716 5,429,656 -1,315,060

Nebraska 7,920,131 7,920,131 6,375,892 -1,544,239

Nevada 13,897,818 13,897,818 11,188,072 -2,709,746

New Hampshire 6,744,716 6,744,716 5,429,656 -1,315,060

New Jersey 47,103,249 47,103,249 37,919,227 -9,184,022

New Mexico 9,009,024 9,009,024 7,252,477 -1,756,547

New York 115,911,639 115,911,639 93,311,605 -22,600,034

North Carolina 40,041,719 40,041,719 32,234,529 -$7,807,190

52 
DEPARTMENT OF HEALTH AND HUMAN SERVICES 

Substance Abuse and Mental Health Services Administration 

FY 2012 DISCRETIONARY STATE/FORMULA GRANTS 

Substance Abuse Prevention and Treatment Block Grant (SABG) 

CFDA #93.959 

FY 2010 FY 2011 FY 2012 

STATE/TERRITORY Appropriation Estimate Estimate +/- FY 2010

North Dakota $5,500,894 $5,500,894 $4,428,350 -$1,072,544

Ohio 66,891,165 66,891,165 53,848,967 -13,042,198

Oklahoma 17,775,259 17,775,259 14,309,503 -3,465,756

Oregon 17,998,935 17,998,935 14,489,568 -3,509,367

Pennsylvania 59,291,507 59,291,507 47,731,063 -11,560,444

Rhode Island 6,744,716 6,744,716 5,429,656 -1,315,060

South Carolina 20,685,249 20,685,249 16,652,114 -4,033,135

South Dakota 5,086,794 5,086,794 4,094,989 -991,805

Tennessee 29,850,946 29,850,946 24,030,716 -5,820,230

Texas 136,456,180 136,456,180 109,850,446 -26,605,734

Utah 17,194,033 17,194,033 13,841,602 -3,352,431

Vermont 5,438,864 5,438,864 4,378,414 -1,060,450

Virginia 43,237,320 43,237,320 34,807,063 -8,430,257

Washington 35,098,858 35,098,858 28,255,409 -6,843,449

West Virginia 8,740,456 8,740,456 7,036,273 -1,704,183

Wisconsin 28,190,657 28,190,657 22,694,144 -5,496,513

Wyoming 3,534,119 3,534,119 2,845,049 -689,070

State Sub-Total 1,683,031,528 1,683,031,528 1,354,880,108 -328,151,420

 $0

American Samoa 362,204 368,518 299,407 -62,797

Guam 982,668 1,001,931 815,152 -167,516

Northern Marianas 483,945 289,096 217,763 -266,182

Puerto Rico 22,115,030 22,271,328 17,931,867 -4,183,163

Palau 117,852 116,775 94,101 -23,751

Marshall Islands 352,969 362,308 296,824 -56,145

Micronesia 601,551 603,270 482,939 -118,612

Virgin Islands 613,703 616,696 494,639 -119,064

Territory Sub-Total 25,629,922 25,629,922 20,632,692 -4,997,230

 $0

Total States/Territories 1,708,661,450 1,708,661,450 1,375,512,800 -333,148,650

SAMHSA Set-Aside 89,929,550 89,929,550 74,711,200 -15,218,350

Transfer 0 0 44,090,000 +44,090,000

1/ TOTAL SAPTBG $1,798,591,000 $1,798,591,000 $1,494,314,000 -$304,277,000

1/ Funding reflects an adjusted base without funding for the 20% prevention set-aside. 

Notwithstanding any other provision of law, section 1922(a) of the Public Health Service Act 

53 
54 

Page intentionally left blank 
SAMHSA State, Tribal, and Community Prevention Grants 

Table of Contents 

SAMHSA/State, Tribal, and Community Prevention Grants Page

1. SAMHSA State, Tribal, and Community Prevention Grants - Overview ........................ 57 

2. Substance Abuse - State Prevention Grants...................................................................... 59 

3. Behavioral Health - Tribal Prevention Grants .................................................................. 63 

4. Mental Health - State Prevention Grants .......................................................................... 67 

 

55 
Page intentionally left blank 

56 
SAMHSA State, Tribal, and Community Prevention Grants - Overview 

(Dollars in Thousands) 

FY 2010

Actual

FY 2011 

Continuing 

Resolution

FY 2012

President's 

Budget

State, Tribal, and Community Prevention Grants................... $480,576 $480,655 $535,000

Substance Abuse - State Prevention Grants (non-add).............. --- --- 395,000

Behavioral Health - Tribal Prevention Grants (non-add)......... --- --- 50,000

ACA Prevention Fund (non-add) ........................................... --- --- (50,000)

Mental Health - State Prevention Grants (non-add)................. 24,993 25,000 90,000

Project LAUNCH (non-add)................................................... (24,993) (25,000) (25,000)

Authorizing Legislation ........................................................Section 516 and 520A of the PHS Act 

FY 2012 Authorization ...............................................................................................................N/A 

Allocation Method ........................................................................................... Discretionary Grants 

Prevention of substance abuse and mental illness and emotional health promotion are essential 

components of the National Prevention Council’s National Prevention and Health Promotion 

Strategy to improve the health of individuals, families and communities and reform the Nation’s 

health care system. The development of any comprehensive prevention strategy must include the 

prevention of substance abuse and mental illness as essential components to achieving and 

maintaining overall health for the American people. 

In FY 2012, SAMHSA is requesting funding that creates three new behavioral health programs 

specifically focused on States and Territories, and Tribes. The purpose of these new programs is 

to help States/Territories and Tribes develop and implement effective practices, strategies, and 

policies to prevent substance abuse and mental illness and to promote emotional health. These 

programs are based on the latest prevention science that has demonstrated the benefits of 

building emotional health in helping to prevent substance abuse and mental illnesses. The 

Substance Abuse – State Prevention Grants, Behavioral Health – Tribal Prevention Grants, and 

Mental Health – State Prevention Grants will encourage States/Territories and Tribes to both 

strengthen substance abuse prevention activities and make promotion of emotional health a 

priority. The President and the Congress have both emphasized the critical role of disease 

prevention and health promotion in the overall health and wellness of the American people. 

These efforts directly support that priority. 

A World Health Organization (WHO) report estimates that 26.2 percent of Americans ages 18 

and older (about one in four adults) suffer from a diagnosable mental disorder in a given year. 

Mental illness is among the top causes for disability claims and is the leading cause of disability 

in the U.S. and Canada among people ages 15-44. The Institute of Medicine (IOM) estimates the 

cost of mental, emotional and behavioral disorders among youth to be approximately $247 

million. Over 33,000 Americans die every year as a result of suicide. With an average age of 

onset for mental disorders occurring before age 14, and three-quarters of adult mental illnesses 

57 
beginning before age 25, a focused approach on disease prevention is necessary in order to 

reduce the impact of mental illness on society. 

Similarly, substance abuse is a significant burden to American society. Nearly 5000 deaths are 

attributable to underage drinking each year. Furthermore, on any given day, an average of 8,000 

people over the age of 12 initiate illicit drug use for the first time. According to the National 

Institute on Drug Abuse (NIDA), estimates of the total overall costs of substance abuse in the 

United States including health costs, crime-related costs and lost productivity exceed half a 

trillion dollars annually. This includes an estimated $181 billion for illicit drugs, $168 billion for 

tobacco, and $185 billion for alcohol. 

Recent research has demonstrated consistently that substance use disorders and many mental 

illnesses are preventable The currently available science reviewed in 2009 by the IOM in its 

report entitled Preventing Mental, Emotional, and Behavioral Disorders Among Young People, 

describes risk factors that can be lessened and protective factors that can be enhanced by 

utilizing multiple institutions/messages and community interventions to build emotional health in 

young children and help prevent substance abuse, depression, conduct disorder and other 

behavioral health issues among adolescents. These risk and protective factors are similar, 

regardless of whether the goal is reduced substance abuse or reduced depression and anxiety 

disorders. While there are similar factors, there are also unique factors for substance abuse. 

Likewise, these risk and protective factors must be addressed within multiple institutions in a 

community – schools, churches, community centers, homes, primary care settings, etc. – over 

time, in order to see measurable differences that are sustained for youth and for communities. 

States and Territories are critical partners in the work of communities. States and Territories set 

policies, support community institutions and often direct or influence how services are funded 

and implemented and how collaborations are created or sustained. Without the commitment of 

States/Territories, the Nation’s communities will not be successful as a whole in making the 

population based changes needed to raise emotionally healthy children who grow into healthy 

adolescents and productive adults. 

The FY 2012 President’s Budget request is $535 million for these three new 

prevention programs, including $395 million for the Substance Abuse - State Prevention Grants, 

$50 million for the Behavioral Health - Tribal Prevention Grants (funded from ACA Prevention 

Funds) and $90 million for the Mental Health - State Prevention Grant. Funding for the 

Substance Abuse - State Prevention Grants includes funding from realignment of the 20 percent 

Prevention Set-aside requirement of the SAPT Block Grant ($345 million) along with funding 

previously used for the Strategic Prevention Framework program ($51 million). Funding for the 

Mental Health - State Prevention Grants includes recycled funding from discretionary mental 

health programs. Funding for the Behavioral Health - Tribal Prevention Grants is requested from 

the Prevention and Public Health Fund of the ACA. 

58 
Substance Abuse - State Prevention Grants 

(Dollars in Thousands) 

FY 2010 

Actual

FY 2011 

Conti nuin g 

Resolution

 FY 2012

President's 

Budget

Substance Abuse - State Prevention Grants.............................. $0 $0 $395,000

Authorizing Legislation ........................................................................ Section 516 of the PHS Act 

FY 2012 Authorization ...............................................................................................................N/A 

Allocation Method ........................................................................................... Discretionary Grants 

Purpose

SAMHSA proposes to introduce a new Substance Abuse – State Prevention Grant (SA-SPG) 

starting in FY 2012, focusing exclusively on preventing substance abuse. The SA-SPG 

represents a significant advance in the Nation’s approach to prevention in several ways. First, it 

creates a sustainable and predictable source of prevention funding for the 50 States, the District 

of Columbia (DC), and eight Territories that will require focus on high risk communities and 

youth. Second, it will move the Strategic Prevention Framework State Incentive Grant (SPFSIG) approach to scale across the Nation. Third, it requires that States and Territories use a 

comprehensive, data-driven planning process to identify and address problems in communities, 

and holds States and the Territories accountable for achieving measurable outcomes for their 

residents. 

Background

The SA-SPGs draw upon the strengths of both block grant and discretionary approaches. First, 

through the 20 percent prevention set-aside of the current formula-based Substance Abuse 

Prevention and Treatment Block Grant (SABG) program, SAMHSA will ensure funding 

availability and decision-making authority for prevention at the State level. At the same time, 

SAMHSA has guided the development of data-driven, needs-based, evidence-proven methods 

for facilitating substance abuse prevention through its discretionary programs, including the SPFSIG. The new SA-SPG program integrates key aspects of both approaches in a systematic and 

logical approach designed to avoid duplication, improve coordination, increase accountability, 

prioritize high-need communities, focus exclusively on substance abuse prevention and require 

States and Territories to support communities in achieving outcomes. The SA-SPG program will 

build on the success of the planning approach promoted through the SPF-SIG, bringing it to scale 

nationwide and shepherding successes into the next step of development. 

The SA-SPG provides prevention funding to ensure that every State and Territory makes 

prevention of substance abuse a priority. The SASPG will allow States and Territories to address 

substance abuse prevention at three levels: universal prevention, which addresses populations at 

59 
large; selected prevention, which targets subgroups of the population who share common risks of 

developing substance abuse disorders (such as children with a family history of substance abuse 

or schools in high poverty areas); and indicated prevention, which addresses individuals with 

multiple risk factors, early symptoms, or behaviors that are precursors for substance abuse, but 

who do not require treatment for substance abuse. States/Territories and communities will be 

able to utilize environmental and individual prevention approaches to achieve measurable results. 

This new program supports SAMHSA’s Prevention of Substance Abuse and Mental Illness 

Strategic Initiative, which aims to create prevention prepared communities where individuals, 

families, schools, workplaces, and communities take action to strengthen protective factors and 

reduce risk factors for substance abuse (including tobacco) and to create environmental changes 

that support community living without the use of substances of abuse. 

Structure and Required Activities: 

The program will consist of discretionary grants to States and Territories. States and Territories 

will continue to be eligible for these funds beyond the initial award so long as they meet the 

requirements of renewal applications, provide the necessary annual reports, and show continued 

movement toward implementing their approved plans. 

Each State and Territory will be required to develop a data-driven strategic plan based on 

information from its epidemiological work group which will be approved by SAMHSA. The 

plan must address, at a minimum: substance abuse, underage drinking (including adults’ 

providing alcohol to minors) and binge drinking; prescription drugs; tobacco use; and it should 

provide for coordinated services for children, youth, and young adults from birth through age 25 

(including working with schools). While the focus will be on youth, additional age groups, 

conditions, and services may be addressed if supported by the State or Territory needs 

assessment. The plan will reflect the results of an assessment of need, a review of the resources 

and capacity within the State or Territory, and in local communities, a plan for carrying out the 

strategy, monitoring the strategy as it is implemented, and an evaluation to identify strengths and 

weaknesses. 

States and Territories will be allowed to retain up to 15 percent of the funds for State-level 

activities to achieve positive outcomes, including the operation of a State or Territory prevention 

advisory group, epidemiological work group, training and technical assistance to communities, 

data collection and evaluation, development and dissemination of State or Territory-wide 

messages and resources, and oversight and monitoring of funded communities. States and 

Territories will be able to use funds for coordinated workforce development, training in 

evidence-based practices, and the development of coordinated infrastructure and service delivery 

systems in high need communities. Up to five percent of the grant funds may be used for 

administrative costs. 

States and Territories will be required to allocate at least 80 percent of the funds to local highrisk, high-need communities to organize coalitions or other approaches to carry out activities in 

keeping with the plan while addressing the particular needs of the community. Each community 

selected for funding will be responsible for aligning its programming with the plan. In carrying 

out these activities, the State or Territory, and communities receiving these funds will be 

60 
required to establish a comprehensive community plan that utilizes evidence-based and/or

proven successful programs, policies or practices. 

Other Requirements:

The SA-SPG will also contain restrictions and limitations similar to those that currently are in 

the other SAMHSA discretionary programs, including prohibiting the use of funds for cash 

payments to participants (except for certain designated incentive payments), construction or 

major renovation of buildings, as a match for any other Federal program, or for services in jails 

and prisons. Using CSAP Discretionary authority, this new SA-SPG can be more directive and 

increase accountability of Federal funds, and it will require States and Territories to monitor and 

report on specific program outcomes, while continuing to allow States and Territories to use 

additional SABG funds for prevention services should they so choose and plan to do so. 

States and Territories that would have received a continuation SPF-SIG or Partnerships for 

Success grant would be strongly encouraged to use SA-SPG funds to continue the services and 

activities provided under those grants to reach their natural conclusion in accordance with their 

sustainability plans. 

The final allocation for this program will reflect a formula that considers the population and 

prevention needs analysis; and that will ensure each State receives no less than the amount 

received under the previous SABG 20 percent prevention set-aside in FY 2010, assuming the 

amount proposed is appropriated by Congress. 

Funding History 

61 

FY Amount

2007 $0

2008 $0

2009 $0

2010 $0

2011 $0
Budget Request 

The FY 2012 President’s Budget request is $395 million, an increase of $395 million from the 

FY 2010 Level. That amount includes funding from combining the 20 percent prevention setaside ($343 million) requirement of the SABG, along with $51 million in funding from the 

previous Strategic Prevention Framework program. 

Outcomes and Outputs 

Substance Abuse - State Prevention Grants 

Table 1: Key Performance Indicators for Substance Abuse - State Prevention Grants 

Measure Most Recent 

Result 

FY 2011 

Performance 

Target 

Associated 

with FY 2010 

PB 

FY 2013 

Performance 

Target 

Associated 

with FY 2012 

Request 

FY 2013 

Performance 

Target +/- FY 

2011 

Performance 

Target 

2.3.85: Number of persons served 

(Output) N/A N/A TBD N/A 

2.3.90: Percentage of youth age 12-

20 who report drinking in the past 

month (HHS Strategic Plan measure) 

(Outcome) 

FY 2009: 

27.2 % 

(Historical 

Actual) 

N/A TBD N/A 

2.3.97: Percentage of youth age 12-

25 who report misuse of prescription 

drugs 

N/A N/A TBD N/A 

The performance measures above are preliminary and are still being refined. As plans for the 

SPG are finalized, the performance measures and targets will be re-evaluated and modified. It is 

expected that measures of emotional health will also be added. 

Grant Award Table 

(whole dollars) FY 2010 FY 2011 FY 2012

Number of Awards 0 0 59

Average Award $0 $0 $2,156,924

Range of Awards $0 $0 $23,355 - $50,331,821

62 
Behavioral Health - Tribal Prevention Grants 

(Dollars in Thousands) 

FY 2010 

Actual

FY 2011 

Continuing 

Resolution

 FY 2012

President's 

Budget

Behavioral Health - Tribal Prevention Grants......................... $--- $--- $50,000

ACA Prevention Fund (non-add) .............................................. --- --- (50,000)

Authorizing Legislation ........................................................Section 516 and 520A of the PHS Act 

FY 2012 Authorization ...............................................................................................................N/A 

Allocation Method ........................................................................................... Discretionary Grants

Purpose

SAMHSA proposes to introduce a new Behavioral Health – Tribal Prevention Grant (BH-TPG)

starting in FY 2012, focusing exclusively on promoting overall behavioral health by preventing 

alcohol and substance abuse and by preventing suicides in the 565 Federally-recognized Tribes. 

Promotion of strong emotional health is an important contributor to the prevention of substance 

abuse and some mental illnesses as well as in reducing their negative impact on Tribal 

communities. The BH-TPG represents a significant advance in the Nation’s approach to 

substance abuse and suicide prevention in several ways. First, it recognizes that emotional health 

is part of overall health and thus supports the Tribes in addressing overall health, including 

preventing and reducing substance abuse, suicides and mental illness, in a coordinated manner. 

Second, it establishes a single coordinated mental health and substance abuse program for all 

Federally-recognized Tribes. Third, SAMHSA will consult and work closely with Tribes and 

Tribal leaders to develop a comprehensive, data-driven planning process to identify and address 

the most serious issues in each Tribal community. Recognizing the Federal obligation to help 

Tribes deal with physical and behavioral health issues, SAMHSA will work in consultation with 

Tribes to determine the best approaches. 

Bringing Substance Abuse and Suicide Prevention to Scale for all Tribes

The proposal recognizes that Tribes currently receive different levels of mental health and 

substance abuse prevention services. Through the BH-TPG, all Tribes would be eligible for a 

base funding amount, with the remaining funds distributed to best serve the Tribal populations. 

SAMHSA will hold consultation(s) consistent with SAMHSA’s Tribal Consultation Policy to 

determine how these funds would be best distributed to address as many of the needs of the 

Tribes as possible. The BH-TPG provides enhanced substance abuse (including alcohol) and 

suicide prevention funding to the Tribes to assure that their pressing needs are being met. This 

effort follows the lead of the President and Congress who have emphasized the importance of 

emotional health, prevention, and health promotion. 

63 
Structure and Required Activities

The program will provide funds to Tribes who choose to apply. This will enable Tribes to 

develop a comprehensive plan to address the most pressing need based on treatment data as well 

as in consultation with SAMHSA. The plan would address the prevention of substance abuse 

and suicide, and will provide for coordinated services. This planning activity is one of the basic 

components of the Tribal Law and Order Act (TLOA) and the Indian Alcohol and Substance 

Abuse Act, which SAMHSA is charged to coordinate in statute. Tribes will continue to be 

eligible for these funds beyond the three-year time frame so long as they meet the requirements 

of renewal applications, provide the necessary annual reports, and show continued movement 

toward implementing their approved plans. 

The plan will reflect the results of an assessment of need, a review of the resources and capacity 

within the Tribal communities, a plan for carrying out the strategy, a monitoring of the strategy 

as implemented, and an evaluation of the strategy to identify strengths and weaknesses. 

SAMHSA will review and approve the plans. 

Tribes will be allowed to use a set percentage (determined after consultation with Tribes) of the 

funds for a combination of service and service-related activities, development and dissemination 

of prevention messages, and provider development and linkage building to support the Tribes in 

achieving outcomes. Funding for infrastructure activities will enable the Tribe to build service 

capacity. The Tribe will present data to support how the allocation will support infrastructure 

and/or provision of services. In carrying out these activities, the Tribe will be required to use 

comprehensive, evidence-based programming, and/or proven successful programming, based on 

either mainstream science or proven Tribal traditions. Up to 20 percent of the grant funds may 

be used to fund key support and development activities, such as operation of a Tribal prevention 

advisory group, support for a Tribal community coalition, access to an epidemiological work 

group, training and technical assistance to communities, data collection and evaluation, and 

oversight and monitoring of activities. 

Approximately 75 percent of Federally-recognized tribes have a total enrollment of 2,000 or 

fewer persons and a greater percentage of these tribes have limited internal capacity or 

infrastructure in place to implement and support needed behavioral health services. Smaller 

Tribes will have the opportunity to work in collaboration with other small Tribes to maximize 

the impact of the resources. SAMHSA will consult with the smaller Tribes to ensure that their 

needs are being met while reducing service overlap. 

 

To ensure that providers in both the mental health and substance abuse fields are trained in both 

substance abuse and mental illness prevention and emotional health concepts and practices, 

Tribes will be able to use funds for coordinated workforce development, training in evidencebased practices, and the development of coordinated infrastructure and service delivery systems. 

Budget Request 

 

The FY 2012 President’s Budget Request is $50 million through the Prevention and Public 

Health Fund of the ACA. Approximately half of the funding would be allocated as a “base 

64 
level” to Federally-recognized Tribes that make an application to receive these funds. It is 

anticipated that the base amount each Tribe would be eligible for is approximately $50,000, 

depending on the number of Tribes that apply. Larger Tribes may be eligible for additional 

funding based on some combination of population and need. The remaining funds will be 

distributed to best serve the population. The details of the funds distribution will be determined 

in consultation with Tribes. 

Outcomes and Outputs 

Behavioral Health - Tribal Prevention Grants 

Table 2: Key Performance Indicators for Behavioral Health - Tribal Prevention Grants 

Measure Most Recent 

Result 

FY 2011 

Performance 

Target 

Associated 

with FY 2010 

PB 

FY 2013 

Performance 

Target 

Associated 

with FY 2012 

Request 

FY 2013 

Performance 

Target +/- FY 

2011 

Performance 

Target 

2.3.92: Number of persons served 

(Output) N/A N/A TBD N/A 

2.3.93: Percentage of youth age 12-

20 who report drinking in the past 

month (Outcome) 

N/A N/A TBD N/A 

2.3.98: Percentage of persons aged 12 

and older who report suicidal ideation N/A N/A TBD N/A 

The Behavioral Health - Tribal Prevention Grants will hold tribes accountable for achieving 

measurable outcomes for their citizens. Program performance measures are still being developed 

and will be provided at a later date. 

Grant Award Table 

(whole dollars) FY 2010 FY 2011 FY 2012

Number of Awards 0 0 655

Minimum Award $0 $0 $50,000

65 
Page intentionally left blank 

66 
Mental Health - State Prevention Grants 

(Dollars in Thousands) 

FY 2010 

Actual

2011 FY

Continuing 

Resolution

FY 2012

President's 

Budget

Mental Health - State Prevention Grants.................................. $24,993 $25,000 $90,000

Project LAUNCH (non-add)...................................................... (24,993) (25,000) (25,000)

Authorizing Legislation ..................................................................... Section 520A of the PHS Act 

FY 2012 Authorization ...............................................................................................................N/A 

Allocation Method ........................................................................................... Discretionary Grants

Purpose

In FY 2008, Congress provided funding to implement the Linking Actions for Unmet Needs in 

Children’s Health (Project LAUNCH) Wellness Initiative. Project LAUNCH promotes and 

enhances the wellness of young children by increasing grantees’ capacity to develop 

infrastructure and implement prevention/promotion strategies necessary to promote wellness for 

young children. LAUNCH has been focused on children aged zero through eight. The FY 2012 

Budget proposes expanding this program construct into State Prevention Grants which will 

promote the wellness of children, youth and young adults up to age 25 building on the findings 

and recommendations of the 2009 IOM report on Preventing Mental, Emotional, and Behavioral 

Disorders Among Youth People. The overall purpose of this new discretionary grant program is 

to provide support to States and Territories in their efforts to implement State-wide 

comprehensive prevention strategies to address the prevention of mental illnesses and reduce the 

impact of mental illness on America’s communities. 

The MH-SPG program will provide funding for all States and U.S. Territories in order to: 

 Use evidence-based practices to promote known protective factors for mental health in 

children and youth and to reduce risk factors for mental illness and substance abuse; 

 Prevent or delay the onset of mental illnesses and prevent suicide; and, 

 Build mental health promotion and mental illness prevention capacity and infrastructure 

at the State, local, and community levels. 

Background

The 2009 Institute of Medicine Report on Preventing Mental, Emotional, and Behavioral 

Disorders Among Young People provides evidence that a set of risk and protective factors affects 

the development of mental and substance use disorders in youth. For example, children with 

strong coping skills who live in safe, stable families and communities tend to develop certain 

mental illnesses less often than those who have not had these advantages. Although many 

mental illnesses have a biological basis, improvements in these personal, family, and community 

factors can help prevent, delay, and/or reduce the severity of these illnesses. Evidence also 

67 
demonstrates that community risk and protective factors, such as poverty, violence, gangs, etc. 

can have a negative impact on the healthy development of young people in neighborhoods. 

Community norms, values, and beliefs are powerful factors in fostering positive community and 

youth development. Collectively, improvements in these areas can reduce the impact of mental 

illness on America’s communities. 

The MH-SPG will require States and Territories to address mental health promotion and mental 

illness prevention at three levels of prevention practice: Universal, which addresses populations 

at large; selective, which targets individuals or subgroups of the population whose risk of 

developing mental, emotional, or behavioral disorders is significantly higher than average (such 

as children with a family history of abuse or schools in high poverty areas); and indicated, which 

addresses individuals with early symptoms or behaviors that are precursors for a disorder, but are 

not yet diagnosable. SAMHSA will require States and Territories to consider and utilize 

environmental and policy approaches as well as individual approaches in developing the 

application for these funds. This coordinated approach supports SAMHSA’s Prevention of 

Substance Abuse and Mental Illness Strategic Initiative, which aims to create prevention 

prepared communities where individuals, families, schools, workplaces, communities, and States 

and Territories take action to promote emotional health and to prevent mental illness, substance 

abuse (including tobacco), and suicide. 

Moving Mental Health Promotion and Mental Illness Prevention to a National Scale

The new Mental Health – State Prevention Grant program brings the success realized in 

SAMHSA’s discretionary grant programs to a broader scale. States and Territories will be 

required to use data to identify communities at highest risk and select proven mental health 

promotion and mental illness prevention programs and practices based on community needs. A 

statewide approach to comprehensive prevention planning will help bring these proven practices 

to an operational and implementation scale. 

By providing a stable and predictable source of funding through the MH-SPG, SAMHSA will 

support the development of a mental health promotion/mental illness prevention infrastructure in 

every State and Territory. This new grant program will require States and Territories to work 

across child-serving and other human service systems (e.g., State and local education authorities, 

schools, maternal and child health, public health, primary care, juvenile justice, child welfare, 

substance abuse, and faith communities) to engage and leverage existing Federal, State, and local 

resources already dedicated to or aligned with the prevention of mental, emotional, and 

behavioral disorders. 

The MH-SPG program is based on recommendations within the 2009 Institute of Medicine’s 

Report, “Preventing Mental, Emotional, and Behavioral Disorders Among Young People,” 

which outlined recommendations for building partnerships across Federal, State, and local 

agencies, and research institutions to address risk factors that can lead to mental illness. As 

recommended by the IOM Report, the MH-SPG program will promote protective factors and 

implement evidence-based programs that prevent or delay the onset of mental disorders and 

prevent suicide by supporting resilience and healthy development among children, youth, and 

young adults. In so doing, States and Territories will help improve the Nation’s behavioral health 

68 
and reduce individual, community and governmental costs associated with substance abuse and 

mental illness. 

The MH-SPG program will require State agencies to use data to identify evidence-based mental 

health promotion and mental illness prevention activities, programs, practices, and policies for 

implementation in high-need/high-risk communities. States and Territories will be expected to 

respond to a set of prevention principles that will guide the MH-SPG, including being culturally 

competent, community-led, data-driven, evidence-based, and outcomes-oriented. This will be an 

infrastructure and service delivery grant program that will provide a comprehensive prevention 

process and will support an array of activities to help grantees build a solid foundation for 

delivering and sustaining effective mental illness prevention services and reducing problems 

associated with mental illness. 

Following a comprehensive needs assessment process, grantees will develop Statewide plans for 

enhancing the prevention infrastructure, training, and service systems at the State and local 

levels. Ultimately, States and Territories will assist and support high-risk/high-need 

communities to promote mental health, reduce mental and substance use disorders, and prevent 

suicide among children, youth, and young adults. 

The MH-SPG program will provide targeted prevention funding to the States and Territories to 

ensure that every State makes the promotion of mental health and the prevention of mental 

illness a priority. This effort follows the lead of the President and Congress who, in passing 

health care legislation, emphasized the importance of prevention as an essential element of 

overall health. 

Structure and Required Activities

The MH-SPG program will be a discretionary formula grant program. States and Territories will 

continue to be eligible for these funds beyond initial grant award so long as they meet the 

requirements of each renewal application, provide the necessary annual reports, and show 

continued movement toward implementing their approved plans. 

Each State/Territory will be required to develop a strategic plan based on national, 

State/Territory, and local epidemiological data sources and should describe a system with 

appropriate monitoring, funding and workforce resources. The plan must address, at a minimum, 

coordinated mental health promotion, mental illness prevention, and suicide prevention services 

for children, youth, and young adults from birth through age 25. States and Territories will be 

expected to work across child and youth serving systems (including working with schools) and 

may include school readiness, violence/trauma prevention, suicide prevention, depression, 

conduct/oppositional defiant disorder, ADHD, eating disorders, high risk behavior, and anxiety 

disorders as priority areas. States and Territories will be expected to indicate the evidence-base, 

utilizing the IOM report or other relevant scientific evidence, of the programs, services and 

activities they plan to fund. Data tracking the outcome of these expenditures, specifically 

decreasing disorders, risk factors, and suicide attempts and completions, and increasing 

protective factors and/or emotional health in the communities funded. 

69 
70 

FY 2011 FY 2013 FY 2013 

 

States and Territories will be required to allocate most of the funds to local communities to 

organize and carry out the promotion and prevention activities identified in the State plan while 

addressing the particular needs of communities. The final allocation strategy, including 

limitations for administrative expenditures, for this new grant program is currently under 

development and will allow all States and Territories to be eligible to receive a Mental Health – 

State Prevention Grant. 

Using the CMHS PRNS authority, this new MH-SPG can be more directive and increase 

accountability of Federal funds and it will require States and Territories to monitor and report on 

specific program outcomes. 

Budget Request 

The FY 2012 President’s Budget request is $90 million, including $25 million to continue grants 

funded under the current Project LAUNCH and $65 million available for new Mental HealthState Prevention Grants (MH-SPG). As grants reach their natural end, funding will be recycled 

from LAUNCH into the new MH-SPGs to expand and enlarge the LAUNCH construct 

Nationwide. 

Outcomes and Outputs

Table 3: Key Performance Indicators for Mental Health - State Prevention Grant 

Measure Most Recent 

Result 

Performance 

Target 

Associated 

with FY 2010 

PB 

Performance 

Target 

Associated 

with FY 2012 

Request

Performance 

Target +/- FY 

2011 

Performance 

Target 

2.3.94: Number of persons served

(Output) N/A N/A TBD N/A 

2.3.95: Number of persons trained in 

mental illness prevention or mental 

health promotion (Outcome) 

N/A N/A TBD N/A 

2.3.99: Percentage of youth age 12-25 

who experienced a Major Depressive 

Episode in the past 12 months 

N/A N/A TBD N/A 
71 

SAMHSA/Innovation and Emerging Issues

Table of Contents 

SAMHSA/Innovation and Emerging Issues Page

1. Summary of Programs ............................................................................................................ 73

2. Agency-Wide Initiatives ......................................................................................................... 75

3. Military Families Initiative ..................................................................................................... 76

4. Health Information Technology Demonstrations ................................................................... 77

5. Prevention Prepared Communities ......................................................................................... 78
72 

Page intentionally left blank 
73 

SAMHSA/Innovation and Emerging Issues

Summary of Programs 

(Dollars in Thousands)

Innovation and Emerging Issues

FY 2010 

Actual

FY 2011 

Continuing 

Resolution

FY 2012 

President's 

Budget

Agency-Wide Initiatives --- --- $14,000

CMHS 327,842 327,689 270,893

CSAP 75,438 75,527 69,376

CSAT 406,434 405,995 390,919

PHS Evaluation Funds 2,000 2,000 2,000

Subtotal, Innovation and Emerging Issues $811,714 $811,211 $747,188

ACA Prevention Fund

Primary and Behavioral Health Care Integration 20,000 35,000 20,000

Garrett Lee Smith Youth Suicide Prevention --- 10,000 ---

Prevention Prepared Communities --- --- 22,600

Screening, Brief Intervention, & Referral to Treatment --- 25,000 ---

Health Surveillance --- 18,000 ---

Subtotal, ACA Prevention Fund 20,000 88,000 42,600

Total PL, Innovation and Emerging Issues $831,714 $899,211 $789,788

The Innovation a nd E merging Issues ( IEI) p rograms i nclude $839.8 m illion, i ncluding $ 92.6 

million f rom t he A CA P revention F und t o s upport all g rant c ontinuations a s w ell a s ta rgeted 

investments in new initiatives. The FY 2012 Budget embraces a new vision for SAMHSA which 

employs the discretionary grants as testing grounds for innovative approaches that, once proven, 

will be brought to scale nationwide by leveraging the Block Grants and State-level prevention 

grants. The programmatic activities include:

• $56.6 million for Agency-Wide Initiatives, including Prevention Prepared Communities, 

Primary and B ehavioral H ealth Integration, Military F amilies, and Health I nformation 

Technology. 

• $270.9 million f or M ental H ealth a ctivities, in cluding P rimary and B ehavioral Health 

Care Integration, S uicide P revention, Youth Violence P revention, Minority A IDS, 

Minority F ellowships, a nd H omelessness P revention. T his i ncludes a H HS/HUD 

Homelessness P revention a nd H ousing Initiative, w hich i s a cr oss-SAMHSA

collaboration with CSAT. 
74 

• $69.4 million for Substance Abuse Prevention activities, including Minority AIDS, STOP 

UAD Act, Fetal Alcohol Spectrum Disorder Center of Excellence, Minority Fellowships, 

and Science and Service Program Coordination. 

• $392.9 million for Substance Abuse Treatment activities, including SBIRT, Targeted 

Capacity Expansion, Pregnant & Postpartum Women, Access to Recovery, Minority 

AIDS, Homeless Programs, Criminal Justice Activities, and Minority Fellowships. This 

includes a HHS/HUD Homelessness Prevention and Housing Initiative, which is a crossSAMHSA collaboration with CMHS. The funding also includes $2.0 million in PHS 

Evaluation Funds for evaluation of SBIRT. 

The IEI program includes grants formerly organized in the Programs of Regional and National 

Significance for the Center for Mental Health Services, the Center for Substance Abuse 

Prevention, and the Center for Substance Abuse Treatment. The program lines and their 

associated funding have been realigned into the IEI budget line, and comparable adjustments for 

FY 2010 and FY 2011 have been made. 

In July 2010, the Obama Administration released the first comprehensive National HIV/AIDS 

Strategy for the United States (NHAS). The NHAS was the result of unprecedented public input, 

including 14 HIV/AIDS community discussions held across the country, as well as an online 

suggestions process, various expert meetings and other inputs. Senior officials at SAMHSA 

were involved in a Federal interagency working group that reviewed recommendations from the 

public and worked with the Office of National AIDS Policy to develop the NHAS. The Strategy 

focuses on three overarching goals: reducing the number of new HIV infections, increasing 

access to care for people living with HIV, and reducing HIV-related health disparities.

SAMHSA is committed to supporting the NHAS through the promotion of evidence-based 

prevention interventions and behavioral health services and treatment for people at risk for or 

living with HIV/AIDS who have co-occurring mental and/or substance use disorders. A mental 

and/or substance use disorder can facilitate HIV transmission and also may negatively impact 

housing stability, adherence to drug protocols, and acceptance of behavioral health treatment and 

services for people living with HIV/AIDS. Thus, behavioral health services are intrgral to a 

comprehensive approach to HIV/AIDS prevention, care and treatment. 

SAMHSA specifically is working with its Federal partners to 1) improve the coordination of 

behavioral health resources and services for racial and ethnic minorities at risk for or living with 

HIV/AIDS living in the 12 cities most impacted by HIV/AIDS; 2) develop a behavioral health 

and HIV/AIDS webpage and related materials that will be located on AIDS.Gov and 

disseminated through the use of social marketing; 3) assess HIV testing capacity and frequency 

in SAMHSA funded drug-treatment centers; 4) address the needs of people living with 

HIV/AIDS who are homeless; 5) address the prejudice and discrimination related to HIV/AIDS; 

and 6) develop self-directed and wellness-centered approaches to behavioral health care for 

people living with HIV/AIDS. 
75 

Agency-Wide Initiatives

(Dollars in Thousands) 

Agency-Wide Initiatives

FY 2010 

Actual

FY 2011 

Continuing 

Resolution

FY 2012 

President's 

Budget

Military Families Initiative --- --- $10,000

Health IT Demonstration Project --- --- 4,000

Subtotal, Agency-Wide Initiatives --- --- $14,000

ACA Prevention Fund

Primary and Behavioral Health Care Integration 20,000 35,000 20,000

Prevention Prepared Communities --- --- 22,600

Subtotal, ACA Prevention Fund within IEI 1/ 20,000 35,000 42,600

Total PL, IEI - Agency-Wide Initiatives $20,000 $35,000 $56,600

1/ Narrative for the Behavioral Health Tribal Prevention Grant can be found in the State, Tribal and 

Community Prevention Grants Chapter

Authorizing Legislation ................ Sections 509, 516, and 520A of the Public Health Service Act

FY 2012 Authorization ......................................................................................................... Expired

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

Program Description and Accomplishments

SAMHSA considers States and Tribes ke y partners in transforming healthcare in America and 

believes that it is imperative to maintain and grow their funding and capacity during this time of 

transition. A s States, Tribes a nd c ommunities a re mo st f amiliar w ith th e b ehavioral h ealth 

service n eeds of th eir populations, it is imp ortant to ma intain th e c ritical b alance b etween 

supporting s ervice capacity a nd i dentifying emerging be st p ractices. A ccordingly, S AMHSA 

proposes f unding f or a n SAMHSA-wide budg et l ine f or Innovation a nd E merging Issues. In 

coordination w ith S AMHSA’s B lock G rants and P revention G rants, where evidence-based 

practices will be brought to scale, the Innovation and Emerging Issues program would support 

States, T ribes a nd c ommunities i n t esting ne w a pproaches, s eeking o ut be st-practices, an d 

developing improved services. Additionally, current programs that show promise are continued 

so that the lessons learned can be fully incorporated into a State’s action plan. 
76 

Funding History

FY Amount

2007 $0

2008 $0

2009 $0

2010 $0

2011 $0

Budget Request

The FY 2012 President’s Budget request is $36.6 million. This funding level reflects new 

funding for new initiatives that show promise, funding for Military Families, Health Information 

Technology, and the Prevention Prepared Communities (funded out of the ACA Prevention 

Fund). 

Military Families Initiative

The FY 2012 President’s Budget request includes $10 million for the Military Families Initiative. 

There is an increasing need to counter the impact of deployment and trauma-related stress on 

military families, particularly children. As the Federal agency in charge of behavioral health for 

all Americans, SAMHSA’s role will shift from supporting to leading through partnerships and 

providing services and supports as needed. This initiative will address the behavioral health 

needs of military service personnel and their families served through the public health service 

system. Utilizing a two-phased funding approach, it would support infrastructure development, 

including coordination and capacity building as well as direct service supports for prevention, 

treatment and recovery support services for those communities most impacted by the needs of 

service members, veterans, and their families. The request includes $3.5 million for Policy 

Academies and $6.5 million to support direct service grants. 

The first phase addresses the requisite infrastructure and capacity building at the state level for 

forming collaborative relationships among agencies responsible for providing behavioral health 

services and those entities such as the Department of Defense, Department of Veterans Affairs, 

National Guard Bureau, and National Guard and Reserve Units who are responsible for service 

members, veterans and their families. The participation of these key Federal, State and local 

partners is critical for successful matching/mapping of service resources and population need. 

Support for infrastructure and capacity building would be accomplished through funding of an 

expanded series of Policy Academies which would be offered to all States and Territories. These 

Policy Academies would provide a forum for all States and Territories to consider how existing 

policies, program resources, and service infrastructure influence the ability of services to respond 

to the target groups, and whether there are efficiencies or modifications to systems or operations 

that might improve those responses. The overall goal of the Policy Academy is to facilitate the 

establishment of a State-wide readiness plan to comprehensively addressing the behavioral 

health needs of military service members, Veterans and their families and strengthens behavioral 
77 

health care systems and services for returning service members, Veterans, and their families 

through ongoing collaboration at the State and local levels. 

The impact and sustainability of the work of the Policy Academies would be strengthened 

through funding that would be made available to the participating States and Territories of each 

Academy to (1) provide support for the implementation of components of the strategic plan for 

infrastructure and coordination for two years following their participation in the Academy; (2) 

develop and implement a GIS mapping system/strategy for the State/Territory to coordinate 

existing resources and areas of need; (3) promote information exchange between behavioral 

health and military and veteran agencies; and (4) promote training of providers to offer informed 

and quality care to this population. Proposed funding for infrastructure and capacity building 

through Policy Academies is $3.5 million. This will provide support for up to 30 States. 

The second phase of funding proposes to provide direct support for behavioral health prevention, 

treatment and recovery support services for communities most impacted by behavioral health 

needs of service members, veterans, and their families. Grants will be provided to States and/or 

communities demonstrating high rates of military populations (including Active Duty, National 

Guard, Reserve and Veteran) in local/regional populations. SAMHSA will work collaboratively 

with our HHS partners at HRSA, ACF and IHS as well as other Federal partners including the 

Departments of Veterans Affairs, Defense, and the National Guard Bureau on this initiative.

These service grants would provide funding for a menu of evidence-based behavioral health 

prevention, treatment and recovery support services, as well as strategies designed to link the 

target population to needed services, and would provide direct assistance to those individuals and 

communities most in need of resources for this population. Grants would be made to based on 

the quality of their application that outlines both need and proposed service strategies, including 

strategies that reduce barriers to care and promote accessibility, and on evidence of existing or 

planned mechanisms to ensure awareness of and connection to existing DoD and VA resources 

as needed. An environmental scan of existing promising prevention strategies and treatment 

programs would be conducted to provide a menu of services that states/communities can draw 

upon in developing their applications The grants would include an evaluation protocol to 

determine not only the effectiveness of the grants but also to determine those most effective 

strategies and services to support future service planning. Proposed funding for direct service 

grants to support the behavioral health service needs of military members and their families is 

$6.5 million and will support up to 10 States. 

Health Information Technology Demonstrations

The FY 2012 President’s Budget request includes $4 million for health information technology 

(HIT) that will focus on creating pilot implementation projects related to behavioral health (BH) 

data standards developed in 2011. SAMHSA will work with States and discretionary grantees 

who will participate in the pilots. Projects will focus on the following three areas in 2012: 

1) Interoperable privacy, confidentiality, and patient consent in electronic health records (EHR) 

and health information exchanges (HIE). Specific activities include the following: 
78 

• Identify and refine policies and requirements that identify terms of choice for patient 

privacy consent directives. 

• Translate policy statements into machine and human readable, near natural language 

(NNL) access and use control specifications. 

• Translate NNL specifications into “tags” that code access, use, and disclosure 

requirements within clinical data elements, clinical record segments, or entire records. 

2) Work on BH data interoperability using national standard constructs will include the 

following: 

• Develop specific data standards using vocabulary adopted by Office of the National 

Coordinator for Health Information Technology (ONC). 

• Develop and collect data on BH quality and performance measures; 

• Partner with other Federal agencies in the adoption of national vocabulary standards in 

EHR systems, personal health record (PHR) systems, and HIEs.

• Test open-source Web services that can be re-used by specialty behavioral health 

prevention and treatment providers nationwide. 

3) Develop an implementation guide for each behavioral health quality measure which: 

• Includes a model of suggested clinical workflow where each quality measure can be 

documented during normal service delivery with meaningful use standard clinical data. 

• Includes specifications needed to automatically report each quality measure and 

supporting data to public authorities. 

• Describes how to objectively document behavioral health needs, services delivered, and 

service outcomes across entire State safety nets.

• Describes how standard clinical data may be mapped to screening or assessment 

instrument questions. 

 Prevention Prepared Communities

The Prevention Prepared Communities program is a cornerstone of the National Drug Control 

Strategy and is designed to lay the foundation for a national, evidence-based, communityoriented system to prevent the onset and progression of substance use and associated mental, 

emotional, and problems (e.g., school dropout, delinquency, and violence), among children and 

youth ages 9 to 25 years. A collaborative effort of the Department of Health and Human 

Services, the Department of Education, and the Department of Justice, in partnership with the 

Office of National Drug Control Strategy, the PPC program will provide local communities and 

States with resources to implement a comprehensive array of drug prevention programs and 

policies based on identified needs. Specifically, the PPC program will fund communities at a 

level that enhances their current capacity for strategic planning and operation within States that 

have established cross-agency collaborations, data collection, and technical assistance 

infrastructure. The FY 2012 President’s Budget request includes $22.6 million from the ACA 

Prevention Fund for PPCs. 

The Prevention Prepared Communities program will assist States and communities in developing 

and implementing effective mental illness and substance abuse prevention practices, strategies, 
79 

and policies that will promote the wellness of individuals age 9-25 and the communities in which 

they live. The program builds on scientific evidence that a common set of risk and protective 

factors contributes to a range of mental, physical, and behavioral problems, including substance 

abuse and other unhealthy behaviors. The initiation and use of substances share early common 

developmental pathways with other mental, emotional, and behavioral problems. As youth 

develop, however, risk factors specific to substance use emerge and must be considered when 

designing drug prevention programs. Thus, targeting risk factors and promoting protective 

factors can prevent substance abuse and some mental illnesses as well as other negative 

outcomes. The goal of Prevention Prepared Communities is to improve community and 

individual level wellness, and health promotion outcomes in a comprehensive, collaborative way. 

Performance measures will be collected at both the community and individual level. Measures 

will include population-based indicators of community wellness and at an individual level will 

include measures of positive mental health, abstinence from substance abuse, better juvenile 

justice outcomes and improved academic achievement. 

Under this program, grantee communities will use data-based approaches to identify their 

predominant substance abuse and mental health issue(s), and will select and implement 

evidence-based strategies to target the identified risk and protective factors contributing to these 

issues. Evidence-based strategies may include individual- and family-focused prevention 

programs and practices, environmental strategies, community-wide public education campaigns, 

school-based curricula, and parenting, social, and life skills training Grantees will collaborate 

with appropriate service providers for ages 9-25 to ensure the utilization of best practices for 

universal, selective, and indicated populations. 

Outcomes and Outputs

Military Families

Table 1: Key Performance Indicators for Military Families Initiative 

Measure Most Recent 

Result

FY 2011 

Performance 

Target 

Associated 

with FY 2010 

PB 

FY 2013 

Performance 

Target 

Associated 

with FY 2012 

Request

FY 2013 

Performance 

Target +/- FY 

2011 

Performance 

Target 

3.4.26: The number of behavioral 

health outcomes for military 

personnel and their families served 

through SAMHSA supported 

programs (HHS Strategic plan 

Measure) (Outcome) 

N/A N/A TBD N/A 

3.4.27: Percentage of adults 

receiving services who report 

improved functioning (Outcome) 

N/A N/A TBD N/A 
80 

Measure Most Recent 

Result

FY 2011 

Performance 

Target 

Associated 

with FY 2010 

PB 

FY 2013 

Performance 

Target 

Associated 

with FY 2012 

Request

FY 2013 

Performance 

Target +/- FY 

2011 

Performance 

Target 

3.4.28: Percentage of children 

receiving services who report 

improved functioning (Outcome) 

N/A N/A TBD N/A 

3.4.29: Percentage of adults 

receiving services who had a 

permanent place to live in the 

community (Outcome) 

N/A N/A TBD N/A 

Prevention Prepared Communities

Table 2: Key Performance Indicators for Prevention Prepared Communities

Measure Most Recent 

Result

FY 2011 

Performance 

Target 

Associated 

with FY 2010 

PB 

FY 2013 

Performance 

Target 

Associated 

with FY 2012 

Request

FY 2013 

Performance 

Target +/- FY 

2011 

Performance 

Target 

3.3.04: Percent funded communities 

with reduced school dropout rates

(Outcome) 

N/A N/A TBD N/A 

3.3.05: Percent funded communities 

with reduced rates of domestic 

violence (Outcome) 

N/A N/A TBD N/A 

3.3.06: Number of youth in funded 

communities who report that they 

talk with one or more 

parent/guardian at least 15 minutes 

every day (Output) 

N/A N/A TBD N/A 

Size of Awards

(Whole Dollars) FY 2010 FY 2011 FY 2012 

Number of Awards 0 0 65

Average Award $0 $0 $246,154

Range of Awards N/A N/A $193,000-$1,500,000 
81 

SAMHSA Innovation & Emerging Issues

Table of Contents 

 

1.

SAMHSA/Center for Mental Health Services (CMHS) Page

Summary of Programs .......................................................................................................... 83

2. Mechanism Table by APT .................................................................................................... 85

3. SAMHSA/Innovation and Emerging Issues – Mental Health Services ................................ 87

4. Co-Occurring State Incentive Grant ..................................................................................... 88

5. Youth Violence Prevention ................................................................................................... 88

6. National Child Traumatic Stress Network ............................................................................ 89

7. Children and Family Programs ............................................................................................. 90

8. Consumer & Family Network Grant..................................................................................... 91

9. Mental Health System Transformation and Health Reform ................................................. 91

10. Primary & Behavioral Health Care Integration (PBHCI) ..................................................... 92

11. Community Resiliency & Recovery Initiative (CRRI) ......................................................... 94

12. GLS Youth Suicide Prevention ............................................................................................. 95

13. AI/AN Suicide Prevention .................................................................................................... 96

14. Homelessness Prevention and Housing Program ................................................................. 96

15. Minority AIDS ...................................................................................................................... 97

16. Criminal & Juvenile Justice Programs .................................................................................. 98

17. Practice Improvement/Training ............................................................................................ 98

18. Consumer & Consumer Support TA Centers ....................................................................... 99

19. Minority Fellowship Program (MFP) ................................................................................... 99

20. Disaster Response ............................................................................................................... 100
82 

Page intentionally left blank 
83 

SAMHSA/Center for Mental Health Services

Innovation & Emerging Issues

Summary of Programs 

The Mental Health Innovation & Emerging Issues (IEI) support States and communities in 

carrying out an array of activities to improve the quality and availability of services in priority 

areas. The FY 2012 President’s Budget request for SAMHSA Mental Health IEI includes 

$270.9 million which covers 22 programmatic activities that include:

• $42.0 million for Mental Health Homelessness Prevention Programs (includes the joint 

Homeless Initiative Program) and Homelessness Education Programs to reduce the 

prevalence and impact of mental disorders in the homeless and improve the transition 

from homelessness into stable and permanent housing, including the joint initiative with 

the Center for Substance Abuse Treatment and the Department of Housing and Urban 

Development; 

• $14.0 million for Primary & Behavioral Health Care Integration to promote more 

integrated services between primary care services and mental health services, by 

providing funding resources to facilitate screening and referral for necessary primary care 

prevention and treatment needs. This program also utilizes $20 million from the 

Affordable Care Act Prevention Fund to further expand the program to implement health 

care reform activities; 

• $48.1 million for Suicide Prevention Programs to improve public and professional 

awareness of suicide and promote prevention. The activities include Garrett Lee Smith 

Suicide grants to States and Colleges, the AI/AN Suicide Prevention Initiative, the 

Garrett Lee Smith Suicide Prevention Resource Center, as well as the Suicide Lifeline;

• $11.3 million for National Traumatic Stress Network to improve treatment and services 

intervention for children and adolescents exposed to traumatic events, by funding a 

network of grantees to disseminate the assessment and treatment strategies developed 

through the Network and provide direct trauma-informed services to children and youth; 

• $94.3 million for Youth Violence Prevention activities. The Youth Violence Prevention 

activities include the Safe Schools/Healthy Students collaborative program with U.S. 

Departments of Education and Justice, and the College Emergency Preparedness 

initiative; 

The Mental Health programs underwent a performance assessment in 2005. The assessment 

cited clear purpose, strong financial management, and effective targeting as strong attributes. 

The assessment also reported the program lacked a clear design linking all projects to 

performance goals and did not collect performance data from all grantees or use performance 

data to hold grantees accountable for improving outcomes. As a result of the performance 

assessment, the program has implemented an automated web-based performance system, the 
84 

Transformation Accountability System, for all of its services programs and is working to expand 

use of the system to the remaining programs. SAMHSA is also working on the development and 

implementation of common performance measures for its technical assistance, infrastructure 

development, and prevention programs. 
85 

SAMHSA/Center for Mental Health Services

Mechanism Table by APT

(Dollars in Thousands)

Innovation & Emerging Issues FY 2010 Actual

FY 2011 

Continuing 

Resolution

FY 2012 

President's 

Budget 

FY 2012 PB +/- 

2010

No. Amount No. Amount No. Amount No. Amount

Grants/Cooperative Agreements:

Continuations.................................................. 300 $126,895 330 $123,969 306 $105,905 -24 -$18,064

New/Competing.............................................. 166 49,016 116 53,651 73 30,770 -43 -22,881

Supplements....................................................

Subtotal.......................................................

 0 1,478 0 0 0 0 0 0

466 177,389 446 177,620 379 136,675 -67 -40,945

Contracts:

Continuations.................................................. 43 136,713 43 140,733 35 128,277 -8 -12,456

New/Competing.............................................. 7 13,741 10 9,336 5 5,941 -5 -3,395

Supplements....................................................

Subtotal.......................................................

 0 0 0 0 0 0 0 0

50 150,453 53 150,069 40 134,218 -13 -15,851

Total, IEI CMHS.............................................. 516 327,842 499 327,689 419 270,893 -80 -56,796
86 

Page intentionally left blank 
87 

SAMHSA/Innovation and Emerging Issues – Mental Health Services

(Dollars in Thousands)

Authorizing Legislation .... Sections 506, 516, 520, 581, and 582 of the Public Health Service Act 

FY 2012 Authorization ......................................................................................................... Expired

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

Innovation & Emerging Issues

FY 2010 

Actual

FY 2011 

Continuing 

Resolution

FY 2012 

President's 

Budget

Co-Occurring State Incentive Grant ............................. $2,168 $2,168 $2,168

Youth Violence Prevention........................................... 94,393 94,502 94,333

National Traumatic Stress Network.............................. 40,798 40,800 11,300

Children and Family Programs...................................... 9,100 9,194 6,486

Consumer and Family Network Grants ........................ 6,223 6,236 4,966

MH System Transformation and Health Reform ......... 29,179 29,106 10,623

Primary and Behavioral Health Care Integration 1/...... 13,987 14,000 14,000

Community Resilience and Recovery Initiative............ 4,979 5,000 5,000

Suicide Lifeline ............................................................ 5,522 5,522 5,522

GLS - Youth Suicide Prevention - States...................... 29,617 29,738 29,738

GLS - Youth Suicide Prevention - Campus ................. 4,972 4,975 4,975

AI/AN Suicide Prevention Initiative ............................ 2,944 2,944 2,944

GLS - Suicide Prevention Resource Center.................. 4,957 4,957 4,957

Homelessness Prevention Programs.............................. 32,265 32,250 39,696

Homelessness Education Programs............................... 2,306 2,306 2,306

Older Adult Programs................................................... 4,810 4,814 0

Minority AIDS ............................................................. 9,283 9,283 9,283

HIV/AIDS Education.................................................... 966 974 774

Criminal and Juvenile Justice Programs....................... 6,684 6,684 6,684

Congressional Projects.................................................. 5,975 5,975 0

Practice Improvement and Training.............................. 9,454 9,001 7,878

Consumer and Consumer Support TA Centers............. 1,927 1,927 1,927

Minority Fellowship Program....................................... 4,279 4,279 4,279

Disaster Response......................................................... 1,054 1,054 1,054

TOTAL, IEI-CMHS $327,842 $327,689 $270,893

1/ In FY 2012, additional $20 million is allocated from the ACA Prevention Fund for PBHCI 
88 

Co-Occurring State Incentive Grant 

Program Description and Accomplishments

The Co-Occurring State Incentive Grant program, jointly administered with CSAT, develops and 

enhances the infrastructure and increases grantee capacity to provide comprehensive, 

coordinated/integrated, and evidence-based treatment services to persons with co-occurring 

mental health and substance abuse disorders. It is estimated that 5.4 million adults in the U.S. 

are affected by co-occurring mental and substance abuse disorders (National Survey on Drug 

Use and Health, 2007). SAMHSA will continue to promote State and local capacity to address 

the prevention, treatment, and recovery support needs of people with and at risk for co-occurring 

disorders including the promotion of resiliency and access to recovery support services for 

people with co-occurring disorders. 

Youth Violence Prevention 

Program Description and Accomplishments

The Safe Schools/Healthy Students Initiative supports the implementation and enhancement of 

integrated, comprehensive community-wide plans that create safe and drug-free schools and 

promote healthy childhood development. In 2009, school districts participating in the Safe 

Schools/Healthy Students Initiative reported a 15 percent decrease in violent incidents. Eightyfour percent of staff at grantee schools said the Safe Schools/Healthy Students Initiative had 

improved school safety, 77 percent said it had reduced violence on campus, and 75 percent said 

it had reduced violence in the community. 

Since 1999, the U.S. Departments of Education, Health and Human Services, and Justice have 

collaborated on the Safe Schools/Healthy Students Initiative. The Safe Schools/Healthy Students 

Initiative is a discretionary grant program that provides students, schools, and communities with 

Federal funding to implement an enhanced, coordinated, comprehensive plan of activities, 

programs, and services that focus on promoting healthy childhood development and preventing 

violence and alcohol and other drug abuse. Eligible local educational agencies or a consortium 

of local educational agencies, in partnership with their community's local public mental health 

authority, local law enforcement agency, and local juvenile justice entity, are able to submit a 

single application for Federal funds to support a variety of activities, curriculums, programs, and 

services. This grant program supports 146 school districts across the country, spanning rural, 

tribal, suburban and urban areas as well as diverse racial, ethnic and economic sectors. Each 

local strategic plan addresses 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 that all 

agencies concerned with the welfare of children and families could collaborate on an ongoing 

basis. The national cross-site evaluation has found a 15% decrease in the number of students 

involved in violent incidents; a 12% decrease in the number of students reporting that they had 
89 

experienced or witnessed violence from year one of the grant period to year three; and that most 

staff at grantee schools reported that the Initiative had made their schools safer. 

In FY 2010, 3,223,075 children were served by the Safe Schools/Healthy Students Initiative. 

Since baseline was set in 2006, the number served has nearly tripled and the target has been 

exceeded each year. 

The Safe Schools/Healthy Students program is expected to serve 116 communities and over 2.3 

million children in FY 2012. SAMHSA anticipates the percentage of children showing 

improvement in substance abuse, violent incidents, and mental health referrals to remain constant 

in FY 2012. 

Following the tragic shooting events at Virginia Polytechnic Institute and State University 

(Virginia Tech) in 2007, SAMHSA and the Department of Education instituted a joint initiative 

called the College Emergency Preparedness program. These competitive grants provide funding 

to institutions of higher education to develop and implement emergency management plans and 

protocols for preventing campus violence that include mental health and other needs of 

individuals as well as developing written plans for assessing and addressing the mental health 

needs of students who may be at risk of causing campus violence. 

National Child Traumatic Stress Network

Program Description and Accomplishments

In FY 2001, Congress authorized the National Child Traumatic Stress Initiative (NCTSI) to 

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

events. The NCTSI funds a national network of grantees that collaborate to develop and promote 

effective community practices for children and adolescents exposed to a wide array of traumatic 

events. Domestic public and private nonprofit entities are eligible to apply for grants. Centers 

are located in or associated with a diverse group of organizations, such as universities, 

community mental health centers, children’s hospitals, children’s advocacy centers, State 

government agencies, schools, and refugee programs. NCTSI experts provide training and 

technical support on intervention approaches to reduce the traumatic effects of disasters on 

children/adolescents and their families in the immediate and longer term phases of disaster 

response. Since its inception, the National Child Traumatic Stress Network (NCTSN) has 

expanded its reach across the country, with current grantees in twenty-nine States. It has 

provided training or education on child trauma to over 900,000 individuals; more than 95,000 

people were trained in 2009 in nearly 3,000 annual training/education events. In FY 2009, 76 

percent of children receiving services had improved outcomes (percentage showing clinically 

significant improvement).

NCTSI continues to impact the care of thousands of children in systems such as child welfare, 

schools, and juvenile justice through the training and consultation provided to these systems. 

The program has implemented new output measures to track numbers trained as well as number 

of screenings and assessments for better overall management.
90 

In FY 2012 SAMHSA proposes to build on the work of the first phase of the NCTSI and 

implement an expansion of the initiative that will ensure that the core practices developed by the 

current NCTSN are delivered to children and youth in need. The Phase I of the NCTSN will 

fund grants to disseminate the assessment and treatment strategies developed through NCTSN 

and provide direct trauma-informed services to children and youth. The program will provide 

mental health professionals, including personnel in the disciplines of psychiatry, psychology, 

social work, psychiatric nursing, and marriage and family therapy, with a didactic and 

experiential program that will increase their capacity to recognize, diagnose, and treat children 

and adolescents exposed to trauma and their families. The primary goal of this effort is to 

increase the number of qualified behavioral health personnel trained to deal with the special 

problems of traumatized children and adolescents, particularly in areas and settings with severe 

shortages of behavioral health professionals or where children are most at risk for exposure to 

trauma such as children of military families and homeless children and families. This will ensure 

that the core evidence-based practices developed by the NCTSN are delivered to children and 

adolescents in need. 

Phase II of this initiative would take advantage of the creativity and flexibility inherent in the 

NCTSN to provide proactive assistance and appropriate interventions in addressing emerging 

traumatic events such as the loss of a parent among children of military veterans. In addition, it 

will allow the Network to respond to needs of children and youth impacted by the trauma of 

unexpected national emergencies and disasters. It also provides SAMHSA with the opportunity 

to align the NCTSN efforts to many of the SAMHSA Strategic Initiatives, such as Trauma and 

Justice, Military Families, Data, Outcomes and Quality, and Prevention of Substance Abuse and 

Mental Illness. 

SAMHSA expects to award up to 10 new NCTSN grants in FY 2012. A training and technical 

assistance center would also be funded, which would support the national education and training 

efforts for the grantees and the field. In-person training would be of short duration (no more than 

five days) and would be supplemented with online distance education resources, including webbased training and technical assistance materials and resources, web conferencing and a blog. 

Grants would be awarded to public or private nonprofit institutions and organizations, and State 

and local government agencies to select individuals for training in the evidence-based practices 

that have been tested and proven effective within the NCTSN and to provide trainee stipends 

and other allowances (i.e., travel expenses, materials fees, etc.) for individuals enrolled in the 

training program. 

Children and Family Programs 

Program Description and Accomplishments

The Children and Family’s Healthy Transitions Program uses a system of care approach to 

promote a seamless transition to independence and the successful adaptation of adult roles and 

responsibilities for youth and young adults with serious mental health conditions and their 

families. Young people with serious mental health conditions (often with co-occurring substance 
91 

abuse) face a difficult transition to adulthood compared to their peers. Moreover, youth who age 

out of child-serving systems may have difficulty obtaining developmentally appropriate, 

culturally-competent and appealing services and supports as they move into adulthood. These atrisk youth are better able to navigate the transition to adulthood by making available evidencebased, age-appropriate services and supports and create supportive State-level policies. 

The Circles of Care program provides tribal and urban Indian communities with tools and 

resources to build systems of care to promote mental health for children, youth and their families 

in American Indian and Alaska Native (AI/AN) communities by developing the capacity and 

infrastructure necessary to plan and implement these systems. As a result, 13 of 23 grantees 

secured Children’s Mental Health Initiative (CMHI) funding, either directly or indirectly to 

implement the grantee’s model.

Consumer & Family Network Grant 

Program Description and Accomplishments

The Consumer and Family Network grant program is an effort to promote consumer, family, and 

youth participation in the development of policies, programs, and quality assurance activities 

related to the mental health systems reform. 

The Statewide Consumer Network program focuses on the needs of adult mental health 

consumers aged 18 and older by strengthening the capabilities of State-wide consumer-run 

organizations to be catalysts for transforming the mental health and related systems in their State; 

thereby ensuring a focus on consumer recovery and resilience. It establishes sustainable 

mechanisms for integrating the consumer voice in State mental health and allied systems to 

expand service system capacity and support policy and program development. The program 

promotes skill development with an emphasis on leadership and business management, as well as 

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

consumers.

The Statewide Family Network provides education and training to increase family organization 

capacity for policy and service development by: 1) strengthening organizational relationships; 2) 

fostering leadership and business management skills among families of children and adolescents 

with serious emotional disturbance; and 3) identifying and address the technical assistance needs 

of children and adolescents with serious emotional disturbances and their families. The 

Statewide Family Network focuses on families: parents, primary caregivers of children, youth 

and young adults. Young adults are eligible up to age 18, up to age 21 if they have an 

Individualized Education Plan, or up to age 26 if transitioning to the adult system. 

Mental Health System Transformation and Health Reform 

Program Description and Accomplishments

SAMHSA supports the President’s efforts to reform health care by engaging in activities that 

support the transformation of the mental health system. These include the Mental Health 

Transformation Grants and Prevention Practices in Schools grants. 
92 

In FY 2010, SAMHSA awarded 20 Mental Health Transformation Grants (formerly Mental 

Health State Incentive Grants) that will promote the adoption and implementation of permanent 

transformative changes in how communities manage and deliver mental health services. In an 

effort to reach a larger number of communities, the FY 2010 Mental Health Transformation 

grant awards are smaller than the earlier grant awards and leverage existing infrastructures to 

accelerate capacities to address critical system and capacity reform needs in their respective 

communities. In order to complement the efforts of other SAMHSA programs, FY 2010 funding 

for Mental health Transformation Grants focused on services for adults with or at-risk for serious 

mental illnesses. Grantees are now expected to implement evidence-based or best practices that 

will create or expand capacity to address prevention of mental illness, trauma-informed care, 

screening, treatment and support services for military personnel, housing and employment 

supports. Necessary changes to policies and organizational structures to support improved 

mental health services will also be supported along with workforce training, implementation of 

evidence-based practices, and improving access to quality mental health services. 

In FY 2010, SAMHSA awarded 22 Prevention Practices in Schools grants. The purpose of this 

program is to prevent aggressive and disruptive behavior among young children in the short term 

and prevent antisocial behavior and the use of illicit drugs in the longer term. Grantees will 

implement an evidence-based practice in schools, specifically the Good Behavior Game, a 

behavioral classroom management strategy that involves helping children learn how to work 

together. The approach of this practice facilitates a positive learning environment and has been 

shown to decrease disruptive behavior in the classroom. 

In FY 2012, SAMHSA will continue to provide technical assistance and support States and 

communities in implementing flexible solutions to address the burdensome problems of 

substance abuse, mental illnesses, and co-occurring disorders in the criminal justice system 

through collaboration between the Center for Substance Abuse Treatment and the Center for 

Mental Health Services. This approach helps local courts find the model that best meets their 

needs and capacities. It also encourages partnership with the behavioral health system to allocate 

treatment and recovery support services effectively and efficiently.

Primary & Behavioral Health Care Integration (PBHCI)

Program Description and Accomplishments

Physical health problems among people with mental illnesses impact quality of life and 

contributes to premature deaths, where these individuals die much earlier than the general 

population. While several factors contribute to this disparity, empirical findings indicate that 

early mortality among people with serious mental illnesses is clearly linked to the lack of access 

to primary care services.

In FY 2009, SAMHSA initiated the Primary and Behavioral Health Care Integration (PBHCI) 

Program and funded 13 PBHCI grants. PBHCI grantees began providing primary care services 

to consumers with serious mental illness in February 2010, and are currently engaged in a variety 

of activities which including developing electronic health record systems, developing data 

collection systems, and perhaps most importantly, providing primary care and health/wellness 
93 

services. In FY 2010, SAMHSA awarded 43 additional grants, mainly funded with Affordable 

Care Act’s Prevention funds. These will be fully supported in FY 2012. 

The PBHCI program will provide resources to facilitate screening and referral for necessary 

primary care prevention and treatment needs; develop a registry/tracking system for all primary 

care needs; provide care management, individualized person-centered planning and coordination 

to increase consumer participation and follow up with all primary care screening, assessment and 

treatment services; provide prevention and wellness support services (including nutrition 

consultation, health education and literacy, tobacco cessation, peer support specialists, selfhelp/management programs); and develop processes for referral and follow-up for needed 

treatments that are not appropriately provided in a primary care setting. By building the 

necessary partnerships, grantees will expand their offerings of primary healthcare services for 

people with mental illnesses, resulting in improved health status. By making available 

coordinated primary care services in community-based behavioral health settings, grantees will 

improve the overall wellness and physical health status of people with serious mental illnesses 

The PBHCI program supports the coordination and integration of primary care services into 

publicly-funded community behavioral health settings. The expected outcome of improved 

health status for people with serious mental illness 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 are deemed crucial to this program. The 

population of focus for this grant program is individuals with serious mental illness served in the 

public mental health system.

SAMHSA expects that people with serious mental illnesses will show improvement in their 

physical health status through participation in this program. This grant program supports 

SAMHSA’s Pledge for Wellness 10 by 10 Campaign to prevent and reduce early mortality 

among people with mental illness by 10 years over the next 10 years. It is expected that better 

coordination and integration of primary and behavioral health care will lead to outcomes 

including improved access to primary care services; improved prevention, early identification 

and intervention to avoid serious health issues including chronic diseases; enhanced capacity to 

holistically serve those with mental and/or substance use disorders; and better overall health 

status of consumers. 

SAMHSA is collaborating with the HHS/Assistant Secretary for Planning and Evaluation 

(ASPE) on the evaluation for this program, which seeks to address three main questions of 

interest: 1) is it possible to integrate the services provided by primary care providers and 

community-based behavioral health agencies; 2) does the integration of primary and behavioral 

health care lead to improvements in the mental and physical health of the population with serious 

mental illnesses and/or substance use disorders served by these integrated models; 3) which 

models of integrated primary and behavioral health care lead to better mental and physical health 

impacts for the population served. 

In FY 2010, SAMHSA, in partnership with the Health Resources and Services Administration 

(HRSA), funded a Training and Technical Assistance Center for Primary and Behavioral Health 
94 

Care Integration (TTA-PBHCI). The purpose of this program is to serve as a national training 

and technical assistance center on the bidirectional integration of primary and behavioral health 

care and related workforce development. The TTA-PBHCI grantee will be expected to provide 

support in two core areas: 1) technical assistance and support to SAMHSA and HRSA grantees 

and 2) serve as a national technical assistance resource to the general public including generating 

and disseminating best practice materials from Federal partners such as HRSA, Agency for 

Healthcare Research and Quality (AHRQ), National Institutes of Health (NIH) and other 

partners.

Community Resiliency & Recovery Initiative (CRRI)

Program Description and Accomplishments

In FY 2010 SAMHSA initiated the Community Resilience and Recovery Initiative (CRRI) grant 

program and awarded three grants over the next four years to support this initiative. This placebased initiative seeks to support evidence-based early interventions to address behavioral health 

problems, such as increased substance and alcohol use, family violence and increased incidence 

of mental health problems for individuals and communities experiencing heightened levels of 

stress, anxiety, and grief related to the economic downturn. This includes the opportunity to 

support collaboration with community law enforcement and drug courts where appropriate. This 

Initiative places a special focus on communities facing significant increases in unemployment.

Suicide Lifeline

Program Description and Accomplishments

The National Suicide Prevention Lifeline, 1-800-273-TALK, coordinates the network of 147 

crisis centers across the U.S. providing suicide prevention and crisis intervention services to 

individuals seeking help at any time, day or night. 

The National Suicide Prevention Lifeline routes calls from anywhere in the U.S. to a network of 

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

services resources, averaging nearly 54,000 calls per month answered. In July 2007, SAMHSA 

partnered with the Department of Veterans Affairs to provide and ensure 24/7 access to a 

veterans suicide prevention hotline. This hotline has answered an average of more than 6,000 

calls from veterans per month and more than 700 calls per month from veteran’s families. The 

National Suicide Prevention Lifeline is also responding to calls from active duty military and 

their families. In addition, the Lifeline has been increasingly responding to letters and emails sent 

to the White House from people in crisis for a variety of reasons, including the impact of the 

economic downturn. 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. This new data collection will help inform SAMHSA and 

HHS on the vital impact the Lifeline is having across the Nation.

In September 2008, SAMHSA awarded six grants to the National Suicide Prevention Lifeline 

crisis centers to provide follow up to suicidal callers. Evaluation and research findings indicate 
95 

that the immediate aftermath of suicidal crises is a time of heightened risk for suicide but has 

great potential for suicide prevention. Preliminary data from this program indicate that when 

asked by an independent evaluator “To what extent did the counselor’s calling you stop you from 

killing yourself,” more than 50% of those receiving follow up phone contact responded “a lot.” 

In FY 2010, SAMHSA added six more crisis center grants to continue to help address the need 

for critical follow up services and supports for people contacting the Lifeline. 

GLS Youth Suicide Prevention 

Program Description and Accomplishments

The Garrett Lee Smith (GLS) Memorial Act authorizes SAMHSA to manage two significant 

youth suicide prevention programs and a resource center. The GLS State/Tribal Youth Suicide 

Prevention and Early Intervention Grant Program currently supports 35 States, 16 Tribes or 

Tribal organizations, and one Territory 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 38 

institutions of higher education to prevent suicide and suicide attempts. The GLS Suicide 

Prevention Resource Center develops effective strategies and best practices to ensure the field 

has access to the most crucial information. 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 youth. 

The importance of suicide prevention measures during this difficult economic time cannot be 

overstated. Researchers have shown a relationship between sustained high rates of 

unemployment and increased risk for and incidence of suicide. In calendar year 2010, the 

Lifeline answered 691,874 calls, an average of 1,896 calls per day from people at risk for 

suicide, more than 60,000 in the last recorded month alone. Between 30-40% of the calls are 

linked to economic distress or concerns about unemployment. National Suicide Prevention 

Lifeline crisis centers across the nation are responding to people in suicidal crises. Urgent 

supplemental funding was provided to the crisis centers in 2009 as well. At the same time these 

centers are threatened with significant cutbacks in funding from State and local governments and 

other sources of support. 

SAMHSA supports an array of initiatives designed to improve public and professional awareness 

of suicide as a preventable public health problem and to enhance the ability of systems that 

promote prevention, intervention, and recovery. Each of the five major grant programs in 

SAMHSA’s suicide prevention portfolio advances the National Strategy for Suicide Prevention. 

In addition to programs that build suicide prevention capacity, SAMHSA also supports the 

Suicide Prevention Resource Center. This initiative promotes the implementation of the 

National Strategy for Suicide Prevention and enhances the nation’s mental health infrastructure 

by providing States, 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 
96 

to prevent suicide. The Suicide Prevention Resource Center works with and supports prevention 

networks to reduce suicides, community by community. Prevention networks are coalitions of 

organizations and individuals working together to promote suicide prevention including Statewide or tribal coalitions, community task forces, regional alliances, and professional groups. 

AI/AN Suicide Prevention 

Program Description and Accomplishments

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 youth. To date, 

nearly 200,000 Tribal members in 20 communities and 2,100 Alaska Natives in five villages 

have been provided specialized technical assistance and support in suicide prevention and related 

topic areas for these communities. In addition, over 750 community members were trained in 

prevention and mental health promotion in these communities. 

Homelessness Prevention and Housing Program 

Program Description and Accomplishments

Homelessness can be prevented. Current estimates for the number of people experiencing 

homelessness on any given night in the U.S. is approximately 664,000 of which 124,000 are 

single adults who are chronically homeless. Approximately 30 percent of the chronically 

homeless population has a serious mental illness and around two-thirds have a primary substance 

use disorder or other chronic health condition that create major difficulties in accessing and 

maintaining stable, affordable, and appropriate housing. 

The goal of SAMHSA’s Strategic Initiative on Recovery Support is to provide supportive 

permanent housing and reduce the barriers that homeless persons with mental and substance use 

disorders and their families experience when accessing effective programs that sustain recovery 

and permanent supportive housing. Two programs are helping to suppor the goals of this 

Strategic Initiative. The Grants for the Benefit of Homeless Individuals (GBHI) program was 

created to enable communities to expand and strengthen their treatment services for homeless 

individuals with substance use disorders, or with co-occurring substance use and mental 

disorders. SAMHSA will fund programs that demonstrate treatment effectiveness in serving 

homeless, runaways, street youth, and homeless veterans and move them to transition into 

permanent supportive housing. Funds are also used to expand and strengthen substance abuse 

treatment services for homeless, alcohol-dependent persons who have histories of public 

inebriation, frequent emergency room visits, and arrests. Services include outreach, screening 

and assessment, referral, direct treatment, and wrap-around services, all directed to permanent 

and stable housing. 
97 

The Services in Supportive Housing (SSH) program was created to help end chronic 

homelessness by funding treatment and support services to individuals and families in 

coordination with permanent supportive housing programs and resources. The SSH program 

provides comprehensive services that focus on outreach, engagement, intensive case 

management, mental health services, substance abuse treatment, benefits support, and linkage to 

permanent housing. The target population is individuals and families with severe mental illness 

or a co-occurring mental and substance use disorder who have been continuously homeless for at 

least one year or have had at least four episodes of homelessness in the past three years. 

The SSH program helps to prevent or reduce chronic homelessness by funding wrap-around 

services for individuals and families experiencing chronic homelessness in coordination with 

existing permanent supportive housing programs and resources. This innovative approach 

provides intensive individualized support services to people with serious psychiatric conditions 

and those with co-occurring mental and substance use disorders and linkages to housing 

resources. Research indicates that this combination of long-term housing and wrap-around 

services leads to improved residential stability and reductions in psychiatric symptoms (Shern, et 

al., 1994). This program provides individuals and families who experience chronic 

homelessness the appropriate services and treatment needed to stay housed in a permanent 

setting.

As of January 2011, the SSH grantees have provided cumulatively over 3,605 persons with 

comprehensive and coordinated mental health and related services. More than half (55 percent) 

of the people served demonstrated improvement in behavioral functioning and represent. With 

the expansion of the SSH program in FY 2010, SAMHSA expects to triple the number of 

individuals provided supportive housing services and provide needed supports to their family 

members. Five new SSH grants were awarded in FY 2010. 

The FY 2012 Budget request for this program is aligned with “Opening Doors: the Federal 

Strategic Plan to Prevent and End Homelessness” which was released in June 2010. This 

program is an essential piece to accomplishing the goals of the Plan. 

Minority AIDS 

Program Description and Accomplishments

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 

persons living with HIV/AIDS and having a mental health need. The Centers for Disease 

Control and Prevention (CDC) reports significantly higher rates of HIV/AIDS among people of 

color. Blacks accounted for 51 percent and Hispanics accounted for 18 percent of all HIV/AIDS 

cases diagnosed in 2007 in the 34 States with name-based reporting (CDC, 2009). Psychiatric 

and psychosocial complications frequently are not diagnosed or addressed either 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 
98 

numerous medical and/or behavioral challenges, such as non-adherence with the treatment 

regimen. Eligible applicants are domestic public and private nonprofit entities. 

Criminal & Juvenile Justice Programs 

Program Description and Accomplishments

Data from the 2008 National Survey on Drug Use and Health show that there were 10.6 million 

adults aged 18 or older who reported an unmet need for mental health care in the past year. This 

included 5.1 million adults who did not receive any mental health services in the past year. The 

data also show that of the 2.5 million Americans with co-occurring serious mental illiness (SMI) 

and substance abuse disorder, over one third (39.5%) of these adults received no treatment at all. 

Studies of criminal populations have found even higher rates of co-occurring psychiatric and 

substance use disorders than the general population.1 

Since 2002, SAMHSA has administered the Jail Diversion Program for Adults involved in the 

criminal justice system and has awarded grants to 40 States and communities. 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 crimes2

. 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 related services including primary health care, housing, 

and job counseling/placement. In 2008, the Jail Diversion Program expanded focus to include 

individuals with trauma-related mental disorders in an effort to reach the growing number of 

individuals with post-traumatic stress disorder involved in the criminal justice system, with a 

specific priority for veterans. The program also limited eligibility to States to pilot local 

diversion programs and replicate them State-wide. To date, grantees have conducted over 

79,000 screenings and diverted over 3,300 persons with mental illness from jail to community 

treatment services. Nineteen of the 24 earliest grantees continued their programs after SAMHSA 

funding ended. 

Practice Improvement/Training 

Program Description and Accomplishments 

SAMHSA addresses the need for disseminating key information such as best-practices and 

evidence base to the mental health delivery system and achieving health care reform by engaging 

in activities that support the mental health system transformation and reform. These activities 

include Historically Black Colleges and Universities (HBCU) – Center of Excellence, 

Elimination of Mental Health Disparities, and Peer Review activities. 

The purpose of the HBCU - Center of Excellence is to network the 103 HBCUs throughout the 

U.S. and promote workforce development through expanding knowledge of best practices, 

 

1

Serious Mental Illness and Arrest, Swartz and Lurigio, 2007

2 Serious Mental Illness and Arrest, Swartz and Lurigio, 2007
99 

leadership development 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. The goals of the HBCU-Center for 

Excellence are to: expand and enhance the existing national network of HBCUs to foster the 

development of programs, and to facilitate collaboration and the exchange of information related 

to substance abuse and mental health; provide culturally appropriate substance abuse and mental 

health disorder resources to HBCUs; and to promote workforce development in substance abuse 

and mental health by exposing HBCU students to a wide range of opportunities in the field, 

including, but not limited to internships, mentoring and leadership trainings. 

Consumer & Consumer Support TA Centers 

Program Description and Accomplishments 

Consumer and Consumer Supported TA Centers foster a recovery-oriented, consumer-driven 

system of care to enhance consumer self-determination and recovery by helping people decrease 

their dependence on expensive social services and avoid inappropriate use of inpatient 

hospitalization through the use of alternative interventions. The program helps improve 

collaboration among consumers, families, advocates, providers and administrators which 

facilitates transforming community mental health services to be more consumer driven and 

family focused. 

Minority Fellowship Program (MFP)

Program Description and Accomplishments

In a partnership of CMHS, CSAP and CSAT, this program increases the knowledge of issues

related to ethnic minority mental health and substance use disorders, as well as improves the

quality of mental health and substance abuse prevention and treatment delivered to ethnic

minorities by providing stipends to doctoral level students to increase the number of culturally 

competent behavioral health professionals who teach, administer, conduct services research, and 

provide direct mental health/substance abuse services to underserved minority populations. 125 

individuals were trained in FY 2009. Since its start in 1973, the Minority Fellowship Program 

(MFP) has helped to support doctoral-level training of ethnic minority psychiatrists, 

psychologists, psychiatric nurses, and social workers. These individuals often serve in key 

leadership positions in mental health and substance abuse direct services, services supervision, 

services substance direct services, services supervision, services research, training, and 

administration. 
100 

Disaster Response 

Program Description and Accomplishments 

The Emergency and Disaster Mental Health National Technical Assistance Center supports 

individuals and communities faced with the behavioral health impact of natural and man made 

disasters. In addition, this National Center supports the FEMA Crisis Counseling Assistance. 

The FEMA Crisis Counseling Assistance and Training Program (CCP) is an inter-agency 

agreement between SAMHSA and the Federal Emergency Management Agency (FEMA) that 

supplies supplemental financial assistance to provide crisis counseling services to disaster 

survivors to promote recovery and mitigate the need for traditional behavioral health services. 

These counseling services assist individuals and communities in recovering from the challenging 

effects of natural and human caused disasters through the provision of community-based

outreach and psycho-educational services. CCP provided over 1.2 million face-to-face 

encounters in FY 2008. In October 2009, the CCP Online Data Collection and Evaluation 

System was released and is a significant advancement for the CCP’s data collection. 

IEI - CMHS Funding History* 

FY Amount

2007 $251,447,000

2008 $274,154,000

2009 $315,883,000

2010 $327,842,000

2011 $327,689,000

* The funding history is based on a comparable basis to previous funding levels to reflect the 

revised budget restructure. 

Budget Request

The FY 2012 President’s Budget request is $270.9 million, a decrease of $56.9 million from the 

FY 2010 Level. The request will support 306 grant and 35 contract continuations, as well as 73 

new grants and five new contracts. The funding level enables the continuation of most 

programmatic activities. The Older Adults program will be terminated. Ten new NCTSN 

grants, 19 GLS-States grants, 21 GLS-Campus grants, 22 Homelessness Prevention grants 

(including 12 new HHS/HUD Homelessness Prevention and Housing Initiative), and one new 

Suicide Lifeline grant will be awarded. The Budget phases out funding for new awards, 

including: Children and Family Programs, Consumer and Family Network Grants, Mental Health 

System Transformation and Health Reform, and Practice Improvement and Training. No 

continuing grant awards will be terminated. SAMHSA will work with the States to use their 

Block Grant and Substance Abuse and Mental Health Prevention Grants to implement the 

practices learned from these programs. 
101 

Outcomes and Outputs

Co-Occurring State Incentive Grants

As the Co-Occurring State Incentive Grants are coming to an end in FY 2009 and no new grants 

are planned, performance measures for this program will no longer be reported. 

Youth Violence Prevention

Table 1: Key Performance Indicators for Youth Violence Prevention 

Measure Most Recent 

Result

FY 2011 

Performance 

Target 

Associated 

with FY 2010 

PB 

FY 2013 

Performance 

Target 

Associated 

with FY 2012 

Request

FY 2013 

Performance 

Target +/- FY 

2011 

Performance 

Target 

3.2.04: Number of children served

(Outcome) 

FY 2010: 

2,328,500

(Target Met) 

2,328,500 2,328,500 Maintain 

3.2.10: Percentage of students who 

receive mental health services

(Outcome) 

FY 2010: 

59.3%

(Target Not 

Met)3

66% 

 

66% Maintain 

3.2.29: Percentage of middle and 

high school students who have been 

in a physical fight on school 

property (Outcome) 

FY 2010: 

19.0% 

(Target 

Exceeded) 

27.0% 27.0% Maintain 

3.2.30: Percentage of middle and 

high school students who report 

current substance abuse (Outcome) 

FY 2010: 

24.0% 

(Target 

Exceeded) 

20.0% 20.0% Maintain 

 

3

This number includes data from a large cohort of grantees funded in 2009. The 2010 result is derived from 60 new grantees and 27 continuing 

grantees. Full implementation of services does not occur until later in 1st year of program. Thus decrease may reflect the impact of the larger new 

cohort.
102 

National Child Traumatic Stress Initiative (NCTSI)

Table 2: Key Performance Indicators for National Traumatic Stress Network 

Measure Most Recent 

Result

FY 2011 

Performance 

Target 

Associated 

with FY 2010 

PB 

FY 2013 

Performance 

Target 

Associated 

with FY 2012 

Request

FY 2013 

Performance 

Target +/- FY 

2011 

Performance 

Target 

3.2.02: Percentage of children 

receiving services showing clinically 

significant improvement (HHS 

Strategic Plan Measure) (Outcome) 

FY 2010: 43%

(Target Not 

Met)4

69% 

 

69% Maintain 

3.2.23: Unduplicated count of the 

number of children and adolescents 

receiving trauma-informed services

(Outcome) 

FY 2010: 1,959

(Target Not 

Met but 

Improved) 

3,217 480 -2,737 

3.2.24: Number of child-serving 

professionals trained in providing 

trauma-informed services

(Outcome)5

FY 2009: 

95,186

(Target Not 

Met but 

Improved) 

100,800 23,800 -77,000 

 

4

Lower number reflects a return to the methodology used to calculate GPRA that was originally used in FY 2006.

5 FY 2010 data is not available due to transfer to TRAC system data collection. Data will be available for FY 2011.
103 

Mental Health System Transformation Grants 

Key Performance Indicators for Mental Health System Transformation Grants6,7,8

Measure Most Recent 

Result

FY 2011 

Performance 

Target 

Associated 

with FY 2010 

PB 

FY 2013 

Performance 

Target 

Associated 

with FY 2012 

Request

FY 2013 

Performance 

Target +/- FY 

2011 

Performance 

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 2010: 

60,924

(Target 

Exceeded) 

746 2,000 +1,254 

Suicide Prevention

Table 3: Key Performance Indicators for Suicide Prevention Activities 

Measure Most Recent 

Result

FY 2011 

Performance 

Target 

Associated 

with FY 2010 

PB 

FY 2013 

Performance 

Target 

Associated 

with FY 2012 

Request

FY 2013 

Performance 

Target +/- FY 

2011 

Performance 

Target 

2.3.59: Total number individuals 

trained in youth suicide prevention9

FY 2010: 

35,371

(Outcome) (Target Met) 

35,371 35,371 Maintain 

2.3.60: Total number of youth 

screened10

FY 2010: 3,729

(Target 

Exceeded) (Output) 3,360 3,360 Maintain 

2.3.61: Number of calls answered by 

the suicide hotline (Output) 

FY 2010: 

664,932

(Target 

Exceeded) 

555,132 555,132 Maintain 

 

6

Program was formally known as Mental Health State Incentive Grants for Transformation

7

This program is still under development and performance measures will be added once the program is finalized. In the interim, targets for FY 

2012 and FY 2013 have been included and are subject to change.

8

FY 2011 targets for this program drop off due to grants coming to a natural end.

9

This measure has been revised for the FY 2011 President's Budget. Previously the measure was cumulative. It has been revised to report its data 

annually. As a result, targets for FY 2009 and 2010 were adjusted and data provided here may appear to differ from those previously published. 10This measure has been revised for the FY 2011 President's Budget. Previously the measure was cumulative. It has been revised to report its 

data annually. As a result, targets for FY 2009 and 2010 were adjusted and data provided here may appear to differ from those previously 

published in the FY 2010 President's Budget. 
104 

Mental Health Services – Homelessness Programs

Table 4: Key Performance Indicators for Mental Health Homelessness Prevention Programs11

Measure Most Recent 

Result

FY 2011 

Performance 

Target 

Associated 

with FY 2010 

PB 

FY 2013 

Performance 

Target 

Associated 

with FY 2012 

Request

FY 2013 

Performance 

Target +/- FY 

2011 

Performance 

Target 

3.4.01: Number of clients served

(Output) 

FY 2010: 3,491

(Target 

Exceeded) 

2,262 2,734 +472

3.4.02: Percentage of adults 

receiving services who report 

improved functioning (Outcome) 

FY 2010: 

63.9% 

(Target Not 

Met but 

Improved) 

68.4% 68.4% Maintain 

3.4.03: Percentage of adults 

receiving services who were 

currently employed (Outcome) 

FY 2010: 13.7 

% 

(Target Not 

Met but 

Improved) 

15.6% 15.6% Maintain 

3.4.05: Percentage of adults 

receiving services who had a 

permanent place to live in the 

community (Outcome) 

FY 2010: 79.4 

% 

(Target 

Exceeded) 

60.6% 74.2% +13.6% 

3.4.06: Percentage of adults 

receiving services who had 

improved social support (Outcome) 

FY 2010: 70 %

(Target Not 

Met but 

Improved) 

78 % 78 % Maintain 

 

11

Prior to FY 2010 president's Budget, Homelessness data was reported in the CMHS Other Capacity table
105 

Key Performance Indicators for Mental Health – Other Capacity12

Measure Most Recent 

Result

FY 2011 

Performance 

Target 

Associated 

with FY 2010 

PB 

FY 2013 

Performance 

Target 

Associated 

with FY 2012 

Request

FY 2013 

Performance 

Target +/- FY 

2011 

Performance 

Target 

1.2.05: Percentage of clients 

receiving services who report 

improved functioning (Outcome) 

FY 2010: 

52.7%

(Target Not 

Met) 

54% 54% Maintain 

1.2.82: Percentage of clients 

receiving services who had a 

permanent place to live in the 

community (Outcome) 

FY 2010: 74.4 

% 

(Target 

Exceeded) 

67.7 % 67.7 % Maintain 

1.2.83: Percentage of clients 

receiving services who are currently 

employed (Outcome) 

FY 2010: 17.2 

% 

(Target 

Exceeded) 

14.0 % 14.0 % Maintain 

Table 5: Key Performance Indicators for Mental Health – Science and Service Activities13,14

Measure Most Recent 

Result

FY 2011 

Performance 

Target 

Associated 

with FY 2010 

PB 

FY 2013 

Performance 

Target 

Associated 

with FY 2012 

Request

FY 2013 

Performance 

Target +/- FY 

2011 

Performance 

Target 

1.4.06: Number of people trained by 

CMHS Science and Service 

Programs (Output) 

FY 2010: 5,835

(Target 

Exceeded) 

4,237 3,390 -847

1.4.08: Percentage of participants 

who report implementing 

improvements in treatment methods 

on the basis of information and 

training provided by the program

(Outcome) 

N/A N/A N/A N/A 

 

12

Prior to 2008, includes Jail Diversion, Older Adults, HIV/AIDS, and Services in Supportive Housing programs. Beginning in 2009, data from 

Services in Supportive Housing will be reported under Homelessness Activities. In 2010, Primary and Behavioral Health Care Integration and 

Healthy Transitions was added.

13Prior to 2008, includes HIV/AIDS education and Historically Black Colleges and Universities National Resource Center for Substance Abuse 

and Mental Health.

14

In the FY 2010 President's Budget it was erroneously noted that Statewide Family/Consumer TA Center contributed to the Science and 

Services measures. This is not the case and thus has been removed from the list of participating programs. 
106 

Measure Most Recent 

Result

FY 2011 

Performance 

Target 

Associated 

with FY 2010 

PB 

FY 2013 

Performance 

Target 

Associated 

with FY 2012 

Request

FY 2013 

Performance 

Target +/- FY 

2011 

Performance 

Target 

1.4.09: Number of individuals 

trained by SAMHSA's Science and 

Services Program (HHS Strategic 

Plan Measure) (Output) 

FY 2010: 

38,624

(Historical 

Actual)15 

N/A N/A N/A 

Grant Award Table 

(Whole Dollars) FY 2010 FY 2011 FY 2012 

Number of Awards 476 482 332

Average Award $408,817 $410,703 $393,127

Range of Awards $15,000-$6,000,000 $15,000-$6,000,000 $15,000-$6,000,000 

 

15NOTE: Data are preliminary and do not reflect all program accomplishments during FY 2010. Reporting periods for component programs vary 

and, therefore, are complete for only a portion of them. Final data for all programs will be available in August 2011. 
107 

SAMHSA Innovation and Emerging Issues

Table of Contents 

1.

SAMHSA/ Center for Substance Abuse Prevention (CSAP) Page

Innovation & Emerging Issues.............................................................................................. 109

2. Mechanism Table by APT .................................................................................................... 111

3. SAMHSA/Innovation and Emerging Issues - Substance Abuse Prevention ........................ 113

4. Minority AIDS Initiative (MAI) ........................................................................................... 113

5. Sober Truth on Preventing Underage Drinking Act (STOP Act) ......................................... 114

6. Science and Service Program Coordination ......................................................................... 116
108 

Page intentionally left blank 
109 

SAMHSA/Center for Substance Abuse Prevention

Innovation & Emerging Issues 

Summary of Programs 

The Substance Abuse Prevention Innovation & Emerging Issues programs (IEI) support States 

and communities in carrying out an array of activities to improve the quality and availability of 

services in priority areas. The FY 2012 President’s Budget request for SAMHSA Substance 

Abuse Prevention IEI includes $69.4 million which covers five programmatic activities, a 

decrease of $6.1 million from the FY 2010 Continuing Resolution. The request includes: 

• $41.4 million for Minority AIDS Initiative (MAI) to continue delivering and sustaining 

high quality and accessible substance abuse and HIV prevention services in the form of 

continuation grants; 

• $7.0 million for Sober Truth on Preventing Underage Drinking (STOP Act) to continue to 

provide grants to organizations that are currently receiving or have received grant funds 

under the Office of National Drug Control Policy’s Drug-free Communities Act of 1997 

to either enhance an existing focus or to add a focus on preventing underage drinking; 

• $4.4 million for Science and Service Program Coordination which primarily supports two

key technical assistance contracts that enable SAMHSA to focus on two critical issues: 

assisting Tribes in obtaining support and implementing outreach to complement the 

Tribal Prevention Grant; development and implementation of policy changes to prevent 

underage drinking. 

• $8.0 million for the Fetal Alcohol Spectrum Disorders (FASD) initiative to continue 

efforts to prevent Fetal Alcohol Spectrum Disorder and increase functioning and quality 

of life for individuals and their families impacted by these disorders. 

• $8.5 million to continue provision of technical assistance to maximize effectiveness 

through the Centers for the Application of Prevention Technologies. 

The Substance Abuse Prevention IEI underwent a program assessment in 2004. The assessment 

cited strong purpose and design, ambitious targets, and strong program management as key 

attributes of the program. Since the program assessment, the program has implemented the 

Strategic Prevention Framework, has refined its outcome measures, and has improved data 

collection and reporting. 
110 

Page intentionally left blank
111 

SAMHSA/ Center for Substance Abuse Prevention

Mechanism Table by APT

(Dollars in Thousands)

FY 2010 FY 2011 FY 2012

Actual CR Pres. Budget

No. Amount No. Amount No. Amount

Innovation and Emerging Issues

Grants/Cooperative Agreements:

Continuations................................................................................ 159 25,161 225 44,501 222 43,919

New/Competing............................................................................. 82 22,666 1 3,950 0 0

Subtotal...................................................................................... 241 47,827 226 48,451 222 43,919

Contracts:

Continuations................................................................................ 10 24,048 11 27,076 10 25,457

New................................................................................................. 3 3,563 0 0 0 0

Subtotal......................................................................................

Subtotal, Innovation and Emerging Issues...............................

13 27,611 11 27,076 10 25,457

254 $75,438 237 $75,527 232 69,376
112 

Page intentionally left blank
113 

SAMHSA/Innovation and Emerging Issues - Substance Abuse Prevention 

(Dollars in Thousands)

 

FY 2010

Actual

FY 2011 

Continuing 

Resolution

 FY 2012

President's 

Budget

MAI......................................................................... $41,385 $41,385 $41,385

STOP Act................................................................. 7,000 7,000 7,000

Congressional Projects .............................................. 3,950 3,950 0

Science & Service Program Coordination.................... 4,845 4,789 4,409

Fetal Alcohol Center of Excellence............................. 9,820 9,821 8,000

Center for the Application of Prevention Technologies. 8,367 8,511 8,511

Minority Fellowship Programs....................................

TOTAL, IEI CSAP

71 71 71

$75,438 $75,527 $69,376

Authorizing Legislation ....................................... Section 516, 519B, 519E, 520A of the PHS Act 

FY 2012 Authorization ......................................................................................................... Expired

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

Minority AIDS Initiative (MAI)

Program Description and Accomplishments

SAMHSA/CSAP’s Minority AIDS Initiative (MAI), implemented in FY 1999, supports efforts 

to reduce health disparities in minority communities by delivering and sustaining high quality 

and accessible substance abuse and HIV prevention services. The program strategies include 

implementing evidence-based prevention practices targeting subpopulations, conducting HIV 

testing and referral for treatment, and preventing/reducing the risk of substance use disorders 

and/or HIV. Grantees are required to target one or more high-risk populations such as African 

American women, adolescents, or individuals who have been released from prisons and jails 

within the past two years. 

The MAI has funded ten cohorts of grants, with currently 122 active grants funded from cohorts 

six through ten, from FY 2005-2010. All grantees are required to use SAMHSA’s Strategic 

Prevention Framework as the model on which they develop their long-range and annual strategic 

plans for delivering prevention services. Program results show an increase of participants’ 

awareness of the risk of substance use and HIV, increased numbers of people undergoing HIV 

tests, and a decrease in participants’ use of alcohol or illicit drugs. In FY 2010, SAMHSA 

developed two new grant programs (the Capacity Building Initiative and the Ready To Respond 

Initiative). Within each sub-program, grantees select an at-risk population to target: 

• The Capacity Building Initiative targets 18-24 year old at-risk populations, including 

minority students on college campuses; 
114 

• The Ready To Respond Initiative allows experienced grantees that have successfully 

provided evidence-based substance abuse and HIV prevention services through the 

Strategic Prevention Framework to expand those services to a high-risk subpopulation. 

Sober Truth on Preventing Underage Drinking Act (STOP Act)

Program Description and Accomplishments

The Sober Truth on Preventing Underage Drinking Act (STOP Act), signed into law in 2006, is 

the nation’s first comprehensive legislation on underage drinking. It establishes a national media 

campaign aimed at underage drinking, funds underage-drinking programs in communities, and 

prevents underage drinking by bolstering community-based coalitions.

This program provides grants to organizations that are currently receiving or have received grant 

funds under the Office of National Drug Control Policy’s Drug-free Communities Act of 1997 to 

either enhance an existing focus or to add a focus on preventing underage drinking. This 

program will strengthen the collaborative efforts and increase participation among all 

stakeholders (e.g., community organizations, coalitions, local and State governments). The 

initial program, funded in FY 2008, provided 79 four year grants to local communities with up to 

$50,000 per community per year. In FY 2010, a total of 99 grants received funding under this 

initiative to strengthen these important efforts. 

Another component of the STOP Act is the National Adult-Oriented Media Public Services 

Campaign, with funding of $1 million in FY 2010. The Underage Drinking Prevention 

campaign urges parents to speak with their children, age 11-15, about underage drinking in order 

to delay the onset of and ultimately reduce underage drinking. Nationwide, more than 37 percent 

of the estimated 10.1 million underage drinkers were provided free alcohol by adults 21 or older 

(2008 NSDUH). Research shows 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.” Many parents also find it difficult to know how or when to start a 

conversation with their children about underage drinking. Through TV, radio, print and outdoor 

activities, SAMHSA’s multicultural campaign seeks to overcome parents’ misperceptions about 

underage drinking by creating a greater urgency around the issue and encourages them to 

communicate with their children about alcohol at an early age. Parents and viewers are 

encouraged to visit www.stopalcoholabuse.gov, funded through the media campaign, to get 

information about teens and alcohol, as well as tips on how to initiate conversations with their 

children about underage drinking. 

The third important component of the STOP Act is the Federal Interagency Coordinating 

Committee on the Prevention of Underage Drinking, with funding of $1 million in FY 2010. 

The Committee will support planning for the Annual Report on State Underage Drinking 

Prevention and Enforcement Activities. The development of this report will include some of the 

information required in the STOP Act, as well as starting work on the development of a plan to 

improve the collection, measurement, and consistency of reporting Federal underage alcohol 

data. In FY 2008, 40 percent of coalitions reported at least a five percent improvement in past 

30-day alcohol use in at least two grades.
115 

These activities together can enhance and expand the capacity of community coalitions through 

establishing and strengthening collaborations with communities, private non-profit agencies, 

Federal, State, local and tribal governments to enhance intergovernmental cooperation and 

coordination on the issue of underage drinking. 

Fetal Alcohol Spectrum Disorders (FASD) 

Program Description and Accomplishments

The Fetal Alcohol Spectrum Disorder (FASD) Center for Excellence, initiated in 2001, is the 

largest alcohol abuse prevention initiative within SAMHSA. The FASD Center for Excellence 

identifies and disseminates information about innovative techniques and effective strategies for 

preventing FASD and increases functioning and quality of life for individuals and their families 

impacted by these disorders. The FASD Center for Excellence identifies gaps and trends in the 

field, synthesizes findings, and develops appropriate materials about FASD for health and social 

service professionals, communities, States, and tribal organizations. The FASD Center of 

Excellence has provided more than 550 trainings, technical assistance events, and consultations 

to approximately 24,000 individuals in the U.S., Territories, and internationally. One of the

FASD Center of Excellence’s key early activities was to establish a database of FASD materials. 

This database is now searchable and contains more than 13,000 resources, including FASD

literature, publications, posters, and public service announcements (PSAs). The FASD Center of 

Excellence also disseminates information through a FASD web site and an information resource 

center hotline, through which it responds to inquiries and contacts from individuals around the 

world. 

The FASD Center for Excellence is advancing the field of FASD prevention and treatment by 

learning what works in States and communities with specific populations using evidence-based 

interventions. Fifteen local, State and juvenile courts are implementing prevention programs and 

eight are implementing diagnosis and intervention programs. All programs are completing their 

second year of implementation. Key current activities include: 

• Achieving buy-in from stakeholders and partners; 

• Attending trainings and technical assistance calls to strengthen techniques for implementing 

the interventions and to address questions resulting from implementation;

• Implementing data collection, storage, and reporting mechanisms developed to support 

evaluation activities;

• Implementing screening and program services to eligible women and children; 

• Convening task forces meetings to provide ongoing direction and feedback on 

implementation and evaluation issues; and 

• Refining plans for the upcoming year based on lessons learned in the first two years. 

In addition, SAMHSA is and will continue to work in conjunction with the Centers for Disease 

Control and Prevention (CDC) on FASD-related initiatives. 
116 

Center for the Application of Prevention Technologies (CAPTs) 

Program Description and Accomplishments

In existence for more than a decade, the Center for the Application of Prevention Technologies 

(CAPT) promotes state-of-the-art behavioral health prevention technologies through three core 

strategies: 1) establishment of technical assistance networks using local experts from each of 

their five regions; 2) development of training activities; and 3) innovative use of communication 

media such as teleconference and video conferencing, online events, and Web-based support. 

These training and technical assistance activities are designed to build the capacity of SAMHSA 

grantees and develop the skills, knowledge, and expertise of their prevention workforce. These 

activities will help support the delivery of effective prevention programs and practices and the 

development of accountability systems for performance measurement and management. 

Through interagency agreements, the CAPT also provides training and technical assistance to 

additional client groups such as the U.S. Department of Education’s Grants to Reduce Alcohol 

Abuse Program. 

The CAPT promotes a 3-tiered strategic approach to effective prevention throughout the 

provision of their skill-building training and capacity-building technical assistance: 1) build 

capacity at the State or grantee level, 2) prepare States to roll out the Strategic Prevention 

Framework process at the local level, and 3) work directly with States and their communities to 

select and implement effective prevention programs and practices, integrate prevention efforts 

across State systems, and sustain these efforts. 

During FY 2009, the CAPT devoted 18,000 hours to provide 1,427 capacity-building technical 

assistance services to 5,243 individuals representing 350 organizations, resulting in the delivery 

of 100,000 hours of client service. In addition, it delivered 535 on-site and web-based events to 

advance SAMHSA’s Strategic Prevention Framework priorities, the majority of which were skill 

development trainings and training-of-trainers. Collectively, the CAPT provided 3,745 hours of 

training to 14,226 individuals from 60 States, Territories, and Tribes. Ninety-eight percent of 

recipients of substantive CAPT services reported that the service had been useful to them in their 

work, and ninety-four percent reported that the service substantively enhanced their ability to 

provide effective prevention services.

Science and Service Program Coordination

Program Description and Accomplishments

The Science and Service Program Coordination category primarily supports two key contracts 

that enable SAMHSA to address two critical issues: Native American substance abuse 

prevention, and underage drinking. 

The Native American Center for Excellence (NACE) supports behavioral health outreach 

activities to Tribal nations and organizations to help them to apply for SAMHSA and other 

Federal agency grants and to have a clear understanding of the need for coordinating prevention 
117 

funding, establishing and implementing prevention policies and evidence-based programs, 

utilizing strategic planning, and developing infrastructure. The Center also provides technical 

assistance to these communities to develop and implement their outreach activities. In addition, 

the NACE website and environmental scan report, collect, and disseminate information on both 

cultural- and evidence-based prevention and intervention strategies for the public, grantees, and 

grantors. 

NACE has developed training and technical assistance to build learning communities of tribal 

members, content experts, and other stakeholders. In addition, NACE continues to build content 

expertise and knowledge dissemination in five prevention domains (youth, community, family, 

schools, and Tribal leaders/policy) through routine literature reviews, focused peer-to-peer 

discussion groups, and development of technical papers and abstracts. NACE also supports 

SAMHSA’s efforts to expand eligibility to grant programs to Federally-approved Tribal 

organizations through technical assistance and developing linkages between Native communities 

as mentors in this effort. This program will support the Tribes in the implementation of the new 

Tribal Prevention Grant. 

The Underage Drinking Prevention Education Initiative combats underage drinking and provides 

effective and appropriate prevention programs, activities, and strategies. In addition, it supports 

States and their communities by providing training to get the community organized, build 

capacity, and plan for sustainability around the prevention of underage alcohol use. The funding 

assists in reaching out to more than 50 million families, their children, and other youth-serving 

organizations through town-hall meetings, technical assistance, guidance, activities, information 

about promising approaches, and materials and tools that help concerned members of the 

community organize around underage drinking issues. 

The Underage Drinking Prevention Education Initiative 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. In 2010, this initiative supported a national forum to bring together States from 

the Governor’s level to begin a dialogue around State plans for addressing the underage drinking 

issue in each State. In addition, funds will be provided to support efforts to mobilize States and 

their communities, families, and youth with the opportunity to engage in discussion on the 

seriousness of underage drinking as a public health issue and the strategies needed to reduce and 

prevent youth alcohol use. The initiative will also work with the STOP Act grantees to continue 

the synergy that was created through previous town hall meetings and the national forum in 

implementing appropriate activities and strategies to prevent underage drinking. 
118 

Funding History* 

FY Amount

2007 $ 65,949,000

2008 $ 72,120,000

2009 $ 73,910,000

2010 $ 75,438,000

2011 $ 75,527,000

* The funding history is based on a comparable basis to previous funding levels to reflect the 

revised budget restructure. 

Budget Request

The FY 2012 President’s Budget request is $69.4 million, a decrease of $6.1 million from the

FY 2010 level. The request will support 222 grants and 10 contracts. This level of funding 

enables the continuation of all programmatic activities. No continuing grant awards will be 

terminated. SAMHSA will work with the States to use their Block Grant and Substance Abuse 

and Mental Health Prevention Grants to implement the practices learned from these programs.

Outcomes and Outputs

Minority AIDS Initiative: Substance Abuse Prevention, HIV Prevention and Hepatitis 

Prevention for Minorities and Minorities Re-entering Communities Post-Incarceration 

(HIV)

Table 1: Key Performance Indicators for Minority AIDS Initiative1,2,3

Measure Most Recent 

Result

FY 2011 

Performance 

Target 

Associated 

with FY 2010 

PB 

FY 2013 

Performance 

Target 

Associated 

with FY 2012 

Request

FY 2013 

Performance 

Target +/- FY 

2011 

Performance 

Target 

2.3.56: Number of individuals 

exposed to substance abuse/hepatitis 

education services (Output) 

FY 2009: 3,431

(Target 

Exceeded) 

1,5354

 1,535 Maintain 

 

1

Previously, data collected in a given FY were reported in the following year. For example, results for 2008 would reflect data collected in 2007. 

In order to achieve consistency across SAMHSA, reporting has been revised so that results for a given FY reflect data actually collected in that 

year, except where otherwise noted.

2

HIV Cohort 7 serves different population groups so baseline data from this cohort will be established and entered in FY 2011.

3

The out years of this program are under development and performance measures will be added once the program is finalized. In the interim, 

targets for FY 2011 and FY 2012 have been included and are subject to change. 

4 This measure is expected to decline and change from substance abuse/hepatitis education to substance abuse/HIV education in FY 2011 

following the close-out of Cohort 6 grants and newer Cohorts not yet functioning at optimum levels. Cohort 7 and later cohorts are not focusing 

on hepatitis education, but rather focusing on HIV education.
119 

Measure Most Recent 

Result

FY 2011 

Performance 

Target 

Associated 

with FY 2010 

PB 

FY 2013 

Performance 

Target 

Associated 

with FY 2012 

Request

FY 2013 

Performance 

Target +/- FY 

2011 

Performance 

Target 

2.3.82: Percent of program 

participants that rate the risk of 

substance abuse as moderate or great 

(all ages) (Outcome) 

FY 2009: 94.4 

% 

(Baseline) 

94.4 % 94.4 % Maintain 

2.3.83: Percent of program 

participants who report no use of 

alcohol at pre-test who remain nonusers at post-test (all ages)

(Outcome) 

FY 2009: 91.2 

% 

(Baseline) 

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 2009: 92.6 

% 

(Baseline) 

92.6 % 92.6 % Maintain 

Sober Truth on Preventing Underage Drinking

Table 2: Key Performance Indicators for Sober Truth on Preventing Underage Drinking (STOP Act) 

Measure Most Recent 

Result

FY 2011 

Performance 

Target 

Associated 

with FY 2010 

PB 

FY 2013 

Performance 

Target 

Associated 

with FY 2012 

Request

FY 2013 

Performance 

Target +/- FY 

2011 

Performance 

Target 

3.3.01: Percentage of coalitions that 

report at least 5% improvement in 

the past 30-day use of alcohol in at 

least two grades5

FY 2009: 

53.3%

(Target 

(Outcome) Exceeded) 

41% 46.7% +5.7% 

 

5

The FY 2010, 2011, 2012, and 2013 targets were based on the baseline number calculated last year using FY 2008 data (40.0%). This baseline is 

based on data submitted by these coalitions before they were awarded a STOP Act grant. Starting with FY 2009, CSAP is evaluating the impact 

of STOP Act funds on the outcome measures. To do this for the FY 2009 calculation, CSAP selected coalitions that submitted data collected after 

their STOP funds had a chance to make an impact. The cutoff point was 3 months after receipt of the grant award. Any data collected before that 

date were considered inappropriate for assessing the impact of STOP funds. Only 17 coalitions met this criterion in FY 2009 so the 53.3% is 

based on that very small number of grantees. Conversely, the baseline figure (40%) was based on data from a larger number of grantees, so CSAP 

has higher confidence in that number. Altering the targets through 2013 based on the small N in the 2009 data reported to date would probably 

result in targets that are not as realistic as the 41% based on a more representative sample of coalitions. For this reason, CSAP recommends 

keeping the targets as they are until more robust actuals can be collected.
120 

Measure Most Recent 

Result

FY 2011 

Performance 

Target 

Associated 

with FY 2010 

PB 

FY 2013 

Performance 

Target 

Associated 

with FY 2012 

Request

FY 2013 

Performance 

Target +/- FY 

2011 

Performance 

Target 

3.3.02: Percentage of coalitions that 

report improvement in youth 

perception of risk from alcohol in at 

least two grades (Outcome) 

FY 2009: 

53.8%

(Target Not 

Met) 

63.4% 63.4% 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 2009: 

42.9%

(Target Not 

Met) 

56.7% 56.7% Maintain 

Science and Service Program Coordination

Table 3: Key Performance Indicators for Prevention – Science and Service Activities

Measure Most Recent 

Result

FY 2011 

Performance 

Target 

Associated 

with FY 2010 

PB 

FY 2013 

Performance 

Target 

Associated 

with FY 2012 

Request

FY 2013 

Performance 

Target +/- FY 

2011 

Performance 

Target 

2.3.71: Number of people provided 

technical assistance (TA) Services6

FY 2009: 

18,985

(Target Not 

Met) (Output) 

21,420 13,143 -8,277 

2.3.74: Percentage of TA recipients 

who reported that the TA 

recommendations have been fully 

implemented7

FY 2009: 

65.1%

(Target 

(Outcome) Exceeded) 

54% 60.2% +6.2% 

2.3.75: Number of persons receiving 

prevention information directly8

FY 2009: 505

(Target Not 

(Output) Met) 

5509

 36810 -182 

 

6

Updated to include Center for the Application of Prevention Technology (CAPT), Native American Center of Excellence (NACE), Fetal 

Alcohol Spectrum Disorders Center of Excellence (FASD), MEI, and Prevention Fellowships.

7

Includes only the CAPT.

8

Includes Town Hall Meetings and FASD.
121 

Measure Most Recent 

Result

FY 2011 

Performance 

Target 

Associated 

with FY 2010 

PB 

FY 2013 

Performance 

Target 

Associated 

with FY 2012 

Request

FY 2013 

Performance 

Target +/- FY 

2011 

Performance 

Target 

1.4.09: Number of individuals 

trained by SAMHSA's Science and 

Services Program (HHS Strategic 

Plan Measure) (Output) 

FY 2010: 

38,624

(Historical 

Actual)11 

N/A N/A N/A 

Grant Award Table 

(whole dollars) FY 2010 FY 2011 FY 2012

Number of Awards 241 226 222

Average Award $198,452 $214,385 $197,833

Range of Awards $25,000 - $335,000 $25,000 - $500,000 $25,000 - $500,000

 9 The Town Hall Meetings (THM) are conducted only in even-numbered years, so the targets in odd-numbered years reflect only the direct TA 

activities of FASD.

10 The Town Hall Meetings (THM) are conducted only in even-numbered years, so the targets in odd-numbered years reflect only the direct TA 

activities of FASD.

11

NOTE: Data are preliminary and do not reflect all program accomplishments during FY 2010. Reporting periods for component programs vary 

and, therefore, are complete for only a portion of them. Final data for all programs will be available in August 2011. 
122 

Page intentionally left blank 
123 

SAMHSA Innovation & Emerging Issues

Table of Contents 

SAMHSA/Center for Substance Abuse Treatment (CSAT) Page

1. Innovation & Emerging Issues.............................................................................................. 125

2. Mechanism Table by APT .................................................................................................... 127

3. SAMHSA/Innovation and Emerging Issues - Substance Abuse Treatment ......................... 129

4. Co-Occurring State Incentive Grants .................................................................................... 129

5. Screening, Brief Intervention and Referral to Treatment ..................................................... 130

6. Targeted Capacity Expansion-General ................................................................................. 131

7. Pregnant & Post-Partum Women .......................................................................................... 131

8. Strengthening Treatment Access & Retention ...................................................................... 132

9. Recovery Community Services Program .............................................................................. 133

10. Access to Recovery ............................................................................................................... 133

11. Children & Family Programs ................................................................................................ 134

12. Treatment Systems for Homelessness .................................................................................. 135

13. Minority AIDS ...................................................................................................................... 136

14. Criminal Justice Activities .................................................................................................... 137

15. Minority Fellowship.............................................................................................................. 139

16. Special Initiatives/Outreach .................................................................................................. 140
124 

Page intentionally left blank 
125 

SAMHSA/Center for Substance Abuse Treatment

Innovation & Emerging Issues 

Summary of Programs 

The Substance Abuse Treatment Innovation & Emerging Issues programs (IEI) support States 

and communities in carrying out an array of activities to improve the quality and availability of 

services in priority areas. The FY 2012 President’s Budget request for SAMHSA Substance 

Abuse Treatment IEI includes $392.9 million which covers 14 programmatic activities. The 

request includes: 

• $27.1 million for Screening, Brief Intervention, and Referral to Treatment (SBIRT) for 

continuation grants/cooperative agreements to add screening and brief intervention/referral 

services within States, campuses and general medical settings, and an evaluation of the

program; 

• $17.4 million for Targeted Capacity Expansion for continuation grants/cooperative 

agreements to units of State and local governments and tribal entities 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; 

• $98.5 million for the Access to Recovery Program (ATR) to support continuation grant 

awards to States and Tribal organizations through a recovery-oriented system of care 

approach to service delivery utilizing electronic vouchers and client choice; 

• $30.7 million for Children and Family Programs for continuation grants/cooperative 

agreements 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 family centered;

• $47.4 million for Treatment Systems for Homeless continuation grants/cooperative 

agreements to enable communities to expand and strengthen their substance abuse treatment 

services for homeless (including chronically homeless) individuals with substance abuse 

disorders, or with co-occurring substance abuse disorders and mental illness; 

• $65.9 million for Minority AIDS continuation grants/cooperative agreements to provide 

substance abuse treatment services, pre-treatment services, 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 the provision of other medical and 

social services available in the local community; 

• $67.6. million for Criminal Justice activities, to support continuation grants/cooperative 

agreements for Drug Court grants that provide treatment, housing, vocational, and 

employment services; for Family Treatment Drug Courts; and for Ex-Offender Re-entry 

programs to provide screening, assessment and comprehensive treatment, and recovery 

services to offenders reentering the community.
126 

The Substance Abuse Treatment IEI underwent a program assessment in 2002. The assessment 

cited strong design and positive impact as strong attributes of the program. As a result of the 

assessment, the program is providing benchmark data to allow grantees to gauge how they 

perform compared to other grantees in their program area; including language in new program 

announcements (as appropriate) around incentives and disincentives based on grantee 

performance; and to improve the integration of the monthly tracking system of performance that 

supports monitoring of grantees by team leaders and project officers. 
127 

SAMHSA/Center for Substance Abuse Treatment

Mechanism Table by APT

(Dollars in Thousands)

Innovations & Emerging Issues

FY 2010

Actual

No. Amount

FY 2011

CR

No. Amount

FY 2012

Pres. Budget

No. Amount

FY 2012 Request 

+/- 2010 

No. Amount

Grants/Cooperative Agreements:

Continuations.......................................... 446 $189,436 510 $288,596 411 $256,244 -35 $66,808

New/Competing...................................... 204 152,357 113 52,516 173 72,613 -31 -79,744

Supplements............................................

Subtotal..............................................

(8) 1,100 0 0 0 0 -8 -1,100

650 342,893 623 341,112 584 328,857 -66 -14,036

Contracts:

Continuations.......................................... 25 59,377 34 63,683 32 58,512 +7 -865

New/Competing...................................... 14 5,947 3 3,200 2 5,550 -12 -397

Supplements............................................

Subtotal..............................................

Subtotal, IEI.............................................

 0 0 0 0 0 0 0 0

39

689

65,324

$408,217

37

660

66,883

$407,995

34

618

64,062

$392,919

 -5

 -71

 -1,262

 -$15,298
128 

Page intentionally left blank 
129 

SAMHSA/Innovation and Emerging Issues - Substance Abuse Treatment 

(Dollars in Thousands)

FY 2010

Actual

FY 2011 

CR

FY 2012

Pres. Budget

Co-occurring State Incentive Grants (SIGs) 4,262 4,263 4,263

Screening, Brief Intervention and Referral to Treatment 29,106 29,106 29,106

TCE - General 29,022 28,989 17,411

Pregnant & Postpartum Women 16,000 16,000 16,000

Strengthening Treatment Access and Retention 1,773 1,775 1,675

Recovery Community Services Program 5,669 5,236 2,450

Access to Recovery 99,380 98,954 98,454

Children and Family Programs 30,576 30,678 30,678

Treatment Systems for Homeless 42,530 42,750 47,360

Minority AIDS 65,911 65,988 65,988

Criminal Justice Activities 67,189 67,635 67,635

Congressional Projects 4,593 4,593 ---

Minority Fellowship Program 547 547 547

Special Initiatives/Outreach 2,509 2,400 2,271

Addiction Technology Transfer Centers 9,150 9,081 9,081

TOTAL, IEI CSAT $408,217 $407,995 $392,919

Authorizing Legislation ............................................... Section 506, 508, 509, 514 of the PHS Act 

FY 2012 Authorization ......................................................................................................... Expired

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

Co-Occurring State Incentive Grants (COSIGs)

Program Description and Accomplishments

The COSIG program has two primary goals: to develop and enhance the infrastructure of States 

and their treatment service systems and to increase the capacity of States to provide accessible, 

effective, comprehensive, coordinated/integrated, evidence-based treatment services to persons 

with co-occurring mental and substance use disorders and their families. The Co-Occurring 

program has been administered collaboratively by the Center for Mental Health Services and the 

Center for Substance Abuse Treatment, with the initial five-year COSIG grants awarded to seven 

States in 2003. The most recent awards were made in 2007. 

COSIG grants support capacity-building, infrastructure development, and enhancement goals 

and activities over the five-year term of the projects. States identified the following elements as 

important for infrastructure development and enhancement: screening and assessment; 

complementary licensure and credentialing requirements; service coordination and network 

building; financial planning and information sharing. While the COSIG program has focused 

primarily on infrastructure development and enhancement, several grantees have exercised an 

option to conduct pilot services projects within their States. The grantees are supported by the 
130 

Co-Occurring Center for Excellence (COCE), which provides training and technical assistance. 

The COCE is co-funded by SAMHSA/CSAT and CMHS. 

Screening, Brief Intervention and Referral to Treatment (SBIRT)

Program Description and Accomplishments

Screening, Brief Intervention and Referral to Treatment (SBIRT) was initiated in 

SAMHSA/CSAT in FY 2003, using cooperative agreements to expand and enhance the 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. According to SAMHSA’s National Survey on Drug Use and Health (NSDUH), in 2008 

approximately 21 million people needed treatment for a substance use disorder but did not 

receive it. Of those, 95 percent did not feel they needed treatment. Therefore, most people with 

or at risk for a substance use disorder are unlikely to seek help from the specialty treatment 

system. They are far more likely to present in some other medical setting. 

Substance abuse is one of our Nation’s most significant public health challenges, and the SBIRT 

approach can intervene early in the disease process before individuals achieve dependency, and 

can motivate the addicted client to engage in substance abuse treatment. 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 

persons with more serious problems and encourage them to obtain appropriate specialty 

treatment services. 

Since the beginning of this program, more than one million individuals have been screened. Of 

those, 23% required a brief intervention, brief treatment or referral to specialty treatment 

programs. The first cohort of SBIRT cooperative agreements was awarded in 2003 to six States 

and one Tribal entity. Cooperative agreements were awarded to four more States in 2006 and 

four in 2008. In 2005, 12 Treatment Capacity Expansion (TCE), Screening and Brief 

Intervention (SBI) grants were awarded to colleges and universities to address campus drinking 

and drug use. In 2008, in an effort to incorporate SBIRT into general health care practice, 11 

grants were awarded to embed SBIRT training and practice in medical residency programs. In 

2009, an additional six grants were awarded, increasing the number of medical residency 

programs to 17. In FY 2010, SAMHSA/CSAT supported continuation of eight State SBIRT 

grants and seventeen Medical Residency SBIRT Training grants. 

The SBIRT cooperative agreements require grant recipients to effect practice change throughout 

the spectrum of medical practice. This is achieved through implementation of SBIRT programs 

in all levels of primary care, including hospitals, trauma centers, health clinics, nursing home, 

employee assistance programs, and school systems. Practice change is also envisioned as 

altering the educational structure of medical schools by developing and implementing SBIRT 

curriculum as standard and permanent practice. 
131 

SBIRT has great future potential for promoting changes to the entire primary care medical 

service delivery system. Expansion of the SBIRT program would be expected to include 

dentistry, pediatrics and adolescent care organizations, community health and mental health 

agencies, and other locations where primary care services are offered. New diagnostic codes 

have been adopted by 16 U.S. States, making it easier for doctors to get reimbursed for screening 

Medicaid patients. 

Targeted Capacity Expansion-General (TCE-General)

Program Description and Accomplishments

Targeted Capacity Expansion (TCE-General) program was initiated in FY 1998 to help 

community’s bridge gaps in treatment services. TCE funding supports grants to units of State 

and local governments and tribal entities to expand or enhance a community’s ability to provide 

rapid, strategic, comprehensive, integrated, community-based responses to a specific, welldocumented substance abuse capacity problem. TCE projects use grant funding to expand and/or 

enhance treatment capacity using evidence-based treatment practices, report on performance 

measurements, and address cultural relevance in their treatment and recovery services. Since FY 

1998, grants have been awarded to address the following targeted populations or urgent, unmet 

and emerging treatment needs: American Indian and Alaska Natives, Asian Americans, Pacific 

Islanders, rural areas, methamphetamine abuse, e-therapy, grassroots partnerships, and other 

populations. 

Pregnant & Postpartum Women (PPW) 

Program Description and Accomplishments

Women with substance use disorders and their children, particularly those living at or near the 

poverty line, are among the most vulnerable of populations, and they often have histories of 

physical violence, sexual abuse, co-occurring mental health disorders, and HIV/AIDS. Their 

children often have multiple health, developmental, and social problems, and are at risk for 

neglect, abuse, and removal from their families and communities. The risk of infant mortality is 

highly correlated with a pregnant mother’s substance abuse, lack of prenatal care, and 

demographic factors, such as poverty and a lower level of education. 

The national treatment infrastructure has not kept pace with the demand or complexity of needs 

experienced by this population, such as access to primary health care, mental health care, social 

and recovery support services. Services are also often lacking for their minor children impacted 

by the perinatal and environmental effects of maternal substance use and abuse. To improve the 

overall treatment outcomes for the family unit as a whole, service must be designed to address 

the needs of fathers of the children, partners of the women, and other extended family members. 

Meeting the needs of the entire family requires coordination of services with multiple agencies 

and across systems that often have different philosophies and approaches. 

SAMHSA/CSAT’s Pregnant and Postpartum Women (PPW) program has supported gender and 

culturally specific residential treatment service grants for pregnant, postpartum, and other 
132 

parenting women. Using a family-centered treatment approach, with women and their minor 

children at the center, the program has focused on the strengths and resources of the entire 

family, supporting sustained recovery for individual family members, and improving overall 

family functioning. 

Strengthening Treatment Access & Retention (STAR)

Program Description and Accomplishments

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 (or 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 peerto-peer learning opportunities. 

Based on the NIATx program success, CSAT funded a follow-on effort in 2006, the 

Strengthening Treatment Access and Retention – 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. Under STAR-SI, program 

grantees have: (1) used process improvement methods to improve both State and treatment 

agency level organizational processes that impact client access to and retention in outpatient 

substance abuse treatment services; (2) developed provider and payer capacity to implement 

process improvement methods through the operation of peer-to-peer learning networks; (3) 

partnered with outpatient treatment providers, including, when applicable, the State treatment 

provider association and key fiscal intermediaries, in program design and implementation; and 

(4) implemented performance management systems to track progress and provide feedback to 

participating treatment providers on performance outcomes. 

In FY 2010, 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. STAR also conducted a learning collaborative 

with over 300 treatment providers on how to improve third party billing practices in anticipation 

of the transition to increasing Medicaid clients under health care reform.
133 

Recovery Community Services Program (RCSP)

Program Description and Accomplishments

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 design and deliver peer-to-peer 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; gay, lesbian, 

and transgender populations; African-American; Latino; rural populations; persons recently 

released from incarceration; the homeless; and adolescents. 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 are seeking 

recovery, along with their family members and significant others, and include both providers and 

recipients of recovery support services. 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.

Access to Recovery (ATR)

Program Description and Accomplishments

Access to Recovery (ATR) provides grants to States, Tribes, and Tribal organizations to carry 

out voucher programs that expand substance abuse treatment capacity and promote choice 

among clinical treatment and recovery support providers in order to facilitate client recovery 

from substance abuse. The objectives of the program are to expand substance abuse treatment 

capacity by increasing the number and types of providers (including faith-based and grass-roots 

providers), to allow clients to play a more significant role in the development of their treatment 

plans through the use of electronic vouchers, and to link clinical treatment with critical recovery 

support services such as childcare, transportation, and mentoring. The populations served 

through ATR include the following: youth, users of methamphetamine, individuals involved with 

the criminal justice system, and women with dependent children. ATR enhances accountability 

by measuring outcomes and monitoring data to deter fraud and abuse. 

ATR was launched in 2004 when 15 three-year grants were awarded, which provided services to 

almost 200,000 clients. A second cohort of 24 three-year ATR grants was awarded in September 

2007. The second ATR cohort was projected to serve a target number of 30,000 clients in its 

first year (FY 2008); however, the actual number served was more than 50,000. The number 

served in FY 2009 was approximately 89,600 which exceeded the target of 65,000 clients. FY 

2010 outcome data show that 82.9% of the clients had success achieving and maintaining no past 

month substance use. In addition, by six month follow-up, 47 percent reported being housed; 96 
134 

percent had no involvement in the criminal justice system; and 91 percent reported being socially 

connected. 

The third ATR cohort was expanded to a four-year program. ATR is designed to: (1) allow 

recovery to be pursued through personal choice and many pathways; (2) require grantees to 

manage performance based 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 recommended target is 225,000 clients for this third cohort, which began 

in FY 2010, with approximately 33,500 to be served in the first year, 70,750 clients to be served 

in the two subsequent years, and 50,000 to be served in the final year. 

Children & Family Programs

Program Description and Accomplishments

Despite the availability of effective substance abuse treatment practices for adolescents and their 

families/primary caregivers, these practices are not being adequately utilized in the field. In 

response, SAMHSA/CSAT created the Adolescent Treatment grants which 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 family centered.

Forty-eight grantee sites across the nation are implementing the Assertive Community 

Reinforcement Approach and the Assertive Continuing Care (ACRA/ACC) treatment 

interventions. ACRA and ACC were developed with funding from SAMHSA/CSAT and the 

National Institute on Alcohol Abuse and Alcoholism (NIAAA), and have proven effective in 

building community capacity for family centered treatment. These approaches are in the public 

domain, allow for cost-effective training of multiple staff, and are amenable to a train-thetrainers approach, ensuring sustainability over time. 

The Family Centered Treatment grantees are receiving training and ongoing coaching for their 

clinical supervisors and clinicians that will lead to certification in the ACRA/ACC intervention 

model. In addition, each site has received training and certification to conduct a standardized biopsychosocial clinical assessment that identifies substance use disorders, co-occurring mental 

health disorders, and family support and functioning. Utilizing this intensive process ensures that 

a standardized implementation of the intervention is completed. Important lessons to be learned 

from these grantee sites include how to effectively implement and sustain best and proven 

practices in community based agencies. 

In addition to the Adolescent Treatment grant programs, SAMHSA/CSAT 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. The vast majority 

of children, particularly babies, who are placed in protective custody, have a parent with a 

substance use disorder. Thus, it is imperative that child welfare, substance abuse treatment 

providers, and the courts work efficiently together. This program provides technical assistance 

and training to grantees awarded under an ACF grant program entitled “Targeted Grants to 

Increase the Well Being of and to Improve the Permanency Outcomes for Children Affected by 
135 

Methamphetamine and Other Substance Abuse”. Activities include in-depth technical 

assistance, working more closely with legislators and Governors’ offices, forging more extensive 

partnerships with family drug courts, and planning greater emphasis on work with Tribes. 

Treatment Systems for Homelessness

Program Description and Accomplishments

SAMHSA/CSAT manages two grant portfolios under its Grants for the Benefit of Homeless 

Individuals (GBHI) program, both of which provide focused services to individuals with a 

substance use disorder or who have co-occurring substance use and mental health disorders. 

Through a recovery and public health oriented system of care, grantees are encouraged to 

address gender, age, race, ethnicity, sexual orientation, disability status, veteran’s status, and 

criminal justice status as these issues relate to both co-occurring disorder services and to 

substance use disorder services for homeless individuals. 

The purpose of the GBHI program is to enable communities to expand and strengthen their 

substance abuse treatment services for homeless (including chronically homeless) individuals 

with substance abuse disorders, or with co-occurring substance abuse disorders and mental 

illness and move them to permanent supportive housing. SAMHSA/CSAT funds programs that 

demonstrate treatment effectiveness in serving runaways, homeless and street youth, homeless 

veterans, and other support services to move and maintain chronically homeless individuals with 

mental and substance use disorders into permanent supportive housing. In addition, 

SAMHSA/CSAT provides funds for expansion and strengthening substance abuse treatment 

services for homeless, alcohol-dependent persons who have histories of public inebriation, 

frequent emergency room visits, arrests, mental illness, or co-occurring substance use and mental 

health disorders. 

Through this grant program, grantees link substance abuse treatment services with housing 

programs and other services (e.g. mental health treatment, primary care). Funds support direct 

services, including the following types of activities: conducting outreach and pre-service 

strategies to expand access to treatment services to underserved populations; purchasing or 

providing direct treatment (including screening, assessment, and care management) services for 

populations at risk; purchasing or providing “wrap-around” services; and collecting data using 

specified tools and standards to measure and monitor substance abuse treatment services and 

costs. In particular, programs are encouraged to implement evidence-based practices that result 

in treatment outcomes such as abstinence from alcohol and substance use, reduced criminal 

justice system involvement, employment, and stable housing. 

In FY 2008, consistent with congressional intent, SAMHSA/CSAT began allocating part of its 

GBHI funds for grants that address services in supportive housing (SSH). Like 

SAMHSA/CSAT’s GBHI grants for the homeless population, the SSH grants seek to expand and 

strengthen treatment services for persons who are homeless by providing linkages to appropriate 

treatment for substance use or other support services. SAMHSA/CSAT defines services in 

supportive housing for the purposes of the SSH grants as housing that is permanent, affordable, 
136 

and linked to health, mental health, employment, and other support services. This approach 

combines long-term, community-based housing assistance and intensive individualized treatment 

and recovery support services to chronically homeless individuals with substance use disorders. 

It is a cost-effective combination of affordable housing with substance abuse treatment services 

that helps people live more stable, productive lives and leads to reductions in substance use. 

The GBHI and SSH grants are complementary approaches that provide a comprehensive 

response to homeless persons living with substance use. Both support the implementation of 

effective, evidence-based practices, and the combination of the two approaches allows 

SAMHSA/CSAT to support communities in reaching their homeless populations in need of 

treatment wherever they are found, whether in supportive housing or other community-based 

settings. 

Since the inception of the GBHI program, SAMHSA/CSAT homeless grants have served 43,956 

individuals. The currently active portfolio has served over 12,855 individuals. Each grantee 

collects information on the clients that are served through the grant funds. The information is 

entered into a Web-based data system that allows for tracking and accountability of grantee 

performance on the goals outlined in the grant proposal. Outcome data available for a subset of 

clients served by the program through the active GBHI grantees show that individuals 

demonstrate:

• 79.7 percent increase in employment or engaging in productive activities; 

• 163.4 percent increase in persons with a permanent place to live in the community;

• 38.3 percent increase in no past months substance use; 

• 23.9 percent improvement in no/reduced alcohol or illegal drug related health, 

behavioral or social consequences. 

The FY 2012 Budget request for this program is aligned with “Opening Doors: the Federal 

Strategic Plan to Prevent and End Homelessness” which was released in June 2010. This 

program is an essential piece to accomplishing the goals of the Plan. 

Minority AIDS

Program Description and Accomplishments

Minority AIDS 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; 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 
137 

of access to drug treatment, HIV/AIDS testing and counseling services, and the provision of 

other medical and social services available in the local community. 

In FY 2010, SAMHSA/CSAT’s TCE/HIV program served approximately 15,750 individuals. 

Of these individuals, approximately 68 percent were between the ages of 25 and 54 years. 

Approximately 31 percent identified themselves as Hispanic/Latino in ethnicity; 46 percent as 

African American; 22 percent white; 2 percent Asian, Native Hawaiian or Pacific Islander; and 4 

percent as American Indian/Alaska Native. 

Criminal Justice Activities

Program Description and Accomplishments

Criminal justice activities include grant programs which focus on diversion, alternatives to 

incarceration, and re-entry from incarceration for adolescents, teens, and adults with substance 

use disorders, and/or co-occurring substance use and mental disorders. Criminal justice program 

grantees are tasked with providing a coordinated and comprehensive continuum of supervision, 

programs and services to help members of the target population become productive, responsible 

and law abiding citizens. In addition, the program provides States and communities the 

flexibility they need to tailor court solutions to local needs in order to break the patterns of 

incarceration and recidivism associated with drugs, alcohol, and co-occurring mental disorders.

Drug Courts

Problem solving 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. In 2007, the criminal 

justice system was the largest single source of referrals to substance abuse treatment. As 

treatment drug courts and other problem solving courts addressing drug and other behavioral 

health-related issues are being established at a high rate, communities are challenged to find 

sufficient substance abuse treatment and recovery support resources for people referred by the 

courts. 

The number of such courts in the nation with a focus on drug treatment has increased, from 

1,200 in 2005 to over 2,400 in 2010. Even with the increase in the availability of these courts, 

there is a limited amount of treatment, mental health, and recovery support services available. 

Approximately 10 percent of individuals in need of substance abuse treatment within the 

criminal justice system actually receive treatment as part of their justice system supervision. 

In FY 2010, SAMHSA/CSAT funded 8 new Juvenile Treatment Drug Court grants for three

years at an average cost of $325,000 per year. There were also three new Juvenile Treatment 

Drug Court grants that were funded in collaboration with the Department of Justice (DOJ)/Office 

of Juvenile Justice and Delinquency Prevention (OJJDP) and in partnership with Robert Wood 

Johnson for four years at an average cost of $200,000 per year. This collaborative program was 

initiated in FY 2009, with the award of three grants. These funds will provide services to 
138 

support substance abuse treatment, assessment, case management, and program coordination for 

those in need of treatment drug court services. Priority for the use of funding will be given to 

address gaps in the continuum of treatment. 

In FY 2010, SAMHSA/CSAT funded 17 new Adult Treatment Drug Court grants for three years 

at an average cost of $325,000 per year. Also in FY 2010, SAMHSA and DOJ/Office of Justice 

Programs /Bureau of Justice Affairs (BJA) developed a joint program to enhance court services, 

coordination, and substance abuse treatment capacity of adult drug courts. The purpose of this 

joint initiative is for applicants to submit one application that outlines a comprehensive strategy 

for enhancing drug court capacity. SAMHSA and BJA jointly funded 28 new Adult Treatment 

Drug Court grants. Each grantee was awarded one separate grant from each agency, representing 

an innovative braided funding opportunity. This collaboration was modeled after the successful 

SAMHSA and DOJ/OJJDP collaborative Juvenile Treatment Drug Court grant program.

Children exposed to methamphetamine laboratories not only face great physical danger from 

chemical contamination and fire explosions, but they are at a heightened risk for abuse, neglect, 

and continued social and developmental problems. In addition, substance use and addiction are 

frequently associated with the neglect and abuse of children and this has placed an immense 

burden on the dependency courts, child welfare systems, and treatment providers. To address 

this situation, the Administration provided assistance to the Children Affected by 

Methamphetamine/Family Treatment Drug Court program in FY 2010. These grants will 

provide a Child Case Coordinator to link available community-based social services resources 

that will focus on the trauma to these youngest victims caused by substance 

abuse/methamphetamine use in the family and concurrent criminal justice involvement. This 

program will provide a collaborative approach to child case coordination of services for these 

children of methamphetamine-addicted parents by including judges, treatment providers, child 

welfare specialists, and attorneys. In FY 2010, SAMHSA/CSAT funded 12 grants at $370,000 

per year for up to four years. 

In FY 2012, SAMHSA will continue to provide technical assistance and support States and 

communities in implementing flexible solutions to address the burdensome problems of 

substance abuse, mental illnesses, and co-occurring disorders in the criminal justice system 

through collaboration between the Center for Substance Abuse Treatment and the Center for 

Mental Health Services. This approach helps local courts find the model that best meets their 

needs and capacities. It also encourages partnership with the behavioral health system to allocate 

treatment and recovery support services effectively and efficiently.

Offender Re-entry Program

The justice system is seen as the nexus of public health and public safety, given the number of 

individuals involved in both drugs and crime who cause significant impact on American society. 

In 2002, the estimated cost to society of drug abuse was $180.9 billion; $107.8 billion of that 

total was associated with drug-related crime, including criminal justice system costs and costs 

borne by victims of crime. The cost of treating drug abuse (including research, training and 

prevention) was estimated at $15.8 billion – a fraction of the overall costs to society. 
139 

Research shows that for the drug-involved offender’s most positive gains made as the result of 

prison-based treatment rapidly dissipate if the individual is not linked to effective communitybased services upon return to the community. In FY 2002, with the number of reentering 

offenders totaling over 625,000 persons, Federal agencies began to respond to the accompanying 

public safety and public health issues by funding new programs such as the Serious and Violent 

Offender Re-entry Initiative and the Prisoner Re-entry Initiative. SAMHSA participated as a 

Federal partner in both of these initiatives. In FY 2004, SAMHSA’s Young Offender Re-entry 

Program (YORP) was initiated with the awarding of 12 grants to expand and enhance treatment 

capacity for juveniles and young offenders returning to their communities from correctional or 

detention facilities. This offender re-entry initiative was designed to facilitate reintegration into 

the community by providing pre-release screening, assessment and transition planning in 

institutional corrections settings and linking clients to community-based treatment and recovery 

services upon release. In FY 2005, a second cohort of 13 grants was funded as part of an $11 

million effort to respond to the escalating number of alcohol and drug involved offenders 

returning to the community. 

SAMHSA recognizes the need to continue efforts to return and reintegrate offenders back into 

the community by providing substance abuse treatment and other related re-entry services while 

also ensuring public safety for the community and family. The Offender Re-entry 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. In FY 2009, SAMHSA/CSAT funded 24 new ORP 

grants and 18 in FY 2010. These grants are funded for three years at an average cost of 

$400,000 per year. 

SAMHSA and DOJ/Bureau of Justice Assistance share a mutual interest in supporting and 

shaping offender re-entry-treatment services, as both agencies fund “offender re-entry” 

programs. These two Agencies have a longstanding partnership regarding criminal justicesubstance abuse treatment issues. SAMHSA and DOJ/Bureau of Justice Assistance have 

developed formal agreements to further encourage and engage in mutual interests and activities 

related to criminal justice-treatment issues. SAMHSA and DOJ/Bureau of Justice Assistance 

will continue to plan and coordinate relevant activities. Offender Re-entry Program grantees are 

expected to seek out and coordinate with local Federally-funded offender re-entry initiatives, 

including DOJ/Bureau of Justice Assistance’s Prisoner Re-entry Initiative or “Second Chance 

Act” offender re-entry programs, as appropriate. 

Minority Fellowship Program (MFP)

Program Description and Accomplishments

In a partnership with CMHS, CSAP and CSAT, this program increases the knowledge of issues

related to ethnic minority mental health and substance use disorders, as well as improves the

quality of mental health and substance abuse prevention and treatment delivered to ethnic 

minorities by providing stipends to doctoral level students to increase the number of culturally 

competent behavioral health professionals who teach, administer, conduct services research, and 

provide direct mental health/substance abuse services to underserved minority populations. 125 
140 

individuals were trained in FY 2009. Since its start in 1973, the Minority Fellowship Program 

(MFP) has helped to support doctoral-level training of ethnic minority psychiatrists, 

psychologists, psychiatric nurses, and social workers. These individuals often serve in key 

leadership positions in mental health and substance abuse direct services, including supervision, 

direct services, services research, training, and administration. 

Addiction Technology Transfer Centers (ATTCs)

Program Description and Accomplishments

The Addiction Technology Transder Center (ATTC) Network is comprised of one national 

coordinating center and fourteen geographically dispersed regional ATTCs covering all States, 

the District of Columbia, Puerto Rico, the Virgin Islands, and U.S. Territories in the Pacific. The 

Regional Centers support national activities and implement 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 evidence-based and promising practices to addictions 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 Web-based 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 23,000 people were trained in 2010, exceeding the target of 20,516. 

Approximately 96 percent of participants report implementing improvements in treatment 

methods based on the information they received from the training they attended. 

Special Initiatives/Outreach

Program Description and Accomplishments

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 103 HBCUs throughout the U.S. 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 HBCU – Center for 

Excellence also supports a policy academy which focuses on workforce development, leadership 

development, cross-systems collaboration, cultural competency and eliminating disparities. The 

HBCU – Center for Excellence collaborate with other HHS agencies including HHS/Office of 

Minority Health (OMH), to achieve the objectives of various Executive Orders on educational 

excellence for minority populations. 

In FY 2010, SAMHSA/CSAT entered into an inter-agency agreement with the Agency for 

Healthcare Research and Quality (AHRQ) to examine and graphically display selected trends in 
141 

hospital-based 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. 

Through the HBCU-Center for Excellence, approximately 19 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. 

IEI - CSAT Funding History * 

FY Amount

2007 $343,254,000 

2008 $344,167,000 

2009 $358,323,000 

2010 $408,217,000 

2011 $407,995,000 

* The funding history is based on a comparable basis to previous funding levels to reflect the 

revised budget restructure. 

Budget Request

The FY 2012 President’s Budget request is $392.9 million, a decrease of $15.3 million from the 

FY 2010 level. The request will support 584 grants and 34 contracts. This level of funding 

enables the continuation of all programmatic activities. The Budget phases out funding for new 

awards, including: Targeted Capacity Expansion, Recovery Community Services Program, and 

Special Initiatives/Outreach. No continuing grant awards will be terminated. SAMHSA will 

work with the States to use their Block Grant and Substance Abuse and Mental Health 

Prevention Grants to implement the practices learned from these programs. 

Outcomes and Outputs

Co-Occurring State Incentive Grants

As the Co-Occurring State Incentive Grants are coming to an end in FY 2009 and no new grants 

are planned, performance measures for this program will no longer be reported. 
142 

Screening, Brief Intervention and Referral to Treatment

Table 1: Key Performance Indicators for Screening, Brief Intervention and Referral to Treatment

Measure Most Recent 

Result

FY 2011 

Performance 

Target 

Associated 

with FY 2010 

PB 

FY 2013 

Performance 

Target 

Associated 

with FY 2012 

Request

FY 2013 

Performance 

Target +/- FY 

2011 

Performance 

Target 

1.2.40: Number of clients served

(Output) 

FY 2010: 

275,473

(Target 

Exceeded) 

139,650 139,650 Maintain 

1.2.41: Percentage of clients 

receiving services who had no past 

month substance use (Outcome) 

FY 2010: 34%

(Target Not 

Met) 

50% 50% Maintain 

Access to Recovery

Table 2: Key Performance Indicators for Access to Recovery

Measure Most Recent 

Result

FY 2011 

Performance

Target 

Associated 

with FY 2010 

PB 

FY 2013 

Performance 

Target 

Associated 

with FY 2012 

Request

FY 2013 

Performance 

Target +/- FY 

2011 

Performance 

Target 

1.2.32: Number of clients gaining 

access to treatment1

FY 2010: 

69,552

(Target 

Exceeded) 

(Output) 33,500 70,750 +37,250 

1.2.33: Percentage of adults 

receiving services who had no past 

month substance use (Outcome) 

FY 2010: 

82.9%

(Target 

Exceeded) 

82% 83% +1% 

 

1

Initial Access to Recovery grants were made in August 2004, close to the end of FY 2004. Services were not necessarily provided in the same 

year Federal funds were obligated. Thus, although the baseline reported for FY 2005 represented people served in FY 2005, most of the funding 

consisted of FY 2004 dollars. With the FY 2004 grants, it was estimated that 125,000 clients would be served over the three year grant period. 

The second cohort of grants was awarded in September 2007.
143 

Measure Most Recent 

Result

FY 2011 

Performance

Target 

Associated 

with FY 2010 

PB 

FY 2013 

Performance 

Target 

Associated 

with FY 2012 

Request

FY 2013 

Performance 

Target +/- FY 

2011 

Performance 

Target 

1.2.35: Percentage of adults 

receiving services who had 

no/reduced involvement with the

criminal justice system (Outcome) 

FY 2010: 

96.3%

(Target 

Exceeded) 

96% 96% Maintain 

1.2.36: Percentage of adults 

receiving services who had 

improved social support (Outcome) 

FY 2010: 

91.1%

(Target 

Exceeded) 

91% 91% Maintain 

Treatment System for Homelessness (GBHI)

Table 3: Key Performance Indicators for Treatment System for Homelessness 

Measure Most Recent 

Result

FY 2011 

Performance 

Target 

Associated 

with FY 2010 

PB 

FY 2013 

Performance 

Target 

Associated 

with FY 2012 

Request

FY 2013 

Performance 

Target +/- FY 

2011 

Performance 

Target 

3.4.22: Percentage of clients 

receiving services who had no past 

month substance use (Outcome) 

FY 2010: 66 %

(Target Not 

Met) 

67.4 % 67.4 % Maintain 

3.4.23: Number of clients served

(Output) 

FY 2010: 5,398

(Target Not 

Met) 

7,005 7,005 Maintain 

3.4.24: Percentage of clients 

receiving services who were 

currently employed or engaged in 

productive activities (Outcome) 

FY 2010: 32 %

(Target Not 

Met but 

Improved) 

32.7 % 32.7 % Maintain 

3.4.25: Percentage of clients 

receiving services who had a 

permanent place to live in the 

community (Outcome) 

FY 2010: 29.4 

% 

(Target 

Exceeded) 

25.6 % 25.6 % Maintain 
144 

Table 4: Key Performance Indicators for Criminal Justice – Juvenile and Adult Drug Courts

Measure Most Recent 

Result

FY 2011 

Performance 

Target 

Associated 

with FY 2010 

PB 

FY 2013 

Performance 

Target 

Associated 

with FY 2012 

Request

FY 2013 

Performance 

Target +/- FY 

2011 

Performance 

Target 

1.2.63: Percentage of juvenile clients 

receiving services who were 

currently employed or engaged in 

productive activities (Outcome) 

FY 2009: 89%

(Target 

Exceeded) 

88% 88%2

 Maintain 

1.2.64: Percentage of juvenile clients 

receiving services who had a 

permanent place to live in the 

community (Outcome) 

FY 2009: 79%

(Target Not 

Met) 

82% 82% Maintain 

1.2.65: Percentage of juvenile clients 

receiving services who had no 

involvement with the criminal 

justice system (Outcome) 

FY 2009: 92%

(Target Not 

Met) 

95% 95% Maintain 

1.2.67: Percentage of juvenile clients 

receiving services who had no past 

month substance use (Outcome) 

FY 2009: 73%

(Target Met) 73% 73% Maintain 

1.2.70: Number of juvenile clients 

served (Output) 

FY 2009: 376

(Target Not 

Met) 

1,4633

 1,463 Maintain 

1.2.72: Percentage of adult clients 

receiving services who were 

currently employed or engaged in 

productive activities4

FY 2010: 57%

(Target Met) 

(Outcome) 

57% 57% Maintain 

1.2.73: Percentage of adult clients 

receiving services who had a 

permanent place to live in the 

community5

FY 2010: 

42.3%

(Target 

(Outcome) Exceeded) 

42% 43% +1% 

 

2 Targets reflect a decrease in funding anticipated for this program.

3 This target has been revised from the FY 2010 President’s Budget based on the FY 2010 Appropriation.

4

Targets set for this measure in the FY 2010 President's Budget were based on Juvenile Drug Court data. Data for Adult Drug Courts clients is 

now available. As a result, the targets for FY 2010, 2011 and 2012 have been revised to be more appropriate to the population of this program. 5

Targets set for this measure in the FY 2010 President's Budget were based on Juvenile Drug Court data. Data for Adult Drug Courts clients is 

now available. As a result, the targets for FY 2010, 2011 and 2012 have been revised to be more appropriate to the population of this program. 
145 

Measure Most Recent 

Result

FY 2011 

Performance 

Target 

Associated 

with FY 2010 

PB 

FY 2013 

Performance 

Target 

Associated 

with FY 2012 

Request

FY 2013 

Performance 

Target +/- FY 

2011 

Performance 

Target 

1.2.74: Percentage of adult clients 

receiving services who had no 

involvement with the criminal 

justice system (Outcome) 

FY 2010: 93%

(Target Met) 93% 93%6

 Maintain 

1.2.76: Percentage of adult clients 

receiving services who had no past 

month substance use (Outcome) 

FY 2010: 

85.4%

(Target 

Exceeded) 

73% 73%7

 Maintain 

1.2.79: Number of adult clients 

served 8

FY 2010: 3,533

(Target 

Exceeded) (Output) 5,265 5,265 Maintain 

Table 5: Key Performance Indicators for Criminal Justice – Ex-Offender Re-Entry

Measure Most Recent 

Result

FY 2011 

Performance 

Target 

Associated 

with FY 2010 

PB 

FY 2013 

Performance 

Target 

Associated 

with FY 2012 

Request

FY 2013 

Performance 

Target +/- FY 

2011 

Performance 

Target 

1.2.80: Number of clients served

(Outcome) 

FY 2010: 1,772

(Target 

Exceeded) 

2,9129 2,912 Maintain 

1.2.81: Percentage of clients who 

had no past month substance use

(Outcome) 

FY 2010: 

77.5%

(Target 

Exceeded) 

70% 69% -1% 

 

6 Targets reflect a decrease in funding anticipated for this program.

7 Targets reflect a decrease in funding anticipated for this program.

8

Targets set for this measure in the FY 2010 President's Budget were based on Juvenile Drug Court data. Data for Adult Drug Courts clients is 

now available. As a result, the targets for FY 2010, 2011, and 2012 have been revised to be more appropriate to the population of this program. 9 This target has been revised from the FY 2010 President’s Budget based on the FY 2010 Appropriation.
146 

Measure Most Recent 

Result

FY 2011 

Performance 

Target 

Associated 

with FY 2010 

PB 

FY 2013 

Performance 

Target 

Associated 

with FY 2012 

Request

FY 2013 

Performance 

Target +/- FY 

2011 

Performance 

Target 

1.2.84: Percentage of clients 

receiving services who had no 

involvement with the criminal 

justice system (Outcome) 

FY 2010: 94.9 

% 

(Target Not 

Met) 

95% 96 % +1% 

Table 6: Key Performance Indicators for Treatment – Other Capacity10 

Measure Most Recent 

Result

FY 2011 

Performance 

Target 

Associated 

with FY 2010 

PB 

FY 2013 

Performance 

Target 

Associated 

with FY 2012 

Request

FY 2013 

Performance 

Target +/- FY 

2011 

Performance 

Target 

1.2.25: Percentage of adults 

receiving services who had no past 

month substance use (Outcome) 

FY 2010: 

67.9%

(Target 

Exceeded) 

62% 66% +4%

1.2.26: Number of clients served

(Output) 

FY 2010: 

37,365

(Target 

Exceeded) 

34,784 34,784 Maintain 

1.2.27: Percentage of adults 

receiving services who were 

currently employed or engaged in 

productive activities (Outcome) 

FY 2010: 46%

(Target Not 

Met but 

Improved) 

47% 47% Maintain 

1.2.28: Percentage of adults 

receiving services who had a 

permanent place to live in the 

community (Outcome) 

FY 2010: 49%

(Target Met) 49% 49% Maintain 

1.2.29: Percentage of adults 

receiving services who had no 

involvement with the criminal 

justice system (Outcome) 

FY 2010: 96%

(Target 

Exceeded) 

95% 96% +1%

 

10Includes TCE General, HIV/AIDS Outreach, Addiction Treatment for Homeless Persons, Assertive Adolescent and Family Treatment, Family 

and Juvenile Drug Courts, Young Offender Re-Entry Program, Pregnant and Post-Partum Women, Recovery Community Service – Recovery, 

Recovery Community Service – Facilitating, and Child and Adolescent State Incentive Grants. 
147 

Table 7: Key Performance Indicators for Treatment – Science and Service Activities11

Measure Most Recent 

Result

FY 2011 

Performance 

Target 

Associated 

with FY 2010 

PB 

FY 2013 

Performance 

Target 

Associated 

with FY 2012 

Request

FY 2013 

Performance 

Target +/- FY 

2011 

Performance 

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 2010: 

96.2%

(Target 

Exceeded) 

90% 90% Maintain 

1.4.02: Number of individuals 

trained per year (Output) 

FY 2010: 

23,034

(Target 

Exceeded) 

20,516 20,516 Maintain 

1.4.09: Number of individuals 

trained by SAMHSA's Science and 

Services Program (HHS Strategic 

Plan Measure) (Output) 

FY 2010: 

38,624

(Historical 

Actual)12

N/A 

 

N/A N/A 

Size of Awards

(whole dollars) FY 2010 FY 2011 FY 2012

Number of Awards 650 623 584

Average Award $343,485 $372,891 $380,581

Range of Awards $300,000 - $550,000 $300,000 - $580,000 $300,000 -$580,000

 

11

Includes Knowledge Application Program, Faith Based Initiatives, Strengthening Treatment Access and Retention, Addiction Technology 

Transfer Centers, and SAMHSA Conference Grants. 

12

NOTE: Data are preliminary and do not reflect all program accomplishments during FY 2010. Reporting periods for component programs vary 

and, therefore, are complete for only a portion of them. Final data for all programs will be available in August 2011. 
148 

Page intentionally left blank
149 

Children’s Mental Health Services Program

(Dollars in Thousands)

FY 2010 

Actual

FY 2011 

Continuing

Resolution

FY 2012 

President's 

Budget

Budget Authority.............................................................. $121,316 $121,316 $121,316

Authorizing Legislation .................................. Section 561 to 565 of the Public Health Service Act 

FY 2012 Authorization ......................................................................................................... Expired

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

Program Description and Accomplishments

The Children’s Mental Health Services Program was first authorized in 1992. The program 

supports the development of comprehensive, community-based systems of care for children and 

adolescents with serious emotional disorders and their families. Systems of care is an approach 

to the delivery of services that recognizes the importance of family, school and community, and 

seeks to promote the full potential of every child and youth by addressing their physical, 

emotional, intellectual, cultural and social needs. Accordingly, a system of care is a coordinated 

network of community-based services and supports that are organized to meet the challenges of 

children and youth with serious mental health needs and their families. 

Since 1993, the program has funded 164 grantees across the country; serving 95,884 children, 

and adolescents and their families. Grants are funded for a total of six years, with an increasing 

non-Federal match requirement over the term of the award. The match requirement is intended 

to promote sustainability of the local systems of care beyond the grant period. Sixty-four percent 

of system of care communities sustained five years post-Federal funding. 

National program evaluation data collected for more than a decade indicate that systems of care 

are successful, resulting in many favorable outcomes for children, youth and their families, 

including: 

• Sustained mental health improvements, including improvements for participating 

children and youth in clinical outcomes after six months of program participation; 

• Improvements in school attendance and achievement; 

• Reductions in suicide-related behaviors;

• Decreases in utilization of inpatient care and reduced costs due to fewer days in inpatient 

care;

• Significant reductions in contacts with law enforcement agencies.

A hallmark of this program is that youth and families partner with providers and policy makers 

in service delivery and system reform planning and decision-making. In addition to the 

substantial roles children, youth, and families play in the care they receive, services are delivered 
150 

in the least restrictive environment with evidence-based treatments and interventions. Care 

management ensures that planned services and supports are delivered appropriately and 

effectively. 

Funding History

FY Amount

2007 $104,078,000

2008 $102,260,000

2009 $108,373,000

2010 $121,316,000

2011 $121,316,000

Budget Request

The FY 2012 President’s Budget request is $121.3 million, the same as the FY 2010 Level. The 

funding will fully support 62 grant continuations and five contracts. 

Outcomes and Outputs

Children's Mental Health Services

Table 1: Key Performance Indicators for Children’s Mental Health Services 

Measure Most Recent 

Result

FY 2011 

Performance 

Target 

Associated 

with FY 2010 

PB 

FY 2013 

Performance 

Target 

Associated 

with FY 2012 

Request

FY 2013 

Performance 

Target +/- FY 

2011 

Performance 

Target 

3.2.16: Number of children receiving 

services (Output)1

FY 2010: 

4,930

(Target Not 

Met) 

 13,051 4,930 -8,121 

3.2.25: Percentage of children 

receiving services who report social 

support (Outcome) 

FY 2010: 85.7 

% 

(Target Not 

Met) 

87.6 % 87.6 % Maintain 

 

1

FY 2010 source for this measure has been transferred from the cross-site evaluation to the TRAC data collection system. The lower actual and 

subsequent targets are due to the fact that grantee use of the TRAC system is slower than expected. 
151 

Measure Most Recent 

Result

FY 2011 

Performance 

Target 

Associated 

with FY 2010 

PB 

FY 2013 

Performance 

Target 

Associated 

with FY 2012 

Request

FY 2013 

Performance 

Target +/- FY

2011 

Performance 

Target 

3.2.26: Percentage of children 

receiving services who report 

improved functioning (Outcome) 

FY 2010: 51.3 

% 

(Target 

Exceeded) 

50.2 % 50.2 % Maintain 

3.2.27: Number of people in the 

mental health and related workforce 

trained in specific mental healthrelated practices/activities as a result 

of the program (Output) 

N/A N/A TBD N/A 

3.2.28: Number of organizations that 

entered into formal written tier/intraorganizational agreements (e.g. 

MOUs/MOAs) to improve mental 

health-related practices/activities as a 

result of the grant (Output) 

N/A N/A TBD N/A 

Grant Awards Table

(Whole Dollars) FY 2010 FY 2011 FY 2012 

Number of Awards 75 66 61

Average Award $1,283,200 $1,495,136 $1,613,377

Range of Awar $330,000-$2,000,000 $330,000-$2,000,000 $330,000-$2,000,000
152 

Page intentionally left blank 
153 

Projects for Assistance in Transition from Homelessness

(Dollars in thousands)

Authorizing Legislation ............................................. Section 521 of the Public Health Service Act 

FY 2012 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. PATH is unique in 

that it alone is 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. PATH connects this largely un-served population to critical services 

and resources to assist them on the road of recovery. PATH funds community-based outreach, 

mental health, substance abuse, case management and other supportive services, and a limited set 

of housing services in 483 communities from all 50 States, the District of Columbia, Puerto Rico, 

Guam, American Samoa, the U.S. Virgin Islands, and the Northern Mariana Islands. 

The PATH formula calculates State allotments based on the population living in urbanized areas. 

These population data are updated after each census. This program requires matching funds of $1 

to every $3 of Federal funds. In the past several years, State and local matching funds exceeded 

the required amount. 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 cooccurring mental and substance use disorder. The PATH budget supports 56 grants to States and 

Territories, as well as centralized activities like technical assistance and evaluation. 

In 2008, the PATH program contacted 134,932 homeless persons, ten percent short of the target 

of 150,000. The program has begun to implement several activities to increase its performance 

on all the National Outcome Measures. Regarding the required match of $1 for every $3 of 

Federal funds, previously PATH grantees reported on the number of persons served by Federal

PATH funds only. Grantees will now report on all persons served using Federal and matching 

funds and will expand reporting of outcomes for clients. 

PATH implemented other activities to assure greater consistency of data collection and reporting 

to improve performance. In 2009, PATH developed national definitions for outreach, enrollment 

and engagement. Online training on these definitions was provided for all 56 State grantees and 

483 local providers. In addition, a partnership has been established with the Department of 

Housing and Urban Development (HUD) to determine the feasibility of having all PATH 

FY 2011 FY 2012 

FY 2010 Continuing President's 

Actual Resolution Budget

Budget Authority.............................................................. $65,047 $65,047 $65,047
154 

grantees collect and report PATH data in the Homeless Management Information System

(HMIS).

In December 2009, PATH began a process to prepare grantees to report in HMIS, involving a 

series of webinar-based exposure trainings, onsite regional trainings, intensive peer-to-peer and 

technical assistance activities, and online course, and pilot testing. Some States adopted the 

HMIS for their use early on with great success. These “early adopters” will serve as mentors and 

peer-to-peer trainers to those who are at the beginning stages of HMIS adoption. 

Involving consumers in the PATH program is essential. The program established a PATH 

consumer-provider network that developed a consumer involvement curriculum to assist in the 

planning, design, and delivery of PATH at the local, State, and national levels. Located 

at http://pathprogram.samhsa.gov, the recently re-designed PATH website provides tools and 

information for consumers, PATH providers, other homeless service providers, policy makers 

and the general public. It also presents opportunities for providers working with individuals who 

are homeless to connect with each other.

Funding History

FY Amount

2007 $54,261,000

2008 $53,313,000

2009 $59,687,000

2010 $65,047,000

2011 $65,047,000

Data Elements Used to Calculate FY 2012 Allotments 

Population: 2000 Population (all ages combined) of Urbanized Areas from U.S. Census Bureau 

for the States, the District of Columbia and Puerto Rico (2000 Census); no population data 

required for the Territories. 

Budget Request

The FY 2012 President’s Budget request is $65.0 million, same level as the FY 2010 Level. The 

funding level will continue all current programmatic activities. 
155 

Outcomes and Outputs

Projects to Assist in the Transition from Homelessness

Table 1: Key Performance Indicators for Projects to Assist in the Transition from Homelessness

Measure Most Recent 

Result

FY 2011 

Performance 

Target 

Associated 

with FY 2010 

PB 

FY 2013 

Performance 

Target 

Associated 

with FY 2012 

Request

FY 2013 

Performance 

Target +/- FY 

2011 

Performance 

Target 

3.4.15: Percentage of enrolled 

homeless persons who receive 

community mental health services

(Outcome) 

FY 2009: 49%

(Target 

Exceeded) 

47% 50% +3%

3.4.16: Number of homeless persons 

contacted (Outcome) 

FY 2009: 

165,954

(Target 

Exceeded) 

182,000 182,000 Maintain 

3.4.17: Percentage of contacted 

homeless persons with serious 

mental illness who become enrolled 

in services (Outcome) 

FY 2009: 50%

(Target Not 

Met) 

55% 55% Maintain 

3.4.20: Number of PATH providers 

trained on SSI/SSDI Outreach, 

Access, Recovery (SOAR) to ensure 

eligible homeless clients are 

receiving benefits (Output) 

FY 2009: 5,104

(Target 

Exceeded) 

5,420 5,420 Maintain 
156 

DEPARTMENT OF HEALTH AND HUMAN SERVICES

Substance Abuse and Mental Health Services Administration

FY 2011 DISCRETIONARY STATE/FORMULA GRANTS

Projects for Assistance in Transition from Homelessness (PATH)

CFDA # 93.150 

FY 2010 

Appropriation

FY 2011 

Estimate

 FY 2012 

STATE/TERRITORY Estimate +/- FY 2010

Alabama $588,000 $588,000 $588,000 $0

Alaska 300,000 300,000 300,000 0

Arizona 1,184,000 1,184,000 1,184,000 0

Arkansas 300,000 300,000 300,000 0

California 9,073,000 9,073,000 9,073,000 0

Colorado 973,000 973000 973000 0

Connecticut 863,000 863,000 863,000 0

Delaware 300,000 300,000 300,000 0

District Of Columbia 300,000 300,000 300,000 0

Florida 4,081,000 4,081,000 4,081,000 0

Georgia 1,518,000 1,518,000 1,518,000 0

Hawaii 300,000 300000 300000 0

Idaho 300,000 300,000 300,000 0

Illinois 2,950,000 2,950,000 2,950,000 0

Indiana 1,033,000 1,033,000 1,033,000 0

0

Iowa 338,000 338,000 338,000 0

Kansas 366,000 366,000 366,000 0

Kentucky 475,000 475000 475000 0

Louisiana 768,000 768,000 768,000 0

Maine 300,000 300,000 300,000 0

Maryland 1,287,000 1,287,000 1,287,000 0

Massachusetts 1,707,000 1,707,000 1,707,000 0

Michigan 1,993,000 1,993,000 1,993,000 0

Minnesota 821,000 821,000 821,000 0

Mississippi 300,000 300,000 300,000 0

Missouri 936,000 936,000 936,000 0

Montana 300,000 300,000 300,000 0

Nebraska 300,000 300,000 300,000 0

Nevada 508,000 508,000 508,000 0

New Hampshire 300,000 300,000 300,000 0

New Jersey 2,349,000 2,349,000 2,349,000 0

New Mexico 300,000 300,000 300,000 0

New York 4,697,000 4,697,000 4,697,000 0

North Carolina 1,139,000 1,139,000 1,139,000 0

North Dakota $300,000 $300,000 $300,000 $0
157 

DEPARTMENT OF HEALTH AND HUMAN SERVICES

Substance Abuse and Mental Health Services Administration

FY 2011 DISCRETIONARY STATE/FORMULA GRANTS

Projects for Assistance in Transition from Homelessness (PATH)

CFDA # 93.150 

FY 2010 

Appropriation

FY 2011 

Estimate

 FY 2012 

STATE/TERRITORY Estimate +/- FY 2010

Ohio $2,215,000 $2,215,000 $2,215,000 $0

Oklahoma 449,000 449,000 449,000 0

Oregon 599,000 599,000 599,000 0

Pennsylvania 2,487,000 2,487,000 2,487,000 0

Rhode Island 300,000 300,000 300,000 0

South Carolina 568,000 568,000 568,000 0

South Dakota 300,000 300,000 300,000 0

Tennessee 898,000 898,000 898,000 0

Texas 4,482,000 4,482,000 4,482,000 0

Utah 530,000 530,000 530,000 0

Vermont 300,000 300,000 300,000 0

Virginia 1,428,000 1,428,000 1,428,000 0

Washington 1,304,000 1,304,000 1,304,000 0

West Virginia 300,000 300,000 300,000 0

Wisconsin 861,000 861,000 861,000 0

Wyoming 300,000 300,000 300,000 0

State Sub-total 60,868,000 60,868,000 60,868,000 0

American Samoa 50,000 50,000 50,000 0

Guam 50,000 50,000 50,000 0

Northern Marianas 50,000 50,000 50,000 0

Puerto Rico 1,053,000 1,053,000 1,053,000 0

Virgin Islands 50,000 50,000 50,000 0

Territory Sub-Total 1,253,000 1,253,000 1,253,000 0

Total States/Territories 62,121,000 62,121,000 62,121,000 0

Set Aside 2,926,000 2,926,000 2,926,000 0

TOTAL PATH $65,047,000 $65,047,000 $65,047,000 $0
158 

Page intentionally left blank 
159 

SAMHSA Regulatory & Oversight Functions 

Regulatory & Oversight Functions Page

1. Seclusion & Restraint ..................................................................................................... 161

2. Protection and Advocacy for Individuals with Mental Illness........................................ 162

3. Mandatory Drug Testing ................................................................................................. 166

4. Opioid Drug Treatment/Regulatory Activities ............................................................... 166

5. National All Schedules Prescription Electronic Reporting (NASPER) .......................... 167
160 

Page intentionally left blank 
161 

Regulatory & Oversight Functions 

(Dollars in Thousands)

FY 2011 

Continuing 

Resolution

FY 2012 

President's 

Budget

FY 2010 

Regulatory and Oversight Functions Actual

Seclusion and Restraint $2,482 $2,449 $2,449

Protection and Advocacy (PAIMI) 36,380 36,380 36,380

Mandatory Drug Testing 5,202 5,206 5,206

Opioid Drug Treatment Regulatory Activities 8,988 8,903 8,903

Prescription Drug Monitoring (NASPER)

TOTAL, Regulatory and Oversight Functions

2,000 2,000 2,000

$55,052 $54,938 $54,938

Authorizing Legislation ........... Section 501, 509, 516, 519B, 519E, 520A, 399O of the PHS Act; 

........................................................................................................... Section 102 of the PAIMI Act 

FY 2012 Authorization ......................................................................................................... Expired

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

The programs realigned within Regulatory and Oversight Functions include program lines 

formerly in the Programs of Regional and National Significance for the Center for Mental Health 

Services, the Center for Substance Abuse Prevention, and the Center for Substance Abuse 

Treatment. The programs lines and their associated funding have been realigned into the ROF 

budget line, and comparable adjustments for FY 2010 and FY 2011 have been made. These 

programs include, Opioid Drug Treatment, Mandatory Drug Testing, Prescription Monitoring, 

Seclusion and Restrain, and Protection and Advocacy for Individuals with Mental Illness 

(PAIMI). 

Seclusion & Restraint

Program Description and Accomplishments

This program supports States/Tribes in their efforts to adopt best practices to reduce and 

ultimately eliminate the use of restraint and seclusion in institutional and community based 

settings that provide mental health services including services for people with co-occurring 

substance abuse and mental health disorders. 

In FY 2010, SAMHSA awarded the National Technical Assistance Center for Trauma and 

Justice: Promoting Alternatives to Seclusion and Restraint and Implementation of Trauma 

Informed Care. The overall purpose of the technical assistance center is to provide national 

leadership in reducing the pervasive, harmful, and costly health impact of violence and trauma 

by integrating trauma-informed approaches throughout health and behavioral healthcare systems, 

and to divert people with substance use and mental disorders from criminal and juvenile justice 

systems into trauma-informed treatment and recovery.
162 

Protection and Advocacy for Individuals with Mental Illness

Program Description and Accomplishments

The Protection and Advocacy for Individuals with Mental Illness Program (PAIMI) provides 

formula grant awards to support protection and advocacy systems designated by the Governor of 

each State and the Territories, and the Mayor of the District of Columbia. State protection and 

advocacy systems monitor facility compliance with respect to the rights of individuals through 

activities that ensure the enforcement of the Constitution and Federal and State laws. State 

protection and advocacy systems monitor public and private residential care and treatment 

facilities and non-medical community-based facilities for children and youth. The Budget 

Request will support 57 grants to States and Territories. An independent evaluation of the 

program was completed in FY 2009 which confirmed that PAIMI programs provide those with 

psychiatric disability a voice in the exercise of their rights and are highly successful in achieving 

client and system goals and objectives. 

In 2008, the PAIMI program: 

• Provided casework to 4,425 children and adolescents and 13,043 adults and elderly 

individuals with mental illness;

• Closed 14,772 cases, of which 4,271 were related to abuse, 2,860 to neglect, and 7,641 to 

a violation of individual rights; 

• Resolved 87 percent of alleged abuse cases, 84 percent of alleged neglect cases, and 89 

percent of alleged rights violations cases that resulted in positive change for the client in 

her/his environment, community, or facility. 

The FY 2011 funding will serve over 22,000 persons in FY 2012, drawing upon a marginal cost 

analysis conducted for this program (which estimated an average cost per complaint resolved 

successfully in FY 2009 of $3,164). For complaints of alleged abuse that resulted in positive 

change for the client in her or his environment, community, or facility as a result of PAIMI 

involvement, the outcome has improved each year from 78% in FY 2005 to 87% in FY 2008. 

The PAIMI program underwent a performance assessment in 2005. The assessment cited the 

fact that the program serves a clear need and is reporting positive outcomes as strong attributes 

of the program. As a result of the performance assessment, the program has provided grantees 

with guidelines as to how to calculate the number of PAIMI-eligible individuals impacted; has 

provided technical assistance on the right to access facilities, consumers, and information 

through the National Disability Rights Network; and an independent evaluation of the program 

was conducted. This program is one of eight protection and advocacy (P&A) programs housed in 

three Federal departments. The different reporting and evaluation requirements translate into a 

significant paperwork burden for recipients. To help remedy this problem, HHS, along with the 

Department of Education and the Social Security Administration, is committed to improving 

federal program coordination related to the monitoring and evaluating of these programs. 
163 

Data Elements Used to Calculate FY 2012 Allotments 

Population: July 1, 2009 Population Estimates (all ages combined) from U.S. Census Bureau 

for the States, the District of Columbia, and Puerto Rico. July 1, 2010 Population Estimates (all 

ages combined) from U.S. Census Bureau for the Territories other than Puerto Rico. 

Income: 2009 Per Capita Income from Department of Commerce/Bureau of Economic 

Analysis.
164 

DEPARTMENT OF HEALTH AND HUMAN SERVICES 

Substance Abuse and Mental Health Services Administration 

FY 2012 DISCRETIONARY STATE/FORMULA GRANTS 

Protection and Advocacy for Individuals with Mental Illness (PAIMI)

CFDA # 93.138 

FY 2010 

Appropriation

FY 2011 

Estimate

 FY 2012 

STATE/TERRITORY Estimate +/- FY 2010

Alabama $453,033 $451,210 $453,124 +$91

Alaska 430,800 430,800 430,800 0

Arizona 615,499 636,135 635,901 +20,402

Arkansas 430,800 430,800 430,800 0

California 3,157,066 3,156,541 3,146,731 -10,335

Colorado 430,800 430,800 431,213 +413

Connecticut 430,800 430,800 430,800 0

Delaware 430,800 430,800 430,800 0

District Of Columbia 430,800 430,800 430,800 0

Florida 1,639,586 1,642,945 1,648,480 +8,894

Georgia 919,227 932,582 936,659 +17,432

Hawaii 430,800 430,800 430,800 0

Idaho 430,800 430,800 430,800 0

Illinois 1,118,508 1,111,634 1,107,122 -11,386

Indiana 613,654 612,763 612,730 -924

Iowa 430,800 430,800 430,800 0

Kansas 430,800 430,800 430,800 0

Kentucky 430,800 430,800 430,800 0

Louisiana 430,800 430,800 430,800 0

Maine 430,800 430,800 430,800 0

Maryland 460,430 458,172 457,986 -2,444

Massachusetts 516,687 516,280 523,381 +6,694

Michigan 956,242 944,052 944,864 -11,378

Minnesota 452,067 447,934 451,832 -235

Mississippi 430,800 430,800 430,800 0

Missouri 561,160 558,480 554,121 -7,039

Montana 430,800 430,800 430,800 0

Nebraska 430,800 430,800 430,800 0

Nevada 430,800 430,800 430,800 0

New Hampshire 430,800 430,800 430,800 0

New Jersey 695,242 688,789 688,996 -6,246

New Mexico 430,800 430,800 430,800 0

New York 1,581,203 1,585,334 1,597,390 +16,187

North Carolina 869,277 881,640 883,864 +14,587

North Dakota 430,800 430,800 430,800 0
165 

DEPARTMENT OF HEALTH AND HUMAN SERVICES 

Substance Abuse and Mental Health Services Administration 

FY 2012 DISCRETIONARY STATE/FORMULA GRANTS 

Protection and Advocacy for Individuals with Mental Illness (PAIMI)

CFDA # 93.138 

FY 2010 

Appropriation

FY 2011 

Pres. Budget

 FY 2012 

STATE/TERRITORY Estimate +/- FY 2011

Ohio $1,085,963 $1,080,596 $1,073,598 -$12,365

Oklahoma 430,800 430,800 430,800 0

Oregon 430,800 430,800 430,800 0

Pennsylvania 1,110,883 1,099,490 1,103,290 -7,593

Rhode Island 430,800 430,800 430,800 0

South Carolina 441,509 446,302 446,340 +4,831

South Dakota 430,800 430,800 430,800 0

Tennessee 593,337 595,120 597,534 +4,197

Texas 2,184,785 2,194,491 2,213,502 +28,717

Utah 430,800 430,800 430,800 0

Vermont 430,800 430,800 430,800 0

Virginia 666,229 665,862 659,708 -6,521

Washington 561,991 564,558 564,949 +2,958

West Virginia 430,800 430,800 430,800 0

Wisconsin 517,377 516,223 512,792 -4,585

Wyoming 430,800 430,800 430,800 0

State Sub-total 33,833,355 33,849,533 33,877,707 +28,174

American Samoa 230,800 230,800 230,800 0

Guam 230,800 230,800 230,800 0

Northern Marianas 230,800 230,800 230,800 0

Puerto Rico 665,045 648,867 620,693 -44,352

Virgin Islands 230,800 230,800 230,800 0

Territory Sub-Total 1,588,245 1,572,067 1,543,893 -28,174

American Indian Consortium 230,800 230,800 230,800 0

Total States/Territories 35,652,400 35,652,400 35,652,400 0

SAMHSA Set-Aside 727,600 727,600 727,600 0

TOTAL, MHBG $36,380,000 $36,380,000 $36,380,000 $0
166 

Mandatory Drug Testing 

Program Description and Accomplishments

The Federal Drug-Free Workplace Mandatory Drug Testing program, initiated in 1986 by 

Executive Order #12564 and Public Law 100-71 in 1987, provides funding for accreditation and 

ongoing quality assurance of laboratories that perform mandatory drug testing for Federal and 

non-Federal employees across the nation. The National Laboratory Certification Program is a 

core and crucial component that impacts all Executive Branch agencies related to public safety 

and national security clearance, including pre-hire and periodic testing for over 400,000 of the 

approximately 2.2 million non-uniformed service Federal employees, such as the Federal Bureau 

of Investigation, the Drug Enforcement Administration, and many others in the Department of 

Defense and the intelligence agencies. The contract is also critical to support employee drug 

testing federally mandated by the Department of Transportation and the Nuclear Regulatory 

Commission, in total approximately 6.8 million drug tests per year. The mandatory drug testing 

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. The Workplace 

Helpline receives requests for assistance from small business owners who represent the vast 

majority of enterprise in the American economy, and from individuals regarding prescription 

drugs, illicit drugs, and alcohol use. 

Opioid Drug Treatment/Regulatory Activities

Program Description and Accomplishments

SAMHSA/CSAT employs a number of contracts that support its regulatory efforts and 

monitoring activities of opioid treatment programs. Some examples include: 

• Certification of Opioid Treatment Programs (OTPs) that use Methadone, Subutex, or 

Suboxone to treat patients with opioid dependence. SAMHSA carries out this responsibility 

by enforcing the regulations that established the accreditation-based system, and it is 

accomplished in coordination with the Drug Enforcement Administration (DEA), States, 

Territories, and the District of Columbia. An OTP must comply with applicable State

licensing requirements to operate as an OTP and must meet regulatory requirements set forth 

in Title 42 Code of Federal Regulations Part 8 (42 CFR Part 8). Within the regulations there 

is also a requirement for each OTP to achieve formal accreditation by a SAMHSA/CSAT 

recognized accreditation body.

• Physician Clinical Support System-Methadone, a national mentoring network offering

support (clinical updates, evidence-based outcomes, and training) to physicians and other 

medical professionals in the appropriate use of methadone for the treatment of chronic pain 

and opioid addiction. This program also addresses the nation’s rise in methadone-associated 

deaths that has been spurred by misuse/abuse, and fatal drug interactions involving 

methadone and other prescription medications, over the counter medications, and illicit drugs 

• Physician Clinical Support System-Buprenorphine, a program designed to assist practicing 

physicians that wish to incorporate into their practices the treatment of prescription opioid 

and heroin dependent patients using the medication buprenorphine. The goal of this program 
167 

is to expand access to office-based buprenorphine treatment by first providing expert 

education and training to physicians on the appropriate use of buprenorphine, and to then 

certify their eligibility to treat opioid dependent patients.

• Opioid Treatment Technical Assistance Program (OTTAP), of which the primary objective is 

to educate and prepare OTPs to achieve accreditation by SAMHSA’s approved accreditation 

bodies. Accreditation has been shown to improve treatment and access to treatment for 

patients and provides the opportunity for OTPs to incorporate best practices in their treatment 

programs. Other goals include improving OTP administration and management, increasing 

staff retention, providing more OTP staff training, increasing availability of comprehensive 

services and emergency services, and improving patient outcomes. Even though most OTPs 

have been able to achieve initial accreditation (approximately 97% of over 1,160 active OTPs 

are accredited), continuing technical assistance is considered necessary to assist OTPs in 

maintaining accreditation, as they are subject to re-survey, occurring at least triennially.

Prescription Drug Monitoring 

National All Schedules Prescription Electronic Reporting (NASPER)

Program Description and Accomplishments

The National All Schedules Prescription Electronic Reporting Act (NASPER), is a formula grant 

program, that was authorized in 2005 (Public Law 109-60) and received its first appropriation in 

FY 2009. The purpose of this program is to: 1) foster the establishment of State-administered 

controlled substance monitoring systems in order to ensure that health care providers and law 

enforcement officials and other regulatory bodies have access to accurate, timely prescription 

history information that they may use as a tool for the early identification of patients at risk for 

addiction in order to initiate appropriate medical interventions and avert the tragic personal, 

family, and community consequences of untreated addiction; and 2) develop, based on the 

experiences of existing State controlled substance monitoring programs, a set of best practices to 

guide the establishment of new State programs and the improvement of existing programs. 

By requiring standards for security, privacy, confidentiality and interoperability, NASPER 

expands the utility of prescription monitoring programs (PMPs), allowing more States to share 

information internally and regionally with neighboring States, a key shortcoming of the existing 

system. In addition, the expansion and establishment of prescription monitoring systems has the 

potential for assisting in the early identification of patients at risk for addiction. Early 

identification of individuals in need of treatment is a key public health concern and leads to 

enhanced substance abuse treatment interventions. 

As of 2009, approximately 40 States had an operational PMP or current legislation authorizing 

establishment of PMPs. Although current State PMPs vary, they essentially require that 

pharmacies, physicians, or both, submit information on prescriptions dispensed for certain 

controlled substances as mandated by State law. Prescriber and patient information relating to 

prescriptions issued for controlled stimulants, sedatives/depressants, anxiolytics, narcotics and 

other covered drugs is transmitted to a central office within each State. 
168 

The allocation formula for the NASPER grant program distributes one percent of the 

appropriation to each eligible State, with an additional amount distributed based on the ratio of 

the number of pharmacies in the State to the number of pharmacies in all States. 

The Secretary must approve grants to all States that are qualified (defined as the 50 States and 

the District of Columbia). To qualify for a grant award, a State must submit an application that 

meets all the NASPER requirements including the following: the State must demonstrate that it 

has enacted legislative or regulatory authority for a PMP; the State must have penalty provisions 

for unauthorized patient information disclosures; the State must include substances in Schedules 

II-IV in its PMP; and the State must agree to collect information in accordance with standards 

developed by the Department. 

To implement NASPER and the 2009 appropriation, the Department was required to solicit 

Federal Register Notice (FRN) comments on proposed minimum standards. Before developing 

proposed minimum standards, and issuing the FRN, SAMHSA sought input from and consulted 

with the field and also obtained the Secretary’s delegation of authority to implement NASPER. 

Several States and pharmacy entities subsequently commented on the proposed minimum 

standards. SAMHSA carefully considered the comments and incorporated revised minimum 

standards into the request for applications (RFA). A total of thirteen States submitted 

applications for grants, and each applicant subsequently received an award of FY 2009 funds. A 

new RFA was published in FY 2010. 

In 2009, SAMHSA reported that the misuse of prescription drugs decreased significantly 

between 2007 and 2008 among those aged 12 and older, including among adolescents, according 

to the 2008 National Survey on Drug Use and Health (NSDUH). The report also indicated that 

progress has been made in curbing other types of illicit drug use. For example, past month 

methamphetamine use among those aged 12 and older dropped sharply from approximately 

529,000 people in 2007 to 314,000 in 2008. Similarly, the level of current cocaine use among 

the population aged 12 and older has decreased from 1.0 percent in 2006 to 0.7 percent in 2008. 

Promising results from the latest survey also were also found for the most part among youth (12 

to 17 year olds). Among youth there was a significant decline in overall past month illicit drug 

use, from 11.6 percent in 2002 to 9.3 percent in 2008. Although the rate of current marijuana use 

among youth has remained level at about 6.7 percent over the past few years there have been 

significant decreases in the current use of alcohol, cigarettes and non-medical use of prescription 

drugs since 2007. Non-medical use of prescription drugs dropped from 3.3 percent in 2007 to 

2.9 percent in 2008. 

The State Allotment calculation assumes that all 50 States and the District of Columbia will 

apply and are approved. The count of pharmacies in each State is based on the most recent data 

provided on the Drug Enforcement Administration’s (DEA) website. FY 2010 and FY 2011 

calculations assume no change to the most recent data provided by the DEA and assumes that all 

50 States and the District of Columbia will apply and be approved. In 2009, 13 States applied 

for and were approved for funding. 

 

To be eligible to receive a grant under NASPER, the State must demonstrate that the State has 

enacted legislation or regulations to permit the implementation of the State controlled substance 
169 

monitoring program and the imposition of appropriate penalties for the unauthorized use and 

disclosure of information maintained in such program. Additional requirements for applications 

are set forth under 42 U.S.C. section 399(O)(c), and include budget cost estimates, 

interoperability standards, uniform electronic formats, access to information, penalties for 

unauthorized disclosures and other issues. 

Funding History

FY Amount

2007 $49,079,000

2008 $51,669,000

2009 $54,448,000

2010 $55,052,000

2011 $54,938,000

Budget Request

The FY 2012 President’s Budget request is $54.9 million, a decrease of $0.1 million from the FY 

2010 Level. The funding level will continue all current programmatic activities. 

Outcomes and Outputs

Protection & Advocacy

Table 1: Key Performance Indicators for Protection and Advocacy 

Measure

Most Recent 

Result

FY 2011 

Performance 

Target 

Associated 

with FY 2010 

PB 

FY 2013 

Performance 

Target 

Associated 

with FY 2012 

Request

FY 2013 

Performance 

Target +/- FY 

2011 

Performance 

Target 

3.4.12: Number of people served by 

the PAIMI program (Outcome) 

FY 2009: 

16,951

(Target Not 

Met) 

22,325 17,9001

 -4,425

 

1

Target was reduced to reflect most recent actual given previous two years of performance results were off nearly 30 percent and not due to any 

2012 budget reductions. 
170 

Measure

Most Recent 

Result

FY 2011 

Performance 

Target 

Associated 

with FY 2010 

PB 

FY 2013 

Performance 

Target 

Associated 

with FY 2012 

Request

FY 2013 

Performance 

Target +/- FY 

2011 

Performance 

Target 

3.4.19: Number attending public 

education/constituency training and 

public awareness activities (Output) 

FY 2009: 

92,953

(Target Not 

Met but 

Improved) 

120,000 92,9532 -27,047 

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 

decision-making, or elimination of 

other barriers to personal decisionmaking, as a result of PAIMI 

involvement (Outcome) 

FY 2009: 88.0 

% 

(Historical 

Actual) 

87.0 % 87.0 % Maintain 

Grant Award Table 

(Whole Dollars) FY 2010 FY 2011 FY 2012 

Number of Awards 75 73 73

Average Award $527,832 $529,485 $529,485

Range of Awards $22,000-$3,156,541 $22,000-$3,156,541 $22,000-$3,156,541

 

2

Target was reduced to reflect most recent actual given previous two years of performance results were off nearly 30 percent and not due to any 

2012 budget reductions. 
 

Public Awareness and Support

(Dollars in Thousands)

FY 2010

Actual

FY 2011

Continuing 

Resolution

FY 2012

President’s 

Budget

Program Level........................................................

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

$14,230 

---

$14,230 

---

 $13,571

13,571

Authorizing Legislation ........................................Section 501, 509, 516 and 520A of the PHS Act 

FY 2012 Authorization ......................................................................................................... Expired

Allocation Method ............................................................................................................. Contracts

Program Description and Accomplishments

Too many Americans are not getting the help they need, and many opportunities to prevent and 

intervene early are being missed. By combining sound public health practices with sciencebased training, communications and marketing approaches, the Public Awareness and Support 

Initiative will reduce the disparities between people in need and receiving prevention and 

treatment services by improving training and increasing education about 1) confronting 

discrimination and misinformation; 2) increasing public knowledge about the effectiveness of 

treatment and opportunities for recovery; 3) educating the public about self, peer, and family 

care; and 4) improving understanding about how to access treatment and insurance coverage for 

mental health and substance use services. 

The purpose of the Public Awareness and Support Initiative is to increase understanding of 

mental and substance use disorders to achieve the full potential of prevention, help people 

recognize signs and symptoms and seek assistance with the same urgency as any other health 

condition, and make recovery the expectation. Training and education principles and techniques 

can be used to target behavior changing strategies needed to achieve this goal.

To better utilize limited funding resources, SAMHSA is proposing to restructure public 

awareness and support training and education activities. The funding for SAMHSA training and 

education activities will be consolidated into one budget line that incorporates separate 

SAMHSA budget lines. Creating a single budget line administered by SAMHSA’s Office of 

Communications will create a consistent approach across SAMHSA for application of training 

and education principles and techniques. This new approach will help align training and 

education activities with SAMHSA priorities and devote resources toward achieving the purpose 

of the Public Awareness and Support Initiative. 

171 
172 

Background 

The use of training and education principles and techniques is a well-established, science-based 

strategy capable of influencing a target audience to voluntarily accept, reject, modify, or abandon 

a behavior for the benefit of individuals, groups, or society as a whole. For example, the 

National High Blood Pressure Education Program (NHBPEP), established in 1972, demonstrates 

success from using a strategic planning framework and a marketing mix. The year the program 

began, less than one-fourth of the American population knew of the relationship between 

hypertension, stroke, and heart disease. Today, more than three-fourths of the American 

population understands this connection. As a result, virtually all Americans have had their blood 

pressure measured at least once, and three-fourths of the population has it measured every six 

months. Just as Americans are aware of the connection between hypertension, stroke and heart 

disease and take action to monitor their blood pressure, they should become aware of the 

connection between mental and substance use disorders and health and take action to prevent and 

treat these conditions. 

Mental and substance use disorder prevention, treatment and recovery support services provide 

people in need with the opportunity for improved health and well-being. It is currently projected 

that mental illness and substance abuse will become the leading cause of disability in the world 

by 2020 unless significant action is taken to increase access and improve the understanding of 

these health conditions. Substance abuse and mental illness prevention and treatment services 

are clearly a critical component of health care and community-based strategies that advance and 

protect the Nation's health. Expenditures for these services ultimately lower costs for families, 

businesses, and governments. For example, studies have shown that the cost-benefit ratios for 

programs for early treatment and prevention for addictions and mental illnesses range from 1:2 to 

1:10, which means that every $1.00 invested could yield $2.00 to $10.00 savings in health costs, 

criminal and juvenile justice costs, educational costs, lost productivity, etc. 

While American attitudes are generally favorable toward prevention and treatment efforts, 

millions of Americans who could benefit from these services never receive help. SAMHSA’s 

National Survey on Drug Use and Health (NSDUH) suggests that people do not receive help for

substance abuse or mental health disorder for various reasons including fear/misinformation, 

potential for discrimination, concern about confidentiality, and not knowing where to go for help. 

Opportunities for preventing or intervening early to mitigate the morbidity and mortality 

associated with these disorders are often missed. Current research indicates that half of all 

mental illnesses begin by age 14 and three-fourths begin by age 24. Initial symptoms typically 

precede a disorder by two to four years. Preventing and/or delaying initiation of substance abuse 

can reduce the potential need for treatment later in life. For example, among the 14 million 

adults aged 21 or older who were classified as having past year alcohol dependence or abuse, 

more than 13 million (95%) had started drinking alcohol before age 21. In one study, 94% of 

primary care physicians failed to diagnose substance use disorders properly. Over 33,000 people 

die by suicide in the U.S. every year. Approximately 90% of people who die by suicide had a 

mental disorder and 40% had visited their primary care doctor within the past month – yet the 

question of suicide was seldom raised. 
Behavioral health is essential to health and public understanding of this concept is key to 

improving health status and reducing costs to families, communities and governments. As a 

result, SAMHSA has launched the Public Awareness and Support Initiative which is being 

advised by the SAMHSA Communications Governance Council. As part of the Public 

Awareness and Support Initiative, the SAMHSA is consolidating 88 websites, combining 

multiple 800 numbers into a single point of entry, creating and promoting a single user-friendly 

facility locator service, and building a public engagement strategy using social media to create a 

consistent message and purpose across multiple disparate platforms. This will consolidate 

resources and implement a transmedia communications strategy that segments and targets public, 

provider and payer audiences with behavioral health information critical to improving health and 

reducing costs. Rather than multiple entry points for behavioral health information, the Initiative 

will create a single interaction point for the public for communication products, services and 

messages related to behavioral health. 

A transmedia approach is required to reach diverse U.S. populations, each having a distinct set of 

wants, needs and communications channels. Traditional media (broadcast, print and news) and 

expanded online engagement, social and mobile media, interaction and community building will 

be used to increase the visibility and impact of behavioral health resources. Elements of this new 

communications approach and public engagement strategy includes web, social media (e.g. 

Twitter1

, Facebook2, YouTube3, etc), analytics and metrics, media monitoring, graphic design, 

mapping/geospatial, data/API development, video/multimedia, mobile messaging, and ongoing 

assessments of new and emerging technologies. 

The Public Awareness and Support Initiative is being driven by research with SAMHSA 

stakeholders, including web-based public engagement strategies/platforms, and applies the 

communications and marketing principles of customer research and audience segmentation, 

message development and evaluation. Because it is based on customer needs and input, the 

Public Awareness and Support Initiative is dynamic and evolving based on the shifting landscape 

of communications technologies and government involvement with the public. 

Budget Request

The FY 2012 President’s Budget request is $13.6 million, which reflects the consolidation of 

funding available for the SHIN and web development contracts from across SAMHSA to support 

SAMHSA-wide public awareness and technical assistance activities. It also reflects efficiencies 

realized through the consolidation of multiple web development contracts, resulting in more 

streamlined operations without loss of capabilities.

 

1 These are trademarked names of their respective websites.

2 These are trademarked names of their respective websites. 3 These are trademarked names of their respective websites.

173 
Outcomes and Outputs

Public Awareness Activities

Table 1: Key Performance Indicators for Public Awareness and Support4

Measure Most Recent 

Result

FY 2010 

Target

FY 2012 

Target

FY 2012 +/- 

FY 2010

2.3.76: Number of persons receiving 

prevention information indirectly from 

advertising, broadcast, or website5

(Output)

FY 2009: 

1,443,077

(Target 

Exceeded)

906,7076 1,250,0007 +343,2938

4.4.06: Percentage of persons 

reporting knowledge of how to find 

treatment services for mental and 

substance use disorders (Outcome)

N/A N/A TBD N/A

4.4.07: Percentage of persons

indicating they were screened by a 

health care provider for mental and 

substance use disorder (Outcome)

N/A N/A TBD N/A

4.4.08: Percentage of persons taking 

steps to prevent mental and substance 

use disorders in their lives (Outcome)

N/A N/A TBD N/A

4.4.09: Percentage of parents 

reporting they are comfortable talking 

to their children about alcohol and 

drugs (Outcome)

AN/ N/A TBD N/A

 

4 There is no delay between fiscal year funding and the performance year.

5

Includes Town Hall Meetings, FASD, and MEI (Community Outreach).

6 This is the FY 2011 performance target associated with the FY 2010 PB since there is a delay between fiscal year funding and performance 

year.

7 This is the FY 2013 performance target associated with the FY 2012 request since there is a delay between fiscal year funding and performance 

year.

8 This is the delta between the FY 2013 performance target and the FY 2011 performance target.

174 
 

 

Performance & Quality Information Systems 

(Dollars in Thousands)

FY 2010

Actual

FY 2011

Continuing 

Resolution

FY 2012

President's 

Budget

Program Level....................................................... $30,165 $30,987 $12,996

PHS Evaluation Fund........................................ $6,596 $6,596 $12,996

Authorizing Legislation .......................................Section 501, 509, 516, and 520A of the PHS Act 

FY 2012 Authorization ......................................................................................................... Expired

Allocation Method ............................................................................................................... Contract

Program Description and Accomplishments

In January 2010, SAMHSA launched a new initiative focusing on data, outcomes, and quality. 

The goal of this initiative is to strengthen the integration of data begun with the previous data 

strategy. This new initiative will allow SAMHSA to meet the Administration’s expectations for 

high quality and accessible data and create new opportunities to meet the information needs of 

individuals, families, and communities. A guiding principle of this new data strategy is that the 

data be meaningful and useful for decision-making and policy development. Central to this 

strategy is improving the balance in the collection of prevention and treatment data for substance 

use and mental disorders, providing clarity in how performance measures are collected and used, 

developing new systems for coordinating across systems, and then disseminating quality 

information in a readily accessible format. 

SAMHSA leadership has determined that integrating both performance data and information on 

the quality and effectiveness of interventions better serve State and community needs and 

promotes quality improvement efforts consistent with the President’s health care reform goals. 

This new initiative will coordinate the performance measurement efforts with quality 

improvement activities and promote greater efficiencies in the collection, analysis, and reporting 

of data and other information. It will also facilitate accountability and improve the quality and 

accessibility of data and other information for use by program staff, grantees, and the public. An 

important function of these activities will be its capacity to collect and disseminate data across 

prevention and mental health and substance abuse programs that share goals and funding lines; 

something extremely difficult given the current systems.

In FY 2011, SAMHSA will take steps to modify the Substance Abuse Information System 

(SAIS), Prevention Management Reporting and Training Tool (PMRT) and the Transformation 

Accountability System (TRAC) to incorporate both substance abuse and mental health 

performance measures. Concurrently, SAMHSA will develop a new Request for Proposal (RFP) 

for a consolidated data warehouse system. This initiative will incorporate the management and 

outcome measurement needs of each Center while providing greater access by grantees and other 

shareholders. 

175 
Concurrent with the effort to integrate the performance management data systems, SAMHSA 

will take steps to closely coordinate the activities of the National Registry of Evidence-based 

Programs and Practices (NREPP) with the data reporting systems. In this way, information on 

effective interventions can inform agency efforts to improve service activities and outcomes for 

individuals who suffer from or who are at risk for mental and substance use disorders. Activities 

to advance the dissemination of these efforts will be further guided by the results of the ARRACER funded study on effective dissemination practices to be completed by 2012. 

Funding History

FY Amount

2007 $0 

2008 $0 

2009 $0 

2010 $0 

2011 $0 

Budget Request

The FY 2012 President’s Budget request is $13.0 million, with $11 million for the performance 

management system and $2 million for the NREPP program. By September 2011, SAMHSA 

will develop an acquisition proposal for an integrated performance measurement and 

management platform to be operational in FY 2012. The performance management system will 

adapt current systems to accept cross-cutting mental health and substance abuse data from all of 

SAMHSA’s programs. $24.8 million is reduced from the Services Accountability, and Program 

Coordination and Evaluation budget lines to reflect comparability adjustments and projected 

savings. 

Outcomes and Outputs

Performance and Quality Information Systems 

Table 1: Key Performance Indicators for Performance and Quality Improvement Systems1

1 There is no delay between fiscal year funding and performance year.

Measure Most Recent 

Result

FY 2010 

Target

FY 2012 

Target

FY 2012 +/- 

FY 2010

4.4.10: Combined count of webpage 

hits, hits to the locator, and hits to 

SAMHDA for SAMHSA-supported 

data sets (Output) 

FY 2009: 

4,833,000

(Baseline) 

5,195,000 6,000,300 +805,300 

4.4.11: Number of evidence-based 

programs or practices in review

(Output) 

FY 2010: 40

(Target Met) 40 44 +4 

176 

 
177 

SAMHSA/Center for Behavioral Health Statistics and Quality

(Dollars in thousands) 

FY 2011 

Continuing 

Resolution

FY 2012 

President's 

Budget

FY 2010 

CBHSQ Activities Enacted

National Data Collection

DAWN $17,000 $17,000 $12,000

NSDUH 47,000 47,000 59,000

National Analytic Center 2,500 2,500 3,500

DASIS 12,094 12,094 12,850

C-EMS --- --- 1,000

Data Archive 1,500 1,500 1,500

FTE/Operations 2,605 2,605 3,640

TOTAL PL, CBHSQ $82,699 $82,699 $93,490

Program Description

The data collection, analytic, and quality standards programs at SAMHSA support a number of 

federal, State, local, and Tribal governments, as well as researchers and non-governmental 

organizations, to develop timely and credible data and statistical information to improve the 

quality and outcomes of services provided to individuals, families, communities and tribal 

communities. 

There are three structural components within SAMHSA’s Center for Behavioral Health Statistics 

and Quality (CBHSQ) supporting an integrated data strategy that informs policy and measures 

program impact at the national, State, Territory, community and program level. These 

components include survey and data collection, evaluation and analysis, and quality and 

performance improvement.

Budget Request

The FY 2012 President’s Budget request for SAMHSA’s data initiatives is $93.5 million, an 

increase of $10.8 million from the FY 2010 Level. CBHSQ’s budget is funded from the SABG 

Set-Aside as well as Health Surveillance & Program Support. $85.0 million is requested for data 

collection and surveillance activities. This funding request includes $59 million for the National 

Survey on Drug Use and Health (NSDUH), $12 million for the Drug Abuse Warning Network 

(DAWN), $13 million for the Drug Abuse Services Information System (DASIS) and $1 million 

is requested to support the development of the Community Early Warning and Monitoring 
178 

System (CEMS). NSDUH serves as the nation’s primary source for information on the 

incidence, prevalence of substance use and mental disorders and related health conditions. 

DAWN is a national public health surveillance system that monitors emergency room visits for 

drug and mental illness-related problems. This represents a partnership with the National Center 

for Health Statistics/CDC which is expected both to increase response rates and improve the 

quality of data available to help inform public policy and prevention and treatment initiatives. 

These changes are consistent with proposals presented in previous budgets. DASIS is the 

primary source for data on treatment and treatment admissions. One aspect of this program is 

the treatment locator which is accessed more than 2 million times a year by individuals, families, 

community groups and organizations to identify appropriate treatment services. The DASIS 

project is currently piloting two new programs with the intent to integrate mental health facilities 

surveys and mental health treatment admissions. SAMHSA expects to integrate these efforts in 

FY 2012 and to field an integrated survey in FY 2013. $6.1 million is requested to support 

analytic and evaluation activities responsive to SAMHSA and HHS priorities. This funding 

request includes support for the National Analytic Center which supports a range of analyses and 

report writing on policy- and practice-specific topics in response to requests from SAMHSA 

Centers, HHS agencies (CDC, AHRQ, FDA, and the Surgeon General’s Office), the Office of 

National Drug Control Policy, and the Department of Justice. The funding also supports the 

Substance Abuse and Mental Health Data Archive (SAMHDA) which serves as SAMHSA’s 

primary repository for public access data files. SAMHDA provides free access and on-line 

analytic tools to the public. Funds within this request will also be used to develop a program for 

providing public access to restricted files to expand the use and application of data collected 

under the survey contracts. Funding will also support analytic staff positions to meet the 

demands for additional analyses and reports in support of health reform efforts.

Additionally, within the Performance and Quality Information Systems line, $13 million is 

requested for quality and performance measurement efforts. This funding request includes $10 

million for a consolidated data platform that provides a uniform collection and reporting system 

that will provide SAMHSA management and staff with the ability to analyze programs at various 

levels (state, program, community, etc.), provide each Center with tailored information in realtime about the progress and activities of their grantees, and provide data to grantees to support 

them in the efficient and effective implementation of projects. This is a reduction of 

approximately $5 million spent across the three programmatic centers which currently gather 

data through three unique data systems. The funding also includes $3 million for the 

continuation of the National Registry of Evidence-based Programs and Practices which is a 

searchable online system that supports States, communities in identifying and implementing 

evidence-based mental health promotion, substance abuse prevention, and substance abuse and 

mental health treatment interventions. 
179 

Health Surveillance and Program Support

FY 2010 

Actual

FY 2011

Continuing 

Resolution

FY 2012 

President's 

Budget 

Program Level................................................................. $101,947,000 $101,947,000 $127,594,000

Budget Authority (non-add)............................................. 79,197,000 79,197,000 82,166,000

PHS Evaluation Funds (non-add).................................... $22,750,000 $22,750,000 $45,428,000

FTEs

(Health Surveillance and Program Support)................ 485 485 485

(Block Grant Set-aside).................................................. 52 52 59

Total, FTE....................................................................... 537 537 544

Authorizing Legislation ............................................. Section 501 of the Public Health Service Act 

FY 2012 Authorization ...................................................................................................... Indefinite

Allocation Method ....................................................... Direct Federal/Intramural, Contracts, Other

Program Description and Accomplishments

The Health Surveillance and Program Support budget supports the majority of SAMHSA staff 

who plan, direct, and administers SAMHSA programs and who provide technical assistance and 

program guidance to States, mental health and substance abuse professionals, clients, and the 

general public. SAMHSA staffing represents a critical component of the budget. Staff not 

financed directly through the Health Surveillance and Program Support account provide direct 

State technical assistance and are funded through the five percent Block Grant set-asides. There 

are currently 52 FTEs dedicated to Block Grant technical assistance. This budget supports 

contracts for monitoring State formula and block grants and the national surveys. In addition, 

this budget supports the Unified Financial Management System, administrative activities such as 

human resources, information technology and the centralized services provided by Program 

Support Center and the Department. 
180 

National Surveys

(Dollars in Thousands)

FY 2011 

Continuing 

Resolution

FY 2012 

President's 

Budget

FY 2010 

Enacted

PHS Evaluation Funds

CBHSQ Data Collection Activities $21,750 $21,750 $43,779

NSDUH Mental Health 1,000 1,000 1,000

Data Archive - Restricted Use 0 0 649

Total, PHS Evaluation Funds 22,750 22,750 45,428

Budget Authority

CDC National Health Interview Survey 2,000 2,000 2,000

Total, Budget Authority 2,000 2,000 2,000

Funding History

FY Amount FTEs

2007 $76,714,000 528

2008 $75,381,000 544

2009 $77,381,000 549

2010 $101,947,000 535

2011 $101,947,000 535

Budget Request

The FY 2012 President’s Budget request is $127.6 million, an increase of $25.6 million over the 

FY 2010 Level. This reflects an increase in Budget Authority of $2.9 million and an increase in 

PHS Evaluation Funds of $22.7 million. These increases will be used to finance technical 

assistance, evaluation and data collection activities associated with the new substance abuse, 

mental health and behavioral health prevention programs, and to continue and enhance State

technical assistance capacity in all 10 HHS regional offices. SAMHSA is currently assessing the 

impact of restructuring its budget and the results of a major policy review of all grants and 

contracts on providing additional assistance to the States within the Health Surveillance and 

Program Support budget. These funds will also be used to address the goals and objectives of 

the Data, Outcomes and Quality Strategic Initiative lead by CBHSQ. Additional details on the 

CBHSQ budget can be found in the preceding chapter. Finally, SAMHSA is undergoing a review 

of its contracts which is expected to result in revisions to its regular contract planning process. 

The review, which includes those activities financed by the block grant set-asides, will determine 

where efficiencies and consolidations may be warranted. The goal of the review is to have 

policy-driven grants and contracts planning process and to bring these activities in closer 

alignment with the mission and vision for SAMHSA. 
181 

Summary of Changes 

(Dollars in Thousands)

Increases:

Built-in:

Annualization of Commisioned Corps pay raise +22

Increase for January Pay raise 1/ +108

Increase in rental payments to GSA +119

Additional FTEs +1,225

Subtotal, Built-in +1,473

Program:

Overseas Rightsizing +5

Technical Assistance, Evaluation and Data Activities +12,398

CBHSQ Data Evaluation Activities BA/PHS Evaluation Funds

Subtotal, Program

+10,791

+23,194

Total, Increase +24,667

Program:

HHS Joint Funding Arrangement 

Subtotal, Program

-20

 -20

Total, Decreases -20

Net Change +$24,647

1/ Reflects 0% and 1.4% pay raise for civilian and military personnel, respectively
182 

Page intentionally left blank 
183 

Saint Elizabeths Hospital

Building and Facilities

FY 2010 

Actual

FY 2011

Continuing 

Resolution

FY 2012 

President's 

Budget 

Budget Authority............................................................ $795,000 $795,000 $0

Authorizing Legislation ................................................... Section 501 of Public Health Service Act 

FY 2012 Authorization ...................................................................................................... Indefinite

Allocation Method ................................................................................................................... Other

Program Description and Accomplishments

On December 9, 2004, the Department of Health and Human Services (DHHS) transferred the 

West Campus of the St. Elizabeths Hospital to the General Services Administration (GSA). Along 

with this transfer, the DHHS and GSA signed a Memorandum of Agreement outlining each 

agency’s responsibilities and requirements with regards to the transfer and subsequent associated 

activities. 

One such requirement was for DHHS to pay for any further actions necessary to remediate (cleanup) hazardous substances found on the site after the date of transfer. Following the transfer, GSA 

discovered the remnants of a former landfill. Preliminary samples collected from various depths 

showed the presence of lead, dioxins, and other hazardous substances. As a result of the 

Memorandum of Agreement, DHHS is responsible for covering the cost of actions required to 

remediate this contamination. 

Budget Request

The FY 2012 budget does not include additional funding to support the Department’s 

environmental remediation activities at St. Elizabeths Hospital. In consultation with GSA, the 

Assistant Secretary for Administration has determined that funding through FY 2010 is sufficient 

to address current remediation activities. 
184 

Page intentionally left blank 
 

DEPARTMENT OF HEALTH AND HUMAN SERVICES

Substance Abuse and Mental Health Services Administration

RESOURCE SUMMARY

FY 2010

Enacted 4

FY 2011

CR

FY 2012

Pres. Budget 

Drug Resources by Function

Prevention 566,218 566,476 550,514

Treatment 1,991,169 1,990,900 2,027,965

Total, Drug Resources by Function 2,557,387 2,557,376 2,578,479

Drug Resources by Decision Unit 1

Substance Abuse Block Grant (Treatment) 1,454,713 1,454,713 1,494,314

State, Tribal and Community Prevention Grants 455,486 455,655 ---

Behavioral Health - Tribal Prevention Grants --- --- 25,000

Substance Abuse - State Prevention Grants --- --- 395,000

Innovation and Emerging Issues 2

Prevention 75,438 75,527 94,476

Treatment 408,434 407,995 399,419

Total, Innovation and Emerging Issues 483,872 483,522 493,895

Regulatory & Oversight Functions 3

Prevention 5,206 5,206 5,206

Treatment 10,903 10,903 10,903

Total, Regulatory & Oversight Functions 16,109 16,109 16,109

Public Education and Support

Prevention 2,749 2,749 2,714

Treatment 8,808 8,808 10,857

Total, Public Education and Support 11,557 11,557 13,571

Performance and Quality Information Systems 3

Prevention 6,950 6,950 2,599

Treatment 26,753 26,923 10,397

Total, Performance and Quality Information Systems 33,703 33,873 12,996

Health Surveillance and Program Support

Prevention 20,389 20,389 25,519

Treatment 81,558 81,558 102,075

Total, Health Surveillance and Program Support 101,947 101,947 127,594

Total, Drug Resources by Decision Unit 2,557,387 2,557,376 2,578,479

Drug Resources Personnel Summary

Total FTEs (direct only) 537 537 544

Drug Resources as a Percent of Budget

Total Agency Budget $3,582,701 $3,651,209 $3,649,248

Drug Resources Percentage 71.4% 70.0% 70.7%

185 
186 

 

Footnotes

1

 SAMHSA's budget structure has been realigned; please see previous individual sections of this submission for further explanation of the 

changes. Includes $25 million Tribal Prevention Grant funded out of ACA Prevention Funds

2 A detailed breakout of programs within the Innovation and Emerging Issues can be found on the following page; does not include Mental 

Health Programs. Reflects funding for Prevention Prepared Communities ($22.6 million) for Prevention in FY 2012 frorm the ACA 

Prevention Fund; does not reflect ACA Prevention Fund allocation funding for SBIRT ($25.0 million) and Health Surveillance ($18.0 

million) in FY 2011.

3 Regulatory and Oversight Functions reflects Mandatory Drug Testing for Prevention; Opioid Treatment and NASPER for Treatment. 

Performance and Quality Information Systems reflects pro-rated portion of the consolidated data collection platform for Prevention; Opioid 

Treatment and NASPER for Treatment. Performance and Quality Information Systems reflects pro-rated portion of the consolidated data 

collection platform for Prevention and Treatment.

4 FY 2010 budget reflects a total reduction of $508,000 transferred to HHS, of which $339,000 was under Drug budget lines. FY 2011 

funding reflects the comparable adjustment with the exclusion of $25 million of related HRSA funding and approximately $17 million for 

Mental Health Joint Initiatives funding.
187 

Drug Budget IEI Split between Prevention and Treatment FY 2010-FY 2012

(Dollars in Thousands)

FY 2010 

Enacted

FY 2011

CR

FY 2012 

Pres. Budget

IEI-CSAP

Minority AIDS Initiative $41,385 $41,385 $41,385

STOP Act 7,000 7,000 7,000

1/ Prevention Prepared Communities 0 0 22,600

Congresional Projects 3,950 3,950 0

Science and Service Program Coordination 4,845 4,789 4,409

Minority Fellowship Program 71 71 71

Fetal Acohol Syndrome 9,820 9,821 8,000

Center for the Application of Prevention Technologies

Agency Wide Initiatives

8,367 8,511 8,511

Military Families 0 0 2,500

Total, CSAP

IEI-CSAT

$75,438 $75,527 $94,476

PHS Evaluation Funds $2,000 $2,000 $2,000

Co-occurring State Incentive Grants (SIGs) 4,262 4,263 4,263

Screening, Brief Intervention and Referral to Treatment 27,106 27,106 27,106

TCE - General 29,022 28,989 17,411

Pregnant & Postpartum Women 16,000 16,000 16,000

Strengthening Treatment Access and Retention 1,773 1,775 1,675

Recovery Community Services Program 5,669 5,236 2,450

Access to Recovery 99,380 98,954 98,454

Children and Family Programs 30,576 30,678 30,678

Treatment Systems for Homeless 42,530 42,750 47,360

Minority AIDS 65,911 65,988 65,988

Criminal Justice Activities 67,406 67,635 67,635

Congressional Projects 4,593 4,593 0

Minority Fellowship Program 547 547 547

Special Initiatives/Outreach 2,509 2,400 2,271

Addiction Technology Transfer Centers

Agency Wide Initiatives

9,150 9,081 9,081

Health IT 0 0 4,000

Military Families 0 0 2,500

Total, CSAT $408,434 $407,995 $399,419

Total, Drug Budget IEI $483,872 $483,522 $493,895

1/ Funded out of ACA Prevention Funds
188 

 Page intentionally left blank
189 

MISSION

The Substance Abuse and Mental Health Services Administration’s (SAMHSA) mission is to 

build resilience and facilitate recovery for people with, or at risk for, substance abuse and mental 

illness. SAMHSA supports the President’s National Drug Control Strategy through a broad 

range of programs focusing on prevention and treatment of drug use. Major programs for FY 

2012 will include the Substance Abuse Block Grant, the new State Substance Abuse Prevention 

grant, competitive grant programs reflecting Innovation and Emerging Issues (IEI), programs 

funded through the Prevention and Public Health Fund of the ACA Prevention Fund (including 

Prevention Prepared Communities and the new Behavioral Health – Tribal Prevention Grants), 

and a Prescription Drug Monitoring program (NASPER). These programs are administered 

through SAMHSA’s Centers for Substance Abuse Prevention (CSAP) and Substance Abuse 

Treatment (CSAT).

METHODOLOGY 

SAMHSA distributes drug control funding into two functions: prevention and treatment. 

Included in prevention are SAMHSA/CSAP funds supporting the new State Substance Abuse 

Prevention grant, competitive grant programs reflecting Innovation and Emerging Issues (IEI), 

programs funded through the Prevention and Public Health Fund of the ACA Prevention Fund

(including Prevention Prepared Communities and the new Behavioral Health – Tribal Prevention 

Grants), and 20% of SAMHSA Program Management funds. Included in treatment are 

SAMHSA/CSAT funds supporting Programs of Regional and National Significance (PRNS), 

100% of the Substance Abuse Prevention and Treatment Block Grant (SAPTBG) funds, 80% of 

SAMHSA Program Management funds, and all funding that supports the Prescription Drug 

Monitoring Program (NASPER). 

BUDGET SUMMARY

In FY 2012, SAMHSA requests a total of $2,578.479 million for drug control activities, which is 

an increase of $21.1 million over the FY 2010 level. The Budget directs resources to activities 

that have demonstrated improved health outcomes and that increase service capacity. SAMHSA 

has eight major drug-related decision units: Substance Abuse Block Grant, State Substance 

Abuse Prevention Grants, Innovation and Emerging Issues, Regulatory and Oversight Functions, 

Public Education and Support, Performance and Quality Information Systems, Affordable Care 

Act Prevention Fund, and Program Management. Each decision unit is discussed below:
190 

Innovation and Emerging Issues – Prevention 

Total FY 2012 Request: $94.5 million

(Reflects $18.9 million increase from 2010) 

The Substance Abuse Prevention Innovation and Emerging Issues programs (IEI) support States 

and communities in carrying out an array of activities to improve the quality and availability of 

services in priority areas.

The FY 2012 President’s Budget request for SAMHSA Substance Abuse Prevention IEI includes 

$94.5 million which covers seven programmatic activities, an increase of $18.9 million from the

FY 2010 level primarily due to not funding the Congressional Projects. The request includes:

$41.4 million for Minority AIDS; $7.0 million for Sober Truth on Preventing Underage Drinking 

(STOP Act); $8.0 million for the Fetal Alcohol Spectrum Disorders (FASD) contract; $8.5 

million to continue provision of technical assistance to maximize effectiveness through the 

Centers for the Application of Prevention Technologies; and $7.0 million for other IEI activities 

such as Science and Service Program Coordination, Military Families, and Minority Fellowships 

Program.

Minority AIDS Initiative

Total FY 2012 Request: $41.4 million

(Reflects same level as 2010) 

SAMHSA/CSAP’s Minority AIDS Program, implemented in FY 1999, supports efforts to reduce 

health disparities in minority communities by delivering and sustaining high quality and 

accessible substance abuse and HIV prevention services. The program strategies include 

implementing evidence-based prevention practices targeting subpopulations, conducting HIV 

testing and referral for treatment, and preventing/reducing the risk of substance use disorders 

and/or HIV. Grantees are required to target one or more high-risk populations such as African 

American women, adolescents, or individuals who have been released from prisons and jails 

within the past two years. 

The Minority AIDS Program has funded ten cohorts of grants, with currently 122 active grants 

funded from cohorts six through ten, from FY 2005-2010. In FY 2010, SAMHSA developed 

two new grant programs (the Capacity Building Initiative and the Ready To Respond Initiative). 

Within each sub-program, grantees select an at-risk population to target:

• The Capacity Building Initiative targets 18-24 year old at-risk populations, including 

minority students on college campuses;

• The Ready To Respond Initiative allows experienced grantees that have successfully 

provided evidence-based substance abuse and HIV prevention services through the 

Strategic Prevention Framework to expand those services to a high-risk subpopulation.

The request supports 122 continuations in FY 2012. 
191 

Sober Truth on Preventing Underage Drinking Act (STOP Act)

Total FY 2012 Request: $7.0 million

(Reflects same level as 2010) 

The Sober Truth on Preventing Underage Drinking Act (STOP Act) provides grants to 

organizations that are currently receiving or have received grant funds under the Office of 

National Drug Control Policy’s Drug-free Communities Act of 1997 to either enhance an 

existing focus or to add a focus on preventing underage drinking. This program will strengthen 

the collaborative efforts and increase participation among all stakeholders (e.g. community 

organizations, coalitions, local and State governments). The initial program, funded in FY 2008, 

provided 79 four year grants to local communities with up to $50,000 per community per year. 

In FY 2010, a total of 99 grants received funding under this initiative to strengthen these 

important efforts. 

Fetal Alcohol Center of Excellence

Total FY 2012 Request: $8.0 million

(Reflects $1.8 million decrease from 2010) 

The Fetal Alcohol Spectrum Disorder (FASD) Center for Excellence, initiated in 2001, is the 

largest alcohol abuse prevention initiative within SAMHSA. The Center for Excellence identifies 

and disseminates information about innovative techniques and effective strategies for preventing 

Fetal Alcohol Spectrum Disorder and increases functioning and quality of life for individuals and 

their families impacted by these disorders. 

Center for the Application of Prevention Technologies

Total FY 2012 Request: $8.5 million

(Reflects a $0.1 million increase from 2010) 

The Center for the Application of Prevention Technologies (CAPT) promotes state-of-the-art 

prevention technologies through three core strategies: 1) establishment of technical assistance 

networks using local experts from each of their five regions; 2) development of training 

activities; and 3) innovative use of communication media such as teleconference and video 

conferencing, online events, and Web-based support. These training and technical assistance

activities are designed to build the capacity of SAMHSA grantees and develop the skills, 

knowledge, and expertise of their prevention workforce. These activities will help support the 

delivery of effective prevention programs and practices and the development of accountability 

systems for performance measurement and management. Through interagency agreements, the 

CAPT also provides training and technical assistance to additional client groups such as the U.S. 

Department of Education’s Grants to Reduce Alcohol Abuse Program.

Other IEI Activities

Total FY 2012 Request: $7.0 million

(Reflects $2.1 million increase from 2010) 

The FY 2012 Budget includes resources of $7.0 million for other IEI activities such as Science 

and Service Program Coordination, Military Families, and Minority Fellowships Program.
192 

Innovation and Emerging Issues – Treatment 

Total FY 2012 Request: $399.4 million

(Reflects $9.0 million decrease from 2010) 

The Substance Abuse Treatment Innovation and Emerging Issues programs (IEI) support States 

and communities in carrying out an array of activities to improve the quality and availability of 

services in priority areas.

The FY 2012 President’s Budget request for SAMHSA Substance Abuse Treatment IEI includes 

$399.4 million which covers sixteen programmatic activities, a decrease of $9.0 million from the 

FY 2010 level primarily. The request includes: $99.0 million for Access to Recovery; $29.1 

million for Screening, Brief Intervention and Referral to Treatment; $47.4 million for Treatment 

Systems for Homeless; $67.6 million for Criminal Justice Activities of which $43.7 million will 

fund Drug Courts and $22.5 million for Ex- Offender Reentry. 

Access to Recovery

FY 2012 Request: $98.9 million

(Reflects same level as 2010) 

FY 2012 resources for ATR reflect $99.0 million to support a new Request for Applications 

(RFA) for a third cohort (approximately 30 new grants). The RFA expanded ATR to a 4-year 

program. ATR is designed to: (1) allow recovery to be pursued through personal choice and 

many pathways; (2) require grantees to manage performance based 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 program is administered through 

recognized Tribal Organizations or through the Single State Authority overseeing substance 

abuse activities. ATR uses vouchers, coupled with state flexibility and executive discretion, to 

offer an opportunity to create positive change in substance use disorder treatment and recovery 

service delivery across the Nation. 

Screening, Brief Intervention and Referral to Treatment Activities 

FY 2012 Request: $27.1 million

(Reflects same level as 2010) 

Substance abuse is one of our Nation’s most significant public health challenges, and the SBIRT 

approach can intervene early in the disease process before individuals achieve dependency, and 

can motivate the addicted client to engage in substance abuse treatment. Since the beginning of 

this program, more than one million individuals have been screened. Of those, 23% required a 

brief intervention, brief treatment or referral to specialty treatment programs. The FY 2010 

resources of $27.1 million supported continuation of eight State SBIRT grants, and seventeen 

Medical Residency SBIRT Training grants. The FY 2012 Budget will fully fund the 

continuation of four State grants (four State grants will end in September 2011) and seventeen 

Medical Residency Training programs. 
193 

Treatment Drug Courts

FY 2012 Request: $43.7 million

(Reflects same level as 2010)

Drug courts are problem-solving courts which help reduce recidivism and substance abuse 

among offenders and increase an offender’s likelihood of successful rehabilitation through early, 

continuous, and intense judicially supervised treatment, mandatory periodic drug testing, 

community supervision, and appropriate sanctions and other habilitation services. In FY 2010, 

SAMHSA funded 17 new adult Problem Solving Court grants and 8 new juvenile Problem 

Solving Court grants for three years at an average cost of $325,000 per year. There were also 3 

new juvenile Problem Solving Court grants that were funded in collaboration with the Office of 

Juvenile Justice and Delinquency Prevention (OJJDP) within the Department of Justice for four 

years at an average cost of $200,000 per year. These funds will provide services to support 

substance abuse treatment, assessment, case management, and program coordination for those in 

need of treatment drug court services. Priority for the use of funding will be given to address 

gaps in the continuum of treatment. 

In FY 2010, SAMHSA and the Office of Justice Programs /Bureau of Justice Affairs (BJA) 

developed a joint program to enhance court services, coordination, and substance abuse 

treatment capacity of adult drug courts. The purpose of this joint initiative is for applicants to 

submit one application that outlines a comprehensive strategy for enhancing drug court capacity. 

SAMHSA and BJA jointly funded 28 new adult Problem Solving Court grants. Each grantee was 

awarded one separate grant from each agency, representing an innovative braided funding 

opportunity. This collaboration was modeled after a successful collaborative grant program 

initiated in FY 2009 between SAMHSA and the Office of Juvenile Justice and Delinquency 

Prevention (OJJDP) to support juvenile drug courts.

Ex-Offender Re-Entry Program

FY 2012 Request: $22.6 million

(Reflects $4.6 million increase from 2010)

SAMHSA recognizes the need to continue efforts to return and reintegrate offenders back into 

the community by providing substance abuse treatment and other related re-entry services while 

also ensuring public safety for the community and family. The ex-offender re-entry 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. The FY 2012 request of $22.6 million will provide $12.2 million for 

continuation of 28 grants and $10.4 million for the award of approximately 24 new grants. 

Treatment Systems for Homeless Programs

FY 2012 Request: $47.4 million

(Reflects $4.6 million increase from 2010)

SAMHSA/CSAT manages two grant portfolios under its Grants for the Benefit of Homeless 

Individuals (GBHI) program, both of which provide focused services to individuals with a 

substance use disorder or who have co-occurring disorders. Through a recovery and public 

health oriented system of care, grantees are encouraged to address gender, age, race, ethnicity, 

sexual orientation, disability status, veteran’s status, and criminal justice status as these issues 
194 

relate to both substance use disorder services and co-occurring disorder services for homeless 

individuals. The FY 2012 Budget reflects resources of $47.4 million to support continuation of 

85 grants of which $4.2 million will support a new cohort of approximately nine new grants. 

The FY 2010 GBHI portfolio includes services in supportive housing (SSH) grants that seek to 

expand and strengthen treatment services for clients already in housing that is permanent, 

affordable, and linked to health, employment, and other support services. This approach 

combines long-term, community-based housing assistance with intensive individualized 

treatment and recovery support services. 

Other IEI Treatment Programs

FY 2012 Request: $158.4 million

(Reflects $8.6 million decrease from 2010)

The FY 2012 Budget includes resources of $158.4 million for several other Treatment Capacity 

programs including: Co-occurring State Incentive Grants; Strengthening Treatment Access and 

Retention; the Minority AIDS Initiative; Children and Family Programs; Pregnant and PostPartum Women (PPW); Recovery Community Services Program (RCSP); Minority Fellowship 

Program; Special Initiatives/Outreach; Addiction Technology Transfer Centers; Military 

Families, Health Information Technology; and Targeted Capacity Expansion (TCE) General. 

The FY 2012 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 providers to achieve specific 

performance targets. Examples of grant awards could include supplements for treatment 

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. 

Substance Abuse Prevention and Treatment Block Grant

FY 2012 Request: $1.419 billion

(Reflects an increase of $44.0 million from 2010) 

The overall goal of the SABG is to support and expand substance abuse treatment services, while 

providing maximum flexibility to states. States and territories may expend their funds only for 

the purpose of planning, carrying out, and evaluating activities related to these services. States 

may provide SABG funds to community and faith-based organizations to provide services. Of 

the amounts appropriated for the SABG, 95 percent 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. Remaining funds are used for data 

collection, technical assistance, and program evaluation, which are retained by SAMHSA for 

these purposes. The set-aside is distributed among CSAP, CSAT, and CBHSQ for purposes of 

carrying out the functions prescribed by the SABG legislation. The FY 2010 resources of $1.455 
195 

billion provided grant awards to 60 jurisdictions: states, territories, the District of Columbia, and 

the Red Lake Band of Chippewa Indians in Minnesota. These resources will support 

approximately 2 million treatment episodes. The SABG program in FY 2011 is funded at the 

same level as FY 2010, and will provide support to the current 60 jurisdictions for a similar level 

of prevention and treatment services. The FY 2012 request of $1.499 billion will provide support 

to the current 60 jurisdictions for a similar level of treatment services.

Substance Abuse – State Prevention Grants

FY 2012 Request: $395.0 million

(Reflects $395.0 million increase from 2010) 

SAMHSA proposes a new Substance Abuse - State Prevention Grant (SA-SPG) starting in FY 

2012, focusing exclusively on preventing substance abuse. The SA-SPG represents a significant 

advance in the Nation’s approach to prevention in several ways. First, it creates a sustainable 

and predictable source of prevention funding for all States that will require focus on high risk 

communities and youth. Second, it will move the Strategic Prevention Framework State 

Incentive Grant (SPF-SIG) approach to scale. Third, it requires that States use a comprehensive, 

data-driven planning process to identify and address problems in communities, and holds States 

accountable for achieving measurable outcomes for their citizens. 

The program will consist of 3-year discretionary grants to States. The final allocation for this 

program will reflect a formula that considers the population and prevention needs analysis, and 

that will ensure each State receives no less than the amount received under the SABG 20% setaside in FY 2010. Each State will be required to develop a data-driven strategic plan based on 

information from its epidemiological work group. States may retain 15% of the funds for 

infrastructure activities to support the communities in achieving outcomes. Key State activities 

are operation of a State prevention advisory group and epidemiological work group, training and 

technical assistance to communities, data collection and evaluation, development and 

dissemination of statewide messages and resources, and oversight and monitoring of funded 

communities. States will be able to use funds for coordinated workforce development, training 

in evidence-based practices, and the development of coordinated infrastructure and service 

delivery systems. Up to an additional 5% of the grant funds may be used for administrative 

costs.

Health Surveillance and Program Support

FY 2012 Request: $127.6 million

(Reflects $25.6 million increase from 2010)

The FY 2012 resources of $127.6 million, support staffing and activities to administer SAMHSA 

programs. Program Management supports the majority of SAMHSA staff who plan, direct, and 

administer agency programs and who provide technical assistance and program guidance to 

states, mental health and substance abuse professionals, clients, and the general public. In

addition, Program Management includes funding for a portion of the survey activities conducted 

by the SAMHSA Center for Behavioral Health Statistics and Quality (CBHSQ). Agency staffing 

represents a critical component of the budget. There are currently 57 members of the SAMHSA 

staff who provide direct state technical assistance and are funded through the 5% Block Grant 
196 

set-asides. Program Management also includes: contracts for block grant investigations 

(monitoring); support for the Unified Financial Management System (UFMS); administrative 

activities such as Human Resources, Information Technology, and centralized services provided 

by the Program Support Center and the Department of Health and Human Services. The FY 

2011 Budget reflects increased funding for current CBHSQ National Surveys and for a new 

CBHSQ initiative to design, develop, and field-test a community-level early warning system to 

detect emergence of new drug threats and to assist in identifying the public health and public 

safety consequences of drug abuse. SAMHSA/CBHSQ will be working closely and 

collaboratively with NIDA, NIAAA, and ONDCP on all development and deployment aspects of 

this system.

Regulatory and Oversight Functions 

FY 2012 Request: $16.1 million

(Reflects same level as 2010) 

These programs include, Opioid Drug Treatment, Mandatory Drug Testing, Prescription 

Monitoring. SAMHSA employs a number of contracts that support its regulatory efforts and 

monitoring activities. Some examples include: 

• Certification of Opioid Treatment Programs (OTPs) that use Methadone, Subutex, or 

Suboxone to treat patients with opioid dependence by a SAMHSA/CSAT recognized 

accreditation body.

• Physician Clinical Support System-Methadone, a national mentoring network offering 

support (clinical updates, evidence-based outcomes, and training) to physicians and other 

medical professionals in the appropriate use of methadone for the treatment of chronic pain 

and opioid addiction. This program also addresses the nation’s rise in methadone-associated 

deaths that has been spurred by misuse/abuse, and fatal drug interactions involving 

methadone and other prescription medications, over the counter medications, and illicit drugs 

• Physician Clinical Support System-Buprenorphine, a program designed to assist practicing 

physicians that wish to incorporate into their practices the treatment of prescription opioid 

and heroin dependent patients using the medication buprenorphine. 

• Opioid Treatment Technical Assistance Program (OTTAP), of which the primary objective is 

to educate and prepare OTPs to achieve accreditation by SAMHSA’s approved accreditation 

bodies necessary to assist OTPs in maintaining accreditation, as they are subject to re-survey, 

occurring at least triennially.

• The Federal Drug-Free Workplace Mandatory Drug Testing program, initiated in 1986 by 

Executive Order 12564 and the Public Law 100-71 in 1987, provides funding for 

accreditation and ongoing quality assurance of laboratories that perform mandatory drug 

testing for Federal and non-Federal employees across the nation. The National laboratory 

Certification Program is a core and crucial component that impacts all Executive Branch 

agencies related to public safety and national security clearance.

• The National All Schedules Prescription Electronic Reporting Act (NASPER), is a formula 

grant program, that was authorized in 2005 (Public Law 109-60) and received its first 

appropriation in FY 2009. The purpose of this program is to: 1) foster the establishment of 

State-administered controlled substance monitoring systems in order to ensure that health 

care providers and law enforcement officials and other regulatory bodies have access to 
197 

accurate, timely prescription history information that they may use as a tool for the early 

identification of patients at risk for addiction in order to initiate appropriate medical 

interventions and avert the tragic personal, family, and community consequences of untreated 

addiction; and 2) develop, based on the experiences of existing State controlled substance 

monitoring programs, a set of best practices to guide the establishment of new State 

programs and the improvement of existing programs.

Public Education and Support

FY 2012 Request: $13.6 million

(Reflects a $2.0 million increase from 2010) 

The FY 2012 Budget Request is $13.6 million, which reflects the consolidation of funding 

available for the SHIN and web development contracts from across SAMHSA. It also reflects 

efficiencies realized through the consolidation of multiple web development contracts, resulting 

in more streamlined operations without loss of capabilities. These efficiencies generate a savings 

of $5.0 million, which would result in the total funding needed to support these activities to be 

nearly $19 million if the consolidations were not undertaken. 

Performance and Quality Information Systems

FY 2012 Request: $13.0 million

(Reflects a $20.7 million decrease from 2010)

The FY 2012 Budget Request is $13.0 million, with $11 million for the performance 

management system and $2 million for the NREPP program, the same level as the FY 2011 

President’s Budget. By September 2011, SAMHSA will develop an acquisition proposal for an 

integrated performance measurement and management platform to be operational in FY 2012. 

The performance management system will adapt current systems to accept cross-cutting mental 

health and substance abuse data from all of SAMHSA’s programs. $24.8 million is reduced 

from the Services Accountability, and Program Coordination and Evaluation budget lines to 

reflect comparability adjustments and projected savings. 

Prevention Prepared Communities 

FY 2012 Request: $22.6 million

(Reflects $22.6 million increase from 2010) 

The Prevention Prepared Communities program will assist communities in developing 

community prevention systems offering evidence-based prevention of substance abuse and 

mental illness across the course of childhood and adolescence in multiple community venues. 

The program builds on scientific evidence that a) a common set of risk factors is predictive of a 

range of negative outcomes, such as academic failure (including school dropout), aggression, 

violence, delinquency, and substance use; b) mental, emotional, and behavioral problems tend to 

co-occur; c) some experiences early in development are highly predictive of later positive and 

negative outcomes; d) intervening early and throughout childhood and adolescence can reduce 

risk factors and change children’s trajectories in a positive fashion; and e) shared community 
198 

environments can play an influential role in supporting healthy behaviors. The FY 2012 

President’s Budget request is $22.6 million. Of the total amount, $20.6 million will support up to 

48 grants to states and communities and $2 million for evaluation.

Behavioral Health – Tribal Prevention Grants 

FY 2012 Request: $25.0 million 

(Reflects $25.0 million increase from 2010) 

SAMHSA proposes to introduce a new Behavioral Health – Tribal Prevention Grant (BH-TPG) 

starting in FY 2012, focusing exclusively on promoting overall behavioral health by preventing 

alcohol and substance abuse and by preventing suicides. Promotion of strong emotional health is 

an important contributor to the prevention of substance abuse and some mental illnesses as well 

as in reducing their negative impact on Tribal communities. The BH-TPG represents a 

significant advance in the Nation’s approach to alcohol abuse and suicide prevention in several 

ways. First, it recognizes that emotional health is part of overall health and thus supports the 

Tribes in addressing overall health, including preventing and reducing substance abuse, suicides 

and mental illness, in a coordinated manner. Second, it establishes a single coordinated program 

for all Federally-recognized Tribes. Third, SAMHSA will consult and work closely with Tribes 

and Tribal leaders to develop a comprehensive, data-driven planning process to identify and 

address the most serious issues in each Tribal community. Recognizing the Federal obligation to 

help Tribes deal with physical and behavioral health issues, SAMHSA will work in consultation 

with Tribes to determine the best approaches. 
199 

Performance

Introduction

This section on the FY 2010 performance of SAMHSA programs is based on agency GPRA 

documents and other agency information. The tables include performance measures, targets, and 

achievements for the latest year for which data are available.

Over the past several years, SAMHSA, in collaboration with the states, has identified a set of 

standardized National Outcome Measures (NOMs) that are monitored across all SAMHSA 

programs. The NOMs have been identified for both treatment and prevention programs and have 

common methodologies for data collection and analysis. 

SAMHSA continues to implement on-line data collection and reporting systems for mental 

health, substance abuse prevention and treatment programs, and has assisted states in developing 

their data infrastructures. 

Substance Abuse Prevention and Treatment Block Grant (SAPTBG)

SABG

Selected Measures of Performance FY 2010 

Target

FY 2010 

Actual

Percent of clients reporting no drug use in the past month at 

discharge 

70.3% TBR – Nov 

2011 

Number of admissions to substance abuse treatment programs 

receiving public funding

1,881,551 TBR – Nov 

2012 

Discussion

SAMHSA has established a data-driven block grant mechanism which monitors the National 

Outcome Measures (NOMs) and improves data collection, analysis, and utilization. Data for the 

treatment NOMs are drawn from a combination of sources, including the Web Block Grant 

Application System (WEBBGAS). A major milestone was reached when the reporting of NOMs 

was made mandatory in the FY 2008 SABG Application. 

In 2005, the CSAT and CSAP funded an Independent Evaluation of the Substance Abuse 

Prevention and Treatment Block Grant (SABG) Program. The evaluation was completed in 

December of 2008. The purpose of the evaluation was to assess the extent to which the SABG 

Program is effective, functioning as intended, and achieving desired outcomes. 

The evaluation resulted in a number of key findings, which include: a demonstrated positive 

effect on the health and lives of substance abuse treatment clients; the SAPTBG as a major 

impetus for improving State prevention and treatment systems’ infrastructure and capacity; 

States’ ability to leverage SAPTBG requirements, resources, and Federal guidance to sustain and 

improve their systems; demonstration of effective federal and state management of the program; 

and a contribution to the development and maintenance of successful State collaborations with 

other agencies and stakeholders concerned with preventing and treating substance abuse.
200 

Data on FY 2010 achievements are not yet available. For FY 2009, the Block Grant program 

exceeded the target (1,881,515) for the number of clients served: a total of 2,132,206 clients. 

The FY 2009 data show that 81.5% of clients had abstained from alcohol at discharge, 75.7% 

had abstained from drug use (exceeding the 2009 target of 69%), 42.9% were employed, and 

92% reported having no involvement with the criminal justice system.

20% Prevention Set-Aside 

SABG – 20% Prevention Set-Aside

Selected Measures of Performance FY 2010 

Target

FY 2010 

Actual

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) 

45.1% TBR—

August 

2011

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) 

51% TBR—

August 

2011

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)

52.9% TBR—

August 

2011

Number of participants served in prevention programs 17,482,060 TBR—

August 

2011 

Discussion

States are placing an increased emphasis on implementing the Strategic Prevention Framework 

(SPF) with SABG funds. As a result, the strategic plans developed by their local SAPT-funded 

communities ensure the: a) identification of populations with the greatest need for evidencebased prevention programs, practices and policies; b) allocation resources where most they are 

most needed; and c) achievement of outcomes through a data-driven process. To assist with 

these tasks, the SPF provides States and their funded communities with an array of tools 

designed to monitor the performance of their programs.

For example, the City of Quincy, Massachusetts has—in collaboration with Impact Quincy— 

successfully worked toward the goal of reducing fatal and non-fatal opioid overdoses over the 

past two years. Using the SPF, Impact Quincy has been able to develop training materials to 

educate and help create awareness about opioid overdose and related issues among active users, 

bystanders, healthcare providers, and criminal justice personnel. The trainings provide important 

information on recognizing the signs of overdose; prevention and management strategies (such 

as rescue breathing and calling 911); and overdose reversal strategies (such as administration of 

nasal Naloxone). 

Impact Quincy’s efforts have led to critically important policy and practice changes that have 

impacted the way Quincy Police and Fire Department personnel respond to overdoses. All 
201 

Quincy Police Department officers are now required to be trained in the use of nasal Naloxone 

and are authorized to carry it to respond to overdose emergencies during all shifts. In addition, 

Norfolk County Community Corrections inmates are now receiving opioid overdose trainings 

and, as appropriate, are connected with treatment services upon release. The commitment of the 

Mayor of Quincy and other city officials, as well as key stakeholders within the community, has 

also been a vital component to this community’s success. 

In terms of actual performance, data for FY 2010 are not yet available and are expected to be 

reported during August 2011. However, FY 2009 actual performance data showed that the 20% 

Prevention Set-Aside of the SABG served a total of 112,716,508 participants through prevention 

programs, practices and strategies—exceeding its target of serving 17,482,060 participants 1,2

. 

In addition, data showed that other FY2009 targets were exceeded including: a) the percentage of 

States showing an increase in state-level estimates of survey respondents—ages 12 through 17—

who rated the risk of substance abuse as ‘moderate’ or ‘great’ (Target 45.1%; Actual 58.8%3); b) 

the percentage of States that reported a decrease in 30-day use of alcohol among participants 

ages 12 through 20 (Target 51%; Actual 72.5%); and c) the percentage of States that reported a 

decrease in 30-day use of other illicit drugs among participants ages 12 through 17 (Target 

52.9%; Actual 56.9%). 

Programs of Regional and National Significance (PRNS) 

Treatment PRNS

Selected Measures of Performance FY 2010 

Target

FY 2010 

Actual

Percentage of adults receiving services who were currently 

employed or engaged in productive activities

51% 44.5%

Percentage of adults receiving services who had a permanent 

place to live in the community

49% 49.0%

Percentage of adults receiving services who had no 

involvement with the criminal justice system

94% 96.0%

Increase percentage of adults receiving services who 

experienced no/reduced alcohol or illegal drug related health, 

behavioral or social, consequences 

66% 87.6%

Percentage of adults receiving services who had no past 

month substance use 

62% 67.9%

Number of clients served4 34,784 30,156

 

1 Data based off of information reported by SABG grantees through the WEBBGAS.

2 It is important to note that many prevention programs, practices and strategies implemented through the 20% Prevention SetAside of the SABG are at the population-level and, as a result, may include duplicate counts.

3 Data based off of 2008 NSDUH pooled estimates (2006/2007 and 2007/2008).

4 Total of SAMHSA’s CSAT Capacity programs excluding Access to Recovery and the Screening, Brief Intervention, and Referral to 

Treatment Program. 

5

Measures reflect those clients served in currently active grants for the year shown. Data are collected at a six month follow-up 

point. Client length of stay varies by case; therefore, some may be discharged by this point while others are still in treatment.
202 

Discussion

The Treatment PRNS provides funding to implement service improvements, using proven 

evidence-based approaches, system changes, and programs to promote identification and 

increase the availability of practices with potential for broad service improvement. The PRNS 

enables SAMHSA’s CSAT to address emerging issues in the field. CSAT integrates data and 

performance into program and management decisions via, a real-time data reporting system. 

Staff routinely monitor grantees’ progress to ensure that program goals and objectives are being 

met. 

The Programs of Regional and National Significance are made up of many different services 

programs. One of these is the Screening, Brief Intervention, and Referral to Treatment program 

(SBIRT), implemented in 2003. In FY 2010, SBIRT provided over 275,000 substance abuse 

screenings in primary care and generalist settings. 

Normalizing Alcohol and Drug Screening in Colorado5

José Esquibel has a dream: to make screening for alcohol and substance abuse problems as routine as 

diabetes screening in every health care facility in Colorado. And the Screening, Brief Intervention, and 

Referral to Treatment (SBIRT) grant the state received from SAMHSA is helping to make that dream a 

reality. Eight hospitals, six primary care settings, and eight HIV clinics across the state are already using 

the SBIRT approach. Funding for serving the HIV clinics comes from the state’s Ryan White CARE Act 

funding. 

A project partner called the Colorado Clinical Guidelines Collaborative is helping to spread the word by 

condensing best practices in various subject areas into two-page guides distributed to its network of 

physicians. To further ensure sustainability, the project is also targeting health care payers. The state 

recently passed a law requiring that insurance companies in Colorado pay for alcohol screenings 

beginning in January 2010. Now the project is taking the message to the public. “We want to 

communicate to the public that someone should be asking them questions about how alcohol and drugs 

affect their health whenever they’re in a health care setting,” said Mr. Esquibel.

The Access to Recovery program, also a key PRNS program, was implemented in 2005. Data 

from that program follows:

ATR

Selected Measures of Performance FY 2010 

Target

FY 2010 

Actual

Percentage of adults receiving services who had no past 

month substance use 

82% 82.9%

Percentage of adults receiving services who had improved 

family and living conditions 

53% 43.6%

Percentage of adults receiving services who had no 96% 96.3%

 

5 Excerpted from SAMHSA News, November/December 2009, Volume 17, Number 6

SAMHSA News is the national newsletter of the Substance Abuse and Mental Health Services 

Administration (SAMHSA), U.S. Department of Health and Human Services (HHS).” 
203 

involvement with the criminal justice system

Percentage of adults receiving services who had improved 

social support

91% 91.1%

Percentage of adults receiving services who were currently 

employed or engaged in productive activities

54% 49.5%

Average cost per client through ATR $1,572 $1,374

Number of clients gaining access to treatment 65,000 69,522

Discussion

The Access to Recovery (ATR) program provides grants to States, Tribes, and Tribal 

organizations to undertake voucher programs that expand substance abuse treatment capacity and 

promote choice among clinical treatment and recovery support providers. 

In 2010, the ATR program substantially exceeded its target for the number of clients served: 

69,522 clients as compared to the target of 65,000. Moreover, the program’s achievements 

include a number of positive developments measured at the time of discharge: an abstinence 

level of 82.9%, an employment level of 49.5%, an improved social support level of 91.1%, and a 

level of 96.3% of clients having no involvement with the criminal justice system. 

Juvenile and Adult Drug Courts

Introduction

The data for the treatment completion measure is collected from clients upon discharge from the 

program. The other two measures are collected at 6 month follow-up post intake. SAMHSA 

grantees are required to have an 80% follow-up rate at 6 months post intake. Given the variation 

in data collection time points, it is possible to have data reported for one measure but not the 

other depending on data availability.

Substance Abuse Drug Courts

Selected Measures of Performance FY 2010 

Target

FY 2010 

Actual

Percentage of adults receiving services who had a permanent 

place to live in the community 

42% 42.3%

Percentage of adult clients that complete treatment 53% 45.6%

Percentage of adults receiving services who had no 

involvement with the criminal justice system

93% 93.0%

Discussion

The Drug Court program provides funding to address the treatment needs of substance-using 

individuals involved in a Drug Court. The Program is designed to provide holistic treatment and 

wrap-around services to criminally-involved substance-using individuals in order to assist them 

in achieving and maintaining abstinence from substance use along with improving their overall 

quality of life. 
204 

This program funds several types of grants including those specifically for juvenile or adult 

clients and those focused on families. SAMSHA reports performance data for the Adult and 

Juvenile Drug Courts separately. As a result, the data and targets are reported separately based 

on which grants are currently funded (Adult or Juvenile). Since Adult Drug Courts were recently 

funded, the results are shown here.

The Adult Drug Court Program demonstrated successful results in 2010, meeting or exceeding 

targets related to housing and criminal justice involvement. The Adult Drug Court Program did 

not meet its target for treatment completion; however, SAMHSA considers this to be within 

acceptable range of the target set.

Prevention PRNS

Prevention PRNS

Selected Measures of Performance FY 2010 

Target

FY 2010 

Actual

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 drugs6

59.8% TBR - August 

2011 

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 

78.7% TBR - August 

2011 

HIV: Percent of program participants (age 12-17) that rate the 

risk of substance abuse as moderate or great

87.0% TBR - August 

2011

HIV: Percent of participants (age 18 and up) who used illicit 

drugs at pre-test who report a decrease in 30-day use at posttest 

70.6% TBR - August 

2011 

Discussion

The Prevention PRNS include a number of major programs such as the Strategic Prevention 

Framework State Incentive Grants (SPF SIG) and the Minority Substance Abuse/HIV Prevention 

Initiative (MAI). 

The SPF SIG is a public health approach that requires participating States—as well as their 

funded communities—to apply the multiple steps of the SPF7 before implementing programs 

related to substance abuse prevention. Therefore, the SPF SIG requires grantees to focus initial 

efforts and resources on developing and/or expanding current infrastructure, as well as increasing 

their capacity to implement prevention programs8. By initially targeting and improving 

infrastructure and capacity, results obtained through the implementation of selected prevention 

programs and strategies will, over time, have stronger, more lasting effects on participants. It is 

important to note that, because communities are required to complete steps 1 through 3 prior to 

implementation, a lag may exist between the awards of grants and when community and/or state-

 

6 SPF SIGs are Strategic Prevention Framework State Incentive Grants 7 SPF process includes the following five steps: Assessment, Capacity, Planning, Implementation, and Evaluation

8 While the first three steps of the SPF process are completed by the State prior to funding communities; communities are required 

to complete the entire SPF after receiving funds from the State
205 

level changes are observed. In addition, any changes in state-level estimates of use and non-use 

may be affected by numerous factors outside of the prevention programs, and, as a result, cannot 

be solely attributed to the SPF SIG9

. 

Unlike the SPF SIG, the MAI program funds communities (rather than states) and focuses on 

increasing community capacity to deliver substance abuse evidence-based prevention services 

with a focus on HIV. The MAI program was redesigned in FY 2007 to incorporate the SPF 

within program activities; as a result, baseline data were collected for new measures that 

reflected the change in the program’s structure. 

Data regarding actual performance for FY 2010 are not yet available and are expected to be 

reported during August 2011. However, FY 2009 actual performance data showed that the SPF 

SIG program nearly met its target regarding the percentage of states showing a decrease in 30-

day use of illicit drugs among participants ages 12 through 17 (Target 59.8%; Actual 59.6%). In 

addition, results also showed an improvement in the percentage of States showing an increase in 

the perception of risk from substance abuse among participants ages 12 through 17 between FY 

2008 (47.1 %) and FY 2009 (55.3%).10

For the MAI program—specifically the HIV 6-cohort—FY 2009 actual performance data 

showed that the program exceeded its target regarding the percentage of participants—ages 12 

through 17—who rated the risk of substance abuse as ‘moderate’ or ‘great’ (Target: 76.6%; 

Actual 90%). Results also showed an improvement in the percentage of participants (ages 18 

and up) who used illicit drugs at pre-test, but reported a decrease in 30-day use at post-test 

between FY 2008 (59.1%) and FY 2009 (62.2%). 

 

9 The current cohort of SPF SIG grants are ending in FY 2011. However this model is being implemented in several 

other planned programs for FY 2012.

10 It is important to note that these data are based on aggregate estimates across cohorts that started at different times; as a result, 

caution must be used in their interpretation.
206 

Page intentionally left blank 
207 

Substance Abuse and Mental Health Services Administration

Object Classification Tables – Direct

(Dollars in Thousands)

Object Class - Direct Budget Authority

FY 2011 

Estimate

FY 2012 

Estimate

FY 2012 +/- 

FY 2011

Direct Obligations 1/:

Personnel Compensation:

Full Time Permanent (11.1)................................................

Other than Full-Time Permanent (11.3)...............................

Other Personnel Compensation (11.5).................................

Military Personnel Compensation (11.7)...............................

Special personal services payments (11.8)...........................

Subtotal Personnel Compensation:

Civilian Personnel Benefits (12.1)........................................

Military Personnel Benefits (12.2).......................................

Benefits for Former Personnel (13.1)..................................

Subtotal Pay Costs:

Travel (21.0).........................................................................

Transportation of Things (22.0)..............................................

Rental Payments to GSA (23.1).............................................

Rental Payments to Others (23.2)..........................................

Communications, Utilities and Misc. Charges (23.3)................

Printing and Reproduction (24.0)............................................

Other Contractual Services:

Advisory and Assistance Services (25.1).............................

Other Services (25.2).........................................................

Other Purchases of Goods & Svc from Govt Accts (25.3)....

Operation & Maintenance of Facilities (25.4).......................

Medical Care (25.6)...........................................................

Operation and Maintenance of Equipment (25.7)..................

 Subtotal Other Contractual Services:.............................

$45,244

1,853

972

4,079

105

$45,071

1,846

968

4,148

106

 -$173

 -7

 -4

+69

+1

52,253 52,139 -114

11,930

2,094

 0

11,884

2,129

 0

 -46

+35

 0

66,277 66,152 -125

1,658

44

7,023

1

744

2,744

29,261

229,001

102,671

1,292

 0

277

1,785

45

7,142

1

756

2,788

27,008

212,291

94,731

1,292

 0

277

+127

+1

+119

 0

+12

+44

 0

 -2,253

 -16,710

 -7,940

 0

 0

 0

362,502 335,599 -26,903

Supplies and Materials (26.0).................................................

Equipment (31.0)...................................................................

Grants, Subsidies, and Contributions (41.0)..............................

Insurance Claims & Indemnities (42.0)...................................

Interest & Dividends (43.0)...................................................

Advance to Others (61.0)......................................................

Subtotal Non-Pay Costs.....................................................

Total Direct Obligations: ..................................................

1,159

291

2,987,826

1,355

 0

 0

1,159

291

2,969,830

1,355

 0

 0

 0

 0

 -17,996

 0

 0

 0

3,365,347 3,320,751 -44,596

$3,431,624 $3,386,903 -$44,721

Average Cost per FTE

Civilian FTEs

Civilian Average Salary

Percent Change

Military FTEs

Military Average Salary

Percent Change

Total SAMHSA FTEs

Total SAMHSA Average Salary

Percent Change

436

$137.9

+0.50%

436

$137.3

 -0.38%

51

121.0

+1.90%

51

123.1

+1.68%

487

$136.1

+0.63%

487

$135.8

-0.19%

1/ Personnel Compensation differs slightly from the FY 2012 President's Budget Appendix due to 

realignment of new staff to reimbursable. Due to review of all contracts, these are estimates and funding 

may shift among object classes based on the results of this review.
208 

Substance Abuse and Mental Health Services Administration

Salaries and Expenses

(Dollars in Thousands)

Salary and Expenses 1/

FY 2011 

Estimate

FY 2012 

Estimate

FY 2012 +/- 

FY 2011

Personnel Compensation:

Full Time Permanent (11.1)................................................ $45,244 $45,071 -173

Other than Full-Time Permanent (11.3)............................... 1,853 1,846 -7

Other Personnel Compensation (11.5)................................. 972 968 -4

Military Personnel Comprensation (11.7)............................. 4,079 4,148 +69

Special personal services payments (11.8)........................... 105 106 +1

Subtotal Personnel Compensation: 52,253 52,139 -114

Civilian Personnel Benefits (12.1)........................................ 11,930 11,884 -46

Military Personnel Benefits (12.2)....................................... 2,094 2,129 +35

Benefits for Former Personnel (13.1).................................. 0 0 0

Subtotal Pay Costs: 66,277 66,152 -125

Travel (21.0)......................................................................... 1,658 1,785 +127

Transportation of Things (22.0).............................................. 44 45 +1

Rental Payments to Others (23.2).......................................... 1 1 0

Communications, Utilities and Misc. Charges (23.3)................ 744 756 +12

Printing and Reproduction (24.0)............................................ 2,744 2,788 +44

Other Contractual Services: 0

Advisory and Assistance Services (25.1)............................. 17,001 15,692 -1,309

Other Services (25.2)......................................................... 224,879 208,469 -16,410

Other Purchases of Goods & Svc from Govt Accts (25.3).... 25,928 23,922 -2,005

Operation & Maintenance of Facilities (25.4)....................... 1,292 1,292 0

Medical Care (25.6)........................................................... 0 0 0

Operation and Maintenance of Equipment (25.7).................. 277 277 0

 Subtotal Other Contractual Services:............................. 269,376 249,653 -19,724

Supplies and Materials (26.0)................................................. 1,159 1,159 0

Subtotal Non-Pay Costs..................................................... 275,726 256,187 -19,540

Total, Salaries and Expenses............................................. $342,003 $322,339 -$19,665

Direct FTE......................................................................... 487 494 +7

1/ Personnel Compensation differs slightly from the FY 2012 President's Budget Appendix due to 

realignment of new staff to reimbursable. Due to review of all contracts, these are estimates and funding 

may shift among object classes based on the results of this review.
209 

Substance Abuse and Mental Health Services Administration

Detail of Full Time Equivalent (FTE)

2010 

Actual 

Civilian

2010 

Actual 

Military

2010 

Actual 

Total

2011 Est. 

Civilian

2011 Est. 

Military

2011 Est. 

Total

2012 Est. 

Civilian

2012 Est. 

Military

2012 Est. 

Total

CMHS

Direct:........................................... 78 15 93 79 17 96 79 17 96

Reimbursable:.............................. 15 7 22 14 3 17 14 3 17

Total: ........................................ 93 22 115 93 20 113 93 20 113

CSAP

Direct:........................................... 77 15 92 77 15 92 77 15 92

Reimbursable:.............................. 11 --- 11 12 --- 12 12 --- 12

Total: ........................................ 88 15 103 89 15 104 89 15 104

CSAT

Direct:........................................... 94 11 105 93 11 104 93 11 104

Reimbursable:.............................. 1 --- 1 1 --- 1 1 --- 1

Total: ........................................ 95 11 106 94 11 105 94 11 105

OA

Direct:........................................... 35 1 36 35 1 36 35 1 36

Reimbursable:.............................. --- --- --- --- --- --- 7 --- 7

Total: ........................................ 35 1 36 35 1 36 42 1 43

OAS/1

Direct:........................................... 27 2 29 27 3 30 27 3 30

Reimbursable:.............................. --- 2 2 --- 1 1 --- 1 1

Total: ........................................ 27 4 31 27 4 31 27 4 31

OPPB/1

Direct:........................................... 31 2 33 31 2 33 31 2 33

Reimbursable:.............................. 1 --- 1 1 --- 1 1 --- 1

Total: ........................................ 32 2 34 32 2 34 32 2 34

OPS/1

Direct:........................................... 93 1 94 94 2 96 94 2 96

Reimbursable:.............................. 10 1 11 10 1 11 10 1 11

Total: ........................................ 103 2 105 104 3 107 104 3 107

St. Elizabeths

Direct:........................................... --- --- --- --- --- --- --- --- --- Reimbursable:.............................. --- 7 7 --- 7 7 --- 7 7

Total: ........................................ --- 7 7 --- 7 7 --- 7 7

SAMHSA FTE Total: .................. 473 64 537 474 63 537 481 63 544

/1 This table represents the organization structure prior to August 16, 2010. It does not reflect the reallocation of FTE 

among the new OPPI, OFR, OMTO and CBHSQ.
210 

Substance Abuse and Mental Health Services Administration

Detail of Positions 

2010

Actual

2011

Estimate

2012

Estimate

Executive Level I 0 0 0

Executive Level II 0 0 0

Executive Level III 0 0 0

Executive Level IV 1 1 1

Executive Level V 0 0 0

Subtotal 1 1 1

Total - Exec Level Salaries $156,387 $157,169 $157,169

SES 15 15 15

Subtotal 15 15 15

Total, SES salaries $2,572,800 $2,585,664 $2,585,664

GM/GS-15 69 69 69

GM/GS-14 125 126 126

GM/GS-13 125 128 130

GS-12 39 40 40

GS-11 21 21 21

GS-10 3 3 3

GS-09 18 16 18

GS-08 17 17 17

GS-07 17 15 18

GS-06 10 10 10

GS-05 9 9 9

GS-04 2 2 2

GS-03 1 1 1

GS-02 1 1 1

GS-01 0 0 0

Subtotal 457 458 465

Total, GS salaries $49,841,591 $50,090,798 $50,090,798

CC-08/09 1 1 1

CC-07 1 1 1

CC-06 12 13 13

CC-05 16 17 17

CC-04 19 20 20

CC-03 13 9 9

CC-02 2 2 2

CC-01 0 0 0

Subtotal 64 63 63

Total, CC salaries $7,421,286 $7,525,184 $7,630,537

Total Positions 537 537 544

Average ES level ES ES ES

Average ES salary $156,387 $158,577 $157,169

Average SES level SES SES SES

Average SES salary $171,520 $172,378 $172,378

Average GS grade 12.4 12.5 12.5

Average GS salary $106,956 $107,760 $107,760

Average CC level 4.5 4.6 4.6

Average CC salaries $115,958 $119,447 $121,120
211 

Programs Proposed for Elimination 

Substance Abuse and Mental Health Services Administration

Programs Proposed for Reduction

The following table shows the programs proposed for elimination in the President’s 2011 Budget request. 

Following the table is a brief summary of each program and the rationale for its reduction. 

 (Dollars in Millions)

Strategic Prevention Framework (-$111.777 million) 

 FY 2011 FY 2012 FY 2011 +/-FY 2012

Strategic Prevention Framework 111.777 --- -111.777

Much of the funding from the Strategic Prevention Framework program has been redirected to 

the Substance Abuse – State Prevention Grant, which would provide a comprehensive, long-term 

funding source for the States to implement substance abuse prevention strategies. 

Older Adult Programs (-$4.814 million) 

FY 2011 FY 2012 FY 2011 +/-

FY 2012

Older Adult Programs 4.814 --- -4.814

The Older Adults Grant program has come to a natural end. SAMHSA encourages States and 

Territories to bring the service concepts to scale by utilizing their Mental Health Block Grant and 

Mental Health – State Prevention Grant funding to provide services. 

St. Elizabeths Hospital – Environmental Remediation (-$0.795 million) 

FY 2011 FY 2012 FY 2011 +/-

FY 2012

St. Elizabeths Hospital - Environmental Remediation 0.795 --- -0.795

As General Services Administration has indicated that they will not need funding from 

SAMHSA in FY 2012 for environmental remediation activities at the former St. Elizabeths 

Hospital site, there is no request for this activity. 
212 

FY 2012 HHS Enterprise Information Technology and 

Government-Wide E-Gov Initiatives 

SAMHSA Allocation Statement:

SAMHSA will use $289,931.00 of its FY 2012 budget to support Department-wide enterprise 

information technology and government-wide E-Government initiatives. Operating Divisions 

help to finance specific HHS enterprise information technology programs and initiatives, 

identified through the HHS Information Technology Capital Planning and Investment Control 

process, and the government-wide E-Government initiatives. The HHS enterprise initiatives 

meet cross-functional criteria and are approved by the HHS IT Investment Review Board based 

on funding availability and business case benefits. Development is collaborative in nature and 

achieves HHS enterprise-wide goals that produce common technology, promote common 

standards, and enable data and system interoperability.

Of the amount specified above, $21,554.00 is allocated to developmental government-wide EGovernment initiatives for FY 2012. This amount supports these government-wide EGovernment initiatives as follows:

FY 2012 Developmental E-Gov Initiatives*

 Line of Business - Human Resources $1,050.00

 Line of Business - Grants Management $4,313.00

 Line of Business - Financial $6,021.00

 Line of Business - Budget Formulation and Execution $4,421.00

 Disaster Assistance Improvement Plan $5,749.00

 Federal Health Architecture (FHA) $0.00

 Line of Business - Geospatial $0.00

FY 2012 Developmental E-Gov Initiatives Total $21,554.00 

* Specific levels presented here are subject to change, as redistributions to meet changes in resource demands are 

assessed.

Prospective benefits from these initiatives are:

Lines of Business-Human Resources Management: Provides standardized and interoperable 

HR solutions utilizing common core functionality to support the strategic management of Human 

Capital

Lines of Business-Grants Management: Supports end-to-end grants management activities 

promoting improved customer service; decision making; financial management processes; 

efficiency of reporting procedure; and, post-award closeout actions. The Administration for 

Children and Families (ACF) is a GMLOB consortia lead, which has allowed ACF to take on 

customers external to HHS. These additional agency users have allowed HHS to reduce overhead 

costs for internal HHS users. Additionally, NIH is an internally HHS-designated Center of 

Excellence. This effort has allowed HHS agencies using the NIH system to reduce grants 

management costs. Both efforts have allowed HHS to achieve economies of scale and 
213 

 

efficiencies, as well as streamlining and standardization of grants processes, thus reducing 

overall HHS costs for grants management systems and processes. 

Lines of Business-Financial Management: Supports efficient and improved business 

performance while ensuring integrity in accountability, financial controls and mission 

effectiveness by enhancing process improvements; achieving cost savings; standardizing 

business processes and data models; promoting seamless data exchanges between Federal 

agencies; and, strengthening internal controls.

Lines of Business-Budget Formulation and Execution: Allows sharing across the Federal 

government of common budget formulation and execution practices and processes resulting in 

improved practices within HHS. 

Disaster Assistance Improvement Plan (DAIP): The DAIP, managed by Department of 

Homeland Security, assists agencies with active disaster assistance programs such as HHS to 

reduce the burden on other federal agencies which routinely provide logistical help and other 

critical management or organizational support during disasters. 

In addition, $167,473.00 is allocated to ongoing government-wide E-Government initiatives for 

FY 2012. This amount supports these government-wide E-Government initiatives as follows:

FY 2012 Ongoing E-Gov Initiatives*

 E-Rule Making $9,511.00

 Integrated Acquisition Environment $45,616.00

 GovBenefits $14,163.00

 Grants.Gov $98,183.00

FY 2012 Ongoing E-Gov Initiatives Total $167,473.00 

* Specific levels presented here are subject to change, as redistributions to meet changes in resource demands are 

assessed.
214 

Page intentionally left blank 
215 

SAMHSA FY 2012 Budget Structure Crosswalk 

All-Purpose Table 

(Dollars in Thousands)

Program Activities

FY 2010 

Actual

FY 2011 

Continuing 

Resolution

FY 2012 

President's 

Budget

FY 2012 

Prevention 

Fund

Mental Health:

Programs of Regional and National Significance.................................

Children's Mental Health Services........................................................ $121,316 $121,316 $121,316 ---

Protection & Advocacy......................................................................... $36,380 $36,380 $36,380 ---

PATH Homeless Formula Grant........................................................... $65,047 $65,047 $65,047 ---

Mental Health Services Block Grant..................................................... 399,735 399,735 413,645 ---

PHS Evaluation Funds.......................................................................... 21,039 21,039 21,039 ---

$361,352 $361,521 $273,342 $20,000

Subtotal, Mental Health Services Block Grant..................................... 420,774 420,774 434,684 ---

Subtotal, Mental Health..................................................................... 1,004,869 1,005,038 930,769 20,000

Substance Abuse Prevention:

Programs of Regional and National Significance................................. 202,040 202,209 74,582 ---

Subtotal, Substance Abuse Prevention.............................................. 202,040 202,209 74,582 ---

Substance Abuse Treatment:

Programs of Regional and National Significance................................. 443,863 444,033 399,822 ---

PHS Evaluation Funds.......................................................................... 8,596 8,596 2,000 ---

Subtotal................................................................................................ 452,459 452,629 401,822 ---

Prescription Drug Monitoring (NASPER)....................................... 2,000 2,000 2,000 ---

Substance Abuse Block Grant............................................................... 1,719,391 1,719,391 1,419,603 ---

PHS Evaluation Funds.......................................................................... 79,200 79,200 74,711 ---

Subtotal, Substance Abuse Block Grant............................................... 1,798,591 1,798,591 1,494,314 ---

Subtotal, Substance Abuse Treatment.............................................. 2,253,050 2,253,220 1,898,136 ---

TOTAL, SUBSTANCE ABUSE........................................................ 2,455,090 2,455,429 1,972,718 ---

Substance Abuse - State Prevention Grant....................................... --- --- 395,000 ---

Behavioral Health - Tribal Prevention Grant.................................. --- --- --- 50,000

Mental Health - State Prevention Grant 1/....................................... --- --- 90,000 ---

SAMHSA Agency-Wide Initiatives 2/............................................... --- --- 14,000 22,600

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

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

Public Awareness and Support.......................................................... --- --- 13,571 ---

PHS Evaluation Funds (non-add)..................................................... --- --- 13,571 ---

Subtotal, SAMHSA-Wide Programs................................................. --- --- 525,567 72,600

Health Surveillance and Program Support............................................ 79,197 79,197 82,166 ---

PHS Evaluation Funds.......................................................................... 22,750 22,750 45,428 ---

Subtotal, Health Surveillance and Program Support...................... 101,947 101,947 127,594 ---

St. Elizabeths Hospital B&F.............................................................. 795 795 --- ---

Data Evaluation.................................................................................. --- --- --- ---

TOTAL, SAMHSA Discretionary PL............................................... 3,562,701 3,563,209 3,556,648 92,600

Less PHS Evaluation Funds................................................................. 131,585 131,585 169,745 ---

TOTAL, SAMHSA Budget Authority.............................................. $3,431,116 $3,431,624 $3,386,903 $92,600

FTEs 537 537 544

1/ Includes Project LAUNCH ($25 million) in FY 2012

2/ Includes Military Families ($10 million), Health IT ($4 million), and PPC ($22.6 million)
216 

Center for Mental Health Services 

Programs of Regional & National Significance 

Summary of Activities 

(Dollars in thousands)

Programs of Regional & National Significance

FY 2010 

Actual

FY 2011

Continuing 

Resolution

FY 2012 

President's 

Budget

CAPACITY:

Co-Occurring State Incentive Grant 2,168 2,168 2,168

Seclusion & Restraint $2,482 $2,449 $2,449

Youth Violence Prevention 94,393 94,502 94,333

National Traumatic Stress Network 40,798 40,800 11,300

Children and Family Programs 9,100 9,194 6,486

Performance Management and Coordination Activities 2,818 3,166 0

Consumer and Family Network Grants 6,223 6,236 4,966

MH System Transformation and Health Reform 29,179 29,106 10,623

Project LAUNCH 24,993 25,000 25,000

Primary and Behavioral Health Care Integration 13,987 14,000 14,000

Community Resilience and Recovery Initiative 4,979 5,000 5,000

Suicide Lifeline 5,522 5,522 5,522

GLS - Youth Suicide Prevention - States 29,617 29,738 29,738

GLS - Youth Suicide Prevention - Campus 4,972 4,975 4,975

AI/AN Suicide Prevention Initiative 2,944 2,944 2,944

Homelessness Prevention Programs 32,265 32,250 39,696

Older Adult Programs 4,810 4,814 0

Minority AIDS 9,283 9,283 9,283

Criminal and Juvenile Justice Programs 6,684 6,684 6,684

Congressional Projects

Subtotal, Capacity

5,975 5,975 0

333,192 333,806 275,167

SCIENCE AND SERVICE:

GLS - Suicide Prevention Resource Center 4,957 4,957 4,957

Practice Improvement and Training 9,454 9,001 7,878

SAMHSA Health Information Network (SHIN)

National Registry of Evidence-based Programs and Practices 

(NREPP)

2,673 2,673 0

Consumer and Consumer Support 

? Technical Assistance Centers

544 544 0

1,927 1,927 1,927

Minority Fellowship Program 4,279 4,279 4,279

Disaster Response 1,054 1,054 1,054

Homelessness 2,306 2,306 2,306

HIV/AIDS Education

Subtotal, Capacity

TOTAL, PRNS

966 974 774

28,160

$361,352

27,715

$361,521

23,175

$298,342
217 

Center for Substance Abuse Prevention

Programs of Regional & National Significance 

Summary of Activities 

(Dollars in thousands)

Programs of Regional & National Significance

FY 2010 

Actual

FY 2011 

Continuing 

Resolution

FY 2012

President's 

Budget

CAPACITY:

Strategic Prevention Framework $111,705 $111,777 $0

Mandatory Drug Testing 5,202 5,206 5,206

Minority AIDS 41,385 41,385 41,385

Performance Management 6,296 6,300 0

Sober Truth on Preventing Underage Drinking (STOP Act) 7,000 7,000 7,000

Congressional Projects 

Subtotal, Capacity

3,950 3,950 0

175,538 175,618 53,591

SCIENCE AND SERVICE:

Fetal Alcohol Spectrum Disorder 9,820 9,821 8,000

Center for the Application of Prevention Technologies 8,367 8,511 8,511

Science and Service Program Coordination 4,845 4,789 4,409

National Registry of Evidence-based Programs and Practices 650 650 0

SAMHSA Health Information Network 2,749 2,749 0

Minority Fellowship Program

Subtotal, Science and Service

TOTAL, PRNS

71 71 71

26,502

$202,040

26,591

$202,209

20,991

$74,582
218 

Center for Substance Abuse Treatment

Programs of Regional & National Significance 

Summary of Activities 

(Dollars in thousands)

Programs of Regional & National Significance

FY 2010 

Actual

FY 2011

Continuing 

Resolution

FY 2012

President's 

Budget

CAPACITY:

Co-occurring State Incentive Grants (SIGs) $4,262 $4,263 $4,263

Opioid Treatment Programs/Regulatory Activities 8,988 8,903 8,903

Screening, Brief Intervention and Referral to Treatment a/ 29,106 29,106 29,106

TCE-General 29,022 28,989 17,411

Pregnant & Postpartum Women 16,000 16,000 16,000

Strengthening Treatment Access and Retention 1,773 1,775 1,675

Recovery Community Services Program 5,669 5,236 2,450

Access to Recovery 99,380 98,954 98,454

Children and Families 30,576 30,678 30,678

Treatment Systems for Homeless 42,530 42,750 47,360

Minority AIDS 65,911 65,988 65,988

Criminal Justice Activities 67,406 67,635 67,635

Treatment Drug Courts (non-add) 43,771 43,882 43,691

Family Dependency/Treatment Drug Courts (non-add within Drug Courts) 5,000 5,000 5,000

Ex-Offender Re-Entry (non-add) 18,002 22,242 22,568

Services Accountability b/ 20,226 20,816 ---

Congressional Projects

Subtotal, Capacity

4,593 4,593 ---

425,442 425,686 389,923

SCIENCE AND SERVICE:

Addiction Technology Transfer Centers 9,150 9,081 9,081

Minority Fellowship Program 547 547 547

Special Initiatives/Outreach c/ 2,509 2,400 2,271

Information Dissemination 4,329 4,553 ---

National Registry of Evidence-Based Programs & Practices 893 893 ---

SAMHSA Health Information Network 4,255 4,255 ---

Program Coordination and Evaluation d/

Subtotal, Science and Service

5,334 5,214 ---

27,017 26,943 11,899

TOTAL, PRNS $452,459 $452,629 $401,822
219 

 

FY 2010 Budget Structure

Mental Health Block Grant

Substance Abuse Prevention and Treatment Block Grant

PRNS Strategic Prevention Framework (CSAP)

PRNS (CMHS)

Co-Occurring State Incentive Grants 

Youth Violence & Prevention

National Traumatic Stress Network

Children & Family Programs

Consumer & Family Network Grants 

MH System Transformation

Primary & Behavioral Health Care Integration

Community Resiliency & Recovery Initiative

Suicide Lifeline 

GLS Youth Suicide Prevention – State

GLS Youth Suicide Prevention – Campus

AI/AN Suicide Prevention 

MH Homelessness Prevention Programs

Older Adult Programs 

MAI & HIV/AIDS Education

Criminal & Juvenile Justice Programs 

Congressional Projects 

GLS Suicide Prevention Resource Center 

Practice Improvement/Training 

Consumer & Consumer Support TA Centers 

Minority Fellowship Programs

Disaster Response

FY 2012 Proposed Structure

Mental Health Block Grant

Substance Abuse Block Grant

Substance Abuse - State Prevention Grants (NEW)

Behavioral Health - Tribal Prevention Grants (NEW)

Mental Health - State Prevention Grants (NEW)

Innovations & Emerging Issues – Agency Wide (NEW) 

Innovations & Emerging Issues (CMHS)

Co-Occurring State Incentive Grants 

Youth Violence & Prevention

National Traumatic Stress Network

Children & Family Programs

Consumer & Family Network Grants 

MH System Transformation

Primary & Behavioral Health Care Integration

Community Resiliency & Recovery Initiative

Suicide Lifeline

GLS Youth Suicide Prevention 

AI/AN Suicide Prevention 

MH Homelessness Prevention Programs

Older Adult Programs 

MAI & HIV/AIDS Education

Criminal & Juvenile Justice Programs 

Congressional Projects 

GLS Suicide Prevention Resource Center 

Practice Improvement/Training 

Consumer & Consumer Support TA Centers 

Minority Fellowship Programs

Disaster Response

FY 2010 Compared to FY 2012
220 

FY 2010 Budget Structure

PRNS (CSAP)

MAI 

STOP Act 

Congressional Projects 

Fetal Alcohol Center of Excellence

Center for the Application of Prevention Technologies

Science & Service Program Coordination

Minority Fellowship Programs 

PRNS (CSAT)

Co-Occurring State Incentive Grants

SBIRT 

Targeted Capacity Expansion

Pregnant & Post-Partum Women

Strengthening Treatment Access & Retention

Recovery Community Services Program

Access to Recovery

Children & Family Programs

Treatment Systems for Homeless

MAI

Criminal Justice Activities

Congressional Projects 

Addiction Technology Transfer Centers

Minority Fellowship Programs 

Special Initiatives/Outreach

FY 2012 Proposed Structure

Innovations & Emerging Issues (CSAP)

MAI 

STOP Act 

Congressional Projects 

Fetal Alcohol Center of Excellence

Center for the Application of Prevention Technologies

Science & Service Program Coordination

Minority Fellowship Programs 

Innovations & Emerging Issues (CSAT)

Co-Occurring State Incentive Grants

SBIRT 

Targeted Capacity Expansion

Pregnant & Post-Partum Women

Strengthening Treatment Access & Retention

Recovery Community Services Program

Access to Recovery

Children & Family Programs

Treatment Systems for Homeless

MAI

Criminal Justice Activities

Congressional Projects 

Addiction Technology Transfer Centers

Minority Fellowship Programs 

Special Initiatives/Outreach

FY 2010 Compared to FY 2012 (cont.)
221 

FY 2010 Budget Structure

PRNS 

Opioid Drug Treatment/Regulatory Activities (CSAT)

Mandatory Drug Testing (CSAP)

Prescription Drug Monitoring (CSAT)

Seclusion & Restraint (CMHS)

Protection & Advocacy

PRNS – CMHS, CSAP, CSAT

SHIN

PRNS 

Performance Management & Coordination (CMHS)

NREPP

Services Accountability (CSAP)

Services Accountability (CSAT)

Program Coordination & Evaluation (CSAT)

FY 2012 Proposed Structure

Regulatory & Oversight Functions (NEW)

Opioid Drug Treatment/Regulatory Activities

Mandatory Drug Testing 

Prescription Drug Monitoring

Seclusion & Restraint 

Protection & Advocacy

Public Awareness and Support (NEW)

Performance & Quality Information Systems (NEW)

Performance Management & Coordination

NREPP

FY 2010 Compared to FY 2012 (cont.)
222 

Center for Mental Health Services

Programs of Regional & National Significance 

Mechanism by Summary of Activities 

(Dollars in thousands) 

Programs of Regional & National Significance

CAPACITY

FY 2010 

Actual

No. Amount

FY 2011 

Continuing 

Resolution

No. Amount

FY 2012 

President's 

Budget

No. Amount

Co-Occurring SIG 

Grants

Continuations................................................................................................ $0 $0 $0 $0 $0 $0

New/Competing............................................................................................

Subtotal.....................................................................................................

 0 0 0 0 0 0

 0 0 0 0 0 0

Contracts

Continuations................................................................................................ 1 2,006 1 2,168 1 2,168

New/Competing............................................................................................

Subtotal.....................................................................................................

Total, Co-Occurring SIG..............................................................................

 0 162 0 0 0 0

1 2,168 1 2,168 1 2,168

1 2,168 1 2,168 1 2,168

Seclusion & Restraint

Grants

Continuations................................................................................................ 0 0 0 0 0 0

New/Competing............................................................................................

Subtotal.....................................................................................................

 0 0 0 0 0 0

 0 0 0 0 0 0

Contracts

Continuations................................................................................................ 0 0 1 2,449 1 2,449

New/Competing............................................................................................

Subtotal.....................................................................................................

Total, Seclusion & Restraint.........................................................................

1 2,482 0 0 0 0

1 2,482 1 2,449 1 2,449

1 2,482 1 2,449 1 2,449

Youth Violence Prevention

Grants

Continuations................................................................................................ 1 6,000 1 6,000 1 6,000

New/Competing............................................................................................

Subtotal.....................................................................................................

 0 0 0 0 0 0

1 6,000 1 6,000 1 6,000

Contracts

Continuations................................................................................................ 6 83,152 6 88,402 5 87,733

New/Competing............................................................................................

Subtotal.....................................................................................................

Total, Youth Violence Prevention................................................................

1 5,241 1 100 1 600

7 88,393 7 88,502 6 88,333

8 94,393 8 94,502 7 94,333

National Traumatic Stress Network

Grants

Continuations................................................................................................ 58 30,348 47 25,954 3 1,792

New/Competing............................................................................................

Subtotal.....................................................................................................

5 3,560 15 7,000 10 6,500

63 33,908 62 32,954 13 8,292

Contracts

Continuations................................................................................................ 3 6,516 1 6,246 1 2,125

New/Competing............................................................................................

Subtotal.....................................................................................................

Total, National Traumatic Stress Network..................................................

 0 374 1 1,600 0 883

3 6,890 2 7,846 1 3,008

66 40,798 64 40,800 14 11,300

Children and Family Programs

Grants

Continuations................................................................................................ 15 $5,530 7 $4,107 15 $5,677

New/Competing............................................................................................

Subtotal.....................................................................................................

 0 747 8 2,178 0 0

15 6,277 15 6,285 15 5,677

Contracts

Continuations................................................................................................ 2 1,979 3 2,809 0 809

New/Competing............................................................................................

Subtotal.....................................................................................................

Total, Children and Family Programs.........................................................

1 844 0 100 0 0

3 2,823 3 2,909 0 809

18 $9,100 18 $9,194 15 $6,486
223 

Center for Mental Health Services

Programs of Regional & National Significance 

Mechanism by Summary of Activities 

(Dollars in thousands) 

FY 2011 

Continuing 

Resolution

No. Amount

FY 2012 

President's 

Budget

No. Amount

FY 2010 

Actual

No. Amount

Programs of Regional & National Significance

Performance Management and Coordination Activities

Grants

Continuations................................................................................................ $0 $0 $0 $0 $0 $0

New/Competing............................................................................................

Subtotal.....................................................................................................

0 0 0 0 0 0

0 0 0 0 0 0

Contracts

Continuations................................................................................................ 2 2,803 2 3,166 0 0

New/Competing............................................................................................

Subtotal.....................................................................................................

Total, Perf. Mgmt. and Coordination Activities.........................................

0 15 0 0 0 0

2 2,818 2 3,166 0 0

2 2,818 2 3,166 0 0

Consumer and Family Network Grants 

Grants

Continuations................................................................................................ 18 1,250 79 5,178 61 3,928

New/Competing............................................................................................

Subtotal.....................................................................................................

57 3,927 0 0 0 0

75 5,177 79 5,178 61 3,928

Contracts

Continuations................................................................................................ 0 1,046 1 1,058 1 1,038

New/Competing............................................................................................

Subtotal.....................................................................................................

Total, Consumer and Family Network Grants ...........................................

0 0 0 0 0 0

0 1,046 1 1,058 1 1,038

75 6,223 80 6,236 62 4,966

MH System Transformation and Health Reform

Grants

Continuations................................................................................................ 2 4,381 42 16,460 48 10,623

New/Competing............................................................................................

Subtotal.....................................................................................................

42 16,489 6 4,500 0 0

44 20,870 48 20,960 48 10,623

Contracts

Continuations................................................................................................ 2 6,887 3 7,297 0 0

New/Competing............................................................................................

Subtotal.....................................................................................................

Total, MH Sys. Trans. and Health Reform.................................................

2 1,423 1 849 0 0

4 8,309 4 8,146 0 0

48 29,179 52 29,106 48 10,623

Project LAUNCH Wellness Initiative

Grants

Continuations................................................................................................ 18 16,780 24 21,300 25 21,300

New/Competing............................................................................................

Subtotal.....................................................................................................

6 4,513 0 0 0 0

24 21,293 24 21,300 25 21,300

Contracts

Continuations................................................................................................ 1 3,320 1 3,500 1 3,700

New/Competing............................................................................................

Subtotal.....................................................................................................

Total, Project LAUNCH Wellness Initiative...............................................

0 380 0 200 0 0

1 3,700 1 3,700 1 3,700

25 24,993 25 25,000 26 25,000

Primary and Behavioral Health Care Integration

Grants

Continuations................................................................................................ 13 6,449 23 12,242 23 12,200

New/Competing............................................................................................

Subtotal.....................................................................................................

10 5,887 0 0 0 0

23 12,336 23 12,242 23 12,200

Contracts

Continuations................................................................................................ 0 1,086 1 1,600 1 1,800

New/Competing............................................................................................

Subtotal.....................................................................................................

Total, PBHCI.................................................................................................

1 565 0 158 0 0

1 1,651 1 1,758 1 1,800

24 $13,987 24 $14,000 24 $14,000
224 

Center for Mental Health Services

Programs of Regional & National Significance 

Mechanism by Summary of Activities

(Dollars in thousands) 

Programs of Regional & National Significance

FY 2010 

Actual

No. Amount

FY 2011 

Continuing 

Resolution

No. Amount

FY 2012 

President's 

Budget

No. Amount

Community Resilience and Recovery Initiative

Grants

Continuations................................................................................................ 0 $0 3 $4,163 3 $4,186

New/Competing............................................................................................

Subtotal.....................................................................................................

3 4,180 0 0 0 0

3 4,180 3 4,163 3 4,186

Contracts

Continuations................................................................................................ 0 0 1 679 1 814

New/Competing............................................................................................

Subtotal.....................................................................................................

Total, CRRI....................................................................................................

1 799 0 158 0 0

1 799 1 837 1 814

4 4,979 4 5,000 4 5,000

Suicide Lifeline

Grants

Continuations................................................................................................ 7 3,247 7 3,724 12 726

New/Competing............................................................................................

Subtotal.....................................................................................................

6 838 6 360 1 3,200

13 4,085 13 4,084 13 3,926

Contracts

Continuations................................................................................................ 0 1,437 1 1,338 0 1,056

New/Competing............................................................................................

Subtotal.....................................................................................................

Total, Suicide Lifeline....................................................................................

0 0 1 100 0 540

0 1,437 2 1,438 0 1,596

13 5,522 15 5,522 13 5,522

GLS - Youth Suicide Prevention - States

Grants

Continuations................................................................................................ 48 23,328 18 8,896 32 15,368

New/Competing............................................................................................

Subtotal.....................................................................................................

0 0 32 15,368 19 9,120

48 23,328 50 24,264 51 24,488

Contracts

Continuations................................................................................................ 2 5,779 1 3,756 2 4,850

New/Competing............................................................................................

Subtotal.....................................................................................................

Total, GLS-Youth Suicide Prevention-States..............................................

0 510 1 1,718 0 400

2 6,289 2 5,474 2 5,250

50 29,617 52 29,738 53 29,738

GLS - Youth Suicide Prevention - Campus 

Grants

Continuations................................................................................................ 38 3,659 22 2,162 16 1,600

New/Competing............................................................................................

Subtotal.....................................................................................................

0 0 16 1,600 21 2,100

38 3,659 38 3,762 37 3,700

Contracts

Continuations................................................................................................ 1 1,313 1 963 1 1,175

New/Competing............................................................................................

Subtotal.....................................................................................................

Total, GLS-Youth Suicide Prevention-Campus..........................................

0 0 0 250 0 100

1 1,313 1 1,213 1 1,275

39 4,972 39 4,975 38 4,975

AI/AN Suicide Prevention Initiative 

Grants

Continuations................................................................................................ 0 0 0 0 0 0

New/Competing............................................................................................

Subtotal.....................................................................................................

0 0 0 0 0 0

0 0 0 0 0 0

Contracts

Continuations................................................................................................ 2 2,944 2 2,944 2 2,284

New/Competing............................................................................................

Subtotal.....................................................................................................

Total, AI/AN Suicide Prevention Initiative ................................................

0 0 0 0 0 660

2 2,944 2 2,944 2 2,944

2 $2,944 2 $2,944 2 $2,944
225 

Center for Mental Health Services

Programs of Regional & National Significance 

Mechanism by Summary of Activities 

(Dollars in thousands) 

Programs of Regional & National Significance

FY 2010 

Actual

No. Amount

FY 2011 

Continuing 

Resolution

No. Amount

FY 2012 

President's 

Budget

No. Amount

Homelessness Prevention Programs

Grants

Continuations................................................................................................ 57 $21,720 61 $23,376 51 $20,308

New/Competing............................................................................................

Subtotal.....................................................................................................

5 1,999 2 800 22 9,850

62 23,719 63 24,176 73 30,158

Contracts

Continuations................................................................................................ 3 7,196 3 7,511 3 7,942

New/Competing............................................................................................

Subtotal.....................................................................................................

Total, Homelessness Prevention Programs..................................................

1 1,350 0 563 2 1,596

4 8,546 3 8,074 5 9,538

66 32,265 66 32,250 78 39,696

Older Adult Programs

Grants

Continuations................................................................................................ 10 4,091 0 0 0 0

New/Competing............................................................................................

Subtotal.....................................................................................................

0 0 10 4,095 0 0

10 4,091 10 4,095 0 0

Contracts

Continuations................................................................................................ 1 679 0 435 0 0

New/Competing............................................................................................

Subtotal.....................................................................................................

Total, Older Adult Programs........................................................................

0 40 1 284 0 0

1 719 1 719 0 0

11 4,810 11 4,814 0 0

Minority AIDS 

Grants

Continuations................................................................................................ 16 8,297 0 0 16 8,320

New/Competing............................................................................................

Subtotal.....................................................................................................

0 0 16 8,320 0 0

16 8,297 16 8,320 16 8,320

Contracts

Continuations................................................................................................ 1 986 0 0 2 963

New/Competing............................................................................................

Subtotal.....................................................................................................

Total, Minority AIDS ...................................................................................

0 0 2 963 0 0

1 986 2 963 2 963

17 9,283 18 9,283 18 9,283

Criminal/Juvenile Justice Programs

Grants

Continuations................................................................................................ 12 4,747 13 5,219 13 5,231

New/Competing............................................................................................

Subtotal.....................................................................................................

1 394 0 0 0 0

13 5,141 13 5,219 13 5,231

Contracts

Continuations................................................................................................ 1 1,124 1 1,465 1 1,453

New/Competing............................................................................................

Subtotal.....................................................................................................

Total, Criminal/Juvenile Justice Programs.................................................

0 419 0 0 0 0

1 1,543 1 1,465 1 1,453

14 6,684 14 6,684 14 6,684

Total, Congressional Projects.......................................................................... 25 5,975 0 5,975 0 0

Subtotal, CAPACITY....................................................................................... 509 333,192 496 333,806 418 275,167
226 

Center for Mental Health Services

Programs of Regional & National Significance 

Mechanism by Summary of Activities 

(Dollars in thousands) 

Programs of Regional & National Significance

SCIENCE AND SERVICE

FY 2010 

Actual

No. Amount

FY 2011 

Continuing 

Resolution

No. Amount

FY 2012 

President's 

Budget

No. Amount

GLS - Suicide Prevention Resource Center

Grants

Continuations................................................................................................ 0 $0 1 $4,471 1 $4,471

New/Competing............................................................................................

Subtotal.....................................................................................................

1 4,471 0 0 0 0

1 4,471 1 4,471 1 4,471

Contracts

Continuations................................................................................................ 0 0 0 486 0 486

New/Competing............................................................................................

Subtotal.....................................................................................................

Total, GLS - Suicide Prev. Resource Center...............................................

 0 486 0 0 0 0

 0 486 0 486 0 486

1 4,957 1 4,957 1 4,957

Practice Improvement and Training

Grants

Continuations................................................................................................ 0 243 1 243 1 243

New/Competing............................................................................................

Subtotal.....................................................................................................

6 250 0 0 0 0

6 493 1 243 1 243

Contracts

Continuations................................................................................................ 11 8,078 10 7,870 7 6,473

New/Competing............................................................................................

Subtotal.....................................................................................................

Total, Information Dissemination & Training............................................

 0 883 1 888 2 1,162

11 8,961 11 8,758 9 7,635

17 9,454 12 9,001 10 7,878

SAMHSA Health Information Network (SHIN)

Grants

Continuations................................................................................................ 0 0 0 0 0 0

New/Competing............................................................................................

Subtotal.....................................................................................................

 0 0 0 0 0 0

 0 0 0 0 0 0

Contracts

Continuations................................................................................................ 1 2,673 0 0 0 0

New/Competing............................................................................................

Subtotal.....................................................................................................

Total, SHIN....................................................................................................

 0 0 0 2,673 0 0

1 2,673 0 2,673 0 0

1 $2,673 0 $2,673 0 $0

National Registry of Evidence-based Programs and Practices (NREPP)

Grants

Continuations................................................................................................ 0 0 0 0 0 0

New/Competing............................................................................................

Subtotal.....................................................................................................

 0 0 0 0 0 0

 0 0 0 0 0 0

Contracts

Continuations................................................................................................ 1 544 0 544 0 0

New/Competing............................................................................................

Subtotal.....................................................................................................

Total, NREPP.................................................................................................

 0 0 0 0 0 0

1 544 0 544 0 0

1 $544 0 $544 0 $0

Consumer and Consumer Support Technical Assistance Centers

Grants

Continuations................................................................................................ 0 0 5 1,774 5 1,777

New/Competing............................................................................................

Subtotal.....................................................................................................

5 1,777 0 0 0 0

5 1,777 5 1,774 5 1,777

Contracts

Continuations................................................................................................ 0 0 0 153 0 150

New/Competing............................................................................................

Subtotal.....................................................................................................

Total, Consumer/Cons. Support TA Ctrs....................................................

 0 150 0 0 0 0

 0 150 0 153 0 150

5 $1,927 5 $1,927 5 $1,927
227 

Center for Mental Health Services

Programs of Regional & National Significance 

Mechanism by Summary of Activities 

(Dollars in thousands) 

Programs of Regional & National Significance

FY 2010 

Actual

No. Amount

FY 2011 

Continuing 

Resolution

No. Amount

FY 2012 

President's 

Budget

No. Amount

Minority Fellowship Program

Grants

Continuations................................................................................................ 5 $3,605 0 $0 5 $3,455

New/Competing............................................................................................

Subtotal.....................................................................................................

 0 0 5 3,455 0 0

5 3,605 5 3,455 5 3,455

Contracts

Continuations................................................................................................ 1 674 1 724 0 824

New/Competing............................................................................................

Subtotal.....................................................................................................

Total, Minority Fellowship Program...........................................................

 0 0 0 100 0 0

1 674 1 824 0 824

6 4,279 6 4,279 5 4,279

Disaster Response

Grants

Continuations................................................................................................ 0 0 0 0 0 0

New/Competing............................................................................................

Subtotal.....................................................................................................

 0 0 0 0 0 0

 0 0 0 0 0 0

Contracts

Continuations................................................................................................ 1 1,054 1 1,054 1 1,054

New/Competing............................................................................................

Subtotal.....................................................................................................

Total, Disaster Response...............................................................................

 0 0 0 0 0 0

1 1,054 1 1,054 1 1,054

1 1,054 1 1,054 1 1,054

Homelessness

Grants

Continuations................................................................................................ 0 0 0 0 0 0

New/Competing............................................................................................

Subtotal.....................................................................................................

 0 0 0 0 0 0

 0 0 0 0 0 0

Contracts

Continuations................................................................................................ 2 2,306 1 1,118 2 2,306

New/Competing............................................................................................

Subtotal.....................................................................................................

Total, Homelessness.......................................................................................

 0 0 1 1,188 0 0

2 2,306 2 2,306 2 2,306

2 2,306 2 2,306 2 2,306

HIV/AIDS Education

Grants

Continuations................................................................................................ 0 0 0 0 0 0

New/Competing............................................................................................

Subtotal.....................................................................................................

 0 0 0 0 0 0

 0 0 0 0 0 0

Contracts

Continuations................................................................................................ 3 471 4 657 4 774

New/Competing............................................................................................

Subtotal.....................................................................................................

Total, HIV/AIDS Education..........................................................................

 0 495 0 317 0 0

3 966 4 974 4 774

3 966 4 974 4 774

Subtotal, SCIENCE AND SERVICE.............................................................. 37 28,160 31 27,715 28 23,175

TOTAL, CMHS PRNS..................................................................................... 546 $361,352 527 $361,521 446 $298,342
228 

Center for Substance Abuse Prevention

Programs of Regional & National Significance 

Mechanism by Summary of Activities 

(Dollars in thousands)

 

Programs of Regional & National Significance

FY 2010 

Actual

No. Amount

FY 2011 

CR

No. Amount

FY 2012 

Pres. Budget

No. Amount

CAPACITY:

Strategic Prevention Framework

Grants

Continuations.......................................................................................... 46 $76,960 41 $60,835 0 $0

New/Competing......................................................................................

Subtotal..................................................................................................

11 12,980 12 27,118 0 0

57 89,940 53 87,953 0 0

Contracts

Continuations.......................................................................................... 10 21,765 9 23,824 0 0

New....................................................................................................... 0 0 0 0 0 0

Subtotal..................................................................................................

Total, Strategic Prevention Framework

10 21,765 9 23,824 0 0

67 111,705 62 111,777 0 0

Mandatory Drug Testing

Contracts

Continuations.......................................................................................... 4 4,360 7 5,206 7 5,206

New....................................................................................................... 3 842 0 0 0 0

Subtotal..................................................................................................

Total, Mandatory Drug Testing

7 5,202 7 5,206 7 5,206

7 5,202 7 5,206 7 5,206

Minority AIDS

Grants

Continuations.......................................................................................... 60 20,085 125 39,430 122 38,848

New/Competing......................................................................................

Subtotal..................................................................................................

62 18,516 0 0 0 0

122 38,601 125 39,430 122 38,848

Contracts

Continuations.......................................................................................... 0 339 1 1,955 1 2,537

New....................................................................................................... 1 2,445 0 0 0 0

Subtotal..................................................................................................

Total, Minority AIDS

1 2,784 1 1,955 1 2,537

123 41,385 126 41,385 123 41,385

Performance Management

Contracts

Continuations.......................................................................................... 3 6,296 3 6,300 0 0

New....................................................................................................... 0 0 0 0 0 0

Subtotal..................................................................................................

Total, Performance Management

3 6,296 3 6,300 0 0

3 6,296 3 6,300 0 0

STOP Act

Grants

Continuations.......................................................................................... 99 5,005 100 5,000 100 5,000

New/Competing......................................................................................

Subtotal..................................................................................................

 0 0 0 0 0 0

99 5,005 100 5,000 100 5,000

Contracts

Continuations.......................................................................................... 1 995 2 2,000 2 2,000

New....................................................................................................... 1 1,000 0 0 0 0

Subtotal..................................................................................................

Total, STOP Act

2 1,995 2 2,000 2 2,000

101 7,000 102 7,000 102 7,000

Congressional Projects

Grants

Continuations.......................................................................................... 0 0 0 0 0 0

New/Competing......................................................................................

Subtotal..................................................................................................

12 3,950 1 3,950 0 0

12 3,950 1 3,950 0 0

 Total, Congressional Projects 12 3,950 1 3,950 0 0

 Subtotal, Capacity 313 $175,538 301 $175,618 232 $53,591
229 

Center for Substance Abuse Prevention

Programs of Regional & National Significance 

Mechanism by Summary of Activities 

(Dollars in thousands)

Programs of Regional & National Significance

FY 2010 

Actual

No. Amount

FY 2011 

CR

No. Amount

FY 2012 

Pres. Budget

No. Amount

SCIENCE AND SERVICE:

Fetal Alcohol Center of Exellence

Contracts

Continuations.......................................................................................... 1 $9,820 1 $9,821 1 $8,000

New....................................................................................................... 0 0 0 0 0 0

Subtotal..................................................................................................

Total, Fetal Alcohol Center of Exellence

1 9,820 1 9,821 1 8,000

1 9,820 1 9,821 1 8,000

Center for the Application of Prevention Technologies

Grants

Continuations.......................................................................................... 0 0 0 0 0 0

New/Competing......................................................................................

Subtotal..................................................................................................

8 200 0 0 0 0

8 200 0 0 0 0

Contracts

New....................................................................................................... 0 0 0 0 0 0

Subtotal..................................................................................................

Total, Center for the Application of Prevention Technologies

2 8,167 2 8,511 2 8,511

10 8,367 2 8,511 2 8,511

 Science & Service Program Coordination

Grants

Continuations.......................................................................................... 0 0 0 0 0 0

New/Competing......................................................................................

Subtotal..................................................................................................

 0 0 0 0 0 0

 0 0 0 0 0 0

Contracts

Continuations.......................................................................................... 6 4,727 5 4,789 4 4,409

New....................................................................................................... 1 118 0 0 0 0

Subtotal..................................................................................................

 Total, Science & Service Program Coordination

7 4,845 5 4,789 4 4,409

7 4,845 5 4,789 4 4,409

NREPP

Contracts

Continuations.......................................................................................... 1 650 1 650 0 0

New....................................................................................................... 0 0 0 0 0 0

Subtotal..................................................................................................

Total, NREPP

1 650 1 650 0 0

1 650 1 650 0 0

SAMHSA Health Information Network

Contracts

Continuations.......................................................................................... 1 2,749 1 2,749 0 0

New....................................................................................................... 0 0 0 0 0 0

Subtotal..................................................................................................

Total, SHIN

1 2,749 1 2,749 0 0

1 2,749 1 2,749 0 0

Minority Fellowship Programs

Grants

Continuations.......................................................................................... 0 71 0 71 0 71

New/Competing......................................................................................

Subtotal..................................................................................................

 0 0 0 0 0 0

 0 71 0 71 0 71

 Total, Minority Fellowship Programs 0 71 0 71 0 71

 Subtotal, Science and Service 20 26,502 10 26,591 7 20,991

Total, CSAP 333 $202,040 311 $202,209 239 $74,582
230 

Center for Substance Abuse Treatment

Programs of Regional & National Significance 

Mechanism by Summary of Activities 

(Dollars in thousands)

Programs of Regional & National Significance

FY 2010

Actual

No. Amount

FY 2011

CR

No. Amount

FY 2012

Pres. Budget

No. Amount

CAPACITY:

Co-occurring State Incentive Grants (SIGs) 

 Grants

Continuations ............................................................................................... 4 $1,298 2 $1,100 0 $0

New/Competing ..........................................................................................

Subtotal.....................................................................................................

0 0 0 0 0 0

4 1,298 2 1,100 0 0

 Contracts

Continuations ............................................................................................... 2 2,964 1 3,163 1 3,213

New/Competing ..........................................................................................

Subtotal.....................................................................................................

Total, Co-occurring State Incentive Grants (SIGs)..................................

0 0 0 0 1 1050

2 2,964 1 3,163 2 4,263

6 4,262 3 4,263 2 4,263

Opioid Treatment Programs/Regulatory Activities

 Grants

Continuations ............................................................................................... 2 1,435 1 500 2 1,000

New/Competing ..........................................................................................

Subtotal.....................................................................................................

1 500 1 500 0 0

3 1,935 2 1,000 2 1,000

 Contracts

Continuations ............................................................................................... 8 5,491 10 6,968 12 7,903

New/Competing ..........................................................................................

Subtotal.....................................................................................................

 Total, Opioid Treatment Programs/Regulatory Activities......................

5 1,562 2 935 0 0

13 7,053 12 7,903 12 7,903

16 8,988 14 8,903 14 8,903

Screening, Brief Intervention and Referral to Treatment 

 Grants

Continuations ............................................................................................... 25 25,449 21 15,619 36 24,920

New/Competing ..........................................................................................

Subtotal.....................................................................................................

0 0 15 9,301 0 0

25 25,449 36 24,920 36 24,920

 Contracts

Continuations ............................................................................................... 0 3,657 0 4,186 0 4,186

New/Competing ..........................................................................................

Subtotal.....................................................................................................

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

0 0 0 0 0 0

0 3,657 0 4,186 0 4,186

TCE - General 

 Grants

Continuations ............................................................................................... 37 12,033 31 11,772 18 6,969

New/Competing ..........................................................................................

Subtotal.....................................................................................................

17 6,654 24 6,000 0 0

54 18,687 55 17,772 18 6,969

 Contracts

Continuations ............................................................................................... 5 8,928 7 11,217 5 10,442

New/Competing ..........................................................................................

Subtotal.....................................................................................................

Total,TCE - General..................................................................................

2 1407 0 0 0 0

7 10,335 7 11,217 5 10,442

61 29,022 62 28,989 23 17,411

25 29,106 36 29,106 36 29,106

Pregnant & Postpartum Women 

 Grants

Continuations ............................................................................................... 27 12,518 10 4,933 26 12,784

New/Competing ..........................................................................................

Subtotal.....................................................................................................

0 0 16 7,851 0 0

27 12,518 26 12,784 26 12,784

 Contracts

Continuations ............................................................................................... 1 3,482 1 3216 0 3,216

New/Competing ..........................................................................................

Subtotal.....................................................................................................

Total, Pregnant & Postpartum Women ....................................................

0 0 0 0 0 0

1 3,482 1 3,216 0 3,216

28 $16,000 27 $16,000 26 $16,000
231 

Center for Substance Abuse Treatment

Programs of Regional & National Significance 

Mechanism by Summary of Activities 

(Dollars in thousands) 

Programs of Regional & National Significance

FY 2010

Actual

No. Amount

FY 2011

CR

No. Amount

FY 2012

Pres. Budget

No. Amount

Strengthening Treatment Access and Retention

 Grants

Continuations ............................................................................................... 0 $0 0 $0 0 $0

New/Competing ..........................................................................................

Subtotal.....................................................................................................

0 0 0 0 0 0

0 0 0 0 0 0

 Contracts

Continuations ............................................................................................... 0 1,478 1 1,775 1 1,675

New/Competing ..........................................................................................

Subtotal.....................................................................................................

Total, Strengthening Treatment Access and Retention...........................

3 295 0 0 0 0

3 1,773 1 1,775 1 1,675

3 1,773 1 1,775 1 1,675

Recovery Community Services Program

 Grants

Continuations ............................................................................................... 8 2,687 6 2,150 6 2,150

New/Competing ..........................................................................................

Subtotal.....................................................................................................

5 1,747 8 2,686 0 0

13 4,434 14 4,836 6 2,150

 Contracts

Continuations ............................................................................................... 0 635 1 400 0 300

New/Competing ..........................................................................................

Subtotal.....................................................................................................

Total, Recovery Community Services Program.......................................

0 600 0 0 0 0

0 1235 1 400 0 300

13 5,669 15 5,236 6 2,450

Access to Recovery

 Grants

Continuations ............................................................................................... 0 0 30 96,954 30 96,954

New/Competing ..........................................................................................

Subtotal.....................................................................................................

30 94,788 0 0 0 0

30 94,788 30 96,954 30 96,954

 Contracts

Continuations ............................................................................................... 0 1649 1 2,000 1 1,500

New/Competing .......................................................................................... 1 2943 0 0 0 0

Subtotal.....................................................................................................

Total, Access to Recovery........................................................................

1 4,592 1 2,000 1 1,500

31 99,380 31 98,954 31 98,454

Children and Family Programs

 Grants

Continuations ............................................................................................... 14 4,328 47 14,332 34 10,575

New/Competing ..........................................................................................

Subtotal.....................................................................................................

34 10,122 0 0 12 4291

48 14,450 47 14,332 46 14,866

 Contracts

Continuations ............................................................................................... 5 16,032 4 15,646 4 11,312

New/Competing ..........................................................................................

Subtotal.....................................................................................................

Total, Children and Family Programs.......................................................

1 94 1 700 1 4500

6 16,126 5 16,346 5 15,812

54 30,576 52 30,678 51 30,678

Treatment Systems for Homeless 

 Grants

Continuations ............................................................................................... 73 27,604 73 26,407 88 34,741

New/Competing .......................................................................................... 23 7,956 15 7,281 9 4183

Subtotal..................................................................................................... 96 35,560 88 33,688 97 38,924

 Contracts

Continuations ............................................................................................... 2 6,970 2 6,562 4 8,436

New/Competing .......................................................................................... 0 0 2 2500 0 0

Subtotal.....................................................................................................

Total, Treatment Systems for Homeless..................................................

2 6,970 4 9,062 4 8,436

98 $42,530 92 $42,750 101 $47,360
232 

Center for Substance Abuse Treatment

Programs of Regional & National Significance 

Mechanism by Summary of Activities 

(Dollars in thousands)

Programs of Regional & National Significance

FY 2010

Actual

No. Amount

FY 2011

CR

No. Amount

FY 2012

Pres. Budget

No. Amount

Minority AIDS 

 Grants

Continuations ............................................................................................... 138 $62,734 123 $55,715 68 $29,016

New/Competing ..........................................................................................

Subtotal.....................................................................................................

0 0 11 4982 71 32081

138 62,734 134 60,697 139 61,097

 Contracts

Continuations ............................................................................................... 0 3,177 1 5,291 1 4,891

New/Competing ..........................................................................................

Subtotal.....................................................................................................

Total, Minority AIDS.................................................................................

0 0 0 0 0 0

0 3,177 1 5,291 1 4,891

138 65,911 135 65,988 140 65,988

Criminal Justice Activities

 Grants

Continuations ............................................................................................... 99 31,888 151 49,936 105 37,588

New/Competing ..........................................................................................

Subtotal.....................................................................................................

86 26,497 24 9,822 65 22927

185 58,385 175 59,758 170 60,515

 Contracts

Continuations ............................................................................................... 5 8,600 9 7,877 9 7,120

New/Competing ..........................................................................................

Subtotal.....................................................................................................

Total, Criminal Justice Activities.............................................................

6 421 0 0 0 0

11 9,021 9 7,877 9 7,120

196 67,406 184 67,635 179 67,635

Services Accountability 

 Contracts

Continuations ............................................................................................... 0 20,226 0 20,816 0 0

New/Competing ..........................................................................................

Subtotal.....................................................................................................

Total, Services Accountability...................................................................

0 0 0 0 0 0

0 20,226 0 20,816 0 0

0 20,226 0 20,816 0 0

Congressional Projects

 Grants

Continuations ............................................................................................... 0 0 0 0 0 0

New/Competing .......................................................................................... 9 4,593 0 4593 0 0

Subtotal..................................................................................................... 9 4,593 0 4593 0 0

Total, Congressional Projects................................................................... 9 4,593 0 4,593 0 0

Subtotal, Capacity...................................................................................... 678 $425,442 652 $425,686 610 $389,923
233 

Center for Substance Abuse Treatment

Programs of Regional & National Significance 

Mechanism by Summary of Activities 

(Dollars in thousands)

Programs of Regional & National Significance

FY 2010

Actual

No. Amount

FY 2011

CR

No. Amount

FY 2012

Pres. Budget

No. Amount

SCIENCE AND SERVICE:

Addiction Technology Transfer Centers

 Grants

Continuations ............................................................................................... 15 $8,050 15 $8,831 0 $0

New/Competing .......................................................................................... 0 0 0 0 15 8,831

Supplements.................................................................................................

Subtotal.....................................................................................................

(8) 1,100 0 0 0 0

15 9,150 15 8,831 15 8,831

 Contracts

Continuations ............................................................................................... 0 0 1 250 1 250

New/Competing ..........................................................................................

Subtotal.....................................................................................................

 Total, Addiction Technology Transfer Centers.......................................

0 0 0 0 0 0

0 0 1 250 1 250

15 9,150 16 9,081 16 9,081

Minority Fellowship Program

 Grants

Continuations ............................................................................................... 5 547 0 547 0 547

New/Competing ..........................................................................................

Subtotal.....................................................................................................

Total, Minority Fellowship Program.........................................................

0 0 0 0 0 0

5 547 0 547 0 547

5 547 0 547 0 547

Special Initiatives/Outreach 

 Grants

Continuations ............................................................................................... 1 300 1 300 0 0

New/Competing ..........................................................................................

Subtotal.....................................................................................................

0 0 0 0 1 300

1 300 1 300 1 300

 Contracts

Continuations ............................................................................................... 5 2,022 5 2,100 5 1,971

New/Competing ..........................................................................................

Subtotal.....................................................................................................

Total, Special Initiatives/Outreach ...........................................................

1 187 0 0 0 0

6 2209 5 2100 5 1,971

7 2,509 6 2,400 6 2,271

Information Dissemination

 Contracts

Continuations ............................................................................................... 1 3,894 1 4,553 0 0

New/Competing ..........................................................................................

Subtotal.....................................................................................................

Total, Information Dissemination..............................................................

0 435 0 0 0 0

1 4,329 1 4,553 0 0

1 4,329 1 4,553 0 0

National Registry of Evidence-Based Programs & Practices

 Contracts

Continuations ............................................................................................... 0 893 0 893 0 0

New/Competing ..........................................................................................

Subtotal.....................................................................................................

Total, NREPP ...........................................................................................

0 0 0 0 0 0

0 893 0 893 0 0

0 893 0 893 0 0

SAMHSA Health Information Network

 Contracts

Continuations ............................................................................................... 1 4,255 0 0 0 0

New/Competing ..........................................................................................

Subtotal.....................................................................................................

Total, SAMHSA Health Information Network.........................................

0 0 0 4,255 0 0

1 4,255 0 4,255 0 0

1 4,255 0 4,255 0 0

Program Coordination and Evaluation

 Contracts

Continuations ............................................................................................... 4 4,774 3 4,600 0 0

New/Competing .......................................................................................... 0 560 16 614 0 0

Supplements.................................................................................................

Subtotal.....................................................................................................

0 0 0 0 0 0

4 5,334 19 5,214 0 0

Total, Program Coordination and Evaluation ........................................... 4 5,334 19 5,214 0 0

Subtotal, Science and Service.................................................................... 33 27,017 42 26,943 22 11,899

Total,CSAT 711 $452,459 694 $452,629 632 $401,822
234 

Page intentionally left blank 
Affordable Care Act Prevention and Public Health Fund 

(Dollars in Thousands) 

ACA Prevention Fund FY 2010 FY 2011 FY 2012 

Primary and Behavioral Health Care Integration 1/ $20,000 $35,000 $20,000

Garrett Lee Smith Youth Suicide Prevention --- 10,000 ---

Health Surveillance --- 18,000 ---

Screening, Brief Intervention, & Referral to Treatment --- 25,000 ---

Prevention Prepared Communities --- --- 22,600

Behavioral Health - Tribal Prevention Grants --- --- 50,000

Total, ACA Prevention Fund $20,000 $88,000 $92,600

1/ Reflects ACA Prevention Fund only; $14 million for PBCHI is funded out of Budget Authority

235 
Behavioral Health - Tribal Prevention Grants 

(Dollars in Thousands) 

FY 2010 FY 2011 FY 2012 

Program Level...................................................................... --- --- $50,000

ACA Prevention Fund (non-add).......................................... --- --- 50,000

Authorizing Legislation ........................................................Section 516 and 520A of the PHS Act 

FY 2012 Authorization ...............................................................................................................N/A 

Allocation Method ........................................................................................... Discretionary Grants

Purpose

SAMHSA proposes to introduce a new Behavioral Health - Tribal Prevention Grant (BHTPG) 

starting in FY 2012, focusing exclusively on promoting overall behavioral health by preventing 

alcohol and substance abuse and by preventing suicides in the 565 Federally-recognized Tribes. 

Promotion of strong emotional health is an important contributor to the prevention of substance 

abuse and some mental illnesses as well as in reducing their negative impact on Tribal 

communities. The BHTPG represents a significant advance in the Nation’s approach to 

substance abuse and suicide prevention in several ways. First, it recognizes that emotional health 

is part of overall health and thus supports the Tribes in addressing overall health, including 

preventing and reducing substance abuse, suicides and mental illness, in a coordinated manner. 

Second, it establishes a single coordinated mental health and substance abuse program for all 

Federally-recognized Tribes. Third, SAMHSA will consult and work closely with Tribes and 

Tribal leaders to develop a comprehensive, data-driven planning process to identify and address 

the most serious issues in each Tribal community. Recognizing the Federal obligation to help 

Tribes deal with physical and behavioral health issues, SAMHSA will work in consultation with 

Tribes to determine the best approaches. 

Bringing Substance Abuse and Suicide Prevention to Scale for all Tribes

The proposal recognizes that Tribes currently receive different levels of mental health and 

substance abuse prevention services. Through the BHTPG, all Tribes would be eligible for a 

“basic” amount of funds, with the remaining funds distributed to best serve the Tribal 

populations. SAMHSA will hold consultation(s) consistent with SAMHSA’s Tribal 

Consultation Policy to determine how these funds would be best distributed to address as many 

of the needs of the Tribes as possible. The BHTPG provides enhanced substance abuse 

(including alcohol) and suicide prevention funding to the Tribes to assure that their pressing 

needs are being met. This effort follows the lead of the President and Congress who have 

emphasized the importance of emotional health, prevention, and health promotion. 

236 
Structure and Required Activities

The program will consist of grants to Tribes who chose to apply. A three-year time period will 

enable Tribes to develop a comprehensive plan to address the most pressing need based on 

treatment data as well as in consultation with SAMHSA. The plan would address the prevention 

of substance abuse and suicide, and will provide for coordinated services. This planning activity 

is one of the basic components of the Tribal Law and Order Act (TLOA) and the Indian Alcohol 

and Substance Abuse Act, which SAMHSA is charged to coordinate in statute. Tribes will 

continue to be eligible for these funds beyond the three-year time frame so long as they meet the 

requirements of renewal applications, provide the necessary annual reports, and show continued 

movement toward implementing their approved plans. 

The plan will reflect the results of an assessment of need, a review of the resources and capacity 

within the Tribal communities, a plan for carrying out the strategy, a monitoring of the strategy 

as implemented, and an evaluation of the strategy to identify strengths and weaknesses. 

SAMHSA will review and approve the plans. 

Tribes will be allowed to use set percentage (determined after consultation with Tribes) of the 

funds for a combination of service and service-related activities, development and dissemination 

of prevention messages, and provider development and linkage building to support the Tribes in 

achieving outcomes. Funding for infrastructure activities will enable the Tribe to build service 

capacity. The Tribe will present data to support how the allocation will support infrastructure 

and/or provision of services. In carrying out these activities, the Tribe will be required to use 

comprehensive, evidence-based programming, and/or proven successful programming, based on 

either mainstream science or proven Tribal traditions. Up to 20 percent of the grant funds may 

be used to fund key support and development activities, such as operation of a Tribal prevention 

advisory group, support for a Tribal community coalition, access to an epidemiological work 

group, training and technical assistance to communities, data collection and evaluation, and 

oversight and monitoring of activities. 

Approximately 75 percent of Federally-recognized tribes have a total enrollment of 2,000 or 

fewer persons and a greater percentage of these tribes have limited internal capacity or 

infrastructure in place to implement and support needed behavioral health services. Smaller 

Tribes will have the opportunity to work in collaboration with other small Tribes to maximize 

the impact of the resources. SAMHSA will consult with the smaller Tribes to ensure that their 

needs are being met while reducing service overlap. 

 

To ensure that providers in both the mental health and substance abuse fields are trained in both 

substance abuse and mental illness prevention and emotional health concepts and practices, 

Tribes will be able to use funds for coordinated workforce development, training in evidencebased practices, and the development of coordinated infrastructure and service delivery systems. 

Budget Request 

 

The FY 2012 President’s Budget Request is $50 million through the Prevention and Public 

Health Fund of the ACA. Approximately half of the funding would be allocated as a “base 

237 
level” to Federally-recognized Tribes that make an application to receive these funds. It is 

anticipated that the base amount each Tribe would be eligible for is approximately $50,000, 

depending on the number of Tribes that apply. Larger Tribes may be eligible for additional 

funding based on some combination of population and need. The remaining funds will be 

distributed to best serve the population. The details of the funds distribution will be determined 

in consultation with Tribes. 

Outcomes and Outputs 

Behavioral Health - Tribal Prevention Grants 

Table 1: Key Performance Indicators for Behavioral Health - Tribal Prevention Grants 

Measure Most Recent 

Result 

FY 2012 

Performance 

Target 

Associated with 

FY 2011 PB 

FY 2013 

Performance 

Target 

Associated with 

FY 2012 

Request 

FY 2013 

Performance 

Target +/- FY 

2012 

Performance 

Target 

2.3.92: Number of persons served (Output) N/A N/A Baseline N/A 

2.3.93: Percentage of youth age 12-20 who 

report drinking in the past month (Outcome) N/A N/A Baseline N/A 

The Behavioral Health - Tribal Prevention Grants will hold tribes accountable for achieving 

measurable outcomes for their citizens. Program performance measures are still being developed 

and will be provided at a later date. 

Grant Award Table 

(whole dollars) FY 2010 FY 2011 FY 2012

Number of Awards 0 0 565

Minimum Award $0 $0 $50,000

238 
Primary & Behavioral Health Care Integration (PBHCI) 

(Dollars in Thousands) 

FY 2010 FY 2011 FY 2012 

Program Level...................................................................... $34,000 $49,000 $34,000

ACA Prevention Fund (non-add).......................................... 20,000 35,000 20,000

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

FY 2012 Authorization .........................................................................................................Expired 

Allocation Method ............................................................................................. Competitive Grants 

Physical health problems among people with mental illnesses and addictions impact quality of 

life and contribute to premature deaths, where these individuals die much earlier than the general 

population. While several factors contribute to this disparity, empirical findings indicate that 

early mortality among people with serious mental illnesses is clearly linked to the lack of access 

to primary care services. 

In FY 2009, SAMHSA initiated the Primary and Behavioral Health Care Integration (PBHCI) 

Program and funded 13 PBHCI grants. PBHCI grantees began providing primary care services 

to consumers with serious mental illness in February 2010, and are currently engaged in a variety 

of activities which including developing electronic health record systems, developing data 

collection systems, and perhaps most importantly, providing primary care and health/wellness 

services. In FY 2010, SAMHSA awarded 43 additional grants, mainly funded with Affordable 

Care Act’s Prevention funds. 

The PBHCI program will provide resources to facilitate screening and referral for necessary 

primary care prevention and treatment needs; develop a registry/tracking system for all primary 

care needs; provide care management, individualized person-centered planning and coordination 

to increase consumer participation and follow up with all primary care screening, assessment and 

treatment services; provide prevention and wellness support services (including nutrition 

consultation, health education and literacy, tobacco cessation, peer support specialists, selfhelp/management programs); and develop processes for referral and follow-up for needed 

treatments that are not appropriately provided in a primary care setting. By building the 

necessary partnerships, grantees will expand their offerings of primary healthcare services for 

people with mental illnesses, resulting in improved health status. By making available 

coordinated primary care services in community-based behavioral health settings, grantees will 

improve the overall wellness and physical health status of people with serious mental illnesses 

The PBHCI program supports the coordination and integration of primary care services into 

publicly-funded community behavioral health settings. The expected outcome of improved 

health status for people with serious mental illness and substance use disorders 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 behavioral health 

conditions. Partnerships between primary care and behavioral health organizations are deemed 

239 
crucial to this program. The population of focus for this grant program is individuals with 

serious mental illness and SUD served in the public behavioral health system. 

SAMHSA expects that people with serious mental illnesses and SUD will show improvement in 

their physical health status through participation in this program. This grant program supports 

SAMHSA’s Pledge for Wellness 10 by 10 Campaign to prevent and reduce early mortality 

among people with mental illness by 10 years over the next 10 years. It is expected that better 

coordination and integration of primary and behavioral health care will lead to outcomes 

including improved access to primary care services; improved prevention, early identification 

and intervention to avoid serious health issues including chronic diseases; enhanced capacity to 

holistically serve those with mental and/or substance use disorders; and better overall health 

status of consumers. 

SAMHSA is collaborating with the HHS/Assistant Secretary for Planning and Evaluation 

(ASPE) on the evaluation for this program, which seeks to address three main questions of 

interest: 1) is it possible to integrate the services provided by primary care providers and 

community-based behavioral health agencies; 2) does the integration of primary and behavioral 

health care lead to improvements in the mental and physical health of the population with serious 

mental illnesses and/or substance use disorders served by these integrated models; 3) which 

models of integrated primary and behavioral health care lead to better mental and physical health 

impacts for the population served. 

In FY 2010, SAMHSA, in partnership with the Health Resources and Services Administration 

(HRSA), funded a Training and Technical Assistance Center for Primary and Behavioral Health 

Care Integration (TTA-PBHCI). The purpose of this program is to serve as a national training 

and technical assistance center on the bidirectional integration of primary and behavioral health 

care and related workforce development. The TTA-PBHCI grantee will be expected to provide 

support in two core areas: 1) technical assistance and support to SAMHSA and HRSA grantees 

and 2) serve as a national technical assistance resource to the general public including generating 

and disseminating best practice materials from Federal partners such as HRSA, Agency for 

Healthcare Research and Quality (AHRQ), National Institutes of Health (NIH) and other 

partners. 

Budget Request 

The FY 2012 President’s Budget request is $20 million allocated from the ACA Prevention 

Fund, the same as the FY 2010 Level. The request will support 34 grant and one Training and 

Technical Assistance Center. 

240 
Prevention Prepared Communities 

(Dollars in thousands) 

FY 2010 FY 2011 FY 2012 

Program Level...................................................................... --- --- $22,600

ACA Prevention Fund (non-add).......................................... --- --- 22,600

Authorizing Legislation ....................................................................... Section 516 of the PHS Act 

FY 2012 Authorization .........................................................................................................Expired 

Allocation Method ............................................................................................. Competitive Grants 

The Prevention Prepared Communities program will assist States and communities in developing 

and implementing effective mental illness and substance abuse prevention practices, strategies, 

and policies that will promote the wellness of individuals age 9-25 and the communities in which 

they live. The program builds on scientific evidence that a common set of risk and protective 

factors contributes to a range of mental, physical, and behavioral problems, including substance 

abuse and other unhealthy behaviors. Thus, targeting risk factors and promoting protective 

factors can prevent substance abuse and some mental illnesses as well as other negative 

outcomes. The goal of Prevention Prepared Communities is to improve community and 

individual level wellness, and health promotion outcomes in a comprehensive, collaborative way. 

Performance measures will be collected at both the community and individual level. Measures 

will include population-based indicators of community wellness and at an individual level will 

include measures of positive mental health, abstinence from substance abuse, better juvenile 

justice outcomes and improved academic achievement. 

Under this program, grantee communities will use data-based approaches to identify their 

predominant substance abuse and mental health issue(s), and will select and implement 

evidence-based strategies to target the identified risk and protective factors contributing to these 

issues. Evidence-based strategies may include individual- and family-focused prevention 

programs and practices, environmental strategies, community-wide public education campaigns, 

school-based curricula, and parenting, social, and life skills training Grantees will collaborate 

with appropriate service providers for ages 9-25 to ensure the utilization of best practices for 

universal, selective, and indicated populations. 

Budget Request 

The FY 2012 President’s Budget request is $22.6 million allocated from the ACA Prevention 

Fund. The request will support 30 new grants and two new contracts. 

241 
242 

Page intentionally left blank